Make America Healthy, Again? The Past, Present and Future of Dietary Guidelines

Dietary guidelines have been placed under unprecedented scrutiny in the past decade, as the "obesity epidemic" enters its fifth decade with limited evidence of public health progress. In the era of successful obesity pharmacotherapy, there is a heightened sense of urgency to make progress on dietary prevention of obesity and related chronic diseases, contributing to both diverse criticism of guidelines and low degrees of trust in nutritional sciences. In this review, I view nutritional guidance through a historical lens, tracking its development from its genesis through the modern focus on obesity and chronic diseases and consider criticisms of past and existing dietary guidance. I reflect on themes that emerge from this history and consider potential paths forward to improve the quality of nutritional guidance and actualize its goals of improving population health.