The 2021 Global Nutrition Report, an independent assessment of the state of global nutrition, was dedicated to nutrition equity.  According to the report, “there are marked differences in nutrition outcomes, or nutrition inequalities, by key sociodemographic characteristics such as geographic location, age, gender, ethnicity, education and wealth.”  The report further noted that “considerable progress has been made in measuring nutrition inequalities, but we have been less clear on understanding and confronting inequity.”

ASN has made it a priority to fill this knowledge gap by dedicating resources to understanding and confronting nutrition inequity in all its forms.  In June 2020, the ASN Board of Directors issued A Statement from the Board of Directors of the American Society for Nutrition, in which the Board expressed its commitment to prioritizing diversity and inclusion.  In particular, the Board committed to advocating for “increased governmental and non-governmental resources and solutions to address the nutrition and health disparities that disproportionally impact communities of color in America.”

ASN Journals play a key role in ASN’s commitment to understanding and addressing nutrition inequities by fostering and publishing original research studies and reviews.  Below are a few examples from each of our four peer-reviewed journals:

Racial and Ethnic Representation among a Sample of Nutrition- and Obesity-focused Professional Organizations in the United States, The American Journal of Clinical Nutrition, October 2021

Research shows that individuals from racial and ethnic minority backgrounds consider it important to have access to providers from diverse backgrounds.  Tiffany L. Carson et al. concur, noting that “a diverse cadre of obesity- and nutrition-focused health care professionals is needed to further improve nutrition-related health outcomes.”  The authors assessed race and ethnicity data among the membership of the Academy of Nutrition and Dietetics and American Board of Obesity Medicine over the past five years.  The authors’ findings “demonstrate stark disparities in the prevalence of racial and ethnic minorities among the US population and that of researchers and health care providers in the areas of obesity and nutrition.”  Data from the Academy of Nutrition and Dietetics, for example, show underrepresentation of Black (2.6%), Asian (3.9%), Latinx (3.1%), Native Hawaiian or Pacific Islander (1.3%), and American Indian or Alaskan Native (0.3%) individuals compared with the general US population.  Underrepresentation of racial and ethnic minorities was also reported among the American Board of Obesity Medicine diplomates: Black (6.0%), Latinx (5.0%), Native American (0.2%).  The authors concluded with a “call to action for professional societies to launch an intentional effort to systematically track race and ethnicity among membership and increase racial and ethnic diversity among their membership.”

Social Determinants of American Indian Nutritional Health, Current Developments in Nutrition, May 2019

The American Indian population suffers from significant health disparities compared to the general US population, including a higher incidence of nutrition-related chronic diseases such as diabetes, cancer, and heart disease.  American Indians, for example, have the highest prevalence of diabetes and the highest diabetes mortality rates in the United States.  This article, published in “Proceedings of the First and Second Annual Conferences on Native American Nutrition,” an annual supplement of Current Developments in Nutrition, shows how these health disparities are rooted in the histories of American Indian populations, including historical trauma, abusive boarding schools, poverty, and food deserts.  In addition, findings from the Adverse Childhood Experiences Study show that adverse childhood experiences such as abuse, neglect, and household dysfunction, which have been linked to poor nutritional health outcomes, are more prevalent in many American Indian communities.  “To effectively address these disparities,” Donald Warne et al. argue that “a multipronged approach in collaboration with stakeholders is needed to address the upstream social determinants of health and to increase access to healthier foods.”

Racial-Ethnic Disparities in Obesity and Biological, Behavioral, and Sociocultural Influences in the United States: A Systematic Review, Advances in Nutrition, January 2021

ASN member Jungwon Min et al. examined racial and ethnic disparities in obesity prevalence in the United States, with a focus on the biological, behavioral, and sociocultural factors that may underlie these disparities.  In order to conduct their research, the authors searched the scientific literature for studies that used national survey data published between January 2007 to September 2020.  Forty-seven studies met the inclusion criteria.  Among the review findings, the authors noted that “patterns of body dissatisfaction and body perception, and their motivation for weight loss were varied by sex and race/ethnicity.”  For example, non-Hispanic Blacks were more likely to underestimate their weight status compared to Hispanics and non-Hispanic Whites.  According to the authors, “this characteristic is especially apparent in females and those with less than a high school education compared with those with a college education.  Therefore, it is essential to promote the correct weight perception and healthy body image to encourage healthy weight control behaviors, especially for non-Hispanic Black females.”  Overall, the authors recommend that “differences in biological, behavioral, and sociocultural characteristics should be considered in future public health intervention efforts to combat obesity in the USA.”

Disparities in Risks of Inadequate and Excessive Intake of Micronutrients during Pregnancy, The Journal of Nutrition, September 2021

Katherine A. Sauder et al. worked with data from a sample of nearly 10,000 pregnant females across the United States who had participated in 1 of 15 observational cohorts in the US Environmental Influences on Child Health Outcomes Consortium in order to compare risks of inadequate or excessive micronutrient intake among pregnant females based on age, race, ethnicity, education, and pre-pregnancy BMI.  According to the study findings, “particularly at risk for inadequate daily intake were participants who were aged 14-18 years, identified as Hispanic, Black, or other races/ethnicities (i.e., not non-Hispanic White), had less than a high school education, or had overweight or obesity before pregnancy.”  Even with dietary supplement use, the authors noted that more than 20% of participants were at risk of inadequate intake of one or more micronutrients, especially in some population subgroups.  Overall, fewer than 5% of participants in this study were at risk of excessive daily intake for any micronutrient, but this increased with dietary supplement use, most notably for iron, folic acid, and zinc.  In particular, non-Hispanic Black females who took dietary supplements were at the highest risk of excessive daily intake of folic acid, which is concerning as studies indicate this may lead to higher cardiometabolic risks among their offspring.

Interested in learning more?  These ASN Journals articles provide additional insight into the incidence, causes, and potential solutions to nutritional inequity: