From our medical director

Why It’s Time to Rethink the Dietary Guidelines

For decades, the U.S. Dietary Guidelines have shaped what we eat, how doctors and dietitians advise patients, and even what’s served in schools and hospitals. They were intended to help us stay healthy and prevent chronic disease. Yet here we are: rates of obesity, diabetes, and metabolic dysfunction are higher than ever. Something isn’t working.

The problem isn’t that Americans don’t try to follow the guidelines. The deeper issue is that the guidelines themselves are flawed—built on shaky science, confusing messaging, and an outdated view of nutrition that has unintentionally pushed us toward hunger, overeating, and worsening health.

The Low-Fat Legacy

The biggest misstep began in the late 1970s, when fat—particularly saturated fat—was cast as the villain. The guidelines pushed us toward a low-fat diet, often at the expense of protein and nutrient-dense foods. To compensate, we loaded our plates with refined, processed carbs that dramatically raise blood sugar.

The result? A diet that leaves us hungry, craving more, and prone to overeating. Too many carbs can lead to weight gain, insulin resistance, and type 2 diabetes. Instead of addressing these problems, the guidelines doubled down on the message: eat less fat, more “healthy” carbs, and health will follow.

But health didn’t follow. Instead, the nation got sicker.

Guidelines People Don’t Want—or Can’t—Follow

A common defense of the guidelines is: “If only people followed them, we’d be healthier.” That argument misses the point. Guidelines that are unrealistic, unsatisfying, or don’t match how our bodies actually work aren’t helpful.

A diet low in protein and fat often leaves people unsatisfied, pushing them to seek out snacks and processed foods to fill the gap. Hunger isn’t a willpower problem—it’s a biological signal. If your diet doesn’t meet your needs, no amount of discipline will fix it.

In other words: it’s not the public’s fault for “failing” to follow the guidelines. It’s the guidelines’ that have failed the public.

The Health Halo Effect

Another flaw is the overly simplistic health halo the guidelines give to broad food categories. Phrases like “healthy whole grains” or “eat more fruits and vegetables” sound good on paper. But in practice, they send the wrong message: that these foods can be eaten without limits simply because they’re “healthy.”

Whole grains are still a dense source of carbohydrates, and overconsuming them can worsen blood sugar control. Fruits and vegetables can be valuable to some for their fiber and micronutrients, but even fruit can easily be overeaten, leading to higher blood sugar, insulin levels, and metabolic dysfunction. And don’t even get us started on fruit juice, dried fruit, and starchy vegetables like potatoes, which can quickly turn into a sugar and starch overload.

By failing to acknowledge the harmful effects of overconsuming even “healthy foods,” the guidelines create confusion—and open the door to overeating foods that may be nutrient-rich but still problematic in excess.

The (Not so) Quiet Restriction of Animal Foods

One of the most striking (but less often acknowledged) aspects of the guidelines is their restriction of animal foods. Meat, eggs, and full-fat dairy are often discouraged or minimized, despite being some of the most nutrient-dense and most filling foods available.

Animal foods provide high-quality protein and essential nutrients like iron, zinc, vitamin B12, and heme iron—nutrients that are far more bioavailable than plant-based sources. They also deliver the most protein per calorie, which makes them powerful tools for satiety, muscle maintenance, and metabolic health.

Yet instead of encouraging people to include these foods, the guidelines often frame them as risky or unhealthy, largely based on weak associations from observational studies rather than rigorous clinical evidence.

Built on Weak Science

That brings us to the foundation of the guidelines themselves: the science.

Much of the evidence used to shape the recommendations comes from epidemiological studies—large population surveys that look for associations between diet and disease. While these studies can generate hypotheses, they cannot prove cause and effect. They’re also riddled with recall bias (can you remember exactly what you ate last month?), confounding variables (do people who eat red meat also happen to exercise less, smoke more, or eat more fast food?), and very small effect sizes (a risk ratio of 1.2 is a far cry from that of tobacco and cancer risk of between 15 and 20).

Yet time and again, these weak associations have been treated as hard evidence. But with data this weak, it’s nearly impossible to translate the risk to an individual, or to know if the data applies to them at all. The result is guidance that may look authoritative but doesn’t reflect the complexities of individual biology or real-world behavior.

What We Need Instead

It’s time for a shift. New guidelines should focus on realistic, biologically sound principles:

  • Prioritize protein. Adequate protein helps regulate appetite, maintain muscle, and prevent overeating. Animal foods aren’t the only way to get protein, but they are the most efficient way. We don’t have to promote animal foods for everyone, but we certainly shouldn’t restrict them.
  • Stop fearing fat. Natural healthy fats from meat, dairy, eggs, fish, nuts, and avocados support brain health and satiety. The science suggesting harm is low quality and flawed. It’s time to remove the fear.
  • Control carbohydrates. Carbs aren’t inherently bad for everyone, but the type and amount matter. Highly processed and refined carbs drive insulin resistance. And those already with insulin resistance struggle to properly handle even so-called “healthy” carbs.
  • Context matters. We don’t eat foods in isolation. What matters is how foods fit into your overall diet and your individual health.
  • Focus on the goal. The end goal is improving metabolic health—not getting someone to eat in one particular way. We have to acknowledge the metabolic benefits of eating a very low-carb, higher fat diet. Again, it may not be right for everyone, but it should at least be a supported option for many. 

The Bottom Line

The Dietary Guidelines were meant to protect public health, but instead, they’ve helped fuel an epidemic of obesity and metabolic disease. By overemphasizing a low-fat diet, downplaying protein, demonizing animal foods, and relying on weak science, they’ve led millions into patterns of eating that are unsatisfying and unsustainable.

It’s time to acknowledge the failure—and to rebuild guidelines that reflect what people actually need: nutrient-dense, satisfying foods that support long-term metabolic health.

Only then can we stop blaming individuals for “failing to follow the rules” and start creating rules that actually work.

Related topics