Americans just got a new report card on their diet. A study published in the Journal of the American Medical Association (JAMA) analyzed the dietary habits of nearly 44,000 adults between 1999 and 2016 and found that our overall diet is slightly healthier than it was 20 years ago.

Americans just got a new report card on their diet. A study published in the Journal of the American Medical Association (JAMA) analyzed the dietary habits of nearly 44,000 adults between 1999 and 2016 and found that our overall diet is slightly healthier than it was 20 years ago. Using a 100-point Healthy Eating Index scale, U.S. adults scored a two-point rise from 55.7 to 57.7.
While the slight improvement in our diet is good news, our current diet score is far from reason to celebrate. During the study years, the rate of diabetes in the United States nearly doubled to 7 percent of the population, and 70 percent of the population is now obese or overweight. Heart disease remains the No. 1 killer in the country.
So what improved in our diet during the last 20 years?
We lowered our total carbohydrate intake from 52.5 percent of our daily calories to 50.5 percent. This is likely because we are eating 3 percent fewer foods with added sugars, especially soda.
We increased our high-quality carbs by 3 percent. This includes foods like whole grains, whole fruit, nonstarchy vegetables and beans.
We are eating more plant proteins, from 1 percent to 6 percent, mainly in the form of nuts.
But our diet is still high in foods that contribute to heart disease, diabetes and obesity.
Here’s what we still need to improve:
We are still averaging about 14 percent of our calories from added sugar. The 2015 Dietary Guidelines for Americans recommends no more than 10 percent.
Our saturated fat intake increased from 11.5 percent to 12 percent. Our goal is to receive less than 10 percent of calories from saturated fat.
Only 9 percent of our carbohydrate calories are coming from healthy complex carbs that provide fiber and help fill us up. Whole grains, fruit, vegetables and beans are examples of complex carbohydrates. The majority of our carbohydrates (42 percent) are still in the form of refined grains, such as white bread, pasta, cereals and sugary snacks.  It is recommended that half of our carbs be whole grain, but they currently comprise only a little more than 25 percent of our carb calories.
We are eating a little more protein, but unfortunately more of it is coming from red meat and processed meats.
What can you do to improve your diet?
Eat more fruits and vegetables. Many people complain that fresh fruits and vegetables cost too much for their budget. Look beyond the produce aisle. Frozen vegetables and fruit, as long as they are packaged without additional salt, sugar, or fat, are just as nutritious as fresh and are considerably cheaper. Canned fruits and vegetables are fine, too. Look for fruits that are water- or juice-packed without added sweeteners, and vegetables that contain no or minimal added salt.
Avoid ultra-processed foods as much as possible. There is some evidence that eating ultra-processed foods  leads to obesity and disease more than eating the same calories worth of less processed food. What are ultra-processed foods? Fruit-flavored drinks, hot dogs, chips, packaged desserts, chicken nuggets, fish sticks and lunchmeats are a few examples. In general, the fewer the ingredients in a purchased food product, the better.
Watch out for added sugar. Sugar is put in many foods, including premade sauces, condiments and bread. Read labels, and choose foods that have the least amount of sugar added. The new food label, due to be released soon, will help identify added sugars.
Pick your proteins. Decrease your portion size of meat, especially red meat. Incorporate more skinless chicken or fish into your meals. Avoid or limit processed meats like bacon, sausage, cold cuts and other ready-to-eat meats. Replace some of your meat with plant proteins, like beans or nuts.
Swap out those refined grains for more whole grains. Ask for whole grain bread instead of white. Use brown or wild rice in place of white rice. Choose whole grain cereals and pastas at the store.
Best advice? Cook at home, from scratch as much as you can. Start with raw food, and season it yourself.