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The Dietary Guidelines for Americans 2025–2030 come with big rhetoric. “Real food.” A hard line on highly processed products and added sugar. A protein target that reads like sports nutrition, 1.2–1.6 g/kg. Set next to Mediterranean and DASH, the update is marketed as a correction.
The underlying evidence did not suddenly change in 2026. What changed is the framing. DGA puts processing and protein up front and leaves the cardio-protective pattern story in the background.
Mediterranean and DASH still sit on the strongest kind of nutrition evidence: randomized trials tied to outcomes that matter. For Mediterranean, PREDIMED showed fewer major cardiovascular events when a Mediterranean diet was supplemented with extra-virgin olive oil or nuts. For DASH, the early trials demonstrated meaningful blood-pressure reductions from the dietary pattern itself, and DASH-Sodium showed that cutting sodium amplifies that effect.
The sharpest split is fats and dairy. DASH was built around the standard cardiovascular playbook: keep saturated fat down, shift the fat mix toward unsaturated sources. The American Heart Association states that logic directly, and Cochrane reviews report fewer cardiovascular events when saturated fat is reduced, especially when replaced with polyunsaturated fats. DGA keeps a formal saturated-fat limit on paper, yet the examples pull readers in a different direction. Full-fat dairy is treated as a default, and butter or beef tallow are presented as acceptable options. The intellectual defense leans on food-matrix arguments and on what replaces what. That debate exists in serious cardiology journals. The practical issue is simpler: a public message that sounds permissive around saturated fat tends to travel farther than the footnotes.
Protein is the other headline. DGA makes it a central tool. Mediterranean and DASH treat protein as part of overall diet structure, with common sources that include fish and legumes, plus moderate dairy depending on the variant. Higher protein can help with satiety and lean-mass retention, especially during weight loss, but it does not have the same depth of randomized evidence on hard cardiovascular endpoints that the Mediterranean pattern has. It also lacks a single, clean target outcome in the way DASH has with blood pressure.
DGA does get one thing exactly right as a modern emphasis: ultra-processed food. Here we have a rare causal anchor. In a controlled inpatient randomized trial, participants ate more and gained weight on an ultra-processed diet compared with a minimally processed diet. Mediterranean and DASH often reduce ultra-processed intake as a consequence of their food choices. DGA makes it a named target.
If you want a workable stance without joining a tribe, keep the backbone as Mediterranean or DASH if cardiovascular risk is the main concern. Pull the strongest, least controversial parts from DGA: cut added sugar aggressively and push ultra-processed food down to the margins. Treat protein targets as a setting you adjust to your goal and your lab profile. Treat the butter, tallow, and full-fat dairy messaging with caution unless you are tracking lipids and you understand what fat sources you are swapping in and out.
1. Dietary Guidelines for Americans 2025–2030. https://cdn.realfood.gov/DGA.pdf
2. PREDIMED (NEJM, 2018) https://www.nejm.org/doi/full/10.1056/NEJMoa1800389
3. DASH trial (NEJM, 1997) https://www.nejm.org/doi/full/10.1056/NEJM199704173361601
4. DASH-Sodium (NEJM, 2001). https://www.nejm.org/doi/full/10.1056/NEJM200101043440101
5. AHA Presidential Advisory (Circulation, 2017). https://www.ahajournals.org/doi/10.1161/CIR.0000000000000510
6. Cochrane Review (2020). https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011737.pub3/full
7. JACC State-of-the-Art Review (Astrup et al., 2020). https://www.jacc.org/doi/10.1016/j.jacc.2020.05.077
8. Hall et al. (Cell Metabolism, 2019). https://www.cell.com/cell-metabolism/fulltext/S1550-4131(19)30248-7
