The National Health and Nutrition Examination Survey (NHANES) offers a publicly available set of data on what we eat in the United States. Sponsored by the Centers for Disease Control, data is collected from about 10,000 people every two years. Chris Taylor, PhD, RDN, LD, professor of Medical Dietetics and Family Medicine, has been analyzing this data set for almost 20 years.
“I look at dietary patterns,” Taylor said. “For 75 years, much of the work in nutrition science has been focused on individual nutrients. Carbohydrates, for example, or fat. But we eat food, not nutrients. I wanted to take a step back and better understand food patterns overall.”
Taylor strives to combine analytical ability with his knowledge of nutrition and dietetics.
“Too many people use the data without a nutrition background,” he said. “They don’t understand the differences of whether calories come from cookies or celery. We want to overlay nutrition information with consumption data. We need to understand food and make sense of it. For example, what do certain nutrients do, where do they come from, what happens if you don’t eat them and what happens if you replace them with something else?”
Taylor has spent the past several years understanding dietary patterns in children, patients with diabetes and older adults. He noticed a pattern across all groups of a forgotten area of calorie consumption: snacks.
“For many people, snacks contribute a meal’s worth of calorie intake every day,” Taylor said. “When focused on average calories, people forget about what they consume in a nibble here or a nibble there. But if we opened a restaurant of menu items based on what we snack on, people would be appalled to call those meals.”
Thanks in part to Taylor’s analytics, Abbott Nutrition Health Institute (ANHI) is creating educational materials for healthcare providers to help diabetes patients manage their disease more effectively. Taylor sees educational opportunities for other groups as well, specifically children and older adults.
“We’re trying to better understand malnutrition,” Taylor said. Pediatricians and family physicians previously looked at weight and height as metrics for a classification called “failure to thrive.”
“We have more malnutrition in U.S. kids than you’d expect,” Taylor said. He and his colleagues are exploring a more refined definition, which could include additional metrics to develop a scale with mild, moderate and severe designations.
“We realized that kids who are malnourished aren’t eating that much worse than kids who aren’t malnourished,” he said. “But these differences may cause mild to moderate growth limitations.”
Taylor believes that earlier intervention, such as improved education, is key to helping kids live healthier lives. “We are learning that when they’re already behind, it’s that much harder for them to catch up,” he said.
Another group that may need early intervention in nutrition education is older adults. What may surprise many is the age group that needs it.
“We learned that adults in their 50s exhibit the poorest diet quality,” Taylor said. “Many of them are still working full time and are more likely to eat out.” They’re less likely to meet appropriate nutrient thresholds and tend to consume poorer quality food.
“These are adults who aren’t setting a stage for successful aging,” Taylor said. “Typically, we don’t counsel people on nutrition until there’s a problem [like obesity or diabetes]. We need to understand how important nutrition is to successful aging strategies. We need to start talking earlier rather than addressing poor outcomes when adults are in their 60s or 70s.
“The single nutrient perspective makes you miss the important point. Just focusing on one element like low carbohydrates doesn’t help us understand the big picture. What strategies should you employ? You need to look at the influence of the entire diet.”
View Dr. Taylor’s ANHI course Utilization of NHANES Data to Assess Pediatric Undernutrition at go.osu.edu/TaylorCourse