Continuing Survey Of Food Intakes By Individuals Research Articles

Consumers' Restaurant Choice Behavior and the Impact of Socio-Economic and Demographic Factors

ABSTRACT This study investigates economic and socio-demographic factors influencing food facility choice for an evening meal. Multinomial logistic regression analysis was conducted using data from the 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII) and the Diet and Health Knowledge Survey (DHKS). Results indicate that income, age, household size, household composition (presence of a young child), urbanization, day of the week, and season of the year affect the choice of a particular foodservice facility for an evening meal. The demand for evening meals at full-service restaurants is likely to increase due to the aging of “baby boomers,” increasing household income, and decreasing household size. Quick-service restaurants, as they strive to maintain and grow market share, might consider focusing on the needs of households with young children.

Procedures for screening out inaccurate reports of dietary energy intake.

To review existing methods and illustrate the use of a new, simple method for identifying inaccurate reports of dietary energy intake (rEI). Comparison of rEI with energy requirements estimated by using total energy expenditure predicted (pTEE) from age, weight, height and sex using a previously published equation. Propagation of error calculations was performed and cut-offs for excluding rEI at plus or minus two standard deviations (+/-2 SD) and +/-1 SD for the agreement between rEI and pTEE were established. Dietary survey in a US national cohort: the Continuing Survey of Food Intakes by Individuals (CSFII), 1994-96. Men and non-pregnant, non-lactating women aged 21-45 years in the CSFII who provided two multiple-pass 24-hour recalls, height and weight (n = 3755). Average rEI was 77% of pTEE in men, and 64% of pTEE in women. Calculated cut-offs were rEI <40% or >160% of pTEE (+/-2 SD) and <70% or >130% of pTEE (+/-1 SD), respectively. Use of only the +/-1 SD cut-offs, not the +/-2 SD cut-offs, resulted in a relationship between rEI and body weight similar to what was expected (based on an independently calculated relationship between rEI and measured TEE). Exclusion of rEI outside either the +/-2 SD (11% of subjects) or +/-1 SD (57% of subjects) cut-offs did not affect mean reported macronutrient intakes, but did markedly affect relationships between dietary composition and body mass index. When examining relationships between diet and health, use of +/-1 SD cut-offs may be preferable to +/-2 SD cut-offs for excluding inaccurate dietary reports.

Beverage Choices of Young Females: Changes and Impact on Nutrient Intakes

Objective To examine trends in beverage consumption and evaluate the impact of beverage choices on the nutrient intakes of females ages 12 to 19 years. Design Dietary intake data from the USDA's Nationwide Food Consumption Surveys, including the Continuing Survey of Food Intakes by Individuals (CSFII), were assessed for trends in beverage consumption. The CSFII 1994-1996 data was used to examine the diets of young females grouped based on their milk and soda consumption status. Mean energy, nutrient, and beverage intakes were compared. Subjects Females with complete dietary intake information on Day 1 of the survey were included in the study. There were 732 females ages 12 to 19 years in the CSFII 1994-1996. Statistical Analysis Percentages of females consuming specific beverages were estimated. Pairwise mean comparisons were made between groups based on milk and soda consumption status. Results Milk intakes decreased by 36% whereas that of sodas and fruit drinks almost doubled from the late 1970s to the mid 1990s. The CSFII 1994-1996 data showed that between ages 12 and 19 years, intakes of fruit juices, soda, tea, fruit drinks, and alcoholic beverages either increased or remained relatively steady, while milk intakes decreased with an increase in age. At age 12 years, 78% drank milk and had the lowest soda intake (276 g), while at age 19-years, only 36% drank milk and drank a high amount of soda (423 g). Those who did not drink milk had inadequate intakes of vitamin A, folate, calcium, phosphorus, and magnesium. Application A rapid decrease in milk intake during the early adolescent years indicates a need for interventions at this age. Dietitians should identify barriers to drinking milk and recommend strategies for including appropriate food sources to increase calcium intakes during growing years. Nutrition educators should provide parents of adolescent children with ideas for ensuring the adequacy of their children's calcium intakes. J Am Diet Assoc. 2002; 102: 1234–1239.

The influence of individual choices and attitudes on adiposity.

To determine which dietary and lifestyle choices and which attitudes toward diet and health most contribute to adiposity and whether those factors differ by gender. Multiple regression was used to estimate the effect of energy intake, energy expenditure, resources, demographics, and attitudes toward diet and health on self-reported body mass index (BMI) in a nationally representative sample of the US population. This study used secondary data from the 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII) and its telephone follow-up, the Diet and Health Knowledge Survey (DHKS). CSFII is a nationally representative survey of individuals which obtained 24 h recalls of all food intake on two nonconsecutive days. The DHKS data set obtained information on knowledge and attitudes toward dietary guidance and health from individuals 20 y of age and over, who participated in the CSFII. Our sample consisted of responses from 5512 individuals. We found that many of the variables previously found to or hypothesized to influence body weight do so. Our analysis shows that choices and attitudes do matter for adiposity. Moreover, the analysis shows that the choices males and females make often have quite different effects on BMI. For females all the variables we constructed to represent energy intake, energy expenditure, and financial and human resources are significant. Most of the variables that characterize attitudes toward diet and health are significant. For males, far fewer variables are significant. Our tests for gender-related differences show that whether or not males believe their weight is predetermined has no influence on BMI. In contrast, women who do not believe that their weight is predetermined have lower BMI values than those who believe weight is genetically determined. While our qualitative conclusion--choices and attitudes affect BMI--is unsurprising, the quantitative aspects are important. The analysis shows that factors affecting BMI differ systematically by gender. Understanding these systematic differences is critical to the design of information campaigns. Our analysis suggests that entirely different campaigns are necessary to communicate the importance of diet and lifestyle choices to men and to women.

Dietary Boron Intake in the United States: CSFII 1994–1996

We have developed a Boron Nutrient Database and estimated dietary boron intake using the Continuing Survey of Food Intakes by Individuals (CSFII) 1994–1996. Boron intakes were calculated for each CSFII 1994–1996 respondent who completed two 24-h dietary recall interviews ( n=15 267). Means, percentiles, and associated standard errors of usual intake were estimated using statistical methods of Nusser et al. (1996). Mean boron intakes for school-age children and adolescents ranged from 0.80 ± 0.01 mg/d ( S.E.) for 4–8-year olds to 1.02 ± 0.04 mg/d for males aged 14–18. For female and male adults, the mean intakes were 1.00 ± 0.01 and 1.28 ± 0.02 mg/d, respectively. The 5th and 95th percentiles were 0.43 and 1.29 mg/d for 4–8-year olds, 0.47 and 1.79 mg/d for males aged 14–18, 0.41 and 1.87 mg/d for adult females and 0.53 and 2.40 mg/d for adult males. Food groups contributing the most to boron intake of respondents age 4 and older were fruits (25.1% of boron intake), beverages (19.5%), vegetables (18.1%) and grains (14.1%). These boron intake estimates from a U.S. representative sample are within the range of previous estimates. Boron intake was calculated for each person at the individual food level, enabling more detailed analyses of intakes and food sources.

Overview of the Diets of Lower- and Higher-Income Elderly and Their Food Assistance Options

With the elderly becoming an ever-larger proportion of the American population, their dietary well-being is of increasing concern. In particular, lower-income elderly may face special challenges in maintaining a healthful diet. This group makes up a sizeable proportion of the elderly population; we estimate that almost 1 in 5 (19%) of the elderly have household incomes at or below 130% of the federal poverty level, the income level that generally qualifies a household to participate in the federal Food Stamp Program. Here we examine the dietary intakes and related behaviors, as well as the food security status, of lower- and higher-income elderly and review major US government food and nutrition assistance programs that can be of benefit to the elderly, particularly those of low income. Our subjects are individuals 60 years of age and over, living in community (noninstitutionalized) settings. Data on dietary intakes and behaviors were obtained from the US Department of Agriculture's Continuing Survey of Food Intakes by Individuals (CSFII), 1994–96. Food security data were obtained from the 1999 Current Population Survey (CPS), conducted by the US Census Bureau. For both the CSFII and the CPS, sampling weights were used to generate nationally representative estimates. We found that lower-income elderly consume significantly fewer calories than higher-income elderly, fewer servings of major Food Guide Pyramid food groups, and most nutrients. Approximately 6% of elderly households report some degree of food insecurity. Although food and nutrition assistance programs can benefit elderly individuals, many do not participate. Many lower-income elderly also face physiological and social obstacles to obtaining a healthful diet. How best to meet these varied needs is a challenge for nutrition educators, researchers, and policy makers.

Differences in Dietary Patterns of Nonsmoking Adults Married to Smokers vs. Nonsmokers

Purpose. To compare dietary intakes of nonsmoking adults married to smokers or non-smokers. Design. Respondents to the U.S. Department of Agriculture's Continuing Survey of Food Intakes by Individuals (CSFII), 1994 to 1996 (response rate = 76.1% for 2 days of dietary intake). Nonsmoking adults aged 18 and older were grouped according to the smoking status of their spouse. Setting. In-home interviews in all 50 states and Washington, D.C. Subjects. The selected sample included 757 men and 754 women who were married to nonsmokers, and 197 men and 262 women who were married to smokers. Measures. Selected demographic variables, food group servings, food energy, and densities of selected nutrients were compared using χ2 and analysis of covariance. Results. Men and women married to smokers had greater (p ⩽ .025) energy-adjusted intakes of total and saturated fat but significantly lower (p ⩽ .05) energy-adjusted intakes of fiber and vitamin A. Men married to smokers consumed significantly more (p &lt; .025) energy-adjusted cholesterol and ethanol but significantly less calcium (p = .026); women married to smokers consumed significantly less (p = .014) energy-adjusted folate. Men married to smokers consumed significantly more (p ⩽ .05) alcoholic beverages, coffee, and soft drinks; women married to smokers consumed significantly less water (p = .014) but more cheese and table sweeteners (p ⩽ .05). Conclusions. Nonsmoking men and women who were married to smokers had compromised dietary intakes. Nonsmoking men whose wives smoked, in particular, had unhealthy diets due to elevated intakes of fat and cholesterol and low intakes of vitamin A, calcium, and fiber. Health professionals should continue to provide tobacco cessation instruction and dietary guidance, but also be aware of at-risk patients' immediate family members who likely share an increased risk of disease because of poor diet quality and exposure to environmental tobacco smoke.

Fortification Contributed Greatly to Vitamin and Mineral Intakes in the United States, 1989–1991

The objective of this work was to quantify the contribution of fortification (defined here as adding nutrients beyond traditional enrichment standards) to dietary nutrient intakes in the United States. A list of fortified foods was developed that was relevant at the time of the analyses, and prefortification (naturally occurring) nutrients in the fortified foods were determined from industry-supplied data. Using dietary data from the 1989-1991 Continuing Survey of Food Intakes by Individuals (CSFII), intakes of nine nutrients were determined both as reported in the CSFII (i.e., postfortification) and also by using prefortification nutrient levels for the identified fortified foods. We report data for the total population age >/= 1 y based on respondents (n = 11,710) with 3 d of dietary data, as well as select age/gender subgroups. All data were weighted. Fortification substantially increased the intakes of all nutrients examined except calcium, in all age/gender groups but especially in children. In numerous cases, fortification was responsible for boosting median or 25th percentile intakes from below to above the RDA. The breakfast cereal category was responsible for nearly all the intake of nutrients from fortified foods, except vitamin C for which juice-type beverages made as great or a greater contribution. These data from 1989 to 1991 serve as a useful baseline with which to compare contributions of fortification as the practice expands. The large contribution of fortification even in 1989-1991 suggests that continued monitoring of fortification practices, using methods such as those presented here, is important.

U.S. dietary exposures to heterocyclic amines.

Heterocyclic amines (HAs) formed in fried, broiled or grilled meats are potent mutagens that increase rates of colon, mammary, prostate and other cancers in bioassay rodents. Studies of how human dietary HA exposures may affect cancer risks have so far relied on fairly crudely defined HA-exposure categories. Recently, an integrated, quantitative approach to HA-exposure assessment (HAEA) was developed to estimate compound-specific intakes for particular individuals based on corresponding HA-concentration estimates that reflect their meat-type, intake-rate, cooking-method and meat-doneness preferences. This method was applied in the present study to U.S. national Continuing Survey of Food Intakes by Individuals (CSFII) data on meats consumed and cooking methods used by >25,000 people, after adjusting for underreported energy intake and conditional on meat-doneness preferences estimated from additional survey data. The U.S. population average lifetime time-weighted average of total HAs consumed was estimated to be approximately 9 ng/kg/day, with 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) estimated to comprise about two thirds of this intake. Pan-fried meats were the largest source of HA in the diet and chicken the largest source of HAs among different meat types. Estimated total HA intakes by male vs. female children were generally similar, with those by (0- to 15-year-old) children approximately 25% greater than those by (16+-year-old) adults. Race-, age- and sex-specific mean HA intakes were estimated to be greatest for African American males, who were estimated to consume approximately 2- and approximately 3-fold more PhIP than white males at ages <16 and 30+ years, respectively, after considering a relatively greater preference for more well-done items among African Americans based on national survey data. This difference in PhIP intakes may at least partly explain why prostate cancer (PC) kills approximately 2-fold more African American than white men, in view of experimental data indicating that PhIP mutates prostate DNA and causes prostate tumors in rats.

Use of the Core Food Model to Estimate Mineral Intakes Part 2. Estimation of Mineral Intakes

The Core Food Model was recently used to provide the Institute of Medicine's (IOM) Food and Nutrition Board with data on intakes of selected minerals. The information was requested for review by the Committee charged with establishing dietary reference intakes (DRI) for micronutrients. The current Model uses the Continuing Survey of Food Intakes by Individuals (CSFII) 1994–1996 survey files and Food and Drug Administrations (FDA) laboratory analysis of mineral concentrations in the Total Diet Study food collections from the third quarter of 1991 through the first quarter of 1997. Excluding human milk, 5703 uniquely coded food items identified in CSFII 1994–1996 were mapped to 306 Core Foods. Each Core Food has an assigned mineral value derived primarily from FDA's laboratory analysis. For Core Foods not analyzed by FDA, substitute values for representative food items were obtained from U.S. Department of Agriculture's (USDA) CSFII Code Book or Standard Reference 12, or from published literature depending on the mineral. This creates the Core Food Mineral Table. Linking this table to the CSFII 1994–1996 individual food file (447713 records), mineral intakes are calculated by the HTImap program for 18 age/gender groups with percentile distribution within age group, as well as for the total population. Estimates of calcium intake illustrate a specific application of the Core Food Model.

Use of the Core Food Model to Estimate Mineral Intakes Part 1. Selection of U.S. Core Foods

The core food dietary intake model may be used to assess the average daily consumption of nutrients and other food components by a population and by population subgroups. The core food model identifies the most commonly consumed foods for a population and uses these foods to represent the entire food supply. For this project, 306 core foods of the U.S. diet were selected using food consumption data from the 1994–1996 U.S. Department of Agriculture (USDA) Continuing Survey of Food Intakes by Individuals (CSFII). The USDA CSFII included about 15 000 participants, who provided a 24-h diet recall and a 1-day food record. The core foods were identified by aggregating the 5703 foods consumed by survey participants into groups based on food type, food use, and similarity of composition. The foods within each grouping were ranked in terms of frequency of use and gram intake, and one food item within each group was selected to become a core food and represent its group. Each core food assumed the full dietary intake (gram weight) for all the foods in its group. The 306 core foods are listed within 42 subgroups organized by food type and common use. The list of 306 core foods may be shortened by further aggregation to match the needs of different investigators. For example, limited data on food composition may warrant the use of a shorter core food list.

Food Insecurity Is Positively Related to Overweight in Women

Although individuals with poor food security might be expected to have reduced food intake, and thus reduced body fat and less likelihood of being overweight, these associations have not been adequately studied. The purpose of the current study was to examine the relationship between food insecurity and overweight as measured by body mass index (BMI) using data from the nationally representative 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII). Overweight was defined as BMI >27.3 kg/m(2) for women and 27.8 kg/m(2) for men. Food insecurity was related to overweight status for women (n = 4509, P < 0.0001), but not for men (n = 4970, P = 0.44). Excluding the 11 severely insecure women, the prevalence of overweight among women increased as food insecurity increased, from 34% for those who were food secure (n = 3447), to 41% for those who were mildly food insecure (n = 966) and to 52% for those who were moderately food insecure (n = 86). Food insecurity remained a significant predictor of overweight status, after adjustment for potentially confounding demographic and lifestyle variables (P < 0.01). In a logistic regression analysis, mildly insecure women were 30% more likely to be overweight than those who were food secure [odds ratio (OR) 1.3, P = 0.005]. Thus, food insecurity had an unexpected and paradoxical association with overweight status among women with a higher prevalence of overweight among the food insecure, and a resulting potential for increased incidence of obesity-related chronic diseases. Given that the rates of both overweight and food insecurity are on the rise, this research area warrants further investigation.

Popular Diets: Correlation to Health, Nutrition, and Obesity

Objective To examine the association between a range of health and nutrition indicators and popular diets.Design The Continuing Survey of Food Intake by Individuals (CSFII) 1994–1996 data were used to examine the relationship between prototype popular diets and diet quality as measured by the healthy eating index (HEI), consumption patterns, and body mass index (BMI). The prototype diets included vegetarian (no meat, poultry, or fish on day of survey) and non-vegetarian. The nonvegetarian group was further subdivided into low carbohydrate (less than 30% of energy from carbohydrate), medium (30% to 55%), and high (greater than 55% of energy). Within the high carbohydrate group, participants were classified as having Pyramid or non-Pyramid eating patterns. The Pyramid group was defined as 30% or less of energy from fat and at least one serving from the five major food groups in the USDA Food Guide Pyramid. Finally, the non-Pyramid group was further subdivided into low fat (less than 15% of energy from fat) and moderate fat (15% to 30% of energy from fat). In addition, a review of the published scientific literature was conducted; all studies identified were included in the review.Subjects 10,014 adults, aged 19 years and older, from the 1994–1996 CSFII were included in the analyses of extant data. More than 200 individual studies were included in the review of the literature.Results Analyses of the CSFII indicate that diet quality as measured by HEI was highest for the high carbohydrate Pyramid group (82.9) and lowest for the low carbohydrate group (44.6). Energy intakes were low for the vegetarians (1,606 kcals) and high carbohydrate/low fat group (1360 kcals). BMIs were lowest for women in the vegetarian group (24.6) and the high carbohydrate/low fat group (24.4); for men, the lowest BMIs were observed for vegetarians (25.2) and the high carbohydrate Pyramid group (25.2). Review of the literature suggests that weight loss is independent of diet composition. Energy restriction is the key variable associated with weight reduction in the short term.Conclusions Diets that are high in carbohydrate and low to moderate in fat tend to be lower in energy. The lowest energy intakes were observed for those on a vegetarian diet. The diet quality as measured by HEI was highest for the high carbohydrate groups and lowest for the low carbohydrate groups. The BMIs were significantly lower for men and women on the high carbohydrate diet; the highest BMIs were noted for those on a low carbohydrate diet. J Am Diet Assoc. 2001; 101:411–420.

Clinical implications of trends in food intake among US adolescents.

The accompanying research article by Cavadini and colleagues raises many concerns over the eating patterns of US adolescents and the possible long-term health implications of these behaviors. Analyzing data collected from 1965 through 1996 as part of the Continuing Survey of Food Intakes by Individuals (CSFII), the authors found some disturbing trends in eating patterns and weight status of teens, including a substantial increase in body mass index (BMI). Other national surveys, including the National Health and Nutrition Examination Survey (NHANES), have also shown a temporal increase in body mass index (BMI).1 According to new guidelines on the detection and treatment of overweight among youth, a BMI value that is equal to or greater than the 85th percentile, but less than the 95th percentile, classifies a teenager as at-risk for overweight, while a BMI value equal to or greater than the 95th percentile classifies a teen as overweight.2 Using these guidelines, the prevalence of overweight among US adolescents has more than doubled since 1965.3 The exact reasons for this dramatic increase in overweight among US youth are not known. Genetic factors alone cannot account for such a striking increase in obesity in such a relatively short time span. Environmental factors have been suggested, such as an increase in energy and/or fat consumption, but the data reported by Cavadini and colleagues only partially support this hypothesis. The intake of both energy and total fat among US adolescents appears to have declined from 1965 to 1989, after which time they began to increase. These relative changes in calorie and fat consumption are not, however, consistent with the increases in BMI. Clearly, other factors must be involved—such as a decrease in energy expenditure secondary to a decrease in physical activity and a change in the overall composition of the dietary intake. Cavadini and colleagues reported a dramatic increase in the consumption of carbonated beverages accompanied by a reduction in the consumption of fluid milk. Harnack and colleagues, also using CSFII data, reported that carbonated beverages replace milk in the diets of adolescents, thus increasing the intake of sugar and other caloric sweeteners and reducing the nutrient density of the diet.4 In fact, national data suggest that sweeteners and added sugars alone provide more than 16% of the total calories and 12% of total carbohydrate consumed by US adolescents.5 This is particularly alarming in light of recent increases in BMI values and the prevalence of overweight among adolescents.1,3 Another concern raised by the increase in carbonated beverage consumption accompanied by the decrease in fluid milk consumption is the resulting reduction of intakes of calcium and vitamin D. Calcium intake among adolescents is suboptimal. Stang and colleagues, also using data from the CSFII, showed that as many as two-thirds of US adolescents do not consume at least 75% of the Daily Recommended Intake or Recommended Daily Allowances for calcium.6 This trend is more pronounced among female teens. The long-term implications of reduced intakes of calcium and vitamin D may include a reduction in peak bone mass and a concomitant increased risk of osteoporosis. Recent data suggest that the consumption of carbonated beverages increases an adolescent's lifetime risk of bone fractures, particularly among physically active females.7 A disconcerting clinical situation is imaginable among young and middle-aged adults: their chronic long-term consumption of carbonated beverages leads to a greatly reduced peak bone mass, compounded by obesity which causes them to carry excessive weight and prevents them from participating in moderate to strenuous physical activity. Certainly, the optimal time for intervention related to improving dietary intake and maintaining a healthy body weight is during childhood and adolescence. The Guidelines for Adolescent Preventive Services suggest that annual screening and education be provided to adolescents around the issues of eating a healthy diet and maintaining a healthy weight.8 The study by Cavadini and colleagues clearly illustrates the need for providing routine anticipatory guidance to children, adolescents, and their families with regard to eating and physical activity behaviors. Bright Futures in Practice: Nutrition,9 and the soon-to-be-released Bright Futures in Practice: Physical Activity, provide guidelines for developmentally appropriate anticipatory guidance on these topics that can be implemented in clinical settings.

Zinc and Copper Intakes and Their Major Food Sources for Older Adults in the 1994–96 Continuing Survey of Food Intakes by Individuals (CSFII)

Zinc and copper are two trace minerals essential for important biochemical functions and necessary for maintaining health throughout life. Several national food surveys revealed marginally to moderately low contents of both nutrients in the typical American diet. Using data from the respondents >/= 60 y old in the 1994-96 Continuing Survey of Food Intakes by Individuals (CSFII), we examined average dietary intakes of zinc, copper and relevant dietary factors; primary dietary contributors of zinc and copper; and Zn:Cu ratios of the primary dietary contributors. Data were analyzed with the use of a chi(2) test, Student's t test and multivariate analysis of covariance with Bonferroni correction. The daily zinc intake was 12 +/- 6.4 mg for men and 8.0 +/- 4.0 mg for women (P < 0.05); the daily copper intake was 1.3 +/- 0.7 mg for men and 1.0 +/- 0.5 mg for women (P < 0.05). Foods such as beef, ground beef, legumes, poultry, ready-to-eat and hot cereals, and pork constituted the major sources of zinc. Copper consumption was contributed mainly by legumes, potato and potato products, nuts and seeds, and beef. The less-than-recommended intakes of zinc and copper by the elderly were likely associated with age, low income and less education. The intakes of zinc and copper could be improved by more frequent consumption of food sources rich in these minerals. An inherent limitation of this study was the use of the 24-h dietary recall method, which may underestimate usual dietary intakes. Nonetheless, this study affirms the need for assessment of zinc and copper nutriture in the elderly.

The relation between dietary change and rising US obesity.

To determine if the source from which food is obtained has contributed to the increased obesity of the US population, while controlling for demographic, lifestyle and regional factors. Multiple regression was used to estimate the effect of food source on body mass index (BMI) while accounting for other factors which have been shown to affect obesity in a nationally representative sample of the US population. This study used secondary data from the 1994-1996 Continuing Survey of Food Intake by Individuals (CSFII). The CSFII is a nationally representative sample of 16,103 individuals, obtaining for each respondent 24 h recalls of all food intake on two nonconsecutive days as well as demographics and information on lifestyle choices. For a large number of demographic and lifestyle factors, our results support those which have previously been found to contribute to increased overweight. Our contribution is to examine whether the source from which food is obtained also contributes to increased overweight. Our evidence suggests that this is the case. The average height for males in our sample was 1.77 m. For two such males, one who ate food away from home (FAFH) during the previous 24 h period and the other who did not, results suggest that the first will be about 1 kg heavier, all other factors being equal. For two females of average height (1.63 m) the same is true for those who ate fast food, but not at restaurants. In all cases, except females who ate at restaurants, the effects are significant in the regression (P<0.05). The trends in both increased US obesity and in increased consumption of FAFH are unlikely to be coincidental. FAFH, and particularly fast food consumption, are likely to be contributing factors to increased obesity.

Low intakes of vegetables and fruits, especially citrus fruits, lead to inadequate vitamin C intakes among adults

To determine vitamin C intakes among adults and to identify differences in dietary intake associated with vitamin C consumption. This cross-sectional study compared vitamin C intake, nutrient intake, and food group choices of adults with low (<30 mg/d), marginal (30-60 mg/d), and desirable (>60 mg/d) vitamin C intakes. Data from 2472 men and 2334 women aged 25-75 y were obtained from the 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII). Overall, 18% of the sample had low vitamin C intakes, 24% had marginal intakes, and 58% had desirable intakes. In addition to consuming less vitamin C, adults with low vitamin C intakes consumed significantly less (P</=0.001) energy-adjusted (ie nutrient/1000 kcal) folate, fiber, beta-carotene, and vitamin B6, and significantly more (P<0.001) fat. Compared to adults with low intakes, adults with desirable vitamin C intakes consumed significantly more (P</=0.001) high-vitamin C fruit juice and low-vitamin C vegetables, while consuming significantly less (P</=0.009) soft drinks, coffee/tea and alcoholic beverages. On average, adults with desirable vitamin C intakes consumed more than five daily servings of vegetables and fruits, of which more than one was citrus. Adults with low and marginal vitamin C intakes consumed less than one-fifth of a serving of citrus. A considerable number of adults under-consume vitamin C and total vegetables and fruits. Nutritionists should continue to promote five to nine daily servings of vegetables and fruits, at least one of which should be rich in vitamin C.

Pesticide residues and acute risk assessment the US EPA approach

The US Environmental Protection Agency (EPA) assesses acute dietary exposure to pesticide residues using a tiered approach, proceeding from conservative to more refined assumptions as the risk management situation requires. Toxicity and food residue data used by EPA in assessing acute dietary risk are obtained from studies submitted by chemical companies in support of pesticide registration and tolerance setting. The primary source of food consumption data used by EPA in acute dietary risk assessments is the Continuing Survey of Food Intakes by Individuals (CSFII) 1989–1991.

Antioxidant intakes and smoking status: data from the Continuing Survey of Food Intakes by Individuals 1994–1996

Cigarette smoking is a major risk factor for several chronic oxidative diseases that can be ameliorated by antioxidants. This study identified the typical dietary intakes and the major food group contributors of the antioxidants beta-carotene, vitamin C, and vitamin E by smoking status. The 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII) provided the current sample (n = 6749), who were categorized as non- (n = 3231), former (n = 1684), and current (n = 1834) smokers. In the CSFII, individuals' food intakes were estimated with two 24-h dietary recalls. Data were analyzed by using a chi-square test with a simultaneous Fisher's z test, analysis of variance with Scheffe's test, multivariate analysis of covariance, and analysis of covariance with Bonferroni adjustment for multiple comparisons. The sample consisted of 3707 men and 3042 women. Current smokers tended to be younger with less education and lower incomes than nonsmokers and former smokers. The average body mass index (in kg/m(2)) of current smokers was 25.8, the lowest of the 3 groups. Current smokers had the lowest dietary antioxidant intake. Fatty foods such as luncheon meats, condiments and salad dressings, and ground beef contributed more to the antioxidant intakes of current smokers than to those of the other 2 groups, whereas fruit and vegetables contributed less. Current smokers consumed the fewest numbers of servings of all nutrient-bearing groups in the food guide pyramid, except the meat group. Future interventions should target the clustering of cigarette smoking and other unhealthy lifestyle habits, eg, an imprudent diet.

Nutrient intakes and dietary patterns of young children by dietary fat intakes

Objective: To determine whether low fat intake is associated with increased risk of nutritional inadequacy in children 2 to 8 years old and to identify eating patterns associated with differences in fat intake. Study design: Using 2 days of recall from the Continuing Survey of Food Intake by Individuals (CSFII), 1994 to 1996, we classified 2802 children into quartiles of energy intake from fat (<29%, 29% to 31.9% [defined as moderate fat], 32% to 34.9%, and ≥35%) and compared nutrient intakes, the proportion of children at risk for inadequate intakes, Food Pyramid servings, and fat content per serving across quartiles. Results: More children in quartile 2 were at risk for inadequate intakes of vitamin E, calcium, and zinc than children in higher quartiles ( P < .0001); more children in quartiles 3 and 4 were at risk for inadequate intakes of vitamins A and C and folate ( P < .001). Fruit intake decreased across quartiles ( P < .0001); whereas vegetable, meat, and fat-based condiment intakes increased ( P < .0001). Fat per serving of grain, vegetables, dairy, and meat increased across quartiles ( P < .0001). Conclusions: Moderate-fat diets were not consistently associated with an increased proportion of children at risk for nutritional inadequacy, and higher-fat diets were not consistently protective against inadequacy. Dietary fat could be reduced by judicious selection of lower-fat foods without compromising nutritional adequacy. (J Pediatr 2000;136:181-7)