The Standard American Diet, often referred to as SAD, isn’t exactly a sterling example of healthy eating, but a new study in the journal BMJ Open suggests it may be worse than previously thought. When scientists surveyed the eating habits of a representative sample of more than 9,000 Americans, they found that nearly 60% of their calories came from so-called ultra-processed foods like soft drinks, snacks, cakes, pizza and frozen meals.
Those foods tend to be higher than whole foods in salt and fat, but they also contain added flavors, colors, emulsifiers, hydrogenated oils and other things not found in the average kitchen. They’re high in sugar too. The study found that nearly 90% of the sugar in the U.S. diet isn’t coming from fruit; it’s coming from ultra-processed foods, where it’s added to improve flavor, even in savory items like soups and sauces.
People who reported eating the least ultra-processed food also ate the least added sugar. This strongly suggests that a way to lower intake of sugar–which is linked to diabetes, heart disease and extra body fat–is to reduce excessively processed foods in the diet. The bottom line, says nutrition researcher Carlos Monteiro, the study’s lead author: “Eat more minimally processed foods, more fresh dishes and meals that you prepare yourself.”
This appears in the March 21, 2016 issue of TIME.