Nationwide Food Consumption Survey Research Articles

Food Composition Databases (FCDBs): A Bibliometric Analysis.

Food composition databases (FCDBs) are important tools that provide information on the nutritional content of foods. Previously, it was largely unclear what nutritional contents and which FCDBs were involved in highly cited papers. The bibliometric study aimed to identify the most productive authors, institutions, and journals. The chemicals/chemical compounds with high averaged citations and FCDBs used by highly cited papers were identified. In July 2023, the online database Web of Science Core Collection (WoSCC) was queried to identify papers related to FCDBs. A total of 803 papers were identified and analyzed. The first paper indexed in WoSCC was published in 1992 by Pennington, which described the usefulness of FCDB for researchers to identify core foods for their own studies. In that paper, the FCDB described was the USDA 1987-88 NFCS (the United States Department of Agriculture 1987-88 Nationwide Food Consumption Survey). The most productive author was Dr. Paul M. Finglas, the Head of the Food Databanks National Capability at the Quadram Institute (Norwich, UK) and the Managing Director of EuroFIR. His most cited paper among this dataset was about the development of an online Irish food composition database together with EuroFIR. The most productive institutions were the USDA and the World Health Organization (WHO) instead of universities. Flavonoid was the most recurring chemical class among the highly cited ones. The anti-oxidative properties and protective effects against heart disease and cancer of flavonoids might be some of the reasons for their popularity in research. Among the highly cited papers, the most heavily used FCDBs were the USDA database for the flavonoid content of selected foods, Fineli, the USDA National Nutrient Database for Standard Reference (USNDB), EuroFIR eBASIS-Bioactive Substances in Food Information Systems, and Phenol-Explorer. High-quality national and international FCDBs should be promoted and made more accessible to the research and public communities to promote better nutrition and public health on a global scale.

A Food Industry Perspective on Folic Fortification

The U.S. Public Health Service (PHS) has recommended that all women of childbearing years, capable of becoming pregnant, consume 400 fig folic acid/d to reduce their risk of having a neural tube defect (NTD)-affected pregnancy. The U.S. Food and Drug Administration subsequently proposed a fo late fortification scheme for cereal grains, which also allowed the continued fortification of breakfast cereals at 0.1 mg per serving. To determine the contribution of ready-to-eat breakfast cereals (RTEC) to folate in takes in women of childbearing years, data were ana lyzed from the U.S. Department of Agriculture’s 1989-1991 Continuing Survey of Food Intakes by In dividuals and 1987-1988 Nationwide Food Consumption Survey. Women consuming RTEC have higher intakes of folate than women reporting no RTEC consumption. Recent reports indicate that most women are unaware of the PHS recommendation to consume more folate, and many health professionals are not advising women of the need to consume adequate folate during the childbearing years. The food industry has been an effective communicator of health and nutrition messages and should be encouraged to raise awareness about the role of folate in NTDs. Better analysis also needs to be conducted to identify women at risk of low folate intakes, so that targeted educational efforts can be made and appropriate vehicles identified for delivering folate to these women.

Composition and Nutritional Quality of the Diet in Spanish Households during the First Wave of the COVID-19 Pandemic

In Spain, the health crisis caused by the COVID-19 pandemic led to the declaration of a state of alarm in the whole country in 2020; in this context, a nationwide lockdown was implemented, potentially altering the dietary habits of the population. The aims of this study were to describe the diet and its nutritional quality in Spanish households during the first COVID-19 epidemic wave and to compare them with the same period in 2019. Data on monthly foods and beverages household purchases in 2019 and 2020 were obtained from the nationwide Food Consumption Surveys. In April, there was an average increase, compared with 2019, of more than 40% for all food groups, with significant peaks in: alcoholic beverages (75%), appetizers (60%), eggs (59%), sugar and sweets (52%), and vegetables (50%). In March, the greatest peak was for pulses, with a 63% increment. The mean energy value of purchased foods in April was 2801 kcal/person/day, corresponding to an increase of 771 kcal/person/day (+38%), compared to the same month of 2019 (March and May: +520 kcal (+26%), June: +343 kcal (+18%)). Regarding nutrient density, there was a reduction in calcium, iodine, zinc, selenium, riboflavin, vitamins B12, D, A, especially retinol, and an increase in fibre, sodium, folic acid, carotenes and vitamin E. Alcohol content per 1000 kcal increased by more than 20% from April to July. Food purchase patterns in Spanish households changed during lockdown and after it, with no appreciable improvement in the quality of the diet.

Disparities in Snacking Trends in US Adults over a 35 Year Period from 1977 to 2012.

Background: Previous studies have indicated that snacking is contributing to increased calories in the American diet, and that the contribution of snacks to energy intake has increased in recent decades. Objective: The objective was to examine trends in the energy intake deriving from snacks and food sources of snacks for US adults over 35 years from 1977 to 2012, and whether these trends differ across sociodemographic groups. Methods: Participants included 74,291 US adults aged ≥19 years who participated in the 1977–1978 Nationwide Food Consumption Survey (NFCS); the 1989–1991 Continuing Survey of Food Intake by Individuals (CSFII), the 1994–1996 CSFII, the 1997–1998 CSFII, National Health and Nutrition Examination Survey (NHANES) 2003–2004, NHANES 2005–2006, NHANES 2009–2010 and NHANES 2011–2012; all surveys are a stratified random sample of the total civilian, non-institutionalized US population. Overall patterns of snacking, trends in energy intake from snacking, trends in snacking food and beverage sources and energy intake from snacks across racial/ethnic, age, education and income groups were examined. Results: For all US adults there was a significant increase in per capita energy intake from snacks from 1977 to 2012 (p < 0.01). Non-Hispanic blacks had the highest snacking energy intake from sugar-sweetened beverages (SSBs) in each year (p < 0.01 for all), with a peak intake in 2003–2006 of 76 kcal per capita per day. Intake of salty snacks increased in all groups between 1977 and 2012, with non-Hispanic blacks having the highest intake in 2009–2012 (p < 0.01). No significant differences were found between income or education groups. Conclusions: Results show that snacking remains a significant component of the US diet and the foods consumed at these snacks (SSBs, desserts and sweets and salty snacks) are not the types of foods recommended by the US dietary guidelines. Our finding that non-Hispanic blacks are consuming a higher proportion of SSBs and salty snacks than other groups, and showing the largest increase in energy intake deriving from snacks overall over the past 35 years, is indeed concerning.

A Consistent Database of Nutrient Intakes 1978‐Present Can Improve Analyses of Consumption Trends

For decades, the Federal Government has conducted nationally representative surveys of Americans' food and nutrient intakes. Major surveys used for dietary trend analyses include the U.S. Department of Agriculture (USDA)'s 1977–78 Nationwide Food Consumption Survey (NFCS) and the 1989–91 and 1994–96 Continuing Survey of Food Intakes by Individuals (CSFII), as well as the National Center for Health Statistics (NCHS)' National Health and Nutrition Examination Survey (NHANES). These surveys are used by researchers and policymakers to assess long‐term trends, yet methodological changes such as changes in nutrient databases can have important influences on results. The dietary references (i.e., nutrient values per 100 grams) utilized in the 1977–78 NFCS and 1989–91 CSFII differed from the 1994‐present databases, and did not contain some key nutrients like sodium. We link current dietary reference values to the 1977–78 NFCS and 1989–91 CSFII databases to create a consistent database that includes all the nutrients that can be analyzed today. We present examples of how the use of a consistent database can affect trend data using 1977–78 NFCS, the 1989–91 CSFII, and the continuous waves of NHANES 2003‐present. We describe the database we created to conduct these analyses, which will be publicly available upon completion.Support or Funding InformationSupported by U.S.Department of Agriculture Economic Research Service Cooperative Research Agreement No. 58‐4000‐6‐0009.

Causes of Increased Energy Intake Among Children in the U.S., 1977–2010

Changes in total energy intake have been reported among children and adolescents, but the extent to which the components of total energy-energy density; portion size; and the number of eating/drinking occasions (EO)-drive these changes is unknown. The objective of the current study was to examine the relative contribution to changes in daily total energy. Using cross-sectional nationally representative data from the Nationwide Food Consumption Survey (1977-1978); the Continuing Survey of Food Intake of Individuals (1989-1991); and the National Health and Nutrition Examination Surveys (1994-1998 and 2005-2010) for children and adolescents (aged 2-18 years), changes in total energy (kcal/day) were mathematically decomposed to determine the relative contributions of its three component parts: portion size (g/EO); energy density (kcal/g/EO); and eating/drinking occasions (n). Analyses were completed in 2012. Over the full period, there was an increase in total energy intake (+108 kcal/day) and the number of daily eating/drinking occasions (+1.2). The average portion size per eating/drinking occasion increased between 1977-1978 and 1989-1991, and then dropped by about 85 g/EO between 1989-1991 and 2005-2010. The average energy density per eating/drinking occasion has fluctuated over time, reaching its highest level in 2005-2010 (1.24 kcal/g/EO). The decomposition results show that between 1977-1978 and 2005-2010, changes in the number of eating/drinking occasions per day and portion size per eating occasion were the largest contributors to annualized changes in daily total energy (+19 and -13 kcal/day/year, respectively). Variations in trends were observed for race/ethnicity and parental education subgroups. These findings highlight potentially important intervention targets for reducing energy imbalances in U.S. youth.

Addendum to the MyPyramid Equivalents Database 2.0

BackgroundThe MyPyramid Equivalents Database (MPED) provides amounts of food groups and subgroups in foods consumed in nationwide food consumption surveys. The most recent MPED issued by the Agricultural Research Service (ARS) was Version 2.0, created for use with the National Health and Nutrition Examination Survey (NHANES) 2003-04. Several of the Center for Nutrition Policy and Promotion's (CNPP) projects require food group equivalents data for foods from more recent NHANES. ObjectiveTo provide a supplementary database of food group equivalents for more recent NHANES foods, for use in CNPP projects. DescriptionAdditional foods (n=820) reported in NHANES 2005-06 and 2007-08 were identified for inclusion in several CNPP projects, including the new online diet assessment tool, the SuperTracker. Cup and ounce equivalents were calculated for 750 foods by using the approach described in the documentation for the MPED 2.0. The USDA National Nutrient Database for Standard Reference, Release 23 (2010) was used for calculations. ARS provided equivalents data for 70 formulated foods. The Addendum to the MPED includes cup or ounce equivalents per 100 grams of food for each USDA food group and subgroup, grams of discretionary solid fats and oils, teaspoons of added sugars, alcoholic beverages, as well as whole fruit and fruit juice equivalents. The Addendum database and documentation are available on the CNPP web site at: http://www.cnpp.usda.gov/OtherProjects.htm. ConclusionThe Addendum provides useful data for foods from more recent NHANES that are not in MPED 2.0. It will be available until the next equivalents database is released by ARS.

Trends in Energy Intake among US Children by Eating Location and Food Source, 1977-2006

Background Little is known about the influence of location of food consumption and preparation upon daily energy intake of children. Objective To examine trends in daily energy intake by children for foods eaten at home or away from home, by source of preparation, and for combined categories of eating location and food source. Subjects The analysis uses data from 29,217 children aged 2 to 18 years from the 1977-1978 Nationwide Food Consumption Survey, 1989-1991 and 1994-1998 Continuing Survey of Food Intakes by Individuals, and 2003-2006 National Health and Nutrition Examination Surveys. Methods Nationally representative weighted percentages and means of daily energy intake by eating location were analyzed for trends from 1977 to 2006. Comparisons by food source were examined from 1994 to 2006. Analyses were repeated for three age groups: 2 to 6 years, 7 to 12 years, and 13 to 18 years. Difference testing was conducted using a t test. Results Increased energy intake (+179 kcal/day) by children from 1977-2006 was associated with a major increase in energy eaten away from home (+255 kcal/day). The percentage of daily energy eaten away from home increased from 23.4% to 33.9% from 1977-2006. No further increase was observed from 1994-2006, but the sources of energy shifted. The percentage of energy from fast food increased to surpass intake from schools and become the largest contributor to foods prepared away from home for all age groups. For foods eaten away from home, the percentage of daily energy from stores increased to become the largest source of energy eaten away from home. Fast food eaten at home and store-bought food eaten away from home increased significantly. Conclusions Eating location and food source significantly influence daily energy intake for children. Foods prepared away from home, including fast food eaten at home and store-prepared food eaten away from home, are fueling the increase in total energy intake. However, further research using alternative data sources is necessary to verify that store-bought foods eaten away from home are increasingly store-prepared.

Energy Density, Portion Size, and Eating Occasions: Contributions to Increased Energy Intake in the United States, 1977–2006

Competing theories attempt to explain changes in total energy (TE) intake; however, a rigorous, comprehensive examination of these explanations has not been undertaken. Our objective was to examine the relative contribution of energy density (ED), portion size (PS), and the number of eating/drinking occasions (EOs) to changes in daily TE. Using cross-sectional nationally representative data from the Nationwide Food Consumption Survey (1977-78), Continuing Survey of Food Intakes of Individuals (1989-91), and National Health and Nutrition Examination Surveys (1994-98 and 2003-06) for adults (aged ≥19 y), we mathematically decompose TE (kcal/d) to understand the relative contributions of each component-PS (grams/EO), ED (kcal/g/EO) and EO(number)-to changes in TE over time. There was an increase in TE intake (+570 kcal/d) and the number of daily EOs (+1.1) between 1977-78 and 2003-06. The average PS increased between 1977-78 and 1994-98, then dropped slightly between 1994-98 and 2003-06, while the average ED remained steady between 1977-78 and 1989-91, then declined slightly between 1989-91 and 1994-98. Estimates from the decomposition statistical models suggest that between 1977-78 and 1989-91, annualized changes in PS contributed nearly 15 kcal/d/y to increases in TE, while changes in EO accounted for just 4 kcal/d/y. Between 1994-98 and 2003-06 changes in EO accounted for 39 kcal/d/y of increase and changes in PS accounted for 1 kcal/d/y of decline in the annualized change in TE. While all three components have contributed to some extent to 30-y changes in TE, changes in EO and PS have accounted for most of the change. These findings suggest a new focus for efforts to reduce energy imbalances in US adults.

Dietary exposure to persistent organochlorine pesticides in 2007 Chinese total diet study

Dietary exposure to persistent organochlorine pesticides (OCPs) was assessed for Chinese populations, using the total diet study (TDS) approach in 2007. Multistage random cluster sampling method was used in this study. 108 composite samples, representative of foods “as consumed” by the Chinese were analyzed for residues of OCPs by a multi-residue method. The result showed that hexachlorobenzene (HCB), dichloro-diphenyl-trichloroethane (DDT), chlordane compounds (CHLs), hexachlorocyclohexane (HCH) and heptachlor could be detected in, respectively 84%, 39%, 37%, 13% and 5% of all samples. Concentrations of DDT in all samples ranged from undetectable levels to 72.2μg/kg. Others were minor components in the OCPs profile. The residual levels of OCPs were significantly below the Extraneous Maximum Residue Limits (EMRLs). Based on the 2000 nationwide food consumption survey, the average dietary exposure of the Chinese to DDT, HCH, HCB, CHLs, and heptachlor was estimated to be 0.016, 0.002, 0.009, 0.006, and 0.001μg/kg body weight per day respectively, showing a significant decrease trend compared with the past. The major food groups contributing to dietary OCPs were aquatic foods, meats, and cereals. The average and high end estimated daily intakes of different OCPs for the Chinese were both lower than the tolerable daily intake (TDI) suggested by authorities indicating low health risk of OCPs dietary exposure among Chinese adults at present. However, the risk of carcinogenicity of the OCPs should be concerned with if the carcinogenicity effects from the exposures to these OCPs were considered.

Estimated dietary intake of nitrite and nitrate in Swedish children

This study examines the intake of nitrate and nitrite in Swedish children. Daily intake estimates were based on a nationwide food consumption survey (4-day food diary) and nitrite/nitrate content in various foodstuffs. The mean intake of nitrite from cured meat among 2259 children studied was 0.013, 0.010 and 0.007 mg kg−1 body weight day−1 in age groups 4, 8–9 and 11–12 years, respectively. Among these age groups, three individuals (0.1% of the studied children) exceeded the acceptable daily intake (ADI) of 0.07 mg nitrite kg−1 body weight day−1. The mean intake of nitrate from vegetables, fruit, cured meat and water was 0.84, 0.68 and 0.45 mg kg−1 body weight day−1 for children aged 4, 8–9 and 11–12 years, respectively. No individual exceeded the ADI of 3.7 mg nitrate kg−1 body weight day−1. However, when the total nitrite intake was estimated, including an estimated 5% endogenous conversion of nitrate to nitrite, approximately 12% of the 4-year-old children exceeded the nitrite ADI. Thus, the intake of nitrite in Swedish children may be a concern for young age groups when endogenous nitrite conversion is included in the intake estimates.

Estimation of age-specific per capita home-produced food intake among populations that garden, farm, or raise animals

Intake of home-produced foods may be a concern in areas where chemical contamination exists. Estimating exposure to contaminants in home-produced foods requires knowledge of the amount of these foods consumed. The US Environmental Protection Agency's (US EPA's) Exposure Factors Handbook provides data on consumption of home-produced foods based on the US Department of Agriculture's (USDA's) 1987-1988 Nationwide Food Consumption Survey (NFCS), the most recent national food survey that contains the information necessary to estimate home-produced consumption. These data represent "consumer-only" intake rate distributions for various age and demographic categories. "Consumers-only" information is also provided for households who garden, farm, and raise animals for all age groups combined. However, these "consumer-only" values may not always be appropriate when assessing chronic exposures. Furthermore, data for all ages combined may not be useful for estimating exposure among age groups that may be of particular concern. This paper provides age-specific "per capita" intake rate distributions of home-produced foods specifically for the populations that garden, farm, and raise animals, using data from EPA's Exposure Factors Handbook.

Supersizing, volumetrics, or constant eating: causes of increased energy intake in US adults

The relative effect of energy density (ED), the number of eating occasions (EO), and portion size (PS) to total energy (TE) intake are unknown. Using cross‐sectional nationally‐representative data from the Nationwide Food Consumption Survey (1977–78, n=17,464), Continuing Survey of Food Intake of Individuals (1989–91, n=8,340), and National Health and Nutrition Examination Surveys (1994–98 and 2003–06, n=9,460) for adults (aged ≥ 19 y) we mathematically decompose TE (kcal/d) to understand the relative contributions of each component ‐ PS (g/EO), ED (kcal/g/EO) and EO(#) ‐ to changes in TE over time. There was a steady increase in TE intake (+437 kcal, p&lt;0.001) and the number of daily EO (+1.0 p&lt;0.001) between 1977–78 and 2003–06. The average PS steadily increased between 1977–78 and 1994–98 then non‐significantly decreased between 1994–98 and 2003–06, while the average ED remained relatively stable over the 30‐year period. Between 1977–78 and 1989–91 changes in PS dominated (84.9% of the TE change), while changes in EO accounted for 37.1% of TE change. However, between 1994–98 and 2003–06 changes in EOs accounted for 88.2% and changes in PS accounted for just 22.6% of change in TE. While all three components contributed to the 30‐yr change, changes in EO and PS have consistently accounted for the greatest percent of change in total energy intake. These findings suggest a new focus for obesity prevention efforts.

Food instruction booklet design for the Nigeria food consumption and nutrition survey 2001-2003

In 2001-2003, the International Institute of Tropical Agriculture (IITA), in collaboration with the federal government of Nigeria, USAID and the US Department of Agriculture (USDA), conducted a nationwide food consumption survey. Since the last national survey occurred in 1963, a major objective was to establish national baseline data for women and children under 5 years old. To ensure the accuracy and quality of detailed food intake data, IITA adapted the USDA Food Instruction Booklet (FIB), a compilation of foods consumed in the country, divided into food groups and subgroups. A Nigerian food composition database formed the basis of the Nigerian FIB, whereby, food groups, probes, a food index, and measurement guides with conversion tables were compiled. The Nigerian FIB included 18 major food groups and 79 subgroups compared to 16 food groups and 100 subgroups in the USDA FIB. For both countries, these food groups highlight how food is categorized and consumed. A typical example was how each country grouped grains and cereals. The Nigerian FIB included four separate groups (cereals, cereal products, confectionaries, and pasta). In the USDA FIB, breads and sweet breads were put together as one group. Cereal, pasta and rice were together as a second group. Examples of these food groups and probes are presented. While both FIBs contained measurement guides (cups, spoons, thickness sticks, rulers), the Nigerian FIB also included indigenous guides. These guides allowed for food weight conversions using local utensils, weights of foods cooked at home and purchased away from home, weights of foods with different sizes, and weights of food items with different measuring tools. Another unique element in the Nigerian FIB was the inclusion of scientific names for foods, their English names, and local names in the three Nigerian languages (Hausa, Yoruba, Igbo). The FIB highlights cultural similarities and differences in food consumption and demonstrates how one country’s survey instrument can be adapted to meet the needs of another.Key Words: food instruction booklet, survey instrument

Snacking Increased among U.S. Adults between 1977 and 20061–3

This study built on limited knowledge about patterns and trends of adult snacking in the US. We selected adults aged 19 y and older (n = 44,754) between 1977–1978 and 2003–2006 with results weighted and adjusted for sample design effects. Differences testing, by a Student’s t test, used STATA 10 (P ≤ 0.01). We defined a snacking event as intake of foods over a 15-min period and excluded food defined as snacks but eaten at a meal. Dietary data were obtained from the first 2 d for the 1977–1978 Nationwide Food Consumption Survey (NFCS 77) and the 1989–1991 Continuing Survey of Food Intake by Individuals (CSFII 89); and 2-d dietary data from the 1994–1996 CSFII (CSFII 96) and the NHANES from 2 consecutive surveys: NHANES 2003–2004 and NHANES 2005–2006 (NHANES 03–06). Results showed that snacking prevalence increased significantly from 71 to 97% in 2003–2006 with increases in both the 1989–1994 and the 1994–2006 periods. In all adults, snacking occasions increased 0.97 events over this time period (P < 0.01) and the contribution of snacks to total energy intake increased from 18 to 24% (P < 0.01). The energy density of snacks (food plus beverages) also increased progressively over the time period studied. Important changes in snacking food sources were found among desserts, salty snacks, candies, and sweetened beverages. More research is needed to gain a better understanding of the implications for overall energy intake and energy imbalance.

National Estimates of Dietary Fructose Intake Increased from 1977 to 2004 in the United States1–4

Our purpose was to conduct a new analysis to update and extend previously published trends of fructose availability and estimated fructose intake and food sources of dietary fructose from the 1977-1978 Nationwide Food Consumption Survey (NFCS) data. We estimated fructose usual intake with data from NHANES 1999-2004 for 25,165 individuals (1 y and older, excluding pregnant and lactating women and breast-fed infants) using the Iowa State C-SIDE software. We applied food group-specific conversion factors to individual measures of sugar intakes following the earlier study. Sweetener availability in the United States increased from 1978, peaked in 1999, and declined through 2005. The high-fructose corn syrup percentage of sweeteners increased from 16% in 1978 to 42% in 1998 and then stabilized. Since 1978, mean daily intakes of added and total fructose increased in all gender and age groups, whereas naturally occurring (N) fructose intake decreased or remained constant. Total fructose intake as percentage of energy and as percentage of carbohydrate increased 1 and 1.2%, whereas daily energy and carbohydrate intakes increased 18 and 41%, respectively. Similar to 1978 results, nonalcoholic beverages and grain products were the principal food sources of added fructose. Fruits and fruit products were the main dietary sources of N fructose in 2004; in 1978, grain products and vegetables were more predominant food sources. Although comparison of estimates of fructose intakes between data from the 1977-1978 NFCS and the NHANES 1999-2004 showed an increase, this increase was dwarfed by greater increases in total daily energy and carbohydrate intakes.

Are older Americans making better food choices to meet diet and health recommendations?

Trends in food consumption by elderly men and women were recently reported using data from the US Nationwide Food Consumption Surveys of 1977-1978 and 1987-1988. Problems of interpretation arise because of the significant nonresponse rates that occurred during the NFCS survey and other difficulties related to comparison of population nutrient intakes over time.

High-fructose corn syrup: is this what's for dinner?

Background:Research on trends in consumption of added sugar and high-fructose corn syrup (HFCS) in the United States has largely focused on calorically sweetened beverages and ignored other sources. Objective:We aimed to examine US consumption of added sugar and HFCS to determine long-term trends in availability and intake from beverages and foods. Design:We used 2 estimation techniques and data from the Nationwide Food Consumption Surveys (1965 and 1977), Continuing Survey of Food Intake by Individuals (1989–1991), and the National Health and Nutrition Examination Surveys (1999–2000, 2001–2002, and 2003–2004) to examine trends in HFCS and added sugar both overall and within certain food and beverage groups. Results:Availability and consumption of HFCS and added sugar increased over time until a slight decline between 2000 and 2004. By 2004, HFCS provided roughly 8% of total energy intake compared with total added sugar of 377 kcal · person−1 · d−1, accounting for 17% of total energy intake. Although food and beverage trends were similar, soft drinks and fruit drinks provided the most HFCS (158 and 40 kcal · person−1 · d−1 in 2004, respectively). Moreover, among the top 20% of individuals, 896 kcal · person−1 · d−1 of added sugar was consumed compared with 505 kcal · person−1 · d−1 of HFCS. Among consumers, sweetened tea and desserts also represented major contributors of calories from added sugar (>100 kcal · person−1 · d−1). Conclusion:Although increased intake of calories from HFCS is important to examine, the health effect of overall trends in added caloric sweeteners should not be overlooked.

Nutrient Effects on the Calcium Economy: Emphasizing the Potassium Controversy

The calcium economy is a dynamic state influenced by fluxes in dietary calcium intake, intestinal calcium absorption, and renal calcium conservation. The relationship of selected bone-related nutrients to these calcium fluxes exhibits both constructive and destructive interactions that affect the overall state of calcium balance. The basis of the calcium requirement and the impact of vitamin D, protein, phosphorus, sodium, and caffeine on the calcium economy are reviewed. Against this background, emerging data on potassium are presented. Data from balance studies of healthy white women at midlife were reviewed to assess the effect of diet potassium on the calcium economy under steady-state conditions. Potassium was inversely associated with both urinary calcium excretion and intestinal calcium absorption, yielding no significant net change in calcium balance. In the population reported on here, dairy, meat, and cereal grains together contributed 56%, and fruits and vegetables 44%, of total dietary potassium. To the extent that fruit and vegetable potassium is a surrogate for high bicarbonate, this cohort did not have a dietary intake pattern allowing for measurement or interpretation of the potential effect of a high-bicarbonate-containing diet on long-term steady-state calcium balance. Potassium itself is uniformly well absorbed regardless of the dietary source. Mean 24-h urinary potassium averaged 92% of dietary intake. According to nationwide food consumption surveys, milk is the number 1 single food source of potassium in all age groups in the United States.

Shifts in Patterns and Consumption of Beverages Between 1965 and 2002

Beverage patterning may play a role in partially explaining the rising rates of obesity in the United States, yet little work on overall trends and patterns exits. Our objective was to examine trends and patterns of beverage consumption among U.S. adults. We used data from the nationally representative Nationwide Food Consumption Surveys (1965, 1977 to 1978) and the National Health and Nutrition Surveys (1988 to 1994, 1999 to 2002). To examine trends we determined percent consuming and per capita and per consumer caloric intake from all beverages. We used cluster analysis to determine year-specific beverage patterns in 1977 and 2002. The percentage of calories from beverages significantly increased between 1965 (11.8%), 1977 (14.2%), 1988 (18.5%), and 2002 (21.0%); this represents an overall increase of 222 calories per person per day from beverages, resulting largely from increased intake of calorically sweetened beverages. Beverage patterns in 2002 were more complex than in 1977 and were dominated by a greater number of beverages, reflecting the increase in alcohol, soda, and diet beverages. Calories from beverages increased substantially from 1965 to 2002, providing a considerable source of daily calories. Given the upward trends in calorically sweetened, nutrient-deficient beverages and the shifts in overall beverage patterns, addressing beverage intake is a salient issue for adults.