Disparities in plain, tap and bottled water consumption among US adults: National Health and Nutrition Examination Survey (NHANES) 2007–2014

AbstractObjectiveDifferences in bottled v. tap water intake may provide insights into health disparities, like risk of dental caries and inadequate hydration. We examined differences in plain, tap and bottled water consumption among US adults by sociodemographic characteristics.DesignCross-sectional analysis. We used 24 h dietary recall data to test differences in percentage consuming the water sources and mean intake between groups using Wald tests and multiple logistic and linear regression models.SettingNational Health and Nutrition Examination Survey (NHANES), 2007–2014.SubjectsA nationally representative sample of 20 676 adults aged ≥20 years.ResultsIn 2011–2014, 81·4 (se 0·6) % of adults drank plain water (sum of tap and bottled), 55·2 (se 1·4) % drank tap water and 33·4 (se 1·4) % drank bottled water on a given day. Adjusting for covariates, non-Hispanic (NH) Black and Hispanic adults had 0·44 (95 % CI 0·37, 0·53) and 0·55 (95 % CI 0·45, 0·66) times the odds of consuming tap water, and consumed B=−330 (se 45) ml and B=−180 (se 45) ml less tap water than NH White adults, respectively. NH Black, Hispanic and adults born outside the fifty US states or Washington, DC had 2·20 (95 % CI 1·79, 2·69), 2·37 (95 % CI 1·91, 2·94) and 1·46 (95 % CI 1·19, 1·79) times the odds of consuming bottled water than their NH White and US-born counterparts. In 2007–2010, water filtration was associated with higher odds of drinking plain and tap water.ConclusionsWhile most US adults consumed plain water, the source (i.e. tap or bottled) and amount differed by race/Hispanic origin, nativity status and education. Water filters may increase tap water consumption.

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Change in methodology for collection of drinking water intake in What We Eat in America/National Health and Nutrition Examination Survey: implications for analysis

Public Health Nutrition ◽

10.1017/s1368980012000316 ◽

2012 ◽

Vol 15 (7) ◽

pp. 1190-1195 ◽

Cited By ~ 8

Author(s):

Rhonda S Sebastian ◽

Cecilia Wilkinson Enns ◽

Joseph D Goldman ◽

Alanna J Moshfegh

Keyword(s):

Drinking Water ◽

Water Intake ◽

National Health ◽

Tap Water ◽

Lower Percentage ◽

Nutrition Examination Survey ◽

Cross Sectional ◽

Health And Nutrition ◽

The Usa ◽

Gender Groups

AbstractObjectiveTo provide updated estimates of drinking water intake (total, tap, plain bottled) for groups aged ≥1 year in the USA and to determine whether intakes collected in 2005–2006 using the Automated Multiple-Pass Method for the 24 h recall differ from intakes collected in 2003–2004 via post-recall food-frequency type questions.DesignCross-sectional, observational study.SettingWhat We Eat in America (WWEIA), the dietary intake component of the US National Health and Nutrition Examination Survey (NHANES).SubjectsIndividuals aged ≥1 year in 2003–2004 (n 8249) and 2005–2006 (n 8437) with one complete 24 h recall.ResultsThe estimate for the percentage of individuals who reported total drinking water in 2005–2006 was significantly (P < 0·0000) smaller (76·9 %) than that for 2003–2004 (87·1 %), attributable to a lower percentage reporting tap water (54·1 % in 2005–2006 v. 67·0 % in 2003–2004; P = 0·0001). Estimates of mean tap water intake differed between the survey cycles for men aged ≥71 years.ConclusionsSurvey variables must be examined before combining or comparing data from multiple WWEIA/NHANES release cycles. For at least some age/gender groups, drinking water intake data from NHANES cycles prior to 2005–2006 should not be considered comparable to more recent data.

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Perceived and objective diet quality in US adults: a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES)

Public Health Nutrition ◽

10.1017/s1368980014000196 ◽

2014 ◽

Vol 17 (12) ◽

pp. 2641-2649 ◽

Cited By ~ 22

Author(s):

Tiffany M Powell-Wiley ◽

Paige E Miller ◽

Priscilla Agyemang ◽

Tanya Agurs-Collins ◽

Jill Reedy

Keyword(s):

National Health ◽

Diet Quality ◽

Mexican Americans ◽

Saturated Fat ◽

Cross Sectional Study ◽

Nutrition Examination Survey ◽

Cross Sectional ◽

Dietary Recall ◽

Health And Nutrition ◽

Total Fat

AbstractObjectiveThe Dietary Approaches to Stop Hypertension (DASH) dietary pattern has been shown to reduce cardiometabolic risk. Little is understood about the relationship between objective diet quality and perceived diet quality (PDQ), a potential psychosocial barrier to appropriate dietary intake. We compared PDQ and diet quality measured by a nutrient-based DASH index score in the USA.DesignCross-sectional study. Participants in the 2005–2006 National Health and Nutrition Examination Survey (NHANES) rated diet quality on a 5-point Likert scale and PDQ scores were generated (low, medium, high). A single 24 h dietary recall was used to estimate DASH index scores (range 0–9 points) by assigning 0, 0·5 or 1 point (optimal) for nine target nutrients: total fat, saturated fat, protein, cholesterol, fibre, Ca, Mg, K and Na.SettingNationally representative sample of the US population.SubjectsAdults aged ≥19 years in 2005–2006 NHANES (n 4419).ResultsParticipants with high PDQ (33 %) had higher DASH index scores (mean 3·0 (sd 0·07)) than those with low PDQ (mean 2·5 (sd 0·06), P < 0·001), but average scores did not align with targets for intermediate or optimal DASH accordance. Adults with high PDQ reported higher total fat, saturated fat and Na intakes compared with optimal DASH nutrient goals. Differences between those with high v. low PDQ were similar for Whites and Blacks, but there was no difference between PDQ groups for Mexican Americans.ConclusionsAmong Whites and Blacks, but not Mexican Americans, high PDQ may be associated with higher diet quality, but not necessarily a diet meeting DASH nutrient goals. This disconnect between PDQ and actual diet quality may serve as a target in obesity prevention.

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Common ways Americans are incorporating fruits and vegetables into their diet: intake patterns by meal, source and form, National Health and Nutrition Examination Survey 2007–2010

Public Health Nutrition ◽

10.1017/s1368980016000586 ◽

2016 ◽

Vol 19 (14) ◽

pp. 2535-2539 ◽

Cited By ~ 9

Author(s):

Latetia V Moore ◽

Heather C Hamner ◽

Sonia A Kim ◽

Karen Dalenius

Keyword(s):

National Health ◽

Fruits And Vegetables ◽

Nutrition Examination Survey ◽

Cross Sectional ◽

Dietary Recall ◽

Health And Nutrition ◽

Recall Data ◽

Retail Outlets ◽

Diet Intake

AbstractObjectiveWe explored how Americans aged ≥2 years who consumed the recommended amount of fruits and vegetables on a given day incorporated fruits and vegetables into their diet compared with those who did not consume recommended amounts.DesignWe used 1 d of dietary recall data from the National Health and Nutrition Examination Survey (NHANES) 2007–2010 to examine cross-sectional differences in mean intakes of fruits and vegetables in cup-equivalents by meal, source and form between the two groups.SettingUSA.SubjectsNHANES 2007–2010 participants aged ≥2 years (n 17 571) with 1 d of reliable 24 h recall data.ResultsOn a given day, the proportions of fruits and vegetables consumed at different meals were similar between those who consumed recommended amounts and those who did not. Among adults, 59–64 % of their intake of fruits was consumed at breakfast or as a snack and almost 90 % came from retail outlets regardless of whether they consumed the recommended amount or not. Adults who consumed the recommended amount of fruits ate more fruits in raw form and with no additions than those who did not. Among children and adults, 52–57 % of vegetables were consumed at dinner by both groups. Retail outlets were the main source of vegetables consumed (60–68 %).ConclusionsOur findings indicate that habits of when, where and how consumers eat fruits and vegetables might not need to change but increasing the amount consumed would help those not currently meeting the recommendation.

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Diet quality on meatless days: National Health and Nutrition Examination Survey (NHANES), 2007–2012

Public Health Nutrition ◽

10.1017/s136898001700026x ◽

2017 ◽

Vol 20 (9) ◽

pp. 1564-1573 ◽

Cited By ~ 9

Author(s):

Zach Conrad ◽

Micaela Karlsen ◽

Kenneth Chui ◽

Lisa Jahns

Keyword(s):

Healthy Eating ◽

National Health ◽

Diet Quality ◽

Healthy Eating Index ◽

Dietary Quality ◽

Nutrition Examination Survey ◽

Cross Sectional ◽

Dietary Recall ◽

Health And Nutrition ◽

Game Birds

AbstractObjectiveTo compare diet quality scores between adult non-meat eaters and meat eaters, and to compare the consumption of diet components across quintiles of diet quality.DesignCross-sectional analysis. The Healthy Eating Index-2010 (HEI-2010) and Alternative Healthy Eating Index-2010 (AHEI-2010) were used to assess mean diet quality. Differences in consumption of diet components between quintiles of diet quality were tested usingpost hocWald tests andztests.SettingThe National Health and Nutrition Examination Survey (NHANES), 2007–2012.SubjectsThe sample consisted of 16810 respondents aged≥18 years, including 280 individuals who reported not consuming meat, poultry, game birds or seafood on two non-consecutive days of dietary recall. Dietary data were obtained from one dietary recall per individual.ResultsNon-meat eaters had substantially greater HEI-2010 and AHEI-2010 scores than meat eaters (P<0·05). Among non-meat eaters, mean consumption across HEI-2010 quintiles demonstrated different (P<0·05) amounts of empty calories and unsaturated:saturated fatty acids. Mean consumption across AHEI-2010 quintiles demonstrated different (P<0·05) amounts of nuts and legumes, vegetables and PUFA.ConclusionsPublic health messages targeted at vegetarians and others who may choose to eat meat-free on certain days should emphasize decreased consumption of empty calories, and increased consumption of nuts and legumes, PUFA and vegetables, as a way to improve overall dietary quality.

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Association between self-reported length of time in the USA and blood lead levels: National Health and Nutrition Examination Survey 2013–2016

BMJ Open ◽

10.1136/bmjopen-2018-027628 ◽

2019 ◽

Vol 9 (7) ◽

pp. e027628 ◽

Cited By ~ 2

Author(s):

Christelene Jack Horton ◽

Lalatendu Acharya ◽

Ellen M Wells

Keyword(s):

National Health ◽

Survey Design ◽

Blood Lead ◽

Nutrition Examination Survey ◽

Women Of Childbearing Age ◽

Linear Regression Models ◽

Childbearing Age ◽

Cross Sectional ◽

Health And Nutrition ◽

The Usa

ObjectivesThe aim of this study is to determine the association between length of time in the USA with blood lead (BPb).DesignPopulation-based cross-sectional study using data from the 2013–2016 National Health and Nutrition Examination Survey.SettingUSA.Participants5933 men and women (≥15 years); subgroups of men only (n=2867), women only (n=3064) and women of childbearing age (15–45 years) (n=1580).Primary and secondary outcomesThe primary outcome was BPb concentration. The main exposure variable was self-reported number of years spent in the USA, categorised as: born in the USA; 0–4 years; 5–9 years; 10–19 years and ≥20 years. We used linear regression models adjusted for race/ethnicity, education, blood cotinine, age, sex (as appropriate) and accounted for complex survey design.ResultsWomen of childbearing age who have lived 0–4 years in the USA have, on average, a 54% (95% CI 36% to 75%) higher BPb compared with women born in the USA. Corresponding results for all women, men and the entire population were 49% (95% CI 34% to 66%), 49% (95% CI 28% to 75%) and 49% (95% CI 33% to 66%), respectively. Similar, statistically significant, results were observed for other time periods (5–9 years, 10–19 years and ≥20 years); the magnitude of the association decreased with increasing time in the USA.ConclusionsThis study provides additional evidence that newcomers to the USA may be a population at higher risk of elevated BPb.

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Top food sources of percentage of energy, nutrients to limit and total gram amount consumed among US adolescents: National Health and Nutrition Examination Survey 2011–2014

Public Health Nutrition ◽

10.1017/s1368980018002884 ◽

2018 ◽

Vol 22 (4) ◽

pp. 661-671 ◽

Cited By ~ 7

Author(s):

Ana Carolina Leme ◽

Tom Baranowski ◽

Debbe Thompson ◽

Sonia Philippi ◽

Carol O’Neil ◽

...

Keyword(s):

Total Energy ◽

National Health ◽

Food Sources ◽

Plain Water ◽

Bakery Products ◽

Nutrition Examination Survey ◽

Food Category ◽

Cross Sectional ◽

Added Sugars ◽

Health And Nutrition

AbstractObjectiveTo identify most commonly consumed foods by adolescents contributing to percentage of total energy, added sugars, SFA, Na and total gram intake per day.DesignData from the National Health and Nutrition Examination Survey (NHANES) 2011–2014.SettingNHANES is a cross-sectional study nationally representative of the US population.ParticipantsOne 24 h dietary recall was used to assess dietary intake of 3156 adolescents aged 10–19 years. What We Eat in America food category classification system was used for all foods consumed. Food sources of energy, added sugars, SFA, Na and total gram amount consumed were sample-weighted and ranked based on percentage contribution to intake of total amount.ResultsThree-highest ranked food subgroup sources of total energy consumed were: sugar-sweetened beverages (SSB; 7·8 %); sweet bakery products (6·9 %); mixed dishes – pizza (6·6 %). Highest ranked food sources of total gram amount consumed were: plain water (33·1 %); SSB (15·8 %); milk (7·2 %). Three highest ranked food sources of total Na were: mixed dishes – pizza (8·7 %); mixed dishes – Mexican (6·7 %); cured meats/poultry (6·6 %). Three highest ranked food sources of SFA were: mixed dishes – pizza (9·1 %); sweet bakery products (8·3 %); mixed dishes – Mexican (7·9 %). Three highest ranked food sources of added sugars were: SSB (42·1 %); sweet bakery products (12·1 %); coffee and tea (7·6 %).ConclusionsIdentifying current food sources of percentage energy, nutrients to limit and total gram amount consumed among US adolescents is critical for designing strategies to help them meet nutrient recommendations within energy needs.

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Examining Recent Trends in the Racial Disparity Gap in Tap Water Consumption: NHANES 2011–2018

Public Health Nutrition ◽

10.1017/s1368980021002603 ◽

2021 ◽

pp. 1-20

Author(s):

Asher Y. Rosinger ◽

Anisha I. Patel ◽

Francesca Weaks

Keyword(s):

Water Consumption ◽

Tap Water ◽

Ethnic Disparities ◽

Prevalence Ratio ◽

Bottled Water ◽

Water Crisis ◽

Cross Sectional ◽

The Us ◽

Recent Trends ◽

Nationally Representative

Abstract Objective As tap water distrust has grown in the US with greater levels among Black and Hispanic households, we aimed to examine recent trends in not drinking tap water including the period covering the US Flint Water Crisis and racial/ethnic disparities in these trends. Design Cross-sectional analysis. We used log-binomial regressions and marginal predicted probabilities examined US nationally-representative trends in tap and bottled water consumption overall and by race/ethnicity. Setting The National Health and Nutrition Examination Survey data, 2011–2018. Participants Nationally-representative sample of 9,439 children aged 2-19 and 17,268 adults. Results Among US children and adults, respectively, in 2017-2018 there was a 63% (adjusted prevalence ratio [PR]:1.63, 95%CI: 1.25-2.12, p<0.001) and 40% (PR:1.40, 95%CI: 1.16-1.69, p=0.001) higher prevalence of not drinking tap water compared to 2013-2014 (pre-Flint Water Crisis). For Black children and adults, the probability of not drinking tap water increased significantly from 18.1% (95%CI: 13.4-22.8) and 24.6% (95%CI: 20.7-28.4) in 2013–14 to 29.3% (95%CI: 23.5-35.1) and 34.5% (95%CI: 29.4-39.6) in 2017–2018. Among Hispanic children and adults, not drinking tap water increased significantly from 24.5% (95%CI: 19.4-29.6) and 27.1% (95%CI: 23.0-31.2) in 2013-14 to 39.7% (95%CI: 32.7-46.8) and 38.1% (95%CI: 33.0-43.1) in 2017-2018. No significant increases were observed among Asian or white persons between 2013-14 and 2017-18. Similar trends were found in bottled water consumption. Conclusions This study found persistent disparities in the tap water consumption gap from 2011–2018. Black and Hispanics’ probability of not drinking tap water increased following the Flint Water Crisis.

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Prevalence, awareness, treatment, and control of dyslipidemia among diabetes mellitus patients and predictors of optimal dyslipidemia control: results from the Korea National Health and Nutrition Examination Survey

Lipids in Health and Disease ◽

10.1186/s12944-021-01455-3 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Seung Jae Kim ◽

Oh. Deog Kwon ◽

Kyung-Soo Kim

Keyword(s):

Diabetes Mellitus ◽

Optimal Control ◽

National Health ◽

Age Groups ◽

Density Lipoprotein ◽

Nutrition Examination Survey ◽

Cross Sectional ◽

Health And Nutrition ◽

Factors Influencing ◽

And Control

Abstract Background This study aimed to investigate the prevalence, awareness, treatment, and control rates of dyslipidemia and identify the predictors of optimal control (low-density lipoprotein cholesterol < 100 mg/dL) among patients with diabetes mellitus (DM). Methods A cross-sectional study was conducted using the representative Korea National Health and Nutrition Examination Survey (2014–2018). Overall, 4311 patients with DM, aged ≥19 years, and without cardiovascular diseases were selected, and the prevalence, awareness, treatment, and control rates of dyslipidemia were calculated. Univariate and multivariate logistic regression analyses were conducted to evaluate the factors influencing the optimal control of dyslipidemia. Results Dyslipidemia was prevalent in 83.3% of patients with DM, but the awareness and treatment rates were 36.5 and 26.9%, respectively. The control rate among all patients with dyslipidemia was 18.8%, whereas it was 61.1% among those being treated. Prevalence and awareness rates were also significantly higher in women than in men. Dyslipidemia was most prevalent in those aged 19–39 years, but the rates of awareness, treatment, and control among all patients with dyslipidemia in this age group were significantly lower than those in other age groups. The predictors of optimal control were age ≥ 40 years [range 40–49 years: adjusted odds ratio (aOR) 3.73, 95% confidence interval (CI) 1.43–9.72; 50–59 years: aOR 6.25, 95% CI 2.50–15.65; 60–69 years: aOR 6.96, 95% CI 2.77–17.44; 70–79 years: aOR 9.21, 95% CI 3.58–23.74; and ≥ 80 years: aOR 4.43, 95% CI 1.60–12.27]; urban living (aOR 1.44, 95% CI 1.15–1.80); higher body mass index (aOR 1.27, 95% CI 1.13–1.42); lower glycated hemoglobin levels (aOR 0.71, 95% CI 0.67–0.76); hypertension (aOR 1.53, 95% CI 1.22–1.92); poorer self-rated health status (aOR 0.72, 95% CI 0.62–0.84); and receiving regular health check-ups (aOR 1.58, 95% CI 1.25–2.00). Conclusions Most patients with DM were diagnosed with dyslipidemia, but many were unaware of or untreated for their condition. Therefore, their control rate was suboptimal. Thus, by understanding factors influencing optimal control of dyslipidemia, physicians should make more effort to encourage patients to undergo treatment and thus, adequately control their dyslipidemia.

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Healthcare provider counselling for weight management behaviours among adults with overweight or obesity: a cross-sectional analysis of National Health and Nutrition Examination Survey, 2011–2018

BMJ Open ◽

10.1136/bmjopen-2020-039295 ◽

2020 ◽

Vol 10 (11) ◽

pp. e039295

Author(s):

Mary L. Greaney ◽

Steven A. Cohen ◽

Furong Xu ◽

Christie L Ward-Ritacco ◽

Deborah Riebe

Keyword(s):

Older Adults ◽

National Health ◽

Weight Status ◽

Calorie Intake ◽

Nutrition Examination Survey ◽

Cross Sectional ◽

Health And Nutrition ◽

Race Ethnicity ◽

Sectional Analysis ◽

Overweight Or Obesity

ObjectivesTo determine if adults with overweight or obesity received counselling from their healthcare providers (HCPs) to lose weight and/or adopt healthful behaviours associated with weight loss, and whether they took action on their HCPs’ recommendations.DesignCross-sectional analysis of 2011–2018 National Health and Nutrition Examination Survey (NHANES) data.SampleNHANES respondents aged 18+ who were overweight/obese and had seen an HCP in the previous 12 months (n=13 158).MethodsRespondents reported if their HCPs recommended they control/lose weight, increase exercise/physical activity (PA) and/or reduce fat/calorie intake, and if they adopted the offered recommendation(s). Weighted logistic regression models examined receipt of HCP counselling by sex, age, race/ethnicity, and weight status accounting for demographic characteristics and complex sampling. Similar analyses examined reported adoption of HCPs’ recommendations.ResultsThe sample was 53.1% women, 45.0% were overweight and 55.0% had obesity. In total, 40.4% received counselling to control/lose weight, 49.5% to increase exercise/PA and 38.9% to reduce fat/calorie intake. The following groups were less likely (p<0.001) to receive counselling: men; younger adults (aged 18–39) versus middle-aged (aged 40–64) and older adults (aged 65+); White versus Black and Hispanic respondents; overweight respondents versus respondents with obesity. Approximately half of those advised to make changes reported doing so (53.6% controlled/lost weight, 57.3% increased exercise/PA, 51.8% reduced fat/calorie intake). Differences in the adoption of recommendations were identified by sex, age group, race/ethnicity and weight status (all p<0.05); women, middle-aged and older adults, Black and Hispanic respondents and individuals with obesity were more likely to adopt one or more recommendations.ConclusionMost respondents did not receive HCP counselling, and approximately half of those who received counselling reported taking action. HCPs may need training to provide counselling and to offer recommendations tailored to the social contexts of populations less likely to adopt weight control related recommendations.

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Associations between Fasting Duration, Timing of First and Last Meal, and Cardiometabolic Endpoints in the National Health and Nutrition Examination Survey

Nutrients ◽

10.3390/nu13082686 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2686

Author(s):

Michael D. Wirth ◽

Longgang Zhao ◽

Gabrielle M. Turner-McGrievy ◽

Andrew Ortaglia

Keyword(s):

Energy Consumption ◽

National Health ◽

Survey Design ◽

Glycosylated Hemoglobin ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Nutrition Examination Survey ◽

Cross Sectional ◽

Health And Nutrition ◽

Fasting Duration

Background: Research indicates potential cardiometabolic benefits of energy consumption earlier in the day. This study examined the association between fasting duration, timing of first and last meals, and cardiometabolic endpoints using data from the National Health and Nutrition Examination Survey (NHANES). Methods: Cross-sectional data from NHANES (2005–2016) were utilized. Diet was obtained from one to two 24-h dietary recalls to characterize nighttime fasting duration and timing of first and last meal. Blood samples were obtained for characterization of C-reactive protein (CRP); glycosylated hemoglobin (HbA1c %); insulin; glucose; and high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol. Survey design procedures for adjusted linear and logistic regression were performed. Results: Every one-hour increase in nighttime fasting duration was associated with a significantly higher insulin and CRP, and lower HDL. Every one-hour increase in timing of the last meal of the day was statistically significantly associated with higher HbA1c and lower LDL. Every one-hour increase in first mealtime was associated with higher CRP (β = 0.044, p = 0.0106), insulin (β = 0.429, p < 0.01), and glucose (β = 0.662, p < 0.01), and lower HDL (β = −0.377, p < 0.01). Conclusion: In this large public health dataset, evidence for the beneficial effect of starting energy consumption earlier in the day on cardiometabolic endpoints was observed.

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