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Americans Are Still Eating Too Much Added Sugar, Fat

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Foods with refined grains and sugar
Credit: iStock/happy_lark

Most of us know one of the best health moves we can make is to skip the junk food and eat a nutritious, well-balanced diet. But how are we doing at putting that knowledge into action? Not so great, according to a new analysis that reveals Americans continue to get more than 50 percent of their calories from low-quality carbohydrates and artery-clogging saturated fat.

In their analysis of the eating habits of nearly 44,000 adults over 16 years, NIH-funded researchers attributed much of our nation’s poor dietary showing to its ongoing love affair with heavily processed fast foods and snacks. But there were a few bright spots. The analysis also found that, compared to just a few decades ago, Americans are eating more foods with less added sugar, as well as more whole grains (e.g., brown rice, quinoa, rolled oats), plant proteins (e.g., nuts, beans), and sources of healthy fats (e.g., olive oil).

Over the last 20-plus years, research has generated new ideas about eating a proper diet. In the United States, the revised thinking led to the 2015-2020 Dietary Guidelines for Americans. They recommend eating more fruits, vegetables, whole grains, and other nutrient-dense foods, while limiting foods containing added sugars, saturated fats, and salt.

In the report published in JAMA, a team of researchers wanted to see how Americans are doing at following the new guidelines. The team was led by Shilpa Bhupathiraju, Harvard T. H. Chan School of Public Health, Boston, and Fang Fang Zhang, Tufts University, Boston.

To get the answer, the researchers looked to the National Health and Nutrition Examination Survey (NHANES). The survey includes a nationally representative sample of U.S. adults, age 20 or older, who had answered questions about their food and beverage intake over a 24-hour period at least once during nine annual survey cycles between 1999-2000 and 2015-2016.

The researchers assessed the overall quality of the American diet using the Healthy Eating Index-2015 (HEI-2015), which measures adherence to the 2015-2020 Dietary Guidelines. The HEI-2015 scores range from 0 to 100, with the latter number being a perfect, A-plus score. The analysis showed the American diet barely inching up over the last two decades from a final score of 55.7 to 57.7.

That, of course, is still far from a passing grade. Some of the common mistakes identified:

• Refined grains, starchy vegetables, and added sugars still account for 42 percent of the average American’s daily calories.
• Whole grains and fruits provide just 9 percent of daily calories.
• Saturated fat consumption remains above 10 percent of daily calories, as many Americans continue to eat more red and processed meat.

Looking on the bright side, the data do indicate more Americans are starting to lean toward the right choices. They are getting slightly more of their calories from healthier whole grains and a little less from added sugar. Americans are also now looking a little more to whole grains, nuts, and beans as a protein source. It’s important to note, though, these small gains weren’t seen in lower income groups or older adults.

The bottom line is most Americans still have an awfully long way to go to shape up their diets. The question is: how to get there? There are plenty of good choices that can help to turn things around, from reading food labels and limiting calories or portion sizes to exercising and finding healthy recipes that suit your palate.

Meanwhile, nutrition research is poised for a renaissance. Tremendous progress is being made in studying the microbial communities, or microbiomes, helping to digest our foods. The same is true for studies of energy metabolism, genetic variation influencing our dietary preferences, and the effects of aging.

This is an optimum time to enhance the science and evidence base for human nutrition. That may result in some updating of the scoring system for the nation’s dietary report card. But it will be up to all of us to figure out how to ace it.

References:

[1] Trends in Dietary Carbohydrate, Protein, and Fat Intake and Diet Quality Among US Adults, 1999-2016. Shan Z, Rehm CD, Rogers G, Ruan M, Wang DD, Hu FB, Mozaffarian D, Zhang FF, Bhupathiraju SN. JAMA. 2019 Sep 24;322(12):1178-1187.

Links:

Eat Right (National Heart, Lung, and Blood Institute/NIH)

Dietary Fats (MedlinePlus, National Library of Medicine/NIH)

ChooseMyPlate (U.S. Department of Agriculture)

Healthy Eating Index (Department of Agriculture)

NIH Nutrition Research Task Force (National Institute of Diabetes and Digestive and Kidney Disease/NIH)

Dietary Guidelines for Americans (U.S. Department of Health and Human Services)

Shilpa Bhupathiraju (Harvard T. H. Chan School of Public Health, Boston)

Fang Fang Zhang (Tufts University, Boston)

NIH Support: National Institute on Minority Health and Health Disparities; National Institute of Diabetes and Digestive and Kidney Diseases


Are Sports Organizations Playing a Role in America’s Obesity Problem?

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Sports SponsorsLast September, the National Football League struck a deal with Frito-Lay that allowed the company to produce limited-edition bags of Tostitos tortilla chips, with each package bearing the logo of one of 19 featured NFL teams. Several months earlier, Major League Baseball announced that Nathan’s Famous would be its first-ever official hot dog. Now the first-ever comprehensive analysis of such food and beverage sponsorships by major sports organizations shows just how pervasive these deals are. The confusing messages they send about physical fitness and healthy eating habits can’t be helping our national problem with obesity [1].

Among the 10 sports organizations that young viewers watch most, from the NFL to Little League, the NIH-funded research team identified dozens of sponsors and hundreds of associated advertisements promoting food and beverage products. The vast majority of those ads touted unhealthy items, including chips, candies, sodas, and other foods high in fat, sodium, or sugar, and low in nutritional value.

Those findings are especially concerning in light of the latest figures from the National Health and Nutrition Examination Survey (NHANES), co-supported by NIH [2], It shows that, despite long-standing public health efforts to curb the obesity epidemic, more than 18 percent of young people in America remain obese. Among adults, the picture is even more discouraging: nearly 40 percent of American adults were obese in 2015-2016, up from about 34 percent in 2007-2008.


Creative Minds: Do Celebrity Endorsements Influence Teens’ Health?

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Marie Bragg

Marie Bragg

Marie Bragg is a first-generation American, raised by a mother who immigrated to Florida from Trinidad. She watched her uncle in Florida cope effectively with type 2 diabetes, taking prescription drugs and following doctor-recommended dietary changes. But several of her Trinidadian relatives also had type 2 diabetes, and often sought to manage their diabetes by alternative means—through home remedies and spiritual practices.

This situation prompted Bragg to develop, at an early age, a strong interest in how approaches to health care may differ between cultures. But that wasn’t Bragg’s only interest—her other love was sports, having played on a high school soccer team that earned two state championships in Florida. That made her keenly aware of the sway that celebrity athletes, such as Michael Jordan and Serena Williams, could have on the public, particularly on young people. Today, Bragg combines both of her childhood interests—the influence of celebrities and the power of cultural narratives—in research that she is conducting as an Assistant Professor of Population Health at New York University Langone Medical Center and as a 2015 recipient of an NIH Director’s Early Independence Award.