Trends in Dietary Carbohydrate, Protein, and Fat Intake and Diet Quality Among US Adults, 1999-2016
Trends in Dietary Carbohydrate, Protein, and Fat Intake and Diet Quality Among US Adults, 1999-2016
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DOI：
10.1001/jama.2019.13771
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发表时间：
2019-09-24
影响因子：
120.7
通讯作者：
Bhupathiraju, Shilpa N.
中科院分区：
文献类型：
--
作者：
Shan, Zhilei;Rehm, Colin D.;Bhupathiraju, Shilpa N.
要点问题从1999年到2016年，美国成年人的碳水化合物、脂肪和蛋白质摄入量的趋势是什么？在这项包括43996名成年人的具有全国代表性的系列横断面研究中，低质量碳水化合物(主要是添加糖)的减少，而高质量碳水化合物(主要是全谷物)、植物蛋白(主要是全谷物和坚果)和多不饱和脂肪的增加。然而，42%的能量摄入量仍然来自低质量的碳水化合物，饱和脂肪的摄入量仍保持在能量的10%以上。美国成年人饮食中的常量营养素组成有所改善，但低质量碳水化合物和饱和脂肪的摄入量仍然居高不下。重要的是，经济、营养政策和食品加工方法的变化会影响膳食常量营养素的摄入量和饮食质量。有必要评估饮食摄入量、食物来源和饮食质量的趋势，以便为决策者提供信息。目的调查美国成年人膳食常量营养素摄入量、食物来源和饮食质量的变化趋势。设计、设置和参与者对美国全国代表性的24小时饮食回忆数据进行了连续横断面分析，这些数据来自9个国家健康和营养检查调查周期(1999-2016)，调查对象为20岁或以上的成年人。ExposureSurvey周期。主要结果和衡量标准饮食中大量营养素的摄入量及其亚类、食物来源和2015年健康饮食指数(范围为0-100；得分越高表明饮食质量越好；尚未定义最小的临床重要差异)。结果共调查43996人(加权平均年龄46.9岁，女性占51.9%)。从1999年到2016年，总碳水化合物的估计能量从52.5%下降到50.5%(差异，-2.02%；95%可信区间，-2.41%到-1.63%)，总蛋白质和总脂肪的估计能量分别从15.5%上升到16.4%(差异，0.82%；95%可信区间，0.67%-0.97%)和从32.0%上升到33.2%(差异，1.20%；95%可信区间，0.84%-1.55%)(均P
Key PointsQuestionWhat were the trends in carbohydrate, fat, and protein intake among US adults from 1999 to 2016? FindingsIn this nationally representative serial cross-sectional study that included 43996 adults, there were decreases in low-quality carbohydrates (primarily added sugar) and increases in high-quality carbohydrates (primarily whole grains), plant protein (primarily whole grains and nuts), and polyunsaturated fat. However, 42% of energy intake was still derived from low-quality carbohydrates and the intake of saturated fat remained above 10% of energy. MeaningThe macronutrient composition of diet among US adults has improved, but continued high intake of low-quality carbohydrates and saturated fat remain.ImportanceChanges in the economy, nutrition policies, and food processing methods can affect dietary macronutrient intake and diet quality. It is essential to evaluate trends in dietary intake, food sources, and diet quality to inform policy makers. ObjectiveTo investigate trends in dietary macronutrient intake, food sources, and diet quality among US adults. Design, Setting, and ParticipantsSerial cross-sectional analysis of the US nationally representative 24-hour dietary recall data from 9 National Health and Nutrition Examination Survey cycles (1999-2016) among adults aged 20 years or older. ExposureSurvey cycle. Main Outcomes and MeasuresDietary intake of macronutrients and their subtypes, food sources, and the Healthy Eating Index 2015 (range, 0-100; higher scores indicate better diet quality; a minimal clinically important difference has not been defined). ResultsThere were 43996 respondents (weighted mean age, 46.9 years; 51.9% women). From 1999 to 2016, the estimated energy from total carbohydrates declined from 52.5% to 50.5% (difference, -2.02%; 95% CI, -2.41% to -1.63%), whereas that of total protein and total fat increased from 15.5% to 16.4% (difference, 0.82%; 95% CI, 0.67%-0.97%) and from 32.0% to 33.2% (difference, 1.20%; 95% CI, 0.84%-1.55%), respectively (all P