How Can We Improve the American Diet?

The typical  American eating pattern is a hodgepodge of contradictions. When it comes to food and health, we want it all. Americans want the convenience to eat what we want, when we want it without harming the environment or our bodies. We want great health with less effort. Unfortunately, something’s gotta give!Let’s look at some of the hot trends when it comes to food and health.Meal Delivery ServicesThe number of meal delivery services has exploded since the humble beginnings of Blue Apron ten years ago. There are at least 15 different services available to consumers and profits from such services are expected to grow to over 13 billion dollars this year. Some services like Pete’s Paleo and Factor75 offer dietary restrictions such as gluten-free, paleo and keto-friendly options. 1Meal delivery services have reinvigorated our desire to cook at home. They take away the need to find recipes, shop, chop, prep and cook meals. Not only do they provide chef-designed meals to assemble, many have moved to a heat and eat model. This makes it even easier to get lunch or dinner on the table. Are they any better than meals you’d make at home or frozen meals you’d get at the store?For one thing, the meals arrive in various types of packaging. Several companies have moved towards a greener “compostable” or recycled cardboard for their packaged meals, but may still use lots of paper and plastic when tiny amounts of ingredients are individually bundled. Perhaps not the greatest for our landfills.With meal kits that you assemble, fat and sodium can be controlled by using more or less of an ingredient. The heat and eat options have less ability to be modified. A review of several systems indicated that sodium content in these meals varies from 600 mg to up to 1500 mg per meal. 2 So much for Dietary Guidelines!Fad DietsJanuary is the worst time of year for fad diets. Everyone wants a quick fix from their holiday hangover and a jump start to the new year. Fad diets are often recycled trends from years past.High protein, low carb diets remain the frontrunner when it comes to fad diets. Avoiding high sugar desserts and processed carbs makes total sense for weight loss and general health. These calorie-laden foods don’t provide any nutrition and excess intake may lead to weight gain over time. Highly refined foods have also been associated with diabetes and heart disease.3However, avoiding fruit, beans, whole grains and most dairy products limits all of the beneficial nutrients from these foods. Fiber, vitamins, minerals, antioxidants, phytochemicals and taste are missing when they’re left behind. A steady diet of bacon, eggs, sausage and low carb vegetables can’t be great for your heart or gut microbiome, though short term studies (6 months or less) don’t show detrimental effects.4Research has been mixed, finding some benefits including weight loss and reversal of diabetes with low-carb diets, while the risk of heart disease and other chronic conditions may go up. 5 There’s no shortage of bars, drinks, snacks and beverages to accommodate this diet pattern.Functional IngredientsSpeaking of bars, drinks and snacks, welcome to our obsession with functional ingredients. Functional ingredients are defined as ingredients or compounds added to foods to provide some type of health benefit.Examples of functional ingredients include protein, pre- and pro-biotics, and “healthy fats”. We can likely get most of these ingredients naturally in the everyday foods we eat.Americans already eat plenty of protein, yet consumers may see it as a health benefit when trying to manage appetite, lose weight or build muscle. The RDA is .36 grams of protein per pound of body weight. This equates to 63 grams per day for a 175 lb. person, which can easily be obtained with a few servings of chicken or fish, dairy products, beans or legumes and certain grains like quinoa or farro.Protein bars and shakes offer convenient forms of protein for busy people, but may also be accompanied by sugar, artificial sweeteners, sodium or saturated fat.Probiotics or PrebioticsPrebiotics are the “food” for probiotics- the good bacteria that makes up your microbiome in your large intestine. Prebiotic fibers include inulin and chicory root. You may see them in granola bars, cereal and other processed foods. These additives may cause GI upset (gas/bloating) in people that are sensitive to fiber (i.e those with IBS).Prebiotics are found naturally in artichokes, bananas, garlic, onions, soybeans and whole grains while probiotics are in yogurt, kefir, sauerkraut, miso and other fermented foods. Eating a diet high in fiber from a variety of sources in addition to foods containing probiotics will help maintain a healthy gut microbiome. 6Healthy fats- Omega-3-fatty acids and MUFAS (monounsaturated fatty acids) from avocado and olive oil may aid in reducing inflammation associated with chronic disease. But why not just eat foods that contain these fats? Salmon, walnuts and ground flaxseed provide omega-3-fatty acids while canola, olive, olive oil, avocados and avocado oil provide monounsaturated fats. These are readily available in our food system and likely less expensive than foods fortified with them.Strategies for Improvement:

1. Cook at home more often. If you're using a meal delivery service, check out the nutrition information on the company’s websites for what you're getting. Pay special attention to fat and sodium.
2. Gradually change your diet for long term weight loss success. Start with reducing the added sugars you eat. Once you're feeling good about that change, move on to cutting out alcohol if you drink. Add bouts of exercise throughout the day -- like getting up to walk for 5 minutes every hour.
3. Eat more plant-based protein including beans, legumes and whole grains. This reduces fat in your diet and boosts vitamin, mineral and fiber intake.
4. Question the value of functional ingredients. Can you get the same nutrients through regular food? Is the higher price tag really worth it?
5. Aim to get food in food versus bars, shakes, and meal replacements. Cups of yogurt, low-fat string cheese, nuts and seeds, apples, bananas and grapes are some simple foods to grab and go if you’re in a hurry. They’re much cheaper with less unwanted ingredients like artificial colors, sweeteners and saturated fat.

By Lisa Andrews, MEd, RD, LDReferences:

1. Food delivery industry in the U.S. - statistics & facts | Statista
2. The Healthiest Meal Delivery Kits: A Nutritional Study and Analysis (Updated 2020) (reviewmeals.com)
3. Medina-Remón A, Kirwan R, Lamuela-Raventós RM, Estruch R. Dietary patterns and the risk of obesity, type 2 diabetes mellitus, cardiovascular diseases, asthma, and neurodegenerative diseases. Crit Rev Food Sci Nutr. 2018 Jan 22;58(2):262-296.
4. Tinguely D, Gross J, Kosinski C. Efficacy of Ketogenic Diets on Type 2 Diabetes: a Systematic Review. Curr Diab Rep. 2021 Aug 27;21(9):32
5. Seidelmann SB, Claggett B, Cheng S, Henglin M, Shah A, Steffen LM, Folsom AR, Rimm EB, Willett WC, Solomon SD. Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis. Lancet Public Health. 2018 Sep;3(9):e419-e428.
6. Tanes C, Bittinger K, Gao Y, Friedman ES, Nessel L, Paladhi UR, Chau L, Panfen E, Fischbach MA, Braun J, Xavier RJ, Clish CB, Li H, Bushman FD, Lewis JD, Wu GD. Role of dietary fiber in the recovery of the human gut microbiome and its metabolome. Cell Host Microbe. 2021 Mar 10;29(3):394-407.e5

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