In my training as a doctor of naturopathic medicine, I’ve seen a wide array of educational materials about nutrition, much of it focused on specific nutrients and their links to disease prevention. Although of course it’s important that we understand how nutrients interact with our bodies, I often found this maze of specific nutrient information made it difficult to see the big picture.
Thinking about nutrition as a collection of individual nutrients acting in a vacuum lends itself to an isolating approach that attempts to use nutrients as supplements, “prescribed” for specific ailments, rather than what I believe is a better approach for real-life, daily living: Using a healthy, whole foods-based diet to help promote optimal health and disease prevention.
When Michael Pollan published his books on food politics and created what I consider the best adage ever written in nutrition culture (“Eat food. Not too much. Mostly plants.”), I began to see the forest for the trees. We had been creating a culture of supplementary advice rather than a daily guideline of best food intake. In this article, I will attempt to provide dietary guidelines that I believe offer the best, most well-rounded advice available for daily food intake throughout our lives, designed to improve health and wellness.
The Introduction of the Food Pyramid
The USDA was founded in 1862 in an effort to establish U.S. policy on agriculture, food, forestry and farming—a mighty task for any department and an ever-changing one as we learn more each day about what our bodies, soil and crops require for good health. The USDA’s first published dietary recommendations to the nation were released in 1894, before the existence of vitamins and minerals had even been discovered. In the years since, the USDA has developed numerous concepts and updated its recommendations many times to suit changing knowledge and situations. For example, in 1943 the USDA announced the “Basic Seven” food groups, a modification of nutritional guidelines to help people deal with food shortages during the war. To simplify, they later introduced the four basic food groups (protein, dairy, grains, vegetables/fruit), which remain in use to this day.
Unfortunately, the politics of agriculture have often clouded this nutritional information, and thus our collective understanding of what is truly good for our bodies. In the 1970s, in an effort to curb a rise in chronic diseases such as stroke and heart disease, the USDA revisited the food pyramid, adding a category of “fats, sweets and alcoholic beverages” to be consumed “in moderation.” These updates were heavily influenced by American food lobbies, including sugar lobbies, corn lobbies and more. (To read more about these developments, read The Great Cholesterol Myth.)
The modern food pyramid, introduced in 1992, was created by a variety of voices, including agricultural lobbyists and groups such as the Soft Drink Association. The recommendations weren’t based on research (other than consumer research) and, when research was available, it was not very sound or plentiful enough to guide us well. In 2005, it was changed to MyPyramid to add a segment for oil and to reflect physical activity, though not much else changed. In 2011, the USDA scrapped the pyramid for the MyPlate illustration to try out a different visual, but this change actually reduced the specific recommendations and looked a little like the old four groups.
A Better Approach: The Healthy Eating Guide
In 2005, researchers from the Department of Nutrition at the Harvard School of Public Health released a new guide, called the Healthy Eating Pyramid (today, they also have a similar Healthy Eating Plate). This was a groundbreaking resource that drew attention to a nutrition guideline that focused not only on dietary intake, but also on food quality, as well as exercise recommendations. The Healthy Eating Pyramid was touted as evidence-based and free of influence by outside interests. It focuses on whole grains, fruits and vegetables, nuts, seeds, beans, healthy fats, a variety of lean meats and eggs. It also limits its recommendations on intake of red meats, processed meats, dairy, processed grains and sugars—pieces of advice that counter the wishes of strong U.S. food lobbies.
What sets the Healthy Eating Pyramid apart are its acknowledgements of the importance of food variety in the diet, and of seeking sustainably sourced foods. Unlike the USDA’s food pyramid, it lumps in white processed grains with sugars in the “use sparingly” category, and it makes healthy fats an important component of the diet (in the USDA pyramid, “fats, oils & sweets” are grouped together in the “use sparingly” section). All in all, it recommends more variety and packs more nutrient density and disease prevention per serving than any other recommendation in history.
However, this guide still doesn’t address all the dietary recommendations I’d make for disease prevention and general wellness, and it neglects to include age-specific recommendations. It also recommends some foods as healthful with no qualifications, when these can be problem foods for many people. A case in point: My 9-year-old came home from school one day saying she’d learned that she had to eat dairy every day—the USDA recommends two to three servings of dairy daily, while the Harvard guide recommends one to two dairy servings daily. For most people, dairy in moderation is fine. But for some, it can cause significant inflammation in the gut and cardiovascular system and, over time, can increase the risk of many diseases such as cardiovascular disease; exacerbate gout and other joint diseases; create hormone imbalances, gastrointestinal diseases and digestion problems; and slowly degrade the islet cells in the pancreas, leading to type 2 diabetes. In my clinical work, I’ve found that overly high dairy intake has contributed to many of my patients’ symptoms. It’s rare that someone needs to avoid dairy entirely, except in true allergy scenarios, but when it’s a main dietary staple, it can be a real troublemaker.
Creating a Simpler Food Guide
I decided to create an easy-to-use, all-ages guide aimed at optimal health and disease prevention. I wanted to include many more examples of the varieties of foods within each category, as well as visual guidelines for general proportions within the daily diet. Rather than making dairy its own category, for example, I placed dairy as part of the overall protein category. We need to eat protein every day; we don’t necessarily need to eat dairy every day. On the other hand, I break fruits and vegetables out of their combined category and include daily recommendations for greens and antioxidants, because I believe it’s crucial that we not only eat produce daily, but that we eat a wide range of types of produce daily.
The idea is that you need something from each category routinely to build a healthy body, and the percentages give you a general idea of how much to eat each day. I also added guidelines for movement each day to fulfill exercise needs and gave some age-specific recommendations.
Includes: Organic meats raised on pasture; cold-water fatty fish and other seafood (cross-check mercury concerns with sustainable fishing practices when choosing seafood); nuts and nut butters; beans and legumes; full-fat dairy (cow-, goat- and sheep-milk-based foods) made from the milk of grass-fed animals; alternative milks if greater than 7g protein per serving (coconut and hemp milk); grains if greater than 10g protein per serving (quinoa).
Amount: Proteins should be eaten two to four times day as a main dietary building block. Frequency should be ultimately determined by an individual’s needs in terms of exercise and energy demands.
Note: Protein is necessary to build muscle, stabilize blood sugar, and create all of our necessary hormones, enzymes and antibodies.
Green vegetables: 35%
Includes: Peas, kale, chard, green beans, spinach, lettuce, Brussels sprouts, cucumbers, asparagus, arugula, cabbage, bok choy, broccoli, zucchini, okra and other green vegetables; homegrown or locally grown and organic is always best.
Amount: These should be eaten freely and should make up about half your plate in every main meal, as they provide more nutrients and fiber than any other food.
Note: Growing a salad mix that offers a variety of greens is a great way to incorporate an array of nutrients within one daily salad.
Includes: Apples, blueberries, cherries, cranberries, mangos, raspberries, melons, red peppers, tomatoes, carrots (especially purple carrots), sweet potatoes, blue potatoes, eggplant, beets, oranges, grapefruit, squash, blackberries, orange peppers, bananas, elderberries, mulberries (almost any dark red, blue or purple fruits and dark chocolate—hey, you have to have some fun!); homegrown or locally grown and organic is always best.
Amount: These should be a relatively smaller portion of the daily intake and could be eaten as one fruit (in the case of apples, for example) or five to 10 bites (in the case of cherries, for example) of any of the above daily, or two squares of dark chocolate per day. Mix it up, as variety is important for getting the various important nutrients from these foods.
Note: Dark chocolate contains flavonoids such as procyanidins and epicatechins that improve cardiovascular health.
Whole grains: 13%
Includes: Quinoa, amaranth, millet, corn, whole-grain brown rice, wild rice, bulgur wheat, buckwheat, oats; preferably choose organic and non-GMO.
Amount: These should be eaten in smaller amounts. Aim for about a quarter of your main meals or as little as five to 10 bites a day, depending on your daily energy requirements.
Note: Technically both seeds, quinoa and wild rice are generally categorized as grains and offer fiber as well as protein and other minerals. Bulgur wheat is a quick-cooking form of whole wheat.
Fermented foods: 5%
Includes: Sauerkraut, kimchi, high-quality yogurt, tempeh, miso.
Amount: A small amount daily keeps digestion working properly and helps the immune system stay strong.
Note: Many studies have shown a link between diets that include sufficient probiotic intake via fermented foods and improved overall health.
Healthy fats: 2%
Includes: Olive oil, coconut oil, sesame oil, sunflower oil, flaxseed oil, butter and lard from grass-fed animals.
Amount: These are a small amount of the overall diet, but they’re crucial. Infants and children need fats for adequate brain and organ development, as well as immune system support. After age 50, we need more of these fats to maintain skin and hair health, as well as to support our organ systems. Higher fat intake is generally needed during pregnancy and lactation.
Note: Choose lard and butter from animals raised on pasture for optimal nutrition. Most lard you’ll find in the grocery store includes hydrogenated lard. Any fat or oil that has been hydrogenated or partially hydrogenated contains trans fats, incredibly unhealthy fats we should never consume.
Notes on Various Ages
Although I tried to make this guide inclusive of every type of food, keep in mind that it is designed to be tailored to your family’s preferences. The key element I hoped to emphasize was the importance of variety. Use these guidelines to further tailor your diet to the stages of life.
Adult nutrition: As adults with stressful and busy lives, we often rely on old standbys and quick meals rather than expanding our cooking and dining repertoire. However, when dealing with stress, it’s even more important to consume a wide variety of high-quality nutrients. It will not only help us deal with the stress of work and family demands, but also help prevent or minimize future health problems, such as joint pain, memory loss, depression and fatigue. At this age, we may need more fermented foods, healthy fats and antioxidant foods to help undo the damage done by stress and the shortcut eating of processed foods. Stress often inhibits our ability to digest and creates higher levels of inflammation, depleting antioxidants and good fatty acids. So eating more berries, omega-3 rich foods and fermented foods helps offset this and keep us at our best.
Senior nutrition: As we age, our skin and hair loses some of its luster and we tend to need fewer carbohydrates and more lean proteins and fats to meet our daily needs. We also need adequate fiber to keep our digestion running smoothly. I usually advise eating the highest possible level of vegetables, fruits and whole grains to maximize fiber intake. Focus on fish and healthy fats to help keep skin and hair healthy. Fruits such as dark red-purple berries also help to keep the cardiovascular and urinary systems strong, so I usually recommend more of these as well.
Child nutrition: When working with kids, I find that visuals are helpful for guidance on both what to eat and how much to eat. Kids love to play with their food, so try making faces with green beans and tomatoes, eating a rainbow, and letting kids pick food themselves from the garden or farmers market. Patio gardens are great for helping show kids where food comes from and encouraging them to eat more plants—I planted lettuce in a pot one year and my kids grazed on it so much that I found it hard to keep it growing.
Exercise and Movement
No guide would be complete without the foundation of exercise. It is crucial that we incorporate movement into our daily lives. It doesn’t necessarily need to involve the gym. Walking is fine; getting in 10,000 steps per day should be your goal. Working in muscle strengthening is also important to keep our bones strong and put all of that good mineral intake to work. Use this simple guide to exercise by age group:
3 to 10 years: One hour of active play per day minimum; allow them to do their usual running about and incorporate outdoor play as much as possible.
10 to 18 years: One hour three to five times per week of cardio activities, such as walking, running, swimming, hiking, team sports, dance, aerobics or kickboxing. These combine cardio activity with strength training.
18 to 45 years: One to two hours of walking or at least 30 minutes of moderate- to high-intensity cardio activity three to four days a week; strength training one to two times a week (weight-lifting or body-weight exercises such as squats, lunges and push-ups); also one to two days a week of stress-reducing exercise such as yoga, dance or tai chi.
45+ years: Keep the focus on daily movement for one to two hours a day and incorporate more toning exercises such as walking, yoga, dance or tai chi with a focus on stress reduction to help offset hormonal changes and middle-area weight gain. Keep up weight-based strength training to maintain bone density and endurance.
Our Advice: Variety and Quality Foods
Today we are gaining a far more complex understanding of the microclimates of our bodies. For example, we now know that all fiber isn’t created equal: Some fiber, such as that from whole grains and vegetables, feeds our healthy gut flora, while highly processed fiber and sugars tend to irritate our gut and cause inflammation. We’re also beginning to understand the connection between sustainable farming methods, food and health. For example, we now know that growing monoculture crops such as corn and potatoes results in less bacterial diversity in the soil and food. This leads to higher disease sensitivity in the crops, as well as poorer digestion of those foods in our intestines. Our bodies fare better with variety, both in types of foods and in species of those foods. Choosing not only a wide array of foods but different varieties of those foods will help improve our health.
Sheila Kingsbury is a licensed naturopathic physician and chair of botanical medicine at Bastyr University. She blogs regularly on botanicals, family health, nutrition and home remedies at Natural Family Apothecary.