Therapeutic properties have been attributed to the diet since ancient times. Epidemiological evidence starting in the early 1960s supports the relationship between different dietary components, dietary balance and the development of risk factors for prevalent chronic diseases in Western societies. There is also evidence supporting the protective effect of other components of the diet and lifestyle, like regular physical activity. During the last two years, groups of Spanish experts in the field of food, nutrition and health sciences have been involved in the process of analysing each food group in Spanish food patterns under a standard format. For each food group, current level of consumption, trends and scientific evidence linking each particular group or its components with patterns of disease, risk factors or protective effects have been determined from a public health perspective. Conclusions and recommendations for each food group, agreed under consensus by the Spanish Society of Community Nutrition (SENC) collaborative group of experts, are summarised and reflected in the Food Guide Pyramid presented in this paper.