By Donna Feldman, MS, RD

There are 18-odd countries ringing the Mediterranean Sea, all with unique variations on Mediterranean cuisine. Many of these countries have official food guidelines to promote health, similar to the USDA Food Pyramid. But with so many Mediterranean countries, it's difficult to create one standard Mediterranean Food Pyramid. Oldways Preservation and Trust, a U.S. organization dedicated to promoting traditional food patterns and healthy eating, did create one to fit general principles of Mediterranean eating. Spain uses a food pyramid, as does Greece. All of these pyramids and guidelines have a common theme: daily consumption of whole grain foods, fruits, vegetables and olive oil-in short, an emphasis on traditional Mediterranean foods.

The USDA Food Pyramid, by contrast, was criticized for the continued emphasis on dairy and meat food groups, as well as its failure to address different types of fats. It has since morphed into the more personalized MyPyramid food guide (www.mypyramid.gov) in an attempt to address some of those concerns. Dissatisfied with the USDA effort, nutrition researchers at the Harvard School of Public Health recently created their own food pyramid that has much in common with Mediterranean pyramids (http://www.hsph.harvard.edu/nutritionsource/pyramids.html). In fact, the Harvard version places even more emphasis on daily olive oil consumption, putting it on the bottom of the triangle along with whole grain foods.

This article will discuss the Greek Pyramid to represent the Mediterranean ideal, since the traditional Mediterranean diet is associated with Crete.

USDA and Mediterranean food pyramids: common themes

Both the USDA and Greek pyramids place grain-based foods at the bottom of the pyramid, representing the basis of the daily diet. While the Mediterranean version emphasizes whole grains (8 servings/day), the U.S. version includes numerous refined flour products (6-11 servings/day). The next section includes both the fruit and vegetable groups. The Greek pyramid is more specific in serving recommendations: 3 of fruit and 6 of vegetables; while the U.S. pyramid gives ranges: 2-4 for fruit, 3-5 for vegetables. One major difference shows up: the Greek pyramid does not include potatoes here, while the U.S. pyramid does. In other words, the U.S. recommendations would count mashed potatoes the same as a green salad, even though the nutrient content of each is dramatically different.

USDA and Mediterranean food pyramids: major differences

One major difference is the "Daily/Weekly/Monthly" designation on the Mediterranean version. The USDA Food Pyramid is intended to show recommended intakes of different food groups for daily consumption. The "daily" section of the Mediterranean does not include red meat, sweets, or even potatoes. It is limited to grains, fruits, vegetables, cheese, yogurt and olive oil. Daily olive oil use is clearly recommended, since this food has its very own rung of the triangle, just above fruits and vegetables. By comparison, the USDA Food Pyramid lumps all fats and oils along with sweets in the very top point of the pyramid, with only "sparing" use advised. Clearly the USDA Pyramid does not address the known health effects of different fats and oils.

The top sections of both pyramids showcase most of the high protein foods. The Greek pyramid gives different protein sources different rankings of importance, with separate sections: fish, poultry, beans and nuts, eggs and red meat. Fish consumption is recommended almost daily, but red meat is limited to once a week at most. Contrast this with the more vague USDA recommendations for 2-3 servings per day from a group that includes all meat, fish, beans, nuts, and eggs. For example, it would be easy to interpret this to justify 3 servings of red meat daily, and never eat fish or nuts.

The dairy recommendations are similar-2/day on the Mediterranean Pyramid; 2-3 on the USDA version. However, in Greek cuisine, "dairy" means primarily yogurt and cheese, both derived from sheep's or goat's milk. In the U.S., "dairy" means cow's milk products, including whole milk and high-fat cheeses.

USDA and Mediterranean food pyramids: other differences

The Greek Pyramid and the Harvard and Oldways' versions of Mediterranean-style food plans include exercise recommendations. The Harvard and Oldways' Pyramids put exercise right at the bottom of the triangle, to illustrate the importance of daily physical activity to the overall health goals of the food plan. The Greek Pyramid places a clear recommendation for physical activity alongside the "daily" section of the triangle. The USDA Pyramid does not include exercise recommendations.

The other big difference is wine consumption. The Greek Mediterranean Pyramid places wine, "in moderation," clearly in the daily consumption category. Other Mediterranean pyramids also include wine. The USDA Pyramid graphic makes no reference to wine and only mentions "alcohol" consumption on the last page of the explanations. Wine is grouped together with other alcoholic beverages and given no special consideration.

For more information on wine and it's health benefits see the following article for TheDietChannel: Wine: The Health Benefits of Drinking Red Wine.

USDA and Mediterranean food pyramids: which diet is healthier?

A diet based on the Mediterranean Pyramid would be largely vegetarian, with daily emphasis on grain foods, vegetables, fruit, cheese, yogurt and olive oil. It would be high fiber, low sugar, and high fat, due to the olive oil. Fish, poultry, or occasionally red meat could be included daily. By contrast, the USDA pyramid diet would include meat, poultry or dairy several times a day. Most of the fat in the USDA version would come from meat, cheese, and vegetable oil. Most of the fat in the Mediterranean version would be from olive oil, with smaller amounts from nuts.

Given what we know about the benefits of olive oil, high-fiber plant foods, and limiting sweets and saturated fats, it's clear that the food plan outlined by the Mediterranean Food Pyramid would result in a healthier diet. The USDA pyramid gives prominence to meat and dairy products and fails to address the issue of fat type by lumping all fats and oils together in one group.

Conclusion: the Mediterranean Food Pyramid helps improve food choices

The Mediterranean Food Pyramid is a great guide for anyone wanting to improve their food choices. The pyramid created by the Greek government gives clear recommendations for servings and types of foods. Even if you did not manage to follow the recommendations 100%, making basic changes to emphasize plant-based foods and olive oil, while de-emphasizing meats and sweets would result in a healthier diet.

For more information and changing to a mediterranean diet see the following article from TheDietChannel: Get Healthy with a Mediterranean-Style Diet.

For more information on the USDA Food Pyramid and kids see the following article from TheDietChannel: The Food Guide Pyramid for Kids Explained.