Does the New Food Pyramid Match What We Know About Cancer Prevention?

With the debut of the new “inverted” food pyramid from the U.S. Department of Health and Human Services, nutrition guidance is getting a dramatic reset. The updated dietary guidelines - which places protein, full-fat dairy, and healthy fats at the very top- have sparked significant discussion, raising important questions about whether these recommendations align with what we know about cancer prevention.  

For Cancer Prevention Month, we spoke with Columbia outpatient oncology certified senior clinical dietitian Sabrina Oliver, MS, RD, CSO, CDN, on her key takeaways from the new recommendations and how people can interpret the guidelines through a cancer-prevention lens.  

From a cancer prevention perspective, what stood out to you in the new guidelines?    

One of the more positive changes is the stronger emphasis on minimally processed foods. Anything that encourages people to eat more fresh produce, especially fruits and dark leafy greens, is a step forward. What I didn’t see was the mention of plant-based proteins. There is plenty of research to support the benefits of eating more legumes, nuts, seeds, and whole soy based foods - not only for general health, but for also for lowering cancer risk. These foods didn’t get the attention they deserve, especially since we encourage people to limit red meat and processed foods.  

What parts of the new pyramid concern you most?  

The biggest concerns for me revolve around the meat and alcohol recommendations. The American Institute for Cancer Research (AICR) is very clear, with strong evidence: people should avoid processed meats entirely and limit red meat consumption. While the new pyramid briefly acknowledges processed meats, it doesn’t meaningfully emphasize the importance of limiting red meat, which is a missed opportunity in cancer prevention messaging.   

The alcohol recommendations are also surprisingly lenient. The AICR recommends not drinking alcohol at all for cancer prevention, and for patients undergoing chemotherapy, alcohol should be avoided altogether during treatment. The lack of stronger messaging around alcohol really stood out to me as something that could confuse people about current evidence.  

The new recommendations seem to highlight carbohydrates again. What should people take away from that?  

Carbohydrates, especially whole grains and complex carbs, can absolutely be part of a healthy diet. They provide fiber, vitamins, minerals, and steady energy. There’s nothing wrong with eating foods like brown rice, quinoa, whole-grain bread, or sweet potatoes. I’m glad we’re moving past the idea that “carbs are always bad.”    

From an educational perspective, people may benefit more from understanding what a balanced meal looks like rather than relying on a pyramid shape that can feel abstract. “MyPlate,” the previous visual used to recommend food intake, was more practical because people could picture how to build a meal. A pyramid can make it harder for people to translate recommendations into everyday choices.  

There’s a huge emphasis on animal-based proteins. What are some good alternative protein sources for those interested?  

There are so many great options. Fish is excellent, not only as a protein source, but for its healthy fats. Eggs, poultry, and shellfish are solid choices too. I always encourage people to think about plant-based proteins like beans, lentils, chickpeas, nuts, seeds, and whole soy foods, all of which offer important nutrients. Dairy can also be a good source of protein. Foods like quinoa contribute protein as well, even if people don't always think of them that way. There’s an abundance of ways to meet protein needs without relying heavily on red meat.  

Protein in general is a big topic in the updated guidelines. What should people know?  

Protein needs are incredibly individualized. The previous  recommendation - 0.8 grams per kilogram of body weight- was on the low side, especially for people undergoing treatment or trying to maintain muscle mass during cancer care and treatment. The new guidelines raise the recommended amount of protein which may be appropriate for some people, but if someone is generally healthy, not very active, and maintaining their weight, they probably don’t need such a high protein intake.   

Excess protein becomes excess calories and can put unnecessary strain on the kidneys. What concerns me is that, as a society, we tend to latch onto nutrition trends - first it was low-fat everything, now protein everything - and those extremes rarely serve people well. If the new guidelines push people toward high-protein, high-fat diets, that could have unintended consequences.  These may include a rise in saturated fat intake, which has long been associated with health risks.  

Why is saturated fat something to pay attention to in cancer prevention?  

Saturated fat can contribute to obesity, and obesity is a well-established risk factor for many cancers. Many foods high in saturated fat- particularly red meats, also independently increase cancer risk. So, the danger really exists in those two pathways.  

That said, not all saturated fats are equally harmful in the context of a balanced diet. Full-fat dairy, for example, can be perfectly fine for many people, and low-fat or non-fat products often come with additives, sweeteners, or artificial ingredients that some people don't tolerate well. It's about balance, not eliminating all sources of fat.  

Is there anything you wish the guidelines had addressed more clearly?  

I was surprised that physical activity wasn’t meaningfully addressed in any way. Diet is incredibly important, but so is lifestyle and movement, especially for cancer prevention. Public health recommendations need to acknowledge both.