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Dietary-Fat Intake in the US Population

Deputy Under Secretary, Research, Education, and Economics (E.T.K.), Department of Agriculture, Washington, DC
Agricultural Research Service (S.A.B.), Department of Agriculture, Washington, DC
Center for Nutrition Policy and Promotion (R.P.), Department of Agriculture, Washington, DC

Address reprint requests to: Eileen T. Kennedy, Deputy Under Secretary, Research, Education and Economics, Department of Agriculture, Washington, DC 20250.

	ABSTRACT

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Objective: This article looks at the food group choices by individuals grouped based on fat intake, saturated fat intake, and use of lowfat foods.

Methods: Food consumption data from USDA’s National Food Consumption Surveys (NFCS) and the Continuing Survey of Food Intakes by Individuals (CSFII) were used to look at changes in the mean energy, percent calories from fat and saturated-fat and total-fat intakes over time. USDA’s 1995 CSFII data were used to evaluate the diets of individuals grouped based on percent calories from fat and use of low-fat foods. Individuals six to 50 years old who had complete food intake records were included and five age-gender classifications were used.

Results: The percent of calories from total fat and saturated fat have steadily declined over the last 30 years, and the amount of fat in the diet has increased from 1989 to 1995. Those whose diets met the Dietary Guidelines Recommendations for fat and saturated fat had lower fat intakes. Except for adult males, those with low-fat diets had higher intakes of total-food amount. Also, lower saturated-fat intakes were associated with lower energy intakes. In general, high-fruit-and-grain-products consumption were seen in groups with low-fat intake. For those who included low-fat foods in their diets and also had low-fat intakes, rice and pasta were the major foods of choice for calories. Fried potatoes were one of the main sources of calories for high-fat groups.

Conclusion: The study showed individuals whose diets included low-fat foods are more likely to have a diet that meets the dietary guidelines recommendations for fat and saturated fat.

Key words: fat, saturated fat, lowfat foods, trend

	INTRODUCTION

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Over the past 30 years the links between diet and a range of chronic diseases have become much clearer [1]. The typical American diet is linked to obesity, heart diseases and certain forms of cancer. In response to the body of research on diet and chronic disease, a series of dietary recommendations has emerged [2, 3, 4]. One consistent recommendation among the various sets of dietary guidelines is to limit the amount of total fat and saturated fat consumed.

The present paper examines the trends in dietary intake focusing on total fat and saturated fat consumed.

	METHODS

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The US Department of Agriculture has been monitoring consumption patterns at the household and/or individual level for over 40 years. While these nationally representative consumption surveys have varied in the specific protocols used, one consistent survey technique has been the use of the 24-hour recall for assessment of individual dietary intake. A database was developed using 24-hour recall information from 1965 to 1995 to analyze trends in energy, total-fat and saturated-fat intake of individuals.

The 1965 survey included 19,015 individuals, with 4,007 people under nine years of age, 6,936 men and 8,072 women aged nine years and older. The 1977–78 survey had a total sample of 12, 042, with 2,494 less than nine years old, 3,912 men and 5,636 women over age nine years.

The 1985 and 1986 surveys were limited to women 19 to 50 years old and their children ages one to five. In 1985 there were 2,228 women and 690 preschool children. In 1986 there were 2,057 women and 547 children ages one to five.

For the 1989–1991 surveys there were a total of 15, 192 participants: 5,140 in 1989, 4,889 in 1990 and 5,163 in 1991. In 1989, 570 survey individuals were five years old or younger, 1979 were males six years and older and 2,591 were females six years and older. Similarly in 1990 and 1991, 535 and 536 individuals were five years or younger; 1,829 and 1,955 males and 2,525 and 2,676 females were ages six years and older, respectively.

The 1995 USDA Continuing Survey of Food Intake by Individuals (CSFII) is a nationally representative survey of food consumption patterns in the United States [5]. The 1995 data from the CSFII were used to construct a database on types of fat-modified foods consumed by individuals ages six years and older. The sample of subjects was as follows: 478 children ages six to eleven; 182 males 12 to 18 years; 181 females 12 to 18 years; 620 males 19 to 50 years and 655 females 19 to 50 years of age. The CSFII contains approximately 7,000 food codes. All descriptors in the database that indicated a fat modified food were identified (i.e., fat-free, reduced fat, skim, lean, and so on) and a fat-modified foods database was created.

	RESULTS

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Trends
For the period 1965 to 1989/91 there is a clear downward trend in mean energy consumption for both males and females (Table 1). Similar results not presented here are seen for children seven to eleven years old, males and females ages 12 to 18 and 51 years and older. However, in the 1994/95 period there is a reversal of this trend, and energy consumption increases. It is important to note that, despite this slight upward trend, mean energy consumption in 1995 is less than in 1965 for all groups.

Similar to the downward trend in energy intake, total fat consumption as a percent of calories has declined in the 1965 to 1995 period (Table 1). The average change in total fat intake is 10.6% and 9.1% for males and females, respectively. Saturated fat as a percentage of total calories has also declined during the same time period (Table 1).

While the percent of calories from total fat and saturated fat has steadily declined over the last 30 years, the absolute intake of fat and saturated fat exhibit a different pattern (Table 1). There is a decrease in consumption of grams of total fat and grams of saturated fat from 1965 to 1989/91; however, from 1989/91 to 1995, grams of fat increased for adult males and females. In 1995, the absolute intakes of saturated fat increased for males, but not females. There is the rather unusual phenomenon of a decline in fat as a percent of caloric intake, while fat intake in grams increases. This is an artifact of increasing energy consumption.

Dietary Patterns in 1995
While the general trends over the past 30 years provide insights into how consumption patterns have changed, additional analyses were conducted to ascertain the underlying food patterns in the American population that are contributing to these changes in fat and saturated fat intakes. There was a particular interest in assessing the role of fat-modified foods in influencing changes in consumption.

The 1995 USDA/HHS Dietary Guidelines for Americans serve as the basis for federal nutrition policy [2]. The guidelines recommend a diet with 30% or fewer of total calories from fat and less than 10% of calories from saturated fat; the 30%/10% recommendations apply to individuals five years of age and older. For ease of reading, this report will use "low fat" to describe diets furnishing 30% or fewer of their calories from fat and "high fat" as diets providing more than 30% of their calories from fat.

Table 2 provides the results for children six to eleven years and males and females, twelve to eighteen years of age and 19 to 50 years old for 1995. Each age group is divided into low-fat and high-fat consumers. Some general conclusions emerge. (Results for 1994 are similar.)

Not surprisingly, given the classification criterion, those people consuming a low-fat diet eat fewer grams of total fat and saturated fat. What is possibly more surprising is the order of magnitude of these differences. In adult males ages 19 to 50 years, consumption varies from 59 grams to 116 grams of fat in the low-fat vs. high-fat groups, respectively.

With the exception of adult males, the low-fat diet groups consume a greater physical quantity of food. Thus, individuals consuming low-fat diets also have less energy-dense diets.

The 1995 data were reanalyzed using saturated fat intakes to classify dietary patterns (Table 3). Here again, comparing the results across age and gender groupings, some general patterns emerge.

The total fat intake in grams continues to be dramatically less in the low saturated-fat groups for all ages. People who are consuming less saturated fat also simultaneously consume diets which have reduced total fat.

More of the calories in the low saturated-fat groups derive from low-fat or reduced-fat foods. The physical quantity of food consumed is higher in the low saturated-fat group, again with the exception of males 19 to 50 years old.

The 1995 CSFII data were also analyzed to provide detail on the underlying dietary patterns for children and adults that contribute to fat and saturated-fat consumption (Table 4).

Vegetable consumption does not exhibit the same pattern as fruits. In fact, in a number of the high-fat, age and gender groups, vegetable intake is higher, not lower, than in their low-fat counterparts. On closer inspection, however, vegetables among the high-fat cohorts are found to come disproportionately from French fries.

Grain-product consumption is higher in most of the low-fat groups.

Milk-product consumption is about the same or slightly higher in the low-fat diets. However, the bigger difference is that low-fat milk choices (1% and skim milk) contribute more to total milk consumption in the low-fat diet groups.

With the exception of teen males, the total amount of meat eaten is less in the low fat groups.

The energy density of the diets of low-fat consumers is lower than that of the consumers of high fat diets. This is true for all age groups.

There are a variety of ways to lower fat and saturated fat in the diet. An individual need not use any low-fat or reduced-fat products to eat a diet ostensibly consistent with the Dietary Guidelines for fat and saturated fat. Similarly, the use of fat-modified foods could vary and not necessarily result in consumption of a low-fat or low-saturated-fat diet. To examine these potentially different fat-reduction strategies, the present sample was classified into three broad groups: non-users, low users and high users of fat modified foods. Non-users do not use any low-fat, reduced-fat or fat-modified product. The low-use category includes individuals who consume two or fewer fat-modified foods; high use individuals consume three or more fat-modified foods.

The pattern of consumption in the different food subgroups of adults (males and females) who are non-users, low users and high users of fat-modified foods is given in Table 5. The non-users of fat modified foods pursue a different fat-reduction strategy than do the low users and high users of fat modified foods. For low users and high users consuming low-fat diets, rice and pasta are an important source of calories. This is not true for non-users. Non-users who achieve a low-fat intake appear to do so by substituting carbohydrate for fat; much of this increased carbohydrate comes from sugar, mainly from carbonated beverages.

Individuals with high-fat diets who are also high users of fat-modified foods are an interesting group. Their overall dietary patterns are similar in many respects to those of the low-fat, high-user groups, but they are simply consuming more of each food group. The data presented here cannot clarify the underlying motivation of the high fat/high user group. One could speculate that because these individuals are using fat-modified foods, they assume they can use more.

Finally, Table 6 shows the distribution of subjects from 1989/91, 1994 and 1995 categorized by non-use, low use or high use of fat modified foods. Only about 10% of the study subjects in any given time period are classified as high users of fat-modified foods. However, high users of fat-modified foods are more likely to have diets with 30% or fewer of total calories from fat. For low users, it is about equally likely that individuals will be above or below the 30% fat-calories cut-off. Non-users of fat-modified foods, are less likely to achieve a diet with fewer than 30% of the calories from fat. These data suggest that use of fat-modified foods does help individuals achieve a low-fat and low-saturated-fat diet.

	SUMMARY AND CONCLUSIONS

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Individuals of all ages who consume a diet with fewer than 30% of calories from fat consistently have lower energy intakes. The data suggest that reducing fat intake is one effective strategy for also reducing total energy consumption. However, the data presented represent group means; an individual’s consumption across a number of days can fluctuate between low-fat and a higher-fat intake. The group data suggest that individuals who consume a low-fat diet on any given day, simultaneously also consume a lower energy intake. Given the increasing rates of obesity in the United States at an earlier age, dietary-fat reduction may be an effective part of an overall strategy to balance energy consumption with energy needs.

In each of the age and gender groups consuming fewer than 30% of calories from fat and fewer than 10% of calories from saturated fat, fat-modified foods play a more important role in their diets than in the diets of people who are consuming higher levels of fat and saturated fat. These data are clear that fat-modified foods make a more significant contribution to diets of consumers with low-fat intakes. While one cannot argue cause and effect from the results presented, the patterns established for the relationship between fat-modified foods and low-fat intakes are consistent.

There are some issues concerning nutrient and energy density that warrant further attention. In most cases, a fat-reduction strategy resulted in subjects consuming less energy-dense diets. Often the focus on overall diet quality is lost in the national obsession with lowering fat intakes. While macronutrients such as fat and saturated fat clearly deserve attention, other aspects of the diet cannot be overlooked. It would be a mistake to equate all low-fat diets with nutritionally optimal diets. The data in this paper suggest the fat-reduction strategy that is followed has implications for the ultimate quality of the diet.

The data presented in this paper provide some insight into how people achieve low fat levels in their diet. Some food patterns appear to be key to an effective fat-reduction strategy. Fruit, grains and skim milk are three food items that are routinely found in low-fat diets. The differences in fruit intakes are dramatic between individuals with low-fat and high-fat diets. It may not be fruit itself that is responsible, but that fruit consumption is a proxy for other dietary behaviors that are important in achieving appropriate levels of fat and saturated fat in the diet.

People who are high utilizers of fat-modified foods are more likely to have a diet that is low in total fat and saturated fat. This low-fat, high-user group relies on traditional foods that have a lower fat content, among them i.e., skim milk and lean meats. This same group also chooses low-fat grain mixtures, cakes, cookies and pies. Unfortunately only about 10% of the sample falls in the high-utilization category. A much larger percentage of individuals includes either non-users (42%) or low users (48%) of fat modified foods.

Non-users of fat-modified foods are less likely to consume low-fat diet. However, when the non-users do eat a low-fat diet, the diet appears to be achieved by substituting carbohydrates—largely refined carbohydrates—for fat.

Results indicate that reductions in total fat and saturated fat in the diet occur in parallel. This circumstance needs to be considered when messages about specific fat-reduction strategies are developed for the consumer.

An obvious conclusion that emerges is that fat-reduction strategies are likely to be effective if an individual is able to move from high-fat, saturated-fat diets to low-fat, nutrient-dense diets. Some hints at how consumers are now doing this emerge from the tables. Clearly one strategy is partially to replace higher-fat foods with low-fat substitutes. The switch from a high-fat snack to fruit is one example; the change from whole milk to skim milk is another example. These changes require some explicit behavior change on the part of the consumer.

A second strategy is to target key food sources of fat in the diet and provide fat-modified options. In the case of six to eleven year-old children, both high-fat and low-fat groups eat similar amounts of grain mixtures and sweet snacks. Lower fat choices within these categories provide an entry point for modifying diet without requiring changes in dietary behavior.

Fat reduction strategies have many faces and policy makers need to consider the effect of each particular approach on overall diet quality.

Received January 1, 1998. Accepted August 1, 1998.

	REFERENCES

TOP ABSTRACT INTRODUCTION METHODS RESULTS SUMMARY AND CONCLUSIONS REFERENCES

 

1. National Research Council Committee on Diet and Health: "Diet and Health: Implications for Reducing Chronic Diseases." Washington, DC: National Academy Press, 1989.
2. U.S. Department of Agriculture and Department of Health and Human Services: "Nutrition and Your Health: Dietary Guidelines for Americans," 4th edition. Washington, DC: USDA and DHSS, 1995.
3. Krauss RM, Deckelbaum RJ, Ernst N, Fisher E, Howard BV, Knopp AH, Kotchen T, Lichtenstein AH, McGill HC, Pearson TA, Prewitt TE, Stone NJ, Horn LV, Weinberg, R: Dietary guidelines for healthy American adults. A statement for health professionals from the Nutrition Committee, American Heart Association. Circulation 94: 1795–1800, 1996.[Free Full Text]
4. American Cancer Society: Dietary guidelines advisory committee guidelines on diet, nutrition, and cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin 46: 325–341, 1996.[Abstract]
5. Tippett KS, Cypel YS (eds): "Continuing Survey of Food Intakes by Individuals and the Diet and Health Knowledge Survey, 1994–1996." Washington, DC: U.S. Department of Agriculture, Agricultural Research Service, 1998.

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