Am J Clin Nutr. 2022 Aug 30:nqac238. doi: 10.1093/ajcn/nqac238. Online ahead of print.
BACKGROUND: High energy intake from non-nutrient dense sources correlates with poorer diet quality.
OBJECTIVES: To, 1) estimate total energy intake, and energy from solid fats and added sugars, and combined (SOFAS), and identify their top food category sources for ages 2-18 years in 2015-2018, and 2) describe trends over time in 2009-2018.
DESIGN: Data were from the National Health and Nutrition Examination Survey. Pairwise differences were examined using univariate t statistics (2015-2018, n=5,038), and trends by age, and over time (2009-2018, n=14,038) examined using orthogonal polynomials.
RESULTS: In 2015-2018, SOFAS contributed (mean [SE], 30.0% [0.3%]) of total energy. Solid fats 16.1% [0.2%] and added sugars 13.8% [0.2%] each contributed >10%. The contribution of added sugars increased with age from 11.1% (2-3 years) to 14.4% (14-18 years), and was higher for all other race/Hispanic origins than Non-Hispanic Asians. Top five sources of energy were sweet bakery products, savory snacks, pizza, other mixed dishes, and unflavored milk, and for SOFAS also included soft drinks, other desserts, candy and snack bars. Total energy did not change between 2009-2018, but energy from SOFAS, and servings of solid fats, and added sugars declined. The contribution of unflavored milk to total energy declined for all ages and most race/Hispanic origins. Fruit drinks (all ages) and soft drinks (9-18 years) remained among top added sugars sources despite declines. The contribution of sweet bakery products to energy from SOFAS increased for most ages, and candy and snack bars to energy from added sugars.
CONCLUSIONS: In 2015-2018, SOFAS contributed over 30% of total energy for ages 2-18 years, which doubled the Dietary Guidelines for Americans’ recommended limit of 15%. Top five sources of total energy were similar to those of solid fats, and those of SOFAs similar to those of added sugars. These results may inform public health efforts for improving diet quality.