The People's Perspective on Medicine

American Diets Are a Little Better Now

Over the last decade and a half, American diets have improved, but the changes are modest. More of us should be eating whole grains and protein from plants.
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Public health experts have long been concerned that common American diets are contributing to obesity and chronic diseases such as diabetes, heart disease and cancer. As a result, they do their best to offer guidelines on what diets to follow. How are we doing?

Are American Diets Improving?

Despite lots of information about how to eat healthfully, Americans are still getting too much of their energy from low-quality carbohydrates. Nutrition scientists drew this conclusion from analyzing Nutrition Health and Examination Survey (NHANES) data from 1999 to 2016 (JAMA, Sept. 24, 2019).

Although American diets got a little better over that time frame, the change was quite modest. On the positive side, people consumed fewer calories from added sugar and from fruit juice. Liquid calories raise blood sugar quickly, but people may still be hungry after drinking soda or juice. Since added sugar has been a weakness of American diets for some time, reducing it is good news.

Other news is not as good. For one thing, Americans are still getting about 14 percent of their calories from added sugars. For another, only 9 percent of calories in a typical American diet come from whole fruits and whole grains. About 42 percent comes from highly refined grains, added sugar and starchy vegetables such as potatoes.

The scientists note that people may be eating fewer refined carbohydrates in response to changes in dietary guidelines away from low-fat diets and towards healthy fats and plant sources of protein. Popular diet trends such as the Paleo, Atkins, vegan and vegetarian diets may also be shaping American diets now. However, by far the most widely consumed sources of protein are red meat and processed meat. Relatively few people rely on seafood or plant sources such as whole grains, nuts, and legumes for their protein. In addition, poorer people are not eating better than they have in the past. Sadly, low-quality carbohydrates are cheap calories.

How Is the Healthy Eating Index?

The estimated Healthy Eating Index went from 55.7 to 57.7. Although this change is statistically significant, it leaves plenty of room for improvement.

Learn More:

If you would like recipes and guidance on healthful meals, you may want to consider our book, Recipes & Remedies From The People’s Pharmacy. Many of the distinguished nutrition scientists we have interviewed over the years contributed some of their favorite recipes for healthy eating.

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    About the Author
    Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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    • Shan Z et al, "Trends in dietary carbohydrate, protein, and fat intake and diet quality among US adults, 1999-2016." JAMA, Sept. 24, 2019. doi:10.1001/jama.2019.13771
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    Health experts are changing their assessments/opinions based on recent research. Red meat is not as bad as was originally thought. And foods high in carbohydrates, particularly simple carbs, have been found to be contributing to many everyday/common health issues.

    Nothing about salt, especially for an aging population. We recently moved to a senior facility that provides dinner and everything is salty. The 30ish chef says he tried lower salt and got complaints that everything was bland. He also says no one will eat brown rice or whole wheat pasta. I have congestive heart failure and should limit salt but that is a daily challenge. I can always order a baked potato but when I asked for a baked sweet potato option, no, that is every two to three weeks.

    So you want to kill us on carbs? My cardiologist who saved my life by putting me on low-carb diet now wants me to go a step further and go to a low-carb AND low protein diet — 70% fat, 20% protein (from animal sources and not beans) and just 10% carbs (fiber and other carbs combined). That is bringing my triglycerides and inflammation down even further (two major sources of heart trouble). And he recommends eating everything in just one meal a day (preferably evening). I wish I had never allowed all my “dietarily-correct” friends to convince me into eat all that lousy pasta in the 80s-90s! Some “experts” are now saying that cow farts are a main contributor to global warming. So we should all become vegans or, for some reason, “chickenitarians?”

    I have an alternative. Let’s eat more beef and less beans. That will greatly reduce the methane produced by those 6 billion or so middle-sized mammals we call “Homo Sap!” And our hearts will work better, too!

    It’s great your cardiologist is guiding you on your dietary choices. They won’t necessarily work for everyone else.

    There is so much conflicting information in the world of ‘health.’ Please weigh in on the “plant paradox” which
    strongly discourages whole grains in the American diet.

    We are still finding our way in understanding what comprises a healthy diet. Thank you

    American diets are contributing to obesity & chronic diseases? I think it’s time to quit tippy-toeing around the issue and state emphatically that they do! KFC just introduced a glazed-doughnut chicken sandwich! Bad food choices abound at every turn. And our addiction to sugar & bad-fat-laden foods drive us to choose them. On a recent road trip, my husband and I stopped into a fast-food restaurant for a cup of coffee and to use the rest room. Of the nine people standing in line, only the two of us could see our shoes if we looked down. Bad choices abound. And the addicted are standing in line waiting to get their fixes.

    * Be nice, and don't over share. View comment policy^