What Americans eat drives global nutrition research

What Americans eat drives global nutrition research

FRTo track energy and sodium intake and determine nutritional indices used worldwide, the What We Eat in America program has quietly become one of the most influential data sources in modern nutritional science, driving research, monitoring and policy evaluation around the world.

Study: The reporting of “What We Eat in America” nutrient intake data in the scientific literature: A scoping review. Photo credit: Hryshchyshen Serhii/Shutterstock.com

A recent study in theNutrition magazineexamined the extent to which The What We Eat in America (WWEIA) nutrient data were published in the peer-reviewed scientific literature.

The What We Eat in America (WWEIA) study, a component of the U.S. national nutrition surveillance program called the National Health and Nutrition Examination Survey (NHANES), plays a critical role in informing and evaluating health and wellness policies, dietary guidelines, and food programs.

Importance of national nutrition surveillance

Assessing the nutritional content of foods through national nutritional surveillance is essential. The United States Department of Agriculture (USDA) plays a key role in characterizing foods based on their nutrient profiles. NHANES has been conducted continuously in the United States for over two decades and serves as the federal government's primary program for assessing the health and nutritional status of the population.

WWEIA serves as the dietary intake component of the U.S. NHANES, a key national surveillance program jointly managed by the USDA and the U.S. Department of Health and Human Services (HHS). WWEIA collects two 24-hour dietary recalls from a representative sample of noninstitutionalized Americans using the Automated Multiple-Pass Method (AMPM). The resulting data is used to support public health policy, develop nutritional guidelines, and evaluate food programs.

The Food and Nutrient Database for Dietary Studies (FNDDS), developed and maintained by the USDA, forms the basis for determining nutritional values. These features are specifically designed to analyze dietary intake data from WWEIA, NHANES, FNDDS, and AMPM and serve as interconnected tools within national nutrition surveillance. The foods and beverages listed in FNDDS are based on AMPM questions and answer choices. In addition to nutrient and food ingredient values ​​for foods and beverages consumed in the United States, FNDDS also contains comprehensive reference data for all nutritional values.

A look at a decade of nutritional studies

The current review included all nutritional components estimated in FNDDS, called nutrients, with the exception of added vitamin E and vitamin B12. This scoping review included publications that analyzed the US population or its subgroups using WWEIA or NHANES dietary intake data. All research contexts and applications of nutrient analysis were considered, with the exception of studies that focused solely on dietary supplement intake.

Eligible studies were English-language publications from January 2013 to October 2023 that reported at least one nutrient using WWEIA and NHANES data from any cycle of continuous NHANES (1999–2020). All relevant studies were obtained from multiple databases including Ovid MEDLINE.

Global dependence on US nutrition data

A total of 12,589 studies were displayed in the initial search. After removing duplicates, 2,203 studies met the inclusion criteria and were included in the scoping review. The number of studies has almost quadrupled, from 106 in 2013 to 414 in 2022. 375 studies were published between January 1 and October 18, 2023, reflecting the sub-year covered by the review.

Of the 2,203 publications reviewed, energy was cited in 78% of research. Nutrients commonly reported in at least a quarter of publications included total saturated fatty acids (SFAs), sodium, protein, polyunsaturated fatty acids (PUFAs), fiber, monounsaturated fatty acids (MUFAs), total fat, and carbohydrates.

Of the 63 nutrients examined, 42 appeared in over 100 studies, 26 in over 300, and 11 in over 500. The least commonly reported nutrients were individual SFAs and MUFAs and theobromine, each reported in approximately 2% of studies. At least one mineral, mainly sodium, was reported in 57% of studies. At least one vitamin was mentioned in approximately 35% of articles, with vitamin C mentioned most frequently (22%).

Researchers from 60 countries on six continents contributed to these studies. Approximately 18% of publications had authors from multiple countries. Most studies included authors from North America (64%), followed by Asia (37%), Europe (9%), South America (3%), Oceania (2%) and Africa (1%).

Thirty-one percent of publications used one of 38 nutritional indices, a more than threefold increase in ten years. The USDA Healthy Eating Index (HEI) and the Dietary Inflammatory Index were the most commonly used, while other indices each appeared in 5% or fewer of these studies. Fourteen percent of studies focused only on children (≤19 years), 51% on adults (≥20 years), and 33% included both age groups. Approximately 9% of studies used WWEIA and NHANES data in association with mortality outcomes.

WWEIA reporting trends highlight enduring research and policy value

This is the first study to systematically examine how often national nutrition surveillance data are published in the scientific literature. The number of studies has quadrupled in 10 years, with contributions from researchers around the world. Typically, nutrients that appear most frequently in the literature are those that have an established role in chronic disease risk and public health guidelines, such as: B. Energy, protein, sodium as well as total SFAs and PUFAs. The diverse and widespread use of these continuously collected, nationally representative data underscores their continued importance in nutrition research.

Advances in nutritional assessment methods and analysis, as well as integration with new data sources, will further increase the value of WWEIA and NHANES data. Continuous improvements in data accessibility, accuracy and granularity will enable more targeted research on population subgroups and dietary trends. As nutritional science evolves, these robust data sets will continue to be critical to inform policy, guide dietary recommendations, and address future public health challenges.

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