Rhonda Sebastian

EFFECT OF SNACKING FREQUENCY ON ADOLESCENTS' DIETARY INTAKES AND MEETING NATIONAL RECOMMENDATIONS

PURPOSE To determine how snacking level impacts intake of nutrients and food groups and assists in meeting recommendations outlined in the U.S. Department of Agricultures MyPyramid Food Guidance System. METHODS Dietary data based on 24-hour recall from 4357 adolescents 12-19 years of age participating in the National Health and Nutrition Examination Survey 2001-2004 (NHANES) were analyzed. Regression analyses were applied to examine the effect of snacking on nutrient and food group intake and to determine its effect on the likelihood of meeting MyPyramid recommendations. RESULTS Food energy, carbohydrate, total sugars, and vitamin C intake were positively associated, whereas protein and fat intake were negatively associated, with snacking frequency. Fruit intake increased, whereas solid fat intake decreased, as snacking incidence rose. Increasing snacking frequency was also associated with a greater likelihood of meeting milk and oil recommendations for boys and meeting fruit recommendations for both genders. Non-Hispanic black adolescents were less likely to meet their milk recommendations at low and high snacking levels and more likely to meet their fruit recommendations at high levels only. Foods consumed as snacks provided 12-39% of the days total number of portions of the five MyPyramid food groups, 35% of total discretionary calorie intake, and 43% of total added sugar intake. CONCLUSIONS Snacking frequency affects intake of macronutrients and a few micronutrients and promotes consumption of fruits. Top food choices for snacks provide an excess of discretionary calories in the form of added sugars and fats. Modification of these choices would assist adolescents in consuming diets more consistent with national recommendations.

Monitoring Sodium Intake of the US Population: Impact and Implications of a Change in What We Eat in America, National Health and Nutrition Examination Survey Dietary Data Processing

Accurate monitoring of US sodium intake requires familiarity with national dietary data collection and processing procedures. This article describes a data processing step that impacts sodium intake estimates, reasons for discontinuing the step, and implications of its discontinuation. This step, termed salt adjustment, was performed in US Department of Agriculture (USDA) dietary intake surveys from 1985 through 2008. In What We Eat in America (WWEIA), the dietary intake interview component of the National Health and Nutrition Examination Survey (NHANES), the salt content of specific foods was reduced on the basis of a question about household use of salt in cooking. For individuals whose households used salt in cooking occasionally or less often, some or all of the salt attributable to home preparation was removed from foods that typically have salt added during preparation and were obtained from the store. The growing availability of preprepared foods in stores challenges the validity of using store purchase as a proxy indicator of home food preparation, and increased restaurant/fast-food consumption implies fewer reported foods are eligible for the procedure. In addition, USDAs Automated Multiple-Pass Method for the 24-hour dietary recall provides accurate sodium intake estimates without applying the salt-adjustment step. The final WWEIA, NHANES data release to contain salt-adjusted sodium data was 2007-2008. When assessing the effectiveness of sodium-reduction efforts over time, the nutrition community (eg, researchers, analysts, providers) must be aware of this change in WWEIA, NHANES beginning in 2009-2010 and account for it using appropriate baseline estimates.

Fruit and vegetable intake of US adults estimated by two methods: What We Eat In America, National Health and Nutrition Examination Survey 2009-2012.

OBJECTIVE Estimates of fruit and vegetable (FV) consumption vary depending on intake definition, which may be determined by research purpose. Researchers have used two methods to evaluate intake: epidemiological and behavioural. The present study describes FV intake by adults using epidemiological v. behavioural approaches. DESIGN One-day dietary intake data from What We Eat In America, National Health and Nutrition Examination Survey 2009-2012 were used. Sample weights were used to produce nationally representative estimates. FV intake (in cup-equivalents (CE)) was estimated using the Food Patterns Equivalents Database. The epidemiological method considered all FV after disaggregating foods and beverages. The behavioural method included foods that provided at least 0·2 CE FV per 100 g, and excluded sources high in fat, added sugar and Na. SETTING Nationally representative survey of the US population. SUBJECTS Adults (n 10 563) aged ≥20 years. RESULTS For epidemiological v. behavioural, fruit intake was 1·1 v. 1·0 CE for males and 1·0 v. 0·9 CE for females. Vegetable intake was 1·8 v. 1·1 CE for males and 1·5 v. 1·0 CE for females. CONCLUSIONS The definition of FV intake affects estimates of consumption by the population and is an important consideration when planning and comparing research studies. The method used should align with research goals to assure accurate interpretation and validity of results.

Dietary Flavonoid Intake Is Inversely Associated with Cardiovascular Disease Risk as Assessed by Body Mass Index and Waist Circumference among Adults in the United States

Although flavonoids may confer anti-inflammatory and anti-oxidant benefits, no research has examined if flavonoid intake is related to cardiovascular disease (CVD) risk defined by anthropometric measures in the USA population. This study sought to determine whether flavonoid intake is associated with combined body mass index (BMI) and waist circumference (WC) measures indicative of high, very high, or extremely high (“high+”) risk for CVD, using one day of 24-h recall data from adult (≥20 years) participants in What We Eat in America, National Health and Nutrition Examination Survey 2007–2010. Individuals were divided into categories of intake of total flavonoids and each flavonoid class, and adjusted estimates of the percentages at high+ CVD risk (based on BMI and WC, as per National Heart, Lung, and Blood Institute guidelines) were calculated. Inverse linear trends were found in percentages of adults at high+ CVD risk by intake of total flavonoids, anthocyanidins, flavan-3-ols, and flavanones (p < 0.01). For individuals in the highest (versus the lowest) intake category of anthocyanidins, flavan-3-ols, and flavanones, relative risk and confidence intervals (RR and CI, respectively) were 0.86 (99% CI: 0.79, 0.93), 0.88 (99% CI: 0.79, 0.98), and 0.89 (99% CI: 0.80, 0.98), respectively. Research is needed to determine whether the inverse relationships found in this study are applicable to CVD endpoints at the population level.