03 Sep Gains Seen In US Food Quality, But Room For Further Improvement

MedicalResearch.com Interview with:
Dong D. Wang, MD, MSc
Department of Nutrition
Harvard School of Public Health
Boston, Massachusetts

Medical Research: What are the main findings of the study?
Dr. Wang:

• The quality of the US diet improved modestly from 1999 to 2010, but the dietary quality of US population remains far from optimal and huge room exists for further improvements.
• More than half of the improvement in diet quality was due to a large reduction in consumption of trans fat.
• he improvement in dietary quality was greater among persons with higher socioeconomic status and healthier body weight, thus disparities that existed in 1999 increased over the next decade.

Medical Research: Were any of the findings unexpected?

• The quality of the US diet improved modestly and steadily overall from 1999 to 2010, but the dietary quality of US population remains far from optimal. This was somewhat surprising because this period included a severe economic recession.
• The gap in dietary quality between low and high socioeconomic status widened over time, although this was not too surprising because gaps in income have been increasing.
• The gradually increasing sodium intake over the 12 years.
• Mexican Americans had the best dietary quality, while non-Hispanic blacks had the poorest dietary quality. The difference between non-Hispanic whites and non-Hispanic blacks was more likely to be explained by socioeconomic inequity, whereas difference between non-Hispanic whites and Mexican Americans may be due to dietary traditions and culture.

Medical Research: What should clinicians and patients take away from your report?

• Considering the elevated disease risk associated with poor dietary quality, dietary assessment and counseling in clinical settings deserves greater attention. Our previous study based on data from the Nurses’ Health Study has found that a 7.2 point increase in AHEI-2010 was associated with a 15% lower risk of major chronic disease in women; this 7.2-point improvement could be readily translated into clinicians’ advice, e.g., increasing whole fruits consumption by three servings per day or cutting back consumption of sugar sweetened beverages from one or more per day to two 8-oz glasses per week, which could result in substantial reduction in disease burden.

Medical Research: What recommendations do you have for future research as a result of this study?

• In addition to creating evidence to inform dietary recommendations and consumer’s practice, studies that focus on changing the food environment through collective actions, such as structural interventions and regulations, are imperative for sustainable dietary quality improvement; population with low socioeconomic status are likely to benefit most from the collective actions.
• The widened gap in dietary quality between low and high socioeconomic status over time suggests the need for additional actions to improve dietary quality for those with low socioeconomic status.

Medical Research: What are the public health implications?

• This improvement in dietary quality reflected favorable changes in both consumers’ food choices and food processing, likely motivated by both public policy and nutrition education.
• The overall dietary quality remains poor, indicating room for vast improvement and presenting challenges for both public health researchers and policy makers.
• The prominent reduction of trans fat indicates that collective actions, such as legislation and taxation, by creating an environment that fosters and supports individuals’ healthy choice, are more effective and efficient to reduce dietary risk factors than actions that solely depend on personal responsibility, such as consumers’ voluntary behavior change; population with low socioeconomic status are likely to benefit most from the collective actions.

Citation:

Wang DD, Leung CW, Li Y, et al. Trends in Dietary Quality Among Adults in the United States, 1999 Through 2010. JAMA Intern Med. Published online September 01, 2014. doi:10.1001/jamainternmed.2014.3422.

Last Updated on September 3, 2014 by Marie Benz MD FAAD