Researchers studied the healthfulness of foods from diﬀerent sources (schools, grocery stores, restaurants) in a group of 20,905 children and 39,757 adults in the period from 2003-2004 to 2017-2018. During this time, the proportion of children eating food of poor diet quality from schools decreased by more than half, from 56% to 24%. Most of these improvements occurred after 2010, in line with the Healthy Hunger Free Kids Act (which updated school nutrition standards) and were associated with kids eating more whole grains and less saturated fat, sugary drinks, and salt at schools. Additionally, the proportion of people eating food of poor diet quality from grocery stores decreased from 53% to 45% in kids and from 40% to 33% in adults, largely due to eating more whole grains and fewer sugary drinks. Food from restaurants tended to be less healthy, with very small improvements in diet quality over the study period. The researchers also found that school food improvements after 2010 were the most equitable improvements, as nutrition improved more evenly across racial and sociodemographic lines. On the other hand, most of the improvements in nutrition from grocery store or restaurant foods tended to be concentrated in high-income households.
JAMA Network Open. 2021 Apr 1;4(4):e215262. doi: 10.1001/jamanetworkopen.2021.5262. (Liu J et al.)