The CDC's Second National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population Is a Valuable Tool for Researchers and Policy Makers

Abstract

The CDC's National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population (Nutrition Report) is a serial publication that provides ongoing assessment of the population's nutritional status. The Nutrition Report presents data on blood and urine biomarker concentrations (selected water- and fat-soluble vitamins and nutrients, trace elements, dietary bioactive compounds) from a representative sample of the population participating in the NHANES. The Second Nutrition Report (released in 2012) contains reference information (means and percentiles) for 58 biomarkers measured during all or part of 2003-2006, stratified by age, sex, and race-ethnicity. Where available, we presented cutoff-based prevalence data during 2003-2006 and data on changes in biomarker concentrations or prevalence since 1999. Blood vitamin concentrations were generally higher in older (≥ 60 y) than in younger (20-39 y) adults and lower in Mexican Americans and non-Hispanic blacks than in non-Hispanic whites. Nearly 80% of Americans (aged ≥ 6 y) were not at risk of deficiencies in any of the 7 vitamins studied (vitamins A, B-6, B-12, C, D, and E and folate). Deficiency rates varied by age, sex, and race-ethnicity. Approximately 90% of women (aged 12-49 y) were not at risk of iron deficiency, but only 68% were not at risk of deficiencies in iron and all 7 vitamins. Young women (20-39 y) had median urine iodine concentrations bordering on insufficiency. First-time data are presented on plasma concentrations of 24 saturated and mono- and polyunsaturated fatty acids. Tabulation and graphical presentation of NHANES data in the Second Nutrition Report benefits those organizations involved in developing and evaluating nutrition policy.

Sociodemographic and Lifestyle Variables Are Compound- and Class-Specific Correlates of Urine Phytoestrogen Concentrations in the U.S. Population

“…Urine and serum/plasma concentrations of these compounds can serve as indicators of dietary isoflavone and lignan intake (12,13), and so their measurement in cross-sectional studies such as the NHANES can go beyond simply assessing exposure and provide insight on a populationÕs dietary habits. Most recently, the NHANES urine phytoestrogen data for 2003-2006 were analyzed and presented in the CDCÕs Second National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2012 (Second Nutrition Report) (14,15), the latest in a series of publications providing descriptive statistics on nutritional and diet-related biological indicators as a tool for establishing reference levels, identifying disparities, tracking trends over time, and evaluating the effectiveness of public health interventions. The NHANES urine phytoestrogen data have been used in other similar descriptive analyses (16,17).…”

The Validity of Self-reported Dietary Intake Data: Focus on the “What We Eat In America” Component of the National Health and Nutrition Examination Survey Research Initiative

“…12,21 Objective tools also suffer from measurement error, and the limitations of contemporary dietary biomarker techniques have been discussed in the scientific literature. 12,[19][20][21] Hébert et al 17 provided an excellent overview of key advances in dietary assessment methods, suggestions for further improvement, and detailed counterpoints that address many of the issues raised by Archer et al 1 Adding to these suggestions for improvement, research investigating a greater variety of validated biomarkers for both foods and nutrients, the development of low-cost and minimally invasive dietary biomarkers, study designs that utilize dietary biomarkers to support self-reported dietary intake data, and novel technologies to assess and monitor dietary intake could greatly advance nutrition and obesity research.…”

“…Furthermore, the biomarkers could provide information on specific dietary factors (eg, energy intake [doubly labeled water], protein intake [urinary nitrogen excretion], or fruit/ vegetable intake [blood carotenoid concentrations]) but not specific foods consumed (eg, carrots, cantaloupe) or overall diet quality. 20 The sources of nutrients (ie, foods vs dietary supplements) would not be known, unless individuals were asked to recall this information. Biomarker results may also vary depending on physiologic states (eg, fasted vs fed 21 ) and whether the biomarker reflected long-term vs short-term dietary intake.…”

Nutrition as Medicine to Improve Outcomes in Adolescents Sustaining a Sports-related Concussion

“…85 In separate studies, Tang et al 86 and Cekic et al 87 demonstrated that vitamin D deficiency was associated with more adverse pathophysiological outcomes following TBI. Of note, an estimated 40% of adolescents have insufficient vitamin D. 88 Further, in a clinical sample, Hua et al 89 …”