A spoonful less sugar, tad more fat: US diets lacking

Dietary challenges remain

CHICAGO, Sept 25, (Agencies): Americans’ diets are a little less sweet and a little crunchier but there’s still too much sugar, white bread and artery-clogging fat, a study suggests.

Overall, the authors estimated there was a modest improvement over 16 years on the government’s healthy eating index, from estimated scores of 56 to 58. That’s hardly cause for celebration – 100 is the top score.

Diets are still too heavy on foods that can contribute to heart disease, diabetes, obesity and other prevalent US health problems, said co-author Fang Fang Zhang, a nutrition researcher at Tufts University near Boston.

The study was published Tuesday in the Journal of the American Medical Association. The results are from an analysis of US government health surveys from 1999 to 2016 involving nearly 44,000 adults.

“Despite observed improvements,” the authors wrote, “important dietary challenges” remain.

Among them: Getting Americans to cut down on snack foods, hot dogs, fatty beef, butter and other foods containing saturated fats. The study found these unhealthy fats increased from 11.5% to almost 12% of daily calories, above the recommended 10% limit.

And while the biggest change was a small drop in added sugars, from about 16% to roughly 14%, that’s still too high. The government says less than 10% of daily calories should come from added sugars.

Decline

Researchers think fewer sweetened sodas contributed to the decline, but Zhang noted added sugars are often found in foods that don’t even seem sweet, including some yogurts and tomato sauce.

Fruits, nuts, oatmeal and other whole grains are among the types of foods adults ate slightly more of. Still, each of those contributed to less than 5% of daily calories in 2016, the study found.

Salt intake dipped slightly and a small decline in fruit juice contributed to a drop in low-quality carbs. But these still amount to 42% of daily calories, including many likely from highly processed white bread and other refined grains, Zhang said.

The study is based on in-person health surveys conducted every two years that ask adults to recall what foods they ate in the previous 24 hours. Starting in 2003, adults were asked that question twice several days apart.

The study lists food groups rather than individual foods; for example “whole grains”, not oatmeal, and “refined grains”, not white bread but Zhang said those two foods are among the most common grains in the US diet.

US dietary guidelines recommend a “healthy eating pattern” to reduce chances of developing chronic disease. The focus should be on nutrient-dense foods including vegetables, fruits, whole grains, low-fat dairy products; plus varied proteins sources including seafood, lean meats and poultry, eggs nuts and seeds, the recommendations say.

During the study years, US diabetes rates almost doubled, to more than 7%; obesity rates increased during many of those years, with about 70% of US adults now overweight or obese. Heart disease remains the leading cause of death.

Besides continued public health efforts, “Cooperation from the food industry” is key, a journal editorial said, including by reducing sugar, salt and saturated fats in foods.

“Our findings show that we still have a long way to go to meet dietary recommendations,” said Shilpa Bhupathiraju, senior author of the study and a nutrition researcher at Harvard Medical School and Brigham and Women’s Hospital in Boston.

Refined

“This includes further increasing intakes of whole grains, whole fruit, non-starchy vegetables, nuts, and legumes, and lowering intakes of refined grains, added sugars, and saturated fat,” Bhupathiraju said by email.

Under US dietary recommendations, adults should fill about half their plate with a variety of fruits and vegetables and make half of their grains whole grains, not white bread or white rice.

Adults should also consume less than 10% of calories from added sugars, and less than 10% of calories from added fats.

People in the study did cut back on calories from “low-quality” carbs by reducing their intake of added sugars, and fruit juice.

Increased consumption of animal protein, meanwhile, was driven by people getting more calories from poultry and eggs.

Higher plant protein intake was driven by increased consumption of whole grains, nuts, and soy.

The study didn’t assess whether specific factors impacted shifts in US eating habits.

One limitation of the study is it relied on surveys asking people to recall and report everything the ate in the previous 24 hours. These 24-hour recall questionnaires don’t always give an accurate picture of how people really eat, the study team notes. Researchers also lacked data on any health outcomes that might have changed as a result of shifts in eating habits.

Still, some changes for the better found in the study should help move Americans’ health in the right direction, said Linda Van Horn, author of an editorial accompanying the study and chief of nutrition at the Feinberg School of Medicine at Northwestern University in Chicago.

“Diets that are high in ‘complex’ or naturally occurring dietary carbohydrates are higher dietary quality than ‘refined’ carbohydrates that are processed and depleted of most of the vitamins, minerals and dietary fiber that are inherent in the naturally occurring carbs,” Van Horn said by email.

“Often refined carb foods contain high amounts of sugar (sweetened cereals) salt (snack crackers) or fat,” Van Horn added. “The US diet includes far more refined carbs than naturally occurring, high fiber carbs, so an improvement in this area – e.g. more whole grain breads and cereals – is a good thing.”

“If all Americans would include more fruits, vegetables and whole grains they would greatly improve their overall diet quality while hopefully reducing intake of sugar, salt and saturated fats that are detrimental to health,” Van Horn said.