D
Chapter 2 Appendix



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Food Marketing to Children and Youth: Threat or Opportunity? D Chapter 2 Appendix

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Food Marketing to Children and Youth: Threat or Opportunity? TABLE D-1 Estimated Energy Requirements for Proposed Food Intake Patterns of U.S. Children and Adolescents, Ages 2–18 Years Age Boys   Girls Sedentary Low Active Active Sedentary Low Active Active EER Target Pattern EER Suggested Patterns EER Suggested Patterns Age EER Target Pattern EER Suggested Patterns EER Suggested Patterns 2 1,050 1,000 1,050 1,000–1,400 1,050 1,000–1,400 2 997 1,000 997 1,100–1,200 997 1,000–1,400 3 1,162   1,324   1,485   3 1,080   1,243   1,395   4 1,215 1,400 1,390 1,400–1,600 1,566 1,600–2,000 4 1,133 1,200 1,310 1,400–1,600 1,475 1,400–1,800 5 1,275   1,466   1,658   5 1,189   1,379   1,557   6 1,328 1,535 1,742 6 1,247 1,451 1,642 7 1,394 1,617 1,840 7 1,298 1,515 1,719 8 1,453 1,692 1,931 8 1,360 1,593 1,810 9 1,530 1,800 1,787 1,800–2,200 2,043 2,000–2,600 9 1,415 1,600 1,660 1,600–2,000 1,890 1,800–2,000 10 1,601   1,875   2,149   10 1,470   1,729   1,972   11 1,691 1,985 2,279 11 1,538 1,813 2,071 12 1,798 2,200 2,113 2,400–2,800 2,428 2,800–3,200 12 1,617 1,800 1,909 2,000 2,183 2,400 13 1,935   2,276   2,618   13 1,684   1,992   2,281   14 2,090 2,459 2,829 14 1,718 2,036 2,334 15 2,223 2,618 3,013 15 1,731 2,057 2,362 16 2,320 2,736 3,152 16 1,729 2,059 2,368 17 2,366 2,796 3,226 17 1,710 2,042 2,353 18 2,383 2,823 3,263 18 1,690 2,024 2,336 NOTE: This table shows target and suggested energy intake levels for each age and gender group for proposed Food Guide Pyramid (FGP) intake patterns. These target and suggested levels are based on Estimated Energy Requirements (EER) calculated by gender, age, and activity level for reference-sized individuals (IOM, 2002). Sedentary is defined as a lifestyle that includes only the physical activity of independent living. Low active is defined as a lifestyle that includes a physical activity equivalent to walking about 1.5 to 3 miles per day at 3 to 4 miles per hour, in addition to the activities of independent living. Active is defined as a lifestyle that includes a physical activity equivalent to walking more than 3 miles daily at 3 to 4 miles per hour, in addition to the activities of independent living. Target patterns are the energy levels assigned to each age and gender group that are used to determine the nutrient adequacy of the food guidance system daily food intake patterns for each group. One target pattern is set for each age and gender group, and is appropriate for most sedentary individuals in the group, based on the calculated EER. For children ages 9 to 13, energy levels for the target patterns were selected at the higher end of the age range to allow for growth spurts during this period. Suggested patterns are the food guidance system daily food intake patterns that are generally appropriate for low active or active individuals for each age and gender group, based on their EER. These suggested patterns are not used to determine nutritional adequacy of the pattern but to suggest appropriate food selections for those requiring more calories than the target patterns provide.

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Food Marketing to Children and Youth: Threat or Opportunity?   SOURCES: IOM (2002–2005); USDA (2003).

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Food Marketing to Children and Youth: Threat or Opportunity? TABLE D-2 Dietary Reference Intake Recommendations of Macronutrients for Children and Adolescents, Ages 1–18 Years Age Carbohydrate Protein Fat Saturated Fat Trans Fat Cholesterol Added Sugars Fibera Total Daily Water AIb 1–3   As low as possible while consuming a nutritionally adequate diet As low as possible while consuming a nutritionally adequate diet As low as possible while consuming a nutritionally adequate diet Limit to no more than 25% of total calorie intake   1.3 L/d (% Energy AMDR) 45–65 5–20 30–40   (~44 oz) (g/d) 130 13   19   4–8     1.7 L/d (% Energy AMDR) 45–65 10–30 25–35   (~60 oz) (g/d) 130 19   25   9–13     Boys   2.4 L/d (% Energy AMDR) 45–65 10–30 25–35   (~84 oz) (g/d) 130 34   31   Girls   2.1 L/d (% Energy AMDR) 45–65 10–30 25–35   (~72 oz) (g/d) 130 34   26   14–18   Boys   3.3 L/d (% Energy AMDR) 45–65 10–30 25–35   (~112 oz) (g/d) 130 52   38   Girls   2.3 L/d (% Energy AMDR) 45–65 10–30 25–35   (~92 oz) (g/d) 130 46   26   NOTE: AMDR = Acceptable Macronutrient Distribution Range. AI = Adequate Intake. aExtrapolated from the adult value. This level represents the best estimate based on limited or uncertain available evidence when it was determined. bThe AI for “total daily water” includes fluids from all foods and beverages consumed, including drinking water. Conversion factors: 3 L = 33.8 fluid oz; 1 L = 1.06 qt; 1 cup = 8 fluid oz. SOURCES: IOM (2002–2005, 2005).

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Food Marketing to Children and Youth: Threat or Opportunity? TABLE D-3 Dietary Reference Intake Recommendations of Micronutrients for U.S. Children and Adolescents, Ages 1–18 Years Age Vitamin A (µg/d) Vitamin C (mg/d) Vitamin E (mg/d) Vitamin B6a (mg/d) Folate (µg/d) Caa,b (mg/d) Iron (mg/d) Naa (mg/d) Ka (mg/d) Mg (mg/d) 1–3 300 15 6 0.5 150 500 7 1,000 3,000 80 4–8 400 25 7 0.6 200 800 10 1,200 3,800 130 9–13   Boys 600 45 11 1.0 300 1,300 8 1,500 4,500 240 Girls 600 45 11 1.0 300 1,300 8 1,500 4,500 240 14–18   Boys 900 75 15 1.3 400 1,300 11 1,500 4,700 410 Girls 700 65 15 1.2 400 1,300 15 1,500 4,700 360 NOTE: Both the Recommended Dietary Allowances (RDAs) and Adequate Intakes (AIs) may be used as goals for individual intake. RDAs are established to meet the needs of nearly all individuals (97–98 percent) in a group. The AI for life stages and gender groups other than breastfed infants is believed to cover the needs of all individuals in a group. However, lack of data or uncertainty in the data preclude being able to specify with confidence the percentage of individuals covered by this intake. aIndicates an AI since an RDA value could not be determined. bExtrapolated from the adult value. This level represents the best estimate based on limited or uncertain available evidence when it was determined. SOURCES: IOM (1997, 1998, 2000, 2001, 2005).

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Food Marketing to Children and Youth: Threat or Opportunity? TABLE D-4 Survey of National Dietary Data for U.S. Individuals, 1971–2000 Survey Dates Population Sample Size Dietary Intake Methodology NHANES I 1971–1974 Ages 1–74 years; oversampling of women of childbearing age, ages 5 and younger, adults ages 60–74, and persons with income below poverty 20,749a Single 24-hour dietary recall, no weekend intakes NHANES II 1976–1980 Ages 6 months–74 years; oversampling of children ages 5 years and younger, adults ages 60–74 years, and persons with income below poverty 20,322a Single 24-hour dietary recall, no weekend intakes NFCS 1977–1978 All ages; oversampling of low incomeb and elderly; 48 states 30,467c Three consecutive days (single 24-hour dietary recall and 2-day food record) NHANES III 1988–1994 Ages 2 months and older; oversampling of Mexican Americans, African Americans, ages 2 months–5 years, and ages 60 years and older 31,311a Single 24-hour dietary recall and 3-month food frequency questionnaire; second 24-hour recall on a subsample (~5%) CSFII 1989– All ages; oversampling of 1991 low incomeb; 48 states 15,192c Two nonconsecutive 24-hour dietary recalls CSFII 1994–1996, 1998d All ages; oversampling of low income; ages 0–9 years; 50 states 15,968c; 5,559c Two nonconsecutive 24-hour dietary recalls NHANES 1999–2000e All ages; oversampling of Mexican Americans, African Americans, ages 12–19 years, ages 60 years and older, pregnant women, and low incomeb 8,604c Single 24-hour dietary recall, and second recall on a subsample (~10%) NOTE: NHANES = National Health and Nutrition Examination Survey. NFCS = National Food Consumption Survey. CSFII = Continuing Survey of Food Intakes by Individuals. IU = International Units. aExamined persons. bLow income is defined as household income at or below 130 percent of the poverty line, the income cut-off level for eligibility for the Food Stamp Program. cPersons with 1-day intakes. dSupplemental sample of children ages 0–9 years added to the CSFII 1994–1996. eNHANES started a continuous data collection beginning in 1999. The most recent data were available for 1999–2000. CSFII is now incorporated into NHANES. SOURCE: Adapted from Briefel and Johnson (2004). Reprinted with permission.

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Food Marketing to Children and Youth: Threat or Opportunity? TABLE D-5 Mean Intakes and Changesa or Trendsb in Intakes of Selected Nutrients of Girls and Boys, Ages 6–11 Years and 12–19 Years, as Reported in CSFII 1994–1996, 1998 and Compared to NFCS 1977–1978 and CSFII 1989–1991 Nutrient Girls 6–11 yrs Girls 12–19 yrs Boys 6–11 yrs Boys 12–19 yrs Energy (kcal) 1,825 1,910 2,050 2,766 ↑ Protein (% kcal) 13.9 ↓ 14.0 ↓ 14.0 ↓* 14.4 ↓ Fat (% kcal) 32.6 ↓* 32.2 ↓* 32.6 ↓** 33.1 ↓** Saturated fat (% kcal)c 12 11 12 12 Carbohydrate (% kcal) 54.9 ↑** 55.0 ↑** 54.8 ↑** 53.2 ↑** Fiber (g)c 12 13 14 17 Vitamin A (IU) 4,475 4,817 5,242 6,361 Vitamin C (mg) 95 95 103 ↑ 119 Thiamin (mg) 1.48 ↑ 1.44 ↑ 1.77 ↑* 2.13 ↑ Riboflavin (mg) 1.91 1.75 2.28 ↑ 2.58 Niacin (mg) 18.1 19.0 ↑ 21.5 ↑ 27.8 ↑* Vitamin B6 (mg) 1.52 1.53 ↑ 1.84 ↑ 2.21 ↑ Vitamin B12 (µg) 3.87 ↓* 3.80 ↓ 4.53 ↓ 5.85 ↓ Calcium 865 771 984 1,145 Phosphorous (mg) 1,138 1,108 1,292 1,633 Magnesium (mg) 219 223 249 311 Iron (mg) 13.8 ↑ 13.8 ↑** 16.6 ↑** 19.8 ↑* NOTE: CSFII = Continuing Survey of Food Intakes by Individuals. NFCS = National Food Consumption Survey. IU = International Units. aSignificant increase (↑) or decrease (↓) in mean intakes (or percentages) between 1977–1978 and 1994–1996, 1998 (p < 0.001). bSignificant, progressive rise or fall in mean intakes (or percentages) from 1977–1978 through 1989–1991 to 1994–1996, 1998; *p < 0.05, **p < 0.01. cData from 1977–1978 and 1989–1991 are not provided. SOURCES: Adapted from Enns et al. (2002, 2003).

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Food Marketing to Children and Youth: Threat or Opportunity? TABLE D-6 Food Sources of Energy Among U.S. Children and Adolescents, Ages 2–18 Years (CSFII 1989–1991) Rank Food Group Girls and Boys 2–18 Years Girls and Boys 2–5 Years Girls and Boys 6–11 Years Boys 12–18 Years Girls 12–18 Years     % Energy 1 Milk 11.7 15.4 12.4 9.5 8.8 2 Yeast bread 9.3 8.7 9.1 9.8 9.7 3 Cakes/cookies/quick breads/donuts 6.2 5.8 6.4 6.3 6.0 4 Beef 5.7 4.3 5.4 7.0 6.4 5 Ready-to-eat cereal 4.5 5.3 4.8 4.1 3.3 6 Carbonated soft drinks 4.3 2.5 3.2 6.1 6.3 7 Cheese 3.7 3.3 3.4 3.8 4.4 8 Potato chips/corn chips/popcorn 3.1 2.0 2.9 3.3 4.6 9 Sugars/syrups/jams 3.0 2.6 3.3 3.0 2.9 10 Poultry 2.6 2.8 2.4 2.5 3.2     % Carbohydrate 1 Yeast bread 13.0 12.1 12.7 14.0 13.7 2 Carbonated soft drinks 8.5 4.9 6.1 12.3 12.3 3 Milk 7.9 10.2 8.2 6.6 6.1 4 Ready-to-eat cereal 7.4 8.6 7.9 6.9 5.5 5 Cakes/cookies/quick breads/donuts 7.2 6.6 7.4 7.4 7.1 6 Sugars/syrups/jams 6.0 5.1 6.5 6.1 5.8 7 Fruit drinks 4.3 5.4 4.4 3.5 3.9 8 Pasta 3.9 4.4 4.0 3.2 4.1 9 White potatoes 3.7 3.0 3.8 4.0 4.0 10 Orange/grapefruit juice 2.9 3.0 2.5 3.1 3.5     % Fat 1 Milk 13.8 19.0 15.0 10.7 10.3 2 Beef 9.7 7.3 9.1 11.7 10.6 3 Cheese 7.4 7.1 7.0 7.4 8.8 4 Margarine 6.8 7.5 6.7 7.0 6.0 5 Cakes/cookies/quick breads/donuts 6.6 6.4 6.8 6.7 6.2 6 Potato chips/corn chips/popcorn 4.9 3.4 4.5 5.1 7.3 7 Salad dressings/mayonnaise 4.3 2.6 3.7 5.3 6.1 8 Oils 4.2 3.7 4.3 4.2 4.3 9 Yeast bread 3.8 3.6 3.8 3.9 3.9 10 Other fats 3.5 2.8 3.5 3.6 4.1   SOURCE: Subar et al. (1998). Reproduced by permission of Pediatrics 102(4 Pt 1):913–923, ©1989–1991.

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Food Marketing to Children and Youth: Threat or Opportunity? TABLE D-7 Top 10 Foods and Beverages Contributing to Energy Intake in the U.S. Population, NHANES 1999–2000 and NHANES IIIa Rank Food % Total Energy Cumulative % Total Energy NHANES 1999–2000 1 Regular soft drinks 7.1 7.1 2 Cake, sweet rolls, doughnuts, pastries 3.6 10.6 3 Hamburgers, cheeseburgers, meat loaf 3.1 13.8 4 Pizza 3.1 16.8 5 Potato chips, corn chips, popcorn 2.9 19.7 6 Rice 2.7 22.4 7 Rolls, buns, English muffins, bagels 2.7 25.0 8 Cheese or cheese spread 2.6 27.6 9 Beer 2.6 30.2 10 French fries, fried potatoes 2.2 32.4 NHANES III 1988–1994 1 Regular soft drinks 6.0 6.0 2 Cake, sweet rolls, donuts, pastries 3.9 9.9 3 Pizza 3.3 13.2 4 White bread including Italian or French 3.3 16.5 5 Hamburgers, cheeseburgers, meatloaf 3.1 19.6 6 Beer 2.7 22.3 7 Rolls, buns, English muffins, bagels 2.6 24.9 8 Potato chips, corn chips, popcorn 2.6 27.5 9 Rice 2.3 29.8 10 French fries, fried potatoes 2.3 32.1 aIncludes both adults and children of both sexes. SOURCE: Adapted from Block (2004). Reprinted from Journal of Food Composition and Analysis, Vol 17, Block G, Foods contributing to energy intake in the US: Data from NHANES II and NHANES 1999–2000, Pages 439–447, 2004, with permission from Elsevier.

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Food Marketing to Children and Youth: Threat or Opportunity? TABLE D-8 Mean Sodium Intake (mg) for U.S. Children and Adolescents, 1971–2000a Age/Sex Years NHANES I 1971–1974 NHANES II 1976–1980 NHANES III 1988–1994 NHANES 1999–2000 Both Sexes 1–2 1,631 1,828 1,983 2,148 3–5 1,925 2,173 2,594 2,527 6–11 2,393 2,716 3,164 3,255 Boys 12–15 2,923 3,405 4,240 3,858 16–19 3,219 4,030 4,904 4,415 Girls 12–15 2,094 2,567 3,200 3,034 16–19 1,812 2,336 3,160 3,048 aIncludes food sources and sodium used in food preparation but not salt added to food at the table. SOURCE: Reprinted, with permission, adapted from Briefel and Johnson (2004). TABLE D-9 Trends in Sweetened Beverage and Milk Consumption by Children and Adolescents, Ages 2–18 Years Measurement Years Sweetened Beveragesa Milk Percentage of total daily calorie intakeb 1977–1978 4.8 13.2   1989–1991 6.1 11.2 1994–1996 8.5 8.8 1999–2001 10.3 8.3 Percentage of consumers 1977–1978 74.5 94.3   1989–1991 74.2 90.3 1994–1996 84.7 84.6 Servingsc 1977–1978 2.02 3.46   1989–1991 2.2 2.89 1994–1996 2.55 2.75 Portionsd (fluid ounces) 1977–1978 13.1 15.4   1989–1991 15.8 14.1 1994–1996 18.9 13.6 aIncludes soft drinks and fruit drinks. bBased on mean per capita intake. cServings are the number of discrete times an individual consumes an item. dPortions are the amount consumed by an individual at one eating occasion. SOURCE: Adapted from Nielsen and Popkin (2004). Reprinted from American Journal of Preventive Medicine, Vol 27, Nielsen SJ, Popkin BM, Changes in beverage intake between 1997 and 2001, Pages 205–210, 2004, with permission from American Journal of Preventive Medicine.

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Food Marketing to Children and Youth: Threat or Opportunity? REFERENCES Block G. 2004. Foods contributing to energy intake in the US: Data from NHANES III and NHANES 1999–2000. J Food Comp Analysis 17(3-4):439–447. Briefel RR, Johnson CL. 2004. Secular trends in dietary intake in the United States. Annu Rev Nutr 24:401–431. Enns CW, Mickle SJ, Goldman JD. 2002. Trends in food and nutrient intakes by children in the United States. Fam Econ Nutr Rev 14(2):56–68. Enns CW, Mickle SJ, Goldman JD. 2003. Trends in food and nutrient intakes by adolescents in the United States. Fam Econ Nutr Rev 15(2):15–27. IOM (Institute of Medicine). 1997. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: National Academy Press. IOM. 1998. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, DC: National Academy Press. IOM. 2000. Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium and Catotenoids. Washington, DC: National Academy Press. IOM. 2001. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press. IOM. 2002–2005. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC: The National Academies Press. IOM. 2005. Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. Washington, DC: The National Academies Press. Nielsen SJ, Popkin BM. 2004. Changes in beverage intake between 1997 and 2001. Am J Prev Med 27(3):205–210. Subar AF, Krebs-Smith SM, Cook A, Kahle LL. 1998. Dietary sources of nutrients among US children, 1989–1991. Pediatrics 102(4 Pt 1):913–923. USDA. 2003. Federal Register Notice on Technical Revisions to the Food Guide Pyramid. Table 2: Energy Levels for Proposed Food Intake Patterns. Center for Nutrition Policy and Promotion. [Online]. Available: http://www.cnpp.usda.gov/pyramid-update/FGP%20docs/TABLE%202.pdf [accessed March 28, 2005].