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The Collective for Health Equity and Well-Being

Cooperative Extension’s Collective for Health Equity and Well-Being is a community of Extension personnel and their partners united by their shared commitment to advancing health equity and well-being. Members work together to support the implementation of Cooperative Extension’s National Framework for Health Equity and Well-Being (2021) to ensure that all people can be as healthy as they can be.

Keep Your Patients Healthy Throughout Adulthood by Improving Nutrition

Authors:  Dana DeSilva, PhD, RD, ORISE Health Policy Fellow, and LT Dennis Anderson-Villaluz, MBA, RD, LDN, FAND, Nutrition Advisor,  U.S. Department of Health and Human Service's Office of Disease Prevention and Health Promotion

Adults’ dietary patterns often reflect habits that they established during childhood and adolescence. Sometimes, this means carrying unhealthy habits into adulthood — but it’s never too late to make changes. Health educators can use the Dietary Guidelines for Americans, 2020–2025 to support adults in following a healthy dietary pattern, engaging in regular physical activity, and maintaining a healthy weight.

A healthy dietary pattern can promote health and reduce the risk of chronic disease. However, usual dietary patterns across the adult life stage (ages 19 to 59) don’t align with the Dietary Guidelines recommendations. The Healthy Eating Index (HEI) measures diet quality based on the Dietary Guidelines. Adults ages 19 to 30 currently have an HEI score of 56 out of 100, while adults ages 31 to 59 have a score of 59. This shows that healthy eating patterns improve slightly as Americans age, but are still far from ideal.

Meeting Food Group Needs with Nutrient-Dense Foods and Beverages

The onset or progression of diet-related chronic diseases often occurs in adulthood. So it’s especially important for health professionals to encourage adults to increase intakes of fruits and vegetables and replace refined grains with whole grains. Encourage to:

  • Make half their plate a mix of fruits and veggies
  • Try whole-grain products, like whole-wheat bread and pasta, brown rice, and oatmeal

Encouraging your audience to eat foods rich in calcium and vitamin D can also help them meet their nutrient needs. Adequate intake of these nutrients is especially important to promote optimal bone health and prevent osteoporosis in older adulthood. Suggest to:

  • Eat low-fat or fat-free dairy and yogurt or fortified soy beverages or soy yogurt
  • Incorporate seafood into their eating routine

Guiding Adults Toward Nutrient-Dense Options

Choosing nutrient-dense options means choosing foods and beverages that contain little or no added sugars, saturated fat, or sodium. It also means drinking no alcohol, or drinking only in moderation.

Added sugars contribute to daily calories without adding any nutritional value. Strategies for reducing added sugars include:

  • Reducing portion sizes of desserts and sweet snacks
  • Eating foods with added sugars less often, like limiting dessert to special occasions
  • Using the Nutrition Facts label to identify hidden sources of added sugars, like sauces
  • Choosing options without added sugars, like fresh fruits instead of sweets

Eating too many foods high in saturated fat can increase risk for heart disease. Help your patients reduce intake of saturated fat by encouraging them to:

  • Select lean meats and poultry and low-fat or fat-free dairy products
  • Cook with oils that are higher in unsaturated fats, such as canola, corn, or olive oils
  • Cut down on foods high in saturated fats, such as burgers, pizza, and ice cream

Sodium is found in foods from almost all food categories across the food supply. Limiting sodium in the diet reduces risk for high blood pressure and heart disease. Talk with your patients about ways to lower sodium intake such as:

  • Cooking at home more often, using fresh foods instead of processed foods
  • Checking the % Daily Value (DV) on the Nutrition Facts label to see if foods are a low source of sodium (5% DV or less) or high source of sodium (20% DV or more)
  • Swapping salt for herbs and spices when flavoring foods

Drinking alcohol can make it difficult for adults to meet dietary recommendations without getting too many calories. Excess alcohol consumption also increases risk of several health conditions and death. Health professionals are uniquely positioned to discuss appropriate alcohol consumption with adults. Follow these tips to discuss alcohol with your patients:

  • If patients don’t currently drink alcohol, emphasize that there’s no reason to start
  • Remember that some people shouldn’t drink at all, such as women who are pregnant
  • If patients choose to drink, advise them to limit alcohol to 1 drink or less in a day for women and 2 drinks or less in a day for men
  • Remind all patients that drinking less is better for health than drinking more

Supporting Access to Healthy Foods

Helping adults become more aware of the foods and beverages that make up their typical dietary patterns and identifying areas for improvement can empower people to make changes to the types of foods they purchase or prepare. People need support in making healthy choices at home, at work, and when eating out.

Food access is a challenge for some adults, and this makes it difficult to achieve a healthy dietary pattern. To ensure that your patients have the best chance at meeting dietary recommendations, consider referring them to government programs that help low-income adults by supplementing their food budgets:

You can also direct your patients to programs that provide food and educational resources to support adults in making healthy food choices within a limited budget:

Sharing these resources with your patients gives them a better chance at achieving a healthy dietary pattern.

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Thank you so much for this excellent summary of the current status healthy  eating across the United States and a convenient link to the Dietary Guidelines for Americans, 2020 - 2025.

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