Not enough fruit and vegetables or too many cookies, candies, salty snacks, and soft drinks?
OBJECTIVE
There are many contributors to obesity, including excess consumption of "discretionary calories" (foods high in sugar and fat and low in essential nutrients), lack of fruit/vegetable consumption, and insufficient physical activity. This study contrasted physical activity, fruit/vegetable consumption, and discretionary calorie consumption from selected foods relative to the 2005 dietary guidelines.


METHODS
We conducted a cross-sectional survey in 228 urban census tracts in Los Angeles County (LAC) and Southern Louisiana (SL) and estimated calories in the past 24 hours from fruit, vegetables, cookies, candy, salty snacks, sweetened soda, and alcohol among 2,767 participants.


RESULTS
The population-weighted mean daily intake of calories from candy, cookies, salty snacks, soda, and alcohol was 438 in LAC and 617 in SL. Alcohol comprised a small portion of the calories consumed. Reported discretionary calorie consumption from a small set of items exceeded guidelines by more than 60% in LAC and 120% in SL. In contrast, the mean consumption of fruit and vegetables fell 10% short in LAC and 20% in SL. There was significant heterogeneity in consumption of cookies, candy, salty snacks, and soda across income, gender, and race.


CONCLUSIONS
The overconsumption of discretionary calories was much greater than the underconsumption of fruit and vegetables. This finding suggests that unless the excessive consumption of salty snacks, cookies, candy, and sugar-sweetened beverages is curtailed, other interventions focusing on increasing physical activity and fruit and vegetable consumption will have a limited impact on obesity control. It may be politically more expedient to promote an increase in consumption of healthy items rather than a decrease in consumption of unhealthy items, but it may be far less effective.
Cohen
Deborah A
DA
RAND Corporation, 1776 Main St., Santa Monica, CA 90407, USA. dcohen@rand.org
Sturm
Roland
R
Scott
Molly
M
Farley
Thomas A
TA
Bluthenthal
Ricky
R
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004032:Diet; D004034:Diet Surveys; D019422:Dietary Sucrose; D002149:Energy Intake / Q000502:physiology*; D005260:Female; D005638:Fruit; D006801:Humans; D015141:Los Angeles; D008145:Louisiana; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D009765:Obesity / Q000209:etiology / Q000517:prevention & control; D017673:Sodium Chloride, Dietary; D014675:Vegetables; D055815:Young Adult
D019422:Dietary Sucrose; D017673:Sodium Chloride, Dietary
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