Trends in Reported Calcium and Magnesium Intake from Diet and Supplements by Demographic Factors: National Health and Nutrition Examination Survey, 2003-2018

Omonefe O Omofuma; Dai Fang; Nicholas Yell; Olajumoke Falomo; Jihong Liu; Susan E Steck

doi:10.1016/j.jand.2024.04.017

Trends in Reported Calcium and Magnesium Intake from Diet and Supplements by Demographic Factors: National Health and Nutrition Examination Survey, 2003-2018

J Acad Nutr Diet. 2024 May 6:S2212-2672(24)00205-3. doi: 10.1016/j.jand.2024.04.017. Online ahead of print.

Authors

Omonefe O Omofuma¹, Dai Fang², Nicholas Yell³, Olajumoke Falomo⁴, Jihong Liu⁵, Susan E Steck⁶

Affiliations

¹ Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC; Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD. Electronic address: otomonefe@yahoo.com.
² Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC. Electronic address: daif@email.sc.edu.
³ Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC. Electronic address: yelln@email.sc.edu.
⁴ Department of Nutritional Sciences, College of Agriculture and Life Sciences, University of Wisconsin-Madison, WI. Electronic address: olajumokefalomo@gmail.com.
⁵ Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC. Electronic address: liu@mailbox.sc.edu.
⁶ Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC. Electronic address: stecks@mailbox.sc.edu.

PMID: 38718857
DOI: 10.1016/j.jand.2024.04.017

Abstract

Background: Calcium and magnesium are important micronutrients necessary for normal body functioning.

Objective: The objective of the study was to approximate usual nutrient intakes and estimate proportion of adults meeting the estimated average requirement (EAR) of calcium and magnesium from diet, and diet plus supplements (total intake). Trends in the proportion of adults meeting the EAR were estimated by sex, age, and race and ethnicity.

Design: The study utilized data from the National Health and Nutrition Examination Survey (NHANES), a cross-sectional survey of a nationally representative sample of the United States civilian and noninstitutionalized population.

Participants and setting: The continuous NHANES survey data from 2003-2004 through 2017-2018 for dietary intake, and 2007-2008 through 2017-2018 for total intake were analyzed. The study sample included males and females (not lactating/pregnant) aged ≥19 years with two reliable 24-hour dietary recalls and energy intake >500 - <6000 kcal/day (n=35,037).

Main outcome measures: Mean daily intake and trends of proportion of adults meeting/exceeding the EAR for calcium and magnesium were estimated.

Statistical analyses performed: The National Cancer Institute's (NCI) method was used to calculate daily intakes for calcium and magnesium by demographic subgroups. SAS SURVEYMEAN AND SURVEYFREQ procedures were used to estimate means and standard errors (SE) for continuous variables and frequencies and percentages for categorical variables, and two sample t-test for p-values. Trends were estimated with NCI's Joinpoint trend analysis program.

Results: Mean daily dietary calcium intake and proportions of adults meeting the EAR from both diet and supplements was lowest among females (859 mg / 61.9%), adults aged ≥71 years (865 mg / 60.3%) and non-Hispanic black (NHB) individuals (782 mg / 48.6%) compared to males, younger age groups and other races and ethnicities. Magnesium intake reported from diet was lowest in adults ≥71 years (276 mg) while total magnesium intake and proportion of meeting the EAR from both diet and supplements was lowest in females (302 mg) and males (52%) respectively, adults 19-30 years (305 mg / 48.5%) and NHB individuals (274 mg / 35.5%). The trends in the proportion of females and NH white (NHW) adults meeting the EAR from total calcium intake decreased significantly (p-value <0.05) by 2.9% and 2.0% respectively.

Conclusions: Females and adults aged ≥71 years had the lowest reported mean daily dietary calcium intake and proportion meeting the EAR for calcium from diet and supplements. Males and adults aged 19-30 years had the lowest proportion meeting the EAR for magnesium from diet and supplements with adults aged 19-30 years also having the lowest reported total magnesium intake from diet and supplements. NHB individuals had the lowest proportion of meeting the EARs for calcium and magnesium from reported total intake. The trends in the proportion of females and NHW individuals meeting the EARs for calcium through total intake decreased over time and remained stable in other subpopulations and for magnesium.

Keywords: Calcium; dietary supplements; disparities; estimated average requirement; magnesium.