Gender differences in food and nutrient intakes and status indices from the National Diet and Nutrition Survey of people aged 65 years and over.

OBJECTIVES: To determine the patterns and possible explanations for gender differences in food choices, nutrient intakes and status indices, especially for micronutrients, in a representative sample of older people living in Britain, who participated in the National Diet and Nutrition Survey of people aged 65 y and over during 1994-95. DESIGN: The Survey procedures included a health-and-lifestyle interview, a four-day weighed diet record, anthropometric measurements and a fasting blood sample for biochemical indices. SETTING: Eighty randomly-selected postcode sectors from mainland Britain. SUBJECTS: Of 1556 older people not living in institutions who were interviewed, 80% agreed to provide a complete four-day diet record and 63% agreed to give a blood sample for status index measurements. INTERVENTIONS: None. MAIN RESULT: The most highly significant gender differences in food choices were that women ate more butter, full-fat milk and certain beverages, cakes, apples, pears and bananas, whereas men ate more eggs, sugar, certain meat products and drank more alcoholic drinks, especially beer and lager. When adjusted for energy intakes, the younger women (65-79 y) had higher intakes than the younger men, of fat, retinol, vitamin C and calcium. The older women (80+ y) had higher intakes than older men, of fat and vitamin E, but lower intakes of protein, zinc and beta-carotene. The younger women had better status indices than the younger men: for alpha- and beta-carotenes, beta-cryptoxanthin and vitamin C. Women had higher plasma concentrations of cholesterol and HDL cholesterol, phosphate and copper, but lower indices of iron and vitamin D status, than men. These gender differences in status were not altered by inclusion of the corresponding nutrient intakes in the model. CONCLUSIONS: There are gender differences in food choices, in energy and nutrient intakes and in nutritional blood status indices in older British people, especially those aged 65-79 y. Some of the status differences are attenuated in the age group of 80 y and older, whereas others are enhanced. The relationships between the quantity and type of foods or nutrients consumed, and nutrient status, are complex. With respect to suspected risk and protective factors for vascular disease, women aged 65-79 y had significantly better status for plasma alpha- and beta-carotene, ascorbate, HDL-cholesterol and homocysteine; but, in contrast, they had lower blood haemoglobin concentrations and higher concentrations of total and non-HDL-cholesterol.     

Micronutrient intakes of pre-adolescent children living in London

Abstract

The aim of the current study was to report on the micronutrient intakes of a sample of pre-adolescent children from a range of socio-economic backgrounds. Eighty-five children aged 7–10 years completed 7-day weighed food diaries, which were used to assess habitual intake of selected micronutrients. Intakes were then compared with the current Department of Health reference values and the findings of the UK National Diet and Nutrition Survey for young people. These children failed to meet the reference values set by the Department of Health for zinc (73% of sample) and potassium (68% of sample), and intakes of calcium, potassium, vitamin B₁₂, vitamin D and folate were lower than the findings of the UK National Diet and Nutrition Survey. Among this sample, dietary changes are required to ensure that children follow a well-balanced diet for optimum health and development.     

Associations between added sugars and micronutrient intakes and status: further analysis of data from the National Diet and Nutrition Survey of Young People aged 4 to 18 years

Added sugars are often viewed as 'empty calories', negatively impacting micronutrient intakes, yet reviews consider the evidence inconclusive. This study aimed to quantify associations between dietary added sugars (as a percentage of energy) and micronutrient intake and biochemical status in the National Diet and Nutrition Survey. Using data from 1688 British children aged 4-18 years who completed 7 d weighed dietary records in 1997, micronutrient intakes were examined across quintiles of added sugars. After excluding low energy reporters, mean dietary intakes of most nutrients exceeded the reference nutrient intake, except for zinc. Compared with quintile 1 (9% added sugars), high consumers in quintile 5 (23% added sugars) had micronutrient intakes ranging from 24% lower to 6% higher (mean 14% lower). Zinc intakes in quintile 1 v. quintile 5 averaged 93% v. 78% of reference nutrient intake; magnesium 114% v. 94%; iron 115% v. 100%; and vitamin A 111% v. 92%, respectively. Plasma levels of magnesium, zinc and carotenoids did not vary across quintiles, but weak negative correlations were observed with serum ferritin and transferrin saturation. Plasma selenium was inversely correlated with added sugars (r -0.17; P < 0.0001) but there was no association with glutathione peroxidase. The impact of added sugars on micronutrient intakes appears modest overall but may have relevance for children consuming inadequate amounts of nutrient-rich foods coupled with a diet high in added sugars (approximately 23%). Further work is needed to explore the impact of different sources of added sugars and to refine assessments of inadequate intakes and status.     

Dietary intakes and nutrient status of vegetarian preschool children from a British national survey

Background Dietary intakes and nutrient status were compared in meat‐eaters and non‐meat‐eaters from the National Diet and Nutrition Survey of children aged 1.5–4.5 years. Methods Children (n = 1351) were categorized as ‘omnivores’ or ‘vegetarians’, according to whether they consumed meat or meat products during a 4‐day dietary record. Blood samples were also obtained for analysis of haematological and biochemical nutrient status. Results Three per cent of children were ‘vegetarian’. They consumed higher proportions of milk and milk products, although this was significant only in older children (P = 0.007), owing to high consumption by the high proportion of Asian children. In vegetarians, energy intakes tended to be lower in both age groups. Percentage energy from protein and fat were lower, while that from carbohydrate was higher compared with omnivores. Cholesterol intakes were lower, significantly so for younger children (P < 0.001). Intakes of micronutrients were either higher (vitamins C and E, potassium) or lower (niacin and sodium) in younger vegetarians compared with omnivores. Energy‐adjusted intakes of iron and zinc did not differ significantly from those of omnivores, although both intakes were low in many children (6–20% < LRNI), particularly in the younger group. Haematological and biochemical nutrient status indices showed few differences. Serum ferritin was lower in vegetarians, significantly so in younger children (P = 0.002). Antioxidant vitamin (A, C and E) status tended to be higher in vegetarians, while vitamin B₁₂ intakes and status were more than adequate. Apart from poorer vitamin D intake and status in older Asian vegetarians, very few ethnic differences were observed. Conclusions Nutrient intakes and status were generally adequate in preschool children who did not eat meat. Although serum ferritin levels were inferior (particularly in vegetarians under 3 years old), the lower intakes of fat, cholesterol and sodium, and higher antioxidant vitamin intakes and status indices were potentially beneficial. Given a balanced diet, adequate nutrient intakes and status can be maintained without consuming meat.     

Vitamin D: seasonal and regional differences in preschool children in Great Britain

OBJECTIVES: To examine seasonality of 25-hydroxyvitamin D (25OH-D) levels in British preschool children and the effect of vitamin D supplementation on this. DESIGN: The National Diet and Nutrition Survey of children aged 1.5 4.5 y in Britain during 1992-3 measured dietary intakes and blood status indices, including those for vitamin D, during all four seasons. The present study addresses the seasonal dependence of the relation between vitamin D intake and status. SETTING: 100 randomly selected postcode sectors throughout Britain, whose locations were classified as (a) Scotland; (b) Northern England; (c) Central, Wales, South+SW; (d) London+SE. SUBJECTS: Of 1859 whose parents or guardians were interviewed, 1675 provided a weighed diet estimate, and blood vitamin D status (25OH-D) was measured in 756, with approximately equal numbers in each season. RESULTS: Vitamin D status is highly dependent on season: moreover, the relation between vitamin D intake and status is also seasonally dependent, being strong in the winter and negligible in the summer. During the winter, those children who had relatively low 25OH-D concentrations generally were those not receiving vitamin D supplements. Vitamin D intakes and supplement use were lower in the north than in the south of Britain. CONCLUSIONS: For British preschool children, dietary vitamin D is of much greater importance in the winter than in the summer. There is evidence of regional inequality, with lesser use of supplements in the north. Supplements are needed in the winter, to achieve satisfactory vitamin D status and minimise the risk of rickets and of poor bone health, especially in high-risk groups.     

Zinc and vitamin A intake and status in a national sample of British young people aged 4-18 y

OBJECTIVE: To examine zinc and vitamin A intake and status and associated dietary, socio-demographic, lifestyle and physiological factors in British young people. DESIGN: National Diet and Nutrition Survey of young people aged 4-18 y. SETTING: Great Britain, 1997. SUBJECTS: Complete 7-day weighed dietary records were provided by 1520 participants, while 1193 provided blood samples. RESULTS: A total of 13 and 11% of participants respectively reported low dietary intakes of zinc and vitamin A (retinol equivalents), relative to the UK lower reference nutrient intake. These percentages were not altered significantly by including contributions to intake from supplements, mainly containing vitamin A (as retinol). Likelihood of low zinc and/or vitamin A intake was more often associated with age, sex and likely under-reporting of food consumption than with other socio-demographic and lifestyle factors. Low zinc and vitamin A intakes were generally less likely in those with higher consumption of dairy foods (mainly milk). Zinc and vitamin A status (assessed by plasma zinc and retinol concentrations) were adequate in almost all participants. Plasma zinc concentration was not significantly associated with zinc intake. Plasma retinol concentration was correlated with vitamin A intake (overall r=0.17, P<0.001; adjusted for age and plasma alpha(1)-antichymotrypsin concentration) and increased significantly with age (P<0.001) in both sexes. A significant association was found between plasma zinc and retinol concentrations in boys only (r=0.17, P=0.001). CONCLUSION: Zinc and vitamin A intakes and status were generally adequate in this national sample of British young people.     

North-south differences in some indices of Vitamin B6 nutritional status in older British people

The National Diet and Nutrition Survey, nationally representative for the British population aged 65 years and over, has revealed a north-south geographical gradient, with a decline from south to north of vitamin B6 status indices. The present study further explores the possible explanatory factors (dietary intake of vitamin B6 and riboflavin, alcohol consumption, smoking habits and some other lifestyle determinants) on the difference of vitamin B6 indices--plasma concentrations of pyridoxal phosphate (pPLP) and pyridoxic acid (pPA), between older people living in the north (Scotland, North of England) and the south (Southern England, Wales and Midlands). The results showed that older people living in the northern half of Britain are at greater risk of poor vitamin B6 status, mainly as a result of low intakes of this vitamin, than the people living in the southern half of the country. Riboflavin intake, alcohol consumption, smoking and socio-economic status also correlated with the north-south gradient of pPLP and pPA. Other potential determinants such as use of vitamin B6 supplements, medicines probably affecting vitamin B6 metabolism, were not independent correlates of the north-south gradient in vitamin B6 status indices. This may have important implications for disease-risk geographical gradients in the UK.     

Moderate alcohol intake and nutritional status in nonalcoholic elderly subjects

Three hundred and seventy-three female and 213 male nonalcoholic subjects, aged 60-100 y, who had participated in a nutritional status survey of elderly people in the Boston area were grouped according to usual alcohol intake: 0-4, 5-14, or 15+ g/d. The age- and sex-adjusted mean intake of calories, fat, protein, carbohydrate, and 10 micronutrients and the mean levels of 14 nutrient and 22 nonnutrient biochemical indices were compared for the three categories of alcohol intake. The mean micronutrient intakes were also adjusted for total caloric intake and the mean nutrient biochemical concentrations were also adjusted for the corresponding nutrient intakes. The results suggest that caloric intake and blood concentrations of retinol, iron, ferritin, HDL cholesterol, AST, and ALT increased with increasing alcohol intake whereas folate and phosphorus intakes and blood measures of riboflavin, copper, zinc, urea nitrogen, and creatinine decreased with increasing alcohol intake.     

Multivitamin/Multimineral Supplement Use is Associated with Increased Micronutrient Intakes and Biomarkers and Decreased Prevalence of Inadequacies and Deficiencies in Middle-Aged and Older Adults in the United States

Abstract

Micronutrient inadequacies are common in older adults and using a multivitamin/multimineral supplement (MVM) may improve their nutritional status. National Health and Nutrition Examination Survey data were analyzed to determine micronutrient intakes based on diet and MVM use in adults aged ≥51?years. Deficiencies were evaluated using nutrient biomarkers. The National Cancer Institute Method was used to estimate usual intakes of 18 micronutrients stratified by age and frequency of MVM use. Compared with food alone, MVM use was associated with higher nutrient intake and lower prevalence of inadequacies of almost all micronutrients examined and improved nutrient biomarker status of folate, iodine, selenium, and vitamins B₆, B₁₂, and D. Regular MVM use (≥16?days/month) decreased the odds of clinical deficiency (defined by biomarker status) of vitamins B₆ and D but increased the proportion exceeding the tolerable upper intake level of folic acid. Vitamin B₆ deficiency in MVM non-users was common and increased with age.     

Nutrient intake and body weight in a large HIV cohort that includes women and minorities

OBJECTIVE: Evaluate the baseline nutrient intake of an HIV positive population that includes significant representation from women and minorities, and determine the relationship between state of disease and nutritional intake. DESIGN: Baseline data from a prospective study (Nutrition for Healthy Living). SUBJECTS: Individuals with HIV in the Boston and Rhode Island area (n = 516); 25% were women and 30% were minorities. METHODS: Nutrient intakes from 3-day food records, which included vitamin/mineral supplements, were estimated by gender and nonwhite vs white categories, after grouping by CD4 lymphocyte counts. STATISTICAL ANALYSES: Spearman correlation coefficients, Wilcoxon signed rank test, Wilcoxon rank sum test, chi2 test, and restricted cubic spline model were used for data analyses as indicated. RESULTS: Macronutrient but not micronutrient intake was statistically and inversely associated with decreasing CD4 cell counts. The median intake of micronutrients was higher in the study sample compared with the same age and gender group in NHANES III data; however, 25% to 35% of the women in our study sample had dietary intakes of less than 75% of the DRIs for vitamins A, C, E and B-6, and iron and zinc. White men had statistically higher values of all micronutrients compared with nonwhite men. Body mass index for men and women ranged from 23 to 25. CONCLUSIONS/APPLICATIONS: Median values for micronutrient intake from food plus vitamin/mineral supplements were adequate in the overall population studied, but a large percent of women and minorities had inadequate nutrient intakes and would benefit from dietary assessment and counseling.     

Plasma pyridoxal phosphate and pyridoxic acid and their relationship to plasma homocysteine in a representative sample of British men and women aged 65 years and over.

Concentrations of pyridoxal phosphate and pyridoxic acid were measured in fasting plasma samples from British men and women aged 65 years and over, participating in a National Diet and Nutrition Survey during 1994-5, selected to be representative of the population of mainland Britain. In this population, the concentration of pyridoxal phosphate declined, whereas pyridoxic acid rose, with increasing age and frailty; however, both status indicators were strongly and directly (with a positive coefficient) correlated with estimates of vitamin B6 intake. This was little affected by the inclusion of food energy and protein intakes in the model. Forty-eight percent of the participants living in the community and 75% of those living in institutions had plasma pyridoxal phosphate concentrations below a range considered normal from other studies. In a univariate regression model, plasma pyridoxal phosphate concentrations were inversely correlated with plasma homocysteine concentrations, consistent with the hypothesis that vitamin B6 status may influence plasma homocysteine levels, and hence vascular disease risk. However, this relationship was partly attenuated in a multiple regression model including age, sex, domicile and biochemical status indices, including those of folate and vitamin B12. There was evidence that plasma pyridoxal phosphate was sensitive to metabolic conditions associated with inflammation and the acute-phase reaction, and that plasma pyridoxic acid was sensitive to renal function. Thus, neither index is an ideal predictor of vitamin B6 status in older people, unless these confounding factors are allowed for. Since poor vitamin B6 status may have health implications, e.g. for immune function, cognition, and for essential intermediary metabolic pathways in older people, it needs to be investigated as a possible public health problem.     

Iron deficiency in older people: interactions between food and nutrient intakes with biochemical measures of iron; further analysis of the National Diet and Nutrition Survey of people aged 65 years and over.

OBJECTIVE: To quantitatively investigate relationships between food consumption, nutrient intake and biochemical markers of iron status in a population of older people. DESIGN: National Diet and Nutrition Survey: cross-sectional survey of a nationally representative population of men and women aged 65 y and over. SETTING: Mainland Great Britain SUBJECTS: 1268 participants (651 men and 617 women) who provided both dietary intake and blood biochemistry. 986 were living in private households and 282 were living in residential or nursing homes. RESULTS: Intakes of alcohol, vitamin C, protein, haem and non-haem iron and fibre were positively associated with iron status. Consumption of meat, poultry and fish were positively associated with six measures of iron status, and vegetables and potatoes with four measures. Calcium, dairy foods and tea generally had a negative association with most measures of iron status. CONCLUSIONS: A varied diet containing meat, poultry and fish, vegetables and fruit, with a moderate intake of alcohol will make a positive contribution to the iron status of elderly people.     

Relationship between methylmalonic acid,homocysteine, vitamin B12 intake and status and socio-economic indices,in a subset of participants in the British National Diet and Nutrition Survey of people aged 65 y and over

OBJECTIVE: Assessment of functional vitamin B(12) status in a subset of the respondents in the British National Diet and Nutrition Survey of people aged 65 y and over. SETTING: National Diet and Nutrition Survey: a British nationwide cross-sectional sample of people aged 65 y and over, living either in the community or in institutions such as nursing homes, during one calendar year spanning 1994-1995. METHODS: Methylmalonic acid (MMA) concentrations were measured in plasma samples from 313 subjects (ca 14% of those originally enrolled in the survey). The results were compared with those for serum vitamin B(12), vitamin B(12) intakes and other status and intake estimates and with socio-demographic indices. RESULTS: Of the NDNS participants overall, 20% had serum vitamin B(12) concentrations<150 pmol/l. In the subset studied here, 24% of free-living and 46% of institution-living participants had MMA>0.5 micromol/l. Geometric mean MMA increased with age, from 0.25 micro mol/l in people aged 65-74 y to 0.38 micro mol/l in people aged 85+y. There was little evidence for any gender difference in MMA. It was inversely correlated with serum vitamin B(12) and with red blood cell folate; it was positively correlated directly with total homocysteine, but not significantly with serum folate or with vitamin B(12) intake. Among respondents with high MMA, a subgroup had normal serum vitamin B(12) but higher-than-average plasma urea and creatinine. Socio-demographic co-variates of MMA included receipt of State income benefits, social class of head of household, and educational attainment. These indices were not correlated with serum vitamin B(12). CONCLUSIONS: The progressive increase in MMA with age is metabolic evidence for increasing risk of functional vitamin B(12) deficiency with increasing age in older people. There is evidence that renal function is linked to high MMA in some older people. Age and renal function are thus both important when establishing upper reference limits for MMA. The socio-demographic observations suggest a link between poverty and poor functional vitamin B(12) status in older British people.     

Vitamins and minerals: A model for safe addition to foods

BACKGROUND: Significant subgroups in most European populations have intakes below nationally recommended levels for several vitamins, minerals and trace elements, placing individuals at risk of suboptimal intake of important vitamins and minerals. The voluntary addition of micronutrients to the appropriate foods may help address the risks associated with low micronutrient intakes. However, concerns need to be addressed regarding the potential for unacceptably high intakes, particularly for those people consuming very large amounts of food. AIM OF THE STUDY: To develop a model to estimate the level of each micronutrient that can be added safely to foods. METHODS: A theoretical model was developed based on the critical factors which determine the risk of unacceptably high intake for each micronutrient at high levels of food/energy intakes. These included 1) Tolerable Upper Intake Levels (UL), 2) high micronutrient intakes in Europe at the 95(th) percentile intake for each nutrient, 3) the proportion of fortified foods in the diets of individuals at the 95(th) percentile for energy intakes, 4) the proportion of foods to which micronutrients could practically be added, and 5) a range of estimates for the fractions of foods which might be actually fortified for each nutrient. A maximum level was set up for each micronutrient per typical serving or 100 kcal portion. The outputs of the model were then compared against a recent model developed by AFSSA, based on the food intake data in France. RESULTS: Three categories of micronutrients were identified, in which micronutrients could be added safely to foods at levels (per serving, e. g., 100 kcal) 1) greater than 1 European Commission Recommended Daily Intake (EC RDA): vitamin B12, vitamin C, vitamin E, riboflavin, panthothenic acid, niacin and thiamine; 2) between 50 and 100 % of the EC RDA: vitamin B6, vitamin D, folic acid, biotin, copper, iodine and selenium; 3) between 10 and 40 % of the EC RDA: iron, zinc, calcium, phosphorus and magnesium. A fourth category consisting of retinol, for which high end intake levels are close to UL for some population subgroups in Europe and thus requires further consideration. CONCLUSIONS: A wide range of vitamins and minerals can be added safely to foods at nutritionally important levels in the current diets of Europeans.     

High-Risk Nutrient Intakes Among Low-Income Mexican Women in Chicago, Illinois

Objectives The Cross-sectional Cooking, Eating, Nutrition, and Shopping (CENAS) Survey was used to obtain data on food consumption patterns of low-income Mexicans living in Chicago, Ill.

Design As part of the CENAS Survey, 186 Mexican women provided 24-hour dietary recall data.

Outcome measures Distributions of macronutrient and micronutrient intakes were determined. The proportions of CENAS Survey participants achieving the National Heart Association and National Cancer Institute dietary guidelines were calculated. Intakes of Mexican women in Chicago were compared with intakes of Mexican women of similar socioeconomic status in Texas, Mexican-American women participating in phase 1 of the third National Health and Nutrition Examination Survey (1988-1991), and Mexican-American women participating in the Hispanic Health and Nutrition Examination Survey (1982-1984).

Statistical analysis t Tests were used to compare the nutrient intakes of CENAS Survey respondents with published results from other studies.

Results The proportion of respondents reporting intakes less than two thirds of Recommended Dietary Allowances for nine micronutrients ranged from 11% (thiamin and riboflavin) to 82% (folacin). Respondents also reported median fat (34% of energy) and fiber (16.9 g/day) intakes that departed from recommendations to reduce the risk of heart disease and cancer.

Applications and conclusions Half or more of the Mexican women interviewed in Chicago reported inadequate consumption of calcium, folate, zinc, and iron; higher than recommended intakes of fats; and lower than recommended intakes of fiber, indicating the need for nutrition education and intervention. Their nutrient consumptions differed significantly from those of Mexican-American women in the United States, suggesting possible regional or temporal variation in dietary patterns and underscoring the need for population-specific interventions. J Am Diet Assoc, 1995; 95:1409-1413.     

Longitudinal assessment of micronutrient intake among African-American and white girls: The National Heart, Lung, and Blood Institute Growth and Health Study

OBJECTIVE: Low intakes of micronutrients among adolescents may be linked to long-term health risks, especially in African-American girls. This report describes intake of key micronutrients relative to the Dietary Reference Intakes in a sample of African-American and white girls. DESIGN: Longitudinal analyses used data from 3-day food records collected in the National Heart, Lung, and Blood Institute Growth and Health Study. SUBJECTS/SETTING: Subjects included 1,166 white and 1,213 African-American girls (aged 9 to 18 years). MAIN OUTCOME MEASURES: Estimated usual daily intakes of vitamins A, E, C, D, B-6, B-12, magnesium, folate, calcium, and zinc were compared to the Adequate Intake (for vitamin D and calcium) or the Estimated Average Requirement (EAR) (all other micronutrients). STATISTICAL ANALYSES PERFORMED: Usual daily intake of each micronutrient was estimated. For nutrients with an EAR, the EAR cut-point method was used to assess the prevalence of low nutrient intakes. Mixed models were used to identify age and racial differences in usual daily intake of each nutrient. RESULTS: African-American girls consumed less vitamin A and D, calcium, and magnesium compared to white girls. Regardless of race, a substantial percentage of girls had intakes below the EAR: vitamin E (81.2% to 99.0%), magnesium (24.0% to 94.5%), folate (46.0% to 87.3%). Intakes of vitamins A, D, and C; calcium; and magnesium decreased across years. As girls aged, there was an increasing proportion with intakes below the EAR for vitamins A, C, B-6, and B-12. CONCLUSIONS: Food and nutrition professionals should continue to educate adolescent girls, especially those who are African American, about the importance of a nutrient-dense diet for optimum health.     

Micronutrient status and intake in the UK – where might we be in 10 years' time?

Poor dietary choices not only manifest in obesity, which is currently the main public health focus in the UK, but can also lead to inadequate micronutrient intakes, with implications for health. Recent dietary survey data and measurements of status biomarkers have highlighted folate, vitamin D, calcium, iron and iodine to be amongst the micronutrients of most concern for particular subgroups of the UK population. Those most vulnerable to inadequate intakes of these micronutrients include adolescents, ethnic minorities and lower socio‐economic groups. Teenage girls and women of childbearing age are of particular concern because of their high requirements for some micronutrients and the impact poor micronutrient intakes can have on the health of their offspring. Yet, compared to other food concerns, relatively little importance seems to be given by consumers to the micronutrient density of foods. This review explores different factors that may influence micronutrient intakes and status over the following decade and beyond. Over the next few years, it is likely that the micronutrients of concern remain similar, although continuation of dietary trends could result in further decreases in iron and calcium intakes. In an obesogenic and sedentary environment, where many people are being encouraged to reduce their energy intakes, increasing the micronutrient density of the diet is essential to prevent a concurrent decrease in micronutrient intake. Investment in fortification policies/practices or sustained government programmes aimed at raising awareness of micronutrients of most concern or encouraging supplementation, for example focusing on folate and vitamin D, could considerably improve population micronutrient intakes. Over the longer term, with sufficient investment in research and support from healthcare professionals and the food industry, adequate micronutrient intakes could be achieved across the UK population. However, global food security issues, including retaining food supply in response to an increase in demand for food, energy and water, and changing climate, could potentially hamper these efforts.     

How access, isolation and other factors may influence food consumption and nutrient intake in materially deprived older men in the UK

Summary   The proportion of older people in the UK population is rising, and those aged 65 years and over are particularly at risk of malnutrition. This is caused by factors such as underlying disease, poor oral health, decreased mobility, limited transport to local shops, social isolation and poverty. Older men, particularly those who live alone, may be even more at risk of an inadequate diet. This paper presents findings from a subset of the Low Income Diet and Nutrition Survey, a national survey of materially deprived individuals aged 2 years and over in the UK. The influence of social, physical and other factors on foods consumed and nutrient intake in 234 men (unweighted sample) aged 65 years and over who either lived alone or with other(s) of retirement age is investigated. Mean energy intakes fell below the estimated average requirement (84%), while mean intakes of several micronutrients fell below the reference nutrient intake (vitamin D 35%, magnesium 77%, potassium 75%, and zinc 88%). Men living in households where the person mainly responsible for shopping and preparing food had poorer cooking skills had a lower consumption of vegetables, wholemeal bread and fish and fish dishes, and lower intakes of energy and selected nutrients. Men who experienced difficulty in chewing consumed less fruit, vegetables, wholemeal bread and meat and meat dishes, and had lower intakes of protein and selected nutrients. Interventions need to focus on improving cooking skills, especially in men who live or eat alone, and on increasing the consumption of fruit and vegetables in those with poor oral health, especially those who have difficulty chewing.     

Findings from the latest National Diet and Nutrition Survey

The National Diet and Nutrition Survey (NDNS) of adults aged 19-64 years, carried out in 2000-1, is part of the NDNS programme, a series of cross-sectional surveys aiming to provide detailed quantitative information on the diet, nutritional status and related characteristics of the British population. The programme is split into four surveys of different population age-groups, conducted at approximately three-yearly intervals. In the survey of adults food consumption data were collected from 1724 respondents using a 7 d weighed-intake dietary record. Other components included: height, weight, waist and hip circumference and blood pressure measurements; a 24 h urine sample; a blood sample; a record of physical activity. Results have been published in four volumes covering food consumption, energy and macronutrient intakes, micronutrient intakes and nutritional status, including physical measurements and physical activity. The results have shown that, based on a comparison of nutrient intakes with the UK dietary reference values, adults in Britain are generally getting sufficient nutrients from their diets. However, younger adults (particularly women) and those in lower socio-economic groups are more likely to have low micronutrient intakes and lower levels of some nutritional status indices. The proportion of food energy derived from total fat has fallen since the last survey of this age-group in 1986-7 and is close to the dietary reference value, while the proportion of energy derived from saturated fatty acids and non-milk extrinsic sugars exceeds the dietary reference values. The prevalence of overweight and obesity has increased since 1986-7 and physical activity levels are low.