Whole grain consumption trends and associations with body weight measures in the United States: results from the cross sectional National Health and Nutrition Examination Survey 2001-2012.

BACKGROUND: The purpose of this study was (1) to describe intakes of total grain and whole grain in the United States over the past 12 years and major dietary sources, and (2) to determine the relationship between whole grain intake and adiposity measures for children and adults. METHODS: Cross-sectional dietary data from the continuous National Health and Nutrition Examination Survey 2001-12 (6 2-year cycles) for children 6-18 years (n = 15,280) and adults 19+ years (n = 29,683) were linked to the My Pyramid and Food Patterns Equivalents Databases to assess daily intake of total grain and whole grain. These populations were classified into groups based on average whole grain intake: 0 ounce equivalents (oz eq)/day, > 0 and <1 oz eq/day, and ≥1 oz eq/day. Within these classifications, body mass index, waist circumference, and percent overweight/obese were identified. Regression and logistic regression analyses were used to assess associations between these dependent variables and whole grain intake. RESULTS: Adults consumed a mean 0.72 whole grain oz eq/day in 2001-02 and 0.97 oz eq/day in 2011-12 and children consumed a mean 0.56 whole grain oz eq/day in 2001-02 and 0.74 oz eq/day in 2011-12. While over 70 % of children and 60 % of adults met daily intake recommendations for total grain, less than 1.0 and 8.0 % percent of children and adults, respectively, met whole grain recommendations in 2011-12. Adults and children who consumed whole grain had significantly better intakes of nutrients and dietary fiber compared to non-consumers. From 2001 to 2012, grain mixed dishes and yeast breads were the leading sources of total grain, while yeast breads and ready to eat cereals were the leading sources of whole grain for both children and adults. Multiple regression analysis showed a significant, inverse relationship between body mass index and waist circumference with respect to whole grain intake after adjustment for covariates in both children and adults (p < 0.05). Similarly, logistic regression analysis showed a significant inverse relationship between percent overweight/obese and whole grain intake (p < 0.05). CONCLUSIONS: Although most children and adults meet daily intake goals for grain foods overall, whole grain as a portion of total grain intake continues to be consumed at levels well below recommendations. The data from the current study suggest that greater whole grain consumption is associated with better intakes of nutrients and healthier body weight in children and adults. Continued efforts to promote increased intake of whole grain foods are warranted.

Associations between yogurt, dairy, calcium, and vitamin D intake and obesity among U.S. children aged 8-18 years: NHANES, 2005-2008.

The aim of this study was to investigate associations of yogurt and dairy consumption with energy, macronutrient, calcium, and vitamin D intakes, and associations with indicators of overweight/obesity in U.S. children in the National Health and Nutrition Examination Survey (NHANES 2005-2008). Using 24-hour recall data, children 8-18 years of age were classified to dairy consumption groups of <1, 1 to <2, or 2+ dairy servings, and yogurt consumers were those who reported eating yogurt during at least one of two dietary intake interviews. NHANES anthropometric measurements were used, and BMI and BMI-for-age percentiles were calculated. Yogurt and dairy consumption were associated with higher intakes of calcium, vitamin D and protein. Yogurt intake was associated with lower total fat and saturated fat intakes and body fat as measured by subscapular skinfold thickness. This study supports consumption of yogurt and higher amounts of dairy as eating patterns associated with greater intake of specific shortfall nutrients, and lower body fat in U.S. children.

Total dietary fiber intakes in the US population are related to whole grain consumption: results from the National Health and Nutrition Examination Survey 2009 to 2010.

Whole grain (WG) foods have been shown to reduce chronic disease risk and overweight. Total dietary fiber is associated with WG and its health benefits. The purpose was to determine whether associations exist between WG intake (no-WG intake, 0 ounce equivalent [oz eq]; low, >0-<3 oz eq; high, ≥3 oz eq) and total dietary fiber intake among Americans 2 years and older. One-day food intake data from the US National Health and Nutrition Examination Survey 2009 to 2010 (n = 9042) showed that only 2.9% and 7.7% of children/adolescents (2-18 years) and adults (≥19 years) consumed at least 3 WG oz eq/d, respectively. For children/adolescents and adults, individuals in the high WG intake group were 59 and 76 times more likely to fall in the third fiber tertile, respectively, compared with those with no-WG intake. Total dietary fiber intake from food sources varied by WG intake group for children/adolescents and adults with more total dietary fiber consumed from ready-to-eat (RTE) and hot cereals and yeast breads/rolls in the high WG intake group compared with the no-WG intake group. Major WG sources for children/adolescents and adults included yeast bread/rolls (24% and 27%, respectively), RTE cereals (25% and 20%, respectively), and oatmeal (12% and 21%, respectively). Among those with the highest WG intake, WG RTE cereal with no added bran was the greatest contributor to total dietary fiber compared with other RTE cereal types. Whole grain foods make a substantial contribution to total dietary fiber intake and should be promoted to meet recommendations.

Ready-to-eat cereal consumption and the School Breakfast Program: relationship to nutrient intake and weight.

BACKGROUND: Children in the United States exhibit high rates of nutrient inadequacy and overweight/obesity; other international studies report similar associations. The School Breakfast Program (SBP) may help alleviate these conditions for youth in the United States. This research examined the association of ready-to-eat (RTE) breakfast cereal consumption with students' (SBP participants and nonparticipants) dietary nutrient intake and weight status. METHODS: Data were from the third School Nutrition Dietary Assessment Study (SNDA-III), conducted in 2004-2005. Analyses included all 2298 SNDA-III participants (ages 5-18 years), who completed a dietary recall and whose parents completed an interview. Students were categorized as skipping versus eating breakfast; students eating breakfast were categorized by SBP participation (SBP participant vs nonparticipant) and breakfast type (with vs without RTE cereal). Analyses estimated the association of these categorizations with total daily nutrient intake and weight-related measures, after adjusting for covariates. RESULTS: RTE cereal breakfast consumers (regardless of SBP participation) had greater intake of vitamin A, iron, and whole grain, compared with noncereal breakfast eaters. Breakfast consumers (regardless of SBP participation and type) had greater intake of vitamins A and C, calcium, iron, dietary fiber, and whole grain, relative to breakfast skippers. CONCLUSIONS: The SBP increases opportunity for improved nutrient intake and healthier body weight through breakfast consumption, especially whole grain RTE cereals, as recommended by the Dietary Guidelines 2010.

Ready-to-Eat Cereal Consumption Patterns: The Relationship to Nutrient Intake, Whole Grain Intake, and Body Mass Index in an Older American Population.

Objective. To investigate the relationship between ready-to-eat (RTE) breakfast cereal consumption patterns and body mass index (BMI), nutrient intake, and whole grain intake in an older American population. Design. A cross-sectional survey of US households, collected by the NPD Group via the National Eating Trends (NET) survey. Main outcome measures include BMI, nutrient intake, and whole grain intake. Subjects/Setting. The sample included 1759 participants age 55 and older, which was divided into approximate quartiles based on intake of RTE breakfast cereal for the 2-week period (0 servings, 1-3 servings, 4-7 servings, and ≥8 servings). Results. In the multivariate linear regression analysis adjusted for energy and age; intake of dietary fiber, whole grains, and the majority of micronutrients examined were found to be positively associated with frequent RTE cereal consumption. The proportion of participants consuming less than the Estimated Average Requirement (EAR) was lower for the highest quartile of RTE cereal consumers compared to nonconsumers, for the majority of vitamins and minerals examined. Significant differences in BMI between RTE breakfast cereal intake groups were found for men. Conclusion. Results suggest that ready-to-eat breakfast cereals may contribute to the nutritional quality of the diets of older Americans. Prospective studies and experimental trials are needed to better evaluate the role of RTE cereal consumption in energy balance.

Top food sources contributing to vitamin D intake and the association of ready-to-eat cereal and breakfast consumption habits to vitamin D intake in Canadians and United States Americans.

UNLABELLED: This study aimed to determine dietary vitamin D intake of U.S. Americans and Canadians and contributions of food sources to total vitamin D intake. Total of 7- or 14-d food intake data were analyzed for vitamin D by a proprietary nutrient assessment methodology that utilized food intake data from the Natl. Eating Trends(®) service, portion size data from NHANES 1999-2004, and nutrient values using the Univ. of Minnesota's Nutrition Data System for Research software. Study participants were 7837 U.S. Americans and 4025 Canadians, ≥2-y-old males and females. The main outcome measures were total dietary vitamin D intake, percent contribution of foods to total vitamin D intake, and vitamin D intake by cereal and breakfast consumption habits. ANOVA was used to determine differences in means or proportions by age and gender and according to breakfast consumption habits. Mean vitamin D intake ranged from 152 to 220 IU/d. Less than 2% of participants in all age groups from the United States and Canada met the 2011 Recommended Daily Allowance (RDA) for vitamin D from foods. Milk, meat, and fish were the top food sources for vitamin D for both Americans and Canadians. Ready-to-eat (RTE) cereal was a top 10 source of vitamin D for Americans but not Canadians. Vitamin D intake was higher with more frequent RTE cereal and breakfast consumption in both countries, largely attributable to greater milk intake. PRACTICAL APPLICATION: Most U.S. Americans and Canadians do not meet the 2011 Inst. of Medicine recommended daily allowance (RDA) for vitamin D for their age groups from foods. Increasing breakfast and cereal consumption may be a useful strategy to increase dietary vitamin D intake to help individuals meet the RDA for vitamin D, particularly by increasing milk intake. However, it is likely that additional food fortification or vitamin D supplementation is required to achieve the RDA.

Weight indicators and nutrient intake in children and adolescents do not vary by sugar content in ready-to-eat cereal: results from National Health and Nutrition Examination Survey 2001-2006.

Few studies have explored the relationship between sugar content in cereal and health outcome among children and adolescents. This study was designed to investigate the associations between ready-to-eat cereals, categorized by sugar content, with weight indicators and nutrient intake profiles. Data collected from 6- to 18-year-old US children and adolescents (N = 9660) in the National Health and Nutrition Examination Survey 2001-06 were used to analyze cereal consumption. Body mass index (BMI), BMI-for-age, waist-to-height ratio, percent overweight or obese, mean day-1 intake, and usual daily intake of macronutrients and micronutrients were the dependent variables; day-1 cereal intake, categorized by tertiles of sugar content, was the main independent variable. Weighted regression with adjustment for the survey design was used to model the dependent variables as a function of day-1 cereal intake, adjusting for age group, sex, race/ethnicity, total day-1 intake of energy, calcium and sugar, the Healthy Eating Index-2005 total score, and household income. For all tertiles of sugar classifications of cereal, children who consumed cereal had significantly lower BMI compared with children who consumed no cereal (P's < .05). Similarly, when compared with children who consumed no cereal, those who ate cereal consumed significantly less fat and cholesterol and significantly more carbohydrates, sugar, whole grains, vitamin A, thiamin, riboflavin, niacin, vitamin B(6), folic acid, vitamin B(12), vitamin C, calcium, magnesium, iron, and zinc. Lower weight and positive nutrient profiles were associated with cereal consumption regardless of sugar content.

Cereal consumption and indicators of cardiovascular risk in adolescent girls.

OBJECTIVE: To examine the association between cereal consumption and cardiovascular risk factors including waist, height, total cholesterol, LDL cholesterol and HDL cholesterol in a sample of adolescent girls. DESIGN: Longitudinal study. SETTING: The study was conducted from 1987 to 1997 and data were collected at three study sites (University of California at Berkeley, University of Cincinnati and Westat Inc., Rockville, MD, USA). Mixed models were used to estimate the association between the number of days of eating cereal and these four outcome variables. SUBJECTS: Girls (n 2371) who participated in the 10-year National Heart, Lung, and Blood Growth and Health Study (NGHS) and completed a 3 d food diary in years 1-5 and 7, 8 and 10. RESULTS: Adolescent girls who ate cereal more often had lower waist-to-height ratio (P<0.005), lower total cholesterol (P<0.05) and lower LDL cholesterol (P<0.05), taking into account sociodemographic variables, physical activity levels and total energy intake. CONCLUSIONS: Findings suggest that cereal consumption is associated with markers of cardiovascular risk and that childhood patterns of consumption may influence the development of risk factors later in adolescence.

Prospective associations among cereal intake in childhood and adiposity, lipid levels, and physical activity during late adolescence.

Cereal consumption is a common dietary behavior that has been associated with positive health outcomes. The objective of this study was to examine prospective associations between cereal intake in childhood and percent body fat, waist-to-hip ratio, lipid levels, and physical activity during late adolescence. In this longitudinal investigation (data collected 1987-1997), data were analyzed for the 2,379 girls who participated in the 10-year National Heart, Lung, and Blood Institute Growth and Health Study. The cumulative percent of days that each girl consumed cereal during childhood (based on 3-day food diaries collected during six study visits between ages 11.5 and 18.6 years) was examined in relation to percent body fat, waist-to-hip ratio, lipid levels, and physical activity measured at age 18.6 years. Results indicated that nearly all girls (90.1%) reported eating cereal and 18.7% reported eating cereal on half or more of the days reported in the food diaries. Girls who ate cereal on a greater percentage of days during childhood had lower percent body fat and total cholesterol, and were more likely to exhibit high levels of physical activity and less television viewing during Study Year 10 (P values<0.05). Further research should explore lifestyle issues related to cereal consumption.

The relationship of ready-to-eat cereal consumption to nutrient intake, blood lipids, and body mass index of children as they age through adolescence.

OBJECTIVE: To examine sex differences and longitudinal changes in ready-to-eat (RTE) cereal and breakfast consumption in the Dietary Intervention Study in Children, and the relationship between RTE cereal intake with nutrient intake, blood lipids, and body mass index (BMI). DESIGN: Secondary analyses based on data from Dietary Intervention Study in Children, a randomized, controlled, multicenter, clinical trial with five sets of three 24-hour recalls. SUBJECTS/SETTING: Children (n=660) from six clinics aged 8 to 10 years at study entry. Participants had serum low-density lipoprotein cholesterol levels between the 80th and 98th percentiles for age, and were followed for a mean of 7.5 years. INTERVENTION: Children were randomized to a total fat- and saturated fat-modified dietary intervention or usual care. STATISTICAL ANALYSES: Frequency of RTE cereal and breakfast consumption was examined by sex and age. Mixed models by sex were used to examine the relationship of RTE cereal consumption to average daily intake of nutrients, blood lipids, and BMI. RESULTS: For all children, RTE cereal and breakfast consumption declined with age. Boys consumed RTE cereal more often compared with girls. Except for energy, RTE cereal consumption was positively associated with all measures of nutrients for both sexes. In boys, higher RTE cereal consumption was associated with lower total and low-density lipoprotein cholesterol levels and lower BMI. CONCLUSIONS: Food and nutrition professionals should continue to educate youth and their parents on the nutritional benefits of routinely eating RTE cereal.

Consumption of breakfast cereal is associated with positive health outcomes: evidence from the National Heart, Lung, and Blood Institute Growth and Health Study.

The purpose of this study was to examine 3 possible explanations for the documented association between cereal consumption and positive health outcomes. The study design was a descriptive, longitudinal study known as the National Heart, Lung, and Blood Institute Growth Health Study. Data from annual 3-day food records were analyzed to answer study questions. The National Heart, Lung, and Blood Institute Growth Health Study recruited 2379 girls (1166 white and 1213 black), age 9 to 10 at baseline. Frequency of consumption of breakfast cereal; other types of foods eaten at breakfast; and macronutrients, micronutrients, beverages, and fruits and vegetables and physical activity were the main outcome measures. The association of type of breakfast (cereal breakfast vs breakfast without cereal) with the outcomes of interest was estimated using regression techniques. The major findings were (1) cereal consumed at breakfast provided more fiber, iron, folic acid, and zinc and less fat, sodium, sugar, and cholesterol, compared with the nutrients in foods eaten during noncereal breakfasts. The cereal consumed provided less protein, carbohydrates, and calcium, compared to foods consumed during noncereal breakfasts; (2) eating cereal for breakfast appeared to facilitate milk consumption (leading to increased calcium intake) and to displace fats/sweets, quick breads, soda, and meat/eggs as breakfast foods. Eating cereal at breakfast was associated with increased consumption of fiber and carbohydrates and decreased consumption of fats throughout the day; and (3) greater physical activity was also associated with cereal breakfast. In conclusion, cereal consumption as part of a healthy lifestyle may play a role in maintaining adequate nutrient intake and physical activity among girls.

Whole grain consumption and body mass index in adult women: an analysis of NHANES 1999-2000 and the USDA pyramid servings database.

OBJECTIVE: To examine the relationship between whole grain consumption and body mass index (BMI) in a sample of American adult women. METHODS: Dietary intake data from the National Health and Nutrition Examination Survey 1999-2000 were linked to the USDA Pyramid Servings Database. Women 19 years of age and older (n = 2,092) were classified into groups based on their average whole grain (WG) intake: 0 servings, more than 0 but less than 1 serving, and > or =1 servings per day. Within these classifications, mean BMI, mean waist circumference and percent overweight/obese (BMI > or = 25) were identified as primary dependent variables. Regression and logistic regression analyses were used to assess associations between BMI, waist circumference and percent of the population overweight/obese (BMI > or =25) and WG consumption. RESULTS: Women consuming at least one serving of WG had a significantly lower mean BMI and waist circumference than women with no WG consumption (p < 0.05). Multiple regression analysis showed a significant inverse relationship between BMI and whole grain intake after adjustment for age, energy intake, dietary fiber and alcohol intake (p = 0.004). This effect was mildly attenuated but remained significant after further adjustment for level of physical activity, smoking status, ethnicity and education (p = 0.018). The odds ratio for having a BMI > or = 25 was 1.47 (95% CI 1.12-1.94; p for trend 0.013) for women consuming no WG compared to those consuming at least one serving, after adjustment for all covariates. CONCLUSIONS: These data support other research suggesting increased WG intake may contribute to a healthy body weight in adult women.

Longitudinal patterns of breakfast eating in black and white adolescent girls.

OBJECTIVE: The objective was to describe the pattern of breakfast eating over time ("breakfast history") and examine its associations with BMI and physical activity. RESEARCH METHODS AND PROCEDURES: This longitudinal investigation of patterns of breakfast eating included 1,210 black and 1,161 white girls who participated in the 10-year, longitudinal National Heart, Lung, and Blood Institute Growth and Health Study (NGHS). Three-day food records were collected during annual visits beginning at ages 9 or 10 up to age 19. Linear regression and path analysis were used to estimate the associations between breakfast history, BMI, and physical activity. RESULTS: Among girls with a high BMI at baseline, those who ate breakfast more often had lower BMI at the end of the study (age 19), compared with those who ate breakfast less often. Path analysis indicated that energy intake and physical activity mediated the association between patterns of breakfast eating over time and BMI in late adolescence. DISCUSSION: The association between regular breakfast consumption over time and moderation of body weight among girls who began the study with relatively high BMI suggests that programs to address overweight in children and adolescents should emphasize the importance of physical activity and eating breakfast consistently.

The relationship of breakfast and cereal consumption to nutrient intake and body mass index: the National Heart, Lung, and Blood Institute Growth and Health Study.

OBJECTIVE: To describe changes in breakfast and cereal consumption of girls between ages 9 and 19 years, and to examine the association of breakfast and cereal intake with body mass index (BMI) and consumption of nutrients. DESIGN: Data from the National Heart, Lung, and Blood Institute Growth and Health Study, a longitudinal biracial observational cohort study with annual 3-day food records. SUBJECTS/SETTING: The National Heart, Lung, and Blood Institute Growth and Health Study recruited 2,379 girls (1,166 white and 1,213 black), ages 9 and 10 years at baseline, from locations in the Berkeley, CA; Cincinnati, OH; and Washington, DC, areas. MAIN OUTCOME MEASURES: Frequency of consumption of breakfast (including cereal vs other foods) and cereal; BMI; and dietary fat, fiber, calcium, cholesterol, iron, folic acid, vitamin C, and zinc. STATISTICAL ANALYSES: Generalized estimating equations methodology was used to examine differences in the frequency of breakfast and cereal eating by age. Generalized estimating equations and mixed models were used to examine whether breakfast and cereal consumption were predictive of BMI and nutrient intakes, adjusting for potentially confounding variables. RESULTS: Frequency of breakfast and cereal consumption decreased with age. Days eating breakfast were associated with higher calcium and fiber intake in all models, regardless of adjustment variables. After adjusting for energy intake, cereal consumption was related to increased intake of fiber, calcium, iron, folic acid, vitamin C, and zinc, and decreased intake of fat and cholesterol. Days eating cereal was predictive of lower BMI. CONCLUSIONS: Cereal consumption as part of an overall healthful lifestyle may play a role in maintaining a healthful BMI and adequate nutrient intake among adolescent girls.

Ready-to-eat cereal consumption: its relationship with BMI and nutrient intake of children aged 4 to 12 years.

OBJECTIVE: To examine the relationship between ready-to-eat cereal consumption habits and body mass index of a sample of children aged 4 to 12 years. DESIGN: Fourteen-day self-reported food diary records were obtained from a sample of 2,000 American households from February 1998 through February 1999. Height and weight of the family members were also self-reported. SUBJECTS/SETTING: The sample population of 603 children, aged 4 to 12 years, was broken into tertiles based on cereal consumption over the 14 days: (three or fewer, four to seven, or eight or more servings). STATISTICAL ANALYSIS: Logistic regression and analysis of variance were used to determine associations between frequency of ready-to-eat cereal consumption and body mass index or nutrient intakes. RESULTS: More than 90% of children aged 4 to 12 years consumed ready-to-eat cereal at least once in the two-week collection period. Within tertiles of consumption, children in the upper tertile had lower mean body mass indexes than those in the lowest tertile consistently across all age groups (P<.01). Additionally, the proportion of children aged 4 to 12 years who were at risk for overweight/overweight was significantly lower in the upper tertile of cereal consumption (P<.05). Children in the upper tertile also had lower fat intakes and higher intakes of many micronutrients. APPLICATIONS: The consumption of ready-to-eat cereals at breakfast should be encouraged as a component of an eating pattern that promotes the maintenance of healthful body weights and nutrient intakes in children.

Nutrition Monitoring Application in the Food Industry.

Nutrition scientists in the food industry use nutrition monitoring data in a variety of ways that include developing nutrition communications for consumers and health professionals, guiding product development and reformulation, and applying research applications. Continuous nutrition monitoring is essential to influence positively the nutrient content of the food supply and meet the changing nutrition needs of the population. This article reviews food industry application of nutrient intake information and provides specific examples of use.