Who consumed sweet foods?

On the intake day, 61% of all adults consumed sweet foods, and percentages did not differ between men (58%) and women (64%; data not shown). As figure 1 illustrates, a significantly larger percentage of adults in the oldest age group than in the younger groups reported a sweet food. The same relationship was observed by sex, though among men only the youngest and oldest groups differed.

Figure 1

Percentage who consumed sweet foods, by sex and age, 2015-2018. *Positive linear trend (p<0.001) by age group. ^a,bWithin sex, estimates with different letters are significantly different (p<0.001).

Did the percentage of adults who consumed sweet foods differ by race and Hispanic origin?

Among adults of all ages, the percentage who consumed sweet foods was higher for non-Hispanic (NH) White adults than for NH Black or NH Asian adults (figure 2; p<0.001). These overall findings reflect the findings in the oldest age group. In contrast, no differences by race/Hispanic origin were found among individuals age 20-39 years and 40-59 years.

Figure 2

Percentage of adults who consumed sweet foods, by age and race/Hispanic origin, 2015-2018. ^a,bWithin age group, estimates with different letters are significantly different (p<0.001).

Did the percentage of adults who consumed sweet foods differ by income?

As shown in figure 3, a significantly larger percentage of adults in the middle and highest family income groups consumed sweet foods as compared to those in the lowest income group (p< 0.001). These findings reflect differences in sweet foods consumption between the lowest family income group and one or more of the higher family income groups among adults ≥ 40 years.

Figure 3

Percentage of adults who consumed sweet foods, by age and family income (Poverty Income Ratio), 2015-2018. *Positive linear trend (p<0.001) by age group. ^a,bWithin age group, estimates with different letters are significantly different from one (more...)

What types of sweet foods did adults eat?

Considering all instances of sweet foods eaten by adults, slightly fewer than one-half (45%) were sweet bakery products, and nearly one-third were candy (31%), as shown in figure 3. Looking at the WWEIA Food Categories (shown outside the pie chart below; see “Definitions” on page 8) that are included in those food groups, cookies and brownies were the most commonly reported (24%), followed by candy containing chocolate (16%).

Figure 4

Distribution of sweet foods by type among adults, 2015-2018. ¹Percentages of sweet foods in WWEIA Food Categories do not sum to percentage for the indicated food group due to rounding.

Was total daily energy intake higher for sweet foods reporters than for non-reporters?

In all age groups, total energy was higher on the intake day for sweet foods reporters than for non-reporters (p<0.001; see “Definitions” on page 8). Moreover, the amount of energy provided by sweet foods for reporters more or less accounted for the difference in energy intake between reporters and non-reporters. For example, for adults age 20-39 years, the difference in total energy intake between reporters and non-reporters was 341 kilocalories, and reporters in that age group obtained 354 kilocalories from sweet foods.

There was little variation by age group in the amount of energy that sweet foods contributed to daily intake of reporters (354 to 383 kilocalories). However, sweet foods accounted for a significantly higher percentage of total energy among adults 60+ years (19%) than among those 20-39 years (15%) and 40-59 years (16%; p<0.001).

Figure 5

Energy intake (kilocalories) among adults by sweet foods reporting status, 2015-2018. *Total daily energy intake is significantly higher for sweet foods reporters than for non-reporters (p<0.001).

How much did sweet foods contribute to reporters’ total daily intakes of energy and selected nutrients?

Figure 6 illustrates sweet foods’ contributions to intakes of selected nutrients relative to their contribution to energy intake. For adult reporters, sweet foods provided 16% of total energy, 36% of added sugars, and 22% of saturated fats, but only 15% or less of all vitamins and minerals examined.

Figure 6

Percentage of total daily intakes of energy and selected nutrients contributed by sweet foods among adults who consumed them, 2015-2018. ¹DFE = dietary folate equivalents.

How much energy did reporters obtain from the different types of sweet foods?

The mean daily energy contributions of sweet foods to intakes of those who reported them ranged from 161 kilocalories from candy to 372 kilocalories from sweet bakery products, as shown in table 1. The table also gives examples of each type of sweet food and their energy content.

Table 1

Sweet foods: Mean energy contribution per reporter and examples, by sweet food type, 2015–2018.

Definitions

Poverty Income Ratio (PIR)

The ratio of family income to poverty level expressed as a percentage. The poverty measure used in calculating the PIR was the Department of Health and Human Services’ poverty guidelines (8).

Reporter/non-reporter

In general, anyone who ate a sweet food at least once on the intake day was considered a “reporter,” whereas anyone who did not was considered a “non-reporter.” In all, 5,758 adults were classified as sweet food reporters (2,682 males and 3,076 females), and 4,001 were classified as non-reporters (2,040 males and 1,961 females). Classification as a reporter or non-reporter for this analysis has no implications as to habitual intake.

Sweet foods, total

Included the following food groups, which are based on WWEIA Food Categories, and excluded fruit and all types of beverages:

• Snack/meal bars: Cereal bars; nutrition bars.
• Sweet bakery products: Cakes and pies; cookies and brownies; doughnuts, sweet rolls, pastries.
• Candy: Candy containing chocolate; candy not containing chocolate.
• Other desserts: Ice cream and frozen dairy desserts: pudding; gelatins, ices, sorbets.

WWEIA Food Categories

A scheme applied to classify each food and beverage reported in WWEIA, NHANES into one of approximately 160 mutually exclusive categories (www.ars.usda.gov/Services/docs.htm?docid=23429). If two or more sweet foods were linked as having been consumed together, all linked items were classified together into the most appropriate category. For example, if chocolate chips were reported as a topping on ice cream, both the chocolate chips and the ice cream were assigned to the category “ice cream and frozen dairy desserts,” and the chocolate chips were not included in the category “candy containing chocolate.” Similarly, items that would not be classified as sweet foods on their own were classified as such if they were consumed as part of a group of linked items in which the predominant item was a sweet food, e.g., whipped cream added to pie was classified in the category “cakes and pies.”

Data source

Estimates in this data brief are based on one day of data from WWEIA, NHANES 2015-2018 (9). Day 1 dietary data were collected in person using the 5-step USDA Automated Multiple-Pass Method for the 24-hour recall (10). A total of 9,759 individuals age ≥20 years (4,722 males and 5,037 females) provided complete and reliable dietary intake data. Only in the race-specific analysis (see page 3), non-Hispanic individuals who were multi-racial or of a racial group other than those listed (418 adults, of whom 234 were sweet foods reporters) were excluded. Sample weights were applied in all analyses to produce nationally representative estimates. Intakes of energy and nutrients were calculated using the 2015-2016 and 2017-2018 versions of USDA’s Food and Nutrient Database for Dietary Studies (11). Intake of added sugars was estimated using the 2015-2016 and 2017-2018 versions of the Food Patterns Equivalents Database (FPED; ¹²).

References

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U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015-2020 Dietary Guidelines for Americans. 8th Edition. December 2015. http://health​.gov/dietaryguidelines​/2015/guidelines/.

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Huth PJ, Fulgoni VL, Keast DR, Park K, Auestad N. Major food sources of calories, added sugars, and saturated fat and their contribution to essential nutrient intakes in the U.S. diet: Data from the National Health and Nutrition Examination Survey (2003-2006). Nutr J. 2013;12:116. Published 2013 Aug 8. doi:10.1186/1475-2891-12-116 [PMC free article: PMC3751311] [PubMed: 23927718] [CrossRef]

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8.

U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. Poverty guidelines. https://aspe​.hhs.gov/poverty-guidelines. Published January 8, 2020.

9.

Centers for Disease Control and Prevention, National Center for Health Statistics. NHANES Questionnaires, Datasets, and Related Documentation. https://wwwn​.cdc.gov/nchs/nhanes/. Updated August 4, 2020.

10.

USDA Food Surveys Research Group. AMPM - USDA Automated Multiple Pass Method. www​.ars.usda.gov/nea/bhnrc/fsrg/ampm. Updated July 25, 2020.

11.

USDA Food Surveys Research Group. FNDDS Documentation and Databases. www​.ars.usda.gov/fsrg/fndds/download. Updated July 15, 2020.

12.

USDA Food Surveys Research Group. FPED Databases and SAS Data Sets. www​.ars.usda.gov/fsrg/fped/download. Updated October 28, 2020.

Sebastian RS, Wilkinson Enns C, Martin CL, Goldman JD, and Moshfegh AJ. Sweet foods consumption by adults in the U.S.: What We Eat in America, NHANES 2015-2018. Food Surveys Research Group Dietary Data Brief No. 33. November 2020.