Vegetable Consumption and Selected Nutrient Intakes of Women of Childbearing Age.

OBJECTIVE: To examine intake of selected nutrients and vegetable consumption of women of childbearing age (WCBA) from 19-50 years of age, across race/ethnicities, and annual household incomes. DESIGN: Dietary data from the National Health and Nutrition Examination Survey 2009-2012 and the Food Pattern Equivalents Database 2009-2012. PARTICIPANTS: The study sample included 3,058 WCBA who were non-Hispanic white (NHW), non-Hispanic black (NHB), Mexican American (MA), and of other races/ethnicities (ORE) with annual household incomes of < $25,000, $25,000-75,000 or > $75,000. VARIABLES MEASURED: Average daily consumption of vegetables and mean intakes of nutrients of concern from foods, including potassium (K), dietary fiber (DF), calcium, magnesium, iron, vitamin C, and folates. ANALYSIS: The analysis compared mean vegetable consumption and nutrient intake from food to current recommendations across race/ethnicity and household income categories. RESULTS: On average, WCBA consumed 1.43 cup equivalents/d of total vegetables and NHB WCBA consumed fewer vegetables than did NHW (P < .01), MA (P < .01), and ORE (P < .01) WCBA. Mean consumption of starchy vegetables, including white potatoes (WP), by WCBA was also below the recommended 5-6 cups of starchy vegetables per week. Average intake of K was 2,364 mg, or about half of the recommended 4,700 mg. Mean DF intake, 15.4 g, was about 60% of the recommended 25 g. In general, NHB WCBA consumed fewer vegetables than did NHW (P < 0.01), MA (P < 0.01), and ORE (P < 0.01) WCBA. On average, WCBA in households with incomes < $25,000 consumed fewer vegetables and had lower intakes of K, DF, calcium, and iron than did WCBA with household incomes > $75,000 (P < .05). CONCLUSIONS AND IMPLICATIONS: These results showed that WCBA had low vegetable consumption, including starchy vegetables, compared with recommendations in the Dietary Guidelines for Americans, 2015-2020. Potassium and DF intakes were low among WCBA, but especially so for NHB WCBA and WCBA with limited financial resources. Government-sponsored food assistance programs should consider policies that encourage WCBA to consume more vegetables, including starchy vegetables, such as WP and lima beans that are rich in K and an important source of DF.

Nutrient Intakes and Vegetable and White Potato Consumption by Children Aged 1 to 3 Years.

In 2020, for the first time, the Dietary Guidelines for Americans will include recommendations for children from birth to age 24 mo. We examined average nutrient intakes as well as total vegetable and white potato (WP) consumption among children aged 1-3 y using day 1 dietary data from the NHANES 2009-2012 and the Food Patterns Equivalents Database 2009-2012. Appropriate survey weights were used to calculate average daily consumption of total vegetables and WPs, which included French-fried potatoes and chips, for boys and girls aged 1-3 y. We calculated mean intakes of selected nutrients of concern, including vitamin D, potassium, dietary fiber (DF), and calcium. We also examined intakes of selected nutrients by major food group. Average intakes of most nutrients, including calcium, by children aged 1-3 y exceeded Dietary Reference Intakes (DRIs). However, average intakes of potassium, DF, and vitamin D were 67%, 55%, and 49% of DRIs, respectively. Mean total vegetable intake was less than the recommendation of 1 cup/d. Boys and girls aged 1-3 y consumed an average of 0.58 cup equivalents of total vegetables on the day of the survey, which included 0.16 cups of WPs. Average vegetable consumption and mean intakes of potassium, DF, and vitamin D were far below recommendations. The consumption of all vegetables, particularly those that are excellent sources of potassium and DF, such as potatoes, should be encouraged.

Executive summary.

The impact of dietary fats and oils on health continues to be a controversial subject. In addition, the ability of the food industry to freely alter the fat content and composition of foods to meet dietary recommendations is limited by how these food components affect food quality and stability. Therefore, a recent workshop was held to bring together food and nutrition scientists to highlight nutritional research and product innovations that explore the nutritional impact of fatty acids in the food supply. The latest research on metabolic responses and health benefits associated with foods made with new nutritional and functional oils was discussed, along with a detailed look at how science-based advances in preparation methods and processing technologies affect the nutrient profile of food products, including potato products. Additional discussion was provided on how oil innovations align with dietary guidance and policy. This supplement issue presents articles on those presentations.

Changes in mean intake of fatty acids and intake of saturated and trans fats from potatoes: NHANES 2005-2006, 2007-2008, and 2009-2010.

Studies have shown that higher than usual intakes of trans fatty acids (TFAs) have adverse effects on blood lipids. Because of this, in 2006 the US FDA mandated labeling of TFAs on food packages. The food and restaurant industries, including the potato industry, reformulated their foods to reduce or eliminate partially hydrogenated vegetable oils and TFAs. Before mandatory labeling, grain-based desserts, yeast breads, and French-fried potatoes (FFPs) were the top sources of TFAs in the food supply; by 2007, potato food manufacturers and quick-service restaurants had reduced or eliminated TFAs without increasing saturated fatty acids (SFAs). FFPs are no longer a source of TFAs in the food supply. This study examined energy and fatty acid intake among children aged 6-11 y, adolescents aged 12-18 y, and adults aged ≥19 y across 3 time periods by using data from the NHANES 2005-2006, 2007-2008, and 2009-2010. On average, intakes of total energy, total fat, SFAs, and monounsaturated fatty acids (MUFAs) decreased significantly between 2005-2006 and 2009-2010 among children and adolescents; however, the intake of polyunsaturated fatty acids (PUFAs) did not change. Among adults, intakes of total fat, SFAs, and MUFAs decreased; however, total energy and PUFA intake did not change. On the day of the 2009-2010 survey, ∼13% of children and 10% of adolescents reported consuming fried FFPs, whereas <7% of adults reported consumption of fried FFPs. Intakes of SFAs and TFAs from fried FFPs decreased significantly between 2005-2006 and 2009-2010 among children, adolescents, and adults. This study confirms that intake of TFAs from FFPs is trivial.

Contributions of white vegetables to nutrient intake: NHANES 2009-2010.

Vegetables, especially white potatoes, provide significant levels of key nutrients of concern, such as potassium and dietary fiber. Per capita availability (PCA) data for vegetables-often used as a proxy for vegetable consumption-show that vegetable consumption, including consumption of white potatoes, declined in the past decade. Using dietary data for participants in the NHANES 2009-2010, we examined total vegetable, white potato, and French-fried potato consumption among all age-gender groups as well as mean energy, potassium, and dietary fiber intakes. Mean total energy intake for the US population (≥2 y old) was 2080 kcal/d, with white potatoes and French-fried potatoes providing ∼4% and ∼2% of total energy, respectively. Individuals who consumed white potatoes had significantly higher total vegetable and potassium intakes than did nonconsumers. In addition, the proportion of potassium and dietary fiber contributed by white potatoes was higher than the proportion that they contributed to total energy. Among white potato consumers aged 14-18 y, white potatoes provided ∼23% of dietary fiber and ∼20% of potassium but only ∼11% of total energy in the diet. The nutrient-dense white potato may be an effective way to increase total vegetable consumption and potassium and dietary fiber intake.

Associations of various family characteristics and time use with children's body mass index.

This study used multiple regression models to estimate associations of various family characteristics and time use with the body mass index (BMI) z-scores of 734 boys and 725 girls aged 5-18y from the Panel Study of Income Dynamics Child Development Supplement 2003. The strongest relationship in the data was between the BMI of the head of household and a child's BMI z-score (p < 0.001). Time spent sleeping, performing sedentary behaviors, and participating in physical activities was not associated with a child's BMI z-score. This suggests that a family-oriented approach to prevent and treat childhood and adolescent overweight is required.

Sugar-sweetened beverages and body mass index in children and adolescents: a meta-analysis.

BACKGROUND: Rates of overweight and obesity have increased. Consumption of sugar-sweetened beverages (SBs) may play a role. OBJECTIVE: The purpose of this meta-analysis was to determine whether the results of original research with the use of longitudinal and randomized controlled trials (RCTs) support the hypothesis that SB consumption is associated with weight gain among children and adolescents. DESIGN: The MEDLINE database was used to retrieve all original studies of SBs and weight gain involving children and adolescents. Twelve (10 longitudinal and 2 RCT) studies were reviewed. Eight of the longitudinal studies and both RCT studies were incorporated into a quantitative meta-analysis. Forest plots and overall estimates and CIs for the association of the difference (Delta) in SB consumption with Deltabody mass index (BMI; in kg/m(2)) were produced. Funnel plots were examined as a diagnostic test for publication bias. Databases of unpublished scientific studies were searched. Sensitivity tests were conducted to examine the robustness of the meta-analysis results. RESULTS: The overall estimate of the association was a 0.004 (95% CI: -0.006, 0.014) change in BMI during the time period defined by the study for each serving per day change in SB consumption with the fixed-effects model and 0.017 (95% CI: -0.009, 0.044) with the random-effects model. The funnel plot is consistent with publication bias against studies that do not report statistically significant findings. The sensitivity tests suggest that the results are robust to alternative assumptions and new studies. CONCLUSION: The quantitative meta-analysis and qualitative review found that the association between SB consumption and BMI was near zero, based on the current body of scientific evidence.

A critical examination of the evidence relating high fructose corn syrup and weight gain.

The use of high fructose corn syrup (HFCS) has increased over the past several decades in the United States while overweight and obesity rates have risen dramatically. Some scientists hypothesize that HFCS consumption has uniquely contributed to the increasing mean body mass index (BMI) of the U.S. population. The Center for Food, Nutrition, and Agriculture Policy convened an expert panel to discuss the published scientific literature examining the relationship between consumption of HFCS or "soft drinks" (proxy for HFCS) and weight gain. The authors conducted original analysis to address certain gaps in the literature. Evidence from ecological studies linking HFCS consumption with rising BMI rates is unreliable. Evidence from epidemiologic studies and randomized controlled trials is inconclusive. Studies analyzing the differences between HFCS and sucrose consumption and their contributions to weight gain do not exist. HFCS and sucrose have similar monosaccharide compositions and sweetness values. The fructose:glucose (F:G) ratio in the U.S. food supply has not appreciably changed since the introduction of HFCS in the 1960s. It is unclear why HFCS would affect satiety or absorption and metabolism of fructose any differently than would sucrose. Based on the currently available evidence, the expert panel concluded that HFCS does not appear to contribute to overweight and obesity any differently than do other energy sources. Research recommendations were made to improve our understanding of the association of HFCS and weight gain.

Demographics, not beverage consumption, is associated with diet quality.

BACKGROUND: Demographic characteristics and beverage choices may affect diet quality. OBJECTIVE: To estimate the independent associations between consumption of food categories of the US Department of Agriculture Food Guide Pyramid, beverage consumption, gender, age, family income, and race/ethnicity with the Healthy Eating Index (HEI). METHODS: Data from the Continuing Survey of Food Intake by Individuals 1994-96, 1998 were used to develop multiple regression models of demographics and food and beverage consumption regressed on the HEI. RESULTS: After adolescence (13-19 years), males consistently had a lower diet quality than females. Young adults (20-29 years) had the poorest diet quality. Family income had a positive association with the HEI. Controlling for income, African-Americans had lower HEI scores than other race/ethnicity groups. Caucasians consumed significantly more milk products than did the other race/ethnicity groups. Consumption of beverages had a weak but positive association with the HEI. CONCLUSIONS: Family income and race/ethnicity have unique and independent associations with the HEI and dietary patterns.

Beverage consumption in the US population.

OBJECTIVE: The purpose of this study was to examine beverage consumption across age, sex, and race/ethnicity categories using the most current data available, the National Health and Nutrition Examination Survey 1999-2002. DESIGN: Beverage consumption that included fluid milk, fruit juices, regular and diet carbonated soft drinks, regular and diet fruit drinks/ades, coffee, and tea was examined among white, African-American, and Mexican-American persons in age groups 6 to 11 years, 12 to 19 years, 20 to 39 years, 40 to 59 years, and >60 years. Data from the National Health and Nutrition Examination Survey 1999-2002 were used in this study. STATISTICAL ANALYSIS: Group means were estimated for the age group, sex, and race/ethnicity subgroups. The probability that any of these group means were equal to one another was tested using statistical software. RESULTS: The data showed marked differences in beverage consumption depending on age, sex, and race/ethnicity. In general, males consumed more beverages than did females. Specifically, white and Mexican-American persons of all ages consumed more milk than did African-American persons. On average, African-American males and females of all ages consumed significantly more fruit drinks/ades than did other race/ethnicity groups. In contrast, white persons consumed more carbonated soft drinks than did other race/ethnicity groups. CONCLUSION: Average beverage consumption varied depending on age, sex, and race/ethnicity. Knowledge of differences in beverage consumption patterns is important for food and nutrition professionals and nutrition policymakers. Better understanding of the many factors that influence beverage consumption levels is needed.

Changes in calcium intake and association with beverage consumption and demographics: comparing data from CSFII 1994-1996, 1998 and NHANES 1999-2002.

BACKGROUND: Consumption of soft drinks has been hypothesized to be negatively associated with calcium intake. However, fortification of some foods and beverages may have affected calcium intake. OBJECTIVE: The purpose of this study was to examine changes in calcium intake and the association of milk consumption with key beverage consumption and demographic variables using the most current data available. DESIGN: Several techniques were used to describe how age, gender, race/ethnicity, and beverage consumption were associated with milk and calcium intake using the Continuing Survey of Food Intake by Individuals 1994-1996, 1998 (CSFII) and the National Health and Nutrition Examination Survey 1999-2002 (NHANES). Using bivariate and multivariate regression analyses, we examined the independent relationships of total non-beverage energy intake, fluid milk consumption, non-milk beverage consumption, and demographics with calcium intake. RESULTS: During the time period between CSFII and NHANES, milk consumption decreased and RCSD consumption increased among children 6-11 y. Calcium intake was unaffected. Among other age categories, milk consumption either did not change or increased (females 40-59 y), while RCSD consumption increased. Calcium intake either did not change or increased in most age-gender categories, including adolescent females. Fluid milk consumption exhibited the strongest association with calcium intake. Fruit juice consumption was also positively associated with calcium intake in most age-gender categories. Consumption of other beverages, including RCSD, had little or no association with calcium intake. CONCLUSIONS: Consumption of low-fat milk should be encouraged, but calcium fortification of certain foods and beverages and calcium supplementation may be needed to further increase calcium intake.

A risk analysis model of the relationship between beverage consumption from school vending machines and risk of adolescent overweight.

Risk analysis is a widely used tool to understand problems in food safety policy, but it is seldom applied to nutrition policy. We propose that risk analysis be applied more often to inform debates on nutrition policy, and we conduct a risk assessment of the relationship of regular carbonated soft drink (RCSD) consumption in schools and body mass index (BMI) as a case study. Data for RCSD consumption in schools were drawn from three data sets: the Continuing Survey of Food Intake by Individuals 1994-1996, 1998 (CSFII), the National Health and Nutrition Examination Survey 1999-2000 (NHANES), and the National Family Opinion (NFO) WorldGroup Share of Intake Panel (SIP) study. We used the largest relationship between RCSD and BMI that was published by prospective observational studies to characterize the maximum plausible relationship in our study. Consumption of RCSD in schools was low in all three data sets, ranging from 15 g/day in NFO-SIP to 60 g/day in NHANES. There was no relationship between RCSD consumption from all sources and BMI in either the CSFII or the NHANES data. The risk assessment showed no impact on BMI by removing RCSD consumption in school. These findings suggest that focusing adolescent overweight prevention programs on RCSD in schools will not have a significant impact on BMI.

Controversy and statistical issues in the use of nutrient densities in assessing diet quality.

The use of nutrient densities, such as percentage of daily energy from added sugars (%E(AS)), creates serious statistical analysis and interpretation problems. This article examines the statistical analyses used in the September 2002 National Academy of Sciences' Institute of Medicine (IOM) draft report on Dietary Reference Intakes for macronutrients. The most critical issues involve the use of a ratio, %E(AS), as the key analytic variable and the use of a model that does not properly control for total energy in the diet. Upon analyzing the same data from the National Health and Nutrition Examination Survey III, an alternative statistical approach using multiple regression to partition total energy into "energy from added sugars" and "energy from other sources" produced very different results than the IOM analysis. Whereas the IOM reported decreasing intakes of calcium, vitamin A, iron, and zinc with increasing %E(AS), we found that the association of energy from added sugars with micronutrient intake was inconsistent and small. Energy from other sources had a much stronger and consistent association with micronutrient intake. We conclude that consumption of added sugars has little or no association with diet quality.

Regulatory issues of functional foods, feeds, and nutraceuticals.

It is clear that the prospects of functional foods and nutraceuticals already excite the scientific community into discovering new substances that promise to extend healthy life. The greatest challenge will remain in the public policy and regulatory arenas, which will encourage research and development of products providing health benefits and permit remarking of products in truthful, nonmisleading communications while protecting public health and maintaining public confidence.

Associations of adequate intake of calcium with diet, beverage consumption, and demographic characteristics among children and adolescents.

OBJECTIVE: The objective of this study is to examine various factors associated with total calcium intake and percent adequate intake (% AI) of calcium by children and adolescents, with respect to age, gender, race/ethnicity, and diet and beverage choices. DESIGN: Data from the U.S. Department of Agriculture's Continuing Survey of Food Intake by Individuals 1994-96, 98 were used in the analyses. Age groupings (2-3, 4-8, 9-13, and 14-18 year olds) were based on the National Academy of Sciences recommendations for AI of calcium-500, 800, 1,300, and 1,300 mg calcium per day, respectively. RESULTS: Consumption of milk products was strongly and positively associated with calcium intake. Consumption of carbonated soft drinks and other non-dairy beverages was also positively associated with calcium intake, but this association was very weak. Beverage choices of African-American children and adolescents are significantly different than white and Hispanic children and adolescents. For example, African-American adolescent girls consume fewer milk products and more fruit drinks/ades. Average daily carbonated soft drink consumption is approximately 1.6 and 1.0 twelve ounce cans among 14-18 year old boys and girls, respectively. CONCLUSION: Carbonated soft drink consumption among adolescent girls is modest and does not appear to be linked to decreased calcium intake. The analyses in this paper show that creative effective, efficient, and targeted policies should be considered to help adolescent girls increase calcium intake. Making low-fat milk products, flavored milks, calcium-fortified beverages and foods more attractive and available will help encourage girls to consume more of this important mineral. When adequate calcium intake is not achieved through foods, health professionals should consider recommending calcium supplements.

The role of beverage consumption, physical activity, sedentary behavior, and demographics on body mass index of adolescents.

The percentage of US adolescents who are overweight or at-risk of overweight has increased over the past 20 years. Using data from the third National Health and Nutrition Examination Survey 1988-1994, multivariate regression models of body mass index (BMI) for adolescent males and females aged 12-16 years were developed to examine the relative importance of demographics, beverage consumption, physical activity, and sedentary behavior for maintaining a healthy body weight. The models explained between 11% and 19% of the variance in BMI. Demographic characteristics accounted for roughly one-half of the explained variance in the models. Age was positively associated with BMI for males and females. Family income had a negative association with BMI for females, but no association with BMI for males. The variables for race/ethnicity and region were only occasionally statistically significant. A strong negative association was found between BMI and participation in team sports or exercise programs for both males and females. The estimate of the relationship between television viewing and BMI was positive but not statistically significant. Consumption of regular carbonated soft drinks (RCSD) and fruit drinks/ades--two beverages widely hypothesized to be positively associated with BMI--were not statistically significant in any of the models. Consumption of diet carbonated soft drinks was very low and was positively associated with BMI for females but not for males. The potential impacts of increasing participation in teams or exercise programs, reducing television viewing, and reducing RCSD consumption on BMI were examined. Increasing participation in teams or exercise programs consistently had the largest impact on reducing predicted BMI. The impact of reducing television viewing had the next largest impact. Reducing consumption of RCSD had the smallest impact. Policies that revitalize physical activity and physical education programs for all students--not just student athletes--and educational efforts that discourage sedentary behavior will be far more successful in combating overweight than an undue focus on beverage consumption.

Demographic and lifestyle factors associated with body mass index among children and adolescents.

Cases of overweight and obesity among adults, adolescents, and children are escalating in the United States. Using data from the Continuing Survey of Food Intake for Individuals (CSFII) 1994-1996 and 1998, and the National Health and Nutrition Examination Survey III (NHANES), we developed multivariate regression models to examine the association between demographic and lifestyle variables (gender, race/ethnicity, age, family income, diet, and television viewing) and the body mass index (BMI) of children aged 6-11 years, and adolescents aged 12-19 years for CSFII and aged 12-16 years for NHANES. In the children's model, the statistically significant demographic predictors of BMI were age, race, gender, and family income. Among adolescents, the demographic predictors were age, race, and gender. Among the lifestyle variables, dietary factors were not associated with BMI in children. On the contrary, carbohydrates (less added sugars) had a statistically significant inverse relationship to BMI among adolescents. In both children and adolescents, television viewing was markedly associated with BMI, and participation in team sports was negatively associated with BMI. The overall process by which overweight develops is complex, and our four models explained only a small portion of total variance of BMI. The CSFII models explained 8.5% of the variance for children and 11.4% of the variance for adolescents. The NHANES models explained 8.8% of the variance for children and 12.5% of the variance for adolescents. Demographic variables accounted for roughly one-half of the explained variance for both children and adolescents. The rest of the explained variance was accounted for by television viewing, diet, and family income.

Total beverage consumption and beverage choices among children and adolescents.

Patterns of beverage consumption among children and adolescents are related to age, race, and gender. The relationship between body mass index (BMI) and beverage consumption is unclear. In this paper, the total amount and the types of beverages consumed were analyzed according to age, race, and gender. Multivariate regression models were estimated for consumption of milk, juices, fruit drinks/ades, and carbonated soft drinks. Descriptive and multivariate regression analysis of children aged 6-19 from the US Department of Agriculture's Continuing Survey of Food Intake by Individuals 1994-96, 98 was performed. It was found that age, race, and gender play a significant role in the total amount, types, and relative proportions of beverages consumed by children and adolescents. Individuals in the first decile drink approximately 212.9 g beverages per day, whereas individuals in the tenth decile drink 2036.2 g. Boys drink more of most beverages than girls do. Older teens tend to drink more carbonated beverages, fruit drinks/ades, and citrus juice, but less fluid milk and non-citrus juice. White adolescent boys are heavy consumers of most beverages, including carbonated soft drinks, milk, and fruit drinks/ades. BMI is positively associated with consumption of diet carbonated beverages and negatively associated with consumption of citrus juice. BMI was not associated with consumption of milk, regular carbonated beverages, regular or diet fruit drinks/ades, or non-citrus juices. In conclusion, total beverage consumption and beverage choices are strongly related to age, race, and gender. BMI was only related to consumption of diet carbonated beverages and milk, and those relationships were weak.

Breast cancer risk and lifestyle differences among premenopausal and postmenopausal African-American women and white women.

BACKGROUND: Very little is known about the role of lifestyle in breast cancer risk, and even less is known about whether differences in lifestyle contribute to the disparities in this risk between African-American women and white women. In this study, the authors examined differences in diet and physical activity between African-American women and white women and discuss the research that is needed regarding the role of lifestyle in breast cancer risk. METHODS: The authors used bivariate and multiple regression analyses to estimate the difference between African-American women and white women in body mass index (BMI), physical activity, the Healthy Eating Index, intake of selected nutrients, and serum levels of some micronutrients. Data were taken from the National Health and Nutrition Examination Survey III, 1988-1994. RESULTS: African-American women had a higher BMI, and older African-American women were less active physically compared with white women. African-American women of all ages had a poorer quality diet, and they consumed more protein and cholesterol but less dietary fiber, folate, and vitamin A. African-American women had lower predicted serum levels of folate and vitamin A but higher predicted serum levels of lutein. CONCLUSIONS: The current findings generally are consistent with the hypothesis that nutrition differences may contribute to the higher rate of breast cancer experienced by younger African-American women, although extensive research is needed. More longitudinal data and research on nutrition, genetics, and breast cancer among African-American women are needed. Studies should examine how to help African-American women make behavioral changes to reduce their risk of breast cancer.