US Dietary Quality Better But Leaves Room For Improvement

Daniel (Dong) Wang MD, MSc Department of Nutrition, Harvard School of Public Health Boston, MA Interview with:
Daniel (Dong) Wang MD, MSc

Department of Nutrition, Harvard School of Public Health
Boston, MA 02115


Medical Research: What are the main findings of the study?

Dr. Wang:

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

Medical Research: What was most surprising about the results?

Dr. Wang:

  • The gap in dietary quality between low and high socioeconomic status widened over time.
  • The gradually increasing sodium intake over the 12 years was surprising given constant efforts to reduce salt intake by the federal dietary guidelines, the American Heart Association, as well as other public health organizations.
  • The quality of the US diet steadily improved over the 12 years. This was somewhat surprising because this period included a severe economic recession.

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

Dr. Wang:

  • 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?

Dr. Wang:

  • In addition to creating scientific evidence to inform dietary recommendations and consumer’s practice, future studies and public health programs 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.


Trends in Dietary Quality Among Adults in the United States, 1999 Through 2010

Wang DD, Leung CW, Li Y, et al. Trends in Dietary Quality Among Adults in the United States, 1999 Through 2010. JAMA Intern Med. 2014;174(10):1587-1595. doi:10.1001/jamainternmed.2014.3422.


Last Updated on October 8, 2014 by Marie Benz MD FAAD