Abstract
Background
Dried fruits are shelf-stable alternatives to fresh fruit that avert common barriers
to consuming fruit. Consumption of dried fruits may facilitate greater fruit consumption
and contribute to better diet quality and nutrient intakes.
Objective
Our aims were to assess differences in diet quality and cardiometabolic health between
dried fruit consumers and nonconsumers, and evaluate differences in nutrient intakes
on days when dried fruits were consumed vs not consumed.
Design
This is a cross-sectional analysis of data from the National Health and Nutrition
Examination Survey 2007-2016.
Participants/setting
Mean dried fruit intakes were estimated in adults 20 years and older (n = 25,590)
who completed a dietary recall. Dried fruit consumers (one-quarter cup-equivalent/day
or more) were defined in respondents with 2 complete dietary recalls (n = 22,311).
Within-person differences in nutrient intakes were assessed in respondents who consumed
dried fruit on 1 of 2 dietary recalls (n = 1,233).
Main outcome measures
Cardiometabolic risk factors, diet quality scored using the Healthy Eating Index 2015,
and nutrient intakes were assessed.
Statistical analyses
Diet quality and cardiometabolic health were compared in consumers vs nonconsumers
using multivariate linear regression, adjusted for demographic and lifestyle factors.
Within-person differences in nutrient intakes on days when dried fruits were consumed
vs not were assessed using multivariate linear regression.
Results
Mean ± standard error dried fruit intake was 0.04 ± 0.001 cup-equivalents and represented
3.7% of total fruit consumed. Consumers (7.2% of adults) had higher quality diets
than nonconsumers (mean ± standard error Healthy Eating Index 2015 score = 60.6 ±
0.5 vs 52.6 ± 0.3; P < 0.001) and lower mean body mass index, waist circumference, and systolic blood
pressure (P < 0.01). Total carbohydrate, dietary fiber, potassium, and polyunsaturated fat intakes
were greater on days when dried fruits were consumed vs not consumed (P < 0.001). Total calorie intakes were also greater (208-215 kcal; P ≤ 0.002) when dried fruits were consumed.
Conclusions
Dried fruit consumption is associated with higher diet quality and greater intakes
of underconsumed nutrients. However, dried fruits do not appear to displace other
calorie sources on days when consumed.
Keywords
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References
- Health effects of dietary risks in 195 countries, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017.Lancet. 2019; 393: 1958-1972
- 2015-2020 Dietary Guidelines for Americans. 8th ed. Published 2015.https://health.gov/dietaryguidelines/2015/guidelines/Date accessed: April 26, 2019
- Whole fruits and fruit fiber emerging health effects.Nutrients. 2018; 10
- Fruit polyphenols: A review of anti-inflammatory effects in humans.Crit Rev Food Sci Nutr. 2016; 56: 419-444
- The effects of polyphenols and other bioactives on human health.Food Funct. 2019; 10: 514-528
- Intrinsic and extrinsic factors impacting absorption, metabolism, and health effects of dietary carotenoids.Adv Nutr. 2018; 9: 465-492
- Fruit and vegetable consumption and the incidence of hypertension in three prospective cohort studies.Hypertension. 2016; 67: 288-293
- Food groups and risk of hypertension: A systematic review and dose-response meta-analysis of prospective studies.Adv Nutr. 2017; 8: 793-803
- Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality—A systematic review and dose-response meta-analysis of prospective studies.Int J Epidemiol. 2017; 46: 1029-1056
- Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies.Crit Rev Food Sci Nutr. 2019; 59: 1071-1090
- Food groups and risk of type 2 diabetes mellitus: A systematic review and meta-analysis of prospective studies.Eur J Epidemiol. 2017; 32: 363-375
- Fruit consumption and risk of type 2 diabetes: Results from three prospective longitudinal cohort studies.BMJ. 2013; 347
- Fruit and vegetable intake and risk of type 2 diabetes mellitus: Meta-analysis of prospective cohort studies.BMJ Open. 2014; 4e005497
- National Cancer Institute. Epidemiology and Genomics Research Program. Updated October 31, 2019. Accessed December 28, 2019.
- A qualitative study of perceived barriers to fruit and vegetable consumption among low-income populations, North Carolina, 2011.Prev Chron Dis. 2013; 10: E34
- Barriers and facilitators for consumer adherence to the Dietary Guidelines for Americans: The HEALTH Study.J Acad Nutr Diet. 2013; 113: 1317-1331
- Understanding barriers and facilitators of fruit and vegetable consumption among a diverse multi-ethnic population in the USA.Health Promot Int. 2008; 23: 42-51
- Position of the Academy of Nutrition and Dietetics: Total diet approach to healthy eating.J Acad Nutr Diet. 2013; 113: 307-317
- Economic Research Service, US Department of Agriculture. Updated August 20, 2019. Accessed December 29, 2019.
- Total fruit and vegetable consumption increases among consumers of frozen fruit and vegetables.Nutrition. 2018; 46: 115-121
- Canned vegetable and fruit consumption is associated with changes in nutrient intake and higher diet quality in children and adults: National Health and Nutrition Examination Survey 2001-2010.J Acad Nutr Diet. 2016; 116: 940-948
- Frequent canned food use is positively associated with nutrient-dense food group consumption and higher nutrient intakes in US children and adults.Nutrients. 2015; 7: 5586-5600
- Dried fruit consumption is associated with improved diet quality and reduced obesity in US adults: National Health and Nutrition Examination Survey, 1999-2004.Nutr Res. 2011; 31: 460-467
- Socioeconomic gradient in consumption of whole fruit and 100% fruit juice among US children and adults.Nutr J. 2015; 14: 3
- Diet quality is positively associated with 100% fruit juice consumption in children and adults in the United States: NHANES 2003-2006.Nutr J. 2011; 10: 17
- Intake of 100% fruit juice is associated with improved diet quality of adults: NHANES 2013-2016 analysis.Nutrients. 2019; 11: 2513
- 2019. US Department of Agriculture Agricultural Research Service.https://fdc.nal.usda.gov/index.htmlDate accessed: April 26, 2019
- Association of raisin consumption with nutrient intake, diet quality, and health risk factors in US adults: National Health and Nutrition Examination Survey 2001-2012.Food Nutr Res. 2017; 61: 1378567
- Within-person compensation for snack energy by US adults, NHANES 2007-2014.Am J Clin Nutr. 2019; 109: 1145-1153
- Update on NHANES dietary data: Focus on collection, release, analytical considerations, and uses to inform public policy.Adv Nutr. 2016; 7: 121-134
- Agricultural Research Service, Food Surveys Research Group. Published 2010.http://www.ars.usda.gov/nea/bhnrc/fsrgDate accessed: June 20, 2019
- Agricultural Research Service, Food Surveys Research Group. Published 2012. Accessed June 20, 2019.
- Agricultural Research Service, Food Surveys Research Group. Published 2014. Accessed June 20, 2019.
- Agricultural Research Service, Food Surveys Research Group. Published 2016. Accessed June 20, 2019.
- Agricultural Research Service, Food Surveys Research Group. Published 2018 Accessed June 20, 2019.
- US Department of Agriculture, Agricultural Research Service. Accessed June 20, 2019..
- 21CFR101.12. US Food and Drug Administration, Department of Health and Human Services. Accessed June10, 2020..https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr%20=%20101.12Date accessed: June 10, 2020
- Update of the Healthy Eating Index: HEI-2015.J Acad Nutr Diet. 2018; 118: 1591-1602
- Division of Cancer Control and Population Sciences, National Cancer Institute NCI. Accessed December 27, 2019.
- Centers for Disease Control and Prevention, National Center for Health Statistics. Accessed December 26, 2019.
- 2020. Scientific Report of the 2020 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Agriculture and the Secretary of Health and Human Services. US Department of Agriculture, Agricultural Research Service. Published July 2020. Accessed August 20, 2020.
- Energy Value of Foods: Basis and Derivation. Agriculture Handbook. No. 74.US Department of Agriculture, Washington, DC1973
- SAS [computer program]. Version 9.4. SAS Institute Inc, Cary, NC2018
- Statistical methods for estimating usual intake of nutrients and foods: A review of the theory.J Am Diet Assoc. 2006; 106: 1640-1650
- Centers for Disease Control and Prevention, National Center for Health Statistics. Accessed June 10, 2020.
- Centers for Disease Control and Prevention, National Center for Health Statistics. Published 2019. Accessed December 27, 2019.
- Sources of food group intakes among the US population, 2001-2002.J Am Diet Assoc. 2008; 108: 804-814
- Common ways Americans are incorporating fruits and vegetables into their diet: Intake patterns by meal, source and form, National Health and Nutrition Examination Survey 2007-2010.Public Health Nutr. 2016; 19: 2535-2539
- Trends in dietary carbohydrate, protein, and fat intake and diet quality among US adults, 1999-2016.JAMA. 2019; 322: 1178
- Effect of consumption of dried California Mission figs on lipid concentrations.Ann Nutr Metab. 2011; 58: 232-238
- The effect of fruit in different forms on energy intake and satiety at a meal.Appetite. 2009; 52: 416-422
- The relationship between dietary energy density and energy intake.Physiol Behav. 2009; 97: 609-615
- Dietary energy density is associated with energy intake and weight status in US adults.Am J Clin Nutr. 2006; 83: 1362-1368
- Dietary energy density and obesity: How consumption patterns differ by body weight status.Eur J Nutr. 2018; 57: 351-361
- Dietary energy density is associated with obesity and other biomarkers of chronic disease in US adults.Eur J Nutr. 2015; 54: 59-65
- Dietary energy density is associated with obesity and the metabolic syndrome in US adults.Diabetes Care. 2007; 30: 974-979
- Addressing current criticism regarding the value of self-report dietary data.J Nutr. 2015; 145: 2639-2645
- Estimating usual dietary intake from National Health and Nutrition Examination Survey Data Using the National Cancer Institute Method.Vital Health Stat 2. 2018; : 1-63
Biography
V. K. Sullivan is a graduate research assistant, The Pennsylvania State University, University Park.
Biography
M. Na is an assistant professor, The Pennsylvania State University, University Park.
Biography
D. N. Proctor is a professor of kinesiology, physiology, and medicine, The Pennsylvania State University, University Park.
Biography
P. M. Kris-Etherton is a distinguished professor of nutrition, The Pennsylvania State University, University Park.
Biography
K. S. Petersen is an assistant research professor, The Pennsylvania State University, University Park.
Article info
Publication history
Published online: October 28, 2020
Accepted:
August 21,
2020
Received:
April 6,
2020
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST P. M. Kris-Etherton was the principal investigator on a grant funded by the INC International Nut & Dried Fruit Council and the California Dried Plum Board.
FUNDING/SUPPORT There is no funding to disclose. Analyses and manuscript preparation were performed as part of dissertation research supported by the Department of Nutritional Sciences at The Pennsylvania State University.
Identification
Copyright
© 2021 by the Academy of Nutrition and Dietetics.
