Abstract
BackgroundTo our knowledge, no studies have examined energy intakes by food purchase location and food source using a representative sample of US children, adolescents and adults. Evaluations of purchase location and food sources of energy may inform public health policy.MethodsAnalyses were based on the first day of 24-hour recall for 22,852 persons in the 2003-4, 2005-6, and 2007-8 National Health and Nutrition Examination Surveys (NHANES). The most common food purchase locations were stores (grocery store, supermarket, convenience store, or specialty store), quick-service restaurants/pizza (QSR), full-service restaurants (FSR), school cafeterias, or food from someone else/gifts. Specific food sources of energy were identified using the National Cancer Institute aggregation scheme. Separate analyses were conducted for children ages 6-11y, adolescents ages 12-19y, and adults aged 20-50y and ≥51y.ResultsStores (grocery, convenience, and specialty) were the food purchase locations for between 63.3% and 70.3% of dietary energy in the US diet. Restaurants provided between 16.9% and 26.3% of total energy. Depending on the respondents’ age, QSR provided between 12.5% and 17.5% of energy, whereas FSR provided between 4.7% and 10.4% of energy. School meals provided 9.8% of energy for children and 5.5% for adolescents. Vending machines provided <1% of energy. Pizza from QSR, the top food away from home (FAFH) item, provided 2.2% of energy in the diets of children and 3.4% in the diets of adolescents. Soda, energy, and sports drinks from QSR provided approximately 1.2% of dietary energy.ConclusionsRefining dietary surveillance approaches by incorporating food purchase location may help inform public health policy. Characterizing the important sources of energy, in terms of both purchase location and source may be useful in anticipating the population-level impacts of proposed policy or educational interventions. These data show that stores provide a majority of energy for the population, followed by quick-service and full-service restaurants. All food purchase locations, including stores, restaurants and schools play an important role in stemming the obesity epidemic.
Highlights
To our knowledge, no studies have examined energy intakes by food purchase location and food source using a representative sample of US children, adolescents and adults
For primary school-aged children (6-11y), 63.3% of energy came from stores, 12.2% from quick-service restaurants/pizza (QSR), and 9.8% from school cafeterias
Among adolescents (12-19y), 63.1% of energy came from stores, 17.5% from QSR and 7.0% from full-service restaurants (FSR)
Summary
No studies have examined energy intakes by food purchase location and food source using a representative sample of US children, adolescents and adults. Evaluations of purchase location and food sources of energy may inform public health policy. Foods away from home (FAFH) represent an increasing proportion of energy in the American diet [1,2,3]. The potential links between dietary energy obtained away from home and obesity have become a public health concern [2,5,6]. The United States Department of Agriculture’s (USDA) Economic Research Service (ERS) has classified meals as FAFH if the majority of energy in that meal, excluding beverages, came from fast food or full-service restaurants, cafeterias, or taverns [5]. The definition of away from home foods should encompass all foods that are prepared, purchased, and consumed away from home, including those obtained from schools, workplace cafeterias, and vending machines
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