Many Middle-Aged and Older Americans Not Getting Adequate Nutrition

New Study Published in the Journal of the American Dietetic Association Evaluates Supplement Intake

St. Louis, MO – Micronutrients such as calcium, magnesium, potassium and vitamin C play essential roles in maintaining health. As older adults tend to reduce their food intake as they age, there is concern that deficits in these micronutrients lead to medical problems. In a study published in the March 2009 issue of the Journal of the American Dietetic Association, researchers examined how well different ethnic groups met the recommended daily allowances (RDAs) through food intake and supplement consumption. The study determined that many middle-aged and older Americans are not getting adequate nutrition.

Using data drawn from the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective cohort study designed to investigate the prevalence, correlates and progression of subclinical cardiovascular disease, researchers examined over 6200 participants from 4 ethnic groups, Caucasian, African American, Hispanic and Chinese. Dietary intakes were determined from food frequency questionnaires and respondents were asked to provide amounts and frequencies of micronutrient consumption using label information from their supplements. These data were used to calculate whether the RDAs or Adequate Intake (AI) levels were being met. The large sample size and multiple ethnic groups in this population gave investigators enough power to examine interactions between supplementation and ethnicity.

Over half of the population took supplements, and supplement users were more likely to be older, women, Caucasian and college-educated. Calcium and vitamin C supplements were most common. Although dietary intake of calcium, magnesium, potassium and vitamin C was similar between supplement users and non-users for both men and women, there were differences in median dietary intake levels between the different ethnic groups. Chinese Americans tended to have the lowest dietary intakes, particularly in calcium where both Chinese and African Americans had significantly lower dietary intakes of calcium than Caucasians and Hispanics.

The study also evaluated differences between multivitamins and high-dose supplements. While high-dose calcium was associated with meeting RDA/AIs for all ethnic groups, some high-dose supplements could also cause users to exceed their Tolerable Upper Intake Levels (ULs). For calcium, 15.0% of high-dose users exceeded the UL compared to 1.9% of multivitamin users and 2.1% of non-users. For magnesium, 35.3% of high-dose supplement users exceeded the UL compared to 0% of both multivitamin users and non-users. In addition, 6.6% high-dose vitamin C users exceeded the UL compared to 0% of both multivitamin users and non-users.

The study also found that potassium intake was very much below the RDA whether supplements were taken or not. This could point to a need to reformulate supplements to deliver higher potassium doses.

Writing in the article, Pamela J. Schreiner, MS, PhD, Professor and Director of Graduate Studies, Division of Epidemiology and Community Health, University of Minnesota, states, “The present study indicates a clear association between meeting RDA/AIs and supplement use for calcium, magnesium and vitamin C. However, even with the assistance of dietary supplements many middle-aged and older Americans are not getting adequate nutrition, and there was no association between supplement use and meeting the AI for potassium. In addition, those taking high-dose vitamin supplements were more likely to exceed the UL for that nutrient. Future studies should explore dietary supplementation along with other methods to improve nutrition in middle-aged and older Americans.”

The article is “Supplement use contributes to meeting recommended dietary intakes for calcium, magnesium and vitamin C in four ethnicities of middle-aged and older Americans: The Multi-Ethnic Study of Atherosclerosis” by Andrea N. Burnett-Hartman, MPH, Annette L. Fitzpatrick, PhD, Kun Gao, MPH, PhD, Sharon A. Jackson, PhD, and Pamela J. Schreiner, MS, PhD. It appears in the Journal of the American Dietetic Association, Volume 109, Issue 3 (March 2009) published by Elsevier.

Full text of the article featured above is available upon request. Contact Lynelle Korte at 314-453-4841 or jadamedia@elsevier.com to obtain a copy. Journalists wishing interviews should contact Pamela J. Schreiner, MS, PhD, Professor and Director of Graduate Studies, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, Tel: 612-626-9097, Fax: 612-624-0315,:schreiner@epi.umn.edu.

Notes for Editors:
Authors:
Andrea N. Burnett-Hartman, MPH, Pre-Doctoral Research Assistant, Department of Epidemiology, University of Washington, Seattle, WA

Annette L. Fitzpatrick, PhD, Research Assistant Professor, Department of Epidemiology, University of Washington, Seattle, WA

Kun Gao, MPH, PhD, Manager, Global Health Economics, Amgen Inc., Thousand Oaks, CA

Sharon A. Jackson, PhD, Northrop Grumman contractor to the Division of Heart Disease
and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, GA

Pamela J. Schreiner, MS, PhD, Professor and Director of Graduate Studies, Division of
Epidemiology and Community Health, University of Minnesota, Minneapolis, MN

March is National Nutrition Month®
http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/NNM_2007_home.htm
The theme for March 2009 is “Eat Right.”
National Nutrition Month® is a nutrition education and information campaign created annually in March by the American Dietetic Association. The campaign focuses attention on the importance of making informed food choices and developing sound eating and physical activity habits. Registered Dietitian Day, also celebrated in March, increases awareness of registered dietitians as the indispensable providers of food and nutrition services and recognizes RDs for their commitment to helping people enjoy healthy lives.

About the Journal of the American Dietetic Association
The official journal of the American Dietetic Association the Journal of the American Dietetic Association is the premier source for the practice and science of food, nutrition and dietetics. The monthly, peer-reviewed journal presents original articles prepared by scholars and practitioners and is the most widely read professional publication in the field. The Journal focuses on advancing professional knowledge across the range of research and practice issues such as: nutritional science, medical nutrition therapy, public health nutrition, food science and biotechnology, foodservice systems, leadership and management and dietetics education.

About the American Dietetic Association
The American Dietetic Association is the world’s largest organization of food and nutrition professionals. ADA is committed to improving the nation’s health and advancing the profession of dietetics through research, education and advocacy.

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