CNN
—
Subscribe to CNN’s Eat, But Better: Mediterranean Style. Our eight-part guide will show you a delicious, expert-backed eating lifestyle that will boost your health for life.
A ray of light shines through it the dark clouds of America’s battle against poor nutrition and its resulting health problems, according to a new study that analyzed two decades of nutritional data.
“There is good news. Americans are starting to hear the message about nutrition, and some companies and restaurants are starting to make healthier products. It’s a small improvement,” said senior study author and cardiologist Dr. Dariush Mozaffarian, director of the Food is Medicine Institute at Tufts University in Boston.
However, he added that most of the improvement occurred between 1999 and 2010, with no subsequent progress in nutrition.
“We have come to a standstill as a nation – and that does not bode well for our health,” Mozaffarian said. “If I were to rate America based on its diet, I would give it a D, just above an F.”
The number of adults in the United States who had a poor diet fell from about 49% to just over 37% between 1999 and 2020 – a drop of 11.4%, while those who ate a little better nutritionally fell by 10.5% rose, the study showed.
A poor diet was defined as one that included too many refined grains, processed meats and sugary drinks, including fruit juice, as well as ultra-processed foods full of added sugar, salt and fat. Healthy choices such as fruits and vegetables are extremely low with this eating style.
“Fruit and vegetable intake has not increased at all in the last 20 years, which is quite striking,” says Mozaffarian.
An ideal diet included at least the daily recommended servings of fruits and vegetables, as well as more beans, whole grains, nuts and seeds. Dietary guidelines such as those from the American Heart Association suggest eating 4 to 5 cups per day of canned, fresh or frozen fruits and the same amount for vegetables.
The nutritionally ideal diet also included few sugary drinks, processed meats, refined grains and ultra-processed foods, which are often high in added sugars, fat and salt, the study said.
Unfortunately, the number of people eating an ideal diet — including those 9 cups of fruits and vegetables — increased by less than 1%, the study found.
“People often ask me, ‘If diet is slowly improving, why are obesity and diabetes still on the rise?’ It is still rising because only 1.58% of Americans are following an ideal diet. We still have a long way to go,” Mozaffarian said.
According to the U.S. Food and Drug Administration, more than a million Americans die each year from diet-related diseases such as obesity, cancer, heart disease and type 2 diabetes, while unhealthy diets and food insecurity cost the United States an estimated $1.1 trillion. healthcare expenditures and lost productivity per year.
“I think it’s right to highlight that food quality in the US remains dismal. There is no mystery why Americans are experiencing epidemics of obesity and diabetes and declining life expectancy,” said Dr. Walter Willett, professor of epidemiology and nutrition at the Harvard TH Chan School of Public Health in Boston, in an email. He was not involved in the investigation.
The study, published Monday in the Annals of Internal Medicine, analyzed nutritional information from nearly 52,000 U.S. adults who participated in the National Health and Nutrition Examination Survey, or NHANES.
Nutritional gains were greatest among women, younger adults, Hispanic adults, and people with higher education and higher incomes who had access to private health insurance. Smaller gains were seen among men, black or older adults, and those with lower incomes, lower education levels, non-private health insurance, and food insecurity issues.
“The disparities in the population based on education, income, race and ethnicity are the same or sometimes getting worse,” Mozaffarian said.
The study found that people with lower incomes saw a 5% improvement in diet quality, while people with higher incomes improved their nutrition score by 16%.
“We must avoid solely blaming the victims of America’s dysfunctional food system for the terrible diets documented in the study,” Willett said. “We are failing to educate students in our schools about nutrition and feeding them unhealthy food.
“Our health care system is almost completely inadequate, we allow advertising to lure children into junk food and drinks that cause them to die prematurely, and we indirectly subsidize unhealthy food in many ways that make healthier options relatively more expensive and less available to low-income earners. income Americans,” he said.
There are simple steps you can take to improve the nutritional quality of your diet, experts say.
Cook at home as often as possible: “My best suggestion is to shop at the grocery store as much as possible, rather than getting your food at a coffee shop, deli or quick-service restaurant,” Mozaffarian said.
Even eating at a full service restaurant should be limited, he added. Previous research by Mozaffarian and his team found that about 80% of all food Americans consumed in restaurants was of poor nutritional quality.
“Shockingly, even when we compared fast-food restaurants to sit-down restaurants, there was no dramatic difference in quality,” he said.
Instead, try to choose minimally processed foods to cook at home and avoid the ready-made convenience foods that are so common in the grocery store. Take your lunch and snacks to work.
Don’t drink your sugar. Americans are starting to get the idea that sugary soft drinks are unhealthy, but they haven’t yet made the connection that energy, sports and caffeinated drinks can contain just as much sugar, Mozaffarian said.
“Energy drinks, pre-sweetened iced tea and specialty coffee drinks may contain more sugar than soda,” he said. “I see people walking out of the coffee shop with drinks with whipped cream on them. Don’t drink your sugar.”
But once sugary drinks are removed from the equation, only “6% of the country’s calories come from added sugars in foods,” Mozaffarian said. “In contrast, about 35% of the country’s calories come from refined grains and starches.”
Limit refined grains. Overall, refined grains are the largest contributor to Americans’ poor diets, with 5.2 servings per day — “nearly two servings per meal of refined grains such as refined bread, refined rice, crackers, chips and other ultra-processed foods,” Mozaffarian said.
Whole grains still contain the bran and germ, a nutritional powerhouse full of healthy fats. antioxidants, minerals and E and B vitamins. Whole grains take longer to digest, don’t raise blood sugar levels as quickly as refined grains and are higher in fiber, which can reduce the risk of chronic disease, promote weight loss and improve digestion.
“Some examples of whole grains include barley, bulgur, farro, millet, quinoa, black rice, brown rice, red rice, wild rice, oatmeal and popcorn,” according to My Plate, the U.S. Department of Agriculture website.
Refined grains such as white flour, corn grits, white bread and white rice have been milled, with the bran and germ removed, to give them a finer texture and a longer shelf life. Milling also removes nutrients such as dietary fiber, iron and vitamins. Refined grains are found in almost all ultra-processed foods, including breakfast cereals, desserts, baked goods, breads and crackers.
Replace refined grains. Instead, nourish your gut microbiome with fruits and vegetables, beans, nuts and seeds, and minimally processed whole grains,” says Mozaffarian. Fermented foods such as yogurt, sauerkraut and kimchi can also help the microbiome, he added.