How has our diet changed in the last decade?

New study in JAMA, “Dietary Intake Among US Adults, 1999-2012“:

Importance: Most studies of US dietary trends have evaluated major macronutrients or only a few dietary factors. Understanding trends in summary measures of diet quality for multiple individual foods and nutrients, and the corresponding disparities among population subgroups, is crucial to identify challenges and opportunities to improve dietary intake for all US adults.

Objective: To characterize trends in overall diet quality and multiple dietary components related to major diseases among US adults, including by age, sex, race/ethnicity, education, and income.

Design, Setting, and Participants: Repeated cross-sectional investigation using 24-hour dietary recalls in nationally representative samples including 33 932 noninstitutionalized US adults aged 20 years or older from 7 National Health and Nutrition Examination Survey (NHANES) cycles (1999-2012). The sample size per cycle ranged from 4237 to 5762.

Exposures: Calendar year and population sociodemographic subgroups.

Main Outcomes and Measures: Survey-weighted, energy-adjusted mean consumption and proportion meeting targets of the American Heart Association (AHA) 2020 continuous diet scores, AHA score components (primary: total fruits and vegetables, whole grains, fish and shellfish, sugar-sweetened beverages, and sodium; secondary: nuts, seeds, and legumes, processed meat, and saturated fat), and other individual food groups and nutrients.

Researchers used the NHANES survey from 1999-2012 to look at how diet changed among Americans over those years. Specifically, they looked at how food and nutrient components changed.

They found that the AHA diet score (from 0 to 50 points) improved from 19 to 21.2, for a 12% bump. The consumption of whole grains went up, as did nuts and seeds. Sugar-sweetened beverages went down.

No real changes were seen in consumption of fruits and vegetables, processed meats, saturated fats, or sodium. But whole fruit consumption went up and fruit juice went down (which is good) – that’s just missed when you lump fruit and juice together.

The percentage of adults with “poor diets” dropped from 55.9% to 45.6%, and “intermediate” diets increased from 43.5% to 52.9%.

As with so many things in health, disparities exist. While the percentage of non-Hispanic whites with a poor diet dropped from 53.9% to 42.8%, similar improvements didn’t really happen for non-Hispanic blacks or Mexican Americans. In fact, there seem to be worsening disparities by income level.

Things look better, overall. That’s the good news. The bad news is that things don’t look better for everyone, and it’s potentially the people who have the most to gain who are being left behind.

There’s a lot of data in this piece. Go check it out. We still have much work to do.


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