What should we eat, in what quantities and how often continues to concern an increasingly health-conscious society. A food pyramid explains what we should eat on a daily basis—and how much. Yet, basic questions remain: What nutrients are you not getting in your diet that may be essential, and how does one supplement them? Are we eating too many carbohydrates? Now enters the pyramid dilemma, which can be acute for those seeking a healthier lifestyle.

Dr. Stoy Proctor, chairman of the Seventh-day Adventist Church’s Nutrition Council, and Dr. Allan Handysides, director of the church’s health ministries department, addressed some of these concerns following the release of a new vegetarian food pyramid created by Carol Johnston, dietitian and nutrition professor at Arizona State University East.

The pyramid, like the church’s vegetarian pyramid, is heavy on vegetables, nuts and seeds, beans and other protein foods, and recommends oils, which the United States Department of Agriculture says to use sparingly. Johnston’s model combines a lacto-ovo and total vegetarian diet and separates the vegetable section into two parts, singling out “green, leafy vegetables” into one section. Fruits are divided as well—“dried fruits” are separate from regular fruits. The model also includes water at the bottom of the pyramid, suggesting eight cups daily and more with increased activity.

Proctor and Handysides say that Johnston’s model follows with the health principles that the Adventist Church has long promoted, but they also admit that “except for meat and our being vegetarian, the USDA [model] can’t be beat.”

“There are food guides around the world, and it’s all a matter of refinement,” Proctor says. “They’re all saying the same thing. It bothers me that everybody is coming out with their own.”

“There’s a danger that the more pyramids that come out, the pyramid becomes less and less significant,” Handysides adds. “It’s very important that we should have a pyramid that by far and away the majority of people believe represents an appropriate thing. It’s good in a way that people are discussing the food group, but there should be an official pyramid in which all of these various modifications are brought to a head. The proliferation of too many of them will confuse the public.”

Johnston’s vegetarian pyramid is praised by John Scharffenberg, an adjunct professor of nutrition at the church’s Loma Linda University. “It’s an excellent and well-thought-out pyramid, with good scientific and referenced reasoning to back it up,” he says. One of the good things about it is the way the vegetable and fruit groups are divided, Scharffenberg says. The pyramid was published in May, 2002, in the American Society for Nutritional Sciences’ Journal of Nutrition, and will also be published in the spring 2003 newsletter of the American Dietetic Association’s Nutrition Education for the Public practice group.

According to Proctor, there’s an advantage for the church’s vegetarian food pyramid. “When I go around the world and teach the pyramid across all kinds of cultures, it works everywhere,” he says. “The vegetarian pyramid has been very popular because it follows more closely to the USDA pyramid.”

Handysides cautions that the USDA food pyramid is only a guideline. “It’s not an absolute expression of every nuance of nutrition.”

The USDA has performed a lot of research and will make some minor changes in the next several years, Proctor says. “The main difference is they talk about meat and we talk about meat alternatives.”

“When the agricultural department revises its food pyramid, all of the pyramids that have been released will be taken into account,” Handysides says. “All philosophies and concerns will be brought together and synthesized as a simple as possible guide for the public. Everyone has to be a part of the equation—if the food isn’t available to everybody, the pyramid doesn’t do them any good.”

The Adventist Church’s vegetarian food pyramid model, published in 17 scientific journals, was released in 1993 and a total plant food pyramid was released in 2000. A problem that many vegetarians have is getting the nutrients they need. This is especially a concern for vegans, Handysides says, because they are missing vital nutrients if they do not take dairy equivalents. The Adventist Church’s health ministries department does not encourage a vegan diet.

“One of the problems of denigrating milk or decrying dairy is you make people think it’s such a hopeless food, or bad food, that they don’t want to have it’s equivalent. You may not want the animal product—but you want its equivalent. All these people that are having a battle over milk are blurring this necessity that there must be dairy equivalents. We have no ax to grind with anyone who wants to be a vegan, [but] they need the same stuff that’s in there [milk]. You need those equivalents.”

What about obesity? The USDA food pyramid has been heavily criticized as being a contributor to obesity. There are some theories, Proctor says, for the criticism. “America is eating a lot of carbohydrates, Americans are fat, therefore carbohydrates are causing obesity. Well, maybe it’s the sugar, or not enough exercise. [Fast food chains such as] McDonalds and Wendy’s have double and triple burgers and people are eating all of them. To say this correlation between carbohydrates and the pyramid is causing obesity [is not a valid reason]—correlation doesn’t equal cause.”

“One of the ways that correlation does equal cause is the serving size,” Handysides adds. “What was meant as a serving size when the food pyramid was devised is not what is understood as being a serving size by consumers. The portion size is what’s making people fat in North America—the portion size people eat is not the portion size that’s being talked about in the pyramid. The pyramids need to address that issue.”

Handysides says that eating a healthy diet can depend a lot on what consumers buy when they go to the grocery store. “If shoppers will look at the pyramid and say, ‘This is what I will buy,’ that’s where people can really influence the health of the nation.”

The church has promoted a vegetarian lifestyle for more than 130 years. Adventists generally have 50 percent less risk of heart disease, certain types of cancers, strokes and diabetes, according to data analyzed by the [U.S.] National Institute for Health.