Several improvements appear to have taken place in the American diet, according to an analysis of nationally representative surveys carried out over 1999-2012. Adults in the United States are eating more whole grains, nuts, and seeds, and drinking less sugary beverages. However, in other areas of healthy eating the changes are not so positive, and there is evidence of worsening disparities by race/ethnicity, education, and income level.
These were the main findings of a study published in JAMA by Dr. Dariush Mozaffarian, of the Tufts Friedman School of Nutrition Science and Policy, Boston, MA, and colleagues.
An unhealthy diet is a leading cause of poor health, contributing to obesity, diabetes, heart disease, and diet-related cancers.
In the U.S., a poor diet is a key factor in 650,000 deaths every year and 14 percent of all disability-adjusted life-years lost.
Dr. Mozaffarian and colleagues estimate that the proportion of American adults with poor diets fell from 56 percent to 46 percent over the 13-year period 1999-2012.
Also, while the proportion of U.S. adults with ideal diets increased from 0.7 percent to 1.5 percent, it is still low.
For their analysis, the researchers analyzed trends in overall diet quality and several components of food and drink consumption that have been linked to major diseases.
The data came from surveys of nationally representative samples covering 33,932 adults aged 20 years or older from seven cycles (1999-2012) of the National Health and Nutrition Examination Survey (
To decide whether diets were healthy or not, the researchers used a diet score based on the American Heart Association (AHA)
The researchers found many aspects of the diets of U.S. adults improved over the 13-year period, including increased consumption of whole grains, nuts, and seeds, a slight increase in fish and shellfish intake, and reduction in consumption of sugar-sweetened beverages.
The average American also appears to be consuming more fruit in the form of eating the whole fruit instead of drinking it in the form of 100 percent fruit juice.
Whole fruit is considered a healthier option than fruit juice because it contains more fiber, takes longer to consume, and is more satisfying. There is also evidence that the body metabolizes whole fruit differently.
Dr. Mozaffarian and colleagues
When they looked in more detail at the trends, the team found disparities by race/ethnicity, education, and income level. For example, while there was a significant drop (from 54 percent to 43 percent) in non-Hispanic white adults with a poor diet, there were no similar improvements for non-Hispanic black or Mexican American adults.
“There was little evidence of reductions in these disparities and some evidence of worsening diet by income levels,” note the authors.
Dr. Mozaffarian and colleagues explain that understanding trends in dietary habits is important for informing policies to improve diets and reduce diet-related illness.
They conclude their findings should “inform discussions on emerging successes, areas for greater attention, and corresponding opportunities to improve the diets of individuals living in the U.S.”
Dr. Margo A. Denke, a specialist in endocrinology, diabetes, and metabolism – formerly with the University of Texas Southwestern Medical Center in Dallas – notes in an
However, the new study provides “a current dietary report card to help with this task,” she adds.
“Even though there has been some improvement from 1999-2012, clinicians, patients, and the food industry all need to work together to meet the challenge of improving the healthiness of the U.S. diet.”
Dr. Margo A. Denke
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