Usual Dietary Intake, Nutritional Adequacy and Food Sources of Calcium, Phosphorus, Magnesium and Vitamin D of Spanish Children Aged One to <10 Years. Findings from the EsNuPI Study

Abstract

Bone problems in the population begin to be establish in childhood. The present study aims to assess the usual calcium, phosphorus, magnesium, and vitamin D intakes, along with the food sources of these nutrients, in Spanish children participating in the EsNuPI (Estudio Nutricional en Población Infantil Española) study. Two 24 h dietary recalls were applied to 1448 children (1 to &lt;10 years) divided into two sub-samples: one reference sample (RS) of the general population [n = 707] and another sample which exclusively included children consuming enriched or fortified milks, here called “adapted milks” (AMS) [n = 741]. Estimation of the usual intake shows that nutrient intake increased with age for all nutrients except vitamin D. Using as reference the Dietary Reference Values from the European Food Safety Authority (EFSA), calcium and magnesium intakes were found to be below the average requirement (AR) and adequate intake (AI), respectively, in a considerable percentage of children. Furthermore, phosphorus exceeded the AI in 100% of individuals and vitamin D was lower than the AI in almost all children studied. The results were very similar when considering only plausible reporters. When analyzing the food sources of the nutrients studied, milk and dairy products contributed the most to calcium, phosphorus, magnesium, and vitamin D. Other sources of calcium were cereals and vegetables; for phosphorus: meat, meat products, and cereals; for magnesium: cereals and fruits; and, for vitamin D: fish and eggs. These results highlight the desirability of improving the intake concerning these nutrients, which are involved in bone and metabolic health in children. The AMS group appeared to contribute better to the adequacy of those nutrients than the RS group, but both still need further improvement. Of special interest are the results of vitamin D intakes, which were significantly higher in the AMS group (although still below the AI), independent of age.

Breakfast Habits of a Representative Sample of the Spanish Child and Adolescent Population (The ENALIA Study): Association with Diet Quality

“…As far as misreporting is concerned, our results coincide with those of Coulthard et al [ 2 ] which indicated that under–reporting may have been more prevalent for the children in the 11–18 years age group, who provided their own food consumption, in contrast to children in the younger age group, whose diaries were completed by their parents or caregivers. The percentage of misreporting was similar to that found in other studies [ 2 , 32 ].…”

“…And finally, the design, protocol and methodology of the ENALIA study were made in accordance with the recommendations of the European Food Safety Agency (EFSA) "EU Menu" guidance recommendations [43,44]. The sample studied presents anthropometric data similar to those of other Spanish children of the same age [1, 6,21,22,31,32,36,37]. As far as misreporting is concerned, our results coincide with those of Coulthard et al [2] which indicated that under-reporting may have been more prevalent for the children in the 11-18 years age group, who provided their own food consumption, in contrast to children in the younger age group, whose diaries were completed by their parents or caregivers.…”

“…In fact, it is possible that the intake of various micronutrients relevant from a public health point [ 30 ], which have a key role in the growth and healthy development of children, may be affected by skipping breakfast. In addition, some of the foods consumed by children at breakfast, such as dairy products, breakfast cereals, and fruits, are important sources of micronutrients for this age group [ 12 , 13 , 27 , 31 , 32 ], although the role of breakfast cereals is also controversial because of the high content of added sugars or even salt and low content in fiber [ 33 , 34 , 35 ]. Moreover, breakfast habits in childhood track into adulthood, so they should be monitored and improved [ 6 ].…”

Dietary Intake, Nutritional Adequacy and Food Sources of Total Fat and Fatty Acids, and Relationships with Personal and Family Factors in Spanish Children Aged One to <10 Years: Results of the EsNuPI Study

“…Therefore, there is a possibility that these children had an inadequate intake of fat-soluble vitamins. Indeed, our cohort has reported that a large percentage of the EsNuPI population does not meet the recommended intake of vitamin D [49].…”

“…A total of 1448 children ages 1 to <10 years were enrolled in the study; details of the subject characteristics; general, anthropometric, and socio-economic data have been published previously [36,49].…”