Library Index :: Weight in America: Obesity, Eating Disorders, and Other Health Risks :: Preventing Overweight and Obesity - Prevention Efforts Target Families, Communities, And Schools, Is Nutrition Education Working To Improve Americans' Diets?

Preventing Overweight and Obesity - Prevention Efforts Target Families, Communities, And Schools

Public health education, communication, and other programs aimed at families and communities were identified as the cornerstone of prevention efforts. The Call to Action put forth communication strategies and corresponding actions that may be taken to promote awareness about the effects of overweight on health and support healthy eating and physical activity. For example, the communication strategy of educating expectant parents and other community members about the protective effect of breastfeeding against the development of obesity was translated into the action of creating community environments that promote and support breastfeeding. (Children who are ever breastfed are 15%-25% less likely to become overweight, and those who are breastfed for six months or more are 20%-40% less likely.) Similarly, the communication objective to heighten consumer awareness about reasonable food and beverage portion sizes was coupled with action to encourage the food industry to provide sensible food and beverage portion sizes.

Prevention efforts were not only directed to families and communities but also to policy makers whose actions to establish social and environmental policy could support communities and families to be more physically active and consume healthier diets. Policy makers were exhorted to create more community-based obesity prevention and treatment programs for children and adults and provide demonstration grants to improve access to, and availability of, healthy affordable foods in inner cities. They also were advised to enact public policy to create and maintain safe and accessible sidewalks, walking and bicycle paths, and stairs.

In the community, schools offer ideal settings and multiple opportunities for preventing overweight and obesity by educating children about, and engaging them in, healthy eating and physical activity. To reinforce their messages concerning the importance of school physical activity and nutrition programs, schools can ensure that breakfast and lunch programs meet nutrition standards and provide food options that are low in fat, calories, and added sugars. Other ways to enact this communication strategy include offering healthy snacks in vending machines and school stores, and providing all students with quality daily physical education in order to cultivate the knowledge, attitudes, skills, behaviors, and confidence needed to be physically active for life.

Population-Based Prevention Programs Target Racial and Ethnic Minority Groups

Antronette K. Yancey and her colleagues reviewed studies of population-based interventions targeting communities composed primarily of members of racial and ethnic minorities. The investigators reported their findings in "Population-Based Interventions Engaging Communities of Color in Healthy Eating and Active Living: A Review" (Preventing Chronic Disease, vol. 1, no. 1, January 2004). They identified twenty-three interventions intended to promote healthy eating and active lifestyles aimed at African-American, Hispanic, Native American, Alaska Native, Asian, Native Hawaiian or Other Pacific Islander populations that met specific study criteria and were implemented between 1972 and 2000.

Yancey and her colleagues described several initiatives instituted during the 1970s to early 1990s that produced modest but measurable improvement in diet. For example, one program promoted reducing cholesterol and saturated fat intake via targeted print and electronic media in three semi-rural northern California towns with substantial Latino populations. Another intervention sought to engage African-American residents of public housing communities in Birmingham, Alabama, in group exercise programs. A third program cultivated regional coalitions of community-based organizations to develop fitness promotion activities such as walking clubs, cooking demonstrations and classes, aerobic exercise classes, walking trails, and health fairs.

NATIONAL INITIATIVE AIMS TO HELP AFRICAN-AMERICAN WOMEN MAINTAIN A HEALTHY WEIGHT

The review by Yancey and her colleagues also described another obesity prevention intervention, "Sisters Together: Move More, Eat Better." The national program is an initiative of the Weight-Control Information Network of the National Institute of Diabetes and Digestive and Kidney Diseases (one of the institutes of the National Institutes of Health).

The program expanded upon the success of a pilot community-awareness program conducted in three inner-city communities in Boston, Massachusetts, from 1995 to 1998. The pilot program disseminated the "Move More, Eat Better" message among African-American women aged eighteen to thirty-five via educational materials and such activities as walking groups, dance classes, and cooking demonstrations.

By 2001 the program had produced three educational brochures and had collaborated with national and local newspapers, magazines, radio stations, and consumer and professional organizations to continue to increase awareness about the health benefits of regular physical activity and healthy eating. Another "Sisters Together: Move More, Eat Better" activity produced a cable television show featuring local chefs who prepared healthy menu items available in their restaurants.

To continue to spread the word about the benefits of healthy eating and regular exercise among African-American women and to encourage other groups and organizations to start comparable programs, Sisters Together expanded its promotion efforts in local communities and national media. In 2004 and 2005 Sisters Together met with magazine editors in New York City and embarked on a radio media tour in the top ten urban markets. In addition the group provided exhibits at local and national meetings and health fairs and monthly promotions to health and lifestyle reporters. Community outreach activities took the program's message to bookstores, churches, nail and hair salons, libraries, community health clinics, and historically Black colleges and universities.

Federally Funded National Nutrition Education

Together, the Department of Health and Human Services and the Department of Agriculture (USDA) update Nutrition and Your Health: Dietary Guidelines for Americans every five years. First published in 1980, the guidelines serve as the basis for federal food and nutrition education programs. Historically, some public health professionals believed that the USDA Food Pyramid was flawed because its composition was unduly influenced by pressure from the food industry, whose members know that even subtle changes to the guidelines can affect a food manufacturer's sales. Further, these public health professionals assert that the guidelines should not be expected to represent objective scientific evidence since they are developed by the U.S. government agency responsible for agriculture, rather than health.

In January 2004 members of the Dietary Guidelines Advisory Committee met to discuss the sixth version of Nutrition and Your Health: Dietary Guidelines for Americans. Among the issues the committee considered were a reassessment of the Food Guide Pyramid, the components of a healthy American diet, and energy balance. In preparation for the meeting, the thirteen committee members reviewed recent scientific research, including Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients) (Washington, DC: Institute of Medicine of the National Academies, 2002) and the 2003 World Health Organization (WHO) report on Diet, Nutrition and the Prevention of Chronic Diseases.

The Institute of Medicine report asserted that to meet daily energy and nutritional needs while minimizing risk for chronic disease, adults should get 45% to 65% of their calories from carbohydrates, 20% to 35% from fat, and 10% to 35% from protein. Earlier guidelines advised diets with 50% or more of carbohydrates and 30% or less of fat, with comparable protein-intake recommendations in previous and current guidelines. The guidelines for children were similar to those for adults, except that infants and younger children were advised a slightly higher proportion of fat—25% to 40% of their caloric intake. The report also emphasized balancing diet with physical activity, and recommended total daily calorie consumption for individuals based on height, weight, gender, and four different levels of physical activity. Its recommendation of an hour per day of physical activity was derived from studies of average daily energy expended by people who maintain a healthy weight.

The WHO report, produced in partnership with the Food and Agriculture Organization, called upon a team of global experts to identify new recommendations for governments on diet and exercise to combat obesity and related chronic diseases. The report advised changing daily nutritional intake and increasing energy expenditure by:

  • Reducing consumption of foods high in saturated fat and sugar
  • Sharply reducing the amount of salt in the diet
  • Increasing the amount of fresh fruit and vegetables in the diet
  • Engaging in moderate-intensity physical activity for at least an hour a day

The WHO report specifically recommended limiting fat to between 15% and 30% of total daily intake and saturated fats to less than 10% of this total. It suggested that between 55% and 75% of daily intake should be carbohydrates but that added sugars (refined or simple sugars as opposed to those naturally occurring in fruit and complex carbohydrates) should be limited to 10% or less. Protein should make up 10%-15% of calorie intake and salt should be restricted to less than 5 grams a day (about TABLE 10.1 Comparison of 100 grams of whole-grain wheat flour and enriched, bleached, white, all-purpose flour "Table 6. Comparison of 100 Grams of Whole-Grain Wheat Flour and Enriched, Bleached, White, All-Purpose Flour," in Dietary Guidelines for Americans, 2005, Chapter 5: Food Groups to Encourage, U.S. Department of Health and Human Services, U.S. Department of Agriculture, January 12, 2005, http://www.health.gov/dietaryguidelines/dga2005/document/pdf/Chapter5.pdf (accessed January 13, 2006)one teaspoon). In a press release dated April 23, 2003, Dr. Gro Harlem Brundtland, Director-General of the WHO, said, "Long-term progress will take time. We need to look decades ahead, and make a commitment now, to the health of our current and future generations throughout the globe. The work we are embarked upon could lead to one of the largest positive shifts in population health ever undertaken."

TABLE 10.1
Comparison of 100 grams of whole-grain wheat flour and enriched, bleached, white, all-purpose flour
100 percent whole-grain wheat flour Enriched, bleached, all-purpose white flour
SOURCE: "Table 6. Comparison of 100 Grams of Whole-Grain Wheat Flour and Enriched, Bleached, White, All-Purpose Flour," in Dietary Guidelines for Americans, 2005, Chapter 5: Food Groups to Encourage, U.S. Department of Health and Human Services, U.S. Department of Agriculture, January 12, 2005, http://www.health.gov/dietaryguidelines/dga2005/document/pdf/Chapter5.pdf (accessed January 13, 2006)
Calories, kcal 339.0 364.0
Dietary fiber, g 12.2 2.7
Calcium, mg 34.0 15.0
Magnesium, mg 138.0 22.0
Potassium, mg 405.0 107.0
Folate, DFE, μg 44.0 291.0
Thiamin, mg 0.5 0.8
Riboflavin, mg 0.2 0.5
Niacin, mg 6.4 5.9
Iron, mg 3.9 4.6

New Food Pyramids Debut in 2005

The new pyramid was designed in response to, "Dietary Guidelines for Americans 2005," developed by a panel of scientists and physicians and released in January 2005 by the Department of Health and Human Services and the Department of Agriculture (USDA). As the basis for revising the pyramid, the guidelines emphasize choosing complex carbohydrates over simple ones. For example, they recommend choosing bread and pasta made from whole-grain flour instead of white flour. Table 10.1 shows the difference in nutrient content between 100% whole-grain wheat flour and enriched, bleached, all-purpose white flour.

The new guidelines also stipulated the amount of saturated fat Americans should consume to keep saturated fat below 10% of their total calorie intake. (See Table 10.2.) They advise sharply limiting added sugars and choosing and preparing foods with little salt (sodium chloride) so that intake is less than 2,300 mg (approximately one teaspoon of salt) of sodium per day. Table 10.3 shows the sodium content for selected foods. It is interesting to note that processed foods that do not necessarily taste salty, such as tomato soup, nevertheless contain significant amounts of added sodium.

In April 2005 the government replaced the old single, one-size-fits-all triangular pyramid with twelve TABLE 10.2 Maximum daily amounts of saturated fat to keep saturated fat below 10% of total calorie intake "Table 8. Maximum Daily Amounts of Saturated Fat to Keep Saturated Fat Below 10 Percent of Total Calorie Intake," in Dietary Guidelines for Americans, 2005, Chapter 6: Fats, U.S. Department of Health and Human Services, U.S. Department of Agriculture, January 12, 2005, http://www.health.gov/dietaryguidelines/dga2005/document/pdf/Chapter6.pdf (accessed January 14, 2006)individually-tailored food pyramids and a new guide, called "MyPyramid" to help Americans improve their eating habits. Each of the pyramids is intended to meet the varying nutritional needs of people based on their ages and levels of physical activity. Table 10.4 displays the calorie requirements based on age, gender, and physical activity level calculated by the Institute of Medicine and included in the updated Dietary guidelines.

TABLE 10.2
Maximum daily amounts of saturated fat to keep saturated fat below 10% of total calorie intake
Total calorie intake Limit on saturated fat Intake
Notes: Table shows the maximum gram amounts of saturated fat that can be consumed to keep saturated fat intake below 10 percent of total calorie intake for selected calorie levels. A 2,000-calorie example is included for consistency with the food label. This table may be useful when combined with label-reading guidance.
*Percent daily values on the nutrition facts panel of food labels are based on a 2,000-calorie diet. Values for 2,000 and 2,500 calories are rounded to the nearest 5 grams to be consistant with the nutrition facts panel.
SOURCE: "Table 8. Maximum Daily Amounts of Saturated Fat to Keep Saturated Fat Below 10 Percent of Total Calorie Intake," in Dietary Guidelines for Americans, 2005, Chapter 6: Fats, U.S. Department of Health and Human Services, U.S. Department of Agriculture, January 12, 2005, http://www.health.gov/dietaryguidelines/dga2005/document/pdf/Chapter6.pdf (accessed January 14, 2006)
1,600 18 grams or less
2,000* 20 grams or less
2,200 24 grams or less
2,500* 25 grams or less
2,800 31 grams or less

In contrast to the old pyramid, which featured horizontal bands representing food groups, the new pyramids contain rainbow-colored bands that run vertically from the tip of the pyramids to their bases. The new pyramids also have staircases climbing up one side, exhorting chronically sedentary Americans to become more active. Figure 10.1 shows the cornerstones of the new pyramid food guidance system—physical activity, variety, proportionality, moderation, gradual improvement and personalization. Further, unlike the old pyramid, the new one aims to help people control their portion sizes. The old pyramid used "serving" sizes, while the new one offers the standardized measures such as cups and ounces.

The new pyramid food guidance system delivers basic messages about healthy eating and physical activity that are nearly universally applicable. They are to:

  • Eat at least 3 ounces of whole grain cereals, rice, or pasta every day.
  • Choose low-fat or fat-free milk, yogurt, and other dairy products. Table 10.5 shows the differences in terms of fat and calories between full-fat and low-fat dairy products, meat, fish and baked goods.
  • Choose food and beverages low in added sugars. Table 10.6 lists major sources of added sugars in the American diet.

TABLE 10.3 Range of sodium content for selected foods "Table 15. Range of Sodium Content for Selected Foods," in Dietary Guidelines for Americans, 2005, Chapter 8: Sodium and Potassium, U.S. Department of Health and Human Services, U.S. Department of Agriculture, January 12, 2005, http://www.health.gov/dietaryguidelines/dga2005/document/pdf/Chapter8.pdf (accessed January 14, 2006)

TABLE 10.3
Range of sodium content for selected foods
Food group Sering size Range (mg)
*All snack foods are regular flavor, salted.
Note: None of the examples provided were labeled low-sodium products. Serving sizes were standardized to be comparable among brands within a food. Pizza and bread slices vary in size and weight across brands.
SOURCE: "Table 15. Range of Sodium Content for Selected Foods," in Dietary Guidelines for Americans, 2005, Chapter 8: Sodium and Potassium, U.S. Department of Health and Human Services, U.S. Department of Agriculture, January 12, 2005, http://www.health.gov/dietaryguidelines/dga2005/document/pdf/Chapter8.pdf (accessed January 14, 2006)
Breads, all types 1 oz 95-210
Frozen pizza, plain, cheese 4 oz 450-1200
Frozen vegetables, all types 1/2 c 2-160
Salad dressing, regular fat, all types 2 Tbsp 110-505
Salsa 2 Tbsp 150-240
Soup (tomato), reconstituted 8 oz 700-1260
Tomato juice 8 oz(∼1 c) 340-1040
Potato chips* 1 oz (28.4 g) 120-180
Tortilla chips* 1 oz (28.4 g) 105-160
Pretzels* 1 oz (28.4 g) 290-560

The USDA Web site (http://www.mypyramid.gov) offers consumers the opportunity to receive customized food plans based on age, gender, and activity level. Consumers may then print personalized posters, worksheets, and other information to help them start on their healthy eating plans. In its first three months of operation, the new food pyramid Web site was visited approximately 670 million times. The revised pyramid food guidance system offers a wealth of detailed information about food intake including the number of calories people of various ages and activity levels should consume, the amounts of food to consume from different food groups, and portion size information for twelve different calorie levels, ranging from 1,000 calories to 3,200 calories per day. (See Table 10.7 and Table 10.8.)

The 2005 pyramid education plan also includes sample menus such as the 2,000 calorie food plan shown in Table 10.9 and Table 10.10 as well as Table 10.11, a food tracking chart that helps consumers monitor their intake and assess the quality of their food choices in terms of meeting their nutritional needs within the allotted calorie level.

Fans of the revised dietary guidelines and pyramids assert that even if the new pyramid and online educational resources fail to motivate Americans to change their diets and increase their activity levels, the guidelines will still have a salutary effect in terms of their influence on the food industry. For example, during 2005 food manufacturers moved to eliminate trans fats from their products and added whole grain products in response to the new government guidelines. Table 10.12 shows the major sources of trans fats in the American diet. The trans fat content of processed foods will very likely decline as food manufacturers continue to reformulate their products.

TABLE 10.4 Estimated calorie requirements for each gender and age group at three levels of physical activitya "Table 3. Estimated Calorie Requirements (in Kilocalories) for Each Gender and Age Group at Three Levels of Physical Activity," in Dietary Guidelines for Americans, 2005, Chapter 2: Adequate Nutrients within Calorie Needs, U.S. Department of Health and Human Services, U.S. Department of Agriculture, January 12, 2005, http://www.health.gov/dietaryguidelines/dga2005/document/pdf/Chapter2.pdf (accessed January 14, 2006)

TABLE 10.4
Estimated calorie requirements for each gender and age group at three levels of physical activitya
[Estimates are rounded to the nearest 200 calories]
Gender Age(years) Activity levelb,c,d
Sedentaryb Modrately activec Actived
aThese levels are based on estimated energy requirements (EER) from the Institute of Medicine Dietary Reference Intakes Macronutrients Report, 2002, calculated by gender, age, and activity level for reference-sized individuals. "Reference size," as determined by the Institute of Medicine, is based on median height and weight for ages up to age 18 years of age and median height and weight for that height to give a body mass index (BMI) of 21.5 for adult females and 22.5 for adult males.
bSedentary means a lifestyle that includes only the light physical activity associated with typical day-to-day life
cModerately active means a lifestyle that includes physical activity equivalent to walking about 1.5 to 3 miles per day at 3 to 4 miles per hour, in addition to the light physical activity associated with typical day-to-day life.
dActive means a lifestyle that includes physical activity equivalent to walking more than 3 miles per day at 3 to 4 miles per hour, in addition to the light physical activity associated with typical day-to-day life.
eThe calorie ranges shown are to accommodate needs of different ages within the group. For children and adolescents, more calories are needed at older ages. For adults, fewer calories are needed at older ages.
SOURCE: "Table 3. Estimated Calorie Requirements (in Kilocalories) for Each Gender and Age Group at Three Levels of Physical Activity," in Dietary Guidelines for Americans, 2005, Chapter 2: Adequate Nutrients within Calorie Needs, U.S. Department of Health and Human Services, U.S. Department of Agriculture, January 12, 2005, http://www.health.gov/dietaryguidelines/dga2005/document/pdf/Chapter2.pdf (accessed January 14, 2006)
Child 2-3 1,000 1,000-1,400e 1,000-1,400e
Female 4-8 1,200 1,400-1,600 1,400-1,800
9-13 1,600 1,600-2,000 1,800-2,200
14-18 1,800       2,000       2,400
19-30 2,000 2,000-2,200       2,400
31-50 1,800       2,000       2,200
51+ 1,600       1,800 2,000-2,200
Male 4-8 1,400 1,400-1,600 1,600-2,000
9-13 1,800 1,800-2,200 2,000-2,600
14-18 2,200 2,400-2,800 2,800-3,200
19-30 2,400 2,600-2,800       3,000
31-50 2,200 2,400-2,600 2,800-3,000
51+ 2,000 2,200-2,400 2,400-2,800

Detractors question the choice of the public relations agency hired to help create and promote the new version of the pyramid. The firm, Porter Novelli, has food companies as clients, but both Agriculture Department and agency representatives claimed there was no conflict of interest. The USDA asserts that its staff of scientists, economists, and nutritionists has neither the expertise nor the resources to promote the new pyramid food guidance system. Further, Eric Hentges, the director of the Agriculture Department's Center for Nutrition Policy and Promotion contends that without effective marketing and promotion, "we're not going to be able to get this behavior change or improve anything for Americans" (Libby Quaid, "Government Issues Twelve New Food Pyramids," Associated Press, April 19, 2005).

New Pyramid for Children

In September 2005 the USDA released "MyPyramid for Kids," a new food pyramid for children aged six to eleven, to replace the 1999 version. Like the adult FIGURE 10.1 Anatomy of MyPyramid "Anatomy of MyPyramid," at MyPyramid.gov, United States Department of Agriculture, August 2005, http://mypyramid.gov/downloads/MyPyramid_Anatomy.pdf (accessed January 13, 2006)pyramid, the children's pyramid displays each of the six major food groups using familiar images such as apples for fruits and bread for grains to encourage children to choose healthy foods instead burgers and fries. (See Figure 10.2.) The children's version of the pyramid features a girl running up the steps to the top and kids playing soccer, baseball and basketball, walking a dog, riding a bike, stretching, picnicking, and doing yoga.

Children are encouraged to play hard, and to get more physically active in order to meet the government's recommended sixty minutes of exercise a day. The USDA suggests that children set up home gyms, substituting items such as soup cans and stairs for weights and stair machines. Just as it does for adults, the USDA Web site provides a worksheet that allows kids to record and track their food consumption and physical activity. (See Table 10.13.)

To attract, inform, and entertain children, the USDA Web site features an interactive computer spaceship game. Players who balance food and exercise properly can blast off in an electronic spaceship to Planet Power. Choosing too many foods high in fat and sugar will cause the ship to sputter on the launch pad and release black smoke.

The MyPyramid for Kids program also employs an array of teaching materials for parents, childcare providers, and educators, including tip sheets and posters, lesson plans, CDs, Go Fish game cards, coloring books, and songs. The USDA "Team Nutrition" Web site already boasts school success stories—initiatives ranging from planting a school garden and organizing a school health fair to nutrition education programs, cooking classes, and poster contests.

Like its adult counterpart, the pyramid for kids garnered praise and criticism. In a September 28, 2005, news release, Michael Jacobson, executive director of the Center for Science in the Public Interest (CSPI), said the guidelines did not go far enough, "The materials don't even have the guts to urge kids to drink less soda pop, to eat less candy. If the government really wanted to improve kids' eating habits, it would get junk food out of schools, it would ban junk food advertising on television, it would TABLE 10.5 Differences in saturated fat and calorie content of commonly consumed foods "Table 9. Differences in Saturated Fat and Calorie Content of Commonly Consumed Foods," in Dietary Guidelines for Americans, 2005, Chapter 6: Fats, U.S. Department of Health and Human Services, U.S. Department of Agriculture, January 12, 2005, http://www.health.gov/dietaryguidelines/dga2005/document/pdf/Chapter6.pdf (accessed January 14, 2006)require calorie counts on fast-food menu boards and sponsor hard-hitting educational materials. That would really drive home the point that these empty-calorie foods are causing obesity." Other consumer groups said they believed federal funds would be better spent on a mass media campaign to promote eating fruits and vegetables (Libby Quaid, "Government Unveils Food Pyramid for Kids," Associated Press, September 28, 2005).

TABLE 10.5
Differences in saturated fat and calorie content of commonly consumed foods
Food category Portion Satuated fat content (grams) Calories
SOURCE: "Table 9. Differences in Saturated Fat and Calorie Content of Commonly Consumed Foods," in Dietary Guidelines for Americans, 2005, Chapter 6: Fats, U.S. Department of Health and Human Services, U.S. Department of Agriculture, January 12, 2005, http://www.health.gov/dietaryguidelines/dga2005/document/pdf/Chapter6.pdf (accessed January 14, 2006)
Cheese
Regular cheddar cheese           1 oz 6.0 114
Low-fat cheddar cheese           1 oz 1.2 49
Ground beef
Regular ground beef (25% fat) 3 oz (cooked) 6.1 236
Extra lean ground beef (5% fat) 3 oz (cooked) 2.6 148
Milk
Whole milk (3.24%)           1 cup 4.6 146
Low-fat (1%) milk           1 cup 1.5 102
Breads
Croissant (med) 1 medium 6.6 231
Bagel, oat bran(4″) 1 medium 0.2 227
Frozen desserts
Regular ice cream           1/2 cup 4.9 145
Frozen yogurt, low-fat           1/2 cup 2.0 110
Table spreads
Butter           1 tsp 2.4 34
Soft margarine with zero trans           1 tsp 0.7 25
Chicken
Fried chicken (leg with skin) 3 oz (cooked) 3.3 212
Roasted chicken (breast no skin) 3 oz (cooked) 0.9 140
Fish
Fried fish           3 oz 2.8 195
Baked fish           3 oz 1.5 129

"5-a-Day for Better Health" Program

The "5-a-Day for Better Health" program is the nation's largest public-private nutrition education initiative. The program originated in the California Department of Health Services in 1988 and is jointly sponsored by the National Cancer Institute and the Produce for Better Health Foundation (PBH), a nonprofit consumer-education foundation representing the fruit and vegetable industry. In 2001 the national 5-a-Day partnership expanded to include other voluntary health organizations and produce associations. Along with the National Cancer Institute (NCI), the lead federal agency, and PBH, the partnership now includes representatives from the USDA, TABLE 10.6 Major sources of added sugars in diet "Table 13. Major Sources of Added Sugars (Caloric Sweeteners) in the American Diet," in Dietary Guidelines for Americans, 2005, Chapter 7: Carbohydrates, U.S. Department of Health and Human Services, U.S. Department of Agriculture, January 12, 2005, http://www.health.gov/dietaryguidelines/dga2005/document/pdf/Chapter7.pdf (accessed January 14, 2006). Reprinted from Journal of the American Dietetic Association, vol. 100, J. F. Guthrie and J. F. Morton, "Food Sources of Added Sweeteners in the Diets of Americans," pp. 43-51. Copyright © 2000, with permission from American Dietetic Association.CDC, American Cancer Society, Produce Marketing Association, United Fresh Fruit and Vegetable Association, National Alliance for Nutrition and Activity, and the Association of State and Territorial Directors of Health Promotion and Public Health Education.

TABLE 10.6
Major sources of added sugars in diet
[Food groups that contribute more than 5 percent of the added sugars to diet in decreasing order]
Food categories Contribution to added sugars Intake (percent of total added sugars consumed)
SOURCE: "Table 13. Major Sources of Added Sugars (Caloric Sweeteners) in the American Diet," in Dietary Guidelines for Americans, 2005, Chapter 7: Carbohydrates, U.S. Department of Health and Human Services, U.S. Department of Agriculture, January 12, 2005, http://www.health.gov/dietaryguidelines/dga2005/document/pdf/Chapter7.pdf (accessed January 14, 2006). Reprinted from Journal of the American Dietetic Association, vol. 100, J. F. Guthrie and J. F. Morton, "Food Sources of Added Sweeteners in the Diets of Americans," pp. 43-51. Copyright © 2000, with permission from American Dietetic Association.
Regular soft drinks 33.0
Sugars and candy 16.1
Cakes, cookies, pies 12.9
Fruit drinks (fruitades and fruit punch) 9.7
Dairy desserts and milk products (ice cream, sweetened yogurt, and sweetened milk) 8.6
Other grains (cinnamon toast and honey-nut waffles) 5.8

The "5-a-Day for Better Health" program aims to increase fruit and vegetable consumption. Its objectives are "to increase public awareness of the importance of eating five or more servings of fruits and vegetables every day for better health, and to provide consumers with specific information about how to include more servings of fruits and vegetables into daily eating patterns." Data from the CDC revealed that in 2003, less than one-quarter of Americans (22.6%) ate the recommended five servings per day of fruit and vegetables. (See Figure 10.3.) Research conducted by the USDA (Biing-Hwan Lin, Jane Reed, Gary Lucier, U.S. Fruit and Vegetable Consumption: Who, What, Where, and How Much, Economic Research Service, USDA, October 2004) revealed that fruit and vegetable consumption vary by geography, age, race, and ethnicity as well as whether the food is eaten at home or away from home. The researchers found that:

  • Older adults (age sixty-five and over) eat fewer French fries and potato chips than toddlers; however, older adults eat more fresh and canned potatoes than younger consumers.
  • Toddlers like to eat apples, fresh and processed, while adults aged twenty to fifty-nine eat the fewest apples.
  • Women aged forty and older eat the most spinach, while teenage girls eat the least.

TABLE 10.7 MyPyramid food intake calorie levels "MyPyramid Food Intake Calorie Levels," at MyPyramid.gov, United States Department of Agriculture, August 2005, http://mypyramid.gov/downloads/MyPyramid_Calorie_Levels.pdf (accessed January 13, 2006)

TABLE 10.7
MyPyramid food intake calorie levels
Activity level Males Activity level Females
Sedentary* Mod. active* Active* Sedentary* Mod. active* Active*
Note: Calorie levels are provided for each year of childhood, from 2-18 years, and for adults in 5-year increments.
*Calorle levels are based on the estimated energy requirements (EER) and activity levels from the Institute of Medicine Dietary Reference Intakes Macronutrients Report, 2002.
Sedentary=less than 30 Minutes a day of moderate physical activity in addition to daily activities.
Mod. active=at least 30 minutes up to 60 minutes a day of moderate physical activity in addition to daily activities.
Active=60 or more minutes a day of moderate physical activity in addition to daily activities.
SOURCE: "MyPyramid Food Intake Calorie Levels," at MyPyramid.gov, United States Department of Agriculture, August 2005, http://mypyramid.gov/downloads/MyPyramid_Calorie_Levels.pdf (accessed January 13, 2006)
Age Age
2 1,000 1,000 1,000 2 1,000 1,000 1,000
3 1,000 1,400 1,400 3 1,000 1,200 1,400
4 1,200 1,400 1,600 4 1,200 1,400 1,400
5 1,200 1,400 1,600 5 1,200 1,400 1,600
6 1,400 1,600 1,800 6 1,200 1,400 1,600
7 1,400 1,600 1,800 7 1,200 1,600 1,800
8 1,400 1,600 2,000 8 1,400 1,600 1,800
9 1,600 1,800 2,000 9 1,400 1,600 1,800
10 1,600 1,800 2,200 10 1,400 1,800 2,000
11 1,800 2,000 2,200 11 1,600 1,800 2,000
12 1,800 2,200 2,400 12 1,600 2,000 2,200
13 2,000 2,200 2,600 13 1,600 2,000 2,200
14 2,000 2,400 2,800 14 1,800 2,000 2,400
15 2,200 2,600 3,000 15 1,800 2,000 2,400
16 2,400 2,800 3,200 16 1,800 2,000 2,400
17 2,400 2,800 3,200 17 1,800 2,000 2,400
18 2,400 2,800 3,200 18 1,800 2,000 2,400
19-20 2,600 2,800 3,000 19-20 2,000 2,200 2,400
21-25 2,400 2,800 3,000 21-25 2,000 2,200 2,400
26-30 2,400 2,600 3,000 26-30 1,800 2,000 2,400
31-35 2,400 2,600 3,000 31-35 1,800 2,000 2,200
36-40 2,400 2,600 2,800 36-40 1,800 2,000 2,200
41-45 2,200 2,600 2,800 41-45 1,800 2,000 2,200
46-50 2,200 2,400 2,800 46-50 1,800 2,000 2,200
51-55 2,200 2,400 2,800 51-55 1,600 1,800 2,200
56-60 2,200 2,400 2,600 56-60 1,600 1,800 2,200
61-65 2,000 2,400 2,600 61-65 1,600 1,800 2,000
66-70 2,000 2,200 2,600 66-70 1,600 1,800 2,000
71-75 2,000 2,200 2,600 71-75 1,600 1,800 2,000
76 and up 2,000 2,200 2,400 76 and up 1,600 1,800 2,000
  • High-income consumers drink more orange juice, while low-income consumers drink more orange drinks (less than 10% juice).
  • Consumption of French fries does not vary by income.
  • Compared with low-income consumers, high-income consumers eat more of many vegetables, including fresh garlic, celery, cucumbers, bell peppers, mushrooms, and tomatoes.
  • Eighty-eight percent of French fires are eaten away from home; fast food venues account for 67%.
  • About 60% of catsup is consumed away from home, and fast food outlets account for one-third.
  • African-American consumers, though just 13% of the U.S. population, account for 21% of sweet potato consumption. Puerto Rican Hispanics consume as many sweet potatoes as black consumers.
  • White and Hispanic consumers eat more bell peppers than African-Americans and Asians. Blacks eat one-third less per capita than others.
  • Per capita spinach consumption is highest among Asians.
  • Hispanics consume three times more dry beans per capita than the national average.
  • Consumers in the South eat more fresh cabbage than consumers in other regions.
  • Watermelon consumption is greatest in the West.
  • Consumers purchase sweet corn as fresh, frozen, or canned, in nearly equal proportions.
  • Processed tomato products account for 80% of total tomato consumption. The largest use of tomatoes is for sauces, followed by tomato paste, canned whole tomato products, catsup, and juice.

TABLE 10.8 MyPyramid food intake patterns "MyPyramid Food Intake Patterns," at MyPyramid.gov, United States Department of Agriculture, August 2005, http://mypyramid.gov/downloads/MyPyramid_Food_Intake_Patterns.pdf (accessed January 13, 2006)

TABLE 10.8
MyPyramid food intake patterns
Notes: The suggested amounts of food to consume from the basic food groups, subgroups, and oils to meet recommended nutrient intakes at 12 different calorie levels. Nutrient and energy contributions from each group are calculated according to the nutrient-dense forms of foods in each group (e.g., lean meats and fat-free milk). The table also shows the discretionary calorie allowance that can be accommodated within each calorie level, in addition to the suggested amounts of nutrient-dense forms of foods in each group.
Estimated daily calorie needs To determine which food intake pattern to use for an individual, the following chart gives an estimate of individual calorie needs. The calorie range for each age/sex group is based on physical activity level, from sedentary to active.
aCalorie levels are set across a wide range to accommodate the needs of different individuals. The calorie range chart can be used to help assign individuals to the food intake pattern at a particular calorie level.
bFruit group includes all fresh, frozen, canned, and dried fruits and fruit juices. In general, 1 cup of fruit or 100% fruit juice, or 1/2 cup of dried fruit can be considered as 1 cup from the fruit group.
cVegetable group includes all fresh, frozen, canned, and dried vegetables and vegetable juices. In general, 1 cup of raw or cooked vegetables or vegetable juice, or 2 cups of raw leafy greens can be considered as 1 cup from the vegetable group.
dGrains group includes all foods made from wheat, rice, oats, cornmeal, barley, such as bread, pasta, oatmeal, breakfast cereals, tortillas, and grits. In general, 1 slice of bread, 1 cup of ready-to-eat cereal, or 1/2 cup of cooked rice, pasta, or cooked cereal can be considered as 1 ounce equivalent from the grains group. At least half of all grains consumed should be whole grains.
eMeat & beans group in general, 1 ounce of lean meat, poultry, or fish, 1 egg, 1 Tbsp. peanut butter, 1/4 cup cooked dry beans, or 1/2 ounce of nuts or seeds can be considered as 1 ounce equivalent from the meat and beans group.
fMilk group includes all fluid milk products and foods made from milk that retain their calcium content, such as yogurt and cheese. Foods made from milk that have little to no calcium, such as cream cheese, cream, and butter, are not part of the group. Most milk group choices should be fat-free or low-fat. In general, 1 cup of milk or yogurt, 1 1/2 ounces of natural cheese, or 2 ounces of processed cheese can be considered as 1 cup from the milk group.
gOils include fats, from many different plants and from fish, that are liquid at room temperature, such as canola, corn, olive, soybean, and sunflower oil. Some foods are naturally high in oils, like nuts, olives, some fish, and avocados. Foods that are mainly oil include mayonnaise, certain salad dressings, and soft margarine.
hDiscretionary calorie allowance is the remaining amount of calories in a food intake pattern after accounting for the calories needed for all food groups—using forms of foods that are fat-free or low-fat and with no added sugars.
iSedentary means a lifestyle that includes only the light physical activity associated with typical day-to-day life.
jActive means a lifestyle that includes physical activity equivalent to walking more than 3 miles per day at 3 to 4 miles per hour, in addition to the light physical activity associated with typical day-to-day life.
SOURCE: "MyPyramid Food Intake Patterns," at MyPyramid.gov, United States Department of Agriculture, August 2005, http://mypyramid.gov/downloads/MyPyramid_Food_Intake_Patterns.pdf (accessed January 13, 2006)
Calorie levela 1,000 1,200 1,400 1,600 1,800 2,000 2,200 2,400 2,600 2,800 3,000 3,200
Daily amount of food from each group
Fruitsb 1 cup 1 cup 1.5 cups 1.5 cups 1.5 cups 2 cups 2 cups 2 cups 2 cups 2.5 cups 2.5 cups 2.5 cups
Vegetablesc 1 cup 1.5 cups 1.5 cups 2 cups 2.5 cups 2.5 cups 3 cups 3 cups 3.5 cups 3.5 cups 4 cups 4 cups
Grainsd 3 oz-eq 4 oz-eq 5 oz-eq 5 oz-eq 6 oz-eq 6 oz-eq 7 oz-eq 8 oz-eq 9 oz-eq 10 oz-eq 10 oz-eq 10 oz-eq
Meat and beanse 2 oz-eq 3 oz-eq 4 oz-eq 5 oz-eq 5 oz-eq 5.5 oz-eq 6 oz-eq 6.5 oz-eq 6.5 oz-eq 7 oz-eq 7 oz-eq 7 oz-eq
Milkf 2 cups 2 cups 2 cups 3 cups 3 cups 3 cups 3 cups 3 cups 3 cups 3 cups 3 cups 3 cups
Oilsg 3 tsp 4 tsp 4 tsp 5 tsp 5 tsp 6 tsp 6 tsp 7 tsp 8 tsp 8 tsp 10 tsp 11 tsp
Discretionary calorie allowanceh 165 171 171 132 195 267 290 362 410 426 512 648
Vegetable subgroup amounts are per week
Dark green vegetables 1 c/wk 1.5 c/wk 1.5 c/wk 2 c/wk 3 c/wk 3 c/wk 3 c/wk 3 c/wk 3 c/wk 3 c/wk 3 c/wk 3 c/wk
Orange vegetables .5 c/wk 1 c/wk 1 c/wk 1.5 c/wk 2 c/wk 2 c/wk 2 c/wk 2 c/wk 2.5 c/wk 2.5 c/wk 2.5 c/wk 2.5 c/wk
Legumes .5 c/wk 1 c/wk 1 c/wk 2.5 c/wk 3 c/wk 3 c/wk 3 c/wk 3 c/wk 3.5 c/wk 3.5 c/wk 3.5 c/wk 3.5 c/wk
Starchy vegetables 1.5 c/wk 2.5 c/wk 2.5 c/wk 2.5 c/wk 3 c/wk 3 c/wk 6 c/wk 6 c/wk 7 c/wk 7 c/wk 9 c/wk 9 c/wk
Other vegetables 3.5 c/wk 4.5 c/wk 4.5 c/wk 5.5 c/wk 6.5 c/wk 6.5 c/wk 7 c/wk 7 c/wk 8.5 c/wk 8.5 c/wk 10 c/wk 10 c/wk
Caloria range Caloria range
Children Sedentaryi Activej Children Sedentaryi Activej
2-3 years 1,000 1,400 2-3 years 1,000 1,400
Females Males
4-8 years 1,200 1,800 4-8 years 1,400 2,000
9-13 1,600 2,200 9-13 1,800 2,600
14-18 1,800 2,400 14-18 2,200 3,200
19-30 2,000 2,400 19-30 2,400 3,000
31-50 1,800 2,200 31-50 2,200 3,000
51+ 1,600 2,200 51+ 2,000 2,800

The "5-a-Day for Better Health" program provides customized, age-appropriate health education materials for children such as lesson plans and activity sheets. "There's a Rainbow on My Plate" is a comprehensive nutrition education curriculum that encourages kindergarten through sixth grade students to develop healthy eating habits. The curriculum was designed by PBH, Dole Food Company, Inc., and Crayola®, and in 2003 placed second in PROMO Magazine's 2003 National Pro Awards in the category of the Most Innovative Communication Strategy. "There's a Rainbow on My Plate" debuted in March 2003 in 3,000 supermarkets and 12,000 elementary schools in the United States. Lessons featured information about fresh, dried, frozen, and canned fruits and vegetables and 100% fruit juices as well as the locations of these foods in the supermarket, and definitions of serving sizes. Participating schools received teacher's guides with lesson plans and activity sheets, coloring

TABLE 10.9 Sample menus for a 2000-calorie food plan

TABLE 10.9
Sample menus for a 2000-calorie food plan
Day 1 Day 2 Day 3 Day 4 Day 5
Breakfast
Breakfast burrito
    1 flour tortilla (7″ diameter)
    1 scrambled egg (in 1 tsp soft margarine)
    1/3 cup black beans*
    2 tbsp salsa
1 cup orange juice
1 cup fat-free milk
Lunch
Roast beef sandwich
    1 whole grain sandwich bun
    3 ounces lean roast beef
    2 slices tomato
    1/4 cup shredded romaine lettuce
    1/8 cup sauteed mushrooms (in 1 tsp oil)
    1 1/2 ounce part-skim mozzarella cheese
    1 tsp yellow mustard
3/4 cup baked potato wedges*
1 tbsp ketchup
1 unsweetened beverage
Dinner
Stuffed broiled salmon
    5 ounce salmon filet
    1 ounce bread stuffing mix
    1 tbsp chopped onions
    1 tbsp diced celery
    2 tsp canola oil
1/2 cup saffron (white) rice
    1 ounce slivered almonds
1/2 cup steamed broccoli
    1 tsp soft margarine
1 cup fat-free milk
Snacks
1 cup cantaloupe
Breakfast
Hot cereal
    1/2 cup cooked oatmeal
    2 tbsp raisins
    1 tsp soft margarine
1/2 cup fat-free milk
1 cup orange juice
Lunch
Taco salad
    2 ounces tortilla chips
    2 ounces ground turkey, sauteed in 2 tsp sunflower oil
    1/2 cup black beans*
    1/2 cup iceberg lettuce
    2 slices tomato
    1 ounce low-fat cheddar cheese
    2 tbsp salsa
    1/2 cup avocado
    1 tsp lime juice
1 unsweetened beverage
Dinner
Spinach lasagna
    1 cup lasagna noodles, cooked (2 oz dry)
    2/3 cup cooked spinach
    1/2 cup ricotta cheese
    1/2 cup tomato sauce tomato bits*
    1 ounce part-skim mozzarella cheese
1 ounce whole wheat dinner roll
1 cup fat-free milk
Snacks
1/2 ounce dry-roasted almonds*
1/4 cup pineapple
2 tbsp raisins
Breakfast
Cold cereal
    1 cup bran flakes
    1 cup fat-free milk
    1 small banana
1 slice whole wheat toast
    1 tsp soft margarine
1 cup prune juice
Lunch
Tuna fish sandwich
    2 slices rye bread
    3 ounces tuna (packed in water, drained)
    2 tsp mayonnaise
    1 tbsp diced celery
    1/4 cup shredded romaine lettuce
    2 slices tomato
1 medium pear
1 cup fat-free milk
Dinner
Roasted chicken breast
    3 ounces boneless skinless chicken breast*
1 large baked sweet potato
1/2 cup peas and onions
    1 tsp soft magarine
1 ounce whole wheat dinner roll
    1 tsp soft margarine
1 cup leafy greens salad
    3 tsp sunflower oil and vinegar dressing
Snacks
1/4 cup dried apricots
1 cup low-fat fruited yogurt
Breakfast
1 whole wheat English muffin
    2 tsp soft margarine
    1 tbsp jam or preserves
1 medium grapefruit
1 hard-cooked egg
1 unsweetened beverage
Lunch
White bean-vegetable soup
    11/4 cup chunky vegetable soup
    1/2 cup white beans
2 ounce breadstick
8 baby carrots
1 cup fat-free milk
Dinner
Rigatoni with meat sauce
    1 cup rigatoni pasta (2 ounces dry)
    1/2 cup tomato sauce tomato bits
*    2 ounces extra lean cooked ground
    beef (sauteed in 2 tsp vegetable oil)
    3 tbsp grated Parmesan cheese
Spinach salad
    1 cup baby spinach leaves
    1/2 cup tangerine slices
    1/2 ounce chopped walnuts
    3 tsp sunflower oil and vinegar dressing
1 cup fat-free milk
Snacks
1 cup low-fat fruited yogurt
Breakfast
Cold cereal
    1 cup puffed wheat cereal
    1 tbsp raisins
    1 cup fat-free milk
1 small banana
1 slice whole wheat toast
    1 tsp soft margarine
    1 tsp jelly
Lunch
Smoked turkey sandwich
    2 ounces whole wheat pita bread
    1/4 cup romaine lettuce
    2 slices tomato
    3 ounces sliced smoked turkey breast*
    1 tbsp mayo-type salad dressing
    1 tsp yellow mustard
1/2 cup apple slices
1 cup tomato juice*
Dinner
Grilled top loin steak
    5 ounces grilled top loin steak
3/4 cup mashed potatoes
    2 tsp soft margarine
1/2 cup steamed carrots
    1 tbsp honey
2 ounces whole wheat dinner roll
    1 tsp soft margarine
1 cup fat-free milk
Snacks
1 cup low-fat fruited yogurt

TABLE 10.9 Sample menus for a 2000-calorie food plan [CONTINUED] "Sample Menus for a 2000 Calorie Food Plan," at MyPyramid.gov, United States Department of Agriculture, August 2005, http://mypyramid.gov/downloads/samplemenu.pdf (accessed January 14, 2006)

TABLE 10.9
Sample menus for a 2000-calorie food plan [CONTINUED]
Day 6 Day 7 Food group Daily average over one week Nutrient Daily average over one week
Notes: Averaged over a week, this seven day menu provides all of the recommended amounts of nutrients and food from each food group. Italicized foods are part of the dish or food that preceeds it.
SOURCE: "Sample Menus for a 2000 Calorie Food Plan," at MyPyramid.gov, United States Department of Agriculture, August 2005, http://mypyramid.gov/downloads/samplemenu.pdf (accessed January 14, 2006)
Breakfast Breakfast Grains Total grains (oz eq) 6.0 Calories 1,994
French toast Pancakes Whole grains 3.4 Protein, g 98
    2 slices whole wheat French toast     3 buckwheat pancakes Refined grains 2.6 Protein, % kcal 20
    2 tsp soft margarine Vegetables* Total vegetables (cups) 2.6 Carbohydrate, g 264
    2 tsp soft margarine     3 tbsp maple syrup Fruits Fruits (cups) 2.1 Carbohydrate % kcal 53
    2 tsp soft margarine 1/2 cup strawberries Milk Milk (cups) 3.1 Total fat, g 67
1/2 medium grapefruit 3/4 cup honeydew melon Meat & beans Meat/beans (oz eq) 5.6 Total fat, % kcal 30
1 cup fat-free milk 1/2 cup fat-free milk Oils Oils (tsp/grams) 7.2 tsp/32.4 g Saturated fat, g 16
Saturated fat, % kcal 7.0
Lunch Lunch *Vegetable subgroups (Weekly totals) Monounsaturated fat, g 23
Vegetarian chili on baked potato Manhattan clam chowder Dark-green vegetables (cups) 3.3 Polyunsaturated fat, g 23
    1 cup kidney beans *     3 ounces canned clams (drained) Orange vegetables (cups) 2.3 Linoleic acid, g 21
***1/2 cup tomato sauce w/tomato tidbits* Beans/peas (cups) 3.0 Linoleic acid, g 1.1
3/4 cup mixed vegetables Starchy vegetables (cups) 3.4 Cholesterol, mg 207
   3 tbsp chopped onions    1 cup ncanned tomatoes* Other vegetables (cups) 6.6 Total dietary fiber, g 31
    1 ounce lowfat cheddar cheese 10 whole wheat crackers* Potassium, mg 4,715
1 medium orange Sodium, mg* 1,948
    1 tsp vegetable oil 1 cup fat-free milk Calcium, mg 1,389
    1 medium baked potato Dinner Magnesium, mg 432
1/2 cup cantaloupe Vegetable stir-fry Copper, mg 1.9
3/4 cup lemonade Iron, mg 21
Dinner     4 ounces tofu (firm) Phosphorus, mg 1,830
    1/4 cup green and red bell peppers Zinc, mg 14
Hawaiian pizza Thiamin, mg 1.9
    2 slices cheese pizza     1/2 cup bok choy Riboflavin, mg 2.5
    1 ounce canadian bacon     2 tbsp vegetable oil Niacin equivalents, mg 24
   1/4 cup pineapple 1 cup brown rice Vitamin B6, mg 2.9
   2 tbsp mushrooms 1 cup lemon-flavored iced tea Vitamin B12, mcg 18.4
    2 tbsp chopped onions Snacks Vitamin C, mg 190
    1 cup leafy greens 1 ounce sunflower seeds* Vitamin E, mg (AT) 18.9
    1 cup leafy greens Vitamin A, mcg (RAE) 1,430
    3 tsp sunflower oil and vinegar dressing 1 large banana Dietary folate equivalents, mcg 558
1 cup low-tat fruited yogurt
1 cup fat-free milk *Starred items are foods that are labelled as no-salt-added, low-sodium, or low-salt versions of the foods. They can also be prepared from scratch with little or no added salt. All other foods are regular commercial products which contain variable levels of sodium. Average sodium level of the 7 day menu assumes no-salt-added in cooking or at the table.
Snacks
5 whole wheat crackers*
1/8 cup hummus
1/2 cup fruit cocktail (in water or juice)

TABLE 10.10 MyPyramid food choices based on 2,000 calories per day "MyPyramid Steps to a Healthier You," at MyPyramid.gov, United States Department of Agriculture, August 2005, http://mypyramid.gov/downloads/results/results_2000_18.pdf (accessed January 14, 2006)

TABLE 10.10
MyPyramid food choices based on 2,000 calories per day
[Based on the information you provided, this is your daily recommended amount from each food group.]
Grains 6 ounces Vegetables 2 1/2 cups Fruits 2 cups Milk 3 cups Meat & beans 5 1/2 ounces
Note: This calorie level is only an estimate of your needs. Monitor your body weight to see if you need to adjust your calorie intake.
SOURCE: "MyPyramid Steps to a Healthier You," at MyPyramid.gov, United States Department of Agriculture, August 2005, http://mypyramid.gov/downloads/results/results_2000_18.pdf (accessed January 14, 2006)
Make half your grains whole
Aim for at least 3 ounces of whole grains a day
Vary your veggies
Aim for these amounts each week:
Dark green veggies=3 cups
Orange veggies=2 cups
Dry beans & peas=3 cups
Starchy veggies=3 cups
Other veggies=6 1/2 cups
Focus on fruits
Eat a variety of fruit
Go easy on fruit juices
Get your calcium-rich foods
Go low-fat or fat-free when you choose milk, yogurt, or cheese
Go lean with protein
Choose low-fat or lean meats and poultry
Vary your protein routine-choose more fish, beans. peas, nuts, and seeds
Find your balance between food and physical activity.
Be physically active for at least 30 minutes most days of the week.
Know your limits on fats, sugars, and sodium.
Your allowance for oils is 6 teaspoons a day.
Limit extras—solid fats and sugars—to 265 calories a day.
Your results are based on a 2,000 calorie pattern.          Name: _________

books, packs of crayons, and take-home flyers for parents with Dole coupons.

Nutrition research has revealed that active men should consume even more than the five servings of fruit and vegetables the program has promoted since its inception. In 2000 the "5-a-Day for Better Health" program launched "Men Shoot for 9" to encourage men to eat nine servings of fruits and vegetables every day. Along with reducing risk for heart disease, high blood pressure, stroke, many cancers, and diabetes, diets rich in fruits and vegetables can help to prevent overweight and obesity. Fruits and vegetables are naturally low in calories and fat, and their high water and fiber content produce feelings of fullness and satiety. Combined with an active lifestyle and low-fat diet, eating greater amounts of fruits and vegetables and fewer high-calorie foods at meals can help control weight. The "Men Shoot for 9" program teaches men that they can feel full and consume fewer calories when they substitute vegetables for foods that contain more fat and calories.

September 2005 was designated "National 5-a-Day Month" and the Produce for Better Health Foundation and the National 5-a-Day Partnership encouraged participation in the program by issuing 5-a-Day recipes to help people readily incorporate produce into their diets, as well as worksite nutrition programs to help employers educate workers and create environments that offer increased choices for fruits and vegetables.

State Funding for Prevention Efforts

The CDC Nutrition and Physical Activity Program to Prevent Obesity and Other Chronic Diseases aims to help states prevent obesity and other chronic diseases by focusing on poor nutrition and inadequate physical activity. The program supports states to develop and implement nutrition and physical activity interventions. The program sponsors initiatives to help populations balance caloric intake and expenditure, increase physical activity, improve nutrition by increasing consumption of fruits and vegetables, reduce television time, and increase breastfeeding.

In 2005–06, twenty-one states were funded at $400,000 to $450,000 for capacity building—state health departments are gathering data, building partnerships, and creating statewide health plans. Essentially, capacity building lays the necessary groundwork upon which to institute nutrition and physical activity interventions. In addition, seven states were funded at $750,000 to $1.3 million for basic implementation, bringing the total number of states that received funding to twenty-eight. Figure 10.4 shows the states funded for basic implementation and those that received funds for capacity building.

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