Recent population adherence to and knowledge of United States federal nutrition guides, 1992-2013: a systematic review.

The Dietary Guidelines for Americans dictates the federal nutrition programs, policies, and recommendations of the United States. Corresponding nutrition guides have been established to help educate the public about the dietary intake patterns recommended in these guidelines as well as to ameliorate the US obesity epidemic and its health-related outcomes. The purpose of this systematic review was to summarize population adherence to and knowledge of these guiding US nutrition guides issued since 1992, including the Food Guide Pyramid, MyPyramid, and MyPlate. Of the 31 studies included in the review, 22 examined adherence, 6 examined knowledge, and 3 examined both adherence and knowledge. Across studies, adherence to nutrition guides was low, with participants consuming inadequate levels of fruit, vegetables, and dairy in particular. Knowledge of nutrition guides increased over time since publication and decreased with age of the participants. An association between knowledge of and adherence to nutrition guides was not found. Disparities in knowledge and adherence existed across demographic groups. Based on these findings, it is suggested that federal dietary guidance can be strengthened by increasing dissemination of nutrition guides to the public and tailoring promotional activities to specific demographic and socioeconomic groups.