change needed is to adjust the number of daily servings for each
food group in order to reduce the total calorie level to 800 to
1,200 a day. These lower levels will provide for weight loss or
maintenance for the adult or teenager with PWS, whose calorie needs
are about 60 percent of those without PWS.
although the five main food groups—bread, vegetable, fruit, meat,
and milk—remain the same, the positions of two of the groups need to
be changed on the pyramid to reflect a change in the recommended
number of servings. Each group has a specific number of servings
that determines its position on the pyramid.
The Food Groups
Food Pyramid has a base of the Bread group, which would provide the
highest number of daily servings. The PW Pyramid, on the other hand,
has as its base the Vegetable group, with 6-8 servings a day.
For those familiar with the Red-Yellow-Green Diet, these would be
"GO" foods, i.e., foods low in calories and fat. Making the
vegetable group the base of the pyramid and the bulk of the diet
will allow a large volume of food to be eaten without many
Bread group, which includes cereal, pasta, and rice, moves up
the pyramid with a decrease in number of servings to three to five
per day. We would also include starchy vegetables like corn, peas,
and potatoes in this group because they have the same amount of
calories per serving as breads.
Fruit group includes fresh fruit, canned fruit, juice, and dried
fruits. Many people think of fruit as a "free" food. While it is a
good snack and a good source of fiber and vitamins, it does have
calories that should be counted if one is on a restricted diet. The
daily servings should be four—one at each meal and one for snack.
Milk group includes yogurt, milk, and cheese. To fit the needs
of the person with PWS, the servings per day should be two, and the
products chosen should be nonfat or low in fat. Fat-free, sugar-free
frozen yogurt also can be used as a milk serving.
Meat group includes meat, fish, poultry, eggs, peanut butter,
and cooked dried beans. The USDA also includes nuts in this group,
but due to their high fat content they should be eliminated from the
PW Pyramid. And the USDA suggests two to three meat servings per day
of 2�-to-3-oz. portions. To decrease the calories for the PW meal
plan, we changed the portion size to 2 oz. and suggest one to two
servings a day. This means that a person on 800 calories could
divide the 2 oz. serving to provide 1 oz. at lunch and 1 oz. at
dinner, and a person on 1,200 calories could have 2 oz. at lunch and
2 oz. at dinner.
the meat group, the serving sizes on our PW Pyramid are unchanged
from the USDA Food Pyramid. They are as follows:
1/2 cup cooked or 1 cup raw
1 slice bread; 1/2 cup rice, pasta, or starchy vegetable; 1 oz.
1/2 cup canned, 1/2 cup or 1 piece fresh, 1/4 cup dried; 1/2 cup
1 cup skim milk or lite yogurt, 1 oz. cheese, 1/2 cup frozen
fat-free sugar-free yogurt
2 oz. cooked lean meat, fish, or poultry;
1 egg, 1/2 cup cooked dried beans; 1
tablespoon peanut butter
Oils, and Sweets
The top of
the USDA Pyramid shows fats, oils, and sweets. These are denoted
by symbols that are concentrated in this area and dispersed
throughout the other groups. The USDA suggests that these foods be
used sparingly to add extra calories. These foods include butter,
margarine, regular dressing, candy, sugars, sweets, fatty desserts,
gravy, and fried foods, to name a few. The foods from this group
add unwanted calories and few nutrients to the Prader-Willi diet.
They should be limited to once a month for an 800-calorie plan and
once a week for a 1,200-calorie plan. We have deleted the fat
symbols throughout the PW Pyramid, because all foods chosen should
be low in fat and sugar.
modified pyramid as a guide to weight loss and maintenance, in
conjunction with a favorite exercise program, can be an easy way to
ensure a healthy, nutritious diet for the person with Prader-Willi
For additional information on the Red,
Yellow, Green System for Weight Control, contact registered
dietitian, Katie Burns, RD, LDN, at The Children's Institute by