Dietary Guidelines
and Food Guides
Today, government authorities are as concerned about overnutrition as they once were about undernutrition.
Research confirms that dietary excesses, especially of energy, sodium, certain fats, and alcohol, contribute
to many chronic diseases, including heart disease, cancer, stroke, diabetes, and liver disease.10 Only two
common lifestyle habits have more influence on health than a person’s choice of diet: smoking and
other tobacco use, and excessive drinking of alcohol. Note, however, that although diet is a powerful influence
on these diseases, they cannot be prevented by a healthy diet alone; genetics, physical activity, age, gender,
and other factors also play a role. Within the range set by genetic inheritance, however, disease development is
strongly influenced by the foods a person chooses to eat. Sound nutrition does not depend on the selection of
any one food. Instead, it depends on the overall eating pattern—the combination of many different foods and
beverages at numerous meals over days, months, and years.
So how can health care professionals help people select foods to create an eating pattern that supplies all the
needed nutrients in amounts consistent with good health? The principle is simple enough: encourage clients to
eat a variety of foods that supply all the nutrients the body needs. In practice, how do people do this? It helps
to keep in mind that a nutritious diet achieves six basic ideals.
Dietary Ideals
A nutritious diet has the following six characteristics:
• Adequacy
• Balance
• kCalorie (energy) control
• Nutrient density
• Moderation
• Variety
The first, adequacy, was already addressed in the earlier discussion on the DRI. An adequate diet has enough
energy and enough of every nutrient (as well as fiber) to meet the needs of healthy people.
Second is balance: the food choices do not overemphasize one nutrient or food type at the expense of another.
Balance in the diet helps to ensure adequacy. The essential minerals calcium and iron illustrate the importance
of dietary balance.
Meat is rich in iron but poor in calcium. Conversely, milk is rich in calcium but poor in iron. Use some meat
for iron; use some milk for calcium; and save some space for other foods, too, because a diet consisting of milk
and meat alone would not be adequate. For other nutrients, people need to consume other protein foods, whole
grains, vegetables, and fruit.
The third characteristic is kcalorie (energy) control: the foods provide the amount of energy needed to
maintain a healthy body weight—not more, not less. The key to kcalorie control is to select foods that deliver
the most nutrients for the least food energy.
This fourth characteristic is known as nutrient density. Nutrient density promotes adequacy and kcalorie
control. Consider foods containing calcium, for example. You can get about 300 milligrams of calcium from
either 11 2 ounces of cheddar cheese or 1 cup of fat-free milk, but the cheese delivers about twice as much food
energy (kcalories) as the milk. The fat-free milk, then, is twice as calcium dense as the cheddar cheese; it
offers the same amount of calcium for half the kcalories. Both foods are excellent choices for adequacy’s sake
alone, but to achieve adequacy while controlling kcalories, the fat-free milk is the better choice. (Alternatively,
a person could select a low-fat cheddar cheese providing kcalories comparable to fat-free milk.) Just as a
financially responsible person pays for rent, food, clothes, and tuition on a limited budget, healthy people
obtain iron, calcium, and all the other essential nutrients on a limited energy (kcalorie) allowance. Success
depends on getting many nutrients for each kcalorie “dollar.” For example, a can of cola and a handful of
grapes may both provide about the same number of kcalories, but grapes deliver many more nutrients. A
person who makes nutrient-dense choices, such as fruit instead of cola, can meet daily nutrient needs on a
lower energy budget. Such choices support good health.
Foods that are notably low in nutrient density—such as cakes, pies, candy, and colas— deliver empty
kcalories. The kcalories these foods provide are called “empty” because they deliver a lot of energy (from
added sugars, solid fats, or both) but little or no protein, vitamins, or minerals. The concept of nutrient density
is relatively simple when examining the contributions of one nutrient to a food or diet. With respect to calcium,
milk ranks high and meats rank low. With respect to iron, meats rank high and milk ranks low. But which food
is more nutritious? Answering that question is a more complex task because we need to consider several
nutrients—those that may harm health and those that may be beneficial. 12 Ranking foods based on their overall
nutrient composition is known as nutrient profiling. Researchers have yet to agree on an ideal way to rate
foods based on the nutrient profile, but when they do, nutrient profiling will be quite useful in helping
consumers identify nutritious foods and plan healthy diets.13
The fifth characteristic of a nutritious diet is moderation. Moderation contributes to adequacy, balance, and
kcalorie control. Foods rich in fat and sugar often provide enjoyment and energy but relatively few nutrients. In
addition, they promote weight gain when eaten in excess. A person who practices moderation eats such foods
only on occasion and regularly selects foods low in solid fats and added sugars, a practice that automatically
improves nutrient density. Returning to the example of cheddar cheese and fat-free milk, the milk not only
offers more calcium for less energy, but it contains far less fat than the cheese.
Finally, the sixth characteristic of a nutritious diet is variety: the foods chosen differ from one day to the next.
A diet may have all the virtues just described and still lack variety if a person eats the same foods day after day.
People should select foods from each of the food groups daily and vary their choices within each food group
from day to day, for a couple of reasons.
Nutrient Recommendations
Nutrient recommendations are used as standards to evaluate healthy people’s energy and nutrient intakes.
Nutrition experts use the recommendations to assess nutrient intakes and to guide people on amounts to
consume. Individuals can use them to decide how much of a nutrient they need to consume.
Dietary Reference Intakes
Defining the amounts of energy, nutrients, and other dietary components that best support health is a huge task.
Nutrition experts have produced a set of standards that define the amounts of energy, nutrients, other dietary
components, and physical activity that best support health.
These recommendations are called Dietary Reference Intakes (DRI) and reflect the collaborative
efforts of scientists in both the United States and Canada.* The inside front covers of this book
present the DRI values.
Setting Nutrient Recommendations: RDA and AI
One advantage of the DRI is that they apply to the diets of individuals. The DRI committee offers
two sets of values to be used as nutrient intake goals by individuals:
1. A set called the Recommended Dietary Allowances (RDA) and a set called
2. Adequate Intakes (AI). Based on solid experimental evidence and other reliable
observations, the RDA are the foundation of the DRI. The AI values are based on less extensive
scientific findings and rely more heavily on scientific judgment. The committee establishes an AI
value whenever scientific evidence is insufficient to generate an RDA. To see which nutrients
have an AI and which have an RDA, turn to the inside front cover. In the last several decades,
abundant new research has linked nutrients in the diet with the promotion of health and the
prevention of chronic diseases. An advantage of the DRI is that, where appropriate, they take
into account disease prevention as well as an adequate nutrient intake. For example, the RDA
for calcium is based on intakes thought to reduce the likelihood of osteoporosis-related
fractures later in life. To ensure that the vitamin and mineral recommendations meet the needs
of as many people as possible, the recommendations are set near the top end of the range of
the population’s estimated average requirements. Small amounts above the daily requirement
do no harm, whereas amounts below the requirement may lead to health problems. When
people’s intakes are consistently deficient, their nutrient stores decline, and over time this
decline leads to deficiency symptoms and poor health.
Dietary Reference Intakes
(DRI): a set of values for the dietary nutrient intakes of healthy people . These values are used
for planning and assessing diets.
Recommended Dietary Allowances (RDA): a set of values reflecting the average daily amounts
of nutrients considered adequate to meet the known nutrient needs of practically all healthy
people in a particular life stage and gender group; a goal for dietary intake by individuals.
Adequate Intakes (AI): a set of values that are used as guides for nutrient intakes when
scientific evidence is insufficient to determine an RDA. requirement: the lowest continuing
intake of a nutrient that will maintain a specified criterion of adequacy. deficient: in regard to
nutrient intake, describes the amount below which almost all healthy people can be expected,
over time, to experience deficiency symptoms.
FIGUR
Estimated Average Requirements (EAR): the average daily nutrient intake levels estimated to
meet the requirements of half of the healthy individuals in a given age and gender group; used
in nutrition research and policymaking and as the basis on which RDA values are set.
Tolerable Upper Intake Levels (UL): a set of values reflecting the highest average daily nutrient
intake levels that are likely to pose no risk of toxicity to almost all healthy
individuals in a particular life stage and gender group. As intake increases above the UL, the
potential risk of adverse health effects increases.
Estimated Energy Requirement (EER): the dietary energy intake level that is predicted to
maintain energy balance in a healthy adult of a defined age, gender, weight, and physical
activity level consistent with good health.
FIGURE 1-3
Guidelines:
1. Follow a healthy eating pattern across the lifespan.! All food and beverage choices matter. Choose a
healthy eating pattern at an appropriate kcalorie level to help achieve and maintain a healthy body
weight, support nutrient adequacy, and reduce the risk of chronic disease.
Consume a healthy eating pattern that accounts for all foods and beverages within an appropriate
kcalorie level. A healthy eating pattern includes:
• A variety of vegetables from all of the subgroups—dark green, orange, legumes (beans and
peas), starchy, and other.
• Fruits, especially whole fruits.
• Grains, at least half of which are whole grains.
• Fat-free or low-fat dairy, including milk, yogurt, cheese, and /or fortified soy beverages.
• A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and
peas), and nuts, seeds, and soy products.
• Oils.
A healthy eating pattern limits:
• Saturated fats and!trans!fats, added sugars, and sodium.
• Consume less than 10 percent of kcalories per day from added sugars.
• Consume less than 10 percent of kcalories per day from saturated fats.
• Consume less than 2,300 milligrams per day of sodium.
• If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and
up to two drinks per day for men—and only by adults of legal drinking age.
2. Focus on variety, nutrient density, and amount To meet nutrient needs within kcalorie limits, choose
a variety of nutrient-dense foods across and within all food groups in recommended amounts.
3. Limit kcalories from added sugars and saturated fats and reduce sodium intake. Consume an eating
pattern low in added sugars, saturated fats, and sodium. Cut back on foods and beverages higher in
these components to amounts that fit within healthy eating patterns.
4. Shift to healthier food and beverage choices. Choose nutrient-dense foods and beverages across and
within all food groups in place of less healthy choices. Consider cultural and personal preferences to
make these shifts easier to accomplish and maintain.
5. Support healthy eating patterns for all. Everyone has a role in helping to create and support healthy
eating patterns in multiple settings nationwide, from home to school to work to communities.
Review Notes
• The Dietary Reference Intakes (DRI) are a set of nutrient intake values that can be
used to plan and evaluate dietary intakes for healthy people.
• The Estimated Average Requirement (EAR) defines the amount of a nutrient that
supports a specific function in the body for half of the population.
• The Recommended Dietary Allowance (RDA) is based on the EAR and establishes a
goal for dietary intake that will meet the needs of almost all healthy people.
• An Adequate Intake (AI) serves a similar purpose as the RDA when an RDA cannot
be determined.
• The Tolerable Upper Intake Level (UL) establishes the highest average daily nutrient
intake level that appears safe for almost all healthy people.
• The Estimated Energy Requirement (EER) defines the energy intake level needed to
maintain energy balance in a healthy adult of a defined age, gender, weight, height,
and physical activity level.
• The Acceptable Macronutrient Distribution Ranges (AMDR) define the proportions
contributed by carbohydrate, fat, and protein to a healthy diet.
Reference:
Nutrition for Health and Healthcare 6th Edition - Linda Kelly DeBruyne
