Dietary guidelines for Americans (DGA): 2025–2030: similarities and contrasts with the recommendations document of the Spanish society of atherosclerosis (SEA) (2024 update)

The publication of the 2025−2030 Dietary Guidelines for Americans (DGA)¹ in January 2026 and the 2024 update of the Spanish Society of Arteriosclerosis’ (SEA)² dietary guidelines offer an opportunity to examine the extent to which two frameworks for dietary guidance with different objectives converge: population-based public health in the US versus cardiovascular prevention in the Spanish context.

The interest in comparing them is not merely academic: in a globalised setting, nutritional messages travel rapidly and are sometimes put into clinical practice with no further detail. The following summarises points of convergence and divergence relevant to dietary advice.

Both documents share a central tenet: prioritising minimally processed, nutrient-dense foods. The DGA propose a deliberately simple message ("eat real food") and are structured around broad food groups (vegetables and fruits, whole grains, proteins, dairy, and healthy fats), with quantitative targets and an explicit call to reduce ultra-processed foods, added sugars, and sugary drinks.¹ The SEA document frames these recommendations within the traditional Mediterranean diet, focusing on its proven impact on cardiovascular and metabolic risk.²

The differences arise primarily from the purpose and context. The DGA are a population-based guide throughout the life cycle (including sections for childhood and adolescence) and, therefore, incorporate practical thresholds (e.g., daily servings, added sugars and salt per meal).¹ The SEA, on the other hand, is a clinician's support document that renders cardiovascular evidence into specific recommendations on frequency and choice, with greater emphasis on food substitution within the dietary matrix.²

A prime example is the treatment of cooking fats. The DGA prioritise oils with essential fatty acids "such as olive oil," but allow for "other options" such as butter or beef tallow, while maintaining the general limit for saturated fats (<10% of energy).¹ In SEA, extra virgin olive oil (EVOO) remains the recommended daily fat of choice, and prudent use of oils rich in polyunsaturated fats is advised (preferably raw), while frying with butter or certain spreads is discouraged.² This difference is significant: in cardiovascular prevention, the message about replacing saturated fats with unsaturated fats is a central part of the advice.

A similar nuance is observed in the dairy group. The DGA highlights whole dairy products without added sugars and establishes a target of 3 servings/day in a 2,000 kcal diet.¹ The SEA recommends at least two servings per day, allowing for whole or skimmed versions and highlighting the potentially beneficial role of fermented dairy products; it also introduces specific precautions (e.g., aged cheeses for hypertensive individuals due to their salt content).²

In contrast, the discourse strongly converges on reducing ultra-processed foods and those with "added sweetness." The DGA call for avoiding "highly processed" foods (both savoury and sweet) and limiting products with additives such as colourings, flavourings, preservatives, and non-nutritive sweeteners. They even propose an operational threshold of ≤10 g of added sugars per meal.¹ The SEA, supported by the NOVA classification and observational and mechanistic evidence, recommends avoiding ultra-processed foods and warns that both sugary and artificially sweetened beverages are associated with an increased cardiometabolic risk, proposing water as the preferred substitute.²

Finally, alcohol illustrates the weight of cultural context and the evidence framework. The DGA adopt a minimisation approach ("drink less alcohol for better health"), identifying groups that should avoid it altogether.¹ The SEA maintains a conditional recommendation: for regular drinkers, wine should be consumed in moderation with meals, with limits of 30 g/day for men and 15 g/day for women, and restrictive messages for young people and the elderly.²

Overall, the common core—more vegetables and fruits, whole grains, legumes, nuts, and fish; fewer ultra-processed foods, sugary drinks, and excess salt—outlines shared ground that, in practice, approximates an "updated" Mediterranean pattern. The main differences lie in how the message is put across (population-based vs. clinical) and in the inclusion of certain animal-based foods (protein, whole dairy products, and solid fats). Table 1 summarises the most relevant comparative elements.

Table 1.

Summarise comparison between the DGA 2025–2030 (USA) and the SEA dietary recommendations document (updated 2024).

Aspect	DGA 2025−2030 (U.S.A.)^1	2024 SEA document (Spain)^2
Conceptual framework	- Public health message: “Eat real food.” Diet structured around major food groups (protein, dairy, vegetables, fruits, healthy fats, and whole grains) with serving targets. Emphasis on reducing ultra-processed foods, added sugars, sugary drinks, and non-nutritive sweeteners.	- Traditional Mediterranean diet as a framework for cardiovascular prevention. From nutrients → foods integrated into a diet. Includes tables of portions and frequency (Tables 7 and 8).
Main goal	- Guidance for the general population and all life stages. Goal: To improve metabolic health and reduce chronic disease through nutrient-dense foods, home preparation, and reduced processing.	- Document for healthcare professionals focused on cardiovascular and metabolic prevention. Special emphasis on high-risk populations or those with cardiovascular disease.
Fruit and vegetables	- Consume a variety of foods, preferably whole. Targets (2,000 kcal diet): vegetables 3 servings/day; fruits 2 servings/day. 100% juice is recommended in limited portions or diluted.	- Five combined daily servings. One or more servings may be juices without added sugar (preferably homemade). Maximum benefits are described with 3 servings of vegetables and 2 of fruit.
Pulses	- Include pulses as a source of plant-based protein and fibre. They are part of the "protein foods" group and a dietary pattern based on nutrient-dense foods.	- An integral part of the Mediterranean diet. Recommends increasing plant-based protein and advises against preparations with meat fats (chorizo, bacon, etc.).
Cereals	- Prioritise whole grains rich in fibre. Significantly reduce refined carbohydrates (e.g., white bread, packaged breakfast options, flour tortillas, crackers). Goal: 2−4 servings/day (depending on energy needs).	- At least one portion of grains at each meal, preferably unrefined/whole grain. Discourages pastries, cakes, cookies, and similar products.
Fats	- Prioritise oils with essential fatty acids, such as olive oil. Other options may include butter or beef tallow. General limit: saturated fat <10% of energy.	- Use EVOO daily in the kitchen and at the table. Use oils rich in polyunsaturated fats (corn/soybean/sunflower) only raw; avoid using them at high temperatures. Frying with seed oils, margarine, or butter is not recommended; avoid trans fats and hydrogenated oils.
Fish and seafood	- Fish is included as a protein source, with omega-3-rich fish being particularly noteworthy. This recommendation aligns with the goal of "prioritising protein at every meal."	- Eat oily fish at least 3 times a week, 2 of those times as oily fish. The cardiometabolic benefits of n-3 polyunsaturated fatty acids are detailed.
Red and processed meats	- Red meat is included as a protein source. It is recommended to choose meats with no or minimal added sugars, refined carbohydrates/starches, and chemical additives, and to avoid fried preparations. No explicit frequency limit is established.	- Processed meat is discouraged except occasionally. Moderate consumption of unprocessed meat is recommended: a maximum of 3−4 times per week, preferably poultry and lean meats; remove visible fat. It advises reducing meat and increasing plant protein for sustainability.
Dairy	- Recommends whole dairy products without added sugars. Goal: (2,000 kcal diet): 3 servings/day. Emphasizes its role in infancy and childhood.	- ≥2 servings/day, whole or skimmed, fermented or not, without added sugars. Favours yogurt and fermented dairy products; caution with aged cheeses for those with hypertension due to their salt content.
Added sugars	- No added sugars are recommended. Operational threshold: a meal should not contain >10 g of added sugars. Proposes education on identifying them on labels.	- Limit added sugars as much as possible and avoid sugary drinks. Considers sugary drinks an indicator of an unhealthy diet.
Sugary drinks	- Avoid sugary drinks (soft drinks, fruit drinks, energy drinks).	- Avoid drinks with added sugars: not only fizzy drinks, but also processed juices and dairy drinks.
Sweetened drinks	- Limit foods and beverages with non-nutritive sweeteners. Point out they are not considered part of a healthy or nutritious	- Avoid artificially sweetened beverages. While acknowledging the debate, these are considered just as undesirable as sugary drinks; water is the primary substitute.
Ultra-processed foods	- Avoid highly processed ready-to-eat foods (both savoury and sweet). Prioritise home-cooked meals and nutrient-dense options. Limit additives: flavourings, colourings (including petroleum-based dyes), preservatives, and non-nutritive sweeteners.	- Avoid ultra-processed foods (NOVA) and promote fresh or minimally processed foods. It warns about salt, nitrates, added fats/sugars, and the risk of partially hydrogenated and trans fats.
Salt/sodium	- Sodium: <2,300 mg/day in the population ≥14 years (children, less). Very active people may require more sodium to compensate for losses through sweat. Avoid ultra-processed foods high in sodium.	- Reduce salt in cooking and at the table. Limit precooked meals, canned goods, salted foods, processed meats, carbonated beverages, and other ultra-processed foods.
Alcohol	- Consume less alcohol to improve health. Identify groups that should avoid it completely (pregnancy, alcohol use disorder, certain medications, or medical conditions).	- Conditional recommendation: If a regular drinker, consume wine in moderation with meals. Table 8: Limit 30 g/day for men and 15 g/day for women; young people should abstain; men >65 years ≤20 g/day.
Level of advocacy	- Includes quantitative targets (servings, protein g/kg, sugar and sodium thresholds), along with a simple message.	- High clinical prescription: portion sizes and frequency, with pathophysiological and evidence-based justification for cardiovascular prevention.
Clinical applicability	- Useful for general and family dietary advice. Requires adaptation when the main objective is individualised cardiovascular prevention.	- Designed for cardiovascular clinical practice in Spain. It converts evidence into purchasing, cooking, and food substitution decisions, facilitating its use in the clinic.

EVOO: extra virgin olive oil; DGA: Dietary Guidelines for Americans; SEA: Spanish Society of Arteriosclerosis.

One point that deserves special attention for discussion is the emphasis of the DGA on "prioritising protein at every meal," with a quantitative recommendation of 1.2–1.6 g/kg/day and a broad list of sources, including red meat.¹ The SEA, on the other hand, proposes moderation in unprocessed meats (maximum 3–4 times/week) and advises against processed meats, also recommending increasing plant-based protein for health and sustainability reasons.² For clinicians or nutritionists in the cardiovascular field, this contrast requires contextualisation: the goal is not to maximise protein per se, but to choose sources and substitutions that improve the lipid profile, blood pressure, and inflammation, without displacing cardio-protective foods.

From their different outlooks, both documents point in the same direction: rebuilding the diet around whole foods. The remaining task is interpretation: converting these public health messages into concrete decisions in shopping, cooking, and consultations. In Spain, the Mediterranean framework of the SEA provides a particularly useful clinical map. The DGA, for their part, offer simple language and quantitative goals that can facilitate communication. Integrating the best of both can strengthen the effectiveness of dietary advice and its sustained adoption.