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There’s a crack of light shining through the dark clouds of America’s battle against poor nutrition and the health problems that result, according to a new study analyzing two decades of nutritional data.
“There is good news. Americans are starting to hear the message about nutrition, and some companies and restaurants are starting to make healthier products. It’s a small improvement,” said lead study author and cardiologist Dr. Dariush Mozaffarian, director of the Food is Medicine Institute at Tufts University in Boston.
However, he added, most of the improvement occurred between 1999 and 2010, with no progress in nutrition after that.
“We are at a standstill as a nation – and that does not bode well for our health,” Mozaffarian said. “If I were grading America on its diet, I would give it a D, just above an F.”
In the United States, the number of adults with poor diets declined from about 49% to just over 37% between 1999 and 2020, a decline of 11.4%, while those who did ate slightly better nutritionally increased by 10.5%, according to the study.
A poor diet was defined as a diet containing too many refined grains, processed meats, and sugary drinks, including fruit juices, as well as ultra-processed foods high in added sugar, salt, and fat. Healthy choices such as fruits and vegetables are extremely low in this eating style.
“Consumption of fruits and vegetables has not increased at all over this 20-year period, which is quite striking,” Mozaffarian said.
An ideal diet included at least the recommended daily servings of fruits and vegetables, as well as more beans, whole grains, nuts and seeds. Dietary guidelines such as those from the American Heart Association suggest eating 4 to 5 cups per day of canned, fresh, or frozen fruits and the same amount of vegetables.
The nutritionally ideal diet also contained few sugary drinks, processed meats, refined grains and ultra-processed foods, often high in added sugars, fats and salt, the study found.
Unfortunately, the number of people who followed an ideal diet – including those 9 cups of fruits and vegetables – increased by less than 1%, according to the study.
“People often ask me, ‘Well, if diet is slowly improving, why do obesity and diabetes continue to increase?’ » This number continues to rise as only 1.58% of Americans have an ideal diet. We still have a long way to go,” Mozaffarian said.
More than a million Americans die each year from diet-related illnesses such as obesity, cancer, heart disease and type 2 diabetes, according to the U.S. Food and Drug Administration, while Poor diet and food insecurity cost the United States approximately $1.1 trillion in health care costs and lost productivity each year.
“I think it’s fair to point out that food quality remains dismal in the United States. “It’s no secret that Americans are experiencing epidemics of obesity and diabetes and declining life expectancy,” said Dr. Walter Willett, professor of epidemiology and nutrition at the Harvard TH Chan School. of Public Health in Boston, in an email. He did not participate in the study.
The study, published Monday in Annals of Internal Medicine, analyzed dietary information from nearly 52,000 U.S. adults who participated in the National Health and Nutrition Examination Survey, or NHANES.
Nutritional gains were greatest among women, young adults, Hispanic adults, and those with more education and higher incomes who had access to private health insurance. Less progress was seen among men, black or older adults, and people with less income, lower education, nonprivate health insurance, and food insecurity concerns.
“Disparities within the population in terms of education, income, race and ethnicity are the same, and sometimes even getting worse,” Mozaffarian said.
The study found that low-income people saw a 5% improvement in nutritional quality, while those with higher incomes improved their nutrition score by 16%.
“We must avoid simply blaming the victims of America’s dysfunctional food system for the terrible diets documented in the survey,” Willett said. “We fail to educate students about nutrition in our schools and we feed them unhealthy diets.
“Our healthcare system is almost completely lacking, we allow advertising to seduce children into junk food and drinks that kill them prematurely, and we indirectly subsidize unhealthy foods in various ways, making healthier options relatively less expensive. expensive and less accessible to low-income people. income Americans,” he said.
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There are simple ways to take your diet from a D to an A, experts say.
According to experts, there are simple steps you can take to improve the nutritional quality of your diet.
Cook at home as often as possible: “My main suggestion is to shop at the grocery store as much as you can, rather than buying your food at a coffee shop, sandwich shop or fast-food restaurant,” Mozaffarian said.
Even eating in a full service dining should be limited, he added. Previous research by Mozaffarian and his team found that about 80 percent of all food Americans eat at restaurants is low quality.
“Surprisingly, even when we compared fast food to table service restaurants, there was no dramatic difference in quality,” he said.
Instead, try to choose minimally processed foods to cook at home and avoid the ready-to-heat-and-eat foods so common at the grocery store. Bring your lunch and snacks to work.
Don’t drink your sugar. Americans are beginning to understand that sugary sodas are unhealthy, but they haven’t yet understood that energy, sports and caffeinated drinks can also be high in sugar, Mozaffarian said.
“Energy drinks, pre-sweetened iced teas and coffee drinks may contain more sugar than soda,” he said. “I see people coming out of the cafe with drinks covered in whipped cream. Don’t drink your sugar.
However, once sugary drinks are removed from the equation, only “6 percent of the country’s calories come from added sugar in foods,” Mozaffarian said. “In contrast, about 35% of the country’s calories come from refined grains and starches.”
Limit refined grains. Overall, refined grains contribute the most to Americans’ poor-quality diets, at 5.2 servings per day – “nearly two servings per meal of refined grains such as refined bread, refined rice, crackers, chips, and other ultra-processed foods,” Mozaffarian. said.
Whole grains still contain bran and germ, which are a nutritional powerhouse full of healthy fats, antioxidants, minerals, and vitamins E and B. Whole grains take longer to digest, do not raise blood sugar as quickly as refined grains, and contain more fiber, which may reduce the risk of chronic disease, promote weight loss weight and improve digestion.
“Some examples of whole grains include barley, bulgur, farro, millet, quinoa, black rice, brown rice, red rice, wild rice, oatmeal, and popcorn” , according to My Plate, the U.S. Department of Agriculture’s website.
Refined grains such as white flour, corn grits, white bread and white rice have been ground, removing the bran and germ, to give them a finer texture and longer shelf life. Grinding also removes nutrients like dietary fiber, iron and vitamins. Refined grains are found in almost all ultra-processed foods, including breakfast cereals, desserts, pastries, bread and crackers.
Substitute refined grains. Instead, nourish your gut microbiome with minimally processed fruits and vegetables, beans, nuts and seeds, and whole grains,” Mozaffarian said. Fermented foods like yogurt, sauerkraut and kimchi can also help the microbiome, he added.