Describe and evaluate current dietary patterns and beverage consumption.
Approach to Answering the Question
Data Analysis and Food Pattern Modeling Cross-Cutting Working Group
Data Analysis Protocol
Developed for each scientific question being examined, the protocol describes the plan for how the data analysis will be conducted. The protocol provides the:
- Analytic framework,
- Analytic plan, and
- Analysis results.
For this question, dietary patterns will be described and evaluated in the following ways:
- The Healthy Eating Index - 2015 will be used to assess eating patterns of Americans ages 2+
- Average HEI-2015 total and components scores
- Distribution of HEI-2015 scores
- Food group and subgroup amounts per 100 calories will be used to describe dietary patterns of infants and toddlers
- Food Category contributions to total energy intake by age, sex, race and income
Beverage consumption will be described and evaluated in the following ways:
- Types of beverages consumed and their contribution to total beverage consumption
- Percent of U.S. population consuming types of beverages on a given day
- Volume of beverages consumed on a given day
- Variations in beverage consumption by age-sex groups
- Variations in beverage consumption by race-ethnicity
- Variations in beverage consumption by income
- Percent of energy, nutrients and food components from beverage types
- Macro/Micro nutrients
- Added sugars and caffeine
Note: The analytic plan for infants and toddlers is still in development. The analytic plan for ages 2+ is being implemented.
Draft Conclusion Statement
The draft conclusion statements listed below describe the state of the science related to the specific question examined. Draft conclusions are not considered final until they have been deliberated with and decided upon by the full Committee and published in the Committee’s final advisory report. Individual conclusion statements should not be interpreted as dietary guidance or the Committee’s overarching advice to the Departments.
The committee’s evaluation of food and beverage intake patterns started with infants ages 6 to less than 12 months. Once complementary foods and beverages are introduced to older infants, dietary patterns begin to evolve and vary to a large extent based on breastfeeding practices. With the exception of dairy, patterns of food group intakes and category sources of food groups among those 12 to 24 months are similar to those of the U.S. population ages 2 years and older.
For Americans ages 2 years and older, diet quality assessed by the Healthy Eating Index (HEI-2015), is not consistent with the existing recommendations in the Dietary Guidelines for Americans. Average diet quality has slightly improved in the last 10 years. Differences in overall HEI scores are seen across age, sex, race-ethnic, and income subgroups and by pregnancy and lactation status, though differences are small and poor diet quality is observed across all groups. HEI scores suggest that intakes are notably misaligned with recommendations for whole grains, fruits, vegetables, fatty acids ratio1, sodium, added sugars, and saturated fats across the population. Comparisons of diet quality are not possible from birth to less than 24 months of age as HEI recommendations do not exist.
For those 2 years and older, foods and beverages consumed via mixed dishes (e.g., burgers/sandwiches, casseroles, pizza, etc.), snacks and sweets, and beverages (other than milk and 100% juice) contribute 50 to 60% of total energy intake. Food subcategory source contributions to energy vary by age, sex, race-ethnicity, and income; however, for the total population the top five contributors to energy intakes include burgers and sandwiches; desserts and sweet snacks; rice, pasta and other grain-based mixed dishes; sweetened beverages; and chips, crackers, and savory snacks.
Beverages account for approximately 15 to 18% of total energy intake for Americans ages 2 years and older and for 30 to 60% of total added sugars intake. Non-Hispanic black and Hispanic children have the highest consumption of sweetened beverages and the lowest consumption of water. Non-Hispanic black children have the lowest consumption of milk. Intake of fluid milk is highest in early childhood and is progressively lower in older age groups up until adulthood; conversely, the intake of sweetened beverages is lowest among younger children but progressively higher among older age groups. Among all adults, alcoholic beverages contribute 21% (females; third largest source) and 31% (males; second largest source) of total daily beverage energy.
1Fatty acids ratio refers to the ratio of poly- and mono-unsaturated fatty acids to saturated fatty acids in the diet.