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 the United States population. Objective To examine alignment of intakes of food groups and energy from solid fats, added sugars, and alcohol with the 2005 Dietary Guidelines and MyPyramid, by family income and race/ethnicity. Design Data from the National Health and Nutrition Examination Survey (NHANES), a cross-sectional nationally-representative survey, for 2001-2004. Participants/setting Persons aged 2 years and older 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 (NHW), non-Hispanic Black (NHB), and Mexican-American (MA)). Statistical analyses performed The National Cancer Institute (NCI) 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 NHB. Marked differences were observed for milk—15% of NHB children met the minimum recommendations compared to 42% of NHW children and 35% of MA children; a similar pattern was evident for adults. One in five Mexican American adults met the dry beans and peas recommendations compared to approximately 2% of NHW and NHB. 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 NHB, are especially poor in relation to dietary recommendations, supporting the need for comprehensive strategies to enable healthier dietary intake patterns.