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pdfDietary Guidelines
for Americans
2005
U.S. Department of Health and Human Services
U.S. Department of Agriculture
www.healthierus.gov/dietaryguidelines
i
MESSAGE FROM THE SECRETARIES
We are pleased to present the 2005 Dietary Guidelines for Americans. This document is intended to be a primary
source of dietary health information for policymakers, nutrition educators, and health providers. Based on the latest
scientific evidence, the 2005 Dietary Guidelines provides information and advice for choosing a nutritious diet,
maintaining a healthy weight, achieving adequate exercise, and “keeping foods safe” to avoid foodborne illness.
This document is based on the recommendations put forward by the Dietary Guidelines Advisory Committee. The
Committee was composed of scientific experts who were responsible for reviewing and analyzing the most current
dietary and nutritional information and incorporating this into a scientific evidence-based report. We want to thank
them and the other public and private professionals who assisted in developing this document for their hard work
and dedication.
The more we learn about nutrition and exercise, the more we recognize their importance in everyday life. Children
need a healthy diet for normal growth and development, and Americans of all ages may reduce their risk of chronic
disease by adopting a nutritious diet and engaging in regular physical activity.
However, putting this knowledge into practice is difficult. More than 90 million Americans are affected by chronic
diseases and conditions that compromise their quality of life and well-being. Overweight and obesity, which are
risk factors for diabetes and other chronic diseases, are more common than ever before. To correct this problem,
many Americans must make significant changes in their eating habits and lifestyles.
We live in a time of widespread availability of food options and choices. More so than ever, consumers need good
advice to make informed decisions about their diets. The 2005 Dietary Guidelines will help Americans choose a
nutritious diet within their energy requirements. We believe that following the recommendations in the Dietary
Guidelines will assist many Americans in living longer, healthier, and more active lives.
Tommy G. Thompson
Secretary of Health and Human Services
Ann M. Veneman
Secretary of Agriculture
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ACKNOWLEDGMENTS
The U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) acknowledge
the recommendations of the Dietary Guidelines Advisory Committee—the basis for this edition. The Committee
consisted of Janet C. King, Ph.D., R.D. (chair), Lawrence J. Appel, M.D., M.P.H., Benjamin Caballero, M.D., Ph.D., Fergus
M. Clydesdale, Ph.D., Penny M. Kris-Etherton, Ph.D., R.D., Theresa A. Nicklas, Dr.P.H., M.P.H., L.N., F. Xavier Pi-Sunyer,
M.D., M.P.H., Yvonne L. Bronner, Sc.D., R.D., L.D., Carlos A. Camargo, M.D., Dr.P.H., Vay Liang W. Go, M.D., Joanne R.
Lupton, Ph.D., Russell R. Pate, Ph.D., Connie M. Weaver, Ph.D., and the scientific writer/editor, Carol Suitor, Sc.D.
The Departments also acknowledge the work of the departmental scientists, staff, and policy officials responsible for
the production of this document:
From HHS: Laura Lawlor, Michael O'Grady, Ph.D., Cristina Beato, M.D., Les Crawford, D.V.M., Ph.D., Barbara Schneeman,
Ph.D., Kathryn Y. McMurry, M.S., Deb Galuska, Ph.D., Van Hubbard, M.D., Ph.D., Mary Mazanec, M.D., J.D., Penelope
Royall, P.T., M.S.W., Laina Bush, M.B.A., Diane Thompson M.P.H., R.D., Susan Anderson, M.S., R.D., Jean Pennington,
R.D., Ph.D., Susan M. Krebs-Smith, Ph.D., R.D., Wendy Johnson-Taylor, Ph.D., Kim Stitzel, M.S., R.D., Jennifer Weber, R.D.,
M.P.H., Pamela E. Starke-Reed, Ph.D., Paula R. Trumbo, Ph.D., Jennifer Seymour, Ph.D., Darla Danford, D.Sc., M.P.H, R.D.,
Christine Dobday, Donna Robie Howard, Ph.D., Ginny Gunderson, and Adam Michael Clark, Ph.D.
From USDA: Beth Johnson, M.S., R.D., Eric Bost, Eric Hentges, Ph.D., Kate Coler, Rodney Brown, Ph.D., Carole Davis,
M.S., R.D., Dorothea K. Vafiadis, M.S., Joan M.G. Lyon, M.S., R.D., L.D., Trish Britten, Ph.D., Molly Kretsch, Ph.D., Pamela
Pehrsson, Ph.D., Jan Stanton, M.S., M.B.A., R.D., Susan Welsh, Ph.D., Joanne Guthrie, M.P.H., R.D., Ph.D., David Klurfeld,
Ph.D., Gerald F. Combs, Jr., Ph.D., Beverly Clevidence, Ph.D., Robert Mitchell Russell, M.D., Colette I. Thibault, M.S., R.D.,
L.D., Sedigheh-Essie Yamini, Ph.D., R.D., Kristin L. Marcoe, M.B.A., R.D., and David M. Herring, M.S.
The Departments also acknowledge the important role of those who provided input and public comments throughout
this process. Finally, the Departments acknowledge the contributions of numerous other internal departmental scientists
and staff that contributed to the production of this document, including the members of the Independent Scientific
Review Panel who peer reviewed the recommendations of the document to ensure they were based on a preponderance
of scientific evidence.
D I E TA R Y G U I D E L I N E S F O R A M E R I C A N S , 2 0 0 5
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Contents
MESSAGE FROM THE SECRETARIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i
ACKNOWLEDGMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii
EXECUTIVE SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .v
CHAPTER 1
Background and Purpose of the Dietary Guidelines for Americans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
CHAPTER 2
Adequate Nutrients Within Calorie Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
CHAPTER 3
Weight Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
CHAPTER 4
Physical Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
CHAPTER 5
Food Groups To Encourage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
CHAPTER 6
Fats . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
CHAPTER 7
Carbohydrates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
CHAPTER 8
Sodium and Potassium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
CHAPTER 9
Alcoholic Beverages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
CHAPTER 10
Food Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
APPENDIX A
Eating Patterns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
APPENDIX A-1
DASH Eating Plan at 1,600-, 2,000-, 2,600-, and 3,100-Calorie Levels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
APPENDIX A-2
USDA Food Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
APPENDIX A-3
Discretionary Calorie Allowance in the USDA Food Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
APPENDIX B
Food Sources of Selected Nutrients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
APPENDIX B-1
Food Sources of Potassium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56
APPENDIX B-2
Food Sources of Vitamin E . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
APPENDIX B-3
Food Sources of Iron . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
APPENDIX B-4
Non-Dairy Food Sources of Calcium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
APPENDIX B-5
Food Sources of Calcium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
APPENDIX B-6
Food Sources of Vitamin A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
APPENDIX B-7
Food Sources of Magnesium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
APPENDIX B-8
Food Sources of Dietary Fiber . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63
APPENDIX B-9
Food Sources of Vitamin C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
APPENDIX C
Glossary of Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
APPENDIX D
Acronyms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
D I E TA R Y G U I D E L I N E S F O R A M E R I C A N S , 2 0 0 5
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LIST OF FIGURES
LIST OF TABLES
FIGURE 1.
Percent Increase or Decrease
From Current Consumption (Zero Line)
to Recommended Intakes
TABLE 1.
Sample USDA Food Guide and the Dietary
Approaches to Stop Hypertension (DASH)
Eating Plan at the 2,000-Calorie Level
FIGURE 2.
Adult BMI Chart
TABLE 2.
FIGURE 3.
Example of Boys’ BMI Growth Curve
(2 to 20 years): Boys’ Body Mass
Index-For-Age Percentiles
Comparison of Selected Nutrients in the DASH
Eating Plan, the USDA Food Guide, and Nutrient
Intakes Recommended Per Day by the Institute
of Medicine (IOM)
FIGURE 4.
Sources of Dietary Sodium
TABLE 3.
FIGURE 5.
Temperature Rules for Safe Cooking
and Handling of Foods
Estimated Calorie Requirements (in Kilocalories)
for Each Gender and Age Group at Three Levels
of Physical Activity
TABLE 4.
Calories/Hour Expended in Common Physical
Activities
TABLE 5.
Fruits, Vegetables, and Legumes (Dry Beans)
That Contain Vitamin A (Carotenoids), Vitamin C,
Folate, and Potassium
TABLE 6.
Comparison of 100 Grams of Whole-Grain
Wheat Flour and Enriched, Bleached, White,
All-Purpose Flour
TABLE 7.
Whole Grains Available in the United States
TABLE 8.
Maximum Daily Amounts of Saturated Fat
To Keep Saturated Fat Below 10 Percent
of Total Calorie Intake
TABLE 9.
Differences in Saturated Fat and Calorie
Content of Commonly Consumed Foods
TABLE 10.
Contribution of Various Foods to Saturated
Fat Intake in the American Diet
(Mean Intake = 25.5 g)
TABLE 11.
Contribution of Various Foods to Trans Fat
Intake in the American Diet
(Mean Intake = 5.84 g)
TABLE 12.
Relationship Between LDL Blood Cholesterol Goal
and the Level of Coronary Heart Disease Risk
TABLE 13.
Major Sources of Added Sugars
(Caloric Sweeteners) in the American Diet
TABLE 14.
Names for Added Sugars That Appear
on Food Labels
TABLE 15.
Range of Sodium Content for Selected Foods
TABLE 16.
Calories in Selected Alcoholic Beverages
D I E TA R Y G U I D E L I N E S F O R A M E R I C A N S , 2 0 0 5
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Executive Summary
The Dietary Guidelines for Americans [Dietary Guidelines]
provides science-based advice to promote health and to
reduce risk for major chronic diseases through diet and
physical activity. Major causes of morbidity and mortality
in the United States are related to poor diet and a seden
tary lifestyle. Some specific diseases linked to poor diet
and physical inactivity include cardiovascular disease,
type 2 diabetes, hypertension, osteoporosis, and certain
cancers. Furthermore, poor diet and physical inactivity,
resulting in an energy imbalance (more calories consumed
than expended), are the most important factors contrib
uting to the increase in overweight and obesity in this
country. Combined with physical activity, following a diet
that does not provide excess calories according to the
recommendations in this document should enhance the
health of most individuals.
An important component of each 5-year revision of the
Dietary Guidelines is the analysis of new scientific informa
tion by the Dietary Guidelines Advisory Committee (DGAC)
appointed by the Secretaries of the U.S. Department of
Health and Human Services (HHS) and the U.S. Department
of Agriculture (USDA). This analysis, published in the DGAC
Report (http://www.health.gov/dietaryguidelines/dga2005/
report/), is the primary resource for development of the
report on the Guidelines by the Departments. The Dietary
Guidelines and the report of the DGAC differ in scope and
purpose compared to reports for previous versions of the
Guidelines. The 2005 DGAC report is a detailed scientific
analysis. The scientific report was used to develop the
Dietary Guidelines jointly between the two Departments
and forms the basis of recommendations that will be used
by USDA and HHS for program and policy development.
D I E TA R Y G U I D E L I N E S F O R A M E R I C A N S , 2 0 0 5
vi
Thus it is a publication oriented toward policymakers,
nutrition educators, nutritionists, and healthcare providers
rather than to the general public, as with previous
versions of the Dietary Guidelines, and contains more
technical information.
The intent of the Dietary Guidelines is to summarize and
synthesize knowledge regarding individual nutrients and
food components into recommendations for a pattern
of eating that can be adopted by the public. In this publi
cation, Key Recommendations are grouped under nine
inter-related focus areas. The recommendations are based
on the preponderance of scientific evidence for lowering
risk of chronic disease and promoting health. It is impor
tant to remember that these are integrated messages that
should be implemented as a whole. Taken together, they
encourage most Americans to eat fewer calories, be more
active, and make wiser food choices.
A basic premise of the Dietary Guidelines is that nutrient
needs should be met primarily through consuming foods.
Foods provide an array of nutrients and other compounds
that may have beneficial effects on health. In certain cases,
fortified foods and dietary supplements may be useful
sources of one or more nutrients that otherwise might be
consumed in less than recommended amounts. However,
dietary supplements, while recommended in some cases,
cannot replace a healthful diet.
Two examples of eating patterns that exemplify the
Dietary Guidelines are the USDA Food Guide (http://
www.usda.gov/cnpp/pyramid.html) and the DASH
(Dietary Approaches to Stop Hypertension) Eating Plan.1
Both of these eating patterns are designed to integrate
dietary recommendations into a healthy way to eat for
most individuals. These eating patterns are not weight
loss diets, but rather illustrative examples of how to eat
in accordance with the Dietary Guidelines. Both eating
patterns are constructed across a range of calorie levels
to meet the needs of various age and gender groups. For
the USDA Food Guide, nutrient content estimates for
each food group and subgroup are based on population-
Taken together, [the
Dietary Guidelines ]
encourage most
Americans to eat
fewer calories, be
more active, and make
wiser food choices.
weighted food intakes. Nutrient content estimates for
the DASH Eating Plan are based on selected foods
chosen for a sample 7-day menu. While originally devel
oped to study the effects of an eating pattern on the
prevention and treatment of hypertension, DASH is one
example of a balanced eating plan consistent with the
2005 Dietary Guidelines.
Throughout most of this publication, examples use a
2,000-calorie level as a reference for consistency with the
Nutrition Facts Panel. Although this level is used as a
reference, recommended calorie intake will differ for indi
viduals based on age, gender, and activity level. At each
calorie level, individuals who eat nutrient-dense foods
may be able to meet their recommended nutrient intake
without consuming their full calorie allotment. The remain
ing calories—the discretionary calorie allowance—allow
individuals flexibility to consume some foods and beverages
that may contain added fats, added sugars, and alcohol.
The recommendations in the Dietary Guidelines are for
Americans over 2 years of age. It is important to incorporate
the food preferences of different racial/ethnic groups, vege
1 NIH Publication No. 03-4082, Facts about the DASH Eating Plan, United States Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute,
Karanja NM et al. Journal of the American Dietetic Association (JADA) 8:S19-27, 1999. http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/.
D I E TA R Y G U I D E L I N E S F O R A M E R I C A N S , 2 0 0 5
vii
tarians, and other groups when planning diets and devel
oping educational programs and materials. The USDA Food
Guide and the DASH Eating Plan are flexible enough to
accommodate a range of food preferences and cuisines.
The Dietary Guidelines is intended primarily for use
by policymakers, healthcare providers, nutritionists, and
nutrition educators. The information in the Dietary
Guidelines is useful for the development of educational
materials and aids policymakers in designing and imple
menting nutrition-related programs, including federal
food, nutrition education, and information programs. In
addition, this publication has the potential to provide
authoritative statements as provided for in the Food
and Drug Administration Modernization Act (FDAMA).
Because the Dietary Guidelines contains discussions
where the science is emerging, only statements included
in the Executive Summary and the sections titled “Key
Recommendations,” which reflect the preponderance
of scientific evidence, can be used for identification of
authoritative statements. The recommendations are inter
related and mutually dependent; thus the statements
in this document should be used together in the context
of planning an overall healthful diet. However, even
following just some of the recommendations can have
health benefits.
The following is a listing of the Dietary Guidelines
by chapter.
ADEQUATE NUTRIENTS WITHIN
CALORIE NEEDS
Key Recommendations
• Consume a variety of nutrient-dense foods and bever
ages within and among the basic food groups while
choosing foods that limit the intake of saturated and
trans fats, cholesterol, added sugars, salt, and alcohol.
• Meet recommended intakes within energy needs by
adopting a balanced eating pattern, such as the USDA
Food Guide or the DASH Eating Plan.
Key Recommendations for Specific Population Groups
• People over age 50. Consume vitamin B12 in its
crystalline form (i.e., fortified foods or supplements).
• Women of childbearing age who may become pregnant.
Eat foods high in heme-iron and/or consume iron-rich
plant foods or iron-fortified foods with an enhancer of
iron absorption, such as vitamin C-rich foods.
• Women of childbearing age who may become pregnant
and those in the first trimester of pregnancy. Consume
adequate synthetic folic acid daily (from fortified foods
or supplements) in addition to food forms of folate from
a varied diet.
• Older adults, people with dark skin, and people exposed
to insufficient ultraviolet band radiation (i.e., sunlight).
Consume extra vitamin D from vitamin D-fortified foods
and/or supplements.
WEIGHT MANAGEMENT
Key Recommendations
• To maintain body weight in a healthy range,
balance calories from foods and beverages with
calories expended.
• To prevent gradual weight gain over time, make
small decreases in food and beverage calories and
increase physical activity.
Key Recommendations for Specific Population Groups
• Those who need to lose weight. Aim for a slow, steady
weight loss by decreasing calorie intake while main
taining an adequate nutrient intake and increasing
physical activity.
• Overweight children. Reduce the rate of body weight
gain while allowing growth and development. Consult
a healthcare provider before placing a child on a
weight-reduction diet.
• Pregnant women. Ensure appropriate weight gain
as specified by a healthcare provider.
• Breastfeeding women. Moderate weight reduction
is safe and does not compromise weight gain of the
nursing infant.
• Overweight adults and overweight children with
chronic diseases and/or on medication. Consult a
healthcare provider about weight loss strategies prior
to starting a weight-reduction program to ensure
appropriate management of other health conditions.
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viii
PHYSICAL ACTIVITY
FOOD GROUPS TO ENCOURAGE
Key Recommendations
• Engage in regular physical activity and reduce
sedentary activities to promote health, psychological
well-being, and a healthy body weight.
• To reduce the risk of chronic disease in adulthood:
Engage in at least 30 minutes of moderate-intensity
physical activity, above usual activity, at work or
home on most days of the week.
• For most people, greater health benefits can be
obtained by engaging in physical activity of more
vigorous intensity or longer duration.
• To help manage body weight and prevent gradual,
unhealthy body weight gain in adulthood: Engage in
approximately 60 minutes of moderate- to vigorousintensity activity on most days of the week while
not exceeding caloric intake requirements.
• To sustain weight loss in adulthood: Participate in
at least 60 to 90 minutes of daily moderate-intensity
physical activity while not exceeding caloric intake
requirements. Some people may need to consult
with a healthcare provider before participating in
this level of activity.
• Achieve physical fitness by including cardiovascular
conditioning, stretching exercises for flexibility, and
resistance exercises or calisthenics for muscle strength
and endurance.
Key Recommendations
• Consume a sufficient amount of fruits and vegetables
while staying within energy needs. Two cups of fruit
and 21/2 cups of vegetables per day are recommended
for a reference 2,000-calorie intake, with higher or
lower amounts depending on the calorie level.
• Choose a variety of fruits and vegetables each day.
In particular, select from all five vegetable subgroups
(dark green, orange, legumes, starchy vegetables, and
other vegetables) several times a week.
• Consume 3 or more ounce-equivalents of whole-grain
products per day, with the rest of the recommended
grains coming from enriched or whole-grain products.
In general, at least half the grains should come from
whole grains.
• Consume 3 cups per day of fat-free or low-fat milk or
equivalent milk products.
Key Recommendations for Specific Population Groups
FATS
• Children and adolescents. Engage in at least 60
minutes of physical activity on most, preferably all,
days of the week.
• Pregnant women. In the absence of medical or obstetric
complications, incorporate 30 minutes or more of
moderate-intensity physical activity on most, if not all,
days of the week. Avoid activities with a high risk of
falling or abdominal trauma.
• Breastfeeding women. Be aware that neither acute nor
regular exercise adversely affects the mother’s ability
to successfully breastfeed.
• Older adults. Participate in regular physical activity to
reduce functional declines associated with aging and
to achieve the other benefits of physical activity identi
fied for all adults.
Key Recommendations
• Consume less than 10 percent of calories from
saturated fatty acids and less than 300 mg/day
of cholesterol, and keep trans fatty acid consumption
as low as possible.
• Keep total fat intake between 20 to 35 percent of
calories, with most fats coming from sources of polyun
saturated and monounsaturated fatty acids, such as
fish, nuts, and vegetable oils.
• When selecting and preparing meat, poultry, dry beans,
and milk or milk products, make choices that are lean,
low-fat, or fat-free.
• Limit intake of fats and oils high in saturated and/or
trans fatty acids, and choose products low in such fats
and oils.
D I E TA R Y G U I D E L I N E S F O R A M E R I C A N S , 2 0 0 5
Key Recommendations for Specific Population Groups
• Children and adolescents. Consume whole-grain prod
ucts often; at least half the grains should be whole
grains. Children 2 to 8 years should consume 2 cups
per day of fat-free or low-fat milk or equivalent milk
products. Children 9 years of age and older should
consume 3 cups per day of fat-free or low-fat milk or
equivalent milk products.
ix
• Children and adolescents. Keep total fat intake between
30 to 35 percent of calories for children 2 to 3 years of age
and between 25 to 35 percent of calories for children and
adolescents 4 to 18 years of age, with most fats coming
from sources of polyunsaturated and monounsaturated
fatty acids, such as fish, nuts, and vegetable oils.
become pregnant, pregnant and lactating women, chil
dren and adolescents, individuals taking medications
that can interact with alcohol, and those with specific
medical conditions.
• Alcoholic beverages should be avoided by individuals
engaging in activities that require attention, skill, or
coordination, such as driving or operating machinery.
CARBOHYDRATES
FOOD SAFETY
Key Recommendations
• Choose fiber-rich fruits, vegetables, and whole
grains often.
• Choose and prepare foods and beverages with little
added sugars or caloric sweeteners, such as amounts
suggested by the USDA Food Guide and the DASH
Eating Plan.
• Reduce the incidence of dental caries by practicing
good oral hygiene and consuming sugar- and starchcontaining foods and beverages less frequently.
Key Recommendations
• To avoid microbial foodborne illness:
• Clean hands, food contact surfaces, and fruits
and vegetables. Meat and poultry should not
be washed or rinsed.
• Separate raw, cooked, and ready-to-eat foods
while shopping, preparing, or storing foods.
• Cook foods to a safe temperature to kill
microorganisms.
• Chill (refrigerate) perishable food promptly and
defrost foods properly.
• Avoid raw (unpasteurized) milk or any products
made from unpasteurized milk, raw or partially
cooked eggs or foods containing raw eggs, raw
or undercooked meat and poultry, unpasteurized
juices, and raw sprouts.
Key Recommendations for Specific Population Groups
SODIUM AND POTASSIUM
Key Recommendations
• Consume less than 2,300 mg (approximately
1 tsp of salt) of sodium per day.
• Choose and prepare foods with little salt. At the same
time, consume potassium-rich foods, such as fruits
and vegetables.
Key Recommendations for Specific Population Groups
• Individuals with hypertension, blacks, and middle-aged
and older adults. Aim to consume no more than 1,500
mg of sodium per day, and meet the potassium recom
mendation (4,700 mg/day) with food.
ALCOHOLIC BEVERAGES
Key Recommendations
• Those who choose to drink alcoholic beverages should
do so sensibly and in moderation—defined as the
consumption of up to one drink per day for women
and up to two drinks per day for men.
• Alcoholic beverages should not be consumed by some
individuals, including those who cannot restrict their
alcohol intake, women of childbearing age who may
Key Recommendations for Specific Population Groups
• Infants and young children, pregnant women, older
adults, and those who are immunocompromised. Do
not eat or drink raw (unpasteurized) milk or any products
made from unpasteurized milk, raw or partially cooked
eggs or foods containing raw eggs, raw or undercooked
meat and poultry, raw or undercooked fish or shellfish,
unpasteurized juices, and raw sprouts.
• Pregnant women, older adults, and those who are
immunocompromised: Only eat certain deli meats and
frankfurters that have been reheated to steaming hot.
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1
chapter
1
Background and Purpose of the
Dietary Guidelines for Americans
The Dietary Guidelines for Americans [Dietary Guidelines],
first published in 1980, provides sciencebased advice to
promote health and to reduce risk for chronic diseases
through diet and physical activity. The recommendations
contained within the Dietary Guidelines are targeted to the
general public over 2 years of age who are living in the
United States. Because of its focus on health promotion and
risk reduction, the Dietary Guidelines form the basis of
federal food, nutrition education, and information programs.
By law (Public Law 101445, Title III, 7 U.S.C. 5301 et seq.),
the Dietary Guidelines is reviewed, updated if necessary,
and published every 5 years. The process to create the
Dietary Guidelines is a joint effort of the U.S. Department
of Health and Human Services (HHS) and the U.S.
Department of Agriculture (USDA) and has evolved to
include three stages.
In the first stage, an external scientific Advisory Committee
appointed by the two Departments conducted an analysis
of new scientific information and prepared a report summa
rizing its findings.2 The Advisory Committee’s report was
made available to the public and Government agencies for
comment. The Committee’s analysis was the primary
resource for development of the Dietary Guidelines by the
Departments. A significant amount of the new scientific
information used by the Dietary Guidelines Advisory
Committee (DGAC) was based on the Dietary Reference
Intake (DRI) reports published since 2000 by the Institute
of Medicine (IOM), in particular the macronutrient report
and the fluid and electrolyte report.
During the second stage, the Departments jointly devel
oped Key Recommendations based on the Advisory
Committee’s report and public and agency comments.
2 For more information about the process, summary data, and the resources used by the Advisory Committee, see the 2005 Dietary Guidelines Advisory Committee Report
(2005 DGAC Report) at http://www.health.gov/dietaryguidelines.
D I E TA R Y G U I D E L I N E S F O R A M E R I C A N S , 2 0 0 5
2
The Dietary Guidelines details these sciencebased policy
recommendations. Finally, in the third stage, the two
Departments developed messages communicating the
Dietary Guidelines to the general public.
Because of the threepart process used to develop and
communicate the 2005 Dietary Guidelines, this publication
and the report of the DGAC differ in scope and purpose
compared to reports for previous versions of the Guidelines.
The 2005 DGAC report is a detailed scientific analysis that
identifies key issues such as energy balance, the conse
quences of a sedentary lifestyle, and the need to emphasize
certain food choices to address nutrition issues for the
American public. The scientific report was used to develop
the Dietary Guidelines jointly between the two Departments,
and this publication forms the basis of recommendations
that will be used by USDA and HHS for program and
policy development. Thus it is a publication oriented
toward policymakers, nutrition educators, nutritionists
and healthcare providers rather than to the general public,
as with previous versions of the Dietary Guidelines, and
contains more technical information.
New sections in the Dietary Guidelines, consistent with
its use for program development, are a glossary of terms
and appendixes with detailed information about the
USDA Food Guide and the Dietary Approaches to Stop
Hypertension (DASH) Eating Plan as well as tables listing
sources of some nutrients. Consumer messages have
been developed to educate the public about the Key
Recommendations in the Dietary Guidelines and will be
used in materials targeted for consumers separate from
this publication. In organizing the Dietary Guidelines for
the Departments, chapters 2 to 10 were given titles that
characterize the topic of each section, and the Dietary
Guidelines itself is presented as an integrated set of Key
Recommendations in each topic area.
These Key Recommendations are based on a preponder
ance of the scientific evidence of nutritional factors that
are important for lowering risk of chronic disease and
promoting health. To optimize the beneficial impact of
these recommendations on health, the Guidelines should
be implemented in their entirety.
IMPORTANCE OF THE DIETARY GUIDELINES
FOR HEALTH PROMOTION AND DISEASE
PREVENTION
Good nutrition is vital to good health and is absolutely
essential for the healthy growth and development of
children and adolescents. Major causes of morbidity and
mortality in the United States are related to poor diet and
a sedentary lifestyle. Specific diseases and conditions
linked to poor diet include cardiovascular disease, hyper
tension, dyslipidemia, type 2 diabetes, overweight and
obesity, osteoporosis, constipation, diverticular disease,
iron deficiency anemia, oral disease, malnutrition, and
some cancers. Lack of physical activity has been associ
ated with cardiovascular disease, hypertension, overweight
and obesity, osteoporosis, diabetes, and certain cancers.
Furthermore, muscle strengthening and improving balance
can reduce falls and increase functional status among
older adults. Together with physical activity, a highquality
diet that does not provide excess calories should enhance
the health of most individuals.
Poor diet and physical inactivity, resulting in an energy
imbalance (more calories consumed than expended), are
the most important factors contributing to the increase
in overweight and obesity in this country. Moreover, over
weight and obesity are major risk factors for certain chronic
diseases such as diabetes. In 1999–2002, 65 percent of
U.S. adults were overweight, an increase from 56 percent
in 1988–1994. Data from 1999–2002 also showed that 30
percent of adults were obese, an increase from 23 percent
in an earlier survey. Dramatic increases in the prevalence
of overweight have occurred in children and adolescents
of both sexes, with approximately 16 percent of children
and adolescents aged 6 to 19 years considered to be over
weight (1999–2002).3 In order to reverse this trend, many
Americans need to consume fewer calories, be more
active, and make wiser choices within and among food
groups. The Dietary Guidelines provides a framework to
promote healthier lifestyles (see ch. 3).
Given the importance of a balanced diet to health, the
intent of the Dietary Guidelines is to summarize and
synthesize knowledge regarding individual nutrients and
3 Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of overweight and obesity among U.S. children, adolescents, and adults, 19992002. Journal of the American Medical
Association (JAMA) 291(23):28472850, 2004.
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3
food components into recommendations for an overall
pattern of eating that can be adopted by the general public.
These patterns are exemplified by the USDA Food Guide
and the DASH Eating Plan (see ch. 2 and app. A). The
Dietary Guidelines is applicable to the food preferences
of different racial/ethnic groups, vegetarians, and other
groups. This concept of balanced eating patterns should
be utilized in planning diets for various population groups.
There is a growing body of evidence which demonstrates
that following a diet that complies with the Dietary
Guidelines may reduce the risk of chronic disease.
Recently, it was reported that dietary patterns consistent
with recommended dietary guidance were associated
with a lower risk of mortality among individuals age 45
years and older in the United States.4 The authors of the
study estimated that about 16 percent and 9 percent of
mortality from any cause in men and women, respectively,
could be eliminated by the adoption of desirable dietary
behaviors. Currently, adherence to the Dietary Guidelines
is low among the U.S. population. Data from USDA illustrate
the degree of change in the overall dietary pattern of
Americans needed to be consistent with a food pattern
encouraged by the Dietary Guidelines (fig. 1).
A basic premise of the Dietary Guidelines is that nutrient
needs should be met primarily through consuming foods.
Foods provide an array of nutrients (as well as phyto
chemicals, antioxidants, etc.) and other compounds that
may have beneficial effects on health. In some cases, forti
fied foods may be useful sources of one or more nutrients
that otherwise might be consumed in less than recom
mended amounts. Supplements may be useful when they
fill a specific identified nutrient gap that cannot or is not
otherwise being met by the individual’s intake of food.
Nutrient supplements cannot replace a healthful diet.
Individuals who are already consuming the recommended
amount of a nutrient in food will not achieve any addi
tional health benefit if they also take the nutrient as
a supplement. In fact, in some cases, supplements and
fortified foods may cause intakes to exceed the safe levels
of nutrients. Another important premise of the Dietary
Guidelines is that foods should be prepared and handled
in such a way that reduces risk of foodborne illness.
4
USES OF THE DIETARY GUIDELINES
The Dietary Guidelines is intended primarily for use by
policymakers, healthcare providers, nutritionists, and
nutrition educators. While the Dietary Guidelines was
developed for healthy Americans 2 years of age and older,
where appropriate, the needs of specific population groups
have been addressed. In addition, other individuals may
find this report helpful in making healthful choices. As
noted previously, the recommendations contained within
the Dietary Guidelines will aid the public in reducing their
risk for obesity and chronic disease. Specific uses of the
Dietary Guidelines include:
Development of Educational Materials and
Communications.
The information in the Dietary Guidelines is useful for the
development of educational materials. For example, the
federal dietary guidancerelated publications are required
by law to be based on the Dietary Guidelines. In addition,
this publication will guide the development of messages
to communicate the Dietary Guidelines to the public.
Finally, the USDA Food Guide, the food label, and Nutrition
Facts Panel provide information that is useful for imple
menting the key recommendations in the Dietary Guidelines
and should be integrated into educational and communi
cation messages.
Development of NutritionRelated Programs.
The Dietary Guidelines aids policymakers in designing
and implementing nutritionrelated programs. The Federal
Government bases its nutrition programs, such as the
National Child Nutrition Programs or the Elderly Nutrition
Program, on the Dietary Guidelines.
Development of Authoritative Statements.
The Dietary Guidelines has the potential to provide
authoritative statements as provided for in the Food
and Drug Administration Modernization Act (FDAMA).
Because the recommendations are interrelated and mutu
ally dependent, the statements in this publication should
be used together in the context of an overall healthful
diet. Likewise, because the Dietary Guidelines contains
discussions about emerging science, only statements
included in the Executive Summary and the highlighted
boxes entitled “Key Recommendations,” which reflect the
preponderance of scientific evidence, can be used for
identification of authoritative statements.
Kant AK, Graubard BI, Schatzkin A. Dietary patterns predict mortality in a national cohort: The national health interview surveys, 1987 and 1992. Journal of Nutrition (J Nutr) 134:17931799, 2004.
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4
a,b
FIGURE 1. Percent Increase or Decrease From Current Consumption (Zero Line) to Recommended Intakes
A graphical depiction of the degree of change in average daily food consumption by Americans that would be needed to be consistent with the food
patterns encouraged by the Dietary Guidelines for Americans. The zero line represents average consumption levels from each food group or subgroup by
females 31 to 50 years of age and males 31 to 50 years of age. Bars above the zero line represent recommended increases in food group consumption,
while bars below the line represent recommended decreases.
400
Percent change from current consumption
Food Groups
and Oils
300
250
200
150
100
50
0
50
Fruit
Group
Vegetable
Group
Grain
Group
Actual change from consumption to recommended intakes:
+0.8 cups
+0.9 cups
+0.1 oz
Females
+1.2 cups
+0.9 cups
1.0 oz
Males
Meat & Bean
Group
Milk
Group
Oils
+0.4 oz
1.4 oz
+1.6 cups
+1.2 cups
+0.4 g
4.2 g
400
Percent change from current consumption
Subgroups,
Solid Fats, and
Added Sugars
Females 3150 (1800 calories)
Males 3150 (2200 calories)
350
350
Females 3150 (1800 calories)
Males 3150 (2200 calories)
300
250
200
150
100
50
0
50
100
Dark green Orange
Legumes
Starchy
Other
Vegetables
Actual change from consumption to recommended intakes:
+0.3 cups +0.2 cups +0.3 cups 0.1 cups +0.1 cups
Females
+0.3 cups +0.2 cups +0.2 cups +0.2 cups +0.0 cups
Males
Whole
grains
Enriched
grains
Grains
+2.2 oz
+2.6 oz
2.1 oz
3.6 oz
Solid
fats
Added
sugars
Discretionary Calories
18 g
27 g
14 tsp
18 tsp
a USDA Food Guide in comparison to National Health and Nutrition Examination Survey 20012002 consumption data.
b Increases in amounts of some food groups are offset by decreases in amounts of solid fats (i.e., saturated and trans fats) and added sugars so that total calorie intake is at the recommended level.
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5
chapter
2
Adequate Nutrients
Within Calorie Needs
OVERVIEW
Many Americans consume more calories than they need
without meeting recommended intakes for a number
of nutrients. This circumstance means that most people
need to choose meals and snacks that are high in
nutrients but low to moderate in energy content; that
is, meeting nutrient recommendations must go hand
in hand with keeping calories under control. Doing so
offers important benefits—normal growth and develop
ment of children, health promotion for people of all ages,
and reduction of risk for a number of chronic diseases
that are major public health problems.
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Based on dietary intake data or evidence of public health
problems, intake levels of the following nutrients may be
of concern for:
• Adults: calcium, potassium, fiber, magnesium, and
vitamins A (as carotenoids), C, and E,
• Children and adolescents: calcium, potassium, fiber,
magnesium, and vitamin E,
• Specific population groups (see below): vitamin B12,
iron, folic acid, and vitamins E and D.
At the same time, in general, Americans consume too
many calories and too much saturated and trans fats,
cholesterol, added sugars, and salt.
6
DISCUSSION
Meeting Recommended Intakes
Within Energy Needs
A basic premise of the Dietary Guidelines is that food
guidance should recommend diets that will provide all
the nutrients needed for growth and health. To this end,
food guidance should encourage individuals to achieve
the most recent nutrient intake recommendations of the
Institute of Medicine, referred to collectively as the Dietary
Reference Intakes (DRIs). Tables of the DRIs are provided
at http://www.iom.edu/Object.File/Master/21/372/0.pdf.
KEY RECOMMENDATIONS
• Consume a variety of nutrientdense foods and bever
ages within and among the basic food groups while
choosing foods that limit the intake of saturated and
trans fats, cholesterol, added sugars, salt, and alcohol.
• Meet recommended intakes within energy needs by
adopting a balanced eating pattern, such as the USDA
Food Guide or the DASH Eating Plan.
Key Recommendations for Specific Population Groups
An additional premise of the Dietary Guidelines is that
the nutrients consumed should come primarily from foods.
Foods contain not only the vitamins and minerals that are
often found in supplements, but also hundreds of naturally
occurring substances, including carotenoids, flavonoids
and isoflavones, and protease inhibitors that may protect
against chronic health conditions. There are instances
when fortified foods may be advantageous, as identified
in this chapter. These include providing additional sources
of certain nutrients that might otherwise be present only
in low amounts in some food sources, providing nutrients
in highly bioavailable forms, and where the fortification
addresses a documented public health need.
• People over age 50. Consume vitamin B12 in its
crystalline form (i.e., fortified foods or supplements).
• Women of childbearing age who may become pregnant.
Eat foods high in hemeiron and/or consume ironrich
plant foods or ironfortified foods with an enhancer of
iron absorption, such as vitamin Crich foods.
• Women of childbearing age who may become
pregnant and those in the first trimester of pregnancy.
Consume adequate synthetic folic acid daily (from
fortified foods or supplements) in addition to food
forms of folate from a varied diet.
• Older adults, people with dark skin, and people
exposed to insufficient ultraviolet band radiation
(i.e., sunlight). Consume extra vitamin D from
vitamin Dfortified foods and/or supplements.
Two examples of eating patterns that exemplify the Dietary
Guidelines are the DASH Eating Plan and the USDA Food
Guide. These two similar eating patterns are designed to
integrate dietary recommendations into a healthy way
to eat and are used in the Dietary Guidelines to provide
examples of how nutrientfocused recommendations can
be expressed in terms of food choices. Both the USDA
Food Guide and the DASH Eating Plan differ in important
ways from common food consumption patterns in the
United States. In general, they include:
• More dark green vegetables, orange vegetables, legumes,
fruits, whole grains, and lowfat milk and milk products.
• Less refined grains, total fats (especially cholesterol, and
saturated and trans fats), added sugars, and calories.
Both the USDA Food Guide and the DASH Eating Plan
are constructed across a range of calorie levels to meet
the nutrient needs of various age and gender groups.
Table 1 provides food intake recommendations, and table 2
provides nutrient profiles for both the DASH Eating Plan
and the USDA Food Guide at the 2,000calorie level. These
tables illustrate the many similarities between the two
eating patterns. Additional calorie levels are shown in
appendixes A1 and A2 for the USDA Food Guide and
the DASH Eating Plan. The exact amounts of foods in
these plans do not need to be achieved every day, but
on average, over time. Table 3 can aid in identification of
an individual’s caloric requirement based on gender, age,
and physical activity level.
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Variety Among and Within Food Groups
Each basic food group5 is the major contributor of at least
one nutrient while making substantial contributions of
many other nutrients. Because each food group provides
a wide array of nutrients in substantial amounts, it is
important to include all food groups in the daily diet.
Both illustrative eating patterns include a variety of nutrient
dense foods within the major food groups. Selecting a
variety of foods within the grain, vegetable, fruit, and meat
groups may help to ensure that an adequate amount of
nutrients and other potentially beneficial substances are
consumed. For example, fish contains varying amounts of
fatty acids that may be beneficial in reducing cardiovas
cular disease risk (see ch. 6).
…meeting nutrient
recommendations
must go hand in hand
with keeping calories
under control.
NutrientDense Foods
Nutrientdense foods are those foods that provide substan
tial amounts of vitamins and minerals (micronutrients)
and relatively few calories. Foods that are low in nutrient
density are foods that supply calories but relatively small
amounts of micronutrients, sometimes none at all. The
greater the consumption of foods or beverages that are
low in nutrient density, the more difficult it is to consume
enough nutrients without gaining weight, especially for
sedentary individuals. The consumption of added sugars,
saturated and trans fats, and alcohol provides calories
while providing little, if any, of the essential nutrients. (See
ch. 7 for additional information on added sugars, ch. 6 for
information on fats, and ch. 9 for information on alcohol.)
Selecting lowfat forms of foods in each group and forms
free of added sugars—in other words nutrientdense
versions of foods—provides individuals a way to meet
their nutrient needs while avoiding the overconsumption
of calories and of food components such as saturated fats.
However, Americans generally do not eat nutrientdense
forms of foods. Most people will exceed calorie recom
mendations if they consistently choose higher fat foods
within the food groups—even if they do not have dessert,
sweetened beverages, or alcoholic beverages.
If only nutrientdense foods are selected from each food
group in the amounts proposed, a small amount of calories
5
can be consumed as added fats or sugars, alcohol, or other
foods—the discretionary calorie allowance. Appendixes
A2 and A3 show the maximum discretionary calorie
allowance that can be accommodated at each calorie level
in the USDA Food Guide. Eating in accordance with the
USDA Food Guide or the DASH Eating Plan will also keep
intakes of saturated fat, total fat, and cholesterol within
the limits recommended in chapter 6.
Nutrients of Concern
The actual prevalence of inadequacy for a nutrient can
be determined only if an Estimated Average Requirement
(EAR) has been established and the distribution of usual
dietary intake can be obtained. If such data are not avail
able for a nutrient but there is evidence for a public health
problem associated with low intakes, a nutrient might still
be considered to be of concern.
Based on these considerations, dietary intakes of the follow
ing nutrients may be low enough to be of concern for:
• Adults: calcium, potassium, fiber, magnesium, and
vitamins A (as carotenoids), C, and E,
• Children and adolescents: calcium, potassium, fiber,
magnesium, and vitamin E,
• Specific population groups: vitamin B12, iron, folic acid,
and vitamins E and D.
The food groups in the USDA Food Guide are grains; vegetables; fruits; milk, yogurt, and cheese; and meat, poultry, fish, dry beans, eggs, and nuts. Food groups in the DASH Eating Plan are grains
and grain products; vegetables; fruits; lowfat or fatfree dairy; meat, poultry, and fish; and nuts, seeds, and dry beans.
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8
Efforts may be warranted to promote increased dietary
intakes of potassium, fiber, and possibly vitamin E, regard
less of age; increased intakes of calcium and possibly
vitamins A (as carotenoids) and C and magnesium by
adults; efforts are warranted to increase intakes of calcium
and possibly magnesium by children age 9 years or older.
Efforts may be especially warranted to improve the dietary
intakes of adolescent females in general. Food sources of
these nutrients are shown in appendix B.
Low intakes of fiber tend to reflect low intakes of whole
grains, fruits, and vegetables. Low intakes of calcium
tend to reflect low intakes of milk and milk products. Low
intakes of vitamins A (as carotenoids) and C and magne
sium tend to reflect low intakes of fruits and vegetables.
Selecting fruits, vegetables, whole grains, and lowfat and
fatfree milk and milk products in the amounts suggested
by the USDA Food Guide and the DASH Eating Plan will
provide adequate amounts of these nutrients.
Most Americans of all ages also need to increase their
potassium intake. To meet the recommended potassium
intake levels, potassiumrich foods from the fruit, vegetable,
and dairy groups must be selected in both the USDA Food
Guide and the DASH Eating Plan. Foods that can help
increase potassium intake are listed in table 5 (ch. 5) and
appendix B1.
using the USDA Food Guide, selecting foods that are lower
in sodium than others is especially necessary to meet the
recommended intake level at calorie levels of 2,600/day and
above. Food choices that are lower in sodium are identi
fied in chapter 8.
Considerations for Specific Population Groups
People Over 50 and Vitamin B12
Although a substantial proportion of individuals over age
50 have reduced ability to absorb naturally occurring
vitamin B12, they are able to absorb the crystalline form.
Thus, all individuals over the age of 50 should be encour
aged to meet their Recommended Dietary Allowance
(RDA) (2.4 µg/day) for vitamin B12 by eating foods fortified
with vitamin B12 such as fortified cereals, or by taking the
crystalline form of vitamin B12 supplements.
Women and Iron
Based on blood values, substantial numbers of adolescent
females and women of childbearing age are iron deficient.
Thus, these groups should eat foods high in hemeiron
(e.g., meats) and/or consume ironrich plant foods (e.g.,
spinach) or ironfortified foods with an enhancer of iron
absorption, such as foods rich in vitamin C (e.g., orange
juice). Appendix B3 lists foods that can help increase
iron intake and gives their iron and calorie content.
Women and Folic Acid
Most Americans may need to increase their consumption
of foods rich in vitamin E (αtocopherol) while decreasing
their intake of foods high in energy but low in nutrients.
The vitamin E content in both the USDA Food Guide and
the DASH Eating Plan is greater than current consump
tion, and specific vitamin Erich foods need to be included
in the eating patterns to meet the recommended intake of
vitamin E. Foods that can help increase vitamin E intake
are listed in appendix B2, along with their calorie content.
Breakfast cereal that is fortified with vitamin E is an
option for individuals seeking to increase their vitamin E
intake while consuming a lowfat diet.
In addition, most Americans need to decrease sodium
intake. The DASH Eating Plan provides guidance on how
to keep sodium intakes within recommendations. When
Since folic acid reduces the risk of the neural tube defects,
spina bifida, and anencephaly, a daily intake of 400 µg/day
of synthetic folic acid (from fortified foods or supplements
in addition to food forms of folate from a varied diet) is
recommended for women of childbearing age who may
become pregnant. Pregnant women should consume 600
µg/day of synthetic folic acid (from fortified foods or
supplements) in addition to food forms of folate from a
varied diet. It is not known whether the same level of
protection could be achieved by using food that is natu
rally rich in folate.
Special Groups and Vitamin D
Adequate vitamin D status, which depends on dietary
intake and cutaneous synthesis, is important for optimal
calcium absorption, and it can reduce the risk for bone
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9
loss. Two functionally relevant measures indicate that
optimal serum 25hydroxyvitamin D may be as high as
80 nmol/L. The elderly and individuals with dark skin
(because the ability to synthesize vitamin D from exposure
to sunlight varies with degree of skin pigmentation) are at
a greater risk of low serum 25hydroxyvitamin D concen
trations. Also at risk are those exposed to insufficient
ultraviolet radiation (i.e., sunlight) for the cutaneous
production of vitamin D (e.g., housebound individuals).
For individuals within the highrisk groups, substantially
higher daily intakes of vitamin D (i.e., 25 µg or 1,000
International Units (IU) of vitamin D per day) have been
recommended to reach and maintain serum 25hydroxyvit
amin D values at 80 nmol/L. Three cups of vitamin D
fortified milk (7.5 µg or 300 IU), 1 cup of vitamin Dfortified
orange juice (2.5 µg or 100 IU), and 15 µg (600 IU) of
supplemental vitamin D would provide 25 µg (1,000 IU)
of vitamin D daily.
Fluid
The combination of thirst and normal drinking behavior,
especially the consumption of fluids with meals, is usually
sufficient to maintain normal hydration. Healthy individ
uals who have routine access to fluids and who are not
exposed to heat stress consume adequate water to meet
their needs. Purposeful drinking is warranted for individuals
who are exposed to heat stress or perform sustained
vigorous activity (see ch. 4).
Flexibility of Food Patterns for Varied Food Preferences
The USDA Food Guide and the DASH Eating Plan are
flexible to permit food choices based on individual and
cultural food preferences, cost, and availability. Both can
also accommodate varied types of cuisines and special
needs due to common food allergies. Two adaptations of
the USDA Food Guide and the DASH Eating Plan are:
6
Vegetarian Choices
Vegetarians of all types can achieve recommended
nutrient intakes through careful selection of foods.
These individuals should give special attention to their
intakes of protein, iron, and vitamin B12, as well as
calcium and vitamin D if avoiding milk products. In
addition, vegetarians could select only nuts, seeds, and
legumes from the meat and beans group, or they could
include eggs if so desired. At the 2,000calorie level, they
could choose about 1.5 ounces of nuts and 2/3 cup
legumes instead of 5.5 ounces of meat, poultry, and/or
fish. One egg, 1/2 ounce of nuts, or 1/4 cup of legumes is
considered equivalent to 1 ounce of meat, poultry, or fish in
the USDA Food Guide.
Substitutions for Milk and Milk Products
Since milk and milk products provide more than 70 percent
of the calcium consumed by Americans, guidance on other
choices of dietary calcium is needed for those who do not
consume the recommended amount of milk products.
Milk product consumption has been associated with
overall diet quality and adequacy of intake of many nutri
ents, including calcium, potassium, magnesium, zinc, iron,
riboflavin, vitamin A, folate, and vitamin D. People may
avoid milk products because of allergies, cultural prac
tices, taste, or other reasons. Those who avoid all milk
products need to choose rich sources of the nutrients
provided by milk, including potassium, vitamin A, and
magnesium in addition to calcium and vitamin D (see
app. B). Some nondairy sources of calcium are shown in
appendix B4. The bioavailability of the calcium in these
foods varies.
Those who avoid milk because of its lactose content may
obtain all the nutrients provided by the milk group by
using lactosereduced or lowlactose milk products, taking
small servings of milk several times a day, taking the
enzyme lactase before consuming milk products, or eating
other calciumrich foods. For additional information, see
appendixes B4 and B5 and NIH Publication No. 032751.6
NIH Publication No. 032751, U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, March 2003. http://diges
tive.niddk.nih.gov/ddiseases/pubs/lactoseintolerance/index.htm.
D I E TA R Y G U I D E L I N E S F O R A M E R I C A N S , 2 0 0 5
10
a
TABLE 1. Sample USDA Food Guide and the DASH Eating Plan at the 2,000Calorie Level
Amounts of various food groups that are recommended each day or each week in the USDA Food Guide and in the DASH Eating Plan (amounts are daily
unless otherwise specified) at the 2,000calorie level. Also identified are equivalent amounts for different food choices in each group. To follow either eating
pattern, food choices over time should provide these amounts of food from each group on average.
b
Food Groups and Subgroups
USDA Food Guide Amount
DASH Eating Plan Amount
Equivalent Amounts
Fruit Group
2 cups (4 servings)
2 to 2.5 cups (4 to 5 servings)
1/2 cup equivalent is:
• 1/2 cup fresh, frozen, or canned fruit
• 1 med fruit
• 1/4 cup dried fruit
• USDA: 1/2 cup fruit juice
• DASH: 3/4 cup fruit juice
Vegetable Group
• Dark green vegetables
• Orange vegetables
• Legumes (dry beans)
• Starchy vegetables
• Other vegetables
2.5 cups (5 servings)
3 cups/week
2 cups/week
3 cups/week
3 cups/week
6.5 cups/week
2 to 2.5 cups (4 to 5 servings)
1/2
Grain Group
• Whole grains
• Other grains
6 ounceequivalents
3 ounceequivalents
3 ounceequivalents
7 to 8 ounceequivalents
(7 to 8 servings)
1 ounceequivalent is:
• 1 slice bread
• 1 cup dry cereal
• 1/2 cup cooked rice, pasta, cereal
• DASH: 1 oz dry cereal
(1/2 –11/4 cup depending
on cereal type—check label)
Meat and Beans Group
5.5 ounceequivalents
6 ounces or less
meat, poultry, fish
1 ounceequivalent is:
• 1 ounce of cooked lean meats,
poultry, fish
• 1 egg
• USDA: 1/4 cup cooked dry beans
or tofu, 1 Tbsp peanut butter,
1/2 oz nuts or seeds
• DASH: 11/2 oz nuts, 1/2 oz seeds,
1/2 cup cooked dry beans
4 to 5 servings per week
c
nuts, seeds, and dry beans
cup equivalent is:
• 1/2 cup of cutup raw or
cooked vegetable
• 1 cup raw leafy vegetable
• USDA: 1/2 cup vegetable juice
• DASH: 3/4 cup vegetable juice
Milk Group
3 cups
2 to 3 cups
1 cup equivalent is:
• 1 cup lowfat/fatfree milk, yogurt
• 11/2 oz of lowfat or
fatfree natural cheese
• 2 oz of lowfat or
fatfree processed cheese
Oils
24 grams (6 tsp)
8 to 12 grams (2 to 3 tsp)
1 tsp equivalent is:
• DASH: 1 tsp soft margarine
• 1 Tbsp lowfat mayo
• 2 Tbsp light salad dressing
• 1 tsp vegetable oil
Discretionary Calorie Allowance
• Example of distribution:
d
Solid fat
Added sugars
267 calories
18 grams
8 tsp
~2 tsp (5 Tbsp per week)
1 Tbsp added sugar equivalent is:
• DASH: 1 Tbsp jelly or jam
• 1/2 oz jelly beans
• 8 oz lemonade
a All servings are per day unless otherwise noted. USDA vegetable subgroup amounts and amounts of DASH nuts, seeds, and dry beans are per week.
b The 2,000calorie USDA Food Guide is appropriate for many sedentary males 51 to 70 years of age, sedentary females 19 to 30 years of age, and for some other gender/age groups who are more
physically active. See table 3 for information about gender/age/activity levels and appropriate calorie intakes. See appendixes A2 and A3 for more information on the food groups, amounts, and
food intake patterns at other calorie levels.
c In the DASH Eating Plan, nuts, seeds, and dry beans are a separate food group from meat, poultry, and fish.
d The oils listed in this table are not considered to be part of discretionary calories because they are a major source of the vitamin E and polyunsaturated fatty acids, including the essential fatty acids, in
the food pattern. In contrast, solid fats (i.e., saturated and trans fats) are listed separately as a source of discretionary calories.
D I E TA R Y G U I D E L I N E S F O R A M E R I C A N S , 2 0 0 5
11
TABLE 2. Comparison of Selected Nutrients in the Dietary Approaches to Stop Hypertension (DASH) Eating Plana,
the USDA Food Guideb, and Nutrient Intakes Recommended Per Day by the Institute of Medicine (IOM)c
Estimated nutrient levels in the DASH Eating Plan and the USDA Food Guide at the 2,000-calorie level, as well as the nutrient intake levels recom
mended by the Institute of Medicine for females 19—30 years of age.
Nutrient
DASH Eating Plan
(2,000 kcals)
USDA Food Guide
(2,000 kcals)
IOM Recommendations
for Females 19 to 30
Protein, g
108
91
RDA: 46
Protein, % kcal
21
18
AMDR: 10—35
Carbohydrate, g
288
271
RDA: 130
Carbohydrate, % kcal
57
55
AMDR: 45—65
Total fat, g
48
65
—
Total fat, % kcal
22
29
AMDR: 20—35
Saturated fat, g
10
17
—
5
7.8
ALAPd
21
24
—
Saturated fat, % kcal
Monounsaturated fat, g
Monounsaturated fat, % kcal
10
11
—
Polyunsaturated fat, g
12
20
—
Polyunsaturated fat, % kcal
5.5
9.0
—
Linoleic acid, g
11
18
AI: 12
Alpha-linolenic acid, g
1
1.7
AI: 1.1
136
230
ALAPd
30
31
AI: 28e
Potassium, mg
4,706
4,044
AI: 4,700
Sodium, mg
2,329f
1,779
AI: 1,500, UL: <2,300
Calcium, mg
1,619
1,316
AI: 1,000
500
380
RDA: 310
2
1.5
RDA: 0.9
Cholesterol, mg
Total dietary fiber, g
Magnesium, mg
Copper, mg
Iron, mg
Phosphorus, mg
21
18
RDA: 18
2,066
1,740
RDA: 700
Zinc, mg
14
14
RDA: 8
Thiamin, mg
2.0
2.0
RDA: 1.1
Riboflavin, mg
2.8
2.8
RDA: 1.1
Niacin equivalents, mg
31
22
RDA: 14
Vitamin B6, mg
3.4
2.4
RDA: 1.3
Vitamin B12, μg
7.1
8.3
RDA: 2.4
Vitamin C, mg
Vitamin E (AT)
g
Vitamin A, μg (RAE)
h
181
155
RDA: 75
16.5
9.5
RDA: 15.0
851
1,052
RDA: 700
a DASH nutrient values are based on a 1-week menu of the DASH Eating Plan. NIH publication No. 03-4082. www.nhlbi.nih.gov.
b USDA nutrient values are based on population-weighted averages of typical food choices within each food group or subgroup.
c Recommended intakes for adult females 19—30; RDA = Recommended Dietary Allowance; AI = Adequate Intake; AMDR = Acceptable Macronutrient Distribution Range; UL = Upper Limit.
d As Low As Possible while consuming a nutritionally adequate diet.
e Amount listed is based on 14 g dietary fiber/1,000 kcal.
f The DASH Eating Plan also can be used to follow at 1,500 mg sodium per day.
g AT = mg d-α-tocopherol
h RAE = Retinol Activity Equivalents
D I E TA R Y G U I D E L I N E S F O R A M E R I C A N S , 2 0 0 5
12
TABLE 3. Estimated Calorie Requirements (in Kilocalories) for Each Gender and Age Group
at Three Levels of Physical Activitya
Estimated amounts of calories needed to maintain energy balance for various gender and age groups at three different levels of physical activity. The esti
mates are rounded to the nearest 200 calories and were determined using the Institute of Medicine equation.
Activity Levelb,c,d
Gender
Age (years)
Sedentaryb
Child
2–3
1,000
1,000–1,400
1,000–1,400
Female
4–8
1,200
1,400–1,600
1,400–1,800
Male
Moderately Activec
e
Actived
e
9–13
1,600
1,600–2,000
1,800–2,200
14–18
1,800
2,000
2,400
19–30
2,000
2,000–2,200
2,400
31–50
1,800
2,000
2,200
51+
1,600
1,800
2,000–2,200
4–8
1,400
1,400–1,600
1,600–2,000
9–13
1,800
1,800–2,200
2,000–2,600
14–18
2,200
2,400–2,800
2,800–3,200
19–30
2,400
2,600–2,800
3,000
31–50
2,200
2,400–2,600
2,800–3,000
51+
2,000
2,200–2,400
2,400–2,800
a These levels are based on Estimated Energy Requirements (EER) from the Institute of Medicine Dietary Reference Intakes macronutrients report, 2002, calculated by gender, age, and activity level for
referencesized individuals. “Reference size,” as determined by IOM, is based on median height and weight for ages up to age 18 years of age and median height and weight for that height to give a
BMI of 21.5 for adult females and 22.5 for adult males.
b Sedentary means a lifestyle that includes only the light physical activity associated with typical daytoday life.
c Moderately active means a lifestyle that includes physical activity equivalent to walking about 1.5 to 3 miles per day at 3 to 4 miles per hour, in addition to the light physical activity associated with
typical daytoday life
d Active means a lifestyle that includes physical activity equivalent to walking more than 3 miles per day at 3 to 4 miles per hour, in addition to the light physical activity associated with typical dayto
day life.
e The calorie ranges shown are to accommodate needs of different ages within the group. For children and adolescents, more calories are needed at older ages. For adults, fewer calories are needed at
older ages.
D I E TA R Y G U I D E L I N E S F O R A M E R I C A N S , 2 0 0 5
13
chapter
3
Weight Management
OVERVIEW
The prevalence of obesity in the United States has
doubled in the past two decades. Nearly onethird of
adults are obese, that is, they have a body mass index
(BMI ) of 30 or greater. One of the fastest growing
segments of the population is that with a BMI >– 30 with
accompanying comorbidities. Over the last two decades,
the prevalence of overweight among children and
adolescents has increased substantially; it is estimated
that as many as 16 percent of children and adolescents
are overweight, representing a doubling of the rate
among children and tripling of the rate among adoles
cents. A high prevalence of overweight and obesity is
of great public health concern because excess body fat
leads to a higher risk for premature death, type 2
D I E TA R Y G U I D E L I N E S F O R A M E R I C A N S , 2 0 0 5
diabetes, hypertension, dyslipidemia, cardiovascular
disease, stroke, gall bladder disease, respiratory dysfunc
tion, gout, osteoarthritis, and certain kinds of cancers.
Ideally, the goal for adults is to achieve and maintain
a body weight that optimizes their health. However, for
obese adults, even modest weight loss (e.g., 10 pounds)
has health benefits, and the prevention of further weight
gain is very important. For overweight children and
adolescents, the goal is to slow the rate of weight gain
while achieving normal growth and development.
Maintaining a healthy weight throughout childhood
may reduce the risk of becoming an overweight or obese
adult. Eating fewer calories while increasing physical
activity are the keys to controlling body weight.
14
While overweight and obesity are currently significant
public health issues, not all Americans need to lose weight.
People at a healthy weight should strive to maintain their
weight, and underweight individuals may need to increase
their weight.
DISCUSSION
Overweight and obesity in the United States among adults
and children has increased significantly over the last two
decades. Those following typical American eating and
activity patterns are likely to be consuming diets in excess
of their energy requirements. However, caloric intake is
only one side of the energy balance equation. Caloric
expenditure needs to be in balance with caloric intake to
maintain body weight and must exceed caloric intake to
achieve weight loss (see tables 3 and 4). To reverse the
trend toward obesity, most Americans need to eat fewer
calories, be more active, and make wiser food choices.
Prevention of weight gain is critical because while the
behaviors required are the same, the extent of the behav
iors required to lose weight makes weight loss more
challenging than prevention of weight gain. Since many
adults gain weight slowly over time, even small decreases
in calorie intake can help avoid weight gain, especially if
accompanied by increased physical activity. For example,
for most adults a reduction of 50 to 100 calories per day
may prevent gradual weight gain, whereas a reduction
of 500 calories or more per day is a common initial goal
in weightloss programs. Similarly, up to 60 minutes of
moderate to vigorousintensity physical activity per day
may be needed to prevent weight gain, but as much as 60
to 90 minutes of moderateintensity physical activity per
day is recommended to sustain weight loss for previously
overweight people. It is advisable for men over age 40,
women over age 50, and those with a history of chronic
diseases such as heart disease or diabetes to consult with
a healthcare provider before starting a vigorous exercise
program. However, many people can safely increase their
physical activity without consulting a healthcare provider.7
KEY RECOMMENDATIONS
• To maintain body weight in a healthy range, balance
calories from foods and beverages with calories
expended.
• To prevent gradual weight gain over time, make small
decreases in food and beverage calories and increase
physical activity.
Key Recommendations for Specific Population Groups
• Those who need to lose weight. Aim for a slow, steady
weight loss by decreasing calorie intake while main
taining an adequate nutrient intake and increasing
physical activity.
• Overweight children. Reduce the rate of body weight
gain while allowing growth and development. Consult
a healthcare provider before placing a child on a
weightreduction diet.
• Pregnant women. Ensure appropriate weight gain as
specified by a healthcare provider.
• Breastfeeding women. Moderate weight reduction is
safe and does not compromise weight gain of the
nursing infant.
• Overweight adults and overweight children with
chronic diseases and/or on medication. Consult a
healthcare provider about weight loss strategies prior
to starting a weightreduction program to ensure
appropriate management of other health conditions.
Monitoring body fat regularly can be a useful strategy for
assessing the need to adjust caloric intake and energy
expenditure. Two surrogate measures used to approximate
body fat are BMI (adults and children) and waist circum
ference (adults).8 BMI is defined as weight in kilograms
divided by height, in meters, squared. For adults, weight
status is based on the absolute BMI level (fig. 2). For
children and adolescents, weight status is determined by
the comparison of the individual’s BMI with age and
genderspecific percentile values (see fig. 3 for a sample
boys’ growth curve). Additional growth curves can be
7
For more information on recommendations to consult a healthcare provider, see Physical Activity and Public Health—A Recommendation from the Centers for Disease Control and Prevention and the
American College of Sports Medicine, JAMA 273:402407, 1995. http://wonder.cdc.gov/wonder/prevguid/p0000391/P0000391.asp.
8
NIH Publication Number 004084, The Practical Guide: Identification, Evaluation and Treatment of Overweight and Obesity in Adults, U.S. Department of Health and Human Services, National
Institutes of Health, National Heart, Lung, and Blood Institute, October 2000. http://www.nhlbi.nih.gov/guidelines/obesity/prctgd_c.pdf
D I E TA R Y G U I D E L I N E S F O R A M E R I C A N S , 2 0 0 5
15
found at http://www.cdc.gov/growthcharts. BMI is more
accurate at approximating body fat than is measuring
body weight alone. However, BMI has some limitations.
BMI overestimates body fat in people who are very muscular
and underestimates body fat in people who have lost
muscle mass. The relationship between BMI and body fat
varies somewhat with age, gender, and ethnicity. In addi
tion, for adults, BMI is a better predictor of a population’s
8
disease risk than an individual’s risk of chronic disease.
For children gaining excess weight, small decreases in
energy intake reduce the rate at which they gain weight
(body fat), thus improving their BMI percentile over time.
As another surrogate measure, waist circumference can
approximate abdominal fat but should be measured very
carefully. Fat located in the abdominal region is associated
8
with a greater health risk than peripheral fat.
Some proposed calorielowering strategies include eating
foods that are low in calories for a given measure of food
(e.g., many kinds of vegetables and fruits and some soups).
However, when making changes to improve nutrient intake,
one needs to make substitutions to avoid excessive calorie
intake. The healthiest way to reduce calorie intake is to
reduce one’s intake of added sugars, fats, and alcohol,
which all provide calories but few or no essential nutrients
(for more information, see chs. 6, 7, and 9).
Special attention should be given to portion sizes, which
have increased significantly over the past two decades
(http://hin.nhlbi.nih.gov/portion/index.htm). Though there
are no empirical studies to show a causal relationship
between increased portion sizes and obesity, there are
studies showing that controlling portion sizes helps limit
calorie intake, particularly when eating caloriedense foods
(foods that are high in calories for a given measure of
food). Therefore, it is essential that the public understand
how portion sizes compare to a recommended amount of
food (i.e., serving) from each food group at a specific caloric
level. The understanding of serving size and portion size is
important in following either the DASH Eating Plan or the
USDA Food Guide (see app. A). When using packaged
foods with nutrient labels, people should pay attention
8
Eating fewer
calories while
increasing physical
activity are the
keys to controlling
body weight.
to the units for serving sizes and how they compare
to the serving sizes in the USDA Food Guide and the
DASH Eating Plan.
Lifestyle change in diet and physical activity is the best
first choice for weight loss. A reduction in 500 calories
or more per day is commonly needed. When it comes to
body weight control, it is calories that count—not the
proportions of fat, carbohydrates, and protein in the diet.
However, when individuals are losing weight, they should
follow a diet that is within the Acceptable Macronutrient
Distribution Ranges (AMDR) for fat, carbohydrates, and
protein, which are 20 to 35 percent of total calories, 45 to
65 percent of total calories, and 10 to 35 percent of total
calories, respectively. Diets that provide very low or very
high amounts of protein, carbohydrates, or fat are likely
to provide low amounts of some nutrients and are not
advisable for longterm use. Although these kinds of
weight loss diets have been shown to result in weight
reduction, the maintenance of a reduced weight ultimately
will depend on a change in lifestyle. Successful and
sustainable weight loss and weight maintenance strate
gies require attention to both sides of the energy balance
equation (i.e., caloric intake and energy expenditure).
NIH Publication Number 004084, The Practical Guide: Identification, Evaluation and Treatment of Overweight and Obesity in Adults, U.S. Department of Health and Human Services, National
Institutes of Health, National Heart, Lung, and Blood Institute, October 2000. http://www.nhlbi.nih.gov/guidelines/obesity/prctgd_c.pdf
D I E TA R Y G U I D E L I N E S F O R A M E R I C A N S , 2 0 0 5
16
TABLE 4. Calories/Hour Expended in Common Physical Activities
Some examples of physical activities commonly engaged in and the average amount of calories a 154pound individual will expend by engaging in each
activity for 1 hour. The expenditure value encompasses both resting metabolic rate calories and activity expenditure. Some of the activities can constitute
either moderate or vigorousintensity physical activity depending on the rate at which they are carried out (for walking and bicycling).
Moderate Physical Activity
Approximate Calories/Hr for a 154 lb Persona
Hiking
370
Light gardening/yard work
330
Dancing
330
Golf (walking and carrying clubs)
330
Bicycling (<10 mph)
290
Walking (3.5 mph)
280
Weight lifting (general light workout)
220
Stretching
180
Vigorous Physical Activity
Approximate Calories/Hr for a 154 lb Persona
Running/jogging (5 mph)
590
Bicycling (>10 mph)
590
Swimming (slow freestyle laps)
510
Aerobics
480
Walking (4.5 mph)
460
Heavy yard work (chopping wood)
440
Weight lifting (vigorous effort)
440
Basketball (vigorous)
440
a Calories burned per hour will be higher for persons who weigh more than 154 lbs (70 kg) and lower for persons who weigh less.
Source: Adapted from the 2005 DGAC Report.
D I E TA R Y G U I D E L I N E S F O R A M E R I C A N S , 2 0 0 5
17
FI G UR E 2 . Adult BMI Chart
Locate the height of interest in the left-most column and read across the row for that height to the weight of interest. Follow the column of the weight up to the
top row that lists the BMI. BMI of 18.5—24.9 is the healthy weight range, BMI of 25—29.9 is the overweight range, and BMI of 30 and above is in the obese range.
BMI
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Weight in Pounds
Height
4'10"
91
96
100
105
110
115
119
124
129
134
138
143
148
153
158
162
167
4'11"
94
99
104
109
114
119
124
128
133
138
143
148
153
158
163
168
173
5'
97
102
107
112
118
123
128
133
138
143
148
153
158
163
158
174
179
5'1"
100
106
111
116
122
127
132
137
143
148
153
158
164
169
174
180
185
5'2"
104
109
115
120
126
131
136
142
147
153
158
164
169
175
180
186
191
5'3"
107
113
118
124
130
135
141
146
152
158
163
169
175
180
186
191
197
5'4"
110
116
122
128
134
140
145
151
157
163
169
174
180
186
192
197
204
5'5"
114
120
126
132
138
144
150
156
162
168
174
180
186
192
198
204
210
5'6"
118
124
130
136
142
148
155
161
167
173
179
186
192
198
204
210
216
5'7"
121
127
134
140
146
153
159
166
172
178
185
191
198
204
211
217
223
5'8"
125
131
138
144
151
158
164
171
177
184
190
197
203
210
216
223
230
5'9"
128
135
142
149
155
162
169
176
182
189
196
203
209
216
223
230
236
5'10"
132
139
146
153
160
167
174
181
188
195
202
209
216
222
229
236
243
5'11"
136
143
150
157
165
172
179
186
193
200
208
215
222
229
236
243
250
6'
1
40
147
154
162
169
177
184
191
199
206
213
221
228
235
242
250
258
6'1"
144
151
159
166
174
182
189
197
204
212
219
227
235
242
250
257
265
6'2'
148
155
163
171
179
186
194
202
210
218
225
233
241
249
256
264
272
6'3'
152
160
168
176
184
192
200
208
216
224
232
240
248
256
264
272
279
Healthy Weight
Overweight
Obese
Source: Evidence Report of Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, 1998. NIH/National Heart, Lung, and Blood Institute (NHLBI).
D I E TA R Y G U I D E L I N E S F O R A M E R I C A N S , 2 0 0 5
18
FIGURE 3. Example of Boys’ BMI Growth Curve (2 to 20 years): Boys’ Body Mass IndexForAge Percentiles
Calculate the BMI for an individual child using the following:
BMI = Weight (kg)/(Height [cm])2 x 10,000 or BMI = Weight (lb)/(Height [in])2 x 703
Find the age of the child on the bottom, xaxis, and read up the chart from that age to the calculated BMI on the left and right, yaxis. The curve that is
closest to the spot where the age and BMI of the child meet on the graph indicate the BMI percentile for this child relative to the population.
Published May 30, 2000 (modified 10/16/00).
Source: Developed by the National Center for Health Statistics in collaboration with the National Center for Chronic Disease Prevention and Health Promotion. http://www.cdc.gov/growthcharts (2000).
Other growth charts are available at this source.
D I E TA R Y G U I D E L I N E S F O R A M E R I C A N S , 2 0 0 5
19
chapter
4
Physical Activity
OVERVIEW
Americans tend to be relatively inactive. In 2002, 25 percent
of adult Americans did not participate in any leisure time
physical activities in the past month,9 and in 2003, 38
percent of students in grades 9 to 12 viewed television 3
or more hours per day.10 Regular physical activity and
physical fitness make important contributions to one’s
health, sense of well-being, and maintenance of a healthy
body weight. Physical activity is defined as any bodily
movement produced by skeletal muscles resulting in
energy expenditure (http://www.cdc.gov/nccdphp/dnpa/
physical/terms/index.htm). In contrast, physical fitness is
a multi-component trait related to the ability to perform
physical activity. Maintenance of good physical fitness
enables one to meet the physical demands of work and
leisure comfortably. People with higher levels of physical
fitness are also at lower risk of developing chronic disease.
Conversely, a sedentary lifestyle increases risk for over
weight and obesity and many chronic diseases, including
coronary artery disease, hypertension, type 2 diabetes,
osteoporosis, and certain types of cancer. Overall,
mortality rates from all causes of death are lower in
physically active people than in sedentary people.
Also, physical activity can aid in managing mild to
moderate depression and anxiety.
9
Behavioral Risk Factor Surveillance System, Surveillance for Certain Health Behaviors Among Selected Local Areas—United States, Behavioral Risk Factor Surveillance System, 2002, Morbidity and
Mortality Weekly Report (MMWR), 53, No SS-05. http://www.cdc.gov/brfss/.
10
Youth Risk Behavior Surveillance System, Youth Risk Behavior Surveillance—United States, 2003 MMWR 53(SS-2):1–29, 2004. http://www.cdc.gov/healthyyouth/yrbs/.
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20
DISCUSSION
Regular physical activity has been shown to reduce the
risk of certain chronic diseases, including high blood
pressure, stroke, coronary artery disease, type 2 diabetes,
colon cancer and osteoporosis. Therefore, to reduce the
risk of chronic disease, it is recommended that adults
engage in at least 30 minutes of moderateintensity phys
ical activity on most, preferably all, days of the week. For
most people, greater health benefits can be obtained by
engaging in physical activity of more vigorous intensity
or of longer duration. In addition, physical activity appears
to promote psychological wellbeing and reduce feelings
of mild to moderate depression and anxiety.
Regular physical activity is also a key factor in achieving
and maintaining a healthy body weight for adults and
children. To prevent the gradual accumulation of excess
weight in adulthood, up to 30 additional minutes per day
may be required over the 30 minutes for reduction of
chronic disease risk and other health benefits. That is,
approximately 60 minutes of moderate to vigorous
intensity physical activity on most days of the week may
be needed to prevent unhealthy weight gain (see table
4 for some examples of moderate and vigorousintensity
physical activities). While moderateintensity physical
activity can achieve the desired goal, vigorousintensity
physical activity generally provides more benefits than
moderateintensity physical activity. Control of caloric
intake is also advisable. However, to sustain weight loss
for previously overweight/obese people, about 60 to 90
minutes of moderateintensity physical activity per day
is recommended.
Most adults do not need to see their healthcare provider
before starting a moderateintensity physical activity
program. However, men older than 40 years and women
older than 50 years who plan a vigorous program or who
have either chronic disease or risk factors for chronic
disease should consult their physician to design a safe,
effective program. It is also important during leisure time
to limit sedentary behaviors, such as television watching
and video viewing, and replace them with activities
requiring more movement. Reducing these sedentary
activities appears to be helpful in treating and preventing
overweight among children and adolescents.
KEY RECOMMENDATIONS
• Engage in regular physical activity and reduce
sedentary activities to promote health, psychological
wellbeing, and a healthy body weight.
• To reduce the risk of chronic disease in adulthood:
Engage in at least 30 minutes of moderateintensity
physical activity, above usual activity, at work or
home on most days of the week.
• For most people, greater health benefits can be
obtained by engaging in physical activity of more
vigorous intensity or longer duration.
• To help manage body weight and prevent gradual,
unhealthy body weight gain in adulthood: Engage in
approximately 60 minutes of moderate to vigorous
intensity activity on most days of the week while
not exceeding caloric intake requirements.
• To sustain weight loss in adulthood: Participate in at
least 60 to 90 minutes of daily moderateintensity
physical activity while not exceeding caloric intake
requirements. Some people may need to consult
with a healthcare provider before participating in
this level of activity.
• Achieve physical fitness by including cardiovascular
conditioning, stretching exercises for flexibility, and
resistance exercises or calisthenics for muscle strength
and endurance.
Key Recommendations for Specific Population Groups
• Children and adolescents. Engage in at least 60
minutes of physical activity on most, preferably all,
days of the week.
• Pregnant women. In the absence of medical or obstetric
complications, incorporate 30 minutes or more of
moderateintensity physical activity on most, if not all,
days of the week. Avoid activities with a high risk of
falling or abdominal trauma.
• Breastfeeding women. Be aware that neither acute nor
regular exercise adversely affects the mother’s ability
to successfully breastfeed.
• Older adults. Participate in regular physical activity
to reduce functional declines associated with aging
and to achieve the other benefits of physical activity
identified for all adults.
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21
Different intensities and types of exercise confer different
benefits. Vigorous physical activity (e.g., jogging or other
aerobic exercise) provides greater benefits for physical
fitness than does moderate physical activity and burns
more calories per unit of time. Resistance exercise (such
as weight training, using weight machines, and resistance
band workouts) increases muscular strength and endurance
and maintains or increases muscle mass. These benefits
are seen in adolescents, adults, and older adults who
perform resistance exercises on 2 or more days per week.
Also, weightbearing exercise has the potential to reduce
the risk of osteoporosis by increasing peak bone mass
during growth, maintaining peak bone mass during adult
hood, and reducing the rate of bone loss during aging. In
addition, regular exercise can help prevent falls, which is
of particular importance for older adults.
The barrier often given for a failure to be physically
active is lack of time. Setting aside 30 to 60 consecutive
minutes each day for planned exercise is one way to
obtain physical activity, but it is not the only way. Physical
activity may include short bouts (e.g., 10minute bouts)
of moderateintensity activity. The accumulated total is
what is important—both for health and for burning calories.
Physical activity can be accumulated through three to six
10minute bouts over the course of a day.
Elevating the level of daily physical activity may also
provide indirect nutritional benefits. A sedentary lifestyle
limits the number of calories that can be consumed
without gaining weight. The higher a person’s physical
activity level, the higher his or her energy requirement
and the easier it is to plan a daily food intake pattern that
meets recommended nutrient requirements.
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Proper hydration is important when participating in phys
ical activity. Two steps that help avoid dehydration
during prolonged physical activity or when it is hot
include: (1) consuming fluid regularly during the activity
and (2) drinking several glasses of water or other fluid
after the physical activity is completed (see chs. 2 and 8).
Regular physical activity
and physical fitness
make important contri
butions to one’s health,
sense of wellbeing, and
maintenance of a
healthy body weight.
22
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23
chapter
5
Food Groups To Encourage
OVERVIEW
Increased intakes of fruits, vegetables, whole grains,
and fatfree or lowfat milk and milk products are likely
to have important health benefits for most Americans.
While protein is an important macronutrient in the diet,
most Americans are already currently consuming enough
(AMDR = 10 to 35 percent of calories) and do not need to
increase their intake. As such, protein consumption, while
important for nutrient adequacy, is not a focus of this
document. Although associations have been identified
between specific food groups (e.g., fruits and vegetables)
and reduced risk for chronic diseases, the effects are inter
related and the health benefits should be considered in
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the context of an overall healthy diet that does not exceed
calorie needs (such as the USDA Food Guide or the DASH
Eating Plan; see ch. 2). The strength of the evidence for
the association between increased intake of fruits and
vegetables and reduced risk of chronic diseases is variable
and depends on the specific disease, but an array of
evidence points to beneficial health effects.
Compared with the many people who consume a dietary
pattern with only small amounts of fruits and vegetables,
those who eat more generous amounts as part of a
healthful diet are likely to have reduced risk of chronic
diseases, including stroke and perhaps other cardiovas
24
cular diseases, type 2 diabetes, and cancers in certain
sites (oral cavity and pharynx, larynx, lung, esophagus,
stomach, and colonrectum). Diets rich in foods containing
fiber, such as fruits, vegetables, and whole grains, may
reduce the risk of coronary heart disease. Diets rich in
milk and milk products can reduce the risk of low bone
mass throughout the life cycle. The consumption of milk
products is especially important for children and adoles
cents who are building their peak bone mass and
developing lifelong habits. Although each of these food
groups may have a different relationship with disease
outcomes, the adequate consumption of all food groups
contributes to overall health.
DISCUSSION
Fruits, vegetables, whole grains, and milk products are
all important to a healthful diet and can be good sources
of the nutrients of concern (see ch. 2). When increasing
intake of fruits, vegetables, whole grains, and fatfree or
lowfat milk and milk products, it is important to decrease
one’s intake of lessnutrientdense foods to control calorie
intake. The 2,000calorie level used in the discussion is
a reference level only; it is not a recommended calorie
intake because many Americans should be consuming
fewer calories to maintain a healthy weight.
Fruits and Vegetables
Four and onehalf cups (nine servings) of fruits and
vegetables are recommended daily for the reference
2,000calorie level, with higher or lower amounts
depending on the caloric level. This results in a range of 21/2
to 61/2 cups (5 to 13 servings) of fruits and vegetables each
day for the 1,200 to 3,200calorie levels11 (app. A2). Fruits
and vegetables provide a variety of micronutrients and
fiber. Table 5 provides a list of fruits and vegetables that are
good sources of vitamins A (as carotenoids) and C, folate,
and potassium. In the fruit group, consumption of whole
fruits (fresh, frozen, canned, dried) rather than fruit juice
for the majority of the total daily amount is suggested to
ensure adequate fiber intake. Different vegetables are rich
in different nutrients. In the vegetable group, weekly
intake of specific amounts from each of five vegetable
subgroups (dark green, orange, legumes [dry beans],
KEY RECOMMENDATIONS
• Consume a sufficient amount of fruits and vegetables
while staying within energy needs. Two cups of fruit
and 21/2 cups of vegetables per day are recommended
for a reference 2,000calorie intake, with higher or
lower amounts depending on the calorie level.
• Choose a variety of fruits and vegetables each day. In
particular, select from all five vegetable subgroups
(dark green, orange, legumes, starchy vegetables, and
other vegetables) several times a week.
• Consume 3 or more ounceequivalents of wholegrain
products per day, with the rest of the recommended
grains coming from enriched or wholegrain products.
In general, at least half the grains should come from
whole grains.
• Consume 3 cups per day of fatfree or lowfat milk or
equivalent milk products.
Key Recommendations for Specific Population Groups
• Children and adolescents. Consume wholegrain prod
ucts often; at least half the grains should be whole
grains. Children 2 to 8 years should consume 2 cups
per day of fatfree or lowfat milk or equivalent milk
products. Children 9 years of age and older should
consume 3 cups per day of fatfree or lowfat milk or
equivalent milk products.
starchy, and other vegetables)12 is recommended for
adequate nutrient intake. Each subgroup provides a some
what different array of nutrients. In the USDA Food Guide
at the reference 2,000calorie level, the following weekly
amounts are recommended:
Dark green vegetables
3 cups/week
Orange vegetables
2 cups/week
Legumes (dry beans)
3 cups/week
Starchy vegetables
3 cups/week
Other vegetables
61/2 cups/week
Most current consumption patterns do not achieve the
recommended intakes of many of these vegetables. The
DASH Eating Plan and the USDA Food Guide suggest
increasing intakes of dark green vegetables, orange
11
See appendix A2 and table D116 from the 2005 DGAC Report (or USDA website) for information on children age 2 to 3 years.
12
Includes all fresh, frozen, canned, cooked, or raw forms of vegetables. Examples of vegetables are dark green (broccoli, spinach, most greens); orange (carrots, sweetpotatoes, winter squash,
pumpkin); legumes (dry beans, chickpeas, tofu); starchy (corn, white potatoes, green peas); other (tomatoes, cabbage, celery, cucumber, lettuce, onions, peppers, green beans, cauliflower, mush
rooms, summer squash).
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25
vegetables, and legumes (dry beans) as part of the overall
recommendation to have an adequate intake of fruits and
vegetables (see ch. 2).
Whole Grains
In addition to fruits and vegetables, whole grains are
an important source of fiber and other nutrients. Whole
grains, as well as foods made from them, consist of the
entire grain seed, usually called the kernel. The kernel is
made of three components—the bran, the germ, and the
endosperm. If the kernel has been cracked, crushed, or
flaked, then it must retain nearly the same relative propor
tions of bran, germ, and endosperm as the original grain
to be called whole grain. In the grainrefining process,
most of the bran and some of the germ is removed,
resulting in the loss of dietary fiber (also known as cereal
fiber), vitamins, minerals, lignans, phytoestrogens,
phenolic compounds, and phytic acid. Some manufac
turers add bran to grain products to increase the dietary
fiber content. Refined grains are the resulting product
of the grainrefining processing. Most refined grains are
enriched before being further processed into foods.
Enriched refined grain products that conform to standards
of identity are required by law to be fortified with folic
acid, as well as thiamin, riboflavin, niacin, and iron. Food
manufacturers may fortify wholegrain foods where
regulations permit the addition of folic acid. Currently, a
number of wholegrain, readytoeat breakfast cereals are
fortified with folic acid. As illustrated by the comparison
of wholewheat and enriched white flours in table 6, many
nutrients occur at higher or similar levels in whole grains
when compared to enriched grains, but whole grains have
less folate unless they have been fortified with folic acid.
Consuming at least 3 or more ounceequivalents of whole
grains per day can reduce the risk of several chronic
diseases and may help with weight maintenance. Thus,
daily intake of at least 3 ounceequivalents of whole
grains per day is recommended by substituting whole
grains for refined grains. However, because three servings
may be difficult for younger children to achieve, it is
recommended that they increase whole grains into their
diets as they grow. At all calorie levels, all age groups
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Increased intakes
of fruits, vegetables,
whole grains, and
fatfree or lowfat
milk and milk
products are likely
to have important
health benefits for
most Americans.
should consume at least half the grains as whole grains
to achieve the fiber recommendation. All grain servings
can be wholegrain; however, it is advisable to include
some folatefortified products, such as folatefortified
wholegrain cereals, in these wholegrain choices.
Whole grains cannot be identified by the color of the food;
labelreading skills are needed. Table 7 identifies names
of whole grains that are available in the United States.
For information about the ingredients in wholegrain and
enrichedgrain products, read the ingredient list on the
food label. For many wholegrain products, the words
“whole” or “whole grain” will appear before the grain
ingredient’s name. The whole grain should be the first
ingredient listed. Wheat flour, enriched flour, and degermi
nated cornmeal are not whole grains. The Food and Drug
Administration requires foods that bear the wholegrain
health claim to (1) contain 51 percent or more wholegrain
ingredients by weight per reference amount and (2) be
low in fat.
26
Milk and Milk Products
Another source of nutrients is milk and milk products.
Milk product consumption has been associated with
overall diet quality and adequacy of intake of many nutri
ents. The intake of milk products is especially important
to bone health during childhood and adolescence. Studies
specifically on milk and other milk products, such as
yogurt and cheese, showed a positive relationship
between the intake of milk and milk products and bone
mineral content or bone mineral density in one or more
skeletal sites (see table 1 for information on equivalent
amounts of milk products).
Adults and children should not avoid milk and milk prod
ucts because of concerns that these foods lead to weight
gain. There are many fatfree and lowfat choices without
added sugars that are available and consistent with an
overall healthy dietary plan. If a person wants to consider
milk alternatives because of lactose intolerance, the most
reliable and easiest ways to derive the health benefits
associated with milk and milk product consumption is to
choose alternatives within the milk food group, such as
yogurt or lactosefree milk, or to consume the enzyme
lactase prior to the consumption of milk products. For
individuals who choose to or must avoid all milk products
(e.g., individuals with lactose intolerance, vegans), non
dairy calciumcontaining alternatives may be selected to
help meet calcium needs (app. B4).
TABLE 5. Fruits, Vegetables, and Legumes (Dry Beans) That Contain Vitamin A (Carotenoids),
Vitamin C, Folate, and Potassium
Many of the fruits, vegetables, and legumes (beans) are considered to be important sources of vitamin A (as carotenoids), vitamin C, and potassium in the
adult population. Intakes of these nutrients, based on dietary intake data or evidence of public health problems, may be of concern. Also listed are sources
of naturally occurring folate, a nutrient considered to be of concern for women of childbearing age and those in the first trimester of pregnancy. Folic acid
fortified grain products, not listed in this table, are also good sources.
Sources of vitamin A (carotenoids) (see app. B6)
Bright orange vegetables like carrots, sweetpotatoes, and pumpkin
• Tomatoes and tomato products, red sweet pepper
• Leafy greens such as spinach, collards, turnip greens, kale, beet and mustard greens, green leaf lettuce, and romaine
• Orange fruits like mango, cantaloupe, apricots, and red or pink grapefruit
•
Sources of vitamin C
• Citrus fruits and juices, kiwi fruit, strawberries, guava, papaya, and cantaloupe
• Broccoli, peppers, tomatoes, cabbage (especially Chinese cabbage), brussels sprouts, and potatoes
• Leafy greens such as romaine, turnip greens, and spinach
Sources of folate
• Cooked dry beans and peas
• Oranges and orange juice
• Deep green leaves like spinach and mustard greens
Sources of potassium (see app. B1)
• Baked white or sweetpotatoes, cooked greens (such as spinach), winter (orange) squash
• Bananas, plantains, many dried fruits, oranges and orange juice, cantaloupe, and honeydew melons
• Cooked dry beans
• Soybeans (green and mature)
• Tomato products (sauce, paste, puree)
• Beet greens
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27
TABLE 6. Comparison of 100 Grams of WholeGrain Wheat Flour and Enriched, Bleached, White, AllPurpose Flour
Some of the nutrients of concern and the fortification nutrients in 100 percent wholewheat flour and enriched, bleached, allpurpose white (wheat) flour.
Dietary fiber, calcium, magnesium and potassium, nutrients of concern, occur in much higher concentrations in the wholewheat flour on a 100gram basis
(percent). The fortification nutrients—thiamin, riboflavin, niacin, and iron—are similar in concentration between the two flours, but folate, as Dietary Folate
Equivalent (DFE), µg, is higher in the enriched white flour.
100 Percent WholeGrain Wheat Flour
Enriched, Bleached, AllPurpose White Flour
339.0
364.0
Dietary fiber, g
12.2
2.7
Calcium, mg
34.0
15.0
Magnesium, mg
138.0
22.0
Potassium, mg
405.0
107.0
Folate, DFE, µg
44.0
291.0
Thiamin, mg
0.5
0.8
Riboflavin, mg
0.2
0.5
Niacin, mg
6.4
5.9
Iron, mg
3.9
4.6
Calories, kcal
Source: Agricultural Research Service Nutrient Database for Standard Reference, Release 17.
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TABLE 7. Whole Grains Available in the United States
Whole grains that are consumed in the United States either as a single food (e.g., wild rice, popcorn) or as an ingredient in a multiingredient food (e.g., in
multigrain breads). This listing of whole grains was determined from a breakdown of foods reported consumed in nationwide food consumption surveys,
by amount consumed. The foods are listed in approximate order of amount consumed, but the order may change over time. In addition, other whole grains
may be consumed that are not yet represented in the surveys.
Whole wheat
Whole oats/oatmeal
Wholegrain corn
Popcorn
Brown rice
Whole rye
Wholegrain barley
Wild rice
Buckwheat
Triticale
Bulgur (cracked wheat)
Millet
Quinoa
Sorghum
Source: Agriculture Research Service Database for CSFII 1994–1996.
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29
chapter
6
Fats
OVERVIEW
DISCUSSION
Fats and oils are part of a healthful diet, but the type of
fat makes a difference to heart health, and the total
amount of fat consumed is also important. High intake of
saturated fats, trans fats, and cholesterol increases the risk
of unhealthy blood lipid levels, which, in turn, may increase
the risk of coronary heart disease. A high intake of fat
(greater than 35 percent of calories) generally increases
saturated fat intake and makes it more difficult to avoid
consuming excess calories. A low intake of fats and oils
(less than 20 percent of calories) increases the risk of inadequate intakes of vitamin E and of essential fatty acids and
may contribute to unfavorable changes in high-density
lipoprotein (HDL) blood cholesterol and triglycerides.
Fats supply energy and essential fatty acids and serve as
a carrier for the absorption of the fat-soluble vitamins A, D,
E, and K and carotenoids. Fats serve as building blocks
of membranes and play a key regulatory role in numerous
biological functions. Dietary fat is found in foods derived
from both plants and animals. The recommended total fat
intake is between 20 and 35 percent of calories for adults.
A fat intake of 30 to 35 percent of calories is recommended
for children 2 to 3 years of age and 25 to 35 percent of
calories for children and adolescents 4 to 18 years of age.
Few Americans consume less than 20 percent of calories
from fat. Fat intakes that exceed 35 percent of calories are
associated with both total increased saturated fat and
calorie intakes.
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30
To decrease their risk of elevated lowdensity lipoprotein
(LDL) cholesterol in the blood, most Americans need to
decrease their intakes of saturated fat and trans fats, and
many need to decrease their dietary intake of cholesterol.
Because men tend to have higher intakes of dietary
cholesterol, it is especially important for them to meet this
recommendation. Populationbased studies of American
diets show that intake of saturated fat is more excessive
than intake of trans fats and cholesterol. Therefore, it is
most important for Americans to decrease their intake
of saturated fat. However, intake of all three should be
decreased to meet recommendations. Table 8 shows, for
selected calorie levels, the maximum gram amounts
of saturated fat to consume to keep saturated fat intake
below 10 percent of total calorie intake. This table may
be useful when combined with labelreading guidance.
Table 9 gives a few practical examples of the differences
in the saturated fat content of different forms of commonly
consumed foods. Table 10 provides the major dietary
sources of saturated fats in the U.S. diet listed in
decreasing order. Diets can be planned to meet nutrient
recommendations for linoleic acid and αlinolenic acid
while providing very low amounts of saturated fatty acids.
Based on 1994–1996 data, the estimated average daily
intake of trans fats in the United States was about 2.6
percent of total energy intake. Processed foods and oils
provide approximately 80 percent of trans fats in the diet,
compared to 20 percent that occur naturally in food from
animal sources. Table 11 provides the major dietary
sources of trans fats listed in decreasing order. Trans fat
content of certain processed foods has changed and is
likely to continue to change as the industry reformulates
products. Because the trans fatty acids produced in the
partial hydrogenation of vegetable oils account for more
than 80 percent of total intake, the food industry has an
important role in decreasing trans fatty acid content of the
food supply. Limited consumption of foods made with
processed sources of trans fats provides the most effective
means of reducing intake of trans fats. By looking at the
food label, consumers can select products that are lowest
in saturated fat, trans fats,13 and cholesterol.
To meet the total fat recommendation of 20 to 35 percent
of calories, most dietary fats should come from sources of
13
KEY RECOMMENDATIONS
• Consume less than 10 percent of calories from
saturated fatty acids and less than 300 mg/day
of cholesterol, and keep trans fatty acid consumption
as low as possible.
• Keep total fat intake between 20 to 35 percent of calo
ries, with most fats coming from sources of
polyunsaturated and monounsaturated fatty acids,
such as fish, nuts, and vegetable oils.
• When selecting and preparing meat, poultry, dry beans,
and milk or milk products, make choices that are lean,
lowfat, or fatfree.
• Limit intake of fats and oils high in saturated and/or
trans fatty acids, and choose products low in such
fats and oils.
Key Recommendations for Specific Population Groups
• Children and adolescents. Keep total fat intake
between 30 to 35 percent of calories for children 2 to
3 years of age and between 25 to 35 percent of calo
ries for children and adolescents 4 to 18 years of age,
with most fats coming from sources of polyunsatu
rated and monounsaturated fatty acids, such as fish,
nuts, and vegetable oils.
polyunsaturated and monounsaturated fatty acids.
Sources of omega6 polyunsaturated fatty acids are
liquid vegetable oils, including soybean oil, corn oil, and
safflower oil. Plant sources of omega3 polyunsaturated
fatty acids (αlinolenic acid) include soybean oil, canola
oil, walnuts, and flaxseed. Eicosapentaenoic acid (EPA)
and docosahexaenoic acid (DHA) are omega3 fatty acids
that are contained in fish and shellfish. Fish that naturally
contain more oil (e.g., salmon, trout, herring) are higher
in EPA and DHA than are lean fish (e.g., cod, haddock,
catfish). Limited evidence suggests an association
between consumption of fatty acids in fish and reduced
risks of mortality from cardiovascular disease for the
general population. Other sources of EPA and DHA may
provide similar benefits; however, more research is
needed. Plant sources that are rich in monounsaturated
fatty acids include vegetable oils (e.g., canola, olive, high
oleic safflower, and sunflower oils) that are liquid at room
temperature and nuts.
Including the amount of trans fats on the Nutrition Facts Panel is voluntary until January 2006.
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31
Considerations for Specific Population Groups
Evidence suggests that consuming approximately two
servings of fish per week (approximately 8 ounces total)
may reduce the risk of mortality from coronary heart
disease and that consuming EPA and DHA may reduce
the risk of mortality from cardiovascular disease in people
who have already experienced a cardiac event.
Federal and State advisories provide current information
about lowering exposure to environmental contaminants
in fish. For example, methylmercury is a heavy metal toxin
found in varying levels in nearly all fish and shellfish. For
most people, the risk from mercury by eating fish and
shellfish is not a health concern. However, some fish
contain higher levels of mercury that may harm an unborn
baby or young child's developing nervous system. The
risks from mercury in fish and shellfish depend on the
amount of fish eaten and the levels of mercury in the fish.
Therefore, the Food and Drug Administration (FDA) and
the Environmental Protection Agency are advising women
of childbearing age who may become pregnant, pregnant
women, nursing mothers, and young children to avoid
some types of fish and shellfish and eat fish and shellfish
that are lower in mercury. For more information, call FDA’s
food information line tollfree at 1888SAFEFOOD or visit
http://www.cfsan.fda.gov/~dms/admehg3.html.
TABLE 8. Maximum Daily Amounts of Saturated
Fat To Keep Saturated Fat Below 10 Percent of Total
Calorie Intake
…most Americans
need to decrease their
intakes of saturated
fat and trans fats,
and many need to
decrease their dietary
intake of cholesterol.
Lower intakes (less than 7 percent of calories from satu
rated fat and less than 200 mg/day of cholesterol) are
recommended as part of a therapeutic diet for adults with
elevated LDL blood cholesterol (i.e., above their LDL blood
cholesterol goal [see table 12]). People with an elevated
LDL blood cholesterol level should be under the care of a
healthcare provider.
Total Calorie Intake
1,600
Limit on Saturated
Fat Intake
18 g or less
The maximum gram amounts of saturated fat that can be consumed to
keep saturated fat intake below 10 percent of total calorie intake for
selected calorie levels. A 2,000calorie example is included for consistency
a
2,000
20 g or less
2,200
24 g or less
with the food label. This table may be useful when combined with label
reading guidance.
a
2,500
25 g or less
2,800
31 g or less
a Percent Daily Values on the Nutrition Facts Panel of food labels are based on a 2,000calorie diet.
Values for 2,000 and 2,500 calories are rounded to the nearest 5 grams to be consistent with the
Nutrition Facts Panel.
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32
TABLE 9. Differences in Saturated Fat and Calorie Content of Commonly Consumed Foods
This table shows a few practical examples of the differences in the saturated fat content of different forms of commonly consumed foods. Comparisons are
made between foods in the same food group (e.g., regular cheddar cheese and lowfat cheddar cheese), illustrating that lower saturated fat choices can be
made within the same food group.
Food Category
Portion
Saturated Fat Content (grams)
Calories
• Regular cheddar cheese
1 oz
6.0
114
• Lowfat cheddar cheese
1 oz
1.2
49
• Regular ground beef (25% fat)
3 oz (cooked)
6.1
236
• Extra lean ground beef (5% fat)
3 oz (cooked)
2.6
148
• Whole milk (3.24%)
1 cup
4.6
146
• Lowfat (1%) milk
1 cup
1.5
102
• Croissant (med)
1 medium
6.6
231
• Bagel, oat bran (4")
1 medium
0.2
227
Cheese
Ground beef
Milk
Breads
Frozen desserts
• Regular ice cream
1/2
cup
4.9
145
• Frozen yogurt, lowfat
1/2
cup
2.0
110
• Butter
1 tsp
2.4
34
• Soft margarine with zero trans
1 tsp
0.7
25
• Fried chicken (leg with skin)
3 oz (cooked)
3.3
212
• Roasted chicken (breast no skin)
3 oz (cooked)
0.9
140
• Fried fish
3 oz
2.8
195
• Baked fish
3 oz
1.5
129
Table spreads
Chicken
Fish
Source: ARS Nutrient Database for Standard Reference, Release 17.
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TABLE 10. Contribution of Various Foods to Saturated Fat Intake in the American Diet (Mean Intake = 25.5 g)
The major dietary sources of saturated fats in the U.S. diet listed in decreasing order.
Food Group
Contribution
(percent of total sat fat consumed)
Cheese
13.1
Beef
11.7
Milk
a
7.8
Oils
4.9
Ice cream/sherbet/frozen yogurt
4.7
Cakes/cookies/quick breads/doughnuts
4.7
Butter
4.6
b
Other fats
4.4
Salad dressings/mayonnaise
3.7
Poultry
3.6
Margarine
3.2
Sausage
3.1
Potato chips/corn chips/popcorn
2.9
Yeast bread
2.6
Eggs
2.3
a The milk category includes all milk, including whole milk, lowfat milk, and fatfree milk.
b Shortening and animal fats
Source: Adapted from Cotton PA, Subar AF, Friday JE, Cook A, Dietary Sources of Nutrients among U.S. Adults, 1994–1996. JADA 104:921931, 2004.
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TABLE 11. Contribution of Various Foods to Trans Fat Intake in the American Diet (Mean Intake = 5.84 g)
The major dietary sources of trans fats listed in decreasing order. Processed foods and oils provide approximately 80 percent of trans fats in the diet,
compared to 20 percent that occur naturally in food from animal sources. Trans fats content of certain processed foods has changed and is likely to
continue to change as the industry reformulates products.
Food Group
Contribution
(percent of total trans fats consumed)
Cakes, cookies, crackers, pies, bread, etc.
40
Animal products
21
Margarine
17
Fried potatoes
8
Potato chips, corn chips, popcorn
5
Household shortening
4
a
Other
5
a Includes breakfast cereal and candy. USDA analysis reported 0 grams of trans fats in salad dressing.
Source: Adapted from Federal Register notice. Food Labeling; Trans Fatty Acids in Nutrition Labeling; Consumer Research To Consider Nutrient Content and Health Claims and Possible Footnote or
Disclosure Statements; Final Rule and Proposed Rule. Vol. 68, No. 133, p. 4143341506, July 11, 2003. Data collected 19941996.
TABLE 12. Relationship Between LDL Blood Cholesterol Goal and the Level of Coronary Heart Disease Risk
Information for adults with elevated LDL blood cholesterol. LDL blood cholesterol goals for these individuals are related to the level of coronary heart
disease risk. People with an elevated LDL blood cholesterol value should make therapeutic lifestyle changes (diet, physical activity, weight control) under the
care of a healthcare provider to lower LDL blood cholesterol.
If Someone Has:
LDL Blood Cholesterol Goal Is:
a
CHD or CHD risk equivalent
Less than 100 mg/dL
b
Two or more risk factors other than elevated LDL blood cholesterol
b
Zero or one risk factor other than elevated LDL blood cholesterol
Less than 130 mg/dL
Less than 160 mg/dL
a CHD (coronary heart disease) risk equivalent = presence of clinical atherosclerotic disease that confers high risk for CHD events:
Clinical CHD
Symptomatic carotid artery disease
Peripheral arterial disease
Abdominal aortic aneurysm
Diabetes
Two or more risk factors with >20% risk for CHD (or myocardial infarction or CHD death) within 10 years
b Major risk factors that affect your LDL goal:
Cigarette smoking
High blood pressure (140/90 mmHg or higher or on blood pressure medication)
Low HDL blood cholesterol (less than 40 mg/dL)
Family history of early heart disease (heart disease in father or brother before age 55; heart disease in mother or sister before age 65)
Age (men 45 years or older; women 55 years or older)
Source: NIH Publication No. 013290, U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute, National Cholesterol Education Program
Brochure, High Blood Cholesterol What You Need to Know, May 2001. http://www.nhlbi.nih.gov/health/public/heart/chol/hbc_what.htm.
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chapter
7
7
Carbohydrates
OVERVIEW
Carbohydrates are part of a healthful diet. The AMDR for
carbohydrates is 45 to 65 percent of total calories. Dietary
fiber is composed of nondigestible carbohydrates and
lignin intrinsic and intact in plants. Diets rich in dietary
fiber have been shown to have a number of beneficial
effects, including decreased risk of coronary heart disease
and improvement in laxation. There is also interest in the
potential relationship between diets containing fiberrich
foods and lower risk of type 2 diabetes. Sugars and starches
supply energy to the body in the form of glucose, which
is the only energy source for red blood cells and is the
preferred energy source for the brain, central nervous
system, placenta, and fetus. Sugars can be naturally
present in foods (such as the fructose in fruit or the
lactose in milk) or added to the food. Added sugars, also
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known as caloric sweeteners, are sugars and syrups that
are added to foods at the table or during processing or
preparation (such as high fructose corn syrup in sweet
ened beverages and baked products). Although the body’s
response to sugars does not depend on whether they are
naturally present in a food or added to the food, added
sugars supply calories but few or no nutrients.
Consequently, it is important to choose carbohydrates
wisely. Foods in the basic food groups that provide
carbohydrates—fruits, vegetables, grains, and milk—are
important sources of many nutrients. Choosing plenty of
these foods, within the context of a caloriecontrolled diet,
can promote health and reduce chronic disease risk.
However, the greater the consumption of foods containing
large amounts of added sugars, the more difficult it is to
36
consume enough nutrients without gaining weight.
Consumption of added sugars provides calories while
providing little, if any, of the essential nutrients.
DISCUSSION
The recommended dietary fiber intake is 14 grams per
1,000 calories consumed. Initially, some Americans will
find it challenging to achieve this level of intake. However,
making fiberrich food choices more often will move
people toward this goal and is likely to confer significant
health benefits.
The majority of servings from the fruit group should come
from whole fruit (fresh, frozen, canned, dried) rather than
juice. Increasing the proportion of fruit that is eaten in the
form of whole fruit rather than juice is desirable to increase
fiber intake. However, inclusion of some juice, such as
orange juice, can help meet recommended levels of potas
sium intake. Appendixes B1 and B8 list some of the best
sources of potassium and dietary fiber, respectively.
Legumes—such as dry beans and peas—are especially
rich in fiber and should be consumed several times
per week. They are considered part of both the vegetable
group and the meat and beans group as they contain
nutrients found in each of these food groups.
Consuming at least half the recommended grain servings
as whole grains is important, for all ages, at each calorie
level, to meet the fiber recommendation. Consuming at
least 3 ounceequivalents of whole grains per day can
reduce the risk of coronary heart disease, may help with
weight maintenance, and may lower risk for other chronic
diseases. Thus, at lower calorie levels, adults should
consume more than half (specifically, at least 3 ounce
equivalents) of whole grains per day, by substituting
Diets rich in dietary
fiber have been shown
to have a number of
beneficial effects.
KEY RECOMMENDATIONS
• Choose fiberrich fruits, vegetables, and whole grains
often.
• Choose and prepare foods and beverages with little
added sugars or caloric sweeteners, such as amounts
suggested by the USDA Food Guide and the DASH
Eating Plan.
• Reduce the incidence of dental caries by practicing
good oral hygiene and consuming sugar and starch
containing foods and beverages less frequently.
whole grains for refined grains. (See table 7 for a list of
whole grains available in the United States.)
Individuals who consume food or beverages high in added
sugars tend to consume more calories than those who
consume food or beverages low in added sugars; they also
tend to consume lower amounts of micronutrients. Although
more research is needed, available prospective studies
show a positive association between the consumption of
calorically sweetened beverages and weight gain. For this
reason, decreased intake of such foods, especially bever
ages with caloric sweeteners, is recommended to reduce
calorie intake and help achieve recommended nutrient
intakes and weight control.
Total discretionary calories should not exceed the
allowance for any given calorie level, as shown in the
USDA Food Guide (see ch. 2). The discretionary calorie
allowance covers all calories from added sugars, alcohol,
and the additional fat found in even moderate fat choices
from the milk and meat group. For example, the 2,000
calorie pattern includes only about 267 discretionary
calories. At 29 percent of calories from total fat (including
18 g of solid fat), if no alcohol is consumed, then only 8
teaspoons (32 g) of added sugars can be afforded. This
is less than the amount in a typical 12ounce calorically
sweetened soft drink. If fat is decreased to 22 percent
of calories, then 18 teaspoons (72 g) of added sugars is
allowed. If fat is increased to 35 percent of calories, then
no allowance remains for added sugars, even if alcohol
is not consumed.
In some cases, small amounts of sugars added to nutrient
dense foods, such as breakfast cereals and reducedfat
milk products, may increase a person’s intake of such
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37
…the greater the
consumption of
foods containing
large amounts of
added sugars, the
more difficult it is
to consume enough
nutrients without
gaining weight.
products help reduce the risk of dental caries. Most
bottled water is not fluoridated. With the increase in
consumption of bottled water, there is concern that
Americans may not be getting enough fluoride for
maintenance of oral health. A combined approach
of reducing the frequency and duration of exposure
to fermentable carbohydrate intake and optimizing
oral hygiene practices, such as drinking fluoridated
water and brushing and flossing teeth, is the most
effective way to reduce incidence of dental caries.
Considerations for Specific Population Groups
Older Adults
Dietary fiber is important for laxation. Since constipation
may affect up to 20 percent of people over 65 years of
age, older adults should choose to consume foods rich
in dietary fiber. Other causes of constipation among this
age group may include drug interactions with laxation
and lack of appropriate hydration (see ch. 2).
Children
foods by enhancing the palatability of these products, thus
improving nutrient intake without contributing excessive
calories. The major sources of added sugars are listed in
table 13 (app. A3 provides examples of how added sugars
can fit into the discretionary calorie allowance).
The Nutrition Facts Panel on the food label provides the
amount of total sugars but does not list added sugars
separately. People should examine the ingredient list to
find out whether a food contains added sugars. The ingre
dient list is usually located under the Nutrition Facts Panel
or on the side of a food label. Ingredients are listed in
order of predominance, by weight; that is, the ingredient
with the greatest contribution to the product weight
is listed first and the ingredient contributing the least
amount is listed last. Table 14 lists ingredients that are
included in the term “added sugars.”14
Sugars and starches contribute to dental caries by providing
substrate for bacterial fermentation in the mouth. Thus,
the frequency and duration of consumption of starches
and sugars can be important factors because they increase
exposure to cariogenic substrates. Drinking fluoridated
water and/or using fluoridecontaining dental hygiene
14
Carbohydrate intakes of children need special considera
tions with regard to obtaining sufficient amounts of
fiber, avoiding excessive amounts of calories from added
sugars, and preventing dental caries. Several cross
sectional surveys on U.S. children and adolescents have
found inadequate dietary fiber intakes, which could
be improved by increasing consumption of whole fruits,
vegetables, and wholegrain products. Sugars can improve
the palatability of foods and beverages that otherwise
might not be consumed. This may explain why the
consumption of sweetened dairy foods and beverages
and presweetened cereals is positively associated with
childrens’ and adolescents’ nutrient intake. However,
beverages with caloric sweeteners, sugars and sweets,
and other sweetened foods that provide little or no
nutrients are negatively associated with diet quality and
can contribute to excessive energy intakes, affirming the
importance of reducing added sugar intake substantially
from current levels. Most of the studies of preschool
children suggest a positive association between sucrose
consumption and dental caries, though other factors
(particularly infrequent brushing or not using fluoridated
toothpaste) are more predictive of caries outcome than
is sugar consumption.
For information on amounts of added sugars in some common foods, see KrebsSmith, SM. Choose beverages and foods to moderate your intake of sugars: measurement requires quantification.
The Journal of Nutrition (J Nutr) 131(2SI): 527S535S, 2001.
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TABLE 13. Major Sources of Added Sugars (Caloric Sweeteners) in the American Diet
Food groups that contribute more than 5 percent of the added sugars to the American diet in decreasing order.
Food Categories
Contribution to Added Sugars Intake
(percent of total added sugars consumed)
Regular soft drinks
33.0
Sugars and candy
16.1
Cakes, cookies, pies
12.9
Fruit drinks (fruitades and fruit punch)
9.7
Dairy desserts and milk products
8.6
(ice cream, sweetened yogurt, and sweetened milk)
Other grains (cinnamon toast and honeynut waffles)
5.8
Source: Guthrie and Morton, Journal of the American Dietetic Association, 2000.
TABLE 14. Names for Added Sugars That Appear on Food Labels
Some of the names for added sugars that may be in processed foods and listed on the label ingredients list.
Brown sugar
Invert sugar
Corn sweetener
Lactose
Corn syrup
Maltose
Dextrose
Malt syrup
Fructose
Molasses
Fruit juice concentrates
Raw sugar
Glucose
Sucrose
Highfructose corn syrup
Sugar
Honey
Syrup
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chapter
8
Sodium and Potassium
OVERVIEW
On average, the higher an individual’s salt (sodium chloride)
intake, the higher an individual’s blood pressure. Nearly
all Americans consume substantially more salt than they
need. Decreasing salt intake is advisable to reduce the
risk of elevated blood pressure. Keeping blood pressure in
the normal range reduces an individual’s risk of coronary
heart disease, stroke, congestive heart failure, and kidney
disease. Many American adults will develop hypertension
(high blood pressure) during their lifetime. Lifestyle
changes can prevent or delay the onset of high blood
pressure and can lower elevated blood pressure. These
changes include reducing salt intake, increasing potassium
D I E TA R Y G U I D E L I N E S F O R A M E R I C A N S , 2 0 0 5
intake, losing excess body weight, increasing physical
activity, and eating an overall healthful diet.
DISCUSSION
Salt is sodium chloride. Food labels list sodium rather than
salt content. When reading a Nutrition Facts Panel on a
food product, look for the sodium content. Foods that are
low in sodium (less than 140 mg or 5 percent of the Daily
Value [DV]) are low in salt.
Common sources of sodium found in the food supply are
provided in figure 4. On average, the natural salt content
of food accounts for only about 10 percent of total intake,
40
while discretionary salt use (i.e., salt added at the table
or while cooking) provides another 5 to 10 percent of total
intake. Approximately 75 percent is derived from salt
added by manufacturers. In addition, foods served by food
establishments may be high in sodium. It is important to
read the food label and determine the sodium content of
food, which can vary by several hundreds of milligrams
in similar foods. For example, the sodium content in
regular tomato soup may be 700 mg per cup in one brand
and 1,100 mg per cup in another brand. Reading labels,
comparing sodium contents of foods, and purchasing the
lower sodium brand may be one strategy to lower total
sodium intake (see table 15 for examples of these foods).
KEY RECOMMENDATIONS
An individual’s preference for salt is not fixed. After
consuming foods lower in salt for a period of time, taste
for salt tends to decrease. Use of other flavorings
may satisfy an individual’s taste. While salt substitutes
containing potassium chloride may be useful for some
individuals, they can be harmful to people with certain
medical conditions. These individuals should consult
a healthcare provider before trying salt substitutes.
during food processing and on changes in food selection
(e.g., more fresh, lessprocessed items, less sodiumdense
foods) and preparation.
Discretionary salt use is fairly stable, even when foods
offered are lower in sodium than typical foods consumed.
When consumers are offered a lower sodium product, they
typically do not add table salt to compensate for the lower
sodium content, even when available. Therefore, any
program for reducing the salt consumption of a population
should concentrate primarily on reducing the salt used
Lifestyle changes can
prevent or delay the
onset of high blood
pressure and can lower
elevated blood pressure.
• Consume less than 2,300 mg (approximately 1 tsp of
salt) of sodium per day.
• Choose and prepare foods with little salt. At the same
time, consume potassiumrich foods, such as fruits and
vegetables.
Key Recommendations for Specific Population Groups
• Individuals with hypertension, blacks, and middleaged
and older adults. Aim to consume no more than 1,500
mg of sodium per day, and meet the potassium recom
mendation (4,700 mg/day) with food.
Reducing salt intake is one of several ways that people
may lower their blood pressure. The relationship between
salt intake and blood pressure is direct and progressive
without an apparent threshold. On average, the higher
a person’s salt intake, the higher the blood pressure.
Reducing blood pressure, ideally to the normal range,
reduces the risk of stroke, heart disease, heart failure,
and kidney disease.
Another dietary measure to lower blood pressure is to
consume a diet rich in potassium. A potassiumrich diet
also blunts the effects of salt on blood pressure, may
reduce the risk of developing kidney stones, and possibly
decrease bone loss with age. The recommended intake
of potassium for adolescents and adults is 4,700 mg/day.
Recommended intakes for potassium for children 1 to 3
years of age is 3,000 mg/day, 4 to 8 years of age is
3,800 mg/day, and 9 to 13 years of age is 4,500 mg/day.
Potassium should come from food sources. Fruits and
vegetables, which are rich in potassium with its bicarbonate
precursors, favorably affect acidbase metabolism, which
may reduce risk of kidney stones and bone loss. Potassium
rich fruits and vegetables include leafy green vegetables,
fruit from vines, and root vegetables. Meat, milk, and cereal
products also contain potassium, but may not have the
same effect on acidbase metabolism. Dietary sources of
potassium are listed in table 5 and appendix B1.
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Considerations for Specific Population Groups
Individuals With Hypertension, Blacks, and MiddleAged
and Older Adults. Some individuals tend to be more salt
sensitive than others, including people with hypertension,
blacks, and middleaged and older adults. Because blacks
commonly have a relatively low intake of potassium and
a high prevalence of elevated blood pressure and salt sensi
tivity, this population subgroup may especially benefit from
an increased dietary intake of potassium. Dietary potassium
can lower blood pressure and blunt the effects of salt on
blood pressure in some individuals. While salt substitutes
containing potassium chloride may be useful for some
individuals, they can be harmful to people with certain
medical conditions. These individuals should consult a
healthcare provider before using salt substitutes.
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FIGURE 4. Sources of Dietary Sodium
The relative amounts of dietary
sodium in the American diet.
77% Food Processing
12% Naturally Occurring
6% At the Table
5% During Cooking
Source: Mattes RD, Donnelly D. Relative contributions of dietary sodium sources. J Am Coll Nutr. 1991 Aug;10(4):38393.
TABLE 15. Range of Sodium Content for Selected Foods
The ranges of sodium content for selected foods available in the retail market. This table is provided to exemplify the importance of reading the food label
to determine the sodium content of food, which can vary by several hundreds of milligrams in similar foods.
Food Group
Serving Size
Range (mg)
Breads, all types
1 oz
95–210
Frozen pizza, plain, cheese
4 oz
450–1200
c
2–160
Salad dressing, regular fat, all types
2 Tbsp
110–505
Salsa
2 Tbsp
150–240
8 oz
700–1260
Tomato juice
8 oz (~1 c)
340–1040
a
1 oz (28.4 g)
120–180
a
1 oz (28.4 g)
105–160
1 oz (28.4 g)
290–560
Frozen vegetables, all types
Soup (tomato), reconstituted
Potato chips
Tortilla chips
a
Pretzels
1/2
a All snack foods are regular flavor, salted.
Source: Agricultural Research Service Nutrient Database for Standard Reference, Release 17 and recent manufacturers label data from retail market surveys. Serving sizes were standardized to be compa
rable among brands within a food. Pizza and bread slices vary in size and weight across brands.
Note: None of the examples provided were labeled lowsodium products.
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chapter
9
Alcoholic Beverages
OVERVIEW
The consumption of alcohol can have beneficial or harmful
effects depending on the amount consumed, age and
other characteristics of the person consuming the alcohol,
and specifics of the situation. In 2002, 55 percent of U.S.
adults were current drinkers. Fortyfive percent of U.S.
adults do not drink any alcohol at all.15 Abstention is
an important option. Fewer Americans consume alcohol
today as compared to 50 to 100 years ago.
The hazards of heavy alcohol consumption are well
known and include increased risk of liver cirrhosis, hyper
tension, cancers of the upper gastrointestinal tract, injury,
15
violence, and death. Moreover, certain individuals who are
more susceptible to the harmful effects of alcohol should
not drink at all. In addition, alcohol should be avoided by
those participating in activities that require attention, skill,
and/or coordination.
Alcohol may have beneficial effects when consumed in
moderation. The lowest allcause mortality occurs at an
intake of one to two drinks per day. The lowest coronary
heart disease mortality also occurs at an intake of one to
two drinks per day. Morbidity and mortality are highest
among those drinking large amounts of alcohol.
Behavioral Risk Factor Surveillance System, Surveillance for Certain Health Behaviors Among Selected Local Areas—United States, Behavioral Risk Factor Surveillance System, 2002, MMWR, 53, No SS
05. http://www.cdc.gov/brfss/.
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DISCUSSION
Alcoholic beverages supply calories but few essential
nutrients (see table 16). As a result, excessive alcohol
consumption makes it difficult to ingest sufficient nutri
ents within an individual’s daily calorie allotment and to
maintain a healthy weight. Although the consumption of
one to two alcoholic beverages per day is not associated
with macronutrient or micronutrient deficiencies or with
overall dietary quality, heavy drinkers may be at risk of
malnutrition if the calories derived from alcohol are substi
tuted for those in nutritious foods.
The majority of American adults consume alcohol. Those
who do so should drink alcoholic beverages in moderation.
Moderation is defined as the consumption of up to one drink
per day for women and up to two drinks per day for men.
Twelve fluid ounces of regular beer, 5 fluid ounces of wine,
or 1.5 fluid ounces of 80proof distilled spirits count as one
drink for purposes of explaining moderation. This definition
of moderation is not intended as an average over several
days but rather as the amount consumed on any single day.
The effect of alcohol consumption varies depending on
the amount consumed and an individual’s characteristics
and circumstances. Alcoholic beverages are harmful when
consumed in excess. Excess alcohol consumption alters
judgment and can lead to dependency or addiction and
other serious health problems such as cirrhosis of the
liver, inflammation of the pancreas, and damage to the
heart and brain. Even less than heavy consumption of
alcohol is associated with significant risks. Consuming
more than one drink per day for women and two drinks per
day for men increases the risk for motor vehicle accidents,
other injuries, high blood pressure, stroke, violence, some
KEY RECOMMENDATIONS
• Those who choose to drink alcoholic beverages should
do so sensibly and in moderation—defined as the
consumption of up to one drink per day for women and
up to two drinks per day for men.
• Alcoholic beverages should not be consumed by some
individuals, including those who cannot restrict their
alcohol intake, women of childbearing age who may
become pregnant, pregnant and lactating women, chil
dren and adolescents, individuals taking medications
that can interact with alcohol, and those with specific
medical conditions.
• Alcoholic beverages should be avoided by individuals
engaging in activities that require attention, skill, or
coordination, such as driving or operating machinery.
types of cancer, and suicide. Compared with women who
do not drink, women who consume one drink per day
appear to have a slightly higher risk of breast cancer.
Studies suggest adverse effects even at moderate alcohol
consumption levels in specific situations and individuals.
Individuals in some situations should avoid alcohol—those
who plan to drive, operate machinery, or take part in other
activities that require attention, skill, or coordination. Some
people, including children and adolescents, women of
childbearing age who may become pregnant, pregnant
and lactating women, individuals who cannot restrict
alcohol intake, individuals taking medications that can
interact with alcohol, and individuals with specific medical
conditions should not drink at all. Even moderate drinking
during pregnancy may have behavioral or developmental
consequences for the baby. Heavy drinking during preg
nancy can produce a range of behavioral and psychosocial
problems, malformation, and mental retardation in the baby.
Alcoholic beverages
supply calories but
few essential nutrients.
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Moderate alcohol consumption may have beneficial health
effects in some individuals. In middleaged and older
adults, a daily intake of one to two alcoholic beverages
per day is associated with the lowest allcause mortality.
More specifically, compared to nondrinkers, adults who
consume one to two alcoholic beverages a day appear
to have a lower risk of coronary heart disease. In contrast,
among younger adults alcohol consumption appears to
provide little, if any, health benefit, and alcohol use among
young adults is associated with a higher risk of traumatic
injury and death. As noted previously, a number of strate
gies reduce the risk of chronic disease, including a healthful
diet, physical activity, avoidance of smoking, and mainte
nance of a healthy weight. Furthermore, it is not
recommended that anyone begin drinking or drink more
frequently on the basis of health considerations.
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TABLE 16. Calories in Selected Alcoholic Beverages
This table is a guide to estimate the caloric intake from various alcoholic beverages. An example serving volume and the calories in that drink are shown for beer,
wine, and distilled spirits. Higher alcohol content (higher percent alcohol or higher proof) and mixing alcohol with other beverages, such as calorically sweetened
soft drinks, tonic water, fruit juice, or cream, increases the amount of calories in the beverage. Alcoholic beverages supply calories but provide few essential nutrients.
Beverage
Approximate Calories
a
Per 1 Fluid Oz
Example Serving
Volume
Approximate Total
b
Calories
12
12 oz
144
Beer (light)
9
12 oz
108
White wine
20
5 oz
100
Red wine
21
5 oz
105
Sweet dessert wine
47
3 oz
141
80 proof distilled spirits
(gin, rum, vodka, whiskey)
64
1.5 oz
96
Beer (regular)
a Source: Agricultural Research Service (ARS) Nutrient Database for Standard Reference (SR), Release 17. (http://www.nal.usda.gov/fnic/foodcomp/index.html) Calories are calculated to the nearest
whole number per 1 fluid oz.
b The total calories and alcohol content vary depending on the brand. Moreover, adding mixers to an alcoholic beverage can contribute calories in addition to the calories from the alcohol itself.
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chapter
10
Food Safety
OVERVIEW
DISCUSSION
Avoiding foods that are contaminated with harmful
bacteria, viruses, parasites, toxins, and chemical and
physical contaminants are vital for healthful eating. The
signs and symptoms of foodborne illness range from
gastrointestinal symptoms, such as upset stomach, diarrhea, fever, vomiting, abdominal cramps, and dehydration,
to more severe systemic illness, such as paralysis and
meningitis. It is estimated that every year about 76 million
people in the United States become ill from pathogens in
food; of these, about 5,000 die. Consumers can take simple
measures to reduce their risk of foodborne illness, especially
in the home.
The most important food safety problem is microbial
foodborne illness. All those who handle food, including
farmers, food producers, individuals who work in markets
and food service establishments, and other food preparers,
have a responsibility to keep food as safe as possible. To
keep food safe, people who prepare food should clean
hands, food contact surfaces, and fruits and vegetables;
separate raw, cooked, and ready-to-eat foods; cook foods
to a safe internal temperature; chill perishable food
promptly; and defrost food properly. For more important
information on cooking, cleaning, separating, and chilling,
see www.fightbac.org.
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48
KEY RECOMMENDATIONS
Consumers can
take simple measures
to reduce their risk
of foodborne illness,
especially in the home.
When preparing and consuming food, it is essential to
wash hands often, particularly before and after preparing
food, especially after handling raw meat, poultry, eggs, or
seafood. A good hand washing protocol includes wetting
hands; applying soap; rubbing hands vigorously together
for 20 seconds; rinsing hands thoroughly under clean,
running warm water; and drying hands completely using
a clean disposable or cloth towel.
Washing may be the only method that consumers have to
reduce pathogen load on fresh produce that will not be
either peeled or subsequently cooked. A good protocol for
washing fresh fruits and vegetables includes removing
and discarding outer leaves, washing produce just before
cooking or eating, washing under running potable water,
scrubbing with a clean brush or with hands, and drying
the fruits or vegetables using a clean disposable or cloth
towel. Free moisture on produce may promote survival and
growth of microbial populations. Therefore, drying the food
is critical if the item will not be eaten or cooked right away.
People should read the labels of bagged produce to deter
mine if it is readytoeat. Readytoeat, prewashed bagged
produce can be used without further washing if kept
refrigerated and used by the “useby” date. If desired,
prewashed, readytoeat produce can be washed again.
Raw meat and poultry should not be washed because this
creates the danger of crosscontamination and is not neces
sary. Washing these foods can allow most bacteria that are
present on the surface of the meat or poultry to spread to
readytoeat foods, kitchen utensils, and counter surfaces.
• To avoid microbial foodborne illness:
• Clean hands, food contact surfaces, and fruits
and vegetables. Meat and poultry should not
be washed or rinsed.
• Separate raw, cooked, and readytoeat foods
while shopping, preparing, or storing foods.
• Cook foods to a safe temperature to kill
microorganisms.
• Chill (refrigerate) perishable food promptly and
defrost foods properly.
• Avoid raw (unpasteurized) milk or any products
made from unpasteurized milk, raw or partially
cooked eggs or foods containing raw eggs, raw
or undercooked meat and poultry, unpasteurized
juices, and raw sprouts.
Key Recommendations for Specific Population Groups
• Infants and young children, pregnant women, older
adults, and those who are immunocompromised. Do
not eat or drink raw (unpasteurized) milk or any products
made from unpasteurized milk, raw or partially cooked
eggs or foods containing raw eggs, raw or undercooked
meat and poultry, raw or undercooked fish or shellfish,
unpasteurized juices, and raw sprouts.
• Pregnant women, older adults, and those who are
immunocompromised: Only eat certain deli meats and
frankfurters that have been reheated to steaming hot.
It is important to separate raw, cooked, and readytoeat
foods while shopping, preparing, or storing. This prevents
crosscontamination from one food to another. In addition,
refrigerator surfaces can become contaminated from high
risk foods such as raw meats, poultry, fish, uncooked hot
dogs, certain deli meats, or raw vegetables. If not cleaned,
contaminated refrigerator surfaces can, in turn, serve as a
vehicle for contaminating other foods.
Uncooked and undercooked meat, poultry and eggs and
egg products are potentially unsafe. Raw meat, poultry
and eggs should always be cooked to a safe internal
temperature (see fig. 5). The best way to tell if meat, poultry
and egg dishes are cooked safely is to use a food ther
mometer. Leftover refrigerator foods should also be
reheated to the proper internal temperature. Bacteria grow
D I E TA R Y G U I D E L I N E S F O R A M E R I C A N S , 2 0 0 5
49
most rapidly in the range of 40°F and 140°F. To keep food
out of this danger zone, keep cold food cold (below 40°F)
and hot food hot (above 140°F). Figure 5 provides informa
tion for temperature rules for proper cooking and food
handling. Proper cooking makes most uncooked foods safe.
The refrigerator should be set at no higher than 40°F
and the freezer at 0°F, and these temperatures should be
checked with an appliance thermometer. Refrigerated
leftovers may become unsafe within 3 to 4 days. Despite
the appearance of a food, it may not be safe to eat. Not
all bacterial growth causes a food’s surface to discolor or
smell bad. It may be unsafe to taste fresh or leftover food
items when there is any doubt about their safety. Safe
disposal of the food is indicated if there is a question
about whether or not a food is safe to eat. “If in doubt—
throw it out.”
Considerations for Specific Population Groups
Some people may be at high risk for developing foodborne
illness. These include pregnant women and their fetuses,
young children, older adults, people with weakened
immune systems, and individuals with certain chronic
illnesses. These people should pay extra attention to food
safety advice.
D I E TA R Y G U I D E L I N E S F O R A M E R I C A N S , 2 0 0 5
For example, pregnant women, older adults, and those
who are immunocompromised are at risk of developing
listeriosis, a potentially lifethreatening illness caused by
the bacterium Listeria monocytogenes. Some deli meats
and frankfurters that have not been reheated to steaming
hot and some readytoeat foods are associated with liste
riosis and pose a highrisk to certain individuals. All these
foods should be heated to a safe internal temperature.
In addition, these individuals should take special care not
to eat or drink raw (unpasteurized) milk or any products
made from unpasteurized milk (such as some soft cheeses),
raw or partially cooked eggs or foods containing raw eggs,
raw or undercooked meat and poultry, unpasteurized
juices, and raw sprouts. They should also avoid raw or
undercooked fish or shellfish.
New information on food safety is constantly emerging.
Recommendations and precautions for people at high
risk are updated as scientists learn more about preventing
foodborne illness. Individuals in highrisk categories should
seek guidance from a healthcare provider. In addition, up
todate information is available at the Government’s food
safety website at www.foodsafety.gov.
50
Appendixes
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51
a
APPENDIX A. EATING PATTERNS 1,600, 2,000, 2600, and 3,100Calorie Levels
a
Appendix A1: The DASH Eating Plan at 1,600, 2,000, 2600, and 3,100Calorie Levels
The DASH eating plan is based on 1,600, 2,000, 2,600 and 3,100 calories. The number of daily servings in a food group vary depending on caloric needs
(see Table 3 on page 12 to determine caloric needs). This chart can aid in planning menus and food selection in restaurants and grocery stores.
Food Groups
b
Grains
1,600
Calories
2,000
Calories
2,600
Calories
3,100
Calories
Serving Sizes
Examples and Notes
Significance of Each
Food Group to
the DASH Eating Plan
6
7—8
10—11
12—13
1 slice bread,
Whole wheat bread,
Major sources of
servings
servings
servings
servings
English muffin, pita
energy and fiber
1 oz dry cereal,
1/2
cup cooked rice,
c
pasta, or cereal
bread, bagel, cereals,
grits, oatmeal, crackers,
unsalted pretzels,
and popcorn
Vegetables
3—4
4—5
5—6
6
1 cup raw leafy vegetable Tomatoes, potatoes,
servings
servings
servings
servings
1/2
cup cooked vegetable carrots, green peas,
6 oz vegetable juice
squash, broccoli,
Rich sources of
potassium,
magnesium, and fiber
turnip greens, collards,
kale, spinach, artichokes,
green beans, lima beans,
sweetpotatoes
Fruits
4
4—5
5—6
6
servings
servings
servings
servings
6 oz fruit juice
1 medium fruit
1/4
cup dried fruit
1/2
cup fresh, frozen,
or canned fruit
Apricots, bananas,
Important sources of
dates, grapes, oranges,
potassium,
orange juice, grapefruit,
magnesium, and fiber
grapefruit juice, mangoes,
melons, peaches,
pineapples, prunes, raisins,
strawberries, tangerines
Lowfat or fatfree
2—3
2—3
3
3—4
8 oz milk
Fatfree or lowfat milk,
Major sources of
dairy foods
servings
servings
servings
servings
1 cup yogurt
fatfree or lowfat
calcium and protein
11/2 oz cheese
buttermilk, fatfree or
lowfat regular
or frozen yogurt, low
fat and fatfree cheese
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52
Appendix A1: Continued
Food Groups
1,600
Calories
2,000
Calories
2,600
Calories
3,100
Calories
Serving Sizes
Examples and Notes
Significance of Each
Food Group to
the DASH Eating Plan
Meat, poultry, fish
1—2
servings
2 or less
servings
2
servings
2—3
servings
3 oz cooked meats,
poultry, or fish
Select only lean;
trim away visible fats;
broil, roast, or boil
instead of frying;
remove skin from
poultry
Rich sources of
protein and
magnesium
Nuts, seeds, legumes 3—4
servings/
week
4—5
servings/
week
1
serving
1
serving
1/3
cup or 11/2 oz nuts
2 Tbsp or 1/2 oz seeds
1/2 cup cooked dry beans
or peas
Almonds, filberts,
mixed nuts, peanuts,
walnuts, sunflower seeds,
kidney beans, lentils
Rich sources of
energy, magnesium,
potassium, protein,
and fiber
DASH has 27 percent
of calories as fat
(low in saturated fat),
including fat in
or added to foods
d
Fat and oils
2
servings
2—3
servings
3
servings
4
servings
1 tsp soft margarine
1 Tbsp lowfat mayonnaise
2 Tbsp light salad dressing
1 tsp vegetable oil
Soft margarine,
lowfat mayonnaise,
light salad dressing,
vegetable oil
(such as olive, corn,
canola, or safflower)
Sweets
0
servings
5
servings/
week
2
servings
2
servings
1 Tbsp sugar
1 Tbsp jelly or jam
1/2 oz jelly beans
8 oz lemonade
Maple syrup, sugar,
Sweets should
jelly, jam,
be low in fat
fruitflavored gelatin,
jelly beans, hard candy,
fruit punch sorbet, ices
a NIH publication No. 034082; Karanja NM et al. JADA 8:S19—27, 1999.
b Whole grains are recommended for most servings to meet fiber recommendations.
c Equals 1/2 —11/4 cups, depending on cereal type. Check the product’s Nutrition Facts Label.
d Fat content changes serving counts for fats and oils: For example, 1 Tbsp of regular salad dressing equals 1 serving; 1 Tbsp of a lowfat dressing equals 1/2 serving; 1 Tbsp of a fatfree dressing
equals 0 servings.
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53
Appendix A2. USDA Food Guide
The suggested amounts of food to consume from the basic food groups, subgroups, and oils to meet recommended nutrient intakes at 12 different calorie
levels. Nutrient and energy contributions from each group are calculated according to the nutrientdense forms of foods in each group (e.g., lean meats and
fatfree milk). The table also shows the discretionary calorie allowance that can be accommodated within each calorie level, in addition to the suggested
amounts of nutrientdense forms of foods in each group.
Daily Amount of Food From Each Group (vegetable subgroup amounts are per week)
Calorie Level
1,000
1
Food Group
1,200
1,400
1,600
1,800
2,000
2,200
2,400
2,600
2,800
3,000
3,200
Food group amounts shown in cup (c) or ounceequivalents (ozeq), with number of servings (srv) in parentheses when
it differs from the other units. See note for quantity equivalents for foods in each group.2 Oils are shown in grams (g).
Fruits
3
Vegetables
1 c
(2 srv)
1 c
(2 srv)
1.5 c
(3 srv)
1.5 c
(3 srv)
1.5 c
(3 srv)
2 c
(4 srv)
2 c
(4 srv)
2 c
(4 srv)
2 c
(4 srv)
2.5 c
(5 srv)
2.5 c
(5 srv)
2.5 c
(5 srv)
1c
(2 srv)
1.5 c
(3 srv)
1.5 c
(3 srv)
2 c
(4 srv)
2.5 c
(5 srv)
2.5 c
(5 srv)
3 c
(6 srv)
3 c
(6 srv)
3.5 c
(7 srv)
3.5 c
(7 srv)
4 c
(8 srv)
4 c
(8 srv)
2 c/wk
3 c/wk
1.5 c/wk
2 c/wk
2.5 c/wk
3 c/wk
2.5 c/wk 3 c/wk
5.5 c/wk 6.5 c/wk
3 c/wk
2 c/wk
3 c/wk
3 c/wk
6.5 c/wk
3 c/wk
2 c/wk
3 c/wk
6 c/wk
7 c/wk
3 c/wk
2 c/wk
3 c/wk
6 c/wk
7 c/wk
3 c/wk
2.5 c/wk
3.5 c/wk
7 c/wk
8.5 c/wk
3 c/wk
3 c/wk
3 c/wk
2.5 c/wk 2.5 c/wk 2.5 c/wk
3.5 c/wk 3.5 c/wk 3.5 c/wk
7 c/wk
9 c/wk
9 c/wk
8.5 c/wk 10 c/wk 10 c/wk
Dark green veg. 1 c/wk 1.5 c/wk 1.5 c/wk
Orange veg.
.5 c/wk
1 c/wk 1 c/wk
Legumes
.5 c/wk
1 c/wk 1 c/wk
Starchy veg.
1.5 c/wk 2.5 c/wk 2.5 c/wk
Other veg.
3.5 c/wk 4.5 c/wk 4.5 c/wk
4
Grains
3 ozeq
4 ozeq
5 ozeq
5 ozeq
6 ozeq
6 ozeq
7 ozeq
8 ozeq
9 ozeq
10 ozeq
10 ozeq
10 ozeq
1.5
1.5
2
2
2.5
2.5
3
2
3
3
3
3
3.5
3.5
4
4
4.5
4.5
5
5
5
5
5
5
2 ozeq
3 ozeq
4 ozeq
5 ozeq
6 ozeq 6.5 ozeq 6.5 ozeq
7 ozeq
7 ozeq
7 ozeq
Milk
2c
2c
2c
3 c
3 c
3 c
3 c
3 c
3 c
3 c
3 c
3 c
5
15 g
17 g
17 g
22 g
24 g
27 g
29 g
31 g
34 g
36 g
44 g
51g
165
171
171
132
195
267
290
362
410
426
512
648
Whole grains
Other grains
Lean meat
and beans
Oils
5 ozeq 5.5 ozeq
Discretionary
6
calorie allowance
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54
Notes for Appendix A2:
1 Food items included in each group and subgroup:
Fruits
All fresh, frozen, canned, and dried fruits and fruit juices: for example, oranges and orange juice, apples and apple juice, bananas, grapes, melons, berries, raisins. In developing
the food patterns, only fruits and juices with no added sugars or fats were used. See note 6 on discretionary calories if products with added sugars or fats are consumed.
Vegetables
In developing the food patterns, only vegetables with no added fats or sugars were used. See note 6 on discretionary calories if products with added fats or sugars are consumed.
• Dark green vegetables All fresh, frozen, and canned dark green vegetables, cooked or raw: for example, broccoli; spinach; romaine; collard, turnip,and mustard greens.
• Orange vegetables
All fresh, frozen, and canned orange and deep yellow vegetables, cooked or raw: for example, carrots, sweetpotatoes, winter squash, and pumpkin.
• Legumes
(dry beans and peas)
All cooked dry beans and peas and soybean products: for example, pinto beans, kidney beans, lentils, chickpeas, tofu.
(See comment under meat and beans group about counting legumes in the vegetable or the meat and beans group.)
• Starchy vegetables
All fresh, frozen, and canned starchy vegetables: for example, white potatoes, corn, green peas.
• Other vegetables
All fresh, frozen, and canned other vegetables, cooked or raw: for example, tomatoes, tomato juice, lettuce, green beans, onions.
Grains
In developing the food patterns, only grains in lowfat and lowsugar forms were used. See note 6 on discretionary calories if products that are higher in fat and/or added
sugars are consumed.
• Whole grains
All wholegrain products and whole grains used as ingredients: for example, wholewheat and rye breads, wholegrain cereals and crackers, oatmeal, and brown rice.
• Other grains
All refined grain products and refined grains used as ingredients: for example, white breads, enriched grain cereals and crackers, enriched pasta, white rice.
Meat, poultry, fish,
dry beans, eggs, and
nuts (meat & beans)
All meat, poultry, fish, dry beans and peas, eggs, nuts, seeds. Most choices should be lean or lowfat. See note 6 on discretionary calories if higher fat products are consumed.
Dry beans and peas and soybean products are considered part of this group as well as the vegetable group, but should be counted in one group only.
Milk, yogurt, and
cheese (milk)
All milks, yogurts, frozen yogurts, dairy desserts, cheeses (except cream cheese), including lactosefree and lactosereduced products. Most choices should be fatfree
or lowfat. In developing the food patterns, only fatfree milk was used. See note 6 on discretionary calories if lowfat, reducedfat, or whole milk or milk products—or milk
products that contain added sugars are consumed. Calciumfortified soy beverages are an option for those who want a nondairy calcium source.
2 Quantity equivalents for each food group:
Grains
The following each count as 1 ounceequivalent (1 serving) of grains: 1/2 cup cooked rice, pasta, or cooked cereal; 1 ounce dry pasta or rice; 1 slice bread; 1 small muffin
(1 oz); 1 cup readytoeat cereal flakes.
Fruits and vegetables
The following each count as 1 cup (2 servings) of fruits or vegetables: 1 cup cutup raw or cooked fruit or vegetable, 1 cup fruit or vegetable juice, 2 cups leafy salad greens.
Meat and beans
The following each count as 1 ounceequivalent: 1 ounce lean meat, poultry, or fish; 1 egg; 1/4 cup cooked dry beans or tofu; 1 Tbsp peanut butter; 1/2 ounce nuts or seeds.
Milk
The following each count as 1 cup (1 serving) of milk: 1 cup milk or yogurt, 11/2 ounces natural cheese such as Cheddar cheese or 2 ounces processed cheese.
Discretionary calories must be counted for all choices, except fatfree milk.
3 Explanation of vegetable subgroup amounts: Vegetable subgroup amounts are shown in this table as weekly amounts, because it would be difficult for consumers to select foods from each subgroup
daily. A daily amount that is oneseventh of the weekly amount listed is used in calculations of nutrient and energy levels in each pattern.
4 Explanation of grain subgroup amounts: The whole grain subgroup amounts shown in this table represent at least three 1ounce servings and onehalf of the total amount as whole grains for all
calorie levels of 1,600 and above. This is the minimum suggested amount of whole grains to consume as part of the food patterns. More whole grains up to all of the grains recommended may be
selected, with offsetting decreases in the amounts of other (enriched) grains. In patterns designed for younger children (1,000, 1,200, and 1,400 calories), onehalf of the total amount of grains is
shown as whole grains.
5 Explanation of oils: Oils (including soft margarine with zero trans fat) shown in this table represent the amounts that are added to foods during processing, cooking, or at the table. Oils and soft
margarines include vegetable oils and soft vegetable oil table spreads that have no trans fats. The amounts of oils listed in this table are not considered to be part of discretionary calories because
they are a major source of the vitamin E and polyunsaturated fatty acids, including the essential fatty acids, in the food pattern. In contrast, solid fats are listed separately in the discretionary calorie
table (appendix A3) because, compared with oils, they are higher in saturated fatty acids and lower in vitamin E and polyunsaturated and monounsaturated fatty acids, including essential fatty acids.
The amounts of each type of fat in the food intake pattern were based on 60% oils and/or soft margarines with no trans fats and 40% solid fat. The amounts in typical American diets are about 42%
oils or soft margarines and about 58% solid fats.
6 Explanation of discretionary calorie allowance: The discretionary calorie allowance is the remaining amount of calories in each food pattern after selecting the specified number of nutrientdense
forms of foods in each food group. The number of discretionary calories assumes that food items in each food group are selected in nutrientdense forms (that is, forms that are fatfree or lowfat
and that contain no added sugars). Solid fat and sugar calories always need to be counted as discretionary calories, as in the following examples:
• The fat in lowfat, reduced fat, or whole milk or milk products or cheese and the sugar and fat in chocolate milk, ice cream, pudding, etc.
• The fat in higher fat meats (e.g., ground beef with more than 5% fat by weight, poultry with skin, higher fat luncheon meats, sausages)
• The sugars added to fruits and fruit juices with added sugars or fruits canned in syrup
• The added fat and/or sugars in vegetables prepared with added fat or sugars
• The added fats and/or sugars in grain products containing higher levels of fats and/or sugars (e.g., sweetened cereals, higher fat crackers, pies and other pastries, cakes, cookies)
Total discretionary calories should be limited to the amounts shown in the table at each calorie level. The number of discretionary calories is lower in the 1,600calorie pattern than in the 1,000,
1,200, and 1,400calorie patterns. These lower calorie patterns are designed to meet the nutrient needs of children 2 to 8 years old. The nutrient goals for the 1,600calorie pattern are set to meet the
needs of adult women, which are higher and require that more calories be used in selections from the basic food groups. Additional information about discretionary calories, including an example of
the division of these calories between solid fats and added sugars, is provided in appendix A3.
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Appendix A3. Discretionary Calorie Allowance in the USDA Food Guide
The discretionary calorie allowance is the remaining amount of calories in each calorie level after nutrientdense forms of foods in each food group are
selected. This table shows the number of discretionary calories remaining in each calorie level if nutrientdense foods are selected. Those trying to lose
weight may choose not to use discretionary calories. For those wanting to maintain their weight, discretionary calories may be used to increase the amount
of food selected from each food group; to consume foods that are not in the lowest fat form (such as 2% milk or mediumfat meat) or that contain added
sugars; to add oil, fat, or sugars to foods; or to consume alcohol. The table shows an example of how these calories may be divided between solid fats and
added sugars.
Discretionary calories that remain at each calorie level
Food Guide
calorie level
Discretionary
1
calories
1,000
1,200
1,400
1,600
1,800
2,000
2,200
2,400
2,600
2,800
3,000
3,200
165
171
171
132
195
267
290
362
410
426
512
648
Example of division of discretionary calories: Solid fats are shown in grams (g); added sugars in grams (g) and teaspoons (tsp).
2
Solid fats
3
Added sugars
11 g
14 g
14 g
11 g
15 g
18 g
19 g
22 g
24 g
24 g
29 g
34 g
20 g
(5 tsp)
16 g
(4 tsp)
16 g
(4 tsp)
12 g
(3 tsp)
20 g
(5 tsp)
32 g
(8 tsp)
36 g
(9 tsp)
48 g
(12 tsp)
56 g
(14 tsp)
60 g
(15 tsp)
72g
(18 tsp)
96 g
(24 tsp)
1 Discretionary calories: In developing the Food Guide, food items in nutrientdense forms (that is, forms that are fatfree or lowfat and that contain no added sugars) were used. The number of
discretionary calories assumes that food items in each food group are selected in nutrientdense forms. Solid fat and sugar calories always need to be counted as discretionary calories, as in the
following examples:
The fat in lowfat, reduced fat, or whole milk or milk products or cheese and the sugar and fat in chocolate milk, ice cream, pudding, etc.
The fat in higher fat meats (e.g., ground beef with more than 5% fat by weight, poultry with skin, higher fat luncheon meats, sausages)
The sugars added to fruits and fruit juices with added sugars or fruits canned in syrup
The added fat and/or sugars in vegetables prepared with added fat or sugars
The added fats and/or sugars in grain products containing higher levels of fats and/or sugars (e.g., sweetened cereals, higher fat crackers, pies and other pastries, cakes, cookies)
Total discretionary calories should be limited to the amounts shown in the table at each calorie level. The number of discretionary calories is lower in the 1,600 calorie pattern than in the 1,000, 1,200,
and 1,400calorie patterns. These lower calorie patterns are designed to meet the nutrient needs of children 2 to 8 years old. The nutrient goals for the 1,600 calorie pattern are set to meet the needs
of adult women, which are higher and require that more calories be used in selections from the basic food groups. The calories assigned to discretionary calories may be used to increase intake from
the basic food groups; to select foods from these groups that are higher in fat or with added sugars; to add oils, solid fats, or sugars to foods or beverages; or to consume alcohol. See note 2 on
limits for solid fats.
2 Solid fats: Amounts of solid fats listed in the table represent about 7 to 8% of calories from saturated fat. Foods in each food group are represented in their lowest fat forms, such as fatfree milk and
skinless chicken. Solid fats shown in this table represent the amounts of fats that may be added in cooking or at the table, and fats consumed when higher fat items are selected from the food groups
(e.g., whole milk instead of fatfree milk, chicken with skin, or cookies instead of bread), without exceeding the recommended limits on saturated fat intake. Solid fats include meat and poultry fats
eaten either as part of the meat or poultry product or separately; milk fat such as that in whole milk, cheese, and butter; shortenings used in baked products; and hard margarines.
Solid fats and oils are separated because their fatty acid compositions differ. Solid fats are higher in saturated fatty acids, and commonly consumed oils and soft margarines with no trans fats are
higher in vitamin E and polyunsaturated and monounsaturated fatty acids, including essential fatty acids. Oils listed in appendix A2 are not considered to be part of the discretionary calorie allowance
because they are a major source of the essential fatty acids and vitamin E in the food pattern.
The gram weights for solid fats are the amounts of these products that can be included in the pattern and are not identical to the amount of lipids in these items, because some products
(margarines, butter) contain water or other ingredients, in addition to lipids.
3 Added sugars: Added sugars are the sugars and syrups added to foods and beverages in processing or preparation, not the naturally occurring sugars in fruits or milk. The amounts of added sugars
suggested in the example are NOT specific recommendations for amounts of added sugars to consume, but rather represent the amounts that can be included at each calorie level without over
consuming calories. The suggested amounts of added sugars may be helpful as part of the Food Guide to allow for some sweetened foods or beverages, without exceeding energy needs. This use of
added sugars as a calorie balance requires two assumptions: (1) that selections are made from all food groups in accordance with the suggested amounts and (2) that additional fats are used in the
amounts shown, which, together with the fats in the core food groups, represent about 2730% of calories from fat.
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APPENDIX B. FOOD SOURCES OF SELECTED NUTRIENTS
Appendix B1. Food Sources of Potassium
Food Sources of Potassium ranked by milligrams of potassium per standard amount, also showing calories in the standard amount.
(The AI for adults is 4,700 mg/day potassium.)
Potassium (mg)
Calories
Sweetpotato, baked, 1 potato (146 g)
694
131
Tomato paste, 1/4 cup
664
54
Food, Standard Amount
Beet greens, cooked, cup
655
19
Potato, baked, flesh, 1 potato (156 g)
610
145
White beans, canned, 1/2 cup
595
153
Yogurt, plain, nonfat, 8oz container
579
127
Tomato puree, cup
549
48
Clams, canned, 3 oz
534
126
1/2
1/2
Yogurt, plain, lowfat, 8oz container
531
143
Prune juice, 3/4 cup
530
136
Carrot juice, 3/4 cup
517
71
Blackstrap molasses, 1 Tbsp
498
47
Halibut, cooked, 3 oz
490
119
Soybeans, green, cooked, 1/2 cup
485
127
Tuna, yellowfin, cooked, 3 oz
484
118
Lima beans, cooked, 1/2 cup
484
104
Winter squash, cooked, 1/2 cup
448
40
Soybeans, mature, cooked, 1/2 cup
443
149
Rockfish, Pacific, cooked, 3 oz
442
103
Cod, Pacific, cooked, 3 oz
439
89
Bananas, 1 medium
422
105
Spinach, cooked, 1/2 cup
419
21
Tomato juice, cup
417
31
Tomato sauce, 1/2 cup
405
39
3/4
Peaches, dried, uncooked, 1/4 cup
398
96
Prunes, stewed, 1/2 cup
398
133
Milk, nonfat, 1 cup
382
83
Pork chop, center loin, cooked, 3 oz
382
197
Apricots, dried, uncooked, 1/4 cup
378
78
Rainbow trout, farmed, cooked, 3 oz
375
144
Pork loin, center rib (roasts), lean, roasted, 3 oz
371
190
Buttermilk, cultured, lowfat, 1 cup
370
98
Cantaloupe, medium
368
47
1%—2% milk, 1 cup
366
102—122
Honeydew melon, 1/8 medium
365
58
Lentils, cooked, 1/2 cup
365
115
1/4
Plantains, cooked, 1/2 cup slices
358
90
Kidney beans, cooked, 1/2 cup
358
112
Orange juice, 3/4 cup
355
85
Split peas, cooked, 1/2 cup
355
116
Yogurt, plain, whole milk, 8 oz container
352
138
Source: Nutrient values from Agricultural Research Service (ARS) Nutrient Database for Standard Reference, Release 17. Foods are from ARS single nutrient reports, sorted in descending order by
nutrient content in terms of common household measures. Food items and weights in the single nutrient reports are adapted from those in 2002 revision of USDA Home and Garden Bulletin No. 72,
Nutritive Value of Foods. Mixed dishes and multiple preparations of the same food item have been omitted from this table.
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Appendix B2. Food Sources of Vitamin E
Food Sources of Vitamin E ranked by milligrams of vitamin E per standard amount; also calories in the standard amount.
(All provide > 10% of RDA for vitamin E for adults, which is 15 mg α–tocopherol [AT]/day.)
Food, Standard Amount
AT (mg)
Calories
Fortified readytoeat cereals, ~1 oz
1.6—12.8
90—107
Sunflower seeds, dry roasted, 1 oz
7.4
165
Almonds, 1 oz
7.3
164
Sunflower oil, high linoleic, 1 Tbsp
5.6
120
Cottonseed oil, 1 Tbsp
4.8
120
Safflower oil, high oleic, 1 Tbsp
4.6
120
Hazelnuts (filberts), 1 oz
4.3
178
Mixed nuts, dry roasted, 1 oz
3.1
168
Turnip greens, frozen, cooked, 1/2 cup
2.9
24
Tomato paste, cup
2.8
54
Pine nuts, 1 oz
2.6
191
Peanut butter, 2 Tbsp
2.5
192
Tomato puree, 1/2 cup
2.5
48
1/4
Tomato sauce, cup
2.5
39
Canola oil, 1 Tbsp
2.4
124
1/2
Wheat germ, toasted, plain, 2 Tbsp
2.3
54
Peanuts, 1 oz
2.2
166
Avocado, raw, 1/2 avocado
2.1
161
Carrot juice, canned, 3/4 cup
2.1
71
Peanut oil, 1 Tbsp
2.1
119
Corn oil, 1 Tbsp
1.9
120
Olive oil, 1 Tbsp
1.9
119
Spinach, cooked, 1/2 cup
1.9
21
Dandelion greens, cooked, cup
1.8
18
Sardine, Atlantic, in oil, drained, 3 oz
1.7
177
Blue crab, cooked/canned, 3 oz
1.6
84
Brazil nuts, 1 oz
1.6
186
Herring, Atlantic, pickled, 3 oz
1.5
222
1/2
Source: Nutrient values from Agricultural Research Service (ARS) Nutrient Database for Standard Reference, Release 17. Foods are from ARS single nutrient reports, sorted in descending order by
nutrient content in terms of common household measures. Food items and weights in the single nutrient reports are adapted from those in 2002 revision of USDA Home and Garden Bulletin No. 72,
Nutritive Value of Foods. Mixed dishes and multiple preparations of the same food item have been omitted from this table.
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Appendix B3. Food Sources of Iron
Food Sources of Iron ranked by milligrams of iron per standard amount; also calories in the standard amount.
(All are > 10% of RDA for teen and adult females, which is 18 mg/day.)
Food, Standard Amount
Iron (mg)
Calories
23.8
126
Fortified readytoeat cereals (various), ~ 1 oz
1.8 —21.1
54—127
Oysters, eastern, wild, cooked, moist heat, 3 oz
10.2
116
5.2—9.9
134—235
4.9—8.1
Varies
Soybeans, mature, cooked, cup
4.4
149
Pumpkin and squash seed kernels, roasted, 1 oz
4.2
148
White beans, canned, cup
3.9
153
Blackstrap molasses, 1 Tbsp
3.5
47
1/2
Lentils, cooked, cup
3.3
115
Spinach, cooked from fresh, 1/2 cup
3.2
21
Clams, canned, drained, 3 oz
Organ meats (liver, giblets), various, cooked, 3 oz
a
Fortified instant cooked cereals (various), 1 packet
1/2
1/2
Beef, chuck, blade roast, lean, cooked, 3 oz
3.1
215
Beef, bottom round, lean, 0” fat, all grades, cooked, 3 oz
2.8
182
Kidney beans, cooked, 1/2 cup
2.6
112
Sardines, canned in oil, drained, 3 oz
2.5
177
Beef, rib, lean, 1/4” fat, all grades, 3 oz
2.4
195
Chickpeas, cooked, 1/2 cup
2.4
134
Duck, meat only, roasted, 3 oz
2.3
171
Lamb, shoulder, arm, lean, 1/4 ” fat, choice, cooked, 3 oz
2.3
237
Prune juice, 3/4 cup
2.3
136
Shrimp, canned, 3 oz
2.3
102
Cowpeas, cooked, cup
2.2
100
Ground beef, 15% fat, cooked, 3 oz
2.2
212
Tomato puree, cup
2.2
48
Lima beans, cooked, 1/2 cup
2.2
108
Soybeans, green, cooked, 1/2 cup
2.2
127
Navy beans, cooked, 1/2 cup
2.1
127
1/2
1/2
Refried beans, cup
2.1
118
Beef, top sirloin, lean, 0” fat, all grades, cooked, 3 oz
2.0
156
Tomato paste, 1/4 cup
2.0
54
1/2
a High in cholesterol.
Source: Nutrient values from Agricultural Research Service (ARS) Nutrient Database for Standard Reference, Release 17. Foods are from ARS single nutrient reports, sorted in descending order by
nutrient content in terms of common household measures. Food items and weights in the single nutrient reports are adapted from those in 2002 revision of USDA Home and Garden Bulletin No. 72,
Nutritive Value of Foods. Mixed dishes and multiple preparations of the same food item have been omitted from this table.
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Appendix B4. NonDairy Food Sources of Calcium
NonDairy Food Sources of Calcium ranked by milligrams of calcium per standard amount; also calories in the standard amount. The bioavailability may
a
vary. (The AI for adults is 1,000 mg/day.)
Food, Standard Amount
Fortified readytoeat cereals (various), 1 oz
Calcium (mg)
Calories
236–1043
88–106
Soy beverage, calcium fortified, 1 cup
368
98
Sardines, Atlantic, in oil, drained, 3 oz
325
177
b
Tofu, firm, prepared with nigari , 1/2 cup
253
88
Pink salmon, canned, with bone, 3 oz
181
118
Collards, cooked from frozen, 1/2 cup
178
31
Molasses, blackstrap, 1 Tbsp
172
47
Spinach, cooked from frozen, 1/2 cup
146
30
Soybeans, green, cooked, 1/2 cup
130
127
Turnip greens, cooked from frozen, 1/2 cup
124
24
Ocean perch, Atlantic, cooked, 3 oz
116
103
99—110
97—157
106
80
White beans, canned, cup
96
153
Kale, cooked from frozen, 1/2 cup
90
20
Okra, cooked from frozen, cup
88
26
Soybeans, mature, cooked, 1/2 cup
88
149
Blue crab, canned, 3 oz
86
84
Beet greens, cooked from fresh, 1/2 cup
82
19
Oatmeal, plain and flavored, instant, fortified, 1 packet prepared
Cowpeas, cooked, 1/2 cup
1/2
1/2
Pakchoi, Chinese cabbage, cooked from fresh, cup
79
10
Clams, canned, 3 oz
78
126
1/2
Dandelion greens, cooked from fresh, 1/2 cup
74
17
Rainbow trout, farmed, cooked, 3 oz
73
144
a Both calcium content and bioavailability should be considered when selecting dietary sources of calcium. Some plant foods have calcium that is well absorbed, but the large quantity of plant foods
that would be needed to provide as much calcium as in a glass of milk may be unachievable for many. Many other calciumfortified foods are available, but the percentage of calcium that can be
absorbed is unavailable for many of them.
b
Calcium sulfate and magnesium chloride.
Source: Nutrient values from Agricultural Research Service (ARS) Nutrient Database for Standard Reference, Release 17. Foods are from ARS single nutrient reports, sorted in descending order by
nutrient content in terms of common household measures. Food items and weights in the single nutrient reports are adapted from those in 2002 revision of USDA Home and Garden Bulletin No. 72,
Nutritive Value of Foods. Mixed dishes and multiple preparations of the same food item have been omitted from this table.
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Appendix B5. Food Sources of Calcium
Food Sources of Calcium ranked by milligrams of calcium per standard amount; also calories in the standard amount.
(All are > 20% of AI for adults 1950, which is 1,000 mg/day.)
Food, Standard Amount
Calcium (mg)
Calories
Plain yogurt, nonfat (13 g protein/8 oz), 8oz container
452
127
Romano cheese, 1.5 oz
452
165
Pasteurized process Swiss cheese, 2 oz
438
190
Plain yogurt, lowfat (12 g protein/8 oz), 8oz container
415
143
Fruit yogurt, lowfat (10 g protein/8 oz), 8oz container
345
232
Swiss cheese, 1.5 oz
336
162
Ricotta cheese, part skim, cup
335
170
Pasteurized process American cheese food, 2 oz
323
188
Provolone cheese, 1.5 oz
321
150
Mozzarella cheese, partskim, 1.5 oz
311
129
Cheddar cheese, 1.5 oz
307
171
Fatfree (skim) milk, 1 cup
306
83
Muenster cheese, 1.5 oz
305
156
1% lowfat milk, 1 cup
290
102
Lowfat chocolate milk (1%), 1 cup
288
158
2% reduced fat milk, 1 cup
285
122
Reduced fat chocolate milk (2%), 1 cup
285
180
Buttermilk, lowfat, 1 cup
284
98
Chocolate milk, 1 cup
280
208
Whole milk, 1 cup
276
146
Yogurt, plain, whole milk (8 g protein/8 oz), 8oz container
275
138
Ricotta cheese, whole milk, 1/2 cup
255
214
Blue cheese, 1.5 oz
225
150
Mozzarella cheese, whole milk, 1.5 oz
215
128
Feta cheese, 1.5 oz
210
113
1/2
Source: Nutrient values from Agricultural Research Service (ARS) Nutrient Database for Standard Reference, Release 17. Foods are from ARS single nutrient reports, sorted in descending order by
nutrient content in terms of common household measures. Food items and weights in the single nutrient reports are adapted from those in 2002 revision of USDA Home and Garden Bulletin No. 72,
Nutritive Value of Foods. Mixed dishes and multiple preparations of the same food item have been omitted from this table.
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Appendix B6. Food Sources of Vitamin A
Food Sources of Vitamin A ranked by micrograms Retinol Activity Equivalents (RAE) of vitamin A per standard amount; also calories in the standard amount.
(All are > 20% of RDA for adult men, which is 900 mg/day RAE.)
Food, Standard Amount
a
Organ meats (liver, giblets), various, cooked, 3 oz
Vitamin A (µg RAE)
Calories
1490—9126
134—235
Carrot juice, 3 /4 cup
1692
71
Sweetpotato with peel, baked, 1 medium
1096
103
953
42
Carrots, cooked from fresh, cup
671
27
Spinach, cooked from frozen, 1/2 cup
573
30
Collards, cooked from frozen, cup
489
31
Kale, cooked from frozen, 1/2 cup
478
20
Mixed vegetables, canned, 1/2 cup
474
40
Turnip greens, cooked from frozen, 1/2 cup
441
24
Pumpkin, canned, 1/2 cup
1/2
1/2
Instant cooked cereals, fortified, prepared, 1 packet
285—376
75—97
Various readytoeat cereals, with added vit. A, ~1 oz
180—376
100—117
Carrot, raw, 1 small
301
20
Beet greens, cooked, 1/2 cup
276
19
Winter squash, cooked, cup
268
38
Dandelion greens, cooked, 1/2 cup
260
18
Cantaloupe, raw, medium melon
233
46
Mustard greens, cooked, 1/2 cup
221
11
Pickled herring, 3 oz
219
222
Red sweet pepper, cooked, 1/2 cup
186
19
Chinese cabbage, cooked, cup
180
10
1/2
1/4
1/2
a High in cholesterol.
Source: Nutrient values from Agricultural Research Service (ARS) Nutrient Database for Standard Reference, Release 17. Foods are from ARS single nutrient reports, sorted in descending order by
nutrient content in terms of common household measures. Food items and weights in the single nutrient reports are adapted from those in 2002 revision of USDA Home and Garden Bulletin No. 72,
Nutritive Value of Foods. Mixed dishes and multiple preparations of the same food item have been omitted from this table.
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Appendix B7. Food Sources of Magnesium
Food Sources of Magnesium ranked by milligrams of magnesium per standard amount; also calories in the standard amount.
(All are > 10% of RDA for adult men, which is 420 mg/day.)
Food, Standard Amount
Magnesium (mg)
Calories
151
148
Brazil nuts, 1 oz
107
186
Bran readytoeat cereal (100%), ~1 oz
103
74
Pumpkin and squash seed kernels, roasted, 1 oz
Halibut, cooked, 3 oz
91
119
Quinoa, dry, 1/4 cup
89
159
Spinach, canned, 1/2 cup
81
25
Almonds, 1 oz
78
164
Spinach, cooked from fresh, 1/2 cup
78
20
Buckwheat flour, 1/4 cup
75
101
Cashews, dry roasted, 1 oz
74
163
Soybeans, mature, cooked, 1/2 cup
74
149
Pine nuts, dried, 1 oz
71
191
Mixed nuts, oil roasted, with peanuts, 1 oz
67
175
White beans, canned, 1/2 cup
67
154
Pollock, walleye, cooked, 3 oz
62
96
Black beans, cooked, cup
60
114
Bulgur, dry, 1/4 cup
57
120
1/2
Oat bran, raw, 1/4 cup
55
58
Soybeans, green, cooked, 1/2 cup
54
127
Tuna, yellowfin, cooked, 3 oz
54
118
Artichokes (hearts), cooked, 1/2 cup
50
42
Peanuts, dry roasted, 1 oz
50
166
Lima beans, baby, cooked from frozen, 1/2 cup
50
95
Beet greens, cooked, cup
49
19
Navy beans, cooked, 1/2 cup
48
127
Tofu, firm, prepared with nigari , 1/2 cup
47
88
Okra, cooked from frozen, 1/2 cup
47
26
Soy beverage, 1 cup
47
127
Cowpeas, cooked, 1/2 cup
46
100
Hazelnuts, 1 oz
46
178
Oat bran muffin, 1 oz
45
77
Great northern beans, cooked, cup
44
104
Oat bran, cooked, 1/2 cup
44
44
1/2
a
1/2
Buckwheat groats, roasted, cooked, cup
43
78
Brown rice, cooked, 1/2 cup
42
108
Haddock, cooked, 3 oz
42
95
1/2
a Calcium sulfate and magnesium chloride.
Source: Nutrient values from Agricultural Research Service (ARS) Nutrient Database for Standard Reference, Release 17. Foods are from ARS single nutrient reports, sorted in descending order by
nutrient content in terms of common household measures. Food items and weights in the single nutrient reports are adapted from those in 2002 revision of USDA Home and Garden Bulletin No. 72,
Nutritive Value of Foods. Mixed dishes and multiple preparations of the same food item have been omitted from this table.
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Appendix B8. Food Sources of Dietary Fiber
Food Sources of Dietary Fiber ranked by grams of dietary fiber per standard amount; also calories in the standard amount.
(All are >10% of AI for adult women, which is 25 grams/day.)
Food, Standard Amount
Navy beans, cooked, 1/2 cup
Dietary Fiber (g)
Calories
9.5
128
Bran readytoeat cereal (100%), cup
8.8
78
Kidney beans, canned, 1/2 cup
8.2
109
Split peas, cooked, 1/2 cup
8.1
116
Lentils, cooked, 1/2 cup
7.8
115
1/2
Black beans, cooked, 1/2 cup
7.5
114
Pinto beans, cooked, 1/2 cup
7.7
122
Lima beans, cooked, 1/2 cup
6.6
108
Artichoke, globe, cooked, 1 each
6.5
60
White beans, canned, cup
6.3
154
Chickpeas, cooked, 1/2 cup
6.2
135
1/2
Great northern beans, cooked, cup
6.2
105
Cowpeas, cooked, 1/2 cup
5.6
100
1/2
Soybeans, mature, cooked, 1/2 cup
Bran readytoeat cereals, various, ~1 oz
5.2
149
2.6—5.0
90—108
Crackers, rye wafers, plain, 2 wafers
5.0
74
Sweetpotato, baked, with peel, l medium (146 g)
4.8
131
Asian pear, raw, 1 small
4.4
51
Green peas, cooked, 1/2 cup
4.4
67
Wholewheat English muffin, 1 each
4.4
134
Pear, raw, 1 small
4.3
81
Bulgur, cooked, cup
4.1
76
Mixed vegetables, cooked, 1/2 cup
4.0
59
Raspberries, raw, 1/2 cup
4.0
32
Sweetpotato, boiled, no peel, 1 medium (156 g)
3.9
119
Blackberries, raw, 1/2 cup
3.8
31
Potato, baked, with skin, 1 medium
3.8
161
1/2
Soybeans, green, cooked, 1/2 cup
3.8
127
Stewed prunes, 1/2 cup
3.8
133
Figs, dried, 1/4 cup
3.7
93
Dates, 1/4 cup
3.6
126
Oat bran, raw, 1/4 cup
3.6
58
Pumpkin, canned, 1/2 cup
3.6
42
Spinach, frozen, cooked, cup
3.5
30
2.8—3.4
96
Almonds, 1 oz
3.3
164
Apple with skin, raw, 1 medium
3.3
72
Brussels sprouts, frozen, cooked, cup
3.2
33
Wholewheat spaghetti, cooked, 1/2 cup
3.1
87
1/2
Shredded wheat readytoeat cereals, various, ~1 oz
1/2
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Appendix B8: Continued
Food, Standard Amount
Banana, 1 medium
Dietary Fiber (g)
Calories
3.1
105
Orange, raw, 1 medium
3.1
62
Oat bran muffin, 1 small
3.0
178
Guava, 1 medium
3.0
37
Pearled barley, cooked, 1/2 cup
3.0
97
Sauerkraut, canned, solids, and liquids, cup
3.0
23
Tomato paste, 1/4 cup
2.9
54
1/2
Winter squash, cooked, 1/2 cup
2.9
38
Broccoli, cooked, 1/2 cup
2.8
26
Parsnips, cooked, chopped, 1/2 cup
2.8
55
Turnip greens, cooked, 1/2 cup
2.5
15
Collards, cooked, cup
2.7
25
Okra, frozen, cooked, 1/2 cup
2.6
26
Peas, ediblepodded, cooked, 1/2 cup
2.5
42
1/2
Source: ARS Nutrient Database for Standard Reference, Release 17. Foods are from single nutrient reports, which are sorted either by food description or in descending order by nutrient content in
terms of common household measures. The food items and weights in these reports are adapted from those in 2002 revision of USDA Home and Garden Bulletin No. 72, Nutritive Value of Foods.
Mixed dishes and multiple preparations of the same food item have been omitted.
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Appendix B9. Food Sources of Vitamin C
Food Sources of Vitamin C ranked by milligrams of vitamin C per standard amount; also calories in the standard amount.
(All provide > 20% of RDA for adult men, which is 90 mg/day.)
Food, Standard Amount
Vitamin C (mg)
Calories
188
56
Red sweet pepper, raw, cup
142
20
Red sweet pepper, cooked, 1/2 cup
116
19
Kiwi fruit, 1 medium
70
46
Orange, raw, 1 medium
70
62
61—93
79—84
60
15
Guava, raw, 1/2 cup
1/2
Orange juice,
3 /4
cup
Green pepper, sweet, raw, 1/2 cup
Green pepper, sweet, cooked, cup
51
19
50—70
71—86
Vegetable juice cocktail, 3 /4 cup
50
34
Strawberries, raw, 1/2 cup
49
27
Brussels sprouts, cooked, cup
48
28
Cantaloupe, 1/4 medium
47
51
1/2
Grapefruit juice, 3 /4 cup
1/2
Papaya, raw, medium
47
30
Kohlrabi, cooked, 1/2 cup
45
24
1/4
Broccoli, raw, 1/2 cup
39
15
Edible pod peas, cooked, 1/2 cup
38
34
Broccoli, cooked, 1/2 cup
37
26
Sweetpotato, canned, 1/2 cup
34
116
Tomato juice, 3 /4 cup
33
31
Cauliflower, cooked, 1/2 cup
28
17
Pineapple, raw, cup
28
37
Kale, cooked, 1/2 cup
27
18
Mango, cup
23
54
1/2
1/2
Source: Nutrient values from Agricultural Research Service (ARS) Nutrient Database for Standard Reference, Release 17. Foods are from ARS single nutrient reports, sorted in descending order by
nutrient content in terms of common household measures. Food items and weights in the single nutrient reports are adapted from those in 2002 revision of USDA Home and Garden Bulletin No. 72,
Nutritive Value of Foods. Mixed dishes and multiple preparations of the same food item have been omitted from this table.
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APPENDIX C. GLOSSARY OF TERMS
Acceptable Macronutrient Distribution Ranges (AMDR)—Range of intake
Chronic Diseases—such as heart disease, cancer, and diabetes—are the
for a particular energy source that is associated with reduced risk of chronic
leading causes of death and disability in the United States. These diseases
disease while providing intakes of essential nutrients. If an individual
account for 7 of every 10 deaths and affect the quality of life of 90 million
consumes in excess of the AMDR, there is a potential of increasing the risk
Americans. Although chronic diseases are among the most common and
of chronic diseases and/or insufficient intakes of essential nutrients.
costly health problems, they are also among the most preventable.
Adopting healthy behaviors such as eating nutritious foods, being physically
Added Sugars—Sugars and syrups that are added to foods during
processing or preparation. Added sugars do not include naturally occurring
active, and avoiding tobacco use can prevent or control the devastating
effects of these diseases.
sugars such as those that occur in milk and fruits.
Coronary Heart Disease—A narrowing of the small blood vessels that
Adequate Intakes (AI)—A recommended average daily nutrient intake level
supply blood and oxygen to the heart (coronary arteries).
based on observed or experimentally determined approximations or esti
mates of mean nutrient intake by a group (or groups) of apparently
Daily Food Intake Pattern—Identifies the types and amounts of foods that
healthy people. The AI is used when the Estimated Average Requirement
are recommended to be eaten each day and that meet specific nutritional
cannot be determined.
goals. (Federal Register Notice, vol. 68, no. 176, p. 53536, Thursday,
September 11, 2003)
Basic Food Groups—In the USDA food intake patterns, the basic food
groups are grains; fruits; vegetables; milk, yogurt, and cheese; and meat,
Danger Zone—The temperature that allows bacteria to multiply rapidly and
poultry, fish, dried peas and beans, eggs, and nuts. In the DASH Eating Plan,
produce toxins, between 40°F and 140°F. To keep food out of this danger
nuts, seeds, and dry beans are a separate food group from meat, poultry,
zone, keep cold food cold and hot food hot. Keep food cold in the refriger
fish, and eggs.
ator, in coolers, or on ice in the service line. Keep hot food in the oven, in
heated chafing dishes, or in preheated steam tables, warming trays, and/or
Body Mass Index (BMI)—BMI is a practical measure for approximating total
body fat and is a measure of weight in relation to height. It is calculated as
weight in kilograms divided by the square of the height in meters.
Cardiovascular Disease—Refers to diseases of the heart and diseases of the
blood vessel system (arteries, capillaries, veins) within a person’s entire
body, such as the brain, legs, and lungs.
Cholesterol—A sterol present in all animal tissues. Free cholesterol is a
component of cell membranes and serves as a precursor for steroid
hormones, including estrogen, testosterone, aldosterone, and bile acids.
Humans are able to synthesize sufficient cholesterol to meet biologic require
ments, and there is no evidence for a dietary requirement for cholesterol.
• Dietary cholesterol—Consumed from foods of animal origin, including
meat, fish, poultry, eggs, and dairy products. Plant foods, such as grains,
fruits and vegetables, and oils from these sources contain no dietary
cholesterol.
• Serum cholesterol—Travels in the blood in distinct particles containing
both lipids and proteins. Three major classes of lipoproteins are found
in the serum of a fasting individual: lowdensity lipoprotein (LDL), high
density lipoprotein (HDL), and verylowdensity lipoprotein (VLDL).
Another lipoprotein class, intermediatedensity lipoprotein (IDL),
resides between VLDL and LDL; in clinical practice, IDL is included in
the LDL measurement.
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slow cookers. Never leave perishable foods, such as meat, poultry, eggs,
and casseroles, in the danger zone longer than 2 hours or longer than 1
hour in temperatures above 90°F.
Dietary Fiber—Nonstarch polysaccharides and lignin that are not digested
by enzymes in the small intestine. Dietary fiber typically refers to nondi
gestable carbohydrates from plant foods.
Dietary Reference Intakes (DRIs)—A set of nutrientbased reference values
that expand upon and replace the former Recommended Dietary
Allowances (RDAs) in the United States and the Recommended Nutrient
Intakes (RNIs) in Canada. They are actually a set of four reference values:
Estimated Average Requirements (EARs), RDAs, AIs, and Tolerable Upper
Intake Levels (ULs).
Discretionary Calorie Allowance—The balance of calories remaining in a
person’s energy allowance after accounting for the number of calories
needed to meet recommended nutrient intakes through consumption of
foods in lowfat or no added sugar forms. The discretionary calorie
allowance may be used in selecting forms of foods that are not the most
nutrientdense (e.g., whole milk rather than fatfree milk) or may be addi
tions to foods (e.g., salad dressing, sugar, butter).
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Energy Allowance—A person’s energy allowance is the calorie intake at
which weight maintenance occurs.
Estimated Average Requirements—EAR is the average daily nutrient intake
level estimated to meet the requirement of half the healthy individuals in a
particular life stage and gender group.
Listeriosis—A serious infection caused by eating food contaminated with the
bacterium Listeria monocytogenes, which has recently been recognized as
an important public health problem in the United States. The disease affects
primarily pregnant women, their fetuses, newborns, and adults with weak
ened immune systems. Listeria is killed by pasteurization and cooking;
however, in certain readytoeat foods, such as hot dogs and deli meats,
Estimated Energy Requirement—The EER represents the average dietary
contamination may occur after cooking/manufacture but before packaging.
energy intake that will maintain energy balance in a healthy person of a
Listeria monocytogenes can survive at refrigerated temperatures.
given gender, age, weight, height, and physical activity level.
FDAMA—The Food and Drug Administration Modernization Act, enacted
Nov. 21, 1997, amended the Federal Food, Drug, and Cosmetic Act relating
to the regulation of food, drugs, devices, and biological products. With the
passage of FDAMA, Congress enhanced FDA’s mission in ways that recog
Macronutrient—The dietary macronutrient groups are carbohydrates,
proteins, and fats.
Micronutrient—Vitamins and minerals that are required in the human diet
in very small amounts.
nized the Agency would be operating in a 21st century characterized by
Moderate Physical Activity—Any activity that burns 3.5 to 7 kcal/min or
increasing technological, trade, and public health complexities.
the equivalent of 3 to 6 metabolic equivalents (METs) and results in
FightBAC!—A national public education campaign to promote food safety to
consumers and educate them on how to handle and prepare food safely. In
this campaign, pathogens are represented by a cartoonlike bacteria char
acter named “BAC.”
Foodborne Disease—Caused by consuming contaminated foods or bever
ages. Many different diseasecausing microbes, or pathogens, can
contaminate foods, so there are many different foodborne infections. In
addition, poisonous chemicals, or other harmful substances, can cause
foodborne diseases if they are present in food. The most commonly recog
nized foodborne infections are those caused by the bacteria Campylobacter,
achieving 60 to 73 percent of peak heart rate. An estimate of a person’s
peak heart rate can be obtained by subtracting the person’s age from 220.
Examples of moderate physical activity include walking briskly, mowing the
lawn, dancing, swimming, or bicycling on level terrain. A person should
feel some exertion but should be able to carry on a conversation comfort
ably during the activity.
Monounsaturated Fatty Acids—Monounsaturated fatty acids (MUFAs) have
one double bond. Plant sources that are rich in MUFAs include vegetable
oils (e.g., canola oil, olive oil, high oleic safflower and sunflower oils) that
are liquid at room temperature and nuts.
Salmonella, and E. coli O157:H7, and by a group of viruses called calicivirus,
NutrientDense Foods—Nutrientdense foods are those that provide
also known as the Norwalk and Norwalklike viruses.
substantial amounts of vitamins and minerals and relatively fewer calories.
Heme Iron—One of two forms of iron occurring in foods. Heme iron is
OunceEquivalent—In the grains food group, the amount of a food counted
bound within the ironcarrying proteins (hemoglobin and myoglobin) found
as equal to a oneounce slice of bread; in the meat, poultry, fish, dry beans,
in meat, poultry, and fish. While it contributes a smaller portion of iron to
eggs, and nuts food group, the amount of food counted as equal to one
typical American diets than nonheme iron, a larger proportion of heme
ounce of cooked meat, poultry, or fish. Examples are listed in table 1 and
iron is absorbed.
appendix A1.
High Fructose Corn Syrup (HFCS)—A corn sweetener derived from the wet
n6 PUFAs—Linoleic acid, one of the n6 fatty acids, is required but cannot
milling of corn. Cornstarch is converted to a syrup that is nearly all dextrose.
be synthesized by humans and, therefore, is considered essential in the diet.
HFCS is found in numerous foods and beverages on the grocery store shelves.
Primary sources are liquid vegetable oils, including soybean oil, corn oil,
Hydrogenation—A chemical reaction that adds hydrogen atoms to an
unsaturated fat, thus saturating it and making it solid at room temperature.
LeisureTime Physical Activity—Physical activity that is performed during
exercise, recreation, or any additional time other than that associated with
one’s regular job duties, occupation, or transportation.
and safflower oil.
n3 PUFAs—αlinolenic acid is an n3 fatty acid that is required because it is
not synthesized by humans and, therefore, is considered essential in the diet.
It is obtained from plant sources, including soybean oil, canola oil, walnuts,
and flaxseed. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)
are long chain n3 fatty acids that are contained in fish and shellfish.
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Pathogen—Any microorganism that can cause or is capable of causing disease.
Polyunsaturated Fatty Acids—Polyunsaturated fatty acids (PUFAs) have two
or more double bonds and may be of two types, based on the position of
the first double bond.
Portion Size—The amount of a food consumed in one eating occasion.
Recommended Dietary Allowance (RDA)—The dietary intake level that is
Vegetarian—There are several categories of vegetarians, all of whom avoid
meat and/or animal products. The vegan or total vegetarian diet includes
only foods from plants: fruits, vegetables, legumes (dried beans and peas),
grains, seeds, and nuts. The lactovegetarian diet includes plant foods plus
cheese and other dairy products. The ovolactovegetarian (or lactoovovege
tarian) diet also includes eggs. Semivegetarians do not eat red meat but
include chicken and fish with plant foods, dairy products, and eggs.
sufficient to meet the nutrient requirement of nearly all (97 to 98 percent)
Vigorous Physical Activity—Any activity that burns more than 7 kcal/min or
healthy individuals in a particular life stage and gender group.
the equivalent of 6 or more metabolic equivalents (METs) and results in
Resistance Exercise—Anaerobic training, including weight training, weight
machine use, and resistance band workouts. Resistance training will
increase strength, muscular endurance, and muscle size, while running
and jogging will not.
achieving 74 to 88 percent of peak heart rate. An estimate of a person’s
peak heart rate can be obtained by subtracting the person’s age from 220.
Examples of vigorous physical activity include jogging, mowing the lawn
with a nonmotorized push mower, chopping wood, participating in high
impact aerobic dancing, swimming continuous laps, or bicycling uphill.
Saturated Fatty Acids—Saturated fatty acids have no double bonds. They
Vigorousintensity physical activity may be intense enough to represent a
primarily come from animal products such as meat and dairy products. In
substantial challenge to an individual and results in a significant increase in
general, animal fats are solid at room temperature.
heart and breathing rate.
Sedentary Behaviors—In scientific literature, sedentary is often defined in
WeightBearing Exercise—Any activity one performs that works bones and
terms of little or no physical activity during leisure time. A sedentary lifestyle
muscles against gravity, including walking, running, hiking, dancing, gymnas
is a lifestyle characterized by little or no physical activity.
tics, and soccer.
Serving Size—A standardized amount of a food, such as a cup or an
Whole Grains—Foods made from the entire grain seed, usually called the
ounce, used in providing dietary guidance or in making comparisons
kernel, which consists of the bran, germ, and endosperm. If the kernel has
among similar foods.
been cracked, crushed, or flaked, it must retain nearly the same relative
Tolerable Upper Intake Level (UL)—The highest average daily nutrient
intake level likely to pose no risk of adverse health affects for nearly all indi
proportions of bran, germ, and endosperm as the original grain in order to
16
be called whole grain.
viduals in a particular life stage and gender group. As intake increases above
the UL, the potential risk of adverse health affects increases.
Trans fatty acids—Trans fatty acids, or trans fats, are unsaturated fatty acids
that contain at least one nonconjugated double bond in the trans configu
ration. Sources of trans fatty acids include hydrogenated/partially
hydrogenated vegetable oils that are used to make shortening and commer
cially prepared baked goods, snack foods, fried foods, and margarine. Trans
fatty acids also are present in foods that come from ruminant animals (e.g.,
cattle and sheep). Such foods include dairy products, beef, and lamb.
16
AACC Press Release, AACC To Create ConsumerFriendly Whole Grain Definition, March 5, 2004. http://www.aaccnet.org/news/CFWholeGrain.asp.
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APPENDIX D. ACRONYMS
AI—Adequate Intakes
AMDR—Acceptable Macronutrient Distribution Range
ARS—Agricultural Research Service
BMI—Body Mass Index
CSFII—Continuing Survey of Food Intakes by Individuals
DASH—Dietary Approaches to Stop Hypertension
DFE—Dietary Folate Equivalent
DHA—Docosahexaenoic acid
DRI—Dietary Reference Intake
DV—Daily Value
EAR—Estimated Average Requirement
EER—Estimated Energy Requirement
EPA—Eicosapentaenoic acid
FDA—Food and Drug Administration
FDAMA—Food and Drug Administration Modernization Act
HDL—Highdensity lipoprotein
HHS—U.S. Department of Health and Human Services
IU—International unit
LDL—Lowdensity lipoprotein
RAE—Retinol Activity Equivalent
RDA—Recommended Dietary Allowance
USDA—U.S. Department of Agriculture
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NOTES
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This publication, as well as the booklet, Finding Your Way to a Healthier You, may be viewed and downloaded from the
Internet at www.healthierus.gov/dietaryguidelines.
To purchase printed copies of this publication (Stock Number 001-000-04719-1) or the booklet, Finding Your Way to a
Healthier You (Stock Number 001-000-04718-3), call the U.S. Government Printing Office toll-free at (866) 512-1800, or access
the GPO Online Bookstore at http://bookstore.gpo.gov.
Suggested citation: U.S. Department of Health and Human Services and U.S. Department of Agriculture. Dietary Guidelines
for Americans, 2005. 6th Edition, Washington, DC: U.S. Government Printing Office, January 2005.
The U.S. Departments of Agriculture (USDA) and Health and Human Services (HHS) prohibit discrimination in their programs and activities on the
basis of race, color, national origin, sex, religion, age, disability, political beliefs, sexual orientation, or marital or family status. (Not all prohibited
bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print,
audiotape, etc.) should contact USDA’s TARGET Center at (202) 720-2600 (voice and TDD).
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 14th and Independence Avenue,
SW, Washington, DC 20250-9410 or call (202) 720-5964 (voice and TDD). USDA and HHS are equal opportunity providers and employers.
HHS Publication number: HHS-ODPHP-2005-01-DGA-A
USDA Publication number: Home and Garden Bulletin No. 232
| File Type | application/pdf |
| File Title | 15822_TextFinal_508 |
| Author | Elizabeth Kaney |
| File Modified | 2005-05-16 |
| File Created | 2005-03-07 |