This past Thursday, Michelle Obama unveiled the USDA’s new MyPlate icon (to replace the food pyramid we all learned about growing up, which has long been criticized, as well as the newer MyPyramid).
A quick note on the actual content of the MyPlate icon – while I think the idea of having half your plate be fruits and vegetables is an important one and one I’m happy to see emphasized, I worry about “grains” and “proteins” – some grains are better than others and does everyone know what constitutes proteins? I think one of the best guidelines for what to eat in terms of comprehensiveness is The Healthy Eating Pyramid (and indeed, its creators were quick to point out that though a major improvement, MyPlate “still falls short on giving people the nutrition advice they need to choose the healthiest diets”), but I realize The Healthy Eating Pyramid is too much information to make for a truly useful icon, particularly for kids. My other content concern regarding MyPlate – where is water?? We really need to emphasize the importance of water intake (especially in place of sugar sweetened beverages!) and I think that’s something the USDA could easily have done here but failed to do.
On the health communications side, the icon is a wonderfully simplified what-to-eat tool that very directly connects recommendations to our decision-making by using what we all eat on – a plate. The website seems easy to navigate, provides useful explanations of the different categories of foods on the plate, and interactive tools to plan and track what you eat. I was also excited to see useful and fun use of twitter – “snap a photo of your next meal and share with us on Twitter using the hashtag #MyPlate”. Some quick googling suggests the icon has been met mostly with praise – from the food service industry to produce industry to nutritionists and communications experts. Half your plate should be fruits and vegetables is a very simple message, and those are often the ones that work best.
Whether or not this simple message will actually change behavior is another question altogether…To change behavior, communication in of itself is rarely, if ever, enough. One very practical linkage I’d like to see is the sale of “MyPlate”s and the use of “MyPlate”s in schools. Behavior economics research has shown that physical indicators like the size of your plate and having partitioned plates with specific sections for specific foods can actually have a huge impact on what people choose to eat (e.g., Pedersen et. al.’s 2007 study found using a portion control plate – pictured here – was effective in promoting weight loss and decreases in need for medication in obese patients with type 2 diabetes). Then of course, there are the broader issues of food cost and access, taste preferences, etc. – but this is just one campaign, and we can’t expect it to address everything.
Another note on the health communications side – I read some of the comments on the USDA’s youtube video introducing the MyPlate icon (when will I learn reading comments is a bad idea?) and found a slew of comments expressing outrage and disgust at the $2 million that went into developing the icon, the accompanying website, and the campaign overall.
Do people have any idea how much the food industry invests in advertising? According to Advertising Age, U.S. food, beverage and restaurant industries spend over $12 billion a year on “measured media” advertising alone (TV, radio, magazine, newspaper, billboard, and Internet ads), not to mention product placement in toys and games, and the use of characters and celebrities.
Public health has to compete, and when we do, we get slaughtered for wasting taxpayer money. I’m not advocating for careless use of funds. Nor am I saying this campaign was necessarily worth the $2 million – that will depend on what evaluation of the campaign suggests as to its effect. But developing effective communication tools and campaigns takes resources – and whether it’s the junk food industry of cigarette companies, groups with interests opposing those of the public health community spend a lot more money than public health will ever have. It infuriates me when people attack public health spending as fruitless or excessive without thinking about what the impact could be or what forces public health interests are fighting against. (On the flip side, it infuriates me when money spent on public health or other good causes is assumed to be money well spent – we do have a responsibility to be effective and cost efficient with money from donors, taxpayers, etc. and this is not always the case).
Outrage over the money spent on health communications campaigns like this one reminds me of a scene in West Wing when someone from the Justice Department approaches Josh and Leo requesting more money for a lawsuit against big tobacco and is met with an incredulous we already gave you $30 million, how can you possibly need more?. He responds: “We have 31 lawyers on a case against 5 tobacco companies, just one of which has 342. We won’t count the 13 subsidiaries that have mounted their own defense. Tobacco has spent 380 million dollars to the government’s 36, so when I come here asking you for money, it’s not because the Justice Department blew its allowance on videogames!”
Later, Josh talks about how this is a “phenomenally important case…[and] we’re fighting it with paper clips and a slingshot.”
We’re fighting it with paper clips and a slingshot – true of many a public health fight.