Voluntary food fortification in the United States: potential for excessive intakes.

BACKGROUND: Historically, the voluntary addition of micronutrients to foods in the United States has been regarded as an important means to lessen problems of nutrient inadequacy. With expanding voluntary food fortification and widespread supplement use, it is important to understand how voluntary food fortification has an impact on the likelihood of excessive usual intakes. Our objective was to investigate whether individuals in the United States with greater frequency of exposure to micronutrients from voluntarily fortified foods (vFF) are more likely to have usual intakes approaching or exceeding the respective tolerable upper intake levels (UL). SUBJECTS/METHODS: The National Cancer Institute method was applied to data from the 2007-2008 National Health and Nutrition Examination Survey (NHANES) to estimate the joint distribution of usual intake from both vFF and non-vFF sources for 12 nutrients and determine the probability of consuming these nutrients from vFF on a given day. For each nutrient, we estimated the distribution of usual intake from all food sources by quintile of probability of consuming vFF and compared the distributions with ULs. RESULTS: An increased probability of consuming zinc, retinol, folic acid, selenium and copper from vFF was associated with a greater risk of intakes above the UL among children. Among adults, increased probability of consuming calcium and iron from vFF was associated with a greater risk of intakes above the UL among some age/sex groups. CONCLUSION: The high nutrient exposures associated with vFF consumption in some population subgroups suggest a need for more careful weighing of the risks and benefits of uncontrolled food fortification.

US and France adult fruit and vegetable consumption patterns: an international comparison.

BACKGROUND/OBJECTIVES: To observe fruit and vegetable consumption as it relates to body mass index (BMI) and other variables, by analyzing the health surveys of two countries -- the United States and France -- with traditionally distinct diets, and identifying factors that may explain the differences. SUBJECTS/METHODS: Two nationally representative surveys that assess food intake via 24-h diet recalls. Respondents include 2126 women and 1911 men from the US National Health and Nutrition Examination Survey, and 1572 women and 1141 men from the French Nutrition Barometer Survey. Standard linear regression models and t-tests of both simple and predictive marginal means were run employing the software package SUDAAN. RESULTS: Americans appear to consume fruits and vegetables less often than their French counterparts (1.04 vs 1.33 times per day fruits; 1.98 vs 2.29 times per day vegetables). American men consume fruits and vegetables least often (0.98 times per day fruits; 1.88 times per day vegetables) than do American women or French men (1.10 vs 1.25 times per day fruits; 2.07 vs 2.18 times per day vegetables). French women consume fruits and vegetables most often (1.41 times per day fruits; 2.41 times per day vegetables). The French have lower mean BMI than Americans (23.34 vs 28.22 women; 25.20 vs 28.02 men). Regression analyses showed that age, BMI and educational attainment are strongly associated with frequency of consumption. CONCLUSIONS: These results support our hypothesis that the French tend to eat fruits and vegetables more often than Americans. This study proves to be an important first step in determining some of the influential factors that may affect various populations' consumption of fruits and vegetables.

Accidental subdural catheterisation.

A case of accidental subdural catheterisation is presented, and its course is compared with previously reported subdural injections of local anaesthetic agents. The importance of obtaining proof of the site of malposition of an epidural catheter is stressed.