During 1999–2016, the average proportion of daily calorie intake that refined grains, added sugar, and starchy vegetables represented decreased by 3% in the U.S., according to the new JAMA study.
However, these low quality carbohydrates still account for 42% of daily calories, while high quality carbohydrates — such as whole grains and fruits — only account for 9%.
Over the same period, total fat intake went up by 1%. Half of this increase was due to saturated fat, which now accounts for 12% of daily calories. This figure is above the 10% maximum in the U.S. dietary guidelines.
“Although there are some encouraging signs that the American diet improved slightly over time, we are still a long way from getting an ‘A’ on this report card,” says co-senior study author Dr. Fang Fang Zhang, a nutrition epidemiologist at the Friedman School of Nutrition Science and Policy at Tufts University in Boston, MA.
For the study, the researchers drew on the records of the nationally representative National Health and Nutrition Examination Survey (NHANES).
Their analysis included dietary data from nearly 44,000 adults who had reported what they had consumed in a 24-hour period at least once between 1999 and 2016. Their average age was 47 years, and 52% were female.
Carbs, proteins, and fats in U.S. diet
The researchers estimated nutrient intake with the help of a U.S. Department of Agriculture (USDA) database.
They assessed dietary quality using the USDA’s Healthy Eating Index (HEI), which measures how well a diet aligns with the U.S. dietary guidelines.
- Total carbohydrates fell from 52.5% to 50.5%.
- Total protein increased from 15.5% to 16.4%.
- Total fat increased from 32.0% to 33.2%.
- Low quality carbohydrates fell from 45.1% to 41.8%.
- High quality carbohydrates increased from 7.42% to 8.65%.
- Plant protein increased from 5.38% to 5.76%.
- Saturated fat increased from 11.5% to 11.9%.
- Polyunsaturated fat increased from 7.58% to 8.23%.
The increase in high quality carbohydrate consumption came mostly from whole grains, while the reduction in low quality carbohydrate consumption was primarily due to lower intake of added sugar.
“Because low quality carbs are associated with disease risk, taking in higher quality carbs could mean better health for Americans in the future,” says first study author Zhilei Shan, Ph.D.
Shan is a nutritional epidemiology fellow in the Harvard T.H. Chan School of Public Health in Boston, MA. During the study, he was also working at Tongji Medical College at Huazhong University of Science and Technology in China.
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