Abstract Consumption of empty calories, the sum of energy from added sugar and solid fat, exceeds recommendations, but little is known about where US children obtain these empty calories. The ...objectives of this study were to compare children's empty calorie consumption from retail food stores, schools, and fast-food restaurants; to identify food groups that were top contributors of empty calories from each location; and to determine the location providing the majority of calories for these key food groups. This cross-sectional analysis used data from 3,077 US children aged 2 to 18 years participating in the 2009-2010 National Health and Nutrition Examination Survey. The empty calorie content of children's intake from stores (33%), schools (32%), and fast-food restaurants (35%) was not significantly different in 2009-2010. In absolute terms, stores provided the majority of empty calorie intake (436 kcal). The top contributors of added sugar and solid fat from each location were similar: sugar-sweetened beverages, grain desserts, and high-fat milk ∗ from stores; high-fat milk, grain desserts, and pizza from schools; and sugar-sweetened beverages, dairy desserts, french fries, and pizza from fast-food restaurants. Schools contributed about 20% of children's intake of high-fat milk and pizza. These findings support the need for continued efforts to reduce empty calorie intake among US children aimed not just at fast-food restaurants, but also at stores and schools. The importance of reformed school nutrition standards was suggested, as prior to implementation of these changes, schools resembled fast-food restaurants in their contributions to empty calorie intake.
Abstract Heretofore, corporate voluntary pledges to improve the health of Americans have been linked neither to explicit measurable commitments nor to a framework for an independent evaluation. The ...Healthy Weight Commitment Foundation (HWCF), whose members include 16 of the nation's leading consumer packaged goods food and beverage manufacturers, voluntarily pledged to collectively remove 1 trillion calories from their products by 2012 (against a 2007 baseline), and 1.5 trillion calories by 2015. The pledge is designed to reduce the calorie gap commensurate with the HWCF companies' role in the U.S. diet. To date, no system exists for documenting the nutritional and public health impacts of industry-led changes in the food supply on individual diets. The current study represents a unique opportunity to understand how the consumer packaged goods food and beverage sector is changing and how these changes are associated with changes in the American diet. It presents data on national caloric sales from this sector, purchases of these goods by various subpopulations, and methods linking these to individual intakes of Americans. Findings show that HWCF companies accounted for approximately 25% of calories consumed in the U.S. in 2007 and that the 1.5 trillion–calorie pledge (about 14 calories/day/capita) accounts for 0.8% of the calories sold across all consumer packaged goods food and beverage brands in 2007. The authors hope that this evaluation will continue to create models and methods for demonstrating the effects of changes in the food supply on individual diets, particularly among those from vulnerable subpopulations.
Background: In the past decade, the United States has seen declining energy intakes and plateauing obesity levels.Objective: We examined whether these observed trends suggest a longer-term shift in ...dietary and health behavior that is independent of adverse economic conditions.Design: We used nationally representative cross-sectional surveys on intake and longitudinal household food purchase data along with random-effects models to address this question. Data included individuals in NHANES 2003–2004 to 2009–2010 (children: n = 13,422; adults: n = 10,791) and households from the 2000–2011 Nielsen Homescan Panel (households with children: n = 57,298; households with adults only: n = 108,932).Results: In both data sets, we showed that children decreased their calories the most. Even after we controlled for important socioeconomic factors, caloric purchases fell significantly from 2003 to 2011 (P < 0.001), particularly for households with children. The Great Recession was associated with small increases in caloric purchases, in which a 1–percentage point increase in unemployment in the local market was associated with a 1.6–4.1-kcal · capita−1 · d−1 (P < 0.001) increase in total calories purchased. Results also indicated shifts in caloric purchases were driven more by declines in caloric purchases from beverages than food.Conclusions: US consumers have exhibited changes in intake and purchasing behavior since 2003 that were independent from changing economic conditions linked with the Great Recession or food prices. Public health efforts in the past decade may have contributed to this trend.
Abstract Our understanding of the use of caloric and noncaloric sweeteners in the US food supply is limited. This study uses full ingredient list and Nutrition Facts label data from Gladson Nutrition ...Database and nationally representative purchases of consumer packaged foods from Nielsen Homescan in 2005 through 2009 to understand the use of caloric sweeteners (including fruit juice concentrate) and noncaloric sweeteners in consumer packaged foods. Of the 85,451 uniquely formulated foods purchased during 2005 through 2009, 75% contain sweeteners (68% with caloric sweetener only, 1% with noncaloric sweetener only, 6% with both caloric and noncaloric sweeteners). Caloric sweetener are in >95% of cakes/cookies/pies, granola/protein/energy bars, ready-to-eat cereals, sweet snacks, and sugar-sweetened beverages. Noncaloric sweetener are in >33% of yogurts and sport/energy drinks, 42% of waters (plain or flavored), and most dietetic sweetened beverages. Across unique products, corn syrup is the most commonly listed sweetener, followed by sorghum, cane sugar, high-fructose corn syrup, and fruit juice concentrate. Also, 77% of all calories purchased in the United States in 2005-2009 contained caloric sweeteners and 3% contained noncaloric sweeteners, and 73% of the volume of foods purchased contained caloric sweetener and 15% contained noncaloric sweetener. Trends during this period suggest a shift toward the purchase of noncaloric sweetener−containing products. Our study poses a challenge toward monitoring sweetener consumption in the United States by discussing the need and options available to improve measures of caloric sweetener and noncaloric sweetener and additional requirements on Nutrition Facts labels on consumer packaged foods.
Abstract Despite the historical rise and recent plateau of child overweight and obesity, levels remain exceedingly high. To understand these trends and identify targets for intervention it is ...important to examine concomitant trends in children's diets. The objective of our analysis was to describe 21-year trends in total energy intake and the major food and beverage sources of energy among 2- to 18-year-olds in the United States. Six nationally representative surveys were examined in 2012, the Continuing Survey of Food Intakes by Individuals (1989-1991 and 1994-1996, 1998) and the National Health and Nutrition Examination Survey (2003-2004, 2005-2006, 2007-2008, and 2009-2010). Total energy intake among US children and adolescents rose considerably from 1989 to 2004, and subsequently declined through 2010. Seven sources were consistently major contributors across all time points: sugar-sweetened beverages, pizza, full-fat milk, grain-based desserts, breads, pasta dishes, and savory snacks. Intakes of full-fat milk, meats and processed meat products, ready-to-eat cereals, burgers, fried potatoes, fruit juice, and vegetables decreased from 1989-2010 whereas intakes of nonfat milk, poultry, sweet snacks and candies, and tortilla- and corn-based dishes increased linearly over the 21-year period. Significant nonlinear time trends were observed with recent decreases in intakes of sugar-sweetened beverages, pizza, pasta dishes, breads and rolls, and savory snacks and recent increases in intake of fruit. Energy intakes of US children began to decline in 2003-2004 and continued to decline through 2009-2010. However, among preschool children (aged 2 to 5 years) and children from low-income families, total energy intakes in 2009-2010 still remained significantly higher than in 1989-1991.
Long-term trends mask critical recent dynamics in the prevalence of under- and overweight.
The objective of this study was to compare annualized prevalence rates of both under- and overweight among ...nonpregnant women aged 19-49 y during the periods covering 1) the 1990s-the early 2000s and 2) the early 2000s-the late 2000s or early 2010s, by rural-urban residence.
Data are from nationally representative surveys (29 Demographic and Health Surveys and 4 national surveys). Standardized protocols were used to measure weight and height. Underweight was defined as body mass index (BMI) < 18.5 kg/m(2) and overweight as BMI ≥ 25 kg/m(2).
From the 1990s to the early 2000s, most countries were making progress on decreasing the prevalence of underweight, especially in rural areas. Although many countries continued to make progress more recently, several countries in Sub-Saharan Africa that previously had a decreasing prevalence of underweight now have an increasing prevalence of underweight. For example, in rural areas of Senegal, the prevalence of underweight decreased 0.23% annually between 1992 and 2005, then increased 1.60% annually between 2005 and 2010. Meanwhile, the prevalence of overweight is increasing in nearly all countries, and in approximately half of all countries, the rate of increase is greater in rural areas than in urban areas. Although underweight persists as more prevalent than overweight in rural areas of many East Asian, South Asian, and Sub-Saharan African countries, the ratio of underweight to overweight in many countries has decreased over time, indicating that this trend is reversing.
Select countries in Sub-Saharan Africa may be more susceptible to food crises and should be targets for intervention. At the same time, global health efforts need to focus on preventing overweight, particularly in rural areas, which are quickly catching up to their urban counterparts.
MyPlate is a tool designed to educate the general US population on how to eat in alignment with the Dietary Guidelines for Americans; yet, there is a lack of data on who has heard of MyPlate over ...time.
The objective of this analysis was to examine the prevalence of awareness of MyPlate within the US population and if awareness changes differentially over time.
This study was a serial, cross-sectional survey.
Three survey waves of data (2013-2018) were used from the National Health and Nutrition Examination Survey of adults aged 20 years or older (n = 17,023).
Percentage of the US adult population who had heard of MyPlate was measured and stratified by sex, age, citizenship status, education, household food security status, income, receipt of Supplemental Nutrition Assistance Program (SNAP) benefits, and receipt of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) benefits.
Global Wald tests were used to assess whether prevalence of awareness of MyPlate differed by sociodemographic characteristics. Tests of homogeneity using likelihood ratio tests of nested logistic regression models were used to assess whether differences in awareness of MyPlate by various sociodemographic characteristics changed over time from 2013 to 2018.
Twenty percent (19.5%) (n = 875) of the analytic sample of participants aged 20 years and older had heard of MyPlate in 2013-2014, 24.5% (n = 1,020) in 2015-2016, and 24.6% (n = 1,086) in 2017-2018. Awareness of MyPlate changed differentially over time (P value < .1) from 2013 to 2018 by income, household food security status, and receipt of SNAP benefits, with slower increases in awareness for households with lowest income over time, narrowing of differences in awareness by household food security status over time, and persistent differences in awareness by receipt of SNAP benefits over time.
These results highlight the current low awareness of MyPlate, disparities in awareness of MyPlate immediately after implementation by sociodemographic characteristics, and increases in awareness over time at differential rates within levels of income, food security status, and ever receipt of SNAP benefits. Given that the Dietary Guidelines for Americans 2025-2030 are currently in development, new strategies should be considered to disseminate tools that translate the updated Dietary Guidelines in such a way that reach the general population equitably upon implementation within the United States.
Abstract Background Between 1989 and 2008, obesity increased markedly in children of all ages. We examined changes in the diets of children ages 2 to 6 years in the United States between 1989 and ...2008. Our study provides new insight into diet changes that might have contributed to the sharp rise in obesity during this period. Objective Our aim was to describe changes in diet among 2- to 6-year-old children from 1989 to 2008 related to sharp rises in obesity during this period. Participants This analysis included 10,647 children ages 2 to 6 years from the following five nationally representative surveys of dietary intake in the United States: Continuing Survey of Food Intake in Individuals 1989-1991 and 1994-1998 and the What We Eat In America, National Health and Nutrition Examination Surveys 2003-2004, 2005-2006, and 2007-2008. Diet data were categorized into groupings using the University of North Carolina-Chapel Hill approach. Statistical analyses Analyses were carried out using a single 24-hour dietary recall with appropriate survey weighting. T tests were used to compare means across survey years, with P <0.05 considered significant. Results During the 20-year period, there were increases in per capita intake of savory snacks (+51 kcal; P <0.01), pizza/calzones (+32 kcal; P <0.01), sweet snacks and candy (+25 kcal; P <0.01), mixed Mexican dishes (+22 kcal; P <0.01), and fruit juice (+18 kcal; P <0.01), and total daily energy intake increased by 109 kcal (from 1,475 to 1,584 kcal) ( P <0.05). Fruit intake increased marginally (+24 kcal; P <0.01). Six of the 10 greatest absolute changes in per capita intake between sequential survey years occurred between Continuing Survey of Food Intake in Individuals 1994-1998 and National Health and Nutrition Examination Surveys 2003-2004 ( P <0.05). Conclusions Foods high in added sugars and solid fats, such as savory snacks, pizza/calzones, mixed Mexican dishes, sweet snacks and candy, and fruit juice, predominated the top changes in per capita consumption between 1989 and 2008.
Corporate voluntary pledges to improve the health of Americans have not been held to either explicit measurable outcomes or a framework for independent evaluation. The Healthy Weight Commitment ...Foundation (HWCF), whose members include 16 of the nation's leading consumer packaged goods (CPG) food and beverage manufacturers, voluntarily pledged to collectively sell 1 trillion fewer calories in the U.S. marketplace by 2012 (against a 2007 baseline), and sell 1.5 trillion fewer calories by 2015. This paper presents the findings of an independent evaluation of the 2012 HWCF marketplace pledge, conducted in 2013. The 16 HWCF companies collectively sold approximately 6.4 trillion fewer calories (-10.6%) in 2012 than in the baseline year of 2007. Taking into account population changes over the 5-year period of 2007-2012, CPG caloric sales from brands included in the HWCF pledge declined by an average of 78 kcal/capita/day. CPG caloric sales from non-HWCF national brands during the same period declined by 11 kcal/capita/day, and there were similar declines in calories from private label products. Thus, the total reduction in CPG caloric sales between 2007 and 2012 was 99 kcal/capita/day. This independent evaluation is the first to evaluate food industry compliance with its calorie reduction pledges and to assess how sales from the CPG food and beverage sector are changing. An accompanying paper investigates the extent to which the HWCF pledge affected household-level changes in CPG calories purchased, controlling for important economic and sociodemographic factors affecting household food purchases over this period.
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