Abstract
Background: Understanding trend in nutritional status is crucial to inform national health priorities to improve diets and reduce related diseases. The present study aimed to analyze trends in the concentrations of all measured nutritional biomarkers and their status among US adults across 14 years.Methods: Trends on the concentrations of nutritional biomarkers and nutritional status evaluated by the prevalence of deficiency, inadequacy, excess, and dyslipidemia were analyzed among US adults in 7 cross-sectional National Health and Nutrition Examination Surveys (NHANES 2003–2016) and by age, sex, race/ethnicity, and socioeconomic status.Results: A total of 38,505 participants (weighted mean age of 47.2 years, 51.4% women) were included in the present study. Across 14 years, increased trends were found in red blood cell (RBC) folate, serum vitamin B12, vitamin D and albumin, the prevalence of iodine deficiency, vitamin B6 inadequacy, and hypophosphatemia, whereas decreased trends were observed in serum vitamin E, phosphorus, total calcium, total protein, apolipoprotein B (Apo B), low-density-lipoprotein cholesterol (LDL-C), triglyceride (TG), total cholesterol (TC), blood lead, cadmium, mercury, and the prevalence of vitamin C deficiency, vitamin D inadequacy, iodine excess, and dyslipidemia with elevated LDL-C, TC, TG, and lowered HDL/LDL. Non-Hispanic blacks (NHB) and participants with low socioeconomic status were accounted for the poor nutritional status of most biomarkers compared to their comparts.Conclusion: Most nutritional biomarkers and their status were improved among US adults from 2003 to 2016, but some specific populations should be paid much attention to improve their nutritional status, especially for NHB and participants with low socioeconomic status.
Highlights
Diet and nutritional status play an important role in the prevention and management of leading causes of death and non-communicable diseases [1]
The trends of several nutritional biomarkers have been reported in some studies, such as blood folate [6], serum vitamin C [7], B12 [8], and urinary iodine [9] in the National Health and Nutrition Examination Surveys (NHANES 1988–2010, 1988–2004, 1988–2006, and 2001–2012, respectively), serum 25-hydroxyvitamin D [25(OH)D] in the NHANES (1998–2014) and Canadian Multicentre Osteoporosis Study (CaMos 1997–2007) [10, 11], blood lead, cadmium, and mercury in Korea NHANES (KNHANES 2005–2011) [12], serum lipid profiles in the National Center for Health Statistics (NCHS; 1998–2010), and Coronary Artery Risk Development in Young Adults (CARDIA, 1985–2011) study [13, 14]
Serum vitamin A, B12, C, E, 25(OH)D, folate [both serum and red blood cell (RBC)], calcium, iron-status indicators [iron, ferritin, transferrin saturation (TS), and erythrocyte protoporphyrin (EP)], potassium, sodium, phosphorous, total protein, albumin, apolipoprotein B (Apo B), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), plasma vitamin B6, blood lead, cadmium, mercury, urine arsenic, and iodine were examined in the NHANES
Summary
Diet and nutritional status play an important role in the prevention and management of leading causes of death and non-communicable diseases [1]. Understanding their trends is crucial to inform national health priorities to improve diets and reduce the risk of dietrelated diseases. Self-reported dietary data is one of the main methods for assessing dietary intake, subjective recall poses a great challenge for obtaining an accurate evaluation of diet and nutritional status [3]. Limited evidence is available on the trends of all possible measured nutritional biomarkers at the population level and specific subgroups, which would help to provide important guidance to improve the nutritional status of the American population. Understanding trend in nutritional status is crucial to inform national health priorities to improve diets and reduce related diseases. The present study aimed to analyze trends in the concentrations of all measured nutritional biomarkers and their status among US adults across 14 years
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