Total Usual Intake of Shortfall Nutrients Varies With Poverty Among US Adults

J Nutr Educ Behav. 2017 Sep;49(8):639-646.e3. doi: 10.1016/j.jneb.2016.11.008. Epub 2017 May 20.


Objective: To examine shortfall nutrient intakes (ie, calcium, folate, potassium, magnesium, and vitamins A, C, D, and E) by poverty-to-income ratio (PIR).

Design: National Health and Nutrition Examination Survey 2011-2012, a nationally representative, cross-sectional survey.

Participants: US adults with complete data on poverty status and diet were included (n = 4,524).

Analysis: The National Cancer Institute method was used to estimate total usual micronutrient intakes from foods, beverages, medications, and dietary supplements reported on 2 24-hour dietary recalls using measurement error correction.

Main outcome measures: Calcium, folate, potassium, magnesium, and vitamins A, C, D, and E across 3 PIR categories: <130%, 130% to 350%, and ≥350%.

Results: Mean intakes of folate, vitamin C, and vitamin D were significantly greater in men, and magnesium in women, across all PIR categories. Except for calcium in men and vitamin C in women, the highest PIR category had significantly higher mean total usual intakes of all remaining shortfall micronutrients. Importantly, men and women in the highest PIR category (≥350%) were significantly less likely to have intakes below the Estimated Average Requirement across all micronutrients compared with those in the lower PIR categories.

Conclusions and implications: Even with dietary supplements, large proportions of US adults have micronutrient intakes below the Estimated Average Requirement. Adults at the highest adjusted income have higher micronutrient intakes and lower risk of inadequacy than those with lower incomes.

Keywords: NHANES; diet quality; dietary supplements; micronutrients; minerals; poverty; shortfall nutrients; vitamins.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Diet / standards
  • Diet / statistics & numerical data*
  • Dietary Supplements
  • Female
  • Humans
  • Male
  • Micronutrients*
  • Nutrition Surveys*
  • Poverty
  • United States / epidemiology
  • Vitamins*
  • Young Adult


  • Micronutrients
  • Vitamins