Reassessing the food guide pyramid: Decision-making framework

Food guides are dynamic nutrition education tools based on current nutrition recommendations, data on foods consumed by the target population, and nutrient content of those foods. As new nutrient/food recommendations are proposed, food guides must be reassessed to ensure that they continue to meet nutrient objectives. A framework for conducting this assessment is described, consisting of six major steps. The first two steps identify the specific source and nature of a new nutrition standard and consider data on prevalence of inadequate intakes in the population in order to establish research priorities among candidate issues.The third step assesses the ability of current food guide recommendations to meet the proposed new standard, leading to a fourth step, ii needed, in which potential changes to the Food Guide are systematically explored. A fifth step considers the consistency of any potential food guide modifications with current objectives for practicality and usefulness of the guide to its target audience. The final step recognizes that some nutrient recommendations may have no feasible dietary solution, and supplements must be considered. As examples, this paper applies this framework to determining implications for food guidance of the new Dietary Reference Intakes for calcium, magnesium, and folic acid and presents options for consideration in providing individualized dietary guidance for specific age groups regarding these nutrients. Application of this assessment framework can help assure nutrition educators, researchers, and policy makers that proposed modifications to food guidance are based on a systematic, documented research process, consistent with established goals and objectives of the Food Guide and with current nutritional data and recommendations. Assessment activities can help identify research needs for improved data on nutrient composition of food and data on consumer understanding and application of food guidance principles. These activities can also help inform those who establish nutrition standards or propose fortification levels of the potential consequences of their recommendations for food-guide-based diet patterns.