Low-calorie- and calorie-sweetened beverages: diet quality, food intake, and purchase patterns of US household consumers

Abstract Objectives Low-calorie sweetened beverages (LCSBs) are an increasingly consumed alternative to sugary beverages (SBs), yet their impact on children's overall diet is unclear. We aimed to compare total energy, macronutrient intake, and diet quality assessed by the Healthy Eating Index (HEI-2015), among consumers of LCSBs (alone or concurrently with SB use) with those reporting SB (sugar-sweetened beverages plus fruit juices) or water consumption, using national-level data collected during the five most recent 2-year cycles of the National Health and Nutrition Examination Survey (NHANES). Methods We used 24-hour dietary recalls from 10,257 children enrolled in NHANES 2007–2016 to assess energy and macronutrient intake and calculate adjusted mean HEI-2015 scores among children and adolescents categorized by their beverage intake over the previous 24 hours as follows: LCSB consumers (≥4oz. LCSB, <4oz SB), SB consumers (≥4oz SB, <4oz LCSB), and LCSB + SB consumers (≥4oz each) compared to water consumers (≥4oz water, <4oz LCSB and <4 oz SBs). Sample weights and complex survey procedures were used for all analyses. Results Adjusting for socio-demographic factors and BMI percentile, LCSB, SB, and LCSB + SB total energy intake was 184, 348, and 413 kcal higher and added sugar intake was 40, 164, and 180 kcal higher, respectively, compared to among water consumers (P < 0.05 for all pairwise comparisons). Overall diet quality was also significantly lower for LCSB, SB, and LCSB + SB consumers compared to water consumers (HEI-2015 scores of 49.0 ± 0.9, 49.1 ± 0.3, 48.9 ± 0.6, and 51.7 ± 0.6 for LCSB, SB, LCSB + SB, and water, respectively, P < 0.05 for all pairwise comparisons). Conclusions While cross-sectional analyses cannot establish causation, these findings challenge the utility of LCSB for weight management in children and adolescents. Our results align with current recommendations that water is the best alternative to SBs in children. Funding Sources This work was funded by the Sumner M. Redstone Global Center for Prevention and Wellness Pilot Studies Program.

Download Full-text

Effect of ultraprocessed food intake on cardiometabolic risk is mediated by diet quality: a cross-sectional study

BMJ Nutrition, Prevention & Health ◽

10.1136/bmjnph-2020-000225 ◽

2021 ◽

pp. bmjnph-2020-000225

Author(s):

Jennifer Griffin ◽

Anwar Albaloul ◽

Alexandra Kopytek ◽

Paul Elliott ◽

Gary Frost

Keyword(s):

Food Intake ◽

Energy Intake ◽

Food Consumption ◽

Outcome Measures ◽

Diet Quality ◽

Cardiometabolic Risk ◽

Saturated Fat ◽

Secondary Outcome ◽

Cross Sectional ◽

Occupational Cohort

ObjectiveTo examine the effect of the consumption of ultraprocessed food on diet quality, and cardiometabolic risk (CMR) in an occupational cohort.DesignCross-sectional.SettingOccupational cohort.Participants53 163 British police force employees enrolled (2004–2012) into the Airwave Health Monitoring Study. A total of 28 forces across the UK agreed to participate. 9009 participants with available 7-day diet record data and complete co-variate data are reported in this study.Main outcome measuresA CMR and Dietary Approaches to Stop Hypertension score were treated as continuous variables and used to generate measures of cardiometabolic health and diet quality. Secondary outcome measures include percentage of energy from fat, saturated fat, carbohydrate, protein and non-milk extrinsic sugars (NMES) and fibre grams per 1000 kcal of energy intake.ResultsIn this cohort, 58.3%±11.6 of total energy intake was derived from ultraprocessed (NOVA 4) foods. Ultraprocessed food intake was negatively correlated with diet quality (r=−0.32, p<0.001), fibre (r=−0.20, p<0.001) and protein (r = −0.40, p<0.001) and positively correlated with fat (r=0.18, p<0.001), saturated fat (r=0.14, p<0.001) and nmes (r=0.10, p<0.001) intake . Multivariable analysis suggests a positive association between ultraprocessed food (NOVA 4) consumption and CMR. However, this main effect was no longer observed after adjustment for diet quality (p=0.209). Findings from mediation analysis indicate that the effect of ultraprocessed food (NOVA 4) intake on CMR is mediated by diet quality (p<0.001).ConclusionsUltraprocessed food consumption is associated with a deterioration in diet quality and positively associated with CMR, although this association is mediated by and dependent on the quality of the diet. The negative impact of ultraprocessed food consumption on diet quality needs to be addressed and controlled studies are needed to fully comprehend whether the relationship between ultraprocessed food consumption and health is independent to its relationship with poor diet quality.

Download Full-text

Assessment of the developmental success of Anopheles coluzzii larvae under different nutrient regimes: effects of diet quality, food amount and larval density

Malaria Journal ◽

10.1186/s12936-018-2530-z ◽

2018 ◽

Vol 17 (1) ◽

Cited By ~ 1

Author(s):

Patric Stephane Epopa ◽

Hamidou Maiga ◽

Domonbabele François de Sales Hien ◽

Roch Kounbobr Dabire ◽

Rosemary Susan Lees ◽

...

Keyword(s):

Diet Quality ◽

Larval Density ◽

Anopheles Coluzzii ◽

Quality Food

Download Full-text

Evaluation of Food-Intake Behavior in a Healthy Population: Personalized vs. One-Size-Fits-All

Nutrients ◽

10.3390/nu12092819 ◽

2020 ◽

Vol 12 (9) ◽

pp. 2819

Author(s):

Femke P. M. Hoevenaars ◽

Charlotte M. M. Berendsen ◽

Wilrike J. Pasman ◽

Tim J. van den Broek ◽

Emmanuel Barrat ◽

...

Keyword(s):

Food Intake ◽

Whole Grains ◽

Dietary Advice ◽

Controlled Clinical Trial ◽

Healthy Population ◽

National Guidelines ◽

Sweetened Beverages ◽

Gender And Age ◽

Health Initiatives ◽

Added Salt

In public health initiatives, generic nutrition advice (GNA) from national guidelines has a limited effect on food-intake improvement. Personalized nutrition advice (PNA) may enable dietary behavior change. A monocentric, randomized, parallel, controlled clinical trial was performed in males (n = 55) and females (n = 100) aged 25 to 70 years. Participants were allocated to control, GNA or PNA groups. The PNA group consisted of automatically generated dietary advice based on personal metabolic health parameters, dietary intake, anthropometric and hemodynamic measures, gender and age. Participants who received PNA (n = 51) improved their nutritional intake status for fruits P (p < 0.0001), whole grains (p = 0.008), unsalted nuts (p < 0.0001), fish (p = 0.0003), sugar-sweetened beverages (p = 0.005), added salt (p = 0.003) and less unhealthy choices (p = 0.002), whereas no improvements were observed in the control and GNA group. PNA participants were encouraged to set a goal for one or multiple food categories. Goal-setting led to greater improvement of food categories within the PNA group including; unsalted nuts (p < 0.0001), fruits (p = 0.0001), whole grains (p = 0.005), fish (p = 0.0001), dairy (p = 0.007), vegetables (p = 0.01) and unhealthy choices (p = 0.02). In a healthy population, participants receiving PNA changed their food-intake behavior more favorably than participants receiving GNA or no advice. When personal goals were set, nutritional behavior was more prone to change.

Download Full-text

METABOLIC SYNDROME PREVALENCE IS NOT ASSOCIATED WITH DIET QUALITY IN THE CHILEAN ELDERLY POPULATION: A CROSS SECTIONAL ANALYSIS FROM THE NATIONAL HEALTH SURVEY 2009-2010

Journal of Aging Research and Lifestyle ◽

10.14283/jarcp.2016.104 ◽

2016 ◽

pp. 1-7

Author(s):

C. Dussaillant ◽

G. Echeverría ◽

L. Villarroel ◽

C.B. Yu ◽

A. Rigotti ◽

...

Keyword(s):

Blood Pressure ◽

Metabolic Syndrome ◽

Waist Circumference ◽

Food Intake ◽

Diet Quality ◽

Elderly Population ◽

The Elderly ◽

National Health Survey ◽

Cross Sectional ◽

Sectional Analysis

Objectives: To analyze the relationship between the prevalence of metabolic syndrome, food intake, and diet quality in elderly (≥65 years old) Chilean population. Design: Cross sectional analysis based on the last national health survey performed in the years 2009 and 2010 (ChNHS 2009-2010). Setting: Non-institutionalized individuals of 65 years or older were selected and visited at home. Participants: A subsample of 505 elderly adults from the ChNHS 2009-2010 who answered a food questionnaire and had appropriate information to diagnose metabolic syndrome following the ATPIII-NCEP guidelines. Measurements: Fasting blood samples were obtained in order to measure blood lipids and fasting blood glucose. Blood pressure, waist circumference, and body mass index (BMI) were also measured. A 5-item food frequency questionnaire was applied to all the participants of NHS 2009-2010. Results: The overall prevalence of metabolic syndrome in the Chilean adult population was 37.7%, increasing in frequency with advancing age. Among the elderly (≥65 years old), metabolic syndrome was found in 57.2% of the sample. Elevated blood pressure and increased waist circumference were the most prevalent metabolic syndrome components among this group (88% and 80%, respectively). Low intake of fruits, vegetables, whole cereals, fish, and dairy was seen among the elderly, and no association was found between food intake nor diet quality and metabolic syndrome prevalence. Conclusion: Metabolic syndrome is highly prevalent among the Chilean elderly population and its prevalence is not associated with food intake or diet quality in this age group.

Download Full-text

The Impact of Adding Sugars to Milk and Fruit on Adiposity and Diet Quality in Children: A Cross-Sectional and Longitudinal Analysis of the Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants (IDEFICS) Study

Nutrients ◽

10.3390/nu10101350 ◽

2018 ◽

Vol 10 (10) ◽

pp. 1350 ◽

Cited By ~ 4

Author(s):

Marika Dello Russo ◽

Wolfgang Ahrens ◽

Stefaan De Henauw ◽

Gabriele Eiben ◽

Antje Hebestreit ◽

...

Keyword(s):

Diet Quality ◽

Dietary Guidelines ◽

Dietary Quality ◽

Inverse Association ◽

Cross Sectional ◽

Sweetened Beverages ◽

Idefics Study ◽

The Impact ◽

Age And Sex

Sugar, particularly as free sugars or sugar-sweetened beverages, significantly contributes to total energy intake, and, possibly, to increased body weight. Excessive consumption may be considered as a proxy of poor diet quality. However, no previous studies evaluated the association between the habit of adding sugars to “healthy” foods, such as plain milk and fresh fruit, and indicators of adiposity and/or dietary quality in children. To answer to these research questions, we Panalysed the European cohort of children participating in the IDEFICS study. Anthropometric variables, frequency of consumption of sugars added to milk and fruit (SAMF), and scores of adherence to healthy dietary pattern (HDAS) were assessed at baseline in 9829 children stratified according to age and sex. From this cohort, 6929 children were investigated again after two years follow-up. At baseline, a direct association between SAMF categories and adiposity indexes was observed only in children aged 6–<10 years, while the lower frequency of SAMF consumption was significantly associated with a higher HDAS. At the two year follow-up, children with higher baseline SAMF consumption showed significantly higher increases in all the anthropometric variables measured, with the exception of girls 6–<10 years old. The inverse association between SAMF categories and HDAS was still present at the two years follow-up in all age and sex groups. Our results suggest that the habit to adding sugars to foods that are commonly perceived as healthy may impact the adherence to healthy dietary guidelines and increase in adiposity risk as well.

Download Full-text

Skipping Breakfast Is Associated with Diet Quality and the Distribution of Food Intake Throughout the Day: NHANES 2005–20016

Current Developments in Nutrition ◽

10.1093/cdn/nzaa046_034 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 534-534

Author(s):

Owen Kelly ◽

Stephanie Fanelli ◽

Sara Thomas ◽

Jessica Krok-Schoen ◽

Satya Jonnalagadda ◽

...

Keyword(s):

Food Intake ◽

Healthy Eating ◽

Diet Quality ◽

Diabetes Management ◽

Population Based ◽

Healthy Eating Index ◽

Dietary Intakes ◽

Nutrient Intakes ◽

Diabetes Status ◽

Skipping Breakfast

Abstract Objectives Distribution of carbohydrate intakes (carb choices) throughout the day are an important aspect to diabetes management and reducing blood glucose spikes. Skipping breakfast represents a behavior of concern, providing an extension of the overnight fast and may result in elevated sugar levels later in the day. Therefore, the purpose of this study was to evaluate dietary intake differences, including carbohydrates, based on consuming breakfast or not, and by diabetes status. Methods Adults over 30 years from NHANES 2005–2016 were classified into nondiabetes (HbA1c <5.7%, n = 14,701), prediabetes (HbA1c 5.7–6.4%, n = 5855) and diabetes (HbA1c (≥6.5%, n = 2881). Dietary intakes were assessed using a multiple pass 24-hour recall to estimate intakes from the foods and beverages reported as consumed on the day prior to the NHANES visit. Breakfast was self-defined by participants. Total population-based means (95% CI) of nutrient intakes, MyPlate equivalents, and Healthy Eating Index 2015 scores from the day of intake were calculated across levels of glycemic control and skipping breakfast status. Results Across all groups, adults who reported breakfast consumption had a significantly better overall diet quality, while total intakes of whole grains and fiber were significantly lower in those who skipped breakfast. Intakes of added sugars were not significantly different between those who skipped versus consumed breakfast. Conclusions The absence of breakfast on the day of intake was related to differential intakes of several nutrients related to healthy eating and glycemic management, resulting in a poorer overall diet quality. Healthcare professionals could evaluate meal skipping patterns and its impact on overall nutrient intakes, and the distribution of food intake throughout the day, in people with diabetes, to help improve disease management. Funding Sources Abbott Nutrition.

Download Full-text

Parent–child cooking meal together may relate to parental concerns about the diets of their toddlers and preschoolers: a cross-sectional analysis in Japan

Nutrition Journal ◽

10.1186/s12937-019-0480-0 ◽

2019 ◽

Vol 18 (1) ◽

Cited By ~ 1

Author(s):

Midori Ishikawa ◽

Kumi Eto ◽

Miki Miyoshi ◽

Tetsuji Yokoyama ◽

Mayu Haraikawa ◽

...

Keyword(s):

Food Intake ◽

Young Children ◽

Dietary Habits ◽

Nutrition Survey ◽

Cross Sectional ◽

Picky Eating ◽

Sweetened Beverages ◽

Cooking Practices ◽

Sectional Analysis ◽

Parent Child

Abstract Background Parents often have concerns about the food habits of their young children. Cooking is a frequent behavior related to dietary activities at home. We hypothesized that “a parent cooking meals together with young children might alleviate dietary concerns.” The aim of this study was to identify the relationship between parental cooking practices (e.g., cooking meals together with the child) and diet-related concerns. Methods Data were extracted from the “National nutrition survey on preschool children” conducted among nation-wide households with toddlers and preschoolers in 2015 by the Ministry of Health, Labour and Welfare of Japan. Parents were classified into two groups comprising those who cooked meals together with their children and those who did not. The following variables were compared: taking too much time to eat (slow eaters), “picky” eating (eating only certain foods), inconsistent food intake (eating too much or too little), playing with food/utensils while eating, preferring sweetened beverages and snacks over meals, eating too fast to chew well, not swallowing food, disinterested in eating, and spitting out food. The associations between parent–child cooking meals together and the concerns pertaining to the child’s dietary habits and food intake were analyzed and compared between the two groups. Results The concerns of “picky eating” and “playing with food/utensils while eating” were lower, while “eating too much” was higher in the parent-cooking together group. The intake frequency of fish, soybeans/soy products, vegetables, and milk among children were higher in the “cooking together” group than among those in the “not cooking together” group. Children in the “cooking together” group consumed a significantly greater variety of foods than those in the “not cooking together” group. Conclusions Cooking a meal together with a child may be related to the parent’s lower concerns about the dietary habits of the child, including “picky eating” and “playing with food/utensils while eating,” but may also be related to the higher concerns of “eating too much.”

Download Full-text

Determinants of the Lifestyle Changes during COVID-19 Pandemic in the Residents of Northern Italy

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17176287 ◽

2020 ◽

Vol 17 (17) ◽

pp. 6287 ◽

Cited By ~ 5

Author(s):

Raffaella Cancello ◽

Davide Soranna ◽

Gaia Zambra ◽

Antonella Zambon ◽

Cecilia Invitti

Keyword(s):

Food Intake ◽

Diet Quality ◽

Odds Ratio ◽

Healthy Lifestyle ◽

Northern Italy ◽

Lifestyle Changes ◽

Prevalence Odds Ratio ◽

Insomnia Symptoms ◽

Prevalence Risk Ratio ◽

Sedentary Subjects

Background: The confinement recommended during COVID-19 pandemic could affect behavior and health. Methods: We conducted a self-reported survey in northern Italy to observe the lockdown effects on lifestyle changes and to assess their determinants. Prevalence Odds Ratio and Prevalence Risk Ratio were determined. Results: 490 adults (84% female) completed the survey: 13% and 43% reported improved and unchanged sleep quality, respectively, while 43% had insomnia symptoms. Among the 272 active subjects in pre-lockdown, 14% continued habitual exercising, 18% increased it and 68% reduced it; 27% of sedentary subjects started physical exercise; 34% reported an improvement in diet quality; 42% increased food intake and 13% decreased it; and 38% of the smokers increased cigarette consumption. Age and the pre-lockdown habit of regular physical exercising were the mainly determinants of lifestyle changes whereas BMI, gender, and the presence of chronic diseases did not. Living with other people increased the likelihood of increasing the food intake (p = 0.002). Conclusions: More than a third of people were able to positively reorganize their lives during the forced home confinement. It is worth to disseminate information to preserve a healthy lifestyle even when confined at home.

Download Full-text

Second Version of a Mini-Survey to Evaluate Food Intake Quality (Mini-ECCA v.2): Reproducibility and Ability to Identify Dietary Patterns in University Students

Nutrients ◽

10.3390/nu12030809 ◽

2020 ◽

Vol 12 (3) ◽

pp. 809

Author(s):

María Fernanda Bernal-Orozco ◽

Patricia Belen Salmeron-Curiel ◽

Ruth Jackelyne Prado-Arriaga ◽

Jaime Fernando Orozco-Gutiérrez ◽

Nayeli Badillo-Camacho ◽

...

Keyword(s):

Cluster Analysis ◽

Discriminant Analysis ◽

Food Intake ◽

University Students ◽

Excellent Agreement ◽

Dietary Patterns ◽

Weighted Kappa ◽

Health Science ◽

Sweetened Beverages ◽

Group 2

Evaluation of food intake quality using validated tools makes it possible to give individuals or populations recommendations for improving their diet. This study’s objective was to evaluate the reproducibility and ability to identify dietary patterns of the second version of the Mini Food Intake Quality Survey (Mini-ECCA v.2). The survey was administered using a remote voting system on two occasions with four-week intervals between administrations to 276 health science students (average age = 20.1 ± 3.1 years; 68% women). We then performed a per-question weighted kappa calculation, a cluster analysis, an ANOVA test by questionnaire item and between identified clusters, and a discriminant analysis. Moderate to excellent agreement was observed (weighted κ = 0.422–0.662). The cluster analysis identified three groups, and the discriminant analysis obtained three classification functions (85.9% of cases were correctly classified): group 1 (19.9%) was characterized by higher intake of water, vegetables, fruit, fats, oilseeds/avocado, meat and legumes (healthy food intake); group 2 (47.1%) frequently consumed both fish and unhealthy fats (habits in need of improvement); group 3 (33%) frequently consumed sweetened beverages, foods not prepared at home, processed foods, refined cereals and alcohol (unhealthy food intake). In conclusion, the Mini-ECCA v.2 has moderate to excellent agreement, and it is able to identify dietary patterns in university students.

Download Full-text