Dietary quality and diet-related factors among u.s. emerging adults (18-23y) are a cause for concern, nhanes 2015-2018

Authors: COWAN-PYLE, ALEXANDRA - Texas A&M University Institute For Advancing Health Through Agriculture; BAILEY, REGAN - Texas A&M University Institute For Advancing Health Through Agriculture; GAO, JINGJING - University Of Texas Health Science Center; Hess, Julie; ADEMU, LILIAN - Texas A&M University Institute For Advancing Health Through Agriculture; LANKES SMITH, JANE - Texas A&M University Institute For Advancing Health Through Agriculture; MITCHELL, DIANE - Texas A&M University Institute For Advancing Health Through Agriculture; RACINE, ELIZABETH - Texas A&M Agrilife

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/24/2024
Publication Date: N/A
Citation: N/A

Interpretive Summary: In the past decade, nutrition research has noted a decline in diet quality during adolescence (ages 14 to 18) that begins to reverse during adulthood. However, diet quality during the transition from adolescence to adulthood has not previously been well characterized. This manuscript uses representative national survey data from the U.S. to investigate diet quality specifically among emerging adults (ages 18 to 23). Similar to adolescent Americans, emerging adults had significantly lower overall diet quality compared to adults ages 24 years and older. This gap in diet quality extending from adolescence through early adulthood indicates a need for public health interventions focused on this overlooked subgroup of the U.S. population.

Technical Abstract: Background: Poor dietary quality is a risk factor for diet-related chronic disease and suboptimal nutritional patterns often begin early in the life course. While the dietary intakes of young children, adolescents, and middle-aged and older adults are well established, much less is known about emerging adults, who represent a unique timepoint in life, as they are undergoing significant changes in food environments, autonomy, finances, and caregiver and parental involvement. Objective: To examine dietary quality, as assessed via the Healthy Eating Index (HEI), by demographic, socioeconomic, and health-related characteristics among U.S. emerging adults (18-23y) who participated in the 2015-2018 National Health and Nutrition Examination Survey (NHANES). Methods: NHANES data were collected via a household interview and 2 24-hour dietary recalls (24HRS). Usual dietary intakes from the 24HRs were approximated using the multivariate National Cancer Institute Method to compute mean HEI-2015 overall and component scores (range 0-100, higher scores indicating higher dietary quality). Results: Overall dietary quality among U.S. emerging adults [HEI-2015: 50.3] was significantly lower than other U.S. adults (=24y) [HEI-2015: 56.3; p<0.0167], with differences primarily driven by lower intakes of whole fruit, vegetables, and whole grains, and higher intakes of sodium, refined grains, and saturated fat. Few differences in HEI-2015 scores were noted across population subgroups by sex, food security, family income, and food assistance program participation, except for added sugar; intakes of added sugar were significantly higher among women, food insecure, and food assistance program participants as compared to their counterparts, respectively. Conclusions: Dietary quality is poor among U.S. emerging adults and persists across all population subgroups, suggesting a significant need for tailored public health interventions to improve dietary quality among this population. Future research investigating to what extent emerging adults prioritize healthful behaviors and exploring other indicators for identifying nutritionally vulnerable subgroups may be impactful for identifying disparities among this life stage.