USDA Dietary Guidelines for Americans – References
References

USDA Dietary Guidelines for Americans – References

  1. Flegal, K., Carroll, M., Kuczmarski, R., & Johnson, C. (1997). Overweight and obesity in the United States: prevalence and trends, 1960–1994. In International Journal of Obesity (Vol. 22, Issue 1, pp. 39–47). Springer Science and Business Media LLC. https://doi.org/10.1038/sj.ijo.0800541 
  2. Centers for Disease Control, “Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017–2018,” NCHS Data Brief, No. 360, Feb 2020. Available: https://www.cdc.gov/nchs/data/databriefs/db360-h.pdf 
  3. Centers for Disease Control, “About Chronic Diseases.”  The number is based on data from 2016. Available here: https://www.cdc.gov/chronic-disease/about/index.html
  4. The report cited by the CDC for the 60% number: Buttorff, C., Ruder, T., & Bauman, M., Multiple Chronic Conditions in the United States, The Rand Corporation, 2017.
  5. Araújo, J., Cai, J., & Stevens, J. (2019). Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016. In Metabolic Syndrome and Related Disorders (Vol. 17, Issue 1, pp. 46–52). Mary Ann Liebert Inc. https://doi.org/10.1089/met.2018.0105
  6. Page, Irvine H., Edgar V. Allen, Francis L. Chamberlain, Ancel Keys, Jeremiah Stamler, and Fredrick J. Stare. “Dietary Fat and Its Relation to Heart Attacks and Strokes.” Circulation 23, no. 1 (1961): 133–136. 
  7. Keys, Ancel, ed. “Coronary Heart Disease in Seven Countries.” Circulation 41 and 42, no. 1 suppl. 1, American Heart Association Monograph No. 29 (April 1970): 1–211.
  8. Ancel Keys and Joseph T. Anderson, “The Relationship of the Diet to the Development of Atherosclerosis in Man,” Symposium on Atherosclerosis (Washington, DC: National Academy of Sciences–National Research Council, 1954), 189. 
  9. Teicholz, N. The Big Fat Surprise. 2014 (Simon & Schuster: New York), pp. 32-36.
  10. Ibid., pp. 37-38.
  11. Ibid., pp. 40-42.
  12. [Ibid., pp. 60-61.
  13. * There are only three macronutrients from which all foods are comprised: protein, fat, and carbohydrate. 
  14. Stamler, J.; Epstein, F.H. Coronary heart disease: Risk factors as guides to preventive action. Prev. Med. 1972, 1, 27–48.
  15. Cohen, E., Cragg, M., deFonseka, J., Hite, A., Rosenberg, M., & Zhou, B. (2015). Statistical review of US macronutrient consumption data, 1965–2011: Americans have been following dietary guidelines, coincident with the rise in obesity. In Nutrition (Vol. 31, Issue 5, pp. 727–732). Elsevier BV. https://doi.org/10.1016/j.nut.2015.02.007 
  16. * Note: Although the Dietary Guidelines stopped using the “low-fat” language in 2010, the USDA-HHS “Dietary Patterns” are all de facto low in fat, between 31% and 32% of calories as fat, which falls squarely within the definition of the “low-fat diet” in the scientific literature.
  17. * In 1990, Congress passed the National Nutrition Monitoring Act, which requires that all federal programs follow the Dietary Guidelines.
  18. Jeanine Bentley. U.S. Trends in Food Availability and a Dietary Assessment of Loss- Adjusted Food Availability, 1970-2014, EIB-166, U.S. Department of Agriculture, Economic Research Service, January 2017. 
  19. Dietary Guidelines Advisory Committee. 2015. Scientific Report of the 2015 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Health and Human Services and the Secretary of Agriculture. U.S. Department of Agriculture, Agricultural Research Service, Washington, DC., Committee, Part D. Ch 1 Figure D1.27 and Part D, Ch 1, Figure D1.28, p. 144.
  20. Prentice, Ross L., Cynthia A. Thomson, Bette Caan, et al. “Low-Fat Dietary Pattern and Cancer Incidence in the Women’s Health Initiative Dietary Modification Randomized Controlled Trial.” Journal of the National Cancer Institute 99, no. 20 (October 17, 2007): 1534–1543. 
  21. Howard, Barbara V., Linda Van Horn, Judith Hsia, et al. “Low-Fat Dietary Pattern and Risk of Cardiovascular Disease: The Women’s Health Initiative Randomized Controlled Dietary Modification Trial.” Journal of the American Medical Association 295, no. 6 (February 8, 2006): 655–666  
  22. Tinker LF, Bonds, DE, Margolis, KL, et al.  “Low-fat dietary pattern and risk of treated diabetes mellitus in postmenopausal women: the Women’s Health Initiative randomized controlled dietary modification trial,” Arch Intern Med. 2008 July 28;168(14):1500-11.
  23. Beresford, Shirley A. A., Karen C. Johnson, et al. “Low-Fat Dietary Pattern and Risk of Colorectal Cancer: The Women’s Health Initiative Randomized Controlled Dietary Modification Trial.” Journal of the American Medical Association 295, no. 6 (February 8, 2006): 643–654  
  24. Howard, Barbara V., JoAnn E. Manson, Marcia L. Stefanick, et al. “Low-Fat Dietary Pattern and Weight Change Over 7 Years: The Women’s Health Initiative Dietary Modification Trial.” Journal of the American Medical Association 295, no. 1 (January 4, 2006): 39– 49.
  25. Noakes, T. D. (2021). Hiding unhealthy heart outcomes in a low-fat diet trial: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial finds that postmenopausal women with established coronary heart disease were at increased risk of an adverse outcome if they consumed a low-fat ‘heart-healthy’ diet. In Open Heart (Vol. 8, Issue 2, p. e001680). BMJ. https://doi.org/10.1136/openhrt-2021-001680 
  26. USDA, Human Nutrition Information Service, Dietary Guidelines Advisory Committee, Agricultural Research Service. 2000. Report of the Dietary Guide- lines Advisory Committee on the dietary guidelines for Americans, 2000: to the Secretary of Health and Human Services and the Secretary of Agriculture, Washington DC, Springfield VA: The Committee, National Technical Information Service, p. 36
  27. [27] Dietary Guidelines Advisory Committee. 2015. Scientific Report of the 2015 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Agriculture and the Secretary of Health and Human Services. Washington, DC, USA, U.S. Department of Agriculture, Agricultural Research Service, Part D, Ch 6, p. 13, lines 460–461.
  28. Ibid., Part D, Ch 6, p. 13, lines 460–461.
  29. Krishnan, S., Adams, S. H., Allen, L. H., Laugero, K. D., Newman, J. W., Stephensen, C. B., Burnett, D. J., Witbracht, M., Welch, L. C., Que, E. S., & Keim, N. L. (2018). A randomized controlled-feeding trial based on the Dietary Guidelines for Americans on cardiometabolic health indexes. In The American Journal of Clinical Nutrition (Vol. 108, Issue 2, pp. 266–278). Elsevier BV. https://doi.org/10.1093/ajcn/nqy113 
  30. * Note: the study summary reports an improvement in one measure of blood pressure for the women following the guidelines, compared to controls, but this statement is not supported by the data in the paper, which shows no benefit.
  31. Teicholz N. The scientific report guiding the US dietary guidelines: is it scientific? BMJ 2015; 351 :h4962 doi:10.1136/bmj.h4962
  32. For current data in chart: CNPP, Food and Nutrition Services, U.S. Department of Agriculture, Food Pattern Modeling: Ages 2 Years and Older: 2020 Dietary Guidelines Advisory Committee Food Pattern Modeling Report,” July 15, 2020, Tables 5.1, 5.10, 5.11. Available at: https:// www.dietaryguidelines.gov/sites/default/files/2020 07/FoodPatternModeling_Report_2YearsandOlder.pdf.
  33. For 1965 data: Cohen, E., Cragg, M., deFonseka, J., Hite, A., Rosenberg, M., & Zhou, B. (2015). Statistical review of US macronutrient consumption data, 1965–2011: Americans have been following dietary guidelines, coincident with the rise in obesity. In Nutrition (Vol. 31, Issue 5, pp. 727–732). Elsevier BV. https://doi.org/10.1016/j.nut.2015.02.007
  34. Ludwig, D.S.; Aronne, L.J.; Astrup, A.; de Cabo, R.; Cantley, L.C.; Friedman, M.I.; Heymsfield, S.B.; Johnson, J.D.; King, J.C.; Krauss, R.M.; et al. The carbohydrate-insulin model: A physiological perspective on the obesity pandemic. Am. J. Clin. Nutr. 2021, 114, 1873–1885
  35. Kelly, C. T., Mansoor, J., Dohm, G. L., Chapman, W. H. H., III, Pender, J. R., IV, & Pories, W. J. (2014). Hyperinsulinemic syndrome: The metabolic syndrome is broader than you think. In Surgery (Vol. 156, Issue 2, pp. 405–411). Elsevier BV. https://doi.org/10.1016/j.surg.2014.04.028
  36. Berger, A. & Fung, J., “Hyperinsulinemia and Insulin Resistance: Scope of the Problem, Journal of Insulin Resistance, 2016, 1(1).
  37. Cucuzzella, M., Bailes, J., Favret, J., Paddu, N., & Bradley, A. B. (2024). Beyond Obesity and Overweight: The Clinical Assessment and Treatment of Excess Body Fat in Children. In Current Obesity Reports (Vol. 13, Issue 2, pp. 276–285). Springer Science and Business Media LLC. https://doi.org/10.1007/s13679-024-00565-0
  38. Baharuddin, B. (2024). The Impact of Fructose Consumption on Human Health: Effects on Obesity, Hyperglycemia, Diabetes, Uric Acid, and Oxidative Stress With a Focus on the Liver. In Cureus. Springer Science and Business Media LLC. https://doi.org/10.7759/cureus.70095
  39. Teicholz, N.; Croft, S.M.; Cuaranta, I.; Cucuzzella, M.; Glandt, M.; Griauzde, D.H.; Jerome-Zapadka, K.; Kalayjian, T.; Murphy, K.; Nelson, M.; et al. Myths and Facts Regarding Low-Carbohydrate Diets. Nutrients 2025,17,1047. https://doi.org/ 10.3390/nu17061047
  40. Teicholz, N.; Croft, S.M.; Cuaranta, I.; Cucuzzella, M.; Glandt, M.; Griauzde, D.H.; Jerome-Zapadka, K.; Kalayjian, T.; Murphy, K.; Nelson, M.; et al. Myths and Facts Regarding Low-Carbohydrate Diets. Nutrients 2025,17,1047. https://doi.org/ 10.3390/nu17061047
  41. Teicholz, N. “USDA Ignoring the Science on Low-Carb Diets,” Unsettled Science, Substack, June 26, 2022.
  42. Grootveld, M., Ruiz Rodado, V., Silwood, C.J.L. “Detection, monitoring, and deleterious health effects of lipid oxidation products generated in culinary oils during thermal stressing episodes” Inform. November/December 2014, Vol.25 (10).
  43. Ramsden, C. E., Zamora, D., Leelarthaepin, B., Majchrzak-Hong, S. F., Faurot, K. R., Suchindran, C. M., Ringel, A., Davis, J. M., & Hibbeln, J. R. (2013). Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis. In BMJ (Vol. 346, Issue feb04 3, pp. e8707–e8707). BMJ. https://doi.org/10.1136/bmj.e8707
  44. IOM (Institute of Medicine). 2013. Sodium intake in populations: Assessment of evidence. Washington, DC: The National Academies Press.National Academies of Sciences, Engineering, and Medicine. 2013. Sodium Intake in Populations: Assessment of Evidence. Washington, DC: The National Academies Press. https://doi.org/10.17226/18311.
  45. Graudal, N., Jürgens, G., Baslund, B., & Alderman, M. H. (2014). Compared With Usual Sodium Intake, Low- and Excessive-Sodium Diets Are Associated With Increased Mortality: A Meta-Analysis. In American Journal of Hypertension (Vol. 27, Issue 9, pp. 1129–1137). Oxford University Press (OUP). https://doi.org/10.1093/ajh/hpu028
  46. Lelli, D., Antonelli-Incalzi, R., Bandinelli, S., Ferrucci, L., & Pedone, C. (2018). Association Between Sodium Excretion and Cardiovascular Disease and Mortality in the Elderly: A Cohort Study. In Journal of the American Medical Directors Association (Vol. 19, Issue 3, pp. 229–234). Elsevier BV. https://doi.org/10.1016/j.jamda.2017.09.004
  47. Mente, A., O’Donnell, M., Rangarajan, S., Dagenais, G., Lear, S., McQueen, M., Diaz, R., Avezum, A., Lopez-Jaramillo, P., Lanas, F., Li, W., Lu, Y., Yi, S., Rensheng, L., Iqbal, R., Mony, P., Yusuf, R., Yusoff, K., Szuba, A., … Yusuf, S. (2016). Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies. In The Lancet (Vol. 388, Issue 10043, pp. 465–475). Elsevier BV. https://doi.org/10.1016/s0140-6736(16)30467-6
  48. van Zanten, A. R. H., De Waele, E., & Wischmeyer, P. E. (2019). Nutrition therapy and critical illness: practical guidance for the ICU, post-ICU, and long-term convalescence phases. In Critical Care (Vol. 23, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s13054-019-2657-5
  49. Phillips, S. M., Chevalier, S., & Leidy, H. J. (2016). Protein “requirements” beyond the RDA: implications for optimizing health. In Applied Physiology, Nutrition, and Metabolism (Vol. 41, Issue 5, pp. 565–572). Canadian Science Publishing. https://doi.org/10.1139/apnm-2015-0550
  50. Weiler, M., Hertzler, S. R., & Dvoretskiy, S. (2023). Is It Time to Reconsider the U.S. Recommendations for Dietary Protein and Amino Acid Intake? In Nutrients (Vol. 15, Issue 4, p. 838). MDPI AG. https://doi.org/10.3390/nu15040838 
  51. Phillips, S. M., Chevalier, S., & Leidy, H. J. (2016). Protein “requirements” beyond the RDA: implications for optimizing health. In Applied Physiology, Nutrition, and Metabolism (Vol. 41, Issue 5, pp. 565–572). Canadian Science Publishing. https://doi.org/10.1139/apnm-2015-0550
  52. Dietary Guidelines Advisory Committee. 2020. Scientific Report of the 2020 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Agriculture and the Secretary of Health and Human Services. U.S. Department of Agriculture, Agricultural Research Service, Washington, DC. Available at: https://doi.org/10.52570/DGAC2020 
  53. Hudson JL, et al. E. Dietary Protein Requirements in Children: Methods for Consideration. Nutrients. 2021 May 5;13(5):1554. doi: 10.3390/nu13051554.
  54. The sodium cap is based largely on studies of the DASH (Dietary Alternatives to Stop Hypertension” diet, which has been tested almost exclusively on middle-aged men with hypertension. See: Teicholz, N. “The Deal with DASH,” Jan 29, 2017. Available at: https://ninateicholz.com/the-deal-on-dash/#more-1035
  55. Teicholz, N. “The Nutrition Coalition Voices Support for the Whole Milk for Healthy Kids Act,” June 1, 2023. Available at: https://www.nutritioncoalition.us/news/tnc-voices-support-for-the-whole-milk-for-healthy-kids-act  (Data on clinical trials is originally from Teicholz, N. The Big Fat Surprise, pp. 152-155).
  56. Source for 60%: Centers for Disease Control, “About Chronic Diseases.”  The number is based on data from 2016. Available here: https://www.cdc.gov/chronic-disease/about/index.html 
  57. Source for 88%: Araújo, J., Cai, J., & Stevens, J. (2019). Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016. In Metabolic Syndrome and Related Disorders (Vol. 17, Issue 1, pp. 46–52). Mary Ann Liebert Inc. https://doi.org/10.1089/met.2018.0105
  58. The Nutrition Coalition, “Congress Says Dietary Guidelines Needed for Americans with Chronic Disease,” July 21, 2023. Available at: https://www.nutritioncoalition.us/news/congress-says-dietary-guidelines-needed-for-americans-with-chronic-disease 
  59. Bouchey C, Ard J, Bazzano L, Heymsfield S, Mayer-Davis E, Sabaté J, Snetselaar L, Van Horn L, Schneeman B, English LK, Bates M, Callahan E, Butera G, Terry N, Obbagy J. Dietary Patterns and Growth, Size, Body Composition, and/or Risk of Overweight or Obesity: A Systematic Review. July 2020. U.S. Department of Agriculture, Food and Nutrition Service, Center for Nutrition Policy and Promotion, Nutrition Evidence Systematic Review. Available at: https://doi.org/10.52570/NESR.DGAC2020.SR0101  
  60. Available here: https://docs.house.gov/meetings/AP/AP00/20230614/115870/HMKP-118-AP00-20230614-SD003.pdf 
  61. Available here: https://nap.nationalacademies.org/catalog/24883/redesigning-the-process-for-establishing-the-dietary-guidelines-for-americans 
  62. Available here: https://nap.nationalacademies.org/catalog/24637/optimizing-the-process-for-establishing-the-dietary-guidelines-for-americans 
  63. * The USDA co-issues the Dietary Guidelines with the US-HHS, but the office that conducts the scientific reviews and administers the guidelines is housed at the USDA.
  64. Relevant excerpts of the report are available here: https://www.nutritioncoalition.us/the-process-of-drafting-the-guidelines-needs-reform 
  65. Available here: https://nap.nationalacademies.org/catalog/26406/evaluating-the-process-to-develop-the-dietary-guidelines-for-americans-2020-2025 
  66. Available here: https://nap.nationalacademies.org/catalog/26653/evaluating-the-process-to-develop-the-dietary-guidelines-for-americans-2020-2025 
  67. Available here: https://nap.nationalacademies.org/catalog/26653/evaluating-the-process-to-develop-the-dietary-guidelines-for-americans-2020-2025 
  68. Teicholz, N. “USDA Fails to Fully Implement National Academies’ Advice for Bringing “Transparency,” “Rigor” to the Dietary Guidelines,” Feb 2, 2024. Available here: https://www.nutritioncoalition.us/news/usda-fails-to-fully-implement-natl-academies-recs-for-transparency 
  69. Cheryl Achterberg, Arne Astrup, Dennis M Bier, Janet C King, Ronald M Krauss, Nina Teicholz, Jeff S Volek, An analysis of the recent US dietary guidelines process in light of its federal mandate and a National Academies report, PNAS Nexus, Volume 1, Issue 3, July 2022, pgac107, https://doi.org/10.1093/pnasnexus/pgac107 
  70. Bodnaruc, A. M., Khan, H., Shaver, N., Bennett, A., Wong, Y. L., Gracey, C., Ly, V., Shea, B., Little, J., Brouwers, M., Bier, D., & Moher, D. (2025). Reliability and reproducibility of systematic reviews informing the 2020–2025 Dietary Guidelines for Americans: a pilot study. In The American Journal of Clinical Nutrition (Vol. 121, Issue 1, pp. 111–124). Elsevier BV. https://doi.org/10.1016/j.ajcnut.2024.10.013 
  71. Teicholz, N. “US Dietary Guidelines: Science is “Subpar,” Cannot be Replicated,” Jan 27, 2025. Unsettled Science, Substack. Available here: https://unsettledscience.substack.com/p/us-dietary-guidelines-science-is 
  72. Volek, J.S.; Phinney, S.D.; Krauss, R.M.; Johnson, R.J.; Saslow, L.R.; Gower, B.; Yancy, W.S., Jr.; King, J.C.; Hecht, F.M.; Teicholz, N.; Bistrian, B.R.; Hamdy, O. Alternative Dietary Patterns for Americans: Low-Carbohydrate Diets. Nutrients 2021, 13, 3299. https://doi.org/10.3390/nu13103299

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