'Identifying interventions': Calcium intake “inadequate” in Asia, says new Lancet study
Calcium is one of the nutrients where its estimated intake from food remains “inadequate” for more than half of the global population, with most of the intake inadequacy coming from Asia and sub-Saharan Africa.
Writing in The Lancet Global Health, researchers from Harvard T H Chan School of Public Health, University of California, Tel Aviv University, Mexico’s National Institute of Public Health studied the estimated intake of 15 micronutrients across 185 countries.
The 15 micronutrients studied consisted of nine vitamins, including vitamin A, E, C, B vitamins, and six minerals, including iodine, calcium, iron, zinc, selenium, and magnesium.
Information from the Global Dietary Database (GDD), which contains individual-level dietary datasets from over 185 countries for more than 50 foods, beverages, and nutrients, is used for this analysis.
Using the most recent GDD data from year 2018, the researchers found that calcium is one of the micronutrients where intake was estimated to be inadequate for over five billion people. This was about 66 per cent of the global population back in 2018.
Region wise, calcium intake inadequacy was highest in South Asia, East Asia, and the Pacific, and sub-Saharan Africa.
In these regions, calcium intake inadequacy was high across all age and sex groups, but especially so among people aged 10 to 30.
In contrast, only countries in North America, Europe, and Central Asia had “a consistently low prevalence” of inadequate calcium intake.
The findings mirror another set of results published in Osteoporosis International, which showed that Asian countries, in particular, China, India, and Indonesia have average calcium intake that were below the recommended daily intake of 1,000mg.
Average intake in China was 338mg, 429mg for India, and 342mg for Indonesia based on that set of findings.
Aside from calcium, findings published in The Lancet showed that iodine and vitamin E were the other two nutrients where there was inadequate intake for over five billion people globally.
The other micronutrients where estimated intake was inadequate for the bulk of the global population were iron, riboflavin, folate, and vitamin C.
Over four billion people globally are said to have inadequate intake of these nutrients.
Within Asia, India was highlighted as having “especially high” inadequacy of riboflavin, folate, vitamin B6 and B12 intake.
“For riboflavin and vitamin B12, high prevalences of inadequate intakes were common only in countries in South Asia and Africa.
“For example, in India, estimated inadequate intakes of riboflavin, folate, vitamin B6, and vitamin B12 were especially high; Madagascar and the Democratic Republic of the Congo had high inadequate niacin (vitamin B3) intakes,” said the researchers.
They added that most of the global population “has inadequate intake of at least one micronutrient.”
For instance, low prevalence of inadequate vitamin E was mainly seen in Pacific Island countries. Inadequate intake of the vitamin was relatively higher in Latin America and Caribbean, followed by North America.
“In combination with existing data on micronutrient deficiencies and supplies, estimates of inadequate global micronutrient intakes can help public health researchers and practitioners to identify which age and sex groups in which countries might be in greatest need of intervention for a wide range of micronutrients,” said the researchers.
They added that this is believed to be the first global estimates on inadequate global micronutrient intakes.
“To our knowledge, this analysis provides the first global estimates of inadequate micronutrient intakes using dietary intake data, highlighting highly prevalent gaps across nutrients and variability by sex.”
Gender differences
The analysis also found gender differences when it comes to the types of micronutrients where intake was lacking.
In women, there was a higher prevalence for inadequate intake of iodine, vitamin B12, iron, selenium, calcium, riboflavin, and folate.
As for men, there was a higher prevalence for inadequate intake of magnesium, vitamin B6, zinc, vitamin A, C, thiamine, and niacin.
“Many of the differences observed could relate to a combination of differing dietary patterns, dietary requirements, and consumption quantities between sexes,” said the researchers.
Source: The Lancet Global Health
Global estimation of dietary micronutrient inadequacies: a modelling analysis
DOI: 10.1016/S2214-109X(24)00276-6
Authors: Passarelli, Simone et al.
