Download Estimated Intakes of Fats, Cholesterol, Fiber

Australian Journal of Basic and Applied Sciences, 5(12): 3171-3178, 2011
ISSN 1991-8178
Estimated Intakes of Fats, Cholesterol, Fiber, Sodium, Calcium, Potassium, and
Magnesium in Jordan
Ref’at A. Alkurd
Department of Nutrition, Faculty of Pharmacy and Medical Sciences, Petra University,
Amman, Jordan.
Abstract: This paper evaluates the estimated intakes of total fats and n-3, n-6, saturated and trans fatty
acids, in addition to cholesterol, dietary fiber, sodium, calcium, potassium and magnesium as
calculated from the most recent data of Jordanian Household Expenditures and Income Survey
(JHEIS) for the year 2006/2007. The estimated intakes of these food constituents were analyzed for
different governorates using a nutrition analysis software program. The results showed that the whole
country (Kingdom) mean of daily per capita intake of total fat was within the recommendations of the
AMDR, whereas, n-3 and n-6 fatty acids were 35% and 47% of the lower range of AMDR,
respectively. The Jordanian estimated consumption of saturated and polyunsaturated fatty acids were
in agreement with the recommendations of the American Heart Association (AHA), whereas, the
consumption of monounsaturated fatty acids was lower than these recommendations. There was a
variation in the estimated intake of these constituents among different governorates. The consumption
of cholesterol for the whole country and all governorates was within the recommendations of the AHA.
The ratio of polyunsaturated/saturated fatty acids for the whole country was 1.3/1 which is within the
recommended ratio (1-1.5/1). The dietary fiber consumption of the whole country was 24.4 g, whereas,
the consumption of the governorates ranged from 20.1 to 28.0 g. Expressed as g/1000 kcal, the dietary
fiber consumption for the whole country was 8 g/1000 kcal which is approximately 2/3 of the DRIs (14
g/1000 kcal). The sodium consumption was more than 5 times its AI, whereas the consumptions of
calcium, potassium and magnesium were lower than their DRIs. It is possible that high prevalence of
CVD among Jordanians is correlated partially with the high intakes of energy and sodium and the low
intake of dietary fiber, n-3 and n-6 fatty acids, calcium, potassium and magnesium. To aid reducing the
risk factors of CVD, the researcher recommends the increase the intake of dietary fibers, particularly
from fruits and vegetables, calcium, potassium and magnesium and the decrease in energy and sodium
intakes. Increased physical activity and weight reduction of the obese and overweight persons are also
recommended.
Key words: Fat, cholesterol, CVD, sodium, Jordan, JHEIS
INTRODUCTION
Cardiovascular disease (CVD) is a general term of all diseases of the heart and blood vessels.
Atherosclerosis is the main cause of CVD. Common examples of CVD include coronary heart disease (CHD),
stroke, hypertension, and myocardial infarction (Rolfes et al., 2009).
Jordan, like other middle-income countries, is attending an epidemiologic transition, which is characterized
by an increase of non-communicable diseases, particularly CVDs, cancer, diabetes, and chronic respiratory
cases (Ajlouni, 2010). The first leading cause of death in Jordan is related to CVD; around 38.2% of the deaths
are caused by this disease (Shishani, 2010). Percentage of deaths according to causes is 16% of ischemic heart
disease (the first cause of death in Jordan) and 6% of cerebrovascular disease (4th cause of death) according to
2002 census data (WHO, 2006). Hypertension, coronary heart disease, and stroke together with cancer are
responsible for more than half of all deaths (WHO, 2003). The Jordanian Ministry of Health reported a national
ratio of hypertension of 25.6% among those aged 18 years and above (MOH, 2007). The Utilization of Health
Services and Delivery Study showed that over 85% of hypertensives were either overweight or obese (Arbaji,
2002).
The pathogenesis of atherosclerosis is multifactorial (Singh et al., 2002). Various studies demonstrated a
definite association between types of dietary fats (triglycerides) and lipoproteins and elevated blood lipid levels,
especially cholesterol (Mensink and Katan, 1992). Diet is the first line of therapy for the management of plasma
lipids in the prevention and treatment of CVD. The goal of dietary therapy is to reduce elevated total cholesterol
and LDL-cholesterol concentrations and thereby reduce CVD morbidity and mortality (Yu-Poth et al., 1999).
Substitution of foods high in polyunsaturated fatty acids (PUFAs) for foods high in saturated fatty acids (SFAs)
and total dietary fat reduction has produced a lowering of blood cholesterol (Schlenker and Long, 2007).
Corresponding Author: Dr. Ref’at Ahmad Alkurd, Assistant Professor of Human Nutrition, Department of Nutrition,
Faculty of Pharmacy and Medical Sciences, Petra University, Amman, Jordan. P.O.Box: 961343.
Fax: +96265715570, E-mail: [email protected]
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The Adult Treatment Panel III (ATP III) suggests a comprehensive lifestyle approach to reduce the risk for
CHD called therapeutic lifestyle changes (TLC) and incorporates the following components: reduced intake of
SFAs and cholesterol, therapeutic dietary options for enhancing LDL lowering (plant stanols/sterols and
increased soluble fiber), weight reduction and increased regular physical activity (NIH, 2002).
The major LDL-raising nutrient component is SFAs in addition to cholesterol (AHA, 2002). The foundation
of the TLC Diet focuses on reducing SFAs (<7% of total energy intake) and cholesterol (<200 mg/day) (NIH,
2002). There is a "dose-response relationship" between SFAs and LDL cholesterol levels; for every 1% increase
in kcalories from SFAs as a percentage of total energy, serum LDL cholesterol increases by around 2%, and a
1% decrease in SFAs will lower serum cholesterol by around 2%. Although weight reduction by itself, even of a
few pounds, will reduce LDL cholesterol levels, weight reduction attained using a kcal-controlled diet low in
SFAs and cholesterol will improve and maintain LDL cholesterol lowering. Although dietary cholesterol does
not have the same influence as SFAs on serum LDL cholesterol levels, high cholesterol intakes raise LDL
cholesterol levels. Therefore reducing dietary cholesterol to <200 mg/day decreases serum LDL cholesterol in
most persons (Schlenker and Long, 2007).
The TLC Diet recommends substitution of MUFA for SFA at an intake level of up to 20% of total energy
intake (NIH, 2002) because MUFAs lower LDL cholesterol levels relative to SFAs without decreasing HDL
cholesterol or TG levels. Therefore, it has been recommended to use plant oils, particularly olive oil, and nuts
because they are the best sources of MUFAs (Schlenker and Long, 2007).
PUFAs, particularly linoleic acid, reduce LDL cholesterol levels when used instead of SFAs and can also
cause small reductions in HDL cholesterol as compared with MUFAs. The TLC Diet recommends the use of
liquid vegetable oils, semiliquid margarines and other margarines low in trans FAs because they are the best
sources of PUFAs. For this reason, the intakes of PUFAs can range up to 10% of total energy intake (NIH,
2002).
In view of the fact that only SFAs and trans FAs increase LDL cholesterol levels (NRC, 1989), serum
levels of LDL cholesterol are unrelated to total fat inake per se. For that reason, it is not crucial to limit total fat
intake for the specific goal of reducing LDL cholesterol levels, provided SFAs are decreased to goal levels
(AHA, 2002).
Controlling hypertension improves CVD risk considerably. Both lifestyle modifications and drug therapies
are used to treat hypertension. For people with prehypertension, changes in diet and lifestyle alone may lower
blood pressure to a normal level. The lifestyle modifications include weight reduction if overweight or obese; a
diet low in sodium and rich in calcium, potassium and magnesium; regular physical activity; and a moderate
alcohol intake (AHA, 2002; NRC, 1989). Combining two or more of these modifications can enhance results.
Weight reduction and dietary changes generally have the most dramatic effects on blood pressure (Rolfes et al.,
2009).
Several studies have confirmed positive effects of sodium reduction on blood pressure in both normotensive
and hypertensive individuals (He and MacGregor, 2002, 2004). Such data provide the basis for current dietary
guidelines for all Americans to limit salt intake to 6 g/day or sodium intake to 2.4 g/day, and for those with
hypertension to limit sodium intake to 1.5 g/day (Pimenta et al., 2009; USDHHS, 2005; Midgley et al., 1996).
Nutritional treatment of congestive heart failure implies a sodium restriction (Verbalis et al., 2007) to 2 g/day
and may be adjusted upwards to 3 g/day if necessary to promote dietary intake (Schlenker and Long, 2007).
The effect of potassium on blood pressure is still being actively investigated. Dietary potassium and blood
pressure are inversely related. High dietary potassium may help prevent and control hypertension (Whelton et
al., 1997). Investigators postulate that this effect occurs because potassium antagonizes the biological effect of
sodium (Dahl et al., 1972); potassium acts directly on the renal tubule to increase the urinary excretion of
sodium chloride. Blood pressure may be more related to sodium/potassium ratio than to the actual amount of
dietary sodium (IOM, 2005; Sacks, 1998).
Higher dairy calcium versus nondairy calcium has been associated with a lower incidence of stroke
(Ascherio et al., 1998). These findings suggest that the effects of calcium may differ, depending on the food
source, or alternatively that other constituents of dairy may be responsible for the observed associations.
Peptides derived from milk proteins, especially fermented milk products, have been shown to function as
angiotensin-converting enzymes, thereby lowering blood pressure (Seppo et al., 2003). A report recommends a
diet rich in fruits, vegetables, and low-fat dairy products over calcium supplementation for the prevention and
management of elvated blood pressure (Chobanian et al., 2003). An intake of dietary calcium to meet the goal of
1000-2000 mg/day is recommended (Sacks, 1998).
Magnisium is a potent inhibitor of vascular smooth-muscle contraction and may play a role in blood
pressure regulation as a vasodilator. Dietary magnesium was inversely related to blood pressure (Ascherio et al.,
1998). The Dietary Approach to Stop Hypertension (DASH) dietary pattern emphasizes foods rich in
magnesium including green leafy vegetables, nuts, and whole grain breads and cereals. Foods high in
magnesium are frequently high in potassium and dietary fiber (NIH, 2009). Overall food sources of magnesium
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rather than supplemental doses of the nutrient are encouraged to prevent or control hypertension (Chobanian et
al., 2003; Sacks, 1998; Matuura et al., 1987).
In this study, it was thought beneficial to estimate the intake of food components that are related to CVDs.
These components include fats and fatty acids, cholesterol, dietary fibers, sodium, calcium, potassium and
magnesium from the latest JHEIS data 2006/2007.
MATERIALS AND METHODS
Data in this paper were based on the Jordanian Household Expenditures and Income Survey (JHEIS)
2006/2007, which aimed at collecting detailed data on the household expenditures and income. The raw data
collection of this survey extended from July, 2006 to January, 2007 (DOS, 2008).
In the JHEIS survey, the annual per capita food consumption data of a representative sample of all
Jordanian households was calculated. The included 12768 households were proportionally distributed among the
different governorates of the whole country (Kingdom) using two-stage cluster stratified sampling method in
light of the housing census frame, 2004. A questionnaire was distributed to households included in the study.
The questionnaire contained data of the expenditure on different food and nonfood categories. Each category
included a number of food items. The data on food items was analyzed using a nutrition analysis software
program (Food Processor SQL nutrition and fitness software, 2008) which included details on the contents of
energy and nutrients for each food item. In case a food item that was not included in the database of the
mentioned program, the nutrient makeup of this food was obtained from other food analysis sources such as
Food Composition Tables for Use in the Middle East (Pellet and Shadarevian, 1970) and Food Composition
Tables of the Gulf Region (Musaiger, 2006). Such foods and their analyses were introduced to the Food
Processor database. Then the daily intakes of total fats, n-3 and n-6 fatty acids, saturated, monounsaturated,
polyunsaturated and trans fatty acids, cholesterol, dietary fibers, sodium, calcium, phosphorus and magnesium
were calculated, and the daily per capita intakes of these food components were obtained using the provided
household expenditure data for 6 months. Consumption values of these food components obtained for the
different governorates were compared with the highest DRI and other professional health recommendations to
assure that needs were met for all age groups (IOM, 2002/2005/2010).
RESULTS AND DISCUSSION
Table (1) shows the daily per capita estimated consumption of energy, fat, dietary fiber, and cholesterol in
the whole country and governorates as indicated in the JHEIS, 2006/2007. The whole country daily energy
consumption (kcal), total fat (g), dietary fiber (g) and cholesterol (mg) were 3031, 87.0, 24.0 and 203.8. In the
governorates they respectively ranged from 2710 in Tafila to 3328 in Madaba, 64.9 in Tafila to 112.9 in Ajloun,
20.1 in Tafila to 28.0 in Jarash and 154.1 in Balqa to 241.3 in Amman.
The DRI values for energy of low active individuals (Tables 2 and 3) are respectively 2680 and 2105 kcal
for the reference man and woman of the age 25 years. The whole country estimated energy consumption (3031
kcal) is 13% and 44% higher than the Estimated Energy Requirements (EER) of the reference man and woman,
respectively. It is important to notify that the highest recommendations were used for the comparison of
nutrients. On the other hand, the “low active level”, not the “very active level” was chosen for comparison of
energy for the purpose of having foods of high nutrient density rather than high energy foods, because enough
energy is needed to sustain a healthy and active life, but too much energy leads to overweight and obesity (IOM,
2005). As indicated by Takruri and his colleges in their study on the energy and macronutrient consumption of
Jordanians as obtained from the JHEIS 2008, the high energy consumption of Jordanians was due to the trend
for increased consumption of meat group, mainly chicken, and sugars (Takruri et al., 2011). The high
consumption of these foods is related to the increased risk of CVD. Except for infants, there are no DRIs (AIs)
for the total fat intake. The highest DRIs (AI, g/day) of dietary fiber are 38 and 26 for males and females of the
age 14-18 year, respectively. The whole country estimated consumption of dietary fiber (24 g/day) is lower than
these recommended AIs. It is well documented that the adequate intake of dietary fibers has many beneficial
physiological effects and protects against constipation, diverticular disease, CVD, colon cancer and diabetes
mellitus. It is also documented that increasing fiber intake lowers blood pressure and serum cholesterol levels
(Anderson et al., 2009).
Table (4) shows the daily per capita estimated intake of SFAs, MUFAs, PUFAs, trans, n-3, and n-6 fatty
acids in the whole country and governorates in Jordan. The consumptions (g/day) of SFAs, MUFAs, PUFAs,
and trans, n-3, and n-6, fatty acids were 21.0, 27.1, 27.0, 1.25, 0.68, and 7.6. In the governorates they
respectively ranged from 15.0 in Tafila to 26.3 in Irbid, 19.6 in Tafila to 38.2 in Ajloun, 18.5 in Aqaba to 37.6 in
Ajloun, 0.80 in Balqa to 1.97 in Ma’an, 0.57 in Ma'an to 0.86 in Ajloun, and 6.7 in Tafila to 9.2 in Irbid.
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Table 1: Daily per capita consumption of energy, fat, dietary fiber and cholesterol in the whole country and governorates in Jordan.
Governorate
Energy (kcal)
Total fat (g)
Dietary fiber (g)
Cholesterol (mg)
Amman
Balqa
Zarqa
Madaba
Irbid
Mafraq
Jarash
Ajloun
Karak
Tafilah
Ma’an
Aqaba
Whole country
2940
3079
2893
3328
3320
2876
3054
3245
3107
2710
3075
2750
3031
92.5
89.4
85.3
97.3
111.4
79.2
82.1
112.9
74.1
64.9
79.4
75.3
87.0
24.0
26.1
22.6
25.2
26.9
21.6
28.0
25.1
21.6
20.1
25.4
21.0
24.0
241.3
154.1
218.2
231.8
234.3
180.7
207.2
227.9
194.4
200.2
175.3
180.7
203.8
Table 2: New reference heights and weights for children and adults as indicated in the DRIs*.
Sex
Age, y
Median BMI (kg/m2)
Median reference height, cm
Male, Female
1–3
—
86
Male
Female
4–8
9–13
14–18
19–30
9–13
14–18
19–30
15.3
17.2
20.5
22.5
17.4
20.4
21.5
115
144
174
177
144
163
163
Reference weight, kg
12
20
36
61
70
37
54
57
* IOM, 2002
Table 3: The estimated energy requirements (EER) for different physical activity (PA) levels of 25-year reference male and female
according to the equations of the DRIs*.
PA level
EER (kcal/day)
Male
Female
Sedentary
2452
1899
Low active
2680
2105
Active
2970
2362
Very active
3445
2671
* Calculations of these figures are based on IOM, 2001.
Table 4: Daily per capita consumption of different fats in the whole country and governorates in Jordan.
Governorate
Daily intake of fat types (g)
SFA
MUFA
PUFA
Trans
Amman
22.7
28.1
28.5
0.91
Balqa
22.2
23.8
28.9
0.80
Zarqa
20.8
25.4
26.7
1.08
Madaba
21.3
28.2
33.7
1.13
Irbid
26.3
37.3
32.2
1.32
Mafraq
20.2
25.6
22.9
1.81
Jarash
21.9
23.4
23.2
1.03
Ajloun
25.0
38.2
37.6
1.89
Karak
16.8
22.7
25.0
1.16
Tafilah
15.0
19.6
20.3
0.95
Ma’an
18.0
27.1
23. 5
1.97
Aqaba
21.7
26.1
18.5
0.89
Whole country
21.0
27.1
27.0
1.25
n-3
0.77
0.59
0.65
0.75
0.84
0.59
0.67
0.86
0.66
0.60
0.57
0.61
0.68
n-6
7.8
6.8
6.9
8.2
9.2
7.4
7.7
8.9
7.7
6.7
7.3
7.0
7.6
Table (5) shows the % share from total estimated energy intake of total fats, SFAs, MUFAs, PUFAs, trans
fats, n-3 FAs and n-6 FAs in addition to dietary fiber intake (g/1000 kcal) and ratio of PUFA to SFA in the
whole country and governorates.
The % of total fats from total energy in the whole country and governorates was within the
recommendations of the Acceptable Macronutrient Distribution Range (AMDR) (Table 6). The SFAs as a % for
total energy of the whole country was 6.2 which lies within the recommendations of healthy individuals and the
TLC Diet. The whole country % of MUFAs from total calories was 8.0 which is less than the recommendations
(10-15%) in the whole country and most of the governorates. The main sources of MUFA in Jordan are olives
and olive oil, which are produced locally in good quantities. The annual production of olives was 140,719.1 tons
in the year 2009 (DOS, 2009). Concerning the % of PUFAs from the total energy, the consumption of the whole
country and most of the governorates was within the recommendations (≤10%). Therefore, to have a healthier
diet, it is advisable to substitute some of the consumed vegetable oils by olive oil; this practice will increase the
% and amount of MUFA consumed in the Jordanian diet. The per capita consumption (g/day) of olive oil (7.5)
comes in the third degree after soybean (14.1) and corn (8.4) oils. It was estimated in the years 2007-2009 that
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the total per capita vegetable oil consumption was 43.2 g/day (DOS, 2009). The % of the trans FAs in the
whole country was relatively low (<1%) which is healthy and in agreement with the American Heart
Association (AHA) recommendations (Lichtenstein, et al., 2006) (Table 7). The percentages of n-3 (0.2%) and
n-6 (2.3%) FAs in the whole country were lower than their recommendations. To increase the consumption of n3 FAs it is advisable to substitute some of the consumed chicken by fatty fishes such as herring, mackerel,
salmon and tuna; this practice will also decrease the consumed amounts of total fat, SFA and cholesterol. The
intake of dietary fibers in the whole country (7.9 g/1000 kcal) was approximately half the recommendations of
14 g/1000 kcal. The ratios of PUFA/SFA (1.3/1) were within their recommendations (1-1.5/1) in the whole
country and most of the governorates.
Table 5: The percentage share of fats out of total energy intake (TEE), dietary fiber intake (g/1000 kcal) and PUFA/SFA ratio in whole
country and governorates in Jordan.
Governorate
fats % share of TEE
Dietary
fiber PUFA/S
g/1000 kcal
FA
Total
SFA
MUFA
PUFA
Trans
n-3
n-6
Amman
Balqa
Zarqa
Madaba
Irbid
Mafraq
Jarash
Ajloun
Karak
Tafilah
Ma’an
Aqaba
Whole country
28.3
25.9
26.4
26.2
30.0
24.7
24.0
31.0
21.4
21.5
23.1
24.6
25.6
6.9
6.4
6.4
5.7
7.1
6.3
6.4
6.9
4.9
5.0
5.2
7.1
6.2
8.6
6.9
7.9
7.6
10.1
8.0
6.8
10.5
6.6
6.5
7.9
8.5
8.0
8.7
8.4
8.3
9.1
8.7
7.2
6.8
10.4
7.2
6.7
6.8
6.0
7.9
0.3
0.2
0.3
0.3
0.4
0.6
0.3
0.5
0.3
0.3
0.6
0.3
0.4
0.24
0.17
0.20
0.20
0.23
0.18
0.20
0.24
0.19
0.20
0.17
0.20
0.20
2.4
2.0
2.1
2.2
2.5
2.3
2.3
2.5
2.2
2.2
2.1
2.3
2.3
8.2
8.5
7.8
7.6
8.1
7.5
9.2
7.7
7.0
7.4
8.3
7.6
7.9
1.3/1
1.3/1
1.3/1
1.6/1
1.2/1
1.1/1
1.1/1
1.5/1
1.5/1
1.4/1
1.3/1
0.9/1
1.3/1
Table 6: Acceptable Macronutrient Distribution Range (AMDR) for >19 years old as a percent of total energy intake*.
Energy-yielding nutrient
AMDR
Carbohydrate
45-65%
Fat
20-35%
n-3 fatty acids
0.6-1.2%
n-6 fatty acids
5.0-10 %
Protein
10-35%
* Institute of Medicine (IOM), 2002/2005
Table 7: American Heart Association 2006 diet recommendations for CVD risk reduction*.
1.
Balance calorie intake and physical activity to achieve or maintain a healthy body weight.
2.
Consume a diet rich in vegetables and fruits.
3.
Choose whole grain, high-fiber foods.
4.
Consume fish, especially oily fish, at least twice a week.
5.
Limit intake of saturated fat to <7% of energy, trans-fat to <I % of energy, and cholesterol to <300 mg/day by:
Choosing lean meats and vegetable alternatives.
Selecting fat-free (skim), 1% -fat, and low-fat dairy products.
Minimizing intake of partially hydrogenated fats.
6.
Minimize your intake of beverages and foods with added sugars.
7.
Choose and prepare foods with little or no salt.
8.
When consuming alcohol, do so in moderation.
9.
When eating food that is prepared outside of the home, follow the American Heart Association Diet and Lifestyle Recommendations.
*Modified from Lichtenstein AH et al: Diet and lifestyle recommendations revision 2006: a scientific statement from the American
Heart Association Committee, Circulation 114:83, 2006.
The whole country estimated consumptions, as % of the total energy intake, were healthy for total fat, SFA,
PUFA and trans FA and the ratio of PUFA/SFA; whereas the percentages of MUFA and n-3 and n-6 FAs were
unhealthy as they are lower than their recommendations. The consumption of dietary fiber, g/1000 kcal, was
also less than the recommendations. The estimated total energy consumption of the whole country was higher
than the EER assigned in the DRIs recommendations. According to these results of energy, fat and fiber intake
and for the purpose of decreasing the risks of CVD, it is advisable to increase the daily consumption of MUFA,
especially from olive oil, to not less than 10% of the total energy intake and to decrease the total energy and the
PUFA intakes. It is also advisable to increase the daily intake of fibers from its natural food sources such as
fruits, vegetables and whole grains and legumes.
Table (8) shows the per capita estimated consumption (mg/day) of sodium, calcium, potassium, and
magnesium in the whole country and governorates. The whole country consumption (mg/day) was 7623, 829,
3130, and 302 for sodium, calcium, potassium, and magnesium, respectively. The estimated intakes of these
nutrients ranged respectively from 4747 in Karak to 10877 in Balqa, 654 in Tafilah to 949 in Irbid, 2624 in
Aqaba to 3672 in Irbid and 257 in Tafilah to 359 in Irbid.
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Table 8: Daily per capita intake (mg) of some hypertension-related minerals in the whole country and governorates in Jordan.
Governorate
Sodium
Calcium
Potassium
Magnesium
Amman
7062
873
3188
307
Balqa
10877
909
3058
297
Zarqa
6767
824
3018
295
Madaba
8896
917
3522
341
Irbid
9155
949
3672
359
Mafraq
6556
753
2740
267
Jarash
8537
916
3522
327
Ajloun
9600
919
3574
332
Karak
4747
688
2776
282
Tafilah
6281
654
2812
257
Ma’an
7232
793
3049
286
Aqaba
5762
747
2624
274
Whole country
7623
829
3130
302
The whole country estimated intakes of sodium, calcium, potassium, and magnesium, as a % of the DRIs
were 508%, 82.9%, 66.8%, and 94.4% (compared to males, 31-50 years) and 71.9% (compared to females, 3150 years), respectively. The DRIs of these minerals are presented in Table 9. These results indicate that there
was very high intake of sodium, while the intakes of calcium, potassium and magnesium were mildly to
moderately low. Takruri et al., (2011) found that the whole country consumption of fruits and vegetables was
lower than the recommendations; if fruits and vegetables are consumed in sufficient amounts, this will increase
the consumed amounts of dietary fiber (mg/1000 kcal) and potassium. The consumption of good quantities of
green leafy vegetables, nuts, and whole grain breads and cereals ensures a sufficient intake of magnesium. They
also found that Jordanians were consuming very limited servings of milk group (0.6 serving per capita/day)
which is the main dietary source of calcium.
Table 9: DRI’s of some minerals and n-3 and n-6 fatty acids.
Nutrient
Calcium (mg), RDA
Phosphorus (mg), RDA
Potassium (mg), AI
Sodium (mg), AI
Magnesium, RDA
n-3 fatty acids (g), AI
n-6 fatty acids (g), AI
Institute of Medicine (IOM), 1997/2005/2010
DRI (19-30, 31-50 years)
Males
1000
700
4700
1500
310-320
1.3
17
Females
1000
700
4700
1500
400-420
1.1
12
Conclusion:
It might be concluded that dietary factors contribute to the causation of high prevalence of CVD, including
hypertension. In Jordan, the low intakes of MUFAs, n-3 and n-6 FAs, dietary fibers, calcium, potassium,
magnesium and high consumption of energy and sodium. Also, the good dietary factors are the healthy intakes
of cholesterol, total fats, SFAs, PUFAs, trans FAs and PUFA/SFA ratio.
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