Consumption of energy-dense, nutrient-poor foods by adult Americans: nutritional and health implications. The third National Health and Nutrition Examination Survey, 1988-1994.
BACKGROUND
Current dietary guidance recommends limiting the intake of energy-dense, nutrient-poor (EDNP) foods, but little is known about recent consumption patterns of these foods.


OBJECTIVE
The contribution of EDNP foods to the American diet and the associated nutritional and health implications were examined.


METHODS
Data from the third National Health and Nutrition Examination Survey (n = 15611; age >/=20 y) were used. EDNP categories included visible fats, nutritive sweeteners and sweetened beverages, desserts, and snacks. The potential independent associations of EDNP food intake with intakes of energy, macronutrients, micronutrients, and serum vitamin, lipid, and carotenoid profiles were examined with linear and logistic regression procedures.


RESULTS
EDNP foods supplied approximately 27% of energy intake; alcohol provided an additional 4%. The relative odds of consuming foods from all 5 food groups and of meeting the recommended dietary allowance or daily reference intake for protein and several micronutrients decreased with increasing EDNP food intake (P: < 0.0001). Energy intake and percentage of energy from fat were positively related to EDNP intake. Serum concentrations of vitamins A, E, C, and B-12; folate; several carotenoids; and HDL cholesterol were inversely related (P: </= 0. 0005) whereas serum homocysteine concentration was positively related (P: = 0.02) to EDNP food intake.


CONCLUSIONS
The results suggest that EDNP foods were consumed at the expense of nutrient-dense foods, resulting in 1) increased risk of high energy intake, 2) marginal micronutrient intake, 3) poor compliance with nutrient- and food group-related dietary guidance, and 4) low serum concentrations of vitamins and carotenoids.
Kant
A K
AK
Department of Family, Nutrition, and Exercise Sciences, Queens College of the City University of New York, Flushing, NY 11367, USA. ahkqc@cunyvm.cuny.edu
D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data*; D000368:Aged; D003611:Dairy Products / Q000706:statistics & numerical data; D004032:Diet / Q000523:psychology / Q000706:statistics & numerical data*; D002523:Edible Grain / Q000378:metabolism; D002149:Energy Intake / Q000502:physiology*; D007887:Fabaceae / Q000378:metabolism; D005247:Feeding Behavior / Q000208:ethnology / Q000502:physiology*; D005260:Female; D005638:Fruit / Q000378:metabolism; D006801:Humans; D007407:Interviews as Topic; D016014:Linear Models; D008297:Male; D008460:Meat / Q000706:statistics & numerical data; D017058:Mexican Americans / Q000523:psychology / Q000706:statistics & numerical data*; D018977:Micronutrients / Q000378:metabolism; D008875:Middle Aged; D015999:Multivariate Analysis; D009749:Nutrition Surveys; D010946:Plants, Medicinal; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014675:Vegetables / Q000378:metabolism; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data*
D018977:Micronutrients