HMN 2026: What the new US dietary guidelines mean for kids

Earlier this year, the U.S. Department of Health and Human Services and the U.S. Department of Agriculture released the 2025–2030 Dietary Guidelines for Americans—a mixed-bag of guidance that has been both lauded and criticized by the medical science world.

For children and teens, the new recommendations exhibit both strengths and weaknesses, says pediatrician Anisha Patel, MD, professor of pediatrics at Stanford Medicine Children’s Health. Some of the recommendations are supported by strong evidence, while others lack evidence, are contradictory, or may be difficult for certain groups to follow.

Patel sees patients as a primary-care pediatrician at the Gardner Packard Children’s Health Center, where she often helps parents figure out how to put dietary advice into practice for their kids. She also conducts research on preventing childhood obesity—such as by studying how to help students make healthy beverage choices at school—and has written a cookbook featuring low-sugar versions of popular recipes.

“In general, I didn’t see many places where the new recommendations strayed too far from the American Academy of Pediatrics dietary guidance,” Patel said. “But there are some instances. I have concerns for how we handle those in a clinical setting, and how they get implemented more broadly.”

Patel recently coauthored a viewpoint in JAMA about the pediatric implications for the new guidelines. Here are five things she says parents should know about what the new guidelines mean for babies, children, and teens:

1. Curbing ultra-processed food is great—and aligns with efforts to make school food healthier

“It was exciting to see the focus on removing ultra-processed foods from the diet,” Patel said. The guidelines define these to include highly processed, prepared or ready-to-eat foods, as well as foods and beverages with artificial flavors or sweeteners, and sugar-sweetened beverages. (Researchers sometimes use other definitions.) These foods tend to have low nutrient density—meaning they contain a lot of calories but few other nutrients such as vitamins, minerals, or fiber—and can contribute to childhood obesity.

Prior versions of the guidelines did not emphasize getting ultra-processed foods out of the diet, Patel said, adding, “The implementation of that advice will be challenging, but I think the recommendation itself is great.”

California recently passed legislation that says ultra-processed foods must be phased out of the state’s school meals by 2035. Patel’s team, including Andrea Pedroza-Tobias, Ph.D., an instructor in pediatrics at Stanford Medicine, has already begun working with California school districts to understand what challenges school food service managers foresee as they shift away from ultra-processed menu items.

“On a related note, I also like the advice to decrease intake of highly processed or refined grains,” Patel said. “There is good evidence that eating more whole grains is helpful for everyone’s health.”

2. Avoiding added sugars is smart—but may be tricky with school-aged kids

The new guidelines recommend kids consume no added sugars until age 10, whereas the prior guidelines suggested kids not eat anything with added sugar until age 2.

There’s plenty of evidence that consuming added sugars can be harmful, especially for children, and especially while forming their dietary preferences, Patel said, adding that she appreciates the recommendation.

“Much of my research has focused on getting kids to drink water instead of sugar-sweetened beverages, which are a major source of added sugars in children’s diets,” Patel said. “We’ve done educational campaigns in several California school districts to encourage students to drink water, while also working with schools to make sure campuses have appealing water bottle filling stations.”

But Patel thinks there will be challenges with implementing the recommendation to completely avoid added sugars for kids up to age 10. How, she asks, will it be put into action and how will experts provide supportive environments for families so they can follow this advice?

One big concern is that older kids enter the school environment, so there will need to be efforts to change that system’s food supply. The food industry has a whole host of products that they sell to schools, and they are good at reformulating products, she said. “For instance, if new regulations say there is to be no added sugar in yogurt, they might add fruit syrup concentrate instead, which is a different name for what is basically added sugar,” Patel said. “Or they may add non-nutritive sweeteners—also not recommended for children.”

The new dietary guidelines don’t offer guidance on concerns like these, she said, whereas the prior version of the guidelines had much more information about policy and implementation.

3. ‘More protein’ advice could have unintended consequences

The new dietary guidelines emphasize eating more protein, particularly from meat and other animal products. But Americans generally have sufficient protein intake—and that’s true for most children, too.

“We’re seeing that adolescents may now think they need to increase their protein intake, which is not necessarily true, and that they may add protein in less-healthy ways,” Patel said. “Some teens are consuming protein supplements, including products that are not FDA-approved, or are eating processed foods with added protein.” If someone eats more protein than they need to maintain healthy body structures and grow, it either gets burned for energy or converted into fat.

The emphasis in the new guidelines on protein from animal sources is also concerning, Patel said. Meat and other animal products are higher in saturated fat and are less sustainable for the planet than high-protein plant foods, such as beans. Many people do not eat animal protein due to personal preferences or cultural or religious traditions. Animal products are also more expensive. It worries Patel that individuals living in poverty may have less access to recommended foods under the new guidelines.

“In addition, while kids typically get plenty of protein, many children don’t consume enough fiber,” she said. “This can contribute to constipation, a very common childhood problem. Plant foods—including many that are high in protein—provide fiber that kids need in their diets, while high-protein animal foods do not.”

4. Advice on full-fat dairy conflicts with messages about saturated fat

The new guidelines say to consume no more than 10% of daily calories from saturated fat—which has been the recommended limit on saturated fat for decades. Eating too much saturated fat, which comes mostly from animal products, has long been linked to higher levels of LDL, the “bad” cholesterol, as well as higher risk for heart disease.

However, the guidelines also encourage people to consume more full-fat dairy products, such as whole milk and full-fat yogurt. It would be difficult to do that and not exceed the saturated fat limit, Patel said.

“I co-chaired an expert panel that worked with four leading national health and nutrition organizations to develop healthy beverage guidelines for school-aged children,” she said. “The panel decided that even though the evidence suggests possible benefits to consuming whole-fat dairy, including lower obesity rates, there weren’t enough rigorous studies to change the recommendation away from low-fat products.”

Patel’s team, along with Lorrene Ritchie, Ph.D., of the University of California Nutrition Policy Institute, is currently conducting an study looking at the impact of whole milk versus lower fat milk in toddlers. Families who participate are being randomized to consume one of the two types of milk. The scientists are tracking kids’ growth, development, microbiome, and cardiovascular outcomes.

“We think it’s really important to do this research because prior studies associating whole fat milk consumption with lower obesity risk haven’t been randomized controlled trials that are able to definitively show that whole milk is actually responsible for lowering obesity,” Patel said.

“We need more rigorous research in this space. I don’t think the evidence is strong enough to support this shift in dietary guidelines yet.”

5. Pediatricians and dietitians can help with individualized advice

The guidelines are brief and they hit some key points—they support breastfeeding for infants, for instance—but there are many situations they don’t cover, Patel said. Even for a simple question, such as when to switch from whole milk to low-fat milk, which has typically been recommended when a child turns 2, many families need individualized advice.

“Right now, I look at each patient and determine, “Does this make sense for them personally, based on family history and their current growth trajectory?'” she said. “And that’s not a simple issue. Kids’ food needs and preferences change a lot as they grow. They often go through a picky phase as preschoolers. They need more nutrition when they hit their growth spurt during puberty. They might take up a new sport and suddenly their calorie needs go way up.”

In addition, she points out, lots of children and teens face more complex nutritional challenges because of a chronic condition such as diabetes, a food allergy, or an eating disorder. And many families experience food insecurity and need help from their health care team in getting connected to programs that can help them make sure they have enough food for their kids.

“So one size doesn’t fit all in terms of the dietary guidelines, especially not for kids,” Patel said. “I recommend that families ask their pediatrician for help or consult with a registered dietitian. We have lots of experts who can work with parents and children one-on-one and help them make dietary choices that will work well for them.”

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