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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.
J Am Diet Assoc. 2009 Mar; 109(3):422-9.JA

Abstract

BACKGROUND

Low intake of nutrients is associated with poor health outcomes. We examined the contribution of dietary supplementation to meeting recommended dietary intakes of calcium, magnesium, potassium, and vitamin C in participants of the Multi-Ethnic Study of Atherosclerosis, a cohort of white, African-American, Hispanic, and Chinese-American participants ages 45 to 84 years. We also assessed the prevalence of intakes above Tolerable Upper Intake Levels (ULs).

METHODS

At the baseline exam in 2000-2001, 2,938 men and 3,299 women completed food frequency questionnaires and provided information about dietary supplementation. We used relative risk regression to estimate the probability of meeting Recommended Dietary Allowances (RDAs) or Adequate Intakes (AIs) in supplement users vs nonusers and Fisher's exact tests to compare the proportion of those exceeding ULs between the two groups. RDAs, AIs, and ULs were defined by the National Academy of Sciences Food and Nutrition Board's Dietary Reference Intakes (DRIs).

RESULTS

After adjustment for age and education, the relative risk of meeting RDAs or AIs in supplement-users vs nonusers ranged from 1.9 (1.6, 2.3) in white men to 5.7 (4.1, 8.0) in African-American women for calcium, from 2.5 (1.9, 3.3) in Hispanic men to 5.2 (2.4, 11.2) in Chinese men for magnesium, and from 1.4 (1.3, 1.5) in African-American women to 2.0 (1.7, 2.2) in Chinese men for vitamin C. The relative risks for meeting RDAs for calcium differed significantly by ethnicity (P<0.001) and sex (P<0.001), and by ethnicity for magnesium (P=0.01). The relative risk for each sex/ethnicity strata was close to 1 and did not reach statistical significance at alpha=.05 for potassium. For calcium, 15% of high-dose supplement users exceeded the UL compared with only 2.1% of nonusers. For vitamin C, the percentages were 6.6% and 0%, and for magnesium, 35.3% and 0% (P<0.001 for all).

CONCLUSIONS

Although supplement use is associated with meeting DRI guidelines for calcium, vitamin C and magnesium, many adults are not meeting the DRI guidelines even with the help of dietary supplements, and the effect of supplementation can vary according to ethnicity and sex. However, supplementation was not significantly associated with meeting DRIs for potassium. Also, high-dose supplement use is associated with intakes above ULs for calcium, magnesium, and vitamin C.

Authors+Show Affiliations

Fred Hutchinson Cancer Research Center, and Department of Epidemiology, University of Washington, Seattle, WA, USA. anbh@u.washington.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

19248857

Citation

Burnett-Hartman, Andrea N., et al. "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." Journal of the American Dietetic Association, vol. 109, no. 3, 2009, pp. 422-9.
Burnett-Hartman AN, Fitzpatrick AL, Gao K, et al. 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. J Am Diet Assoc. 2009;109(3):422-9.
Burnett-Hartman, A. N., Fitzpatrick, A. L., Gao, K., Jackson, S. A., & Schreiner, P. J. (2009). 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. Journal of the American Dietetic Association, 109(3), 422-9. https://doi.org/10.1016/j.jada.2008.11.023
Burnett-Hartman AN, et al. 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. J Am Diet Assoc. 2009;109(3):422-9. PubMed PMID: 19248857.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Burnett-Hartman,Andrea N, AU - Fitzpatrick,Annette L, AU - Gao,Kun, AU - Jackson,Sharon A, AU - Schreiner,Pamela J, PY - 2007/10/02/received PY - 2008/08/22/revised PY - 2008/08/22/accepted PY - 2009/3/3/entrez PY - 2009/3/3/pubmed PY - 2009/3/27/medline SP - 422 EP - 9 JF - Journal of the American Dietetic Association JO - J Am Diet Assoc VL - 109 IS - 3 N2 - BACKGROUND: Low intake of nutrients is associated with poor health outcomes. We examined the contribution of dietary supplementation to meeting recommended dietary intakes of calcium, magnesium, potassium, and vitamin C in participants of the Multi-Ethnic Study of Atherosclerosis, a cohort of white, African-American, Hispanic, and Chinese-American participants ages 45 to 84 years. We also assessed the prevalence of intakes above Tolerable Upper Intake Levels (ULs). METHODS: At the baseline exam in 2000-2001, 2,938 men and 3,299 women completed food frequency questionnaires and provided information about dietary supplementation. We used relative risk regression to estimate the probability of meeting Recommended Dietary Allowances (RDAs) or Adequate Intakes (AIs) in supplement users vs nonusers and Fisher's exact tests to compare the proportion of those exceeding ULs between the two groups. RDAs, AIs, and ULs were defined by the National Academy of Sciences Food and Nutrition Board's Dietary Reference Intakes (DRIs). RESULTS: After adjustment for age and education, the relative risk of meeting RDAs or AIs in supplement-users vs nonusers ranged from 1.9 (1.6, 2.3) in white men to 5.7 (4.1, 8.0) in African-American women for calcium, from 2.5 (1.9, 3.3) in Hispanic men to 5.2 (2.4, 11.2) in Chinese men for magnesium, and from 1.4 (1.3, 1.5) in African-American women to 2.0 (1.7, 2.2) in Chinese men for vitamin C. The relative risks for meeting RDAs for calcium differed significantly by ethnicity (P<0.001) and sex (P<0.001), and by ethnicity for magnesium (P=0.01). The relative risk for each sex/ethnicity strata was close to 1 and did not reach statistical significance at alpha=.05 for potassium. For calcium, 15% of high-dose supplement users exceeded the UL compared with only 2.1% of nonusers. For vitamin C, the percentages were 6.6% and 0%, and for magnesium, 35.3% and 0% (P<0.001 for all). CONCLUSIONS: Although supplement use is associated with meeting DRI guidelines for calcium, vitamin C and magnesium, many adults are not meeting the DRI guidelines even with the help of dietary supplements, and the effect of supplementation can vary according to ethnicity and sex. However, supplementation was not significantly associated with meeting DRIs for potassium. Also, high-dose supplement use is associated with intakes above ULs for calcium, magnesium, and vitamin C. SN - 1878-3570 UR - https://www.unboundmedicine.com/medline/citation/19248857/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_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8223(08)02186-X DB - PRIME DP - Unbound Medicine ER -