The Dietary Guidelines for Americans (DGAs), published by the US Department of Health and Human Services (HHS) and the US Department of Agriculture (USDA), provide science-based recommendations on what to eat and drink to promote health, reduce the risk of chronic disease, and meet nutrient needs. The guidelines provide a framework for policy makers and nutrition and health professionals to help individuals consume a healthy and nutritionally adequate diet. They also help inform dietary planning for federal programs including the National School Lunch Program, the Supplemental Nutritional Assistance Program (SNAP), and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
The DGAs are updated every five years, with each update building on the previous set of guidelines. The 2015–2020 guidelines emphasized healthy dietary patterns over individual foods. The 2020–2025 guidelines were released in December 2020.
Who the dietary guidelines are — and aren’t — meant for
The DGAs are recommendations for the general public including healthy people, those with overweight and obesity, and those at risk for chronic disease. While just about everyone can benefit from choosing more nutrient-dense foods and following a healthy eating pattern, those who already have one or more nutrition-related chronic diseases, such as type 2 diabetes or heart disease, could benefit from more condition-specific dietary guidance. Ask your doctor for recommendations; he or she may refer you to a registered dietitian for more specific advice.
Recommendations for pregnant and lactating women, infants, and toddlers
For the first time, the DGAs include infants and toddlers from birth through 24 months, and women who are pregnant and lactating. Notably, the guidelines include a recommendation encouraging the introduction of potential allergens like peanuts, egg, and cow milk products to infants at about 6 months. They also recommend that children under the age of 2 years not consume foods containing any added salt or sugar. Exposure to these foods early in life can increase preference for them later in life, potentially contributing to overweight and obesity. (Read this blog post for more details on what the new guidelines recommend for infants, children, and teens.)
Guidelines promote healthy dietary patterns across preferences and cultures
Most Americans consume a dietary pattern that does not align with the DGAs, falling short when it comes to vegetables, fruits, whole grains, nuts, seeds, legumes, and low-fat dairy. Often, simple swaps can help you eat more nutrient-dense foods, which are high in nutrients but relatively low in calories. For instance, trade your full-fat yogurt with added sugar for plain, low-fat yogurt with fresh fruit; serve whole-wheat pasta instead of white pasta; or swap beans for meat in your favorite chili recipe.
The new DGAs provide a framework for healthy eating that can be adopted across cultures and food preferences. For example, their selection of nutrient-dense vegetables includes chamnamul, a Korean spring green, and yucca, a nutty-flavored tuber native to South America. The DGAs also note that flavoring foods with spices and herbs can allow for reductions in added sugar, salt, and saturated fat.
No change to added sugar recommendation
HHS and USDA took this Scientific Report of the 2020 Dietary Guidelines Advisory Committee and public comment into consideration when updating the guidelines. The report recommended that added sugar be cut from 10% of total daily calories to 6%. However, the 2020–2025 guidelines did not make this change, leaving in place their recommendation that “a healthy dietary pattern limits added sugars to less than 10 percent of calories per day.”
The top source of added sugar in the American diet is sugar-sweetened beverages. Research has shown that sugar-sweetened beverages increase risk for high blood pressure and fatty liver disease. Sugar lacks nutrients and contributes to obesity, increasing heart disease risk.
The American Heart Association recommends women limit added sugar to 6 teaspoons or 100 calories per day, and about 9 teaspoons or 150 calories per day for men. The DGA’s recommendation of 10% of a 2,000-calorie diet is about 50 grams (12 teaspoons) of sugar per day. The USDA and HHS state that the science on added sugar has not changed, and that allowing 10% of calories from added sugar allows for flexibility in the diet.
From my perspective as a registered dietitian, 50 grams of sugar is too high. I advise my patients to check packaged foods for added sugar, because many packaged foods that appear healthy contain high amounts of added sugar. For example, some Greek yogurt may have up to 9 grams per serving, cold cereal up to 16 grams per serving, and granola bars up to 18 grams per serving.
Guidelines do not change alcohol upper limits for men
The advisory committee also encouraged tightening alcohol limits for men, suggesting that the upper daily limit be dropped from two drinks per day to one drink per day (equal to the current recommendation for women). However, the new guidelines did not adopt this recommendation.
A standard drink is defined as a 5-ounce serving of wine, a 1.5-ounce serving of distilled spirit, or a 12-ounce serving of beer. One drink typically equals about 100 to 150 calories, and contains little nutrients.
The current recommendation of up to two drinks per day for men was introduced in 1990 and is outdated. In those who drink, the lowest risk for all-cause mortality is equal to one US standard drink per day for men and women. Further, there’s no evidence of benefit from two drinks per day. The American Institute for Cancer Research notes that alcohol increases risk for many types of cancer, even at low levels of consumption. In fact, the 2020 American Cancer Society Guideline on Diet and Physical Activity for Cancer Prevention concludes that “it is best not to drink alcohol.”
Despite emerging evidence, the USDA and HHS rejected the recommendation to tighten alcohol consumption guidelines to one drink per day for men, based on “lack of preponderance of evidence.”