Comparative Analysis of Dietary and Supplemental Intake of Calcium and Vitamin D among Canadian Older Adults with Heart Disease and/or Osteoporosis in 2004 and 2015.

Despite the role of calcium and vitamin D in osteoporosis and heart disease, little research has examined changes in the intake of calcium and vitamin D among individuals with these conditions over time. Using data from the 2004 and 2015 Canadian Community Health Surveys, we investigated changes in dietary and supplemental intake of calcium and vitamin D among Canadian older adults aged ≥ 50 years, both with and without heart disease and/or osteoporosis, between 2004 and 2015. Notable declines in dietary calcium intake occurred, particularly among non-supplement users. Surprisingly, individuals with osteoporosis and heart disease, who are at higher nutritional risk, were less likely to use calcium supplements in 2015 compared to 2004. Among calcium supplement users, those with osteoporosis or both conditions experienced significant reductions in their usual calcium intake in 2015, with an increased proportion failing to meet recommended intake levels. Conversely, vitamin D supplement users experienced a substantial rise in vitamin D intake in 2015. In 2015, only a small proportion of supplement users did not meet the recommended vitamin D intake levels. These findings underscore the importance of public health initiatives to facilitate safe increases in calcium and vitamin D intake for older adults, particularly those with heart disease and osteoporosis.

Prevalence of vitamin-mineral supplement use and associated factors among Canadians: results from the 2015 Canadian Community Health Survey.

Vitamin/mineral supplements are used for improving micronutrient intake and preventing deficiencies, particularly for shortfall nutrients. We assessed the prevalence of vitamin/mineral supplement use and associated factors among a representative sample of Canadians aged ≥1 years. We used nationally representative data from the 2015 Canadian Community Health Survey (CCHS)-Nutrition. The prevalence of vitamin/mineral supplement use containing shortfall nutrients (vitamins: A, C, D, B6, B12 and folate; minerals: calcium, magnesium, and zinc) was examined in this study. Logistic regression models were performed to determine factors associated with vitamin/mineral supplement use among Canadian children (1-18 years) and adults (>19 years). The overall prevalence of vitamin/mineral supplement use was 38% among men and 53% among women. Males aged 14-18 years had the lowest prevalence (26.5%; 95% confidence interval (CI) = 21.9-31.0) and females aged ≥71 years had the highest prevalence (67.8%; 95% CI = 64.1-71.5) of vitamin/mineral supplement use. Female gender, older age, higher education level, higher income, living in urban areas, having chronic conditions, having a normal body mass index (BMI), and being non-smoker were independent positive predictors of vitamin/mineral supplement use among adults. Independent positive predictors of vitamin/mineral supplement use among Canadian children included younger age, having a normal BMI, and being food secure. Novelty: The overall prevalence of vitamin/mineral supplement use among Canadian men and women was 38% and 53%, respectively. Sociodemographic and lifestyle variables were associated with vitamin/mineral supplement use, especially among Canadian adults.

Calcium Intake from Food and Supplemental Sources Decreased in the Canadian Population from 2004 to 2015.

BACKGROUND: In light of the publications (2008-2014) linking calcium intake, mainly from supplements, to the elevated risk of cardiovascular events, there is a need to determine if there have been any changes in usual intakes of calcium among Canadians. OBJECTIVE: We aimed to examine changes in dietary and total usual intake of calcium among Canadians aged ≥1 y over the period 2004-2015. METHODS: We used nutrition data from 2 nationally representative surveys conducted in 2004 and 2015 (CCHS 2004 Cycle 2.2 and CCHS-Nutrition 2015). This study included all the Canadians across 10 provinces, and the analyses were performed across different age/sex groups. We used the National Cancer Institute (NCI) method to estimate the usual intake of calcium and the prevalence of calcium inadequacy. Multiple logistic regression was performed to assess the relation between supplement uses and sociodemographic variables. RESULTS: From 2004 to 2015, the usual intake of calcium from food sources significantly decreased in calcium supplement nonusers (from 872 ± 18.2 mg/d to 754 ± 18.0 mg/d), but not in calcium supplement users. The contribution of calcium from the Milk and alternatives food group significantly decreased by 7.5% and 6.1% in calcium supplement users and nonusers, respectively. The prevalence of calcium supplement use significantly decreased from 2004 to 2015 in the Canadian population, from 27.5% to 22.0%. During this time, the percentage contribution of calcium from supplemental sources significantly decreased among Canadians, especially women. The prevalence of calcium inadequacy increased from 58.0% to 68.0% in supplement nonusers; however, among users of calcium supplements, the prevalence of calcium inadequacy remained at ∼31%. CONCLUSIONS: Calcium intake from both food and supplemental sources decreased in the Canadian population over an 11-y period, which must be addressed by policy-makers in their efforts to decrease the high prevalence of calcium inadequacy.

Vitamin D Intake from Supplemental Sources but Not from Food Sources Has Increased in the Canadian Population Over Time.

BACKGROUND: Evidence is lacking to determine whether there have been any changes in dietary or total usual intakes of vitamin D among Canadians, in the light of recent evidence of beneficial health effects beyond bone. OBJECTIVE: We aimed to examine trends in dietary and total usual intake of vitamin D among Canadians aged ≥1 y. METHODS: This study used nationally representative nutrition data from the Canadian Community Health Survey Cycle 2.2 (CCHS 2004) and CCHS Nutrition in 2015. Dietary intake data were collected with use of two 24-h dietary recalls and dietary supplement use was determined by questionnaire. The National Cancer Institute method was used to estimate the usual intake of vitamin D as well as the prevalence of vitamin D inadequacy among Canadians aged ≥1 y. RESULTS: From 2004 to 2015, the usual intake of vitamin D from food significantly decreased (P < 0.05) by 1 µg/d only in vitamin D supplement nonusers. The contribution of Milk and Alternatives food group (i.e., fluid milk, fortified soy beverages, powdered milk, and other milk alternatives) to dietary vitamin D intake significantly decreased (P < 0.05) in both supplement users (by 7.1%) and nonusers (by 5.8%). Prevalence of vitamin D supplement use and percentage contribution of vitamin D from supplemental sources significantly increased (P < 0.05) by 5.0% and 14.9%, respectively, from 2004 to 2015. Total usual intake of vitamin D (food + supplement) significantly increased (P < 0.05) from 15.1 ± 0.3 µg/d in 2004 to 31.5 ± 1.8 µg/d in 2015 in vitamin D supplement users. In contrast to vitamin D supplement nonusers, the prevalence of vitamin D inadequacy significantly decreased (P < 0.05) from 20.6% to 14.1% among users of vitamin D supplements. CONCLUSIONS: The prevalence of vitamin D supplement use and the percentage contribution of vitamin D from supplemental sources has increased in the Canadian population over an 11-y period.