The Latest Food Guidelines from the USA: What It Gets Right – and What It Doesn’t

A step forward – but not the full picture

The newly released food guidelines from the US for 2026 marks a significant shift from previous guidance. For the first time in decades, there is strong and explicit messaging around the need to reduce ultra-processed foods, limit added sugars, and move away from rapidly digestible refined carbohydrates and starches.

This is an important and welcome development. Ultra-processed foods are now widely recognised as major drivers of obesity, metabolic disease, inflammation, gut dysbiosis, and cardiometabolic risk. On this point, the updated U.S. guidance is aligned with a growing global body of evidence.

The emphasis on whole foods, beans and legumes, and less industrially manipulated products is a positive and necessary step.

However, while the intention is commendable, the execution of the pyramid raises serious nutritional, biological, and environmental concerns.

Where the new food guidelines get it right ✔️

There are several areas where the updated guidance deserves credit:

1. Strong stance against ultra-processed foods

The explicit recommendation to reduce ultra-processed foods is long overdue and fully supported by research linking these foods to:

• Obesity

• Type 2 diabetes

• Cardiovascular disease

• Gut microbiome disruption

• Increased cancer risk

  
  

2. Reduced emphasis on refined carbohydrates

The shift away from refined starches and rapidly digestible carbohydrates reflects better understanding of:

• Glycaemic dysregulation

• Insulin resistance

• Metabolic syndrome

This is particularly relevant in a population with high rates of type 2 diabetes and obesity.

3. Inclusion of beans and legumes

The elevation of beans, lentils, and legumes as core foods is a positive move. These foods are consistently associated with:

• Improved glycaemic control

• Lower cardiovascular risk

• Improved gut health

• Reduced all-cause mortality

Where the new food guidelines fundamentally fail ❌

Despite these positives, the pyramid places red meat and full-fat dairy at the top, positioning them as primary drivers of health. This is where the guidance becomes deeply problematic.

Red meat at the top: a scientific concern

Red meat at the top: a scientific concern

In the new food pyramid from the USA, red meat is positioned prominently as a core protein source. This is difficult to reconcile with a substantial and consistent body of evidence linking high red and processed meat intake to a range of adverse health outcomes. The concern extends well beyond colorectal cancer and reflects broader risks associated with Western-style dietary patterns

Why this positioning is so concerning

Placing red meat at the top of a national food pyramid implies that it should be a dietary cornerstone, rather than an occasional or supportive food.

This is difficult to justify given that:

• High red meat intake is consistently linked with chronic disease risk

• Long-lived populations consume far less meat

• Plant-forward diets show protective effects across multiple health outcomes

From a preventive health and public health perspective, this positioning risks reinforcing exactly the dietary patterns that guidelines should be helping populations move away from.

Dairy at the top: biologically unnecessary and clinically inappropriate for many

The placement of full-fat dairy at the top of the pyramid is equally concerning.

Humans do not require dairy

Biologically, humans do not need dairy to survive or thrive. We are:

• The only species that consumes milk beyond weaning

• The only species that consumes the milk of another animal

Well-planned diets can easily meet calcium, protein, and micronutrient needs without dairy.

Full-fat dairy is not suitable for everyone

While full-fat dairy may be appropriate for some individuals, it is not universally suitable, particularly for those with:

• Hypercholesterolaemia

• Gallbladder disease

• Biliary dysfunction

• Certain inflammatory or digestive conditions

• Lactose intolerance or dairy sensitivity , casein sensitivity, or immune reactivity, which affect a substantial amount of people.

For these individuals, placing dairy at the top of the pyramid is not just unhelpful – it is potentially harmful.

A more appropriate role for dairy

Dairy, if consumed, should be:

• Optional

• Individualised

• Consumed in small amounts

• Positioned alongside the pyramid, not at its apex

It is not a driver of health, and it is certainly not essential.

Environmental impact: a glaring omission

Any modern dietary guideline that fails to address environmental sustainability is incomplete.

Environmental experts, including David Attenborough, have repeatedly stated that:

• Current levels of meat and dairy consumption are unsustainable

• Reducing animal agriculture is essential to mitigate climate change

• Food systems must shift towards plant-forward models

Animal agriculture is a major contributor to:

• Greenhouse gas emissions

• Deforestation

• Water depletion

• Biodiversity loss

Promoting increased meat and dairy consumption while claiming to support public health is fundamentally contradictory.

Greenhouse gas emissions per kilogram for different food groups. Adapted from Dr Hannah Ritchie/Our World in Data (2020) Data source: Poore & Nemecek (2018). Chart by Carbon Brief using Highcharts. https://interactive.carbonbrief.org/what-is-the-climate-impact-of-eating-meat-and-dairy/index.html

Political and industry influence

And then there is the broader political context, which is difficult to ignore!

Under the Donald Trump administration, environmental protections were repeatedly rolled back, and climate science was openly dismissed. Against this backdrop, it is reasonable to question whether:

• Meat industry lobbying

• Dairy industry lobbying

• Agricultural corporate interests

have influenced the framing of the pyramid.

This does not negate the positive elements of the guidance, but it does warrant healthy scepticism.

A healthier alternative: the BANT Wellness Pyramid

Unlike the conventional UK Eatwell Guide, the pyramid developed by the British Association for Nutrition and Lifestyle Medicine (BANT) reflects a more functional, biologically realistic, and clinically useful model of nutrition.

According to the BANT Wellness Solution (2022) BANT_WELLNESS-SOLUTION_2022-1, the foundation of the diet is not meat or dairy, but vegetables, leafy greens, whole foods, and lifestyle behaviours.

Key differences that matter

1. Vegetables as the foundation

The BANT pyramid places:

• Unlimited salads, leafy greens, and non-starchy vegetables at the base

• Root vegetables and whole grains as a supportive but clearly secondary layer

This aligns far more closely with evidence on inflammation reduction, gut health, micronutrient density, and long-term disease prevention.

2. Whole grains included – but intelligently

Whole grains such as:

• Whole oats

• Brown and wild rice

• Quinoa

are included intentionally, while refined grains (white bread, pasta) are explicitly limited due to their sugar-like metabolic effects.

This nuance is completely missing from the U.S. pyramid, which tends to oversimplify carbohydrates rather than distinguish quality and processing.

3. Protein in moderation, not dominance

In the BANT model:

• Fish, poultry, and eggs are the primary animal proteins

• Pulses, lentils, beans, nuts, and seeds are strongly encouraged

• Red meat and processed meat are clearly stated as occasional foods only

This directly contrasts with the new USA pyramid, where animal protein, including red meat, is visually and conceptually elevated.

4. Dairy is optional and limited

Crucially, BANT explicitly states that dairy should be:

• Optional

• Limited to small amounts (e.g. a small matchbox of cheese, half a cup of live yoghurt, or a small glass of milk per day)

This reflects both:

• Human biology

• Clinical realities around cholesterol, gallbladder health, inflammation, and digestive tolerance

Dairy is not presented as essential, nor as a driver of health.

5. Lifestyle is built into the model

Unlike the USA pyramid, BANT integrates:

• Sleep timing and duration

• Regular meal patterns

• Movement and daily activity

This reflects modern understanding that nutrition does not operate in isolation.

What real longevity teaches us: lessons from the Blue Zones

When we move beyond policy documents and look at real populations with exceptional longevity, a very different pattern emerges.

The Blue Zones - regions of the world with the highest concentrations of centenarians - consistently demonstrate that:

• Whole grains are a staple, not a problem

• Legumes are eaten daily

• Vegetables dominate the plate

• Meat is eaten sparingly, often only a few times per month

• Dairy is minimal or absent, except in specific fermented forms in limited regions

Examples include:

• Sardinia (Italy)

• Ikaria (Greece)

• Okinawa (Japan)

• Nicoya (Costa Rica)

• Loma Linda (California)

Across these regions, meat is never at the top of the dietary hierarchy, and dairy is certainly not positioned as essential.

Instead, longevity is associated with:

• High fibre intake

• Diverse plant foods

• Whole grains consumed regularly

• Low overall intake of animal protein

• Strong metabolic and insulin sensitivity

This directly contradicts the structure of the new USA pyramid.

Why this matters

Where the U.S. model elevates animal foods, both BANT and Blue Zones demonstrate that health and longevity are driven by plant-dominant diets with modest, optional animal food intake.

The science, the biology, and the lived evidence all point in the same direction.

• The BANT pyramid is more nuanced, more flexible, and more biologically appropriate than the USA’s new guidance

• It recognises that:

  • Whole grains are not the enemy

  • Dairy is optional

  • Red meat should be occasional, not foundational

• Blue Zones reinforce that long-lived populations thrive on plant-rich diets, not meat-centred ones

If we are serious about long-term health and about sustainability - then the USA pyramid should be viewed critically, not adopted wholesale.