The $100,000 Pyramid

 

Justin B. Moore1, Gabrielle Turner-McGrievy2, and Jay E. Maddock3

1Wake Forest School of Medicine, Wake Forest University, U.S.A.

2University of South Carolina, U.S.A.

3Texas A&M University, U.S.A.

 


 



You may be familiar with a television show with Pyramid in the name where participants are paired with a celebrity guest, with the objective to guess a series of mystery words for prize money. Depending on the era in which you were raised, it might have been called the $10,000, $25,000, $50,000, or $100,000 Pyramid. It was first class entertainment in our youth, as the celebrities were funny, the action exciting, and the other television options…limited. The show, as far as we know, has nothing to do with healthy eating, physical activity, or health.

 

The show does present an interesting concept; how would you describe a simple word or phrase if you couldn’t just say it? More relevant to the mission of the Journal of Healthy Eating and Active Living (JHEAL); how would you promote healthy eating and active living if you couldn’t say the word, “health?” In this commentary, we argue that this should be the default approach to the promotion of a diet full of fruits and vegetables and limited in processed foods, salt, and sugar. Also, that health is the least rewarding of the benefits provided by physical activity. When a body of scientific literature exists to suggest that less intrinsically identified goals are less motivating, why do we insist on the promotion of health in a world where everyone else is selling happiness?

 

Perhaps, we have something to learn from mindfulness, or the act of concentrating on one’s thoughts and feelings in the moment. This might be the best place to start when promoting behaviors that are good for one’s health. It’s not a coincidence that many of the behaviors that we wish to promote, when planned with enjoyment and happiness in mind result in positive thoughts and feelings. A nature walk, can bring on a clear mind and feelings of peace. A scramble up a boulder can bring feelings of accomplishment, excitement, and joy. Riding a bike down a country road can bring feelings of exuberance, vigor, and freedom. Despite these benefits, we’ve rarely seen a public health communications campaign extolling the positive emotions elicited by physical activity to the extent that I’ve been told to “Just do it!”

 

When physical activity is promoted, it is often done through walking campaigns (Cavill & Bauman, 2004).  The rationale behind this is that walking is a behavior that mostly adults can perform safely. While this is true, walking indoors on a treadmill can be one of the mostly monotonous and boring forms of physical activity. A recent scoping review published in JHEAL, showed that nature-based physical activity was more beneficial that either indoor physical activity or sedentary time spent in nature alone (Christiana et al., 2021). The enjoyment of time spent in nature makes it easier to stick with the behavior. Enjoyment doesn’t need to stop with nature access. Physical activity as play is inherently enjoyable. Pickleball is seeing a rapid rise in adult participation across the United States (Pickleball Participation Report 2021, 2021). Dancing is another fun, engaging way to get people active, that most people can do and enjoy. Outside of enjoyment, there are many other non-health benefits of being active including improved mood and increased energy. The Wheeling Walks campaign is one that successfully used increase energy as a motivator among older adults (Reger et al., 2002). Active Australia used a campaign called, “Exercise, take it regularly, not seriously” to emphasize fun as a motivator.

 

Similarly, eating a diet of whole foods combined with a variety of herbs and spices should not be so hard to sell either. Most people do not need to think back too far to remember the overprocessed, fat, sugar, salt laden meal they had and the negative emotions that followed, Contrast that with the joy of fresh ingredients combined to elicit a pleasing feel and taste in the mouth. Many barriers exist to creating tasty meals from whole ingredients (cost, time, skill, etc.), but why would anyone attempt to find the money, make the time, or build the skill for the promise of health in the not foreseeable future? Systemic change is needed to overcome these stated barriers, but motivation is necessary to initiate change, so why not sell healthy promoting foods the way they sell sugar-sweetened beverages?

 

Health is rarely a driving factor of food choice. Consumers most often cite taste, followed by cost and convenience as primary reasons why they eat the foods that they eat (Drewnowski & Monsivais, 2020). Humans are driven to seek out foods with a fatty mouthfeel or foods that are sweet or salty (Liem & Russell, 2019). These foods often tend to be nutrient poor and energy dense (Liem & Russell, 2019). The key therefore is to find ways to make healthy foods palatable. This has been difficult, since cooking skills and time devoted to cooking in the US have declined. Between 1985 and 2010, US households decreased time spent cooking by an average of 20 minutes per day (Plessz & Étilé, 2019). On any given day, only a little more than half of US adults report cooking any meals (Smith, Ng, & Popkin, 2013). And knowing how to cook is vital for both ensuring the creation of tasty meals and for meeting nutrient needs. For example, individuals who reported having very adequate cooking skills at ages 18-23 were found to have higher levels of vegetable preparation and lower levels of fast-food consumption 12 years later as compared to those with low adequate skills (Utter, Larson, Laska, Winkler, & Neumark-Sztainer, 2018).

 

While cooking skills can help address the need to make healthy food taste great, convenience and cost must also be addressed. For convenience, let’s take baby carrots as an example. Baby carrots, which are technically called baby cut carrots, are just larger carrots whittled down to a smaller, ready-to-eat size. Baby carrots came on the market in 1987 and within 10 years, carrot consumption increased 117 percent (Baby carrots are not baby carrots - The Washington Post, 2016). This new packaging allowed baby carrots to be as easy to eat as a bag of chips. Finding other ways to get fruit, vegetables, whole grains, and legumes into an easy-to-eat form has the potential to increase uptake of these healthy foods. Lastly, cost must be addressed. Supporting local farmers and subsidizing healthy foods are also important steps. The top three most heavily subsidized foods in the US [corn, wheat, and soy (Environment Working Group (EWG), 2020)] mostly go to animals feed and not to human consumption (Smith, 2019).  Imagine how much the cost would decrease for a delicious roasted vegetable burrito if we subsidized pinto beans and peppers?

 

Lastly, as health behavior scientists, dietitians, and public health nutritionists, we need to emphasize the joy of eating. Envision asking our weight loss participants and clients to track how much joy they felt with eating a meal versus the number of calories they consumed? Cultures outside the US often emphasize the joy eating can bring, especially when done with others (Paponnet-Cantat, 2003; Phull, Wills, & Dickinson, 2015). Providing food to others, like your children, partner, or friends, can be a way to boost the mood of both the provider and the recipient (Hamburg, Finkenauer, & Schuengel, 2014). One can argue that health is universally valued, but like most other things in our lives we don’t miss it until it is gone. Often, we don’t know it’s leaving us until too late. Undiagnosed disease lies dormant too long before a routine screening brings it out into the open. So often the health we’re selling seems like something most people feel they already have until it’s too late. Fortunately, most people would like some more peace, enjoyment, excitement, or happiness in their life. They might be willing to buy a moment of joy if we would offer it to them at an attractive price. What we propose is simple: sell it to them. So, let’s revisit our pyramid game. How can we describe food and physical activity to others as health professionals without saying health? Next time, perhaps try fun, tasty, convenient, affordable, and joyful!!

 

Correspondence

Justin B. Moore, PhD, MS, FACSM 

Department of Implementation Science 

Division of Public Health Sciences 

Wake Forest School of Medicine 

Winston-Salem, NC 27101 

jusmoore@wakehealth.edu

@justinbmoorephd

 

*       Justin B. Moore: 0000-0003-4059-0538

*       Gabrielle Turner-McGrievy: 0000-0002-1683-5729

*       Jay E. Maddock: 0000-0002-1119-0300

 

Conflict of Interest

We have no conflicts of interest to disclose.

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License


 

References

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