One-quarter of calorie intake in children derived from empty calories

About one-quarter of the calories consumed by children and adolescents may be acquired from empty calories, according to a US-based study presented at Nutrition 2020 Live Online.

Data from the National Health and Nutrition Examination Survey (NHANES) from the 2007–2008 through to 2015–2016 periods were used to examine dietary trends of children and adolescents aged 2–18 years. Using day 1 24-hour dietary intake, the researchers calculated the mean intake and contribution of total energy, as well as energy acquired from solid fats or added sugars (empty calories).

The primary sources of energy over the study period were pizza (5.8 percent), other sandwiches (3.9 percent), soft drinks (3.4 percent), cakes and brownies (3.1 percent), and flavoured milk (2.6 percent). [Nutrition 2020 Live Online, abstract P04-147-20]

Energy intake from these sources decreased over the study period. The greatest decrease occurred between the 2011–2012 and 2015–2016 periods for children aged 2–3 years (-8.7 percent; p=0.02) and those aged 4–8 years (-6.8 percent; p=0.0005), while among those aged 14–18 years, the greatest decrease occurred between the 2009–2010 and 2015–2016 periods (-7.0 percent; p=0.005).

“Over the time period studied, we observed a downward trend in the percent of calories coming from empty calories without any associated decrease in total calorie intake,” said study author Dr Edwina Wambogo from the National Cancer Institute in Rockville, Maryland, US. “This trend was mostly driven by declines in added sugars intake, including those from soft drinks and fruit drinks.”

However, >25 percent of total energy intake was still acquired from empty calories in all age groups, with the percentage of empty calorie intake rising with age (26.1–30.0 percent among those aged 2–3 years, 30.0–33.6 percent among those aged 4–8 years, 30.2–34.4 percent in those aged 9–13 years, and 30.5–35.5 years in those aged 14–18 years).

Sources of energy also changed over time, going from beverages to solid foods, and varying with the types of beverages. For instance, among children aged 2–3 years, four of the five main energy sources were beverages (flavoured milk: 3.9–5.7 percent; whole milk: 3.4–5.4 percent; reduced fat milk: 4.2–5.3 percent; and fruit drinks: 2.9–3.1 percent), while among children aged 4–8 years, two of the main energy sources were beverages (flavoured milk: 3.2–4.7 percent; fruit drinks: 3.1–3.3 percent). Among those aged 9–13 years and 14–18 years, soft drinks were the primary source (3.4–4.7 percent and 4.1–6.3 percent, respectively).

“Our findings suggest a need for continued research into what children and adolescents are eating,” noted Wambogo. “Examining the whole landscape of available foods and beverages for children and adolescents can help inform new ways to promote healthier eating,” she said.

Wambogo and co-authors suggested several interventions that may help encourage healthier dietary habits in children and adolescents. These interventions varied from marketing strategies (increasing the marketing of healthier foods, while simultaneously reducing the marketing of unhealthy foods), to reformulating foods (reducing sugar content in beverages), to improving nutrition education (highlighting hidden sources of empty calories). They are also planning to investigate the effect of family income on dietary choices.