Diet quality among US adults improved modestly between 1999 and 2020, researchers have found.

However, they also found that the number of Americans with poor diet quality remains stubbornly high. Most notably, disparities persist and, in some cases, are worsening. 

Poor diet continues to take a toll on American adults. It’s a major risk factor for obesity, type 2 diabetes, cardiovascular disease, and certain cancers, and more than one million Americans die every year from diet-related diseases, according to the Food and Drug Administration.

Poor diet and food insecurity is also costly, attributing to an estimated $1.1 trillion in health care expenditures and lost productivity. These burdens also contribute to major health disparities by income, education, zip code, race, and ethnicity.

“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,” says Dariush Mozaffarian, cardiologist and director of the Food is Medicine Institute at the Friedman School of Nutrition Science and Policy at Tufts University at Tufts University, and senior author of the study published in the Annals of Internal Medicine.

“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.”

The researchers investigated data from 10 cycles of the National Health and Nutrition Examination Survey between 1999 and 2020, a nationally representative survey that includes repeated 24-hour dietary recalls, where people report all foods and beverages consumed during the prior day. The study analyzed 51,703 adults who completed at least one valid 24-hour recall, with 72.6% having done two recalls.

They measured diet quality using the American Heart Association diet score, a validated measure of a healthy diet that includes components like fruits, vegetables, beans and nuts, whole grains, sugary beverages, and processed meat.

They found that the proportion of adults with poor dietary quality decreased from 48.8% to 36.7% over these two decades, while those with intermediate diet quality increased from 50.6% to 61.1%. They also found that the proportion of adults with an ideal diet improved but remained starkly low, from 0.66% to 1.58%.

Read the full article about health inequities by Taraneh Pettinato at Futurity.