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Food Choices: Small Shifts, Large Gains

Published:October 24, 2016DOI:https://doi.org/10.1016/j.jand.2016.08.017
      The 2015-2020 Dietary Guidelines for Americans

      US Department of Health and Human Services and US Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th Edition. December 2015. http://health.gov/dietaryguidelines/2015/guidelines/. Accessed September 28, 2016.

      place an emphasis on building healthy eating patterns across the lifespan. Eating patterns can be described as the combination of foods and beverages that make up an individual’s dietary intake over time. When casting such a wide net, making changes to eating patterns can seem overwhelming. That’s why it’s important to emphasize that every food choice is an opportunity to move toward a healthy eating pattern. Small shifts in food choices—over the course of a week, a day, or even a meal—can make a big difference. This article draws upon the Dietary Guidelines and provides ideas for realistic, small shifts that can help people adopt healthy eating patterns.

      Diving into the Data

      The What We Eat in America portion of the National Health and Nutrition Examination Survey allows registered dietitian nutritionists (RDNs) to evaluate the diets of Americans and identify where shifts need to occur to help Americans achieve eating patterns that align with the Dietary Guidelines. Less than 25% of Americans have intakes of vegetables, fruit, dairy, or oils that meet the amounts recommended in the Healthy US-Style Eating Pattern.

      US Department of Health and Human Services and US Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th Edition. December 2015. http://health.gov/dietaryguidelines/2015/guidelines/. Accessed September 28, 2016.

      A majority of the American population consumes added sugars, saturated fats, and sodium in amounts that exceed the dietary limit. In addition, the high percentage of the population that is overweight or obese suggests that calorie intakes exceed calorie needs.
      Nutritionists at the Center for Nutrition Policy and Promotion (CNPP) examined the data to see, on average, how much and what types of food are being consumed within the USDA Food Categories.

      US Department of Agriculture, Agricultural Research Service. 2015. What We Eat in America Food Categories 2011-2012. https://www.ars.usda.gov/northeast-area/beltsville-md/beltsville-human-nutrition-research-center/food-surveys-research-group/docs/wweianhanes-overview/. Accessed September 28, 2016.

      These data can be used to identify prime opportunities for shifts in the diets of Americans and inform the development of educational programs, recipes, or even cooking classes developed by RDNs to help consumers make shifts toward a healthy eating style.

      Deconstructing the Mixed Dish to Shift Toward Healthy Eating Styles

      Not surprisingly, we find that people often eat foods in mixtures and combinations. Mixed dishes as a category includes pizza, burgers, tacos, sandwiches, and soups, as well as meat, poultry, and seafood mixed dishes and grain-based mixed dishes like casseroles or spaghetti with meatballs. Mixed dishes, especially those containing meats and cheeses, contribute about 35% of the saturated fat and 44% of the sodium in American’s diets. Although vegetable consumption is far from recommended amounts for most Americans, about 30% of reported vegetable intake is from mixed dishes.

      US Department of Health and Human Services and US Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th Edition. December 2015. http://health.gov/dietaryguidelines/2015/guidelines/. Accessed September 28, 2016.

      There are often a variety of improvements that can be made to mixed dishes, allowing people to tailor changes to their specific food preferences. Thus, it doesn’t have to be a one-size-fits-all approach. One realistic strategy is to increase the vegetable content of mixed dishes while decreasing the amounts of other food components that are often overconsumed, such as refined grains or meats and cheese high in saturated fat and/or sodium.
      On any given day, pizza is the second most common dish Americans report consuming, with pepperoni and cheese pizza from a restaurant or fast-food chain being the most frequently reported types. Pizza alone contributes about 6% each of saturated fat and sodium in the American diet. There are a variety of ways that Americans can shift to a healthier pizza. For example, one can substitute vegetable toppings for meat toppings, use smaller amounts of cheese and/or switch to low-fat mozzarella cheese, and/or make the pizza with a whole-grain crust. RDNs with a keen understanding of how mixed dishes can be modified to meet various food and taste preferences will help Americans identify solutions that can be maintained overtime.

      Smart Snacking Shifts

      About two-thirds of adults snack two or more times on any given day.

      Sebastian RS, Wilkinson Enns C, Goldman JD. Snacking Patterns of U.S. Adults: What We Eat In America, NHANES 2007-2008. Food Surveys Research Group Dietary Data Brief No. 4. June 2011. https://www.ars.usda.gov/ARSUserFiles/80400530/pdf/DBrief/4_adult_snacking_0708.pdf. Accessed September 28, 2016.

      Sugar-sweetened beverages and savory snacks such as chips make up about 25% of all snack calories for American adults. Similarly, snacks contribute about 23% of calories for adolescents.

      Sebastian RS, Goldman JD, Wilkinson Enns C. Snacking Patterns of U.S. Adolescents: What We Eat In America, NHANES 2005-2006. Food Surveys Research Group Dietary Data Brief No. 2. September 2010. https://www.ars.usda.gov/ARSUserFiles/80400530/pdf/DBrief/2_adolescents_snacking_0506.pdf. Accessed September 28, 2016.

      Many of the most commonly reported snacks are also high in added sugars, saturated fats, or both. RDNs can encourage Americans to shift to healthier savory snack choices that include whole grains and are lower in sodium and saturated fat (Figure). One realistic shift is to have tortilla chips, a source of whole grains, with tomato salsa rather than a cheese dip. When cheese dips are reported, the average amount reported consumption is about 4 to 6 Tbsp. When salsa is reported, the average reported consumption is about 2 Tbsp. This simple shift to salsa instead of cheese dip can result saving 1.5 g of saturated fat and 212 mg of sodium for one snack. Another popular snack, and a source of whole grains, is popcorn. We can encourage consumers to shift to unbuttered popcorn, which is reported almost half as frequently as buttered popcorn. Having popcorn seasoned with herbs or spices instead of salt is another reasonable strategy for shifting to healthier snacks. Making these types of shifts can help to reduce saturated fat and sodium intake and/or increase vegetable and whole grain intake.
      Figure thumbnail gr1
      FigureEmpower people to make healthy shifts. Modified from Figure 2-2 in the 2015-2020 Dietary Guidelines for Americans.

      US Department of Health and Human Services and US Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th Edition. December 2015. http://health.gov/dietaryguidelines/2015/guidelines/. Accessed September 28, 2016.

      Nearly half of all added sugar consumed by Americans is from beverages such as sugar-sweetened soft drinks, fruit drinks, sweetened coffee and tea, energy drinks, and flavored water. The average reported amount of sugar-sweetened cola consumed at one time is 14 oz, which provides about 160 calories and 39 grams of sugar. The 2015-2020 Dietary Guidelines recommend less than 10% of calories come from added sugars. Shifts to healthier beverage choices can help Americans achieve this target. For those who enjoy carbonated beverages, RDNs can suggest drinking sparkling water with a splash of 100% fruit juice. Many Americans enjoy making fruit-infused water as well. For a special coffee treat, reducing the amount of sugar or flavored syrups can help reduce added sugars intakes. All of the suggestions can help Americans make sustainable shifts towards healthier beverage choices.

      Bringing Shifts to Life

      At CNPP we recognize that healthy eating is easier said than done. The MyPlate, MyWins campaign, which can be found at ChooseMyPlate.gov, is all about finding a healthy eating style that fits into everyday life. RDNs play a critical role in helping people make changes to eating patterns. Considering cultural and personal preferences as well as budgets will make shifts easier to accomplish and maintain. While every food choice is an opportunity to move toward a healthy eating pattern, focusing on commonly consumed foods such as snacks, beverages and mixed dishes allows RDNs to make suggestions for realistic, small shifts that can help people adopt a healthier eating pattern.
      A new set of short MyPlate, MyWins videos will be coming soon. These videos will demonstrate small changes that Americans can make at home or away from home with fun animations. Simple swaps for breakfast, lunch, dinner, snacks, and beverages that meet people where they are will be featured. To visualize the impact of making small changes, the videos will show the potential savings for each small shift (eg, sodium, saturated fat, or added sugars) and how it adds up over time. Additional information will accompany each video on ChooseMyPlate.gov, providing more examples and detailed nutrition information.
      Stay tuned and thank you for being our partners in health!

      References

      1. US Department of Health and Human Services and US Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th Edition. December 2015. http://health.gov/dietaryguidelines/2015/guidelines/. Accessed September 28, 2016.

      2. US Department of Agriculture, Agricultural Research Service. 2015. What We Eat in America Food Categories 2011-2012. https://www.ars.usda.gov/northeast-area/beltsville-md/beltsville-human-nutrition-research-center/food-surveys-research-group/docs/wweianhanes-overview/. Accessed September 28, 2016.

      3. Sebastian RS, Wilkinson Enns C, Goldman JD. Snacking Patterns of U.S. Adults: What We Eat In America, NHANES 2007-2008. Food Surveys Research Group Dietary Data Brief No. 4. June 2011. https://www.ars.usda.gov/ARSUserFiles/80400530/pdf/DBrief/4_adult_snacking_0708.pdf. Accessed September 28, 2016.

      4. Sebastian RS, Goldman JD, Wilkinson Enns C. Snacking Patterns of U.S. Adolescents: What We Eat In America, NHANES 2005-2006. Food Surveys Research Group Dietary Data Brief No. 2. September 2010. https://www.ars.usda.gov/ARSUserFiles/80400530/pdf/DBrief/2_adolescents_snacking_0506.pdf. Accessed September 28, 2016.