Food has been front and center in the Make America Healthy Again movement, Health Secretary Robert F. Kennedy Jr.’s campaign to solve chronic disease in the United States. That’s why forthcoming federal guidance on nutrition could draw extra attention this time around, even as a massive reorganization of the nation’s health workforce unfolds.

The Dietary Guidelines for Americans come out every five years, jointly framed in their final form by federal health and agriculture agencies. The next set is due by December, a year after an outside committee of academic experts reviewed scientific evidence and filed an advisory report.

But on Thursday Kennedy fired a shot at the advisory committee’s report, traditionally the basis of influential government recommendations.

“We’re in the middle of right now, very, very energetically, revising the nutrition guidelines,” Kennedy said Thursday, according to a TV news pool report. “There’s a 453-page document that looks like it was written by the food processing industry. And we’re going to come up with a document that is simple, that lets people know, with great clarity, what kind of foods their children need to eat, what kind of foods they can eat.”

After the first meeting of the MAHA Commission on March 11, it was already an open question as to how closely the 2025-2030 guidelines will hew to the scientific advisers’ recommendations. Their report was framed in terms of equity, a principle the Trump administration has been assailing as unacceptably ideological.

“We will make certain the 2025-2030 Guidelines are based on sound science, not political science,” Agriculture Secretary Brooke Rollins said in a statement released after the MAHA Commission’s closed-door session. “Gone are the days where leftist ideologies guide public policy.”  

And in the same release, “We are going to make sure the dietary guidelines will reflect the public interest and serve public health, rather than special interests,” Kennedy said. “This is a giant step in making America the healthiest country in the world.”

The Scientific Report of the 2025 Dietary Guidelines Advisory Committee was the first to apply a “health equity lens” to its review of scientific literature in an effort to ensure all people have access to healthy food. “Equity” is among terms flagged by the Trump administration in actions felt throughout the country.  

The cycle for new guidance overlaps four-year presidential terms. As one White House administration ended and another one began in January, advice was delivered in December before guidelines become official and after public comments were gathered for 60 days. USDA and HHS will now have until Dec. 31 to release the version that will cover 2025 through 2030.

This is the stage when the new recommendations go behind the curtain after nearly two years of public meetings about the available research. While never an exact copy of the advisory report, guidelines that emerge could look markedly different.  

And they matter. The final guidelines are more than just advice to a nation experiencing both obesity and poor nutrition. Each iteration sets standards for 16 national food assistance programs, affecting 1 in 4 Americans through what children eat in their school lunches and what families can buy through the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the nutrition programs for older Americans. 

STAT asked experts involved in the guideline process over the years what they think. USDA did not respond to STAT’s request for comment. HHS public affairs specialist Joellen Leavelle referred STAT to the press release from USDA and HHS; a request for an interview with a member of the MAHA commission drew no response. Advisory committee leaders did not answer emails asking for their thoughts.

Barbara Schneeman, a University of California, Davis, professor of nutrition emerita who worked on the 2020-2025 guidelines, did say the final product reflected advice from the expert committee overall, with two notable deviations. While the committee’s analysis of added sugars limited intake to 6% of total energy, the guidelines ultimately said less than 10% of energy intake. Moderate drinking stayed at two drinks per day for men, not one drink or less, as the committee concluded, but there was “added emphasis on reducing alcohol intake,” she said.

Dariush Mozaffarian, director of the Food Is Medicine Institute at Tufts, has been watching the process over the years, from scientists poring over data and systematic reviews to the eventual food pyramids evolving from USDA and HHS decision makers. 

“Usually they don’t listen to the report when there’s conflict between eating less of something or avoiding something that’s harmful that could hurt the American food sector, so there’s an inherent conflict of interest,” he said. 

Mozaffarian also noted how the 2020-2025 guidelines had taken less stringent positions than the academic recommendations on drinking and added sugar. Another committee had recommended considering climate issues, but that did not see the light of day, he recalled.

“The first stage is completely transparent,” Mozaffarian said. “Then that goes into a completely opaque black box of the agencies who come up with the final dietary guidelines without any public disclosure of what the discussions were, why they made the decision they did, why they listened to or didn’t listen to any particular decision.” 

USDA, HHS, and the advisory committee have been criticized for combining potential conflicts of interest in one list for all 20 members instead of by individual disclosure. The 2025-2030 roster includes pharmaceutical companies Abbott, Boehringer Ingelheim, Lilly, Novo Nordisk, and Pfizer as well as Beyond Meat, the plant-based meat substitute maker, Dairy Management, and both the American Egg Board and Egg Nutrition. 

The sharpest fissure might be the chasm between the advisory committee’s mission to focus on equity and the White House’s imperative to expunge diversity, equity, and inclusion from the government lexicon and funding. 

“We believe that emphasizing health equity throughout our report can inform the development of the Dietary Guidelines for Americans, 2025–2030, which will support U.S. individuals in meeting their dietary goals,” the report says. 

One committee member, Fatima Cody Stanford, said she didn’t see equity as a political issue. 

“When you think about this idea of equity, all we’re thinking about is making sure that all Americans have access to healthy food at all times,” Stanford, an obesity medicine physician and scientist at Massachusetts General Hospital, told STAT. “We don’t care how much money is in your bank account. We don’t care what family you’re born into. We believe that access to a healthy diet is a human right.”

That principle has inspired her own family.

“As someone whose parents have overseen a food pantry for over 30 years, I can tell you that if you don’t have access to healthy food, you can’t eat healthy,” she said. “You aren’t preventing chronic disease.”

Equity is just one of the administration-flagged words throughout the 421-page report, which also analyzed how to meet the needs of people from different cultures.

“Part of that culturally tailored dietary interventions issue is knowing that I’m going to need to tailor these interventions to fit the person in front of me,” she said about treating her patients for obesity. “Why not do that to ensure the best health outcomes in terms of nutrition for the person in front of me or in front of my dietitians, if that’s going to glean the best health outcomes using the best nutrition for that individual?”

Stanford pushed back at any suggestion the committee’s work was ideological and not based on science, saying that over 22 months the group looked at more than 6,000 pages of reports, reviewed more than 2,000 new references, and analyzed millions of data points.

“When we drew our conclusions, we had to use the literature, not just our own personal beliefs and thoughts and feelings and emotions,” she said.

On the scientific evidence, Mozaffarian takes issue with the data and systematic reviews supplied to the committee because they are prepared by USDA and HHS. In an editorial published in the American Journal of Clinical Nutrition in January, he blamed the exclusion of ultra-processed foods from the report on a flawed review that led the committee to conclude the evidence was too weak.

He hopes the final guidelines remove what he calls a “long-outdated fear of dairy fat,” a view still being debated but one that may align with Kennedy’s, judging by a visit to a Head Start in Alexandria, Va., after which he posted on X, “We are encouraging programs to switch from low-fat dairy — which the antiquated Dietary Guidelines require them to promote — to full fat/whole milk.” 

“That would be unprecedented for them to just basically pull something out of a hat completely that wasn’t even in the scope of this,” Mozaffarian said. “I’m disheartened by the secretary’s focus on seed oils, which are a pretty healthy product.”

Mozaffarian is more concerned about the lack of funding from the National Institutes of Health for nutrition research, needed to bolster future guidelines.

“NIH spends about 4% of its budget on nutrition research and training, and that’s by the most optimistic estimates looking at any grant or project that mentions nutrition,” he said, adding that his research has not been reduced. “I hope my publicly disagreeing on seed oils won’t lead to a cut.”

STAT’s coverage of chronic health issues is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.