American eating habits are improving, albeit slowly, according to a recent study by researchers from Mount Sinai and Tufts University. After analyzing dietary records of 51,703 adults from 1999 to 2020, they found that while more adults are now eating healthier, the overall quality of American diets still leaves much to be desired.
The proportion of adults consuming a “poor” diet decreased from 48.8% to 37.4%, those with an “intermediate quality” diet rose from 50.6% to 61.1%, and the percentage eating an “ideal” diet increased from 0.66% to 1.58%. Despite these positive trends, the researchers emphasize that significant improvements are still needed to overcome the negative impacts of poor nutrition on public health.
The findings, published in the Annals of Internal Medicine, reveal that unhealthy diets continue to be a major factor in the USA’s healthcare challenges. Each year, over one million Americans die from diet-related diseases, as reported by the US Food and Drug Administration.
Study Methodology
To determine if there had been any improvements in American eating habits, the researchers analyzed data from 10 cycles of the National Health and Nutrition Examination Survey. This nationally representative survey asks participants to recall everything they ate in the past 24 hours. The study included 51,703 adults who had completed at least one valid 24-hour dietary recall, with 72.6% providing two recalls.
Diet quality was assessed using the American Heart Association diet score, which values components like fruits, vegetables, beans, nuts, and whole grains while devaluing sugary beverages and processed meats.
Key Findings
The study found that the proportion of adults with poor dietary quality decreased significantly over the two decades, while those with intermediate diet quality saw an increase. Specifically, the proportion of adults eating an “ideal diet” more than doubled but remained low. Improvements in diet were mainly driven by higher consumption of nuts, seeds, whole grains, poultry, cheese, and eggs, alongside lower intakes of refined grains, sugary drinks, fruit juice, and milk. However, total consumption of fruits and vegetables, fish/shellfish, processed meat, potassium, and sodium remained relatively stable.
Demographic Disparities
The improvements were not evenly distributed across demographics. Younger adults, women, Hispanic adults, and people with higher education and income levels showed the most significant dietary changes. In contrast, older adults, men, Black adults, and those with lower education and income levels showed less improvement, although some nutritional gains were still observed.
Socioeconomic Factors
The study highlighted the persistent dietary disparities among different income groups. The proportion of adults with poor diet quality decreased across all income levels, with the most significant reduction among higher-income individuals.
Conclusions and Recommendations
The researchers underscore the need for continued efforts to improve American diets, particularly among marginalized communities who are at higher risk of diet-related diseases such as type 2 diabetes and cardiovascular disease.
“While some improvement, especially lower consumption of added sugar and fruit drinks, is encouraging to see, we still have a long way to go, especially for people from marginalized communities and backgrounds,” said first author Junxiu Liu, now an assistant professor at the Icahn School of Medicine at Mount Sinai.
Dariush Mozaffarian, cardiologist and director of the Food is Medicine Institute, stressed the importance of addressing broader social determinants of health. “We face a national nutrition crisis, with continuing climbing rates of obesity and
type 2 diabetes,” he said. “These diseases afflict all Americans, but especially those who are socioeconomically and geographically vulnerable. We must address nutrition security and other social determinants of health, including housing, transportation, fair wages, and structural racism to address the human and economic costs of poor diets.”
The study calls for comprehensive strategies to improve diet quality and overall health in the US, emphasizing the importance of policies and interventions that promote better nutrition and address the socioeconomic factors that contribute to dietary disparities.