Food backgrounds: overhead view of a large group of food. The composition includes ground meat, beef steak, sausages, salmon steak, eggs, beans, shrimps, wholegrain pasta, vegetables like broccoli, carrots, Bok Choy, green beans, celery, avocado, corn, lettuce, garlic, potatoes, tomatoes and spinach. Fruits like bananas, grape, fig, orange, lemon, apples, pears and berries. Some nuts like walnut, pistachio, pecan and almonds. Dairy products like milk, yogurt, eggs and cheeses. Olive oil. High resolution 42Mp studio digital capture taken with SONY A7rII and Zeiss Batis 40mm F2.0 CF lens
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A recent discussion highlighted the gap between new federal nutrition guidelines and the reality faced by many Americans. During a conversation about diabetes, a woman expressed her fondness for apples and oranges but noted the absence and high cost of fresh fruit at her local corner store. Advocating for people to “eat real food” becomes unrealistic when such food is inaccessible to many.
New Food Pyramid. Available at realfood.gov.
USDA
The U.S. Departments of Health and Human Services and Agriculture have unveiled the Dietary Guidelines for Americans, 2025–2030, marking a major shift in federal nutrition policy. The guidelines prioritize proteins, dairy, healthy fats, vegetables, and fruits while reducing emphasis on refined carbohydrates and ultra-processed foods. Despite their alignment with expert advice, these guidelines remain out of reach for millions due to geographic and financial barriers.
The USDA reports that 39 million Americans reside in areas with limited access to affordable, nutritious food. Many lack nearby grocery stores, relying instead on corner stores and convenience marts. There is minimal guidance from the government on how these communities can adopt the new dietary recommendations.
Food Deserts Are a Longstanding Problem in America
Food deserts are low-income areas located far from supermarkets or large grocery stores. The widely used definition from the USDA includes urban areas where at least 33% of the population lives more than a mile from a supermarket and rural areas where the distance exceeds 10 miles.
Southern and Midwestern states have a higher concentration of people living in low-income, low-access areas, correlating with increased chronic disease rates in these regions. For instance, in Bolivar County, Mississippi, where a Food As Medicine intervention is taking place, 65% of the population is Black and 30% live in poverty. The county’s obesity and diabetes rates are nearly double the national average. This raises questions about whether the new federal food policy considered these communities’ challenges during its formulation.
Food and Health Are Inextricably Linked
The chronic disease crisis in America is influenced by various factors, including environment, genetics, physical activity, and socioeconomic conditions. However, the link between food and chronic disease is undeniable. Nearly 90% of U.S. healthcare spending supports treatment of chronic diseases related to diet and lifestyle. More than 70% of American adults are overweight or obese, and nearly one in three adolescents has prediabetes.
The “Food is Medicine” approach is gaining traction among clinicians, health plans, and researchers. This reflects a growing understanding that nutrition interventions can serve as clinical tools to enhance health outcomes. There is a rising demand for healthcare providers to include nutrition counseling in clinical care. Yet, such guidance is ineffective when people, like the woman who loves fruit but can’t afford it, face a food environment lacking fresh, nutritious options. The disconnect between federal dietary recommendations and the realities of low-income communities calls for urgent attention and action.
Balancing Reality and Food Choices
While new federal recommendations have been issued, communities with limited food access require practical strategies tailored to their situations. Potential solutions include investing in grocery infrastructure in underserved areas, expanding produce prescription programs, supporting corner stores in stocking fresh options, and fostering economic opportunities for those living in poverty.
Communities should also benefit from programs that enhance food and nutrition literacy. These programs should offer culturally relevant, straightforward education on macronutrients, food selection, label reading, meal planning, and practical cooking using accessible ingredients. Organizations like Feeding America address these issues locally, but need sustained, scalable infrastructure to reach those most in need.
The Bottom Line
For decades, the U.S. has examined, researched, and debated increasing healthcare costs and chronic disease burdens. The government has now introduced a new food pyramid, urging Americans to “eat real food.” The irony lies in the absence of a plan for the 39 million people without access to places selling such food while simultaneously cutting the food assistance that enables many in these communities to afford it.
Until federal guidelines are supported by investments in the food environments and infrastructure of the nation’s most underserved areas, the widespread adoption of these new guidelines beyond the affluent is unlikely. Federal nutrition policy must become actionable for everyone by partnering with affected communities and directly investing in their food environments.
