Click to select dietary strategies to increase the phytochemical content of your dietary pattern.

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  • Learning Objectives

    • Learn how to build a healthy plate

    A History of Food Guidance in the U.S.

    The U.S. Dietary Guidelines for Americans and the DRI are important scientific reports to educate health professionals about nutrition and to guide government and other health-related organizations to develop evidence-based health policies that improve the health of all Americans. The United States government has also been providing food and nutrition guidance directly to the public for more than a century to help individuals make healthier dietary and lifestyle choices . You may have heard about "the Four Food Groups" or "The Food Guide Pyramid" or most recently, "My Plate." The government food guidance system has evolved over the years as our understanding of nutrition science and the impact of diet and lifestyle on health has grown. If you are interested in learning more about the history of food guidance in the U.S. a list and description of former tools can be found at: https://www.choosemyplate.gov/brief-history-usda-food-guides

    MyPlate

    MyPlate is the most up-to-date nutrition teaching tool. MyPlate was developed by the United States Department of Agriculture (U.S.D.A.) Center for Nutrition Policy and Promotion as an easy to use visual guide to help all American develop healthy eating patterns. It replaces the former MyPyramid teaching tool and correlates with the 2015 - 2020 U.S. Dietary Guidelines.

    MyPlate organizes foods with similar nutritional value into specific food groups and provides recommendations about how to build a healthy diet. The ChooseMyPlate.gov website also provides a wide range of support materials including information about each food group, an individualized meal planner, recipes and professional videos and handouts such as the MyPlate, MyWins poster shown below to support learning for people of all ages.

    Click to select dietary strategies to increase the phytochemical content of your dietary pattern.

    MyPlate Key Messages include:

    • Focus on whole fruits
    • Vary your veggies
    • Vary your protein routine
    • Make half your grains whole grains
    • Move to low-fat or fat-free milk or yogurt
    • Drink and eat beverages and food with less sodium saturated fat and added sugars
    • Start with small changes that you can enjoy, like having an extra piece of fruit today

    To learn more about MyPlate visit: https://www.choosemyplate.gov/MyPlate

    Building a Healthy Plate: Choose Nutrient-Dense Foods

    Click to select dietary strategies to increase the phytochemical content of your dietary pattern.
    Figure \(\PageIndex{1}\): Ideal healthy plate.

    Click on the different food groups listed to view their food gallery:

    • Fruits
    • Grains
    • Dairy
    • Vegetables
    • Protein

    Planning a healthy diet using the MyPlate approach is not difficult. According to the icon, half of your plate should have fruits and vegetables, one-quarter should have whole grains, and one-quarter should have protein. Dairy products should be low-fat or non-fat. The ideal diet gives you the most nutrients within the fewest calories. This means choosing nutrient-rich foods.

    Fill half of your plate with red, orange, and dark green vegetables and fruits, such as kale, bok choy, kalo (taro), tomatoes, sweet potatoes, broccoli, apples, mango, papaya , guavas, blueberries, and strawberries in main and side dishes. Vary your choices to get the benefit of as many different vegetables and fruits as you can. You may choose to drink fruit juice as a replacement for eating fruit. (As long as the juice is 100 percent fruit juice and only half your fruit intake is replaced with juice, this is an acceptable exchange.) For snacks, eat fruits, vegetables, or unsalted nuts.

    Fill a quarter of your plate with grains such cereals, breads, crackers, rice, and pasta. Half of your daily grain intake should be whole grains. Read the ingredients list on food labels carefully to determine if a food is comprised of whole grains such as 100% whole wheat bread, brown rice and whole grain oats.

    Select a variety of protein foods to improve nutrient intake and promote health benefits. Each week, be sure to include a nice array of protein sources in your diet, such as nuts, seeds, beans, legumes, poultry, soy, and seafood. The recommended consumption amount for seafood for adults is two 4-ounce servings per week. When choosing meat, select lean cuts. Be conscious to prepare meats using little or no added saturated fat, such as butter.

    If you enjoy drinking milk or eating milk products, such as cheese and yogurt, choose low-fat or nonfat products. Low-fat and nonfat products contain the same amount of calcium and other essential nutrients as whole-milk products, but with much less fat and calories. Calcium, an important mineral for your body, is also available in lactose-free and fortified soy beverage and rice beverage products. You can also get calcium in vegetables and other fortified foods and beverages. You can learn more about "dairy free" sources of calcium by clicking the "Dairy" link on the ChooseMyPlate website.

    Fats are essential for your diet as they contain valuable essential fatty acids, but the type you choose and the amount you consume is important. Be sure to choose primarily plant-based liquid oils like olive, soybean and canola oil rather than solid animal fats like butter and lard. You can also get oils from many types of fish, as well as avocados, and unsalted nuts and seeds. Although oils are essential for health they do contain about 120 calories per tablespoon. It is vital to balance oil consumption with total caloric intake. The Nutrition Facts label provides the information to help you make healthful decisions.

    In short, substituting vegetables and fruits in place of foods high in added sugars, solid/saturated fats, and sodium is a good way to make a nutrient-poor diet healthy again. Vegetables are full of nutrients and antioxidants that help promote good health and reduce the risk for developing chronic diseases such as stroke, heart disease, high blood pressure, Type 2 diabetes, and certain types of cancer. Starting with these small shifts in your diet as mentioned above will boost your overall health profile.

    The MyPlate Planner can be used to create an individualized plan with the number of servings and portion sizes from each food group to eat each day to achieve a healthy diet. You can access the MyPlate Planner from the ChooseMyPlate website:

    https://www.choosemyplate.gov/MyPlatePlan

    When Enough Is Enough

    Estimating Portion Size

    Have you ever heard the expression, “Your eyes were bigger than your stomach?” This means that you thought you wanted a lot more food than you could actually eat. Amounts of food can be deceiving to the eye, especially if you have nothing to compare them to. It is very easy to heap a pile of mashed potatoes on your plate, particularly if it is a big plate, and not realize that you have just helped yourself to three portions instead of one.

    The food industry makes following the 2015 Dietary Guidelines a challenge. In many restaurants and eating establishments, portion sizes have increased, use of SoFAS has increased, and consequently the typical meal contains more calories than it used to. In addition, our sedentary lives make it difficult to expend enough calories during normal daily activities. In fact, more than one-third of adults are not physically active at all.

    Click to select dietary strategies to increase the phytochemical content of your dietary pattern.
    Figure \(\PageIndex{5}\): A Comparison of Serving Sizes.

    Source: https://www.nhlbi.nih.gov/health/edu...uments/PD1.pdf

    As food sizes and servings increase it is important to limit the portions of food consumed on a regular basis. Dietitians have come up with some good hints to help people tell how large a portion of food they really have. Some suggest using common items such as a deck of cards while others advocate using your hand as a measuring rule.

    See Table below for some examples.

    Source: American Cancer Society. “Controlling Portion Sizes.” Last revised January 12, 2012. http://www.cancer.org/Healthy/EatHealthyGetActive/TakeControlofYourWeight/controlling-portion-sizes.

    Table \(\PageIndex{3}\): Determining Food Portions.

    Food ProductAmountObject ComparisonHand Comparison
    Pasta, rice ½ c. Tennis ball Cupped hand
    Fresh vegetables 1 c. Baseball
    Cooked vegetables ½ c. Cupped hand
    Meat, poultry, fish 3 oz. Deck of cards Palm of your hand
    Milk or other beverages 1 c. Fist
    Salad dressing 1 Tbsp. Thumb
    Oil 1 tsp. Thumb tip

    everyday connection

    If you wait many hours between meals, there is a good chance you will overeat. To refrain from overeating try consuming small meals at frequent intervals throughout the day as opposed to two or three large meals. Eat until you are satisfied, not until you feel “stuffed.” Eating slowly and savoring your food allows you to both enjoy what you eat and have time to realize that you are full before you get overfull. Your stomach is about the size of your fist but it expands if you eat excessive amounts of food at one sitting. Eating smaller meals will diminish the size of your appetite over time so you will feel satisfied with smaller amounts of food.

    Discretionary Calories

    When following a balanced, healthful diet with many nutrient-dense foods, you may consume enough of your daily nutrients before you reach your daily calorie limit. The remaining calories are discretionary (to be used according to your best judgment). To find out your discretionary calorie allowance, add up all the calories you consumed to achieve the recommended nutrient intakes and then subtract this number from your recommended daily caloric allowance. For example, someone who has a recommended 2,000-calorie per day diet may eat enough nutrient-dense foods to meet requirements after consuming only 1,814 calories. The remaining 186 calories are discretionary. See Table \(\PageIndex{1}\). These calories may be obtained from eating an additional piece of fruit, adding another teaspoon of olive oil on a salad or butter on a piece of bread, adding sugar or honey to cereal, or consuming an alcoholic beverage[1].

    The amount of discretionary calories increases with physical activity level and decreases with age. For most physically active adults, the discretionary calorie allowance is, at most, 15 percent of the recommended caloric intake. By consuming nutrient-dense foods, you afford yourself a discretionary calorie allowance.

    Table \(\PageIndex{1}\): Sample Menu Plan Containing 2,000 Calories.

    MealCaloriesTotal Meal/Snack Calories
    Breakfast
    1 scrambled egg 92
    with sliced mushrooms and spinach 7
    ½ whole-wheat muffin 67
    1 tsp. margarine-like spread 15
    1 orange 65
    8 oz. low-sodium tomato juice 53 299
    Snack
    6 oz. fat-free flavored yogurt 100
    with ½ c. raspberries 32 132
    Lunch
    1 sandwich on pumpernickel bread 160
    with smoked turkey deli meat, 30
    4 slices tomato 14
    2 lettuce leaves 3
    1 tsp. mustard 3
    1 oz. baked potato chips 110
    ½ c. blueberries, with 1 tsp. sugar 57
    8 oz. fat-free milk 90 467
    Snack
    1 banana 105
    7 reduced-fat high-fiber crackers 120 225
    Dinner
    1 c. Greek salad (tomatoes, cucumbers, feta) 150
    with 5 Greek olives, 45
    with 1.5 tsp. olive oil 60
    3 oz. grilled chicken breast 150
    ½ c. steamed asparagus 20
    with 1 tsp. olive oil, 40
    with 1 tsp. sesame seeds 18
    ½ c. cooked wild rice 83
    with ½ c. chopped kale 18
    1 whole-wheat dinner roll 4
    with 1 tsp. almond butter 33 691
    (Total calories from all meals and snacks = 1,814)
    Discretionary calorie allowance: 186

    (Total calories from all meals and snacks = 1,814)
    Discretionary calorie allowance: 186

    Healthy Eating Index

    To assess whether the American diet is conforming to the Dietary Guidelines, the Center for Nutrition Policy and Promotion (CNPP), a division of the USDA, uses a standardized tool called the Healthy Eating Index (HEI)[2].

    The first HEI was developed in 1995 and revised in 2006. This tool is a simple scoring system of dietary components. The data for scoring diets is taken from national surveys of particular population subgroups, such as children from low-income families or Americans over the age of sixty-five. Diets are broken down into several food categories including milk, whole fruits, dark green and orange vegetables, whole grains, and saturated fat, and then a score is given based on the amount consumed. For example, a score of ten is given if a 2,000-kilocalorie diet includes greater than 2.6 cups of milk per day. If less than 10 percent of total calories in a diet are from saturated fat, a score of eight is given. All of the scores are added up from the different food categories and the diets are given a HEI score. Using this standardized diet-assessment tool at different times, every ten years for instance, the CNPP can determine if the eating habits of certain groups of the American population are getting better or worse. The HEI tool provides the federal government with information to make policy changes to better the diets of American people. For more information on the HEI, visit this website: www.cnpp.usda.gov/healthyeatingindex.htm.

    The Whole Nutrient Package versus Disease

    A healthy diet incorporating seven or more servings of fruits and vegetables has been shown in many scientific studies to reduce cardiovascular disease and overall deaths attributable to cancer. The WHO states that insufficient fruit and vegetable intake is linked to approximately 14 percent of gastrointestinal cancer deaths, about 11 percent of heart attack deaths, and 9 percent of stroke deaths globally[3].

    The WHO estimates that, overall, 2.7 million deaths could be avoided annually by increasing fruit and vegetable intake. These preventable deaths place an economic, social, and mental burden on society. This is why, in 2003, the WHO and the Food and Agricultural Organization of the United Nations launched a campaign to promote fruit and vegetable intake worldwide.

    Antioxidant Variety in Food Provides Health Benefits

    Not only has the several-billion-dollar supplement industry inundated us with FDA-unapproved health claims, but science is continuously advancing and providing us with a multitude of promising health benefits from particular fruits, vegetables, teas, herbs, and spices. For instance, blueberries protect against cardiovascular disease, an apple or pear a day reduces stroke risk by over 52 percent, eating more carrots significantly reduces the risk of bladder cancer, drinking tea reduces cholesterol and helps glucose homeostasis, and cinnamon blocks infection and reduces the risk of some cancers. However, recall that science also tells us that no one nutrient alone is shown to provide these effects.

    What micronutrient and phytochemical sources are best at protecting against chronic disease? All of them, together. Just as there is no wonder supplement or drug, there is no superior fruit, vegetable, spice, herb, or tea that protects against all diseases. A review in the July–August 2010 issue of Oxidative Medicine and Cellular Longevity concludes that the plant-food benefits to health are attributed to two main factors—that nutrients and phytochemicals are present at low concentrations in general, and that the complex mixtures of nutrients and phytochemicals provides additive and synergistic effects[4]. In short, don’t overdo it with supplements and make sure you incorporate a wide variety of nutrients in your diet.

    Eating a variety of fruits and vegetables rich in antioxidants and phytochemicals promotes health. Consider these diets:
    Mediterranean diet. Fresh fruit and vegetables are abundant in this diet, and the cultural identity of the diet involves multiple herbs and spices. Moreover, olive oil is the main source of fat. Fish and poultry are consumed in low amounts and red meat is consumed in very low amounts. An analysis of twelve studies involving over one million subjects published in the September 2008 issue of the British Medical Journal reports that people who followed the Mediterranean diet had a 9 percent decrease in overall deaths, a 9 percent decrease in cardiovascular death, a 6 percent decrease in cancer deaths, and a 13 percent reduced incidence of Parkinson’s disease and Alzheimer’s disease[5]. The authors of this study concluded that the Mediterranean diet is useful as a primary prevention against some major chronic diseases.

    Dietary Approaches to Stop Hypertension (DASH diet). Recall from Chapter 7 “Nutrients Important to Fluid and Electrolyte Balance” that the DASH diet is an eating plan that is low in saturated fat, cholesterol, and total fat. Fruits, vegetables, low-fat dairy foods, whole-grain foods, fish, poultry, and nuts are emphasized while red meats, sweets, and sugar-containing beverages are mostly avoided. Results from a follow-up study published in the December 2009 issue of the Journal of Human Hypertension suggest the low-sodium DASH diet reduces oxidative stress, which may have contributed to the improved blood vessel function observed in salt-sensitive people (between 10 to 20 percent of the population)[6].

    Diets high in fruits and vegetables. An analysis of The Nurses’ Health Study and the Health Professionals’ Follow-up Study reported that for every increased serving of fruits or vegetables per day, especially green leafy vegetables and vitamin C-rich fruits, there was a 4 percent lower risk for heart disease[7].

    An article in the January 2009 issue of the Medscape Journal of Medicine reports that fewer than one in ten Americans consumes the recommended amount of fruits and vegetables, which is between five and thirteen servings per day[8]. According to this study, the largest single contributor to fruit intake was orange juice, and potatoes were the dominant vegetable.

    The USDA recommends that you fill half your plate with fruits and vegetables. The number of servings of fruits and vegetables that a person should consume every day is dependent on age, sex, and level of physical activity. For example, a forty-year-old male who exercises for sixty minutes per day should consume 2 cups of fruit and 3½ cups of vegetables, while a fifteen-year-old female who exercises for thirty minutes per day should consume 1½ cups of fruit and 2½ cups of vegetables. (One cup of a fruit or vegetable is equal to one banana, one small apple, twelve baby carrots, one orange, or one large sweet potato.) To find out the amount of fruits and vegetables the Centers for Disease Control and Prevention (CDC) recommends, see Note 8.25 “Interactive 8.4”.

    Improving Fruit and Vegetable Intake at Home and in Your Community

    Eating more fruits and vegetables can make you think better, too. According to a study published in 2009 in the Journal of Alzheimer’s Disease, no matter your age, eating more fruits and vegetables improves your brain function[9]. Check out Note 8.26 “Interactive 8.5” for thirteen fun ways to increase your fruit and vegetable intake.

    The CDC has developed seven strategies to increase American’s intake of fruits and vegetables[10].

    1. Support local and state governments in the implementation of a Food Policy Council, which develops policies and programs that increase the availability of affordable fruits and vegetables.
    2. In the food system, increase the availability and affordability of high-quality fruits and vegetables in underserved populations.
    3. Promote farm-to-where-you-are programs, which is the delivery of regionally grown farm produce to community institutions, farmers markets, and individuals.
    4. Encourage worksites, medical centers, universities, and other community and business establishments to serve more fruits and vegetables in cafeterias and onsite eateries.
    5. Support schools in developing healthy food messages to students by incorporating activities such as gardening into curricula.
    6. Encourage the development and support of community and home gardens.
    7. Have emergency food programs, including food banks and food rescue programs, increase their supply of fruits and vegetables.

    The seven strategies developed by the CDC are based on the idea that improving access to and availability of fruits and vegetables will lead to an increase in their consumption.

    Footnotes

    1. US Department of Agriculture. MyPyramid Education Framework. Accessed July 22, 2012.
    2. Healthy Eating Index. US Department of Agriculture. www.cnpp.usda.gov/healthyeatingindex.htm. Updated March 14, 2012. Accessed November 22, 2017.
    3. Global Strategies on Diet, Physical Activity, and Health. World Health Organization. http://www.who.int/dietphysicalactiv.../en/index.html. Accessed September 30, 2011.
    4. Bouayed, J. and T. Bohn. Exogenous Antioxidants—Double-Edged Swords in Cellular Redox State: Health Beneficial Effects at Physiologic Doses versus Deleterious Effects at High Doses. Oxidative Medicine and Cellular Longevity. 2010; 3(4), 228–37. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2952083/?tool=pubmed. Accessed November 22, 2017.
    5. Sofi F, et al.Adherence to Mediterranean Diet and Health Status: Meta-Analysis. Br Med J. 2008; 337, a1344. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2533524/. Accessed November 22, 2017.
    6. Al-Solaiman Y, et al. Low-Sodium DASH Reduces Oxidative Stress and Improves Vascular Function in Salt-Sensitive Humans. J Hum Hypertens. 2008; 12, 826–35. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2783838/?tool=pubmed. Accessed November 22, 2017.
    7. Joshipura KJ, et al. The Effect of Fruit and Vegetable Intake on Risk for Coronary Heart Disease. Ann Intern Med. 2001; 134(12), 1106–14. http://www.ncbi.nlm.nih.gov/pubmed/11412050. Accessed November 12, 2017.
    8. Kimmons J, et al. Fruit and Vegetable Intake among Adolescents and Adults in the United States: Percentage Meeting Individualized Recommendations. Medscape Journal of Medicine. 2009; 11(1), 26. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2654704/?tool=pubmed. Accessed November 22, 2017.
    9. Polidori MC, et al. High Fruit and Vegetable Intake Is Positively Correlated with Antioxidant Status and Cognitive Performance in Healthy Subjects. Journal of Alzheimer’s Disease. 2009; 17(4), 921–7. http://www.ncbi.nlm.nih.gov/pubmed/19542607. Accessed November 22, 2017.
    10. The CDC Guide to Fruit and Vegetable Strategies to Increase Access, Availability, and Consumption. Centers for Disease Control and Prevention. www.cdph.ca.gov/SiteCollectio...onsumption.pdf. Updated March 2010. Accessed November 22, 2017.

    What is the best way to incorporate phytochemicals into your dietary pattern?

    Summary. The best way to get phytochemicals in your diet is to eat a wide variety of fruits, berries, vegetables, legumes, beans and whole grains. Following the recommended number of servings from the Food Guide is the best way to get all of the nutrients and phytochemicals you need.

    Which of the following options would be the best way to increase intake of dietary fiber quizlet?

    The best way to increase intake of dietary fiber is to eat more? Whole grain cereal, fruits and veggies, and dried peas.

    Which of the following were components of the dietary approaches to stop hypertension dash score select all that apply?

    The Dietary Approaches to Stop Hypertension (DASH) which emphasizes fruits and vegetables, plant proteins, moderate amounts of low-fat dairy products, and low amounts of sweets and sodium, is a healthy eating pattern recommended for the general public by the United States Department of Agriculture [7, 9, 10].

    Which of the following foods has the highest energy density?

    Fat provides 9 calories per gram, making it the nutrient with the highest energy density.