An Economic Gap Between the Recommended Healthy Food Patterns and Existing Diets of Minority Groups in the US National Health and Nutrition Examination Survey 2013-14.

Victor Fulgoni,Adam Drewnowski

doi:10.3389/fnut.2019.00037

Abstract

The US Department of Agriculture (USDA) has identified three Healthy Food Patterns as ways to implement the 2015–2020 Dietary Guidelines for Americans. We estimated the daily cost of the Healthy Vegetarian, US-Style, and Mediterranean Food Patterns (at 2,000 kcal/d) using national food prices adjusted for inflation. We also estimated the cost of existing dietary intakes in $/2,000 kcal/d for persons ≥2 years in the National Health and Nutrition Examination Survey (NHANES 2013–2014) using the same national food prices. The Nutrient Rich Food index (NRF9.3) was used as a measure of diet quality. Compared to existing diets, the USDA Healthy Food Patterns were higher in protein, fiber, vitamins, and minerals; were lower in solid fats, sugars, and sodium, and had higher diet quality scores. However, they also cost more. The cost of existing diets in NHANES was $5.47/d for Hispanics, $5.48/d for African-Americans, $5.94/d for Whites and $6.57/d for Asians. By contrast, the recommended US-Style Pattern cost $8.27/d, the Vegetarian Pattern cost $5.90/d, and the Mediterranean Pattern cost $8.73/d. Further, the Healthy Food Patterns featured some of the recommended food groups in unrealistic amounts. To ensure that the US Dietary Guidelines are both feasible and relevant to minority health, economic modeling studies should accompany government-issued dietary advice.

Highlights

The 2015–2020 edition of the Dietary Guidelines for Americans [1] prominently featured three Healthy Food Patterns as prime examples of eating healthy [1]
The Healthy Vegetarian Pattern, the Healthy US-Style Pattern, and the Healthy Mediterranean-Style Pattern were designed to show that the Dietary Guidelines could be met in a variety of ways [1]
The amounts of different food groups to be included in the US Department of Agriculture (USDA) Healthy Food Patterns were specified and limits were placed on the amounts of solid fats, added sugars, and alcohol [1]

Summary

Introduction

The 2015–2020 edition of the Dietary Guidelines for Americans [1] prominently featured three Healthy Food Patterns as prime examples of eating healthy [1]. The recommended foods were to be in their nutrient-rich forms, low in sodium and with no added sugar [1]. The recommended USDA Healthy Food Patterns are a prominent tool of federal food and nutrition policy. Their estimated monetary cost in relation to the existing US diets has yet to be addressed. Despite decades of dietary advice, the US diet continues to be high in calories, refined grains, added sugars, sodium, and saturated fat and remains low in whole grains, vegetables, and fruit [5, 6]. African Americans and Hispanics consumed lower quality diets as compared to non-Hispanic Whites [5, 6]

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Discussion

Conclusion