Department of Nutrition Science, Purdue University, West Lafayette, IN, USA.
National Cancer Institute, NIH, Bethesda, MD, USA.
Am J Clin Nutr. 2021 Sep 1;114(3):1059-1069. doi: 10.1093/ajcn/nqab113.
Food insecurity is associated with poorer nutrient intakes from food sources and lower dietary supplement use. However, its association with total usual nutrient intakes, inclusive of dietary supplements, and biomarkers of nutritional status among US children remains unknown.
The objective was to assess total usual nutrient intakes, Healthy Eating Index-2015 (HEI-2015) scores, and nutritional biomarkers by food security status, sex, and age among US children.
Cross-sectional data from 9147 children aged 1-18 y from the 2011-2016 NHANES were analyzed. Usual energy and total nutrient intakes and HEI-2015 scores were estimated using the National Cancer Institute method from 24-h dietary recalls.
Overall diet quality was poor, and intakes of sodium, added sugars, and saturated fat were higher than recommended limits, regardless of food security status. Food-insecure girls and boys were at higher risk of inadequate intakes for vitamin D and magnesium, and girls also had higher risk for inadequate calcium intakes compared with their food-secure counterparts, when total intakes were examined. Choline intakes of food-insecure children were less likely to meet the adequate intake than those of their food-secure peers. No differences by food security status were noted for folate, vitamin C, iron, zinc, potassium, and sodium intakes. Food-insecure adolescent girls aged 14-18 y were at higher risk of micronutrient inadequacies than any other subgroup, with 92.8% (SE: 3.6%) at risk of inadequate intakes for vitamin D. No differences in biomarkers for vitamin D, folate, iron, and zinc were observed by food security status. The prevalence of iron deficiency was 12.7% in food-secure and 12.0% in food-insecure adolescent girls.
Food insecurity was associated with compromised intake of some micronutrients, especially among adolescent girls. These results highlight a need for targeted interventions to improve children's overall diet quality, including the reduction of specific nutrient inadequacies, especially among food-insecure children. This study was registered at clinicaltrials.gov as NCT03400436.
食物不安全与较差的食物来源营养素摄入和较低的膳食补充剂使用有关。然而，其与美国儿童的总日常营养素摄入、包括膳食补充剂和营养状况生物标志物的关系尚不清楚。
本研究旨在评估美国儿童的食物安全状况、性别和年龄对总日常营养素摄入、健康饮食指数-2015（HEI-2015）评分和营养生物标志物的影响。
对 2011-2016 年 NHANES 中 9147 名 1-18 岁儿童的横断面数据进行了分析。使用国家癌症研究所方法从 24 小时膳食回忆中估计了日常能量和总营养素摄入以及 HEI-2015 评分。
无论食物安全状况如何，整体饮食质量都很差，钠、添加糖和饱和脂肪的摄入量都高于推荐限量。食物不安全的女孩和男孩摄入维生素 D 和镁不足的风险更高，与食物安全的同龄人相比，女孩摄入钙不足的风险也更高，当检查总摄入量时。与食物安全的同龄人相比，食物不安全儿童的胆碱摄入量不太可能达到充足摄入量。食物安全状况对叶酸、维生素 C、铁、锌、钾和钠的摄入量没有差异。14-18 岁的食物不安全青春期女孩比任何其他亚组都更容易出现微量营养素不足的风险，维生素 D 摄入不足的风险为 92.8%（SE：3.6%）。没有观察到维生素 D、叶酸、铁和锌的生物标志物因食物安全状况而异。食物安全的青春期女孩缺铁的患病率为 12.7%，食物不安全的青春期女孩为 12.0%。
食物不安全与一些微量营养素摄入受损有关，尤其是在青春期女孩中。这些结果强调需要采取有针对性的干预措施来改善儿童的整体饮食质量，包括减少特定的营养不足，尤其是在食物不安全的儿童中。本研究在 clinicaltrials.gov 上注册为 NCT03400436。
