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For kids in the U.S., almost half of their daily energy intake comes from 'empty calories' - foods such as soda and pizza that have little nutritional value, researchers say.

Of an average 2,200 daily calories, around 800 are attributable to solid fats or added sugars, Jill Reedy, PhD, MPH, RD, and Susan M. Krebs-Smith, PhD, MPH, RD, of the National Cancer Institute, reported in the Journal of the American Dietetic Association.

"The landscape of choices available to children and adolescents must change to provide fewer unhealthy foods and more healthy foods with less energy," they wrote.

Mary Story, PhD, RD, of the University of Minnesota, who was not involved in the study, called it "alarming."

"When you look at the finding that 40% of total calories consumed by kids were in the form of empty calories, that's cause for great concern," she told MedPage Today.

She said that despite public health messages promoting the importance of good childhood nutrition, these kinds of foods are still the most abundant and available.

"If you go to convenience stores or corner stores that are close to schools, [these foods] are really cheap and plentiful," she said. "We should not be surprised by this - we should be outraged."

More than 23 million children and adolescents are overweight or obese, leading to chronic health problems that were once relegated to adulthood.

In searching for causes for the obesity epidemic, researchers have long turned their attention to the adolescent diet. For this study, Reedy and Krebs-Smith assessed data from the National Health and Nutrition Examination Survey (NHANES) to identify the top dietary sources of energy, solid fats, and added sugars among those ages 2 to 18.

They found that the top sources of energy were:
  • Grain desserts - cakes, cookies, doughnuts, pies, crisps, cobblers, and granola bars - totaling 138 calories per day
  • Pizza, a close second at 136 calories daily
  • Soda, trailing behind at 118 calories per day
When adding fruit juices to the latter, the amount of energy from the sugar-sweetened beverage category rose to 173 calories.

Nearly 40% of all energy consumed was in the form of empty calories, with 433 calories from solid fats and 365 from added sugars.

That far exceeded federal daily recommendations on empty foods, which are limited to between 8% and 20% of daily energy depending on age.

Half of those empty calories came from six foods - soda, fruit drinks, dairy desserts, grain desserts, pizza, and whole milk.

Story said this is especially concerning because early tastes often set the stage for diet later in life.

"We know that eating patterns' preference for sweet and fat develop early on in life," she told MedPage Today. "Eating patterns can change, but ... these foods are not benefiting kids now."

Evolutionarily, she said, humans are wired to prefer sweets and fats because they are quick sources of energy that can enhance survival. In fact, she said, breast milk is fairly sweet.

But several factors, including irresponsible marketing, Story said, can further ingrain those preferences.

"Food companies should be putting money toward marketing healthier foods," she said, pointing to a recent commercial for baby carrots that attempts to market the health food as if it were junk food.

Asking mom and dad to be better role models may help as well. Earlier this month, a CDC report found that two-thirds of Americans don't get the recommended serving of fruits and vegetables.

The authors noted that rankings for food in the study were limited by decisions about grouping food, frequency of consumption, and over-representation of adolescents. Mean consumption was also based on per capita rather than per-person contributions, and the analysis was based on NHANES 2003-2004 rather than later NHANES data.

In an accompanying editorial, Rae-Ellen Kavey, MD, MPH, of the University of Rochester Medical Center, Rochester, N.Y., wrote that eating lots of added sugars, mostly in the form of sugar-sweetened beverages, is associated "with a constellation of cardiovascular risk factors, both independently and through the development of obesity."
"Reducing consumption of sugar-sweetened beverages should be considered a critical dietary approach to reducing cardiovascular risk in childhood."
Story said ways of accomplishing this would be through a soda tax, stronger federal policies against sugar-sweetened beverages in schools, and restrictions on marketing to children.

"There are strategies out there," she said, "for promoting healthier foods and limiting access to unhealthy ones."

To watch the video for this article click here.

Source

Reedy J, Krebs-Smith SM "Dietary sources of energy, solid fats, and added sugars among children and adolescents in the United States" Journal of the American Dietetic Association 2010; 110: 1477-1484.

Kavey REW "How sweet it is: Sugar-sweetened beverage consumption, obesity, and cardiovascular risk in childhood" Journal of the American Dietetic Association 2010; 110: 1456-1460.