By Megan R. Wilson

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In today’s issue: The winners and losers in the newly released dietary guidelines. … What was left on the cutting room floor. … A tick-tock from The Washington Post detailing how recent changes to the childhood vaccine schedule happened.

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Agriculture Secretary Brooke Rollins during a briefing Wednesday about the revised dietary guidelines. The food pyramid, scrapped during the Obama administration, is back. (Jacquelyn Martin/AP)

	The Lead Brief

What’s in: Beef tallow. What’s out: Emphasizing plant proteins.

The Department of Health and Human Services and the U.S. Department of Agriculture released new dietary guidelines — touting the changes as the “most significant reset of federal nutrition policy in decades.”

The Post’s Rachel Roubein has the story on the new guidelines, which shift recommendations toward more full-fat dairy products, additional protein, and fewer processed foods and refined carbohydrates such as white bread.

“We are ending the war on protein,” a new food pyramid released by the administration today proclaims.

Prior guidelines advised Americans to prioritize skim and low-fat milk, cheese and yogurt, and emphasized lean proteins — poultry, beans, soy products and eggs — over red meats, which some nutritionists have also urged people to limit for health reasons.

The revised dietary guidelines include a suggested limit of 10 grams of added sugar per meal, a more specific amount than the previous recommendation that advised people to consume less than 10 percent of their overall daily calories from added sugars.

→ The new food pyramid replaces the MyPlate model launched during the Obama administration and pitched as a more flexible way to encourage healthier eating. MyPlate had suggested that people “make half your plate fruits and vegetables,” vary their protein selection and ensure half of the grains they consume are whole grains.

Meanwhile, the Trump administration’s food pyramid prioritizes having every “high-quality, nutrient sense protein” from meats and plants in every meal, paired with “healthy fats,” three servings of vegetables and two servings of fruits per day, and two to four servings of whole grains every day.

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Why it matters: Although not all Americans closely adhere to the federal dietary guidelines — which are updated every five years — they serve as a foundation for what’s served in school lunch programs and influence the diets that doctors recommend to patients.

Health Secretary Robert F. Kennedy Jr. has made overhauling the nation’s food supply a priority of his Make America Healthy Again agenda, aimed at addressing chronic disease and childhood illness. The issue is one that polls well among Americans, a contrast to how people have viewed his approach to vaccine policy.

ICYMI: An analysis of Kennedy’s social media posts contained in a recent wide-ranging Washington Post profile about the nation’s top health official showed that he has posted on social media more than twice as frequently about food than vaccines while in office.

The release of the updated dietary guidelines has so far been met with mixed reviews. The American Medical Association praised the dietary guidelines as offering “clear direction.”

But the American Heart Association expressed concern the “recommendations regarding salt seasoning and red meat consumption could inadvertently lead consumers to exceed recommended limits for sodium and saturated fats.” The group also said it would continue to recommend low-fat and fat-free dairy products as more beneficial to heart health.

	Executive Health Brief

In December 2024, prior to President Donald Trump’s inauguration, an advisory committee of health and nutrition experts that typically helps shape the dietary guidelines released a report with recommendations for the update. Along with the release of the revised guidelines, HHS and USDA released a report detailing which of the recommendations it had decided to implement or reject.

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For example, while the administration adopted a recommendation to provide “clear advice” to consumers about the level of sodium in foods, it rejected a suggestion to expand federal efforts at lowering the target amounts of sodium in various foods.

→ In 2024, the Food and Drug Administration issued guidance for the packaged food industry that set goals for the maximum amount of sodium to be included in products such as cream cheese, pesto sauce and deli meats as a means of curbing how much Americans eat — all of which are totally voluntary.

The newly released dietary guidelines maintain the existing recommended 2,300 mg per day maximum that Americans ages 14 and older should eat, with lower amounts for younger kids.

Here are some of the other suggestions the administration didn’t adopt:

• Several recommendations that emphasized favoring plant-based proteins over meats — including advising people to eat more protein-rich beans and lentils while reducing the consumption of red and processed meats.
• Replacing butter or plant-based oils high in saturated fat, such as coconut oil, with vegetable oils that are higher in unsaturated fat.
• Promoting diets for children that included eating smaller nutrient-dense meals or snacks throughout the day. For adults, the panel recommended that “pre-portioned” meals should be used to help reduce the amount of “energy-dense” (see: high-calorie) foods people eat.
• Adding new guidance about “after dinner/evening snacking,” while continuing to recommend that people — especially children — regularly eat breakfast.
• Including findings about alcohol consumption’s impact on health from other expert panels, one of which had been criticized by industry for having ties to anti-alcohol advocates. (On Wednesday, the House Oversight and Government Reform Committee released a report alleging the panel had been biased and “had a predetermined goal” to publish a study suggesting that “no amount of alcohol consumption is safe.”)

	Lobbying Ledger

The alcohol industry is one of the biggest winners in the revised guidelines.

People are now advised to consume “less alcohol for better overall health” — which eliminates the specific recommendations the prior dietary guidelines had prescribed: a maximum of two drinks per day for men and one drink per day for women.

Mehmet Oz, the doctor who leads the Centers for Medicare and Medicaid Services, told reporters Monday that “there was never good data” to back up the one-to-two-drink limits.

“Alcohol is a social lubricant that brings people together,” Oz said. “There's nothing healthier than having a good time with friends.”

However, he advised, “don’t have it for breakfast.”

→ Alcoholic interests were the most prolific in lobbying on the dietary guidelines amid fears that the government would further reduce the recommended daily limit of alcoholic beverages: I checked out the lobbying disclosures and found that at least 58 companies and organizations disclosed advocating on the guidelines — and nearly 40 percent of them represented liquor, beer and wine interests. 

This includes industry groups including the Distilled Spirits Council, the Beer Institute and the Wine Institute — and companies such as Diageo, known for brands such as Ketel One vodka, Bulleit whiskey and Guinness beer, and the Molson Coors Beverage Company, which makes Miller High Life, Blue Moon and Coors.

→ Packaged foods companies were also well represented in the data, in addition to the dairy, soda, sugar and edible oil industries.

	Agency alert

Not only were federal vaccine experts caught off-guard by the sweeping changes to the childhood vaccine schedule announced by the Trump administration earlier this week, they also tell The Post’s Lena H. Sun that the recommendations conflict with their research findings.

Lena’s must-read story goes inside the unilateral decision by top HHS officials to cut the number of suggested shots for all children from 17 to 11, aligning U.S. vaccine policy with Denmark’s in a move criticized by public health experts and medical associations, who argued it puts more people at risk to contract deadly yet preventable illnesses.

One CDC scientist who works on vaccines said career staff were “blindsided” by Monday’s announcement of a revised schedule. Another said that “none of us had any idea this was happening,” and only learned about it when HHS began inviting people to a briefing for reporters.

The Trump administration argued that the changes — which were made without consulting a federal panel of vaccine advisers — are intended to increase trust of public health officials among Americans who believe their children receive too many shots.

Multiple career scientists and researchers, who spoke on the condition of anonymity for fear of retaliation, told Lena they are angered by the bypassing of expertise in Monday’s decision. That anger prompted one agency physician, A. Patricia Wodi, to resign. Wodi, whose responsibilities included changes to the immunization schedule, didn’t immediately respond to a request for comment from The Post.

Officials told reporters Monday that the overhaul had been made following consultations with experts at the FDA, Centers for Disease Control and Prevention, and National Institutes of Health.

THE TIMELINE:

— Dec. 5: Trump directed health agencies to review the childhood vaccine schedule, comparing it to those in peer nations to determine whether the U.S. is an “outlier” in how many shots it recommends.

— Second week of December: Health officials asked experts at the CDC to provide information about the burden of disease and the effectiveness for the vaccines — including influenza, rotavirus and hepatitis A — that the administration announced earlier this week it would no longer broadly recommend, Lena reports. The experts provided the requested information, but there was no briefing or follow-up.

— Dec. 18: CDC experts briefed HHS officials, including Deputy Health Secretary and acting CDC director Jim O’Neill, on how the U.S. vaccine schedule compares to other developed countries.

— Dec. 19: The day Trump administration officials had initially planned to announce the rollback in child vaccine recommendations to align with Denmark’s immunization model, according to Lena’s report, citing people familiar with the plan. The news conference was abruptly called off.

— Jan. 5: HHS announced the childhood vaccine schedule overhaul, leaning on an assessment authored by Tracy Beth Høeg and Martin Kulldorff, who were prominent critics of coronavirus vaccination before joining the department. The changes contradict guidance from career scientists who prepared a presentation outlining how the U.S. vaccine policy is not an international outlier, according to a copy of the presentation obtained by The Washington Post.

Andrew Nixon, an HHS spokesperson, cited surveys showing declining trust in hospitals and physicians after the coronavirus pandemic when responding to Lena’s inquiry about the criticisms from career scientists.

“Pandemic era distrust of public health agencies has since spilled over into broader vaccine concerns,” Nixon told her in an email. “It is clear the U.S. is a global outlier among peer nations in the number of target diseases included in its childhood vaccination schedule and in the total number of recommended vaccine doses.”

However, Jake Scott, an infectious-diseases physician and clinical associate professor at Stanford University, told Lena that Denmark is actually the outlier. The country, home to 6 million people, has one of the most minimal vaccine schedules among developed countries.

	What We’re Reading

“Despite Little Research, Companies Race to Market Autism Tests,” Azeen Ghorayshi reports for the New York Times.

“Eli Lilly Nears Deal for Biotech Ventyx,” the Wall Street Journal’s Lauren Thomas, Jonathan D. Rockoff and Ben Glickman scoop.

“Trump administration tells 5 states their child care funds have been frozen,” Emily Peck reports at Axios.

“Flu reaches highest level in the US in 25 years,” reports Brenda Goodman at CNN.