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Trends in dietary intake among adults with type 2 diabetes: NHANES 1988-2012.

ABSTRACT: Dietary recommendations for adults with diabetes are to follow a healthy diet in appropriate portion sizes. We determined recent trends in energy and nutrient intakes among a nationally representative sample of US adults with and without type 2 diabetes.Participants were adults aged ?20 years from the cross-sectional National Health and Nutrition Examination Surveys, 1988-2012 (N = 49 770). Diabetes was determined by self-report of a physician's diagnosis (n = 4885). Intake of energy and nutrients were determined from a 24-h recall by participants of all food consumed. Linear regression was used to test for trends in mean intake over time for all participants and by demographic characteristics.Among adults with diabetes, overall total energy intake increased between 1988-1994 and 2011-2012 (1689 kcal versus 1895 kcal; Ptrend < 0.001) with evidence of a plateau between 2003-2006 and 2011-2012. In 2007-2012, energy intake was greater for younger than older adults, for men than women, and for non-Hispanic whites versus non-Hispanic blacks. There was no change in the percentage of calories from carbohydrate, total fat or protein. Percentage of calories from saturated fat was similar across study periods but remained above recommendations (11.2% in 2011-2012). Fibre intake significantly decreased and remained below recommendations (Ptrend = 0.002). Sodium, cholesterol and calcium intakes increased. There was no change in energy intake among adults without diabetes and dietary trends were similar to those with diabetes.Future data are needed to confirm a plateau in energy intake among adults with diabetes, although the opportunity exists to increase fibre and reduce saturated fat.

SUBMITTER: Casagrande SS

PROVIDER: S-EPMC5507749 | biostudies-other | 2017 Aug

REPOSITORIES: biostudies-other

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Trends in dietary intake among adults with type 2 diabetes: NHANES 1988-2012.

Casagrande S S SS Cowie C C CC

Journal of human nutrition and dietetics : the official journal of the British Dietetic Association 20170202 4

<h4>Background</h4>Dietary recommendations for adults with diabetes are to follow a healthy diet in appropriate portion sizes. We determined recent trends in energy and nutrient intakes among a nationally representative sample of US adults with and without type 2 diabetes.<h4>Methods</h4>Participants were adults aged ≥20 years from the cross-sectional National Health and Nutrition Examination Surveys, 1988-2012 (N = 49 770). Diabetes was determined by self-report of a physician's diagnosis (n = ...[more]

PMID: 28150347

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Project description:ImportanceMost studies of US dietary trends have evaluated major macronutrients or only a few dietary factors. Understanding trends in summary measures of diet quality for multiple individual foods and nutrients, and the corresponding disparities among population subgroups, is crucial to identify challenges and opportunities to improve dietary intake for all US adults.ObjectiveTo characterize trends in overall diet quality and multiple dietary components related to major diseases among US adults, including by age, sex, race/ethnicity, education, and income.Design, setting, and participantsRepeated cross-sectional investigation using 24-hour dietary recalls in nationally representative samples including 33,932 noninstitutionalized US adults aged 20 years or older from 7 National Health and Nutrition Examination Survey (NHANES) cycles (1999-2012). The sample size per cycle ranged from 4237 to 5762.ExposuresCalendar year and population sociodemographic subgroups.Main outcomes and measuresSurvey-weighted, energy-adjusted mean consumption and proportion meeting targets of the American Heart Association (AHA) 2020 continuous diet scores, AHA score components (primary: total fruits and vegetables, whole grains, fish and shellfish, sugar-sweetened beverages, and sodium; secondary: nuts, seeds, and legumes, processed meat, and saturated fat), and other individual food groups and nutrients.ResultsSeveral overall dietary improvements were identified (P < .01 for trend for each). The AHA primary diet score (maximum of 50 points) improved from 19.0 to 21.2 (an improvement of 11.6%). The AHA secondary diet score (maximum of 80 points) improved from 35.1 to 38.5 (an improvement of 9.7%). Changes were attributable to increased consumption between 1999-2000 and 2011-2012 of whole grains (0.43 servings/d; 95% CI, 0.34-0.53 servings/d) and nuts or seeds (0.25 servings/d; 95% CI, 0.18-0.34 servings/d) (fish and shellfish intake also increased slightly) and to decreased consumption of sugar-sweetened beverages (0.49 servings/d; 95% CI, 0.28-0.70 servings/d). No significant trend was observed for other score components, including total fruits and vegetables, processed meat, saturated fat, or sodium. The estimated percentage of US adults with poor diets (defined as <40% adherence to the primary AHA diet score components) declined from 55.9% to 45.6%, whereas the percentage with intermediate diets (defined as 40% to 79.9% adherence to the primary AHA diet score components) increased from 43.5% to 52.9%. Other dietary trends included increased consumption of whole fruit (0.15 servings/d; 95% CI, 0.05-0.26 servings/d) and decreased consumption of 100% fruit juice (0.11 servings/d; 95% CI, 0.04-0.18 servings/d). Disparities in diet quality were observed by race/ethnicity, education, and income level; for example, the estimated percentage of non-Hispanic white adults with a poor diet significantly declined (53.9% to 42.8%), whereas similar improvements were not observed for non-Hispanic black or Mexican American adults. There was little evidence of reductions in these disparities and some evidence of worsening by income level.Conclusions and relevanceIn nationally representative US surveys conducted between 1999 and 2012, several improvements in self-reported dietary habits were identified, with additional findings suggesting persistent or worsening disparities based on race/ethnicity, education level, and income level. These findings may inform discussions on emerging successes, areas for greater attention, and corresponding opportunities to improve the diets of individuals living in the United States.

Project description:ImportanceDietary supplements are commonly used by US adults; yet, little is known about recent trends in supplement use.ObjectiveTo report trends in dietary supplement use among US adults.Design, setting, and participantsSerial cross-sectional study using nationally representative data from the National Health and Nutrition Examination Survey (NHANES) collected between 1999 and 2012. Participants include noninstitutionalized adults residing in the United States, surveyed over 7 continuous 2-year cycles (sample size per cycle, 4863 to 6213).ExposuresCalendar time, as represented by NHANES cycle.Main outcomes and measuresIn an in-home interview, participants were queried on use of supplements in the preceding 30 days to estimate the prevalence of use within each NHANES cycle, and trends were evaluated across cycles. Outcomes included use of any supplements; use of multivitamins/multiminerals (MVMM; defined as a product containing ≥10 vitamins and/or minerals); and use of individual vitamins, minerals, and nonvitamin, nonmineral supplements. Data were analyzed overall and by population subgroup (including age, sex, race/ethnicity, and educational status), and were weighted to be nationally representative.ResultsA total of 37 958 adults were included in the study (weighted mean age, 46.4 years; women, 52.0% ), with an overall response rate of 74%. Overall, the use of supplements remained stable between 1999 and 2012, with 52% of US adults reporting use of any supplements in 2011-2012 (P for trend = .19). This trend varied by population subgroup. Use of MVMM decreased, with 37% reporting use of MVMM in 1999-2000 and 31% reporting use in 2011-2012 (difference, -5.7% [95% CI, -8.6% to -2.7%], P for trend < .001). Vitamin D supplementation from sources other than MVMM increased from 5.1% to 19% (difference, 14% [95% CI, 12% to 17%], P for trend < .001) and use of fish oil supplements increased from 1.3% to 12% (difference, 11% [95% CI, 9.1% to 12%], P for trend < .001) over the study period, whereas use of a number of other supplements decreased.Conclusions and relevanceAmong adults in the United States, overall use of dietary supplements remained stable from 1999-2012, use of MVMM decreased, and trends in use of individual supplements varied and were heterogeneous by population subgroups.

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Trends in dietary intake among adults with type 2 diabetes: NHANES 1988-2012.

Publications

Trends in dietary intake among adults with type 2 diabetes: NHANES 1988-2012.

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