Every 5 years around June, I write an article about the Dietary Guidelines for Americans. This is because they are reviewed every five years to advise on what Americans should eat to prevent chronic disease. They were first released in 1980, yet the U.S. obesity rate has tripled since then.

The recommendations were designed primarily for healthy bodies, which most Americans don’t have. Not only are 74% of us overweight or obese, but about 40% are insulin-resistant or pre-diabetic. Only around 12% of Americans are metabolically healthy. The guidelines don’t account for the dysfunctional metabolic state of our bodies and frankly assume that people live a healthy lifestyle that consists of frequent exercise and minimal stress.

These Dietary Guidelines are used by professional associations such as the American Medical Association and the American Diabetes Association. They are used to determine what foods to feed our children (National School Lunch Program), what military rations consist of, and what foods are available on SNAP (Supplemental Nutrition Assistance Program) and WIC (Special Nutritional Program for Women, Infants and Children). Feeding programs for the elderly are also based on the Dietary Guidelines. So even though most Americans may know very little about the actual Guidelines, they are used to sculpt advice from medical professionals and even what foods are available to anyone that is fed by a government program.

From the original food pyramid in 1992 to the introduction of MyPlate in 2011, the recommendations have included large portions of processed carbohydrates. Americans suffering from insulin resistance, obesity and diabetes need less carbohydrates in their diets. Excessive carbohydrate intake fuels high insulin levels, as insulin manages the rise in blood sugar caused by carbs. High carbohydrate consumption reduces the clearance of insulin from the body, which further increases blood lipid levels. A 2024 study found that insulin levels rose from 28% to 41% between 1998 and 2018.

There is plenty of evidence to support the notion that when metabolically vulnerable people consume less carbohydrates, their insulin levels decrease. Yet until recently, doctors and scientists advocating low-carb diets were viewed skeptically by the nutrition and cardiology communities.

Processed carbohydrates, often sugar, are particularly damaging and not to be confused with healthy high-fiber carbohydrates in fruits and vegetables. Processed carbs are packed with energy and are absorbed rapidly into the bloodstream, adding to the metabolic chaos.

The current dietary guidelines recommend that 45% to 65% of daily calories come from carbs. That percentage is too high for the metabolically challenged bodies that have become the norm, especially since most people consume carbs in the ultra-processed form. The interior isles of grocery stores are full of cereals, soda, chips, pastas, candy, baked goods, bread, bagels, frozen pizza and other processed carbohydrates that crush our metabolic system.

While I still hear the “calories in versus calories out” theory when it comes to losing weight, that does not mean that your body doesn’t care what those calories consist of. Cutting calories from carbohydrates will lower insulin levels, which in turn helps mobilize fat from fat cells and burn that fat for fuel. Low-carbohydrate diets also keep people feeling full longer and prevent fluctuating feelings of hunger.

So back to the guidelines. In 1990, Congress passed the National Nutrition Monitoring and Related Research Act, which mandated that the Dietary Guidelines be published jointly by the U.S. Department of Agriculture (USDA) and the U.S. Department of Health and Human Services (HHS) every five years. They were last updated in 2020, so it’s time again.

If you pay attention to the news, you know that the new Secretary of HHS is Robert F. Kennedy Jr.. He came out decently and said that he intends to revise Dietary Guidelines for Americans by the end of this summer.

Kennedy and Agriculture Secretary Brooke Rollins have voiced concerns that the previous guidelines were overly influenced by the food industry and not based on sound science.

Some organizations like the Center for Science in the Public Interest (CSPI) express concern that RFK Jr’s personal beliefs could override scientific evidence. CSPI argues that lack of adherence to the current 2020 guidelines, not the guidelines themselves, is the real issue. But data shows the increase in obesity and metabolic disease in this country has risen proportionally with the introduction and consumption of processed foods.

However, as I wrote in 2020, even at the time, those guidelines faced criticism regarding industry ties, exclusion of certain research, and lack of clarity on topics like sugar and alcohol intake.

So what might we see in the 2025 version? Kennedy said "We're going to have four-page dietary guidelines that tell people essentially, eat whole food, eat the food that's good for you.”

Kennedy also told lawmakers that HHS would study food additives and suggested food packaging should contain labels indicating the presence of some additives.

My hope is that the new guidelines not only recommend reduced processed carbohydrate consumption, but will talk about healthy fats. The 2020 MyPlate avoids fats altogether. This likely confirms some unfounded fears of fat and steers consumers toward low-fat, high-carbohydrate foods. Eating butter and healthy oils, like olive, avocado coconut in cooking, on salads, and at the table should be part of everyone’s diet. These healthy fats reduce harmful cholesterol and are good for the heart, and Americans don’t consume enough of them each day.

I would like to see the recommended daily portion of protein and type be increased. A hot dog is not the same as a good piece of salmon. The consensus from people I trust is between 0.8 and 1.2 grams of protein per pound of body weight daily.  There are variables that must be accounted for, such as a person’s activity level, age, any medical conditions they have, and their health goals. For reference, under these recommendations, someone who weighs 180 pounds would need between 144 grams and 216 grams per day.
Not all protein is created equal and the guidelines should emphasize protein from both animal-based (red meat, chicken, fish, eggs) and plant-based options.

The current U.S. Dietary Guidelines recommend that protein make up 10-35% of your daily calories and the recommended Dietary Allowance (RDA) is just 0.8 grams of protein per kilogram of body weight (this is only 0.36 grams per pound), which is roughly 65 grams for the 180 pound person I referenced. Nowhere near enough.

While you might consider it nit-picky, I would like to see the guidelines distinguish between types of vegetables. Americans are particularly deficient in their vegetable consumption—except for potatoes and french fries. Potatoes are chock full of rapidly digested starch, and they have the same effect on blood sugar as refined grains and sweets. Believe it or not, some people (and school lunch programs) consider eating deep fried onion rings a vegetable. Or a sweet potato with brown sugar and marshmallows as a healthy vegetable.

MyPlate recommends dairy at every meal, even though there is little if any evidence that high dairy intakes protect against osteoporosis, and there is considerable evidence that too-high intakes can be harmful. As for sugary drinks, MyPlate says 100% fruit juice counts as part of the Fruit Group. I would like to see the new guidelines talk about consuming mostly water with some coffee or tea (not your sugary Starbucks drink).

The new guidelines don’t have to be published until December 31, 2025, but I am hopeful that RFK Jr and his team at the HHS will make some improvements over the previous recommendations.