Assessing the Public's Comprehension of Dietary Guidelines: Use of MyPyramid or MyPlate Is Associated with Healthier Diets among US Adults

Background: The Dietary Guidelines for Americans (DGA) provide a framework for food and nutrition programming in the United States as well as the foundation for individualized dietary guidance. Public utilization of the DGA, specifically the MyPyramid or MyPlate tool, is not well studied.

Objective: The objective of this study was to evaluate the relationship between public knowledge of the 2010 DGA assessed by use of the MyPyramid or MyPlate dietary plan and various markers of diet intake (including dietary energy density and Food Patterns Equivalents Database component scores) in US adults.

Design: The National Health and Nutrition Examination Survey (NHANES) is a large, cross-sectional survey conducted continuously to monitor the health and nutritional status of US residents. The sampling design of NHANES allows for collection of a nationally representative sample.

Participants/setting: Data from a nationally representative sample of 3,194 adults>18 years with 1 complete day of dietary recall data during the 2011-2014 NHANES were used for this study. During NHANES, participants were asked about knowledge and use of the MyPyramid or MyPlate plan.

Main outcome measures: Mean daily dietary intake was compared between MyPyramid or MyPlate users and nonusers.

Statistical analyses performed: Multivariable regression models were then used to evaluate the relationship between use of MyPlate or MyPyramid and various food pattern components consumed daily. Models were adjusted for age, sex, race or ethnicity, education, household size, family income (using NHANES-provided poverty-to-income ratio), smoking status, beverage energy density, and physical activity.

Results: Subjects who reported using the MyPyramid or MyPlate plan had better diets than subjects who had not tried the MyPyramid or MyPlate plan. Users of MyPyramid or MyPlate had significantly lower dietary energy density (1.8 vs 1.9 kcal/g, P=0.0003) and significantly fewer servings of refined grains (5.9 vs 6.5 oz equivalents, P=0.0007) but more servings of whole grains (1.1 vs 0.8 oz equivalents, P=0.007), more dark green and leafy vegetables (P=0.006), and lower intake of added sugars (18 vs 21 tsp, P=0.0005) and solid fats (34 vs 39 g, P<0.0001) after adjusting for age, sex, race or ethnicity, education, household size, family income (using NHANES-provided poverty-to-income ratio), smoking status, beverage energy density, and physical activity.

Conclusion: In this nationally representative sample, reported use of MyPyramid or MyPlate was associated with more healthful dietary intakes. Future intervention studies are needed to explore facilitators and barriers for using MyPlate as well as the impact of MyPlate use on dietary intake behaviors.