Despite consuming fewer sugar-sweetened beverages and more whole grains, most American children and teenagers still eat poorly, and sociodemographic disparities persist, according to an 18-year national study between 1999 and 2016 of U.S. children's dietary trends.
The research team analyzed the diets of more than 31,000 U.S. youth, 2-19 years old, based on national data across nine cycles of the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2016. They assessed each child's diet as poor, intermediate or ideal, based on three validated dietary scores.
Overall poor diet despite some improvements
The study found that a majority (56%) of American children and adolescents had diets of poor nutritional quality in 2016. This was despite improvements over the 18-year study period including:
· The proportion of children and adolescents with poor diets declined, 77% to 56%
· The proportion of children and adolescents with intermediate diets increased, 23% to 44%
At the end of the study period, adolescents (12-19 years old) had the worst diet of three age categories, with 67% found to have a poor diet, compared with 53% of children aged 6-11 and 40% of kids aged 5 and under.
At the end of the study period, 65% of children from households in the lowest income category had a poor diet, compared with 47% of children in the highest income category.
When the researchers investigated the influence of individual foods and nutrients, they discovered that improvements between 1999 and 2016 amounted to the daily equivalent of:
· Eight fewer ounces of sugar-sweetened beverages (which meant into eight fewer teaspoons of added sugar).
· One-half serving more of whole grains (e.g., a half slice of whole grain bread or a quarter cup of rolled oats).
· One-fifth serving more of whole fruit (about seven grapes or part of an apple).
Healthy foods still below intake guidelines
The researchers found that while intakes of some healthful foods increased, they remained far below general national recommendations. By 2016, kids were eating:
· About 1.8 daily servings of fruits and vegetables (less than half the recommendation of 4.5 servings).
· One daily serving of whole grains (less than one-third the recommendation of three servings).
· Just under half a daily serving of fish (less than 25% of the recommended two servings per week).
The team also found that children's salt intake increased and continued to greatly exceed the recommended daily amount, possibly due to more reliance on processed foods and foods prepared away from home.
The findings of slowly improving, yet still poor, diets among U.S. children are consistent with the slowing of rises in childhood obesity but not any reversal.
Limitations of the study include the fact that self-reported food recall data may be inaccurate due to the possibility that respondents will over-report or under-report their intake of certain foods.
Source: JAMA, March 24/31, 2020.
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