Search results: dietary guidelines

I get asked all the time about what’s happening with the dietary guidelines.  I have no inside information, but am exhausted at the thought that we have to go through all this again.

By law, dietary guidelines have to be re-done every five years, even though they always say the same things: eat more fruits, vegetables, and whole grains; eat less sugar, salt, and saturated fat; balance calories.  OK.  They take take more than 150 pages to say that, but that’s what it all boils down to.

Will they be different in the new MAHA (Make America Healthy Again) era?  I can only speculate.

To review the process:

• A scientific advisory committee reviews the research and writes a report.  This one released its report in December.
• Now, the Departments of Agriculture and Health and Human Services appoint a committee—or somebody—to write the actual guidelines.

USDA Secretary Brooke Rollins says the two departments are working on them and they will come out “hopefully early fall.”  If they do, this will set records.  The guidelines typically are released in late December or early January.

The secretaries have promised they will not continue the tradition of “leftist ideology”  I’m not sure what tradition that is, exactly, although I suspect it means “plant-based.”

I can’t wait to see what happens with:

• Beef: USDA has always been sensitive to the demands of beef, corn, and soybean farmers.  Suggestions to eat less beef are typically phrased euphemistically (“eat lean meat”).
• Fats: RFK Jr wants seed oils replaced with beef tallow.
• Sugar: USDA has always been sensitive to the concerns of sugarbeet and sugarcane producers, historically a powerful lobby.  RFK Jr says sugar is poison.
• Ultra-processed foods:  The scientific advisory committee ducked the issue.  The MAHA folks are concerned about them.
• Emphasis on plant foods: Will the guidelines continue to promote their health benefits?
• Calories: The “C” word.  Will the guidelines bring back a discussion of calories, their principal food sources, and how their intake is affected by ultra-processed foods?
• Sustainability: The “S” word.  I would guess this one stays off the table, but you never know.

This one will be fun to watch.

USDA and HHS have announced an update on the dietary guidelines process.

A quick recap: The Dietary Guidelines Advisory Committee released its report last year.  The agencies are responsible for writing the actual guidelines, based on that report or not.

The USDA Secretary, Brooke Rollins, writes:

Secretary [of HHS] Kennedy and I have a powerful, complementary role in this, and it starts with updating federal dietary guidance. We will make certain the 2025-2030 Guidelines are based on sound science, not political science. Gone are the days where leftist ideologies guide public policy.”

Leftist ideologies?  She has to be kidding.  Since when did leftist ideologies influence the dietary guidelines?

Oh.  Wait.  Silly me.  I get it.  She means meat. 

Plant-based = leftist ideology.

You don’t believe me?  See Nina Teicholz’s editorial in the Wall Street Journal:  Meat will make America Healthy Again.

Ms. Rollins and Mr. Kennedy should reject suggestions from an expert committee that the 2025-30 federal guidelines place an even greater emphasis on plant-based proteins and that they recommend “reducing intakes of red and processed meats.” As the Agriculture Department found in 2010, there is either “no relationship” or a “limited inconsistent” relationship between any protein type and chronic diseases, including obesity, diabetes and cardiovascular disease.

Protein, sure.  But meat?  Consistent evidence for years indicates that people in industrialized countries would be healthier eating less meat and more plants.  Less does not necessarily mean none; it means less than currently consumed and a lot less in some cases.

If USDA and HHS are serious about Making Americans Healthier Again, they will revise the Dietary Guidelines according to the science.  In my view, that means advising eating less of ultra-processed foods, as well as meat.

The 2025-2030 Dietary Guidelines Advisory Committee did not make a recommendation about alcohol.  The agencies, HHS and USDA, will do that later based on two expert reviews.

I wrote about the first, from the National Academies, last week: Review of Evidence on Alcohol and Health.

I also wrote about the Surgeon General’s Advisory on Alcohol and Cancer Risk

Still to come is the report from the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD).

At issue is the amount of alcohol that is safe to drink, if any.

Just for fun, I did a summary of what the Dietary Guidelines say about alcohol from 1980 to 2020.  Note that the Moderation advice has not changed since 1990 (but then see the note on 2020).

                                      Alcohol recommendations: Dietary Guidelines for Americans

YEAR	ALCOHOL ADVICE	BENEFITS	MODERATION
1980	“If you drink alcohol, do so in moderation.”		“One or two drinks daily appear to cause no harm in adults.”
1985	“If you drink alcoholic beverages, do so in moderation.”		“One or two standard-size drinks daily appear to cause no harm in normal, healthy, nonpregnant adults.”
1990	Ditto	“Some studies have suggested that moderate drinking is linked to lower risk for heart attacks.”	No more than 1 drink/day for women, and 2 for men.
1995	Ditto	“Alcoholic beverages have been used to enhance the enjoyment of meals by many societies throughout human history…Current evidence suggests that moderate drinking is associated with a lower risk for coronary heart disease in some individuals.”	Ditto
2000	Ditto	“Even one drink per day can slightly raise the risk of breast cancer…Drinking in moderation may lower risk for coronary heart disease, mainly among men over age 45 and women over age 55.”	Ditto
2005	“Those who choose to drink alcoholic beverages should do so sensibly and in moderation.”	“Alcohol may have beneficial effects when consumed in moderation.  The lowest all-cause mortality  [and heart disease mortality] occurs at an intake of one or two drinks per day…compared with women who do not drink, women who consume one drink per day appear to have a slightly higher risk of breast cancer.”	Ditto
2010	“If alcohol is consumed, it should be consumed in moderation…and only by adults of legal drinking age.”	“Strong evidence from observational studies has shown that moderate alcohol consumption is associated with a lower risk of cardiovascular disease….[and] reduced risk of all-cause mortality among middle-aged and older adults and may help to keep cognitive function intact with age…[but also] increased risk of bfreast cancer, violence, drowning, and injuries from falls and motor vehicle crashes.”	Ditto
2015	Ditto	[heart disease and breast cancer not mentioned	Ditto
2020*	“Limit foods and beverages higher in added sugars, saturated fat, and sodium, and limit alcoholic beverages”	“Emerging evidence suggests that even drinking within the recommended limits may increase the overall risk of death from various causes, such as from several types of cancer and some forms of cardiovascular disease. Alcohol has been found to increase risk for cancer, and for some types of cancer, the risk increases even at low levels of alcohol consumption (less than 1 drink in a day). Caution, therefore, is recommended.”	Ditto

*From the 2020 Dietary Guidelines Advisory Committee report: “evidence points to a general rule that drinking less is better for health than drinking more. Therefore, the focus should remain on reducing consumption among those who drink, particularly among those who drink in ways that increase the risk of harms. The Committee concluded that no evidence exists to relax current Dietary Guidelines for Americans recommendations, and there is evidence to tighten them for men such that recommended limits for both men and women who drink would be 1 drink per day on days when alcohol is consumed.

Despite the language in the 2020 guideline, the agencies did not change the overall recommendation about moderate drinking.

Will the Surgeon General’s Advisory and the upcoming third report cause the agencies to suggest no more than one drink a day for men?  Or suggest that no level of alcohol intake is safe?

I’m looking forward to finding out.

Resource: the process for alcohol in the Dietary Guidelines

The USDA announced last week the arrival of the Scientific Report of the Dietary Guidelines Advisory Committee (DGAC).

The DGAC deserves much praise for getting this job done on time under what I consider to be difficult constraints (large committee size, large areas of research to review, requirement that all recommendations be “evidence-based” which sounds good, but is unreasonable given the inability to conduct long-term controlled clinical studies).

The report is now open for public comment (see information at bottom of post).

The process to develop the Dietary Guidelines for Americans, 2025-2030 is under way. Get involved by providing written and oral comments to the Departments on the Scientific Report of the 2025 Dietary Guidelines Advisory Committee (Scientific Report). You may also sign up to receive email updates on news related to the development of the next edition of the Dietary Guidelines…For more information, visit the Public Comments to the Departments page.

A reminder about the process:  The DGAC report is advisory.  Since 2005, the agencies appoint an entirely separate internal governmental committee to write the actual guidelines.  This, of course, makes the process far more political and subject to lobbying (file comments!).

The recent election will install new leaders of USDA and HHS.  If they follow the same process, they will appoint and instruct the new committee.  Or, they can change the process entirely.

Another reminder: When I was on the DGAC in 1995, our committee chose the research questions, did the research, wrote the scientific report, and wrote the actual guidelines.  Those were the days.

Comments on the DGAC report

For starters, it’s 421 pages.

Its bottom line:

This healthy dietary pattern for individuals ages 2 years and older is: (1) higher in vegetables, fruits, legumes, nuts, whole grains, fish/seafood, and vegetable oils higher in unsaturated fat; and (2) lower in red and processed meats, sugar-sweetened foods and beverages, refined grains, and saturated fat. A healthy dietary pattern, as indicated by the systematic reviews, may also include consumption of fat-free or low-fat dairy and foods lower in sodium, and/or may include plant-based dietary options.

The proposed guidelines:

1. Follow a healthy dietary pattern at every life stage. At every life stage—infancy, toddlerhood, childhood, adolescence, adulthood, pregnancy, lactation, and older adulthood—it is never too early or too late to eat healthfully.
2. Customize and enjoy nutrient-dense food and beverage choices to reflect personal preferences, cultural traditions, and budgetary considerations.
3. Focus on meeting food group needs with nutrient-dense foods and beverages, and stay within calorie limits.
4. Limit foods and beverages higher in added sugars, saturated fat, and sodium, and limit alcoholic beverages.

This looks like all the other Dietary Guidelines since 1980.  Its bottom-line statement is more explicit than previously about reducing red meat and sugar-sweetened beverages.

Worth reading

• Support federal data.  I especially appreciated the strong support for strengthening nutrition monitoring, food composition data (FoodData Central, an invaluable resource), and updating the Dietary Reference Intakes.  Yes!
• The chapter on portion size.  At last!  Larger portions have more calories!

What’s missing

• A separate chapter on calories stated explicitly.  The report discusses concerns about obesity and diet-related chronic disease in an excellent paragraph on page 1, and mentions calories but “stay within calorie limits” doesn’t get at what’s needed.  I want more on “…adults and children [should] consume smaller portions of foods and beverages that are high in energy density and low in nutrient density.”
• A guideline to reduce consumption of ultra-processed foods.  This committee, unwisely in my view, chose not to advise minimizing intake of ultra-processed foods, deeming their definition too uncertain and ignoring what are now three controlled clinical trials demonstrating that diets based on these food induce people to overconsume calories.

What’s confusing

–The addition of recommendations for diets in early childhood.  This was done for the 2020-2025 guidelines and it involved doubling the size of the committee. This makes the committee’s work much harder and its report insufferably long.  I would rather see a separate report on children (this could deal with the effects of food marketing as well).

–The health equity lens.  I’m all for this but its discussion dominates the report.  It is discussed in a separate chapter but then in boxes and other places throughout.  The word “equity” is mentioned 217 times and “health equity lens” 38 times.

Although prior Committees incorporated basic demographic factors such as age, race, and ethnicity into their reviews of the science, this Committee considered additional factors and did so in a holistic manner as it reviewed, interpreted, and synthesized evidence across data analysis, systematic reviews, and food pattern modeling. In particular, this Committee considered factors that reflect social determinants of health (SDOH). In doing so, the Committee could interpret the evidence based on both demographic factors (which are considered to be downstream, i.e., more proximal in terms of their influence on behavior) and socioeconomic and political factors (which are considered to be upstream, i.e., broader societal factors that influence the distribution of power and resources). Addressing SDOH is considered key to achieving a just, equitable society.

Other comments

From the Meat Institute:  Meat Institute Issues Statement on the Scientific Report of the 2025 Dietary Guidelines Advisory Committee

“The Meat Institute remains strongly opposed to the Report’s recommendation to reduce meat consumption and will urge the agencies to reject it,” said Meat Institute President and CEO Julie Anna Potts.

From the Physicians Committee for Responsible Medicine: Prioritizing Plant-Based Protein in the Scientific Report of the 2025-2030 Dietary Guidelines for Americans Committee is a Step Forward, Doctors Say

For the first time, the advisory committee tasked with making scientific recommendations for revising the Dietary Guidelines for Americans recommended that the 2025-2030 Dietary Guidelines “include more nutrient-dense plant-based meal and dietary recommendation options,” prioritize plant-based protein over animal protein, and recognize the many benefits of beans, peas, and lentils as a protein source. The Dietary Guidelines Advisory Committee (DGAC) continued to discourage consuming foods like red meat, eggs, and dairy that are high in saturated fat, while also suggesting that the next Dietary Guidelines for Americans specifically recommend plain drinking water as the primary beverage for people to consume.

I can’t wait to see what comes next.

How to commennt

A 60-day public comment period on the Committee’s Scientific Report is open through February 10, 2025. More information about how to provide written and oral comments to the Departments is available at DietaryGuidelines.gov.

• Read about opportunities to provide public comments, including requirements for oral comments 
• Register to provide oral comments to the Departments.   Note: do this now.  Spaces are limited.
• Submit written public comments to the Departments
• Register to attend the virtual public meeting to hear oral comments on the Scientific Report  

Read the Committee’s Scientific Report 

DietaryGuidelines.gov provides handouts on Food Sources of Select Nutrients.

Alas, calories are not among these handouts, even though 75% of American adults are now considered overweight or obese.

These are meant for nutrition professionals but are fun to see if you want to see what they get.

The page lists lots of other resources.

• Download Handouts & SpreadsheetLearn More About Food Sources
• Print materials on the professional resources page 
• MyPlate Quiz
• MyPlate Plan
• MyPlate Kitchen
• Professional food photography

Will these help you make healhier dietary choices?

Nutrients are not the problem; calories are the problem.

To do something about them, we need a healthier food environment.

I wish the USDA would give that as much attention as it gives nutrients.

The 2025-2030 Dietary Guidelines Advisory Committee (DGAC) report is well underway.   The committee either has submitted or is about to submit its report to HHS and USDA;.  The report has not yet been posted, but presumably will be posted soon.

But understand: the scientific advisory committee is just that: advisory.

The agencies, HHS and USDA, are responsible for writing the actual guidelines.  They choose an internal committee to do that work.  That new committee can pick, choose, add, or subtract from the advisory committee’s report.

So yes, the new Secretaries of HHS and USDA can have a lot of input (and veto power) into the new guidelines.

As I’m fond of repeating, the guidelines process was quite different when I was on the DGAC in 1995.  Then, our committee chose the research topics, reviewed the research, wrote the advisory committee report, and wrote the actual dietary guidelines.  The agencies made only minor tweakings.

The agencies have written the guidelines since 2005, making the process much more subject to politics.

The DGAC, for example, viewed the evidence on ultra-processed foods as too limited to take a stand, yet RFK, Jr says ultra-processed foods are killing us.

The development of the 2025-2030 guidelines will be most interesting to watch.  Stay tuned.

Every five years since 1980, we get to go through the most enormous fuss about dietary guidelines that have not changed in any fundamental way since then.

Then and now, they say eat more vegetables, balance calories, and reduce intake of foods high in sugar, salt, and fat.

You don’t believe me?  Here is the much more straightforward 1980 version.

Reminder: The Dietary Guidelines Advisory Committee is just that: advisory.  The agencies will write the actual guidelines.  Until the guidelines actually appear, everything remains speculative.  They are due to appear by the end of 2025.  Between now and then, we have an election to deal with.  No matter who wins, political appointees in the two sponsoring departments will change and could greatly intervene.

I love the Dietary Guidelines.  They are endlessly entertaining examples of food politics in action.

The current Dietary Guidelines Advisory Committee has produced its draft recommendations.  These, as I discuss tomorrow, are mostly banal, much the same as all guidelines since 1980.

But this year there are two rather shocking exceptions, both having to do with what is not recommended.

Incredible non-recommendation #1.  Reduce the focus of the Dietary Guidelines on reduction of chronic disease risk.

What???  The entire purpose of the Dietary Guidelines is to reduce the risk of diet-related disease.  Chronic diseases—obesity, type-2 diabetes, heart disease, cancer, etc—are the leading causes of death and disability among U.S. adults.

Maybe this was a typo?  Surely this committee means to say “Recommend increasing the focus of the Dietary Guidelines on chronic disease risk reduction.

The current wording is a travesty.  I’m not the only one who thinks so.  See Jerry Mande’s Tweet (X).

Update: I gather the uproar over this did some good and the committee is changing the wording.

Incredible non-recommendation #2.  Say nothing about ultra-processed foods.

The committee made it clear that they were not going to say a word about ultra-processed foods.  At least not now.  Why not?

Scientific experts tasked with advising federal officials drafting the 2025-2030 Dietary Guidelines for Americans said the data were far too limited to draw conclusions…Ultra-processed foods don’t have a recognized definition or a robust body of scientific literature that has studied them, they said, so guidelines would be premature.

Another travesty.  An overwhelming body of observational research suggests harm from diets high in ultra-processed foods.  OK, these studies only demonstrate association, not causation.

But—not one, but two well-controlled clinical trials demonstrate that ultra-processed foods induce people to consume more calories than they would otherwise: 500 more in one trial and more than 800 in the second.  These are enormous differences.

Yes, it would be great to know why, exactly.  And yes, the definition of ultra-processed can be fuzzy with respect to a few—remarkably few—foods.

But what more do you need to know?  Isn’t this enough to tell people that if they want to keep caloric intake under control, a good way to do that would be to limit consumption of ultra-processed foods?

But this committee chose to ignore the controlled trials because they didn’t last long enough.

As I explain in that link, the committee’s hands are tied by having to make “science-based” recommendations.  But in nutrition, most of the science is observational, which is why those controlled trials, short in duration as they are, matter so much.

The committee needs to revisit this decision.  If the guidelines do not include a recommendation to limit intake of ultra-processed foods, they will be ignoring the science and will be behind the times.

Worse, the guidelines will not help Americans reduce their risks for chronic disease.

See: Stat News:  5 questions about the next U.S. dietary guidelines, and the ‘impossible restriction’ on them: Difficulty of nutrition research leaves problems like ultra-processed foods largely unaddressed. 

Tomorrow: the banality of the latest recommendations.