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      Mapping low intake of micronutrients across Europe

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          Abstract

          Achieving an understanding of the extent of micronutrient adequacy across Europe is a major challenge. The main objective of the present study was to collect and evaluate the prevalence of low micronutrient intakes of different European countries by comparing recent nationally representative dietary survey data from Belgium, Denmark, France, Germany, The Netherlands, Poland, Spain and the United Kingdom. Dietary intake information was evaluated for intakes of Ca, Cu, I, Fe, Mg, K, Se, Zn and the vitamins A, B 1, B 2, B 6, B 12, C, D, E and folate. The mean and 5th percentile of the intake distributions were estimated for these countries, for a number of defined sex and age groups. The percentages of those with intakes below the lower reference nutrient intake and the estimated average requirement were calculated. Reference intakes were derived from the UK and Nordic Nutrition Recommendations. The impact of dietary supplement intake as well as inclusion of apparently low energy reporters on the estimates was evaluated. Except for vitamin D, the present study suggests that the current intakes of vitamins from foods lead to low risk of low intakes in all age and sex groups. For current minerals, the study suggests that the risk of low intakes is likely to appear more often in specific age groups. In spite of the limitations of the data, the present study provides valuable new information about micronutrient intakes across Europe and the likelihood of inadequacy country by country.

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          Most cited references 56

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          Predicting basal metabolic rate, new standards and review of previous work.

          After reviewing the literature on basal metabolism, this paper discusses and reviews recent attempts to predict BMR from age, sex and anthropometric measurements. Criticism is made of the scientific and statistical integrity of a widely used table of standard metabolic rates for weight. The statistical screening of data from the literature of the past 50 years is described and equations computed from these screened data are presented. In these equations, BMR is predicted simply from weight or from weight and height with sex and age taken into account. Information is given on error, and tables estimating error for predictions on new data both for individuals and for means of groups of subjects are included. A table of BMRs for weights from 3 to 84 kg for males and females separately is also included. Cross-validation techniques are used to estimate possible threats to validity from various sources including, for example, different procedures of early workers. It was found that in the data available subjects from developing countries not only were smaller and had lower metabolic rates (as was expected) but also had lower rates per unit body weight than European or North American subjects. It is argued that at an individual level the error of prediction must be high since the global operationalisation of BMR confounds separate effects known to participate in complex relations with sex, age and anthropometric indices. The work reported is aimed at meeting a practical need for equations which are simple to apply. However, it was found that little was gained by the use of more complex equations, although they remain of scientific interest.
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            Serum vitamin D concentrations among elderly people in Europe.

            Vitamin D status decreases with age, mainly as a result of restricted sunlight exposure, reduced capacity of the skin to produce vitamin D, and reduced dietary vitamin D intake. We measured wintertime serum 25-hydroxyvitamin D [25(OH)D] concentrations in 824 elderly people from 11 European countries. 36% of men and 47% of women had 25(OH)D concentrations below 30 nmol/L. Users of vitamin D supplements and/or sunlamps had higher 25(OH)D (median 54 nmol/L) than non users (median 31 nmol/L). Surprisingly, lowest mean 25(OH)D concentrations were seen in southern European countries. Low 25(OH)D concentrations could largely be explained by attitudes towards sunlight exposure and factors of physical health status, after exclusion of users of vitamin D supplements or sunlamps. Problems with daily living activities and wearing clothes with long sleeves during periods of sunshine were strong predictors of low wintertime serum 25(OH)D concentrations. These findings show that free-living elderly Europeans, regardless of geographical location, are at substantial risk of inadequate vitamin D status during winter and that dietary enrichment or supplementation with vitamin D should be seriously considered during this season.
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              Foods, Fortificants, and Supplements: Where Do Americans Get Their Nutrients?123

              Limited data are available on the source of usual nutrient intakes in the United States. This analysis aimed to assess contributions of micronutrients to usual intakes derived from all sources (naturally occurring, fortified and enriched, and dietary supplements) and to compare usual intakes to the Dietary Reference Intake for U.S. residents aged ≥2 y according to NHANES 2003–2006 (n = 16,110). We used the National Cancer Institute method to assess usual intakes of 19 micronutrients by source. Only a small percentage of the population had total usual intakes (from dietary intakes and supplements) below the estimated average requirement (EAR) for the following: vitamin B-6 (8%), folate (8%), zinc (8%), thiamin, riboflavin, niacin, vitamin B-12, phosphorus, iron, copper, and selenium (<6% for all). However, more of the population had total usual intakes below the EAR for vitamins A, C, D, and E (34, 25, 70, and 60%, respectively), calcium (38%), and magnesium (45%). Only 3 and 35% had total usual intakes of potassium and vitamin K, respectively, greater than the adequate intake. Enrichment and/or fortification largely contributed to intakes of vitamins A, C, and D, thiamin, iron, and folate. Dietary supplements further reduced the percentage of the population consuming less than the EAR for all nutrients. The percentage of the population with total intakes greater than the tolerable upper intake level (UL) was very low for most nutrients, whereas 10.3 and 8.4% of the population had intakes greater than the UL for niacin and zinc, respectively. Without enrichment and/or fortification and supplementation, many Americans did not achieve the recommended micronutrient intake levels set forth in the Dietary Reference Intake.
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                Author and article information

                Journal
                Br J Nutr
                Br. J. Nutr
                BJN
                The British Journal of Nutrition
                Cambridge University Press (Cambridge, UK )
                0007-1145
                1475-2662
                28 August 2013
                14 January 2013
                : 110
                : 4
                : 755-773
                Affiliations
                [ 1 ]Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Strasse 64 , DE-12101Berlin, Germany
                [ 2 ]Kellogg Europe, The Kellogg Building, Lakeshore Drive , Airside Business Park, Swords, IE, County Dublin, Republic of Ireland
                [ 3 ]Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade , Tadeusa Koscuska 1, PO Box 102, SRB-11000, Belgrade, Serbia
                [ 4 ]Department of Public Health, Ghent University, University Hospital Blok A , 2nd floor, De Pintelaan 185, BE-9000Ghent, Belgium
                [ 5 ]French National Cancer Institute , avenue André Morizet 52, FR-92513 Boulogne-Billancourt Cedex, France
                [ 6 ]Nutrition Research Foundation , Barcelona Science Park, Baldiri Reixac 4-6, ES-08028Barcelona, Spain
                [ 7 ]Department of Clinical Sciences , University of Las Palmas de Gran Canaria, PO Box 550, ES-Las Palmas de Gran Canaria, Spain
                [ 8 ]National Food and Nutrition Institute , 61/63 UI Powsinska, PL-02903Warsaw, Poland
                [ 9 ]National Food Institute , Technical University of Denmark, Mørkhøj Bygade 19, Søborg, Denmark
                [ 10 ]National Institute for Public Health and the Environment (RIVM) , PO Box 1, 3720 BABilthoven, The Netherlands
                [ 11 ]ILSI Europe a.i.s.b.l. , Avenue E. Mounier 83, Box 6, BE-1200Brussels, Belgium
                [ 12 ]Elsie Widdowson Laboratory, MRC Human Nutrition Research , 120 Fulbourn Road, CambridgeCB1 9NL, UK
                Author notes
                [* ] Corresponding author: ILSI Europe, fax +32 2 762 00 44, email publications@ 123456ilsieurope.be
                [†]

                Previously at French Agency for Food, Environmental and Occupational Health & Safety (ANSES), avenue du Général Leclerc, FR-94 701 Maisons-Alfort Cedex, France.

                Article
                S000711451200565X 00565
                10.1017/S000711451200565X
                3785176
                23312136
                © ILSI Europe 2012

                The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution-NonCommercial-ShareAlike licence <  http://creativecommons.org/licenses/by-nc-sa/3.0/>. The written permission of Cambridge University Press must be obtained for commercial re-use.

                Categories
                Full Papers
                Dietary Surveys and Nutritional Epidemiology

                Nutrition & Dietetics

                europe, nutrient requirements, dietary surveys, inadequacies, micronutrients

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