Intriguing new data suggests far more Americans are eating a healthy diet than they were two decades ago — casting doubt on previous studies suggesting our daily menus are worse than ever before.
Researchers from Tufts University in Massachusetts analyzed diets of 51,700 Americans 20 years and older who responded to the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2020.
They assigned 'diet scores' to people based on how closely they followed the American Heart Association's diet, which recommends a high variety of fruits and vegetables, whole grains, plant protein, fish and minimal sugar andalcohol.
A poor diet was defined as less than 40 percent adherence to the AHA guidelines. Over the study period, the proportion of adults with a poor diet decreased from 49 percent to 37 percent.
However, the researchers stated the percentage of people with poor diets is still too high, contributing to the obesity epidemic in America.
High-fat diets are known to increase the risk of obesity, heart disease, and type 2 diabetes
While rates of the increase in body mass index appear to be slowing down, more Americans than ever are now being classified as severely obese,Stat Newsreported.
Senior author of the study Dr Dariush Mozaffarian, cardiologist and director of the Food is Medicine Institute, said: '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.'
Researchers involved in the new study also scored intermediate and ideal diets.
An intermediate diet was 40 percent to 79.9 percent AHA adherence and an ideal diet was at least 80 percent adherence.
Additional results showed those with an intermediate adherence increased from 51 percent to 61 percent and the proportion of Americans with an ideal diet increased, though remained very low, rising from 0.66 percent to 1.6 percent.
However, the changes were not uniform across demographics. Those with a poor diet score decreased from 48 percent to 33 percent only among adults with food security - access to and ability to afford healthy foods.
There was no significant decline, however - 51 percent to 48 percent - for people with food insecurity.
Dr Mozaffarian deemed the disparity between demographics a 'national nutrition crisis.'
He said: '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.'
The above chart shows the estimated trends of adherence to different components of the AHA dietary guidelines
The above chart shows the estimated trends of adherence to the AHA dietary guidelines and the proportion of US adults with poor diet scores
A poor diet has been linked to numerous health problems, including heart disease, obesity, diabetes and some cancers.
The researchers said associated with the low level of Americans following ideal diets, it is not surprising that national rates of diabetes and obesity continue to climb, 'indicating a need for substantial further improvements in diet quality before prevalence of these highly nutrition-sensitive conditions may begin to decrease.'
According to the FDA, 1million Americans die every year from diet-related diseases.
Dr Mozaffarian added: 'Our new research shows that the nation can’t achieve nutritional and health equity until we address the barriers many Americans face when it comes to accessing and eating nourishing food.'
Researchers said specific dietary changes contributed to the trends, including higher intake of nuts, seeds, whole grains, poultry, cheese and eggs.
There was lower consumption of refined grains — such as white bread — drinks with added sugar, fruit juice and milk.
Intake of fruits, vegetables, processed meats and salt remained fairly stable.
While overall trends were seen, improvements in diet quality were highest among younger adults, women, Hispanic adults and people with higher levels of education, income, food security and private health insurance.
Diet improvement was lower among older adults, men, Black adults and people with lower levels of education, income, food security and private health insurance.
Study author Junxiu Liu, assistant professor at the Icahn School of Medicine at Mount Sinai, said: '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.'
The study was published Monday in the Annals of Internal Medicine.
