Dietary guidelines

Guidelines developed every 5 years by USDA and the Department of Health and Human Services, emphasizing variety, balance, and moderation in the total diet without making recommendations regarding specific foods to include or exclude. The Dietary Guidelines for Americans provides recommendations based on gender, age, and level of physical activity.

Protein rich food

Dietary guidelines for Americans 2020-2025

The current dietary guidelines for Americans are available directly from the USDA website here

Some of the key recommendations

The dietary guidelines for Americans has the following 4 key recommendations

1. Follow a healthy dietary pattern at every life stage.
2. Customize and enjoy nutrient-dense food and beverage choices to reflect personal preferences, cultural traditions, and budgetary considerations.
3. Focus on meeting food group needs with nutrient-dense foods and beverages, and stay within calorie limits.
4. Limit foods and beverages higher in added sugars, saturated fat, and sodium, and limit alcoholic beverages

Principles

According to the USDA's dietary recommendations for Americans 2020-2025, the core elements that make up a healthy dietary pattern include:

Dieatary guidelines infographic

• Vegetables of all types—dark-green vegetables; red and orange vegetables; beans, peas, and lentils; starchy vegetables; and other vegetables
• Fruits, especially whole fruit
• Grains, at least half of which are whole grain
• Dairy, including fat-free or low-fat milk, yogurt, and cheese, and/or lactose-free versions and fortified soy beverages and yogurt as alternatives.
• Protein foods, including lean meats, poultry, and eggs; seafood; beans, peas, and lentils; and nuts, seeds, and soy products
• Oils, including vegetable oils and oils in food, such as seafood and nuts Limit foods and beverages higher in added sugars, saturated fat, and sodium, and limit alcoholic beverages.

Dietary guidelines for Americans 2020-2025 The 4 Guidelines

Dietary pattern

At every life stage, meeting food group recommendations—even with nutrient-dense choices—requires most of a person’s daily calorie needs and sodium limits. A healthy dietary pattern doesn’t have much room for extra added sugars, saturated fat, or sodium—or for alcoholic beverages. A small amount of added sugars, saturated fat, or sodium can be added to nutrient-dense foods and beverages to help meet food group recommendations, but foods and beverages high in these components should be limited.

Limits

Limits are:

• Added sugars—Less than 10 percent of calories per day starting at age 2. Avoid foods and beverages with added sugars for those younger than age 2.
• Saturated fat—Less than 10 percent of calories per day starting at age 2.
• Sodium—Less than 2,300 milligrams per day—and even less for children younger than age 14.
• Alcoholic beverages—Adults of legal drinking age can choose not to drink or to drink in moderation by limiting intake to 2 drinks or less in a day for men and 1 drink or less in a day for women, when alcohol is consumed. Drinking less is better for health than drinking more.

There are some adults who should not drink alcohol, such as women who are pregnant.

Dietary guidelines - Food groups

Dark-green vegetables: All fresh, frozen, and canned dark-green leafy vegetables and broccoli, cooked or raw: for example, amaranth leaves, basil, beet greens, bitter melon leaves, bok choy, broccoli, chamnamul, chrysanthemum leaves, chard, cilantro, collards, cress, dandelion greens, kale, lambsquarters, mustard greens, poke greens, romaine lettuce, spinach, nettles, taro leaves, turnip greens, and watercress.

Red and orange vegetables: All fresh, frozen, and canned red and orange vegetables or juice, cooked or raw: for example, calabaza, carrots, red chili peppers, red or orange bell peppers, pimento/pimiento, sweet potatoes, tomatoes, 100% tomato juice, and winter squash such as acorn, butternut, kabocha, and pumpkin.

Beans, Peas, Lentils: All cooked from dry or canned beans, peas, chickpeas, and lentils: for example, black beans, black-eyed peas, bayo beans, brown beans, chickpeas, garbanzo beans, cowpeas, edamame, fava beans, kidney beans, lentils, lima beans, mung beans, navy beans, pigeon peas, pink beans, pinto beans, split peas, soybeans, and white beans. Does not include green beans or green peas.

Starchy vegetables: All fresh, frozen, and canned starchy vegetables: for example, breadfruit, burdock root, cassava, corn, jicama, lotus root, lima beans, immature or raw, (not dried) peas, e.g., cowpeas, black-eyed peas, green peas, pigeon peas, plantains, white potatoes, salsify, tapioca, taro root, dasheen or yautia, water chestnuts, yam, and yucca.

Dieatary guidelines 2020-2025 figure 1

Other Vegetables

All other fresh, frozen, and canned vegetables, cooked or raw: for example, artichoke, asparagus, avocado, bamboo shoots, bean sprouts, beets, bitter melon, bitter gourd, balsam pear, broccoflower, Brussels sprouts, cabbage, green, red, napa, savoy, cactus pads, or nopales, cauliflower, celeriac, celery, chayote, mirliton, chives, cucumber, eggplant, fennel bulb, garlic, ginger root, green beans, iceberg lettuce, kohlrabi, leeks, luffa, Chinese okra, mushrooms, okra, onions, peppers, chili and bell types that are not red or orange in color, radicchio, sprouted beans, e.g. sprouted mung beans, radish, rutabaga, seaweed, snow peas, summer squash, tomatillos, turnips, and winter melons.

Fruits

All fresh, frozen, canned, and dried fruits and 100% fruit juices: for example, apples, apricots, Asian pears, bananas, berries, e.g., blackberries, blueberries, cranberries, currants, dewberries, huckleberries, kiwifruit, loganberries, mulberries, raspberries, and [[strawberries); citrus fruit e.g., calamondin, grapefruit, kumquats, lemons, limes, mandarin oranges, pomelos, tangerines, and tangelos); cherries, dates, figs, grapes, guava, jackfruit, lychee, mangoes, melons, e.g., cantaloupe, casaba, honeydew, and watermelon); nectarines, papaya, passion fruit, peaches, pears, persimmons]], pineapple, plums, pomegranates, prunes, raisins, rhubarb, sapote, soursop, starfruit, and tamarind.

Dieatary guidelines 2020-2025 figure 2

Grains

Whole grains: All whole-grain products and whole grains used as ingredients: for example, amaranth, barley, not pearled, brown rice, buckwheat, bulgur, millet, oats, popcorn, quinoa, dark rye, triticale, whole-grain cornmeal, whole-wheat bread, whole-wheat chapati, whole-grain cereals and crackers, and wild rice.

Refined grains:All refined-grain products and refined grains used as ingredients: for example, white breads, refined-grain cereals and crackers, corn grits, cream of rice, cream of wheat, barley, pearled, masa, pasta, and white rice. Refined-grain choices should be enriched.

Dairy

All fluid, dry, or evaporated milk, including lactose-free and lactose-reduced products and fortified soy beverages, soy milk, buttermilk, yogurt, kefir, frozen yogurt, dairy desserts, and cheeses, e.g., brie, camembert, cheddar, cottage cheese, colby, edam, feta, fontina, goat, gouda, gruyere, limburger, Mexican cheeses [queso anejo]], queso asadero, queso chihuahua], monterey, mozzarella, muenster, parmesan, provolone, ricotta cheese, and Swiss cheese. Most choices should be fat-free or low-fat. Cream]], sour cream, and cream cheese are not included due to their low calcium content.

Protein Foods

Meats, Poultry, Eggs.

Meats

Meats include beef, goat, lamb, pork, and game meat, e.g., bear, bison, deer, elk, moose, opossum, rabbit, raccoon, squirrel.

Poultry

Poultry includes chicken, Cornish hens, dove, duck, game birds, e.g., ostrich, pheasant, and quail, goose, and turkey. Organ meats include brain, chitterlings, giblets, gizzard, heart, kidney, liver, stomach, sweetbreads, tongue, and tripe.

Eggs

Eggs include chicken eggs and other birds’ eggs.

Meats and poultry should be lean or low-fat.

Seafood

Seafood: Seafood examples that are lower in methylmercury include:anchovy, black sea bass, catfish, clams, cod, crab, crawfish, flounder, haddock, hake, herring, lobster, mackerel, mullet, oyster, perch, pollock, salmon, sardine, scallop, shrimp, sole, squid, tilapia, freshwater trout, light tuna, and whiting.

Nuts

Nuts, Seeds, Soy Products:Nuts and seeds include all nuts, tree nuts and peanuts, nut butters, seeds, e.g., chia, flax, pumpkin, sesame, and sunflower, and seed butters, e.g., sesame or tahini and sunflower. Soy includes tofu, tempeh, and products made from soy flour, soy protein isolate, and soy concentrate.

Nuts should be unsalted. Beans, Peas, Lentils:Can be considered part of the protein foods group as well as the vegetable group, but should be counted in one group only.

Food group amounts shown in cup equivalents, (cup eq) or ounce equivalents, ounce eq. Oils are shown in grams. Quantity equivalents for each food group are: Vegetables, Fruits, (1 cup eq):1 cup raw or cooked vegetable or fruit; 1 cup vegetable or fruit juice; 2 cups leafy salad greens; ½ cup dried fruit or vegetable.

Grains, 1 ounce eq:½ cup cooked rice, pasta, or cereal; 1 ounce dry pasta or rice; 1 medium, 1 ounce slice bread, tortilla, or flatbread; 1 ounce of ready-to-eat cereal, about 1 cup of flaked cereal.

Dairy, 1 cup eq):1 cup milk]], yogurt, or fortified soymilk; 1½ ounces natural cheese such as cheddar cheese or 2 ounces of processed cheese.

Protein Foods, 1 ounce eq:1 ounce lean meats, poultry, or seafood; 1 egg; ¼ cup cooked beans or tofu; 1 tbsp nut or seed butter; ½ ounce nuts or seeds.

Glossary of terms - dietary guidelines

Dietary Guidelines for Americans - Glossary of Terms  

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Glossary of terms - dietary guidelines

Dietary Guidelines for Americans - Glossary of Terms  

A

• Acculturation—The process by  which individuals who immigrate into  a new country adopt the attitudes,  values, customs, beliefs, and behaviors  of the new culture. Acculturation  is the gradual exchange between  the original attitudes and behaviors  associated with the originating country  and those of the host culture. 

• Added refined starch—The starch  constituent (see Carbohydrates) of a grain,  such as corn, or of a vegetable, such as  potato, used as an ingredient in another  food. Starches have been refined to remove  other components of the food, such as fiber,  protein, and minerals. Refined starches  can be added to foods as a thickener, a  stabilizer, a bulking agent, or an anti-caking  agent. While refined starches are made  from grains or vegetables, they contain  little or none of the many other components  of these foods that together create a  nutrient-dense food. They are a source of  calories but few or no other nutrients. 

• Added sugars—Syrups and other caloric  sweeteners used as a sweetener in other  food products. Naturally occurring sugars  such as those in fruit or milk are not added  sugars. Specific examples of added sugars  that can be listed as an ingredient include  brown sugar, corn sweetener, corn syrup,  dextrose, fructose, glucose, high-fructose  corn syrup, honey, invert sugar, lactose,  malt syrup, maltose, molasses, raw  sugar, sucrose, trehalose, and turbinado  sugar. (See Carbohydrates, Sugars.) 

B 

• Body Mass Index (BMI)—A measure of  weight in kilograms (kg) relative to height  in meters squared (m 2 ). BMI is considered  a reasonably reliable indicator of total body  fat, which is related to the risk of disease  and death. BMI status categories include  underweight, healthy weight, overweight,  and obese ( Table A6-1). Overweight and  obese describe ranges of weight that are  greater than what is considered healthy  Table A6-1. 

• Underweight  Less than the 5 th  percentile  Less than 18.5 kg/m 2 

• Normal weight  5 th  percentile to less  than the 85 th  percentile  18.5 to 24.9 kg/m 2 

• Overweight  85 th  to less than the 95 th  percentile  25.0 to 29.9 kg/m 2 

• Obese  Equal to or greater than  the 95 th  percentile  30.0 kg/m 2  & greater    for a given height, while underweight  describes a weight that is lower than  what is considered healthy. Because  children and adolescents are growing,  their BMI is plotted on growth charts for  sex and age. The percentile indicates  the relative position of the child’s BMI  among children of the same sex and age.

C

• Calorie balance—The balance between  calories consumed through eating and  drinking and calories expended through  physical activity and metabolic processes.

• Calorie—A unit commonly used

to measure energy content of foods and beverages as well as energy use (expenditure) by the body. A kilocalorie is equal to the amount of energy (heat) required to raise the temperature of 1 kilogram of water 1 degree centigrade. Energy is required to sustain the body’s various functions, including metabolic processes and physical activity. Carbohydrate, fat, protein, and alcohol provide all of the energy supplied by foods and beverages. If not specified explicitly, references to “calories” refer to “kilocalories.”

• Carbohydrates—One of the  macronutrients and a source of energy.  They include sugars, starches, and fiber:

• Fiber—Total fiber is the sum of

dietary fiber and functional fiber. Dietary fiber consists of nondigestible carbohydrates and lignin that are intrinsic and intact in plants (i.e., the fiber naturally occurring in foods). Functional fiber consists of isolated, nondigestible carbohydrates that have beneficial physiological effects in humans. Functional fibers are either extracted from natural sources or are synthetically manufactured and added to foods, beverages, and supplements.

• Starches—Many glucose units

linked together into long chains. Examples of foods containing starch include vegetables (e.g., potatoes, carrots), grains (e.g., brown rice, oats, wheat, barley, corn), and legumes (beans and peas; e.g., kidney beans, garbanzo beans, lentils, split peas).

• Sugars—Composed of one unit (a

monosaccharide, such as glucose or fructose) or two joined units (a disaccharide, such as lactose or sucrose). Sugars include those occurring naturally in foods and beverages, those added to foods and beverages during processing and preparation, and those consumed separately. (See Added Sugars.)

• Cardiovascular disease (CVD)—  Heart disease as well as diseases  of the blood vessel system (arteries,  capillaries, veins) that can lead to heart  attack, chest pain (angina), or stroke. 

• Cholesterol—A natural sterol present  in all animal tissues. Free cholesterol  is a component of cell membranes and  serves as a precursor for steroid hormones  (estrogen, testosterone, aldosterone),  and for bile acids. Humans are able  to synthesize sufficient cholesterol to  meet biologic requirements, and  there is no evidence for a dietary  requirement for cholesterol.

• Blood cholesterol—Cholesterol

that travels in the serum of the blood as distinct particles containing both lipids and proteins (lipoproteins). Also referred to as serum cholesterol. Two kinds of lipoproteins are:

• High-density lipoprotein (HDL-cholesterol)—Blood cholesterol often called “good” cholesterol; carries cholesterol from tissues to the liver, which removes it from the body.

• Low-density lipoprotein (LDL­ Cholesterol)—Blood cholesterol often called “bad” cholesterol; carries cholesterol to arteries and tissues. A high LDL-cholesterol level in the blood leads to a buildup of cholesterol in arteries.

• Dietary cholesterol—

Cholesterol found in foods of animal origin, including meat, seafood, poultry, eggs, and dairy products. Plant foods, such as grains, vegetables, fruits, and oils do not contain dietary cholesterol.

• Cup-equivalent (cup-eq or c-eq)—  The amount of a food or beverage product  that is considered equal to 1 cup from the  vegetables, fruits, or dairy food groups. A  cup-eq for some foods or beverages may  differ from a measured cup in volume  because the foods have been concentrated  (such as raisins or tomato paste), the  foods are airy in their raw form and do  not compress well into a cup (such as  salad greens), or the foods are measured  in a different form (such as cheese).

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D

• DASH eating plan—The DASH (Dietary  Approaches to Stop Hypertension) Eating  Plan exemplifies healthy eating. It was  designed to increase intake of foods  expected to lower blood pressure while  being heart healthy and meeting Institute of  Medicine (IOM) nutrient recommendations.  It is available at specific calorie levels.  It was adapted from the dietary pattern  developed for the Dietary Approaches  to Stop Hypertension (DASH) research  trials. In the trials, the DASH dietary  pattern lowered blood pressure and LDL- cholesterol levels, resulting in reduced  cardiovascular disease risk. The DASH  Eating Plan is low in saturated fats and rich  in potassium, calcium, and magnesium, as  well as fiber and protein. It also is lower  in sodium than the typical American diet,  2015-2020 Dietary Guidelines for Americans — Page 90    and includes menus with two levels of  sodium, 2,300 and 1,500 mg per day. It  meets the Dietary Reference Intakes for  all essential nutrients and stays within  limits for overconsumed nutrients, while  allowing adaptable food choices based on  food preferences, cost, and availability. 

• Diabetes—A disorder of metabolism—  the way the body uses digested food  (specifically carbohydrate) for growth and  energy. In diabetes, the pancreas either  produces little or no insulin (a hormone  that helps glucose, the body’s main source  of fuel, get into cells), or the cells do not  respond appropriately to the insulin that is  produced, which causes too much glucose  to be released in the blood. The three main  types of diabetes are type 1, type 2, and  gestational diabetes. If not controlled,  diabetes can lead to serious complications. 

• Dietary reference intakes (DRIs)—A  set of nutrient-based reference values  that are quantitative estimates of nutrient  intakes to be used for planning and  assessing diets for healthy people. DRIs  expand on the periodic reports called  Recommended Dietary Allowances  (RDAs), which were first published by  the Institute of Medicine in 1941.

• Distribution ranges (AMDR)— Range of intake for a particular energy source (i.e., carbohydrate, fat, and protein) that is associated with reduced risk of chronic disease while providing intakes of essential nutrients. If an individual’s intake is outside of the AMDR, there is a potential of increasing the risk of chronic diseases and/or insufficient intakes of essential nutrients.

• Adequate intakes (AI)

—A recommended average daily nutrient intake level based on observed or experimentally determined approximations or estimates of mean  nutrient intake by a group (or groups)  of apparently healthy people. An AI is  used when the Recommended Dietary  Allowance cannot be determined.

• (EAR)—The average daily nutrient intake level estimated to meet the requirement of half the healthy individuals in a particular life stage and sex group.

Recommended Dietary Allowances

• (RDA)—The average daily dietary intake level that is sufficient to meet the nutrient requirement of nearly all (97 to 98%) healthy individuals in a particular life stage and sex group.

Tolerable Upper Intake Levels

• (UL)—The highest average daily nutrient intake level likely to pose no risk of adverse health effects for nearly all individuals in a particular life stage and sex group. As intake increases above the UL, the potential risk of adverse health effects increases.

E

• Eating behaviors—Individual behaviors  that affect food and beverage choices  and intake patterns, such as what, where,  when, why, and how much people eat. 

• Eating pattern Also called “dietary  pattern”—The combination of foods and  beverages that constitute an individual’s  complete dietary intake over time. This  may be a description of a customary way  of eating or a description of a combination  of foods recommended for consumption.  Specific examples include USDA Food  Patterns and the Dietary Approaches to  Stop Hypertension (DASH) Eating Plan. (See  USDA Food Patterns and DASH Eating Plan.) 

• Energy drink—A beverage that contains  caffeine as an ingredient, along with  other ingredients, such as taurine, herbal  supplements, vitamins, and added sugars.  It is usually marketed as a product that  can improve perceived energy, stamina,  athletic performance, or concentration. 

• Enrichment—The addition of specific  nutrients (i.e., iron, thiamin, riboflavin, and  niacin) to refined grain products in order to  replace losses of the nutrients that occur  during processing. Enrichment of refined  grains is not mandatory; however, those  that are labeled as enriched (e.g., enriched  flour) must meet the standard of identity  for enrichment set by the FDA. When  cereal grains are labeled as enriched, it is  mandatory that they be fortified with folic  acid. (The addition of specific nutrients  to whole-grain products is referred to  as fortification; see Fortification.) 

• Essential nutrient—A vitamin, mineral,  fatty acid, or amino acid required for normal  body functioning that either cannot be  synthesized by the body at all, or cannot be  synthesized in amounts adequate for good  health, and thus must be obtained from a  dietary source. Other food components,  such as dietary fiber, while not essential,  also are considered to be nutrients. 

• Existing report—An existing systematic  review, meta-analysis, or report by a  Federal agency or leading scientific  organization examined by the 2015  Dietary Guidelines Advisory Committee  in its review of the scientific evidence.  A systematic process was used by  the Advisory Committee to assess the  quality and comprehensiveness of the  review for addressing the question  of interest. (See Nutrition Evidence  Library (NEL) systematic review.)

F

• Fats—One of the macronutrients and a  source of energy. (See Solid Fats and Oils.)  Page 91 — 2015-2020 Dietary Guidelines for Americans   

Monounsaturated Fatty Acids

• (MUFAs)—Fatty acids that have one double bond and are usually liquid at room temperature. Plant sources rich in MUFAs include vegetable oils (e.g., canola, olive, high oleic safflower and sunflower), as well as nuts.

Polyunsaturated Fatty Acids

• (PUFAs)—Fatty acids that have two or more double bonds and are usually liquid at room temperature. Primary sources are vegetable oils and some nuts and seeds. PUFAs provide essential fats such as n-3 and n-6 fatty acids.

• n-3 PUFAs—A carboxylic acid with an

18-carbon chain and three cis double bonds, Alpha-linolenic acid (ALA) is an n-3 fatty acid that is essential in the diet because it cannot be synthesized by humans. Primary sources include soybean oil, canola oil, walnuts, and flaxseed. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are very long chain n-3 fatty acids that are contained in fish and shellfish. Also called omega-3 fatty acids.

• n-6 PUFAs—A carboxylic acid with

an 18-carbon chain and two cis double bonds, Linoleic acid (LA), one of the n-6 fatty acids, is essential in the diet because it cannot be synthesized by humans. Primary sources are nuts and liquid vegetable oils, including soybean oil, corn oil, and safflower oil. Also called omega-6 fatty acids.

• Saturated fatty acids—Fatty acids

that have no double bonds. Fats high in saturated fatty acids are usually solid at room temperature. Major sources include animal products such as meats and dairy products, and tropical oils such as coconut or palm oils.

• Trans-fatty acids—Unsaturated fatty

acids that are structurally different from the unsaturated fatty acids that occur naturally in plant foods. Sources of trans fatty acids include partially hydrogenated vegetable oils used in processed foods such as desserts, microwave popcorn, frozen pizza, some margarines, and coffee creamer. Trans fatty acids also are present naturally in foods that come from ruminant animals (e.g., cattle and sheep), such as dairy products, beef, and lamb.

• Food access—Ability to obtain and  maintain levels of sufficient amounts of  healthy, safe, and affordable food for  all family members in various settings  including where they live, learn, work  and play. Food access is often measured  by distance to a store or the number  of stores in an area; individual-level  resources such as family income or  vehicle availability; and neighborhood- level indicators of resources, such as  average income of the neighborhood and  the availability of public transportation. 

• Food categories—A method of grouping  similar foods in their as-consumed forms,  for descriptive purposes. The USDA’s  Agricultural Research Service (ARS) has  created 150 mutually exclusive food  categories to account for each food or  beverage item reported in What We Eat in  America (WWEIA), the food intake survey  component of the National Health and  Nutrition Examination Survey (for more  information, visit: http://seprl.ars.usda.gov/  Services/docs.htm?docid=23429). Examples  of WWEIA Food Categories include soups,  nachos, and yeast breads. In contrast to  food groups, items are not disaggregated  into their component parts for assignment  to food categories. For example, all  pizzas are put into the pizza category. 

• Food hub—A community space anchored  by a food store with adjacent social and  financial services where businesses or  organizations can actively manage the  aggregation, distribution, and marketing  of source-identified food products  to strengthen their ability to satisfy  wholesale, retail, and institutional demand. 

• Food groups—A method of grouping  similar foods for descriptive and guidance  purposes. Food groups in the USDA  Food Patterns are defined as vegetables,  fruits, grains, dairy, and protein foods.  Some of these groups are divided into  subgroups, such as dark-green vegetables  or whole grains, which may have intake  goals or limits. Foods are grouped within  food groups based on their similarity  in nutritional composition and other  dietary benefits. For assignment to food  groups, mixed dishes are disaggregated  into their major component parts. 

• Food pattern modeling—The process  of developing and adjusting daily intake  amounts from food categories or groups  to meet specific criteria, such as meeting  nutrient intake goals, limiting nutrients  or other food components, or varying  proportions or amounts of specific food  categories or groups. This methodology  includes using current food consumption  data to determine the mix and proportions  of foods to include in each group, using  current food composition data to select  a nutrient-dense representative for each  food, calculating nutrient profiles for each  food group using these nutrient-dense  representative foods, and modeling various  combinations of foods and amounts to meet  specific criteria. (See USDA Food Patterns.) 

• Food & nutrition policies—Regulations,  laws, policymaking actions, or formal  or informal rules established by formal  organizations or government units.  Food and nutrition policies are those  that influence food settings and/or  2015-2020 Dietary Guidelines for Americans — Page 92    eating behaviors to improve food and/  or nutrition choices, and potentially,  health outcomes (e.g., body weight). 

• Fortification—As defined by the U.S.  Food and Drug Administration (FDA),  the deliberate addition of one or more  essential nutrients to a food, whether or  not it is normally contained in the food.  Fortification may be used to prevent or  correct a demonstrated deficiency in  the population or specific population  groups; restore naturally occurring  nutrients lost during processing, storage,  or handling; or to add a nutrient to a  food at the level found in a comparable  traditional food. When cereal grains  are labeled as enriched, it is mandatory  that they be fortified with folic acid.

H

• Health—A state of complete physical,  mental, and social well-being and not  merely the absence of disease or infirmity. 

• Healthy eating index (HEI)—A measure  of diet quality that assesses adherence to  the Dietary Guidelines. The HEI is used to  monitor diet quality in the United States  and to examine relationships between diet  and health-related outcomes. The HEI is a  scoring metric that can be applied to any  defined set of foods, such as previously  collected dietary data, a defined menu, or  a market basket. Thus, the HEI can be used  to assess the quality of food assistance  packages, menus, and the U.S. food supply. 

• High-intensity sweeteners—Ingredients  commonly used as sugar substitutes  or sugar alternatives to sweeten and  enhance the flavor of foods and beverages.  People may choose these sweeteners in  place of sugar for a number of reasons,  including that they contribute few or no  calories to the diet. Because high-intensity  sweeteners are many times sweeter than  table sugar (sucrose), smaller amounts  of high-intensity sweeteners are needed  to achieve the same level of sweetness  as sugar in food and beverages. (Other  terms commonly used to refer to sugar  substitutes or alternatives include non­ caloric, low-calorie, no-calorie, and  artificial sweeteners, which may have  different definitions and applications.  A high-intensity sweetener may or  may not be non-caloric, low-calorie,  no-calorie, or artificial sweeteners.) 

• Household food insecurity—  Circumstances in which the availability  of nutritionally adequate and safe  food, or the ability to acquire  acceptable foods in socially acceptable  ways, is limited or uncertain. 

• Hypertension—A condition, also known  as high blood pressure, in which blood  pressure remains elevated over time.  Hypertension makes the heart work too  hard, and the high force of the blood  flow can harm arteries and organs, such  as the heart, kidneys, brain, and eyes.  Uncontrolled hypertension can lead to  heart attacks, heart failure, kidney disease,  stroke, and blindness. Prehypertension  is defined as blood pressure that is  higher than normal but not high enough  to be defined as hypertension.

M

• Macronutrient—A dietary component that  provides energy. Macronutrients include  protein, fats, carbohydrates, and alcohol. 

• Meats & Poultry—Foods that come from  the flesh of land animals and birds. In the  USDA Food Patterns, organs (such as liver)  are also considered to be meat or poultry.

• Meat (also known as “red

meat”)—All forms of beef, pork, lamb, veal, goat, and non-bird game (e.g., venison, bison, elk).

• Poultry—All forms of chicken,

turkey, duck, geese, guineas, and game birds (e.g., quail, pheasant).

• Lean meat & Lean poultry Any meat or poultry that contains less than 10 g of fat, 4.5 g or less of saturated fats, and less than 95 mg of cholesterol per 100 g and per labeled serving size, based on USDA definitions for food label use. Examples include 95% lean cooked ground beef, beef top round steak or roast, beef tenderloin, pork top loin chop or roast, pork tenderloin, ham or turkey deli slices, skinless chicken breast, and skinless turkey breast.

Processed Meat & Processed

• Poultry—All meat or poultry products preserved by smoking, curing, salting, and/or the addition of chemical preservatives. Processed meats and poultry include all types of meat or poultry sausages (bologna, frankfurters, luncheon meats and loaves, sandwich spreads, viennas, chorizos, kielbasa, pepperoni, salami, and summer sausages), bacon, smoked or cured ham or pork shoulder, corned beef, pastrami, pig’s feet, beef jerky, marinated chicken breasts, and smoked turkey products.

• Mixed dishes—Savory food items eaten  as a single entity that include foods from  more than one food group. These foods  often are mixtures of grains, protein foods,  vegetables, and/or dairy. Examples of mixed  dishes include burgers, sandwiches, tacos,  burritos, pizzas, macaroni and cheese, stir- fries, spaghetti and meatballs, casseroles,  soups, egg rolls, and Caesar salad. 

• Moderate alcohol consumption—Up  to one drink per day for women and  up to two drinks per day for men. One  drink-equivalent is described using  the reference beverages of 12 fl oz of  Page 93 — 2015-2020 Dietary Guidelines for Americans    regular beer (5% alcohol), 5 fl oz of  wine (12% alcohol), or 1.5 fl oz of 80  proof (40%) distilled spirits. One drink- equivalent is described as containing  14 g (0.6 fl oz) of pure alcohol.

• Multi-component intervention—  Interventions that use a combination  of strategies to promote behavior  change. These strategies can be  employed across or within different  settings or levels of influence. 

• Multi-level intervention—  Interventions are those that target  change at the individual level as  well as additional levels, such as in  the community (e.g., public health  campaigns), schools (e.g., education), and  food service (e.g., menu modification).

N

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

• Nutrient of concern—Nutrients that  are over-consumed or under-consumed  and current intakes may pose a  substantial public health concern. Data  on nutrient intake, corroborated with  biochemical markers of nutritional  status where available, and association  with health outcomes are all used to  establish a nutrient as a nutrient of  concern. Under-consumed nutrients, or  “shortfall nutrients,” are those with a  high prevalence of inadequate intake  either across the U.S. population or in  specific groups, relative to IOM-based  standards, such as the Estimated Average  Requirement (EAR) or the Adequate Intake  (AI). Overconsumed nutrients are those  with a high prevalence of excess intake  either across the population or in specific  groups, related to IOM-based standards  such as the Tolerable Upper Intake Level  (UL) or other expert group standards. 

• Nutrition evidence library (NEL)  systematic review—A process that  uses state-of-the-art methods to identify,  evaluate, and synthesize research to  provide timely answers to important food  and nutrition-related questions to inform  U.S. Federal nutrition policies, programs,  and recommendations. This rigorous,  protocol-driven methodology is designed  to minimize bias, maximize transparency,  and ensure the use of all available relevant  and high-quality research. The NEL is  a program within the USDA Center for  Nutrition Policy and Promotion.

O

• Oils—Fats that are liquid at room  temperature. Oils come from many different  plants and some fish. Some common  oils include canola, corn, olive, peanut,  safflower, soybean, and sunflower oils.  A number of foods are naturally high in  oils such as nuts, olives, some fish, and  avocados. Foods that are mainly made  up of oil include mayonnaise, certain  salad dressings, and soft (tub or squeeze)  margarine with no trans fats. Oils are high  in monounsaturated or polyunsaturated  fats, and lower in saturated fats than solid  fats. A few plant oils, termed tropical  oils, including coconut oil, palm oil and  palm kernel oil, are high in saturated  fats and for nutritional purposes should  be considered as solid fats. Partially  hydrogenated oils that contain trans fats  should also be considered as solid fats  for nutritional purposes. (See Fats.) 

• Ounce-equivalent (oz-eq)—The amount  of a food product that is considered equal  to 1 ounce from the grain or protein foods  food group. An oz-eq for some foods  may be less than a measured ounce  in weight if the food is concentrated  or low in water content (nuts, peanut  butter, dried meats, flour) or more than  a measured ounce in weight if the food  contains a large amount of water (tofu,  cooked beans, cooked rice or pasta). 

P

• Physical activity—Any bodily  movement produced by the contraction  of skeletal muscle that increases  energy expenditure above a basal  level; generally refers to the subset of  physical activity that enhances health. 

• Point-of-Purchase—A place where  sales are made. Various intervention  strategies have been proposed to affect  individuals’ purchasing decisions at the  point of purchase, such as board or menu  labeling with various amounts of nutrition  information or shelf tags in grocery stores. 

• Portion size—The amount of a food  served or consumed in one eating 

Drink-equivalents are not intended to serve as a standard drink definition for regulatory purposes.  2015-2020 Dietary Guidelines for Americans — Page 94    occasion. A portion is not a standardized  amount, and the amount considered to  be a portion is subjective and varies.

• Prehypertension—See Hypertension.

• Protein—One of the macronutrients;  a major functional and structural  component of every animal cell.  Proteins are composed of amino  acids, nine of which are indispensable  (essential), meaning they cannot be  synthesized by humans and therefore  must be obtained from the diet. The  quality of dietary protein is determined  by its amino acid profile relative to  human requirements as determined by  the body’s requirements for growth,  maintenance, and repair. Protein  quality is determined by two factors:  digestibility and amino acid composition.

R

• Refined grains—Grains and grain  products with the bran and germ  removed; any grain product that is not  a whole-grain product. Many refined  grains are low in fiber but enriched  with thiamin, riboflavin, niacin, and  iron, and fortified with folic acid.

S

• Screen time—Time spent in front  of a computer, television, video  or computer game system, smart  phone or tablet, or related device. 

• Seafood—Marine animals that  live in the sea and in freshwater  lakes and rivers. Seafood includes  fish (e.g., salmon, tuna, trout,  and tilapia) and shellfish (e.g.,  shrimp, crab, and oysters). 

• Sedentary behavior—Any waking  activity predominantly done while in a  sitting or reclining posture. A behavior  that expends energy at or minimally  above a person’s resting level (between  1.0 and 1.5 metabolic equivalents)  is considered sedentary behavior. 

• Serving size—A standardized amount  of a food, such as a cup or an ounce,  used in providing information about a  food within a food group, such as in  dietary guidance. Serving size on the  Nutrition Facts label is determined  based on the Reference Amounts  Customarily Consumed (RACC) for foods  that have similar dietary usage, product  characteristics, and customarily consumed  amounts for consumers to make “like  product” comparisons. (See Portion Size.) 

• Shortfall nutrient—  See Nutrient of Concern. 

• Social-ecological model—  A framework developed to illustrate  how sectors, settings, social and  cultural norms, and individual factors  converge to influence individual food  and physical activity choices. 

• Solid fats—Fats that are usually not  liquid at room temperature. Solid fats are  found in animal foods, except for seafood,  and can be made from vegetable oils  through hydrogenation. Some tropical oil  plants, such as coconut and palm, are  considered as solid fats due to their fatty  acid composition. The fat component of  milk and cream (butter) is solid at room  temperature. Solid fats contain more  saturated fats and/or trans fats than liquid  oils (e.g., soybean, canola, and corn oils),  with lower amounts of monounsaturated  or polyunsaturated fatty acids. Common  fats considered to be solid fats include:  butter, beef fat (tallow), chicken fat, pork  fat (lard), shortening, coconut oil, palm oil  and palm kernel oil. Foods high in solid  fats include: full-fat (regular) cheeses,  creams, whole milk, ice cream, marbled  cuts of meats, regular ground beef, bacon,  sausages, poultry skin, and many baked  goods made with solid fats (such as  cookies, crackers, doughnuts, pastries, and  croissants). (See Fats and Nutrient Dense) 

• Sugar-sweetened beverages—  Liquids that are sweetened with various  forms of added sugars. These beverages  include, but are not limited to, soda  (regular, not sugar-free), fruitades,  sports drinks, energy drinks, sweetened  waters, and coffee and tea beverages  with added sugars. Also called calorically  sweetened beverages. (See Added  Sugars and Carbohydrates: Sugars.)

U

• USDA food patterns—A set of eating  patterns that exemplify healthy eating,  which all include recommended intakes  for the five food groups (vegetables,  fruits, grains, dairy, and protein foods)  and for subgroups within the vegetables,  grains, and protein foods groups. They  also recommend an allowance for  intake of oils. Patterns are provided  at 12 calorie levels from 1,000 to  3,200 calories to meet varied calorie  needs. The Healthy U.S.-Style Pattern  is the base USDA Food Pattern.

Healthy U.S.-Style Eating

• Pattern—A pattern that exemplifies healthy eating based on the types and proportions of foods Americans typically consume, but in nutrient- dense forms and appropriate amounts, designed to meet nutrient needs while not exceeding calorie requirements. It is substantially unchanged from the primary USDA Food Patterns of the 2010 Dietary Guidelines. This pattern is evaluated in comparison to meeting Dietary Reference Intakes for essential nutrients and staying within limits set by the IOM or Dietary Guidelines for overconsumed food components. It aligns closely with the Dietary Approaches to Stop Hypertension Page 95 — 2015-2020 Dietary Guidelines for Americans    (DASH) Eating Plan, a guide for healthy  eating based on the DASH diet which  was tested in clinical trials. (See  Nutrient Dense and DASH Eating Plan.)

Healthy Mediterranean-Style

• Eating pattern—A pattern that exemplifies healthy eating, designed by modifying the Healthy U.S.-Style Pattern to more closely reflect eating patterns that have been associated with positive health outcomes in studies of Mediterranean-Style diets. This pattern is evaluated based on its similarity to food group intakes of groups with positive health outcomes in these studies rather than on meeting specified nutrient standards. It differs from the Healthy U.S.-Style Pattern in that it includes more fruits and seafood and less dairy.

Healthy Vegetarian Eating

• Pattern—A pattern that exemplifies healthy eating, designed by modifying the Healthy U.S.-Style Pattern to more closely reflect eating patterns reported by self-identified vegetarians. This pattern is evaluated in comparison to meeting Dietary Reference Intakes for essential nutrients and staying within limits set by the IOM or Dietary Guidelines for overconsumed food components. It differs from the Healthy U.S.-Style Pattern in that it includes more legumes, soy products, nuts and seeds, and whole grains, and no meat, poultry, or seafood.

V

• Variety—A diverse assortment of foods  and beverages across and within all  food groups and subgroups selected to  fulfill the recommended amounts without  exceeding the limits for calories and  other dietary components. For example,  in the vegetables food group, selecting a  variety of foods could be accomplished  over the course of a week by choosing  from all subgroups, including dark green,  red and orange, legumes (beans and  peas), starchy, and other vegetables.

W

• Whole fruits—All fresh, frozen, canned,  and dried fruit but not fruit juice.

• Whole grains—Grains and grain  products made from the entire grain seed,  usually called the kernel, which consists  of the bran, germ, and endosperm. If the  kernel has been cracked, crushed, or  flaked, it must retain the same relative  proportions of bran, germ, and endosperm  as the original grain in order to be called  whole grain. Many, but not all, whole  grains are also sources of dietary fiber.   

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