The positive news? American diets have made strides toward health improvement in the past two decades. However, the downside is that food insecurity problems have persisted during the same time frame.
These findings come from a recent study published in the Annals of Internal Medicine, where researchers from Tufts University examined American diet quality from 1999 to 2020. The study revealed that while the percentage of adults with poor dietary quality decreased from 48.8% to 37.4% over that period, ongoing disparities in diet quality continue to hinder efforts to achieve health equity.
“Although there have been some improvements in American diets over the past two decades, these improvements have not been widespread, and many Americans are still eating poorly,” said Dariush Mozaffarian, a cardiologist and the study’s senior author. “Our research indicates that national nutritional and health equity cannot be attained until we address the barriers preventing many Americans from accessing and consuming nourishing food.”
The study analyzed data from 51,703 individuals who participated in the National Health and Nutrition Examination Survey during the two decades. Participants reported all foods and drinks consumed on the previous day, which were then compared to the American Heart Association’s diet score, a validated measure of healthy diet habits.
While the proportion of adults with poor diets decreased, there was an increase in those with intermediate and ideal diets, although the latter remained notably low, only rising from 0.66% to 1.58% over the two decades.
Specific trends identified in the study included increased consumption of “ideal” diet foods like nuts/seeds, whole grains, poultry, cheese, and eggs, and decreased consumption of poorer foods such as fruit juice, sugary drinks, and refined grains. Consumption of fruits, vegetables, processed meat, fish/shellfish, potassium, and sodium remained relatively stable.
However, these improvements were uneven across demographic groups. Advancements were more pronounced among younger adults, women, Hispanic adults, and those with higher education, income, food security, and private health insurance. Progress was slower among older adults, men, Black adults, and those with lower education, income, food insecurity, and non-private health insurance.
Mozaffarian emphasized the urgent need to address nutrition security and other social determinants of health, such as housing, transportation, fair wages, and structural racism, to mitigate the human and economic consequences of poor diets.
According to the U.S. Food and Drug Administration, over 1 million Americans die annually from diet-related diseases, including cardiovascular illness, diabetes, certain cancers, and obesity-related ailments.
Disparities in these statistics are evident among minority groups, with non-Hispanic Black adults experiencing higher rates of conditions like high blood pressure compared to the overall population.
Another study from Tufts University revealed that poor diet and food insecurity contribute to approximately $1.1 trillion in annual health care costs and lost productivity.
