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Practice Applications USDA Center for Nutrition Policy and Promotion Corner| Volume 117, ISSUE 2, P181-183, February 2017

Assessing the Reach of MyPlate using National Health and Nutrition Examination Survey Data

Published:January 25, 2017DOI:https://doi.org/10.1016/j.jand.2016.11.015
      The Dietary Guidelines for Americans (DGA) serve as a basis for developing federal nutrition education materials for the public.
      • Tagtow A.
      • Rahavi E.
      • Bard S.
      • Stoody E.E.
      • Casavale K.
      • Mosher A.
      Coming together to communicate the 2015-2020 Dietary Guidelines for Americans.
      Since 1980, the US Department of Agriculture (USDA) and US Department of Health and Human Services have jointly issued the guidelines targeting healthy Americans aged 2 years and older to promote health and reduce the risk of major chronic diseases.
      • Watts M.L.
      • Hager M.H.
      • Toner C.D.
      • Weber J.A.
      The art of translating nutritional science into dietary guidance: History and evolution of the Dietary Guidelines for Americans.
      Over the years, the USDA has adapted communication initiatives using iconic representation of the guidelines such as the Basic 4, Food Guide Pyramid, and MyPyramid. In 2011, the current food guide, MyPlate, was unveiled; MyPlate was conceived as an uncomplicated visual cue that prompts consumers to use food groups as a guide to build healthy plates at meal time.
      • Post R.C.
      A new approach to dietary guidelines communications: Make MyPlate, Your Plate.
      Thanks to support from registered dietitian nutritionists (RDNs) and nutrition educators across a variety of settings, the popularity and public awareness of MyPlate among consumers as well as health professionals has continuously grown.
      • Haven J.
      • Maniscalco S.
      • Bard S.
      • Ciampo M.
      MyPlate myths debunked.
      A few surveys in the past have assessed consumers’ familiarity of the MyPlate graphic and the extent of its use by health professionals. For example, a communications survey released in late 2013 reported that a majority of practicing RDNs (∼75%) used MyPlate to counsel patients.

      14 Top Trends for 2014. New York, NY: Pollock Commuications. 2013. http://www.lpollockpr.com/blog/14-top-diet-trends-2014-2/. Accessed January 10, 2017.

      Similarly, the International Food Information Council Foundation’s 2016 Food and Health Survey that showed the MyPlate icon to participants to assess their familiarity, stated that almost two out of three Americans were able to recognize it.

      Food Decision 2016. Food & Health Survey. International Food Information Council Foundation. http://www.foodinsight.org/sites/default/files/2016-Food-and-Health-Survey-Report_FINAL1.pdf. Accessed November 23, 2016.

      These surveys demonstrate that MyPlate is being widely disseminated to Americans. We know that many Americans recognize MyPlate, but does that knowledge translate to behavior change? Our nutritionists at the Center for Nutrition Policy and Promotion (CNPP) assessed the national reach of MyPlate using the National Health and Nutrition Examination Survey (NHANES) data and evaluated whether recognition of MyPlate is correlated with other health-seeking behaviors. Specifically, we used the diet, behavior, and nutrition component of NHANES 2013-2014 in which eligible respondents (n=6,464) over 16 years of age were asked three questions to ascertain their familiarity with MyPlate: 1) Have you heard of MyPlate? 2) Have you looked up MyPlate on the internet? and 3) Have you tried to follow the plan recommended in MyPlate? The survey also collected demographic, income, diet, and health-related information that was used in this analysis.

      Study Findings

      Within about 2 years of the launch of MyPlate, 20.2% (n=1,054) of the respondents reported that they had heard about MyPlate. Unlike other studies, these participants were not shown a picture of MyPlate; rather, they were asked whether they recognized it by name. Of these, one-third looked it up on the internet (33.2%, n=351) and slightly over one-third (35.3%, n=365) tried to follow the plans recommended in MyPlate.

      Familiarity with Myplate Varies by Demographics

      Similar to previous findings,
      • Wright J.D.
      • Wang C.-Y.
      Awareness of Federal Dietary Guidance in persons aged 16 years and older: Results from the National Health and Nutrition Examination Survey 2005-2006.
      our analysis showed that women are likely to be more receptive to nutrition information when compared with men (25.9% vs 14.2%). This pattern was consistent across all age groups. Women are generally considered the nutritional gatekeepers for families and are often involved in making decisions about a family’s food intake.
      • Haack S.A.
      • Byker C.J.
      Recent population adherence to and knowledge of United States federal nutrition guides, 1992-2013: A systematic review.
      Thus, their familiarity with MyPlate may result in healthy eating patterns for their family.
      Adolescents (30.6%) were the most likely of all age groups to have reported hearing about MyPlate. The familiarity of MyPlate among adolescents is not surprising considering that MyPlate is often hung in classrooms and lunch rooms and used in schools for nutrition education programs. Because of these targeted outreach efforts, school-aged children were likely to be some of the first exposed to the MyPlate symbol when it was launched. Familiarity with MyPlate is less common among older Americans (Figure). With regard to race/ethnicity, non-Hispanic whites were most familiar with MyPlate when compared with Mexican Americans, non-Hispanic blacks, and Asian Americans. However, a recent study suggested that healthy eating index score, a measure of overall diet quality, was not different between races/ethnicities, especially in the absence of food insecurity.
      • Allen A.J.
      • Kuczmarski M.F.
      • Evans M.K.
      • Zonderman A.B.
      • Waldstein S.R.
      Race differences in diet quality of urban food-insecure blacks and whites reveals resiliency in blacks.
      Families that reported an annual income greater than USD $75,000 were most likely to have heard of MyPlate.
      Figure thumbnail gr1
      FigureExtent of MyPlate familiarity across age ranges.

      Relationship between Myplate Familiarity and Diet Quality

      At least four out of five Americans (81%) that expressed familiarity with MyPlate also reported superior diet quality, and this number was even higher (87.5%) among those that reported trying MyPlate. Familiarity with MyPlate was correlated with a respondent’s overall pattern of using nutrition information when eating outside of the home. Over half of the respondents that had heard of MyPlate also noted seeing nutrition information on menus during their previous visit to fast-food outlets (52.7%); further, they also reported using this information to choose fast foods (54%) (Table). Similar findings were noted with eating patterns in restaurants (Table). Overall, two out of three respondents that reported familiarity with MyPlate mentioned that they would likely use nutrition information if available while ordering at a restaurant and fast-food outlet. In contrast, among those that were not familiar with MyPlate, less than 25% said they would likely use nutrition information while choosing their food at a fast-food outlet.
      TableFamiliarity of MyPlate among those that eat outside the home
      Familiar with MyPlateUnfamiliar with MyPlateP value
      Saw nutrition information on the fast-food menu<0.001
      Yes49552.7%1,60539.3%
      No46346.3%2,80159.9%
      Saw nutrition information on the restaurant menu0.015
      Yes36138.2%1,26630.9%
      No59861.4%3,01768.4%
      Don’t know80.4%320.7%
      Used nutrition information to choose fast foods0.003
      Yes25354%59038.8%
      No24246%1,01461.1%
      Used nutrition information to choose restaurant menu0.04
      Yes18350.5%51939.2%
      No17817.8%74560.7%
      Would use fast-food nutrition information, if available<0.001
      Often/Sometimes67870.8%2,45424.5%
      Rarely14815.7%71016.8%
      Never13913.9%1,26728.2%
      Would use nutrition information in a restaurant, if available<0.001
      Often/Sometimes67970.5%2,40755.5%
      Rarely14414.1%72818.6%
      Never14415.4%1,17325.8%
      Empowering people with nutrition information to make informed food and beverage choices has been at the core of MyPlate messages.
      • Levine E.
      • Abbatangelo-Gray J.
      • Mobley A.R.
      • McLaughlin G.R.
      • Herzog J.
      Evaluating MyPlate: An expanded framework using traditional and nontraditional metrics for assessing health communication campaigns.
      When MyPlate was launched in 2011, the MyPlate icon and its associated communication messages were intended to bridge the gap between knowledge and behavior.
      • Levine E.
      • Abbatangelo-Gray J.
      • Mobley A.R.
      • McLaughlin G.R.
      • Herzog J.
      Evaluating MyPlate: An expanded framework using traditional and nontraditional metrics for assessing health communication campaigns.
      Our study findings linking familiarity with MyPlate and self-perceived diet quality, although a correlation—and not causation—provides evidence for bridging the gap. The association between familiarity with MyPlate and using nutrition information on the menu while ordering foods is further attestation to this potential relationship.

      Conclusion

      The reach of MyPlate within only a few years of its existence is promising, and studies using more recent data suggest that nearly two-thirds of Americans recognize the MyPlate icon when they see it. It is possible that more respondents in our study could have recognized MyPlate if the icon was visibly shown to the respondents, rather than asked as a question, “Have you heard of MyPlate?” It is also possible that at the time of the survey, MyPlate messaging had not reached sufficient saturation to produce measurable results in a span of few years.
      • Levine E.
      • Abbatangelo-Gray J.
      • Mobley A.R.
      • McLaughlin G.R.
      • Herzog J.
      Evaluating MyPlate: An expanded framework using traditional and nontraditional metrics for assessing health communication campaigns.
      While these speculations are reasonable, we also recognize that broad segments of the American population such as men, older adults, racial minorities, and people of lower socio-economic status will need more targeted marketing strategies.
      • Wright J.D.
      • Wang C.-Y.
      Awareness of Federal Dietary Guidance in persons aged 16 years and older: Results from the National Health and Nutrition Examination Survey 2005-2006.
      Cognizant of this need, CNPP has been vigorously rolling out several new promotions in the past few years such as the MyPlate, MyWins campaign, which communicates the key messages of the 2015-2020 DGA to consumers, and the MyPlate, MyState initiatives, which bring communities together around healthy eating by supporting local and regional agriculture. In addition, social media outreach efforts have expanded and MyPlate has been translated into other languages.

      US Department of Agriculture/Center for Nutrition Policy and Promotion. ChooseMyPlate: Other Languages. https://www.choosemyplate.gov/other-languages. Published 2016. Accessed November 18, 2016.

      As we reflect on the findings of this research and think about avenues for taking MyPlate to new frontiers, we at CNPP are reaching out to you—our community partners and experts in nutrition—to help us spread the MyPlate message and empower Americans to find their healthy eating styles.

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      2. Food Decision 2016. Food & Health Survey. International Food Information Council Foundation. http://www.foodinsight.org/sites/default/files/2016-Food-and-Health-Survey-Report_FINAL1.pdf. Accessed November 23, 2016.

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        • Kuczmarski M.F.
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