Battle Creek, MI, United States
Battle Creek, 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.

Nicklas T.A.,Baylor College of Medicine | O'Neil C.E.,Louisiana State University | Fulgoni Iii V.L.,Nutrition Impact LLC
BMC Public Health | Year: 2014

Background: The relationship of snacking patterns on nutrient intake and cardiovascular risk factors (CVRF) in adults is unknown. The aim of this study was to examine the associations of snacking patterns with nutrient intake, diet quality, and a selection of CVRF in adults participating in the 2001-2008 National Health and Nutrition Examination Survey. Methods. 24-hour dietary recalls were used to determine intake and cluster analysis was used to identify the snacking patterns. Height and weight were obtained and the health indices that were evaluated included diastolic and systolic blood pressure, high density lipoprotein-cholesterol, low density lipoprotein cholesterol, triacylglycerides, blood glucose, and insulin. Results: The sample was participants (n = 18,988) 19+ years (50% males; 11% African-Americans; 72% white, 12% Hispanic-Americans, and 5% other). Cluster analyses generated 12 distinct snacking patterns, explaining 61% of the variance in snacking. Comparisons of snacking patterns were made to the no snack pattern. It was found that miscellaneous snacks constituted the most common snacking pattern (17%) followed by cakes/cookies/pastries (12%) and sweets (9%). Most snacking patterns were associated with higher energy intakes. Snacking patterns cakes/cookies/pastries, vegetables/legumes, crackers/salty snacks, other grains and whole fruit were associated with lower intakes of saturated fatty acids. Added sugars intakes were higher in the cakes/cookies/pastries, sweets, milk desserts, and soft drinks patterns. Five snack patterns (cakes/cookies/pastries, sweets, vegetable/legumes, milk desserts, soft drinks) were associated with lower sodium intakes. Several snack patterns were associated with higher intakes of potassium, calcium, fiber, vitamin A, and magnesium. Five snacking patterns (miscellaneous snacks; vegetables/legumes; crackers/salty snacks; other grains; and whole fruit) were associated with better diet quality scores. Alcohol was associated with a lower body mass index and milk desserts were associated with a lower waist circumference. No snack patterns were associated with other CVRF studied. Conclusions: Overall, several snacking patterns were associated with better diet quality than those consuming no snacks. Yet, the majority of the snacking patterns were not associated with CVRF. Education is needed to improve snacking patterns in terms of nutrients to limit in the diet along with more nutrient-dense foods to be included in snacks. © 2014 Nicklas et al.; licensee BioMed Central Ltd.

Nicklas T.A.,Baylor College of Medicine | O'Neil C.E.,Louisiana State University | Fulgoni III V.L.,Nutrition Impact LLC
Journal of Nutrition | Year: 2012

The goal of the study was to determine if there was an association between diet quality and cardiovascular risk factors (CVRF) in adults. NHANES 2001-2008 data were used to compare diet quality, as determined by using 2005 Healthy Eating Index (HEI-2005) scores, and CVRF in adults aged $19 y (n = 18,988; 51% men, 50% white, 21% African American, 25% Hispanic American, 4% other). HEI-2005 scores were calculated by using one 24-h dietary recall collected from the participants. Weight and adiposity, blood pressure, and CVRF were measured. Regression analyses were conducted to assess the linear relationship of CVRF and HEI-2005 scores by using appropriate covariates accounting for sample weights and the complex sample design of NHANES. OR were calculated for HEI quartiles and CVRF. BMI (P < 0.0001), waist circumference (WC) (P < 0.0001), diastolic blood pressure (P = 0.0002), C-reactive protein (P = 0.0016), total cholesterol (P = 0.0006), LDL cholesterol (P = 0.0039), and metabolic syndrome (P = 0.0035) were inversely associated with HEI-2005. HDL cholesterol significantly (P = 0.0048) increased across HEI-2005 quartiles. Compared with the lowest HEI-2005 quartile, individuals with the highest diet quality (HEI-2005 quartile 4) were less likely to be overweight or obese (34%) or have elevated WC (35%), elevated blood pressure (26%), metabolic syndrome (35%), and decreased HDL-cholesterol concentrations (21%).Data suggest that diet quality is inversely associated with several CVRF. © 2012 American Society for Nutrition.

Drewnowski A.,University of Washington | Drewnowski A.,University Pierre and Marie Curie | Fulgoni III V.L.,Nutrition Impact LLC
American Journal of Clinical Nutrition | Year: 2014

Nutrient profiling is the technique of rating or classifying foods on the basis of their nutritional value. Foods that supply relatively more nutrients than calories are defined as nutrient dense. Nutrient profile models calculate the content of key nutrients per 100 g, 100 kcal, or per serving size of food. For maximum effectiveness, nutrient profile models need to be transparent, based on publicly accessible nutrient composition data, and validated against independent measures of a healthy diet. These rigorous scientific standards were applied to the development of the Nutrient-Rich Foods (NRF) family of nutrient profile models. First, the NRF models included nutrients to encourage as well as nutrients to limit. Second, NRF model performance was repeatedly tested against the Healthy Eating Index (HEI), an independent measure of a healthy diet. HEI values were calculated for participants in the 1999-2002 NHANES. Models based on 100 kcal and serving sizes performed better than those based on 100 g. Formulas based on sums and means performed better than those based on ratios. The final NRF9.3 index was based on 9 beneficial nutrients (protein; fiber; vitamins A, C, and E; calcium; iron; potassium; and magnesium) and on 3 nutrients to limit (saturated fat, added sugar, and sodium). Higher NRF9.3 scores were associated with lower energy density and more nutrient-rich diets. The nutrient density of foods, paired with a comprehensive program of consumer education, can become the foundation of dietary recommendations and guidelines. © 2014 American Society for Nutrition.

Pereira M.A.,University of Minnesota | Fulgoni III. V.L.,Nutrition Impact LLC
Journal of the American College of Nutrition | Year: 2010

Objectives: The health effects of added sugars have received much attention, but few studies have examined the association between foods that naturally contain sugar, such as 100% fruit juice, and risk of obesity and related conditions. Therefore, our purpose was to study the association between 100% fruit juice intake and risk of obesity and metabolic syndrome in a representative sample of the U.S. population. Methods: Cross-sectional analysis of a multiethnic sample of U.S. adults from the National Health and Nutrition Examination Survey 1999-2004 was undertaken to examine the association between 100% fruit juice consumption and the odds of obesity (body mass index [BMI] ≥ 30 kg/m2) and metabolic syndrome (Adult Treatment Panel [ATP] III definition). We used logistic regression analysis to estimate the odds of obesity and metabolic syndrome per category of fruit juice consumption exposure, while adjusting for covariates that may be confounders of this association. Results: Of 14,196 adults included in the sample, 3961 were consumers of fruit juice. Consumers of 100% fruit juice, relative to nonconsumers, had lower mean BMI, lower waist circumference, and lower homeostasis model assessment (HOMA) insulin resistance (p < 0.001). Level of intake (oz/d) had a linear inverse association with HOMA (p < 0.001), whereas the association with BMI and waist circumference was U-shaped (p < 0.001). Consumers relative to nonconsumers had 22% (95% confidence interval [CI]=13%-30%) lower odds of obesity and 15% (95% CI = 10%-28%) lower odds of metabolic syndrome. After adjustment for demographics and lifestyle factors, the lower odds of obesity remained statistically significant, but a statistically significant reduction in odds of metabolic syndrome was no longer noted. Conclusions: Compared with nonconsumers, those who consumed 100% fruit juice were leaner, were more insulin sensitive, and had lower odds of obesity and metabolic syndrome. The association with metabolic syndrome was explained primarily by other lifestyle factors, while the association with obesity remained independent. Experimental studies are needed to determine whether any direct physiologic link exists between consumption of 100% fruit juice and lower risks for obesity and metabolic syndrome.

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.

Park K.M.,Dairy Research Institute | Fulgoni V.L.,Nutrition Impact LLC
British Journal of Nutrition | Year: 2013

The present cross-sectional study sought to determine the potential relationships between the intake of dairy foods (total dairy products, milk and cheese) and cognitive function through information garnered in the National Health and Nutrition Examination Surveys (1988-94 and 1999-2002). Cognitive measures of vasomotor speed, coding speed and immediate memory recall were assessed from a simple reaction time task (SRTT), symbol-digit substitution test (SDST) and serial digit learning task, respectively, in adults 20-59 years of age. A summation of the percentile rank scores on each of the three tests provided a measure of overall cognitive function. In adults 60 years of age and above, a story recall test and a digit-symbol substitution test (DSST) were utilised to determine cognitive function in an elderly population. The results indicated that cognitive scores for the SRTT were not different between consumers and non-consumers of dairy foods. However, there were associations observed between 20-and 59-year-old consumers of total dairy foods and a higher SDST percentile score (53·2 (se 1·3) to 49·4 (se 2·0)) and a calculated global cognitive percentile score (53·3 (se 1·1) to 50·2 (se 1·4)) compared with non-consumers. A similar significant association was observed with cheese consumers. In adults over 60 years of age, an association between total dairy product consumption and higher DSST percentile scores (51·5 (se 1·9) to 46·2 (se 3·0)) was also observed. These findings highlight the need for additional research on how dairy products may affect cognition and by what mechanisms, through its nutrients or other components. © 2012 The Authors.

Barr S.I.,University of British Columbia | Difrancesco L.,Source Nutrition | Fulgoni V.L.,Nutrition Impact LLC
Journal of Nutrition | Year: 2013

Few studies have assessed the associations between breakfast intake and nutrient adequacy [where inadequacy reflects prevalence of usual intakes below the estimated average requirement (EAR) and potential excess reflects the prevalence above the tolerable upper intake level (UL)]. This study examined associations among breakfast, nutrient intakes, and nutrient adequacy in Canadian adults. Respondents aged≥19 y in the Canadian Community Health Survey 2.2 (n = 19,913)were classif ed as breakfast nonconsumers (11%), ready-to-eat cereal (RTEC) breakfast consumers (20%), or other breakfast consumers (69%). Nutrient intakes from food (24-h recall) and the prevalence of usual intakes below the EAR and above the UL from food alone and from food plus supplements were compared by breakfast group. Usual intake distributions were estimated using the National Cancer Institute method. Breakfast consumers, and to a greater extent RTEC breakfast consumers, had significantly higher intakes of fiber and several vitamins and minerals than breakfast nonconsumers. Compared with nonconsumers, RTEC and other breakfast consumers had significantly lower prevalences below the EARs for vitamin A and magnesium. The prevalences below the EARs of these nutrients and calcium, thiamin,vitamin D, and iron were significantly lower with RTEC breakfasts than with other breakfasts. Similar patterns were observed from food alone compared with food plus supplements. Breakfast consumption did not affect prevalence above the UL based on food sources, although based on food plus supplements, breakfast consumers had slightly higher proportions that were above the UL than nonconsumers for several nutrients. Breakfast, especially an RTEC breakfast,is associated with improved nutrient adequacy and does not meaningfully affect prevalence above the UL. © 2013 American Society for Nutrition.

Fulgoni V.L.,Nutrition Impact LLC | Quann E.E.,National Dairy Research Institute
Nutrition Journal | Year: 2012

Background: Given the epidemic of childhood obesity, it is crucial to assess food and beverage intake trends. Beverages can provide a large number of calories and since consumption patterns seem to develop at a young age we examined beverage consumption trends over three decades. The objective of this study was to assess the beverage (milk, fruit juice, fruit drinks, tea, soy beverages, and soft drinks) consumption trends in children <1-5 years of age. Methods. Data from individuals ages <1-5 years participating in the National Health and Nutrition Examination Survey (NHANES) from 1976-1980, 1988-1994 and 2001-2006 were used to assess beverage consumption and associated calorie and nutrient intakes. Results: During the NHANES 1976-1980 and 1988-1994 periods, approximately 84-85% of children were consuming milk, whereas only 77% were consuming milk during NHANES 2001-2006. Flavored milk intake was relatively low, but increased to 14% during the last decade (p < 0.001). Fruit juice consumption increased dramatically during NHANES 2001-2006 to more than 50% of the population compared to about 30% in the older surveys (p < 0.001). No significant changes were observed in fruit drink intake across all three decades with 35-37% of this population consuming fruit drinks. At least 30% of children consumed soft drinks. Milk was the largest beverage calorie contributor in all three decades surveyed and was the primary contributor of calcium (52-62%), phosphorus (37-42%), magnesium (27-28%), and potassium (32-37%). Fruit juice and fruit drinks each provided 8-10% of calories with soft drinks providing 5-6% of calories. Fruit juice was an important provider of potassium (16-19%) and magnesium (11%). Fruit drinks provided less than 5% of nutrients examined and soft drinks provided very little of the nutrients evaluated. Conclusions: Given concerns about childhood obesity and the need to meet nutrition requirements, it is prudent that parents, educators and child caretakers replace some of the nutrient poor beverages young children are currently consuming with more nutrient dense sources like low-fat and fat-free milk. © 2012 Fulgoni and Quann; licensee BioMed Central Ltd.

Processed foods are an integral part of American diets, but a comparison of the nutrient contribution of foods by level of processing with the recommendations of the Dietary Guidelines for Americans regarding nutrients to encourage or to reduce has not been documented. The mean reported daily dietary intakes of these nutrients and other components were examined among 25,351 participants $2 y of age in the 2003-2008 NHANES to determine the contribution of processed food to total intakes. Also examined was the percent contribution of each nutrient to the total reported daily nutrient intake for each of the 5 categories of food that were defined by the level of processing. All processing levels contributed to nutrient intakes, and none of the levels contributed solely to nutrients to be encouraged or solely to food components to be reduced. The processing level was a minor determinant of individual foods' nutrient contribution to the diet and, therefore, should not be a primary factor when selecting a balanced diet. © 2012 American Society for Nutrition.

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