Changes In Micronutrient Intakes Research Articles

Temporal changes in micronutrient intake among United States Adults, NHANES 2003 through 2018: A cross-sectional study

BackgroundChanges in the United States food supply and food choices make examination of temporal changes in micronutrient intake and their effect on meeting nutrient recommendations necessary. ObjectivesThis study aimed to examine 15-year trends of the contribution of foods and beverages (FB) and dietary supplements (DSs) to meeting nutrient recommendations among United States adults aged 19 y or older and compare usual mean intake distributions of FB alone with those of FB+DSs with dietary reference intakes [percentage below the estimated average requirement (%<EAR) or above the adequate intake (%>AI)]. MethodsThis cross-sectional study used food, beverage, and DSs intake data from NHANES 2003–2018 (N = 39,925) to determine usual mean intakes for 21 micronutrients. Changes in intakes from FB and from FB+DSs, by sex, were compared in a time-trend analysis of 2-y cycles. Changes in mean intake as %<EAR/>AI were determined. ResultsOver the time studied, United States adults underconsumed vitamins A, C, D, E, and K; calcium; potassium; magnesium; and choline, even when DSs intake was included. Sodium was overconsumed. In males, there were significant increases in %<EAR for thiamin, riboflavin, vitamin C, iron, copper, and zinc for intakes from FB. When FB+DSs were considered, there were significant increases in %<EAR for thiamin, riboflavin, vitamin B-12, vitamin C, copper, and zinc and significant decreases in %<EAR for vitamins D and E. In females, there were significant increases in %<EAR for vitamin C and zinc for intakes from FB and from FB+DSs; significant decreases in %<EAR for vitamins D and E, and magnesium for intakes from FB; and a significant decrease in %<EAR for vitamins A and E from FB+DSs. ConclusionsAlthough some progress has been made, nutrient intake and percentage of the population meeting nutritional recommendations among United States adults has changed little over the 15 y studied.

Micronutrient intake from three popular diet patterns in the United States: modeled replacement of foods highest in added sugar and sodium using the National Health and Nutrition Examination Survey, 2005-2018.

Fifty-two percent of adults in the United States reported following a popular diet pattern in 2022, yet there is limited information on daily micronutrient intakes associated with these diet patterns. The objective of the present study was to model the impact on micronutrient intake when foods highest in added sugar and sodium were replaced with healthier alternatives to align with the Dietary Guidelines for Americans recommendations. Dietary data were acquired from 34,411 adults ≥ 20 y in the National Health and Nutrition Examination Survey, 2005-2018. The National Cancer Institute methodology was used to estimate usual dietary intake at baseline of 17 micronutrients using information from up to two dietary recalls per person. A food substitution model was used to evaluate the impact on micronutrient intake when three servings of foods highest in added sugar and sodium were substituted with healthier alternatives. Dietary modeling to replace foods highest in added sugar with healthier alternatives increased the mean intake of fat-soluble vitamins (0.15% for vitamin A to 4.28% for vitamin K), most water-soluble vitamins (0.01% for vitamin B1 to 12.09% for vitamin C), and most minerals (0.01% for sodium to 4.44% for potassium) across all diet patterns. Replacing foods highest in sodium had mixed effects on the mean intake of micronutrients. The intake of most fatsoluble vitamins increased by 1.37-6.53% (particularly vitamin A and D), yet while the intake of some water-soluble vitamins and minerals increased by 0.18-2.64% (particularly vitamin B2, calcium, and iron) others decreased by 0.56-10.38% (notably vitamin B3 and B6, magnesium, sodium, and potassium). Modeled replacement of foods highest in added sugar led to more favorable changes in mean micronutrient intake compared to modeled replacement of foods highest in sodium. Due to the composite nature of mixed dishes that include multiple ingredients, food substitutions may result in both favorable and unfavorable changes in micronutrient intake. These findings highlight the challenges of making singleitem food substitutions to increase micronutrient intake and call for further research to evaluate optimal combinations of replacement foods to maximize the intake of all micronutrients simultaneously.

Increases in protein intake, protein distribution score, and micronutrient intakes in older adults in response to a whole food-based dietary intervention.

Changes in nutrient intakes and protein distribution were analyzed in response to a whole food-based dietary intervention targeting high-protein meals in older adults. Community-dwelling older adults (n = 56; M/F, 28/28; age, 69.3 ± 4.0years) completed a 12-week intervention after randomization to exercise only (EX, n = 19), nutrition only (NUTR, n = 16), or nutrition plus exercise (NUTR + EX, n = 21). NUTR and NUTR + EX followed a dietary intervention targeting ~ 0.4g/kg of protein at each of breakfast, lunch and dinner. Relative protein intake increased in NUTR (0.99 ± 0.34 to 1.43 ± 0.39g/kg, P < 0.001) and NUTR + EX (0.90 ± 0.20 to 1.57 ± 0.49g/kg, P < 0.001). Intakes of cholesterol, B vitamins, selenium and iodine were increased in both NUTR and NUTR + EX (P < 0.05 for all). This dietary intervention was effective at increasing daily protein intake and achieving an even distribution pattern. Changes in micronutrient intake were marked, and reflect the increase in consumption of animal-derived protein-rich food sources.

Effects of dietary counselling on micronutrient intakes in pregnant women in Finland.

The intake of some micronutrients is still a public health challenge for pregnant women in Finland. This study examined the effects of dietary counselling on micronutrient intakes among pregnant women at increased risk of gestational diabetes mellitus in Finland. This study utilised data from was a cluster‐randomised controlled trial (n = 399), which aimed to prevent gestational diabetes. In the intervention group, the dietary counselling was carried out at four routine visits to maternity care and focused on dietary fat, fibre and saccharose intake. A validated 181‐item food frequency questionnaire was used for evaluating the participants' food consumption and nutrient intakes. The differences in changes in micronutrient intakes from baseline (pre‐pregnancy) to 36–37 weeks' gestation were compared between the intervention and the usual care groups using multilevel mixed‐effects linear regression models, adjusted for confounders. Based on the multiple‐adjusted model, the counselling increased the intake of niacin equivalent (coefficient 0.50, 95% confidence interval [CI] 0.03–0.97), vitamin D (0.24, CI 0.05–0.43), vitamin E (0.46, CI 0.26–0.66) and magnesium (5.05, CI 0.39–9.70) and maintained the intake of folate (6.50, CI 1.44–11.56), from early pregnancy to 36 to 37 weeks' gestation. Except for folate and vitamin D, the mean intake of the micronutrients from food was adequate in both groups at baseline and the follow‐up. In conclusion, the dietary counselling improved the intake of several vitamins and minerals from food during pregnancy. Supplementation on folate and vitamin D is still needed during pregnancy.

Changes in micronutrient intake and factors associated with this change among older Australian men: the Concord Health and Ageing in Men Project.

To examine changes in micronutrient intake over 3 years and identify any associations between socio-economic, health, lifestyle and meal-related factors and these changes in micronutrient intakes among older men. Prospective study. Dietary adequacy of individual micronutrient was compared to the estimated average requirement of the nutrient reference values (NRV). Attainment of the NRV for twelve micronutrients was incorporated into a dichotomised variable 'not meeting' (meeting ≤ 6) or 'meeting' (meeting ≥ 7) and categorised into four categories to assess change in micronutrient intake over 3 years. The multinomial logistic regression analyses were conducted to model predictors of changes in micronutrient intake. Seven hundred and ninety-four men participated in a detailed diet history interview at the third wave (baseline nutrition) and 718 men participated at the fourth wave (3-year follow-up). The mean age was 81 years (range 75-99 years). Median intakes of the majority of micronutrients decreased significantly over a 3-year follow-up. Inadequacy of the NRV for thiamine, dietary folate, Zn, Mg, Ca and I were significantly increased at a 3-year follow-up than baseline nutrition. The incidence of inadequate micronutrient intake was 21 % and remained inadequate micronutrient intake was 16·4 % at 3-year follow-up. Changes in micronutrient intakes were significantly associated with participants born in the UK and Italy, low levels of physical activity, having ≥2 medical conditions and used meal services. Micronutrient intake decreases with age in older men. Our results suggest that strategies to improve some of the suboptimal micronutrient intakes might need to be developed and implemented for older men.

Changes in Micronutrient Intake and Status, Diet Quality and Glucose Tolerance from Preconception to the Second Trimester of Pregnancy.

Data on changes in dietary intake and related blood parameters throughout pregnancy are scarce; moreover, few studies have examined their association with glucose homeostasis. Therefore, we monitored intake of folate, vitamin B6, vitamin B12, vitamin D and iron, their status markers, and diet quality from preconception to the second trimester of pregnancy, and we examined whether these dietary factors were associated with glucose homeostasis during pregnancy. We included 105 women aged 18–40 years with a desire to get pregnancy or who were already <24 weeks pregnant. Women at increased gestational diabetes (GDM) risk were oversampled. Measurements were scheduled at preconception (n = 67), and 12 (n =53) and 24 weeks of pregnancy (n =66), including a fasting venipuncture, 75-grams oral glucose tolerance test, and completion of a validated food frequency questionnaire. Changes in micronutrient intake and status, and associations between dietary factors and glucose homeostasis, were examined using adjusted repeated measures mixed models. Micronutrient intake of folate, vitamin B6 and vitamin D and related status markers significantly changed throughout pregnancy, which was predominantly due to changes in the intake of supplements. Micronutrient intake or status levels were not associated with glucose homeostasis, except for iron intake (FE µg/day) with fasting glucose (β = −0.069 mmol/L, p = 0.013) and HbA1c (β = −0.4843 mmol, p = 0.002). Diet quality was inversely associated with fasting glucose (β = −0.006 mmol/L for each DHD15-index point, p = 0.017). It was shown that micronutrient intakes and their status markers significantly changed during pregnancy. Only iron intake and diet quality were inversely associated with glucose homeostasis.

Dietary Micronutrient Intake of Participants in a "Partners Together in Health" Cardiac Rehabilitation Intervention.

Current guidelines for cardiovascular health emphasize a "dietary pattern" approach that could be expected to increase intakes of micronutrients in addition to altering the macronutrient profile. However, the effect of interventions such as cardiac rehabilitation on the micronutrient quality of the diet has not been evaluated. Therefore, the goal of this study was to investigate changes in micronutrient intake of cardiac rehabilitation participants over time. This was a secondary analysis of data from a randomized clinical trial that assessed the effects of the Partners Together in Health intervention on physical activity and healthy eating behaviors. The intake of 9 micronutrients important in cardiovascular health was assessed using 3-d food records. A micronutrient adequacy score was evaluated at 3 time points (baseline, 3 and 6 mo). Changes over time in micronutrient intake were assessed using a general linear model. Sixty-eight participants who were enrolled in the Partners Together in Health interventional trial completed the study. There was no significant difference in the mean micronutrient score at any time point. Intake of individual micronutrients did not improve over the 6-mo time frame with the exception of vitamin E, (8.7 mg vs 6.5 mg for at 6 vs 3 mo, P = .02). The proportion of participants with intakes meeting the Dietary Recommended Intake for each nutrient also remained the same over time. Although cardiac rehabilitation programs may be effective in altering the macronutrient composition, improvements to overall diet quality may be tempered by a lack of improvement in intake of micronutrients.

Micronutrient Intake Changes With the Low FODMAP and mNICE Diets

Introduction: The role of the low FODMAP (fermentable oligo-, di-, mono-saccharides and polyols) diet has gained increasing acceptance for the treatment of irritable bowel syndrome (IBS) but potential safety concerns have been raised regarding nutritional adequacy. Changes in micronutrient intake with a low FODMAP diet have not been previously investigated. Daily micronutrient intake after 4 weeks of a low FODMAP diet or a modified NICE (mNICE) diet was compared to baseline. Methods: A post-hoc analysis of a single-center, randomized-controlled trial of adult patients with IBS-Diarrhea (IBS-D) was utilized which compared the efficacy of a low FODMAP and the mNICE diets on IBS symptoms over a 4-week period. The Nutrition Data System for Research (NDSR) computer program was used to analyze 3-day food diaries at baseline and at 4 weeks. Results: Data from 78 patients who completed the study were included. 41 patients were randomized to the low FODMAP diet and 37 patients were randomized to the mNICE diet. The average BMI in the low FODMAP group was 27.7 ± 6.5 compared to an average BMI of 31.4 ± 7.9 in the mNICE group (p=0.003). Both diets resulted in fewer daily kilocalories and number of daily meals consumed (Table 1). Among the patients on the low FODMAP diet, a statistically significant decrease from baseline in the daily intake retinol, thiamin, riboflavin, calcium, and trans-fatty acids was observed. There was a statistically significant increase from baseline in the intake of vitamin B6. In the mNICE group, there was a statistically significant decrease in the daily intake of polyunsaturated fatty acids only. The remaining micronutrient differences compared to baseline were not statistically significant.Table: No Caption availableConclusion: During a 4-week dietary intervention, the average daily intake of most micronutrients remained stable and within recommended dietary allowances. A low FODMAP diet was associated with a significantly lower daily intake of retinol, thiamin, riboflavin, calcium, trans-fatty acids, while the daily intake of vitamin B6 was increased. The mNICE diet was associated only with lower daily intake of polyunsaturated fatty acids. While statistically significant, the clinical significance of these findings are unclear and suggest that for a short-term elimination diet, the low FODMAP diet is not associated with major micronutrient inadequacies. These findings reinforce the importance of diversifying a patient's diet through reintroduction of foods containing FODMAPs.

Effects of Reduced-fat Diets Consumed Ad Libitum on Intake of Nutrients, Particularly Antioxidant Vitamins

Objectives To determine whether a reduced-fat diet consumed ad libitum can achieve the recommended intakes of other macronutrients, fiber, and cholesterol and whether such a diet affects intake of other important micronutrients such as fat-soluble vitamins. Design Twelve-month, randomized, controlled trial of a reduced-fat, ad libitum diet vs usual diet. Subjects One hundred ten adults older than 40 years with glucose intolerance (2-hour blood glucose concentration=7.0 to 11.0 mmol/L) who were selected from a previous workforce survey. Intervention Monthly small-group meetings aimed at identifying sources of dietary fat and ways to reduce fat consumption. Main outcome measures Nutrient intakes derived from 3-day food diaries at the beginning and end of the study. Blood levels of retinol, α-tocopherol, and beta carotene at the end of the study. Statistical analyses performed Unpaired t tests for determining changes in nutrient intake and antioxidant vitamin concentrations. Separate analyses were conducted with users of mineral and vitamin supplements and people who changed smoking status to reduce potential confounding. Results Fat intake decreased from 35% to 26% of energy in the reduced-fat diet group compared with a 2% decrease in the control group ( P<.0001). Total energy intake also decreased in the 2 groups (−362 vs −59 kcal/day, P<.02). Those changes were reflected in a 3.1±4.7 kg (mean± standard deviation) weight loss in the intervention group compared with a 0.4±3.0 kg weight gain in the control group ( P<.0001). There were no differences between groups in the changes in micronutrient intakes, except for an energy-adjusted increase in beta carotene intake in the reduced-fat diet group. Serum retinol and α-tocopherol concentrations were not different between the groups, but the reduced-fat diet group had higher beta carotene concentrations ( P=.009). Applications A reduced-fat, ad libitum diet can be prescribed to improve overall macronutrient intake and achieve modest weight loss without sacrificing micronutrient intakes. J Am Diet Assoc. 1999;99:1400–1405.