Julia A. Wolfson

Is cooking at home associated with better diet quality or weight-loss intention?

OBJECTIVE To examine national patterns in cooking frequency and diet quality among adults in the USA, overall and by weight-loss intention. DESIGN Analysis of cross-sectional 24 h dietary recall and interview data. Diet quality measures included total kilojoules per day, grams of fat, sugar and carbohydrates per day, fast-food meals per week, and frozen/pizza and ready-to-eat meals consumed in the past 30 d. Multivariable regression analysis was used to test associations between frequency of cooking dinner per week (low (0-1), medium (2-5) and high (6-7)), dietary outcomes and weight-loss intention. SETTING The 2007-2010 National Health and Nutrition Examination Survey. SUBJECTS Adults aged 20 years and over (n 9569). RESULTS In 2007-2010, 8 % of adults lived in households in which someone cooked dinner 0-1 times/week and consumed, on an average day, 9627 total kilojoules, 86 g fat and 135 g sugar. Overall, compared with low cookers (0-1 times/week), a high frequency of cooking dinner (6-7 times/week) was associated with lower consumption of daily kilojoules (9054 v. 9627 kJ, P=0·002), fat (81 v. 86 g, P=0·016) and sugar (119 v. 135 g, P<0·001). Individuals trying to lose weight consumed fewer kilojoules than those not trying to lose weight, regardless of household cooking frequency (2111 v. 2281 kJ/d, P<0·006). CONCLUSIONS Cooking dinner frequently at home is associated with consumption of a healthier diet whether or not one is trying to lose weight. Strategies are needed to encourage more cooking among the general population and help infrequent cookers better navigate the food environment outside the home.

Diet-Beverage Consumption and Caloric Intake Among US Adults, Overall and by Body Weight

OBJECTIVES We examined national patterns in adult diet-beverage consumption and caloric intake by body-weight status. METHODS We analyzed 24-hour dietary recall with National Health and Nutrition Examination Survey 1999-2010 data (adults aged ≥ 20 years; n = 23 965). RESULTS Overall, 11% of healthy-weight, 19% of overweight, and 22% of obese adults drink diet beverages. Total caloric intake was higher among adults consuming sugar-sweetened beverages (SSBs) compared with diet beverages (2351 kcal/day vs 2203 kcal/day; P = .005). However, the difference was only significant for healthy-weight adults (2302 kcal/day vs 2095 kcal/day; P < .001). Among overweight and obese adults, calories from solid-food consumption were higher among adults consuming diet beverages compared with SSBs (overweight: 1965 kcal/day vs 1874 kcal/day; P = .03; obese: 2058 kcal/day vs 1897 kcal/day; P < .001). The net increase in daily solid-food consumption associated with diet-beverage consumption was 88 kilocalories for overweight and 194 kilocalories for obese adults. CONCLUSIONS Overweight and obese adults drink more diet beverages than healthy-weight adults and consume significantly more solid-food calories and a comparable total calories than overweight and obese adults who drink SSBs. Heavier US adults who drink diet beverages will need to reduce solid-food calorie consumption to lose weight.

Calorie changes in chain restaurant menu items: Implications for obesity and evaluations of menu labeling

BACKGROUND Supply-side reductions to the calories in chain restaurants are a possible benefit of upcoming menu labeling requirements. PURPOSE To describe trends in calories available in large U.S. restaurants. METHODS Data were obtained from the MenuStat project, a census of menu items in 66 of the 100 largest U.S. restaurant chains, for 2012 and 2013 (N=19,417 items). Generalized linear models were used to calculate (1) the mean change in calories from 2012 to 2013, among items on the menu in both years; and (2) the difference in mean calories, comparing newly introduced items to those on the menu in 2012 only (overall and between core versus non-core items). Data were analyzed in 2014. RESULTS Mean calories among items on menus in both 2012 and 2013 did not change. Large restaurant chains in the U.S. have recently had overall declines in calories in newly introduced menu items (-56 calories, 12% decline). These declines were concentrated mainly in new main course items (-67 calories, 10% decline). New beverage (-26 calories, 8% decline) and childrens (-46 calories, 20% decline) items also had fewer mean calories. Among chain restaurants with a specific focus (e.g., burgers), average calories in new menu items not core to the business declined more than calories in core menu items. CONCLUSIONS Large chain restaurants significantly reduced the number of calories in newly introduced menu items. Supply-side changes to the calories in chain restaurants may have a significant impact on obesity prevention.

Calorie Changes in Large Chain Restaurants: Declines in New Menu Items but Room for Improvement

INTRODUCTION Large chain restaurants reduced the number of calories in newly introduced menu items in 2013 by about 60 calories (or 12%) relative to 2012. This paper describes trends in calories available in large U.S. chain restaurants to understand whether previously documented patterns persist. METHODS Data (a census of items for included restaurants) were obtained from the MenuStat project. This analysis included 66 of the 100 largest U.S. restaurants that are available in all three of the data years (2012-2014; N=23,066 items). Generalized linear models were used to examine: (1) per-item calorie changes from 2012 to 2014 among items on the menu in all years; and (2) mean calories in new items in 2013 and 2014 compared with items on the menu in 2012 only. Data were analyzed in 2014. RESULTS Overall, calories in newly introduced menu items declined by 71 (or 15%) from 2012 to 2013 (p=0.001) and by 69 (or 14%) from 2012 to 2014 (p=0.03). These declines were concentrated mainly in new main course items (85 fewer calories in 2013 and 55 fewer calories in 2014; p=0.01). Although average calories in newly introduced menu items are declining, they are higher than items common to the menu in all 3 years. No differences in mean calories among items on menus in 2012, 2013, or 2014 were found. CONCLUSIONS The previously observed declines in newly introduced menu items among large restaurant chains have been maintained, which suggests the beginning of a trend toward reducing calories.

Restaurants With Calories Displayed On Menus Had Lower Calorie Counts Compared To Restaurants Without Such Labels

Beginning in December 2016, calorie labeling on menus will be mandatory for US chain restaurants and many other establishments that serve food, such as ice cream shops and movie theaters. But before the federal mandate kicks in, several large chain restaurants have begun to voluntarily display information about the calories in the items on their menus. This increased transparency may be associated with lower overall calorie content of offered items. This study used data for the period 2012-14 from the MenuStat project, a data set of menu items at sixty-six of the largest US restaurant chains. We compared differences in calorie counts of food items between restaurants that voluntarily implemented national menu labeling and those that did not. We found that the mean per item calorie content in all years was lower for restaurants that voluntarily posted information about calories (the differences were 139 calories in 2012, 136 in 2013, and 139 in 2014). New menu items introduced in 2013 and 2014 showed a similar pattern. Calorie labeling may have important effects on the food served in restaurants by compelling the introduction of lower-calorie items.

American adults eligible for the Supplemental Nutritional Assistance Program consume more sugary beverages than ineligible adults.

BACKGROUND There is considerable debate about whether sugar-sweetened beverages (SSBs) should be allowable purchases with benefits from the Supplemental Nutrition Assistance Program (SNAP). PURPOSE To examine national patterns in adult consumption of SSBs by SNAP eligibility. METHODS Cross-sectional analysis of 24-hour dietary recall data obtained from the National Health and Nutrition Examination Survey 2003-2010 (N=17,198), analyzed in 2013. RESULTS In 2003-2010, 65% of adults receiving SNAP consumed SSBs, averaging 307 cal daily, and 74 g of sugar. Compared to adults ineligible for SNAP, adults receiving SNAP consumed a higher percentage of SSBs (65% vs. 59%, p<0.001), more calories from SSB per capita (210 kcal vs. 175 kcal, p=0.001), and more daily calories from SSBs among drinkers (307 kcal vs. 278 kcal, p=0.008). Overall, per capita consumption from SSBs was highest among adults receiving SNAP (210 kcal, 9% total daily intake), followed by adults eligible but not participating in SNAP (192 kcal, 8% total daily intake)--both of which had significantly higher SSB consumption than ineligible adults (175 kcal, 8% total daily intake) (p<0.05). CONCLUSION Adults eligible for SNAP benefits consume more SSBs than ineligible adults.

Trends in SSBs and snack consumption among children by age, body weight, and race/ethnicity

To describe national trends in discretionary calories from sugar‐sweetened beverage (SSB) and snacks by age‐specific body weight categories and by age‐ and weight‐specific race/ethnicity groups. Examining these subpopulations is important as population averages may mask important differences.

The Complex Relationship Between Diet And Health

The relationship between food and health is complex. Everyone needs food to live, but too little food, too much food, or the wrong type of food has negative consequences for health. To increase understanding of this relationship, we describe trends and patterns in food-related diseases among both adults and children. Using an ecological framework, we then describe why food intake is complex with a discussion of three broad levels--macro (including policy and social-cultural norms), local community, and individual environments--and their relationship to food consumption. Given the strong relationship between an individuals food choice and his or her surrounding environment, we end with examples of policy responses that aim to help people overcome environmental disincentives toward healthy eating. Finding ways to make eating healthfully easier and affordable for all populations is essential to shifting the average American diet toward one that promotes health.

U.S. adults and child snacking patterns among sugar-sweetened beverage drinkers and non-drinkers

OBJECTIVE To provide national estimates of snack patterns for sugar-sweetened beverage (SSB) drinkers and non-SSB drinkers among U.S. children and adults. METHODS We analyzed 24-h dietary recall data obtained from the National Health and Nutrition Examination Survey 1999-2010 among children (ages 2 to 19) and adults (aged 20 and older) (N=46,932). RESULTS For children and adults, SSB drinkers were significantly more likely than non-SSB drinkers to consume snacks (children: salty, 60% vs. 50%; sweet, 69% vs. 65%; adults: salty, 64% vs. 58%; sweet, 64% vs. 58%), calories from snacks (children: salty snacks, 258 vs. 213 kcal; sweet snacks, 322 vs. 291 kcal; adults: salty snacks, 261 vs. 236 kcal; sweet snacks, 370 vs. 350 kcal), and total calories (children: 2098 vs. 1,804 kcal; adults: 2329 vs. 2,049 kcal) (p<0.05). Among adolescents, Blacks had a significantly higher percentage of SSB drinkers and salty snack consumers than Whites and Hispanics (SSB consumers: White, 79%; Black, 86%; Hispanic, 82%; salty snack consumers: White, 56%; Black, 62%; Hispanic, 54%; p<0.05). All ages were more likely to consume sweet snacks at home (p<0.05). CONCLUSIONS Adults and children who drink SSBs are more likely to snack and consume more calories from snacks than non-SSB drinkers, particularly Black adolescents and young adults.

Fruit and vegetable consumption and food values: National patterns in the United States by Supplemental Nutrition Assistance Program eligibility and cooking frequency

BACKGROUND More frequent cooking at home may help improve diet quality and be associated with food values, particularly for individuals participating in the Supplemental Nutrition Assistance Program (SNAP). OBJECTIVE To examine patterns of fruit and vegetable consumption and food values among adults (aged 20 and older) in the United States, by SNAP participation and household cooking frequency. METHODS Analysis of cross-sectional 24-hour dietary recall data obtained from the National Health and Nutrition Examination Survey 2007-2010 (N=9560). RESULTS A lower percentage of SNAP participants consumed fruit (total: 35% vs. 46%, p=0.001; fresh: 30% vs. 41%, p<0.001) and vegetables (total: 49% vs. 58%, p=0.004; fresh: 35% vs. 47%, p<0.001) than those ineligible for SNAP. Among SNAP participants, cooking >6times/week was associated with greater vegetable consumption compared to cooking <2times/week (175g vs. 98g, p=0.003). SNAP-eligible individuals who cooked ≥2times/week were more to report price (medium cookers: 47% vs. 33%, p=0.001; high cookers: 52% vs. 40%, p<0.001), ease of preparation (medium cookers: 36% vs. 28%, p=0.002; high cookers: 36% vs. 24%, p<0.001) and how long food keeps (medium cookers: 57% vs. 45%, p<0.001; high cookers: 61% vs. 50%, p<0.001) as important compared to SNAP-ineligible individuals. CONCLUSIONS Fruit and vegetable consumption in the United States is low regardless of cooking frequency. Efforts to improve diet quality should consider values on which food purchases are based.