Hor read that the new American food pyramid revalues fats and also includes butter and full-fat dairy products, if included in a diet made up of minimally processed foods. But is it really a healthy choice according to science? And how does it differ from the indications we follow in Italy and hear every day?
Linda
Doctor Federica Almondo responds
Specialist in Food Science, trained at Dietology and Obesity Center of the San Raffaele Hospital in Milanthe Doctor Federica Almondo it is a point of reference in personalized nutrition, preventive medicine and anti-aging pathways.
After founding and directing Cerva 16 – Nutrition & Anti-aging Center, he created a STUDIO ALMONDO – NUTRITION & LONGEVITYa place where science, technology and a human approach meet to create tailor-made programs. It deals with tools such as genetic tests (DNA), assessments of the state of the intestinal microbiota, analysis of oxidative stress, body composition, indirect calorimetry. But also ANS Analysiss to build highly personalized diets with approach holistic and scientifically validatedsuitable for even the most complex needs.
With excellent training and skills ranging from nutrigenetics and nutrigenomics to nutraceutics, metabolomics and epigeneticsAlmondo is also recognized for her work on intestinal health, menopause, chronic stress management and optimization of psycho-physical energy. Particular attention to ketogenic therapya nutritional approach now totally validated by scientific literature such as effective intervention in many complex pathologiesincluding type 2 diabetes, PCOS, fibromyalgia and lipedema and much more.
Here is his answer to the question.
Doctor Federica Almondo.
Let’s clarify the new American Food Pyramid
Before going into the merits, it is important to clarify that this analysis it does not start from any ideological presupposition. It’s not about defending or attacking the new American food pyramid, but about making one examination based on the most recent scientific evidencethen comparing them with European and Italian guidelines.
A strong image
A first element that has caused discussion is the graphics of the new pyramid: Very large and visually strong images of steaks, cheeses and whole milk. From a communication point of view, this can be confusing, because it risks conveying the idea that some foods, especially those of animal origin, have been “promoted” without distinction. In reality, the message of the document is more complex and must be interpreted as a whole.
Overcoming “fat-phobia”
One of the most obvious changes of the new pyramid is the overcoming of the so-called fat-phobiathat is, the idea that fats are intrinsically harmful and responsible for weight gain. This vision is today considered outdated: numerous studies have shown that weight gain and metabolic risk do not depend on fat itselfbut on the quality of the food, the degree of processing and the overall glycemic load of the diet (Willett et al., New England Journal of Medicine; Hall et al., Cell Metabolism).
What the new American pyramid really says
The new US guidelines place a key message at the center: drastically reduce added sugars and ultra-processed foodsfavoring whole, lightly or unprocessed foods. This point is one of more solid and less controversial of the document and is fully supported by the most recent scientific literature (Malik et al., BMJ; Mozaffarian et al., Circulation).
The reduction of sugars, especially in the form of sugary drinks and refined products, is considered a fundamental lever to combat obesity, type 2 diabetes, metabolic syndrome and low-grade systemic inflammation with rapid and measurable benefits also on cardiovascular risk.
Where the science is aligned
On the topic of fats, the new pyramid is consistent with a now shared point: It’s not the total quantity of fat that matters, but their quality. There is a broad consensus on the favorable role of fats unsaturated – such as those of extra virgin olive oil, dried fruit, seeds and fish – associated with a reduction in cardiovascular and metabolic risk (meta-analysis on The Lancet, JACC).
Also the reference to food matrixi.e. the fat inserted into a real and not isolated food, is in line with the most recent evidence.
The most delicate point: butter and animal fats
The most controversial part concerns the inclusion of butter and animal fats among the usual options for cooking, alongside olive oil. Here the scientific literature is clear: There is no evidence showing comparable cardiovascular benefits between saturated animal fats and unsaturated vegetable fats.
Studies indicate that the health benefit comes primarily from replacement of saturated fats with unsaturated onesnot by their equalization, not even when the saturated fats come from poorly processed foods (Hooper et al., BMJ; Sacks et al., Circulation).
Comparison with Italian and European guidelines
The European and Italian guidelines, inspired by the Mediterranean model, maintain a more prudent approach:
- they clearly favor unsaturated fats;
- indicate butter and animal fats as foods from limitnot to be promoted;
- pay greater attention to population cardiovascular prevention.
The main difference is not in the quantities, in fact even the United States indicates that saturated fats should remain under 10% of calories, exactly like in Europe, as in communicative languagewhich sends a less restrictive message in the US.
Why the United States has changed its approach
To understand this change of direction we need to look at the American healthcare context. In the United States beyond 70% of adults are overweight or obeseabout 1 in 10 adults has diabetes and almost the 90% of public health spending is absorbed by the management of chronic diseases. Obesity and diabetes represent today among the main determinants of cardiovascular riskcontributing significantly to the development of cardiovascular diseases such as: heart attack, stroke and heart failure (CDC; American Heart Association).
Hence the urgency for public health to intervene on metabolic factors that fuel these pathologiesreducing the glycemic and insulin load of the diet: less sugar, less ultra-processed, more satiating foods and better control of blood sugar and insulin. Perhaps this is why the American Ministry of Health has opted for a more pragmatic approach, oriented towards concrete benefits in the short and medium term.
Warning: this is not a one-size-fits-all model
Another critical issue is the poor distinction between healthy populations and people with metabolic or cardiovascular diseases. Evidence shows that tolerance to fats, carbohydrates and proteins varies greatly based on individual health status, an aspect that European guidelines tend to emphasize more.
Those suffering from renal failure, familial hypercholesterolemia, advanced diabetes or cardiovascular diseases must follow more targeted and prudent indications, such as those provided by the European guidelines.
In conclusion
The new American food pyramid has the merit of overcoming fat-phobia and bringing real foods back to the centre, counteracting one of the main problems of modern nutrition: excess sugars and ultra-processed foods. However, on the topic of animal fats, the message is more permissive than the scientific consensus and Italian recommendations, which remain more cautious from a long-term prevention perspective.
In nutrition, what matters is not strong images or slogans, but rather the metabolic context, the state of health and the people to whom the indications are addressed.