The nutrition contribution of dietary supplements on total nutrient intake in children and adolescents

Questionable advisability of vitamin and mineral dietary supplement use in adolescents

OBJECTIVE

Present study aimed to assess potential health risk in Slovenian adolescents due to inadequate diet and/or dietary supplement (DS) use.

METHODS

Data on DS use, micronutrient intake (24-h recall), eating habits (FFQ), body height and mass were collected within ACDSi (Analysis of Children's Development in Slovenia) cross-sectional study conducted in 2014. Adolescents enrolled in first year of 15 secondary schools (average (SD) age: 15.4 (0.7) years, N = 342) were included in the sample.

RESULTS

Adolescents' use of DS (especially multivitamins ingested as a popular drink (60%), magnesium (16%), and vitamin C (10%)) significantly contributed to their absolute intake of vitamins/minerals, resulting in higher percentage of DS users meeting reference values proposed by the nutrition societies of Germany, Austria, and Switzerland (D-A-CH recommendation). Simultaneously, DS users did not exceed the upper tolerable level proposed by the European Food Safety Authority for daily intake. With diet alone, adolescents consumed less than recommended amounts of the following vitamins/minerals: the intake was lowest for fat-soluble vitamins A, D, and E; water-soluble vitamins folate, biotin, and pantothenic acid; and minerals fluoride, iodine, chromium, and molybdenum. Suboptimal intake was due to the fact that around ¾ of adolescents consumed less than 54% of the recommended amounts (according to Optimized Mixed Diet (OMD) recommendations) for fruits, vegetables, milk/dairy products, fish, and cereals/cereal products. In contrast, the diet contributed to the consumption of 200-300% of D-A-CH minimum value for sodium. Furthermore, almost ¾ of adolescents exceeded the recommended amount for meat/meat products (320% of OMD) and sweet/salty snacks (453% of OMD).

CONCLUSIONS

Although DS use improved micronutrient intake in adolescents (especially vitamin C and magnesium), activities on public-health interventions should be focus to improve their diets, especially to achieve increased intakes of fruits, vegetables, cereals/cereal products and milk/dairy products, and to reduce consumption of sweet/salty snacks and meat products.

Association between Eating Habits and Sodium Intake among Chinese University Students

(1) Background: Insufficient evidence exists regarding the dietary habits that may contribute to high sodium intake among college students in China. This cross-sectional study aimed to investigate the dietary sodium intake of college students in Hunan and its association with their dietary habits. (2) Methods: In total, 585 university students from Hunan were recruited for this study. The sodium Food Frequency Questionnaire (sodium-FFQ) and dietary habits were assessed. (3) Results: Excluding cooking salt and high-sodium seasonings, the daily dietary sodium intake among college students in Changsha, Hunan Province, was 1183.74 (563.38, 2054.86) mg/day. A vast majority (89%) of college students reported eating outside of school at least once a week, and approximately one-third (34%) ordered takeaways at least once a week. After adjusting for confounding factors, the associations between the frequency of eating out and ordering takeaways with college students' sodium intake remained significant. (4) Conclusions: The findings indicate that excessive dietary sodium intake among college students in Hunan is a growing concern. College students who frequently eat out and order takeaways tend to have a higher sodium intake. Future research should focus on identifying the main sources of dietary sodium and developing interventions that promote healthy dietary habits among college students.

Food and nutrient intake in dietary supplement users: a nationwide school-based study in Japan

Dietary supplements can be used to compensate for an inadequate diet. However, some studies indicate that supplement users consume healthier diets than non-users, although such data are lacking in Japanese children. The aim of the present study was to investigate the food and nutrient intake of dietary supplement users among school-aged children in Japan. A nationwide school dietary survey was conducted at fourteen elementary schools and thirteen junior high schools in twelve prefectures in Japan. Three-day non-consecutive semi-weighed dietary records were obtained on two weekdays and one weekend day. Analysis of covariance was performed to investigate differences in food and nutrient intake from meals consumed at school and outside of school between dietary supplement users and non-users, adjusted for socio-demographic and health-related characteristics. Of the 910 children included in this analysis, 80 (8⋅8 %) reported supplement use. Based on 3-d dietary records, dietary supplement users consumed higher mean amounts of oils and lower amounts of fruits and vegetables than non-users. In school lunches, users consumed significantly higher amounts of oils and lower amounts of protein than non-users. In meals consumed outside of school, dietary supplement users consumed significantly higher amounts of confectioneries and lower amounts of fruits and vegetables, folate, vitamin C and dietary fibre than non-users. Collectively, our findings indicate that dietary supplement users consumed less healthy diets than non-users. Additional studies are warranted to confirm these results and identify factors contributing to poorer dietary habits in supplement users.

Gastrointestinal Symptoms and Feeding Problems and Their Associations with Dietary Interventions, Food Supplement Use, and Behavioral Characteristics in a Sample of Children and Adolescents with Autism Spectrum Disorders

Autism spectrum disorders (ASD) are characterized by impairments in social interaction, communication, and restricted, stereotyped behavior. Gastrointestinal (GI), nutritional, and feeding problems are often reported in ASD. We investigated the prevalence of GI symptoms, food selectivity, and mealtime difficulties, and their associations with dietary interventions, food supplement use, and behavioral characteristics in a sample involving 247 participants with ASD and 267 controls aged 2-18 years. Data were collected by a questionnaire. GI symptoms were observed in 88.9% of children and adolescents with ASD, more often in girls than in boys. High rates of food selectivity (69.1%) and mealtime problems (64.3%) were found. Food supplements were used by 66.7% of individuals, mainly vitamins/minerals, probiotics, and omega-3 fatty acids. In the ASD sample, 21.2% of subjects followed a diet, mostly based on gluten and milk restriction, including individuals exhibiting food selectivity. Frequency of GI symptoms, food selectivity, and mealtime problems correlated weakly, but significantly with behavioral characteristics in the ASD group, but not with food supplement use. The study demonstrated that higher frequency of GI symptoms, food selectivity, and mealtime problems are a common problem in pre-schoolers, schoolchildren, and adolescents with ASD, and together with dietary modification, they are significantly associated with ASD.

Use of vitamin and mineral supplements among adolescents living in Germany-Results from EsKiMo II

Dietary supplements may contribute to nutrient intake; however, actual data on dietary supplement use among adolescents living in Germany are rare. The aim of this analysis was to describe the current use of dietary supplements, its determinants, and reasons of use. Changes in supplement use over time were evaluated by comparing the results with those from EsKiMo I (2006). Data from the Eating Study as a KiGGS Module EsKiMo II (2015-2017) were used to analyze supplement intake according to sociodemographic, health characteristics, and physical exercise behavior of 12-17-year-olds (n = 1356). Supplement use during the past four weeks was assessed by a standardized computer assisted personal interview. Multivariable logistic regression was used to identify the association between supplement use and its determinants. Between 2015-2017, 16.4% (95%-CI: 13.0-19.7%) of the adolescents used dietary supplements, and its use decreased with lower levels of physical exercise and overweight. Most supplement users used only one supplement, often containing both vitamins and minerals. The most frequently supplemented nutrients were vitamin C and magnesium. The main reported reason to use supplements was 'to improve health'. Prevalence of supplement use was slightly lower in 2015-2017 than in 2006 (18.5%; 95%-CI: 15.8-21.2%). The results underline the importance of including nutrient intake through dietary supplements in nutrition surveys.

Development of Databases on Iodine in Foods and Dietary Supplements

Iodine is an essential micronutrient required for normal growth and neurodevelopment; thus, an adequate intake of iodine is particularly important for pregnant and lactating women, and throughout childhood. Low levels of iodine in the soil and groundwater are common in many parts of the world, often leading to diets that are low in iodine. Widespread salt iodization has eradicated severe iodine deficiency, but mild-to-moderate deficiency is still prevalent even in many developed countries. To understand patterns of iodine intake and to develop strategies for improving intake, it is important to characterize all sources of dietary iodine, and national databases on the iodine content of major dietary contributors (including foods, beverages, water, salts, and supplements) provide a key information resource. This paper discusses the importance of well-constructed databases on the iodine content of foods, beverages, and dietary supplements; the availability of iodine databases worldwide; and factors related to variability in iodine content that should be considered when developing such databases. We also describe current efforts in iodine database development in the United States, the use of iodine composition data to develop food fortification policies in New Zealand, and how iodine content databases might be used when considering the iodine intake and status of individuals and populations.

Association between Eating Out and Socio-Demographic Factors of University Students in Chongqing, China

(1) Objective: We aimed to explore the current situation of eating out and the association with socio-demographic factors of university students in Chongqing, China. (2) Methods: We used self-administered questionnaires to collect information. There are 14 universities in Chongqing; four (Chongqing Medical University, Chongqing University, Chongqing Normal University, and Chongqing University of Science & Technology) were randomly selected. In each selected university, two disciplines were randomly selected. (3) Results: 4595 university students participated in the study. The frequency of eating out was relatively high. The frequency of eating out among females was higher than that among males during weekdays. The two main reasons for eating out were having an opportunity to meet friends (56.0%) and improving diet (39.6%). Bistros (61.7%) and hot-pot restaurants (41.1%) were the favorite places for eating out. Only 36.0% of the participants said they considered nutrition and food safety when selecting restaurants. The majority of the participants demonstrated a high demand for nutrition and food safety knowledge when eating out (77.7%). (4) Conclusions: The higher the monthly living expenses were, the higher the frequency of eating out was. An intervention strategy to reduce the frequency or change the behavior of eating out should be formulated by considering the students’ perspectives.

Do Chinese Children Get Enough Micronutrients?

The aim of this study was to examine usual daily micronutrient intake of Chinese children based on data from the 2011 China Health and Nutrition Survey. We analyzed data from 4 to 17-year-old participants, who provided dietary data on three consecutive days combined with the household weighing method in 2011. Usual daily intake of each nutrient was estimated using a mixed effects model based on the China Food Composition published in 2009. The means, medians and percentages below Estimated Average Requirements (EAR) were reported for selected micronutrients, including calcium, sodium, potassium, iron, zinc, selenium, vitamin A, thiamine, riboflavin and vitamin C. For sodium and potassium, the means and the distribution of intakes were compared to the Adequate Intake (AI) level. The average usual daily intakes of all micronutrients increase with age, and the intakes of boys were found to be higher than girls in the same age group. The average calcium intake increased from 272 mg/day in 4–6 years to 391 mg/day in 14–17 years, but the percentage of inadequate calcium intake remained very high (>96%). The prevalence of inadequacy of calcium was the highest among the mineral nutrients reported in this study. As the requirements of micronutrients increased with age, the percentage of subjects with inadequate intake increased in the 11–17 years age groups. Among 14–17 years group, the percentages of study participants with dietary intakes of calcium, iron, zinc, selenium, vitamin A, thiamine, riboflavin and vitamin C below the EAR were 96.8%, 18.8%, 37.6%, 72.8%, 36.8%, 91.8%. 85.9% and 75.5%, respectively. Among 11–13 years group, the percentages of study participants with dietary intakes of iron, zinc and vitamin A below the EAR were 23.5%, 41.5%, and 41.6%, respectively. Thus, micronutrient deficiency is a problem in Chinese children. Nutrition education and intervention programs are needed to address these nutritional gaps.