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Diet Quality, Added Sugar, and Dietary Fiber Intakes in American ...
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Short Description: Individuals and the Diet and Health Knowledge Survey. 1994-1996 and 1998. Washington, DC: United States. Department of Agriculture, Agricultural Research ...
Content Inside: Diet Quality, Added Sugar, and Dietary Fiber Intakes in American Preschoolers Sibylle Kranz, PhD, RD1 Helen Smiciklas-Wright, PhD2 Lori A. Francis, PhD3 Abstract Purpose: The purpose of this cross-sectional study was to examine the relationship between meeting the intake recommendations for added sugar (AS) and dietary fiber and overall diet quality in American preschoolers from different ethnic backgrounds. Methods: Data from a nationally representative sample of preschoolers participating in the Continuing Survey of Food Intake by Individuals (CSFII) 1994-1996, and 1998 (n=5,437) were categorized into 3 groups: (1) meeting the recommendation for AS intake (10% of energy) and dietary fiber (14 g and 20 g in 2- to 3-year-olds and 4- to 5-year-olds, respectively; n=236); (2) meeting only 1 recommendation (n=1,502); and (3) meeting neither (n=3,699). Dietary AS and dietary fiber sources were ascertained. Mean energy intake, nutrient intake, and food group density were established within each category, and student's t test was employed to determine significant differences. Nutrient and food group density was also examined stratified by 4 distinct ethnic groups. Results: Children meeting both recommendations had better diet quality but also higher energy intakes than children meeting only 1 or neither recommendation. Conclusion: Most American preschoolers do not meet the dietary intake recommendations for AS and dietary fiber. Health professionals should work together to increase dietary fiber density and reduction of added sugar in the diets of preschoolers to improve diet quality and oral health. (Pediatr Dent 2006;28:164-171) KEYWORDS: CHILD NUTRITION, DIET QUALITY, SUGAR INTAKE Obesity and being overweight is a national epidemic. American and Hispanic children are overweight or obese Overweight is defined as body mass index (BMI) compared to non-Hispanic Caucasian children.4,5 of 25 to 29.9 BMI is calculated as weight in kilo- High body weight is the result of excessive energy intake grams divided by the square of height in meters. Obesity along with inadequate energy expenditure. Sugar con- is defined as a BMI of 30 or higher in adults. In children, sumption has been suggested to contribute to high energy overweight is represented by falling higher than the 85th intakes6,7 and is also associated with low diet quality8 and percentile and obesity higher than the 95th percentile on dental caries.9 It is estimated that 40% of children have the Center for Disease Control and Prevention (CDC) tooth decay by the time they turn 6 years old.10 Since most BMI-for-age growth charts.1 Recent estimates based on high sugar foods have low nutrient density, they are con- the National Health and Nutrition Examination Survey sidered sources of "empty calories." Children from certain (NHANES) 1999-2002 indicate that 65% of adults and ethnic groups at high risk for becoming overweight or obese 16% of children 6 to 18 years old are overweight or obese. are also at higher risk for dental caries11 and more likely This represents an increase of 16% in adults and 45% in to consume large amounts of added sugar.12 Thus, limit- children compared to prevalence rates from 1988-1994 ing added sugar consumption in these children not only (NAHNES III).2,3 Although there is an overall increasing improves oral health, but also increases overall diet quality trend in overweight and obesity rates, certain ethnic groups and prevents development of childhood obesity. appear to be at higher risk. More non-Hispanic African Total sugar in the diet is the sum of natural sugar and added sugar.13 Natural sugars include all sugars occurring naturally in foods. Consequently, diets high in natural sugar could be 1Dr. Kranz is assistant professor and 2Dr. Smiciklas-Wright is professor, expected to result in good diet quality. Added sugars are those Department of Nutritional Sciences, and 3Dr. Francis is assistant profes- added in the processing, cooking, or preparing of food and sor, Department of Biobehavioral Health and The Center for Human Development and Family Research in Diverse Contexts Family and Child those added at the table. Much added sugar in the diet comes Health Laboratory, Pennsylvania State University, University Park, Pa. from foods that are also high in fat (eg, pastries and candies). Correspond with Dr. Kranz at sxk72@psu.edu 164 Kranz et al. Diet Quality, Added Sugar, and Dietary Fiber Intakes in American Preschoolers Pediatric Dentistry 28:2 2006
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