Inadequate dietary intake of minerals: prevalence and association with socio-demographic and lifestyle factors

Dietary calcium intake among Iranian adults: Iranian Multicenter Osteoporosis Study (IMOS-2021)

BACKGROUND

Adequate dietary consumption of calcium is crucial in the preservation of bone health and the prevention of osteoporosis. This study investigated the prevalence of insufficient dietary calcium intake among individuals aged ≥50 years in Iran.

METHODS

We analyzed data from the Iranian Multicenter Osteoporosis Study (IMOS-2021). Participants aged 50 years and older completed a 168-item food frequency questionnaire. Insufficient dietary calcium intake was characterized as a daily calcium intake of <1000 mg for men aged 50-70 years, and <1200 mg for men over 70 years and women over 50 years and older. Stata v17 statistical software facilitated a survey set analysis to estimate the population's mean and median dietary calcium intake and the prevalence of insufficient dietary calcium intake.

RESULTS

The study included 1450 participants with a mean age of 60.7±7.9 years. The estimated mean dietary calcium intake in Iran was 1062.7 mg/day (95% CI: 1029.6-1095.8), with a median intake of 943.5 mg/d (95% CI: 910.5-976.4). The prevalence of insufficient dietary calcium intake in Iran was estimated to be 62.9% (95% CI: 60.0%-65.7%). Notably, the prevalence was higher among women at 75.5% (95% CI: 71.9%-78.8%), compared to men at 47.8% (95% CI: 43.4%-52.3%) with a significant difference (P<0.001). In age-related findings, individuals aged 65 years and older had a higher prevalence of insufficient intake, at 69.0% (95% CI: 63.9%-74.0%), versus those under 65 years, at 60.3% (95% CI: 56.9%-63.8%), with this difference being statistically significant (P = 0.007). Furthermore, a significant inverse relationship was identified between both educational years and socioeconomic status and the prevalence of insufficient dietary calcium intake (Ps for trends<0.001).

CONCLUSION

Our findings revealed a significant prevalence of insufficient dietary calcium intake in women and those aged 65 and older. We advocate for targeted public health strategies to ensure sufficient dietary calcium intake across these populations.

[Are there differences between men and women with respect to the factors associated with calcium intake?]

The scope of this article is to verify if there are differences in factors associated with calcium intake between men and women. It is based on a study conducted with data from a health survey in a sample of 1641 individuals aged 20 years or more living in the urban area of the city of Campinas, in the State of São Paulo. Calcium intake was obtained from a 24-hour recall (24hr recall method) and analyzed according to sociodemographic variables, health behavior, frequency of meals and body mass index (BMI). The existence of associations was verified by multiple linear regression tests, and it was detected that the profile of associated factors differed between genders. Physical exercise in the leisure context was only associated with calcium intake in males, while skin color, smoking, income, overweight/obesity, and frequency of having breakfast only revealed an association in females. Schooling and having snacks were associated with calcium intake in both sexes. The analysis of the associated factors indicates segments of the female and male population in which the importance of calcium intake needs to be more closely examined. Furthermore, it highlights the importance of conducting health analyses stratified by sex due to the different behavioral patterns that prevail between the sexes.

Assessment of dietary magnesium intake in the Eastern Province of Saudi Arabia

Magnesium is an essential element and the most abundant intracellular cation after potassium. This cross-sectional study assessed the average dietary magnesium intake among residents of the Eastern Province of Saudi Arabia. Data was collected using a self-reported validated electronic questionnaire between April 2022 and July 2023. The first part of the survey included demographic data, and the second section comprised 33 items, including a semi-quantitative tool specifically designed to evaluate magnesium intake over the last three months. We included 1065 participants, out of whom 61.1% were women. The predominant age group was 19 - 26 years (56.9%), and most participants (83.3%) reported no comorbidities. The majority (48.5%) had normal weight, 246 (23%) were overweight, and 193 (18.1%) were obese. Most participants had low dietary magnesium intake, ranging from one to five times monthly. There was a positive correlation between age and dietary magnesium consumption. The study highlights a concerning trend of low magnesium intake, representing a risk for various chronic diseases. This trend could be linked to increased consumption of typical diets low in magnesium, such as those high in refined sugars, flour, and processed foods, prevalent among the younger Saudi population.

Chemical Composition and Antioxidant Potential of Five Algae Cultivated in Fully Controlled Closed Systems

In this study, the chemical composition and antioxidant profile of five edible macroalgae, Fucus vesiculosus, Palmaria palmata, Porphyra dioica, Ulva rigida, and Gracilaria gracilis, cultivated in fully controlled closed systems, were determined. Protein, carbohydrates, and fat contents ranged between 12.4% and 41.8%, 27.6% and 42.0%, and 0.1% and 3.4%, respectively. The tested seaweeds presented considerable amounts of Ca, Mg, K, Mn, and Fe, which reinforce their favorable nutritional profile. Regarding their polysaccharide composition, Gracilaria gracilis and Porphyra dioica were rich in sugars common to agar-producing red algae, and Fucus vesiculosus was composed mainly of uronic acids, mannose, and fucose, characteristic of alginate and fucoidans, whereas rhamnose and uronic acid, characteristic of ulvans, predominated in Ulva rigida. Comparatively, the brown F. vesiculosus clearly stood out, presenting a high polysaccharide content rich in fucoidans, and higher total phenolic content and antioxidant scavenging activity, determined by DPPH and ABTS. The remarkable potential of these marine macroalgae makes them excellent ingredients for a wide range of health, food, and industrial applications.

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

BACKGROUND & AIMS

We aimed to estimate the prevalence of the inadequate intake and status of magnesium, zinc, and vitamins A, C, E, and D and identify factors associated with micronutrient deficiency in serum/plasma among residents of São Paulo, Brazil.

METHODS

Data from 824 individuals aged ≥14 years were obtained from the 2015 ISA-Nutrition, a population-based, cross-sectional survey. Dietary and supplement intakes were assessed using two 24-h dietary recalls, and the micronutrient inadequacies were estimated using the National Cancer Institute method. Micronutrient status was measured in serum or plasma, and deficiency was established according to the lower limit of the reference values. Receiver operating characteristic curve analysis was used to identify the effect of intake on the micronutrient status in serum/plasma. Logistic regression analysis was applied to assess the association between micronutrient status and individual characteristics.

RESULTS

More than 80% of the population had an inadequate dietary intake of magnesium, vitamin E, and vitamin D. Males had a high prevalence of inadequate dietary intake of vitamin A and zinc. A high-to-moderate prevalence of inadequate vitamin C intake was observed. Vitamin D was the only nutrient with a deficient status comparable to its dietary inadequacy. The other nutrients demonstrated a lower deficiency prevalence compared to dietary inadequacy, and vitamin A demonstrated the lowest prevalence of deficiency in plasma. Generally, dietary intake showed a non-notable association with micronutrient deficiency in serum/plasma. Individuals with fasting glucose concentrations ≥100 mg/dL and those using diuretic drugs had a higher risk of serum magnesium deficiency. Those using lipid-lowering drugs and those with high plasma adiponectin concentrations had a higher risk of serum zinc deficiency. Individuals who smoked and those with hypertension showed a higher risk of plasma vitamin C deficiency. Individuals with average leptin concentrations had a higher risk of plasma vitamin E deficiency. Finally, those with sufficient leisure-time physical activity had a lower risk of serum vitamin D deficiency.

CONCLUSIONS

Residents of the urban areas of São Paulo demonstrated substantially inadequate intakes of most of the assessed micronutrients; however, micronutrient deficiency in serum/plasma was not associated with dietary inadequacy, and it usually demonstrated a lower prevalence than dietary indicators. Thus, using micronutrient intake to determine the serum/plasma profile should be done with caution. The status of the micronutrients varied according to individual characteristics, indicating the interplay of complex mechanisms underlying micronutrient balance.

Dietary Intake, Nutritional Adequacy, and Food Sources of Selected Antioxidant Minerals and Vitamins; and Their Relationship with Personal and Family Factors in Spanish Children Aged 1 to <10 Years: Results from the EsNuPI Study

Minerals and vitamins involved in the antioxidant defense system are essential for healthy growth and proper development during infancy. Milk and dairy products are of particular importance for improving the supply of these nutrients to children. Indeed, the present study aimed to evaluate the nutrient intake and food sources of zinc (Zn), selenium (Se), retinol and carotenoids (sources of vitamin A), and vitamins C and E, and to analyze their relationships with personal and familiar factors in Spanish children from the EsNuPI study. One subpopulation representative of the Spanish population from 1 to <10 years old (n = 707) (reference group, REF) who reported consuming all types of milk over the last year, and another subpopulation of the same age who reported consuming fortified milk formulas (FMFs) (including follow-on formula, young child formula, growing up milk, toddler’s milk, and enriched and fortified milk) (n = 741) (fortified milk consumers, FMCs) completed two 24 h dietary recalls used to estimate their nutrient intakes and to compare them to the European Food Safety Authority (EFSA) Dietary Reference Values (DRVs). The REF reported higher median intakes than FMCs for Se (61 µg/kg vs. 51 µg/kg) and carotenoids (1079 µg/day vs. 998 µg/day). Oppositely, FMCs reported higher intakes than REF for Zn (7.9 mg/day vs. 6.9 mg/day), vitamin A (636 µg/day vs. 481 µg/day), vitamin E (8.9 mg/day vs. 4.5 mg/day), vitamin C (113 mg/day vs. 71 mg/day), and retinol (376 µg/day vs. 233 µg/day). In the REF group, more than 50% of the children met the EFSA recommendations for Zn (79.6%), Se (87.1%), vitamin A (71.3%), and vitamin C (96.7%), respectively. On the other hand, 92.2% were below the EFSA recommendations for vitamin E. In the FMC group, more than 50% of the children met the EFSA recommendations for Zn (55.2%), Se (90.8%), vitamin A (75.7%), vitamin E (66.7%), and vitamin C (100%). We found statistically significant differences between subpopulations for all cases except for Se. In both subpopulations, the main sources of all antioxidant nutrients were milk and dairy products. For carotenoids, the main sources were vegetables and fruits followed by milk and dairy products. A high percentage of children had vitamins A and E intakes below the recommendations, information of great importance to stakeholders. More studies using intakes and biomarkers are needed, however, to determine an association with diverse factors of oxidative damage.

Opportunities for diet quality improvement: the potential role of staple grain foods

OBJECTIVE

Given the high disease burden associated with the low intake of whole grains, modelling studies that estimate the impact of dietary strategies to increase more healthful grain foods consumption are essential to inform evidence-based and culturally specific policies. The current study investigated the potential nutritional impact of replacing staple grain foods with more healthful options.

DESIGN

Based on the 2015 Health Survey of São Paulo, a cross-sectional, population-based study, we modelled the substitution of white rice and white bread with brown rice and whole-wheat bread. Outcomes included changes in more healthful grain foods, energy and nutrient intakes.

SETTING

Urban area of São Paulo, Brazil.

PARTICIPANTS

Participants aged over 12 years who completed a semi-structured questionnaire and one 24-h recall (n 1741).

RESULTS

The substitution of all white rice and white bread with brown rice and whole-wheat bread, respectively, would result in more than 5 % increases in Zn (+9·1 %), Ca (+9·3 %), vitamin E (+18·8 %), dietary fibre (+27·0 %) and Mg (+52·9 %) intake, while more than a 5 % decrease would be seen for total carbohydrate (-6·1 %), folate (-6·6 %), available carbohydrate (-8·5 %), Fe (-8·6 %), vitamin B6 (-12·5 %), vitamin B2 (-17·4 %), and vitamin B1 (-20·7 %). A substantial increase in the amount of more healthful grain foods consumed would be seen (10 g/d to 220 g/d, or from 4 % to 69 % of total grain intake).

CONCLUSIONS

Replacing white rice and white bread with their whole-grain versions has the potential to improve diet quality, suggesting they are prime targets for policy actions aiming at increasing intake of more healthful grain foods.

Dietary Intake and Urinary Excretion of Manganese in Korean Healthy Adults

Manganese (Mn) is an essential element for the body's composition and is required for various functions, including nutrient metabolism, immune system function, and antioxidant ability. However, there are insufficient data on the nutritional status of Mn. In this study, we aimed to analyze the relationship between Mn intake and urinary excretion in Korean adults. A twice dietary intake survey using a 24-h recall method was conducted on 640 adults (320 men and 320 women), aged 20 to 69 years. Eighty 24-h urine samples were also twice collected and urinary Mn excretions were analyzed. Results indicated that total Mn intake per day was 4.1 mg for men and 3.9 mg for women (p < 0.05). Mn intake per 1000 kcal of energy consumption was significantly higher in women than in men (2.0 mg/1,000 kcal vs. 2.2 mg/1000 kcal, p < 0.01). Additionally, Mn intake as a percentage of Adequate Intake was 103.0% for men and 110.3% for women (p < 0.05). Mn was mostly consumed from cereals (1.78 mg/day for men and 1.53 mg/day for women), followed by vegetables, seasonings, fruits, and pulses. The main food sources of Mn were rice (27.8% for men, 22.0% for women), kimchi (3.5% for men, 1.4% for women), and tofu (2.8% for men, 2.3% for women); the percentage of Mn consumed from 20 types of foods was 55.6% (women) to 60.4% (men). Urinary Mn excretion was negatively correlated with Mn intake from cereals and positively with mushrooms only for women after adjusting for confounding factors (p < 0.05). In conclusion, dietary Mn intake by Korean adults was adequate to meet the Dietary Reference Intake, but the relationship between Mn intake and urinary excretion was not clear.

Magnesium intake in a Longitudinal Study of Adult Health: associated factors and the main food sources

This study aimed to identify the sociodemographic and lifestyle factors associated with magnesium intake and describe the main food sources in the Brazilian Longitudinal Study of Adult Health (ELSA-Brazil). This observational, cross-sectional study was conducted using the baseline data from the ELSA-Brazil (2008-2010). Associations between usual magnesium intake and sociodemographic and lifestyle factors were analyzed using multiple linear regression. Food sources were identified by calculating the percentage contribution of each FFQ item to the amount of magnesium provided by all foods. The analysis was performed using Stata® software (version 12), assuming a statistical significance level of 5%. The top food sources to magnesium intake were as follows: beans, oats, nuts, white rice, orange, French bread, cooked fish, boneless meat, whole milk, and whole wheat bread. There were positive associations between magnesium intake and female sex; age ≥60 years; self-reported black, indigenous, or brown skin colors; per capita income ≥3 minimum wages, and moderate or vigorous physical activity levels. Sociodemographic and lifestyle factors were associated with magnesium intake among the evaluated individuals.

Food Sources of Shortfall Nutrients Among US Adolescents: National Health and Nutrition Examination Survey (NHANES) 2011-2014

To identify food sources of shortfall nutrients consumed by adolescents (n = 3156), data from the National Health and Nutrition Examination Survey (NHANES) (2011-2014) were used. Some of the food groups commonly consumed by adolescents made a significant contribution to shortfall nutrient intakes in the diet. Many food sources that provided significant amounts of shortfall nutrients were from foods that also provided nutrients to limit. Awareness of nutrient intakes and food sources is essential to establish dietary guidance in a practical context. Efforts to continue monitoring the food sources of nutrients consumed by adolescents will be important to improve the current knowledge on this topic of research.

Dietary Intake in Population with Metabolic Syndrome: Is the Prevalence of Inadequate Intake Influenced by Geographical Area? Cross-Sectional Analysis from PREDIMED-Plus Study

Inadequate diet influences chronic diseases such as cardiovascular disease (CVD), the leading cause of death in Spain. CVD figures vary from one geographical region to another; this could be associated with different food choices. Our aim was to analyse the influence of geographical area on nutrient intakes among the Spanish adult population with Metabolic Syndrome (MetS). We analysed cross-sectional baseline data from the PREDIMED-Plus study: 6646 Spanish adults, aged 55⁻75 years, with overweight/obesity and MetS in four geographical areas. A validated 143-item Food Frequency Questionnaire (FFQ) was used to assess energy and nutrient intakes. The prevalence of inadequate nutrient intake was estimated according to Dietary Reference Intakes (DRIs). Multivariable-adjusted logistic regression was used to assess the relationship between geographical area (North, Central, East and South areas) and inadequate nutrient intake. People in the North area consumed significantly lower amounts of vegetables and fish but more sugar and alcohol (p < 0.001) than other areas. Dietary fibre, vitamin A, E, calcium and magnesium intakes were all lower among men of North area than in the other areas (p < 0.001). Sex (women), non-smoker and physical activity were also associated to adequate nutrient intake. Geographical area influences nutrient intakes. Its effect on dietary quality should be taken into account when planning food policies.