Debra R Keast

Background Guidance from the United States Food and Drug Administration (FDA) includes targets for the food industry to voluntarily reduce the sodium content (mg/100 g) of packaged, processed, and prepared foods sold by stores and restaurants. Assessments of sodium intake by the United States population are needed to inform sodium-reduction efforts...

Background Serum concentrations of total cholesterol and related lipid measures have been associated with serum concentrations of per- and polyfluoroalkyl substances (PFAS) in humans, even among those with only background-level exposure to PFAS. Fiber is known to decrease serum cholesterol and a recent report based on National Health and Nutrition...

Treatment with prebiotics, a type of dietary fiber, was recently shown to increase antibody concentrations following influenza vaccination in a meta-analysis of clinical trials. In observational epidemiologic studies it is not possible to estimate intake of prebiotics, but quantifying intake of dietary fiber is routine. Our objective was to investi...

Fiber-rich food intake has been associated with lower serum concentrations of perfluoroalkyl substances (PFAS) in some studies and dietary fiber was related to lower serum PFAS in a recent study. Given the previous epidemiologic data suggesting that fiber might decrease serum PFAS concentrations, we examined the relation of serum PFAS concentration...

Fiber-rich food intake has been associated with lower serum concentrations of perfluoroalkyl substances (PFAS) in some studies, but dietary fiber per se has not to our knowledge been examined. Dietary fiber can adsorb some substances and trap them in a viscous gel matrix in the gut, resulting in excretion. We hypothesized that serum PFAS concentrat...

Notmany vegetables rank as a "favorite" among Americans, but tomatoes can fit that description. Consumption of tomatoes in the United States is second only to potatoes. Because of their nutrient density and widespread consumption, tomatoes were highlighted in the 2010 US Department of Agriculture Food Pattern's red and orange vegetable subgroup, wi...

This study determined and compared the mean daily intake of energy and nutrients from processed foods by level of processing (minimally processed; processed for preservation, nutrient enhancement, and freshness; mixtures of combined ingredients; ready-to-eat processed foods; and prepared foods/meals) among non-Hispanic white, non-Hispanic black, an...

Coffee and tea are traditional sources of caffeine in the diet, but other sources, such as energy drinks, are now available. Because risks and benefits of caffeine use are dose dependent, the public health consequences of caffeine consumption cannot be determined without data on amounts currently consumed by the US population. The objective was to...

Despite public health efforts to decrease risk of cardiovascular disease by promoting healthier dietary patterns, Americans persistently under-consume vegetables. Discovering feasible, achievable strategies to increase vegetable intake can contribute to improved dietary patterns and health outcomes. Tomatoes are the most consumed non-starchy vegeta...

The aim of this study was to investigate associations of yogurt and dairy consumption with energy, macronutrient, calcium, and vitamin D intakes, and associations with indicators of overweight/obesity in U.S. children in the National Health and Nutrition Examination Survey (NHANES 2005-2008). Using 24-hour recall data, children 8-18 years of age we...

The 2010 Dietary Guidelines for Americans (DGA) recommends nutrients to increase and to decrease for US adults. The contributions processed foods make to the US intake of nutrients to increase and decrease may vary by the level of processing and by population subgroup. The hypotheses that the intakes of nutrients to increase or decrease, as specifi...

Identification of current food sources of energy and nutrients among US non-Hispanic whites (NHW), non-Hispanic blacks (NHB), and Mexican American (MA) adults is needed to help with public health efforts in implementing culturally sensitive and feasible dietary recommendations. The objective of this study was to determine the food sources of energy...

Even in an era of obesity and dietary excess, numerous shortfall micronutrients have been identified in the diets of US children and adolescents. To help tailor strategies for meeting recommendations, it is important to know what foods contribute greatly to micronutrient intakes. Data are lacking on specific contributions made by added nutrients. O...

The risk of chronic disease cannot be predicted simply by the content of a single nutrient in a food or food group in the diet. The contribution of food sources of calories, added sugars and saturated fat (SFA) to intakes of dietary fiber and micronutrients of public health importance is also relevant to understanding the overall dietary impact of...

Ready-to-eat cereal (RTEC) has been associated with improved nutrient intake and weight status, but intake has not been studied in Mexican-American (MA) children. The objective of this study was to assess whether nutrient intake, mean adequacy ratio (MAR), and weight were associated with classification of 3 breakfast consumption groups: breakfast s...

Fruit contributes to dietary nutrient density and consumption of fruit in several forms (whole, dried, or 100% juice) has been reported to be associated with a healthier dietary pattern. The goal of this study was to examine the associations of the consumption of grapes (including fresh grapes, raisins, and 100% grape juice) with diet quality and f...

The nutritional impact of replacing beverages with coconut water was assessed by modeling dietary data from WWEIA/NHANES 2007–2010. Nutrient intake from beverages consumed by adults aged 19+ y (n=11,481) were determined using combination codes to classify beverages and account for additions. Categories included milk & milk drinks; fruit/vegetable j...

This study examined the associations of dairy and yogurt consumption with intakes of macronutrients, calcium (CA), and vitamin D (VIT D), and obesity measures among American children. Using 1‐day dietary recall data from NHANES 2005–2008, children aged 8–18 yr (n=3,786) were classified by dairy consumption: <1 (31%), 1‐<2 (28%), or 2+ servings (41%...

Dietary modeling was conducted to examine the nutritional impact of replacing beverages with coconut water. Nutrient intake from beverages consumed by WWEIA/NHANES 2007–2010 participants aged 9–18 y (n=3,252) were determined using combination codes to classify beverages and account for additions. Categories included milk & milk drinks; fruit/vegeta...

The animal protein and vegetable protein content of foods consumed in WWEIA/NHANES 2007–2010 were calculated using the relevant USDA Nutrient Database for Standard Reference (SR), the SR‐Link recipe file of the respective Food and Nutrient Database for Dietary Studies, and the MyPyramid Equivalent Database. Animal protein and vegetable protein inta...

Background: Recent detailed analyses of data on dietary sources of energy and nutrients in US children are lacking. The objective of this study was to identify food sources of energy and 28 nutrients for children in the United States. Methods: Analyses of food sources were conducted using a single 24-h recall collected from children 2 to 18 year...

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Identification of current food sources of energy and nutrients among US adults is needed to help with public health efforts to implement feasible and appropriate dietary recommendations. To determine the food sources of energy and 26 nutrients consumed by US adults the 2003-2006 National Health and Nutrition Examination Survey (NHANES) 24-h recall...

Abstract: Many adult Americans fail to meet nutrient requirements. The objective of this study was to examine 24-hour dietary recall data from NHANES 2003–2006 to test the hypothesis that white potatoes (not sweet potatoes) contributed important nutrients within energy needs to adults’ diets. Potato content of survey foods was determined using US D...

Processed foods are an integral part of American diets, but a comparison of the nutrient contribution of foods by level of processing with the recommendations of the Dietary Guidelines for Americans regarding nutrients to encourage or to reduce has not been documented. The mean reported daily dietary intakes of these nutrients and other components...

Background: Previous reports have shown that metabolic syndrome and some metabolic syndrome components are associated with serum 25-hydroxyvitamin D [25(OH)D]. Methods: Using the National Health and Nutrition Examination Surveys (NHANES), 2003-2006, we evaluated the associations of vitamin D intake (n=3543) and vitamin D status [25(OH)D; n=3529]...

To examine if children use supplements to fill gaps in nutritionally inadequate diets or whether supplements contribute to already adequate or excessive micronutrient intakes from foods. Data were analyzed for children (2-18 years) from the National Health and Nutrition Examination Survey 2003-2006, a nationally representative, cross-sectional surv...

More than half of US adults use dietary supplements. Some reports suggest that supplement users have higher vitamin intakes from foods than nonusers, but this observation has not been examined using nationally representative survey data. The purpose of this analysis was to examine vitamin intakes from foods by supplement use and how dietary supplem...

The 2010 Dietary Guidelines recommend that Americans increase vegetable and whole grain intake, minimize intake of added sugars and solid fats, and control calorie intake. Typical American diets fall short of goals for healthy eating patterns, but vegetarian diets are thought to be more consistent with dietary guidelines. Dietary intake from the Na...

Dietary Guidelines for Americans recommends three daily servings of low‐fat and fat‐free milk and milk products for people 9 y and older. Average dairy intake by children 9–18 y is 2.2 servings per day. In the U.S., most children consume at least one snack/day, and about 75% have two or more. This study determined the contribution of dairy foods co...

This study examined the associations between obesity measures, dairy and yogurt consumption, and intakes of calcium (CA), and vitamin D (VIT D) among American children. Using 1‐day dietary recall data from NHANES 2005–2008, children aged 8–18 yr (n=3,786) were classified by CA and VIT D intake tertiles, and dairy consumption: <1 (30%), 1‐<2 (29%),...

This study examined the associations between bone measures, dairy consumption, and intakes of protein (PRO), calcium (CA), and vitamin D (VIT D) among American women. Using 1‐day dietary recall data from NHANES 2005–2008, women aged 19+ yr (n=4,347) were classified by tertiles of PRO, CA and VIT D intake, and dairy consumption: <1 (n=2,239, 47%), 1...

A consumer guideline describing a “Continuum of Processed Foods” available from the International Food Information Council (IFIC) classified store‐bought foods into 5 categories including (1) minimally processed foods, (2) foods processed for preservation, (3) mixtures of combined ingredients, (4) ready‐to‐eat processed foods, and (5) prepared food...

Iron, zinc, and vitamin B12 have long been considered nutrients of concern for vegetarians, and vitamin D and calcium are of concern for both vegetarians (V) and non‐vegetarians (NV). Little data exist on the effect of supplementation on usual intakes of these nutrients, especially in V. Dietary intake from the National Health and Nutrition Examina...

The purpose of this study was to determine the association of out-of-hand nut (OOHN) consumption with nutrient intake, diet quality, and the prevalence of risk factors for cardiovascular disease and metabolic syndrome. Data from 24-hour recalls from individuals aged 2+ years (n = 24,385) participating in the 1999-2004 National Health and Nutrition...

Few recent epidemiologic studies have assessed the effect that nut consumption (including tree nuts and peanuts) has on health risks, including metabolic syndrome (MetS). This study compared the health risk for cardiovascular disease, type 2 diabetes, and MetS of nut consumers with that of nonconsumers. Adults 19+ years (n = 13,292) participating i...

Because dairy products provide shortfall nutrients (eg, calcium, potassium, and vitamin D) and other important nutrients, this study hypothesized that it would be difficult for Americans to meet nutritional requirements for these nutrients in the absence of dairy product consumption or when recommended nondairy calcium sources are consumed. To test...

Dietary supplement use is extensive in US adults. Some reports suggested that supplement users had higher nutrient intakes from the diet than did nonusers, but to our knowledge this finding has not been examined in nationally representative survey data. In this analysis, we examined mineral intakes from the diet by supplement-use categories and how...

Currently available whole-grain foods are not frequently consumed, and few children achieve the whole-grain intake recommendation. To investigate the influence on whole-grain consumption of substituting whole-grain for refined-grain ingredients of foods commonly consumed by children. Secondary cross-sectional analysis of publicly available food con...

Limited data are available on the source of usual nutrient intakes in the United States. This analysis aimed to assess contributions of micronutrients to usual intakes derived from all sources (naturally occurring, fortified and enriched, and dietary supplements) and to compare usual intakes to the Dietary Reference Intake for U.S. residents aged ≥...

This study examined the association between the nutrient contribution of beef, in its lowest and highest fat forms, and diet quality and food patterns in individuals 4+years of age. Beef consumers were categorized into three groups (lowest lean/highest fat [LLHF]; middle lean/middle fat content; and highest lean/lowest fat [HLLF]) based on the lean...

Epidemiological studies examining potential associations between dried fruit consumption, diet quality, and weight status are lacking. The goal of this study was to examine the association of dried fruit consumption with nutrient intake, diet quality, and anthropometric indicators of overweight/obesity. A secondary analysis of dietary and anthropom...

The 2005 Dietary Guidelines recommends three cup equivalents (CEQ) of low‐fat or fat‐free milk or milk products (MMP) for those 9+ yrs. Current intake of MMP is 1.8 CEQ/day (2+ yrs). Changes in energy and nutrient intakes were modeled if 25, 50 or 100% of the population increased MMP just one CEQ/day using NHANES, 2003–2006, data for subjects 2+ yr...

This study examined the nutritional contribution of total beef and lean beef (LB) to the diet of US children and adolescents using the US Department of Agriculture definition of LB as defined in MyPyramid. Twenty-four hour dietary recall data from children 4-8 years of age [y] (n=2474), 9-13 y (n=3273), and adolescents 14-18 y (n=4044) participatin...

Competitive foods/beverages are those in school vending machines, school stores, snack bars, special sales, and items sold à la carte in the school cafeteria that compete with United States Department of Agriculture (USDA) meal program offerings. Grouping à la carte items with less nutritious items allowed in less regulated venues may obfuscate ana...

Snacking is common in adolescents; however, it is unclear if there is an association between snacking and overweight or obesity within the context of the overall diet. This study examined the associations of snacking with weight status and abdominal obesity in adolescents 12-18 y of age (n = 5811). We conducted secondary analyses of 24-h diet recal...

National data comparing nutrient intakes and anthropometric measures in children/adolescents in the United States who skip breakfast or consume different types of breakfasts are limited. To examine the relationship between breakfast skipping and type of breakfast consumed with nutrient intake, nutrient adequacy, and adiposity status. Children aged...

Consumption of lean meat is a valuable addition to a healthy diet because it provides complete protein and is a rich source of vitamin B(12), iron, and zinc. The objective of this study was to examine the nutritional contribution of total beef and lean beef (LB) to the American diet using the USDA definition of LB as defined in MyPyramid. Twenty-fo...

The dietary guidelines recommend consuming meats in its lowest fat form. NHANES 1999–2004 24‐hr dietary recall data were used to compare nutrient intake and diet quality (HEI‐2005) between highest lean/lowest fat (HLLF) beef consumers and lowest lean/highest fat (LLHF) beef consumers aged 4+ y (n = 11,507). Beef intakes were determined by summing a...

NHANES, 1999–2006, data (n=29,343 aged 6+ years) were used to examine associations of ice cream with obesity. Children, adolescents and adults were classified as nonconsumers or consumers of regular/rich or light/fat‐free ice cream served from multiple‐serving packages (MSP) or available as single‐serving products (SSP). Measures of obesity were ov...

NHANES (1999–2004), data were used to examine the association of out‐of‐hand tree nut consumption (almonds, Brazil nuts, cashews, filberts, macadamias, pecans, pine nuts, pistachios, and walnuts) with diet quality, nutrient intakes, and health risks in adults 19+ yrs (n=13,292). Using 24 hour recall data, tree nut consumption was defined as intake...

Many Americans have vitamin D intakes below the Adequate Intake level. This study examined food sources of vitamin D using NHANES, 2003–2006, data and the recently released Vitamin D Addendum to USDA Food and Nutrient Database for Dietary Studies 3.0. Vitamin D intakes were determined for all subjects 2 yrs and older with complete, reliable 24‐hr r...

The impact of substituting whole grains for refined grains in the food supply was examined using 24‐hour dietary recall data from children 9–18 years of age in NHANES, 2003–2004 (n=2,349). Varying proportions of refined wheat flour were replaced depending on the acceptability of whole grain foods tested among children in schools. A proportion of wh...

Diets containing foods that are good sources of potassium and low in sodium may reduce the risk of high blood pressure and stroke. The aim of this study was to examine dietary food sources of potassium (K), and the sodium‐potassium (Na/K) ratio of foods consumed in the U.S. NHANES, 2003–2006, 24‐hr recall data from subjects 2+ years (n=16,822) were...

Dietary food patterns recommended for children and adults include two/three daily servings of dairy foods to provide important bone building nutrients, namely calcium (Ca), phosphorus (P), and vitamin D and contribute to potassium (K) intakes. The aim of this study was to determine dietary sources of Ca, P, vitamin D, and K in the U.S. using NHANES...

Recent epidemiologic studies assessing tree nut (almonds, Brazil nuts, cashews, hazelnuts, macadamia nuts, pecans, pine nuts, pistachios, and walnuts) consumption and the association with nutrient intake and diet quality are lacking. This study determined the association of tree nut consumption and nutrient intake and diet quality using a nationall...

The goal of this study was to determine whether nutrient intake, dietary adequacy, and weight status were associated with type of breakfast consumption: skipping breakfast, consuming ready-to-eat cereal (RTEC) at breakfast, or consuming other types of foods at breakfast. Data from black adolescents 13 to 18 years of age (n = 988) participating in t...

Ranking and/or classifying foods based on their nutrient composition is known as nutrient profiling. Nutrition quality indices need to be tested and validated against quality of the total diet. A family of nutrient-rich foods (NRF) indices were validated against the Healthy Eating Index (HEI), an accepted measure of diet quality. All foods consumed...

NHANES, 1999‐2004, 24‐hr dietary recalls were used to examine the contribution of lean beef (LB) to total nutrient intake in diets of children 9‐13 years (n=3,273), and determine dietary intake differences between LB consumers and non‐consumers.. LB was defined by MyPyramid Equivalents Database as beef contributing <9.28g fat per 100g. The nutrient...

The aim of this study was to examine the association of snacking with diet quality in adolescents aged 12‐18 years (n = 5,811). Snacks/drinks were combined when eating occasions were named in the 24‐h recall, but analysis separated snacks from snacks/drinks that were only drinks. Adolescents were classified by frequency of snack consumption (0, 1,...

The aim of this study was to examine associations of snacking with weight status and abdominal obesity in adolescents aged 12‐18 years (n = 5,811). Snacks/drinks were combined when eating occasions were named in the 24‐h recall, but analysis separated snacks from snacks/drinks that were only drinks. Adolescents were classified by frequency of snack...

NHANES, 1999‐2004, data were used to examine the associations of dried fruit consumption with body weight and adiposity in adults 19+ years (n=13,292). Group definitions were non‐consumers vs. consumers of =1/8 equivalent cup fruit/day from dried fruit (eaten out of hand or contained in foods). Anthropometric assessments were overweight/obesity (BM...

Using 24‐hr recall dietary data from the National Health and Nutrition Examination Survey (NHANES) 2003‐2006 we determined the contribution white potatoes (excluding potato chips) make to the diets of children 2‐18 years (n=7,332) and adults 19+ years (n=9,490). In children, the average consumption of white potatoes was 31.7 g/d per capita and 89.8...

The Nutrient Rich Food Index is calculated as the sum of the Daily Values (DV) of nine nutrients to encourage (protein; fiber; vitamins A, C, and E; Ca; Mg; Fe; K) minus the sum of the DV of three nutrients to limit (saturated fat, Na, and added sugars DV=50) per 100 calories. Using USDA's Food and Nutrient Database for Dietary Studies we calculate...

The National Ambulatory Medical Care Surveys (NAMCS) and National Hospital Ambulatory Medical Care Surveys (NHAMCS) are surveillance systems in the USA that track provider practice patterns at ambulatory care visits. This study investigated the adequacy of the NAMCS/NHAMCS for surveillance of childhood obesity practice patterns. The frequency of ob...

The objective of the present study was to assess whether weight status, nutrient intake and dietary adequacy were associated with breakfast consumption patterns. A representative sample of the US population was used in a secondary analysis of nutrient intake/diet quality and weight status by breakfast consumption patterns. The 1999-2002 National He...

The aim of this study was to describe meal patterns of adolescents ages 12–18 years (n = 5,811), and energy intake from snacks/drinks consumed between meals. NHANES, 1999–2004, Day 1, 24‐h recall data were classified by food group, meal type and time of day. Snacks/drinks were consumed by 90% of adolescents; 653 Kcal from snacks/drinks was 28% of t...

The aim of this study was to examine the association of an RTEC breakfast with diet quality and weight of AA (n=2377) and HA (n=3236) 1 to 18 y in NHANES, 1999–2002. Three breakfast groups were: skippers, RTEC, and other breakfast (OB); age groups were 1–5, 6–12, 13–18 y. Mean adequacy ratio (MAR) score was the average percentage of the Estimated A...

To examine the effect of substituting canola oil for selected vegetable oils and canola oil-based margarine for other spreads on energy, fatty acid, and cholesterol intakes among US adults. Twenty-four-hour food recall data from the 1999-2002 National Health and Nutrition Examination Survey (NHANES) were used to calculate the effect of substituting...

Folic acid fortification is an effective strategy for improving the folate status of women in their childbearing years and for the primary prevention of pregnancies affected by neural tube defects. However, the optimal fortification level has not been identified, and some populations may be at risk of excessive folic acid intakes.

Mean intake of vitamin D in the United States was estimated from food and food plus supplements and compared with recommended intake levels. US men, nonpregnant and nonlactating women, and nonbreastfeeding children aged 1 year and older who participated in the Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994) or the Con...

To estimate the frequency of disordered eating behaviors among college students and associations by gender, ethnicity, participation in social organizations and college athletics and to determine whether responses to eight health behavior and attitude questions and body weight predicted a high score on the Eating Attitudes Test (EAT)-26, a screenin...

One in five Americans has high blood pressure, yet a third are not aware of their condition. To date, an impressive body of evidence supports the beneficial effect of diet on this highly prevalent and deadly, yet modifiable risk factor. Soluble viscous fiber has been recognized for its role in reducing blood cholesterol and emerging clinical data o...