Do the U.S. Dietary Guidelines Help Americans Eat Healthier?

The recently updated Dietary Guidelines for Americans (DGA) and inverted food pyramid help us visualize a healthy diet. The updated DGAs urge us to eat more protein while also telling us that “these Guidelines return us to basics.” But dairy, vegetables, fruits, and whole grains are also on the menu of foods we should be eating more often.

Because the DGAs give guidance to all, the recommendations are designed to meet dietary needs from infancy to old age and every stage in between, including pregnancy and lactation. Yet how do these priorities compare to data on our real dietary shortfalls, what they have been, and whether we need to return to anything?  

My recent review of trends in what Americans eat (published in the Annual Review of Nutrition) took a look at the diets of Americans over time and found:

• Despite some declines from the 1970s, U.S. population protein intake is strong and largely meets the goals of the DGA.
• While not perfect in the past, total dairy intake has declined over time and remains low compared with the DGA targets.
• Americans have consistently had trouble meeting DGA fruit intake goals for decades.
• Similarly, Americans have had a very low and stable intake of vegetables that remains severely short of meeting DGA goals.
• Although the intake of whole grains has been very low, the total intake of all grains has mainly complied with the Guidelines over time.

Priorities based on the diet that Americans are eating compared to what they should be eating suggest that topline messages about increasing vegetables, fruits, and dairy should get the most attention. Protein doesn’t need as much promotion as the other food groups because we tend to get enough already.

Other messages from the new DGAs are more aligned with what Americans need to do to improve their diets. For example, the new DGAs encourage us to limit added sugars in our diets and to choose water and unsweetened beverages. Looking at what Americans drink over time shows us that these recommendations are backed by data.

Sweetened beverages are the top contributor of added sugars to the U.S. diet. The intake of sweetened beverages increased from the 1970s to 2000 both in amount and popularity. Since then, the percent of Americans drinking high-sugar beverages has started to gradually decrease. While this is an improvement, most of us will benefit from increasing our daily water intake and drinking fewer sweetened beverages.

The DGAs also recognize how age and life stages are important to what we eat because of different needs, behaviors, and diets as we age. For example, age makes a big difference in how well we meet recommendations. Sixty-five percent of 2- to 4-year-olds met fruit recommendations while only 13% of 14- to 18-year-olds did. Other factors like sex, race/ethnicity, and income are also important factors that influence our diets. Considering these factors and age will help us make more advancements in guiding the design of menus and programs to meet nutritional needs.

So, what can be done to help the priorities of the DGAs match the need to make the diets of people living in the U.S. healthier? Here are some recommendations:

• Prioritize messages about eating enough fruits and vegetables as a long-standing, continuing need in the U.S. diet.
• Prioritize dairy in DGA messaging to prevent further declines and encourage improvement.
• Continue to recommend water and unsweetened beverages.
• Meet people where they are through health campaigns and programs tailored to different ages, sexes, races/ethnicities, and incomes. For example, making sure that foods meet the cultural diets, preferences, and nutritional needs of children in school lunch programs across the country.

By taking these steps, we may empower dietary changes to move towards a healthier nation.