DIETARY GUIDELINES FOR AMERICANS
What should Americans eat to stay healthy?
These Guidelines are designed to help answer this question. They provide advice for healthy Americans ages 2 years and over about food choices that promote health and prevent disease. To meet the Dietary Guidelines, choose a diet with most of the calories from grains, vegetables, and fruits, low-fat dairy products, lean meats, fish, and poultry. Choose fewer calories from fats and sweets.
Eating is one of life's greatest pleasures
Food choices depend on history, culture, and environment, as well as on energy and nutrient needs. People also eat foods for enjoyment. Family, friends, and beliefs play a major role in the ways people select foods and plan meals. This booklet describes some of the many different and pleasurable ways to combine foods to make healthful diets.
Diet is important to health at all stages of life
Many genetic, environmental, behavioral, and cultural factors can affect health. Understanding family history of disease or risk factors -- body weight and fat distribution, blood pressure, and blood cholesterol, for example -- can help people make more informed decisions about actions to improve health. Food choices are among the most pleasurable and effective of these actions.
Healthful diets help children grow, develop, and do well in school. They enable young and older adults to work productively and feel their best. Food choices also can help to prevent chronic diseases, such as heart disease, certain cancers, diabetes, stroke, and osteoporosis, that are leading causes of death and disability among Americans. Good diets can reduce major risk factors for chronic diseases -- factors such as obesity, high blood pressure, and high blood cholesterol.
Foods contain energy, nutrients, and other components that affect health
People require energy and certain other essential nutrients. These nutrients are essential because the body cannot make them and must obtain them from food. Essential nutrients include vitamins, minerals, certain amino acids, and certain fatty acids. Foods also contain fiber and other components that are important for health. Although each of these food components has a specific function in the body, all of them together are required for overall health. People need calcium to make bones, for example, but many other nutrients also take part in building and maintaining bones.
The carbohydrates, fats, and proteins in food supply energy, which is measured in calories. Carbohydrates and proteins provide 4 calories per gram. Fat contributes more than twice as much -- 9 calories per gram. Alcohol is also high in energy and supplies 7 calories per gram. Foods that are high in fat are also high in calories.
Physical activity fosters a healthful diet
Energy needs vary by age. Older adults, for example, need less food than younger and more active individuals. People who are inactive or trying to lose weight may eat little food and have difficulty meeting their nutrient needs in a satisfying diet. Nearly all Americans need to be more active, because a sedentary lifestyle is unhealthy. Increasing the energy spent in daily activities helps to maintain health and allows people to eat a nutritious and enjoyable diet.
What is a healthful diet?
Healthful diets contain the amounts of essential nutrients and energy needed to prevent nutritional deficiencies and excesses. Healthful diets also provide the right balance of carbohydrate, fat, and protein to reduce risks for chronic diseases, and they are obtained from a variety of foods that are available, affordable, and enjoyable.
The Recommended Dietary Allowances refer to nutrients
Recommended Dietary Allowances (RDA's) are the amounts of nutrients that will prevent deficiencies and excesses in most healthy people. Although some people with average nutrient requirements may eat adequately at levels below the RDA, diets that meet RDA's are almost certain to ensure intake of enough essential nutrients. The Dietary Guidelines describe food choices that will help you meet these recommendations. Like the RDA's, the Guidelines apply to diets consumed over several days and not to single meals or foods.
The Dietary Guidelines describe food choices that promote good health
The Dietary Guidelines are designed to help Americans choose diets that will meet nutrient requirements, promote health, support active lives, and reduce chronic disease risks. Research has shown that certain diets raise risks for chronic diseases. Such diets are high in fat, saturated fat, cholesterol, and salt. They are low in vegetables, fruit, and fiber, and they contain more energy than the body uses. The Guidelines help you choose foods, meals, and diets that will reduce those risks.
Food labels help you make food choices
The Nutrition Facts Label is designed to help you select foods that will meet the Dietary Guidelines. Most processed foods now carry nutrition information. However, foods like coffee and tea (which contain no significant amounts of nutrients), ready-to-eat foods like deli and bakery items, and restaurant food are not required to carry nutrition labels. Labels are also voluntary for many raw foods, but grocers can supply this information for the raw fruits, vegetables, fish, meat, and poultry that are consumed most frequently. Use the new food label to choose healthful foods each day.
EAT A VARIETY OF FOODS
To obtain the nutrients and other substances needed for good health, vary the foods you eat
Foods contain combinations of nutrients and other healthful substances. No single food can supply all nutrients in the amounts you need. For example, oranges provide vitamin C but no vitamin B12. Cheese provides vitamin B12 but no vitamin C. To make sure you eat all of the nutrients and other substances needed for health, choose the recommended number of daily servings from each of five different food groups displayed in the Food Guide Pyramid (figure 1).
click here for a larger version
Use foods from the base of the Food Guide Pyramid as the foundation of your meals
Americans do choose a wide variety of foods. However, people often choose higher or lower amounts from some food groups than recommended in the Food Guide Pyramid. The pyramid shows that foods from the grain group, along with vegetables and fruits, are the basis of healthful diets. Enjoy meals that have rice, pasta, potatoes, or bread at the center of the plate, accompanied by vegetables and fruit, and lean and low-fat foods from the other groups. Limit fats and sugars added in food preparation. Compare the recommended servings in box 1 with what you usually eat.
Box 1. Choose Foods From Each of Five Food Groups
The Food Guide Pyramid shows the recommended balance among food groups in a daily eating pattern. Most of the daily servings of food should be selected from the food groups that are the largest in the picture and closest to the base of the pyramid.
* Choose most of your calories from foods in the grain group (6-11 servings), the vegetable group (3-5 servings), and the fruit group (2-4 servings).
* Eat moderate amounts of foods from the dairy group (2-3 servings) and the meat and beans group (2-3 servings).
* Choose fewer foods high in fat and sugars (consume sparingly).
What counts as a serving?
See box 2 for suggested serving sizes in the Food Guide Pyramid food groups. Notice that some of the serving sizes are smaller than what you might usually eat. For example, many people eat a cup or more of pasta in a meal, which is equal to two or more servings. So, it is easy to eat the number of servings recommended.
Box 2 What Counts as a Serving?*
Bread, Cereal, Rice, and Pasta
- 1 slice of bread
- 1 ounce of ready-to-eat cereal
- 1/2 cup of cooked cereal, rice, and pasta
- 1 cup of raw leafy vegetables
- 1/2 cup of other vegetables - cooked or chopped raw
- 3/4 cup of vegetable juice
- 1 medium apple, banana, orange
- 1/2 cup of chopped, cooked, or canned fruit
- 3/4 cup of fruit juice
Milk, Yogurt, and Cheese
- 1 cup of milk or yogurt
- 1-1/2 ounces of natural cheese
- 2 ounces of process cheese
Meat, Poultry, Fish, Dry Beans, Eggs, and Nuts
- 2-3 ounces of cooked lean meat, poultry, or fish
- 1/2 cup of cooked dry beans, 1 egg, or 2 tablespoons of peanut butter count as 1 ounce of lean meat.
*Some foods fit into more than one category. Starchy vegetables such as potatoes, corn, sweet potatoes, and taro (poi), can be counted as servings in the grain products group instead of as vegetables. Dry beans, peas, and lentils are in the meat group but can be counted as servings of vegetables instead. These crossover foods can be counted as servings from either one or the other group, but not both.
Choose different foods within each food group
You can achieve a healthful, nutritious eating pattern with many combinations of foods from the five food groups. Choosing a variety of foods within and across food groups improves dietary patterns because foods within the same group have different combinations of nutrients and other beneficial substances. For example, some vegetables and fruits are good sources of vitamin C or vitamin A, while others are high in folate (see page 13); still others are good sources of calcium or iron. Choosing a variety of foods within each group also helps to make your meals more interesting from day to day.
What about vegetarian diets?
Some Americans eat vegetarian diets for reasons of culture, belief, or health. Most vegetarians eat dairy products and eggs and, as a group, these lacto-ovo-vegetarians enjoy excellent health. Vegetarian diets are consistent with the Dietary Guidelines and can meet Recommended Dietary Allowances for nutrients. Protein is not limiting in vegetarian diets as long as the variety and amounts of foods consumed are adequate. Meat, fish, and poultry are major contributors of iron, zinc, and B vitamins in most American diets, and vegetarians should pay special attention to these nutrients.
Vegans eat only food of plant origin. Because animal products are the only food sources of vitamin B12, vegans must supplement their diets with a source of this vitamin. In addition, vegan diets, particularly those of children, require care to assure adequacy of vitamin D and calcium, which most Americans obtain from dairy products.
Foods vary in their amounts of calories and nutrients
Some foods such as grains, vegetables, and fruits have many nutrients and other healthful substances but are relatively low in calories. Fat and alcohol are high in calories. Foods high in both sugars and fat contain calories but often are low in vitamins, minerals, or fiber.
People who do not need many calories or who must restrict their food intake, need to choose nutrient-rich foods from the five major food groups with special care. They should obtain most of their calories from foods that contain a high proportion of essential nutrients.
Growing children, teenage girls, and women have higher needs for some nutrients
Many women and adolescent girls need to eat more calcium-rich foods to get the calcium needed for healthy bones throughout life. By selecting low-fat or fat-free dairy items and other low-fat calcium sources, they can obtain adequate calcium and keep fat intake from being too high (box 3). Young children, teenage girls, and women of childbearing age should also eat enough iron-rich foods, such as lean meats and whole-grain or enriched white bread to keep the body's iron stores at adequate levels (box 4).
Box 3. Some Good Sources of Calcium*
* Most foods in the dairy group (see dairy group note below)
-- milk and dishes made with milk, such as potato soup, puddings
-- cheeses like mozzarella, cheddar, Swiss, and Parmesan
* Canned fish with soft bones such as sardines, anchovies, and salmon or the tips of chicken leg bones!
* Leafy greens of the cabbage family, such as kale, mustard greens, and turnip tops, and pak choi.
* Tofu, if processed with calcium sulfate. Read the labels.
* Tortillas made from lime-processed corn. Read the labels.
* Table does not include complete list of examples. You can obtain additional information from "Good Sources of Nutrients," USDA, January 1990.
!Note about dairy group - Some foods in this group are high in fat or cholesterol or both. Choose lower fat and cholesterol foods most often.
Box 4. Some Good Sources of Iron*
* Meats -- beef, pork, and lamb and especially liver and other organ meats!
* Poultry -- chicken, duck, and turkey, especially liver and dark meat!
* Fish -- shellfish, like clams, mussels, and oysters; sardines; anchovies; and other fish!
* Leafy greens of the cabbage family, such as broccoli, kale, turnip greens, collards; lima beans, green peas; dry beans and peas, such as pinto beans, black-eyed peas, and canned baked beans
* Yeast-leavened whole wheat bread and rolls
* Iron-enriched white bread, pasta, rice, and cereals. Read the labels.
* Table does not include complete list of examples. You can obtain additional information from "Good Sources of Nutrients," USDA, January 1990.
!Note about meat, pultry and fish: Some foods in these categories are high in fat or cholesterol or both. Choose lean, lower fat and lower cholesterol foods most often.
Enriched and fortified foods have essential nutrients added to them
National policy requires that specified amounts of nutrients be added to enrich some foods. For example, enriched flour and bread contain added thiamin, riboflavin, niacin, and iron; skim milk, low-fat milk, and margarine are usually enriched with vitamin A; and milk is usually enriched with vitamin D. Fortified foods may have one or several nutrients added in extra amounts. The number and quantity of nutrients added vary among products. Fortified foods may be useful for meeting special dietary needs. Read product labels to know which nutrients are added to foods and in what amounts (figure 2). How these foods fit into your total diet will depend on the amounts you eat and the other foods you consume.
Where do vitamin, mineral, and fiber supplements fit in?
Supplements of vitamins, minerals or fiber also may help to meet special nutritional needs. However, supplements do not supply all of the nutrients and other substances present in foods that are important to health. Supplements of some nutrients taken regularly in large amounts are harmful. Daily vitamin and mineral supplements at or below the Recommended Dietary Allowances are considered safe but are rarely needed by people who eat a variety of foods as recommended in the Food Guide Pyramid.
Sometimes supplements are needed to meet specific nutrient requirements. For example, older people and others with little exposure to sunlight may need a vitamin D supplement. Women of childbearing age may reduce the risk of certain birth defects by consuming folate-rich foods or folic acid supplements. Iron supplements are recommended for pregnant women. However, because foods contain many nutrient and other substances that promote health, the use of supplements cannot substitute for proper food choices.
Advice for today
Enjoy eating a variety of foods. Get the many nutrients your body needs by choosing among the varied foods you enjoy from five groups: grain products, vegetables, fruits, milk and milk products, and other protein-rich plant and animal foods (meat, poultry, fish, eggs, beans, and nuts). Many foods you eat contain servings from more than one food group. For example, soups and stews may contain meat, beans, noodles, and vegetables.
figure 2.*[Graphic showing food label]
This graphic shows two food labels. Because of Figure 2's large size, the
two labels are presented separately as
Left side of page 9, food label, and
Right side of page 9. food label
BALANCE THE FOOD YOU EAT WITH PHYSICAL ACTIVITY. MAINTAIN OR IMPROVE YOUR WEIGHT.
Many Americans are overweight and gain weight as they grow older. Both overweight and adult weight gain are linked to high blood pressure, heart disease, stroke, diabetes, certain types of cancer, arthritis, breathing problems, and other illness. Therefore, most adults should not gain weight. If you are overweight and have one of these problems, you should try to lose weight. If you are uncertain about your risk of developing a problem associated with overweight, you should consult a health professional.
How to maintain your weight
In order to stay at the same body weight, people must balance the amount of energy in food with the amount of energy the body uses. Physical activity is an important way to use up food energy. Most Americans spend much of their working day in activities that require little energy. In addition, many Americans of all ages now spend a lot of leisure time each day being inactive, for example, watching television. To use up dietary energy, spend less time doing sedentary activities like sitting. Spend more time doing activities like walking to the store or around the block. Climb stairs rather than using elevators. Less sedentary activity and more vigorous activity may help you reduce body fat and disease risk. Try to do 30 minutes or more of moderate physical activity on most -- preferably all -- days of the week (see box 6, page 12).
The kinds and amounts of food people eat affect their ability to maintain weight. High-fat foods contain more calories per serving than other foods and may increase the likelihood of weight gain. However, even when people eat less high-fat food, they still can gain weight from eating too much of foods high in starch, sugar, or protein. Eat a variety of foods. Fruits, vegetables, pasta, rice, bread, and other whole-grain foods are filling but are lower in calories than foods rich in fats or oils.
The pattern of eating may also be important. Snacks provide a large percentage of daily calories for many Americans. Unless nutritious snacks are part of the daily meal plan, snacking may lead to weight gain. A pattern of binge eating and fasting may also contribute to weight problems. Maintaining weight is equally important for older people who begin to lose weight as they age. Some of that weight is muscle. Maintaining muscle through regular activity helps to keep older people feeling well and helps to reduce the risk of falls and fractures.
How to evaluate your body weight
The chart to the right lists healthy weight ranges for adults. See where your weight falls on the chart for people of your height. The chart applies to men and women of all ages. The health risks due to excess weight appear to be the same for older adults as for younger adults. Weight ranges are given in the chart because people of the same height may have equal amounts of body fat but different amounts of muscle and bone. However, the ranges do not mean that it is healthy to gain weight, even within the same weight range. The higher weights in the healthiest weight range apply to people with more muscle and bone.
Healthy Weight Ranges for Men and Women
---------------------------------------------------------------------- Height Weight (in Pounds) ---------------------------------------------------------------------- 4'10" 91-119 4'11" 94-124 5'0" 97-128 5'1" 101-132 5'2" 104-137 5'3" 107-141 5'4" 111-146 5'5" 114-150 5'6" 118-155 5'7" 121-160 5'8" 125-164 5'9" 129-169 5'10" 132-174 5'11" 136-179 6'0" 140-184 6'1" 144-189 6'2" 148-195 6'3" 152-200 6'4" 156-205 6'5" 160-211 6'6" 164-216Weights above this range are less healthy for most people. The further you are above the healthy weight range for your height, the higher your weight-related risk (see figure 3). Weights slightly below the range may be healthy for some people but are sometimes the result of health problems, especially when weight loss is unintentional.
Are you overweight?
chart used to determine proper weight or degree of obesity
Location of body fat
Research suggests that the location of body fat also is an important factor in health risks for adults. Excess fat in the abdomen (stomach area) is a greater health risk than excess fat in the hips and thighs. Extra fat in the abdomen is linked to high blood pressure, diabetes, early heart disease, and certain types of cancer. Smoking and too much alcohol increase abdominal fat and the risk of diseases related to obesity. Vigorous exercise helps to reduce abdominal fat and decrease the risk of these diseases. The easiest way to check your body fat distribution is to use a tape measure to see if you have more fat in your stomach area than around your hips. If you are in doubt, your doctor can advise you.
Problems with excessive thinness
Being too thin can occur with anorexia nervosa, other eating disorders, or loss of appetite, and is linked to menstrual irregularity and osteoporosis in women and greater risk of early death in women and men. Many people -- especially women -- are concerned about body weight, even when their weight is normal. Excessive concern about weight may cause or lead to such unhealthy behaviors as excessive exercise, self-induced vomiting, and the abuse of laxatives or other medications. These practices may only worsen the concern about weight. Excessive exercise may also affect hormone production, increase the loss of calcium from bones, and increase the risk of fractures. If you lose weight suddenly or for unknown reasons, see a physician. Unexplained weight loss may be an early clue to a health problem.
If you need to lose weight
You do not need to lose weight if your weight is already within the healthiest range in the figure, if you have gained less than 10 pounds since you reached your adult height, and if you are otherwise healthy. If you are overweight and have excess abdominal fat, a weight-related medical problem, or a family history of such problems, you need to lose weight (see box 5). The same practices that help people maintain a healthy weight may also help them lose weight. It is important to recognize that overweight is a chronic condition which can only be controlled with long-term changes. To reduce caloric intake, eat less fat and control portion sizes. If you are not physically active, spend less time in sedentary activities such as watching television, and be more active throughout the day. As people lose weight, the body becomes more efficient at using energy and the rate of weight loss may decrease. Increased physical activity will help you to continue losing weight and to avoid gaining it back (box 6).
Many people are not sure how much weight they should lose. Weight losses of only 5-10 percent of body weight may improve many of the problems associated with overweight, such as high blood pressure and diabetes. Even a smaller weight loss can make a difference. If you are trying to lose weight, do so slowly and steadily. A generally safe rate is 1/2-1 pound a week until you reach your goal. Avoid crash weight-loss diets that severely restrict calories or the variety of foods. Extreme approaches to weight loss, such as self-induced vomiting or the use of laxatives, amphetamines, or diuretics, are not appropriate and can be dangerous to health.
Weight regulation in children
Children need enough food for proper growth. To promote growth and development and prevent obesity, teach children to eat grains, vegetables, and fruits, as well as low-fat dairy and other protein-rich foods, and to participate in vigorous activity. Limiting television time and encouraging children to play actively in a safe environment are helpful steps. Although limiting fat intake may help to prevent excess weight gain in children, fat should not be restricted for children younger than 2 years of age. Helping overweight children to achieve a healthy weight along with normal growth requires more caution. Modest reductions in dietary fat, such as the use of low-fat milk rather than whole milk, are not hazardous, but major efforts to change a child's diet should be reviewed by a health professional.
Advice for today
Try to maintain your body weight by balancing what you eat with physical activity. If you are sedentary, try to become more active. If you are already very active, try to continue the same level of activity as you age. More physical activity is better than less, and any is better than none. If your weight is not in the healthiest range, try to reduce health risks through better eating and exercise habits. Take steps to keep your weight within the healthiest range (neither too high nor too low). Have children's heights and weights checked regularly by a health professional.
Box 5. To Decrease Calorie Intake
* Eat a variety of foods that are low in calories and high in nutrients.
* Eat less fat and fewer high-fat foods.
* Eat smaller portions and limit second helpings.
* Eat more vegetables and fruits.
* Eat pasta, rice, breads, and cereals without fats and sugars added in preparation or at the table.
* Eat less sugar and fewer sweets (like candy, cookies, cakes, soda).
* Drink less or no alcohol.
Box 6. To Increase Energy Expenditure by Physical Activity
Remember to accumulate 30 minutes or more of moderate physical activity on most -- preferably all -- days of the week.
Examples of moderate physical activities for healthy U.S. adults
walking briskly(3-4 mph) conditioning or general calisthenics home care, general cleaning table tennis mowing lawn, power mower golf-pulling cart or carrying clubs home repair, painting fishing, standing/casting jogging cycling, moderate speed canoeing leisurely (less than or equal to 10 mph) (2.0-3.9 mph) swimming (moderate effort) dancing -------------------------------------------------------------------------- adapted from Pate et al. Journal of the American Medical Association 273:404, 1995
CHOOSE A DIET WITH PLENTY OF GRAIN PRODUCTS, VEGETABLES, AND FRUITS
Grain products, vegetables, and fruits are key parts of a varied diet. They are emphasized in this guideline because they provide vitamins, minerals, complex carbohydrates (starch and dietary fiber), and other substances that are important for good health. They are also low in fat. Most Americans of all ages eat fewer than the recommended number of servings of grain products, vegetables, and fruits, even though these foods are associated with a substantially lowered risk of many chronic diseases, including certain types of cancer.
Most of the calories in your diet should come from grain products, vegetables, and fruits
These include grains high in complex carbohydrates -- breads, cereals, pasta, rice -- found at the base of the Food Guide Pyramid, as well as vegetables such as potatoes and corn. Dry beans (like pinto, navy, kidney, and black beans) are included in the meat group of the pyramid, but they can count as servings of vegetables instead of meat alternatives. Plant foods are generally low in fats, depending on how they are prepared and what is added to them at the table.
Plant foods provide fiber
Fiber is found only in plant foods like whole-grain breads and cereals, beans and peas, and other vegetables and fruits. Because there are different types of fiber in foods, choose a variety of foods daily. Eating a variety of fiber-containing plant foods is important for proper bowel function and can reduce symptoms of chronic constipation, diverticular disease, and hemorrhoids, as well as lower the risk of heart disease and some cancers. However, some of the health benefits associated with a high-fiber diet come from other components present in these foods, not just from fiber itself. For this reason, fiber is best obtained from foods rather than supplements.
Plant foods provide a variety of vitamins and minerals essential for health
Most fruits and vegetables are naturally low in fat and provide many essential nutrients and other food components important for health. These foods are excellent sources of carotenes (including those which form vitamin A), vitamin C, vitamin B6, and folate (see box 7). The antioxidant nutrients found in plant foods (vitamin C, carotene, vitamin E, and the mineral selenium) are presently of great interest to scientists and the public because of their potentially beneficial role in reducing the risk of cancer and certain other chronic diseases. Scientists are also trying to determine if other substances in plant foods protect against cancer.
Folate, also called folic acid, is a B vitamin that, among its many functions, reduces the risk of a serious type of birth defect (see box 8). Minerals such as potassium, calcium, and magnesium, found in a wide variety of vegetables and fruits, may help reduce the risk for high blood pressure (see pages 17-18).
The availability of fresh fruits and vegetables varies by season and region of the country, but frozen and canned fruits and vegetables ensure a plentiful supply of these healthful foods throughout the year. Read the Nutrition Facts Label to help choose foods that are rich in carbohydrates, fiber, and nutrients and low in fat and sodium.
Box 7. Some Good Sources of Carotenes*
Colorful vegetables and fruits
dark green, yellow, orange, and some red ones -- such as spinach, tomatoes, broccoli,
carrots, turnip greens, collards, pumpkins, calabasa, sweet potatoes, oranges, mango,
papayas, and melons like cantaloupe
* Does not include complete list of examples. You can obtain additional information from "Good Sources of Nutrients" USDA, January 1990.
Box 8. Some Good Sources of Folate*
* Dry beans (like red beans, navy beans, soy beans, and lentils), chickpeas, cow peas, and peanuts
* Many vegetables, especially leafy greens (spinach, cabbage, brussel sprouts, romaine, loose-leaf lettuce), peas, okra, sweet corn, beets, and avocados
* Yeast and yeast-leavened breads and rolls and wheat germ. Read the labels.
* Does not include a complete list of examples. You can obtain additional information from "Good Sources of Nutrients," USDA, January 1990.
Advice for today
Eat more grain products (breads, cereals, pasta, and rice), vegetables, and fruits. Eat dry beans, lentils, and peas more often. Increase your fiber intake by eating more of a variety of fiber-rich vegetables and fruits such as broccoli, tomatoes, leafy greens, apples, and bananas (box 9).
Box 9. For a diet with plenty of grain products, vegetables and fruits, eat daily
6-11 servings* of grain products (breads, cereals, pasta, and rice)
* Eat products made from a variety of whole grains, such as wheat, rice, oats, corn, and barley.
* Eat several servings of whole-grain breads and cereals daily.
* Prepare and serve grain products with little or no fats and sugars.
3-5 servings* of various vegetables and vegetable juices
* Choose dark-green leafy and deep-yellow vegetables often.
* Eat dry beans, peas, and lentils often.
* Eat starchy vegetables, such as potatoes and corn.
2-4 servings* of various fruits and fruit juices
* Choose citrus fruits or juices, melons, or berries regularly.
* Eat fruits as desserts or snacks.
* Drink fruit juices.
*See box 2, page 7, for what counts as a serving.
CHOOSE A DIET LOW IN FAT, SATURATED FAT, AND CHOLESTEROL
Some dietary fat is needed for good health. Fats supply energy and essential fatty acids and promote absorption of the fat-soluble vitamins A, D, E, and K. Most people are aware that high levels of saturated fat and cholesterol in the diet are linked to increased blood cholesterol levels and greater risk of heart disease. More Americans are now eating less of fat, saturated fat, and cholesterol-rich foods than in the recent past, and fewer people are getting the most common form of heart disease. Still, many people continue to eat high-fat diets, the number of overweight people has increased, and the risk of heart disease and certain cancers (also linked to fat intake) remains high. This guideline emphasizes the continued importance of choosing a diet with less total fat, saturated fat, and cholesterol.
Foods high in fat should be used sparingly
Some foods and food groups in the Food Guide Pyramid are higher in fat than others. Fats and oils and some types of desserts and snack foods that contain fat provide calories but few nutrients. Many foods in the milk and milk products group and in the meat group (which includes eggs and nuts, as well as poultry and fish) are also high in fat, as are some processed foods in the grain product group. Choosing lower fat options among these foods allows you to eat the recommended servings from these groups and to increase the amount and variety of grains, fruits, and vegetables in your diet without going over your calorie needs.
Choose a diet low in fat
Fat, whether from plant or animal sources, contains more than twice the number of caloriesas an equal amount of carbohydrate or protein. Choose a diet that provides no more than 30 percent of total calories from fat. The upper limit on the grams of fat in your diet will depend on the calories you need. Cutting back on fat can help you consume fewer calories. For example, at 2,000 calories per day, the suggested upper limit of calories from fat is about 600 calories. Because each gram of fat contains 9 calories, 600 calories are about 65 grams of fat. On the Nutrition Facts Label, 65 grams of fat is the Daily Value for a 2,000-calorie intake (figure 4).
food label graphic
Choose a diet low in saturated fat
Fats contain both saturated and unsaturated monounsaturated and polyunsaturated) fatty acids. Your diet should provide less than 10 percent of calories from saturated fat. The fats from meat, milk, and milk products are the main sources of saturated fats in most diets. Lesser amounts are obtained from various vegetable oils. On the Nutrition Facts Label, 20 grams of saturated fat (9 percent of caloric intake) is the Daily Value for a 2,000-calorie level.
Monounsaturated and polyunsaturated fat
Olive and canola oils are particularly high in monounsaturated fats; most other vegetable oils, nuts, and high-fat fish are good sources of polyunsaturated fats. Both kinds of unsaturated fats reduce blood cholesterol when they replace saturated fats in the diet. The fats in fish are low in saturated fatty acids and contain a type of polyunsaturated fatty acid (omega-3) that has been associated with a decreased risk of heart disease in certain people. Remember that the total fat in the diet should be consumed at a moderate level -- that is, no more than 30 percent of calories. Mono- and polyunsaturated fat sources should replace saturated fats within this limit.
Partially hydrogenated vegetable oils, such as those used in many margarines and shortenings, contain a particular form of unsaturated fat (trans fatty acids) that is less effective than mono- or polyunsaturated fats in reducing blood cholesterol.
Choose a diet low in cholesterol
The body makes and requires cholesterol. In addition, cholesterol is obtained from food. Dietary cholesterol comes from animal sources such as egg yolks, meat (especially organ meats such as liver) poultry, fish, and higher fat dairy products. Many of these foods are also high in saturated fats. Choosing foods with less cholesterol and saturated fat will help lower your blood cholesterol levels. The Nutrition Facts Label lists the Daily Value for cholesterol as 300 mg. You can keep your cholesterol intake at this level or lower by emphasizing intakes of grains, vegetables, and fruits and by limiting intake of egg yolks, including those used in cooking.
Advice for children
Advice in the previous sections does not apply to infants and toddlers below the age of 2 years. After that age, children should gradually adopt a diet that, by about 5 years of age, contains no more than 30 percent of calories from fat. As they begin to consume fewer calories from fat, children should replace these calories by eating more grain products, fruits, vegetables, and low-fat dairy products and other protein-rich foods.
Advice for today
To reduce your intake of fat, saturated fat, and cholesterol, follow recommendations in the Food Guide Pyramid, which apply to diets consumed over several days and not to single meals or foods.
* Use fats and oils sparingly.
* Use the Nutrition Facts Label to help you choose foods lower in fat, saturated fat, and cholesterol.
* Eat plenty of grain products, vegetables, and fruits.
* Choose low-fat dairy foods, lean meats, fish, poultry, beans, and peas to get essential nutrients without substantially increasing calorie and saturated fat intakes.
For a Diet Low in Fat, Saturated Fat, and Cholesterol
Fats and Oils
* Use fats and oils sparingly in cooking and at the table.
* Use small amounts of salad dressings and spreads such as butter, margarine, and mayonnaise. Consider using low-fat or fat-free dressings for salads.
* Choose vegetable oils and soft margarines most often because they are lower in saturated fat than solid shortenings and animal fats, even though their caloric content is the same.
* Check the Nutrition Facts Label to see how much fat and saturated fat are in a serving; choose foods lower in fat and saturated fat.
Vegetables, Fruits, and Grains
* Choose low-fat sauces with pasta, rice, and potatoes.
* Use as little fat as possible to cook vegetables and grains.
* Season with herbs, spices, lemon juice, and fat-free or low-fat salad dressings.
Meat, Poultry, Fish, Eggs, Beans, and Nuts
* Choose up to two to three servings of lean fish, poultry, and meats daily. Use meats labeled "lean" or "extra lean." Trim fat from meat; take skin off poultry. (Three ounces of cooked lean beef or chicken without skin - a piece the size of a deck of cards - provides about 6 grams of fat; a piece of chicken with skin or untrimmed meat of that size may have as much as twice this amount of fat.)
* Eat beans and bean products. Most are almost fat free and are a good source of protein and fiber.
* Limit intake of high-fat processed meats, such as sausages, salami, and other cold cuts; choose lower fat varieties by reading the Nutrition Facts Label.
* Use egg yolks and organ meats in moderation. (One egg yolk has about 215 mg of cholesterol; one ounce of cooked chicken liver has about 250 mg of cholesterol.)
Milk and Milk Products
* Choose skim or low-fat milk, fat-free or low-fat yogurt, and low-fat cheese.
* Have up to two to three low-fat servings daily. Add extra calcium to your diet without added fat by choosing fat-free yogurt and low-fat milk more often. [One cup of skim milk has almost no fat, 1 cup of 1 percent milk has 2.5 grams of fat, 1 cup of 2 percent milk has 5 grams (one teaspoon) of fat, and 1cup of whole milk has 8 grams of fat.]
CHOOSE A DIET MODERATE IN SUGARS
Sugars come in many forms
Sugars are carbohydrates. Dietary carbohydrates also include the complex carbohydrates starch and fiber. During digestion all carbohydrates except fiber break down into sugars. Sugars and starches occur naturally in many foods -- including milk, fruits, some vegetables, breads, cereals, and grains -- that also supply other nutrients. Americans eat sugars in many forms, and most people like their taste. Some sugars are used as natural preservatives, thickeners, and baking aids in foods; they are often added to foods during processing and preparation or when they are eaten. The body cannot tell the difference between naturally occurring and added sugars because they are identical chemically.
Sugars, health, and weight maintenance
Scientific evidence indicates that diets high in sugars do not cause hyperactivity or diabetes. The most common type of diabetes occurs in overweight adults. Avoiding sugars alone will not correct overweight. To lose weight reduce the total amount of food you eat and increase your level of physical activity (see pages 9-12.)
To maintain your weight when you eat less fat, replace the lost calories from fat with equal calories from carbohydrates, mainly from the plant foods in the lower half of the Food Guide Pyramid. Some foods that contain a lot of sugars supply calories but few or no nutrients (box 10). These foods are located at the top of the pyramid. For very active people with high calorie needs, sugars can be an additional source of energy. However, because maintaining a nutritious diet and a healthy weight is very important, sugars should be used in moderation by most healthy people and sparingly by people with low calorie needs. This guideline cautions about eating sugars in large amounts and about frequent snacks of foods and beverages containing sugars that supply unnecessary calories and few nutrients.
Sugar substitutes such as sorbitol, saccharin, and aspartame are ingredients in many foods. Most of the sugar substitutes do not provide significant calories and therefore may be useful in the diets of people concerned about calorie intake. Foods containing sugar substitutes, however, may not always be lower in calories than similar products that contain sugars. Unless you reduce the total calories you eat, the use of sugar substitutes will not cause you to lose weight.
Sugars and dental caries
Both sugars and starches can promote tooth decay. The more often you eat foods that contain sugars and starches and the longer these foods are in your mouth before you brush your teeth, the greater the risk for tooth decay. Thus, frequent eating of foods high in sugars and starches as between-meal snacks may be more harmful to your teeth than eating them at meals and then brushing. Regular daily dental hygiene, including brushing and flossing and an adequate intake of fluoride, will help you prevent tooth decay (see box 11).
Advice for today
Use sugars in moderation -- sparingly if your calorie needs are low. Avoid excessive snacking, and brush and floss your teeth regularly. Read the Nutrition Facts Label on foods you buy. The food label lists the content of total carbohydrate and sugars, as well as calories.
Box 10. On a Food Label, Sugars Include --
brown sugar invert sugar
corn sweetener lactose
corn syrup maltose
fruit juice concentrate raw sugar
glucose (dextrose) [table] sugar (sucrose)
high-fructose corn syrup syrup
A food is likely to be high in sugars if one of the above terms appears first or second in the ingredients list, or if several of them are listed.
Box 11. For Healthier Teeth and Gums
* Eat fewer foods containing sugars and starches between meals.
* Brush and floss teeth regularly.
* Use a fluoride toothpaste.
* Ask your dentist or doctor about the need for supplemental fluoride, especially for children.
* If you use a nursing bottle to pacify your infant, serve only water in the bottle.
CHOOSE A DIET MODERATE IN SALT AND SODIUM
Sodium and salt are found mainly in processed and prepared foods
Sodium and sodium chloride -- known commonly as salt -- occur naturally in foods, usually in small amounts. Salt added during preparation or before eating enhances the taste of many foods, and some people are accustomed to the taste of highly salted foods. Salt and other sodium-containing ingredients also have many uses in food processing. Although some people add salt to their food at the table, most dietary sodium or salt comes from foods to which salt has already been added during processing or preparation.
Sodium is associated with high blood pressure
In the body, sodium plays an essential role in regulating fluids and blood pressure. However, many studies in diverse populations have shown that a high sodium intake is associated with more cases of high blood pressure. Most evidence suggests that many people at risk for high blood pressure may reduce their chances of developing this condition by consuming less salt or sodium. Some questions remain about this relationship, partly because many other factors interact with sodium to affect blood pressure.
Other factors affect blood pressure
Following other guidelines in the Dietary Guidelines may also help prevent high blood pressure. An important example is the guideline on weight and physical activity. The role of body weight in blood pressure control is well documented. Blood pressure increases with weight and decreases when weight is reduced. The guideline to consume a diet with plenty of fruits and vegetables also is relevant. Many fruits and vegetables are high in potassium (see box 12). Studies suggest that eating foods high in potassium helps to counter some of the effects of high salt consumption on blood pressure. Alcohol consumption has been associated with high blood pressure. Having an adequate intake of calcium may also be protective. High salt intakes may increase the amount of calcium excreted in the urine and, therefore, increase the body's need for calcium.
Box 12: Some Good Sources of Potassium* ----------------------------------------------------------------- Vegetables and fruits in general, especially --potatoes and sweet potatoes --spinach, swiss chard, broccoli, winter squashes, parsnips, and avocados --dates, bananas, oranges, and cantaloupes --dry beans, peas, and lentils Milk and Yogurt are good sources of potassium and have less sodium than cheese. Cheese has much less potassium and usually has added salt. ------------------------------------------------------------------------
Most Americans consume more salt than is needed
Sodium has an important role in the body. However, most Americans consume more sodium than is needed. The Nutrition Facts Label lists a Daily Value of 2,400 mg per day for sodium (2,400 mg sodium per day is contained in 6 grams of salt). Most people consume more than this amount.
There is no way at present to tell who might develop high blood pressure from eating too much sodium. However, consuming less salt or sodium can be recommended for everyone in the population because it is not harmful to the healthy normal adult (box 13).
Advice for today
Fresh fruits and vegetables have very little sodium, but all groups in the Food Guide Pyramid can include some foods that are high in sodium and other foods that have very little sodium or can be prepared in ways that add flavor without adding salt. Read the Nutrition Facts Label to help identify foods lower in sodium within each group. Use herbs and spices to flavor food. Try to choose versions of foods that you frequently consume which are lower in sodium and salt.
Box 13. To Consume Less Salt and Sodium -- --------------------------------------------------------
* Read the Nutrition Facts Label to determine the amount of sodium in the foods you purchase. The sodium content of foods within processed food categories -- such as cereals, breads, soups, and salad dressings -- often varies widely.
Choose foods lower in sodium, and ask your grocer or supermarket to offer more low-sodium foods. Request less salt in your meals when eating out or traveling.
* If you salt foods in cooking or at the table, add small amounts. Learn to use spices and herbs rather than salt to heighten the flavor of food.
* When planning meals, consider that fresh and most plain frozen vegetables are low in sodium.
* When selecting canned foods, select those prepared without salt.
* Fresh fish, poultry, and meat are lower in sodium than most canned and processed ones.
* Many frozen dinners, packaged mixes, canned soups, and salad dressings contain a considerable amount of sodium. Choose foods lower in sodium content. Remember that condiments such as soy and other sauces, pickles, olives, ketchup, and mustard are high in sodium. Choose lower sodium varieties.
* Fresh fruits and vegetables are a lower sodium alternative to salted snack foods.
IF YOU DRINK ALCOHOLIC BEVERAGES, DO SO IN MODERATION
Alcoholic beverages have been used to enhance the enjoyment of meals by many societies throughout human history. Alcoholic beverages supply calories but few or no nutrients. The alcohol in these beverages has physiologic drug effects and is harmful when consumed in excess. The drug effects of alcohol alter judgment and can lead to dependency and a great many other serious health problems. If adults choose to drink alcoholic beverages, they should consume them only in moderation (see box 14).
Box 14 What Is Moderation?
Moderation is defined as no more than one drink per day
for women and no more than two drinks per day for men.
Count as a drink-
Current evidence suggests that moderate drinking, as defined in box 14, is associated with a lower risk of coronary heart disease in some individuals. However, higher levels of alcohol intake raise the risk for high blood pressure, stroke, heart disease, certain cancers, accidents, violence, suicides, birth defects, and overall mortality (deaths). Too much alcohol may cause cirrhosis of the liver, inflammation of the pancreas, and damage to the brain and heart. Heavy drinkers also are at risk of malnutrition because alcohol contains calories that may substitute for those in more nutritious foods.
Who should not drink?
Some people should not drink alcoholic beverages at all. These include
* Children and adolescents.
* Individuals of any age who cannot restrict their drinking to moderate levels. This is a special concern for recovering alcoholics and people whose family members have alcohol problems.
* Women who are trying to conceive or who are pregnant. Major birth defects, including fetal alcohol syndrome, have been attributed to heavy drinking by the mother while pregnant. While there is no conclusive evidence that an occasional drink is harmful to the fetus or to the pregnant woman, a safe level of alcohol intake during pregnancy has not been established.
* Individuals who plan to drive or take part in activities that require attention or skill. Most people retain some alcohol in the blood up to 2-3 hours after a single drink.
* Individuals using prescription and over-the-counter medications. Alcohol may alter the effectiveness or toxicity of medicines. Also, some medications may increase blood alcohol levels or increase the adverse effect of alcohol on the brain.
Advice for today
If you drink alcoholic beverages, do so in moderation, with meals, and when consumption does not put you or others at risk.
The U.S. Department of Health and Human Services and the U.S. Department of Agriculture acknowledge the recommendations of the Dietary Guidelines Advisory Committee -- the basis for this edition. The committee consisted of Doris Howes Calloway, Ph.D. (chair), Richard J. Havel, M.D. (vice-chair), Dennis M. Bier, M.D., William H. Dietz, M.D., Ph.D., Cutberto Garza, M.D., Ph.D., Shiriki K. Kumanyika, Ph.D., R.D., Marion Nestle, Ph.D., M.P.H., Irwin H. Rosenberg, M.D., Sachiko T. St. Jeor, Ph.D., R.D., Barbara O. Schneeman, Ph.D., and John W. Suttie, Ph.D. The Departments would also like to acknowledge the staff work of the four executive secretaries to the committee: from HHS -- Karil Bialostosky, M.S., and Linda Meyers, Ph.D.; and from USDA -- Eileen Kennedy, D.Sc., and Debra Reed, M.S.
Some of the scientific basis for these guidelines
* Diet, Nutrition, and the Prevention of Chronic Diseases, No. 797. Geneva, World Health Organization, 1990.
* The Surgeon General's Report on Nutrition and Health. U.S. Department of Health and Human Services, Public Health Service, 1988.
* Diet and Health: Implications for Reducing Chronic Disease Risk. National Academy of Sciences, National Research Council, 1989.
* Recommended Dietary Allowances, 10th ed. National Academy of Sciences, National Research Council, 1989.
Information on how to put the guidelines into practice
* Contact the Center for Nutrition Policy and Promotion, USDA, 1120 20th Street, NW, Suite 200 North Lobby, Washington, DC 20036, to order
-- The Food Guide Pyramid, HG-252, 1992
-- Dietary Guidelines and Your Diet, HG-253-1 through 8, 1993. A packet of eight information bulletins on nutrition and your health.
* Contact the Cancer Information Service, Office of Cancer Communications, National Cancer Institute, Building 31, Room 10A16, 9000 Rockville Pike, Bethesda, MD 20892;
National Heart, Lung, and Blood Institute Information Center, P.O. Box 30105, Bethesda, MD 20824-0105;
Weight-Control Information Network of the National Institute of Diabetes and Digestive and Kidney Diseases, 1 Win Way, Bethesda, MD 20892;
Office of Food Labeling, Food and Drug Administration (HFS-150), 200 C Street, SW, Washington, DC 20204.
* Contact your county extension home economist (cooperative extension system) or a nutrition professional in your local public health department, hospital, American Red Cross, dietetic association, diabetes association, heart association, or cancer society.