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The objective of this research is to compare the Day 1 and Day 2 dietary intakes of adults in What We Eat in America, National Health and Nutrition Examination Survey (WWEIA, NHANES) 2013–2016. Dietary recalls of males (n = 2599) and females (n = 2624) 20+ years who had both a Day 1 and Day 2 recall and reported their intake as usual on both days in WWEIA, NHANES 2013–2016 were examined. Mean (±SE) energy intake for males was 2425 ± 26 kcal for Day 1 and 2334 ± 32 kcal for Day 2 (p = 0.004). For females, 1832 ± 18 kcal and 1775 ± 26 kcal were reported for Day 1 and 2, respectively (p = 0.020). There were no significant differences between energy intake on Day 1 and Day 2 within males and females by ten-year age groups. Comparing 20 year age groups for males and females by race/ethnicity (non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, and Hispanic) and income (<131%, 131–350%, and >350% of poverty level) also showed no significant differences in energy intake between Day 1 and Day 2. Mean energy intake of adults was not statistically different between the two days of recall by sex, race/ethnicity or income within selected age groups. Overall, the difference in energy intake was less than 4% for both males and females.

Diet quality in the United States is improving over time but remains poor. Food outlets influence diet quality and represent the environments in which individuals make choices about food purchases and intake. The objective of this study was to use the Healthy Eating Index-2015 (HEI-2015) to evaluate the quality of foods consumed from the four major outlets where food is obtained—stores, full-service restaurants, quick-services restaurants, and schools—and to assess changes over time. This cross-sectional study used 24 h dietary recall data from eight cycles (2003–2004 to 2017–2018) of the National Health and Nutrition Examination Survey (NHANES). Linear trend estimation was used to test for changes in HEI scores over time, and balanced repeated replicate weighted linear regression was used to test for differences in total and component scores between types of food outlets. Overall, Americans are not consuming a mix of foods from any major category of food outlet that aligns with dietary guidelines. The total score for schools (65/100 points) and stores (62/100 points) was significantly higher than full-service (51/100 points) and quick-service (39/100 points) restaurants (p < 0.0001). HEI scores significantly improved over time for schools (p < 0.001), including an increase in whole grains from less than 1 point in 2003–2004 to 7 out of 10 points in 2017–2018. In 2017–2018, schools received the maximum score for total fruits, whole fruits, and dairy. Continued research on strategies for improving the quality of foods consumed from restaurants and stores is warranted.

Dietary fat composition may modulate energy expenditure and body weight. Little is known about the relationship between fatty acid intake and body weight at a population level. The purposes of this study were to compare intakes of energy, macronutrients, and individual fatty acids across BMI categories (1) for the US adult population and, (2) by sociodemographic groups. Reported dietary intake data from the National Health and Nutrition Examination Survey (NHANES) and What We Eat in America (WWEIA) surveys in the years 2005–2012 were analyzed. Overall, we found that the reported intake of carbohydrate, protein, total fat, total saturated fat (as well as long-chain saturated fatty acids 14:0–18:0), and monounsaturated fatty acids (MUFAs) were positively associated with BMI; while lauric acid (a medium-chain saturated fatty acid, 12:0) and total polyunsaturated fatty acids (PUFAs) (as well as all individual PUFAs) were not associated with BMI. Non-Hispanic black individuals demonstrated a negative association between BMI and energy intake and a positive association between total PUFAs, linoleic acid (LA), α-linolenic acid (ALA) and BMI. Individuals with less than a high school education showed a negative association between BMI and DHA. Mexican-Americans reported intakes with no association between BMI and energy, any macronutrient, or individual fatty acids. These findings support those of experimental studies demonstrating fatty acid-dependent associations between dietary fatty acid composition and body weight. Notably, we observed divergent results for some sociodemographic groups which warrant further investigation.

Despite increasing concerns about neurotoxicity of fluoride in children, sources of fluoride exposure apart from municipal water fluoridation are poorly understood. We aimed to describe the associations of demographics, drinking water characteristics, diet, and oral health behaviors with plasma fluoride concentrations in U.S. children. We used data from 3928 6–19-year-olds from the 2013–2016 National Health and Nutrition Examination Survey. We used a 24-h dietary recall to estimate recent consumption of fluoridated tap water and select foods. We estimated the associations of fluoridated tap water, time of last dental visit, use of toothpaste, and frequency of daily tooth brushing with plasma fluoride concentrations. The participants who consumed fluoridated (≥0.7 mg/L) tap water (n = 560, 16%) versus those who did not had 36% (95% CI: 22, 51) higher plasma fluoride. Children who drank black or green tea (n = 503, 13%) had 42% higher plasma fluoride concentrations (95% CI: 27, 58) than non-tea drinkers. The intake of other foods and oral health behaviors were not associated with plasma fluoride concentrations. The consumption of fluoridated tap water and tea substantially increases plasma fluoride concentrations in children. Quantifying the contribution of diet and other sources of fluoride is critical to establishing safe target levels for municipal water fluoridation.

Although flavonoids may confer anti-inflammatory and anti-oxidant benefits, no research has examined if flavonoid intake is related to cardiovascular disease (CVD) risk defined by anthropometric measures in the USA population. This study sought to determine whether flavonoid intake is associated with combined body mass index (BMI) and waist circumference (WC) measures indicative of high, very high, or extremely high (“high+”) risk for CVD, using one day of 24-h recall data from adult (≥20 years) participants in What We Eat in America, National Health and Nutrition Examination Survey 2007–2010. Individuals were divided into categories of intake of total flavonoids and each flavonoid class, and adjusted estimates of the percentages at high+ CVD risk (based on BMI and WC, as per National Heart, Lung, and Blood Institute guidelines) were calculated. Inverse linear trends were found in percentages of adults at high+ CVD risk by intake of total flavonoids, anthocyanidins, flavan-3-ols, and flavanones (p < 0.01). For individuals in the highest (versus the lowest) intake category of anthocyanidins, flavan-3-ols, and flavanones, relative risk and confidence intervals (RR and CI, respectively) were 0.86 (99% CI: 0.79, 0.93), 0.88 (99% CI: 0.79, 0.98), and 0.89 (99% CI: 0.80, 0.98), respectively. Research is needed to determine whether the inverse relationships found in this study are applicable to CVD endpoints at the population level.

The objective of this review was to identify dietary insufficiencies and excesses in children aged two to 11 in the United States (U.S.) and eating habits that merit concern in terms of nutrient and energy density to improve overall diet quality. Data from the What We Eat in America (WWEIA) tables from the National Health and Nutrition Examination Survey (NHANES) were examined as well as survey data from the School Nutrition Dietary Assessment Study (SNDA). Analysis of survey data revealed that children consume insufficient Vitamin D, calcium, and potassium and excess energy, carbohydrates, and sodium. Dietary modifications are necessary to prevent serious deficiencies and the development of chronic illness. Snacking has steadily increased in this population since the 1970s, and snacks provide necessary nutrients. However, carbohydrates and added sugars tend to be over-consumed at snacking occasions. Replacement of current snack choices with nutrient-dense foods could lower the risks of nutrient deficiencies and help lower excess nutrient consumption. Increased consumption of low sugar dairy foods, especially yogurt, at snack times could increase intake of important micronutrients without contributing to dietary excesses.

Flavonoids are polyphenolic phytochemicals with health-promoting properties, yet knowledge about their intake in at-risk populations is limited. This study sought to estimate intakes of total flavonoids and six flavonoid classes in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study; determine if differences in intakes exist by race (African American (AA) and White (W)) and income (< or >125% Federal poverty guidelines); and compare intakes to those of a nationally representative population with similar demographic and socioeconomic characteristics. Data transformation normalized the flavonoid intake distributions prior to conducting statistical tests. With the exception of the flavanone class, flavonoid intakes of AAs were significantly lower than those of W (p < 0.01), regardless of other potential mediating factors including sex, age, and income. Total flavonoid intakes in HANDLS did not differ from intakes in the nationally representative study, but anthocyanidin and flavone intakes were lower, and race specific differences were found for several flavonoid classes. These findings imply that benefits attributable to flavonoid consumption may not be experienced equally by AAs and Whites, nor in vulnerable populations such as that represented by HANDLS relative to the U.S. population, and may play a role in observed health disparities.

To examine the comparability of fruit and vegetable (F&V) intake data in the USA from 2001 to 2014 between data acquired from two national data collection programmes. Cross-sectional analysis. Linear regression models estimated trends in daily per capita intake of total F&V. Pooled differences in intake of individual F&V (n 109) were examined by processing form (fresh, frozen, canned, dried and juice). What We Eat in America (WWEIA, 2001-2014) and Loss-Adjusted Food Availability data series (LAFA, 2001-2014). No temporal trends were observed in daily per capita intake of total F&V from 2001 to 2014 using WWEIA and LAFA. Modest differences between WWEIA and LAFA were observed in mean pooled intake of most individual F&V. WWEIA and LAFA produced similar estimates of F&V intake. However, WWEIA may be best suited for monitoring intake at the national level because it allows for the identification of individual F&V in foods with multiple ingredients, and it is structured for sub-population analysis and covariate control. LAFA does retain advantages for other research protocols, specifically by providing the only nationally representative estimates of food losses at various points in the food system, which makes it useful for examining the adequacy of the food supply at the agricultural, retail and consumer levels.

Estimates of fruit and vegetable (FV) consumption vary depending on intake definition, which may be determined by research purpose. Researchers have used two methods to evaluate intake: epidemiological and behavioural. The present study describes FV intake by adults using epidemiological v. behavioural approaches. One-day dietary intake data from What We Eat In America, National Health and Nutrition Examination Survey 2009-2012 were used. Sample weights were used to produce nationally representative estimates. FV intake (in cup-equivalents (CE)) was estimated using the Food Patterns Equivalents Database. The epidemiological method considered all FV after disaggregating foods and beverages. The behavioural method included foods that provided at least 0·2 CE FV per 100 g, and excluded sources high in fat, added sugar and Na. Nationally representative survey of the US population. Adults (n 10 563) aged ≥20 years. For epidemiological v. behavioural, fruit intake was 1·1 v. 1·0 CE for males and 1·0 v. 0·9 CE for females. Vegetable intake was 1·8 v. 1·1 CE for males and 1·5 v. 1·0 CE for females. The definition of FV intake affects estimates of consumption by the population and is an important consideration when planning and comparing research studies. The method used should align with research goals to assure accurate interpretation and validity of results.

Objective To provide updated estimates of drinking water intake (total, tap, plain bottled) for groups aged ≥1 year in the USA and to determine whether intakes collected in 2005–2006 using the Automated Multiple-Pass Method for the 24 h recall differ from intakes collected in 2003–2004 via post-recall food-frequency type questions. Design Cross-sectional, observational study. Setting What We Eat in America (WWEIA), the dietary intake component of the US National Health and Nutrition Examination Survey (NHANES). Subjects Individuals aged ≥1 year in 2003–2004 (n 8249) and 2005–2006 (n 8437) with one complete 24 h recall. Results The estimate for the percentage of individuals who reported total drinking water in 2005–2006 was significantly (P < 0·0000) smaller (76·9 %) than that for 2003–2004 (87·1 %), attributable to a lower percentage reporting tap water (54·1 % in 2005–2006 v. 67·0 % in 2003–2004; P = 0·0001). Estimates of mean tap water intake differed between the survey cycles for men aged ≥71 years. Conclusions Survey variables must be examined before combining or comparing data from multiple WWEIA/NHANES release cycles. For at least some age/gender groups, drinking water intake data from NHANES cycles prior to 2005–2006 should not be considered comparable to more recent data.