Food and nutrient intakes and their associations with lower BMI in middle-aged US adults: The International Study of Macro-/Micronutrients and Blood Pressure (INTERMAP)

Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
American Journal of Clinical Nutrition (Impact Factor: 6.77). 08/2012; 96(3):483-91. DOI: 10.3945/ajcn.111.025056
Source: PubMed


Clinical trial data show that reduction in total energy intake enhances weight loss regardless of the macronutrient composition of the diet. Few studies have documented dietary patterns or nutrient intakes that favor leanness [BMI (in kg/m²) ≤25] in free-living populations.
This investigation examined associations of usual energy, food, and nutrient intakes with BMI among US participants of the International Study of Macro-/Micronutrients and Blood Pressure (INTERMAP).
The INTERMAP is an international cross-sectional study of dietary factors and blood pressure in men and women (ages 40-59 y) that includes 8 US population samples. The present study included data from 1794 Americans who were not consuming a special diet and who provided four 24-h dietary recalls and 2 timed 24-h urine collections. Multivariable linear regression with the residual method was used to adjust for energy intake; sex-specific associations were assessed for dietary intakes and urinary excretions with BMI adjusted for potential confounders including physical activity.
Lower energy intake was associated with lower BMI in both sexes. Univariately, higher intakes of fresh fruit, pasta, and rice and lower intakes of meat were associated with lower BMI; these associations were attenuated in multivariable analyses. Lower urinary sodium and intakes of total and animal protein, dietary cholesterol, saturated fats, and heme iron and higher urinary potassium and intakes of carbohydrates, dietary fiber, and magnesium were associated with lower BMI in both sexes.
The consumption of foods higher in nutrient-dense carbohydrate and lower in animal protein and saturated fat is associated with lower total energy intakes, more favorable micronutrient intakes, and lower BMI.

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    • "Pressure (INTERMAP), data from 1794 Americans showed that magnesium intake decreased from 150.9 mg/1000 kcal in men with a BMI <25.0 to 138.1 mg/1000 kcal with a BMI ≥30.0; in women, the decrease was from 155.7 to 133.7 mg/1000 kcal (Shay et al., 2012). The preceding findings support the suggestion that magnesium deficiency may contribute to the occurrence of chronic inflammatory stress and associated poor-quality sleep in obesity. "
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    ABSTRACT: Magnesium is required for enzymes used in neurotransmitter synthesis, and is involved in cholinergic, monoaminergic, and amino acid transmitter function. Magnesium blocks the N-methyl-d-aspartate (NMDA) receptor and is an agonist of the γ-amino butyric acid (GABA) receptor. Heightened activation of the NMDA receptor may cause poor sleep architecture, while augmentation of the GABA receptor may improve sleep architecture. Thus, it is not surprising that magnesium deficiency has been associated with sleep disorders, which magnesium supplementation alleviated. Magnesium deficiency may contribute to the inflammatory stress that can result in pathological changes such as diabetes mellitus and cardiovascular disease associated with sleep deprivation or poor-quality sleep. Based on recent survey data, magnesium deficiency such that it would affect sleep quality in humans may be a common occurrence, especially in older adults, obese individuals, and alcohol abusers. Magnesium supplementation may be a treatment that improves sleep quality in some individuals.
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    • "These EARs and RDAs indicate the reason that they are usually higher for men than women—men are more likely to weigh more. Basing the requirement on bodyweight also implies increased EARs and RDAs for overweight and obese individuals, and gives a basis for reports suggesting that a low Mg status occurs more often in obese than non-obese individuals (Rodríguez-Morán and Guerrero-Romero 2004; Huerta et al. 2005; Shay et al. 2012; Guerrero-Romero and Rodriguez-Moran 2013). Of course, bodyweights <70 kg would result in EARs <170 mg day –1 and RDAs <245 mg day –1 . "
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    ABSTRACT: Based on established dietary reference intakes (DRIs) (e.g. estimated average requirements, recommended dietary allowances (RDAs), and reference nutrient intakes), magnesium (Mg) deficiency in the range 50-99% of the requirement commonly occurs throughout the world. Yet, Mg is not often considered a major nutrient of concern for health and wellbeing, although deficient intakes and serum concentrations have been associated with numerous pathological conditions including atherosclerosis, diabetes, osteoporosis and some cancers. Probable reasons for this dichotomy are that evidence of Mg deficiency is not consistently found in pathological conditions with which it has been associated, and not all individuals considered Mg-deficient consistently exhibit these pathological conditions. These inconsistencies could be the outcome of chronic inflammatory stress exacerbated or induced by Mg deficiency being alleviated or prevented by other factors that have anti-inflammatory action (e.g. long-chain n-3 fatty acids). Questionable DRIs resulting in the incorrect conclusion that individuals are Mg-deficient when they are not also may be responsible for the inconsistencies. Since 1997, improved balance data have been reported for the determination of DRIs, which suggest that the RDA for a 70-kg healthy adult would be ∼250mgday-1. Based on the finding that neutral Mg balance was determined to be 2.36mgday-1kg-1 bodyweight, the RDA would vary by bodyweight. Even with changed DRIs, a significant number of adults who do not eat recommended amounts of foods of plant origin would not achieve the suggested adequate intake of Mg. Foods of plant origin, including green vegetables, nuts, pulses and whole grains, are good sources of Mg. However, Mg in these foods can be influenced by the availability of Mg to plants from the soil, and plant genotype. Thus, crop breeding and cultural practices, through modifying the amount of Mg in plant-origin foods, can have a significant impact on achieving an adequate dietary intake of Mg for health.
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