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Megan Maisano, MS, RDN's avatar

2. Doesn’t this contradict Mediterranean Diet recommendations?

Yes and no. The Mediterranean Diet is typically described as emphasizing minimally processed foods, particularly vegetables, fruits, whole grains, legumes, and unsaturated fats, with moderate intake of seafood, dairy, and poultry and limited red meat. In that sense, there is some overlap with the DGA. Where the two diverge is in emphasis: the new DGA places greater focus on protein foods, particularly from animal sources.

While the Mediterranean Diet is certainly a nutritious way of eating, it’s important to recognize that there are many healthy foodways around the world. The “Mediterranean Diet” often carries a health halo and reflects a narrow interpretation of eating patterns from select regions like Italy and Greece, while overlooking others across the Mediterranean, such as North Africa and the Levant, where staple foods and cultural practices differ. This broader context helps explain why the previous DGA included multiple dietary patterns (Healthy U.S., Healthy Vegetarian, and Healthy Mediterranean-Style) rather than promoting a single model.

Megan Maisano, MS, RDN's avatar

4. Is there more emphasis on reducing carbohydrates, and is there science to this?

The new DGA emphasizes limiting refined carbohydrates, not necessarily total carbohydrates, but there are some notable shifts. Fruit and vegetable recommendations remain similar (2 and 2.5 cups in the prior DGA versus 2 and 3 cups in the new DGA, respectively). The biggest change is in grains: the new DGA recommends 2-4 servings per day, down from 6 previously (one serving = ½ cup cooked rice or oats, or one slice of bread or tortilla). In addition, while earlier guidelines recommended that at least half of grains be whole, the new DGA recommends that all grains be whole.

Most experts agree that reducing low-quality carbohydrates - such as added sugars and refined grains - in favor of higher-quality sources like fruits, vegetables, legumes, and whole grains is beneficial. Importantly, research consistently shows that diet *quality* matters more than macronutrient ratios. Some healthy dietary patterns are relatively higher in carbohydrates (e.g., plant-forward diets or for endurance athletes), while others may be lower in carbohydrates, such as for people with type 2 diabetes or prediabetes.

Lastly, it’s important to recognize that refined grains can still play a valuable role in healthy diets, often serving as a vehicle for other nutrient-dense foods. Additionally, many are fortified or enriched, contributing important micronutrients like folic acid - which is especially critical during pregnancy and has significantly reduced the prevalence of neural tube defects since fortification began.

References:

https://jamanetwork.com/journals/jama/fullarticle/2673150

https://www.cdc.gov/folic-acid/about/intake-and-sources.html

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