Pros and cons of myplate

What is the difference between MyPlate and the Food Pyramid?

The importance of a balanced diet dates back to research done in the 1800s. The original research started with data on protein, carbohydrates, ash, and “fuel” value for common foods. In 1902, the man responsible for this research, W.O. Atwater, stated that “the evils of overeating may not be felt at once, but sooner or later they are sure to appear — perhaps in an excessive amount of fatty tissue, perhaps in general debility, perhaps in actual disease.” To this day, the guidelines emphasize the dangers of excess.

The first official food guide in USDA publications was published in 1916. In this guide, foods were categorized into five food groups: milk and meat; cereals; vegetables and fruits; fats and fat foods; and sugar and sugary foods. Throughout the years, several other versions of the guidelines would emerge as research pointed out the benefits and risks of specific kinds of foods and beverages.

In 1992, the Food Guide Pyramid was released as the image for a healthful diet. It emphasized foods from the five major food groups: grain group, vegetable group, fruit group, meat group, and milk group. Fats, oils, and sweets were represented at the very top of the pyramid. The message was that each group provided some, but not all nutrients, and no one food group is more important than the other.

Picture of the Food Pyramid

The Food Pyramid also included a range of servings for each of the food groups. The minimum range was listed for “almost everyone,” and the maximum was based on your calorie needs. The biggest problem with the Pyramid turned out to be the servings listed under each food group. Many people are unaware of the difference between a serving and a portion. A serving is a guideline or standard unit of measurement. We need this measurement to help estimate how much someone consumes. The portion is the actual number of servings that you consume. For example, if you eat a sandwich with two pieces of bread you would have two servings from the grain group. Each piece of bread is one serving, so two pieces would be two servings. That means that your portion was two servings of grains. People would mistakenly think that whatever amount they had at the meal was equal to one serving. That could mean that you were allowed a minimum of six sandwiches if bread was your only source of grains! Of course, this is not the case and it would be extremely difficult to maintain your weight if you did that with each of the food groups.

Another criticism of the Pyramid was the way that the foods were listed. Some people saw the large grain group on the bottom and thought that it was more important than fruits or vegetables. Others saw the top as the most important and that would mean that fats, oils, and sweets were the most important part of their diet. Finally, the Pyramid doesn’t show that whole grains are ideal, you want lowfat versions of meats and dairy, fresh fruits and veggies are ideal, that you need water, or that physical activity is needed.

MyPyramid was the icon that replaced the Food Guide Pyramid. With this modification of the system, the goal was a more personalized approach to healthy eating and physical activity. The image now had colors representing each of the food groups that were spread across the Pyramid, instead of stacked from top to bottom. A person climbing up the stairs on the side was added to emphasize physical activity. The web site http://www.MyPyramid.gov was added to give details on serving sizes and personalize how many are needed from each food group. The hope was that people would use the online tool and get the needed education for the Pyramid to make sense. Unfortunately, many people found this even more complicated than the original Food Guide Pyramid.

Picture of MyPyramid

In the hopes of simplifying the goal of a well-balanced diet, MyPlate was developed. The plate is built off of the 2010 Dietary Guidelines and is divided into four sections: fruits, vegetables, grains, and protein. On the side, is an image for dairy. Along with the plate comes “10 tips to a great plate,” which are based on the Dietary Guidelines and include the following advice:

  1. Balance calories.
  2. Enjoy your food but eat less.
  3. Avoid oversized portions.
  4. Foods to eat more often
  5. Make half your plate fruits and vegetables.
  6. Switch to fat-free or lowfat (1%) milk.
  7. Make half your grains whole grains.
  8. Foods to eat less often
  9. Compare sodium in foods.
  10. Drink water instead of sugary drinks.

Details on each of these and other tips can be found at this government site.

We eat on a plate and not a pyramid so the image of a plate is clearly easier to understand when deciding what a balanced meal should look like. Many believe that MyPlate is going to have a huge impact in changing the American diet. First Lady Michelle Obama announced that MyPlate “is a quick, simple reminder for all of us to be more mindful of foods that we’re eating, and as a mom, I can already tell how much this is going to help parents across the country.”

Childhood Nutrition Facts

  1. Dietary Guidelines Advisory Committee. Scientific Report of the 2015 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary Health and Human Services and the Secretary of Agriculture. Washington, DC: US Department of Health and Human Services; 2015.
  2. US Department of Health and Human Services and US Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at http://health.gov/dietaryguidelines/2015/guidelines/external icon.
  3. Krebs-Smith SM, Guenther PM, Subar AF, et al. Americans do not meet federal dietary recommendations. Journal of Nutrition. 2010;140:1832–1838.
  4. Reedy J, Krebs-Smith SM. Dietary Sources of Energy, Solid fats, and added sugars among children and adolescents in the united States. Journal of the American Dietetic Association. 2010;110:1477–1484.
  5. Institute of Medicine. Preventing Childhood Obesity: Health in the Balance. Washington, DC: The National Academies Press; 2004.
  6. Kushi LH, Byers T, Doyle C, et al. American Cancer Society guidelines on nutrition and physical activity for cancer prevention: Reducing the risk of cancer with healthy food choices and physical activity. A Cancer Journal for Clinicians 2006;56:254–281.
  7. Kaiser LL, Townsend MS. Food insecurity among US children: Implications for nutrition and health. Topics in Clinical Nutrition. 2005;20:313–320.
  8. Alaimo K, Olson CM, Frongillo EA. Food insufficiency and American school-aged children’s cognitive, academic and psychosocial developments. Pediatrics ,2001;108:44–53.
  9. Kleinman RE, Murphy JM, Little M, et al. Hunger in children in the United States: Potential behavioral and emotional correlates. Pediatrics, 1998;101:1–6.
  10. Mesirow MA, Welsh JA. Changing beverage consumption patterns have resulted in fewer liquid calories in the diets of US children: National health and nutrition examination survey 2001–2010. Journal of the Academy of Nutrition and Dietetics. 2015;115(4):559–66.
  11. Kim SA, Moore LV, Galuska D, et al. Vital Signs: Fruit and vegetable intake among children—United States, 2003–2010. MMWR. 2014; 63(No. RR-31):671–6.
  12. Drewnowski A, Rehm CD. Socioeconomic gradient in consumption of whole fruit and 100% fruit juice among US children and adults. Nutr J. 2015;14:3.
  13. Drewnowski A, Rehm CD, Constant F. Water and beverage consumption among children age 4–13 years in the United States: Analyses of 2005–2010 NHANES data. Nutr J. 2013;12(1):85.
  14. US Department of Agriculture. ChooseMyPlate.govexternal icon.
  15. Centers for Disease Control and Prevention. School health guidelines to promote healthy eating and physical activity. MMWR. 2011;60(RR05):1–76.
  16. Taras HL. Nutrition and student performance at school. Journal of School Health. 2005;75:199–213.
  17. Rampersaud GC, Pereira MA, Girard BL, et al. Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents. Journal of the American Dietetic Association. 2005;105:743–760.
  18. Hoyland A, Dye L, Lawton CL. A systematic review of the effect of breakfast on the cognitive performance of children and adolescents. Nutrition Research Reviews. 2009;22:220–243.
  19. Popkin BM, D’Anci KE, Rosenberg IH. Water, hydration, and health. Nutrition Reviews. 2010;68(8):439–458.
  20. Kempton MJ, Ettinger U, Foster R, et al. Dehydration affects brain structure and function in healthy adolescents. Human Brain Mapping. 2011;32:71–79.
  21. Edmonds CJ, Jeffes B. Does having a drink help you think? 6 to 7-year-old children show improvements in cognitive performance from baseline to test after having a drink of water. Appetite. 2009;53:469–472.
  22. Edmonds CJ, Burford D. Should children drink more water? The effects of drinking water on cognition in children. Appetite. 2009;52:776–779.
  23. Benton D, Burgess N. The effect of the consumption of water on the memory and attention of children. Appetite. 2009;53:143–146.

Generations of Americans are accustomed to the food pyramid design, and it’s not going away. In fact, the Healthy Eating Pyramid and the Healthy Eating Plate complement each other.

Consumers can think of the Healthy Eating Pyramid as a grocery list:

  • Vegetables, fruits, whole grains, healthy oils, and healthy proteins like nuts, beans, fish, and chicken should make it into the shopping cart every week, along with a little yogurt or milk if desired.
  • The Healthy Eating Pyramid also addresses other aspects of a healthy lifestyle—exercise, weight control, vitamin D, and multivitamin supplements, and moderation in alcohol for people who drink—so it’s a useful tool for health professionals and health educators.
  • The Healthy Eating Plate and the companion Healthy Eating Pyramid summarize the best dietary information available today. They aren’t set in stone, though, because nutrition researchers will undoubtedly turn up new information in the years ahead. The Healthy Eating Pyramid and the Healthy Eating Plate will change to reflect important new evidence.

A look back: Problems with the Food Guide Pyramid and MyPyramid

Translating nutrition advice into a colorful pyramid is great way to illustrate what foods make up a healthy diet. The shape immediately suggests that some foods are good and should be eaten often, and that others aren’t so good and should be eaten only occasionally. The layers represent major food groups that contribute to the total diet. The problem with the US government’s original Food Guide Pyramid, released in 1992, was that it conveyed the wrong dietary advice. And MyPyramid, its 2005 replacement, was vague and confusing.

With an overstuffed breadbasket as its base, the Food Guide Pyramid failed to show that whole wheat, brown rice, and other whole grains are healthier than refined grains. With fat relegated to the “use sparingly” tip, it ignored the health benefits of plant oils—and instead pointed Americans to the type of low-fat diet that can worsen blood cholesterol profiles and make it harder to keep weight in check. It grouped healthy proteins (fish, poultry, beans, and nuts) into the same category as unhealthy proteins (red meat and processed meat), and overemphasized the importance of dairy products.

MyPyramid, unveiled in 2005, was essentially the Food Guide Pyramid turned on its side, without any explanatory text. Six swaths of color swept from the apex of MyPyramid to the base: orange for grains, green for vegetables, red for fruits, a teeny band of yellow for oils, blue for milk, and purple for meat and beans. The widths suggested how much food a person should choose from each group. A band of stairs running up the side of the Pyramid, with a little stick figure chugging up it, served as a reminder of the importance of physical activity.

According to the USDA, MyPyramid was “designed to be simple,” and to drive people to the USDA’s MyPyramid website where they could get more details. Unless you took the time to become familiar with MyPyramid, though, you would have no idea what it meant. Relying on the website to provide key information—like what the color stripes stand for and what the best choices are in each food group—guaranteed that the millions of Americans without access to a computer or the Internet would have trouble getting these essential facts.

Permission of use

The Healthy Eating Pyramid image on this Web site is owned by Harvard University. It may be downloaded and used without permission for educational and other non-commercial uses with proper attribution, including the following copyright notification and credit line:

Copyright © 2008. For more information about The Healthy Eating Pyramid, please see The Nutrition Source, Department of Nutrition, Harvard T.H. Chan School of Public Health, www.thenutritionsource.org, and and Eat, Drink, and Be Healthy, by Walter C. Willett, M.D., and Patrick J. Skerrett (2005), Free Press/Simon & Schuster Inc.”

Any other use, including commercial reuse or mounting on other systems, requires permission from the Department of Nutrition at the Harvard T.H. Chan School of Public Health. Please contact us to request permission.

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What I Like and Dislike about MyPlate

Nutrition Education Tool 2011

Most people I discuss nutrition with have heard of the Food Guide Pyramid, possibly MyPyramid, but even fewer have heard about MyPlate, which is the current national nutrition education tool for general population nutrition guidance. This post discusses my criticism of MyPlate after a brief criticism of the other nutrition teaching tools.

Nutrition Education Tool 1992 Eleven Grains a Day while I sit at my desk, lolwut!

The Food Guide Pyramid was criticized for overemphasizing grains and not putting enough emphasis on fats, among other things. It also had a hierarchy of importance of food groups, even though clearly protein and vegetables probably should be higher up on that hierarchy. That said, all food groups are important for their own reasons.

MyPyramid attempted to divide the base of the pyramid into all food groups and had a base of physical activity as well, showing that all food groups are important. A criticism of MyPyramid was that it was too hard to understand.

All food groups are important, but this image was too hard and too busy to understand for most. If you get to the top of the pyramid, I guess you get less food.

MyPlate came out in 2011. It was set on a plate, which was supposed to make it easy for people to understand since most people eat off of a plate. While I personally eat all of my meals out of bowls, plates are still easy to understand and can be thought of more as a pie chart. Most people understand pie charts. This is a good part about the current educational model.

MyPlate emphasizes vegetables and is the first teaching model to recognize that you just need “protein,” not necessarily meat, which accomodates vegetarian eating.

What I dislike about MyPlate is that there is no mention of healthy fats on there. Where do the nuts and seeds go? I guess in the protein spot. I always point this out to my clients who don’t need a lot of carbohydrate in their diet due to low activity. I also think that MyPlate makes you think you need a fruit at every meal, which I do not promote. If you want to fit a fruit in every meal, you can, but I don’t think it is necessary.

MyPlate mentions dairy as the source of calcium in your diet. While I have nothing against dairy and promote it as a great way to get high quality protein, vitamins, and minerals, you could just have soymilk, almond milk, or plenty of vegetables that provide calcium. No one is forcing you to have dairy. However, if you do have almond milk, realize you’re not getting protein and are basically having a fat-sugar fortified beverage. If you can fit that in your diet, then enjoy. (diet used loosely as eating habits)

MyPlate doesn’t work very well for certain segments of the population. For athletes, for example, I decrease the size of the vegetables portion to increase the size of the grains portion. Yes, you Paleo fans can make MyPlate work if you use potatoes and sweet potatoes, but not everyone is going to go Paleo, ok? 🙂 For weight loss clients, I sometimes decrease the size of the grains part of the plate to enlarge the vegetables part. For some people who eat tons of fruit who have certain goals, I may decrease the size of that for them.

Harvard’s attempt to compete with the government recommendations. Drab and requires IQ over 100.

The Harvard Plate shows that calcium doesn’t have to come from dairy, and it also cautions against getting too much calcium due to association studies for higher morbidity risks, such as elevated risk of prostate cancer in men. The evidence is far from conclusive on that, so I caution even mentioning it.

Harvard also puts oils under nuts and seeds, which is interesting considering oils are processed from nuts and seeds. Which is a more nutrient-dense source of unsaturated fat? Nuts and seeds. Vegetables and fruits are grouped together. Someone could run with that and not eat vegetables then. Fruits and vegetables were not created equal. There is too much going on in this pyramid to critique it all in this blog post. In short, it isn’t perfect either.

When I work with clients, I tailor a message to them. I may reference MyPlate to jump start a conversation, but I actually use a different teaching method, one I developed myself, that I feel is more effective for clients. If you’re interested, you’ll just have to book an appointment with me to learn about that 🙂

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Strengths & Weaknesses Of The New ChooseMyPlate Model

Earlier this year the USDA introduced a new food model so Americans could better understand what we need to eat for health and prevention. The model shifted away from the reigning My Pyramid, to a simple round plate. Fashioned with vividly colored geometric shapes, the new ChooseMyPlate approach is a move in the right direction, though there are definitely some chips in the china that need to be fixed.

Visually, ChooseMyPlate is much easier to follow. The size of the shapes directly correspond to the proportions we should build on our plates. The green vegetables are the largest graphic on the plate, a welcome change symbolizing the importance of granting vegetables the bulk of our plates. The orange grains group is the next most prominent, followed by the red fruit and the blue dairy groups.

ChooseMyPlate.gov offers more helpful nutrition and lifestyle information on subsequent pages, called “Selected Messages”. One suggested welcome sight is that we drink more water, instead of soda or juice. It is also refreshing to see issues such as monitoring sodium content and portion control are highlighted. I was particularly happy to see encouragement towards eating across the rainbow of fruits & veggies in order to get all the vitamins & minerals we need to attain our best health and prevent disease.

However, one big chip on the plate is that there is simply not enough information. While the Selected Messages on the government website do offer more pertinent details, it is doubtful that most people will seek out this information while surfing the Internet, let alone notice it is even there.

Another huge crack is the missing guidelines in regard to proper portion sizes. While the plate pictures proportions, it does not give specific portions. For instance, we can eyeball a 4 ounce protein serving by using our palm as a template. Or, our pinky finger is the perfect ounce of cheese or peanut butter. With the issue of obesity looming as one of the largest health concerns in the US, knowing portion size and proper caloric allowances is an urgent need for most Americans.

Another weakness in the plate is that the fruit serving does not differentiate between whole fruit & fruit juice, which makes a huge difference when trying to prevent and treat diabetes & weight control. Also unclear is that we need to include Omega 3 fish such as salmon to our meat servings for maximum heart health.

Keeping in mind the importance of lifestyle to our overall health and well-being, the opportunity to include a visual, highlighting the importance of regular exercise and sufficient sleep in our wellness programs could be considered. Another valuable addition would be the different caloric and nutrient requirements for growing children, pregnant women, athletes and the elderly.

The changes made on the USDA’s new ChooseMyPlate food guide are simple to follow, but may be too vague to make the strides needed for Americans to avoid obesity, heart disease and diabetes. The new guidelines are helpful if the consumer seeks out more information in the Selected Messages. As with most things in life, rewards correspond to the amount of effort we put into things, and our health is no different.

What Are the Flaws of MyPlate?

Everyday Health: What are the two worst things about MyPlate?

Misti K. Gueron, MS, RD (khalilicenter.com)

  • You must be literate in English.
  • It can appear overwhelming to balance all food groups at the same meal.

Carolyn O’Neil, MS, RD (oneileating.blogspot.com)

Where’s the butter? Where’s the olive oil? There are no visuals to help figure out how to add fats and oils to your plate.

Tina Ruggiero, MS, RD, LD (gourmetnutritionist.com)

While consumers and professionals will criticize this icon for one or another reason, an icon isn’t going to help you eat smarter, lose weight, get in shape, or feel better about yourself. That’s up to the individual. This new initiative is about education – closing the gap between those who are informed and those who are not. Is this icon perfect? No. But as I see it, this basic plate makes it very clear to people what a “healthy meal” can be. Right now, there are few plates out there that mimic this graphic. So, I applaud this small, positive step toward change. It will make a wonderful teaching tool and may just inspire people to think before they eat.

Lisa De Fazio, MS, RD (lisadefazio.com)

There is no clear definition of the protein choices, such as choosing chicken and fish more often than red meat. Also, you do not need dairy at every meal and having the dairy serving on the diagram makes it seem like you should have it at every meal. Next to the dairy serving on the graphic it should say, “2 servings per day.” Also many people today, including myself, do not consume dairy due to allergies, being vegan, or having lactose intolerance. I think there should be sentence next to the dairy serving stating, “Calcium-fortified dairy, soy, or almond milk substitute.”

Ashley Koff, RD (AshleyKoffApproved.com)

It contradicts its recommendation, water over sugary drinks, with dairy glass symbol at each ‘plate.’ Dairy is a carbohydrate (i.e. sugar). It doesn’t clarify plain milk versus chocolate or flavored miles, and excludes non-drinkable dairy sources (i.e. cheese and yogurt).

Autumn Hoverter, MS, RD, CD (foodwisenutrition.com)

MyPlate doesn’t give any indication of appropriate food choice. Are fried chicken, French fries, and a Caesar salad just as nutritious as baked chicken breast, oven-roasted potatoes and sautéed chard? The answer is no, but MyPlate doesn’t address that. Second, it indicates that you should have fruit at every meal, but that isn’t appropriate for everybody, especially diabetics. Fill half your plate with vegetables and you’ll be fine.

Chrissy Barth, RD, BHT, RYT (livebreathenutrition.com)

  • I would separate the starchy veggies from the non-starchy ones.
  • I would incorporate dietary fats into the visual.

Nancy Clark MS RD CSSD (nancyclarkrd.com)

People wonder how to enjoyably consume vegetables at breakfast.

The information is geared toward the average overweight American. Sports-active people need heartier meals. For example, athletes will fail to consume enough energy if they fill half their plate with fruits and vegetables and they will fail to consume adequate starches to fully fuel their muscles if only one-quarter of their plate is grains.

Jennifer Neily, MS, RD, CSSD, LD (jenniferneily.com)

I was disappointed that half of the plate was not devoted to vegetables vs.vegetables and fruits. I would have liked to have seen that and then fruit on the side like the dairy. Furthermore, where did the physical activity message go? I did like that about the pyramid – the figure walking up the side.

Maye Musk, MS, RD (mayemusk.com)

You still can’t get people to change their eating habits. They will see the picture, but then forget about it. How do we get into their minds? It’s not a magic fix. It takes effort, planning, time. Junk foods are on every corner. People no longer have common sense so will still try fad diets, many excluding fruit. Over 40 years of counseling, I have yet to have a weight-loss client who ate too much fruit.

Carolyn Dunn, PhD (esmmweighless.com)

It does not show how big our plate should be. A large plate may mean more food than we need. Choosing a smaller plate is a good strategy to consume more appropriate portion sizes. A large 10- or 12-inch plate will make your “normal” portions looks like child’s-size portions.

Although more information is on the ChooseMyPlate website, the graphic does not indicate that foods should be as close to whole as possible. Foods should be eaten as close to their natural state as opposed to highly processed.

Martha McKittrick, RD, CDE (martha-nutritionist.com)

While simplicity is its best attribute, it can also be its pitfall! The basic plate doesn’t mention fat all, nor does it distinguish between healthy and not-so-healthy fats. Also, upon first glance, someone may think they have to drink milk to fit in the dairy group. Calcium can also be obtained from low-fat cheese, yogurt, calcium-fortified foods, and some vegetables.

Lauren Antonucci, MS, RD, CSSD, CDE, CDN (nutritionenergy.com)

Overall, I really love the new MyPlate system. I do think it lacks information on healthy and balanced snacking, a place where many people go wrong and overeat total calories, fat, and refined sugar.

Sarah Mirkin, RD, CPT (kitchencoachrd.com)

  • Many people don’t’ have basic nutritional knowledge to know what “protein” foods are or what foods are “grains.” There are links to click on for more details, but it might make it easier for consumers if there were photos of these foods in the model. It’s also missing dietary fat, which is an important part of a healthy diet.
  • The MyPlate model doesn’t mention portion sizes. Plates come in many sizes and food can be piled high. For instance, a simple way to help people understand appropriate portions is to tell them a grain serving should be approximately the size of your fist and protein like the palm of your hand.

Rachel Begun, MS, RD (rachelbegun.com)

We didn’t see much success with the food guide pyramid and MyPyramid icons. I hope consumers and health educators give the MyPlate icon a chance before dismissing it.

Amber Pankonin, MS, RD, CSP, LMNT (beginningwell.com)

Maybe there should be a caption that reads, “Not pictured: Water, physical activity, room for dessert, good fats, knife, spoon.”

Connie Evers, MS, RD, LD (nutritionforkids.com)

  • The strength of MyPlate is also its biggest weakness. A simple graphic cannot possibly communicate all the essentials of eating well. If consumers do not go one step further and visit choosemyplate.gov, they will be missing most of the key MyPlate messages.
  • Because I teach and work with children, I realize they are quite literal. I anticipate a problem interpreting MyPlate because most of the foods eaten by Americans don’t nicely fit on a plate. I would venture to guess that the majority of our meals are combination foods such as pizza, tacos, sandwiches, smoothies, stews, soups, and cereal with fruit and milk.

Karen Ansel, MS, RD, CDN (karenansel.com)

That it doesn’t spell out portion sizes, which is so important for weight control, or distinguish between healthy and unhealthy fats and carbs.

Janet Bond Brill, PhD, RD, LDN, CSSD (drjanet.com)

MyPlate does not address the elephant in the room, the epidemic of overweight and obesity. There is no mention of exercise or even a hint of the concept of balancing out calorie intake with expenditure, nor does it address exactly what foods are healthy.

Janel Ovrut Funk, MS, RD, LDN (eatwellwithjanelblog.com)

The focus on dairy. Some people can’t tolerate dairy and it gives off the impression we need a glass of milk or cup of yogurt to be healthy, when the nutrients in dairy can be found in other foods. I also don’t like the “protein” category. Protein is a nutrient, not a food (like fruits, vegetables, and grains), and protein can be found in vegetables and grains.

Erin Palinski, RD, CDE, CPT (erinpalinski.com)

MyPlate does not contain a section on the plate to show added fats or oils. If someone if filling one-third of their plate with vegetables, but adding large amounts of unhealthy fats, such as butter, to these vegetables, they may be counteracting some of the health benefits of the vegetables.

MyPlate may also want to consider adding a small visual example for occasional added sugar or sweet foods, since many individuals may add an occasional dessert to meals a few times per week. It may help to show a small section of the plate (one-sixth to one-eighth) can be reserved for an occasional sweet one or two times per week to give individuals who choose to include these foods an example of what an appropriate portion size would be.

Timi Gustafson, RD, LDN (timigustafson.com)

It’s a step up from the last version of the government’s dietary guidelines, but it’s still too abstract. Its strength – simplicity – also works against it. I’m all for explaining complex issues, like nutrition, in the easiest ways possible, but some important information tends to gets lost when things get narrowed down too much. For instance, the part on protein: Protein is not food, it’s a nutrient. People still don’t know what sources of protein are better than others.

Choose MYPLATE to Improve Health for Life

Cindy Anderson, Ph.D.

Most people know how important good nutrition is to their health. But most of us find it difficult to eat as healthfully as we think we should. The good news is that help is just a click away – at the USDA ChooseMyPlate website (www.choosemyplate.gov).

ChooseMyPlate is designed to provide information about healthy eating. The website makes it easy to find reliable sources of nutritional information that can make choosing healthy foods effortless. With it are resources to help increase one’s skills in recognizing good food choices that are part of a healthy lifestyle. There are recipes, tips and creative ideas for ensuring that your diet is a healthy one.

The website goes beyond providing general information with its interactive feature called SuperTracker. There, you can personalize your experience by creating your own profile, and getting a plan tailored just for you. The feature allows you to track your daily food intake and physical activities to see how they stack up (www.supertracker.usda.gov).

ChooseMyPlate also has tools for groups with unique nutritional needs and challenges. These include resources on the special nutritional needs during pregnancy: healthy weight gain; eating tips; and ways to make healthier choices for fruits, vegetables, grains, proteins, dairy and oils (www.choosemyplate.gov/moms-pregnancy-breastfeeding). There is information on healthy eating for breastfeeding mothers to assure that their infants receive good nutrition. This information is important because good nutrition begins during pregnancy when the first nutrition a developing baby gets is from its mother. Early nutrition is essential for the healthy development of infants and children and is key to future health as an adult. That is, what we eat today can affect our health in the future.

ChooseMyPlate also has great ideas and information about nutrition for young children (www.choosemyplate.gov/preschoolers.html). The web page has tips for getting kids to try new foods and for developing healthy eating habits and making plans for meals and snacks – all presented in a way tailored to the needs of this challenging age group. It has tools for parents to figure out if their child is growing and developing as expected; these include charts for growth and body mass index standard ranges.

ChooseMyPlate recently added a feature for young adults: the On Campus Tool Kit (). These resources address the special challenges faced by many college students in their first real experience of making eating choices on their own and with a hectic schedule that limits their time and food choices. Addressing the “freshman 15” problem – the weight gain that many new college students experience – the ChooseMyPlate campus tool kit provides information about food choices based on dietary guidelines that promote healthy eating during the college years and beyond.

Good nutrition is key to healthy living. Making the best food choices for yourself and your future just got easier with ChooseMyPlate. Check out those resources and other useful sites at www.nutrition.gov/basic-nutrition/myplate-resources

Monetary Cost of the MyPlate Diet in Young Adults: Higher Expenses Associated with Increased Fruit and Vegetable Consumption

Abstract

Background. Cost is a commonly reported barrier to healthy eating. This is a secondary research analysis designed to examine the food expenditures of young adults on a university campus following the United States Department of Agriculture (USDA) MyPlate guidelines for fruits and vegetables. Methods. Meal receipts and dietary intake were recorded weekly. Anthropometrics and clinical assessments were recorded before intervention. Researchers rated compliance based on the participant’s dietary food log, receipt matching, food pictures, and reports during weekly 1-hour consultations. Results. Fifty-three young adults (18–30 years old) at-risk of, or diagnosed with, metabolic syndrome (MetS) were enrolled in the study, with 10 excluded (n = 43) from analyses due to enrollment in a fixed cost university campus dining meal plan. A two sample t-test assessed differences in food costs and regression analysis determined associations between food cost and diet compliance while controlling for confounding factors of age, sex, and body mass index (BMI). Diet compliant subjects (n = 38) had higher weekly food cost at $95.73 compared to noncompliant subjects (n = 5) who spent $66.24 (). A regression analysis controlling for age, sex, BMI, and geographical region also indicated cost differences based on diet compliance (). Conclusion. Results indicate an ∼$29.00 per week increase in food cost when eating the recommended amount of fruit and vegetables. These findings can contribute to research incentive design, program planning cost, and determining effective interventions to improve diet in this population.

1. Background

Diet quality and weight status are modifiable factors that contribute to diet-related chronic diseases including cardiovascular disease (CVD), type 2 diabetes, and some cancers . Primary (preventing the onset of disease) and secondary (detecting disease in earliest stages) prevention of these diseases can be influenced by adopting healthy eating behavior practices as young adults. However, many young adults do not practice healthy eating . A systematic review of diet quality in 187 countries found young adults aged 20–29 had lower dietary quality (44 points) than older adults (51 points) based on the Healthy Eating Index which is a validated scoring system rated out of 100 points . The United States Departments of Health and Human Services (DHHS) and United States Department of Agriculture (USDA) Dietary Guidelines recommend Americans fill half their plate with fruits and vegetables at each meal (4-5 cups daily) . However, only 12.3% of adults older than 20 years of age meet the recommended goals for fruit and vegetable intake . For most young adults, the amount of fruit and vegetable intake is also suboptimal for the prevention of chronic diseases of adulthood .

Many of the benefits of healthy eating and maintaining a healthy weight are known. However, the continued rise in weight and decrease in food quality indicate there are barriers to adopting healthier behaviors. Young adulthood is a time of self-definition, where individuals establish and practice healthy habits. These habits impact their weight status as they gain more independence in economic and dietary practices . Key influences of dietary intake include current and past social environment, cost, preparation, purchase, and storage of food, knowledge, and motivation .

This study focuses on monetary costs associated with increasing intake of dietary fruit and vegetables in the context of an 8-week, personalized, and diet education program. Populations in the United Kingdom , Holland , and the United States report food cost to be a major barrier to buying healthy foods. Understanding the food cost of a healthy diet is important because even with an effective education program, access to healthy foods, and motivation, people may not make changes which can positively influence their health if they believe they cannot afford the food. Increasing cost is known to influence choice and behavior (e.g.,cigarettes and alcohol, where increasing costs, such as taxes decrease consumption ). In this study, we evaluate food costs associated with a positive dietary change.

The cost of a healthy dietary pattern (increased in fruits, vegetables, and lean protein) has been found to have an increased cost of $1.50 per day in the United States with healthier meat/protein options, contributing to the largest price difference . Another study completed in Europe found there was an 18% increase in cost when the diet consisted of all five food groups instead of just two to three . Mulik and Haynes-Maslow used the most current publicly available data from the USDA to analyze the price of the MyPlate’s dietary guidelines for all food groups. Their findings indicate that men and women (19–30 years old) have an increased cost of food with no significant difference in the type of fruit or vegetable (fresh, canned, or frozen), with an average increase of $3.82 in women and $4.25 in men .

This increased cost can be an important consideration, especially in the young adult and college population. Thirty-two percent of college students report finances are traumatic or very difficult to handle . Increased financial stress, higher cost of a healthy diet, and the young adult time period being understudied indicate food cost for this age group is an area which needs further investigation.

This study was a secondary outcome analysis to a larger study to determine cardiovascular and gut microbiome changes in individuals after an 8-week dietary intervention which focused on increasing fruits and vegetables. The main objective of this prospective analysis was to determine the amount of money spent by young adults following the U.S. Dietary Guidelines (half of the plate consisting of fruits and vegetables). It was hypothesized that participants following the recommended diet would spend more money on food, compared to those who were not compliant with the diet. An increased food cost was determined because participants would be increasing fruit and vegetable intake which would take place of some of the cheaper, less healthy convenience food items which are frequently eaten by this group.

2. Methods

An 8-week diet intervention study was conducted with 53 young adults from West Virginia University (WVU) in two different cohorts, the spring of 2015 and the fall of 2016, investigating increased fruit and vegetable intake on clinical and metabolomic outcomes . Recruitment occurred through word of mouth, flyers posted around campus, announcements in classrooms, and emails to the student body. To be eligible, participants had to be between the ages of 18–30, and be at-risk of, or diagnosed, with metabolic syndrome (MetS). “At-risk of MetS” was defined as 3 or more of the following risk factors: any of the 5 MetS risk factors in addition to BMI (>25 for men or women), personal or family history of CVD, diabetes (type 1, type 2, or gestational), or abnormal lipids, race/ethnicity, low physical activity, increased sedentary time, poor nutritional quality, current smoker, or excessive alcohol intake . The guidelines set forth by the National Cholesterol Education Program Adult Treatment Panel III were used to diagnosis MetS. Individuals with three of the five following criteria were defined with MetS: waist circumference >102 cm (men) and >88 cm (women); serum triglycerides >150 mg/dl; serum HDL <40 mg/dl (men) and <50 mg/dl (women); blood pressure ≥130/85 mm Hg; and fasting blood glucose ≥100 mg/dl . This was determined through in-person anthropometric and blood measurements. Exclusions included a diagnosis or treatment of a serious mental or behavioral disorder within the past year and pregnancy. Students eating the campus meal plan were removed from this analysis since they did not have out-of-pocket costs for much of their food consumption. Approval was obtained from the WVU Institutional Review Board, and informed consent was collected from each subject prior to enrollment in the study.

2.1. Outcome Measures

Demographic information was collected during the health assessment. Geographic region was defined as if the participant identified as being from an Appalachian (encompassing all of West Virginia and parts of 12 other states along the Appalachian Mountains), or non-Appalachian area. Clinical and nutrition history was obtained to assess risk and/or diagnosis of MetS. Weight was measured when participants were minimally clothed, without shoes using digital scales (SECA 874) and recorded to the nearest 0.1 kg. Height was measured in a standing position without shoes using a stadiometer (SECA 213). Body mass index (BMI) was calculated and expressed in kg/m2. Waist circumference was measured at the narrowest point, and hip circumference was measured at the maximum point over light clothing using a Gulick tape meter. Height and waist circumference measurements were recorded to the nearest 0.1 cm after being taken twice and averaged for analysis.

Diet compliance was determined through subjective and objective measures to eliminate bias throughout the 8-week intervention. Compliance with diet and assessment of food expenditures were determined through food pictures (generally taken on their phone and emailed or shown to researcher during counseling session), participant’s dietary food log (matched to food shopping receipts), food pictures (to determine portion sizes), and weekly 1-hour consultation with a trained researcher. Cost of all liquid and solid food and alcohol were determined through food receipts collected from participants every week. Costs were recorded and labeled according to location the food was purchased. Receipts were retrieved from participants for grocery store, restaurant, vending machine, cafe, and any other food establishment purchases. Participants recorded the cost of food in individual food logs when receipts were unavailable.

2.2. Study Procedures

Each participant was instructed to follow a calorie intake (based on the U.S. Dietary Guidelines for Americans) to maintain weight calculated using their current weight, age, and physical activity status; they were asked to maintain their current activity level. Participants were educated on this diet during a two-hour education session prior to the beginning of the study which included food intake expectations, research protocol, healthy eating on a budget, menu ideas, recipes, and sample grocery lists. All subjects were asked to consume a diet consisting of 4-5 servings (cup/ounce equivalents) fruit and vegetables and not change their dietary supplement intake. As part of the main project protocol, participants in the first cohort were also randomly assigned to follow the increased fruit and vegetable diet only or to additionally follow low-refined carbohydrate or low-fat recommendations. All participants within these different groups were evaluated in this paper. Each participant had their USDA MyPlate food group recommendations calculated using the computer software program Nutritionist ProTM (Axxya Systems LLC, Redmond, WA). Participants were provided with kitchen tools (measuring cups and spoons, Tupperware containers, knives, etc.) to facilitate food preparation at home, and financially compensated throughout the 8-week study for a total of $250, which was split into a smaller amount to give at their weekly consultations.

During the weekly consultation, participants also reviewed their daily food log with researchers that were analyzed using Nutritionist Pro. At this time, researchers would use motivational interviewing techniques (all had completed a two-day training) to facilitate behavior change and develop strategies to reach personalized goals. The weekly dietary reports were used as markers to gauge participant improvement and dietary intervention compliance. Dietary compliance was defined as maintaining the diet intervention guidelines 75% of the time during 6 weeks of the intervention, as determined by the researcher.

2.3. Statistical Analysis

Food costs were analyzed with the Stata 14 software system . Two sample t-tests with unequal variances were used to determine differences in food costs between compliant and noncompliant dietary intake status. The unequal variances are used to account for the uneven compliant and noncompliant groups . Results were considered significant if the two-tailed value was ≤0.05. It should be noted that this is a secondary analysis to a larger research study, and thus, the sample size was not powered for this analysis.

3. Results

Ten participants from the primary study group were excluded from this analysis (n = 43) because of enrollment in a campus dining plan which is based on fixed quarterly cost. This study sample was 60% female, and most individuals were diet compliant (88%). Participant living arrangements varied though all reported living outside of the home where they grew up. Demographic information is presented in Table 1, and baseline clinical measurements are included in Table 2. Among participants, there was an even distribution of BMI categories (normal weight = 15, overweight = 10 and 8, and morbidly obese = 10). A detailed analysis of the dietary intake associated with the larger study has been previously reported . By the end of the 8-week study, participants had demonstrated improvements in fruit and vegetable consumption, fiber intake, and a decrease in empty calorie intake with no supplement intake included in the analysis.

Table 1 Demographic characteristics of all included participants at baseline (n = 43). Table 2 Baseline clinical measurements (n = 43).

Compliant individuals, on average, spent $95.73 ± $75.33 per week compared to noncompliant individuals spending $66.24 ± $65.31 per week. Figure 1 shows the average weekly spending of these two groups throughout the 8-week study. Compliant participants spent more on food compared with noncompliant participants (). Spending differences between compliant and noncompliant groups remained after controlling for age, sex, BMI, and region ().

Figure 1 Mean ± SD cost (dollars) of compliant (n = 38) and noncompliant (n = 5) participants during the 8-week diet intervention ().

4. Discussion

Many studies report cost as a barrier which deters some people from buying healthy foods . The principal finding of the present study was that participants who were compliant with the MyPlate diet spent, on average, $29 more per week on food (∼$4 a day) than noncompliant individuals. This finding correlates with prior studies, indicating the higher costs of a healthy diet. A meta-analysis of 27 studies across 10 countries found a healthy diet cost $1.48 more a day than less healthy options . However, a more recent analysis of the cost of the MyPlate recommendations for individuals in this age group did have a similar price increase to the current study ($3-4/day depending on gender and whether fresh, frozen, or canned fruits and vegetables were bought) . The large standard deviations in some of the results may be due to participants not being required to buy groceries every week. Instead, on some weeks, participants’ food cost would be very low since they had bought enough food to last more than one week. Below there will be an exploration of possible reasons for the food cost differences experienced in the groups including the cost of fresh food, young age of the subjects, and geographic location.

In this study, participants bought a variety of food options from all five food groups at restaurants, convenience, and grocery stores. The findings in this study are consistent with the patterns of increased food cost when on an isocaloric diet and asked to increase nutrient density (higher intake of fruits and vegetables). Diets lower in cost were associated with lower consumption of vegetables, fruits, whole grains, and seafood . Another study of 837 French adults separated food cost by food group and concluded that individuals eating more fruits and vegetables in their diet incurred a higher food cost . Another way to look at nutritional quality is using a measure of nutrient density. Foods with a higher nutrient content or density are frequently higher in cost compared to less healthy, calorie-dense options . Further qualitative exploration was completed to analyze group differences in spending habits for this sample size. Noncompliant individuals purchased a low quantity of fruits and vegetables and a high amount of grains and fats from convenience foods. Compliant individuals purchased more fruits and vegetables and a larger variety of food from different food groups. Compliant individuals that spent more money on food tended to purchase more seafood and meat and had a higher frequency of eating away from home compared to compliant individuals that spent less money on food purchases.

In understanding the results of this study, it is important to consider the unique experiences, education, and financial situations of young adulthood. Young adults and university students commonly do not have a traditional job and income stream and have been found to make suboptimal financial decisions . When stratifying diet cost by age group, young adults (20–29 years of age) spent the least and had the lowest diet quality compared to any other age groups . The survey of young adults (18–38 years old) in the Bogalusa Heart Study found those with lower income ate fewer fruits and vegetables, more fats and sweetened beverages, and statistically higher amounts of burgers and sandwiches . The income of young adults as well as their inclination for ready-to-eat, processed, frozen, or canned foods for convenience may be a significant variable for young adults in college to eat a healthy diet .

To increase fruit and vegetable consumption, studies have employed educational interventions, public campaigns, and price reductions. The Supermarket Healthy Eating for Life Trial conducted a randomized controlled trial over three months to determine if a price reduction of fruits and vegetables would result in increased fruit and vegetable consumption. A 20% reduction in price resulted in a 35% increase in fruit and a 15% increase in vegetable purchases. The behavior was not maintained six months after the intervention when food returned to their original cost . A recent study developed a model to compare the effectiveness of a multimedia campaign or price decrease to increase fruit and vegetable consumption using current diet trends, national databases, and other studies to determine projected change. This study demonstrated that media and financial interventions increased fruit and vegetable intake, although the effect of the price reduction was more powerful and sustainable . This supports the role of price incentive or reduced cost as a factor in food purchasing decisions. Our study provided research participation incentives ($250 total/eight weeks) that may have been used to offset participants’ food costs to enable them to buy healthier options, though the financial incentive could have been spent on other items as well.

What an individual chooses to eat is multifactorial and has other determinants besides cost. Other factors can include taste, convenience, interest in health and nutrition, familiarity of the food, cooking skills, and mental health . NHANES data determined taste was the most important factor in food decisions, followed by nutrition, cost, and convenience . Carlson and Frazao further explored reasons for food decisions. In this study, it concluded that higher income individuals may spend more money on food, but their diet was not necessarily healthier than low-income individuals . This indicated that spending more money on food did not guarantee the food being purchased was healthy. So, aside from just financially incentivizing healthy food purchases, it is important to incorporate education on nutrition as well as how to cook and prepare healthy foods that are palatable to the individual. In the population being studied here, there were compliant individuals who were able to spend less money, so with more education, it may be possible to teach the participants how to have a healthy diet with lower cost.

The current study being examined used the combined education and financial incentive component to encourage healthy eating. Another point which should be explored is the perceptions that all healthy food is expensive. For example, the cost of the Mediterranean diet, which is viewed as being healthful, is perceived to cost more. However, some components of the diet cost less (e.g., certain vegetables, beans, legumes, grains, nuts, and some dairy products) and can replace the more expensive items . The fact that healthier diets can cost less given different food-related decisions is a phenomenon called nutrition resilience. This indicates healthy diets can be maintained at a lower cost, given optimal decision-making and knowledge of how to eat healthy on a budget . However, it may take more time than the current study (8 weeks) for individuals to be educated on, explore, and put into practice buying and eating food items that are healthy and affordable.

This study has limitations. First, there was a small number of individuals in the noncompliant group. This could have influenced the resultant higher cost for diet compliant individuals as well as the difference in the cost of healthy eating by the BMI category. To accommodate the uneven group sizes, a t-test with unequal variances was used in the statistical analysis . Second, the amount of money spent on the different food groups was not determined in this study, though dietary intake reveals participants’ fruit and vegetable intake increased. This study was intended to use the basic statistical analysis to compare compliant fruit and vegetable intake and diet cost and thus did not have enough information to accurately analyze the types of food participants were purchasing. Third, income was not obtained which may have also helped to see if that played a role in the amount of money spent on food. To overcome these limitations, further studies should more thoroughly define the locations of the purchased food, as well as the food groups purchased, and include larger sample sizes of young adults from several different geographic regions. This would help to develop further explanations for these groups’ different food-spending habits.

Further qualitative exploration was completed to analyze group differences in spending habits for this sample size. In general, students purchased a variety of food options from all five food groups at restaurants, convenience, and grocery stores. Noncompliant individuals purchased a low quantity of fruits and vegetables and a high amount of grains and fats from convenience foods. Compliant individuals purchased more fruits and vegetables and a larger variety of food from different food groups. Compliant individuals that spent more money on food tended to purchase more seafood and meat and had a higher frequency of eating away from home compared to compliant individuals that spent less money on food purchases.

5. Conclusions

This study contributes new data on the costs of implementing the USDA MyPlate guidelines for young adults living in a university setting. This age group spent $29 more per week, on average, when complying with the national health guidelines. These findings can contribute to research incentive design and program planning cost and determining effective interventions to improve diet in this population. Future research regarding food costs is needed with this age group as well as an expanded analysis to include what food groups or choices are contributing to the food cost. Additional knowledge can contribute to education and public health interventions in this population to increase the affordability of healthy foods and give the education needed by this age group to improve budgeting and food preparation skills to be able to use the healthy foods in a way that is palatable to their tastes and lifestyle.

Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Ethical Approval

The study protocol was approved by the WVU IRB Board.

Consent

All the participants signed a consent form prior to beginning the study.

Disclosure

Part of the manuscript was presented as an abstract/poster at the Society of Nutrition Education and Behavior Annual Meeting in Washington DC in July 2017.

Conflicts of Interest

The authors declare no conflicts of interest.

Authors’ Contributions

The conception of the study was from MDO, PJM, IMO, and JWM with cost/receipt analysis, specifically overseen by MDO. Data were collected by RLC, OAF, MLB, RLH, JAM, CAW, and AMM. Data analysis was done by RLC, OAF, MLB, JAM, CAW, and AAM. And statistical analysis was completed by JR, RLC, OAF, and MDO. The first draft of the manuscript was prepared by RLC with input from MDO, and the final draft was reviewed and approved by all of the authors.

Acknowledgments

The authors thank the entire FRUVEDomics research team at West Virginia University. This work was funded by the following grants: USDA/AFRI #2014-67001-21851; WVU Hatch WVA00641; WV Clinical and Translational Science Institute (NIH/NIGMS Award Number U54GM104942); WVU Mountains of Excellence Pilot Grant Program; and WVU Pediatrics Department Grant.

Executive Summary

In this section:

  1. The Guidelines
  2. Key Recommendations

Over the past century, deficiencies of essential nutrients have dramatically decreased, many infectious diseases have been conquered, and the majority of the U.S. population can now anticipate a long and productive life. At the same time, rates of chronic diseases—many of which are related to poor quality diet and physical inactivity—have increased. About half of all American adults have one or more preventable, diet-related chronic diseases, including cardiovascular disease, type 2 diabetes, and overweight and obesity.

However, a large body of evidence now shows that healthy eating patterns and regular physical activity can help people achieve and maintain good health and reduce the risk of chronic disease throughout all stages of the lifespan. The 2015-2020 Dietary Guidelines for Americans reflects this evidence through its recommendations.

The Dietary Guidelines is required under the 1990 National Nutrition Monitoring and Related Research Act, which states that every 5 years, the U.S. Departments of Health and Human Services (HHS) and of Agriculture (USDA) must jointly publish a report containing nutritional and dietary information and guidelines for the general public. The statute (Public Law 101-445, 7 U.S.C. 5341 et seq.) requires that the Dietary Guidelines be based on the preponderance of current scientific and medical knowledge. The 2015-2020 edition of the Dietary Guidelines builds from the 2010 edition with revisions based on the Scientific Report of the 2015 Dietary Guidelines Advisory Committee and consideration of Federal agency and public comments.

The Dietary Guidelines is designed for professionals to help all individuals ages 2 years and older and their families consume a healthy, nutritionally adequate diet. The information in the Dietary Guidelines is used in developing Federal food, nutrition, and health policies and programs. It also is the basis for Federal nutrition education materials designed for the public and for the nutrition education components of HHS and USDA food programs. It is developed for use by policymakers and nutrition and health professionals. Additional audiences who may use Dietary Guidelines information to develop programs, policies, and communication for the general public include businesses, schools, community groups, media, the food industry, and State and local governments.

Previous editions of the Dietary Guidelines focused primarily on individual dietary components such as food groups and nutrients. However, people do not eat food groups and nutrients in isolation but rather in combination, and the totality of the diet forms an overall eating pattern. The components of the eating pattern can have interactive and potentially cumulative effects on health. These patterns can be tailored to an individual’s personal preferences, enabling Americans to choose the diet that is right for them. A growing body of research has examined the relationship between overall eating patterns, health, and risk of chronic disease, and findings on these relationships are sufficiently well established to support dietary guidance. As a result, eating patterns and their food and nutrient characteristics are a focus of the recommendations in the 2015-2020 Dietary Guidelines.

The 2015-2020 Dietary Guidelines provides five overarching Guidelines that encourage healthy eating patterns, recognize that individuals will need to make shifts in their food and beverage choices to achieve a healthy pattern, and acknowledge that all segments of our society have a role to play in supporting healthy choices. These Guidelines also embody the idea that a healthy eating pattern is not a rigid prescription, but rather, an adaptable framework in which individuals can enjoy foods that meet their personal, cultural, and traditional preferences and fit within their budget. Several examples of healthy eating patterns that translate and integrate the recommendations in overall healthy ways to eat are provided.

The Guidelines

  1. Follow a healthy eating pattern across the lifespan. All food and beverage choices matter. Choose a healthy eating pattern at an appropriate calorie level to help achieve and maintain a healthy body weight, support nutrient adequacy, and reduce the risk of chronic disease.
  2. Focus on variety, nutrient density, and amount. To meet nutrient needs within calorie limits, choose a variety of nutrient-dense foods across and within all food groups in recommended amounts.
  3. Limit calories from added sugars and saturated fats and reduce sodium intake. Consume an eating pattern low in added sugars, saturated fats, and sodium. Cut back on foods and beverages higher in these components to amounts that fit within healthy eating patterns.
  4. Shift to healthier food and beverage choices. Choose nutrient-dense foods and beverages across and within all food groups in place of less healthy choices. Consider cultural and personal preferences to make these shifts easier to accomplish and maintain.
  5. Support healthy eating patterns for all. Everyone has a role in helping to create and support healthy eating patterns in multiple settings nationwide, from home to school to work to communities.

Key Recommendations provide further guidance on how individuals can follow the five Guidelines:

Key Recommendations

The Dietary Guidelines’ Key Recommendations for healthy eating patterns should be applied in their entirety, given the interconnected relationship that each dietary component can have with others.

Consume a healthy eating pattern that accounts for all foods and beverages within an appropriate calorie level.

A healthy eating pattern includes:

  • A variety of vegetables from all of the subgroups—dark green, red and orange, legumes (beans and peas), starchy, and other
  • Fruits, especially whole fruits
  • Grains, at least half of which are whole grains
  • 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 (beans and peas), and nuts, seeds, and soy products
  • Oils

A healthy eating pattern limits:

  • Saturated fats and trans fats, added sugars, and sodium

Key Recommendations that are quantitative are provided for several components of the diet that should be limited. These components are of particular public health concern in the United States, and the specified limits can help individuals achieve healthy eating patterns within calorie limits:

  • Consume less than 10 percent of calories per day from added sugars
  • Consume less than 10 percent of calories per day from saturated fats
  • Consume less than 2,300 milligrams (mg) per day of sodium
  • If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and up to two drinks per day for men—and only by adults of legal drinking age.

In tandem with the recommendations above, Americans of all ages—children, adolescents, adults, and older adults—should meet the Physical Activity Guidelines for Americans to help promote health and reduce the risk of chronic disease. Americans should aim to achieve and maintain a healthy body weight. The relationship between diet and physical activity contributes to calorie balance and managing body weight. As such, the Dietary Guidelines includes a Key Recommendation to

  • Meet the Physical Activity Guidelines for Americans.

Terms To Know

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Several terms are used to operationalize the principles and recommendations of the 2015-2020 Dietary Guidelines. These terms are essential to understanding the concepts discussed herein:

Eating pattern—The combination of foods and beverages that constitute an individual’s complete dietary intake over time. Often referred to as a “dietary pattern,” an eating pattern may describe a customary way of eating or a combination of foods recommended for consumption. Specific examples include USDA Food Patterns and the Dietary Approaches to Stop Hypertension (DASH) Eating Plan.

Nutrient dense—A characteristic of foods and beverages that provide vitamins, minerals, and other substances that contribute to adequate nutrient intakes or may have positive health effects, with little or no solid fats and added sugars, refined starches, and sodium. Ideally, these foods and beverages also are in forms that retain naturally occurring components, such as dietary fiber. All vegetables, fruits, whole grains, seafood, eggs, beans and peas, unsalted nuts and seeds, fat-free and low-fat dairy products, and lean meats and poultry—when prepared with little or no added solid fats, sugars, refined starches, and sodium—are nutrient-dense foods. These foods contribute to meeting food group recommendations within calorie and sodium limits. The term “nutrient dense” indicates the nutrients and other beneficial substances in a food have not been “diluted” by the addition of calories from added solid fats, sugars, or refined starches, or by the solid fats naturally present in the food.

Variety—A diverse assortment of foods and beverages across and within all food groups and subgroups selected to fulfill the recommended amounts without exceeding the limits for calories and other dietary components. For example, in the vegetables food group, selecting a variety of foods could be accomplished over the course of a week by choosing from all subgroups, including dark green, red and orange, legumes (beans and peas), starchy, and other vegetables.

An underlying premise of the Dietary Guidelines is that nutritional needs should be met primarily from foods. All forms of foods, including fresh, canned, dried, and frozen, can be included in healthy eating patterns. Foods in nutrient-dense forms contain essential vitamins and minerals and also dietary fiber and other naturally occurring substances that may have positive health effects. In some cases, fortified foods and dietary supplements may be useful in providing one or more nutrients that otherwise may be consumed in less-than-recommended amounts.

For most individuals, achieving a healthy eating pattern will require changes in food and beverage choices. This edition of the Dietary Guidelines focuses on shifts to emphasize the need to make substitutions—that is, choosing nutrient-dense foods and beverages in place of less healthy choices—rather than increasing intake overall. Most individuals would benefit from shifting food choices both within and across food groups. Some needed shifts are minor and can be accomplished by making simple substitutions, while others will require greater effort to accomplish.

Although individuals ultimately decide what and how much to consume, their personal relationships; the settings in which they live, work, and shop; and other contextual factors strongly influence their choices. Concerted efforts among health professionals, communities, businesses and industries, organizations, governments, and other segments of society are needed to support individuals and families in making dietary and physical activity choices that align with the Dietary Guidelines. Everyone has a role, and these efforts, in combination and over time, have the potential to meaningfully improve the health of current and future generations.

Figure ES-1. 2015-2020 Dietary Guidelines for Americans at a Glance

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The 2015-2020 Dietary Guidelines focuses on the big picture with recommendations to help Americans make choices that add up to an overall healthy eating pattern. To build a healthy eating pattern, combine healthy choices from across all food groups—while paying attention to calorie limits, too.

Check out the 5 Guidelines that encourage healthy eating patterns:

Follow a healthy eating pattern across the lifespan. All food and beverage choices matter. Choose a healthy eating pattern at an appropriate calorie level to help achieve and maintain a healthy body weight, support nutrient adequacy, and reduce the risk of chronic disease.

Follow a healthy eating pattern over time to help support a healthy body weight and reduce the risk of chronic disease.

A healthy eating pattern includes:

A healthy eating pattern limits:

Focus on variety, nutrient density, and amount. To meet nutrient needs within calorie limits, choose a variety of nutrient-dense foods across and within all food groups in recommended amounts.

Choose a variety of nutrient-dense foods from each food group in recommended amounts.

Example meal:

Apples and grapes Lettuce and celery Chicken breast and unsalted walnuts Fat-free milk Whole-grain bread Mayonnaise

Limit calories from added sugars and saturated fats and reduce sodium intake. Consume an eating pattern low in added sugars, saturated fats, and sodium. Cut back on foods and beverages higher in these components to amounts that fit within healthy eating patterns.

Consume an eating pattern low in added sugars, saturated fats, and sodium.

Example sources of:

Shift to healthier food and beverage choices. Choose nutrient-dense foods and beverages across and within all food groups in place of less healthy choices. Consider cultural and personal preferences to make these shifts easier to accomplish and maintain.

Replace typical food and beverages choices with more nutrient-dense options. Be sure to consider personal preferences to maintain shifts over time.

A healthy eating pattern includes:

Meal A

SHIFT

Meal B

Support healthy eating patterns for all. Everyone has a role in helping to create and support healthy eating patterns in multiple settings nationwide, from home to school to work to communities.

Everyone has a role in helping to create and support healthy eating patterns in places where we learn, work, live, and play.

Notes

Definitions for each food group and subgroup are provided throughout Chapter 1. Key Elements of Healthy Eating Patterns and are compiled in Appendix 3. USDA Food Patterns: Healthy U.S.-Style Eating Pattern.

The recommendation to limit intake of calories from added sugars to less than 10 percent per day is a target based on food pattern modeling and national data on intakes of calories from added sugars that demonstrate the public health need to limit calories from added sugars to meet food group and nutrient needs within calorie limits. The limit on calories from added sugars is not a Tolerable Upper Intake Level (UL) set by the Institute of Medicine (IOM). For most calorie levels, there are not enough calories available after meeting food group needs to consume 10 percent of calories from added sugars and 10 percent of calories from saturated fats and still stay within calorie limits.

The recommendation to limit intake of calories from saturated fats to less than 10 percent per day is a target based on evidence that replacing saturated fats with unsaturated fats is associated with reduced risk of cardiovascular disease. The limit on calories from saturated fats is not a UL set by the IOM. For most calorie levels, there are not enough calories available after meeting food group needs to consume 10 percent of calories from added sugars and 10 percent of calories from saturated fats and still stay within calorie limits.

The recommendation to limit intake of sodium to less than 2,300 mg per day is the UL for individuals ages 14 years and older set by the IOM. The recommendations for children younger than 14 years of age are the IOM age- and sex-appropriate ULs (See Appendix 7. Nutritional Goals for Age-Sex Groups Based on Dietary Reference Intakes and Dietary Guidelines Recommendations).

It is not recommended that individuals begin drinking or drink more for any reason. The amount of alcohol and calories in beverages varies and should be accounted for within the limits of healthy eating patterns. Alcohol should be consumed only by adults of legal drinking age. There are many circumstances in which individuals should not drink, such as during pregnancy. See Appendix 9. Alcohol for additional information.

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