Assessing energy and nutrient intake

The amount of energy and nutrients (i.e., sugars, total fats, saturated fats, trans fats, Na and K) and fibre of each reported food item were calculated using the US Food Composition Table (United States Department of Agriculture National Nutrient Database for Standard Reference – Release 28)⁽³¹⁾. Every reported food item was matched to a food item from the United States Department of Agriculture food composition database, selected in a homologation process that allowed a 20 % variation between the known content of energy, macronutrients and Na (obtained from the Chilean Food Composition Table⁽³²⁾ or the nutrient fact panels obtained from Chilean packaged foods). The nutritional information from packaged foods was collected in major supermarket chains in Santiago de Chile (2015 and 2016). Details on the methodology and a description of the nutritional quality of available packaged foods have been described elsewhere^(33,34). Free sugars were estimated using the algorithm proposed by the nutrient profile model launched by the Pan American Health Organization⁽⁸⁾.

The WHO-proposed dietary goals were used for evaluating the prevalence of non-recommended intake of different key nutrients: ≥10 % kilojoules (kJ) of total energy intake for free sugars, ≥30 % kJ of total energy intake for total fats, ≥10 % kJ of total energy intake for saturated fats, ≥1 % kJ of total energy intake for trans fats, < 25 g/8368 kJ for fibre, ≥2000 mg/8368 kJ for Na, <3510 mg/8368 kJ for K and ≥1 for Na:K ratio^(9,35,36). Dietary energy density inadequacy was assessed separately for the diet fraction made of beverages (coffee, tea and herbal teas, soda, soft drinks, sports and energy drinks, fruit and/or vegetable juices, alcoholic beverages and non-alcoholic beers, bottled and flavoured water, tap water and milk)⁽³⁷⁾ and the diet fraction made of foods only (all beverages excluded). Criteria for the diagnosis of energy density inadequacy were ≥9·4 kJ/g for foods and ≥1·67 kJ/g for beverages. The cut-off of 9·4 kJ used for foods was based on the World Cancer Research Fund recommendation for limiting the consumption of high-energy density foods as a method for preventing obesity^(37,38). This cut-off corresponds to the 75th percentile of energy density of foods for the studied sample. The cut-off used for beverages was chosen to correspond also to the 75th percentile of the studied sample.