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Research Research and Professional Briefs| Volume 114, ISSUE 6, P908-917, June 2014

Where Are Kids Getting Their Empty Calories? Stores, Schools, and Fast-Food Restaurants Each Played an Important Role in Empty Calorie Intake among US Children During 2009-2010

Published:November 05, 2013DOI:https://doi.org/10.1016/j.jand.2013.08.012

      Abstract

      Consumption of empty calories, the sum of energy from added sugar and solid fat, exceeds recommendations, but little is known about where US children obtain these empty calories. The objectives of this study were to compare children's empty calorie consumption from retail food stores, schools, and fast-food restaurants; to identify food groups that were top contributors of empty calories from each location; and to determine the location providing the majority of calories for these key food groups. This cross-sectional analysis used data from 3,077 US children aged 2 to 18 years participating in the 2009-2010 National Health and Nutrition Examination Survey. The empty calorie content of children's intake from stores (33%), schools (32%), and fast-food restaurants (35%) was not significantly different in 2009-2010. In absolute terms, stores provided the majority of empty calorie intake (436 kcal). The top contributors of added sugar and solid fat from each location were similar: sugar-sweetened beverages, grain desserts, and high-fat milk
      For this article, “high-fat milk” includes both whole milk and 2% milk, and “low-fat milk“ includes both 1% and nonfat milk.
      For this article, “high-fat milk” includes both whole milk and 2% milk, and “low-fat milk“ includes both 1% and nonfat milk.
      from stores; high-fat milk, grain desserts, and pizza from schools; and sugar-sweetened beverages, dairy desserts, french fries, and pizza from fast-food restaurants. Schools contributed about 20% of children's intake of high-fat milk and pizza. These findings support the need for continued efforts to reduce empty calorie intake among US children aimed not just at fast-food restaurants, but also at stores and schools. The importance of reformed school nutrition standards was suggested, as prior to implementation of these changes, schools resembled fast-food restaurants in their contributions to empty calorie intake.

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      References

      1. Nutrition and Your Health: Dietary Guidelines for Americans, 2010. US Government Printing Office, Washington, DC2010
        • Dietary Guidelines Advisory Committee
        Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010, to the Secretary of Agriculture and the Secretary of Health and Human Services.
        US Department of Agriculture, Agricultural Research Service, Washington, DC2010
        • Taveras E.M.
        • Berkey C.S.
        • Rifas-Shiman S.L.
        • et al.
        Association of consumption of fried food away from home with body mass index and diet quality in older children and adolescents.
        Pediatrics. 2005; 116: e518-e524
        • Kant A.K.
        Reported consumption of low-nutrient-density foods by American children and adolescents: Nutritional and health correlates, NHANES III, 1988 to 1994.
        Arch Pediatr Adolesc Med. 2003; 157: 789-796
        • Templeton S.B.
        • Marlette M.A.
        • Panemangalore M.
        Competitive foods increase the intake of energy and decrease the intake of certain nutrients by adolescents consuming school lunch.
        J Am Diet Assoc. 2005; 105: 215-220
        • Mozaffarian D.
        • Katan M.B.
        • Ascherio A.
        • Stampfer M.J.
        • Willett W.C.
        Trans fatty acids and cardiovascular disease.
        N Engl J Med. 2006; 354: 1601-1613
        • Astrup A.
        • Dyerberg J.
        • Elwood P.
        • et al.
        The role of reducing intakes of saturated fat in the prevention of cardiovascular disease: Where does the evidence stand in 2010?.
        Am J Clin Nutr. 2011; 93: 684-688
        • Vartanian L.R.
        • Schwartz M.B.
        • Brownell K.D.
        Effects of soft drink consumption on nutrition and health: A systematic review and meta-analysis.
        Am J Public Health. 2007; 97: 667-675
        • Welsh J.A.
        • Sharma A.
        • Cunningham S.A.
        • Vos M.B.
        Consumption of added sugars and indicators of cardiovascular disease risk among US adolescents.
        Circulation. 2011; 123: 249-257
        • Welsh J.A.
        • Sharma A.
        • Abramson J.L.
        • Vaccarino V.
        • Gillespie C.
        • Vos M.B.
        Caloric sweetener consumption and dyslipidemia among US adults.
        JAMA. 2010; 303: 1490-1497
        • Kirkpatrick S.I.
        • Dodd K.W.
        • Reedy J.
        • Krebs-Smith S.M.
        Income and race/ethnicity are associated with adherence to food-based dietary guidance among US adults and children.
        J Acad Nutr Diet. 2012; 112: 624-635 e626
        • Krebs-Smith S.M.
        • Guenther P.M.
        • Subar A.F.
        • Kirkpatrick S.I.
        • Dodd K.W.
        Americans do not meet federal dietary recommendations.
        J Nutr. 2010; 140: 1832-1838
        • Slining M.M.
        • Popkin B.M.
        Trends in intakes and sources of solid fats and added sugars among U.S. children and adolescents: 1994-2010.
        Pediatr Obes. 2013; 8: 307-324
        • Poti J.M.
        • Popkin B.M.
        Trends in energy intake among US children by eating location and food source, 1977-2006.
        J Am Diet Assoc. 2011; 111: 1156-1164
        • Briefel R.R.
        • Crepinsek M.K.
        • Cabili C.
        • Wilson A.
        • Gleason P.M.
        School food environments and practices affect dietary behaviors of US public school children.
        J Am Diet Assoc. 2009; 109: S91-107
        • Nielsen S.J.
        • Siega-Riz A.M.
        • Popkin B.M.
        Trends in food locations and sources among adolescents and young adults.
        Prev Med. 2002; 35: 107-113
        • Guthrie J.F.
        • Lin B.H.
        • Frazao E.
        Role of food prepared away from home in the American diet, 1977-78 versus 1994-96: Changes and consequences.
        J Nutr Educ Behav. 2002; 34: 140-150
        • Lachat C.
        • Nago E.
        • Verstraeten R.
        • Roberfroid D.
        • Van Camp J.
        • Kolsteren P.
        Eating out of home and its association with dietary intake: A systematic review of the evidence.
        Obes Rev. 2012; 13: 329-346
        • Reedy J.
        • Krebs-Smith S.M.
        Dietary sources of energy, solid fats, and added sugars among children and adolescents in the United States.
        J Am Diet Assoc. 2010; 110: 1477-1484
      2. US Department of Agriculture, Agricultural Research Service, Beltsville Human Nutrition Research Center, Food Surveys Research Group, and US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. National Health and Nutrition Examination Survey 2009-2010. http://www.cdc.gov/nchs/nhanes/nhanes2009-2010/nhanes09_10.htm. Accessed September 1, 2012.

        • Welsh J.A.
        • Sharma A.J.
        • Grellinger L.
        • Vos M.B.
        Consumption of added sugars is decreasing in the United States.
        Am J Clin Nutr. 2011; 94: 726-734
      3. National Institutes of Health, National Cancer Institute. Documentation for the Pyramid servings database for NHANES III. 2010. http://riskfactor.cancer.gov/pyramid/documentation/ Accessed September 16, 2013.

        • Popkin B.M.
        • Haines P.S.
        • Siega-Riz A.M.
        Dietary patterns and trends in the United States: The UNC-CH approach.
        Appetite. 1999; 32: 8-14
      4. US Department of Agriculture, Agricultural Research Service, Beltsville Human Nutrition Research Center, Food Surveys Research Group, and US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. National Health and Nutrition Examination Survey 2009-2010 MEC in-person dietary interviewers procedure manual. http://www.cdc.gov/nchs/nhanes/nhanes2009-2010/current_nhanes_09_10.htm. Accessed January 1, 2013.

        • Rosenheck R.
        Fast food consumption and increased caloric intake: A systematic review of a trajectory towards weight gain and obesity risk.
        Obes Rev. 2008; 9: 535-547
      5. US Department of Agriculture, Agricultural Research Service, Beltsville Human Nutrition Research Center, Food Surveys Research Group, and US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. NHANES dietary web tutorial. http://www.cdc.gov/nchs/tutorials/Dietary/Basic/PopulationMeanIntakes/intro.htm. Accessed March 1, 2012.

        • Crepinsek M.K.
        • Gordon A.R.
        • McKinney P.M.
        • Condon E.M.
        • Wilson A.
        Meals offered and served in US public schools: Do they meet nutrient standards?.
        J Am Diet Assoc. 2009; 109: S31-S43
        • Johnston L.
        • O'Malley P.
        • Terry-McElrath Y.
        • Colabianchi N.
        School Policies and Practices to Improve Health and Prevent Obesity: National Secondary School Survey Results, School Years 2006-07 and 2007-08. Vol. 1. Bridging the Gap, Institute for Social Research, Ann Arbor, MI2011
        • Bodor J.N.
        • Rose D.
        • Farley T.A.
        • Swalm C.
        • Scott S.K.
        Neighbourhood fruit and vegetable availability and consumption: The role of small food stores in an urban environment.
        Public Health Nutr. 2008; 11: 413-420
        • Larson N.
        • Story M.
        A review of environmental influences on food choices.
        Ann Behav Med. 2009; 38: S56-S73
        • Timperio A.
        • Ball K.
        • Roberts R.
        • Campbell K.
        • Andrianopoulos N.
        • Crawford D.
        Children's fruit and vegetable intake: Associations with the neighbourhood food environment.
        Prev Med. 2008; 46: 331-335
        • He M.
        • Tucker P.
        • Irwin J.D.
        • Gilliland J.
        • Larsen K.
        • Hess P.
        Obesogenic neighbourhoods: The impact of neighbourhood restaurants and convenience stores on adolescents' food consumption behaviours.
        Public Health Nutr. 2012; 15: 2331-2339
        • Bowman S.A.
        • Gortmaker S.L.
        • Ebbeling C.B.
        • Pereira M.A.
        • Ludwig D.S.
        Effects of fast-food consumption on energy intake and diet quality among children in a national household survey.
        Pediatrics. 2004; 113: 112-118
        • French S.A.
        • Story M.
        • Neumark-Sztainer D.
        • Fulkerson J.A.
        • Hannan P.
        Fast-food restaurant use among adolescents: Associations with nutrient intake, food choices and behavioral and psychosocial variables.
        Int J Obes Relat Metab Disord. 2001; 25: 1823-1833
        • Powell L.M.
        • Nguyen B.T.
        Fast-food and full-service restaurant consumption among children and adolescents: Effect on energy, beverage, and nutrient intake.
        Arch Pediatr Adolesc Med. 2013; 167: 14-20
        • Paeratakul S.
        • Ferdinand D.P.
        • Champagne C.M.
        • Ryan D.H.
        • Bray G.A.
        Fast-food consumption among US adults and children: Dietary and nutrient intake profile.
        J Am Diet Assoc. 2003; 103: 1332-1338
        • Johnston L.
        • O'Malley P.
        • Terry-McElrath Y.
        • Colabianchi N.
        School Policies and Practices to Improve Health and Prevent Obesity: National Secondary School Survey Results, School Years 2006-07 and 2009-10. Vol. 2. Bridging the Gap, Survey Research Center, Institute for Social Research, Ann Arbor, MI2012
      6. Healthy Weight Commitment Foundation. Food and beverage manufacturers pledging to reduce annual calories by 1.5 trillion by 2015. 2010. http://www.healthyweightcommit.org/news/Reduce_Annual_Calories/. Accessed December 1, 2012.

        • Slining M.M.
        • Ng S.W.
        • Popkin B.M.
        Food companies' calorie-reduction pledges to improve U.S. diet.
        Am J Prev Med. 2013; 44: 174-184
      7. Walmart launches major initiative to make food healthier and healthier food more affordable. 2011. http://news.walmart.com/news-archive/2011/01/20/walmart-launches-major-initiative-to-make-food-healthier-healthier-food-more-affordable. Accessed December 1, 2012.

      8. Healthy, Hunger-Free Kids Act of 2010. Pub L No. 111-296 (2010).

        • French S.A.
        • Story M.
        Commentary on Nutrition Standards in the National School Lunch and Breakfast Programs.
        Arch Pediatr Adolesc Med. 2013; 167: 8-9
        • US Department of Agriculture, Food and Nutrition Service
        Nutrition standards in the National School Lunch and School Breakfast Programs. Final rule.
        Federal Register. 2012; (77): 4088-4167
        • O'Toole T.P.
        • Anderson S.
        • Miller C.
        • Guthrie J.
        Nutrition services and foods and beverages available at school: Results from the School Health Policies and Programs Study 2006.
        J Sch Health. 2007; 77: 500-521
        • Turner L.
        • Chaloupka F.J.
        Slow progress in changing the school food environment: Nationally representative results from public and private elementary schools.
        J Acad Nutr Diet. 2012; 112: 1380-1389
        • Harris J.L.
        • Schwartz M.B.
        • Brownell K.D.
        Fast food FACTS: Evaluating fast food nutrition and marketing to youth.
        Rudd Center for Food Policy and Obesity. 2010; (Accessed December 1, 2010)
        • Serrano E.L.
        • Jedda V.B.
        Comparison of fast-food and non-fast-food children's menu items.
        J Nutr Educ Behav. 2009; 41: 132-137
        • McDonald's U.S.A.
        Commitments to offer improved nutrition choices.
        (Accessed December 1, 2012)
      9. Arby's Foundation Inc. Arby's introduces new kids meal and partners with Share Our Strength's No Kid Hungry Campaign to help end childhood hunger. http://www.prnewswire.com/news-releases/arbys-introduces-new-kids-meal-and-partners-with-share-our-strengths-no-kid-hungry-campaign-to-help-end-childhood-hunger-130710038.html. Accessed December 2012.

      10. National Restaurant Association. Kids LiveWell. http://www.restaurant.org/foodhealthyliving/kidslivewell/about/. Accessed December 2012.

        • Bornhorst C.
        • Huybrechts I.
        • Ahrens W.
        • et al.
        Prevalence and determinants of misreporting among European children in proxy-reported 24 h dietary recalls.
        Br J Nutr. 2013; 109: 1257-1265
        • Burrows T.L.
        • Martin R.J.
        • Collins C.E.
        A systematic review of the validity of dietary assessment methods in children when compared with the method of doubly labeled water.
        J Am Diet Assoc. 2010; 110: 1501-1510
        • Briefel R.R.
        • Wilson A.
        • Gleason P.M.
        Consumption of low-nutrient, energy-dense foods and beverages at school, home, and other locations among school lunch participants and nonparticipants.
        J Am Diet Assoc. 2009; 109: S79-S90
        • Taber D.R.
        • Chriqui J.F.
        • Chaloupka F.J.
        Differences in nutrient intake associated with state laws regarding fat, sugar, and caloric content of competitive foods.
        Arch Pediatr Adolesc Med. 2012; 166: 452-458

      Biography

      J. M. Poti is a doctoral degree candidate, Department of Nutrition, University of North Carolina, Chapel Hill.

      Biography

      M. M. Slining is a research assistant professor, Department of Nutrition, University of North Carolina, Chapel Hill.

      Biography

      B. M. Popkin is W. R. Kenan, Jr, Distinguished Professor, Department of Nutrition, University of North Carolina, Chapel Hill.