Dietary Guidelines 2015-2020

Table of Contents

Message From the Secretaries ………………………………………………………………………………………. vii
Acknowledgments…………………………………………………………………………………………………………….. viii
Executive Summary………………………………………………………………………………………………………………………………. x
Introduction………………………………………………………………………………………………………………………….. 1
Nutrition & Health Are Closely Related……………………………………………………………………………………………………………………………….. 2

The Dietary Guidelines for Americans: What It Is, What It Is Not ……………………………………………. 5

Developing the Dietary Guidelines for Americans …………………………………………………………………. 6

Stage 1: Review of Current Scientific Evidence ………………………………………………………………………. 7

Stage 2: Development of the Dietary Guidelines for Americans ……………………………………………….. 8

Stage 3: Implementing the Dietary Guidelines for Americans …………………………………………………. 10

A Roadmap to the 2015-2020 Edition of the Dietary Guidelines for Americans ……………………….. 11

Chapter 1. Key Elements of Healthy Eating Patterns………………………………………………………. 13
Introduction ………………………………………………………………………………………………………………………14

About This Chapter ……………………………………………………………………………………………………………. 14

Key Recommendations: Components of Healthy Eating Patterns …………………………………………… 15

Healthy Eating Patterns: Dietary Principles ……………………………………………………………………… 16

The Science Behind Healthy Eating Patterns ………………………………………………………………………… 17

Associations Between Eating Patterns & Health …………………………………………………………………… 17

Associations Between Dietary Components & Health …………………………………………………………… 17

A Closer Look Inside Healthy Eating Patterns ……………………………………………………………………… 18

Food Groups …………………………………………………………………………………………………………………….. 21

Other Dietary Components ………………………………………………………………………………………………… 28

Examples of Other Healthy Eating Patterns ………………………………………………………………………….. 35

Healthy Mediterranean-Style Eating Pattern ………………………………………………………………………… 35

Healthy Vegetarian Eating Pattern ………………………………………………………………………………………. 36

Summary ………………………………………………………………………………………………………………………….. 36

2015-2020 Dietary Guidelines for Americans — Page i
Chapter 2. Shifts Needed To Align With Healthy Eating Patterns………………………….. 37
Introduction ……………………………………………………………………………………………………………………… 38

About This Chapter ……………………………………………………………………………………………………………. 38

Current Eating Patterns in the United States ………………………………………………………………………… 38

A Closer Look at Current Intakes & Recommended Shifts ………………………………………………………. 43

Food Groups ……………………………………………………………………………………………………………………….. 43

Other Dietary Components ………………………………………………………………………………………………… 53

Underconsumed Nutrients & Nutrients of Public Health Concern …………………………………………. 60

Beverages ………………………………………………………………………………………………………………………….. 61

Opportunities for Shifts in Food Choices ……………………………………………………………………………. 61

Summary ………………………………………………………………………………………………………………………………………….. 62

Chapter 3. Everyone Has a Role in Supporting Healthy Eating Patterns…………….. 63
Introduction …………………………………………………………………………………………………………………………………………… 64

About This Chapter …………………………………………………………………………………………………………………………………………. 64

Creating & Supporting Healthy Choices …………………………………………………………………………………………………………………………….. 64

The Social-Ecological Model …………………………………………………………………………………………………………………………………………… 64

Sectors …………………………………………………………………………………………………………………………………………. 65

Settings ………………………………………………………………………………………………………………………………………….. 66

Social & Cultural Norms & Values …………………………………………………………………………………………………………………………………. 66

Individual Factors …………………………………………………………………………………………………………………………………………… 66

Meeting People Where They Are: Contextual Factors & Healthy Eating Patterns …………………… 67

Food Access ……………………………………………………………………………………………………………………….. 67

Household Food Insecurity ……………………………………………………………………………………………………………………………………………. 67

Acculturation ……………………………………………………………………………………………………………………………………………………………… 67

Strategies for Action ………………………………………………………………………………………………………………………………………………………. 68

Summary ……………………………………………………………………………………………………………………………………………………………………….. 72

Page ii — 2015-2020 Dietary Guidelines for Americans
Appendixes
Appendix 1. Physical Activity Guidelines for Americans …………………………………………………………………………………………………….. 73

Appendix 2. Estimated Calorie Needs per Day, by Age, Sex, & Physical Activity Level …………………………………………………………… 77

Appendix 3. USDA Food Patterns: Healthy U.S.-Style Eating Pattern …………………………………………………………………………………… 79

Appendix 4. USDA Food Patterns: Healthy Mediterranean-Style Eating Pattern ……………………………………………………………………. 83

Appendix 5. USDA Food Patterns: Healthy Vegetarian Eating Pattern ………………………………………………………………………………….. 86

Appendix 6. Glossary of Terms ……………………………………………………………………………………………………………………………………….. 89

Appendix 7. Nutritional Goals for Age-Sex Groups Based on Dietary Reference Intakes

& Dietary Guidelines Recommendations ……………………………………………………………………………………………………………………………. 97

Appendix 8. Federal Resources for Information on Nutrition & Physical Activity …………………………………………………………………… 99

Appendix 9. Alcohol ……………………………………………………………………………………………………………………………………………………. 101

Appendix 10. Food Sources of Potassium ……………………………………………………………………………………………………………………….. 104

Appendix 11. Food Sources of Calcium ………………………………………………………………………………………………………………………….. 108

Appendix 12. Food Sources of Vitamin D ……………………………………………………………………………………………………………………….. 111

Appendix 13. Food Sources of Dietary Fiber ……………………………………………………………………………………………………………………. 114

Appendix 14. Food Safety Principles & Guidance ……………………………………………………………………………………………………………. 119

List of Tables
Table I-1. Facts About Nutrition- & Physical Activity-Related Health Conditions in the United States ………………………………………… 2

Table 1-1. Healthy U.S.-Style Eating Pattern at the 2,000-Calorie Level, With Daily or

Weekly Amounts From Food Groups, Subgroups, & Components
Table 1-2. Composition of the Healthy Mediterranean-Style & Healthy Vegetarian Eating Patterns

at the 2,000-Calorie Level, With Daily or Weekly Amounts From Food Groups, Subgroups, & Components
Table A7-1. Daily Nutritional Goals for Age-Sex Groups Based on Dietary Reference Intakes

& Dietary Guidelines Recommendations
………………………………………………………………………………………….. 18

………………………………… 35

Table 2-1. Examples of Vegetables in Each Vegetable Subgroup ………………………………………………………………………………………….. 47

Table A1-1. Physical Activity Guidelines for Americans Recommendations …………………………………………………………………………… 73

Table A1-2. Federal Physical Activity Resources ……………………………………………………………………………………………………………….. 75

Table A2-1. Estimated Calorie Needs per Day, by Age, Sex, & Physical Activity Level ……………………………………………………………. 77

Table A3-1. Healthy U.S.-Style Eating Pattern: Recommended Amounts of Food

From Each Food Group at 12 Calorie Levels ………………………………………………………………………………………………………………………… 80
Table A4-1. Healthy Mediterranean-Style Eating Pattern: Recommended Amounts of Food

From Each Food Group at 12 Calorie Levels ………………………………………………………………………………………………………………………… 84
Table A5-1. Healthy Vegetarian Eating Pattern: Recommended Amounts of Food

From Each Food Group at 12 Calorie Levels ………………………………………………………………………………………………………………………… 87
Table A6-1. Body Mass Index & Corresponding Body Weight Categories for Children & Adults ………………………………………………. 89

……………………………………………………………………………………………………………………………. 97

2015-2020 Dietary Guidelines for Americans — Page iii
Table A8-1. Federal Nutrition & Physical Activity Resources ………………………………………………………………………………………………. 99

Table A9-1. Alcoholic Drink-Equivalents of Select Beverages ……………………………………………………………………………………………. 102
Table A10-1. Potassium: Food Sources Ranked by Amounts of Potassium & Energy

per Standard Food Portions & per 100 Grams of Foods ………………………………………………………………………………………………………. 104
Table A11-1. Calcium: Food Sources Ranked by Amounts of Calcium & Energy

per
Standard
Food
Portions
&
per
100
Grams
of
Foods ……………………………………………………………………………………………………….
108

Table A12-1. Vitamin D: Food Sources Ranked by Amounts of Vitamin D & Energy

per Standard Food Portions & per 100 Grams of Foods ………………………………………………………………………………………………………. 111

Table A13-1. Dietary Fiber: Food Sources Ranked by Amounts of Dietary Fiber

and Energy per Standard Food Portions & per 100 Grams of Foods ……………………………………………………………………………………… 114

Table A14-1. Recommended Safe Minimum Internal Temperatures ……………………………………………………………………………………. 121

List of Figures
Figure ES-1. 2015-2020 Dietary Guidelines for Americans at a Glance ………………………………………………………………………………….xv

Figure I-1. Adherence of the U.S. Population Ages 2 Years & Older to the 2010 Dietary Guidelines,

as Measured by Average Total Healthy Eating Index-2010 (HEI-2010) Scores
Figure I-2. Percentage
of
Adults
Meeting
the
Physical Activity Guidelines

(Aerobic
&
Muscle-Strengthening
Recommendations)
Figure 2-1. Dietary
Intakes
Compared
to
Recommendations.
Percent
of
the

U.S.
Population
Ages
1
Year
&
Older
Who
Are
Below,
At,
or
Above
Each
Dietary
Goal
or
Limit

…………………………………………………………………………… 4

…………………………………………………………………………………………………………… 5

Figure I-3. Science, Policy, Implementation: Developing the 2015-2020 Dietary Guidelines for Americans …………………………………. 6

Figure 1-1. Cup- & Ounce-Equivalents ……………………………………………………………………………………………………………………………… 19

Figure 1-2. Fatty Acid Profiles of Common Fats & Oils ………………………………………………………………………………………………………… 26

Figure 1-3. Hidden Components in Eating Patterns ……………………………………………………………………………………………………………. 29

…………………………………………………. 39

Figure 2-4. Average Vegetable Subgroup Intakes in Cup-Equivalents per Week by Age-Sex Groups,

Compared to Ranges of Recommended Intakes per Week
Figure 2-5. Average Whole & Refined Grain Intakes in Ounce-Equivalents per Day by Age-Sex Groups,

Compared to Ranges of Recommended Daily Intake for Whole Grains & Limits for Refined Grains
Figure 2-6. Average Protein Foods Subgroup Intakes in Ounce-Equivalents

per Week by Age-Sex Groups, Compared to Ranges of Recommended Intake
Figure 2-7. Average Intakes of Oils & Solid Fats in Grams per Day by Age-Sex

Group, in Comparison to Ranges of Recommended Intake for Oils
Figure 2-2. Empower People To Make Healthy Shifts …………………………………………………………………………………………………………. 40

Figure 2-3. Average Daily Food Group Intakes by Age-Sex Groups, Compared to Ranges of Recommended Intake ……………………. 41

……………………………………………………………………………………………………. 44

……………………………………………. 48

………………………………………………………………………… 50

………………………………………………………………………………………… 52

Page iv — 2015-2020 Dietary Guidelines for Americans
Figure 2-8. Typical Versus Nutrient-Dense Foods & Beverages ……………………………………………………………………………………………. 53

Figure 2-9. Average Intakes of Added Sugars as a Percent of Calories per Day by Age-Sex Group,

in Comparison to the Dietary Guidelines Maximum Limit of Less Than 10 Percent of Calories
Figure 2-11. Average Intakes of Saturated Fats as a Percent of Calories per Day by Age-Sex Group,

in Comparison to the Dietary Guidelines Maximum Limit of Less Than 10 Percent of Calories
Figure 2-13. Average Intakes of Sodium in Milligrams per Day by Age-Sex Groups,

Compared to Tolerable Upper Intake Levels (UL)
………………………………………………….. 54

Figure 2-10. Food Category Sources of Added Sugars in the U.S. Population Ages 2 Years & Older …………………………………………. 55

………………………………………………….. 56

Figure 2-12. Food Category Sources of Saturated Fats in the U.S. Population Ages 2 Years & Older ………………………………………… 57

…………………………………………………………………………………………………………………. 58

Figure 2-14. Food Category Sources of Sodium in the U.S. Population Ages 2 Years & Older ………………………………………………….. 59

Figure 3-1. A Social-Ecological Model for Food & Physical Activity Decisions ……………………………………………………………………….. 65

Figure 3-2. Implementation
of
the
Dietary Guidelines Through
MyPlate …………………………………………………………………………………
69

Figure 3-3. Strategies To Align Settings With the 2015-2020 Dietary Guidelines for Americans ……………………………………………… 70