Meeting Dietary Guidelines 
                                                             Recommendations: Older Adults  
                                                                   What We Eat in America, NHANES 2013-2016
     Food Surveys Research Group
     Dietary Data Brief No.                                                 Lois C. Steinfeldt, MPH; Carrie L. Martin, MS, RD;
                             28                                  Joseph D. Goldman, MA; and Alanna J. Moshfegh, MS, RD
     July 2020
   Highlights                               The 2015-2020 Dietary Guidelines for Americans1 (DGA) recommends healthy 
  • Less than a quarter of older            eating patterns to help promote health and prevent chronic disease. Adults 65 
     adults meet the DGA                    years and older, many who will have a higher risk of chronic disease, will make 
     recommendations for                    up 21 percent of the population by 2030, increasing the demand for health 
                                                 2                                      3
     vegetables, fruits, and dairy.         care.  This report compares usual intake to DGA energy-specific intake 
                                            recommendations for 1,422 older adults (698 men and 724 women), defined as 
  • For protein foods, about half of        those age 71 and older, from the 2013-2016 WWEIA, NHANES.4
     older males meet the 
     recommendations compared to            What percentage of older adults meet the DGA food group 
     a third of females.                    recommendations?
  • About half of older Hispanics           Overall, less than half of older adults meet the recommendations for DGA food 
     meettherecommendation for              groups to include in a healthy eating pattern.  The exception is males where just 
     grains compared to about a third       over half meet the DGA recommendations for protein foods.  Dairy has the 
     of non-Hispanic whites                 lowest percentage of older adults meeting the recommendations.  A higher 
     andnon-Hispanic blacks.                percentage of males compared to females meet the recommendations for protein 
  • About a third of older Hispanics        foods and dairy.
     meet the recommendation for                                                                                        †
     fruits compared to a sixth of          Figure 1.  Percentage of older adults meeting DGA food group recommendations
                                                     WWEIA, NHANES 2013-2016
     non-Hispanic whitesand non-
     Hispanic blacks.                                                           Males     Females
  • Less than 10% of lower income                   60                                                     52*
     older adults meet the                          50
     recommendations for vegetables                                                36 40                                37 37
                                                    40
     and less than 30% meet the                ent                                                             30
                                               c    30
     recommendations for protein               er                          21
     foods.                                    P    20         15
                                                                       14
  • Less than half of older adults                  10     8                                    6*
     meet the recommendation to                                                                     1
                                                     0
     limit added sugars to <10% of                       Vegetables    Fruits      Grains       Dairy   Protein Foods    Oils
     total daily energy particularly                     & legumes
     those in lower income levels           †Energy-specific recommendations based on age, sex, and physical activity level
     and who are non-Hispanic               *
                                            Significantly different from females (p<0.001)
     black.                                 SOURCE: What We Eat in America, NHANES 2013-2016, individuals age 71 and older, 2 days
                                             U.S. DEPARTMENT OF AGRICULTURE
                                                      Agricultural Research Service
                                                Beltsville Human Nutrition Research Center
                                                      Food Surveys Research Group
                                            www.ars.usda.gov/nea/bhnrc/fsrg
                                 FSRG Dietary Data Brief -- No. 28 -- July 2020
         Which DGA protein foods contribute to the difference between males and females? 
         Although more males meet overall recommendations for intake of protein foods than females (Figure 1), 
         the only protein subgroup in which there is a difference between males and females is the meat, poultry, 
         eggs subgroup where a higher percentage of males meet the recommendation. 
                                                                                         †
         Figure 2.  Percentage of older adults meeting DGA protein foods recommendations , WWEIA, NHANES 2013-2016
                              59*                            Males   Females
                60
                50                                              44
                                          40                                40
              ent40
              c 30
              er
              P 20                                                                                18
                                                                                                              12
                10
                 0
                            Meat, Poultry, Eggs            Nuts, Seeds, Soy Products                 Seafood
          †Energy-specific recommendations based on age, sex, and physical activity level
          *
          Significantly different from females (p<0.001)
          SOURCE: What We Eat in America, NHANES 2013-2016, individuals age 71 and older, 2 days
         What percentage of older adults meet DGA recommendations for nutrients to 
         limit?
         Fewer than half of older adults meet the recommendations to limit the contribution of added sugars and 
         saturated fats to less than 10% of total energy each, and to limit sodium to less than 2300 mg.  A higher 
         percentage of females than males meet the recommendation to limit sodium.
         Figure 3.  Percentage of older adults meeting DGA recommendations for nutrients to limit, WWEIA, NHANES 2013-2016
                60                                           Males   Females
                50            45
                                          40
              ent40                                                                                           34
              c 30
              er                                                            20
              P 20                                              16
                                                                                                   9*
                10
                 0
                               Added Sugars                      Saturated Fats                       Sodium
                             <10% total energy                 <10% total energy                    <2300 mg
         *
          Significantly different from females (p<0.001)
          SOURCE: What We Eat in America, NHANES 2013-2016, individuals age 71 and older, 2 days
                                                                   -2-
                                 FSRG Dietary Data Brief -- No. 28 -- July 2020
         Race/Ethnicity:  Are there differences in older adults meeting DGA recommendations?
         A higher percentage of  Hispanics meet the recommended intake of grains and fruits than non-Hispanic 
         (NH) whites or NH blacks.  A lower percentage of  NH blacks meet the recommendations for intake of 
         vegetables than NH whites or Hispanics.  
                                                                                                †
          Figure 4.  Percentage of older adults meeting selected DGA food group recommendations by race/ethnicity
                   WWEIA, NHANES 2013-2016
               60                                     NH white    NH black   Hispanic      56
               50                                                                                             45
               40                                                             37 b     b                39           39
                                                                                    34
              ent                                               29
              c30
              er
              P                          a         17b    17b
               20        12a          14
               10               7
                0
                           Vegetables                   Fruits                    Grains                 Protein Foods
                            & legumes
          †Energy-specific recommendations based on age, sex, and physical activity level
          aSignificantly different from non-Hispanic black (p<0.001)
          bSignificantly different from Hispanic (p<0.001)
          SOURCE: What We Eat in America, NHANES 2013-2016, individuals age 71 and older, 2 days
          Higher percentages of non-Hispanic (NH) blacks and Hispanics meet the recommendation to limit 
          saturated fats to 10% of total energy than NH whites.  A higher percentage of NH blacks meet the 
          recommendation to limit sodium to <2300 mg than NH whites or Hispanics.  A lower percentage of NH 
          blacks meet the recommendation to limit added sugars than NH whites or Hispanics. 
          Figure 5. Percentage of older adults meeting DGA nutrients to limit recommendations by race/ethnicity 
                   WWEIA, NHANES 2013-2016
               60                                     NH white    NH black   Hispanic
               50            a               44a
                           42
               40                   33                                                                      b
              ent                                                      27b      28b                       30       28
              c30
              er
              P
               20                                             14                                 12
               10
                0
                               Added sugars                       Saturated fats                        Sodium
                            <10% total energy                   <10% total energy                     <2300 mg
          a
          Significantly different from non-Hispanic black (p<0.001)
          bSignificantly different from non-Hispanic white (p<0.001)
          SOURCE: What We Eat in America, NHANES 2013-2016, individuals age 71 and older, 2 days
                                                                   -3-
                                 FSRG Dietary Data Brief -- No. 28 -- July 2020
          Income:  Are there differences in older adults meeting DGA recommendations?
          The highest income level has a greater percentage of older adults meeting the recommendation for 
          vegetables and legumes compared to those in the lowest income level.  The lowest income level also has a 
          lower percentage meeting the recommendations for protein foods than both the middle and highest income 
          levels.  Income levels reflect family income in terms of the Poverty Income Ratio. 
                                                                                                †
          Figure 6.  Percentage of older adults meeting selected DGA food group recommendations by family income as  
                                        7
                   percentage of poverty , WWEIA, NHANES 2013-2016       
                60                          <131% poverty    131-350% poverty      >350% poverty
                50                                                                                                   45b
                                                                              40    40                        40b
                40                                                                         35
              ent                                                                                       30
              c 30
              er
              P                                    17     16     20
                20                    14
                          8a    11
                10
                 0
                            Vegetables                   Fruits                   Grains                 Protein Foods
                            & legumes
          †Energy-specific recommendations based on age, sex, and physical activity level
          a
          Significantly different from highest income level (p<0.001)
          bSignificantly different from lowest income level (p<0.001)
          SOURCE: What We Eat in America, NHANES 2013-2016, individuals age 71 and older, 2 days
          The highest income level has a greater percentage of older adults meeting the recommendation for added 
          sugars compared to the middle and lowest income groups.  A higher percentage of older adults in the 
          lowest income level meet the recommendation for sodium than both the middle and highest income levels. 
          Figure 7.  Percentage of older adults meeting DGA nutrients to limit recommendations by family income as percentage of 
                          7
                   poverty , WWEIA, NHANES 2013-2016
                60                          <131% poverty     131-350% poverty     >350% poverty
                                             52
                50                    a
                40            a     39
              ent          33                                                                    32
              c 30                                            24                                             b
              er                                                                                          22
              P                                                                 18                                 17b
                20                                                     15
                10
                 0
                               Added sugars                       Saturated fats                        Sodium
                            <10% total energy                   <10% total energy                     <2300 mg
          a
          Significantly different from highest income level (p<0.001)
          bSignificantly different from lowest income level (p<0.001)
          SOURCE: What We Eat in America, NHANES 2013-2016, individuals age 71 and older, 2 days
                                                                   -4-