Project : USDA ARS

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Research Project: The Role of Dietary and Lifestyle Factors on Nutrition and Related Health Status Using Large-Scale Survey Data

Location: Food Surveys Research Group

2021 Annual Report

Objectives
Objective 1: Determine if adherence to Dietary Guidelines recommendations, such as consuming fruits, vegetables, and whole grains, and limiting added sugars and saturated fat, is associated with fewer health risk factors among the population and population subgroups in What We Eat in America, NHANES. [NP107, C2, PS2B] Objective 2: Establish whether variations in meal patterns, such as meal skipping, eating away from home, and snack and beverage consumption, are associated with diet quality and health risk factors among the population and population subgroups in What We Eat in America, NHANES. [NP107, C2, PS2B] Objective 3: Investigate if flavonoid intake is positively associated with diet quality and negatively associated with cardiovascular health markers and health outcomes among at-risk adults in the NIH Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. [NP107, C2, PS2B]

Approach
Diet-related disease rates have risen in the U.S. over the past two decades. Secular trends in food intake show that a majority of Americans continue to follow unhealthy eating patterns. Progress in reversing these trends requires evidence-based, comprehensive, and coordinated strategies. Two large-scale health surveys conducted by the Federal government--the National Health and Nutrition Examination Survey (NHANES) and the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study--provide extensive data on dietary and health measures. What We Eat in America (WWEIA), the dietary component of NHANES, is the sole source of nationally representative food and nutrient intake data in the U.S. It provides food and nutrient estimates for not only the general population, but also for specific subgroups including low-income individuals, children, and minority populations. The National Institutes of Health-sponsored HANDLS study allow estimation of food and nutrient intake in populations who have been identified as particularly vulnerable to nutrition-related diseases. FSRG scientists, responsible for the dietary methodology used in NHANES and HANDLS, are expertly positioned to utilize data from these surveys to conduct secondary data analyses. Factors related to healthy food choices and dietary patterns available from these studies across gender/age and socio-demographic groups will be analyzed to 1) scientifically evaluate factors related to adherence of Dietary Guideline recommendations, particularly those that many fail to meet, and identify associations with health benefits; 2) comprehensively explore the variety of meal patterns across the population and population subgroups and establish associations with dietary quality and health risk factors; and 3) investigate associations of flavonoid intake with diet quality and cardiovascular health markers and health outcomes among at-risk adults in the unique HANDLS study. The evidence-based knowledge resulting from this research will also inform Federal policy addressing the nutritional well-being of Americans through future nutrition program needs.

Progress Report
A published manuscript shows that flavonoid intake is lower among African Americans and individuals with lower incomes in an at-risk population (Hypothesis 3A). Literature review and data preparation for analysis evaluating the relationship of flavonoid intake to diet quality and adherence to national dietary recommendations in an at-risk population has been completed (Hypothesis 3B). Two manuscripts on flavonoids have been submitted to scientific journals; one compares flavonoid intake of Healthy Aging in Neighborhoods of Diversity across the Life Span (HANLDS) study participants to that of the U.S. population (Hypothesis 3C). The other shows that flavonoid intake is inversely related to health measures of cardiovascular disease in an at-risk population (Hypothesis 3D). Research has begun studying the association of flavonoid intake in an at-risk population to a decline in cardiovascular health (Hypothesis 3D). Through an ongoing collaboration with the National Center for Health Statistics, Department of Health & Human Services (DHHS), the Food Surveys Research Group (FSRG) has the lead role for dietary data collection and processing of What We Eat In America (WWEIA), National Health and Nutrition Examination Survey (NHANES). WWEIA, NHANES 2021-2022 restarted in the summer of 2021 with appropriate adjustments to collection protocols to ensure respondents' public health safety after being paused since March of 2020 due to the COVID-19 pandemic. The methodology for 'USDA's Automated Multiple-Pass Method used to collect dietary recalls was updated along with related databases for dietary data coding for the 2021-2022 collection and has been incorporated into the WWEIA collection process for NHANES. Analysis of the WWEIA data was completed to construct research articles for submission to scientific journals, dietary data briefs and summarized data tables released on the FSRG website, and scientific presentations delivered at scientific conferences on a variety of topics, including top fruits and vegetables consumed, sweet foods consumption, late evening eating patterns of adults, intakes of food pattern components compared to recommendations among children and adolescents, comparison of day 1 and day 2 dietary data in WWEIA, assessment of total nutrient intakes of the U.S. population from both food/beverages and dietary supplements, and convenience stores as a source of children and adolescent dietary intakes. Advancing WWEIA data among the research community was strengthened with the development of "Key Points Using WWEIA, NHANES 2017-2018," a document that highlights major features to aid researchers analyzing WWEIA data on 23 topics ranging from WWEIA data files, select variables beyond nutrients, and resources to access on the FSRG website. Two invited workshops were conducted at scientific conferences providing training on WWEIA dietary data and related resources from FSRG. Development of the 37 Food Patterns Equivalents components for all food/beverages in the Food and Nutrient Database for Dietary Studies (FNDDS) 2017-2018 was completed and publicly released on the FSRG website. FSRG scientists work collaboratively serving on the FoodData Central (FDC) Principles group within BHNRC, providing input on key decisions for maintaining and enhancing FDC. A critical input includes data analysis from WWEIA, NHANES on top reported foods consumed by Americans to inform FDC decision making on foods to analyze for nutrient composition. Another contribution is to incorporate the FNDDS 2017-2018 database into FDC to enhance a one-stop web location for all composition databases developed by BHNRC. FSRG scientists are working with the Economic Research Service (ERS) to improve the food patterns groups and Healthy Eating Index database for the National Household Food Acquisition and Purchase Survey 2 (FoodAPS 2). The ERS Food-at-Home database of 53,000 foods was reviewed to determine foods needing revision. Work is progressing on revising more than 13,000 of those foods providing data on nutrients and characteristics to assess Dietary Guidelines for Americans recommendations. FSRG scientists are providing technical consultation on the update of the Thrifty Food Plan, a major initiative by the Office of the Secretary, being led by the Center for Nutrition Policy and Promotion. The update utilizes databases developed and released by FSRG, including the WWEIA, NHANES 2015-2016 dietary intake data and its technical database of nutrient profiles of foods reported in surveys, the Food and Nutrient Database of Dietary Studies 2015-2016, and the Food Patterns Equivalents Database 2015-2016.

Accomplishments
1. Release of Food Patterns Equivalents Database 2017-2018. The Food Patterns Equivalents Database (FPED) provides the basis to assess the diets of individuals compared to the Dietary Guidelines for Americans. FPED was developed by ARS researchers in the Beltsville Human Nutrition Research Center, Beltsville, Maryland. Foods and beverages reported in national dietary surveys have been disaggregated into 37 Food Pattern components, and the amounts consumed of those components have been assessed. The table sets have been released on the web that summarizes food and beverage intakes across the 37 Food Pattern components for 23 age-gender and socio-economic groups for national dietary survey data conducted in 2017-2018. These estimates provide unique data to evaluate food and beverage intakes of Americans compared to recommendations of the 2020-2025 Dietary Guidelines for Americans. The Food Patterns Equivalents Database that converts foods reported in the 2017-2018 survey and the Methodology and User Guide for FPED were also released on the web; all are accessible along with the data tables at www.ars.usda.gov/nea/bhnrc/fsrg.

2. Release of 2015-2018 national dietary intake estimates as compared to nutrient requirements in summary data table sets. Assessing nutrient intakes of the U.S. population in relation to recommended nutrient requirements provides understanding of how nutrient needs are met across population groups and more importantly identifies nutrient shortfalls. Analysis conducted by ARS researchers in the Beltsville Human Nutrition Research Center, Beltsville, Maryland, produced this assessment using data from What We Eat in America (WWEIA), National Health and Nutrition Examination Survey (NHANES) 2013-2016. Vitamin C and calcium are two nutrients in which about 1 out of every 3 Americans had inadequate intakes as compared to recommended requirements. This research, summarized in 18 data tables sets that estimate the proportion of individuals not meeting nutrient recommendations, is beneficial to government groups, health and nutrition policymakers, food industry, nutrition researchers, and the public. All summarized data tables are accessible at www.ars.usda.gov/nea/bhnrc/fsrg.

3. Release of national total nutrient intake estimates in summary dietary data tables. Dietary supplement use in the U.S. continues to increase. Analyzing What We Eat in America (WWEIA), National Health and Nutrition Examination Survey (NHANES) dietary intake, and dietary supplement use data is critical to understand the total intake of nutrients from food and dietary supplements. Analysis conducted by ARS researchers in the Beltsville Human Nutrition Research Center, Beltsville, Maryland, produced summarized tables on nutrient intakes from food and beverages and dietary supplements during 2017-2018. Nutrients most commonly included in dietary supplements reported by Americans include calcium, vitamin D, vitamin B12, or vitamin B6. These tables represent critical reporting of total intakes that have estimates of nutrient intake from dietary supplements. Data tables summarizing total nutrient intakes of the U.S. population can readily be used by government groups, nutrition researchers, and the public. All summarized data tables are accessible at www.ars.usda.gov/nea/bhnrc/fsrg.

4. Release of ten dietary data briefs. Analyzing What We Eat in America (WWEIA), National Health and Nutrition Examination Survey (NHANES) dietary intake data to assess how 'American's dietary status compares to recommendations provides critical information for nutrition policy and education. Analysis conducted by ARS researchers in the Beltsville Human Nutrition Research Center, Beltsville, Maryland, resulted in ten dietary data briefs on single topics of importance to improving dietary status. The advances in knowledge from these analyses are diverse but important to furthering understanding of dietary status and eating patterns. Topics provided insight into children, adolescents, and adults' choices of beverages and sweet foods; fruits and vegetables; and changes in intakes of components of a healthy diet based on guidance in the Dietary Guidelines for Americans. These data briefs are accessible at www.ars.usda.gov/nea/bhnrc/fsrg.

U.S. DEPARTMENT OF AGRICULTURE

Food Surveys Research Group: Beltsville, MD