The modern dietary landscape is increasingly dominated by what's known as the "Western pattern diet," often referred to as the "Standard American Diet" (SAD). This dietary pattern, originating in industrialized Western nations, is characterized by a high intake of pre-packaged foods, refined grains, red and processed meats, sugary drinks, fried foods, and high-fat dairy products. Conversely, it typically involves low consumption of fruits, vegetables, whole grains, fish, nuts, and seeds. This article delves into the definition, components, health implications, and socioeconomic factors associated with the SAD.
Defining the Western Pattern Diet
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. The nature of production also affects the nutrient profile, as in the example of industrially produced animal products versus pasture-raised animal products.
Key Components of the SAD
The SAD is characterized by a high intake of specific food groups and a low intake of others. Key components include:
- High intakes of:
- Sodium
- Red and processed meats
- Trans and saturated fats
- Refined grains
- Sugar-sweetened beverages
- Ultra-processed foods (UPFs)
- Alcohol
- Low intakes of:
- Fruits
- Vegetables
- Whole grains
- Lean protein sources (fish, poultry, nuts, soy)
- Healthy fats (olive oil, avocado)
The Nutritional Imbalance
The SAD is not a balanced diet. A healthy dietary pattern may include: grains, half of which are whole grains; fruits in all colors, especially whole fruits; vegetables in a variety of colors, including beans, peas, and lentils; fat-free or low fat dairy products, such as milk, yogurt, cheese, or lactose-free alternatives; lean protein, such as poultry, eggs, seafood, nuts, and soy products; healthy fats, such as olive oil, nuts, and avocado. A balanced diet ensures people get all the essential nutrients required to maintain good health.
Moreover, even though most Americans eat an excess of calories, many are deficient in certain micronutrients. Sufficient micronutrient status is necessary for optimal energy and foundational functioning (think breathing, staying awake, focus and concentration, motivation for movement). The SAD provides inadequate levels of micronutrients, which may lead to deficiencies in zinc and Vitamins A, C, D, and E.
Read also: The Hoxsey Diet
Historical Context
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. Food available to Americans since 1910. Consumption of beef in the US has fallen since the 1970s, while chicken consumption has grown dramatically.
The Rise of Ultra-Processed Foods
The SAD includes vast amounts of UPFs, which are high in calories, sugar, salt, and fat and contain minimal whole foods. Examples of UPFs include: white bread, sweetened breakfast cereals, savory snacks, candy, cookies, cakes, ice cream, pizza with fatty processed meat toppings, sausages, lunch meats, and bacon. Research suggests that consuming large quantities of UPFs may play a significant role in obesity.
Caloric Intake and Macronutrient Distribution
In 2006 the typical American diet was about 2,200 kilocalories (9,200 kJ) per day, with 50% of calories from carbohydrates, 15% protein, and 35% fat. These macronutrient intakes fall within the Acceptable Macronutrient Distribution Ranges (AMDR) for adults identified by the Food and Nutrition Board of the United States Institute of Medicine as "associated with reduced risk of chronic diseases while providing adequate intakes of essential nutrients," which are 45-65% carbohydrate, 10-35% protein, and 20-35% fat as a percentage of total energy. However, the nutritional quality of the specific foods comprising those macronutrients is often poor, as with the "Western" pattern discussed above. The energy-density of a typical Western pattern diet has continuously increased over time. USDA research conducted in the mid 2010s suggests that the average intake of American adults is at least 2,390 kcal (10,000 kJ) per day. Researchers that used different data collection/analysis methods have predicted that the average was about 3,680 kcal (15,400 kJ) per day. By contrast, a healthy daily intake is much lower.
Added Sugars and Unhealthy Fats
Americans consume more than 13% of their daily calories in the form of added sugars. Americans ages 1 and above consume significantly more added sugars, oils, saturated fats, and sodium than recommended in the dietary guidelines outlined by the Office of Disease Prevention and Health Promotion. 89% of Americans consume more sodium than recommended. Consumers began turning to margarine due to concerns over the high levels of saturated fats found in butter.
Low Consumption of Fruits and Vegetables
Vegetable consumption is low among Americans, with only 13% of the population consuming the recommended amounts. Boys ages 9 to 13 and girls ages 14 to 18 consume the lowest amounts of vegetables relative to the general population. Potatoes and tomatoes, which are key components of many meals, account for 39% of the vegetables consumed by Americans. Whole grains should consist of over half of total grain consumption, and refined grains should not exceed half of total grain consumption.
Read also: Walnut Keto Guide
Health Implications of the SAD
The SAD is linked to a range of adverse health outcomes, including:
Obesity
Obesity occurs when energy intake from food is significantly higher than energy expenditure from physical activity, causing a person to gain weight. Many factors - such as genetics, activity levels, and socioeconomic status - contribute to obesity. One significant factor includes the types and amounts of foods and beverages a person consumes. Research suggests that consuming large quantities of UPFs may play a significant role in obesity. A 2019 study found that a diet with large proportions of UPFs increases energy intake and results in weight gain. The study data suggest that eliminating these foods from the diet decreases energy intake, leading to weight loss.
Heart Disease and Stroke
In 2021, 1 in 6 deaths from heart disease were due to stroke. Certain diet-related factors can increase a person’s risk of heart disease and stroke. These may include consuming the following: a diet high in cholesterol, saturated fats, and trans fats; a high intake of added sugars; too much sodium; too much alcohol. A low quality diet also contributes to other conditions that raise a person’s risk of heart disease and stroke, such as: high blood pressure, high cholesterol levels, obesity. Research indicates that the SAD is a significant risk factor for heart disease and stroke. Another 2021 analysis examined the link between fried foods in the Western diet and heart disease.
Type 2 Diabetes
Approximately 11.3% of the United States population have diabetes, with approximately 90-95% having type 2. People typically have an increased risk of type 2 diabetes if they are overweight or have obesity. A 2023 research model of dietary intake suggests there could be a significant link between type 2 diabetes cases and diet. The researchers note that an insufficient whole grain intake and excessive consumption of refined rice, refined wheat, and processed meat may significantly contribute to the condition. A 2022 publication also suggests that Western diets high in fructose and fat may damage insulin-producing pancreatic beta cells, increasing the risk of type 2 diabetes.
Cancer
The SAD may increase the risk of certain types of cancer. Research suggests that while Western diets high in red meats, fat, and added sugars tend to increase the risk of excess body fat and obesity, the Mediterranean diet may reduce the risk. According to the CDC, there is an association between overweight and obesity and a higher risk of 13 cancer types, including: adenocarcinoma of the esophagus, breast in individuals who have gone through menopause, colorectal, uterine, gallbladder, upper stomach, kidney, liver, ovarian, pancreatic, thyroid, meningioma, multiple myeloma. Individuals may be able to maintain a moderate weight and lower their risk of obesity-related cancers by following a healthy eating plan and getting regular physical activity.
Read also: Weight Loss with Low-FODMAP
Mental Health
Diets high in saturated fats and refined carbohydrates are associated with greater incidences of depression, depressive symptoms, and anxiety. In older adults, an unhealthy diet is associated with a smaller left hippocampus, a brain structure associated with learning, memory, and mood regulation, and is thought to play a role in depression. A study in rats showed that the longer a rat consumed a diet high in fat and sugar, the greater the effect on hippocampal functioning and brain plasticity, resulting in impaired learning and memory.
Socioeconomic Factors Influencing Dietary Choices
Social and economic factors impact the dietary choices available to individuals in a community. These factors may include income, education, employment, and social support. A 2022 analysis of 155,331 adults found that multiple social, economic, and geographical factors were associated with a poor diet. It is high in saturated fats and refined carbohydrates. It is low in fruits, vegetables, and other plant-based foods.
It must be noted that for those who live in food deserts - regions where people have limited access to healthful and affordable food, usually related to insufficient income or living too far away from grocery stores that offer nutritious, healthy food - the standard American diet is sometimes their only option.
Globalization and the Western Diet
The transition into a more westernised diet has several implications, particularly regarding the exportation of foods. As populations become more affluent, reflected in a growing GDP, they have more disposable income to purchase food from other countries, which facilitates this dietary transition. This has been observed in many developing nations. In low and middle income countries, this transition is rapid, and this is observed in countries such as Brazil, India, and South Africa.
In recent years, diets in developing countries such as Mexico, South Africa, and India have transitioned to adopt more elements of the western-style diet. Overall dietary consumption in these regions now reflects a higher balance of processed sugars and fats over lower-calorie food groups like vegetables and starches. In accordance with this pattern, the western-versus-eastern dichotomy has become less relevant as such a diet is no longer "foreign" to any global region (just as traditional East Asian cuisine is no longer "foreign" to the west), but the term is still a well-understood shorthand in medical literature, regardless of where the diet is found.
Environmental Impact
Westernised diets contribute to increasing greenhouse gas emissions. This occurs due to the large global supply chains that food production is a part of. Large areas in Latin America and South-East Asia dedicate a large proportion of their land towards agriculture and forestry, which then gets exported to other countries. Changing global diets also increase emissions. Increasing per capita incomes leads to urbanisation of a population. When this occurs, populations substitute a low-calorie and vegetable intense diet for more energy-intensive products that are characterised by increase in meat and refined fats, oils and sugar consumption.
Strategies for Breaking the Cycle
Given the detrimental effects of the SAD, it's crucial to adopt strategies to break free from its grasp. Some potential strategies include:
- Create boundaries around processed/packaged foods: Limit the consumption of UPFs and prioritize whole, unprocessed foods.
- Prioritize whole grains: Ensure that at least half of your grain intake comes from whole grains.
- Increase fruit and vegetable consumption: Aim for a variety of colorful fruits and vegetables daily.
- Choose lean protein sources: Opt for poultry, fish, nuts, and soy products over red and processed meats.
- Incorporate healthy fats: Include sources like olive oil, nuts, and avocados in your diet.
- Reduce added sugar intake: Limit sugary drinks, candies, and processed foods with added sugars.
- Cook more meals at home: This allows for greater control over ingredients and portion sizes.
- Read food labels carefully: Be mindful of sodium, saturated fat, and added sugar content.
- Plan meals in advance: This can help to make healthier choices and avoid impulsive decisions.
- Seek support from a registered dietitian or healthcare professional: They can provide personalized guidance and support.
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