title: Energy and nutrient intake from pizza in the United States.
abstract: OBJECTIVE
  Pizza consumption is a top contributor to children's and adolescents' caloric intake. The objective of this study was to examine children's and adolescents' pizza consumption patterns and its impact on their energy and nutrient intake.
  
  
  METHODS
  Twenty-four-hour dietary recall data for children aged 2 to 11 and adolescents aged 12 to 19 were drawn from the 2003-2004, 2005-2006, 2007-2008, and 2009-2010 National Health and Nutrition Examination Survey. We tested changes in consumption patterns, including by race/ethnicity, income, meal occasion, and source. Individual-level fixed effects regression models estimated the impact of pizza consumption on total energy intake (TEI) and intakes of sugar, saturated fat, and sodium.
  
  
  RESULTS
  From 2003-2004 to 2009-2010, overall energy intake from pizza declined 25% among children (110 to 83 kcal, P ≤ .05). Among adolescents, although caloric intake from pizza among those who consumed pizza fell (801 to 624 kcal, P ≤ .05), overall pizza intake remained unchanged due to slightly higher pizza consumption prevalence. For children and adolescents, pizza intake fell (P ≤ .05) at dinner time and from fast food. For children and adolescents, respectively, pizza consumption was significantly associated with higher net daily TEI (84 kcal and 230 kcal) and higher intakes of saturated fat (3 g and 5 g) and sodium (134 mg and 484 mg) but not sugar intake, and such affects generally did not differ by sociodemographic characteristics. Pizza consumption as a snack or from fast-food restaurants had the greatest adverse impact on TEI.
  
  
  CONCLUSIONS
  The adverse dietary effects of pizza consumption found in this study suggest that its consumption should be curbed and its nutrient content improved.
authors.affiliation: Division of Health Policy and Administration, School of Public Health, and Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois; powelll@uic.edu.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Powell
authors.affiliation: Economic and Health Policy Research Program, Intramural Research Department, American Cancer Society, Atlanta, Georgia; and.
authors.forename: Binh T
authors.initials: BT
authors.lastname: Nguyen
authors.affiliation: Sumner M. Redstone Global Center for Prevention and Wellness, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia.
authors.forename: William H
authors.initials: WH
authors.lastname: Dietz
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004034:Diet Surveys; D004041:Dietary Fats / Q000008:administration & dosage; D002149:Energy Intake; D057140:Fast Foods; D005260:Female; D006801:Humans; D008297:Male; D009749:Nutrition Surveys; D009753:Nutritive Value; D012959:Socioeconomic Factors; D012982:Sodium, Dietary / Q000008:administration & dosage; D014481:United States
chemical_list: D004041:Dietary Fats; D012982:Sodium, Dietary
keywords: energy intake; nutrition; obesity; pizza consumption