Guidelines Not For People with Diet-Related Diseases

The U.S. Dietary Guidelines policy has been designed only for the prevention of diet-related diseases. It is not designed for the treatment of those diseases. This means that if you have been diagnosed with obesity, diabetes or any other chronic disease, the Dietary Guidelines are not for you.

In 1980, when the Guidelines were launched, they were meant to help healthy Americans prevent diseases such as obesity. At the time, the majority of Americans were healthy, so focusing on prevention made sense. 

Over the years, however, Americans have largely lost their good health. Now, some 93% of Americans have at least one symptom of metabolic disease, such as abdominal obesity or high blood pressure, for which they are taking medication. The Guidelines are therefore now out-of-step with the majority of Americans. 

For a long time, the US Department of Agriculture (USDA) did not make clear that the Guidelines were for prevention only. However, in early 2023, a USDA official admitted this fact:

What exactly does it mean that the Guidelines are not for treatment? In plain terms, the process to create the Guidelines does not include a review of the scientific literature on how to reverse obesity, type 2 diabetes or any other chronic disease. For instance, the 2020 Guidelines process explicitly excluded the entire scientific literature on weight loss. This year, USDA officials announced that the 2025 Guidelines will not examine any of the literature on treating heart disease. 

Confusingly, the USDA continues to state that the Dietary Guidelines are for all Americans, but the above slide makes clear that this is not the case.

Further, the Dietary Guidelines remain a one-size fits-all solution:

It is time to move away from this approach and acknowledge the need for dietary guidance that will serve the vast majority of Americans for whom the Guidelines are no longer relevant.