Energy intake, and the foods and beverages contributing to that, are considered key to understanding the high obesity prevalence worldwide. The relative contributions of energy intake and expenditure to the obesity epidemic, however, remain poorly defined in Spain. The purpose of this study was to contribute to updating data of dietary energy intake and its main sources from food and beverages, according to gender and age. These data were derived from the ANIBES (“Anthropometry, Intake, and Energy Balance in Spain”) study, a cross-sectional study of a nationally representative sample of the Spanish population (from 9–75 years old). A three-day dietary record, collected by means of a tablet device, was used to obtain information about food and beverage consumption and leftovers. The final sample comprised 2009 individuals (1,013 men, 996 women). The observed mean dietary energy intake was 7.6 ± 2.11 MJ/day (8.2 ± 2.22 MJ/day for men and 6.9 ± 1.79 MJ/day for women). The highest intakes were observed among adolescents aged 13–17 years (8.4 MJ/day), followed by children 9–12 years (8.2 ± 1.80 MJ/day), adults aged 18–64 (7.6 ± 2.14 MJ/day) and older adults aged 65–75 years (6.8 ± 1.88 MJ/day). Cereals or grains (27.4%), meats and derivatives (15.2%), oils and fats (12.3%), and milk and dairy products (11.8%) contributed most to daily energy intake. Energy contributions from non-alcoholic beverages (3.9%), fish and shellfish (3.6%), sugars and sweets (3.3%) and alcoholic beverages (2.6%) were moderate to minor. Contributions to caloric profile were 16.8%E from proteins; 41.1%E from carbohydrates, including 1.4%E from fiber; 38.5%E from fats; and 1.9%E from alcohol intake. We can conclude that energy intake is decreasing in the Spanish population. A variety of food and beverage groups contribute to energy intake; however, it is necessary to reinforce efforts for better adherence to the traditional Mediterranean diet.

Our aim was to analyze dietary macronutrient intake and its main sources according to sex and age. Results were derived from the ANIBES (“Anthropometry, Intake and Energy Balance in Spain”) cross-sectional study using a nationally-representative sample of the Spanish population (9–75 years old). Mean dietary protein intake was 74.5 ± 22.4 g/day, with meat and meat products as the main sources (33.0%). Mean carbohydrate intake was 185.4 ± 60.9 g/day and was higher in children and adolescents; grains (49%), mainly bread, were the main contributor. Milk and dairy products (23%) ranked first for sugar intake. Mean lipid intake was 78.1 ± 26.1 g/day and was higher in younger age groups; contributions were mainly from oils and fats (32.5%; olive oil 25.6%) and meat and meat products (22.0%). Lipid profiles showed relatively high monounsaturated fatty acid intake, of which olive oil contributed 38.8%. Saturated fatty acids were mainly (>70%) combined from meat and meat products, milk and dairy products and oils and fats. Polyunsaturated fatty acids were mainly from oils and fats (31.5%). The macronutrient intake and distribution in the Spanish population is far from population reference intakes and nutritional goals, especially for children and adolescents.

The consumption of total and individual sugars is controversial and little is known about consumption and dietary sources in Spain. The purpose was to examine free and intrinsic sugar intake and food and beverage sources. The ANIBES Study (Anthropometry, Intake and Energy Balance in Spain), a cross-sectional study of a representative sample of the Spanish population (9–75 years old; n = 2009) carried out in 2013, was used. Food and beverage records were obtained by a three-day dietary record by using a tablet device. The median total sugar intake was 71.5 g/day (17% Total Energy, TE), the intrinsic sugar intake was 38.3 g/day (9.6% TE), and the free sugar was 28.8 g/day (7.3% TE). Total sugar intake (free and intrinsic) was higher in men than in women for all age groups, although in terms of the contribution to total energy intake, the opposite was observed. Differences were observed for free sugar consumption dependent on age and marked differences (up to two-fold) were observed when considering the percent TE, which was much higher in children and adolescents. For the intrinsic sugar, however, a higher contribution to TE was observed in the elderly. The major sources of intrinsic sugars were fruits (31.8%), milks (19.6%), juices and nectars (11.1%), vegetables (9.89%), yogurt and fermented milk (7.18%), low-alcohol-content beverages (4,94%), bread (2.91%), and sugar soft drinks (2.24%), greater than 90% from diet contribution. As for free sugars, sources were sugar soft drinks (25.5%), sugar (17.8%), bakery and pastry items (15.2%), chocolates (11.4%), yogurt and fermented milk (6.44%), other dairy products (5.99%), jams (3.58%), juices and nectars (2.91%), and breakfast cereals and cereal bars (2.78%), summing up to 90% of the contribution. The present study demonstrates that only a moderate percentage of the Spanish population adhered to the present recommendations for total sugar intake, and urgent efforts are needed to improve diet quality in the youngest populations.

Energy Balance (EB) is an important topic to understand how an imbalance in its main determinants (energy intake and consumption) may lead to inappropriate weight gain, considered to be “dynamic” and not “static”. There are no studies to evaluate EB in Spain, and new technologies reveal themselves as key tools to solve common problems to precisely quantify energy consumption and expenditure at population level. The overall purpose of the ANIBES (“Anthropometry, Intake and Energy Balance”) Study was to carry out an accurate updating of food and beverage intake, dietary habits/behaviour and anthropometric data of the Spanish population (9–75 years, n = 2009), as well as the energy expenditure and physical activity patterns. Anthropometry measurements (weight, height, body mass index, waist circumference, % body fat, % body water) were obtained; diet was evaluated throughout a three-day dietary record (tablet device) accompanied by a 24 h-dietary recall; physical activity was quantified by questionnaire and accelerometers were also employed. Finally, information about perception and understanding of several issues related to EB was also obtained. The ANIBES study will contribute to provide valuable useful data to inform food policy planning, food based dietary guidelines development and other health oriented actions in Spain.

This study aimed to investigate energy, nutrient and food group intakes at breakfast in Spain and to examine for the first time, their relationship to the overall Diet Quality (DQ). The data used were from the Spanish ANIBES (anthropometric data, macronutrients and micronutrients intake, practice of physical activity, socioeconomic data and lifestyles in Spain), a cross-sectional study using a nationally representative sample of the Spanish population (9–75 years old). DQ was assessed using the Nutrient Rich Foods Index, adapted to total diets (NRF9.3d). Most (>85%) of the Spanish population were regular breakfast consumers, although one in five adolescents were breakfast skippers. Breakfast provides just 16–19% of the daily intake of energy. Relative to its daily energy contribution, the Spanish breakfast contributed a higher proportion of daily total carbohydrates, added sugars, sodium, thiamin, riboflavin, folates, iron, potassium, magnesium, phosphorus and especially in calcium. By contrast, the breakfast is low in water intake, protein, dietary fibre, total fat, polyunsaturated fatty acids, beta-carotene and vitamins E and D. In children and teenagers, the most commonly consumed breakfast food was chocolate (mainly as chocolate-flavoured milk and powder), followed by bakery and pastry, whole milk and semi-skimmed milk. In the older groups, a bigger variety of foods were reported. Consumers in the highest NRF9.3d tertile for diet quality tended to have a higher intake of positive nutrients at breakfast than other tertiles, most notably among adults.

Dietary patterns (DPs) are known to be tied to lifestyle behaviors. Understanding DPs and their relationships with lifestyle factors can help to prevent children from engaging in unhealthy dietary practices. We aimed to describe DPs in Spanish children aged 1 to <10 years and to examine their associations with sociodemographic and lifestyle variables. The consumption of toddler and young children milk formulas, enriched and fortified milk within the Spanish pediatric population is increasing, and there is a lack of evidence whether the consumption of this type of milk is causing an impact on nutrient intakes and if they are helping to reach the nutrient recommendations. Within the Nutritional Study in the Spanish Pediatric Population (EsNuPI), we considered two study cohorts and three different age groups in three year-intervals in each of them. The study cohort included 740 children in a representative sample of the urban non-vegan Spanish population and 772 children in a convenience cohort of adapted milk consumers (AMS) (including follow-on formula, toddler’s milk, growing up milk, and fortified and enriched milks) who provided information about sociodemographics, lifestyle, and dietary habits; a food frequency questionnaire was used for the latter. Principal component analysis was performed to identify DPs from 18 food groups. Food groups and sociodemographic/lifestyle variables were combined through a hierarchical cluster algorithm. Three DPs predominated in every age group and study sample: a palatable energy-dense food dietary pattern, and two Mediterranean-like DPs. However, children from the AMS showed a predominant dietary pattern markedly related to the Mediterranean diet, with high consumption of cereals, fruits and vegetables, as well as milk and dairy products. The age of children and certain lifestyle factors, namely level of physical activity, parental education, and household income, correlated closely with the dietary clusters. Thus, the findings provide insight into designing lifestyle interventions that could reverse the appearance of unhealthy DPs in the Spanish child population.