As the rates of obesity and related health problems, such as type
2 diabetes, continue to rise, the quality of our diets is being
increasingly scrutinized by health professionals in both the public
and private sectors. The diets of different sociodemographic groups
are of particular interest to public health officials because of
the disparities among these groups in terms of incidence of certain
diseases, like obesity.
With better knowledge of the dietary differences associated with
gender, education, income, race, and ethnicity, public health officials
can identify groups that are particularly vulnerable to poor health
and devise appropriate strategies.
Looking at average intakes of dietary components such as fats,
cholesterol, and calories across sociodemographic groups shows that
the richer, more educated segments of society have better diets,
on average, than the poorer and less educated groups. Similarly,
the quality of diets tends to increase with age. But assessing dietary
differences by comparing average intakes can be misleading. In fact,
for many nutrients and other dietary components, most groups meet
the intake levels recommended by health authorities. Comparing dietary
differences between groups at different intake levels—that
is, between the light, moderate, and heavy eaters in these groups—provides
a clearer perspective on disparities in diet quality.
High intakes of saturated fats tend to raise blood cholesterol,
a risk factor for heart disease. On average, men with less than
a high school education consume 2 grams more of saturated fat per
day than men with at least some college education. Because 2 grams
of saturated fat is about 6 percent of a 21-50 year old male’s
recommended daily limit of 32 grams, this difference is not so alarming.
What tips the balance is the difference in saturated fat intakes
between the heavy eaters in the two education groups. Among the
heavy eaters—those in the top 10 percent of intake levels (90th
percentile or higher)—men with less than a high school education
consume 7 grams or more additional saturated fat per day than do
men with some college education. For women, the average difference
does give a good indication of the difference in saturated fat intake
by education level across the range of intakes. After adjusting
for other socioeconomic characteristics, Black men and women consume
more cholesterol per day on average than White men and women. The
picture is more alarming at higher intake levels where the gap widens
for both men and women.
This is a sobering message for nutritionists, dietitians, and other
public health professionals. Judging disparities in diet quality
based on average intakes alone may be misleading. Many of the disparities
in the intakes of energy, fats, and cholesterol are more extreme
at the higher, unhealthful levels. Closing these gaps in dietary
quality may pose a greater challenge than we realize.
