Estimated Average Requirement For Vitamin Research Articles

Adequacy of usual intake of Japanese college athletes in various sports clubs.

While many studies have been published on nutrient intake assessment for performance improvement and deficiency prevention in single-sport athletes, few studies have addressed nutrient intakes in athletes from a various sports. The aim of this study was to determine whether Japanese college athletes meet the Dietary Reference Intakes (DRIs) and sports nutrition recommendations (SNRs). Dietary intake was assessed in 1049 Japanese college athletes from a variety of sports using a validated brief-type self-administered diet history questionnaire. The prevalence of inadequate intakes was estimated by comparing the DRIs and SNRs. For protein, riboflavin, niacin, vitamins B-6, vitamins B-12, folate, magnesium, zinc, and copper, <10% of females and males consumed diets that fell below the estimated average requirement (EAR) in the DRIs. A large proportion of female and male college athletes demonstrated intakes that were below the EAR for vitamin A (7.8% and 19.0%, respectively), thiamin (10.4% and 23.9%, respectively), calcium (20.4% and 29.7%, respectively), and iron (24.2% and 2.5%, respectively). Regarding DG for chronic disease prevention in the DRIs, over half of both female and male athletes exceeded the DG for saturated fat acid and sodium, and fell below the DG for dietary fiber. Few of both female and male had intakes below the SNRs for protein and carbohydrates. The results of the present study reveal the nutrient intake status of Japanese college athletes by comparing the DRIs and SNRs. Most meet the SNRs for optimal performance, but not the DRIs for health.

Impact of Simulated Caloric Reduction on Nutrient Adequacy Among U.S. Adults with Overweight or Obesity (National Health and Nutrition Examination Survey [NHANES] 2015–2018)

BackgroundCurrent guidelines for the treatment of obesity recommend dietary restriction to create a caloric deficit, and caloric reductions of 16% to 68% have been achieved in adults with overweight or obesity engaging in intentional weight loss programs. ObjectivesThis study models the impact of simulated caloric reduction on nutrient adequacy among U.S. adults ≥19 y with overweight or obesity using National Health and Nutrition Examination Survey data (2015–2018). MethodsFour levels of caloric reduction (20%, 30%, 40%, and 50%) were modeled by prorating daily calorie intake such that usual intakes of 14 nutrients were reduced proportional to caloric reduction. The percentages below the estimated average requirement (EAR) or above the adequate intake (AI) were estimated at each level of caloric reduction, with and without dietary supplement use. Differences across percentages of simulated caloric reductions were determined using nonoverlapping confidence intervals of the means (97.5th percentile confidence intervals were used to approximate P < 0.05). ResultsThere were significant differences (P < 0.05) in percentages below the EAR (above the AI) between sequential levels of simulated caloric reduction for most of the nutrients analyzed (protein, vitamins A, B-6, folate, and C, calcium, iron, magnesium, potassium, and zinc). For example, after a simulated 30% caloric reduction, 25%–40% of the population had intakes below the EAR for protein, vitamin B-6, and zinc, and 75%–91% of the population had intakes below the EAR for vitamin A, calcium, and magnesium (vs. 4%–18% and 45%–56%, respectively, without caloric reduction). With the inclusion of dietary supplements, percentages below the EAR for all nutrients (except protein) were lower than those for food alone. ConclusionsCaloric reduction may exacerbate nutrient inadequacies among adults with overweight or obesity. Inclusion of nutrient-dense foods, fortified foods, specially formulated products, and/or dietary supplements should be considered for those on calorie-restricted diets for long-term weight loss.

Contribution of base diet, voluntary fortified foods and supplements to micronutrient intakes in the UK.

The objective of the present study was to evaluate the contribution of voluntary fortified foods and supplements to reducing micronutrient shortfalls in the UK population. A secondary analysis of the UK National Diet and Nutrition Survey was conducted (2012/13-2013/14, N 2546, 1·5-95 years). Micronutrient intakes were derived from food consumption intake data and food composition data and calculated as the proportion below or above the Dietary Reference Values for males and females of different age groups, for those on a base diet only, users of fortified foods but no supplements and users of fortified foods and supplements. Of the population consuming a base diet only, 21-45 % and 5-29 % fell below the Estimated Average Requirement (EAR) for minerals and vitamins, respectively. About 3-13 % fewer consumers of fortified foods fell below the EAR for vitamins and minerals. Supplements barely reduced the prevalence of intakes below the EAR. Among supplement non-users and users, 99 and 96 % failed to meet the reference intakes for vitamin D. More women than men were at risk of inadequacies of micronutrient intakes. The prevalence of inadequacies declined with increasing age. Voluntary fortified foods but not supplements made a meaningful contribution to intakes of vitamin and minerals, without risk of unacceptably high intakes. These insights may help the UK to define approaches to address micronutrients of concern in vulnerable groups.

Disparities in Risks of Inadequate and Excessive Intake of Micronutrients during Pregnancy.

Inadequate or excessive intake of micronutrients in pregnancy has potential to negatively impact maternal/offspring health outcomes. The aim was to compare risks of inadequate or excessive micronutrient intake in diverse females with singleton pregnancies by strata of maternal age, race/ethnicity, education, and prepregnancy BMI. Fifteen observational cohorts in the US Environmental influences on Child Health Outcomes (ECHO) Consortium assessed participant dietary intake with 24-h dietary recalls (n=1910) or food-frequency questionnaires (n=7891) from 1999-2019. We compared the distributions of usual intake of 19 micronutrients from food alone (15 cohorts; n=9801) and food plus dietary supplements (10 cohorts with supplement data; n=7082) to estimate the proportion with usual daily intakes below their age-specific daily Estimated Average Requirement (EAR), above their Adequate Intake (AI), and above their Tolerable Upper Intake Level (UL), overall and within sociodemographic and anthropometric subgroups. Risk of inadequate intake from food alone ranged from 0% to 87%, depending on the micronutrient and assessment methodology. When dietary supplements were included, some women were below the EAR for vitamin D (20-38%), vitamin E (17-22%), and magnesium (39-41%); some women were above the AI for vitamin K (63-75%), choline (7%), and potassium (37-53%); and some were above the UL for folic acid (32-51%), iron (39-40%), and zinc (19-20%). Highest risks for inadequate intakes were observed among participants with age 14-18 y (6nutrients), non-White race or Hispanic ethnicity (10 nutrients), less than a high school education (9 nutrients), or obesity (9 nutrients). Improved diet quality is needed for most pregnant females. Even with dietary supplement use, >20% of participants were at risk of inadequate intake of ≥1 micronutrients, especially in some population subgroups. Pregnancy may be a window of opportunity to address disparities in micronutrient intake that could contribute to intergenerational health inequalities.

Consumption of Ready-to-Eat Cereal and Its Associations With Nutrient Intake and Nutrition Adequacy in the United States, NHANES 2017–2018

ObjectivesReady-to-eat cereal (RTEC) has been associated with improved intake of under-consumed nutrients. This study was conducted to examine consumption of RTEC and its association with nutrient intake and nutrition adequacy in the United States using the most recent nationally representative data. MethodsData from National Health and Nutrition Examination Survey (NHANES) 2017–2018 was used. Participants were classified as RTEC eaters or non-eaters depending on whether RETC was reported in their day-1 dietary recall. Total daily nutrient intake was compared by RTEC consumption status using ANOVA for survey data. Percentages below Estimated Average Requirement (EAR) for selected vitamins and minerals that are usually fortified in RTEC products were calculated using the National Cancer Institute method as estimate of usual intake. Data were analyzed in children (2–17 y, N = 2135), adults 18–64 y (N = 3675), and older adults (65 y or older, N = 1221) separately. ResultsAmong children, 34% reported RTEC consumption. The percentage of RTEC consumers was 14% in adults 18–64y and 22% in adults 65y or older. Consumption of RTEC was associated with significantly higher intake of carbohydrate, dietary fiber, calcium, iron, zinc, magnesium, potassium, phosphorus, vitamin A, thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, and vitamin D (all P < 0.05), but not with intake of protein, saturated fat, and vitamin E, in all three groups examined. Children who consumed RTEC also had a significantly lower intake of sodium (2735 mg vs 2929 mg, P = 0.02) and total fat (70 g vs 76 g, P = 0.005) than non-eaters, whereas energy intake was significantly higher in RTEC eaters than non-eaters in adults 18–64y (2390 kcal vs 2171 kcal, P = 0.03) and older adults (2081 kcal vs 1921 kcal, P = 0.03). Percentages below EAR for vitamin A, B vitamins, vitamin C, vitamin D, calcium, zinc, iron were lower in RTEC eaters than non-eaters in all age groups examined. ConclusionsWe found that consumption of RTEC was associated with higher intake of nutrients to encourage and RTEC consumers were more likely to meet nutrient recommendations compared to RTEC non-consumers. Funding SourcesThe study was supported by Bell Institute of Health and Nutrition, General Mills, Inc.

Examining Nutrient Adequacy, Iron Deficiency, and Anemia in US Children 1–3 Years of Age Using Data From NHANES 2001–2016

Abstract Objectives To assess nutrient intake adequacy from foods and beverages and to examine iron deficiency and anemia status in young US children. Methods National Health and Nutrition Examination Survey (NHANES) data for 2001–2016 in children 1–3 years of age were analyzed for mean dietary intake of individual nutrients (n = 5579), serum ferritin (n = 2498), and hemoglobin (n = 3919). Separate analyses for age groups 1–3 and 1–2 years were performed for gender combined and males/females separately. Dietary adequacy was assessed by comparing against estimated average requirements (EARs) and adequate intakes (AIs) as established by the IOM, as well as global recommendations for docosahexaenoic acid (DHAGR). Iron deficiency and anemia status were determined using ferritin (&amp;lt;10 ng/mL) and hemoglobin (&amp;lt;11 g/dL), respectively. Results The percentage of the population with intakes below the EAR for vitamin D, vitamin E, calcium, and iron were 82.7%, 70.9%, 3.6%, and 0.87% of children 1–3 years gender combined, respectively. Only 1% of children in this age group had fiber intakes greater than the AI. In addition, 97.6%-99.3% of these children did not meet the DHAGR of 70–100 mg/day. Similar results were found in the other age/gender groups. Compared to males, females had lower intakes of vitamin D, calcium and fiber, regardless of age. An estimated 6.9% of all children 1–3 years and 8.5% of all children 1–2 years appeared to be iron deficient. In comparison with other races/ethnicities sampled, Hispanic children appeared to have the highest (8.9% 1–3 years; 11.6% 1–2 years) and Non-Hispanic Black children (4.2% 1–3 years; 6.0% 1–2 years) the lowest rates of iron deficiency. Furthermore, 3.5% of all children 1–3 years and 4.3% of all children 1–2 years met the criteria for anemia. Conclusions Overall, dietary intake of US children 1–3 years of age appears to be adequate with the exception of vitamin D, vitamin E, calcium and fiber. Although iron intake was found to be adequate in this population, iron deficiency, as indicated by ferritin status, was still identified at 6.9% of children 1–3 years. Anemia as indicated by hemoglobin status was also identified. DHA intake was below recommendations for nearly all children. More research is needed to investigate these findings. Funding Sources Mead Johnson Nutrition/RB.

Vitamin D Intake among Premenopausal Women Living in Jeddah: Food Sources and Relationship to Demographic Factors and Bone Health.

Background Saudi women depend on food sources to maintain their serum 25(OH) D concentrations because covering by traditional clothing and time spent indoors limit their sun exposure. Little is known about vitamin D intake and its main food sources in Saudi Arabia. In addition, the association between vitamin D and calcium intake and bone mineral density (BMD) in young women is not well researched. Objectives To assess the adequacy of vitamin D intake among Saudi women as compared to the estimated average requirements (EARs), to identify dietary vitamin D sources, to examine potential determinants of vitamin D intake, and to assess bone health and the association of calcium and vitamin D intake with BMD. Methods This cross-sectional study was conducted in 257 premenopausal women aged 20–50 years in Jeddah, Saudi Arabia. Dietary vitamin D and calcium were assessed by the Semiquantitative Food Frequency Questionnaire. BMD was measured using dual-energy X-ray absorptiometry (DXA) in a subset of women (n=102) at the lumbar spine and femur neck. Results Sixty-five percent of women were below the EAR for vitamin D, and 61% fell below the EAR for calcium. Dairy products, supplements, and fish contributed most to vitamin D intake. Increased age was an independent determinant of sufficient vitamin D intake (p < 0.001). The prevalence of osteopenia was 33% in the lumbar spine and 30% in the femur neck. There was a significant positive association between calcium intake and BMD at the lumbar spine (p=0.043) after controlling for body mass index and energy intake. Vitamin D intake was not significantly different between women with low and normal bone mass. Conclusion Premenopausal women in Jeddah have insufficient vitamin D and calcium intakes. Public health strategies to improve nutrition in young women are needed, and expanding fortification programs to include all dairy products would be useful.

Dietary Intake Among Opioid- and Alcohol-Using Pregnant Women

ABSTRACTBackground: Substance abuse in nonpregnant adults has been associated with increased intake in calories and decreased intake of nutrient-dense foods; however, studies examining dietary intake in opioid-using and alcohol-using pregnant women are lacking. Objective: The objective of this study was to evaluate dietary intake in opioid-using pregnant women with or without concurrent light-to-moderate alcohol use as compared to abstaining controls. Methods: This prospective birth cohort included 102 pregnant women classified into four study groups: controls (n = 27), medication-assisted treatment (MAT; n = 26), alcohol (ALC; n = 22), and concurrent use of both substances (MAT + ALC; n = 27). Percentage differences in macro- and micronutrient intake were estimated from the food frequency questionnaire and compared among the study groups. Proportions of participants with intakes below the estimated average requirements (EAR) based on diet and diet with supplements were estimated. Results: Three exposed groups had lower prevalence of multivitamin use in periconceptional period (11.5–31.8%) than controls (44.4%). Unadjusted mean energy intake was significantly higher in the MAT + ALC group compared to controls, while micronutrient intake per 1000 kcal was the highest in the control group for almost all of the micronutrients analyzed. After adjustment for energy intake and sociodemographic characteristics, MAT group had lower estimated dietary intake of iron (−15.0%, p = 0.04) and folate (−16.8%, p = 0.04) compared to controls. A high proportion of participants in all study groups had dietary intake below the EAR for vitamin E, iron, and folate.Conclusion: Results highlight the need for targeted dietary interventions for opioid-using pregnant women.

Usual nutrient intakes of US infants and toddlers generally meet or exceed Dietary Reference Intakes: findings from NHANES 2009–2012

Background: To our knowledge, few studies have described the usual nutrient intakes of US children aged <2 y or assessed the nutrient adequacy of their diets relative to the recommended Dietary Reference Intakes (DRIs).Objective: We estimated the usual nutrient intake of US children aged 6–23 mo examined in NHANES 2009–2012 and compared them to age-specific DRIs as applicable.Design: Dietary intake was assessed with two 24-h recalls for infants aged 6–11 mo (n = 381) and toddlers aged 12–23 mo (n = 516) with the use of the USDA’s Automated Multiple-Pass Method. Estimates of usual nutrient intakes from food and beverages were obtained with the use of the National Cancer Institute method. The proportions of children with intakes below and above the DRI were also estimated.Results: The estimated usual intakes of infants were adequate for most nutrients; however, 10% had an iron intake below the Estimated Average Requirement (EAR), and only 21% had a vitamin D intake that met or exceeded the recommended Adequate Intake (AI). More nutrient inadequacies were noted among toddlers; 1 in 4 had a lower-than-recommended fat intake (percentage of energy), and most had intakes that were below the EAR for vitamins E (82%) and D (74%). Few toddlers (<1%) met or exceeded the AI for fiber and potassium. In contrast, 1 in 2 had sodium intakes that exceeded the Tolerable Upper Intake Level (UL); ≥16% and 41% of the children had excessive intakes (greater than the ULs) of vitamin A and zinc, respectively.Conclusions: The estimated usual intakes of infants were adequate for most nutrients. Most toddlers were at risk for inadequate intakes of vitamins D and E and had diets low in fiber and potassium. The sources contributing to excessive intakes of vitamin A and zinc among infants and toddlers may need further evaluation.

Consuming the daily recommended amounts of dairy products would reduce the prevalence of inadequate micronutrient intakes in the United States: diet modelling study based on NHANES 2007–2010

Background: A large portion of Americans are not meeting the Dietary Reference Intakes (DRI) for several essential vitamins and minerals due to poor dietary choices. Dairy products are a key source of many of the nutrients that are under consumed, but children and adults do not consume the recommended amounts from this food group. This study modelled the impact of meeting daily recommended amounts of dairy products on population-based nutrient intakes.Methods: Two-day 24-h dietary recalls collected from participants ≥2 years (n = 8944) from the 2007–2010 What We Eat in America, National Health and Nutrition Examination Survey (NHANES) were analysed. Databases available from the WWEIA/NHANES and the United States Department of Agriculture (USDA) were used to determine nutrient, food group, and dietary supplement intakes. Modelling was performed by adding the necessary number of dairy servings, using the dairy composite designed by USDA, to each participant’s diet to meet the dairy recommendations outlined by the 2010 Dietary Guidelines for Americans. All analyses included sample weights to account for the NHANES survey design.Results: The majority of children 4 years and older (67.4–88.8 %) and nearly all adults (99.0–99.6 %) fall below the recommended 2.5–3 daily servings of dairy products. Increasing dairy consumption to recommended amounts would result in a significant reduction in the percent of adults with calcium, magnesium, and vitamin A intakes below the Estimated Average Requirement (EAR) when considering food intake alone (0–2.0 vs. 9.9–91.1 %; 17.3–75.0 vs. 44.7–88.5 %; 0.1–15.1 vs. 15.3–48.0 %, respectively), as well as food and dietary supplement intake. Minimal, but significant, improvements were observed for the percent of people below the EAR for vitamin D (91.7–99.9 vs. 91.8–99.9 %), and little change was achieved for the large percentage of people below the Adequate Intake for potassium.Conclusions: Increasing dairy food consumption to recommended amounts is one practical dietary change that could significantly improve the population’s adequacy for certain vitamins and minerals that are currently under-consumed, as well as have a positive impact on health.

Consuming the daily recommended amounts of dairy products would reduce the prevalence of inadequate micronutrient intakes in the United States: diet modeling study based on NHANES 2007-2010.

BackgroundA large portion of Americans are not meeting the Dietary Reference Intakes (DRI) for several essential vitamins and minerals due to poor dietary choices. Dairy products are a key source of many of the nutrients that are under consumed, but children and adults do not consume the recommended amounts from this food group. This study modeled the impact of meeting daily recommended amounts of dairy products on population-based nutrient intakes.MethodsTwo-day 24-h dietary recalls collected from participants ≥2 years (n = 8944) from the 2007–2010 What We Eat in America, National Health and Nutrition Examination Survey (NHANES) were analyzed. Databases available from the WWEIA/NHANES and the United States Department of Agriculture (USDA) were used to determine nutrient, food group, and dietary supplement intakes. Modeling was performed by adding the necessary number of dairy servings, using the dairy composite designed by USDA, to each participant’s diet to meet the dairy recommendations outlined by the 2010 Dietary Guidelines for Americans. All analyses included sample weights to account for the NHANES survey design.ResultsThe majority of children 4 years and older (67.4–88.8 %) and nearly all adults (99.0–99.6 %) fall below the recommended 2.5-3 daily servings of dairy products. Increasing dairy consumption to recommended amounts would result in a significant reduction in the percent of adults with calcium, magnesium, and vitamin A intakes below the Estimated Average Requirement (EAR) when considering food intake alone (0–2.0 vs. 9.9–91.1 %; 17.3–75.0 vs. 44.7–88.5 %; 0.1–15.1 vs. 15.3–48.0 %, respectively), as well as food and dietary supplement intake. Minimal, but significant, improvements were observed for the percent of people below the EAR for vitamin D (91.7–99.9 vs. 91.8–99.9 %), and little change was achieved for the large percentage of people below the Adequate Intake for potassium.ConclusionsIncreasing dairy food consumption to recommended amounts is one practical dietary change that could significantly improve the population’s adequacy for certain vitamins and minerals that are currently under-consumed, as well as have a positive impact on health.

Replacing 100% Fruit Juice with Whole Fruit Results in a Trade Off of Nutrients in the Diets of Children

Introduction: The effect of replacing 100% fruit juice (FJ) with whole fruit (WF) on nutrient intake and adequacy in children’s diets is unclear. The objective of this study was to model the effect of replacing FJ with WF in children’s diets. Methods: Data from children 2-18 years of age (n=6,090) participating in the National Health and Nutrition Examination Survey 2007-2010 were examined. Usual intake (UI) of nutrients was determined from the two 24-hour dietary recalls using the National Cancer Institute method. The percent of the population above the Adequate Intake (AI) or below the Estimated Average Requirement (EAR) were determined by two FJ replacement models: 1) FJ was replaced with a composite of the 20 most commonly consumed WF and 2) individual FJs were replaced by the same WF; both models were replaced with cup equivalents. The models were compared to no FJ replacement. Values with non-overlapping 95th confidence limits between no FJ replacement and each of the models were used to assess differences. Results: Model 1 resulted in decreased UI of total sugars (-5.7 grams/day) and vitamin C (-19.8 mg/day), and a higher percentage with intakes below the EAR for vitamin C (+7.7% units). Model 2 resulted in lower UI for vitamin C (-8.4 mg/day), higher UI for dietary fiber (+1.0 grams/day), and a higher percentage with UI above AI for dietary fiber (+1.6 % units). Conclusions: Replacing FJ with WF had only a limited impact on nutrient intake, with a “trade-off” for fiber with vitamin C and total sugars.

Relationships among Socioeconomic Status, Dietary Intake, and Stress in Breastfeeding Women

BackgroundAs breastfeeding duration increases, it is important to understand diets of breastfeeding women and other factors salient to maternal/offspring health, including stress. It is important to further consider sociodemographic factors, given their associations with nutritional deficiencies and perceived stress. ObjectiveWe cross-sectionally compared breastfeeding women’s dietary intakes from a food frequency questionnaire (assessing from pregnancy through 3 months postpartum) with Estimated Average Requirements (EARs). We hypothesized that dietary intake was related to sociodemographic variables and parenting stress. DesignWe examined a cohort of predominately breastfeeding women. Food frequency questionnaire results were compared with EARs, the Parenting Stress Index: Short Form, and a demographic questionnaire. Participants/settingParticipants included 101 women (of 289 recruited) who breastfed singleton, full-term infants for the first 3 months while using <28 oz formula/wk. The study included community recruitment in rural Oklahoma from 2008 to 2012. Statistical analysesMean and standard deviation or frequencies were reported. One-sample t tests compared EARs with mean dietary intakes over the past 12 months. Pearson correlations and one-way analyses of variance explored relationships among dietary, sociodemographic, and stress variables. ResultsTwenty-two percent of women did not meet EAR minimum energy recommendations and >40% did not meet protein recommendations. Despite widespread supplement use, some consumed less than the EAR for vitamin E (35%), calcium (22%), and vitamin C (19%). Carbohydrate consumption was positively related to the difficult child scale (r=0.19; P=0.05). Dietary riboflavin (r=–0.19; P=0.05) and vitamin D intake (r=–0.19; P=0.05) were negatively related to the parent–child dysfunction scale. ConclusionsDespite efforts to enhance education and counseling regarding adequate perinatal nutrition-related practices, even well-educated women may not meet EARs. This poor dietary intake may be associated with parenting stress and have potential long-term implications for child health.

Tree nut consumption is associated with better nutrient adequacy and diet quality in adults: National Health and Nutrition Examination Survey 2005-2010.

Nutrient adequacy of tree nut consumers has not been examined. The National Health and Nutrition Examination Survey 2005–2010 data were used to assess the association of tree nut consumption by adults 19+ years (n = 14,386) with nutrient adequacy and diet quality. Covariate adjusted usual intake was determined using two 24-h dietary recalls and the National Cancer Institute method. Percentages of the consumption groups below the Estimated Average Requirement (EAR) or above the Adequate Intake (AI) were determined. Diet quality was determined using the Healthy Eating Index-2005 (HEI) score. Usual intake data showed consumers of tree nuts had a lower percentage (p < 0.0001) of the population below the EAR for vitamins A (22 ± 5 vs. 49 ± 1), E (38 ± 4 vs. 94 ± 0.4) and C (17 ± 4 vs. 44 ± 1); folate (2.5 ± 1.5 vs. 12 ± 0.6); calcium (26 ± 3 vs. 44 ± 1); iron (3 ± 0.6 vs. 9 ± 0.4); magnesium (8 ± 1 vs. 60 ± 1); and zinc (1.5 ± 1 vs. 13 ± 1). Tree nut consumers had a higher percentage (p < 0.0001) of the population above the AI for fiber (33 ± 3 vs. 4 ± 0.3) and potassium (12 ± 3 mg vs. 2 ± 0.2 mg). HEI-2005 total score was higher (p < 0.0001) in tree nut consumers (61 ± 0.7 vs. 52 ± 0.3) than non-consumers. Health professionals should encourage the use of tree nuts as part of a dietary approach to healthy eating.

Fresh Pear Consumption is Associated with Better Nutrient Intake, Diet Quality, and Weight Parameters in Adults: National Health and Nutrition Examination Survey 2001-2010

No studies have examined the association of consuming fresh pears on nutrient intake or adequacy, diet quality, and cardiovascular risk factors (CVRF). The purpose of this study was to examine these association in adults (N=24,808) participating the NHANES 2001-2010. Covariate adjusted linear regression was used to compare macronutrients, diet quality, and CVRF. Diet quality was determined using the Healthy Eating Index-2010 (HEI- 2010). The National Cancer Institute method was used to estimate the usual intake (UI) of nutrients. Appropriate sample weights were used. Percentages of the population below the Estimated Average Requirement (EAR) or above the Adequate Intake (AI) were determined. Consumers had higher mean intakes of total sugars and lower total, mono-, and saturated fatty acids, and added sugars than non-consumers; consumers also had higher UI for vitamin C, copper, magnesium, and potassium (p<0.01). Consumers had a higher percentage population meeting the EAR for vitamins A and C, copper, and magnesium; consumers had a higher percentage above the AI for fiber (p<0.01). HEI-2010 was higher in consumers (52.4 ± 0.4 vs 48.5 ± 0.3) (p<0.01). Compared to non-consumers, consumers were 35% less likely to be obese (p<0.05). Fresh pears should be encouraged as a component of an overall healthy diet.

Complementary and alternative medicine use and nutrient intake among individuals with multiple sclerosis in the United States.

Individuals with multiple sclerosis (MS) often use complementary and alternative medicine (CAM). However, specific CAM therapies used within this population have not been thoroughly described, particularly the use of supplements, herbal remedies, and dietary modifications. The aim of this pilot study was to determine the prevalence of specific types of CAM used by adults with MS in the United States. Participants included adults who were diagnosed with MS at least 1 year prior to study enrollment. CAM use was measured using the CAM Supplement of the National Health Interview Survey, and nutrient intake was assessed using an Automated Self-Administered 24-h Recall. This study found that a majority (77 %, n = 27) of the sample used CAM within the past 12 months, the most prevalent type being vitamins/minerals (88.9 %, n = 24), nonvitamin, nonmineral, natural products (NP) (44.4 %, n = 12), relaxation techniques (33.3 %, n = 9), and special diets (29.6 %, n = 8). Regarding diet, median percent calories from fat (37 %) and saturated fat (12 %) were higher than current recommendations, while dietary fiber intake met only 87 % of the adequate intake. Participants following the Paleo (7.4 %, n = 2) diet did not meet the Estimated Average Requirement (EAR) for vitamins D and E, while those on the Swank diet (7.4 %, n = 2) were below the EAR for vitamins C, A, E, and folate. The results support previous findings that CAM therapies are commonly used by individuals with MS. Inadequate intakes of certain vitamins and minerals by those following the Swank and Paleo diet suggest these diets may be too restrictive, thus further research is warranted.

Consumption of Breakfast and the Type of Breakfast Consumed Are Positively Associated with Nutrient Intakes and Adequacy of Canadian Adults

Few studies have assessed the associations between breakfast intake and nutrient adequacy [where inadequacy reflects prevalence of usual intakes below the estimated average requirement (EAR) and potential excess reflects the prevalence above the tolerable upper intake level (UL)]. This study examined associations among breakfast, nutrient intakes, and nutrient adequacy in Canadian adults. Respondents aged ≥19 y in the Canadian Community Health Survey 2.2 (n = 19,913) were classified as breakfast nonconsumers (11%), ready-to-eat cereal (RTEC) breakfast consumers (20%), or other breakfast consumers (69%). Nutrient intakes from food (24-h recall) and the prevalence of usual intakes below the EAR and above the UL from food alone and from food plus supplements were compared by breakfast group. Usual intake distributions were estimated using the National Cancer Institute method. Breakfast consumers, and to a greater extent RTEC breakfast consumers, had significantly higher intakes of fiber and several vitamins and minerals than breakfast nonconsumers. Compared with nonconsumers, RTEC and other breakfast consumers had significantly lower prevalences below the EARs for vitamin A and magnesium. The prevalences below the EARs of these nutrients and calcium, thiamin, vitamin D, and iron were significantly lower with RTEC breakfasts than with other breakfasts. Similar patterns were observed from food alone compared with food plus supplements. Breakfast consumption did not affect prevalence above the UL based on food sources, although based on food plus supplements, breakfast consumers had slightly higher proportions that were above the UL than nonconsumers for several nutrients. Breakfast, especially an RTEC breakfast, is associated with improved nutrient adequacy and does not meaningfully affect prevalence above the UL.

Foods, Fortificants, and Supplements: Where Do Americans Get Their Nutrients?

Limited data are available on the source of usual nutrient intakes in the United States. This analysis aimed to assess contributions of micronutrients to usual intakes derived from all sources (naturally occurring, fortified and enriched, and dietary supplements) and to compare usual intakes to the Dietary Reference Intake for U.S. residents aged ≥2 y according to NHANES 2003–2006 (n = 16,110). We used the National Cancer Institute method to assess usual intakes of 19 micronutrients by source. Only a small percentage of the population had total usual intakes (from dietary intakes and supplements) below the estimated average requirement (EAR) for the following: vitamin B-6 (8%), folate (8%), zinc (8%), thiamin, riboflavin, niacin, vitamin B-12, phosphorus, iron, copper, and selenium (<6% for all). However, more of the population had total usual intakes below the EAR for vitamins A, C, D, and E (34, 25, 70, and 60%, respectively), calcium (38%), and magnesium (45%). Only 3 and 35% had total usual intakes of potassium and vitamin K, respectively, greater than the adequate intake. Enrichment and/or fortification largely contributed to intakes of vitamins A, C, and D, thiamin, iron, and folate. Dietary supplements further reduced the percentage of the population consuming less than the EAR for all nutrients. The percentage of the population with total intakes greater than the tolerable upper intake level (UL) was very low for most nutrients, whereas 10.3 and 8.4% of the population had intakes greater than the UL for niacin and zinc, respectively. Without enrichment and/or fortification and supplementation, many Americans did not achieve the recommended micronutrient intake levels set forth in the Dietary Reference Intake.

Fruit juice consumption decreases the proportion of children with inadequate intakes of key nutrients: NHANES 2003–2006

Fruit juice (FJ) consumption has been under scrutiny despite its nutrient profile. NHANES (2003–2006) data were used to compare the proportion of children ages 2–18 years with intakes of selected vitamins/minerals below recommended levels among consumers (n = 3,976; 51% females) and non‐consumers (n = 3,274; 49% females) of FJ. Using the National Cancer Institute method for usual intake estimation, the percentage of the population with intakes less than the Estimated Average Requirement (EAR) was determined; for nutrients with an Adequate Intake (AI) we also compared the percentage of the population that consumed greater than the AI. A Z‐statistic for differences in population proportions was used to determine significance (p &lt; 0.05). Compared to FJ consumers, a significantly higher percentage of non‐consumers had intakes below the EAR for vitamin A (24.4 ± 2.5 vs. 42.2 ± 2.5 %), vitamin C (0.1 ± 0.2 vs. 38.9 ± 4.1 %), folate (8.8 ± 1.5 vs. 22.1 ± 2.4 %), phosphorus (11.6 ± 2.1 vs. 21.3 ± 2.6 %), and magnesium (25.8 ± 1.7 vs. 46.1 ± 2.0 %). A greater percentage of FJ consumers exceeded the AI for calcium (51.3 ± 2.9 vs. 34.1 ± 2.3 %) and potassium (2.4 ± 0.5 vs. 0.5 ± 0.2 %) as compared to non‐consumers. Males and females benefited similarly from FJ consumption. FJ consumption improves nutrient adequacy and should be encouraged. (Supported by USDA and Juice Products Association)

Vitamin A Inadequacy Observed in a Group of 2- to 6-Year-Old Children Living in Kwangju, Republic of Korea

Dietary intakes and plasma concentrations of retinol and carotenoids were estimated in assessing the vitamin A status of young children in Kwangju, Republic of Korea. Three consecutive 24-hour food recalls and fasting blood samples were obtained from 123 healthy children (58 boys, 65 girls), aged 2-6 years. The daily vitamin A intake (mean +/- SD) was 355.9 +/- 178.1 microg retinol equivalents or 239.0 +/- 111.2 microg retinol activity equivalents. Provitamin A carotenoid intakes were 1211.2 +/- 840.0 microg/day beta-carotene, 234.6 +/- 231.7 microg/day alpha-carotene, and 149.1 +/- 160.7 microg/day beta-cryptoxanthin. Approximately 15-26% of subjects consumed < Korean Estimated Average Requirements (EAR) for vitamin A; whereas, 57-64% consumed < EAR for vitamin A for USA/Canadians. The mean plasma retinol concentration was 1.108 +/- 0.244 micromol/L. There were no significant correlations between intakes and plasma concentrations of retinol and carotenoids. Only 2.4% of children were vitamin A-deficient based on having plasma retinol concentrations <0.70 micromol/L. Plasma retinol concentrations of 42.3% of subjects were 0.70 - <1.05 micromol/L, which is considered indicative of potentially suboptimal vitamin A status. Therefore, some children may be at risk of inadequate vitamin A status in Kwangju, Republic of Korea.