A newly compiled list of commonly consumed foods and beverages in the United States sheds light on why many adults unknowingly consume too much saturated fat and added sugar in their daily diets, a new study suggests.

Beyond the biggest sources in each food category – cheese for saturated fat and soft drinks for added sugar – the study identifies a longer list of popular sources that explains why it is so hard to limit fat and sugar to the recommended 10% of daily calories. This overconsumption of unexpected sources, such as chicken and ketchup, is associated with the risk of a number of diseases, including cardiovascular disease, diabetes and cancer.

The analysis of data from more than 35,000 American adults is part of a project to develop a research tool to better assess these negative aspects of diet. But the work could also open consumers’ eyes to the unexpected sources of fat and sugar that accumulate over the course of a day – and perhaps prompt them to read labels to find out where these hidden sources are, the researchers say.

“Chicken breast is promoted as a low-fat food, but it still contains some saturated fat. However, it is helpful to know how foods with smaller amounts also slowly and secretly introduce saturated fat into the diet,” said lead author Christopher Taylor, professor and director of medical dietetics at Ohio State University’s School of Health and Rehabilitation Sciences.

“If you can get below 10%, you can identify the main culprits, but you can also see where saturated fats and added sugars may still be present in other foods. That doesn’t mean they’re making bad choices – it’s just that you need to be aware of how that morning latte can contribute to it.”

And then there’s the abundance of added sugar, which raises health concerns, says lead author Susan Schembre, an associate professor of oncology at Georgetown University’s Lombardi Comprehensive Cancer Center.

“It’s everywhere. It’s in so many unexpected foods and often in surprising amounts,” she said.

The study was recently published in the journal Nutritional values.

Researchers analyzed data from 36,378 U.S. adults ages 19 and older who participated in the National Health and Nutrition Examination Survey from 2005 to 2018. The survey collects 24-hour dietary recalls from each participant—they report not only what, but also when, all foods and beverages were consumed over the past two days.

Overall, cheese, pizza, ice cream and eggs were the top sources of saturated fat. The top sources of added sugar were soft drinks, tea, fruit drinks and cakes and pies. According to the U.S. Department of Agriculture’s What We Eat in America food list, other categories that contribute to saturated fat intake include cold cuts, cream substitutes, fried potatoes and whole milk. Categories with added sugar include tomato seasoning, granola bars, energy drinks and yeast bread.

The research team also examined differences in major sources of saturated fat and added sugar across a range of ethnic subgroups and age groups, an important detail when evaluating diets to develop more personalized health interventions, Schembre said.

“Before you understand where you can intervene, you need to know what people are consuming,” she said.

The team is developing an app to specifically assess “nutrients of concern” and has shown that this method of analysis produces a representative list of foods that contain the most saturated fat and added sugar. NHANES data are key to understanding diet in the United States, but for disease intervention, it is more efficient and effective to identify the problem foods and beverages as sources of fat, added sugar, and – in the future – sodium.

Not surprisingly, the results of this analysis showed that overall saturated fats accounted for at least 12% of a day’s calories, and added sugar consumption ranged from 14% to 16% of calories. Generally, dietary recommendations focus on avoiding the main culprits, such as pizza and ice cream – which makes this longer list valuable and eye-opening for some, Taylor said.

“There are foods that are high in saturated fat and added sugar that are commonly consumed, and those are targeted, but there’s also the smaller cumulative effect of things that are generally perceived as healthy, but all of them only contribute a small part,” he said. “And then when you add in some of these richer sources, you end up crossing the threshold for that 10% of daily calories.

“We are trying to strike a balance between identifying the most important factors and understanding the things that contribute to them in the background.”

This research was supported by the National Cancer Institute.

Other co-authors were Peter Madril of Ohio State; Cynthia Thompson, Kelli Richardson, and Edward Bedrick of the University of Arizona; Genevieve Dunton of the University of Southern California; Michelle Jospe of Georgetown Lombardi Comprehensive Cancer Center; and Rick Weiss of Viocare Inc.