What’s wrong with the average American diet? Too much and too little. We consume too much salt, fat, sugar and calories and too little nutrients from fresh whole fruits and vegetables.

Three-quarters of Americans don’t eat the recommend five to nine daily servings of fruits and vegetables. More than half exceed the recommendations for protein and grain consumption, but this is made up of red meat, high-fat dairy and refined carbohydrates, not the low saturated fat proteins like nuts and legumes, and the whole grains that are recommended.

We’re also consuming around 500 additional calories per day than we did 40 years ago according to the USDA. And those extra calories we’ve added to our diet come from low-nutrient processed foods.

More than half of what Americans eat is ‘ultra-processed’ according to a 2016 study in BMJ Open. Walk down the aisle of any supermarket and you’ll see them – frozen pizzas, microwaveable meals, breakfast cereal, snack cakes and energy drinks. These are products that use multiple ingredients and food substances not used in home cooking, including artificial flavors, colors, sweeteners, stabilizers and other additives that mimic non-processed foods or mask undesirable qualities of the final product.

We’ve also moved to eating more meals outside the home. According to USDA data, during the late 1970s Americans consumed just over six percent of their calories from restaurant food, by 2008 that had gone up to almost 20 percent.

All of this has led to a condition never before seen – high calorie malnutrition. Americans have an abundance of calories at their disposal, but are lacking in the nutrients found in a healthy, balanced diet rich in vegetables, fruits, whole grains and low-fat proteins. Our current food culture has come to prioritize quantity over quality, fast meals on-the-go over home cooked meals together around the table. And we’ve come to accept pre-made meals and packaged products with inch-long lists of unrecognizable ingredients in tiny type. This shift has happened gradually and for multiple reasons both large and small.

The UConn Rudd Center reported more than $4.6 billion spent on fast food marketing in 2012. Food manufacturers have spent endless time and energy in developing products that are irresistible to the human palate. They’ve even developed a term for it. The “bliss point” is the point at which the amounts of added sugar, salt and fat are in such a combination as to light up your neurological pleasure centers so that you crave more and never get the satisfaction of having had enough.

The marketing of unhealthy food products begins early. The Federal Trade Commission (FTC) reported in 2009 that food and beverage companies spent $1.79 billion marketing products to children, the overwhelming majority of this being spent on cereal, fast food and carbonated beverages.

Where has this shift in eating patterns left us? More than two-thirds of Americans are considered overweight or obese, with some states, including Arkansas, Mississippi and West Virginia reporting more than 35 percent of their populations as obese. Along with the rise in obesity, we’ve seen a steady rise in diabetes over the past 20 years, with 1 in 8 U.S. adults now diagnosed with diabetes. Since more than 60 percent of diabetics will die of heart disease, the U.S. health care system is bracing for an expected surge in heart disease patients as the current population ages.

So how do we change this? It’s too much to expect individuals to make changes significant enough to impact the current chronic disease rates. Over time we’ve created a food system that devalues health. Now we must implement broad, systemic changes that make the consumption of healthy, nutrient-dense foods the easy choice. We won’t see an improvement in the health of Americans until we do.