Prevention - The American Diet: How Has It Changed?

The U.S. government is watching what we eat and thinks we can do better. Thanks to a media blitz from the office of the U.S. Surgeon General,¹² most people are aware of the advice regarding the importance of diet and exercise for health and disease prevention. Many can picture in their heads the government's "Food Guide Pyramid"¹³ outlining what we are supposed to be eating each day for optimal health. Who doesn't know that public health officials thinks we should eat more fruits and vegetables than red meat and less fats, oils, and sweets?

Have we changed our diets to reflect the latest dietary wisdom? The chart shows changes in the consumption of various food commodities between 1970 and 1997. Consumption of red meat, eggs, and whole milk is down, a response to warnings about dangerous cholesterol. We're eating more of everything else, though. Is our diet healthy enough?

Apparently not. The USDA reports that "contrary to recommendations, Americans are consuming record-high amounts of caloric sweeteners and some high-fat dairy products, and near record amounts of added fats…. a hefty increase in grain consumption reflects higher consumption of mostly refined, rather than high-fiber, whole-grain products."

The USDA summarizes data about Americans' overall diet quality in a Healthy Eating Index (HEI). The pie chart shows how we scored in 1996: 71% of people were in the "needs improvement" range, 12% had a good diet, and 17% had a poor diet. Our greatest failings? Not enough fruit, too little milk, says the USDA.

Healthy Eating Index Rating: 1996

Who has the best scores? Children aged 2 to 3 score highest, women score higher than men, and scores increase with education and income. Do we have a bad attitude? When surveyed between 1991-94 about their diets, 62% of men and 38% of women indicated they had no interest in improving their diets. Sixty-nine percent of respondents said "too much emphasis is placed on nutrition" and "eating healthfully is too complicated."

At the other end of the dietary spectrum are the "worried well," the segment of the population that may be overly preoccupied with health and nutrition. They are the ones who snap up the latest dietary trends — the antioxidant vitamins and fortified foods, for example. Sometimes these food additives are a response to a real public health issue — calcium-fortified orange juice, for example, is a response to an observed inadequate intake of calcium among certain groups of people. Other food additives have dietary experts scratching their heads — ginkgo biloba- or ginseng-fortified beverages, for example.

Whereas a century ago, our nutritional problems were due to inadequate intakes of certain vitamins and minerals, we may now be in danger of nutrient overload. The American Dietetic Association cautions that people should monitor what they consume; they may be getting the same nutrients in their fortified foods as they get out of their vitamin bottle.

Whatever the level of our knowledge of nutrition, there are many factors that contribute to our food consumption patterns. We have far more choices available to us now than the traditional meat-and-potatoes fare of the early 20th century. We eat for pleasure as well as from biological need. And the poor spend their grocery dollars differently, as we shall see next.

Healthy Eating Index Rating: 1996

Sources: Center for Nutrition Policy and Promotion. Online. Available: http://www.ers.usda.gov/ Lino, Mark, P. Peter Basiotis, et al. "The Diet Quality of Americans: Strong Link With Nutrition Knowledge." Family Economics and Nutrition Review (1999). v. 12, no. 1, p. 49. Dinkins, PhD, Julia M. "Beliefs and Attitudes of Americans Toward Their Diet." Family Economics and Nutrition Review (June 2000), p. 98. (survey conducted by Market Research Corporation of America; sample size, 1,851 adults 18 years old and over). "Functional foods — Position of ADA." J Am Diet Association 1999. Online. Available: http://www.eatright.com/adap1099.html. June 4, 2002. Spake, Amanda. "Natural Hazards." U.S. News & World Report. 12 February 2001.