New dietary guidelines: Implications for clinical practice

The 2025–2030 US Dietary Guidelines introduce an increased emphasis on whole foods, protein intake, and added sugar restriction, while shifting to a shorter, consumer-facing format.¹ In a recent Contemporary Pediatrics special report discussion, Colleen Sloan, PA-C, RDN; Viet Le, DMSc, MPAS, PA-C, FACC; and Catherine McManus, PhD, RDN, LD, examined how the updates may influence clinical care across pediatric and adult populations.²

Whole foods and the microbiome

McManus identified the emphasis on minimally processed foods as a meaningful advancement. “So I think one thing that really stood out was the really big emphasis on whole foods,” she said, noting that the first line of the guidelines encourages diets built on “whole and nutrient-dense foods.” She added that highly processed foods were “very much discouraged.”

She also pointed to the inclusion of gut health as a notable development. “I think something else that was really nice to see highlighted for the first time in the dietary guidelines was the discussion around gut health and microbiome,” McManus said. She explained that the guidelines acknowledge both the benefits of a healthy microbiome and the potential negative implications of a compromised one.

Le emphasized that the guidelines operate at a population level. When they discourage highly processed foods, “they’re telling the food industry also, hey, you have to make these things available,” he said, underscoring that the document is intended to influence environmental and policy-level change, not solely individual behavior.

A condensed, consumer-focused format

The current iteration marks a structural shift from previous versions exceeding 150 pages to an 11-page document. McManus noted that prior versions were “written for professionals, clinicians, healthcare providers, researchers, educators,” and often difficult for patients to interpret.

Le acknowledged the tradeoff: “You lose some on one end, but you gain some on the other.” While the shorter document simplifies messaging, it may omit details valued by clinicians. He added, “Now we have something that’s a simpler message for patients to understand. And I like that.”

Protein: Quantity vs quality

The updated guidelines increase adult protein recommendations from 0.8 g/kg/day to 1.2–1.6 g/kg/day. McManus explained that the prior 0.8 g/kg/day recommendation was based on nitrogen balance studies, which may not fully reflect optimal intake.

However, both experts stressed that the message is not simply to increase protein indiscriminately. Le stated, “I don’t know that it was really like, add a lot more protein as much as, let’s swap things.” He emphasized that most Americans are not broadly protein-deficient but often rely on processed sources.

McManus reinforced the importance of quality: “I think when it comes to prioritization, not putting as much emphasis on the quantity, maybe, but putting emphasis on really prioritizing like the quality of the proteins that Americans are eating.” She highlighted persistent shortfalls in seafood, shellfish, nuts, and seeds.

Saturated fat and visual confusion

The recommendation to limit saturated fat to less than 10% of total daily calories remains unchanged. Le noted, “Much more explicit was that they said less than 10% of your calories from saturated fats.”

McManus expressed concern that the food pyramid graphic may create confusion. “I do feel there is some misalignment between what the text is communicating and the actual food guide the visual,” she said. She added that based on the portion depictions, “it would be, truthfully, nearly impossible to stay within that less than 10% saturated fat recommendation” if interpreted literally.

Fiber and plant-based proteins

Fiber intake remains below recommended levels across the lifespan. Le commented, “Fiber is not sexy,” but emphasized its cardiometabolic benefits.

McManus agreed that fiber was not as prominently highlighted as in prior versions. She warned that a stronger visual emphasis on animal-based proteins may inadvertently reduce attention to fiber-rich plant proteins. “I don’t think it’s going to encourage it as much as the prior version,” she said.

For pediatric populations and during pregnancy and lactation, McManus emphasized carbohydrate adequacy, stating that carbohydrates are the body’s “preferred source of energy,” particularly during periods of rapid growth.

Pediatric omissions

Panelists identified several pediatric gaps. McManus noted the absence of detailed guidance on breast milk handling and storage, stating that infants are “so vulnerable and so susceptible.” She described this omission as “concerning.”

Sloan highlighted that the avoidance of honey in infants younger than 1 year was not clearly mentioned. Iron was addressed only briefly. McManus observed that it was included “in a very, very brief way,” compared with prior versions, and emphasized the need for education on heme vs nonheme iron sources.

Regarding added sugars, the guidelines state that “no amount of added sugar is recommended” for children aged 5 to 10 years. McManus agreed with limiting added sugars but cautioned against overly rigid interpretation. “I think rather than taking this recommendation to such an extreme and saying no amount of added sugar is recommended, I think it might be beneficial to keep the mindset of like, really trying to limit or even avoid.”

Personalization, access, and culture

The discussion concluded with attention to access and cultural context. McManus noted that some foods highlighted in the guidelines may not be affordable or widely available and stressed sensitivity to cultural traditions. “Food is so deeply ingrained in cultures and in traditions,” she said, cautioning against recommending drastic dietary changes.

She suggested focusing on additions rather than restrictions, encouraging clinicians to consider “what could we add into your diet, rather than focusing in on take these foods away.”

Le echoed the importance of context-driven care. “These are optimal choices, and these are the guidelines are optimized for that. But let’s optimize what you have available,” he said. He added that clinicians must avoid guilt-based messaging and instead help patients move incrementally toward healthier patterns.

Ultimately, the panel agreed that the 2025–2030 Dietary Guidelines provide broad guardrails. Translating them into effective care requires individualized counseling, cultural respect, and practical adaptation to each patient’s environment.

Our Experts:
Colleen Sloan, PA-C, RDN, pediatric physician assistant and registered dietitian; host of The Exam Room Nutrition Podcast.
Catherine McManus, PhD, RDN, LD, assistant professor of nutrition, Case Western Reserve University; Cleveland Clinic Foundation.
Viet Le, DMSc, MPAS, PA-C, FACC, preventive cardiology physician assistant and associate professor of research, Intermountain Health.

References

1. Kennedy, Rollins unveil historic reset of U.S. nutrition policy, put real food back at center of health. US Department of Health and Human Services. January 7, 2026. Accessed February 9, 2026. https://www.hhs.gov/press-room/historic-reset-federal-nutrition-policy.html
2. Special Report: What the 2025–2030 US Dietary Guidelines mean for clinicians and families. Contemporary Pediatrics. February 5, 2026. Accessed February 9, 2026. https://www.contemporarypediatrics.com/video-series/special-report-what-the-2025-2030-us-dietary-guidelines-mean-for-clinicians-and-families