Special Report

States With the Best and Worst Diets

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36. North Carolina
> Adults eating vegetables at least once a day: 78.4% (23rd highest)
> Adults eating fruit at least once a day: 56.7% (13th lowest)
> Students who drink soda/pop at least once a day 26.8%
> Obesity rate: 30.1% (22nd highest)
> Poverty rate: 15.4% (13th highest)

The national adult obesity rate is 28.9%, and in North Carolina 30.1% of adults are obese — one of the higher obesity rates among states. Perhaps contributing to the state’s relatively high obesity rate is the low share of adults eating diets that incorporate healthier options. Only 56.7% of adults eat fruit at least once a day, below the national share of 59.8%.

High school students in the state also exhibit unhealthy dietary habits. Some 26.8% of students in grades nine to 12 drink soda at least once a day, well above the national share of 20.4%. High schoolers in North Carolina are also less likely to regularly eat fruits and vegetables than the typical American high school student.

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37. Ohio
> Adults eating vegetables at least once a day: 75.3% (14th lowest)
> Adults eating fruit at least once a day: 57.1% (Tied –16th lowest)
> Students who drink soda/pop at least once a day N/A
> Obesity rate: 29.8% (25th lowest)
> Poverty rate: 14.6% (18th highest)

Americans who struggle to afford to put food on the table are often less likely to have healthy diets because unhealthy, calorie-dense food is often far less expensive than low calorie, nutrient rich foods such as fruits and vegetables. In Ohio, nearly 15% of households have low or very low food security, meaning they often do not have money for food or have to rely on federal assistance or food pantries. Nationwide, only about 13% of families are similarly food insecure.

Financial constraints may partially explain why adults in Ohio are less likely than most American adults to eat a balanced diet. Only 75.3% of adults in Ohio eat vegetables every day, and only 57.1% consume fruit daily — compared to 77.9% and 59.8% of adults nationwide, respectively.

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38. Missouri
> Adults eating vegetables at least once a day: 76.7% (21st lowest)
> Adults eating fruit at least once a day: 55.6% (11th lowest)
> Students who drink soda/pop at least once a day 21.1%
> Obesity rate: 32.4% (10th highest)
> Poverty rate: 14.0% (22nd highest)

Missouri is among the states with the worst dietary habits. Some 76.7% of adults eat vegetables at least once daily, and only 55.6% of adults eat fruit at least once a day — both below the national figures of 77.9% and 59.8%, respectively. Poor dietary habits in the state are further evidenced by a high obesity rate. The adult obesity rate in Missouri of 32.4% is the tenth highest among states and well above the 28.9% adult obesity rate nationwide.

Obesity can lead to a handful of chronic diseases, including certain cancers and diabetes, which may ultimately lead to premature death. There are 386 deaths before the age of 75 per every 100,000 state residents, well above the national premature death rate of 333 per 100,000.

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39. South Dakota
> Adults eating vegetables at least once a day: 73.9% (9th lowest)
> Adults eating fruit at least once a day: 57.5% (Tied — 18th lowest)
> Students who drink soda/pop at least once a day 23.2%
> Obesity rate: 30.4% (21st highest)
> Poverty rate: 13.3% (Tied — 24 highest)

South Dakota residents of all ages are less likely to have a balanced diet than the typical American. For example, 44.8% of high school students do not eat fruit daily, and 40.8% do not eat vegetables daily, more than the comparable 36.7% and 39.0% nationwide shares.

Eating habits among adults in the state are slightly better, but still lagging behind adults in the majority of states nationwide. Fewer than 3 in every 4 adults in South Dakota eat vegetables at least once daily compared to 77.9% of adults nationwide. Additionally, only 57.5% of adults eat fruit daily compared to 59.8% of adults nationwide. Healthy eating habits can help maintain a healthy weight, and in South Dakota, 30.4% of adults are obese compared to the 28.9% adult obesity rate nationwide.

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40. Iowa
> Adults eating vegetables at least once a day: 73.1% (6th lowest)
> Adults eating fruit at least once a day: 58.3% (20th lowest)
> Students who drink soda/pop at least once a day N/A
> Obesity rate: 32.1% (12th highest)
> Poverty rate: 11.8% (Tied — 18th lowest)

Some 73.1% of adults in Iowa eat vegetables at least once daily, the sixth lowest share of all the states and well below the national figure of 77.9%. In addition to a balanced diet, regular exercise can help individuals maintain a healthy weight. Some 26.3% of adults in the state never engage in physical activity, a slightly larger share than the national inactivity rate of 25.9%. Such unhealthy lifestyles likely contribute to a higher than average obesity rate. In Iowa, 32.1% of adults are obese, well above the national rate of 28.9%.