Disparities in Risks of Inadequate and Excessive Intake of Micronutrients during Pregnancy

Katherine A. Sauder; Robyn N. Harte; Brandy M. Ringham; Patricia M. Guenther; Regan L. Bailey; Akram Alshawabkeh; José F. Cordero; Anne L. Dunlop; Erin P. Ferranti; Amy J. Elliott; Diane C. Mitchell; Monique M. Hedderson; Lyndsay A. Avalos; Yeyi Zhu; Carrie V. Breton; Leda Chatzi; Jin Ran; Irva Hertz-Picciotto; Margaret R. Karagas; Vicki Sayarath; Joseph Hoover; Debra MacKenzie; Kristen Lyall; Rebecca J. Schmidt; Thomas G. O'Connor; Emily S. Barrett; Karen M. Switkowski; Sarah S. Comstock; Jean M. Kerver; Leonardo Trasande; Frances A. Tylavsky; Rosalind J. Wright; Srimathi Kannan; Noel T. Mueller; Diane J. Catellier; Deborah H. Glueck; Dana Dabelea

doi:10.1093/jn/nxab273

Disparities in Risks of Inadequate and Excessive Intake of Micronutrients during Pregnancy

Katherine A. Sauder, Robyn N. Harte, Brandy M. Ringham, Patricia M. Guenther, Regan L. Bailey, Akram Alshawabkeh, José F. Cordero, Anne L. Dunlop, Erin P. Ferranti, Amy J. Elliott, Diane C. Mitchell, Monique M. Hedderson, Lyndsay A. Avalos, Yeyi Zhu, Carrie V. Breton, Leda Chatzi, Jin Ran, Irva Hertz-Picciotto, Margaret R. Karagas, Vicki SayarathJoseph Hoover, Debra MacKenzie, Kristen Lyall, Rebecca J. Schmidt, Thomas G. O'Connor, Emily S. Barrett, Karen M. Switkowski, Sarah S. Comstock, Jean M. Kerver, Leonardo Trasande, Frances A. Tylavsky, Rosalind J. Wright, Srimathi Kannan, Noel T. Mueller, Diane J. Catellier, Deborah H. Glueck, Dana Dabelea

Research output: Contribution to journal › Article › peer-review

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Abstract

Background: Inadequate or excessive intake of micronutrients in pregnancy has potential to negatively impact maternal/offspring health outcomes. Objective: The aim was to compare risks of inadequate or excessive micronutrient intake in diverse females with singleton pregnancies by strata of maternal age, race/ethnicity, education, and prepregnancy BMI. Methods: Fifteen observational cohorts in the US Environmental influences on Child Health Outcomes (ECHO) Consortium assessed participant dietary intake with 24-h dietary recalls (n = 1910) or food-frequency questionnaires (n = 7891) from 1999-2019. We compared the distributions of usual intake of 19 micronutrients from food alone (15 cohorts; n = 9801) and food plus dietary supplements (10 cohorts with supplement data; n = 7082) to estimate the proportion with usual daily intakes below their age-specific daily Estimated Average Requirement (EAR), above their Adequate Intake (AI), and above their Tolerable Upper Intake Level (UL), overall and within sociodemographic and anthropometric subgroups. Results: Risk of inadequate intake from food alone ranged from 0% to 87%, depending on the micronutrient and assessment methodology. When dietary supplements were included, some women were below the EAR for vitamin D (20-38%), vitamin E (17-22%), and magnesium (39-41%); some women were above the AI for vitamin K (63-75%), choline (7%), and potassium (37-53%); and some were above the UL for folic acid (32-51%), iron (39-40%), and zinc (19-20%). Highest risks for inadequate intakes were observed among participants with age 14-18 y (6 nutrients), non-White race or Hispanic ethnicity (10 nutrients), less than a high school education (9 nutrients), or obesity (9 nutrients). Conclusions: Improved diet quality is needed formost pregnant females. Even with dietary supplement use, 20% of participants were at risk of inadequate intake of 1 micronutrients, especially in some population subgroups. Pregnancy may be a window of opportunity to address disparities in micronutrient intake that could contribute to intergenerational health inequalities.

Original language	English
Pages (from-to)	3555-3569
Number of pages	15
Journal	Journal of Nutrition
Volume	151
Issue number	11
DOIs	https://doi.org/10.1093/jn/nxab273
State	Published - 1 Nov 2021

Keywords

Dietary Reference Intakes
diet
dietary supplements
micronutrients
minerals
pregnancy
vitamins

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10.1093/jn/nxab273

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Sauder, K. A., Harte, R. N., Ringham, B. M., Guenther, P. M., Bailey, R. L., Alshawabkeh, A., Cordero, J. F., Dunlop, A. L., Ferranti, E. P., Elliott, A. J., Mitchell, D. C., Hedderson, M. M., Avalos, L. A., Zhu, Y., Breton, C. V., Chatzi, L., Ran, J., Hertz-Picciotto, I., Karagas, M. R., ... Dabelea, D. (2021). Disparities in Risks of Inadequate and Excessive Intake of Micronutrients during Pregnancy. Journal of Nutrition, 151(11), 3555-3569. https://doi.org/10.1093/jn/nxab273

@article{d712eb1c8a29498eb1bc59f3c0594d55,

title = "Disparities in Risks of Inadequate and Excessive Intake of Micronutrients during Pregnancy",

abstract = "Background: Inadequate or excessive intake of micronutrients in pregnancy has potential to negatively impact maternal/offspring health outcomes. Objective: The aim was to compare risks of inadequate or excessive micronutrient intake in diverse females with singleton pregnancies by strata of maternal age, race/ethnicity, education, and prepregnancy BMI. Methods: Fifteen observational cohorts in the US Environmental influences on Child Health Outcomes (ECHO) Consortium assessed participant dietary intake with 24-h dietary recalls (n = 1910) or food-frequency questionnaires (n = 7891) from 1999-2019. We compared the distributions of usual intake of 19 micronutrients from food alone (15 cohorts; n = 9801) and food plus dietary supplements (10 cohorts with supplement data; n = 7082) to estimate the proportion with usual daily intakes below their age-specific daily Estimated Average Requirement (EAR), above their Adequate Intake (AI), and above their Tolerable Upper Intake Level (UL), overall and within sociodemographic and anthropometric subgroups. Results: Risk of inadequate intake from food alone ranged from 0% to 87%, depending on the micronutrient and assessment methodology. When dietary supplements were included, some women were below the EAR for vitamin D (20-38%), vitamin E (17-22%), and magnesium (39-41%); some women were above the AI for vitamin K (63-75%), choline (7%), and potassium (37-53%); and some were above the UL for folic acid (32-51%), iron (39-40%), and zinc (19-20%). Highest risks for inadequate intakes were observed among participants with age 14-18 y (6 nutrients), non-White race or Hispanic ethnicity (10 nutrients), less than a high school education (9 nutrients), or obesity (9 nutrients). Conclusions: Improved diet quality is needed formost pregnant females. Even with dietary supplement use, 20% of participants were at risk of inadequate intake of 1 micronutrients, especially in some population subgroups. Pregnancy may be a window of opportunity to address disparities in micronutrient intake that could contribute to intergenerational health inequalities.",

keywords = "Dietary Reference Intakes, diet, dietary supplements, micronutrients, minerals, pregnancy, vitamins",

author = "Sauder, {Katherine A.} and Harte, {Robyn N.} and Ringham, {Brandy M.} and Guenther, {Patricia M.} and Bailey, {Regan L.} and Akram Alshawabkeh and Cordero, {Jos{\'e} F.} and Dunlop, {Anne L.} and Ferranti, {Erin P.} and Elliott, {Amy J.} and Mitchell, {Diane C.} and Hedderson, {Monique M.} and Avalos, {Lyndsay A.} and Yeyi Zhu and Breton, {Carrie V.} and Leda Chatzi and Jin Ran and Irva Hertz-Picciotto and Karagas, {Margaret R.} and Vicki Sayarath and Joseph Hoover and Debra MacKenzie and Kristen Lyall and Schmidt, {Rebecca J.} and O'Connor, {Thomas G.} and Barrett, {Emily S.} and Switkowski, {Karen M.} and Comstock, {Sarah S.} and Kerver, {Jean M.} and Leonardo Trasande and Tylavsky, {Frances A.} and Wright, {Rosalind J.} and Srimathi Kannan and Mueller, {Noel T.} and Catellier, {Diane J.} and Glueck, {Deborah H.} and Dana Dabelea",

year = "2021",

month = nov,

day = "1",

doi = "10.1093/jn/nxab273",

language = "English",

volume = "151",

pages = "3555--3569",

journal = "Journal of Nutrition",

issn = "0022-3166",

publisher = "Elsevier B.V.",

number = "11",

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Sauder, KA, Harte, RN, Ringham, BM, Guenther, PM, Bailey, RL, Alshawabkeh, A, Cordero, JF, Dunlop, AL, Ferranti, EP, Elliott, AJ, Mitchell, DC, Hedderson, MM, Avalos, LA, Zhu, Y, Breton, CV, Chatzi, L, Ran, J, Hertz-Picciotto, I, Karagas, MR, Sayarath, V, Hoover, J, MacKenzie, D, Lyall, K, Schmidt, RJ, O'Connor, TG, Barrett, ES, Switkowski, KM, Comstock, SS, Kerver, JM, Trasande, L, Tylavsky, FA, Wright, RJ, Kannan, S, Mueller, NT, Catellier, DJ, Glueck, DH & Dabelea, D 2021, 'Disparities in Risks of Inadequate and Excessive Intake of Micronutrients during Pregnancy', Journal of Nutrition, vol. 151, no. 11, pp. 3555-3569. https://doi.org/10.1093/jn/nxab273

TY - JOUR

T1 - Disparities in Risks of Inadequate and Excessive Intake of Micronutrients during Pregnancy

AU - Sauder, Katherine A.

AU - Harte, Robyn N.

AU - Ringham, Brandy M.

AU - Guenther, Patricia M.

AU - Bailey, Regan L.

AU - Alshawabkeh, Akram

AU - Cordero, José F.

AU - Dunlop, Anne L.

AU - Ferranti, Erin P.

AU - Elliott, Amy J.

AU - Mitchell, Diane C.

AU - Hedderson, Monique M.

AU - Avalos, Lyndsay A.

AU - Zhu, Yeyi

AU - Breton, Carrie V.

AU - Chatzi, Leda

AU - Ran, Jin

AU - Hertz-Picciotto, Irva

AU - Karagas, Margaret R.

AU - Sayarath, Vicki

AU - Hoover, Joseph

AU - MacKenzie, Debra

AU - Lyall, Kristen

AU - Schmidt, Rebecca J.

AU - O'Connor, Thomas G.

AU - Barrett, Emily S.

AU - Switkowski, Karen M.

AU - Comstock, Sarah S.

AU - Kerver, Jean M.

AU - Trasande, Leonardo

AU - Tylavsky, Frances A.

AU - Wright, Rosalind J.

AU - Kannan, Srimathi

AU - Mueller, Noel T.

AU - Catellier, Diane J.

AU - Glueck, Deborah H.

AU - Dabelea, Dana

PY - 2021/11/1

Y1 - 2021/11/1

N2 - Background: Inadequate or excessive intake of micronutrients in pregnancy has potential to negatively impact maternal/offspring health outcomes. Objective: The aim was to compare risks of inadequate or excessive micronutrient intake in diverse females with singleton pregnancies by strata of maternal age, race/ethnicity, education, and prepregnancy BMI. Methods: Fifteen observational cohorts in the US Environmental influences on Child Health Outcomes (ECHO) Consortium assessed participant dietary intake with 24-h dietary recalls (n = 1910) or food-frequency questionnaires (n = 7891) from 1999-2019. We compared the distributions of usual intake of 19 micronutrients from food alone (15 cohorts; n = 9801) and food plus dietary supplements (10 cohorts with supplement data; n = 7082) to estimate the proportion with usual daily intakes below their age-specific daily Estimated Average Requirement (EAR), above their Adequate Intake (AI), and above their Tolerable Upper Intake Level (UL), overall and within sociodemographic and anthropometric subgroups. Results: Risk of inadequate intake from food alone ranged from 0% to 87%, depending on the micronutrient and assessment methodology. When dietary supplements were included, some women were below the EAR for vitamin D (20-38%), vitamin E (17-22%), and magnesium (39-41%); some women were above the AI for vitamin K (63-75%), choline (7%), and potassium (37-53%); and some were above the UL for folic acid (32-51%), iron (39-40%), and zinc (19-20%). Highest risks for inadequate intakes were observed among participants with age 14-18 y (6 nutrients), non-White race or Hispanic ethnicity (10 nutrients), less than a high school education (9 nutrients), or obesity (9 nutrients). Conclusions: Improved diet quality is needed formost pregnant females. Even with dietary supplement use, 20% of participants were at risk of inadequate intake of 1 micronutrients, especially in some population subgroups. Pregnancy may be a window of opportunity to address disparities in micronutrient intake that could contribute to intergenerational health inequalities.

AB - Background: Inadequate or excessive intake of micronutrients in pregnancy has potential to negatively impact maternal/offspring health outcomes. Objective: The aim was to compare risks of inadequate or excessive micronutrient intake in diverse females with singleton pregnancies by strata of maternal age, race/ethnicity, education, and prepregnancy BMI. Methods: Fifteen observational cohorts in the US Environmental influences on Child Health Outcomes (ECHO) Consortium assessed participant dietary intake with 24-h dietary recalls (n = 1910) or food-frequency questionnaires (n = 7891) from 1999-2019. We compared the distributions of usual intake of 19 micronutrients from food alone (15 cohorts; n = 9801) and food plus dietary supplements (10 cohorts with supplement data; n = 7082) to estimate the proportion with usual daily intakes below their age-specific daily Estimated Average Requirement (EAR), above their Adequate Intake (AI), and above their Tolerable Upper Intake Level (UL), overall and within sociodemographic and anthropometric subgroups. Results: Risk of inadequate intake from food alone ranged from 0% to 87%, depending on the micronutrient and assessment methodology. When dietary supplements were included, some women were below the EAR for vitamin D (20-38%), vitamin E (17-22%), and magnesium (39-41%); some women were above the AI for vitamin K (63-75%), choline (7%), and potassium (37-53%); and some were above the UL for folic acid (32-51%), iron (39-40%), and zinc (19-20%). Highest risks for inadequate intakes were observed among participants with age 14-18 y (6 nutrients), non-White race or Hispanic ethnicity (10 nutrients), less than a high school education (9 nutrients), or obesity (9 nutrients). Conclusions: Improved diet quality is needed formost pregnant females. Even with dietary supplement use, 20% of participants were at risk of inadequate intake of 1 micronutrients, especially in some population subgroups. Pregnancy may be a window of opportunity to address disparities in micronutrient intake that could contribute to intergenerational health inequalities.

KW - Dietary Reference Intakes

KW - diet

KW - dietary supplements

KW - micronutrients

KW - minerals

KW - pregnancy

KW - vitamins

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U2 - 10.1093/jn/nxab273

DO - 10.1093/jn/nxab273

M3 - Article

C2 - 34494118

AN - SCOPUS:85119584586

SN - 0022-3166

VL - 151

SP - 3555

EP - 3569

JO - Journal of Nutrition

JF - Journal of Nutrition

IS - 11

ER -

Disparities in Risks of Inadequate and Excessive Intake of Micronutrients during Pregnancy

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Keywords

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