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The Healthy Eating Index (HEI) is a measure of diet quality in terms of conformance with federal dietary guidance. Publication of the 2010 Dietary Guidelines for Americans prompted an interagency working group to update the HEI. The HEI-2010 retains several features of the 2005 version: (a) it has 12 components, many unchanged, including nine adequacy and three moderation components; (b) it uses a density approach to set standards, eg, per 1,000 calories or as a percentage of calories; and (c) it employs least-restrictive standards; ie, those that are easiest to achieve among recommendations that vary by energy level, sex, and/or age. Changes to the index include: (a) the Greens and Beans component replaces Dark Green and Orange Vegetables and Legumes; (b) Seafood and Plant Proteins has been added to capture specific choices from the protein group; (c) Fatty Acids, a ratio of polyunsaturated and monounsaturated to saturated fatty acids, replaces Oils and Saturated Fat to acknowledge the recommendation to replace saturated fat with monounsaturated and polyunsaturated fatty acids; and (d) a moderation component, Refined Grains, replaces the adequacy component, Total Grains, to assess overconsumption. The HEI-2010 captures the key recommendations of the 2010 Dietary Guidelines and, like earlier versions, will be used to assess the diet quality of the US population and subpopulations, evaluate interventions, research dietary patterns, and evaluate various aspects of the food environment.

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The US Department of Agriculture Food Patterns were updated for the 2010 Dietary Guidelines for Americans to meet new nutrition goals and incorporate results of food pattern modeling requested by the Dietary Guidelines Advisory Committee. The purpose of this article is to describe the process used and changes in the updated patterns. Changes include renaming the Meat and Beans and Milk Groups to the Protein Foods and Dairy Groups, respectively, to be more encompassing of foods in each. Vegetable subgroups now provide more achievable intake recommendations. Calcium-fortified soymilk is now included in the Dairy Group because of its similarity to foods in that group. Increased amounts of seafoods are recommended in the Protein Foods Group, balanced by decreased amounts of meat and poultry. A limit on calories from solid fats and added sugars is included, replacing the previous discretionary calorie allowance and emphasizing the need to choose nutrient-dense forms of foods. Lacto-ovo vegetarian and vegan patterns that meet nutrition goals were created by making substitutions in the Protein Foods Group, and for vegan patterns, in the Dairy Group. Patterns identify food choices that meet nutritional needs within energy allowances and encourage choosing a variety of foods. They rely on foods in nutrient-dense forms, including a limited amount of calories from solid fats and added sugars. The Food Patterns provide a useful template for educating consumers about healthful food choices while highlighting a large gap between choices many Americans make and healthy eating patterns.

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BACKGROUND: The US Department of Agriculture (USDA) Food Patterns, released as part of the 2010 Dietary Guidelines for Americans, are designed to meet nutrient needs without exceeding energy requirements. They identify amounts to consume from each food group and recommend that nutrient-dense forms-lean or low-fat, without added sugars or salt-be consumed. Americans fall short of most food group intake targets and do not consume foods in nutrient-dense forms. Intake of calories from solid fats and added sugars exceed maximum limits by large margins. OBJECTIVE: Our aim was to determine the potential effect on meeting USDA Food Pattern nutrient adequacy and moderation goals if Americans consumed the recommended quantities from each food group, but did not implement the advice to select nutrient-dense forms of food and instead made more typical food choices. DESIGN: Food-pattern modeling analysis using the USDA Food Patterns, which are structured to allow modifications in one or more aspects of the patterns, was used. Nutrient profiles for each food group were modified by replacing each nutrient-dense representative food with a similar but typical choice. Typical nutrient profiles were used to determine the energy and nutrient content of the food patterns. RESULTS: Moderation goals are not met when amounts of food in the USDA Food Patterns are followed and typical rather than nutrient-dense food choices are made. Energy, total fat, saturated fat, and sodium exceed limits in all patterns, often by substantial margins. With typical choices, calories were 15% to 30% (ie, 350 to 450 kcal) above the target calorie level for each pattern. Adequacy goals were not substantially affected by the use of typical food choices. CONCLUSIONS: If consumers consume the recommended quantities from each food group and subgroup, but fail to choose foods in low-fat, no-added-sugars, and low-sodium forms, they will not meet the USDA Food Patterns moderation goals or the 2010 Dietary Guidelines for Americans.

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BACKGROUND: The US Department of Agriculture Automated Multiple-Pass Method (AMPM) is used for collecting 24-h dietary recalls in What We Eat In America, the dietary interview component of the National Health and Nutrition Examination Survey. Because the data have important program and policy applications, it is essential that the validity of the method be tested. OBJECTIVE: The accuracy of the AMPM was evaluated by comparing reported energy intake (EI) with total energy expenditure (TEE) by using the doubly labeled water (DLW) technique. DESIGN: The 524 volunteers, aged 30-69 y, included an equal number of men and women recruited from the Washington, DC, area. Each subject was dosed with DLW on the first day of the 2-wk study period; three 24-h recalls were collected during the 2-wk period by using the AMPM. The first recall was conducted in person, and subsequent recalls were over the telephone. RESULTS: Overall, the subjects underreported EI by 11% compared with TEE. Normal-weight subjects [body mass index (in kg/m(2)) < 25] underreported EI by <3%. By using a linear mixed model, 95% CIs were determined for the ratio of EI to TEE. Approximately 78% of men and 74% of women were classified as acceptable energy reporters (within 95% CI of EI:TEE). Both the percentage by which energy was underreported and the percentage of subjects classified as low energy reporters (<95% CI of EI:TEE) were highest for subjects classified as obese (body mass index > 30). CONCLUSIONS: Although the AMPM accurately reported EIs in normal-weight subjects, research is warranted to enhance its accuracy in overweight and obese persons.

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