A recent study unveils slight improvements in American diets from 1999 to 2020 but underscores enduring and, in some cases, worsening disparities among different communities. Researchers stress the need for addressing barriers to healthy eating to achieve health equity.
Despite some advances in dietary habits over the past 20 years, many Americans are still struggling with poor diet quality, particularly those from marginalized communities, according to a new study from the Friedman School of Nutrition Science and Policy at Tufts University.
“While we’ve seen some modest improvement in American diets in the last two decades, those improvements are not reaching everyone and many Americans are eating worse,” the study’s senior author Dariush Mozaffarian, who is a cardiologist and director of the Food is Medicine Institute at the Friedman School, said in a statement.
Conducted by researchers at the Food is Medicine Institute, the study, which was published in the Annals of Internal Medicine, analyzed data from the National Health and Nutrition Examination Survey over 21 years. The findings reveal that although the proportion of adults with poor diet quality decreased from 48.8% to 36.7%, significant disparities persist along lines of income, education, race and ethnicity.
For instance, dietary improvements were mostly reported among younger adults, women, Hispanic adults, and individuals with higher levels of education and income who also had better food security and private health insurance. Meanwhile, older adults, men, Black adults and those with lower socio-economic status saw less improvement.
The researchers used the American Heart Association diet score to gauge diet quality, which considers intake of fruits, vegetables, beans, nuts, whole grains, sugary beverages and processed meats. Specific dietary changes noted included higher consumption of nuts, seeds, whole grains, poultry, cheese and eggs and decreased intake of refined grains, sugary drinks, fruit juice and milk, while fruit and vegetable intake remained largely unchanged.
“While some improvement, especially lower consumption of added sugar and fruit drinks, is encouraging to see, we still have a long way to go, especially for people from marginalized communities and backgrounds,” added the study’s first author Junxiu Liu, who was a postdoctoral scholar at the Friedman School at the time of the study and is currently an assistant professor at the Icahn School of Medicine at Mount Sinai.
The research highlights the ongoing and urgent need to address the social determinants of health, including nutrition security, housing, transportation, fair wages and structural racism, as emphasized by Mozaffarian. These factors directly influence Americans’ ability to access and consume healthy food, contributing to disparities in health outcomes such as obesity and type 2 diabetes.
“We face a national nutrition crisis, with continuing climbing rates of obesity and type 2 diabetes,” said Mozaffarian. “These diseases afflict all Americans, but especially those who are socioeconomically and geographically vulnerable. We must address nutrition security and other social determinants of health including housing, transportation, fair wages and structural racism to address the human and economic costs of poor diets.”
This study underscores the importance of proactive policy measures and community interventions aimed at making healthy food more accessible and affordable for everyone, ensuring that improvements in diet quality reach all segments of the population.