INTRODUCTION
In many countries, there are food guides that are designed to educate people about healthful eating.1 Such graphs typically come in 2 types of shapes: hierarchical formats and circle formats.1 In both formats, the graph consists of several parts representing the different food groups (eg, bever- ages, fruits and vegetables). The larger the area of these parts, the more of the corresponding food group should be eaten for healthful nutrition. In hierarchical formats, these parts are arranged from bottom to top, whereas in circle formats, these parts are ar- ranged in a circle with different sized segments (eg, the American MyPlate2 or the German circle of nutrition3). There are essentially 2 possible hierar- chical formats. Either the largest area is at the bottom and the smallest area is on the top of the graph (eg,
the pyramid of the Swiss society of nutrition4) or vice versa (eg, the rain- bow used in Canada’s food guide5). Furthermore, there are food guide shapes such as the American MyPyra- mid that do not fit in either of these groups.6,7
An effective graph conveys the information in a way that viewers understand it and are able to use it. An efficient graph, on the other hand, enables viewers to quickly and easily process the graph and the information depicted in it. A nutrition graph’s effec- tiveness can be assessed by qualitative methods such as focus groups,6,7 and/or it can be measured quantitatively by either asking nutritional knowledge questions or applying different tasks to be completed that require a solid understanding of the depicted nutritional information (eg, rank different meals according to their healthfulness).7-10 A graph’s
efficiency, on the other hand, can be examined by analyzing eye-tracking data showing where, and for how long, people look when processing it.
To date, there have been some studies comparing the effectiveness of circle and pyramid formats. How- ever, the results have been inconsis- tent. Hunt and colleagues compared different circle formats with different pyramid formats and found that indi- viduals using 1 of the circle formats performed slightly better in nutrition tasks than participants using the pyra- mid formats.9 Eissing and Lach, on the other hand, found a slight superi- ority of a 3-dimensional pyramid in conveying nutritional knowledge to school children compared to different circle formats.10 Owing to a lack of empirical data, therefore, it is not known which presentation format most effectively and most efficiently enhances individuals’ understanding. The discussion about which of the format types should be chosen for effective and efficient nutrition edu- cation is thus mainly a theoretical one. The pyramid is criticized because it seems counterintuitive to display the ‘‘best thing’’ at the bottom and the ‘‘worst thing’’ on top of the pyra- mid.11 On the other hand, the circle is seen as advantageous because it
INTRODUCTION
In many countries, there are food guides that are designed to educate people about healthful eating.1 Such graphs typically come in 2 types of shapes: hierarchical formats and circle formats.1 In both formats, the graph consists of several parts representing the different food groups (eg, bever- ages, fruits and vegetables). The larger the area of these parts, the more of the corresponding food group should be eaten for healthful nutrition. In hierarchical formats, these parts are arranged from bottom to top, whereas in circle formats, these parts are ar- ranged in a circle with different sized segments (eg, the American MyPlate2 or the German circle of nutrition3). There are essentially 2 possible hierar- chical formats. Either the largest area is at the bottom and the smallest area is on the top of the graph (eg,
the pyramid of the Swiss society of nutrition4) or vice versa (eg, the rain- bow used in Canada’s food guide5). Furthermore, there are food guide shapes such as the American MyPyra- mid that do not fit in either of these groups.6,7
An effective graph conveys the information in a way that viewers understand it and are able to use it. An efficient graph, on the other hand, enables viewers to quickly and easily process the graph and the information depicted in it. A nutrition graph’s effec- tiveness can be assessed by qualitative methods such as focus groups,6,7 and/or it can be measured quantitatively by either asking nutritional knowledge questions or applying different tasks to be completed that require a solid understanding of the depicted nutritional information (eg, rank different meals according to their healthfulness).7-10 A graph’s
efficiency, on the other hand, can be examined by analyzing eye-tracking data showing where, and for how long, people look when processing it.
To date, there have been some studies comparing the effectiveness of circle and pyramid formats. How- ever, the results have been inconsis- tent. Hunt and colleagues compared different circle formats with different pyramid formats and found that indi- viduals using 1 of the circle formats performed slightly better in nutrition tasks than participants using the pyra- mid formats.9 Eissing and Lach, on the other hand, found a slight superi- ority of a 3-dimensional pyramid in conveying nutritional knowledge to school children compared to different circle formats.10 Owing to a lack of empirical data, therefore, it is not known which presentation format most effectively and most efficiently enhances individuals’ understanding. The discussion about which of the format types should be chosen for effective and efficient nutrition edu- cation is thus mainly a theoretical one. The pyramid is criticized because it seems counterintuitive to display the ‘‘best thing’’ at the bottom and the ‘‘worst thing’’ on top of the pyra- mid.11 On the other hand, the circle is seen as advantageous because it
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