The US has revised their dietary guidelines - should NZ follow suit?

Released as part of Robert F. Kennedy Jr.’s agenda to ‘Make America Healthy Again’,¹ the new Dietary Guidelines for Americans have been criticised for implying that butter, meat and beef tallow are healthy fats; prioritising meat and dairy over plant-based foods; and including a controversial ‘real food’ inverted pyramid.

Are these recommendations evidence-based, and do they align with NZ dietary guidance? 

How do the US guidelines compare to NZ?

Globally there has been a deliberate evidence-based shift towards prioritising plant-based protein sources over animal foods. For example, the recently released Dutch dietary guidelines, developed by an independent scientific advisory body, emphasise that a more plant-based and less animal-based diet is better for health and benefits the environment.² NZ guidelines similarly prioritise legumes, nuts and seeds, over eggs, poultry and red meat.³

The US “real food” inverted pyramid is visually misleading and inconsistent with the text that accompanies it in the guidelines. The US guidelines retain the recommendation to limit saturated fat to <10% of energy intake¹ – consistent with both NZ³ and WHO⁴ guidance. However, experts note this would be impossible if red meat, butter and beef tallow (foods rich in saturated fat) were eaten as encouraged and depicted in the new pyramid.⁵ In addition, wholegrains appear at the tip, while protein foods, dairy, fats, fruit and vegetables form the base, implying higher intake of meat, fish and dairy and less wholegrains – despite the guideline text recommending similar serving sizes across these food groups.¹ Many countries, including NZ,³ have moved away from pyramids, instead using an image of a plate to illustrate how much of the diet should be made up of vegetables and fruit, whole grains, and protein foods such as legumes, chicken, fish or lean red meat.^6,7

Some critics still support the general message in the new US guidelines to eat “whole foods” and avoid highly processed foods. Although this has been interpreted by some as a call to avoid “ultra-processed” food,^8,9 this term is not used in the American guidelines. NZ guidelines already recommend that we “choose and/or prepare foods and drinks that are mostly ‘whole’ and less processed”.³

Are New Zealanders currently following the guidelines?

The reality is we do not know if New Zealanders are using or meeting the guidelines. National nutrition data in NZ are outdated: the most recent adult survey was conducted in 2008–2009,¹⁰ and for children in 2002.¹¹ By contrast, other countries – such as the UK¹² and the USA¹³ – conduct rolling surveys. Closer to home, Australia periodically collects such data, most recently in 2023–2024.¹⁴ Although methods and tools for a new NZ survey have been developed,¹⁵ government funding has not been secured. These national nutrition surveys are essential for designing effective food policies and improving population health (See Appendix).

Why do dietary guidelines matter?

Guidelines are a useful resource for practitioners and underpin wider food policy. For instance, they inform the National Food and Drinks Policy, guiding food provision in hospitals and standards for school lunch programmes – although although a 2025 analysis found school meals did not meet these standards.¹⁶ Public awareness of our dietary guidelines is likely low¹⁷ and should be increased.

Could our dietary guidelines be improved?

Our dietary guidelines are sensible, evidence based and aligned with international recommendations. However, aside from serving size updates in 2020³, they have not been fully revised since 2016. Regular updates are needed to incorporate new evidence; a revision for children and young people is currently underway.

There have been isolated calls to add explicit advice to avoid “ultra-processed” foods into our guidelines.⁶ However, this could confuse consumers, given that many staple foods, such as mass-produced wholegrain bread, are classified as ultra-processed yet are important sources of nutrients like fibre (see Appendix).¹⁸ 

The process to develop the US guidelines has also been criticised because members of the committee had links to the food industry (see Appendix). Industry influence can shape perceptions of what counts as “healthy”. Meat and dairy sectors also often oppose consideration of environmental impacts,¹⁹ yet agriculture contributes roughly one-third of global greenhouse gas emissions.²⁰ Dietary guidelines influence population-level food choices, so incorporating sustainability ensures they promote diets that support both human health and the environmental systems that sustain it.²¹

Future NZ guideline reviews should strengthen transparency and conflict-of-interest processes, drawing on international best practice (see Appendix for how this is managed in Australia).

How do we support NZers to meet the dietary guidelines?

Unhealthy diets low in fruit, vegetables, legumes and wholegrains, and high in sugary drinks, contribute substantially to the burden of disease in NZ.²² There is strong expert consensus on policies to support the population to eat healthier, including: mandatorily restricting marketing of unhealthy food and drink to children, eliminating industrial trans-fats from our food supply, taxing sugary drinks, setting mandatory salt limits for packaged foods, and requiring health-star ratings on all food product labels.²³

Authors' details 

Assoc Prof Kathryn E Bradbury, School of Population Health, Waipapa Taumata Rau | University of Auckland.

Assoc Prof Victoria Egli, Health Equity and Innovation Division of Health, Te Whare Wānanga o Waikato | University of Waikato

Dr Meredith C Peddie, Department of Human Nutrition, Ōtākou Whakaihu Waka | University of Otago

Appendix

Usefulness of national nutrition survey data

Comprehensive data from a national nutrition survey is essential for developing and evaluating cost-effective food policies to improve population health – for example our iodine and folate fortification programmes are designed by modelling data from national nutrition surveys to identify appropriate foods to fortify and the amount of iodine and folate to add to foods, and these policies are in place to ensure proper thyroid function and cognitive development in children (iodine fortification) and to prevent birth defects (folate fortification). Nutrition experts, as well as food industry, have repeatedly called for a new national nutrition survey¹⁵.

Adding a recommendation to our guidelines to avoid ‘ultra-processed’ food would be unhelpful.

The system of classifying foods as ultra-processed comes from Brazil. A major NZ food staple – mass-produced packaged bread – is classified as ‘ultra-processed’ and indeed is the biggest contributor to ultra-processed food intake in NZ^24,25. Food-based dietary guidelines should always be tailored to the country context, reflecting the foods available, accessible, and culturally acceptable²⁶. Currently, our guidelines encourage wholegrain bread, which is important because as a population, we are falling short on fibre intake^10,11, and therefore a message to avoid ultra-processed food would be confusing and unhelpful to incorporate into NZ guidelines.

Criticisms of the US dietary guideline development process

Marion Nestle, a prominent public health champion, has also criticised how the guideline development was politicised – the scientific report from the Dietary Guideline Advisory Committee commissioned during the Biden presidency was rejected and a new committee appointed to develop their own report at pace⁹. Members of this new research committee reported financial relationships with food companies and meat and dairy trade associations⁹, and it’s not surprising the resulting guidelines smack of industry influence^8,9. Meat and dairy products are prioritised over plant-based foods at every turn and in defiance of the original Dietary Guideline Advisory Committee’s recommendation to emphasise plant-based foods by organising the protein foods sub-group to list beans, peas and lentils first and meat, poultry and eggs last¹.

Australia’s policy on conflicts of interest for prospective and appointed dietary guideline committee members

Australia is currently undertaking a thorough update to their dietary guidelines²⁷ and has a stringent policy which outlines which potential conflicts of interest prospective and appointed committee members are required to disclose (such as having received funding from the food industry) and how these will be managed (including by disqualifying potential members from the committee or by removing them from certain discussions)²⁸. Each member’s disclosures are transparently listed on their website²⁸. For future NZ guideline updates, we should improve the transparency and strengthen the process to deal with potential conflict of interests from prospective and appointed committee members.