Diet and supplement assessment in a Brazilian urban population

Authors

  • Alessandra Gaspar Sousa Universidade de Brasília. Faculdade de Ciências da Saúde. Programa de Pós-Graduação em Nutrição Humana. Brasília, Distrito Federal (DF), Brasil https://orcid.org/0000-0003-2650-3848
  • Teresa Helena Macedo da Costa Universidade de Brasília. Faculdade de Ciências da Saúde. Departamento de Nutrição. Brasília, Distrito Federal (DF), Brasil https://orcid.org/0000-0002-3396-5058

DOI:

https://doi.org/10.11606/s1518-8787.2021055002356

Keywords:

Adult, Dietary supplements, Nutritional status, Body mass index, Exercise

Abstract

OBJECTIVE: To assess total usual nutrient intakes from foods and dietary supplements by age, sex, physical activity, and nutritional status, and to compare usual nutrient intakes to the Dietary Reference Intakes among non-users and users of dietary supplements in an urban population. METHODS: Cross-sectional population-based survey with 506 adults conducted in the city of Brasília, Brazil, using 24h food recalls. The 24-HR was collected on two nonconsecutive days, for which individuals reported all food, supplements, and beverages consumed in the previous 24 hours. The estimates of mean and the distribution percentiles were adjusted to reflect usual nutrient intake using the Iowa State University method. The prevalence of inadequate micronutrient intake was estimated according to sex using the Estimated Average Requirement (EAR), and values above the Tolerable Upper Intake Level (UL) were also considered. Also, a comparison was made of the total mean usual intake between supplement users and non-users according to BMI and physical activity. RESULTS: The total mean usual dietary intake was significantly higher among users than non-users of dietary supplements (p ≤ 0.02). Dietary supplement use increased intakes of nutrients and decreased prevalence of inadequacy according to sex, with only small (typically < 13%) increases in the population exceeding the Tolerable Upper Intake Level. There was a significant interaction between physical activity and BMI categories with supplement use. CONCLUSIONS: The population that consumes food supplements comprises individuals with more advanced age, female, normal BMI, and physically active. Our findings show that the use of supplements appears beneficial to attain nutrient adequacy. Careful monitoring of intake from food and supplements is recommended, and the statistical methods must be powerful enough to achieve relevant information.

References

US National Institutes of Health, Office of Dietary Supplements. Strengthening knowledge and understanding of dietary supplements. Bethesda, MD: NIH; 1994 [cited 2018 July 20], Available from: https://ods.od.nih.gov/About/dshea_Wording.aspx [ Links ]

Bailey RL, Gahche JJ, Miller PE, Thomas PR, Dwyer JT. Why US adults use dietary supplements. JAMA Intern Med. 2013;173(5):355-61. https://doi.org/10.1001/jamainternmed.2013.2299 [ Links ]

Dickinson A, Blatman J, El-Dash N, Franco JC. Consumer usage and reasons for using dietary supplements: report of a series of surveys. J Am Coll Nutr. 2014;33(2):176-82. https://doi.org/10.1080/07315724.2013.875423 [ Links ]

Harrison RA, Holt D, Pattison DJ, Elton PJ. Are those in need taking dietary supplements? A survey of 21 923 adults. Br J Nutr. 2004;91(4):617-23. https://doi.org/10.1079/BJN20031076 [ Links ]

Guarriguet D. Combining nutrient intake from food/beverages and vitamin/mineral supplements. Health Rep. 2010;21(4):71-84. [ Links ]

Wallace TC, McBurney M, Fulgoni VL 3rd. Multivitamin/mineral supplement contribution to micronutrients intakes in the United States, 2007-2010. J Am Coll Nutr. 2014;33(2):94-102. https://doi.org/10.1080/07315724.2013.846806 [ Links ]

Brunacio KH, Verly-Jr E, Cesar CLG, Fisberg RM, Marchioni DM. [Use of dietary supplements among inhabitants of the city of São Paulo, Brazil]. Cad Saude Publica. 2013;29(7):1467-72. Portuguese. https://doi.org/10.1590/S0102-311X2013000700020 [ Links ]

Sebastian RS, Cleveland LE, Goldman JD, Moshfegh JD. Older adults who use vitamin/mineral supplements differ from nonusers in nutrient intake adequacy and dietary attitudes. J Am Diet Assoc. 2007;107(8):1322-32. https://doi.org/10.1016/j.jada.2007.05.010 [ Links ]

Carriquiry AL. Estimation of usual intake distributions of nutrients and foods. J Nutr. 2003;133(2):601S-8S. https://doi.org/10.1093/jn/133.2.601S [ Links ]

Thomaz PMD, Costa THM, Silva EF, Hallal PC. Fatores associados à atividade física em adultos, Brasília, DF. Rev Saude Publica. 2010;44(5):894-900. https://doi.org/10.1590/S0034-89102010005000027 [ Links ]

Sousa AG, Costa THM. Assessment of nutrient and food group intakes across sex, physical activity, and body mass index in an urban Brazilian population. Nutrients. 2018;10(11):1714. https://doi.org/10.3390/nu10111714 [ Links ]

World Health Organization. Obesity: preventing and managing the global epidemic: report of a WHO consultion. Geneva (CH): WHO; 1999. (WHO technical report series; n° 894). [ Links ]

Moshfegh AJ, Rhodes DG, Baer DJ, Murayi T, Clemens JC, Rumpler WV, et al. The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes. Am J Clin Nutr. 2008;88(2):324-32. https://doi.org/10.1093/ajcn/88.2.324 [ Links ]

University of Minnesota, Nutrition Coordinating Center. Nutrition Data System for Research NDSR: features. Minneapolis, MN: NCC; 2018 [cited 2018 July 20]. Available from: http://www.ncc.umn.edu/products/features/ [ Links ]

Nusser SM, Carriquiry A, Dodd KW, Fuller WA. A semiparametric transformation approach to estimating usual nutrient intake distributions. J Am Stat Assoc. 1996;91(436):1440-9. https://doi.org/10.2307/2291570 [ Links ]

Pedroza-Tobías A, Hernández-Barrera L, López-Olmedo N, García-Guerra A, Rodríguez-Ramírez S, Ramírez-Silva Y, et al. Usual vitamin intakes by Mexican populations. J Nutr. 2016;146(9):1866S-73S. https://doi.org/10.3945/jn.115.219162 [ Links ]

Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, Other B Vitamins, and Choline Dietary reference intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, DC: National Academies Press; 1998 [cited 2018 July 30]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK114310/ [ Links ]

Institute of Medicine (US) Panel on dietary reference intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids. Washington, DC: National Academies Press; 2000 [cited 2018 July 30]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK225483/ [ Links ]

Institute of Medicine (US), Committee to Review Dietary Reference Intakes for Vitamin D and Calcium; Ross AC, Taylor CL, Yaktine AL, et al, editors. Dietary reference intakes for Calcium and Vitamin D. Washington, DC: National Academies Press; 2011 [cited 2018 July 30]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK56070/ [ Links ]

Institute of Medicine (US) Subcommittee on Interpretation and Uses of Dietary Reference Intakes; Institute of Medicine (US), Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. DRI Dietary reference intakes: applications in dietary assessment. Washington, DC: National Academies Press; 2000 [cited 2018 July 30]. https://www.ncbi.nlm.nih.gov/books/NBK222890/ [ Links ]

Verly Jr E, Darmon N, Sichieri R, Sarti FM. Reaching culturally acceptable and adequate diets at the lowest cost increment according to income level in Brazilian households. PLoS One. 2020;15(3):e0229439. https://doi.org/10.1371/journal.pone.0229439 [ Links ]

Araujo MC, Bezerra IN, Barbosa FS, Junger WL, Yokoo EM, Pereira RA, et al. Macronutrient consumption and inadequate micronutrient intake in adults. Rev Saude Publica. 2013;47 Supl 1:177s-89s. https://doi.org/10.1590/S0034-89102013000700004 [ Links ]

Palchetti CZ, Steluti J, Verly Jr E, Pereira RA, Sichieri R, Marchion DML. Prevalence of inadequate intake of folate after mandatory fortification: results from the first National Dietary Survey in Brazil. Eur J Nutr. 2020;59(6):2793-803. https://doi.org/10.1007/s00394-019-02127-w [ Links ]

SAS Institute. SAS/STAT 9.1 user's guide. Cary, NC; 2004 [cited 2018 July 20]. Available from: https://support.sas.com/documentation/onlinedoc/91pdf/sasdoc_91/stat_ug_7313.pdf [ Links ]

Murphy SP, White KK, Park SY, Sharma S. Multivitamin-multimineral supplements’ effect on total nutrient intake. Am J Clin Nutr. 2007;85(1):280S-4S. https://doi.org/10.1093/ajcn/85.1.280S [ Links ]

Dickinson A, MacKay D. Health habits and other characteristics of dietary supplement users: a review. Nutr J. 2014;13:14. https://doi.org/10.1186/1475-2891-13-14 [ Links ]

Giammarioli S, Boniglia C, Carratù B, Ciarrocchi M, Chiarotti F,Sanzini E. Use of supplements and determinants of usage in a sample Italian population. Public Health Nutr. 2013;16(10):1768-81. https://doi.org/10.1017/S1368980012004314 [ Links ]

Reinert A, Rohrmann S, Becker N, Linseisen J. Lifestyle and diet in people using dietary supplements: a German cohort study. Eur J Nutr. 2007;46(3):165-73. https://doi.org/10.1007/s00394-007-0650-2 [ Links ]

Robson PJ, Siou GL, Ullman R, Bryant HE. Sociodemographic, health and lifestyle characteristics reported by discrete groups of adult dietary supplement users in Alberta, Canada: findings from The Tomorrow Project. Public Health Nutr. 2008;11(12):1238-47. https://doi.org/10.1017/S136898000800219X [ Links ]

Blumberg JB, Frei B, Fulgoni VL, Weaver CM, Zeisel SH. Contribution of dietary supplements to nutritional adequacy in various adult age groups. Nutrients. 2017;9(12):1325. https://doi.org/10.3390/nu9121325 [ Links ]

Bailey RL, Dodd KW, Goldman JA, Gahche JJ, Dwyer JT, Moshfegh AJ. Estimation of total usual calcium and vitamin D intakes in the United States. J Nutr. 2010;140(4):817-22. https://doi.org/10.3945/jn.109.118539 [ Links ]

Santos Q, Sichieri R, Marchioni DML, Verly Jr E. Evaluation of the safety of different doses of folic acid supplements in women in Brazil. Rev Saude Publica. 2013;47(5):952-7. https://doi.org/10.1590/S0034-8910.2013047004769 [ Links ]

Ministério da Saúde (BR), Agência Nacional de Vigilância Sanitária. Resolução da Diretoria Colegiada -RDC N° 150, de 13 de abril de 2017. Dispõe sobre o enriquecimento das farinhas de trigo e de milho com ferro e ácido fólico. Brasília, DF: Anvisa; 2017 [cited 2020 June 23]. http://antigo.anvisa.gov.br/documents/10181/2718376/RDC_150_2017_.pdf/a873d3b9-3e93-49f3-b6c5-0f45aefcd348 [ Links ]

Orozco AM, Yeung LF, Guo J, Carriquiry A, Berry RJ. Characteristics of U.S adults with usual daily folic acid intake above tolerable upper intake level: National Health and Nutrition Examination Survey, 2003-2010. Nutrients. 2016;8(4):195. https://doi.org/10.3390/nu8040195 [ Links ]

Bailey RL, Dodd KW, Gahche JJ, Dwyer JT, McDowell MA, Yetley EA, et al. Total folate and folic acid intake from foods and dietary supplements in the United States: 2003-2006. Am J Clin Nutr. 2010;91(1):231-7. https://doi.org/10.3945/ajcn.2009.28427 [ Links ]

Ryan MJ, Dudash HJ, Docherty M, Geronilla KB, Baker BA, Haff GG, et al. Vitamin E and C supplementation reduces oxidative stress, improves antioxidant enzymes and positive muscle work in chronically loaded muscles of aged rats. Exp Gerontol. 2010;45(11):882-95. https://doi.org/10.1016/j.exger.2010.08.002 [ Links ]

Published

2021-05-24

Issue

Section

Original Articles

How to Cite

Sousa, A. G., & Costa, T. H. M. da. (2021). Diet and supplement assessment in a Brazilian urban population. Revista De Saúde Pública, 55, 26. https://doi.org/10.11606/s1518-8787.2021055002356

Funding data