This review summarizes the results of 15 controlled studies supplementing defined Cr(III) compounds to subjects with impaired glucose tolerance. Three of these (3-4 mumol Cr/d for > 2 mo) produced no beneficial effects: serum glucose, insulin and lipid concentrations remained unchanged. The remaining 12 interventions improved the efficiency of insulin or the blood lipid profile of subjects (ranging from malnourished children and healthy middle-aged individuals to insulin-requiring diabetics). In addition, three cases of impaired glucose tolerance after long-term total parenteral alimentation responding to Cr supplementation have been reported. Chromium potentiates the action of insulin in vitro and in vivo; maximal in vitro activity requires a special chemical form, termed Glucose Tolerance Factor and tentatively identified as a Cr-nicotinic acid complex. Its complete structural identification is a major challenge to chromium research. The development and validation of a procedure to diagnose chromium status is the second challenge. Such a test would allow the assessment of incidence and severity of deficiency in the population and the selection of deficiency in the population and the selection of chromium-responsive individuals. The third challenge is the definition of chromium's mode of action on parameters of lipid metabolism that have been reported from some studies but not others. Future research along these lines might establish whether chromium deficiency is a factor in the much discussed "Syndrome X" of insulin resistance.

Essential trace elements are required by man in amounts ranging from 50 micrograms to 18 milligrams per day. Acting as catalytic or structural components of larger molecules, they have specific functions and are indispensable for life. Research during the past quarter of a century has identified as essential six trace elements whose functions were previously unknown. In addition to the long-known deficiencies of iron and iodine, signs of deficiency for chromium, copper, zinc, and selenium have been identified in free-living populations. Four trace elements were proved to be essential for two or more animal species during the past decade alone. Marginal or severe trace element imbalances can be considered risk factors for several diseases of public health importance, but proof of cause and effect relationships will depend on a more complete understanding of basic mechanisms of action and on better analytical procedures and functional tests to determine marginal trace element status in man.

Dietary iron requirements are dependent on the amount and availability of food iron ingested. On the basis of recent studies of food iron absorption employing extrinsic tag techniques, the availability of heme iron has been defined and estimates of the availability of nonheme iron based on the amounts of enhancing substances appear possible. A model has been developed whereby the availability of iron in a given meal may be estimated. Calculations are made on a meal basis of 1) the amount of heme iron and its availability, and 2) the amount of nonheme iron and its availability as influenced by the meal's content of enhancing factors. Examples of these calculations are provided.

The number of days of food intake data needed to estimate the intake of 29 male (n = 13) and female (n = 16) adult subjects, individually and as a group, was determined for food energy and 18 nutrients. The food intake records were collected in a year-long study conducted by the U.S. Department of Agriculture's Beltsville Human Nutrition Research Center. Each individual's average intake of nutrients and standard deviation over the year were assumed to reflect his or her "usual" intake and day-to-day variability. Confidence intervals (P less than 0.05) for each individual's usual intake were constructed, and from these the number of days of dietary records needed for estimated individual and group intake to be within 10% of usual intake was calculated. The results indicated that the number of days of food intake records needed to predict the usual nutrient intake of an individual varied substantially among individuals for the same nutrient and within individuals for different nutrients; e.g., food energy required the fewest days (averaging 31) and vitamin A the most (averaging 433). This was considerably higher than the number of days needed to estimate mean nutrient intake for this group, which ranged from 3 for food energy to 41 for vitamin A. Fewer days would be needed for larger groups.

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Twenty eight adults, 12 men and 16 women, participated in a 1-yr study designed to assess daily nutrient intake accurately. All subjects lived at home, consumed self-chosen diets, and maintained a detailed daily dietary record throughout the year. During four 7-day balance studies, one in each season of the year, meals, beverages, urine, and feces were analyzed for sodium and potassium content by atomic absorption spectrometry. Total intakes averaged 3.4 g/day for sodium and 2.8 g/day for potassium. The Na:K ratio for all diets analyzed averaged 1.3. Nutrient densities of sodium and potassium were 1.8 and 1.5 g/1000 kcal, respectively. Apparent absorptions of sodium and potassium were 98 and 85%, respectively, and did not change significantly over the wide range of intakes. Average urinary excretions of sodium and potassium were 86 and 77% of total intake, respectively. Mean metabolic balances were positive for sodium, +0.47 g/day, and potassium, +0.28 g/day. The data of this study provide useful information concerning the dietary intakes, excretions, and balances of sodium and potassium for adults based on analytic determination.

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Two hundred sixty-six free-living human volunteers, 21-64 y old, were trained by dietitians to record daily their food intake for at least 7 d. Subsequently, they were fed diets of conventional foods adjusted in amounts to maintain their body weight for greater than or equal to 45 d. Comparing their estimated energy intake with the intake determined to maintain weight yielded mean differences of 2365 and 1792 kJ (565 and 428 kcal) in men and women, respectively, representing an underreporting of 18%. Twenty-two individuals (8%) overestimated and 29 (11%) were accurate to within 419 kJ (100 kcal) of their maintenance requirement. The remaining 215 individuals (81%) reported their habitual intake at 2930 +/- 1586 kJ (700 +/- 379 kcal) below that subsequently determined as their maintenance requirement. These findings suggest caution in the interpretation of food-consumption data.