A Healthy Diet
I.
Principles and Guidelines
Diet planning guides and dietary guidelines are tools that apply principles of good eating and offer
practical advice on healthy habits. Using the diet planning tools together allows individuals to plan
nutrient-dense, well-balanced diets that provide variety and moderation without excessive energy.
Consuming food wisely and practicing healthy habits support overall health.
A. Diet-Planning Principles
1. Adequacy (dietary)—providing sufficient energy and essential nutrients for healthy people
2. Balance (dietary)—consuming the right proportion of foods
3. kcalorie (energy) control—balancing the amount of foods and energy to sustain physical
activities and metabolic needs
4. Nutrient density—measuring the nutrient content of a food relative to its energy content
a. Empty-kcalorie foods denote foods that contribute energy but lack nutrients.
5. Moderation (dietary)—providing enough but not too much of a food or nutrient
6. Variety (dietary)—eating a wide selection of foods within and among the major food groups
B. Dietary Guidelines for Americans
1. Adequate nutrients within energy needs
a. Consume foods from all food groups and limit foods that can be detrimental to health.
b. Consume a balanced diet.
2. Weight management
a. Maintain a healthy body weight.
b. Prevention of weight gain
3. Physical activity
a. Increase energy expenditure and decrease sedentary activities.
b. Include cardiovascular conditioning, stretching, and resistance exercises.
4. Food groups to encourage
a. Choose a variety of fruits, vegetables, milk and milk products, and whole grains.
5. Fats
a. Limit saturated fat, dietary cholesterol, and trans fats.
b. Choose monounsaturated and polyunsaturated fat sources.
c. Choose lean, low-fat, or fat-free foods.
6. Carbohydrates
a. Choose those that are high in fiber.
b. Choose products with a minimal amount of added sugar.
c. Decrease the risk of dental caries.
7. Sodium and potassium
a. Choose foods that are low in salt and high in potassium.
8. Alcoholic beverages
a. Drink in moderation.
b. Some should not consume alcohol.
9. Food safety
a. Wash and cook foods thoroughly and keep cooking surfaces clean.
b. Avoid raw, undercooked, or unpasteurized products.
II. Diet-Planning Guides
Food group plans sort foods into groups based on nutrient content. These guides are important in
selecting foods for a nutritious diet providing balance, variety, adequacy and moderation. A
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combination of whole grains, vegetables, legumes, fruits, meats or meat alternates and milk products
is essential to a healthy diet. Following diet-planning guides can help to meet nutrition and health
goals.
A. The USDA Food Guide assigns foods to the five major food groups of fruits, vegetables, grains,
meat and legumes, and milk.
1. Recommended Amounts
a. The recommended intake of each food group depends upon how many kcalories are
required.
b. There are different kcalorie requirements for those who are sedentary compared to those
who are active.
c. There are five subgroups of vegetables including dark green vegetables, orange and deep
yellow vegetables, legumes, starchy vegetables, and others.
d. Variety should be a goal when choosing vegetables.
2. Notable Nutrients
a. Key nutrients for each group
b. Allows for food substitutions within a group
c. Legumes may be considered a vegetable or a meat alternative
d. The typical American diet requires an increased intake of vegetables, fruits, whole grains,
and milk and a decrease in refined grains, fat, and sugar.
3. Nutrient Density
a. Foods can be of high, medium or low nutrient density.
b. Must consider energy needs when choosing these foods
4. Discretionary KCalorie Allowance
a. Calculated by subtracting the amount of energy required to meet nutrient needs from the
total energy allowance
b. Those with discretionary kcalories may eat additional servings, consume foods with slightly
more fat or added sugar, or consume alcohol.
c. For weight loss, a person should avoid consuming discretionary kcalories.
5. Serving Equivalents
a. Cups are used to measure servings of fruits, vegetables, and milk.
b. Ounces are used to measure servings of grains and meats.
c. Visualization with common objects can be used to estimate portion sizes.
6. Mixtures of Foods
a. Foods that fall into two or more groups
b. Examples are casseroles, soups, and sandwiches
B. Exchange Lists help to achieve kcalorie control and moderation.
1. Foods are sorted by energy-nutrient content.
2. Originally developed for those with diabetes
3. Portion sizes vary within a group
4. Food groupings may not be logical
C. Putting the Plan into Action
1. Choose the number of servings needed from each group.
2. Assign food groups to daily meals and snacks.
D. From Guidelines to Groceries - Processed foods have been treated thus changing their properties.
Fortified foods have improved nutrition.
1. Grains
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2.
3.
4.
5.
a. Refined foods lose nutrients during processing.
b. Enriched foods have nutrients added back including iron, thiamin, riboflavin, niacin, and
folate.
c. Whole-grain products are not refined. Examples include brown rice and oatmeal.
d. Fortified foods have nutrients added that were not part of the original food.
Vegetables
a. Choose fresh vegetables often.
b. Dark green leafy and yellow-orange vegetables are important.
c. Good sources of vitamins, minerals, and fiber
d. Be careful to control added fat and salt.
e. Legumes
1. Variety is important
2. Economical
3. Low-fat, nutrient-rich and fiber-rich
Fruit
a. Choose citrus and yellow-orange fruits.
b. Processed fruits are acceptable alternatives to fresh.
c. Provides vitamins, minerals, fibers and phytochemicals
d. Fruit juices lack fiber but are healthy beverages.
e. Watch energy intakes and fruit “drinks.”
Meat, fish and poultry
a. Provides minerals, protein and B vitamins
b. Choose lean cuts.
c. Textured vegetable protein is a processed soybean protein and can be used in recipes.
d. Weighing can be used to determine portion sizes.
e. Use low-fat cooking methods, and trim and drain fat to reduce fat intake.
Milk
a. Dairy foods are often fortified with vitamins A and D.
b. Imitation foods that resemble other foods are nutritionally inferior.
c. Food substitutes are designed to replace other foods.
d. Many lower fat dairy products are available including fat-free, non-fat, skim, zero-fat, nofat, low-fat, reduced-fat, and less-fat milk.
III. Food Labels
Food labeling is required on almost all packaged foods. Posters or brochures provide nutrition
information for fresh meats and produce. The Daily Values (DV) are based on a 2000-kcalorie
reference diet. There are requirements and guidelines for ingredient lists, serving sizes and nutrition
facts. Health and nutrient claims must follow FDA-specified criteria. Structure-function claims do not
require FDA approval. Consumer education is an important component of the FDA labeling plan
A. The Ingredient List
1. All ingredients listed
2. Descending order of predominance by weight
B. Serving Sizes
1. Facilitate comparisons among foods
2. Need to compare to quantity of food actually eaten
3. Do not necessarily match the USDA Food Guide
C. Nutrition Facts
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1.
2.
3.
4.
5.
6.
7.
8.
Listed by quantity and percentage standards per serving, called Daily Values
kCalories listed as total kcalories and kcalories from fat
Fat listed by total fat, saturated fat, and trans fat
Cholesterol
Sodium
Carbohydrate listed by total carbohydrate, starch, sugars, and fiber
Protein
Vitamin A, vitamin C, iron, and calcium are listed in % DV only.
D. The Daily Values (DV)
1. Estimate of individual foods’ contribution to total diet
2. Based on 2000-kcalorie diet
3. Can also calculate personal daily values
4. Ease in comparing foods
E. Nutrient Claims
1. Must meet FDA definitions and include conditions of use [See attached]
2. No implied claims
3. General terms include free, good source of, healthy, high, less, light or lite, low, more, and
organic.
4. Energy terms include kcalorie-free, low kcalorie, and reduced calorie.
5. Fat and cholesterol terms include percent fat-free, fat-free, low fat, less fat, saturated fat-free, low
saturated fat, less saturated fat, trans fat-free, cholesterol-free, low cholesterol, less cholesterol,
extra lean, and lean.
6. Carbohydrate terms include high fiber and sugar-free.
7. Sodium terms include sodium-free and salt-free, low sodium, and very low sodium.
F. Health Claims
1. Reliable health claims on the FDA “A” list represent clear links between a nutrient and a
disease or health-related condition.
2. “B” list health claims have supportive evidence but are not conclusive.
3. “C” list health claims have limited evidence and are not conclusive.
4. “D” list health claims have little scientific evidence to support the claim.
Nutrition Related Health Claims allowed on Food Labels FDA “A” list
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Calcium and Osteoporosis
Sodium and Hypertension
Dietary fat and Cancer
Saturated fat & Cholesterol and heart disease
Fiber foods and Cancer
Soluble fiber foods and Heart Disease
Fruits and vegetables and Cancer
Oats and Heart Disease
Folic Acid and Neural Tube Defects
1. Name the diet-planning principles and briefly describe how each principle helps in diet
planning.
2. What recommendations appear in the Dietary Guidelines for Americans?
3. Name the five food groups in the USDA Food Guide and identify several foods typical of each
group. Explain how this Guide groups foods, and how the Guide incorporates concepts of
nutrient density and kcalorie control.
4. Review the Dietary Guidelines. What types of grocery selections would you make to achieve
those recommendations?
5. Define the terms notable nutrients, nutrient density, and discretionary kcalorie allowance.
6. Describe the purpose of MyPyramid.
7. Discuss how exchange lists are used in diet planning.
8. What information can you expect to find on a food label? How can this information help you
choose between two similar products?
9. What are the Daily Values? How can they help you meet health recommendations?
10. List and define the three types of claims that may be on a food product.
Reading the Food Label
People look at food labels for different reasons. But whatever the reason, many consumers would like to
know how to use this information more effectively and easily. The following guide is will help you to use
nutrition labels to make quick, informed food choices that contribute to a healthy diet.
The Nutrition Facts Panel
The first place to start when you look at the Nutrition Facts panel is the serving size and the number of
servings in the package (green). Serving sizes are provided in familiar units, such as cups or pieces,
followed by the metric amount, e.g., the number of grams. Serving sizes are based on the amount of food
people typically eat, which makes them realistic and easy to compare to similar foods.
Pay attention to the serving size, including how many servings there are in the food package, and
compare it to how much YOU actually eat. The size of the serving on the food package influences all the
nutrient amounts listed on the top part of the label. One serving of macaroni and cheese equals one cup. If
you ate the whole package, you would eat two cups. That doubles the calories and other nutrient numbers,
including the % Daily Values.
Calories and Calories from Fat
Calories provide a measure of how much energy you get from a serving of this food. The label also tells
you how many of the calories in one serving come from fat. In the example, there are 250 calories in a
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serving of macaroni and cheese. How many calories from fat are there in ONE serving? Answer: 110
calories, which means almost half come from fat. What if you ate the whole package content? Then, you
would consume two servings, or 500 calories, and 220 would come from fat.
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The Nutrients
The top section in the sample nutrition label shows nutrients that are important for your health and
separates them into two main groups. The nutrients listed first are the ones Americans generally eat in
adequate amounts, or even too much. They are identified in yellow on the chart as Limit these Nutrients.
Eating too much fat or too much sodium may increase your risk of certain chronic diseases, like heart
disease, some cancers, or high blood pressure. Eating too many calories is linked to overweight and
obesity.
Americans often don't get enough dietary fiber, vitamin A, vitamin C, calcium, and iron in their diets.
They are identified in blue on the chart as Get Enough of these Nutrients. Eating enough of these
nutrients can improve your health and help reduce the risk of some diseases and conditions. For example,
getting enough calcium can reduce the risk of osteoporosis, in which bones become brittle and break as
one ages.
The Percent Daily Value (%DV)
This part of the Nutrition Facts panel (orange) tells you whether the nutrients (fat, sodium, fiber, etc) in a
serving of food contribute a lot or a little to your total daily diet. Percent DVs are based on
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recommendations for a 2,000 calorie diet. For labeling purposes, FDA set 2,000 calories as the reference
amount for calculating %DVs. The %DV shows you how much of the recommended daily amount of a
nutrient is in a serving of food. By using the %DV, you can tell if this amount is high or low. You may
not know exactly how many calories you consume in a day, but the %DV can provide a frame of
reference, whether or not you eat more or less than 2,000 calories each day.
The label also helps you interpret the numbers (grams and milligrams) by putting them all on the same
scale (0-100%DV), much like a ruler. This way you can tell high from low and know which nutrients
contribute a lot, or a little, to your daily recommended allowance (upper or lower). The Quick Guide will
tell you that 5%DV or less of a nutrient is low and 20%DV or more is high. This means that 5%DV or
less is low for all nutrients, those you want to limit (e.g., fat, saturated fat, cholesterol, and sodium), and
those that you want to consume in greater amounts (fiber, calcium, etc). As the Quick Guide shows,
20%DV or more is high for all nutrients.
Example: Look at the amount of Total Fat in one serving listed on the sample nutrition label for
macaroni and cheese. Is 18%DV contributing a lot or a little to your maximum fat limit of 100% DV?
Check the Quick Guide and see that 18%DV, which is below 20%DV, is not yet high, but what if you ate
the whole package (two servings)? You would double that amount, eating 36% of your daily allowance
for Total Fat. That amount, coming from just one food, would contribute a lot of fat to your daily diet. It
would leave you 64% of your fat allowance for all of the other foods you eat that day.
Sugars and Protein: Note that neither Sugars nor Protein lists a %DV on the Nutrition Facts panel. No
daily reference value has been established because no recommendations have been made for the total
amount of sugars to eat in a day. Keep in mind; the sugars listed on the Nutrition Facts panel include
naturally occurring sugars (like those in fruit and milk) as well as those added to a food or drink. Check
the ingredient list for specifics on added sugars. For protein, a %DV is required to be listed if a claim is
made for protein, such as "high in protein." Otherwise, unless the food is meant for use by infants and
children under 4 years old, none is needed. Current scientific evidence indicates that protein intake is not
a public health concern for most adults and children over 4 years old.
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LABELING TERMS AND THEIR DEFINITIONS
FREE (e.g., sugar-free, cholesterol-free): The amount of the substance in a serving is nutritionally and
physiologically inconsequential. If free is used to describe a food normally free of the substance,
the label must state this (e.g. “vegetable oil, a cholesterol free food).
LOW (e.g., low -fat, low-sodium): This term can be used on foods that can be eaten frequently without
exceeding dietary guidelines for fat, cholesterol, sodium, and/or calories. Maximum amounts per
serving are specified as:
 low fat: 3 g or less per serving
 low saturated fat: 1 g or less per serving
 low sodium: less than 140 mg per serving
 very low sodium: less than 35 mg per serving
 low cholesterol: less than 20 mg per serving
 low calorie: 40 calories or less per serving
If low is used to describe a food normally low in the substance, the label must state this.
LIGHT (e.g. Light Syrup): This can mean three things:
1 A nutritionally altered product contains one-third fewer calories or half the fat of the
reference food. If the food has more than 50 percent or more of its calories from fat, the
reduction must be 50 percent of the fat.
2 The sodium content of a low-calorie, low-fat food has been reduced by 50 percent.
3 Light can also refer to the texture and color of a product , as long as the label explains the
intent, i.e. light brown sugar.
REDUCED (e.g. reduced fat cream cheese): A nutritionally altered product contains 25 percent less of a
nutrient or of calories than the regular, or reference, product. However, a reduced claim can’t be
made on a product if its reference food already meets the requirement for a “low” claim.
LESS (e.g. less fat, less sodium): A food, whether altered or not, contains 25 percent less of a nutrient
than the reference food. For example, pretzels that have 25 per cent less fat than potato chips
could carry a “less” claim.
MORE (e.g., more vitamin C): A serving contains at least 10% more of the Daily Value than the
reference food.
GOOD SOURCE (e.g., good source of vitamin E): A serving contains 10-19% of the Daily Value of a
beneficial nutrient.
Nutrient Standards
RDAs = Recommended Dietary Allowance
RDIs = Reference Daily Intakes (replace the US RDAs)
DRVs = Daily Reference Values (come from the old dietary guidelines)
DV =
Daily Value, used on food labels and based on Calorie intake (from RDI + DRV)
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DRI Terms and Nutrients
Term
Dietary Reference
Intakes (DRI)
Estimated Average
Requirement (EAR)
Recommended Dietary
Allowance (RDA)
Adequate Intake (AI)
Tolerable Upper Intake
Level (UL)
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Definition
A set of values for the dietary
nutrient intakes of healthy people
in the United States and Canada.
The average daily amount of a
nutrient that will maintain a
specific biochemical or
physiological function in half the
healthy people of a given age and
gender group.
The average daily amount of a
nutrient considered adequate to
meet the known nutrient needs of
practically all healthy people; a
goal for dietary intake by
individuals.
The average daily amount of a
nutrient that appears sufficient to
maintain a specified criterion; a
value used as a guide for nutrient
intake when an RDA cannot be
determined.
The maximum daily amount of a
nutrient that appears safe for most
healthy people and beyond which
there is an increased risk of
adverse health effects.
Nutrients
Note: All nutrients with an RDA have
an EAR.
Carbohydrate, protein
Vitamins: Thiamin, riboflavin, niacin,
vitamin B6, folate, vitamin B12, vitamin
C, vitamin A, vitamin E
Minerals: Phosphorus, magnesium,
iron, zinc, iodine, selenium, copper,
molybdenum
Water, total fiber, total fat, linoleic
acid, linolenic acid
Vitamins: Biotin, pantothenic acid,
choline, vitamin D, vitamin K
Minerals: Sodium, chloride, potassium,
calcium, manganese, fluoride,
chromium
Vitamins: Niacin, vitamin B6, folate,
choline, vitamin C, vitamin A, vitamin
D, vitamin E
Minerals: Sodium, chloride, calcium,
phosphorus, magnesium, iron, zinc,
iodine, selenium, copper, manganese,
fluoride, molybdenum, boron, nickel,
vanadium
Compare Your Food Intake to
Recommended Daily Amounts from Each Group
List food item
and amount.
Food Item
Indicate amount consumed from each food group, using the
appropriate unit of measurement (in parentheses).
Fruits
Vegetables Grains
Meat &
Milk
(cups)
(cups)
(oz.)
beans (oz.) (cups)
Oils
(tsp.)
Estimate
values.
Discretionary
kcalories
Breakfast:
Snack:
Lunch:
Snack:
Dinner:
Snack:
Total
consumed
Recommended
based on EER
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Dietary Guidelines for Americans, 1980 to 20051
1985 –
7 Guidelines
1990 –
7 Guidelines
1995 –
7 Guidelines
Eat a variety of
foods
Maintain ideal
weight
Eat a variety of
foods
Maintain
desirable
weight
Eat a variety of
foods
Maintain
healthy weight
Eat a variety of foods
Avoid too
much fat,
saturated fat,
and cholesterol
Eat foods with
adequate starch
and fiber
Choose a diet
low in fat,
saturated fat
and cholesterol
Choose a
diet with
plenty of
vegetables,
fruits and
grain
products
2
Choose a variety of
grains daily, especially
whole grains
Choose a variety of fruits
and vegetables daily
Keep food safe to eat
Choose a diet that is low
in saturated fat and
cholesterol and moderate
Source: adapted from chart prepared by the Center for Nutrition Policy and Promotion, USDA.
See Table 2-1 in the text for key recommendations.
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Choo
se
Sensi
bly
Choose a diet low in
fat, saturated fat and
cholesterol
1
Aim for a healthy weight
Be physically active each
day
Let the Pyramid guide
your food choices
Choose a diet with
plenty of grain
products, vegetables,
and fruits
2005 – Key
Recommendations,
clustered into 9 topics2
Adequate Nutrients within
Energy Needs
Weight Management
Build a Healthy Base
Avoid too
much fat,
saturated fat,
and cholesterol
Eat foods with
adequate starch
and fiber
Balance the food
you eat with
physical activity—
maintain or
improve your
weight
2000 – 10 Guidelines,
clustered into 3 groups
Aim for Fitness
1980 –
7 Guidelines
Physical Activity
Food Groups to Encourage
Fats
Avoid too
much sugar
Avoid too
much sugar
Avoid too
much sodium
Avoid too
much sodium
If you drink
alcohol, do so
in moderation
If you drink
alcoholic
beverages, do
so in
moderation
Use sugars
only in
moderation
Use salt and
sodium only in
moderation
If you drink
alcoholic
beverages, do
so in
moderation
Choose a diet
moderate in sugars
Choose a diet
moderate in salt and
sodium
If you drink alcoholic
beverages, do so in
moderation
in total fat
Choose beverages and
foods to moderate your
intake of sugars
Choose and prepare foods
with less salt
If you drink alcoholic
beverages, do so in
moderation
Carbohydrates
Sodium and Potassium
Alcoholic Beverages
Food Safety
Shading indicates how the order in which the guidelines are presented changes over time.
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A World Tour of Pyramids, Pagodas, and Plates
In China, a family’s meal may include horse meat or fried scorpion; in Great Britain, people traditionally
drink a pot of tea and eat a scone between lunch and dinner; and in India, those with a reverence for life
called ahimsa espouse a vegetarian diet.3 The food supplies, eating habits, and cultural beliefs of people
living in diverse regions of the world are different, but their needs are similar in fundamental ways.
People from every corner of the world need foods—whether cheeseburgers or grasshoppers—to provide
the nutrients necessary to maintain life and defend against disease.
How should a person select foods to maintain good health? In the United States, the Dietary Guidelines
for Americans 2005 offer direction. Other countries provide similar guidelines, and it can be enlightening
to see how U.S. guidelines compare with those from other countries. A tour of dietary guidelines from
around the world finds they are similar in many ways and different in a few. This highlight elaborates on
the Dietary Guidelines for Americans 2005 that were introduced in Chapter 2 and compares them with
guidelines from around the world.
Dietary Guidelines
Governments develop dietary guidelines based on the nutrition problems, food supplies, eating habits, and
cultural beliefs of their populations. These guidelines offer practical suggestions for making food choices
that will support good health and reduce the risk of chronic diseases. They also provide the basis for many
policy and education decisions. Although each set of guidelines reflects the people and foodways of a
specific country, guidelines from around the world display more similarities than differences.
Adequate Nutrients within Energy Needs
P. G. Kittler and K. P. Sucher, Cultural Foods (Belmont, Calif.: Wadsworth/Thomson Learning, 2002).
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3
Each food provides a unique assortment of nutrients. To get all the nutrients in the right amounts without
exceeding energy needs, a person needs to eat a variety of nutrient-dense foods in appropriate quantities.
The Dietary Guidelines for Americans 2005 depend on the USDA Food Guide to direct daily food
choices. Not all nations use the USDA Food Guide, of course, but most consistently feature “variety” in
their message, quite often as the premier guideline. To achieve variety, guidelines in Japan, for example,
recommend eating 30 or more different kinds of foods daily.
The accompanying figure features shapes of various food guide plans from selected nations.4 Most food
guide plans classify foods into the following groups: grains, vegetables, fruits, meats, and milk products,
with a few minor variations. For example, Canada, China, and Portugal cluster fruits and vegetables into
one group; Mexico and the Philippines group milk products with meats.
Potatoes and legumes appear in all food guides, but their locations vary. In the United States, potatoes are
grouped with vegetables, but in Great Britain, Mexico, and Korea, potatoes are listed with the grains.
Sweden separates potatoes and other tubers into their own group, featuring them as a “base food,”
providing a “foundation for a nutritious and inexpensive diet.” As for legumes, the United States includes
them in both the meat and the vegetable groups; Sweden, Germany, and Australia put them in the
vegetable group; and China places them in the milk group.
Most food guide plans describe the recommended number of servings and serving sizes for each food
group. Some, such as Mexico, do not quantify recommendations, but instead offer general guidelines—
“muchas verduras y frutas” (many vegetables and fruits) and “pocos alimentos de origen animal” (little
food of animal origin). In all cases, the guidelines emphasize abundant grains, vegetables, and fruits and
moderate meats and milks.
4
J. Painter, J. Rah, and Y. Lee, Comparison of international food guide pictorial representations, Journal of the
American Dietetic Association 102 (2002): 483-489.
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Weight Management
Healthy body weight plays a key role in reducing the risk of chronic diseases. To that end, the Dietary
Guidelines for Americans 2005 encourage people to maintain body weight in a healthy range by
balancing kcalories from foods and beverages with kcalories expended. Canada, Germany, Australia, and
dozens of other developed countries also advise consumers to “watch your weight and stay active.”
A notable difference is apparent in developing countries, such as Indonesia, where undernutrition
threatens health as much or more than overnutrition does. The focus there is on consuming “foods to
provide sufficient energy.”
Physical Activity
Physical activity not only helps with weight management and disease prevention, but it also improves
cardiovascular fitness, strengthens bones and muscles, controls blood pressure, and promotes
psychological well-being. Furthermore, a person who is physically active can afford to eat more, which
makes it easier to get the nutrients the body needs to stay fit. The Dietary Guidelines for Americans 2005
recommend participating in at least 30 minutes of moderately intense physical activity on most days. This
amount of activity offers some health benefits, but it is not enough to maintain a healthy body weight. To
prevent weight gain and to accrue additional health benefits, most adults need to engage in 60 minutes of
moderate- to vigorous-intensity activity on most days. To sustain weight loss may require even more—at
least 60 to 90 minutes of moderate intensity physical activity daily. (Chapter 8 includes a table showing
energy expenditures for a variety of activities.)
Many of the guidelines from around the world that encourage a healthy body weight mention balancing
physical activity with food intake. For example, Japan’s guideline says to “match daily energy intake
with daily physical activity.”
Food Groups to Encourage
The USDA Food Guide encourages greater consumption of fruits, vegetables, milk and milk products,
and whole grains to provide the nutrients most often missing from the diets of Americans. These food
groups help to supply the diet with fiber, vitamin A, vitamin C, vitamin E, calcium, magnesium, and
potassium.
As Chapter 2 mentioned, the campaign to “eat 5 a day” reflects the recommendation to select a variety of
fruits and vegetables each day. Not only do fruits and vegetables supply vitamins and minerals in
abundance, but their phytochemicals and fibers help to maintain good health and protect against diseases
such as heart disease and cancer. Because different fruits and vegetables deliver different nutrients, it is
especially important to select a variety and to include dark green vegetables, orange vegetables, legumes,
starchy vegetables, other vegetables, citrus fruits, melons, and berries, weekly.
Several nations have a guideline that encourages consumers to “eat plenty of fruits and vegetables.” Many
have adopted a “5 a day” recommendation.
Another food group the USDA Food Guide encourages is milk and milk products. Consumers are advised
to select three cups of fat-free or low-fat milk or the equivalent in milk products daily. Food guides in
Canada and Australia suggest similar amounts, whereas countries such as China, Korea, and Germany
advise the equivalent of one cup or less.
The USDA Food Guide also encourages consumers to make at least half of their grain selections whole
grains such as whole wheat, brown rice, and oats. Canada, Australia, Germany, and Great Britain also
mention the need to “eat plenty of foods rich in starch and fiber,” such as bread and cereals. Guidelines
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from Greece suggest that people “prefer whole grain breads and pastas.” Other countries, such as
Indonesia, recommend that consumers “obtain about half of total energy from complex carbohydrate-rich
foods.”
Fats
Some fat in the diet is essential to good health, but certain kinds of fat, most notably saturated and trans
fats, can be detrimental to heart health as Highlight 5 explains. For this reason, the Dietary Guidelines for
Americans 2005 encourage people to limit saturated and trans fat intake to less than 10 percent of total
kcalories, cholesterol intake to less than 300 milligrams a day, and total fat intake to between 20 and 35
percent of total kcalories.
Most countries make some statement about not eating “too many foods that contain a lot of fat,” but the
recommended limitations vary. Canada, for example, agrees with the United States. Korea suggests
“keeping fat intake at 20 percent of energy intake,” and the Netherlands allows “up to 35 percent.”
Interestingly, both Korea and the Netherlands have lower rates of heart disease than the United States and
Canada.5 The Germans don’t mention “percent kcalories from fat,” but instead restrict dietary fat to 70 to
90 grams per day, which is equivalent to 30 to 40 percent of a 2000-kcalorie diet. The German fat
message adds a preference for fats of plant origin and cautions that meat, sausages, and eggs should be
eaten in moderation. Japan and China—countries with relatively low rates of heart disease—also advise
consumers to “eat more vegetable oils than animal fat.”
Carbohydrates
Foods and beverages containing sugar promote tooth decay. In addition, they frequently deliver many
kcalories with few, if any, nutrients. For these reasons, the Dietary Guidelines for Americans 2005
encourage people to choose and prepare foods and beverages with little added sugars. (Chapter 4 presents
additional dietary strategies to limit tooth decay and Highlight 23 describes the relationships between
dental problems and chronic illnesses.)
Many nations take a similar approach, saying “don’t have sugary foods and drinks too often” or “eat only
a moderate amount of sugars and foods containing added sugars.” Greek guidelines do not address sugar
directly, but urge consumers to “prefer fruits and nuts as snacks, instead of sweets or candy bars” and to
“prefer water over soft drinks”—suggestions that reflect traditional Greek foodways. Other nations,
including Canada, Korea, China, the Philippines, and Japan, do not mention sugars in their dietary
guidelines.
Sodium and Potassium
Because of the link between salt intake and high blood pressure, the Dietary Guidelines for Americans
2005 suggest that consumers choose and prepare foods with little salt. “A little salt” means less than 2300
milligrams of sodium or about one teaspoon of salt (6 grams). Because potassium intake helps to prevent
high blood pressure, consumers are also encouraged to eat potassium-rich foods such as fruits and
vegetables.
Japan is one of the few countries to specify a quantity, and its upper limit on salt is almost twice that of
the U.S. guideline—10 grams a day. Most nations address salt intake without specifying quantities.
Canada states that “the sodium content of the diet should be reduced”; Australia advises that you “choose
low salt foods and use salt sparingly”; and Great Britain suggests that you “minimize salt use.” Indonesia
5
World Health Organization, www.who.int/whosis, visited June 2003.
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and Germany—two countries whose iodine status is less than sufficient—don’t limit salt intake, but
instead remind consumers to use iodized salt.6
Alcoholic Beverages
Because alcohol consumed in excess is detrimental to health in many ways, the Dietary Guidelines for
Americans 2005 advise adults who drink alcoholic beverages to do so sensibly and in moderation.
Moderation is defined as one drink a day for women and two a day for men—and the size of “a drink” is
specified (see Highlight 7).
Most countries agree: “if you drink alcohol, limit your intake.” Canada’s limit on alcohol is “no more
than 5 percent of energy intake as alcohol, or two drinks daily, whichever is less.” Greece cautions those
who drink alcohol to do so only occasionally and in small quantities—specified as 25 milliliters of pure
alcohol (equivalent to a little less than one ounce of pure alcohol, or about two drinks). Great Britain is
less specific and simply suggests that “if you drink, keep within sensible limits.” Some countries, such as
Indonesia, restrict consumption altogether, advising consumers to “avoid drinking alcoholic beverages.”
In Hungary, “alcohol is forbidden for children and pregnant women.” The Netherlands simply
acknowledges “that current alcohol consumption is far too high in many cases.”
Keep Foods Safe to Eat
Maintaining a healthy weight, exercising daily, and selecting a variety of grains, legumes, fruits, and
vegetables protect a person’s health over a lifetime. Foods can also affect immediate health. Foods that
are tainted with harmful bacteria, viruses, parasites, or chemical contaminants can make people sick with
flu-like symptoms of nausea and diarrhea—or worse. Keeping foods safe requires washing hands and
food preparation surfaces often; separating raw, cooked, and prepared foods while shopping, cooking, and
storing; cooking foods to the appropriate temperature; and refrigerating perishable foods promptly.
The prevalence and risks of foodborne illnesses in the developing countries of Southeast Asia are among
the highest in the world.7 Many of these Asian countries include a guideline advising their people to “eat
clean and safe food.” The message in Indonesia and Thailand is to “consume food which is prepared
hygienically.” The Philippine guideline goes on to explain that eating clean and safe food “will prevent
foodborne diseases.”
Additional Comments
As you can see, dietary guidelines from around the world look a little different on the surface, but on
close examination their messages agree with each other. They all support good health.
Guidelines from other countries sometimes address issues that are not covered in the Dietary Guidelines
for Americans 2005. For example, Indonesia encourages its people to “eat breakfast.” Several countries
specify guidelines for iron and calcium. Most of these make general statements, such as “consume iron
rich foods.” Some countries offer suggestions for specific groups of people, most commonly, pregnant or
breastfeeding women. In Indonesia, mothers are advised to “breast feed your baby exclusively for four
months,” and in Australia, guidelines “encourage and support breastfeeding.”
Water and fluid intake are addressed in several sets of dietary guidelines. People of Indonesia are advised
to “drink adequate quantities of fluids that are free from contaminants,” and those in Greece are told to
6
International Council for the Control of Iodine Deficiency Disorder,
www.people.virginia.edu/~jtd/iccidd/mi/regions/americas_map.htm, visited June 2003.
7 M. D. Miliotis and J. W. Bier, International Handbook of Foodborne Pathogens (New York: Marcel Dekker,
2003).
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drink about 1.5 liters of water daily. Canada’s comment on water addresses its fluoride content, rather
than intake. In addition, Canada advises consumers to limit caffeine to no more than the equivalent of
four cups of regular coffee a day.
Healthy Eating Index Components
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