Research
Adherence
Socioeconomic disparities exist in dietary improvements, with higher-income and higher-education individuals showing greater improvements in macronutrient composition and diet quality.
If you have limited resources, focus on the most impactful swaps: reducing added sugars and increasing whole grains. These changes are achievable and contribute to overall diet quality, even if progress is slower than for higher-income groups.
GoodSupportsHIGH confidence
Greater changes in low-quality carbohydrates and polyunsaturated fatty acids were observed among younger vs older individuals and among those with a higher vs lower level of education or income.
Why this rating
Based on the same large dataset, but subgroup analyses are exploratory.
Source
Trends in Dietary Carbohydrate, Protein, and Fat Intake and Diet Quality Among US Adults, 1999-2016
Zhilei Shan et al. · JAMA · 2019
DOI 10.1001/jama.2019.13771
cross_sectional · n=43996Cited 567×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- US adults significantly improved diet quality between 1999 and 2016 by decreasing low-quality carbohydrates (primarily added sugars) and increasing high-quality carbohydrates (primarily whole grains), plant protein, and polyunsaturated fats.Strong
- Despite improvements, US adults continue to consume disproportionately high energy from low-quality carbohydrates and saturated fat remains above recommended levels.Strong
Related findings · Adherence
- Regular physical activity (at least 150 minutes/week of moderate-intensity) reduces all-cause and cardiovascular mortality by 20-30% and lowers the risk of type 2 diabetes by 25-35%.Strong
- Increasing physical activity from a sedentary lifestyle to an active one in middle adulthood significantly reduces the risk of coronary events compared to remaining sedentary.Strong
- Resistance exercise is the only intervention capable of consistently restoring muscle function and strength in sarcopenia, partially overcoming age-related anabolic resistance.Strong
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