Nutritional adequacy is important when diets and dietary alterations are recommended for children. Concern is expressed that low fat intakes may have deleterious effects on growth and development and may be deficient in total calories and essential nutrients. In a study of the effect of variation in percent fat in the diet, a sample of 871 ten-year-olds was stratified according to four different fat intakes: <30% of total kilocalories (kcal), 30% to 35% kcal, 35% to 40% kcal, and >40% kcal. The race/sex distribution was similar within each fat intake group. Fourteen percent of the sample had fat intakes less than 30% of total calories. The amount of calories from breakfast, dinner, and snacks was higher in the children with fat intakes >40% of total calories than those with lower fat intakes. The energy intake of all race/sex groups fell within the recommended range. The low fat intake group was eating 25% less calories than the high fat intake group (1800 kcal vs 2400 kcal). The percentage of calories from carbohydrate, specifically sugar, was greater in the low fat intake group compared with the high fat intake group. Percentage of calories from protein was approximately 13% for all groups. Fiber and starch were the same across all fat intakes. The major fat sources (percentage of total calories), in rank order, in the high fat intake group (>40% kcal) were meats (31%), dairy (16%), fats and oils (10%), and prepared vegetables (10%); whereas in the low fat intake group (<30% kcal) they were dairy (23%), meats (16%), breads (13%), and desserts (12%). Percentage of calories from saturated fat was higher in the high fat intake group (18%) than in the low fat intake group (11%). Interestingly, mean intake of sugar was greater in the low fat intake group (160 g) than in the high fat intake group (129 g). Percentage of total sugar intake in the low and high fat intake groups came from candy (29% vs 21%), beverages (25% vs 19%), and desserts (11% vs 14%). Based on the differences in total caloric intakes, the following is a comparison of the percentage of the high fat intake group vs the percentage of the low fat intake group not meeting the Recommended Dietary Allowances for the following nutrients: vitamins B6 (69% vs 77%), B12 (36% vs 70%), and E (23% vs 55%); thiamin (40% vs 58%), riboflavin (25% vs 45%), and niacin (41% vs 64%). Differences were less dramatic for folacin and iron. Obviously, attention has to be given to overall nutrient adequacy when dietary fat recommendations are made.

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