Do Dietary Guidelines Matter to the Average American? - MedPage Today

Contrary to what some news headlines suggest, the recently released 2025-2030 U.S. Dietary Guidelines for Americans are not radically different than previous iterations. They continue to recommend limits to added sugars, sodium, and saturated fats, and promote nutrient-dense foods as the centerpiece of a healthy diet. That being said, the guidelines also include some recommendations on which there is scientific disagreement; in particular, advice related to protein amount and source, full-fat dairy consumption, and alcohol limits. This isn't the first time dietary guidelines have been controversial.

While these guidelines are important in that they influence federal nutrition programs, they aren't likely to be found next to cookbooks on the kitchen tables of most American families. Indeed, the typical American isn't knowledgeable about or able to meet many of the recommendations, particularly those related to adequate consumption of fruits and vegetables.

Quite simply, it would be wrong to assume that the multiple-fold increase in obesity and diabetes over the last several decades in this country is because we've gotten guidelines wrong. It would also be too lofty of an expectation to assume that chronic diseases in the U.S. will be reversed because of the latest iteration of guidelines.

The reason for this is that healthy diets aren't just a matter of personal responsibility. Rather, individual decision-making is predicated around broader policies, systems, and environments that help make the healthy choice the easy choice.

If we want to reverse our diet-related epidemic, then we urgently need to focus on advancing health-promoting public policies, particularly in areas where there is scientific consensus. What follow are policy actions in three areas that the administration and Congress should swiftly undertake.

Food supply. The FDA should finalize its draft guidance to industry, which offers voluntary targets for companies to reduce sodium in their foods. If finalized, this would reduce sodium intake over 3 years to about 2,750 milligrams/day (from the current target of 3,000 mg/day), gradually moving closer to the nutrition guidelines' upper limit of 2,300. FDA should also ask for public commitments of action from companies in food categories with high sodium contributions. Similarly, the FDA should set industry targets for added sugars across categories (e.g., beverages and desserts) while concurrently monitoring the use of artificial sweeteners.

Congress' upcoming potential reauthorization of the Farm Bill also presents an opportunity to reexamine existing commodity subsidies and risk coverage programs, which grossly disadvantage fruits and vegetables compared to a handful of crops that are ultimately heavily processed and contribute to our nation's unhealthy diet.

Food accessibility. The Treasury Department and Department of Agriculture (USDA) should launch healthy food financing initiatives to incentivize the establishment of new grocery stores and farmers' markets in food deserts across the country. Local governments should also look at zoning policies to facilitate the introduction of healthy food access points while limiting the density of fast-food establishments, which are typically associated with processed food.

With respect to federal nutrition programs, USDA should encourage states to apply for Supplemental Nutrition Assistance Program (SNAP) waivers that incentivize healthy foods and disincentivize unhealthy foods. Research suggests these combined incentive/disincentive programs have the greatest potential in improving health outcomes and reducing preventable healthcare costs.

Any changes to school nutrition programs based on the new dietary guidelines should also be closely evaluated. For example, improvements to school nutritional standards for meals and beverages as part of the Healthy, Hunger-Free Kids Act of 2010 led to reductions in obesity prevalence for children in poverty in the ensuing years.

Food marketing. As referenced in last year's Make America Healthy Again (MAHA) strategy report, HHS and the Federal Trade Commission should act to limit the direct marketing of unhealthy foods to children by "evaluating the use of misleading claims and imagery." In this regard, the U.S. should heed lessons learned from other countries as to the most effective ways to reduce children's exposure to unhealthy food marketing.

FDA should also finalize its proposed rule requiring front-of-package nutritional labels on packaged goods to help the public interpret the relative amounts of added sugars, sodium, and saturated fats. This will further empower consumers and reinforce the contents of the dietary guidelines.

Finally, the President's FY2027 budget and future congressional appropriations should include greater funding for nutrition science. The more we can learn about nutrients and additives, the better confidence we can have in dietary guidelines and the policies that support them.

Policymakers have a significant opportunity to make a substantial dent in diet-related chronic conditions. Guidelines are helpful, but action is what will ultimately make America a healthier nation.

Anand Parekh, MD, MPH, is chief health policy officer at the University of Michigan School of Public Health, former deputy assistant secretary of health at HHS, and author of " Prevention First: Policymaking for a Healthier America." Dan Glickman served as the Secretary of Agriculture from 1995 until 2001.

He previously represented Kansas's 4th congressional district as a Democrat in the House of Representatives for 18 years.