Currently browsing posts about: Dietary-Guidelines

An as yet unpublished evaluation of how well American diets adhere to the dietary guidelines comes to an alarming conclusion: 86.3% are of poor quality.  The study comes from researchers at the Harvard School of Public Health, the University of California San Francisco, and Nourish Science.

The study: Understanding Sociodemographic and Dietary Determinants of Cardiometabolic Risk: Cross-Sectional Evidence from the U.S. Healthy Eating Index to Inform Diet Quality Categories.

Methods: The authors used dietary recall data from the 2009-2018 National Health and Nutrition Examination Surveys (NHANES) and compared participants’ dietary intakes to the Healthy Eating Index.

Results: Compared to adults with high diet quality, those with very low diet quality consumed:

• Less unprocessed or minimally processed foods, fruits, vegetables, whole grains, and seafood
• More ultra-processed foods, refined grains, and red and processed meats

They also were more likely to be overweight, have lower HDL cholesterol, but higher triglycerides, fasting glucose, and hemoglobin A1c (a marker of type-2 diabetes).

The authors explain their study in an Infographic and a YouTube video.

NHANES collects dietary intake information from representative population samples by interview.

The Healthy Eating Index (HEI) was developed in 1995 as a tool to measure adherence to recommendations of the Dietary Guidelines for Americans.  It is calculated on the basis of foods consumed and calories, sodium, saturated fats, and total fats.

The results of this study lead to obvious policy recommendations for healthier eating:

• More unprocessed or minimally processed foods, fruits, vegetables, whole grains, and seafood
• Less ultra-processed foods, refined grains, and red and processed meats

__________

Forthcoming November 11, 2025: What To Eat Now

I have no inside information about what the new Dietary Guidelines will say beyond what I’ve read and what RFK Jr has said: They will be coming out soon and will be short and to the point.

But according to Twitter (X), the source of much leaked information, the new administration “plans to introduce partial bans on alcohol advertising, to bring it ‘closer in line with advertising of unhealthy food.'”

And we now have a Reuters’ Exclusive: US to drop guidance to limit alcohol to one or two drinks per day, sources say

Its summary:

• Americans have long been told to drink two or fewer drinks per day
• New guidelines due as soon as this month
• Expected to include brief statement on limiting drinking
• Alcohol industry faces growing scrutiny of health risks

Reuters’ anonymous sources say “The new guidelines are set to move away from suggesting consumers limit alcohol consumption to a specific number of daily servings, according to the three sources, who asked not to be named to speak freely.”

Reuters also reports:

Major industry players, including Diageo (DGE.L) and Anheuser-Busch InBev (ABI.BR) have lobbied lawmakers throughout the review process. Senate records show the companies spent millions on lobbying efforts related to the guidelines and a range of other issues such as tax and trade in 2024 and 2025. Both companies declined to comment.

What is at stake here?

As I explained in January (Alcohol in the Dietary Guidelines: What the Fuss is About), everyone agrees that too much alcohol is bad for you.  The question is whether any alcohol is bad.

The dietary guidelines have advised since 1990 that women have no more than one drink a day and men no more than two, suggesting that such levels are safe.  But are they?

I discuss the recent reports arguing one way or the other on January 7 (The big fight over alcohol recommendations: not over yet) and January 22 (The Alcohol Saga continues).

Neither RFK Jr nor President Trump drink alochol.

And we have evidence that the Majority of Americans Unaware of Cancer Risks Linked to Alcohol Consumption.

Recent research conducted by The University of Texas MD Anderson Cancer Center unveiled that only approximately 40% of American adults recognize alcohol as a cancer risk factor. This stark gap in knowledge persists despite alcohol’s status as a leading preventable cause of cancer, highlighting the urgent need for enhanced public health communication and policy reforms.

Dietary guidelines are a key component of federal nutrition policy.

I can’t wait to see what they say about alcohol consumption (and everything else), in the light of the MAHA (Make America Healthy Again) agenda.

Politico reports: White House invites 46 farm, food groups to discuss MAHA report

The MAHA report, as I’ve written, could have enormous implications for food system businesses.  The problems it describes with the health of America’s children call for policies that could reduce profits for companies that, for example, produce seed oils, food products with color additives, and ultra-processed foods in general.

The secretaries of HHS and USDA have promised to soon issue dietary guidelines to reduce intake of such foods.

Food companies making products targeted by such views are unlikely to be happy with the report.  If past history is any indication, they will lobby for exceptions, exemptions, and delays, and will insist that the proposed measures have no scientific basis (which some indeed do not), violate the First Amendment, and will cost jobs—the playbook that worked for such a long time for the tobacco industry.

The Politico report is behind a paywall, but Helena Bottemiller Evich obtained a list of who has been invited and writes the details in FoodFix: White House holds flurry of industry meetings in wake of MAHA drama. 

Her list shows separate meetings for fruit and vegetable producers and trade groups, and those for meat and dairy, restaurants, grocers, beverage companies (Big Soda), commodity groups, and Big Ag.

Oh to be a fly on those walls.

It’s hard for me to believe that this administration will do anything to reduce business interests, and early indications are that RFK Jr is merely calling for companies to take voluntary actions, and individuals to take personal responsibility—neither of which is likely to have any chance of Making America Healthy Again.

I look forward to seeing what they do with the dietary guidelines and the next MAHA Commission report on policy—both expected by the end of the summer, apparently.  Stay tuned.

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

*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

I.  Darius Mozaffarian, a nutrition professor at Tufts University, has an editorial in the American Journal of Clinical Nutrition:“The Dietary Guidelines for Americans—is the evidence bar too low or too high?”

He writes about an analysis of the systematic literature reviews SRs) that form the basis of science-based decisions in the guidelines.  His comments gives an insight into the Dietary Guidelines process worth seeing.

For the 2025–2030 DGAC, I served as a peer reviewer for the SR on UPFs…I felt that the SR’s question, design, and planned methods were appropriate, but that its implementation and conclusions were weakened by important deviations from these standards. For example, contradicting its stated eligibility criteria, the SR included numerous studies that did not appropriately or adequately define or assess UPF. Following inclusion of such heterogeneous studies, the SR concluded that the scientific evidence on UPF was limited due to many studies having serious concerns around exposure misclassification as well as evaluating dietary patterns not directly varying in amounts of UPF. This demonstrated a circular and dismaying reasoning: the SR included studies it should not have that had heterogeneous and poorly characterized assessments of UPF, and then concluded that heterogeneous and poorly characterized assessments of UPF limited the strength of the evidence.

He observes:

Most importantly, the DGA and SR requirements make clear that guiding Americans toward a healthier diet is an unfair fight from the start. The food industry can do almost anything it wishes to our food, combining diverse ingredients, additives, and processing methods with virtually no oversight or required evidence for long-term safety  In contrast, the DGAs and other federal agencies can only make recommendations to avoid certain foods or limit certain manufacturing methods when there is extensive, robust, and consistent evidence for harm. In this severely imbalanced playing field, industry wins again and again.

II.  Senator Bernie Sanders posted on Facebook Sanders Statement on How to Make America Healthy Again.  Among other issues, he’s taking on the food industry.

Reform the food industry. Large food corporations should not make record-breaking profits addicting children to the processed foods which make them overweight and prone to diabetes and other diseases. As a start, we must ban junk food ads targeted to kids and put strong warning labels on products high in sugar, salt and saturated fat. Longer term, we can rebuild rural America with family farms that are producing healthy, nutritious food.

III.  California Governor Gavin Newsom “issues executive order to crack down on ultra-processed foods and further investigate food dyes.”

The food we eat shouldn’t make us sick with disease or lead to lifelong consequences. California has been a leader for years in creating healthy and delicious school meals, and removing harmful ingredients and chemicals from food. We’re going to work with the industry, consumers and experts to crack down on ultra-processed foods, and create a healthier future for every Californian.

Comment

Mozaffarian offers these opinions despite disclosing financial ties to food companies.  Sanders is a welcome addition to the handful of legislators concerned about food issues.  Newsom is making it easier for other states to take similar steps.

Maybe there’s a glimmer of hope for coalition building among advocates for healthier food systems.  Maybe this really is a movement!

How’s that for a cheery thought for 2025.  Happy new year everyone!

What are we to make of this?

The National Academies of Sciences, Engineering, and Medicine’s Review of Evidence on Alcohol and Health says moderate drinking

• Reduces all-cause mortality (moderate certainty)
• Reduces the risk of cardiovascular disease (moderate certainty)
• Increases the risk of breast and colorectal cancer (but can’t decide about others)

The Surgeon General, Vivek Murthy, says in his Advisory on Alcohol and Cancer Risk

• Consuming alcohol increases the risk of developing at least 7 types of cancer.
• The causal relationship between alcohol consumption and cancer is firmly established.

Let me try some context.

That alcohol is a risk factor for cancer has been known since the 1980s.

The Surgeon General’s conclusion is especially noteworthy for its lack of ambiguity.  He says flat out: alcohol causes cancer, and 7 kinds no less.

In contrast, the NASEM report talks about low and moderate certainty for its conclusions.

Presumably, both reports were based on the same data.

Here’s what this is about.

At issue: what the 2025-2030 Dietary Guidelines will say about how much alcohol is safe to drink (if any).

Since 1990, Dietary Guidelines have said two standard drinks a day for men and one for women could be considered low risk.

But the 2020-2025 Dietary Guidelines Advisory Committee, based on recent research indicating harm from any level of alcohol intake, said only one drink a day for both men and women was probably OK.

This alarmed the alcohol industry and other industries that profit from drinking.  They convinced Congress and federal agencies to revisit the effects of moderate drinking.

Yet another report on moderate drinking and health, this one from federal agencies, is expected any day now.

The bottom line

While all this is going on, the moral is pretty clear: the less alcohol, the better.

Resources

NASEM report press release

Industry pressure to make sure Dietary Guidelines to not toughen alcohol restrictions

New York Times: What is Moderate Drinking?

Example of alcohol industry pressure on Dietary Guidelines

Rani Rabin has been right on top of this fuss.  See, for example

• Surgeon General calls for cancer warnings on alcohol
• The battle over what to tell Americans about drinking
• US diet panel adds another researcher with alcohol industry ties
• Major study of drinking will be shut down