Variation in Micronutrient Intake and Adequacy by Race, Ethnicity, and Poverty-to-Income Ratio in US Children and Adults: A Cross-Sectional Analysis of the NHANES

Objectives: Identifying disparities in micronutrient intake and adequacy by race/ethnicity and income is essential for promoting health equity, as it may reveal differences in dietary intake that disproportionately affect marginalized groups.Our aim was to determine micronutrient intake and adequacy from food only and from food and dietary supplements (DS) stratified by race/ethnicity, poverty-to-income ratio (PIR), age and gender in a representative sample of US children (age 2-18 years) and adults (age 19+ years).We hypothesized micronutrient intake and adequacy differs by race/ethnicity and PIR within the same age and gender group.Methods: This was a cross-sectional analysis of NHANES (2011-2020).Participants were stratified by gender and age (age 2-18, 19-64, and 65+ y).Five racial and ethnic groups were included (Mexican American/Hispanics [MA/H], non-Hispanic Whites [NHW], non-Hispanic Blacks [NHB], non-Hispanic Asians [NHA] and other race/multiracial [O/M]).PIR was classified as < 1.3 (low-income), 1.3-1.85(middle-income) and >1.85 (high-income).Usual intake of all micronutrients and the percentage of the population below the estimated average requirement (EAR) or above the adequate intake (AI) were calculated for food only and food and DS.Results: Across all age groups and within each race/ ethnicity, those with low-and middle-income had lower diet quality, higher prevalence of food insecurity, used fewer DS, and had lower micronutrient intakes and adequacies compared to those with high income.Income based differences in the percentage of participants below the EAR and above the AI were more prevalent within NHW and NHA than other race/ethnicities.Race/ethnicity differences in micronutrient adequacies were more prevalent in the high-income group than the middleor low-income groups.NHB had the most micronutrient inadequacies across all PIR groups, and the lowest DS use among those in the low-income group.Conclusions: Disparities in micronutrient intake and adequacy exist across race/ethnicity and PIR groups.These findings suggest that targeted interventions based on demographic factors could reduce the risk of chronic diseases and improve longterm health outcomes.