U 5.

Department

of Health and Human Serwces U S Department cf Agriculture

www healthlerus gov/cletxyguldellnes

ii

ACKNOWLEDGMENTS

The US Department Healthand HumanServxes(HHS) the US Department Agriculture(USDA) of and of acknowledge the recommendations the 3etary Guidelmes of Advisory Comnxttee-the basisfor this edltlon The Commlttee consistedof JanetC Kmg,Ph D , R D (chair),LawrenceJ Appel,M D , M PH , BenlammCaballero, D , Ph D , Fergus M M Clydesdale, D PennyM Kns-Etherton, D , R D , Theresa Nlcklas,Dr P H , M P H , L N , F XavierP1-Sunyer, Ph Ph A M D , M P H YvonneL Bronner,SCD , R D , L D , CarlosA Camargo, D , Dr P H , Vay LlangW Go,M D , JoanneR M Lupton,Ph D , RussellR Pate,Ph D , ConmeM Weaver, D , and the sclentlficwnter/edltor,CarolSutor, SCD Ph The Departments acknowledge work of the departmental also the scientists,staff,and pohcyofficialsresponsible for the productionof ths document
From HHS. Laura Lawlos, Mchael O’ Gradyl Ph D, Cnstma Beato, MD I Les Crawford, D VIM, Ph D, Barbara Schneeman, Ph D, Kathryn Y McMum M,S’ Deb Galuska.Ph D, Van Hubbard, MD, Ph D., MaryMazanec, MD, JD., Penelope ., Royall, PT, MS. W, Lama Bus,?,MBA., Diane Thompson MPH., R D, SusanAnderson, MS, R.D., Jean Pennmgton, R D, Ph D, Susan M. Krebs-Snuth, Ph D, RD., Wendy Johnson-Taylor Ph.D.,fim Stitzel, M.S., R D. Jennifer Weber,RD., M.PH., Pamela E Starke-Reec:Ph D, Paula R Tmmbo, Ph D., Jennifer Seymour, Ph D., Dada Danford, D.Sc, MPH, R.D, Chnstme Dobdayl Donna Roble Howard8Ph D, Gmny Gunderson, and Adam iI&chael Clark, Ph.D From USDA. Beth Johnson, MS., R D, Etic Bost, Eric Hentges, Ph.D.,Kate Cole&Rodney Brown, Ph.D., Carole Davis, M.S I R D, Dorothea K V&a&s, MS., Joan M G Lyon, MS, R D., L D, T&h Bntten, Ph D, Molly Kretsch, Ph.D.,Pamela Pehrsson,Ph.D, Jan Stanton, P6S, M.B.A , R D, Susan Welsh,Ph D, Joanne Guthne, MPH, R.D, Ph D, Davrd Murfeld, Ph D, Gerald F Combs, Jr, Ph D, Beverly Clevldence,Ph D, Robert MZchell Russell, MD, Colette I Th&ault, MS, R D, L D, Sedigheh-Essle Y-1, Ph.D.,RD., Knstm L Marcoe, MB.A I R.D, and David M HerMg, MS

The Departments acknowledge importantrole of thosewho providedmput and pubhccommentsthloughout also the this processFmally, Departments the acknowledge contnbutlons numerous the of othermtemaldepartmental scientists and staff that contributedto the productionof this document, mcludmgthe membersof the Independent Sclentlfic ReviewPanelwho peerrenewedthe recommendations the document ensure of to they werebasedon a preponderance of scientific evidence

Contents
MESSAGE FROMTHE SECRETAIdES ACKNOWLEDGMENTS........... EXECUTIVESUMMARY CHAPTER 1 CHAPTER 2 CHAPTER 3 CHAPTER 4 CHAPTER 5 CHAPTER 6 CHAPTER 7 CHAPTER 8 CHAPTER 9 CHAPTER 10 APPENDIX A APPENDIX A- 1 APPENDIX A-2 APPENDIX A-3 APPENDIX B APPENDIX B-l APPENDIX B-2 APPENDIX B-3 APPENDIX B-4 APPENDIX B-5 APPENDIX B-6 APPENDIX B-7 APPENDIX B-8 APPENDIX B-9 APPENDIX C APPENDIX D . Backgrourd . ... ...... ... . .. . ... . .. . ......... ... ..... . . .._.._ _..,.,.. ___.II . . . . . . . . . . . ..v I and Purpose of the Dietary Guidelines for Americans

....................

..........
............ .......... ........ ........... ........ ........

1 5 13 19 23 29 35 39 43 47 51 51 53 55 56 56 57 58 59 60 61 62 63 65 67 70

Adequate Nutrients Within Calone Needs .................................... WeightManagement PhysicalAl%vity ..................................................

........................................................

Food Groups To Encourage ............................................ Fats ............... Carbohydrates Sodrumand ............ Potassrum ............................................... ............................................ ................................. ... ............

........... ... ......

Alcoholrc Eseverages .................................................... FoodSafey ........................................... ......................................................... Levels ... ... ............ ..........

......... .......... ......... ....... ........

EatIngPatterns

DASH Eating Plan at 1,600-, 2,000., 2,600-, and 3,100.Calorie USDA Food Guide ........... ..... .................

.................

Discretionary Calorie Allowance In the USDA Food Curde ................... Food Sources of Selected Nutrients ..... Food Sources of Potassrum ..................... Food Sources of Vitamin E Food Sources of Iron ......................... Non-Dairy Food Sources of Calcium Food SourcesofCalcium .............. ............................. .......... ........................ .......... ......... ......... ...........

......... ......... ........... ........... ...........

.......................................
.......... ...........

...................................... .......................

.......... ......... .........

Food Sources of Vrtamrn A ..........

Food Sources of ,2/lagnesium ............................................. Food Sources of Dretary Fiber ......................... Food Sources of Vrtamin C .............................. Glossary Acronyms ................... ................

........ ......... ...........

0' Terms .............................................
........................................... .........

........

iv --

0

LIST OF FIGURES

LIST OF TABLES

FIGURE 1. Percent Increase or Decrease From Current Consumption (Zero Line) to Recommended Intakes FIGURE2 FIGURE3. Adult BMI Chart Example of Boys’BMI Growth Curve (2 to 20 years). Boys’Body Mass Index-For-AgePercentiles Sources of Dretary Sodium

TABLE 1

Sample USDA Food Guide and the Dietary Approaches to Stop Hypertensron (DASH) Eating Plan at the 2,000-Calorie Level Comparison of Selected Nutrients In the DASH Eating Plan, the USDA Food Guide, and Nutrient Intakes Recommended Per Day by the Institute of Medicine (IOM) Estimated Calorre Requirements (In Krlocafones) for Each Gender and Age Group at Three Levels of PhysrcalAdrvity Calories/Hour Expended rn Common Physical Actrvrties Fruits, Vegetables, and Legumes (Dry Beans) That Contain Vitamin A (Carotenords), Vrtamrn C, Folate, and Potassium Comparison of 100 Grams of Whole-Grain Wheat Flour and Enriched, Bleached, White, All-Purpose Flour Whole Grains Available In the United States Maximum Daily Amounts of Saturated Fat To Keep Saturated Fat Below 10 Percent of Total Calorie intake Differences in Saturated Fat and Calorre Content of Commonly Consumed Foods Contribution of Various Foods to Saturated Fat Intake in the American Diet (Mean Intake = 25.5 g)

TABLE2.

FIGURE4.

TABLE 3.

FIGURE5. Temperature Rules ior Safe Cookrng and Handling of Foods

TABLE 4. TABLE 5.

TABLE 6.

TABLE 7. TABLE 8.

TABLE 9. TABLE 10.

TABLE 11. Contribution of Various Foods to Irons Fat Intake in the American Dret (Mean Intake = 5.84 g) TABLE 12. TABLE 13. TABLE 14. TABLE 15. TABLE 16. Relationship Between LDL Blood Cholesterol Goal and the Level of Coronary Heart Disease Rusk Major Sources of Added Sugars (Caloric Sweeteners) in the American Diet Names for Added Sugars That Appear on Food Labels Range of Sodium Content for Selected Foods Calones In Selected Alcoholic Beverages

V

Executive Summarv
J

The Dietary Gudelmes for Americans IDIetary Gmdehnes] provides science-based adviceto promotehealthand to reducensk for ma]orchronic&eases through&et and physicalactlvXyMajorcauses morbl&ty andmortahty of m the UmtedStatesarerelatedto poordiet and a sedentary hfestyleSomespectic dseases lmkedto poor&et and physicallnactivltyincludecardiovascular disease, type 2 &abetes, hypertension, osteoporosis, certam and cancersFurthermore, &et and physicalmactivlty, poor resulting111 energytialance (morecalones an consumed than expended), the mostimportantfactorscontnb are utmg to the increase overweight obesity111 m and this countryCombmed physicalactivity,followmga &et v&h that doesnot provideexcess ctiones accordmg the to recommendations this docunentshouldenhance 111 the healthof most m&vlduals

An important component each5-year of revlSion the of Dietary Gudehes is the analysis new sclentic mformaof non by the Dietary Guldelmes Advisory Comrmttee (DGAC) appointedby the Secretaries the U S Department of of HealthandHumanServices (HHS) the US Department and of Agriculture (USDA) analysis, ms pubhshed the DGAC m Report(httpllwww healthgov/dletarygLudelmes/dga2005/ report/), the primaryresource development the is for of reporton the Guldelmes the Departments Dietary by The Guldelmes and the reportof the DGACdnYer scopeand 111 purpose compared reportsfor previous to versions the of Gudelznes.The 2005DGACreport1sa detailedscientific analysisThe scientificreportwas usedto developthe Dietary Gudelines jointly betweenthe two Departments and formsthe basisof recommendations ti be used that by USDAand HHSfor program pohcydevelopment and

vi

Thusit is a pubhcation onentedtowardpohcymakers, nutritioneducators, nutntiomsts, healthcare and providers ratherthan to the generalpubhc,as mth previous versionsof the Dietary Guidelines, and containsmore technicalinformation The intent of the Djetary Gulc’ elmesis to summanze and synthesize knowledge regardmg mdlvldualnutnentsand food components recommendations a pattern into for of eatmgthat can be adoptedby the pubhc In this pubhcation,KeyRecommendanons grouped are undernme mter-related focusareasThe recommendations based are on the preponderance sclentlficevidence lowermg of for nsk of chromedisease promotmg and health It is n-nportant to remember thesearemtegrated that messages that shouldbe Implemented a whole Takentogether, as they encourage mostAmericans eat fewer calones, more to be active,and makemser food choices A basicpremiseof the Dietary Guldelules that nutnent is needsshouldbe met pnmanlythroughconsummg foods Foodsprovidean arrayof nutrientsand othercompounds that may havebeneficial effectson health In certamcases, fortified foodsand dietarysupplements be useful may sources oneor morenutner,tsthat othemse might be of consumed lessthan recomriended m amounts However, dietarysupplements, while recommended somecases, m cannotreplacea healthful&et Two examplesof eating patternsthat exemphfythe Dietary Guldelmes are the USDAFoodGuide (http // www usda gov/cnpp/pyramichtml) and the DASH (Dietary Approaches StopHypertension) to EatmgPlan1 Both of theseeatingpatternsare designed mtegrate to dietaryrecommendations a healthyway to eat for mto most mdivldualsTheseeatmgpatternsarenot weight lossdiets,but ratherillustranveexamples how to eat of in accordance vvlththe Dietary GuIdelines Both eating patternsare constructed acrossa rangeof calonelevels to meetthe needsof vanousageand gendergroupsFor the USDAFoodGuide,nutrient content estimatesfor eachfoodgroupand subgroup basedon populatlonare

Takentogether, [the
Dietary Guidelines]

encou&e most Americans eat to fewercalories,be moreactive,andmake wiserfood choices.
weightedfood intakes Nutnent contentestimatesfor the DASHEating Planare basedon selectedfoods chosen a sample7-daymenu mle ongmallydevelfor opedto study the effectsof an eatingpattern on the prevention treatmentof hypertension, and DASHis one example a balanced of eatmgplan consistent wth the
2005 Dietary Guldelmes

Throughoutmost of this pubhcation,examples a use 2,000-calone as a reference consistency the level for vvlth NutritionFactsPanelAlthoughths levelis usedas a reference, recommended caloneintakewill d&er for mcivldualsbasedon age,gender, actlvlty level At each and calonelevel,mdivlduals who eat nutnent-dense foods may be ableto meet their recommended nutnentmtake w&houtconsummg full caloneallotmentTheremmtheir mg &ones-the dwzretlonary calone aUowance--allow m&mduals fletitity to consume somefoodsandbeverages that may contamaddedfats,addedsugars, alcohol and Therecommendations the Dretary Gudelmes are for m Amencans 2 yearsof age It is important mcorporate over to the foodpreferences dtierentraclal/ethmc of groups, vege-

’ NIH Publlcatlon No 03-4082, Factr about the DASH Eating Plan, United Stats Department of Health and Human Seruces, Natlonal instxutes of Health, NatIonal Heart, Lung <md Blood lnstltute Karanla NM et al Iournol oltk Amwcon D~eletrcAsoc~ot~?n (JADA) 8 519.27, 1999 http//wnhlbl nlh gov/health/publlc/heart/hbp/dash/ ! ,--:hL .i,,T,[, / I) :dF: 4l4hicPhi ,a;35

tanans,and other groupswhl3nplanningdiets and developmgeducational programs materialsTheUSDAFood and Guideandthe DASHEatmgPan arefletile enoughto accommodate rangeof foodpreferences cuismes a and The Dietary Guldelmes is mt?ndedprimarily for use by pohcymakers, healthcare providers, nutntiomsts, and nutntlon educatorsThe informationin the Dietary Guldelmes is usefulfor the development educational of matenalsand aidspol~cymakers designingandimplem mentmgnutrition-related progmms, mcludmgfederal food,nutnuon education, mformation and programsIn ad&non,this pubhcation -hepotentialto provide has authoritativestatements providedfor in the Food as and DrugAdmlmstrationModernization (FDAMA) Act Because Dietary Gtudelines contamsdiscussions the wherethe scienceis emergmg, statements only included in the ExecutiveSummary the sectionstitled “Key and Recommendations,” reflectthe preponderance which of sclenttic evidence, be usedfor identtication of can authontatlve statementsTherecommendations mterare relatedand mutuallydependent; the statements thus 111 documentshouldbe usedtogetherm the context this of plannmgan overallhealthful diet However,even followmglust someof the recommendations have can healthbenefits The followmgis a hstmgof the Dietary Gmdelmes by chapter
ADEQUATE NUTRIENTS CALORIE NEEDS ‘ JVITHIN

Key Recommendations

for Specific Population

Groups

People over age 50 Consume vltarnmB..2 its m

crystaltme form (1e , forttied foodsor supplements) Women of chrldbearmg age who may become pregnant. Eat foodshgh 111 heme-iron and/orconsume non-rich plant foodsor non-forttiledfoodswth an enhancer of iron absorption, such as vltamm C-rich foods
Women of childbearing age who may become pregnant and those m the first trimester ofpregnancy Consume

adequate syntheticfohc aad d&y (fromfomhedfoods or supplements) ad&nonto food formsof folatefrom m a vaneddiet
Older adults, people w~ti dark skm, and people exposed to insufficient ultraviolet band rao3atron (1e, stmllght)

Consume extravltamm D from vltamm D-forttied foods and/orsupplements
WEIGHT MANAGEMENT

Key Recommendations . To mamtambody weight m a healthyrange, balancecalonesfrom foodsand beverages wth calonesexpended . To preventgradualweight gam overtune,make smalldecreases food and beverage m calonesand mcrease physicalactlvlty
Key Recommendations for Specific Population Groups

Key Recommendations . Consume vanetyof nutrient-dense a foodsand beverageswth.m and amongthe basic food groupswhile choosmgfoodsthat hmt the mtakeof saturatedand trans fats, cholesterol, addedsugars, and alcohol salt, m Meet recommended intakesMrlthm energyneedsby adoptinga balanced eatmgpattern,such as the USDA FoodGmdeor the DASHEztmg Plan

Zhosewho need to lose weight. Aun for a slow,steady weight loss by decreasmg caloneintake wh_lle mamtaming an adequate nutnent mtakeand increasing physicalactlvlty Overweight children Reduce rate of bodyweight the gamwh_lle allowmggrowthand development Consult a healthcare providerbeforeplacinga child on a weight-reduction &et Pregnant women Ensureappropnate weight gam as specifiedby a healthcare provider Breastfeedmg women. Moderate weight reduction is safeand doesnot comprormse weight gam of the nursmgmfant
Overweight adults and overweight children with chrome diseases and/or on medication Consulta

healthcare provideraboutweight lossstrategespnor to starting a weight-reductionprogramto ensure appropnate management otherhealthconditions of

PHYSICAL ACTIVITY

FOOD GROUPS TO ENCOURAGE

Key Recommendations Key Recommendations n Engage regular m physicalactlvlty andreduce Consume sufficientamountof tits andvegetables a sedentary actlvltiesto promote health,psychologzal whdestaymgvylthmenergy needsTwo cupsof fnut well-being, a healthyk’ weight and ody and2%cupsof vegetables day arerecommended per To reduce nsk of ch:omcdisease adulthood the m for a reference 2,000-calorie intake,wth higheror Engage at least30mmutesof moderate-mtenslty loweramounts m dependmg the calonelevel on physicalactivity,aboveusualacnvlty,at work or Choose vanetyof fruits and vegetables a eachday homeon most daysof the week In particular, selectfrom all five vegetable subgroups Formost people, greater healthbenefitscanbe (darkgreen, orange, legumes, starchyvegetables, and obtamed engagmg physicalactivity of more by in othervegetables) several times a week vigorous mtensltyor longerduranon Consume or moreounce-equivalents whole-gram 3 of To help manage body weight andpreventgradual, productsper day,vylththe rest of the recommended unhealthy bodyweightgamm adulthood Engage in gramscomingfrom enriched whole-gram or products approxunately mmutesof moderate- vlgorous60 to In general, leasthalf the gramsshouldcomefrom at mtensltyactlvlty on most daysof the weekwhile wholegrams not exceedmg caloricmtakerequnements Consume cupsper day of fat-freeor low-fat rmlk or 3 To sustamweight lossm adulthoodParticipate m emvalent milk products at least60to 90mmutesof d&y moderate-tntenslty Key Recommendations for Specific Population Groups physicalactivitywhile not exceeding caloricmtake . Children and adolescents. Consume whole-gram prodrequirements Some people may needto consult ucts often:at leasthalf the gramsshouldbe whole with a healthcare provider beforepartmpaung 111 grams ChMren2 to 8 yearsshouldconsume cups 2 ths levelof activity per day of fat-freeor low-fat milk or ewvalent m& . Achievephysicalfitnessbv includingcardiovascular products CMdren9 yearsof ageandoldershould conditioning, stretchingexercises flexlbihty,and for consume cupsper day of fat-freeor low-fat milk or 3 resistance exerczzes ctisthemcsfor musclestrength or emvalent rmlkproducts and endurance
Key Recommendations
l

for Specific Population

Groups

FATS

CtiIdrenand adolescents Engage at least60 m mmutesof physicalactivity on most,preferably all, daysof the week women. In the ab:;ence medical obstetric of or . Pregnant comphcations, incorporate minutesor moreof 30 moderate-mtensity physicalactivity on most,If not all daysof the week Avoidact:vmes wth a lvgh nsk of fallmgor abdommal trauma n Breastfeeding women. Be awarethat neitheracutenor regular exercise adversely affectsthe mother’abUy s to successfully breastfeed . Older adults Participate regular in physlcalactivity to reducefunctionaldeclmes associated agmgand wth to achieve otherbenefitsof physicalactivity identithe fled for all adults

Key Recommendations . Consume than 10percentof caloriesfrom less saturated fatty acids and less than 300mg/day of cholesterol, keeptransfatty acidconsumpuon and as low as possible 9 Keeptotal fat intakebetween20 to 35 percentof calones, mostfats commg vvlth fromsources polyurof saturated monounsaturated acids,suchas and fatty fish,nuts,andvegetable oils n Whenselectmg prepanng and meat,poultry dry beans, andrmlk or milk products, makechoicesthat arelean, low-fat,or fat-free . Llmlt mtakeof fats andoils high in saturated and/or trans fatty acids,andchoose products in suchfats low ando&i

ix

Key Recommendations

for Specific Fopulatlon

Croups

. Children adolescen& and Keep total fat m takebetween 30to 35percent calones orch&iren2 to 3 yearsof age of :‘ andbetween to 35percent calones &Wren and 25 of for adolescents to 18yearsof age,vvlthmostfats commg 4 fromsources polyunsaturated monounsaturated of and fatty acids,suchas fish,nuts,andvegetable oils
CARBOHYDRATES

n

become pregnant, pregnant lactatmgwomen,ch$ and drenandadolescents, mdivlduals takmgmedlcatlons that canm teractwth alcohol, thosem th specific and medicalconditions Alcohohc beverages shouldbe avoided mdivlduals by engagmg actlvlnesthat reqmre m attention, shall, or coordmation, as dnvmgor operatmg such machmery

FOOD SAFETY

Key Recommendations Choose fiber-rich fnuts,vegetables, whole and gramsoften Choose prepare and foodsiand beverages httle vvlth addedsugarsor caloricsweeteners, as amounts such suggested the USDAFozdGuideandthe DASH by EatingPlan Reduce mcldence dentalcanesby practlcmg the of goodoralhygene and consummg sugar-andstarchcontammg foodsandbeverages frequently less

0

SODIUM AND POTASSIUM

Key Recommendations . Consume than 2,300 (approxunately less mg 1 tsp of salt)of sodmmper day . Choose prepare and foods\nJlth salt At the same httle time, consume potassium-loch foods,such as fruits and vegetables
Key Recommendations
n

Key Recommendations . To avoidrmcroblal foodbome illness Cleanhands,food contactsurfaces, fonts and and vegetablesMeat and poultryshouldnot be washedor nnsed Separate cooked, ready-to-eat raw, and foods while shopping, preparmg, storingfoods or Cookfoodsto a safetemperature lull to rmcroorgamsms Chill (refrigerate) penshable promptlyand food defrostfoodsproperly Avoidraw (unpasteurized)& or anyproducts m madefromunpasteurized raw or pamally rmlk, cooked eggsor foodscontanxng eggs,raw raw or undercooked andpoultry, meat unpasteurized juices,andraw sprouts
Key Recommendations for Specific Populatwn Groups

for Specific Population

Groups

. infants and young children, pregnant women, older adults, and those who are immunocomprom~sedDo

Individuals wXh hypertension, blacks, and rmddle-aged and older adults Aun to consume morethan 1,500 no

mg of sodiumper day,and.neetthe potassium recommendation (4,700 mg/day)\nth food
ALCOHOLIC BEVERAGES
n

not eator dnnkraw (unpasteurized) or anyproducts rmlk madefromunpasteunzed raw or pamallycooked rmlk, eggsor foodscontammg eggs,raw or undercooked raw meatandpoultry,raw or undercooked or shellfish, fish unpasteurized luxes, andraw sprouts
Pregnant women, older adults, and those who are unmunocompromzsed: Onlyeat certam meatsand deh

Key Recommendations m Those who choose drinkalcohohc to beverages should do so sensiblyandm moderatlon-defined the as consumption up to one drink per day for women of andup to two drmksper day for men n Alcohohc beverages shouldnot be consumed some by mdlvlduals, mcludmg thosewho cannotrestricttheir alcoholintake,womenof chlldbeanng who may age

frankfurters havebeenreheated steammg that to hot

chapter II
r

Backgroundand Purposeof the
Dietarv Guidelines for Americans
The DIemy Gwdelmes Amacans [Die&y Guldelmes], for first pubhshed 1980, m providessaence-based adviceto promotehealthandto reducensk for chronx diseases throughdiet andphysicalactrnty The recommendations contamed mtti the Dletay Crudetiesaretargeted the to general pubhcover2 yearsof agewho arelnmg in the UmtedStatesBecause its fozuson healthpromotion of and risk reduction, DietaryGum’ form the basisof the ehnes federal food,nutritioneducation, mformation and programs By law (Pubhc 101-445, III, 7 US C 5301 seq), Law Txle et the DietaryGuIdelmes renewed, is updated necessary, If andpubhshed every5 yearsTheprocess createthe to DietaryGudelules a ]omt effcrtof the U S Department is of Health and HumanService!;(HHS)and the U S Departmentof Agriculture (USDA) has evolvedto and include three stages
* For more mformation
about the process, summay data, and the wwces (2005 DCAC Report) at http //ww health gav/dl:tar/guldelme used by the Adwry

In the tist stage, external an sclentic AdvisoryComttee appomted the two Departments by conducted analysis an of new scienttic mformanon prepared reportsummaand a nzmgits fmdmgs TheAdvisoryComrmttee’ 2 reportwas s madeavdable to the pubhcand Government agencies for commentThe Committee’analysiswas the primary s resource development the DietaryGwdelmes the for of by DepartmentsA signticant amountof the new sclentlfic informationused by the Dietary Guidelines Advisory Comnuttee (DGAC) basedon the DietaryReference was Intake(DRI)reportspubhshed smce2000by the Institute of Medicine(IOM),in particularthe macronutrient report and the fluid and electrolytereport Duringthe secondstage, Departments the ]omtly developedKeyRecommendahons basedon the Advisory Committee’reportand pubhcand agencycomments s

Committee, see the 2W5 Dietary Culdelks

Adwry

Committee Repon

The Dietary Gu2dehnes detallathesescience-based pohcy recommendations Fmally, the thrd stage,the two 111 Departments developed messages commumcatmg the Dietary GudeLmes to the generalpubhc

IMPORTANCE OF THE DIETARY Clii’ DELINES FOR HEALTH PROMOTION AND DISEASE PREVENTION

Because the three-partprocessusedto developand of commumcate 2005Dietary GWehes, this pubhcauon the and the reportof the DGACdiffer in scopeand purpose compared reportsfor prevlo:lsversions the Gudelmes to of The 2005DGACreportis a detailedscientificanalysisthat identifieskey issuessuch as energybalance, consethe quences a sedentary of hfestyle, the needto emphasize and certamfood choicesto address nutntlon issuesfor the Amencanpubhc The sclentlficreportwas usedto develop the Dietary Gudehnes ]omtlybetween two Departments, the and this pubhcatlon formsthe basisof recommendations that will be used by USDAar d HHS for programand pohcy developmentThus it is a pubhcatlonoriented toward pohcymakers, nutrlticn educators, nutntlomsts andhealthcare providers ratherthan to the general pubhc, as wth previousversionsof the Diecaary Guzdelmes,and contamsmoretechmcalmforrlation Poor&et and physicalmactlvlty,resultingm an energy unbalance (morecalonesconsumed than expended), are consistentwth New sectionsm the Dietary Gmdehnes, the most importantfactorscontnbutmgto the mcrease Its usefor programdevelopment, a glossary terms are of III overweight obesitym ths country Moreover, and overand appendutes detailedmfonnationaboutthe wXh weight andobesityaremajornsk factorsfor certamchrome USDAFoodGuideand the DietaryApproaches Stop to diseases such as diabetes In 1999-2002,65 percent of Hypertension (DASH) EatmgPlanas well as tableshstmg US adultswere overweight, mcrease an from 56percent sourcesof somenutnents Consumer messages have III 1988-1994 Datafrom 1999-2002 showedthat 30 also beendeveloped educatethe pubhcaboutthe Key to percentof adultswere obese, mcrease an from 23 percent Recommendations the Dletzy Gudelmes and will be m m an earher survey Dramaticincreases the prevalence 111 usedIII matenalstargetedfor :onsumersseparate from of overweighthaveoccurredm childrenand adolescents this pubhcationIn orgamzmg Dietary Gudelmes for the of both sexes, mth approximately percentof cmdren 16 the Departments, chapters2 to 10were gven titles that and adolescents aged6 to 19yearsconsidered be overto characterize topic of eachsection,and the Dietary the weight (1999-2002) In orderto reverse trend,many 3 this Gmdelmes itself is presented an integratedset of Key as Amencansneedto consumefewer calories,be more Recommendations eachtopic area in active,and makewiser choicesvvlthmand amongfood groups The Dietary Gudelmes providesa frameworkto TheseKeyRecommendanons basedon a preponder are promotehealthierlifestyles(seech 3) ante of the scientific evidenceof nutritionalfactorsthat are important for lowenng risk of chronic diseaseand Giventhe importanceof a balanceddiet to health,the promotinghealth To optimize the beneficialimpact of intent of the Dietary Gmdehnes is to summarizeand theserecommendations health,the Gmdehnesshould on synthesize knowledge regardmg mdlvldualnutnentsand be implemented their entuety III

Goodnutntlon is vital to goodhealth and IS absolutely essentialfor the healthy growth and development of &Wren and adolescents Major causesof morbidityand mortdty 111 UnitedStatesarerelatedto poor&et and the a sedentary tiestyle Spetic diseases conditions and lmkedto poor&et mcludecar&ovascular dsease, hypertension,dyshpiderma, 2 diabetes, type overweightand obesity, osteoporosis, constipation, dverticular &sease, iron deficiencyanerma, cllsease, oral malnutrition, and somecancersLack of physicalactlvlty has beenassociatedwith cardiovascular disease, hypertension, overweight and obesity, osteoporosis, diabetes, certamcancers and Furthermore, musclestrengthenmg lmprovmg and balance can reducefalls and increasefunctionalstatus among olderadults Together physicalacnvlty,a tigh-qutity vvlth &et that doesnot provideexcess calones shouldenhance the healthof most mdlvlduals

3 Hedley AA, Ogden

CL, Johnson CL, Carroll MD, Curt~n LQ Flegal KM Prevalente of overwght ASoC~obon (MMAj 291(2X) 2847.2850,2W4

and obesity among U 5 children, adolescents. and adults, 1999.2002 /ourno/ ?ffheAmencon

Medd

food components recornmendanons an overall into for patternof eatmgthat canbe adopted the general by pubhc Thesepatternsareexemptied by the USDAFoodGmde and the DASHEatmgPlan(seech 2 and app A) The DjetaryGurdehnes apphcable the foodpreferences is to of differentracial/ethnicgroups, vegetarians, other and groupsThis conceptof balanced eatmgpatternsshould be utihzedin plannmg&ets for vanouspopulation groups Thereis a growmgbodyof evidence which demonstrates that followmg a diet that comphes vinththe Dietary Gu&hnes may reducethe risk of chronic disease Recently, was reported thetq patternsconsistent it that v\rlthrecommended detary gcidancewere associated mth a lowerrisk of morttity amongm&vldualsage45 4 yearsand olderin the UmtedStates The authorsof the study estimated about16percentand 9 percentof that mortdty fromany causem menandwomen, respectively, couldbe ehmmated the adoptionof desirable by dietary behaviorsCurrently, adherence the Dietary Gludelmes to is low among US populahon the DatafromUSDAtiustrate the degreeof changein the overalldietarypattern of Americansneededto be consistentwth a food pattern encouraged the Dietary Gmdehnes (fig 1) by A bawcprermse the Dletaq Gmdehnesis that nutnent of needsshouldbe met pnmanlythroughconsummg foods Foodsprovidean arrayof nutrients (aswell as phytochermcals, antloxldants, and othercompounds etc) that may havebeneticial effectson wealthIn somecases, fortfled foodsmay be usefulsources oneor morenutrients of that othervlrlse rmghtbe consumed lessthan recomm mended amounts Supplements be usefulwhen they may fill a spectic identifiednutnent gapthat cannotor is not othermsebeingmet by the mdlvldual’intake of food s Nutrient supplements cannotreplacea healthfuldiet Indlvlduals arealready who consurnmg recommended the amountof a nutnent in food ~nll not achieveany additlonal health benefitIf they alsotake the nutrient as a supplementIn fact, m somecases, supplements and fortifiedfoodsmay causeWakesto exceed safelevels the of nutrients Anotherimportantpremiseof the Dietary GmdehnesISthat foodsshouldbe DreDared handled and in such a way that reduces of foodborne risk illness

USES OF THE DIETARY GUIDELINt’ S

The Dietary Gmdelmes is Intendedpnmanlyfor use by nutritionists, and pohcymakers, healthcare providers, nutrition educatorsWhile the Dietary Gmdelmes was developed healthy for Amencans yearsof ageandolder, 2 whereappropnate, needs specificpopulation the of groups havebeenaddressedIn addition,othermdivldualsmay find this reporthelpfulm makmghealthfulchoices As notedpreviously, recommendations the contamed wthm the DietaryGmdelmesW aid the pubhcm reducmg their nsk for obesityand chronic&seaseSpectic usesof the Dietary Gmdelmesmclude,
Development of Educational Materials and Communications. Themformatlon the Dietary Gwdelmesis usefulfor the III

0

development educatlonal of materials Forexample, the federaldietaryguidance-related pubhcatlons required are by law to be basedon the Dietary Gmdehes In ad&non, ths pubhcatlon mde the development messages v~~ll of to communicate Dietary Gmdehes to the pubhc the FmaUy, USDAFoodGuide, foodlabel,andNutntlon the the FactsPanel providemformation is usefulfor unplethat mentmg key recommendationsthe Dietary Gudelmes the m and shouldbe integrated educational cornmuminto and canonmessages
Development of Nutrition-Related Programs.

The Dietary Gmdehnesads pohcymakers deslgnmg m andlmplementmg nutrition-related programs Federal The Government basesits nutrition programs, such as the NationalChildNutritionPrograms the ElderlyNutntlon or Program, on the Dietary GrudeLmes
Development of Authontatlve Statements.

l

__

The Dietary Guidelines has the potentialto provide authoritativestatementsas providedfor in the Food andDrugAdmmistratlon Modermzation (FDAMA) Act Because recommendations mterrelated mututhe are and ally dependent, statements tis pubhcation the m should be usedtogether111 contextof an overallhealthful the &et Likemse,because Dretary Gmdelmes contams the tiscussionsaboutemergmg science, statements only includedm the Executive Summary the hlgmghted and boxeseniXled “KeyRecommendations,” reflectthe which preponderance sclentlfic evidence, be usedfor of can identificationof authoritativestatements

FIGURE

1 Percent Increase or Decrease From Current Consumption (Zero Line) to RecommendedIntakesarb

A graphlcaldeprctronof the degree of changeIn averagedally food consumptronby Americans would be neededto be consrstent that wrth the food patternsencouragedby the Dietary Qlidehes for Americans The zero line represents averageconsumptronlevelsfrom each food group or subgroup by females31 to 50 yearsof age and males31 to 50 yearsof age. Barsabove the zero line representrecommendedincreases food group consumptron, in whrle bars below the line representrecommended decreases.

-50

L

Fruit Group

Vegetable Group

Grain Group

Meat & Bean Group

Milk Group

Oils

Actualchangefrom consumptionto recommendedIntakes +Ol oz +o 9 cups +0 8 cups Females -10 oz tl.2 cups to 9 cups Males

+04oz -1.4 oz

+16 cups +12 cups

-04g -42g

wbgroups, <ohd Fats, and

400 350 300 250 200 150 100 50 O-50 -100 L Dark green Orange L Legumes Starchy Other
JLlLI

‘ AddedSugars

Whole grains

Ennched grains

Solid fats

Added sugars

Vegetables
Actualchangefrom consumptionto recommendedIntakes: to 3 cups to 2 cups +o 3 cups -0.1 cups +o 1 cups Females +o 3 cups to.2 cups to 2 cups +o 2 cups +o 0 cups Males
d USDA FoodGuidein cornpawn to NatlanaI Health NutritionExamlnatlon and Survey 2CW2W2consumption data

Grains
+22 oz +26oz -2loz -36 oz

Discretionary Calories
-18g -27 g -14 tsp -18 tsp

b Increases amounts somefood groups &et by dweases in amounts solidfats (I e, saturated ironsfats)and addedsugars that totalcalow IntakeISat the recommended in of are of and so level

chapter

AdequateNutrients Within CalorieNeeds
OVERVIEW

ManyAmencans consume e calones rnol than they need without meetmgrecommended Intakesfor a number of nutnents This c~cumstance meansthat most people need to choosemeals and snacks t.hat are high m nutnentsbut low to moderate energycontent,that m IS,meetingnutnentrecommerdatlons must go hand m handmth keepmgcalonesmder control Doingso offersimportantbenefits-normal growth and development of children,healthpromc8tlon peopleof all ages, for andreductionof risk for a numberof chromediseases that aremajorpubhchealthproblems

Basedon detary intake dataor evidence pubhchealth of problems, mtakelevelsof the followmgnutrientsmay be of concernfor . Adults cahum potassmm, fiber,magnesium, and vltammsA (ascarotenolds), and E, C, . Childrenandadolescents calcmm,potassium, fiber, magnesium, vltamm E, and . Specificpopulation groups(seebelow) vLtamm BQ, Iron,fohc acd and vltarnmsE andD At the sametime,m general, Amencansconsume too many calonesandtoo much saturated Vans fats, and cholesterol, addedsugars, salt and

;>IE'ARY (;UlDEtlhES

FOR AMERICPNS,

2005

DISCUSSION

Meeting Recommended Intakes Within Energy Needs A basicprermse the Dietary GLudelmesis that food of guidanceshouldrecommenddietsthat vylll provideall the nutnentsneededfor growth and health To this end, food pdance shouldencourage m&vldualsto acheve the most recentnutnent mtak4recommendations the of Instituteof Meacme,referred collechvely the Dietary to as Reference Intakes(DRIs)Tablesof the DRIsareprovided at http ilwww iom edu/Ob]ect me/Master/21/372/0 pdf

Consume variety of nutnent-dense a foodsand beveragesvvlthmand amongthe basic food groupswl-Llle choosmg foodsthat lunlt the intake of saturatedand Uans fats, cholesterol, addedsugars, and alcohol salt, . Meet recommended intakesmthm energyneedsby adoptmga balancedeatmgpattern,such as the USDA FoodGuideor the DASHEatmgPlan
n

Key Recommendations

for Specific Population Groups

1 People over age 50. Consume vltamm Blz m Its

crystallmeform (1e , fomfied foodsor supplements)
m Women of ch&lbeanng age who may become pregnant An additionalpremiseof the Dletav Gudelmes is that Eat foodshigh 111 heme-ironand/or consumenon-rich the nutnents consumed shoti’ comepnmanlyfrom foods plant foodsor Iron-forttied foodsmth an enhancer of Foodscontamnot only the mt,m-uns mmeralsthat are and iron absorption, such as vitarnm C-rich foods oftenfound m supplements, alsc hundredsof naturally b-X m Women of cmdbeanng age who may become occumngsubstances, mcludmgcarotenoids, flavonoids pregnant and those m the first tnmester of pregnancy and isoflavones, proteaseinhibitors that may protect and Consume adequate syntheticfohc acid caly (from against chromehealth condltlons Thereare instances forttied foodsor supplements) ad&nonto food m when fortified foodsmay be advantageous, identified as formsof folatefrom a vaned&et m this chapter Thesemclude provldmgaddmonalsources 1 Older adults, people vvlth dark skin, and people of certamnutnentsthat rmght othermsebe presentonly exposed to msufficient ultraviolet band rao?ation in low amountsin somefood sources, provldmgnutrients (i e I sutightj Consume extravitamm D from in highly bloavallable forms,and wherethe fortification vltamm D-forttied foodsand/orsupplements addresses documented a pub1c healthneed

Two examples eatmgpatternsthat exemphfy Dietary of the Gudelmes are the DASHEating Planand the USDAFood Guide Thesetwo similar eatmg patterns are designedto integratedietary recommendations a healthy way mto to eat and are used in the Dietary GLudelmesto provide examplesof how nutnent-focusedrecommendations can be expressed terms of food choices Both the USDA m FoodGuideand the DASHEatmg Plan differ in important ways from commonfood consumptionpatternsm the United States In general, they include 1 More darkgreenvegetables, orange vegetables, legumes, inuts,wholegrams, low fat rmlli andm& products and . Less refmedgrams,total fats (especially cholesterol, and saturatedand trans fats),addedsugars, calones and

Both the USDAFoodGuideand the DASHEatmg Plan are constructedacrossa range of calonelevels to meet the nutnent needsof variousage and gendergroups Table1 provides intakerecommendanons, table2 food and provides nutnentprofilesfor both the DASHEating Plan and the USDAFoodGuideat the 2,000.calone These level tables illustrate the many simllantles betweenthe two eating patterns Addltlonal calonelevels are shown m appendixes and A-2 for the USDAFoodGuide and A-l the DASHEatmg Plan The exact amountsof foods m theseplansdo not needto be achievedeveryday,but on average, time Table3 can aid m ldentihcatlonof over an mtimdual’ caloricreqmrement s basedon gender, age, and physicalactlvlty level

DIETARY

GUIDELINES

FOR PMEtiICANS,

2005

Variety Among and Within Food Groups

Eachbasicfoodgroup5 the ma]orcontributorof at least is onenutnent wtile makmgsubstantialcontributionsof manyothernutnents Because eachfood groupprovides a wde array of nutrients m substantialamounts,it is important to include all food groupsin the dally &et Bothtiustratlveeatmgpatternsmcludea vanetyof nutnentdensefoods within the ma]or food groups Selectinga vanetyof foods~thm the graq vegetable, and meat fruit, groupsmay help to ensurethat an adequate amountof nutrientsand other potentiallybeneficialsubstances are consumedFor example, contacs varymgamountsof fish fatty acidsthat may be benefi,zial reducingcardiovasm culardisease (seech 6) risk
Nutrient-Dense Foods

meetingnutrient recommendations mustgohandinhand withkeepingcalories under control.
. . .

Nutnent-dense foodsare thosefoodsthat providesubstartealamountsof vltammsand mmerals(rmcronutnents) and relativelyfew calones Foodsthat are low m nutnent densityare foodsthat supply calonesbut relativelysmall amountsof rmcronutnents, sometunes noneat all The greaterthe consumption foodsor beverages are of that low in nutrient density,the more dficult it is to consume enoughnutnentswthout garmg weight, especially for sedentary mblvldualsThe consumption addedsugars, of saturatedand transfats, and alcoholprovidescalories wWe provldmghttle,If any,of the essenhal nutnents (See ch 7 for addtlonalmformatlon addedsugars, 6 for on ch mfonnation fats,and ch 9 for mformatlon alcohol) on on

can be consumed addedfats or sugars,alcohol,or other as foods-the dscretionarycaloneallowanceAppendures A-2 and A-3 show the maxmum discretionarycalone allowancethat can be accommodated eachcalonelevel at m the USDAFoodGuide Eating111 accordance mth the USDAFoodGuideor the DASHEatmgPlanwill alsokeep mtakesof saturated total fat, and cholesterol fat, w~thm the lusts recommended chapter6 m
Nutrients of Concern

Selectmg low-fat forms of foodsm eachgroupand forms free of addedsugars-m othe: words nutrient-dense versionsof foods-provides II:dlvldualsa way to meet their nutnent needswhile avoldmgthe overconsumption of calonesand of food components such as saturatedfats Based theseconsiderations, on detary mtakesof the followHowever, Amencansgenerallydo not eat nutnent-dense mg nutrientsmay be low enoughto be of concernfor forms of foods Most peoplebill exceedcalonerecomn Adults calcium,potassium, fiber,magnesium, and mendationsif they consistentlychoosehigher fat foods vltammsA (ascarotenoids), and E, C, vvlthmthe food groups+ven d they do not have dessert, . CMdren and adolescents, calcium,potassium, fiber, sweetened beverages, alcohohc or beverages magnesium, vltamm E, and . Specificpopulationgroups vltamm BQ,Iron,fohc acd If only nutnent-dense foodsare selectedfrom eachfood and vltammsE and D groupm the amountsproposed, smallamountof calones a

The actual prevalenceof inadequacyfor a nutnent can be determmed if an Estimated only AverageRewrement (EAR)has been estabhshed the dstnbutlon of usual and &etary mtakecan be obtamed If such data are not availablefor a nutrient but there is evidencefor a pubhchealth problemassociated low stakes, a nutnentrmghtsw1 Mrlth be considered be of concern to

5 The food groups in the USDA Food Guide are gr,nns, vegetables, fruits, rnllk yogurt, and cheese, and meat, poultry, fish. dry beans, eggs, and nuts Food groups in the DASH Eating Plan are grains and grain products. vegetables, iruts. low-fat or fat-free dairy, meat. poultry. and fish. and nuts, seeds, and dry beans I!E-ARY GUIDELIXES FOR AMERICPNS. 2005

Effortsmay be warrantedto promotemcreaseddietary mtakesof potassium, fiber,ant possiblyvltamm E, regardless of age, increasedintakes of calcium and possibly vltarnmsA (as carotenolds)and C and magnesiumby adults,effortsare warrantedto mcreasemtakesof calcium and possiblymagnesiumby cfuldrenage 9 yearsor older Effortsmay be especially warrantedto improvethe dietary Intakesof adolescent femalesIn general Foodsourcesof these nutnents are shown in appendixB Low mtakes of fiber tend to reflect low mtakes of whole grams,fruits, and vegetables Low mtakes of calcium tend to reflect low mtakesof rrulk and milk products Low intakesof vltammsA (as carotenolds) C and magneand sium tend to reflect low mtakesof fruits and vegetables Selectingfruns, vegetables, whole grams,and low-fat and fat-freermlk and nulk productsm the amountssuggested by the USDAFood Guide and the DASHEatmg Plan will provide adequateamountsof these nutnents

usmg the USDAFoodGuide,selectmgfoodsthat are lower m sodiumthan othersis especially necessary meet the to recommended mtakelevel at calonelevelsof 2,60O/day and above Food choicesthat are lower 111 so&urn are identlfied 111 chapter8
Considerations for Specific Population Groups
People Over 50 and Vitamin BII

Although a substantialproportion of mdlvldualsover age 50 have reduced abtity to absorbnaturally occumng vltarnm B12, they are able to absorbthe crystallmeform Thus, all mdlvldualsover the age of 50 shouldbe encouIaged to meet their Recommended Dietary Allowance (RDA)(2 4 pg/day)for vltamm BIZby eatmgfoodsfortn?ed vvlthvltarnmBlz such as forttied cereals, by t&g the or crystallmeform of vltamm BQ,supplements
Women and Iron

Basedon bloodvalues,substantialnumbersof adolescent femalesand women of chldbeanng age are ran deficient Most Amencansof all agesalso need to increasethen Thus, these groups should eat foods high m heme-iron potassiummtake To meet the recommended potassium (e g , meats) and/or consumenon-rich plant foods (e g intake levels,potassium-rich foodsfrom the fit, vegetable, spmach)or iron-fortified foods wrlth an enhancerof iron and daq groupsmust be selectedin both the USDAFood absorption,such as foods rich in vitanun C (e g , orange Guide and the DASH Eatmg Plan Foodsthat can help juice) Appendix B-3 hsts foods that can help increase mcreasepotassiumintake are hsted III table 5 (ch 5) and uon mtake and gves their lson and calone content appenbx B-1
Women and Folic Acid

Most Amencansmay need to increasetheir consumption of foodsrich 111 vltamm E (a-tccopherol)wme decreasing their intake of foodshgh 111 energybut low m nutnents The vltamm E content m both the USDAFood Gude and the DASHEatmg Plan is greaterthan current consumption, and specific vltamm E-rich foodsneed to be mcluded m the eatmg patterns to meet the recommended mtake of vltamm E Foodsthat can help increasevltamm E intake are hstedin appenchx along vvlththeir calonecontent B-2, Breakfastcerealthat is fortified vvlth vltamm E is an option for mdlvldualsseekmg1.0 increasetheir vltarnm E intake while consummga low-fat diet In addmon,most Americansneed to decreasesodium mtake The DASHEatmg Plan;IrovldesgLudance how on to keep sodium mtakesv&hm recommendanons When

Smcefohc acid reducesthe nsk of the neuraltube defects, spmabtida, and anencephaly, dtiy intake of 400ug/day a of syntheticfohc acid (fromfotied foodsor supplements in addmonto food forms of folate from a vaned &et) 1s recommended women of chlldbeanngage who may for becomepregnant Pregnantwomen shouldconsume600 pg/day of synthetic fohc acid (from fortified foods or supplements)in addltlon to food forms of folate from a varied diet It is not known whether the same level of protection could be achievedby usmg food that 1snaturally rich m folate
Special Groups and Vitamin D

Adequatevltamm D status,which dependson dietary mtake and cutaneoussynthesis,is unportant for optimal calcium absorption,and it can reducethe nsk for bone

DIETARY GUIDELINES

FOR AMERICANS,

2005

Smcem& and rmlk productsprovidemorethan 70 percent of the calciumconsumed Amencans, by wdance on other choicesof dietarycalciumis neededfor thosewho do not consumethe recommendedamount of milk products Fluid Milk product consumptionhas been associatedwth The combmatlonof thirst and normal drmkmgbehavior, overall&et quahty and adequacyof mtake of many nutnespeciallythe consumptionof flutds vvlth meals,is usually ents,mcludmg calcium,potassium,magnesium,zinc,iron, sufficient to mamtamnormal hydration Healthy m&vldnboflavm,vltamm A, folate,and vltamm D Peoplemay uals who have routine accessto fluids and who are not avoid milk products becauseof allergies,cultural pracexposedto heat stressconsumeadequatewater to meet tices, taste, or other reasons Those who avoid all milk their needs Purposeful dnnkmgis warrantedfor mdvlduals products need to chooserich sourcesof the nutnents who are exposedto heat stressor perform sustamed provided by milk, mcludmg potassium,vltamm A, and vigorousactlvlty (seech 4) magnesiumm addition to calcium and vltamm D (see app B) Somenon-dauysourcesof calcium are shown m Flexibility of Food Patterns for Varied Food Preferences appenti B-4 The bloavtiabtity of the calcium111 these The USDAFoodGuide and the DASHEatmg Plan are foodsvanes flexible to perrmt food choicesbasedon mdvldual and cultural food preferences, cost, and avalablhty Both can Thosewho avoid rmlk becauseof its lactosecontentmay also accommodate vaned types of msmes and special obtam all the nutnents provided by the milk group by needsdue to commonfood &ryes Two adaptationsof usmglactose-reduced low-lactosermlk products, or takmg the USDAFood Guide and the DASHEating Plan are small servmgsof milk severaltimes a day,takmg the enzymelactasebeforeconsummgrmlk products,or eatmg other calclurr-rich foods For addmonalmformatlon,see appenties B-4 and B-5 and NM Pubhcanon 03-27516 No

loss Two functlonally relevant measuresindicate that optimal serum 25.hydroxyvltammD may be as high as 80 nmoVL The elderly and mdivlduals wth dark skm (because abtity to synthesLze the v&mm D from exposure to slight vanesurlth degreeof slanplgmentauon) at are a greaternsk of low serum 25 -hydroxyvltamm concenD trations Also at nsk are those exposedto msufficlent ultravioletradiation (1e , sunhght)for the cutaneous production of vltamm D (e g , houseboundmdivlduals) For mdivldualswthm the high-nsk groups,substantially higher dally Intakes of vltamm D (1e , 25 pg or 1,000 InternationalUnits (KJ)of vrtammD per day) have been recommended reachand mamtamserum25-hydroxyvltto amm D values at 80 nmol/L Three cups of vltamm Dforttied rmlk (7 5 pg or 300KJ),1 cup of vltamm D-forttied orange]mce (2 5 pg or 100IUI, and 15 pg (600IU) of supplementalvltamm D would provide 25 ,ug(1,000IU) of vltamm D dally

Vegetarian Choices

Vegetariansof all types can achieve recommended nutrient intakes through careful selection of foods These mdlvlduals should gve special attention to their intakes of protem, non, and vltamm B12,as well as calcium and vltamm D if avoldmg milk products In ad&non,vegetananscould select only nuts. seeds,and legumesfrom the meat and beans group, or they could include eggs if so desired At the 2,000.calonelevel, they could chooseabout 1 5 ouncesof nuts ant % cup legumesinstead of 5 5 ouncesof meat, poultry, and/or fish One egg,l/z ounce of nuts, or l/4 cup of legumes1s consideredequ&ent to 1 ounceof meat,poultry or fish 111 the USDAFoodGuide
Substitutions for Milk and Milk Products

6 NIH Publication No 03-2751, U 5 Department of Health and Human Serwes, NatlanaI tlve mddk nth gov/ddaeases/pubsllactoseintolerarlcellnde~htm rlETARY LLIIDELIXES FOR AMERICANS, 2035

lnstltutes NatIonal of Health,

lnst~tute of Diabetes and D~gestwe and Kidney Daeases, March 2003 http //digs-

TABLE 1 . Sample USDA Food Guide and the DASH Eating Plan at the 2,000~CalorieLevela
Amountsof variousfood groupsthat aperecommended day or eachweek In the USDAFoodCurdeand in the DASHEatrng (amountsare dally each Plan unlessotherwise specrfred) the 2,000-calorie Also Identifiedare equivalent at level. amountsfor differentfood choicesIn eachgroup To follow eithereatrng pattern, food chorces time shouldprovidetheseamountsof food from eachgroupon average over Food Groupsand Subgroups Fruit Group USDAFood Guide Amountb
2 cups(4 servings)

DASHEatingPlanAmount
2 to 2 5 cups(4 to 5 servrngs)

EquivalentAmounts l/2 cup equivalent IS * j/zcupfresh,frozen, canned or frurt * 1 med fruit % cup driedfruit . USDA.l/z cup frurtjuice DASH: cup fruit furce Y4
l l

Vegetable Group * Darkgreenvegetables . Orangevegetables . Legumes beans) (dry * Starchy vegetables Othervegetables
l

hups (5 servings) ) 3 cups/week 2 cups/week 3 cups/week 3 cups/week 6.5 cups/week 6 ounce-equivalents 3 ounce-equivalents 3 ounceequivalents

2 to 2.5 cups(4 to 5 servrngs)

j/2 cup equivalent IS: * ‘12 cup of cut-upraw or cookedvegetable . 1 cup raw leafyvegetable * USDA.1% vegetable cup furce * DASHJ/4cup vegetable juice

l

Grain Group * Whole grains Othergrains

7 to 8 ounce-equivalents (7 to 8 servings)

1 ounce-equivalent is 1 slrcebread - 1 cup dry cereal * ~2cup cookedrice,pasta, cereal * DASH:1 oz dry cereal (~2-1~4 depending cup on cerealtype-checklabel)
l

,I_1

5.5 ounceequrvalents

6 ouncesor less

i ounce-equivalent IS:

e-

$!!F;;;;;;;;;;,

1~2 nutsor seeds oz , . DASH 1112 oz nuts,I/2oz seeds,
-.----A Milk

Group

3 cups

2 to 3

cups

a:
l

beans

*
l

Oils

24 grams(6 tsp)

I ~ 8 to 12grams(2 to 3 tsp)

I cup low-fat/fat-free yogurt milk, 1 l/2 oz of low-fator fat-freenaturalcheese 2 02 of low-fator fat-freeprocessed cheese

1 tsp equivalent IS . DASH 1 tsp soft margarine * 1 Tbsplow-fatmayo 2 Tbsplight saladdressing * 1 tsp vegetable oil
l

DiscretionaryCalorieAllowance mExample drstrrbutron of Solidfatd Addedsugars
a All servings are per day unless otherwe

267 calories 18 grams 8‘ csp

-2 tsp (5 Tbspper week)

1 Tbspaddedsugarequivalent is: * DASH.1 Tbspfelly or jam * l/2oz jelly beans -8 oz lemonade

noted USDA vegetable subgroup amounts and amounts of DASH nuts, seeds, and dry beans are per week

b The 2,OCUcalone USDA Food Guide IS appropna:e for many sedentary males 51 to 70 years of age, sedentary females 19 to 30 years of age, and for some other gender/age groups who are more physically aCtlYe See table 3 for mformatlon abotlt gender/age/actlvlly levels and appropriate calorie Intakes See appendixes A-2 and A-3 for more Inform&on on the food groups. amounts, and food Intake patterns at other calorie levels c In the DtiH Eating Plan, nuts. seeds, and dry beans are a separate food group from meat, poultry, and fish d The 011sllsted I” this table are not considered to be part of dlscretlonary calones because they are a major source of the warnin E and polyunsaturated fatty aclds, including the eSSent)alfatty acids, in the food pattern In contrast. solid fals (I e, saturated and trots fats) are listed separately as a source of dxretlonan/ calories DIETAR\ GUIDELINES FOR 4MERICANS. 2005

TABLE 2. Comparison of Selected Nutrients in the Dietary Approaches to Stop Hypertension (DASH) Eating Plant the USDA Food Guide! and Nutrient Intakes Recommended Per Day by the Institute of Medicine (IOM)C
Estrmated nutrient levelsrn the DASHEatingPlanand the USDA Food Cutde at the 2,00C-calorie level, as well as the nutrient Intakelevelsrecommended by the Instituteof Medicinefor females 19-30 yearsof age Nutrient Protern, g Protern, kcal o/a Carbohydrate, g Carbohvdrate, kcal O/o Totalfat, R 1 Totalfat, O/o kcal 1 Saturated g fat, I Saturated O/O fat, kcal I DASHEatingPlan (2,000 kcals)
108 21 288 57

USDAFood Guide (2,000 kcals)
91 18 271 55

IOM Recommendations for Females19 to 30

22 I

29
17 7.8

I

AMDR:20-35 1

I
I

10 I
5 I

I
)

- I
ALAW 1

I Alpha-linolenrc g acrd, Cholesterol, mg Totaldretary fiber, g

I

1 I
4,706

17

I

Al, 11 I

4,044

2,329f 1,619
500 2 21

1,779 1,316
380 15 18 / I / 1,740 14 20 28 22 2.4 8.3
I I

I Phosphorus, mg I Zinc,mg Thramrn, mg f Rrboflavrn. ma

I I
I

2,066 14 2.0 28 31 34

I

I
t

RDA 700 1 RDA 8 1 RDA:1.1 1
RDA:ll 1

71
1

VitamrnC, mg

181 1
165

155 95

1

851

1,052

RDA.150 RDA:700

d DASH nutrient values aie based on a l-week me,,” of the DASH Eabng Plan NIH publication No 034082

wvwnhlb~ mh go”

b USDA nutrient values are based on population-weIghted averages of typical food choices wthin each food group or subgroup c Recommended intakes for adult females 19-30, IROA= Recommended Dietary Allowance, Al = Adequate Intake. AMDR = Acceptable Macronutrient Dlstrlbutlon Range, UL = Upper Limit.

0

d As Low As Powble while consuming a nutrltlonally adequate diet e Amount Itsted IS based on 14 g dleiary flber/l.OMi kcal ’ The DASH Eating Plan also can be used to follow at 1,500 mg sodium per day g AT = mg da-tocopherol h RAE = Retnol Acwty Equivalents

CIETARY

C,UIDELINES

FOR AMEKICANS.

20115

TABLE 3. Estimated Calorie Requirements (in Kilocalories) for Each Gender and Age Group at Three Levels of Physical Activitya
Estimated amountsof calones neededto maintainenergybalance variousgenderand agegroupsat three differentlevelsof physical for actlvltyThe estlmatesare roundedto the nearest :alonesand were determinedusingthe Instituteof Medicineequation. 200 Activity Levekd Gender Child Female I I I Age (years)
2-3

1
Actived
!,000-1,400e 1,400-1,800 1,800-2,200 2,400 2,400 2,200 2,000-2,200 1,600-2,000 2,000-2,600 2,800-3,200 3,000 2,800-3,000 2,400-2,800

j

t
4-8
9-13 14-18

1,400-1,600 1,600 1,800 2,000 1,800 1,600 1,600-2,000 2,000 2,000-2,200 2,000 1,800

19-30 1 I
31-50 51+

r
-

L

d Theselevelsare basedan GtlmatedEnergyRequirements (EER) from the InsMute of Medicine DietaryReference Intakes macronutrlents report,2002,calculated gender,age,and actlvltylevelfor by referencesired lndlvlduals“Reference sue,”as determnedby IOM, ISbasedon medianheightand weightfor agesup to age 18yearsof ageand medianheightand weightfor that heightto givea BMI of 215 for adultfemales 22 5 for adult maleS and b Sedentary meansa lifestyle lncludes th,?lhght that only physlcal actuty associated typicalday-to-day with life c Moderately a&e meansa lifestyle includesphyxa actlvltyequivalent walling about I 5 to 3 milesper day at 3 to 4 milesper hour, I” additionto the light physlcal that to artlvltyassociated with typca day-todaylife d Activemeansa lifestylethat Includes physIcal aalvztyequivalent walkingmorethan 3 milesper day at 3 to 4 milespe6hour, n addnon to the Ijghtphysical to act~vlty associated typlcalday-towith day life e The calorierangesshownare to accommodate rleedsof diferent ageswIthInthe group Forchildrenand adolescents, calonesare neededat older ages For adults,fewer calories neededat mole are older ages

DIETAR\ GUIDELINES

FOR I\MERICANS,

2005

./”

/

OVERVIEW

The prevalenceof obesitym the Umted Stateshas doubledm the past two decades Nearly one-third of adults are obese, is, they havea body massmdex that (BMI) of 30 or greater One of the fastest growmg segmentsof the populationis that wth a BMP 30 tYlth accompanymg comorbltitles Overthe last two decades, the prevalenceof overweight among children and adolescents mcreased has substantially; is estimated it that as many as 16percentof lctildrenand adolescents are overweight,representmg doublmgof the rate a amongchildren and tnplmg o I the rate amongadolescents A tigh prevalence overweightand obesityis of of great pubhc health concernbecauseexcessbody fat leadsto a higher nsk for prematuredeath,type 2

diabetes,hypertension, dyshpldemla, cardiovascular disease, stroke,gall bladderdisease, respiratorydysfunction, gout, osteoarthritis, certamkmds of cancers and Ideally,the goal for adultsis to acheve and mamtam a body weight that optmzes their health However, for obeseadults,evenmodestweight loss (eg 10pounds) hashealthbenefits, the preventlon furtherweight and of gain is very Important For overweight children and adolescents, goal is to slow the rate of weight gam the while achievingnormal growth and development Maintaining a healthy weight throughoutchildhood may reducethe nsk of becornmg overwelght obese an or adult Eating fewer caloneswhile mcreasmgphysical activity are the keys to controllmgbody weight

_ lET4RY

\:UiDFl!hES

FOR AME?ICI,NS,

2005

While overweight and obesity are currently significant pubhc health issues,not all Amencansneed to lose weight Peopleat a healthy weight should stnve to mamtamtheir weight, and underweightmdnlduals may need to mcrease their weight
DISCUSSION

Overweightand obeszym the UmtedStatesamongadults and chkiren has mcreasedsigticantly over the last two decades Thosefollowmg typical American eatmg and actlvlty patternsarehkelyto be consummg &ets m excess of their energyrequirements However,caloric mtake 1s only one side of the energyb&nce equation Caloric expendture needsto be m balancevvlth caloricintake to mamtambody weight and mu:Xexceedcaloricmtaketo a&eve weight loss (seetables 3 and 4) To reversethe trend toward obesity,mostAmencansneedto eat fewer calones,be more active,and make wiser food choices Preventionof weight gam is critical becausewhile the behaviorsrequired are the same,the extent of the behaviors required to lose weight makesweight loss more challengmgthan prevennonof weight gam Smcemany adults gam weight slowly over rime,evensmall decreases m calonemtake can help avolclweight gam,especiallyIf accompamed increasedphysicalactivity For example, by for most adults a reductionof 50 to 100calonesper day may preventgradualweight gam,whereasa reduction of 500calonesor more per day is a commonmmal goal m weight-lossprograms Smnlarly, to 60 mmutesof up moderate-to vigorous-mtenslt!physlcalactlvlty per day may be neededto preventweight gam,but as much as 60 to 90 mmutesof moderate-mtenslty physlcal actlvlty per day is recommended sustamweight lossfor previously to overweightpeople It is advisablefor men over age 40, women over age 50,and those mth a hstory of chrome diseases such as heart &seaseor &abetesto consultwith a healthcareproviderbeforestartmg a vigorousexercise program However,many peoplecan safelyIncreasetheir physicalactivity mthout consLltmga healthcareprovider7

To mamtambody weight 111 healthy range,balance a calonesfrom foods and beveragesMnthcalones expended . To prevent gradualweight gam over tme, make small decreases food and beveragecalonesand mcrease 111 physical actlvlty
n

Key Recommendations
n

for Specific Population Groups

0

Those who need to lose weight km for a slow,steady weight loss by decreasmgcalonemtake while mam tammg an adequatenutnent mtake and mcreasmg physicalactivity . Overweight chkken. Reducethe rate of body weight gam while allowmg growth and development Consult a healthcareproviderbeforeplacmg a cklld on a weight-reduction&et n Pregnant women Ensureappropnateweight gam as specifiedby a healthcareprovider . Breastfeedmg women Moderateweight reduction 1s safe and doesnot compromiseweight gain of the nursmginfant
n

OverweIght adults and overwelght children wzh chrome diseases and/or on medcatlon Consulta

healthcareprovider about weight loss strateges pnor to startmg a weight-reductionprogramto ensure appropnatemanagementof other health condmons Momtonngbody fat regularlycan be a useful strategyfor assessmg need to adjust caloric intake and energy the expenditureTwo surrogatemeasures usedto approximate body fat are BMI (adultsand ctidren) and wast clrcunference(adults)8 BMI is definedas weight in tiograms divided by height, III meters,squared For adults,weight status is based on the absolute BMI level (fig 2) For chldren and adolescents, weight statusis determmed by the comparisonof the m&vldual’ BMI wth age- and s gender-specticpercentllevalues(seefig 3 for a sample boys’growth curve) Addmonal growth curvescan be

l

7 For more inform&on on recommendations ctnsult a healthcare to prwder, see Phyxal Acwty and PublicHealth-A Recommend&m from the Centersfor Disease Controland Preventjon the and AmericanCollegeof SportsMediane,IAMA 273 102-407.1995http //wondwcdrgov/wonder/prwguld/p00W391/~391 asp 6 NIH Pubhcatlon Number0@4084,The Practical Guide Identflcatlon,Evaluation Treatment Ovenvelghtand Obesityin Adults,U 5 Departmentof Healthand HumanSeruces,NatIonal and of lnstltutesof Health,NationalHeart,Lung and BlclodInstitute,October2~00 http//wwnhlbl nlh gov/guldelinesiobeslty/pragd_c pdf DIETAP\ GIIIDELIILES FOR P,VEl?lCANS, 2005

found at http ilwww cdc gov/lpowthcharts BMI is more accurateat approxnnatmgbody fat than is measunng body weight alone However,13MI somelumtatlons has BMI overestimates fat m peoplewho are very muscular body and underestimatesbody fat in people who have lost musclemass The relatlonshp between BMI and body fat vanes somewhatwth age,ge:?der, ethmclty In ad&and non, for adults,BMI is a better predlctor of a population’ s bsease nsk than an mdlvldua ‘ nsk of chromedisease’ s For &ldren gammg excessweight, small decreases m energymtake reducethe rate at which they gam weight (bodyfat), thus improvmgtheir BMI percentileover time As anothersurrogatemeasure, waist circumferencecan approxnnateabdommalfat but shouldbe measuredvery carefullyFat locatedm the abdommalremonis associated with a greaterhealth nsk than penpheralfat 8 Someproposedcalone-loweringstrateges include eatmg foodsthat are low m calonesf3r a given measureof food (eg , many lands of vegetables fnuts and somesoups) and However, when makmgchangesto improvenutnent mtake, oneneedsto makesubsmutlons avoidexcessive to calone intake The healthlest way to :educe calone intake is to reduce one’ mtake of added sugars,fats, and alcohol, s which all providecalonesbut few or no essentialnutnents (for more mformatlon,see chs 6,7, and 9)

Eating fewer calorieswhile increasingphysical activity are the keys to controlling body weight.
to the umts for servmg sizes and how they compare to the servmg sizes m the USDAFood Guide and the DASH Eating Plan

Lifestylechange111 and physical actlvlty is the best diet first choice for weight loss A reduction in 500 calones or more per day is commonlyneeded When it comesto body weight control,it is calonesthat count-not the proportionsof fat, carbohydrates, protelnm the &et and However, when mcllvlduals losmgweight,,they should are Specialattention shouldbe aven to portlon sizes,which follow a &et that is mthm the AcceptableMacronutnent have mcreasedslgmficantly over the past two decades Distnbutlon Ranges(AMDR)for fat, carbohydrates, and (http //hm nhlbi mh gov/portlon/mdex htm) Thoughthere protem,which are 20 to 35 percent of total calones,45 to are no emplncal studies to show a causal relationship 65 percent of total calones,and 10 to 35 percent of total between increasedpornon sizesand obesity,there are calones,respectivelyDiets that provide very low or veIy studiesshowmg that controlling portion sizeshelps hrmt tigh amountsof protem,carbohydrates, fat are likely or calonemtake,particularlywhen eatmgcalone-dense foods to provide low amounts of some nutrients and are not (foodsthat are high m calonesfor a gven measureof advisablefor long-term use Although these kmds of food) Therefore, is essentialthat the pubhc understand weight- loss bets have been shown to result m weight it how potion sizescompareto a recommended amount of reduchon, mamtenance a reducedweight ultimately the of food (1e , servmg)from eachfood group at a specific caloric vvlll depend on a change m hfestyle Successfuland level The understantig of seIvmgaze and portionsize1s sustamable weight loss and weight mamtenancestrateimportant m followmg either the DASHEatmg Plan or the ges requueattentionto both sidesof the energybalance USDAFood Guide (seeapp A) When usmg packaged equation(1e , caloric mtake and energyexpenditure) foods with nutrient labels,pecple should pay attention

8 NIH Publlcatlon Number 00-4084, The Pract~ca Oude ldentlflcatlon, Evaluation and Treatment of Overwght and Obesity in Adults, U S Department of Health and Human Serwces, National lnstltutes of Health, NatlanaI Heart, Lung. and Blcod Institute, October 2CCO http //wnhlbl mh gov/guidellnes/obesth//prctgd_c pdf CIITARY LUl!lELlNES FOR AMEKICANS. 2Oili

TABLE 4. Calories/Hour Expended in Common Physical Activities
Some examplesof physrcalactrvrtres commonly engaged In and the averageamount of calonesa M-pound rndrvidualwill expend by engaging In each actrvrtyfor 1 hour The expendrturevalue encompassesboth resting metabolic rate caloriesand activity expenditure Some of the actrvitrescan constitute either moderate- or vrgorous-lntenatyphysicalactrvrtydepending on the rate at which they are carned out (for walking and brcycling)

ModeratePhyslcalActivity
Hiking Light gardenrng/yardwork --__ __Dancing -__ Golf (walking and carrying clubs) ~~ Brcyclrng (40 mph) __-__ Walkrng (3 5 mph) -_ Weight lrftrng (general light workout) ___. Stretching ____ -__ ~-

ApproximateCalories/Hrfor a 154lb Persona

I __-~

330 330 290 280 -

VigorousPhysicalActivity ___~
RunnlngQogging(5 mph) _____ --__ Bicycling(>lO mph) ___Swimming (slow freestyle laps) ~______ Aerobics --+--I --

ApproximateCalories/Hrfor a 154lb Persona
590 590 -~510 480 ___I-

Walking (4.5 mph) -__ Heavyyard work (chopping wood) ____~ Weight llftrng (vrgorous effort) --Basketball(vigorous)

m/ I 440 440

a ~alones burned per hour will be higher for perwns who wgh Sourte Adapted from the 2W5 DCAC Repon

more than 154 Ibs (70 kg) and lower for persons who wqh

less

YETAR\

CUI3ELINES

FOR

4MERlCANS.

2005

FI G UR E 2. Adult BMI Chart
Locatethe hetght of tnterst rn the left-rrost column and read acrossthe row for that height to the weight of interest.Followthe column of the weight up to the top row that 11%the BMI BMI of 18 5-24.9 ISthe healthy weight range,BMI of 25-299 ISthe overweightrange,and BMI of 30 and above ISIn the obese range

BMI Height

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

Weight in Pounds

Source Evidence Report of Clinical Guidelines on the Identlflcatlon, Evaluation, and Treatment of Overweght and Obesity in Adults, 1998 NlH/Nahonal Heart, Lung, and Blood lnnltute (NHLBI)

3iETARY

CJiDEL,;uES

FOR AMERICANS,

2005

FIGURE 3. Example of Boys’BMI Growth Curve (2 to 20 years): Boys’Body Mass Index-For-Age Percentiles
Calculatethe BMI for an rndrvrdualchild usrng the following: BMI = Weight (kg)/(Height [cm])? x 10,300or BMI = Werght (Ib)/(Herght [In])2 x 703 Find the age of the child on the bottom, x-axis,and read up the chart from that age to the calculatedBMI on the left and right, y-axis The curve that IS closestto the spot where the age and ElMlof the child meet on the graph rndrcatethe BMI percentilefor this child relativeto the popularron.

2 to 20 years: Boys Body mass index-for-age

percentiles

! L4 . -~. , 3

,.,

3‘

I

I

.

.

? 1

.:,I

,1_ ; ,

.

.‘ l

4 m
;
Published May 30, 2000 (modlfled 10/16/00)

A&E (YEARS) -, ,j ;‘ I:, . .:

_ : _ j ‘ r,

Source Developed by the National Center for Health Statstlcs in collaboration wth the National Center for Chronic Disease Preventjon and Health PromotIon http //wcdc Other growth charts are awlable at thts source

gov/growthcharts (2CC9)

DIETARk LUIDELINES

FOR 4’ blERlCANS. 2005

‘ 7 I ----1

1 ! -7 i P t-

,----.

/’ .’ __, ,‘ ;

.. 1

___ _ . .. ” ... ^ _

-I<

Amencanstend to be relative11 mactlve In 2002,25 percent of adult Amencansdid not pamclpatein any leisuretime physical activmes in the past month?and m 2003,38 percentof students111 grades3 to 12 viewed television3 or morehoursper day 10Regularphysicalactivity and physical fitness make important contributionsto one’ s health senseof well-bemg, mamtenance a healthy ant of body weight Physlcal actlvlty is defined as any bodily movementproducedby skeletal muscles resulting in energyexpenditure(http,//www cdc govlnccdphpldnpal physical/terms/mdex htm) In contrast,physicalfitnessis

a mu&-component relatedto the abtity to perform trat physicalacQv@Mamtenance goodphysicalfitness of enablesoneto meet the physicaldemandsof work and leisurecomfortably People hgher levelsof physical wEh fitnessarealsoat lowernsk of developing chronicdisease Conversely,sedentary a hfestyle mcreases for over nsk weight andobesityandmanychronic&eases,mcludmg coronary arterydsease, hypertension, 2 diabetes, type osteoporosis, certam types of cancer overall, and mortahty rates from all causesof death are lower m physically active peoplethan m sedentarypeople Also, physical actlvlty can aid in managmgmild to moderatedepressionand anxiety

9 Behavioral Risk Factor Survetllance System. Surv~llance for Certar Health Behwors Among Selected Local Areas-United States, BehavIoral Risk Factor Swelllance Morfohfy Weekty Report (MMWR). 53, No SO5 http //wcdcgov/brfss/ 13Youth Risk Behauor Surveillance System, Youth Fisk Behawor Swelllance-Unlted States, 2003 MMWR 53(SS-2) I-29, 2004 http //wcdc gov/healthyyouth/Yrb~

System, 2~2, Morb,d,ry and

I

: ‘ I., ,; I9 : 1.: ,-

Regular physicalactlvlty has beenshownto reducethe . Engage regular m physicalactivity and reduce risk of certainchronicdiseases, mcludmghigh blood sedentary actlvmes promotehealth,psychologcal to pressure, stroke,coronary arterydisease, 2 diabetes, type welLbemg, a healthybodyweight and coloncancerand osteoporosis Therefore, reducethe to To reducethe nsk of chrome disease adulthood m risk of chromedisease, is recommended adults it that Engage at least30m m u tes moderate-mtenslty m of engage at least30 m m u tesof moderate-mtenslty in physphysicalactlvlty,aboveusualactivity,at work or ical activity on most,preferably daysof the week For all, h o m eon most daysof the week most people, greater healthbenefitscan be obtamed by Formost people, greater healthbenefitscan be engagmg physicalacmntyof morevigorous tenslty in m obtamed engagmg physicalactlvlty of more by m or of longerdurationIn addtlcn,physical actlmtyappears vigorous tensltyor longerduration m to promotepsycholoacal well-bemgand reducefeelmgs To helpmanage bodyweight andpreventgradual, of tid to moderate depression anxiety and unhealthy bodyweight g a mm adulthood Engage m approxunately m m u tesof moderate- vlgorous60 to Regular physicalactivity is alsoa key factorm achlevmg m tensityactlvlty on most daysof the weekwtie and m a m tammg healthybodyweight for adultsand a not exceetig caloricm takerequirements children To preventthe gradL accumulation excess al of To sustam weightlossm adulthood Pmapate 111 at weight in adulthood, to 30 addtlonalrnmutesper day up least60 to 90 m m u tesof dtiy moderate-mtenslty may be requiredoverthe 30 m inutesfor reductionof physicalactivity while not exceedmg caloricm take chronicdisease and other health benefits That is, risk reqmrements Some peoplemay needto consult approximately m inutesof noderate-to vlgorous60 m th a healthcare providerbefore particlpatmg m intensityphysicalactlvlty on most daysof the weekmay th_ls of activity level be needed preventunhealthy to weight g a m (seetable . Achievephysicalfitnessby mcludmgcardiovascular / 4 for someexamples moderate- vigorous-mtenslty of and conditionmg, stretchmg exercises fletilhty, and for / physicalactlvltles) W h ilemoderate-intensity physlcal resistance exercises c&sthemcsfor musclestrength I or activity can achieve desnedgoal,vigorous-mtenslty the and endurance physicalactivity generally provides morebenefitsthan moderate-intensity physlcalactlvlty Controlof caloric intakeis alsoadvisableHowever, sustamweight loss to CMdrenand adolescents Engage at least60 m for previously overweight/obe:;e people, about60 to 90 m m u tesof physlcalacuvltyon most,preferably all, m inutesof moderate-intensity physicalactlvlty per day daysof the week is recommended Pregnant womenIn the absence me&Cal obstetric of or comphcations, incorporate m inutesor more of 30 Most adultsdo not needto seetheir healthcare provider moderate-mtenslty physical acuvltyon most,If not all, beforestartmga moderate-mtenslty physicalactlvlty daysof the week Avoldactivmes vvltha high nsk of programHowever, e n older :han40 yearsand women m falhngor a b d o m m a l trauma olderthan 50 yearswho plan a vigorous program who or Breastfeeding women Be awarethat neitheracutenor haveeitherchromedseaseor nsk factorsfor chronic regularexercise adversely affectsthe mother’ablhty s disease shouldconsulttheir physician designa safe, to to successfuuv breastfeed effective programIt is alsoimportantdurmgleisuretune O lderadults Participate regularphysicalactivity m to tit sedentary behaviors, as television such watchmg to reducefuncnonal dechnes associated a g m g vvlth and videomewing,and replacethem Mnthactivities andto achevethe otherbenefitsof physIcalactivity requiringmoremovementReducmg thesesedentary identifiedfor all adults activitiesappears be helpfultn treatmgandpreventmg to overwelght amongcmdren and adolescents

/

Dtierent mtensltlesand types of exerciseconferMerent benefits Vigorousphyslcalact:vlty (eg , ]oggmgor other aerobic exercise)provides greater benefits for physlcal fitnessthan doesmoderatephyslcalactivity and bums more calonesper umt of mne Resistance exercise(such as weight trammg, usmgwelgkt machmes, resistance and bandworkouts)maeasesmuscularstrengthand endurance and mamtamsor mcreasesmusclemass Thesebenefits are seenin adolescents,adults, and older adults who performresistanceexerciseso ‘ or moredays per week 12 Also,weight-bearingexercisehas the potennalto reduce the risk of osteoporosisby mcreasmgpeak bone mass dunng growth,mamtammg pe& bonemassdunng adulthood,and reducmgthe rate of bone loss durmg agmg In addition,regularexercisecan help preventfatls,whch 1s of particularimportancefor olcer adults The barrier often given for a failure to be physically active is lack of time Settmg aslde 30 to 60 consecutive minutes each day for planned exerciseis one way to obtamphysicalacnvlty,but it 1snot the only way Physlcal actlvlty may mclude short bouts (e g , 10.mmutebouts) of moderate-mtenslty activity The accumulatedtotal 1s what is Important-both for he.tith and for burnmg calones Physicalactlvlty can be accumulatedthrough three to s1x lo-mmute bouts over the courseof a day Elevating the level of dally physlcal actlvlty may also provide indirect nutritional benefits A sedentaryhfestyle hmlts the number of caloriesthat can be consumed mthout gammgweight The hgher a person’physical s acmnty level,the hgher his or her energyremement and the easierit is to plan a daily food mtake pattern that meetsrecommended nutnent ~equuements

moperhydratlonISimportantwhen pamcipatmgm physical actlvlty Wo steps that help avold dehydration during prolonged physical actlvlty or when it is hot mclude (1)consummgfluid regularlydunng the actlvlty and (2)dnnkmg severalglassesof water or other fluid after the physicalactivity is completed(seechs 2 and 8)

-““.. .“.. .- .- --- -...-. -

.- --- -x - - _..-.- . .- *.- -.---. --_

.-_-I.-I-

I-- -----

----“-. -.--..-- .-.- .- .- ---_ -----

-_ --. . m- ._.-

- -----“__.._.4- --...___.

---7’ ---

Increasedintakes of fruits, vegetables,whole grams, and fat-free or low-fat milk and milk products are hkely to have important health benefits for most Amencans While protein IS an important macronutrientin the diet, mostAmencansare alreadycurrentlyconsummg enough (AMDR= 10to 35 percentof calones) do not needto and increase their Wake As such,protemconsumpnon, wlvle important for nutrient adequacy, not a focus of this is document Although associationshave been identified betweenspecihcfood groupsceg , tits and vegetables) and reducednsk for chromebseases, effectsaremterthe relatedand the health benefitsshouldbe considered m

the context of an overallhealthydiet that doesnot exceed caloneneeds(suchas the USDAFoodGuideor the DASH Eating Plan;see ch 2) The strength of the evidencefor the associationbetween increasedmtake of fruits and vegetables reducednsk of chromebseasesis vanable and and dependson the specific disease, an array of but evidencepoints to beneficialhealth effects Compared vvlththe many peoplewho consumea dietary patternVylthonly small amountsof fruits and vegetables, those who eat more generousamountsas part of a healthful &et are hkely to have reducedrisk of chrome diseases, Including stroke and perhapsother cardlovas-

cular diseases, type 2 diabetes,and cancersin certam sites (oralcavity and pharynx,larynx,lung, esophagus, stomach, colon-rectum) and Dietsrich 111 foodscontammg fiber,such as fnuts, vegetables, whole grams,may and reducethe nsk of coronary hean diseaseDietsrich m rmlk and nulk productscan reducethe nsk of low bone massthroughoutthe tie cycle!The consumption milk of productsis especially unportantfor childrenand adolescents who are bulldmg their peakbone mass and developmg hfelonghabits Alt nougheachof thesefood groupsmay havea differentrelatlonshlp wth disease outcomes, adequate the consumptlcnof all food groups contributesto overallhealth

0

Fruits,vegetables, whole grams,and m& productsare all importantto a healthful&et and can be good sources of the nutnentsof concern(seech 2) Whenincreasing intake of fruits, vegetables, whole grams,and fat-freeor low-fatrmlli and rmlkproductsit ISimportantto decrease one’mtakeof less-nutnent-dense to controlcalone s foods intake The 2,000-calone used111 discussion level the is a reference level only, it is not a recommended calone intakebecause manyAmencansshouldbe consummg fewer calonesto mamtama healthyweight

Consume sticlent amountof fnuts and vegetables a wide staymgvYlthm energyneeds Two cupsof fnut and 2*/zcups of vegetables day arerecommended per for a reference 2,000.calone mtake,with higheror lower amountsdependmg the calonelevel on Choose vanetyof tits and vegetables a eachday In particular,select from all five vegetablesubgroups (darkgreen,orange, legumes, starchyvegetables, and othervegetables) severaltimes a week Consume or moreounce-equivalents whole-gram 3 of productsper day,vlrlththe rest of the recommended gramscommgfrom enrichedor whole-gram products In general, leasthalf the gramsshouldcomefrom at whole grams Consume cupsper day of fat-freeor low-fat rmlk or 3 emvalent rmtkproducts 1 I “~ 1 ‘ I. C:. :#I,, .j * .‘ I

Chzldrenand adolescents Consume whole-gram prod-

ucts often; at least half the gramsshouldbe whole grams Children2 to 8 yearsshouldconsume2 cups per day of fat-freeor low-fat milk or equivalentmilk products Children9 yearsof age and older should consume cupsper day of fat-freeor low-fat m& or 3 emvalent rmlk products starchy,and other vegetables)12 recommended is for adequate nutnentmtake Eachsubgroup provides somea what merent arrayof nutnents In the USDAFoodGmde at the reference 2,000.calone the followmgweekly level, amountsarerecommended Darkgreenvegetables 3 cups/week Orange vegetables 2 cups/week Legumes beans) (dry 3 cups/week Starchyvegetables 3 cups/week Othervegetables 6% cups/week Most currentconsumption patternsdo not achievethe recommended intakesof many of thesevegetablesThe DASHEatmgPlanand the USDAFoodGude suggest increasingintakes of dark greenvegetables, orange

a

Fourand one-halfcups (rimeservmgs) fnuts and of vegetables recommended for the reference are daly 2,000-calorie wth higheror lower amounts level, dependmg the caloriclevel lYusresultsm a rangeof 2% on to 6% cups(5to 13servmgs) fnuts and vegetables of each day for the 1,200. to 3,200.calone levels11 A-2) FruKs (app and vegetables providea vanety of mcronutnentsand fiber Table5 provides IIst of fnuts and vegetables are a that goodsources vltammsA (ascarotenolds) C, folate, of and and potassiumIn the frW group,consumption whole of fnuts (fresh, frozen,canned, dried)ratherthan fnut ]uice for the malontyof the total daly amountis suggested to ensureadequate fiber intake Differentvegetables rich are in differentnutrients In the vegetablegroup,weekly intake of specific amountsfrom each of five vegetable subgroups(darkgreen,orange: legumes[dry beans],

1’See appendix A-2 and table Dl-16 from the 2W5 DGAC Reoart (or USDA website) for information on chtldren age 2 to 3 years I2 hcludes all fw+, frozen, canned. cooked, or raw forms of vegetables Examples of vegetables are dark green (broccoli, spinach, most greens), orange (carrots, sweetpotatoes, winter squash, wmpkln). legumes (dv beans, chickpeas. tofu). starchy (corn, white potatoes, green peas), other (tomatoes, cabbage, celery, cucumber. lettuce. onions, peppers, green beans,, c&lower, mush rooms, summer squash)

vegetables, legumes(drybeans)as part of the overall and recommendation havean adequate to mtakeof fnuts and vegetables ch 2) (see

In ad&non to fruits and vegetables, whole gramsare an important sourceof tier and other nutnents Whole grams,as well as foodsmade Yomthem, consistof the enmegramseed, usuallycalledthe kernel The kernelis madeof threecomponents-thebran the germ,and the endospennIf the kernelhas keen cracked,crushed, or flaked, then it must retamnearlythe samerelativeproportions of bran,germ,and endosperm the ongmalgram (as to be called whole gram In the gram-refmmgprocess, most of the bran and some of the germ is removed, resultmg111 lossof dietary6ber(alsoknown as cereal the fiber),vltamms,mmerals,llgnms, phytoestrogens, phenohccompounds, phytlc acid Somemanufacand turers add bran to gramproductsto mcreasethe dietary fiber content Refinedgramsare the resultmgproduct of the gramrefinmg processingMost refined gramsare enrichedbefore being further processedinto foods Enriched refinedgramproductsthat conformto standards of identity are requiredby law to be forttied wKh fohc acid,as well as thiarnm,nboflavm,macm,and iron Food manufacturersmay fortify whole-gramfoods where regulationspernxt the ad&non of fohc acid Currently, a numberof whole-grm, ready-to-eat breakfast cereals are fortified mth fohc acid As Illustratedby the comparison of whole-wheat enrichedwlute flxxs m table6, many and nutrientsoccurat hgher or slrrllar levelsm whole grams when compared enrichedgrams, whole gramshave to but lessfolateunlessthey havebeenforttied vvlthfohcacid Consummg least3 or moreounce-emvalents whole at of grams per day can reduce the risk of severalchronic diseases may help vinthweight mamtenanceThus, and dally intake of at least 3 ounce-equivalentsof whole grams per day is recommendedby substltutmg whole gramsfor refinedgrams However, because threeservmgs may be difficult for younger children to achieve,it is recommended they mcrease that whole gramsmto their bets as they grow At all calonelevels,all age groups

: *

.

..-- _

shouldconsume leasthalf the grms as whole grams at to achievethe fiber recommendation gram servmgs All can be whole-gram; however, is advisable mclude it to somefolate-fortified products,such as folate-fortified whole-gramcereals,m these whole-gram choices Wholegramscannotbe identifiedby the color of the food, label-readmg &Us are needed Table7 identifiesnames of whole gramsthat are availablem the United States For mformationaboutthe mgredlentsm whole-gramand enriched-gram products,readthe ingredienthst on the food label Formany whole-gramproducts,the words “whole”or “whole gram”will appearbefore the gram mgredlent’name The whole gram shouldbe the tist s mgredlent&ted Wheatflour,enrichedflour,and degennnated cornmeala.renot whole grams The Foodand Drug Admmistratlonrequiresfoodsthat bear the whole-gram health clannto (1)contam51 percentor morewhole-gram mgredientsby weight per referenceamount. (2)be and low in fat

Another sourceof nutnents is milk’ rmlk products and Milk product consumptionhEs been associatedvvlth overall&et qu&ty and adequ;cy of intakeof manynutrents The mtakeof rmlk productsis especially nnportant to bonehealthdurmgchlldhoc8d adolescence and Studies specifically on milk and other rmlk products,such as yogurt and cheese, showed a positive relationship betweenthe mtake of rmlk an3 rnlllt productsand bone mmeralcontentor bonemmeraldensitym one or more skeletalsites (seetable 1 for informationon equ&ent amountsof nulk products)

Adults and chOdren shouldnot avoid nxlk and rnti products becauseof concernsthat thesefoodslead to weight gam Thereare manyfat-freeand low-fat choicesvvlthout added sugarsthat are avalable and consistentwth an overallhealthydietaryplan If a personwants to consider rmlk alternatives because lactosemtolerance, most of the rehableand easiestways to denve the health benefits associated mth rr~lkand rmlk product consumptionISto choosealternatives wRhmthe m& food group,such as yogurt or lactose-freemilk or to consumethe enzyme lactasepnor to the consumptionof milk products For m&vldualswho choose or must avoidall rti products to (eg , m&mdualsCylthlactosemtolerance, vegans), nondauy calciumcontammg alternatives be selected may to help meet calciumneeds(app B-4)

x ’ i’ .’ ( I :‘ <

Many of the frurts, vegetables,and legumes (beans) are consrderedto be Important sources of vitamin A (as carotenords),vrtamrn C, and potassrumIn the adult populatron. Intakes of these nutrients, based on dretary Intake data or evrdenceof public health problems, may be of concern. Also listed are sources of naturally occurnng folate, a nutrient :onsrdered to be of concern for women of chrldbearrngage and those in the frrst trimester of pregnancy Fokcacidforttfted gram products, not lrsted in this table, are also good sources

_Sourcesof karnii A (carotenoid;) (see app. B-6)
. Bright orange vegetables like carrots, sweetpotatoes,and pumpkin Tomatoes and tomato products, red sweet pepper Leafy greens such as spinach, collards,turnip greens, kale, beet and mustard greens, green leaf lettuce, and romaine Orange frurts hke mango, cantaloupe, apricots,and red or pink grapefruit

Sourcesof vitamin C
- Crtrusfruits and lu~ces, krwrfruit, strawbernes,guava, papaya, and cantaloupe . Broccolr,peppers, tomatoes, cabbage (especiallyChinese cabbage), brusselssprouts, and potatoes - Leafy greens such as romaine, turn p greens, and spinach

Sourcesof folate
- Cooked dry beans and peas . Oranges and orange fuice - Deep green leavesIIke spinach and mustard greens

Sourcesof potassium(see app. B-i)
. . . Baked whrte or sweetpotatoes,cooked greens (such as sprnach), winter (orange) squash Bananas,plantains, many dried frurs, oranges and orange juice, cantaloupe, and honeydew melons Cooked dry beans Soybeans(green and mature) Tomato products (sauce, paste, pume) Beet greens

,‘ .

:.

_

,i.

‘ ,I.

->

-,I,

Some of the nutrientsof concernand the fortrflcationnutrients in 100 percentwhole-wheatflour and ennched,bleached,all-purposewhrte (wheat) flour Dietaryfiber, calcrum,magnesrumand potassium,nutrients of concern,occur rn much hrgherconcentratrons the whole-wheatflour on a 100-grambasis In (percent) The fortrfrcatron nutrients-thlamin, nboflawn, niacin,and Iron-are similar in concentrationbetween the two flours, but folate, as Dietary Folate Equtvalent(DFE),pg, IShigher In the enrrchedwhite flour. 100 Percent Whole-Grain Wheat flour Calones,kcal Dietaryfiber, g Calcrum,mg Magnesium,mg Potassrum, mg Folate,DFE,pg Thramrn,mg Rrboflavrn, mg Niacin,mg t Iron, mg . _ I I .
SourceAgrwltural Research Service NutrientDatabase SandardReference, for Release 17

Enriched, Bleached, All-Purpose White flour
3640 27 150 220 1070 2910 08 05 59 46 .

339.0 122 34.0 138.0 405 0 44.0 05 0.2 6.4 3.9

:

_’

.

:

Whole grainsthat are consumedHIthe United Stateseither as a single food (e.g.,wild rice, popcorn) or as an ingredient in a mutt]-rngredrent food (e g , In multi-grain breads).This lrstmgof whole grainswas determined from a breakdownof foods reported consumedrn nationwide food consumpttonsurveys, by amount consumed.The foods are Irstedin approximateorder of amount consumed,but the order may changeover ttme In addition, other whole grams may be consumedthat are not yet representedin the surveys Whole wheat Whole oats/oatmeal Whole-gratncorn Popcorn Brown rice Whole rye Whole-gratnbarley Wild rice Buckwheat Tnttcale Bulgur (crackedwheat) Mrllet Qurnoa Sorghum _
SourceAgriculture Research Serwce Database Wil 1994-1996 for

chapter

p

Fats
OVERVIEW DISCUSSION

Fatsand oils are part of a healthful&et, but the type of Fatssupplyenergyand essential fatty acidsand serveas fat makesa differenceto hear; health, and the total a tamer for the absorptionof the fat-solublevltammsA, D, amountof fat consumed alsc’ is important tigh mtakeof E, and K and carotenoidsFatsserveas btidmg blocks saturated Vansfats,and cholesterol fats, mcreases nsk the of membranes play a key regulatoryrole m numerous and of unhealthy bloodllpld levels, which,m turn,may mcrease blolog& functions Dietaryfat is foundm foodsdenved the risk of coronaryheart diseaseA high intake of fat from both plants and animals The recommended fat total (greaterthan 35 percent of calories)generallyincreases mtakeis between20 and 35percentof calones adults for saturated mtakeand makesit moredifficult to avoid fat A fat mtakeof 30 to 35 percentof calones1srecommended consummgexcesscalones A .ow intake of fats and oils for children 2 to 3 years of age and 25 to 35 percent of (lessthan 20percentof calones: mcreases nsk of madthe caloriesfor childrenand adolescents to 1Eyearsof age 4 equateintakesof vltammE andof essential acidsand FewAmencansconsume than 20 percentof calones fatty less may contributeto unfavorable changesin high-density from fat Fat mtakesthat exceed35 percentof calonesare hpoprotem (HDL)bloodcholesterol tnglycendes and associated mth both total mcreased saturatedfat and calonemtakes

0-

To decrease their nsk of elevatedlow-densityhpoprotem (LDL)cholesterolin the blood,most Americansneed to decrease mtakesof saturated and transfats,and their fat many needto decrease their chetaIymtake of cholesterol Becausemen tend to have higher mtakes of dietary cholesterol, is especially it Importantfor them to meetthis recommendation Population-based stu&es of Amencan diets show that mtake of saturatedfat is moreexcessive than intake of transfats and cholesterolTherefore, 1s It most importantfor Amencansto decrease then intake of saturatedfat However,mtake of all three shouldbe decreased meet recommendations to Table8 shows,for selectedcalorielevels,the maximum gram amounts of saturatedfat to consumeto keep saturatedfat mtake below 10percentof total calonemtake This table may be usefulwhen combmedWth label-readmg guidance Table9 gves a few practicalexamples the dtierences of m the saturated contentof ctierent formsof commonly fat consumedfoods Table 10 prcvldesthe ma]or dietary sourcesof saturatedfats m the U S diet hsted in decreasing order Diets can be plannedto meet nutnent recommendations lmolelcacid and a-lmolemcacid for while provldmgvery low amountsof saturated fatty acids

Consumeless than 10 percent of calonesfrom saturatedfatty acids and less than 300mg/day of cholesterol, keep tram fatty acid consumption and as low as possible m Keeptotal fat intakebetween20 to 35 percentof calones,wth most fats commgfrom sourcesof polyunsaturated monounsaturated acids, and fatty such as fish, nuts, and vegetable oils . Whenselectmgand preparmg meat,poultry,dry beans, and rmlk or rmlk products,makechoicesthat are lean, low-fat, or fat-free n Llrmt mtake of fats and oils high in saturatedand/or tram fatty acids,and chooseproductslow m such fats and oils
n

Key Recommendations for Specific Population Groups
n

Basedon 1994-1996 the estimatedaverage data, daly intake of tram fats m the UmtedStateswas about 2 6 percentof total energyintake Recessedfoodsand oils polyunsaturated monounsaturated acids and fatty provideapproximately percentof transfats in the &et, Sourcesof omega-6polyunsaturated 80 fatty acids are compared 20 percentthat occur naturallyin food from to hmd vegetable mcludmgsoybean corn oil, and oB, oil, animal sources Table 11 provtdesthe major dietary saffloweroil Plantsourcesof omega-3 polyunsaturated sourcesof transfats hsted in decreasing order i?ansfat fatty acids (ol-lmolemc acid)mcludesoybeanoil, canola content of certamprocessed foodshas changedand 1s oil, walnuts,and flaxseed Eicosapentaenolc (EPA) acid hkely to contmueto changeas the mdustryreformulates and docosahexaenolc (DHA)areomega-3 acid fatty acids products Because transfatty acids producedin the the that arecontamed fish and shell&h Fishthat naturally 111 partial hydrogenation vegetable011s of accountfor more contammoreoil (eg , salmon,trout, hemng)arehigher than 80 percentof total mtake the food industry has an m EPAand DHA than arelean fish (eg , cod,haddock, nnportant in decreasmg fatty acid contentof the role trans catfish) Llmlted evidencesuggestsan association food supply Llmlted consumptionof foodsmademth betweenconsumpnon fatty acidsin fish and reduced of processed sources transfats provides most effective nsks of mortahtyfrom cardiovascular of the dseasefor the meansof reducmgmtakeof trans fats By lookmgat the general populationOthersources EPAand DHA may of foodlabel,consumers selec’ can productsthat arelowest t providesimilar benefits,however,more research1s III saturatedfat, transfats,la and cholesterol neededPlantsources are rich m monomsaturated that fatty a&s mcludevegetable (eg , canola, oils ohve, h_lgh To meet the total fat recommendation 20 to 35 percent olelcsafflower, sunflower that arehqludat room of and oils) of calones, most dietaryfats shouldcomefrom sourcesof temperature nuts and

Keeptotal fat intake between30 to 35 percentof calonesfor children 2 to 3 yearsof age and between25 to 35 percent of calories for childrenand adolescents to 18 yearsof age, 4 mth most fats commgfrom sourcesof polyunsaturated and monounsatwated fatty acids,such as fish, nuts, and vegetableoils
Chddren and adolescents

Considerations for Specific Population Groups

Evidence suggests consummg that approxnnately two servmgsof fish per week (apgroxlmately ouncestotal) 8 may reducethe risk of morta.ity from coronaryheart &seaseand that consummg and DHA may reduce EPA the nsk of mort&ty from cardiovascular dseasem people who havealreadyexpenencecl cardiacevent a Federal Stateadvisories and providecurrentinformation aboutlowenngexposure enwonmentalcontammants to 111 Forexample, fish methylmercury a heavymetaltoxm is foundm vaqmg levelsm nearlyall fish and shellfish For most people, risk from mercuryby eating fish and the shellfish is not a health concern However,some fish contam hgher levelsof mercuryr mayharman unborn that baby or young child’ developmg s nervoussystem The risks from mercuryin fish ant shellfishdependon the amountof fish eatenand the 1l:vels mercuryin the fish of Therefore, Foodand DrugMmmistratlon (FDA)and the the EnwonmentalRotectlonAgencyare advlsmgwomen of chMbeanngagewho may becomepregnant, pregnant women,nursingmothers,and young childrento avold sometypes of fish and shellfishand eat fish and shel&h that arelowerm mercuryFormoremformatlon, FDA’ call s foodmformation toll-freeat l-888.SAFEFOOD vlslt lme or http //www cfsanfda gov/-dmsiadmehg3 html

. ~.mostAmericans needtodecrease their intakes of saturated fat and :~ans fats, and manyneedto decrease dietary their intakeof cholesterol.
Lowermtakes(lessthan 7 percentof calones from saturatedfat and lessthan 200mg/day of cholesterol) are recommended part of a therapeutic for adultsmth as &et elevated bloodcholesterol e , abovetheir LDL blood LDL (1 cholesterol [seetable 121)People goal wth an elevated LDLbloodcholesterol shouldbe underthe careof a level healthcare provider

TABLE 8. Maximum Daily Amounts of Saturated Fat To Keep Saturated Fat Below 10 Percent of Total Calorie Intake
The maximum gram amounts of saturaiedfat that can be consumedto keep saturatedfat Intake below 10 percent of total calorie intake for selectedcalone levels.A 2,000-caloneexample is included for consistency with the food label This table may be Lseful when combined with labelreading guidance

TotalCalorieIntake

1,600 2,000" 2,200 2,500a 2,800

--..__

.a Percent Dally Values on the Nutrition Facts Panel of food labels are based on a 2,c~ucalarte diet Values 2,CCOand 2,500 calmes are rounded to the nearest 5 gram to be consistent with the for Nutntlon Facts Panel

TABLE 9. Differences in Saturated Fat and Calorie Content of Commonly Consumed Foods
Thustable shows a few practrcalexamp es of the differencestn the saturatedfat content of different forms of commonly consumedfoods Comparisonsare made between foods In the same food group (e g., regular cheddar cheeseand low-fat cheddar cheese),rllustratrng lower saturatedfat chorcescan be that made withrn the same food group

FoodCategory
Cheese
l

Portion

SaturatedFatContent(grams)

Calories ..--__114 49

Regularcheddar cheese

1 oz 1 OZ

6.0 1.2

- Low-fat cheddar cheese ! Ground beef i - Regularground beef (25% fat) - Extralean ground beef (Y/O fat) ,~~~~-~-----. ---____ Milk * Whole mrlk (3 24o/0) j - Low-fat (1 O/o) milk /~~~~~~ ._~_.._ --~~_____ Breads - Crorssant (med) * Bagel,oat bran (4”) Frozendesserts * Regularice cream - Frozenyogurt, low-fat Tablespreads - Butter - Soft margarinewrth zero truns Chrcken
----i----A--__----

3 oz (cooked) 3 oz (cooked)
--_i--

6.1

~

236

1 cup
1 cup

46 1.5 c

: I

146 102

----__-.-1 medium
1 medrum

66 0.2

~ -b---.------

231 227

112 cup ‘ cup I2 _____-__-~

49
2.0 ,.-----____

145 110

1 tsP ~ I / 1 t-sP

2.4 07

~

34 25

33

.__212 140 I

- Fried chrcken(leg wrth skin)
l

: ~~ ~-

Roastedchicken (breast no skin)
.--~ ----p~---p-

3 oz (cooked) 3 oz (cooked)
___

---------.-

09

------------_i

: Frsh - Friedfish * Bakedfish
SourceARSNutrient Database Standard for Referem, Release 17 3 oz 3 oz 28 15 195 129 1 j

TABLE 1 0. Contribution of Various Foods to Saturated Fat Intake in the American Diet (Mean intake = 15.5 g)
The major dietary sourcesof saturatedfats in the U S diet llsted in decreasingorder

FoodGroup ____Cheese ,..-. .----~---~ Beef MIlka ~___

Contribution (percentof total sat fat consumed)
13.1 ~~___11.7 78 49 47 47 ~46

ti

Other fatsb ___--. _____ Margarine -------+-----~.

4.4 __~~..-37 3.6 , 32 -~~ -~31 ~.- -___ -__-

1;;; -- dressings/mayonnaise Salad .- -.-___Poultry

Sausage j Potato chrps/cornchips/popcorn Yeastbread

i

26

a The mik category includes milk,lncludlng all while milk low-fatmilk and fat-freemilk b Shortening animalfats and SourceAdapted from CottonPA,SubarAF,Friday E,CookA, Dietary Sources Nutrients of amongU S Adults.1994-1996 IADA 104921.931,2004

TABLE 1 1 Contribution of Various Foods to Funs Fat Intake in the American Diet (Mean Intake = 5.84 g)
The major dretarysourcesof trans fats listed in decreasrng order Processed foods and oils provide approxrmately percent of frans fats in the diet, 80 compared to 20 percent that occur naturally rn food from animal sources Trunsfats content of certain processed foods has changed and ISlikely to contrnueto change as the Industry reformulatesproducts

1 FoodGroup &-.-----------; Cakes,cookres,crackers,pres,bread, etc.
i--- ------~----. ~_---___ --------~~--..--~ _____

(percentof total truns fats consumed) -__.. -

i Animal products jd---.-__-. -____------__~ i Margarine
j .-~-~__.--~-~~--.~__..-___. ..- ___ ---__---__----. f--___ -____

! Fried potatoes /-~~~.-.---~__-____--__________ / Potatochrps,corn chrps,popcorn I -~~ / Householdshortenrng
! ~~. ..-.--~~-~

/ Other
a includes breakfast cerealand candy USDA analysts reported0 gramsof trots fatsin saladdressing SourceAdapted from Federal RegMernotlce FoodLabeiKlg, TmrxFattyAods m NutWonLobelmg, Consumer Research CcvwderNutuentContent HealthC/alms Pou,b/eFootnote To and and 01 Dfsclosure Statements, Ru/eand Proposed Vol 68, No 133,p 41433.41506, 11,2003 Datacollected Go/ Rule July 1994-1996

TABLE 12. RelatIonship Between LDL Blood Cholesterol Goal and the Level of Coronary Heart Disease Risk
lnformatronfor adults with elevatedLDL blood cholesterol LDL blood cholesterolgoalsfor these indrvidualsare related to the level of coronary heart drseaserisk Peoplewrth an elevated LCL blood cholesterolvalue should make therapeutic lrfestylechanges(diet, physicalactivrty,werght control) under the care of a healthcareprovrderto lower L3L blood cholesterol

I-----

If SomeoneHas:

____-------~-

p--L--p

1 LDL Blood Cholesterol Goal Is:
Lessthan 100 mg/dL ~-..-’ Lessthan 130 mg/dL Lessthan 160 mg/dL

CHD or CHD risk equIvalenta

Two or more risk factors other than elevatedLDL blood cholesterolb _--_--___.-___~p-.--&pZero or one risk factor other than elevated LDL blood cholesterolb

a CHD (coronaryheartdisease) equivalent presence cllnlcal risk = ot atherosclerotic disease confershigh riskfor CHDevents that . Cllmcal CHD Symptomatic carotidarterydisease Peripheral arterialdisease -Abdominal aorticaneurysm Diabetes Twoor more riskfactorswith >20% riskfor CHD (or myocardlal lnfardlonor CHDdeath)wIthInIOyears b Majorriskfactor,that affectyour LDLgoal CIgarerIe smoking Highblood pressure (140/90mmHgor higher(lr on bloodpressure medlcahon) -Low HDLblood cholesterol than 40 mgidl) (less -Familyhlstoryof earlyheartdisease (heartdae;se I” fatheror brotherbeforeage55, heartdisease motheror sisterbeforeage65) in -Age (men 45 yearsor older,women55 years01older) SourceNIH Publlcatlon 01-3290, Departmstnt Healthand HumanSeMces, No US of National InStltutes Health, of National Heart,Lung,and BloodInstitute, Nattonal Cholesterol Education Program Brochure, BloodCholestwol High WhatYouNeedto Know,May2001 hnp//ww.vnhlb~ gov/heai?h/publlc/heawchol/hbc-what nlh htm

chapter

( 7

Carbohydrates
known as caloricsweeteners, sugarsand syrupsthat are are addedto foods at the table or dunng processmgor Carbohydrates part of a healthful&et TheAMDRfor are preparation(suchas high fructosecorn syrup m sweetcarbohydrates 45 to 65 percentof total calonesDietary is enedbeverages bakedproducts) and Althoughthe body’ s fiber is composedof nondlgestlblecarbohydrates and response sugarsdoesnot dependon whetherthey are to lignm mtrmslc and intact m p ants Diets rich m dietary naturallypresentm a food or addedto the food,added fiber have been shown to have a numberof beneficial effects,mcludmgdecreased of coronary nsk heart disease sugarssupplycalonesbut few or no nutnents and unprovement laxation Thereis alsointerestm the m it potentialrelationstip betweenlets contammgfiber-rich Consequently, is important to choosecamohydrates foodsand lowernsk of type 2 dtabetesSugars starches wisely Foodsm the basic food groups that provide and carbohydrates-tits, vegetables, grams,and roll-are supply energyto the body m the form of glucose, which importantsources manynutnents Choosmg of plentyof ISthe only energysourcefor red blood cells and is the thesefoods,w&n the contextof a calone-controlled &et, preferredenergysourcefor the brain, central nervous can promotehealth and reduce chromediseaserisk system,placenta,and fetus Sugarscan be naturally However, greater consumphon foodscontammg the the of presentm foods (such as the fructose m fruit or the largeamountsof addedsugars, moreticult It 1sto the lactosem rmlk)or addedto the food Added sugars,also
OVERVIEW
CIETARY CJIDELIhES FOR AMERICANS, 20135

consume enoughnutnentswrzhoutgammgweight Consumption addedsugarsprovidescaloneswhle of provldmghttle,if any,of the essential nutnents
DISCUSSION

The recommended dietary filrlerintake is 14 gramsper 1,000 calonesconsumedJ&My, someAmencansvylll fmd it challengmg achieve levelof mtake However, to tlus makmg fiber-rich food choicesmore often ill move peopletoward tlvs goal and is likely to conferslgmficant healthbenefits The malontyof servmgs from the frM groupshouldcome from wholefnut (fresh, frozen,canned, dned)ratherthan ]uce Increasmg proportionof fnut that is eatenm the the formof wholefnut ratherthan ]luceis desirable mcrease to fiber intake However,inclusion of someJuice,such as orange]uce, can help meetrecommended levelsof potassium mtake Appendutes and B-8 hst someof the best B-l sources potassium &etauyfiber,respectively of and

m Choose fiber-richtits, vegetables, whole grams and often . Choose preparefoodsand beverages IIttle and wth addedsugarsor caloricsweeteners, as amounts such suggested the USDAFoodGuideand the DASH by EatmgPlan m Reducethe mcidenceof dentalcanesby practicmg goodoral hygene and consummg sugar-and starchcontammg foodsand beverages frequently less whole gramsfor refmedgrams (Seetable 7 for a hst of whole gramsavailable the UmtedStates11 in Individualswho consume food or beverages m added tigh sugarstend to consumemore caloriesthan those who consume food or beverages m addedsugars;they also low tend to consume loweramounts rmcronuments of Although moreresearch needed, is avalableprospectivestudies show a positiveassociation betweenthe consumption of caloricallysweetened beverages weight gam Forthis and reason, decreased mtakeof suchfoods,especially beverageswth caloricsweeteners, recommended reduce is to calorieintake and help achieverecommended nutrient mtakesand weight control Total discretionarycaloriesshouldnot exceedthe allowancefor any gven calorielevel, as shown in the USDAFoodGuide (seech 2) The tiscrenonarycalone allowancecoversall calones from addedsugars, alcohol, andthe addmonal foundm evenmoderate choices fat fat from the milk and meat group For example, 2,000. the caloriepattern includesonly about 267discretionary calonesAt 29 percentof calones fromtotal fat (mcludmg 18 g of sohdfat),If no alcoholis consumed, only 8 then teaspoons g) of addedsugarscan be affordedThis (32 is lessthan the amountm a typlcal la-ouncecalorically sweetened dnnk If fat is decreased 22 percent soft to of calones, then 18teaspoons g) of addedsugars1s (72 allowed If fat is mcreased 35 percentof calones, to then no allowance remainsfor addedsugars, evenIf alcohol is not consumed In somecases, smallamounts sugars of addedto nutnentdensefoods,such as breakfastcereals reduced-fat and milk products,may increasea person’mtake of such s
DIETARY GUIDELINES FOR AMERICANS. 2005

-

Legumes-such as dry beansand peas-are especially rich in fiber and shouldbe consumedseveraltimes per week Theyareconsidered of both the vegetable part group and the meat and beansgroup as they contain nutrients found in each of thesefood groups Consummg leasthalf the rec’ at ornmended servmgs gram as whole gramsISImportant,53ralI ages,at eachcalone level,to meet the tier recommendation Consummg at least 3 ounce-equvalents whole gramsper day can of reducethe nsk of coronary heartdisease, help mth may weight mamtenance, may owernsk for otherchrome and diseasesThus, at lower calonelevels,adults should consumemore than half (specifically, least 3 ounceat equivalents)of whole gramsper day,by substituting

0

Diets rich in dietary fiber have been shown to have a number of beneficialeffects.

the greaterthe consumptionof foodscontaining large amountsof added sugars,the more difficult it is toconsumeenough nutrients without gaining weight.
. . .

productshelp reducethe risk of dental canes Most bottled water is not fluoridatedWith the increasein consumption bottled water,there is concernthat of Amencansmay not be gettmg enoughfluoridefor maintenance oral health A combinedapproach of of reducingthe frequencyand duration of exposure to fermentable carbohydrate intake and optlmlzmg oral hygienepractices,such as drinking fluoridated water and brushingand flossmgteeth,is the most effective way to reducemcldenceof dental canes
Considerations for Specific Population Groups
Older Adults

Dietaryfiber is unportant laxatlon Smceconstipation for may affect up to 20 percentof peopleover 65 yearsof age,olderadultsshouldchoose consume to foodsrich m dietarytier Othercauses constlpatlon of amongthis agegroupmay mcludedrug mteractlons mth laxatlon and lack of appropriate hydratlon(seech 2:
Children

0

0

Carbohydrate mtakesof childrenneedspecialconslderations with regardto obtainingsufficientamountsof fiber,avoidmg excessive amounts calones of fromadded sugars,and preventingdental canes Severalcrosssectionalsurveys US childrenand adolescents on have foundmadequate dietaryfiber mtakes, which could The Nutrition FactsPanelon the food label providesthe be unproved mcreasmg by consumption wholefruits, of amountof total sugarsbut do’ not hst addedsugars 3s vegetables, whole-gram and productsSugars improve can separatelyPeopleshouldexaminethe ingredienthst to the palatabihty foodsand beverages othercvlse of that find out whethera foodcontams addedsugarsThemgre- rmghtnot be consumedThis may explamwhy the dent hst is usuallylocatedunderthe NutntlonFactsPanel consumption sweetened of dauyfoodsand beverages or on the side of a food label [ngredlents hstedm are and presweetened cereals positivelyassoN:iated is mth orderof predommance, weight; that is, the mgredient chlldrens’ adolescents’ by and nutrientmtake However, wth the greatestcontnbutlonto the productweight beverages caloricsweeteners, vYlth sugarsand sweets, ISlisted first and the mgredielt contnbutmgthe least and other sweetened foodsthat providelittle or no amountis hstedlast Table14.lsts mgrebentsthat are nutnentsarenegatively associated &et qu&ty and vvlth mcluded the term “addedsugars m “12 can contributeto excessive energymtakes,affmnmgthe importance reducmgaddedsugarmtakesubstantially of Sugars starches and contribute dentalcanes provldmg from currentlevels Most of the studiesof preschool to by substrate bacterialfermentation the mouth Thus, for m childrensuggesta positiveassoclatlon betweensucrose the frequencyand dwatlon of consumptionof starches consumption dentalcanes,thoughotherfactors and and sugarscan be importantfactorsbecause mcrease (particularly they mfrequent brushmgor not usmgfluondated exposure canogemc to substratesDrmkmgfluondated toothpaste) moreprelctive of canesoul.come are than water and/or usmg fluoride-contammg dental hygene is sugarconsumption
1‘For nformallon on amounb of added sugars I” wme common foods, see Krebs-Smith. SM Choose beverages and foods to moderate your Intake of sugars measurement requires quantlflcatlon The /ourno/ of Nulr,hon (I Nut-) 131(ZS-I) 5275.5355, 2001 DIETARY CI1IDEtl~ES FOR AMERICPNS, LOO5

foodsby enhancmg palatabtityof theseproducts, the thus lmprovmg nutnentmtakewthout contnbutmg excessive calories The malor sources01addedsugarsare hsted m table13(appA-3 provides examples how addedsugars (of can fit mto the &scretionaty caloneallowance)

TABLE 13. Major Sources of Added Sugars (Caloric Sweeteners) in the American Diet
Food groups that contribute more than 5 percent of the added sugarsto the Amencandiet In decreasingorder.

Contributionto Added SugarsIntake (percentof total addedsugarsconsumed)

Fruit drinks (frultades and fruit punch) ~~e~~~~rn~lk prodycts 1 1; 1

Ice cream sweetenedyogurt and sweetenedmilk) Other grains (cmnamon toast and honey-nut waffles)
SourceCuthw and Morton, lournol of the AmentonDfetetic Assooat~on. Zoo0

TABLE 14. Names for Added Sugars That Appear on Food Labels
Some of the namesfor added sugarsttat may be in processedfoods and listed on the label lngredlentshst. Brown sugar Corn sweetener Corn syrup Dextrose Fructose Fruit juice concentrates Glucose High-fructosecorn syrup Honey Invert sugar Lactose Maltose Malt syrup Molasses Rawsugar Sucrose Sugar Syrup -

DIEYARY GUIDELINES FOR AMERICANS, 2005

chapter 1,O (0
3

Sodiumand Potassium
mtake,losmgexcessbody weight,increasing physical activity,and eatmgan overallhealthful&et On average, higheran md~~~clual’ (so&urnchloride) the salt s mtake,the tigher an mdlvldual’bloodpressureNearly s DISCUSSION all Amencansconsumesubstantiallymoresalt than they Saltis sodiumchlorideFoodlabelshst so&urnratherthan need Decreasing intake 1sadvisableto reducethe salt risk of elevatedbloodpressureKeeptng bloodpressure m salt content When readinga Nutrition FactsPanelon a the normalrangereducesan mdlvldual’nsk of coronary food product,look for the sodiumcontent Foodsthat are s heart disease, stroke,congestiveheart fdure, and ludney low m sodium(lessthan 140mg or 5 percentof the Dally dsease ManyAmencanadultsti develop hypertension Value[DV])arelow m salt (high blood pressure) during then lIfetime Lifestyle Commonsourcesof so&urnfoundin the food supplyare changescan prevent or delay the onset of high blood providedm figure4 On average, naturalsalt content the pressure can lower elevated and bloodpressureThese of food accountsfor only about 10percentof total mtake, changes mcludereducmgsalt Wake,mcreasmg potassium
OVERVIEW

::lE:ARY

CUIDELlhES

FOK

AMERICANS,

2005

while &scretlonarysalt use (1e , salt addedat the table or while cookmg) providesano:;her to 10percentof total 5 intake Approximately 75 percent is derived from salt addedby manufacturers adl%Qon, servedby food In foods estabhshments be high m so&cm It is important to may read the food label and determmethe so&urn content of food,which can vary by severalhundredsof rmlQrams m similar foods For example,the sodium content in regulartomatosoupmay be 7C0mg per cup m one brand and 1,100mg per cup in anotl-.er brand Readmglabels, comparingso&urn contentsof foods,and purchasingthe lower so&urn brand may be one strategyto lower total sodiumintake (seetable 15fo1examplesof thesefoods) An mdlvldual’ preferencefor salt is not fixed After s consummg foodslower m salt for a penodof tune,taste for salt tends to decreaseUse of other flavorings may satisfyan mdvldual’ taste While salt substitutes s contammgpotassiumchloridemay be usefulfor some mdlvlduals,they can be harmful to peopleMnthcertan medical conditions Thesemdlvlduals should consult a healthcareprovider beforet rymg salt substitutes Discretionarysalt use is fairly stable,even when foods offeredare lower in sodiumthan typical foodsconsumed Whenconsumers offereda .owersodiumproduct,they are typicallydo not add table salt t3 compensate the lower for sodium content, even when available Therefore,any programfor reducmgthe salt consumphon a population of shouldconcentratepnmanly cn reducingthe salt used

9 Consume than 2,300mg (approximately tsp of less 1 salt) of so&urnper day . Chooseand preparefoodsv&h httle salt At the same time, consumepotassium-rich foods,such as tits and vegetables
Key Recommendations for Specific Population Groups m Indmduals wth hypertension, blacks, ar;d mddle-aged and older adults km to consumeno more than 1,500

mg of so&urnper day,and meet the potassiumrecommendation(4,700 mg/day)v&h food durmgfood processmg on changes111 selection and food (eg , morefresh,less-processed items,lesssodium-dense foods)and preparation Reducingsalt intake is one of severalways that people may lower then bloodpressure relatlonsh_lp The between salt mtakeand bloodpressureis &rect and progressive vvlthoutan apparentthreshold On average, higher the a person’ salt intake,the higher the blood pressure s Reducingblood pressure, ideally to the no:mal range, reducesthe nsk of stroke,heart disease, heart failure, and ladney disease Another &etary measureto lower blood pressure to 1s consumea diet rich 111 potassiumA potassnm-richdiet also blunts the effects of salt on blood pressure, may reducethe nsk of developmg ludneystones and possibly decrease bone lossmth age The recommended mtake of potassiumfor adolescents adultsis 4,700mg/day and Recommended Wakes for potassiumfor children 1 to 3 years of age 1s3,000mg/day,4 to 8 years of age is 3,800mg/day,and 9 to 13yearsof age is 4,500mg/day Potassium shouldcomefromfoodsourcesNuts and vegetables, whch arerich ~IIpotassium wth its bicarbonate precursors, favorably affecta&base met&o&m, which may reducensk of ladneystonesand boneloss Potassiumrich tits and vegetables mcludeleafygreenvegetables, fnut from vmes,and root vegetables Meat,nti, and cereal productsalsocontampotassium, maynot havethe but sameeffecton aad-basemetabohsmDietarysources of potassium hstedm table5 and appenti 13-l are

0

Lifestylechangescan preventor delaythe onsetof high blood pressureand can lower elevatedblood pressure.

0

DIETAKV

GUIDELINES

iOR

I&!ERICAhS,

2005

Considerations for Specific Population Groups Indmduals With Hypertension, Blacks and Middle-Aged and OlderAdults Some mdvldualstend to be moresalt

sensitivethan others,mcludm’peoplev&h hypertension, g blacks, rmddle-aged o,deradults Because and and blacks commonlyhave a relativelylcw mtake of potassiumand a tigh prevalence elevated of bloodpressure salt sensland tlvlty,this population subgroup especxllybenefitfrom may an mcreased dietarymtakeof potassiumDietarypotassium can lower bloodpressure blunt the effectsof salt on and bloodpressure somemd~cluals While salt substitutes m contammg potassium chloridemay be usefulfor some mdlvlduals,they can be harmfulto peoplewth certain medicalconditions Thesemcivldualsshouldconsulta healthcare provider before usmgsalt substitutes

WE-ARY

r;l:lDEt'llES

FOR AMERlCiihS.

2005

FIGURE 4. Sourcesof Dietaryr Sodil
The relativeamounts of dietary sodium In the Americandiet 77% Food Processing-,

12%

NaturallyOccurring -

6% At the Table-------

5%

During Cookrng/

Source Mattes RD, Donnelly D Relativetontnbutlons of dietary sodium source IAm Co/i Nufr 1991Aug,l0(4) 383-93

TABLE 15. Range of Sodium Content for Selected Foods
The ranges of sodrum content for selectedfoods avarlableIn the retail market.This table is provided to exemplrfythe Importanceof readrngthe food label to determrnethe sodium content of focsd,which can vary by severalhundreds of milkgramsIn stmrlarfoods Food Group Breads,all types Frozenpizza,plain, cheese Frozenvegetables,all types Saladdressing,regularfat, all types --~ Salsa Soup (tomato), reconstituted Tomato juice Potato chIpsa Tortilla chipsa Pretzel?
a All snack foods are regular flavor, salted Source Agricultural Research Serwce Nutrient Datalxse for Standard Reference, Release 17 and recent manufacture6 label data from retall market surveys Serving sues were standardized to be comparable among brands wIthIn a food Puza and bread slices vary in sve and wght across brands Note None of the examples provided were labelec lowsodlbm produas DIETARY :LUIDELlNES FOR I>fvlERICANS. 2005 120-180

110-505 150-240

105-160 1 oz(284g) ~ 290-560

, :i !, ’ !. \”‘ _

The consumpnon alcoholWI havebeneficial harmful of or effectsdepending the amountconsumed, and on age othercharactensncs the person of consummg alcohol, the and specifics the situanonIn 2002,55 of percentof US adultswere currentdrinkers Forty-fivepercentof US adultsdo not drink any alcoholat all 15Abstention1s an importantoption Fewer Amencans consume alcohol today as compared 50 to 100yearsago to The hazardsof heavyalcoholconsumption well are known andmcludemcreased of hvercmhosls, risk hypertension, cancers the uppergastromtestmal mlury, of tract,

violence, death Moreover, and certammdivl,duals are who moresusceptible the harmfuleffectsof alcoholshould to not drmk at all In addition,alcoholshouldbe avoidedby thosepartlcipatmg actlvmes requireattennon, m that slati, and/orcoordmation Alcoholmay havebeneficial effectswhen consumed m moderationThe lowest all-cause mortalty occursat an mtakeof oneto two drmksper day Thelowestcoronary heartdxeasemortahtyalsooccursat an mtakeof oneto two dnnksper day Morbltity andmortdty arebghest amongthosednnkmglargeamounts alcohol of

15Behavtoral Risk Factor Sutwllance System, Surveillance for Certan Health Behwors Among Selected Local Areas-United States, Behavioral Risk Factor Swelllance System. XOZ, MMWR, 53, No S505 xtp&wwcdcgov/brfss/

Alcohohc beveragessupply caloriesbut few essential nutnents (seetable 16) As a result,excessive alcohol consumptionmakesit difficult to ingest sufficient nutrients wlthm an mdlvldual’d&r caloneallotmentand to s mamtama healthyweight Althoughthe consurnpnon of one to two alcohohc beverages day is not associated per wKh macronutnentor rmcronutnentdeficienciesor vvlth overalldietary quahty,heavydnnkersmay be at nsk of malnutntlonti the calonesderivedfrom alcoholare substltuted for thosem nutritious foods

The malontyof Amencanadultsconsumealcohol Those who do so shoulddrinkalcohohc beverages moderation m Moderahon delinedas the ccnsumpnon up to one drink 1s of per dayfor womenand up to two drmksper day for men ^-. -.._. -- __._ --i --111__..._^_-. --.^ --.. -_._._.. I ---.-----.Twelveflud ouncesof regularbeer,5 fluid ouncesof wme, types of cancer,and sucide Compared wth women who or 15 fled ouncesof 80.proofdistied spmtscountas one drinkfor purposes explammg of moderaDon definrtlon do not drink womenwho consumeone dnnk per day Thus appearto have a slightly higher risk of breast cancer of moderatlon not mtendedas an average several is over daysbut ratheras the amountconsumed any smgleday on Stuaes suggestadverse effectsevenat moderatealcohol consumption levelsin specificsituationsand mdlvlduals The effect of alcoholconsumptionvanesdependmgon the amount consumedand an mtivldual’ charactenstlcs Indlvldualsm somesituationsshouldavold alcohol-those s or and circumstances AlcohohcLeverages harmfulwhen who plan to drive,operatemachmery, take part m other are acUvlties requueattention,slall,or coordmationSome that consumedm excess Excessalcoholconsumptionalters people,including children and adolescentswomen of judgment and can lead to dependencyor addlctlon and childbearingage who may becomepregnant,pregnant other serioushealth problemssuch as cirrhosis of the and lactating women,mdlvlduals who cannot restrict liver, inflammationof the pancreas,and damageto the alcoholintake,mdivldualstakmg medicationsthat can heart and bram Evenlessthan heavyconsumptionof mteractmth alcohol,and mdlvldualsvvlthspecificme&Cal alcoholis associatedwith significant risks Consummg morethan one dnnk per day for women and two drinksper conditionsshouldnot dnnk at all Evenmoderatedrmkmg day for men increases nsk for motor vehcle accidents, duMg pregnancymay have behavioralor developmental the other mlunes,high blood presz;ure, stroke,violence,some consequences the baby Heavydnnkmg dunng pregfor nancycan producea rangeof behavioral psychosoclal and - ^... _.-..-_ -.- _._.- _ ___ I __ _.-- _I _-.._ problems, malformanon, mentalretardanon the baby and m

Thosewho chooseto drink alcohohcbeverages should do so sensiblyand m moderation--defined the as consumptionof up to one dnnk per day for women and up to two drinksper day for men Alcohohcbeverages shouldnot be consumedby some m&vlduals,mcludmgthosewho cannot restricttheir alcoholmtake,women of chlldbeanngage who may becomepregnant,pregnantand lactatmgwomen,chlldren and adolescents, mdlvldualstakmg me&canons that can interact wth alcohol,and thosemth spectic medicalconditions Alcohohcbeverages shouldbe avoidedby mdlvlduals engagmgin actlvltlesthat remre attention,skU,or coordmatlon, such as dnvmg or operatmgmachmery

.--.. -_-.-.-- - I

Moderatealcoholconsumption havebeneficialhealth may effectsm somemdivlduals In rmddle-agedand older adults,a dally mtake of one to two alcohohcbeverages per day 1sassociated Mnththe lowest all-causemortalKy More specifically, comparedtc non-dnnkers, adultswho consumeone to two alcohohcbeverages day appear a to have a lower nsk of coronaryheart diseaseIn contrast, amongyoungeradults alcoholconsumptionappearsto providehttle,if any,health becefit,and alcoholuse among young adultsis associated wth a hgher nsk of traumatic injury and death As noted previouslya numberof strateDes reducethe nsk of chrome&ease, mcludmga healthful &et, physicalactivity,avoidanceof smolang, mamteand nance of a healthy weight Furthermore, is not it recommended anyonebegmdnnkmgor dnnk more that frequentlyon the basisof health considerations

s-i 13L.Ii.‘ ‘

r:

~:.hrtii~ :T Sewed Akoholit B~~~q~~

Thus table ISa guideto estrmate caloricintakefrom varrous the alcoholrc beverages. example An servtng volumeand the calones that drinkare shownfor beer, In wane, distilledsp~rii. Higheralcoholcontent(higherpercentalcoholor hrgherproof) and mixingalcoholwith other beverages, as calorically and such sweetened soft drinks, tonic water,frurt turce,or cream,increases amountof calories the beverage the in Alcoholrc beverages supplycalories provrde essentral but few nutrients

_____ --.-----.
Beverage

-_-_-__---

---.--

--

l_l_

.” _-.-. ------

-.--

..-...- -.-. .- _“_-l--l
Approximate Total Caloriesb j
1

Approximate Calories Per 1 fluid Oza
12

Example Serving Volume
12 OZ 12 oz

Beer (regular)

144

/

9 Whrtewine Redwine Sweetdessertwane 80 proof drstilledspirits (grn, rum, vodka,whiskey) .._ __-. __.- _..__._ -21 47

5 oz 3 oz

105 141

I

64

_-.. --_--_--._“-_-

-----

.__-__ _--_.

-.“.--_----

15 oz ..-__ _-___-I

l.-.-l..-

_....--_-___

96 _L

d SourceAgricultural Research Service (ARS) Nument Database Standard for Reference Release (http//w (SR), 17 wholenumberper 1 flud oz

nalusdagov/fnidfoodcomp/inderhtml) Calories calculated the nearest are to

b Thetotal calones alcohol and content deperldlng the brand Moreover, vary on addlng mixers an alcoholic to beverage contribute can calows in addltlon the calories the alcohol to from Itseif

Avoiding foods that are contammatedwzh harmful bacteria,vu-uses, parasites, toxms,and chemicaland physicalcontammants vital for healthfuleatmg The are signs and symptomsof foodbomeIllnessrangefrom gastromtestmal symptoms,such as upset stomach,dlarrhea,fever,vomitmg,abdommalcramps,and dehydration, to more severesystermcIllness,suck as paralysisand memngmsIt is esnmated everyyearabout76 man that peoplem the UmtedStatesbecometi from pathogens m food,of these,about5,000&e Consumers take sunple can measures reducether nsk of foodbome to Illness, especially m the home

The most important food safety problem 1smicrobial foodbome mess All thosewho handlefood,mcludmg farmers, food producers, mdivldualswho work in markets and food serviceestabhshments, other food preparers, and have a responslbtityto keepfood as safeas possibleTo keep food safe,peoplewho prepze food shouldclean hands,food contact surfaces, fnuts and vegetables, and separate cooked, ready-to-eatfoods;cookfoods raw, and to a safe mternal temperature;chill perishablefood promptly,and defrostfood properly Formore unportant mformatlonon cookmg, cleanmg, separatmg, ch&ng, and seewww fightbacorg

,

I’ I

.’

9

_ _

1

.,. _j, ‘,:

I‘I

I, _ _

I

.

,

,

/

~

_,

0-

Whenpreparmg consummg and food,it 1sessential to wash handsoften,particularlybeforeand after prepanng food,especially afterhandlmgraw meat,poultry eggs,or seafoodA goodhand washmgprotocolmcludeswetting hands,applymgsoap,rubbmghandsvigorouslytogether for 20 seconds,nnsmg handsthoroughlyunder clean, runnmgwarm water, and drymghandscompletely usmg a cleandisposable cloth towel or Washmg be the onlymethodthat consumers to may have reducepathogen on freshproduce v&l not be load that eitherpeeledor subsequently cookedA goodprotocolfor washmgfreshtits andvegetables mcludes removmg and dxcardmgouterleaves, washmgproduce before lust cookmgor eatmg, washmguricer runnmgpotablewater, scrubbingvvlth a cleanbrushor mth hands,and drymg the fnuts or vegetables usmga cleandsposable cloth or towel Freemoistureon produce may promotesu~val and growth of microbialpopulation;; Therefore, drymgthe food is ntlcal If the item ti not be eatenor cooked nght away People shouldreadthe labelsof baggedproduce deterto mmeIf it 1sready-to-eat Ready-to-eat, prewashed bagged producecan be used mthout further washmgif kept refrigerated usedby the “use-by”date If desired, and prewashed, ready-to-eat producecan be washedagam

To avoidnxcroblalfoodbome mess Cleanhands,food contact surfaces, fruits and and vegetablesMeat and poultry shouldnot be washedor rmsed Separate cooked,and ready-to-eatfoods raw, while shopping, preparing, storing foods or Cookfoodsto a safetemperature kill to rmcroorgamsms Cm (refrigerate) penshable promptlyand food defrostfoodsproperly Avoid raw (unpasteurized) or any products mik madefrom unpasteurized raw or partially rmlk, cookedeggsor foodscontammg eggs,raw raw or undercooked meat and poultry unpasteurized ]uxes, and raw sprouts s: _‘ ‘ ., ,,._ ,; . ,c; _.,’ i,‘ :! ,;%;f‘ h

Infants and young children, pregnant women, older adults, and those who are immunocompromised Do

not eat or drinkraw (unpasteurized) or anyproducts m& madefrom unpasteunzed raw or partiallycooked rmlk, eggsor foodscontammg eggs,raw or undercooked raw meat and poultry,raw or undercooked or shellfish, fish unpasteurized lulces,and raw sprouts
Pregnant women, older adults, and those who are Immunocomprormsed~Only eat certamdehmeatsand

frankfurters havebeenreheated steammg that to hot 1sImportantto separate cooked, ready-to-eat raw, and foodswtie shoppmg, preparmg, stonngThis prevents or cross-contammahon onefoodto anotherIn addmon, from refngerator surfaces becomecontarnmated tighcan from nsk foodssuchas raw meats,poultry fish,uncooked hot dogs,certamdehmeats,or raw vegetablesE not cleaned, contammated refngerator surfaces 111 seIveas a can, turn, vehiclefor contanunatmg otherfoods Uncooked undercooked and meat,poultry and eggsand egg productsare potentiallyunsafe Raw meat,poultry and eggsshouldalwaysbe cookedto a safemtemal temperature fig 5) Thebestway to tell 11 (see meat,poultry and egg dishesare cookedsafelyis to use a foodthermometerLeftoverrefngerator foodsshouldalsobe reheated the properlntemaltemperature to Hactena grow

e

Rawmeatandpo&y shouldnot be washed because this creates danger cross-conl.ammahon 1snot necesthe of and saryWashmg thesefoodscanallowmostbacteria are that present the surface the meator poultryto spread on of to ready-to-eat foods, latchenutensils, countersurfaces and

most rapidly m the rangeof 40°Fand 140°FTo keep food out of this dangerzone,keep cold food cold (below40°F) and hot food hot (above140°F:lQure 5 providesmformanon for temperaturerules for proper cookmgand food handlmg Propercookmgmakesmost uncookedfoodssafe The refngeratorshouldbe set at no higher than 40°F and the freezerat O”F, thesetemperatures and shouldbe checkedvvlth an apphance thermometerRefngerated leftoversmay becomeunsafevnthm 3 to 4 days Despite the appearance a food,it may not be safeto eat Not of all bacterialgrowth causesa fcod’ surfaceto &color or s smellbad It may be unsafeto tastefreshor leftoverfood items when there is any doubl.about theK safety Safe disposalof the food is mcllcated there is a question If about whether or not a food is safeto eat “If in doubtthrow 1t out ”

For example,pregnant women, older adults, and those who are lmmunocompromlsed at nsk of developing are hstenosls, potentiallyMe-threatenmg a illness causedby the bacteriumLJstena monocylogenesSomedeh meats and frankfurters have not beenreheatedto steammg that hot and someready-to-eatfoodsare associated with hstenoses posea high-riskto certainmdlvlduals All these and foods shouldbe heatedto a safemtemal temperature In ad&non,thesemdvlduals shouldtake specialcarenot to eat or dnnk raw (unpasteurized) or any products rmlk madefrom unpasteurized (suchas somesoft cheeses), rmlk raw or partially cookedeggsor foodscontamlngraw eggs, raw or undercooked meat and poultry,unpasteurized ]uices,and raw sprouts They should also avold raw or undercooked or shellfish fish

New information on food safety is constantly emerging Recommendations precautionsfor people at high and nsk are updatedas scientistslearnmore about preventmg Uness In&mduals1~1 tigh-nsk categories should Somepeoplemay be at high nsk for developmg foodbome foodbome tiess Theseinclude pregnantwomen and their fetuses, seekmdance from a healthcareprovider In ad&non,upto-datemformatlonis availableat the Government’ s food young children,older adults, people with weakened safetywebslte at www foodsafety gov immunesystems,and mdlvldualsmth certamchrome illnessesThesepeopleshouldpay extra attentionto food safetyadvice
.1 ‘ . (1 ‘ pL*,l.; ~\ ,4 4

DANGER

ZONE

0

~

50

Appendixes

51 -

APPENDIX

A. EATING PAlTERNS

Appendix A-1’ The DASH Eating Plan at 1,600-, 2,000-, 2600-, and 3,100-CalorieLevelsa
The DASHeatrng ISbasedon 1,600, plan 2,000,2,600and 3,100 caloriesThe numberof dailyservings a food groupvarydepending caloricneeds rn on (seeTable3 on page12to determrne caloricneeds)Thus chartcanaid rn plannrng menusand food selection restaurants grocery rn and stores

Food Groups

1,600 Calories 6 servrngs

2,000 Calories

2,600 i 3JorJ Calories ~Calories

ServingSizes

Examples Notes and

i
Crainsb

Significance Each of Food Groupto the DASHEatingPlan _______

7-a
servrngs

10-11 servings

12-13 servings

I slicebread, 1 oz dry cereal, ~2 cup cooked rice, pasta, cereal’ or

Wholewheatbread,

Majorsources of English muffrn,pita energyand fiber bread,bagel,cereals, grrts,oatmeal, crackers, unsalted pretzels, and popcorn / Rrchsources of i potassrum,

t------i-----

Vegetables

~3-4

4-5

5-6 servrngs

3 servings

’servings ~servrngs

1 cup rawleafyvegetableTomatoes, potatoes, ‘ cup cooked ~2 vegetable carrots, greenpeas, 6 oz vegetable lulce

---A.-

______-_--~

Fruits

4-5 j servings ~servings I

5-6 6 servings ~servings

6 oz frurtjuice 1 mediumfrurt ‘ cup driedfruit 14 cup fresh,frozen, or canned fruit
l/2

~magnesrum, fiber and squash, broccoli, turnip greens, collards, kale,sprnach, artichokes, greenbeans, beans, lima sweetpotatoes --..Apricots, bananas, Important sources of dates, grapes, oranges, potassrum, and orange juice,grapefrurt, magnesium, fiber grapefrurt mangoes, Juice, melons,peaches, pineapples, prunes, raisrns,~ strawberries, tangerines -.-_____ of Fat-free low-fatmilk, Majorsources or fat-free low-fat or calciumand protein buttermrlk, fat-freeor low-fatregular or frozenyogurt,Iowfat and fat-freecheese

t
j Low-fator fat-free i dairy foods servrngs j servings servings ~servings 1 cup yogurt 1j/2 oz cheese

52

Appendix n-1 : Continued

I ~

~~

: FoodGroups

1,600 1 2,000 / Calories ~ Calories

2,600

~ 3,100

1 ServingSizes

~ Examples Notes and

Calories I Calories

Select lean, only Richsources of trim awayvistblefats; protern and brorl,roast,or boil magnesium I Instead frying; of removeskinfrom poultry ----.---___+______ ,--------+------------~t Nuts,seeds,legumes ~3-4 i 4-5 1 ~ l/3 cup or IV2 02 nuts Almonds, filberts, Richsources of 1 I servings/ seNlngs/ ~serving sen/rlg ~2 Tbspor iz oz seeds mixednuts,peanuts, energy, magnesium, week week 1 1~2 cookeddry beans walnuts, cup sunflower seeds, potassium, protein, i / or peas krdneybeans, lentils andfiber ____t_p.--_--v.--i2 2-3 3 4 Fat and oilsd Softmargarine, / 1 tsp soft margarine DASHhas27 percent servings servings servings servings / 1 Tbsplow-fat mayonnaiselow-fatmayonnaise, of calories fat as (low In saturated fat), I 2 Tbsplightsalad dressing light saladdressing, / ~ 1 tsp vegetable oil vegetable oil rncludtng In fat (suchas olive,corn, or addedto foods I canola, safflower) or c.--- __----____._ + ---t -7Sweets 10 5 2 1 Tbspsugar Maplesyrup,sugar, Sweets should 2 ~servings servings/ servings servtngs 1 Tbspjelly or Iam be low In fat Jelly, iam, week l/2 oz jelly beans fruit-flavored gelatin, 8 oz lemonade jelly beans,hardcandy, frurt punchsorbet,ices
2-3 ~ 3 oz cookedmeats,

i- Meat, poultry, fish

---------t-p
1 l-2 2 or less j 2

y---t------.-....
servings

~~

’ Significance Each of Food Groupto the DASHEatingPlar

1 servrngs

SeNlngs

servings 1 poultry,or fish

I-

c

a NIH publication 034082. Karanfa et al MDA 8 519-27, 1999 No NM b Wholegrainsare recommended most serwys to meetfiber recommendattons for c Equals‘ ‘ cups.dependlog cerealtype Check prod&s Nutmon Facts h-l /4 on the Label d Fatcontentchanges serwngcountsfor fatsand 311s example,I Tbspof regularsaladdresslog For equalsI serving,I Tbspof a low-fatdrewng equalsI/,?serwng,I Tbspof a fat-freedresslog equals0 servings

Appendix A-2. USDA Food Guide
The suggested amountsof food to consume from the basicfood groups, subgroups, 011s meetrecommended and to nutrientIntakes 12drfferent at calone levels Nutrientand energycontnbutiorrs eachgroupare calculated from according the nutrient-dense of foodsin eachgroup(e.g.,leanmeatsand to forms fat-freemilk) Thetablealsoshowsthe discretionary calorieallowance can be accommodated that within eachcalorielevel,rn addrtron the suggested to amountsof nutrient-dense forms of foods rn eachgroup Daily Amount of Food From EachGroup(vegetable subgroupamountsare per week) cm--. ~CalorieLevel . 1,000 1 1,200 i 1,400 j 1,600 / 1,800 1 2,000 1 2,200 ~ 2,400 1 21600 FoodGroup’

2,800

~&+]200

Foodgroupamountsshownin cup (c) or ounce-equivalents (oz-eq), numberof servings in parentheses with (srv) when It differsfrom the otherunrts Seenotefor quantityequivalents foodsin eachgroup2 011s shownIn grams(g) for are 2 c ---------2c (3sr.v) , (4srv) : (4 SN)
(4SN) ~ (4SN) i

25c
(5 SN)

2.5 c (5 SN) (8s;

25c (5 SN) 4c

i Vegetables’
(2s;

15c 15c (3srv) ~ (3 SIV)

25c (5 SN)

25c t (5 SN) ~ (6 SfV; 3 c,‘ wk ~ 2 c/wk 1 3 c/wk ( 3 c/wk 65c/wk 3 c/wk 2 c/wk 3 c,‘ wk 6 c/wk 7 c/wk

(6 s;;

3.5 c (7 SW)

35c (7srv)

(8 SIV)

/ Darkgreenveg Orange veg Legumes Starchy veg Otherveg ~---~ -~-.---I Grains4 Wholegrains Othergrains Leanmeat and beans Mrlk ~~-

I c/wk 1.5 c/wk 15c,/wk 2 c,‘ wk 3 c/wk 5 c/wk 1 c,‘ wk I c/wk I 5 c/wk 2 c/wk 5 c/wk I c/wk I c,‘ 25c/wk wk 3 c/wk 1.5 c/wk 2.5 c/wk 2.5 c/wk 25c,‘ wk 3 c/wk 35c/wk 4.5 c/wk 45c/wk 5.5 c/wk 65c/wk:

3 c/wk 3 c/wk 3 c/wk 3 c/wk 3 c/wk 2 c/wk 2.5 c/wk 2.5 c,‘ wk 2 5 c,‘ 25c/wk wk 3 c/wk 35cJwk 35cJwk 35c/wk 35cJwk 6 c/wk 7 c/wk 7 c,‘ wk 9 c/wk 9 c,‘ wk 7 c/wk 8.5 ciwk 8 5 cjwk lo c/wk lo c/wk

~-~ --_+.-c t f 3 oz-eq 4 oz-eq7 5 oz-eq 5 oz-eq 6 or-eq / 6 oz-eq 7 oz-eq 8 oz-eq 9 oz-eq 10oz-eq 1Doz-eq 10oz-eq

I-

1.5 15
2 oz-eq

.! .?
3 oz-eq

A.4 oz-eq 5 oz-eq 5 oz-eq ,5 5 oz-eq
-.-Immp+--F--t---;----

25 ~ 25 i

3 2

3' 3'

3 3

35

4

4.5 /

5’

5’ 5!

5

1

~--2c-Y -.---I--+--+2c

5 ~ I- 4.5 ! L-._ ---T-----y-;;=; 6 oz-eq ~65 oz-eq] 6 5 oz-eq 7 oz-eq 13c; 3c -....- p---..-3---_ 3c 3c

4

3c~ 3c _ +--------+

3c

3c ----+-

3c

OIIZ 15g i ~~~~- --~- _~ j Dacretronary j calone allowance6 165 1

--0
Notes for Appendix A-2:
: FoodItemsIncludedrn eachgroupand subgroup Fru1ls Vegetables - Orangevegetables * Legumes (dry beansand peas) * Starchy vegetables * Othervegetables
CElilS

54

All fresh,frozen,canned, dred fruitsand frurtfurcesfor example, and oranges orange and furce,apples applefurce.bananas, and grapes, melons, berries, rarsrns developing In the food patterns, forts and furces no addedsugars fatswereused Seenore6 on drscreDono~ only wrtn or co/ones ffprodubs &I oddedsugors f& ore consumed or In developrng food patterns, vegetables no addedfatsor sugars the only wrth wereused Seenote6 on d,soebono~ co/ones /iprod& wrthaddedfotr orsugorsore consumed All fresh,frozen,and cannedorangeand deepyellowvegetables, cookedor raw for example, carrots, sweetpotatoes, wrntersquash, pumpkln and All cookeddry beansand peasand soybeanproductsfor example, plnto beans,icldney beans,ientrls, chrckpeas, tofu (Seecommentunder meatand beansgroupaboutcountmglegumes the vegetable the meatand beansgroup) rn or All fresh,frozen,and cannedstarchyvegetables example, for white potatoes, corn,greenpeas All fresh,frozen,and cannedothervegetatles, cookedor raw for example, tomatoes, tomatofurce,lettuce,greenbeans,omens In developing fotld patterns, gramsIn low-fatand low-sugar the only formswere used Seenob 6 on discretionary co/ones IfprodudF that ore hgher !n fat on~@/or added sugm ore consumed All wholegrainprodtlcband whole gramsusedas rngredrents example, for wholewheatand rye breads, wholegraIncereals crackers, and oatmeal, brown rice and All refinedgrain productsand refinedgrainsusedas mgredrentrfor example, white breads, enrichedgraincereals crackers, and enrichedpasta, v&e rice All meat,poultry,fah, dry beansand peas,eggs,nuts,seedsMostchoices shouldbe leanor low-fatSeenote 6 on d,screlionory co/ones ifhigherfot prod& ore consumed Dry beansand peas,rndsoybeanproductsare consrdered of thusgroupas well as the vegetable part group,but shouldbe countedrn one group onfy All mrlks,yogurts,fro ren yogurts,darrydesserts, cheeses (exceptcreamcheese), rncludrng lactosefree lactosereduced and productsMost chorces shouldbe fat-free or low-fat In developing food patterns, fat-freemilk was used Seenote 6 on dwebonaiy co/ones low-fat,reduced-fator wholem//k or m/k produa-or m//k the only if productsihot confox oddedsugon ore consumedCalcrum-fortriled beverages an optronfor thosewho wanta non-darry soy are calcrum source

cookedor raw for example, broccoli.spinach,romaine,collard,turnrp,and mustardgreens - Darkgreenvegetables All fresh,frozen,and canneddark greenvegetables,

*Whole grains - Othergrams Meat,poultry,fish, dry beans,eggs,and nuts (meat8 beans) Mrlk,yogurt,and cheese(mrlk)

* Quantityequivalents eachfood group for Grains Frurts vegetables and Meatand beans Milk The followingeachcountas I ounce-equ~valentserwng)of grams I/>cup cookedrice,pasta,or cookedcereal,I ouncedry pastaor race.I slrcebread,1 smallmuffin (I (I oz), I cup ready-to-eat cerealflakes The followrng eachccunt as 1 crop(2 sennngs) frurtsor vegetables cup cut-upraw or cookedfruit or vegetable, cup irut or vegetable of 1 I furce,2 cupsleafysaladgreens The followrng eachccunt as I ounceequlvalentI ounceleanmeat,poultry,or fish, I egg, ‘ /scup cookeddry beansor tofu, 1 Tbsppeanutbutter,l/z ouncenub or seeds The followmgeachcrruntas I cup (1 serving)of milk I cup milk or yogurt, I’ ouncesnaturalcheese /2 suchas Cheddar cheese 2 ouncesprocessed or cheese Discretronary caloriesmust be countedfor all choices, exceptfat-freemrlk

3 Explanation vegetable of subgroupamounts Vegetable subgroupamountsare shown in this tableasweeklyamounts, because would be drfhcultfor consumers selectfoodsfrom eachsubgroup It to dally A dallyamountthat ISoneseventhof the weeklyamountlistedISused rn calculatrons nutrientand energylevelsrn eachpattern of 4 Explanatron grainsubgroupamounts The whole grainsubgroupamountsshown rn thustablerepresent leastthree l-ounce servrngs onehalf of the total amountas whole gramsfor all of at and calonelevelsof 1,600and above ThisISthe mrrrmum suggested amountof whole grainsto consumeas part of the food patternsMore whole grainsup to all of the grajnsrecommended be may selected, offsetting with decreases the amountsof other (ennched)grains In patternsdesigned youngerchildren(l,ooO,1,200, 1,4M)calones), rn for and onehalf of the total amountof gramsIS shown as whole grams 5 Explanatron 011s (mcludrng margarrne zerotrons fat) shown in this tablerepresent amountsthat are addedto foods dunng processrng, of 0th soft wrth the cookrngor at the table 011s soft and margannes mcfudevegetable and soft vegetable tablespreads haveno frons fats The amountsof 011s 011s orI that kstedrn this tableare not considered be pan of drxretronarycalorres to because they are a maforsourceof the vrtamrnE and polyunsaturated aads,rncludrng essentral aads,rn the food pattern In contrast, fats are lksted fatty the fatty solrd separately the drscretlonary NI calone table(appendrx because, A-3) compared orIs,they are higherrn saturated acidsand lower In vrtamrnE and polyunsaturated monounsaturated acids,rndudlngessentral acids wrth fatty and fatty fatty The amountsof eachtype of fat in the food Intakepatternwerebasadon 60% 011s and/orsoft margarrnes no rrdnsfats and 4C%solrdfat The amountsrn typrcalAmencan with dietsare about42% oils or soft margannes about 58% solldfats and 6 Explanation drscretronary of calorieallowanceThe drscretionary calorieallowance the remarnrng IS amountof calones eachfood panernafter selecting specrfred rn the numberof nutrrentdense forms of foods in eachfood group The numberof dscrehonary calones assumes food Itemsin eachfood groupare selected nutrrent-dense that rn forms (that is,forms that arefat-freeor low-fat and that containno addedsugars) Solrdfat and sugarcalones alwaysneedto be countedas dlscretronary calones, rn the followingexamples as * The fat rn low-fat,reducedfat, or whole milk or milk productsor cheeseand the sugarand fat rn chocolate milk,Ice cream,pudding,etc - The fat rn higherfat meats(e g, ground beefnlth more than 5% fat by weight.poultrywith skin,hrgherfat luncheonmeats,sausages) - The sugarsaddedto fruits and frutt fuiceswrth addedsugarsor fruits cannedin syrup - The addedfat and/or sugarsrn vegetables prepared addedfat or sugars wrth *The addedfats and/or sugarsin grainproductscontarnrng higherlevelsof fats and/orsugars(e g, sweetened cereals, hrgherfat crackers, and other pasmes, pies cakes,cook@ Totaldrscretronary calones shouldbe ikmlted tie amountsshown rn the tableat eachcalorielevel The numberof drscretronary to calorres lowerin the 1,600calone IS patternthan rn the I,&B, 1,200,and 1,4C%calorre panernsTheselower orlonepatternsare deslgned meetthe nutrientneedsof children2 to 8 yearsold The nutrrentgoalsfor the 1,6C&alorre to patternare set to meetthe needsof adultwomen,whrchare higherand requirethat more calonesbe usedrn selecbons the basicfood groups Addrtronal from Information aboutdrscretronary calones,ncludrng example an of the drvrsron thesecalones of betweensolidfats and addedsugars,ISprovidedrn appendrx A-3

55 --

0

Appendix H-3. Discretionary Marie Allowance in the USDA Food Guide
The drscretronarycalone allowance ISthe remarnrngamount of calones In each calorie level after nutrient-denseforms of foods in each food group are selected.Thustable shows the number of drscretronarycalories remaining In each calorie level If nutrient-densefoods are selected.Those trying to lose weight may choose not to use drscretionarycalories. For those wanting to marntain their werght, discretionarycalones may be used to Increasethe amount of food selected from each food group, to consume foods that are not In the lowest fat form (such as 2010 or medrum-fat meat) or that contain added milk sugars;to add oil, fat, or sugarsto foods, or to consume alcohol The table shows an example of how these calones may be divided between solrd fats and added sugars.

I Discretionarycaloriesthat remain at each calorie level ~--~~__---__
: Food Culde j calorie level i ..-----. -! Discretionary / calories’ I--. -...-.--j ~ 1,000 I 1,203 ~ 1,400 1
!

-1,800 I
195 /

TV--2,200 ------t290 2,400 2,600 d-d-410 L ------.. 2,800 3,000 ~ I 512 -A3,200

1,600 / /
132 /

2,000 I

165L17LL~171.~

I

; I 267 ~ I --L----

362

426 ~

648

Exampleof divisionof discretionary calories:Solidfats are shown in grams (g); addedsugarsin grams(g) and teaspoons (6~).
Soledfats’ Added sugar? I

D~screiionary Maloney developing Food(,ulde,foot Itemsin nutrient-dense In the forms (that IS,forms that are fat-freeor low-fatand that containno addedsugars)were used The numberof dlscretlonary caloriesassum that food Items 111 food groupare selectedin nutrient-dense each forms SolIdfat and sugarcalon alwaysneedto be countedas dlscrenonaly calones, in the as followng examples The fat in low-fat,reducedfat, or whole milk or InIlk productsor cheeseand the sugarand fat in chocolate milk, Icecream,pudding,etc The fat in higherfat meats(e g, groundbeefwith more than 5% fat by weight,poultrywith skin,higherfat luncheonmeats,sausages) The sugarsaddedto fruits and fro0 lu~ces a,ldedsugarsor fruits cannedin syrup with The addedfat and/orsugarsin vegetables prepared addedfat or sugars with The addedfats and/orsugarsI” grain productscontanng Ilgher levelsof fats and/or sugars(e g, sweetened cereals, higherfat crackers, and other pastries. pies cakes,coohs) Totaldlscretlonaly calonesshouldbe lImitedto the amountS shown in the table at eachcalonelevel The numberof dIscretIonan/ caloriesISlower in the 1,KXlcaloriepatternthan in the I,MX),1,200, and 1.4CUcalor1e patternsTheselower caloriepitterns are desIgned meet the nutrientneedsof children2 108 yearsold The nutrientgoalsfor the 1,600caloriepatternare set to meet the needs to of adultwomen,which are higherand requre #at more calonesbe usedin seleCtions the basicfood groups The cdlorlesasslgned dlscretlonary from to calows may be usedto increase Intakefrom the basicfood groups,!a selectfoodsfrom thex groupsthat are hlghw in fat or wth addedsugars, add oils,solid fats,or sugarsto foodsor beverages, to consumealcohol Seenote 2 on to or lhmits solld fats for 2 Solidfats Amountsof solid fats listedin the table represenabout7 to 8% of caloriesfrom saturated Foodsin eachfood groupare represented their lowestfat forms, such as fat-freemik and fat in skinlesschcken Solidfats shown in this table represent amountsof fatsthat may be addedin cooklngor at the table,and fats consumedwhen higherfat itemsare selected the from the food groups (e g, whole milk Instead fat-freemilk. chickenwith skin, or cookiesInsteadof bread),wlthoutexceeding recommended of the llmlts on saturated Intake SolIdfats Includemeat and poultry fats fat eateneitheras part of the meat or poultry prodLa or separately, fat such as that in whole rnllh cheese. butter,shortenings milk and usedin bakedproducts,and hard margarlnes SolIdfats and 011s separated are because fatty acid composltlons their differ Solidfats are higherin saturated sods, and commonlyconsumedoils and soft margarlnes no frons fatsare fatty with higherin vltamln E and polyunsaturated mo?ounsaturated aads,mcludlngeSsent)al acids Oils listed!n appendix are not considered be palt of the dscre:lonarycaloneallowance and fatty fatty A-2 to because are a major sourceof the essential acidsand wtamln E in the food pattern they fatty The gram wghts for solld fatr are the amounts If theseproductsthat can be Includedin the patternand are not Identical the amountof llplds in theseItems.because to some products (margarlnes, butter)containwater or other Ingredients, addmonto llplds in 3 Addedsugars Addedsugarsare the sugarsand syrupsaddedto foodsand beverages processing preparation, the naturallyoccurmg in or not sugars frets or milk The amountsof addedsugars m suggested the exampleare NOT speclflcrecommendations amountS addedsugarsto consume,but ratherrepresent amour% that can be mcludedat eachcalorielevelwithoutoverin for of the consumingcalor The suggested amountsof addedsugarsmay be helpfulas part of the Food&de to allow for some sweetened foods or beverages, without exceeding energyneeds This use of addedsugarsas a caloriebalancerequirestwo awmptionr (1) that seleCtions madefrom all food groupsin accordance the suggested are with amountsand (2) that addItIonal are used I” the fats amountsshown,which,togetherwth the fats in the corefood groups.represent about27.31%of caloriesfrom fat

---

~ 56 I

0

APPENDIX

B. FOOD SOURCES OF SELECTED NUTRIENTS

Appendix B-l. Food Sources oi Potassium
Food Sourcesof Potassiumranked by rnllligramsof potassium per standard amount, also showing caloriesIn the standard amount (The Al for adults IS4,700 mg/day potassium)

~-Food, StandardAmount
Sweetpotato,baked, 1 potato (146 g) Tomato paste, 1%cup Beet greens, cooked, 1~2 cup Potato, baked, flesh, 1 potato (156 g) White beans, canned, 1~2 cup Yogurt, plain, non-fat, 8-0~ container Tomato puree, j/2 cup ~__ Clams, canned, 3 oz ___________---.-~_._ A--.. ~-

Potassium(mg)
694 --&...-.-pp. 664 -w...-----+595 579 549 I 655 *

..--______ ! / --_____ ...______~ 1 d-----pF

Calories
131 54 19 145 153 127 48
126

--~

--~-____
----.---~------;p-

--.---a--

Yogurt, plain, low-fat, 8-0~ container Prune juice, 3/4cup Carrot juice, 314 cup Blackstrapmolasses,1 Tbsp Halibut, cooked, 3 oz Soybeans,green, cooked, ‘ cup /I Tuna, yellowfin, cooked, 3 oz Lima beans, cooked, 1~2 cup Winter squash,cooked, 1~2 cup Soybeans,mature, cooked, I/Zcup -__ Rockfah, Pacific,cooked, 3 oz ~__ Cod, Pa&, cooked, 3 oz Bananas,1 medium Spinach,cooked, ‘12 cup

1 I

~ p--+mm-

534

531
530

~

-.._

143
136

~

--.----j--.-.---,-.

517 498

71
47

-~ ------

~~~~ -~-.-.~.-~_----~~_____ - -+ ---~ --~--

--__-

.fp-.-----‘ 439 __ 8g
105

/

~~-

__-~~__.

.-. --+
-+----

---

----..---.-

422

______-

i

:- Tomato juice, % cup lomato sauce, 112cup
Peaches, dried, uncooked, 1~4 cup Prunes,stewed, 1~2 cup Milk, non-fat, I cup ___~.-~---~~ c- ------__ Pork chop, center loin, cooked, 3 oz ; .-. _- -~__-1 Apricots, dried, uncooked, l/4 cup ! --~_ --_ -__ j Rainbow trout, farmed, cooked, 3 oz ~~~~-----.-! Pork loin, center nb (roasts), lean, roasted, 3 oz / -~~---.. ButtermIlk,cultured, low-fat, 1 cup Cantaloupe, ‘14 medium Honeydew melon, 1%medium f ---I-----Lentils,cooked, l/r cup Plantains,cooked, l/2 cup slices Kidney beans, cooked, I/Zcup Orange juice, 3/4 cup Yogurt, plain, whole milk, 8 oz container

I ~~~---~----------i-i----. ~ ---.- ---+--~-------t------~-~--~~~-~ --~

----------A-----__--__ ..-. ~.--I---

~ --__~__- 365
358 358 355

___1Li ---p--i
115 90 112 AS

I
; j I !

Source Nutrient values from Agricultural Research f8ervxe (AIU) Nutnent Database for Standard Reference, Release 17 Foods are from A R S sqfe nutrient reports, sorted In destendlng order by nutrient content In terms of common household measures Food Items and wghts In the single nutrient reportr are adapted from those in 2002 rewon of USDA Home and Garden Bulletin No 72, NutWe Value of Foods MIxed dishes and multlple preparatlcns of the same food Item have been omitted from this table .I t -4F ; 111 Itim:\-’ ox “\:t: ;Ah’ , D0 :

57

Appendix B-2. Food Sources of Vitamin E
FoodSources VitaminE rankedby milligramsof vltamlnE per standard of amount,also calones the standard in amount (All providez 10%of RDAfor vitaminE for adults,which IS 15 mg a-tocopherol [ATyday) Food, StandardAmount _____-/ ~~.~-~ ~-. i Fortifted ready-to-eat cereals,- 1 oz _____---__ Sunflower seeds, roasted,1 oz dry
I-

~~~.--...----_-

AT(w) .------+.1.6-128 -------+ 74 --7.3-t--+-.

~ .--~ I --

Calories go-107 165 164 120 120 120 178

Almonds,1 oz Sunflower high linolelc,1 Tbsp -.-oil, __ Cottonseed 1 Tbsp oil, Safflower high olelc, 1 Tbsp 011, Hazelnuts (filberts),1 oz Mixednuts,dry roasted,1 oz Turnipgreens, ~-___frozen,cooked,l/2 cup__~____--Tomatopaste,1% cup Pinenuts, 1 oz Peanut butter,2 Tbsp Tomatopuree,I/Zcup Tomatosauce,Iv2 cup Canola011, Tbsp i Wheat ---- germ,toasted,plaln,2 Tbsp -__.-__. Peanuts, oz 1 ---__--___. --____ Avocado, 1~2 raw, avocado Carrotjuice,canned, cup ~4 Peanut 1 Tbsp 011, Corn011, lbsp 1 Olive011, Tbsp 1 Spinach, cooked,‘12 cup

5.6 ~

..-~----___-

___.---.. -~-~

____---_--_ 4 i---~--

48 ~ ___---*-46 --------c+ib;:--:

-----j--L. --__~-. ---i---- -----jppm-----d2-f.

28 26 25 $.-.

-___.--+
.-39~

54 191

___ ~-.--~~

._______

--.----~--.-----i--~-~ ___ --- ---+---~___-.

---.---~~~~~~~-.KL. 2,2 t----L. 2.1 2.1

.----12; -- __~~__166 161 71

--+-----____ ..-+ --~----I ----~_ *~-. ~---~~~-~__-__-----A---

-21 119 1.9 120 ~___ -__-. ..-.- __19 119 _____~ _.__ --~-~ -1.9 21 - --__- ___- 18 A17 .-------.--+~ 16 1.6 15 ~-- ~~~- ~--___--18 177 84 186 222

c Bluecrab,cooked/canned, oz / 3
j Brazilnuts,1 oz c~~-..--.--~-__ j Hernng, Atlantic,pickled,3 oz

Dandelion greens, cooked,1~2 cup Sardine, Atlantic,In 011, drained,3 oz

---

SourceNutrientV&B from Agwftural Research ‘ 5erv1ce (ARS)NutrientDatabase Standard for Reference, Release Foodsare from ARSsinglenutrientreports,sortedin dew-endIng 17 order by nutrientcontentI” terms of commonhousehold measuresFoodItemsand weightsin the singlenutrientrepor&are adapted from thoseI” 2032 rewon of USDAHomeand CardenBulietmNo 72, Nutrlhve Valueof Foods Mixeddishesand mulhplepreparations the samefood Item havebeenomittedfrom this table of

58

Appendix B-3. Food Sources of Iron
Food Sourcesof Iron ranked by mrllrgrirmsof iron per standard amount, also calones tn the standard amount of (All are 2 100/o RDAfor teen and adult females,which IS 18 mglday) ---

Food, StandardAmount )--. .------~ ____
Clams,canned, drarned, 3 oz Fortrfredready-to-eatcereals(various), - I oz Oysters,eastern,weld,cooked, moist heat, 3 oz ~ Organ meats (Iwer, giblets), various, ‘ :ooked, 3 oz a -__ Fortrfied Instant cooked cereals(vanc8us), packet 1 Soybeans,mature, cooked, 1%cup ____-Pumpkrnand squash seed kernels,roasted, I oz ___-.-.White beans, canned, '~2 cup --~____ Blackstrapmolasses,1 Tbsp Lentils, cooked, I/Zcup ---__--Beef, chuck, blade roast, lean, cookecl,3 oz ~--___Beef, bottom round, lean, 0” fat, all grades,cooked, 3 oz Krdney beans, cooked, ‘ cup /I Sardines,canned rn oil, drarned, 3 oz Beef, .-__-- nb, lean, l/c”fat, all grades, 3 02 Chickpeas,cooked, I/Zcup Duck, meat only, roasted, 3 oz Lamb, shoulder, arm, lean, r/e”fat, choice, cooked, 3 oz Prune furce,314 cup *l , _ --~-~-~~----__ Spinach,cooked from fresh, r/2cup -.-.~---- --.--.------+-.

Iron (mg) j ---238 1.8 -21 1 -----&~..-10.2 ____ 5 2-9.9 A-.---49-81 44 --------+-..-4.2 -------d---.-39 3.5 ~ ---T3.3 -t---32 .A--3.1 i 2.8 2.6 -___--.--~_. 2.5 _ 2.4 2.4 2.3 ~ -.-__~ '

Calories
126 54-127 116 134-235 __Varies 149 148 153 47 -- __-___.-__115 21 215 182 112 177 195 134 171

--..___-_---

p”“mp,cannea,5 __----__---__----~-OZ
j Cowpeas,cooked, ‘ cup 12 r Croundbeef ____--__-.15% fat, cooked 3 oz t --. .---L---‘ I Tomato puree, j/2 cup i Lrma beans, cooked, r/2cup i --. .---~___ ; Soybeans,green,@ted, 112 cup pay beans,cookd,

..--- ~_____

23 237 --___ -___ .--.- bag--136 ____I~-.. 2.3 --___2.3 102 ~___--t-..--.~22 ~~---l_ 2.2 22 --____ 100 212 48

‘ CUP ~2
20 2.0

: Reined beans, I/Zcup i Beef, top srrlorn,lean, 0” fat, all grades,cooked, 3 oz t -- - .--.-__~ -__-___ ! Tomato paste, 1%cup
a High I” cholesterol Source Nutrientvaluesfrom Agricultural Research 5ervice(ARS)NutrientDatabase Standard for Reference, Release Foodsare from ARSsinglenutrientreports,sortedin descending 17 order by nutrientcontentin terms of common household measuresFoodItemsand weightsin the singlenutoentreportsare adapted from those in 2002 rewon of USDAHomeand CardenBulletinNo 72, NutWe Valueof Foods Mixeddishesand multiplepreparations the samefood item havebeen omctted of from this table

59

Appendix 8-4. Non-Dairy Foot’Sources of rCalcium
Non-Dairy Food Sourcesof Calcium ranked by mllllgrams of calcium per standard amount; also calories In the standard amount The bioavallabtlitymay vary (The Al for adults IS 1,000 mg/day$

/ Food, StandardAmount r------~_
! Fortlfled ready-to-eatcereals(various), 1 oz I c Soy beverage,calcium forttfied, 1 cup Sardines,Atlantic, In 011, dralned, 3 0;’ Tofu, firm, prepared with nlgarib, 112 cup ~-____~ Pink salmon, canned, with __- 3 O;I bone, ---~ --------------------.------~--.--------...---+-.--+---

--1-c_-~

Calcium (mg) 236-1043 325 --253 -__.._t_~________ 181 -----+.-...-pw -----~-.-178 172 146 130 124 116 .-. 99-110 106 i_~ ~ ~.~~ -~ -~~ 368

Calories
88-106 98 Ii7 88 118 31 47 ~~~~~~ 30 127 24 103 97-157 I 80 1

cup Collards,cooked from frozen, 112
Molasses,blackstrap,1 Tbsp Spinach,cooked from frozen, 1~2 cup Soybeans,green, cooked, 1~2 cup ~__ Turnrp greens, cooked from frozen, I/Zcup Ocean perch, Atlantic, cooked, 3 oz

Oatmeal, plain and flavored, Instant, ortified, 1 packet prepared

Cowpeas, cooked,1~2 cup
White beans, canned, 1~2 cup Kale, cooked from frozen, 1~2 cup Okra, cooked from frozen, 1~2 cup Soybeans,mature, cooked, 1~2 cup Blue crab, canned, 3 oz Beet greens, cooked from fresh, 1~2 cup Pak-chow, Chinese cabbage,cooked from fresh, I/Zcup Clams, canned, 3 oz Dandelion greens, cooked from fresh, I/Zcup Ralnbow trout, farmed, cooked, 3 oz

d Botncalciumcontentand b~oavallablllty should Ibeconsidered when seledingdietan/sourcesof calaum Someplantfoods havecalwm that ISwell absorbed, the largecluanbty plantfoods but of that would be neededto provideas much calciumas in a glass milk may be unachievable many Manyother caloum-fortlfiec of for foodsare available, the percentage c&urn that can be but oi absorbed unawlablefor manyof them IS b Calwm sulfateand magnewm chloride Source Nutrientvaluesfrom Agocultural Research Serwe (AKS)NutrientDatabase Standard for Reference, Release Foodsare from ARSsinglenutrientreports,sortedIn dwcendlngorder by 17 nutrientcontentEliterms of common household rreasures FoodItemsand weightsIn the singlen&lent reportsare adapted from thosein 2002 rewon of USDAHome and GardenBulletinNo 72, Ivutritlve Valueof Foods Mlxeddishesand multlpk preparations the samefood Item havebeen omlttedfrom this table of

60

Appendix H-5. Food Sources of Calcium
Food Sourcesof Calcium ranked by ml ligrams of calcium per standard amount; also caloriesIII the standard amount (All are ~200/0of Al for adults 19-50,which is 1,000 mgiday)

Food, StandardAmount
Plainyogurt, non-fat (13 g protein/8 tx), 8-0~ container
r-----y--

Calcium (mg)
__--..-~--~-____--__-~~~~~--.-----~~~ -~~ -------i--------.452 452
438

I
i

Calories
127 165 ~_
190

’ Roman0 cheese, 1.5 oz t-------cheese.2 oz ! PasteurizedorocessSWISS Plainyogurt, low-fat (12 g protein/8 oz), 8-0~ container ___-. -~ Fruit yogurt, low-fat (10 g probn/8 cz), 8-0~ container SWISS cheese, 1 5 oz Ricottacheese,part skim, vz cup PasteurizedprocessAmencan cheesefood, 2 oz _______Provolone cheese, 1 5 oz Mozzarellacheese,part-skim, 15 oz Cheddar cheese, 1 5 oz Fat-free(Qm) milk, I cup Muenster cheese, 1.5 oz 1% low-fat milk, 1 cup Low-fat chocolate milk (IO/O), I cup 2010 reduced fat milk, I cup Reducedfat chocolate milk (20/o),1 cup Buttermllk,low-fat, I cup Chocolate milk, I cup Whole milk, 1 cup __-Yogurt, plam, whole milk (8 g protein!8 oz), 8-0~ container
~-_____-

___.._ 415 --+---.-----

143
232 162 170

345 336 -------335

---.---------~~__ --..--_--~~~____

323

~~~---~-

188

-__ ___------.

321 311 307
306 305 *---

150 .-.-___ -129 171
a3 156

290 j ------.+..---288 1

102
158

276 _____

146 138

~___----i-~~_ ----+-.
255 225 215 210

275

Ricottacheese,whole milk, 1% cup Blue cheese, 15 oz Mozzarellacheese,whole milk, 1 5 02 Feta cheese, 15 oz

.-

214 150 128 113

Source Nutrtent values from Agricultural Research Sennce (ARS) Nutrient Database for Standard Reference, Release 17 Foods are from A R S single nutrient reports, sorted K dexendlng order by nutrient content in terms of common household measures Food Items and weigh& in the smgle nutrient reports are adapted from those in 2002 rewon of USDA Home and Garden BulletIn No 72, twtritive Value of :oods MIxed dishes and multlpk preparations of the same food Item have been omitted from this table

61

---

0

Appendix B-6. Food Sources of Vitamin A
Food Sourcesof VrtamrnA ranked by micrograms Retinol Activity Equivalents(RAE) of vitamin A per standard amount; also calones In the standard amount (All are >20% of RDAfor adult men, which IS900 mgiday RAE.)

--; Food, StandardAmount
Organ meats (Irver,goblets), various, Icooked,3 oza

Vitamin A @g RAE) ;Caloriesj

/1

Carrot juice, J/4 cup Sweetpotatowrth peel, baked, I medrum Pumpkrn,canned, 1~2 cup Carrots,cooked from fresh, 1~2 cup Spinach,cooked from frozen, 1~2 cup Collards,cooked from frozen, l/2 cup Kale, cooked from frozen, 112 cup Mrxed vegetables,canned, 112 cup

Turnrp greens, cooked from frozen, I/Zcup ~_______ Instant cooked cereals,fortrfred, prepared, I packet Various ready-to-eatcereals,wrth added vrt A, - 1 OL ____--Carrot, raw, 1 small ____--~-~~ Beet greens, cooked, 1%cup Winter squash, cooked, 1~2 cup Dandelron greens, cooked, 1%cup Cantaloupe, raw, 1%medrum melon Mustard greens, cooked, b/2cup Prckledherring 3 oz Red sweet pepper, cooked, 1~2 cup Chrnesecabbage,cooked, 1~2 cup
L --E High in cholesterol Source Nutrientvaluesfrom Agricultural Research Sew~ce (ARS)NutrientDatabase Standard for Reference, Release Foodsare from ARSsinglenutrientreports,sortedI” dexendlngorder by 17 nutrientcontentin terms of commonhousehold treasures Fooditemsand weightsin the singlenutllentreportr are adapted from those in 2002 rewon of USDAHomeand GardenBulletinNo 72, NutWe Valueof Foods Mixeddishesand mulbplepreparations the samefood Item havebeenomatedfrom this table of

---

Appendix K-7. Food Sources of Magnesium
Food Sourcesof Magnesium ranked by milkgrams of magnestum per standard amount, also calories In the standard amount (All are 2 100/o RDA for adult men, whrch is 420 mg/day) of

-Food,StandardAmount
Pumpkrn and squash seed kernels, rc’ asted,1 oz Brazil nuts, 1 oz Bran ready-to-eatcereal (1000/o),m 1 oz Halrbut, cooked, 3 oz Qurnoa, dry, 114 cup Spinach,canned, 1% cup Almonds, 1 oz Spinach,cooked from fresh, ‘ cup ~2 Buckwheatflour, ‘ cup 14 Cashews,dry roasted, I oz Soybeans,mature, cooked, I/Zcup Pine nuts, dried, I oz Mixed nuts, 011 roasted,with peanuts, 1 oz .-~ White beans, canned, r/2cup __---__-Pollock,walleye, cooked, 3 oz ~-__-. Black beans, cooked, ‘ cup ~2 Bulgur, dry, 114 cup cup Soybeans,green, cooked, ‘ cup ~2 Tuna, yellowfrn, cooked, 3 oz Artichokes (hearts), cooked, r/2cup Oat bran, raw, I/Q Peanuts,dry roasted, I oz ___~-__ Lrma beans, baby, cooked from frozen, 1~2 cup Beet greens, cooked, ~2 cup Navy beans, cooked, 112 cup Tofu, firm, prepared with nrgar?, I/ZCLp Okra, cooked from frozen, r/2cup Soy beverage, I cup ---.__ Cowpeas,cooked, 1% cup Hazelnuts, 1 oz Oat bran muffin, I oz ~~__ ~~--l~--------+.---.-___-----__-

Magnesium
.~ -~.. ..-.---- -..151 107 ------~--103 89 78 -------78 75 74 74 71 67 67 62 60 57 ----. 55 54 -----c...-54 ------------t...------50 .-.-____ 50 -~-+3 --g .--I ) 1

Calories
..-______ 148 186 74 119 159 25 164 20 101 163 149 191 175

91 rmm81 ---.

--

Y2d 58 ____ 127 118 42 :

1 ~~ --.--

~~--.--____

~_

I- ~~~~- cooked, 1~2 f Oat bran, cup -------__-~ ----r Buckwheatgroats roasted, cooked, I/Zcup cm---.-~----2-p. I Brown rice, cooked, l/2 cup L ~~~~----_~----__-.-Haddock, cooked, 3 oz
d Caloum suliate and magnewm chloride

! Great northern beans, cooked, r/2cup

-

i-~~~---~~.--~~~---J~-.-~--~-___ --- -+ ~~

---

___-

-~~~~~.44 _.___ __ 43 42 ~--47 --

~_

Source Nutrient values from Agricultural Research Zerwe (ARS) Nutrient Database for Standard Reference, Release 17 foods are from ARS single nutrient reports, sorted in descending order by nutrient content in terms of common household measures Food Items and weights I” the single nutrient reports are adapted from those in 2002 rewon of USDA Home and Garden: Bullehn No 72, Nutrltlve Value of Foods Mtxed dishes and multiple preparations of the same food Item have been omltted from this table

63

---

Appendix B-8. Food Sources oi Dietary Fiber
Food Sourcesof Dretary Frber ranked by grams of dietary fiber per standard amount; also calones In the standard amount (All are >lOO/a Al for adult women, wlich is 25 grams/day) of

Food, StandardAmount
Navy beans, cooked, 1~2 cup Kidney beans, canned, 112 cup Split peas, cooked, 1% cup Lentrls,cooked, 1~2 cup .-__Black beans, cooked, ‘ cup ~2 Prnto beans, cooked, 1~2 cup Lrma beans, cooked, 1~2 cup Artrchoke,globe, cooked, 1 each .--___ .---___ Whrte beans, canned, b/2cup Chrckpeas, cooked, r/zcup Great northern beans, cooked, I/Zcup .--______Cowpeas,cooked, r/zcup Soybeans,mature, cooked, 112 cup Bran ready-to-eatcereals,various, - 1 oz Crackers,rye wafers, plain, 2 wafers Sweetpotato,baked, with peel, I medrum (146 g) .--.__ __----___ Asran pear, raw, 1 small Green peas, cooked, 1% cup Whole-wheat Eng,lshmuRn, 1 each ------~~-~----~~~---__~------~Pear,raw, 1 small Bulgur, cooked, I/Zcup Mixed vegetables,cooked, (12 cup ~__-__ Sweetpotato,boiled, no peel, 1 medium (156 g) ~-___ Blackberries, raw, l/2 cup Potato, baked, with skin, 1 medrum Soybeans,green, cooked, 1~2 cup Stewed prunes, 1% cup ---__ Frgs,dried, 1~4 cup Dates, 1% cup Oat bran, raw, l/e cup Pumpkrn,canned, 1~2 cup
i-

Dietary Fiber (g)
__-__-.--. --~~--~_-..

95
RR

.-

Bran readv-to-eatcereal ~lW/o~. Ii2 CUD

0

--.---i----.

- ----.-&---.---.-.-L-----.~.----_-~~___

-

~-___

------

___.----~-i--------

~~
~-.-~-.-_-~

43 ____ ~--. 41 40 40 39

.._~ -+
_~_-

ai t
76 59 32 I '

_____--~~~~ ~--____

Raspberries, raw, r/2cup

~----. --.~~~.--_-_ --A--

3.8 3.8 38

--~~ _~ --___ 161 1

127

- -~~~ ---____ -.--~ ..-.

~ -----i

~_

Spinach,frozen, cooked, 1~2 cup

t Shredded wheat ready-to-eatcereals,,rarious, -I oz ~-___-~~____-~~
Almonds, 1 oz Apple with skin, raw, 1 medrum

0

t

Brusselssprouts, frozen, cooked, 112 CLIP ~__--Whole-wheat spaghetti, cooked, 1~2 cup

64

Appendix B-8: Continued

i Food,StandardAmount ;-------p-.p----p--

/

--

c

Guava,1 medium
/

I Pearled cup c------ barley,cooked,1~2 : Sauerkraut, canned, solrds, liquics,‘ cup and ~2 ---t-----29 .._.
------,-~ _ 28 2.9

; Tomatopaste,1% cup iI------- squash, Winter cooked,‘ cup --__ /I fe-~Bccoh, cooked,1~2 cup ~--__ ; Pannlps, cooked,chopped,1~2 cup Turnipgreens, cooked,I/Zcup Collards, cooked,I/Zcup Okra,frozen,cooked,1% cup .~ 1 Peas, edible-podded, cooked,1~2 cup

i----

~

~

~-.----~--.----------c----

SourceAFSNutrientDatabase Standard for Reference, Release Foodsare from singlenutrientreports,whichare sortedeitherby food description in descending 17 or order by nutrientcontentin termsof commonhousehold measuresThe food Itemsand wghts in thesereportsare adapted from thoseI” 2002 rewon of USDAHomeand GardenBulletinNo 72, NutntlveValueof Foods Mixeddishesand multiplepreparations the samefood ItemhavebeenomItted of

Appendix 13-9. Food Sources of Vitamin C
Food Sourcesof Vitamin C ranked by milkgrams of vitamin C per standard amount, also calones rn the standard amount. (All provide ~ZOo/o RDA for adult men, whrch is 90 mg/day) of

--’ Food, StandardAmount
~~-~~~~-----. p, -.--~~___--.-__~--~---~-_-~-

Vitamin C (mg)
--188 ______ 142 116 70 70
.-------)--

Calories
~_ ~~_...______ .-___~ 56 20 19 46 62 79-84 -15 19 71-86 34 -27 28 .--~__~ 51 30 24 --____ -.. -_____ ~~~.__~ 15 34 26 116 31 17 37 18 54

raw, 112 cup ~--.____ Red sweet pepper, raw, 1~2 cup KIWIfruit, 1 medium

; --~__--- pepper,cooked,‘ cup ~2 : Red sweet
____---__ Orange, raw, 1 medium c---.-~Orange juice, 314 cup
em--.---

-___---~~ ---~~----_--

61-93 -y-~~_

-__...-

: Green pepper, sweet, raw, l/2 cup Green pepper, sweet, cooked, 1~2 cup --__Crapefrutt juice, 3/4cup Vegetablefurce cocktall,~4 cup Strawbernes,raw, I/Zcup Brusselssprouts, cooked, 1~2 cup Cantaloupe, ‘ medium ~4 Papaya,raw, 114 medrum Kohlrabi, cooked, 112 cup Broccolr,raw, i/2 cup Edible pod peas, cooked, I/Zcup Broccoli,cooked, r/z cup Sweetpotato,canned, 1~2 cup , Tomato lurce, 314cup / Cauliflower, cooked, 112 cup 1 Pineapple,raw, 112 cup ~---____ -__ __.--____ --__ -~---___---

--.____

60 51

---------t---~

____---.. 50-70 ~~-~__-..-____ 50 49 ---i+w.e----L48-----47 45 39 p---+.--pp 38 -___ ----37 ~

--____

__ _~-___~ ___-----.--

34 33 28 :-----c-. .-_____ 28 27 23 ___--

SourceNutrientvdk from Agricultural Research jervlce(ARS)NutnentDatabase Standard for Reference, Release Foodsare from ARSsinglenutrientreports,sortedIn dexendlngorder by 17 nutrientcontentin terms of commonhousehold measuresFoodItemsand weightsin the smglenutrientreportsare adapted from thoseIn 2002 rewlon of USDAHomeand (,ardenBulletinNo 72, NutrlbveValueof Foods Mixeddishesand multtpk preparations the samefood Item havebeenomittedfrom this table of

66

65

APPENDIX

C. GLOSSARY OF TERMS
Chronic Diseases-such heart disease,cancer,and diabetes-are the as
leading causesof death and dlsablhty In the Unlted States.These diseases account for 7 of every 10 deaths and affect the quality oi life of 90 mlllion Americans Although chronic diseasesare among the most common and costly health problems, they are also among the most preventable. Adopting healthy behaviorssuch as eating nutritious foods, berng phy;lcally active,and avoidlng tobacco use can prevent or control ihe devastating effects of these drseases.

AcceptableMacronutrientDistributioll Ranges(AMDR)-Range of Intake
for a particular energy source that is asjoaated with reduced risk of chrome diseasewhile providing Intakesof essentialnutrients. If an lndlvldual consumes In excessof the AMDR, there is a potential of increasingthe rrsk of chronic diseasesand/or insufficient intakes of essentialnutrients

Added Sugars-Sugars and syrups that are added to foods during
processingor preparation.Added sugarsdo not Include naturally occurnng sugarssuch as those that occur in milk and fruits

CoronaryHeart Disease-Anarrowing of the small blood vesselsthat AdequateIntakes(Al)-A recommended average dally nutrient intake level
based on observed or experimentally determined approxlmatlons or estlmates of mean nutrient Intake by a grc’ (or groups) of apparently up healthy people The Al is used when the EstimatedAverage Requirement cannot be determined supply blood and oxygen to the heart (coronary arteries)

Daily Food Intake Pattern-ldent6esthe types and amounts of foods that
are recommended to be eaten each day and that meet speclflcnutritional goals (Federal Reg/sfefNo&e, vol. 68, no 176,p 53536, Thursday, September 11,2003)

BasicFood Groups-In the USDAfood Intake patterns,the basicfood
groups are grains, fruits; vegetables;milk, yogurt, and cneese,and meat, poultry, fish, dried peas and beans, eggs, and nuts In the DASH Eating Plan, nuts, seeds,and dry beans are a separatefood group from meat, poultry, fah, and eggs

DangerZone-The temperature that allow bacteriato multiply rapldly and
produce toxins, between 40°F and 140°F.To keep food out of this danger zone, keep cold food cold and hot food hot Keep food cold In the refngerator, In coolers, or on ice in the serviceline Keep hot food In the oven, in heated chafing dishes,or In preheated steam tables, warmrng trays, and/or

Body Mass Index (BMI)-BMI

IS

a praclcal measurefor approximatingtotal

slow cookers Never leave perishablefoods, such as meat, poultry, eggs, and casseroles, the danger zone longer than 2 hours or longer than 1 In hour In temperaturesabove 90°F Dietary Fiber-Nonstarch polysacchandes lignrn that are not digested and by enzymes in the small intestine Dietary frber typically refers to nondlgestablecarbohydratesfrom plant foods

body fat and ISa measure of weight in relation to height. It IS calculatedas weight In kllograms divided by the squilre of the height In meters

Cardiovascular Disease-Refersto diseasesof the heart and diseasesof the
blood vesselsystem (arteries,capillaner’ veins) within a person’ entire , s body, such as the brain, legs, and lungs

Cholesterol-Asterol present In all anin-al tissues.Free cholesterolIS a
component of cell membranesand servesas a precursorfor steroid hormones, lncludlng estrogen,testosterone,aldosterone,and bile acids Humans are able to synthesizesufflclent cholesterolto meet biologic requlremerits, and there IS no evidencefor a di%ary requtrement for cholesterol, * Dietary cholesterol-Consumed from foods of antmal origin, Including meat, fish, poultry, eggs, and dairy producis Plant foods, such as grams, fruits and vegetables,and 011s from these sources contain no dietary cholesterol

Dietary Reference Intakes(DRls)-A set of nutrient-based reference values
that expand upon and replacethe former RecommendedDietan/ Allowances(RDAs) rn the United Statesand the RecommendedNutrient Intakes(RNls) rn Canada They are actually a set of four referencevalues: EstimatedAverageRequirements(EARs),RDAs,Als, and rolerable Upper Intake Levels(ULs).

DiscretionaryCalorieAllowance-Thebalance calories of remainingin a
person’ energy allowance after accounting for the number of calories s needed to meet recommended nutrient Intakesthrough consumptron of foods in low-fat or no added sugar forms The discretionarycalorie allowance may be used In selectingforms of foods that are not the most nutrient-dense (eg., whole milk rather than fat-free milk) or may be additions to foods (e g , salad dressing,sugar, butter)

* Serum cholesterol-Travels the blood in distinct particles containing In
both lrptds and proteins. Three major classesof llpoprotelns are found in the serum of a fasting Indlvrdual: low-density llpoprotern (LDL), highdensity lipoprotein (HDL), and very-low-density lipoprotein (VLDL) Another hpoprotein class, Intermediate-density lipoprotein (IDL), resides between VLDL and LDL, In clinical practice, IDL IS Included In the LDL measurement

EnergyAllowance-A person’ energy allowance ISthe calorie intake at s
which wetght maintenanceoccurs

Listeriosis-Aserious Infection caused by eating food contaminated with the
bacterium later/a monocyfogenes, which has recently been recognizedas an Important public health problem In the United States The diseaseaffects primarily pregnant women, their fetuses, newborns, and adults with weakened Immune systems.Listenais kllled by pasteurlzatlonand cooking; however, In certain ready-to-eatfoods, such as hot dogs and dell meats, contamination may occur after cooking/manufacturebut before packaglng lateriu monocyfogenes can survive at refrigeratedtemperatures

EstimatedAverageRequirements-EAR the averagedally nutrient intake is
level estimated to meet the requirement of half the healthy lndlviduals In a particular life stage and gender group

EstimatedEnergyRequirement-ThetiERrepresentsthe averagedietary
energy Intake that WIIImaintain energy balance in a healthy person of a given gender, age, weight, height, and physicalactivity level FDAMA-The Food and Drug AdmlnrstratlonModernlzatlon Act, enacted Nov 21, 1997,amended the FederalFood, Drug, and CosmeticAct relating to the regulation of food, drugs, dencer, and biological products. With the passageof FDAMA,Congressenhanced FDA’ mission In ways that recogs nlzed the Agency would be operating iI1 a 2lst century characterizedby Increasingtechnological,trade, and pubhc health complexities

Macronutrient-Thedletatymacronutrient groupsare carbohydrates,
proteins, and fats

Micronutrient-Vitamins mineralsthat are required In the human diet and
in very small amounts

Moderate PhysicalActivity-Any actnlty that burns 3 5 :o 7 kcal/min or
the equivalent of 3 to 6 metabolic equivalents (METS)and results in achieving 60 to 73 percent of peak heart rate. An estimate of a person’ s peak heart rate can be obtalned by subtractingthe person’ age from 220. s Examplesof moderate physlcalactivity Include walking briskly, mowing the lawn, dancing, swImmIng, or bicycling on level terrain P. person should feel some exertion but should be able to carry on a conversationcomfortably during the actwity

FightBAC!-Anatlonal public education campaign to promote food safety to
consumersand educate them on how lo handle and prepare food safely In this campaign, pathogens are represented by a cartoon-like bacteria character named “BAC ”

FoodborneDisease-Caused by consulnlng contaminated foods or beverages Many different disease-causing crobes, or pathogens, can m contaminate foods, so there are many different foodborne Infections In addltlon, poisonous chemicals,or other harmful substances,can cause foodborne dtseasesIf they are present In food. The most commonly recognized foodborne Infectionsare those caused by the bacteria Campylobofiec also known as the Norwalk and Norwalk-likeviruses Heme Iron-One of two forms of iron occurring In foods. Heme Iron IS bound wrthln the Iron-carryingproteins (hemoglobrn and myoglobrn) found In meat, poultry, and fish While It contrlbutes a smaller portlon of Iron to typIcal American diets than non-heme lion, a larger proportion of heme iron ISabsorbed

Monounsaturated FattyAcids-Monounsaturated fatty acids (MUFAs) have
one double bond Plant sourcesthat are rich In MUFAsInclude vegetable 011s g, canola 011, (e olive oil, high oleic safflower and sunflower 011s) that are liquid at room temperature and nuts.

Salmonella, and E co// 0157.H7, and by a group of virusescalled CalicIvIrus, Nutrient-Dense Foods-Nutrient-dense foods are those that provide substantialamounts of vltamlns and minerals and relativelyfewer calories

Ounce-Equivalent-In grains food group, the amount of a food counted the
as equal to a one-ounce slice of bread, in the meat, poultry, fish, dry beans, eggs,and nuts food group, the amount of food counted as equal to one ounce of cooked meat, poultry, or fish Examplesare listed m table I and appendix A-l n-6 PUFAs-Llnoleicacrd, one of the n-6 fatty aads, IS required but cannot be synthesizedby humans and, therefore, is consldered essentialin the diet. Primarysourcesare liquid vegetable oils, lncludlng soybean 011, corn oil, and safflower oil

High FructoseCorn Syrup (HFCS)-A corn sweetener derived from the wet
mllhng of corn CornstarchIS converted to a syrup that is nearly all dextrose HFCSISfound In numerousfoods and beverageson the grocerystore shelves.

Hydrogenation-Achemical reaction that adds hydrogen atoms to an
unsaturatedfat, thus saturallng It and maklng It solid at room temperature

n-3 PUFAs-cc-linolenrc ISan n-3 fatty acid that ISrequired becauseIt IS acid
not synthesizedby humans and, therefore, is conslderedessentialIn the diet It is obtained from plant sources,including soybean011, canola 011, walnuts, and flaxseed Eicosapentaenolc (EPA)and docosahexaenolc (DHA) acid acid are long chain n-3 fatty acidsthat are contained In fish and shellfish

Leisure-Time PhysicalActivity-Physical activitythat is performed during
exercise,recreation,or any additional tirne other than that associatedwith one’ regular lob duties, occupation, or transportation s

69

Pathogen-Any mIcroorganIsm can Icause IScapableof causingdisease that or

Vegetarian-There severalcategoriesof vegetarians,311 whom avoid are of
meat and/or animal products The vegan or total vegetariandiet Includes only foods from plants: fruits, vegetables,legumes (dried beans and peas), grains, seeds,and nuts. The lactovegetariandiet Includes plant foods plus cheeseand other dairy products The ovo-lactovegetanan(or lacto-ovovege tarian) diet also includes eggs Semi-vegetarians not eat red meat but do Include chicken and fish with plant foods, dairy products, and eggs.

Polyunsaturated Acids-Polyunnlturated fatty acids (PUFAs)have two Fatty
or more double bonds and may be of IWOtypes, based on the posrtion of the first double bond.

Portion Size-The amount of a food consumed In one eating occasion
Recommended Dietary Allowance (RIIA)-The dietary Intake level that IS sufflclent to meet the nutrient requirerrent of nearly all (97 to 98 percent) healthy individuals In a particular life stage and gender group Resistance Exercise-Anaerobic trainirg, mcludlng weight training, weight machine use, and resistanceband workouts Resistance training wtll Increasestrength, muscular endurance, and muscle size, while running and logging will not

VigorousPhysicalActivity-Any activitythat burns more than 7 kcal/mln or
the equivalent of 6 or more metabolic equivalents(METS)and results rn achieving 74 to 88 percent of peak heart rate. An estimate of a person’ s peak heart rate can be obtained by subtractingthe person’ age from 220. s Examplesof vigorous physicalactivity include logging, mowing the lawn with a nonmotorized push mower, chopplng wood, partlclpating In highimpact aerobic dancing, swimming continuous laps, or blcycllng uphill Vigorous-lntensltyphyslcalactivity may be Intense enough to represent a substantialchallengeto an rndivldual and results in a significantincreaseIn heart and breathing rate

SaturatedFattyAcids-Saturated fatty aads have no double bonds They
pnmarlly come from animal products such as meat and dairy products In general, animal fats are solid at room temperature

SedentaryBehaviors-In scientificIterture, sedentary IS often defined In
terms of little or no physicalactivity during leisure time A sedentary lifestyle ISa lifestyle characterizedby little or no physicalactlvlty Serving Size-A standardizedamount of a food, such as a cup or an ounce, used In provldlng dietary gurdance or In making comparisons among similar foods

Weight-Bearing Exercise-Any actlvlty one performs that works bones and
musclesagainst gravity, Including walking, running, hiking, dancing, gymnastics, and soccer Whole Grains-Foods made from the entire grain seed, usually called the kernel, which consrstsof the bran, germ, and endosperrr If the kernel has been cracked,crushed, or flaked, it must retain nearly the same relative proportlons of bran, germ, and endosperm as the original grain In order to be called whole grain I6

TolerableUpper Intake Level(UL)-The highest average dally nutrient
Intake level likely to pose no risk of adverse health affectsfor nearly all Indivlduals In a particular life stage and gerder group. As intake Increasesabove the UL, the potential risk of adverse health affects increases 7iuns fatty acids-Trans fatty acids, or t~7nsfats, are unsaturatedfatty acids that contain at least one non-conjugated double bond In the truns configuration Sourcesof trunsfatty acids Include hydrogenated/partially hydrogenatedvegetable 011s are us:d to make shortening and commerthat clally prepared baked goods, snack foods, fried foods, and margarine.7iuns fatty acids also are present In foods that come from ruminant animals (e g, cattle and sheep) Such foods Include dairy products, beef, and lamb

16AACC Press Release, AACC To Create Consumer-Friendly Whole Craln Deflnltion, March 5. 2004 http //waaccnet
1 -\Ki '.L CL. :"t\ C'!i xb1FKIC,\N8. 2ilo;

org/news/CFWhol&rar

asp

70 ---

APPENDIX

D.

ACRONYMS

Al-Adequate Intakes AMDR-Acceptable Macronutnent Distnbutron Range ARS-Agricultural ResearchServrce BMI-Body Mass Index CSFLL-Continurng Survey of Food Intakes by Individuals DASH-Dretary Approachesto Stop Hypertensron DFE-Dretary Folate Equivalent DHA-Docosahexaenorc acid DRI-Dretary ReferenceIntake DV-Dally Value EAR-Estimated Average Requirement EER-Estimated Energy Requrrement EPA-Eicosapentaenorc acid FDA-Food and Drug Admrnrstratron FDAMA-Food and Drug AdmrnrstratronModernizatron Act HDL-High-density lrpoprotern HHS-U 5 Department of Health and tluman Services Winternational unit LDL-Low-density lrpoprotein RAE-Retrnol Activrty Equivalent RDA-Recommended Dietary Allowance USDA-U 5 Department of Agrrculture

71

---

0

NOTES

For sale by the Superinlcndent of Docummts, U.S. Gov -I mnting O~CC Intcm*: bOOkpUrre.gpO.gOV Phone: toll free (866) 512-1800: LX area (202) 512-1800 Fax: (262) 512-2250 Mail: Stop SSOP. Washington. DC 20402-ooO1 ISBN 0-16-072396-l

HHS Publlcahon number HHS-ODPHP-2M)SWDGA-A USDA Publacatlon number Home and Garden BulletIn No 232