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Appendix 4. USDA Food Patterns: Healthy Mediterranean-Style Eating Pattern

The Healthy Mediterranean-Style Pattern is adapted from the Healthy U.S.-Style Pattern, modifying amounts recommended from some food groups to more closely reflect eating patterns that have been associated with positive health outcomes in studies of Mediterranean-Style diets. Food group intakes from the studies that provided quantified data were compared to amounts in the Healthy U.S.-Style Pattern and adjustments were made to better reflect intakes of groups with Mediterranean-Style diets. The healthfulness of the Pattern was evaluated based on its similarity to food group intakes reported for groups with positive health outcomes in these studies rather than on meeting specified nutrient standards.

The Healthy Mediterranean-Style Pattern contains more fruits and seafood and less dairy than does the Healthy U.S.-Style Pattern. The changes in these amounts were limited to calorie levels appropriate for adults, because children were not part of the studies used in modifying the Pattern. The amounts of oils in the Pattern were not adjusted because the Healthy U.S.-Style Pattern already contains amounts of oils that are similar to amounts associated with positive health outcomes in the studies, and higher than typical intakes in the United States. Similarly, amounts of meat and poultry in the Healthy U.S.-Style Pattern are less than typical intakes in the United States and also similar to amounts associated with positive health outcomes in the studies. While not evaluated on nutrient-adequacy standards, nutrient levels in the Pattern were assessed. The Pattern is similar to the Healthy U.S.-Style Pattern in nutrient content, with the exception of calcium and vitamin D. Levels of calcium and vitamin D in the Pattern are lower because less dairy is included for adults. See table footnotes for amounts of dairy recommended for children and adolescents.

To follow this Pattern, identify the appropriate calorie level, choose a variety of foods in each group and subgroup over time in recommended amounts, and limit choices that are not in nutrient-dense forms so that the overall calorie limit is not exceeded.

Table A4-1. Healthy Mediterranean-Style Eating Pattern: Recommended Amounts of Food From Each Food Group at 12 Calorie Levels

Calorie Level of Patterna 1,000 1,200 1,400 1,600 1,800 2,000 2,200 2,400 2,600 2,800 3,000 3,200
Food Groupb Daily Amountc of Food From Each Group (vegetable and protein foods subgroup amounts are per week)
Vegetables 1 c-eq 1½ c-eq 1½ c-eq 2 c-eq 2½ c-eq 2½ c-eq 3 c-eq 3 c-eq 3½ c-eq 3½ c-eq 4 c-eq 4 c-eq
Dark-green vegetables (c-eq/wk) ½ 1 1 1½ 1½ 1½ 2 2 2½ 2½ 2½ 2½
Red and orange vegetables (c-eq/wk) 2½ 3 3 4 5½ 5½ 6 6 7 7 7½ 7½
Legumes (beans and peas) (c-eq/wk) ½ ½ ½ 1 1½ 1½ 2 2 2½ 2½ 3 3
Starchy vegetables (c-eq/wk) 2 3½ 3½ 4 5 5 6 6 7 7 8 8
Other vegetables (c-eq/wk) 1½ 2½ 2½ 3½ 4 4 5 5 5½ 5½ 7 7
Fruits 1 c-eq 1 c-eq 1½ c-eq 2 c-eq 2 c-eq 2½ c-eq 2½ c-eq 2½ c-eq 2½ c-eq 3 c-eq 3 c-eq 3 c-eq
Grains 3 oz-eq 4 oz-eq 5 oz-eq 5 oz-eq 6 oz-eq 6 oz-eq 7 oz-eq 8 oz-eq 9 oz-eq 10 oz-eq 10 oz-eq 10 oz-eq
Whole grainsd (oz-eq/day) 1½ 2 2½ 3 3 3 3½ 4 4½ 5 5 5
Refined grains (oz-eq/day) 1½ 2 2½ 2 3 3 3½ 4 4½ 5 5 5
Dairye 2 c-eq 2½ c-eq 2½ c-eq 2 c-eq 2 c-eq 2 c-eq 2 c-eq 2½ c-eq 2½ c-eq 2½ c-eq 2½ c-eq 2½ c-eq
Protein Foods 2 oz-eq 3 oz-eq 4 oz-eq 5½ oz-eq 6 oz-eq 6½ oz-eq 7 oz-eq 7½ oz-eq 7½ oz-eq 8 oz-eq 8 oz-eq 8 oz-eq
Seafood (oz-eq/wk)f 3 4 6 11 15 15 16 16 17 17 17 17
Meats, poultry, eggs (oz-eq/wk) 10 14 19 23 23 26 28 31 31 33 33 33
Nuts, seeds, soy products (oz-eq/wk) 2 2 3 4 4 5 5 5 5 6 6 6
Oils 15 g 17 g 17 g 22 g 24 g 27 g 29 g 31 g 34 g 36 g 44 g 51 g
Limit on Calories for Other Uses, calories (% of calories)g,h

150

(15%)

100

(8%)

110

(8%)

140

(9%)

160

(9%)

260

(13%)

270

(12%)

300

(13%)

330

(13%)

350

(13%)

430

(14%)

570

(18%)

a,b,c,d See Appendix 3. USDA Food Patterns: Healthy U.S.-Style Eating Pattern, notes a through d.

e Amounts of dairy recommended for children and adolescents are as follows, regardless of the calorie level of the Pattern: For 2 year-olds, 2 cup-eq per day; for 3 to 8 year-olds, 2 ½ cup-eq per day; for 9 to 18 year-olds, 3 cup-eq per day.

f The U.S. Food and Drug Administration (FDA) and the U.S. Environmental Protection Agency (EPA) provide joint guidance regarding seafood consumption for women who are pregnant or breastfeeding and young children. For more information, see the FDA or EPA websites www.FDA.gov/fishadvice; www.EPA.gov/fishadvice.

g,h See Appendix 3, notes e through f.