A Critical Narrative Review Appraisal of the 2025-2030 Dietary Guidelines: Scientific Strengths, Conceptual Gaps, and Overlooked Dimensions of Sustainability and Health Equity

对2025-2030年膳食指南的批判性叙述性综述评价:科学优势、概念缺陷以及可持续性和健康公平性方面被忽视的维度

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Abstract

The 2025-2030 Dietary Guidelines introduce an important shift in public health nutrition, emphasizing minimally processed foods, higher protein intake, greater inclusion of full-fat dairy, and a food-based advice centered on "real food" consumption. While several of these recommendations align with accumulating evidence, particularly the discouragement of ultra-processed foods and added sugars, substantial concerns remain regarding their internal coherence, population-level applicability, risk of misinterpretation, as well as environmental footprint. This critical narrative review evaluates whether the scope, emphasis, and framing of the new guideline components are proportionate to the strength, consistency, and context of the underlying evidence. Using a novel framework that distinguishes between nutritional adequacy, optimization, and therapeutic application, we assess the scientific coherence of key recommendations. A structured literature search was conducted in PubMed, Scopus, and Web of Science focusing on systematic reviews and meta-analyses of randomized controlled trials and large prospective cohort studies relevant to the updated guidelines. Particular attention is given to protein and saturated fat intakes, carbohydrate restriction in chronic disease, and the balance between simplification and scientific precision. Overall, the new guidelines represent a positive shift toward food-based recommendations; however, clearer differentiation between population-level guidance and context-specific interventions is required to preserve scientific rigor, reduce misinterpretation, and enhance public health relevance.

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