Patients don’t often walk into appointments asking about the federal dietary guidelines or visual tools including the food pyramid, UChicago Medicine registered dietitian Sarah Kolb said. Instead, many arrive with general nutrition messages they’ve picked up from friends, social media or the latest diet trends.

Yet the Dietary Guidelines for Americans, the most recent version featuring the traditional food pyramid turned upside down, that was released this year, can be valuable to help shape public health messaging and nutrition education.

"Visual guides can be helpful because they translate complex nutrition information into something quick and easy to understand," she said. "They often serve as a starting point for conversations about balanced eating, especially for families and in schools."

So what do local nutrition experts think about the changes that replace the familiar MyPlate graphic with the inverted food pyramid?

Some say the new model highlights important ideas including whole foods and adequate protein, others worry it could send confusing signals about saturated fat, red meat and grains.

Significant changes

The new design of the dietary guidelines marks a visual and guidance shift, says Sarah Brentlinger, nurse practitioner at NorthShore Health Centers.

"MyPlate was designed as a practical tool for everyday meals," she said. "It used a simple plate graphic that showed proportionate food groups on a dinner plate, which helped Americans visualize how much of each major group should appear in a typical meal."

The pyramid-shaped guidelines return to a tiered design meant to show which food groups should play a bigger role in the diet, Brentlinger said.

"The new food pyramid is inverted, or upside down, which is different from how we have seen it in years before," she said. "The pyramid's tiers imply which food groups are most important versus least important in the overall diet rather than in a single meal, and its design requires interpretation and context to be understood." And that can be difficult, she said.

This food pyramid focuses on three categories — protein, dairy and healthy fats; vegetables and fruits; and whole grains — with the first two categories occupying most of the space.

"This reduces the number of visible categories, but increases abstraction, because the user must infer both quantity and quality from a shape that no longer maps directly on a meal," said Dr. Ezra Mutai, assistant professor of food and nutrition at Purdue University Northwest. "In practice, that means MyPlate still works well as a meal-planning tool, while the new pyramid functions more as a high-level ideological statement about which categories matter most."

Among some of the significant changes are a greater focus on protein intake and full-fat dairy with no added sugars. The guidelines include recommendations to:

• Consume 1.2 to 1.6 grams of protein per kilogram of body weight each day.
• Cook with healthy fats, primarily olive oil, but also butter and beef tallow as options.
• Eat more healthy fats from meat, eggs or seafood or from nuts, full-fat dairy, olives or avocados.
• Eat three servings of vegetables and two servings of fruit each day.
• Eat or drink three servings of dairy per day based on a 2,000-calorie diet.
• Avoid highly processed foods, non-nutritive sweeteners and added sugars.
• Focus on whole grains — not refined carbs.
• Limit alcohol intake.

As with any major shift in dietary guidance, experts say the new model includes strengths and areas that deserve closer scrutiny.

Strengths

Developed in 2011, the MyPlate nutritional guidelines created a visual representation that looked like a meal, which helped people focus on portion control, Brentlinger said. It was user-friendly and could be adapted across all cultures, but she notes that a common criticism was that it oversimplified nutrition and was silent on ultra-processed foods.

"The newest food pyramid focuses on food quality," she said. "It has a strong emphasis on protein, healthy fats and whole foods and leads a stronger stance on the negatives of ultra-processed foods."

Dietitian Kolb says that emphasis on whole foods and reducing highly processed options reflects where nutrition research has been heading.

"At the same time, any visual model has limitations and can oversimplify how foods should be balanced in a real diet," she said.

While most Americans are familiar with the visual guide of the inverted pyramid, the 2025-2030 dietary guidelines also include a 10-page consumer-facing document. This includes more detailed recommendations, including one that urges girls 11 to 14 to consume more iron due to menstruation. Powers Health clinical dietitian Sarah Kremitzki supports this. She also agrees with recommendations that encourage consumers to eat nutrients from different sources, such as vegetables in any form.

"Any vegetable is a good vegetable, whether you have it fresh, frozen or canned," she said.

For older adults at risk of muscle loss, a higher protein emphasis could be beneficial as well, Mutai said.

Drawbacks

That focus on protein that is also drawing some criticism — particularly for visually prioritizing red meat, cheese and whole milk and downplaying fiber, plant-based protein and saturated fat and cardiovascular risk, Mutai says.

"Placing red meat, cheese and whole milk so prominently risks sending a signal that these should be consumed liberally, which is not fully aligned with longstanding evidence linking high intakes of saturated fat and certain meats to cardiometabolic risk," he said.

There is a large disconnect between the graphic and recommendations that is misleading, Brentlinger said.

"With protein, dairy and healthy fats at the broad top and whole grains at the narrow bottom, it can be misinterpreted as telling people to eat more of the groups at the top and less of those at the bottom," she said.

Kremitzki says she's also concerned that there aren't clear examples of what whole grains people should eat. While the guidelines recommend prioritizing fiber-rich whole grains, they only state examples of what to avoid — white bread, ready-to-eat or packaged breakfast options, flour tortillas and crackers.

"A lot of people don't know how to identify a whole grain," she said.

The guidelines are also vague in limiting alcohol and added sugar, simply stating to consume less, Kremitzki said.

And she worries about the recommendation for children to consume fattier whole milk through age 10. The former guidelines recommended to begin phasing out whole milk in favor of lower-fat options around age 2.

Childhood obesity is on the rise with some of the most recent statistics from the Centers for Disease Control and Prevention showing that approximately 1 in 5 U.S. children and adolescents is obese.

"I've also started to see children with high cholesterol," Kremitzki said.

If people interpret the recommendations as encouraging higher protein intake from lean and plant sources, along with abundant vegetables and fruits, whole grains and mostly unsaturated fats, Mutai says he would expect to see improvements in metrics such as weight management, glycemic control, blood pressure and cholesterol.

"However, if the public takes the graphic at face value and substantially increases intake of red meat, high-fat dairy and saturated fats without simultaneously increasing fiber and plant foods, some of those gains could be blunted or even reversed, particularly for cardiovascular risk," he said.

Key takeaways

These guidelines aren't one-size-fits-all, Kolb says. For those with chronic conditions — nearly 60% of Americans, according to the CDC — modifications will be likely necessary.

"Someone managing diabetes, for example, may need to pay closer attention to carbohydrate quality and portion sizes, while those with hypertension may focus more on sodium intake," she said. "Because these needs can vary, it's important not to rely solely on general graphics or guidelines."

Kremitzki recommends speaking with a physician who can refer a patient to a dietitian to help navigate the new recommendations.

"Registered dietitian nutritionists are the experts on medical nutrition therapy and its use for managing chronic conditions," she said.

Dietitians take a look at a wide variety of factors, from medical and surgical histories, to religious preferences, disabilities, mental health and food insecurity. The goal is to offer a one-on-one approach to nutrition guidance, Kremitzki said.

"Each patient has unique needs and deserves personalized, compassionate care," she said.

For example, someone with stage 3 or 4 chronic kidney disease will have a recommended daily protein intake of .6 to .8 g/kg of body weight. However, someone with a more advanced stage 5 may need more protein — as much as 1.2 to 1.5 g/kg, Kremitzki said.

"Dietitians assist patients in learning why their diet needs to adjust, what foods to limit and increase and how to read a nutrition label," she said. "Dietitians also disprove nutrition myths/rumors, provide personalized energy and macronutrient needs, assist in timing of medication administration alongside food to prevent adverse effects and help connect patients with resources for food access to meet their needs."

For most families, the key takeaway is to focus on building meals around whole, minimally processed foods and aiming for balance across food groups, Kolb said.

"Including fruits or vegetables, a protein source and whole grains in meals is a practical starting point," she said. "Nutrition doesn't have to be perfect at every meal, consistent habits over time tend to matter more. If families have specific health concerns or dietary needs, it's helpful to discuss them with a registered dietitian or health-care provider."