These numbers are taken directly from “food availability” data published online by the US Department of Agriculture Economic Research Service. This data provides the most objective measurement of the foods that Americans consume on an annual basis.
After looking at this chart, it’s no wonder Americans are experiencing an epidemic of obesity, diabetes and other diseases directly related to poor nutrition! Fruits and vegetables combined make only ONE APPEARANCE in the top ten foods, but added sugar makes the list TWICE! The standard American diet may as well be renamed the “Meat, wheat, dairy, sugar and oil diet.” Even though we haven’t discussed dairy, beef, pork, poultry or oils in prior posts, I think almost everyone would agree that consuming these ingredients in the amounts shown is certainly not healthy.
Let’s focus on the foods we’ve already discussed in prior blog posts, like added sugar and refined wheat flour, aka top ten ingredients #2, #3 and #9. As a reminder, these foods are essentially devoid of any meaningful nutritional value, they pack a lot of calories and they don’t make you feel full. YET WE EAT 225LBS OF THESE FOODS EVERY SINGLE YEAR! It’s a miracle that the human body can withstand such an insult and keep functioning. Is it any surprise that when someone “cuts out carbs” they lose weight? They’re eliminating roughly 225lbs/year of empty calories…OF COURSE THEY WILL LOSE WEIGHT! Avoiding added sugar and refined flour are cornerstones of any evidence based diet AND most fad diets and probably the only reason why any fad diets work. No diet, healthy or unhealthy, suggests eating added sugars or refined flours. When patients come to me saying that they started a low or no carb diet like Paleo or Ketogenic or Atkins, I’m usually excited for them. They’ve committed to a dietary change, many have lost weight, and they’ve successfully eliminated two very unhealthy foods, added sugars and refined flour. But I also mention that if they substituted other unhealthy foods for added sugar and refined flour, like more processed red meats, then there is a chance that their health may not improve despite their weight loss. If, on the other hand, their new diet includes eating more whole plant-based foods, they are making huge strides towards a healthier lifestyle. Even though the fad diets may not be a healthy option for them long-term, it can be a good stepping stone to healthier long-term eating habits.
If fad diets can lead to weight loss mainly by cutting out three of the top 10 ingredients of the standard American diet, imagine what could happen if all of the top 10 ingredients were healthy. Science is showing us that when people make all of their top 10 ingredients healthy, even for a short period of time, miracles of modern medicine can occur. For example, people with severe heart disease can get rid of chronic chest pain, or people with diabetes mellitus on medications for decades can normalize their blood sugars despite stopping their medications. These types of changes in chronic medical conditions may not occur for everyone, but they are definitely possible. They illustrate the dynamic nature of the human body, especially in response to what we feed it. Profound changes are possible in a relatively short period of time.
“Whoa! I didn’t realize that diet alone could reverse certain chronic diseases! How do you recommend changing the top ten ingredients in the standard American diet?”
When it comes to your top 10, choose the tried and true minimally processed foods that basically everyone can agree are healthy… fruits, vegetables, legumes, intact whole grains, nuts, seeds, spices and herbs. Use small amounts of everything else to make those healthy foods taste good. If you don’t need to use those less healthy ingredients, then don’t. This is what NOT to do. Don’t replace added sugar with lots of artificial sweeteners or stevia. Don’t replace conventionally raised beef with meat alternatives including 15 ingredients that you can’t pronounce. Don’t replace butter with a margarine that is loaded with trans fats. Oh wait…America already made that mistake 50 years ago. Americans keep falling for similar mistakes over and over again! We are constantly buying “newer, better, healthier” foods and supplements that have zero evidence to support their health claims. Don’t fall for those tricks. A food isn’t healthy just because it replaces an unhealthy food.
“Wow Fill, that makes a lot of sense. I need to focus on what I’m actually eating, not just what I’m NOT eating. How did America get itself into this mess?”
Although most people want to eat healthy foods, they don’t want to do so at the expense of taste, cost or convenience. So food companies prioritize taste, cost and convenience (not health) to cater to the desires of the American people. As a result, the vast majority of food that we see every day at grocery stores and restaurants is unhealthy. We get inundated with unhealthy food commercials on our TVs, computers and phones. We pass by several fast food joints every time we drive our cars. When someone decides to break the mold and eat healthier, they have to do so while they are surrounded by a constant barrage of unhealthy food options, with unclear guidance on which foods are actually healthy. This is why the top 10 ingredients of the standard American diet are unhealthy. Americans don’t know who to trust about nutrition. So they substitute coconut oil for canola oil, or rice syrup instead of high fructose corn syrup. Instead of making any real progress towards eating healthier, one unhealthy food is substituted for another.
“That’s so true Fill. I fell for the lure of the trendy acai berry extracts and agave syrups because they seemed like simpler solutions than changing my entire diet. Who do you suggest I trust for accurate nutrition information, aside from this blog?”
Trust someone who has no financial incentive to provide you with advice about food. Trust someone who utilizes evidence based medicine. Trust someone with experience. Ideally, this should be a team of medical providers, like a physician, registered dietitian and nurse who are all well trained in providing nutrition guidance. In addition, a list of reputable nutrition resources can be found in the evidence based medicine tab of this website.
“Thanks for the references. Speaking of which, can you briefly explain the USDA food availability data that was referenced in the first chart?”
The technical definition of food availability per the USDA, is the “amount of food available for human consumption in the United States.” The term ‘available’ is used because we don’t eat all of the food in our food supply. For example, spoiled milk or disfigured peaches are ‘available’ food, but they may be thrown away instead of consumed.
Let’s use the following graphic to understand how the USDA came up with its food availability data. We’ll use the actual data for refined cane and beet sugar (top ten ingredient #3) from 2016.
https://www.nap.edu/read/18978/chapter/2#2
Supply
The U.S. started the year 2016 with 3,960,000 tons of refined cane and beet sugar in beginning stocks, or starting inventory.
U.S. farmers produced 9,137,000 tons of refined cane and beet sugar.
The U.S. imported 3,584,000 tons of refined cane and beet sugar.
Use
The U.S. exported 243,000 tons of refined cane and beet sugar.
The U.S. used 26,000 tons of refined cane and beet sugar for non-food uses (like livestock feed and ethanol production).
The U.S. ended the year with 4,338,000 tons of refined cane and beet sugar in ending stocks, or ending inventory.
| Refined Cane & Beet Sugar Food Availability for 2016 | ||||||
| Supply | Use | |||||
| Beginning Stocks | Total annual Production | Imports | Ending Stocks | Exports | Nonfood Uses | |
| Short Tons |
3,960,000 |
9,137,000 |
3,584,000 |
4,338,000 |
243,000 |
26,000 |
| Short tons | 16,681,000 | 4,607,000 | ||||
| Supply – Use
(short tons) |
12,074,000* | |||||
| Lbs | 22,505,400,000 | |||||
| Lbs/person/year** | 69.6 | |||||
1 short ton = 2,000lbs
*The USDA makes some minor additional adjustments in the inventory, so this isn’t quite the exact number. It’s off by around 0.2-0.3%. They also have a varying conversion from tons to pounds for an unknown reason. In this instance it’s about 6.5% off from the usual conversion of (short) tons to pounds of 1:2,000
**Based on total US population of 323 million people
At the end of the day, an estimated 22,505,400,000lbs of refined cane and beet sugar were sold in 2016 to American consumers or to manufacturers, restaurants, and other American businesses that sell it to consumers in some form. When you divide that number by the roughly 323 million people that live in the United States, it equates to 69.6lbs of refined cane and beet sugar made available to each human being in the U.S. for the year 2016. This is called the “per capita” estimate. In 2015, it was 69.0lbs/person/year. In 2014, it was 68.4lbs/person/year. As you can see, American eating habits don’t change quickly. And since sugar doesn’t spoil very easily (it’s actually a good preservative), these estimates are likely pretty accurate.
“Okay Fill, that’s a lot of math, but it makes sense to me. I’m looking at the top 10 ingredients chart again and I see some limitations to it. The chart is broken down by individual foods. There are far more varieties of fruits and vegetables than commonly consumed meats. If you add up all the fruits or vegetables, it might add up to more than all the meats. How do the total food groups compare?”
Great question. Let’s take a look at all 200 individual foods grouped together into categories.
USDA Food Availability Data for 2016 (or last reported date), by food groups
At first glance, this doesn’t look too bad. Everything on the right half of the graph is healthy (fruits, veggies, grains, legumes and nuts) while everything on the left half of the graph is either healthy in very small amounts, health neutral or clearly unhealthy. But there are a few caveats…
- Food waste
This data doesn’t account for food spoilage and waste. Thus, actual intake for fresh produce, dairy, meats and eggs is likely overestimated, whereas shelf stable or freezable items like grains, legumes, nuts, caloric sweeteners, added fats and fruit juices are likely more accurate. The USDA has “Loss-adjusted” food availability data to account for things like food spoilage and waste, but the USDA states that their estimates aren’t very accurate yet.
- Potatoes
A significant portion of total vegetables includes potatoes that are turned into French fries and chips.
- Grains
Almost all of the grains listed above have been ground into flour, the least healthy form of grains. Even worse, roughly 85% of these grain flours are refined (based on data from a NHANES survey referenced below, not the USDA dataset). Intact whole grains like quinoa, farro, and wild rice are not included in the food availability dataset for unknown reasons.
- Processing
Many of the ingredients above are processed further by restaurants, food companies or individuals at home. For example, fresh vegetables, fish and nuts may be reported to the USDA in their whole form, but later a food manufacturer may combine those ingredients with oil, salt, sugar, preservatives or additional chemicals into a processed, frozen meal. On the other hand, processed ingredients like fruit juice, added fats, caloric sweeteners and flour can’t be “unprocessed.”
- Dairy
Dairy is the category most susceptible to inaccuracy, due to potentially counting milk once and a dairy product made from that same milk a second time (e.g. milk sold by a farm to a food manufacturer, who then produces sour cream, which is counted again).
After taking all of these things into account, suddenly the “healthy” food section has slimmed down to a minority of our overall food intake. In other words, the majority of the standard American diet is unhealthy. As a result, the majority of the American population suffers from symptoms or diseases associated with poor nutrition. Just like a car won’t run well on poor quality gasoline, the human body doesn’t run well on a constant intake of unhealthy food. Sometimes, accumulating several chronic medical diseases or feeling terrible all the time motivates individuals to make drastic dietary changes. And for some of those people, the body has shown a remarkable ability to heal itself. It’s never too late to give the body a chance to heal. I believe the best way to do this long-term is by filling the top ten ingredient list in your life with proven healthy foods. If your diet resembles anything similar to the standard American diet (which is true for the vast majority of Americans), there is a lot of room for improvement. Limiting added sugars and refined grains while adding more fruits, vegetables, legumes, intact whole grains, nuts, seeds, spices and herbs is a great place to start.
Food availability data from USDA ERS, available to the public
https://www.ers.usda.gov/data-products/food-availability-per-capita-data-system/
FAQs about USDA food availability data
https://www.ers.usda.gov/data-products/food-availability-per-capita-data-system/faqs/
Estimate of whole grain consumption as percentage of all grain consumption
https://www.ers.usda.gov/amber-waves/2005/april/americans-whole-grain-consumption-below-guidelines/
Fill, M.D. 