Turning point for US diets? Recessionary effects or behavioral shifts in foods purchased and consumed.

BACKGROUND In the past decade, the United States has seen declining energy intakes and plateauing obesity levels. OBJECTIVE We examined whether these observed trends suggest a longer-term shift in dietary and health behavior that is independent of adverse economic conditions. DESIGN We used nationally representative cross-sectional surveys on intake and longitudinal household food purchase data along with random-effects models to address this question. Data included individuals in NHANES 2003-2004 to 2009-2010 (children: n = 13,422; adults: n = 10,791) and households from the 2000-2011 Nielsen Homescan Panel (households with children: n = 57,298; households with adults only: n = 108,932). RESULTS In both data sets, we showed that children decreased their calories the most. Even after we controlled for important socioeconomic factors, caloric purchases fell significantly from 2003 to 2011 (P < 0.001), particularly for households with children. The Great Recession was associated with small increases in caloric purchases, in which a 1-percentage point increase in unemployment in the local market was associated with a 1.6-4.1-kcal · capita⁻¹ · d⁻¹ (P < 0.001) increase in total calories purchased. Results also indicated shifts in caloric purchases were driven more by declines in caloric purchases from beverages than food. CONCLUSIONS US consumers have exhibited changes in intake and purchasing behavior since 2003 that were independent from changing economic conditions linked with the Great Recession or food prices. Public health efforts in the past decade may have contributed to this trend.