Total Usual Micronutrient Intakes Compared to the Dietary Reference Intakes among U.S. Adults by Food Security Status.

Alexandra E Cowan,Patricia M Guenther,Heather A Eicher-Miller,Kevin W Dodd,Shinyoung Jun,Janet A Tooze,Jaime J Gahche,Regan L Bailey,Nancy Potischman,Johanna T Dwyer,Anindya Bhadra

doi:10.3390/nu12010038

Abstract

This study examined total usual micronutrient intakes from foods, beverages, and dietary supplements (DS) compared to the Dietary Reference Intakes among U.S. adults (≥19 years) by sex and food security status using NHANES 2011–2014 data (n = 9954). DS data were collected via an in-home interview; the NCI method was used to estimate distributions of total usual intakes from two 24 h recalls for food and beverages, after which DS were added. Food security status was categorized using the USDA Household Food Security Survey Module. Adults living in food insecure households had a higher prevalence of risk of inadequacy among both men and women for magnesium, potassium, vitamins A, B6, B12, C, D, E, and K; similar findings were apparent for phosphorous, selenium, and zinc in men alone. Meanwhile, no differences in the prevalence of risk for inadequacy were observed for calcium, iron (examined in men only), choline, or folate by food security status. Some DS users, especially food secure adults, had total usual intakes that exceeded the Tolerable Upper Intake Level (UL) for folic acid, vitamin D, calcium, and iron. In conclusion, while DS can be helpful in meeting nutrient requirements for adults for some micronutrients, potential excess may also be of concern for certain micronutrients among supplement users. In general, food insecure adults have higher risk for micronutrient inadequacy than food secure adults.

Highlights

The 2015–2020 Dietary Guidelines for Americans (DGA) reported a number shortfall nutrients among U.S adults including calcium, iron, magnesium, potassium, choline, folate and vitamins A, C, D, and E [1,2]
The relative contributions of dietary supplements (DS) to total intake varied by nutrient, with the lowest contributions for choline, (0.5%), potassium (0.5%), phosphorus (0.5%), vitamin K (7.0%), and magnesium (8.2%) (Table 1, Table S1)
Of women and 92% of men in the U.S were at risk of inadequate intake from foods alone, yet, the prevalence of vitamin D inadequacy among adults ranged from 59% to 66%, depending on the sex, even when taking into account nutrient intakes from DS

Summary

Introduction

The 2015–2020 Dietary Guidelines for Americans (DGA) reported a number shortfall nutrients among U.S adults including calcium, iron, magnesium, potassium, choline, folate and vitamins A, C, D, and E [1,2]. A systematic review concluded that food insecure adults have lower intakes of vitamin A, vitamin B6, calcium, magnesium, and zinc from diet alone when compared to those who were food secure [4]. Dietary supplement (DS) use is lower in adults living in food insecure U.S households than in those that are food secure [5], implying that differences in micronutrient intakes between the food secure and food insecure population subgroups might be amplified when total nutrient intakes, inclusive of DS, are considered; to our knowledge, no study has compared total usual nutrient intakes by household food security status. The purpose of this analysis was to estimate the prevalence of risk of micronutrient inadequacy and excess by comparing total usual micronutrient intake distributions to the Dietary Reference Intakes (DRI); and to parse out the contributions of DS to the total intakes of U.S adults (1) in the general population and (2) by household food security status, using data from the National Health and Nutrition Examination

Methods

Results

Discussion

Conclusion