Make America Healthy Again

For decades, nutrition education was built like a pyramid: solid, hierarchical, and reassuring. Eat this first, limit that, count these nutrients, and health will follow. It was elegant, stable, and very Egyptian.

The USDA 2025–2030 Dietary Guidelines draft quietly flips this structure upside down. Instead of placing nutrients at the base, it places context there: culture, access, time, behavior, and the food environment. Nutrients are still important, but they no longer hold the structure.

The old model assumed people eat rationally, have access to ideal foods, and follow rules consistently. Clinicians know better. Patients eat under stress, within cultural traditions, and inside systems that often work against healthy choices.

We now have not only an inverted—unsteady—pyramid, but one that is carb-shamed, pro-dairy, and productivity protein-driven.

Bread, rice, grains: the fuel of civilizations. Then obesity and diabetes rates climbed, and we needed someone to blame. Carbs were convenient. Refined sugars, ultra-processed foods, and liquid calories were the real problem, but nuance does not go viral.

Protein became the salvation because it provides better satiety, preservation of lean mass, and improved adherence during weight loss. Protein didn’t just gain scientific support — it gained moral status (discipline, strength, control, “doing things right”). Eating protein felt productive. Eating carbs felt suspicious.

Large cohort studies began showing neutral or even protective associations with dairy consumption. Full-fat dairy did not behave like isolated saturated fat (yogurt is better than butter). The narrative cracked. Psychologically, dairy didn’t return as a hero — it returned as a misunderstood character.

So the new paradigm offers tools to manage behavior, cultural flexibility, and realistic counseling strategies. The new model is inverted, with behavior and context at the base and nutrients at the top. It feels unstable because it is. But it’s also honest.

Carbohydrates were never evil. Protein was never magic. Dairy was never on trial for the right crime.

Nutrition didn’t change sides — we grew up.

🫜Caldow G, Palermo C, Wilson AN. 'What do doctors think they need to know about nutrition?'-a qualitative study of doctors with formal nutrition training. BMC Nutr. 2022 Aug 22;8(1):85. doi: 10.1186/s40795-022-00577-w. PMID: 35996126; PMCID: PMC9394029.

PD: The message is simple: eat real food.