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While these changes point to some improvements in U.S. eating habits
over the past decade, many people still consume too much sugar and
processed food and not enough whole fruits and vegetables, the study
published in JAMA found.
“The overall diet is still far from optimal – less than one-third of
American adults meet guidelines for most foods,” said senior study
author Dr. Dariush Mozaffarian, dean of the Tufts Friedman School of
Nutrition Science and Policy in Boston.
“The single biggest focus should be on reducing highly processed
foods rich in refined grains, starch, added sugars and salt; and
increasing minimally processed healthful foods such as fruits,
non-starchy vegetables, nuts, seeds, beans, fish and yogurt,”
Mozaffarian added by email.
Researchers looked at trends in eating habits for almost 34,000
adults aged 20 or older who participated in seven nationally
representative surveys from 1999 to 2012.
The study team scored diets based, among other things, on how well
people followed recommendations from the American Heart Association
(AHA) that are designed to help prevent chronic health problems like
cardiovascular disease.
Under these guidelines, a healthy diet includes at least 4.5 cups a
day of fruits and vegetables, at least three ounces a day of
fiber-rich whole grains and at least seven ounces a week of fish. It
also caps sodium intake at 1,500 milligrams a day, the amount in
three quarters of a teaspoon (3.75 g) of salt, and limits sodas and
sugary juices at 36 ounces (1 liter) a week.
Overall, the percentage of Americans with poor diets based on these
AHA standards dropped from 56 percent to 46 percent during the study
period. The proportion of people with ideal diets was low but inched
up to 1.5 percent from less than 1 percent.
Racial disparities in eating habits persisted throughout the study
period. The proportion of white people with poor diets declined,
while remaining little changed among black and Hispanic adults.
More affluent adults saw greater improvements in diet than
lower-income people, the study also found.
For some eating patterns – including consumption of total
vegetables, whole grains, unprocessed red meat and milk – trends
over time were similar regardless of race, ethnicity, income or
education levels. Intake of these things was consistently higher for
more affluent people and white people and lower for poor people and
black and Hispanic adults.
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At the same time, salt intake was unchanged for white people but
increased for black and Hispanic people during the study period.
Refined grain consumption dropped for white and black adults while
increasing for Hispanics.
Limitations of the study include its reliance on survey participants
to accurately recall and report what they ate and drank, as well as
the potential for diet fads or food trends in popular culture to
influence how people described their diets, the authors note.
Even so, the findings suggest that doctors need to do a better job
educating patients about how to eat and how food choices influence
their health, Dr. Margo Denke, a former researcher at the University
of Texas Southwestern Medical Center in Dallas noted in an
accompanying editorial.
Physicians also have to recognize that improving diets may be not be
just a question of education, but of access and affordability, Denke
added by email. While it’s possible some people are confused about
what to eat, the bigger problem is that they aren’t sure what to do
when fresh produce isn’t at their local store.
“The import of less expensive fruits and vegetables I believe drove
improved intake among those who have higher incomes,” Denke said.
“How can we pass this on to those who are financially struggling?”
SOURCE: http://bit.ly/28LE2ye JAMA, online June 21, 2016.
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