Dietary patterns characterised by high intake of red and processed meat are associated with detrimental health and environmental outcomes. To better understand how Americans consume red and processed meat, this study examined the food groups that are the greatest contributors to red and processed meat intake in US diets.

Cross-sectional analysis of total red and processed meat, unprocessed red meat and processed meat using data from the National Health and Nutrition Examination Survey (2015–2016 and 2017–2018). Items containing red or processed meat were classified into thirteen mutually exclusive food groups. For highly consumed food groups (≥10 % of meat intake), contribution to meat intake was further assessed by source, sex, income and education.

Nationally representative sample of the US population.

Teens (aged 12–19 years) and adults (aged ≥20 years) who reported meat consumption (n 8178).

Meat mixed dishes (18·6 % (95 % CI 16·2, 20·9)), burgers (17·3 % (95 % CI 15·3, 19·3)) and beef excluding ground (17·0 % (95 % CI 13·8, 20·1)) were the top contributors to unprocessed red meat intake. For processed meat, four food groups made up about four-fifths of total intake: cold cuts and cured meats (37·7 % (95 % CI 34·6, 40·8)), sausages and frankfurters (20·3 % (95 % CI 18·6, 22·0)), bacon (14·0 % (95 % CI 12·3, 15·6)) and pizza (10·1 % (95 % CI 8·7, 11·5)). Fast-food restaurants were the top source for burgers and pizza, whereas stores were the top source for all other highly consumed food groups. Few differences were seen in patterns of intake by sociodemographic characteristics.

No single food group accounts for a majority of meat intake in the USA. Many behaviour change opportunities for healthier, more sustainable substitutions exist.

To introduce the concept ‘nutrition activation’ (the use of health and nutrition information when making food and diet decisions) and to assess the extent to which nutrition activation varies across racial/ethnic groups and explains dietary disparities.

Cross-sectional sample representative of adults in the USA. Primary outcome measures include daily energy intake and consumption of sugar-sweetened beverages (SSB), fast foods and sit-down restaurant foods as determined by two 24 h dietary recalls. We use bivariate statistics and multiple logistic and linear regression analyses to assess racial/ethnic disparities in nutrition activation and food behaviour outcomes.

USA.

Adult participants (n 7825) in the 2007–2010 National Health and Nutrition Examination Survey.

Nutrition activation varies across racial/ethnic groups and is a statistically significant predictor of SSB, fast-food and restaurant-food consumption and daily energy intake. Based on the sample distribution, an increase from the 25th to 75th percentile in nutrition activation is associated with a decline of about 377 kJ (90 kcal)/d. Increased nutrition activation is associated with a larger decline in SSB consumption among whites than among blacks and foreign-born Latinos. Fast-food consumption is associated with a larger ‘spike’ in daily energy intake among blacks (+1582 kJ (+378 kcal)/d) than among whites (+678 kJ (+162 kcal)/d).

Nutrition activation is an important but understudied determinant of energy intake and should be explicitly incorporated into obesity prevention interventions, particularly among racial/ethnic minorities.

To set out a policy analysis of food taxes as a way of influencing food consumption and behaviour.

The study draws on examples of food taxes from the developed world imposed at national and local levels. Studies were identified from a systemised search in six databases with criteria designed to identity articles of policy relevance.

The dominant approach identified from the literature was the imposition of food taxes on food to raise general revenue, such as Value Added Tax in the European Union. Food taxes can be applied in various ways, ranging from attempts to directly influence behaviour to those which collect taxes for identified campaigns on healthy eating through to those applied within closed settings such as schools. There is a case for combining taxes of unhealthy foods with subsidies of healthy foods. The evidence from the literature concerning the use and impact of food taxes on food behaviour is not clear and those cases identified are mainly retrospective descriptions of the process. Many food taxes have been withdrawn after short periods of time due to industry lobbying.

Small taxes with the clear purpose of promoting the health of key groups, e.g. children, are more likely to receive public support. The focus of many tax initiatives is unclear; although they are generally aimed at consumers, another focus could be food manufacturers, using taxes and subsidies to encourage the production of healthier foods, which could have an effect at a population level. Further consideration needs to be given to this aspect of food taxes. Taxing food (and subsidies) can influence food behaviour within closed systems such as schools and the workplace.