The Problem with MyPyramid: A Critique of the Intervention- Rashida Taher

Introduction

The first US dietary guidelines were introduced in 1894 and were designed to prevent dietary deficiency. In 1916, the first food guide was published and two decades later the ‘Basic Four’ food groups (milk, meats, fruits/vegetables, and grains) were established. Since the inception of dietary guidelines, malnutrition waned and the concern of dietary guidelines shifted from issues of deficiency toward issues of excess. This was because the US population was now consuming more calories than ever before, and overweight/obesity was becoming a real concern. By the 1970’s the guidelines included a fifth category: fats, sweets, and alcohol. Moderating indulgence of this category was heavily emphasized. A graphic representation of the food groups followed later and was designed to convey three key dietary concepts: variety in foods, proportionality in sizes, and moderation of fats, sweets, and alcohol. By 1992 this representation had evolved into the first Food Guide Pyramid. Although nutritional literature continued to be updated after the creation of the first Food Guide Pyramid, MyPyramid itself was not. In 2005, after years of criticism from numerous scientific nutrition groups, the government unveiled a new version of the Food Guide Pyramid in conjunction with www.mypyramid.gov (1). This website thoroughly defines each food group, and includes other resources to personalize individual dietary needs. It was specifically designed with the younger population in mind. The new pyramid accompanied by its auxiliary resources, improved upon the previous pyramid because it recognized that there is not a “one-size-fits-all” guideline to eating healthy (2).

Unfortunately, the new version of the pyramid continues to be a failure. The reasons are as follows: 1) requires individuals to take initiative; 2) fails to account for the role of major food corporations; and 3) does not promote autonomy. This paper will examine each reason in depth, in order to explain why this intervention will not be successful at changing healthy eating behavior.

MyPyramid Requires Individual’s to take Initiative

MyPyramid is flawed because it requires individuals to take initiative. The intervention incorrectly assumes that every American has regular access to the internet as well as healthy foods, and is ready and willing to eat healthy if the correct information is available. This is not the case in reality (3, 4). The intervention fails to take into account the fact that access, interpersonal relationships, and their affect on personal barriers, take precedence above healthy eating habits. If eating healthy conflicts with one of these, then a person will choose to not eat healthy. Subsequently, the intervention becomes a failure.

According to the intervention’s design, it is necessary for an individual to visit the website if MyPyramid is to be understood (4). Unfortunately, not every American has access to the internet, let alone MyPyramid’s web-based resources (3). Those who lack internet access are more likely to live in low SES neighborhoods where the availability of fresh fruits and vegetables is limited due to a tendency to have fewer grocery stores. Even if fresh fruits and vegetables are readily accessible, they are usually more costly than unhealthy options (5). Therefore, even if a person would like to consume a balanced diet, lack of access in the form of teaching resources as well as the cost of availability of food, could prevent them from doing so. In such cases, people will gravitate towards accessible and inexpensive options, which have the unfortunate consequence of being unhealthy.

Strong interpersonal relationships among friends and family are extremely important because of their ability our affect quality of life. Regular socialization is a key to maintaining these relationships. However, social norms have created a culture centered on food. Quite often, these foods tend to be unhealthy due to issues of availability (5). Although the long-term risk of socialization linked to eating unhealthy foods is a decrease in personal health, the immediate benefit is an increase on quality of life. Immediate benefits usually outweigh long-term ones. Consequently, many are willing to exchange future health for present quality of life.

Personal barriers reduce self efficacy, which is a person’s belief in his or her ability to perform an action. Self efficacy is a central concept of Social Cognitive Theory and has been adopted by a number of other behavioral theories. These theories assert that if a person lacks an adequate amount of self-efficacy, than they are incapable of performing the behavior in question (6-8). If a person cannot access the web-based resources on healthy eating, or the healthy foods themselves, belief in their ability to eat healthy will be negligent. Similarly, if a person cannot remove themselves from socialization involving food, they will not feel capable of eating healthy.

MyPyramid is a failure because it is not designed to account for access and interpersonal relationships, and how they affect self-efficacy. If access and interpersonal relationships negatively affect self-efficacy, then a personal may not feel capable of eating healthy. If a person does not feel capable of eating healthy, then the intervention will be a failure. A successful intervention would not place such a huge burden on the individual, but MyPyramid does.

MyPyramid Does not Account for the Role of Food Corporations

MyPyramid is flawed because it does not account for the role of food corporations in creating a tendency to choose unhealthy foods in the first place (9). Social science theories have evolved to include both internal factors like personal belief or expectation, and external factors like culture or situation, in order to explain what influences behavior (7). MyPyramid does not address any external factors that influence unhealthy dietary choices. Such external factors include larger portion sizes, misleading labeling, and consumer manipulation (9-12). The intervention cannot work because it overlooks the corporate practices that have contributed to unhealthy diets.

For years food corporations have been steadily increasing portion sizes in restaurants, fast food chains, and grocery store packaging. The corporations’ purpose for doing this is to maintain profit share in a growing food market. Large portions attract consumers because they feel that they are getting more ‘bang for the buck’. This attraction has led to an expectation for large portions and dissatisfaction with small ones. Increasing portion sizes have the adverse consequence of increasing total caloric consumption, which has contributed to the overweight/obesity epidemic seen today (10).

In addition to increasing portion sizes, another tactic that food corporations are using to attract consumers is the advertising of trans-fat-free foods. Doritos, Kentucky Fried Chicken, and other high-calorie foods use labels to emphasize a lack of trans-fat, in hope that consumers will be more inclined to choose these products. The labeling blinds consumers to the large number of calories found in the foods. This has contributed to a belief that people can eat large portions with impunity, so long as the food is clearly marked ‘0 grams trans fat’ (1).

Many food corporations use Marketing Theory to create a false association between a product and consumer values. This tactic has been used by Pepsi (11, 12). In 1997, Pepsi ushered in “generation next” in an attempt to regain momentum in the cola wars. “Generation next” was centered on celebrating and identifying with the emerging youth culture. It focused on hopefulness, innovation, and youth humor. Commercials, billboards, and other advertisements attempted to woo young consumers by idealizing portrayals of the hobbies and habits of adolescence. In this way Pepsi Co. was able to create an association between Pepsi and the glamour of youth in the minds’ of consumers around the world. This associated had the added bonus of encouraging blindness to the health risks associated with overindulgence, such as tooth decay, osteoporosis and obesity (11-13).

MyPyramid is a failure because it does not hold food corporations accountable for their contribution to unhealthy diet choices. By ignoring larger portion sizes, misleading labeling, and consumer manipulation, the intervention sends the message that individuals are the only ones to blame for the overweight/obesity epidemic. In reality, these corporate practices have negatively influenced individual dietary choices. A successful intervention would address these external factors, but the new pyramid does not.

MyPyramid Does not Promote Autonomy

MyPyramid is flawed because it does not promote autonomy, or the capacity to make un-coerced choices. Autonomy is valued because it is an extension of individual freedom (13). Personal choice is an important component in determining our diet. MyPyramid is a failure because it is a government attempt to limit autonomy in regards to dietary choice. Such an attempt will be especially ill received by the younger audience, for which the intervention is specifically aimed.

The government is the source of MyPyramid and the message of eating healthy. The source of a message can affect how well it is received. Unfortunately in the case of government, the American population does not perceive it as a trustworthy source. Preconceived negative notions regarding the government are pervasive throughout US culture. Therefore, along with a need to eat healthy, the message may be perceived as another attempt to yield power over the daily life of an American (17). In one survey nearly 70% of the respondents said that the government should not be the ones to tell people how to eat. This is because many consider dietary choices to be a personal issue for which the government should not interfere (18). According to Psychological Reactance Theory, any force on a person that threatens or reduces his/her perceived behavioral freedoms, including choice, will elicit a negative response. In order to reestablish the threatened behavioral freedom, a person can use direct restoration, which is engaging in the forbidden act. Indirect restoration is also plausible and involves either ignoring the threat or increasing desire for the behavior (14, 15). On that notion, those who ignore the food pyramid’s guidelines and continue to eat unhealthy are restoring their autonomy. Ignoring the guidelines was an evident strategy the old pyramid, and it will be with the new one as well (5).

Although MyPyramid is directed towards the population at large, it is specifically aimed at the younger audience. This is because the benefits of eating healthy are far more pronounced if started at a young age. Although adolescents are more malleable than adults when it comes to changing and sustaining a behavior, they are also more averse to being told what to do. This is because they are at a point in their lives where they are starting to execute more freedom of choice. Therefore, they are more sensitive to a possible threat to their autonomy. This sensitivity is exacerbated when the source of the threat comes from an authoritative figure like the government (19). Consequently, adolescents may have an even stronger inclination than adults to reestablish their freedom, using either direct or indirect restoration (15).

MyPyramid is a failure because it limits autonomy of dietary choice. Although the government’s intention is to help the US population make healthy choices, the target population may not see it that way. Being told what to do is a threat to personal freedom and can elicit negative emotions that require a corrective response. The effect can be even more pronounced if the threat comes from an untrustworthy source. This is especially true for younger populations, who are very sensitive to threats of freedom. A successful intervention would take steps to ensure autonomy, but MyPyramid does not.

Conclusion

The future consequences of an overweight/obesity epidemic in the United States are very disheartening. Obesity is a pressing financial problem for Medicare. One study found that obese seventy-year-olds will spend over $39,000 more on health care that those of normal weight. Moreover, they will enjoy fewer disability-life years and experience higher rates of diabetes, hypertension, and heart disease (20). This reflects the fact that overweight/obesity is not the only risk associated with an unhealthy diet. By sustaining a healthy diet throughout the population, the health care industry would save billons of dollars annually by not having to treat these preventable diseases. (21). Thus, appropriate measures to combat this epidemic must be taken. Although MyPyramid is an attempt to do that, it will not be effective for the following reasons: 1) it requires individuals take initiative, 2) it fails to account for the role of major food corporations, and 3) it does not promote autonomy. Each reason must be taken into consideration if a successful intervention is to be created. As it currently stands, the New Food Pyramid will not positively impact healthy eating behavior or curb the increase in overweight/obese people in the United States.

Introduction to Be Fit-Eat Right

Over the past twenty years, there has been a rampant increase in obesity/overweight in the United States (28). Thus far, programs, policies, and interventions to reduce its prevalence have proved inadequate. Part one of this paper pointed out three significant flaws of one such intervention called MyPyramid. Part two of this paper introduces an alternative approach entitled Be Fit-Eat Right, in order to combat the obesity epidemic.

Be Fit-Eat Right reduces the burden of obesity/overweight in the United States by establishing regular Farmers Markets throughout the nation and marketing fruits and vegetables in a fashion similar to corporate food advertising. Farmers Markets are food markets capable of being held in a variety of public spaces. These food markets, in combination with the efficient marketing of fruits and vegetables to the US population, promote healthy eating behavior by correcting for MyPyramid’s three flaws. Flaw 1--requires individuals to take initiative-- is resolved by improving access to healthy foods through increasing the number of Farmer’s Markets throughout the nation. Flaw 2 --fails to account for the role of major food corporations--is resolved by using marketing strategies to create a desire for fruits and vegetables. Flaw 3 --does not promote autonomy-- is resolved by subtly nudging individuals to eat healthy by increasing access through Farmers Markets and desire through marketing strategies. This paper will explain how Be Fit-Eat Right utilizes Farmers Markets and marketing strategies to improve upon each inadequacy and make healthy eating a salient part of daily living.

Be Fit-Eat Right Promotes Access

Farmers Markets have become very successful within the last few decades because they can easily be organized in a variety of open locations, such as parking lots. Be Fit-Eat Right establishes regular Farmers Markets throughout the nation and provides consumers with access to fresh fruits and vegetables. Not only does this allow farmers the opportunity to sell produce directly to consumers, but it also eliminates the cost of financing the middle man, like grocery stores. Farmer’s Markets also offer the opportunity to socialize because they create a fun, festive atmosphere. In many areas they have become important community institutions where farmers and residents are able to interact and learn healthy eating habits (22).

Farmers Markets tend to be concentrated in more affluent neighborhoods (29). This is because farmers are earning a livelihood and are driven towards locations where they are able to earn more for their products. The limited purchasing ability among those in low SES neighborhoods may not be adequate to keep farmers and their markets in business (23). For that reason, Be Fit-Eat right uses government funding to subsidize farmers wishing to start-up and maintain food markets in low SES neighborhoods. Subsidization effectively decreases individual consumer cost of produce purchased at Farmers Markets in low-income areas. With limited consumer purchasing power no longer being an issue, Be Fit-Eat Right is able to increase the number of Farmer’s Markets in traditionally low-profit yielding areas.

MyPyramid was a failure because it expected individuals to take initiative and overcome barriers to healthy eating. Those barriers mentioned in part one include: cost and availability of food; the importance of interpersonal relationships; and a lack of knowledge regarding healthy eating habits. However, these barriers are not an issue for Be Fit-Eat Right because Farmers Markets effectively overcome them. The proliferation of Farmers Markets increases the availability of healthy foods because these food markets are distributed across neighborhoods of all SES levels. Government subsidization makes the foods accessible to everyone. These food markets also provide an opportunity for socialization. Arts, crafts, and games in addition to fresh produce are included in these food markets to attract more people and increase turnout. Large turnout creates the appearance that everyone is attending these food markets. According to social psychologist Robert Cialdini, “people want to do what they think others will do” (24). As more and more people attend Farmers Markets, they will become a part of our social norm. Furthermore, knowledge of healthy diets is enhanced with the distribution of pamphlets and flyers at these food markets. The combination of access, social norm status, and knowledge, ultimately serve to reduce barriers and enhance healthy eating behavior.

Be Fit-Eat Right Acknowledges Corporate Marketing

In general, a good marketing strategy attracts attention, stimulates interest, creates desire, and brings about action (11). Food corporations have spent significant amounts of money to optimize good marketing strategies in order to promote their products efficiently (9-12). Be Fit-Eat Right recognizes this and utilizes the same strategy to promote healthy eating. In the past, food marketing has aggressively focused on promoting unhealthy foods to the detriment of healthy ones (25). Be Fit Eat Right devotes time, energy and resources to advertise fruits, vegetables and other healthy foods so that they are promoted on par with unhealthy ones.

The use of effective marketing strategies by Be Fit-Eat Right is implemented through the assembly of a team of advertising and public health firms. Advertising firms have the skills, aptitude and experience necessary to successfully promote any product or service. Public health firms have the knowledge and understanding to recognize what behaviors must be changed to promote healthy. In Be Fit-Eat Right these firms collaborate to create promotional material designed to change eating behavior. Under this approach, advertising can create an association between enhanced physical performance and eating fruits. A potential ad for bananas could enlist professional athletes and include the slogan “____(athlete’s name) appreciates the potassium-power delivered by this high energy fruit”(26). The endorsed athlete is appropriately chosen depending upon the region in which the ad is presented. Gatorade has successfully used this association technique for years.

MyPyramid was a failure because it ignored the role of major food corporations in creating an environment that promotes unhealthy foods. This is not a problem for Be Fit-Eat Right because it acknowledges the effectiveness of major food corporate marketing. In response, it utilizes similar strategies to provide healthy foods with a competitive edge. Consumers are attracted to and interested in larger portion sizes, trans-fat-free labeling, and foods/beverages that appear to reinforce core values. They have a desire to consume items that fit this criterion, and that consequently pushes them towards purchasing certain products. Under Be Fit-Eat Right, the use of marketing principles through the guidance of conventional advertising and public health firms influence consumers to choose healthy, well balanced diets.

Be Fit-Eat Right Promotes Autonomy

Autonomy is the capacity to make un-coerced choices, and it is valued because it is an extension of individual freedom (13). Be Fit-Eat Right recognizes that constraining individual autonomy can have an effect opposite of what is intended. This is especially true with adolescents (14, 15, 19). With that in mind, Be Fit-Eat Right avoids telling consumers what to eat. Instead, it preserves autonomy while simultaneously using subtler nudges to encourage consumers to make better dietary choices.

Marketing strategies and Farmers Markets are the source of these subtle nudges. By using marketing principles to promote healthy foods, Be Fit-Eat Right essentially creates an incentive for eating healthy. With the potential ad for bananas discussed earlier, this incentive extends beyond health-which for some is not a large enough incentive- to enhanced physical performance. Farmers Markets also create an incentive for eating healthy by providing cheap and accessible produce. These incentives provide a gentle push toward making healthy choices.

MyPyramid was a failure because it did not promote autonomy and ordered behavior changed. On the other hand, Be Fit-Eat Right does not directly tell people what to do and respects individuals’ decision-making capabilities. This is important because when autonomy is threatened, individuals seek methods to restore it (14, 15, 19). This threat is exacerbated under MyPyramid because the government is the message’s source. This is especially true for adolescents who are at a point in their lives where they are sensitive to threats of freedom (19). Under MyPyramid, individuals sought to restore autonomy either by increasing their desire for unhealthy foods or choosing to ignore the message all together (5, 18). These tactics will not be used in Be Fit-Eat Right, since it avoids directly telling people what to eat. Instead, it provides a gentle push toward healthy eating behavior. In the end, the decision to eat healthy foods is made autonomously, in the absence of overt persuasion.

Conclusion

The obesity and overweight epidemic in the United States is at an unprecedented rate. The epidemic has had a substantial financial impact on the healthcare industry. It is now responsible for treating the complications associated with obesity/overweight which include hypertension, diabetes, heart disease, and cancer (20, 28). As the epidemic continues to rise, its impact on the beleaguered healthcare system will only worsen. Two of the Healthy People 2010 national health objectives are 1) to reduce the prevalence of overweight and obesity among adults to less than 15% and 2) to reduce the prevalence of obesity among children and adolescents to less than 5% (28). MyPyramid, the US government’s latest version of the food pyramid, falls short of reaching that goal. It fails to address issues that social sciences have been advocating for years, including the importance of access, social environment (e.g. corporate marketing), and autonomy (5, 6, 9). MyPyramid does not account for individuals unable to access healthy foods due to cost or lack of availability, nor does it provide easy access to information on healthy eating habits. It also ignores the role of food corporations in creating a desire for unhealthy foods. Lastly, it does not promote autonomy because it overtly tells people what to eat. Fortunately, Be Fit-Eat Right improves upon these inadequacies. It increases access to healthy foods and information related to healthy diets by providing government subsidization to farmers willing to maintain food markets in low SES neighborhoods. Be Fit-Eat Right also uses marketing techniques to increase individual desire for fruits and vegetables. Lastly, it promotes autonomy by gently pushing individuals to eat more healthy foods, rather than ordering behavior change. Be Fit-Eat Right is able to accomplish all of this because it embraces the insight provided by the social sciences. If we truly want to control the obesity/overweight epidemic, public health must first integrate the social sciences into its practice, in a fashion similar to Be Fit-Eat Right.

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