Impact of Plant Protein Intakes on Nutrient Adequacy in the US.

There is an increasing interest in plant-based diets and higher levels of plant proteins due to rising concerns around health and environmental sustainability issues. We determined the effects of increasing quartiles of plant protein in the diet on nutrient adequacy using a large nationally representative observational dataset. Twenty-four-hour dietary-recall data from NHANES 2013-2018 from 19,493 participants aged 9+ years were used to assess nutrient intakes. Nutritional adequacy was assessed by estimating the percentage of the population with intakes below the EAR or above the AI. A quartile trend was assessed using regression and the significance was set at Pquartile trend < 0.05. With increasing quartiles of plant protein, the adequacy decreased for calcium, potassium, and vitamin D and increased for copper and magnesium for adolescents. Among the adults aged 19-50 years, the adequacy decreased for protein, choline, selenium, vitamin B12, and zinc and increased for copper, folate, iron, magnesium, thiamin, and vitamin C with increasing quartiles of plant protein. The adequacy for calcium, vitamin A, and zinc decreased and it increased for copper, folate, magnesium, thiamin, and vitamin C with increasing quartiles of plant protein among adults aged 51+ years. The results indicate that diets of mixed protein sources (from both animals and plants) are the most nutritionally adequate.

Contribution of Beef to Key Nutrient Intakes and Nutrient Adequacy in Pregnant and Lactating Women: NHANES 2011-2018 Analysis.

Beef is an important source of high-quality protein and several micronutrients, including iron, zinc, and B-vitamins. The objective was to assess the association of beef intake with nutrient intake and adequacy among pregnant and lactating women using 24-h dietary recall data. Usual intakes from foods were determined with the National Cancer Institute (NCI) method and % population below Estimated Average Requirement (EAR) or above Adequate Intake (AI) were estimated. A high proportion of pregnant and lactating women had inadequate intakes for vitamin D (94%), vitamin E (82%), vitamin C (52%), and vitamin A (50%), magnesium (35%), folate (31%), zinc (25%), and vitamin B6 (22%); only 4% and 35% met AI for choline and potassium, respectively. About 67% of pregnant and lactating women were beef consumers, consuming 49 g beef/day. Beef consumers had higher intakes (p < 0.05) of energy, protein, calcium, iron, phosphorus, selenium, sodium, zinc, thiamin, riboflavin, and niacin, and a higher proportion (p < 0.05) met nutrient recommendations for protein, calcium, iron, zinc, thiamin, riboflavin, niacin, vitamin B6, and vitamin B12 compared to non-consumers. In conclusion, pregnant and lactating women generally have inadequate nutrient intakes from their diets. Beef consumers have higher intakes and adequacy for certain nutrients, many of which are inherently available in beef or in foods eaten with beef.

Assessment of Beverage Trends and Replacing Nondairy Caloric Beverages with Milk at Meals across Childhood Improves Intake of Key Nutrients at Risk of Inadequate Consumption: An NHANES Modeling Study.

Background: Milk is a key source of important nutrients including the nutrients of public health concern. However, most Americans do not meet current (dairy) United States Department of Agriculture (USDA) dietary guideline recommendations, and the intake has been declining. Objective: The aim of this study was to investigate milk and beverage intake trends and nutrient intakes from these products in United States children aged 6-18 y and to model the effect of isocaloric substitution of nondairy beverages with milk. Methods: Data from National Health and Nutrition Examination Survey (NHANES) 2001-2018 for children age 6-8 (N = 4696), 9-13 (N = 8117) and 14-18 y (N = 8514) were used with milk and other beverage intakes determined from the first 24-h in-person dietary recall. Nutrient intake was determined using the NHANES cycle-specific total nutrient intake files. Nutrient modeling was performed by isocaloric substitution with milk of all nondairy beverages consumed during lunch and dinner meals combined. Sample-weighted analyses were performed using SAS 9.4. Results: Between ages 6-8 and 14-18 y, daily intake of milk and flavored milk decreased by 10% and 62%, respectively, while daily intake of caloric beverages excluding milk increased by 96%. Daily intake from caloric beverages and milk combined decreased for fiber, protein, fat, saturated fat, calcium, magnesium, potassium, vitamin A, and vitamin D and increased for energy, carbohydrates, added sugars, and folate between ages 6-8 y and 14-18 y. Isocaloric substitution of all caloric nondairy beverages at meals with milk (using nutrient contribution of USDA milk, not further specified (NFS)) resulted in increases in protein, fat, saturated fat, calcium, magnesium, potassium, sodium, vitamin A, folate, vitamin B12, and vitamin D and decreases in carbohydrate, fiber, and added sugar. Conclusion: These findings provide additional evidence to support dietary recommendations for milk, and efforts should be made on behalf of leading health professionals and childhood meal programs to highlight milk as a beverage of choice in children and adolescents.

Effect of Adding Pulses to Replace Protein Foods and Refined Grains in Healthy Dietary Patterns.

Pulses are dry seeds of legumes which are high in fiber and contain plant protein and several important macronutrients. Our aim was to model the nutritional effects of substituting servings of protein foods and/or refined grains with servings of beans and peas in the Healthy U.S.-Style Pattern identified in the Dietary Guidelines for Americans, 2020-2025. Dietary modeling was accomplished by substituting nutrients of protein foods and/or refined grains with nutrients of the USDA's beans and peas (pulses) composite in the 2000 kcal Healthy U.S.-Style Pattern. A 10% or more change was used as an indicator of meaningful differences. Cost implications were computed by adding the cost of pulses and subtracting the cost of protein foods/refined grains according to the modeling scenario. The substitution of 6-8 oz/week protein foods with 1.5-2.0 cups/week pulses increased fiber and decreased cholesterol. Higher amounts of pulses replacing refined grains or combinations of protein foods and refined grains generally increase fiber, iron, magnesium, potassium, and copper depending on the modeling scenarios. All modeling scenarios of substituting the servings of protein foods alone or in combination with refined grains with the servings of pulses were associated with cost savings. Our results suggest that encouraging increased pulse consumption may be an effective strategy for improving diet.

Association of Pork (All Pork, Fresh Pork and Processed Pork) Consumption with Nutrient Intakes and Adequacy in US Children (Age 2-18 Years) and Adults (Age 19+ Years): NHANES 2011-2018 Analysis.

Pork is a rich source of high-quality protein and select nutrients. The objective of this work was to assess the intakes of all pork (AP), fresh pork (FP) and processed pork (PP) and their association with nutrient intake and meeting nutrient recommendations using 24 h dietary recall data. Usual intake was determined using the NCI method and the percentage of the population with intakes below the Estimated Average Requirement, or above the Adequate Intake for pork consumers and non-consumers, was estimated. About 52, 15 and 45% of children and 59, 20 and 49% of adults were consumers of AP, FP and PP, respectively, with mean intakes in consumers of 47, 60 and 38 g/day for children and 61, 77 and 48 g/day for adults, respectively. Among consumers of AP, FP and PP, the intakes of copper, potassium, selenium, sodium, zinc, thiamine, niacin, vitamin B6 and choline were higher (p < 0.05) and a higher (p < 0.05) proportion met nutrient recommendations for copper, potassium, zinc, thiamin and choline compared to non-consumers. There were additional differences (p < 0.05) in intakes and adequacies for other nutrients between consumers and non-consumers depending upon the age group and pork type. In conclusion, pork intake was associated with higher intakes and adequacies in children and adults for certain key nutrients.

Dairy food consumption is beneficially linked with iodine status in US children and adults: National Health and Nutrition Examination Surveys 2001-2018.

OBJECTIVES: The objective of this study was to determine the association between the consumption of dairy foods with urinary iodine concentration (UIC) and iodine deficiency risk in a nationally representative sample of the US population. DESIGN, SETTING AND PARTICIPANTS: 24-hour dietary recall data and laboratory data for UIC (µg/l) from subjects 2+ years old US population participating in National Health and Nutrition Examination Surveys 2001-2018 were used (n 26 838) for analyses after adjusting for demographic covariates. Significant associations were assessed at P < 0·05. RESULTS: Mean intakes of total dairy were 2·21, 2·17 and 1·70 cup equivalents (cup eq) among those 2-8, 9-18 and 19+ years, respectively. Of the dairy components, intake of milk was highest followed by cheese and yogurt for all age groups. Total dairy intakes were positively associated with UIC among those 2-8 years (ß = 29·9 ± 9·9 µg/l urine/cup eq dairy) and 9-18 years (ß = 26·0 ± 4·8 µg/l urine/cup eq dairy) but not associated among those 19+ years. Total dairy intakes were associated with lowered risks (30 %, 21 % and 20 % for among 2-8, 9-18 and 19+ years, respectively) of being classified as iodine insufficient (UIC < 100 µg/l) or lowered risk (47 %, 30 % and 26 % among 2-8, 9-18 and 19+ years, respectively) of being classified as iodine severely deficient (UIC < 20 µg/l). CONCLUSIONS: The results indicate that dairy foods are beneficially associated with UIC and lowered iodine deficiency risk.

Nutritional Effects of Removing a Serving of Meat or Poultry from Healthy Dietary Patterns-A Dietary Modeling Study.

Meat and poultry are nutrient-dense sources of protein and typically are recommended as part of an overall healthy diet. The objective was to assess the nutritional impact of removing a serving of meat/poultry in Healthy Dietary Patterns (HDPs) using a similar approach to that used by the USDA for Dietary Guidelines for Americans. Composites of minimally processed and further processed meat and poultry were developed and their nutrient profiles were used to accomplish modeling by removing nutrients of each meat and poultry composite from the HDPs. The removal of a 3 oz (85 g) serving of meat or poultry resulted in decreases (10% or more from baseline) in protein and several key micronutrients including iron, phosphorus, potassium, zinc, selenium, thiamine, riboflavin, niacin, vitamin B6, vitamin B12, and choline as well as cholesterol and sodium in the HDPs, and the decreases were consistent for most nutrients with the removal of either minimally processed (fresh) or further processed meat or poultry and even after adjusting for changes in calories. In conclusion, the results of this dietary modeling study show that the removal of a meat and poultry serving from HDPs resulted in decreases in protein and several key nutrients.

Association of 100% Fruit Juice Consumption with Cognitive Measures, Anxiety, and Depression in US Adults.

Cognitive decline, anxiety, and depression are significant contributors to human ill health and decreased quality of life. Intake of fruits including 100% juice is associated with beneficial effects on several health outcomes. The current study explored the potential associations between consumption of 100% fruit juice and neurocognitive markers in adults. Twenty-four-hour dietary recall data from the National Health and Nutrition Examination Survey (NHANES) 1988-1994, 1999-2018 for adults 20+ years (N = 62,606) were used to assess 100% fruit juice intake, and NHANES questionnaire data were used for the assessment of neurocognition. Association of usual intake of 100% fruit juice with neurocognitive outcomes were assessed by regression analysis after adjusting for demographic, lifestyle, dietary, and health-related covariates. About 21% of adults were fruit juice consumers and the intake was a little over 2 oz per day. Consumers of 100% fruit juice had 16.3% fewer days per month of feeling anxious compared to non-consumers. There were no significant associations of 100% fruit juice usual intake with other neurocognitive measures. A large number of potential confounding variables have been identified to be associated with one or more neurocognitive measures suggesting that these may be important parameters to include in future studies.

Contribution of beef to key nutrient intakes in American adults: an updated analysis with NHANES 2011-2018.

Beef represents an important source of high-quality dietary protein and several micronutrients including iron, zinc, and B vitamins. Consumption of lean meat including lean beef is recommended by the Dietary Guidelines for Americans 2020-2025 as part of overall healthy diet. Given beef intake has been declining, the objective of this study was to provide updated evaluation of the nutritional contribution of beef types. Twenty-four-hour dietary recall data from adults age 19+ years (n = 19,766) participating in the National Health and Nutrition Examination Survey 2011-2018 was used to assess intakes. On the day of recall, 49.3%, 40.2%, 26.3%, and 15.3% adults consumed total beef, lean fresh beef, ground beef, and processed beef, respectively, with mean intakes of 45.6, 36.6, 21.3, and 6.23 g/day, respectively. Intake of total beef contributed to daily intakes of energy (5.4%), protein (14%), vitamin B12 (20%), zinc (21%), choline (11%), niacin (9.4%), vitamin B6 (8.3%), iron (7.6%), phosphorus (6.8%), potassium (5.6%), and magnesium (3%). Lean fresh beef contributed most to the daily intakes of energy and nutrients followed by ground and processed beef. Beef intake also contributed to daily intakes of fat (8.7%), saturated fat (11%), and sodium (2.9%) and lean fresh beef contributed less intakes of fat and saturated fat than ground and processed beef. Beef and particularly lean fresh beef were efficient sources of nutrients and provided more nutrients per 100 kcal than the total diet. In conclusion, based on nutrient contribution, these findings provide evidence to support inclusion of beef (especially lean fresh beef) in dietary recommendations.

Association between Intake of Total Dairy and Individual Dairy Foods and Markers of Folate, Vitamin B6 and Vitamin B12 Status in the U.S. Population.

Vitamin B6, B12 and folate are required for energy metabolism and have been identified as nutrients of concern for certain population groups. This study examined the cross-sectional association between the consumption of dairy (total dairy, milk, yogurt and cheese) and biomarkers and adequacy for these nutrients in a nationally representative sample. Twenty-four-hour dietary recall data and concentrations of RBC folate (ng/mL), serum folate (ng/mL), and serum vitamins B6 (nmol/L) and B12 (pg/mL) were obtained from the National Health and Nutrition Examination Survey 2001−2018 (n = 72,831) and were analyzed by linear and logistic regression after adjusting for demographic variables. Significance was set at p < 0.01. Mean intakes of total dairy were 2.21, 2.17, 1.83 and 1.51 cups eq among consumers aged 2−8, 9−18, 19−50 and 51+ years, respectively. Higher intakes of total dairy as well as individual dairy foods (especially milk and yogurt) were positively associated with serum and RBC folate, serum vitamin B6 and serum B12, and generally, with 9−57% lower risk of inadequate or deficient levels of these vitamins. These findings suggest that encouraging dairy consumption may be an effective strategy for improving micronutrient status and provide continued evidence to support the current dietary recommendations for dairy and dairy products.

Association of Dietary Protein Intake and Grip Strength Among Adults Aged 19+ Years: NHANES 2011-2014 Analysis.

Background: Research on the role of protein in the diet has evolved beyond a focus on quantity to include the impact of its quality and distribution across meal times in an effort to optimize dietary protein recommendations. Objective: To determine the association of dietary protein amount, type, and intake pattern with grip strength in adults. Design: Data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014 for adults 19 + years (N = 9,214) were used with exclusions for pregnant and lactating women. Intakes of dietary total protein (TP), animal protein (AP, including dairy), plant protein (PP), and leucine (Leu) were determined using day 1 24 h dietary recall data after adjusting for the complex sample design of NHANES. Regression analyses were used to assess the association of dietary protein and leucine intake quartiles, and whether consuming > 20 g of dietary protein at one or more meals was related to grip strength with adjustment for age, gender, and ethnicity. Results: Mean intake of TP among adults aged 19 + years was 83.6 ± 0.5 g/day, and 2/3rd of this was from animal sources (including dairy). Grip strength increased (p < 0.05) with increasing quartiles of TP, AP, PP, and leucine among all adults 19 + years (ß = 1.340.19, 1.27 ± 0.19, 0.76 ± 0.20, and 1.33 ± 0.23, respectively), 19-50 years (ß = 1.14 ± 0.27, 1.06 ± 0.25, 0.77 ± 0.30, and 1.18 ± 0.27, respectively), and 51 + years (ß = 0.95 ± 0.26, 1.08 ± 0.27, and 1.05 ± 0.27, respectively, for TP, AP, and Leu); however, the increase was more pronounced for AP than PP. Grip strength also increased (p < 0.05) with increasing the number of meal occasions containing > 20 g of dietary protein (ß = 1.50 ± 0.20, 1.41 ± 0.25, and 0.91 ± 0.37 for 19+, 19-50, and 51 + years, respectively), and significant increases were detected for two meals compared to zero meals. Conclusion: Dietary protein quantity, quality, and distribution should be considered collectively when looking to optimize protein intake to support muscle strength and function.

Intake of Potatoes Is Associated with Higher Diet Quality, and Improved Nutrient Intake and Adequacy among US Adolescents: NHANES 2001-2018 Analysis.

Potatoes are nutrient rich white vegetables, however, research on their impact on public health is limited. The objective of this study was to provide updated evaluation of the cross-sectional association between potato consumption and diet quality, nutrient intake and adequacy. Twenty-four hour diet recall data from adolescents (n = 16,633; age 9-18 years) were used to assess intakes. Usual intakes of nutrients were determined using the National Cancer Institute method and diet quality was calculated using the Healthy Eating Index-2015 (HEI-2015) after adjusting for demographic factors. Consumers of potatoes (baked or boiled potatoes, mashed potatoes and potato mixtures, fried potatoes, and potato chips) had higher (p < 0.05) HEI-2015 total score and subcomponent scores for total vegetables, total protein foods, and refined grain than non-consumers. Consumers also had higher (p < 0.05) intake of energy, dietary fiber, protein, copper, magnesium, phosphorus, potassium, selenium, sodium, zinc, niacin, vitamin B6, vitamin C, vitamin K and total choline; and higher (p < 0.05) adequacy for protein, copper, magnesium, phosphorus, potassium, zinc, thiamine, niacin, vitamin B6, vitamin C, and vitamin K than non-consumers. In conclusion, adolescent potato consumption was associated with higher diet quality, nutrient intake, and adequacy and therefore encouraging their consumption may be an effective strategy for improving nutritional status.

Nutritional impact of adding a serving of mushrooms on usual intakes and nutrient adequacy using National Health and Nutrition Examination Survey 2011-2016 data.

To evaluate the nutritional impact of adding a serving of mushrooms on usual intakes and population adequacy of nutrients the National Health and Nutrition Examination Survey (NHANES) 2011-2016 dietary data for 9-18 years and 19+ years and a composite of commonly consumed raw mushrooms as well as oyster mushrooms (nutrient profiles from USDA data) were used for modeling. Usual intakes of nutrients and the percent population below the Estimated Average Requirement (EAR) or above the Adequate Intake (AI) were estimated before and after addition of mushrooms. Means with nonoverlapping 95th percentile confidence levels were used to assess meaningful differences. Addition of a serving (84 g) of mushrooms to the diet resulted in an increase in dietary fiber (5%-6%), copper (24%-32%), phosphorus (6%), potassium (12%-14%), selenium (13%-14%), zinc (5%-6%), riboflavin (13%-15%), niacin (13%-14%), and choline (5%-6%) in both adolescents and adults; and in iron (2.32%), thiamin (4.07%), folate (3.66%), and vitamin B6 (4.64%) in adults only, but had no impact on energy, carbohydrate, fat, or sodium. Addition of a serving of mushrooms also decreased the % below EAR for copper, phosphorus, and riboflavin for those 9-18 years and for copper, phosphorus, selenium, zinc, thiamine, riboflavin, niacin, folate, and vitamin B6 for those 19+ years and increased the % above AI for potassium for both age groups. Addition of oyster mushrooms additionally increased 12%-13% vitamin D, and 12%-15% choline in the NHANES 2011-2016 diets. Addition of mushrooms exposed to UV light to increase vitamin D levels to 5 µg/serving also almost doubled vitamin D intake (98%-104%) and decreased inadequacy. Addition of a serving of mushrooms would also add 2.2 mg ergothioneine and 3.5 mg glutathione to the diet. Addition of a mushroom serving to the diet would increase several micronutrients including shortfall nutrients, without having any impact on energy, sodium, or fat.

Nutritional impact of adding a serving of mushrooms to USDA Food Patterns - a dietary modeling analysis.

Mushrooms are part of vegetables and are important source of nutrients and bioactive compounds. The objective was to assess the nutritional impact of adding a serving of mushrooms in USDA Food Patterns using a similar approach to that used by USDA for Dietary Guidelines. A composite of commonly consumed raw mushrooms (white, brown/crimini and portabella; at 1:1:1 ratio) and raw speciality mushrooms (oyster mushrooms) were used for modeling. The United States Department of Agriculture (USDA) Food Data central database (https://fdc.nal.usda.gov/) was used to obtain nutrient profiles of mushrooms. Nutritional profiles of USDAs Food Patterns were obtained from the Scientific Report of the 2015 Dietary Guidelines Advisory Committee, Appendix E-3 (https://health.gov/dietaryguidelines/2015-scientific-report/15-appendix-E3/) and dietary modeling was accomplished by adding nutrients from mushrooms. Addition of an 84 g serving of commonly consumed raw mushrooms to USDA Food Patterns resulted in about 1% increase in calories, less than 5% increase in macronutrients, 2-3% increase in fiber, 8-12% increase in potassium, 12-18% increase in riboflavin, 11-26% increase in niacin, 11-23% selenium and 16-26% increase in copper depending upon the pattern type and calorie level. Mushrooms exposed to UV light to increase vitamin D levels to 200 IU/serving also increased vitamin D by 67-90% in USDA Food Patterns. Addition of oyster mushroom also additionally increased 8-11% vitamin D and 10-16% choline in USDA Food Patterns. Addition of mushrooms had minimal effect on sodium (1% or less increase) and no effect on saturated fat or cholesterol in USDA Food Patterns. Based on published data, a serving of commonly consumed mushrooms would also be expected to add 2.2 mg ergothioneine and 3.5 mg glutathione to the USDA Food Patterns. Addition of mushrooms to USDA Food Patterns increased several micronutrients including shortfall nutrients (such as potassium, vitamin D and choline), and had a minimal or no impact on overall calories, sodium or saturated fat.

Association of Milk Consumption and Vitamin D Status in the US Population by Ethnicity: NHANES 2001-2010 Analysis.

Vitamin D has been identified as a nutrient of public health concern, and higher intake of natural or fortified food sources of vitamin D, such as milk, are encouraged by the 2015-2020 Dietary Guidelines for Americans. We, therefore, examined the association of milk consumption and vitamin D status in the United States (US) population. Twenty-four-hour dietary recall data and serum 25(OH)D concentrations were obtained from the National Health and Nutrition Examination Survey 2001-2010 and were analyzed by linear and logistic regression after adjusting for anthropometric and demographic variables. Significance was set at p < 0.05. Approximately 57-80% children and 42-60% adults were milk consumers. Milk intake (especially reduced-fat, low fat and no-fat milk) was positively associated (plinear trend < 0.05) with serum vitamin D status and with a 31-42% higher probability of meeting recommended serum vitamin D (>50 nmol/L) levels among all age groups. Serum vitamin D status was also associated with both type and amount of milk intake depending upon the age and ethnicity. In conclusion, the results indicate that milk consumers consistently have higher serum vitamin D levels and higher probability of meeting recommended levels. Therefore, increasing milk intake may be an effective strategy to improve the vitamin D status of the US population.

Association of Yogurt Consumption with Nutrient Intakes, Nutrient Adequacy, and Diet Quality in American Children and Adults.

The popularity of yogurt has increased among consumers due to its perceived health benefits. This study examined the cross-sectional association between yogurt consumption and nutrient intake/adequacy, dietary quality, and body weight in children and adults. National Health and Nutrition Examination Survey 2001-2016 data (n = 65,799) were used and yogurt consumers were defined as those having any amount of yogurt during in-person 24-h diet recall. Usual intakes of nutrients were determined using the National Cancer Institute method and diet quality was calculated using the Healthy Eating Index-2015 (HEI-2015) scores after adjusting data for demographic and lifestyle factors. The data show that approximately 6.4% children and 5.5% adults consume yogurt, with a mean intake of yogurt of 150 ± 3 and 182 ± 3 g/d, respectively. Yogurt consumers had higher diet quality (10.3% and 15.2% higher HEI-2015 scores for children and adults, respectively); higher intakes of fiber, calcium, magnesium, potassium, and vitamin D; and higher percent of the population meeting recommended intakes for calcium, magnesium, and potassium than non-consumers. Consumption of yogurt was also associated with lower body weight, body mass index (BMI), and 23% showed a lower risk of being overweight/obese among adults only. In conclusion, yogurt consumption was associated with higher nutrient intake, nutrient adequacy, and diet quality in both children and adults.

Protein intake is more stable than carbohydrate or fat intake across various US demographic groups and international populations.

BACKGROUND: The optimal macronutrient composition of the diet is controversial and many adults attempt to regulate the intake of specific macronutrients for various health-related reasons. OBJECTIVE: The objective was to compare stability and ranges of intakes of different macronutrients across diverse adult populations in the USA and globally. METHODS: US dietary intake data from NHANES 2009-2014 were used to determine macronutrient intake as a percentage of total energy intake. Variability in macronutrient intake was estimated by calculating the difference between 75th and 25th percentile (Q3-Q1) IQRs of macronutrient intake distributions. In addition, intake data from 13 other countries with per capita gross domestic product (GDP) over $10,000 US dollars (USD) were used to assess variability of intake internationally since there are large differences in types of foods consumed in different countries. RESULTS: Protein, carbohydrate, and fat intake (NHANES 2009-2014) was 15.7 ± 0.1, 48.1 ± 0.1, and 32.9 ± 0.1% kcal, respectively, in US adults. The IQR of protein intake distribution (3.73 ± 0.11% kcal) was 41% of carbohydrate intake distribution (9.18 ± 0.20% kcal) and 58% of fat intake distribution (6.40 ± 0.14% kcal). The IQRs of carbohydrate and fat intake distributions were significantly (P <0.01) influenced by age and race; however, the IQR of protein intake was not associated with demographic and lifestyle factors including sex, race, income, physical activity, and body weight. International mean protein intake was 16.3 ± 0.2% kcal, similar to US intake, and there was less variation in protein than carbohydrate or fat intake. CONCLUSION: Protein intake of the US population and multiple international populations, regardless of demographic and lifestyle factors, was consistently ∼16% of total energy, suggesting biological control mechanism(s) tightly regulate protein intake and, consequently, influence intake of other macronutrients and food constituents. Substantial differences in intake of the other macronutrients observed in US and international populations had little influence on protein intake. This trial was registered at the ISRCTN registry as ISRCTN46157745 (https://www.isrctn.com/ISRCTN4615774).

Demographics, sleep, and daily patterns of caffeine intake of shift workers in a nationally representative sample of the US adult population.

STUDY OBJECTIVE: Caffeine is the most widely consumed stimulant in the world, and sociodemographic factors including occupation are associated with intake. Shift work, required in various occupations, is associated with poor sleep, inadequate diet, and adverse health effects. Using a large nationally representative database, demographics, sleep, and caffeine intake of US adults working various shifts were assessed. METHODS: The 24-hour dietary recall data from NHANES 2005-2010 (N = 8,500) were used to estimate caffeine intake from foods and beverages. Work shifts were self-reported as follows: regular day shift; evening shift; night shift; rotating shift; or other shift. Regression analyses assessed associations of shift work with caffeine intake after adjustment for sociodemographic factors. RESULTS: Approximately 74% of employed adults were day-shift workers and 26% were nonday-shift workers. Night-shift workers slept for 6.25 ± 0.09 hours per day, somewhat less than day-shift workers who only slept 6.83 ± 0.02 hours (p < .0001). Mean 24-hour weekday caffeine intake of evening-, night-, and rotating-shift workers (217 ± 23, 184 ± 19, and 206 ± 15 mg, respectively) was similar (p > .3) to day-shift workers (203 ± 5 mg). Regardless of work schedule, individuals consumed the most caffeine during morning hours. Evening- and night-shift workers reported consuming 36%-46% less caffeine during their work hours and 72%-169% more during nonwork hours than day-shift workers (p < .01). CONCLUSIONS: Total daily caffeine intake of shift workers is similar to nonshift workers; most caffeine is consumed in the morning regardless of shift. Because shift workers consume less caffeine during regular work hours and more during nonwork hours than day workers, they may be using caffeine to, in part, optimize off-duty alertness.

Comparing the cost of essential nutrients from different food sources in the American diet using NHANES 2011-2014.

BACKGROUND: One reason that some Americans do not meet nutrient needs from healthy eating patterns is cost. Food cost affects how people eat, and healthy diets tend to be more expensive. Cost is also important for diet sustainability. Sustainable eating patterns must be both nutritionally adequate and affordable. The objective of this study was to compare the cost of obtaining shortfall nutrients from different food groups to help identify cost-effective ways Americans can move towards healthy and sustainable eating patterns. METHODS: This analysis used dietary intake data from the National Health and Nutrition Examination Survey from 2011 to 2012 and 2013-2014 (n = 5876 children 2-18 years and n = 9953 adults 19-99 years). Americans' nutrient intake from food categories in "What We Eat in America" and the 2015-2020 Dietary Guidelines for Americans was determined using the Food and Nutrient Database for Dietary Studies. Food cost and the cost of nutrients were obtained from Center for Nutrition Promotion and Policy food cost database 2001-2002 and 2003-2004 (adjusted for inflation). RESULTS: The daily mean cost of food was $4.74 ± 0.06 for children and $6.43 ± 0.06 for adults. "Protein foods" and "mixed dishes" were the two most expensive food categories (43-45% of daily food costs), while "grains," "fruits," and "vegetables" combined accounted for ~ 18% of the daily cost, and "milk and dairy" accounted for 6-12% of total daily food costs in both adults and children. "Milk and dairy" were the least expensive dietary sources of calcium and vitamin D in the American diet, while "grains" were the least expensive sources of iron and magnesium, and "protein foods" were the least expensive sources of choline. "Fruits" and "vegetables" were the least expensive sources of potassium and vitamin C, respectively, and "snacks and sweets" were the least expensive sources of vitamin E. CONCLUSION: "Milk and dairy" were inexpensive sources of three of the four nutrients of public health concern (calcium, vitamin D, and potassium), while "grains" were the least expensive source of fiber. The results of this work reinforce the importance of consuming a variety of nutrient-rich foods for cost-effective, sustainable eating patterns.

Intake of 100% Fruit Juice Is Associated with Improved Diet Quality of Adults: NHANES 2013-2016 Analysis.

Fruit intake is generally associated with better diet quality and overall health. This report examined the effect of 100% fruit juice (considered a part of total fruit servings) and its replacement with whole fruits equivalents on nutrient intake and diet quality. National Health and Nutrition Examination Survey 2013-2016 data (24-h dietary recall) from adults 19+ years (n = 10,112) were used to assess the diet quality and nutrient intakes and to isocalorically replace with 100% fruit juice intakes whole fruit equivalents in a modeling analysis. About 15.6% adults were 100% fruit juice consumers. Consumers had higher diet quality (10% higher Healthy Eating Index, HEI 2015 score), and higher intakes of energy, calcium, magnesium, potassium, vitamin C and vitamin D than non-consumers. Consumption of 100% fruit juice was also associated with lower risk of being overweight/obese (-22%) and having metabolic syndrome (-27%). Replacing 100% fruit juice with whole fruits equivalents did not affect nutrient intake except for a modest increase (+6.4%) in dietary fiber. Results show that 100% fruit juice intake was associated with better diet quality and higher nutrient intake. Replacement of 100% fruit juice intake with whole fruits equivalents had no significant effect on nutrients except for dietary fiber.