Comments on: Do the Five Food Groups make sense?

By: Rachel Dickens

Rachel Dickens — Wed, 13 Feb 2013 23:58:33 +0000

Hi Bill, I have only just come across your website and am looking forward to reading more of your articles! I am particularly interested in your mention of the dairy food group and its links to the Dairy Industry. I was intrigued when Harvard put out their food plate and I am looking forward to researching more into this area (you may have possibly already written an article on this!). I certainly do not get my 3 serves of dairy a day. Thanks for your insight!

By: Bill Shrapnel

Bill Shrapnel — Tue, 12 Feb 2013 00:15:29 +0000

Hi Rachel. I understand that it may be difficult for any dietitian-nutritionist to decide on a practice that’s inconsistent with national guidelines. So, it is incumbent on our national authorities to ensure that their advice is up-to-date. But is it?
Who knows what our new Australian Dietary Guidelines (expected to be released this week) will have to say? The draft released for consultation in December 2011 was appalling. Despite the systematic reviews finding no links between dietary fat intake or energy density and body weight, the text was full of comments about the need to limit energy-dense foods to address overweight. The same old advice – without an evidence base.
The section on saturated fat and heart disease was even worse – a relevant literature review wasn’t even conducted. After four years of stonewalling I am told the authorities finally agreed with the Heart Foundation’s position that saturated fats should be replaced by unsaturated fats (not carbohydrate). This has been known since 2009 yet it was very nearly excluded from guidelines being released in 2013.
The review of the Dietary Guidelines has taken FIVE YEARS! I suspect that the guidelines will be 2-3 years out of date before they are even released. I no longer look to the Dietary Guidelines for guidance. I read a lot, go to conferences and make up my own mind. That way I have a chance of being up-to-date, at least in my areas of expertise. Regards, Bill.

By: Rachael

Rachael — Mon, 11 Feb 2013 23:33:26 +0000

Thank you for your reply. I had a read of your earlier post – another interesting one! It does make it quite difficult when we have a national document which shapes so much of our practice. It is even more challenging for those of us who have not been practicing in the field for very long and who have really only been exposed to these documents (rather than a wider evidence base) and encouraged – by senior and respected professionals – to use them as a basis for our assessments and recommendations. And further that much of our educational material is based on these national recommendations. Personally I would find it a bit confronting to decide to disregard national guidelines when making recommendations.

And with regard to what we recommend in the way of healthy foods vs. energy density – I do agree with your comments. We aren’t going to advise against a healthy foods just because they are higher in calories. Having said that, we wouldn’t promote excessive consumption of, say, nuts just because they are good for us. We can still have too much of a good thing!

For me, the simple messages of balance, moderation and looking at the overall diet (in terms of both calories and nutrients) seems to be the best approach.

By: Bill Shrapnel

Bill Shrapnel — Mon, 11 Feb 2013 08:03:21 +0000

Hi Paul. I agree with everything you have said. The issue of vegetarian diets is a tough one. There is often a lot of passion at play and nutrition science can play second fiddle. Separate modelling of vegan and vegetarian diets would certainly highlight some nutritional challenges and how they may be overcome. But equating beef and macadamias is silly. 92% of the calories in macadamias come from fat! Regards, Bill

By: Paul

Paul — Mon, 11 Feb 2013 04:23:05 +0000

Thank you for this article Bill – these issues with the food grouping system need to be highlighted.

Agree totally that the meat grouping doesn’t make much sense. Just how do macadamia nuts and beef belong in the same group? Perhaps as well as conservatism there is an element of political correctness as well in that the model tries too hard to incorporate vegetarian diets?

Would another approach be to consider vegetarian and/or vegan diets as a completely separate issue with their own modelling system – rather than trying to incorporate vegan diets into the modelling by having nuts and legumes incorporated into a “meat and alternatives” group? Maybe the results would be quite different if the modelling for vegan diets was started from square one, with legumes as a food group, and sources of fat (nuts, oils/spreads, avocado) as another.

By: Bill Shrapnel

Bill Shrapnel — Mon, 11 Feb 2013 03:07:21 +0000

Hi Dianne. Nice historical insights. Thanks for filling in the gaps for us. I couldn’t agree more that we need to ‘re-examine the groupings and move forward’. The trouble is that there is a deep vein of conservatism in nutrition that won’t allow this to happen. In the recent dietary modelling for the development of the new food guide nuts and seeds were separated from the meats and modelled as an independent group. But when the design for the guide was put together they bundled nuts and seeds back in with the meats. There is no logic to it; it’s just the way it’s always been done. Can’t go changing things Dianne. There is plenty of food politics at play in 2013. Regards, Bill.

By: Bill Shrapnel

Bill Shrapnel — Mon, 11 Feb 2013 02:53:04 +0000

And a good two cents worth it is, Rachel. Of course you are right – the energy densities of fruits and vegetables differ considerably. But the question I would ask is: how relevant is energy density to obesity? Based on research published in the last decade, I don’t think it’s that important (see my earlier post ‘Do calorie-rich foods make you fat?’ June 2012).
Should we advise against the consumption of nuts because they are energy dense? A healthy food is a healthy food, irrespective of its energy density. If you target energy density you end up recommending a low fat/high carbohydrate diet, which we now know is less than optimal for chronic disease prevention. Regards, Bill

By: Rachael

Rachael — Mon, 11 Feb 2013 02:11:13 +0000

I have only just discovered your site, and am really enjoying reading your posts. I have only read a few, but here I would like to add a point of view to your discussion re combining fruit and vegetable groups. Whilst there are indeed common nutrients, you have only mentioned the micros. What about macros, namely carbohydrate? With the exception of a few vegetables, the majority of fruits are much more energy-dense (a quick scroll through NUTTAB suggests >10% CHO in fruits vs. <5% for most veg), especially when considering dried and canned fruits, which are still 'allowed' as a serve of fruit. One of the great things about having the two separate groups is that, again with the exception of the starchy veg, we can 'fill up' on veggies with minimal contribution to our daily caloric intake. Imagine if we recommend 5 serves of fruit OR veg, and have people opting mostly for fruit – is this not in part misleading? I feel that the density of key nutrients should be considered – for instance folate is more predominant in certain vegetables than in fruits. Just my two cents worth!

By: Dianne Volker

Dianne Volker — Mon, 11 Feb 2013 00:46:45 +0000

I am excited about your comments! We know that much of the five food groups represents the politics of food in the 1920-30s. Diary products were given a special group status to economically assist the dairy industry. This concept was further developed by Clements when he conducted the 1936-1938 Final Report on Nutrition which was designed to prove to the Australian population they were not malnourished during the depression. It is a very worthy concept that we re-examine the groupings and move forward. I will support this approach.