Real food is back and nutrition science is back at the centre of policy, according to the Australian Metabolic Health Society.
Everything in the health world has just changed. This week, the US released its 2025–2030 Dietary Guidelines for Americans, in a momentous reset in global nutrition policy history.
While the guidelines formally apply only to Americans, their implications extend well beyond U.S. borders — including to Australia, where national dietary guidelines are currently under review — and to the rest of the world.
Dietary guidelines do not simply inform personal food choices. They shape healthcare practice, public health messaging, institutional food provision, agricultural priorities, and research funding.
When a country as influential as the US changes course, the ripple effects are far-reaching.
How we got here
Modern dietary guidelines emerged in the late 20th century, with a strong emphasis on reducing fat and prioritising grain-based foods. The original food pyramid of the 1990s placed bread, rice and pasta at its base, while limiting natural protein-rich foods and fats.
Over the same period, rates of obesity, type 2 diabetes, fatty liver disease and other chronic conditions rose dramatically across the Western world. Dietary guidance failed to halt — and may have contributed to — worsening metabolic health outcomes for generations.
The new US guidelines are a clear departure from this failed nutrition policy legacy.
This is a pivotal acknowledgement. For decades, patients with diet-driven disease have been told medication was their only option. These guidelines restore hope — and align policy with decades of evidence showing many chronic conditions can be improved or reversed through nutrition.
They directly address the reality that the majority of adults are now metabolically unhealthy — and that dietary policy must change accordingly.
What’s changed — and why it matters
The updated guidance prioritises:
- Higher protein intake;
- Healthy fats;
- Whole, intact grains;
- Fruits, vegetables and gut health.
And explicitly advises reducing:
- Ultra-processed foods;
- Sugary snacks and sugar-sweetened drinks;
- Refined carbohydrates.
Importantly, the guidelines also acknowledge potential nutrient gaps in vegetarian and vegan diets, an issue well documented in the scientific literature but rarely addressed clearly in public policy.
The core message is straightforward: eat real, nutrient-dense food; prioritise protein; and limit highly processed products.
This is not a radical departure from science. It is a correction, and a much overdue reset.
A major shift for chronic disease care
One of the most consequential changes is the formal recognition of lower carbohydrate dietary approaches for people living with chronic disease. The guidelines state:
“Individuals with certain chronic diseases may experience improved health outcomes when following a lower-carbohydrate diet.”
This matters because the guidelines are explicitly written for the approximately 240 million American adults who are metabolically unhealthy — people living with insulin resistance, obesity, diabetes, hypertension and fatty liver disease.
For the first time, national nutrition policy acknowledges that a single dietary prescription does not suit everyone — and that carbohydrate reduction can be a legitimate therapeutic strategy.
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Why Australia should pay close attention
Australia faces a strikingly similar health profile:
- The majority of adults are metabolically unhealthy;
- Chronic disease accounts for a growing proportion of healthcare expenditure;
- Many patients are offered lifelong pharmaceutical treatment as the primary response to diet-driven conditions.
Medication can be essential and lifesaving. But when pharmacology is positioned as the only solution, people are denied agency — and the possibility of remission or even reversal of their chronic disease.
Nutrition policy matters because it legitimises what clinicians can recommend and what patients are encouraged to try.
With the Australian Dietary Guidelines under review, this is a pivotal moment in our history. Australia has the opportunity and responsibility to align its guidance with contemporary evidence rather than legacy assumptions.
AMHS call for accountability
The Australasian Metabolic Health Society (AMHS) is a multidisciplinary organisation representing clinicians, researchers and allied health professionals working at the forefront of metabolic health.
AMHS has long advocated for dietary guidance that reflects real-world clinical outcomes and high-quality evidence. We stand ready to support:
- Policymakers reviewing national nutrition guidance;
- Health bodies modernising public health frameworks;
- Health professionals seeking practical, evidence-aligned approaches to care.
Australian health bodies and policymakers must now reflect the nutrition science evidence in reforming dietary guidelines, so that Australia can respond to the scale and urgency of the metabolic health crisis we are facing.
The science is clear. The clinical experience is extensive. The cost of inaction is immeasurable — in lives, quality of life, and healthcare spending.
Real food is back on the plate. Nutrition science is back at the centre of policy.
Australia must not fall behind.
These guidelines represent a decisive return to real food, metabolic health, and clinical evidence. This is what AMHS has worked for so that lives are not lost to preventable disease.
What should happen next
- Australian dietary guidelines should explicitly prioritise metabolic health, not simply nutrient targets;
- Low-carbohydrate dietary approaches should be formally recognised and supported as therapeutic options for chronic disease;
- Ultra-processed foods should be clearly discouraged in public health messaging;
- Guidelines must support clinician flexibility, allowing nutrition advice to be tailored to individual metabolic needs;
- Implementation plans should follow rapidly, ensuring guidance translates into real-world change across healthcare, education and institutional food systems.
Claire McDonnell is the executive director of the Australian Metabolic Health Society. Dr James Muecke and Dr Penny Figtree are senior members of the AMHS.
