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 From 1999 to 2016, the proportion of calories U.S. adults get from
carbohydrates declined from 52.5% to 50.5%, researchers found when
they analyzed nationally representative nutrition surveys. Over that
same period, the proportion of calories from protein increased from
15.5% to 16.4% and the proportion from fat climbed from 32% to
33.2%.
The proportion of calories from so-called "low quality" carbs like
sweets, white bread and French fries decreased from 45.1% to 41.8%
during the study period. Calories from "high quality" carbs like
whole grains and brown rice increased from 7.4% to 8.7%.
"Our findings show that we still have a long way to go to meet
dietary recommendations," said Shilpa Bhupathiraju, senior author of
the study and a nutrition researcher at Harvard Medical School and
Brigham and Women's Hospital in Boston.
"This includes further increasing intakes of whole grains, whole
fruit, non-starchy vegetables, nuts, and legumes, and lowering
intakes of refined grains, added sugars, and saturated fat,"
Bhupathiraju said by email.
Under U.S. dietary recommendations, adults should fill about half
their plate with a variety of fruits and vegetables and make half of
their grains whole grains, not white bread or white rice. (http://bit.ly/2mq0eWe)
Adults should also consume less than 10% of calories from added
sugars, and less than 10% of calories from added fats. (http://bit.ly/2lrAuZj)
People in the study did cut back on calories from "low-quality"
carbs by reducing their intake of added sugars, and fruit juice.
Increased consumption of animal protein, meanwhile, was driven by
people getting more calories from poultry and eggs.
Higher plant protein intake was driven by increased consumption of
whole grains, nuts, and soy.
The study didn't assess whether specific factors impacted shifts in
U.S. eating habits.
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One limitation of the study is it relied on surveys asking people to
recall and report everything the ate in the previous 24 hours. These
24-hour recall questionnaires don't always give an accurate picture
of how people really eat, the study team notes.
Researchers also lacked data on any health outcomes that might have
changed as a result of shifts in eating habits.
Still, some changes for the better found in the study should help
move Americans' health in the right direction, said Linda Van Horn,
author of an editorial accompanying the study and chief of nutrition
at the Feinberg School of Medicine at Northwestern University in
Chicago.
"Diets that are high in 'complex' or naturally occurring dietary
carbohydrates are higher dietary quality than 'refined'
carbohydrates that are processed and depleted of most of the
vitamins, minerals and dietary fiber that are inherent in the
naturally occurring carbs," Van Horn said by email.
"Often refined carb foods contain high amounts of sugar (sweetened
cereals) salt (snack crackers) or fat," Van Horn added. "The U.S.
diet includes far more refined carbs than naturally occurring, high
fiber carbs, so an improvement in this area - e.g. more whole grain
breads and cereals - is a good thing."
"If all Americans would include more fruits, vegetables and whole
grains they would greatly improve their overall diet quality while
hopefully reducing intake of sugar, salt and saturated fats that are
detrimental to health," Van Horn said.
SOURCE: http://bit.ly/2lrEclH JAMA, online September 24, 2019.
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