Improvements In US Diet Helped Reduce Disease Burden And Lower Premature Deaths, 1999-2012; Overall Diet Remains Poor

Health Aff (Millwood). 2015 Nov;34(11):1916-22. doi: 10.1377/hlthaff.2015.0640.


Evaluation of time trends in dietary quality and their relation to disease burden provides essential feedback for policy making. We used an index titled the Alternate Healthy Eating Index 2010 to evaluate trends in dietary quality among 33,885 US adults. From 1999 to 2012 the index increased from 39.9 to 48.2 (perfect score = 110). Gaps in performance on the index across socioeconomic groups persisted or widened. Using data relating index scores to health outcomes in two large cohorts, we estimated that the improvements in dietary quality from 1999 to 2012 prevented 1.1 million premature deaths. Also, this improvement in diet quality resulted in 8.6 percent fewer cardiovascular disease cases, 1.3 percent fewer cancer cases, and 12.6 percent fewer type 2 diabetes cases. Although the steady improvement in dietary quality likely accounted for substantial reductions in disease burden from 1999 to 2012, overall dietary quality in the United States remains poor. Policy initiatives are needed to ensure further improvements.

Keywords: Disparities; Epidemiology; Legal/Regulatory Issues; Politics; Public Health.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / mortality
  • Cost of Illness*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / mortality
  • Diet, Healthy*
  • Female
  • Health Surveys
  • Humans
  • Male
  • Mortality, Premature / trends*
  • Neoplasms / epidemiology
  • Neoplasms / mortality
  • United States / epidemiology