Snacking, skipping breakfast, eating high-calorie foods, and eating

out have all increased in the past decades, and have been suggested as contributors to the increased prevalence of overweight and

obesity. These eating behaviors have been shown to be related to

overeating, according to small cross-sectional and clinical studies. 

The Nutrition and Health Characteristics of Low-Income

Populations study examined several eating behaviors for children

and adults using 1988-94 National Health and Nutrition

Examination Survey (NHANES-III) data. The measures provide

a baseline to monitor eating behaviors of Americans, focusing on

the low-income population. Participants in the Food Stamp

Program (FSP) and the Special Supplemental Nutrition Program

for Women, Infants, and Children (WIC) are identified.

Nonparticipants are separated into income-eligible and higher

income groups using the income eligibility cutoff of 130-percent

and 185-percent poverty level for FSP and WIC, respectively.

School-age children and older adults ages 60 and above are

grouped into three income classes—lowest income (130 percent

of poverty level or less), low income (greater than 130 and no

more than 185 percent), and higher income (above 185 percent).

Additional population groups are created using gender and age.

Because of data limitations, the WIC portion of this summary

presents findings only for children ages 1-4.

The dietary interview component of the NHANES-III collected

dietary intake data using a 24-hour recall. Respondents reported

all foods and beverages consumed during the day before the

interview. For each food consumed, the respondent reported the

amount, time, eating occasion, and place. These data were used

to identify meal patterns, including the number of meals and

snacks consumed, breakfast eating, milk and soft drink consumption, and supplement use.

Meal Patterns: Number of Meals, Breakfast

Eating, and Snacks Consumed

Each food intake was recorded into one of four possible meals

(breakfast, brunch, lunch, and dinner/supper) or four possible

snack categories (snack/beverage, infant feeding, extended consumption, and other). The number of meals consumed each day

showed a “U” shape with respect to age, declining from a high

of 3.0 meals among 1- to 2-year-olds to a low of 2.4 meals among

12- to 19-year-olds, then increasing to 2.8 meals among those

ages 60 and older (fig. 1). The proportion of individuals eating

fewer than three meals a day exhibited an inverse “U” shape with

respect to age. More than half of 12- to 29-year-olds (51 percent)

reported eating fewer than three meals during the previous day,

more than double the 23 percent for the 6- to 11-year-olds.

Breakfast consumption habits have been linked to body weight,

with breakfast skippers more likely to weigh more (Lin et al.,

2004). On average, 55 percent of Americans reported eating

breakfast. Mirroring the age pattern for meals, the percentage of

Americans consuming breakfast also exhibits a “U” shape with

respect to age. Over 90 percent of 1- to 5-year-olds consumed

breakfast, but the proportion dropped precipitously to only 14

percent among 12- to 19-year-olds. Breakfast consumption

steadily increased among adults, so that by age 50-59, nearly 60

percent consumed breakfast every day, and over 93 percent of

those in their 80s did (fig. 2).

The majority of Americans (88 percent) snacked at least once a

day. Preschoolers were more likely to snack at least once (95

percent), whereas fewer than 80 percent of those older than 70

years did so. The frequency in snacking declined with age, from

a high of 3.1 snacks per day among 1- to 2-year-olds to fewer

than two snacks among those ages 70 and older.

FSP Participants. Compared with higher income nonparticipants,

FSP participants consumed fewer meals (2.5 vs. 2.7 meals), and

were more likely to report fewer than three meals in the preceding day (44 percent vs. 33 percent). Preschool children and

females who participated in the FSP were less likely to consume

breakfast than their higher income counterparts (88 percent vs.

93 percent for preschool children; 50 percent vs. 57 percent for

females). FSP participants were less likely than higher income

nonparticipants to consume a daily snack (83 percent vs. 89 percent). This was true for both males and females. Furthermore,

both income-eligible and higher income nonparticipants consumed more snacks than FSP participants did (2.0 vs. 2.3 vs. 1.8).

United States

Department of

Agriculture

Economic 

Research

Service

Agriculture Information Bulletin 796-4 February 2005

Nutrition and Health Characteristics of

Low-Income Populations

Meal Patterns, Milk and Soft

Drink Consumption, and

Supplement Use

Elizabeth Frazao, (202) 694-5455, efrazao@ers.usda.gov
WIC Children. Most children ages 1-4 consumed three meals in

the preceding day. WIC children were more likely than higher

income children to consume fewer than three meals (16 percent

vs. 10 percent). This difference is largely attributable to a difference among 2-year-olds, where the prevalence of consuming

fewer than three meals is twice as high among WIC participants

as higher income nonparticipants (12 percent vs. 6 percent).

WIC children were also less likely than higher income children

to consume breakfast (88 percent vs. 94 percent). Although WIC

children were equally likely as children in the other two groups

to consume a snack, WIC children consumed more snacks than

income-eligible nonparticipating children (2.8 vs. 2.6).

School-Age Children. School-age children consumed an average

of 2.6 meals, and 36 percent of them consumed fewer than three

meals a day. The proportion of children eating fewer than three

meals increases with age, from a low of 20 percent for ages 5-10

to a high of 55 percent for ages 14-18. Children in the lowest income group consumed fewer meals than children in the higher

income group (2.6 vs. 2.7) and were more likely to have consumed fewer than three meals a day (39 percent vs. 34 percent).

Forty-six percent of all school-age children reported eating breakfast, although children in the lowest income group were less likely

than those in the higher income group to consume breakfast (44

percent vs. 48 percent). This difference is concentrated among

2 Economic Research Service / USDA

Agriculture Information Bulletin 796-4

1-2

3.0 2.9 2.8

2.4 2.5 2.6 2.7 2.7 2.8 2.8 2.8

Source: National Health and Nutrition Examination Survey, 1988-94.

Number of meals

Figure 1

Meals consumed per day, by age

3-5 6-11 12-19 20-29 30-39

Age in years

40-49 50-59 60-69 70-79 80+

1-2

93.1 89.7

85.3

14.2

35.9

40.6

45.8

59.6

75.1

86.4

93.6

Source: National Health and Nutrition Examination Survey, 1988-94.

Percent

Figure 2

Americans consuming breakfast, by age

3-5 6-11 12-19 20-29 30-39

Age in years

40-49 50-59 60-69 70-79 80+
those ages 11-13. Nearly 90 percent of school-age children consumed at least one snack per day, with children ages 11-18 consuming an average of two snacks per day. 

Older Americans. Older adults in the lowest income group were

less likely to consume three meals than older adults in the higher

income group (67 percent vs. 80 percent). This pattern is

observed for both males and females. The percentage of elderly

who consumed fewer than three meals tends to decrease with

age. Twenty-eight percent of older adults ages 60-64 consumed

fewer than three meals, compared with 19 percent of those ages

85 and older. Older adults in the lowest income group were less

likely to eat breakfast than older adults in the other two income

groups (78 percent vs. 83 percent vs. 84 percent). Older adults in

the lowest income group were also less likely to consume a

snack than their higher income counterparts (77 percent vs. 84

percent) and consumed fewer snacks (1.4 vs. 1.9). Both patterns

were observed for males and females. Among the elderly, snacking also tends to decrease with age. While 87 percent of those

ages 60-69 reported eating at least one snack in the preceding

day, only 68 percent of those ages 85 and older reported one or

more snacks.

Consumption of Fluid Milk and Soft Drinks

Data from the national food supply indicate that Americans are

consuming substantially less milk and substantially more soft

drinks than they were 25 years ago (USDA/ERS, 2004).

Concerns have been raised about the potential impact of this

trend on calcium intake, particularly among children and adolescents (French et al., 2003).

This study confirms that milk consumption is low and that soft

drink consumption outstrips milk consumption in virtually all

age and gender categories, except those ages 1-8 (fig. 3). With

the exception of children younger than 9 and boys ages 9-13, all

gender and age groups consumed less than 1 full (8-oz) serving

of fluid milk a day. In contrast, both males and females ages 4

and above consumed at least 1 serving of soft drinks. Boys

between the ages of 14 and 18 consumed the most soft drinks,

averaging 3 servings a day. 

FSP Participants. The findings for the general population were

also observed for FSP participants and both groups of nonparticipants. No differences in the consumption of milk and soft drinks

were found among FSP participants and nonparticipants, for both

males and females. There were small differences for certain age

groups between FSP participants and higher income nonparticipants, but no consistent pattern in the differences is observed.

WIC Children. Unlike older children, children ages 1-4 consumed more milk than soft drinks (1.2 servings vs. 0.8 servings).

This pattern was observed for WIC participants and both groups

of nonparticipants. Overall, there were no between-group differences in mean consumption of milk and soft drinks. Among 2-

year-olds, however, WIC participants consumed more milk than

income-eligible nonparticipants (1.2 servings vs. 1.0 serving).

The data also shows that milk consumption decreases with age,

whereas soft drink consumption increases with age. While children ages 1-3 consumed more milk than soft drinks, by the age

of 4 consumption of soft drinks matched consumption of milk,

averaging one serving of each.

Economic Research Service / USDA 3

Agriculture Information Bulletin 796-4

1-3

1.4

0.6

1.0 1.0

0.9

1.5

0.7

0.6 0.6

2.7 2.6

2.2

1.8

0.5 0.5

1.3

Source: National Health and Nutrition Examination Survey, 1988-94.

Number of 8-oz servings

Figure 3

Average consumption of milk and soft drinks, by age

4-8 9-13 14-18

Age in years

19-30 31-50 51-70 71+

Milk Soft drinks
School-Age Children. The data on school-age children confirm

that soft drink consumption outstripped milk consumption for all

age and gender groups. On average, school-age children consumed 0.8 serving of milk and 2 servings of soft drinks per day.

The only difference between income groups in milk consumption

was found among 9- to 13-year-olds. In this age group, the lowest

income group consumed less milk than the higher income group

(0.7 serving vs. 0.8 serving), mainly because of the difference

among boys.

Use of Vitamin and Mineral Supplements 

Women who take supplements tend to weigh less than other

women (Lin et al., 2004). It has been suggested that supplement

use is a marker for diets lower in fat and high in fiber. Use of vitamin and mineral supplements may mitigate inadequate nutrient

intake from foods. Methods have not been developed yet to adequately incorporate supplement data into measures of individual

nutrient intake, but examination of supplement use may provide

useful insights. NHANES-III respondents were asked whether

they used vitamin or mineral supplements during the preceding

month. If supplements were used, respondents were asked to

show the actual bottles or jars to interviewers so that the type of

supplement and associated dosage information could be recorded.

The data show that 40 percent of all individuals used a vitamin

or mineral supplement in the month before participating in the

survey. The use of supplements declined initially with age from

46 percent among those ages 1-3 to 25 percent among those ages

14-18, and then rose with age to 49 percent among those older

than 70. On average, 46 percent of preschoolers ages 1-4, 30

percent of children ages 5-18, and 48 percent of older adults

used a vitamin and/or mineral supplement. Multivitamin-mineral

combinations were most popular, used by 47 percent of users,

followed by multiple vitamins taken by 35 percent of users. The

vitamin-mineral combination supplements likely include nutrients potentially deficient in the diet, such as vitamin C, iron, and

zinc; calcium is likely also included, but generally at levels well

below other minerals relative to the 1989 Recommended Daily

Allowances.

FSP Participants. FSP participants were less likely than either

income-eligible or higher income nonparticipants to use vitamin

or mineral supplements (26 percent vs. 32 and 44 percent). This

pattern applied to both males and females, and was significant

among nearly all age groups. Multivitamin-mineral combinations

were the most popular supplements among FSP participants as

well as among nonparticipants. 

WIC Children. WIC children were less likely than higher

income children to take a vitamin or mineral supplement (39

percent vs. 55 percent). This was true for each age cohort.

However, among 2-year-olds, WIC participants were more likely

to receive supplements than income-eligible nonparticipants (48

percent vs. 32 percent). Nearly all children who received supplements received only one supplement. In all three groups, the

type of supplement used most often was a multivitamin (53 percent of all children who received supplements), followed by a

multivitamin-mineral combination (40 percent).

School-Age Children. School-age children in the lowest income

group were less likely than those in the higher income group to

use vitamin or mineral supplements (20 percent vs. 37 percent).

This pattern held true for both males and females and for all age

and gender subgroups. Similarly, the vast majority of school-age

children who used supplements (82 percent) took one supplement that was either a multivitamin or a multivitamin-mineral

combination. 

Older Americans. Elders in the lowest income group were less

likely than those in the higher income group to use supplements

(40 percent vs. 53 percent). This pattern was observed for males

and females. In all three income groups, use of supplements was

more common among females than males. The two most common types of supplement used were a multivitamin-mineral

combination (46 percent of the elderly who used one or more

supplements) and a single vitamin supplement (38 percent).

Information Sources

Lin B.H., C.L. Huang and S.A. French (2004). “Factors associated with women’s and children’s body mass indices by income

status,” International J. Obesity 28:536-43.

U.S. Department of Agriculture, Economic Research Service

(2004). Per capita food consumption data system. Retrieved

August 1, 2004, from www.ers.usda.govbriefing/consumption/

supply.htm.

French S.A., B.H. Lin, and J.F. Guthrie (2003). “National Trends

in Soft Drink Consumption Among Children and Adolescents

Aged 6-17 Years: Prevalence, Amounts and Sources, 1977/78

Through 1994/98,” J, American Dietetic Assoc. 103:1326-31.

4 Economic Research Service / USDA

Agriculture Information Bulletin 796-4

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, sex,

religion, age, disability, political beliefs, sexual orientation, or marital or family status. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET

Center at (202) 720-2600 (voice and TDD).

To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 14th and Independence Avenue,

SW, Washington, DC 20250-9410, or call (202) 720-5964 (voice and TDD). USDA is an equal opportunity provider and employer.

For more information, see www.ers.usda.gov/publications/ 

efan04014-1, 04014-2, 04014-3, 04014-4.

NOTE: These studies were not designed to assess program

impacts. Do not interpret any reported differences between 

program participants and nonparticipants as impacts of food

assistance programs.