Tuesday 20 March 2018

Who decides what we eat?

When the Food Pyramid was revised in November, many questioned the validity of the extra shelf full of sugary drinks and fatty foods. Jamie Ball asks our health watchdogs if lobbying had anything to do with that sixth shelf, and just who has the authority to tell the nation what to put on their dinner plates

The United States Department of Agriculture's 'ChooseMyPlate' replaced their food pyramid in 2011. The food groups on the plate include grains, protein, vegetables, fruits and dairy
The United States Department of Agriculture's 'ChooseMyPlate' replaced their food pyramid in 2011. The food groups on the plate include grains, protein, vegetables, fruits and dairy

For almost a quarter of a century, the Food Pyramid has been sold as the easy-to-swallow, illustrative benchmark for healthy eating in Ireland. Recent revisions however, have left some consumers wondering who decides which foods go on what shelf, and whether the Pyramid is susceptible to lobbying from special interests.

Introduced in 1993 and devised by the Department of Health, the Food Pyramid organises foods and drinks into five main shelves, beginning with the most nutritionally crucial shelf on the bottom. Relaunched last November, its most recent incarnation since 2012 features a top, sixth shelf, separated from the rest of the Pyramid, containing foods and drinks high in fat, sugar and salt.

Not only have fruit and vegetables replaced wholemeal bread, potatoes, rice, pasta and cereals as the occupier of the foundational bottom shelf, but their recommended servings have increased from five, to seven times a day. Furthermore, serving sizes have been updated to be more comprehensible and applicable to our busy, everyday lives.

In revising the Pyramid last year, the Department extensively consulted key stakeholders such as Government-led initiative Healthy Ireland, the HSE, the Food Safety Authority of Ireland, the Irish Nutrition & Dietetic Institute, Safefood, and the Health Research Board. It then developed a specific nutrition technical group, made up of experienced dietitians and nutritionists, to deduce the exact serving sizes and calories.

Ursula O'Dwyer, dietitian and health promotion policy adviser at the Department of Health, says input to the Pyramid was not open to lobbying, but that some food and drink manufacturers on the top shelf typically request a meeting with the Minister for Health at least once every two years.

"In the earlier days it was around how they are going to promote physical activity as a way to use up the calories in their products, but more recently it's been about food reformulation: how they are going to change their products so they would be lower in sugars, salts and fats."

Fats, spreads and oils were on the top shelf, along with unhealthy treats, up until the Pyramid's 2012 revision, but were then relocated to a fifth shelf by themselves, according to O'Dwyer.

"We split these up to say that these foods were needed, in small amounts, but that the top shelf is not needed at all for health. And we've now gone that bit further by separating the top shelf from the Pyramid," she says.

Dr Cliodhna Foley-Nolan, director of human health and nutrition at the food safety promotion board, Safefood, says: "I can tell you we were party to all the developments of this Food Pyramid, as well as the previous one, and there was absolutely no food industry or agricultural influence. I understand why people are asking and I know that it's a valid question to ask, but I can stand over its impartiality."

November's revisions came in response to Healthy Ireland's 2016 survey, drawn from over 700 interviews, which showed that three in five of us eat snacks everyday, with 42pc of the population eating six or more portions each day. Furthermore, only 33pc of women and 21pc of men claimed to be eating the then-minimum recommended guideline of five daily portions of fruit and vegetables.

"One of the reasons we chose the Pyramid is because it's a conceptual model, and once you get the idea of what's on the lower shelves then you've an understanding of it," says O'Dwyer, who adds that international research suggests the pyramid structure has a better retention among consumers than a dinner plate split up into different food groups, as is used in the US.

"Particularly with our obesity problems we decided we should give people a serving size indication. Just saying 'eat less or more' doesn't indicate how much."

However, obesity and the Food Pyramid have a somewhat uncomfortable rapport in this country, as obesity has been steadily on the rise since the Pyramid was first introduced. So what will make this latest reboot better than other incarnations?

O'Dwyer says in previous years the Pyramid was brought out as a leaflet and poster, whereas it's hoped new online dietary information will make greater inroads in changing not just consumer awareness, but behaviour.

In addition, calories in are only as relevant as calories out, so the Pyramid now comes as one of a suite of measures presented by Healthy Ireland (healthyireland.ie ) that offer practical support tools for recommended physical activity, as well as suggestions on a healthy workplace, quitting smoking, reducing alcohol intake and improving one's sexual and mental health.

Dr Foley-Nolan says the guidelines for the Pyramid are informed by the most recent, reputable national and international scientific research, as well as being influenced by consumer lifestyle and dietary habits. She says there are "some challenges for people's understanding and also for more clarity on portion size. There is also a big gap between knowledge and behaviour. So while knowledge is at a pretty good level, the ability to translate that into the everyday resolve to apply it is an issue, given a food environment that is focused so heavily on processed foods".

The Dublin-based, privately-funded Nutrition & Health Foundation, says it addresses Ireland's health challenges by bringing together industry, government, state agencies, scientists, health professionals and other relevant stakeholders. According to its website, those stakeholders include financial support from the likes of Coca Cola HBC Ireland, PepsiCo International and Mars Ireland.

A nutritionist by training, Nutrition & Health Foundation manager Dr Muireann Cullen, says it does not lobby the Department of Health over input to the Pyramid, and is not aware of other food industry bodies lobbying either, but accepts that different food industry sectors might not be happy with some changes made to the Pyramid over the years.

"A lot of people understand the concept of the pyramid - even schoolchildren know about it. As parents are doing the best they can for their kids, it's about supporting them in making healthier choices. But it's not a case of them always having to do it, as there will be times when treats are absolutely fine. So it's about being practical and realistic," says Cullen.

"The pyramid has evolved based on the best national and international evidence, and it will continue to evolve. Science should always be evolving and we should always be learning, taking note of those learnings and then devising what's appropriate for our national health."

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