Food Group Patterns Research Articles

Can snacking on almonds displace discretionary foods in the diets of habitual snackers?

Snacking frequency has increased in recent years, with many snack options being nutrient-poor and likely contributing to excessive energy intakes (1,2). At the same time, nut intakes have remained low(3). While almonds, like many other snacks, are high in fat and energy, they are rich in beneficial unsaturated fats, fibre, vitamins, minerals, and phytonutrients. Snacking on almonds may offer substantial health advantages, including improving energy balance and overall diet quality, compared to typical modern snack foods. The healthier diets observed among nut consumers may be partially explained by addition of nuts to the diet leading to displacement of other, less desirable foods. We aimed to compare the effects of consuming a snack of almonds vs sweet biscuits or savoury crackers daily for one year on displacement of discretionary foods and food group patterns. We used a randomised controlled parallel study design involving 136 non-obese habitual discretionary snack consumers aged 18–65. Participants were randomly assigned to receive a snack of either almonds, or biscuits, daily for one year. These isocaloric snacks provided either 10% of participants’ total energy requirements or 1030 kJ (equivalent to 42.5 g almonds), whichever was higher. Dietary intake was measured using three-day weighed diet records record at baseline, 3, 6, and 12 months. Of the participants, 101 (74%) were female, with a mean (SD) age of 35.6 (13.4) years and BMI of 23.7 (3.0) kg/m2. Those assigned to the almond group increased their percentage total energy (%TE) from nuts and seeds from 1.4% (baseline) to 13.8% (12 months), while those assigned to the biscuit group increased %TE from biscuits and crackers from 5.1% to 12.4%. There was a non-statistically significant (p = 0.053) decrease in %TE from discretionary foods to 12-months for almond group compared to the biscuit group. %TE from discretionary foods decreased significantly in the almond group from baseline to 12-months (mean (95% CI) difference: −4.9% (−8.3, −1.5) p = 0.005), with no evidence of a change observed in the biscuit group (−0.0% (−3.6, 3.6) p = 0.994). Regular consumption of nuts as a snack food may improve diet quality by displacing discretionary food intake among regular discretionary snack consumers. However, the observed displacement was incomplete relative to the energy provided by the study snack. Snacking is driven by factors beyond simply satisfying hunger, including flavour, texture, and overall eating experience. We hypothesise that – among this group of discretionary snack consumers – partial displacement, and hence the continued consumption of other snack foods, was likely due to the sensory properties of consuming almonds alone being insufficient to fulfil hedonic satiation. Strategies to improve sensory appeal of almonds to discretionary snack consumers may assuage subsequent snack-seeking behaviour and provide important advantages in terms of both energy balance and diet quality.

Developing a novel optimisation approach for keeping heterogeneous diets healthy and within planetary boundaries for climate change

Background and objectivesCurrent dietary habits have substantial negative impacts on the health of people and the planet. This study aimed to develop a novel approach for achieving health-promoting and climate-friendly dietary recommendations for a broad range of consumers.Subjects and methodsHierarchical clustering analysis was combined with linear programming to design nutritionally adequate, health-promoting, climate-friendly and culturally acceptable diets using Swedish national dietary data (n = 1797). Diets were optimised for the average consumption of the total population as well as for the dietary clusters.ResultsThree dietary clusters were identified. All optimised diets had lower shares of animal-source foods and contained higher amounts of plant-based foods. These dietary shifts reduced climate impacts by up to 53% while leaving much of the diet unchanged. The optimised diets of the three clusters differed from the optimised diet of the total population. All optimised diets differed considerably from the food-group pattern of the EAT-Lancet diet.ConclusionsThe novel cluster-based optimisation approach was able to generate alternatives that may be more acceptable and realistic for a sustainable diet across different groups in the population.

Designing Nutritionally Adequate and Climate-Friendly Diets for Omnivorous, Pescatarian, Vegetarian and Vegan Adolescents in Sweden Using Linear Optimization.

Low-carbon diets can counteract climate change and promote health if they are nutritionally adequate, affordable and culturally acceptable. This study aimed at developing sustainable diets and to compare these with the EAT-Lancet diet. The Swedish national dietary survey Riksmaten Adolescents 2016–2017 was used as the baseline. Diets were optimized using linear programming for four dietary patterns: omnivores, pescatarians, vegetarians and vegans. The deviation from the baseline Riksmaten diet was minimized for all optimized diets while fulfilling nutrient and climate footprint constraints. Constraining the diet-related carbon dioxide equivalents of omnivores to 1.57 kg/day resulted in a diet associated with a reduction of meat, dairy products, and processed foods and an increase in potatoes, pulses, eggs and seafood. Climate-friendly, nutritionally adequate diets for pescatarians, vegetarians and vegans contained fewer foods and included considerable amounts of fortified dairy and meat substitutes. The optimized diets did not align very well with the food-group pattern of the EAT-Lancet diet. These findings suggest how to design future diets that are climate-friendly, nutritionally adequate, affordable, and culturally acceptable for Swedish adolescents with different dietary patterns. The discrepancies with the EAT diet indicate that the cultural dietary context is likely to play an important role in characterizing sustainable diets for specific populations.

Does COVID-19 change dietary habits and lifestyle behaviours in Kuwait: a community-based cross-sectional study

BackgroundThe coronavirus pandemic has transformed and continues to transform and affect the daily lives of communities worldwide, particularly due to the lockdown restrictions. Therefore, this study was designed to understand the changes in dietary and lifestyle behaviours that are major determinants of health during the COVID-19 outbreak.MethodsA cross-sectional study was conducted through an online questionnaire using a convenience sample of 415 adults living in Kuwait (age range 18–73 years).ResultsThe rate of skipping breakfast remained consistent, with a slight increase during the pandemic. Lunch remained the main reported meal before and during COVID-19. Compared to before COVID-19, people were much more likely have a late-night snack or meal during COVID-19 (OR = 3.57 (95% CI 1.79–7.26), p < 0.001). Moreover, there was a drastic decrease in the frequency of fast-food consumption during COVID-19, up to 82% reported not consuming fast food (p < 0.001). There was a significant increase in the percentage of participants who had their main meal freshly made (OR = 59.18 (95% CI 6.55–1400.76), p = 0.001). Regarding food group patterns, no significant differences were found before and during the pandemic in terms of the weekly frequency of consumption, except in the case of fish and seafood. There were no remarkable changes in beverage consumption habits among participants before and during the pandemic, except for Americano coffee and fresh juice. Furthermore, there was a great reduction in physical activity and an increase in the amount of screen time and sedentary behaviours. A notable increase was detected in day-time sleep and a decrease in night-time sleep among participants.ConclusionIn general, this study indicates some changes in daily life, including changes in some eating practices, physical activity and sleeping habits during the pandemic. It is important that the government considers the need for nutrition education programmes and campaigns, particularly during this critical period of the pandemic in Kuwait.

Dietary quality of lunches in senior leisure service facilities in South Korea: analysis of data from the 2013-2017 Korea National Health and Nutrition Examination Survey.

BACKGROUND/OBJECTIVESThis study analyzed the quality of lunches provided in senior leisure service (SLS) facilities and compared institutional foodservice (IF) and non-institutional foodservice (non-IF).SUBJECTS/METHODSData of 390 adults aged 65 years or older who ate lunches in SLS facilities were analyzed using the information from the 2013–2017 Korea National Health and Nutrition Examination Survey. The participants were classified into IF (n = 129) and non-IF (n = 261) groups according to meal type provided. The intake of major food groups, energy and nutrients, and nutrient adequacy ratio (NAR) and mean adequacy ratio (MAR) were analyzed. The diversity of meals was evaluated by food group patterns, dietary diversity score (DDS) and dietary variety score (DVS). Energy intake was adjusted in model 1, while energy and sex were adjusted in model 2. All confounding variables were adjusted in model 3.RESULTSThe intake of seafoods (P < 0.001 in models 1, 2, and 3), seaweeds (P < 0.01 in models 1 and 2), and dairy products (P < 0.05 in models 1, 2, and 3) was significantly higher in the IF group. No significant difference existed in energy intake; however, the intake of all nutrients except carbohydrate and vitamin C was significantly higher in the IF group. NAR of all nutrients, excluding vitamin C, was higher in the IF group, and MAR was also higher in the IF group (P < 0.001 in models 1, 2, and 3). The IF group had significantly higher DDS and DVS than the non-IF group (P < 0.001).CONCLUSIONSThe lunches provided in SLS facilities were better in terms of quantity and quality when provided through IF than through non-IF. More systematic foodservice programs should be implemented in SLS facilities, especially in facilities wherein users prepare their own meals.

How low can dietary greenhouse gas emissions be reduced without impairing nutritional adequacy, affordability and acceptability of the diet? A modelling study to guide sustainable food choices.

To assess the compatibility between reduction of diet-related greenhouse gas emissions (GHGE) and nutritional adequacy, acceptability and affordability dimensions of diet sustainability. Dietary intake, nutritional composition, GHGE and prices were combined for 402 foods selected among those most consumed by participants of the Individual National Study on Food Consumption. Linear programming was used to model diets with stepwise GHGE reductions, minimized departure from observed diet and three scenarios of nutritional constraints: none (FREE), on macronutrients (MACRO) and for all nutrient recommendations (ADEQ). Nutritional quality was assessed using the mean adequacy ratio (MAR) and solid energy density (SED). France. Adults (n 1899). In FREE and MACRO scenarios, imposing up to 30 % GHGE reduction did not affect the MAR, SED and food group pattern of the observed diet, but required substitutions within food groups; higher GHGE reductions decreased diet cost, but also nutritional quality, even with constraints on macronutrients. Imposing all nutritional recommendations (ADEQ) increased the fruits and vegetables quantity, reduced SED and slightly increased diet cost without additional modifications induced by the GHGE constraint up to 30 % reduction; higher GHGE reductions decreased diet cost but required non-trivial dietary shifts from the observed diet. Not all the nutritional recommendations could be met for GHGE reductions ≥70 %. Moderate GHGE reductions (≤30 %) were compatible with nutritional adequacy and affordability without adding major food group shifts to those induced by nutritional recommendations. Higher GHGE reductions either impaired nutritional quality, even when macronutrient recommendations were imposed, or required non-trivial dietary shifts compromising acceptability to reach nutritional adequacy.

Energy compensation and nutrient displacement following regular consumption of hazelnuts and other energy-dense snack foods in non-obese individuals

Regular nut consumption reduces cardiovascular disease risk, partly from improvements to dietary quality. Examining how individuals make dietary changes when consuming nuts may reveal key behavioural eating patterns beneficial for the development of dietary interventions. We examined the effects of nuts in comparison with other energy-dense snacks on energy compensation, nutrient displacement, and food group patterns. This was a 12-week randomised, controlled, parallel study with four arms: ~1100kJ/day for each of hazelnuts (42g), chocolate (50g), potato crisps (50g), or no added snack food. Diet records, body composition, and physical activity were measured at baseline and week 12, in 102 non-obese participants. Significant improvements in diet quality were observed in the hazelnut group, particularly when consumed as snacks. Intakes of monounsaturated fat (MUFA) and vitamin E were significantly higher (all P<0.05), whereas saturated fat and carbohydrate were significantly lower (both P≤0.022) in the hazelnut group compared to the other groups. Partial energy compensation did not differ significantly between groups, but nutrient displacement values for MUFA and fibre differed significantly. Within the hazelnut group, there was nearly complete displacement for fibre, partial displacement for energy, protein, total fat, MUFA, PUFA, potassium, folate, and vitamin E, and overcompensation for carbohydrate and sugar. Our results demonstrate that energy compensation occurs for all three intervention snacks in this non-obese population. Regular nut consumption significantly improves nutrient profiles compared to other snacks with changes occurring at the snack level.

Development of Food Based Dietary Guidelines for Kenyan Women Using Linear Programming

Objectives: Women in Kenya are at high risk of multiple micronutrient deficiencies due to low intake through monotonous diets. Country-specific food based dietary recommendations (FBRs) facilitate dietary improvement. Main objective was to develop and evaluate FBRs based on the existing diet using linear programming for women of reproductive age from Mbooni division, Eastern Kenyan. Methods: A consumption study was conducted among 205 woman (19-50 yrs.) using three nonconsecutive 24-hour recalls. Excel, Access and SPSS were used to prepare required model parameters (foods consumed by >10% of women, including median portion size, weekly frequency consumption, food composition values, food group patterns (median and range), staple/snacks. Linear programming (‘Optifood') was used to develop and evaluate FBRs. Results: Out of 62 foods, 30 foods were consumed by more than 10% of the surveyed women. Fat, iron, folate and vitamin-B12 requirements could not be met both in worst (≥70%RNI) and best case (≥100% RNI) scenario diets, covering 43.6%, 48.4%, 30.0% & 18.8% of RNI. Calcium, vitamin A, riboflavin, niacin, B6 and zinc intake was inadequate, but requirements could be met by inclusion of kale, pumpkin leaves, red beans, cow's milk and cooking fat. Conclusions: Realistic food based dietary guidelines based on locally available foods for Kenyan women were successfully developed using linear programming. These guidelines will ensure at least 70% RNI of energy, protein, calcium, vitamin A, C, B1, B2, B5, B6, and zinc. To obtain adequate amounts of fat, folate, iron and vitamin-B12 in the women's diet, alternative strategies are required. © 2015 Ngala et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Conference Abstract

Psychological factors are important correlates of dietary pattern in overweight adults.

Abdominal obesity, the central distribution of adipose tissue, is a well-established cardiometabolic disease risk factor. The prevalence has steadily increased since 1988, and now more than 50% of adults have abdominal obesity. Psychological distress coupled with increased dietary energy density (ED) may contribute to abdominal obesity. Guided by the stress and coping model, this study examined the relationship between psychological factors (perceived stress and depressive symptoms) and dietary ED in overweight, working adults. The first hypothesis tested if psychological factors explained a significant amount of food and beverage ED variance above that accounted for by demographic factors. The second hypothesis tested if psychological factors explained a significant amount of food and nonalcoholic beverage ED variance above that accounted for by demographic factors. Post hoc analyses compared macronutrient composition and food group pattern between overweight, working adults with and without depressive symptoms. This descriptive, cross-sectional, correlation study was composed of 87 overweight, working adults (mean age, 41.3 [SD, 10.2] years; mean body mass index, 32.1 [SD, 6.1] kg/m²; 73.6% women; 50.6% African American). Participants completed the Beck Depression Inventory II and Perceived Stress Scale and weighed-3-day-food record analyzed for caloric intake (kilocalories) and weight (in grams) of consumed foods and beverages that were used to calculate ED (in kilocalories/gram). Height and weight were measured to calculate body mass index. Descriptive statistics, Mann-Whitney U test, and sequential regression modeling were used for data analysis. Depressive symptoms were reported by 21.9% of participants and explained variance in food and beverage ED above that accounted for by African American race and reporting adequate caloric intake. Depressive symptoms explained variance in food and nonalcoholic beverage ED above that accounted for male sex, African American race, and reporting adequate caloric intake. Perceived stress and depressive symptoms were positively correlated; however, perceived stress was not a significant predictor of food and beverage ED. Depressive symptoms, potentially modifiable, were 4 times that found in the general population and independently predicted increased food and beverage ED. Further research is needed to determine if improvements in depressive symptoms alter dietary ED, potentially reducing cardiometabolic disease risk.

A food pattern that is predictive of flavonol intake and risk of pancreatic cancer

Background:In the Multiethnic Cohort (MEC) study, we showed inverse associations between flavonols and pancreatic cancer risk. Objective:We aimed to define a food pattern associated with intakes of quercetin, kaempferol, and myricetin; to examine the association of that pattern with pancreatic cancer risk; and to investigate the associations in an independent study. Design:Reduced rank regression was applied to dietary data for 183 513 participants in the MEC. A food group pattern was extracted and simplified and applied to dietary data of 424 978 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Dietary intake in both studies was assessed by using specially developed questionnaires. Multivariate Cox proportional hazards models were used to estimate relative risks for pancreatic cancer in the MEC (610 cases) and the EPIC (517 cases) studies. Results:The food group pattern consisted mainly of tea, fruit, cabbage, and wine. In the MEC, inverse associations with pancreatic cancer in smokers were observed for the food group pattern [relative risk: 0.59 (95% CI: 0.31, 1.12) when extreme quintiles were compared;P for trend = 0.03]. In the EPIC study, the simplified pattern was not associated with pancreatic cancer risk (P for trend = 0.78). Conclusions:A food pattern associated with the intake of quercetin, kaempferol, and myricetin was associated with lower pancreatic cancer risk in smokers in a US-based population. However, failure to replicate the associations in an independent study weakens the conclusions and raises questions about the utility of food patterns for flavonols across populations.

Development of food groupings to guide dietary advice for people with diabetes

AbstractObjective: To describe the development and characteristics of a food categorisation system and its application to guide advice for diabetes treatment.Design and methods: Foods commonly consumed by 16 adults with diabetes were grouped by macronutrient content and type of fat to form a set of reference food groups for dietary advice. Means for energy and macronutrients from individual food groups were then used to construct an overall intake pattern targeting 8000 kJ and relative amounts of carbohydrate, protein and fat (saturated fatty acids (SFA) &lt; 10%E and (polyunsaturated fatty acids) PUFA ∼ 10%E). Variation in energy and macronutrients contributed by all foods partitioned into each food group was assessed by the coefficient of variation of data on the whole diet.Results: To differentiate between sources of fat, 13 food groups emerged and 10 were deemed acceptable to nutritional guidelines for diabetes treatment. The food group pattern was judged adequate for the achievement of dietary recommendations with low‐potential variation in total energy (5%) and macronutrient proportions (protein 6%, fat 6%, carbohydrate 3%), but higher for fat types (SFA 22%, (monounsaturated fatty acids) MUFA 11%, PUFA 12%). Targeted proportions for fat types were achieved only when daily servings of PUFA‐rich, oils, nuts and oily fish or soy were included in an ideal intake pattern.Conclusions: In theory, a dietary pattern constructed from food group sources of macronutrients and individual fat types results in low‐potential variation from recommended nutrient targets and, therefore, is appropriate to guide advice for the treatment of diabetes.

Impact of a Cost Constraint on Nutritionally Adequate Food Choices for French Women: An Analysis by Linear Programming

Objective to predict, for French women, the impact of a cost constraint on the food choices required to provide a nutritionally adequate diet. Design Isocaloric daily diets fulfilling both palatability and nutritional constraints were modeled in linear programming, using different cost constraint levels. For each modeled diet, total departure from an observed French population’s average food group pattern (“mean observed diet”) was minimized. Results To achieve the nutritional recommendations without a cost constraint, the modeled diet provided more energy from fish, fresh fruits and green vegetables and less energy from animal fats and cheese than the “mean observed diet.” Introducing and strengthening a cost constraint decreased the energy provided by meat, fresh vegetables, fresh fruits, vegetable fat, and yogurts and increased the energy from processed meat, eggs, offal, and milk. For the lowest cost diet (ie, €3.18/d), marked changes from the “mean observed diet” were required, including a marked reduction in the amount of energy from fresh fruits (−85%) and green vegetables (−70%), and an increase in the amount of energy from nuts, dried fruits, roots, legumes, and fruit juices. Implications Nutrition education for low-income French women must emphasize these affordable food choices.

Variety of Food Choices is Associated with the Nutritional Quality of Diets of College Students in Korea

This study was performed to evaluate effects of dietary variety scores (DVS) and dietary diversity scores (DDS) on the nutritional quality of the diets of Korean college students, and to examine the association between food group intake patterns and nutritional adequacy. This study examined the relationship of dietary diversity scores (DDS), dietary variety scores (DVS), and food group intake patterns with nutrient intakes using 24-hour recall data (n=358). The DDS was calculated from the sum of each of the five food groups consumed as a score of “1”. DVS was determined by counting the number of food items consumed daily. Food group intake patterns were expressed with the presence or omission of five major food groups-dairy, meat, grain, fruit, and vegetable. The four most prevalent food group patterns and the proportion of the population reporting them were as follows; no dairy and fruit, 23%; no dairy, 20%; no dairy, meat, and fruit, 15%; all food groups, 14%. Even though the DDS or DVS was higher, the majority of this study population failed to meet the Korean RDA for calcium in both genders and iron in women. Higher DVS scores (≥31), within all DDS groups, were associated with the largest proportion of individuals consuming more than 75% of the Korean RDA for selected nutrients. The consistency of these results indicates that screening diets to evaluate the overall dietary variety and variety among the major food groups including food group intake patterns provide meaningful information about their quality.

Individual Foods and Food Group Patterns of the Oldest Old

This study compares the dietary patterns of centenarians (n = 73) with sexagenarians (n = 76) and octogenarians (n = 83). A Daily Diet Diary was developed to code the responses of the 24-hour dietary recalls. Centenarians and octogenarians had higher consumption frequencies of milk (P < 0.001) and grains (P < 0.01) and fewer (P < 0.05) skipped breakfasts than sexagenarians. However, centenarians also consumed high fat foods, such as whole milk (P < 0.001) and biscuits (P < 0.01), and coffee (P < 0.05) more frequently than the two younger cohorts. Several of the variations found in the food patterns among the three age groups may reflect cohort differences, rather than true antecedents for longevity.

Using Cluster Analysis to Examine Dietary Patterns: Nutrient Intakes, Gender, and Weight Status Differ Across Food Pattern Clusters

Objective This study explored the usefulness of cluster analysis in identifying food choice patterns of three groups of adults in relation to their energy intake. Design Food frequency data were converted to percentage of total energy from 38 food groups and entered into a cluster analysis procedure. Subjects in the emerging food group patterns were compared in terms of weight status, demographics, and the nutrition composition of their usual diet. Setting Data were collected as part of three studies in two US metropolitan areas using identical protocols. Participants were university employees (103 women and 99 men) who volunteered for a reliability study of health behavior questionnaires and moderately obese volunteers (223 women and 101 men) to two weight-loss studies who were recruited by newspaper advertisements. Statistical analysis performed Subjects were clustered according to food energy sources using the FASTCLUS procedure in the Statistical Analysis System. One-way analysis of variance and χ 2 analysis were then performed to compare the weight status, nutrient intakes, and demographics of the food patterns. Results Six food pattern clusters were identified. Subjects in the two clusters associated with high consumption of pastry and meat had significantly higher fat intakes ( P=.0001). Subjects in two other clusters, those associated with high intake of skim milk and a broad distribution of energy sources had significantly higher micronutrient levels ( P=.0001). Body mass index and the distribution of gender were also significantly different across clusters. Conclusions The success of cluster analysis in identifying dietary exposure categories with unique demographic and nutritional correlates suggests that the approach may be useful in epidemiologic studies that examine conditions such as obesity, and in the design of nutrition interventions. J Am Diet Assoc. 1997:97:272–279.

Food pattern, diet quality, and related characteristics of schoolchildren in New York State

Objectives To examine the food patterns and diet quality of elementary schoolchildren in New York State (outside of New York City) and to determine sociodemographic characteristics correlated with diet quality. Design A nonquantitative 24-hour recall administered to students and a brief questionnaire completed by parents. Sample 1,797 second and fifth graders (51% of those asked) in 51 randomly selected schools (46% of those asked) in New York State outside of New York City. Statistical analyses Multiple regression analyses, η 2, and t tests. Results On the day they were surveyed, 40% of students did not eat vegetables, except for potatoes or tomato sauce; 20% did not eat fruit; 36% ate at least four different types of snack foods, and 16% of fifth graders did not eat breakfast. Children who ate a school lunch ate significantly more dairy foods and fruits and vegetables, and fewer snack-foods than those who brought lunch from home. Fifth graders ate significantly more snack foods and were more likely to skip breakfast than second graders; boys had lower food-group pattern scores than girls; children of lower socioeconomic status had less diverse diets but ate less snack foods than children of higher socioeconomic status; children with single parents were more likely to skip breakfast and to eat fewer vegetables than those with two parents; and children with mothers employed outside the home had less diverse diets than those with mothers at home. Applications/conclusions The findings indicate that nutrition interventions are clearly needed for this age group and that targeted messages should be based on sociodemographic characteristics.

Association of fruit and vegetable intake with dietary fat intake

We examined the relation of fruit and vegetable intake with dietary fat intake under conditions in which individuals consume recommended number of portions of dairy, meat and grain foods, using 24-hour dietary recall data from the NHANES II of 1976–80. Only recalls that included at least 2 servings each of dairy foods and meat and 4 servings of grains, but variable servings of fruits and vegetables (ranging from 0 to 2 or more) were examined, yielding a total of 9 food group patterns (possible combinations of food group servings) as reported by 1,490 respondents. In patterns ranging from 0 to 2 servings each of fruits and vegetables, the mean percent of energy as fat varied from 39% to 36%. We observed a slight trend for decreasing energy from fat with increasing number of fruit-but not vegetable-servings. Consumption of fruits and vegetables was not associated with selection of lower-fat foods in the meat, dairy or grain groups. The percent of daily fat contributed by the miscellaneous food group (containing visible fats, sweeteners, and baked products with a high fat or sugar content) increased with increasing vegetable-but not fruit-servings. These results suggest that without conscious effort to reduce fat intake, an increase in fruit and vegetable intake may have a relatively minor impact on reduction of dietary fat.