Diet Quality in the United States Improved During the Great Recession and Deteriorated During Economic Recovery

Background

Macroeconomic changes are associated with population health outcomes, such as mortality, accidents, and alcohol use. Diet quality is a risk or protective factor that could be influenced by economic conditions.

Objective

This study examined the trajectory of diet quality measured by the Healthy Eating Index 2015 before, during, and after the 2008–2009 Great Recession.

Design

Repeated cross-sectional survey data from the National Health and Nutrition Examination Survey were analyzed.

Participants/Setting

The analytic sample included 48,679 adults who completed at least one dietary recall from National Health and Nutrition Examination Survey 1999–2018.

Main Outcome Measures

Diet quality was assessed with a 24-hour dietary recall to calculate the Healthy Eating Index 2015 total scores, a measure of the conformance with the 2015–2020 Dietary Guidelines for Americans.

Statistical Analyses Performed

Least squares regression was used to adjust for demographic changes across waves.

Results

Diet quality improved noticeably during the Great Recession and deteriorated as economic conditions improved.

Conclusions

Deteriorating economic circumstances may constrain choices, but that does not necessarily imply a worsening of dietary quality. During the Great Recession, American diets became more consistent with Dietary Guidelines for Americans recommendations, possibly because of a shift toward food prepared at home instead of prepared food bought away from home.