Dietary Supplement Use in Relation to Socio-Demographic and Lifestyle Factors, including Adherence to Mediterranean-Style Diet in University Students.

The study aimed to examine socio-demographic and lifestyle determinants, including diet quality, of dietary supplement (DS) use among 2545 students who attended public universities in Warsaw. The data was collected using a self-administered health and lifestyle questionnaire and a 5-day dietary record method. Diet quality was assessed using a Mediterranean Diet Score. To determine the covariates of DS use, multivariate-adjusted logistic regression models with an estimation of odds ratios (ORs) and 95% confidence intervals (95% CIs) were used. The results showed that 41% of participants were DS users. The following predictors of DS use were identified: gender (male vs. female; OR:0.62, 95% CI:0.50-0.79), physical activity (high vs. low; OR:1.79, 95% CI:1.45-2.20), BMI (≥25 vs. 18.5-24.9 kg/m2; OR:0.77, 95% CI:0.61-0.98), cigarette smoking (yes vs. no; OR:0.67, 95% CI:0.52-0.86), and presence of chronic diseases (yes vs. no; OR:2.37, 95% CI:1.89-2.98). Moreover, higher nutritional knowledge, special diet usage, eating more meals/day, and fortified food consumption were determinants of DS use. Adherence to the Mediterranean-style diet was positively associated with DS use, a 1-score increment was associated with a 10% (p-trend = 0.011) higher probability of DS usage. Given that the use of vitamins and/or minerals is common among university students and their users are characterized by eating a higher quality diet, investigating the contribution of DS in overall dietary nutrient intake warrants further study.

The Influence of Iron and Zinc Supplementation on Iron Apparent Absorption in Rats Fed Vitamins and Minerals Reduced Diets.

Deficient human diet is usually reduced in many nutrients, but animal studies on iron absorption have been only carried out for rats fed well-balanced (control) and iron-deficient diets. The aim of this study was to evaluate the effect of iron or iron/zinc supplementation on iron apparent absorption (IAA) in rats fed a diet reduced in all vitamins and minerals (R). The study was conducted on 77, 6-week-old male Wistar rats in 3 stages as follows: stage I, 4-week period of adaptation to R diet (50% less vitamins and minerals compared to AIN-93M recommendations); stage II, 4-week supplementation period with iron (RSFe) or iron/zinc (RSFeZn); stage III, 2-week post-supplementation period (rats fed R diet). Feces samples to IAA determination were collected at the 20-22nd days of stage I and II and the 10-12th days of stage III. To determine the changes in IAA after introducing and discontinuation of supplementation, feces were collected for 3 days after introducing (stage II) and 5 days after the supplementation discontinuation (stage III). At the end of stage II, compared to R rats, the IAA was statistically significantly higher in RSFe and RSFeZn rats (30.3 ± 2.0% vs. 47.4 ± 1.2% and 51.0 ± 1.7%, respectively). After introducing iron or iron/zinc supplementation, the IAA stabilized fast already in the first day, while after discontinuation of the supplementation, at least 4 days was required to the stabilization. At the end of stage III, the IAA was significantly lower in RSFe (15.8 ± 6.6%) than in RSFeZn rats (43.4 ± 5.9%). In conclusion, to confirm that iron and zinc supplementation is more beneficial than iron supplementation only, especially after discontinuation of supplementation, further research among humans is necessary.

Intake of Vitamins and Minerals From Voluntarily Fortified Foods and/or Dietary Supplements in School Adolescents in Central-Eastern Poland.

Background: The key issue is whether voluntarily fortified foods and vitamin/mineral supplements available on the market serve public health needs. The study aim was to estimate nutrient intakes from voluntarily fortified foods and vitamin/mineral supplements in relation to the Dietary Reference Intake (DRI) in adolescents (n = 759) aged 13-19 who attended public secondary schools in Central-Eastern Poland. Methods: Data on the consumption of voluntarily fortified foods were collected using a semi-quantitative food frequency questionnaire containing 58 food items. Data on the use of dietary supplements were assessed via an open-ended question. The content of nutrients was estimated using the producer's labeling declaration. The distribution of nutrient intakes according to the percentage of DRI categories (<20%, 20-39.9%, 40-59.9%, 60-79.9%, 80-99.9%, 100-119%, or >120%) was estimated. Results: Consumption of voluntarily fortified foods was a common behavior in adolescents (86.7% of participants), while vitamin/mineral supplements were used by less than one-fifth of them (17.7%). The amounts of nutrient intakes from fortified foods and/or supplements were at different levels: (I) vitamins A, D, calcium, magnesium (>50% of adolescents did not exceed 20% of DRI); (II) vitamins E, B12, iron (>50% of respondents consumed at least 20% of DRI); (III) niacin and pantothenic acid (>50% of respondents consumed at least 40% of DRI); IV) vitamins C, B1, B2, B6, folate, biotin (>50% of participants consumed at least 60% of DRI). In a subgroup of respondents who used fortified foods and supplements simultaneously (n = 126), some nutrients (i.e., vitamins C, B1, B2, B6, niacin, and biotin) were consumed in amounts ≥150% of DRI. Intake above the Tolerable Upper Intake Levels was observed for niacin, vitamin A, B6 and folic acid in individual cases (up to 1.1% of respondents); a higher risk of overconsumption was associated with using vitamin/mineral supplements than voluntarily fortified foods. Conclusion: Adolescents should be educated on how to reasonably use fortified foods and dietary supplements to help to overcome the potential deficiency of nutrients without causing excessive consumption.

Dietary Fibre May Mitigate Sarcopenia Risk: Findings from the NU-AGE Cohort of Older European Adults.

Sarcopenia is characterised by a progressive loss of skeletal muscle mass and physical function as well as related metabolic disturbances. While fibre-rich diets can influence metabolic health outcomes, the impact on skeletal muscle mass and function is yet to be determined, and the moderating effects by physical activity (PA) need to be considered. The aim of the present study was to examine links between fibre intake, skeletal muscle mass and physical function in a cohort of older adults from the NU-AGE study. In 981 older adults (71 ± 4 years, 58% female), physical function was assessed using the short-physical performance battery test and handgrip strength. Skeletal muscle mass index (SMI) was derived using dual-energy X-ray absorptiometry (DXA). Dietary fibre intake (FI) was assessed by 7-day food record and PA was objectively determined by accelerometery. General linear models accounting for covariates including PA level, protein intake and metabolic syndrome (MetS) were used. Women above the median FI had significantly higher SMI compared to those below, which remained in fully adjusted models (24.7 ± 0.2% vs. 24.2 ± 0.1%, p = 0.011, η2p = 0.012). In men, the same association was only evident in those without MetS (above median FI: 32.4 ± 0.3% vs. below median FI: 31.3 ± 0.3%, p = 0.005, η2p = 0.035). There was no significant impact of FI on physical function outcomes. The findings from this study suggest a beneficial impact of FI on skeletal muscle mass in older adults. Importantly, this impact is independent of adherence to guidelines for protein intake and PA, which further strengthens the potential role of dietary fibre in preventing sarcopenia. Further experimental work is warranted in order to elucidate the mechanisms underpinning the action of dietary fibre on the regulation of muscle mass.

Different Socio-Demographic and Lifestyle Factors Can Determine the Dietary Supplement Use in Children and Adolescents in Central-Eastern Poland.

Vitamin/mineral supplement (VMS) use has become increasingly popular in children and adolescents; however, different predictors may be associated with their usage. Therefore, the aim of this study was to compare determinants of VMS use in 1578 children and adolescents. Data was collected among parents of children (≤12 years old) and among adolescents (>12 years old) who attended public schools by a self-administered questionnaire. Multivariate-adjusted logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for determining the predictors of VMS use. In children, the following determinants of VMS use were indicated: socioeconomic status (average vs. very good/good; OR: 1.69, 95% CI: 1.16⁻2.48), physical activity (1⁻5 vs. <1 h/week; OR: 1.44, 95% CI: 1.02⁻2.04), BMI (≥25 vs. 18.5⁻24.9 kg/m²; OR: 0.67, 95% CI: 0.46⁻0.98), and presence of chronic diseases (yes vs. no; OR: 2.32, 95% CI: 1.46⁻3.69). In adolescents, gender (male vs. female; OR: 0.56, 95% CI: 0.37⁻0.87), residential area (rural vs. urban; OR: 0.63, 95% CI: 0.40⁻0.99), BMI (<18.5 vs. 18.5⁻24.9 kg/m²; OR: 0.35, 95% CI: 0.17⁻0.73), and health status (average/poor vs. at least good; OR: 1.96, 95% CI: 1.13⁻3.39) were factors of VMS use. In both groups, the mother's higher educational level, fortified food consumption and diet modification towards better food choices were predictors of VMS use. In conclusion, most of the predictors of VMS use were different in children and adolescents.

Gender-specific association of body composition with inflammatory and adipose-related markers in healthy elderly Europeans from the NU-AGE study.

OBJECTIVES: The aim of this work was to examine the cross-sectional relationship between body composition (BC) markers for adipose and lean tissue and bone mass, and a wide range of specific inflammatory and adipose-related markers in healthy elderly Europeans. METHODS: A whole-body dual-energy X-ray absorptiometry (DXA) scan was made in 1121 healthy (65-79 years) women and men from five European countries of the "New dietary strategies addressing the specific needs of elderly population for a healthy aging in Europe" project (NCT01754012) cohort to measure markers of adipose and lean tissue and bone mass. Pro-inflammatory (IL-6, IL-6Rα, TNF-α, TNF-R1, TNF-R2, pentraxin 3, CRP, alpha-1-acid glycoprotein, albumin) and anti-inflammatory (IL-10, TGF-ß1) molecules as well as adipose-related markers such as leptin, adiponectin, ghrelin, and resistin were measured by magnetic bead-based multiplex-specific immunoassays and biochemical assays. RESULTS: BC characteristics were different in elderly women and men, and more favorable BC markers were associated with a better adipose-related inflammatory profile, with the exception of skeletal muscle mass index. No correlation was found with the body composition markers and circulating levels of some standard pro- and anti-inflammatory markers like IL-6, pentraxin 3, IL-10, TGF-ß1, TNF-α, IL-6Rα, glycoprotein 130, TNF-α-R1, and TNF-α-R2. CONCLUSIONS: The association between BC and inflammatory and adipose-related biomarkers is crucial in decoding aging and pathophysiological processes, such as sarcopenia. DXA can help in understanding how the measurement of fat and muscle is important, making the way from research to clinical practice. KEY POINTS: • Body composition markers concordantly associated positively or negatively with adipose-related and inflammatory markers, with the exception of skeletal muscle mass index. • No correlation was found with the body composition markers and circulating levels of some standard pro- and anti-inflammatory markers like IL-6, pentraxin 3, IL-10, TGF-ß1, TNF-α, IL-6Rα, gp130, TNF-α-R1, and TNF-α-R2. • Skeletal muscle mass index (SMI) shows a good correlation with inflammatory profile in age-related sarcopenia.

Cross-Sectional Analysis of the Correlation Between Daily Nutrient Intake Assessed by 7-Day Food Records and Biomarkers of Dietary Intake Among Participants of the NU-AGE Study.

Methods for measuring diet composition and quantifying nutrient intake with sufficient validity are essential to study the association between nutrition and health outcomes and risk of diseases. 7-day food records provides a quantification of food actually and currently consumed and is interesting for its use in intervention studies to monitor diet in a short-term period and to guide participants toward changing their intakes. The objective of this study is to analyze the correlation/association between the daily intake of selected nutrients (collected by a 7-day food records plus a mineral/vitamin supplementation questionnaire) and estimates of energy expenditure as well as blood and urine biomarkers of dietary intakes in 1,140 healthy elderly subjects (65-79 years) at baseline of the NU-AGE intervention study (NCT01754012, clinicaltrials.gov). The results show that: the daily intake of energy correlated significantly with predicted total energy expenditure (pTEE) (ρ = 0.459, p < 0.001, and q < 0.001); protein intake correlated significantly with the ratio of 24 h urinary urea to creatinine excretion (ρ = 0.143 for total protein intake, ρ = 0.296 for animal protein intake, and ρ = 0.359 for protein intake/body weight, p < 0.001 and q < 0.001 for each correlation); vitamin B12 and folate intakes correlated significantly with their serum concentrations (ρ = 0.151 and ρ = 0.363, respectively; p < 0.001 and q < 0.001 for each correlation); sodium and potassium intakes correlated significantly with their 24 h urinary excretion (ρ = 0.298 and ρ = 0.123, respectively; p < 0.001 and q < 0.001 for each correlation); vitamin B12 and folate intakes were negatively associated with plasma homocysteine measure (p = 0.001 and p = 0.004, respectively); stratifying subjects by gender, the correlations between energy intake and pTEE and between potassium intake and its 24 h urinary excretion lost their significance in women. Even if the plasma and urinary levels of these nutrients depend on several factors, the significant correlations between daily reported intake of nutrients (protein, vitamin B12, folate, and sodium) and their blood/urinary markers confirmed that the 7-day food records (plus a supplementation questionnaire) provides reliable data to evaluate short-term current dietary intake in European elderly subjects and it can be exploited to guide and monitor NU-AGE participants through the shift of their diet according NU-AGE recommendations.

Intake of Vitamins and Minerals from Voluntarily Fortified Foods in School Children in Central-Eastern Poland.

Objective: To estimate vitamin and mineral intakes from voluntarily fortified foods (VFFs) in relation to the Dietary Reference Intake (DRI) in children aged 6 - 12. Methods: The study was conducted among 677 school children from Central-Eastern Poland. Data on VFFs consumption were collected using a semi-quantitative food frequency questionnaire containing 58 food items available on the Polish market; the content of nutrients in VFFs was estimated using the producers labelling declaration. The amounts of nutrients consumed from VFFs were compared to DRI and Tolerable Upper Intake Levels (ULs). The distribution of nutrient intakes according to the percentage of DRI categories (<20%, 20 - 39.9%, 40 - 59.9%, 60 - 79.9%, 80 - 99.9%, 100 - 119%, and >120%) was investigated. Results: In our study, 78.3% (n = 530) of children were classified as VFF-consumers. The most often consumed groups of VFFs were cereal products and juices/non-alcoholic beverages (92.5% and 76.6% of children, respectively). The amounts of vitamin D intake were negligible (92.5% of children did not exceed 20% of DRI from VFFs); vitamins A, E, B12 and calcium were small (>60% did not exceed 40% of DRI); vitamins B1, B2, niacin, folic acid, pantothenic acid and iron were moderate (>25% consumed 80% of DRI or above); while vitamins C, B6 and biotin were high (>40% consumed 100% of DRI or above). Intake above ULs was observed for niacin and folic acid (2.6% and 1.1% of children, respectively). Conclusions: Substantial differences between the VFFs contribution of various micronutrients to the DRIs were observed. Consumption of VFFs may prevent inadequate intakes for the majority of nutrients. Keywords: children, DRI, inadequate intake, minerals, fortified foods, vitamins.

Iron absorption after introducing and discontinuation of iron and zinc supplementation in rats.

The aim of this study was to investigate the changes in iron apparent absorption (IAA%) during and after iron and zinc supplementation in rats. The study was conducted on 6-week old male Wistar rats in 3 stages: 4-week period of adaptation to the control (C) and iron deficient (D) diets (stage I); 4-week period of supplementation with 10-time more iron (CSFe, DSFe), zinc (CSZn, DSZn) or both iron and zinc (CSFeZn, DSFeZn) compared to C diet (stage II); 2-week of post-supplementation period (rats were fed the same diets as in the adaptation period, stage III). IAA% was measured in five consecutive days directly after introducing and discontinuation of iron and zinc supplementation as well as in the end of stage II (days: 22-24th) and stage III (days: 8-10th). Overall in the second day after introducing and in the fifth day after discontinuation of iron or iron and zinc supplementation, the IAA% had undergone to the level compatible with the values in the end of each stage. At the end of stage II, IAA% in CSFeZn (54.1 ± 2.7%) rats was not different from the IAA% in CSFe rats (53.9 ± 1.9%), but in DSFeZn group IAA% (49.4 ± 2.1%) was significantly lower than in DSFe (57.4 ± 2.3%) group. Moreover, IAA% after stage II and stage III in DSZn group was significantly lower (39.2 ± 2.8% and 38.6 ± 2.6%, respectively) than in group D (60.7 ± 1.9% and 54.3 ± 3.0%, respectively). In conclusion, zinc administered simultaneously with iron (Zn:Fe weight ratio=1:1) decreased IAA% in adult rats fed on iron deficient diet, but not in rats fed on control diet. IAA% reduction by zinc supplementation has been extended to 10 days after discontinuation of the treatment. Adaptation of the rats to high doses of iron or iron and zinc and also to the cessation of these treatments was relatively fast. However, IAA% was stabilized faster after introducing the supplementation than it's discontinuation.

[Influence of selected factors on fortified food intake by children]. / Wplyw wybranych czynników na spozycie przez dzieci produktów wzbogacanych.

BACKGROUND: The range of food products fortified with vitamins and minerals in Poland is growing rapidly in the last years. Also the consumption of such food and dietary supplements is increasing. Therefore there is a risk of excessive intake of vitamins and minerals. OBJECTIVE: The aim of the study was to analyze the determinants of intake of food products fortified with vitamins and minerals among children aged 6-12. MATERIAL AND METHODS: Data was collected by a questionnaire specially developed and a FFQ method including vitamins and/or minerals in fortified food products. There were collected data from parents of 743 children (374 boys, 369 girls) attending primary schools, placed in four different districts of Poland. RESULTS: More than 70% of children consumed food products fortified with vitamins and/or minerals, among them 76% - every day. As a main reason of intake of fortified food by children, parents mentioned the beneficial effects on health (86.2% parents) and taste preferences (61.2%). However, the main reason of no consuming this kind of products, were proper nutrition of the children (57.4%), no influence on health (30.3%) and prohibitive price (24,1%). There were statistically significant relationships between intake of food fortified with vitamins and/or minerals and children's age (75.8% of age 6-9 years vs. 58.1% of age 10-12 years), health condition (71.6% of children with good and very good health status -assessed by parents - vs. 55.6% with average and poor health status), the number of meals eaten during the day (75.6% eating 4 meals/day vs. 67.8% - 5 and more meals vs. 52.3% - 3 meals), regular breakfast eating (71.8% eating vs. 50.0% non consumption), brunch eating (73.3% vs. 54.0% respectively), afternoon snack eating (75.7% vs. 59.4%) and using of dietary supplements (84.6% among children who use supplements vs. 61.4% among non users). CONCLUSIONS: It was established that about 22% of parents were unaware that their children consumed food fortified with vitamins and/or minerals. Food fortified with vitamins and/or minerals was consumed more frequently among younger children, specially among those who eat more meals per day and with good and very good health status. Due to the fact that many children consumed both fortified foods and dietary supplements, there is a risk of exceeding levels consider as safe (UL) of some vitamins and/or minerals.

[Minerals intake from drinking water by young women]. / Spozycie skladników mineralnych z woda pitna przez mlode kobiety.

OBJECTIVE: The aim of this study was to assess the intake of calcium, magnesium, iron, zinc, potassium and sodium with drinking water among 19-26 years old women, students at the Warsaw University of Life Sciences (SGGW). MATERIAL AND METHODS: Data on intake of drinking water and food products were collected based on 4-day record method. Information about kind of water usage to prepare beverages and meals were obtained by using a specific questionnaire. Minerals concentrations in water samples were assessed using the atomic spectrophotometer absorption (ASA) technique. RESULTS: The average consumption of drinking water equaled 870 +/- 389 cm3/d (100-2738 cm3/d). The drinking water used by the women for meals or beverages preparation contributed in 9,8% of calcium and 3,8% of magnesium to their daily diet. Contribution of tap water in the intake of calcium and magnesium depended on the contents of these minerals in water, and amounted from 6,0% (< or = 68,3 mg calcium on dm3 water--1st quartile) to 14,8% (> 112 mg/dm3--4th quartile) for calcium and from 2,9% (< or = 10,9 mg/dm3) to 4,7% (> 15,4 mg/dm3) for magnesium. The contribution of iron, zinc, potassium and sodium was low, and not exceeded 2%. Comparing the average content of minerals in non-boiled and boiled tap water the cooking process influenced the levels of calcium (95,8 +/- 31,8 vs 89,7 +/- 31,1 mg/dm3), magnesium (12,1 +/- 3,24 vs. 12,7 +/- 3,04 mg/dm3), zinc (0,35 +/- 0,87 vs. 0,17 +/- 0,89 mg/dm3), potassium (3,31 +/- 2,67 vs. 3,66 +/- 4,18 mg/dm3) and sodium (23,2 +/- 15,4 vs. 25,9 +/- 17,2 mg/dm3). Nevertheless, from the nutritional point of view the differences in the concentrations of these minerals were insignificant. Conclusions. Drinking water can be an important source of calcium and magnesium in diet, wherein the amount of the supplied element depends on its content in drinking water used for preparing beverages and/or meals.

[Factors influenced vitamin or mineral supplements use in a chosen group of children aged 6-12]. / Czynniki warunkujace stosowanie suplementów diety zawierajacych witaminy i/lub skladniki mineralne w wybranej grupie dzieci w wieku 6-12 lat.

BACKGROUND: Due to growing popularity of food supplements the producers of such products introduce food supplements developed especially for children. This, as a consequence, may lead to a risk of exceeded intake of some nutrients. OBJECTIVE: The aim of this study was to identify determinants of vitamin/mineral supplements intake in 6-12-year-old children. METHOD: The study was conducted by questionnaire method among parents of 743 children attending primary schools. Dietary supplements during the year preceding the survey received 40% of children, while 16.7% on the tested day. RESULTS: It was found that women with secondary and higher education level more frequently reported use of such preparations by their children (43% and 40% respectively). Supplements received more children with moderate or slight deficient body weight (54.2%) compared to children with severe deficiency (29.7%) or obese (25.8%); children with chronic diseases (56%) compared to healthy (37%), participating in extracurricular sport activities (49%) compared to non-participating (35%) and children with more correct dietary habits. Simultaneously supplements and fortified products were used by 34% of children. CONCLUSIONS: . The decision of supplements use parents often undertook alone (67% of preparation), while only 31% of them after medical consultation. There is a need to educate children and their parents about the use of supplements and the risks associated with it.

[Vitamin and mineral supplement use and mortality among group of older people]. / Suplementacja diety witaminami i skladnikami mineralnymi a umieralnosc w grupie osób starszych.

The aim of this study was to determine whether the use of supplements was associated with all-cause mortality among older people. The study included 643 people aged 75-80 (305 men and 338 women) from Warsaw and Olsztyn regions. The basic information about respondents and about vitamin and/or mineral supplement intake were collected in 1999, while data about deaths from all-causes were collected in Warsaw region till the end of December 2003 and in Olsztyn region till to end of August 2004. The Cox Proportional Hazard Regression Models were used to assess the all-cause mortality risk among supplements users and nonusers. The risk of all-cause mortality was 113% (95%CI: 15 - 294%) higher among men who used vitamin A supplements compared to those who not used this nutrient as supplements, for vitamin E the risk was 89% (95%CI: 3 - 248%) higher, for vitamin B1 - 102% (95%CI: 9 - 271%), vitamin B2 - 99% (95%CI: 8 - 268%), vitamin PP - 103% (95%CI: 12 - 268%), vitamin B6 - 103% (95%CI: 10 - 273%), iron - 105% (95%CI: 2 - 308%) and for zinc -160% (95%CI: 30 - 414%) higher. Among smoking men who used vitamin B6, PP, iron and zinc supplements compared to those who were smokers and not used these supplements there were a significantly higher risk of all-cause mortality i.e. 118% (95%CI: 7 - 344%) and 106% (95%CI: 2 - 317%), 150% (95%CI: 14 - 448%) and 164% (95%CI: 122 - 472%), respectively. No such relationships were observed in older women. Further investigations are needed to explain the associations between supplement use and smoking in relation to mortality risk.