Dietary Guidelines for Americans is a publication issued by the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA). The goals of these guidelines are to help people maintain a healthy weight and to reduce the risk of chronic diseases such as diabetes and heart disease. The latest scientific research on diet and nutrition is used to develop the recommendations.

Revised every five years to reflect current scientific knowledge, the guidelines offer advice for healthy food choices and a healthy, active life for people over 2 years of age and for specific populations. They also encourage dietary habits that may reduce the risk of chronic diseases. The most recent version was released in 2005.

The guidelines are grouped into nine general topics and include 41 key recommendations. Of these, 23 are for the general public and 18 are for specific populations (e.g., children, pregnant or breastfeeding women, overweight adults, older adults). The latest revision has a stronger emphasis on calorie control and physical activity because almost two-thirds of Americans are overweight or obese and more than half do not get enough physical activity. The general topics include:

• Adequate nutrients and calorie needs
• Weight management
• Physical activity
• Food groups to encourage
• Fats
• Carbohydrates
• Sodium and potassium
• Alcoholic beverages
• Food safety

The Dietary Guidelines for Americans is an initiative developed by the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA) to encourage people to eat healthy and to engage in regular physical exercise. The goal of the guidelines is to help people maintain a healthy weight and to reduce the risk of chronic diseases such as diabetes and heart disease, high blood pressure, osteoporosis and some times of cancer. They are based on the most current scientific research and federal law requires that they be reviewed and updated every five years.

The guidelines were first issued in 1980 and apply to people over the age of 2. The sixth edition of the Dietary Guidelines for Americans was released in 2005 (after previous updates in 1985, 1990, 1995 and 2000) and emphasizes the importance of controlling weight to reduce obesity. 

The newest version of these guidelines places increased emphasis on reducing calorie intake and increasing physical activity. These guidelines are based on what is known as the “ABCs of health.” This includes the following:

• Aim for fitness. Aim for a healthy weight and be physically active each day.
  
  
• Build a healthy base. Let the Food Guide Pyramid help determine food choices from the basic food groups (e.g., grains, fruits and vegetables) and keep foods safe to eat.
  

  

• Choose sensibly. Choose a diet low in saturated fat and cholesterol and moderate in total fat. Food and beverages should contain only moderate levels of sugars and be low in salt. In addition, alcoholic beverages should be consumed in moderation or avoided altogether.

The information in the guidelines also is divided into topics:

• Topics 1 through 3: Suggestions for consuming nutrient-dense foods to meet energy needs, maintaining a healthy weight and incorporating physical activity into the daily routine.
  
  
• Topic 4: Examines the right dietary balance encompassing the major food groups, including fruits and vegetables, proteins, whole grains and milk products.
  
  
• Topics 5 through 7: Guidelines for choosing foods with the right amounts of fats, carbohydrates, and sodium and potassium.
  
  
• Topic 8: Urges moderation when consuming alcoholic beverages.
  
  
• Topic 9: Encourages food handling and cooking techniques intended to encourage food safety and minimize the likelihood of foodborne illness.

The guidelines are used to define national nutrition policies and are used to determine the content of federal nutrition programs, such as the National Child Nutrition Programs and the Elderly Nutrition Program. They are also used to create educational materials.

Experts generally recommend incorporating these guidelines into the Food Guide Pyramid, a method of categorization that helps people determine how many servings are needed from the various food groups.

Learning to read and interpret the labels on food packaging also can help people to plan healthier diets.

The Dietary Guidelines are designed to be flexible and focused on a person’s long-term habits rather than concentrating narrowly on a single meal or a single day. Vegetarians and people who prefer certain types of ethnic foods may use these guidelines as easily as those with more mainstream American diet preferences. It is important to remember that these guidelines are only effective if people follow them. Occasionally, it is acceptable to stray from the guidelines and indulge in less healthy foods or to skip a workout session or two. However, such slips should be the exception rather than the rule.

The first three recommendations deal with calorie needs, weight management and the role of physical activity. Overweight and obesity are major problems in the United States, affecting about two-thirds of Americans. Being overweight substantially raises the risk of many different types of illness, including cancer, diabetes, heart attack, high blood pressure, high cholesterol, osteoporosis and stroke. The first three guidelines are intended to combat this trend.

A brief overview of these guidelines is as follows:

Adequate Nutrients Within Calorie Needs

• Consume a variety of nutrient-dense foods and beverages within and among the basic food groups while choosing foods that limit the intake of saturated fats and trans fats, cholesterol, added sugars, salt, and alcohol.
  
  
• Meet recommended intakes by adopting a balanced eating pattern, such as the U.S. Department of Agriculture (USDA) Food Guide or the Dietary Approach to Stop Hypertension (DASH) eating plan.

Many Americans consume too many calories and too much saturated fat, trans fat, cholesterol, added sugars and salt. According to the latest research, intake levels for calcium, potassium, fiber, magnesium and vitamin E may be a concern for children and adolescents. For adults, intake levels of the same nutrients and vitamin A and vitamin C are a concern.

In general, both the Food Guide Pyramid and the DASH diet encourage consuming vegetables, fruits, legumes, whole grains, and low-fat or fat-free milk products.

Dietary recommendations for population groups include the following:

• People over 50 should consume vitamin B12 in fortified foods or supplements.
  
  
• Women of childbearing age or who may become pregnant should eat foods high in heme iron (e.g., meats) and/or consume iron-rich plant foods (e.g., spinach) or iron-fortified foods with an enhancer of iron absorption (e.g., foods rich in vitamin C).
  
  
• Women of childbearing age who may become pregnant and those in the first trimester of pregnancy should consume adequate folic acid daily in the form of fortified foods or supplements. They also are encouraged to eat foods rich in folate.
  
  
• Older adults, people with dark skin, and people without enough exposure to ultraviolet radiation such as sunlight should consume extra vitamin D from vitamin D-fortified foods and/or supplements.

Weight Management

• Maintain weight in a healthy range, balance calories from foods and beverages with calories expended.
  
  
• In order to prevent gradual weight gain over time, small decreases in food and caloric beverages can be made along with increased physical activity.

The incidence of obesity in the United States has doubled in the past two decades. Achieving and maintaining a healthy weight can help to decrease a person’s risk for high blood pressure, high blood cholesterol, heart disease, stroke, type 2 diabetes, gallbladder disease, gout, respiratory disfunction, osteoarthritis and certain types of cancer.

Balancing calories consumed with calories expended through daily activities will help achieve and maintain a healthy weight. One way is by making sensible food choices and controlling portion sizes. Because most adults gain weight slowly over time, a reduction of 50 to 100 calories per day may prevent this gradual weight gain. For weight loss, reducing 500 calories a day while consuming a nutritionally adequate diet is a common goal. Also, people who are sedentary are urged to work toward increasing their level of activity.

Dietary recommendations for certain population groups include:

• People who need to lose weight should aim for a slow, steady weight loss by decreasing calories, maintaining an adequate nutrient intake and increasing physical activity.
  
  
• Overweight children should reduce the rate of weight gain while still eating enough to maintain growth and development. Consult a healthcare provider before placing a child on a weight-reduction diet.
  
  
• Pregnant women should ensure appropriate weight gain as specified by a healthcare provider. Pregnant women should neither gain too much or too little weight.
  
  
• Breastfeeding women can lose moderate amounts of weight safely, as long as this does not compromise the weight gain of the infant.
  
  
• Overweight adults, people with chronic diseases and/or on medication should consult a healthcare provider about weight loss strategies prior to starting a reduction program. This helps ensure appropriate management of other health conditions.

Physical Activity

• Engage in regular physical activity to promote health, psychological well-being and a healthy weight.
  
  
• Achieve physical fitness by performing cardiovascular conditioning, stretching exercises for flexibility, and resistance exercises or calisthenics for muscle strength and endurance.

People who take in more calories than they expend gain weight. However, those who expend more calories than they take in usually lose weight. Regular exercise can help people expend more calories, or strike a better balance between consuming and expending calories. Exercise also has other benefits, including reducing the risk of chronic disease, increasing bone density and muscle size and strength.

Healthy adults who want to improve fitness and reduce the risk of chronic disease are encouraged to exercise for 30 minutes or more at a moderate to intense level on most days of the week. However, individual needs may vary. For most people, additional health benefits can be obtained by engaging in physical activity of more vigorous intensity or for longer duration.

Up to 60 minutes of moderate- to vigorous-intensity physical activity per day may be needed to prevent gradual, unhealthy weight gain in adulthood. Overweight people are urged to engage in 60 to 90 minutes of moderate-intensity physical activity per day as a way to sustain weight loss, but should consult with a healthcare provider before participating in an activity of this level. Men older than 40, women older than 50, and any adult with a chronic disease or at risk for a chronic disease should consult their healthcare provider prior to starting an exercise program.

Exercise recommendations for certain population groups include:

• Children and adolescents should engage in at least 60 minutes of physical activity on most – or preferably all – days of the week.
  
  
• Pregnant women should incorporate 30 minutes or more of moderate-intensity physical activity on most or all days of the week. This should only be done in the absence of medical or obstetric complications and activities with a high risk of falling or abdominal trauma should be avoided.
  
  
• Breastfeeding women can safely exercise without affecting the ability to successfully nurse.
  
  
• Older adults should participate in regular physical activity to reduce functional declines associated with aging and to promote health, emotional well being and appropriate weight.

Of the nine key recommendations for the general population, four through seven address balancing food groups and obtaining healthy amounts of specific nutrients (e.g., fats, carbohydrates, sodium and potassium). Each food group has nutrients that are important to good health. The best way to make sure the body obtains all these nutrients is to eat a well-balanced diet that contains foods from each of these food groups.

A brief overview of these guidelines includes:

Food Groups to Encourage

• Consume a sufficient amount of fruits and vegetables while staying within energy needs. Two cups (473 milliliters [ml]) of fruit and 2.5 cups (592 ml) of vegetables per day are recommended for a 2,000-calorie intake, with higher or lower amounts depending on the calorie level.
  
  
• Choose a variety of fruits and vegetables each day. In particular, select from all five vegetable subgroups (dark green, orange, legumes, starchy vegetables like corn and other vegetables) several times a week.
  
  
• Consume 3 or more ounce-equivalents (85 grams) of whole grain products per day. In general, at least half of the daily grains should come from whole grains.
  
  
• Consume 3 cups (710 ml) per day of fat-free or low-fat milk or equivalent dairy products.

Different foods contribute nutrients to a person’s diet. Therefore, it is important to eat a variety of foods each day. Fruits, vegetables, whole grains and milk products are all important to a healthy diet. Diets high in these foods are associated with reduced chronic disease risk. In addition, these food groups contribute many important nutrients and substances, such as fiber, calcium, potassium, magnesium, and vitamins A, C and E. It is important to remember to decrease intake of less nutrient-dense foods while increasing intake of whole grains, fruits, vegetables and low-fat milk products to control overall daily calorie intake and avoid unwanted weight gain.

Fruits and vegetables provide a variety of micronutrients and fiber. Four and one-half cups (1.1 liters) of fruits and vegetables daily are recommended for a 2,000-calorie level diet. Depending on calorie level, daily fruit and vegetable intake recommendations will vary. It is important to remember that specific fruits and vegetables are rich in different nutrients. Two recent studies have found that most Americans still do not include enough fruits and vegetables in their diets.

Whole grains provide more nutrients and fiber than in refined grains. The fiber in whole grains, as well as fruits and vegetables, promotes good bowel function and may lower the risk of some cancers and heart disease. Consuming at least 3 or more ounce-equivalents (85 grams) of whole grains per day can reduce these risks and may help with weight maintenance. Since consuming this amount may be difficult for younger children, the guidelines recommend that all age groups consume at least half the grains as whole grains. Some examples of whole grain foods include whole wheat, whole oats/oatmeal, whole-grain corn, popcorn, brown rice, whole rye, whole-grain barley, wild rice, buckwheat, triticale, bulgur (cracked wheat), millet, quinoa and sorghum. Whole grain should be the first ingredient listed on the whole grain product.

Daily intake of dairy products is especially important during childhood and adolescence to help promote bone health. For those individuals who choose to or must avoid milk products, non-dairy calcium-rich foods should be included to meet calcium needs. Some examples include:

• Fortified ready-to-eat cereals
• Calcium-fortified soy beverages and orange juice
• Sardines
• Tofu
• Canned salmon with bones
• Spinach
• Collard greens
• Soybeans
• Turnip greens
• White beans

Specific dietary recommendations for children and adolescents indicate that they should consume whole grain products often. Whenever possible, at least half the grains should be whole grains. Children 2 to 8 years should consume 2 cups per day of fat-free or low-fat milk or the equivalent. Children 9 years of age and older should consume 3 cups per day of fat-free or low-fat milk or equivalent products.

Fats

• Consume less than 10 percent of total calories from saturated fatty acids and less than 300 milligrams (mg) per day of cholesterol, and keep trans fatty acid consumption as low as possible.
  
  
• Total fat intake should be between 20 percent to 35 percent of calories, with most fats coming polyunsaturated and monounsaturated fatty acids such as fish, nuts and vegetable oils.
  
  
• When selecting and preparing meat, poultry, dry beans, and milk or milk products, make choices that are lean, low-fat, or fat-free.
  
  
• Limit intake of fats and oils high in saturated and/or trans fatty acids, and choose products low in such fats and oils.
  

  

Fats in foods provide energy and essential fatty acids. They also help in the absorption of fat soluble vitamins. However, too much total fat, saturated fat and trans fat in the diet may increase blood cholesterol levels and the risk of heart disease. The updated 2005 guidelines do not recommend an excessively low intake of fat. Instead, people are urged to consume low to moderate levels of unsaturated fats, low amounts of saturated fats and the least possible amount of trans fats. Diets also should be low in cholesterol.

The guidelines recommend substituting vegetable oils (high in monounsaturated and polyunsaturated fats) for butter, margarine or lard (high in saturated or trans fats). They also urge people to choose lean meats, fish and poultry. Consuming beans and peas allows essential nutrients without excess calories or unhealthy fats.

Dietary recommendations for children and adolescents indicate that total fat intake should be between 30 percent to 35 percent of calories for children 2 to 3 years of age and between 25 percent to 35 percent of calories for children and adolescents 4 to 18 years of age. Most fats should come from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts and vegetable oils.

Carbohydrates

• Choose fiber-rich fruits, vegetables and whole grains frequently.
  
  
• Choose and prepare foods and beverages with little added sugars or sweeteners.
  
  
• Reduce the incidence of dental caries by practicing good oral hygiene and consuming sugar- and starch-containing foods less frequently.

Americans consume 25 percent more added sugar now than in they did 1970, according to the USDA. Most of the added sugar comes from soft drinks, fruit drinks, cookies, cakes, other baked goods, candy, breakfast cereals and ice cream. These foods or drinks contribute a significant source of added calories and few nutrients.

The guidelines recommend choosing sensibly to avoid excess sugar intake by limiting foods with added sugars. Common names for added sugars are brown sugar, corn sweetener, corn syrup, dextrose, fructose, fruit juice concentrate, glucose, high fructose corn syrup, honey, lactose, malt syrup, maltose, molasses, raw sugar, invert sugar and sucrose. If any of these sugars appears first or second on the ingredient list, or if several are listed, the food is likely to be high in added sugars.

The guidelines encourage consuming at least half the recommended grain servings as whole grains – instead of refined grains or simple sugars – to meet fiber recommendations. In addition, choose carbohydrates from the basic food groups, such as fruits, vegetables, grains and milk. These are also a source of many other nutrients.

Sodium and Potassium

• Consume less than 2,300 milligrams (mg) or approximately 1 teaspoon of salt per day.
  
  
• Choose and prepare foods with little salt. At the same time, consume potassium-rich foods, such as fruits and vegetables.

Sodium helps regulate fluid balance in the body by helping to keep enough water in the cell to allow it to perform normally without bursting. Usually, the body adjusts to the varying levels of sodium it encounters from day to day. However, a high-sodium diet can put some people at risk for certain health conditions.

The salt in foods can play a significant role in regulating blood pressure and fluid status. Decreasing salt intake is recommended to reduce the risk of developing high blood pressure. This condition can increase one’s risk of heart disease, stroke, heart failure, and kidney disease.

Approximately 75 percent of total salt intake comes from processed or prepared foods. The body requires about half of a gram of sodium per day, and the guidelines recommend that people consume no more than 2.3 grams of sodium per day. The average American consumes at least 9 grams of sodium per day, with many Americans eating more than 12 grams on a daily basis. Most Americans would benefit from reducing salt intake.

To reduce salt intake, read food labels and choose foods that are labeled “low in sodium.” Eat fresh fruits and vegetables and refrain from adding salt when cooking or eating.

Another strategy to help lower blood pressure is to consume a diet rich in potassium. Potassium-rich foods include fruits and vegetables such as green leafy vegetables, fruit from vines and root vegetables. The guidelines also recommend other methods for reducing blood pressure, including losing excess weight, increasing physical activity and eating a healthy diet.

The last two of the nine key recommendations for the general population deal with alcoholic beverages and general food safety. A brief overview of these guidelines includes:

Alcoholic Beverages

• People who choose to drink alcoholic beverages should do so sensibly and in moderation. Moderation is defined as one drink per day for women and up to two drinks per day for men.
  
  
• Alcoholic beverages should not be consumed by some people, including those who cannot restrict their alcohol intake, individuals with a family medical history of alcoholism, women of childbearing age who may become pregnant, pregnant and lactating women, children and adolescents, individuals taking medications that can interact with alcohol and those with specific medical conditions.
  
  
• Alcoholic beverages should be avoided when engaging in activities that require attention, skill or coordination, such as driving or operating machinery.

The guidelines recommend drinking alcohol in moderation, if at all. Alcoholic beverages are a source of calories with few or no nutrients. They can be harmful and hazardous to one's health when consumed in excess. One drink is defined as 12 ounces (355 ml) of beer, 5 ounces (148 ml) of wine or 1.5 ounces (44 ml) of 80-proof distilled spirits.

Food Safety

To avoid microbial foodborne illness:

• Wash hands, food contact surfaces, and fruits and vegetables. Meat and poultry should not be washed or rinsed.
  
  
• Separate raw, cooked, and ready-to-eat foods while shopping, preparing, or storing foods.
  
  
• Cook foods to a safe temperature to kill microorganisms.
  
  
• Refrigerate perishable food promptly and defrost foods properly.
  
  
• Avoid raw (unpasteurized) milk or any products made from unpasteurized milk, raw or partially cooked eggs. Also, avoid foods containing raw eggs, raw or partly cooked meat and poultry, unpasteurized juices, and raw sprouts.

It is important to keep foods safe to eat. Many products contain safety instructions on the package, such as “Keep Refrigerated.” When unsure about the safety of a food or packaged item, throw the item out. Eating a small portion of food contaminated with harmful bacteria or germs can make a person sick.

Make sure to wash hands properly prior to preparing and handling food. Pregnant women, young children, older adults and people with a weakened immune system are at high risk for foodborne illnesses. To avoid foodborne illnesses caused by bacteria, viruses, toxins, parasites and other contaminants present in foods, cook, reheat and store foods at safe temperatures.

High-risk food handling also increases the chance of serious and life-threatening foodborne illnesses. For example, unsafe food handling and preparation may allow pathogens such as salmonella, Clostridium and staphylococcus to enter the bloodstream. These pathogens commonly cause nausea, vomiting and diarrhea and in some cases have been linked to heart conditions such as heart failure. They may also increase the risk of complications in patients with existing heart problems.

Dietary recommendations include:

• Infants and young children, pregnant women, older adults, and those with compromised immune systems should not eat or drink unpasteurized milk or any products made from unpasteurized milk. They also should avoid foods containing raw or partially cooked eggs, raw or undercooked meat and poultry, raw or undercooked fish or shellfish, unpasteurized juices, and raw sprouts.
  
  
• Pregnant women, older adults, and people with compromised immune systems should only eat certain deli meats and steaming hot frankfurters.

The Dietary Guidelines are not designed to determine how much food a person can eat. Instead, they provide general recommendations for what should be eaten as well as promoting healthy lifestyle.

Different people have specific daily energy needs. Human energy is measured by a unit of heat called a calorie. A faster metabolism or high levels of physical activity may require some people to have a higher-calorie diet. Those with slower metabolisms or who get little physical activity may require fewer calories. Age, gender and health conditions are also factors affecting the number of calories that reflect an adequate diet. Most nutrition facts labels provide the daily value information based on a 2,000- and/or 2,500–calorie daily diet.

Consulting the physician or dietitian can help people design a specific eating plan.

Preparing questions in advance can help patients have more meaningful discussions regarding their conditions. Patients may wish to ask their doctor or registered dietitian the following questions related to food intake levels:

1. Should I follow everything listed on the Dietary Guidelines?
   
   
2. Do I need to keep my salt intake lower than the general recommendation (2,300 mg)? If so, what is my guideline?
   
   
3. Past guidelines have suggested that I need to keep my fat intake lower than the general recommendation. Now that the guidelines have changed in terms of fat recommendations, can I change my diet?
   
   
4. Am I in a risk group that requires me to make additional changes to my diet?
   
   
5. Are there any other recommendations from the Dietary Guidelines that should be adjusted for me? What about for my family?
   
   
6. Can you recommend an eating program to help me get closer to my dietary recommendations?
   
   
7. Might I benefit from consulting a dietitian? Could you recommend one?
   
   
8. Do you know of good cookbooks that can help me plan meals that incorporate these guidelines?
   
   
9. How often can I safely stray from these guidelines and indulge my appetite for less healthy foods?
   
   
10. Where can I get a copy of the full 2005 Dietary Guidelines for Americans?