In today’s world of trendy diets, healthy eating movements and a keener eye by consumers on what they put into their bodies, one would imagine Americans’ eating habits would get high marks. However, despite some improvement in the overall American diet, a study published recently by researchers at the Harvard T.H. Chan School of Public Health and the Friedman School of Nutrition Science and Policy at Tufts University sees plenty of improvement still to make. Perhaps more concerning, their research showed healthy eating habits may be easier to accomplish for some Americans than others.

The study, published on September 24, 2019 in the Journal of the American Medical Association, covered dietary trends spanning nearly two decades and examined the diets of nearly 45,000 adults.

Some of the data found by the researchers should not be surprising given today’s food trends. Total carbohydrate intake dropped by about 2%, including a cutting back of low-quality carbs by 3%. Additionally, total fat intake increased by 1%. This lower-carb, higher-fat intake aligns well with such trendy diets and lifestyles as keto and paleo.

The researchers did note Americans are, by and large, still consuming too many trans fats, averaging about 12% of daily caloric intake; recommended daily intake is 10% of calories. Additionally, even with the overall decrease in carbohydrate intake, the research found low-quality carbs from refined grains, starchy vegetables and added sugars accounted for 42% of the typical American’s daily calories, while high-quality carbs, such as from whole grains and fruit, accounted for only 9%. Clearly, while Americans are decreasing their carb intake slightly, there is great room to improve the quality of carb consumption along with the quantity.

The research also touched on another vital piece of the dietary puzzle, whether intended or not. “Eating healthy” is something most people aspire to do, regardless of age, sex, social standing or otherwise. However, a dive into the data shows those with lower education and income may struggle to keep up with the financial demands of a healthier lifestyle.

According to the researchers, higher-income adults reduced their intake of low-quality carbs at double the rate of those living below the poverty line—a 4% decrease for the former group, just a 2% decrease for the latter. Overall, there was no meaningful improvement in diet seen for adults with less than a high school education or those living below the poverty line.

“Although there are some encouraging signs that the American diet improved slightly over time, we are still a long way from getting an ‘A’ on this report card. Our study tells us where we need to improve for the future,” said Fang Fang Zhang, nutrition epidemiologist at the Friedman School of Nutrition Science and Policy at Tufts University and co-senior author. “These findings also highlight the need for interventions to reduce socioeconomic differences in diet quality, so that all Americans can experience the health benefits of an improved diet.”

The good news is, the researchers believe improvement is possible for all demographics. For example, the researchers noted most protein consumed by Americans comes in the form of red and processed meats.

“Our research suggests that Americans have an opportunity to diversify their sources of protein to include more seafood, beans, soy products, nuts and seeds,” noted co-senior author Shilpa Bhupathiraju, research scientist at the Harvard T.H. Chan School of Public Health, also with Harvard Medical School and Brigham and Women’s Hospital. With today’s near-explosion of plant-based protein offerings, including at such far-reaching and accessible locations as Burger King, Carl’s Jr. and others, perhaps these higher-quality proteins will become more available for those most in need of healthier choices at affordable prices. And, as pointed out by Zhilei Shan, nutritional epidemiology fellow at the Harvard T.H. Chan School of Public Health and lead author of the study, “Because low-quality carbs are associated with disease risk, taking in higher-quality carbs could mean better health for Americans in the future.”

Americans are, slowly but surely, getting better about what they eat. But while small gains have been made, more improvement is needed. It is up to not only consumers, though; suppliers, brands, retailers and everyone else along the supply chain share a responsibility to make these better-for-you foods more accessible and affordable for all.