Diet and supplement assessment in a Brazilian urban population

Sousa, Alessandra Gaspar; Costa, Teresa Helena Macedo da

doi:10.11606/s1518-8787.2021055002356

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Original Article • Rev. Saúde Pública 55 • 2021 • https://doi.org/10.11606/s1518-8787.2021055002356 copy

Diet and supplement assessment in a Brazilian urban population

Authorship SCIMAGO INSTITUTIONS RANKINGS

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.

DESCRIPTORS:
Adult; Dietary Supplements; Nutritional Status; Body Mass Index; Exercise

		Total		Non-users		Users		p
		n = 506		n = 327		n = 179
		n	%	n	%	n	%
Sex								0.49
	Men	216	42.7	136	41.6	80	44.7
	Women	290	57.3	191	58.4	99	55.3
Age group								0.03^a a Significantly different at p ≤ 0.05.
	20–30y	187	36.9	131	40	56	31.3
	31–50y	175	34.6	115	35.2	60	33.5
	≥ 50y	144	28.5	81	24.8	63	35.2
BMI (kg/m²)								0.06
	< 25	269	53.2	175	52.9	94	52.5
	25–29.9	166	32.8	99	30.3	67	37.4
	≥ 30	73	14.4	55	16.8	18	10.1
Physical activity								< 0.0001^a a Significantly different at p ≤ 0.05.
	Yes	387	76.5	231	70.6	156	87.2
	No	119	23.5	96	29.4	23	12.8
Socioeconomic class								0.51
	A	111	21.9	67	20.5	44	24.6
	B	272	53.7	181	55.3	91	50.8
	C-D-E	123	24.3	79	24.2	44	24.6

		Non-users				Users-foods				Users-total				All
		PI		Above ul		PI		Above ul		PI		Above ul		PI		Above ul
		%	95%CI	%	95%Cl	%	95%Cl	%	95%Cl	%	95%Cl	%	95%Cl	%	95%Cl	%	95%Cl
n		327				179				179				506
Calcium (mg)
	Men	2.3	2.2–2.4	2.2	2.1–2.3	2.9	2.8–3.0	6.1	6.0–6.2	1.4	1.4–1.4	12.6	12.5–12.7	2.5	2.5–2.5	7.45	7.4–7.5
	Women	13.2	13.1–13.3	0.2	0.2–0.2	18.8	18.7–18.9	0.2	0.2–0.2	5.8	5.6–6.0	0.1	0.1–0.1	12.3	12.2–12.4	2.2	2.2–2.2
Folate (mcg)
	Men	26.6	26.4–26.8	0	0	19.5	19.3–19.7	0.4	0.4–0.4	7.4	7.2–7.6	10.6	10.4–10.8	19.4	19.3–19.5	0.8	0.8–0.8
	Women	63.3	63.3–63.4	0	0	56.2	56.0–56.4	0	0	25.8	25.5–26.1	0	0	52.1	52–52.2	0	0
Vitamin C (mg)
	Men	27.5	27.4–27.6	1.5	1.5–1.5	13.1	12.8–13-4	0	0	3.5	3.3–3.7	0	0	18.6	18.5–18.7	1.9	1.9–1.9
	Women	22.2	22.1–22.3	1.8	1.8–1.8	11.6	11.4–11.8	0.5	0.5–0.5	3.9	3.8–4.0	0	0	15.1	15.0–15.2	0.6	0.6–0.6
Vitamin D (mcg)
	Men	96.9	96.8–97	0	0	84.7	84.5–84.9	0	0	32.2	32–32.4	2.4	2.3–2.5	64.1	64.0–64.2	0.4	0.4–0.4
	Women	96.6	96.5–96.7	0	0	98.9	98.9–98.9	0	0	34.8	34.6–35.0	4.7	4.6–4.8	68.3	68.2–68.4	1.9	1.9–1.9
Vitamin E (mg)
	Men^a a Asymmetrical distribution.	93.9	93.8–94	0	0	80.3	80.1–80.5	0	0					58.9	58.8–59.0	0	0
	Women	99.5	99.5–99.5	0	0	98.2	98.1–98.3	0	0	54.0	53.9-54.1	0	0	81.7	81.6–81.8	0	0

Nutrients	BMI < 25kg/m²		BMI 25–29.9kg/m²		BMI > 30kg/m²		p	Physical activity		Physical inactivity		p^b b Significantly different at p ≤ 0.05 using robust ANOVA for the interactions of BMI categories x supplements and physical activity x supplement.
	94	173	67	99	18	55		156	231	23	96
	Users	Non-users	Users	Non-users	Users	Non-users		Users	Non-users	Users	Non-users
Calcium (mg)^a a Mean ± standard error.	1,469.4±393.8	1,263.2±357.2	1,408.5±451.3	1,380±297.7	1,159.9±345.3	1,289.7±385.7	0.0029	1,605.1±870.2	1,340.8±387.7	1,185.4±288.1	1,218.3±315	0.0212
Folate (mcg)^a a Mean ± standard error.	521.5±692.2	334.6±108.3	711.5±545.9	356.9±73.4	347.1±127.7	318.9±69.1	0.0034	602.7±1,155.3	346.8±102.3		319.2±74.1
Vitamin C (mg)^a a Mean ± standard error.	294.7±152.3	453.2±1,898.1	279.7±274.7	216.4±382.4	377.4±566.9	291.4±529.1	0.0001	278.1±192.4	222.6±387.4	334.3±323.3	968±7,003.0	0.3687^c c Significant different for supplement p < 0.00001.
Vitamin D (mcg)^a a Mean ± standard error.	34.9±95.2	4.6±3.4	28.9±59.8	4.5±1.8		4.2±1.9	0.1454^c c Significant different for supplement p < 0.00001.	22.6±46.4	4.7±2.7	27.9±19.8	3.8±1.4	< 0.0001
Vitamin E (mg)^a a Mean ± standard error.	21.8±24.5	6.6±2.2	15.7±9.8	6.9±1.4	144.3±171.1	10.9±3.3	0.0001	21.2±18.6	7.0±2.4		5.9±1.7

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[1] Correspondence: Alessandra Gaspar Sousa, Universidade de Brasília, Faculdade de Ciências da Saúde, Departamento de Nutrição Campus, Universitário Darcy Ribeiro, 70919-970, Asa Norte, Brasília, DF, Brasil. E-mail: alessandragaspars@gmail.com