New U.S. Dietary Guidelines Provide Sound Guidance

Would you consider yourself to be a person with “healthy eating patterns?” Better yet, do you know what “healthy eating patterns” are? If you answered “no” to either of these questions, then this article is especially for you. Even if you answered “yes,” this article could be for you, too!

In the United States, we actually have a tool intended to help us make healthy food and beverage choices for the purposes of promoting good health, preventing chronic disease, and helping people to achieve and maintain a healthy weight: the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture’s (USDA) Dietary Guidelines for Americans (Dietary Guidelines).

Jointly published by the HHS and USDA every five years since 1980, each edition of the Dietary Guidelines reflects an extensive review of the body of nutrition science and addresses pressing public health concerns as well as the nutrition needs of specific populations. The eighth edition was recently released and is summarized here.

Dietary Guidelines for Americans

Whether you eat three or five times a day, the foods and beverages consumed or avoided form a pattern. Eating patterns are the sum total of foods and drinks that one tends to consistently consume, and they interact to impact our health. There are five main guidelines outlined, and healthy eating patterns are at the core. These guidelines offer the most benefit when they are followed in entirety.

  1. Follow a healthy eating pattern across one’s lifespan
  2. Focus on variety, nutrient density and amount
  3. Limit calories from added sugars and saturated fats and reduce sodium intake
  4. Shift to healthier food and beverage choices
  5. Support healthy eating patterns for all

The Healthy U.S.-Style Eating Pattern (2000 calorie level) is one example of an eating pattern and will be used to demonstrate the specific amounts for food groups and how following such a pattern can help people comply with the guidelines. Please note there is more than one way to achieve a healthy diet, and eating patterns can be adjusted to a degree to fit your cultural and economic lifestyle. For additional information, you can review the dietary guidelines for different eating patterns/calorie levels that may fit your personal needs.

Here are the guidelines’ core principles:

Vegetables

All the five vegetable subgroups – dark green, red and orange, legumes (beans and peas), starch and other foods such as avocados – should be included in a healthy diet. The recommended daily amount is 2½ cup-equivalents. Each of the different subgroups provides specific combinations of nutrients including vitamins A, C, E and K, iron and folate, so it is important to choose to eat vegetables from all the subgroups.

Fruits

This group includes whole fruits – fresh, canned, frozen and dried forms, and 100 percent fruit juice. Fruits are an invaluable source of dietary fiber, potassium and vitamin C. The recommended daily intake is 2 cup-equivalents. Because 100 percent fruit juice contains less fiber and can contribute to extra calories when consumed in excess, half of your daily intake of fruits should be obtained from whole fruits. Additionally, canned fruits, fruit juices and even dried foods may have added sugars which can contribute to extra calories. It is important to always read your food labels and select those prepackaged fruits with the least amount of added sugars.

Grains

A healthy diet emphasizes whole grains while limiting consumption of processed grains and their byproducts. Whole grains such as brown rice, oats and quinoa are rich in dietary fiber, iron and other nutrients such as vitamin A, B6 and zinc, whereas refined grains, including ready-to-eat cereals and breads, are processed and contain significantly less nutrients. However, many of them are enriched with iron and B vitamins such as folic acid, making them “enriched grains.” At least half of the recommended grain intake of six-ounce equivalents per day should come from whole grains.

It is especially important for pregnant women to have “enriched grains” in their diet because they are fortified with folic acid, which prevents against fetal neural tube defects, birth defects of the brain, spine, or spinal cord that happen in the first month of pregnancy, often before a woman even knows that she is pregnant.

Dairy

A healthy diet includes fat-free and low-fat (1 percent) dairy. These products include milk, yogurt and cheese and are fortified with calcium, vitamins A and D, potassium and other nutrients. If you cannot eat dairy products, you should look for foods that provide similar nutritional value such as soy milk, almond milk, or orange juice enriched with calcium and vitamin D. Fish is also a great source of vitamin D. Whole milk, 2 percent milk and regular cheese have more fat, sodium (salt) and more calories, therefore their intake should be minimized. The recommended daily dairy amount depends on your age and ranges from 2 to 3 cup-equivalents per day.

Protein

This group contains both animal and plant sources including seafood, meats, poultry, nuts and soy. Proteins are an important source of B vitamins, zinc, copper, vitamin D and E. The different protein sources provide various amounts of these nutrients. For example: meat, poultry and seafood are a greater source of heme iron than plant sources. In animal foods, iron attached to proteins is referred to as heme iron. In plant foods, iron is not attached to heme proteins and is then referred to as non-heme iron. Heme iron is typically absorbed at a rate of 7-35 percent. Non-heme iron is typically absorbed at a rate of 2-20 percent. Iron is especially important for young children and women of childbearing age. To maintain a balance of these nutrients, the guidelines make specific recommendations on the weekly intake of these proteins, but total daily intake should be 5½ ounce-equivalents. (roughly the size of 1 ½ playing card decks).

Oils

Oils such as canola, olive and sunflower are fats that are liquid at room temperature. They are not really considered a food group, but are an important part of a healthy diet because they are a primary source of essential fatty acids and vitamin E. The recommended daily intake is 27 grams or 5 teaspoons.

Alcohol

There is no dietary need for alcohol. Intake should be no more than one drink daily for women and up to two drinks per day for men of legal drinking age.

Many Americans have typical eating patterns that are not those outlined in the current Dietary Guidelines. But how different is the typical American diet from the recommended diet? Well, about 75 percent have an eating pattern that is low in fruits, vegetables, dairy and oil. Fifty percent are meeting or exceeding the total grains and protein recommendations, and most exceed the recommendations for added sugars, saturated fats and sodium. Do you see yourself in any of these groups?

If so, here are some ways to launch your way into a healthier eating pattern:

  • Vegetables: consider selecting a green salad or vegetable side dish with most meals/snacks.
  • Fruits: consider including fruits as side dishes, select fruits as snack options, and replace cakes and cookies for desert with whole fruits.
  • Grains: consider increasing whole grains and decreasing refined grains by reading your food labels! Foods with whole grains as the first ingredient instead of enriched flour are better choices.
  • Dairy: consider drinking fat-free or low-fat milk with meals and include yogurt as a snack choice. (But beware of high sugar content in some yogurts.) Using lower fat options will reduce saturated fats and sodium.
  • Protein: consider increasing protein variety by including seafood options once or twice weekly and using legumes, nuts or seeds in place of typical protein options like poultry, eggs and meat.
  • Oils: consider using vegetable oil instead of butter when preparing food and increasing the intake of foods that naturally have good oils, such as seafood and nuts.
  • Added sugars: choose beverages without added sugars, and limit desserts and sweetened snacks.
  • Saturated fats: read the food labels and opt for foods higher in polyunsaturated and monounsaturated fats.
  • Sodium: reading the food label is your best bet. Also, a home–cooked meal is the best way to know and control the amount of sodium in each meal.

Making lifestyle changes is an effort that can have a lasting benefit for you personally, as well as on your family...and even future generations. For some, the necessary shifts will be minor, but for others greater efforts will be required. If you need help in making these changes, speak with your medical care team.

The U.S. Department of Health and Human Services and U.S. Department of Agriculture 2015 – 2020 Dietary Guidelines for Americans 8th Edition is available at: http://health.gov/dietaryguidelines/2015/guidelines/

Dr. Khadeen Cheesman is currently a second-year Fellow in the Division of Endocrinology, Diabetes and Bone Disease at the Icahn School of Medicine at Mount Sinai in New York City, where she also completed her internal medicine training. She received her medical degree from Columbia University College of Physician and Surgeons, NYC. She is currently board certified in Internal Medicine.

Dr. Alexandria Atuahene Opata is a second-year Fellow in the Division of Endocrinology, Diabetes and Bone Disease at the Icahn School of Medicine at Mount Sinai, New York City. She received her medical degree from the University of Medicine and Dentistry of New Jersey-New Jersey Medical School and completed her internal medicine training at North Shore Long Island Jewish Health System in Long Island. She is currently board certified in Internal Medicine.