For the first time, experts are plugging a low-carb food pyramid.
With chronic illnesses soaring across the United States, a group of doctors and nutrition researchers say it’s time to reconsider the foundation of American dietary advice—starting from the bottom up.
In a peer-reviewed paper published in Nutrients, the authors contend that the traditional carb-heavy diet has not only failed to safeguard public health but may be contributing to rising rates of obesity and Type 2 diabetes. They propose a new low-carbohydrate food pyramid designed for the vast majority of American adults showing signs of metabolic dysfunction.
Their model—built on protein, full-fat dairy, and healthy fats—challenges decades of federal guidance and reignites a long-simmering debate about dietary fat’s role in chronic disease.
Rethinking the Pyramid
The original food pyramid, introduced by the U.S. Department of Agriculture in 1992, stacked grains at the base, fruits and vegetables in the middle, and fats and oils at the top.
Though replaced in 2011 by MyPlate—a graphic that uses a dinner plate divided into five food groups (fruits, vegetables, grains, protein foods, and dairy)—the original pyramid’s grain-centric emphasis still lingers in public messaging and perception.
The paper calls that framework outdated and potentially harmful. Its 24 authors, including physicians, dietitians, and metabolic researchers, say the traditional model overlooks growing evidence linking high carbohydrate intake to obesity, diabetes, and other chronic illnesses.
In its place, they introduce a striking alternative: the first low-carbohydrate food pyramid. At its base are foods once discouraged—meat, eggs, full-fat dairy, and healthy oils. Non-starchy vegetables and low-sugar fruits occupy the middle tier. At the top are starchy vegetables, higher-sugar fruits, and nuts, recommended only in limited amounts. Foods high in carbohydrates—such as grains, rice, beans, and added sugars—are excluded entirely.
The authors describe the model as both low-carbohydrate and ketogenic—terms they use interchangeably in the paper. A ketogenic diet typically restricts carbohydrate intake to between 20 and 50 grams per day, shifting the body into a fat-burning state called ketosis.
But some experts caution against treating all carbohydrates as equal. “Whole grains are associated with better health outcomes, while refined grains are the opposite,” said Alex Leaf, a nutrition writer with a master’s degree.
By Sheramy Tsai
