Poor dietary quality is one of the primary causes of chronic disease and preventable death in the U.S.: How do we know?

Population-level data on nutrition and nutrition-related diseases indicate it is as challenging to eat healthy in the U.S. today as it has ever been in the past.

A 2013 study by the National Academy of Science found in 2010 Diet and Exercise passed Tobacco as the largest cause of preventable death in the US - prematurely killing an estimated 400,000 Americans per year. This estimate rose from 2000 estimates by 50,000 [1]

Estimates of Preventable Factors Causing U.S. Premature Mortality

Preventable Factors Causing Premature Mortality

(% of total U.S. mortality)
Source: https://www.ncbi.nlm.nih.gov/books/NBK279981/

Weight problems are one of the most common yet most neglected public health issues. The U.S. Surgeon General declared obesity an epidemic and top priority in 2003, referencing "It’s the fastest-growing cause of disease and death in America. And it’s completely preventable" [2]. Yet, despite government action, the percent of population with weight problems has continued to grow. More than two-thirds of the U.S. population is now overweight, obese or extreme obese. Incidence of obesity have more than doubled since 1980 while incidence of extreme obesity has more than quadrupled.

Source: https://www.cdc.gov/nchs/data/hestat/obesity_adult_13_14/obesity_adult_13_14.htm

Other public health metrics related to coronary heart disease have also gotten worse since the 80s. While incidence of high cholesterol has been reduced since the cholesterol-lowering best selling drug of all time statin Lipitor first went on the market in 1996, incidence of diabetes, hypercholesterolemia, and hypertension have increased. For all three diseases, poor diet is a major modifiable risk factor [3], [4], [5].

Source: https://www.cdc.gov/nchs/data/hus/2015/053.pdf

Why have these diseases continued to increase despite major government intervention to reduce incidence? The CDC cites behavior (primarily poor diet quality and lack of physical activity) and environment (poor access to supermarkets and safe places for physical activity) as the primary reasons behind the obesity epidemic [6]. When those around us eat unhealthy, we're also more likely to eat unhealthy. A 2014 systematic review of 15 studies assessing whether social norms affected food choice concluded seeing others decisions significantly increased the likelihood participants would make a similar choice. [7].

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