In America, Healthy Eating Is for the Privileged

Although kale salad is making its way to some family dinners, the fact remains that eating healthy is often thought of as something for the rich to entertain, and for the bottom rung to struggle with. According to new study published in the Journal of the American Medical Association, authors give credence to this gap, finding that the rich are eating healthier and the poor are still eating worse.

Using a survey from the National Health and Nutrition Examination Survey, the authors charted the eating habits of American diets from roughly 29,124 adults from 1999 to 2010. They indexed the habits using the Harvard School of Public Health’s Alternate Eating Index, which, while monitoring healthy eating habits, is also used to predict chronic diseases in the U.S. population.

If an individual scored higher on the index, it indicates they eat healthier food items such as fruits (not including juice), vegetables (not including starches like potatoes) and whole grains. A lower score entails the opposite, where the individual most likely eats foods high in fat, sugar and sodium.

What they found was that scores for low-income adults were lower than the average but also their numbers did not increase in the past 12 years. Compare this to high-income adults whose scores increased more than six points from 2009 to 2010.

On the bright side, and not accounting for socioeconomic status, we’re drinking less sugary drinks and fruit juices. We’re also eating more fruits and whole grains, nuts legumes and polyunsaturated fats. On the down side, we’re not eating enough vegetables, we’ve increased our sodium intake and still haven’t made a significant dent in eating any less red or processed meats.


“The good news is that the overall quality of the U.S. diet has been increasing in the past decade,” Frank Hu, one of the study’s authors, told The Atlantic. He also said the gap was “disturbing” and graded the U.S. diet in the B- range.

Today more than one-third of adults and 17 percent of youth are obese, according to the CDC. Recently, a new report found that obesity rates rose in six states in 2013, which is actually somewhat good news considering in 2005 every state increased their obesity rates.  The ubiquity of processed foods in America makes eating healthy foods, to say the least, nearly impossible.

The authors believe much of the healthy-eating gap could be explained by price, which is obviously a big concern when choosing what to eat, especially when real median incomes have remained the same since 1989. As Tom Philpott points out in Mother Jones, according to the USDA, “food-secure households spent 30 percent more on food than their food-insecure peers in 2013, and that includes expenditures from the Supplemental Nutrition Assistance Program (SNAP).”

On top of this, the study authors add that healthy foods generally cost more than unhealthy ones and that access to healthful foods also widens the gap — many low-income residents do not own a car to reach supermarkets with better, healthier foods. Lastly, education plays a big role as the dietary quality “was lowest and improved slowly in participants who had completed no more than 12 years of education, whereas dietary quality in participant who had completed college was consistently high and improved exponentially.”

As the authors write it’s “imperative for sustainable dietary quality improvement” especially for those whose socioeconomic status places them in the bottom levels of income, adding: “Collective actions, such as legislation and taxation, that aim toward creating an environment that fosters and supports individuals’ healthful choices are more effective at reducing dietary risk factors than actions that solely depend on personal responsibility, such as consumers’ individual voluntary behavior change.”

Among the study’s others findings, poor eating habits among blacks and whites “disappeared” once the socioeconomic variants were adjusted, meaning, once they both became sufficiently rich. However, Mexican Americans and whites maintained their significant differences across the board, something the authors believes is a matter of traditions and culture and not so much economic standing. Mexican Americans also had the best dietary quality of the race/ethnic groups and blacks had the poorest diets.

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