What new dietary guidelines mean for pediatric practice

The 2025–2030 Dietary Guidelines for Americans introduce changes involving protein sources, dairy fat, and highly processed foods, but pediatricians should continue emphasizing established principles of healthy eating rather than substantially changing their counseling practices, according to Natalie D. Muth, MD, MPH, RDN, MBA.

Muth, a pediatrician, obesity medicine specialist, registered dietitian, adjunct associate professor at the UCLA Fielding School of Public Health, and co-founder of Namio Health, discussed the guidelines and their implications for clinical practice at the American Academy of Pediatrics (AAP) 2026 National Conference & Exhibition.

She emphasized that nutrition recommendations must also account for family circumstances, food access, and the policies influencing what children eat.

What changes should pediatricians know?

Although the updated guidelines have generated attention, Muth said their overall implications for routine pediatric counseling are relatively limited.

"It's really important to encourage whole grains, fruits, vegetables, really trying to get things that are healthy sources of protein," Muth said.

One change places greater emphasis on animal protein. However, Muth cautioned against interpreting that shift as a reason to discourage plant-based protein sources.

She noted that plant proteins remain healthy options and that pediatricians do not need to substantially change their recommendations based on the revised emphasis.

Another notable change involves dairy products, particularly the recommendation favoring whole milk rather than reduced-fat or low-fat milk for children.

Muth explained that this recommendation has not necessarily been incorporated into guidance from other organizations, including the AAP.

She also emphasized that evidence comparing the health effects of different dairy fat levels remains mixed.

"So we don't actually know, and it probably doesn't make that much of a difference what type of fat is in the dairy products that our patients consume," Muth said.

For pediatricians, she suggested that the revised dairy recommendation should be understood within the context of ongoing uncertainty rather than treated as a definitive reason to change existing counseling.

How should clinicians address highly processed foods?

Muth identified the guidelines' discussion of ultra-processed and highly processed foods as another important development.

Previous editions did not explicitly address these foods in the same way, making the updated language an opportunity for additional conversations with families.

She noted that pediatricians already encourage consumption of whole foods, including fruits, vegetables, and whole grains.

However, clinicians can now place greater emphasis on helping families reduce their intake of ultra-processed foods when feasible.

"I think pediatricians are already encouraging their families to eat whole foods and really emphasizing those whole foods, but we can start having more conversations about ultra-processed foods and really trying to minimize that as much as possible," Muth said.

How can pediatricians make nutrition counseling realistic?

Muth emphasized that knowing what constitutes a healthy diet does not necessarily mean families have the resources or circumstances needed to follow dietary recommendations.

Food access, nutrition security, social determinants of health, and household environments all influence dietary choices.

Rather than providing prescriptive advice, pediatricians should begin by understanding what families currently eat and identifying achievable opportunities for improvement.

Muth recommended asking open-ended questions and working collaboratively toward small changes.

"They're the experts on their lives, and what's going to work best for them, so we can be kind of more of a guide or a coach rather than dictating or advising people to do something that may not be really very realistic for them," she said.

This approach can help align recommendations with families' priorities and available resources.

What role should pediatricians play in nutrition policy?

Beyond clinical counseling, Muth emphasized that federal dietary guidelines influence nutrition programs, including school meals, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and potentially the Supplemental Nutrition Assistance Program (SNAP).

She encouraged pediatricians to advocate for policies that make nutritious foods more accessible.

"We want our families to eat better, less processed foods, more fruits and vegetables. Then the policies need to support that," Muth said.

Specific priorities include adequate SNAP funding, support for SNAP-Ed, nutritious school meals, and access to meals for children who need them.

For pediatricians, Muth's recommendations reinforce that effective nutrition counseling requires both evidence-based guidance and attention to the economic and environmental barriers families face. Improving children's diets, she emphasized, depends not only on individual choices but also on systems that make healthier choices possible.

Reference

Muth N. Healthy Active Living: 2025 Dietary Guidelines for Americans. Presented at: American Academy of Pediatrics 2026 National Conference & Exhibition; October 5, 2026; San Diego, CA.