Association between the Nutritional Quality of Household At-Home Food Purchases and Chronic Diseases and Risk Factors in the United States, 2015

Abstract

Lower diet quality is a leading preventable risk factor for obesity and chronic diseases. This study assesses differences in the nutritional quality of at-home food purchases, using the Healthy Eating Index (HEI)-2015 and its components, among households with and without a member reporting type 2 diabetes (T2D), cardiovascular disease (CVD), obesity, and/or smoking. We use the 2015 IRI Consumer Network nationally representative household food purchase scanner data, combined with the IRI MedProfiler and the USDA’s Purchase-to-Plate Crosswalk datasets. For each/multiple condition(s), the difference in mean HEI score adjusted for covariates is tested for equivalence with the respective score against households without any member with the condition(s). The HEI score is higher for households without a member with reported T2D (2.4% higher), CVD (3.2%), obesity (3.3%), none of the three conditions (6.1%, vs. all three conditions), and smoking (10.5%) than for those with a member with the respective condition. Households with a member with T2D score better on the added sugar component than those with no member reporting T2D. We found that the average food purchase quality is lower than the recommended levels, especially for households with at least one member reporting a chronic condition(s).

Can Ordering Groceries Online Support Diet Quality in Adults Who Live in Low Food Access and Low-Income Environments?

“…Using both metrics, higher-quality diets were associated with a home food environment. Given the important role of the home food environment in diet composition, focusing on grocery selections and the availability of healthy foods may be a way to enhance diet quality [ 2 ]. For instance, in a group of mostly African American, low-income, overweight/obese women, higher consumption of fruits and vegetables was predicted by having more of them in the home [ 63 ].…”

“…Diet quality, or the concept of the healthfulness of the overall pattern of the diet, is an important determinant of health. In U.S. nationally representative data, poor diet quality is associated with a greater prevalence of chronic disease and/or risk factors such as excess adiposity, elevated blood pressure, and elevated total cholesterol and hemoglobin A1C [ 1 ], with low-income households reporting the lowest diet quality and greater incidence of associated disease risk factors [ 2 ]. The ability of low-income households to obtain healthy foods is dependent on interactions between the food environment, what is perceived as acceptable, and policies that increase healthy food access and affordability.…”