In today’s world of trendy diets, healthy eating movements and a keener eye by consumers on what they put into their bodies, one would imagine Americans’ eating habits would get high marks. However, despite some improvement in the overall American diet, a study published recently by researchers at the Harvard T.H. Chan School of Public Health and the Friedman School of Nutrition Science and Policy at Tufts University sees plenty of improvement still to make. Perhaps more concerning, their research showed healthy eating habits may be easier to accomplish for some Americans than others.

The study, published on September 24, 2019 in the Journal of the American Medical Association, covered dietary trends spanning nearly two decades and examined the diets of nearly 45,000 adults.

Some of the data found by the researchers should not be surprising given today’s food trends. Total carbohydrate intake dropped by about 2%, including a cutting back of low-quality carbs by 3%. Additionally, total fat intake increased by 1%. This lower-carb, higher-fat intake aligns well with such trendy diets and lifestyles as keto and paleo.

The researchers did note Americans are, by and large, still consuming too many trans fats, averaging about 12% of daily caloric intake; recommended daily intake is 10% of calories. Additionally, even with the overall decrease in carbohydrate intake, the research found low-quality carbs from refined grains, starchy vegetables and added sugars accounted for 42% of the typical American’s daily calories, while high-quality carbs, such as from whole grains and fruit, accounted for only 9%. Clearly, while Americans are decreasing their carb intake slightly, there is great room to improve the quality of carb consumption along with the quantity.

The research also touched on another vital piece of the dietary puzzle, whether intended or not. “Eating healthy” is something most people aspire to do, regardless of age, sex, social standing or otherwise. However, a dive into the data shows those with lower education and income may struggle to keep up with the financial demands of a healthier lifestyle.

According to the researchers, higher-income adults reduced their intake of low-quality carbs at double the rate of those living below the poverty line—a 4% decrease for the former group, just a 2% decrease for the latter. Overall, there was no meaningful improvement in diet seen for adults with less than a high school education or those living below the poverty line.

“Although there are some encouraging signs that the American diet improved slightly over time, we are still a long way from getting an ‘A’ on this report card. Our study tells us where we need to improve for the future,” said Fang Fang Zhang, nutrition epidemiologist at the Friedman School of Nutrition Science and Policy at Tufts University and co-senior author. “These findings also highlight the need for interventions to reduce socioeconomic differences in diet quality, so that all Americans can experience the health benefits of an improved diet.”

The good news is, the researchers believe improvement is possible for all demographics. For example, the researchers noted most protein consumed by Americans comes in the form of red and processed meats.

“Our research suggests that Americans have an opportunity to diversify their sources of protein to include more seafood, beans, soy products, nuts and seeds,” noted co-senior author Shilpa Bhupathiraju, research scientist at the Harvard T.H. Chan School of Public Health, also with Harvard Medical School and Brigham and Women’s Hospital. With today’s near-explosion of plant-based protein offerings, including at such far-reaching and accessible locations as Burger King, Carl’s Jr. and others, perhaps these higher-quality proteins will become more available for those most in need of healthier choices at affordable prices. And, as pointed out by Zhilei Shan, nutritional epidemiology fellow at the Harvard T.H. Chan School of Public Health and lead author of the study, “Because low-quality carbs are associated with disease risk, taking in higher-quality carbs could mean better health for Americans in the future.”

Americans are, slowly but surely, getting better about what they eat. But while small gains have been made, more improvement is needed. It is up to not only consumers, though; suppliers, brands, retailers and everyone else along the supply chain share a responsibility to make these better-for-you foods more accessible and affordable for all.

It’s been a few decades since the U.S. nutritional guidelines on fats were established, advising consumers to avoid or limit their intake. When marketers responded with low-fat options, many of these products added sugars to improve the flavor profile that the fats once provided. More recently, however, it seems consumers are moving on from their concerns about fat and taking a closer look at their sugar intake.

NPD’s Dieting Monitor asks adults which items they’re trying to cut down on or avoid completely in their diets. Fat has topped that list since the service was introduced. In 2014, for the first time, sugar narrowly edged out fats for the number-one spot on the list. This shift is largely due to less concern about the health impact of fats; 10 years ago, about 75% of adults wanted to avoid fat, but in 2018, that figure dropped to about 64%. Today, more than 70% of adults want to cut down on or avoid sugars in their diets.

This intention to avoid sugars is evident in some of the categories growing and declining in Americans’ food consumption. While cold cereal remains the top item consumed at breakfast thanks to its convenient preparation and clean-up, eggs command greater share of breakfasts today vs. a decade ago. While U.S. consumers are not quite consuming eggs at the same frequency as in the 1980s (when cholesterol was just starting to make its way into the vernacular), this increase at breakfast represents a shift away from simple carbohydrates and toward more protein-based items.

There is also a move away from sugars at snack time. Since 2006, NPD data have shown a slow but steady decline in sweet snack food consumption, which includes candy bars, donuts and chocolate candy. At the same time, more consumers now reach for products such as protein bars, fresh fruit and yogurt. And consumption of meat snacks among adults has grown as they provide consumers the “sweet” spot they seek—low in sugars, high in protein, convenient, tasty.

One might conclude consumers want it all—their collective sweet tooth satisfied while avoiding the sugar at the same time—and therefore sugars should be replaced with alternative sweeteners. That, however, will take some time and education for consumers. Even for the natural low-calorie sweetener stevia, fewer than 40% of U.S. adults are or would consider using it, NPD data show. While that’s higher than artificial sweeteners such as aspartame or saccharine (26% and 22%, respectively), it still shows a resistance to sugar substitutes. Use of stevia and other natural low-calorie sweeteners has been rising slowly over the last decade, however, indicating consumers are slowly accepting these options as viable substitutions while artificial sweeteners have been declining.

And using natural ingredients seems to be the nexus of consumer demands even when it’s time to indulge and helps to explain why sugar is still preferred despite the desire to remove it from the diet. Sugar, regardless of its demonization by consumers, is natural, plant-based and makes foods taste good. Providing sweet foods is a tough needle to thread today because while there might be an ingredient that consumers are trying to avoid, they still want it when they give themselves the permission to indulge. They would rather have the sugar, which might add pounds to their waistlines, versus an ingredient that is unnatural.

Of course, sweet foods won’t entirely be a thing of the past. After all, there’s a reason consumers still eat ice cream, chocolate and confections—the taste. However, it seems consumers are reserving them for specific times and occasions rather than considering them everyday options. Consumers are more likely to consume sweet snack foods toward the end of the day when they’re looking for a treat or a reward for themselves, such as after a long day at work. Marketers of sweetened foods or beverages should examine whether it makes sense to find ways to lower their products’ sugar content or communicate to consumers about being the perfect solution for when they are more open to consuming sweet products.

The NPD Group continuously monitors shifts in consumption patterns, arming the industry with input for fact-based decisions about where to focus their long-term strategies. To learn more about the topics discussed here, contact Darren Seifer at [email protected]

 

Sugar and sweet foods are part of everyday life for many people. And yet, excess sugar and calories contribute to the detrimental effects of chronic conditions like obesity and type 2 diabetes, which take a substantial toll on individuals, communities and our health care system. As we confront the realities of how diet impacts health, a broad swath of the U.S. population is making efforts to improve their daily food choices.

By tracking consumer views on dietary trends and food choices in the annual Food & Health Survey, the International Food Information Council (IFIC) Foundation has documented public opinion shifts on dietary trends, purchasing drivers and consumer perceptions around sugar and sugar alternatives.

The 2019 iteration of the Survey indicated that 3 out of 4 respondents believe they’re following a better diet than they did 10 years ago, and the number one way they say they’ve changed their diet is by limiting sugar intake. In fact, 80% of respondents state that they’re trying to limit or avoid sugars, with the top reported sugar reduction strategy being drinking water instead of caloric drinks and eliminating certain foods and beverages from their diet. A smaller percentage—around 20%—claim they are now using low-calorie sweeteners instead of sugar, switching from full-calorie drinks to low- and no-calorie options, or choosing sugar-free options when available. All this is to say that people are trying to consume less sugar through a variety of different means, and this effort seems to be paying off; the 2013-2014 National Health and Nutrition Examination Survey (NHANES) indicates that consumption of added sugars as a percentage of total calories has decreased over the past two decades, although mean energy intake from added sugars still remains above national targets.

With a few exceptions, the types of sugars consumed are nutritionally equivalent—each provides about four calories per gram. Nonetheless, certain caloric sweeteners have had the luxury of being thought of as “healthier” than table sugar, also known as sucrose. This healthy halo extends to calorie-containing “natural” sweeteners like agave, honey, maple syrup and coconut sugar, which may provide trace amounts of nutrients like vitamins and minerals. Unfortunately, the beneficial components contained in these foods are far outweighed by the calories and grams of sugar they provide.

One exception to this is allulose, a rare, naturally-occurring sugar that has gained traction in recent years after achieving Generally Recognized As Safe (GRAS) status in three separate notifications in 2012, 2014 and 2017. In April 2019, FDA exempted allulose from “Total Sugars” and/or “Added Sugars” on the Nutrition Facts label, instead allowing it to be listed under the grams of “Total Carbohydrate.” This exemption is due to its lower caloric value and impact on blood sugar and dental caries compared to added sugars.

Sugar alcohols, a type of carbohydrate with a chemical structure that partially resembles sugar and partially resembles alcohol, provide another option for calorie and sugar reduction. They are incompletely absorbed and metabolized by the body, so they consequently contribute fewer calories than most sugars. However, total daily intake of some types of sugar alcohols, like sorbitol and mannitol, should be limited due to their potential to cause gastrointestinal discomfort and laxative effects.

Low- or no-calorie sweeteners (LNCS) provide yet another alternative to caloric sweeteners, lowering added sugar intake while still providing the satisfaction of enjoying something sweet without the potential side effects associated with some sugar alcohols. When added to foods and beverages, they reduce or completely eliminate the calories and sugars and do not cause an increase in blood sugar. The 2019 Food & Health Survey indicated that 1 in 3 people primarily use LNCS to sweeten foods, as opposed to sugar or not using any type of sweetener. Primary reasons for choosing LNCS include a desire to consume less sugar, to lose weight, consume fewer calories and manage diabetes or blood sugar.

In the U.S., there are several “high-intensity” (meaning that they are many times sweeter than sugar) LNCS permitted for use: aspartame, sucralose, acesulfame potassium (ace-K), steviol glycosides (often referred to as stevia sweeteners), monk fruit extracts, saccharin, neotame and advantame. Two of these, stevia and monk fruit sweeteners, are derived from plant sources and are often thought of as “natural” sweeteners. With 38 percent of Food & Health Survey respondents indicating that they buy products because they are advertised as “natural” on the label, this distinction may influence purchasing decisions for calorie- and sugar-conscious consumers who are still seeking sweetness.

Despite their lack of calories and effect on blood sugar, some consumers show skepticism over the healthfulness and safety of LNCS—even those thought of as “natural”. Over 70 percent of Food & Health Survey respondents who do not use LNCS to sweeten a food or beverage state that they abstain because they think LNCS are unhealthy, and nearly 3 in 10 say they have been advised to avoid them by a health care professional. However, these concerns are not borne out by safety regulations in the U.S. and around the world – the U.S. Food and Drug Administration, European Food Safety Authority and other international health agencies have repeatedly reviewed and emphasized the safety of LNCS currently on the market.

While diet trends may come and go, IFIC Foundation consumer research indicates that an interest and effort toward lowering sugar intake isn’t just a passing fad. Sugar intake data from NHANES support this trend. The wide spectrum of available sugar alternatives and reduced-sugar products on the market today gives people the opportunity to choose what best fits their needs, providing them with the ability to control their sugar intake without having to sacrifice sweetness. Such options fill a critical need that shows no sign of slowing. Accordingly, the IFIC Foundation’s focus on addressing consumer questions and knowledge gaps fills a critical need for effective communications around sugars and alternatives that prioritizes evidence over anecdote.

Learn more about natural sweeteners from Ali and others during the “The Shift from Sugar to Natural Sweeteners” session on Saturday, Oct. 19 at 8:30am, at SupplySide West in Las Vegas.

Ali Webster, Ph.D., RD, is the associate director for Nutrition Communications at the International Food Information Council Foundation. In this role, she is responsible for developing and managing nutrition science-focused communication programs for consumers and health professionals. Webster holds a doctorate in nutrition and a bachelor’s in nutrition science, both from the University of Minnesota, and completed her dietetic internship at the University of Minnesota Medical Center.