Introduction
Subjects and methods
The NHANES
Study population and dietary intake
Determination of apple product consumption
Healthy Eating Index (HEI-2010)
Anthropometric and physiological measures
Statistical analyses
Results
Apple consumption and demographic characteristics
Total apple products | Whole apples | Apple sauce | Apple juice | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Variable | Consumers (n = 3,482) LSM ± SE | Non-Consumers (n = 9,857) LSM ± SE | P-value | Consumers (n = 1,891) LSM ± SE | Non-Consumers (n = 11,448) LSM ± SE | P - value | Consumers (n = 332) LSM ± SE | Non-Consumers (n = 13,007) LSM ± SE | P-value | Consumers (n = 1,714) LSM ± SE | Non-Consumers (n = 11,625) LSM ± SE | P-value |
Gender (%) | ||||||||||||
Female | 49.9 ± 1.4 | 49.0 ± 0.8 | 0.584 | 50.4 ± 1.8 | 49.0 ± 0.8 | 0.466 | 49.5 ± 3.2 | 49.2 ± 0.8 | 0.930 | 49.9 ± 2.1 | 49.1 ± 0.8 | 0.732 |
Ethnicity (%) | ||||||||||||
NHW | 58.3 ± 2.0 | 61.0 ± 2.0 | 0.334 | 57.1 ± 2.3 | 60.8 ± 2.0 | 0.220 | 76.7 ± 3.2 | 59.7 ± 1.9 |
<0.001
| 55.6 ± 2.6 | 60.9 ± 1.9 | 0.105 |
NHB | 13.0 ± 1.1 | 14.9 ± 1.1 | 0.227 | 10.6 ± 1.1 | 15.0 ± 1.1 |
0.004
| 12.4 ± 2.0 | 14.5 ± 1.0 | 0.367 | 15.4 ± 1.4 | 14.3 ± 1.0 | 0.508 |
MA | 15.9 ± 1.3 | 12.4 ± 1.2 | 0.039 | 18.0 ± 1.5 | 12.5 ± 1.2 |
0.004
| 5.2 ± 1.3 | 13.6 ± 1.2 |
<0.001
| 16.1 ± 1.6 | 12.9 ± 1.1 | 0.104 |
Age (Years) | 8.3 ± 0.2 | 10.7 ± 0.1 |
<0.001
| 9.1 ± 0.2 | 10.3 ± 0.1 |
<0.001
| 7.2 ± 0.3 | 10.2 ± 0.1 |
<0.001
| 7.2 ± 0.2 | 10.5 ± 0.1 |
<0.001
|
PIR | 2.6 ± 0.1 | 2.5 ± 0.1 | 0.486 | 2.6 ± 0.1 | 2.5 ± 0.1 | 0.155 | 2.6 ± 0.2 | 2.5 ± 0.1 | 0.504 | 2.4 ± 0.1 | 2.5 ± 0.1 | 0.159 |
PA (%) | ||||||||||||
Sedentary | 13.0 ± 1.0 | 12.7 ± 0.6 | 0.839 | 12.4 ± 1.3 | 12.9 ± 0.5 | 0.722 | 8.2 ± 1.7 | 12.9 ± 0.5 |
0.009
| 16.0 ± 1.6 | 12.3 ± 0.5 | 0.032 |
Moderate | 20.4 ± 1.1 | 19.8 ± 0.7 | 0.676 | 20.4 ± 0.7 | 17.6 ± 1.6 | 0.115 | 32.7 ± 3.7 | 19.6 ± 0.7 |
<0.001
| 20.8 ± 1.7 | 19.9 ± 0.7 | 0.590 |
Active | 66.7 ± 1.3 | 67.5 ± 0.9 | 0.621 | 66.8 ± 0.8 | 70.0 ± 2.2 | 0.164 | 59.1 ± 3.7 | 67.5 ± 0.8 | 0.025 | 63.2 ± 1.9 | 67.8 ± 0.8 | 0.025 |
Current smoker (%) | 2.5 ± 0.4 | 7.5 ± 0.5 |
<0.001
| 6.8 ± 0.4 | 2.3 ± 0.4 |
<0.001
| 1.3 ± 0.7 | 6.3 ± 0.4 |
<0.001
| 2.6 ± 0.7 | 6.7 ± 0.4 |
<0.001
|
Alcohol (g) | 0.3 ± 0.1 | 0.6 ± 0.1 | 0.012 | 0.5 ± 0.1 | 0.3 ± 0.1 | 0.075 | 0.0 ± 0.0 | 0.5 ± 0.1 |
<0.001
| 0.2 ± 0.1 | 0.5 ± 0.1 | 0.016 |
HEI-2010
Healthy eating index-2010 & Components | Total apple products | Apples | Apple sauce | Apple juice | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Consumers (n = 3,482) LSM ± SE | Non-Consumers (n = 9,857) LSM ± SE | P-value | Consumers (n = 1,891) LSM ± SE | Non-Consumers (n = 11,448) LSM ± SE | P-value | Consumers (n = 332) LSM ± SE | Non-Consumers (n = 13,007) LSM ± SE | P-value | Consumers (n = 1,714) LSM ± SE | Non-Consumers (n = 11,625) LSM ± SE | P-value | |
Total Score | 50.4 ± 0.4 | 41.9 ± 0.3 |
<0.001
| 52.5 ± 0.5 | 42.7 ± 0.3 |
<0.001
| 52.1 ± 0.8 | 47.2 ± 0.4 |
<0.001
| 51.4 ± 0.6 | 46.5 ± 0.4 |
<0.001
|
Total Vegetables | 2.2 ± 0.1 | 2.1 ± 0.03 | 0.519 | 2.3 ± 0.1 | 2.1 ± 0.03 | 0.108 | 1.7 ± 0.1 | 2.0 ± 0.03 | 0.055 | 2.0 ± 0.1 | 2.0 ± 0.04 | 0.730 |
Greens & Beans | 0.7 ± 0.1 | 0.6 ± 0.03 | 0.052 | 0.8 ± 0.1 | 0.6 ± 0.02 | 0.021 | 0.4 ± 0.1 | 0.6 ± 0.03 | 0.070 | 0.6 ± 0.1 | 0.5 ± 0.03 | 0.162 |
Total Fruit | 4.2 ± 0.04 | 1.9 ± 0.1 |
<0.001
| 4.4 ± 0.1 | 2.2 ± 0.04 |
<0.001
| 4.0 ± 0.1 | 3.1 ± 0.1 |
<0.001
| 4.4 ± 0.1 | 2.9 ± 0.1 |
<0.001
|
Whole Fruit | 3.6 ± 0.1 | 1.5 ± 0.1 |
<0.001
| 4.7 ± 0.04 | 1.6 ± 0.04 |
<0.001
| 4.4 ± 0.1 | 2.5 ± 0.1 |
<0.001
| 2.8 ± 0.1 | 2.5 ± 0.1 | 0.071 |
Whole Grains | 2.0 ± 0.1 | 1.7 ± 0.1 |
<0.001
| 2.1 ± 0.1 | 1.8 ± 0.1 | 0.002 | 2.5 ± 0.3 | 2.1 ± 0.1 | 0.102 | 2.2 ± 0.1 | 2.1 ± 0.1 | 0.457 |
Dairy | 7.1 ± 0.1 | 6.8 ± 0.1 | 0.028 | 7.2 ± 0.1 | 6.9 ± 0.1 | 0.043 | 8.0 ± 0.3 | 7.7 ± 0.1 | 0.227 | 7.8 ± 0.2 | 7.7 ± 0.1 | 0.521 |
Total Protein Foods | 3.4 ± 0.04 | 3.5 ± 0.03 | 0.032 | 3.5 ± 0.1 | 3.5 ± 0.03 | 0.451 | 3.3 ± 0.1 | 3.3 ± 0.03 | 0.608 | 3.3 ± 0.1 | 3.4 ± 0.04 | 0.362 |
Seafood & Plant Protein | 1.4 ± 0.1 | 1.3 ± 0.03 | 0.113 | 1.6 ± 0.1 | 1.3 ± 0.03 | 0.001 | 1.3 ± 0.2 | 1.4 ± 0.1 | 0.699 | 1.3 ± 0.1 | 1.4 ± 0.1 | 0.230 |
Fatty Acid Ratio | 3.8 ± 0.1 | 3.7 ± 0.1 | 0.466 | 3.9 ± 0.1 | 3.8 ± 0.1 | 0.377 | 3.3 ± 0.3 | 3.4 ± 0.1 | 0.787 | 3.5 ± 0.2 | 3.3 ± 0.1 | 0.281 |
Sodium | 5.3 ± 0.1 | 4.9 ± 0.1 |
<0.001
| 5.3 ± 0.2 | 5.0 ± 0.1 | 0.019 | 6.1 ± 0.4 | 5.4 ± 0.1 | 0.091 | 5.7 ± 0.2 | 5.4 ± 0.1 | 0.072 |
Refined Grains | 5.4 ± 0.1 | 5.1 ± 0.1 | 0.022 | 5.3 ± 0.2 | 5.2 ± 0.1 | 0.408 | 6.2 ± 0.4 | 5.7 ± 0.1 | 0.300 | 6.0 ± 0.2 | 5.6 ± 0.1 | 0.064 |
Empty Calories | 11.2 ± 0.2 | 8.6 ± 0.1 |
<0.001
| 11.5 ± 0.3 | 8.9 ± 0.12 |
<0.001
| 11.1 ± 0.4 | 10.1 ± 0.2 | 0.025 | 11.7 ± 0.3 | 9.8 ± 0.2 |
<0.001
|
Weight and adiposity measures
Consumers | Non-Consumers | P-value | |
---|---|---|---|
LSM ± SEb | LSM ± SE | ||
Total Apple Products
| |||
BMI z-score | 0.4 ± 0.04 | 0.5 ± 0.03 |
0.009
|
Waist Circumference (cm) | 68.2 ± 0.3 | 68.9 ± 0.3 | 0.066 |
% Overweight | 14.1 ± 1.0 | 15.5 ± 0.6 | 0.233 |
% Obese | 13.5 ± 0.9 | 16.9 ± 0.8 |
0.004
|
% Overweight or Obese | 27.6 ± 1.5 | 32.4 ± 1.0 |
0.007
|
Whole Apples
| |||
BMI z-score | 0.3 ± 0.1 | 0.5 ± 0.02 |
0.008
|
Waist Circumference (cm) | 68.1 ± 0.4 | 68.9 ± 0.3 | 0.105 |
% Overweight | 14.5 ± 1.6 | 15.2 ± 0.6 | 0.695 |
% Obese | 12.6 ± 1.1 | 16.6 ± 0.7 |
0.003
|
% Overweight or Obese | 27.1 ± 2.0 | 31.8 ± 1.0 | 0.040 |
Apple Sauce
| |||
BMI z-score | 0.4 ± 0.1 | 0.5 ± 0.02 | 0.301 |
Waist Circumference (cm) | 67.7 ± 0.6 | 68.8 ± 0.2 | 0.101 |
% Overweight | 14.2 ± 2.4 | 15.1 ± 0.6 | 0.688 |
% Obese | 11.2 ± 2.0 | 16.2 ± 0.7 | 0.018 |
% Overweight or Obese | 25.4 ± 3.2 | 31.3 ± 1.0 | 0.078 |
Apple Juice
| |||
BMI z-score | 0.4 ± 0.1 | 0.5 ± 0.02 | 0.502 |
Waist Circumference (cm) | 68.5 ± 0.4 | 68.8 ± 0.2 | 0.528 |
% Overweight | 15.6 ± 1.6 | 15.0 ± 0.6 | 0.722 |
% Obese | 13.8 ± 1.2 | 16.3 ± 0.7 | 0.074 |
% Overweight or Obese | 29.4 ± 2.2 | 31.4 ± 1.0 | 0.407 |
Consumersa | ||||
---|---|---|---|---|
ORb,c | LCL | UCL | P-value | |
Total Apple Products
| ||||
Obese | 0.75 | 0.59 | 0.95 |
0.002
|
Overweight | 0.89 | 0.72 | 1.11 | 0.173 |
Overweight or Obese | 0.79 | 0.66 | 0.94 |
0.001
|
Apples
| ||||
Obese | 0.70 | 0.52 | 0.95 |
0.003
|
Overweight | 0.95 | 0.68 | 0.32 | 0.681 |
Overweight or Obese | 0.79 | 0.60 | 1.04 | 0.027 |
Apple Sauce
| ||||
Obese | 0.62 | 0.32 | 1.18 | 0.056 |
Overweight | 0.92 | 0.54 | 1.58 | 0.693 |
Overweight or Obese | 0.73 | 0.45 | 1.19 | 0.098 |
Apple Juice
| ||||
Obese | 0.80 | 0.58 | 1.10 | 0.068 |
Overweight | 1.05 | 0.76 | 1.45 | 0.707 |
Overweight or Obese | 0.90 | 0.69 | 1.19 | 0.331 |