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PMID: 31374893; PMCID: PMC6723869. 162 Zhang, Y., He, T., Hu, Y., & Gao, C. (2024). Low-Carbohydrate Diet is More Helpful for Weight Loss Than Low-Fat Diet in Adolescents with Overweight and Obesity: A Systematic Review and Meta-Analysis. Diabetes, Metabolic Syndrome and Obesity, Volume 17, 2997–3007. https://doi.org/10.2147/dmso.s467719. 163 Yuan, X., Wang, J., Yang, S., Gao, M., Cao, L., Li, X., Hong, D., Tian, S., & Sun, C. (2020). Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid that can be difficult for the average person to understand. This complexity may contribute to the worrying statistic that less than 10% of Americans follow a diet that aligns fully with the DGA. 186 Additionally, there are more fundamental criticisms of the DGA’s approach that warrant serious consideration. Specifically, the DGA: • Maintain problematic reductionist recommendations, 187 188 such as: • Advising people to “reduce saturated fat” or “limit sodium” instead of focusing on minimizing ultra-processed foods. • Treating all calories similarly, rather than distinguishing between nutrient-dense foods and ultra-processed products. • Remain largely agnostic to how foods are produced or processed: There is little distinction between industrially processed foods and home-cooked or whole foods if their nutrient profiles look similar. Added sugars, saturated fats and sodium are treated as proxies for ultra-processed foods. For instance, a cup of whole-grain ready to eat fortified breakfast cereal and a cup of oatmeal with fruit might both count as “whole grain servings,” and the guidelines do not weigh in on differences in processing. • Do not explicitly address UPFs: The 2025 Dietary GuidelinesAdvisory Committee (DGAC) under the BidenAdministration opted not to issue recommendations limiting UPFs. Although they concluded that a diet higher in UPFs was associated with greater risk of obesity and/or being overweight, they graded the evidence as “limited.” 189 The DGAC noted methodological discrepancies in existing stud- ies—particularly variations in defining and measuring UPFs— rather than an absence of concern or research rigor. Meanwhile, other countries explicitly urge citizens to avoid or limit UPFs: • Brazil’s guidelines explicitly advise people to “avoid ultra-processed foods.” and emphasize home cooking, shared meals, and cultural food traditions. 190 • Japan’s guidelines, rooted in traditional dietary culture, emphasize staple foods, side dishes, and moderation, and stress portion variety, food education in schools, and daily physical activity. 191 • The Nordic countries’ guidelines (2023) recommend “minimal intake of…processed foods containing high amounts of added fats, salt, and sugar.” 192 They also integrate nutrition and reducing food waste in one framework that prioritizes whole grains, legumes, root vegetables, and sustainable fish. • France’s guidelines encourage cooking from scratch, enjoying minimally processed foods, limiting ultra-processed, high sugar/ fat items, and seasonal, local, and organic choices. 193 194 The DGA have a history of being unduly influenced by corporate interests. For example: • The infamous 1992 Food Pyramid, which was influenced by research from the sugar industry, 195 196 197 recommended carbohydrates at the base of the pyramid and made no differentiation between refined grains and whole grains. • In 2015, the DGAC recommendation to reduce processed meat consumption faced pushback from the meat production industry, which led to these recommendations being removed from the final published guidelines. 198 • A recent analysis found that 95% of the 2020DGAC 2020 DGAC members had some form of relationship with industry actors, most often through research funding but also as board members, speakers/honoraria, or consultants. 199 Government Programs Compounding the Issue Over the past 50 years, several well-intentioned government programs have been launched to improve children’s nutrition and access to food. However, as these programs have grown in size and complexity, many have drifted from their original goals: