The myplate icon does not address the types of foods that should be chosen from each food group.

MyPlate was developed in 2011 under the direction of the Center for Nutrition Policy and Promotion of the US Department of Agriculture to serve as the primary educational resource for communicating and promoting the Dietary Guidelines for Americans (DGA)1, 2 to the general public. MyPlate is a visual icon conceived to be a simple representation of the food group distribution on a meal setting that reflects recommended food patterns (Figure). Rather than serving as a food guidance system itself, it aims to prompt consumers to think about and improve their food choices.3, 4, 5 Seven key messages were developed alongside the icon to promote key behaviors. Companion resources (eg, ChooseMyPlate, MyPlate Plan)6 were made available to assist consumers in identifying more specific food targets based on individual caloric needs. Social media campaigns were launched for mass exposure and dissemination to the general public.7

Considering that almost half of all Americans are affected by diet-related chronic diseases,8 effective communication of dietary recommendations is critical. MyPlate was created to replace the previous communication initiative MyPyramid, developed in 2005 to replace the Food Guide Pyramid (1992). Although MyPlate predecessors were developed through extensive qualitative marketing research,9 their insufficient value to improve consumer internalization and behavioral response to the DGA revealed the need for a more memorable and actionable tool for consumers.10, 11 MyPlate was created through formative research that included focus groups and surveys conducted across the country with adults with young children at home.2, 12 Consumers indicated that the MyPlate icon better communicates messages about variety and proportions than does MyPyramid.9

Determining the metrics to evaluate the MyPlate initiative was emphasized soon after its release.12 Levine et al12 proposed a framework to identify immediate and short-term outcomes at different levels of socioecological influence and long-term impact indicators of reach, adoption, and efficacy. Reports found in the peer-reviewed literature are mostly limited to observational, cross-sectional studies evaluating behavior change mediators (eg, awareness, knowledge, attitudes, use) and self-reported dietary indicators. However, there is a paucity of evidence drawn from robust experimental designs testing the effectiveness of MyPlate to improve mediators of behavior change and dietary outcomes and potential variability among population groups, especially those not originally represented during the development of the initiative. In addition, feasibility studies on adopting and implementing the initiative by key disseminating partners have not yet been conducted. This information is necessary to guide decision makers to address the needs of specific clientele for maximum impact through the improvement, tailoring, and adoption of relevant initiatives’ features and components.

Recent epidemiological evidence indicated that awareness of the dietary guidance icons is associated with greater diet quality (as measured by the Healthy Eating Index),5 yet not much is known regarding whether and how MyPlate contributed to this. In 2012, the following questions were posed: How will researchers know whether the MyPlate initiative is effective? How will the initiative's success be measured, and over what period of time?12 Eight years later, these questions have not been adequately answered. Understanding the effectiveness of MyPlate to promote favorable dietary behaviors is critical to advancing communication of the DGA in a variety of settings and population groups, thus determining the value of the initiative. The purposes of this article are to review how MyPlate is represented in the literature, particularly the state of evidence on its usefulness and effectiveness across settings and populations, and to provide potential directions for the more rigorous research needed on this tool.

Current State of Evidence

The authors conducted a literature search to identify articles reporting on MyPlate awareness and use, and related outcomes. Databases searched include Google Scholar, PubMed, and Science Direct, as well as leading nutrition journals (JNEB and Journal of the Academy of Nutrition and Dietetics). Articles were chosen if they had been published since MyPlate's inception and included this tool in the findings or results. Articles that did not report findings related to MyPlate or only reported

Discussion

Improving the state of evidence regarding MyPlate use and effectiveness is warranted, as is exploring the contribution of its educational components to improve diet and physical activity across the diversity of population groups, both as stand-alone tools and as part of health promotion programs. This is especially critical given the intended far-reaching public exposure to the initiative, the large efforts and resources needed to make it possible, and the implications to public dietary health

Implications for Research and Practice

In this Perspective, the case was presented that after 8 years of being launched, the value of MyPlate to advancing adoption of the DGAs and improving nutritional outcomes in the population remain largely unclear. A paucity of rigorous, theory-based evaluations of the initiative is the main cause of this knowledge gap. The dearth of evidence is particularly stark on the relevance of MyPlate to populations at high risk for nutrition disparities and its adoption by stakeholders strategically

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