May 2018 Issue

Undoing the Unhealthful Western Diet

The typical American diet may be hazardous to your health. EN explores which dietary changes can have the biggest positive impact.

The term “Western diet” might conjure images of cowboys eating beans by a campfire, but it actually refers to a pattern of unhealthful dietary choices common in the U.S. Most Americans eat lots of refined grains (like white bread, pasta, cakes, and cookies), red and processed meats, fried foods, sweets, and high-fat dairy products (like ice cream and cheese). On the whole, we drink too many sugar-sweetened beverages, and don’t choose enough fruits, vegetables, fish, whole grains, nuts, seeds, or legumes (beans and lentils). “These Western-style diets are low in fiber and several vitamins and minerals, and are higher in saturated fat, sodium, and added sugar,” says Nicola McKeown, PhD, a scientist for the USDA Nutrition Epidemiology Program and an associate professor at the Friedman School of Nutrition Science and Policy at Tufts University. This combination of too few healthful nutrients and too many unhealthful ones takes a toll on our health. “This dietary pattern has been associated with a higher risk of obesity, cardiovascular disease, type 2 diabetes, osteoporosis, Alzheimer’s, gout, and certain cancers.”

Make a Healthy Shift.

A recent study by Mozzaffarian and colleagues examined the relationship between 10 dietary factors and death from heart disease, stroke, and type 2 diabetes among U.S. adults. “The authors noted that the highest proportion of deaths seemed to be related to excess sodium intake, high intake of processed meats, insufficient intake of nuts and seeds, and low intake of seafood omega-3 fats,” says McKeown. All of these factors are common in a Western dietary pattern, which involves eating too much processed meat and too little seafood, and choosing salty snack chips instead of nutrient-rich nuts, for example. This study reinforces a long list of other research suggesting that Americans can decrease their risk for many chronic diseases and increase their lifespan by adjusting their dietary choices.

5 Tips for Moving Away from the Western Diet.

McKeown offers the following tips for shifting from a Western-style diet to an eating pattern that nourishes your body for long-term health. Pick one or two personal goals to work toward. Even small changes that move you toward a more nutritious diet can help improve your long-term health.

baocn cheeseburger

TheCrimsonMonkey | Gettyimages.com

Shift away from these typical American meal options.

1. Cut Back On Salt. Not adding salt at the table and cutting salt in cooking can help, but the majority of sodium in the Western diet comes from foods in boxes, bags, and restaurants. “Cutting out highly processed and prepared foods, if these are a staple in your diet, will have a substantial impact on your daily sodium intake,” says McKeown. “It may take time to adjust to the lower sodium in your diet.”

2. Limit Processed Meats. Processed meats are a big contributor to sodium intake, are typically high in saturated fat, and have been linked to increased risk of certain cancers. “Skip the sausages, bacon, hot dogs, salami, bologna, and ham,” says McKeown. “Choose chicken, fish, or beans instead.”

3. Think Plants First. “Move towards a more plant-based diet,” says McKeown. “In other words, load up on fresh or frozen vegetables, fruits, nuts, beans, and unprocessed whole-grains, such as brown rice, bulgur, wheat berries, steel cut oats, and quinoa. Be creative and try new foods. Reach for the goal of five or more servings of fruits and vegetables per day.”

4. Watch for Added Sugars. The American Heart Association recommends limiting added sugars intake to less than six teaspoons (24 grams) a day for women and nine teaspoons (36 grams) for men. Check labels for added sugars content. You may be unpleasantly surprised by what you find! “If you are feeling like you need something sweet, grab a piece of fruit,” says McKeown.

5. Rethink What You Drink. Drinks are the leading source of added sugars in the Western diet. Water is the best choice, but coffee (minus all the sugar and fat), tea, and low- or non-fat milk (or unsweetened plant “milks”) are good choices as well. “To help increase water intake, try getting a couple of 32-ounce water bottles, and carry a full one with you to hydrate throughout the day,” says McKeown.

Diet Steps to Better Health

Western Meal

(small steps)


Double bacon cheeseburger

Small hamburger with lettuce, tomato, onion

Grilled or baked chicken or fish, or plant protein (i.e., beans, lentils, or tofu)

French fries

Baked potato chips

Side salad, vegetables, or whole grain, such as brown rice


Half 100% fruit juice mixed with seltzer

Water, or unsweetened coffee or tea

Ice cream

Small cookie and a glass of low- or non-fat milk

Fruit (fresh, frozen, canned/drained, or dried)