Module 1
Digestion
Below is a picture of the Digestive Tract, also referred to as the Alimentary Tract, which
includes all the organs associated with the digestive tract.
There are two types of digestions, Mechanical and Chemical
Mechanical digestion begins in the mouth with the mashing and tearing of food into smaller
particles, exposing greater surface area, which aids in chemical digestion. The food moves
down through the esophagus into the stomach. The stomach acts like a churn, especially for
fats, breaking them into fat droplets. Once the food, called chyme, leaves the stomach, for
the most part, mechanical digestion is complete.
Chemical digestion also begins in the mouth with very weak enzymes that begin to
breakdown foods into its nutrient components, starch and some lipids begin breakdown
here. These enzymes are secreted in the saliva. Saliva, which is made of water, salts and
enzymes, promotes swallowing action, and protects the tooth enamel as well as the lining of
the esophagus and stomach.
When foods enter the stomach, HCl acid is secreted which begins the breakdown of proteins
into smaller particles called protein fragments. (Note: the stomach has several protective
features that prevent HCL acid from damaging the stomach lining.)
Still not a great deal of chemical digestion occurs in the stomach.
The action zone of chemical digestion is the small intestines, especially the first two portions.
Digested nutrients (including water) are than absorbed from the small intestines.(Note: a few
nutrients & water are absorbed in the large intestines ).
As we travel through our studies of nutrition we will discover how the foods or nutrients we
eat affect digestion and absorption.
A: Food Choices
An individual's health is determined by their genetic make-up and lifestyle choices and
behaviors. For example, a person is thought to be genetically predisposed to a disease (say,
diabetes), if they have a strong family history for that disease - perhaps a grandparent, parent
and sibling all have diabetes. But everyone who is genetically predisposed to diabetes does not
develop diabetes. The health and lifestyle behaviors practiced throughout life have a major
impact on disease risk and can influence whether an individual develops a disease for which
they have a strong genetic tendency. It has been said that "genetics loads the gun, but lifestyle
factors pull the trigger". Isn't it nice to know that we are not doomed by our genetics?
Diet and nutrition is one aspect of a healthy lifestyle that can minimize disease risk. Many of
the dietary guidance recommendations we will be covering in this module are meant to do
exactly that. Unfortunately, most of us choose foods for many reasons and health is often not
the main criteria used in deciding what to eat. In fact, many of our food choices are almost
unconscious - grab and go with little thought at all. Mindless Eating, by Brian Wansink is a
fascinating book that explores how much our food choices are controlled by factors we are not
even aware of. Becoming more aware of why we choose the foods that we eat is the first step
in making positive changes.
Chapter One, in your textbook, reviews many factors that influence food choice. After reading
this chapter, think about the foods that you ate during the past 24 hours. Why did you choose
the foods that you ate? If you are like most people, food has many different roles in your life
and you probably select foods for many different reasons at various times.
To me, variations in food choice among individuals is one reason nutrition is so
interesting. Considering the many influences on food choice, the study of nutrition involves not
only chemistry and biology, but also psychology, sociology, geography, political science and
economics. Marion Nestle, a well-known nutrition professor at NYU, speaks often on topics
related to the politics of food and nutrition. Her book, What to Eat is a fascinating discussion
of food choice in a larger, societal context. The link below brings you to her website and
blog. First thing you should do whenever reading nutrition information on the internet, go to
the About tab and read Marion Nestlé’s qualifications and credentials. Then, read the
following blog post: January 10, 2011 - Who Decides What Your Children Eat?
You'll
need to scroll down the page to read the article.
B: Nutrients
The study of nutrition begins with an understanding of nutrients. In the body, nutrients supply
energy, serve as structural/building materials and help to regulate body processes. The body
can make some of the nutrients that it needs, such as Vitamin D and K. Many nutrients cannot
be made (or cannot be made in sufficient quantity) and must be obtained from the foods we
eat. Nutrients that must be obtained from food are called essential nutrients.
Here are some key concepts:

The nutrient categories are Carbohydrates (CHO), Proteins (PRO), Fats, Vitamins,
Minerals and Water. Foods can be chemically analyzed to determine their
composition. Through chemical analysis, we know the amount of carbohydrate, protein,
fat, vitamins, minerals and water in an amount of a food. The food composition tables
in your textbook(either in the back for hard copy or at the bottom of the chapter listing
in the e-copy) show the nutrient content of many different foods. You will need to be
familiar with using these tables, as we will refer to them often.

The energy in a food is measured in kilocalories (abbreviated kcalories or kcal). The
term Calories is often used to mean kilocalories - kcalories is the correct scientific term,
calorie is the popular use term. Only carbohydrates, proteins and fats provide
energy. These are called the energy-yielding nutrients. We use energy for physical
activity and to support dynamic metabolic body processes.

Most foods are mixtures of all 3 energy yielding nutrients. For example, 1 cup of whole
milk has 11 grams CHO, 8 grams PRO, 8 grams FAT. Try using the food composition
tables in your textbook to look up the CHO, PRO and FAT content of 12 animal
crackers (answer below). Once we know how much CHO, PRO and FAT a food contains,
then we can calculate how much energy it provides. Commit these numbers to
memory...
1 gram CHO= 4 calories
1 gram PRO = 4 calories
1 gram Fat = 9 calories
So, to determine the energy content of 1 cup of whole milk .....(11 grams CHO x 4) + (8 grams PRO x
4) + (8 grams FAT x 9) = 148 kcal.
See if you can calculate the kcalories in 12 animal crackers. (answer below)
ANSWERS: 12 animal crackers have 22 grams CHO, 2 grams PRO, 4 grams FAT
12 animal crackers have 132 kcalories (22 grams CHO x 4) + (2 grams PRO x 4) + (4 grams FAT x 9)
Although alcohol contains 7 kcals per gram it is not considered an essential nutrient.
C: Dietary Reference Intake
The Dietary Reference Intakes (DRI) are a set of nutrient standards issued by the Food and Nutrition
Board which is part of the Institute of Medicine (IOM) in the National Academies of Science. The Food
and Nutrition Board is a highly-qualified group of expert scientists assembled from universities and
research organizations in the United States and Canada to study a topic. The DRI's include the RDA
(Recommended Dietary Allowance).
For example the DRI/RDA for calcium, women age 19-30 is 1,000mg/day.
We will re-visit this topic later in the course.
CDRR—Chronic Disease Risk Reduction- This is a new DRI value recently added by the USDA
The newest of the DRI values, the CDRR, identify nutrient intake levels associated with lowered risks of
chronic diseases. This sets the CDRR apart from all other DRI categories, which focus on nutrient
deficiency or toxicity. The CDRR, in contrast, reflect a level of nutrient intake that can be expected to
reduce the risk of a chronic disease in a healthy population, taking into account that such risks vary
among individuals in ways unrelated to nutrition.*
Currently, a CDRR for sodium is established in relation to heart disease and hypertension. High-quality
scientific evidence demonstrates that increasing sodium intakes beyond this level incurs a higher risk of
these life-threatening diseases in healthy people. People who currently consume more than the CDRR of
sodium can expect to reduce their risks by reducing their intakes.* The DASH diet, which we will review
in Module 6, is an example of a diet that helps a person lower their sodium intake.
D: Key Elements of Healthy Eating Patterns
Key Elements of Healthy Eating Patterns: These notes are taken from the USDA guidelinesPlease
note: The hot links and the more buttons do not work. Some of the formatting is weird, the article
did not copy and paste well. But it is still a good article.
Make sure to watch the spinach video lower down the page.
A Closer Look Inside Healthy Eating Patterns
In this section:
1. Food Groups
2. Other Dietary Components
The following sections describe a healthy eating pattern and how following such a pattern can help
people meet the Guidelines and its Key Recommendations. Throughout, it uses the Healthy U.S.-Style
Eating Pattern as an example to illustrate the specific amounts and limits for food groups and other
dietary components that make up healthy eating patterns. The Healthy U.S.-Style Eating Pattern is one
of three USDA Food Patterns and is based on the types and proportions of foods Americans typically
consume, but in nutrient-dense forms and appropriate amounts. Because calorie needs vary based on
age, sex, height, weight, and level of physical activity (seeAppendix 2. Estimated Calorie Needs per Day,
by Age, Sex, and Physical Activity Level), the pattern has been provided at 12 different calorie levels
(see Appendix 3. USDA Food Patterns: Healthy U.S.-Style Eating Pattern). The 2,000-calorie level of the
Pattern is shown in Table 1-1.
The Healthy U.S.-Style Eating Pattern is the same as the primary USDA Food Patterns of the 2010 Dietary
Guidelines. Two additional USDA Food Patterns—the Healthy Mediterranean-Style Eating Pattern and
the Healthy Vegetarian Eating Pattern—are found at the end of this chapter and reflect other styles of
eating (see Appendix 4. USDA Food Patterns: Healthy Mediterranean-Style Eating Pattern and Appendix
5. USDA Food Patterns: Healthy Vegetarian Eating Pattern). These three patterns are examples of
healthy eating patterns that can be adapted based on cultural and personal preferences. The USDA Food
Patterns also can be used as guides to plan and serve meals not only for the individual and household
but in a variety of other settings, including schools, worksites, and other community settings.
Table 1-1.Healthy U.S.-Style Eating Pattern at the 2,000-Calorie Level, With Daily or Weekly Amounts
From Food Groups, Subgroups, and Components
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The Healthy U.S.-Style Eating Pattern is designed to meet the Recommended Dietary Allowances (RDA)
and Adequate Intakes for essential nutrients, as well as Acceptable Macronutrient Distribution Ranges
(AMDR) set by the Food and Nutrition Board of the IOM. This eating pattern also conforms to limits set
by the IOM or Dietary Guidelines for other nutrients or food components (see Appendix 6. Glossary of
Terms and Appendix 7. Nutritional Goals for Age-Sex Groups Based on Dietary Reference Intakes and
Dietary Guidelines Recommendations). Nutritional goals for almost all nutrients are met (see Appendix
3 for additional information).
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Within a food group, foods can come in many forms and are not created equal in terms of what counts
as a cup or an ounce. Some foods are more concentrated, and some are more airy or contain more
water. Cup- and ounce-equivalents identify the amounts of foods from each food group with similar
nutritional content. In addition, portion sizes do not always align with one cup-equivalent or one ounceequivalent. See examples below for variability.
½ cup portion of green beans =
½ cup-equivalent vegetables
1 cup portion of spinach = ½ cup-equivalent vegetables, the same is true for lettuce
Importance of Calorie Balance Within Healthy Eating Patterns
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Food Groups
Eating an appropriate mix of foods from the food groups and subgroups—within an appropriate
calorie level—is important to promote health. Each of the food groups and their subgroups provides an
array of nutrients, and the amounts recommended reflect eating patterns that have been associated
with positive health outcomes. Foods from all of the food groups should be eaten in nutrient-dense
forms. The following sections describe the recommendations for each of the food groups, highlight
nutrients for which the food group is a key contributor, and describe special considerations related to
the food group.
Vegetables
Healthy intake: Healthy eating patterns include a variety of vegetables from all of the five
vegetable subgroups—dark green, red and orange, legumes (beans and peas), starchy, and
other.[10] These include all fresh, frozen, canned, and dried options in cooked or raw forms, including
vegetable juices. The recommended amount of vegetables in the Healthy U.S.-Style Eating Pattern at the
2,000-calorie level is 2½ cup-equivalents of vegetables per day. In addition, weekly amounts from each
vegetable subgroup are recommended to ensure variety and meet nutrient needs.
Key nutrient contributions: Vegetables are important sources of many nutrients, including dietary fiber,
potassium, vitamin A,[11] vitamin C, vitamin K, copper, magnesium, vitamin E, vitamin B6, folate, iron,
manganese, thiamin, niacin, and choline. Each of the vegetable subgroups contributes different
combinations of nutrients, making it important for individuals to consume vegetables from all the
subgroups. For example, dark-green vegetables provide the most vitamin K, red and orange vegetables
the most vitamin A, legumes the most dietary fiber, and starchy vegetables the most potassium.
Vegetables in the “other” vegetable subgroup provide a wide range of nutrients in varying amounts.
Considerations: To provide all of the nutrients and potential health benefits that vary across different
types of vegetables, the Healthy U.S.-Style Eating Pattern includes weekly recommendations for each
subgroup. Vegetable choices over time should vary and include many different vegetables. Vegetables
should be consumed in a nutrient-dense form, with limited additions such as salt, butter, or creamy
sauces. When selecting frozen or canned vegetables, choose those lower in sodium.
This is a cool video on the potential benefits of Spinach
About Legumes (Beans and Peas)
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Fruits
Healthy intake: Healthy eating patterns include fruits, especially whole fruits. The fruits food group
includes whole fruits and 100% fruit juice. Whole fruits include fresh, canned, frozen, and dried forms.
The recommended amount of fruits in the Healthy U.S.-Style Eating Pattern at the 2,000-calorie level is 2
cup-equivalents per day. One cup of 100% fruit juice counts as 1 cup of fruit. Although fruit juice can be
part of healthy eating patterns, it is lower than whole fruit in dietary fiber and when consumed in excess
can contribute extra calories. Therefore, at least half of the recommended amount of fruits should come
from whole fruits. When juices are consumed, they should be 100% juice, without added sugars. Also,
when selecting canned fruit, choose options that are lowest in added sugars. One-half cup of dried fruit
counts as one cup-equivalent of fruit. Similar to juice, when consumed in excess, dried fruits can
contribute extra calories.
Key nutrient contributions: Among the many nutrients fruits provide are dietary fiber, potassium, and
vitamin C.
Considerations: Juices may be partially fruit juice, and only the proportion that is 100% fruit juice counts
(e.g., 1 cup of juice that is 50% juice counts as ½ cup of fruit juice). The remainder of the product may
contain added sugars. Sweetened juice products with minimal juice content, such as juice drinks, are
considered to be sugar-sweetened beverages rather than fruit juice because they are primarily
composed of water with added sugars (see the Added Sugars section below). The percent of juice in a
beverage may be found on the package label, such as “contains 25% juice” or “100% fruit juice.” The
amounts of fruit juice allowed in the USDA Food Patterns for young children align with the
recommendation from the American Academy of Pediatrics that young children consume no more than
4 to 6 fluid ounces of 100% fruit juice per day.[12] Fruits with small amounts of added sugars can be
accommodated in the diet as long as calories from added sugars do not exceed 10 percent per day and
total calorie intake remains within limits.
Grains
Healthy Intake: Healthy eating patterns include whole grains and limit the intake of refined grains and
products made with refined grains, especially those high in saturated fats, added sugars, and/or sodium,
such as cookies, cakes, and some snack foods. The grains food group includes grains as single foods (e.g.,
rice, oatmeal, and popcorn), as well as products that include grains as an ingredient (e.g., breads,
cereals, crackers, and pasta). Grains are either whole or refined. Whole grains (e.g., brown rice, quinoa,
and oats) contain the entire kernel, including the endosperm, bran, and germ. Refined grains differ from
whole grains in that the grains have been processed to remove the bran and germ, which removes
dietary fiber, iron, and other nutrients. The recommended amount of grains in the Healthy U.S.-Style
Eating Pattern at the 2,000-calorie level is 6 ounce-equivalents per day. At least half of this amount
should be whole grains (see the How To Make at Least Half of Grains Whole Grains call-out box).
Key nutrient contributions: Whole grains are a source of nutrients, such as dietary fiber, iron, zinc,
manganese, folate, magnesium, copper, thiamin, niacin, vitamin B6, phosphorus, selenium, riboflavin,
and vitamin A.[13] Whole grains vary in their dietary fiber content. Most refined grains are enriched, a
process that adds back iron and four B vitamins (thiamin, riboflavin, niacin, and folic acid). Because of
this process, the term “enriched grains” is often used to describe these refined grains.
Considerations: Individuals who eat refined grains should choose enriched grains. Those who consume
all of their grains as whole grains should include some grains, such as some whole-grain ready-to-eat
breakfast cereals, that have been fortified with folic acid. This is particularly important for women who
are or are capable of becoming pregnant, as folic acid fortification in the United States has been
successful in reducing the incidence of neural tube defects during fetal development. Although grain
products that are high in added sugars and saturated fats, such as cookies, cakes, and some snack foods,
should be limited, as discussed in the Added Sugars and Saturated Fats sections below, grains with some
added sugars and saturated fats can fit within healthy eating patterns.
How To Make at Least Half of Grains Whole Grains
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Dairy
Healthy intake: Healthy eating patterns include fat-free and low-fat (1%) dairy, including milk, yogurt,
cheese, or fortified soy beverages (commonly known as “soymilk”). Soy beverages fortified with calcium,
vitamin A, and vitamin D, are included as part of the dairy group because they are similar to milk based
on nutrient composition and in their use in meals. Other products sold as “milks” but made from plants
(e.g., almond, rice, coconut, and hemp “milks”) may contain calcium and be consumed as a source of
calcium, but they are not included as part of the dairy group because their overall nutritional content is
not similar to dairy milk and fortified soy beverages (soymilk). The recommended amounts of dairy in
the Healthy U.S.-Style Pattern are based on age rather than calorie level and are 2 cup-equivalents per
day for children ages 2 to 3 years, 2½ cup-equivalents per day for children ages 4 to 8 years, and 3 cupequivalents per day for adolescents ages 9 to 18 years and for adults.
Key nutrient contributions: The dairy group contributes many nutrients, including calcium, phosphorus,
vitamin A, vitamin D (in products fortified with vitamin D), riboflavin, vitamin B12, protein, potassium,
zinc, choline, magnesium, and selenium.
Considerations: Fat-free and low-fat (1%) dairy products provide the same nutrients but less fat (and
thus, fewer calories) than higher fat options, such as 2% and whole milk and regular cheese. Fat-free or
low-fat milk and yogurt, in comparison to cheese, contain less saturated fats and sodium and more
potassium, vitamin A, and vitamin D. Thus, increasing the proportion of dairy intake that is fat-free or
low-fat milk or yogurt and decreasing the proportion that is cheese would decrease saturated fats and
sodium and increase potassium, vitamin A, and vitamin D provided from the dairy group. Individuals
who are lactose intolerant can choose low-lactose and lactose-free dairy products. Those who are
unable or choose not to consume dairy products should consume foods that provide the range of
nutrients generally obtained from dairy, including protein, calcium, potassium, magnesium, vitamin D,
and vitamin A (e.g., fortified soy beverages [soymilk]). Additional sources of potassium, calcium, and
vitamin D are found in Appendix 10, Appendix 11, and Appendix 12, respectively.
Protein Foods
Healthy intake: Healthy eating patterns include a variety of protein foods in nutrient-dense forms. The
protein foods group comprises a broad group of foods from both animal and plant sources and includes
several subgroups: seafood; meats, poultry, and eggs; and nuts, seeds, and soy products. Legumes
(beans and peas) may also be considered part of the protein foods group as well as the vegetables group
(see the About Legumes (Beans and Peas) call-out box). Protein also is found in some foods from other
food groups (e.g., dairy). The recommendation for protein foods in the Healthy U.S.-Style Eating Pattern
at the 2,000-calorie level is 5½ ounce-equivalents of protein foods per day.
Key nutrient contributions: Protein foods are important sources of nutrients in addition to protein,
including B vitamins (e.g., niacin, vitamin B12, vitamin B6, and riboflavin), selenium, choline, phosphorus,
zinc, copper, vitamin D, and vitamin E). Nutrients provided by various types of protein foods differ. For
example, meats provide the most zinc, while poultry provides the most niacin. Meats, poultry, and
seafood provide heme iron, which is more bioavailable than the non-heme iron found in plant sources.
Heme iron is especially important for young children and women who are capable of becoming pregnant
or who are pregnant. Seafood provides the most vitamin B12 and vitamin D, in addition to almost all of
the polyunsaturated omega-3 fatty acids, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA),
in the Patterns (see the About Seafood call-out box). Eggs provide the most choline, and nuts and seeds
provide the most vitamin E. Soy products are a source of copper, manganese, and iron, as are legumes.
Considerations: For balance and flexibility within the food group, the Healthy U.S.-Style Eating Pattern
includes weekly recommendations for the subgroups: seafood; meats, poultry, and eggs; and nuts,
seeds, and soy products. A specific recommendation for at least 8 ounce-equivalents of seafood per
week also is included for the 2,000-calorie level (see the About Seafood call-out box). One-half ounce of
nuts or seeds counts as 1 ounce-equivalent of protein foods, and because they are high in calories, they
should be eaten in small portions and used to replace other protein foods rather than being added to
the diet. When selecting protein foods, nuts and seeds should be unsalted, and meats and poultry
should be consumed in lean forms. Processed meats and processed poultry are sources of sodium and
saturated fats, and intake of these products can be accommodated as long as sodium, saturated fats,
added sugars, and total calories are within limits in the resulting eating pattern (see the About Meats
and Poultry call-out box). The inclusion of protein foods from plants allows vegetarian options to be
accommodated.
About Seafood
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About Meats and Poultry
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Oils
Healthy intake: Oils are fats that contain a high percentage of monounsaturated and polyunsaturated
fats and are liquid at room temperature. Although they are not a food group, oils are emphasized as part
of healthy eating patterns because they are the major source of essential fatty acids and vitamin E.
Commonly consumed oils extracted from plants include canola, corn, olive, peanut, safflower, soybean,
and sunflower oils. Oils also are naturally present in nuts, seeds, seafood, olives, and avocados. The fat
in some tropical plants, such as coconut oil, palm kernel oil, and palm oil, are not included in the oils
category because they do not resemble other oils in their composition. Specifically, they contain a
higher percentage of saturated fats than other oils (see Dietary Fats: The Basics call-out box). The
recommendation for oils in the Healthy U.S.-Style Eating Pattern at the 2,000-calorie level is 27 g (about
5 teaspoons) per day.
Key nutrient contributions: Oils provide essential fatty acids and vitamin E.
Considerations: Oils are part of healthy eating patterns, but because they are a concentrated source of
calories, the amount consumed should be within the AMDR for total fats without exceeding calorie
limits. Oils should replace solid fats rather than being added to the diet. More information on types of
fats is provided in the Dietary Fats: The Basicscall-out box, and information on the relationship between
dietary fats and health is discussed in the Saturated Fats,Trans Fats, and Cholesterol section, below.
Dietary Fats: The Basics
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Limits on Calories That Remain After Food Group Needs Are Met in Nutrient-Dense Forms
The USDA Food Patterns are designed to meet food group and nutrient recommendations while staying
within calorie needs. To achieve this goal, the Patterns are based on consuming foods in their nutrientdense forms (i.e., without added sugars and in the leanest and lowest fat forms, see Appendix 6). For
nearly all calorie levels, most of the calories in the USDA Food Patterns are needed for nutrient-dense
food choices, and only a limited number remain for other uses. These calories are indicated in the USDA
Food Patterns as “limits on calories for other uses.” For example, after food group needs are met in the
Healthy U.S.-Style Eating Pattern from 1,000 to 1,600 calories, only 100 to 170 calories per day remain
within the limit for other uses. In the 2,000-calorie pattern, the limit for other uses is 270 calories and in
the 2,800-calorie pattern, 400 calories (see Appendix 3, Appendix 4, and Appendix 5). Calories up to the
limit for the specific pattern can be used to eat foods that are not in nutrient-dense forms (e.g., to
accommodate calories from added sugars, added refined starches, or solid fats) or to eat more than the
recommended amount of nutrient-dense foods. If alcohol is consumed, calories from alcoholic
beverages should also be accounted for within this limit to keep total calorie intake at an appropriate
level.
As discussed in Chapter 2, in contrast to the healthy choices that make up the Patterns, foods from most
food groups as they are typically consumed in the United States are not in nutrient-dense forms. In
addition, foods and beverages are consumed that are primarily composed of added sugars and/or solid
fats, and provide excess calories without contributing to meeting food group recommendations. The
excess calories consumed from these sources far exceed the limited number of calories available for
choices other than nutrient-dense foods in each food group.
From a public health perspective, it is important to identify the calories that are needed to meet food
group needs to help inform guidance on limits from calories from added sugars, solid fats, alcohol[21], or
other sources, in order to help individuals move toward healthy eating patterns within calorie limits. The
USDA Food Patterns can be used to plan and serve meals for individuals, households, and in a variety of
organizational settings (e.g., schools, worksites, and other community settings). The limit on calories for
other uses can assist in determining how to plan and select foods that can fit within healthy eating
patterns, such as how many calories are available to select foods from a food group that are not in
nutrient-dense forms. As discussed in the next portion of the chapter, additional constraints apply
related to other dietary components when building healthy eating patterns.
Figure 1-3.Hidden Components in Eating Patterns
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Many of the foods and beverages we eat contain sodium, saturated fats, and added sugars. Making
careful choices, as in this example, keeps amounts of these components within their limits while
meeting nutrient needs to achieve a healthy eating pattern.
Contributes
Purple bullet Sodium*
Green bullet Saturated fats
Blue bullet Added sugars
*foods very low in sodium not marked
Other Dietary Components
In addition to the food groups, it is important to consider other food components when making food
and beverage choices. The components discussed below include added sugars, saturated fats, trans fats,
cholesterol, sodium, alcohol, and caffeine. For each component, information is provided on how the
component relates to eating patterns and outlines considerations related to the component.
See Chapter 2 for a further discussion of each of these components, current intakes, and shifts that are
needed to help individuals align with a healthy eating pattern.
Added Sugars
Healthy intake: Added sugars include syrups and other caloric sweeteners. When sugars are added to
foods and beverages to sweeten them, they add calories without contributing essential nutrients.
Consumption of added sugars can make it difficult for individuals to meet their nutrient needs while
staying within calorie limits. Naturally occurring sugars, such as those in fruit or milk, are not added
sugars. Specific examples of added sugars that can be listed as an ingredient include brown sugar, corn
sweetener, corn syrup, dextrose, fructose, glucose, high-fructose corn syrup, honey, invert sugar,
lactose, malt syrup, maltose, molasses, raw sugar, sucrose, trehalose, and turbinado sugar.
Healthy eating patterns limit added sugars to less than 10 percent of calories per day. This
recommendation is a target to help the public achieve a healthy eating pattern, which means meeting
nutrient and food group needs through nutrient-dense food and beverage choices and staying within
calorie limits. When added sugars in foods and beverages exceed 10 percent of calories, a healthy eating
pattern may be difficult to achieve. This target also is informed by national data on intakes of calories
from added sugars, which as discussed in Chapter 2, account on average for almost 270 calories, or
more than 13 percent of calories per day in the U.S. population.
The USDA Food Patterns show that an eating pattern with enough foods from all food groups to meet
nutrient needs without eating too many calories has only limited room for calories from added sugars.
At most lower calorie levels (i.e., 1,200 to 1,800 calories), the calories that remain after meeting food
group recommendations in nutrient-dense forms (“limits on calories for other uses”) are less than 10
percent per day of calories; however, at higher calorie levels, the limits on calories for other uses are
more than 10 percent per day. The recommendation to limit added sugars to no more than 10 percent
of calories is a target that applies to all calorie levels to help individuals move toward healthy eating
patterns within calorie limits.
Although the evidence for added sugars and health outcomes is still developing, the recommendation to
limit calories from added sugars is consistent with research examining eating patterns and health.
Strong evidence from mostly prospective cohort studies but also randomized controlled trials has shown
that eating patterns that include lower intake of sources of added sugars are associated with reduced
risk of CVD in adults, and moderate evidence indicates that these eating patterns are associated with
reduced risk of obesity, type 2 diabetes, and some types of cancer in adults. As described earlier, eating
patterns consist of multiple, interacting food components, and the relationships to health exist for the
overall eating pattern, not necessarily to an isolated aspect of the diet. Moderate evidence indicates a
relationship between added sugars and dental caries in children and adults.
Considerations: Added sugars provide sweetness that can help improve the palatability of foods, help
with preservation, and/or contribute to functional attributes such as viscosity, texture, body, color, and
browning capability. As discussed in Chapter 2, the two main sources of added sugars in U.S. diets are
sugar-sweetened beverages and snacks and sweets. Many foods high in calories from added sugars
provide few or no essential nutrients or dietary fiber and, therefore, may contribute to excess calorie
intake without contributing to diet quality; intake of these foods should be limited to help achieve
healthy eating patterns within calorie limits. There is room for Americans to include limited amounts of
added sugars in their eating patterns, including to improve the palatability of some nutrient-dense
foods, such as fruits and vegetables that are naturally tart (e.g., cranberries and rhubarb). Healthy eating
patterns can accommodate other nutrient-dense foods with small amounts of added sugars, such as
whole-grain breakfast cereals or fat-free yogurt, as long as calories from added sugars do not exceed 10
percent per day, total carbohydrate intake remains within the AMDR, and total calorie intake remains
within limits.
It should be noted that replacing added sugars with high-intensity sweeteners may reduce calorie intake
in the short-term, yet questions remain about their effectiveness as a long-term weight management
strategy. High-intensity sweeteners that have been approved by the U.S. Food and Drug Administration
(FDA) include saccharin, aspartame, acesulfame potassium (Ace-K), and sucralose.[22] Based on the
available scientific evidence, these high-intensity sweeteners have been determined to be safe for the
general population. This means that there is reasonable certainty of no harm under the intended
conditions of use because the estimated daily intake is not expected to exceed the acceptable daily
intake for each sweetener. The FDA has determined that the estimated daily intake of these highintensity sweeteners would not exceed the acceptable daily intake, even for high consumers of each
substance.
Saturated Fats, Trans Fats, and Cholesterol
Saturated Fats
Healthy intake: Intake of saturated fats should be limited to less than 10 percent of calories per day by
replacing them with unsaturated fats and while keeping total dietary fats within the age-appropriate
AMDR. The human body uses some saturated fats for physiological and structural functions, but it
makes more than enough to meet those needs. Individuals 2 years and older therefore have no dietary
requirement for saturated fats.
Strong and consistent evidence shows that replacing saturated fats with unsaturated fats, especially
polyunsaturated fats, is associated with reduced blood levels of total cholesterol and of lowdensity lipoprotein-cholesterol (LDL-cholesterol). Additionally, strong and consistent evidence shows
that replacing saturated fats with polyunsaturated fats is associated with a reduced risk of CVD events
(heart attacks) and CVD-related deaths.
Some evidence has shown that replacing saturated fats with plant sources of monounsaturated fats,
such as olive oil and nuts, may be associated with a reduced risk of CVD. However, the evidence base
for monounsaturated fats is not as strong as the evidence base for replacement with polyunsaturated
fats. Evidence has also shown that replacing saturated fats with carbohydrates reduces blood levels of
total and LDL-cholesterol, but increases blood levels of triglycerides and reduces highdensity lipoprotein-cholesterol (HDL-cholesterol). Replacing total fat or saturated fats with
carbohydrates is not associated with reduced risk of CVD. Additional research is needed to determine
whether this relationship is consistent across categories of carbohydrates (e.g., whole versus refined
grains; intrinsic versus added sugars), as they may have different associations with various health
outcomes. Therefore, saturated fats in the diet should be replaced with polyunsaturated
and monounsaturated fats.
Considerations: As discussed in Chapter 2, the main sources of saturated fats in the U.S. diet include
mixed dishes containing cheese, meat, or both, such as burgers, sandwiches, and tacos; pizza; rice,
pasta, and grain dishes; and meat, poultry, and seafood dishes. Although some saturated fats are
inherent in foods, others are added. Healthy eating patterns can accommodate nutrient-dense foods
with small amounts of saturated fats, as long as calories from saturated fats do not exceed 10 percent
per day, intake of total fats remains within the AMDR, and total calorie intake remains within limits.
When possible, foods high in saturated fats should be replaced with foods high in unsaturated fats, and
other choices to reduce solid fats should be made (see Chapter 2).
Trans Fats
Individuals should limit intake of trans fats to as low as possible by limiting foods that contain synthetic
sources oftrans fats, such as partially hydrogenated oils in margarines, and by limiting other solid fats. A
number of studies have observed an association between increased intake of trans fats and increased
risk of CVD. This increased risk is due, in part, to its LDL-cholesterol-raising effect.
Trans fats occur naturally in some foods and also are produced in a process called hydrogenation.
Hydrogenation is used by food manufacturers to make products containing unsaturated fatty acids solid
at room temperature (i.e., more saturated) and therefore more resistant to becoming spoiled or rancid.
Partial hydrogenation means that some, but not all, unsaturated fatty acids are converted to saturated
fatty acids; some of the unsaturated fatty acids are changed from a cis to trans configuration. Trans fatty
acids produced this way are referred to as “artificial” or “industrially produced” trans fatty acids.
Artificial trans fatty acids are found in the partially hydrogenated oils[23] used in some margarines, snack
foods, and prepared desserts as a replacement for saturated fatty acids. Although food manufacturers
and restaurants have reduced the amounts of artificial trans fats in many foods in recent years, these
fats can still be found in some processed foods, such as some desserts, microwave popcorn, frozen
pizza, margarines, and coffee creamers.
Naturally occurring trans fats, known as “natural” or “ruminant” trans fats, are produced by ruminant
animals. Naturaltrans fats are present in small quantities in dairy products and meats, and consuming
fat-free or low-fat dairy products and lean meats and poultry will reduce the intake of natural trans fats
from these foods. Because natural trans fats are present in dairy products and meats in only small
quantities and these foods can be important sources of nutrients, these foods do not need to be
eliminated from the diet.
Dietary Cholesterol
The body uses cholesterol for physiological and structural functions but makes more than enough for
these purposes. Therefore, people do not need to obtain cholesterol through foods.
The Key Recommendation from the 2010 Dietary Guidelines to limit consumption of dietary cholesterol
to 300 mg per day is not included in the 2015 edition, but this change does not suggest that dietary
cholesterol is no longer important to consider when building healthy eating patterns. As recommended
by the IOM,[24] individuals should eat as little dietary cholesterol as possible while consuming a healthy
eating pattern. In general, foods that are higher in dietary cholesterol, such as fatty meats and high-fat
dairy products, are also higher in saturated fats. The USDA Food Patterns are limited in saturated fats,
and because of the commonality of food sources of saturated fats and dietary cholesterol, the Patterns
are also low in dietary cholesterol. For example, the Healthy U.S.-Style Eating Pattern contains
approximately 100 to 300 mg of cholesterol across the 12 calorie levels. Current average intake of
dietary cholesterol among those 1 year and older in the United States is approximately 270 mg per day.
Strong evidence from mostly prospective cohort studies but also randomized controlled trials has shown
that eating patterns that include lower intake of dietary cholesterol are associated with reduced risk of
CVD, and moderate evidence indicates that these eating patterns are associated with reduced risk of
obesity. As described earlier, eating patterns consist of multiple, interacting food components and the
relationships to health exist for the overall eating pattern, not necessarily to an isolated aspect of the
diet. More research is needed regarding the dose-response relationship between dietary cholesterol
and blood cholesterol levels. Adequate evidence is not available for a quantitative limit for dietary
cholesterol specific to the Dietary Guidelines.
Dietary cholesterol is found only in animal foods such as egg yolk, dairy products, shellfish, meats, and
poultry. A few foods, notably egg yolks and some shellfish, are higher in dietary cholesterol but not
saturated fats. Eggs and shellfish can be consumed along with a variety of other choices within and
across the subgroup recommendations of the protein foods group.
Sodium
Healthy intake: The scientific consensus from expert bodies, such as the IOM, the American Heart
Association, and Dietary Guidelines Advisory Committees, is that average sodium intake, which is
currently 3,440 mg per day (seeChapter 2), is too high and should be reduced. Healthy eating patterns
limit sodium to less than 2,300 mg per day for adults and children ages 14 years and older and to the
age- and sex-appropriate Tolerable Upper Intake Levels (UL) of sodium for children younger than 14
years (see Appendix 7). Sodium is an essential nutrient and is needed by the body in relatively small
quantities, provided that substantial sweating does not occur.[25] Sodium is primarily consumed as salt
(sodium chloride).
The limits for sodium are the age- and sex-appropriate ULs. The UL is the highest daily nutrient intake
level that is likely to pose no risk of adverse health effects to almost all individuals in the general
population. The recommendation for adults and children ages 14 years and older to limit sodium intake
to less than 2,300 mg per day is based on evidence showing a linear dose-response relationship between
increased sodium intake and increased blood pressure in adults. In addition, moderate evidence
suggests an association between increased sodium intake and increased risk of CVD in adults. However,
this evidence is not as consistent as the evidence on blood pressure, a surrogate indicator of CVD risk.
Calorie intake is highly associated with sodium intake (i.e., the more foods and beverages people
consume, the more sodium they tend to consume). Because children have lower calorie needs than
adults, the IOM established lower ULs for children younger than 14 years of age based on median intake
of calories. Similar to adults, moderate evidence also indicates that the linear dose-response
relationship between sodium intake and blood pressure is found in children as well.
Adults with prehypertension and hypertension would particularly benefit from blood pressure lowering.
For these individuals, further reduction to 1,500 mg per day can result in even greater blood pressure
reduction. Because of the linear dose-response relationship between sodium intake and blood pressure,
every incremental decrease in sodium intake that moves toward recommended limits is encouraged.
Even without reaching the limits for sodium intake, strong evidence indicates that reductions in sodium
intake can lower blood pressure among people with prehypertension and hypertension. Further, strong
evidence has demonstrated that adults who would benefit from blood pressure lowering should
combine the Dietary Approaches to Stop Hypertension (DASH) dietary pattern with lower sodium intake
(see Dietary Approaches to Stop Hypertension call-out box).
Considerations: As a food ingredient, sodium has multiple uses, such as in curing meat, baking,
thickening, enhancing flavor (including the flavor of other ingredients), as a preservative, and in
retaining moisture. For example, some fresh meats have sodium solutions added to help retain moisture
in cooking. As discussed in Chapter 2, sodium is found in foods across the food supply, including mixed
dishes such as burgers, sandwiches, and tacos; rice, pasta, and grain dishes; pizza; meat, poultry, and
seafood dishes; and soups. Multiple strategies should be implemented to reduce sodium intake to the
recommended limits (see Chapter 3. Everyone Has a Role in Supporting Healthy Eating Patterns).
Dietary Approaches to Stop Hypertension (DASH)
more▼
Alcohol
Alcohol is not a component of the USDA Food Patterns. The Dietary Guidelines does not recommend
that individuals who do not drink alcohol start drinking for any reason. If alcohol is consumed, it should
be in moderation—up to one drink per day for women and up to two drinks per day for men—and only
by adults of legal drinking age.[6] There are also many circumstances in which individuals should not
drink, such as during pregnancy. For the purposes of evaluating amounts of alcohol that may be
consumed, the Dietary Guidelines includes drink-equivalents. One alcoholic drink-equivalent is described
as containing 14 g (0.6 fl oz) of pure alcohol.[26] The following are reference beverages that are one
alcoholic drink-equivalent: 12 fluid ounces of regular beer (5% alcohol), 5 fluid ounces of wine (12%
alcohol), or 1.5 fluid ounces of 80 proof distilled spirits (40% alcohol).[27] The amount of alcohol and
calories in beverages varies and should be accounted for within the limits of healthy eating patterns so
that calorie limits are not exceeded. See Appendix 9. Alcohol for additional information.
Healthy Mediterranean-Style Eating Pattern
A Healthy Mediterranean-Style Eating Pattern (Appendix 4) was designed by modifying the Healthy U.S.Style Eating Pattern, taking into account food group intakes from studies examining the associations
between Mediterranean-Style eating patterns and health.
The Healthy Mediterranean-Style Eating Pattern contains more fruits and seafood and less dairy than
does the Healthy U.S.-Style Eating Pattern. The healthfulness of the Healthy Mediterranean-Style
Pattern was evaluated based on its similarity to Mediterranean-Style patterns described in studies with
positive health outcomes rather than on meeting specified nutrient standards. However, nutrient
content of the Pattern was assessed and found to be similar to the Healthy U.S.-Style Eating Pattern,
except for calcium and vitamin D. Calcium and vitamin D are lower because the amounts of dairy were
decreased, as shown in Appendix 4, to more closely match data from studies of Mediterranean-Style
eating patterns.
Healthy Vegetarian Eating Pattern
A Healthy Vegetarian Eating Pattern (Appendix 5) replaces the previous Lacto-ovo Vegetarian
Adaptation of the USDA Food Patterns from the 2010 Dietary Guidelines. The Healthy Vegetarian Eating
Pattern was developed taking into account food choices of self-identified vegetarians in the National
Health and Nutrition Examination Survey (NHANES) and provides recommendations to meet the Dietary
Guidelines for those who follow a vegetarian pattern.
In comparison to the Healthy U.S.-Style Eating Pattern, the Healthy Vegetarian Eating Pattern includes
more legumes (beans and peas), soy products, nuts and seeds, and whole grains. It contains no meats,
poultry, or seafood, and is identical to the Healthy U.S.-Style Eating Pattern in amounts of all other food
groups. The Pattern is similar in meeting nutrient standards to the Healthy U.S.-Style Pattern, but is
somewhat higher in calcium and dietary fiber and lower in vitamin D, due to differences in the foods
included in the protein foods group, specifically more tofu and beans and no seafood, as shown
in Appendix 5.
Healthy Mediterranean-Style Eating Pattern
A Healthy Mediterranean-Style Eating Pattern (Appendix 4) was designed by modifying the Healthy U.S.Style Eating Pattern, taking into account food group intakes from studies examining the associations
between Mediterranean-Style eating patterns and health.
The Healthy Mediterranean-Style Eating Pattern contains more fruits and seafood and less dairy than
does the Healthy U.S.-Style Eating Pattern. The healthfulness of the Healthy Mediterranean-Style
Pattern was evaluated based on its similarity to Mediterranean-Style patterns described in studies with
positive health outcomes rather than on meeting specified nutrient standards. However, nutrient
content of the Pattern was assessed and found to be similar to the Healthy U.S.-Style Eating Pattern,
except for calcium and vitamin D. Calcium and vitamin D are lower because the amounts of dairy were
decreased, as shown in Appendix 4, to more closely match data from studies of Mediterranean-Style
eating patterns.
Healthy Vegetarian Eating Pattern
A Healthy Vegetarian Eating Pattern (Appendix 5) replaces the previous Lacto-ovo Vegetarian
Adaptation of the USDA Food Patterns from the 2010 Dietary Guidelines. The Healthy Vegetarian Eating
Pattern was developed taking into account food choices of self-identified vegetarians in the National
Health and Nutrition Examination Survey (NHANES) and provides recommendations to meet the Dietary
Guidelines for those who follow a vegetarian pattern.
In comparison to the Healthy U.S.-Style Eating Pattern, the Healthy Vegetarian Eating Pattern includes
more legumes (beans and peas), soy products, nuts and seeds, and whole grains. It contains no meats,
poultry, or seafood, and is identical to the Healthy U.S.-Style Eating Pattern in amounts of all other food
groups. The Pattern is similar in meeting nutrient standards to the Healthy U.S.-Style Pattern, but is
somewhat higher in calcium and dietary fiber and lower in vitamin D, due to differences in the foods
included in the protein foods group, specifically more tofu and beans and no seafood, as shown
in Appendix 5.
Healthy Mediterranean-Style Eating Pattern
A Healthy Mediterranean-Style Eating Pattern (Appendix 4) was designed by modifying the Healthy U.S.Style Eating Pattern, taking into account food group intakes from studies examining the associations
between Mediterranean-Style eating patterns and health.
The Healthy Mediterranean-Style Eating Pattern contains more fruits and seafood and less dairy than
does the Healthy U.S.-Style Eating Pattern. The healthfulness of the Healthy Mediterranean-Style
Pattern was evaluated based on its similarity to Mediterranean-Style patterns described in studies with
positive health outcomes rather than on meeting specified nutrient standards. However, nutrient
content of the Pattern was assessed and found to be similar to the Healthy U.S.-Style Eating Pattern,
except for calcium and vitamin D. Calcium and vitamin D are lower because the amounts of dairy were
decreased, as shown in Appendix 4, to more closely match data from studies of Mediterranean-Style
eating patterns.
Healthy Vegetarian Eating Pattern
A Healthy Vegetarian Eating Pattern (Appendix 5) replaces the previous Lacto-ovo Vegetarian
Adaptation of the USDA Food Patterns from the 2010 Dietary Guidelines. The Healthy Vegetarian Eating
Pattern was developed taking into account food choices of self-identified vegetarians in the National
Health and Nutrition Examination Survey (NHANES) and provides recommendations to meet the Dietary
Guidelines for those who follow a vegetarian pattern.
In comparison to the Healthy U.S.-Style Eating Pattern, the Healthy Vegetarian Eating Pattern includes
more legumes (beans and peas), soy products, nuts and seeds, and whole grains. It contains no meats,
poultry, or seafood, and is identical to the Healthy U.S.-Style Eating Pattern in amounts of all other food
groups. The Pattern is similar in meeting nutrient standards to the Healthy U.S.-Style Pattern, but is
somewhat higher in calcium and dietary fiber and lower in vitamin D, due to differences in the foods
included in the protein foods group, specifically more tofu and beans and no seafood, as shown
in Appendix 5.
D. The Dietary Guidelines and USDA 'MyPlate
The Dietary Guidelines for Americans are issued every 5 years by the U.S. Department of Health and
Human Services (HHS) and the U.S. Department of Agriculture (USDA). The Dietary Guidelines apply to
Americans age 2 and older and are meant to provide advice about how a diet can promote health and
reduce disease risk. The Dietary Guidelines also form the basis of all federal nutrition policy and
education. Any nutrition related program that receives federal funds (for example, school lunch
programs) must adhere to the Dietary Guidelines. Below is a summary of the new guidelines. You can
also view the complete 2020-25 Dietary Guidelines report
at: https://www.dietaryguidelines.gov/sites/default/files/202012/Dietary_Guidelines_for_Americans_2020-2025.pdf
Key Recommendations from the new 2020-25 Dietary Guidelines for Americans

Consume a healthy eating pattern that accounts for all foods and beverages within an
appropriate calorie level.
A healthy eating pattern includes:

A variety of vegetables from all the subgroups—dark green, red and orange, legumes (beans and
peas), starchy, and other

Fruits, especially whole fruits, at least 1 serving

Grains, at least half of which are whole grains

Fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy beverages

A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and
peas), and nuts, seeds, and soy products (a plant protein should count for either a protein
food or vegetable but not both)

Oils
A healthy eating pattern limits:

Saturated fats and trans fats, added sugars, and sodium
Key Recommendations are provided for several components of the diet which should be limited. These
components are of particular public health concern in the United States, and the specified limits can
help individuals achieve healthy eating patterns within calorie limits:
Consume less than 10 percent of calories per day from added sugars[3]
Consume less than 10 percent of calories per day from saturated fats[4]
Consume less than 2,300 milligrams (mg) per day of sodium[5]
If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and
up to two drinks per day for men—and only by adults of legal drinking age.[6]
Healthy Eating Patterns: Dietary Principles
Healthy eating patterns support a healthy body weight and can help prevent and reduce the risk of
chronic disease throughout periods of growth, development, and aging as well as during pregnancy. The
following principles apply to meeting the Key Recommendations:
An eating pattern represents the totality of all foods and beverages consumed. All foods consumed as
part of a healthy eating pattern fit together like a puzzle to meet nutritional needs without exceeding
limits, such as those for saturated fats, added sugars, sodium, and total calories. All forms of foods,
including fresh, canned, dried, and frozen, can be included in healthy eating patterns.
Nutritional needs should be met primarily from foods. Individuals should aim to meet their nutrient
needs through healthy eating patterns that include nutrient-dense foods. Foods in nutrient-dense forms
contain essential vitamins and minerals and dietary fiber and other naturally occurring substances that
may have positive health effects. In some cases, fortified foods and dietary supplements may be useful
in providing one or more nutrients that otherwise may be consumed in less than recommended
amounts
Healthy eating patterns are adaptable. Individuals have more than one way to achieve a healthy eating
pattern. Any eating pattern can be tailored to the individual’s socio-cultural and personal preferences.
The Dietary Guidelines include a suggested eating pattern called the USDA Food Guide. The USDA Food
Guide recommends specific types and amounts of foods for 12 calorie levels. Table 1-6 in your textbook
shows the food intake pattern for 8 of the 12 calorie levels. The USDA Food Guide was developed to
help the public choose a diet that would meet nutrient needs (from the DRI) but also minimize the risk
of developing chronic diseases, such as cancer, diabetes and heart disease.
Empty Calories (previously called 'Discretionary Calories') and Nutrient Density are important concepts
that were first included in the 2005 Dietary Guidelines. Foods that are nutrient-dense have a lot of
nutrients compared to the amount of calories they provide. If people eat mainly nutrient dense foods,
they will be able to meet all their nutrient needs, without eating too many calories. Here is an example which of the foods below is more nutrient-dense?
Chicken Breast, Roasted
142 calories, 50 mg. Magnesium, 12 mg. Niacin, .51 mg. B6
Breaded Chicken Patty
213 calories, 15 mg. Magnesium, 5 mg. Niacin, .23 mg. B6
Empty (Discretionary) Calories are the calories left to "spend" after nutrient needs (as specified in the
DRI) have been met. Empty Calories generally refer to foods that supply energy, but few nutrients. If a
person follows the 2000 kcal food intake pattern from the USDA Food Guide and if their food choices are
nutrient dense (Roasted Chicken Breast instead of Chicken Patty), they will meet their nutrient needs in
just 1735 calories. With nutrient needs covered, the remaining 265 calories can be "spent" on foods
any foods they choose - ice cream, candy, sugar, alcohol - the skies the limit up to 265 calories.
In Spring 2011, the USDA unveiled a new icon to communicate the concepts in the 2010 Dietary
Guidelines. The new 'MyPlate' symbol replaces the well-known food pyramid (MyPyramid). The
USDA MyPyramid graphic was introduced in 2005 to represent the concepts in the 2005 Dietary
Guidelines. Like MyPyramid, the new 'MyPlate' is primarily a web-based consumer education tool.
Daily Food Plan from myplate, if you click on the title, you will be redirected to the Myplate site for
that specific food group. Look at the daily table and any other (+) table This is really important
information. We will refer to the myplate guidelines frequently in this course.
GRAINS
6 ounces
1. Make half your grains whole
Aim for at least 3 ounces of whole grains a day
1 oz of grain =
1 slice of bread
1 cup ready to eat cereal
1/2 cup cooked pasta, rice or cereal(like oatmeal)
3 cups pop corn
1/2 bagel, roll or English muffin
VEGETABLES
2 1/2 cups
2. Vary your veggies: consume smaller portions and include a greater variety of choices at each meal,
i.e. ½ cup of broccoli and ½ cup of carrots instead of 1 cup of carrots. 1 C of Lettuce and other greens
is equal to only 1/2 a cup of veggie.
Aim for these amounts each week:
Dark green veggies = 1 1/2 cups
Red & orange veggies = 5 1/2 cups
Beans & peas = 1 1/2 cups
Starchy veggies = 5 cups
Other veggies = 4 cups
FRUITS
2 cups
3. Focus on fruits
Eat a variety of fruit
Choose whole or cut-up fruits more often than fruit juice
Only 100% fruit juice counts as a fruit. Lemonade does not.
DAIRY
3 cups
4. Get your calcium-rich foods
Drink fat-free or low-fat (1%)milk or fortified soy based for the same amount of calcium and other
nutrients as whole milk, but less fat and Calories
Select fat-free or low-fat yogurt and cheese, or try calcium-fortified soy products
PROTEIN
5 1/2 ounces
5. Go lean with protein
Twice a week, make seafood the protein on your plate
Vary your protein routine— choose beans, peas, nuts, and seeds more often
Keep meat and poultry portions small and lean
Eggs belong in the category, 1 large egg = 1 oz of protein
6. Find your balance between food and physical activity
Be physically active for at least 150 minutes each week.
7. Know your limits on saturated fats, sugars, and sodium, choose foods low in these nutrients.
The allowance for oils is 6 teaspoons a day (2000kcal diet)
Limit Calories from solid fats and added sugars to 260 Calories a day.
Reduce sodium intake to less than 2300 mg a day.
Sample menu(diet) which provides approximately 2,000 kcals, Please notice how specific the menu is in
regards to portion amounts. When writing menu you need to include portion amounts.
BREAKFAST
1 cup shredded wheat
½ cup sliced banana
½ cup fat-free milk
1 slice whole wheat toast
2 tsp all-fruit preserves
1 cup fat-free chocolate milk
LUNCH
Turkey sandwich
1 whole wheat pita bread (2 oz)
3 ounces roasted turkey, sliced
2 slices tomato
¼ cup shredded lettuce
1 tsp mustard
1 Tbsp mayonnaise
½ cup grapes
1 cup tomato juice
DINNER
4 ounces broiled beef steak
2/3 cup mashed potatoes made with milk and 2 tsp tub margarine
½ cup cooked green beans
1 tsp tub margarine
1 tsp honey
1 ounce whole wheat roll
1 tsp tub margarine
Frozen yogurt and berries:
½ cup frozen yogurt (chocolate)
¼ cup sliced strawberries
1 cup fat-free milk
SNACKS
1 cup frozen yogurt (chocolate)
The menu above meets the myplate recommendations, see the summary chart below.
Food group
minimum
recommendations
# of servings from menu
Dairy 3 C
2 cups of milk
Low fat
1 cup of frozen yogurt
Hit the target.
Vegetable group 2
½C
Vary sources
1 C of Lettuce &
other greens is = to
only 1/2 a cup of
veggie.
1 cup tomato juice
1/2 cup green beans
2/3 cup potatoes
2 slices tomato
1/4 cup of lettuce(=1/8 cup serving)
A little over, but that's ok for vegetables.
Fruit 2 C
1/2 cup bananas
Only 1 cup juice
1cup grapes
1/2 cup berries
Hit the target.
Grain 6 oz
1 cup shredded wheat = 1 oz
At least 3 oz whole
grain
1 sl. ww bread = 1 oz pita = 2 oz
ww roll = 1 oz
1/4 cup granola = 1/3 oz
I'm a little under here
Meat 5 ½ oz
3 oz of turkey
Low fat
4 oz of beef
Vary sources
including seafood,
legumes and nuts
I'm a little over here
Take some time now to explore the MyPlate website (link below) to familiarize yourself with the
materials, resources and interactive tools found here.
www.choosemyplate.gov/
Below, is a copy and paste from the Dietary Guideline 2020-2025 of the executive summary for the new
guidelines.
The Guidelines for 2020-2025
Make every bite count with the Dietary Guidelines for Americans: Here’s how:
Follow a healthy dietary pattern at every life stage
At every life stage—infancy, toddlerhood, childhood, adolescence, adulthood, pregnancy, lactation, and
older adulthood—it is never too early or too late to eat healthfully.
For about the first 6 months of life, exclusively feed infants human milk. Continue to feed infants
human milk through at least the first year of life, and longer if desired. Feed infants iron-fortified infant
formula during the first year of life when human milk is unavailable. Provide infants with supplemental
vitamin D beginning soon after birth.
At about 6 months, introduce infants to nutrient-dense complementary foods. Introduce infants to
potentially allergenic foods along with other complementary foods. Encourage infants and toddlers to
consume a variety of foods from all food groups. Include foods rich in iron and zinc, particularly for
infants fed human milk.
From 12 months through older adulthood, follow a healthy dietary pattern across the lifespan to meet
nutrient needs, help achieve a healthy body weight, and reduce the risk of chronic disease.
1. Customize and enjoy nutrient-dense food and beverage choices to reflect personal preferences,
cultural traditions, and budgetary considerations.
A healthy dietary pattern can benefit all individuals regardless of age, race, or ethnicity, or current
health status. The Dietary Guidelines provides a framework intended to be customized to individual
needs and preferences, as well as the food ways of the diverse cultures in the United States.
2. Focus on meeting food group needs with nutrient-dense foods and beverages, and stay within
calorie limits
An underlying premise of the Dietary Guidelines is that nutritional needs should be met primarily from
foods and beverages—specifically, nutrient-dense foods and beverages. Nutrient-dense foods provide
vitamins, minerals, and other health-promoting components and have no or little added sugars,
saturated fat, and sodium. A healthy dietary pattern consists of nutrient-dense forms of foods and
beverages across all food groups, in recommended amounts, and within calorie limits.
The core elements that make up a healthy dietary pattern include:
Vegetables of all types—dark green; red and orange; beans, peas, and lentils; starchy; and other
vegetables.
Fruits, especially whole fruit Grains, at least half of which are whole grain.
Dairy, including fat-free or low-fat milk, yogurt, and cheese, and/or lactose-free versions and fortified
soy beverages and yogurt as alternatives.
Protein foods, including lean meats, poultry, and eggs; seafood; beans, peas, and lentils; and nuts,seeds,
and soy products
Oils, including vegetable oils and oils in food, such as seafood and nuts
3. Foods and beverages higher in added sugars, saturated fat, and sodium, and limit alcoholic
beverages
At every life stage, meeting food group recommendations—even with nutrient-dense choices—requires
most of a person’s daily calorie needs and sodium limits. A healthy dietary pattern doesn’t have much
room for extra added sugars, saturated fat, or sodium—or for alcoholic beverages. A small amount of
added sugars, saturated fat, or sodium can be added to nutrient-dense foods and beverages to help
meet food group recommendations, but foods and beverages high in these components should be
limited.
Limits are:
Added sugars—Less than 10 percent of calories per day starting at age 2. Avoid foods and beverages
with added sugars for those younger than age 2.
Saturated fat—Less than 10 percent of calories per day starting at age 2.
Sodium—Less than 2,300 milligrams per day—and even less for children younger than age 14.
Alcoholic beverages—Adults of legal drinking age can choose not to drink, or to drink in moderation by
limiting intake to 2 drinks or less in a day for men and 1 drink or less in a day for women, when alcohol is
consumed. Drinking less is better for health than drinking more. There are some adults who should not
drink alcohol, such as women who are pregnant
Sample Menus for a 2000 Calorie Food Pattern
These menus provides all of the recommended amounts of nutrients and food from each food group.
(Italicized foods are part of the dish or food that proceeds it.) You should note that the portions sizes
are listed for all food choices. Also, instead of serving 1 cups of one type of veggie, efforts are made to
serve smaller portions, 1/2 Cup of 2 vegetables. Remember that salad greens, like lettuce, have a lot of
water so 1 cup of iceberg lettuce is = to 1/2 serving(or cup).
Sample menus for 2,000 kcal using MyPlate guidelines
Day 1
BREAKFAST
Breakfast burrito
1 flour tortilla (7" diameter) 1 scrambled egg (in 1 tsp soft margarine), 1/3 cup black beans, 2 tbsp salsa
1 cup orange juice
1 cup fat-free milk
LUNCH
Roast beef sandwich
1 whole grain sandwich, bun, 3 ounces lean roast beef, 2 slices tomato ,1/4 cup shredded romaine
lettuce, 1/8 cup sauteed mushrooms
(in 1 tsp oil), 1 1/2 ounce part-skim mozzarella cheese, 1 tsp yellow mustard
3/4 cup baked potato wedges*
1 tbsp ketchup
1 unsweetened beverage, flavored seltzer
DINNER
Stuffed broiled salmon
5 ounce salmon filet, 1 ounce bread stuffing mix
1 tbsp chopped onions, 1 tbsp diced celery, 2 tsp canola oil
1/2 cup saffron (brown) rice
1 ounce slivered almonds
1/2 cup steamed broccoli
1 tsp soft margarine
1 cup fat-free milk
SNACKS
1 cup cantaloupe
Day 2
BREAKFAST
1/2 cup cooked oatmeal ,2 tbsp raisins, 1 tsp soft margarine
1/2 cup fat-free milk
1 cup orange juice
LUNCH
Taco salad 2 ounces tortilla chips, 2 ounces ground turkey sauteed in 2 tsp sunflower oil, 1/2 cup black
beans, 1/2 cup iceberg lettuce, 2 slices tomato, 1 ounce low-fat cheddar cheese ,2 tbsp salsa, 1/2 cup
avocado, 1 tsp lime juice
1 unsweetened beverage
DINNER
Spinach lasagna
1 cup lasagna noodles cooked (2 oz dry), 2/3 cup cooked spinach, 1/2 cup ricotta cheese
1/2 cup tomato sauce, 1 ounce part-skim mozzarella cheese
1 ounce whole wheat dinner roll
1 cup fat-free milk
SNACKS
1/2 ounce dry-roasted almonds, 1/4 cup pineapple, 2 tbsp raisins
Day 3
BREAKFAST
Cold cereal
1 cup bran flakes, 1 cup fat-free milk, 1 small banana
1 slice whole wheat toast
1 tsp soft margarine
1/2 cup sliced mixed berries
LUNCH
Tuna fish sandwich
2 slices rye bread, 3 ounces tuna (packed in water, drained), 2 tsp mayonnaise, 1 tbsp diced celery, 1/4
cup shredded romaine lettuce, 2 slices tomato
1 medium pear
1 cup fat-free milk
DINNER
Roasted chicken breast
3 ounces boneless skinless chicken breast*
1 large baked sweet potato
1/2 cup peas and onions
1 tsp soft margarine
1 ounce whole wheat dinner roll
1 tsp soft margarine
1 cup leafy greens salad (this is 1/2 of a serving of veggie)
3 tsp sunflower oil and vinegar dressing
SNACKS
1/4 cup dried apricots 1 cup low-fat fruited yogurt
E. Labeling
A large part of our Western diet includes packaged and processed food. Without food labeling,
consumers would have no idea what is in packaged food items. Food Labeling laws were developed to
provide consumers with the information needed to determine whether these foods are
healthy. Responsibility for food labeling falls under the duties of the Food and Drug Administration
(FDA). Food labels have not changed for many years, but there is much discussion about updating our
current labeling system. In particular, many groups are calling for uniform "front of package" labeling
symbols that would help consumers quickly and easily identify healthier packaged food items. Front of
package symbols have been developed by many individual food manufacturers and grocery store chains
(including Wegmans), but each is different. Many experts feel that this is creating confusion among
consumers, thus the desire to create one, national system.
Current food labeling laws define the information that must be included on a food package, including:

Ingredient List

Standard serving size and # of servings

Nutrition Facts label
Labeling laws also regulate various claims that can be included on a food package. The types of claims
allowed are:

Nutrient Claims (defines terms such as low fat, low sodium, high fiber, etc.)

Health Claims (describe the relationship between a nutrient/food substance and a disease risk)
In 2020 the USDA and FDA has come out with some new guidelines regarding labeling. Packages that
contain more than 1 serving needs to include nutrient information for both a a single serving and the
entire content of the package.
The common or usual name of the product.
The name and address of the manufacturer, packer, or distributor.
The net contents in terms of weight, measure, or count.
The nutrient contents of the product (Nutrition Facts panel).
The ingredients in descending order of predominance by weight and in ordinary language.
Essential warnings, such as alerts about ingredients that often cause allergic reactions or other
problems.
On your next trip to the grocery store, look closely at food packages and how they are labeled. Can you
find...a nutrient claim? a health claim? a front-of-package symbol?
F. Identifying Nutrition Misinformation
Nutrition, like other health and medical fields, is plagued with misinformation. Food and nutrition
professionals must know how to locate reliable credible nutrition information that is science-based. And
they must be able to recognize and avoid nutrition misinformation.
Use this checklist when evaluating nutrition information for reliability:
Who is responsible for the information? What are their qualifications? Look for:

Government agencies and well known consumer health organizations such as the American
Heart Association and the American Cancer are good sources of reliable information. Be wary of
organizations you are unfamiliar with until you have done your research. An impressive
sounding name does necessarily mean an organization is credible.

Individuals who are responsible for the information in an article or website should have
qualifications and credentials relevant to the topic. Look for professional designations such as
MD (medical doctor), RD (Registered Dietitian) or education credentials such as advanced
degrees from reputable and well known educational institutions. Beware of made-up
credentials or mail order degrees. If you aren't sure what a credential is....be
suspicious. Quackwatch, an organization that watches for and publicizes bogus health, medical
and nutrition information, has information on their website about fake credential and
degrees. You can find the Quackwatch website at: www.quackwatch.com/
What about the Internet?

Misinformation is everywhere on the internet, often in disguise. Be cautious and examine
website carefully.

Stick to .gov and .edu sites for the most credible, science based information. If using .com or
.org sites, be sure to closely examine the About Us tab. If the website is credible, you should be
able to find names and qualifications of people responsible for the information posted on the
site. Look for the mission and overall purpose of the organization that owns the website.

Look for the HON (Health on the Net) symbol for assurance that the website complies with basic
standards of reliability.
Red Flags
In Chapter 1, Controversy, review the figure C1-1 Earmarks of Nutrition Quackery. Watch for these
signs of misinformation:

Quick Easy Fix - "Lose weight easily without diet or exercise"

Too Good to Be True - "Lose 20 pounds in one week"

Trying to sell you something - be suspicious if nutrition information is in any way linked to the
sale of a product.

"Good" foods and "Bad" foods - credible nutrition professionals do not oversimplify advice by
categorizing foods as good or bad.

Uses testimonials as "evidence" that a product or method works - "I started using Product X and
I have never looked or felt better"

Dramatic statements or dire warnings that are not backed by reputable scientific organizations I recently received an e-mail forward that claimed, "fruit should never be eaten in combination
with other foods or it would rot in GI tract and give off dangerous toxins". Really? how
ridiculous!

Using studies in inappropriate ways, such as oversimplifying results or drawing conclusions that
were not supported by the study results. Nutrition misinformation often takes partial
information from real studies but overstates or misrepresents the findings to support bogus
claims.
One last thing
There are a few things that I would like to quickly point out. First off, honey is no better for you than
sugar. If you look at the nutrient composition of honey in comparison to sugar you will see that they are
basically the same. They also have about the same rate of absorption so overall there is no nutritional
advantage.
I show my bias against the low-cal or no-cal sugar substitutes and I tend not to discuss them much at all.
The presence of these items in foods, I believe, tends to encourage the over-consumption of food items
that are not healthy or of nutritional benefit to us. The current research supports this belief. Products
such as soda, which often replaces milk or water in the diet, sugar-free candy and bakery products
provide little nutrition to the individual. Alternative sweeteners may help to provide some variety for
diabetics and sugar alcohol gum containing sorbitol, mannitol and xylitol may help to reduce the
incidence of dental caries.
Aspartame, a low-calorie sugar substitute is made from the amino acids phenylalanine and aspartic acid.
Individuals with PKU(phenylketone urea) cannot metabolize phenylalanine and must avoid, as much as
possible, this substance. They should avoid diet soda since most of it contains phenylalanine found in
nutra-sweet.
And no, too much sugar will not make a child hyperactive., although the caffeine in the chocolate may.
Oh, yes, one last thing. I want you to try a small experiment. Take a clear drinking glass. Place into it the
amount of sugar that you put in your coffee or tea(use a teaspoon measure), then add enough
teaspoons of sugar to equal ten. Ten teaspoons of sugar is how much you get from one 12-ounce coke.
Pepsi or similar soft drink. The average person puts no more than four teaspoons of sugar in their coffee
or tea. How do you feel about drinking a beverage with so much sugar?
Also, make sure you read the Controversy 2, Are Some Foods "Superfoods" fro Health?
Article on Paelo Diet May 2015
Unless you've been living in a cave, you've heard of the Paleo diet.
It's often called the "caveman" diet -- though devotees prefer the term "ancestral nutrition" -- because it
harkens back to the eating habits of Early Man in the Paleolithic Era, a menu involving lean meats,
veggies, healthful fats, and fruits and nuts minus today's heavy reliance on processed foods, refined
sugar, dairy, grains, legumes, salt and vegetable oils.
Modern Paleo practitioners swear by it, touting weight loss, better health and energy. It's long been big
in the high-intensity exercise world of CrossFit training, and in the past couple of years, it's swelled in
mainstream popularity to mammoth proportions. There are books, magazines, conferences and
products galore. Whole Foods Markets devotes entire sections to Paleo foods, and it was the mostGoogled diet of 2013 -- although it's still a bit of a hard sell in the vegan-strong Bay Area. The latest
notable devotee is Jeb Bush, who credits Paleo with a 30-pound weight loss since December.
Critics charge that only a handful of short-term studies have been done on the plan's claims, and instead
they point to exhaustive research on meat-heavy diets posing health risks, as well as vitamin deficiencies
caused by eliminating entire food groups. Plus, they note that Paleolithic man lived only to about age 35,
while billions of modern-day humans around the world thrive on gluten-rich foods.
So is Paleo just another passing fad on our diet plate? Or a healthful option for the modern world?
PROPS FOR PALEO
Michelle Tam, of Palo Alto, a former pharmacist who holds a degree in food science and nutrition from
UC Berkeley, has been called the Martha Stewart of Paleo, and she wants people to have fun with their
food. Her Nom Nom Paleo blog -- complete with a comic-strip explanation of the diet -- gets 100,000plus hits a day. She has a cookbook, an iPad app and even a Nom Nom action figure with her trademark
pigtail hairstyle. She also works in partnership with Whole Foods to tag Paleo-friendly food choices in
many of their stores.
The menus, she says, are not all about bacon.
"The caveman term makes it sound like it's just a crazy fad, like it's the new Atkins diet and all we're
doing is eating bacon all the time. But I'm telling you, it's not," she says adding that she's far from "Paleo
perfect," and believes eating habits should evolve for individual needs. "For me, it's just about eating
whole and non-processed foods, being mindful of what you're putting in your mouth."
Before she switched to Paleo in 2010, her dinner plate was probably a 4-ounce portion of chicken
breast, and the rest was likely "a giant whole-grain pasta dish," she says. Now, her protein portion is
slightly larger, but it's "clean" protein -- high-quality meat from grass-fed cattle -- and the rest of the
plate is vegetables.
"I feel like I eat more vegetables now than when I was a semi-vegetarian," she says. "I'm totally not
trying to re-create what the caveman ate. I live in modern times. I just want to be the healthiest version
of myself and find ways to make myself and my family healthier. Obviously, there are things we borrow
from our past. But I'm not going to overlook new studies."
She also believes in the Paleo "lifestyle," involving good sleep and exercise, and a focus on managing
stress. "Even if you eat a super-clean diet but you're super stressed, it's not going to work. You can't eat
your way out of that."
MORE RESEARCH NEEDED
Nutritionists say we indeed need more studies on Paleo. While many see benefits to the program,
there's still concern about some of the food restrictions.
"There are healthy aspects, certainly if people are eating more vegetables and fruits and fewer sugars
and refined grains," says Alison Ryan, a clinical dietitian at Stanford Health Care. "Even if you're not
following (Paleo) strictly, it may get people to skip the Wonder Bread and maybe have a larger portion
of vegetables. So that's a good thing."
But it's not right for everyone, she says, noting concern for a plan that eliminates entire food groups.
"Every bean or lentil, and every grain is eliminated, but there's a very large body of evidence showing
the benefits of consuming whole grains," she says. "The places in the world, like Okinawa, where people
live the longest -- they eat plant-based, grain-based diets that typically don't have a lot of meat."
Stacy DeRosa, a registered dietitian working in outpatient nutrition counseling at Alta Bates Summit
Medical Center in the East Bay, agrees there are healthful aspects but wonders if the average person can
implement the plan without guidance.
"If you're just looking at it as 'I'm gonna eat a lot of meat,' you can run the risk of really high fat, really
high protein, not enough carbs," she says. "And now without grains, without dairy, you're not getting
enough glucose, not enough calcium.
"If somebody did want to follow a diet like this, see a specialist. Really sit down with your doctor or a
dietitian to make sure you're getting what you need, just for you. It has to be individualized."
Andy Landgraf, 26, a sales associate in Berkeley, has been doing Paleo for the past year. He's lost about
20 pounds, says he feels great and plans to stick to the diet.
"A bunch of my friends were doing it -- one so he could lose weight for his wedding. So I did a lot of
research and decided to try it," he says. "I look at it like just making healthier eating choices. I basically
do no dairy, no cheese, no bread. I don't even use vegetable oil."
He feels the science is "a little iffy" when it comes to limiting things like legumes, so he'll eat some beans
on occasion. He says he was very strict on the food plan at first but has since "slacked off a little bit."
"Still, I'm going to keep doing it," he says. "I don't see myself ever chowing down on bread and cheese
anymore."
Contact Angela Hill at ahill@bayareanewsgroup.com, or follow her on Twitter @GiveEmHill.
Paleo diet Basics
Paleolithic-style diets vary across the Internet, but according to Palo Alto's Michelle Tam, who writes the
Nom Nom Paleo blog, these are the core tenets of the meal plans:
· Eat whole, unprocessed, nutrient-dense foods. Priorities are meats and eggs from grass-fed animals,
wild-caught seafood and vegetables. Enjoy fruit, nuts and seeds in moderation.
· Abstain from gluten-containing grains, legumes, sugar and what she calls "laboratory-concocted
Frankenfoods."