Dietary Cholesterol Intake and Sources among U.S Adults: Results from National Health and Nutrition Examination Surveys (NHANES), 2001?2014.
ABSTRACT: The 2015 Dietary Guidelines for Americans recommends that individuals should minimize their dietary cholesterol intake. However, current dietary cholesterol intake and its food sources have not been well-characterized. We examined dietary cholesterol intake by age, sex, race, and food sources using 24-h dietary recall data from a nationally representative sample of 5047 adults aged 20 years or older who participated in NHANES (2013?2014 survey cycle). We also reported trends in cholesterol intake across the past seven NHANES surveys. Mean dietary cholesterol intake was 293 mg/day (348 mg/day for men and 242 mg/day for women) in the 2013?2014 survey cycle; 39% of adults had dietary cholesterol intake above 300 mg/day (46% for men and 28% for women). Meat, eggs, grain products, and milk were the highest four food sources of cholesterol, contributing to 96% of the total consumption. Both average cholesterol intake and food source varied by age, sex, and race (each p < 0.05). Mean cholesterol intake of the overall population had been relatively constant at ~290 mg/day from 2001?2002 to 2013?2014 (p-trend = 0.98). These results should inform public health efforts in implementing dietary guidelines and tailoring dietary recommendations.
Project description:Interest in the health effects of dietary phosphorus is burgeoning, yet sources and trends in phosphorus consumption have not been well characterized. We describe trends in and primary sources of dietary phosphorus in a nationally representative sample of 34,741 US adults, 20+ years old (NHANES 2001-2014). Dietary sources of phosphorus were estimated in nine food groups and 26 food categories. Phosphorus consumption was expressed in absolute intake, phosphorus density, and proportion contributed by dietary sources. Between 2001 and 2014, dietary phosphorus intake increased from 1345 to 1399 mg/day (p-trend = 0.02), while calorie intake slightly declined (p-trend = 0.1). Grains were the largest dietary phosphorus source, followed by meats, and milk products. Soft drinks accounted for just 3.3% of total dietary phosphorus. Phosphorus intake from grains increased 68 mg/day (p < 0.001), 25 mg/day from meats (p = 0.02), and decreased 75 mg/day (p < 0.001) from milk products. Dietary phosphorus intake and the phosphorus density of the diet are increasing. Grains are an important dietary phosphorus source that has increased in total consumption and phosphorus density. Further research is needed to determine if this is due to individuals' selection of grains or the composition of those available.
Project description:Dietary cholesterol intake increased dramatically over the past two decades in the elderly Chinese population. However, the nationwide dietary cholesterol intake and its related factors seldom been investigated. Based on data from 16,594 participants aged 60 years or older (49.0% male, 54.8% urban residents) from the China National Nutrition and Health Survey (CNHS) 2010-2012, we aimed to describe the intake of cholesterol and major food contributions, as well as its association with serum cholesterol level and relationship with protein intake. Mean daily cholesterol intake for all participants was 217.4 mg, the mean cholesterol intakes in urban and rural areas were 264.0 mg and 168.8 mg, respectively. Cholesterol intake levels varied by age, gender, BMI and region (p < 0.001). In addition, the proportion of all participants who consumed greater than 300 mg of cholesterol per day was 26.6%. Eggs, red meats, and seafood were the top three food sources and their contributions to total daily cholesterol intake were 57.7%, 24.0% and 10.9% respectively. Serum total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) were related to dietary cholesterol intake, with each 100 mg increase in dietary cholesterol intake apparently leading to a 0.035 mmol/L (p = 0.001) increase in serum TC and a 0.038 mmol/L (p < 0.001) increase in LDL-C. The partial correlation coefficients between dietary cholesterol and total protein, high-quality protein, intake of protein per kilogram body weight (BW), and high-quality protein percentage were 0.538, 0.580, 0.426, and 0.548, respectively, after adjusting for age, gender, and energy, fat and carbohydrate intakes (p < 0.001). In conclusion, there was a substantial urban-rural difference in cholesterol intake. Eggs and red meat were the main sources of dietary cholesterol intake. Serum TC and LDL-C were associated with dietary cholesterol and the response was linear. Dietary cholesterol intake was closely related to the intake of high-quality protein.
Project description:Phosphorus intake in Europe is far above recommendations. We present baseline data from three human intervention studies between 2006 and 2014 regarding intake and excretion of phosphorus and calcium. All subjects documented their nutritional habits in weighed dietary records. Fasting blood samples were drawn, and feces and urine were quantitatively collected. Dietary phosphorus intake was estimated based on weighed dietary records and urine phosphorus excretions. Food sources were identified by allocation to defined food product groups. Average phosphorus consumption was 1338 mg/day and did not change from 2006 to 2014, while calcium intake decreased during this period (1150 to 895 mg/day). The main sources for phosphorus intake were bread/cereal products, milk/milk products and meat/meat products/sausage products and the main sources of calcium intake included milk/milk products/cheese, bread/cereal products and beverages. There was no difference between estimated phosphorus intake from the weighed dietary records and urine phosphorus excretion. In conclusion, we demonstrated constant phosphorus intakes far above the recommendations and decreasing calcium intakes below the recommendations in three German collectives from 2006 to 2014. Furthermore, we could show in case of usual intakes that an estimated phosphorus intake from urine phosphorus excretion is similar to the calculated intake from weighed dietary records.
Project description:Limiting dietary sodium intake has been a consistent dietary recommendation. Using NHANES 2007-2010 data, we estimated current sodium intake and modeled the potential impact of a new sodium reduction technology on sodium intake. NHANES 2007-2010 data were used to assess current sodium intake. The National Cancer Institute method was used for usual intake determination. Suggested sodium reductions using SODA-LO (®) Salt Microspheres ranged from 20% to 30% in 953 foods and usual intakes were modeled by using various reduction factors and levels of market penetration. SAS 9.2, SUDAAN 11, and NHANES survey weights were used in all calculations with assessment across gender and age groups. Current (2007-2010) sodium intake (mg/day) exceeds recommendations across all age gender groups and has not changed during the last decade. However, sodium intake measured as a function of food intake (mg/g food) has decreased significantly during the last decade. Two food categories contribute about 2/3rd of total sodium intake: "Grain Products" and "Meat, Poultry, Fish & Mixtures". Sodium reduction, with 100% market penetration of the new technology, was estimated to be 230-300 mg/day or 7-9% of intake depending upon age and gender group. Sodium reduction innovations like SODA-LO (®) Salt Microspheres could contribute to meaningful reductions in sodium intake.
Project description:Calcium is an important nutrient for child development. The main objective of this study was to assess calcium intake and its adequacy with dietary reference intake (DRI) in Spanish children. The ANIVA (Antropometría y Nutrición Infantil de Valencia) study is a descriptive cross-sectional study. During two academic years 2013-2014 and 2014-2015, 1176 schoolchildren aged 6-9 years were selected from 14 primary schools in Valencia (Spain). Three-day food records were used to assess dietary intake, completed by parents/guardian. Anthropometric data (weight and height) were evaluated in all subjects. Nutritional intake was compared to estimated average requirements (EARs) and adequate intake (AI) values to determine nutritional adequacy. A percentage of 25.77% had inadequate calcium intake, and a significantly higher prevalence was observed in girls (p = 0.006). Adequate calcium intake showed a positive association with the height z-score (p = 0.032). When assessing dietary patterns, schoolchildren with adequate calcium intakes had better nutritional adequacy in all nutrients, except cholesterol (p = 0.086) and fluorine (p = 0.503). These results suggest a public health problem that must be addressed through nutrition education programs to increase intake of calcium-rich food and to correct the associated dietary pattern.
Project description:Identification of current food sources of energy and nutrients among US adults is needed to help with public health efforts to implement feasible and appropriate dietary recommendations. To determine the food sources of energy and 26 nutrients consumed by US adults the 2003-2006 National Health and Nutrition Examination Survey (NHANES) 24-h recall (Day 1) dietary intake data from a nationally representative sample of adults 19+ years of age (y) (n = 9490) were analyzed. An updated USDA Dietary Source Nutrient Database was developed for NHANES 2003-2006 using current food composition databases. Food grouping included ingredients from disaggregated mixtures. Mean energy and nutrient intakes from food sources were sample-weighted. Percentages of total dietary intake contributed from food sources were ranked. The highest ranked sources of energy and nutrients among adults more than 19 years old were: energy - yeast bread/rolls (7.2%) and cake/cookies/quick bread/pastry/pie (7.2%); protein-poultry (14.4%) and beef (14.0%); total fat - other fats and oils (9.8%); saturated fatty acids - cheese (16.5%) and beef (9.1%); carbohydrate - soft drinks/soda (11.4%) and yeast breads/rolls (10.9%); dietary fiber - yeast breads/rolls (10.9%) and fruit (10.2%); calcium - milk (22.5%) and cheese (21.6%); vitamin D - milk (45.1%) and fish/shellfish (14.4%); and potassium - milk (9.6%) and coffee/tea/other non-alcoholic beverages (8.4%). Knowledge of primary food sources of energy and nutrients can help health professionals design effective strategies to reduce excess energy consumed by US adults and increase the nutrient adequacy of their diets.
Project description:Thiamin, riboflavin, niacin, and vitamin B? are essential micronutrients that are mainly involved in energy metabolism; they may prevent the occurrence of developmental abnormalities and chronic degenerative and neoplastic diseases. The aim was to analyze dietary intake and food sources of those four nutrients in subjects (n = 2009) aged 9?75 years old from the Spanish ANIBES (Anthropometry, Intake, and Energy Balance in Spain) study. Dietary data were collected by means of a validated, photo-based three-day dietary food record. Underreporting was analysed according to the European Food and Safety Authority (EFSA, Parma, Italy) protocol. Mean (max?min) reported intake for the whole population of thiamin was 1.17 ± 0.02 mg/day, (0.30?3.44 mg/day), riboflavin 1.44 ± 0.02 mg/day, (0.37?3.54 mg/day), niacin 29.1 ± 0.2 mg/day (6.7?109 mg/day), and vitamin B? 1.54 ± 0.01 mg/day (0.28?9.30 mg/day). The main sources of intake for thiamin, niacin, and vitamin B? were meat and meat products, and for riboflavin were milk and dairy products. An elevated percentage of the Spanish ANIBES population meets the EFSA recommended intakes for thiamin (71.2%), riboflavin (72.0%), niacin (99.0%), and vitamin B? (77.2%).
Project description:To determine whether increasing calcium intake from dietary sources affects bone mineral density (BMD) and, if so, whether the effects are similar to those of calcium supplements.Random effects meta-analysis of randomised controlled trials.Ovid Medline, Embase, Pubmed, and references from relevant systematic reviews. Initial searches were undertaken in July 2013 and updated in September 2014.Randomised controlled trials of dietary sources of calcium or calcium supplements (with or without vitamin D) in participants aged over 50 with BMD at the lumbar spine, total hip, femoral neck, total body, or forearm as an outcome.We identified 59 eligible randomised controlled trials: 15 studied dietary sources of calcium (n=1533) and 51 studied calcium supplements (n=12,257). Increasing calcium intake from dietary sources increased BMD by 0.6-1.0% at the total hip and total body at one year and by 0.7-1.8% at these sites and the lumbar spine and femoral neck at two years. There was no effect on BMD in the forearm. Calcium supplements increased BMD by 0.7-1.8% at all five skeletal sites at one, two, and over two and a half years, but the size of the increase in BMD at later time points was similar to the increase at one year. Increases in BMD were similar in trials of dietary sources of calcium and calcium supplements (except at the forearm), in trials of calcium monotherapy versus co-administered calcium and vitamin D, in trials with calcium doses of ? 1000 versus <1000 mg/day and ? 500 versus >500 mg/day, and in trials where the baseline dietary calcium intake was <800 versus ? 800 mg/day.Increasing calcium intake from dietary sources or by taking calcium supplements produces small non-progressive increases in BMD, which are unlikely to lead to a clinically significant reduction in risk of fracture.
Project description:Background The aim of this study was to identify associations between dietary intakes of eggs and cholesterol and all-cause and heart disease mortality in a US population. Methods and Results Data from the National Health and Nutrition Examination Survey 1999-2014 were used in this study, which included 37 121 participants ?20 years of age. Dietary information was assessed via 24-hour dietary recalls at baseline. Mortality status was documented until December 31, 2015. Cox proportional hazards models were used to examine the associations between dietary intakes of eggs and cholesterol and all-cause and heart disease mortality. During a median follow-up of 7.8 years, 4991 deaths were documented, including 870 deaths from heart disease. No significant association was observed between additional daily consumption of half an egg and all-cause mortality (multivariable-adjusted hazard ratio, 1.04; 95% CI, 0.96-1.13), or heart disease mortality (0.96; 0.80-1.14). Each 50-mg/day increase of cholesterol intake was inversely associated with all-cause mortality among participants with daily intake <250 mg (0.87; 0.77-0.98), but positively associated with all-cause mortality among participants with daily intake ?250 mg (1.07; 1.01-1.12). No significant association was found between dietary cholesterol intake and heart disease mortality. Conclusions No significant association was found between egg consumption and mortality in US adults. The association between dietary cholesterol intake and all-cause mortality depended on the baseline intake levels, with an inverse association in those with lower intake levels (<250 mg/day) but a positive association in those with higher intake levels (?250 mg/day).
Project description: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.