Recognition of federal dietary guidance icons is associated with greater diet quality

Authors: Jahns, Lisa; Conrad, Zachary; JOHNSON, LUANN - University Of North Dakota; Raatz, Susan; KRANZ, SIBYLLE - University Of Virginia

Submitted to: Journal of the Academy of Nutrition and Dietetics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/30/2018
Publication Date: 8/23/2018
Citation: Jahns, L.A., Conrad, Z.S., Johnson, L.K., Raatz, S.K., Kranz, S. 2018. Recognition of federal dietary guidance icons is associated with greater diet quality. Journal of the Academy of Nutrition and Dietetics. https://doi.org/10.1016/j.jand.2018.05.026.
DOI: https://doi.org/10.1016/j.jand.2018.05.026

Interpretive Summary: The USDA develops consumer-friendly messaging to help American’s to follow the Dietary Guidelines for Americans. In recent years, this messaging has taking the form of the Food Guide Pyramid, the MyPyramid, and the MyPlate icons. While the purpose of the icons and associated educational material is to improve eating habits, few studies have described awareness of the guidance and concurrent diet quality. The objective of this study was to examine the prevalence of individuals who reported hearing of the dietary guidance icons, and to describe the association between having heard of the icons and people’s diet quality. We used data from participants in the nationally representative, cross-sectional survey: National Health and Nutrition Examination -What We Eat In America surveys between 2005 and 2014. Awareness of the Food Guide Pyramid, MyPyramid, or MyPlate icons was measured by asking people if they had ever heard of the icons. We reported the percentatge of people who answered affirmatively by by sociodemographic characteristics (i.e., sex, age, race/ethnicity); we also measured people’s diet quality using the USDA-NCI Healthy Eating Index (HEI) scores derived from 24-hr dietary recall data. We found that in all years, those with less than a high school diploma were the least likely to report having heard of the icons (P < 0.001). In every survey wave except 2011-2012, participants with low or marginal food security status were less likely to report affirmatively (P < 0.001), and SNAP participants and SNAP eligible non-participants were least likely to report having heard of the icons (P < 0.001) except for 2005-2006. Diet quality scores were higher among those who had heard of MyPyramid in 2007-2012 (P < 0.05) and MyPlate in 2013-2014 (P < 0.001) compared to those who had not heard of the icon. In conclusion, recognition of the federal dietary guidance icons was associated with higher diet quality in recent years.

Technical Abstract: Background: While the purpose of federal dietary guidance is to improve eating habits, few studies have described awareness of the guidance and concurrent diet quality. Objective: To examine the prevalence of individuals who reported hearing of dietary guidance icons and describe the association between having heard of the icons and diet quality. Design: Nationally representative, cross-sectional survey. Participants/setting: Participants (n=23,343) from the National Health and Nutrition Examination -What We Eat In America surveys 2005-2014 waves. Intervention: None. Main outcome measures: Awareness of the Food Guide Pyramid, MyPyramid, or MyPlate icons by sociodemographic characteristics; diet quality measured using the Healthy Eating Index (HEI) scores derived from 24-hr recall data. Statistical analyses performed: Global Wald tests were used to test for differences in awareness of the icons within each sociodemographic group. Total HEI scores were calculated using the population-ratio method. Z-scores were used to test the differences in HEI total scores between those with knowledge of the icons and those who responded negatively to the question. Results: In all waves, those with less than a high school diploma were the least likely to report having heard of the icons (P < 0.001). In every wave except 2011-2012, participants with low or marginal food security status were less likely to report affirmatively (P < 0.001), and SNAP participants and SNAP eligible non-participants were least likely to report having heard of the icons (P < 0.001) except for 2005-2006. HEI scores were higher among those who had heard of MyPyramid in 2007-2012 (P < 0.05) and MyPlate in 2013-2014 (P < 0.001) compared to those who had not heard of the icon. Conclusions: Recognition of the federal dietary guidance icons was associated with higher diet quality in recent years, but the cross-sectional nature of the data precludes conclusions of causality.