Prevalence Of Inadequacy Research Articles

Micronutrient inadequacy differs by intake of fat amount and class among adults that consume a restricted carbohydrate diet: National Health and Nutrition Examination Survey, 2007-2018

BackgroundRestricted carbohydrate diets remain among the most popular for weight loss and general health improvement. Recent evidence demonstrates that carbohydrate restricted diets are low in overall diet quality, yet their association with micronutrient inadequacy has not been well characterized at a population-level in adults in the United States. Objective1) To evaluate the prevalence of not meeting daily micronutrient recommendations in US adults that met the Acceptable Macronutrient Distribution Ranges (AMDRs) and those who restricted carbohydrate to <45% energy, and 2) examine the effect of total fat and fat class on these results for the restricted carbohydrate group. DesignThis study utilized 24-hour recall data on food and nutrient intake from respondents in the National Health and Nutrition Examination Survey (NHANES) 2007-2018. Participants/settingThis study included 15,029 respondents who were ≥20 y, had complete and reliable nutrient intake data, and were not pregnant or breastfeeding. Main outcome measuresThe main outcome was the prevalence of not meeting daily micronutrient recommendations based on Dietary Reference Intakes (DRIs). Statistical analyses performedThe National Cancer Institute’s usual intake methodology was used to estimate usual dietary intake and the prevalence of the US adult population not meeting the DRIs. ResultsCompared to participants that met the AMDRs, those that consumed restricted carbohydrate diets had greater prevalence of inadequacy (% <Estimated Average Requirement) for vitamin A (46.7% vs 33.6%), folate (12.9% vs 4.3%), vitamin C (42.5% vs 23.3%), vitamin D (64.6% vs 61.3%), magnesium (45.2% vs 41.3%), and iron (3.0% vs 1.3%), and lower prevalence of inadequacy for zinc (8.1% vs 12.2%) and vitamins B-12 (1.7% vs 2.8%; P<0.05 for all comparisons). Restricted carbohydrate diet consumers had a lower likelihood of exceeding the Adequate Intake (AI) for vitamin K (57.8% vs 67.6%) and potassium (32.1% vs 39.2%; P<0.001 for both), higher likelihood of exceeding the AI for choline (16.9% vs 5.6%, P<0.001), and a greater proportion exceeded the Chronic Disease Risk Reduction Intake (CDRR) for sodium (92.1 vs 88.5%, P<0.001). Fat amount and class in those consuming restricted carbohydrate diets modified many of these associations, but the effects were heterogenous across micronutrients. ConclusionThis study shows that there are different types of restricted carbohydrate diets that can be characterized by fat amount and class, each with their own association with micronutrient intake. This information can be used by clinicians to provide more targeted dietary counseling to their patients who restrict carbohydrates, depending on the amount and type of fat they consume.

Problematic behaviors at mealtimes and the nutritional status of Brazilian children with Autism Spectrum Disorder.

The aim of this study was to explore problematic behaviors and their association with the food consumption and nutritional status of children with Autism Spectrum Disorder (ASD). This is a cross-sectional study which enrolled 90 Brazilian children (aged 2-10 years) with ASD. A sociodemographic questionnaire, the ASD Eating Behavior Assessment Scale, and the 24-h recall were used. Age, height, total body weight, and Body Mass Index (BMI) were accessed to estimate nutritional status (BMI/Age). Consumption of fruits, vegetables, total calories, macro and micronutrients (calcium, iron, zinc, omega 3 and omega 6), and Body Mass Index (BMI) were assessed. The regression models were adjusted for covariates (prevalence ratio - PR, α = 0.05). All studied children presented problematic behaviors at mealtimes, with a predominance of food selectivity (57.8%), followed by changes in mealtime skills (34.4%), changes in masticatory motor skills (25.6%), oppositional eating behaviors (20.4%), and rigid eating behaviors (20.0%). Food selectivity was associated with excess body weight (PR: 1.94; 95% CI: 1.08-3.51) and absence of vegetable consumption (PR: 0.61; 95% CI: 0.46-0.81). Rigid eating behaviors was associated with low consumption of fiber (PR: 1.42; 95% CI: 1.15-1.75) and zinc (PR: 2.15; 95% CI: 1.33-3.45), and with excessive caloric (PR: 1.14; 95% CI: 1.02-1.29) and lower calcium intake (PR: 0.52; 95% CI: 0.29-0.91). Selectivity and rigidity behaviors have different relationships with food consumption and are associated with a higher prevalence of inadequacies, which may lead to nutritional risks for children. Further studies may investigate the influence of problematic behaviors and excess body weight in ASD.

Association between provegetarian food patterns and micronutrient adequacy in preschoolers: the SENDO project

This study aims to examine the association between different versions of a provegetarian food pattern and micronutrient adequacy in a population of children from the SENDO Project. Children aged 4–5 years old were recruited and baseline information on diet, lifestyle and socio-demographic characteristics was collected through self-administered online questionnaires completed by their parents. Scores were calculated for overall, healthful, and unhealthful provegetarian food patterns (FP) using an a priori approach. Participants were categorized into tertiles according to their scores. Micronutrient adequacy was assessed using the Estimated Average Requirement (EAR) cut-off point. Multivariate analyses were performed to evaluate the relationship between tertiles of each provegetarian FP and the risk of inadequate micronutrient intake (failing to meet ≥ 3 requirements). Despite lower intakes of certain micronutrients, children with higher scores in the healthful provegetarian FP did not exhibit a higher prevalence of inadequacy. Children in the highest tertile of this index had 0.47-fold lower odds (95%CI 0.23–0.95) of having ≥ 3 inadequate micronutrient intakes than their peers in the lowest tertile, after adjusting for potential confounders. In contrast, children in the highest tertile of the unhealthful provegetarian FP had 20.06-fold higher odds (95%CI 9.19–43.79) of having ≥ 3 inadequate micronutrient intakes compared to children in the lowest tertile. Conclusions: Adherence to a healthful provegetarian food pattern is associated with improved nutritional adequacy in preschoolers, while following an unhealthful pattern is detrimental to micronutrient adequacy. These results suggest that moderate reductions in animal food consumption within a healthy diet may not compromise micronutrient adequacy in young children. Further research is needed to explore the impact of diets reduced in animal food intake on the health of children.What is Known:• There's a notable trend towards plant-based diets due to health and sustainability concerns.• Research links plant-based diets in adults with lower risks of obesity, cardiovascular disease, and cancer.What is New:• A new study examines how different versions of a provegetarian food pattern affect micronutrient adequacy in children, using a moderate and stepwise approach.• Following a healthful provegetarian food pattern enhances nutritional adequacy in preschoolers, whereas an unhealthful pattern negatively impacts micronutrient adequacy.

Bouillon fortification as a strategy to address inequities in micronutrient adequacy of diets in Nigeria.

Bouillon is a widely consumed condiment in many West African countries, including Nigeria. Although Nigeria has mandatory fortification standards for multiple food vehicles, bouillon fortification could help address remaining gaps in micronutrient intake. Using household food consumption data, we used the nutrient density method to model the additional contribution of bouillon fortified with vitamin A (40-250µg/g bouillon), folic acid (20-120µg/g), vitamin B12 (0.2-2µg/g), iron (0.6-5mg/g), and zinc (0.6-5mg/g) for meeting micronutrient requirements of women of reproductive age (WRA) and children aged 6-59 months. Accounting for existing fortification programs, our results showed that, except for iron, the prevalence of inadequacy was substantially higher among WRA and children living in poorer and rural households. Given the ubiquity of bouillon consumption, bouillon fortification has the potential to virtually eliminate vitamin A, folate, and vitamin B12 inadequacy, reduce the prevalence of zinc inadequacy by over 20 percentage points, and improve equity in the micronutrient adequacy of diets across socioeconomic strata and urban and rural residence. Our results also suggested that designing a bouillon fortification program would require careful planning to balance reductions in inadequacy with the risk of high intakes. This evidence provides important input into decisions around bouillon fortification in Nigeria.

The potential contributions of bouillon fortification to meeting micronutrient requirements among women and preschool children in Senegal: A modeling study using household consumption and expenditure survey data.

To reduce micronutrient deficiencies, Senegal mandates the fortification of refined oil with vitamin A and wheat flour with iron and folic acid. Expanding Senegal's large-scale food fortification programs to include fortified bouillon could help fill the remaining gaps in dietary micronutrient requirements. Using 7-day household food consumption data collected between 2018 and 2019, we assessed the potential contributions of bouillon fortified with vitamin A (40-250μg/g bouillon), folic acid (20-120μg/g), vitamin B12 (0.2-2μg/g), iron (0.6-5mg/g), and zinc (0.6-5mg/g) for meeting micronutrient requirements of women of reproductive age (WRA; 15-49 years old) and children (6-59 months old). Most households (90%) reported consuming bouillon, including poor and rural households. At modeled fortification levels, bouillon fortification reduced the national prevalence of inadequacy by up to ∼20 percentage points (pp) for vitamin A, 34 pp (WRA) and 20 pp (children) for folate, 20 pp for vitamin B12, 38 pp (WRA) and 30 pp (children) for zinc, and ∼8 pp for iron. Predicted reductions in inadequacy were generally larger among poor and rural populations, especially for vitamins A and B12. Our modeling suggests that bouillon fortification has the potential to substantially reduce dietary inadequacy of multiple micronutrients and could also help address inequities in dietary micronutrient inadequacies in Senegal.

Prevalence of micronutrient inadequacy differs by severity of food insecurity among adults living in Canada in 2015.

Household food insecurity is generally associated with poorer quality diets in Canada, but whether household food insecurity heightens the probability of inadequate micronutrient intakes is unknown. The objective of this research was to investigate how prevalence of micronutrient inadequacy differed by severity of household food insecurity among adults in Canada. Using the 2015 Canadian Community Health Survey Nutrition, this study included participants aged 19-64 years who completed up to two 24 h dietary recalls and provided details about household food insecurity (n=9486). Children and older adults were not included due to sample size limitations. Usual micronutrient intake distributions were estimated by a four-level measure of food insecurity status using the National Cancer Institute method. Welch's t tests assessed differences in prevalence of inadequacy for selected micronutrients. Prevalence differed for some micronutrients among those living in marginally and moderately food insecure compared to food-secure households. The greatest differences in prevalence of inadequacy were observed between severely food-insecure and food-secure households: vitamin A (60.0%, SE=11.9vs. 40.6%, SE=2.7, p<0.0001), vitamin B6 (42.7%, SE=9.1vs. 12.8%, SE=2.5, p<0.0001), folate (39.4%, SE=10.0vs. 15.9%, SE=2.2, p<0.0001), vitamin C (63.3%, SE=5.2vs. 29.1%, SE=2.8, p<0.0001), calcium (78.6%, SE=6.4vs. 58.7%, SE=1.3, p<0.0001), magnesium (75.6%, SE=9.5vs. 48.7%, SE=1.2, p<0.0001), and zinc (34.9%, SE=10.0vs. 23.2%, SE=2.4, p=0.0009). Apparent underreporting also differed by severity of food insecurity, with increased underreporting observed with worsening food insecurity. The probability of inadequate micronutrient intakes among adults rises sharply with more severe household food insecurity in Canada.

Abstract 2198: Poverty, food insecurity, and nutritional inflammatory mediators of allostatic load

Abstract Background: Though widely recognized in cancer pathogenesis, inflammatory pathways of allostatic load remain vaguely understood. A partial explanation may be found within the realm of food insecurity and micronutrient inadequacies, defined as nutrient intake less than the estimated average requirement. Many micronutrient deficiencies contribute to pro-inflammatory and immunocompromised milieus. Inadequacies, however, which may present without overt symptoms, are not currently well studied. The purpose of this study was to examine relationships between known inflammation-associated nutritional biomarkers of micronutrients and biomarker variables of allostatic load. Methods: Using NHANES 2017/2018 surveys, adults &amp;gt; 18 years without renal or hepatic disorders, pregnancy, alcohol, or supplement use were included. Plasma levels of vitamins A, B9, C, D, E, calcium (Ca), ferritin (Fe), phosphorus (P), potassium (K) and sodium (Na) were grouped into deficiency, inadequate and adequate groups based on clinically recognized standards. Micronutrient prevalence was assessed and variables of allostatic load [blood pressure, glucose, albumin, creatinine, red cell distribution width (RDW), high density lipoprotein (HDL), low density lipoprotein (LDL), cholesterol and triglycerides] were analyzed for mean differences among micronutrient groups, food security and poverty. Results: From 3,317 unique participants, inadequacy prevalence percentages were quantified as: vitamins A (0.4%), B9 (12.2%), C (58.3%), D (39.6%), E (21.0%), P (11.4%), K (3.4%), Na (24.2%), Ca (59.5%), and Fe (37.4%) [p &amp;lt; 0.001]. Statistically significant differences were identified in age [C, D, E, Ca, Fe, P, Na (p &amp;lt; 0.004)], race/ethnicity [B9, C, D (p &amp;lt; 0.006)], gender [C, E, Ca, Fe, P, K, Na (p &amp;lt; 0.018)], poverty [A, B9, C, D, E, Fe, K (p &amp;lt; 0.025)], and food security [B9, C, D, E, P (p &amp;lt; 0.032)]. Associations to allostatic load were discovered in: albumin [A, C, D, Ca, Fe, P, Na (p &amp;lt; 0.025)], glucose [C, E, Fe, P, Na (p &amp;lt; 0.009)], HDL [C, D, E, Fe, P, K (p&amp;lt;0.045)], LDL [E, Ca, Fe, Na (p&amp;lt;0.028)], creatinine [C, D, Ca, Fe (p&amp;lt;0.001)], triglycerides [B9, D, E, Fe (p&amp;lt;0.033)], cholesterol [C, D, E, Ca, Fe, Na (p&amp;lt;0.006)], B/P [C, E, Fe, P, Na (p &amp;lt; 0.035)], and RDW [C, D, Ca, Fe (p &amp;lt; 0.001)]. Poverty was significantly associated with all variables of allostatic load (F = 2.85, p = 0.002). Food security was significantly correlated with albumin (p &amp;lt; 0.001), glucose (p = 0.005) and HDL (p &amp;lt; 0.001). Conclusion: Allostatic load, poverty, and food security were significantly associated with subclinical micronutrient statuses, which may not present with signs of deficiency and are not currently well assessed. Similarly, poverty was significantly associated with all variables of allostatic load, though food security was only identified to be associated with albumin, glucose, and HDL, suggesting that food security may not be currently adequately defined for surveillance. Citation Format: Jennifer M. Crook, Eunkyung Lee, Opeyemi Bolajoko, Rui Xie. Poverty, food insecurity, and nutritional inflammatory mediators of allostatic load [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2198.

Iodine intake in the Swiss population 100years after the introduction of iodised salt: a cross-sectional national study in children and pregnant women.

The Swiss voluntary salt iodisation programme has successfully prevented iodine deficiency for 100years, but dietary habits are changing and todayonly one-third of processed foods contain iodised salt. We aimed to monitor the current iodine status in childrenand pregnant women. We conducted a nationwide cross-sectional study in children (6-12years) and pregnant women and measured the urinary iodine concentration (UIC) in spot urine samples. We estimated the iodine intake using UIC and urinary creatinine concentration (UCC) and determined the prevalence of intakes below the average requirement (AR) using the SPADE method. We measured dried blood spot (DBS) thyroglobulin (Tg), TSH and total T4 in pregnant women. The median UIC was 127μg/L (bootstrapped 95% CI 119, 140, n = 362) in children and 97μg/L (bootstrapped 95% CI 90, 106, n = 473) in pregnant women. The estimated prevalence of inadequate iodine intake (< 65μg/day) was 5.4% (bootstrapped 95% CI 0.0, 14.6) in children. Half (47%) of the women consumed iodine-containing multivitamin and mineral supplements (≥ 150μg/day). Compared to non-users, users had higher median UIC (129 vs. 81μg/L, P < 0.001), lower prevalence of inadequacy (< 160μg/day; 0.2 vs. 31%) and lower DBS-Tg (23 vs. 29μg/L, P < 0.001). All women were euthyroid. The Swiss diet and current salt fortification provides adequate iodine intake in children, but not in all pregnant women. Iodine supplements cover the dietary gap in pregnancy but are not universally consumed. Therefore, improved use of iodised salt in processed foods is desired to ensure adequate iodine intake in all population groups. This trial was registered at clinicaltrials.gov as NCT04524013.

A Landscape of Micronutrient Dietary Intake by 15- to 65-Years-Old Urban Population in 8 Latin American Countries: Results From the Latin American Study of Health and Nutrition.

Latin American countries have shifted from traditional diets rich in micronutrients to a Westernized diet rich in high energy-dense foods and low in micronutrients. This study aimed to determine the prevalence of adequate micronutrient intakes in urban populations of 8 Latin American countries. Micronutrient dietary intake data were collected from September 2014 to August 2015 from 9216 men and women aged 15.0 to 65.0 years living in urban populations of 8 Latin American countries. Dietary intake was collected using two 24-hour recalls on nonconsecutive days. Micronutrient adequacy of intake was calculated using the Estimated Average Requirement cut-off method. In general terms, the prevalence of inadequate intake of thiamine, riboflavin, niacin, folate, cobalamin, iron, phosphorus, copper, and selenium ranged from 0.4% to 9.9%. In contrast, the prevalence of inadequacy of pyridoxine, zinc, vitamin C, and vitamin A ranged from 15.7% to 51.5%. The nutrients with a critical prevalence of inadequacy were magnesium (80.5%), calcium (85.7%), and vitamin D (98.2%). The highest prevalence of inadequate intakes was observed in the low educational level, participants with overweight/obesity, in men, and varies according to socioeconomic status. There is an urgent need to define direct regional actions and strategies in Latin America aimed at improving micronutrient adequacy, either through staple food fortification programs, agronomic biofortification, or food policies that facilitate economic access to micronutrient-rich foods.

Iron-Fortified Foods Are Needed To Meet the Estimated Average Requirement for Iron in Australian Infants Aged 6 to 12 Months

BackgroundMeeting iron intake recommendations is challenging for infants 6–12 mo, especially breastfed infants. Three-quarters of Australian infants 6–12 mo have iron intakes below the estimated average requirement (7 mg), placing them at risk of iron deficiency. After 6 mo, breastmilk is no longer sufficient to meet the increased demand for iron, and iron-rich complementary foods are recommended. Iron-fortified foods may be a means of improving iron intake in infants, particularly those that are breastfed. ObjectivesThe aims of the study were as follows: 1) to examine the effect of milk-type and fortified foods on iron intake and the prevalence of inadequacy in infants 6–12 mo; 2) to model the effect of fixed amounts of iron-fortified infant cereal (IFIC) at 6 levels of iron fortification on total iron intake and the prevalence of inadequacy; and 3) to assess the effect IFIC on the intake of other nutrients in the diet. DesignSecondary analysis of cross-sectional dietary intake data of infants 6–12 mo (n = 286) participating in the Australian Feeding Infants and Toddlers Study (OzFITS) 2021. ResultsMedian (interquartile range) iron intake was 8.9 (7.5, 10.3); 6.3 (4.5, 8.2); and 2.7 (1.5, 4.4) mg/d in formula-fed, combination-fed, and breastfed infants, respectively. The corresponding prevalence of inadequacy was 19%, 67%, and 96%. Infants who consumed fortified foods had higher median iron intakes than those who did not, 6.2 compared with 1.9 mg/d. Dietary modeling showed that consuming 18 g (300 kJ) of IFIC, fortified at 35 mg/100 g dry weight, reduces the prevalence of inadequacy for iron from 75% to 5% for all infants. ConclusionsIron intakes are low in Australian infants, especially for breastfed infants in the second half of infancy. Modeling shows that 300 kJ of IFIC, the current manufacturer-recommended serving, fortified at 35 mg/100 g dry weight, added to infant diets would be an effective means to reduce the prevalence of inadequacy for iron.

Nutrition Literacy Level in Bank Employees: The Case of a Large Brazilian Company.

Nutrition Literacy (NL) positively impacts diet quality and has the potential to promote health and prevent nutrition-related chronic diseases. Brazil is one of the countries with the highest rates of nutrition-related chronic diseases. Nevertheless, in Brazil, few studies have explored the NL levels of its population. To provide remote access to the Nutrition Literacy Assessment Instrument for Brazilians (NLit-Br) and assess Brazilian bank employees, we conducted a study to estimate the validity of the NLit-Br online and to investigate whether bank employees have an adequate NL level. In the first step, we randomly assigned 21 employees from three financial institution branches to two groups to complete NLit-Br paper and online versions. After an interval period, both groups completed the NLit-Br with an opposite delivery method (paper vs. online). We compared the validity of the digital and paper versions of the NLit-Br by the Intraclass Correlation Coefficient (ICC), and the reliability by Kuder-Richardson formula 20. Second, we evaluated 1174 bank employees using the NLit-Br online version. We found an excellent absolute agreement (ICC ≥ 0.75) between the paper and online versions. The questionnaire had good internal consistency (KR-20 = 0.64). The sample was characterized as mostly male (61.0%), married/cohabitant (73.8%), and white (69.8%), with high household income (85.2%), and graduated or postgraduate (97.4%). The mean age of the population was 42.1 (SD = 7.6) years. Subjects predominantly had possibly inadequate NL (62.3%). The online NLit-Br total score was significantly associated with gender, age, and household income (p < 0.05). Women and individuals with higher incomes had a higher degree of NL. Subjects over 50 years old had a lower degree of NL. There was no significant association between the NLit-Br score and the participants' education. The NLit-Br online is a valid instrument to assess NL remotely. The population studied showed a high prevalence of inadequacy of the NL. Therefore, there is a need for targeted actions to improve the NL of bank employees.

Estimating habitual iodine intake and prevalence of inadequacy from spot urine in cross-sectional studies: a modeling analysis to determine the required sample size

BackgroundThe habitual/usual iodine intake and the prevalence of iodine inadequacy may be estimated from spot urinary iodine concentrations in cross-sectional studies by collecting a repeat spot urine in a subgroup of the study population and accounting for within-person variability in iodine intake. However, guidance on the required overall sample size (N) and the replicate rate (n) is lacking. ObjectivesTo determine the sample size (N) and replicate rate (n) needed to estimate the prevalence of iodine inadequacy in cross-sectional studies. MethodsWe used data from local observational studies conducted in women 17–49 y old in Switzerland (N = 308), South Africa (N = 154), and Tanzania (N = 190). All participants collected 2 spot urine samples. We calculated the iodine intake using urinary iodine concentrations and accounted for urine volume using urinary creatinine concentration. For each study population, we estimated the habitual iodine intake distribution and determined the prevalence of iodine intake below the average requirement using the Statistical Program to Assess habitual Dietary Exposure (SPADE). We used the obtained model parameters in power analyzes and estimated the prevalence of iodine inadequacy for different sample sizes (N = 400, 600, and 900) and replicate rates (n = 50, 100, 200, 400, 600, and 900). ResultsThe estimated prevalence (95% CI) of inadequate iodine intake was 21% (15, 28%), 5.1% (1.3, 8.7%), and 8.2% (3.4, 13%) for Swiss, South African, and Tanzanian women, respectively. An N of 400 women, with a repeated measure (n) in 100 women, achieved a satisfactory precision of the prevalence estimate in all study populations. Increasing the replicate rate (n) improved the precision more effectively than increasing the N of the study. ConclusionsThe sample size for cross-sectional studies aiming to assess the prevalence of inadequate iodine intake depend on the expected prevalence, the overall variance in intake, and the study design. However, an N of 400 participants with a repeated measure of 25% may be used as guidance when planning observational studies applying simple random sampling.This trial was registered at clinicaltrials.gov as NCT03731312.

Higher adherence to the EAT-Lancet reference diet is associated with higher nutrient adequacy in the NutriNet-Santé cohort: a cross-sectional study

BackgroundIn 2019, the EAT-Lancet Commission proposed a planetary and healthy reference diet; however, its nutritional quality has been rarely evaluated. ObjectiveAcross different adherence levels to the EAT-Lancet reference diet, the following were our objectives:1) describe the food and nutritional intakes of the French population, 2) evaluate the nutrient quality, and 3) investigate the consistency between the French national recommendations and the EAT-Lancet reference diet. MethodsThis cross-sectional study was conducted among participants of the NutriNet-Santé cohort, and the sample was weighted on the characteristics of the general French population. Adherence to the EAT-Lancet reference diet was estimated using the EAT-Lancet Diet Index (ELD-I). Usual nutrient intakes were obtained using the variance reduction method. We used the estimated average requirements cut-point method to estimate the proportion of participants who meet their respective nutritional requirements. Furthermore, the adequacy of the French food-based dietary recommendations [Programme National Nutrition Santé (PNNS)] according to adherence to the EAT-Lancet reference diet was studied. ResultsThe weighted sample was composed of 98,465 participants. Except for bioavailable zinc and vitamin B12, we observed a decrease in the nutrient inadequacy prevalence when the adherence to the EAT-Lancet reference diet increased, particularly for vitamin B9 (Q1 = 37.8% compared with Q5 = 5.5%, P < 0.0001) and vitamin C (Q1 = 59.0% compared with Q5 = 10.8 %, P < 0.0001). However, inadequacy prevalence remained high in all ELD-I quintiles, particularly for fiber (95.9%), vitamin B1 (70.8%), iodine (48.4%), and magnesium (76.8%). Higher ELD-I score was associated with higher adherence for most components of the PNNS, except for food groups that are not specifically included in the EAT-Lancet reference diet and are typical of the French diet, including alcohol, processed meat, and salt. ConclusionIn the French context, although issues with the intake of certain nutrients may occur, a diet that remains within the planetary limits as the EAT-Lancet reference diet allows a favorable nutritional quality.This trial was registered at clinicaltrials.gov as NCT03335644.

Dietary diversity and micronutrients adequacy among the women of reproductive age at St. Martin’s island in Bangladesh

Minimum dietary diversity for women, an important dimension of diet quality, has been widely used as a proxy indicator for micronutrient adequacy. In low- and middle-income countries (LMICs), women of reproductive age (WRA) particularly are at high risk of inadequate micronutrient intake resulting from poor diversified diets. Therefore, the present study aimed to assess dietary diversity and micronutrients adequacy in the diets of WRA of St. Martin’s island, along with their socio-economic determinants. A cross-sectional study was conducted on a representative sample of 201 WRA living at St. Martin’s island. Utilizing the Estimated Average Requirement (EAR) cut-point approach, the adequacy of micronutrient intake was evaluated from observed 24-h recall dietary data. The recent guideline of FAO was employed to evaluate Minimum Dietary Diversity for Women (MDD-W). Binary logistic regression and multiple linear regression analyses were performed to identify socio-economic determinants of MDD-W and micronutrients adequacy. The mean (SD) dietary diversity score was 4.25 (1.17) and about 40.3% of the participants met the MDD-W cut-off. Starchy staples (100%), meat/poultry/fish (87%), and other vegetables (79%) were consumed more frequently, while, the least reported food groups were dairy (2%), nuts and seeds (11%), and vitamin A-rich fruits and vegetables (11%). Except for Niacin, intake of all micronutrients was inadequate, with an inadequacy prevalence of 36–100%. Educational level, and decision-making role of women were significantly related to their dietary diversity. On the other hand, age, decision-making role, and MDD-W were important determinants of micronutrient adequacy. In conclusion, the WRA of St. Martin's island consumed neither a sufficient amount of micronutrients nor an adequate diversity of foods. In addition, several socio-economic components are linked with dietary diversity and micronutrient adequacy. Therefore, attention is needed to decide on the best strategies to improve the quality of diet and dietary diversity for WRA in this setting.

Vitamin D Status of People 3 to 79 Years of Age from the Canadian Health Measures Survey 2012–2019

BackgroundVitamin D is recognized in bone health and the prevention of rickets and osteomalacia. ObjectiveThis study aimed to assess vitamin D status of people in Canada and to identify factors associated with vitamin D inadequacy and deficiency. MethodsSerum 25-hydroxyvitamin D (25(OH)D) from the Canadian Health Measures Survey (cycles 3–6, n = 21,770, 3–79 y) were evaluated for geometric means and proportions <40 (inadequate) and <30 (risk of deficiency) nmol/L. Factors associated with inadequacy or deficiency were tested using logistic regression. ResultsMean serum 25(OH)D was 57.9 (95% CI: 55.4, 60.5) nmol/L; the prevalence of inadequacy was 19.0% (95% CI: 15.7, 22.3) and risk of deficiency was 8.4% (95% CI: 6.5, 10.3). Prominent dietary factors associated with inadequacy in adults included: not consuming fish compared with ≥1/wk (adjusted ORadj: 1.60; 95% CI: 1.21, 2.11), none compared with ≥1/d for cow’s milk (ORadj: 1.41; 95% CI: 1.02, 1.94) or margarine (ORadj: 1.42; 95% CI: 1.08, 1.88); or nonuser compared with user of vitamin D supplements (ORadj: 5.21; 95% CI: 3.88, 7.01). Notable demographic factors included: younger adults compared with 71 to 79 y (19–30 y ORadj: 2.33; 95% CI: 1.66, 3.29); BMI ≥30 compared with <25 kg/m2 (ORadj: 2.30; 95% CI: 1.79, 2.95); lower household income quartile 1 compared with 4 (ORadj: 1.46; 95% CI: 1.00, 2.15); and self-reported Black (ORadj: 8.06; 95% CI: 4.71, 13.81), East/Southeast Asian (ORadj: 3.83; 95% CI: 2.14, 6.85), Middle Eastern (ORadj: 4.57; 95% CI: 3.02, 6.92), and South Asian (ORadj: 4.63; 95% CI: 2.62, 8.19) race compared with White. Similar factors were observed in children and for deficiency. ConclusionsMost people in Canada have adequate vitamin D status; nonetheless, racialized groups have an elevated prevalence of inadequacy. Further research is required to evaluate if current strategies to improve vitamin D status, including increasing vitamin D in fortified foods and supplements, and dietary guidance to include a source of vitamin D every day help to reduce health inequality in Canada.

Correction: Moumin et al. Usual Nutrient Intake Distribution and Prevalence of Inadequacy among Australian Children 0–24 Months: Findings from the Australian Feeding Infants and Toddlers Study (OzFITS) 2021. Nutrients 2022, 14, 1381

The authors would like to correct an error in their recently published paper [...].

Improving Pregnant Women’s Iodine Intake Estimates and Its Prevalence of Inadequacy through the Use of Salt and Seasoning Covariates

(1) Measuring usual iodine intake is a complex task due to the food consumption variability and its natural concentration in food. Therefore, the use of covariates to adjust statistical methods to estimate usual intake could improve the estimates obtained through dietary surveys. This study aims to evaluate the influence of salt and seasoning usage covariates on the estimates of usual iodine intake and the prevalence of its inadequacy. (2) A cross-sectional study was conducted with Brazilian pregnant women's food consumption data obtained with 24-h recall (n = 2247). The usual iodine intake was adjusted for intraindividual variability, supplement use, temporal effects, data collection methods, and sociodemographic characteristics with the tool UCD/NCI SIMPLE in the SAS software. Then, salt and seasoning usage covariates were used to adjust the distribution. The harmonized intake reference values for populations were used to assess intake adequacy. (3) The adjustments for salt and seasoning usage yielded a higher mean of usual iodine intakes. The only exception was the adjustment for the "habit of adding salt to meals after preparing/cooking", which produced a lower mean of usual intake and increased the prevalence of insufficient intake. (4) Salt and seasoning usage covariates affect the estimates evaluated. However, more studies are necessary to evaluate the influence observed.

Prevalência de inadequação e fatores associados à ingestão adequada de minerais em adolescentes e adultos jovens brasileiros

ABSTRACT Objective To describe the prevalence of inadequate mineral intake and associated factors with calcium, iron, zinc, magnesium, phosphorus, and sodium intakes in individuals aged 15-24.9 years. Methods We analyzed 476 individuals from the Brazilian Study of Nutrition and Health, stratified into two age groups (adolescents aged 15-18.9 years and young adults aged 19-24.9 years). Mineral intake was obtained from two 24-hour Dietary Recalls. The values of the Estimated Average Requirement and the Tolerable Upper Intake Levels were considered to calculate the prevalence of inadequacy. Multiple logistic regression was used to determine associated factors with mineral intake. Results Calcium and magnesium had the highest prevalence of inadequacy (&gt;83%) in both sexes and age groups. Sodium intake was above Tolerable Upper Intake Levels for the majority of the population studied (&gt;68%). The intake of all minerals was different between the sexes for the two age groups (p&lt;0.01), and it was not different between age groups (p&gt;0.05). The associated factors with mineral intake were sex (calcium, iron, phosphorus, and sodium), age group (calcium, magnesium, phosphorus, and sodium), and physical activity (calcium, iron, and magnesium), followed by socioeconomic level (zinc and sodium) and body weight status (iron and sodium). Conclusion The expressive portion of the studied population is at nutritional risk for calcium, magnesium, and sodium. Such data can contribute to the national public policy revision that is related to micronutrient intake and the adoption of healthier habits by adolescents and young adults.

Serum 25 hydroxyvitamin D concentrations in individuals over 80 years old and their correlations with musculoskeletal and health parameters.

The present study aims to evaluate the serum concentrations of 25 hydroxyvitamin D[25(OH)D] in individuals aged ≥80 years, independent, free-living in Sao Paulo, Brazil (Lat 23.5 oS), and to investigate their associations with musculoskeletal system, physical performance and health markers. This cross-sectional study included 212 community dwellers aged ≥80 years and evaluated serum 25(OH)D, PTH, calcium, albumin, phosphorus, creatinine, bone markers, and bone mineral density. Physical performance was evaluated with stationary march, Flamingo, and functional reach tests, questionnaires to assess falls and fractures in the previous year, energy expenditure (MET), and Charlson index. Physical activity was evaluated with the International Physical Activity Questionnaire. Vitamin D deficiency (<20 ng/mL) was observed in 56% and severe vitamin D deficiency (<10 ng/mL) in 13% of those individuals. Serum concentrations of 25(OH)D were significantly and positively associated with BMD total hip (p = 0.001), femoral neck (p = 0.011) and 33% radius (p = 0.046) BMDs, MET (p = 0.03) and functional reach test (p = 0.037) and negatively with age (p = 0.021), PTH (p = 0.004) and osteoporosis diagnosis (p = 0.012). Long-lived individuals with 25(OH)D ≥ 20 ng/mL had higher total hip and femoral neck BMDs (p = 0.012 and p = 0.014, respectively) and lower PTH (p = 0.030). In multiple linear regression analysis, age and osteoporosis diagnosis remained negatively associated with 25(OH)D levels (p = 0.021 and p = 0.001, respectively), while corrected calcium and cholecalciferol use remained positively associated (p = 0.001 and p = 0.024, respectively). We observed high vitamin D inadequacy prevalence in those Brazilian community dwellers' oldest old. Serum concentrations of 25(OH)D were positively associated with bone mass and dynamic balance, and negatively with PTH and osteoporosis diagnosis. Additionally, 25(OH)D ≥ 20 ng/mL was associated with better bone mass and lower PTH levels.

Adequacy of calcium and vitamin D nutritional status in a nationally representative sample of Irish teenagers aged 13–18 years

Context and purposeIn light of the key roles of vitamin D and calcium in adolescent bone health, there is a critical need for representative data on nutritional status for both micronutrients in teenagers. The present work used data from the recent representative National Teens’ Food Survey II (2019–2020) to assess calcium and vitamin D intakes of teenagers in Ireland, including adequacy of such intakes, as well as, for the first time, to characterise serum 25-hydroxyvitamin D (25(OH)D) concentrations and their determinants.MethodsUsual calcium and vitamin D intake estimates were generated using food intake data (via 4-day weighed food records) from a nationally representative sample of teenagers aged 13–18 years in Ireland (n 428). Serum 25(OH)D was measured (via LC–MS/MS) in the 57.5% (n 246) who provided a blood sample.ResultsSixty-seven and 94% of Irish teenagers had intakes of calcium and vitamin D below the respective Estimated Average Requirements values, reflecting a high degree of inadequacy of intake for both micronutrients (and higher in girls than boys; P < 0.001). In addition, 21.7% and 33.1% of teenagers had serum 25(OH)D < 30 nmol/L (risk of vitamin D deficiency) and 30–49.9 nmol/L (inadequacy), respectively. Extended winter sampling, being aged 16–18 years, low total vitamin D intake, being overweight/obese or being of non-white skin type were significant (P < 0.05) predictors of serum 25(OH)D < 30 nmol/L.ConclusionsThere was a high prevalence of inadequacy of intake of calcium and vitamin D in Irish teenagers, and a fifth were at increased risk of vitamin D deficiency.