What Do United States Adolescents Eat? Food Group Consumption Patterns and Dietary Diversity from a Decade of Nationally Representative Data

Abstract

Background: Although the importance of adolescent nutrition has gained attention in the global nutrition community, there is a gap in research focused on adolescent dietary diversity and food group consumption.

Objectives: This study aimed to characterize population-level food group consumption patterns and quantify the extent of dietary diversity among United States adolescents using a large nationally representative sample of adolescents aged 10-19 y.

Methods: We used 24-h dietary recall data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018 to construct the 10 food groups comprising the minimum dietary diversity for women (MDD-W) indicator and estimated the prevalence of intake of each food group. A composite metric adolescent dietary diversity score (ADDS) was derived for each adolescent where 1 point was awarded per food group. Both population scores and the distribution of individual scores were estimated. Differences in proportions of food groups consumed across sociodemographic categories were tested using the Rao-Scott χ² test, and pairwise comparisons were expressed as population prevalence differences and prevalence ratios.

Results: Food group consumption patterns were very similar across 2 d of dietary recall but varied significantly by sex, race/ethnicity, and income status. The food groups with the highest prevalence of consumption were grains, white, roots, and tubers (∼99%), milk products (∼92%), and meat, poultry, and fish (∼85%), whereas <15% of adolescents consumed key micronutrient-dense foods, such as vitamin A-rich fruits and vegetables and dark green vegetables. The mean ADDS was 4.69, with modest variation across strata.

Conclusions: On average, United States youth consumed fewer than 5 food groups on a given day. The lack of dietary variety and relatively low prevalence of consumption of several micronutrient-rich plant-based foods could pose a risk for adolescents' ability to achieve micronutrient adequacy in the United States.

Keywords: United States adolescents; dietary diversity; food group consumption patterns.

FIGURE 1

Participant flow chart.

FIGURE 2

Differences in proportion (%) of adolescents aged 10–19 y consuming each of the 10 food groups between 2 d of 24-h dietary recall in the NHANES, 2007–2018 (n = 9203). ∗Significant difference in proportion consuming food groups between day 1 and day 2 of dietary recall based on Rao-Scot χ², P < 0.05.

FIGURE 3

Proportion (%) of adolescents aged 10–19 y by adolescent dietary diversity score (ADDS) on day 1 of dietary recall in the NHANES, 2007–2018 (n = 9198). ADDS is a composite metric where 1 point is awarded per food group consumed for a maximum score of 10. Five adolescents who consumed 0 food groups were excluded from the analysis of ADDS. Panels show various strata examined: (A) sex; (B) race/ethnicity; and (C) income status.