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Diet Quality of Americans Differs by Age, Sex, Race/Ethnicity, Income, and Education Level

https://doi.org/10.1016/j.jand.2012.08.011Get rights and content

Abstract

An index that assesses the multidimensional components of the diet across the lifecycle is useful in describing diet quality. The purpose of this study was to use the Healthy Eating Index-2005, a measure of diet quality in terms of conformance to the 2005 Dietary Guidelines for Americans, to describe the diet quality of Americans by varying sociodemographic characteristics in order to provide insight as to where diets need to improve. The Healthy Eating Index-2005 scores were estimated using 1 day of dietary intake data provided by participants in the 2003-2004 National Health and Nutrition Examination Survey. Mean daily intakes of foods and nutrients, expressed per 1,000 kilocalories, were estimated using the population ratio method and compared with standards that reflect the 2005 Dietary Guidelines for Americans. Participants included 3,286 children (2 to 17 years), 3,690 young and middle-aged adults (18 to 64 years), and 1,296 older adults (65+ years). Results are reported as percentages of maximum scores and tested for significant differences (P≤0.05) by age, sex, race/ethnicity, income, and education levels. Children and older adults had better-quality diets than younger and middle-aged adults; women had better-quality diets than men; Hispanics had better-quality diets than blacks and whites; and diet quality of adults, but not children, generally improved with income level, except for sodium. The diets of Americans, regardless of socioeconomic status, are far from optimal. Problematic dietary patterns were found among all sociodemographic groups. Major improvements in the nutritional health of the American public can be made by improving eating patterns.

Section snippets

Study Sample

HEI-2005 scores were estimated using 1 day of dietary intake data provided by 8,272 participants in the 2003-2004 National Health and Nutrition Examination Survey, the most recent cycle for which the necessary food group data were available. Dietary data were collected by trained interviewers using the US Department of Agriculture Automated Multiple Pass Method, which is standardized, computer-assisted, and validated.20 The study sample included all participants (including pregnant and

HEI-2005 Total Scores

The HEI-2005 mean total scores for all children, adults, and older adults are found in Tables 1, 2, and 3, respectively. The total score was 56 for both children and adults, and 65 for older adults. Children ages 2 to 5 years had higher total scores than those 6 to 11 or 12 to 17 years of age, and adults 55 to 64 years had higher total scores than all younger adult groups. The oldest participants, age 75 years and older, had a higher total score than those 65 to 74 years old, as well as the

Conclusions

According to this descriptive study, the diet quality of Americans differed by sociodemographic characteristics. In general, children and older adults have better-quality diets than younger and middle-aged adults; women have better-quality diets than men; Hispanics have better-quality diets than blacks and whites; and diet quality generally improves with income level, with the exception of sodium.

The diets of Americans 2 years and older, regardless of socioeconomic status, are far less than

Acknowledgements

The authors would like to thank Breda Munoz of RTI International for advice on statistical analyses.

H. A. B. Hiza is a nutritionist, US Department of Agriculture, Center for Nutrition Policy and Promotion, Alexandria, VA

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    H. A. B. Hiza is a nutritionist, US Department of Agriculture, Center for Nutrition Policy and Promotion, Alexandria, VA

    K. O. Casavale is a nutritionist, US Department of Agriculture, Center for Nutrition Policy and Promotion, Alexandria, VA

    P. M. Guenther is a nutritionist, US Department of Agriculture, Center for Nutrition Policy and Promotion, Alexandria, VA

    C. A. Davis was director, Nutrition Promotion (retired), US Department of Agriculture, Center for Nutrition Policy and Promotion, Alexandria, VA

    Available online 15 November 2012

    STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.

    FUNDING/SUPPORT Support for this study was provided by US Department of Agriculture/Center for Nutrition Policy and Promotion.

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