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…meeting nutrient recommendations must go hand in hand with keeping calories under control.
5 The food groups in the USDA Food Guide are grains; vegetables; fruits; milk, yogurt, and cheese; and meat, poultry, fish, dry beans, eggs, and nuts. Food groups in the DASH Eating Plan are grains and grain products; vegetables; fruits; lowfat or fatfree dairy; meat, poultry, and fish; and nuts, seeds, and dry beans.
(RDA) (2.4 μg/day) for vitamin B 12 by eating foods fortified with vitamin B 12 such as fortified cereals, or by taking the crystalline form of vitamin B 12 supplements.
Women and Iron
Based on blood values, substantial numbers of adolescent females and women of childbearing age are iron deficient. Thus, these groups should eat foods high in hemeiron (e.g., meats) and/or consume ironrich plant foods (e.g., spinach) or ironfortified foods with an enhancer of iron absorption, such as foods rich in vitamin C (e.g., orange juice). Appendix B3 lists foods that can help increase iron intake and gives their iron and calorie content.
Women and Folic Acid
Since folic acid reduces the risk of the neural tube defects, spina bifida, and anencephaly, a daily intake of 400 μg/day of synthetic folic acid (from fortified foods or supplements in addition to food forms of folate from a varied diet) is recommended for women of childbearing age who may become pregnant. Pregnant women should consume 600 μg/day of synthetic folic acid (from fortified foods or supplements) in addition to food forms of folate from a varied diet. It is not known whether the same level of protection could be achieved by using food that is naturally rich in folate.
Special Groups and Vitamin D
Adequate vitamin D status, which depends on dietary intake and cutaneous synthesis, is important for optimal calcium absorption, and it can reduce the risk for bone
DI E TARY GUIDE L INE S FO R AM E R IC ANS , 2 0 0 5 9
loss. Two functionally relevant measures indicate that optimal serum 25hydroxyvitamin D may be as high as 80 nmol/L. The elderly and individuals with dark skin (because the ability to synthesize vitamin D from exposure to sunlight varies with degree of skin pigmentation) are at a greater risk of low serum 25hydroxyvitamin D concentrations. Also at risk are those exposed to insufficient ultraviolet radiation (i.e., sunlight) for the cutaneous production of vitamin D (e.g., housebound individuals). For individuals within the highrisk groups, substantially higher daily intakes of vitamin D (i.e., 25 μg or 1,000 International Units (IU) of vitamin D per day) have been recommended to reach and maintain serum 25hydroxyvitamin D values at 80 nmol/L. Three cups of vitamin Dfortified milk (7.5 μg or 300 IU), 1 cup of vitamin Dfortified orange juice (2.5 μg or 100 IU), and 15 μg (600 IU) of supplemental vitamin D would provide 25 μg (1,000 IU) of vitamin D daily.
Fluid
The combination of thirst and normal drinking behavior, especially the consumption of fluids with meals, is usually sufficient to maintain normal hydration. Healthy individuals who have routine access to fluids and who are not exposed to heat stress consume adequate water to meet their needs. Purposeful drinking is warranted for individuals who are exposed to heat stress or perform sustained vigorous activity (see ch. 4).
Flexibility of Food Patterns for Varied Food Preferences
The USDA Food Guide and the DASH Eating Plan are flexible to permit food choices based on individual and cultural food preferences, cost, and availability. Both can also accommodate varied types of cuisines and special needs due to common food allergies. Two adaptations of the USDA Food Guide and the DASH Eating Plan are:
Vegetarian Choices
Vegetarians of all types can achieve recommended nutrient intakes through careful selection of foods. These individuals should give special attention to their intakes of protein, iron, and vitamin B12, as well as calcium and vitamin D if avoiding milk products. In addition, vegetarians could select only nuts, seeds, and legumes from the meat and beans group, or they could include eggs if so desired. At the 2,000calorie level, they could choose about 1.5 ounces of nuts and 2/ 3 cup legumes instead of 5.5 ounces of meat, poultry, and/or fish. One egg, 1/ 2 ounce of nuts, or 1/ 4 cup of legumes is considered equivalent to 1 ounce of meat, poultry, or fish in the USDA Food Guide.
Substitutions for Milk and Milk Products
Since milk and milk products provide more than 70 percent of the calcium consumed by Americans, guidance on other choices of dietary calcium is needed for those who do not consume the recommended amount of milk products. Milk product consumption has been associated with overall diet quality and adequacy of intake of many nutrients, including calcium, potassium, magnesium, zinc, iron, riboflavin, vitamin A, folate, and vitamin D. People may avoid milk products because of allergies, cultural practices, taste, or other reasons. Those who avoid all milk products need to choose rich sources of the nutrients provided by milk, including potassium, vitamin A, and magnesium in addition to calcium and vitamin D (see app. B). Some nondairy sources of calcium are shown in appendix B4. The bioavailability of the calcium in these foods varies.
Those who avoid milk because of its lactose content may obtain all the nutrients provided by the milk group by using lactosereduced or lowlactose milk products, taking small servings of milk several times a day, taking the enzyme lactase before consuming milk products, or eating other calciumrich foods. For additional information, see appendixes B4 and B5 and NIH Publication No. 032751. 6
6 NIH Publication No. 032751, U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, March 2003. http://digestive.niddk.nih.gov/ddiseases/pubs/lactoseintolerance/index.htm.
DI E TARY G UID E L I N E S FO R AM E R IC AN S , 2 0 0 5 10
TABLE 1. Sample USDA Food Guide and the DASH Eating Plan at the 2,000Calorie Level a
Amounts of various food groups that are recommended each day or each week in the USDA Food Guide and in the DASH Eating Plan (amounts are daily unless otherwise specified) at the 2,000calorie level. Also identified are equivalent amounts for different food choices in each group. To follow either eating pattern, food choices over time should provide these amounts of food from each group on average.
Food Groups and Subgroups |
USDA Food Guide Amount b |
DASH Eating Plan Amount |
Equivalent Amounts |
Fruit Group |
2 cups (4 servings) |
2 to 2.5 cups (4 to 5 servings) |
1 / 2 cup equivalent is: • 1 / 2 cup fresh, frozen, or canned fruit • 1 med fruit |
• 1 / 4 cup dried fruit • USDA: 1 / 2 cup fruit juice • DASH: 3 / 4 cup fruit juice |
|
Vegetable Group |
2.5 cups (5 servings) |
2 to 2.5 cups (4 to 5 servings) |
1 / 2 cup equivalent is: |
• Dark green vegetables |
3 cups/week |
• 1 / 2 cup of cutup raw or |
|
• Orange vegetables |
2 cups/week |
cooked vegetable |
|
• Legumes (dry beans) |
3 cups/week |
• 1 cup raw leafy vegetable |
|
• Starchy vegetables |
3 cups/week |
• USDA: 1 / 2 cup vegetable juice |
|
• Other vegetables |
6.5 cups/week |
• DASH: 3 / 4 cup vegetable juice |
|
Grain Group |
6 ounceequivalents |
7 to 8 ounceequivalents |
1 ounceequivalent is: |
• Whole grains • Other grains |
3 ounceequivalents 3 ounceequivalents |
(7 to 8 servings) |
• 1 slice bread • 1 cup dry cereal |
• 1 / 2 cup cooked rice, pasta, cereal |
|
• DASH: 1 oz dry cereal |
|
( 1 / 2 –1 1 / 4 cup depending on cereal type—check label) |
|
Meat and Beans Group |
5.5 ounceequivalents |
6 ounces or less |
1 ounceequivalent is: |
meat, poultry, fish |
• 1 ounce of cooked lean meats, |
|
poultry, fish |
|
4 to 5 servings per week nuts, seeds, and dry beans c |
• 1 egg • USDA: 1 / 4 cup cooked dry beans |
|
or tofu, 1 Tbsp peanut butter, |
|
1 / 2 oz nuts or seeds |
|
• DASH: 1 1 / 2 oz nuts, 1 / 2 oz seeds, |
|
1 / 2 cup cooked dry beans |
|
Milk Group |
3 cups |
2 to 3 cups |
1 cup equivalent is: • 1 cup lowfat/fatfree milk, yogurt • 1 1 / 2 oz of lowfat or |
fatfree natural cheese |
|
• 2 oz of lowfat or |
|
fatfree processed cheese |
|
Oils |
24 grams (6 tsp) |
8 to 12 grams (2 to 3 tsp) |
1 tsp equivalent is: |
• DASH: 1 tsp soft margarine |
|
• 1 Tbsp lowfat mayo |
|
• 2 Tbsp light salad dressing • 1 tsp vegetable oil |
|
Discretionary Calorie Allowance • Example of distribution: Solid fat d Added sugars |
267 calories 18 grams 8 tsp |
~2 tsp (5 Tbsp per week) |
1 Tbsp added sugar equivalent is: • DASH: 1 Tbsp jelly or jam • 1 / 2 oz jelly beans • 8 oz lemonade |
a All servings are per day unless otherwise noted. USDA vegetable subgroup amounts and amounts of DASH nuts, seeds, and dry beans are per week.
b The 2,000calorie USDA Food Guide is appropriate for many sedentary males 51 to 70 years of age, sedentary females 19 to 30 years of age, and for some other gender/age groups who are more physically active. See table 3 for information about gender/age/activity levels and appropriate calorie intakes. See appendixes A2 and A3 for more information on the food groups, amounts, and
food intake patterns at other calorie levels.
c In the DASH Eating Plan, nuts, seeds, and dry beans are a separate food group from meat, poultry, and fish.
d The oils listed in this table are not considered to be part of discretionary calories because they are a major source of the vitamin E and polyunsaturated fatty acids, including the essential fatty acids, in
the food pattern. In contrast, solid fats (i.e., saturated and trans fats) are listed separately as a source of discretionary calories.
DI E TARY G UID E L I N E S FO R AM E R IC AN S , 2 0 0 5 11
TABLE 2. Comparison of Selected Nutrients in the Dietary Approaches to Stop Hypertension (DASH) Eating Plan a , the USDA Food Guide b , and Nutrient Intakes Recommended Per Day by the Institute of Medicine (IOM) c Estimated nutrient levels in the DASH Eating Plan and the USDA Food Guide at the 2,000-calorie level, as well as the nutrient intake levels recommended by the Institute of Medicine for females 19—30 years of age.
Nutrient |
DASH Eating Plan (2,000 kcals) |
USDA Food Guide (2,000 kcals) |
IOM Recommendations for Females 19 to 30 |
Protein, g |
108 |
91 |
RDA: 46 |
Protein, % kcal |
21 |
18 |
AMDR: 10—35 |
Carbohydrate, g |
288 |
271 |
RDA: 130 |
Carbohydrate, % kcal |
57 |
55 |
AMDR: 45—65 |
Total fat, g |
48 |
65 |
— |
Total fat, % kcal |
22 |
29 |
AMDR: 20—35 |
Saturated fat, g |
10 |
17 |
— |
Saturated fat, % kcal |
5 |
7.8 |
ALAP d |
Monounsaturated fat, g |
21 |
24 |
— |
Monounsaturated fat, % kcal |
10 |
11 |
— |
Polyunsaturated fat, g |
12 |
20 |
— |
Polyunsaturated fat, % kcal |
5.5 |
9.0 |
— |
Linoleic acid, g |
11 |
18 |
AI: 12 |
Alpha-linolenic acid, g |
1 |
1.7 |
AI: 1.1 |
Cholesterol, mg |
136 |
230 |
ALAP d |
Total dietary fiber, g |
30 |
31 |
AI: 28 e |
Potassium, mg |
4,706 |
4,044 |
AI: 4,700 |
Sodium, mg |
2,329 f |
1,779 |
AI: 1,500, UL: <2,300 |
Calcium, mg |
1,619 |
1,316 |
AI: 1,000 |
Magnesium, mg |
500 |
380 |
RDA: 310 |
Copper, mg |
2 |
1.5 |
RDA: 0.9 |
Iron, mg |
21 |
18 |
RDA: 18 |
Phosphorus, mg |
2,066 |
1,740 |
RDA: 700 |
Zinc, mg |
14 |
14 |
RDA: 8 |
Thiamin, mg |
2.0 |
2.0 |
RDA: 1.1 |
Riboflavin, mg |
2.8 |
2.8 |
RDA: 1.1 |
Niacin equivalents, mg |
31 |
22 |
RDA: 14 |
Vitamin B 6 , mg |
3.4 |
2.4 |
RDA: 1.3 |
Vitamin B 12 , μg |
7.1 |
8.3 |
RDA: 2.4 |
Vitamin C, mg |
181 |
155 |
RDA: 75 |
Vitamin E (AT) g |
16.5 |
9.5 |
RDA: 15.0 |
Vitamin A, μg (RAE) h |
851 |
1,052 |
RDA: 700 |
a DASH nutrient values are based on a 1-week menu of the DASH Eating Plan. NIH publication No. 03-4082. www.nhlbi.nih.gov. b USDA nutrient values are based on population-weighted averages of typical food choices within each food group or subgroup. c Recommended intakes for adult females 19—30; RDA = Recommended Dietary Allowance; AI = Adequate Intake; AMDR = Acceptable Macronutrient Distribution Range; UL = Upper Limit. d As Low As Possible while consuming a nutritionally adequate diet. e Amount listed is based on 14 g dietary fiber/1,000 kcal. f The DASH Eating Plan also can be used to follow at 1,500 mg sodium per day. g AT = mg d-α-tocopherol h RAE = Retinol Activity Equivalents
DIETARY GUIDELINES FOR AMERICANS, 2005 12
TABLE 3. Estimated Calorie Requirements (in Kilocalories) for Each Gender and Age Group at Three Levels of Physical Activity a
Estimated amounts of calories needed to maintain energy balance for various gender and age groups at three different levels of ysical activity. The estimates are rounded to the nearest 200 calories and were determined using the Institute of Medicine equation.
b,c,d Activity Level |
|
Gender |
Age (years) |
b Sedentary |
c Moderately Active |
Active d |
Child |
2–3 |
1,000 |
e 1,000–1,400 |
e 1,000–1,400 |
Female |
4–8 9–13 14–18 19–30 31–50 51+ |
1,200 1,600 1,800 2,000 1,800 1,600 |
1,400–1,600 1,600–2,000 2,000 2,000–2,200 2,000 1,800 |
1,400–1,800 1,800–2,200 2,400 2,400 2,200 2,000–2,200 |
Male |
4–8 9–13 14–18 19–30 31–50 51+ |
1,400 1,800 2,200 2,400 2,200 2,000 |
1,400–1,600 1,800–2,200 2,400–2,800 2,600–2,800 2,400–2,600 2,200–2,400 |
1,600–2,000 2,000–2,600 2,800–3,200 3,000 2,800–3,000 2,400–2,800 |
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