1
|
Omofuma OO, Fang D, Yell N, Falomo O, Liu J, Steck SE. Trends in Reported Calcium and Magnesium Intake from Diet and Supplements by Demographic Factors: National Health and Nutrition Examination Survey, 2003-2018. J Acad Nutr Diet 2024:S2212-2672(24)00205-3. [PMID: 38718857 DOI: 10.1016/j.jand.2024.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 03/25/2024] [Accepted: 04/30/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Calcium and magnesium are important micronutrients necessary for normal body functioning. OBJECTIVE The objective of the study was to approximate usual nutrient intakes and estimate proportion of adults meeting the Estimated Average Requirement (EAR) of calcium and magnesium from diet, and diet plus supplements (total intake). Trends in the proportion of adults meeting the EAR were estimated by sex, age, and race and ethnicity. DESIGN The study utilized data from the National Health and Nutrition Examination Survey, a cross-sectional survey of a nationally representative sample of the US civilian and noninstitutionalized population. PARTICIPANTS AND SETTING The continuous National Health and Nutrition Examination Survey survey data from 2003-2004 through 2017-2018 for dietary intake, and 2007-2008 through 2017-2018 for total intake were analyzed. The study sample included men and women (not lactating/pregnant) ages 19 years and older with 2 reliable 24-hour dietary recalls and energy intake >500 to <6,000 kcal/day (N = 35 037). MAIN OUTCOME MEASURES Mean daily intake and trends of proportion of adults meeting/exceeding the EAR for calcium and magnesium were estimated. STATISTICAL ANALYSES PERFORMED The National Cancer Institute's method was used to calculate daily intakes for calcium and magnesium by demographic subgroups. SAS SURVEYMEAN and SURVEYFREQ procedures were used to estimate means ± SE for continuous variables and frequencies and percentages for categorical variables, and 2-sample t test for P values. Trends were estimated with National Cancer Institute's Joinpoint trend analysis program. RESULTS Mean daily dietary calcium intake and proportions of adults meeting the EAR from both diet and supplements was lowest among women (859 mg [61.9%]), adults ages 71 years and older (865 mg [60.3%]) and non-Hispanic Black individuals (782 mg [48.6%]) compared with men, younger age groups, and other races and ethnicities. Magnesium intake reported from diet was lowest in adults ages 71 years and older (276 mg), whereas total magnesium intake and proportion of meeting the EAR from both diet and supplements was lowest in women (302 mg) and men (52%), respectively, adults ages 19 to 30 years (305 mg [48.5%]), and non-Hispanic Black individuals (274 mg [35.5%]). The trends in the proportion of women and non-Hispanic White adults meeting the EAR from total calcium intake decreased significantly (P < .05) by 2.9% and 2.0%, respectively. CONCLUSIONS Women and adults ages 71 years and older had the lowest reported mean daily dietary calcium intake and proportion meeting the EAR for calcium from diet and supplements. Men and adults ages 19 to 30 years had the lowest proportion meeting the EAR for magnesium from diet and supplements with adults ages 19 to 30 years also having the lowest reported total magnesium intake from diet and supplements. Non-Hispanic Black individuals had the lowest proportion of meeting the EARs for calcium and magnesium from reported total intake. The trends in the proportion of women and non-Hispanic White individuals meeting the EARs for calcium through total intake decreased over time and remained stable in other subpopulations and for magnesium.
Collapse
Affiliation(s)
- Omonefe O Omofuma
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.
| | - Dai Fang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Nicholas Yell
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Olajumoke Falomo
- Department of Nutritional Sciences, College of Agriculture and Life Sciences, University of Wisconsin-Madison, Wisconsin
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Susan E Steck
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| |
Collapse
|
2
|
Lee S, Huh I, Kang S, Nam YE, Cho Y, Kamruzzaman M, Hong J, Kwon O, Park T. Meta-Analysis of Randomized Clinical Trials Evaluating Effectiveness of a Multivitamin Supplementation against Oxidative Stress in Healthy Subjects. Nutrients 2022; 14:nu14061170. [PMID: 35334829 PMCID: PMC8955918 DOI: 10.3390/nu14061170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 02/01/2023] Open
Abstract
A meta-analysis has been widely applied to draw general conclusions using a set of studies with similar purposes and designs. This study aimed to perform a meta-analysis of six randomized placebo-controlled trials, independently conducted for the relationship between a plant-based multivitamin/mineral supplementation (PMS) and oxidative stress for 6 to 8 weeks, to provide overall estimates of those effects. In detail, linear mixed model analysis was first conducted on each study to obtain individual estimates; then, two types of meta-analysis were applied to combine the individual estimates from all available studies (overall meta-analysis) and region-specific studies (subgroup meta-analysis). In the meta-analysis, we selected 19 biomarker variables that overlapped in at least two studies and found 6 variables significant in at least one meta-analysis. The overall estimates of beta coefficients were 0.17 for vitamin C, 0.80 for vitamin B6, 0.46 for vitamin B12, 0.81 for folate, 0.36 for β-carotene, and -0.17 for oxidized LDL (ox-LDL). Subsequent association analysis revealed significant negative correlations between plasma free radical scavenging nutrients and plasma ox-LDL levels, indicating a general benefit of PMS in alleviating oxidative stress by providing exogenous oxidant scavengers.
Collapse
Affiliation(s)
- Seoyoung Lee
- College of Liberal Studies, Department of Liberal Studies, Seoul National University, Seoul 08826, Korea;
| | - Iksoo Huh
- College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul 03080, Korea;
| | - Seunghee Kang
- Graduate Program in System Health Science and Engineering, Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea; (S.K.); (Y.-e.N.)
| | - Yea-eun Nam
- Graduate Program in System Health Science and Engineering, Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea; (S.K.); (Y.-e.N.)
| | - Youngseo Cho
- Department of Statistics, Seoul National University, Seoul 08826, Korea; (Y.C.); (M.K.)
| | - Md Kamruzzaman
- Department of Statistics, Seoul National University, Seoul 08826, Korea; (Y.C.); (M.K.)
| | - Jina Hong
- Access Business Group International, LLC, 5600 Beach Blvd., Buena Park, CA 90621, USA;
| | - Oran Kwon
- Graduate Program in System Health Science and Engineering, Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea; (S.K.); (Y.-e.N.)
- Correspondence: (O.K.); (T.P.)
| | - Taesung Park
- Department of Statistics, Seoul National University, Seoul 08826, Korea; (Y.C.); (M.K.)
- Correspondence: (O.K.); (T.P.)
| |
Collapse
|
3
|
Xiao Z, Sun X, Zhaxi D, Zhang F, Ji Y, Cheng T, Li X, Xu X. Distinct Nutrient Intake Style in Inhabitants of Ultra-High-Altitude Areas in North of Tibet, China: A Cross-Sectional Study Based on Newly Developed Tibetan Food Frequency Questionnaires. Front Nutr 2021; 8:743896. [PMID: 35004798 PMCID: PMC8733569 DOI: 10.3389/fnut.2021.743896] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/22/2021] [Indexed: 12/13/2022] Open
Abstract
Dietary pattern is quite distinct among the inhabitants of high-altitude areas because of environmental and geographical uniqueness; hence, it is important to investigate this data as accurately as possible. However, very few data are related to these populations up to now. Based on the food frequency questionnaire (FFQ) used in the Chinese population, a revised Tibetan edition was developed with respect to the lifestyle in high-altitude areas. After assessment of validity and reproducibility, a nutrition intake survey was conducted among 1,071 randomly sampled Tibetan people. In addition, the Bland-Altman approach was used to compare the agreement between the two dietary tools. For the reproducibility analysis, intraclass correlation coefficients (ICC) were calculated to examine the agreement of food groups and nutrients from the two FFQs (FFQ1 and FFQ2). Nutrient intake was calculated using food composition tables. For the validity analysis, Pearson's correlation of food groups intakes varied from 0.22 to 0.91 (unadjusted). The correlations of nutrients ranged from 0.24 to 0.76 (unadjusted). In the analysis of reliability, the ICC of food groups varied from 0.27 to 0.70 (unadjusted). The ICC of nutrient intakes ranged from 0.22 to 0.87 (unadjusted). The results of nutritional analysis showed that ~25% of foods consumed frequently were traditional Tibetan foods. However, traditional Han foods were frequently consumed. In addition, the energy, iron, and protein intakes for male or female subjects were close to the Chinese Dietary Nutrient Reference Intake (Chinese DRIs); however, fat and sodium intakes were significantly higher than the Chinese DRIs. Interestingly, lower intakes of other types of nutrition, such as vitamin C were detected in people living in high-altitude areas. Our data indicated that excess consumption of fat and sodium and insufficient intake of vitamin C were common among Tibetan people, as compared with the most Chinese people living in the plateau areas. More investigations are needed to reveal the association between the food intake style and high-altitude endemic diseases.
Collapse
Affiliation(s)
- Zhen Xiao
- Institute of High Altitude Medicine, People's Hospital of Naqu Affiliated to Dalian Medical University, Naqu, China
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xianzhi Sun
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Duoji Zhaxi
- Institute of High Altitude Medicine, People's Hospital of Naqu Affiliated to Dalian Medical University, Naqu, China
| | - Fan Zhang
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Yuchen Ji
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Tingting Cheng
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Xiaofeng Li
- Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China
| | - Xiaoguang Xu
- Institute of High Altitude Medicine, People's Hospital of Naqu Affiliated to Dalian Medical University, Naqu, China
- Department of Neurosurgery, Second Affiliated Hospital of Dalian Medical University, Dalian, China
| |
Collapse
|
4
|
Gkouskou KK, Grammatikopoulou MG, Vlastos I, Sanoudou D, Eliopoulos AG. Genotype-guided dietary supplementation in precision nutrition. Nutr Rev 2020; 79:1225-1235. [PMID: 33367884 DOI: 10.1093/nutrit/nuaa132] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Achieving adequate micronutrient status, while avoiding deficiencies, represents a challenge for people globally. Consequently, many individuals resort to oral nutrient supplementation (ONS) in order to correct suboptimal dietary intakes. Advances in the fields of nutrigenetics and nutritional genomics have identified differences in response to micronutrient supplementation according to genetic makeup, adding dietary supplement use to the clinician's toolkit in the precision nutrition era. This review focuses on published evidence linking genetic variants to the responses associated with some of the most popular dietary supplements. With an increasing number of health professionals becoming involved in the prescription of ONS, identifying and matching individuals to the appropriate dietary supplement according to their genotype is important for achieving optimal health benefits and micronutrient equilibrium, while reducing the adverse events and financial costs often associated with excessive ONS.
Collapse
Affiliation(s)
- Kalliopi K Gkouskou
- Department of Biology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Embiodiagnostics, Biology Research Company, Heraklion, Crete, Greece
| | - Maria G Grammatikopoulou
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | - Ioannis Vlastos
- Department of Biology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Despina Sanoudou
- Clinical Genomics and Pharmacogenomics Unit, 4th Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Center for New Biotechnologies and Precision Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Center of Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Aristides G Eliopoulos
- Department of Biology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Center for New Biotechnologies and Precision Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Center of Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| |
Collapse
|
5
|
Vatanparast H, Islam N, Patil RP, Shafiee M, Whiting SJ. Calcium Intake from Food and Supplemental Sources Decreased in the Canadian Population from 2004 to 2015. J Nutr 2020; 150:833-841. [PMID: 31891395 PMCID: PMC7138660 DOI: 10.1093/jn/nxz318] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/18/2019] [Accepted: 12/03/2019] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND In light of the publications (2008-2014) linking calcium intake, mainly from supplements, to the elevated risk of cardiovascular events, there is a need to determine if there have been any changes in usual intakes of calcium among Canadians. OBJECTIVE We aimed to examine changes in dietary and total usual intake of calcium among Canadians aged ≥1 y over the period 2004-2015. METHODS We used nutrition data from 2 nationally representative surveys conducted in 2004 and 2015 (CCHS 2004 Cycle 2.2 and CCHS-Nutrition 2015). This study included all the Canadians across 10 provinces, and the analyses were performed across different age/sex groups. We used the National Cancer Institute (NCI) method to estimate the usual intake of calcium and the prevalence of calcium inadequacy. Multiple logistic regression was performed to assess the relation between supplement uses and sociodemographic variables. RESULTS From 2004 to 2015, the usual intake of calcium from food sources significantly decreased in calcium supplement nonusers (from 872 ± 18.2 mg/d to 754 ± 18.0 mg/d), but not in calcium supplement users. The contribution of calcium from the Milk and alternatives food group significantly decreased by 7.5% and 6.1% in calcium supplement users and nonusers, respectively. The prevalence of calcium supplement use significantly decreased from 2004 to 2015 in the Canadian population, from 27.5% to 22.0%. During this time, the percentage contribution of calcium from supplemental sources significantly decreased among Canadians, especially women. The prevalence of calcium inadequacy increased from 58.0% to 68.0% in supplement nonusers; however, among users of calcium supplements, the prevalence of calcium inadequacy remained at ∼31%. CONCLUSIONS Calcium intake from both food and supplemental sources decreased in the Canadian population over an 11-y period, which must be addressed by policy-makers in their efforts to decrease the high prevalence of calcium inadequacy.
Collapse
Affiliation(s)
- Hassan Vatanparast
- School of Public Health, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada,College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada,Address correspondence to HV (e-mail: )
| | - Naorin Islam
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada
| | - Rashmi Prakash Patil
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada
| | - Mojtaba Shafiee
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada
| | - Susan J Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada
| |
Collapse
|
6
|
Willemse JPMM, Meertens LJE, Scheepers HCJ, Achten NMJ, Eussen SJ, van Dongen MC, Smits LJM. Calcium intake from diet and supplement use during early pregnancy: the Expect study I. Eur J Nutr 2020; 59:167-174. [PMID: 30661104 PMCID: PMC7000487 DOI: 10.1007/s00394-019-01896-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 01/08/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE Adequate calcium intake during pregnancy is of major importance for the health of both mother and fetus. Up to date, evidence on the prevalence of inadequate calcium intake among pregnant women is sparse for Western countries, and it is unknown to what extent inadequate dietary calcium intake is adequately balanced by supplement use. The objective of this study was to estimate calcium intake from diet and supplement use during the early pregnancy in The Netherlands. METHODS As part of the Expect cohort study, 2477 pregnant women (8-16 weeks of gestation) completed an online questionnaire including questions on baseline characteristics, the use of calcium containing supplements, and a short food-frequency questionnaire (FFQ). Intake data were used to calculate median calcium intakes from diet, from supplements, and combined, and to compare these values with currently accepted requirement levels. RESULTS Forty-two percent of the pregnant women had a total calcium intake below the estimated average requirement of 800 mg/day. Median (interquartile range) calcium intake was 886 (611-1213) mg/day. Calcium or multivitamin supplements were used by 64.8% of the women at 8 weeks of gestation, with a median calcium content of 120.0 (60.0-200.0) mg/day. Prenatal vitamins were the most often used supplements (60.6%). CONCLUSIONS Forty-two percent of Dutch pregnant women have an inadequate calcium intake. Supplements are frequently used, but most do not contain sufficient amounts to correct this inadequate intake.
Collapse
Affiliation(s)
- Jessica P M M Willemse
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Linda J E Meertens
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands
| | - Hubertina C J Scheepers
- Department of Obstetrics and Gynaecology, Maastricht University Medical Centre, PO 5800, 6202 AZ, Maastricht, The Netherlands
| | - Nina M J Achten
- Maastricht University, PO 616, 6200 MD, Maastricht, The Netherlands
| | - Simone J Eussen
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Martien C van Dongen
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands
| | - Luc J M Smits
- Department of Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands
| |
Collapse
|
7
|
Kang S, Lim Y, Kim YJ, Jung ES, Suh DH, Lee CH, Park E, Hong J, Velliquette RA, Kwon O, Kim JY. Multivitamin and Mineral Supplementation Containing Phytonutrients Scavenges Reactive Oxygen Species in Healthy Subjects: A Randomized, Double-Blinded, Placebo-Controlled Trial. Nutrients 2019; 11:E101. [PMID: 30621298 PMCID: PMC6356358 DOI: 10.3390/nu11010101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 12/26/2018] [Accepted: 12/29/2018] [Indexed: 02/06/2023] Open
Abstract
Phytonutrients and vitamin and mineral supplementation have been reported to provide increased antioxidant capacity in humans; however, there is still controversy. In the current clinical trial, we examined the antioxidant and DNA protection capacity of a plant-based, multi-vitamin/mineral, and phytonutrient (PMP) supplementation in healthy adults who were habitually low in the consumption of fruits and vegetables. This study was an eight-week, double-blind, randomized, parallel-arm, and placebo-controlled trial. PMP supplementation for eight weeks reduced reactive oxygen species (ROS) and prevented DNA damage without altering endogenous antioxidant system. Plasma vitamins and phytonutrients were significantly correlated with ROS scavenging and DNA damage. In addition, gene expression analysis in PBMC showed subtle changes in superoxide metabolic processes. In this study, we showed that supplementation with a PMP significantly improved ROS scavenging activity and prevented DNA damage. However, additional research is still needed to further identify mechanisms of actions and the role of circulating phytonutrient metabolites.
Collapse
Affiliation(s)
- Seunghee Kang
- Department of Nutritional Science and Food Management, Ewha Womans Universiy, Seoul 03760, Korea.
| | - Yeni Lim
- Department of Nutritional Science and Food Management, Ewha Womans Universiy, Seoul 03760, Korea.
| | - You Jin Kim
- Department of Nutritional Science and Food Management, Ewha Womans Universiy, Seoul 03760, Korea.
| | - Eun Sung Jung
- Department of Systems Biotechnology, Konkuk University, Seoul 05029, Korea.
| | - Dong Ho Suh
- Department of Bioscience and Biotechnology, Konkuk University, Seoul 05029, Korea.
| | - Choong Hwan Lee
- Department of Bioscience and Biotechnology, Konkuk University, Seoul 05029, Korea.
| | - Eunmi Park
- Department of Food and Nutrition, Hannam University, Daejeon 34430, Korea.
| | - Jina Hong
- Access Business Group International, LLC, 5600 Beach Blvd., Buena Park, CA 90621, USA.
| | - Rodney A Velliquette
- Access Business Group International, LLC, 5600 Beach Blvd., Buena Park, CA 90621, USA.
| | - Oran Kwon
- Department of Nutritional Science and Food Management, Ewha Womans Universiy, Seoul 03760, Korea.
| | - Ji Yeon Kim
- Department of Food Science and Technology, Seoul National University of Science and Technology, Seoul 01811, Korea.
| |
Collapse
|
8
|
Crowley EK, Long-Smith CM, Murphy A, Patterson E, Murphy K, O'Gorman DM, Stanton C, Nolan YM. Dietary Supplementation with a Magnesium-Rich Marine Mineral Blend Enhances the Diversity of Gastrointestinal Microbiota. Mar Drugs 2018; 16:E216. [PMID: 29925774 PMCID: PMC6024889 DOI: 10.3390/md16060216] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 04/25/2018] [Accepted: 06/09/2018] [Indexed: 02/06/2023] Open
Abstract
Accumulating evidence demonstrates that dietary supplementation with functional food ingredients play a role in systemic and brain health as well as in healthy ageing. Conversely, deficiencies in calcium and magnesium as a result of the increasing prevalence of a high fat/high sugar "Western diet" have been associated with health problems such as obesity, inflammatory bowel diseases, and cardiovascular diseases, as well as metabolic, immune, and psychiatric disorders. It is now recognized that modulating the diversity of gut microbiota, the population of intestinal bacteria, through dietary intervention can significantly impact upon gut health as well as systemic and brain health. In the current study, we show that supplementation with a seaweed and seawater-derived functional food ingredient rich in bioactive calcium and magnesium (0.1% supplementation) as well as 70 other trace elements, significantly enhanced the gut microbial diversity in adult male rats. Given the significant impact of gut microbiota on health, these results position this marine multi-mineral blend (MMB) as a promising digestive-health promoting functional food ingredient.
Collapse
Affiliation(s)
- Erin K Crowley
- Department of Anatomy and Neuroscience, University College Cork, T12XF62 Cork, Ireland.
| | | | - Amy Murphy
- APC Microbiome Ireland, Teagasc Food Research Centre, Moorepark, Fermoy, P61 C996 Cork, Ireland.
- School of Microbiology, University College Cork, T12YT20 Cork, Ireland.
| | - Elaine Patterson
- APC Microbiome Ireland, Teagasc Food Research Centre, Moorepark, Fermoy, P61 C996 Cork, Ireland.
| | - Kiera Murphy
- APC Microbiome Ireland, Teagasc Food Research Centre, Moorepark, Fermoy, P61 C996 Cork, Ireland.
| | - Denise M O'Gorman
- Marigot Ltd., Strand Farm, Currabinny, Carrigaline, P43NN62 Cork, Ireland.
| | - Catherine Stanton
- APC Microbiome Ireland, Teagasc Food Research Centre, Moorepark, Fermoy, P61 C996 Cork, Ireland.
- APC Microbiome Ireland, University College Cork, T12YT20 Cork, Ireland.
| | - Yvonne M Nolan
- Department of Anatomy and Neuroscience, University College Cork, T12XF62 Cork, Ireland.
- APC Microbiome Ireland, University College Cork, T12YT20 Cork, Ireland.
| |
Collapse
|
9
|
Contribution of Dietary Supplements to Nutritional Adequacy in Race/Ethnic Population Subgroups in the United States. Nutrients 2017; 9:nu9121295. [PMID: 29182574 PMCID: PMC5748746 DOI: 10.3390/nu9121295] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 11/08/2017] [Accepted: 11/20/2017] [Indexed: 12/23/2022] Open
Abstract
The U.S. Centers for Disease Control and Prevention has reported that nutritional deficiencies in the U.S. population vary by age, gender, and race/ethnicity, and could be as high as nearly one third of certain population groups. Based on nationally representative data in 10,698 adults from National Health and Nutrition Examination Surveys (NHANES) primarily from 2009-2012, assessments were made of race/ethnic differences in the impact of dietary supplements on nutrient intake and prevalence of inadequacies. Compared to food alone, use of any dietary supplement plus food was associated with significantly higher intakes of 14 to 16 of 19 nutrients examined in all race/ethnic groups; and significantly (p < 0.01) reduced rates of inadequacy for 8/17 nutrients examined in non-Hispanic whites, but only 3-4/17 nutrients (calcium, and vitamins A, D, and E) for other race/ethnic groups. Across race/ethnic groups an increased prevalence of intakes above the Tolerable Upper Intake Level (UL) was seen for 1-9/13 nutrients, but all were less than 5% of the population. In conclusion, use of dietary supplements is associated with increased micronutrient intake, decreased nutrient inadequacies, and slight increases in prevalence above the UL in all race/ethnicities examined, with greater benefits among non-Hispanic whites.
Collapse
|
10
|
Gahche JJ, Bailey RL, Potischman N, Dwyer JT. Dietary Supplement Use Was Very High among Older Adults in the United States in 2011-2014. J Nutr 2017; 147:1968-1976. [PMID: 28855421 PMCID: PMC5610553 DOI: 10.3945/jn.117.255984] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 06/21/2017] [Accepted: 08/07/2017] [Indexed: 12/31/2022] Open
Abstract
Background: Dietary supplements (DSs) have the potential to be both beneficial and harmful to health, especially in adults aged ≥60 y, and therefore it is important to monitor the patterns of their use.Objective: This study evaluated DS use by adults aged ≥60 y to characterize the use of DSs, determine the motivations for use, and examine the associations between the use of DSs and selected demographic, lifestyle, and health characteristics.Methods: Data from 3469 older adults aged ≥60 y from the 2011-2014 NHANES were analyzed. DSs used in the past 30 d were ascertained via an interviewer-administered questionnaire in participants' homes. The prevalence of overall DS use and specific types of DSs were estimated. The number of DSs reported and the frequency, duration, and motivation(s) for use were assessed. Logistic regression models were constructed to examine the association between DS use and selected characteristics.Results: Seventy percent of older adults in the United States reported using ≥1 DS in the past 30 d; 54% of users took 1 or 2 products, and 29% reported taking ≥4 products. The most frequently reported products were multivitamin or mineral (MVM) (39%), vitamin D only (26%), and omega-3 fatty acids (22%). Women used DSs almost twice as often as men [adjusted OR (aOR), 1.8; 95% CI: 1.5, 2.3). Those not reporting prescription medications were less likely to take a DS than those reporting ≥3 prescription medications (aOR, 0.4; 95% CI: 0.3, 0.6). The most frequently reported motivation for DS use was to improve overall health (41%).Conclusions: Use of DSs among older adults continues to be high in the United States, with 29% of users regularly taking ≥4 DSs, and there is a high concurrent usage of them with prescription medications.
Collapse
Affiliation(s)
- Jaime J Gahche
- Office of Dietary Supplements, National Institutes of Health, Bethesda, MD;
| | - Regan L Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, IN; and
| | - Nancy Potischman
- Office of Dietary Supplements, National Institutes of Health, Bethesda, MD
| | - Johanna T Dwyer
- Office of Dietary Supplements, National Institutes of Health, Bethesda, MD;,Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| |
Collapse
|
11
|
|
12
|
Fang X, Liang C, Li M, Montgomery S, Fall K, Aaseth J, Cao Y. Dose-response relationship between dietary magnesium intake and cardiovascular mortality: A systematic review and dose-based meta-regression analysis of prospective studies. J Trace Elem Med Biol 2016; 38:64-73. [PMID: 27053099 DOI: 10.1016/j.jtemb.2016.03.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 03/11/2016] [Accepted: 03/29/2016] [Indexed: 01/18/2023]
Abstract
BACKGROUND Although epidemiology studies have reported the relationship, including a dose-response relationship, between dietary magnesium intake and risk of cardiovascular disease (CVD), the risk for CVD mortality is inconclusive and the evidence for a dose-response relationship has not been summarized. OBJECTIVE We conducted a systematic review and meta-analysis of prospective studies to summarize the evidence regarding the association of dietary magnesium intake with risk of CVD mortality and describe their dose-response relationship. DESIGN We identified relevant studies by searching major scientific literature databases and grey literature resources from their inception to August 2015, and reviewed references lists of retrieved articles. We included population-based studies that reported mortality risks, i.e. relative risks (RRs), odds ratios (ORs) or hazard ratios (HRs) of CVD mortality or cause-specific CVD death. Linear dose-response relationships were assessed using random-effects meta-regression. Potential nonlinear associations were evaluated using restricted cubic splines. RESULTS Out of 3002 articles, 9 articles from 8 independent studies met the eligibility criteria. These studies comprised 449,748 individuals and 10,313 CVD deaths. Compared with the lowest dietary magnesium consumption group in the population, the risk of CVD mortality was reduced by 16% in women and 8% in men. No significant linear dose-response relationship was found between increment in dietary magnesium intake and CVD mortality across all the studies. After adjusting for age and BMI, the risk of CVD mortality was reduced by 24-25% per 100mg/d increment in dietary magnesium intake in women of all the participants and in all the US participants. CONCLUSION Although the combined data confirm the role of dietary magnesium intake in reducing CVD mortality, the dose-response relationship was only found among women and in US population.
Collapse
Affiliation(s)
- Xin Fang
- Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Chun Liang
- Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, 200003 Shanghai, China
| | - Mei Li
- Department of Cardiology, Shanghai Changzheng Hospital, Second Military Medical University, 200003 Shanghai, China
| | - Scott Montgomery
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 70185 Örebro, Sweden; Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, 17177 Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, WC1E 6BT, UK
| | - Katja Fall
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 70185 Örebro, Sweden; Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Jan Aaseth
- Faculty of Public Health, Hedmark University College, 2411 Elverum, Norway; Innlandet Hospital Trust, Kongsvinger Hospital Division, 2226 Kongsvinger, Norway
| | - Yang Cao
- Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 70185 Örebro, Sweden.
| |
Collapse
|
13
|
Raffield L, Agarwal S, Hsu F, de Boer I, Ix J, Siscovick D, Szklo M, Burke G, Frazier-Wood A, Herrington D. The association of calcium supplementation and incident cardiovascular events in the Multi-ethnic Study of Atherosclerosis (MESA). Nutr Metab Cardiovasc Dis 2016; 26:899-907. [PMID: 27514606 PMCID: PMC5026586 DOI: 10.1016/j.numecd.2016.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 06/24/2016] [Accepted: 07/08/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS Many US adults use calcium supplements to address inadequate dietary intake and improve bone health. However, recent reports have suggested that use of calcium supplements may elevate cardiovascular disease (CVD) risk. In this study, we examined associations between baseline calcium supplement use and incident myocardial infarction (MI) (n = 208 events) and CVD events (n = 641 events) over 10.3 years in men and women from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort (n = 6236), with dietary calcium intake at baseline also examined as a supplementary objective. METHODS AND RESULTS Using Cox proportional hazards models, no compelling associations between calcium intake from supplements or diet and incident CVD events were observed upon multivariate adjustment for potential confounders. An association with lower MI risk was observed comparing those with low levels of calcium supplement use (1-499 mg) to those using no calcium supplements (hazard ratio 0.69, 95% CI 0.48, 0.98, p = 0.039). Relationships were homogeneous by gender, race/ethnicity, or chronic kidney disease. Results were also similar when the analysis was limited to postmenopausal women only. CONCLUSION Analysis of incident MI and CVD events in the MESA cohort does not support a substantial association of calcium supplement use with negative cardiovascular outcomes.
Collapse
Affiliation(s)
- L.M. Raffield
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - S. Agarwal
- Department of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - F.C. Hsu
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - I.H. de Boer
- Division of Nephrology and Kidney Research Institute, Departments of Medicine and Epidemiology, University of Washington, Seattle, WA
| | - J.H. Ix
- Nephrology Section, Veterans Affairs San Diego Healthcare System, Division of Nephrology and Hypertension, University of California School of Medicine, San Diego, CA
| | | | - M. Szklo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - G.L. Burke
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - A.C. Frazier-Wood
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX
| | - D.M. Herrington
- Section on Cardiology, Wake Forest School of Medicine, Winston-Salem, NC
| |
Collapse
|
14
|
Rosanoff A, Dai Q, Shapses SA. Essential Nutrient Interactions: Does Low or Suboptimal Magnesium Status Interact with Vitamin D and/or Calcium Status? Adv Nutr 2016; 7:25-43. [PMID: 26773013 PMCID: PMC4717874 DOI: 10.3945/an.115.008631] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Although much is known about magnesium, its interactions with calcium and vitamin D are less well studied. Magnesium intake is low in populations who consume modern processed-food diets. Low magnesium intake is associated with chronic diseases of global concern [e.g., cardiovascular disease (CVD), type 2 diabetes, metabolic syndrome, and skeletal disorders], as is low vitamin D status. No simple, reliable biomarker for whole-body magnesium status is currently available, which makes clinical assessment and interpretation of human magnesium research difficult. Between 1977 and 2012, US calcium intakes increased at a rate 2-2.5 times that of magnesium intakes, resulting in a dietary calcium to magnesium intake ratio of >3.0. Calcium to magnesium ratios <1.7 and >2.8 can be detrimental, and optimal ratios may be ∼2.0. Background calcium to magnesium ratios can affect studies of either mineral alone. For example, US studies (background Ca:Mg >3.0) showed benefits of high dietary or supplemental magnesium for CVD, whereas similar Chinese studies (background Ca:Mg <1.7) showed increased risks of CVD. Oral vitamin D is widely recommended in US age-sex groups with low dietary magnesium. Magnesium is a cofactor for vitamin D biosynthesis, transport, and activation; and vitamin D and magnesium studies both showed associations with several of the same chronic diseases. Research on possible magnesium and vitamin D interactions in these human diseases is currently rare. Increasing calcium to magnesium intake ratios, coupled with calcium and vitamin D supplementation coincident with suboptimal magnesium intakes, may have unknown health implications. Interactions of low magnesium status with calcium and vitamin D, especially during supplementation, require further study.
Collapse
Affiliation(s)
| | - Qi Dai
- Vanderbilt Epidemiology Center, Department of Medicine, School of Medicine, Vanderbilt University, Nashville, TN; and
| | | |
Collapse
|
15
|
Abstract
This article covers some important concepts and controversies in modern nutritional science. It describes a diet style designed to maximize health, longevity, and disease reversal—foundationally structured on the quality and comprehensive adequacy of nutrients rather than the balance of macronutrients, as is more popular today. I call such a diet, which attempts to optimize micronutrients, a nutritarian diet. I will review a small case series demonstrating typical results in diabetics and some of my clinical observations over the last 25 years treating people with a nutritarian diet, which could be either vegan or flexitarian. I will also discuss health concerns observed from an unsupplemented vegan diet, specifically the risk of depression and later life dementia in individuals with enhanced need for long-chain omega-3 fatty acids.
Collapse
Affiliation(s)
- Joel Fuhrman
- Nutritional Research Foundation, Flemington, New Jersey (JF)
| |
Collapse
|
16
|
Heinemann M, Willers J, Bitterlich N, Hahn A. Verwendung von Nahrungsergänzungsmitteln mit Vitaminen und Mineralstoffen – Ergebnisse einer deutschlandweiten Verbraucherbefragung. J Verbrauch Lebensm 2014. [DOI: 10.1007/s00003-014-0912-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
17
|
Kang M, Kim DW, Baek YJ, Moon SH, Jung HJ, Song YJ, Paik HY. Dietary supplement use and its effect on nutrient intake in Korean adult population in the Korea National Health and Nutrition Examination Survey IV (2007-2009) data. Eur J Clin Nutr 2014; 68:804-10. [PMID: 24824011 DOI: 10.1038/ejcn.2014.77] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 03/06/2014] [Accepted: 03/19/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND/OBJECTIVES Although there is an increasing trend of dietary supplement (DS) use, few researches have evaluated nutrient intake from DS. This study aimed to establish a nutrient database (NDB) for DS and estimate the effect of DS on total nutrient intake by Korean adults. SUBJECTS/METHODS The NDB for DS was established using the label information of products reported in the Korea National Health and Nutrition Examination Survey (KNHANES) IV. Of the 16,031 participants who were ≥20 years old, 2053 products were reported as being taken by 5606 subjects. But nutrient composition could be identified by searching product name only in 1158 products consumed by 3844 subjects (DS users). Total nutrient intake of DS users was obtained by combining intakes from diet and DS. RESULTS Dietary supplement use was higher in women, in middle-aged people and in those with higher education and low smoking and drinking preferences. Nutrients obtained from food were higher in DS users than in nonusers for most nutrients, particularly in women. When total nutrient intake was evaluated in DS users, the percentage of subjects whose intake was below the estimated average requirement for Koreans decreased for several vitamins and minerals, but the percentage of subjects whose intake was above the tolerable upper intake levels increased for vitamin A, vitamin C and iron. CONCLUSIONS The newly developed NDB for DS will be an important resource for more accurate assessment of nutrient intake as well as evaluation of the relationship between nutrition and health. Further research is needed to update a more comprehensive NDB applicable to diverse populations.
Collapse
Affiliation(s)
- M Kang
- Department of Food and Nutrition, Seoul National University, Seoul, Republic of Korea
| | - D W Kim
- Health Policy Research Department, Korea Institute for Health and Social Affairs, Seoul, Republic of Korea
| | - Y J Baek
- Department of Food and Nutrition, Seoul National University, Seoul, Republic of Korea
| | - S-H Moon
- Department of Food and Nutrition, Seoul National University, Seoul, Republic of Korea
| | - H J Jung
- Research Institute of Human Ecology, College of Human Ecology, Seoul National University, Seoul, Republic of Korea
| | - Y J Song
- Department of Food Science and Nutrition, Catholic University, Bucheon, Republic of Korea
| | - H-Y Paik
- 1] Department of Food and Nutrition, Seoul National University, Seoul, Republic of Korea [2] Research Institute of Human Ecology, College of Human Ecology, Seoul National University, Seoul, Republic of Korea
| |
Collapse
|
18
|
Hruby A, Meigs JB, O'Donnell CJ, Jacques PF, McKeown NM. Higher magnesium intake reduces risk of impaired glucose and insulin metabolism and progression from prediabetes to diabetes in middle-aged americans. Diabetes Care 2014; 37:419-27. [PMID: 24089547 PMCID: PMC3898748 DOI: 10.2337/dc13-1397] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To assess 7-year associations between magnesium intake and incident prediabetes and/or insulin resistance (IR), and progression from these states to type 2 diabetes. RESEARCH DESIGN AND METHODS In 2,582 community-dwelling participants 26-81 years old at baseline, magnesium intake and risk of incident "metabolic impairment," defined as impaired fasting glucose (FG) (≥5.6 to <7.0 mmol/L), impaired glucose tolerance (2-h postload glucose ≥7.8 to <11.1 mmol/L), IR, or hyperinsulinemia (≥90th percentile of homeostasis model assessment of IR or fasting insulin, respectively), was estimated among those with normal baseline status, and risk of incident diabetes was estimated among those with baseline metabolic impairment. In participants without incident diabetes, we examined magnesium intake in relation to 7-year changes in fasting and postload glucose and insulin, IR, and insulin sensitivity. RESULTS After adjusting for age, sex, and energy intake, compared with those with the lowest magnesium intake, those with the highest intake had 37% lower risk of incident metabolic impairment (P trend = 0.02), and in those with baseline metabolic impairment, higher intake was associated with 32% lower risk of incident diabetes (P trend = 0.05). In the combined population, the risk in those with the highest intake was 53% (P trend = 0.0004) of those with the lowest intake. Adjusting for risk factors and dietary fiber attenuated associations in the baseline normal population but did not substantially affect associations in the metabolically impaired. Higher magnesium intake tended to associate with lower follow-up FG and IR, but not fasting insulin, postload values, or insulin sensitivity. CONCLUSIONS Magnesium intake may be particularly beneficial in offsetting risk of developing diabetes among those at high risk. Magnesium's long-term associations with non-steady-state (dynamic) measures deserve further research.
Collapse
|
19
|
Mensink GBM, Fletcher R, Gurinovic M, Huybrechts I, Lafay L, Serra-Majem L, Szponar L, Tetens I, Verkaik-Kloosterman J, Baka A, Stephen AM. Mapping low intake of micronutrients across Europe. Br J Nutr 2013; 110:755-73. [PMID: 23312136 PMCID: PMC3785176 DOI: 10.1017/s000711451200565x] [Citation(s) in RCA: 180] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 08/17/2012] [Accepted: 08/29/2012] [Indexed: 02/06/2023]
Abstract
Achieving an understanding of the extent of micronutrient adequacy across Europe is a major challenge. The main objective of the present study was to collect and evaluate the prevalence of low micronutrient intakes of different European countries by comparing recent nationally representative dietary survey data from Belgium, Denmark, France, Germany, The Netherlands, Poland, Spain and the United Kingdom. Dietary intake information was evaluated for intakes of Ca, Cu, I, Fe, Mg, K, Se, Zn and the vitamins A, B₁, B₂, B₆, B₁₂, C, D, E and folate. The mean and 5th percentile of the intake distributions were estimated for these countries, for a number of defined sex and age groups. The percentages of those with intakes below the lower reference nutrient intake and the estimated average requirement were calculated. Reference intakes were derived from the UK and Nordic Nutrition Recommendations. The impact of dietary supplement intake as well as inclusion of apparently low energy reporters on the estimates was evaluated. Except for vitamin D, the present study suggests that the current intakes of vitamins from foods lead to low risk of low intakes in all age and sex groups. For current minerals, the study suggests that the risk of low intakes is likely to appear more often in specific age groups. In spite of the limitations of the data, the present study provides valuable new information about micronutrient intakes across Europe and the likelihood of inadequacy country by country.
Collapse
Affiliation(s)
- G B M Mensink
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Strasse 64, DE-12101 Berlin, Germany
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Nutrition-Focused Wellness Coaching Promotes a Reduction in Body Weight in Overweight US Veterans. J Acad Nutr Diet 2013; 113:928-35. [DOI: 10.1016/j.jand.2013.04.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 04/02/2013] [Indexed: 01/21/2023]
|
21
|
Kang SC, Kim HJ, Kim MH. Effects of Astragalus membranaceus with supplemental calcium on bone mineral density and bone metabolism in calcium-deficient ovariectomized rats. Biol Trace Elem Res 2013; 151:68-74. [PMID: 23136088 DOI: 10.1007/s12011-012-9527-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 10/11/2012] [Indexed: 10/27/2022]
Abstract
It has been reported that Astragalus membranaceus, an Asian traditional herb, has an estrogenic effect in vitro. To examine the possible role of A. membranaceus extract with supplemental calcium (Ca) on bone status in calcium-deficient (LCa) ovariectomized (OVX) rats, a total of 48 female rats were divided into six groups: (1) normal control, (2) sham operation with LCa (sham-LCa), (3) OVX with LCa (OVX-LCa), (4) A. membranaceus supplementation with OVX-LCa (OVX-MLCa), (5) Ca supplementation with OVX (OVX-Ca), and (6) A. membranaceus and Ca supplementation with OVX (OVX-MCa). A. membranaceus ethanol extract (500 mg/kg BW) and/or Ca (800 mg/kg BW) were administered orally for 8 weeks along with a Ca-deficient diet. Results revealed that Ca supplementation with or without A. membranaceus extract significantly improved bone mineral density, biomechanical strength, and ash weight of the femur and tibia in OVX rats. High Ca with A. membranaceus combination supplementation significantly increased the ash weight of the femur and tibia and decreased urinary Ca excretion compared with supplementation of Ca alone. Uterine weight was not changed by A. membranaceus administration in OVX rats. These results suggest that A. membranaceus extract combined with supplemental Ca may be more protective against the Ca loss of bone than A. membranaceus or supplementation of Ca alone in calcium-insufficient postmenopausal women.
Collapse
Affiliation(s)
- Se-Chan Kang
- Department of Life Science, Gachon University, Seongnam, Gyeonggi, Republic of Korea
| | | | | |
Collapse
|
22
|
Rosanoff A, Weaver CM, Rude RK. Suboptimal magnesium status in the United States: are the health consequences underestimated? Nutr Rev 2012; 70:153-64. [PMID: 22364157 DOI: 10.1111/j.1753-4887.2011.00465.x] [Citation(s) in RCA: 183] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
In comparison with calcium, magnesium is an "orphan nutrient" that has been studied considerably less heavily. Low magnesium intakes and blood levels have been associated with type 2 diabetes, metabolic syndrome, elevated C-reactive protein, hypertension, atherosclerotic vascular disease, sudden cardiac death, osteoporosis, migraine headache, asthma, and colon cancer. Almost half (48%) of the US population consumed less than the required amount of magnesium from food in 2005-2006, and the figure was down from 56% in 2001-2002. Surveys conducted over 30 years indicate rising calcium-to-magnesium food-intake ratios among adults and the elderly in the United States, excluding intake from supplements, which favor calcium over magnesium. The prevalence and incidence of type 2 diabetes in the United States increased sharply between 1994 and 2001 as the ratio of calcium-to-magnesium intake from food rose from <3.0 to >3.0. Dietary Reference Intakes determined by balance studies may be misleading if subjects have chronic latent magnesium deficiency but are assumed to be healthy. Cellular magnesium deficit, perhaps involving TRPM6/7 channels, elicits calcium-activated inflammatory cascades independent of injury or pathogens. Refining the magnesium requirements and understanding how low magnesium status and rising calcium-to-magnesium ratios influence the incidence of type 2 diabetes, metabolic syndrome, osteoporosis, and other inflammation-related disorders are research priorities.
Collapse
Affiliation(s)
- Andrea Rosanoff
- Center for Magnesium Education & Research, 13-1255 Malama Street, Pahoa, HI 96778, USA.
| | | | | |
Collapse
|
23
|
Roman Viñas B, Ribas Barba L, Ngo J, Gurinovic M, Novakovic R, Cavelaars A, de Groot LCPGM, van't Veer P, Matthys C, Serra Majem L. Projected prevalence of inadequate nutrient intakes in Europe. ANNALS OF NUTRITION AND METABOLISM 2011; 59:84-95. [PMID: 22142665 DOI: 10.1159/000332762] [Citation(s) in RCA: 211] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Accepted: 08/15/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND The purpose of this study was to analyze the prevalence of nutrient intake inadequacy in Europe, applying the Nordic Nutritional Recommendations in the context of the EURRECA Network of Excellence. METHODS Nutrient data was obtained from the European Nutrition and Health Report II. Those nutritional surveys using a validated food frequency questionnaire or diet history and a food diary/ register with at least 7 days of registers or with an adjustment for intraindividual variability were included. The nutrients analyzed were: vitamin C, vitamin D, vitamin B(12), folic acid, calcium, iron, zinc, selenium, copper, and iodine. The estimated average requirement cut point was applied to estimate inadequacy. The Nordic and Institute of Medicine nutrient recommendations were used as references. RESULTS The mean prevalence of inadequacy was below 11% for zinc, iron, and vitamin B(12) (only in the elderly), and it was 11-20% for copper in adults and the elderly and for vitamin B(12) in adults and vitamin C in the elderly. The prevalence was above 20% for vitamin D, folic acid, calcium, selenium, and iodine in adults and the elderly and for vitamin C in adults. CONCLUSIONS Vitamin C, vitamin D, folic acid, calcium, selenium, and iodine were the nutrients showing a higher prevalence of inadequate intakes in Europe.
Collapse
Affiliation(s)
- Blanca Roman Viñas
- Community Nutrition Research Centre of the Nutrition Research Foundation, University of Barcelona Science Park, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Bae YJ, Bu SY, Kim JY, Yeon JY, Sohn EW, Jang KH, Lee JC, Kim MH. Magnesium supplementation through seaweed calcium extract rather than synthetic magnesium oxide improves femur bone mineral density and strength in ovariectomized rats. Biol Trace Elem Res 2011; 144:992-1002. [PMID: 21584658 DOI: 10.1007/s12011-011-9073-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Accepted: 05/04/2011] [Indexed: 10/18/2022]
Abstract
Commercially available seaweed calcium extract can supply high amounts of calcium as well as significant amounts of magnesium and other microminerals. The purpose of this study was to investigate the degree to which the high levels of magnesium in seaweed calcium extract affects the calcium balance and the bone status in ovariectomized rats in comparison to rats supplemented with calcium carbonate and magnesium oxide. A total of 40 Sprague-Dawley female rats (7 weeks) were divided into four groups and bred for 12 weeks: sham-operated group (Sham), ovariectomized group (OVX), ovariectomized with inorganic calcium and magnesium supplementation group (OVX-Mg), and ovariectomized with seaweed calcium and magnesium supplementation group (OVX-SCa). All experimental diets contained 0.5% calcium. The magnesium content in the experimental diet was 0.05% of the diet in the Sham and OVX groups and 0.1% of the diet in the OVX-Mg and OVX-SCa groups. In the calcium balance study, the OVX-Mg and OVX-SCa groups were not significantly different in calcium absorption compared to the OVX group. However, the femoral bone mineral density and strength of the OVX-SCa group were higher than those of the OVX-Mg and OVX groups. Seaweed calcium with magnesium supplementation or magnesium supplementation alone did not affect the serum ALP and CTx levels in ovariectomized rats. In summary, consumption of seaweed calcium extract or inorganic calcium carbonate with magnesium oxide demonstrated the same degree of intestinal calcium absorption, but only the consumption of seaweed calcium extract resulted in increased femoral bone mineral density and strength in ovariectomized rats. Our results suggest that seaweed calcium extract is an effective calcium and magnesium source for improving bone health compared to synthetic calcium and magnesium supplementation.
Collapse
Affiliation(s)
- Yun Jung Bae
- Department of Food and Nutritional Sciences, Hanbuk University, Dongducheon, 483-120, South Korea
| | | | | | | | | | | | | | | |
Collapse
|
25
|
Chiuve SE, Korngold EC, Januzzi JL, Gantzer ML, Albert CM. Plasma and dietary magnesium and risk of sudden cardiac death in women. Am J Clin Nutr 2011; 93:253-60. [PMID: 21106914 PMCID: PMC3021423 DOI: 10.3945/ajcn.110.002253] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Magnesium has antiarrhythmic properties in cellular and experimental models; however, its relation to sudden cardiac death (SCD) risk is unclear. OBJECTIVE We prospectively examined the association between magnesium, as measured in diet and plasma, and risk of SCD. DESIGN The analysis was conducted within the Nurses' Health Study. The association for magnesium intake was examined prospectively in 88,375 women who were free of disease in 1980. Information on magnesium intake, other nutrients, and lifestyle factors was updated every 2-4 y through questionnaires, and 505 cases of sudden or arrhythmic death were documented over 26 y of follow-up. For plasma magnesium, a nested case-control analysis including 99 SCD cases and 291 controls matched for age, ethnicity, smoking, and presence of cardiovascular disease was performed. RESULTS After multivariable adjustment for confounders and potential intermediaries, the relative risk of SCD was significantly lower in women in the highest quartile compared with those in the lowest quartile of dietary (relative risk: 0.63; 95% CI: 0.44, 0.91) and plasma (relative risk: 0.23; 95% CI: 0.09, 0.60) magnesium. The linear inverse relation with SCD was strongest for plasma magnesium (P for trend = 0.003), in which each 0.25-mg/dL (1 SD) increment in plasma magnesium was associated with a 41% (95% CI: 15%, 58%) lower risk of SCD. CONCLUSIONS In this prospective cohort of women, higher plasma concentrations and dietary magnesium intakes were associated with lower risks of SCD. If the observed association is causal, interventions directed at increasing dietary or plasma magnesium might lower the risk of SCD.
Collapse
Affiliation(s)
- Stephanie E Chiuve
- Center for Arrhythmia Prevention, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | | | | | | | | |
Collapse
|
26
|
Chiuve SE, Korngold EC, Januzzi JL, Gantzer ML, Albert CM. Plasma and dietary magnesium and risk of sudden cardiac death in women. Am J Clin Nutr 2011; 93:253-260. [PMID: 21106914 DOI: 10.3945/ajcn.110.00225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Magnesium has antiarrhythmic properties in cellular and experimental models; however, its relation to sudden cardiac death (SCD) risk is unclear. OBJECTIVE We prospectively examined the association between magnesium, as measured in diet and plasma, and risk of SCD. DESIGN The analysis was conducted within the Nurses' Health Study. The association for magnesium intake was examined prospectively in 88,375 women who were free of disease in 1980. Information on magnesium intake, other nutrients, and lifestyle factors was updated every 2-4 y through questionnaires, and 505 cases of sudden or arrhythmic death were documented over 26 y of follow-up. For plasma magnesium, a nested case-control analysis including 99 SCD cases and 291 controls matched for age, ethnicity, smoking, and presence of cardiovascular disease was performed. RESULTS After multivariable adjustment for confounders and potential intermediaries, the relative risk of SCD was significantly lower in women in the highest quartile compared with those in the lowest quartile of dietary (relative risk: 0.63; 95% CI: 0.44, 0.91) and plasma (relative risk: 0.23; 95% CI: 0.09, 0.60) magnesium. The linear inverse relation with SCD was strongest for plasma magnesium (P for trend = 0.003), in which each 0.25-mg/dL (1 SD) increment in plasma magnesium was associated with a 41% (95% CI: 15%, 58%) lower risk of SCD. CONCLUSIONS In this prospective cohort of women, higher plasma concentrations and dietary magnesium intakes were associated with lower risks of SCD. If the observed association is causal, interventions directed at increasing dietary or plasma magnesium might lower the risk of SCD.
Collapse
Affiliation(s)
- Stephanie E Chiuve
- Center for Arrhythmia Prevention, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | | | | | | | | |
Collapse
|
27
|
Impact of a Nutrition Education Program to Increase Intake of Calcium-Rich Foods by Chinese-American Women. ACTA ACUST UNITED AC 2011; 111:143-9. [DOI: 10.1016/j.jada.2010.10.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2010] [Accepted: 07/02/2010] [Indexed: 11/22/2022]
|
28
|
Saquib J, Rock CL, Natarajan L, Saquib N, Newman VA, Patterson RE, Thomson CA, Al-Delaimy WK, Pierce JP. Dietary intake, supplement use, and survival among women diagnosed with early-stage breast cancer. Nutr Cancer 2011; 63:327-33. [PMID: 21391124 PMCID: PMC3078826 DOI: 10.1080/01635581.2011.535957] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Previous studies examining the relationship between micronutrient intakes and survival following diagnosis of breast cancer have reported mixed results. This may be partly due to considerable variance in amounts of micronutrients consumed from diet and supplements across studies. Early-stage breast cancer survivors (N = 3081) completed four 24-h dietary and supplement recalls at the baseline assessment (1995 to 2000) and were followed for a median of 9.0 yr. Mean micronutrient intakes were compared to dietary reference intakes (DRI) to assess micronutrient adequacy for both users and nonusers of supplements. Cox regressions were performed to assess whether intakes of selected micronutrients were associated with all-cause mortality. Four hundred and twelve deaths occurred between baseline and August 2009. Among these women, more supplement users had adequate micronutrient intakes than nonusers for 15 out of 17 micronutrients. Less than 10% of supplement users (<2% of nonsupplement users) reported levels that exceeded the tolerable upper limit for each micronutrient except magnesium. After adjusting for age, tumor characteristics, and health status variables, micronutrient intakes were not significantly associated with all-cause mortality. Dietary supplements may improve overall micronutrient intakes of breast cancer survivors. However, vitamin and mineral intakes were not associated with all-cause mortality.
Collapse
Affiliation(s)
- Juliann Saquib
- Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA
| | - Cheryl L. Rock
- Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA
| | - Loki Natarajan
- Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA
| | - Nazmus Saquib
- Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA
| | - Vicky A. Newman
- Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA
| | - Ruth E. Patterson
- Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA
| | - Cynthia A. Thomson
- Arizona Cancer Center, Department of Nutritional Sciences, University of Arizona, Tucson, AZ
| | - Wael K. Al-Delaimy
- Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA
| | - John P. Pierce
- Moores UCSD Cancer Center, University of California, San Diego, La Jolla, CA
| |
Collapse
|
29
|
Factors associated with use of calcium and calcium/vitamin D supplements in older Mexican Americans: Results of the Hispanic EPESE study. ACTA ACUST UNITED AC 2010; 8:161-9. [PMID: 20439065 DOI: 10.1016/j.amjopharm.2010.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2010] [Indexed: 11/21/2022]
Abstract
BACKGROUND Current studies indicate that older Mexican Americans take fewer calcium or calcium/vitamin D supplements than do older non-Hispanic whites. Factors associated with calcium supplement use are not completely understood in this ethnic group. OBJECTIVE The purpose of this article was to determine the prevalence of calcium or calcium/vitamin D supplementation and factors associated with their use in older Mexican Americans. METHODS A cross-sectional survey was conducted in a random sample of older Mexican Americans residing in the southwestern United States who had participated in the Hispanic Established Populations for the Epidemiologic Study of the Elderly. Self-identified Mexican Americans >or=75 years of age were enrolled through household interviews in 2004-2005. Each subject was asked to bring all prescription and nonprescription medications that they had used regularly during the previous 2 weeks to allow the interviewer to record the product names. Dosages were not recorded. Subjects were assigned to 1 of 3 categories based on their use of calcium or calcium/vitamin D supplements during the previous 2 weeks: (1) calcium supplement only, (2) calcium/vitamin D supplement, or (3) vitamin D supplement only. The subjects' sociodemographic and cultural factors, self-reported health and functional status, cognitive status, number of comorbidities, and use of antiosteoporosis medications were recorded. RESULTS A total of 2069 older Mexican Americans (1272 women, 797 men; mean age, 81.9 years) were enrolled. The overall prevalence of calcium supplement use was 10.6% (weighted). Calcium supplements were used more often by women (odds ratio [OR] = 1.76; 95% CI, 1.17-2.63), subjects with multiple comorbidities (OR = 1.29; 95% CI, 1.10-1.50), those who interviewed in English (OR = 1.59; 95% CI, 1.06-2.40), and those who used antiosteoporosis medications (OR = 3.57; 95% CI, 1.85-6.89). CONCLUSIONS Use of calcium or calcium/vitamin D supplements was low (<60%) among this group of older Mexican Americans. Men are particularly at risk. More should be done to raise awareness regarding the benefits of calcium supplementation in this ethnic group.
Collapse
|
30
|
Nakamura YK, Omaye ST. Lipophilic compound-mediated gene expression and implication for intervention in reactive oxygen species (ROS)-related diseases: mini-review. Nutrients 2010; 2:725-36. [PMID: 22254050 PMCID: PMC3257678 DOI: 10.3390/nu2070725] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Revised: 07/02/2010] [Accepted: 07/05/2010] [Indexed: 12/31/2022] Open
Abstract
In addition to exhibiting antioxidant properties, conjugated linoleic acid (CLA) and vitamin E may modulate gene expression of endogenous antioxidant enzymes. Depending on cellular microenvironments, such modulation reflects either antioxidant or prooxidant outcomes. Although epidemiological/experimental studies have indicated that CLA and vitamin E have health promoting properties, recent findings from clinical trials have been inconclusive. Discrepancies between the results found from prospective studies and recent clinical trials might be attributed to concentration-dependent cellular microenvironment alterations. We give a perspective of possible molecular mechanisms of actions of these lipophilic compounds and their implications for interventions of reactive oxygen species (ROS)-related diseases.
Collapse
Affiliation(s)
- Yukiko K Nakamura
- Department of Nutrition, University of Nevada, Reno, Nevada 89557-0208, USA.
| | | |
Collapse
|
31
|
Bailey RL, Dodd KW, Goldman JA, Gahche JJ, Dwyer JT, Moshfegh AJ, Sempos CT, Picciano MF. Estimation of total usual calcium and vitamin D intakes in the United States. J Nutr 2010; 140:817-22. [PMID: 20181782 PMCID: PMC2838624 DOI: 10.3945/jn.109.118539] [Citation(s) in RCA: 405] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Our objective in this study was to estimate calcium intakes from food, water, dietary supplements, and antacids for U.S. citizens aged >or=1 y using NHANES 2003-2006 data and the Dietary Reference Intake panel age groupings. Similar estimates were calculated for vitamin D intake from food and dietary supplements using NHANES 2005-2006. Diet was assessed with 2 24-h recalls; dietary supplement and antacid use were determined by questionnaire. The National Cancer Institute method was used to estimate usual nutrient intake from dietary sources. The mean daily nutrient intake from supplemental sources was added to the adjusted dietary intake estimates to produce total usual nutrient intakes for calcium and vitamin D. A total of 53% of the U.S. population reported using any dietary supplement (2003-2006), 43% used calcium (2003-2006), and 37% used vitamin D (2005-2006). For users, dietary supplements provided the adequate intake (AI) recommendation for calcium intake for approximately 12% of those >or=71 y. Males and females aged 1-3 y had the highest prevalence of meeting the AI from dietary and total calcium intakes. For total vitamin D intake, males and females >or=71, and females 14-18 y had the lowest prevalence of meeting the AI. Dietary supplement use is associated with higher prevalence of groups meeting the AI for calcium and vitamin D. Monitoring usual total nutrient intake is necessary to adequately characterize and evaluate the population's nutritional status and adherence to recommendations for nutrient intake.
Collapse
Affiliation(s)
- Regan L. Bailey
- Office of Dietary Supplements, and; National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-7517; USDA, Agricultural Research Service, Beltsville, MD; Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD 20782,To whom correspondence should be addressed. E-mail:
| | - Kevin W. Dodd
- Office of Dietary Supplements, and; National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-7517; USDA, Agricultural Research Service, Beltsville, MD; Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD 20782
| | - Joseph A. Goldman
- Office of Dietary Supplements, and; National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-7517; USDA, Agricultural Research Service, Beltsville, MD; Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD 20782
| | - Jaime J. Gahche
- Office of Dietary Supplements, and; National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-7517; USDA, Agricultural Research Service, Beltsville, MD; Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD 20782
| | - Johanna T. Dwyer
- Office of Dietary Supplements, and; National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-7517; USDA, Agricultural Research Service, Beltsville, MD; Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD 20782
| | - Alanna J. Moshfegh
- Office of Dietary Supplements, and; National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-7517; USDA, Agricultural Research Service, Beltsville, MD; Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD 20782
| | - Christopher T. Sempos
- Office of Dietary Supplements, and; National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-7517; USDA, Agricultural Research Service, Beltsville, MD; Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD 20782
| | - Mary Frances Picciano
- Office of Dietary Supplements, and; National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-7517; USDA, Agricultural Research Service, Beltsville, MD; Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD 20782
| |
Collapse
|