Comparing Two Days of Dietary Intake in What We Eat in America (WWEIA), NHANES, 2013-2016.

The objective of this research is to compare the Day 1 and Day 2 dietary intakes of adults in What We Eat in America, National Health and Nutrition Examination Survey (WWEIA, NHANES) 2013-2016. Dietary recalls of males (n = 2599) and females (n = 2624) 20+ years who had both a Day 1 and Day 2 recall and reported their intake as usual on both days in WWEIA, NHANES 2013-2016 were examined. Mean (±SE) energy intake for males was 2425 ± 26 kcal for Day 1 and 2334 ± 32 kcal for Day 2 (p = 0.004). For females, 1832 ± 18 kcal and 1775 ± 26 kcal were reported for Day 1 and 2, respectively (p = 0.020). There were no significant differences between energy intake on Day 1 and Day 2 within males and females by ten-year age groups. Comparing 20 year age groups for males and females by race/ethnicity (non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, and Hispanic) and income (<131%, 131-350%, and >350% of poverty level) also showed no significant differences in energy intake between Day 1 and Day 2. Mean energy intake of adults was not statistically different between the two days of recall by sex, race/ethnicity or income within selected age groups. Overall, the difference in energy intake was less than 4% for both males and females.

Fruit and Vegetable Consumption of US Adults by Level of Variety, What We Eat in America, NHANES 2013-2016.

BACKGROUND: Dietary guidance encourages consuming a variety of fruit and vegetables (FVs), which has been associated with higher FV intake and nutrient adequacy. Dietary intake of adults in the United States has not been described in the context of variety. OBJECTIVES: The objective of this study was to describe FV consumption of adults in the United States by level of FV variety. METHODS: One day of dietary intake data of adults aged ≥20 y (n = 10,064) in What We Eat in America, NHANES 2013-2016 were used. FV variety was the count of foods consumed that contributed to total FV intake. Each FV was counted only once; a mixed dish counted as 1. Variety levels were high (≥5 items, n = 2316); moderate (3-4 items, n = 3423); or low (1-2 items, n = 3746). Differences between each level of variety were compared by t test. RESULTS: Among the low, moderate, and high levels, total FV intakes were 1.4, 2.6, and 4.4 cup equivalents (CE), respectively. CE amounts of FVs consumed were 0.3, 0.6, and 1.4 of vegetables excluding potatoes; 0.2, 0.3, and 0.3 of potatoes; 0.3, 0.6, and 1.2 of fruit; and 0.4, 0.4, and 0.5 from mixed dishes, respectively; percentages of each level reporting intake were 34%, 64%, and 89% for vegetables excluding potatoes; 23%, 34%, and 32% for potatoes; 22%, 49%, and 75% for fruit; and 72%, 71%, and 72% for mixed dishes, respectively. CONCLUSIONS: Those with more variety of FV intake include whole FVs more frequently and in higher amounts. These results support suggestions for encouraging more FVs at snacks and as side dishes and salads at meals to increase total intake.

Estimating Sodium and Potassium Intakes and Their Ratio in the American Diet: Data from the 2011-2012 NHANES.

BACKGROUND: The dietary sodium-to-potassium ratio (Na:K) is shown to be more strongly associated with an increased risk of cardiovascular disease (CVD) and CVD-related mortality than either sodium or potassium intake alone. OBJECTIVE: The aim was to estimate the Na:K in the diet of US adults. METHODS: Among US adults from the 2011-2012 NHANES (≥20 y; 2393 men and 2337 women), the National Cancer Institute method was used to estimate sodium and potassium intakes, Na:K, and the percentage of individuals with Na:K <1.0 utilizing the complex, stratified, multistage probability cluster sampling design. RESULTS: Overall, women had a significantly lower Na:K than men (mean ± SE: 1.32 ± 0.02 compared with 1.45 ± 0.02). Non-Hispanic whites had a significantly lower Na:K than non-Hispanic blacks and non-Hispanic Asians (1.34 ± 0.02 compared with 1.54 ± 0.03 and 1.49 ± 0.04, respectively). Only 12.2% ± 1.5% of US adults had a Na:K < 1.0. The Na:K decreased linearly as age increased. Most adults (90% ± 0.8%) had sodium intakes >2300 mg/d, whereas <3% had potassium intakes >4700 mg/d. Grains and vegetables were among the highest contributors to sodium intakes for adults with Na:K < 1.0, compared with protein foods and grains for those with Na:K ≥ 1.0. Vegetables and milk and dairy products constituted the primary dietary sources of potassium for individuals with Na:K < 1.0, whereas mixed dishes and protein foods contributed the most potassium for individuals with ratios ≥1.0. Individuals with a Na:K < 1.0 were less likely to consume mixed dishes and condiments and were more likely to consume vegetables, milk and dairy products, and fruit than those with a Na:K ≥ 1.0. CONCLUSION: Only about one-tenth of US adults have a Na:K consistent with the WHO guidelines for reduced risk of mortality. Continued efforts to reduce sodium intake in tandem with novel strategies to increase potassium intake are warranted.

The USDA Automated Multiple-Pass Method accurately assesses population sodium intakes.

BACKGROUND: Given current sodium-reduction strategies, accurate and practical methods to monitor sodium intake in the US population are critical. Although the gold standard for estimating sodium intake is the 24-h urine collection, few studies have used this biomarker to evaluate the accuracy of a dietary instrument. OBJECTIVE: Our objective was to compare self-reported dietary intake of sodium with 24-h urinary excretion obtained in the USDA Automated Multiple-Pass Method (AMPM) Validation Study. DESIGN: Subjects were healthy, weight-stable volunteers aged 30-69 y recruited from the Washington, DC, area. Data from 465 subjects who completed at least one 24-h recall and collected a complete 24-h urine sample during the same period were used to assess the validity of sodium intake. Reporting accuracy was calculated as the ratio of reported sodium intake to that estimated from the urinary biomarker (24-h urinary sodium/0.86). Estimations of sodium intake included salt added in cooking but did not include salt added at the table. RESULTS: Overall, the mean (95% CI) reporting accuracy was 0.93 (0.89, 0.97) for men (n = 232) and 0.90 (0.87, 0.94) for women (n = 233). Reporting accuracy was highest for subjects classified as normal weight [body mass index (in kg/m(2)) <25]: 1.06 (1.00, 1.12) for men (n = 84) and 0.99 (0.94, 1.04) for women (n = 115). For women only, reporting accuracy was higher in those aged 50-69 y than in those who were younger. CONCLUSION: Findings from this study suggest that the USDA AMPM is a valid measure for estimating sodium intake in adults at the population or group level.

The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes.

BACKGROUND: The US Department of Agriculture Automated Multiple-Pass Method (AMPM) is used for collecting 24-h dietary recalls in What We Eat In America, the dietary interview component of the National Health and Nutrition Examination Survey. Because the data have important program and policy applications, it is essential that the validity of the method be tested. OBJECTIVE: The accuracy of the AMPM was evaluated by comparing reported energy intake (EI) with total energy expenditure (TEE) by using the doubly labeled water (DLW) technique. DESIGN: The 524 volunteers, aged 30-69 y, included an equal number of men and women recruited from the Washington, DC, area. Each subject was dosed with DLW on the first day of the 2-wk study period; three 24-h recalls were collected during the 2-wk period by using the AMPM. The first recall was conducted in person, and subsequent recalls were over the telephone. RESULTS: Overall, the subjects underreported EI by 11% compared with TEE. Normal-weight subjects [body mass index (in kg/m(2)) < 25] underreported EI by <3%. By using a linear mixed model, 95% CIs were determined for the ratio of EI to TEE. Approximately 78% of men and 74% of women were classified as acceptable energy reporters (within 95% CI of EI:TEE). Both the percentage by which energy was underreported and the percentage of subjects classified as low energy reporters (<95% CI of EI:TEE) were highest for subjects classified as obese (body mass index > 30). CONCLUSIONS: Although the AMPM accurately reported EIs in normal-weight subjects, research is warranted to enhance its accuracy in overweight and obese persons.