Comparing Two Days of Dietary Intake in What We Eat in America (WWEIA), NHANES, 2013–2016

The objective of this research is to compare the Day 1 and Day 2 dietary intakes of adults in What We Eat in America, National Health and Nutrition Examination Survey (WWEIA, NHANES) 2013–2016. Dietary recalls of males (n = 2599) and females (n = 2624) 20+ years who had both a Day 1 and Day 2 recall and reported their intake as usual on both days in WWEIA, NHANES 2013–2016 were examined. Mean (±SE) energy intake for males was 2425 ± 26 kcal for Day 1 and 2334 ± 32 kcal for Day 2 (p = 0.004). For females, 1832 ± 18 kcal and 1775 ± 26 kcal were reported for Day 1 and 2, respectively (p = 0.020). There were no significant differences between energy intake on Day 1 and Day 2 within males and females by ten-year age groups. Comparing 20 year age groups for males and females by race/ethnicity (non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, and Hispanic) and income (<131%, 131–350%, and >350% of poverty level) also showed no significant differences in energy intake between Day 1 and Day 2. Mean energy intake of adults was not statistically different between the two days of recall by sex, race/ethnicity or income within selected age groups. Overall, the difference in energy intake was less than 4% for both males and females.     

Usual Nutrient Intake Distribution and Prevalence of Inadequacy among Australian Children 0–24 Months: Findings from the Australian Feeding Infants and Toddlers Study (OzFITS) 2021

(1) Background: Breastmilk provides all the nutrition an infant requires between 0–6 months. After that, complementary foods are needed to meet the child’s increasing energy and nutrient requirements. Inadequate energy and nutrient intake may lead to growth faltering, impaired neurodevelopment, and increased disease risk. While the importance of early life nutrition is well recognized, there are few investigations assessing the nutritional adequacy of Australian children <24 months. Here, we describe usual energy and nutrient intake distributions, including the prevalence of inadequate intakes and exceeding the upper limit (UL), in a national sample of Australian children 6– 24 months and infants < six months who had commenced solids and/or formula. (2) Methods: Dietary intakes were assessed using a one-day food record for 976 children with a repeat one-day record in a random subset. (3) Results: Based on the Nutrient Reference Values for Australia and New Zealand, children’s intakes were above the Adequate Intake or Estimated Average Requirement for most nutrients. Exceptions were iron and zinc where the prevalence of inadequacy was estimated to be 75% and 20%, respectively, for infants aged 6–11.9 months. Low iron intake was also observed in one quarter of toddlers 12–24 months. On average, children consumed 10% more energy than predicted based on Estimated Energy Requirements, and ~10% were classified as overweight based on their weight for length. One third of toddlers exceeded the tolerable upper limit for sodium and consumed > 1000 mg/day. Of the children under six months, 18% and 43% exceeded the UL for vitamin A (retinol) and zinc. (4) Conclusions: Compared to nutrient reference values, diets were sufficient for most nutrients; however, iron was a limiting nutrient for infants aged 6–11.9 months and toddlers 12–24 months potentially putting them at risk for iron deficiency. Excessive sodium intake among toddlers is a concern as this may increase the risk for hypertension.     

Food Sources of Energy and Nutrients among Children in the United States: National Health and Nutrition Examination Survey 2003–2006

Background: Recent detailed analyses of data on dietary sources of energy and nutrients in US children are lacking. The objective of this study was to identify food sources of energy and 28 nutrients for children in the United States. Methods: Analyses of food sources were conducted using a single 24-h recall collected from children 2 to 18 years old (n = 7332) in the 2003–2006 National Health and Nutrition Examination Survey. Sources of nutrients contained in foods were determined using nutrient composition databases. Food grouping included ingredients from disaggregated mixtures. Mean energy and nutrient intakes from the total diet and from each food group were adjusted for the sample design using appropriate weights. Percentages of the total dietary intake that food sources contributed were tabulated by rank order. Results: The two top ranked food/food group sources of energy and nutrients were: energy—milk (7% of energy) and cake/cookies/quick bread/pastry/pie (7%); protein—milk (13.2%) and poultry (12.8%); total carbohydrate—soft drinks/soda (10.5%) and yeast bread/rolls (9.1%); total sugars—soft drinks/soda (19.2%) and yeast breads and rolls (12.7%); added sugars—soft drinks/soda (29.7%) and candy/sugar/sugary foods (18.6%); dietary fiber—fruit (10.4%) and yeast bread/rolls (10.3%); total fat—cheese (9.3%) and crackers/popcorn/pretzels/chips (8.4%); saturated fatty acids—cheese (16.3%) and milk (13.3%); cholesterol—eggs (24.2%) and poultry (13.2%); vitamin D—milk (60.4%) and milk drinks (8.3%); calcium—milk (33.2%) and cheese (19.4%); potassium—milk (18.8%) and fruit juice (8.0%); and sodium—salt (18.5%) and yeast bread and rolls (8.4%). Conclusions: Results suggest that many foods/food groupings consumed by children were energy dense, nutrient poor. Awareness of dietary sources of energy and nutrients can help health professionals design effective strategies to reduce energy consumption and increase the nutrient density of children’s diets.     

20-Year trends in dietary and meal behaviors were similar in U.S. children and adolescents of different race/ethnicity

Recent survey data reveal persistent race/ethnic disparities in prevalence of adiposity in U.S. children and adolescents. We examined race/ethnic differentials in time trends in dietary behaviors of Americans 2-19 y of age to understand if these trends track those observed for body weight. We used dietary data from the NHANES 1988-1994, 1999-2002, and 2003-2008 (n = 24,131) to examine changes in reported energy intake, amount of foods and beverages, number of eating occasions, and percent of energy from foods and beverages, among non-Hispanic white, non-Hispanic black, and Mexican American 2-19 y olds. Multivariable regression analyses appropriate for complex surveys were used to examine these associations. The secular increase in mean number of eating occasions was significant (P-trend < 0.0001) in all age and race/ethnic groups; however, a corresponding increase in the amount of foods and beverages, or total energy intake was not observed. In non-Hispanic black and Mexican American 2-5 and 12-19 y olds, the secular increase in number of eating occasions, and in non-Hispanic black 12-19 y olds, the increase in percent of energy from all beverages or non-nutritive beverages were greater relative to non-Hispanic whites. In conclusion, the observed race/ethnic differences in trajectory of changes in dietary behaviors over past 20 y were modest and were not accompanied by a significant increase in energy intake. Cautious interpretation is urged due to potential underreporting of dietary intake in national surveys. There was a suggestion of convergence in some race/ethnic differentials in dietary behaviors due to greater relative changes in possibly adverse behaviors in non-Hispanic blacks, especially adolescents.     

Removing Potatoes from Children's Diets May Compromise Potassium Intake

White potatoes are a forgotten source of nutrients. The goal of this study was to identify the nutritional implications of replacing a composite of white potatoes with a composite of vegetables commonly consumed by children aged 2–18 y (n = 3460) in a nationally representative sample. The NHANES 2005–2012 24-h dietary recall data were used to determine nutrient intake. Two replacement models were developed: one for potato consumers and another for those consuming vegetables other than potatoes. Analyses focused on 1) mean nutrient contributions per 1 cup equivalent vegetable composite (VC)/potato composite (PC) consumed by participants, and 2) mean daily nutrient intake when the nutrients per 1 cup equivalent PC replaced the nutrients per 1 cup equivalent VC. Covariate adjusted analysis was tested for statistical significance (P < 0.002). When 1 cup equivalent VC replaced 1 cup equivalent PC, significantly lower mean intakes were found for 20 of the 23 nutrients studied and higher mean intakes of total sugars, folate, and calcium. Differences were found including higher total intakes of monounsaturated fatty acids and potassium and lower total intakes of vitamins A and K. The percentage contribution of the PC to total daily nutrient intake was 6% for total energy, 8% for total fat, 5% for saturated fatty acids, 13% for dietary fiber, 4% for sodium, and 11% for potassium. Both composites contributed a variety of nutrients to the total diet; the consumption of white potatoes may be an important strategy to help meet the potassium recommendation.     

A Comparison of the Effects of Young-Child Formulas and Cow’s Milk on Nutrient Intakes in Polish Children Aged 13–24 Months

Adequately balanced daily food rations that provide the body with sufficient amounts of energy and nutrients, including minerals, are particularly important in early childhood when rapid physical, intellectual and motor development takes place. Cow’s milk (CM) and young-child formulas (YCFs) are introduced to a child’s diet past the first year of age. The main aim of the present study was to perform a qualitative and a quantitative analysis of daily food rations of young children based on the recommendations of the daily food ration model. An attempt was also made to determine whether the type of consumed milk (YCF or CM) adequately meets young children’s energy demands and contributes to the incorporation of different food groups into a balanced and healthy diet for children aged 13–24 months. A total of 714 parents between October 2019 and March 2020 filled out a food frequency questionnaire. In the second stage of the study, the parents participated in a dietary recall and were asked to keep diaries of all meals and foods consumed by children over a period of three days. The mean daily intake of CM/YCF and fermented milks was determined at 360 mL ± 128 mL, and it accounted for 55.4% of the guideline values. Flavored dairy products were consumed more frequently than fermented milks without added sugar or flavoring (94 ± 17 g vs. 56 ± 26 g, p < 0.05). Diets incorporating CM were significantly more abundant in protein than YCF diets (29.3 g vs. 21.9 g; p < 0.01). Liquid intake was somewhat higher in children fed YCFs (1280.8 mL vs. 1120.1; p < 0.05), mainly due to the higher consumption of fruit juice, nectars and sweetened hot beverages (246 ± 35 mL in the YCF group vs. 201 ± 56 mL in the CM group; p < 0.05). Children fed YCF consumed significantly larger amounts of sweetened beverages such as tea sweetened with sugar or honey, sweetened hot chocolate or instant teas (OR = 2.54; Cl: 1.32–3.26; p < 0.001), than children receiving CM. This group was also characterized by higher consumption of sweetened dairy products, mainly cream cheese desserts, fruit yogurt and yogurt with cereal (OR = 1.87; Cl: 1.36–2.54; p < 0.01), as well as a lower daily intake of plain fermented milks (OR = 0.56; Cl: 0.21–0.79; p < 0.001). The daily food intake and the quality of the diets administered to children aged 13–24 months were evaluated and compared with the model food ration. It was found that milk type influenced children’s eating habits and preference for sweet-tasting foods. The study also demonstrated that Polish parents and caregivers only have limited knowledge of nutritional guidelines for toddlers.     

Anthropometric,Familial- and Lifestyle-Related Characteristics of School Children Skipping Breakfast in Jeddah,Saudi Arabia

Breakfast is a vital meal that provides children with important nutrients and energy. This study examined the anthropometric, familial- and lifestyle-related characteristics of school children skipping breakfast. A total of 1149 children (boys: 45.5%), 6 to 12 years old (mean and SD: 9.3 ± 1.7 years), were randomly selected from elementary schools in Jeddah. Weight and height were measured. Breakfast eating frequency, socio-demographics, and lifestyle behaviors were assessed using a specifically designed self-report questionnaire reported by the parents. Nearly 80% of the children skipped daily breakfast at home with no significant age or gender differences. The most common reasons for skipping breakfast at home included not feeling hungry and waking up late for school. Fried egg sandwiches and breakfast cereals were most frequently consumed for breakfast. Strong parental support for breakfast as the main daily meal was significantly associated with daily breakfast intake. Logistic regression analyses, adjusted for age, gender, and socio-demographics, revealed that paternal education (aOR = 1.212, 95% CI = 1.020–1.440, p = 0.029), maternal education (aOR = 1.212, 95% CI = 1.003–1.464, p=0.046), insufficient sleep (aOR = 0.735, 95% CI = 0.567–0.951, p = 0.019), and BMI <25 kg/m² (aOR = 1.333, 95% CI = 1.015–1.752, p = 0.039) were significantly associated with breakfast intake. The findings have implications for children’s health and school performance. Concerted effort is required to promote breakfast consumption among Saudi children.     

Comparison of a Full Food-Frequency Questionnaire with the Three-Day Unweighted Food Records in Young Polish Adult Women: Implications for Dietary Assessment

The food frequency questionnaire (FFQ) and the food record (FR) are among the most common methods used in dietary research. It is important to know that is it possible to use both methods simultaneously in dietary assessment and prepare a single, comprehensive interpretation. The aim of this study was to compare the energy and nutritional value of diets, determined by the FFQ and by the three-day food records of young women. The study involved 84 female students aged 21–26 years (mean of 22.2 ± 0.8 years). Completing the FFQ was preceded by obtaining unweighted food records covering three consecutive days. Energy and nutritional value of diets was assessed for both methods (FFQ-crude, FR-crude). Data obtained for FFQ-crude were adjusted with beta-coefficient equaling 0.5915 (FFQ-adjusted) and regression analysis (FFQ-regressive). The FFQ-adjusted was calculated as FR-crude/FFQ-crude ratio of mean daily energy intake. FFQ-regressive was calculated for energy and each nutrient separately using regression equation, including FFQ-crude and FR-crude as covariates. For FR-crude and FFQ-crude the energy value of diets was standardized to 2000 kcal (FR-standardized, FFQ-standardized). Methods of statistical comparison included a dependent samples t-test, a chi-square test, and the Bland-Altman method. The mean energy intake in FFQ-crude was significantly higher than FR-crude (2740.5 kcal vs. 1621.0 kcal, respectively). For FR-standardized and FFQ-standardized, significance differences were found in the mean intake of 18 out of 31 nutrients, for FR-crude and FFQ-adjusted in 13 out of 31 nutrients and FR-crude and FFQ-regressive in 11 out of 31 nutrients. The Bland-Altman method showed an overestimation of energy and nutrient intake by FFQ-crude in comparison to FR-crude, e.g., total protein was overestimated by 34.7 g/day (95% Confidence Interval, CI: −29.6, 99.0 g/day) and fat by 48.6 g/day (95% CI: −36.4, 133.6 g/day). After regressive transformation of FFQ, the absolute difference between FFQ-regressive and FR-crude equaled 0.0 g/day and 95% CI were much better (e.g., for total protein 95% CI: −32.7, 32.7 g/day, for fat 95% CI: −49.6, 49.6 g/day). In conclusion, differences in nutritional value of diets resulted from overestimating energy intake by the FFQ in comparison to the three-day unweighted food records. Adjustment of energy and nutrient intake applied for the FFQ using various methods, particularly regression equations, significantly improved the agreement between results obtained by both methods and dietary assessment. To obtain the most accurate results in future studies using this FFQ, energy and nutrient intake should be adjusted by the regression equations presented in this paper.     

Relative Validity and Reproducibility of a Semi-Quantitative Food Frequency Questionnaire for Determining Nutrient Intake in Older Adults in New Zealand: The REACH Study

Dietary intake is an important predictor of health and disease outcomes. This cross-sectional study evaluated the relative validity and reproducibility of a semi-quantitative food frequency questionnaire (FFQ) for assessing energy and nutrient intake in older adults. Dietary data were collected 2018–2019 in Auckland, New Zealand from a convenience sample of community-dwelling adults (65–74 years, n = 294, 37% male) using a 109-item self-administered FFQ at baseline (FFQ1) and four weeks later to assess reproducibility. FFQ1 was compared to a four-day food record to determine relative validity. Agreement between dietary assessment tools was assessed for both raw and energy-adjusted nutrient intakes using paired t-tests, correlation coefficients, weighted kappa statistic, Bland–Altman plots, and linear regression analysis. Energy adjustments moderately improved the relative validity and reproducibility for most nutrients. For energy and energy-adjusted nutrient intakes, the mean correlation coefficients were 0.38 (validity) and 0.65 (reproducibility); the mean weighted kappa statistics were 0.27 (validity) and 0.51 (reproducibility). A significant slope of bias was present in 54% (validity) and 25% (reproducibility) of Bland–Altman plots. The Researching Eating, Activity, and Cognitive Health (REACH) FFQ has acceptable relative validity and good reproducibility for ranking nutrient intakes in older New Zealand adults, but is less suitable for assessing absolute nutrient intakes.     

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.     

Food intake survey of kindergarten children in Korea: Part 1 food,energy, and nutrient intake

Objectives

Nutrient intakes of children were surveyed at the time when a nation-wide shift took place in the Republic of Korea from agriculture-based to industrialized society. Taking advantage of the survey locations (see below), possible delay in nutritional improvement in rural areas (as compared with that in an urban area) was also examined.

Methods

In total, 108 4- to 6-year-old children (boys and girls in combination) in 4 kindergartens (KGs; 1 in Seoul and 3 in Jeju Island) participated in the survey in 2003–2004. 24-h food duplicate samples were prepared by the mother of each child. Food items in each duplicate sample were separated and coded with reference to the Dietary Reference Intake for Koreans (the 2005 version). Nutrient intake of the day was estimated from the code and weight followed by summation for daily intake.

Results

The children in the KG in Seoul studied were younger, and therefore were smaller in body size than those in other KGs. Thus, it was considered necessary to evaluate nutrient intake not only on a daily basis, but after adjustment for body weight. The AM daily intake of energy (protein in parenthesis) for the 108 children was 1479 kcal (55 g)/day or 69.8 kcal (2.6 g)/kg body weight/day. Evaluation by individual nutrient suggested that the intake was sufficient for almost all nutrients except for sodium and potassium. Sodium and potassium intake (2285 and 1840 mg/day, respectively) was in excess and insufficient, respectively, with potential risk of inducing hypertension later in life.

Conclusions

Inter-KG difference was not remarkable and therefore urban–rural difference was not apparent. Nutrient intakes as a whole appeared to be sufficient urban and rural areas. Nevertheless, excess Na intake coupled with insufficient K intake was a common problem.     

Within- and Between-Individual Variation in Nutrient Intake in Children and Adolescents

BackgroundLittle is known regarding the number of 24-hour recalls required to rank-order children and adolescents on usual intake for diet–disease studies.ObjectiveTo determine the within- to between-individual variance ratios and number of 24-hour recalls required to rank-order individuals on usual intake for select macro- and micronutrients in a large, multiracial/ethnic sample of children and adolescents.DesignCross-sectional survey.Participants/settingChildren and adolescents ages 6 to 17 years participating in the 2007-2008 and 2009-2010 National Health and Nutrition Examination Survey (NHANES).Main outcome measuresVariance ratios for predefined sex, age (children age 6 to 11 years, adolescents age 12 to 17 years), and racial/ethnic groups (Mexican American/Hispanic, non-Hispanic black, and non-Hispanic white).Statistical analysisMixed-effects linear regression models were used to estimate within- and between-individual variance components for selected nutrients. The number of 24-hour recalls required to rank-order participants on usual intake (absolute values and energy-adjusted) was obtained from the nutrient variance ratios for various levels of accuracy.ResultsVariance ratios were more than 1 for all nutrients examined. High values (variance ratio >3) were observed for protein, saturated and unsaturated fatty acids, cholesterol, and several micronutrients. Variance ratios for absolute nutrient intakes were similar for both sexes within age groups, but higher for children than for adolescents. A total of six to nine and three to six 24-hour recalls were typically sufficient to rank-order children and adolescents, respectively, on usual intake with an accuracy of r=0.8. Additional recalls were required to achieve the same accuracy for energy-adjusted nutrients. Variance ratios were similar for adolescents across racial/ethnic groups, but highly variable in children.ConclusionsA total of six to nine 24-hour recalls may represent a reasonable trade-off between accuracy and participant burden for rank-ordering nutrient intakes in children and adolescents. Additional research is required to determine whether this may be reduced using statistical modeling–based approaches and the number of recalls children and adolescents will reliably complete.     

Frequent Canned Food Use is Positively Associated with Nutrient-Dense Food Group Consumption and Higher Nutrient Intakes in US Children and Adults

In addition to fresh foods, many canned foods also provide nutrient-dense dietary options, often at a lower price, with longer storage potential. The aim of this study was to compare nutrient-dense food group intake and nutrient intake between different levels of canned food consumption in the US. Consumption data were collected for this cross-sectional study from 9761 American canned food consumers (aged two years and older) from The NPD Group’s National Eating Trends^® (NET^®) database during 2011–2013; and the data were assessed using The NPD Group’s Nutrient Intake Database. Canned food consumers were placed into three groups: Frequent Can Users (≥6 canned items/week); n = 2584, Average Can Users (3–5 canned items/week); n = 4445, and Infrequent Can Users (≤2 canned items/week); n = 2732. The results provide evidence that Frequent Can Users consume more nutrient-dense food groups such as fruits, vegetables, dairy products, and protein-rich foods, and also have higher intakes of 17 essential nutrients including the shortfall nutrients—potassium, calcium and fiber—when compared to Infrequent Can Users. Therefore, in addition to fresh foods, diets higher in nutrient-dense canned food consumption can also offer dietary options which improve nutrient intakes and the overall diet quality of Americans.     

Nutrient Intake in Children 4–13 Years Old in Ibadan,Nigeria

The paucity of adequate data on dietary and nutrient intakes of school-age children is a barrier to addressing malnutrition and associated risks in Nigeria. This study included 955 children aged 4–13 years from Ibadan, Nigeria, using a stratified random sampling design. Information on family socio-demographic characteristics was reported, and child anthropometrics were measured. Dietary intake data were collected using a multi-pass 24 h dietary recall method; 20% of subjects completed a second 24 h recall to estimate usual nutrient intakes. Means and distributions of usual intakes of energy and nutrients as well as prevalence of inadequacy were estimated. Usual energy intake (kcal/day) was 1345 and 1590 for younger (4–8 years) and older (9–13 years) age groups, respectively. The macronutrient intakes of most children did not conform to Adequate Macronutrient Distribution Ranges (AMDRs), which were characterized by a higher proportion of energy from carbohydrates and lower proportion from total fats. Protein intake was largely within the AMDR. Compared to recommendations, over 60% of 4–8-year-old children had inadequate intakes of calcium, copper, iron, folate, and vitamins A, D, and E. There were more micronutrient inadequacies in the older children. This study identifies nutrition gaps and suggests future research and education to improve child nutrition in Nigeria.     

Modelling the Impact of Reducing Ultra-Processed Foods Based on the NOVA Classification in Australian Women of Reproductive Age

Women of reproductive age have a high proportion of overweight/obesity and an overall poor nutritional intake and diet quality. Nutritional modelling is a method to forecast potential changes in nutrition composition that may offer feasible and realistic changes to dietary intake. This study uses simulation modelling to estimate feasible population improvements in dietary profile by reducing ultra-processed food (UPF) consumption in Australian women of reproductive age. The simulation used weighted data from the most recent 2011–2012 National Nutrition and Physical Activity Survey. A total of 2749 women aged 19–50 years was included, and 5740 foods were examined. The highest daily energy, saturated fat, and added sugar and sodium came from UPF. Reducing UPF by 50% decreased energy intake by 22%, and saturated fat, added sugar, sodium, and alcohol by 10–39%. Reducing UPF by 50% and increasing unprocessed or minimally processed foods by 25% led to a lower estimated reduction in energy and greater estimated reductions in saturated fat and sodium. Replacement of 50% UPF with 75% of unprocessed or minimally processed foods led to smaller estimated reductions in energy and nutrients. Our results provide insight as to the potential impact of population reductions in UPF, but also increasing intake of unprocessed or minimally processed foods, which may be the most feasible strategy for improved nutritional intake.     

Dietary Patterns of Infants and Toddlers Are Associated with Nutrient Intakes

Dietary patterns are a useful summary measure of diet. Few studies have examined the nutrient profiles underpinning the dietary patterns of young children. The study aim is to determine whether dietary patterns at 6 and 15 months of age are associated with nutrient intakes at 8 and 18 months, respectively. Participants were children from the Avon Longitudinal Study of Parents and Children who had complete dietary pattern and nutrient intake data (n = 725 at 6–8 months, n = 535 at 15–18 months). The association between tertiles of dietary pattern scores and nutrient intake was examined using a non-parametric test for trend. Scores on the home-made traditional pattern (6–8 months) were positively associated with median energy intake. Each dietary pattern had different associations with energy-adjusted intakes of macro- and micro-nutrients. At both times, the discretionary pattern was positively and the ready-prepared baby foods pattern was negatively associated with sodium intake. At 6–8 months, calcium and iron intakes decreased across scores on the home-made traditional and breastfeeding patterns, but increased across the ready-prepared baby food patterns. These findings highlight that dietary patterns in infants and toddlers vary in their underlying energy and nutrient composition.     

Higher Iron Intake Is Independently Associated with Obesity in Younger Japanese Type-2 Diabetes Mellitus Patients

We aimed to analyze the association between dietary iron intake and obesity assessed by BMI after adjustment for nutrient intake (macronutrients and fiber) and food groups. The study design was cross-sectional. Patients with type-2 diabetes (n = 1567; 63.1% males; mean age 62.3 ± 11.6 years) were included in the study. To assess diet, consumption of typical food groups was determined by a food frequency questionnaire. Obesity was defined as BMI ≥ 25 kg/m². We performed a binary regression analysis between quartiles of iron intake and obesity by quartiles of age group. A direct linear association was found for the highest quartile of iron intake and obesity in the younger age group of 30 to 54 years (OR = 3.641, 95% CI = 1.020–12.990; p trend = 0.011). Multivariate analysis using food groups as opposed to nutrients revealed a positive trend for obesity in the younger age group after adjusting for lifestyle factors, energy intake and bean and vegetable intake (p trend = 0.023). In all participants, an inverse association was observed before adjustment by vegetable intake (OR = 0.453, 95% CI = 0.300–0.684; p trend = 0.001). Higher iron intake was associated with obesity independent of macronutrient and fiber intake but only in the youngest quartile of age group examined.     

Energy Intake,Profile, and Dietary Sources in the Spanish Population: Findings of the ANIBES Study

Energy intake, and the foods and beverages contributing to that, are considered key to understanding the high obesity prevalence worldwide. The relative contributions of energy intake and expenditure to the obesity epidemic, however, remain poorly defined in Spain. The purpose of this study was to contribute to updating data of dietary energy intake and its main sources from food and beverages, according to gender and age. These data were derived from the ANIBES (“Anthropometry, Intake, and Energy Balance in Spain”) study, a cross-sectional study of a nationally representative sample of the Spanish population (from 9–75 years old). A three-day dietary record, collected by means of a tablet device, was used to obtain information about food and beverage consumption and leftovers. The final sample comprised 2009 individuals (1,013 men, 996 women). The observed mean dietary energy intake was 7.6 ± 2.11 MJ/day (8.2 ± 2.22 MJ/day for men and 6.9 ± 1.79 MJ/day for women). The highest intakes were observed among adolescents aged 13–17 years (8.4 MJ/day), followed by children 9–12 years (8.2 ± 1.80 MJ/day), adults aged 18–64 (7.6 ± 2.14 MJ/day) and older adults aged 65–75 years (6.8 ± 1.88 MJ/day). Cereals or grains (27.4%), meats and derivatives (15.2%), oils and fats (12.3%), and milk and dairy products (11.8%) contributed most to daily energy intake. Energy contributions from non-alcoholic beverages (3.9%), fish and shellfish (3.6%), sugars and sweets (3.3%) and alcoholic beverages (2.6%) were moderate to minor. Contributions to caloric profile were 16.8%E from proteins; 41.1%E from carbohydrates, including 1.4%E from fiber; 38.5%E from fats; and 1.9%E from alcohol intake. We can conclude that energy intake is decreasing in the Spanish population. A variety of food and beverage groups contribute to energy intake; however, it is necessary to reinforce efforts for better adherence to the traditional Mediterranean diet.     

Nutritional Adequacy of Dietary Intake in Women with Anorexia Nervosa

Understanding nutrient intake of anorexia nervosa (AN) patients is essential for the treatment. Therefore, estimates of total energy and nutrient consumption were made in a group of young women (19 to 30 years) with restricting and binge purge subtypes of AN participating in an ecological momentary assessment study. Participants completed three nonconsecutive 24-hour diet recalls. Mean nutrient intakes were stratified by subtype and by quartiles of energy intake and compared to the age specific Dietary Reference Intake (DRI) levels, as well as to the reported intakes from the What We Eat In America (WWEIA) dietary survey 2011–2012. Reported intake was determined for energy, macronutrients, and micronutrients. The mean body mass index (BMI) for all participants was 17.2 ± 0.1 kg/m². Reported nutrient intake was insufficient for participants in quartiles 1–3 of both AN subtypes when compared to the DRIs. Intake reported by participants in quartile 4 of both subgroups met requirements for most nutrients and even met or exceeded estimated energy needs. Counseling of AN patients should be directed to total food consumption to improve energy intake and to reduce individual nutritional gaps.     

Frequency of Sweet and Salty Snack Food Consumption Is Associated with Higher Intakes of Overconsumed Nutrients and Weight-For-Length z Scores During Infancy and Toddlerhood

BackgroundCurrent dietary guidelines recommend avoiding foods and beverages with added sugars and higher sodium before age 2 years.ObjectiveThe aim was to describe daily snack food intake (frequency and total energy) and the associations with overconsumed nutrients (added sugars, sodium, and saturated fats) and child weight-for-length z scores.DesignA cross-sectional, secondary analysis of baseline data from an ongoing longitudinal intervention was conducted.Participants and settingA sample of 141 caregivers with infants (aged 9 to 11 months) and toddlers (aged 12 to 15 months) was recruited in Buffalo, NY, between 2017 and 2019.Main outcome measuresThree 24-hour dietary recalls were used to categorize 'sweet and salty snack foods' or 'commercial baby snack foods' based on the US Department of Agriculture What We Eat in America food group classifications and estimate nutrient intakes. Child recumbent length and weight were measured by trained researchers.Statistical analysisDaily frequency (times/day), energy (kcal/day), and overconsumed nutrients from snack food intake were calculated. Multivariable regression models examined associations between the frequency of and energy from snack food intake with overconsumed nutrients and child weight-for-length z scores.ResultsInfants consumed snack foods on average 1.2 times/day contributing 5.6% of total daily energy, 19.6% of added sugars, and 6.8% of sodium. Toddlers consumed snack foods on average 1.4 times/day contributing 8.9% of total daily energy, 40.0% of added sugars, and 7.2% of sodium. In adjusted models including all children, greater frequency of sweet and salty snack food intake, but not commercial baby snack foods, was associated with higher weight-for-length z scores.ConclusionsSnack foods are frequently consumed by infants and toddlers and contribute to the intake of overconsumed nutrients such as added sugars and sodium. Given the current guidelines to avoid added sugars and higher sodium before age 2 years, additional recommendations related to nutrient-dense snack intake may be beneficial.