Plant-first food pyramid brings international dietary guidelines together in adaptable global guide
· Medical Xpressby Ellie Larsen, Brigham Young University
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Dietary guidance varies by country, and no international food pyramid has brought its recommendations together until now. BYU nutritional science professor Karen Della Corte led a global team of nutrition scientists to develop an International Food Guide Pyramid that reflects broad scientific agreement and can be adapted across cultures and borders.
With the International Carbohydrate Quality Consortium, Della Corte compared national and regional dietary guidelines from Canada, Germany, Australia, China and the Nordic countries. She also synthesized evidence from more than 250 scientific publications and drew on the EAT-Lancet Planetary Health Diet to identify shared principles of healthy eating.
"Despite what people often hear, there's actually substantial agreement in nutrition science about the foundations of healthy eating," Della Corte said. "We wanted to bring those shared principles together and translate an extensive body of scientific evidence into a coherent and practical food guide pyramid."
The pyramid, published in Advances in Nutrition, highlights three guidelines:
- Make plant foods the foundation of a healthy diet.
- Choose healthier sources of fat and protein.
- Prioritize carbohydrate quality.
The pyramid emphasizes plant-based proteins but does not exclude animal foods. It can also be adapted for vegetarian and vegan diets.
The EAT-Lancet Commission suggests that adopting its proposed healthy, plant-forward diet could prevent approximately 15 million premature deaths each year. Such changes could also reduce greenhouse gas emissions and other environmental impacts associated with livestock farming.
"Our diet has to be not only for our own health but also for the health of our planet," said David Jenkins of the University of Toronto, creator of the glycemic index. "Our science base has to be appropriately comprehensive to include that."
The pyramid also distinguishes saturated fats, found in foods such as butter, cream and fatty meats, from unsaturated fats. Replacing saturated fats with unsaturated fats, particularly those from plant oils, can improve long-term cardiovascular health, Della Corte said.
The guide also emphasizes carbohydrate quality. "Not all carbohydrates are created equal," Della Corte said. Quality depends on factors such as fiber content, processing, food structure and glycemic index, which measures how carbohydrate-containing foods affect blood glucose. The pyramid prioritizes high-quality carbohydrate sources and recommends limiting refined grains and sugary sodas.
"For both health and sustainability reasons, carbohydrate-rich foods should provide a substantial share of our energy, so their quality is particularly important," Anette Buyken, professor at Paderborn University in Germany, said.
"Alongside sugar and fiber content, we should consider how these foods affect blood glucose, as reflected by their glycemic index. Especially because many people worldwide are insulin resistant and therefore at increased risk of type 2 diabetes."
Getting "enough" carbohydrates isn't the goal, Della Corte says. People should choose the best-quality carbohydrates available where they live. The research also highlights how the pyramid aligns with traditional healthy dietary patterns, including Mediterranean and Nordic diets, as well as vegetarian diets, and found that many locally available staples already make for healthy alternatives.
"A healthy diet won't look exactly the same for everyone around the world," Della Corte said.
"Durum pasta, basmati rice, tortillas, rice noodles, bulgur and many other low- to moderate-glycemic-index staples can all fit into a healthy diet. People can follow the same underlying principles using traditional foods that are locally available, affordable, and culturally appropriate for them."
"When you're designing a meal, start by thinking about the plant foods you want to emphasize," Della Corte said. "What vegetables, whole or lower-GI grains, beans or lentils could you include?"
Della Corte offered these ways to apply the pyramid's principles:
- Choose beans, peas, lentils, fish, poultry or yogurt more often than red and processed meats, and don't make meat the biggest part of a meal.
- Choose snacks such as nuts, seeds, fruit or vegetables with hummus instead of less nutritious processed snacks.
- Choose whole-grain bread over refined white bread and whole-grain or high-fiber cereals over refined, puffed, flaked or popped cereals.
- Cook with canola or olive oil instead of animal fats such as butter or tallow.
- Drink water or sugar-free sparkling water instead of sugary soda.
Many guidelines recommend keeping sugar below 10% of total calorie intake, but Della Corte said sugar sources can have different health implications. Research suggests sugary drinks are particularly concerning, while sugars from other foods don't carry the same risks.
"We need food environments that make it easy to put the pyramid's recommendations into practice," Buyken said. "Knowing what is healthy and being motivated to eat healthily is not enough when these choices are difficult or expensive. Nutrition policies need to support this through measures on food marketing, access and prices."
Della Corte said she hopes this research will make nutrition science more accessible and understandable.
"In all that I do, I'm trying to consider how this benefits the world. Here at BYU, we are encouraged to use our knowledge and talents to serve others. I see this research as an opportunity to do exactly that—contribute to improving human health and making scientific knowledge more accessible to people around the world."
Della Corte led the pyramid's development alongside 22 nutrition scientists around the world.
More information
Karen A Della Corte et al., Toward International Dietary Guidance: A Food Guide Pyramid for Human and Planetary Health, Advances in Nutrition (2026). DOI: 10.1016/j.advnut.2026.100738
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