NCHS Data Brief ■ No. 49 ■ November 2010

u.s. department of health and human services

Centers for Disease Control and Preven

National Center for Health Statis

Trends in Intake of Energy and Macronutrients in Adults 

From 1999–2000 Through 2007–2008

Jacqueline D. Wright, Dr.P.H., and Chia-Yih Wang

The Surgeon General’s recent call for renewed efforts to address the 

high prevalence of obesity in the U.S. adult population highlights the 

need for better understanding of trends in consumption of energy and the 

macronutrients protein, carbohydrate, and fat (1). The National Health 

and Nutrition Examination Survey (NHANES) is the primary national 

data system that provides information to monitor the nutritional status of 

the U.S. population. A previous study using NHANES data to report on 

trends in intake of energy and macronutrients from 1971–1974 through 

1999–2000 showed statistically significant increases in intake of energy 

and carbohydrate, and a decrease in intake of fat in men and women (2). 

The objectives of this report are to present current estimates of intake of 

energy and intake of protein, carbohydrate, total fat, and saturated fat, and 

to evaluate trends in intake of these nutrients over the past decade.

Keywords: nutrition surveys • caloric intake • diet • nutrients

What is the average energy intake for men and women?

In 2007–2008 the average energy intake for men was 2,504 kcals and for 

women it was 1,771 kcals (Figure 1). 

Key findings

• In 2007–2008 the average 

energy intake for men was 2,504 

kilocalories (kcals) and for 

women it was 1,771 kcals.

• The average carbohydrate 

intake was 47.9% of total 

kilocalories (% kcals) for men 

and 50.5% kcals for women; 

average protein intake was 

15.9% kcals for men and 15.5% 

kcals for women; average total 

fat intake was 33.6% kcals 

for men and 33.5% kcals for 

women; and average saturated 

fat intake was 11.0% kcals for 

men and 11.1% kcals for women.

• Energy intake appeared 

relatively stable over the 10-year 

period from 1999–2008; there 

were no statistically significant 

linear increases or decreases in 

total energy intake.

• There were statistically 

significant trends in intake 

of the macronutrients: 

average carbohydrate intake 

decreased and average protein 

intake increased in both men 

and women.

NOTE: Kcals are kilocalories.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey. kcals

Figure 1. Energy intake (kcals) by sex and race-ethnicity for adults aged 20 and over, 

1999–2008

0

1,700

1,900

2,100

2,300

2,500

2,700

2,900

1999–2000 2001–2002 2003–2004 2005–2006 2007–2008

Non-Hispanic black Mexican American

Non-Hispanic white All women

Mexican American Non-Hispanic black

Non-Hispanic white

All men

Women

Men
NCHS Data Brief ■ No. 49 ■ November 2010

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There were no statistically significant linear increases or decreases in total energy intake from 

1999–2000 through 2007–2008. In 2007–2008, non-Hispanic white men had higher energy 

intakes than non-Hispanic black or Mexican-American men; however, these differences were 

not consistently significant across all earlier survey periods. No other differences were observed 

among other sex and race-ethnicity groups in 2007–2008.

What are the average macronutrient intakes for men and women?

In this report, intake of macronutrients is expressed as percent of total energy (% kcals). For 

2007–2008, the average carbohydrate intake was 47.9% kcals for men and 50.5% kcals for 

women; average protein intake was 15.9% kcals for men and 15.5% kcals for women; average 

total fat intake was 33.6% kcals for men and 33.5% kcals for women; and average saturated fat 

intake was 11.0% kcals for men and 11.1% kcals for women (Figure 2).

NOTE: Kcals are kilocalories.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey.

Figure 2. Macronutrient intake (percent kcals) by sex in adults aged 20 and over, 1999–2008 Percent kcals Percent kcals

0

10

20

30

40

50

60

Saturated fat

Protein

Fat

Carbohydrate

2007–

2008

2005–

2006

2003–

2004

2001–

2002

1999–

2000

0

10

20

30

40

50

60

Saturated fat

Protein

Fat

Carbohydrate

2007–

2008

2005–

2006

2003–

2004

2001–

2002

1999–

2000

Men Women
NCHS Data Brief ■ No. 49 ■ November 2010

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Were there any increases or decreases in carbohydrate intake in the 

population over the 10 years studied?

There was a decrease in carbohydrate intake in both men and women (Figure 2). There were 

trends in specific subgroups, including a decrease in carbohydrate intake in non-Hispanic white 

and black men and in non-Hispanic white women (Figure 3).

NOTE: Kcals are kilocalories.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey.

Figure 3. Carbohydrate intake (percent kcals) by sex and race-ethnicity for adults aged 20 and over, 1999–2008 Percent kcals Percent kcals

0

44

48

52

56

60

Mexican American

Non-Hispanic black

Non-Hispanic white

2007–

2008

2005–

2006

2003–

2004

2001–

2002

1999–

2000

0

44

48

52

56

60

Mexican American

Non-Hispanic black

Non-Hispanic white

2007–

2008

2005–

2006

2003–

2004

2001–

2002

1999–

2000

Men Women

Were there any increases or decreases in protein intake in the population 

over the 10 years studied?

There was an increase in protein intake in men and women (Figure 2); between 1999–2000 

and 2007–2008 intake increased from 15.6% kcals to 15.9% kcals in men and it increased 

from 15.2% kcals to 15.5% kcals in women.

Were there any increases or decreases in intake of total fat in the 

population over the 10 years studied?

There were no significant trends in total fat intake in men and women of all race-ethnicities 

combined (Figure 2), however there was an increase in non-Hispanic black men and women; 

between 1999–2000 and 2007–2008 intake increased from 30.5% kcals to 33.7% kcals in 

non-Hispanic black men and it increased from 32.1% kcals to 34.4% kcals in non-Hispanic 

black women.
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Were there any increases or decreases in intake of saturated fat in the 

population over the 10 years studied?

The increase in men and women was not statistically significant (Figure 2), but trends were seen 

in some subgroups with an increase in saturated fat intake in non-Hispanic black men and women 

and in non-Hispanic white women (Figure 4).

NOTE: Kcals are kilocalories.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey.

Figure 4. Saturated fat intake (percent kcals) by sex and race-ethnicity for adults aged 20 and over, 1999–2008 Percent kcals Percent kcals

0

4

8

12

16

20

Non-Hispanic black Mexican American

Non-Hispanic white

2007–

2008

2005–

2006

2003–

2004

2001–

2002

1999–

2000

0

4

8

12

16

20

Non-Hispanic black Mexican American

Non-Hispanic white

2007–

2008

2005–

2006

2003–

2004

2001–

2002

1999–

2000

Men Women

Were there differences in nutrient intake between sex and race-ethnicity 

groups examined here that persisted across each of the five 2-year survey 

periods in the 10 years studied?

Men consume more total calories than women. Carbohydrate intake was higher in women than in 

men. Saturated fat intake was lower in Mexican-American men than in non-Hispanic white men.
NCHS Data Brief ■ No. 49 ■ November 2010

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Summary

These results show that while population energy intakes have been relatively stable over the past 

decade, there have been changes in intake of some macronutrients. Although these changes are 

modest in magnitude, they indicate statistically significant population-level trends have occurred. 

Some of these trends warrant further investigation. In 2007–2008, none of the groups examined 

met the recommendation in the Dietary Guidelines for Americans to consume less than 10% of 

energy from saturated fat, and there was a statistically significant upward trend in non-Hispanic 

black men and women and in non-Hispanic white women (3).

The most recent analysis of trends in obesity for the period from 2007–2008 indicate no 

significant increase from 1999–2000 for women; there was a significant increase for men 

although only for the period from 1999–2000 to 2001–2002 (4). These trends are not inconsistent 

with the relatively stable trends in total energy intake, although many factors affect the trends in 

population levels of obesity.

It is important to consider trends in energy and macronutrient intakes in the development and 

evaluation of program and policy initiatives aimed at nutrition education and obesity prevention 

in the population. These findings show broad population trends and indicate the need for analyses 

to examine factors associated with these trends.

Definitions

Total energy intake: Includes energy intake from protein, carbohydrate, and total fat and energy 

intake from alcohol. Because intake from alcohol is not presented here, the sum of percent kcals 

for any group will not add to 100.

Calculation of percent kcals for macronutrients: Intake of macronutrients is given in grams on 

the data files and the following standard conversion factors are used to convert grams to kcals:

4 kcals/gram for protein and carbohydrate and 9 kcals/gram for total fat and saturated fat.

Total fat: Includes all forms of fat—saturated, polyunsaturated, and monounsaturated.
NCHS Data Brief ■ No. 49 ■ November 2010

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Data source and methods

NHANES data were used for these analyses (5). NHANES is designed to monitor the health 

and nutritional status of the civilian, noninstitutionalized U.S. population. The survey consists 

of interviews conducted in participants’ homes, standardized physical examinations conducted 

in mobile examination centers (MECs), and laboratory tests using blood and urine specimens 

provided by participants during the physical examination.

The NHANES sample is selected though a complex, multistage design that includes selection of 

primary sampling units (counties), household segments within the counties, and finally sample 

persons from selected households. The sample design includes oversampling to provide more 

precise estimates for certain population subgroups. In 1999 NHANES became a continuous 

survey fielded on an ongoing basis. Each year of data collection is based on a representative 

sample covering all ages of the civilian noninstitutionalized U.S. population. Public-use data files 

are released in 2-year cycles.

Dietary sample weights, which account for the differential probabilities of selection, nonresponse 

and noncoverage and additionally, day of the week of dietary recall and nonresponse to the 

dietary interview, were incorporated into the estimation process. All data analyses were performed 

using the statistical software SAS version 9.2 (SAS Institute, Cary, N.C.) and SUDAAN version 

10.0 (RTI, Research Triangle Park, N.C.). In order to compare prevalence estimates between 

subgroups that differed with respect to age distribution, all estimates except age-specific 

estimates were adjusted by the direct method to the 2000 U.S. population age distribution using 

the 20-year age intervals: 20–39 years, 40–59 years, and 60 years and over. Statistical tests 

of linear trends by survey were performed using orthogonal polynomial contrasts and tests of 

differences between population subgroups were performed using t-tests at the p <0.05 level. 

Adjustments for multiple comparison were made using the Bonferroni method by dividing 0.05 

by the number of comparisons (6).

Information on demographic traits was collected via personal interview in the household. 

Information on nutrient intake was obtained from one 24-hour dietary recall interview 

administered in-person in the MEC. In 1999–2001, the dietary interview data collection system 

used was similar to that used in NHANES III, conducted from 1988 through 1994 and used 

a multiple-pass approach (7). In 2002, as a part of survey integration efforts with the U.S. 

Department of Agriculture’s (USDA) What We Eat in America/Continuing Survey of Food 

Intakes by Individuals, NHANES began to use the 24-hour dietary recall data collection system 

developed by researchers at USDA’s Agricultural Research Service, the Automated Multiple-Pass 

Method (8). Nutrient intakes were calculated from the individual foods and beverages reported in 

the dietary recall interview. In NHANES 1999–2000, reported foods and beverages were coded 

using USDA’s Survey Nutrient Database (versions 1994–1996 and 1998) (9). From 2001–2002 

through 2007–2008, reported foods and beverages were coded using USDA’s Food and Nutrient 

Database for Dietary Studies (10).
NCHS Data Brief ■ No. 49 ■ November 2010

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About the authors

Jacqueline D. Wright and Chia-Yih Wang are with the Centers for Disease Control and Prevention’s 

National Center for Health Statistics, Division of Health and Nutrition Examination Surveys.

References

1. U.S. Department of Health and Human Services. The Surgeon General’s Vision for a Healthy 

and Fit Nation. Rockville, MD. 2010.

2. CDC. Trends in intake of energy and macronutrients—United States, 1971–2000. MMWR 

53:80–2. 2004.

3. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 

Dietary guidelines for Americans, 2005. 2005. Available from: http://www.healthierus.gov/

dietaryguidelines/.

4. Flegal K, Carroll M, Ogden C, et al. Prevalence and trends in obesity among U.S. adults, 

1999–2008. JAMA 303:235–41. 2010.

5. Centers for Disease Control and Prevention. National Center for Health Statistics. National 

Health and Nutrition Examination Surveys. NHANES Datasets and Related Documentation. 

Hyattsville, MD. 2010. Available from: http://www.cdc.gov/nchs/nhanes/nhanes_questionnaires.htm.

6. Neter J, Wasserman W, Kutner M. Applied linear statistical models, 2d ed. Homewood, IL: 

Richard D. Irwin, Inc. 1985.

7. Centers for Disease Control and Prevention. National Center for Health Statistics. National 

Health and Nutrition Examination Survey: Dietary Interviewers Procedures Manual, 2000. 

Available from: http://www.cdc.gov/nchs/nhanes/nhanes1999-2000/current_nhanes_99_00.htm.

8. Agricultural Research Service, Food Surveys Research Group. USDA Automated MultiplePass Method for Dietary Recalls. 2006. Available from: http://www.ars.usda.gov/Services/docs.

htm?docid=7710.

9. U.S. Department of Agriculture. Agricultural Research Service Food Surveys Research Group. 

Food survey technical databases. U.S. Department of Agriculture 1994–1998.

10. Agricultural Research Service, Food Surveys Research Group. USDA Food and Nutrient 

Database for Dietary Studies. 2004. Available from: http://www.ars.usda.gov/Services/docs.

htm?docid=12089.
NCHS Data Brief ■ No. 49 ■ November 2010

Suggested citation

Wright JD, Wang C-Y. Trends in intake of 

energy and macronutrients in adults from 

1999–2000 through 2007–2008. NCHS 

data brief, no 49. Hyattsville, MD: National 

Center for Health Statistics. 2010. 

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Edward J. Sondik, Ph.D., Director

Jennifer H. Madans, Ph.D., Associate 

 Director for Science

Division of Health and Nutrition 

Examination Surveys

Clifford L. Johnson, M.S.P.H., Director

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