1. In children ages 2 to 18 years, overall energy intake from pizza has declined 25% from 2003 to 2010.
2. Pizza consumption increased daily intake of sodium and saturated fat, but had no significant impact upon sugar intake.
Evidence Rating Level: 1 (Excellent)
Study Rundown: In the United States, pizza consumption accounts for the second leading source of energy intake after grain desserts in children ages 2 to 18 years. Poor diet, along with imbalanced energy and nutrient intake, is a major contributor to diseases like childhood obesity, type 2 diabetes mellitus, and hypertension. As such, pizza intake amongst children is important to quantify and examine as it pertains to the overall health of United States children. This study evaluated pizza intake from dietary recalls in a national database spanning from 2003 to 2010. Results indicated that while children’s overall energy intake from pizza declined from 2003 to 2010, pizza still comprised a good portion of children’s diets. Their overall total energy intake was significantly higher on days when they consumed pizza compared to days they did not. Limitations in this study include biases secondary to retrospective dietary recall and the variability and difficulty in assessing nutritional content of different types of pizza is difficult. The study proposes improvement in nutritional content of pizza and curbing of its intake in children.
In-Depth [retrospective cohort study]: Data was taken from the National Health and Nutrition Examination Survey, collected in 2003 to 2004, 2005 to 2006, 2006 to 2007, 2007 to 2008, and 2009 to 2010. The analysis included 2 consecutive 24-hour dietary recalls for children ages 2 to 18 years conducted by trained dietary interviewers. Proxy respondents either reported or helped to report for children under the age of 12, while children over the age of 12 completed their own dietary interviews. Overall energy consumption from pizza declined by 25% from 2003 to 2010 (P ≤ 0.05). While the prevalence of eating pizza increased amongst adolescents, the individual caloric intake from pizza decreased from 801 to 624 kcal (P ≤ 0.05). Children who consumed pizza as a snack, rather than a meal, had the most adverse impacts upon total energy intake. Pizza consumption increased intake of sodium and saturated fat, but had no significant impact upon sugar intake. Of note, pizza consumption from school, rather than from fast-food restaurants, was not linked to higher overall energy intake.
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