Healthy Eating

What is Healthy Eating

Eating healthy doesn’t have to mean dieting or giving up all the foods you love. An overall healthy eating pattern is tailored to your personal and cultural food preferences. This eating pattern can include a variety of vegetables, fruits, whole grains, beans, legumes, fish, skinless poultry, nuts, and fat-free/low-fat dairy products, and should limit sugary drinks, sweets, fatty or processed meats, solid fats, and salty or highly processed foods. It’s all about making smart choices. Learn how to ditch the junk, give your body the nutrient-dense fuel it needs, and love every minute of it! (Source ¹).

Because how much calories you eat and what food groups you need are highly dependent on your age, sex, and your level of physical activity. For the most accurate way calculate how much food and calories you need to eat per day from each food group >>> Go to the United States Department of Agriculture’s MyPlate Daily Checklist ² >>> https://www.choosemyplate.gov/myplate-daily-checklist-input
Simply enter your age, sex, height, weight, and physical activity level to get a plan that’s right for you. The MyPlate Daily Checklist shows your food group targets – what and how much to eat within your calorie allowance.

Health is defined as the state of being free from illness or injury. Health describes a person’s physical or mental condition. It’s synonymous with well-being, vigor, wellness, good-shape, good condition.

Nutrition is characteristic of foods and beverages that are nutrient dense, that provide vitamins, minerals, and other substances that contribute to adequate nutrient intakes or may have positive health effects, with little or no solid fats and added sugars, refined starches, and sodium. Ideally, these foods and beverages also are in forms that retain naturally occurring components, such as dietary fiber. All vegetables, fruits, whole grains, seafood, eggs, beans and peas, unsalted nuts and seeds, fat-free and low-fat dairy products, and lean meats and poultry—when prepared with little or no added solid fats, sugars, refined starches, and sodium—are nutrient dense foods. These foods contribute to meeting food group recommendations within calorie and sodium limits. The term “nutrient dense” indicates the nutrients and other beneficial substances in a food have not been “diluted” by the addition of calories from added solid fats, sugars, or refined starches, or by the solid fats naturally present in the food.

Malnutrition refers to deficiencies, excesses, or imbalances in a person’s intake of energy and/or nutrients. The term malnutrition addresses 3 broad groups of conditions:

Undernutrition, which includes wasting (low weight-for-height), stunting (low height-for-age) and underweight (low weight-for-age);
Micronutrient-related malnutrition, which includes micronutrient deficiencies (a lack of important vitamins and minerals) or micronutrient excess; and
Overweight, obesity and diet-related noncommunicable diseases (such as heart disease, stroke, diabetes and some cancers). Which is the main topic of discussion of this entire site. In adults, overweight is defined as a Body Mass Index (BMI) of 25 or more, whereas obesity is a BMI of 30 or more. Overweight and obesity result from an imbalance between energy consumed (too much) and energy expended (too little). Worldwide, people are consuming foods and drinks that are more energy-dense (high in sugars and fats), and engaging in less physical activity.

Diet is an important determinant of chronic disease risk, particularly heart disease. This Cochrane review (source ³) assessed the effects of providing dietary advice to healthy adults in order to produce sustained improvements in their diets. Whether dietary improvement would reduce the risk factors associated with heart disease was also examined. They found 44 trials in which healthy adults were randomly assigned to receive dietary advice or no dietary advice. The dietary improvements recommended to the people in the intervention groups centred largely on the reduction of salt and fat intake and an increase in the intake of fruit, vegetables and fibre. Advice was delivered in a variety of ways, including one-to-one contact, group sessions and written materials. There were variations in intensity of the intervention, ranging from one contact per study participant to 50 hours of counselling over four years. The duration of the trials ranged from three months to four years, with a median follow-up period of 12 months. There was some evidence of greater effectiveness in people told that they were at risk of heart disease or cancer. Modest improvements were shown in cardiovascular risk factors, such as blood pressure and total and LDL-cholesterol levels. In the trials that separated effects by gender, women tended to make larger reductions in fat intake but there was insufficient evidence to show whether this translated to a larger reduction in total cholesterol levels. Two trials followed people up 10 to 15 years after the end of the trials and showed that the beneficial changes in cardiovascular risk factors may have resulted in a reduced incidence of heart disease, stroke or heart attack, although more evidence is needed to confirm this.

Nutrition with Healthy Eating Patterns & Health Are Closely Related

There are very few studies to date examining provision of, or advice to increase the consumption of, fruit and vegetables in the absence of additional dietary interventions or other lifestyle interventions for the primary prevention of cardiovascular disease (e.g. high blood pressure, heart attacks, stroke). The limited evidence suggests advice to increase fruit and vegetables as a single intervention has favourable effects on cardiovascular disease risk factors but more trials are needed to confirm this.

Evidence shows that healthy eating patterns, are associated with positive health outcomes. The evidence base for associations between eating patterns and specific health outcomes continues to grow. Strong evidence shows that healthy eating patterns are associated with a reduced risk of cardiovascular disease (CVD). Moderate evidence indicates that healthy eating patterns also are associated with a reduced risk of type 2 diabetes, certain types of cancers (such as colorectal and postmenopausal breast cancers), overweight, and obesity. Emerging evidence also suggests that relationships may exist between eating patterns and some neurocognitive disorders and congenital anomalies.

Within this body of evidence, higher intakes of vegetables and fruits consistently have been identified as characteristics of healthy eating patterns; whole grains have been identified as well, although with slightly less consistency. Other characteristics of healthy eating patterns have been identified with less consistency and include fat-free or low-fat dairy, seafood, legumes, and nuts. Lower intakes of meats, including processed meats; processed poultry; sugar-sweetened foods, particularly beverages; and refined grains have often been identified as characteristics of healthy eating patterns.

Additional information about how food groups and dietary components fit within healthy eating patterns is discussed throughout this site. For example, research has shown that vegetables and fruits are associated with a reduced risk of many chronic diseases, including CVD, and may be protective against certain types of cancers. Additionally, some evidence indicates that whole grain intake may reduce risk for CVD and is associated with lower body weight. Research also has linked dairy intake to improved bone health, especially in children and adolescents.

A healthy eating pattern limits:

Saturated fats and trans fats, added sugars, and sodium. Limit calories from added sugars and saturated fats and reduce sodium intake.
Consume an eating pattern low in added sugars, saturated fats, and sodium. Cut back on foods and beverages higher in
these components to amounts that fit within healthy eating patterns.
Replace typical food and beverages choices with more nutrient-dense options. Choose nutrient-dense foods and beverages across and within all food groups in place of less healthy choices. Consider cultural and personal preferences to make these shifts easier to accomplish and maintain.

Reduced dietary Salt (sodium) for the prevention of cardiovascular disease

Fact #1: Science strongly supports the link between less sodium intake and healthier lives – even in children and teens ⁴. For example, kids who eat high sodium diets are about 35% more likely to have elevated blood pressure than kids who eat lower sodium diets ⁵. And the rate of high blood pressure is increasing in American children. In addition to heart health, sodium impacts bone, brain, stomach, and kidney health ⁶.

Fact #2: There has been a lot of noise about some sodium studies, leading to confusion and helping efforts to undermine nutrition standards for school meals. A large body of scientific research indicates that lowering sodium intake lowers blood pressure in adults and children. ⁷.

Fact #3: Actually, more than 99 percent of schools are successfully meeting the updated meal standards ⁸. Some schools are already meeting the USDA’s 2017 targets. Many companies already offer foods that meet the target limits set by the USDA ⁹. A variety of methods exist that can help reduce sodium in foods ¹⁰, and modelling suggests that some newly developed ingredients could make a big impact. ¹¹.

Fact #4: Replacing nutrient-poor, high-sodium foods with healthier foods could improve overall consumption of other beneficial nutrients. Gradually lowering the sodium content in foods can decrease kids’ (and adults’) taste for salty food over time. ¹².

Cardiovascular disease includes heart attacks and strokes and is a major cause of premature death and disability. In the most updated clinical and scientific review first published in 2014 (source ¹³). The review of a total of eight trials with 7284 participants found dietary advice and salt substitution did reduce the amount of salt eaten, which led to a small reduction in blood pressure by six months. There was weak evidence of benefit for cardiovascular events, but these findings were inconclusive and were driven by a single trial among retirement home residents, which reduced salt intake in the kitchens of the homes.

The findings of the review do not mean that advising people to reduce salt should be stopped. However, additional measures – reducing the amount of hidden salt in processed foods, for example – will make it much easier for people to achieve a lower salt diet. Overall many of the trials failed to report sufficient detail to assess their potential risk of bias. Further evidence of the effects of different ways of reducing dietary salt on clinical events is needed from experimental and observational studies to underpin public health policies.

The review concluded that despite collating more event data than previous systematic reviews of randomised controlled trials, there is insufficient power to confirm clinically important effects of dietary advice and salt substitution on cardiovascular mortality in normotensive or hypertensive populations. Their estimates of the clinical benefits from advice to reduce dietary salt are imprecise, but are larger than would be predicted from the small blood pressure reductions achieved. Further well-powered studies would be needed to obtain more precise estimates. Their findings do not support individual dietary advice as a means of restricting salt intake. It is possible that alternative strategies that do not require individual behaviour change may be effective and merit further trials.

The specified limits can help you achieve healthy eating patterns within calorie limits:

Consume less than 10 percent of calories per day from added sugars.
Consume less than 10 percent of calories per day from saturated fats.
Consume less than 2,300 milligrams (mg) per day of sodium.
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.

A healthy eating pattern is not a rigid prescription, but rather, an adaptable framework in which individuals can enjoy foods that meet their personal, cultural, and traditional preferences and fit within their budget.

Healthy Eating means consuming the right quantities of foods from all food groups in order to lead a healthy life. Healthy eating means eating a variety of foods that give you the nutrients you need to maintain your health, feel good, and have energy. These nutrients include protein, carbohydrates, fat, water, vitamins, and minerals. Several examples of healthy eating patterns that translate and integrate the recommendations in overall healthy ways to eat are provided.

What Does “Healthy Eating” Mean ?

According to the Dietary Guidelines for Americans, a healthy diet:

Emphasizes vegetables, fruits, whole grains, and fat-free or low-fat milk products.
Includes lean meats, poultry, fish, beans, eggs, and nuts.
Is low in saturated fats, trans fats, cholesterol, salt, and added sugars. Limit calories from added sugars and saturated fats and
reduce sodium intake. Consume an eating pattern low in added sugars, saturated fats, and sodium. Cut back on foods and beverages higher in these components to amounts that fit within healthy eating patterns.
Balances the calories you take in from food and beverages with the calories burned through physical activity to maintain a healthy weight.

Here are some tips to help you meet the guidelines:

Eating fruits and vegetables of different colors gives your body a wide range of valuable nutrients. A variety of vegetables from all of the subgroups—dark green, red and orange, legumes (beans and peas), starchy.
Include foods that contain fiber such as fruits, vegetables, beans, and whole-grains.
Eat lean cuts of meat and poultry. Trim away excess fat and remove skin from poultry before cooking.
Pay attention to portion sizes, especially at restaurants. Smaller portions equal fewer calories.
Season your food with lemon juice, herbs, and spices, rather than using butter and salt.
Choose foods that are baked, broiled, braised, grilled, steamed, sautéed, or boiled, rather than fried.
When eating out, select a dish from the menu, rather than getting your money’s worth at the all-you-can-eat buffet.

Nutrition is important for everyone. When combined with being physically active and maintaining a healthy weight, eating well is an excellent way to help your body stay strong and healthy. What you eat can affect your immune system, your mood, and your energy level.

Diet is often referred to as some dietary regimen for losing weight. However, diet simply means what food we eat in the course of a 24-hour, one week, or one month, etc.

Healthy US Style Eating Pattern is based on the types and proportions of foods Americans typically consume, but in nutrient-dense forms and appropriate amounts. It is designed to meet nutrient needs while not exceeding calorie requirements and while staying within limits for over-consumed dietary components.

Vegetables and fruits, 1 cup-equivalent is: 1 cup raw or cooked vegetable or fruit, 1 cup vegetable or fruit juice, 2 cups leafy salad greens, ½ cup dried fruit or vegetable.
Grains, 1 ounce-equivalent is: ½ cup cooked rice, pasta, or cereal; 1 ounce dry pasta or rice; 1 medium (1 ounce) slice bread; 1 ounce of ready-to-eat cereal (about 1 cup of flaked cereal).
Dairy, 1 cup-equivalent is: 1 cup milk, yogurt, or fortified soymilk; 1½ ounces natural cheese such as cheddar cheese or 2 ounces of processed cheese.
Protein Foods, 1 ounce-equivalent is: 1 ounce lean meat, poultry, or seafood; 1 egg; ¼ cup cooked beans or tofu; 1 Tbsp peanut butter; ½ ounce nuts or seeds.

What and How much Should you Eat ?

For an average adult male who requires 2000 Calories (8368 kilojoules)

Note: 1 Calorie (kilocalories) = 4.184 kilojoules (kJ)

An important part of maintaining a healthy weight and healthy lifestyle is to maintain energy balance is the amount of ENERGY OUT (physical activity) that you do. People who are more physically active burn more calories than those who are not as physically active.

The same amount of ENERGY IN (calories consumed) and ENERGY OUT (calories burned) over time = weight stays the same

More IN than OUT over time = weight gain
More OUT than IN over time = weight loss
To lose weight, most people need to reduce the number of calories they get from food and beverages (energy IN) and increase their physical activity (energy OUT).
For a weight loss of 1–1 ½ pounds per week, daily intake should be reduced by 500 to 750 calories ¹⁴. In general:
Eating plans that contain 1,200–1,500 calories each day will help most women lose weight safely.
Eating plans that contain 1,500–1,800 calories each day are suitable for men and for women who weigh more or who exercise regularly.

**Estimated Calorie Requirements (in kilocalories) for Each Gender and Age Group at Three Levels of Physical Activity.**
Gender	Age (years)	Activity Level
Gender	Age (years)	Sedentary	Moderately Active	Active
Child	2-3	1,000	1,000 – 1,400	1,000 – 1,400
Female	4 – 8	1,200	1,400 – 1,600	1,400 – 1,800
Female	9-13	1,600	1,600 – 2,000	1,800 – 2,000
Female	14-18	1,800	2,000	2,400
Female	19-30	2,000	2,000 – 2,200	2,400
Female	31-50	1,800	2,000	2,200
Female	51+	1,600	1,800	2,000 – 2,200
Male	4-8	1,400	1,400 – 1,600	1,600 – 2,000
Male	9-13	1,800	1,800 – 2,200	2,000 – 2,600
Male	14-18	2,200	2,400 – 2,800	2,800 – 3,200
Male	19-30	2,400	2,600 – 2,800	3,000
Male	31-50	2,200	2,400 – 2,600	2,800 – 3,000
Male	51+	2,000	2,200 – 2,400	2,400 – 2,800

Source: HHS/USDA Dietary Guidelines for Americans: 2005 ¹⁵

These levels are based on Estimated Energy Requirements from the IOM Dietary Reference Intakes macronutrients report, 2002, calculated by gender, age, and activity level for reference-sized individuals. “Reference size,” as determined by IOM, is based on median height and weight for ages up to age 18 years of age and median height and weight for that height to give a BMI of 21.5 for adult females and 22.5 for adult males.
Sedentary means a lifestyle that includes only the light physical activity associated with typical day-to-day life.
Moderately active means a lifestyle that includes physical activity equivalent to walking about 1.5 to 3 miles per day at 3 to 4 miles per hour, in addition to the light physical activity associated with typical day-to-day life.
Active means a lifestyle that includes physical activity equivalent to walking more than 3 miles per day at 3 to 4 miles per hour, in addition to the light physical activity associated with typical day-to-day life.
The calorie ranges shown are to accommodate needs of different ages within the group. For children and adolescents, more calories are needed at older ages. For adults, fewer calories are needed at older ages.
Note: 1 Calorie (kilocalories) = 4.184 kilojoules (kJ)
For an average adult male who requires 2000 Calories = 8368 kilojoules

Healthy Eating Plan

A healthy eating plan gives your body the nutrients it needs every day while staying within your daily calorie goal for weight loss. A healthy eating plan also will lower your risk for heart disease and other health conditions.

A healthy eating plan ¹⁴:

Emphasizes vegetables, fruits, whole grains, and fat-free or low-fat dairy products
Includes lean meats, poultry, fish, beans, eggs, and nuts
Limits saturated and trans fats, sodium, and added sugars
Controls portion sizes

How to Eat Healthy

Follow these steps to help you eat healthy:

Eat the right types of food by following Healthy Food Guide. Choose a variety of foods from each of the four food groups.
Eat the recommended amount of food for your age, sex, and activity level.
Read food labels to compare and choose healthier foods when shopping. The Nutrition Facts table and the Percent Daily Value can help you make better choices.
Limit foods and drinks that are high in calories, fat, sugar, and sodium.

A healthy eating pattern limits:

Saturated fats and trans fats, added sugars, and sodium
Consume less than 10 percent of calories per day from added sugars
Consume less than 10 percent of calories per day from saturated fats
Consume less than 2,300 milligrams (mg) per day of sodium
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.

Key Recommendations that are quantitative are provided for several components of the diet that 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.

Vegetables
- Dark-green vegetables: All fresh, frozen, and canned dark-green leafy vegetables and broccoli, cooked or raw: for example, broccoli; spinach; romaine; kale; collard, turnip, and mustard greens.
- Red and orange vegetables: All fresh, frozen, and canned red and orange vegetables or juice, cooked or raw: for example, tomatoes, tomato juice, red peppers, carrots, sweet potatoes, winter squash, and pumpkin.
- Legumes (beans and peas): All cooked from dry or canned beans and peas: for example, kidney beans, white beans, black beans, lentils, chickpeas, pinto beans, split peas, and edamame (green soybeans). Does not include green beans or green peas.
- Starchy vegetables: All fresh, frozen, and canned starchy vegetables: for example, white potatoes, corn, green peas, green lima beans, plantains, and cassava.
- Other vegetables: All other fresh, frozen, and canned vegetables, cooked or raw: for example, iceberg lettuce, green beans, onions, cucumbers, cabbage, celery, zucchini, mushrooms, and green peppers.
Fruits
- All fresh, frozen, canned, and dried fruits and fruit juices: for example, oranges and orange juice, apples and apple juice, bananas, grapes, melons, berries, and raisins.
Grains
- Whole grains: All whole-grain products and whole grains used as ingredients: for example, whole-wheat bread, whole-grain cereals and crackers, oatmeal, quinoa, popcorn, and brown rice.
- Refined grains: All refined-grain products and refined grains used as ingredients: for example, white breads, refined grain cereals and crackers, pasta, and white rice. Refined grain choices should be enriched.
Dairy
- All milk, including lactose-free and lactose-reduced products and fortified soy beverages (soymilk), yogurt, frozen yogurt, dairy desserts, and cheeses. Most choices should be fat-free or low-fat. Cream, sour cream, and cream cheese are not included due to their low calcium content.
Protein Foods
- All seafood, meats, poultry, eggs, soy products, nuts, and seeds. Meats and poultry should be lean or low-fat and nuts should be unsalted. Legumes (beans and peas) can be considered part of this group as well as the vegetable group, but should be counted in one group only.

Evidence shows that healthy eating patterns are associated with positive health outcomes. And the evidence base for associations between eating patterns and specific health outcomes continues to grow. Strong evidence shows that healthy eating patterns are associated with a reduced risk of cardiovascular disease. Moderate evidence indicates that healthy eating patterns also are associated with a reduced risk of type 2 diabetes, certain types of cancers (such as colorectal and postmenopausal breast cancers), overweight, and obesity. Emerging evidence also suggests that relationships may exist between eating patterns and some neuro-cognitive disorders and congenital anomalies.

Lower intakes of meats, including processed meats; processed poultry; sugar-sweetened foods, particularly beverages; and refined grains have often been identified as characteristics of healthy eating patterns.

A) 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. 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, 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.

B) 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). 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 US Department of Agriculture (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. 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.

C) 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.

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. 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.

D) 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 cup-equivalents 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.

E) 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. 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. 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. 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. The inclusion of protein foods from plants allows vegetarian options to be accommodated.

F) 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. 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 and information on the relationship between dietary fats and health is discussed in the Saturated Fats, Trans Fats, and Cholesterol section, below.

G) 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 low-density 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 high-density 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: 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.

H) Trans Fats

Individuals should limit intake of trans fats to as low as possible by limiting foods that contain synthetic sources of trans 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 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. Natural trans 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.

I) 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, 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.

J) 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, 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. Sodium is an essential nutrient and is needed by the body in relatively small quantities, provided that substantial sweating does not occur. 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.

The DASH Eating Plan is high in vegetables, fruits, low-fat dairy products, whole grains, poultry, fish, beans, and nuts and is low in sweets, sugar-sweetened beverages, and red meats. It is low in saturated fats and rich in potassium, calcium, and magnesium, as well as dietary fiber and protein. It also is lower in sodium than the typical American diet, and includes menus with two levels of sodium, 2,300 and 1,500 mg per day.

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. 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.

Healthy Eating on a Budget

PLAN

+ Know how much money you have to spend on food.
+ Before you head to the grocery store, plan your meals for the week. Include meals like stews, casseroles, or stir-fries, which “stretch” expensive items into more portions. Check to see what foods you already have and make a list for what you need to buy.
+ Plan meals and snacks for the week according to an established budget.
+ Find quick and easy recipes online.
+ Include meals that will “stretch” expensive food items (stews, casseroles, stir‐fried dishes).
+ Make a grocery list.
+ Get the best price. Check the local newspaper, online, and at the store for sales and coupons. Ask about a loyalty card for extra savings at stores where you shop. Look for specials or sales on meat and seafood — often the most expensive items on your list.
+ Check for sales and coupons in the local paper or online and consider discount stores.
+ Read the sales flyer. Sales flyers are usually released mid-week and can be found at the store’s entrance, in the newspaper, or on their website.
+ Ask about a loyalty card at your grocery store.
+ Eat before you shop. Grocery shopping hungry can lead to impulse buying and unhealthy food choices.

PURCHASE

+ Eat before you shop. Grocery shopping hungry can lead to impulse buying and unhealthy food choices.
+ Buy groceries when you are not hungry and when you are not too rushed.
+ Use coupons – but only for items that you know you’ll use.
+ Stick to the grocery list and stay out of the aisles that don’t contain items on your list.
+ Buy store brands if cheaper.
+ Stores often stock the priciest items at eye level. You can save big by looking at the upper and lower shelves too.
+ Buy in bulk. It is almost always cheaper to buy foods in bulk. Smart choices are family packs of chicken, steak, or fish and larger bags of potatoes and frozen vegetables. Before you shop, remember to check if you have enough freezer space.
+ Buy only the amounts of fresh foods you can use before it spoils.
+ Find and compare unit prices listed on shelves to get the best price.
+ Choose fresh fruits and vegetables in season; buy canned vegetables with less salt.
+ Convenience foods like frozen dinners, pre-cut vegetables, and instant rice, oatmeal, or grits will cost you more than if you were to make them from scratch. Take the time to prepare your own — and save!
+ Certain foods are typically low-cost options all year round. Try beans for a less expensive protein food. For vegetables, buy carrots, greens, or potatoes. As for fruits, apples and bananas are good choices.
+ Cook once… eat all week! Prepare a large batch of favorite recipes on your day off (double or triple the recipe). Freeze in individual containers. Use them throughout the week and you won’t have to spend money on take-out meals.
+ Spice up your leftovers — use them in new ways. For example, try leftover chicken in a stir-fry or over a garden salad, or to make chicken chili. Remember, throwing away food is throwing away your money!
+ Eating out. Restaurants can be expensive. Save money by getting the early bird special, going out for lunch instead of dinner, or looking for “2 for 1” deals. Stick to water instead of ordering other beverages, which add to the bill.

American Heart Association – Suggested Servings from Each Food Group – https://healthyforgood.heart.org/eat-smart/articles/suggested-servings-from-each-food-group[↩]
https://www.choosemyplate.gov/myplate-daily-checklist-input[↩][↩]
Cochrane Review 4 June 2013 – Increased fruit and vegetable intake to prevent cardiovascular disease – http://www.cochrane.org/CD009874/VASC_increased-fruit-and-vegetable-intake-to-prevent-cardiovascular-disease[↩]
Appel et al. Reducing Sodium Intake in Children: A Public Health Investment. Journal of Clinical Hypertension. 2015:1–6.[↩]
Rosner et al. Childhood blood pressure trends and risk factors for high blood pressure: The NHANES experience 1998-2008. Hypertension. 2013;62:247-254.[↩]
Appel et al. The importance of population-wide sodium reduction as a means to prevent cardiovascular disease and stroke: A call to action from the American Heart Association. Circulation. 2011, 15;123(10):1138-43.[↩]
Whelton et al. Sodium, blood pressure, and cardiovascular disease: Further evidence supporting the American Heart Association sodium reduction recommendations. Circulation. 2012;126:2880-2889 4/14/2015[↩]
Statement from Secretary Vilsack on New Data Showing the Vast Majority of Schools Now Meet the Updated Meals Standards. USDA. May 6, 2015. Accessed online at http://www.fns.usda.gov/school-meals/school-meal-certification-data[↩]
National Alliance for Nutrition and Activity. Mission: Possible Companies Can Meet USDA’s New Sodium Limits for School Meals. Accessed online 8/14/2014: http://cspinet.org/new/pdf/NANA%20 Sodium%20products%20that%20meet%20new%20guidelines%20oct%2014.pdf[↩]
Antman et al. Stakeholder discussion to reduce population-wide sodium intake and decrease sodium in the food supply: A conference report from the American Heart Association sodium conference 2013 planning group. Circulation. 2014.[↩]
Agarwal et al. Sodium Intake Status in United States and Potential Reduction Modeling: an NHANES 2007-2010 analysis. Food Science and Nutrition. 2015. DOI: 10.1002/ fsn3.248[↩]
IOM. 2010. Strategies to Reduce Sodium Intake in the United States. Washington, DC: The National Academies Press[↩]
Cochrane Review 18 December 2014 – Reduced dietary salt for the prevention of cardiovascular disease – http://www.cochrane.org/CD009217/VASC_reduced-dietary-salt-for-the-prevention-of-cardiovascular-disease[↩]
National Institutes of Health, Department of Health and Human Services – Healthy Eating Plan – https://www.nhlbi.nih.gov/health/educational/lose_wt/eat/calories.htm[↩][↩]
https://www.nhlbi.nih.gov/health/educational/wecan/healthy-weight-basics/balance.htm[↩]