Only 14 percent of American adults consume both ≥2 fruits per day and  ≥3 vegetables per day, which falls short of the Healthy People 2010 objectives for fruit and vegetable consumption,¹ and most need improvement in the overall healthfulness of their diets to reduce the risk of many leading causes of morbidity and mortality.²  Differences between subgroups or disparities in dietary quality also persist across geography and various sociodemographic factors (e.g., race/ethnicity, socioeconomic status, age).^3,4  Addressing factors related to the environment, such as limited access to healthier foods and policies that influence their price and availability, may be an important first step in reducing disparities in dietary quality.⁵

The Centers for Disease Control and Prevention’s (CDC’s) Division of Nutrition, Physical Activity, and Obesity (DNPAO) prioritizes various evidenced-based and promising policy and environmental strategies in its efforts to improve dietary behaviors for all Americans. However, although some policy and environmental approaches inherently address disparities (i.e., improving access to healthier foods in under-served neighborhoods),  others may actually increase disparities if certain segments of the population adopt or benefit more from the strategies than do more vulnerable populations.

To develop a better understanding of how to use strategies to reduce disparities in dietary quality and to mitigate potential differential uptake of the strategies that may worsen disparities, DNPAO held a 13-member expert panel meeting in November 2009 with experts from multiple sectors, including local government, academia and nonprofit organizations. Participants were selected based on expertise in DNPAO priority strategies, particularly in regards to public health interventions among disparate populations. The meeting sessions were structured by priority strategies for improved dietary quality: I. Improving Healthier Food Availability, II. Promoting Healthier Foods through Policy, and III. Encouraging Healthier Beverage Choices.

Panelists were asked to consider obstacles that states and communities may encounter when planning, designing and implementing the strategies to address what disparities there are in diet quality and whether there is potential for differential uptake of the strategies by subgroups. Panelists also discussed critical factors for success that should be conveyed to states and communities to ensure that the strategies help to reduce disparities in diet quality. Recommendations from the panel will help DNPAO tailor research and surveillance efforts, as well as guidance to states and communities, to improve disparities in dietary quality.  A full report of the proceedings is forthcoming.  The findings and conclusions of this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.