Research
Original Research
Dietary Sources of Energy, Solid Fats, and Added Sugars among Children and Adolescents in the United States

https://doi.org/10.1016/j.jada.2010.07.010Get rights and content

Abstract

Objective

The objective of this research was to identify top dietary sources of energy, solid fats, and added sugars among 2- to 18-year-olds in the United States.

Methods

Data from the National Health and Nutrition Examination Survey, a cross-sectional study, were used to examine food sources (percentage contribution and mean intake with standard errors) of total energy (data from 2005-2006) and energy from solid fats and added sugars (data from 2003-2004). Differences were investigated by age, sex, race/ethnicity, and family income, and the consumption of empty calories—defined as the sum of energy from solid fats and added sugars—was compared with the corresponding discretionary calorie allowance.

Results

The top sources of energy for 2- to 18-year-olds were grain desserts (138 kcal/day), pizza (136 kcal/day), and soda (118 kcal/day). Sugar-sweetened beverages (soda and fruit drinks combined) provided 173 kcal/day. Major contributors varied by age, sex, race/ethnicity, and income. Nearly 40% of total energy consumed (798 of 2,027 kcal/day) by 2- to 18-year-olds were in the form of empty calories (433 kcal from solid fat and 365 kcal from added sugars). Consumption of empty calories far exceeded the corresponding discretionary calorie allowance for all sex–age groups (which range from 8% to 20%). Half of empty calories came from six foods: soda, fruit drinks, dairy desserts, grain desserts, pizza, and whole milk.

Conclusions

There is an overlap between the major sources of energy and empty calories: soda, grain desserts, pizza, and whole milk. The landscape of choices available to children and adolescents must change to provide fewer unhealthy foods and more healthy foods with less energy. Identifying top sources of energy and empty calories can provide targets for changes in the marketplace and food environment. However, product reformulation alone is not sufficient—the flow of empty calories into the food supply must be reduced.

Section snippets

Data Source and Sample

Data from the National Health and Nutrition Examination Survey (NHANES), a cross-sectional study, were used to examine food sources of total energy (during years 2005-2006) and energy from solid fats and added sugars (during years 2003-2004). NHANES is a nationally representative survey with a complex multistage, stratified probability sample. Trained interviewers conducted in-person 24-hour dietary recalls with all eligible persons, using automated data collection systems that included

Results

Mean intakes of energy, solid fats, and added sugars, along with the contributions (percentage and absolute intake) of specific foods contributing at least 2%, are available online at http://riskfactor.cancer.gov/diet/foodsources/energy/. Data are provided for persons aged 2 to 18 years and by age, sex, race/ethnicity, and income level. For ease of presentation, mean intakes of energy, solid fats, and added sugars, and results from the top five sources are summarized in Table 1, Table 2 and

Discussion

To our knowledge, this is the first research to provide data on sources of solid fats and added sugars (collectively, empty calories) as well as total energy, among diets of children and adolescents, examined by race/ethnicity, income, and age groups. The variables examined are based on the most recent available data on a nationally representative sample of US children and adolescents.

Several previously published analyses laid the foundation for this work (15, 16, 17, 18, 20, 21, 22, 23, 24).

Conclusions

The epidemic of obesity among children and adolescents is now widely regarded as one of the most important public health problems in the United States. Most experts agree that the solution will involve changes in both diet and physical activity to affect energy balance. For diet, this means a reduction in energy from current consumption levels. Although reduction in energy intake from any source could lead to weight change, it seems imprudent to advise children to cut down on key

J. Reedy is a nutritionist, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD.

References (28)

  • C.L. Ogden et al.

    Prevalence of high body mass index in US children and adolescents, 2007-2008

    JAMA

    (2010)
  • W.H. Dietz

    Health consequences of obesity in youth: Childhood predictors of adult disease

    Pediatrics

    (1998)
  • J.B. Schwimmer et al.

    Health-related quality of life of severely obese children and adolescents

    JAMA

    (2003)
  • S.J. Nielsen et al.

    Trends in energy intake in US between 1977 and 1996: Similar shifts seen across age groups

    Obesity Res

    (2002)
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    J. Reedy is a nutritionist, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD.

    S. M. Krebs-Smith is chief, Risk Factor Monitoring and Methods Branch in the Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD.

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