What the 2025-2030 Dietary Guidelines Mean for Heart Health

In an interview with Pharmacy Times in advance of the National Lipid Association’s (NLA) 2026 Fall Clinical Lipid Update, Carol F. Kirkpatrick, PhD, MPH, RDN, FNLA, director of the Idaho State University (ISU) Wellness Center and a clinical associate professor in the Kasiska Division of Health Sciences (KDHS) at ISU, discussed what changed in the 2025-2030 Dietary Guidelines for Americans and what those changes mean for cardiometabolic health.

Kirkpatrick noted that the guidelines are intended for the general population and that many core messages—eating vegetables, fruits, and whole grains and limiting highly processed foods, added sugars, alcohol, and sodium—carry over from previous editions. What has shifted, she explained, is emphasis. The guidelines now prioritize protein at every meal, with a specific target of 1.2 to 1.6 g/kg of body weight per day. Kirkpatrick said randomized controlled trial evidence supports replacing refined carbohydrates with healthful proteins, preferably from plants, to improve lipoproteins and lipids. Full-fat dairy, which drew significant press attention, can fit into a healthy dietary pattern, she said, but it requires more effort to keep saturated fat in check.

The guidelines' strong message to reduce refined carbohydrate is a clear benefit, particularly for patients with prediabetes or insulin resistance, and the consumer-facing document repeats limits on added sugars across several recommendations. Kirkpatrick cautioned, however, that patients should not be made to feel guilty about what they eat. She also highlighted that the guidelines no longer provide a numeric limit for alcohol, noting that alcohol is not helpful for patients with elevated blood pressure or triglycerides.

Finally, the guidelines include a new statement that some people with certain chronic diseases may do better with a lower-carbohydrate diet. Kirkpatrick said many patients with prediabetes or insulin resistance could do very well with that approach, but she urged caution with blanket statements and emphasized working with health care providers. For pharmacists, these shifts create new openings for counseling and patient care.