Mean Percentage Of Energy Research Articles

Ultraprocessed food intake and body mass index change among youths: a prospective cohort study

BackgroundSuboptimal diets may promote undesired weight gain in youths, with high ultraprocessed food (UPF) intake becoming a significant concern in the United States. ObjectivesWe evaluated the association between UPF intake and body mass index [BMI (in kg/m2)] change in large United States youth cohorts. MethodsParticipants included children and adolescents (7–17 y) from the Growing Up Today Study (GUTS1 and GUTS2) who completed baseline and ≥1 follow-up diet and anthropometrics assessment (GUTS1 1996–2001: N = 15,797; GUTS2 2004–2011: N = 9720). Follow-up years were based on diet assessment availability. UPFs were categorized using the Nova system, with intakes evaluated as the cumulative mean percent energy from UPFs and subgroups. BMI was assessed using self-reported body weight/height. Changes in BMI annually and over 2, 4–5, and 7 y in association with UPF intake were examined using multivariable repeated-measure linear mixed models. ResultsAt baseline, the mean percentage of energy from UPFs was 49.9% in GUTS1 and 49.5% in GUTS2 participants; mean BMI was 18.7 and 19.8, respectively. After multivariable adjustments for sociodemographic and lifestyle factors, each 10% increment in UPF intake was associated with a 0.01 (95% confidence interval: 0.003, 0.03) increase annually and a 0.07 (0.01, 0.13) increase over 5 y in GUTS1 participants. In GUTS2, increases were 0.02 (0.003, 0.04) annually and 0.09 (0.01, 0.18) over 4 y. Among GUTS1, statistically significant annual BMI increases of 0.02–0.07 were associated with elevated intake of ultraprocessed breakfast cereals, savory snacks, and ready-to-eat/heat foods, especially pizza, burgers, and sandwiches. No association was found between UPF intake and overweight/obesity risk. ConclusionsA higher UPF intake was associated with a modest yet significant increase in BMI in large prospective cohorts of United States youths, calling for public health efforts to promote healthful food intake among youths to prevent excessive weight gain.

Higher consumption of ultra-processed food is associated with cardiovascular risk in Korean adults: KNHANES 2016–2018

BackgroundExcessive consumption of ultra-processed foods (UPFs) has been linked to an increased risk of cardiovascular disease. We aimed to investigate the association between the percentage of energy intake from UPFs and the American Heart Association’s cardiovascular health (CVH) metrics in Korean adults.MethodsThis study analyzed adults aged 40 years and older using data from the Korean National Health and Nutrition Examination Survey 2016–2018 (n = 9,351). All foods or beverages reported in a 24-h dietary recall were categorized using the NOVA system, and the percentage of energy from UPFs was calculated. Each CVH metric was scored 0–2 (poor, intermediate, ideal). The sum of six component scores was classified as inadequate, average, or optimum. Multinomial logistic regression models were used to estimate the covariate-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for inadequate and average CVH versus optimum CVH.ResultsThe mean percentage of energy from UPFs was 24.2%. After adjusting for covariates, participants in the highest UPF quartile had 26% higher odds of having inadequate CVH than those in the lowest quartile (OR 1.26, 95% CI 0.94–1.69, P-trend = 0.03). The percentage of energy from UPFs was positively associated with current smoking, physical inactivity, body mass index, and total cholesterol and was inversely associated with blood pressure and fasting glucose.ConclusionThe percentage of energy from UPFs accounted for one-fourth of total calorie intake in Korean adults aged 40 years and older. Higher UPF consumption was associated with poorer CVH, underscoring the potential of limiting UPF consumption as a preventative measure for cardiovascular diseases.

Dietary intakes of individuals with temporomandibular disorders: A comparative study.

There are some studies regarding the potential effects of temporomandibular disorders (TMD) on food intake and eating habits, however the comparison of nutritional intakes and status of individuals with and without TMD have not been adequately reported. Thus, the study aimed to assess the dietary intakes of individuals with TMD, and investigate if there is a difference in nutritional intakes between healthy individuals with and without TMD. Individuals were grouped as 'study group (with TMD)' versus 'control group (no TMD)' according to Fonseca Anamnestic Index. The Oral Health Impact Profile-14 (OHIP-14) was used to assess oral health-related quality of life. Chewing function was evaluated with the Test of Masticating and Swallowing Solids (TOMASS). A 24-h dietary recall method was used to measure daily dietary intakes of the participants, and daily energy, macro- and micronutrient intakes were calculated. In addition, all drinks and foods in dietary records were classified under a specific modification level as 'Liquid-blenderized', 'Minced-moist & soft' and 'Easy-to chew & regular solid foods'. The participants in the study group (30 participants) had higher OHIP-14 score (p < .01) than control group (30 participants). According to TOMASS, number of bites (p = .003) and total time (p = .007) were both higher in the study group than control group. There was no difference in the number of chewing cycles (p = .100) and number of swallowing (p = .764) between groups. No difference was detected between groups in terms of energy, protein, carbohydrate and fat intake. There was no significant difference between groups in mean percentage of energy and macronutrient intakes from modified and regular food textures (p > .05). This study showed that there was no difference between individuals with and without TMD in terms of dietary intakes. The study results suggest that nutritional status of individuals with TMD is similar with healthy individuals without TMD.

Dietary protein intake during pregnancy and birth weight among Chinese pregnant women with low intake of protein

BackgroundPrevious studies have yielded inconsistent results on the association between maternal dietary protein intake and birth weight. Moreover, little is known about the effects of dietary protein intake from different sources on fetal growth. This study aimed to investigate the associations of different dietary protein sources (total protein, animal protein, plant protein, and major dietary protein sources) during pregnancy with birth weight and the related adverse birth outcomes.Methods7310 women were recruited using a stratified multistage random sampling method at 0–12 months (median: 3; 10–90th percentile: 0–7) after delivery in Shaanxi, China. Maternal diets were gathered by a validated FFQ and other characteristics were collected by a standard questionnaire. Multilevel linear or logistic regression models were used to estimate birth weight changes or ORs (95% CIs) for adverse birth outcomes associated with different dietary protein sources during pregnancy.ResultsThe mean percentage of energy from total protein was 11.4% (SD 2.2), with only 27.4% of total protein derived from animal protein. Per 3% increase in energy from total protein, animal protein, and dairy protein was associated with birth weight increases of 19.4 g (95% CI 6.0–32.9), 20.6 g (4.8–36.5), and 18.2 g (4.7–31.7), respectively. Per 3% increase in energy from total protein, animal protein, and dairy protein was also associated with lower risks of low birth weight (LBW) (total protein: OR = 0.78, 95% CI 0.64–0.94; animal protein: 0.79, 0.65–0.96; dairy protein: 0.71, 0.56–0.91), small for gestational age (SGA) (total protein: 0.88, 0.79–0.98; animal protein: 0.87, 0.78–0.97; dairy protein: 0.81, 0.68–0.96), and intrauterine growth retardation (IUGR) (total protein: 0.84, 0.72–0.98; animal protein: 0.86, 0.75–0.98; dairy protein: 0.78, 0.66–0.92). We observed no associations of plant protein and other major dietary protein sources with birth weight and the above birth outcomes. The results did not change when maternal protein was substituted for fat or carbohydrate.ConclusionsAmong Chinese pregnant women with low intake of protein, higher intake of dietary protein, in particular animal protein and dairy protein, is associated with higher birth weight and lower risks of LBW, SGA, and IUGR.

Resemblance of nutrient intakes in three generations of parent-offspring pairs: Tehran lipid and Glucose Study.

The degree of maintaining nutrient intake patterns, conformed in the family, for offspring into adulthood is unknown. The aim of this study was to investigate the correlation between nutrient intakes in three younger-middle-older generations of Tehranian adults by sex. Of individuals who participated in 2012-15 phase of the Tehran Lipid and Glucose Study, 1286 families (4685 subjects), who had at least two members of the family with complete data in two or three generations were entered in this cross-sectional study. The energy and nutrient intakes of parents and their young or adult offspring or grandparents-grandson/granddaughter dyads were compared. The differences were estimated using pairwise t-test and partial correlation. Data of parents with their offspring were paired based on living arrangement. There were 857 fathers (mean age: 55.4±11.1) and 1394 mothers (mean age: 50.1±11.4). The mean age of grandfathers and grandmothers were 69.4±7.9 and 63.7±8.5 respectively. The significant correlation in fathers-sons and father-daughter (living with their parents) pairs were observed for 9 and 7 nutrients, respectively. Correlations for most nutrients were significant for mother-daughter or sons (living with their parents) dyads. The mean percentage of energy from total fat and trans-fatty acids of sons or daughters (living with their parents) were higher than their parents. For most nutrients, there were no significant adjusted correlations between parents-adult offspring (living independent of their parents) dyads. Also few nutrient intakes of grandparents-grandson or granddaughter dyads were correlated. The nutrient intakes of adult offspring were not associated with their parents; this correlation for younger and older generations disappeared. There were weak to moderate correlation between nutrient intakes of parent-offspring dyads that lived with their parents. The resemblance was higher for mother-offspring than father-offspring. Overall, total fat and trans-fatty acid intakes of young offspring were higher than their parents.

Ultra-processed foods and added sugars in the Chilean diet (2010).

To assess the consumption of ultra-processed foods and analyse its association with the content of added sugars in the Chilean diet. Cross-sectional study of national dietary data obtained through 24 h recalls and classified into food groups according to the extent and purpose of food processing (NOVA classification). Chile. A probabilistic sample of 4920 individuals (aged 2 years or above) studied in 2010 by a national dietary survey (Encuesta Nacional de Consumo Alimentario). Ultra-processed foods represented 28·6 (se 0·5) % of total energy intake and 58·6 (se 0·9) % of added sugars intake. The mean percentage of energy from added sugars increased from 7·7 (se 0·3) to 19·7 (se 0·5) % across quintiles of the dietary share of ultra-processed foods. After adjusting for several potential sociodemographic confounders, a 5 percentage point increase in the dietary share of ultra-processed foods determined a 1 percentage point increase in the dietary content of added sugars. Individuals in the highest quintile were three times more likely (OR=2·9; 95 % CI 2·4, 3·4) to exceed the 10 % upper limit for added sugars recommended by the WHO compared with those in the lowest quintile, after adjusting for sociodemographic variables. This association was strongest among individuals aged 2-19 years (OR=3·9; 95 % CI 2·7, 5·9). In Chile, ultra-processed foods are important contributors to total energy intake and to the consumption of added sugars. Actions aimed at limiting consumption of ultra-processed foods are being implemented as effective ways to achieve WHO dietary recommendations to limit added sugars and processed foods, especially for children and adolescents.

A survey of feeding, activity, supplement use and energy consumption in North American agility dogs.

A survey was designed and administered at eighteen agility competitions across the Northeast and Midwest USA in 2015 to obtain information regarding competition level, training, feeding practices, owner-reported weight, body condition score (BCS) and supplement use. Average energy intake per d from reported consumption was assessed for all dogs in ideal body condition based on manufacturers' or US Department of Agriculture database information. To assess the respective parameters across competition levels (novice, open, master/elite), non-parametric or parametric ANOVA or χ2 was used to determine significance. There were 494 respondents with usable data. Results showed that approximately 99 % of respondents used treats and 62 % utilised supplements. Of the respondents, 61 % fed primarily commercial dry food. Approximately 25 % of owners fed foods other than commercial dry (i.e. raw/home-prepared or freeze-dried). This 25 % of non-traditional diets included: 11 % home-prepared raw/cooked diets, 11 % commercial raw/cooked diets, and the remaining 3 % were fed commercial freeze-dried raw products. The remaining 14 % fed a mix of commercial dry food and raw/home-cooked blend. Average BCS was 4·7 (sd 1·1). Mean energy consumption of 238 dogs (BCS 4-5/9) was 444 (sd 138) kJ/kg body weight0·75 per d (106 (sd 33) kcal/kg body weight0·75 per d), with no significant differences observed between dogs at different levels of competition. The mean percentage of energy from treats was 15·1 (sd 12·7) % of overall energy consumption.

Diet quality of Italian yogurt consumers: an application of the probability of adequate nutrient intake score (PANDiet)

The diet quality in yogurt consumers and non-consumers was evaluated by applying the probability of adequate nutrient intake (PANDiet) index to a sample of adults and elderly from the Italian food consumption survey INRAN SCAI 2005–06. Overall, yogurt consumers had a significantly higher mean intake of energy, calcium and percentage of energy from total sugars whereas the mean percentage of energy from total fat, saturated fatty acid and total carbohydrate were significantly (p < 0.01) lower than in non-consumers. The PANDiet index was significantly higher in yogurt consumers than in non-consumers, (60.58 ± 0.33 vs. 58.58 ± 0.19, p < 0.001). The adequacy sub-score for 17 nutrients for which usual intake should be above the reference value was significantly higher among yogurt consumers. The items of calcium, potassium and riboflavin showed the major percentage variation between consumers and non-consumers. Yogurt consumers were more likely to have adequate intakes of vitamins and minerals, and a higher quality score of the diet.

Diet quality and eating behavioural patterns in preschool children in Hong Kong.

To assess the diet quality and eating behaviour of preschool children, investigate parents' feeding practices, and obtain information on the kindergarten nutrition environment of Hong Kong children aged 30-60 months. Dietary information was obtained using multiple 24-hour recalls. Questionnaires were developed to obtain information on children' seating behaviour, parents' feeding practices and preschool nutrition environment. A total of 302 children and 23 local kindergartens from three regions of Hong Kong were surveyed. The results showed consumption of vegetable and fruit were adequate; however, consumption of grain and meat were excessive, while milk and dairy intakes were inadequate. On average, the children consumed 1,280 kcal per day, or 92% of the Chinese Nutrition Society's energy recommendation. For macronutrients, the mean percentages of energy from carbohydrate, protein and fat were 55%, 17% and 28%, respectively, which are within the United States Acceptable Macronutrient Distribution Ranges. The mean intakes of carbohydrate and protein were 175 g and 53.4 g, respectively. For micronutrients, the mean intakes of vitamin D, calcium, iron and zinc were significantly lower than the reference nutrient intake or adequate intake (p<0.05), but those of sodium and niacin were significantly higher than the tolerable upper intake levels (p<0.05). This study showed that diet quality among children in Hong Kong needs to be improved, as some nutrients are consumed in excess whereas others are consumed in inadequate amounts. Other results on children's eating behaviour, parent's feeding practices and school nutrition environment are also reported.

Current status and trends of both dietary fat and cholesterol intake among Chinese children and adolescents aged 7 to 17 years old in 9 provinces of China, from 1991 to 2009

To study the current status and trends of fat and cholesterol intake among Chinese children and adolescents in 9 provinces from 1991 to 2009, so as to provide evidence on dietary guidance. Data was collected in 1991, 1993, 1997, 2000, 2004, 2006 and 2009 from the China Health and Nutrition Survey. Sample would include 7 - 17 years old healthy children and adolescents with a complete 3-day 24-hour-dietary data. Figures on the intake of fat, cholesterol, mean percentage of energy from fat and food source of fat per capita were calculated and compared with the Chinese Dietary Reference Intakes (DRIs). Data showed that, in 1991 - 2009, the dietary fats, mean percentage of energy from total fat and intake of cholesterol had an increasing trend in the population of 9 provinces and were 65.8 g/d, 240.0 mg/d and 32.0% respectively, in 2009. The percentage of population whose mean energy coming from total fat and reached 57.0% in 2009. The dietary structure of children and adolescents in Chinese 9 provinces had changed significantly. 57.0% of the studied subjects had more than 30% increase of their fat intake exceeding the Chinese DRIs. It was necessary to provide children and adolescent with basic knowledge on nutrition, in order to properly control the intake of food rich in fat and cholesterol.

Current Status of Nutrition Transition in South Korea based on the 2005 Korean National Health and Nutrition Survey

South Korea has undergone a unique nutrition transition pattern, and shown relatively lower level of total dietary fat and obesity compared with other Asian countries with commensurate income level. This study reports the current status of energy and macronutrient intake and weight in South Korea using the latest 2005 Korean National Health and Nutrition Survey (n=6436, ≥3 yr, 45% women). The energy intake from macronutrients in South Koreans peaked at 15‐19 yr old and averaged 2,208±24 kcal in men and 1,783±15 kcal in women. The mean percentages of energy from carbohydrate, protein, and fat were 65%, 15%, and 20%, respectively. The energy intake from fat was highest in 3‐5yr old boys and 15‐19 yr old girls, and decreased with age. Body Mass Index (BMI) of adults was 23.9±0.1 kg/m2 in men and 23.3±0.1 kg/m2 in women. The prevalence of obesity (BMI≥25) in adult men and women were 27.4% and 22.5%, respectively. The energy intake from fat and the prevalence of obesity in South Korea are still lower than those of other countries at comparable economic development level, however they have been increasing over the last decade with differential rates across age groups. Better understanding on the unique trends related to energy and macronutrient intake is essential to address current and future nutritional health issues in South Korea as well as other developing countries undergoing similar economic and nutritional transitions.

Lack of Relationship between Calcium Intake and Body Size in an Obesity-Prone Population

Objective Dietary calcium intake, especially from dairy products, may have a protective effect against obesity. This study aimed to determine if calcium intake is associated with body weight and adiposity in Pima Indians, an obesity-prone population. Research Methods and Procedures Subjects were 65 Pima Indian adults (35 men/30 women, age 33±8 years [mean±standard deviation]) participating in a study of eating behavior and 78 Pima Indian children (36 boys/42 girls, age 10.4±0.3 years) participating in a study of childhood obesity. Height and weight were measured, and body composition was determined by dual-energy x-ray absorptiometry. Food intake in adults was assessed using the Block 1998 Food Questionnaire; food intake in children was assessed using a 24-hour recall with parental assistance. Results In adults, mean energy intake was 3,163±1,037 kcal/day, mean percentage of energy from fat was 41%±7%, and calcium intake was 914±333 mg/day. In children, mean energy intake was 1,988±733 kcal/day, mean percentage of energy from fat was 36%±9%, and calcium intake was 637±352 mg/day, half the recommended daily intake for this age group. There were no significant associations between calcium intake and body weight ( r=0.05, P=.71; r=0.04, P=.73), body fat ( r=0.16, P=.19; r=0.12, P=.42), or body mass index ( r=0.01, P=.97; r=0.04, P=.77) in either adults or children, respectively. Discussion One explanation for the lack of association between reported calcium intake and body size in Pima Indians may be that the high-fat, high-energy diet consumed by the population overwhelmed the “anti-obesigenic” effect of calcium. Conclusions We were unable to find an association between calcium intake and body size or adiposity in Pima Indian adults and children. Although the essentiality of calcium to bone health is well established, the role of calcium and dairy product intake in obesity and weight management remains uncertain.

Determination of dietary habits as a risk factor of cardiovascular heart disease in Turkish adolescents.

To investigate dietary habits and evaluate these with regard to cardiovascular risk status in Turkish adolescents aged 12-19 years. A total of 300 adolescents, 135 males and 165 females aged between 12 and 19, were included in the study. Dietary intake was determined by using 3-day food records (including 1 weekend day). Adolescents' smoking habits and familial chronic diseases were recorded. The values obtained for energy and nutrient intakes were compared with RDA and DRI and recommendations given by AHA. The mean energy intakes of male and female subjects were 1964 +/- 723 kcal and 1804 +/- 486 kcal respectively. According to NHANES III, age-standardized (CDC: Centers for Disease Control and Prevention) prevalence of overweight indicated that 20.7% among male and 17.5% among female adolescents were at risk for becoming overweight. The prevalence of premature CHD family history was found to be 9.6% for males and 11.5 % for females. The prevalence of current smoking was found to be 22.2 % for males and 18.2 % for females. In addition, 29.6% of the males and 37.6% of the females were physically inactive (p < 0.05); however, male adolescents (48.2%) were significantly more likely than female adolescents (52.1 %) to report sufficient moderate physical activity (p < 0.05). The dietary fiber intake was slightly below the recommended intake of 10 g per 1000 kcal. Compared to the AHA averages, these adolescents had significantly higher intake of total fat, saturated fat, sodium and dietary cholesterol and lower intake of polyunsaturated fat, monounsaturated fat and dietary fiber. The Turkish adolescents also had higher amounts of energy from fat. The mean percentage of energy from fat was 34.2 +/- 6% TE for males and 35.2 +/- 6.8 % TE for females; saturated fat was 11.8 +/- 6.8 % TE for males and 12.1 +/- 8.9 for females. The intake of fat and saturated fat was higher than the AHA recommendations. The polyunsaturated to saturated fat ratio was 0.4 +/- 0.2 and reflected a high saturated fat (12.0 +/- 7.7% TE) and low polyunsaturated fat (5.5 +/- 3.9 % TE) diet. In addition, the percentage of adolescents who did not meet 66% of RDA for vitamin E, B6, and folates and the recommendation for RDA dietary fiber is presented. Approximately, 80% of adolescents failed to meet the dietary recommendation of the AHA for polyunsaturated fatty acids, and about 26.7% reported a cholesterol intake higher than 100 mg/1000 kcal. It can be said that fiber, total fat, saturated fatty acid, cholesterol and sodium intake of Turkish adolescents are found to be high; however, their vitamin E, vitamin B6 and folate intake are found to be low compared to AHA recommendations. Turkish adolescents' fruit and vegetable intake are also found to be low.

Changes in the nutrient content of school lunches: results from the Pathways study

Background Pathways, a randomized trial, evaluated the effectiveness of a school-based multicomponent intervention to reduce fatness in American-Indian schoolchildren. The goal of the Pathways food service intervention component was to reduce the fat in school lunches to no more than 30% of energy from fat while maintaining recommended levels of calories and key nutrients. Methods The intervention was implemented by school food service staff in intervention schools over a 3-year period. Five consecutive days of school lunch menu items were collected from 20 control and 21 intervention schools at four time periods, and nutrient content was analyzed. Results There was a significantly greater mean reduction in percent energy from fat and saturated fat in the intervention schools compared to the control schools. Mean percentages of energy from fat decreased from 33.1% at baseline to 28.3% at the end of the study in intervention schools compared to 33.2% at baseline and 32.2% at follow-up in the control schools ( P < 0.003). There were no statistically significant differences for calories or nutrients between intervention and control schools. Conclusions The Pathways school food lunch intervention documented the feasibility of successfully lowering the percent of energy from fat, as part of a coordinated obesity prevention program for American-Indian children.

Moderate dietary fat consumption as a risk factor for ischemic heart disease in a population with a low fat intake: a case-control study in Korean men

Dietary fat intake is associated with the incidence of ischemic heart disease (IHD) in Western countries. In populations in which both the average dietary fat consumption and the incidence of IHD are lower than in Western countries, the association of dietary fat intake with IHD incidence remains unknown. We conducted a case-control study to examine the association of dietary fat with IHD incidence in Korean men. The case group consisted of 108 patients with electrocardiogram-confirmed myocardial infarction or angiographically confirmed (> or =50% stenosis) IHD who were admitted to a university teaching hospital in Seoul, Republic of Korea. The controls were 142 age-matched patients admitted to the departments of ophthalmology and orthopedic surgery at the same hospital. Dietary fat intake was assessed by a nutritionist using a semiquantitative food-frequency questionnaire. Body mass index (BMI), cigarette use, alcohol intake, exercise, and history of disease were determined during an interview and examination. In a univariate analysis, the mean percentages of energy from total fat, saturated fatty acids, and monounsaturated fatty acids were significantly higher in the cases than in the controls. BMI, smoking, and a history of hypertension were associated with the occurrence of IHD. In multiple logistic analyses, total fat intake was a significant risk factor (odds ratio: 1.08 for 1% of energy intake; 95% CI: 1.02, 1.14) after adjustment for BMI and smoking. In a population with a relatively low fat intake (19% of energy intake), a moderate increase in total fat intake may be a risk factor for IHD.

Energy and fat intakes of children and adolescents in the United States: data from the National Health and Nutrition Examination Surveys

Dietary factors related to body weight and chronic disease risk are of interest because of recent increases in the prevalence of overweight. Secular trends in energy and fat intakes of youths aged 2-19 y were assessed. Current intakes were compared with recommendations. Dietary 24-h recall data from the third National Health and Nutrition Examination Survey (1988-1994) and earlier national surveys were examined. Mean energy intake changed little from the 1970s to 1988-1994 except for an increase among adolescent females. Over the same time period, the mean percentage of energy from total and saturated fat decreased, but remained above recommendations, with overall means of 33.5% of energy from fat and 12.2% of energy from saturated fat. In 1988-1994, approximately 1 in 4 youths met the recommendations for intakes of fat and saturated fat and 3 in 4 met the recommendation for cholesterol intake. Beverages contributed 20-24% of energy across all ages and soft drinks provided 8% of energy in adolescents. Except for adolescent girls, beverage energy contributions were generally higher among overweight than nonoverweight youths; soft drink energy contribution was higher among overweight youths than among nonoverweight youths for all groups. The lack of evidence of a general increase in energy intake among youths despite an increase in the prevalence of overweight suggests that physical inactivity is a major public health challenge in this age group. Efforts to increase physical activity and decrease nonnutritive sources of energy may be important approaches to counter the rise in overweight prevalence.

Psychosocial Correlates of Healthful Diets: Baseline Results from the Working Well Study

Background. This report examines psychosocial factors related to selection of healthful diets. Understanding why people select healthful diets can lead to rational design and evaluation of nutrition intervention programs. Methods. Data are from 16,287 respondents to the baseline survey for the Working Well Trial, a randomized, controlled trial of worksite-based health promotion. The psychosocial constructs we measured were predisposing factors (beliefs, perceived benefits, and motivation; 5 items, Cronbach′s α = 0.65) and enabling factors (barriers, norms, and social support; 6 items, Cronbach′s α = 0.57). The healthful diet outcomes were intakes of fat, fiber, and servings of fruits and vegetables (from a food frequency questionnaire) and intention and self-efficacy to decrease fat and increase fruits and vegetables. Results. Based on a 5-point scale (1 = low to 5 = high), the mean predisposing factor scale score was much higher than the enabling factor scale score (3.77 vs 2.50, P < 0.001). Comparing respondents in the highest category of the predisposing scale to those in the lowest, mean percentage of energy from fat was 22.4% lower (−9 percentage points), fiber was 85.2% higher (+4.6 g/1,000 kcal), and fruits and vegetables were 100% higher (+1.6 servings/day) (all trends, P < 0.001). Associations were similar, but much weaker, for the enabling scale. Multiple regression models, which included covariates related to diet and the predisposing and enabling scales, explained a total of between 13 and 26% of the variance in diet and intention to change diet. After control for covariates, the predisposing scale remained a significant and strong predictor of diet and intention to change diet but the enabling scale explained small and nonsignificant amounts of variance. Conclusions. Predisposing factors are strong predictors of current diet and intention to change diet. Final results from the Working Well Trial will provide more information on whether enabling factors can be enhanced by intervention and whether these changes result in healthier eating patterns.

A study of the nutritional composition of primary school children's packed lunches and school meals

A survey of the nutritional composition of primary school children's packed lunches and school meals over I week in October 1990 was carried out in an inner‐city school in Nottingham where the majority of children had free school meals and were therefore by definition from low‐income families. Maximum, minimum and mean levels of energy, protein, fat, carbohydrate and dietary fibre were calculated from food composition tables, together with the proportions of the energy contributed by fat, carbohydrate and protein. There were very large differences in the ranges of protein (2.6–24.7 g), fat (10.0–55.3 g) and carbohydrate (33.7–160.9 g) in packed lunches compared to those from school meals (protein 23.3–81.9 g, fat 24.0–65.5g and carbohydrate 37.2–140.3) although the mean percentage of energy from fat was similar in the packed lunches compared to the school meals (43.1 vs. 42.7). The mean energy provided by the school meals was approximately 33% higher than that from packed lunches (2554 kJ vs. 3386 kJ). Whilst accurate food consumption measurements were not performed, observational studies of the children indicated that food was left uneaten, particularly with packed lunches where the crisps and chocolate were often eaten first and the sandwiches remained half‐eaten or untouched.

Correlates of maintenance of a low-fat diet among women in the Women's Health Trial

Background. The Women's Health Trial (WHT) was a feasibility study for a randomized controlled trial designed to test the hypothesis that a reduction in dietary fat reduces breast cancer incidence among women age 45 to 69. Between 1984 and 1988, 2,064 women participated in its two phases. Methods. A follow-up study of 525 women who were randomized to receive the WHT dietary intervention program was conducted to assess maintenance of the diet 1 year on average after the trial ended. Among 448 participants, the mean percentage of energy from fat as measured by a food frequency questionnaire was 40.0% at baseline, 26.3% at the end of the trial, and 27.7% at follow-up. Based on 408 women with complete data, a recursive model was estimated, describing the influence of baseline characteristics of the women on attendance at intervention program sessions, adherence to the diet during the trial, and long-term maintenance of the diet after the trial ended. The effects of women's experiences during the trial on adherence and long-term maintenance were investigated as well. Results. Attendance at the educational sessions was strongly related to adherence to the diet during the trial ( P < 0.001), and adherence was the most important predictor of long-term maintenance ( P < 0.001). The percentage of energy from dietary fat at baseline was an important correlate of both adherence ( P < 0.001) and long-term maintenance ( P < 0.001). College-educated women were more likely to adhere to the diet during the trial ( P < 0.001). Feelings of deprivation adversely affected long-term maintenance ( P < 0.01), primarily through their effect on adherence during the trial ( P = 0.01). Costliness of the diet in time and money negatively influenced long-term maintenance ( P < 0.05). Development of a distaste for fat encouraged adherence ( P = 0.06). Conclusions. The low-fat dietary pattern established during the WHT was maintained for as long as 20 months after the trial ended. A recursive model was useful in analyzing the process and correlates of long-term maintenance of dietary behavior change. Both predisposing variables and women's experiences while on a low-fat diet were associated with long-term maintenance. The results suggest that feelings of deprivation should be avoided, perhaps by use of low-fat substitutes, by those attempting to lower their dietary fat and that more research is needed on the development of a distaste for fat among individuals who adopt low-fat diets.

Comparison of nutrient intakes by male vs. female heads of households

Nutrient intakes by male and female heads within a household were examined in regard to the feasibility of substituting dietary data of one partner for data of the other partner in diet/disease studies. Three-day individual food intake data from male and female heads of household were used when both members participated in the spring quarter of the Nationwide Food Consumption Survey 1977-78. The mean percentage of energy from fat was higher for male heads than for female heads, whereas the mean percentages of energy from protein and carbohydrate were higher for female heads than for male heads (p less than .05). However, the differences between male and female heads in percentages of energy from protein, fat, and carbohydrate were only 1.5 percentage points or less. At the current state of knowledge, that difference is too small to be associated with a difference in health status. In diet/disease studies involving percentages of energy from protein, fat, and carbohydrate, substitution of dietary data of one partner for data of the other partner does not appear likely to produce misleading results and, therefore, would not be precluded. Mean intakes of energy and all 12 nutrients examined as percentages of the RDAs differed significantly between male heads and female heads (p less than .05). In studies involving intakes of energy or any of the 12 nutrients examined, substitution of dietary data of one partner for data of the other partner is not recommended.