The Healthy Eating Pyramid

Forget what you think you know about a healthy, life-enhancing diet. Researchers at Harvard have created a new menu for overall well-being and longevity.

For decades`, the U.S. government’s own “food pyramid” stood as the national standard for a healthy diet. But it turns out that because of flawed science and flagrant conflicts of interest between objective science and biased research sponsorship, the data was, at best, well-intentioned.

Now, researchers at the Harvard School of Public Health have unveiled their support for a new approach dubbed “The Healthy Eating Pyramid.” Based on the latest science, and unaffected by businesses and organizations with a stake in its messages, the Healthy Eating Pyramid is a simple, trustworthy guide to choosing a healthy diet. Its foundation is daily exercise and weight control, since these two related elements strongly influence your chances of staying healthy. The Healthy Eating Pyramid builds from there, showing that you should eat more foods from the bottom part of the pyramid (vegetables, whole grains) and less from the top (red meat, refined grains, sugary drinks).

The Healthy Eating Pyramid sits on a foundation of daily exercise and weight control. Why? These two related elements strongly influence your chances of staying healthy. They also affect what you eat and how your food affects you. Exercise and weight control are also linked through the simple rule of energy balance: Weight change = calories in – calories out. If you burn as many calories as you take in each day, there’s nothing left over for storage in fat cells, and weight remains the same. Eat more than you burn, though, and you end up adding fat and pounds. Regular exercise can help you control your weight, and it is key part of any weight-loss effort. The other bricks of the Healthy Eating Pyramid include the following:

Whole Grains

The body needs carbohydrates mainly for energy. The best sources of carbohydrates are whole grains such as oatmeal, whole wheat bread, and brown rice. They deliver the outer (bran) and inner (germ) layers along with energy-rich starch. The body can’t digest whole grains as quickly as it can highly processed carbohydrates such as white flour. This keeps blood sugar and insulin levels from rising, then falling, too quickly. Better control of blood sugar and insulin can keep hunger at bay and may prevent the development of type 2 diabetes. Plus, a growing body of research suggests that eating a diet rich in whole grains may also protect against heart disease.

Healthy Fats and Oils

Surprised that the Healthy Eating Pyramid puts some fats near the base, indicating they are okay to eat? Although this recommendation seems to go against conventional wisdom, it’s exactly in line with the evidence and with common eating habits. The average American gets one-third or more of his or her daily calories from fats, so placing them near the foundation of the pyramid makes sense. Note, though, that it specifically mentions healthy fats and oils, not all types of fat. Good sources of healthy unsaturated fats include olive, canola, soy, corn, sunflower, peanut, and other vegetable oils, trans fat-free margarines, nuts, seeds, avocadoes, and fatty fish such as salmon. These healthy fats not only improve cholesterol levels (when eaten in place of highly processed carbohydrates) but can also protect the heart from sudden and potentially deadly rhythm problems.

Vegetables and Fruits

A diet rich in vegetables and fruits has bountiful benefits. Among them: It can decrease the chances of having a heart attack or stroke; possibly protect against some types of cancers; lower blood pressure; help you avoid the painful intestinal ailment called diverticulitis; guard against cataract and macular degeneration, the major causes of vision loss among people over age 65; and add variety to your diet and wake up your palate.

Nuts, Seeds, Beans and Tofu

These plant foods are excellent sources of protein, fiber, vitamins, and minerals. Beans include black beans, navy beans, garbanzos, lentils, and other beans that are usually sold dried. Many kinds of nuts contain healthy fats, and packages of some varieties (almonds, walnuts, pecans, peanuts, hazelnuts, and pistachios) can now even carry a label saying they’re good for your heart.

Fish, Poultry and Eggs

These foods are also important sources of protein. A wealth of research suggests that eating fish can reduce the risk of heart disease, since fish is rich in heart-healthy omega-3 fats. Chicken and turkey are also good sources of protein and can be low in saturated fat. Eggs, which have long been demonized because they contain fairly high levels of cholesterol, aren’t as bad as they’ve been cracked up to be. In fact, an egg is a much better breakfast than a doughnut cooked in an oil rich in trans fats or a bagel made from refined flour. People with diabetes or heart disease, however, should limit their egg yolk consumption to no more than 3 a week. But egg whites are very high in protein and are a fine substitute for whole eggs in omelets and baking.

Dairy (1-2 servings/day) or Vitamin D/calcium Supplements

Building bone and keeping it strong takes calcium, vitamin D, exercise, and a whole lot more. Dairy products have traditionally been Americans’ main source of calcium and, through fortification, vitamin D. But most people need at least 1,000 IU of vitamin D per day, far more than the 100 IU supplied by a glass of fortified milk. (See the multivitamins section, below, for more information on vitamin D needs.) And there are other healthier ways to get calcium than from milk and cheese, which can contain a lot of saturated fat. Three glasses of whole milk, for example, contains as much saturated fat as 13 strips of cooked bacon. If you enjoy dairy foods, try to stick mainly with no-fat or low-fat products. If you don’t like dairy products, taking a vitamin D and calcium supplement offers an easy and inexpensive way to meet your daily vitamin D and calcium needs.

Use Sparingly: Red Meat and Butter

These sit at the top of the Healthy Eating Pyramid because they contain lots of saturated fat. Eating a lot of red meat may also increase your risk of colon cancer. If you eat red meat every day, switching to fish, chicken, or beans several times a week can improve cholesterol levels. So can switching from butter to olive oil. And eating fish has other benefits for the heart.

Use Sparingly: Refined Grains — White Bread, Rice, and Pasta; Potatoes; Sugary Drinks and Sweets; Salt

Why are these all-American staples at the top, rather than the bottom, of the Healthy Eating Pyramid? White bread, white rice, white pasta, other refined grains, potatoes, sugary drinks, and sweets can cause fast and furious increases in blood sugar that can lead to weight gain, diabetes, heart disease, and other chronic disorders. Whole grain carbohydrates cause slower, steadier increases in blood sugar that don’t overwhelm the body’s ability to handle carbohydrate. The salt shaker is a new addition to the “Use Sparingly” tip of the Healthy Eating Pyramid, one that’s based on extensive research linking high-sodium diets to increased risk of heart attack and stroke.

Multivitamin With Extra Vitamin D (for most people)

A daily multivitamin, multimineral supplement offers a kind of nutritional backup, especially when it includes some extra vitamin D. While a multivitamin can’t in any way replace healthy eating, or make up for unhealthy eating, it can fill in the nutrient holes that may sometimes affect even the most careful eaters. You don’t need an expensive name-brand or designer vitamin. A standard, store-brand, RDA-level one is fine for most nutrients—except vitamin D. In addition to its bone-health benefits, there’s growing evidence that getting some extra vitamin D can help lower the risk of colon and breast cancer. Aim for getting at least 1,000 IU of vitamin D per day; multiple vitamins are now available with this amount. (Many people, especially those who spend the winter in the northern U.S. or have darker skin, will need extra vitamin D, often a total of 3,000 to 4,000 IU per day, to bring their blood levels up to an adequate range. If you are unsure, ask your physician to check your blood level.) Look for a multivitamin that meets the requirements of the USP (U.S. Pharmacopeia), an organization that sets standards for drugs and supplements.

Optional: Alcohol in Moderation (not for everyone)

Scores of studies suggest that having an alcoholic drink a day lowers the risk of heart disease. Moderation is clearly important, since alcohol has risks as well as benefits. For men, a good balance point is one to two drinks a day; in general, however, the risks of drinking, even in moderation, exceed benefits until middle age. For women, it’s at most one drink a day; women should avoid alcohol during pregnancy.

Forget About Numbers and Focus on Quality

You’ll notice that the Healthy Eating Pyramid does not give specific advice about the numbers of cups or ounces to have each day of specific foods. That’s because it’s not meant to be a rigid road map, and the amounts can vary depending on your body size and physical activity. It’s a simple, general, flexible guide to how you should eat when you eat.

There’s just one basic guideline to remember: A healthy diet includes more foods from the base of the pyramid than from the higher levels of the pyramid. Within this guideline, however, there’s plenty of flexibility for different styles of eating and different food choices. A vegetarian can follow the Healthy Eating Pyramid by emphasizing nuts, beans, and other plant sources of protein, and choosing non-dairy sources of calcium and vitamin D; someone who eats animal products can choose fish or chicken for protein, with occasional red meat.

Choosing a variety of fresh, whole foods from all the food groups below the “Use Sparingly” category in the Healthy Eating Pyramid will ensure that you get the nutrients you need. It will also dramatically lower your salt intake, since most of the salt in the U.S. diet lurks in processed food—canned soups, frozen dinners, deli meats, snack chips, and the like.

Perhaps the only foods that are truly off-limits are foods that contain trans fat from partially hydrogenated oils. Luckily, in the U.S. and Canada, trans fats must be listed on nutrition labels. More and more food manufacturers, restaurants, and even entire communities are going trans fat-free, making it easier to avoid this health-damaging type of fat.

Other Alternatives

The Healthy Eating Pyramid summarizes the best dietary information available today. It isn’t set in stone, though, because nutrition researchers will undoubtedly turn up new information in the years ahead. The Healthy Eating Pyramid will change to reflect important new evidence.
This isn’t the only alternative to the USDA’s MyPyramid. The Asian, Latin, Mediterranean, and vegetarian pyramids promoted by Oldways Preservation and Exchange Trust (http://www.oldwayspt.org) are also good, evidence-based guides for healthy eating. The Healthy Eating Pyramid takes advantage of even more extensive research and offers a broader guide that is not based on a specific culture. The original Healthy Eating Pyramid is described in greater detail in Eat, Drink, and Be Healthy: The Harvard Medical School Guide to Healthy Eating, by Walter C. Willett, M.D. (the Fredrick John Stare Professor of Epidemiology and Nutrition in the Departments of Nutrition and Epidemiology at Harvard School of Public Health) with Patrick J. Skerrett (published by Free Press, 2005).

5 Quick Tips

Here are some additional recommendations for getting maximum results from the Healthy Eating Pyramid.

  1. Start with exercise. A healthy diet is built on a base of regular exercise, which keeps calories in balance and weight in check. Read five quick tips for staying active and getting to your healthy weight, and a dozen ideas for fitting exercise into your life.
  2. Focus on food, not grams. The Healthy Eating Pyramid doesn’t worry about specific servings or grams of food, so neither should you. It’s a simple, general guide to how you should eat when you eat.
  3. Go with plants. Eating a plant-based diet is healthiest.  Choose plenty of vegetables, fruits, whole grains, and healthy fats, like olive and canola oil.
  4. Cut way back on American staples. Red meat, refined grains, potatoes, sugary drinks, and salty snacks are part of American culture, but they’re also really unhealthy. Go for a plant-based diet rich in non-starchy vegetables, fruits, and whole grains. And if you eat meat, fish and poultry are the best choices.
  5. Take a multivitamin, and maybe have a drink. Taking a multivitamin can be a good nutrition insurance policy. Moderate drinking for many people can have real health benefits, but it’s not for everyone. Those who don’t drink shouldn’t feel that they need to start. Read about balancing alcohol’s risks and benefits.