A new study of more than 50,000 people highlights the suboptimal quality of the average U.S. diet.
Results of the study, conducted by the Food is Medicine Institute at Tufts University Friedman School of Nutrition Science and Policy, show that more than 1 in 3 U.S. adults surveyed in 2020 had poor diet quality. Less than 2% meet the American Heart Association’s ideal diet quality.one
“We are facing a national nutrition crisis with rising rates of obesity and type 2 diabetes,” said Dariush Mozaffarian, MD, PhD, a cardiologist and director of the Food is Medicine Institute.2“These diseases affect all Americans, but especially those who are socioeconomically and geographically vulnerable. To address the human and economic costs of malnutrition, we must address nutritional security and other social determinants of health, such as housing, transportation, fair wages, and structural racism.”
As the United States deals with rising epidemics of obesity and type 2 diabetes, which increase the prevalence of cardiovascular diseases, the quality of nutrition in the United States is stated to be the primary driver of this increase in risk factors. However, despite the resurgence of interest in diet and nutrition in a population, few studies provide a comprehensive assessment of trends in overall diet quality among U.S. adults.
With this in mind, Mozaffarian and Junxiu Liu, PhD, designed the current study to address these research gaps using nationally representative data. The cross-sectional study, funded by the National Institutes of Health, drew on data from adults ages 20 and older who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2020.one
To be included in the study, patients were required to recall at least 1 valid 24-hour dietary recall in the dietary interview component of NHANES. In total, 51,703 adults who completed at least 1 valid 24-hour dietary recall were identified for inclusion. The mean age of this group was 47.0 years and 51.9% were female. Of those with 1 valid 24-hour dietary recall, 72.6% provided 2 recalls.one
Researchers identified several notable trends over the study period. These include an increase in the proportion of older adults (from 16.3% to 21.7%), a decrease in the proportion of younger patients (from 53.8% to 43.7%), and an increase in the proportion of Hispanic adults (from 14.0%). from 16.1% to 16.1%) and an increase in the proportion of those who reported having a University degree or higher (from 49.8% to 62.1%). Additionally, researchers found that SNAP participation more than doubled (from 8.62% to 16.7%), the rate of government-sponsored health insurance increased (from 13.2% to 28.1%), and private health insurance They stated that the rate decreased (from 67.2% to 58.4%). ).one
The study’s primary outcome of interest was the proportion of patients who met the goals of the validated AHA 2020 continuous score. Poor diet, using the AHA score, which awards higher scores based on higher consumption of fruits and vegetables, whole grains, fish and shellfish, nuts, seeds, and legumes and less consumption of sugar-sweetened beverages, processed meat, saturated fat, and sodium. Less than 40% adherence was defined as 40% to 79.9% adherence as moderate, and at least 80% adherence as ideal.one
Results of the study showed that the estimated proportion of U.S. adults with poor diet quality decreased from 48.8% to 37.4% (difference, -11.4 percentage points; 95% CI, -16.8 to -5.96 percentage points score) indicates that the estimated proportion with medium quality is increasing. from 50.6% to 61.1% (difference, 10.5 percentage points; 95% CI, 5.20 to 16.1 points) and the estimated rate with ideal nutrition from 0.66% to 1.58% increased to (difference, 0.93 percentage points; 95% CI, 0.35 to 1.51 percentage points) (P. trend <.001 for each from 1999 to 2020). When outcome was assessed continuously, results showed that the mean AHA score increased over the study period from 32.8 out of 80 to 36.7 out of 80 (difference, 3.95; 95% C, 2.28) to 5.62. (P. <.001 for trend).one
When evaluating specific trends in nutrition, results were statistically significant for sugar intake (86.2 to 63.1 grams per day), sugar-sweetened beverages (1.73 to 1.0 servings per day), fruit juice (0.44 to 0.22 servings per day). showed that significant decreases were observed. ), refined grains (5.49 to 5.24 servings per day), and dairy (0.90 to 0.54 servings per day) (P. for trend <.001 each).one
The researchers highlighted numerous inequalities found in their study; These included greater improvements in diet quality among younger adults versus older adults, among those with higher incomes versus those with lower incomes, among those with food security versus those with food insecurity, and among those with or without private or public health insurance.P. for interactionone
“Although we have seen a modest improvement in the American diet over the past two decades, these improvements do not reach everyone, and many Americans are becoming worse nourished,” Mozaffarian said.2“Our new research shows that the nation cannot achieve nutrition and health equity unless we eliminate the barriers many Americans face in accessing and eating nutritious foods.”
References:
- Liu J, Mozaffarian D. Trends in Diet Quality Among U.S. Adults from 1999 to 2020 by Race, Ethnicity, and Socioeconomic Disadvantage. Annals of Internal Medicine. Published online June 17, 2024. doi:10.7326/M24-0190
- Tuft University. American diets have a long way to go to achieve health equity. In terms of news. June 17, 2024. Accessed June 17, 2024. https://www.newswise.com/articles/american-diets-have-a-long-way-to-go-to-achieve-health-equity.