Dietary Cholesterol Intake and Sources among U.S Adults: Results from National Health and Nutrition Examination Surveys (NHANES), 2001–2014

The 2015 Dietary Guidelines for Americans recommends that individuals should eat as little dietary cholesterol as possible. However, current dietary cholesterol intake and its food sources have not been well-characterized. We examined dietary cholesterol intake by age, sex, race, and food sources using 24-hour dietary recall data from a nationally representative sample of 5047 adults aged 20 years or older who participated in NHANES (2013–2014 survey cycle). We also reported trends in cholesterol intake across the past 7 NHANES surveys. Mean dietary cholesterol intake was 293 mg/day (348 mg/day for males and 242 mg/day for females) in the 2013–2014 survey cycle; 39% of adults had dietary cholesterol intake above 300 mg/day (46% for males and 28% for females). Meat, eggs, grain products, and milk were the highest four food sources of cholesterol, contributing to 96% of the total consumption. Both average cholesterol intake and food source varied by age, sex, and race (each p < 0.05). Mean cholesterol intake of the overall population had been relatively constant at ~290 mg/day from 2001–2002 to 2013–2014 (p-trend = 0.98). These results should inform public health efforts in implementing dietary guidelines and tailoring dietary recommendations.

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Sodium and Potassium in the American Diet: Important Food Sources from NHANES 2015–2016 (P18-045-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz039.p18-045-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Moises Torres-Gonzalez ◽

Christopher Cifelli ◽

Sanjiv Agarwal ◽

Victor Fulgoni

Keyword(s):

Dietary Guidelines ◽

Food Sources ◽

Ratio Method ◽

Dietary Recall ◽

Funding Sources ◽

Major Food ◽

Recall Data ◽

Cured Meat ◽

A Minor ◽

Sodium And Potassium

Abstract Objectives This analysis used data from the 2015–2016 National Health and Nutrition Examination Survey (NHANES) to identify major food sources of sodium, potassium, or both in the American diet. Methods Twenty-four-hour dietary recall data (n = 7817) from the dietary component of the 2015–2016 NHANES was used. Data was analyzed separately for children age 2–18 years and for adults age 19 + years using day one sample weights. Percent sodium and potassium contributions from 48 food subgroups of “What We Eat in America” were determined using SAS (PROC SURVEYREG) and the ratio method. Results The top five food sources of sodium for children 2–18 years of age were: mixed dishes – sandwiches (8.9%), mixed dishes – pizza (8.4%), cured meat/poultry (6.7%), mixed dishes – grain based (6.2%), and poultry (6.0%). Major food sources of potassium for children were milk (11.7%), fruits (7.1%), white potatoes (5.6%), mixed dishes – sandwiches (5.2%), and 100% fruit juices (4.8%). In adults, the top five sources of sodium were mixed dishes – sandwiches (7.5%), cured meat/poultry (7.0%), mixed dishes – Mexican (6.1%), poultry (5.5%), and breads, rolls, tortillas (5.4%). Major food sources of potassium for adults were coffee and tea (8.1%), vegetables, excluding potatoes (7.9%), fruits (6.2%), white potatoes (6.1%), and milk (4.9%). Milk was a minor source of sodium for children (2.6%) and in adults (1.2%). While previous research shows cheese as a source of sodium in the U.S. diet, cheese as consumed was not one of the top 5 sources of sodium for adults or children. However, it is a component of several of the mixed dishes identified in this analysis. Conclusions In children, sandwiches was a top food source of both sodium and potassium. There were no other overlaps in sources of sodium and potassium. Mixed dishes were top food sources of sodium in the diets of both children and adults, while milk, fruits, and potatoes were top food sources of potassium for both groups. This information could be used to help Americans move closer to Dietary Guidelines for Americans recommendations for both sodium and potassium. Funding Sources National Dairy Council.

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Diet

10.2310/fm.1408 ◽

2015 ◽

Author(s):

Elizabeth G Nabel

Keyword(s):

Dietary Fiber ◽

Daily Intake ◽

Blood Lipid ◽

Dietary Guidelines ◽

Food Sources ◽

Healthy Weight ◽

Dietary Recommendations ◽

Animal Products ◽

Vegetable Foods ◽

Fiber Proteins

An unhealthy diet is a major risk factor for chronic diseases such as cardiovascular diseases, cancer, diabetes, and conditions related to obesity. In the 20th century, the average American diet shifted from one based on fresh, minimally processed vegetable foods to one based on animal products and highly refined, processed foods, leading to an increased consumption of calories, fat, cholesterol, refined sugar, animal protein, sodium, and alcohol and far less fiber and starch than was healthful. As a result, more than one third of US adults are obese, with an estimated medical cost of $147 billion. Physicians have an important role in educating patients about healthful nutrition and in providing dietary guidelines. This module discusses the role of energy in weight loss; the structure of fat and cholesterol, their effects on blood lipid levels and cardiovascular risk, and related dietary recommendations; carbohydrates; dietary fiber; proteins; vitamin and mineral consumption; water and food consumption; and the relationship between diet and health. Tables review the principles of a healthy diet; recommended daily intake of fat and other nutrients; types of dietary fiber and representative food sources; types of vitamins; essential minerals and trace elements; and dietary guidelines for healthy people. Figures include a graph showing the percentage of adults who are healthy weight, overweight, and obese and the structure of fat and cholesterol. This review contains 2 highly rendered figures, 6 tables, and 37 references.

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Replacing the nutrients in dairy foods with non-dairy foods will increase cost, energy intake and require large amounts of food: National Health and Nutrition Examination Survey 2011–2014

Public Health Nutrition ◽

10.1017/s1368980020001937 ◽

2020 ◽

pp. 1-12

Author(s):

Christopher J Cifelli ◽

Nancy Auestad ◽

Victor L Fulgoni

Keyword(s):

National Health ◽

Tap Water ◽

Phase 1 ◽

Dietary Guidelines ◽

Nutrition Examination Survey ◽

Dairy Foods ◽

Health And Nutrition ◽

The Us ◽

Dietary Guidelines For Americans ◽

Nationally Representative

Abstract Objective: The US Dietary Guidelines for Americans recommends increased consumption of the dairy group to three daily servings for ages 9+ years to help achieve adequate intakes of prominent shortfall nutrients. Identifying affordable, consumer-acceptable foods to replace dairy’s shortfall nutrients is important especially for people who avoid dairy. Design: Linear programming identified food combinations to replace dairy’s protein and shortfall nutrients. We examined cost, energy and dietary implications of replacing dairy with food combinations optimised for lowest cost, fewest kJ or the smallest amount of food by weight. Setting: National Health and Nutrition Examination Survey (2011–2014). Participants: Nationally representative sample of US population; 2 years and older (n 15 830). Results: Phase 1 (only dairy foods excluded): when optimised for lowest cost or fewest kJ, all non-dairy food replacements required large amounts (2·5–10 cups) of bottled/tap water. Phase 2 (dairy and unreasonable non-dairy foods excluded (e.g. baby foods; tap/bottled water): when intake of non-dairy foods was constrained to <90th percentile of current intake, the lowest cost food combination replacements for dairy cost 0·5 times more and provide 5·7 times more energy; the lowest energy food combinations cost 5·9 times more, provide 2·5 times more energy and require twice the amount of food by weight; and food combinations providing the smallest amount of food by weight cost 3·5 times more and provide five times more energy than dairy. Conclusions: Identifying affordable, consumer-acceptable foods that can replace dairy’s shortfall nutrients at both current and recommended dairy intakes remains a challenge.

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Association between Dietary Cholesterol and Their Food Sources and Risk for Hypercholesterolemia: The 2012–2016 Korea National Health and Nutrition Examination Survey

Nutrients ◽

10.3390/nu11040846 ◽

2019 ◽

Vol 11 (4) ◽

pp. 846 ◽

Cited By ~ 9

Author(s):

Dongjoo Cha ◽

Yongsoon Park

Keyword(s):

Low Density Lipoprotein ◽

Dietary Cholesterol ◽

Density Lipoprotein ◽

Serum Levels ◽

Food Sources ◽

Direct Effects ◽

Low Density Lipoprotein Cholesterol ◽

Processed Meats ◽

Health And Nutrition ◽

Cholesterol Intake

It remains unclear whether cholesterol intake can increase serum cholesterol. Therefore, the present study aimed to investigate the hypothesis that the risk for hypercholesterolemia was not associated with intake of dietary cholesterol after adjusting for saturated fatty acid (SFA). Based on the data from the 2012–2016 KNHANES, dietary cholesterol was positively associated with the risk for abnormalities in total cholesterol (TC) (odds ratio (OR): 1.153, 95% confidence interval (CI): 0.995–1.337; p = 0.028) and low-density lipoprotein cholesterol (LDL-C) (OR: 1.186, 95% CI: 1.019–1.382; p = 0.018) levels before adjusting for SFA; after adjusting for SFA, no significant associations were found between these variables. The mediation analysis showed that dietary cholesterol had no direct effects on the serum levels of TC and LDL-C; in contrast, SFA had significant indirect effects on the association between dietary cholesterol and serum levels of TC and LDL-C. Furthermore, processed meats, but not eggs and other meats, were positively associated with the risk for abnormalities in both TC (OR: 1.220, 95% CI: 1.083–1.374; p = 0.001) and LDL-C (OR: 1.193, 95% CI: 1.052–1.354; p = 0.004) levels. The present study suggested that higher intake of processed meats with high SFA, but not dietary cholesterol was associated with higher risk for abnormalities in TC and LDL-C levels.

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Intake of Fried Fish at Home and Away from Home in the United States Using Nationally-Representative Data from WWEIA, 2005–14 (P04-192-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz051.p04-192-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Linda Kantor ◽

Biing-Hwan Lin

Keyword(s):

United States ◽

Fast Food ◽

The United States ◽

Dietary Guidelines ◽

Refined Grains ◽

Dietary Recall ◽

Funding Sources ◽

Nationally Representative ◽

Nutrition Educators ◽

At Home

Abstract Objectives The objective of our study is to inform nutrition monitoring and education efforts to boost seafood consumption in the United States by describing patterns of fried fish intake, both at home (FAH) and away from home (FAFH) among the U.S. population. Methods We used 24-hr dietary recall data from the What We Eat in America (WWEIA) survey, the dietary intake component of the National Health and Nutrition Examination Survey (NHANES), combined for 2005–14. We describe mean protein-ounce equivalents for fried fish (fish sticks, fish sandwiches and patties, and battered, breaded, coated fried seafood) at home and at restaurants, fast food places, schools and other away from home places. Results Fried seafood accounted for 1 in 5 seafood meals and 30% of total seafood calories in the United States in 2005–14. Fried types accounted for twice the share of FAFH seafood meals and 40% more seafood calories as FAH seafood. Among FAFH places, fried seafood had the highest share of total seafood meals and calories at schools (68 and 65%) followed by fast food places (38 and 46%). Fried seafood was more likely to be of inferior nutrition compared to non-fried seafood. For example, fried seafood accounted for more than one third of the solid fats from seafood meals and contained the most refined grains per 100 grams (1.27 FPEs for fish sticks, patties, and nuggets and 0.66 FPEs per 100 grams for other fried fish). Conclusions Our analysis shows that fried seafood is consumed more often at FAFH places, especially schools, and is a notable source of some food components, such as solid fats and refined grains, that are discouraged by the Dietary Guidelines Healthy Eating Patterns. Nutrition educators, school meal personnel, and policymakers may use these results as they develop strategies to increase Americans’ seafood intake. Funding Sources None.

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Exclusion of Dietary Cholesterol from The Specific Food Restrictions: A Review in Indonesia

Jurnal Sains Boga ◽

10.21009/jsb.001.1.01 ◽

2018 ◽

Vol 1 (1) ◽

pp. 1-11

Author(s):

Mirza Rizqi Zulkarnain

Keyword(s):

Dietary Cholesterol ◽

Dietary Guidelines ◽

Blood Cholesterol ◽

Trans Fats ◽

Added Sugars ◽

Cholesterol Levels ◽

Saturated Fats ◽

Dietary Guidelines For Americans ◽

Specific Restriction ◽

Specific Food

Hypercholesterolemia, the presence of high levels of cholesterol in the blood, is one of the major risk factor for cardiovascular disease (CVD). One of the key recommendation in the Dietary Guidelines for Americans 2010, is to consume less than 300 mg of dietary cholesterol per day. The same amount is also adopted in Indonesia (BPOM, 2016) until today. However, in the latest Dietary Guidelines for Americans 2015-2020, dietary cholesterol is no longer included in the list of specific foods that should be limited. The added sugars, sodium, saturated fats and trans fats remain on the list of food components that should be reduced. Generally, foods that are higher in dietary cholesterol are also higher in saturated fats. But there are also some foods that are higher in cholesterol but not in saturated fats. According to the latest recommendation, this kind of foods can be consumed without any specific restriction. In this review, some of clinical studies related to the association between dietary cholesterol and blood cholesterol levels are selected. The findings from those studies will be summarized to consider whether the same recommendation should be implemented in other countries, especially in Indonesia.

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Dietary quality among children from 6 months to 4 years, NHANES 2011–2016

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqz261 ◽

2019 ◽

Author(s):

Heather C Hamner ◽

Latetia V Moore

Keyword(s):

Dietary Guidelines ◽

Dietary Quality ◽

Dietary Recommendations ◽

Added Sugars ◽

Sweetened Beverages ◽

The Us ◽

Age Appropriate ◽

Dietary Guidelines For Americans ◽

Modified Diet

ABSTRACT Background The US Dietary Guidelines for Americans provide dietary recommendations for individuals aged ≥2 y and metrics exist to assess alignment. Nonfederal feeding recommendations exist for children <2 y, but limited metrics and assessment of dietary quality are available. Objective We aimed to assess dietary quality of children aged 6 mo–4 y using a modified Diet Quality Index Score (DQIS). Methods NHANES 2011–2016 dietary data were used to estimate the dietary quality of children 6 mo–4 y old using a modified DQIS. Differences in mean modified DQIS by demographics were assessed using linear regression. Results Mean modified DQIS ± SE was 22.4 ± 0.23 out of 45 possible points (50%) for children 6 mo–4 y of age on a given day. Modified DQIS scores on a given day decreased with age (27.7 ± 0.27 for 6- to 11-mo-olds, 23.9 ± 0.31 for 1-y-olds, 21.4 ± 0.26 for 2- to 3-y-olds, and 20.6 ± 0.49 for 4-y-olds; P < 0.0001 for trend). Children 6–11 mo old had 16% higher overall modified DQIS scores than 1-y-olds (P < 0.0001) and higher modified DQIS subcomponent scores for refined grains and protein, indicating higher age-appropriate intakes (P < 0.05). Similarly, children 6–11 mo old also had higher modified DQIS subcomponent scores, indicating no or limited intake, for 100% fruit juice, sugar-sweetened beverages, other added sugars, and salty snacks (P < 0.02). Conclusions Dietary quality declines with age and may begin as early as 1 y. The modified DQIS tool could help assess the dietary quality of young children. This may be important when identifying programmatic and policy efforts aimed at establishing and maintaining healthy dietary patterns beginning at an early age.

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Getting the food list ‘right’: an approach for the development of nutrition-relevant food lists for household consumption and expenditure surveys

Public Health Nutrition ◽

10.1017/s1368980018002847 ◽

2018 ◽

Vol 22 (2) ◽

pp. 246-256

Author(s):

Winnie Bell ◽

Jennifer C Coates ◽

Beatrice L Rogers ◽

Odilia I Bermudez

Keyword(s):

Stepwise Regression ◽

Household Survey ◽

Household Consumption ◽

Food Groups ◽

Dietary Recall ◽

Household Level ◽

Rural Bangladesh ◽

Contribution Analysis ◽

Recall Data ◽

Nationally Representative

AbstractObjectiveThe present paper aimed to demonstrate how 24 h dietary recall data can be used to generate a nutrition-relevant food list for household consumption and expenditure surveys (HCES) using contribution analysis and stepwise regression.DesignThe analysis used data from the 2011/12 Bangladesh Integrated Household Survey (BIHS), which is nationally representative of rural Bangladesh. A total of 325 primary sampling units (PSU=village) were surveyed through a two-stage stratified sampling approach. The household food consumption module used for the analysis consisted of a 24 h open dietary recall in which the female member in charge of preparing and serving food was asked about foods and quantities consumed by the whole household.SettingRural Bangladesh.ParticipantsA total of 6500 households.ResultsThe original 24 h open dietary recall data in the BIHS were comprised of 288 individual foods that were grouped into ninety-four similar food groups. Contribution analysis and stepwise regression were based on nutrients of public health interest in Bangladesh (energy, protein, fat, Fe, Zn, vitamin A). These steps revealed that a list of fifty-nine food items captures approximately 90 % of the total intake and up to 90 % of the between-person variation for the key nutrients based on the diets of the population.ConclusionsThe study illustrates how 24 h open dietary recall data can be used to generate a country-specific nutrition-relevant food list that could be integrated into an HCES consumption module to enable more accurate and comprehensive household-level food and nutrient analyses.

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Sources of sodium in Australian children's diets and the effect of the application of sodium targets to food products to reduce sodium intake

British Journal Of Nutrition ◽

10.1017/s0007114510003673 ◽

2010 ◽

Vol 105 (3) ◽

pp. 468-477 ◽

Cited By ~ 37

Author(s):

Carley A. Grimes ◽

Karen J. Campbell ◽

Lynn J. Riddell ◽

Caryl A. Nowson

Keyword(s):

Sodium Intake ◽

Food Sources ◽

Dietary Recall ◽

Processed Meats ◽

Poultry Products ◽

Food Standards ◽

Nationally Representative ◽

The Uk ◽

Activity Survey ◽

The Impact

The average reported dietary Na intake of children in Australia is high: 2694 mg/d (9–13 years). No data exist describing food sources of Na in Australian children's diets and potential impact of Na reduction targets for processed foods. The aim of the present study was to determine sources of dietary Na in a nationally representative sample of Australian children aged 2–16 years and to assess the impact of application of the UK Food Standards Agency (FSA) Na reduction targets on Na intake. Na intake and use of discretionary salt (note: conversion of salt to Na, 1 g of NaCl (salt) = 390 mg Na) were assessed from 24-h dietary recall in 4487 children participating in the Australian 2007 Children's Nutrition and Physical Activity Survey. Greatest contributors to Na intake across all ages were cereals and cereal-based products/dishes (43 %), including bread (13 %) and breakfast cereals (4 %). Other moderate sources were meat, poultry products (16 %), including processed meats (8 %) and sausages (3 %); milk products/dishes (11 %) and savoury sauces and condiments (7 %). Between 37 and 42 % reported that the person who prepares their meal adds salt when cooking and between 11 and 39 % added salt at the table. Those over the age of 9 years were more likely to report adding salt at the table (χ2199·5, df 6,P < 0·001). Attainment of the UK FSA Na reduction targets, within the present food supply, would result in a 20 % reduction in daily Na intake in children aged 2–16 years. Incremental reductions of this magnitude over a period of years could significantly reduce the Na intake of this group and further reductions could be achieved by reducing discretionary salt use.

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Foods Consumed by US Adults From Cafeterias and Vending Machines: NHANES 2005 to 2014

American Journal of Health Promotion ◽

10.1177/0890117118821846 ◽

2019 ◽

Vol 33 (5) ◽

pp. 666-674

Author(s):

Stephen J. Onufrak ◽

Hatidza Zaganjor ◽

Latetia V. Moore ◽

Heather C. Hamner ◽

Joel E. Kimmons ◽

...

Keyword(s):

Healthy Eating Index ◽

Dietary Guidelines ◽

Dietary Quality ◽

Cross Sectional ◽

Dietary Recall ◽

Vending Machines ◽

Sweetened Beverages ◽

Recall Data ◽

Vegetables And Fruits

Purpose: As part of wellness efforts, employers may seek to improve the nutritional quality of foods offered and consumed in cafeterias and vending machines. However, little is known about who consumes food from these venues and the types and dietary quality of the foods consumed. Design: Cross-sectional. Setting: Nonschool cafeterias and vending machines. Participants: US adults ≥20 years old. Measures: Prevalence of consuming foods, most common foods eaten, leading calorie sources, 2010 Healthy Eating Index Analysis: Using 24-hour dietary recall data from NHANES 2005-2014 (N = 25,549 adults), we estimated the prevalence of consuming foods, assessed the most commonly consumed foods, and calculated dietary quality of foods. Results: On a given day, 3.1% of adults consumed foods from cafeterias and 3.9% from vending machines. Consumers averaged 692 kcal from cafeterias and 264 kcal from vending machines. Cafeteria consumers had higher income and education, while vending consumers were more likely to be male and younger adults. Common cafeteria foods included vegetables and fruits, but cafeteria foods were generally high in sodium and low in whole grains. Sugar-sweetened beverages and candies accounted for approximately half of all vending calories. Conclusion: Foods chosen from cafeterias and vending machines do not align well with the Dietary Guidelines for Americans. Improving the dietary quality of foods consumed from these venues could impact millions of adults.

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