The Society of Metabolic Health Practitioners (SMHP™) welcomes the new Dietary Guidelines for Americans, which are a significant improvement on previous versions and represent the first move towards more evidence-based dietary guidelines.

Positive changes include:

• Prioritization of whole, nutrient-dense foods, primarily from protein (animal or plant-based), dairy, vegetables, fruits, healthy fats,
• The explicit restriction of refined carbohydrates and added sugars, including non-nutritive sweeteners
• Increase in protein intake from 0.8 g/kg of body weight per day to a target of 1.2 to 1.6 g/kg of body weight per day
• Full-fat dairy is endorsed.
• Consumption of healthy fats encouraged (no limit specified)
• Recognition of the central role of metabolic dysfunction in obesity, diabetes, and cardiovascular disease
• Inclusion of low-carbohydrate dietary patterns as a recommended intervention for obesity, type 2 diabetes, and cardiovascular disease represents a decisive alignment with interventional evidence and real-world clinical outcomes delivered daily by metabolic health clinicians

Points for improvement:

• Retaining the 10% cap on saturated fat is disappointing, as it appears at odds with current evidence where randomized controlled trials  do not reflect harm, particularly when saturated fat replaces refined carbohydrates

Overall, much of what is recommended mirrors the metabolic nutrition pyramid long advanced by SMHP and its members. Ten years ago, LowcarbUSA^®, the sister organization of the SMHP, advocated for ‘turning consensus on its head’ with its inverted food pyramid.  Both inverted pyramids prioritize healthy fats, proteins, vegetables and fruit. This alignment reflects what SMHP clinicians on the front lines have demonstrated for years.

Changes in the US dietary guidelines also hold promise for SMHP members globally, as they may represent a tipping point that sees a shift in recommendations worldwide. A real, whole-foods dietary pattern, lower in carbohydrates, may be applied across a wide range of cultures and populations, as demonstrated by our successful clinicians from around the world.

As an ACCME-accredited organization representing thousands of clinicians delivering evidence-based metabolic care, the SMHP is encouraged by the substantial progress reflected in these guidelines and will continue to advocate for policies grounded in clinical outcomes, mechanistic science, and patient-centered results.

These advances, remaining gaps, and emerging cardiovascular data will be addressed in depth at our upcoming conference in Boca Raton, where clinicians, researchers, and other professionals will continue to shape new advances, debate the unknowns, and contribute to the future of metabolic health care.