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Title: Food sources of energy and nutrients of public health concern and nutrients to limit with a focus on milk and other dairy foods in children 2 to 18 years of age: National Health and Nutrition Examination Survey, 2011-2014

Author
item O'NEIL, CAROL - LOUISIANA STATE UNIVERSITY AGCENTER
item NICKLAS, THERESA - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC)
item FULGONI III, VICTOR - NUTRITION IMPACT, LLC

Submitted to: Nutrients
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/2/2018
Publication Date: 8/9/2018
Citation: O'Neil, C.E., Nicklas, T.A., Fulgoni III, V.L. 2018. Food sources of energy and nutrients of public health concern and nutrients to limit with a focus on milk and other dairy foods in children 2 to 18 years of age: National Health and Nutrition Examination Survey, 2011-2014. Nutrients. 10:1050. http://doi.org/10.3390/nu10081050.
DOI: https://doi.org/10.3390/nu10081050

Interpretive Summary: Many children are not meeting the current nutrient recommendation. The purpose of this study was to determine the food sources of energy, nutrients of public health concern, and nutrients to limit with a focus on dairy foods. Twenty-four-hour dietary recall data from children 2-5 (n = 1511), 6-11 (n = 2193), and 12-18 years (n = 2172) participating in NHANES 2011-2014 were analyzed. This study showed that for children in all three age groups studied, mixed dishes containing dairy foods contributed to calcium, vitamin D, and potassium intake—three of the nutrients of public concern. A caution of dairy food consumption is that full fat dairy can contribute saturated fatty acids to the diet and cheese, a major component of many of the mixed dishes, such as pizza and Mexican foods, contributes not only saturated fatty acids, but sodium to the diet. The study also showed that fortifying foods with vitamin D was important since few foods contain naturally occurring vitamin D. The study also showed that children, especially those 6–11 and 12–18 years consumed a large proportion of total energy from energy-dense low-nutrient food groups, such as sugar sweetened beverages and sweet bakery products. Those foods contributed little to the nutrients of public health concern, but did contribute to the nutrients to limit, notably added saturated fatty acids and added sugars. Awareness of food and beverage sources of nutrients can help health professionals design and promote effective age-appropriate strategies to increase the nutrient density of the diet. In addition, this awareness can help the food industry to design and market foods frequently consumed by children that are acceptable and lower in energy and nutrients to limit.

Technical Abstract: Many children are not meeting current nutrient recommendations. The objective of this study was to determine the food sources of energy, nutrients of public health concern, and nutrients to limit with a focus on dairy foods. Twenty-four-hour dietary recall data from children 2-5 (n = 1511), 6-11 (n = 2193), and 12-18 years (n = 2172) participating in NHANES 2011-2014 were analyzed. Energy, fiber, calcium, potassium, vitamin D, added sugars, saturated fatty acids (SFA), and sodium intakes were sample-weighted and ranked on percentage contribution to the diet using specific food group intake and disaggregated data for dairy foods. For children 2-5, 6-11, and 12-18 years, milk, sweet bakery products, and sweetened beverages, respectively were the top food sources of energy, respectively. For calcium, potassium, and vitamin D, milk was the top ranked food source in all age groups. For children 2-5, 6-11, and 12-18 years, milk, sweet bakery products, and pizza, respectively were the top three ranked food sources of SFA; and sugar sweetened beverages and sweet bakery products were to top two food group sources of added sugars. Cured meats/poultry, pizza, and pizza, respectively, were the top ranked food sources of sodium for the three age groups. Identification of food sources of these nutrients can help health professionals implement appropriate dietary recommendations and plan age-appropriate interventions.