Public health approach to addressing hyperphosphatemia among dialysis patients.

Elevated serum phosphorus levels are a major source of morbidity and mortality for the 350,000 Americans receiving chronic dialysis treatment. Despite the widespread application of medical and behavioral interventions, the prevalence of hyperphosphatemia remains exceedingly high. At first glance, a public health perspective may seem inappropriate for addressing a disorder of mineral metabolism among patients receiving a life-sustaining treatment. However, we analyzed this topic from a public health perspective and identified many opportunities to improve the management of hyperphosphatemia, including (1) media and cultural messages about food, (2) the availability of appropriate foods and medications, (3) physical structures such as the location of products in grocery stores, and (4) social structures such as food-labeling laws.

Dietary intake of macronutrients, micronutrients, and other dietary constituents: United States 1988-94.

OBJECTIVES: This report presents national estimates of dietary intakes of macronutrients, micronutrients, and other dietary constituents for persons 2 months and older, by sociodemographic variables. METHODS: The third National Health and Nutrition Examination Survey (NHANES III) (1988-94), the source of these data, was designed to provide information on the health and nutritional status of the civilian noninstitutionalized U.S. population. The analytic sample for these analyses included 29,105 participants with complete and reliable dietary recalls. RESULTS: This report provides mean, median, and standard error of the mean dietary intake data for the U.S. population, 1988-94. Dietary intake estimates were derived from NHANES III 24-hour recall data. Foods reported during the survey were coded using the U.S. Department of Agriculture (USDA) Survey Nutrient Database (SNDB) and the University of Minnesota Nutrition Coordinating Center (NCC) data. Food composition values for macronutrients, vitamins, minerals, and other food components are based on SNDB and NCC data. CONCLUSIONS: Data on nutrient intakes are a crucial piece of information toward the determination of total dietary intake. Together with anthropometric and laboratory data, information on nutrient intake can be used to assess nutritional status and elucidate the relationship between nutrition and health.