Maureen L. Storey

A Critical Examination of the Evidence Relating High Fructose Corn Syrup and Weight Gain

The use of high fructose corn syrup (HFCS) has increased over the past several decades in the United States while overweight and obesity rates have risen dramatically. Some scientists hypothesize that HFCS consumption has uniquely contributed to the increasing mean body mass index (BMI) of the U.S. population. The Center for Food, Nutrition, and Agriculture Policy convened an expert panel to discuss the published scientific literature examining the relationship between consumption of HFCS or “soft drinks” (proxy for HFCS) and weight gain. The authors conducted original analysis to address certain gaps in the literature. Evidence from ecological studies linking HFCS consumption with rising BMI rates is unreliable. Evidence from epidemiologic studies and randomized controlled trials is inconclusive. Studies analyzing the differences between HFCS and sucrose consumption and their contributions to weight gain do not exist. HFCS and sucrose have similar monosaccharide compositions and sweetness values. The fructose:glucose (F:G) ratio in the U.S. food supply has not appreciably changed since the introduction of HFCS in the 1960s. It is unclear why HFCS would affect satiety or absorption and metabolism of fructose any differently than would sucrose. Based on the currently available evidence, the expert panel concluded that HFCS does not appear to contribute to overweight and obesity any differently than do other energy sources. Research recommendations were made to improve our understanding of the association of HFCS and weight gain.

Demographics, not beverage consumption, is associated with diet quality

Background Demographic characteristics and beverage choices may affect diet quality. Objective To estimate the independent associations between consumption of food categories of the US Department of Agriculture Food Guide Pyramid, beverage consumption, gender, age, family income, and race/ethnicity with the Healthy Eating Index (HEI). Methods Data from the Continuing Survey of Food Intake by Individuals 1994–96, 1998 were used to develop multiple regression models of demographics and food and beverage consumption regressed on the HEI. Results After adolescence (13–19 years), males consistently had a lower diet quality than females. Young adults (20–29 years) had the poorest diet quality. Family income had a positive association with the HEI. Controlling for income, African-Americans had lower HEI scores than other race/ethnicity groups. Caucasians consumed significantly more milk products than did the other race/ethnicity groups. Consumption of beverages had a weak but positive association with the HEI. Conclusions Family income and race/ethnicity have unique and independent associations with the HEI and dietary patterns.

Changes in Calcium Intake and Association with Beverage Consumption and Demographics: Comparing Data from CSFII 1994–1996, 1998 and NHANES 1999–2002

Background: Consumption of soft drinks has been hypothesized to be negatively associated with calcium intake. However, fortification of some foods and beverages may have affected calcium intake. Objective: The purpose of this study was to examine changes in calcium intake and the association of milk consumption with key beverage consumption and demographic variables using the most current data available. Design: Several techniques were used to describe how age, gender, race/ethnicity, and beverage consumption were associated with milk and calcium intake using the Continuing Survey of Food Intake by Individuals 1994–1996, 1998 (CSFII) and the National Health and Nutrition Examination Survey 1999–2002 (NHANES). Using bivariate and multivariate regression analyses, we examined the independent relationships of total non-beverage energy intake, fluid milk consumption, non-milk beverage consumption, and demographics with calcium intake. Results: During the time period between CSFII and NHANES, milk consumption decreased and RCSD consumption increased among children 6–11 y. Calcium intake was unaffected. Among other age categories, milk consumption either did not change or increased (females 40–59 y), while RCSD consumption increased. Calcium intake either did not change or increased in most age-gender categories, including adolescent females. Fluid milk consumption exhibited the strongest association with calcium intake. Fruit juice consumption was also positively associated with calcium intake in most age-gender categories. Consumption of other beverages, including RCSD, had little or no association with calcium intake. Conclusions: Consumption of low-fat milk should be encouraged, but calcium fortification of certain foods and beverages and calcium supplementation may be needed to further increase calcium intake.

Income and race/ethnicity influence dietary fiber intake and vegetable consumption.

Grains, fruits, and vegetables are the primary sources of dietary fiber (DF), with the white potato contributing nearly 7% of the DF to the US food supply. The DF composition of the white potato-with or without the skin and regardless of cooking method-compares well with the DF content of other vegetables. Many health benefits, including improved gastrointestinal health, are attributed to greater DF consumption; however, less than 3% of males and females have an adequate intake of DF. Because of this population-wide shortfall, DF is considered to be a nutrient of concern. In this study, using data from the National Health and Nutrition Examination Survey 2009 to 2010, we examined the mean intake of DF across sex, age, race/ethnicity, family income, and poverty threshold. This study shows that mean intake of DF is far below recommendations, with children and adolescents aged 2 to 19 years consuming an average of less than 14 g of DF per day. Adults 20+ years old consume, on average, about 17 g of DF per day, and men consume significantly more DF than women. Non-Hispanic black adults consume significantly less DF compared with other race/ethnic groups. Lower family income and living at less than 131% of poverty were associated with lower DF intakes among adults. Federal and local government policies should encourage consumption of all vegetables, including the white potato, as an important source of DF.

A Risk Analysis Model of the Relationship Between Beverage Consumption from School Vending Machines and Risk of Adolescent Overweight

Risk analysis is a widely used tool to understand problems in food safety policy, but it is seldom applied to nutrition policy. We propose that risk analysis be applied more often to inform debates on nutrition policy, and we conduct a risk assessment of the relationship of regular carbonated soft drink (RCSD) consumption in schools and body mass index (BMI) as a case study. Data for RCSD consumption in schools were drawn from three data sets: the Continuing Survey of Food Intake by Individuals 1994-1996, 1998 (CSFII), the National Health and Nutrition Examination Survey 1999-2000 (NHANES), and the National Family Opinion (NFO) WorldGroup Share of Intake Panel (SIP) study. We used the largest relationship between RCSD and BMI that was published by prospective observational studies to characterize the maximum plausible relationship in our study. Consumption of RCSD in schools was low in all three data sets, ranging from 15 g/day in NFO-SIP to 60 g/day in NHANES. There was no relationship between RCSD consumption from all sources and BMI in either the CSFII or the NHANES data. The risk assessment showed no impact on BMI by removing RCSD consumption in school. These findings suggest that focusing adolescent overweight prevention programs on RCSD in schools will not have a significant impact on BMI.

Contributions of White Vegetables to Nutrient Intake: NHANES 2009–2010

Vegetables, especially white potatoes, provide significant levels of key nutrients of concern, such as potassium and dietary fiber. Per capita availability (PCA) data for vegetables-often used as a proxy for vegetable consumption-show that vegetable consumption, including consumption of white potatoes, declined in the past decade. Using dietary data for participants in the NHANES 2009-2010, we examined total vegetable, white potato, and French-fried potato consumption among all age-gender groups as well as mean energy, potassium, and dietary fiber intakes. Mean total energy intake for the US population (≥2 y old) was 2080 kcal/d, with white potatoes and French-fried potatoes providing ∼4% and ∼2% of total energy, respectively. Individuals who consumed white potatoes had significantly higher total vegetable and potassium intakes than did nonconsumers. In addition, the proportion of potassium and dietary fiber contributed by white potatoes was higher than the proportion that they contributed to total energy. Among white potato consumers aged 14-18 y, white potatoes provided ∼23% of dietary fiber and ∼20% of potassium but only ∼11% of total energy in the diet. The nutrient-dense white potato may be an effective way to increase total vegetable consumption and potassium and dietary fiber intake.

Changes in Mean Intake of Fatty Acids and Intake of Saturated and trans Fats from Potatoes: NHANES 2005–2006, 2007–2008, and 2009–2010

Studies have shown that higher than usual intakes of trans fatty acids (TFAs) have adverse effects on blood lipids. Because of this, in 2006 the US FDA mandated labeling of TFAs on food packages. The food and restaurant industries, including the potato industry, reformulated their foods to reduce or eliminate partially hydrogenated vegetable oils and TFAs. Before mandatory labeling, grain-based desserts, yeast breads, and French-fried potatoes (FFPs) were the top sources of TFAs in the food supply; by 2007, potato food manufacturers and quick-service restaurants had reduced or eliminated TFAs without increasing saturated fatty acids (SFAs). FFPs are no longer a source of TFAs in the food supply. This study examined energy and fatty acid intake among children aged 6-11 y, adolescents aged 12-18 y, and adults aged ≥19 y across 3 time periods by using data from the NHANES 2005-2006, 2007-2008, and 2009-2010. On average, intakes of total energy, total fat, SFAs, and monounsaturated fatty acids (MUFAs) decreased significantly between 2005-2006 and 2009-2010 among children and adolescents; however, the intake of polyunsaturated fatty acids (PUFAs) did not change. Among adults, intakes of total fat, SFAs, and MUFAs decreased; however, total energy and PUFA intake did not change. On the day of the 2009-2010 survey, ∼13% of children and 10% of adolescents reported consuming fried FFPs, whereas <7% of adults reported consumption of fried FFPs. Intakes of SFAs and TFAs from fried FFPs decreased significantly between 2005-2006 and 2009-2010 among children, adolescents, and adults. This study confirms that intake of TFAs from FFPs is trivial.

Nutrient Intakes and Vegetable and White Potato Consumption by Children Aged 1 to 3 Years

In 2020, for the first time, the Dietary Guidelines for Americans will include recommendations for children from birth to age 24 mo. We examined average nutrient intakes as well as total vegetable and white potato (WP) consumption among children aged 1-3 y using day 1 dietary data from the NHANES 2009-2012 and the Food Patterns Equivalents Database 2009-2012. Appropriate survey weights were used to calculate average daily consumption of total vegetables and WPs, which included French-fried potatoes and chips, for boys and girls aged 1-3 y. We calculated mean intakes of selected nutrients of concern, including vitamin D, potassium, dietary fiber (DF), and calcium. We also examined intakes of selected nutrients by major food group. Average intakes of most nutrients, including calcium, by children aged 1-3 y exceeded Dietary Reference Intakes (DRIs). However, average intakes of potassium, DF, and vitamin D were 67%, 55%, and 49% of DRIs, respectively. Mean total vegetable intake was less than the recommendation of 1 cup/d. Boys and girls aged 1-3 y consumed an average of 0.58 cup equivalents of total vegetables on the day of the survey, which included 0.16 cups of WPs. Average vegetable consumption and mean intakes of potassium, DF, and vitamin D were far below recommendations. The consumption of all vegetables, particularly those that are excellent sources of potassium and DF, such as potatoes, should be encouraged.