Micronutrient Dilution and Added Sugars Intake in U.S. Adults: Examining This Association Using NHANES 2009–2014

There is inconsistent evidence regarding the impact of added sugars consumption on micronutrient dilution of the diet. We examined the associations between added sugars intake deciles and nutrient adequacy for 17 micronutrients in U.S. adults 19+ (n = 13,949), 19–50 (n = 7424), and 51+ y (n = 6525) using two days of 24 hour dietary recall data from the National Health and Nutrition Examination Survey (NHANES) 2009–2014 and regression analysis. Added sugars intake deciles ranged from <3.8 to >23.3% of calories among adults 19+ y, with a median intake of 11.0% of calories. Significant associations (p ≤ 0.01) between added sugars intake deciles and percentage of the population below the Estimated Average Requirement (EAR) were found for magnesium, vitamin C, vitamin D, and vitamin E; only the association with magnesium remained significant after dropping the two highest and lowest deciles of intake, suggesting a threshold effect. Intakes below approximately 18% of calories from added sugars were generally not associated with micronutrient inadequacy. However, even at the lower deciles of added sugars, large percentages of the population were below the EAR for these four micronutrients, suggesting that adequate intakes are difficult to achieve regardless of added sugars intake.

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Comparison of Various Methods to Determine Added Sugars Intake to Assess the Association of Added Sugars Intake and Micronutrient Adequacy

Nutrients ◽

10.3390/nu12092816 ◽

2020 ◽

Vol 12 (9) ◽

pp. 2816

Author(s):

Victor L. Fulgoni ◽

P. Courtney Gaine ◽

Maria O. Scott

Keyword(s):

Vitamin D ◽

Practical Reasons ◽

Adequate Intake ◽

Added Sugars ◽

Dietary Recall ◽

Health And Nutrition ◽

Recall Data ◽

Average Intake ◽

Similar Association ◽

Method Preference

Different methods for determining the effect of added sugars intake among children and adults on meeting recommended nutrient intakes were compared using 24 h dietary recall data from the National Health and Nutrition Examination Survey (NHANES) 2011–2014. Four methods were used to determine deciles of added sugars intake (as the percentage of total calories): 1 day intake, 2 day average intake, and individual usual intake (UI) determined with the National Cancer Institute (NCI) and the multivariate Markov Chain Monte Carlo methods. Percentages of the population below the Estimated Average Requirement (EAR) for calcium and vitamin D/above the Adequate Intake (AI) for potassium and dietary fiber for each decile of added sugars intake were assessed with the NCI method. Using regression analyses, added sugars intake deciles (by any method) in children were inversely associated (p < 0.001) with percentages below the EAR/above the AI of vitamin D, calcium, potassium, and fiber. In adults, added sugars intake deciles were inversely associated with meeting recommendations for vitamin D, potassium, and fiber. There were no significant between-method differences for regression coefficients for any nutrients investigated. Overall, these methods showed a similar association of added sugars intake with nutrient inadequacy/adequacy; therefore, method preference may depend more on practical reasons.

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Association of Added Sugars Intake with Micronutrient Adequacy in U.S. Children and Adolescents: NHANES 2009–2014

Current Developments in Nutrition ◽

10.1093/cdn/nzz126 ◽

2019 ◽

Cited By ~ 4

Author(s):

Victor L Fulgoni ◽

P Courtney Gaine ◽

Maria O Scott ◽

Laurie Ricciuto ◽

Loretta DiFrancesco

Keyword(s):

Vitamin D ◽

Children And Adolescents ◽

Threshold Effect ◽

Added Sugars ◽

Dietary Recall ◽

Health And Nutrition ◽

Calcium Magnesium ◽

Excessive Consumption ◽

Using Data ◽

The Relationship

Abstract Background A concern about the excessive consumption of added sugars is the potential for micronutrient dilution, particularly for children and adolescents; however, the evidence is inconsistent. Objective We examined the associations between added sugars intake and micronutrient adequacy in U.S. children and adolescents using data from the National Health and Nutrition Examination Survey (NHANES) 2009–2014. Methods Children and adolescents 2–18 (n = 7,754), 2–8 (n = 3,423), and 9–18 y (n = 4,331) were assigned to deciles of added sugars intake based on the average of two days of dietary recall. Usual intake of micronutrients was determined using two dietary recalls and the National Cancer Institute method. Within each age group, regression analyses were used to assess the relationship between added sugars intake decile and percentage of the population below the Estimated Average Requirements (EARs) for 17 micronutrients. Results Deciles of added sugars intake (% of calories) ranged from <6.4 to >22.8 among children and adolescents 2–18 y, with a median intake of 13.3% of calories. Significant positive associations (P < 0.01) between added sugars intake and percentage of the population (2–18 y) below the EAR were found only for calcium, magnesium, and vitamin D. These associations virtually disappeared after dropping the two highest and lowest deciles of intake, suggesting a threshold effect; intakes below approximately 19% of calories from added sugars were generally not associated with micronutrient inadequacy. Conclusions As added sugars intake increased, there was a threshold above which an increase in the prevalence of inadequate intakes for calcium, magnesium, and vitamin D among U.S. children and adolescents was observed. However, even at the lower deciles of added sugars, large percentages of the population were below the EAR for these nutrients, suggesting that adequate intakes of these nutrients are difficult to achieve independent of added sugars intake.

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Common ways Americans are incorporating fruits and vegetables into their diet: intake patterns by meal, source and form, National Health and Nutrition Examination Survey 2007–2010

Public Health Nutrition ◽

10.1017/s1368980016000586 ◽

2016 ◽

Vol 19 (14) ◽

pp. 2535-2539 ◽

Cited By ~ 9

Author(s):

Latetia V Moore ◽

Heather C Hamner ◽

Sonia A Kim ◽

Karen Dalenius

Keyword(s):

National Health ◽

Fruits And Vegetables ◽

Nutrition Examination Survey ◽

Cross Sectional ◽

Dietary Recall ◽

Health And Nutrition ◽

Recall Data ◽

Retail Outlets ◽

Diet Intake

AbstractObjectiveWe explored how Americans aged ≥2 years who consumed the recommended amount of fruits and vegetables on a given day incorporated fruits and vegetables into their diet compared with those who did not consume recommended amounts.DesignWe used 1 d of dietary recall data from the National Health and Nutrition Examination Survey (NHANES) 2007–2010 to examine cross-sectional differences in mean intakes of fruits and vegetables in cup-equivalents by meal, source and form between the two groups.SettingUSA.SubjectsNHANES 2007–2010 participants aged ≥2 years (n 17 571) with 1 d of reliable 24 h recall data.ResultsOn a given day, the proportions of fruits and vegetables consumed at different meals were similar between those who consumed recommended amounts and those who did not. Among adults, 59–64 % of their intake of fruits was consumed at breakfast or as a snack and almost 90 % came from retail outlets regardless of whether they consumed the recommended amount or not. Adults who consumed the recommended amount of fruits ate more fruits in raw form and with no additions than those who did not. Among children and adults, 52–57 % of vegetables were consumed at dinner by both groups. Retail outlets were the main source of vegetables consumed (60–68 %).ConclusionsOur findings indicate that habits of when, where and how consumers eat fruits and vegetables might not need to change but increasing the amount consumed would help those not currently meeting the recommendation.

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Relationships between Subclinical Hypothyroidism and Metabolic Syndrome and Vitamin D Status in Korean Adults: Korea National Health and Nutrition Examination Survey 2013-2015

Korean Journal of Health Promotion ◽

10.15384/kjhp.2020.20.1.10 ◽

2020 ◽

Vol 20 (1) ◽

pp. 10-15

Author(s):

You-Lee Kim ◽

A-Lum Han ◽

Sae-Ron Shin

Keyword(s):

Metabolic Syndrome ◽

Vitamin D ◽

Regression Analysis ◽

Multiple Regression Analysis ◽

Multiple Regression ◽

National Health ◽

Subclinical Hypothyroidism ◽

Nutrition Examination Survey ◽

Vitamin D Status ◽

Health And Nutrition

Background: Many studies have established the association between overt hypothyroidism and metabolic syndrome (MS). However, the relationship between subclinical hypothyroidism (SCH) and MS varies from study to study. This study aimed to investigate associations between SCH and components of MS and vitamin D status in Korean adults.Methods: Using data from the 6th Korea National Health and Nutrition Examination Survey (2013-2015), chi-squared tests and t-tests were used to explore relationships between thyroid hormones and components of MS and vitamin D status. Multiple regression analysis was undertaken to assess relationships between SCH and components of MS and vitamin D.Results: Systolic blood pressure and fasting glucose were significantly higher in the euthyroid (EUT) group than in the SCH group, and vitamin D status was significantly lower in the SCH group than EUT. However, in multiple regression analysis, SCH presented no significant association with components of MS or vitamin D status even after adjusting for age, sex, drinking, and smoking.Conclusions: In Korean adults, there is no significant association between SCH and MS or vitamin D.

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Association between Ready-to-Eat Cereal Consumption and Nutrient Intake, Nutritional Adequacy, and Diet Quality in Adults in the National Health and Nutrition Examination Survey 2015–2016

Nutrients ◽

10.3390/nu11122952 ◽

2019 ◽

Vol 11 (12) ◽

pp. 2952

Author(s):

Yong Zhu ◽

Neha Jain ◽

Vipra Vanage ◽

Norton Holschuh ◽

Anne Hermetet Agler ◽

...

Keyword(s):

United States ◽

Dietary Intake ◽

National Health ◽

Diet Quality ◽

The United States ◽

Healthy Eating Index ◽

Nutrition Examination Survey ◽

Food Groups ◽

Dietary Recall ◽

Health And Nutrition

This study examined differences in dietary intake between ready-to-eat cereal eaters and non-eaters in adults from the United States. Participants (n = 5163) from the National Health and Nutrition Examination Survey 2015–2016 were included. One-day dietary recall was used to define ready-to-eat cereal consumption status and estimate dietary intake in eaters and non-eaters. Data from Food Patterns Equivalent Database 2015–2016 were used to compare intakes of food groups by consumption status. Diet quality was assessed by Healthy Eating Index 2015. Nineteen percent of US adults were ready-to-eat cereal eaters; they had a similar level of energy intake as non-eaters, but they had significantly higher intake of dietary fiber, and several vitamins and minerals, such as calcium, iron, magnesium, potassium, zinc, vitamin A, thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, and vitamin D. They were also more likely to meet nutrient recommendations. Compared to non-eaters, ready-to-eat cereal eaters had the same level of added sugar intake but they had significantly higher intake of whole grains, total fruits, and dairy products. The diet quality of ready-to-eat cereal eaters was significantly higher than that of non-eaters. The study supports that ready-to-eat cereal eaters have better dietary intake with a healthier dietary pattern than non-eaters in the United States.

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