Temporal changes in micronutrient intake among United States Adults, NHANES 2003 through 2018: A cross-sectional study

Changes in the United States food supply and food choices make examination of temporal changes in micronutrient intake and their effect on meeting nutrient recommendations necessary. This study aimed to examine 15-year trends of the contribution of foods and beverages (FB) and dietary supplements (DSs) to meeting nutrient recommendations among United States adults aged 19 y or older and compare usual mean intake distributions of FB alone with those of FB+DSs with dietary reference intakes percentage below the estimated average requirement (%AI). This cross-sectional study used food, beverage, and DSs intake data from NHANES 2003-2018 (N = 39,925) to determine usual mean intakes for 21 micronutrients. Changes in intakes from FB and from FB+DSs, by sex, were compared in a time-trend analysis of 2-y cycles. Changes in mean intake as %AI were determined. Over the time studied, United States adults underconsumed vitamins A, C, D, E, and K; calcium; potassium; magnesium; and choline, even when DSs intake was included. Sodium was overconsumed. In males, there were significant increases in %<EAR for thiamin, riboflavin, vitamin C, iron, copper, and zinc for intakes from FB. When FB+DSs were considered, there were significant increases in %<EAR for thiamin, riboflavin, vitamin B-12, vitamin C, copper, and zinc and significant decreases in %<EAR for vitamins D and E. In females, there were significant increases in %<EAR for vitamin C and zinc for intakes from FB and from FB+DSs; significant decreases in %<EAR for vitamins D and E, and magnesium for intakes from FB; and a significant decrease in %<EAR for vitamins A and E from FB+DSs. Although some progress has been made, nutrient intake and percentage of the population meeting nutritional recommendations among United States adults has changed little over the 15 y studied.