(P22-017-24) Impact of Calorie Reduction on Nutrient Adequacy Among US Adults With Overweight or Obesity (Modeling Study Using NHANES 2015–2018)

Objectives: To identify shortfalls in nutrient intakes that may occur when adults undertake weight loss via caloric restriction, the impact of calorie reduction on nutrient adequacy among US adults with overweight or obesity was modeled using NHANES 2015-2018 data.

Methods: Intakes of calories and fourteen nutrients were evaluated, and our levels of calorie reduction (20, 30, 40, and 50%) were modelled by pro-rating daily calorie intake such that nutrient intakes were reduced proportional to calorie reduction Usual intakes of nutrients for each age/gender group [19+y (n=6,131), 19-50 y (n=3,312), and 51+ y (n=2,819)] were determined using the National Cancer Institute method using 2 d of 24-h dietary recalls and 2-d sampling weights, with and without dietary supplement use. Percentages < estimated average requirement (EAR) or > adequate intake (AI) were estimated at each level of calorie reduction for all adults and males and females separately, based on food intakes only and on intakes from food and dietary supplements. Differences across percentages of simulated calorie reductions were determined using non-overlapping confidence intervals of the means (97.5^th percentile confidence intervals were used to approximate p< 0.05).

Results: The %< EAR at baseline, and at 30 and 50% levels of calorie reduction for those 19+y were respectively as follows: protein: 3.7, 26.0, 72.2%; vitamin A: 47.5, 78.3, 95.0%; folate (DFE) 15.7, 46.8, 80.1%; vitamin B6: 13.9, 40.7, 70.5%; vitamin C: 52.8, 75.6, 90.9%; vitamin D: 96.7, 99.5, 100%; vitamin E: 81.1, 96.8, 99.8%; calcium: 44.6, 78.3, 95.9; iron: 5.1, 16.2, 39.3%; magnesium: 55.7, 91.4, 99.6%; and zinc: 18.3, 59.2, 92.5%. Similarly, the % >AI were respectively as follows: choline: 8.3, 0.3, 0.0%; potassium: 27.3, 1.9, 0.01%; and total fiber: 6.7, 0.5, 0.01%. In general, the inclusion of dietary supplements did not change the trends observed with intakes based on food only; also in general, analyses stratified by age groups showed similar results to that of the 19+ y age group.

Conclusions: In conclusion, calorie reduction may exacerbate nutrient inadequacies among adults with overweight or obesity, and thus, inclusion of nutrient-dense foods, fortified foods, specially formulated products, and/or dietary supplements should be considered for those undergoing chronic weight management.

Funding Sources: Abbott Laboratories