Breakfast in the United States: Food and Nutrient Intakes in Relation to Diet Quality in National Health and Examination Survey 2011–2014. A Study from the International Breakfast Research Initiative

The contribution of breakfast to diet quality (DQ) can inform future dietary guidelines. This study examined breakfast nutrition in relation to overall DQ, using dietary data from the first reported day of the National Health and Examination Survey (NHANES) 2011–2014 (n = 14,488). Relative DQ was assessed using the Nutrient Rich Foods Index (NRF9.3) and the USDA Healthy Eating Index 2015 (HEI 2015). The sample was stratified by NRF9.3 tertiles and by age and socioeconomic groups. Four out of 5 NHANES participants had breakfast on the day of the interview. Breakfast provided 19–22% of dietary energy depending on age. Breakfast intakes of complex carbohydrates and total sugars were proportionately higher and intakes of protein and fats were lower relative to breakfast energy intakes. Breakfast provided more that 20% of daily intakes of B vitamins, vitamins A and D, folate, calcium, iron, potassium and magnesium. Eating breakfast was associated with higher NRF9.3 DQ scores. Breakfasts associated with the top tertile of NRF9.3 scores had less added sugars and fats than those associated with the bottom tertile. Such breakfasts had more fruit and juices, more whole grain products, more milk and yogurt and less meat and eggs. Breakfast patterns and food choices that favored fruit, whole grains and dairy were associated with healthiest diets.

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Breakfast in the United States: Food and Nutrient Intakes in Relation to Diet Quality in NHANES 2011-2014. A Study from the International Breakfast Research Initiative (IBRI)

10.20944/preprints201808.0109.v1 ◽

2018 ◽

Cited By ~ 1

Author(s):

Adam Drewnowski ◽

Colin Rehm ◽

Florent Vieux

Keyword(s):

Diet Quality ◽

The United States ◽

Whole Grains ◽

Healthy Eating Index ◽

Dietary Guidelines ◽

Added Sugars ◽

Research Initiative ◽

United States Food ◽

Daily Intakes ◽

Calcium Iron

Abstract: The contribution of breakfast to diet quality (DQ) can inform future dietary guidelines. This study examined breakfasts that were associated with highest-quality diets. Dietary data came from the first reported day of the National Health and Examination Survey (NHANES) 2011-2014 (n=14,488). DQ measures were the Nutrient Rich Foods Index (NRF9.3) and the USDA Healthy Eating Index 2015 (HEI 2015). Analyses of breakfast intakes were conducted by NRF9.3 tertiles and by age and socioeconomic groups. Four out of 5 NHANES participants ate breakfast. Breakfast provided 19-22% of dietary energy depending on age. Breakfast intakes of complex carbohydrates and total sugars were higher and intakes of protein and fats were lower relative to energy intakes. Breakfast provided more that 20% of daily intakes of B vitamins, vitamins A and D, folate, calcium, iron, potassium and magnesium. Eating breakfast was associated with higher NRF9.3d scores. Breakfasts associated with top tertile of NRF9.3d had more carbohydrates and less added sugars and fats. Such breakfasts had more fruit and juices, more whole grains, more milk and yogurt and less meat and eggs. Breakfast patterns that favored fruit, whole grains, and dairy were associated with healthiest diets.

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Association between Ready-to-Eat Cereal Consumption and Nutrient Intake, Nutritional Adequacy, and Diet Quality in Adults in the National Health and Nutrition Examination Survey 2015–2016

Nutrients ◽

10.3390/nu11122952 ◽

2019 ◽

Vol 11 (12) ◽

pp. 2952

Author(s):

Yong Zhu ◽

Neha Jain ◽

Vipra Vanage ◽

Norton Holschuh ◽

Anne Hermetet Agler ◽

...

Keyword(s):

United States ◽

Dietary Intake ◽

National Health ◽

Diet Quality ◽

The United States ◽

Healthy Eating Index ◽

Nutrition Examination Survey ◽

Food Groups ◽

Dietary Recall ◽

Health And Nutrition

This study examined differences in dietary intake between ready-to-eat cereal eaters and non-eaters in adults from the United States. Participants (n = 5163) from the National Health and Nutrition Examination Survey 2015–2016 were included. One-day dietary recall was used to define ready-to-eat cereal consumption status and estimate dietary intake in eaters and non-eaters. Data from Food Patterns Equivalent Database 2015–2016 were used to compare intakes of food groups by consumption status. Diet quality was assessed by Healthy Eating Index 2015. Nineteen percent of US adults were ready-to-eat cereal eaters; they had a similar level of energy intake as non-eaters, but they had significantly higher intake of dietary fiber, and several vitamins and minerals, such as calcium, iron, magnesium, potassium, zinc, vitamin A, thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, and vitamin D. They were also more likely to meet nutrient recommendations. Compared to non-eaters, ready-to-eat cereal eaters had the same level of added sugar intake but they had significantly higher intake of whole grains, total fruits, and dairy products. The diet quality of ready-to-eat cereal eaters was significantly higher than that of non-eaters. The study supports that ready-to-eat cereal eaters have better dietary intake with a healthier dietary pattern than non-eaters in the United States.

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Dietary intake and diet quality by weight category among a racially diverse sample of women in Birmingham, Alabama, USA

Journal of Nutritional Science ◽

10.1017/jns.2020.51 ◽

2020 ◽

Vol 9 ◽

Author(s):

Rebecca B. Little ◽

Renee Desmond ◽

Tiffany L. Carson

Keyword(s):

Diet Quality ◽

Weight Status ◽

Vegetable Intake ◽

The United States ◽

Healthy Eating Index ◽

Dietary Guidelines ◽

Rank Test ◽

Deep South ◽

Weight Category ◽

Maximum Score

Abstract Diet is a modifiable contributor to health. The lack of adherence to recommended dietary guidelines may contribute to the disproportionate burden of obesity and other chronic conditions observed in the Deep South region of the United States. The objective of this cross-sectional study was to describe food group intake and diet quality by race and weight status of women in the Deep South. Study participants were eighty-nine healthy female volunteers (56 % black, 44 % white, mean age 39⋅7 ± 1⋅4 years) recruited from Birmingham, AL, USA. Body Mass Index (BMI) determined weight status (non-obese/obese). Healthy Eating Index-2010 (HEI-2010) calculated from dietary recalls assessed diet quality. Wilcoxon sum-rank test compared HEI-2010 scores by race and weight status. χ2 analysis compared the percentage of women who achieved maximum points for HEI-2010 index food components by subgroup. Caloric and macronutrient intake did not differ by race or weight status (mean kcal 1863⋅0 ± 62⋅0). Median Total HEI-2010 Score for the sample was 51⋅9 (IQR: 39⋅1–63⋅4). Although there was no statistical difference in diet quality by race, more whites achieved the maximum score for vegetable intake compared to blacks, while blacks reported higher total fruit intake. Non-obese women reported better diet quality (56⋅9 v. 46⋅1; P = 0⋅04) and eating more whole fruits, and more achieved the maximum score for protein from plant and seafood sources. In summary, differences in diet quality were observed by weight status, but not race among this sample. These results point to tailored dietary interventions for women in metropolitan areas of Alabama, USA.

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Adherence to Dietary Guidelines in Adults by Diabetes Status: Results From the 2012 Mexican National Health and Nutrition Survey

Nutrients ◽

10.3390/nu12113464 ◽

2020 ◽

Vol 12 (11) ◽

pp. 3464

Author(s):

Nancy López-Olmedo ◽

Satya Jonnalagadda ◽

Ana Basto-Abreu ◽

Alan Reyes-García ◽

Carolyn J. Alish ◽

...

Keyword(s):

Healthy Eating Index ◽

Dietary Guidelines ◽

Linear Regression Models ◽

Nutrition Survey ◽

Added Sugars ◽

Diabetes Status ◽

Dietary Component ◽

Daily Intakes ◽

Nutrient Profiles ◽

And Control

The aims of the present study were to compare the adherence to dietary guidelines and evaluate potential differences in nutrient profiles among adults by diabetes status. We used the Mexican Alternate Healthy Eating Index (MxAHEI) to evaluate adherence to dietary guidelines. We calculated the MxAHEI scores (total and by dietary component) with scales from 0 (non-adherence) to 100 (perfect adherence) based on a food frequency questionnaire. Mean daily intakes of macronutrients and micronutrients (g, mg, mcg/1000 kcal per day) were also estimated by diabetes status. Sex-specific, multivariable linear regression models were estimated to test whether MxAHEI scores as well as nutrient intakes were different by diabetes status. Mexican adults had low adherence to the dietary guidelines irrespective of their diabetes status (score < 50 points). Among men, the MxAHEI score was 2.6 points higher among those with diabetes than those without diabetes (46.9; 95% confidence intervals (CI): 44.6, 49.2 vs. 44.3; 95% CI: 44.2, 45.6, respectively). Among women, the total MxAHEI score was similar in individuals with diabetes compared to those without diabetes. Lower intakes of carbohydrates and added sugars and higher intakes of protein, calcium, and zinc were observed in individuals with diabetes. Our findings support the development of strategies focused on promoting dietary patterns that can help to prevent and control the disease.

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Food and beverage choices contributing to dietary guidelines adherence in the Lower Mississippi Delta

Public Health Nutrition ◽

10.1017/s1368980011001443 ◽

2011 ◽

Vol 14 (12) ◽

pp. 2099-2109 ◽

Cited By ~ 11

Author(s):

Jessica L Thomson ◽

Stephen J Onufrak ◽

Carol L Connell ◽

Jamie M Zoellner ◽

Lisa M Tussing-Humphreys ◽

...

Keyword(s):

Diet Quality ◽

Mississippi Delta ◽

Healthy Eating Index ◽

Dietary Guidelines ◽

Alcoholic Beverages ◽

Demographic Differences ◽

Homogeneous Population ◽

Added Sugars ◽

Food And Beverage ◽

Component Scores

AbstractObjectivesThe objectives of the present study were to evaluate diet quality among Lower Mississippi Delta (LMD) residents using the Healthy Eating Index-2005 (HEI-2005) and to identify the top five dietary sources contributing to HEI-2005 components. Demographic differences in HEI-2005 scores were also explored.DesignDiet quality was evaluated using HEI-2005. Demographic differences in HEI-2005 scores were investigated using multivariable regression models adjusting for multiple comparisons. The top five dietary sources contributing to HEI-2005 components were identified by estimating and ranking mean MyPyramid equivalents overall and by demographic characteristics.SettingDietary data, based on a single 24 h recall, from the Foods of Our Delta Study 2000 (FOODS 2000) were used in the analyses.SubjectsFOODS 2000 adult participants 18 years of age or older.ResultsYounger age was the largest determinant of low diet quality in the LMD with HEI-2005 total and seven component scores declining with decreasing age. Income was not a significant factor for HEI-2005 total or component scores. The top five dietary sources differed by all five of the demographic variables, particularly for total vegetables and energy from solid fats, alcoholic beverages and added sugars (SoFAAS). Soft drinks were the leading source of SoFAAS energy intake for all demographic groups.ConclusionsThe assessment of diet quality and identification of top dietary sources revealed the presence of demographic differences for selected HEI-2005 components. These findings allow identification of food patterns and culturally appropriate messaging and highlight the difficulties of treating this region as a homogeneous population.

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Association between Ready-to-Eat Cereal Consumption and Nutrient Intake, Nutritional Adequacy, and Diet Quality among Infants, Toddlers, and Children in the National Health and Nutrition Examination Survey 2015–2016

Nutrients ◽

10.3390/nu11091989 ◽

2019 ◽

Vol 11 (9) ◽

pp. 1989 ◽

Cited By ~ 3

Author(s):

Jessica D. Smith ◽

Yong Zhu ◽

Vipra Vanage ◽

Neha Jain ◽

Norton Holschuh ◽

...

Keyword(s):

National Health ◽

Diet Quality ◽

Saturated Fat ◽

Food Group ◽

Healthy Eating Index ◽

Dietary Quality ◽

Nutrition Examination Survey ◽

Whole Grain ◽

Health And Nutrition ◽

Calcium Iron

Ready-to-eat (RTE) cereal is a popular food among children. However, there are no recent data on the associations between RTE cereal consumption and dietary outcomes in the U.S. Therefore, we sought to investigate how RTE cereal was associated with nutrient and food group intakes and overall dietary quality among children aged 0.5 to 17 years using the latest data from the National Health and Nutrition Examination Survey (NHANES 2015–2016). Thirty-six percent of children reported consuming RTE cereal. RTE cereal eaters consumed the same number of calories as non-eaters but had higher intakes of total carbohydrates, total sugar, fiber, calcium, iron, magnesium, potassium, zinc, vitamin A, thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, and vitamin D, as well as lower intakes of total fat and saturated fat (p ≤ 0.0007). We also found that children who consumed RTE cereal had 29% higher total dairy intake (p < 0.0001) and 61% higher whole grain intake (p < 0.0001). Lastly, children who ate RTE cereal had higher diet quality than the children that did not eat RTE cereal, as shown by Healthy Eating Index 2015 total score (52.6 versus 47.7, p < 0.0001). Therefore, consumption of whole-grain fortified RTE cereals should be encouraged as part of healthy dietary patterns for children.

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Healthy Eating Index Protocol: Review, Update, and Development Process to Reflect Dietary Guidance Across the Lifespan

Current Developments in Nutrition ◽

10.1093/cdn/nzab038_059 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 447-447

Author(s):

Jill Reedy ◽

TusaRebecca Pannucci ◽

Kirsten Herrick ◽

Jennifer Lerman ◽

Marissa Shams-White ◽

...

Keyword(s):

Healthy Eating ◽

Diet Quality ◽

Dietary Patterns ◽

Development Process ◽

Life Stage ◽

The United States ◽

Nutrition Policy ◽

Healthy Eating Index ◽

Dietary Guidelines ◽

Infants And Toddlers

Abstract Objectives The Healthy Eating Index (HEI) is a measure of diet quality, independent of quantity, that can be used to assess alignment with the Dietary Guidelines for Americans (DGAs), which are the basis of nutrition policy for the United States (US) government and the foundation of all federal nutrition guidance. The recently released 2020–2025 DGAs include recommendations for infants and toddlers for the first time, and necessitate a review, update, and development process of the HEI to reflect healthy eating across the lifespan. Methods Since 2005, researchers at the HHS National Cancer Institute (NCI) and the USDA Center for Nutrition Policy and Promotion have collaborated to revise the HEI based on updates to the DGAs, and the HEI-2015 is the most recent iteration. The process includes: 1) gathering information from dietary guidelines, experts, and federal stakeholders; 2) considering substantive changes and needs for new development; and 3) completing validation analyses. Results Updates to the HEI have aimed to maintain stability, reflecting the consistency of recommendations over time. A guiding principle is to only make changes to the HEI that have a strong rationale. With no significant changes in the USDA Dietary Patterns, few changes are anticipated for the HEI for 2 years and older; instead, the emphasis for the update process is focusing on considerations for an index for infants and toddlers under 2 years. Additionally, the Scientific Report of the 2020 Dietary Guidelines Advisory Committee identified the development of a scoring system (such as the HEI) for infants and toddlers as a research recommendation, because comparisons of diet quality using the HEI have thus far only been possible for Americans 2 years and older. The HEI review, update, and development process aims to consider analyses with distributions of HEI scores across the lifespan with nationally representative data and diverse cohorts. Conclusions The HEI is a valuable tool for research that can be used in nutrition interventions, epidemiology, and consumer nutrition education programs. The timely release of a new HEI will enable application across the lifespan and support additional methodological research to examine needs specific to each life stage and how to model optimal trajectories of healthy dietary patterns. Funding Sources None.

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Abstract P410: Added Sugars Intake, Diet Quality and All-Cause Mortality Among US Adults: Prospective Data from National Health and Nutrition Examination Survey III

Circulation ◽

10.1161/circ.129.suppl_1.p410 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Molly Jung ◽

Robert C Kaplan ◽

Yasmin Mossavar-Rahmani ◽

Shankar Viswanathan ◽

Judith Wylie-Rosett ◽

...

Keyword(s):

Energy Intake ◽

National Health ◽

Diet Quality ◽

Healthy Eating Index ◽

Nutrition Examination Survey ◽

Men And Women ◽

Added Sugars ◽

Health And Nutrition ◽

Usual Intake ◽

All Cause Mortality

Objectives: To better understand the relationship between added sugars intake and diet quality, and to estimate associations between added sugars intake with all-cause mortality Methods: National Health and Nutrition Examination Survey III data were linked to mortality data (1988-2006), among 13,902 US adults between ages 18-74 yr having energy intake within 500-3500calories for women and 800-4000 calories for men, no history of a heart attack, stroke, or congestive heart failure. Usual intake of added sugars and energy were estimated using the NCI method and categorized into gender-specific quartiles. Diet quality was assessed using the Healthy Eating Index 2005 score (HEI-2005). Associations between added sugars intake and mortality were estimated using Cox proportional hazards regression adjusting for age, race/ethnicity, body mass index (BMI), and usual total energy intake after testing for multiplicative interaction by each of these covariates. Results: Mean intake of added sugar was 17.2 (95% Confidence Interval (CI) 16.8, 17.6) teaspoons (tsp) in women and 25.0 (95% CI 24.4, 25.7) tsp in men. Higher usual intake of added sugars was associated with being younger, a current smoker, and having between 12 and 15 years of education among both men and women. Higher usual intake of added sugars was related to a lower HEI score in women versus a higher HEI score in men (Quartile (Q) 4 for HEI =61.62 versus Q1=64.73 in women, p=0.0002; (Q4=62.71 vs. Q1=60.07 in men, p=0.0209). Higher HEI scores for the grain, fruit, vegetable, meat, and variety components were related to lower intake of added sugars; whereas, the fats, cholesterol, and sodium components of the HEI were related to higher intake of added sugars in men and women. During a median follow-up period of 14 years, a total of 1,889 deaths were recorded. After multivariable adjustment, higher added sugars intake was not associated with increased all-cause mortality (hazard ratio (HR) 95% CI of Q4 vs Q1, 1.08 (0.77, 1.52)). Interpretation: Epidemiological studies suggested that higher sugars intake is associated with an increased risk of obesity and cardiovascular diseases (CVD). These findings indicate higher intake of added sugars is associated with lower diet quality in women, but not men. Added sugars intake was not significantly associated with all-cause mortality in this representative sample of the US population.

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Designing Optimal Breakfast for the United States Using Linear Programming and the NHANES 2011–2014 Database: A Study from the International Breakfast Research Initiative (IBRI)

Nutrients ◽

10.3390/nu11061374 ◽

2019 ◽

Vol 11 (6) ◽

pp. 1374 ◽

Cited By ~ 6

Author(s):

Florent Vieux ◽

Matthieu Maillot ◽

Colin D. Rehm ◽

Adam Drewnowski

Keyword(s):

Linear Programming ◽

Dietary Patterns ◽

Eating Habits ◽

The United States ◽

Dietary Guidelines ◽

Added Sugars ◽

Health And Nutrition ◽

Research Initiative ◽

Nationally Representative

The quality of dietary patterns can be optimized using a mathematical technique known as linear programming (LP). LP methods have rarely been applied to individual meals. The present LP models optimized the breakfast meal for those participants in the nationally representative National Health and Nutrition Examination Survey 2011–2014 who ate breakfast (n = 11,565). The Nutrient Rich Food Index (NRF9.3) was a measure of diet quality. Breakfasts in the bottom tertile of NRF9.3 scores (T1) were LP-modeled to meet nutrient requirements without deviating too much from current eating habits. Separate LP models were run for children and for adults. The LP-modeled breakfasts resembled the existing ones in the top tertile of NRF9.3 scores (T3), but were more nutrient-rich. Favoring fruit, cereals, and dairy, the LP-modeled breakfasts had less meat, added sugars and fats, but more whole fruit and 100% juices, more whole grains, and more milk and yogurt. LP modeling methods can build on existing dietary patterns to construct food-based dietary guidelines and identify individual meals and/or snacks that need improvement.

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Daily Snacking Occasions, Snack Size, and Snack Energy Density as Predictors of Diet Quality among US Children Aged 2 to 5 Years

Nutrients ◽

10.3390/nu11071440 ◽

2019 ◽

Vol 11 (7) ◽

pp. 1440 ◽

Cited By ~ 6

Author(s):

Alexandria Kachurak ◽

Regan L. Bailey ◽

Adam Davey ◽

Lauren Dabritz ◽

Jennifer Orlet Fisher

Keyword(s):

Energy Density ◽

Diet Quality ◽

Saturated Fat ◽

Healthy Eating Index ◽

Dietary Quality ◽

Health Examination ◽

Added Sugars ◽

The Mean ◽

Nationally Representative ◽

Daily Intakes

Whether snacks help young children meet nutritional needs or merely contribute to excessive intakes is debated. This research evaluated associations of snacking with dietary quality among US preschoolers (two to five years, n = 4217) in the 2005–2016 National Health Examination Survey (NHANES). Snacking occasions, size, and energy density (ED) were estimated from two 24-hr dietary recalls. Diet quality indices included the 2015 Healthy Eating Index (HEI-2015, 0–100), the mean adequacy ratio (MAR, 0–100) for five shortfall nutrients (vitamin D, calcium, fiber, potassium, and iron), and the mean % of recommended limits for added sugars, saturated fat, and sodium. Linear regressions included snacking parameters, demographics, and dietary reporting accuracy. Children had a mean HEI-2015 of 53.0, a MAR of 67.7, and intake of 121.4% of nutrients to limit. Daily snacking occasions were positively associated with HEI-2015 scores, whereas mean snack size and ED were negatively associated with HEI-2015 and MAR scores (all p < 0.05). Snack ED was positively associated with daily intakes of added sugar, saturated fat, and sodium (p < 0.001). These nationally representative findings reveal that more frequent, smaller, and less energy-dense snacks are associated with higher diet quality among US preschoolers.

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