A Three-Axis Conceptual Framework for Dietary Risk: Universal, Age–Generational and Sex-Specific Deviations from Dietary Recommendations in a Cross-Sectional Study of Adults
- 1Federal Research Centre of Nutrition, Biotechnology and Food Safety, 2/14 Ustinsky Proyezd, Moscow 109240, Russia
- 2I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of the Russian Federation, Moscow 119991, Russia
- 3East-Siberian Institute of Medical and Ecological Research, 3, Microdistrict 12a, Angarsk 665826, Russia
Abstract
Background/Objectives: Dietary risk factors account for a substantial share of the non-communicable disease burden, and generation theory offers a lens for explaining why eating patterns differ between people socialised under different economic and food-supply conditions. Data on generational and sex differences in the habitual diet remain scarce. We hypothesised that dietary risk in this population is structured along three axes—universal, age–generational and sex-specific—each potentially requiring a different preventive approach. This study aimed to characterise differences in energy, macronutrient, micronutrient and food-group intake between generations and between sexes, to quantify the adequacy of intake against national (MR 2.3.1.0253-21) and WHO reference values, to identify which deviations are universal, which differ between birth-year groups and which are sex-specific, and to propose corresponding levels of preventive action. Methods: We performed a cross-sectional analysis of habitual dietary intake in 1601 adults (405 men, 1196 women; age 18–76 years) recruited during preventive examinations and community screenings in the Republic of Buryatia and the Irkutsk Region in three survey waves in 2022–2024. Habitual intake was quantified with a validated semi-quantitative food-frequency questionnaire covering 60 food items and yielding daily intakes of energy, macronutrients, fatty-acid classes, added sugars, dietary fibre, minerals, vitamins and 14 food groups. Participants were classified by birth year into three generations: Baby Boomers (1943–1963, n = 140), Generation X (1964–1984, n = 915) and Generation Y/Z (1985–2005, n = 546). Intakes were compared with the Russian methodological recommendations MR 2.3.1.0253-21 and with WHO recommendations. Group comparisons used the Kruskal–Wallis test, with Dunn post-hoc tests and Bonferroni correction, and the Mann–Whitney U test; Benjamini–Hochberg FDR correction was applied across outcomes. Generational trends were additionally modelled on rank-transformed outcomes with adjustments for survey site. Dietary patterns were derived via principal component analysis of energy-adjusted food-group intakes. Reporting follows the STROBE-nut guidelines. With 1601 participants, the study had >80% power to detect |ρ| ≥ 0.07. Results: Three patterns emerged. Universal: total fat exceeded 30%E in 99.8% of participants (median 41.5–42.5%E in men, 46.5–48.0%E in women), saturated fatty acids exceeded 10%E in 95.1%, reported dietary fibre was below 20 g/day in 99.3% (median 6.1–6.6 g/day), although the composition data were shown to reflect crude rather than total dietary fibre, salt equivalent exceeded 5 g/day in 93.4%, the Na:K molar ratio exceeded 1 in 98.9% and calcium was below the requirement in 75.6%. Age–generational: discretionary sugars differed markedly between birth-year groups—the proportion of sugar-sweetened beverage (SSB) consumers rose from 52.2% to 74.7% across generations in men (+22.6 percentage points, +43% relative) and from 20.2% to 51.7% in women (+31.5 points, +156% relative; both p < 0.001, q < 0.001; rank-biserial r = 0.38 and 0.33), mean SSB intake reached 78.4 g/day in Generation Y/Z men and the proportion of men exceeding the 10%E limit for added sugars rose more than threefold, from 8.7% to 32.1% (p = 0.001); in men, the intake of bread, pasta and cereals (397 → 362 g/day) and starch fell across generations, while vitamin C rose (77.2 → 106.8 mg/day, p = 0.004). Principal component analysis identified a “sweetened-beverage and discretionary foods” pattern whose score increased monotonically from older to younger generations in both sexes (men Δ = +0.64 z-units, p < 0.001; women Δ = +0.41, p = 0.002); the gradient persisted after an adjustment for survey site, within each survey wave and after restriction to plausible energy reporters. Sex-specific: reported iron intake fell below the sex-specific reference value in 74.9–77.7% of women versus 4.1–7.9% of men, despite the higher absolute intake in men; men reported higher absolute energy, protein, bread product, potato, sodium and iron intake, while women reported higher fat and polyunsaturated fatty acid contribution to energy and higher vegetable intake; differences in fruit, confectionery and vitamin C did not persist after an adjustment for survey site. Conclusions: In this adult population, the classical dietary risks—excess saturated fat, excess salt and low calcium—were shared by all birth-year groups and both sexes, whereas the intake of sugar-sweetened beverages and added sugars was concentrated in adults born after 1985; because the design is cross-sectional, this difference may reflect age, birth cohort or both. These findings are consistent with a conceptual three-axis framework of dietary risk—universal, age–generational and sex-specific—in which each axis may call for a different preventive approach: population-wide measures addressing fat, salt, calcium and fish; age-targeted measures addressing sweetened beverages in younger adults; and, in women, an evaluation of the low reported iron intake against biochemical markers of iron status in future studies. The framework was derived from a regional sample and requires external validation; it could be tested in other populations.
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BibTeX
@article{nikityuk2026threeaxis,
title = {{A Three-Axis Conceptual Framework for Dietary Risk: Universal, Age–Generational and Sex-Specific Deviations from Dietary Recommendations in a Cross-Sectional Study of Adults}},
author = {Dmitry B. Nikityuk and Olga G. Bogdanova and Irina A. Lapik and Inna Yu. Tarmaeva},
journal = {Nutrients},
year = {2026},
month = nov,
doi = {10.3390/nu18213644},
url = {https://www.mdpi.com/2072-6643/18/21/3644},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - A Three-Axis Conceptual Framework for Dietary Risk: Universal, Age–Generational and Sex-Specific Deviations from Dietary Recommendations in a Cross-Sectional Study of Adults
AU - Dmitry B. Nikityuk
AU - Olga G. Bogdanova
AU - Irina A. Lapik
AU - Inna Yu. Tarmaeva
PY - 2026
DA - 2026/11/01
JO - Nutrients
DO - 10.3390/nu18213644
UR - https://www.mdpi.com/2072-6643/18/21/3644
AB - Background/Objectives: Dietary risk factors account for a substantial share of the non-communicable disease burden, and generation theory offers a lens for explaining why eating patterns differ between people socialised under different economic and food-supply conditions. Data on generational and sex differences in the habitual diet remain scarce. We hypothesised that dietary risk in this population is structured along three axes—universal, age–generational and sex-specific—each potentially requiring a different preventive approach. This study aimed to characterise differences in energy, macronutrient, micronutrient and food-group intake between generations and between sexes, to quantify the adequacy of intake against national (MR 2.3.1.0253-21) and WHO reference values, to identify which deviations are universal, which differ between birth-year groups and which are sex-specific, and to propose corresponding levels of preventive action. Methods: We performed a cross-sectional analysis of habitual dietary intake in 1601 adults (405 men, 1196 women; age 18–76 years) recruited during preventive examinations and community screenings in the Republic of Buryatia and the Irkutsk Region in three survey waves in 2022–2024. Habitual intake was quantified with a validated semi-quantitative food-frequency questionnaire covering 60 food items and yielding daily intakes of energy, macronutrients, fatty-acid classes, added sugars, dietary fibre, minerals, vitamins and 14 food groups. Participants were classified by birth year into three generations: Baby Boomers (1943–1963, n = 140), Generation X (1964–1984, n = 915) and Generation Y/Z (1985–2005, n = 546). Intakes were compared with the Russian methodological recommendations MR 2.3.1.0253-21 and with WHO recommendations. Group comparisons used the Kruskal–Wallis test, with Dunn post-hoc tests and Bonferroni correction, and the Mann–Whitney U test; Benjamini–Hochberg FDR correction was applied across outcomes. Generational trends were additionally modelled on rank-transformed outcomes with adjustments for survey site. Dietary patterns were derived via principal component analysis of energy-adjusted food-group intakes. Reporting follows the STROBE-nut guidelines. With 1601 participants, the study had >80% power to detect |ρ| ≥ 0.07. Results: Three patterns emerged. Universal: total fat exceeded 30%E in 99.8% of participants (median 41.5–42.5%E in men, 46.5–48.0%E in women), saturated fatty acids exceeded 10%E in 95.1%, reported dietary fibre was below 20 g/day in 99.3% (median 6.1–6.6 g/day), although the composition data were shown to reflect crude rather than total dietary fibre, salt equivalent exceeded 5 g/day in 93.4%, the Na:K molar ratio exceeded 1 in 98.9% and calcium was below the requirement in 75.6%. Age–generational: discretionary sugars differed markedly between birth-year groups—the proportion of sugar-sweetened beverage (SSB) consumers rose from 52.2% to 74.7% across generations in men (+22.6 percentage points, +43% relative) and from 20.2% to 51.7% in women (+31.5 points, +156% relative; both p < 0.001, q < 0.001; rank-biserial r = 0.38 and 0.33), mean SSB intake reached 78.4 g/day in Generation Y/Z men and the proportion of men exceeding the 10%E limit for added sugars rose more than threefold, from 8.7% to 32.1% (p = 0.001); in men, the intake of bread, pasta and cereals (397 → 362 g/day) and starch fell across generations, while vitamin C rose (77.2 → 106.8 mg/day, p = 0.004). Principal component analysis identified a “sweetened-beverage and discretionary foods” pattern whose score increased monotonically from older to younger generations in both sexes (men Δ = +0.64 z-units, p < 0.001; women Δ = +0.41, p = 0.002); the gradient persisted after an adjustment for survey site, within each survey wave and after restriction to plausible energy reporters. Sex-specific: reported iron intake fell below the sex-specific reference value in 74.9–77.7% of women versus 4.1–7.9% of men, despite the higher absolute intake in men; men reported higher absolute energy, protein, bread product, potato, sodium and iron intake, while women reported higher fat and polyunsaturated fatty acid contribution to energy and higher vegetable intake; differences in fruit, confectionery and vitamin C did not persist after an adjustment for survey site. Conclusions: In this adult population, the classical dietary risks—excess saturated fat, excess salt and low calcium—were shared by all birth-year groups and both sexes, whereas the intake of sugar-sweetened beverages and added sugars was concentrated in adults born after 1985; because the design is cross-sectional, this difference may reflect age, birth cohort or both. These findings are consistent with a conceptual three-axis framework of dietary risk—universal, age–generational and sex-specific—in which each axis may call for a different preventive approach: population-wide measures addressing fat, salt, calcium and fish; age-targeted measures addressing sweetened beverages in younger adults; and, in women, an evaluation of the low reported iron intake against biochemical markers of iron status in future studies. The framework was derived from a regional sample and requires external validation; it could be tested in other populations.
SN - 2072-6643
ER -