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Royal Academy of Nutrition and Health Eating

22. How Does the Average American Diet Stack Up?

The food supply in the United States provides an array of nutritious choices to meet the dietary needs of most Americans.

Fresh fruits and vegetables, whole grains, and lean meats, fish, and poultry are usually easily accessible and affordable through grocery stores and farmers' markets. Yet, with such an abundance of healthy foods to choose from, are Americans adopting healthy diets?

The Quality of the American Diet

In general, Americans eat too much added sugar, sodium, and saturated fat, and too little fiber and some vitamins and minerals.

Their low fiber intake is partly due to their inadequate consumption of fruits and vegetables, and their overconsumption of refined rather than whole grains.

At the same time, while dietary fiber intakes are below recommended levels, added sugars account for an average of 16 percent of Americans' daily calories. This is largely due to Americans' love of soft drinks and other sugary beverages, as well as sweets and treats. For most of them, their fat intake is at the higher end of the recommended range, at about 34 percent.

 Their eat too much saturated fat, and many of them exceed the recommended dietary cholesterol intake of less than 300 milligrams per day. With regard to the micronutrients, American men meet their recommendations for most vitamins and minerals but women often fall short of many – including iron, for example.

Americans, in general, eat too much sodium, but not enough vitamin D, potassium, and calcium.  In an attempt to balance their lack of healthy food choices, 50 percent of Americans take at least one dietary supplement per day.

The lack of a healthy diet may also be due to where they eat. Americans spend over 40 percent of their food budget consuming food outside the home.  As mentioned earlier, many of them buy prepared foods from the supermarket or take-out meals from restaurants. If you don't prepare a meal yourself, it can be more difficult to keep track of how much sugar, sodium, or fat you're consuming.

Research shows that these prepared foods purchased outside the home tend to be less nutritious than those foods prepared in the home. Eating one or more fast-food meals a week can increase the risk of weight gain, overweight, and obesity. Skipping breakfast may also be a hindrance to the waistline.

Research suggests that children and adolescents who do not eat breakfast are at a higher risk for overweight and obesity.


9. What is nutrition?

We Choose Foods for Many Other Reasons

Your favorite foods taste delicious—that's why they're your favorites. You also choose certain other foods because they're staples of your culture, or they've become an important aspect of your social life.

Some of your food selections are determined by trends, influenced by media messages, or reflect the amount of time or money you have available. Sometimes, you choose a food just because it's there. Let's explore each of these factors more closely.



23. Rates of Overweight and Obesity in Americans

Americans have been battling the bathroom scale for decades, and the scale is winning.

The prevalence of both overweight and obesity has become epidemic in the United States.

As people take in more calories than they burn, usually due to more sedentary lifestyles, they create a recipe for poor health.

Over 65 percent of American adults are overweight and of those, 34 percent are considered obese. Whereas the latest statistics indicate that the epidemic of obesity may be slowing, rates are still too high, and reducing them is a top health care priority.

Unfortunately, the rate of excessive weight gain is increasing for younger Americans. Currently, over  10  percent  of  children  aged  2  to  5  years  and  approximately  17 percent of those aged 6 to 19 are considered obese.

Along with the weight gain have come higher rates of type 2 diabetes, particularly among children, and increased rates of heart disease, cancer, and stroke.

Ironically, being overweight doesn't necessarily mean being well fed. In fact, many of the poorest Americans are obese and malnourished.


24. Improving Americans' Diets Is One Goal of Healthy People 2020

 The U.S. Surgeon General has issued calls for a nationwide health improvement program since 1979.

The latest edition of this report, Healthy People 2020, contains a set of health goals and objectives for the nation to achieve over the second decade of the twenty-first century.

Healthy People 2020 focuses on several overarching goals:

  • Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death.
  • Achieve health equity, eliminate disparities, and improve the health of all groups.
  • Create social and physical environments that promote good health for all.
  • Promote quality of life, healthy development, and healthy behaviors across every stage of life.

There are more than 35 topic areas in Healthy People 2020, ranging from ensuring that Americans have adequate access to health services to improvements in their diets and physical activity. Objectives are developed within each topic area.

For example, current research indicates that Americans body weights are increasing rather than decreasing. Thus, "Nutrition and Weight Status" is one topic area. Its goal is to promote health and reduce chronic diseases associated with diet and weight.

There are numerous objectives developed within this topic area that, if fulfilled, will help Americans improve their diet and reduce their weight.

Consuming adequate amounts of fruits and vegetables are beneficial to managing one's weight.

Americans should increase their intake of both of these food sources to help them improve their nutrition and weight status.

Europeans and citizens of other developed countries have the same problems.

This isn't exactly what's meant by the phrase "You are what you eat," but its close.


Obesity: Carrying an excessive amount of body fat above the level of being overweight.

Overweight: Carrying extra weight on your body in relation to your height.

Healthy People 2020: A set of disease prevention and health promotion objectives for Americans to meet during the second decade of the new millennium.

Healthy People 2020 Nutrition and Weight


  • Increase the proportion of adults who are at a healthy weight
  • Reduce the proportion of adults who are obese
  • Reduce the proportion of children and adolescents who are considered obese
  • Increase the contribution of fruits to diets of the population age 2 years and older
  • Increase the variety and contribution of vegetables to the diets of the population aged 2 and older

The Take-Home Message:

Incidences of overweight and obesity among Americans are prevalent, yet many people are falling short of some nutrient needs. Healthy  People  2020 is  a  set  of  health  objectives  for  the nation to achieve over the second decade of the twenty-first century.


25. Poor, Obese, and Malnourished: A Troubling Paradox

Food costs money, so people who are poor have less money to buy food.

Therefore, people who are poor are less likely to be overweight or obese right?

Makes sense, but the conclusion is wrong. In survey after survey, rates of obesity turn out to be highest among people with the lowest incomes. The numbers are greater for women than for men, but for both genders.

Americans living near or below the poverty level have much higher rates of obesity than affluent Americans. And despite their obesity, these lowest-income Americans are also malnourished. How can this be so?

In 1995, a pediatrician named William Dietz, now considered a leading expert on obesity, published an account of a 7-year-old patient: a girl weighing more than twice her ideal body weight and living in poverty.

Dietz entitled his case study "Does Hunger Cause Obesity?" and proposed two possible scenarios in which it might: When a family lacks money, its members choose foods that provide them with the greatest number of calories at the lowest cost. These foods tend to be high in fat and sugar and low in nutrients, such as vitamins, minerals, and fiber.

Thus, although overfed, individuals on this kind of diet can be significantly malnourished.

When a person experiences hunger, the body adapts by slowing energy expenditure and "hoarding" calories:In other words, episodes of food shortages might cause increased body fat.

More recently, Angie Tagtow, head of the Hunger and Environmental Nutrition group, identified another possible link among hunger, malnutrition, and obesity: the family's living environment.

Economics influences not only what a family can afford to buy but also where it can afford to live, and this affects its proximity to quality food stores and farmers' markets versus fast-food restaurants and convenience stores.

Economics also affects access to transportation, social services, and nutrition education and assistance. Adam Drewnowski, director of the Center for Public Health Nutrition of the University of Washington, adds one more factor: the greater palatability of low-cost foods. In other words, chips and cookies tend to satisfy our taste buds more than peppers and pears.

He cites laboratory studies suggesting that we're more likely to overeat cheap junk foods, and contends that limited money for food may shift a poor family's purchases toward more palatable foods that fill people up with the maximum calories at the minimum cost.

Drewnowski points out that a low-income family of four gets $104 a week in food assistance, which breaks down to $3.71 per person per day.

Think about it: If you had just $3.71 to buy a day's worth of food, how would you spend it? Would you be more concerned with getting the right balance of nutrients or purchasing high-volume, less nutritious foods that keep hunger at bay throughout the day?



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