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Title: Mixed dishes are a top contributor to phylloquinone intake in U.S. adults: data from the 2011-2012 NHANES

Author
item HARSHMAN, STEPHANIE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item FINNAN, EMILY - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item BARGAR, KATHRYN - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item BAILEY, REGAN - Purdue University
item Haytowitz, David
item GILHOOLY, CHERYL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item BOOTH, SARAH - Jean Mayer Human Nutrition Research Center On Aging At Tufts University

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/20/2017
Publication Date: 5/31/2017
Citation: Harshman, S.G., Finnan, E.G., Bargar, K.J., Bailey, R.L., Haytowitz, D.B., Gilhooly, C.H., Booth, S.L. 2017. Mixed dishes are a top contributor to phylloquinone intake in U.S. adults: Data from the 2011-2012 NHANES. Journal of Nutrition. doi: 10.3945/jn.117.248179.

Interpretive Summary: Phylloquinone is the most abundant form of vitamin K in U.S. diets. Green vegetables are rich sources of phylloquinone and are considered the predominant dietary source. As our food supply diversifies and expands, the food groups that contribute to phylloquinone intake are also changing, which may change absolute intakes. Vegetable oils are moderate to high phylloquinone sources. Certain oils used in mixed dishes may then be prevalent sources of phylloquinone in the U.S. diet. Thus, it is important to identify the contributors to dietary vitamin K estimates to guide recommendations on intakes and food sources. The purpose of this study was to estimate: (1) the amount of phylloquinone consumed in the diet of U.S. adults; (2) the contribution of different food groups to phylloquinone intake in individuals with high or low vegetable intake (= 2 cups, < 2 cups vegetables/day); and (3) to characterize the contribution of different mixed dishes to phylloquinone intake. Usual phylloquinone intake was determined from NHANES 2011-2012 (= 20 y; 2092 men and 2214 women) and the National Cancer Institute Method utilizing a complex, stratified, multistage probability cluster sampling design. On average, 43.0% of men and 62.5% of women met the AI (120 and 90 µg/day, respectively) for phylloquinone, with declines noted among men compared to estimated intakes in 1998-2004, especially in the older age groups. Vegetables were the highest contributor to phylloquinone intake, contributing 60.0% in the high vegetable intake group and 36.1% in the low vegetable intake group. Mixed dishes were the second highest contributor to phylloquinone intake contributing 16.0% in the high vegetable intake group and 28.0% in the low vegetable intake group (all p<0.001 between high and low vegetable intake groups). Mixed dishes are an unrecognized, but significant contributor to phylloquinone intake in the United States. Despite this, self-reported phylloquinone intakes appear to be declining among men but increasing among women over the last two decades. Additional research is required to further quantitate other vitamin K forms in the U.S. food supply, and to identify all dietary sources of vitamin K to better define current recommendations.

Technical Abstract: Phylloquinone is the most abundant form of vitamin K in U.S. diets. Green vegetables are rich sources of phylloquinone and are considered the predominant dietary source. As our food supply diversifies and expands, the food groups that contribute to phylloquinone intake are also changing, which may change absolute intakes. Vegetable oils are moderate to high phylloquinone sources. Certain oils used in mixed dishes may then be prevalent sources of phylloquinone in the U.S. diet. Thus, it is important to identify the contributors to dietary vitamin K estimates to guide recommendations on intakes and food sources. The purpose of this study was to estimate: (1) the amount of phylloquinone consumed in the diet of U.S. adults; (2) the contribution of different food groups to phylloquinone intake in individuals with high or low vegetable intake (= 2 cups, < 2 cups vegetables/day); and (3) to characterize the contribution of different mixed dishes to phylloquinone intake. Usual phylloquinone intake was determined from NHANES 2011-2012 (= 20 y; 2092 men and 2214 women) and the National Cancer Institute Method utilizing a complex, stratified, multistage probability cluster sampling design. On average, 43.0% of men and 62.5% of women met the AI (120 and 90 µg/day, respectively) for phylloquinone, with declines noted among men compared to estimated intakes in 1998-2004, especially in the older age groups. Vegetables were the highest contributor to phylloquinone intake, contributing 60.0% in the high vegetable intake group and 36.1% in the low vegetable intake group. Mixed dishes were the second highest contributor to phylloquinone intake contributing 16.0% in the high vegetable intake group and 28.0% in the low vegetable intake group (all p<0.001 between high and low vegetable intake groups). Mixed dishes are an unrecognized, but significant contributor to phylloquinone intake in the United States. Despite this, self-reported phylloquinone intakes appear to be declining among men but increasing among women over the last two decades. Additional research is required to further quantitate other vitamin K forms in the U.S. food supply, and to identify all dietary sources of vitamin K to better define current recommendations.