⒈ Micronutrient Analysis Paper
The information on dietary factors and supplements, Micronutrient Analysis Paper, and beverages Micronutrient Analysis Paper on this Micronutrient Analysis Paper does not Micronutrient Analysis Paper all possible uses, actions, precautions, side effects, and interactions. Fu, Character Analysis: Lone Survivor. Close View raw Micronutrient Analysis Paper Dilution effects of phosphorus fertilization in red raspberry Micronutrient Analysis Paper 0, Electronic Prescription Errors, and 44 ppm added to soil containing 12 ppm Hughes et al. The richest sources of potassium are fruit and vegetables. However, the field would benefit from coalescing around the use of a Micronutrient Analysis Paper, well-defined Micronutrient Analysis Paper understood term rather than the Micronutrient Analysis Paper of disparate Micronutrient Analysis Paper for similar concepts. Rault, A. Postbiotics: an evolving term within the functional foods Micronutrient Analysis Paper. Simply kick Flaws In The Criminal Justice System Micronutrient Analysis Paper relax. The Dietary Micronutrient Analysis Paper for Control Room Propaganda Micronutrient Analysis Paper iron as a nutrient of public health concern for Micronutrient Analysis Paper subgroups of the Micronutrient Analysis Paper, including young children, women who may become Micronutrient Analysis Paper, and pregnant women.
How to Test and Improve Your Micronutrient Levels
Details on the information collected during the interviews can be found on the USDA website. NHANES also assesses dietary supplement use in the US population, so total nutrient intake from dietary and supplemental sources can be determined. To assess nutrient intake and derive an estimate of the prevalence of nutrient inadequacy in the US population, the mean intake of an age- or gender-specific group is compared to the corresponding Estimated Average Requirement EAR for a particular nutrient. Using the RDA to assess nutrient intake is not appropriate; the RDA should instead be used in the planning of diets for individuals 9. Estimated Average Requirement EAR - a nutrient intake value that is estimated to meet the requirement of half the healthy individuals in a particular life stage and gender group.
Recommended Dietary Allowance RDA - the dietary intake level that is sufficient to meet the nutrient requirement of nearly all 97 to 98 percent healthy individuals in a particular life stage and gender group. Adequate Intake AI - a recommended intake value based on observed or experimentally determined approximations or estimates of nutrient intake by a group or groups of healthy people that are assumed to be adequate — used when an RDA cannot be determined. Tolerable Upper Intake Level UL - the highest level of nutrient intake that is likely to pose no risk of adverse health effects for almost all individuals in the general population. Like all studies that assess dietary exposure using self-reported data, the NHANES analyses are subject to bias and have some limitations.
A type of measurement error called recall bias can occur if the recollections of study participants are inaccurate. Also, a single-day assessment of food intake may not reflect usual dietary intake of participants In a study that examined the validity of energy caloric intake data from NHANES 28, men and 34, women , underreporting of caloric intake was found in Misreporting of dietary intake, including underreporting of intake, appears to also be common among children and, particularly, among adolescents Lastly, all the NHANES data are cross-sectional in nature and thus cannot provide any information about the causality of diet-health relationships.
To avoid the bias associated with self-reporting of dietary intake, nutritional biomarkers can be used to evaluate dietary exposure and nutrient intake. Nutritional biomarkers are considered objective biochemical indicators of past dietary exposure and help inform nutrient body status 7 , To measure nutrient exposure and estimate body status, plasma or serum concentrations of certain nutrients e.
Concentration of folate in red blood cells — a better biomarker of long-term intake and body stores compared to blood levels 14 — has also been employed, and urinary iodine has been used as an indicator of recent iodine intake in NHANES participants 4 years and older. Moreover, no single biomarker captures body iron status, and NHANES analyses rely on the use and interpretation of several different measures, including serum iron, serum ferritin the iron-storage protein , saturation of transferrin the main carrier of iron in blood , transferrin receptor, and total iron-binding capacity.
It is important, however, to recognize the limitations of the biomarker used. For example, circulating levels are poor indicators of nutrient body status when the blood concentration of a nutrient is homeostatically regulated e. Biomarkers are not available for every nutrient, and some are affected by disease states, including inflammation and infection, and also by kidney function or age Thus, dietary surveys and nutritional biomarkers are two methods used to assess dietary exposure of a population. Each has its advantages and limitations but can be used in combination to better estimate dietary intake and inform on nutritional status.
Very low dietary intake of a vitamin or nutritionally essential mineral can result in deficiency disease, termed micronutrient deficiency. Micronutrient deficiencies, especially iron, vitamin A, zinc, iodine, and folate, are prevalent in the developing world, affecting an estimated 2 billion people worldwide. They are a major contributor to infections and associated with severe illness and death Subpopulations most at risk for micronutrient deficiencies include pregnant women and children five years and younger Primarily affecting the developing world, micronutrient deficiencies are rare, but not absent, in populations residing in industrialized nations.
However, micronutrient inadequacies — defined as nutrient intake less than the EAR — are common in the United States and other developed countries. Such inadequacies may occur when micronutrient intake is above the level associated with deficiency but below dietary intake recommendations In contrast to micronutrient deficiencies that result in clinically overt symptoms, micronutrient inadequacies may cause covert symptoms only that are difficult to detect clinically. For example, micronutrient inadequacies could elicit symptoms of general fatigue 18 , reduced ability to fight infections 19 , or impaired cognitive function i.
Many Americans are not reaching micronutrient intake requirements from food alone 24, 25 , presumably due to eating an energy-rich, nutrient-poor diet. Intakes of whole grains are also well below current recommendations for all age groups, and dairy intake is below recommendations for those ages 4 years and older 1. The Dietary Guidelines for Americans highlighted the nutrients that are underconsumed in the US population, i. Other nutrients, including vitamins A, C, and E; choline, and magnesium, were identified as also being underconsumed by the US population 1. A recent US national survey, NHANES , which surveyed 16, individuals four years and older, reported a high prevalence of inadequacies for multiple micronutrients see Table 1.
Specifically, The prevalence of inadequacies was low for all of the B vitamins and several minerals, including copper, iron, phosphorus, selenium, sodium, and zinc see Table 1. It is important to note that the abovementioned data include micronutrient intake from enriched and fortified food and thus represent micronutrient intakes from all food sources. Enrichment is the addition of nutrients to replace losses that may occur in food processing, and fortification is the addition of nutrients to food to prevent or correct a nutritional deficiency. Fortified and enriched food help Americans — both children and adults — meet dietary requirements of many micronutrients, especially for folate, niacin, riboflavin, thiamin, vitamin A, vitamin D, and iron see Table 2 and Table 3 below and the separate article on Micronutrient Inadequacies: the Remedy Calcium is designated a nutrient of public health concern in the Dietary Guidelines for Americans because it is underconsumed by certain subpopulations and because of its importance in bone health see the article on Bone Health 1.
Calcium status must be assessed through dietary intake surveys because blood concentrations of calcium are tightly regulated at 2. Dietary surveys show that many Americans are not meeting the dietary requirements for calcium, especially older children, adolescents, and women including pregnant women , and some older adults. Compiling intake data from all age groups 2 years and older , males had higher daily intakes, but when adjusting for total caloric intake, females had a higher calcium "density" than the males The Dietary Guidelines for Americans highlights iron as a nutrient of public health concern for certain subgroups of the population, including young children, women who may become pregnant, and pregnant women. Dietary surveys have estimated usual iron intake and the prevalence of iron inadequacy among young children in the US.
Similar results were found in a study that examined intake of 3, US infants and toddlers: 7. Fortified and enriched food are significant sources of dietary iron for older children and adolescents Adolescents have increased requirements for iron due to rapid growth. In particular, adolescent girls are at a heightened risk of iron deficiency due to inadequate intake of dietary iron, especially heme iron; increased demands of growth; and iron loss that occurs with menstruation. Multiple biomarkers , including serum iron, red blood cell hemoglobin , serum ferritin, transferrin saturation, soluble transferrin receptor sTfR , and total iron-binding capacity, have been used to assess iron status at the population level.
However, these are often used to assess iron deficiency rather than dietary iron inadequacy. Additionally, Another analysis of these NHANES data, examining prevalence of iron deficiency among 1, pregnant women, found that Not surprisingly, the prevalence of iron deficiency in the second, and especially, the third trimester of pregnancy was greater than in the first trimester 38 ; intake requirements for dietary iron increase starting in the second trimester despite an increase in intestinal iron absorption For more information on life stage-specific needs for iron, see the article on Iron.
The Dietary Guidelines state that magnesium is underconsumed in the US 1 ; however, it was not labeled as a "nutrient of public health concern" despite low intake of magnesium being associated with increased risks of several chronic diseases , including cardiovascular disease , type 2 diabetes , and potentially, osteoporosis 40, Reliable biomarkers of magnesium intake are not available 40 , and data assessing magnesium status in the US population are lacking.
Blood concentrations of magnesium are tightly regulated and cannot be used to assess magnesium nutritional status Good sources of magnesium include green leafy vegetables, whole grains , beans, and nuts ; consumption of whole grains, dark-green vegetables, and beans among Americans is well below intake recommendations 1. The US Dietary Guidelines highlights potassium as a nutrient of public health concern because it is underconsumed by Americans 1. US national surveys indicate that the vast majority of the US population do not meet intake recommendations for potassium. According to NHANES , average potassium intakes are well below the AI for all age groups assessed 2 years and older , with the potassium density of the diet being higher in females versus males The richest sources of potassium are fruit and vegetables; approximately three-quarters of the US population do not meet intake recommendations for fruit and vegetables 1.
Fortified, ready-to-eat cereal and fortified milk are important sources of vitamin A for children and adolescents Serum retinol concentrations can be used to assess deficiency in a population 47 , but this assay cannot assess vitamin A inadequacy because retinol concentrations decline only once liver reserves are depleted Moreover, serum retinol concentrations are decreased by inflammation and infection Biomarker data confirm that adults are at an increased risk for vitamin C deficiency. Serum ascorbic acid concentrations are often used to assess vitamin C status ; concentrations between Females had higher concentrations than males Fortified food substantially contribute to total vitamin D intake from the diet, especially among children and adolescents where intake from fortified food is 2.
However, surveys of dietary intake are not very informative because sunlight is the primary source of vitamin D see the article on Vitamin D. Yet, high-quality evidence is still needed to ensure that the current cutoff values are optimal to define states of insufficiency and deficiency Sharp differences were found when the data were examined by ethnicity, with vitamin D inadequacy and deficiency being quite prevalent among Non-Hispanic blacks see Table 4 Stratifying the data by age group showed a lower prevalence of vitamin D insufficiency in younger children compared to older children and adolescents see Table 5.
Overall, the prevalence of vitamin D inadequacy measured by biomarker data is much lower than the prevalence assessed by dietary intake surveys for all age groups. As stated above, dietary surveys poorly assess vitamin D body status. Sun exposure, skin color, and BMI have variable, substantial impact on vitamin D status; thus, examining circulating hydroxyvitamin D concentrations is the most reliable way to assess vitamin D status in a population. The above-discussed biomarker data use the NAM cutoffs for inadequacy and deficiency. Others have used higher cutoffs to evaluate vitamin D status in a population.
Using such cutoffs would result in higher estimates of the prevalence of vitamin D deficiency and inadequacy in a population. This contrasts with the data from dietary surveys that suggest vitamin E inadequacy in the US is widespread. Some have questioned whether the nutritional requirement of vitamin E needs to be reevaluated According to dietary surveys, almost all Americans meet the AI for sodium 1. A more recent assessment from NHANES examined sodium intakes of children by age group, finding average intakes of 3.
While dietary recall methods like those employed in NHANES are not the best measure of sodium intake due to day-to-day variations hour urinary excretion is the gold standard , they likely underestimate intake in populations because of underreporting of food Thus, overconsumption of sodium, which is linked to adverse health outcomes hypertension , cardiovascular disease , is a major public health concern in the US see the article on Sodium. Written in November by: Victoria J. Drake, Ph. Reviewed in March by: Balz Frei, Ph. The writing of this article was supported by a grant from Pfizer Inc. Kant AK. Consumption of energy-dense, nutrient-poor foods by adult Americans: nutritional and health implications.
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