Dietary Intake by Urbanization Level Among U.S. Youth Ages 2 -19 Years, NHANES 2013–2018

Abstract

Abstract Objectives To describe differences in dietary intake of select foods and nutrients by level of urbanization in U.S. youth ages 2–19 years. Methods Data from 8301 youth in the National Health and Nutrition Examination Survey, 2013–2018 were used. Mean ratios were estimated for % of fruit consumed as whole fruit (WF) and grains as whole grains (WG), % of energy from added sugars (AS) and saturated fats (SF), and mean intake of fiber, potassium, and sodium on a given day. Proportions consuming >50% (fruit as WF and grains as WG), <10% of energy (AS and SF), and population means for fiber, potassium, and sodium, compared to the age and sex-specific daily nutritional goals, were also estimated. Trends across urbanization [large metropolitan statistical areas (MSAs), medium or small MSAs, and non-MSAs], by sex, and by income (lower income: <130% Federal poverty level (FPL) and higher income: ≥130% FPL) were examined using orthogonal polynomials with P < 0.05 significance level. Results Adjusted for age, on a given day, the percentage who consumed >50% of fruit as WF increased significantly from 43.7% in non-MSAs to 51.0% in large MSAs, and a significant increase was seen among males. The % of energy from AS decreased significantly from 15.5% in non-MSAs to 13.2% in large MSAs, and significant declines were also seen among males and among lower income youth, and the percentage of males who consumed <10% of energy from AS also increased significantly from 30.5% in non-MSAs to 40.5% in large MSAs. Fiber intake increased significantly from 12.9 g in non-MSAs to 14.5 g in large MSAs, and significant increases in intake were seen among males and higher income youth. More than 10% (10.5%) of youth in non-MSAs and 14.8% of youth in large MSAs were at or above the daily nutritional goals for fiber. Overall, there were no trends by urbanization for WG, SF, potassium, and sodium. Conclusions These findings provide insight into dietary intake of US youth by level of urbanization, and sociodemographic factors that may influence intake, including sex and income. Overall, with increasing urbanization level, a higher proportion of youth consumed >50% of fruit as WF, <10% of energy from AS, and more fiber. Funding Sources N/A.