The Healthy Dietary Patterns Highlighted in the 2020-2025 Dietary Guidelines for Americans

We recently summarized the 2020–2025 Dietary Guidelines for Americans (DGA), which were released in December 2020. In case you missed that article, here is a refresher: The DGA provide science-based advice on what to eat and drink to promote health, reduce the risk for chronic disease and meet daily nutrient needs. The DGA are the foundation of federal food, nutrition and health policies and programs, and they have been revised every five years since 1980.

The 2020–2025 DGA provide four overarching guidelines that encourage healthy eating patterns at each stage of life, stressing that many individuals will need to make shifts in their food and beverage choices to achieve a healthy eating pattern:

Follow a healthy eating pattern at every life stage.
Customize and enjoy nutrient-dense food and beverage choices that reflect personal preferences, cultural traditions and budgetary constraints.
Focus on meeting food group needs with nutrient-dense foods and beverages, and stay within recommended calorie limits.
Limit foods and beverages that are higher in added sugars, saturated fat and sodium, and limit alcoholic beverages.

These guidelines are not intended to be overly prescriptive; rather, they are meant to be customized based on an individual’s personal preferences and needs. This article focuses on the first guideline—following a healthy eating pattern at every stage of life—and explores the three recommended eating patterns that are highlighted in the DGA.

The Importance of Healthy Dietary Patterns

A hallmark of the DGA is the importance placed on healthy dietary patterns as a whole—rather than on individual nutrients or foods in isolation. But what is a dietary pattern? A dietary pattern is the combination of foods and beverages consumed over the course of any given day, week, or year. As a result, dietary patterns can be more closely associated with overall health status and disease risk than consumption of individual foods or nutrients. According to the DGA, a healthy dietary pattern consists of nutrient-dense forms of foods and beverages across all food groups, in recommended amounts, and within calorie limits. As with the previous version, the 2020–2025 DGA provide examples of three dietary patterns that align with DGA recommendations; they are defined as Healthy U.S.-Style, Healthy Vegetarian and Healthy Mediterranean-Style. Additionally, the DASH Diet has received a nod for aligning with DGA recommendations. Let’s take a look at each of these dietary patterns.

Breaking Down the Dietary Patterns in the DGA

The Healthy U.S.-Style Dietary Pattern

The Healthy U.S.-Style Dietary Pattern emphasizes fruits, vegetables, whole grains, low- and fat-free dairy, healthy fats, lean meats and poultry. It limits calories from added sugars and refined starches. The Healthy U.S.-Style Dietary Pattern is based on the types and proportions of foods that Americans typically consume, but it recommends that they be eaten in nutrient-dense forms, prepared with minimal added sugars, refined starches and sodium, and consumed in appropriate amounts.

See the Healthy U.S.-Style Dietary Pattern recommendations here.

The Healthy Vegetarian Dietary Pattern

The Healthy Vegetarian Dietary Pattern is a variation of the Healthy U.S.-Style Dietary Pattern that does not include meats, poultry or seafood. Compared with the Healthy U.S.-Style Dietary Pattern, the Healthy Vegetarian Dietary Pattern is higher in soy products (particularly tofu and other processed soy products); beans, peas, and lentils; nuts and seeds; and whole grains. Inclusion of dairy and eggs would make this dietary pattern an example of a lacto-ovo vegetarian pattern. Like the Healthy U.S.-Style Dietary pattern, all foods in the Healthy Vegetarian Dietary Pattern are assumed to be in nutrient-dense forms and prepared with minimal added sugars, refined starches or sodium. Foods are also lean or in low-fat forms, with the exception of dairy, which includes whole-fat fluid milk, reduced-fat plain yogurt, and reduced-fat cheese. Within this dietary pattern, there are no calories recommended for additional added sugars, saturated fat, or for more food than what’s advised within a particular food group.

There are some special considerations for very young children and women who are pregnant or lactating if they are following the Healthy Vegetarian Dietary Pattern:

The Vegetarian Dietary Pattern during the second year of life (12–23 months)

If feeding toddlers a lacto-ovo vegetarian diet, iron deficiency may be of particular concern, since plant foods contain only non-heme iron, which is absorbed less efficiently than the heme iron found in animal foods. Vitamin B12 also may be of concern because it is present only in animal foods. In these cases, parents, caregivers, and guardians should consult with a healthcare provider to determine whether supplementation of iron, vitamin B12, and/or other nutrients is necessary, and if so, what the appropriate levels are for meeting young children’s unique needs.

Pregnant or lactating women

Pregnant or lactating women following a vegetarian or vegan dietary pattern should consult with a healthcare provider to determine whether supplementation of iron, vitamin B12, and/or other nutrients such as choline, zinc, iodine, or EPA/DHA is necessary and if so, what the appropriate levels are for meeting their unique needs. It’s important to note that all pregnant or lactating women are encouraged to consult with a healthcare provider about the need for possible dietary supplementation, as nutrient needs rise during this life stage.

See the Healthy Vegetarian Dietary Pattern recommendations here.

The Healthy Mediterranean-Style Dietary Pattern

The Healthy Mediterranean-Style Dietary Pattern highlighted in the DGA is based on the Mediterranean Diet, which focuses on the traditional foods eaten in the countries that surround the Mediterranean Sea. The Mediterranean Diet emphasizes plant-based foods while incorporating some animal foods—in particular, fish—and includes sweets, red meat and processed meats only sparingly. This dietary pattern has been associated with many health benefits, primarily related to heart health. When following the Healthy Mediterranean-Style Dietary Pattern, calories up to a specified limit can be used for added sugars, saturated fat, and/or alcohol (for non-pregnant adults of legal drinking age only) or to eat more than what’s recommended for a particular food group.

See the Healthy Mediterranean-Style Dietary Pattern recommendations here.

The DASH Diet

Another dietary pattern received a nod of approval from the 2020–2025 DGA: the Dietary Approaches to Stop Hypertension (DASH) Diet, which has many of the same characteristics as the Healthy U.S.-Style Dietary Pattern. However, this dietary pattern emphasizes in particular limiting a person’s intake of sodium, in some cases recommending less sodium than the DGA. Additional details on the DASH Diet are available here.

In Summary

While these are the dietary patterns highlighted in the 2020–2025 Dietary Guidelines for Americans, it is important to note that consumers are encouraged to consider them alongside their own unique life stages, cultural preferences and needs. If you’re looking for more tangible ways to improve your eating habits, you can learn how to use these recommendations to create your very own MyPlate Plan here. Additional resources on how to make the DGA work for you and your family can be found on the U.S. Department of Agriculture’s website, here.

See below for IFIC resources related to dietary patterns highlighted by the DGA:

This article includes contributions from Kris Sollid, RD, and Ali Webster, PhD, RD.