Usual Energy Intake Research Articles

Emotion-driven impulsiveness and snack food consumption of European adolescents: Results from the I.Family study

We aimed to investigate the association between emotion-driven impulsiveness and snack food consumption in 1039 European adolescents aged 12–18 years. During the cross-sectional examination in 2013/2014, complete information was collected on: emotion-driven impulsiveness (using the negative urgency subscale from the Urgency, Premeditation, Perseverance, Sensation seeking, and Positive urgency (UPPS-P) Impulsive Behaviour Scale) and snacking behaviour operationalised as 1) consumption frequency of daily snacks, 2) consumption frequency of energy-dense snacks (both measured using Food Frequency Questionnaire) and 3) usual energy intake of food consumed per snacking occasion in calories. The latter was measured using online self-administered 24-h dietary recalls and was estimated based on the National Cancer Institute (NCI) Method. Anthropometric variables were measured and BMI z-score (zBMI) calculated. Age, sex, highest education level of the family and country of residence were assessed using a questionnaire. Mixed-effect regression analyses were separately conducted for each snacking behaviour outcome with emotion-driven impulsiveness as the exposure. After controlling for zBMI, age, sex, country and socioeconomic status, emotion-driven impulsiveness was positively associated with daily consumption frequency of snacks (β = 0.07, 95% Confidence Interval (CI) [0.02, 0.12]) and consumption frequency of energy-dense snacks (β = 0.25, 95% CI [0.19, 0.31]), but not with usual energy intake of food per snacking (β = 2.52, 95% CI [-0.55, 5.59]). Adolescents with a stronger emotion-driven impulsiveness tendency reported a higher snacking frequency and specifically more energy-dense snacks, whereas the energy intake of snack food seemed less important. These findings have implications for obesity prevention and treatment as they indicate the importance of targeting emotion-driven impulsiveness as a strategy to avoid excessive snacking.

Case Study: Physical Capacity and Nutritional Status Before and After a Single-Handed Yacht Race.

During solitary sailing, the sailor is exposed to sleep deprivation and difficulties in consuming regular meals. Sailor weight loss is often reported. In the present case study, we describe changes in the physical capacity and nutritional status of an athlete attempting a single-handed yacht race around the globe. An Italian male ocean racer (Gaetano Mura) asked for our help to reach an optimum level of physical and nutritional preparation. We planned his diet after assessing his anthropometric parameters and body composition, as well as his usual energy intake and nutritional expenditure. The diet consisted of 120 meals stored in sealed plastic bags. Before his departure, GM performed two incremental exercise tests (cycle ergometry and arm crank ergometry) to assess his physical capacity. Cardiac functions were also estimated by Doppler echocardiography. All measures and exercise tests were repeated 10 days after GM finished the race, which lasted 64 days. Anthropometric measures did not change significantly, with the exception of arm fat area and thigh muscle area, which decreased. There were evident increments in maximum oxygen intake and maximum workload during arm cranking after the race. On the contrary, maximum oxygen uptake and maximum workload decreased during cycling. Finally, end-diastolic and stroke volume decreased after the race. It was concluded that nutritional counseling was useful to avoid excessive changes in nutritional status and body composition due to 64 days of solitary navigation. However, a reduction in physical leg capacity and cardiovascular functions secondary to leg disuse were present.

Familial Resemblance in Dietary Intakes of Children, Adolescents, and Parents: Does Dietary Quality Play a Role?

Information on familial resemblance is important for the design of effective family-based interventions. We aimed to quantify familial correlations and estimate the proportion of variation attributable to genetic and shared environmental effects (i.e., familiality) for dietary intake variables and determine whether they vary by generation, sex, dietary quality, or by the age of the children. The study sample consisted of 1435 families (1007 mothers, 438 fathers, 1035 daughters, and 1080 sons) from the multi-center I.Family study. Dietary intake was assessed in parents and their 2–19 years old children using repeated 24-h dietary recalls, from which the usual energy and food intakes were estimated with the U.S. National Cancer Institute Method. Food items were categorized as healthy or unhealthy based on their sugar, fat, and fiber content. Interclass and intraclass correlations were calculated for relative pairs. Familiality was estimated using variance component methods. Parent–offspring (r = 0.11–0.33), sibling (r = 0.21–0.43), and spouse (r = 0.15–0.33) correlations were modest. Parent–offspring correlations were stronger for the intake of healthy (r = 0.33) than unhealthy (r = 0.10) foods. Familiality estimates were 61% (95% CI: 54–68%) for the intake of fruit and vegetables and the sum of healthy foods and only 30% (95% CI: 23–38%) for the sum of unhealthy foods. Familial factors explained a larger proportion of the variance in healthy food intake (71%; 95% CI: 62–81%) in younger children below the age of 11 than in older children equal or above the age of 11 (48%; 95% CI: 38–58%). Factors shared by family members such as genetics and/or the shared home environment play a stronger role in shaping children’s intake of healthy foods than unhealthy foods. This suggests that family-based interventions are likely to have greater effects when targeting healthy food choices and families with younger children, and that other sorts of intervention are needed to address the intake of unhealthy foods by children.

Following a dietary pattern based on Dietary Guidelines for Americans may lead to reduced preference for sweet taste

ObjectiveDietary intake of added sugars in the United States is significantly higher than what is recommended by the Dietary Guidelines for Americans (DGA) and by other health organizations. There is limited research on how reducing the intake of added sugars would affect or change taste perception related to sugar. Our objective was to determine if sweet taste threshold and sweet preference changes in response to a diet intervention based on the recommendations in the 2010 DGA compared to an intervention based on the typical American diet (TAD) as described by recent surveys of U.S. adults.MethodsData for this report is from an eight‐week controlled feeding trial. Overweight or obese women, with insulin resistance and/or dyslipidemia, aged 20–65 years were randomized into one of two diet groups: the DGA diet or the TAD. Detection taste threshold was determined using a three‐alternative‐forced choice method and sweet preference was measured using the Monell forced‐choice, paired‐comparison tracking procedure. Measurements were obtained prior to the dietary intervention at baseline (BL), and after the diet intervention (ADI) to evaluate changes in taste acuity and hedonic preference. Data were log transformed, and analysis of covariance was used to identify differences between the two diet groups. In addition, the change in acuity and hedonic preference was calculated as ADI‐BL. Wilcoxon's rank test was used to identify differences in these parameters between the two groups. This is an on‐going study, with more participant cohorts being added to reach n = 44.ResultsPreliminary results were generated for the first 16 women (Age: DGA ‐ 45.0, TAD‐42.5 y; BMI: DGA – 30.4, TAD – 33.0 kg/m2) who have completed the study. Usual energy intake (kcals), and percent‐added sugars or sweet‐food intake were not different at BL between DGA and TAD (p = 0.92, 0.63, 0.92, respectively). There was no significant difference (p > 0.05) between diets in the change in sweet threshold or sweet preference. The DGA intervention, however, resulted in a larger reduction in the level of preferred sweetness compared to the TAD diet, when controlling for BL preference (p = 0.03).ConclusionsConsuming a diet following the DGA may possibly lower preference for sweet foods when compared to a TAD. Further, data from the complete cohort will be used to add to this report upon study completion.Support or Funding InformationFunded by National Dairy Council and USDA, ARS CRIS project #2032 51530 022 00D

Simulated effects of home fortification of complementary foods with micronutrient powders on risk of inadequate and excessive intakes in West Gojjam, Ethiopia

Home fortification of complementary foods (CFs) with multiple micronutrient powders (MNPs) is being scaled up in various countries, but little is known about the prevailing complementary feeding practices and the type and nutrient gaps to be filled with MNPs. The present study evaluated the complementary feeding practices of young children and simulated the risk of inadequate and excessive intakes associated with home fortification with MNPs. We have assessed the sociodemographic status, anthropometry, and complementary feeding practices of young children (N=122) in Mecha district, rural Ethiopia. Using a 2-day, quantitative 24-hr recall, usual intakes of energy, protein, iron, zinc, and calcium were estimated. The risks of inadequate and excessive iron and zinc intakes with or without home fortification scenarios were assessed. The simulations considered intakes from CFs assuming average breast milk contributions and additional nutrients provided by the MNPs. Stunting was highly prevalent (50%) and was associated with a lower dietary diversity (P=.009) and nutrient intakes from the CFs. Median energy, zinc, and calcium intakes were below the estimated needs from CFs; protein needs were met. Median dietary iron intake appeared adequate, but 76%, 95% CI [68%, 84%], of children had inadequate intake (assuming low bioavailability), whereas another 8%, 95% CI: [3%, 13%], had excessive intakes. Simulation of daily and alternative day's fortification with MNP decreased the prevalence of inadequate iron and zinc intake but significantly increased the risk of excessive intakes that remained unacceptably high for iron (>2.5%). Untargeted MNP interventions may lead to excessive intakes, even in settings where poor complementary feeding practices are prevalent.

DietaryPatternsofEuropeanChildrenandTheir ParentsinAssociationwithFamilyFood Environment:ResultsfromtheI.FamilyStudy.

The aim of this study was to determine whether an association exists between children’s and parental dietary patterns (DP), and whether the number of shared meals or soft drink availability during meals strengthens this association. In 2013/2014 the I.Family study cross-sectionally assessed the dietary intakes of families from eight European countries using 24-h dietary recalls. Usual energy and food intakes from six- to 16-year-old children and their parents were estimated based on the NCI Method. A total of 1662 child–mother and 789 child–father dyads were included; DP were derived using cluster analysis. We investigated the association between children’s and parental DP and whether the number of shared meals or soft drink availability moderated this association using mixed effects logistic regression models. Three DP comparable in children and parents were obtained: Sweet & Fat, Refined Cereals, and Animal Products. Children were more likely to be allocated to the Sweet & Fat DP when their fathers were allocated to the Sweet & Fat DP and when they shared at least one meal per day (OR 3.18; 95% CI 1.84; 5.47). Being allocated to the Sweet & Fat DP increased when the mother or the father was allocated to the Sweet & Fat DP and when soft drinks were available (OR 2.78; 95% CI 1.80; 4.28 or OR 4.26; 95% CI 2.16; 8.41, respectively). Availability of soft drinks and negative parental role modeling are important predictors of children’s dietary patterns.

Repeat 24-hour recalls and locally developed food composition databases: a feasible method to estimate dietary adequacy in a multi-site preconception maternal nutrition RCT

ABSTRACTBackground: Our aim was to utilize a feasible quantitative methodology to estimate the dietary adequacy of >900 first-trimester pregnant women in poor rural areas of the Democratic Republic of the Congo, Guatemala, India and Pakistan. This paper outlines the dietary methods used.Methods: Local nutritionists were trained at the sites by the lead study nutritionist and received ongoing mentoring throughout the study. Training topics focused on the standardized conduct of repeat multiple-pass 24-hr dietary recalls, including interview techniques, estimation of portion sizes, and construction of a unique site-specific food composition database (FCDB). Each FCDB was based on 13 food groups and included values for moisture, energy, 20 nutrients (i.e. macro- and micronutrients), and phytate (an anti-nutrient). Nutrient values for individual foods or beverages were taken from recently developed FAO-supported regional food composition tables or the USDA national nutrient database. Appropriate adjustments for differences in moisture and application of nutrient retention and yield factors after cooking were applied, as needed. Generic recipes for mixed dishes consumed by the study population were compiled at each site, followed by calculation of a median recipe per 100 g. Each recipe’s nutrient values were included in the FCDB. Final site FCDB checks were planned according to FAO/INFOODS guidelines.Discussion: This dietary strategy provides the opportunity to assess estimated mean group usual energy and nutrient intakes and estimated prevalence of the population ‘at risk’ of inadequate intakes in first-trimester pregnant women living in four low- and middle-income countries. While challenges and limitations exist, this methodology demonstrates the practical application of a quantitative dietary strategy for a large international multi-site nutrition trial, providing within- and between-site comparisons. Moreover, it provides an excellent opportunity for local capacity building and each site FCDB can be easily modified for additional research activities conducted in other populations living in the same area.

Low‐fat Yogurt Consumption Reduces Markers of Chronic Inflammation in Apparently Healthy Lean and Obese Women

The objective of this study was to determine whether daily low‐fat yogurt consumption would reduce biomarkers of chronic inflammation by improving intestinal barrier function in apparently healthy lean and obese women. Lean and obese women (18.5–27 vs. 30–40 kg/m2; n = 30/group) participated in a randomized, controlled study where they received 12 oz low‐fat yogurt (YL, yogurt lean; YO, yogurt obese) or soy pudding (CL, control lean; CO, control obese) daily for 9 wk while maintaining their usual energy intake. Plasma biomarkers of inflammation and intestinal barrier function were determined in the fasted state at wk 0, 3, 6, and 9. At baseline, obese participants had higher plasma lipopolysaccharide‐binding protein (LBP), LBP/soluble CD14 (sCD14) ratio, immunoglobulin M endotoxin‐core antibody (IgM EndoCAb), interleukin 6 (IL‐6), high‐sensitivity C‐reactive protein (hsCRP), tumor necrosis factor alpha (TNF‐α) and TNF‐α/soluble tumor necrosis factor receptor II (sTNF‐RII) ratio than lean participants. After 9 wk of yogurt consumption, YO biomarkers of chronic inflammation were lower than those at baseline: IL‐6 by 17%, hsCRP by 9%, TNF‐α by 7%, and TNF‐α/sTNF‐RII by 7%. Also, at 9 wk, plasma IgM EndoCAb, peripheral blood mononuclear cell mRNA expression of transforming growth factor beta 1 and nuclear factor kappa B inhibitor alpha increased by 5%, 20%, and 54% respectively in YO compared to those at 0 wk. YL also had decreased TNF‐α, TNF‐α/sTNF‐RII and increased IgM EndoCAb from baseline. Biomarkers of inflammation were unaffected in those receiving soy pudding regardless of obesity status. CO had an 11% increase in LBP/sCD14 ratio. Therefore, consumption of low‐fat yogurt for 9 weeks appears to improve intestinal barrier function and reduce fasting biomarkers of chronic inflammation in both lean and obese women.Support or Funding InformationDairy Research Institute

Food Sources of Total Energy, Total Sugars and Added Sugars Among Infants, Toddlers and Preschoolers Living in Mexico: Findings from the 2012 Mexican National Health and Nutrition Survey

Excessive usual energy intakes (total energy intake > 1.5SD above the estimated average energy requirement) have been reported for Mexican infants (14%), toddlers (33%), and preschoolers (14%). The consumption of energy dense, nutrient‐poor foods and beverages already begins in infancy and increases rapidly through age 3 years. To further understand the dietary intakes of young Mexican children, the food sources of total energy and sugars were examined, using data from a nationally representative sample of children ages 0–47.9 months (m) (n=2057) from the 2012 Mexican National Health and Nutrition Survey (ENSANUT 2012). Dietary intake data from a single, proxy‐reported 24‐hour dietary recall for each child was assessed in infants 0–11 months (m) (n=411), toddlers 12–23m (n=538) and preschoolers 24–47m (n=1108). Per capita percentage contributions to intakes of total energy (TE), total sugars (TS), and added sugars (AS) were calculated for 1) major food groups (milks, grains, fruits, vegetables, meat/proteins, mixed dishes, sweets and sugar‐sweetened beverages (SSB)) and 2) specific foods and beverages. Overall, trends in major food group sources of TE and TS from ages 0–47m showed a decrease in the contribution of milks (from ~96 to 13%) and an increase in the contribution of sweets and SSB (from ~2 to 26%). Sweets and SSB contributed more than half of the AS intake during infancy (~54–66%) and increased to more than two thirds of AS intake among toddlers and preschoolers (~66–70%). Overall, the leading sources of TE and TS among infants were breast milk, infant formula, and also cow's milk in ages 6–11m; the top sources of AS were cookies, yogurt, sugar‐sweetened tea/coffee, fruit flavored drinks, and ice cream. Compared to infants, the diets of toddlers and preschoolers were more diverse. The major sources of TE were cow's milk, tortillas, soups, stews, egg dishes (mixed dishes), and sweetened breads. Cow's milk, fresh fruit, sugar‐sweetened tea/coffee and carbonated sodas were major contributors of TS. Overall, three to four of the top five food sources of AS were sweets and SSB contributing ~38% of total intake of AS for toddlers and ~30% for preschoolers. Yogurt and cow's milk were also among the top sources of AS, but unlike sweets and SBB, these foods provide key nutrients for young children and are major food sources of calcium and vitamin D in Mexican toddlers and preschoolers. These findings provide important insights into the consumption patterns of sweets and SSB and the key dietary sources contributing to intakes of energy and sugars. Understanding the dietary sources of energy and nutrients is critical in influencing the development of early dietary patterns and improving the diets and long term health of young Mexican children.Support or Funding InformationFunded by Nestlé Research Center, Lausanne, Switzerland.

Characterizing the Nutritional Health of Unaccompanied Homeless Youth

ObjectiveThere is a dearth of information about the nutritional health of homeless youth, a population considered one of the most vulnerable within society. Nutritional health influences the risk for poorer physical and mental health outcomes. Homeless youth experience various health challenges that could be related to their nutritional health. The goal of this study is to describe the nutritional and dietary status of a sample of homeless youth in a Midwestern city in the United States.MethodsAn observational study of homeless youth was conducted. Youth were recruited from a local drop‐in center in Columbus, Ohio. After providing informed consent, data on socio‐demographic characteristics and dietary intake was collected. Dietary intake data was based on 24‐hour dietary recalls collected on two nonconsecutive days. Anthropometric and body composition measurements were also assessed. Nutrient intakes were adjusted to usual intake and compared to Estimated Average Requirements (EAR) for age and gender to determine adequacy of intakes. Descriptive statistics were used in characterizing the sample.ResultsOf the 36 participants with currently available data, ages ranged from 18–24 years (median of 21). A similar number of participants identified themselves as African American (39%, n=14) and White (42%, n=15). One‐quarter are female and 36% indicated some form of employment. Eight percent are underweight and 44% (95% CI: 27.9%–61.9%) are overweight or obese (BMI≥25). Average usual energy intake is 1861 ± 757 kcal. More than 85% of the sample have inadequate intakes of calcium, magnesium, vitamin A, and vitamin C, with 100% not consuming adequate amounts of vitamins D and E.ConclusionInadequate nutrient intake as well as overweight and obesity are prevalent among homeless youth. Our findings support consequences of difficulty with food access reported within this population. Inadequate intake of essential nutrients may expose homeless youth to poor physical and mental health outcomes.Support or Funding InformationThis study was funded by The Ohio State University, College of Education and Human Ecology, Faculty Seed Grant and by Grant #UL1TR001070.

Cross-sectional and longitudinal associations between energy intake and BMI z-score in European children.

BackgroundEvidence for the effect of dietary energy on BMI z-scores in young children is limited. We aim to investigate cross-sectional and longitudinal effects of daily energy intake (EI) on BMI z-scores of European boys and girls considering growth-related height dependencies of EI using residual EI.MethodsTo investigate cross-sectional and longitudinal effects of daily energy intake (EI) on BMI z-scores of European boys and girls considering growth-related height dependencies of EI using residual EI.MethodsSubjects were children aged 2- < 10 y old (N = 2753, 48.2 % girls) participating in the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) baseline and follow-up examination. Usual EI (kcal/day) was calculated based on the National Cancer Institute-method excluding subjects with implausible reported EI. Effect of age, height and sex-adjusted residuals of EI on BMI z-score was investigated stratified by baseline age –group (2- < 4 y, 4- < 6 y, 6- < 8 y and 8- < 10 y) cross-sectionally using linear regression models adjusted for relevant confounders (crude model: age, sex, country; fully adjusted model: plus parental ISCED level, parental BMI, screen time; subgroup analysis: plus objectively measured physical activity). Longitudinal associations were estimated between changes in (Δ) residual EI per year and ΔBMI z-score per year with adjustments analogously to the cross-sectional models but with additional adjustment for residual EI at baseline.ResultsCross-sectionally, positive associations were observed between residual EI and BMI z-score for the full study sample, for boys and in older (≥6 years) but not in younger children in the crude and fully adjusted model. Longitudinally, small positive associations were observed between Δresidual EI per y on ΔBMI z-score per y for the full study sample and in 4- < 6 y olds in the crude and fully adjusted model.ConclusionIn conclusion, EI above the average intakes for a certain sex, age and height are weakly associated with BMI z-scores in European children. Residual EI may be considered as a useful exposure measure in children as it accounts for growth-related changes in usual EI during childhood.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-016-0344-3) contains supplementary material, which is available to authorized users.

Dietary energy density was associated with diet quality in Brazilian adults and older adults

Cross-sectional and longitudinal studies present association of low dietary energy density with higher intake of vitamins, minerals and dietary fiber, lower intake of fat, and better balance of macronutrients. The objective of this study was to verify the relationship between dietary energy density and diet quality measured by an index of diet quality. This study used data from 496 adults and 445 older adults of cross-sectional population-based survey from São Paulo conducted in 2008–2009, Brazil. Dietary intake data was assessed by two 24-h dietary recalls. Dietary energy density values were calculated based on foods only method. Dietary energy density and revised Brazilian Health Eating Index and its components, were estimated by usual intake using Multiple Source Method. The relationship between dietary energy density and the total revised Brazilian Health Eating Index and its components were assessed by Gaussian family log-link model for each age group. The analyses showed an inverse association between dietary energy density and total revised Brazilian Health Eating Index in adults (T2:β = 0.96, p < 0.001; T2:β = 0.86, p < 0.001) and older adults (T2:β = 0.96, p < 0.001; T2:β = 0.90, p < 0.001), and an inverse association between dietary energy density and nine of twelve revised Brazilian Health Eating Index components in adult and/or older adults groups. Dietary energy density was associated with diet quality in Brazilian adults and older adults regardless of sex, per capita household income, body mass index, physical activity level, current smoking habits status, alcohol beverage drinking status and usual energy intake (kilocalories) from beverages.

Estimating usual intakes mainly affects the micronutrient distribution among infants, toddlers and pre-schoolers from the 2012 Mexican National Health and Nutrition Survey.

To compare estimates from one day with usual intake estimates to evaluate how the adjustment for within-person variability affected nutrient intake and adequacy in Mexican children. In order to obtain usual nutrient intakes, the National Cancer Institute's method was used to correct the first 24 h dietary recall collected in the entire sample (n 2045) with a second 24 h recall collected in a sub-sample (n 178). We computed estimates of one-day and usual intakes of total energy, fat, Fe, Zn and Na. 2012 Mexican National Health and Nutrition Survey. A total of 2045 children were included: 0-5·9 months old (n 182), 6-11·9 months old (n 228), 12-23·9 months old (n 537) and 24-47·9 months old (n 1098). From these, 178 provided an additional dietary recall. Although we found small or no differences in energy intake (kJ/d and kcal/d) between one-day v. usual intake means, the prevalence of inadequate and excessive energy intake decreased somewhat when using measures of usual intake relative to one day. Mean fat intake (g/d) was not different between one-day and usual intake among children >6 months old, but the prevalence of inadequate and excessive fat intake was overestimated among toddlers and pre-schoolers when using one-day intake (P6 months. There was overall low variability in energy and fat intakes but higher for micronutrients. Because the usual intake distributions are narrower, the prevalence of inadequate/excessive intakes may be biased when estimating nutrient adequacy if one day of data is used.

Validation of a Brief Dietary Assessment Tool for Estimating Dietary EPA and DHA Intake in Australian Adults at Risk of Cardiovascular Disease

Background: Short food frequency questionnaires (FFQs) are powerful screening instruments for estimating nutrient intakes and play an important role in risk stratification in vulnerable populations. Omega-3 fatty acids are of increasing importance in the prevention of chronic and degenerative disease, especially in older adults who are at higher risk of these chronic conditions. A short FFQ exists to rapidly assess omega-3 intake from marine sources, however it has not previously been validated for agreement with total omega-3 intake and ability to identify suboptimal omega-3 intakes in older adults or for use in Australia.Objective: The aim of the study was to validate a 9-item marine omega-3 FFQ (MFQ) for assessment of omega-3 intake against a validated 74-item semiquantitative FFQ.Methods: One hundred and eight participants (mean age 67 ± 10 years, 47% male) completed the MFQ designed to estimate omega-3 intake from marine sources and the 74-item FFQ designed to estimate usual omega-3 and total energy intake in addition to other nutrients. To test agreement between the two questionnaires for estimating total omega-3 intake, mean bias and 95% limits of agreement (LOA) were calculated. Sensitivity and specificity were assessed using 2 × 2 contingency tables based on whether participants did or did not meet National Heart Foundation (NHF) recommendations for omega-3 intake per day.Results: Mean intake of omega-3 estimated from the MFQ was 210 ± 235 mg/day compared with 295 ± 260 mg/day as estimated by the FFQ. Mean bias (95% LOA) for omega-3 assessed by the two questionnaires was 89 mg/day (−475 mg to 653 mg). The MFQ achieved 98% sensitivity and 31% specificity for the omega-3 cut-off of 500 mg/day. When nutrient composition of the marine products were replaced with Australian data, mean intake of omega-3 was 230 ± 253 mg and the mean bias improved to 64 mg (−681 mg to 553 mg) and achieved 93% sensitivity and 40% specificity.Conclusions: The MFQ shows promise as a rapid screening tool for identifying older adults with intakes of omega-3 fatty acids likely to be below recommendations for chronic and degenerative disease risk reduction. Given the clinically meaningful mean bias and wide LOA, it cannot be recommended as an appropriate tool for the purpose of reporting average intake of individuals. Use of Australian nutrient data improved the mean bias of the tool in estimating total omega-3 intake. The values should be replaced and the MFQ could then be a useful tool for research purposes at the population level.

Low dietary diversity and micronutrient adequacy among lactating women in a peri-urban area of Nepal.

The main objectives were to assess the adequacy of the micronutrient intakes of lactating women in a peri-urban area in Nepal and to describe the relationships between micronutrient intake adequacy, dietary diversity and sociodemographic variables. A cross-sectional survey was performed during 2008-2009. We used 24 h dietary recall to assess dietary intake on three non-consecutive days and calculated the probability of adequacy (PA) of the usual intake of eleven micronutrients and the overall mean probability of adequacy (MPA). A mean dietary diversity score (MDDS) was calculated of eight food groups averaged over 3 d. Multiple linear regression was used to identify the determinants of the MPA. Bhaktapur municipality, Nepal. Lactating women (n 500), 17-44 years old, randomly selected. The mean usual energy intake was 8464 (sd 1305) kJ/d (2023 (sd 312) kcal/d), while the percentage of energy from protein, fat and carbohydrates was 11 %, 13 % and 76 %, respectively. The mean usual micronutrient intakes were below the estimated average requirements for all micronutrients, with the exception of vitamin C and Zn. The MPA across eleven micronutrients was 0·19 (sd 0·16). The diet was found to be monotonous (MDDS was 3·9 (sd 1·0)) and rice contributed to about 60 % of the energy intake. The multiple regression analyses showed that MPA was positively associated with energy intake, dietary diversity, women's educational level and socio-economic status, and was higher in the winter. The low micronutrient intakes are probably explained by low dietary diversity and a low intake of micronutrient-rich foods.

Assessing Dietary Intake and Growth of Infants

Objective: Early cessation of breastfeeding and introduction of solids is common in Australia, which may have implications for child growth and obesity risk. This study aimed to contrast usual energy and macronutrient intake of infants against requirements according to feeding modality (n=670) and determine whether early introduction of solids and cessation of breastfeeding were independently associated with rapid growth (weight gain z-score ≥ 0.67) between birth to age six months (n=220). Methods: An analysis of data from mothers and infants participating in the NOURISH and South Australian Infant Dietary Intake (SAIDI) studies was undertaken. Both studies enrolled mothers on the postnatal wards from 11 large hospitals in South Australia and Brisbane consecutively. Anthropometric data, infant feeding practices and three days of infant dietary intake data were collected at birth and again when infants were aged 4-8 months. Results: Usual energy intakes were above estimated requirements for infants aged 4-

Fast food intake in Canada: Differences among Canadians with diverse demographic, socio-economic and lifestyle characteristics.

To estimate the contribution of fast food to daily energy intake, and compare intake among Canadians with varied demographic, socioeconomic and lifestyle characteristics. Using the National Cancer Institute method, nationally representative estimates of mean usual daily caloric intake from fast food were derived from 24-hour dietary recall data from the Canadian Community Health Survey Cycle 2.2 (n = 17,509) among participants age ≥ 2 years. Mean daily intake and relative proportion of calories derived from fast food were compared among respondents with diverse demographic (age, sex, provincial and rural/urban residence), socio-economic (income, education, food security status) and health and lifestyle characteristics (physical activity, fruit/vegetable intake, vitamin/ mineral supplement use, smoking, binge drinking, body mass index (BMI), self-rated health and dietary quality). On average, Canadians reported consuming 146 kcal/day from fast food, contributing to 6.3% of usual energy intake. Intake was highest among male teenagers (248 kcal) and lowest among women ≥ 70 years of age (32 kcal). Fast food consumption was significantly higher among respondents who reported lower fruit and vegetable intake, poorer dietary quality, binge drinking, not taking vitamin/mineral supplements (adults only), and persons with higher BMI. Socio-economic status, physical activity, smoking and self-rated health were not significantly associated with fast food intake. While average Canadian fast food consumption is lower than national US estimates, intake was associated with lower dietary quality and higher BMI. Findings suggest that research and intervention strategies should focus on dietary practices of children and adolescents, whose fast food intakes are among the highest in Canada.

Usual energy and macronutrient intakes in 2-9-year-old European children.

Valid estimates of population intakes are essential for monitoring trends as well as for nutritional interventions, but such data are rare in young children. In particular, the problem of misreporting in dietary data is usually not accounted for. Therefore, this study aims to provide accurate estimates of intake distributions in European children. Cross-sectional setting-based multi-centre study. A total of 9560 children aged 2-9 years from eight European countries with at least one 24-h dietary recall (24-HDR). The 24-HDRs were classified in three reporting groups based on age- and sex-specific Goldberg cutoffs (underreports, plausible reports, overreports). Only plausible reports were considered in the final analysis (N=8611 children). The National Cancer Institute (NCI)-Method was applied to estimate population distributions of usual intakes correcting for the variance inflation in short-term dietary data. The prevalence of underreporting (9.5%) was higher compared with overreporting (3.4%). Exclusion of misreports resulted in a shift of the energy and absolute macronutrient intake distributions to the right, and further led to the exclusion of extreme values, that is, mean values and lower percentiles increased, whereas upper percentiles decreased. The distributions of relative macronutrient intakes (% energy intake from fat/carbohydrates/proteins) remained almost unchanged when excluding misreports. Application of the NCI-Method resulted in markedly narrower intake distributions compared with estimates based on single 24-HDRs. Mean percentages of usual energy intake from fat, carbohydrates and proteins were 32.2, 52.1 and 15.7%, respectively, suggesting the majority of European children are complying with common macronutrient intake recommendations. In contrast, total water intake (mean: 1216.7 ml per day) lay below the recommended value for >90% of the children. This study provides recent estimates of intake distributions of European children correcting for misreporting as well as for the daily variation in dietary data. These data may help to assess the adequacy of young children's diets in Europe.

Differences in energy and micronutrient intakes among Central Texas WIC infants and toddlers after the package change.

To assess nutrient intakes after the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) package changes within an at-risk, majority Hispanic population of WIC infants and toddlers in Central Texas. For this cross-sectional observational study, Nutrition Data System for Research was used to collect 24-hour recalls of infants and toddlers from a sample of caregivers in 2009 and 2011. Usual nutrient intakes were estimated and compared with Dietary Reference Intakes using the National Cancer Institute method. Mean single-day nutrient intakes were compared using Mann-Whitney tests. Subjects were children ages 4-24 months (2009, n = 84; 2011, n = 120). After the package change, usual energy intakes exceeded recommended levels for infants (79% in excess of Estimated Energy Requirement), but fell below recommended levels for toddlers (88% below Estimated Energy Requirement). Also after the package change, mean usual intake of vitamin D was below the Estimated Average Requirement for toddlers (6.54 vs 10 μg), and mean usual intakes of vitamin A and zinc exceeded the Tolerable Upper Intake Level for all groups. Whereas lower energy intake may reduce obesity risk, in toddlers, lower energy intake increases risk for micronutrient deficiencies. Recommendations include culturally appropriate education and reinstatement of previous milk allotment in the toddler package.

Abstract P410: Added Sugars Intake, Diet Quality and All-Cause Mortality Among US Adults: Prospective Data from National Health and Nutrition Examination Survey III

Objectives: To better understand the relationship between added sugars intake and diet quality, and to estimate associations between added sugars intake with all-cause mortality Methods: National Health and Nutrition Examination Survey III data were linked to mortality data (1988-2006), among 13,902 US adults between ages 18-74 yr having energy intake within 500-3500calories for women and 800-4000 calories for men, no history of a heart attack, stroke, or congestive heart failure. Usual intake of added sugars and energy were estimated using the NCI method and categorized into gender-specific quartiles. Diet quality was assessed using the Healthy Eating Index 2005 score (HEI-2005). Associations between added sugars intake and mortality were estimated using Cox proportional hazards regression adjusting for age, race/ethnicity, body mass index (BMI), and usual total energy intake after testing for multiplicative interaction by each of these covariates. Results: Mean intake of added sugar was 17.2 (95% Confidence Interval (CI) 16.8, 17.6) teaspoons (tsp) in women and 25.0 (95% CI 24.4, 25.7) tsp in men. Higher usual intake of added sugars was associated with being younger, a current smoker, and having between 12 and 15 years of education among both men and women. Higher usual intake of added sugars was related to a lower HEI score in women versus a higher HEI score in men (Quartile (Q) 4 for HEI =61.62 versus Q1=64.73 in women, p=0.0002; (Q4=62.71 vs. Q1=60.07 in men, p=0.0209). Higher HEI scores for the grain, fruit, vegetable, meat, and variety components were related to lower intake of added sugars; whereas, the fats, cholesterol, and sodium components of the HEI were related to higher intake of added sugars in men and women. During a median follow-up period of 14 years, a total of 1,889 deaths were recorded. After multivariable adjustment, higher added sugars intake was not associated with increased all-cause mortality (hazard ratio (HR) 95% CI of Q4 vs Q1, 1.08 (0.77, 1.52)). Interpretation: Epidemiological studies suggested that higher sugars intake is associated with an increased risk of obesity and cardiovascular diseases (CVD). These findings indicate higher intake of added sugars is associated with lower diet quality in women, but not men. Added sugars intake was not significantly associated with all-cause mortality in this representative sample of the US population.