Prevalence Of Inadequate Vitamin Research Articles

Association of Vitamin D Intake in Pregnant Women and Birth Weight

Background: Insufficient maternal consumption of vitamin D can have adverse effects on fetal development and increase the likelihood of low birth weight. This research aimed to establish the correlation between the quantity of vitamin D consumed by expectant mothers and the weight of newborns. Methods: This study utilized an analytical observational design with a cross-sectional approach, collecting data from August to November 2022. Information on Vitamin D intake and birthweight was obtained via questionnaire interviews with 96 pregnant women delivering at the University of North Sumatera Hospital or Maharani Women’s and Children Hospital. Semi-Food Frequency Questionnaires (FFQs) served as the data collection instrument. Non-probability consecutive sampling was employed. Statistical techniques, including Chi-square and Fisher's Exact test, were used for data analysis. Findings indicated a prevalence of inadequate vitamin D intake among mothers (3.125%). The mean daily consumption of vitamin D among expectant women was 19.99 μg/day. Mother's education level did not significantly influence the outcome (p=0.589). Results: The results of this study suggest that there was no significant association between maternal age at pregnancy (p=0. 135), gestational age (p=0. 771), parity (p=0958), and baby's sex (p=0. 448) with birth weight. Conclusion: An observed association existed between the prenatal intake of vitamin D and neonatal birth weight in expectant mothers.

Dietary Intake of Micronutrients and Disease Severity in Patients with Amyotrophic Lateral Sclerosis.

Vitamins and essential metals have been studied as potential risk and prognostic factors in amyotrophic lateral sclerosis (ALS). This study aimed to evaluate the prevalence of inadequate micronutrient intake in ALS patients, comparing subgroups according to the disease severity. Data were obtained from the medical records of 69 individuals. Assessment of disease severity was determined by the revised ALS Functional Scale (ALSFRS-R), using the median as the cutoff. The prevalence of inadequate micronutrient intake was estimated using the Estimated Average Requirements (EAR) cut-point method. The prevalence of inadequate vitamin D, E, riboflavin, pyridoxine, folate, cobalamin, calcium, zinc, and magnesium intake was considered severe. Patients with lower ALSFRS-R scores had lower intakes of vitamin E (p < 0.001), niacin (p = 0.033), pantothenic acid (p = 0.037), pyridoxin (p = 0.008), folate (p = 0.009) and selenium (p = 0.001). Therefore, ALS patients should be monitored regarding dietary intake of micronutrients essential in neurological processes.

Vitamin D Deficiency Prevalence in Hospitalized Patients with COVID-19 Significantly Decreased during the Pandemic in Slovakia from 2020 to 2022 Which Was Associated with Decreasing Mortality.

The coronavirus disease 2019 (COVID-19) pandemic has led to changes in lifestyle, which could influence vitamin D status on a population level. The purpose of our study was to compare 25-hydroxyvitamin D (25[OH]D) levels in patients hospitalized because of severe COVID-19 during two waves of the pandemic (2020/21 vs. 2021/22). A total of 101 patients from the 2021/22 wave were compared with 101 sex- and age-matched subjects from the 2020/21 wave. Patients from both groups were hospitalized during the winter season from 1 December to 28 February. Men and women were analyzed together and separately. The mean 25(OH)D concentration increased from 17.8 ± 9.7 ng/mL to 25.2 ± 12.6 ng/mL between waves. The prevalence of vitamin D deficiency (<20 ng/mL) decreased from 82% to 54%. The prevalence of adequate serum 25(OH)D concentration (>30 ng/mL) increased from 10% to 34% (p < 0.0001). The proportion of patients with a history of vitamin D supplementation increased from 18% to 44% (p < 0.0001). Low serum 25(OH)D concentration was independently associated with mortality after adjusting for age and sex for the whole cohort of patients (p < 0.0001). The prevalence of inadequate vitamin D status in hospitalized patients with COVID-19 in Slovakia decreased significantly, probably due to a higher rate of vitamin D supplementation during the COVID-19 pandemic.

Dietary inadequacies overestimate the blood deficiencies of magnesium, zinc, and vitamins A, C, E, and D among residents of Sao Paulo

We aimed to estimate the prevalence of the inadequate intake and status of magnesium, zinc, and vitamins A, C, E, and D and identify factors associated with micronutrient deficiency in serum/plasma among residents of São Paulo, Brazil. Data from 824 individuals aged ≥14 years were obtained from the 2015 ISA-Nutrition, a population-based, cross-sectional survey. Dietary and supplement intakes were assessed using two 24-h dietary recalls, and the micronutrient inadequacies were estimated using the National Cancer Institute method. Micronutrient status was measured in serum or plasma, and deficiency was established according to the lower limit of the reference values. Receiver operating characteristic curve analysis was used to identify the effect of intake on the micronutrient status in serum/plasma. Logistic regression analysis was applied to assess the association between micronutrient status and individual characteristics. More than 80% of the population had an inadequate dietary intake of magnesium, vitamin E, and vitamin D. Males had a high prevalence of inadequate dietary intake of vitamin A and zinc. A high-to-moderate prevalence of inadequate vitamin C intake was observed. Vitamin D was the only nutrient with a deficient status comparable to its dietary inadequacy. The other nutrients demonstrated a lower deficiency prevalence compared to dietary inadequacy, and vitamin A demonstrated the lowest prevalence of deficiency in plasma. Generally, dietary intake showed a non-notable association with micronutrient deficiency in serum/plasma. Individuals with fasting glucose concentrations ≥100mg/dL and those using diuretic drugs had a higher risk of serum magnesium deficiency. Those using lipid-lowering drugs and those with high plasma adiponectin concentrations had a higher risk of serum zinc deficiency. Individuals who smoked and those with hypertension showed a higher risk of plasma vitamin C deficiency. Individuals with average leptin concentrations had a higher risk of plasma vitamin E deficiency. Finally, those with sufficient leisure-time physical activity had a lower risk of serum vitamin D deficiency. Residents of the urban areas of São Paulo demonstrated substantially inadequate intakes of most of the assessed micronutrients; however, micronutrient deficiency in serum/plasma was not associated with dietary inadequacy, and it usually demonstrated a lower prevalence than dietary indicators. Thus, using micronutrient intake to determine the serum/plasma profile should be done with caution. The status of the micronutrients varied according to individual characteristics, indicating the interplay of complex mechanisms underlying micronutrient balance.

Prevalence of inadequate vitamin D level and its predictors in children presenting with torus fractures.

Review of the published articles does not show any study done to see if children with torus fracture are with Vitamin D deficiency. The aim of this study was to determine association of inadequacy of Vitamin D level with torus fracture and its predictors in children in Karachi Pakistan. Patient underage of 13years came with torus fracture were included in study, and managed non-operatively with below elbow cast. Proforma was made which includes demographic data (age, gender, nutritional status) and exposure to sunlight, dietary habits, kind to apparel and type of accommodation they were living at. All participants underwent measurement of serum vitamin D level. Out of 558 children presented with limb fractures in emergency department, 190 (34.05%) had torus fracture, with mean age of 6.0 ± 4.2years. 93 (48.94%) in pre-school group, 59 (31.05%) in school and 38 (20%) were breast-fed. On nutritional status, malnourished were 72 (37.89%), out of which 32 (44.44%) had first-degree malnutrition. On vitamin D level status only 52 (27.36%) participants had Vitamin D within normal range while 86 (45.26%) were found Vitamin D deficient. We found that vitamin D level is directly related to nutritional status, duration of sun exposure maternal vitamin d levels and not significantly related to age, gender, type of accommodation and different fabric types. In this study torus fracture in children is significantly associated with Vitamin D deficiency, with common predictors including nutritional status, maternal Vitamin D level for lactating mothers and duration of exposure of sunlight. Vitamin D supplementation in children can prevent a significant number of fractures via national programs for food fortification and increase the awareness of general population on the importance of sunlight exposure and intake of food rich in Vitamin D.

Decreased Vitamin C Intake from Food and Supplements in the US Pregnant and Non-Pregnant Population: From NHANES 1999–2018

ObjectivesTo examine how vitamin C intake among women of reproductive age changed from 1999 to 2018 using data from 10 cycles of the National Health and Nutrition Examination Survey (NHANES) from 1999–2000 to 2017–2018.MethodsUsual vitamin C intake and prevalence of inadequate intake were estimated among pregnant and non-pregnant women 20–44 y who participated in NHANES 1999–2018 (n = 11,129), using the National Cancer Institute Method. Covariates included dietary recall sequence, intake day of the week, and dietary supplement use. Regression models were used to test for trends in vitamin c intake from foods, supplements, foods and supplements combined, and prevalence of inadequate vitamin C intake over 10 cycles of NHANES.Results1,392 were pregnant at the time of the exam. Vitamin C intake from foods alone in pregnant women decreased from 125 ± 6.7 mg in 1999–2000 to 103 ± 5.3 mg in 2017–2018 (p for trend = .0003). Supplemental vitamin c intake among pregnant women decreased from 140 ± 2.8 mg in 1999–2000 to 56 ± 0.9 mg in 2009–2010, followed by an apparent plateau between 2011–2018 (p for trend = .02). Consequently, intake foods and supplements combined decreased from 265 ± 31.9 mg in 1999–2000 to 158 ± 16.7 mg in 2017–2018 (p for trend = .0001). Inadequate intake (% < EAR) increased from 10.5 ± 2.2% in 2001–2002 to 17.2 ± 3.1% in 2017–2018 (p for trend = .015). Vitamin C intake from foods alone in non-pregnant women (n = 9,737) decreased from 84 ± 3.9 mg in 1999–2000 to 71 ± 2.5 mg in 2017–2018 (p for trend < .0001). Supplemental vitamin C intake among non-pregnant women decreased from 101 ± 1.3 mg in 1999–2000 to 41 ± 0.5 mg in 2009–2010 followed by an increase to 86 ± 2.7 mg in 2017–2018 (p for trend = .0075). Consequently, intake from foods and supplements combined decreased from 186 ± 15.4 mg in 1999–2000 to 119 ± 5.9 mg in 2009–2010 followed by an increase to 157 ± 28.4 mg in 2017–2018 (p for trend = .0045). Inadequate intake increased from 27.5 ± 2.5% in 1999–2000 to 38.6 ± 2.4% in 2017–2018 (p for trend < .0001).ConclusionsOver the past 2 decades, decreases in vitamin C intake from foods has outpaced the more recent increases in supplemental vitamin C intake among women 20–44 y. Pregnant women's vitamin C intake from both foods and supplements decreased during this time, which may result in an increased risk of infections, premature birth, and eclampsia.Funding SourcesFunded by the Reckitt|Mead Johnson Nutrition.

Evolution of energy and nutrient intake in Brazil between 2008-2009 and 2017-2018.

ABSTRACTOBJECTIVE:To assess the evolution of energy and nutrient intake and the prevalence of inadequate micronutrients intakes according to sociodemographic characteristics and Brazilian regions.METHODS:The food consumption of 32,749 individuals from the National Dietary Survey of the Household Budget Survey 2008–2009 was analyzed by two food registries, as well as 44,744 subjects from two 24-hour recalls in 2017–2018. Usual intake and percentage of individuals with consumption below the average recommendation for calcium, magnesium, phosphorus, copper and zinc, vitamins A, C, D, E, thiamine, riboflavin, pyridoxine and cobalamin were estimated. Sodium intake was compared to the reference value to reduce the risk of chronic diseases. Analyses were stratified by sex, age group, region and income.RESULTS:Mean daily energy intake was 1,753 kcal in 2008–2009 and 1,748 kcal in 2017–2018. The highest prevalence of inadequacy (> 50%) in the two periods were calcium; magnesium; vitamins A, D and E; pyridoxine and, only among adolescents, phosphorus. There was an increase in the prevalence of inadequate vitamin A, riboflavin, cobalamin, magnesium, and zinc among women, and riboflavin among men. The prevalence of inadequacy decreased for thiamine. Sodium intake was excessive in approximately 50% of the population in both periods. The highest variations (about 50%) in the prevalence of inadequacy between the lowest and highest income (< 0.5 minimum wage and > 2 minimum wages per capita) were observed for vitamin B12 and C in both periods. The North and Northeast regions had the highest prevalence of inadequacy.CONCLUSION:Both surveys found high prevalence of inadequate nutrient intake and excessive sodium intake. The inadequacy varies according to income strata, increasing in the poorest regions of the country.

Micronutrient intake and prevalence of micronutrient inadequacy among women (15-49 y) and children (6-59 mo) in South Kivu and Kongo Central, Democratic Republic of the Congo (DRC).

Iron biofortified beans and carotenoid enriched cassava are proposed as a solution to combat iron and vitamin A deficiencies, respectively, in the Democratic Republic of Congo (DRC). To inform the need for biofortified foods, we conducted a survey in 2014 in two provinces of the DRC, South Kivu and Kongo Central. Unexpectedly, women of reproductive age (WRA; 15-49 y) and their children (6-59 m) had a low prevalence of biochemical iron and vitamin A deficiency, based on ferritin and retinol binding protein, respectively. To better understand the lack of biochemical deficiency of these nutrients, we examined the prevalence of inadequate intake for these and other select nutrients. Dietary intake was assessed using 24-hour recalls among 744 mother-child dyads. Repeat recalls on a non-consecutive day were conducted with a subsample of the study population to account for intra-individual variation and estimate usual intake. In WRA, the prevalence of inadequate iron intakes were 33% and 29% in South Kivu and Kongo Central, respecitvely. The prevalence of inadequate vitamin A intakes among WRA was low in South Kivu (18%) and negligible in Kongo Central (1%). Iron inadequacy was highest in infants (6-11 m) at 82% and 64% in South Kivu and Kongo Central, respectively. Among older children (12-59 m) in both provinces, the prevalence of iron inadequacy was similar at ~20%. There was a high prevalence of inadequate zinc intake in women and children (i.e. 79-86% among WRA and 56-91% among children 6-59 m) consistent with our findings of a high prevalence of low serum zinc in the same sample. Dietary data here corroborate the low prevalence of biochemical vitamin A deficiency but not iron. However, any change to the supply of red palm oil (primary source of vitamin A) would dramatically reduce population vitamin A intakes, thus a carotenoid enriched cassava program may be beneficial as a safety net measure. Crops biofortified with zinc also appear warranted. We caution that our findings cannot be extrapolated to the entire Congo where diverse agro-ecological landscape exist or when political and environmental shocks occur which challenge food production.

Dietary Lipid Intake Influences the Alpha-tocopherol Levels in Human Milk.

Dietary lipid intake is associated with serum alpha-tocopherol levels; however, its impact on human milk is unknown. The objective of this study was to evaluate the relationship between maternal intake of vitamin E, lipids, and fatty acids and the concentration of alpha-tocopherol in human milk. We conducted a longitudinal observational study, including 143 lactating women on 7, 30, and 90 days postpartum. Dietary intake was collected using 24-hour recall. On day 90, a human milk sample was collected and analyzed for alpha-tocopherol concentration. The prevalence of inadequate vitamin E intake was determined by the Estimated Average Requirement (16 mg/day), and the alpha-tocopherol concentration was analyzed by high-performance liquid chromatography. Dietary intake of vitamin E was associated with the intake of lipids (r = 0.237, P = 0.004) and fatty acids (P < 0.05), and 100% of the participants had inadequate vitamin intake. Mean alpha-tocopherol concentration in the human milk samples was 7.11 (standard deviation 3.95) μmol/L and was correlated with lipid (r = 0.201, P = 0.042) and polyunsaturated fatty acid intake (r = 0.235, P = 0.017). Higher vitamin E levels were found in participants with the highest quartile of polyunsaturated fatty acid intake. Alpha-tocopherol concentration was associated with the dietary intake of lipids and fatty acids, demonstrating that its bioavailability is associated with fats in the mammary gland. These results suggest development of appropriate strategies to increase the levels of vitamin E in breast milk that may help to prevent and treat vitamin E deficiency.

Change in Australian Vitamin A Intakes over Time

ABSTRACTBackgroundThe mean intake of vitamin A of Australians aged 2 y and older was 300 µg retinol equivalents lower in the 2011–2012 national nutrition survey than in 1995 and decreases preponderated in adults rather than young children.ObjectiveThis aim of this study was to identify the foods associated with this change and to examine how the method used to adjust for within-person variability affects the estimated prevalence of inadequate intakes in both surveys.MethodsFoods contributing to vitamin A intake were calculated from the first day of data. The prevalence of inadequate intakes was calculated using a 2-d average, the Iowa State University method, and the National Cancer Institute (NCI) method and either taken from the published reports or calculated using Food Standards Australia New Zealand's in-house software.ResultsIn adults, lower consumption of liver, yellow fat spreads, milk products, and carrots and similar root vegetables accounted for most of the change in intake. Vitamin A intake data were less right-skewed in 2011–2012 than in 1995. The prevalence of inadequate vitamin A intake depended on the adjustment method chosen: for example, in 2011–2012 it ranged between 3% and 55% in men aged 19–30 y. The NCI method prevalence (21% for this group) is taken as the preferred estimate of inadequacy because the method adjusts around the mean and accounts for several other sources of variance. However, the NCI method could not be used to analyze the 1995 survey.ConclusionsThe lower vitamin A intake in Australia was related to changes in retinol intake rather than carotenoid intake and to lower consumption of several different types of food. The estimated prevalence of inadequate intake depends on the statistical method chosen for analysis. A direct measure of vitamin A status is needed to allow conclusions about the implications of the decreasing intake of this vitamin.

Dietary Micronutrients Intake Status among Chinese Elderly People Living at Home: Data from CNNHS 2010-2012.

The aim of this study was to examine the status of usual dietary micronutrient intakes among Chinese elderly living at home. The data was based on China National Nutrition and Health Survey (CNNHS) 2010–2012. We analyzed data from the participants aged 60-year-old and more (n = 16,612) living at home, who provided dietary data on three days 24 h dietary survey combining with the household weighing method. The means and distribution percentiles for usual intakes of dietary micronutrients were estimated using the Multiple Source Method (MSM). The prevalence of inadequacy for the selected micronutrients was expressed using the proportion of individuals with usual intakes below the Estimated Average Requirement (EAR). For vitamin E, sodium and potassium, the means and the distribution of intakes were compared to the Adequate Intake (AI) level. Usual dietary intakes of most micronutrients were inadequate in the participants, especially folate, calcium, vitamin B6 and vitamin B2, with the prevalence of inadequacy more than 90%. However, dietary sodium intake was extremely high with an average usual intake of 4702 mg/day. The usual dietary intakes of all selected micronutrients in old males were higher than females, and the prevalence of inadequacy of most micronutrients was higher in old women (p < 0.01). The subjects aged 60–74 years tended to have higher usual dietary micronutrient intakes and lower prevalence of inadequate micronutrients than those aged 75 years and over (p < 0.01). Higher usual dietary intakes and lower prevalence of inadequacy of most micronutrients were found in the elderly living in the southern region (p < 0.01). The average usual intakes of most micronutrients declined with socioeconomic status. The prevalence of inadequate vitamin A, B2, C, calcium and selenium below EAR increased with socioeconomic status (p < 0.01, p for trend < 0.01). Thus, essential micronutrients insufficient intake is a public health concern among Chinese community-dwelling old population, especially the females, older people, the elderly in undeveloped areas or living in northern regions. Nutrition education and appropriate approach should be undertaken to address these problems.

Prevalence of inadequate vitamin D values and associated risk factors in university students of the city of Asunción

La vitamina D es una hormona cumple una funcion en la regulacion de numerosos genes que participan en la proliferacion y maduracion celular. El objetivo de este trabajo fue determinar la prevalencia de valores inadecuados de esta vitamina en jovenes sanos de Asuncion e identificar los posibles factores de riesgo asociados. Estudio observacional descriptivo basado en datos clinico-epidemiologicos y en la determinacion de la 25-hidroxivitamina D (25-OH vitamina D) por el metodo de quimioluminiscencia (CMIA). Se considero valor adecuado ≥30 ng/dl, inadecuado por debajo de este rango y deficiente ≤20 ng/dl. El analisis estadistico se realizo con el programa R–proyect. Para establecer factores de riesgo para tener deficiencia de vitamina D se utilizo regresion logistica bi y multivariante. Se incluyeron 817 jovenes universitarios de edad promedio 21 anos. La concentracion de vitamina D tuvo una media de 25 ± 8 ng/dl, oscilando entre 64,3 y 2,4 ng/dl. El 75,5% de los participantes tenian valores inadecuados de vitamina D. La deficiencia de vitamina D fue significativamente (p = 0,006) mas frecuente en mujeres, personas con sobrepeso (p = 0,03), con falta de exposicion al sol (p = 0,001) y con sedentarismo (p = 0,0001). Este estudio confirma la elevada prevalencia de valores inadecuados de vitamina D en nuestro pais y permite definir un perfil de muy alto riesgo para las jovenes sedentarias y con sobrepeso, lo que justifica una atencion especial de parte de los medicos y las instituciones responsables de la salud publica en nuestro pais.

Energy and Nutrient Intakes of Rural Nigerian Schoolchildren: Relationship With Dietary Diversity.

Undernutrition among schoolchildren is a prevalent public health problem which may be due to inadequate energy and nutrient intakes associated with low dietary diversity. This study assessed dietary diversity scores (DDS), energy and nutrient intakes of schoolchildren (6-15 years), and risks factors of DDS and determined if energy and nutrient intakes were dependent on dietary diversity. The study involved a 2-stage random sampling of 90 schoolchildren. Dietary diversity and nutrient intake data were obtained through a 3-day weighed food intake. Analysis of variance, t test, and χ2 with Cochran-Mantel-Haenszel test were used to determine relationships among and between variables; P < .05 was reported as significant. Few (22.2%) had high DDS with no significant difference (P > .05) between age groups and sex. Children from male headed households were more likely to have medium DDS (odds ratio [OR] = 3.231; 95% confidence interval [CI] = 1.037-10.070) than those from female headed households (P < .05). Low nutrient intakes were observed among 85.6% for niacin, 76.7% for calcium, 72.2% for riboflavin, 54.4% for protein, 32.2% for thiamine, and 15.6% for vitamin C. Among boys, prevalence of inadequate riboflavin intake was significantly (P < .05) higher among 6- to 9-year-olds. Among girls, prevalence of inadequate vitamin A intake was significantly (P < .01) higher among 10 to 15-year-olds. Children with adequate intakes of iron (OR = 0.744, 95% CI = 0.653-0.847) and thiamine (OR = 5.651, 95% CI = 1.214-26.310) were more likely to have high DDS. The schoolchildren had low energy and nutrient intakes. Iron and thiamine, intakes were dependent on DDS.

Prevalence and predictors of vitamin D-deficiency in frail older hospitalized patients

BackgroundVitamin D deficiency is known to be highly prevalent in older persons. However, the prevalence in the subgroup of frail older hospitalized patients is not clear. We sought to investigate the prevalence and predictors of vitamin D deficiency in frail older hospitalized patients.Methods217 consecutively geriatric hospitalized patients with routine measurements of 25-hydroxyvitamin D [25 (OH)D] at hospital admission were analyzed retrospectively, including information of previous vitamin D supplementation and the geriatric assessment. Serum 25 (OH)D concentrations < 20 ng/ml and between 20 and 29.99 ng/ml were classified as deficient and insufficient, respectively, whereas concentrations ≥30 ng/ml were considered as desirable. A stepwise binary logistic regression model was performed to assess the simultaneous effects of age, gender and geriatric assessments on the prevalence of low vitamin D concentration.ResultsMean age of the cohort was 81.6 ± 8.0 years (70.0% females). Mean serum 25(OH)D was 12.7 ± 12.9 ng/ml. Of 167 (77%) subjects without known previous vitamin D supplementation, only 21 (12.6%) had serum concentrations ≥20 ng/ml and only 8 (4.2%) had desirable serum concentrations ≥30 ng/ml. In total population, 146 (87.4%) participants were vitamin D deficient. Despite vitamin D supplementation, 22 of 50 participants (44.0%) were vitamin D deficient and only 19 (38.0%) had desirable concentrations of ≥30 ng/ml. In a stepwise logistic regression analysis, only previous intake of vitamin D supplementation and high Geriatric Depression Scale score (GDS-15) were significantly associated with vitamin D deficiency.ConclusionsIn the group of frail older hospitalized patients without previous vitamin D supplementation, the prevalence of inadequate vitamin D concentrations is extremely high. Therefore, usefulness of the routine measurement of vitamin D status before initiating of supplementation appears to be questionable in this patient group.

Inadequacies in the habitual nutrient intakes of patients with metabolic syndrome: a cross-sectional study.

BackgroundDietary factors are important environmental factors associated with the prevalence of metabolic syndrome (MS). The objective of this study was to assess the habitual nutrient intakes of patients with MS.MethodsA cross-sectional study included 103 patients (82 % women) with MS seen at the endocrinology outpatient clinic of Hospital Universitario Onofre Lopes. Habitual nutrient intake data were collected at two 24-h dietary recalls. Macronutrient intake adequacies were classified according to the I Brazilian guidelines for the diagnosis and treatment of metabolic syndrome. The prevalence of inadequate micronutrient intake was estimated using the estimated average requirements (EAR) cut-point method after adjusting for intra- and interpersonal variances and energy.ResultsThe mean energy intake of the included patients was 1523.0 ± 592.2 kcal/d, higher in men (1884.0 vs. 1441.5 kcal/d in women; p = 0.003). The recommended percentage protein intake was exceeded in both women and men (18 % in women and 19 % in men). Although men consumed more fiber (18.8 vs. 13.3 g/d in women; p = 0.011), their intake was still inadequate. Women consumed more fat (47.6 vs. 41.3 g/d in men; p = 0.007). The prevalence of inadequate vitamin D and calcium intakes exceeded 80 % in both men and women and across all age groups. The same was observed for magnesium in men and women aged more than 30 years. The prevalence of inadequate vitamin E, riboflavin, and zinc intakes in men ranged from 50 to 75 %. The prevalence of inadequate vitamin A, vitamin C, thiamin, vitamin B6, copper, and selenium intakes in men and women was less than 50 %.ConclusionsPatients with MS had high protein intake, low fiber intake, and high a prevalence of inadequate vitamin D, magnesium, and calcium intakes.

Seasonal variation of vitamin D levels in Swiss athletes

Introduction: Vitamin D deficiency is very prevalent in world population and growing evidence shows that also athletes are affected. Vitamin D deficiency causes beside bone disorders, musculoskeletal pain, muscle weakness and is associated with many other health disorders. For athletes in particular it may impair training and performance, prolong recovery and increase risk of injury. We therefore analyzed vitamin D levels in Swiss athletes focusing on prevalence according to age, gender, seasonal variations, indoor or outdoor sports, sunscreen use and vitamin D supplementation. Methods: This study was performed in a convenient sample of 655 Swiss Olympic athletes over one year. Blood samples were obtained and a questionnaire was filled in at Swiss Olympic Medical Centers or Bases during an annual routine exam. Data were then sent to the central laboratory of the Aarau hospital where they were processed and sent to us in an anonymized version. Vitamin D levels were categorized into deficiency (≤ 50 nmol/l), insufficiency (between 50 and 75 nmol/l) and adequate levels (&gt; 75 nmol/l) of 25-hydroxyvitamin D. By means of the questionnaire, we assessed age, gender, type of sport, symptoms possibly related to vitamin D deficiency during the last year, frequency of sunscreen use and vitamin D-containing medications of the athletes. Results: 13.5% of the participants (total number = 651) presented a vitamin D deficiency, 37.8% a vitamin D insufficiency so that more than half of the athletes (51.2%) had inadequate vitamin D levels. Inadequate vitamin D levels were more prevalent in younger athletes, during seasons with lower sun exposure, in indoor sports during the sun deprived seasons, in athletes without vitamines supplementation and in athletes of lower Swiss Olympic classes compared to their counterparts. Conclusions: The results of the study show that the prevalence of inadequate vitamin D levels in Swiss athletes is substantial for younger athletes (&lt; 18 years of age) and for indoor athletes during sun deprived periods of the year. However, a general vitamin supplementation containing vitamin D reduced the prevalence of vitamin D inadequacy which is especially relevant during sun deprived seasons.

CALCIUM AND VITAMIN D STATUS IN MORBIDLY OBESE PATIENTS AND IN PATIENTS AFTER BILIOPANCRETIC DIVERSION/DUODENAL SWITCH

Objective: The objective was to estimate the prevalence of inadequate vitamin D status and secondary hyperparathyroidism (SHPT) in morbidly obese patients and in patients who underwent biliopancreatic diversion/duodenal switch surgery (BPD/DS) Design: 3 groups were included in the cross-sectional comparative study: group 1 - morbidly obese (MO) patients with BMI > 40 and without type 2 diabetes mellitus (n=22), group 2 � patients in the long-term period after BPD/DS (n=23); group 3 � healthy normal weight controls (n=22). Results: 25(OH)D levels were significantly different in the controls (21.8 ng/dl), in the MO (8.8 ng/dl) and in the BPD/DS patients (8.6 ng/dl). Parathyroid hormone (PTH) elevation was found in 4 (18%) MO patients, in 12 (52 %) patients after BPD/DS, and was not detected in the control group. The frequency of SHPT was significantly higher in the operated group (52 %) in comparison with the MO group (18 %) (р=0.029). Conclusions: Vitamin D deficiency and secondary hyperparathyroidism are significantly more prevalent in MO patients than in normal weight subjects. In the long-term period after BPD secondary hyperthyroidism is more frequent than in MO and is not always accompanied by vitamin D depletion. Special attention should be paid for adequate control of calcium metabolism and supplementation by calcium and vitamin D.

Strengthening the contribution of aquaculture to food and nutrition security: The potential of a vitamin A-rich, small fish in Bangladesh

BackgroundSince 1961, global per capita fish consumption has nearly doubled. Much of the increase has been due to aquaculture. Bangladesh, the world's eighth largest fish producing country, has been part of this transformation. Despite having vitamin A supplementation and fortification programs, the prevalence of inadequate vitamin A intake (IVAI) in Bangladesh is very high, estimated to be 60%. The promotion of a small indigenous fish, high in vitamin A – mola carplet – offers a promising food-based approach to improving vitamin A status of the 98% of Bangladeshis who eat fish. The objective of this paper was to conduct a benefit–cost analysis of a national household pond Mola Promotion Program (MPP) in Bangladesh. MethodsUsing the 2005 Bangladesh Household Income and Expenditure Survey (HIES) and nutrition and health statistics, we developed baseline estimates of usual vitamin A intake, the prevalence of IVAI and disability-adjusted life years (DALYs) attributable to vitamin A deficiency (VAD). Drawing on a WorldFish project and HIES data, we designed and modeled the implementation of a MPP, and calculated the additional vitamin A intake it would provide, calculated new incidence rates of VAD-related health outcomes and estimated MPP-attributable annual changes in DALYs. The MPP's total health benefits were calculated over the program's 11-year phase-in as the annual sum of DALYs saved. The MPP's costs were estimated as the sum of the costs of a small fish program of the Fisheries Development Program plus the costs of mola brood stock, other inputs and additional farmer training-related costs. Program costs and benefits were combined to produce estimates of the cost-effectiveness of the program. ResultsAn 11-year, $23 million project would increase average daily vitamin A intakes by 7μg retinol activity equivalent (RAE), reduce the prevalence of IVAI by 1.1 percentage points, and save 3000 lives and 100,000 DALYs, at a cost of $194 per DALY saved. The MPP's impact would be concentrated among homestead pond-fishing households that would consume 60% of the additional mola produced. Among these, it would reduce IVAI prevalence by 7 percentage points. If the MPP was implemented for at least 20years, it would dominate – have higher health benefits and lower total costs – than a national vitamin A wheat flour fortification program. ConclusionBy World Bank and World Health Organization criteria, the MPP is a cost-effective approach to reduce the burden of micronutrient malnutrition in Bangladesh.

Suboptimal Serum α-Tocopherol Concentrations Observed among Younger Adults and Those Depending Exclusively upon Food Sources, NHANES 2003-20061-3.

Vitamin E is an essential nutrient for human health, with an established function as a lipid-soluble antioxidant that protects cell membranes from free radical damage. Low vitamin E status has been linked to multiple health outcomes, including total mortality. With vitamin E being identified as a ‘shortfall nutrient’ because >90% of American adults are not consuming recommended amounts of vitamin E, we aimed to determine the prevalence of both clinical vitamin E deficiency (serum α-tocopherol concentration < 12 μmol/L) and failure to meet a criterion of vitamin E adequacy, serum α-tocopherol concentration of 30 μmol/L, based on the Estimated Average Requirement (EAR) and lowest mortality rate in the Alpha-Tocopherol Beta-Carotene (ATBC) study. The most recent nationally-representative cross-sectional data (2003–2006) among non-institutionalized US citizens with available serum concentrations of α-tocopherol from the National Health and Nutrition Examination Survey (NHANES); Centers for Disease Control and Prevention were analyzed. Serum α-tocopherol distributions were compared between those reporting consumption of food without supplement use (FOOD) and food and supplement use (FOOD+DS) by sex, age, and race/ethnicity. Only 1% of the US population is clinically deficient. FOOD consumers have lower average α-tocopherol levels (24.9± 0.2 μmol/L) than FOOD+DS users (33.7 ± 0.3 μmol/L), even when adjusted for total cholesterol. Using a criterion of adequacy of 30 μmol/L, 87% of persons 20-30y and 43% of those 51+y had inadequate vitamin E status (p<0.01). A significant greater prevalence of FOOD compared to FOOD+DS users did not meet the criterion of adequacy which was based on the EAR and low ATBC mortality rate consistently across age, sex, and race/ethnic groups. The prevalence of inadequate vitamin E levels is significantly higher among non-users of dietary supplements. With declining usage of vitamin E supplements, the population should be monitored for changes in vitamin E status and related health outcomes.

Prevalence of inadequate vitamin d status and associated factors in children with cystic fibrosis.

This study aimed to determine the prevalence of inadequate serum 25-hydroxyvitamin D (25(OH)D) levels in a pediatric Canadian cystic fibrosis (CF) population and to assess the effectiveness of a vitamin D supplementation protocol on improving vitamin D status. A secondary objective was to analyze factors that may be associated with inadequate 25(OH)D levels. Vitamin D supplementation, 25(OH)D levels, and factors hypothesized to be associated with 25(OH)D levels were collected through a retrospective chart review (2010 and 2011) of 96 patients (1-18 years) at one CF clinic in Canada. Adequacy of 25(OH)D was set at ≥75 nmol/L. Patients with inadequate 25(OH)D levels in 2010 were prescribed an additional 1000 IU/d for levels <60 nmol/L or 400 IU/d for levels 60-75 nmol/L. Inadequate 25(OH)D levels were observed in 26% of patients in 2010 and 23% in 2011. After supplementation was increased for those with inadequate 25(OH)D levels in 2010 (n = 20), a significant increase in 25(OH)D levels was observed in 2011 (P = .03). Adequate status was achieved in 50% of these patients (n = 10). Age was significantly negatively associated with 25(OH)D levels in both years (P = .002). Percentage of forced expiratory volume in 1 second was significantly positively associated with 25(OH)D levels in 2011 (P = .03). While vitamin D supplementation was effective at increasing serum 25(OH)D, this protocol did not achieve optimal serum 25(OH)D levels in 25% of the population. Increasing age had the strongest association with 25(OH)D. Current supplementation protocols may require reevaluation based on emerging evidence and revised Cystic Fibrosis Foundation guidelines.