New dietary guidelines are due out this fall, and based on public comments by Health Secretary Robert F. Kennedy Jr., they could amount to a radical departure from what Americans have seen in years past.
The Department of Health and Human Services and the U.S. Department of Agriculture — the two agencies that issue the guidelines — update them every five years to reflect the latest research findings.
Typically, they follow many of the recommendations of a scientific advisory committee that spends about two years reviewing the evidence and compiling a dense scientific report.
The advice in the 2025 scientific report hasn't changed much from previous years. It emphasizes consuming fruits and vegetables, lean meat, legumes and whole grains, and avoiding too much saturated fat, added sugar and refined carbs.
But Kennedy has strong views about food and has made no secret of his disdain for the existing guidelines.
In public appearances, he has disparaged the process for developing them and seems to conflate the 2025 scientific report with the actual guidelines, calling the document "incomprehensible" and "Biden guidelines." (In reality the most recent guidelines were issued in 2020 during President Trump's first term.)
And Kennedy has pledged the upcoming ones will be a mere four to six pages, with a focus on "whole foods, healthy foods and local foods."
If he follows through on this promise, it will cause "substantial chaos," says Kevin Klatt, a nutrition research scientist at UC Berkeley.
Many people still think of the dietary guidelines as synonymous with the food pyramid, which was phased out more than a decade ago in favor of a new graphic called "MyPlate." In reality they function primarily as a policy document.
They contain specific terminology and targets for calories and nutrients that guide federal food aid for mothers and infants, free school lunches, and what's served in military bases and federal prisons.
"Replacing that with a four-page consumer-oriented document telling people to eat 'whole foods' and 'unprocessed foods,' none of which has a real definition?" says Klatt. "There's no way that that can hold any policy weight."
Emily Hilliard, press secretary for the Department of Health and Human Services, did not offer any details to NPR about who is writing the guidelines or what will be in them, but instead referred to the MAHA strategy report and said they "will align with science, data, and health recommendations in a concise, user-friendly format."
There's no disagreement with the idea that the quality of the American diet is very poor, in particular because of its reliance on refined starches and added sugars, says Frank Hu, who chairs the department of nutrition and epidemiology at Harvard University.
"The question is how to deal with it?" he says.
As it stands, most of the public doesn't actually follow the guidelines.
The Trump administration has attributed this, in part, to the "technical language" they're written in. But Klatt says changing how Americans eat and reducing obesity and diet-related diseases requires much more than giving people a few pages of advice.
While influential for federal policy, the guidelines can't, on their own, radically reshape the broader food landscape, which is driven by social and economic factors.
"I think that's a fantasy," says Klatt. "We've been saying to eat less sugar since the 1980 dietary guidelines."
And yet Kennedy has promised big changes, some of which could trigger heated debate. So, cue the sound of sizzling beef tallow and check out what might be in store.
Saturated fat and meat could get another look
Overhauling standard advice on saturated fat would be controversial.
The guidelines have long advised limiting saturated fats like those found in red meat, to less than 10% of daily calories because of evidence showing this kind of fat can increase cholesterol, which can increase heart disease risk.
And the 2025 review of the evidence came down squarely behind the current guidelines, issued five years ago.
But Kennedy has made no secret of his affinity for meat and the saturated fat that comes along with it, describing his own eating habits as "a carnivore diet."
He's touted Thanksgiving turkey fried in beef tallow, and in March sat down for burger and fries at a Steak 'n Shake in Florida to highlight their switch from cooking with vegetable oil to beef tallow. At a July meeting with governors in Colorado, he said the new guidelines would be "common sense" and "stress the need to eat saturated fats," including dairy, "good meat, fresh meat and vegetables."
Thought leaders in the MAHA movement argue that animal products have been vilified, and some advocate for low-carb, higher fat diets like the ketogenic diet or the carnivore diet.
And in recent years, researchers have started looking into low-carb, higher fat diets, with some studies finding improvement in markers of cardiovascular health, though more research is still needed.
The evidence for the link between saturated fat and cardiovascular disease began with studies in the 1950s when Americans ate more red meat. Then in the diet craze of the 1980s, marketers pushed a lot of low-fat snack foods that were high in refined carbohydrates and sugar. But swapping fat for sugar and empty carbs is also problematic, and it has been complicated to untangle the effects of ever-changing dietary patterns.
Instead of saturated fat, the current guidelines encourage eating foods that are high in unsaturated fat, including nuts, avocados and olive oil, which are linked to lower cardiovascular risk.
At this point, Frank Hu of Harvard doesn't see a rationale to "make a major shift" in dietary recommendations.
"Has the science really changed that much in the last 20 years in terms of saturated fat? Not really," he says.
Whole fat dairy vs. skim milk
Alongside his embrace of meat, Kennedy has also championed full-fat dairy products, saying he plans to end the "attack on whole milk, cheese and yogurt" in the new guidelines.
That comes after decades of the American public being told to opt for fat-free or low-fat dairy, largely out of concern for the amount of saturated fat in these foods.
As with saturated fat, it has been difficult to parse the complex relationships between dairy fat, cholesterol and cardiovascular risk, leading some researchers to rethink the issue.
Richard Bruno, a professor of human nutrition at The Ohio State University, says there's evidence suggesting "consuming saturated fat from dairy foods doesn't seem to be behaving the way we think it should behave, based on the historical evidence that [it] is linked to heart disease."
Bruno is among the researchers who argue the data don't support the existing recommendation to favor low-fat dairy.
Because dairy is such a broad category, it's challenging to make sweeping statements, argues Benoît Lamarche, who directs the Nutrition, Health and Society Center in Quebec. He was part of a recent effort to gather experts and review all the data on dairy fat and cardiometabolic health. He says they concluded there's not enough evidence to support an exclusive recommendation for either type of dairy.
On the other hand, Hu still thinks it's wise to avoid too much full-fat dairy because it comes with more overall calories and saturated fat.
But he says the bigger problem is that many Americans eat dairy in the form of pizza, burgers, and other foods that are "loaded with sodium, refined starch and processed meats."
Beans and legumes may get dissed
This year's scientific report recommends the protein section of the dietary guidelines be changed to emphasize eating more beans, peas and lentils, while cutting back on red and processed meats.
Given Kennedy's stance on animal products, Christopher Gardner, the director of nutrition studies at the Stanford Prevention Research Center, who helped write the scientific advisory report, says he's concerned the guidelines will instead emphasize meat consumption.
That's unfortunate, he says, because the proposed change was based on a careful review of research. Gardner says if people replace some of the meat in their diet with beans and other legumes, they consume less saturated fat. "Beans are a great source of fiber — meat has none — and a great source of plant protein," he told NPR. Less than 10% of Americans get enough fiber in their diets.
In one hint at how the MAHA movement sees the issue, science writer Nina Teicholz wrote an op-ed in the Wall Street Journal titled "Meat Will Make America Healthy Again" urging Kennedy and Agriculture Secretary Brooke Rollins to reject the recommendation to emphasize plant-based proteins. Teicholz founded the Nutrition Coalition, which lobbies for changes to the dietary guidelines. In her op-ed she argues that "most plant-based proteins lack at least one of the nine essential amino acids" and are harder to absorb.
But Gardner points out you can get all your essential amino acids from a plant diet by eating a variety of plant foods. And though most plant proteins may not be "complete" in the way animal proteins are, he says, the body absorbs amino acids from different foods eaten throughout the day. Diets rich in plant proteins are linked to less chronic disease.
Ultraprocessed food in the spotlight
Kennedy has been sharply critical of ultraprocessed foods, saying they're "poisoning" Americans and blaming them for the chronic disease epidemic. And the recent MAHA Commission report states that they've led "to nutrient depletion, increased caloric intake, and exposure to harmful additives."
The Trump administration committed to developing a "government-wide definition" for ultraprocessed food.
But in the dietary guidelines advisory report, the scientific committee didn't make any explicit recommendations on the topic.
"We did say there was a relationship between consumption of ultraprocessed foods and health outcomes, and specifically to growth, body composition, and obesity, but the relationship was limited," says Deanna Hoelscher, who's at the UTHealth Houston School of Public Health and was a member of the 2025 dietary guidelines committee.
The report authors noted there are few rigorous trials on these foods and varied ways to define them, making it hard to draw firm conclusions across studies.
Barbara Schneeman, who chaired the 2020 scientific committee, says concerns about ultraprocessed food are twofold: There are the ingredients and then there's the actual processing.
"If you look at the key things in the dietary guidelines, they address limiting the intake of added sugars, saturated fat, the same with sodium," she says, "But we really have little to no information on the processing side of it."
And there are concerns about the impact of any new definition of ultraprocessed foods. Susan Mayne, an epidemiologist at the Yale School of Public Health and former Food and Drug Administration official, says such a definition needs to avoid sweeping up foods that "are actually beneficial for our health" even if they have some processed ingredients, such as certain yogurts or whole-grain breads.
Softening alcohol guidance?
It's unclear where the new guidelines will land on alcohol but the lead up to weighing the issue has sparked controversy.
A growing body of research points to a link between alcohol consumption and an increased risk of cancer, stroke and premature death. What's still debatable is the exact threshold at which risks increase.
The current guidelines advise up to one drink a day for women and two for men.
In crafting the new guidelines, the federal government was expected to consider two separate reviews of the evidence on alcohol and its health effects. One found health risks start to increase "even at relatively low levels of alcohol consumption."
Trade groups representing the alcohol industry were quick to criticize that study after the draft was released in January — and called for it to be "disregarded."
And that seems to have happened. Katherine Keyes, an epidemiologist at Columbia University, who helped analyze the data, says in August the authors learned their study would not be considered for the dietary guidelines.
"To not even evaluate the evidence we have seems like a real missed opportunity," she says.
Meanwhile, the other report on alcohol — this one commissioned by Congress and done by a committee at the National Academies of Sciences, Engineering and Medicine — couldn't make any conclusions about alcohol with "high certainty" because of concerns about the quality of evidence.
It concluded that moderate drinking was associated with a lower risk of dying, including from cardiovascular related events like heart attacks. It also showed, with moderate certainty, that drinking was linked with a higher risk of breast cancer.
Those findings don't support actually recommending alcohol for health, says Dr. Ned Calonge, an epidemiologist at the Colorado School of Public Health who chaired the NASEM committee, but he cautions against making blanket statements like there are no "safe levels of alcohol."
Mike Marshall, who leads the U.S. Alcohol Policy Alliance and advocates for more public awareness around the harms of drinking, worries industry pressure will lead to a softer recommendation in the guidelines.
"This is a major crisis and to be focused on making America healthy again without addressing alcohol is inexplicable to me," he says.
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