by Marion Nestle

Currently browsing posts about: Dietary-Guidelines

Jun 3 2026

American Journal of Public Health series on Ultraprocessed Foods: My Editorial

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
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Jun 2 2026

American Journal of Health Promotion: papers on misinformation: my latest

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 write books about the politics of food, most recently What to Eat Now. When my first book on the topic, Food Politics: How the Food Industry Influences Nutrition and Health, appeared in 2002, the first question everyone asked me was “What does food have to do with politics?” But since President Donald Trump appointed Robert F. Kennedy Jr as Secretary of Health and Human Services, I am no longer asked that question. Trump introduced Kennedy’s nomination with this statement: “For too long, Americans have been crushed by the industrial food complex and drug companies who have engaged in deception, misinformation, and disinformation when it comes to public health.”1 It is now more obvious than ever that just as food has cultural, religious, and socioeconomic dimensions, it also has political dimensions. Here, I present examples of how politics affects food choice in three areas especially vulnerable to misinformation: food and nutrition research, ultra-processed foods, and dietary guidelines.

Food and Nutrition Research

Food companies are not social service or public health agencies; their primary, first-priority job is to generate profits for shareholders. One way food companies express this priority is to sponsor research. But industry-funded studies tend to follow what Sheldon Krimsky termed the “funding effect”—industry-funded studies strongly tend to produce results favorable to the sponsor’s commercial interests.2 Such studies are not invariably biased in a corporate-friendly direction; they just are skewed in that direction more often than not. When researching my book on this topic, Unsavory Truth, I was only able to find 11 studies published on the funding effect in food and nutrition research (by 2018). These varied in methods, products, and health effects, but all reported benefits to sponsors’ interests. Recipients of industry funding often appear unaware of the influence of industry funding and deny it. They may conduct their studies according to high scientific standards, but investigations of funding effects demonstrate that the bias mainly shows up in the framing of the research question or in the interpretation of results (null results interpreted as positive, for example). It is one thing to call for open-ended research on diet and health, but quite another to request proposals for research to demonstrate benefits. Food companies are unlikely to sponsor research that might produce unfavorable results.3
Some scientists argue that concerns about funding effects represent ad hominem attacks on researchers. Career goals, scientific beliefs, dietary practices, and belief systems, they insist, are just as biasing as industry funding; disclosure is sufficient to deal with the problem.4 But not all influences in science pose conflicts of interest. All scientists have beliefs about the likely outcome of their research; they have hypotheses they are trying to prove. These beliefs differ among researchers, as do the outcomes of their studies. But with industry funding, the biases are the same; they tend to favor the sponsor’s interests.5 Companies fund studies to “prove” their products are superfoods, or health promoting, or at least not harmful. Industry-funded research is about marketing, not science.

Ultra-Processed Foods

In 2025, The Lancet released three comprehensive reports on the science,6 policy,7 and politics8 of ultra-processed foods (I am a co-author on the last two). The process for producing these reports was lengthy and difficult, not least because the journal’s editors were skeptical of the concept of ultra-processed foods and pushed the authors to clarify the concepts and strengthen the evidence. Eventually the editors were convinced; they introduced the reports with an editorial powerfully titled “Ultra-processed foods: time to put health before profit.”9
Ultra-processed foods were defined by Carlos Monteiro et al in 2009 according to what they called the Nova system, which divides 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 ultra-processed (Nova 4).6,10 Ultra-processed foods are industrially produced, do not resemble the foods from which they were produced, typically contain sugars, salt, and industrial chemicals, and are designed to be irresistible (if not addictive)–and highly profitable. Many studies link diets high in ultra-processed foods to poor health outcomes. Although most of these studies are observational and cannot prove causation, well controlled clinical trials demonstrate that ultra-processed diets induce people to greatly overconsume calories, without realizing it.11 This result alone is reason enough for advice to reduce consumption of ultra-processed foods.
Understandably, the food industry opposes this concept: eating less is bad for business. Food trade associations argue that all foods are processed, processing is necessary, and the concept of ultra-processed is poorly defined, especially because it excludes highly nutritious foods such as commercial whole wheat breads and yogurts. The food industry is joined in these criticisms by some nutrition scientists concerned about inaccuracies in observational studies and the short duration and limited number of subjects in the controlled clinical trials.12 These criticisms hold grains of truth, but the overwhelming preponderance of evidence argues in favor of advice to reduce intake of ultra-processed foods.
The food industry, however, is on the attack. It much prefers education focused on salt, sugar, and saturated fat (encouraging product reformulation) Business advisors call for strongly defending ultra-processed foods in two ways. The food industry should educate the public about the benefits of ultra-processed foods and the flaws in the Nova classification system; it also should conduct its own research to demonstrate those benefits and flaws13–misinformation via public relations and funded research.

Dietary Guidelines

The call for education brings me to the 2025-2030 dietary guidelines, supporting documents released on January 7, 2026, and the process used to produce them. When I was a member of the Dietary Guidelines Advisory Committee (DGAC) in 1995, we selected the topics to be researched, did the research, wrote the research report—and wrote the actual dietary guidelines. We turned these documents over to HHS and USDA to be printed. We were fully responsible for their content. That changed in 2005 when the agencies took over writing the guidelines. Since 2010, the agencies have taken over the entire process except for
the DGAC research review. The dietary guidelines are now an almost entirely political—rather than scientific—document.
The DGAC for the 2025-2030 guidelines was appointed during the previous administration; it released its report in December 2024.14 Its recommendations were much like those of previous guidelines since 1980: balance calories; eat more fruits, vegetables, and whole grains; reduce intake of sugars, sodium, saturated fat, alcohol, red and processed meat; choose low-fat dairy. Although this DGAC was asked to consider a recommendation on ultra-processed foods, it chose not to on the basis of flaws in observational data and the short duration of the one, then available, exceptionally well-controlled clinical trial conducted in a metabolic ward.11
The Trump administration’s HHS and USDA, however, rejected most of that report and started over. It gave nine experts three months or less to write their own reviews of the science; these formed the basis of the new guidelines and the new inverted pyramid food guide released under the slogan “Eat real food.” While most of the eight guidelines are similar to those issued previously, one of the differences is advice to limit intake of highly processed foods (a euphemism for ultra-processed). So far, so good.15
Beyond that advice, however, the new guidelines include recommendations less well supported by existing evidence. They call for prioritizing and doubling intake of protein (a euphemism for red meat), consuming whole milk, and choosing “healthy” fats rich in essential fatty acids. Unfortunately, the guidelines’ examples of such fats are olive oil, butter, and beef tallow, none of them good sources of the two essential fatty acids, linoleic and linolenic. Errors like these, confusing messages (add salt, but restrict sodium; eat animal fats but keep saturated fat to 10% or less of calories), and the way animal-source foods are presented in the accompanying website for the inverted pyramid (RealFood.gov), make the guidelines appear to have been influenced by the meat and dairy industries, especially because so many writers of the science summaries reported financial ties to meat and dairy trade associations.16 The guidelines also appear to reflect the dietary ideology of Secretary Kennedy, who consumes a publicly avowed carnivore diet.
The new dietary guidelines are aimed explicitly at personal responsibility for dietary choice. But placing the dietary burden entirely on individuals absolves the government from doing anything other than educate. 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 or marketing. But to really help people eat real food and reduce intake of ultra-processed foods, we need a wide range of policy options—taxes, subsidies, marketing, procurement, product placement7—to make healthier foods more available, accessible, and affordable, so that the healthy choice is the easier choice.

Declaration of conflicting interests

The author receives honoraria for lectures and royalties from books about the politics of food.

Funding

The author received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

References

1. Trump DJ. @RealDonaldTrump; 2024. https://x.com/realDonaldTrump/status/1857170020427595797. Accessed 21 Mar 2026.
Google Scholar
2. Krimsky S. Do financial conflicts of interest bias research? An inquiry into the “funding effect” hypothesis. Sci Technol Hum Val. 2013;38(4):566-587.
3. Nestle M. Unsavory Truth: How Food Companies Skew the Science of What We Eat.. Basic Books; 2018.
4. Cope MB, Allison DB. White hat bias: a threat to the integrity of scientific reporting. Acta Paediatr. 2010;99:1615-1617.
5. Bero LA, Grundy Q, Abelson J, Dobbins M, Carter N, Pavord I. Why having a (nonfinancial) interest is not a conflict of interest. PLoS Biol. 2016;14(12):e2001221.
6. Monteiro CA, Louzada ML, Steele-Martinez E, et al. Ultra-processed foods and human health 1. Ultra-processed foods and human health: the main thesis and the evidence. Lancet. 2025;406(10520):2667-2684.
7. Scrinis G, Popkin BM, Covalan C, et al. Ultra-processed foods and human health 2. Policies to halt and reverse the rise in ultra-processed food production, marketing, and consumption. Lancet. 2025;406:2685-2702.
8. Baker P, Slater S, White M, et al. Ultra-processed foods and human health 3. 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.
9. Lancet. Editorial: Ultra-Processed foods: time to put health before profit. 2025;406(10520):2601.
10. Monteiro CA. Nutrition and health. The issue is not food, nor nutrients, so much as processing. Public Health Nutr. 2009;12(5):729-731.
11. Hall KD, Ayuketah A, Brychta R, 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.
12. Ludwig DS, Willett WC, Putt ME. Concerns over conclusions in an ultra-processed food trial. Nat Med. 2026;32(2):463-464.
13. Southey F. The UPF problem: no more burying heads in the sand. Food Navigator-Europe. 2025. https://www.foodnavigator.com/Article/2025/11/27/food-and-drink-makers-cant-ignore-upf-problem-any-longer/. Accessed 21 Mar 2026.
14. HHS USDA. Scientific Report of the 2025 Dietary Guidelines Advisory Committee. 2024. Accessed Mar 21, 2026. https://www.dietaryguidelines.gov/2025-advisory-committee-report
15. HHS USDA. Dietary guidelines for Americans, 2025-2030. 2026. https://www.dietaryguidelines.gov/. Accessed 21 Mar 2026.
16. Neves FS, Nilson EAF, Mendes LL, Khandpur N, Nestle M. The 2025–2030 US dietary guidelines: an analysis of scientific integrity and global health governance. Lancet Reg Health, Am. 2026;56:101402.
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May 29 2026

Weekend reading: Industry influenced opinion of the week

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.

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Apr 8 2026

HHS issues new guidelines for food served in hospitals

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.

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Apr 7 2026

Dietary guidelines: AHA v. MAHA

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.

In response, senior food advisor to RFK, Jr, Calley Means, posted:

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.

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Feb 27 2026

Weekend reading: My latest publication: Dietary guidelines: Brazil vs. U.S.

I was invited by Brazilian colleagues to collaborate on a brief paper comparing the new US guidelines to those in Brazil.

Neves FS, Nilson EAF, Mendes LL, Khandpur N, Nestle M.  The 2025-2030 US Dietary Guidelines: A retreat from scientific integrity and global health governance.  Lancet Regional Health—Americas.  2026; 56:101402

The United States (US) has recently released the Dietary Guidelines for Americans 2025–2030. While the policy introduces sound recommendations for vegetables, fruits, and whole grains, and limits added sugars and ultra-processed foods (UPFs) (termed “highly processed foods” within the text), it fails to reflect the contemporary scientific consensus by prioritising animal proteins, animal fats, and full-fat dairy products. Additionally, this political position follows a supplementary institutional report that dismisses previous efforts to include health equity and social determinants in the empirical evidence base, labelling such integration a “methodological deficiency”. Consequently, these guidelines depart from the international standards required for non-communicable diseases (NCDs) prevention., Given US normative influence, this regression legitimises corporate interests, threatening transnational health governance and food and nutrition security.
          The inherent contradiction within the 2025–2030 guidelines is profound. By promoting animal-source proteins and full-fat dairy, the document proposes a dietary pattern fundamentally inconsistent with its own goal of limiting saturated fat intake below 10% of total calories. This internal incoherence reflects decision-making that continues to prioritise the economic interests of specific industrial sectors over NCDs prevention. The paradoxical nature of the guidelines is evidenced by the reliance on an anachronistic visual communication tool. While the inclusion of processing-based terminology is a progressive step, the reintroduction of a hierarchical food pyramid model represents a semiotic retreat into a reductionist era of public health. This abstraction fails to capture the complexity of modern food systems or the distinction between food types and the extent of industrial processing. While the international community moves towards representations emphasising fresh foods and the social context of eating, the US return to a pyramid isolates nutrients from the food matrix.
           In sharp contrast, the Dietary Guidelines for the Brazilian Population remains the gold standard for food and nutrition frameworks. Published in 2014, the Brazilian approach introduced an epistemological shift away from the dominant reductionist paradigm by moving dietary advice towards the degree and purpose of industrial food processing. This strategy, facilitated by the Nova classification system, acknowledges that industrial alterations to food matrices have wide-reaching implications for biological integrity, metabolic health, social structures, and environmental sustainability.
            As Table 1 illustrates, the contrast between the US and the Brazilian standards is defined by their diverging methodological and conceptual foundations. By prioritising an adequate and healthy diet centred on fresh and minimally processed foods, Brazil provides a robust template for addressing the interactions between human biology, cultural identity, and planetary health, achieving maximum scores across metrics of public health and sustainability.,,
Feature Dietary Guidelines for Americans 2025–2030 Dietary Guidelines for the Brazilian population
Guiding paradigm Focus on nutrient density and individual responsibility; health is framed as a matter of personal choice and moral deficit. Multidimensional approach integrating biological, social, and environmental health; focus on food systems and collective well-being.
Scientific integrity Supplementary report authored by experts with documented conflicts of interest with the beef, dairy, and food industries. Independent process led by academic researchers, strictly free from commercial influence and industry sponsorship.
Classification system Traditional food groups with an absence of technical criteria for industrial processing; focus remains on isolated nutrients. Nova classification categorising foods by the degree and purpose of industrial processing (fresh and minimally processed foods, culinary ingredients, processed foods, and UPFs).
Visual communication Reintroduction of an anachronistic hierarchical food pyramid model, representing a semiotic retreat into reductionism. Rejection of the pyramid in favour of food-based representations that emphasise meals and the social context of eating.
Core recommendations Prioritisation of animal proteins and full-fat dairy; selective recommendations against processed products. Dietary foundation of fresh, plant-based foods and the categorical avoidance of UPFs.
Saturated fat management Mathematical paradox between a 10% intake limit and the promotion of animal fats; absence of guidance on unsaturated fat substitution. Achieved through patterns based on fresh foods; explicit emphasis on replacing animal fats and UPFs with plant-based oils and whole foods.
Environmental sustainability Omission of the climate crisis and planetary boundaries from the policy framework; silence on the environmental impact of livestock. Sustainability as a core principle; promotion of biodiverse, just, and resilient food systems that respect planetary limits.
Equity and determinants Rejection of the “health equity lens”; social and environmental determinants dismissed as a “methodological deficiency”. Structural pillars: integration of social justice, social determinants of health, and the promotion of food sovereignty.
Global influence and sovereignty Functions as a permissive framework that dilutes the narrative on food sovereignty and serves as a scientific alibi for industrial actors. A paradigm of regulatory sovereignty; provides the conceptual framework for pioneering policies like warning labels and fiscal measures.

Table 1

Conceptual and methodological comparison between the 2025–2030 US Dietary Guidelines and the Dietary Guidelines for the Brazilian Population.
UPFs = ultra-processed foods.
           The conceptual divergence between these frameworks reflects a broader tension between public health principles and the narrative of personal responsibility. By rejecting social and environmental determinants, the 2025–2030 US guidelines shift the entire burden of health onto individual choice, ignoring the structural barriers defining the food environment., The reintroduction of individual responsibility as the central axis of food policy is an ideological framework that converts systemic failures into individual moral deficits, thereby legitimising state regulatory inaction., In an era where NCDs prevention requires robust environmental and policy interventions, the US return to a personal responsibility framework represents a dangerous abdication of the state-led public health mandate.
            The erosion of scientific integrity within the US policy framework is a manifestation of the commercial determinants of health. The formulation of these guidelines suggests a clear case of corporate capture. While official political discourse promises to “Make America Healthy Again” by addressing corporate influence, the supplementary scientific report was authored by experts with documented conflicts of interest with the beef, dairy, and food industries., These commercial interests have effectively undermined the promotion of an adequate and healthy diet. Reversing this trend requires decisive state-led interventions beyond individual choice, necessitating robust policies to restrict UPF production and structural reforms to address the corporate actors dominating global supply.,
            The failure of the 2025–2030 US guidelines to address the environmental dimensions of diet is negligent in an era of ecological instability. While the international community aligns with the EAT-Lancet 2.0 consensus, which emphasises that food systems must operate within planetary boundaries, the US guidelines remain silent on the climate crisis. Transitioning towards plant-forward diets is a foundational requirement for mitigating the environmental degradation caused by intensive livestock systems. The omission of these factors ignores the reality of the Global Syndemic, in which obesity, undernutrition, and climate change are interconnected pandemics driven by the same food system failures. By failing to address environmental impacts, the US promotes a model of consumption linked to planetary health degradation, further endangering global food and nutrition security.
             The axis of scientific integrity has shifted to the Global South, where Latin American nations—including Brazil, Chile, Colombia, Mexico, Peru, and Uruguay—uphold food systems that are socially just and environmentally sustainable. These countries have pioneered transformative interventions, such as Brazil’s focus on food processing, Chile’s warning labels, and UPF taxation in Mexico and Colombia. The political and economic power of the US increases the likelihood that its guidelines will be leveraged by transnational corporations to dismantle these regulations. In international bodies like the Codex Alimentarius, the US framework provides a scientific alibi for industrial actors to dispute sovereign policies, framing evidence-based regulations as barriers to trade. This reflects documented precedents, such as the use of US policy to circumvent international protections for breastfeeding, illustrating how domestic guidelines can function as instruments to impede global health progress.
           Ultimately, the 2025–2030 US Dietary Guidelines do not represent a legitimate departure from scientific progress, but a case of corporate capture with direct implications for national and global morbidity. The World Health Organization, the Food and Agriculture Organization of the United Nations, and the global public health community must act decisively to protect the integrity of dietary guidelines against the corporate concessions represented in the US guidelines, which dismiss established evidence on the health impacts of food processing and social determinants. Transnational health governance must be insulated from the influence of corporations that seek to undermine public health for private gain., Resisting the global influence of this flawed framework is essential to ensure that future generations have access to an adequate and healthy diet that respects both cultural heritage and planetary limits.
           The leadership vacuum created by the US concessions offers a pivotal opportunity for the Global South to redefine public health governance. Latin American nations, supported by regional networks such as the Latin American Inter-institutional Network for Technical Cooperation on Food Environments and the Prevention of NCDs, are already demonstrating the efficacy of science-based, conflict-of-interest-free leadership. Safeguarding global health now requires fostering cross-regional collaborations, securing independent funding, and consolidating Brazil and the region as the pioneers of food system transformation. The era of corporate concessions has ended; the era of evidence-based leadership has begun.

Contributors

FSN conceptualised the study. FSN, EAFN, LLM, NK, and MN performed the formal analysis. FSN drafted the original manuscript. EAFN, LLM, NK, and MN provided critical revisions and edited the manuscript. All authors had full access to all the data in the study and had final responsibility for the decision to submit for publication.

Declaration of interests

The authors declare no competing interests.

Acknowledgements

None.
Funding: This manuscript did not receive any specific funding.

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Feb 20 2026

Weekend reading: Dietary Guidelines from the food industry’s perspective

I subscribe to lots of food industry newsletters from the William Reed company, all of them written by top-notch reporters who cover topics thoroughly and accurately.  They write about things food companies need to know about.  I do too.  I find them invaluable.

For example: It would never have occurred to me to consider how the guidelines might affect forced labor in the food supply chain.

This collection of articles on the new dietary guidelines comes from FoodNavigator-USA.

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Feb 18 2026

What should dietitians/nutritionists say about the new dietary guidelines?

A reader writes (my edit to preserve requested anonymity):

It’s been quite the undertaking to update what to tell patients and clients about the new DGA.  So many resources I’ve always referred to with MyPlate, eating patterns, and more are gone.  I am now having to replace them with other resources and recommendations from the American Heart Association, the Academy of Nutrition and Dietetics, American College of Obstetricians and Gynecologists, and more.  We dietitians are supposed to be fully aligned with the 2025 DGA.  And what about nutrition textbooks?  My suggestion: “integrates the new 2025 DGA through an evidence based lens to foster critical thinking.”

Perfect!  I love “integrates the new 2025 DGA through an evidence based lens to foster critical thinking.”

That’s what we all need to be doing with students, patients, clients, colleagues, friends, and family.

Let’s hear it for critical thinking!

Resource

I’ve been sent a link to a webinar on precisely this topic.  I haven’t had a chance to watch it yet but I sure hope the speakers got into the weeds.

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