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

Background and Aim: Dietary guidelines play a central role in shaping food and nutrition policy, food regulations, education, and food and agricultural systems worldwide. Recent controversies with the 2026 Dietary Guidelines for Americans (DGA) have highlighted inconsistencies in the processes used to develop dietary guidance, including evidence synthesis, policy formulation, and public-facing recommendations. In parallel, rising burdens from diet-related chronic diseases, environmental pressures, and health inequities underscore the need for globally relevant recommendations that address both human and planetary health. Making health and sustainable diets affordable for all is consistent with health as a human right. Given our expertise in carbohydrate nutrition, our aim here was to develop an evidence-informed International Food Guide Pyramid emphasizing optimal carbohydrate-containing staples. Methods: The International Carbohydrate Quality Consortium (ICQC) applied an evidence-review framework to identify dietary patterns, food substitution effects, and consistency across major scientific bodies, drawing on a narrative synthesis of consistent national dietary guideline sources to inform the pyramid's structure. Quantitative intake ranges from the EAT-Lancet Commission reference diet were used to guide the relative visual proportions of food groups within the pyramid, preserving rank order and magnitude. Qualitative support and contextual interpretation were derived from authoritative evidence syntheses. Results: 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 sources of fat, while foods high in saturated fat are generally limited. Animal-source foods are included in moderate amounts, with poultry and fish preferred over red meat, and dairy incorporated in modest amounts. Carbohydrate quality is emphasized through prioritization of wholegrain 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, especially as beverages. The framework also accommodates plant-based dietary patterns. Conclusions: 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.