Cheese Consumption by U.S. Children and Adolescents, What We Eat in America, NHANES 2017 - 2018

Authors: Sebastian, Rhonda; Goldman, Joseph; Moshfegh, Alanna

Submitted to: Worldwide Web Site: Food Surveys Research Group
Publication Type: Research Technical Update
Publication Acceptance Date: 5/8/2024
Publication Date: 5/13/2024
Citation: Sebastian, R.S., Goldman, J.D., Moshfegh, A.J. 2024. Cheese Consumption by U.S. Children and Adolescents, What We Eat in America, NHANES 2017 - 2018. Worldwide Web Site: Food Surveys Research Group. Available: https://www.ars.usda.gov/nea/bhnrc/fsrg/wweia/dbrief.

Interpretive Summary: Cheese is a rich source of many nutrients. Dietary intake of cheese has been reported in cup equivalents, but information about intake in grams is lacking. Using data from What We Eat in America (WWEIA), the dietary interview component of NHANES 2017- 2018, we examined cheese. We identified who consumes it, food category contributors to its intake, and its contributions to energy and nutrients. We found that 74% of children 2-19 years consume cheese on any given day. The likelihood of consuming cheese does not vary by gender. However, an inverse linear trend in prevalence by age group was seen. A smaller percentage of non-Hispanic Asian children consume cheese relative to children in all other race/ethnic groups. Mixed dishes such as pizza, sandwiches, and tacos account for the vast majority of cheese intake; in fact, 6 in 10 children report a mixed dish containing cheese on the intake day. On a 1,000-kilocalorie basis, cheese consumers had higher intakes of saturated fat and calcium relative to children who do not consume cheese. Among consumers, cheese contributes on average 7% of daily energy intake, 13% of fat and protein, 21% of saturated fat, and 30% of calcium. This novel information about cheese consumption can inform policymakers, food manufacturers, dietitians, nutritionists, and consumers about its considerable role in the diets of U.S. children.

Technical Abstract: Cheese contains notable amounts of calcium and vitamin D, two nutrients that are under-consumed by children in the U.S. However, it also contains considerable amounts of saturated fat and sodium, which are consumed in excess. Because cheese is a common ingredient in many foods, quantifying intake is challenging. To date, dairy intake has been reported in “cup equivalents,” a term that makes sense for foods such as milk and yogurt but less so for cheese. Comprehensive characterization of cheese consumption in gram amounts is lacking. One day of dietary intake data from 2,380 children 2-19 years collected in the nationally representative survey What We Eat in America, NHANES 2017- 2018, was analyzed. Two-tailed t-tests compared percentages of children consuming cheese by demographic characteristics and nutrient intakes between cheese consumers and non-consumers on a 1,000-kilocalorie basis. Regression analyses identified trends in prevalence of consumption by age. On any given day, 74% of American children consume cheese. Whereas prevalence does not differ by gender, an inverse linear trend by age was observed (p<0.001). Non-Hispanic Asian children are less likely to consume cheese relative to those in other race/ethnic groups. No differences were noted by family income. Mixed dishes (e.g., pizza, sandwiches) account for 78% of cheese intake by weight. Sixty percent of children report a mixed dish containing cheese on the intake day, and the mean intake of cheese per report of a mixed dish is 28 g. Compared to non-consumers, cheese consumers have higher intakes of saturated fat and calcium on an energy density (1,000-kilocalorie) basis. Cheese contributes 7% of consumers’ total intake of energy, 11-15% of protein, total fat, cholesterol, vitamins A and B12, and sodium, 21% of saturated fat, and 30% of calcium. Cheese is a mainstay in the diets of U.S. children. Modifying choices to lower fat options could lessen the impact of this highly consumed food on intake of overconsumed nutrients while simultaneously retaining its beneficial contributions to nutrients that are lacking in the diets of most children.