Toward International Dietary Guidance: A Food Guide Pyramid for Human and Planetary Health

Dietary guidelines shape food policy, education, and food systems worldwide. Recent controversies in dietary guideline development, together with rising burdens of diet-related chronic disease and increasing environmental pressures, highlight the need for globally relevant dietary guidance aligned with both human and planetary health. We developed an evidence-informed International Food Guide Pyramid emphasizing optimal carbohydrate-containing staple foods. The International Carbohydrate Quality Consortium (ICQC) developed the proposed framework using a four-step evidence-review process involving comparison of major national and regional dietary guideline systems, integration of evidence syntheses and selected primary studies, and expert consensus. Quantitative intake ranges from the EAT–Lancet Commission reference diet informed the relative visual proportions of food groups, while the guiding principles were derived from convergence across dietary guideline systems and complementary evidence syntheses. The resulting pyramid depicts a plant-forward omnivorous dietary pattern supported by epidemiological and clinical evidence indicating benefits for cardiometabolic health and chronic disease prevention. Vegetables, fruits, whole grains, and legumes constitute foundational components of the pyramid. Nuts, seeds, and unsaturated plant oils are emphasized as primary fat sources, while foods high in saturated fat are generally limited. Animal-source foods are included in modest amounts, with plant protein sources emphasized, poultry and fish preferred over red meat, and dairy incorporated in modest amounts, consistent with dietary patterns associated with lower environmental impacts. Carbohydrate quality is emphasized through prioritization of whole-grain foods alongside traditional low-glycemic index grain staples, favoring carbohydrate sources rich in dietary fiber, intact plant cells, and micronutrients while limiting sugars consumed in low-nutrient forms, particularly sugar-sweetened beverages. The framework also accommodates vegan and other primarily plant-based dietary patterns. This evidence-informed International Food Guide Pyramid integrates quantitative modeling and qualitative evidence synthesis to provide a coherent, flexible, and globally adaptable dietary framework aligned with both human and planetary health.