Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
Am J Clin Nutr. 2021 Sep 1;114(3):1039-1048. doi: 10.1093/ajcn/nqab129.
Trends in junk food consumption, a risk for obesity, are not well established.
We examined national trends in types of junk food (excluding beverages) and their sources (grocery, restaurants, schools, etc.), overall and in population subgroups.
We assessed 29,970 children (aged 2-19 y) and 44,501 adults (aged ≥20 y) with 24-h dietary recall data from 9 NHANES cycles (2001-2002 to 2017-2018). Trends in junk food were assessed over time using 1-d values for individuals with single recalls and 2-d means for others.
From 2001 to 2018, percent energy (%E) from junk food remained stable for children (from 18.1% to 17.5%, P-trend = 0.25) and decreased for adults (14.1% to 13.0%, P-trend = 0.002). Among children, increases occurred in %E from crackers (1.19% to 1.35%) and snack/meal bars (0.38% to 0.69%) and decreases in candy (2.58% to 1.96%) and other desserts (3.11% to 2.48%) (all P-trends < 0.01). Among adults, increases occurred in snack/meal bars (0.31% to 0.78%, P-trend < 0.001) and decreases in candy (1.97% to 1.55%; P-trend < 0.001), sweet bakery products (5.52% to 4.98%; P-trend = 0.04), and other desserts (2.19% to 1.86%; P-trend = 0.001). In 2017-2018, grocery stores provided the largest proportion of junk food (72.7% for children, 77.1% for adults), followed by other sources (13.1%, 12.1%), restaurants (8.05%, 9.11%), schools (4.86%), and worksites (1.99%). In both children and adults, junk food intake was higher among non-Hispanic white and black Americans compared with Mexican Americans, among those with higher compared with lower education, among women compared with men, and among older compared with younger adults. In sensitivity analyses using only 1-d recalls, mean junk food intake each cycle was ∼0.8-1.0 and 0.3-0.4%E units higher in children and adults, respectively, with otherwise similar trends and subgroup differences over time.
From 2001 to 2018, %E from junk food represented nearly 1 in 5 calories among children, without change, and nearly 1 in 7 calories, with modest decrease, among adults, with disparities in subgroups.
垃圾食品消费趋势是肥胖的一个风险因素，但目前还没有明确的趋势。
我们研究了（不包括饮料）各类垃圾食品及其来源（杂货店、餐馆、学校等）在全国范围内的变化趋势，并按人群亚组进行了分析。
我们评估了 9 个 NHANES 周期（2001-2002 年至 2017-2018 年）中 29970 名儿童（2-19 岁）和 44501 名成年人（≥20 岁）的 24 小时膳食回忆数据。采用个体单天值和他人 2 天均值评估垃圾食品随时间的变化趋势。
从 2001 年到 2018 年，儿童的垃圾食品能量百分比（E）保持稳定（从 18.1%降至 17.5%，P 趋势=0.25），而成年人的垃圾食品 E 则有所下降（从 14.1%降至 13.0%，P 趋势=0.002）。在儿童中，饼干（从 1.19%增加到 1.35%）和零食/餐棒（从 0.38%增加到 0.69%）的 E 百分比增加，而糖果（从 2.58%降至 1.96%）和其他甜点（从 3.11%降至 2.48%）的 E 百分比则有所下降（所有 P 趋势<0.01）。在成年人中，零食/餐棒的 E 百分比增加（从 0.31%增加到 0.78%，P 趋势<0.001），糖果（从 1.97%降至 1.55%，P 趋势<0.001）、甜面包制品（从 5.52%降至 4.98%，P 趋势=0.04）和其他甜点（从 2.19%降至 1.86%，P 趋势=0.001）的 E 百分比有所下降。2017-2018 年，杂货店提供的垃圾食品比例最大（儿童为 72.7%，成人 77.1%），其次是其他来源（13.1%，12.1%）、餐馆（8.05%，9.11%）、学校（4.86%）和工作场所（1.99%）。在儿童和成人中，与墨西哥裔美国人相比，非西班牙裔白人和黑人美国人的垃圾食品摄入量更高，与教育程度较低的人相比，教育程度较高的人的垃圾食品摄入量更高，与男性相比，女性的垃圾食品摄入量更高，与年轻人相比，老年人的垃圾食品摄入量更高。在仅使用 1 天回忆的敏感性分析中，每个周期儿童和成人的平均垃圾食品摄入量分别约为 0.8-1.0 和 0.3-0.4%E 单位，且随时间推移，趋势和亚组差异大致相似。
从 2001 年到 2018 年，儿童摄入的垃圾食品 E 占总能量的近 1/5，没有变化，而成年人摄入的垃圾食品 E 占总能量的近 1/7，略有下降，且存在亚组差异。
