In 1829, Sylvester Graham created a cracker of white flour and wheat bran (now known as the Graham Cracker). which he believed could foster good health when combined with fresh fruits and vegetables, cold baths, sexual restraint and abstinence from tea, coffee and tobacco. Poverty, however, was the most frequent cause of poor health. In 1906, a study estimated that two million children were malnourished in the United States. In the early 20th century, doctors and scientists discovered the causes of pellegra, scurvy and rickets were deficiencies in niacin, vitamin C and D respectively. With the endorsement of the American Medical Association and other medical organizations, manufacturers began to enrich flour and milk and other products with vitamins. American diets also imporved due to refrigeration, canning and railroads that made it possible for people to consume milk, fruits and vegetables year-round, greatly improving their health.
More recently, over-consumption of food high in calories without nutritional value, such as fast food, has led to a rise in obesity and diabetes. In the past four decades, American consumption of fast food, processed foods, carbohydrates and fats has risen astronomically. During this time, the number of fast food outlets has increased from 30,000 to more than 160,000. Similarly, the introduction of high fructose corn syrup has helped increase sugar consumption by 19% since 1970. Suburbanization, increased auto use and greater time pressures have led families to eat out more and exercise less.
These trends have led to a new form of malnutrition: 25% of all Americans are obese, double the 1990 rate. Obesity among African-Americans is 51% higher than among whites, 21% higher among Hispanics than among whites. Correlating with the rise in obesity is an increase in diabetes, which has doubled since 1990 to more than 23 million people. Responses to this crisis include the development of green markets and making fresh fruits and vegetables more available in poor neighborhoods.