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

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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Total, Fresh, Lean, and Fresh Lean Beef Consumption in Relation to Nutrient Intakes and Diet Quality among U.S. Adults, 2005–2016

Nutrients ◽

10.3390/nu11030563 ◽

2019 ◽

Vol 11 (3) ◽

pp. 563 ◽

Cited By ~ 1

Author(s):

Ruopeng An ◽

Sharon Nickols-Richardson ◽

Reginald Alston ◽

Sa Shen ◽

Caitlin Clarke

Keyword(s):

Diet Quality ◽

Eating Habits ◽

Saturated Fat ◽

Dietary Quality ◽

Nutrient Intakes ◽

Confounding Bias ◽

Lean Beef ◽

Nationally Representative ◽

Daily Intakes ◽

Health Eating

(1) Background: This study assessed the influence of beef consumption on nutrient intakes and diet quality among U.S. adults. (2) Methods: Nationally-representative sample (n = 27,117) from 2005–2016 National Health and Nutrition Examination Survey was analyzed. First-difference estimator addressed confounding bias from time-invariant unobservables (e.g., eating habits, taste preferences) by using within-individual variations in beef consumption between 2 nonconsecutive 24 h dietary recalls. (3) Results: Approximately 54%, 39%, 12%, and 7% of U.S. adults consumed beef, lean beef, fresh beef, and fresh lean beef, respectively. Overall diet quality measured by the Health Eating Index-2015 (HEI-2015) score among beef, fresh beef, lean beef, and fresh lean beef consumers was lower than beef non-consumers. Regression analyses found that beef, fresh beef, lean beef, and fresh lean beef consumption was associated with higher daily intakes of total energy, protein, sodium, choline, iron, selenium, zinc, phosphorus, and multiple B vitamins. Beef, fresh beef, and lean beef consumption but not fresh lean beef consumption was associated with higher saturated fat intake. Beef consumption was not found to be associated with overall dietary quality measured by the HEI-2015 score. (4) Conclusions: Beef consumers may increase the intake of fresh and lean beef over total beef consumption to maximize the nutritional gains from beef portions while minimizing the resulting increases in energy, saturated fat, and sodium.

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Fresh and Lean Pork Consumption in Relation to Nutrient Intakes and Diet Quality among US Adults, NHANES 2005-2016

Health Behavior and Policy Review ◽

10.14485/hbpr.6.6.3 ◽

2019 ◽

Vol 6 (6) ◽

pp. 570-581 ◽

Cited By ~ 1

Author(s):

Ruopeng An ◽

Sharon M Nickols-Richardson ◽

Reginald Alston ◽

Caitlin Clarke

Keyword(s):

Diet Quality ◽

Eating Habits ◽

Saturated Fat ◽

Healthy Eating Index ◽

Nutrient Intakes ◽

Confounding Bias ◽

Nationally Representative ◽

Daily Intakes ◽

Pork Consumption ◽

Lean Pork

Objective: In this study, we assessed the influence of pork consumption on nutrient intakes and diet quality among US adults. Methods: We used a nationally-representative sample (N=27,117) from the National Health and Nutrition Examination Survey (NHANES) 2005–2016 waves for analysis. First-difference estimator addressed confounding bias from time-invariant non-observables (eg, eating habits, taste preferences) by using within-individual variations in pork consumption between 2 nonconsecutive 24-hour dietary recalls. Results: Approximately 19.4%, 16.5%, and 16.1% of US adults consumed pork, fresh pork, and fresh lean pork, respectively. Prevalence of pork, fresh pork, and fresh lean pork consumption differed by sex, race/ethnicity, and education level. Increased fresh and lean pork rather than total pork intake was related to marginally improved nutritional intakes (ie, protein, magnesium, potassium, selenium, zinc, phosphorus, and vitamins B1, B2, B3, and B6) with lesser increases in daily total energy, saturated fat, and sodium intakes. Pork, fresh pork, and fresh lean pork consumption was not found to be associated with the Healthy Eating Index (HEI)-2015 score. Conclusion: US adult pork consumers may increase their share of fresh and fresh lean pork over total pork consumption in an effort to increase their daily intakes of beneficial nutrients while minimizing intakes of energy, saturated fat, and sodium.

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Self-Reported Olfactory Dysfunction and Diet Quality: Findings from the 2011–2014 National Health and Nutrition Examination Survey (NHANES)

Nutrients ◽

10.3390/nu13124561 ◽

2021 ◽

Vol 13 (12) ◽

pp. 4561

Author(s):

Shristi Rawal ◽

Valerie B. Duffy ◽

Lauren Berube ◽

John E. Hayes ◽

Ashima K. Kant ◽

...

Keyword(s):

Energy Density ◽

National Health ◽

Diet Quality ◽

Dietary Diversity ◽

Saturated Fat ◽

Healthy Eating Index ◽

Olfactory Dysfunction ◽

Self Report ◽

Nutrition Examination Survey ◽

Health And Nutrition

We identified associations between self-reported olfactory dysfunction (OD) and dietary attributes in participants aged ≥40 years (n = 6,356) from the nationally representative 2011–2014 National Health and Nutrition Examination Survey (NHANES). The chemosensory questionnaire and 24-hour dietary recalls were administered by trained interviewers. OD was defined as self-report of either smell problems in the last year, worse smell relative to age 25, or perceiving phantom odors. Dietary outcomes included Healthy Eating Index 2015 score (HEI) with adequacy and moderation components (higher scores indicated higher diet quality), dietary diversity, energy density, and intake of major food groups. Survey-weighted linear regression models estimated OD–diet associations, adjusting for socio-demographic, lifestyle, and clinical factors. Adjusted mean difference (95% CI) between those with versus without OD, showed that adults with OD had significantly lower HEI moderation score (−0.67 (−1.22, −0.11)) and diets higher in energy density (0.06 (0.00, 0.11)), and percent energy from saturated fat (0.47 (0.12, 0.81)), total fat (0.96 (0.22, 1.70)), and added sugar (1.00 (0.33, 1.66)). Age and sex-stratified analyses showed that younger females (40–64 years) primarily accounted for the associations with diet quality and total/saturated fat intake. These findings inform dietary screening and recommendations for adults who report OD, including those experiencing transient or persistent smell loss with COVID-19.

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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

Nutrients ◽

10.3390/nu10091200 ◽

2018 ◽

Vol 10 (9) ◽

pp. 1200 ◽

Cited By ~ 38

Author(s):

Adam Drewnowski ◽

Colin Rehm ◽

Florent Vieux

Keyword(s):

National Health ◽

Diet Quality ◽

The United States ◽

Healthy Eating Index ◽

Dietary Guidelines ◽

Added Sugars ◽

Research Initiative ◽

United States Food ◽

Daily Intakes ◽

Calcium Iron

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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Abstract P206: Diet Quality is Lower Among Adolescents Who Skip Lunch

Circulation ◽

10.1161/circ.141.suppl_1.p206 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Spencer M Clason ◽

Lori Spruance ◽

Leann Myers ◽

Keelia O'Malley ◽

Carolyn Johnson

Keyword(s):

Diet Quality ◽

Dietary Habits ◽

Assessment Tool ◽

Dietary Assessment ◽

School Setting ◽

Healthy Eating Index ◽

Dietary Quality ◽

Added Sugars ◽

Dietary Recall ◽

Quality Diet

Introduction: A healthy diet is key in preventing chronic diseases and black adults have higher rates of hypertension, obesity, and heart disease death rates compared to their white counterparts. Because dietary habits track from adolescence to adulthood, it is important to understand dietary habits of adolescents. This study aimed to examine the dietary quality among adolescents who skip lunch compared to those who do not. Methods: Data were collected in 2012 from 718 adolescents attending schools in New Orleans, Louisiana. Schools were high-poverty and closed-campus. Adolescents participated in a 24-hour dietary recall using the Automated Self-Administered 24-Hour (ASA24) Dietary Assessment Tool and data were converted into Healthy Eating Index (HEI-10) scores (range 0-100; higher scores reflect higher quality diet). Mean scores were compared between students who skipped lunch and those who did not. Results: Of the 718 respondents, 88.3% were black and 15.3% of students skipped lunch. Students who ate lunch had a mean HEI score of 46.6 compared to a mean score of 41.7 for students who skipped lunch (p<0.001). Students who skipped lunch also had significantly lower intake of total vegetables, whole fruits, total dairy, total protein, and higher intake of empty calories (Solid fats, alcohols, and added sugars (SoFASS)). Conclusions: Skipping lunch was associated with lower quality diet, though diet quality was low among all students. Students who skip lunch are less likely to consume vegetables, whole fruits, whole grains, and proteins and have higher intake of SoFASS. Considering over 15% of the sample did not eat lunch in a closed-campus school setting, further research should consider how to encourage students to participate in the National School Lunch Program. Table 1. HEI score comparisons between those who skip and do not skip lunch.

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The association between parental views on dietary quality and physical activity levels

Health Education Journal ◽

10.1177/0017896919873939 ◽

2019 ◽

Vol 79 (2) ◽

pp. 237-249

Author(s):

Dawn S Earnesty ◽

Getrude Mphwanthe ◽

Gayle M Shipp ◽

Deanne Kelleher ◽

Julie Plasencia ◽

...

Keyword(s):

Physical Activity ◽

Linear Regression ◽

Health Care Professionals ◽

Saturated Fat ◽

Healthy Eating Index ◽

Child Behaviour ◽

Dietary Quality ◽

Linear Regression Models ◽

Added Sugars ◽

Parental Views

Introduction: Numerous external factors, including parental influences, impact the dietary quality and physical activity of children. In this study, we examined if parental views were associated with the dietary quality and physical activity of children. Design: A cross-sectional observational study was used to recruit and collect data from a purposive sample of 176 parents and their children, 4–11 years of age. Setting: A suburban school district in Michigan, USA. Methods: Healthy Eating Index (HEI) 2005 scores were calculated from child food frequency data, and bivariate linear regression was used to test associations between the total HEI 2005 and fruit, total vegetable, solid fats and added sugars (SoFAAs) and saturated fat dietary components, as well as relative to the parent’s views of raising children. Multivariate linear regression models were used to evaluate the relationship between the HEI score and the parental views. Multinomial linear regression was used to test associations between physical activity and parental views on their children’s behaviours related to health outcomes. Results: Children whose parents had firm parenting views were significantly more likely to eat vegetables and foods and beverages that were lower in saturated fat and added sugars. Parental views on child behaviour were not associated with physical activity of children. Conclusion: Parental views on child behaviour and other influences on child dietary quality are complex. As a result, health care professionals including dieticians should use a multifaceted approach to assess how parental views shape guidance regarding children’s dietary quality and subsequent health.

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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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Self-Reported Olfactory Dysfunction and Diet Quality: Findings From the 2011–2014 National Health and Nutrition Examination Survey (NHANES)

Current Developments in Nutrition ◽

10.1093/cdn/nzab053_078 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 1085-1085

Author(s):

Shristi Rawal ◽

Valerie Duffy ◽

John Hayes ◽

Ashima Kant ◽

Chuan-Ming Li ◽

...

Keyword(s):

Energy Density ◽

Diet Quality ◽

Saturated Fat ◽

Healthy Eating Index ◽

Olfactory Dysfunction ◽

Income Poverty ◽

Linear Regression Models ◽

Added Sugar ◽

Total Fat ◽

Taste And Smell

Abstract Objectives To identify associations of self-reported olfactory dysfunction (OD) with attributes of diet quality in a nationally-representative sample of US adults. Methods In this cross-sectional study, we utilized self-reported taste and smell, and dietary data collected from participants 40 years and older (n = 6356) in the NHANES 2011–2014. In the home-interview, a taste and smell questionnaire asked about smell-related problems, treatments and related conditions. Dietary information was collected by trained dietary interviewers using an in-person 24-h dietary recall interview and an automated multi-pass method. Self-reported OD was based on 3 questions, and defined as affirmative response to either a smell problem in the last 12 months, worse ability to smell since age 25, or smelling phantom odors. Diet quality was assessed using the Healthy Eating Index 2015 (HEI-2015) and its adequacy and moderation components (higher scores indicating higher diet quality). Other qualitative attributes included energy density of all foods (kcal/g), % energy from fat, and added sugar. Independent associations between self-reported OD and dietary attributes were estimated with survey-weighted linear regression models adjusting for age, gender, race/ethnicity, education, income-poverty ratio, and chronic disease score (based on reported diabetes, cancer, stroke and heart attack). Results The prevalence of OD was 22.3% (95% CI: 20.4%--24.2%) and the average HEI-2015 score was 53.2 (0.4 SE). Compared to those without OD, adults with OD had higher energy density diets and higher % of energy from total fat, saturated fat and added sugar. Adjusted βs (95% CI) reflecting mean differences between those with and without OD were 0.06 (0.00, 0.12) for energy density of foods, 0.45 (0.10, 0.80) for % energy from saturated fat, 0.94 (0.19, 1.69) for % energy from total fat, and 0.96 (0.27, 1.65) for % energy from added sugar. Additionally, OD was significantly associated with lower scores on the moderation component of the HEI-2015 [βs (95% CI) = −0.62 (−1.19, −0.05). Conclusions These findings may help inform dietary screening and recommendations for adults who perceive OD, including those experiencing transient or persistent smell loss with COVID-19. Funding Sources NIDCD; NCATS.

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Evaluation of a nutrient-rich food index score in the Netherlands

Journal of Nutritional Science ◽

10.1017/jns.2015.4 ◽

2015 ◽

Vol 4 ◽

Cited By ~ 12

Author(s):

Diewertje Sluik ◽

Martinette T. Streppel ◽

Linde van Lee ◽

Anouk Geelen ◽

Edith J. M. Feskens

Keyword(s):

Energy Density ◽

Saturated Fat ◽

Dietary Guidelines ◽

Dietary Quality ◽

Cereal Products ◽

Nutrient Density ◽

Rich Food ◽

The Individual ◽

Methodological Considerations ◽

Development And Validation

AbstractNutrient-rich food (NRF) index scores are dietary quality indices based on nutrient density. We studied the design aspects involved in the development and validation of NRF index scores, using the Dutch consumption data and guidelines as an example. We evaluated fifteen NRF index scores against the Dutch Healthy Diet Index (DHD-index), a measure of adherence to the Dutch dietary guidelines, and against energy density. The study population included 2106 adults from the Dutch National Food Consumption Survey 2007–2010. The index scores were composed of beneficial nutrients (protein, fibre, fatty acids, vitamins, minerals), nutrients to limit (saturated fat, sugar, Na) or a combination. Moreover, the influence of methodological decisions was studied, such as the choice of calculation basis (100 g or 100 kcal (418 kJ)). No large differences existed in the prediction of the DHD-index by the fifteen NRF index scores. The score that best predicted the DHD-index included nine beneficial nutrients and three nutrients to limit on a 100-kcal basis, the NRF9.3 with a model R2 of 0·34. The scores were quite robust with respect to sex, BMI and differences in calculation methods. The NRF index scores were correlated with energy density, but nutrient density better predicted the DHD-index than energy density. Consumption of vegetables, cereals and cereal products, and dairy products contributed most to the individual NRF9.3 scores. In conclusion, many methodological considerations underlie the development and evaluation of nutrient density models. These decisions may depend upon the purpose of the model, but should always be based upon scientific, objective and transparent criteria.

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