Consumption of Mixed Dishes by American Children and Adolescents: An Analysis Beyond Calories, Saturated Fat and Sodium
Authors: Houchins Jenny A. , Cifelli Christopher J. , Demmer Elieke , Fulgoni Victor L. 
Published: November 2023

In consideration of the prevalence of overweight and obesity in the USA, suggestions have been made to reduce consumption of mixed dishes, modify the way they are prepared, or consume smaller portion sizes. It can be argued that the best place to modify mixed dishes consumption patterns might be in children and adolescents, as eating patterns developed during childhood can continue into adulthood. When making recommendations for dietary patterns moving forward, it is critical to look not only at the amount of energy or nutrients to limit contributed by mixed dishes, but also at their total nutrient contribution. The goal of this project was to evaluate the contribution mixed dishes have on total nutrient intake in American children and adolescents, and also, evaluate potential unintended consequences of removing these foods from the diet. Data from the dietary component of 2009–2012 National Health and Nutrition Examination Survey were used in this study. For the current analysis, the first day interview data were used for children and adolescents aged 6–18 y (total n=4,414; females (F) (n=2,145) and males (M) (n=2,269)). Analysis was conducted separately for school‐aged children 6–11 y (n=2,300) and adolescents 12–18 y (n=2,114). Estimated mean (± standard error) daily nutrient intake and percent daily contribution were determined by each age and gender group. Besides baseline intake, two dietary models were examined in this study: 1) nutrients from mixed dishes were replaced by the nutrient profile from all other consumptions (based on energy) and, 2) nutrients from the top 25 mixed dishes were replaced by the nutrient profile from all other consumptions. The average daily energy contribution of mixed dishes to the diet of American children and adolescents was is 423±16 kcal and 532±28 kcal, respectively. On average, mixed dishes contributed 21±1% daily energy for F and 22±1% for M 6–11 y. These foods provide 24±1% and 26±1% daily energy for F and M 12–18 y, respectively. Mixed dishes contributed a meaningfully greater proportion of total fat (27±1%) for M 6–11 y, saturated fat for F (27±1%) and M (28±1%) ages 6–11 y, and sodium for all (30±1%–37±2%), as compared to the energy contribution of these foods. On average, mixed dishes contributed a similar proportion of calcium (19±1%–24±2%) and iron (22±1%–27±2%) to the diet for all groups, and a similar proportion of potassium (20±1% for F, 22±1% for M) in adolescents aged 12–18 y, as compared to the energy contribution of these foods. When evaluated at the level of food groups, mixed dishes account for 32±1% and 37±2% of total grains in children and adolescents, respectively, 32±1% and 31±2% of total vegetables, 29±1% and 33±1% of the protein group and 20±1% and 26±2% of total dairy. Removing mixed dishes from the diet and replacing with the remaining foods consumed had minimal effect on under‐consumed nutrients of public health concern, however, sodium consumption was lowered when these foods are replaced. Overall, this analysis shows mixed dishes make meaningful contributions to nutrient intake, beyond energy and nutrients to limit.Support or Funding InformationNational Dairy Council