You might think smoking is America’s No. 1 health concern. Although it is true that quitting smoking is extremely important for your health, America’s No. 1 health enemy is a bad diet. 

The typical American diet increases risk for disease, disability and death. Diet-related health concerns include heart disease, diabetes, cancer, high blood pressure, stroke and obesity. The Global Burden of Diseases Study, published in 2016 in the journal The Lancet, found that poor diet contributes to one in five deaths worldwide. That means unhealthy eating kills more people than smoking. And although globally, the average lifespan has increased, we spend more of our years in ill health.

The most recent State of U.S. Health report (1990-2010) analyzed 14 components of the American diet and found that the typical diet is low in fruit, nuts, seeds and vegetables, and high in sodium, processed meats, sugar-sweetened beverages and trans fats. We are also deficient in omega-3 fats, whole grains, fiber and polyunsaturated fats. More than a third of adults reported eating fruit less than one time a day, and less than 22 percent reported eating a vegetable on a daily basis. 

According to the U.S. Department of Agriculture, we get about 63 percent of our calories from refined and processed foods, such as soda, breads and packaged snacks. Another 25 percent of our calories come from animal products, and just 12 percent comes from plant foods — with half of that coming from potatoes. 

To compound our diet problem, we are eating too many calories. As a result, more than two-thirds of adults and nearly one-third of all children in the United States are either overweight or obese.

The typical American solution to any health problem is to take a pill, but a pill won’t fix the cause of our health crisis. Making changes to current eating patterns can be an overwhelming task, but small shifts in food choices can make a big difference long-term. Following are some ideas for small shifts that can help you adopt a healthier eating pattern.

Change your physical activity. Only 20 percent of adults meet the Physical Activity Guidelines for aerobic and muscle-strengthening activity. Evidence shows that increments of physical activity as short as 10 minutes at a time can be beneficial. 

Don’t drink your calories. Cut out sugary beverages and juices, and choose water or no-calorie drinks instead. If you drink alcohol, do so in moderation.

Eat at least one vegetable that isn’t a potato and one fruit every day. It’s recommended that we eat five to nine servings each day, so make it a goal to keep adding.

Eat regular meals, slowly and without distraction. Skipping meals doesn’t make you lose weight and may make you eat more later in the day. Avoid eating while multitasking, which often leads to mindlessly consuming too many calories. Slow down, and enjoy your meal.

Be mindful of portions. Our biggest problem is probably that we simply eat too much. Use your hands as a guide: Meat should be no bigger than the palm of your hand, a fist is a good size for side dishes, and your thumb is an appropriate portion for most fats. Try to fill half of your plate with fruits or vegetables, one-fourth with meat and one-fourth with starch, such as potatoes, pasta or rice. 

Make at least half of your grains, whole grains. Use whole grain bread, brown rice, and cereals with bran or wheat instead of corn or rice.

Pack snacks with nutrients. Swap out your high-calorie, nutrient-empty snacks, such as chips and soda, for nutrient-dense snacks, such as an apple and peanut butter, a handful of nuts, or hummus and carrot sticks.

Eat out less often. Restaurant and fast foods are often high in fat, sodium, calories, sugar and carbs. Plus, the portions are generally oversized. Cook at home more often, and make extra to pack for lunch. 

If you don’t love it, don’t eat it. Too often we eat just because food is around rather than because we are actually hungry. Think about the foods you eat, and be picky! 

It is true that we are what we eat. If we choose to eat a diet that isn’t nourishing and benefitting our bodies, then we can’t expect our bodies to remain healthy and fit for long.

Anita Marlay, R.D., L.D., is a dietitian in the Cardiopulmonary Rehab department at Lake Regional Health System in Osage Beach, Mo.