Overall US Dietary Quality Remained Low

Higher socioeconomic status associated with a healthier diet

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Since 2000, US officials have made several policy changes in nutrition and proper food processing. But a new study found that, despite government efforts to promote proper diet, eating habits in the US remained a national concern.

The study found that, while the US diet showed some improvement in the last 12 years, the overall quality remained low.

The study authors also found that people with more money were eating better, while those with less were eating worse.

"Speak with a nutritionist if you have concerns about your diet."

"It is sad but not surprising that the diet quality of those with lower socioeconomic status continues to be worse than those with a higher socioeconomic status," said Mary Finckenor, MA, RD, dietitian and diabetes educator at Cardiac Rehabilitation at Morristown Medical Center.

"This problem has several root causes," Finckenor explain. "Those living in lower income areas have less access to supermarkets or grocery stores where fresh produce and better quality foods are available. Where fresh wholesome foods are available, they often are prohibitively expensive. What is available is much less expensive, highly processed lower-quality foods.  Combine that with heavy advertising for junk and you create an environment where it’s extremely difficult for people living in lower-income areas to make healthier choices for themselves and their families."

Lead study author Dong Wang, MD, of the Harvard School of Public Health, and colleagues gathered study data from a sample of 29,124 US adults between ages 20 and 85 who participated in the 1999-2010 National Health and Nutrition Examination Surveys.

The authors reviewed dietary quality over time using the Alternate Health Eating Index (AHEI-2010), which they created. The AHEI-2010 scores dietary quality on a scale of 0 to 110 to predict major chronic disease. Higher scores meant better diets.

The average score increased from 39.9 during 1999-2000 to almost 50 by 2009-2010. The increase was likely due to government efforts to ban trans fats in restaurants, the study authors noted. Reduction in trans fat intake accounted for over half of the score boost.

According to the Mayo Clinic, many doctors consider trans fat to be the worst type of fat because it raises bad cholesterol and lowers good cholesterol.

“The study provides the most direct evidence to date that the extensive efforts by many groups and individuals to improve U.S. dietary quality are having some payoff, but it also indicates that these efforts need to be expanded” Dr. Wang said in a press release.

Unhealthy diets have often been associated with heart disease, type 2 diabetes and some cancers.

The authors also noted a large improvement in dietary quality among people who made more money and were educated beyond high school.

"The overall improvement in diet quality is encouraging, but the widening gap related to income and education presents a serious challenge to our society as a whole,” said Dr. Walter Willett, a senior author of the study.

The study authors said future efforts to improve nutrition in the US should take into account the inequality in food choices for those who make less money.

This study was published Sept. 1 in JAMA Internal Medicine.

The authors disclosed no conflicts of interest.

Review Date: 
September 8, 2014
Last Updated:
September 12, 2014