Adding more beans to the US typical dietary pattern can lead to greater intake of shortfall nutrients and a higher diet quality in younger and older adults.

INTRODUCTION: Data on nutrient and diet quality outcomes when additional beans are consumed as part of the typical American dietary pattern are scarce. The purpose of this study was to assess the effect of increased bean consumption, in the typical American dietary pattern, on the intake of shortfall nutrients and overall diet quality. METHODS: Using data from the US National Health and Nutrition Examination Survey, 2001-2018, the current analyses modeled the addition of one and two servings of canned and dried beans in all adults (N = 44,574; ≥19 y), younger adults (N = 23,554; 19-50 y) and older adults (N = 21,020; ≥51 y). The beans considered were kidney beans, black beans, chickpeas, and pinto beans. RESULTS: The modeling of beans to the typical American dietary pattern resulted in significant increases in the intake of several shortfall nutrients, including dietary fiber, potassium, magnesium, iron, folate, and choline (p's < 0.0001). Modeling 1 and 2 servings of beans daily to the US typical dietary pattern significantly increased overall diet quality in all adult age groups considered. Total diet quality, as measured by Healthy Eating Index-2015 scores, was 15-16 % greater with an additional serving of beans and 19-20 % higher with 2 servings of beans relative to the US typical dietary pattern (p values<0.0001). CONCLUSIONS: Dietary patterns that are rich in beans are associated with significantly higher diet quality scores and greater intake of shortfall nutrients, including nutrients of public health concern. Dietary guidance should consider the health benefits associated with the promotion of increased consumption of canned and dry beans in dietary patterns as benefits seen in younger adults continue to older adulthood.

Adult dietary patterns with increased bean consumption are associated with greater overall shortfall nutrient intakes, lower added sugar, improved weight-related outcomes and better diet quality.

BACKGROUND: Limited evidence is available that focuses on beans within American dietary patterns and health. The purpose of this study was to identify commonly consumed adult dietary patterns that included beans and compare shortfall nutrient intakes and diet quality, relative to adults whose typical dietary pattern did not include beans. METHODS: The analyses used data from the National Health and Nutrition Examination Survey, 2001-2018. Cluster analysis was used to identify bean patterns of consumption, while the USDA food coding system defined daily beans consumed. Five bean dietary patterns of consumption were identified, of which four patterns included both canned beans and dry beans, while one pattern had no bean consumption. Bean consumption was defined as those consuming kidney beans, black beans, chickpeas, and/or pinto beans. RESULTS: Adults consuming Bean Dietary Patterns 1, 2, 3 and 4 had significantly higher diet quality scores (as assessed by USDA's Healthy Eating Index-2015) compared to the no-bean pattern (61.2 ± 0.5, 58.9 ± 0.5, 55.2 ± 0.4 and 56.5 ± 0.8 vs 48.8 ± 0.2 p's < 0.0001). Bean consumers also had significantly higher intakes of several shortfall nutrients (choline, alpha-linolenic acid, folate, iron, magnesium and vitamin E) relative to non-consumers of beans. Similarly, intake of dietary fiber, potassium and calcium, all nutrients of public health concern were significantly higher in bean patterns compared to no-beans. Bean Dietary Pattern 1 (~ 13.5% of total daily kcal from beans or ~ 2 servings of beans/day) and 2 (~ 9.5% of total daily kcal from beans or ~ 1.7 servings of beans/day) were significantly associated with lower BMI, decreased body weight and improved waist circumference relative to no-beans. CONCLUSIONS: Dietary patterns that are rich in canned and dry beans were associated with significantly higher diet quality scores and greater intake of shortfall nutrients, including nutrients of public health concern. Bean dietary patterns were also associated with improved weight-related outcomes. Dietary guidance should consider the nutrient and health benefits associated with the promotion of increased canned and dry bean consumption in American dietary patterns.

Egg Usual Intake is Associated with Choline Adequacy in US Infants and Young Children.

Although most US children do not meet recommendations for choline intake, there are also no data available assessing usual egg intake in younger children and choline adequacy. Therefore, data from the National Health and Nutrition Examination Survey, 2001-2018 were analyzed to identify usual egg intake in infants (birth to 1 y; N = 4770) and young children (2-5 y; N = 6930) and to determine mean percentage of infants and children above the Adequate Intake (AI) for daily choline intake. The percent of infants above the AI when consuming the lowest usual egg intake level (<0.25 oz eq) was 33.4 ± 1.3. When comparing 0.25-0.5, 0.5-0.75, 0.75-1.0, and ≥1.0 oz eq to <0.25 oz eq of usual egg intake, the percent of infants above the AI for choline was 67.4 ± 1.6, 84.9 ± 2.1, 93.2 ± 1.5, and 98.1 ± 1.3, respectively (all P < 0.0001). The percent of children above the AI when consuming the lowest usual egg intake level (<0.25 oz eq) was 22.31. Comparing 0.25- 0.5, 0.5-0.75, 0.75-1.0, and ≥1.0 oz eq to <0.25 oz eq of usual egg intake demonstrated significant increases in the percent of toddlers above the AI for choline, such that 51.41%, 72.57%, and 84.94% and 92.57%, respectively, were above the recommended daily intake for choline (all P < 0.0001). Similar findings were seen when assessing infants and children of different socioeconomic status. Overall, the percent of infants and children above the AI was higher with each increasing level of usual egg intake. Given the association of higher choline intakes with egg consumption, increasing usual egg intake in infants and young children may help elevate the percentage meeting the established AI for choline intake and thus, improve choline adequacy in childhood.

Application of a New Carbohydrate Food Quality Scoring System: An Expert Panel Report.

Carbohydrate foods (≥40% energy from carbohydrates) are the main source of energy in the US diet. In contrast to national-level dietary guidance, many regularly consumed carbohydrate foods are low in fiber and whole grains but high in added sugar, sodium, and/or saturated fat. Given the important contribution of higher-quality carbohydrate foods to affordable healthy diets, new metrics are needed to convey the concept of carbohydrate quality to policymakers, food industry stakeholders, health professionals, and consumers. The recently developed Carbohydrate Food Quality Scoring System is well aligned with multiple key healthy messages on nutrients of public health concern from the 2020-2025 Dietary Guidelines for Americans. Two models are described in a previously published paper: one for all non-grain carbohydrate-rich foods (e.g., fruits, vegetables, legumes) known as the Carbohydrate Food Quality Score-4 (CFQS-4), and one for grain foods only known as the Carbohydrate Food Quality Score-5 (CFQS-5). These CFQS models provide a new tool that can guide policy, programs, and people towards improved carbohydrate food choices. Specifically, the CFQS models represent a way to unify and reconcile diverse ways to describe different types of carbohydrate-rich foods (e.g., refined vs. whole, starchy vs. non-starchy, dark green vs. red/orange) and make for more useful and informative messaging that better aligns with a food's nutritional and/or health contributions. The present paper's aims are to show that the CFQS models can inform future dietary guidelines and help support carbohydrate food recommendations with other health messages aimed at promoting foods that are nutrient-dense, fiber-rich, and low in added sugar.

Dairy Food Consumption Is Associated with Reduced Risk of Heart Disease Mortality, but Not All-Cause and Cancer Mortality in US Adults.

Previous evidence has linked animal protein intake, including dairy foods, with an increased risk in mortality from all-causes and certain chronic diseases, including cancer and heart disease. The objective of the current analysis was to examine associations between total dairy consumption with mortality from all-causes, cancer, and heart disease. Data for adults (≥19 y; n = 54,830) from the Third National Health and Nutrition Examination Survey (NHANES) and NHANES 1999-2014 were linked with mortality data through 2015. Individual usual intake for dairy foods were estimated using the National Cancer Institute method. Hazard ratio (HR) models were fit for mortality types (all cause, cancer, heart disease) and measures of usual intakes of dairy. Multivariable analysis further adjusted for age, gender, ethnicity, waist circumference, smoking status, education level, chronic condition status (i.e., based on cancer, myocardial infarct, and diabetes/diabetes medication reported), weight loss attempts, and % kcal from animal protein. No associations were seen between dairy food intake and mortality risk from all-causes [HR = 0.97; confidence intervals (CI): 0.85-1.11; p = 0.67], and cancer [HR = 0.95; CI: 0.75-1.20; p = 0.65] when comparing the lowest quartile to the highest quartile of consumption. Dairy food consumption was associated with a 26% reduced risk for heart disease mortality when comparing the lowest quartile to the highest quartile [HR = 0.74; CI: 0.54-1.01; p = 0.05]. Further analyses in different age groups showed that dairy food consumption was associated with 39% and 31% reduced risk for heart disease mortality in older adults 51-70 and ≥51 y, respectively [adults 51-70 y: HR = 0.61; CI: 0.41-0.91; p = 0.01; adults ≥51 y: HR = 0.69; CI: 0.54-0.89; p = 0.004]. These results contradict previous findings that have linked dairy foods to increased mortality risk. Further, dairy foods as part of a healthy dietary pattern, may help lower heart disease mortality risk.

A New Carbohydrate Food Quality Scoring System to Reflect Dietary Guidelines: An Expert Panel Report.

Existing metrics of carbohydrate food quality have been based, for the most part, on favorable fiber- and free sugar-to-carbohydrate ratios. In these metrics, higher nutritional quality carbohydrate foods are defined as those with >10% fiber and <10% free sugar per 100 g carbohydrate. Although fiber- and sugar-based metrics may help to differentiate the nutritional quality of various types of grain products, they may not aptly capture the nutritional quality of other healthy carbohydrate foods, including beans, legumes, vegetables, and fruits. Carbohydrate food quality metrics need to be applicable across these diverse food groups. This report introduces a new carbohydrate food scoring system known as a Carbohydrate Food Quality Score (CFQS), which supplements the fiber and free sugar components of previous metrics with additional dietary components of public health concern (e.g., sodium, potassium, and whole grains) as identified by the Dietary Guidelines for Americans. Two CFQS models are developed and tested in this study: one that includes four dietary components (CFQS-4: fiber, free sugars, sodium, potassium) and one that considers five dietary components (CFQS-5: fiber, free sugars, sodium, potassium, and whole grains). These models are applied to 2596 carbohydrate foods in the Food and Nutrient Database for Dietary Studies (FNDDS) 2017−2018. Consistent with past studies, the new carbohydrate food scoring system places large percentages of beans, vegetables, and fruits among the top scoring carbohydrate foods. The whole grain component, which only applies to grain foods (N = 1561), identifies ready-to-eat cereals, oatmeal, other cooked cereals, and selected whole grain breads and crackers as higher-quality carbohydrate foods. The new carbohydrate food scoring system shows a high correlation with the Nutrient Rich Food (NRF9.3) index and the Nutri-Score. Metrics of carbohydrate food quality that incorporate whole grains, potassium, and sodium, in addition to sugar and fiber, are strategically aligned with multiple 2020−2025 dietary recommendations and may therefore help with the implementation of present and future dietary guidelines.

Patterns of Egg Consumption Can Help Contribute to Nutrient Recommendations and Are Associated with Diet Quality and Shortfall Nutrient Intakes.

Limited data are available on how eggs are consumed in the typical American eating pattern and the contribution to usual intakes, diet quality and in meeting recommendations. The objectives of the present analysis included identifying how eggs are consumed within U.S. dietary patterns and how these patterns are associated with the usual intakes of shortfall nutrients and diet quality (Healthy Eating Index 2015) using data from the combined National Health and Nutrition Examination Survey (NHANES) from 2001-2016. An additional objective included assessing the differences between egg consumers and egg non-consumers in nutrient intakes and nutrient adequacy. Several egg-containing dietary patterns were identified, and two egg patterns were associated with a greater diet quality compared to a no egg pattern (p < 0.0001). Most egg patterns identified were similar in diet quality scores when compared to the no egg pattern; however, the two egg patterns had lower diet quality scores. Egg consumption combined with a greater intake of total protein foods, seafood and plant protein, total vegetables, total fruit, whole fruit, whole grains and dairy foods, and a lower intake of refined grains and added sugars contributed to an improved diet quality, supporting that no one food is responsible for a healthy dietary pattern. Egg consumers demonstrated significantly higher intakes of dietary fiber, calcium, magnesium, potassium, total choline, vitamin A, vitamin C, vitamin D and vitamin E when compared to egg non-consumers. A comparison of egg consumers and egg non-consumers found egg consumers had significantly less percentages of the population below the EAR for calcium, iron, magnesium, vitamin A, vitamin C and vitamin E. Similarly, the percentage of the population above the recommendations for potassium and choline were greater for egg consumers vs. egg non-consumers. In egg consumers, 24.4% of the population was above the AI for dietary choline when compared to 4.3% of egg non-consumers (p < 0.0001). Findings from the present analysis demonstrate that eggs and egg-containing foods can be an important part of a healthy dietary pattern when balanced accordingly with other nutrient-dense foods.

The Role of Fortified and Enriched Refined Grains in the US Dietary Pattern: A NHANES 2009-2016 Modeling Analysis to Examine Nutrient Adequacy.

Background: While dietary recommendations call for greater whole-grain intake and reduced refined grain consumption, there are limited peer-reviewed studies examining the influence of fortified/enriched refined grains on nutrient adequacy. Methods: A modeling analysis using data from National Health and Nutrition Examination Survey (NHANES) 2009-2016 estimated usual daily intake of shortfall nutrients for Dietary Guidelines for Americans (DGA) in the current dietary pattern and when specific percentages of fortified/enriched refined grain foods (bread, ready-to-eat cereals, and all-grained foods) were removed from the diet (19-50-year-old adults, N = 11,169; 51-99-year-old adults, N = 9,641). Results: While American adults are currently falling short of nutrient recommendations, eliminating 25, 50, and 100% of all grains consumed in the US dietary pattern resulted in a greater percentage of adults not meeting recommendations for several shortfall nutrients, including dietary fiber, folate DFE, iron, and magnesium. Removal of all grains led to a reduced energy intake by ~10% in both age groups examined. Currently, ~3.8% of 19-50-year-old adults meet the adequate intake (AI) for dietary fiber. Removal of 25, 50, and 100% of grains from the diet resulted in 2.6 ± 0.3, 1.8 ± 0.2, and 0.7 ± 0.1% of adults exceeded the AI for dietary fiber, respectively. Similarly, 11.0 and 13.8% of younger and older adults, respectively, fall short of folate, DFE recommendations with the current diet. Following the removal of 100% of grains from the diet, 43.4 ± 1.1 and 56.2 ± 1.0%, respectively, were below the estimated average requirement (EAR) for folate DFE. For iron, current dietary pattern consumption shows 8.4% and 0.8% of younger and older adults, respectively, are not meeting iron recommendations, however, removal of 100% of grains from the diet results in nearly 10 and 22% falling short of the EAR. Currently, about 51 and 54% of younger and older adults are below the EAR for magnesium; however, with the removal of 100% of grains, 68 and 73%, respectively, fall below the EAR. Conclusion: Removal of specific refined grains led to an increased percentage of Americans not meeting recommendations for several shortfall nutrients, including dietary fiber, folate, iron, and magnesium.

Toward an Evidence-Based Definition and Classification of Carbohydrate Food Quality: An Expert Panel Report.

Carbohydrate-containing crops provide the bulk of dietary energy worldwide. In addition to their various carbohydrate forms (sugars, starches, fibers) and ratios, these foods may also contain varying amounts and combinations of proteins, fats, vitamins, minerals, phytochemicals, prebiotics, and anti-nutritional factors that may impact diet quality and health. Currently, there is no standardized or unified way to assess the quality of carbohydrate foods for the overall purpose of improving diet quality and health outcomes, creating an urgent need for the development of metrics and tools to better define and classify high-quality carbohydrate foods. The present report is based on a series of expert panel meetings and a scoping review of the literature focused on carbohydrate quality indicators and metrics produced over the last 10 years. The report outlines various approaches to assessing food quality, and proposes next steps and principles for developing improved metrics for assessing carbohydrate food quality. The expert panel concluded that a composite metric based on nutrient profiling methods featuring inputs such as carbohydrate-fiber-sugar ratios, micronutrients, and/or food group classification could provide useful and informative measures for guiding researchers, policymakers, industry, and consumers towards a better understanding of carbohydrate food quality and overall healthier diets. The identification of higher quality carbohydrate foods could improve evidence-based public health policies and programming-such as the 2025-2030 Dietary Guidelines for Americans.

Increasing Egg Consumption at Breakfast Is Associated with Increased Usual Nutrient Intakes: A Modeling Analysis Using NHANES and the USDA Child and Adult Care Food Program School Breakfast Guidelines.

The objective of the current modeling analysis was three-fold: (1) to examine usual nutrient intakes in children when eggs are added into dietary patterns that typically do not contain eggs; (2) to examine usual nutrient intakes with the addition of eggs in the Child and Adult Care Food Program (CACFP) school breakfast; and (3) to examine nutrient adequacy when eggs are included in routine breakfast patterns and with the addition of eggs to the CACFP school breakfast program. Dietary recall data from the National Health and Nutrition Examination Survey 2011-2016 (children aged 1-18 years-old; n = 9254; CACFP n = 159) were used in the analysis. The usual intakes of pantothenic acid, riboflavin, selenium, and vitamin D increased ≥10 percent (relative to the baseline values) with the addition of one egg at breakfast. The usual intakes of protein and vitamin A at breakfast were also increased by more than 10 percent compared to the baseline values with the addition of two eggs. Similar outcomes were observed with the addition of eggs to the CACFP school breakfast. The percent of children above the adequate intake for total choline increased to 43.6 and 57.8% with one and two eggs, respectively, compared to 22.6% at the baseline. The addition of eggs at breakfast can contribute to nutrient intakes and overall dietary adequacy and play a role in public health initiatives aimed at increasing the intake of under-consumed nutrients and nutrients of concern.

Modeling the Removal and Addition of Eggs in the Current US Diet is Linked to Choline and Lutein + Zeaxanthin Usual Intakes in Childhood.

BACKGROUND: Limited data are available examining nutritional implications for removing/adding eggs in childhood dietary patterns. Additionally, usual intake data are lacking for choline and lutein + zeaxanthin in childhood. OBJECTIVES: To determine usual intakes of choline and lutein + zeaxanthin in egg consumers and model the removal and addition of eggs within dietary patterns on choline and lutein + zeaxanthin intakes. METHODS: Data from the NHANES, 2011-2014, were analyzed in egg consumers (infants, n = 130; children/adolescents, n = 980) of various age groups during childhood. Additionally, a modeling analysis was conducted to examine choline and lutein + zeaxanthin intake following the removal and addition of eggs to the current American diet of children. RESULTS: Overall, modeling removal of eggs from the diet in all age groups examined showed decreases in choline intakes, resulting in significantly fewer subjects above the recommended Adequate Intake (AI) for choline. In contrast, the addition of 1 egg per week to the current American eating pattern resulted in nearly 10% more infants 6-23 months of age being above the AI for choline intake. The addition of 7 eggs per week to the current dietary pattern of infants would nearly achieve 100% of infants meeting the AI for choline. In children 2-8 years old, modeling an additional 7 eggs per week to the current dietary pattern resulted in approximately 94% of children being above the AI for choline, while the addition of 7 eggs per week increases the percentages above the AI to 23.0% and 52.4% in children aged 9-18 and 2-18 years, respectively. In children aged 2-8 and 2-18 years old, the addition of 7 eggs per week also showed meaningful increases in lutein + zeaxanthin usual intakes relative to the current dietary pattern (i.e., lutein + zeaxanthin increased from nearly 775 mcg/day to approximately 916 mcg/day and 780 mcg/day to approximately 931 mcg/day, respectively). CONCLUSIONS: The current data support egg consumption as part of healthy dietary patterns to help meet established choline recommendations, while concurrently increasing lutein and zeaxanthin intakes in childhood.

Mango Consumption Is Associated with Improved Nutrient Intakes, Diet Quality, and Weight-Related Health Outcomes.

As nutrient-dense fruits, mangoes are commonly consumed globally and are important sources of nutrients in the diet. Nonetheless, mangoes remain relatively under-consumed in the United States. The objective of the present analysis was to examine nutrient intakes, diet quality, and health outcomes using data from NHANES 2001-2018 in children and adult mango consumers (n = 291; adults n = 449) compared with mango non-consumers (children n = 28,257; adults n = 44,574). Daily energy and nutrient intakes were adjusted for a complex sample design of NHANES using appropriate weights. Mango consumption was not associated with daily energy intake, compared with non-consumption, in both children and adults. Children consuming mangoes had a significantly lower daily intake of added sugar, sodium, total fat, and a higher intake of dietary fiber, magnesium, potassium, total choline, vitamin C, and vitamin D, compared with non-consumers. In adults, mango consumers had significantly higher daily intakes of dietary fiber, magnesium, potassium, folate, vitamin A, vitamin C, and vitamin E and significantly lower intakes of added sugar and cholesterol, compared with non-consumers. Mango consumption was also associated with a better diet quality vs. mango non-consumers (p < 0.0001). Mango consumption in adolescents was associated with lower BMI z-scores, compared with non-consumption. In adults, BMI scores, waist circumference, and body weight were significantly lower only in male mango consumers when compared with mango non-consumers. The current results support that mango consumption is associated with improved nutrient intakes, diet quality, and certain health outcomes. Thus, dietary strategies that aim to increase mango consumption in the American population should be evaluated as part of future dietary guidance.

Do Refined Grains Have a Place in a Healthy Dietary Pattern: Perspectives from an Expert Panel Consensus Meeting.

Although dietary guidance recommends increasing consumption of whole grains and concurrently limiting consumption of refined and/or enriched grain foods, emerging research suggests that certain refined grains may be part of a healthy dietary pattern. A scientific expert panel was convened to review published data since the release of 2015 dietary guidance in defined areas of grain research, which included nutrient intakes, diet quality, enrichment/fortification, and associations with weight-related outcomes. Based on a 1-d roundtable discussion, the expert panel reached consensus that 1) whole grains and refined grains can make meaningful nutrient contributions to dietary patterns, 2) whole and refined grain foods contribute nutrient density, 3) fortification and enrichment of grains remain vital in delivering nutrient adequacy in the American diet, 4) there is inconclusive scientific evidence that refined grain foods are linked to overweight and obesity, and 5) gaps exist in the scientific literature with regard to grain foods and health.

Pasta Consumption Is Linked to Greater Nutrient Intakes and Improved Diet Quality in American Children and Adults, and Beneficial Weight-Related Outcomes Only in Adult Females.

The present analyses evaluated associations between pasta consumption, nutrient intakes, and diet quality in U.S. children (2-18 years-old; N = 323) and adults (≥19 years-old; N = 400) using the US National Health and Nutrition Examination Survey, 2001-2012 dataset. An additional aim included assessing associations with pasta consumption and weight-related outcomes in adults. Consumption of dry, domestic, and imported wheat pasta/noodles without eggs defined pasta consumers. Energy intake was similar when comparing pasta consumers vs. non-consumers of pasta. Pasta consumers had increased daily intake of dietary fiber (16 ± 0.6 vs. 13 ± 0.1 g/d, p < 0.0001; 21 ± 0.8 vs. 16 ± 0.1 g/d, p < 0.0001), folate, DFE (701 ± 30 vs. 528 ± 5 µg/d, p < 0.0001; 733 ± 42 vs. 546 ± 4 µg/d, p < 0.0001), iron (16 ± 0.5 vs. 14 ± 0.1 mg/d, p = 0.01; 18 ± 0.9 vs. 16 ± 0.1 mg/d, p = 0.01), magnesium (249 ± 7 vs. 231 ± mg/d, p = 0.006; 327 ± 12 vs. 297 ± 2 mg/d, p < 0.02), and vitamin E as α-tocopherol (7 ± 0.4 vs. 6 ± 0.05 mg/d, p = 0.012; 10.0 ± 0.4 vs. 7.7 ± 0.1 mg/d, p < 0.0001), when compared to non-consumers of pasta, in children and adults, respectively. Daily intakes for potassium, calcium, vitamin A and vitamin D were similar when comparing pasta consumers to non-consumers of pasta. Adult pasta consumers had reduced added sugar and saturated fat intake, while no differences were observed for sodium intake vs. non-pasta consumption. Pasta consumption in children was associated with lower saturated fat, with no differences seen in added sugar and sodium intake. Pasta consumption was associated with an improved diet quality relative to non-pasta consumption (children: 48.6 ± 1.0 vs. 45.6 ± 0.2, p = 0.002; adult: 51.0 ± 0.9 vs. 48.9 ± 0.2, p = 0.024). No associations were observed when evaluating pasta consumption in all adults, however, gender-specific analysis revealed reduced body mass index, waist circumference, and body weight in females aged 19-50 years when compared to no pasta consumption. Overall, pasta consumption was associated with a better diet quality, improved nutrient intakes and lower intake of nutrients to limit relative to non-pasta consumption in Americans.

Eggs Are Cost-Efficient in Delivering Several Shortfall Nutrients in the American Diet: A Cost-Analysis in Children and Adults.

The purpose of the current study was to examine the cost of eggs in relation to nutrient delivery in children and adults. The present analysis used dietary intake data from the National Health and Nutrition Examination Survey 2013-2016 (egg consumers: 2-18 years-old, N = 956; 19+ years-old, N = 2424). Inflation adjusted food cost and the cost of nutrients were obtained from the Center for Nutrition Promotion and Policy food cost database. Cost and nutrient profiles for What We Eat in America food categories were compared to whole eggs. Of the 15 main food groups examined, whole eggs ranked third for lowest cost per 100 g (excluding beverages), such that eggs cost 0.35 USD per 100 g, with dairy and grains representing the first and second most cost-efficient foods, at 0.23 USD and 0.27 USD per 100 g, respectively. In children and adults, eggs represented a cost-efficient food for protein delivery, such that eggs provided nearly 2.7% and 3.7% of all protein in the diet, respectively, at a cost of about 0.03 USD per g of protein. Eggs contributed 3.8% and 6.0% of all vitamin A in the diet of children and adults, at a cost of approximately 0.002 USD and 0.003 USD per RAE mcg of vitamin A, respectively. In children 2-18 years-old, nearly 12% of all choline in the diet is delivered from eggs, at a cost of approximately 0.002 USD per mg of choline. Similarly, in adults 19-years-old+, eggs provide nearly 15% of all dietary choline in the diet, at a cost of approximately 0.002 USD per mg of choline. Eggs provide nearly 5% and 9.5% of all vitamin D in the diet of children and adults, at a cost of approximately 0.21 USD and 0.22 USD per mcg of vitamin D, respectively. Overall, eggs ranked as the most cost-efficient food for delivering protein, choline, and vitamin A, second for vitamin E, and third for vitamin D in children. In adults, eggs ranked as the most cost-efficient food for delivering protein and choline, second for vitamin A, and third for vitamin D and vitamin E. In summary, eggs represent an economical food choice for the delivery of protein and several shortfall nutrients (choline, vitamin A, and vitamin D) in the American diet.

Grain Foods in US Infants are Associated with Greater Nutrient Intakes, Improved Diet Quality and Increased Consumption of Recommended Food Groups.

There are limited data providing guidance on grain foods as part of a healthy dietary pattern in infants and may represent a gap in knowledge for the development of the 2020-2025 Dietary Guidelines for Americans Scientific Advisory Committee report currently in progress. An analysis using infant data from the National Health and Nutrition Examination Survey was conducted to assess grain food relationships with nutrient and energy intakes, diet quality, and food group consumption in infant consumers relative to non-consumers. Grain consumers were defined as infants consuming foods from the main grain food group, as defined by the US Department of Agriculture, and included whole and refined/enriched grains. All infants consuming grain foods had greater energy (kcal) vs. grain non-consumers (p's < 0.0047). While infant grain consumers 6- to 12-months-old (N = 942) had higher daily intakes of sodium and added and total sugars, these infants also had significantly higher dietary fiber, calcium, folate, potassium, magnesium, zinc, phosphorus, choline, thiamin, riboflavin, and vitamin B6 compared to non-consumers. In 13- to 23-month-olds (N = 1668), grain consumption was associated with greater daily dietary fiber, iron, zinc, magnesium, phosphorus, folate, riboflavin, niacin, thiamin, vitamin A, vitamin B6, and vitamin B12 relative to non-consumers. Diet quality scores were significantly higher in all infant grain consumers examined in comparison to non-consumers (p's < 0.0065). Grain intake was also linked with greater daily intake of several recommended food groups in both younger and older infants versus non-consumption of grains. The current analysis provides evidence to substantiate the inclusion of whole and enriched grain foods as part of the infant dietary pattern as beneficial associations between grain food consumption and dietary quality are apparent. Eliminating and/or reducing grain foods in infant dietary patterns may lead to unintended nutrient and health consequences.

Type of Sandwich Consumption Within a US Dietary Pattern Can Be Associated with Better Nutrient Intakes and Overall Diet Quality: A Modeling Study Using Data from NHANES 2013-2014.

BACKGROUND: Previous research in adults has reported an association between sandwich consumers and increased daily energy, total fat, and sodium intakes and decreased dietary fiber intake. Additionally, sandwich consumers had a lower diet quality, as compared to non-sandwich consumers. However, the research failed to differentiate between the types of sandwiches consumed. OBJECTIVES: The purpose of this study was to model different sandwiches, using both whole-grain bread (WGB), enriched-grain bread (EGB), and soft taco tortillas, to examine associations with energy (kcal), nutrient intakes, and diet quality, in comparison to the typically consumed sandwich (control). METHODS: Data from the NHANES 2013-2014 was used to complete the analyses in adults ≥19 years old, and USDA food composites were used to create 5 sandwich types, using WGB, EGB, or soft corn tortillas. RESULTS: In the modeling analysis, adults consuming the soft corn tortilla taco had lower energy, as compared to those eating the typical sandwich. Total fat intakes were lower in the WGB and EGB grilled chicken/cheese/vegetable sandwiches and in the soft taco tortilla, in comparison to the control sandwich. Sodium intakes were lower in the WGB and EGB grilled chicken/cheese/vegetable sandwiches and in the soft taco tortilla, in comparison to the typical sandwich consumed. All WGB sandwich models and the soft taco tortilla had greater daily dietary fiber intakes, in comparison to the control sandwich. WGB, EGB, and tortilla sandwiches were also associated with greater intakes of shortfall nutrients. All sandwich models, except EGB with meat/cheese/vegetables, had higher diet qualities, in comparison to the control. CONCLUSIONS: The current data support the inclusion of certain WGB and EGB sandwiches/tortillas, within recommended dietary patterns, in American adults, and suggest that ingredients within a sandwich, rather than the just the bread component, can be an important contributor to overall nutrient intakes and nutrients to limit in the diet.

Egg Consumption in U.S. Children is Associated with Greater Daily Nutrient Intakes, including Protein, Lutein + Zeaxanthin, Choline, α-Linolenic Acid, and Docosahexanoic Acid.

Dietary pattern recommendations include consuming a variety of nutrient-dense foods in children and adolescents to promote optimal growth and development. The current study investigated associations with egg consumption and nutrient intakes, diet quality, and growth outcomes relative to non-egg consumers. The analysis used data from the U.S. National Health and Nutrition Examination Survey (NHANES) 2001-2012 in children and adolescents aged 2-18 years (N = 3,299, egg consumers; N = 17,030, egg non-consumers). Daily energy and nutrient intakes were adjusted for the complex sample design of NHANES using appropriate weights. Consuming eggs was associated with increased daily energy intake relative to non-egg consumption. Children and adolescents consuming eggs had elevated daily intake of protein, polyunsaturated, monounsaturated and total fat, α-linolenic acid, docosahexaenoic acid (DHA), choline, lutein + zeaxanthin, vitamin D, potassium, phosphorus, and selenium. Egg consumers had greater consumption, sodium, saturated fat, with reduced total and added sugar versus egg non-consumers. The analysis also showed that egg consumption was linked with lower intake of dietary folate, iron, and niacin. No associations were determined when examining diet quality and growth-related measures. A sub-analysis considering socioeconomic status showed that egg consumption was positively related with daily lutein + zeaxanthin and DHA intake. The current analysis demonstrated several nutrient-related benefits to support the continued inclusion of eggs in the dietary patterns of children and adolescents.

Consumption Patterns of Grain-Based Foods among Adults in Canada: Evidence from Canadian Community Health Survey-Nutrition 2015.

In this study, we used the Canadian Community Health Survey-Nutrition (CCHS) 2015 data to examine the consumption patterns of grain-based foods (GBFs) for Canadian adults. We used a k-mean cluster analysis based on the contribution of 21 grain-based foods to total energy intake of adults in Canada to find the dietary patterns of GBFs. Cluster analyses rendered seven dietary patterns including: 'other bread', 'cake and cookies', 'pasta', 'rice', 'mixed', 'white bread', and finally 'whole wheat and whole-grain bread'. 'No grain' and 'rice' consumers had lower intakes of dietary fibre, folate, iron and calcium, which are the nutrients of public health concern in Canada. Adults consuming a 'mixed grain' dietary pattern had a greater daily intake of calcium, potassium, magnesium, riboflavin, and vitamin B6 than those in the 'no grain' dietary pattern. We also observed that a considerable proportion of individuals clustered in the 'rice' group are immigrants and belong to households with lower income levels.

Consumption Patterns of Grain-Based Foods among Children and Adolescents in Canada: Evidence from Canadian Community Health Survey-Nutrition 2015.

The current analyses used data from the Canadian Community Health Survey-Nutrition 2015 to investigate grain-based food (GBF) dietary patterns of consumptions among 6,400,000 Canadian children and adolescents 2 to 18 years old. Nutrient intakes, socioeconomic differences, body mass index (BMI) z-scores, and intakes of several food groups were examined across the identified grain patterns of consumption. We employed k-mean cluster analysis to identify the consumption patterns of grain products. Based on the contributions of 21 grain food groups to the total energy intake of each individual, seven GBF consumption patterns were identified including other bread; salty snacks; pasta; rice; cakes and cookies; white bread; and mixed grains. Individuals having less than one serving of grain products were also separately categorized as no-grain consumers. Mean energy intake (kcal/day) was lowest for the "no-grain" consumers and greatest in children/adolescents consuming a "salty snacks" pattern when all GBF patterns were compared. Children and adolescents with "no-grain" and "rice" GBF consumption patterns had significantly lower intakes of several nutrients including dietary fiber, folate, magnesium, calcium, iron, zinc, thiamin, niacin, and riboflavin. No associations were observed with any of the identified GBF patterns and BMI z-scores. In addition, the socioeconomic status (SES) indicators such as household incomes and immigration status of participants were shown to be significantly different across the identified clusters.