title: Update on NHANES Dietary Data: Focus on Collection, Release, Analytical Considerations, and Uses to Inform Public Policy.
abstract: NHANES is the cornerstone for national nutrition monitoring to inform nutrition and health policy. Nutritional assessment in NHANES is described with a focus on dietary data collection, analysis, and uses in nutrition monitoring. NHANES has been collecting thorough data on diet, nutritional status, and chronic disease in cross-sectional surveys with nationally representative samples since the early 1970s. Continuous data collection began in 1999 with public data release in 2-y cycles on ∼10,000 participants. In 2002, the Continuing Survey of Food Intakes by Individuals and the NHANES dietary component were merged, forming a consolidated dietary data collection known as What We Eat in America; since then, 24-h recalls have been collected on 2 d using the USDA's Automated Multiple-Pass Method. Detailed and targeted food-frequency questionnaires have been collected in some NHANES cycles. Dietary supplement use data have been collected (in detail since 2007) so that total nutrient intakes can be described for the population. The continuous NHANES can adapt its content to address emerging public health needs and reflect federal priorities. Changes in data collection methods are made after expert input and validation/crossover studies. NHANES dietary data are used to describe intake of foods, nutrients, food groups, and dietary patterns by the US population and large sociodemographic groups to plan and evaluate nutrition programs and policies. Usual dietary intake distributions can be estimated after adjusting for day-to-day variation. NHANES remains open and flexible to incorporate improvements while maintaining data quality and providing timely data to track the nation's nutrition and health status. In summary, NHANES collects dietary data in the context of its broad, multipurpose goals; the strengths and limitations of these data are also discussed in this review.
authors.affiliation: National Health and Nutrition Examination Survey, National Center for Health Statistics, CDC, Hyattsville, MD; n.ahluwalia@cdc.gov.
authors.forename: Namanjeet
authors.initials: N
authors.lastname: Ahluwalia
authors.affiliation: Office of Dietary Supplements, NIH, Bethesda, MD; and.
authors.forename: Johanna
authors.initials: J
authors.lastname: Dwyer
authors.affiliation: National Health and Nutrition Examination Survey, National Center for Health Statistics, CDC, Hyattsville, MD;
authors.forename: Ana
authors.initials: A
authors.lastname: Terry
authors.affiliation: Food Surveys Research Group, USDA, Beltsville, MD.
authors.forename: Alanna
authors.initials: A
authors.lastname: Moshfegh
authors.affiliation: National Health and Nutrition Examination Survey, National Center for Health Statistics, CDC, Hyattsville, MD;
authors.forename: Clifford
authors.initials: C
authors.lastname: Johnson
mesh_terms: D004032:Diet; D005247:Feeding Behavior; D006291:Health Policy; D006801:Humans; D009749:Nutrition Surveys / Q000379:methods*; D011634:Public Health; D012107:Research Design; D014481:United States
keywords: dietary assessment; epidemiology; nutrition databases; nutrition policy; nutritional surveillance; public policy; usual intake