Objective: The contribution of subsidized food commodities to total food consumption is unknown. We estimated the proportion of individual energy intake from food commodities receiving the largest subsidies from 1995 to 2010 (corn, soyabeans, wheat, rice, sorghum, dairy and livestock). Design: Integrating information from three federal databases (MyPyramid Equivalents, Food Intakes Converted to Retail Commodities, and What We Eat in America) with data from the 2001-2006 National Health and Nutrition Examination Surveys, we computed a Subsidy Score representing the percentage of total energy intake from subsidized commodities. We examined the score's distribution and the probability of having a 'high' (≥70th percentile) v. 'low' (≤30th percentile) score, across the population and subgroups, using multivariate logistic regression. Setting: Community-dwelling adults in the USA. Subjects: Participants (n 11 811) aged 18-64 years. Results: Median Subsidy Score was 56·7 % (interquartile range 47·2-65·4 %). Younger, less educated, poorer, and Mexican Americans had higher scores. After controlling for covariates, age, education and income remained independently associated with the score: compared with individuals aged 55-64 years, individuals aged 18-24 years had a 50 % higher probability of having a high score (P <0·0001). Individuals reporting less than high-school education had 21 % higher probability of having a high score than individuals reporting college completion or higher (P = 0·003); individuals in the lowest tertile of income had an 11 % higher probability of having a high score compared with individuals in the highest tertile (P = 0·02). Conclusions: Over 50 % of energy in US diets is derived from federally subsidized commodities.
Keywords
Dietary intake Subsidized food commodities Obesity Diabetes National Health and Nutrition Examination SurveysIn the USA, 26 % and 14 % of mortality and disabilityadjusted life years, respectively, are related to our dietary patterns (1) . Traditionally, diets high in total energy, refined carbohydrates, and red and processed meats have been implicated in the development of obesity, diabetes and common co-morbidities, particularly CVD (2)(3)(4) , while diets high in fruit and vegetables are associated with reduced risks (5,6) . Currently, more than one-third (36 %) of American adults are obese (7) and 12 % have diabetes (8) , while heart disease is the leading cause of death (9) . Finding suitable policy interventions that positively influence the nation's diet and resulting cardiometabolic health has been challenging. The US Department of Agriculture (USDA) and US Department of Health and Human Services set nutritional recommendations that encourage consumption of diets high in fruits and vegetables and lower in energy, sugar, salt and saturated fat, but a recent report suggests that the majority of Americans do not meet these dietary guidelines (10) . Moreover, current US agricultural policies promote the production of refined grains, dairy and meat products. Fro...