Welcome to Straight Talk on Health. I’m your host Dr. Chet Zelasko. Straight Talk on Health is a joint production with WGVU in Grand Rapids MI. I examine the practical application of health information. Nutrition. Exercise. Diet. Supplementation. I look at the science behind them, and let you know whether it’s something to consider or not. You can check out other things that I do on my website Drchet.com and sign up for my free emails.
What were the Dietary Guidelines that were published for 2015? Can you remember any of them? What are the Dietary Guidelines for 2025? Did you read them? Here’s your chance.
The 2015 Dietary Guidelines were released 10 years ago; the 2025 version about a month ago. Research was reviewed. Meetings were held. Comments were given. Experts gave input to both. Millions of dollars were spent. Was there anything groundbreaking in the 2015 Guidelines? The 2025 version? Maybe you’ve heard about the emphasis on protein and saturated fat in the 2025 version.
If you read any of the commentary about the latest dietary guidelines, you would have thought there were radical changes. “Eat or drink full-fat dairy! Use beef tallow! Ultra-processed food should be eliminated!”
When you have the time, spend it by going to the USDA website and reading the summaries of the 2015 DG and the 2025 DG. The scientific documents are a hundred pages or so but the summaries are only 4-5 pages long with plenty of pictures. In my opinion, there are very few differences between the recommendations. Both still use the same base of 2,000 calories per day. The recommended percentage of fat intake is the same – no more than 30%. The same number of fruits and vegetables are recommended—still way too low at two and three respectively. Sodium intake—the same. Eat whole grains, not refined carbohydrates. So where did all the discussion come from? Let’s take a look.
The new DG suggest a “Higher Protein Intake.” The recommendation is warranted given that we don’t get enough protein, based on the most recent research. Maybe there’s slightly more emphasis on animal protein, but all plant-based sources of protein including beans and nuts are given just like they always have been.
Because both sets of guidelines talk about adjusting nutrient intake based on stages of life, there’s an increase of protein recommended at different life stages.
You can now use “Full-Fat Dairy and Tallow for Cooking.” Although the focus on these two stirred a lot of online commotion, these are not meaningful changes in the recommendation for consuming dairy products or deep-fat frying in oils. While the commentary reached a high-pitched crescendo in the podcast and influencer world, you will probably figure out why it was meaningless. When you read the recommendations, in 2015 and 2025, the guidelines say not to exceed 10% of daily calories from saturated fat. One cup of milk would contain five grams of saturated fat, about 25% of the recommended daily intake for the average person. Fry something in beef tallow and depending on the food, that could use up the rest of the day’s entire fat recommendation. This is not different from the 2015 recommendations in any substantive way.
You should eat Fewer Ultra-Processed Foods.” One more time, there’s no difference in the recommendations for avoiding ultra-processed foods. The 2015 guideline didn’t call them ultra-processed foods because that’s a recent addition to the lexicon, but the pictures definitely show foods high in processed carbohydrates, sugars, and fats. In the 2025, I’m hard-pressed by a sandwich being considered an ultra-processed food but those are part of the 2025 DG.
The real problems with the 2015 guidelines were two-fold and will probably happen again for 2025 guidelines: Most Americans will never read the synopsis. Even if they do, they most likely wouldn’t change their eating habits to a more nutritious diet that’s based on vegetables, fruits, quality protein from all sources, whole grains, and a reasonable intake of fat. They haven’t since the DG were first introduced in 1980 and while I hate to be negative, I don’t think they will now either.
When I wrote this a few weeks ago in my twice weekly email, someone use AI to compare the 2025 DG with the 2015 DG. It was really interesting. It pointed out all the differences between the two versions—took up almost a full page on a sheet of paper. But it proved that while AI can follow algorithms, it doesn’t have the experience to understand nuance using UPF as an example. That word wasn’t used in 2014 when the 2015 DG were written so it said that was different yet the document refers to foods that are clearly UPF. It should also have known that 5 servings of fruits and vegetables are not enough in a healthy diet. Maybe it needs more training. Or maybe simply stated, we all need to eat less, eat better, and let’s throw in “move more” just for the heck of it—because that was part of the DG as well.
As long as we’re talking about guidelines, The American Heart Association PREVENT Online Calculator has just been released. PREVENT stands for Predicting Risk of Cardiovascular Disease EVENTs. If you search for “The American Heart Association PREVENT Online Calculator” in your favorite search engine, you should find it. While you’re there, you can calculate your 10 year risk of cardiovascular disease, your risk of heart failure, and your risk of Atherosclerotic Cardiovascular Disease (ASCVD). This new model has a goal of catching cardiac disease earlier. The age of risk assessment was expanded to include people aged 30-79 years.
More than that, it was designed to be race-free. Instead, they are using ZIP codes to identify environmental factors that can influence the development heart disease. As I said, the goal is to encourage people to use it earlier and adjust their lifestyle at a younger age to reduce the risk the older that they get.
I decided to play around with the numbers. First, I ran it with my actual numbers: age, SBP, eGFR, Total cholesterol, HDL cholesterol, BMI, no statin or BP, non-smoker, no history of diabetes. There are three more options specific to Chronic Kidney disease, diabetes with the HbA1c, and zip code. I only entered my zip code as I’ve never been tested for the others as there was no need. My 10 year risk of CVD was 18.8%, ASCVD was 10.7, and heart failure was 10.3%.
I was disappointed so I began to manipulate the variables. BMI from OW to Normal weight. No change. Raise HDL to over 60 mg/dl. Reduced .5% Taking a statin reduced it by 3%. Then I lowered the age by 30 years. It reduced the CVD to .5% and the ASCVD to 5.5%. We can’t change our age so I guess I’m stuck. Or am I?
Just like the USDA DG give us a goal for dietary changes, the AHA PREVENT calculator helps refine lifestyle by giving us targets to aim for. While changing your BMI when it’s close to a healthy BMI may not be important when you’re over 60, it can be significant when you’re 30 or 40 years old. It will reduce your BP, your risk of diabetes, and your risk of kidney issues. The benefits you get now accrue for benefits you can collect later. Read the DG and adopt them just one item at a time. Calculate the risk of CVD now so it stays as close to 0 for as long as you can. Prevention is better than treatment.
That’s all the time I have for this episode. If you like this podcast, please hit the share button and tell your friends and colleagues about it. Until next time, this is Dr. Chet Zelasko saying health is a choice. Choose wisely today and every day.
https://professional.heart.org/en/guidelines-and-statements/prevent-calculator
