DALLAS — The American Heart Association (AHA) has issued updated dietary guidance that conflicts with recommendations for meat and dairy and differs on views about grain-based and processed foods in the 2025-2030 US Dietary Guidelines for Americans (DGA).

In its 2026 Dietary Guidance to Improve Cardiovascular Health scientific report, released March 31, the AHA recommends that US consumers shift from meat to plant-based sources of protein — such as legumes (beans, peas and lentils), nuts and seeds — and eat fish and seafood regularly. The association also cautioned about red meat consumption, noting that “if red meat is desired” consumers should opt for lean cuts and limit portion size and frequency to minimize consumption of saturated fat and to avoid processed meat products to limit intake of sodium and additives.

“The 2026 guidance recognizes that most people currently consume more protein from meat than plants,” the AHA said in announcing the report, which updates its 2021 guidance. “So (AHA) guidance now supports multiple healthy protein choices, including plant-rich sources, and encourages the exchange of red meat for multiple alternate protein-rich foods, both plant and animal.”

The 2025-2030 DGA also calls for Americans to eat a variety of proteins for a healthy diet but, in an inverted food pyramid, endorses regular consumption of foods like red meat and full-fat dairy, which is discouraged by many nutritionists.

Emphasizing “real food,” the flipped pyramid puts meat, dairy and healthy fats on the widest tier at the top but positions grain-based foods — specifying whole grains only — at the bottom tip. That marks a big departure from the old food pyramid, which had bread, cereal, rice and pasta as foundational foods at the base, while dairy, meat/fish and proteins like eggs, beans and nuts sat in a narrower tier toward the top, with fats and oils at the tip to indicate they be eaten sparingly. The inverted pyramid graphic pictures steak, cheese, ground beef and whole milk in the top tier.

In its latest guidance on dairy, the AHA upheld its earlier stance that consumers favor low-fat or fat-free products over full-fat options. That’s at odds with the DGA, which touts full-fat dairy as a key source of protein and decries a “remarkable lack of evidence” to support “enduring guidance” to replace whole-fat dairy with low-fat products.

“While still recommending low-fat and fat-free dairy products as a preferred choice to control calories and fat intake, the updated (AHA) guidance recognizes that the potential health benefits of these compared with full-fat dairy products continue to be debated,” the association said.

The AHA deems consumption of low/no-fat dairy as beneficial, despite acknowledging the inconsistency of research on the cardiovascular disease (CVD) risk of whole-fat dairy.

The American Heart Association's latest dietary recommendations update its 2021 guidance. Source: American Heart Association

“Of note, the effect of replacing full-fat dairy products with nonfat and low-fat dairy products or other non-dairy sources of unsaturated fat shifts the composition of dietary patterns toward higher unsaturated-to-saturated fat ratios, those associated with most favorable cardiovascular health,” the AHA’s scientific report said.

The AHA also broadened its guidance on food sources for replacing saturated fats with healthy unsaturated fats, including from nuts, seeds, avocados and non-tropical plant oils. Its earlier recommendations focused on using liquid plant oils rather than animal fat, tropical oils or partially hydrogenated fats (trans fats). While supporting the DGA recommendation for saturated fat consumption to not exceed 10% of total daily calories, the AHA’s update doesn’t back the DGA’s endorsement of butter and beef tallow as fat options when preparing meals.

“Animal fats (e.g. beef tallow and butter) and tropical oils (e.g. coconut oil, cocoa butter and palm oil) are relatively high in saturated fat, whereas non-tropical plant oils (e.g. soybean, canola and olive oils) are relatively high in unsaturated fat,” the AHA’s scientific report said. The analysis also noted “strong evidence” shows that replacing butter with plant oils and spreads containing mainly unsaturated fat reduces low-density lipoprotein cholesterol concentrations, as does replacing beef fat/tallow or lard with non-tropical plant oils.

“In summary, as part of heart-healthy dietary patterns, non-tropical plant sources of fat should be used as part of food preparation in place of animal fats and tropical oils,” the report said.

Regarding grain-based foods, the AHA continues to recommend whole-grain options, noting they provide more benefits for cardiovascular health than refined grains — in line with the current DGA. The association said foods such as whole wheat bread, brown rice and oatmeal offer consumers “better choices” than refined grain foods like white bread and white rice.

“Whole grains are defined by the presence of all three components of the grain kernel — the starchy endosperm, inner germ and outer bran — and provide a complex matrix of dietary fiber, vitamins, minerals and other bioactive compounds,” AHA said in its scientific report, citing whole wheat, oats, brown rice, quinoa, barley and rye. “A substantial body of observational evidence from large-cohort studies demonstrates that regular consumption of whole grain foods compared with infrequent intake is associated with lower risks of CVD, coronary heart disease, stroke, type 2 diabetes and metabolic syndrome and more favorable cardiovascular risk factors, including blood pressure, blood lipids and glycemic control. Randomized controlled feeding trials have demonstrated that replacing refined grains with whole grains leads to improvements in cardiovascular risk factors.”

Yet the AHA’s updated guidance on grain foods marks a significant departure from the DGA. Whereas the AHA simply describes whole grains as a healthier option than refined grains, the DGA pegs refined grains as potentially harmful to health, calling them “highly purified sources of starch” that produce “long chains of glucose — a form of sugar” and rapidly spike blood sugar when consumed.

The 2025-2030 Dietary Guidelines for Americans puts more emphasis on meat and full-fat dairy in an inverted food pyramid positioning grains at the bottom.

Source: US Department of Health and Human Services

“Refined grain foods — white bread, crackers, breakfast cereals, chips, pastries and pasta — can therefore act metabolically like sugar, delivering fast-absorbing carbohydrates with few nutrients or fiber to slow absorption,” the 2025-2030 DGA scientific report said. “Take-home message: Refined grains are sugar in disguise.”

In addition, the AHA doesn’t make a recommendation for daily servings of grain foods, while the DGA lowers this food group’s dietary standing to the bottom tip of its inverted pyramid. The DGA now recommends 2 to 4 servings of whole grains daily, down from 6 to 11 servings from the grains group in the original food pyramid and the quarter-plate suggestion for grains in the later MyPlate meal model.

Also like the DGA, the AHA’s 2026 dietary recommendations urge consumers to choose “minimally processed foods,” or those that are “close to their natural state, with minimal added commercial ingredients, rather than those that are highly processed with additives.” The association’s scientific report said that, “for consistency,” it refers to the latter food category as “ultra processed foods” (UPFs).

“Food processing has resulted in both beneficial and adverse effects,” the AHA explained. “Benefits include improved food safety; extended shelf life; reduced costs; nutrient fortification to correct inadequacies; and preservation of nutritional, functional and sensory qualities. Drawbacks include high levels of sodium, added sugars and ingredients not normally present in food, as well as modifications that remove healthful components such as fiber and some nutrients.”

The DGA said highly processed foods “tend to have refined grains and/or added sugars; refined fats and oils; long, complicated ingredient lists including chemical additives (e.g. artificial sweeteners, flavor enhancers, artificial colors and emulsifiers).” Some of its observations are based on the widely cited Nova classification system, which has drawn criticism for focusing on processing level rather than nutritional value.

AHA’s scientific report raises questions about Nova and the lack of a consensus definition for UPFs, currently being pursued by the US Department of Agriculture and Department of Health and Human Services.

“Variability that has emerged in terminology can be attributed to the lack of a generally accepted classification system,” the AHA said. “The most commonly used one is Nova, which classifies ultra-processed foods based on the extent and purpose of industrial processing and if they contain cosmetic additives or ingredients not commonly used in home cooking, without factoring in nutrient content.”

The AHA also cited a “strong evidence base” that associates dietary patterns high in UPFs with adverse health outcomes — including obesity, CVD, type 2 diabetes and all-cause mortality — but noted that evidence falls short of establishing cause.

“Evidence is limited for mechanisms of actions linking dietary patterns high in ultra-processed foods to adverse health outcomes,” its scientific report said. “This may be due to the wide range of potential causal factors in the broad category of foods classified as ultra-processed.”