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Introduction HELEN A. GUTHRIE In this session, two previously unpublished studies are presented an analysis of variety in the diet and an analysis of snacking and eating away from home. The 1977-1978 Nationwide Food Consumption Survey (NFCS) (USDA, 1983, 1984) and the Health and Nutrition Examination Surveys (HANES I and NHANES II) (USDHEW, 1979, 1984) have provided insights into the eating trends of Americans and the resulting nutritional adequacy of their diets (Crocetti and Guthrie, 1982~. Some results from those analyses confimned commonly held beliefs about how Americans eat. Other results, however, were surprising and brought into question long-held assumptions about eating trends in the United States. These findings are briefly presented here. NFCS AND HANES Since their inception, both NECS and HANES have provided infor- mation on the food and nutrient intake of the U.S. population. In order to use the findings of the early surveys for nutritional guidance, nutrition intervention programs, and food and agricultural policy, it became obvious that information beyond what Americans eat was needed; for example, we needed information on social, economic, demographic, and cultural factors associated with varying food patterns. Therefore, the 1977-1978 NFCS was modified to provide data sufficient to identify and determine the nutritional consequences of venous eating patterns of persons and to identify the demographic characteristics of 87
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88 EATING TRENDS AND NUTRITIONAL CONSEQUENCES respondents with common patterns of nutritional adequacy and inade- quacy. Similarly, NHANES It collected sufficient additional information on health practices to permit inferences about health nutrition indicators. Meal Patterns The NFCS indicated that 90% of all respondents ate regular meals- that is, two or three meals each day for 3 consecutive days (Crocetti and Guthrie, 19821. Of these, two-thirds ate three meals on each of 3 days, 8% ate two meals on each of 3 days, and the remaining respondents ate two or three meals on each of 3 days. The nutritional adequacy of re- spondents' diets was directly related to the number of days that respondents consumed regular meals, regardless of the number of snacks. Almost 50% of those who regularly ate two meals per day skipped breakfast, whereas when others missed a meal, it was more often the midday meal than breakfast. When the meal pattern differed for one day, that day was almost invariably a weekend day. The classification of eating occasion was based on the respondent's designation of breakfast, lunch, supper, snack, and so on. Snacking Three-quarters of the NFCS respondents reported snacking at least once in 3 days. When their intakes were compared to appropriate Recommended Dietary Allowances, those who snacked had more nutritionally adequate diets than those who did not snack, and as the number of snacks increased, the adequacy of diets of all age groups increased. This finding suggests that the nutrient density of snack foods was as high as that of foods selected for meals. For most people who snacked, the snacks provided from 10% to 20C%o of calories and of 10 assessed nutrients. Traditional snack foods, such as pretzels, chips, and soft dnnks, were eaten more often as part of a meal than as a snack; candy and ice cream were the only two foods mentioned more often as snacks than as part of a meal. As anticipated, the frequency of snacking declined with age. Compliance win Nutritional Guidance The NECS data were analyzed to determine the extent to which re- spondents chose foods that conformed to the basic four food guidance approach the major nutrition education effort at the time of the survey (Crocetti and Guthrie, 1982; Guthne and Wright, 19841. At least one- half the number of recommended servings from each of the four food
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INTRODUCTION 89 groups was consumed by 83% of respondents during the 3-day period, whereas only 3% consumed the recommended 6 servings from both the meat and milk groups and 12 servings from both the cereal and the fruit and vegetable groups. The higher the degree of compliance with the basic four recommendations, the more adequate the diet; however, respondents who followed the food pattern did not necessarily show a recommended distribution of caloric intake from carbohydrates, fat, and protein. Food Choice Although grocery stores reportedly stock several thousand food items and the USDA tables of food composition contain well over 4,000 entries, NFCS respondents reported a relatively small number of these foods with any frequency (Guthne and Wright, 1984~. For instance, oranges and orange juice, apples, and bananas accounted for 62% of the mentions of fruits; potatoes, tomatoes, lettuce, beans, peas, and corn accounted for 73% of the mentions of vegetables. Similarly, data from both NHANES and NFCS showed that more than 80% of the assessed nutrients came from fewer than six different foods. In addition, some foods reported in He NFCS were clearly identified with either children or adults (Crocetti and Guthne, 1982~. For example, milk, ice cream, soft dnnks, and nut buyers were consumed more frequently by children than by adults, whereas eggs and cheese were consumed more by adults. Tea and coffee, reported an average of 5.27 times over a 3-day period, were the most frequently reported items, followed closely by milk (5.1 mentions) and bread (4.7 mentions). This information should provide a basis for developing a less burdensome approach to assessing dietary intake and adequacy. Data from He NFCS and NHANES are voluminous, and nutritionists must continue to study Hem in order to answer questions about relation- ships among food patterns, nutrient adequacy, health indicators, and social factors. The following two papers analyze data from the NFCS that relate to variety in the diet and to snacking and eating away from home; such analyses provide a better understanding of the complexities of Amencan eating patterns and a stronger foundation on which to base nutrition policies and education efforts. REFERENCES Croeetti, A. F., and H. A. Gutlwie. 1982. Eating Behavior and Associated Nutrient Quality of Diets. Final report for contract 53-22 U4-9-192, October. Human Nutrition Center, Science and Education Administration. U.S. Department of Agriculture, Washington, D.C. Gutless, H. A., and H. S. Wright. 1984. Assessing Dietary Intakes. Final report for contract
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90 EATING TRENDS ED N=RITION~ CONSEQUENCES 58-3198-2-57, December. Human Nutrition Information Center. U.S. Department of Agri- culture, Washington, D.C. USDA (U.S. l:)epartment of Agriculture). 1983. Food Intakes: Individuals in 48 States, Year 1977-78. Human Nutrition Information Service, Consumer Nutrition Division, Nationwide Food Consumption Survey 1977-78, Report No. l-1, August. U.S. Department of Agriculture, Hyattsville, Md. USDA (U.S. Department of Agriculture). 1984. Food Intakes: Individuals in 48 States, Year 1977-78. Human Nutrition Information Service, Consumer Nutrition Division, Nationwide Food Consumption Survey 1977-78, Report No. I-2, November. U.S. Department of Agri- culture, Hyattsville, Md. USDHEW (U.S. Department of Health, Education, and Welfare). 1979. Dietary lutake Source Data: United States, 1971-74. DHEW Publication No. (PHS) 79-1221. Public Health Service, Office of Health Research, Statistics, and Technology. National Center for Health Statistics, Hyattsville, Md. USDHHS (U.S. Department of Health and Human Services). 1984. Dietary Intake Source Data: United States, 1976-80. DHEW Publication No. (PHS) 83-1681. Public Health Service, Office of Health Research, Statistics, and Technology. National Center for Health Statistics, Hyatts- ville, Md.