Okemos, MI, United States
Okemos, MI, United States

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Fulgoni V.L.,Nutrition Impact LLC | Keast D.R.,Food and Nutrition Database Research Inc. | Bailey R.L.,Office of Dietary Supplements | Dwyer J.,Tufts University
Journal of Nutrition | Year: 2011

Limited data are available on the source of usual nutrient intakes in the United States. This analysis aimed to assess contributions of micronutrients to usual intakes derived from all sources (naturally occurring, fortified and enriched, and dietary supplements) and to compare usual intakes to the Dietary Reference Intake for U.S. residents aged $2 y according to NHANES 2003-2006 (n = 16,110). We used the National Cancer Institute method to assess usual intakes of 19 micronutrients by source. Only a small percentage of the population had total usual intakes (from dietary intakes and supplements) below the estimated average requirement (EAR) for the following: vitamin B-6 (8%), folate (8%), zinc (8%), thiamin, riboflavin, niacin, vitamin B-12, phosphorus, iron, copper, and selenium (,6% for all). However, more of the population had total usual intakes below the EAR for vitamins A, C, D, and E (34, 25, 70, and 60%, respectively), calcium (38%), and magnesium (45%). Only 3 and 35% had total usual intakes of potassium and vitamin K, respectively, greater than the adequate intake. Enrichment and/or fortification largely contributed to intakes of vitamins A, C, and D, thiamin, iron, and folate. Dietary supplements further reduced the percentage of the population consuming less than the EAR for all nutrients. The percentage of the population with total intakes greater than the tolerable upper intake level (UL) was very low for most nutrients, whereas 10.3 and 8.4% of the population had intakes greater than the UL for niacin and zinc, respectively. Without enrichment and/or fortification and supplementation, many Americans did not achieve the recommended micronutrient intake levels set forth in the Dietary Reference Intake. © 2011 American Society for Nutrition.


Bailey R.L.,Office of Dietary Supplements | Fulgoni V.L.,Nutrition Impact LLC | Keast D.R.,Food and Nutrition Database Research Inc. | Dwyer J.T.,U.S. National Institutes of Health
Journal of the Academy of Nutrition and Dietetics | Year: 2012

Background: More than half of US adults use dietary supplements. Some reports suggest that supplement users have higher vitamin intakes from foods than nonusers, but this observation has not been examined using nationally representative survey data. Objective: The purpose of this analysis was to examine vitamin intakes from foods by supplement use and how dietary supplements contribute to meeting or exceeding the Dietary Reference Intakes for selected vitamins using data from the National Health and Nutrition Examination Survey among adults (aged ≥19 years) in 2003-2006 (n=8,860). Results: Among male users, mean intakes of folate and vitamins A, E, and K from food sources were significantly higher than among nonusers. Among women, mean intakes of folate and vitamins A, C, D, and E from foods were higher among users than nonusers. Total intakes (food and supplements) were higher for every vitamin we examined among users than the dietary vitamin intakes of nonusers. Supplement use helped lower the prevalence of intakes below the Estimated Average Requirement for every vitamin we examined, but for folic acid and vitamins A, B-6, and C, supplement use increased the likelihood of intakes above the Tolerable Upper Intake Level. Conclusions: Supplement use was associated with higher mean intakes of some vitamins from foods among users than nonusers, but it was not associated with the prevalence of intakes less than the Estimated Average Requirement from foods. Those who do not use vitamin supplements had significantly higher prevalence of inadequate vitamin intakes; however, the use of supplements can contribute to excess intake for some vitamins. © 2012 Academy of Nutrition and Dietetics.


O'Neil C.E.,Louisiana State University | Keast D.R.,Food and Nutrition Database Research Inc. | Nicklas T.A.,Baylor College of Medicine | Fulgoni III V.L.,Nutrition Impact LLC
Journal of the American College of Nutrition | Year: 2011

Background: Few recent epidemiologic studies have assessed the effect that nut consumption (including tree nuts and peanuts) has on health risks, including metabolic syndrome (MetS). Objective: This study compared the health risk for cardiovascular disease, type 2 diabetes, and MetS of nut consumers with that of nonconsumers. Design: Adults 19{thorn} years (n = 13,292) participating in the 1999-2004 National Health and Nutrition Examination Survey were used. Intake from 24-hour recalls was used to determine intake. Nut/tree nut consumers consumed ≥≥1/2 ounce per day. Covariate-adjusted means, standard errors, and prevalence rates were determined for the nut consumption groups. Results: The prevalence of nut consumers was 18.6% ± 0.7% and 21.0% ± 0.9% in those 19-50 years and 51 years and older, respectively. Nut consumption was associated with a decreased body mass index (27.7 kg/m2 ± 0.2 vs 28.1 ± 0.1 kg/m2, p <0.05), waist circumference (95.6 ± 0.4 cm vs 96.4 ± 0.3 cm, p <0.05), and systolic blood pressure (121.9 ± 0.4 mmHg vs 123.20 ± 0.3 mmHg, p <0.01) compared with nonconsumers. Tree nut consumers also had a lower weight (78.8 ± 0.7 kg vs 80.7 ± 0.3 kg, p <0.05). Nut consumers had a lower percentage of two risk factors for MetS: hypertension (31.5% ± 1.0% vs 34.2% ± 0.8%, p <0.05) and low high density lipoprotein-cholesterol (HDL-C) (29.6% ± 1.0% vs 34.8% ± 0.8%, p <0.01). Tree nut consumers had a lower prevalence of four risk factors for MetS: abdominal obesity (43.6% ± 1.6% vs 49.5% ± 0.8%, p <0.05), hypertension (31.4% ± 1.2% vs 33.9% ± 0.8%, p <0.05), low HDL-C (27.9% ± 1.7% vs 34.5% ± 0.8%, p <0.01), high fasting glucose (11.4% ± 1.4% vs 15.0% ± 0.7%, p <0.05), and a lower prevalence of MetS (21.2% ± 2.1% vs 26.6% ± 0.7%, p < 0.05). Conclusion: Nut/tree nut consumption was associated with a decreased prevalence of selected risk factors for cardiovascular disease, type 2 diabetes, and MetS.


Keast D.R.,Food and Nutrition Database Research Inc. | Nicklas T.A.,Baylor College of Medicine | O'Neil C.E.,Louisiana State University
American Journal of Clinical Nutrition | Year: 2010

Background: Snacking is common in adolescents; however, it is unclear if there is an association between snacking and overweight or obesity within the context of the overall diet. Objective: This study examined the associations of snacking with weight status and abdominal obesity in adolescents 12-18 y of age (n = 5811). Design: We conducted secondary analyses of 24-h diet recalls and anthropometric data from the National Health and Nutrition Examination Survey (NHANES) 1999-2004. We classified adolescents by frequency of snack consumption (0, 1, 2, 3, and ≥4 snacks/d) and by the percentage of energy intake from snacks (0%, <10%, 10-19%, 20-29%, 30-39%, and ≥40%). We classified adolescents who had a body mass index (BMI) ≥85th percentile of BMI-for-age as overweight or obese. We defined abdominal obesity as a waist circumference ≥90th percentile. We determined covariate-adjusted prevalences of overweight or obesity and abdominal obesity and odds ratios with SUDAAN software (release 9.0.1; Research Triangle Institute, Research Triangle Park, NC). Results: Mean values of all obesity indicators studied were inversely associated with snacking frequency and percentage of energy from snacks. The prevalence of overweight or obesity and of abdominal obesity decreased with increased snacking frequency and with increased percentage of energy from snacks. Odds ratios (95% CIs) for overweight or obesity and for abdominal obesity ranged from 0.63 (0.48, 0.85) to 0.40 (0.29, 0.57) and from 0.61 (0.43, 0.86) to 0.36 (0.21, 0.63) for 2 to ≥4 snacks/d, respectively. Reduced risks of overweight or obesity and abdominal obesity were associated with snacking. Conclusion: Snackers, compared with nonsnackers, were less likely to be overweight or obese and less likely to have abdominal obesity. © 2010 American Society for Nutrition.


Keast D.R.,Food and Nutrition Database Research Inc. | O'Neil C.E.,Louisiana State University | Jones J.M.,St. Catherine University of Saint Paul
Nutrition Research | Year: 2011

Epidemiological studies examining potential associations between dried fruit consumption, diet quality, and weight status are lacking. The goal of this study was to examine the association of dried fruit consumption with nutrient intake, diet quality, and anthropometric indicators of overweight/obesity. A secondary analysis of dietary and anthropometric data collected from adult (19+ years) participants (n = 13 292) of the 1999-2004 National Health and Nutrition Examination Survey was conducted. Dried fruit consumers were defined as those consuming amounts 1/8 cup-equivalent fruit per day or more and identified using 24-hour recalls. Diet quality was measured using the Healthy Eating Index 2005. Covariate-adjusted means, SEs, prevalence rates, and odds ratios were determined to conduct statistical tests for differences between dried fruit consumers and nonconsumers. Seven percent of the population consumed dried fruit. Mean differences (P < .01) between consumers and nonconsumers in adult shortfall nutrients were dietary fiber (+6.6 g/d); vitamins A (+173 μg retinol activity equivalent per day), E (+1.5 mg α-tocopherol per day), C (+20 mg/d), and K (+20 mg/d); calcium (+103 mg/d); phosphorus (+126 mg/d); magnesium (+72 mg/d); and potassium (+432 mg/d). Dried fruit consumers had improved MyPyramid food intake, including lower solid fats/alcohol/added sugars intake, and a higher solid fats/alcohol/added sugars score (11.1 ± 0.2 vs 8.2 ± 0.1) than nonconsumers. The total Healthy Eating Index 2005 score was significantly higher (P < .01) in consumers (59.3 ± 0.5) than nonconsumers (49.4 ± 0.3). Covariate-adjusted weight (78.2 ± 0.6 vs 80.7 ± 0.3 kg), body mass index (27.1 ± 0.2 vs 28.1 ± 0.2), and waist circumference (94.0 ± 0.5 vs 96.5 ± 0.2 cm) were lower (P < .01) in consumers than nonconsumers, respectively. Dried fruit consumption was associated with improved nutrient intakes, a higher overall diet quality score, and lower body weight/adiposity measures. © 2011 Elsevier Inc.


O'Neil C.E.,Louisiana State University | Keast D.R.,Food and Nutrition Database Research Inc. | Fulgoni III V.L.,Nutrition Impact LLC | Nicklas T.A.,Baylor College of Medicine
Nutrients | Year: 2012

Identification of current food sources of energy and nutrients among US adults is needed to help with public health efforts to implement feasible and appropriate dietary recommendations. To determine the food sources of energy and 26 nutrients consumed by US adults the 2003-2006 National Health and Nutrition Examination Survey (NHANES) 24-h recall (Day 1) dietary intake data from a nationally representative sample of adults 19+ years of age (y) (n = 9490) were analyzed. An updated USDA Dietary Source Nutrient Database was developed for NHANES 2003-2006 using current food composition databases. Food grouping included ingredients from disaggregated mixtures. Mean energy and nutrient intakes from food sources were sample-weighted. Percentages of total dietary intake contributed from food sources were ranked. The highest ranked sources of energy and nutrients among adults more than 19 years old were: energy-yeast bread/rolls (7.2%) and cake/cookies/quick bread/pastry/pie (7.2%); protein-poultry (14.4%) and beef (14.0%); total fat-other fats and oils (9.8%); saturated fatty acids-cheese (16.5%) and beef (9.1%); carbohydrate-soft drinks/soda (11.4%) and yeast breads/rolls (10.9%); dietary fiber-yeast breads/rolls (10.9%) and fruit (10.2%); calcium-milk (22.5%) and cheese (21.6%); vitamin D-milk (45.1%) and fish/shellfish (14.4%); and potassium-milk (9.6%) and coffee/tea/other non-alcoholic beverages (8.4%). Knowledge of primary food sources of energy and nutrients can help health professionals design effective strategies to reduce excess energy consumed by US adults and increase the nutrient adequacy of their diets. © 2012 by the authors; licensee MDPI, Basel, Switzerland.


Fulgoni V.L.,Nutrition Impact LLC | Fulgoni V.L.,Oak Ridge Institute for Science and Education | Keast D.R.,Oak Ridge Institute for Science and Education | Keast D.R.,Food and Nutrition Database Research Inc. | Lieberman H.R.,U.S. Army
American Journal of Clinical Nutrition | Year: 2015

Background: Coffee and tea are traditional sources of caffeine in the diet, but other sources, such as energy drinks, are now available. Because risks and benefits of caffeine use are dose dependent, the public health consequences of caffeine consumption cannot be determined without data on amounts currently consumed by the US population. Objective: The objective was to obtain an up-to-date, nationally representative estimate of caffeine consumption in adults. Design: Dietary intake data from NHANES from 2001 to 2010 for adults ≥19 y of age were used (n = 24,808). Acute and usual intake of caffeine was estimated from all caffeine-containing foods and beverages. Trends in consumption and changes in sources of caffeine were also examined. Results: Eighty-nine percent of the adult US population consumed caffeine, with equal prevalence in men and women. Usual mean ± SE per capita caffeine consumption when nonusers were included was 186 ± 4 mg/d, with men consuming more than women (211 ± 5 vs. 161 ± 3 mg/d, P < 0.05). Usual intake in consumers was 211 ± 3 mg/d, with 240 ± 4 mg/d in men and 183 ± 3 mg/d in women (P<0.05); 46% was consumed in a single consumption event. In consumers, acute 90th and 99th percentiles of intake were 436 and 1066 mg/d, respectively. Consumption was highest in men aged 31-50 y and lowest in women aged 19-30 y. Beverages provided 98% of caffeine consumed, with coffee (~64%), tea (~16%), and soft drinks (~18%) predominant sources; energy drinks provided <1%, but their consumption increased substantially from 2001 to 2010. Conclusions: Although new caffeine-containing products were introduced into the US food supply, total per capita intake was stable over the period examined. © 2015 American Society for Nutrition.


Berner L.A.,California Polytechnic State University, San Luis Obispo | Keast D.R.,Food and Nutrition Database Research Inc | Bailey R.L.,U.S. National Institutes of Health | Dwyer J.T.,U.S. National Institutes of Health | Dwyer J.T.,Tufts University
Journal of the Academy of Nutrition and Dietetics | Year: 2014

Background: Even in an era of obesity and dietary excess, numerous shortfall micronutrients have been identified in the diets of US children and adolescents. To help tailor strategies for meeting recommendations, it is important to know what foods contribute greatly to micronutrient intakes. Data are lacking on specific contributions made by added nutrients. Objective: Our aims were to examine the impact of fortification on nutrient adequacy and excess among US children and adolescents and to rank food sources of added nutrient intake and compare rankings with those based on total nutrient intake from foods. Design and statistical analyses: Data were from 7,250 respondents 2 to 18 years old in the National Health and Nutrition Examination Survey 2003-2006. Datasets were developed that distinguished nutrient sources: intrinsic nutrients in foods; added nutrients in foods; foods (intrinsic plus added nutrients); and total diet (foods plus supplements). The National Cancer Institute method was used to determine usual intakes of micronutrients by source. The impact of fortification on the percentages of children having intakes less than the Estimated Average Requirement and more than the Upper Tolerable Intake Level was assessed by comparing intakes from intrinsic nutrients to intakes from intrinsic plus added nutrients. Specific food sources of micronutrients were determined as sample-weighted mean intakes of total and added nutrients contributed from 56 food groupings. The percentage of intake from each grouping was determined separately for total and added nutrients. Results: Without added nutrients, a high percentage of all children/adolescents had inadequate intakes of numerous micronutrients, with the greatest inadequacy among older girls. Fortification reduced the percentage less than the Estimated Average Requirement for many, although not all, micronutrients without resulting in excessive intakes. Data demonstrated the powerful influence of fortification on food-source rankings. Conclusions: Knowledge about nutrient intakes and sources can help put dietary advice into a practical context. Continued monitoring of top food sources of nutrients and nutrient contributions from fortification will be important. © 2014 Academy of Nutrition and Dietetics.


Bailey R.L.,U.S. National Institutes of Health | Fulgoni III V.L.,Nutrition Impact LLC | Keast D.R.,Food and Nutrition Database Research Inc. | Dwyer J.T.,Tufts University
American Journal of Clinical Nutrition | Year: 2011

Background: Dietary supplement use is extensive in US adults. Some reports suggested that supplement users had higher nutrient intakes from the diet than did nonusers, but to our knowledge this finding has not been examined in nationally representative survey data. Objective: In this analysis, we examined mineral intakes from the diet by supplement-use categories and how these supplements contributed to meeting or exceeding Dietary Reference Intakes for selected minerals. Design: Data from adults (≥19 y of age; n = 8860) who participated in NHANES 2003-2006, a nationally representative, cross-sectional survey, were examined. Supplement use was defined as the participant's self-reported use of a supplement that contained one or more selected minerals. Results: Dietary intakes of minerals from food sources were higher for magnesium, copper, potassium, and selenium in male supplement users than in nonusers. For women, dietary intakes of minerals from food sources were higher for users than for nonusers for each mineral examined except for selenium. In women, users of calcium-containing dietary supplements were much more likely to meet the Estimated Average Requirement (EAR) than were nonusers. Even after consideration of supplement use, >14% of adults had inadequate intakes for calcium and magnesium on the basis of the percentage of adults with usual intakes less than the EAR. The prevalence of adults who exceeded the tolerable upper intake level (UL) for calcium, zinc, iron, and magnesium was higher in users than in nonusers. Conclusions: Individuals who used mineral-containing dietary supplements had higher mineral intakes from food sources in the diet than did nonusers. For all minerals examined, and particularly for calcium and magnesium in men and women and iron in women, supplement use decreased the prevalence of intake inadequacy for each respective mineral; however, supplements contributed to risk of potentially excessive intakes for calcium, iron, zinc, and magnesium. © 2011 American Society for Nutrition.


Freedman M.R.,San Jose State University | Keast D.R.,Food and Nutrition Database Research Inc.
Nutrition Research | Year: 2011

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. © 2011 Elsevier Inc.

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