Income and race/ethnicity are associated with adherence to food-based dietary guidance among US adults and children

Abstract

Background: Income and race/ethnicity are associated with differences in dietary intakes that may contribute to health disparities among members of the US population.

Objective: To examine alignment of intakes of food groups and energy from solid fats, added sugars, and alcohol with the 2005 Dietary Guidelines for Americans and MyPyramid, by family income and race/ethnicity.

Design: Data from the National Health and Nutrition Examination Survey, a cross-sectional, nationally representative survey, for 2001-2004.

Participants/setting: Persons aged ≥2 years for whom reliable dietary intake data were available (n=16,338) were categorized by income (lowest, middle, and highest) and race/ethnicity (non-Hispanic white, non-Hispanic black, and Mexican American).

Statistical analyses performed: The National Cancer Institute method was used to estimate the proportions of adults and children in each income and race/ethnic group whose usual intakes met the recommendations.

Results: Higher income was associated with greater adherence to recommendations for most food groups; the proportions meeting minimum recommendations among adults in the highest income group were double that observed for the lowest income group for total vegetables, milk, and oils. Fewer differences by income were apparent among children. Among the race/ethnic groups, the proportions meeting recommendations were generally lowest among non-Hispanic blacks. Marked differences were observed for milk-15% of non-Hispanic black children met the minimum recommendations compared with 42% of non-Hispanic white children and 35% of Mexican-American children; a similar pattern was evident for adults. One in five Mexican-American adults met the dry beans and peas recommendations compared with approximately 2% of non-Hispanic whites and non-Hispanic blacks. Most adults and children consumed excess energy from solid fats and added sugars irrespective of income and race/ethnicity.

Conclusions: The diets of some subpopulations, particularly individuals in lower-income households and non-Hispanic blacks, are especially poor in relation to dietary recommendations, supporting the need for comprehensive strategies to enable healthier dietary intake patterns.