Contribution of fortified margarines and other plant-based fats to micronutrient intake in the Netherlands

Purpose In the Netherlands, margarines and other plant-based fats (fortified fats) are encouraged to be fortified with vitamin A and D, by a covenant between the Ministry of Health and food manufacturers. Frequently, these types of fats are also voluntarily fortified with other micronutrients. The current study investigated the contribution of both encouraged as well as voluntary fortification of fortified fats on the micronutrient intakes in the Netherlands. Methods Data of the Dutch National Food Consumption Survey (2012–2016; N = 4, 314; 1–79 year.) and the Dutch Food Composition Database (NEVO version 2016) were used to estimate micronutrient intakes. Statistical Program to Assess Dietary Exposure (SPADE) was used to calculate habitual intakes and compared to dietary reference values, separate for users and non-users of fortified fats. Results Of the Dutch population, 84% could be considered as user of fortified fats. Users consumed mostly 1 fortified fat a day, and these fats contributed especially to the total micronutrient intake of the encouraged fortified micronutrients (vitamins D and A; 44% and 29%, respectively). The voluntary fortification also contributed to total micronutrient intakes: between 7 and 32%. Vitamin D and A intakes were up to almost double among users compared to non-users. Intakes were higher among users for almost all micronutrients voluntarily added to fats. Higher habitual intakes resulted into higher risks of excessive vitamin A-intakes among boys and adult women users. Conclusion Consumption of fortified fats in the Netherlands resulted into higher vitamin A and D-intakes among users, compared to non-users of these products.

Assessment of Food Supplement Consumption in Polish Population of Adults

Introduction: In recent years, there has been a great interest in food supplements. However the use of food supplements can be associated with the risk of excessive intake of vitamins or minerals which may have adverse health effects.Objective: Assessment of food supplement consumption in the adult population in Poland.Materials and Methods: The study was conducted on 1,831 adults (913 men, 918 women) from which 178 (59 men, 119 women) food supplement users were selected. The consumption of food supplements were assessed by the 24-h recall repeated two times and the food propensity questionnaire (FPQ).Results: 10% of the subjects consumed food supplements during the 12 months prior to the study (6% of men, 13% of women) and among users 68% (79% of men and 88% of women) in the day before the survey. Most respondents (44%) used vitamin supplements during the year. More men than women (27 vs. 11%, p = 0.0059) used mineral supplements while more women than men used vitamin and mineral supplements (31 vs. 8%, p = 0.0008). The most frequently supplemented vitamins were: B6 (58%), C (53%), and D (47%) and minerals were: magnesium (43%), zinc (34%), and iron (29%). More women than men supplemented vitamin B6 (71 vs. 40%, p = 0.0012), vitamin D (54 vs. 36%, p = 0.0061) and magnesium (49 vs. 34%, p = 0.0075). Intake of riboflavin, pantothenic acid and manganese were higher in the group of men (respectively: 3.3 mg ± 6.0 vs. 1.4 mg ± 0.3, p = 0.0329; 9.4 mg ± 5.6 vs. 6.1 mg ± 2.0, p = 0.0357; 2.2 mg ± 0.9 vs. 1.3 mg ± 0.6, p = 0.0080) but intake of vitamin D was higher in the group of women (15.7 μg ± 20.4 vs. 33.1 μg ± 26.4, p = 0.0085). In many cases, the intake of vitamins and minerals from food supplements covered the Dietary Reference Values for these nutrients in 100%. In some persons the intake of biotin, vitamin B12, C, B6, riboflavin, niacin was higher than the reference values several dozen times. The intake of vitamins and minerals exceed UL in a few cases relating to vitamin B6 and magnesium.Conclusions: A minority of adults in Poland used food supplements. However, those products were a significant source of vitamins and minerals. Intake of vitamins and minerals from food supplements should be monitored.

Unveiling the Correlation between Inadequate Energy/Macronutrient Intake and Clinical Alterations in Volunteers at Risk of Metabolic Syndrome by a Predictive Model

Although lifestyle-based interventions are the most effective to prevent metabolic syndrome (MetS), there is no definitive agreement on which nutritional approach is the best. The aim of the present retrospective analysis was to identify a multivariate model linking energy and macronutrient intake to the clinical features of MetS. Volunteers at risk of MetS (F = 77, M = 80) were recruited in four European centres and finally eligible for analysis. For each subject, the daily energy and nutrient intake was estimated using the EPIC questionnaire and a 24-h dietary recall, and it was compared with the dietary reference values. Then we built a predictive model for a set of clinical outcomes computing shifts from recommended intake thresholds. The use of the ridge regression, which optimises prediction performances while retaining information about the role of all the nutritional variables, allowed us to assess if a clinical outcome was manly dependent on a single nutritional variable, or if its prediction was characterised by more complex interactions between the variables. The model appeared suitable for shedding light on the complexity of nutritional variables, which effects could be not evident with univariate analysis and must be considered in the framework of the reciprocal influence of the other variables.

Magnesium: Biochemistry, Nutrition, Detection, and Social Impact of Diseases Linked to Its Deficiency

Magnesium plays an important role in many physiological functions. Habitually low intakes of magnesium and in general the deficiency of this micronutrient induce changes in biochemical pathways that can increase the risk of illness and, in particular, chronic degenerative diseases. The assessment of magnesium status is consequently of great importance, however, its evaluation is difficult. The measurement of serum magnesium concentration is the most commonly used and readily available method for assessing magnesium status, even if serum levels have no reliable correlation with total body magnesium levels or concentrations in specific tissues. Therefore, this review offers an overview of recent insights into magnesium from multiple perspectives. Starting from a biochemical point of view, it aims at highlighting the risk due to insufficient uptake (frequently due to the low content of magnesium in the modern western diet), at suggesting strategies to reach the recommended dietary reference values, and at focusing on the importance of detecting physiological or pathological levels of magnesium in various body districts, in order to counteract the social impact of diseases linked to magnesium deficiency.

Assessment of calcium and vitamin D content in meals served for preschool children attending to kindergartens in some Silesian cities

Background. Adequate nutrition is one of the most important factors for influencing growth and development of children. Providing adequate amounts of minerals is extremely important in the developmental age, especially in periods of intensive growth. Calcium and vitamin D deficiency may have a negative impact on the health of children, both in the short and long term. Objective. The aim of this study was to evaluate the content of calcium and vitamin D in the meals of preschoolers and to compare the obtained results to Polish dietary reference values for children aged 4-6 years. Material and methods. The study was conducted in 40 randomly selected kindergartens in some Silesian cities and were concerning 1,746 children. 10-day-menus and preschool inventory reports describing the amount of food used for meal preparation were obtained from every kindergarten. 10-day-menus were analysed in terms of calcium and vitamin D content with the use of the Dieta 5 software. The obtained results were developed in Microsoft Excel 2016. Results. The analysis of 10-days menus showed significant deficiencies in both calcium and vitamin D intake in the assessed food rations. The mean calcium level was 416.0 mg while vitamin D was 1.47 μg. The content of calcium and vitamin D in the examined 10-days menus did not meet the dietary reference values. Conclusions. The necessity to modify menus in terms of increasing the consumption of the analysed nutrients was demonstrated, as well as the need to implement nutritional education for preschool staff and parents was suggested.

Approaches to setting dietary reference values for micronutrients, and translation into recommendations

Dietary reference values (DRV) are estimates of the daily amounts of nutrients or food energy that meet the needs of healthy people. In the UK, three terms are used to express these estimates, assuming a normal distribution of requirements in a population. These are the estimated average requirement, the lower reference nutrient intake and the reference nutrient intake. DRV are for use in a variety of settings, including the assessment of adequacy and safety of nutrient or energy intake in a population group, in the design of meal provision in care settings, in food labelling and in considering food fortification strategies. DRV, and other expressions of nutrient requirements, assume a relationship between the intake of a nutrient and some criterion of adequacy, the outcome. Estimates of requirements are based on a diverse range of measures of adequacy, according to available evidence. The Scientific Advisory Committee on Nutrition (SACN) is the body responsible for reviewing and setting DRV for the UK population. The work of SACN is guided by a framework of evidence that relates food and nutrients to health. There have been calls for the harmonisation of approaches used in the setting of nutrient requirements, globally, and an increased transparency in the decision-making process. Some progress has been made in this regard, but there is a great deal of work to be done.

Sex differences in requirements for micronutrients across the lifecourse

For many people, micronutrient requirement means the amount needed in the diet to ensure adequacy. Dietary reference values (DRV) provide guidance on the daily intake of vitamins and minerals required to ensure the needs of the majority in the population are covered. These are developed on estimates of the quantity of each micronutrient required by the average person, the bioavailability of the micronutrient from a typical diet and the interindividual variability in these amounts. Sex differences are inherent in the requirements for many micronutrients because they are influenced by body size or macronutrient intake. These are reflected in different DRV for males and females for some micronutrients, but not all, either when data from males and females are combined or when there is no evidence of sex differences. Pregnancy and lactation represent times when micronutrient requirements for females may differ from males, and separate DRV are provided. For some micronutrients, no additional requirement is indicated during pregnancy and lactation because of physiological adaptations. To date, little account has been taken of more subtle sex differences in growth and maturation rates, health vulnerabilities and in utero and other programming effects. Over the years, the MRC Nutrition and Bone Health Group has contributed data on micronutrient requirements across the lifecourse, particularly for calcium and vitamin D, and shown that supplementation can have unexpected sex-specific consequences that require further investigation. The present paper outlines the current issues and the need for future research on sex differences in micronutrient requirements.

SUPPLEMENTATION WITH VITAMIN D - CURRENT RECOMMENDATIONS

Background: Vitamin D (calciferol) is a group of fat-soluble compounds, which are essential for calcium homeostasis, immunomodulation, antiproliferative effects, and more. It can also be viewed as a prohormone. Almost every cell in the human body has a receptor for vitamin D. Its synthesis depends on multiple factors. Review results: Vitamin D deficiency affects almost 50% of the world’spopulation, making it the most common vitamin deficit. There are multiple causes, mostly related to the modern lifestyle and ineffective exposition to the sun. The modern diet also lacks good sources of the vitamin, which makes supplementation the best option for optimal health. Supplements should be administered after serum level tests. Measurements below 20 ng/ml (50 nmol/l) are indication for supplementation. How effective the supplementation is will depend on the type of supplement, individual’s genetic factors, and with what foods the supplement is taken with. Dietary reference values for adequate intake and tolerable upper limit should be taken into consideration as well. Serum levels above 30 ng/ml (above 70 nmol/l) are considered optimal for health. There is a risk of toxicity in cases of over-supplementation and serum levels above 150 ng/ml (375 nmol/l). Conclusion: The widespread vitamin D deficiency leads to many public health risks. Supplementation can have a therapeutic effect in many different conditions. To maximize the effect, and reduce the risks of toxicity, an individual assessment of the most appropriate regimen and the dosage of vitamin D supplementation is needed.

Analysis of dietary patterns and nutritional adequacy in lactating women: a multicentre European cohort (ATLAS study)

Eating habits of lactating women can influence the nutrient composition of human milk, which in turn influences nutrient intake of breastfed infants. The aim of the present study was to identify food patterns and nutritional adequacy among lactating women in Europe. Data from a multicentre European longitudinal cohort (ATLAS study) were analysed to identify dietary patterns using cluster analysis. Dietary information from 180 lactating women was obtained using 3-d food diaries over the first 4 months of lactation. Four dietary patterns were identified: ‘vege-oils’, ‘fish-poultry’, ‘confectionery-salads’ and ‘mixed dishes’. Nutrition adequacy was not significantly different between clusters, but the ‘vege-oils’ cluster tended to yield the highest nutrition adequacy measured by Mean Adequacy Ratio. Compared with European dietary reference values (DRVs) for lactating women, women in all clusters had inadequate intakes of energy, pantothenic acid, folate, vitamin C, vitamin A, vitamin D, zinc, iodine, potassium and linoleic acid. Adequate intake for fibre and α-linolenic acid was only achieved in the ‘vege-oils’ cluster. Overall, fat intake was above DRVs. The present study showed that various dietary patterns do not adequately supply all nutrients, indicating a need to promote overall healthy dietary habits for European lactating women.

Complementary Feeding in the Preterm Infants: Summary of Available Macronutrient Intakes and Requirements

Limited data are available regarding the nutritional needs for preterm infants. In most cases, guidelines refer to the acquisition of neuromotor skills, adequate weight and corrected chronological age. While waiting for the establishment of specific nutritional indications for premature infants we proposed the weaning recommendations for term infants of the Italian Society of Human Nutrition with LARNs (Reference intake Levels of Nutrients and energy for the Italian population) of 2014, the Dietary Reference Values for nutrients of European Food Safety Authority (EFSA) of 2017 and the Nutrient Reference Values for Australia and New Zealand Including Recommended Dietary Intakes of 2017.