Dataset Information

Added Sugar Intake among Pregnant Women in the United States: National Health and Nutrition Examination Survey 2003-2012.

ABSTRACT: BACKGROUND:Despite associations of dietary added sugar with excess weight gain and chronic disease risk, intake among most Americans exceeds the recommended limits (<10% total energy). Maternal diet plays an important role in pregnancy-related outcomes, but little is known about the extent of added sugar intake during pregnancy. OBJECTIVE:To assess intake and identify the top sources of added sugars in the diets of pregnant vs nonpregnant women in the United States. DESIGN:Cross-sectional analysis of data from the National Health and Nutrition Examination Survey (NHANES), 2003-2004 to 2011-2012. PARTICIPANTS:Four thousand one hundred seventy-nine pregnant and nonpregnant women (aged 20 to 39 years) who completed a dietary recall. STATISTICAL ANALYSES PERFORMED:Survey-weighted analyses were used to estimate means (95% CIs) in total grams and as percentage of total energy for added sugar intake by pregnancy status and by demographic subgroup and to identify leading sources of added sugar. RESULTS:Added sugar intake trended toward being higher in pregnant compared with nonpregnant women in absolute grams, 85.1 g (95% CI: 77.4 to 92.7) vs 76.7 g (95% CI: 73.6 to 79.9), respectively (P=0.06), but was lower among pregnant women when total energy intake was accounted for, 14.8% (95% CI: 13.8 to 15.7) vs 15.9% (95% CI: 15.2 to 16.6) of total energy, respectively (P=0.03). Among pregnant women, added sugar intake was similar among demographic subgroups. However, in multivariable regression, pregnancy status significantly modified the associations of education and income with added sugar intake, whereby less educated and lower-income women who were pregnant had lower added sugar intakes compared with those who were not pregnant, but more educated or higher-income women did not exhibit this pattern. The top five sources of added sugar for all women were sugar-sweetened beverages; cakes, cookies, and pastries; sugars and sweets; juice drinks and smoothies; and milk-based desserts. CONCLUSIONS:Although pregnant women had higher energy intakes, this was not attributed to higher intakes of added sugar. Although education and income affected consumption during pregnancy, intake of added sugar among all women, regardless of pregnancy status, exceeded recommendations.

SUBMITTER: Cioffi CE

PROVIDER: S-EPMC5924618 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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Added Sugar Intake among Pregnant Women in the United States: National Health and Nutrition Examination Survey 2003-2012.

Cioffi Catherine E CE Figueroa Janet J Welsh Jean A JA

Journal of the Academy of Nutrition and Dietetics 20180109 5

<h4>Background</h4>Despite associations of dietary added sugar with excess weight gain and chronic disease risk, intake among most Americans exceeds the recommended limits (<10% total energy). Maternal diet plays an important role in pregnancy-related outcomes, but little is known about the extent of added sugar intake during pregnancy.<h4>Objective</h4>To assess intake and identify the top sources of added sugars in the diets of pregnant vs nonpregnant women in the United States.<h4>Design</h4> ...[more]

PMID: 29325892

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Project description:BACKGROUND:Findings from studies of alcohol and obesity measures (eg, waist circumference [WC] and body mass index [BMI; calculated as kg/m2]) are conflicting. Residual confounding by dietary intake, inconsistent definitions of alcohol consumption across studies, and the inclusion of former drinkers in the nondrinking comparison group can contribute to the mixed literature. OBJECTIVE:This study examines associations of alcoholic beverage consumption with dietary intake, WC, and BMI. DESIGN:Cross-sectional data from the 2003-2012 National Health and Nutrition Examination Survey were analyzed. PARTICIPANTS/SETTING:Adults 20 to 79 years of age (n=7,436 men; n=6,939 women) were studied. MAIN OUTCOME MEASURES:Associations of alcoholic beverage consumption with energy (kcal), macronutrient and sugar intakes (% kcal), WC, and BMI were determined. STATISTICAL ANALYSES PERFORMED:Multivariable linear regression models were used to determine associations of average daily volume and drinking quantity (ie, drinks per drinking day) with dietary intake and obesity measures. Former and never drinkers were analyzed as distinct categories; associations of drinking with WC and BMI were examined with and without adjustment for dietary intake variables. RESULTS:Heavier-drinking men (?3 drinks/day) and women (?2 drinks/day) consumed less nonalcoholic energy (? -252 kcal/day, 95% CI -346 to -159 kcal/day and ? -159 kcal/day, 95% CI -245 to -73 kcal/day, respectively) than moderate drinkers (1 to 2 drinks/day in men and 1 drink/day in women). By average daily drinking volume, differences in WC and BMI between former and moderate drinkers were +1.78 cm (95% CI 0.51 to 3.05 cm) and +0.65 (95% CI 0.12 to 1.18) in men and +4.67 cm (95% CI 2.95 to 6.39 cm) and +2.49 (95% CI 1.64 to 3.34) in women. Compared with moderate drinking, heavier drinking volume was not associated with WC or BMI among men or women. In men, drinking ?5 drinks/drinking day was associated with higher WC (? 3.48 cm, 95% CI 1.97 to 5.00 cm) and BMI (? 1.39, 95% CI 0.79 to 2.00) compared with men who consumed 1 to 2 drinks/drinking day. In women, WC and BMI were not significantly different for women drinking ?4 drinks/drinking day compared with 1 drink/drinking day. CONCLUSIONS:Differences in dietary intake across drinking subgroups and separation of former drinkers from nondrinkers should be considered in studies of alcohol intake in relation to WC and BMI.

Project description:IntroductionConsumption of added sugars (AS) has been associated with increased risk for liver disease and risk factors for cardiovascular disease. The objective of this study was to further understand the relationship of AS intake with liver enzymes and risk factors for cardiovascular disease in adults (n = 29,687) participating in the National Health and Nutrition Examination Survey (NHANES) 2001-2012.MethodsIndividual usual intake (IUI) of AS was estimated using the Markov Chain Monte Carlo ratio method using two days of 24-hour dietary recalls gathered using standardized protocols. Subjects were separated into six consumption groups: 0 to <5%, 5 to <10%, 10 to <15%, 15 to <20%, 20 to <25% and ≥25% of energy as added sugars. Linear and group trends were determined using regression analyses for liver enzymes, cardiovascular risk factors, weight parameters, glucose, metabolic syndrome, and C-reactive protein. Logistic regression calculated odds ratios for these biomarkers above established risk levels (p < 0.01).ResultsThere was an inverse group trend association with AS IUI for lower body mass index (beta = -0.12 kg/m2 across AS intake groups); % overweight/obese or % obese also showed inverse group trend (-1.44, -0.77, % units across AS intake groups, respectively). Liver enzymes did not show a significant association with AS IUI. Mean plasma glucose levels (mg/dL) showed an inverse linear (beta = -0.13 mg/dL per AS intake); and group association with energy from AS IUI (beta = -0.71mg/d L across AS intake groups). There was no association of AS intake with the risk of elevated uric acid levels; however, the odds of reduced uric acid levels was 17% lower with increasing intake of energy from AS IUI in group trend analysis only (0.83; 0.72-0.95 [99th CI]).ConclusionAlthough it is sensible to consume AS in moderation, results suggested that higher intakes of AS were not consistently associated with physiologic parameters. Since the data were cross-sectional, they cannot be used to assess cause and effect. Thus, additional studies are warranted to confirm these findings with more rigorous study designs.

Project description:BackgroundReexamining the prevalence of persons infected with tuberculosis (TB) is important to determine trends over time. In 2011-2012 a TB component was included in the National Health and Nutrition Examination Survey (NHANES) to estimate the reservoir of persons infected with TB.MethodsCivilian, noninstitutionalized U.S. population survey participants aged 6 years and older were interviewed regarding their TB history and eligibility for the tuberculin skin test (TST) and interferon gamma release assay (IGRA) blood test. Once eligibility was confirmed, both tests were conducted. Prevalence and numbers of TST positive (10 mm or greater), IGRA positive, and both TST and IGRA positive were calculated by adjusting for the complex survey design after applying corrections for item nonresponse and digit preference in TST induration measurements. To examine TST positivity over time, data from NHANES 1999-2000 were reanalyzed using the same statistical methods. The TST was performed using Tubersol, a commercially available purified protein derivative (PPD), rather than PPD-S, which was the antigen used in NHANES 1999-2000. Prior patient history of TB vaccination was not collected in this study nor were patients examined for the presence of a Bacillus of Calmette and Guerin (BCG) vaccine scar.ResultsFor NHANES 2011-2012, TST and IGRA results were available for 6,128 (78.4%) and 7,107 (90.9%) eligible participants, respectively. There was no significant difference between the percentage of the U.S. population that was TST positive in 2011-2012 (4.7% [95% CI 3.4-6.3]; 13,276,000 persons) compared with 1999-2000 (4.3%; 3.5-5.3). In 2011-2012 the percentage that was IGRA positive was 5.0% (4.2-5.8) and double TST and IGRA positivity was 2.1% (1.5-2.8). The point estimate of IGRA positivity prevalence in foreign-born persons (15.9%; 13.5-18.7) was lower than for TST (20.5%; 16.1-25.8) in 2011-2012. The point estimate of IGRA positivity prevalence in U.S.-born persons (2.8%; 2.0-3.8) was higher than for TST (1.5%; 0.9-2.6).ConclusionsNo statistically significant decline in the overall estimated prevalence of TST positivity was detected from 1999-2000 to 2011-2012. The prevalence of TB infection, whether measured by TST or IGRA, remains lower among persons born in the United States compared with foreign-born persons.

Project description:BACKGROUND:Recent detailed analyses of data on dietary sources of energy and nutrients in US children are lacking. The objective of this study was to identify food sources of energy and 28 nutrients for children in the United States. METHODS:Analyses of food sources were conducted using a single 24-h recall collected from children 2 to 18 years old (n = 7332) in the 2003-2006 National Health and Nutrition Examination Survey. Sources of nutrients contained in foods were determined using nutrient composition databases. Food grouping included ingredients from disaggregated mixtures. Mean energy and nutrient intakes from the total diet and from each food group were adjusted for the sample design using appropriate weights. Percentages of the total dietary intake that food sources contributed were tabulated by rank order. RESULTS:The two top ranked food/food group sources of energy and nutrients were: energy - milk (7% of energy) and cake/cookies/quick bread/pastry/pie (7%); protein - milk (13.2%) and poultry (12.8%); total carbohydrate - soft drinks/soda (10.5%) and yeast bread/rolls (9.1%); total sugars - soft drinks/soda (19.2%) and yeast breads and rolls (12.7%); added sugars - soft drinks/soda (29.7%) and candy/sugar/sugary foods (18.6%); dietary fiber - fruit (10.4%) and yeast bread/rolls (10.3%); total fat - cheese (9.3%) and crackers/popcorn/pretzels/chips (8.4%); saturated fatty acids - cheese (16.3%) and milk (13.3%); cholesterol - eggs (24.2%) and poultry (13.2%); vitamin D - milk (60.4%) and milk drinks (8.3%); calcium - milk (33.2%) and cheese (19.4%); potassium - milk (18.8%) and fruit juice (8.0%); and sodium - salt (18.5%) and yeast bread and rolls (8.4%). CONCLUSIONS:Results suggest that many foods/food groupings consumed by children were energy dense, nutrient poor. Awareness of dietary sources of energy and nutrients can help health professionals design effective strategies to reduce energy consumption and increase the nutrient density of children's diets.

Dataset Information

Added Sugar Intake among Pregnant Women in the United States: National Health and Nutrition Examination Survey 2003-2012.

Publications

Added Sugar Intake among Pregnant Women in the United States: National Health and Nutrition Examination Survey 2003-2012.

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