Eating habits among Americans has always been a subject of ridicule. Super size that, value combo this. Now the fast-growing wealth inequality is rearing its ugly head at the dinner table. While eating habits have improved among most Americans, the poor have been left behind.

That’s not to say wealthier people are titans of making healthy eating choices. An index that measures healthy eating habits scored the average American at 47 in 2009-2010. That was up from 40 in 2000, A perfect score on the index is 110. So, don’t break out the wheatgrass smoothies in celebration just yet.

The gap in scores between low-income adults and high-income actually increased from 4 points to 6 in the same time period. Low-income adults also scored below the national average.

A higher score on the index means that a person is eating more heart-healthy foods including fruits, vegetables, healthy fats and whole grains. The higher you score on the index, the lower your risk of obesity and the chronic illnesses it contributes to. This list includes diabetes, heart disease and strokes.

The study was published in the journal JAMA Internal Medicine. Most of the uptick in the average score can be attributed to the reduction of trans fat in our diets. Not exactly a green revolution in the kitchen, so researchers are stressing the need for better nutrition education. We can now train ourselves to like healthier foods.

For low-income, it’s not just education that is the problem. Low-income adults often live in food deserts. The access to healthy options just isn’t there, or is priced out of their reach. Instead, inexpensive, processed foods are all that’s available.

The study highlights the need for the government to do more, as the poor eating habits are quickly becoming a health concern. Research warns that government benefits such as food stamps are not enough themselves to combat the problem. Some have suggested limiting food stamps to covering healthy foods.

That sounds great in theory, but doesn’t address the food desert problem that afflicts many urban and rural areas. A comprehensive approach is more likely to succeed that addresses education, access and cost.

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