Current developments in nutrition · 2026
Population-Level Changes in Folate, Iodine, and Vitamin D Status over More than 20 Years: Biomarker Data from the Cross-Sectional National Health and Nutrition Examination Survey (NHANES 1999-2000 through August 2021-August 2023).
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Pfeiffer Christine M, Sternberg Maya R, Powers Carissa D, Ogden Cynthia L, Jefferds Maria Elena D, Crider Krista S, Juan WenYen, Gahche Jaime J, Rybak Michael E, Fazili Zia, Zhang Ming, Mineva Ekaterina M, Jarrett Jeffery M
Аннотация
BACKGROUND: The National Health and Nutrition Examination Survey (NHANES) has monitored biomarkers for 4 key nutrients important for pregnancy outcomes, neurological development, and healthy growth-folate, vitamin D, iodine, and iron-during most survey cycles from 1999 to 2000 through August 2021-August 2023 as part of the continuous NHANES. These biomarker data offer a unique opportunity to assess long-term trends in the US population.
OBJECTIVES: This study aimed to describe concentration trends for 7 biomarkers/indicators after adjusting for demographic changes over time.
METHODS: We used the following NHANES data: serum folate (SFOL) and red blood cell folate (RBF) for persons aged ≥3 y and women of reproductive age (WRA, 12-49 y) for 1999-August 2023 (except 2017-2018), serum 25-hydroxyvitamin D (25OHD) for persons aged ≥3 y for 2001-August 2023, urine iodine (UI) for persons aged ≥3 y for 2001-2018, and serum ferritin [(FER) and FER adjusted for inflammation (FERadj)], serum soluble transferrin receptor, and body iron index (BII) for WRA and children aged 1-5 y for 2003-August 2023 (except 2011-2014). We assessed trends as overall concentration change using logistic regression (unadjusted and adjusted for age, sex, and race and Hispanic origin) and as a linear trend if the overall change was significant.
RESULTS: After adjusting for demographic changes, mean concentrations of all 7 biomarkers/indicators showed significant overall temporal changes (except for FER in children and BII in WRA) and significant linear trends (except for FERadj in children). SFOL (∼25%-30%), RBF (∼10%), and UI (∼25%-30%) concentrations decreased, whereas 25OHD (∼20%) concentrations increased. FER concentrations decreased in WRA (∼15%) and remained unchanged in children.
CONCLUSIONS: Considering the long monitoring period, biomarker changes were moderate. Nonetheless, these changes highlight the need to address declining iodine, iron, and folate status in WRA and increasing vitamin D status in supplement users.
OBJECTIVES: This study aimed to describe concentration trends for 7 biomarkers/indicators after adjusting for demographic changes over time.
METHODS: We used the following NHANES data: serum folate (SFOL) and red blood cell folate (RBF) for persons aged ≥3 y and women of reproductive age (WRA, 12-49 y) for 1999-August 2023 (except 2017-2018), serum 25-hydroxyvitamin D (25OHD) for persons aged ≥3 y for 2001-August 2023, urine iodine (UI) for persons aged ≥3 y for 2001-2018, and serum ferritin [(FER) and FER adjusted for inflammation (FERadj)], serum soluble transferrin receptor, and body iron index (BII) for WRA and children aged 1-5 y for 2003-August 2023 (except 2011-2014). We assessed trends as overall concentration change using logistic regression (unadjusted and adjusted for age, sex, and race and Hispanic origin) and as a linear trend if the overall change was significant.
RESULTS: After adjusting for demographic changes, mean concentrations of all 7 biomarkers/indicators showed significant overall temporal changes (except for FER in children and BII in WRA) and significant linear trends (except for FERadj in children). SFOL (∼25%-30%), RBF (∼10%), and UI (∼25%-30%) concentrations decreased, whereas 25OHD (∼20%) concentrations increased. FER concentrations decreased in WRA (∼15%) and remained unchanged in children.
CONCLUSIONS: Considering the long monitoring period, biomarker changes were moderate. Nonetheless, these changes highlight the need to address declining iodine, iron, and folate status in WRA and increasing vitamin D status in supplement users.