Temporal changes in micronutrient intake among United States Adults, NHANES 2003 through 2018: A cross-sectional study.

BACKGROUND: Changes in the United States food supply and food choices make examination of temporal changes in micronutrient intake and their effect on meeting nutrient recommendations necessary. OBJECTIVES: This study aimed to examine 15-year trends of the contribution of foods and beverages (FB) and dietary supplements (DSs) to meeting nutrient recommendations among United States adults aged 19 y or older and compare usual mean intake distributions of FB alone with those of FB+DSs with dietary reference intakes [percentage below the estimated average requirement (%AI)]. METHODS: This cross-sectional study used food, beverage, and DSs intake data from NHANES 2003-2018 (N = 39,925) to determine usual mean intakes for 21 micronutrients. Changes in intakes from FB and from FB+DSs, by sex, were compared in a time-trend analysis of 2-y cycles. Changes in mean intake as %AI were determined. RESULTS: Over the time studied, United States adults underconsumed vitamins A, C, D, E, and K; calcium; potassium; magnesium; and choline, even when DSs intake was included. Sodium was overconsumed. In males, there were significant increases in %

Mycoprotein: The Future of Nutritious Nonmeat Protein, a Symposium Review.

Mycoprotein is an alternative, nutritious protein source with a meat-like texture made from Fusarium venenatum, a naturally occurring fungus. Its unique method of production yields a significantly reduced carbon and water footprint relative to beef and chicken. Mycoprotein, sold as Quorn, is consumed in 17 countries, including the United States. In line with current dietary guidelines, mycoprotein is high in protein and fiber, and low in fat, cholesterol, sodium, and sugar. Mycoprotein may help maintain healthy blood cholesterol levels, promote muscle synthesis, control glucose and insulin levels, and increase satiety. It is possible that some susceptible consumers will become sensitized, and subsequently develop a specific allergy. However, a systematic evidence review indicates that incidence of allergic reactions remains exceptionally low. Mycoprotein's nutritional, health, and environmental benefits affirms its role in a healthful diet. Future research that focuses on the long-term clinical benefits of consuming a diet containing mycoprotein is warranted.

Canned Vegetable and Fruit Consumption Is Associated with Changes in Nutrient Intake and Higher Diet Quality in Children and Adults: National Health and Nutrition Examination Survey 2001-2010.

BACKGROUND: Canned vegetables and fruit (CV+CF) are ubiquitous throughout the food supply. Yet information regarding their specific contribution to nutrient intake and health measures is lacking. OBJECTIVE: The objective of this study was to examine the association of CV+CF with nutrient intake, diet quality, anthropometric indicators of overweight/obesity, and blood pressure in a nationally representative population. DESIGN AND PARTICIPANTS: A secondary analysis of cross-sectional data from 17,344 children and 24,807 adults in the National Health and Nutrition Examination Survey 2001-2010 was conducted. A dataset was developed that distinguished CV+CF consumers from nonconsumers. MAIN OUTCOME MEASURES: Diet quality was calculated using the Healthy Eating Index 2010. STATISTICAL ANALYSES: Regression analysis determined differences between groups. RESULTS: About 11% of the population consumed CV+CF on a given day. Compared with nonconsumers, child (n=2,066) and adult (n=2,746) CV+CF consumers ate more energy, and energy adjusted dietary fiber, total sugar, choline, and potassium, and less fat and saturated fat. Child consumers also ate more energy adjusted protein, vitamin A, calcium, and magnesium. Child and adult consumers and nonconsumers had comparable energy adjusted sodium and added sugar intakes. Compared with nonconsumers, the total Healthy Eating Index 2010 score was higher (P<0.001) in child (45.8±0.5 vs 43.3±0.3) and adult (49.0±0.4 vs 47.4±0.3) consumers. Covariate adjusted body weight, body mass index, waist circumference, and blood pressure were comparable in both of the child and adult groups. CONCLUSIONS: Results suggest CV+CF consumption was associated with higher intake of select nutrients, a higher-quality diet, and comparable adiposity measures and blood pressure.

Nutritional translation blended with food science: 21st century applications.

This paper, based on the symposium "Real-World Nutritional Translation Blended With Food Science," describes how an integrated "farm-to-cell" approach would create the framework necessary to address pressing public health issues. The paper describes current research that examines chemical reactions that may influence food flavor (and ultimately food consumption) and posits how these reactions can be used in health promotion; it explains how mechanical engineering and computer modeling can study digestive processes and provide better understanding of how physical properties of food influence nutrient bioavailability and posits how this research can also be used in the fight against obesity and diabetes; and it illustrates how an interdisciplinary scientific collaboration led to the development of a novel functional food that may be used clinically in the prevention and treatment of prostate cancer.

Is "processed" a four-letter word? The role of processed foods in achieving dietary guidelines and nutrient recommendations.

This paper, based on the symposium "Is 'Processed' a Four-Letter Word? The Role of Processed Foods in Achieving Dietary Guidelines and Nutrient Recommendations in the U.S." describes ongoing efforts and challenges at the nutrition-food science interface and public health; addresses misinformation about processed foods by showing that processed fruits and vegetables made important dietary contributions (e.g., fiber, folate, potassium, vitamins A and C) to nutrient intake among NHANES 2003-2006 participants, that major sources of vitamins (except vitamin K) were provided by enrichment and fortification and that enrichment and fortification helped decrease the percentage of the population below the Estimated Average Requirement for vitamin A, thiamin, folate, and iron; describes how negative consumer perceptions and consumer confusion about processed foods led to the development of science-based information on food processing and technology that aligns with health objectives; and examines challenges and opportunities faced by food scientists who must balance consumer preferences, federal regulations, and issues surrounding food safety, cost, unintended consequences, and sustainability when developing healthful foods that align with dietary guidelines.

White potatoes, including french fries, contribute shortfall nutrients to children's and adolescents' diets.

To test the hypothesis that white potatoes (WP), oven-baked fries (OBF), and french fries (FF) contribute important nutrients within energy needs to children's and adolescents' diets, secondary analysis of 24-hour dietary recall data from the National Health and Nutrition Examination Survey 2003-2006 was conducted. Potato content of survey foods was determined using US Department of Agriculture recipe databases (Standard Reference (SR)-Link files). Nutrient content of potatoes was determined by linking SR codes to US Department of Agriculture food composition data. Daily nutrient intakes from potatoes were determined by applying the composition database to respondent's recall data. Sample-weighted data were analyzed; t tests assessed differences between age and sex groups. Results indicated that approximately 35% of children and adolescents consumed WP + FF + OBF; 18% consumed FF. Intakes were lower in children compared with adolescents (P < .01). Among adolescents, more boys than girls consumed FF (P < .05); boys ate larger amounts of WP + FF + OBF (134 g/d) and FF (100 g/d) (P < .01). Both WP + FF + OBF and FF provided 9% to 12% of total daily energy (but was within energy requirements in the highest consumers); 8% to 15% of daily fat (>75% monounsaturated fatty acids + polyunsaturated fatty acids); ≥ 10% dietary fiber, vitamin B(6), and potassium; 5% or greater thiamin, niacin, vitamin K, phosphorus, magnesium, and copper; and less than 5% sodium intake, for all sex -age groups. The combination WP + FF + OBF provided 5% or greater vitamin C for all sex-age groups and 5% or greater vitamin E and iron for most groups; FF provided 5% or greater vitamin E intakes for all. These cross-sectional data show that WP, including FF, provided shortfall nutrients within energy requirements to children and adolescents and, when consumed in moderate amounts, can be part of healthful diets.

Point-of-purchase nutrition information influences food-purchasing behaviors of college students: a pilot study.

The goal of point-of-purchase (POP) nutrition information is to help consumers make informed, healthful choices. Despite limited evaluation, these population-based approaches are being advocated to replace traditional, more expensive, individual behavior-change strategies. Few studies have examined the effect of POP information on buying patterns of college students, a group with high obesity rates and poor eating habits. This quasi-experimental pilot project sought to determine whether the "Eat Smart" POP program affected food-purchasing habits of multiethnic college students shopping at an on-campus convenience store. Baseline sales data of foods in the cereal, soup, cracker, and bread categories were collected for 6 weeks during Fall 2008. After Winter break, a few food items within each of these food categories were labeled as healthful using a "Fuel Your Life" shelf tag, and sales data were then collected for 5 weeks. In each of the four food categories, nontagged foods were available at the identical price as tagged items. Following intervention, there were increased sales of tagged items (measured as a percentage of total sales) in the cereal, soup, and cracker categories, while sales of bread decreased. Although none of these changes were statistically significant, the intervention resulted in a 3.6%±1.6% (P=0.082) increase in the percentage of sales from tagged items. Thus, providing POP nutrition information in a college campus convenience store may promote healthful food choices. A longer study examining the effect of POP on sales of items in other food categories is warranted.

Obesity and Food Choices Among Faculty and Staff at a Large Urban University.

OBJECTIVE: in order to address increasing health care costs associated with obesity, this study sought to determine prevalence of overweight and obesity and examine eating behaviors, food choices, health beliefs, and attitudes of university employees. PARTICIPANTS AND METHODS: an online survey was distributed to > 3,800 faculty and staff at a large public metropolitan university in Winter 2008. RESULTS: almost half (48%) of 806 respondents were classified as overweight or obese. Compared to those with normal weights, overweight and obese respondents consumed fewer fruits and vegetables (p < .05), were less confident in making healthful food choices (p < .001), and were more influenced by food choices available in on-campus dining facilities (p < .05). CONCLUSIONS: obesity among university employees warrants attention. Because these employees have less self-efficacy and consume less healthful diets than their normal weight colleagues, universities need to improve on-campus access to healthful foods.

Point-of-purchase nutrition information influences food-purchasing behaviors of college students: a pilot study.

The goal of point-of-purchase (POP) nutrition information is to help consumers make informed, healthful choices. Despite limited evaluation, these population-based approaches are being advocated to replace traditional, more expensive, individual behavior-change strategies. Few studies have examined the effect of POP information on buying patterns of college students, a group with high obesity rates and poor eating habits. This quasi-experimental pilot project sought to determine whether the "Eat Smart" POP program affected food-purchasing habits of multiethnic college students shopping at an on-campus convenience store. Baseline sales data of foods in the cereal, soup, cracker, and bread categories were collected for 6 weeks during Fall 2008. After Winter break, a few food items within each of these food categories were labeled as healthful using a "Fuel Your Life" shelf tag, and sales data were then collected for 5 weeks. In each of the four food categories, nontagged foods were available at the identical price as tagged items. Following intervention, there were increased sales of tagged items (measured as a percentage of total sales) in the cereal, soup, and cracker categories, while sales of bread decreased. Although none of these changes were statistically significant, the intervention resulted in a 3.6%+/-1.6% (P=0.082) increase in the percentage of sales from tagged items. Thus, providing POP nutrition information in a college campus convenience store may promote healthful food choices. A longer study examining the effect of POP on sales of items in other food categories is warranted.

Gender, residence and ethnicity affect freshman BMI and dietary habits.

OBJECTIVES: To examine relationships between gender, ethnicity, and residency, with factors influencing weight gain in 756 multiethnic college freshmen. METHODS: An online survey obtained participants' height and weight; consumption of fruits, vegetables, dairy, and meals; dieting and exercise patterns. RESULTS: Ten percent of Asians were underweight; most lived off campus. Forty percent of Hispanics were overweight/obese; most lived on campus. After starting college, on-campus students decreased intake of fruits, vegetables, dairy products, and meal frequency; off-campus students decreased dairy and dinner frequency (P < 0.001). Few met dietary guidelines. CONCLUSIONS: Moving to campus may contribute to weight gain in some ethnic groups.

Development, evaluation, and validation of environmental assessment tools to evaluate the college nutrition environment.

OBJECTIVE: To develop, evaluate, and validate 2 nutrition environment assessment tools (surveys), for specific use in combating overweight on college/university campuses. PARTICIPANTS AND METHODS: Invitations to complete surveys were e-mailed to food service and health center directors at 47 universities, Winter 2008. Overall response rate was 48%. Responses from the 39 individuals who completed tool evaluations at the end of each survey were analyzed. Follow-up interviews and site visits performed through Summer 2008 validated responses. RESULTS: The majority of respondents (64%) indicated tools were effective at assessing their nutrition environments; 78% believed these types of assessment tools to be important to their school. CONCLUSION: Food service and health center directors support use of nutrition environment assessment tools and found them effective at clarifying existing nutrition programs, policies, and food offerings on their campuses. Conducting assessments using these tools could improve university nutrition environments by identifying areas needing improvement.

Impact of after-school nutrition workshops in a public library setting.

OBJECTIVE: To determine if after-school nutrition workshops conducted in public libraries were related to lasting changes in food choice. METHODS: "Snack Smart" workshops, based on Social Cognitive Theory, were conducted in 8 branch libraries (49 ethnically diverse children, ages 9 to 14) to assess changes in consumption of targeted food items by pretest, posttest, and follow-up food frequency questionnaires. Results were analyzed using the Friedman test for repeated measures and Wilcoxon signed rank test. RESULTS: Intake of milk, vegetables, and water significantly increased at 3-week posttest (P < .05), but only water intake showed a significant change from pretest to follow-up 3 months later. CONCLUSIONS AND IMPLICATIONS: This low-intensity program did not produce lasting behavior change, as measured by changes in food frequency at 3 months post- intervention. The study supports the need to critically evaluate out-of-school nutrition programs for lasting impact.

Early childhood feeding: assessing knowledge, attitude, and practices of multi-ethnic child-care providers.

Early childhood is a critical period for shaping and influencing feeding and lifestyle behaviors that have implications for future weight and health. With more women in the workforce, families have become reliant on child care. Thus, the child-feeding relationship has become a shared responsibility between the parent and child-care provider. Little is known about the impact of child-care providers on development of early childhood feeding behaviors and subsequent risk for obesity, especially in the Hispanic ethnic group. This research examined child-feeding attitudes, practices, and knowledge of multi-ethnic home-based and center-based child-care providers. Questionnaires were completed by a convenience sample of 72 providers, 50 of whom completed a pre- and post-test on child-feeding knowledge after receiving a 90-minute class based on Satter's division of responsibility feeding model during the spring of 2008. Results indicate many providers had practices consistent with this model. However, substantial differences were reported by Hispanic providers, who were statistically more likely to encourage children to finish meals before dessert, prepare foods they perceived as well-liked by children, coach children to eat foods perceived as appropriate, and not eat with children during meals. A substantial increase in knowledge from 73% correct at pretest to 82% at post-test was noted, with a substantial increase in knowledge on five of 13 questions. However, knowledge was not always congruent with behavior. This study points to differences among providers based on ethnicity, and strongly recommends recruiting Hispanic child-care providers to participate in educational programs and community efforts to prevent obesity.

Reducing portion size reduces food intake and plate waste.

As portion size (PS) increases, so does food intake. The effect of decreasing PS on food intake in a nonlaboratory setting is unknown. This 5-week study sought to determine whether decreasing PS resulted in decreased intake of the same food, and if so, at what point further PS reductions might lack benefit. It also assessed effects of PS reduction on food production and waste in a university all-you-can-eat dining facility (DF). Subjects were primarily freshmen who regularly ate lunch at the DF, and self-selected French fries (FF) presented in individual paper bags, portioned originally at 88 g, and decreased approximately 15 g/week for 3 weeks. Diners were covertly observed choosing one or more bags. Total FF production and plate waste (PW) were determined daily. Decreasing PS resulted in significant decreases in consumption per diner (P < 0.05) and PW (P < 0.05), and nonsignificant decreases in total FF consumption and production. PS was positively correlated with consumption per diner (r = 0.897, P = 0.001) and PW (r = 0.852, P = 0.001), but inversely correlated with number of diners choosing >or=2 bags (r = -0.809, P = 0.003). Total FF production was positively correlated with PW (r = 0.728, P = 0.011). This study shows that reducing PS of a particular item in an all-you-can-eat environment results in reduced intake of that food for most individuals, and that reducing PS reduces PW and food production.

The role of optimal healing environments in the management of childhood obesity.

The prevalence of childhood and adolescent obesity has increased steadily over the past three decades such that obesity is now a major worldwide pediatric health risk factor. Pediatric obesity is associated with significant health problems, and is an important early risk factor for adult morbidity and mortality. This paper focuses on the role and components of optimal healing environments (OHEs) that may be useful in the management of childhood obesity: healing intention, healing relationships, health promotion and disease prevention, and healing spaces. Diet, physical activity, and behavior modification strategies used in the treatment of childhood obesity are also reviewed.