The American diet has long been a topic of discussion, especially when contrasted with dietary habits in other parts of the world. Infamous for its inclination towards processed foods overloaded with sugar, salt, and fat, the American diet stands in stark contrast to the eating habits prevalent in many European countries and elsewhere. This article delves into a comprehensive comparison of the American diet with those of other nations, exploring the factors that contribute to these differences, the health implications, and potential avenues for change.
Introduction: The State of the American Diet
Through the course of the last several decades, the rate of obesity has progressively increased and is now one of the leading causes of death worldwide. According to the Center for Disease Control, the prevalence of obesity in the United States was 30.5% in 1999. This increased to 42.4% by 2017. In conjunction with this, chronic illnesses associated with obesity such as diabetes and cardiovascular disease are now among the top causes of death in the United States.
The Rise of Ultra-Processed Foods in America
The consumption of ultra-processed foods (UPFs) in America is at an all-time high, with over 50% of daily calories eaten being sourced from UPFs. These foods, typically high in sugar, salt, and fat while being low in fiber and micronutrients, include items such as candy bars, hot dogs, chips, granola bars, and chicken nuggets. The increase in consumption of UPFs is due to the growing population, urbanization, and industrialization.
Defining Ultra-Processed Foods
“Ultra-processed” is a technical term for these types of foods that is part of a food classification hierarchy called the NOVA classification system. The NOVA system classifies all types of food, starting with a tier for “minimally processed” foods. This first category includes foods that are either whole or have undergone processes that change their original state but do not add anything to the original food. These processes include drying, freezing, pasteurization, roasting, boiling, drying, or vacuum packaging. The second category is “processed culinary ingredients,” which are also minimally processed because they have undergone processes to extract them from their original form. They are typically considered “ingredients” and used to season and cook foods from the first group. Sugar, oil, spices, and salt would all fit in this category. The next group is “processed” foods, and includes canned foods, bread, jam, and yogurt. These foods are typically the result of processes that combine foods from the first two categories to create a new food. Finally, ultra-processed foods are products of industrial processes and ingredients derived from whole foods.
Historical Context of UPF Production
The creation of ultra-processed foods occurred as technology developed because UPF production requires large-scale factories and industrially produced additives, which were not created until recently. Food processing has existed throughout history, as ancient peoples dried, froze, and otherwise preserved their food in many ways. More advanced food processing technology began in the 19th century with techniques such as pasteurization and hermetic bottling. The NOVA classification system mentioned earlier was created by a group at Brazil’s University of São Paulo Centre for Epidemiological Studies in Health and Nutrition in 2009, during which time they coined the term “ultra-processed.” The onset of this system sought to provide terminology for a rising trend in diet in Brazilian homes.
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Factors Contributing to UPF Overconsumption in America
America specifically struggles with overconsumption of UPFs, in part, because it is an developed, industrialized country. Industrialization helps to predict if a country will be able to facilitate the production of UPFs, as it requires large-scale factories and industrially produced additives. Other countries with similar socioeconomic statuses and industrialization to the US, such as the UK and Canada, are also consuming similarly high amounts of UPFs.
The exponentially growing population has led to an increase in UPF consumption because UPFs are cheaper to produce and can produce more food than traditional food production. Before the population was as large as it is today, traditional, preindustrial diet patterns and food production methods such as family farming, sharecropping, subsistence farming, and small community living were able to support the population.
Urbanization increases UPF consumption as more of the population lives far away from rural areas and easy access to home-grown food. Beyond just population growth, the location of the population has shifted toward urban areas and influenced UPF consumption. International studies confirm that people in urban areas consume more ultra-processed foods.
Another contributing factor in the rise of UPFs is industrialization because it enabled the creation of food processing technology and also plays a significant role in what foods are available to the public. Industrialization’s role in the creation of the technology needed to create UPFs was discussed previously with developments in food processing like trans-fats, which were later discovered to increase the risk of heart disease. In fact, a 2% increase in calories from trans-fats leads to a 23% increase in the incidence of heart disease.
Influence of the Food Industry
Although it may seem like consumers have full agency over the choices they make while shopping for food, this is not the case. Research illustrated that multiple factors interacted with one another to determine healthy eating, with the largest scope of influence being global factors, and the least significant factor being individual choice. Global factors influence the decisions and policies enacted by the government, which in turn affect industry and market factors, community environment factors, and sociocultural influences, all of which have a more significant impact than an individual choice on food selection. This influence means that the food industry has a strong and cascading influence on all the factors that fall under it, including individual choice. This huge increase in industry interest related to ultra-processed foods stems from the opportunity to make money doing so.
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Health Implications of the American Diet
UPFs lead to declines in the physical health and mental health of the US population, as those who consume higher amounts of UPFs are more likely to be depressed, overweight, and have a higher all-cause mortality risk. Increased consumption of UPFs leads to increased risk for all-cause and cause-specific mortality, cardiovascular disease. Producing UPFs encourages the unsustainable practices of industrial factory farming. Ultra-processed food consumption has been linked with a host of major health outcomes because of its physical effect on the body. These health outcomes are not isolated to a specific health condition, but rather a group of chronic Non-communicable diseases.
Physical Health
Ultra-processed foods affect the body and its processes in many ways. The high energy density of many UPFs promotes a change in body composition that trends towards higher adiposity and weight. Other mechanisms by which UPFs can influence physical health are, spikes in blood sugar from simple carbohydrates, increased blood lipid levels from processed sources of fat, and low levels of fiber. Repeated, intense spikes in blood sugar are the beginning steps for the development of type 2 diabetes. As the body mounts an insulin response to these spikes, the body may eventually become insulin resistant, which leads to type 2 diabetes over time. Increased blood lipid levels play a role in the development of cardiovascular disease because they increase circulating levels of cholesterol. Elevated cholesterol can then go on to influence the development of CVD. Low levels of fiber decrease the feeling of fullness and therefore encourage people to eat more until they do feel full. This eating pattern means that people end up eating more calories but feeling less full when they consume UPFs. As people consume more calories, they are more likely to develop obesity and other weight-related Non-communicable diseases. UPFs also have a correlation with gastrointestinal problems and poor gut health. For instance, research indicates they may be correlated with the recent rise in irritable bowel syndrome. Low levels of fiber continue to play a role here as fiber is needed for optimal health of the gut microbiota, which subsists off of these molecules.
Mental Health
Ultra-processed foods also play a role in people’s mental health and well-being, as UPF consumption increases the prevalence of mental health disorders. Mental disorders are the leading cause of disability on a global scale, and their prevalence is only continuing to rise. Research revealed that one of the many factors that played a role in these rising trends was UPF consumption. For example, UPFs have the capacity to exacerbate or incite the onset of conditions like depression. The relationship between UPFs and depression is so significant that for every 10% increase in calories consumed as UPFs per day, adults experience an 11% higher risk of developing depression.
Comparing the American Diet to Other Countries
The American diet is infamous for its inclination towards processed foods overloaded with sugar, salt, and fat. As of 2024, World Population Review ranks European countries such as Norway, Sweden, Netherlands, Germany, and Italy among some of the healthiest in the world. The National Institute of Diabetes and Digestive and Kidney Diseases states that “Nearly 1 in 3 adults (30.7%) are overweight” and “More than 2 in 5 adults (42.4%) have obesity.” The United States ranks 13th in worldwide obesity rates according to the WHO, while European countries rank much lower; Italy lands at 107, Sweden at 128, and France at 149.
Contrasting Eating Cultures: A Student's Perspective
North Penn High School’s very own students have felt these diet discrepancies weigh on themselves through the French exchange program. “I’ve noticed fat loss. However, the diet’s effects go further than looks; Reegan Burns, a North Penn High School senior who participated in the same French exchange program last year, notes that she felt noticeably more energized when in France. “The food in France was normally made with less coloring and also contained real sugar, rather than chemicals in the things such as candies and soda. A concerning study by the Journal of the Academy of Nutrition and Dietetics found that “60% of foods purchased by Americans contain technical food additives including coloring or flavoring agents, preservatives, and sweeteners,” showcasing that the effects felt by Feliciano and Burns felt weren’t because of nothing. Inversely, Margot Tandonnet, a student from France currently attending North Penn High School in the exchange program, has taken notice of the effects America’s ways of eating have had on her in the three months she has been here so far. experience a gain of weight during the year because of the difference of diet. I know I gained some weight. It is absolutely normal, because our body is not used to this food. “The fast food culture is much more present and popular here in America. “It is true that there are a lot of stereotypes about unhealthy eating in America because of the fast food culture that is here. Interestingly, Feliciano still eats fast food, and notes she does so even more than she did here at home. “I’ve been eating more fast food here than I would in the USA. I see lots of teenagers at fast food places. The food in France isn’t as flavorful or as sweet as in the USA. I think the cutting out of sugar added to the fat loss I’ve experienced.
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School Food and Nutritional Awareness
Even further than eating out, the variations between food was apparent even in schools. “The food was very different, although a lot more expensive. We would eat things like chicken legs, quiches, pastas, rice, various fruits and vegetables, and it always came with a dairy item, dessert, bread, and a side dish. In addition to a quality difference within school food, Feliciano also notes that in French grocery stores, the French measure the healthiness of their food through “nutri-scores,” adding to the awareness of health in the country. “There is a thing called “nutri-score” in France, which ranks how healthy the food item in a grocery store is. It ranges from A to E,” Feliciano said. On the flip side, besides organic stores and farmer’s markets, American grocery stores make it easy to reach for junk foods directly from the shelves, without much attention given to what the label reads.
Dietary Patterns Around the World: A Brief Overview
The idea of a balanced diet isn’t new to most of us. Narratives like “eat lots of fruits and veggies” and “make sure to eat your protein” have been embedded into our minds ever since we were young. If we close our eyes we can see the faint outline of the food pyramid we learned in school-each color and section depicting a different food group. Let’s take a brief journey around the world to see if there’s a thing or two we can learn from other diets across the globe. switched over from the food pyramid diagram to MyPlate in 2011, which displays the varying consumption levels of each food group slotted out on a plate instead of the classic pyramid design. This depiction of the food groups on a plate aids in showing roughly how much of each food group should be consumed during each meal, making the concept more visual and easier to grasp long term. In deeper information, MyPlate recommends varying what types of fruits, vegetables, grains, proteins, and forms of dairy that we consume.
Japan’s food pyramid is depicted as a spinning top, looking almost like an upside-down pyramid. top is a tiny cartoon man running around a glass of liquid. This signifies the importance of physical activity and the necessity of water and tea intake on a daily basis. The next section of the top is grains, followed by vegetables then fish, and meat dishes. it is interesting how little fruit Japan’s pyramid suggests and how much focus is placed on physical activity and liquid intake throughout the day-both things of which MyPlate did not include.
Greece’s food model is depicted in a pyramid design but is divided into daily, weekly, and monthly sections. The base and what is suggested as the largest part of one’s weekly diet consists of whole grains and unrefined cereals and products. The weekly section is divided up as well, containing most proteins, carbohydrates, and sweets. The top of the pyramid, which is recommended to be consumed only monthly, is red meat. This pyramid is vastly different from Japan’s and the United State’s, simply from a viewpoint of daily, weekly, and monthly consumption. This splits up one’s diet to the basic food types to be consumed daily, then simple carbs, poultry, and fish only a few times per week, and red meat only a few times per month. From a health standpoint, this brings one’s diet back to the basics, on an ecological level as well a diet as such can be beneficial.
South Africa’s food diagram depicts circles of food, each filled with its own food group and sized according to how much should be consumed daily. split peas, lentils, dairy, meat, eggs, and fish in smaller portions. The interesting thing about this diagram is the added category for beans, lentils, soya, and split peas. Each suggested diet definitely ranges from country to country, but it is fascinating to see how each diet compares with America. It seems maybe as a country we can adapt our diets and adopt bits and pieces of other countries.
Examining UPF Availability in Supermarkets
To understand the food availability in the United States, we selected two of the largest, mainstream, supermarket retail chains focused on affordable choices, such as Walmart and Target, and a higher end supermarket focused on health and quality, Whole Foods. For the comparison with Europe, we focused on mainstream budget-friendly supermarkets. We selected Carrefour and Mercadona in France and Spain, respectively, and Walmart and Target in the United States.
The analyses focused on staple food products. Given that the product classification may vary from shop to shop, we included staple food products present in all the selected supermarkets: Bread, Canned goods, Cereals, Eggs, Milk, Vegetables, and Yogurt. As part of the selection criteria, we excluded subcategories not found in all supermarkets.
Key Findings on UPF Prevalence
The prevalence of NOVA 4 products (UPFs) at Whole Foods ranged between 0 and 81% for individual food categories, yielding an overall average of 41%. In contrast, Walmart’s range was 3% to 92% and Target’s range was 0 to 98%, with overall averages in each store of 58%. Thus, in staple foods categories, Walmart had 42% more UPFs and Target 41% more than Whole Foods.
The average number of UPF markers found in the UPFs followed the same tendency. Walmart UPFs had the highest number of UPF markers, followed closely by Target and then trailed substantially by Whole Foods. On average, we found 75% more UPF markers in the UPFs from Walmart vs. Whole Foods, and 57% more UPF markers in the foods from Target vs. Whole Foods. Specifically, 61% of Walmart UPFs have 3 or more UPF markers, compared with 56% in Target and 32% in Whole Foods. There are 92% more UPF products with at least 3 markers at Walmart than at Whole Foods and 77% more at Target than Whole Foods.
Cross-Country Comparisons
main supermarkets have 41% more UPFs than the main supermarkets in France and Spain. Also, the number of UPF markers (cosmetic additives and other substances) is 41% higher than in Europe. Interestingly, the supermarket leaders we studied in Europe have the same UPF percentage as Whole Foods.
Factors Influencing Dietary Choices
The Western pattern diet is a modern dietary pattern originating in the industrialized West which is generally characterized by high intakes of pre-packaged foods, refined grains, red and processed meat, high-sugar drinks, candy and sweets, fried foods, high-fat dairy products (such as butter), eggs, potato products, and corn products (including high-fructose corn syrup). Conversely, there are generally low intakes of fruits, vegetables, whole grains, fish, nuts, and seeds.
Historical and Economic Influences
The Western diet present in today's world is a consequence of the Neolithic Revolution and Industrial Revolutions. The Neolithic Revolution introduced the staple foods of the western diet, including domesticated meats, sugar, alcohol, salt, cereal grains, and dairy products. The modern Western diet emerged after the Industrial Revolution, which introduced new methods of food processing including the addition of cereals, refined sugars, and refined vegetable oils to the Western diet, and also increased the fat content of domesticated meats.
Cultural and Lifestyle Factors
Americans eat 31 percent more packaged food than fresh food, and they consume more packaged food per person than their counterparts in nearly all other countries. A sizable part of the American diet is ready-to-eat meals, like frozen pizzas and microwave dinners, and sweet or salty snack foods.
Addressing the Challenges and Potential Solutions
Given the increasingly evident health risks of UPF consumption, this is a major health problem. The best practices for alleviating the overconsumption of UPFs include responsibility at a public policy level. The current UPF situation in the United States compromises public health and calls for immediate action.
Regulatory Interventions and Public Awareness
Given the significant impact of UPFs on public health and the challenges in altering consumer behavior in an environment dominated by these products, regulatory intervention seems necessary. History shows the effectiveness of such approaches. Such intervention could include stricter regulations on UPF content and labeling, public awareness campaigns about the health risks associated with UPFs, and incentives for supermarkets to promote healthier food options. While consumer education and empowerment are crucial, the scale of the problem requires a robust approach.
Individual Choices and Dietary Awareness
Taking into account the differences faced between eating cultures, our diet is due for some changes. The addition of a variety of fruits, vegetables, and proteins into meals can provide some extra, much needed energy, and opting for foods without excess salts, sugars, and additives can improve one’s physical health. Being aware of what exactly we’re reaching for when we choose each meal is another great first step.
Practical Tips for a Healthier Diet
Eat whole, real foods. This means buying things that come from the ground or are raised on the ground. Even if you don’t get discounts for buying whole foods, you may find yourself spending less since you don’t need as much to feel full. Get rid of hidden sugars and sneaky additives. Avoid eating out as much as possible. These tenants of healthy eating apply no matter where you live.