title: Micronutrient Intake among Children in Puerto Rico: Dietary and Multivitamin-Multimineral Supplement Sources.
abstract: BACKGROUND
  Micronutrients are critical for healthy growth and development of children. Micronutrient intake from dietary sources is inadequate among some children and may be improved by use of multivitamin and multimineral (MVMM) supplements.
  
  
  OBJECTIVE
  To assess micronutrient intake from dietary and MVMM supplement sources among 12-year-old children in Puerto Rico.
  
  
  METHODS
  A representative sample of 732 children enrolled in an oral health study in Puerto Rico, who completed dietary and MVMM assessments through one 24-h recall, were included in this analysis. Micronutrient intake sources were described and compared to the Dietary Reference Intakes (DRIs) using the Estimated Average Requirement when available (used Adequate Intake for vitamin K and pantothenic acid). Micronutrient profiles of MVMM users and non-users were compared using t-tests.
  
  
  RESULTS
  Mean intakes of vitamins A, D, E, and K, pantothenic acid, calcium, and magnesium from food and beverage sources were below the DRIs. From food and beverage sources, MVMM users had higher intakes of riboflavin and folate compared to non-users (p < 0.05). When MVMM supplements were taken into account, users had higher intakes of all nutrients except vitamin K. With the help of MVMM, users increased intake of vitamins E, A, D, and pantothenic acid to IOM-recommended levels but calcium, magnesium, and vitamin K remained below guidelines.
  
  
  CONCLUSIONS
  Micronutrient intake from diet was below the IOM-recommended levels in the total sample. MVMM use improved intake of selected micronutrients and facilitated meeting recommendations for some nutrients. Public health measures to improve micronutrient intake among children in Puerto Rico are needed.
authors.affiliation: 1 Nutrition Program, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, Puerto Rico.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lopez-Cepero
authors.affiliation: 1 Nutrition Program, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, Puerto Rico.
authors.forename: Roxana
authors.initials: R
authors.lastname: Torres
authors.affiliation: 2 School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, Puerto Rico.
authors.forename: Augusto
authors.initials: A
authors.lastname: Elias
authors.affiliation: 3 Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Milagros C
authors.initials: MC
authors.lastname: Rosal
authors.affiliation: 1 Nutrition Program, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, Puerto Rico.
authors.forename: Cristina
authors.initials: C
authors.lastname: Palacios
keywords: Children; Hispanics; Puerto Rico; dietary supplements; micronutrient intake