Chapter 7: Healthy Eating
Healthy Intake: Healthy eating patterns include whole grains and limit the intake of refined grains and products made with refined grains, especially those high in saturated fats, added sugars, and/or sodium, such as cookies, cakes, and some snack foods. The grains food group includes grains as single foods (e.g., rice, oatmeal, and popcorn), as well as products that include grains as an ingredient (e.g., breads, cereals, crackers, and pasta). Grains are either whole or refined. Whole grains (e.g., brown rice, quinoa, and oats) contain the entire kernel, including the endosperm, bran, and germ. Refined grains differ from whole grains in that the grains have been processed to remove the bran and germ, which removes dietary fiber, iron, and other nutrients. The recommended amount of grains in the Healthy U.S.-Style Eating Pattern at the 2,000-calorie level is 6 ounce-equivalents per day. At least half of this amount should be whole grains.
Key nutrient contributions: Whole grains are a source of nutrients, such as dietary fiber, iron, zinc, manganese, folate, magnesium, copper, thiamin, niacin, vitamin B6, phosphorus, selenium, riboflavin, and vitamin A. Whole grains vary in their dietary fiber content. Most refined grains are enriched, a process that adds back iron and four B vitamins (thiamin, riboflavin, niacin, and folic acid). Because of this process, the term “enriched grains” is often used to describe these refined grains.
Considerations: Individuals who eat refined grains should choose enriched grains. Those who consume all of their grains as whole grains should include some grains, such as some whole-grain ready-to-eat breakfast cereals, that have been fortified with folic acid. This is particularly important for women who are or are capable of becoming pregnant, as folic acid fortification in the United States has been successful in reducing the incidence of neural tube defects during fetal development. Although grain products that are high in added sugars and saturated fats, such as cookies, cakes, and some snack foods, should be limited, as discussed in the Added Sugars and Saturated Fats sections below, grains with some added sugars and saturated fats can fit within healthy eating patterns.
Healthy intake: Healthy eating patterns include fat-free and low-fat (1%) dairy, including milk, yogurt, cheese, or fortified soy beverages (commonly known as “soymilk”). Soy beverages fortified with calcium, vitamin A, and vitamin D, are included as part of the dairy group because they are similar to milk based on nutrient composition and in their use in meals. Other products sold as “milks” but made from plants (e.g., almond, rice, coconut, and hemp “milks”) may contain calcium and be consumed as a source of calcium, but they are not included as part of the dairy group because their overall nutritional content is not similar to dairy milk and fortified soy beverages (soymilk). The recommended amounts of dairy in the Healthy U.S.-Style Pattern are based on age rather than calorie level and are 2 cup-equivalents per day for children ages 2 to 3 years, 2½ cup-equivalents per day for children ages 4 to 8 years, and 3 cup-equivalents per day for adolescents ages 9 to 18 years and for adults.
Key nutrient contributions: The dairy group contributes many nutrients, including calcium, phosphorus, vitamin A, vitamin D (in products fortified with vitamin D), riboflavin, vitamin B12, protein, potassium, zinc, choline, magnesium, and selenium.
Considerations: Fat-free and low-fat (1%) dairy products provide the same nutrients but less fat (and thus, fewer calories) than higher fat options, such as 2% and whole milk and regular cheese. Fat-free or low-fat milk and yogurt, in comparison to cheese, contain less saturated fats and sodium and more potassium, vitamin A, and vitamin D. Thus, increasing the proportion of dairy intake that is fat-free or low-fat milk or yogurt and decreasing the proportion that is cheese would decrease saturated fats and sodium and increase potassium, vitamin A, and vitamin D provided from the dairy group. Individuals who are lactose intolerant can choose low-lactose and lactose-free dairy products. Those who are unable or choose not to consume dairy products should consume foods that provide the range of nutrients generally obtained from dairy, including protein, calcium, potassium, magnesium, vitamin D, and vitamin A (e.g., fortified soy beverages [soymilk]).
Healthy intake: Healthy eating patterns include a variety of protein foods in nutrient-dense forms. The protein foods group comprises a broad group of foods from both animal and plant sources and includes several subgroups: seafood; meats, poultry, and eggs; and nuts, seeds, and soy products. Legumes (beans and peas) may also be considered part of the protein foods group as well as the vegetables group (see the About Legumes (Beans and Peas) call-out box). Protein also is found in some foods from other food groups (e.g., dairy). The recommendation for protein foods in the Healthy U.S.-Style Eating Pattern at the 2,000-calorie level is 5½ ounce-equivalents of protein foods per day.
Key nutrient contributions: Protein foods are important sources of nutrients in addition to protein, including B vitamins (e.g., niacin, vitamin B12, vitamin B6, and riboflavin), selenium, choline, phosphorus, zinc, copper, vitamin D, and vitamin E). Nutrients provided by various types of protein foods differ. For example, meats provide the most zinc, while poultry provides the most niacin. Meats, poultry, and seafood provide heme iron, which is more bioavailable than the non-heme iron found in plant sources. Heme iron is especially important for young children and women who are capable of becoming pregnant or who are pregnant. Seafood provides the most vitamin B12 and vitamin D, in addition to almost all of the polyunsaturated omega-3 fatty acids, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), in the Patterns (see the About Seafood call-out box). Eggs provide the most choline, and nuts and seeds provide the most vitamin E. Soy products are a source of copper, manganese, and iron, as are legumes.
Considerations: For balance and flexibility within the food group, the Healthy U.S.-Style Eating Pattern includes weekly recommendations for the subgroups: seafood; meats, poultry, and eggs; and nuts, seeds, and soy products. A specific recommendation for at least 8 ounce-equivalents of seafood per week also is included for the 2,000-calorie level (see the About Seafood call-out box). One-half ounce of nuts or seeds counts as 1 ounce-equivalent of protein foods, and because they are high in calories, they should be eaten in small portions and used to replace other protein foods rather than being added to the diet. When selecting protein foods, nuts and seeds should be unsalted, and meats and poultry should be consumed in lean forms. Processed meats and processed poultry are sources of sodium and saturated fats, and intake of these products can be accommodated as long as sodium, saturated fats, added sugars, and total calories are within limits in the resulting eating pattern (see the About Meats and Poultry call-out box). The inclusion of protein foods from plants allows vegetarian options to be accommodated.
Healthy intake: Healthy eating patterns include a variety of vegetables from all of the five vegetable subgroups—dark green, red and orange, legumes (beans and peas), starchy, and other. These include all fresh, frozen, canned, and dried options in cooked or raw forms, including vegetable juices. The recommended amount of vegetables in the Healthy U.S.-Style Eating Pattern at the 2,000-calorie level is 2½ cup-equivalents of vegetables per day. In addition, weekly amounts from each vegetable subgroup are recommended to ensure variety and meet nutrient needs.
Key nutrient contributions: Vegetables are important sources of many nutrients, including dietary fiber, potassium, vitamin A, vitamin C, vitamin K, copper, magnesium, vitamin E, vitamin B6, folate, iron, manganese, thiamin, niacin, and choline. Each of the vegetable subgroups contributes different combinations of nutrients, making it important for individuals to consume vegetables from all the subgroups. For example, dark-green vegetables provide the most vitamin K, red and orange vegetables the most vitamin A, legumes the most dietary fiber, and starchy vegetables the most potassium. Vegetables in the “other” vegetable subgroup provide a wide range of nutrients in varying amounts.
Considerations: To provide all of the nutrients and potential health benefits that vary across different types of vegetables, the Healthy U.S.-Style Eating Pattern includes weekly recommendations for each subgroup. Vegetable choices over time should vary and include many different vegetables. Vegetables should be consumed in a nutrient-dense form, with limited additions such as salt, butter, or creamy sauces. When selecting frozen or canned vegetables, choose those lower in sodium.
Healthy intake: Healthy eating patterns include fruits, especially whole fruits. The fruits food group includes whole fruits and 100% fruit juice. Whole fruits include fresh, canned, frozen, and dried forms. The recommended amount of fruits in the Healthy U.S.-Style Eating Pattern at the 2,000-calorie level is 2 cup-equivalents per day. One cup of 100% fruit juice counts as 1 cup of fruit. Although fruit juice can be part of healthy eating patterns, it is lower than whole fruit in dietary fiber and when consumed in excess can contribute extra calories. Therefore, at least half of the recommended amount of fruits should come from whole fruits. When juices are consumed, they should be 100% juice, without added sugars. Also, when selecting canned fruit, choose options that are lowest in added sugars. One-half cup of dried fruit counts as one cup-equivalent of fruit. Similar to juice, when consumed in excess, dried fruits can contribute extra calories.
Key nutrient contributions: Among the many nutrients fruits provide are dietary fiber, potassium, and vitamin C.
Considerations: Juices may be partially fruit juice, and only the proportion that is 100% fruit juice counts (e.g., 1 cup of juice that is 50% juice counts as ½ cup of fruit juice). The remainder of the product may contain added sugars. Sweetened juice products with minimal juice content, such as juice drinks, are considered to be sugar-sweetened beverages rather than fruit juice because they are primarily composed of water with added sugars (see the Added Sugars section below). The percent of juice in a beverage may be found on the package label, such as “contains 25% juice” or “100% fruit juice.” The amounts of fruit juice allowed in the USDA Food Patterns for young children align with the recommendation from the American Academy of Pediatrics that young children consume no more than 4 to 6 fluid ounces of 100% fruit juice per day. Fruits with small amounts of added sugars can be accommodated in the diet as long as calories from added sugars do not exceed 10 percent per day and total calorie intake remains within limits.