Trends in Diet Quality Among Youth in the United States, 1999-2016
Trends in Diet Quality Among Youth in the United States, 1999-2016
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DOI：
10.1001/jama.2020.0878
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发表时间：
2020-03-24
影响因子：
120.7
通讯作者：
Mozaffarian, Dariush
中科院分区：
文献类型：
--
作者：
Liu, Junxiu;Rehm, Colin D.;Mozaffarian, Dariush
重要性 先前对美国青少年饮食趋势的研究评估了主要常量营养素或仅评估了少数食物，或使用了较旧的数据。目的 描述美国青少年饮食质量的趋势。设计、设置和参与者 使用来自 9 个国家健康和营养检查调查 (NHANES) 周期（1999-2016）的 2 至 19 岁青少年的 24 小时饮食回忆进行系列横断面调查。 暴露 日历年和人口社会人口学特征。主要结果和测量主要结果是经调查加权、能量调整后的膳食成分平均消耗量以及满足美国心脏协会 (AHA) 2020 年连续饮食评分目标的比例（范围为 0-50；基于水果和蔬菜、全谷物、鱼和贝类、含糖饮料和钠的总量）。其他结果是 AHA 二级评分（范围，0-80；添加坚果、种子和豆类；加工肉类；和饱和脂肪）和健康饮食指数 (HEI) 2015 评分（范围，0-100）。不良饮食被定义为遵守率低于 40%（分数 = 64）。饮食得分越高表明饮食质量越好；结果 31 420 名 2 至 19 岁的青少年中，平均年龄为 10.6 岁；最小的临床重要差异尚未量化。 49.1%为女性。从1999年到2016年，估计的AHA主要饮食评分从14.8（95％CI，14.1-15.4）显着增加到18.8（95％CI，18.1-19.6）（改善27.0％），估计的AHA次要饮食评分从29.2（95％CI，28.1-30.4）增加到33.0（95％） CI，32.0-33.9）（改善 13.0%），估计 HEI-2015 分数从 44.6（95% CI，43.5-45.8）到 49.6（95% CI，48.5-50.8）（改善 11.2%）（P
IMPORTANCE Prior studies of dietary trends among US youth have evaluated major macronutrients or only a few foods or have used older data.OBJECTIVE To characterize trends in diet quality among US youth.DESIGN, SETTING, AND PARTICIPANTS Serial cross-sectional investigation using 24-hour dietary recalls from youth aged 2 to 19 years from 9 National Health and Nutrition Examination Survey (NHANES) cycles (1999-2016).EXPOSURES Calendar year and population sociodemographic characteristics.MAIN OUTCOMES AND MEASURES The primary outcomes were the survey-weighted, energy-adjusted mean consumption of dietary components and proportion meeting targets of the American Heart Association (AHA) 2020 continuous diet score (range, 0-50; based on total fruits and vegetables, whole grains, fish and shellfish, sugar-sweetened beverages, and sodium). Additional outcomes were the AHA secondary score (range, 0-80; adding nuts, seeds, and legumes; processed meat; and saturated fat) and Healthy Eating Index (HEI) 2015 score (range, 0-100). Poor diet was defined as less than 40% adherence (scores, = 64, respectively). Higher diet scores indicate better diet quality; a minimal clinically important difference has not been quantified.RESULTS Of 31 420 youth aged 2 to 19 years included, the mean age was 10.6 years; 49.1% were female. From 1999 to 2016, the estimated AHA primary diet score significantly increased from 14.8 (95% CI, 14.1-15.4) to 18.8 (95% CI, 18.1-19.6) (27.0% improvement), the estimated AHA secondary diet score from 29.2 (95% CI, 28.1-30.4) to 33.0 (95% CI, 32.0-33.9) (13.0% improvement), and the estimated HEI-2015 score from 44.6 (95% CI, 43.5-45.8) to 49.6 (95% CI, 48.5-50.8) (11.2% improvement) (P