Monitoring Foods and Nutrients Sold and Consumed in the United States: Dynamics and Challenges

Abstract

The food products available, purchased, and consumed in the United States are changing rapidly (1), yet there is little understanding among nutrition professionals of the nature of these changes and what they mean for nutritional health. In 2010, we identified over 85,000 uniquely formulated products in the US food system (2), while there were around 7,600 foods with unique nutrient compositions in the US Department of Agriculture (USDA) food composition tables (FCT)(3). In addition, the USDA updates the nutrient composition of foods in the FCTs periodically, while the food industry claims to be making key product reformulations (on calories, sodium, sugar, trans-fat, and other saturated fat) as part of major commitments (4, 5), along with shifts in industry norms and government regulations. The evolution of the US food system reflects innovations in food production, delivery, preservation and preparation, changing economic conditions, social norms and expectations regarding food availability, safety, variety, and knowledge. Government policy and food industry actions affect the food supply, consumer behavior (demand), and ultimately the diet and health of the US population. The Institute of Medicine, National Cancer Institute (NCI), Centers for Disease Control and Prevention (CDC), Economic Research Service of the USDA, recent conferences, workshops, and publications have highlighted the urgency for finding ways to improve diets by addressing these structural changes (6–8). Historically, national aggregate data sources exist that provide macro-level and per-capita measures of food purchase, availability, and nutritional quality— the USDA food balance data (since 1909) and food disappearance data (since 1970) (9), and the Bureau of Labor Statistics’ Consumer Expenditure Survey (since 1980) (10). However, none of these surveys provides detail data regarding specific food products, their nutritional composition, and who consumed them. In the 1990s, the National Nutrition Monitoring and Related Research Program (NNMRRP) laid the groundwork for improvements in nutrition monitoring efforts across various agencies and included over 50 surveillance activities that monitor and evaluate the US population’s health and nutritional status (11). Unfortunately, the NNMRRP could not provide continuous support for these agencies to keep up with the rapidly changing landscape of the food supply. By 2005, an expert panel reported that there was not a single data source that provided all of the needed information to address research on food and nutrition policies (6). Rather, researchers rely on numerous public and commercial data sources designed independently with varying purposes, not as parts of a unifying system for monitoring food and nutrient intakes. , These data sources vary in sample size, representativeness, breadth and depth of measures, and costs. Clearly, there is a need to enhance the monitoring of our food and nutrition environment in order to create effective programs and policies across the areas of public health, agriculture, economic development, and welfare. Data sources that monitor the foods sold, purchased, or consumed in the United States are summarized in Supplementary Table 1. These sources include: