Micronutrient intake from three popular diet patterns in the United States: modeled replacement of foods highest in added sugar and sodium using the National Health and Nutrition Examination Survey, 2005-2018

Avonti Basak Tukun; Sarah Rowe; LuAnn K Johnson; David C Love; Martha Belury; Zach Conrad

doi:10.3389/fnut.2023.1217774

Micronutrient intake from three popular diet patterns in the United States: modeled replacement of foods highest in added sugar and sodium using the National Health and Nutrition Examination Survey, 2005-2018

Front Nutr. 2023 Oct 13:10:1217774. doi: 10.3389/fnut.2023.1217774. eCollection 2023.

Authors

Avonti Basak Tukun¹, Sarah Rowe², LuAnn K Johnson³, David C Love^{4

5}, Martha Belury⁶, Zach Conrad^{7

8}

Affiliations

¹ OSU Nutrition Interdisciplinary Graduate Program, The Ohio State University, Columbus, OH, United States.
² College of Arts and Sciences, William & Mary, Williamsburg, VA, United States.
³ Independent Contractor, Warren, MN, United States.
⁴ Johns Hopkins Center for a Livable Future, Johns Hopkins University, Baltimore, MD, United States.
⁵ Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
⁶ Department of Food Science and Technology, The Ohio State University, Columbus, OH, United States.
⁷ Department of Kinesiology, William & Mary, Williamsburg, VA, United States.
⁸ Global Research Institute, William & Mary, Williamsburg, VA, United States.

Abstract

Introduction: Fifty-two percent of adults in the United States reported following a popular diet pattern in 2022, yet there is limited information on daily micronutrient intakes associated with these diet patterns. The objective of the present study was to model the impact on micronutrient intake when foods highest in added sugar and sodium were replaced with healthier alternatives to align with the Dietary Guidelines for Americans recommendations.

Methods: Dietary data were acquired from 34,411 adults ≥ 20 y in the National Health and Nutrition Examination Survey, 2005-2018. The National Cancer Institute methodology was used to estimate usual dietary intake at baseline of 17 micronutrients using information from up to two dietary recalls per person. A food substitution model was used to evaluate the impact on micronutrient intake when three servings of foods highest in added sugar and sodium were substituted with healthier alternatives.

Results: Dietary modeling to replace foods highest in added sugar with healthier alternatives increased the mean intake of fat-soluble vitamins (0.15% for vitamin A to 4.28% for vitamin K), most water-soluble vitamins (0.01% for vitamin B₁ to 12.09% for vitamin C), and most minerals (0.01% for sodium to 4.44% for potassium) across all diet patterns. Replacing foods highest in sodium had mixed effects on the mean intake of micronutrients. The intake of most fatsoluble vitamins increased by 1.37-6.53% (particularly vitamin A and D), yet while the intake of some water-soluble vitamins and minerals increased by 0.18-2.64% (particularly vitamin B₂, calcium, and iron) others decreased by 0.56-10.38% (notably vitamin B₃ and B₆, magnesium, sodium, and potassium).

Discussion: Modeled replacement of foods highest in added sugar led to more favorable changes in mean micronutrient intake compared to modeled replacement of foods highest in sodium. Due to the composite nature of mixed dishes that include multiple ingredients, food substitutions may result in both favorable and unfavorable changes in micronutrient intake. These findings highlight the challenges of making singleitem food substitutions to increase micronutrient intake and call for further research to evaluate optimal combinations of replacement foods to maximize the intake of all micronutrients simultaneously.

Keywords: NHANES; low grain diet; micronutrient intake; popular diet; restricted-carbohydrate diet; time-restricted diet.

Grants and funding

This work was supported by the Institute for the Advancement of Food and Nutrition Sciences Carbohydrate Committee (IAFNS) and the Margaret S. Glauber Faculty-Student Fellowship at William & Mary. IAFNS is a non-profit science organization that pools funding from industry collaborators and advances science through in-kind and financial contributions from public and private sector participants. DL was supported by the Johns Hopkins Center for a Livable Future with a gift from the Greater Kansas City Community Foundation. The funders had no role in the design, analysis, interpretation, or presentation of the data and results. View this project on the Open Science Framework at https://archive.org/details/osf-registrations-z3fme-v1.