What Determine Dietary Quality Among Americans?

Eating a healthy diet can prevent many diseases including heart disease, cancer, high blood pressure and stroke. The message is clear and well understood by people. In fact, Americans’ eating habits have improved, except among the poor.

What prevent poor people from eating healthy foods? According to a 12-year study, there is a widening wealth gap regarding diet, and even among wealthier adults, food choices remain far from ideal.

Researchers from the Harvard School of Public Health, Harvard Medical School and University of California found that based on a perfect score of 110 points on healthy eating, American adults averaged just 40 points between 1999 and 2000, climbing steadily to 47 points between 2009 and 2010. Their findings were published in October 2014’s issue in ‘JAMA Internal Medicine’.

Most of the improvement in the American diet was due to a steady decline in the consumption of trans fats and sugar-sweetened beverages, giving a minor boost to overall diet scores. Besides these, American diets remained consistent, with low scores for fruits, vegetables, and whole grains.

Compared with high-income adults, the scores for low-income adults averaged almost 4 points lower between 1999 and 2000 and the difference increased to more than 6 points between 2009 and 2010.

People with higher scores spend more on heart-healthy foods including vegetables, fruits, whole grains and healthy fats. This also means that these people will have a lower risk of obesity and chronic diseases including heart disease, stroke and diabetes. On the other hand, people with low scores might face a higher risk of getting these diseases.

Obviously, the widening rich-poor diet gap will have profound impact on the public health implications. The researchers pointed out that diet-linked chronic diseases like diabetes have become more common in Americans in general, and especially among the poor.

The growing disparity is likely due to the recent recession that deepened income inequality and lower the affordability of low-income Americans for healthy foods. The national obesity epidemic is closely related to poverty. Low-income Americans are more likely to put on weight. Statistics showed that more than 33 percent of adults who earn less than $15,000 per year are considered to be obese, compared with about 25 percent of people who earn more than $50,000 per year.

Poorer Americans often lack access to nearby grocery stores where they can buy healthy food. Meanwhile, it is also because some processed foods are less expensive than those that are more nutritious like fresh produce and whole grains.

As indicated by the researchers, education alone might not be very effective to improve the dietary quality if the food environment and food system do not change at all.