Dietary Reference Intakes Research Articles

Estimation of the vitamin D (VD) status of pregnant Japanese women based on food intake and VD synthesis by solar UV-B radiation using a questionnaire and UV-B observations

Although vitamin D (VD; serum 25 hydroxyvitamin D) deficiency (< 20 ng/mL) is widespread among Japanese women, the VD status among pregnant women is unknown. This study aimed to determine the VD status of pregnant Japanese women during different meteorological seasons and to determine the factors controlling VD status. A total of 309 pregnant Japanese women were recruited at 28 weeks of gestation at the gynecology department of a university hospital in Tokyo between August 2018 and October 2019. Blood samples were collected to measure serum 25(OH)D levels. Two questionnaires were completed: a brief self-administered dietary history questionnaire (BDHQ) and an outdoor exposure history questionnaire to determine skin sunlight exposure and the use of sunscreen. Among the recruited subjects, 268 were included in the statistical analysis. The average VD intake from food was 9.0 μg/day, the average VD synthesis from UV-B was 15.2 μg/day, and the average sum of VD intake and nominal VD synthesis was 24.1 μg/day; this exceeded the recommended 2011 Dietary Reference Intake for the USA and Canada (15.0 μg/day). However, the average serum 25(OH)D level (11.4 ng/mL) was very low, indicating widespread VD deficiency. Serum 25(OH)D and VD synthesis by solar UV-B were significantly correlated only during the high UV-B season. The 25(OH)D level was weakly correlated with the VD intake from food in all seasons. We obtained a statistically significant correlation between serum 25(OH)D level and VD intake from food using the BDHQ. We also obtained a statistically significant correlation between the serum 25(OH)D level and VD synthesis from solar UV-B exposure, especially during the high UV-B season. Our logistic regression analysis model predicted VD deficiency in 88.0% of subjects. Our method might be possible to be used to predict the VD status of pregnant Japanese women, although another validation cohort is needed to verify the ability of the estimation equation.

Modeling lacto-vegetarian, pescatarian, and "pescavegan" USDA food patterns and assessing nutrient adequacy for healthy non-pregnant, non-lactating adults.

The 2020-2025 Dietary Guidelines for Americans (DGA) includes a Healthy Vegetarian Dietary Pattern (HVDP) with dairy foods and eggs as one of its three recommended dietary patterns for non-pregnant, non-lactating healthy adults. This study evaluates whether pescatarian, lacto-vegetarian, and "pescavegan" adaptations of the HVDP can be nutritionally adequate if modeled with foods recommended by the DGA. The nutrient composition of these three alternative models of the HVDP were assessed at 1, 800-, 2, 000-, 2, 200-, and 2,400- kcal/day using similar food pattern modeling procedures as the 2020 DGA. For the pescatarian and pescavegan models, 0.5 ounce-equivalent of refined grains per day was replaced with seafood. For the lacto-vegetarian and pescavegan models, eggs were replaced with equal proportions of the other vegetarian protein foods. In the pescavegan model, dairy foods were replaced by a dairy alternative group comprised of fortified soy milk and soy yogurt. All models at all energy levels were within Acceptable Macronutrient Distribution Ranges (AMDRs) for all macronutrients, contained ≤5% of total kcal from saturated fat, and met recommendations for most micronutrients. Nutrients provided below the Dietary Reference Intakes (DRIs) in these models included iron, sodium, vitamin D, vitamin E, and choline. Micronutrients provided at less than 50% of their respective DRIs included vitamin D and choline. Adapting the HVDP for lactovegetarian, pescatarian, and pescavegan dietary patterns provided adequate amounts of macronutrients and most micronutrients.

한국형 총식이조사 및 UV/태양광 조사 버섯에서의 비타민 D 분석

This study was conducted to evaluate vitamin D intake of Koreans in a total diet study (TDS) and to determine the effect of irradiation on vitamin D synthesis in mushrooms. For analysis, sample were saponified and extracted with hexane, and vitamin D was quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Based on the validation results, the recovery of the National Institute of Standards and Technology (NIST) standard reference sample (SRM) 1849a was 96.7% and the z-score of −1.6 was obtained by the Food Analysis Performance Assessment Scheme (FAPAS) proficiency test (PT) 21115. Vitamin D2 was not detected in any samples, and the highest level of vitamin D3 was detected in mackerel and anchovies ranging from 24.2 to 120.2 μg/kg. The mean daily intake of vitamin D was 0.99 μg/day, as estimated from the vitamin D contents of the analyzed foods and their corresponding intake. The adequate intake (AI) of vitamin D based on the Dietary reference intakes for Koreans provided by the Ministry of Health and Welfare is 5-15 μg/day for Koreans aged 6 to 75 years. Compared with this AI, vitamin D intake of Koreans estimated in this study was inadequate. For that, the increased vitamin D content in ultraviolet (UV)/sun light irradiated mushrooms warrants further research to increase vitamin D intake of Koreans through diet.

Adult Survivors of Childhood Cancer Have Poor Adherence to Dietary Guidelines

Background: Poor nutritional intake can exacerbate the chronic disease burden in childhood cancer survivors, whereas a healthful diet serves a protective function. Few studies have provided detailed evaluations of the diet of childhood cancer survivors.Objectives: This study aimed to evaluate diet quality and dietary intakes of key food groups and nutrients in a large cohort of childhood cancer survivors and whether cancer and treatment characteristics have an impact on survivors’ long-term intake.Methods: Diet was assessed in 2570 adult survivors of childhood cancer enrolled in the St. Jude Lifetime cohort (mean age = 32.3 y) by using the Block food-frequency questionnaire. The Healthy Eating Index–2010 (HEI-2010) was calculated to quantify diet quality. Cancer diagnosis and treatment exposure were abstracted from medical records. Differences in HEI-2010 by patient characteristics and treatment exposure were examined by using ANCOVA.Results: The mean ± SD HEI-2010 in childhood cancer survivors was 57.9 ± 12.4 of a maximum score of 100. Referenced to Dietary Reference Intakes, survivors consumed inadequate amounts of vitamin D, vitamin E, potassium, fiber, magnesium, and calcium (27%, 54%, 58%, 59%, 84%, and 90% of the recommended intakes) but excessive amounts of sodium and saturated fat (155% and 115% of the recommended intakes) from foods. Survivors diagnosed when <5 y of age had a lower diet quality than did those diagnosed when ≥5 y of age (mean HEI-2010 score: 56.9 compared with 58.2; P = 0.046). Survivors who received higher radiation doses to the abdomen had a lower diet quality than those who received lower doses (mean HEI-2010 scores = 58.9, 57.2, 56.7, and 56.1 for doses of 0, 1–19.9, 20–29.9, and ≥30 Gy, respectively; P = 0.02).Conclusions: Long-term childhood cancer survivors have poor adherence to the 2010 Dietary Guidelines for Americans. Findings reinforce the need to incorporate nutrition into cancer care to improve diet quality and to reduce morbidities.

Amino Acid Intake and Conformance With the Dietary Reference Intakes in the United States: Analysis of the National Health and Nutrition Examination Survey, 2001–2018

BackgroundThe lack of complete amino acid composition data in food composition databases has made determining population-wide amino acid intake difficult. ObjectivesThis cross-sectional study characterizes habitual intakes of each amino acid and adherence to dietary requirements for each essential amino acid (EAA) in the US population. MethodsFood and Nutrient Database for Dietary Studies ingredient codes with missing amino acid composition data were matched to similar ingredients with available data so that amino acid composition could be determined for 100% of foods reported in the dietary intake assessment component of NHANES. Amino acid intakes during NHANES 2001–2018 (n = 72,831; ≥2 y) were calculated as relative (mg·kg of ideal body weight−1·d−1) intakes. Data from NHANES 2011–2018 were used to determine the percentage of population consuming less than that recommended by the DRIs for each EAA by age, sex, and race/ethnicity. ResultsRelative intakes of EAAs and NEAAs were greatest in those 2–3 y and lowest in older individuals (≥71 y or ≥80 y). In females aged 2–18 y, relative intakes of EAAs were lowest in non-Hispanic White (NHW; histidine, lysine, threonine, methionine, and cysteine) and non-Hispanic Black (NHB; valine, isoleucine, leucine, phenylalanine, tryptophan, and tyrosine) populations and highest in the Asian population. In females aged ≥19 y, relative intakes were lowest in NHW (lysine and methionine only) and NHB populations and highest in the Asian population. In males aged 2–18 y, relative intakes of EAAs were lowest in the NHB population and highest in the Asian population. In males ≥19 y, relative intakes were lowest in NHB and NHW (lysine only) populations and highest in the Hispanic population. Less than 1% of individuals aged ≥19 y did not meet the Estimated Average Requirements for each EAA. ConclusionsEAA intakes in the US population exceed recommended minimum population requirements. Future studies can use the method described here to quantify amino acid intake and examine relationships with health and disease.

Assessment of Dietary Phosphorus Intake and Implementation of Parental Phosphate Education in Pediatric Chronic Kidney Disease.

Management of dietary phosphorus intake is a challenge in children with chronic kidney disease and is governed by regional food sources and culinary practices. The aim of this study was to evaluate dietary intake of phosphorus in these children and assess the utility of parental phosphate education for control of hyperphosphatemia. This prospective study included children aged 2-18 years with CKD stages 2-5D. Phosphorus intake was assessed by 24-hour dietary recall, analyzed using food processor software, and interpreted based on dietary reference intake (DRI) and suggested dietary intake (SDI). Parents of those with hyperphosphatemia were subjected to a structured phosphate education, and serum phosphate was monitored every 2 months for 6 months. Seventy children were recruited (mean age 9.4 ± 3.4 years, CKD5/5D: 51% (n = 36)) with median duration of CKD being 3.8 (IQR2,6) years. In the overall cohort, 50% (35/70) had phosphorus intake exceeding DRI with no significant difference between groups [CKD 5/5D,52.7% (n = 19) vs CKD2-4 47% (n = 16), P = 0.63]. Mean daily phosphorus intake was comparable between children with and without hyperphosphatemia [908 ± 279 mg vs 814 ± 302 mg, P = 0.1]. Based on DRI, 44% of children with normal serum phosphate and 58% with hyperphosphatemia had increased dietary intake of phosphorus (P = 0.15). Based on SDI, 26% with normal serum phosphate and 94% with hyperphosphatemia had increased dietary phosphorus intake (P < 0.001). Hyperphosphatemia was observed in 51% (CKD 2-4); 33% CKD5-5D 66%, P = 0.6). Among 29 children completing 6 months of follow up, there was a significant reduction in mean serum phosphate levels (P = 0.001) which was independent of age, stage of CKD or intake of phosphate binders. At end of the study, hyperphosphatemia persisted in 34%. Compared to DRI, dietary assessment of phosphorus intake based on SDI was significantly associated with hyperphosphatemia in children with CKD 2-5D. In the majority, repeated parental structured phosphate education over 6 months was useful in managing hyperphosphatemia.

The Efficacy and Safety of Dietary Counseling in Prevention and Treatment of Dental Caries in Children

Dental caries is a multifactorial disease influenced by various factors, including diet, oral hygiene practices, and genetic predisposition. Preventive strategies are crucial in the pediatric population. Early intervention and prevention are key to mitigating the burden of dental caries. Energy needs are higher in early childhood, necessitating more frequent meals. Dietary counseling aims to modify behaviors and promote healthy choices to reduce caries risk. The United States Dietary Guidelines provide recommendations for promoting health and preventing disease. Dietary Reference Intakes specify nutrient requirements based on age and gender. Dietary counseling plays a valuable role in promoting oral health and preventing dental caries. Studies show a clear link between sugar intake and tooth decay. Dietary modifications, such as reducing sugary beverage consumption, can be implemented gradually to ensure compliance. Effective counseling interventions have shown reductions in early childhood caries incidence. However, challenges remain in encouraging healthy eating habits. Preventive educational initiatives for new mothers have been successful in reducing caries prevalence. The prenatal period is critical for oral health, and pregnant women should be educated about a healthy diet. Adequate nutrition in the first year of life is essential, and breastfeeding is encouraged. Introducing sugar early can lead to a preference for high-sugar foods. Caregivers should promote healthy meal and snack patterns. From ages one to five, nutritious foods should be provided, and high-sugar foods limited to mealtimes. By addressing these considerations, dental professionals can contribute to preventing dental caries in children

Situation and trends in dietary minerals intakes of adults aged 18-35 years in 15 provinces (autonomous regions, municipalities) of China in 1989-2018

To analyze the current situation and long term trends in minerals intakes from 1989 to 2018 in adults aged 18 to 35 years in 15 provinces(autonomous regions, municipalities) of China. Based on the data of China Health and Nutrition Survey from 1989 to 2018. Adults aged 18 to 35 were selected as study subjects. According to the dietary survey result of 3-day 24-hour dietary review method and weighing accounting method, the mineral intake was calculated and analyzed. Nonparametric statistical method was used to analyze the trend of dietary minerals intake with years. Comparing the dietary minerals intake with the dietary reference intakes, the trend of the proportion of people at risk of insufficient dietary minerals intake was analyzed by Cochran-Armitage trend test. According to the different demographic characteristics in 2018, the minerals intake status and the proportion of people with insufficient dietary minerals intake were analyzed. In 2018, the median intakes of dietary minerals of adults were 302.96 mg/d of calcium, 887.91 mg/d of phosphorus, 1451.69 mg/d of potassium, 3760.09 mg/d of sodium, 238.50 mg/d of magnesium, 19.40 mg/d of iron, 9.91 mg/d of zinc, 43.54 μg/d of selenium, 1.41 mg/d of copper and 4.59 mg/d of manganese, respectively, with significant gender differences(P&lt;0.05). The intakes of dietary calcium, phosphorus, magnesium, potassium, selenium and copper in urban areas were significantly higher than those in rural areas(Z values were 3.00, 2.04 and 3.10, respectively, P&lt;0.05). The dietary intakes of calcium, phosphorus, magnesium, potassium, selenium and copper showed significant differences among regions, education levels and income levels. From 1989 to 2018, the dietary mineral intake of calcium, phosphorus, potassium, sodium, magnesium, iron, zinc, copper and manganese of adults aged 18-35 in 15 provinces(autonomous regions and municipalities) of China showed a downward trend, only selenium intake showed an upward trend, and the intake of men was higher than that of women. The proportion of people at risk of inadequate intake of dietary phosphorus, magnesium, iron, zinc and copper showed an increasing trend year by year. In each survey year, the proportion of people at risk of insufficient calcium intake was more than 90%. From 1989 to 2018, there was a risk of insufficient intake of minerals in adults aged 18-35 in 15 provinces(autonomous regions, municipalities) in China, and the problem of inadequate calcium intake was serious.

A Teaching Kitchen Program Improves Employee Micronutrient and Healthy Dietary Consumption.

To measure changes in micronutrient adequacy and diet quality in healthcare and university employees who underwent a 10-week teaching kitchen program. Thirty-eight healthcare and university employees participated in a 10-week teaching kitchen program. Twenty-seven completed self-administered, 24-hour dietary recalls to measure dietary intake at baseline and 3-months. Micronutrient adequacy and diet quality was assessed using Dietary Reference Intakes (DRIs) and the Healthy Eating Index (HEI). Seventy percent of participants were classified as low or moderate micronutrient adequacy at baseline. The proportion of participants with high micronutrient adequacy increased from 30% to 48% at 3-month follow-up. Total HEI and most HEI components increased at follow-up; with a statistically significant increase in seafood/plant protein score (P = .007). Our results suggest an inadequacy in micronutrient intake in university and healthcare employees and that teaching kitchens may help improve micronutrient adequacy and diet quality.

Relationship between overweight and obesity and insufficient micronutrient intake: a nationwide study in Taiwan.

The aim of the present study is to examine whether overweight or obese people in Taiwan have an inadequate intake of selected micronutrients. A population-based study was conducted using data from the Nutrition and Health Survey in Taiwan (NAHSIT) 2013-2016. We evaluated fourteen nutrient intakes using the 24 h dietary recall method. The dietary reference intake (DRI) adherence was estimated by the prevalence of participants whose intake was lower than the recommended dietary allowance (RDA) or adequate intakes (AIs) for selected micronutrients. Body mass index (BMI) ≥ 27 kg/m2 and waist circumference (WC), with men having WC ≥ 90 cm or women having WC ≥ 80 cm, were defined as obesity. A total of 3075 participants aged 19 years and above were included. After adjusting for confounders, we found that obese women have a lower DRI adherence of vitamin C (odds ratio (OR) 0⋅73, 95 % confidence interval (CI) 0⋅56, 0⋅95) and magnesium (OR 0⋅72, 95 % CI 0⋅54, 0⋅95), compared with normal-weight women. Obese men have a higher DRI adherence of vitamin B3 (OR 1⋅70, 95 % CI 1⋅29, 2⋅23), iron (OR 1⋅46, 95 % CI 1⋅06, 2⋅00) and zinc (OR 1⋅41, 95 % CI 1⋅07, 1⋅85), compared with normal-weight men. Similar findings were found using WC to define obesity. We conclude that obese women may have insufficient intakes of vitamin A, vitamin C and magnesium.

Проблема качества питания пациентов с воспалительными заболеваниями кишечника, получающих биологическую терапию

Food nutrients can directly regulate the function of the immune system and determine the composition of the intestinal microbiota and its activity in relation to the production of biologically active metabolites. Patients with inflammatory bowel disease (IBD) receiving biological therapy should be attentive to the quality of their diet to reduce the risk of negative disease scenarios. Objective. To evaluate the features of dietary patterns in patients with IBD receiving biological therapy and compare them with nutritional indicators of patients with irritable bowel syndrome (IBS). Patients and methods. The study included 56 patients who were divided into two groups: IBS group (n = 28) and a control group comprising of patients with IBS and diarrhea (n = 28). All patients were pair-matched by sex and age. Data on actual intake were collected from all participants using the 24-h dietary recall method. The dishes of the obtained diets were converted into constituent products according to the tab of dishes, which were summed up by weight per day and compared with dietary reference intakes according to the concept of the healthy eating pyramid for the calculated caloric content of the diet. To assess food diversity, the method of calculating the unique values (count base diversity) of food products from the diet by 11 groups was used: cereals, meat and eggs, fish and non-fish products of the sea, fatty foods, dairy products, vegetables, legumes and nuts, fruits and berries, confectionery, beverages, sauces, and spices with counting the number of positions in each of the studied food groups. A comparison of the mean values of the number of positions in each of the studied food groups was used to compare the dietary diversity in patients. The analysis of diets according to the method of culinary processing of dishes and products was performed by dividing them into 6 categories: cooked without heat treatment, boiled, stewed, fried, baked in the oven, or grilled. The total weight of food consumed per day by the individual (excluding thermostable components – water and salt) and the percentage of each of the categories of culinary processing in the diet (calculated by weight) were considered. As an integral indicator of the quality of diet, the participants’ diets were assessed using the criteria of the Healthy Eating Index 2015 (HEI 2015), which reflects the percentage of compliance with the optimal diet according to the American guidelines on healthy eating. Results. A comparison of the diets of the studied food groups in patients with IBD revealed a low intake of dietary fiber (17.3 ± 5.8 vs. 22.9 ± 7.6 g/day, p = 0.006) and a decrease in the frequency of meals (4.0 ± 0.9 vs. 4.9 ± 0.8 times per day, p = 0.003). Their diets were characterized by lower consumption of fruits (0.19 ± 0.26 vs. 0.55 ± 0.54, p = 0.002), vegetables (0.61 ± 0.37 vs. 0.95 ± 0.47, p = 0.01) and meat and fish products (1.43 ± 0.76 vs. 2.03 ± 1.15, p = 0.042), and higher consumption of fatty foods (1.62 ± 0.71 vs. 1.15 ± 0.97, p = 0.019). The profile of heat treatment of foods in patients with IBD differed significantly with a higher proportion of fried foods (13.79 ± 13.34% vs. 7.55 ± 9.32%, p = 0.047) and baked foods (16.00 ± 8.54% vs. 12.00 ± 11.36%, p = 0.013). The results of the assessment of dietary diversity showed that patients in the IBD group consumed significantly fewer types of fruits (1.00 ± 1.13 vs. 1.96 ± 1.47, p = 0.013) and grain products (2.07 ± 1.12 vs. 2.64 ± 1.12, p = 0.05) and more varieties of confectionery (1.57 ± 0.90 vs. 1.10 ± 0.78, p = 0.035). An integral assessment of the quality of the diet based on HEI 2015 showed a significantly lower value in individuals with IBD compared with those of patients with IBS (40.11 ± 12.04% vs. 51.53 ± 9.31%, p = 0.001). Conclusion. Currently, the role of diet therapy in supporting pharmacotherapy for IBD is greatly underestimated. Most of patients with IBD have disordered and unbalanced diets, and measures aimed at optimizing their nutritional status may improve the quality of life of patients and reduce the burden of spending health resources on expensive therapies and surgical interventions. Key words: healthy diet, dietary pattern, dietary assessment, IBD

Vitamin D Status of Anabaptist Children in Southwestern Ontario, Canada

The objective was to determine vitamin D status of Old Order Anabaptist children in rural Southwestern, Ontario, Canada, given concerns of community healthcare professionals. Fifty-two children (2.5 months - 6.5 years) (56% female) were recruited. Finger prick blood spot (BSp) samples were analyzed for 25-hydroxy (OH) vitamins D2 &amp; D3 (BSp25(OH)D). Three-day food records were evaluated using Dietary Reference Intakes and Canada’s Food Guide (CFG) (Bush, et al. 2007). Compared to national Canadian data: mean BSp25(OH)D concentrations (78±31 nmol/L) were similar; a slightly smaller proportion (0% vs 2%) were at risk of deficiency (&lt;30 nmol/L) or had inadequate status (4% vs 7%) (&lt;40 nmol/L); and 10% vs 1% had BSp25(OH)D higher than 125 nmol/L. BSp25(OH)D was significantly associated (r2=0.358; p=0.001) with total vitamin D intake. From food alone, vitamin D intake was 68±39 IU/day, lower than the Recommended Dietary Allowance (RDA) of 600 IU/day, and intakes were all below the Estimated Average Requirement (EAR) of 400 IU. Even including supplemental vitamin D, 87% were below the EAR (total intake=213±194 IU/day). No children had vitamin D intakes greater than the Upper Limit. Servings of milk and alternates were 1.6±0.8/day (CFG=2/day). Unfortified farm milk was consumed by 88% of children and 89% received a vitamin D supplement. Results were comparable to recent Canadian data suggesting that most children have adequate vitamin D status. Nevertheless, these findings support the need to encourage appropriate vitamin D intake (from food and supplements) to achieve the RDA for Old Order Anabaptist children in these communities. [Abstract by authors.]

Soybean bran as the fat replacer in gluten-free cookie formulation: Physicochemical properties and sensory profiles

Soybean bran (SB) partially replaced fat (30%?50%) in a gluten-free cookie formulation. Dough properties, physical (cookie dimension and weight loss), textural (hardness and fracturability), colour and sensory parameters, as well as nutritional profiles were evaluated to characterize full-fat (FFC) and fat-reduced cookies (FRC). Based on the obtained results, it was concluded that the fat reduction in cookie formulation at 30% maintained the sensory properties of the FFC. Furthermore, it was revealed that the fat replacement using SB at 30% resulted in the fat-reduced value-added gluten-free cookies in terms of dietary fibre and minerals. A daily portion of the 30% FRC meets 11.87% and 18.04% of dietary reference intakes (DRIs) for dietary fibres, 26.50% of DRIs for calcium, 35.71% and 46.88% of DRIs for magnesium and 65.43% and 83.61% of DRIs for manganese, for male and female adults, respectively.

Dietary micronutrient intake of children aged 2-5 years in China in 2019-2021

To describe dietary intake of calcium, iron, zinc, selenium, vitamin A, vitamin B_1, vitamin B_2 and vitamin C and compare the intake between urban and rural areas among preschool children aged 2-5 years based on the data from the National Nutrition and Health Systematic Survey for Children 0-17 Years of Age in China. Children from 14 provinces were selected by multi-stage stratified random cluster sampling, and the dietary data of preschool children aged 2-5 years were recorded using the 3 day 24-hour weighted food records method. SAS 9.4 was used to calculate dietary intake of these micronutrients based on the Chinese Food Composition Table and to compare the intake between urban and rural areas. The risk of insufficient or excessive intake of micronutrients among Chinese children aged 2-5 years was assessed according to the Chinese Dietary Reference Intakes(DRIs) 2013 edition. A total of 820 children aged 2 to 5 years were selected. The median daily dietary calcium intake of children aged 2-5 years in China was 433.7, 338.9, 356.4 and 347.4 mg, respectively. The median daily dietary intake of vitamin B_1 of children aged 2-5 years was 0.5 mg for all age groups. The median daily dietary vitamin B_2 intake of children aged 2-5 years was 0.7, 0.6, 0.6 and 0.6 mg, respectively. The median daily dietary intake of vitamin C of children aged 2-5 years was 37.9, 37.4, 44.0 and 40.0 mg, respectively. The median daily dietary selenium intake of children aged 2-5 years was 17.1, 20.5, 22.7 and 22.3 μg, respectively. Dietary calcium intake for aged 2-5 years, dietary vitamin B_2 intake for aged 2-4 years, dietary iron, selenium, zinc and vitamin B_1 intake for aged 2-3 years was significantly greater in urban children than rural children. Among all nutrients, the proportion of dietary calcium intakes below the estimated average requirement(EAR) was the highest in aged 2-5 years(61.4%, 76.4%, 91.4% and 91.5%, respectively). The proportions of dietary vitamin B_1, vitamin C and selenium intake lower than EAR of children aged 2-5 years in China were 52.4%-63.2%, 42.8%-50.2% and 46.6%-58.7%, respectively. The dietary calcium intake of children aged 2-5 years in China remains insufficient for these children, especially for rural children. Dietary vitamin B_1, vitamin C and selenium intake should be improved.

Evaluation of calcium intake levels and sources among pregnant women in a Chengdu hospital in 2017

Investigate and evaluate the levels and sources of calcium intake of pregnant women in Chengdu during three trimesters. Use the data of a cohort study in Chengdu in 2017. The healthy singleton pregnant women with 8-14 weeks of pregnancy in an obstetrical clinic of a maternal-and-child health care institution in Chengdu were selected as the object of the study. Data on maternal demographic characteristics and the use information of calcium supplements in the past month of each trimester were collected by questionnaire investigation. The dietary intakes data of pregnant women in each trimester was collected by the 3-day 24-hour dietary recall method. The dietary calcium intake and the contribution of calcium from different foods were calculated based on the Chinese Food Composition Table(2018). The total calcium intake was obtained by adding the dietary calcium and supplement calcium intake. The calcium intake was evaluated with reference to the Chinese Dietary Nutrient Reference Intakes(2013). Valid samples of 1653 cases in early pregnancy, 1024 cases in middle pregnancy and 1017 cases in late pregnancy were finally included. The median intake of total calcium was 523.3, 1280.5 and 1491.3 mg/d in three trimesters, respectively. The adequate rate of total calcium intake was 16.3%, 63.2% and 67.1%, the insufficient rate was 69.0%, 15.7% and 11.2%, the excess rate was 0.2%, 9.1% and 14.4%, respectively. The median intake of dietary calcium was 453.0, 613.0 and 723.0 mg/d in three trimesters respectively. The dietary calcium adequate rates were 7.1%, 9.7% and 16.2%, the dietary calcium deficiency rates were 82.0%, 75.0%, 62.6%, respectively. The main food sources of dietary calcium in each pregnancy were dairy foods, vegetables, tubers and grains. The contribution of dairy foods to the dietary calcium was 33.8%, 37.7% and 40.2%, respectively. The median intake of milk was 125.0, 235.3 and 250.0 g/d, respectively. Among all pregnant women, the calcium supplement use in three trimesters was 36.2%, 93.4% and 91.7%, respectively; the median intake of supplement calcium was 0.0, 625.0 and 750.0 mg/d, respectively. Among pregnant women who met the dietary calcium standard, the use of calcium supplements in the three trimesters was 38.1%, 95.0% and 94.5%, respectively; the median intake of supplemental calcium was 0.0, 725.0 and 750.0 mg/d, respectively. The insufficient and excessive total calcium intake coexisted among pregnant women in Chengdu, with the insufficient dietary calcium intake prominent in all trimesters. The use of calcium supplements was common in middle and late pregnancy.

PS-P14-5: THE LINK BETWEEN SALT KNOWLEDGE, SALT REDUCTION AWARENESS AND SALT REDUCTION BEHAVIOR

Objective: The effects of salt on health are well known. However, salt intake is still high in Japan and the number of hypertensive patients is increasing. Therefore, we investigated the association between knowledge, awareness, and behavior towards salt among university students. Design and Methods: 72 university students (11 males and 61 females) from the Department of Nutrition (group N) and 70 university students (10 males and 60 females) from other departments than nutrition (group O) was included in the study. Knowledge and awareness of salt and their behavior were investigated using questionnaires and a salt checklist. Results: In terms of knowledge of salt, the target amount of salt intake (g/day) was answered as 7.2 ± 0.6 in group N and 15.0 ± 13.9 in group O, with no significant difference. When the target amount of 7–8 g/day of the Japanese Dietary Reference Intakes was used as the correct answer range, the percentage of correct answers was 86% in group N and 10% in group O (p &lt; 0.001). The correct answer rate for seasonings with high salt content was 86% in group N and 27% in group O (p &lt; 0.0001). There was no significant difference in the percentage of correct answers for low-salt condiments. The percentage of correct answers for diseases associated with salt intake was significantly higher in group N. The proportion with low-salt awareness was significantly higher in group N (p &lt; 0.0001). The total score on the salt checklist was 10.7 ± 3.0 in group N and 13.4 ± 4.7 in group O (p &lt; 0.0005). Conclusion: The students from the Department of Nutrition had a higher level of salt reduction awareness, more knowledge about salt and a lower total score on the salt checklist. Medical and food knowledge may be useful in linking salt reduction knowledge with awareness and behavior.

Assessment of nutrient intakes of children and adolescents with recessive dystrophic epidermolysis bllosa, severe subtype.

Background and aims: epidermolysis bullosa (EB) is a rare disease presenting with skin fragility and formation of blisters. Constant presence of skin lesions, loss of blood, wastage of heat through the open skin, increased turnover of proteins and infections, result in increased energy, protein, and micronutrient needs. This study investigated the intake adequacy of energy, protein, zinc, iron, and dietary fiber in children with epidermolysis bullosa. Methods: this cross-sectional, analytical study was conducted with children and adolescents of up to 18 years of age with recessive dystrophic EB, severe subtype. Demographic data and clinical manifestations affecting food consumption were collected. Nutritional assessment was performed through anthropometric data. We used a formula to estimate specific energy needs for EB, and ratio of skin lesions was also evaluated to assist in estimating energy needs. A protein adequacy of 115 % to 200 % of the Recommended Dietary Allowance was considered for the adequacy of protein intake. And the Dietary Reference Intake tables according to sex and age were used as a reference for micronutrients. Intake assessment was performed using seven consecutive daily food records. Sip feed consumption was considered for intake assessment. Results: all patients showed undernutrition and presented at least three clinical symptoms that affect food consumption: pseudosyndactyly, microstomy, and blisters in the oral cavity. Sip feed constituted between 20 % and 50 % of the patients' energy intake. Intake of iron and zinc was adequate for most patients (confidence of adequacy ≥ 0.85), while fiber intake was below the reference value. Conclusions: this study underscores the importance of nutritional monitoring for EB patients, which is often interpreted as a skin disease but has enormous nutritional repercussions.

S-49-5: PRACTICAL AND PERSONAL EDUCATION OF DIETARY THERAPY IN HYPERTENSIVE PATIENTS

Hypertension is the most important risk factor of cardiovascular death in Japan. The annual number of deaths due to hypertension is estimated to be 100,000 persons. The number of hypertensives in Japan is estimated to be 43 million. Of these individuals, 33% are estimated to be unaware of hypertension, 11 % are aware but untreated, and 29% are poorly controlled despite ongoing treatment. Thus, measures to reduce the number of untreated and poorly controlled hypertensive patients are needed. Lifestyle modifications including dietary therapy are quite important regardless of the use of antihypertensive drugs. Especially, salt reduction is most important because Japanese individuals still consume a significant amount of salt. The Dietary Reference Intakes for Japanese 2020, issued by the Ministry of Health, Labour and Welfare, propose a salt intake goal of &lt; 7.5 g/day for men and &lt; 6.5 g/day for women. Regarding the goal of salt reduction in hypertensive patients, the hypertension guideline by the Japanese Society of Hypertension 2019 (JSH2019) proposes a goal of &lt; 6 g/day. Although salt intake in Japan gradually decreased in the early 2000 s, the declining trend has not been seen in recent years, and thus it seems difficult to achieve these target salt intake levels. To overcome this challenge, the JSH announced the JSH Tokyo Declaration and pledged to create a specific action plan to achieve the target salt intake level of &lt; 6 g/day. Since the awareness of salt reduction may not necessarily lead to actual salt reduction, the assessment of salt intake of the individuals is essential when the medical stuffs provide the guidance of salt reduction. In the practical clinical settings, the combination of the assessment of dietary contents using simple questionnaires and the estimation of salt intake using spot urine specimen is recommended. Repeated assessment of salt intake and the practical guidance by the medical stuffs is useful for the long-term adherence of salt reduction. Nevertheless, it is difficult to achieve the target salt intake levels. To support individuals’ efforts to reduce salt intake, the JSH Salt Reduction Committee certifies 124 delicious low-salt foods as of April, 2022. Annual sales of these products are about 45 billion yen and the reduction in salt consumption is estimated to be about 1,000 tons. Through the utilization of these products and the efforts to improve the food environment, a society with low-salt and healthy diet will be expected to come.

Uticaj polifenola na razvoj ateroskleroze

Polyphenols represent one of the biggest and most widespread groups of secondary plant metabolites with more than 8000 polyphenolic compounds. Fruits, vegetables and beverages such as tea and red wine are the main sources of polyphenols. A significant number of studies indicate the ability of certain polyphenols to delay the development of atherosclerosis. According to the same polyphenols reduce lipid deposition, oxidative stress, inflammation of the blood vessel wall, proliferation of vascular smooth muscle cells and endothelial dysfunction. The widespread use of polyphenols requires further research on bioavailability, absorption and transformation. It is necessary to determine the effect of individual polyphenols as well as the interaction with other bioactive compounds, define the dietary reference intake and the safety of use in certain subpopulations.

PS-P09-5: DIET QUALITY PARTIALLY MEDIATES THE ASSOCIATION BETWEEN ULTRA-PROCESSED FOOD CONSUMPTION AND OBESITY

Objective: High consumption of ultra-processed food (UPF) is associated with an increased risk of obesity, which at least partly due to the poor nutritional profile of these foods. However, little is known about the magnitude of the direct and indirect effects of UPF consumption on obesity. Thus we evaluated whether the association between UPF consumption and obesity is mediated by overall diet quality. Design and method: This study is a cross-sectional analysis of the baseline data of adults aged 30–64 years (n = 6,894) which participated in the Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) cohort study. Dietary intake was assessed by a validated 112-items food frequency questionnaire. Using the NOVA food classification, 23 FFQ items were classified as UPF. Diet quality was assessed using the Korean Healthy Eating Index (KHEI) based on the 2015 Dietary Reference Intake for Koreans. Height, weight, and waist circumference (WC) were measured and body mass index (BMI, kg/m2) was calculated. Obesity was defined as ≧ 25.0 kg/m2. Abdominal obesity was defined as ≧ 90 cm for male and ≧ 85 cm for female. Single mediation models were used to estimate the mediating effect of UPF consumption (% kcal) on obesity, after adjusting for sex, age, research center, income, education, marital status, smoking, drinking, and sitting time. All analyses were performed using SAS version 9.4. Results: UPF accounted for 17.9% of total energy intake and the mean BMI and WC was 24.1 kg/m2 and 82.3 cm. The prevalence of obesity and abdominal obesity was 35.4% and 30.2%, respectively. UPF consumption (per 10% kcal increase) was associated with higher levels of BMI (0.13 kg/m2, P &lt; 0.001) and WC (0.39 cm, P &lt; 0.001), and also with higher odds of obesity (OR = 1.07, 10.1–1.13) and abdominal obesity (OR = 1.10, 1.04–1.17), after adjustment for confounders. The association of UPF consumption with BMI (14.3%, 95% CI: 1.9–26.8), WC (18.1%, 95% CI: 5.3–30.8), and abdominal obesity (20.9%, 95% CI: 6.0–35.8) were partially mediated by KHEI, but the association between UPF and overall obesity was not mediated by KHEI (17.2%, 95% CI: -1.1–35.4). Conclusions: Our findings suggest that the association between UPF consumption and obesity is partially, but not all, mediated by diet quality. Although our findings have a limitation on causal inference between UPF consumption and obesity, it may help understand the mediational structure between them and seek strategies for prevention of obesity.