Modeled replacement of traditional soybean and canola oil with high-oleic varieties increases monounsaturated fatty acid and reduces both saturated fatty acid and polyunsaturated fatty acid intake in the US adult population.

BACKGROUND: High-oleic (HO) seed oils are being introduced as replacements for trans fatty acid (TFA)-containing fats and oils. Negative health effects associated with TFAs led to their removal from the US Generally Recognized As Safe list. HO oils formulated for use in food production may result in changes in fatty acid intake at population levels. Objectives: The purposes of this study were to 1) identify major food sources of soybean oil (SO) and canola oil (CO), 2) estimate effects of replacing SO and CO with HO varieties on fatty acid intake overall and by age and sex strata, and 3) compare predicted intakes with the Dietary Reference Intakes and Adequate Intakes (AIs) for the essential fatty acids (EFAs) α-linolenic acid (ALA) and linoleic acid (LA). Design: Food and nutrient intakes from NHANES waves 2007-2008, 2009-2010, 2011-2012, and 2013-2014 in 21,029 individuals aged ≥20 y were used to model dietary changes. We estimated the intake of fatty acid with the replacement of HO-SO and HO-CO for commodity SO and CO at 10%, 25%, and 50% and evaluated the potential for meeting the AI at these levels. RESULTS: Each modeling scenario decreased saturated fatty acids (SFAs), although intakes remained greater than recommended for all age and sex groups. Models of all levels increased the intake of total monounsaturated fatty acids (MUFAs), especially oleic acid, and decreased the intake of total polyunsaturated fatty acids (PUFAs), particularly LA and ALA. Replacement of traditional with HO oils at 25-50% places specific adult age and sex groups at risk of not meeting the AI for LA and ALA. Conclusions: The replacement of traditional oils with HO varieties will increase MUFA intake and reduce both SFA and PUFA intakes, including EFAs, and may place specific age and sex groups at risk of inadequate LA and ALA intake.

Depletion and repletion of fruit and vegetable intake alters serum bone turnover markers: a 28-week single-arm experimental feeding intervention.

This study was designed to evaluate the effects of elevated fruit and vegetable intake on bone turnover markers. In all, twenty-nine subjects (nine male and twenty female, with a mean age of 32·1 (sem 2·5) years) participated in a 28-week single-arm experimental feeding intervention trial and consumed a prescribed low-fruit and vegetable diet for 6 weeks (depletion-1), a provided high-fruit and vegetable diet for 8 weeks (fruit: 360-560 g; vegetables: 450-705 g), another prescribed low-fruit and vegetable diet for 6 weeks (depletion-2) and then their usual diets for 8 weeks (repletion). Serum bone-related biomarkers were analysed with commercial ELISA kits. Plasma carotenoid levels decreased as a result of the depletion phase and increased with the high-fruit and vegetable diet. Compared with the baseline, depletion-1 resulted in higher serum bone resorption marker C-terminal telopeptide of type 1 collagen (CTX) and lower bone formation marker alkaline phosphatase (BAP) (CTX, 0·68 (sem 0·05) v. 0·97 (sem 0·08) ng/ml and BAP, 10·7 (sem 0·7) v. 9·5 (sem 0·8) µg/l for the baseline and the depletion-1, respectively, P<0·05). High intake of fruit and vegetables decreased serum CTX (P<0·05) to 0·60 (sem 0·04) ng/ml and increased serum BAP to 11·3 (sem 0·7) µg/l (P<0·05), compared with the depletion-1 phase. Serum concentrations of CTX were inversely correlated and those of BAP were positively correlated with blood lycopene. These data show that increased fruit and vegetable consumption at or above federal dietary guidance may be beneficial to bone health.

Greater vegetable variety and amount are associated with lower prevalence of coronary heart disease: National Health and Nutrition Examination Survey, 1999-2014.

BACKGROUND: The 2015-2020 Dietary Guidelines for Americans (DGA) provides specific intake recommendations for vegetable variety and amount in order to protect against chronic disease. However, to the best of our knowledge, no studies have examined the link between DGA recommended vegetable variety and cardiometabolic disease. To address this research gap, our aim was to estimate the relationship between vegetable variety, vegetable amount, and prevalent cardiometabolic disease subtypes, and to assess potential determinants of vegetable variety. METHODS: Data on food intake and reported cardiometabolic disease status were acquired for 38,981 adults from the National Health and Nutrition Examination Survey (1999-2014). Vegetable variety was measured using a modified dietary diversity index that was adjusted for the potential confounding effects of vegetable amount. Temporal trends in vegetable variety and amount were assessed using univariate linear regression models. Multivariate logistic regression models were used to estimate the relationship between vegetable variety and prevalent disease, and between vegetable amount and prevalent disease. Multivariate ordered logistic regression models were used to assess the relationship between vegetable variety and explanatory variables. RESULTS: Overall, vegetable variety decreased (P = 0.035) from 1999 to 2014, but vegetable amount did not (P = 0.864). Intake of starchy vegetables decreased (P < 0.001), and intake of dark green vegetables increased (P < 0.001) over this 16-year period, but no trends were observed for other subgroups. An inverse linear relationship was observed between vegetable variety and prevalent coronary heart disease (P-trend = 0.032) but not other prevalent diseases; and between vegetable amount and coronary heart disease (P-trend = 0.026) but not other prevalent diseases. Individuals who reported consuming dark green vegetables had lower odds of having cardiovascular disease (0.86, 95% CI: 0.74-0.99) and coronary heart disease (0.78, 0.65-0.94) compared to individuals who reported not consuming any green vegetables. Living with a domestic partner was associated with greater vegetable variety (P = < 0.001), and currently smoking was associated with lower vegetable variety (P = < 0.001). Vegetable variety and amount were positively associated (P < 0.001). CONCLUSIONS: Vegetable variety and amount were inversely associated with prevalent coronary heart disease. Vegetable variety was strongly associated with vegetable amount, likely mediated by reduced habituation and increased liking. Increasing vegetable variety and amount are still important messages for the public.

Nutrient intake disparities in the US: modeling the effect of food substitutions.

BACKGROUND: Diet quality among federal food assistance program participants remains low, and little research has assessed the diet quality of food insecure non-participants. Further research is needed to assess the extent to which food substitutions can improve the nutritional status of these vulnerable populations. Substituting egg dishes for other commonly consumed dishes at certain eating occasions may be an effective strategy for improving the daily nutrient intake among these groups. Eggs are rich in many important nutrients, and are low-cost and part of a wide range of cultural food menus, which are important considerations for low-income and ethnically diverse populations. To help guide the focus of targeted nutrition interventions and education campaigns for vulnerable populations, the present work begins by 1) estimating the prevalence of nutrient inadequacy among these groups, and then models the effect of consuming egg dishes instead of commonly consumed dishes at each eating occasion on 2) the prevalence of nutrient inadequacy, and 3) the mean intake of nutrients. METHODS: Dietary data from 34,741 adults ≥ 20 y were acquired from the National Health and Nutrition Examination Survey, 2001-2014. Diet pattern modeling was used to substitute commonly consumed egg dishes for commonly consumed main dishes at breakfast, lunch, and dinner. National Cancer Institute usual intake methods were used to estimate the prevalence of inadequate intake of 31 nutrients pre- and post-substitution, and a novel index was used to estimate change in intake of all nutrients collectively. RESULTS: Substituting eggs for commonly consumed main dishes at lunch or dinner did not change total daily nutrient intake for each group (P > 0.05), but decreased the prevalence of vitamin D inadequacy by 1-4 percentage points (P < 0.01). Substituting eggs for commonly consumed foods at breakfast increased the prevalence of folate inadequacy by 8-12 percentage points among each group (P < 0.01). CONCLUSIONS: When making food substitutions to increase nutrient intake, eating occasion should be an important consideration. Further research is needed to better understand how food substitutions affect diet costs, which may be an important driver of food purchasing decisions among low income individuals with limited food budgets.

A diet high in carotenoid-rich vegetables and fruits favorably impacts inflammation status by increasing plasma concentrations of IFN-α2 and decreasing MIP-1ß and TNF-α in healthy individuals during a controlled feeding trial.

The health benefits of vegetable and fruit (VF) intake include benefits for diseases that have an inflammatory component, although the relationship between VF intake and systemic inflammatory status is unclear due to the lack of comprehensive analysis of inflammatory markers in most studies. Therefore, our hypothesis was that the consumption of carotenoid-rich vegetables and fruits in the diet would have a beneficial effect on systemic inflammation status. In this study, we determined the association between varying doses of carotenoid-rich VF intake, plasma carotenoids, and a broad array of markers including 26 cytokines and high-sensitivity C-reactive protein. Data were derived from a single-arm controlled clinical feeding trial in which healthy, nonobese individuals received a low-carotenoid prescription for 6 weeks and then consumed a provided high-VF diet for 8 weeks. Proinflammatory cytokines and plasma carotenoids were measured at baseline, at 6 weeks, and at the end of the 8-week feeding period. Maximum likelihood estimation was used to calculate overall correlations between total plasma carotenoid concentrations and the cytokines. Plasma carotenoids decreased during the low-carotenoid treatment and increased during the feeding treatment. Of the inflammatory markers measured, we found increased plasma concentrations of interferon α-2 (P = .003) and decreased macrophage inflammatory protein-1ß (P = .027) and tumor necrosis factor-α (P = .012) after consumption of the carotenoid-rich diet. These results indicate that consumption of VF may be important in the maintenance of beneficial inflammatory homeostasis.

Optical assessment of skin carotenoid status as a biomarker of vegetable and fruit intake.

Resonance Raman spectroscopy (RRS) and reflection spectroscopy (RS) are optical methods applicable to the non-invasive detection of carotenoids in human skin. RRS is the older, more thoroughly validated method, whereas RS is newer and has several advantages. Since collective skin carotenoid levels serve as a biomarker for vegetable and fruit intake, both methods hold promise as convenient screening tools for assessment of dietary interventions and correlations between skin carotenoids and health and disease outcomes. In this manuscript, we describe the most recent optimized device configurations and compare their use in various clinical and field settings. Both RRS and RS devices yield a wide range of skin carotenoid levels between subjects, which is a critical feature for a biomarker. Repeatability of the methods is 3-15% depending on the subject's skin carotenoid level and the uniformity of its local distribution. For 54 subjects recruited from an ophthalmology clinic, we first checked the validity of the relatively novel RS methodology via biochemical serum carotenoid measurements, the latter carried out with high performance liquid chromatography (HPLC). A high correlation between RS skin and serum HPLC carotenoid levels was established (R = 0.81; p < 0.001). Also, a high correlation was found between RS and RRS skin levels (R = 0.94 p < 0.001). Subsequent comparisons of skin carotenoid measurements in diverse age groups and ethnicities included 569 Japanese adults, 947 children with ages 2-5 screened in 24 day care centers in San Francisco, and 49 predominantly Hispanic adults screened at an outdoor health fair event. Depending on the particular subject group, correlation coefficients between the RRS and RS methods ranged between R ∼0.80 and R ∼0.96. Analysis of the Japanese screening showed that, on average, skin carotenoid levels are higher in women compared to men, skin levels do not depend on age, and tobacco smokers have reduced levels versus non-smokers. For the two most ethnically diverse groups with widely varying melanin levels, we investigated the effect of dermal melanin on RS and RRS skin carotenoid levels. The analysis revealed that large variations in skin carotenoid levels remain detectable independent of the particular melanin index. This behavior is consistent with the absence of melanin effects on the skin carotenoid levels generated with the instrument configurations. The RS method has an advantage over RRS in its relative simplicity. Due to its detection of skin reflection over a wide spectral range from the near UV to the near IR, it has the unique ability to quantify each of the major tissue chromophores and take them into account in the derivation of skin carotenoid levels.

A non-invasive assessment of skin carotenoid status through reflection spectroscopy is a feasible, reliable and potentially valid measure of fruit and vegetable consumption in a diverse community sample.

OBJECTIVE: To assess the feasibility, reliability and validity of reflection spectroscopy (RS) to assess skin carotenoids in a racially diverse sample. DESIGN: Study 1 was a cross-sectional study of corner store customers (n 479) who completed the National Cancer Institute Fruit and Vegetable Screener as well as RS measures. Feasibility was assessed by examining the time it took to complete three RS measures, reliability was assessed by examining the variation between three RS measures, and validity was examined by correlation with self-reported fruit and vegetable consumption. In Study 2, validity was assessed in a smaller sample (n 30) by examining associations between RS measures and dietary carotenoids, fruits and vegetables as calculated from a validated FFQ and plasma carotenoids. SETTING: Eastern North Carolina, USA. RESULTS: It took on average 94·0 s to complete three RS readings per person. The average variation between three readings for each participant was 6·8 %. In Study 2, in models adjusted for age, race and sex, there were statistically significant associations between RS measures and (i) FFQ-estimated carotenoid intake (P<0·0001); (ii) FFQ-estimated fruit and vegetable consumption (P<0·010); and (iii) plasma carotenoids (P<0·0001). CONCLUSIONS: RS is a potentially improved method to approximate fruit and vegetable consumption among diverse participants. RS is portable and easy to use in field-based public health nutrition settings. More research is needed to investigate validity and sensitivity in diverse populations.

Smokers report lower intake of key nutrients than nonsmokers, yet both fall short of meeting recommended intakes.

Smoking is a major risk factor in the development of preventable disease which may be due to a poorer diet and the reduced nutrient intake of smokers. Our objective was to compare and evaluate the reported intake of current smokers with that of nonsmokers among participants of a study evaluating stress and smoking. We hypothesized (1) that overall energy and nutrient intake would be reduced in smokers compared with nonsmokers and (2) that smokers would have increased noncompliance with Dietary Reference Intakes (DRIs). Men and women (smokers n=138, nonsmokers n=46) completed a 3-day diet record at baseline. Mean energy and nutrient intakes were stratified by smoking status and compared with DRI levels. The mean body mass index was 28.3±0.5kg/m2 for smokers and 27.2±1.0kg/m2 for nonsmokers. Compared with nonsmokers, the smokers reported lower intakes of energy, total polyunsaturated fatty acids, linolenic acid, docosahexaenoic acid, total sugars, calcium, iron, magnesium, phosphorus, potassium, vitamin C, riboflavin, niacin, pantothenic acid, vitamin B6, folate, vitamin A, and vitamin E. Smokers reported reduced compliance with the DRIs for iron, phosphorus, vitamin C, riboflavin, and folate compared with nonsmokers. Unlike other evaluations of smokers vs nonsmokers, we observed no difference in body weight between groups. Smokers and nonsmokers alike reported dietary intakes lower than the DRIs for many nutrients. However, the reported nutrient intake of the smokers was substantially lower than nonsmokers for key nutrients, and they were more likely to not comply with the DRIs for essential nutrients, placing them at increased risk of chronic disease.

Using Skin Carotenoids to Assess Dietary Changes in Students After 1 Academic Year of Participating in the Shaping Healthy Choices Program.

OBJECTIVE: To determine whether fourth-grade students participating in the Shaping Healthy Choices Program (SHCP), a school-based nutrition intervention, would change vegetable and carotenoid intake measured by skin carotenoids and dietary intake. METHODS: Single-group pretest-posttest with a self-selected, convenience sample of students (n = 30) participating in the SHCP, which lasted 1 academic year (9 months). Dietary intake of vegetables and carotenoids as measured by Block food frequency questionnaire and skin carotenoids as measured by Raman spectroscopy were collected at the school preintervention and postintervention. RESULTS: Reported carotenoid intake decreased by 1.5 mg (P = .05) and skin carotenoids decreased by 2,247.9 RRS intensity units (P = .04). Change in reported intake correlated with change in skin carotenoids (r = .43; P = .02). CONCLUSIONS AND IMPLICATIONS: The reported decrease in vegetable and carotenoid intake was unanticipated; nevertheless, the RRS measurements confirmed this. RRS data can help evaluate changes in fruit and vegetable intake.

Time Trends and Patterns of Reported Egg Consumption in the U.S. by Sociodemographic Characteristics.

Eggs have the potential to contribute essential nutrients to nutritionally vulnerable populations on limited food budgets. Further research is needed to better understand patterns of egg consumption across diverse sociodemographic groups in order to inform clinical practice to improve nutrient adequacy. Data on demographics and egg intake of 29,694 U.S. adults were obtained from the National Health and Nutrition Examination Survey, 2001-2012. The National Cancer Institute's usual intake methodology was used to estimate the distribution of egg intake. Linear and logistic regression models were used to test for time trends in egg consumption and for differences between sociodemographic groups. The proportion of the U.S. population, overall (21%-22%; p = 0.311) and by sociodemographic group (p > 0.05 for all groups), that reported consuming eggs remained unchanged from 2001 to 2012. Mean egg consumption increased overall from 23.0 (95% CI, 20.8-25.2) g/day in 2001-2002 to 25.5 (22.7-28.4) g/day in 2011-2012 (p = 0.012), but not among food insecure individuals (p = 0.816) and Supplemental Nutrition Assistance Program (SNAP) participants (p = 0.399). No differences in the odds of egg consumption were observed by income level, food security status, or SNAP participation status (p > 0.05 for all groups). Given the nutritional benefits of eggs, as well as their low cost and culinary versatility, the results presented here have important implications for reducing disparities in health outcomes and diet quality, in particular among food insecure individuals and SNAP participants. Further research is needed to examine factors that influence egg consumption and associated nutrient intake, and to identify potential barriers to increasing egg consumption, such as egg price changes, across diverse sociodemographic groups.

Innovative Techniques for Evaluating Behavioral Nutrition Interventions.

Assessing outcomes and the impact from behavioral nutrition interventions has remained challenging because of the lack of methods available beyond traditional nutrition assessment tools and techniques. With the current high global obesity and related chronic disease rates, novel methods to evaluate the impact of behavioral nutrition-based interventions are much needed. The objective of this narrative review is to describe and review the current status of knowledge as it relates to 4 different innovative methods or tools to assess behavioral nutrition interventions. Methods reviewed include 1) the assessment of stress and stress responsiveness to enhance the evaluation of nutrition interventions, 2) eye-tracking technology in nutritional interventions, 3) smartphone biosensors to assess nutrition and health-related outcomes, and 4) skin carotenoid measurements to assess fruit and vegetable intake. Specifically, the novel use of functional magnetic resonance imaging, by characterizing the brain's responsiveness to an intervention, can help researchers develop programs with greater efficacy. Similarly, if eye-tracking technology can enable researchers to get a better sense as to how participants view materials, the materials may be better tailored to create an optimal impact. The latter 2 techniques reviewed, smartphone biosensors and methods to detect skin carotenoids, can provide the research community with portable, effective, nonbiased ways to assess dietary intake and quality and more in the field. The information gained from using these types of methodologies can improve the efficacy and assessment of behavior-based nutrition interventions.

Diet Quality of Items Advertised in Supermarket Sales Circulars Compared to Diets of the US Population, as Assessed by the Healthy Eating Index-2010.

BACKGROUND: Supermarkets use sales circulars to highlight specific foods, usually at reduced prices. Resulting purchases help form the set of available foods within households from which individuals and families make choices about what to eat. OBJECTIVE: The purposes of this study were to determine how closely foods featured in weekly supermarket sales circulars conform to dietary guidance and how diet quality compares with that of the US population's intakes. DESIGN: Food and beverage items (n=9,149) in 52 weekly sales circulars from a small Midwestern grocery chain in 2009 were coded to obtain food group and nutrient and energy content. Healthy Eating Index-2010 (HEI-2010) total and component scores were calculated using algorithms developed by the National Cancer Institute. HEI-2010 scores for the US population aged 2+ years were estimated using data from the 2009-2010 National Health and Nutrition Examination Survey. HEI-2010 scores of circulars and population intakes were compared using Student's t tests. RESULTS: Mean total (42.8 of 100) HEI-2010 scores of circulars were lower than that of the US population (55.4; P<0.001). Among individual components, Total Protein Foods was the only one for which 100% of the maximum score was met by both circulars and the population. The scores were also similar between the circulars and population for Whole Grains (22%; P=0.81) and Seafood and Plant Proteins (70% to 74%; P=0.33). Circular scores were lower than those of the population for Total and Whole Fruits, Total Vegetables and Greens and Beans, Dairy, Sodium, and Empty Calories (P<0.001); they were higher only for Fatty Acids (P=0.006) and Refined Grains (P<0.001). CONCLUSIONS: HEI-2010 total scores for these sales circulars were even lower than US population scores, which have been shown repeatedly to reflect low diet quality. Supermarkets could support improvements in consumer diets by weekly featuring foods that are more in concordance with food and nutrient recommendations.

Intake of seafood in the US varies by age, income, and education level but not by race-ethnicity.

Current US federal dietary guidance recommends regular consumption of seafood (fish + shellfish) to promote health; however, little is known about how well Americans meet the guideline, particularly population subgroups that may be at risk for inadequate intake. The purposes of this study were to describe the prevalence of seafood consumption and, among consumers, the amounts of seafood eaten by sex, age group, income and education level, and race-ethnicity. Data from 15,407 adults aged 19+ participating in the 2005-2010 National Health and Nutrition Examination Surveys were analyzed using methods to account for sporadic intake of seafood. Over 80% of Americans reported consuming any seafood over the past 30 days, 74% reported consuming fish, and 54% reported eating shellfish. The percentages varied by socio-demographic group. Younger age and lower income and education levels were associated with lower odds of being a seafood consumer (p < 0.0001). Among those who reported eating seafood, the average amount eaten of any seafood was 158.2 ± 5.6 g/week. Among seafood consumers, women and individuals of lower age and education levels consumed less seafood. Approximately 80%-90% of seafood consumers did not meet seafood recommendations when needs were estimated by energy requirements. A great deal of work remains to move Americans toward seafood consumption at current recommended levels.

Resonance Raman spectroscopic evaluation of skin carotenoids as a biomarker of carotenoid status for human studies.

Resonance Raman spectroscopy (RRS) is a non-invasive method that has been developed to assess carotenoid status in human tissues including human skin in vivo. Skin carotenoid status has been suggested as a promising biomarker for human studies. This manuscript describes research done relevant to the development of this biomarker, including its reproducibility, validity, feasibility for use in field settings, and factors that affect the biomarker such as diet, smoking, and adiposity. Recent studies have evaluated the response of the biomarker to controlled carotenoid interventions, both supplement-based and dietary [e.g., provision of a high-carotenoid fruit and vegetable (F/V)-enriched diet], demonstrating consistent response to intervention. The totality of evidence supports the use of skin carotenoid status as an objective biomarker of F/V intake, although in the cross-sectional setting, diet explains only some of the variation in this biomarker. However, this limitation is also a strength in that skin carotenoids may effectively serve as an integrated biomarker of health, with higher status reflecting greater F/V intake, lack of smoking, and lack of adiposity. Thus, this biomarker holds promise as both a health biomarker and an objective indicator of F/V intake, supporting its further development and utilization for medical and public health purposes.

The declining prevalence of overweight among Russian children: income, diet, and physical activity behavior changes.

The aim of this study is to examine the relationships among income, diet, physical activity behaviors and overweight among Russian children during a period of economic upheaval. Subjects include 2151 schoolchildren aged 7-13 derived from cross-sectional waves of the Russia Longitudinal Monitoring Surveys in 1995 and in 2002. Diet was assessed by 24-h recall and physical activity (h/week) and household income by parental questionnaire. Hours spent in vigorous activities were low (1.0-1.5 h/week), and time spent in sedentary behaviors increased from 31 to 37 h/week between 1995 and 2002. In 1995 there was a direct relationship of income to energy and fat intake, and time spent in vigorous activity, and an inverse relationship of income to h/week spent in moderate activities (such as walking to school). The effect of having low income parents was less in 2002 than in 1995. Overweight prevalence did not differ significantly by income in either year, but there was a significant decline in overweight among high income children. Only hours spent in moderate physical activity was moderately protective against overweight. Income disparities do not explain trends in overweight among Russian children.

Docosahexaenoic acid: measurements in food and dietary exposure.

The Dietary Reference Intakes (DRIs) were established to be an indicator of adequacy of dietary nutrients as well as providing levels for adequacy in reducing risk of chronic diseases such as neurodegenerative diseases, cardiovascular diseases, cancers, diabetes mellitus, etc. One particular nutrient that is increasingly discussed as a potential candidate for the generation of a DRI is the omega-3 (n-3) fatty acid docosahexaenoic acid (DHA) due to its potential benefits in reducing risk for cardiovascular disease, role in resolution of inflammation, its importance in cognitive function in infants and inhibiting the progression of neurodegenerative diseases in the elderly. Each reference value refers to and is predicated on estimates of daily nutrient intake and the goal of this paper is to review these intakes. The confidence of these values is critical in establishing dose-response relationships. This paper reports intake values for DHA and examines how these data were generated and the relative confidence in these values. The adult US population is estimated to consume 80-100 mg/d of DHA based on a nationally representative sample of > 8400 individuals as part of the National Health and Nutrition Examination Survey (NHANES). This value and those presented for women and men at various ages appear reasonable and should be used as the basis for establishing an Adequate Intake (AI) for DHA.