title: Dietary sources of energy, solid fats, and added sugars among children and adolescents in the United States.
abstract: OBJECTIVE
  The objective of this research was to identify top dietary sources of energy, solid fats, and added sugars among 2- to 18-year-olds in the United States.
  
  
  METHODS
  Data from the National Health and Nutrition Examination Survey, a cross-sectional study, were used to examine food sources (percentage contribution and mean intake with standard errors) of total energy (data from 2005-2006) and energy from solid fats and added sugars (data from 2003-2004). Differences were investigated by age, sex, race/ethnicity, and family income, and the consumption of empty calories-defined as the sum of energy from solid fats and added sugars-was compared with the corresponding discretionary calorie allowance.
  
  
  RESULTS
  The top sources of energy for 2- to 18-year-olds were grain desserts (138 kcal/day), pizza (136 kcal/day), and soda (118 kcal/day). Sugar-sweetened beverages (soda and fruit drinks combined) provided 173 kcal/day. Major contributors varied by age, sex, race/ethnicity, and income. Nearly 40% of total energy consumed (798 of 2,027 kcal/day) by 2- to 18-year-olds were in the form of empty calories (433 kcal from solid fat and 365 kcal from added sugars). Consumption of empty calories far exceeded the corresponding discretionary calorie allowance for all sex-age groups (which range from 8% to 20%). Half of empty calories came from six foods: soda, fruit drinks, dairy desserts, grain desserts, pizza, and whole milk.
  
  
  CONCLUSIONS
  There is an overlap between the major sources of energy and empty calories: soda, grain desserts, pizza, and whole milk. The landscape of choices available to children and adolescents must change to provide fewer unhealthy foods and more healthy foods with less energy. Identifying top sources of energy and empty calories can provide targets for changes in the marketplace and food environment. However, product reformulation alone is not sufficient-the flow of empty calories into the food supply must be reduced.
authors.affiliation: Risk Factor Monitoring and Methods Branch, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892, USA. reedyj@mail.nih.gov
authors.forename: Jill
authors.initials: J
authors.lastname: Reedy
authors.forename: Susan M
authors.initials: SM
authors.lastname: Krebs-Smith
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D001628:Beverages / Q000009:adverse effects / Q000706:statistics & numerical data; D002253:Carbonated Beverages / Q000009:adverse effects / Q000706:statistics & numerical data; D002648:Child; D002664:Child Nutritional Physiological Phenomena / Q000502:physiology*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004032:Diet / Q000706:statistics & numerical data*; D004041:Dietary Fats / Q000008:administration & dosage* / Q000009:adverse effects; D019422:Dietary Sucrose / Q000008:administration & dosage* / Q000009:adverse effects; D002149:Energy Intake; D005006:Ethnicity; D005260:Female; D005502:Food / Q000145:classification; D006801:Humans; D007182:Income; D008297:Male; D009749:Nutrition Surveys; D009753:Nutritive Value; D009765:Obesity / Q000453:epidemiology / Q000209:etiology; D017678:Sex Distribution; D014481:United States
chemical_list: D004041:Dietary Fats; D019422:Dietary Sucrose