The Double Health and Climate Pyramid (Double Pyramid) is built on an evidence-based methodology to foster health and longevity, and reduce the impact of food choices on the ecosystem, and more specifically on climate change. The Double Pyramid communicates in a simple and direct way the features of a balanced, healthy, and sustainable diet by advising on the appropriate frequency of consumption for all food groups and showing the associated impact on health and the climate.
The Health Pyramid is based on scientific literature linking food choices in the adult population and health outcomes. In particular, the risk of cardiovascular diseases, which are the most important cause of death and disability worldwide. Associations of food choices with other non-communicable diseases like cancer and diabetes follow similar gradients. Foods have been grouped according to their origin (whether animal – meats, eggs, fish, dairy – or plant-based – cereals, legumes, vegetables, fruits, nuts) and to their nutritional characteristics into 18 food groups. In addition, the literature on the consumption of condiments and beverages has also been reviewed. These groups have been stratified in seven layers on the basis of their association with the risk of cardiovascular diseases.
The food groups associated with the highest beneficial impact on cardiovascular diseases and, more in general, on health, are placed at the bottom of the Health Pyramid in the first layer, and include fruit, vegetables, and wholegrain foods. Moving up to the second layer, there are food groups for which regular consumption should be encouraged but without exceeding one daily serving for each of them: refined cereal foods with a low Glycemic Index, like pasta, parboiled rice and barley, as well as nuts, fermented milk like yogurt, olive oil and other non-tropical vegetable oils, such as corn and sunflower oil. The third layer includes foods like legumes (i.e.: beans, peas, lentils, chickpeas) and fish that are associated with a reduced risk of cardiovascular disease, and therefore should be consumed in three to four servings per week. The fourth layer includes foods like poultry, eggs, cheese, and milk that have neither a beneficial nor a detrimental relationship with the risk of chronic diseases if their intake is moderate. The next three layers of the pyramid contain food groups for which there is evidence of an association with an increased cardiovascular risk. The foods included in the fifth layer are high Glycemic Index foods like white bread, refined rice, and potatoes. Animal fats and tropical oils, as well as red meat are placed in the sixth layer of the pyramid since their consumption is associated with a significantly increased risk of cardiovascular events. Since cakes and pastries are rich in saturated fat but also in refined flour and sugar, they are placed in the sixth layer as well. At the top of the pyramid, in the seventh layer, there are foods, like processed meats (i.e.: sausages, bacon, salami), high in saturated fat and salt, associated with a high risk of cardiovascular and other chronic diseases and that should be consumed only occasionally since they are not a necessary component of a balanced diet.
Beverages and salt are not included in the food pyramid but there are footnotes that summarize relevant advice on their consumption. In particular, there are very consistent data showing that the regular consumption of soft drinks is associated with a higher cardiovascular risk, besides untoward effects on body weight and diabetes; therefore, these beverages should only be consumed occasionally. As for alcoholic drinks, there is very convincing evidence that moderate consumption (no more than 2 glasses of wine or 1 can of beer) is associated with a lower risk of cardiovascular diseases. Similarly, intake of up to 3 cups of tea or coffee has been shown to be linked with protection against heart diseases and other health outcomes. These recommendations are aimed for those who already consume these beverages, provided that their amounts do not exceed the limits indicated above since. The footnotes also contain an alert about keeping salt intake below 5 grams per day, and a recommendation to be physically active and practice daily mindfulness.
The Climate Pyramid is based on the database provided within the EU Su-Eatable Life project, which classifies different foods according to their carbon footprint. This indicator represents the climate-related impacts associated with the production of a commodity or a service throughout its entire life cycle, and it is expressed in terms of carbon dioxide equivalent emissions (kg CO2-eq). It is characterized by a rigorous method defined by the IPCC and it is usually included in environmental impact analysis or study. Its widespread application provides a vast amount of literature and data covering a wide spectrum of food items. Additionally, the carbon footprint is relevant for informing policymaking, especially in the context of climate mitigation and decarbonization pathways, such as those advocated by the Green Deal and the Farm to Fork Strategy of the European Union.
The different food items included in the database have been grouped into the 18 food groups considered in the Health Pyramid. A median carbon footprint of each food group has been calculated. The resulting 18 carbon footprint values, one for each food groups, have been clustered into layers of the Climate Pyramid. These layers are scaled from very low to very high carbon footprint.
The results show that the production of animal-based products, especially red meat, followed by cheese and processed meat (layers 5-7), causes the highest GHG emissions compared to plant-based products, mainly due to the production of the significant amount of feed required by the animals (especially ruminants) and emissions of methane from manure. Fish is in layer 4, with medium carbon footprint mainly caused either by feed production for farmed fish or transportation and logistics in the case of species caught offshore by trawling and long line fishing fleets. Secondary animal-based products, such as milk, fermented milk, eggs, and poultry have low and medium-low emissions (layers 2-4), with the production of protein-based feed being the main cause of GHG emissions for poultry and eggs. Plant-based products, either fresh or characterized by low levels of processing, make the smallest contribution to climate change (layer 1). The main causes of GHG emissions are production inputs, from cultivation to distribution (e.g. chemicals, fertilizers, fuel and energy used for machinery and irrigation), and emissions from fertilized soils, such as dinitrogen oxide (N2O), which has a global warming potential about 300 times higher than CO2.
The resulting Double Health and Climate Pyramid is offered as a tool to inform daily food choices and encourage dietary patterns that are healthy for humans and more sustainable for the planet. The Health Pyramid orders food according to frequency of consumption, with the base including those that should be eaten more often (fruit, vegetables, and wholegrains). Legumes and fish are the preferred sources of protein, while red meat and high glycemic foods should be consumed in moderation. The Climate Pyramid shows that the production of animal-based products makes the highest contribution to climate change, while plant-based products make the smallest. As a result, the Double Pyramid corroborates the message that through a varied and balanced diet we can promote our health, longevity, and wellbeing, while reducing our carbon footprint. In fact, foods that should be consumed more frequently for our health also have a low climate impact.
The Double Pyramid journey of the Barilla Foundation started in 2010, find out more.
