In accordance with Federal civil rights law and U.S. Department of Agriculture. (USDA) and U.S. Department of Health and Human Services (HHS) civil rights.
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This publication may be viewed and downloaded from the internet at DietaryGuidelines.gov. Suggested citation: U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Available at DietaryGuidelines.gov . In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) and U.S. Department of Health and Human Services (HHS) civil rights and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language) should https://www. ocio.usda.gov/document/ad-3027 a letter addressed to USDA. The letter must contain the complainant™s name, address, telephone 1. Mail: U.S. Department of Agriculture 1400 Independence Avenue, SW 2. 3. Email: program.intake@usda.gov USDA is an equal opportunity provider, employer, and lender. December 2020

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Table of Contents Message From the Secretaries .vAcknowledgments vi Executive Summary ..vii Introduction .1 Setting the Stage .Grounded in Science and Focused on Public Health ..A Spotlight on Dietary Patterns .6Healthy Dietary Patterns at Every Life Stage ..6Dietary Guidelines for Americans : What It Is, What It Is Not 7Quantitative Guidance on Foods, Not Nutrient Requirements ..7Health Promotion, Not Disease Treatment .7Developing the Dietary Guidelines for Americans ..7Stage 1: Identify Topics and Supporting ..Stage 2: Appoint a Dietary Guidelines Advisory .. Dietary Guidelines ..11Stage 4: Implement the Dietary Guidelines 12A Roadmap to the Dietary Guidelines for Americans, 2020-2025 ..14Chapter 1: Nutrition and Health Across the Lifespan: The Guidelines and Key Recommendations 15The Guidelines 17Guideline 1: Follow a Healthy Dietary Pattern at Every Life Stage .19What Is a Dietary Pattern? ..19 A Healthy Dietary Pattern Supports .Most Americans Do Not Follow a Healthy Dietary Pattern .26Guideline 2: ..27Guideline 3: Focus on Meeting Food Group Needs With Nutrient-Dense Foods and Beverages, ..Vegetables .Fruits Grains . Protein Foods Oils.Beverages Guideline 4: Limit Foods and Beverages Higher in Added Sugars, Saturated Fat, and Sodium, and Limit Alcoholic Beverages Added Sugars ..41Saturated Fat 44Sodium ..46Alcoholic Beverages 49Support Healthy Dietary Patterns for All Americans ..Looking Toward the Life Stages ..Chapter 2: Infants and Toddlers 51Introduction ..Putting the Key Recommendations Into Action ..Feed Infants Human Milk for the First 6 Months, If Possible ..Provide Infants Supplemental Vitamin D Beginning Soon After Birth .6Introduce Infants to Nutrient-Dense Introduce Infants to Potentially Allergenic Foods .. Beverages To Meet Energy and Nutrient Needs Establish a Healthy Beverage Pattern .61Healthy Dietary Pattern During a Toddler’s Second Year of Life . ..Supporting Healthy Eating 67Accessing a Healthy Dietary Pattern . .

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Chapter 3: Children and Adolescents 69 Introduction ..71Healthy Dietary Patterns .72 .. Sugar-Sweetened Beverages .. Adolescent Nutrition Supporting Healthy Eating Accessing a Healthy Dietary Pattern .90 .90Chapter 4: Adults .91Introduction ..Healthy Dietary Patterns . ..97 .101Dietary Fiber 101 ..101Saturated Fat .102Sodium 102Added Sugars Alcoholic Beverages .104Supporting Healthy Eating .104Accessing a Healthy Dietary Pattern . Women Who Are Pregnant or Lactating .. 106Chapter 5: Women Who Are Pregnant or Lactating .107 Introduction 109Healthy Dietary Patterns ..110 .Meeting Nutrient Needs.Folate/Folic Acid .Iron .Iodine 116 .117Seafood ..117Alcoholic Beverages .117 ..Supporting Healthy Eating .120Chapter 6: Older Adults .121 Introduction Healthy Dietary Patterns ..124 126 .Protein .Vitamin B12 Beverages .129Supporting Healthy Eating .129Healthy Eating Through the Lifespan Appendixes ..131 Appendix 1: Nutritional Goals for Age-Sex Groups .Appendix 2 : .. : USDA Dietary Patterns .142

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List of Tables Table I-1: Facts About Nutrition-Related Health Table 1-1 : Healthy U.S.-Style Dietary Pattern at the .20Table 2-1 : Healthy U.S.-Style Dietary Pattern for Longer Receiving Human Milk or Infant Formula, With Daily or Weekly Amounts From Food Groups, .64Table 2-2: .67Table 3-1: Healthy U.S.-Style Dietary Pattern for Weekly Amounts From Food Groups, Subgroups, ..74Table 3-2 : Healthy U.S.-Style Dietary Pattern for With Daily or Weekly Amounts From Food Groups, .Table 3-3 : Healthy U.S.-Style Dietary Pattern for With Daily or Weekly Amounts From Food Groups, .Table 4-1 : Healthy U.S.-Style Dietary Pattern for Adults .96Table 5-1 : Healthy U.S.-Style Dietary Pattern for Women Who Are Pregnant or Lactating, With Daily or Weekly Amounts From Food Groups, ..111Table 5-2 : During Pregnancy and Lactation for Women With a Healthy Prepregnancy Weight .112Table 5-3 : Weight Gain Recommendations for Pregnancy 112Table 6- 1: Healthy U.S.-Style Dietary Pattern for Adults Ages 60 and Older, With Daily or Weekly Amounts ..Table A1-1 : Daily Nutritional Goals, Ages 6 Through 11 Months and ..Table A1-2: Daily Nutritional Goals, Ages 2 and Older Table A1-3: Daily Nutritional Goals for Women Who Are Pregnant, by Age Group and Trimester ..Table A1-4: Daily Nutritional Goals for Women Who Are Lactating, by Age Group and Months Postpartum .Table A2-1: .Table A2-2 : by Age, Sex, and Physical Activity Level, Ages 2 and Older 141Table A2-3 : During Pregnancy and Lactation for Women With a Healthy Prepregnancy Weight .141Table A3-1: Healthy U.S.-Style Dietary Pattern for Longer Receiving Human Milk or Infant Formula, With Daily or Weekly Amounts From Food Groups, ..Table A3-2 : Healthy U.S.-Style Dietary Pattern for Ages 2 and Older, With Daily or Weekly Amounts ..144Table A3-3 : Healthy Vegetarian Dietary Pattern for No Longer Receiving Human Milk or Infant Formula, With Daily or Weekly Amounts From Food Groups, ..147Table A3-4 : Healthy Vegetarian Dietary Pattern for Ages 2 and Older, With Daily or Weekly Amounts ..Table A3-5 : Healthy Mediterranean-Style Dietary Pattern for Ages 2 and Older, With Daily or Weekly Amounts From Food Groups, Subgroups, 149

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Message From the Secretaries We are pleased to present the Dietary Guidelines for Americans, 2020-2025 Guidelines provide recommendations by life stage, from birth through older adulthood. food and beverage choices later. And the science has evolved to focus on the importance of a healthy dietary pattern over time. The science also shows it™s never too late to start and maintain a healthy dietary pattern, which can yield Dietary Guidelines includes This edition of the Dietary Guidelines nutrition and health topics for each life stage. We thank the 20 distinguished scientists on the 2020 Dietary Guidelines to the Departments for our development of this 9th edition of the Dietary Guidelines important considerations for future research, such as a need to reconsider the Dietary Reference Intakes. The U.S. and fat, and carbohydrateŒthe timeline for these macronutrient reviews has not been established. USDA and HHS are Dietary Guidelines. Using the new edition of the Dietary Guidelines modest changes each day that push Americans closer to meeting the recommendations. It™s more important than ever to make healthy eating a priority in the United States. With the release of the Dietary Guidelines for Americans, Dietary Guidelines for Americans Thank you for all you do to help Americans make strides toward aligning closer to the Dietary Guidelines as we all work together to help the public lead healthier lives. /Sonny Perdue/ Sonny Perdue Secretary, U.S. Department of Agriculture /Alex M. Azar II/ Alex M. Azar II Secretary, U.S. Department of Health and Human Services

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Acknowledgments The U.S. Department of Agriculture and U.S. Department of Health and Human Services acknowledge the work of of the Dietary Guidelines for Americans.Dietary Guidelines Advisory Committee Members production of this document. Dietary Guidelines Writing Team Kelley S. Scanlon, PhD, RD. Reviewers The Departments acknowledge the contributions of numerous other internal departmental scientists and external peer reviewers who provided consultation and review during the production of this document. Finally, the Departments would like to acknowledge the important role of the Federal staff who supported the development of this edition of the Dietary Guidelines, and of those who provided public comments throughout the process.

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Executive SummaryExecutive Summary The foods and beverages that people consume have connection between food and health has been well documented for many decades, with substantial and increasingly robust evidence showing that a healthy can help people achieve and maintain good health and reduce the risk of chronic diseases throughout all stages of the lifespan: infancy and toddlerhood, childhood and adolescence, adulthood, pregnancy and lactation, and older adulthood. The core elements of a healthy dietary pattern are remarkably consistent across the lifespan and across health outcomes. Dietary Guidelines for Americans have provided science-based advice on what to eat and drink to promote health, reduce risk of chronic disease, and meet nutrient needs. Dietary Guidelines the 1990 National Nutrition Monitoring and Related the U.S. Departments of Agriculture (USDA) and of a report containing nutritional and dietary information and guidelines for the general public. The statute Dietary Guidelines Dietary and consideration of Federal agency and public comments. is designed for policymakers and nutrition and health professionals to help all individuals and their families consume a healthy, nutritionally adequate diet. The information in Dietary Guidelines and evaluate Federal food, nutrition, and health policies

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Executive Summary | Page viii and programs. It also is the basis for Federal nutrition education materials designed for the public and for the nutrition education components of USDA and HHS nutrition programs. State and local governments, schools, the food industry, other businesses, community groups, and media also use Dietary Guidelines and communication for the general public. The aim of the Dietary Guidelines is to promote health and prevent disease. Because of this public health orientation, the Dietary Guidelines is not intended to contain clinical guidelines for treating chronic mix of genetic, biological, behavioral, socioeconomic, and environmental factors, and people with these conditions have unique health care requirements that require careful oversight by a health professional. The to inform the Dietary Guidelines is representative of the people at risk for diet-related chronic conditions and diseases, such as cardiovascular disease, type 2 diabetes, and obesity, and some people who are living with one or more of these diet-related chronic illnesses. At the same time, it is essential that Federal agencies, the Dietary Guidelines their patients as part of an individual, multifaceted Consistent and Evolving Although many recommendations have remained relatively consistent over time, the Dietary Guidelines also has built upon previous editions and evolved as Dietary Guidelines for Americans, 2020-2025 important ways: diseases, such as cardiovascular disease, type 2 diabetes, obesity, and some types of cancer, are very health problem. Today, more than half of adults have one or more diet-related chronic diseases. As a result, recent editions of the Dietary Guidelines have focused on healthy individuals, as well as those with overweight or obesity and those who are at risk of chronic disease. A fundamental premise of the 2020-2025 Dietary Guidelines food and beverage choices to better support healthy dietary patterns. The second is its focus on dietary patterns. Researchers and public health experts, including registered dietitians, understand that nutrients and foods are not consumed in isolation. Rather, people synergistically to affect health. The Dietary Guidelines for Americans, 2015-2020 puts this understanding into action by focusing its recommendations on consuming a healthy dietary pattern. The 2020-2025 Dietary Guidelines carries forward this emphasis on the rather than on individual nutrients, foods, or food groups in isolation. The third is its focus on a lifespan approach. This edition of the Dietary Guidelines highlights the importance of encouraging healthy dietary patterns at every life stage from infancy through older adulthood. It provides recommendations for healthy dietary patterns and considering healthy dietary pattern characteristics that should be carried forward into the next stage of 2020-2025 Dietary Guidelines includes recommendations for healthy dietary patterns for infants and toddlers. The Guidelines2020-2025 Dietary Guidelines overarching Guidelines that encourage healthy eating individuals will need to make shifts in their food and beverage choices to achieve a healthy pattern. The dietary pattern is not a rigid prescription. Rather, the elements within which individuals make tailored and affordable choices that meet their personal, cultural, and traditional preferences. Several examples of healthy dietary patterns that translate and integrate the recommendations in overall healthy ways to eat are provided. The Guidelines are supported by Key Recommendations that provide further guidance on healthy eating across the lifespan.

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