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Figure 1-8

Making Nutrient-Dense Choices:

One Meal At a Time
Slight changes to individual parts of a meal can make a big difference. This meal shows examples of small shifts to
more nutrient-dense choices that significantly improve the nutritional profile of the meal overall while delivering on
taste and satisfaction.

Typical Burrito Bowl Nutrient-Dense Burrito Bowl

Total Calories = 1,120 Total Calories = 715

White rice (1½ cups) Brown rice (1 cup) + Romaine lettuce (½ cup)

Black beans (⅓ cup) Black beans, reduced sodium (⅓ cup)

Chicken cooked with sauce (2 ounces) Grilled chicken with spice rub (2 ounces)

No grilled vegetables Added grilled vegetables (⅓ cup)

Guacamole (½ cup) Sliced avocado (5 slices)

Jarred salsa (¼ cup) Fresh salsa/pico de gallo (¼ cup)

Sour cream (¼ cup) No sour cream

Cheese (⅓ cup) Reduced-fat cheese (⅓ cup)

Jalapeño (5 slices) Jalapeño (5 slices)

Iced tea with sugar (16 ounces) Iced tea, no sugar (16 ounces)

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Figure 1-9
Making Healthy Choices: One Day At a Time
Small changes to more nutrient-dense, single food and beverage choices that, when combined, become a nutrient-
dense meal, can lead to a whole day made up of nutrient-dense meals and snacks. The following example, which
comes in under 2,000 calories, shows how people can make thoughtful choices that meet their food group needs,
stay within limits, and, importantly, that they can enjoy.

BREAKFAST
Total calories: 375
• Banana-Walnut Overnight Oats
(350 calories):
» Oats (½ cup raw)
» Low-fat, plain Greek yogurt
(¼ cup)
» Fat-free milk (¼ cup)
» Banana (½ banana)
» Walnuts (4 nuts)
» Honey (1 tsp)
• Coffee (25 calories):
» Coffee (1 cup)
» Fat-free milk (¼ cup)

LUNCH
Total calories: 715
• Chicken Burrito Bowl
(710 calories)
» Brown rice (1 cup)
» Romaine lettuce (½ cup)
» Black beans, low sodium
(⅓ cup)
» Grilled chicken with spice rub
(2 ounces)
» Grilled vegetables (⅓ cup)
» Sliced avocado (5 slices)
» Fresh salsa/pico de gallo
(¼ cup)
» Reduced-fat cheese (⅓ cup)
» Jalapeño (5 slices)
• Iced Tea, No Sugar
(16 ounces) (5 calories)

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 Guideline

The nutrient density and healthfulness of what people eat and drink often is determined
ultimately by how a food item, dish or meal is prepared, at home and away from home, or
produced by a manufacturer. Based on the U.S. food supply and marketplace, the examples of
healthy dietary patterns in this edition are achievable through thoughtful, informed choices one
decision, one meal, one day at a time—and consistently over time.

DINNER
Total calories: 585
• Oven-Roasted Tilapia and
Vegetables With Pasta
(510 calories)
» Tilapia (4 ounces)
» Broccoli (½ cup)
» Carrots (⅓ cup)
» Summer squash (⅓ cup)
» Pasta (¾ cup cooked)
» Garlic-herb oil (1 Tbsp)
• Orange (1 medium)
(75 calories)
• Sparkling Water
(8 ounces) (0 calories)

SNACKS
Total calories: 300
• Air-Popped Popcorn
(2 cups) (60 calories)
• Yogurt and Peaches
(240 calories)
» Plain, low-fat Greek yogurt
(1 cup yogurt)
» Canned peaches packed in
100% juice (½ cup)

TOTAL CALORIES
FOR THE DAY:
2,000

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As such, a nutrient-dense diet, where most nutritional to support a healthy dietary pattern over
needs are met by 85% of the calories consumed, offers time. Additionally, if alcoholic beverages
a small amount of leeway to add minimal amounts are consumed, intakes should be within the
of added sugars or saturated fat to the diet. For limits described in this chapter, and calories should
example, one way to use remaining calories is to add be accounted for to keep total calorie intake at an
small amounts of added sugars or saturated fat to appropriate level.
some nutrient-dense foods to help make some foods
more palatable while working towards meeting food Added Sugars
group recommendations—for example, oatmeal with a A healthy dietary pattern limits added sugars to less
small amount of brown sugar or vegetables prepared than 10 percent of calories per day. Added sugars
with small amounts of butter. However, to achieve a can help with preservation; contribute to functional
healthy dietary pattern, all (or mostly all) food group attributes such as viscosity, texture, body, color, and
recommendations should be met with foods and browning capability, and/or help improve the palatability
beverages that are in nutrient-dense forms. of some nutrient-dense foods. In fact, the nutrient-
dense choices included in the Healthy U.S.-Style Dietary
A healthy dietary pattern has little room available for Pattern are based on availability in the U.S. food supply
foods and beverages high in added sugars, saturated and include 17-50 calories from added sugars, or
fat, and/or sodium. Intakes of foods and beverages 1.5-2 percent of total calories.
high in these components should be limited. These
foods and beverages should be occasional choices— Foods and beverages high in calories from added sugars
consumed in small portions. should be limited to help achieve healthy dietary patterns
within calorie limits. When added sugars in foods and
While intakes of added sugars, saturated fat, and beverages exceed 10 percent of calories, a healthy
sodium should be limited, the guidance below is dietary pattern within calories limits is very difficult to
intended to allow programs and individuals to have achieve. Most Americans have less than 8 percent of
some flexibility to choose a healthy dietary pattern calories available for added sugars, including the added
within calorie limits that fits personal preferences and sugars inherent to a healthy dietary pattern. The limit for
cultural traditions—and allows day-to-day flexibility added sugars is based on the following assumptions:

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• Most calorie levels have less than 15 percent less than the allotted amount of calories for saturated
of calories remaining after meeting food group fat, 10 percent of added sugars may fit in a healthy
recommendations through nutrient-dense choices. dietary pattern.

• Approximately half of remaining calories are Added sugars account on average for almost 270
consumed as saturated fat and half consumed as calories—or more than 13 percent of total calories—per
added sugars. day in the U.S. population. As shown in Figure 1-10,
the major sources of added sugars in typical U.S. diets
• Total saturated fat intakes meet the recommendation are sugar-sweetened beverages, desserts and sweet
for less than 10 percent of total calorie intake. snacks, sweetened coffee and tea, and candy. Together,
these food categories make up more than half of the
• No alcoholic beverages are consumed. intake of all added sugars while contributing very little
to food group recommendations.
• Overall calorie intake does not exceed intake needs to
maintain or achieve a healthy weight. Individuals have many potential options for reducing the
intake of added sugars, including reducing the intake
Based on the assumptions above, an individual who of major sources of added sugars. Strategies include
needs 2,000 calories per day (based on age, sex, reducing portions, consuming these items less often,
and physical activity level) has less than 7 percent and selecting options low in added sugars. For those
of calories available for added sugars. Individuals with a weight loss goal, limiting intake of foods and
who need 2,800 calories per day or less have less beverages high in added sugars is a strategy to help
than 8 percent of calories available for added sugars. reduce calorie intake.
Individuals who need more than 3,000 calories may
have a total of 9 to 10 percent of calories available for It should be noted that replacing added sugars with
added sugars. In this portion of the population that low- and no-calorie sweeteners may reduce calorie
requires high calorie intake, an upper limit of 10 percent intake in the short-term and aid in weight management,
of calories from added sugars may be consumed while yet questions remain about their effectiveness as a
still meeting food group recommendations in nutrient- long-term weight management strategy. For additional
dense forms. The 10 percent added sugar limit allows information about high-intensity sweeteners permitted
for flexibility in food choices over time but also requires for use in food in the United States, see fda.gov/food/
careful planning. For example, if one chooses to eat food-additives-petitions/high-intensity-sweeteners.

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Figure 1-10

Top Sources and Average Intakes of Added

Sugars: U.S. Population Ages 1 and Older

Breakfast
Cereals & Bars
Candy &
7 % Sugars Higher Fat
Milk & Yogurt

9% 4 %

Added Sugars
Average Intake:
266 kcal/day Sugar-Sweetened Desserts &
Beverages Sweet Snacks

24% 19%
Other Sources
Coffee & Tea
19%
Sandwiches

7 % 11%

Within Sugar-Sweetened Within Desserts &

Beverages: Sweet Snacks:
Other Sources Doughnuts,

1%
Other Sources Sweet Rolls,

1% 3
& Pastries
%

Cookies &
& IceCream
Ice Cream&&
Soft Drinks Cookies

16
Fruit Drinks Brownies Frozen Dairy
Frozen

5 6
Brownies Desserts

55
Dairy Desserts
% %%
S

% %%

2
Cakes &
Cakes & Pies
Pies
% Sport &
Energy Drinks
4 %%

Data Source: Analysis of What We Eat in America, NHANES, 2013-2016, ages 1 and older, 2 days dietary intake data, weighted.

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Saturated Fat Strategies to lower saturated fat intake include reducing

For those 2 years and older, intake of saturated fat intakes of dessert and sweet snacks by consuming
should be limited to less than 10 percent of calories per smaller portion sizes and eating these foods less often.
day by replacing them with unsaturated fats, particularly Additional strategies include reading food labels to
polyunsaturated fats. Although some saturated fat is choose packaged foods lower in saturated fats and
inherent in foods (e.g., high-fat meat), some sources are choosing lower fat forms of foods and beverages
added (e.g., butter on toast). Similar to added sugars, (e.g., fat-free or low-fat milk instead of 2 percent or
some of the nutrient-dense choices included in the whole milk; lean rather than fatty cuts of meat). When
Healthy U.S.-Style Dietary Pattern include saturated fat. cooking and purchasing meals, select lean meat and
Approximately 5 percent of total calories inherent to the lower fat cheese in place of high-fat meats and regular
nutrient-dense foods in the Healthy U.S.-Style Dietary cheese—or replace them with ingredients with oils,
Pattern are from saturated fat from sources such as such as nuts, seeds, or avocado. Cook and purchase
lean meat, poultry, and eggs; nuts and seeds; grains; products made with oils higher in polyunsaturated and
and saturated fatty acids in oils. As such, there is little monounsaturated fat (e.g., canola, corn, olive, peanut,
room to include additional saturated fat in a healthy safflower, soybean, and sunflower) rather than butter,
dietary pattern while staying within limits for saturated shortening, or coconut or palm oils.
fat and total calories.
A note on trans fats and dietary cholesterol: The
Current average intakes of saturated fat are 11 percent National Academies recommends that trans fat
of calories. Only 23 percent of individuals consume and dietary cholesterol consumption to be as low
amounts of saturated fat consistent with the limit of as possible without compromising the nutritional
less than 10 percent of calories. The main sources adequacy of the diet. The USDA Dietary Patterns are
of saturated fat in the U.S. diet include sandwiches, limited in trans fats and low in dietary cholesterol.
including burgers, tacos, and burritos; desserts and Cholesterol and a small amount of trans fat occur
sweet snacks; and rice, pasta, and other grain-based naturally in some animal source foods. As of June
mixed dishes (Figure 1-11). Saturated fat is commonly 2018, partially hydrogenated oils (PHOs), the major
found in higher amounts in high-fat meat, full-fat dairy source of artificial trans fat in the food supply, are no
products (e.g., whole milk, ice cream, cheese), butter, longer Generally Recognized as Safe (GRAS). Therefore,
coconut oil, and palm kernel and palm oil. PHOs are no longer added to foods.

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Figure 1-11

Top Sources and Average Intakes of

Saturated Fat: U.S. Population Ages 1 and Older

Eggs

Pizza
3 %

Poultry,
Excluding Deli & 5 % Higher Fat
Milk & Yogurt
Meat, Poultry &
Seafood Mixed

6
Mixed Dishes

4
Dishes

% %
4 %
Spreads
Saturated Fat
Average Intake:
239 calories/day
3 %
Sandwiches Desserts &

19%
Sweet Snacks

11% Meats,
Excluding Deli
& Mixed Dishes

Cheese
Rice, Pasta & Other Chips, Crackers
3 %

4
Grain-Based & Savory
Snacks

4
Vegetables, Mixed Dishes

7
% Excluding
Starchy
% %

4 % Other Sources
Starchy
Vegetables 20%
3 %

Within Within Desserts &

Sandwiches: Sweet Snacks:
Breakfast
Sandwiches Cakes & Pies
Chicken & Turkey

2 3
Sandwiches
%
%
2 % Cookies &
Brownies

4 3
Other Burritos &
Sandwiches Ice Cream &
Tacos

6
% %
4
Frozen Dairy
% Desserts
%

1 3 %
Burgers

%
2 %

Hotdog Doughnuts,
Sandwiches Sweet Rolls
& Pastries

Data Source: Analysis of What We Eat in America, NHANES, 2013-2016, ages 1 and older, 2 days dietary intake data, weighted.

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Sodium
Sodium is an essential nutrient primarily consumed as
salt (sodium chloride). Healthy eating patterns
limit sodium to the Chronic Disease Risk Reduction
(CDRR) levels defined by the National Academies—
1,200 mg/day for ages 1 through 3; 1,500 mg/day for
ages 4 through 8; 1,800 mg/day for ages 9 through 13;
and 2,300 mg/day for all other age groups. The CDRR for
sodium was established using evidence of the benefit of
reducing sodium intake on cardiovascular risk and
hypertension risk.

As a food ingredient, sodium is used in multiple ways,

including curing meat, baking, as a thickening agent, as a
flavor enhancer, as a preservative, and to retain moisture.
The nutrient-dense choices in the Healthy U.S.-Style
Dietary Pattern provide approximately 60-100 percent of
the age-specific CDRR for sodium across calorie levels
with amounts ranging from about 1,000 to 2,200 mg.
For most calorie levels and at most ages, there is very
little room for food choices that are high in sodium.

Average intakes of sodium are high across the U.S.

population compared to the CDRRs. Average intakes
for those ages 1 and older is 3,393 milligrams per day,
with a range of about 2,000 to 5,000 mg per day. Only a
small proportion of total sodium intake is from sodium
inherent in foods or from salt added in home cooking
or at the table. Most sodium consumed in the United
States comes from salt added during commercial food
processing and preparation, including foods prepared
at restaurants.

Sodium is found in foods from almost all food categories

across the food supply (Figure 1-12), including mixed
dishes such as sandwiches, burgers, and tacos; rice,
pasta, and grain dishes; pizza; meat, poultry, and
seafood dishes; and soups. Calorie intake is highly
associated with sodium intake (i.e., the more foods and
beverages people consume, the more sodium they tend
to consume).

Because sodium is found in so many foods, multiple

strategies should be implemented to reduce sodium
intake to the recommended limits. Careful choices are
needed in all food groups to reduce intake. Strategies
to lower sodium intake include cooking at home more
often; using the Nutrition Facts label to choose products
with less sodium, reduced sodium, or no-salt-added, etc.;
and flavoring foods with herbs and spices instead of salt
based on personal and cultural foodways.

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Figure 1-12

Top Sources and Average Intakes of Sodium:

U.S. Population Ages 1 and Older

Yeast Breads
& Tortillas Deli & Cured

3
Products

3
Poultry,
Excluding Deli & %
Mixed Dishes %

5
Starchy
Vegetables

4
% Chips, Crackers
% Pizza

5
& Savory Snacks

Eggs
%
4 %
Sodium
Average Intake: 3 % Breakfast
Cereals & Bars

3
3,393 mg/day Sandwiches Rice, Pasta &
Other Grain-Based
%

21%
Mixed Dishes

8%
Desserts &
Vegetables, Sweet Snacks

4
Excluding Starchy

7%
Soups %
4 %
Meat, Poultry
& Seafood
Mixed Dishes Other Sources

5 %
Condiments
& Gravies
19%
3 %

Within Within Rice, Pasta &

Sandwiches: Other Grain-Based
Hotdog Mixed Dishes:
2 2
Sandwiches Breakfast
% Sandwiches
Other Sources

3%
% Other
Mexican Dishes,
Chicken & Turkey Excludes
Other

4
Tacos & Burritos

3 1
Sandwiches
Sandwiches

7
% % %
%

1
Other Sources

1 3 2
%
% % % Rice Mixed
Dishes
Pasta Mixed Dishes,
PBJ Excludes
Sandwiches Burritos & Macaroni & Cheese
Tacos

Data Source: Analysis of What We Eat in America, NHANES, 2013-2016, ages 1 and older, 2 days dietary intake data, weighted.

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