A Pilot Study on the Prevalence of Micronutrient Imbalances in a Dutch General Population Cohort and the Effects of a Digital Lifestyle Program
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Measurements of Vitamins, Minerals, and Other Blood Biomarkers
2.3. Food Group and Supplement Consumption
2.4. Digital Lifestyle Program
2.5. Statistical Analysis
3. Results
3.1. Vitamin and Mineral Status
3.1.1. B Vitamins
3.1.2. Vitamin D
3.1.3. Iron Status
3.2. Consumption of Major Food Groups and Supplements
3.3. Impact of Food Group Consumption on Vitamin and Mineral Status
3.4. Effect of a Digital Lifestyle Intervention on Nutrient Status and Food Group Consumption
3.4.1. B Vitamins
3.4.2. Vitamin D
3.4.3. Iron Status
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
Food Group | Lower Threshold (Portions) | Upper Threshold (Portions) |
---|---|---|
Shellfish | 1 per week | 3–6 per week |
Vegetables | 3 per day | No upper limit |
Legumes | 1 per day | No upper limit |
Nuts and seeds | 1 per day | 2 per day |
Soy * | 2 per week | 3 per day |
Lean fish | 1 per week | 6 per week |
Meat substitutes * | 1 per day | 6 per week |
Whole grain foods | 2 per day | 4 per day |
Low-fat dairy | 1 per day | 2 per day |
Fresh fruit | 2 per day | 3 per day |
Leafy greens | 1 per day | No upper limit |
Herbs and spices | 1 per day | No upper limit |
Coffee and tea | No lower limit | 3 per day |
Fatty fish | 1 per week | 6 per week |
Dark chocolate | No lower limit | 1 per day |
Sweets | No lower limit | 3–6 per week |
Sweetened beverages | No lower limit | 1–2 per week |
Calorie-rich spreads | No lower limit | 3–6 per week |
Red meat | No lower limit | 1–2 per week |
Poultry | 1 per week | 3–6 per week |
Take-out/fast food | No lower limit | <1 per week |
Eggs | 2 per week | 1 per day |
Full-fat dairy | No lower limit | 3–6 per week |
Refined grains | No lower limit | 3–6 per week |
Oils rich in saturated fat | No lower limit | 1 per day |
Processed meat | No lower limit | 1–2 per week |
Oils rich in unsaturated fat | No lower limit | 3 per day |
(Added) salt | No lower limit | 1 per day |
Water | 6 glasses per day | No upper limit |
Appendix B
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Marker (Unit) | Reference Range |
---|---|
Vitamin B6 (nmol/L) | Deficiency: <20 Low: 20–30 Normal: 30–180 High: >180 |
Folate (nmol/L) | Low: <10 Normal: ≥10 |
Vitamin B12 (pmol/L) | Deficiency: <120 Low: 120–250 Normal: ≥250 |
Vitamin D (nmol/L) | Deficiency: <25 Insufficiency: 50–80 Normal: 80–180 Elevated: >180 |
Iron (µmol/L) | Deficiency: <10 Normal: 10–30 High: ≥30 |
Hemoglobin (mmol/L) | Men: 8.5–11 Women: 7.5–10 |
Ferritin (µg/L) | Men: 30–400 Women: 15–150 |
Transferrin (g/L) | 2.0–3.6 |
Transferrin saturation (%) | 15–45 |
Marker or Characteristic | Baseline Status, Total Cohort (n = 348) |
---|---|
Demographics | |
Sex (% female) | 56% |
Age (years, SD) | 44.6 (11.1) |
Vitamin B6 | |
Mean (SD), in nmol/L | 74.5 (59.6) |
Deficient | 3 (0.9%) |
Risk of deficiency | 26 (7.5%) |
Normal | 282 (81%) |
Excess | 16 (4.6%) |
Folate | |
Mean (SD), in nmol/L | 18.9 (9.9) |
Deficient | 52 (14.9%) |
Normal | 296 (85.1%) |
Vitamin B12 | |
Mean (SD), in pmol/L | 371 (193) |
Deficient | 2 (0.6%) |
Insufficient | 80 (23%) |
Normal | 266 (76.4%) |
Vitamin D | |
Mean (SD), in nmol/L | 68 (25) |
Deficient | 4 (1.1%) |
Insufficient | 79 (22.7%) |
Suboptimal | 178 (51.2%) |
Normal | 84 (24.1%) |
Excessive | 3 (0.9%) |
Iron status | |
Mean iron (SD), in µmol/L | 20.4 (6.9) |
Iron deficiency anemia | 3 (0.9%) |
Overt iron deficiency | 14 (4%) |
Normal iron + low ferritin | 12 (3.4%) |
Normal iron | 304 (87.4%) |
Iron overload High iron and ferritin | 3 (0.9%) 30 (8.6%) |
Isolated high ferritin | 40 (11.5%) |
Marker | Before Lifestyle Intervention (n) a | After Lifestyle Intervention (n) a | p-Value b |
---|---|---|---|
Vitamin B6 | n = 29 | n = 5 | |
Mean (SD), in mmol/L | 27.2 (2.1) | 78.2 (39.4) | 0.04 |
Improved | - | 4 (80%) | |
Normalized | - | 4 (80%) | |
Folate | n = 52 | n = 12 | |
Mean (SD), in mmol/L | 8.3 (1.7) | 12.7 (6.8) | 0.05 |
Improved | - | 8 (67%) | |
Normalized | - | 7 (58%) | |
Vitamin B12 | n = 82 | n = 20 | |
Mean (SD), in mmol/L | 205 (32) | 264 (78) | 0.006 |
Improved | - | 14 (70%) | |
Normalized | - | 9 (45%) | |
Vitamin D | n = 68 | n = 22 | |
Mean (SD), in mmol/L | 40 (6) | 68 (24) | <0.001 |
Improved | - | 19 (86.4%) | |
Normalized | - | 3 (13.6%) | |
Iron status c | n = 45 | n = 12 | |
Mean (SD), in mmol/L | 34.6 | 23.2 | <0.001 |
Improved | - | 10 (83.3%) | |
Normalized | - | 9 (75%) |
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Castela Forte, J.; Gannamani, R.; Folkertsma, P.; Kanthappu, S.; van Dam, S.; Wolffenbuttel, B.H.R. A Pilot Study on the Prevalence of Micronutrient Imbalances in a Dutch General Population Cohort and the Effects of a Digital Lifestyle Program. Nutrients 2022, 14, 1426. https://doi.org/10.3390/nu14071426
Castela Forte J, Gannamani R, Folkertsma P, Kanthappu S, van Dam S, Wolffenbuttel BHR. A Pilot Study on the Prevalence of Micronutrient Imbalances in a Dutch General Population Cohort and the Effects of a Digital Lifestyle Program. Nutrients. 2022; 14(7):1426. https://doi.org/10.3390/nu14071426
Chicago/Turabian StyleCastela Forte, José, Rahul Gannamani, Pytrik Folkertsma, Saro Kanthappu, Sipko van Dam, and Bruce H. R. Wolffenbuttel. 2022. "A Pilot Study on the Prevalence of Micronutrient Imbalances in a Dutch General Population Cohort and the Effects of a Digital Lifestyle Program" Nutrients 14, no. 7: 1426. https://doi.org/10.3390/nu14071426