The American diet has improved slightly, but more regulations are needed to encourage healthful eating.
A further study recommends three new interventions to reduce childhood obesity that would save more in health care costs than they would cost to implement.
The research, carried out by teams from Harvard T.H. Chan School of Public Health in Boston, MA, highlights critical dietary issues facing Americans.
In the first study, lead author Dong Wang and colleagues analyzed how changes in dietary quality from 1999-2012 impacted disease and premature death.
They examined dietary quality among 33,885 American adults from the National Health and Nutrition Examination Survey (NHANES), using a measure called the Alternate Healthy Eating Index 2010.
They also used information from two long-running studies - the Nurses' Health Study and Health Professionals Follow-Up Study - involving roughly 173,000 people.
Better diet saves 1.1 million lives
Over 14 years, healthier eating habits cumulatively prevented 1.1 million premature deaths.
- In 2013, 17% of 2-19 year-olds in the US were obese
- Obesity among children fell from 13.9% in 2003-4 to 8.4% in 2011-12
- Among children and teens aged 2-19, obesity is defined as having a BMI at or above the 95th percentile of the relevant age growth charts.
Moreover, it appears that the burden of disease can be reduced substantially by only small improvements in dietary quality.
In addition, disparities across socioeconomic groups sharpened during that time, with black people having the poorest dietary quality, reflecting differences in income and education.
Also, apart from significant reductions in trans fat and sugar-sweetened beverages, improvements in most key components of healthful diets were either minimal or nonexistent.
The drop in trans fat intake succeeded largely due to regulatory actions, such as the Food and Drug Administration (FDA) recently banning its use.
The authors call for additional policies, such as expanding taxation on sugary beverages or mandating less salt in food, to help maintain and accelerate improvements in the national diet.
"Our findings provide further justification for promoting healthful diets as a national priority for chronic disease prevention, as well as for legislative and regulatory actions to improve the food supply more broadly."
Interventions proposed to save lives and money
In the second study, Prof. Steven Gortmaker and colleagues analyzed the cost-effectiveness of interventions for reducing childhood obesity in the US. Their findings support the first study's calls for regulatory action.
Researchers looked at the US population from 2015-25, reviewed existing evidence and predicted the costs and effectiveness of interventions through their impact on body mass index (BMI), obesity prevalence and obesity-related health care costs.
Three potential interventions and their related savings were:
- A tax on sugar-sweetened beverages, which would prevent 576,000 cases of childhood obesity, saving $30.78 for each dollar spent
- Removing tax subsidies on adverts for unhealthy food for children would prevent 129,100 cases of obesity and save $32.53 for every dollar
- Establishing nutrition standards for food and drinks sold in schools outside of school meals would prevent 345,000 cases of obesity, saving $4.56 per dollar spent.
The authors say that the US "will not be able to treat its way out of the obesity epidemic," and they recommend focusing on implementing cost-effective preventive interventions with broad population reach.
The findings highlight the need to push forward with recent reforms to the school food environment, such as the Smart Snacks in School regulations and the Healthy, Hunger-Free Kids Act of 2010.
Prof. Gortmaker stresses the need to invest in preventing childhood obesity, as early interventions have the best chance of reducing long-term obesity prevalence and related mortality and health care costs.
Medical News Today reported earlier this year that competitive food and drink prices can help reduce childhood obesity.