Prevalence Of Nutrient Inadequacy Research Articles

Computing levels of nutrient inadequacy from household consumption and expenditure surveys: A case study

This paper presents an approach to estimate the between-subject variability in nutrient intake (through the coefficient of variation [CV]) and a method to estimate the prevalence of nutrient inadequacy (PoNI) (for eight micronutrients) using household consumption and expenditure survey (HCES) data. Prevalence values are compared to individual-level estimates derived using the National-Cancer-Institute method. Data come from the 2015 Bangladesh Integrated-Household-Survey, which conducted a household-level 7-day recall (7DR) and two rounds of individual-level 24-hour recall (24HR), filled by one respondent on behalf of all members, for the same rural households. The PoNI values based on 7DR are lower than those calculated from 24HR data, due to the larger average intake estimates from 7DR data. After controlling for differences in average intake estimates and adjusting household-level data for random measurement errors, the PoNI values from 7DR and 24HR data are remarkably close. This highlights the potential use of HCES data (conducted according to international agreed standards) for estimating the level of between-subject variability in usual nutrient intake in a population. The CVs from HCES could be used to compute the PoNI using average intake estimates from individual-level data; and the inadequacy of global nutrient supply using Supply and Utilization Accounts data.

Impact of Short-Term Nutrient Supplementation Versus Nutrition Education/Counselling on Macro- and Micronutrient Intakes Among Persons on Maintenance Haemodialysis

Abstract Objectives We evaluated the of nutrient supplementation versus nutrition education/counselling on nutrient intakes among persons with end-stage renal disease (ESRD) on maintenance hemodialysis (MH). Methods Participants had anthropometry measured in addition to four consecutive 24-hour recall at baseline and during intervention both interventions. Persons in the intervention groups (IVG) received a supplement containing 550 kcal of energy, 23 grams of fat, 36 g of whey protein and specific amounts of micronutrients daily for 8 weeks. Following a 2 week washout period, the IVG received personalized nutrition education/counselling on weekly for over an 8-week period. Person in the NIVG did not receive nutrition supplements or personalized nutrition education/counselling. Both groups received the routine healthcare offered at their respective treatment centers. Participation in the study was voluntary following both written and oral consent. The study was approved by the university's Ethics Committee. Results All together 69 persons (IVG = 33; NIVG = 36) participated in the study. IVG and NIVG were similar in age sex distribution, weight and height. There were no significant differences in mean nutrient intake between persons in the IVG and NIVG. Supplementation resulted is significantly higher intakes of macro- and micro-nutrients and reduction in the prevalence of nutrient inadequacies when compared to personalized nutrition education/counselling per se. Conclusions Among participants, supplementation resulted in significantly higher intakes of the indexed nutrients compared to nutrition education/counselling. Our findings suggest that persons on MH attending designated treatment clinics may benefit from a program that that includes nutrition supplementation. Funding Sources The Campus Research and Publication Fund Committee.

Influence of ultra-processed foods on prevalence of inadequacy in Portuguese adults and elderly

Abstract Background Ultra-processed foods (UPF) consumption has been widely associated with low diet quality. We aim to investigate its energy contribution and influence on prevalence of nutrient inadequacy in Portugal. Methods Cross-sectional representative study involving 3102 adults and 750 elderly enrolled in the 2015-2016 National Food, Nutrition and Physical Activity Survey. Dietary intake was assessed by two non-consecutive 24h recalls. Food items were classified according to the NOVA system. Total energy intake and energy contribution provided by UPF group were determined. Inadequate intake was evaluated across quintiles (Q) of UPF consumption by adjusted Poisson regressions. We adjusted the usual intake estimate by Multiple Source Method and considered the World Health Organization (WHO) recommendations. Results UPF contributed with 24% and 16% of daily energy intake in adults (1904 kcal/day) and elderly (1603 kcal/day), respectively. In both age groups, practically all individuals had inadequate intake of sodium, while about a half or more of population had inadequate intake of fibre and potassium. As the dietary share of UPF increased, the prevalence of inadequacy of free sugars (PR = 1.53 for adults and 1.56 for elderly) and saturated fat (PR = 1.18 and 1.15, respectively) increased significantly. In adults, this same trend was also seen for fibre (PR = 1.03) and potassium (PR = 1.12). Particularly relevant was the increase in prevalence of inadequacy of free sugar from 10.5% (Q1) to 67.6% (Q5) in adults and 5.8% (Q1) to 41.8% (Q5) in elderly. Prevalence of inadequacy of saturated fat raised from 27.3% (Q1) to 68.9% (Q5) in adults and 29.4% (Q1) to 46.8% (Q5) in elderly. Conclusions Effective strategies are needed to reduce UPF consumption among Portuguese adults and elderly in order to prevent them from diet-related non-communicable diseases. Funding FAPESP 2018/07391-9, 2019/05972-7 (MCR), 2016/14302-7 (FR); POCI-01-0145-FEDER-032090. Key messages Ultra-processed food contributes with 24% and 16% of daily energy intake in Portuguese adults and elderly. As the ultra-processed food consumption increases, the prevalence of inadequacy of free sugars and saturated fat increases for both, while inadequacy of fiber and potassium also increases for adults.

Ultra-processed foods drive to unhealthy diets: evidence from Chile.

To assess the consumption of ultra-processed foods and its association with the overall dietary content of nutrients related to non-communicable diseases (NCD) in the Chilean diet and to estimate the population attributable fraction of ultra-processed food consumption on the unhealthy nutrient content. Cross-sectional analysis of dietary data collected through a national survey (2010). Chile. Chilean population aged ≥2 years (n 4920). In Chile, ultra-processed foods represented 28·6 % of the total energy intake. A significant positive association was found between the dietary share of ultra-processed foods and NCD-promoting nutrients such as dietary energy density (standardised regression coefficient (β) = 0·22), content of free sugars (β = 0·45), total fats (β = 0·26), saturated fats (β = 0·19), trans fats (β = 0·09) and Na:K ratio (β = 0·04), while a significant negative association was found with the content of NCD-protective nutrients such as K (β = -0·19) and fibre (β = -0·31). The content of Na (β = 0·02) presented no significant association. Except for Na, the prevalence of inadequate intake of all nutrients (WHO recommendations) increased across quintiles of the dietary share of ultra-processed foods. With the reduction of ultra-processed foods consumption to the level seen among the 20 % lowest consumers (3·8 % (0-9·3 %) of the total energy from ultra-processed foods), the prevalence of nutrient inadequacy would be reduced in almost three-fourths for trans fats; in half for energy density (foods); in around one-third for saturated fats, energy density (beverages), free sugars and total fats; in near 20 % for fibre and Na:K ratio and in 13 % for K. In Chile, decreasing the consumption of ultra-processed foods is a potentially effective way to achieve the WHO nutrient goals for the prevention of diet-related NCD.

Diet Diversity and Micronutrient Adequacy among Filipino School-Age Children.

Previous studies have shown that the dietary diversity of young Filipino children to be limited and that the prevalence of nutrient inadequacies is high. This study extends the current knowledge to examine the relationship between diet diversity and the probability of adequacy of micronutrients among Filipino schoolchildren (aged 6 to 12 years), by the wealth status and dwelling location. The dietary intake data were collected using a single 24-h recall from 6460 children in the Filipino National Nutrition Survey 2013. The diet diversity score (DDS) and the probability of adequacies (PA) of 11 micronutrients were calculated, and further stratified by socio-economic status (SES) and dwelling location. The diet diversity was generally low (mean DDS = 4 out of 9). Children from the lowest SES, and living in rural areas, tended to have a lower DDS. Children with a DDS of 1 were likely to be inadequate in all 11 micronutrients. The higher DDS (≥6) was associated with higher PAs for the B vitamins but not for calcium, folate, iron, vitamin A and to large extent, vitamin C. This suggests that it was difficult for this population to achieve adequacy in these 5 micronutrients. More rigorous research on the topic is needed. Better access to nutrient-rich or fortified staple foods, in tandem with increased education on the importance of dietary diversity, are potential strategies to support children in achieving adequate micronutrient intakes.

Heightened Nutritional Vulnerability Among Food-insecure Canadians in 2015 Than 2004 (P04-053-19)

ObjectivesHousehold food insecurity is a persistent public health issue in Canada. Analyses of dietary intake data from the 2004 Canadian Community Health Survey (CCHS) showed heightened nutritional vulnerability among adults and, to a lesser degree, children in food-insecure households. Given the rise in food prices since 2004, people in food-insecure households may now be at heightened nutritional risk. The objective of this study is to determine how nutritional vulnerability associated with household food insecurity has changed between 2004 and 2015. MethodsDietary intake was assessed on the 2004 CCHS Nutrition (n = 35,107) and 2015 CCHS Nutrition (n = 20,487) using 24-hour recalls, with household food insecurity assessed using the Household Food Security Survey Module. The National Cancer Institute method was used to estimate usual intakes of nutrients of public health concern (calcium, magnesium, vitamin A, vitamin C, folate, zinc, potassium) for food-insecure participants, by survey year, considering children 1–8 years (yr) and 9–18 yr and male and female adults, 19–64 yr. Prevalence of nutrient inadequacy was assessed using the EAR cut-point approach. Differences in usual intake and prevalence of inadequacy between surveys were assessed using t-tests. Weighted bootstrap technique was utilised to generate variance estimates. ResultsIn 2004 and 2015, 8.4% of individuals lived in moderately or severely food-insecure households. Mean usual intakes were lower and prevalence of nutrient inadequacy were higher across groups in 2015 than 2004, but not all differences were statistically significant. Differences in mean potassium and vitamin C intakes were significant in all groups; differences for folate and magnesium were significant in all groups except older children. Calcium was significantly lower in all groups except adult males, and vitamin A was significantly lower in all groups except young children. Young children had significantly lower intakes of zinc. Older children and male adults had significantly higher prevalence of inadequacy for vitamin C. ConclusionsNutritional vulnerability associated with household food insecurity has worsened over time in Canada and remains an area in need of intervention. Funding SourcesOntario Graduate Scholarship, Canada Graduate Scholarship-Masters, Canadian Institutes of Health Research.

Nutrient intake disparities in the US: modeling the effect of food substitutions

BackgroundDiet quality among federal food assistance program participants remains low, and little research has assessed the diet quality of food insecure non-participants. Further research is needed to assess the extent to which food substitutions can improve the nutritional status of these vulnerable populations. Substituting egg dishes for other commonly consumed dishes at certain eating occasions may be an effective strategy for improving the daily nutrient intake among these groups. Eggs are rich in many important nutrients, and are low-cost and part of a wide range of cultural food menus, which are important considerations for low-income and ethnically diverse populations. To help guide the focus of targeted nutrition interventions and education campaigns for vulnerable populations, the present work begins by 1) estimating the prevalence of nutrient inadequacy among these groups, and then models the effect of consuming egg dishes instead of commonly consumed dishes at each eating occasion on 2) the prevalence of nutrient inadequacy, and 3) the mean intake of nutrients.MethodsDietary data from 34,741 adults ≥ 20 y were acquired from the National Health and Nutrition Examination Survey, 2001–2014. Diet pattern modeling was used to substitute commonly consumed egg dishes for commonly consumed main dishes at breakfast, lunch, and dinner. National Cancer Institute usual intake methods were used to estimate the prevalence of inadequate intake of 31 nutrients pre- and post-substitution, and a novel index was used to estimate change in intake of all nutrients collectively.ResultsSubstituting eggs for commonly consumed main dishes at lunch or dinner did not change total daily nutrient intake for each group (P > 0.05), but decreased the prevalence of vitamin D inadequacy by 1–4 percentage points (P < 0.01). Substituting eggs for commonly consumed foods at breakfast increased the prevalence of folate inadequacy by 8–12 percentage points among each group (P < 0.01).ConclusionsWhen making food substitutions to increase nutrient intake, eating occasion should be an important consideration. Further research is needed to better understand how food substitutions affect diet costs, which may be an important driver of food purchasing decisions among low income individuals with limited food budgets.

Nutrients intake in elderly residing in Lebanese nursing homes

PurposeThe purpose of this study was to assess nutrient intakes in elderly living in Lebanese nursing homes (NHs).Design/methodology/approachThis cross-sectional study was conducted in 36 long-term care institutions from all over Lebanon. Out of 2,094 residents, 98 (69 women and 29 men) elderly met the inclusion criteria and successfully completed the interview question. Dietary food intake was assessed using the 24-h food recall. The analysis used a Chi-square test and independent samples t-test or Mann–Whitney test, as appropriate.FindingsA high percentage of elderly (reaching 100 per cent) had a low intake of energy, protein, linolenic acid, linoleic acid, fibers, vitamins and minerals, and the prevalence of nutrient inadequacy was significantly different between sexes for copper intake (p = 0.02). The results of this study highlight the nutrient inadequacies among the majority of elderly living in long-term care institutions and particularly in women and elderly residing in NHs located away from the capital Beirut.Originality/valueThis study is quite original; this is the first study performed nationwide in Lebanon covering not only the largest number of NHs in various locations but also elderly under custodial settings and with diverse backgrounds.

Overview of the Dietary Intakes of the Mexican Population: Results from the National Health and Nutrition Survey 2012

Background:Mexico is facing the double burden of malnutrition: stunting and micronutrient deficiencies in young children, iron deficiency in pregnant women, and widespread obesity across age groups.Objective:The aim was to summarize and discuss findings published in this supplement on dietary intakes and the eating habits of the Mexican population.Methods:A 24-h recall questionnaire that used the multiple-pass method with a repeated measure in a fraction of the sample was applied in a nationally representative sample. We estimated mean intakes and percentages of inadequacy for macronutrients and micronutrients; mean intakes and percentages of the population who adhere to dietary recommendations for food groups; sources of added sugars; intakes of discretionary foods by mealtime, place, and activity; and mean dietary intakes in children <2 y old.Results:Infant formula was consumed by almost half of infants aged <6 mo and sugar-sweetened beverages were consumed by two-thirds of children aged 12–23 mo. In the different age groups, a high proportion of the population had excessive intakes of added sugars (58–85%) and saturated fats (54–92%), whereas a high prevalence of insufficient intakes was found for fiber (65–87%), vitamin A (8–70%), folates (13–69%), calcium (26–88%), and iron (46–89%). Discretionary foods (nonbasic foods high in saturated fats and/or added sugars) contributed 26% of the population’s total energy intake, whereas only 1–23% met recommendations for legumes, seafood, fruit, vegetables, and dairy foods.Conclusions:High proportions of Mexicans consume diets that do not meet recommendations. Breastfeeding and complementary feeding diverged from recommendations, intakes of discretionary foods were high, and the prevalence of nutrient inadequacies and age groups not meeting intake recommendations of basic food groups were also high. The results are consistent with the high prevalence of the double burden of malnutrition and are useful to design food and nutrition policies.

Theoretical Impact of Replacing Whole Cow's Milk by Young-Child Formula on Nutrient Intakes of UK Young Children: Results of a Simulation Study

Background: Research into the role of young-child formulae (YCF) in a child's diet is limited and there is no consensual recommendation on its use. We evaluated the theoretical nutritional impact of replacing the existing practice of consuming cow's milk by YCF. Methods: From the UK Diet and Nutrition Survey of Infants and Young Children, whole cow's milk consumers, aged 12-18 months (n = 591) were selected for simulation scenarios. In Scenario 1, we tested the replacement of all whole cow's milk (434 ± 187 ml/day) by a matching volume of YCF, and in Scenario 2, all whole cow's milk was replaced by the on-pack recommended daily intake of 300 ml. Nutrient intakes before and after simulation scenarios were compared and evaluated against nutrient recommendations. Results: Intakes of protein and saturated fatty acids were significantly decreased, whereas essential fatty acid intakes were increased. The prevalence of nutrient inadequacy before simulation was 95.2% for vitamin D and 53.8% for iron. After simulation, inadequacy decreased to 4.9% (Scenario 1) and 0% (Scenario 2) for vitamin D and to 2.7% (Scenario 1) and 1.1% (Scenario 2) for iron. Conclusions: Replacement of habitual cow's milk intake by a matching volume or 300 ml of YCF may lead to nutritional intakes more in line with recommendations in young children.

The Mediterranean diet and nutritional adequacy: a review.

The Mediterranean dietary pattern, through a healthy profile of fat intake, low proportion of carbohydrate, low glycemic index, high content of dietary fiber, antioxidant compounds, and anti-inflammatory effects, reduces the risk of certain pathologies, such as cancer or Cardiovascular Disease (CVD). Nutritional adequacy is the comparison between the nutrient requirement and the intake of a certain individual or population. In population groups, the prevalence of nutrient inadequacy can be assessed by the probability approach or using the Estimated Average Requirement (EAR) cut-point method. However, dietary patterns can also be used as they have moderate to good validity to assess adequate intakes of some nutrients. The objective of this study was to review the available evidence on the Nutritional Adequacy of the Mediterranean Diet. The inclusion of foods typical of the Mediterranean diet and greater adherence to this healthy pattern was related to a better nutrient profile, both in children and adults, with a lower prevalence of individuals showing inadequate intakes of micronutrients. Therefore, the Mediterranean diet could be used in public health nutrition policies in order to prevent micronutrient deficiencies in the most vulnerable population groups.

Food and Nutrient Intake of Pregnant Women of the out Patient Department of General Hospital, Calabar, Nigeria

This study investigated nutrient intake and the prevalence of nutrient inadequacy among pregnant women who attended antenatal clinic in General Hospital Calabar, Cross River State, Nigeria, and assess factors associated with nutrient inadequacy. Pregnant women who attended prenatal clinic in general Hospital Calabar, Nigeria was surveyed. Nutrient intake was estimated based on information provided by the women on the amount, type and frequency of various foods eaten. The survey showed that 33% 0f the respondents were under weight, 55.3% had normal BMI and 41.3% of the pregnant women were overweight. The respondents who prefer rice and noodles were 44%, 84% of the respondents like hot food, 12.0% like cold food, while 4.0% like both hot and cold food and 71% of them had no food preference. The respondents met 41.9% of Recommended Dietary Allowance (RDA) for energy. Maternal age, educational level, gestational age at enrolment, and pregnancy Body Mass Index (BMI) were significantly associated with inadequacy of nutrients intake. The study showed that only 41.9% of the respondents met the Recommended Dietary Allowance (RDA) for energy, while more than 5% had normal Body Mass Index (BMI).KEYWORDS: Nutrients, Pregnant, Dietary, Prevalence, Women.

Statistical Innovations Improve Prevalence Estimates of Nutrient Risk Populations: Applications in São Paulo, Brazil

The objective of this study was to estimate the prevalence of inadequate micronutrient intake and excess sodium intake among adults age 19 years and older in the city of São Paulo, Brazil. Twenty-four–hour dietary recall and sociodemographic data were collected from each participant (n=1,663) in a cross-sectional study, Inquiry of Health of São Paulo, of a representative sample of the adult population of the city of São Paulo in 2003 (ISA-2003). The variability in intake was measured through two replications of the 24-hour recall in a subsample of this population in 2007 (ISA-2007). Usual intake was estimated by the PC-SIDE program (version 1.0, 2003, Department of Statistics, Iowa State University), which uses an approach developed by Iowa State University. The prevalence of nutrient inadequacy was calculated using the Estimated Average Requirement cut-point method for vitamins A and C, thiamin, riboflavin, niacin, copper, phosphorus, and selenium. For vitamin D, pantothenic acid, manganese, and sodium, the proportion of individuals with usual intake equal to or more than the Adequate Intake value was calculated. The percentage of individuals with intake equal to more than the Tolerable Upper Intake Level was calculated for sodium. The highest prevalence of inadequacy for males and females, respectively, occurred for vitamin A (67% and 58%), vitamin C (52% and 62%), thiamin (41% and 50%), and riboflavin (29% and 19%). The adjustment for the within-person variation presented lower prevalence of inadequacy due to removal of within-person variability. All adult residents of São Paulo had excess sodium intake, and the rates of nutrient inadequacy were high for certain key micronutrients.

Should Household Consumption and Expenditures Surveys (HCES) be Used for Nutritional Assessment and Planning?

Household Consumption and Expenditures Surveys (HCES) are routinely conducted in several countries on nationally representative samples, often on a regular basis. The HCES have been considered as a potential alternative to more expensive surveys of individuals'food intakes for use in nutritional assessment and in planning programs such as food fortification. HCES gather information on household food availability (purchased, produced, or received as gifts) and use over a given period of time, often the past week or month. To discuss the potential usefulness of HCES consumption data for nutritional assessment and planning for populations of households and individuals within the households. There are several limitations to the HCES, most notably the difficulty of estimating the intrahousehold allocation of foods and therefore of quantifying the actual food intake of individual household members. Another concern is the lack of information on the variability of consumption over time, making it difficult to estimate the distribution of usual consumption, and thus the prevalence of nutrient inadequacies or excesses. Other potential limitations might be addressed by improvements to the HCES questionnaires, such as including information on foods that are available but not consumed and those that are consumed outside the home. Research is needed to better understand both the strengths and the weaknesses of the HCES data when used to assess and plan intakes at the household and individual levels.

Prevalence of nutrient inadequacy in pregnant women in the United States

Studies are lacking on the prevalence of nutrient inadequacy (PNI) from food and food and dietary supplements (total) among pregnant US women ages 14 to 50 yrs old. This study evaluated the PNI for vitamins A, C, E, D, B12, and folate, iron, zinc, calcium, magnesium and prevalence of nutrient adequacy (PNA) for potassium and choline in pregnant women (n=612). NHANES (2003–2006 or 2005–2008) consumption data were analyzed to estimate usual nutrient intake distributions using the National Cancer Institute and the Iowa State statistical methods. A probability approach method was used to determine nutrient inadequacy for iron. The PNI was determined by the proportion of pregnant women with usual nutrient intakes below the population‐weighted Estimated Average Requirement (EAR). For potassium and choline, the PNA was based on the Adequate Intakes (AIs). Pregnant women had PNIs for vitamins A, E, and D, folate, magnesium, and calcium of 36, 95, 88, 40, 57, 21% from food only; and 22, 51, 48, 28, 55, and 19 % from total intake, respectively. Lower PNIs were found for vitamins C and B12, iron, and zinc. Only 4 and 13% of pregnant women had usual intakes above the AIs for potassium and choline, respectively. The prevalence of nutrient inadequacy in pregnant women is high for certain nutrients despite supplement use. Examination of food sources for pregnant women may inform choices for improving intakes of inadequate nutrients.

Development of a Food Frequency Questionnaire: For Toddlers of Low-German-Speaking Mennonites from Mexico

Little is known about dietary intakes in toddlers of Low-German-Speaking Mennonites from Mexico, although some of these toddlers might be at risk for nutritional deficiencies. A 97-item, culturally sensitive, interviewer-administered food frequency questionnaire (FFQ) was developed and validated for health professionals to assess dietary intake in these children aged 12 to 36 months. Cultural foods on the FFQ were determined via focus groups; a pilot study tested content and formatting. The FFQ was administered to parents/caregivers of 22 toddlers in a southern Ontario community of Low-German-Speaking Mennonites from Mexico. Validity was determined by comparing nutrient intakes from the FFQ and from the 24-hour recalls, using Bland-Altman plots, Pearson correlations, and Student's t-tests. Test-retest reliability was compared between two FFQ administrations (n=14) one month apart, via intraclass correlations (ICCs). Bland-Altman plots showed good agreement between the FFQ and the 24-hour recall; Pearson correlations between methods were significant for protein, folate, calcium, and caffeine. Student's t-tests were not significantly different between methods for 11 of 12 nutrients. Test-retest reliability was good on the basis of acceptable ICC for eight of 12 nutrients. The prevalence of nutrient inadequacies was low, except for folate. These results are promising for implementation of a simple, quick, culturally sensitive FFQ with the potential to provide reliable estimates of mean intakes in toddlers of Low-German-Speaking Mennonites from Mexico.

Risk of Nutrient Inadequacies in Elite Canadian Athletes With Spinal Cord Injury

Energy intakes of adults with spinal cord injury (SCI) have been reported to be relatively low, with many micronutrients below recommended amounts, but little is known about the diets of athletes with SCI. The purpose of this cross-sectional, observational study was to assess energy intakes and estimate the prevalence of dietary inadequacy in a sample of elite Canadian athletes with SCI (n = 32). Three-day self-reported food diaries completed at home and training camp were analyzed for energy (kcal), macronutrients, vitamins, and minerals and compared with the dietary reference intakes (DRIs). The prevalence of nutrient inadequacy was estimated by the proportion of athletes with mean intakes below the estimated average requirement (EAR). Energy intakes were 2,156 ± 431 kcal for men and 1,991 ± 510 kcal for women. Macronutrient intakes were within the acceptable macronutrient distribution ranges. While at training camp, >25% of men had intakes below the EAR for calcium, magnesium, zinc, riboflavin, folate, vitamin B12, and vitamin D. Thiamin, riboflavin, calcium, and vitamin D intakes were higher at home than training camp. Over 25% of women had intakes below the EAR for calcium, magnesium, folate, and vitamin D, with no significant differences in mean intakes between home and training camp. Vitamin/mineral supplement use significantly increased men's intakes of most nutrients but did not affect prevalence of inadequacy. Women's intakes did not change significantly with vitamin/mineral supplementation. These results demonstrate that athletes with SCI are at risk for several nutrient inadequacies relative to the DRIs.

Widespread Micronutrient Inadequacies Among Adults in Prince Edward Island

The prevalence of micronutrient inadequacies was assessed among adult residents of Prince Edward Island (PEI) in the PEI Nutrition Survey. A peer-reviewed protocol was used in this cross-sectional survey, in which 24-hour recalls were administered during in-home interviews. A stratified random sample of 1,995 adults aged 18 to 74 participated. Median nutrient intakes with and without supplements were calculated; intakes were adjusted for day-to-day variability. Chi-square testing was used to assess differences in prevalence of inadequacy by age and sex. Most of the sample (more than 90%) had folate intakes below the Estimated Average Requirement (EAR). Magnesium and vitamin C intakes were low in more than 50% of the sample. Iron intakes were adequate in all groups except women aged 19 to 50, 29% of whom had intakes below the EAR. Women were more likely than men to have inadequate intakes. Median calcium intakes fell below recommendations for all age and sex groups. Supplement use had little impact on dietary adequacy in this sample. This study underscores the need for public health interventions designed to reduce the very high prevalence of nutrient inadequacies in the PEI adult population. In addition, education is needed on the selection of appropriate vitamin and mineral supplements.

Feeding Infants and Toddlers Study: Characteristics and Usual Nutrient Intake of Hispanic and Non-Hispanic Infants and Toddlers

Objective To compare demographic and maternal characteristics and usual nutrient intakes of Hispanic and non-Hispanic infants and toddlers 4 to 24 months of age in the United States. Design We conducted three interviews by telephone to collect information on sociodemographic and maternal characteristics, feeding practices, and dietary intake in the 2002 Feeding Infants and Toddlers Study. We collected 24-hour dietary recalls, including a second day’s intake on a subsample, using the Nutrition Data System for Research. We used the Personal Computer version of the Software for Intake Distribution Estimation to estimate usual nutrient intake and nutrient adequacy and excess for three age subgroups—infants 4-5 months, infants 6-11 months, and toddlers 12-24 months—and Hispanic or non-Hispanic ethnicity. Subjects A national sample of 3,022 infants and toddlers age 4-24 months, including 371 Hispanic and 2,637 non-Hispanic subjects. Statistical analysis We compared means, percentile distributions, and percentages by age/Hispanic ethnicity subgroup, and applied the Dietary Reference Intakes to assess nutrient intakes. Results Mothers of Hispanic infants and toddlers were younger, less likely to be married, and had lower education levels than mothers of non-Hispanic infants and toddlers ( P<.01). Hispanic infants and toddlers had significantly higher rates of participation in the Special Supplemental Nutrition Program for Women, Infants, and Children than non-Hispanic infants and toddlers (42% to 23%) and were more likely to reside in urban areas and have lower annual household income levels ( P<.01). There were no significant differences in usual energy intake between Hispanic and non-Hispanic infants and toddlers, and mean usual energy intake exceeded the mean estimated energy requirement for all age/ethnicity subgroups. Hispanic toddlers consumed a significantly higher proportion of energy from carbohydrate (56% to 53%, P<.01) and a significantly lower percentage of energy from fat (31% to 33%, P<.01) than non-Hispanics. Comparing usual mean intakes, Hispanic infants age 6 to 11 months had a significantly lower intake of calcium than non-Hispanics (means of 574 mg and 626 mg per day, respectively, P<.05) and a significantly higher intake of sodium compared with non-Hispanics of the same age (means of 647 mg to 476 mg per day, P<.01). For infants, mean usual intakes were adequate for all nutrients. For toddlers, the prevalence of nutrient inadequacy was low (<1%) with the exception of vitamin E, which was inadequate for 39% of Hispanic toddlers and 50% of non-Hispanic toddlers. For nutrients with defined Tolerable Upper Intake Levels, more than one third to almost half of toddlers exceeded the Tolerable Upper Intake Levels for vitamin A and zinc, and more than half (53% and 58% for Hispanics and non-Hispanic toddlers, respectively) exceeded the Tolerable Upper Intake Level for sodium. Usual mean intakes of vitamins A, C, and E and folate, potassium, and fiber were significantly higher among Hispanic toddlers compared with non-Hispanic toddlers. Conclusions The Feeding Infants and Toddlers Study data provide information that is useful to practitioners, Special Supplemental Nutrition Program for Women, Infants, and Children program staff, and parents for delivering nutrition education messages that are consistent with dietary guidance for infants and toddlers as well as compatible with cultural preferences.

Effects of Increased Consumption of Fluid Milk on Energy and Nutrient Intake, Body Weight, and Cardiovascular Risk Factors in Healthy Older Adults

Objective To assess the impact of increased consumption of milk, without other dietary advice, on older adults' energy and nutrient intakes, weight, cardiovascular risk factors (blood pressure, plasma lipid levels), and quality of life. Subjects/setting Two hundred four healthy men and women, aged 55 to 85 years, who consumed fewer than 1.5 dairy servings per day were chosen from six US academic health centers. Design Randomized, controlled open trial. Intervention Advice to increase skim or 1% milk intake by 3 cups per day (n=101) or to maintain usual diet (n=103) for 12 weeks after a 4-week baseline period. Main outcome measures Changes in energy and nutrient intake assessed from 3-day food records, body weight, blood pressure, and plasma lipid levels. Statistical analyses performed Group-by-time analysis of variance with repeated-measures, χ 2 test. Results Compliance with the intervention was good. Compared with controls, participants in the milk-supplemented group significantly increased energy, protein, cholesterol, vitamins A, D, and B-12, riboflavin, pantothen ate, calcium, phosphorus, magnesium, zinc, and potassium intakes. Prevalence of nutrient inadequacy, assessed for nutrients with Estimated Average Requirements, decreased among women in the milk group for magnesium (40% .at baseline vs 13% at 12 weeks, P<.001) and vitamin B-12 (6% vs 0%, P<.05) and tended to decrease ( P<.10) for protein and thiamin (women) and magnesium and vitamin B-6 (men). The milk group gained 0.6 kg more than control group ( P<.01); however, weight gain was less than predicted, which suggests some compensation for the added energy from milk. Blood pressure decreased similarly over time in both groups. Total and low-density lipoprotein cholesterol levels, and the ratio of total cholesterol to high-density lipoprotein cholesterol, were unchanged. Triglyceride levels increased within the normal range in the milk group ( P=.002). Quality of life scores were high at baseline and remained high throughout. Applications/conclusions Older adults can successfully increase milk intake, thereby meaningfully improving their nutrient intakes. Dietitians can play a key role in disseminating this advice. J Am Diet Assoc. 2000; 100:810-817.