The federal government's new dietary guidelines come out Thursday, after a year of arguments, lobbying and directives from Congress.
For the first time, the guidelines recommend limiting added sugar to 10 percent or less of calories.
They also recommend that people eat more fruit, vegetables and whole wheat and point out most Americans do not eat a healthy diet, are overweight and risk getting heart disease and other illnesses as a result.
The guidelines suggest cutting salt and saturated fat but stop short of telling people to eat less red or processed meat despite the strong evidence that both can cause cancer.
Not everyone will be happy with the final guidelines, which get rewritten every five years, but they are based on sound science, said Health and Human Services Secretary Sylvia Burwell.
"We want to make things easier and simpler for consumers," Burwell told NBC News. "One of the things we are steering people to is small changes."
Congress directed HHS and the U.S. Department of Agriculture to stick to recommendations that are strongly supported by science. There's overwhelming evidence that too much sugar causes diabetes, heart disease and weight gain, Burwell said.
"There's a lot of added sugars in beverages," Burwell said.
Despite heavy lobbying by the food industry, the guidelines — which set the standard for federal food programs such as school lunches and food stamps — also recommend that most people get 2,300 mg of salt a day or less. The average American gets 3,400 mg a day, Burwell said — and that can lead to high blood pressure.
More than 90 percent of children and 89 percent of adults aged 19 and older eat too much sodium, the Centers for Disease Control and Prevention said in a report released coincide with the new guidelines.
"More than three quarters of sodium in the American diet is estimated to come from processed and restaurant food, which gives consumers little choice when it comes to lowering daily intake," the CDC said. "A key strategy for lowering population-wide sodium intake is gradually reducing sodium in the food supply."
Most people are not going to even be able to get down to consuming just 10 percent of calories from sugar or fat, the report says — not if they are going to fit in enough fruits, vegetables and whole grains, too.
In a 2,000 calorie-a-day diet, that means 200 calories from sugar. But a 12-ounce canned soft drink alone has 120-150 calories, all of them from sugar — and most food labels even don't tell people how many calories come from sugar.
"How do you convert grams of sugar to teaspoons?" asked NBC News Health and Nutrition editor Madelyn Fernstrom. "It's not user-friendly at all."
Most Americans get enough protein now, the report says, and males usually get more than they need. What people need more of are vegetables, fruits and whole grains.
"The things that you need to be careful about are sodium, that added sugar and saturated fat," Burwell said.
And the report says consumers, policymakers, the food industry and others need to work together to help Americans eat healthier diets.
Burwell says new food labels coming out this year will help. The Food and Drug Administration plans to require sugar details on labels.
HHS and USDA walked a fine line in issuing the guidelines. They considered advice from nutrition and public health experts, food industry experts, farmers and politicians. HHS also considered 29,000 comments submitted by the public.
There are some changes from the recommendations made by a panel of experts almost a year ago. While the new guidelines mention that cholesterol in food isn't necessarily harmful - it doesn't directly raise blood cholesterol - they say people should eat as little cholesterol as possible.
"Often saturated fat and cholesterol do come together," Burwell said. So if people cut saturated fat and sugar, their cholesterol should go down, studies have shown.
The new guidelines also say that caffeine and alcohol appear to be safe in limited amounts, but say no one should start drinking either if they do not do so already.
The report makes clear that Americans will have to change the way they eat to meet the guidelines.
"Today, about half of all American adults—117 million people—have one or more preventable, chronic diseases, many of which are related to poor quality eating patterns and physical inactivity," Burwell and Agriculture Secretary Thomas Vilsack say in an introduction to the report.
"Rates of these chronic, diet-related diseases continue to rise, and they come not only with increased health risks, but also at high cost."
The guidelines also give three diet types to choose from: a typical American diet, a Mediterranean-style diet and a vegetarian diet.
They say a healthy eating pattern includes:
- A variety of vegetables: dark green, red and orange, legumes (beans and peas), starchy and other vegetables
- Fruits, especially whole fruit
- Grains, at least half of which are whole grain
- Fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy beverages
- A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes such as beans and peas, soy products, and nuts and seeds
- Oils from plants: canola, corn, olive, peanut, safflower, soybean, and sunflower oils, as well as nuts, seeds, seafood, olives, and avocados.