Defining A Healthy Diet: Challenges and Conundrums

Paul Branscum, PhD, RD

Manoj Sharma MBBS, PhD, MCHES, FAAHB
Abstract: As researchers and practitioners, we are often asked the question ‘what makes up a healthy diet.’
The purpose of this commentary was to bring light to this issue, and help define important behaviors that
lead to consuming a healthy diet. A brief background of dietary recommendations is provided, including
recommendations for macronutrients and micronutrients, as well as foods and food groups. After reading
this commentary, it should be clear that whereas the concept of a healthy diet can be vague and abstract,
there are key recommendations that help discern healthy and unhealthy eating. Also, even though the term
healthy diet may be too vague for scientific investigation, social and behavioral scientists can predict and
change behaviors related to a healthy diet, including those related to Dietary Reference Intakes [e.g., “Con-
suming between 900 and 3000 micrograms of Vitamin A everyday of the week” (for an adult man)] and
MyPlate recommendations (e.g., “Consuming at least 4 oz (or equivalent) of whole grains, every day of the
week”). Guidance on defining appropriate behaviors for scientific investigation and practice is presented.
Keywords: healthy diet; nutrition; healthy eating behaviors.
INTRODUCTION etables, and whole grains and less salt, saturated and
As researchers and practitioners, we are often trans-fats, and added sugars.
asked the question ‘what makes up a healthy diet.’ Steps towards Defining a Healthy Diet: Micro
Although at first this question may appear to have and Macro Nutrient Recommendations
a simple answer, the answer is surprisingly difficult One aspect of a healthy diet is that it contains
to articulate. Currently, the U.S. dietary guidelines food. Whereas the definition of the term food may
describe a healthy diet as one that: (1) “Emphasizes appear to be clear, various definitions have been
fruits, vegetables, whole grains, and fat-free or low- proposed. Merriam Webster’s Online Dictionary
fat milk and milk products;” (2) “Includes lean describes food as “material consisting essentially
meats, poultry, fish, beans, eggs, and nuts;” and (3) of protein, carbohydrate, and fat used in the body
“Is low in saturated fats, trans fats, cholesterol, salt of an organism to sustain growth, repair, and vital
(sodium), and added sugars” (United States Depart- processes and to furnish energy” also “such food to-
ment of Agriculture [USDA], 2011). It is important gether with supplementary substances (as minerals,
to note that these guidelines are meant for the gener- vitamins, and condiments).” Because the Food and
al public two years of age or older. The World Health Drug Administration (FDA) has jurisdiction over
Organization (WHO) recommends that diets for the regulation and safety of food, the term food has
populations should: (1) balance energy to maintain been defined by the Federal Food, Drug, and Cos-
a healthy weight; (2) limit energy from fats, con- metic Act as “(1) articles used for food or drink for
sume unsaturated fats instead of saturated fats, and man or other animals, (2) chewing gum, and (3) ar-
eliminate trans-fats; (3) eat more fruits, vegetables, ticles used for components of any such article” (Fed-
legumes, whole grains and nuts; (4) eat less added eral Food, Drug, and Cosmetic Act, 2009). Compo-
and free sugars; and (5) limit overall salt intake and nents that make up the food we eat are classified into
ensure salts are iodized (WHO, 2011). From these macronutrients (nutrients are body need in relatively
two definitions one can see defining a healthy diet is large amounts, and are typically measured in grams)
difficult and often abstract. The Academy of Nutri- and micronutrients (nutrients our bodies need in
tion and Dietetics (AND) adds that the most impor- relatively small amounts and can be measured in
tant factor in determining a healthy diet is to inspect milligrams or micrograms or even smaller amounts).
one’s entire diet and eating behaviors. When con-
sumed in moderation, all foods can be consumed as It is beyond the scope of this commentary to
part of a healthy diet, making it difficult, or virtually discuss the various types of macronutrients and mi-
impossible, to label specific foods as ‘good’ or ‘bad’ cronutrients; however, when defining a healthy diet,
(AND, 2014). one should be aware that there are a number of rec-
ommendations pertaining to macronutrients and
When examining these definitions, it becomes micronutrients that would help define a healthy diet.
clear that a healthy diet should be one that contains The genesis of the government making nutrient rec-
an adequate amount of macronutrients and micro- ommendations dates back to 1941, when the Food
nutrients, contain enough energy (or calories) to and Nutrition Board developed the first set of rec-
prevent weight loss, but also not more calories than ommendations for vitamins, minerals, protein, and
the body needs which will promote weight gain, and calories (Otten, Hellwig, & Meyers, 2006). These
foods should be balanced to include more fruits, veg-
Send correspondence to: Paul Branscum, Assistant Professor, University of Oklahoma, Department of Health and
Exercise Science, 1401 Asp Avenue, Norman, OK 73019 pbranscum@ou.edu Manoj Sharma, Professor, Behavioral &
Environmental Health, School of Health Sciences, Jackson State University, Jackson, MS.
- 271 -

recommendations were meant to serve as a “yard-
stick” to measure success towards good nutrition, and
have served as the basis for almost all federal and
state food and nutrition programs and policies. The
recommendations also have grown from 9 nutrients
to 27. Overall, micronutrients and macronutrients
are recommended under the umbrella term dietary
reference intake (DRI). A number of DRIs exist, en-
compassing nutrient recommendations that would
help to classify a healthy diet. Estimated Average Re-
quirements (EARs) are the first type of recommen-
dation, and encompasses the daily average intake of
nutrients that are estimated to meet the needs of half
of individuals of a particular gender and life stage.
EARs also are considered the primary reference point
for assessing the adequacy of nutrient intakes of spe-
cial groups, however values are not meant to serve as
a goal for individual intake. Currently 19 nutrients
have EAR’s (Otten, et al., 2006).
The next type of DRI is the Recommended Di-
etary Allowance (RDA), which represents the aver-
age daily nutrient needs of almost all (97%-98%)
of healthy individuals in a particular gender and life
stage. Unlike EARs, RDAs are meant to serve as a
guide for individual nutrient intake, because it is
typically above the requirements for most people in
a special group. Individuals who consume less than
the RDA of a specific nutrient may still consume
an adequate amount; however, the less they con-
sume the nutrient the greater the risk becomes for
a nutrient deficiency. RDAs also can be calculated
from EARs because they are generally two standard
deviations greater (Otten, et al., 2006). Thus: RDA
= EAR + 2 Standard Deviations. Another proposed
rule of thumb for calculating RDAs from EARs
(Byrd-Bredbenner, Moe, Beshgetoor, & Berning,
2009) is: RDA = EAR * 1.2.
Another type of DRI is the Adequate Intake
(AI), which represents the estimated daily nutrient
needs for nutrients that individual requirements can-
not be determined. This gives the public a guide to
determine the intake of certain nutrients that is ade-
quate on a daily basis. This level of intake is based on
observational and experimental studies that approxi-
mate nutrient needs for relatively healthy individuals
to maintain a defined nutrient state in a life stage.
Examples of a defined nutrient state include normal
growth, maintenance of normal circulating nutrient
values, or other aspects of nutritional well-being or
general health. An example of a nutrient that has an
AI is calcium that has no RDA because there is no
laboratory test that indicates calcium status in the
body. Even under extreme situations, such as mal-
nutrition or starvation, circulating levels of calcium
in the blood can remain normal. Because this is the
case, there is inadequate information available to de-
termine an EAR (and an RDA) for calcium, and an
AI was developed in its place (Otten, et al., 2006).
Other nutrients with AIs include certain types of
fatty acids, fiber, and nine vitamins and minerals.
The next type of DRI is the Tolerable Upper
Branscum, Sharma
Intake Level (UL), which represents the highest pos-
sible level of daily intake of a nutrient that will likely
create no adverse health risks for almost all individ-
uals in the population in a life stage. ULs are not
meant to serve as a goal for intake; rather, they are
meant to serve as a ceiling for intake because con-
suming nutrients above a UL presents the possibility
of having a nutrient toxicity. This recommendation
was designed to protect the public from consuming
too much of a nutrient (Otten, et al., 2006). For
example, the UL for vitamin A is 3000 µg/day. In-
takes greater than this can lead to multiple problems
including headache, vomiting, a dry mucus mem-
brane, and joint and bone pain (Byrd-Bredbenner,
et al., 2009).
Energy has a special type of DRI known as the
Estimated Energy Requirement (EER). An EER
is defined as the amount of energy an individual
should consume to maintain an energy balance,
whereby the amount of energy they expend (e.g.,
through physical activities) equals the amount of en-
ergy they consume (e.g., through foods and drinks).
Energy can expressed in multiple ways, but is usu-
ally expressed in calories. Factors that are considered
when estimating energy requirements are age, gen-
der, height, weight, and level of physical activity. The
EERs for men and women over the age 19 are: men
662 – (9.53 x Y) + PA x [(15.91 x W) + (539.6 x H)];
women 354 – (6.91 x Y) + PA x [(9.36 x W) + (726 x
H)] where Y = years; W = weight in kilograms; H =
Height in meters; PA = Physical Activity Coefficient
(Otten, et al., 2006, p. 84).
The newest category of DRIs includes Adequate
Macronutrient Distribution Ranges (AMDRs).
AMDR represents an acceptable range for daily
intake of fats, proteins, and carbohydrates that re-
duces the chances for chronic disease over the long
term, allows the consumption of essential nutrients
at adequate levels, and are associated with sufficient
energy (or calorie) intake and physical activity to
maintain energy balance. AMDRs are the same for
both genders but differ at three life stages (Otten,
et al., 2006). For young children the AMDRs are
30% to 40% fat, 5% to 20% protein, and 45% to
65% carbohydrates. For children, the AMDR’s are
25% to 35% fat, 10% to 30% for protein, and 45%
to 65% carbohydrates. For adults the AMDR’s are
20% to 35% fat, 10% to 35% protein, and 45%
to 65% carbohydrates. Any combination within the
AMDRs is acceptable (Otten, et al., 2006).
Steps towards Defining a Healthy Diet: Dietary
Guidelines and MyPlate
Whereas understanding macronutrient and mi-
cronutrient recommendations are important for a
healthy diet, such recommendations do not include
actual foods or food groups, for which there is a
long history of recommendations. W. O. Atwater is
credited as the first scientist to develop components
that led to making dietary standards (Welch, Davis,
& Shaw, 1992a). In 1894, Atwater published food
tables with data on protein, fat, carbohydrates, ash
- 272 -
 American Journal of Health Studies Vol 29 (4) 2014
(mineral matter), and ‘fuel’ values of foods that were
commonly eaten at the time. These standards were
meant to represent protein and calorie needs for the
average man. His work led to the development of
food guides as we know them today.
The first food guide was developed by Caroline
Hunt, a nutrition expert working for the USDA.
Published in 1916 in Food for Young Children, her
guide categorized foods into five groups: milk and
meat, vegetables and fruits, fats and fat foods, sugars,
and sugary foods. Later she published the guide How
to Select Foods that targeted the general population.
In the 1930s, as a result of the great depression, fam-
ilies needed advice concerning how to choose foods
under financial constraints. Food buying guides were
then developed by Hazel Stiebeling, a food econo-
mist in the USDA’s Bureau of Home Economics,
which consisted of food plans at four cost levels for
families on different budgets. Each level gave guid-
ance on choosing foods from 12 categories: milk;
potatoes and sweet potatoes; dry beans, peas and
nuts; tomatoes and citrus fruits; leafy green and yel-
low vegetables; other vegetables and fruits; eggs; lean
meats; poultry and fish; flours and cereals; butter;
other fats; and sugars (Welch, et al., 1992a).
In the 1940s the USDA’s bureau of Home Eco-
nomics developed Eat the Right Food to Help Keep
you Fit, and shortly thereafter, the Basic Seven food
guide was issued as part of the National Wartime Nu-
trition Guide. This reduced the food groups to seven,
including: milk and milk products; meat, poultry,
fish, eggs, dried beans, peas, and nuts; bread, flour,
and cereals; leafy green vegetables; potatoes and oth-
er fruits and vegetables; citrus, tomato, cabbage, and
salad greens; and butter-fortified margarine (Welch,
et al., 1992a). After World War II, this guide was
revised as the National Food Guide, but was diffi-
cult to use given its lack of specificity. In 1956 the
USDA reissued the food guide into four groups, in
the Essentials of an Adequate Diet. Four food groups
included in this guide were milk and milk products,
meats, fruits and vegetables, and grain products. In
1977 a new direction for government food guidance
was established with the publication of the Dietary
Goals for the United States. This report set goals for
protein, carbohydrates, fat, fatty acids, cholesterol,
sugars, and sodium. Then, in 1980, the first edition
of the Dietary Guidelines for Americans was published
jointly by the USDA and the Department of Health
and Human Services, to provide the public with
the most up-to-date information on healthy eating
(Welch, et al., 1992a). Since the 1980s this publica-
tion has been revised every five years. This is done
according to the National Nutrition Monitoring and
Related Research Act of 1990 (Public Law 101-445)
which states:
At least every five years the Secretaries shall publish
a report entitled "Dietary Guidelines for Americans."
Each such report shall contain nutritional and dietary
information and guidelines for the general public, and
shall be promoted by each Federal agency in carrying
- 273 -
out any Federal food, nutrition, or health program (Na-
tional Nutrition Monitoring and Related Research
Act, 1990).
A summary of every published set of Dietary
Guidelines is found in Appendix A. The first Di-
etary Guidelines contained six key messages, and
with each new edition published, the key messages
slightly changed. The most current version is the Di-
etary Guidelines for Americans 2010, and when put
together, the current guidelines encompass two over-
arching concepts: (1) maintain calorie balance over
time to achieve and sustain a healthy weight; and
(2) focus on consuming nutrient-dense foods and
beverages. The first concept deals with two goals: (1)
achieving a healthy weight; and (2) maintaining a
healthy weight. There is no ideal weight for every
individual; however, there are ranges for healthy
weight and other criteria that can be used as a guide,
such as the body mass index (Teague, Mackenzie, &
Rosenthal, 2011). The second concept deals with
focusing on nutrient dense foods and beverages.
A nutrient dense food is one that provides a good
source of vitamins and minerals, with fewer calories.
Nutrient dense foods that are recommended include
fruits, vegetables, whole grains, and fat-free or low-
fat dairy foods.
The Dietary Guidelines for Americans 2010 is
further broken into five chapters with interrelated
key recommendations. Chapter two, entitled ‘Bal-
ancing Calories to Manage Weight’ discusses the
term calorie balance, ways Americans can achieve
calorie balance, and describes various factors asso-
ciated with overweight and obesity. Chapter three,
entitled ‘Foods and Food Components to Reduce’
discusses various diet components that Americans
generally eat in excess, including foods high in so-
dium, saturated fats, trans-fats, cholesterol, added
sugars, refined grains, and for some, alcohol. The
chapter further discusses how Americans can replace
these foods and food components with healthier
alternatives. Chapter four, entitled ‘Foods and Nu-
trients to Increase’ discusses various dietary compo-
nents that are needed to address nutrient adequacy,
disease prevention, and overall health and wellness.
Key foods the chapter focuses on include vegetables,
fruits, whole grains, fat-free or low-fat milk and milk
products, proteins, and oils. Key vitamins and min-
erals that are discussed include potassium, dietary
fiber, calcium, and vitamin D. Chapter five, entitled
‘Building Healthy Eating Patterns’ culminates the
previous chapters to discuss how to eat an overall
healthy diet. The final chapter, chapter six, entitled
‘Helping Americans Make Healthy Choices’ dis-
cusses two critically important concepts. First is the
importance of their physical activity and food envi-
ronment as it relates to having a healthy weight. The
second concept deals with making America healthy,
and addressing how all elements of our society, in-
cluding individuals and families, communities, busi-
ness and industry, and various levels of government
play a role (USDA, & DHHS, 2010).

Whereas the Dietary Guidelines were meant
to serve as a resource for the public and nutrition
educators, once the first guidelines were published in
1980, the USDA started work on developing a pic-
torial guide that would translate the recommenda-
tions in an illustration. The first food guide was test-
ed thoroughly to be informative, simple, useful and
also visually pleasing. In 1984, in cooperation with
the American Red Cross, the USDA released a Food
Wheel. To update the food wheel, USDA researchers
tested five different graphics to consumer groups in
the late 1980s, and the pyramid design was found to
be most appealing to consumers as it was visually ap-
pealing, as well as easy to use and remember (Welsh,
Davis, Shaw, 1992b). In 1992, the USDA unveiled
the new Food Guide Pyramid, which increased the
number of food groups from 4 to 6 (grain, fruits,
vegetables, milk, meat, and fats, oils, and sweets).
In 2005, the USDA retired the Food Guide Pyra-
mid and replaced it with MyPyramid: Steps to a
Healthier You. This food guide rectified misconcep-
tions about the old pyramid that were unclear. For
example, the Food Guide Pyramid recommended
adults consume 6 to 11 servings of grains per day,
and consumers were confused about this recommen-
dation, because it brought up the questions: Should
I consume 6 servings or 11 servings? How much is
one serving? What kinds of grains are important? To
make this more clear, MyPyramid released 12 differ-
ent pyramids with calorie levels from 1000 calories
to 3200 calories, and gave specific guidance on each
food group, in terms of which foods to include, and
how much.
In 2011, the USDA released the MyPlate food
guide, abandoning the pyramid schematic in place
of a place setting (Figure 1). The place setting, and
specifically, the plate, was chosen to remind consum-
ers what a healthy meal looks like when they eat.
Upon looking at the MyPlate food guide, it becomes
clear which food groups are emphasized and which
foods should be limited. The four sections of the
plate symbolize the amount of space on a plate that
fruits, vegetables, grains, and proteins should take.
The place setting also emphasizes the importance of
dairy foods by the placement of a cup.
Figure 1. The U.S Department of Agriculture MyPlate
Branscum, Sharma
Starting in the upper left hand corner of the
plate is the fruit group. The key message for the fruit
group is to focus on fruit, which emphasizes the need
to eat whole fruits instead of fruit-flavored foods,
or fruit juices. This was done because whole fruits
are typically nutrient dense, whereas fruit juices are
typically calorically dense and have no fiber. Going
clockwise around the plate, the next group is the
grains group. Foods in this group are those that are
made from any type of grain, including wheat, rice,
cornmeal and oats. The key message for this group
is to make at least half of your grains whole. MyPlate
categorizes grains as whole grains and refined grains,
with whole grains containing the entire grain kernel
(bran, germ, and endosperm) and refined grains as
those that have the bran and germ removed, which
in turn removes the dietary fiber, iron, and many B
vitamins. The next group is the protein group, which
was previously named the meat and beans group. The
key message for this group is go lean with protein.
Foods from this group include various types of ani-
mal proteins, including meats (seafood, beef, poultry
etc.) and eggs. Vegetarian or vegan options in this
group include soy products, nuts, seeds, beans and
peas. Regardless of which type of protein food an
individual eats, lower fat and leaner options are rec-
ommended. Rounding out the plate is the vegetable
group. The key message for this group is to vary your
vegetables. There are also five categories of vegetables
from which individuals should consume on a regu-
lar basis. These includes dark green vegetables (e.g.,
broccoli, collard greens), red and orange vegetables
(e.g., carrots, tomatoes), beans and peas (e.g., black
beans, soy beans), starchy vegetables (e.g., corn, po-
tatoes), and other vegetables (e.g., celery, onions).
Also included in the place setting is the cup for
the dairy group. The key message for this group is
get your calcium rich foods. This group includes all
types of dairy products such as milk, cheese, and yo-
gurt; but, an addition to this group, from the old
food guide is calcium fortified soy beverages (which
was considered a vegetable in the MyPyramid food
guide). Not depicted on the MyPlate are oils, empty
calories, and physical activity. Oils are not consid-
ered a food group, but are recognized as important
because they provide essential nutrients. Many
Americans get enough oil in their diet, and the key
message for this recommendation is choose oils high
in monosaturated and polyunsaturated fats, in place
of butters and shortening. Empty calories are also ad-
dressed in this food guide system. A large amount of
empty calories comes from foods with solid fats and
added sugars. Finally, physical activity is addressed
in this food guide system. Americans should engage
in moderate to vigorous physical activities on most
days of the weeks. There are no specific recommen-
dations for young children (2-5 years). For children
and adolescents 6-17 years of age, it is recommended
to engage in at least 60 minutes of activity each day.
For adults (18-64 years) 2 hours and 30 minutes of
aerobic physical activity at a moderate level or 1 hour
and 15 minutes of aerobic physical activity at a vig-
- 274 -
 American Journal of Health Studies Vol 29 (4) 2014
orous level is recommended.
DISCUSSION
Defining a Healthy Diet
After reading this commentary, it should be
clear that whereas the concept of a healthy diet can
be vague and abstract, there are key recommenda-
tions that help differentiate healthy and unhealthy
eating. It also should be clear that a healthy diet is
a term too vague for scientific investigation. How-
ever, social and behavioral scientists can predict and
change behaviors related to a healthy diet. All of the
DRI recommendations are based on daily intakes;
therefore, researchers can study the important envi-
ronmental and psychosocial determinants of why in-
dividuals consume adequate or inadequate amounts
of micronutrients or macronutrients on a daily basis,
and practitioners should tailor messages about DRI
to daily intakes. Food guides, such as MyPlate, also
mostly recommend the amounts of each food groups
that should be consumed on a daily basis, as with the
fruits, dairy, and protein food groups; however, spe-
cial recommendations have been made for the vege-
tables group (sub-types of vegetables should be eaten
on a weekly basis), and the grains group (which gives
daily recommendations of the entire group, and dai-
ly minimum amounts of whole grains).
Researchers interested in predicting and chang-
ing health behaviors related to a healthy diet should
be careful when delineating the behavior they wish
to investigate. As Fishbein and Ajzen (2010) note:
Because our concern is with predicting and under-
standing human social behavior, the first and in some
ways the most crucial step is to clearly define the behav-
ior of interest, a task that is much more complex than it
might at first appear (p. 29).
According to Fishbein and Ajzen (2010), all
behaviors should be defined using the elements of
the TACT (Target Action Context and Time) acro-
nym. Said another way, a behavior should include
an action, a target for the action, a context in which
the action is performed, and a time to perform the
behavior. For example, using the DRI and MyPlate
recommendations, the following behaviors related to
a healthy diet may be predicted and intervened upon
with respect to adult men:
• Consuming between 900 and 3000 micro-
grams of Vitamin A everyday of the week.
*Note: Because the AI of Vitamin A is
900 micrograms and the UL is 3000 micrograms, 6, 2015 from http://www.choosemyplate.gov/
a healthy diet would be one that contained a level
between these two recommendations.
• Consuming protein between 10% and
35% of my daily calorie intake, every day of the
week.
• Consuming at least 4 oz (or equivalent) of
whole grains, every day of the week.
This is not to say the only important behaviors
related to a healthy diet are those related to the DRIs
and MyPlate. It is vital for researchers and practi-
- 275 -
tioners to be aware of any special or specific behav-
iors related to a healthy diet within the populations
with which they wish to work. For example, among
athletes, protein needs are higher (1.2 – 2.0 g/kg of
body weight) than sedentary individuals (0.80 g/kg
of body weight) (Fink, Mikesky, & Burgoon, 2013);
among pregnant women, micronutrient and mac-
ronutrient needs are higher (USDA, 2014); and for
adults on hemodialysis, high amounts of salt, potas-
sium, and phosphorous can be problematic; there-
fore, choosing foods low in these nutrients is rec-
ommended (National Kidney Foundation, 2014).
In conclusion, it should be clear that whereas we all
strive for a healthy diet for ourselves, and the mem-
bers of the community we serve, we also should be
aware that a healthy diet is really a concept that can
be operationalized only to specific behaviors.
References
Academy of Nutrition and Dietetics (AND).
(2014). Does Eating a Healthy Diet Mean I
Can’t Eat My Favorite Foods? Retrieved January
6, 2015 from http://www.eatright.org/Public/
content.aspx?id=10646.
Byrd-Bredbenner, C., Moe, G., Beshgetoor, D.,
& Berning, J. (2009). Wardlaw’s perspective in
nutrition. New York, NY: McGraw Hill.
Federal Food, Drug, and Cosmetic Act, 21, U.S.C.
§ 321 (2009).
Fink, H. H., Mikesky, A. E., & Burgoon, L. A.
(2013). Practical applications in sports nutrition.
Burlingon, MA: Jones & Bartlett Publishers.
Fishbein, M., & Ajzen, I. (2010). Predicting and
changing behavior: The reasoned action approach.
New York, NY: Psychology Press.
National Kidney Foundation. (2014). Dietary
guidelines for adults starting on hemodialysis.
Retrieved January 6, 2015 from https://www.
kidney.org/atoz/content/dietary_hemodialysis.
National Nutrition Monitoring and Related Re-
search Act, 7, U.S.C. § 5341 (1990).
Otten, J. J., Hellwig, J. P., & Meyers, L. D. (eds).
(2006). Dietary reference intakes: The essential
guide to nutrient requirements. Washington,
DC: National Academies Press.
Teague, M. L., Mackenzie, S. L. C., Rosenthal, D.
M. (2011). Your health today. (3rd ed.). New
York, NY: McGraw Hill.
United States Department of Agriculture (USDA).
(2011). Dietary guidelines. Retrieved January
dietary-guidelines.html.
United States Department of Agriculture (USDA).
(2014). Nutritional needs during pregnancy.
Retrieved January 6, 2015 from http://www.
choosemyplate.gov/pregnancy- breastfeeding/
pregnancy-nutritional-needs.html.
World Health Organization (WHO). (2011).
Global strategy on diet, physical activity and
health: Diet. Retrieved January 6, 2015
from http://www.who.int/dietphysicalactivity/
diet/en/index.html.
 Branscum, Sharma
Welch, S., Davis, C., & Shaw, A. (1992a). A brief
history of food guides in the United States.
Nutrition Today, Nov/Dec, 6-11.
Welch, S., Davis, C., & Shaw, A. (1992b). Devel-
opment of the Food Guide Pyramid. Nutrition
Today, Nov/Dec, 12-23.

- 276 -
 American Journal of Health Studies Vol 29 (4) 2014
Appendix A Key guidelines and recommendations from the 1980 to 2010 dietary guidelines for Americans
19801 19852 19903 19954 20005 20056 20107
7 Guidelines 7 Guidelines 7 Guidelines 7 Guidelines 10 Guidelines in 3 groups Key Recommenda- Key Recommenda-
tions are grouped tions are grouped
under 9 inter-relat- under 5 inter-related
ed focus areas focus areas
Eat a variety of Eat a variety of Eat a variety of foods Eat a variety of foods Aim for Aim for a healthy weight Adequate nutri- Balancing calories
foods foods Fitness ents within calorie to manage weight
needs
Maintain ideal Maintain ideal Maintain ideal weight Balance the food Be Physical active each day Weight manage- Foods and food
weight weight you eat with physical ment components to
activity-maintain or reduce
improve your weight
Avoid too much Avoid too much Choose a diet low in Choose a diet with Build a Let the Pyramid guide your Physical activity Foods and nutri-
fat, saturated fat, fat, saturated fat, fat, saturated fat and plenty of grain prod- healthy food choices ents to increase
and cholesterol and cholesterol cholesterol ucts, vegetables, and base
fruits
Eat foods with Eat foods with Choose a diet with Choose a diet low in Choose a variety of grains Food groups to Building healthy
adequate starch adequate starch plenty of vegetables, fat, saturated fat and daily, especially whole grains encourage eating patters
and fiber and fiber fruits and grain prod- cholesterol
ucts
Avoid too much Avoid too much Use sugars only in Choose a diet low in Choose a variety of fruits Fats Helping Ameri-
sugar sugar moderation fat, saturated fat and and vegetables daily cans make healthy
cholesterol choices
Avoid too much Avoid too much Use salt and sodium Choose a diet moder- Keep food safe to eat Carbohydrates
sodium sodium only in moderation ate in sugars
If you drink If you drink alco- If you drink alcoholic Choose a diet moder- Choose Choose a diet that is low in Sodium and Potas-
alcoholic do so in holic beverages, do beverages, do so in ate in salt and sodium sensibly saturated fat and cholesterol sium
moderation so in moderation moderation and moderate in total fat
If you drink alcoholic Choose beverages and foods Alcoholic beverages
beverages, do so in to moderate your intake of
moderation sugars
Choose and prepare foods Food Safety
with less salt
If you drink alcoholic bever-
ages, do so in moderation
- 277 -
 Branscum, Sharma
Appendix A Key guidelines and recommendations from the 1980 to 2010 dietary guidelines for Americans
Sources:
1. United States Department of Agriculture and United States Department of Health and Human Services. (1980). Dietary guidelines for Americans. Washington, DC: U.S. Government
Printing Office.
2. United States Department of Agriculture and United States Department of Health and Human Services. (1985). Dietary guidelines for Americans. 2nd ed. Washington, DC: U.S. Gov-
ernment Printing Office.
3. United States Department of Agriculture and United States Department of Health and Human Services. (1990). Dietary guidelines for Americans. 3rd ed. Washington, DC: U.S. Gov-
ernment Printing Office.
4. United States Department of Agriculture and United States Department of Health and Human Services. (1995). Dietary guidelines for Americans. 4th ed. Washington, DC: U.S. Gov-
ernment Printing Office.
5. United States Department of Agriculture and United States Department of Health and Human Services (2000). Dietary guidelines for Americans. 5th ed. Washington, DC: U.S. Gov-
ernment Printing Office.
6. United States Department of Agriculture and United States Department of Health and Human Services. (2005). Dietary guidelines for Americans. 6th ed. Washington, DC: U.S. Gov-
ernment Printing Office..
7. United States Department of Agriculture and United States Department of Health and Human Services. (2010). Dietary guidelines for Americans. 7th ed. Washington, DC: U.S. Gov-
ernment Printing Office.
All materials under public domain
- 278 -
Copyright of American Journal of Health Studies is the property of Expert Health Data
System, Inc. and its content may not be copied or emailed to multiple sites or posted to a
listserv without the copyright holder's express written permission. However, users may print,
download, or email articles for individual use.