2021 Food and Health Survey: How Much Have We Learned About Healthy Eating?

By April 6, 2021 No Comments
2021 Food and Health Survey: How Much Have We Learned About Healthy Eating?

When it comes to good health, you have a lot more control than you may think. According to a recent study led by Harvard T.H. Chan School of Public Health, maintaining just five healthy habits at middle-age may increase the number of years you live free of today’s most common debilitating diseases, including diabetes, heart disease, and cancer:

  1. Eating a healthy diet
  2. Exercising regularly
  3. Keeping a healthy body weight
  4. Not drinking too much alcohol
  5. Not smoking

It’s no surprise that “eating a healthy diet” was number-one on the list. A mountain of research shows that eating wholesome, nutritious foods can decrease the risk of disease. Indeed, according to a 2020 study of over 79,000 men and women, the types of foods we eat are more important to health than even our body mass index (BMI).

The question is, are Americans getting the message? We wanted to find out, so we surveyed 600 individuals about their health and food choices. We were excited to see that the overall results showed a positive trend, but there remain some areas where we can do better.

You’ll learn:

Consumers are Careful to Read Food Labels

consumers are careful to read food labels

The U.S. Department of Agriculture (USDA) reported a few years ago that American adults were choosing healthier foods and consuming healthier diets. Nearly half of adults surveyed were using the Nutrition Facts Panel on food labels most or all of the time when making food choices.

The individuals in our survey did even better than that. Over a third (34 percent) reported reading packaging and nutrition labels for every food item purchased, while another nearly 33 percent reported that they read packaging and nutrition labels when they weren’t sure if a food item met their requirements.

Taken together, that’s 67 percent, or over two-thirds of respondents are reading nutrition labels most or all of the time. Only 7.33 percent never read the food and nutrition labels at all.

Surprisingly, more men said they always read food labels than women (42.34 percent vs 28.13 percent). We don’t know why this might be, but it’s possible that women may be more familiar with their regular food purchases and therefore not need to check them every time. Women were more likely to read the labels if they weren’t sure about the product.

Consumers are Looking for “Natural” Foods

When looking at food labels, in addition to checking the nutrition facts, consumers were most likely to check to see if the food was said to be “natural.” Overall, 38.85 percent of respondents said that they looked for the words “all-natural” or “certified naturally grown” on food labels, while about 37.23 percent looking for the terms “organic” or “certified USDA organic.”

Though it’s heartening to see that consumers are concerned about eating more natural food items, their responses to this question reveal a potential source of confusion.

The word “natural” is not regulated by the food industry like “organic” is. So far, the US Food and Drug Administration (FDA) has not established a formal definition for the term “natural” in food labeling, which means that manufacturers can use the word on their product labels when the products may not be that natural after all.

The animal rights group Animal Legal Defense Fund filed a lawsuit a couple of years ago against meat company Hormel, claiming the company engaged in potentially misleading advertising of their animal products.

Specifically, the plaintiffs claimed the Hormel Natural Choice label led consumers to believe that its meat products didn’t contain antibiotics or hormones when, in fact, they do. The court dismissed the case, but it brought to light the fact that Hormel Natural Choice uses the same hormone- and antibiotic-treated animals used to produce other Hormel meat choices like Spam.

Our survey respondents aren’t the only ones who were fooled. According to a Consumer Reports survey, 59 percent of those polled checked for a “natural” label when shopping for food.

Look for the Term “Organic” Instead

When it comes to seeking out natural foods, younger shoppers were a little savvier about the natural-organic divide than older shoppers. Those between the ages of 18 and 44 were more likely to look for “organic” before “natural,” while those 45 and older looked for “natural” items first.

Those younger shoppers have got it down, as the term “organic,” particularly the phrase “USDA certified organic,” is highly regulated and can help consumers to make healthier food choices. Products labeled as “100% organic” must contain only organically produced ingredients and processing aids, including water and salt. No other ingredients or additives are permitted.

Products labeled “organic” must contain at least 95 percent organically produced ingredients (excluding water and salt), and any remaining ingredients must appear on the USDA National Organic Program (NOP) list of allowed substances.

Products containing either of these labels must be grown, handled, and processed without the use of pesticides or other synthetic chemicals, irradiation, fertilizers made of synthetic ingredients, or bioengineering.

Finally, products labeled as “made with organic [blank]” must contain at least 70 percent organic ingredients. Those that contain less than that cannot use the word “organic” anywhere on the principal display panel, but they can identify specific ingredients that are organically produced on the ingredients list.

Consumers are Eating More Fruits and Vegetables

consumers are eating more fruits and vegetablesCountless studies have found that sufficient intake of fruits and vegetables (F&V) is associated with a reduced risk of chronic disease and improved body weight management. The 2015-2020 U.S. Dietary Guidelines for Americans recommends that F&V constitute one-half of the plate at each meal for this reason.

Unfortunately, most of us aren’t getting enough quite yet. The U.S. Centers for Disease Control and Prevention (CDC) reported in 2017 that just one in 10 adults met the federal fruit and vegetable recommendations, which are to eat at least 1.5-2 cups per day of fruit and 2-3 cups per day of vegetables.

Our survey showed that consumers are trying to do better. When asked how their eating habits had changed compared to 10 years ago, nearly half of the respondents (47.67 percent) said that they were eating more fruits and vegetables. When asked what items they tried to consume regularly or more often, over half said the same—fruits and vegetables.

Indeed, this change of eating more fruits and vegetables held across all age groups and income levels.

Americans Eat Too Much Sugar

americans eat too much sugar

Several recent studies have shown that we Americans are eating too much sugar, and it’s not good for us. The American Heart Association (AHA) states that American adults consume an average of 77 grams of sugar per day, more than three times the recommended amount for women. (The AHA recommends no more than 9 teaspoons or 36 grams per day for men, and no more than 6 teaspoons or 25 grams per day for women.)

Eating all that sugar increases the risk for weight gain and obesity, type 2 diabetes, and heart disease, according to the CDC. In a 2014 study published in JAMA Internal Medicine, researchers found an association between a high-sugar diet and a greater risk of dying from heart disease.

People who got 17-21 percent of their total calories from added sugars had a 38 percent higher risk of dying from cardiovascular disease compared to those who consumed only 8 percent of their calories as added sugar.

Consumers are getting the message and they’re trying to cut back. When asked how their eating habits had changed compared to 10 years ago, cutting back on sugar and/or unhealthy fats came in a close second to eating more fruits and vegetables across all age groups. Our respondents were also savvy enough to know that sugar was the likely culprit in weight gain, over carbohydrates or fats.

Consumers are Trying to Cut Back on Sugar

The AHA states that 77 percent of Americans are striving for less sugar in their diets. As to how they’re doing that, we got some answers in our survey.

Overall, respondents said they were trying to cut back on sugar-sweetened beverages to curb their sugar intake. Over two-thirds (64.67 percent) stated they were drinking water instead of soda, fruit juice, or other high-calorie (and high-sugar) beverages.

Almost half (42 percent) were also eliminating specific foods and beverages from their diet to cut back on sugar. Other popular methods included:

  • Reducing the consumption of carbohydrates
  • No longer adding sugar to foods or beverages
  • Reading nutrition labels to purchase foods with less sugar

These results held across both genders and all age groups, though over a quarter (26.34 percent) of respondents 45 and older were also likely to consume smaller portion sizes in their efforts to limit sugar intake.

Consumers are Making Other Healthy Changes to Their Diets

consumers are making other healthy changes to their diets

In addition to eating more fruits and vegetables and less sugar, consumers are working to make other healthy changes to their diets. Popular options included:

  • Limiting the intake of sugar and/or unhealthy fats
  • Limiting the intake of salt/sodium
  • Choosing healthier protein sources
  • Following a healthier diet in general
  • Eating smaller portions
  • Paying closer attention to diet

Women were also more likely than men to say that they were eating less fast food and junk food (30.68 percent compared to 22.58 percent). Men were more likely than women to say they were limiting their intake of sugar and/or unhealthy fats (43.95 percent compared to 39.49 percent) as well as sodium (37.90 percent compared to 28.13 percent). This could be because overall, more men tend to eat too much sodium than women.

When Considering Diets, Clean Eating Came Out on Top

According to the 13th Annual Food and Health Survey completed in 2018, more than one in three Americans are dieting. That doesn’t necessarily mean they are trying to lose weight, but that they are following a specific diet or eating pattern.

For our respondents, “clean eating” came out on top when it came to specific diets—more than 3 out of 10 (35.83 percent) said they had tried the diet over the past year. Clean eating, in general, involves consuming more whole foods such as fruits, vegetables, lean proteins, whole grains, and healthy fats, while limiting processed snack foods, sweets, and other packaged foods.

But Intermittent Fasting was Popular Too

The second most popular dieting pattern was intermittent fasting—about 28 percent had tried it in the past year. When looking at gender, both men and women were more likely to have tried intermittent fasting than clean eating, while more men have tried clean eating overall (45.16 percent vs 29.26 percent of women).

Indeed, intermittent fasting has seen a surge in popularity over the past couple of years. This may be attributed to glowing testimonials by celebrities such as Jennifer Anniston and Hugh Jackman, but it may also be because intermittent fasting is flexible and often, effective. It doesn’t require calorie counting or food restriction, other than timing.

Individuals set an eating window that works for them (say, 8:00 a.m. to 6:00 p.m. every day), and then make their own food choices during that time frame while avoiding food the rest of the time. This makes this diet particularly adaptable to busy schedules and lifestyles, and results show that it works.

Going without food for a while causes changes in the body that can be conducive to weight loss. Harvard Health notes that between meals, as long as we don’t snack, insulin levels will go down, fat cells will release stored sugar, and we’ll lose weight. Though intermittent fasting may not be effective for everyone, it can be helpful to many.

What About the Low-Carb and Other Diets?

The third most popular diet was the low-carb, ketogenic, or high-fat diet—about 24.83 percent of our respondents had tried it. Women (22.16 percent) were also more likely than men (17.74 percent) to have tried a weight-loss diet (calorie restriction).

Men (23.39 percent) were more likely than women (15.91 percent) to be following a low-sodium diet. Since men were more likely than women (33.87 percent vs. 22.16 percent) to be suffering from high blood pressure, this makes sense.

Over a quarter of our respondents though (27 percent) reported that they weren’t dieting at all.

Losing Weight Still the Main Reason to Go on a Diet

losing weight is the main reason people diet

When it comes to why consumers were dieting or following a particular eating pattern, our survey showed that one thing hasn’t changed much: “losing weight” remained the most popular reason.

The results of another recent survey found similar results. Commissioned by biotechnology company Gelesis and released in January 2021, the survey showed that over half (51 percent) of Americans want to lose weight by exercising and changing their diets.

When narrowing our survey results to specific age groups, however, we found slightly different results:

  • Respondents 54 and older were more interested in going on a diet to reduce the risk of future health conditions than to lose weight, though losing weight remained an important objective as well.
  • The younger crowd (18-24) went on a diet to lose weight but were just as concerned about improving their physical appearance.

Other common reasons across all age groups for wanting to go on a diet or change eating patterns included:

  • Wanting to have more energy/feel better overall
  • Wanting to reduce the risk of future health conditions
  • Wanting to improve physical appearance
  • Wanting to prevent weight gain

Consumers Understand that Food is Medicine

We also found that consumers understand that different foods can have different health benefits. When shopping for food overall, the majority of our survey respondents (44.50 percent) said that they looked most for weight management or weight loss benefits. Finding foods to help digestive health (yogurt, anyone?) was the second most popular response.

This is a good sign, as it shows that consumers know that food can help them achieve their health goals. Other popular benefits sought from food included:

  • Energy enhancement/better athletic performance
  • Cardiovascular/heart health
  • Immune health
  • Brain function/improved focus
  • Improved muscle strength/building muscle

Indeed, food is medicine. It can be so effective at not only preventing but treating disease that researchers argued in a 2020 study for “increased integration of specific food and nutrition interventions in…the healthcare system, an initiative known as ‘food is medicine.’”

Consumers are Well-Educated When It Comes to a Balanced Diet

consumers are well-educated when it comes to a balanced dietWe also found that consumers are getting the message when it comes to which foods are healthy and which ones are not. Nearly half (45 percent) stated that they considered fiber an excellent part of a well-balanced diet, while 40 percent considered whole grains to be so.

Our results also showed the recognition of the following as important parts of a balanced diet:

  • Prebiotics and probiotics
  • Omega-3 fatty acids
  • Plant proteins
  • Dairy products
  • Animal proteins
  • Unsaturated fats

The good news was that “sugar” was last on the list in all cases, indicating that our respondents were well aware that sugar is not part of a healthy diet.

Consumers Still Put Taste First—and Can You Blame Them?

consumers still put taste-first

Even though consumers have learned a lot about food and health, our survey shows that in the end, we care most about taste.

Sixty percent of respondents said taste was extremely important in their purchasing decisions. This one consideration was, by far, the leading factor influencing food choices, and scientists say that’s normal, as our sense of taste can be a matter of survival.

Dr. Preet Bano Singh researches taste in Norway, and noted in a University of Oslo article that the sense of taste “is possibly the only one of the five classical senses that for humans is actually essential to life.”

Indeed, if the sense of taste is impaired, it can affect a person’s food intake, nutritional status, and consequently their health condition. Senses of smell and taste are also vital in the identification of valuable nutrients and have been essential to survival throughout human evolution.

Putting Taste First Can Get You Into Trouble

Unfortunately, this survival drive can get us into trouble if we’re not careful. Food manufacturers are well aware of how taste drives purchasing decisions, which is why so many of them add extra sugar to foods that don’t need sweetening (like bread, soups, condiments, and more).

One could say that the attempt to appeal to our sense of taste is what’s driving the obesity epidemic in this country, as food manufacturers tap into the three factors that make our taste buds go crazy: salt, sugar, and fat. We’re programmed to crave these things, and all three trigger reward responses in our brains, while also adding inches to our waists.

The food manufacturers may reap the financial awards from this approach, but the general public suffers, as is clear from our current obesity epidemic. And in some cases, there’s another factor working against us: Price.

Price Was the Second Most Important Factor When Buying Food

consumers still put taste-first

In our survey, “price” was the second most important factor when it came to purchasing food. Over a third of respondents (35.67 percent) rated it as “extremely important” while nearly half (46.83 percent) said it was “important.” Interestingly, even those in low-income groups—under $25,000 per year—ranked price as second, behind taste.

Of course, it makes sense that price matters when it comes to buying food. Unfortunately, this too can lead to unhealthy food choices.

In a 2013 review of 27 studies in 10 countries, researchers found that unhealthy food was about $1.50 cheaper per day than healthy food. Sticking to that healthy diet would cost you about $550 more per year.

Indeed, if you’re feeding a large family on a limited salary, you may find that it’s cheaper (and faster) to buy from the dollar menu or purchase cheap premade frozen dinners than to buy all the whole foods you’d need to create those meals yourself.

Other studies have found conflicting results, but there’s a third factor working against us that these studies often fail to consider: convenience.

Consumers Want Food to be Fast and Convenient

We all live busy lives these days, and many of us struggle to find time to cook healthy meals.

Therefore, it was no surprise that nearly a quarter (23.17 percent) of respondents stated that “convenience” was extremely important in their food choices, while close to half (43.17 percent) said it was important.

It’s interesting to note that convenience was right in line with “healthfulness,” in our results. Nearly a third (32 percent) of our respondents considered healthfulness one of the most important factors in buying foods, above convenience. Yet both healthfulness and convenience were considered important (41.50 percent vs. 43.17 percent).

The close call between these two considerations does make you wonder how often convenience may have won out when these consumers were making food purchases.

Chart illustrating answer distribution from women respondents only

When looking at women only, the results changed a little. Women were more likely to rate “healthfulness” as extremely important (28.13 percent) when choosing foods compared to convenience (21.59 percent). Men also cared about both healthfulness and convenience, with 37.5 percent of men rating healthfulness as extremely important and 25.4 percent of men rating convenience as extremely important.

Long-term, our eating choices can either enhance or diminish our health and quality of life. The non-profit organization The Plutus Foundation shares these tips for eating healthy (and conveniently) on a budget:

  • Plan your meals ahead. Create a shopping list and stick to it to keep costs in check.
  • Buy frozen fruits and vegetables. These are just as nutritious (sometimes more so) than fresh options and will reduce food waste. They are also quick and easy to use in a pinch.
  • Buy in bulk. Purchase food staples in large quantities for discounted prices. This works particularly well with meat.
  • Cut up your own fruits and vegetables. Pre-cut produce is convenient and expensive. Cut your own and freeze it if desired.
  • Cook large batches and store portions. Save money by making large portions of healthy meals and eating leftovers or freezing them.

We’re Snacking Too Much

how often do you snack?Snacking has been a confusing subject for several years now. Whereas some health experts have recommended we eat more, smaller meals throughout the day (increasing snacking), others have advised avoiding snacking if possible.

The problem is that the studies on snacking have been inconsistent. Whereas some indicate that snacking can contribute to overweight and obesity, others fail to show that. Some studies have even suggested that snacking might contribute to reduced weight and increased nutrient intake.

Meanwhile, according to our survey results, consumers are snacking, whether it’s good for them or not. Over 40 percent of our respondents stated that they snack two or more times a day. Another third (36.33 percent) said they snacked once per day. A mere 2.83 percent said they never snacked.

The frequency of snacking did taper off with age. Those 45 and older were more likely to snack just once a day rather than twice (38.17 percent vs. 31.72 percent).

We Snack for a Variety of Reasons that Have Nothing to Do with Hunger

In our survey, the most common reason given for snacking was to satisfy hunger or thirst (21.83 percent). But that came in only slightly above craving something sweet (21.50 percent). About a fifth of our respondents said they snacked “almost always” because they were dealing with sugar cravings. After all, just because we know excess sugar isn’t good for us doesn’t mean we don’t want it!

It’s not just sugar cravings that are compelling us to snack. According to our survey, we snack because we’re hungry or thirsty only about a fifth of the time (21.83 percent). The rest of the time, we’re snacking for other reasons like these:

  • We’re craving something sweet or salty
  • We need an energy boost
  • The snacks are there—readily available
  • We’re in the habit of snacking
  • We’re bored
  • We’re feeling emotional
  • We want to reward ourselves
  • Everyone else is snacking

Looking at this list, we can see that the average person snacks for a variety of reasons that have nothing to do with real hunger or thirst. This points to the need to re-evaluate our snacking habits about four-fifths of the time.

Tips to Help You Snack Healthfully

tips to help you snack healthfully

There are two main ways to make sure your snacks contribute to your health:

  1. Make sure that your snacking isn’t adding calories to your daily diet.
  2. Choose nutritious snacks.

If you eat a snack and then feel less hungry at your next meal, you’re probably doing fine. If you eat a snack and then eat just as much as usual at your next meal, though, you could be increasing your overall calories, which will lead to weight gain over time.

In a study of overweight men, for instance, researchers found that those who ate a 200-calorie snack two hours after breakfast ended up eating only 100 fewer calories at lunch—resulting in a total increased intake of 100 calories. So make sure you carefully balance your meals and snacks to avoid increasing daily calories.

Choose your snack foods carefully. Eating high-fat, high-sugar, or high-salt foods will add empty calories to your diet that are more likely to lead to weight gain. Eating high-fiber, protein-rich foods, however, will keep you satisfied longer and may even help you lose weight.

Good snacking options include:

  • String cheese
  • Fresh fruit or vegetable slices
  • Sunflower seeds
  • Nuts
  • Low-sugar yogurt
  • Cottage cheese with fruit
  • Hardboiled egg

If you have trouble making healthy choices for snacks, it could be because you’re battling difficult cravings.

Food Cravings Can Compel Us to Snack Unnecessarily

Food cravings can be hard to ignore. They attack out of the blue and drive us to eat those items that we know will set us back in terms of our weight-loss or health goals.

Scientists haven’t completely figured out cravings yet, but they’re working on it. One thing they do know is that cravings rarely signal that you’re lacking in certain nutrients.

Instead, they’re likely to be caused by a variety of factors, including stress, hunger, hormonal imbalances, lack of sleep, a sedentary lifestyle, or outside influence (someone just brought donuts into the office).

Before eating that snack, stop and ask yourself: “Why am I doing this?” If you’re not really hungry or thirsty, consider doing something else instead. Getting into the habit of questioning your snacking habits can help you lose weight and improve your overall health.

To beat a craving, try these tips:

  • Distract yourself by playing a game on your phone or going for a walk.
  • Do something relaxing, like listening to calming music, meditating, or knitting.
  • Make a fist—it can help boost your willpower to resist.
  • Brush your teeth. You’ll be less likely to want to snack afterward.
  • Drink a tall glass of ice water.
  • Chew a piece of gum.

We’re Drinking More Water

We were pleased to find that nearly two-thirds of our respondents (60.83 percent) are focused on consuming water regularly or often. Water was the top choice in a long list of healthy foods, with fruits and vegetables coming in second.

This is good news because many studies have indicated that Americans aren’t drinking enough water on the whole. In a 2013 study by the CDC reported in the Chicago Tribune, researchers found that 43 percent of adults were drinking less than four cups of water a day. The CDC didn’t say how much water was “enough,” because needs vary from person to person, but did acknowledge that less than four 8-ounce cups is usually not enough.

We know that consuming inadequate amounts of water increases the risk of dehydration, kidney stones, and poor cognitive performance, so it’s good to see that people are working to drink more water each day.

We’re Also Trying to Consume More Fiber

we're trying to consumer more fiber

Fiber is a miracle nutrient in many ways. It not only helps keep our digestive systems running smoothly, but it’s also been linked to a lower risk of heart disease, chronic inflammation, and diabetes.

In our survey, over half of respondents (57.50 percent) stated they were trying to consume more fiber, which is good to see. According to a 2017 study, only about five percent of the population meets the daily recommendation for fiber intake (25 grams for women and 38 grams for men).

Interestingly, when examining the data in separate groups, we found that more of our male respondents were most interested in increasing their fiber intake (62.90) than our female respondents (53.69 percent). When divided into age groups, those 54 and over were most likely to be trying to increase their intake of vegetables—which of course, are fiber-rich!

Consumers are Trying to Avoid Alcohol

When asked which item they were trying most to avoid, most of our respondents (39.17 percent) said “alcohol.” That was a little surprising, as the health messages related to alcohol have been confusing.

Several studies, for instance, have suggested that drinking a glass of wine with dinner may help prevent heart disease, and decrease the risk of mortality due to cardiovascular disease. Yet more recent research has suggested that we need to be more careful than we thought about alcohol intake.

In a 2018 study, for instance, researchers analyzed data from nearly 600,000 people who drank at least some alcohol and monitored their health over time. They found that regardless of gender, higher alcohol consumption was associated with a higher rate of stroke, fatal aneurysms, heart failure, and death.

Our respondents must have heard about this, as both men and women were interested in cutting back on their alcohol intake. The results held over most age groups, though those over the age of 54 were more interested in avoiding trans fats than alcohol, but only slightly (50 percent compared to 48.94 percent).

Chart illustrating 54+ responses only

Other items that respondents were working to avoid included:

  • Sugar
  • Trans fats
  • Saturated fats
  • Salt/sodium

Limitations of the Survey: Audience Demographics

While the results of this study were revealing and interesting, it is important when reviewing the data to understand the audience demographics.

  • Race: Most of our respondents were white.
  • Education: Over half of our respondents were college-educated, while another about a third were high school or vocational/technical college graduates.
  • Location: Nearly half (42.33 percent) of our respondents lived in suburban areas, whereas about a third (32 percent) lived in urban areas. Only about a quarter lived in rural areas or small towns.
  • Health status: About a third (34.50) of respondents stated they were being treated for depression/anxiety/stress, while over a quarter (27 percent) said they were being treated for high blood pressure. About a third (31.33 percent) were not being treated for any common health condition.

We did have a wide variety of income levels among our respondents, from under $25,000 to $150,000 or more per year.

Had the demographics been different—the results may have been different as well.

Congratulate Yourself—and Keep Working!

Overall, we found the results of this survey to be very positive. It’s clear we know which foods we should be eating more often and which ones we should be limiting. We’re reading labels and shopping more carefully, and doing our best to choose foods we know will benefit our overall health.

We have good reason to celebrate how far we’ve come. Meanwhile, we’re still struggling to maintain a healthy weight, cut back on sugar and alcohol, and manage our food cravings. If we keep following the research and focusing on our daily meals, though, we’ll soon conquer these challenges as well.