17.8 Balancing Food Choices

What is the Right Balance of Carbohydrate, Protein, and Fat Consumption?

Conflicting information exists about what is the best ratio of macronutrients in the diet. Carbohydrate, fat, and protein are all essential nutrients, and we need to consume a reasonable balance of all three of them for optimal functioning. We need to get enough of each to be healthy, without getting too much. The Food and Nutrition Board of the Institute of Medicine has determined an Acceptable Macronutrient Distribution Range or AMDR for each of the macronutrients to help guide nutritious eating patterns (Institute of Medicine, Food and Nutrition Board, 2005):

• 10-35% of total daily calories from protein
• 20-35% of total daily calories from fat
• 45-65% of total daily calories from carbohydrate

Notice that these are ranges. That means individuals have flexibility in how they balance the macronutrients. For example, one person may choose to have a diet that’s relatively high in protein, whereas another may choose to have a diet that’s relatively high in fat, and either is perfectly OK as long as each of the macronutrients is consumed in adequate amounts. The following are examples of patterns individuals could follow that are all within the acceptable ranges:

Because the guidelines provide ranges, we don’t need to consume the same proportions every day or stress about trying to get an exact amount or proportion of each macronutrient.

One way to balance the macronutrients—and get the micronutrients your body needs, too—without getting technical about tracking and calculating everything you consume, is to try to incorporate each of the following into each meal:

• Vegetable and/or fruit
• Grains, ideally whole grains
• A healthy source of protein
• A source of unsaturated fat

Try to get into the habit of asking yourself, what’s missing? Or, what might be overrepresented?

Also keep in mind that the type of each of the macronutrients that you choose is just as important if not more important than their overall proportions in the diet (De Souza, Swain, Appel, & Sacks, 2008; Katz & Meller, 2014; Swain, McCarron, Hamilton, Sacks, & Appel, 2008). This means prioritizing unsaturated fats over saturated and trans fats and complex carbohydrates over simple sugars. It’s recommended that (U.S. Department of Agriculture, U.S. Department of Health and Human Services, 2020; American Heart Association, 2015):

• Added sugars make up less than 10% of total calories,
• Saturated fat make up no more than 10%—ideally less than 7%—of total calories, and
• Trans fat be avoided.

All Foods Can Fit

A nutritious eating pattern really can include all foods—even foods that are less nutrient dense and more energy dense. Balance and moderation across nutrient dense and energy dense foods is key. This is important when it comes to both beverages—including alcohol, soda, specialty coffee drinks, and other sugar-sweetened beverages—and foods—which includes restaurant meals, homemade foods, and processed foods. Any food can fit into an overall nutritious eating pattern; just keep the big picture in mind. Prioritizing whole foods, plants, unsaturated fats, and healthy sources of protein fuels the body with the macronutrients and micronutrients it needs. Consider what your body needs, and balance eating for nourishment with eating for enjoyment. More than just a means of fueling our bodies, eating can also be enjoyable. Food should taste good! If certain preparation methods, seasonings, or condiments make nutrient dense foods like grains, vegetables, or sources of specific vitamins and minerals more palatable for you, then use them.

Guides and Tools for Achieving Balance

Several models exist to help guide efforts around balance. For example, USDA’s MyPlate, Harvard School of Public Health’s Healthy Eating Plate, and Canada’s Food Guide all represent recommended proportions of food to eat from different food groups relative to the other food groups. In general, the idea is for half of the plate to be fruits and/or vegetables, a quarter grain, and a quarter protein. In real life, not all meals will look exactly like this with each of the foods separated on the plate, but the idea is to incorporate relative proportions of different food groups, even if the ingredients are combined into a soup, oven-baked dish, salad, or other type of mixed dish.

We recognize that some people are attracted to the idea of having a specific diet to follow, at least initially, because it provides a plan and might make food choices seem easier. If that’s the case for you, the following are research-based and consistent with the characteristics of a nutritious eating pattern (Katz & Meller, 2014):

• Mediterranean-style Diet
• DASH and OmniHeart Diets
• Diabetes Prevention Program diet

In addition, while historically both the Zone and South Beach diets have been heavily marketed for commercial purposes, the core concepts of both are similar to the OmniHeart diets, and consistent with the characteristics of a nutritious eating pattern (De Souza et al., 2008).

Find What Works Best For You

Keep in mind that different people have different nutrient and energy needs depending on activity level, age, size, life stage, health or disease status, and other factors such as personal goals; what’s considered ideal varies from person to person. How many calories you need may be different than how many calories your friends or family members may need. Further, certain health conditions may require a deviation from what might be recommended on a more general level. For example, lactose intolerance requires the avoidance of many dairy products and celiac disease requires the avoidance of gluten; fortunately, alternatives to dairy do exist, like nut milks and cheeses, as well as many gluten-free grains, including quinoa, rice, buckwheat, and corn. Other common concerns include things like irritable bowel syndrome—or IBS—and gastroesophageal reflux disease—or GERD—both of which are often treated with dietary changes. If you regularly experience any sort of gastrointestinal distress—abdominal cramping or pain, bloating, diarrhea, constipation, or heartburn, for example—and particularly if it interferes with your functioning and quality of life, it’s worth meeting with a trusted health professional to explore the problem and learn how to address it. If you have any questions about your individual needs, we recommend you talk with a trusted health professional. Continue to experiment to find what works best for you and your individual needs, preferences, values, and traditions.