Nutrient adequacy and diet quality in overweight and non-overweight Hispanic Children – the VIVA LA FAMILIA Study Theresa A. Wilson, MS, RD: USDA/ARS Anne L. Adolph, BS: USDA/ARS Nancy F. Butte, PhD.: USDA/ARS JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Wilson T, et al. J Am Diet Assoc. 2009; 109 (June).

Nutrient adequacy and diet quality in overweight and non-overweight Hispanic Children – the VIVA LA FAMILIA Study Hypothesis: Overweight Hispanic children have higher energy intakes but lower diet quality than non-overweight Hispanic children. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Wilson T, et al. J Am Diet Assoc. 2009; 109 (June).

Nutrient adequacy and diet quality in overweight and non-overweight Hispanic Children – the VIVA LA FAMILIA Study Specific Aims: Document the dietary intake of a cohort of 993 Hispanic children from low-socioeconomic status. Assess the diet quality and nutrient adequacy compared to the US Dietary Guidelines. Test for differences in diet quality and energy intake between overweight and non-overweight children. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Wilson T, et al. J Am Diet Assoc. 2009; 109 (June).

Nutrient adequacy and diet quality in overweight and non-overweight Hispanic Children – the VIVA LA FAMILIA Study Results: Macronutrient intakes of non-overweight and overweight Hispanic children enrolled in the VIVA LA FAMILIA Study Carbohydrate (%E) Energy (kcal/d) Carbohydrate (g/d) Protein (%E) Protein (g/d) Fat (g/d) Fat (%E) †* ‡ * Energy intake was higher in overweight compared to non-overweight children (P<0.02), adjusted for age and sex. The distribution of macronutrients differed only slightly between BMI groups. Mean fat intake as a percent of total energy approached the recommended upper limit of 35% in all groups. ‡ Sex X BMI status (P=0.04-0.001) † Sex (P=0.04-0.001) * BMI status (P=0.02-0.001) Non-overweight Boys Overweight Boys Non-overweight Girls Overweight Girls JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Wilson T, et al. J Am Diet Assoc. 2009; 109 (June). BMI = Body Mass Index

Nutrient adequacy and diet quality in overweight and non-overweight Hispanic Children – the VIVA LA FAMILIA Study Results: Fat and cholesterol intakes of non-overweight and overweight Hispanic children enrolled in the VIVA LA FAMILIA Study Linoleic acid (g/d) a-Linolenic acid (g/d) SFA (g/d) Cholesterol (mg/d) SFA (%E) † †* Mean intake of saturated fat exceeded the US Dietary Guidelines which limit SFA to ≤ 10% of total daily calories. ‡ Sex X BMI status (P=0.05) † Sex (P=0.04-0.003) * BMI status (P=0.02-0.001) Non-overweight Boys Overweight Boys Non-overweight Girls Overweight Girls SFA = Saturated Fatty Acid BMI = Body Mass Index JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Wilson T, et al. J Am Diet Assoc. 2009; 109 (June). 5

Nutrient adequacy and diet quality in overweight and non-overweight Hispanic Children – the VIVA LA FAMILIA Study Results: Dietary sugar intakes of non-overweight and overweight Hispanic children enrolled in the VIVA LA FAMILIA Study Total Sugars (g/d) Added Sugars (g/d) Total Sugars (%E) Total fiber (g/d) Added Sugars Fructose (g/d) † ‡ Percent of energy from total sugars was nearly 30% and fiber intake fell well below the recommended 25 grams set by the US Dietary Guidelines. ‡ Sex X BMI status (P=0.05) † Sex (P=0.04-0.003) * BMI status (P=0.02-0.001) Non-overweight Boys Overweight Boys Non-overweight Girls Overweight Girls JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION BMI = Body Mass Index Wilson T, et al. J Am Diet Assoc. 2009; 109 (June). 6

mean ± standard deviation Nutrient adequacy and diet quality in overweight and non-overweight Hispanic Children – the VIVA LA FAMILIA Study Results: Percent of total energy intake from the 15 food categories most commonly consumed by non-overweight and overweight Hispanic children enrolled in the VIVA LA FAMILIA Study  Food Category Boys Girls Non-overweight Overweight Non-Overweight n 220 274 265 234 mean ± standard deviation Grains 10.8 ± 8.9 11.7 ± 7.7 11.0 ± 8.2 10.8 ± 7.7 Soda 6.7 ± 6.5 6.8 ± 6.6 5.5 ± 6.8 6.4 ± 6.8 Beefa 5.8 ± 7.9 5.5 ± 8.0 4.5 ± 6.3 5.1 ± 7.4 Dessertsa 5.6 ± 7.2 3.9 ± 6.3 5.3 ± 7.7 5.5 ± 7.7 Poultry 5.3 ± 8.5 6.1 ± 7.6 5.6 ± 8.2 5.3 ± 7.2 Cold cerealb 5.1 ± 5.9 3.9 ± 4.8 4.5 ± 5.4 3.2 ± 4.6 Pizza 4.9 ± 8.5 4.3 ± 8.5 4.2 ± 8.8 3.4 ± 6.9 Whole milkb 4.3 ± 6.2 3.2 ± 5.2 4.3 ± 7.0 3.0 ± 5.7 Snack chipsc 4.1 ± 6.6 3.3 ± 5.6 4.1 ± 6.0 5.7 ± 7.7 Fruit drinks 3.6 ± 5.5 3.4 ± 5.0 4.2 ± 6.2 Fruit juicec 2.8 ± 4.3 3.2 ± 5.0 4.1 ± 5.5 2.6 ± 4.1 Fruit 2.7 ± 3.8 2.6 ± 3.3 3.1 ± 4.2 2.9 ± 3.7 Processed meats 2.7 ± 4.7 3.8 ± 6.0 3.3 ± 5.1 3.1 ± 5.5 Other milk 2.7 ± 4.3 3.2 ± 4.9 2.7 ± 4.1 2.9 ± 4.5 Burgers 2.5 ± 6.2 3.2 ± 8.2 1.8 ± 5.1 2.5 ± 6.5 a Adjusted for family membership and age, significant difference by sex (P=0.002-0.034) b Adjusted for family membership and age, significant difference by BMId status (P=0.001-0.04) c Adjusted for family membership and age, significant interaction by sex X BMI status (P=0.004) d BMI=body mass index JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Wilson T, et al. J Am Diet Assoc. 2009; 109 (June). 7

mean ± standard deviation Nutrient adequacy and diet quality in overweight and non-overweight Hispanic Children – the VIVA LA FAMILIA Study Results: Number of food servings from 9 major USDA food groups consumed by non-overweight and overweight Hispanic children enrolled in the VIVA LA FAMILIA Study  Food Group Recommend- ed Rangea Boys Girls Non-overweight Overweight Non-Overweight n 220 274 265 234 mean ± standard deviation Fruitsb 2-5 1.8 ± 2.0 1.8 ± 1.9 2.0 ± 2.0 1.5 ± 1.6 Vegetablesc 2-8 1.9 ± 1.8 1.9 ± 1.5 1.6 ± 1.3 1.8 ± 1.3 Grainsd 3-10 7.2 ± 3.3 6.9 ± 2.8 5.4 ± 2.2 5.8 ± 2.7 Meatse 2-7 4.8 ± 3.0 5.8 ± 3.5 3.8 ± 2.2 4.5 ± 2.8 Dairyd 2-3 2.4 ± 1.5 2.0 ± 1.2 2.0 ± 1.3 Fatsc 2.6 ± 2.5 2.9 ± 2.6 2.6 ± 2.3 2.6 ± 2.2 Sweets 1.0 ± 2.0 0.8 ± 1.5 0.9 ± 2.0 0.8 ± 1.2 Beveragese 2.7 ± 2.1 2.9 ± 2.3 2.0 ± 1.8 2.7 ± 1.9 Miscellaneousd 1.2 ± 1.7 1.0 ± 1.3 0.8 ± 1.1 Consumption of fruits and vegetables are well below recommendations from My Pyramid. a Recommendations are based on MyPyramid b Adjusted for family membership and age, significant interaction by sex X BMIf status (P=0.003) c Adjusted for family membership and age, significant difference by BMI status (P=0.001-0.05) d Adjusted for family membership and age, significant difference by sex (P=0.001) e Adjusted for family membership and age, significant difference by sex, BMI status (P=0.001-0.003) f BMI=body mass index JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Wilson T, et al. J Am Diet Assoc. 2009; 109 (June). 8

Nutrient adequacy and diet quality in overweight and non-overweight Hispanic Children – the VIVA LA FAMILIA Study Results: Z-scores for vitamins of non-overweight and overweight Hispanic children enrolled in the VIVA LA FAMILIA Study Z-score Vitamin E Vitamin A ‡ † Vitamin C Thiamin Riboflavin Niacin Vitamin B6 Folate Vitamin B12 Mean vitamin intakes did not differ between overweight and non-overweight children except vitamin E intake (girls only). Z-scores for assessment of nutrient adequacy exceeded 1.0, indicating mean usual intakes were most likely adequate in these children, except in the case of vitamin A, vitamin D, vitamin E, and pantothenic acid. Non-overweight Boys Overweight Boys Non-overweight Girls Overweight Girls ‡ Sex X BMI status (P=0.03) † Sex (P=0.04-0.001) JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION BMI = Body Mass Index Wilson T, et al. J Am Diet Assoc. 2009; 109 (June). 9

Nutrient adequacy and diet quality in overweight and non-overweight Hispanic Children – the VIVA LA FAMILIA Study Results: Z-scores for minerals of non-overweight and overweight Hispanic children enrolled in the VIVA LA FAMILIA Study Protein Ca Na K z-score †* † P Mg Fe Zn Cu Mean mineral intakes did not differ between overweight and non-overweight children except higher selenium and sodium intakes. Z-scores for assessment of nutrient adequacy exceeded 1.0, indicating mean usual intakes were most likely adequate in these children, except in the case of magnesium, calcium, and potassium. Sodium intake for all groups was > 2600 mg and exceeded the adequate intake level. Non-overweight Boys Overweight Boys Non-overweight Girls Overweight Girls † Sex (P=0.04-0.001) * BMI status (P=0.03-0.001) JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION BMI = Body Mass Index Wilson T, et al. J Am Diet Assoc. 2009; 109 (June). 10

Summary and Conclusions Nutrient adequacy and diet quality in overweight and non-overweight Hispanic Children – the VIVA LA FAMILIA Study Summary and Conclusions The z-scores for vitamin, protein, and mineral intakes of the diets of the children enrolled in the VIVA LA FAMILIA Study were adequate for most nutrients. Excessive intakes of saturated fat, sugar, and sodium were reported, as well as low intakes of fruits and vegetables along with limited dietary variety. These dietary habits do not promote long-term health. These findings were not different between overweight and non-overweight children except that the overweight children did report significantly greater amounts of energy than the non-overweight children. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Wilson T, et al. J Am Diet Assoc. 2009; 109 (June). 11