Currently browsing posts about: Dietary-Guidelines

As anyone familiar with my work will know, I have made a career out of commenting on government dietary advice.  The Dietary Guidelines for Americans are particularly entertaining as quintessential examples of food politics in action, the latest ones in particular.

To summarize: They offered two excellent messages–Eat Real Food, and limit ultra-processed foods–but undermined them with unsubstantiated advice (double the protein), inconsistencies (eat more sources of saturated fat, but limit it to 10% of calories), omissions (salt, mentioned but no guideline), and errors (no, beef tallow is not a source of essential fatty acids).

And now the latest: The Physicians Committee for Responsible Medicine (PCRM) has sued to have the guidelines withdrawn and not used.

Guidelines Violated Federal Law Requiring Transparency, Balance, and Evidence…A “Secret Panel” of food-industry insiders handpicked by the Department of Health and Human Services and the U.S. Department of Agriculture illegally influenced the recommendations in the 2025-2030 Dietary Guidelines for Americans, argues a lawsuit the Physicians Committee for Responsible Medicine filed with the United States District Court for the District of Columbia on Aug. 19, 2026…“The government allowed the meat and dairy industries to ghostwrite the Dietary Guidelines,” said Physicians Committee President Neal D. Barnard, MD. “They put money in industry’s pocket and cholesterol in Americans’ arteries.”

PCRM is a Washington, DC-based group “dedicated to saving and improving human and animal lives through plant-based diets and ethical and effective scientific research.”

It particularly objects to the way the new guidelines and pyramid food guide prioritize meat and dairy foods.

Its lawsuit focuses on the unusually hasty and non-FACA [Federal Advisory Committee Act] process:

Instead of issuing Dietary Guidelines based on an internal review of the DGAC Report as had been the longstanding practice, Defendants, without any oversight or public  input, hastily assembled a handpicked panel of meat, dairy, and fad diet industry insiders (“Secret Panel”) for the purpose of attacking the FACA-compliant
DGAC Report and creating a substantially altered report entitled The Scientific Foundation for the Dietary Guidelines for Americans, 2025–2030….Although Defendants had previously vowed to “toss out the people who were writing the guidelines with conflicts of interest,” Defendants assembled a Secret Panel that was rife with conflicts of interest…Defendants then published Dietary Guidelines tha…embrace saturated fats, halve the recommended fruit and vegetable servings, remove daily alcohol intake limits, and promote fad diets.

PCRM says the 2025–2030 Dietary Guidelines pose dangers to

• Children, whose school food programs must adhere to the Dietary Guidelines
• Individuals with medical conditions who might follow the baseless medical advice incorporated into the Dietary Guidelines
• Americans who are at risk for diet-related diseases, including obesity, diabetes, and cardiovascular disease, and might follow the scientifically unfounded Dietary Guidelines, which are designed to promote fatty, high-cholesterol products of industries with which the Dietary Guidelines’ authors are affiliated.

I can’t wait to see what happens with this one.  Stay tuned.

Washington Post reporter, Tim Carman, contacted me for comment about a speech he heard made by RFK Jr’s top food advisor, Calley Means, in which Means made patently false charges about my work.  From Carman’s report, MAHA Mondays at the Great American State Fair miss one obvious problem:

Means suggested her research had been bankrolled by sugar and tobacco industries, the latter of which once owned major food companies. The industries “funded her to say that basically the base of our diet should be carbs,” Means said. He added that the report made Americans afraid of foods other than grains.

These charges surprised me for two reasons: (1) Anyone even remotely familiar with my work would know these statements could not possibly be true, and (2) I am not MAHA’s enemy. I support parts of its agenda, and am on record as calling for coalition-building around common objectives.

Means began making the false claims on June 30, when we were on a panel at the Aspen Ideas Festival, moderated by Corby Kummer.  You can watch the session here and make your own decision about how it went.

I would have let the whole thing go, except that Calley Means followed it up with his speech at the Great American State Fair on July 6.  Tim Carman sent me a transcript of Means’ remarks:

In the 1980s, a group called the Sugar Research Council paid her to do a lot of research. And they really funded her to say that basically the base of our diet should be carbs, and the base our diet to be grains, and we should fear fat. And really, we should fear a lot of natural foods in favor of grains. And her research, she claims credit for being the architect of the 1992 food pyramid. And I told her, when we talked last week, I think it’s actually demonstrable that the dietary guidance from the 1990s has been the most destructive public health document in modern history, because they put grains and carbs at the base of the pyramid. And they didn’t differentiate whole grains or refined grains. Why did they do that? That was directly prompted by the food industry, which at the time was the cigarette industry.

Carman asked: “Any of this true?”

Good grief no. Not only are these statements false; they are spectacularly false.

Let’s take them line by line.

Means: In the 1980s, a group called the Sugar Research Council paid her to do a lot of research.

False. In the 1980s, I was teaching nutrition to medical students at the University of California San Francisco (UCSF) school of medicine and running a nutrition education program funded by NIH and, later, by the John Tung Foundation.  To avoid conflicts of interest, I have a long-standing policy of not taking payments from food companies.  The policy is posted on this site here.

Means: And they really funded her to say that basically the base of our diet should be carbs, and the base our diet to be grains, and we should fear fat.

False.  Here, I think he must be referring to the Sugar Research Foundation (SRF) which funded researchers at Harvard who wrote a skewed review of diet and heart disease in the New England Journal of Medicine in 1967; the review downplayed sugar, and emphasized fat. The SRF’s role in this research was exposed in 2016 in JAMA Internal Medicine by Cristin Kearns, Laura Schmidt and Stanton Glantz: Sugar Industry and Coronary Heart Disease Research: A Historical Analysis of Internal Industry Documents.  I wrote the commentary on this study: “Food industry funding of nutrition research: The relevance of history for current debates.”  I also wrote about both pieces on this site.

Means: And really, we should fear a lot of natural foods in favor of grains.

False.  Here, I think, he must be talking about my role as managing editor of the 1988 Surgeon General’s Report on Nutrition and Health. The report summarized the research consensus of that time.

“Fats and cholesterol. Reduce consumption of fat (especially saturated fat) and cholesterol.  Choose foods relatively low in these substances, such as vegetables, fruits, whole grain foods, fish, poultry, lean meats, and low-fat dairy products.”

“Complex carbohydrates and fiber: Increase consumption of whole grain foods and cereal products, vegetables (including dried beans and peas), and fruits.”

The National Academies’ even more comprehensive report, Diet and Health: Implications for Reducing Chronic Disease Risk, made similar recommendations in 1989.

Means: And her research, she claims credit for being the architect of the 1992 food pyramid.

False. I have never claimed such responsibility; I had none. My only role in the 1992 pyramid was to work closely with a reporter for the New York Times, Marian Burros, to expose how the meat industry induced the USDA to suppress the pyramid when it was about to be released in 1991.  I devoted an entire chapter of my book, Food Politics, to providing the evidence for this.

Means: And I told her, when we talked last week, I think it’s actually demonstrable that the dietary guidance from the 1990s has been the most destructive public health document in modern history,

True.  This is what he said and, I assume, is what he thinks.

Means:  because they put grains and carbs at the base of the pyramid. And they didn’t differentiate whole grains or refined grains.

False. The USDA’s pyramid brochure said: “Choose a diet with plenty of grain products, vegetables, and fruits which provide needed vitamins, minerals, fiber, and complex carbohydrates, and can help you lower your intake of fat.”

It also says, “Here are some selection tips: ☛ To get the fiber you need, choose several servings a day of foods made from whole grains, such as whole-wheat bread and whole-grain cereals. ☛ Choose most often foods that are made with little fat or sugars. These include bread, english muffins, rice, and pasta… ☛ Baked goods made from flour, such as cakes, cookies, croissants, and pastries, count as part of this food group, but they are high in fat and sugars.”

Means: Why did they do that? That was directly prompted by the food industry, which at the time was the cigarette industry.

Misleading. Yes, the cigarette industry owned Kraft Foods and other food companies at that time, and taught those companies how to use the tobacco playbook to promote unhealthy products (as we only recently learned).  But the major food industry influences on dietary guidelines and food guides in the 1980s and 1990s were the meat and dairy industries, as I describe in Food Politics. As far as I can tell, they still are, as witnessed by the 2025-2030 guidelines and inverted pyramid.

But that’s not all.  Calley Means said on Instagram: “At @aspenideas, I spoke with @marionnestle – an architect of the 1990s U.S. Dietary Guidelines that led to an explosion of refined carbohydrates and ultraprocessed food in the American diet.”

Misleading again.  I was indeed a member (although hardly the architect) of the 1995 Dietary Guidelines Scientific Advisory Committee.  Here is what the 1995 guidelines said about grains.

“Most of the calories in your diet should come from grain products, vegetables, and fruits These include grain products high in complex carbohydrates—breads, cereals, pasta, rice—found at the base of the Food Guide Pyramid, as well as vegetables such as potatoes and corn. Dry beans (like pinto, navy, kidney, and black beans) are included in the meat and beans group of the Pyramid, but they can count as servings of vegetables instead of meat alternatives.”

Doesn’t this look a lot like what the 2025-2030 guidelines say about grains?  I think it does.

Yes, the 1995 guidelines did not say anything about reducing intake of ultra-processed foods.  How could they? The term was not coined until 2009.

So: Why on earth is Calley Means attacking my work?

I can only speculate.  I see the underlying issue in our current food problems as the food industry having profits to stockholders as its primary fiduciary responsibility, as I have described for decades in my daily newsletter foodpolitics.com, and in my books, most notably,

• Food Politics: How the Food Industry Influences Nutrition and Health
• Soda Politics: Taking on Big Soda (and Winning)
• Unsavory Truth: How Food Companies Skew the Science of What We Eat.

In making false charges, could Calley Means possibly be attempting to deflect attention from the difficulties MAHA is confronting in implementing its agenda? (I will say more about that tomorrow).  Means seems to view me as an appropriate target for deflection.  Obviously, I disagree.

MAHA’s agenda appears to be running up against the pushback that inevitably happens when you do something that might threaten food industry profits. See, for example:

• Food Dive: As MAHA clashes with courts, is RFK Jr’s food policy agenda on life support?
• Food Fix: Major MAHA policy plans now seem less imminent
• New York Times: Has the MAHA movement given up?
• Rolling Stone: Are MAGA and MAHA Heading for Divorce?

A final comment

Reasonable people can disagree about elements of nutrition policy. But reasonable people cannot invent a history that did not exist.

If Calley Means or anyone else believes that I have misrepresented the science or the historical record in my lengthy body of work, show me the evidence. I will be happy to consider it.

That’s how Gold Standard Science works.  Otherwise, it’s just name-calling.

Addition

I was just sent this link to Vanity Fair’s article about Calley Means.

_____________________

Pub date is September 8. Pre-orders through UC Press get a 30% discount. Use promo code UCPSAVE30.

An article in Food Business News caught my eye: The companies most exposed to consumer UPF concerns. 

The article is based on an analysis by BNP Paribus, which tracks the effects of the new dietary guidelines on the food industry.

It looked at the percent of 12 food companies’ products that are ultra-processed (Nova 4 classification).

I had to look up Flowers Foods; they make popular bread brands.

Food Business News reports sales data:

Nova 1 products

• Outsell Nova 4 by 7%.
• Sales up 15% in yogurt, 10% in frozen meals and vegetables, 2.5% in fruit snacks and candy, 2% in nut butters and cereal/granola.

Nova 4 products

• Sales up approximately 2% in yogurt and less than 1% in cereals/granola
• Sales down 2.5% in nut butters, 2% in frozen meals and vegetables, and less than 2% in fruit snacks and candy

Comment

This could indicate a trend toward healthier diets, depending on what else people are eating.

It’s hard to know whether these trends are due to the new Dietary Guidelines, which recommended limits on ultra-processed foods, to the effects of GLP-1 drugs, or to inflation.

Whatever the reason, major food companies making lots of ultra-processed foods seem to be vulnerable right now.

I’m guessing they will be reformulating their products as soon as they can.

The American Journal of Public Health has just published a series of papers on ultraprocessed foods to which I contributed this editorial.  These papers are released today as part of the launch of new initiative, FedUP! aimed at establishing policies to help reduce consumption of ultraprocessed foods and prevent their harm to health.

Press releases for the series and campaign are here and here (longer, more quotes).  

The other papers are on the AJPH webpage dedicated to this series; all are open access.

Here is the recording of the press conference.

Press coverage is here.

And here is my editorial.

The Politics of Ultraprocessed Foods: Dietary Guidelines for Americans

Marion Nestle, PhD, MPH

On January 7, 2026, the Trump administration’s Departments of Health and Human Services (HHS) and Agriculture (USDA) jointly released the 2025–2030 Dietary Guidelines for Americans. For the first time since they were established in 1980, these called for “a dramatic reduction in highly processed foods laden with refined carbohydrates, added sugars, excess sodium, unhealthy fats, and chemical additives.” The actual guideline, one of eight, says “Limit highly processed foods, added sugars, & refined carbohydrates.” ¹

Although these statements do not use the term “ultraprocessed,” that is clearly what they mean. The guidelines are based on a commissioned scientific foundation report that refers repeatedly to ultraprocessed foods and cites major studies of their health effects.² Those studies, largely observational, used the Nova classification system to divide foods into four categories based on their degree of processing: unprocessed or minimally processed (Nova 1), processed culinary ingredients (Nova 2), processed (Nova 3), and ultraprocessed (Nova 4).³ The scientific foundation report notes three reasons for avoiding the Nova 4 term: no consensus definition of “ultraprocessed” exists, defining refined starches and sugars as Nova 2 underestimates dietary intake of Nova 4 foods, and the Nova system classifies some nutrient-dense foods as ultraprocessed. On this basis, the guidelines use “highly processed” as a euphemism.

Even so, the very mention of processing in the US dietary guidelines must be considered an important forward step. In advising limits on highly processed foods, HHS and USDA reversed the decision made by the Biden administration’s Dietary Guidelines Advisory Committee (DGAC). That committee judged the category of ultraprocessed to be too ambiguously defined, and the observational evidence for its harm to health too subject to error, to warrant an “eat less” recommendation.⁴ I view this decision as overly cautious. Yes, observational studies can only demonstrate association, not causation, but of more than 100 studies of ultraprocessed diets and health, nearly all found such diets to increase risks for chronic disease and overall mortality.³

Furthermore, the DGAC excluded consideration of the one exceptionally well-controlled randomized clinical trial available at the time. The participants in that study were housed in a metabolic ward—they could not lie or cheat about what they were eating—and given a diet of either minimally processed or nutritionally comparable ultraprocessed foods. The study results were unexpected and dramatic; the participants consumed an average of 500 calories a day more on the ultraprocessed diet, without realizing it.⁵ The DGAC eliminated this trial from consideration because it had set criteria for inclusion that required studies to last longer and involve more participants.⁶ I thought the DGAC should have made an exception for this trial; metabolic ward studies are enormously expensive and few human volunteers are willing to be locked in one for more than a few weeks.

At issue is the preponderance of research; scientists can interpret it differently. The Trump administration’s commissioned research review found “robust and consistent adverse associations between HPF [highly processed food] consumption and a broad range of chronic health outcomes, often in a dose–response fashion,” and concluded that “the current evidence base provides a strong rationale for immediate action at the individual, population, institutional, and policy levels.”⁷ Many researchers and nutrition professionals, including me, agree with this assessment.⁸

This guideline is new, but most of the other 2025 dietary guidelines are consistent with long-standing scientific consensus on the benefits of eating more vegetables, fruits, and whole grains, and limiting intake of added sugars, sodium, and alcohol, although they call for greater restriction of sugars and less precise (vague) restriction of alcohol. The guidelines sharply diverge from consensus in recommending a doubling of protein—a euphemism for meat—and in not emphasizing plant foods more strongly. They promote greater intake of meat along with full-fat dairy, butter, and beef tallow, but inconsistently limit saturated fat to 10% of calories.¹

The agencies’ fact sheet makes the politics explicit; it uses the word “evangelizing.” Its major point: previous governments have lied to you about dietary risks, and you need to take personal responsibility for what you eat. In doing so, the guidelines reject concerns about health equity—and, therefore, policies that might address social determinants of health—as deserving of consideration.⁹ Despite promises that the guidelines would be free of conflicts of interest, four of the nine writers of the research reviews report financial ties to meat and dairy industry groups, and three more disclose ties to other food industries.³ The conflicted interests and emphasis on animal-based foods make these guidelines appear to have been captured by the meat and dairy industries.¹⁰

I cannot determine whether these guidelines were influenced more by corporate capture or by the personal ideologies of the agency secretaries; they, after all, selected the individuals who wrote the research reviews and are responsible for what the guidelines say. I also do not know how even “highly processed” made it into the guidelines in the face of what surely must have been intense food industry opposition. The food industry, joined by some nutrition scientists, much prefers guidelines based on nutrient content: sugar, salt, fat. Doing so permits the few frequently cited nutrient-dense Nova 4 products—some whole wheat breads, yogurts, and power bars, and plant-based meats—to be considered processed, not ultraprocessed.

Critics of the ultraprocessed concept endlessly invoke the same arguments: there is no scientific consensus on the meaning of the term, and the concept risks undermining “established, evidence-based nutrition strategies,” thereby shifting “the focus away from the most important thing about food which is the nutrition aspect.”¹¹ But thoughtful rebuttals to these arguments note that food misclassifications do not appear to change study conclusions; well-controlled clinical trials have now been repeated with similar, biologically plausible results; the mechanisms of action of ultraprocessed foods are under study; and even “healthy” ultraprocessed foods induce greater calorie consumption.²

Behind food industry arguments is the enormous profitability of ultraprocessed products. Indeed, the very purpose of ultraprocessing is profit maximization—using low-cost ingredients to create irresistible and long-lasting products—so much so that this goal is built into its Nova definition.^2,9 The food industry’s objection to the inclusion of processing as a consideration in dietary guidelines comes down to this: eating less is bad for business.

The call for limits on ultraprocessed foods may be groundbreaking in US dietary guidelines, but in 2015, Brazil issued guidelines that included advice to “Make natural or minimally processed foods the basis of your diet.”¹² Unlike US guidelines. these were based on the idea that healthy diets should derive from socially and environmentally sustainable food systems. This is a major conceptual difference from the US approach, which emphasizes personal responsibility above all others.

When individuals are deemed entirely responsible for their own dietary intake, government policies need focus only on education. If objections to the guidelines from the food industry have been mild so far, it is surely because its leaders know that education is not enough to change dietary behavior. They much prefer education to policies aimed at regulating product contents and marketing. But to really help people reduce intake of ultraprocessed foods, we need a wide range of policy options—taxes, subsidies, marketing, procurement, product placement¹³—aimed at making healthier foods more available, accessible, and affordable.

ABOUT THE AUTHOR

Marion Nestle is with the Department of Nutrition and Food Studies, New York University, New York, NY.

Correspondence

Correspondence should be sent to Marion Nestle, Department of Nutrition and Food Studies, New York University, New York NY 10003 (e-mail: marion.nestle@nyu.edu). Reprints can be ordered at http://www.ajph.org by clicking the “Reprints” link.

DOI: https://doi.org/10.2105/AJPH.2026.308530

CONFLICTS OF INTEREST

Marion Nestle earns honoraria from lectures and royalties from books about the politics of food.

REFERENCES

1. US Dept of Health and Human Services and US Dept of Agriculture. Dietary Guidelines for Americans, 2025-2030.  Available at: https://cdn.realfood.gov/DGA.pdf.  Accessed April 4, 2026.
2. US Dept of Health and Human Services and US Dept of Agriculture. The scientific foundation for the dietary guidelines for Americans, 2025–2030. Available at: https://cdn.realfood.gov/Scientific%20Report.pdf. Accessed March 4, 2026.
3. MonteiroCA, LouzadaML, Steele-MartinezE, et al. Ultra-processed foods and human health: the main thesis and the evidence. Lancet. 2025;406(10520):2667–2684. https://doi.org/10.1016/S0140-6736(25)01565-X
4. US Dept of Health and Human Services and US Dept of Agriculture. Scientific Report of the 2025 Dietary Guidelines Advisory Committee. Dec 2024. Available at: https://www.dietaryguidelines.gov/2025-advisory-committee-report. Accessed April 3, 2026.
5. HallKD, AyuketahA, BrychtaR, et al. Ultra-processed diets cause excess calorie intake and weight gain: an inpatient randomized controlled trial of ad libitum food intake. Cell Metab. 2019;30(1):67–77.e3. https://doi.org/10.1016/j.cmet.2019.05.008
6. LaMotteS. They’re up to 70% of the American diet. But the US has no policy on ultraprocessed foods. CNN Health. November 22, 2024. Available at: https://www.cnn.com/2024/11/22/health/ultraprocessed-food-us-dietary-guidelines-wellness. Accessed February 27, 2026.
7. GoranM. Appendix 4.1. In: U.S. Dept of Health and Human Services and U.S.Dept of Agriculture. Impact of highly processed foods on multiple health outcomes: umbrella review of prior meta-analysis.The Scientific Foundation for the Dietary Guidelines for Americans: Appendices. Jan 7, 2026. Available at: https://cdn.realfood.gov/Scientific%20Report%20Appendices.pdf. Accessed April 3, 2026.
8. BakerP, SlaterS, WhiteM, et al. Towards unified global action on ultra-processed foods: understanding commercial determinants, countering corporate power, and mobilising a public health response. Lancet. 2025;406(10520):2703–2726. https://doi.org/10.1016/S0140-6736(25)01567-3
9. US Dept of Health and Human Services and US Dept of Agriculture. Fact sheet: Trump administration resets US nutrition policy, puts real food back at the center of health. January 7, 2026. Available at: https://www.hhs.gov/press-room/fact-sheet-historic-reset-federal-nutrition-policy.html. Accessed February 27, 2026.
10. NevesFS, NilsonEAF, MendesLL, et al. The 2025–2030 US Dietary Guidelines: an analysis of scientific integrity and global health governance. Lancet Reg Health Am. 2026;56:101402. https://doi.org/10.1016/j.lana.2026.101402
11. Food Navigator—Europe. Industry takes aim at Lancet’s deadly UPF report. November 20, 2025. Available at: https://www.foodnavigator.com/Article/2025/11/20/lancet-upf-report-sparks-industry-pushback-over-policy-and-evidence-gaps/#:~:text=Most%20question%20the%20scientific%20basis,clarity%20instead%20of%20damning%20reports. Accessed February 27, 2026.
12. Brazil Ministry of Health. Dietary guidelines for the Brazilian population. 2015. Available at: https://bvsms.saude.gov.br/bvs/publicacoes/dietary_guidelines_brazilian_population.pdf. Accessed February 27, 2026.
13. ScrinisG, PopkinBM, CorvalanC, et al. Policies to halt and reverse the rise in ultra-processed food production, marketing, and consumption. Lancet. 2025;406(10520):2685–2702. https://doi.org/10.1016/S0140-6736(25)01566-1

The True Health Initiative held its 2nd Annual Global Health Misinformation Symposium, in which I participated.  The papers from the symposium have just been published in the American Journal of Health Promotion.  They are available under the heading “Knowing Well, Being Well” on the journal’s site.  All are open access.  My contribution is here.

Food Politics in an Era of Misinformation

Marion Nestle, PhD, MPH

I usually do posts about conflicts of interest on Mondays, but wanted to acknowledge the death of Carlo Petrini right away this week.  So here’s the Monday post.

David A Cleveland, Research Professor in the Department of Geography, and Environmental Studies, University of California, Santa Barbara, sent this one:

Skimming through this I found an emphasis on ‘nuance’, obscuring key distinctions, and calls for more research, while giving little attention to the fundamental basics that could be the basis for nutrition + env dietary guidelines, e.g. that same nutrients from animal-source foods have much higher climate and environmental impact than those nutrients from plant foods, or imported and off-season produce has higher impact than local in season.

The study: Conrad, Z. 2026. Should the Dietary Guidelines for Americans include sustainability? A critical perspective. The American Journal of Clinical Nutrition:101309. DOI: https://doi.org/10.1016/j.ajcnut.2026.101309.

Its conclusion: “The federal government, which has responsibility for translating the scientific evidence into publicly accessible dietary guidance, is not currently well-positioned to communicate the nuances of nutrition-sustainability science to the general public.”

Conflict of interest: “ZC has received research awards for diet sustainability projects from the United States Department of Agriculture (Pulse Crop Health Initiative), the Jeffress Trust Awards Program for Research Advancing Health Equity, American Pistachio Growers, the National Dairy Council, and the National Pork Board.”

Comment: The beef industry did not pay for this commentary and neither did the dairy industry, both big contributors to greenhouse gas emissions.  The author reports working on sustainability projects for the dairy and pork industries, and understands the financial connections as posing conflicted interests, which they most certainly do.

The study begins with a useful review of attempts to get sustainability into the dietary guidelines, starting with the groundbreaking 1980 paper by Joan Gussow and Kate Clancy, “Dietary Guidelines for Sustainability” [16].  It covers the valiant attempt by the 2015 Dietary Guidelines Advisory Committee to recommend consideration of sustainability when making recommendations about intake of red meat. (here’s my version of that bizarre saga).  But the author concludes that we just don’t know enough about sustainability to make such recommendations.  I think we do.

Mehmet Oz’s Centers for Medicare & Medicaid Services (CMS) sent a memo to hospitals last week, telling them to align their food service policies and practices with the 2025–2030 dietary guidelines (see announcement in video).

Hospitals should:

• Limit ultra-processed food options for patients.
• Eliminate sugar-sweetened beverages unless clinically appropriate in limited scenarios.
• Eliminate refined grains and replace them with 100% whole grains.
• Prioritize minimally processed protein sources, including plant-based options.
• Emphasize vegetables, fruits, legumes, nuts, seeds, seafood, and healthy fats.
• Ensure baked, broiled, roasted, stir-fried, or grilled vegetables and proteins – and eliminate deep fried cooking methods
• Eliminate processed meats and foods high in added sugars, sodium, and artificial additives.
• Ensure meals contain less than 10 grams of added sugar, unless clinically appropriate.

These sound terrific!

According to RFK Jr’s advisor, Calley Means, these guidelines will be enforced.

Hospital food, of course, has been criticized heavily for decades.  A hospital director once explained to me that it was the only place in his budget that was discretionary, the only option he had for cutting spending, which he did.

But as always, the situation is complicated and the devil is in the details. Kevin Klatt, a nutrition professor in Toronto, questions on his Substack whether this is “anything more than the nutrition political theatre that we’ve come to expect from this federal administration/MAHA?”

He reviews the regulatory issues but also points out that clinical (hospital-based) nutrition is not the same as public health nutrition.

Patients who are acutely ill and hospitalized are not the general public that the DGAs are made for…Patients who are hospitalized often have conditions that impact their nutritional requirements, alter their ability to digest, absorb, and assimilate nutrients, and major barriers to consuming a normal diet – everything from altered taste and smell to the inability to chew and swallow…It’s clear no clinical dietitians…were in the room when this memo was put out…or it was always meant as more political performance before the midterms, as RJK Jr is being encouraged to quiet down on vaccines and play to his foodie base.

Yes, clinical dietitians must deal with their patients’ needs.

But surely these rules ought to apply to the hospital cafeterias and vending machines that serve visitors and staff.  That alone would be a big step forward.

Here too, I can’t wait to see how it all plays out.

The American Heart Association has just published its updated dietary guidelines: The 2026 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association  [the press release is here].

These constitute a firm rebuttal to the MAHA (Make America Healthy Again) guidelines issued in January.

The AHA’s clear and straightforward messages are beautifully illustrated:

The AHA messages particularly differ from the MAHA messages:

• Protein: Plant rather than animal sources
• Meat: Lean cuts, avoid processed, limit portions
• Dairy: Low-fat or fat-free rather than full-fat
• Fats: Unsaturated rather than saturated; nontropical oils rather than animal fats and tropical oils

The Wall Street Journal summarized the differences in its headline: Heart Association clashes with RFK, Jr over red meat, dairy, and beef tallow.

The recommendations, released Tuesday by the association, contrast with dietary guidelines that the Trump administration introduced earlier this year. The differences add to disagreements between the federal government and mainstream medical groups on medicine and nutrition advice, after the Health and Human Services Department under Health Secretary Robert F. Kennedy Jr., for instance, sought to dial back vaccine recommendations and President Trump told pregnant women to minimize Tylenol use.

I suppose clashing is a matter of perception, but the differences are real.

Earlier, Calley Means had posted a more gracious response:

Wow!  Applause to the American Heart Association.  Let’s hope its graphic replaces the meat-heavy inverted pyramid and ends up in all the textbooks.

One last point: This is dietary advice for heart disease prevention, but it works for everything else too—obesity, other major chronic diseases, overall longevity, and while it’s at it, planetary as well as human health.