The changing landscape of food and diet

February is American Heart Month – and while heart disease remains one of the leading causes of death for men and women in the U.S., there are ways to prevent it. One of those ways is by eating a healthy diet with more fruits, vegetables and whole grains, and less saturated fat, trans fat and sodium. But with the prevalence of fast food and processed foods, eating healthier can be a challenge for many. Originally published with the Boston Globe in October, we set out to explore how food and diet have changed over the past few decades and how local organizations are doing their part to make whole foods more accessible, as well as information on what a healthy diet consists of.

Food has evolved in the US over the past 50-plus years.

The average muffin more than doubled in size and calories from 1.5 ounces to 4 ounces, and 210 calories to 500. The microwave was introduced to residential homes, paving the way for the creation and marketing of microwave-specific — and often processed — foods. Gluten-free, vegan, and dairy-free diets emerged as Americans discovered new food allergies or sought lifestyle changes.

Whether backed by science, innovation, or culture, what we’re eating, how it’s made, and how we approach nutrition continues to change.

Diets, then and now

When looking at diets from ancient civilizations, molecular markers show that a wider variety of foods were consumed compared to today — about 1/3 more. Thanks to food globalization, today’s diet consists mainly of four categories: sugar, corn, wheat, and rice. Irrigation and manufactured fertilizers allow for crops to be grown outside of their normal regions, while supermarkets working with supply chains have a majority share of food retailing in wealthier countries.

“Food is now available 24/7, often with a few clicks on our phones or computers,” says Jason Block, general internal medicine physician and Harvard Medical School associate professor of population medicine at the Harvard Pilgrim Health Care Institute. “This, along with an increase in processed foods, has led to much more unhealthy food consumption and a worsened diet for many Americans.”

Not only have diets evolved when it comes to what we’re eating and have access to, but how our food is packaged and preserved has changed too. With the development of supermarkets and membership warehouses like Costco and BJ’s Wholesale Club, consumers have more choices than ever, often being able to purchase a week or even a month’s worth of groceries in one trip.

Processed foods, which are defined by the US Department of Agriculture as any food that has undergone any changes to their natural state, aren’t all unhealthy but you do have to pay attention to nutrition labels. For instance, some canned fruits have additives like sugar or sodium to preserve their look and taste for an extended shelf life.

The cost of health

There are certain foods that are “ultra-processed,” which goes beyond the incorporation of salt, sugar, or fat to include artificial flavors or colors. These are often produced with low cost ingredients, making them profitable to sell and inexpensive to purchase — but there’s a catch. Higher consumption rates of these foods can lead to adverse health effects, with research showing a connection to cardiovascular diseases, certain cancers, and other health conditions.

But in a country with rising grocery prices, processed or ultra-processed foods may be more feasible for lifestyle or location.

“The price of healthy foods also presents a challenge to low-income families that limits the ability to consistently eat healthfully,” Block says, noting that healthier foods like fresh produce can be expensive or harder to access for those living in food deserts.

Nearly 60 percent of a US adult’s daily calories comes from ultra-processed food, presenting a larger need for easily accessible, healthy options. At a national level, initiatives like Healthy People 2030 aim to help consumers get the recommended amounts of healthy foods to reduce risk for chronic disease and improve health, but it only works if everyone does their part.

Local access to whole foods

At the local level, access to healthy, whole foods is improving with community programs like mobile markets and grocery distribution. The Greater Boston Food Bank (GBFB) for instance — in addition to being the engine that drives a powerful food distribution network in Eastern Massachusetts — began prioritizing relationships with community health centers to tackle hunger in high-need communities.

One example of this in action is with Cambridge Health Alliance (CHA), who learned from a food security screening that 51 percent of their patients experience food insecurity. The two organizations, together with Point32Health, run a mobile food market in Revere for CHA patients and community members, which helps provide food assistance that other food pantries and meal programs couldn’t meet the demand for.

“For the past year, we’ve been seeing over 500 households — ranging from seniors and families with children to multi-generational families and more — each month come to our market for fresh fruits and vegetables,” says Jean Granick, program manager at CHA.

The mobile market provides a welcoming atmosphere for those who may fear the stigma of using other forms of food assistance such as food pantries or the Supplemental Nutrition Assistance Program (SNAP). Held once a month in a busy area of the city, the mobile market distributes approximately 25-30 pounds of fresh fruits and vegetables and three to four non-perishable items. The food is generously provided by GBFB and selected through the expertise of their registered dietitian nutritionists.

“For one in three people in Massachusetts, hunger is not an emergency. It’s a daily lived reality with a profound impact on our health and well-being. That’s why providing nutritious food to our neighbors is a top priority,” says Catherine D’Amato, president and CEO at The Greater Boston Food Bank.

And Granick agrees. “We know that lack of access to quality food has a significant impact on an individual and their family to maintain good health — and we want to change that for the better.”

Nutrition counseling yields healthy results

Another local initiative aimed at improving food insecurity is Good Measures Good Food Prescription, an innovative food prescription and nutrition coaching program, which is the result of a collaboration between Cambridge Health Alliance, Good Measures, and Point32Health, the parent company of Harvard Pilgrim Health Care and Tufts Health Plan. Available to eligible members that have or are at risk of a diet-related disease due to food insecurity, this initiative offers medically tailored, culturally appropriate groceries delivered to members’ homes via Instacart and nutrition counseling at no cost.

And the program is improving access to nutritious food, as Donna K. Lencki, chief executive officer of Good Measures shares. “Early results are showing promising health outcomes,” says Lencki.

Whether a new diet emerges or how food is made changes again over the next 50 years, it’s clear that food is ever-evolving. The best course of action is to continue to do your part in the community you live in to ensure healthy food is accessible and stay educated on the best ways to fuel your body so you can live the healthiest life possible.