But then come four additional guidelines: “Prioritise protein foods at every meal,” “Consume dairy,” “Incorporate healthy fats,” and “Limit alcoholic beverages.” These redefine protein to favour meat rather than plant consumption, prioritise full fat rather than low fat dairy foods, specify butter and beef tallow as examples of healthy fats, and omit warnings about alcohol as a cancer risk. This reverses decades of heart health advocacy.
Questionable provenance
Most troubling is the lack of due process, dismissal of scientific consensus, and overt conflicts of interests in producing these guidelines, despite stated promises that they would reflect “gold standard science” and would not reflect corporate interests.6 Since 1980, the production of the guidelines has followed a two to three year process: a scientific report is written by the Dietary Guidelines Advisory Committee, the report is used to develop the guidelines, and a food guide is based on the guidelines. When I was a member of the committee in 1995, we set the research questions, reviewed the research, wrote the scientific report, and wrote the guidelines. Later, the departments of health and agriculture jointly took over all stages except the research review, allowing politics to overpower the science.
For these new guidelines, the agencies rejected the scientific report commissioned during the Biden presidency7 and appointed their own committee, giving it only three months to produce its 90 page report and 418 page appendix.89 Although the agencies insisted that these guidelines would not reflect industry influence and would be free of conflicts of interest, they kept neither promise. Most members of the research committee reported financial ties to food companies with vested interests in dietary advice; four members, for example, reported financial relationships with beef, pork, and dairy trade associations.910
One lawsuit is already charging the agencies with disregarding congressionally mandated processes for preparing the guidelines and, instead, relying on the recommendations of a “hastily assembled … panel of meat, dairy, and fat diet industry insiders,”11 whose names were revealed only on publication of their report. Who wrote the guidelines and designed the pyramid remains undisclosed.
Previous guidelines emphasised the benefits of diets based on lean meats, low fat dairy products, and plant sources of protein.12 These do the opposite. Although they say, “Every meal must prioritize high-quality, nutrient-dense protein from both animal and plant sources,” animal sources clearly come first, making protein seem a euphemism for meat. The guidelines recommend increasing protein intake from 0.8 g/kg body weight to 1.2 to 1.6 g/kg, despite current US consumption levels already being close to 1.2 g/kg, two thirds of which comes from meat.13 Furthermore, there is scarce evidence that exceeding current levels provides additional benefit.14 Adhering to higher protein goals while keeping saturated fat to 10% of calories will be challenging.
The messages about meat and full fat dairy are explicitly evangelical.7 Health and human services secretary, Robert F Kennedy Jr, posted on X, “Beef is BACK.” He and agriculture secretary, Brooke Rollins, appear on X with milk moustaches promoting full fat dairy. It too is “BACK,” supported by a new law requiring whole milk to be offered in schools.15 As for alcohol, health official Mehmet Oz said, “I don’t think you should drink alcohol, but it does allow people an excuse to bond and socialise, and there’s probably nothing healthier than having a good time with friends in a safe way.”16 Such messages minimise the risks of alcohol to health and society.17
The idea behind these messages is that eating real food and avoiding ultraprocessed food will achieve satiety and promote health, which they well might.51819 But largely plant based diets benefit health—and the environment.2021 In contrast, meat and dairy production pollute the environment, release greenhouse gases, and raise issues of animal welfare and worker safety.2223 These guidelines ignore such issues.
Also omitted is any discussion of the resources needed to follow such advice. Real food is more expensive than ultraprocessed foods and requires cooking skills, kitchens, equipment, and time. Not everyone has such things, but the agencies explicitly reject equity as a consideration.7 These guidelines also must be understood within the context of the current dismantling of the US public health system. We need public health to support diets that really can promote human and environmental health.
