A Rare Reset in Dietary Guidelines

By Bret Scher, MD

The Departments of Health and Human Services and Agriculture just released the 2025-2030 Dietary Guidelines for Americans, resetting the federal nutrition advice that shapes how Americans eat.

As a physician, I have seen firsthand how federal recommendations emphasizing low-fat, carbohydrate-heavy diets coincided with skyrocketing rates of obesity and diet-related disease.

Against that record, the updated guidelines represent a much-needed course correction.

By refocusing on whole foods from both plant and animal sources, the guidance centers nutrient density and food quality — recognizing vegetables and fruits alongside meat, poultry, fish, eggs, and dairy as core components of a healthy diet.

That emphasis on real, whole foods is reinforced by a restoration of protein to a central role. Treated for years as secondary to carbohydrate intake, the updated guidelines recognize protein’s importance in preserving lean muscle, supporting metabolic health, improving satiety, and promoting healthy aging.

The guidelines also take a more direct approach to refined carbohydrates and added sugars by more clearly acknowledging the metabolic risks of their excess intake.

In fact, for the first time, the guidelines explicitly acknowledge that Americans with certain chronic diseases may benefit from therapeutic low-carbohydrate dietary approaches. That recognition aligns with decades of evidence demonstrating improvement — and in many cases reversal — of conditions such as obesity, type 2 diabetes, hypertension, and fatty liver disease.

This shift is particularly important given today’s health landscape. More than 75% of U.S. adults are overweight or have obesity. Roughly 93% show signs of metabolic dysfunction, and nearly one in three adolescents has prediabetes.

With that in mind, the focus now turns to implementation. That work should include clearer guidance on tailoring fat, protein, and carbohydrate intake to individual needs.

This need for clarity is especially evident when it comes to dietary fat. The guidelines’ emphasis on whole, nutrient-dense foods — including meat, fish, eggs, and dairy — is welcome. At the same time, the long-standing recommendation to limit saturated fat to 10% of daily calories — which these guidelines retained — will require careful interpretation in the context of whole food sources and overall dietary patterns.

For Americans following lower-carbohydrate approaches, who rely more heavily on protein and fats for energy as they reduce carbohydrate intake, rigid fat caps can make these diets harder to follow.

Other areas would also benefit from continued refinement. The updated guidelines still recommend two to four servings of grains per day. In practice, particularly within federal programs, this can shape implementation choices that favor refined and processed grain products over truly fiber-rich whole foods.

On the implementation side, a similar opportunity exists with added sugars. While the new guidelines don’t outright ban added sugars, they clarify that no amount is recommended as part of a healthy diet. Ideally, school lunch programs should respond by further limiting sweetened cereals, sugary yogurts, and flavored milk, especially as childhood obesity and metabolic disease rise.

The 2025-2030 Dietary Guidelines mark real progress. They recognize the central role of diet quality, acknowledge the importance of metabolic health, and move federal nutrition policy closer to what modern science and clinical experience support.

The task now is to build on that progress through thoughtful implementation and continued refinement. Nutrition policy should help Americans prevent and manage chronic disease — and these guidelines provide a strong foundation to do so.

Bret Scher, MD, is a board-certified cardiologist and lipidologist and the founding medical director of the Coalition for Metabolic Health. This piece originally ran in RealClearHealth.