Nutritious Dietary Patterns

Dietary patterns (also called eating patterns) are the combinations and quantities of food and beverages consumed over time. Consistent evidence indicates that, in general, a plant-based dietary pattern is more health-promoting than the current average U.S. diet. However, a “plant-based” eating patterns doesn’t mean only plants; pairing high-quality protein foods, like eggs, with plants is essential for the synthesis and maintenance of muscle tissue, and for achieving optimal vitamin and mineral intakes.

The 2015-2020 Dietary Guidelines for Americans recommend three healthy eating patterns, all of which include eggs. But what are the sample eating patterns, and what are the key differences between them?

To learn more about healthy eating patterns, including those recommended in the 2015-2020 Dietary Guidelines, and how eggs fit within those patterns, explore the following PowerPoint, and feel free to share it with friends!

Healthy Eating Patterns: How do Eggs Fit?

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New Directions in Macronutrient Distribution at AAPA Conference 2014


Last month, physician assistants gathered from far and wide in Boston, Massachusetts for their annual professional development-filled Memorial Day weekend event, the American Academy of Physician Assistants (AAPA) Impact Conference. Eager to explore the various educational sessions, workshops and career expansion opportunities, PAs were surely not disappointed by the impressive pool of resources made available.

One of the first product theater presentations of the conference (New Directions in Macronutrient Intake and Weight Management: Moving from Science to Solutions) was by the Egg Nutrition Center’s Senior Director of Nutrition Research and Communications, Tia Rains, PhD. Over breakfast, Dr. Rains discussed the changing dietary patterns over the past 30 years, explored the history of public health recommendations during that time and highlighted the ever-evolving paradigm for macronutrient intakes. After examining the latest scientific evidence, Dr. Rains translated research findings into practical applications for PAs to help individuals build healthy meals.

Dr. Rains described how dietary trends, including the “fat phobia” that comprised the past half-century, have led Americans to develop dietary habits characterized by an unideal distribution of macronutrient intake throughout the day. This has been fueled, at least in part, by decreases in the consumption of red meat, whole milk and eggs (1) and increases in grain product consumption, particularly from snacks (2). Interestingly, though partially stemming from recommendations of respected health organizations, these habits have been decidedly unsuccessful in reducing rampant rates of overweight, obesity and related chronic illnesses (3).

To achieve the wide range of benefits of optimal macronutrient distribution, the most recent body of evidence suggests a need for slightly higher protein intake than is typically consumed, particularly shifting protein intake towards higher intakes at the morning meal. While the American diet often contains the majority of protein intake at dinner, studies show that stimulation of muscle protein synthesis and greater satiety requires at least 25 grams of protein in one sitting (4). Therefore, evenly distributing protein intake throughout the day, aiming for 25-30 grams of protein in each meal, may maximize the benefits of protein versus a skewed distribution (5).

The benefits of consuming dietary protein at levels that exceed the minimum recommended daily amount (0.8 g/kg body weight/d) are vast, with research showing positive effects on satiety, blood glucose modulation, the blood lipid profile (specifically, plasma triglycerides), body composition and weight maintenance (6). Studies continue to elucidate the mechanisms behind these benefits, with most recent discoveries supporting increased satiety hormones, augmented thermic effect of food and heightened resting rates of metabolism (7,8). Importantly, increased protein intakes have also been associated with management or prevention of obesity, heart disease, metabolic syndrome, type 2 diabetes, osteoporosis and sarcopenia (9).

After an in-depth discussion of the latest research on macronutrient distribution, Dr. Rains shared healthy, protein-rich breakfast options for physician assistants to share with their patients in order to help them reach optimal protein intakes at their morning meals. Greek yogurt parfaits, egg sandwiches on whole grain bread and cottage cheese with fruit are all delicious choices that can contain optimal amounts of protein.

If you’re looking for additional information on this topic, feel free to check out ENC’s Patient/Client Education Materials. What was your favorite educational session at AAPA this year? We’d love to hear from you, so please reply in the comment section below!



1)      Harnack LJ, Jeffry RW, Boutelle KN. Temporal trends in energy intake in the United States: an ecological perspective. Am J Clin Nutr. 2000; 71(6):1478-84.

2)      Briefel RR, Johnson CL. Secular trends in dietary intake in the United States. Annu Rev Nutr. 2004; 24:401-31.

3)      Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among U.S. adults, 1999-2010. JAMA. 2012; 307(5):491-497.

4)      Paddon-Jones D, Rasmussen BB. Dietary protein recommendations and the prevention of sarcopenia. Curr Opin Clin Nutr Metab Care. 2009;12:86-90.

5)      Mamerow MM, Mettler JA, English KL, Casperson SL, Arentson-Lantz E, Sheffield-Moore M, Layman DK, Paddon-Jones D. J Nutr. 2014; 144(6):876-80.

6)      Institute of Medicine. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids. Washington, DC: National Academies Press, 2005.

7)      Leidy HJ, Bossingham MJ, Mattes RD, Campbell WW. Increased dietary protein consumed at breakfast leads to an initial and sustained feeling of fullness during energy restriction compared to other meal times. Br J Nutr. 2009; 101(6):798-803.

8)      Wycherley TP, Moran LJ, Clifton PM, Noakes M, Brinkworth GD. Effects of energy-restricted high-protein, low-fat compared with standard-protein, low-fat diets: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2012; 96:1281-98.

9)      Protein summit 2007: exploring the impact of high-quality protein on optimal health. Am J Clin Nutr. 2008;87:1515S-1581S.

New Evidence on Breakfast, Energy Balance, and Weight Loss

meal_plate_952x392-300x123In late 2013, the health halo surrounding breakfast was dented by an article published in The American Journal of Clinical Nutrition questioning the scientific evidence supporting recommendations to consume breakfast to achieve and maintain a healthy body weight.1  The authors argued that the overwhelming majority of the evidence was based on observational studies identifying associations between breakfast and body weight.  Very few randomized controlled trials (RCTs) specifically evaluating theeffects of daily breakfast consumption compared to no breakfast, on body weight outcomes, were available, and those that had been published did not strongly support a benefit of breakfast.  Since then, several RCTs evaluating breakfast consumption have been published, better defining the impact of regular breakfast meals on energy balance, with unexpected and intriguing results.

Researchers at the University of Alabama-Birmingham recently published results from a 16-week weight loss trial in 309 overweight and obese adults (aged 20-65 y) randomly assigned to receive instructions to either consume breakfast or skip breakfast. 2 Compliance within each group was high, with more than 90% of participants following their instructions.  There were no differences between groups for weight loss, suggesting that a general recommendation to eat breakfast is not influential in promoting weight loss in those trying to lose weight.  It is important to note that breakfast type was not controlled in this study, an important consideration in light of prior evidence showing greater satiety with higher protein breakfasts.3

While the weight loss results may seem perplexing given the evidence linking breakfast consumption to lower body mass indices, results from another RCT in the same journal suggest that breakfast may impart a benefit on a different aspect of energy balance.  Researchers from the University of Bath and Queen’s Medical Centre in the United Kingdom compared the effects of a prescribed breakfast meal (≥700 kcal before 11:00 am) to extended fasting (0 kcal until noon) on energy expenditure (via accelerometer) and energy intake (via food diaries) in lean adults over 6 weeks.4  Results were interesting, in that the breakfast eaters were more physically active, burning approximately 400 more kcal a day in activity (mostly light-intensity activity).  Energy intake was also increased in the breakfast eaters, with no differences between groups for changes in body weight.  The authors suggest that the availability of glucose in the morning provides the fuel necessary to facilitate physical activity.  Whether this same outcome will be seen in overweight or obese adults remains to be determined.

At the very least, the topic of breakfast is getting a lot more interesting!



1) Brown AW, Bohan Brown MM, Allison DB. Belief beyond the evidence: using the proposed effect of breakfast on obesity to show 2 practices that distort scientific evidence. Am J Clin Nutr. 2013;98:1298-308.

2) Dhurandhar EJ, Dawson J, Alcorn A, Larsen LH, Thomas EA, Cardel M, Bourland AC, Astrup A, St-Onge MP, Hill JO, Apovian CM, Shikany JM, Allison DB. The effectiveness of breakfast recommendations on weight loss: a randomized controlled trial. Am J Clin Nutr. 2014 Jun 4. [Epub ahead of print]

3) Westerterp-Plantenga MS, Lemmens SG, Westerterp KR. Dietary protein – its role in satiety, energetics, weight loss and health. Br J Nutr. 2012;108 Suppl 2:S105-12.

4) Betts JA, Richardson JD, Chowdhury EA, Holman GD, Tsintzas K, Thompson D. The causal role of breakfast in energy balance and health: a randomized controlled trial in lean adults. Am J Clin Nutr. 2014 Jun 4. [Epub ahead of print]

National Nutrition Month® 2014: “Enjoy the Taste of Eating Right”

Each March, the Academy of Nutrition and Dietetics celebrates National Nutrition Month®, and this year the Academy members are encouraging everyone to “Enjoy the Taste of Eating Right.” While social, emotional and health factors play a role in the foods people choose to eat, research confirms that taste is the number-one reason why one food is purchased over another. This year’s theme focuses on combining taste and nutrition to create healthy meals that follow the recommendations of the 2010 Dietary Guidelines for Americans.

As a health professional, you can use the theme of National Nutrition Month® to help clients build a healthy and delicious plate at every meal by simply expanding the range of foods they choose. When guiding patients and clients, share the following tips to help them explore new foods and flavors:

  • Try adding a new fruit or vegetable to your diet each week. Deeply colored fruits and vegetables contain higher concentrations of vitamins, minerals and antioxidants, so aim to eat fruits and vegetables that represent every color of the rainbow.
  • Embark on a taste adventure by trying ethnic foods. Many ethnic cuisines offer healthy choices. When deciding what to order, look for items with whole grains like brown rice that are packed with produce and topped with lean protein.
  • Experiment with new preparation techniques and different spices/ingredients as you prepare healthy foods that are staples in your home. This food experience will add a new twist to daily meals!
    • For example, encourage clients to choose wholesome foods like eggs, which provide 13 essential vitamins and minerals. Advise them to incorporate eggs in a new and exciting way such as adding hard-boiled egg wedges to a pasta salad to pack a protein punch.

For more ideas on how to build a healthy plate at each meal, visit and check out ENC’s educational materials. To learn more about National Nutrition Month® and find other nutrition education ideas and activities, please visit the Academy of Nutrition and Dietetics website.

What are some of your favorite National Nutrition Month® Activities?

ENC Alliance Spotlight: Oldways and its Mediterranean Foods Alliance

Today we’re highlighting one of our health professional alliances – Oldways and its Mediterranean Foods Alliance (MFA).


We recently partnered with MFA to create an education material, What is the Mediterranean Diet?, and it was also highlighted in their newest online toolkit for the Oldways Nutrition Exchange program. The education material will give our HPs a great overview of the Mediterranean Diet, including some “fun history” on eggs and how they are eaten in tandem with other nutritious and delicious foods in the diet.


ENC also provides nutrition information for their MFA Fresh Fridays, a bi-weekly e-newsletter that is distributed to over 10,000 people.  Our most recent contribution was in their Recipe Remix edition.  Also, be sure to check out their 12 Great Ways to Use Eggs handout and a past Q&A blog with one of our Health Professional Advisors, Mary Donkersloot.

Here is a little more about this group:

Oldways and its Mediterranean Foods Alliance help people live longer, healthier lives by encouraging people to seek out the joys of good foods and drinks, consumed with pleasure, in the company of family and friends. The Mediterranean Foods Alliance works with member companies to raise awareness of the Mediterranean Diet, and to develop and distribute educational Med Diet materials to consumers and healthcare professionals. They advocate for the Mediterranean Diet as a path to good health because scores of leading scientists have rated the it as one of the healthiest diets in the world, while millions of people have rated it as one of the most delicious!

We both focus on healthy food choices and lifestyle habits, and we are egg-cited to continue our partnership with this great group and give eggs the company they deserve.

Kick Start Your Metabolism with a Better Breakfast

Kathleen-Zelman-150x150Today’s post comes from Kathleen Zelman, MPH, RD/LD. Zelman is the Director of Nutrition for WebMD.  Zelman has extensive media experience, including 12 years as a national spokeswoman and an elected member of the board of directors for the American Dietetic Association (ADA)-now the Academy of Nutrition and Dietetics and currently serves as one of ENC’s Health Professional Advisors.

You’ve heard it time and again, breakfast is the most important meal of the day.  But what constitutes a healthy breakfast? Does a cup of morning Joe and a donut qualify as a nutritious meal?  Not exactly.

America’s Fitness Doctor™ Dr. Rob Kominiarek, D.O., medical director of the Alpha Male Medical Institute, recently offered up a challenge to choose the best breakfast that will supercharge your metabolism:

A.  Scrambled eggs with diced peppers on a bed of arugula with 10-grain bread sliced avocado and one cup of berries.

B.  Steel cut oats with added flax, walnuts, and a cup of berries.

C.  Rolled Oats with a cup of berries and a glass of orange juice.

So which breakfast is the winner?  According to Dr. Rob, breakfast A is the winner even though all of the breakfast options are healthy, he says options B and C may lead to eating more food later in the day.

What Makes a Better Breakfast?

The combination of eating eggs, peppers, arugula, avocado, and berries is a winner because it contains high protein, high fiber, low sugar foods.  This meal outshines the others because it includes anti-inflammatory foods, healthy fats, lean protein and fiber to help stabilize blood sugar and keep you feeling full for hours. In addition, higher protein foods tend take more energy – or calories -to metabolize.

But all calories are not created equally.  Foods that are digested quickly can lead to higher blood sugars which in turn can trigger hunger, overeating and weight gain. By maintaining stable blood sugars throughout the day you promote health, wellness, consistent energy, and utilization of digested and stored energy.

Start Your Day Off Right


Breaking the fast is important, for kids and adults, to get your metabolism perking and provide necessary fuel to your body and your brain.  Make your own healthy breakfast by including a source of lean protein (poultry, dairy, seafood, beef, tofu), colorful veggies, a whole grain and berries or other high fiber low sugar fruits.

A healthy breakfast is one that you consume within a few hours of rising and ideally includes a source of protein, fiber and smart carbs.  No time for breakfast, grab and go a smoothie with fruit, 100% juice and Greek yogurt or a yogurt parfait with fruit, nutty granola and yogurt.