Dietary habits, nutrient intake and biomarkers for folate, vitamin D, iron and iodine status among women in childbearing ages in Sweden

Transcription

1 Dietary habits, nutrient intake and biomarkers for folate, vitamin D, iron and iodine status among women in childbearing ages in Sweden W Becker, AK Lindroos, C Nälsén, E Warensjö Lemming, V Öhrvik Risk-Benefit Assessment Department National Food Agency, Uppsala, Sweden

2 Key points Background Monitoring diet, exposure and nutrition status Material and Methods. Riksmaten survey, Market Basket studies, biomarkers for selected nutrients Results Intake of foods, key nutrients Nutrition status: folate, vit D, iron, iodine Conclusions Key findings, interpretation Public health significance

3 NFAs national food surveys basis for monitoring dietary exposure National dietary surveys Hulk 1989 Riksmaten Riksmaten children 2003 Market Basket Studies Analyses of composite food samples based on food supply (Food Balance Sheets) Riksmaten adults Biomonitoring

4 Riksmaten adults d record - consecutive Web-based data recording Questionnaire lifestyle factors, specific foods Blood and urine sampling

5 Web-tool, meal type, place and time

6 Web-tool, food selection

7 Portion sizes - predefined

8 Data collection Representative population sample 5000 adults, yr, stratified by sex, region and age group (18-30, 31-44, 45-64, yr) May 2010 July interviewers involved in data collection (contact, questionnaires, follow-up Biomarkers: blood and urine in a sub-sample (1000)

9 Biomarkers Vitamins folate, vitamin D (plasma) Minerals Fe, Na, I (urine) Contaminants bisfenola, heavy metals, PCBer, ftalates, flame retardants, etc. Other Serum fatty acids DON, antibodies, micro kernels

10 21 municipalities participated 7 AMM regions 3 municip/region 4 instances/yr Mora Fagersta Karlstad Ale Färgelanda Göteborg Örkelljunga Lund Lomma Åsele Umeå Härjedalen Borlänge Uppsala Stockholm Örebro Linköping Vadstena Värnamo Vallentuna Botkyrka

11 Flow chart subjects contacted Nonresponse Diet - response: web (36%) questionnaire (43%) Biomonitoring: ~300 blood/urine (30%) Nutrients Contaminants

12 Food intake among women g/d yr yr yr yr 50 0 Vegetables Fruit, berries Juice Potatoes Fish, seafood Soft drinks, cordials

13 Macronutrient composition among women yr yr yr yr Protein, E% Fat, E% SFA, E% Added sugars, E% Fibre, g/10 MJ

14 Folate - lower reported intake among young women µg/d Kvinnor Women Män Men år år år år RI: 400 µg/d for women in childbearing ages Others: 300 µg/d

15 Folate intake fruit and vegetables g/d F&V < 200 g/d F&V g/d F&V g/d F&V > 500 g/d

16 Folate status no significant age differences 20 nmol/l Women Md P-folate y y y y

17 Folate status no significant age differences nmol/l y y y y Women Md ery-folate

18 Vitamin D - lower reported intake among young women µg/d ,2 6,2 6,6 Kvinnor Women 7,6 6,6 7,7 6,9 Män Men 9, år år år år RI: 10 µg/d

19 Vitamin D status no age differences Mean P-25OHD, nmol/l yr yr yr yr Women

20 Iron - lower reported intake among young women mg/d ,9 9,7 9,9 Kvinnor Women 9,4 11,7 11,9 10,8 Män Men år år år år RI, women in childbearing ages: 15 mg/d Others: 9 mg/d

21 Ferritin status (µg/l) among women years years years years Overall difference between age groups p<0.001

22 Iodine status - IUC UIC, µg UIC/g Creatinine Creatinine, g/24h I, µg/24h All women men

23 Conclusions Main findings Women in childbearing ages vs. older women Lower intakes of fruit and vegetables, fish and wholegrain, but higher intakes of soft drinks Lower intakes of dietary fibre, higher added sugars Intakes of some micronutrients below RI No differences in vit D, folate or iodine status between age groups Limitations Low participation rate: 36%, especially among younger age groups More well-educated in final sample Under-reporting: c. 20%

24 Conclusions cont. Implications for preconception health Diet quality: lower among young women major improvements warranted Future pregnancy outcomes Adherence to dietary guidelines Includes advice on physical activity Advice on folic acid Use of iodised salt Use vit D-fortified dairy products Adequate sun-exposure

25 Swedish dietary guidelines Sweden's dietary guidelines summed up in "one minute." LIMIT

26 Thank you for listening! Some useful references/links: - National Food Agency: - Nordic Nutrition Recommendations 2012: