Second National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population

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1 Second National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population Second National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2012 National Ce nter for Environmental Health Division of Laboratory Sciences

2 TABLE OF CONTENTS Introduction ... 1 ... 2 Background 3 ... Addressing Data Needs ... 3 Public Health Uses ... 4 Data Presented for Biochemical Indicators ... 5 Interpreting the Data ... 6 Sources of Information on Nutrition Monitoring to Help Interpret the Data ... 7 The National Health and Nutrition Examination Survey (NHANES) 7 ... Data Analysis ... 10 References ... 13 1 Water-Soluble Vitamins ... 14 B Vitamins and Related Biochemical Compounds 14 ... Background Information ... 18 Highlights Figure H.1.a Age-adjusted geometric mean concentrations of serum folate in the U.S. population aged 4 years and older by gender or race/ethnicity, NHANES 1988–2006 ... 19 Figure H.1.b Age-adjusted geometric mean concentrations of RBC folate in the U.S. population aged 4 years and older by gender or race/ethnicity, NHANES 1988–2006 ... 19 Figure H.1.c Age-adjusted geometric mean concentrations of serum vitamin B12 in the U.S. population aged 4 years and older by gender or race/ethnicity, NHANES 1991–2006 ... 20 Figure H.1.d Prevalence estimates of low serum vitamin B12, high plasma methylmalonic acid, and high plasma total homocysteine concentrations in U.S. persons 60 years and older, NHANES 2003–2006 ... 20 Detailed Observations ... 20 Table 1.1.a.1 Serum folate: Concentrations ... 22 Figure 1.1.a Serum folate: Concentrations by age group ... 23 Tables 1.1.a.2–5 ... 24 Serum folate: Concentrations by race/ethnic group Serum folate: Concentrations by survey cycle ... 26 Table 1.1.b Serum folate: Concentrations by survey cycle 27 ... Figure 1.1.b ... 28 Table 1.2.a.1 Red blood cell folate: Concentrations Red blood cell folate: Concentrations by age group Figure 1.2.a 29 ... Tables 1.2.a.2–5 Red blood cell folate: Concentrations by race/ethnic group ... 30 Table 1.2.b ... 32 Red blood cell folate: Concentrations by survey cycle Figure 1.2.b Red blood cell folate: Concentrations by survey cycle ... 33 Table 1.2.c Red blood cell folate: Prevalence (< 95 ng/mL) ... 34 Table 1.2.d ... 35 Red blood cell folate: Prevalence by survey cycle (< 95 ng/mL) ... Table 1.3.a.1 36 Serum pyridoxal-5’-phosphate: Concentrations Figure 1.3.a Serum pyridoxal-5’-phosphate: Concentrations by age group ... 37 Tables 1.3.a.2–5 Serum pyridoxal-5’-phosphate: Concentrations by race/ethnic group ... 38 Table 1.3.c Serum pyridoxal-5’-phosphate: Prevalence (< 20 nmol/L) ... 40 Table 1.4.a.1 Serum 4-pyridoxic acid: Concentrations ... 42 Figure 1.4.a. Serum 4-pyridoxic acid: Concentrations by age group ... 43 ... 44 Tables 1.4.a.2–5 Serum 4-pyridoxic acid: Concentrations by race/ethnic group Table of Contents i

3 Table 1.5.a.1 ... 46 Serum vitamin B12: Concentrations Serum vitamin B12: Concentrations by age group ... 47 Figure 1.5.a Serum vitamin B12: Concentrations by race/ethnic group ... 48 Tables 1.5.a.2–5 Serum vitamin B12: Concentrations by survey cycle ... 50 Table 1.5.b Serum vitamin B12: Concentrations by survey cycle 51 Figure 1.5.b ... ... 52 Table 1.5.c Serum vitamin B12: Prevalence (< 200 pg/mL) Serum vitamin B12: Prevalence by survey cycle (< 200 pg/mL) ... Table 1.5.d 53 Table 1.6.a.1 Plasma total homocysteine: Concentrations ... 54 ... 55 Figure 1.6.a Plasma total homocysteine: Concentrations by age group Plasma total homocysteine: Concentrations by race/ethnic group ... 56 Tables 1.6.a.2–5 Table 1.6.b ... 58 Plasma total homocysteine: Concentrations by survey cycle Figure 1.6.b Plasma total homocysteine: Concentrations by survey cycle ... 59 Table 1.6.c Plasma total homocysteine: Prevalence (> 13 μmol/L) ... 60 Table 1.6.d ... 61 Plasma total homocysteine: Prevalence by survey cycle (> 13 μmol/L) ... 62 Table 1.7.a.1 Plasma methylmalonic acid: Concentrations Plasma methylmalonic acid: Concentrations by age group ... 63 Figure 1.7.a Tables 1.7.a.2–5 ... 64 Plasma methylmalonic acid: Concentrations by race/ethnic group Table 1.7.b Plasma methylmalonic acid: Concentrations by survey cycle ... 66 Figure 1.7.b Plasma methylmalonic acid: Concentrations by survey cycle ... 67 Table 1.7.c ... 68 Plasma methylmalonic acid: Prevalence (> 271 nmol/L) Table 1.7.d Plasma methylmalonic acid: Prevalence by survey cycle (> 271 nmol/L) ... 69 References ... 70 ... 72 Vitamin C 72 ... Background Information ... 74 Highlights Figure H.1.e Age-adjusted prevalence estimates of vitamin C deficiency in the U.S. population aged 6 years and older by race/ethnicity or gender, NHANES 2003–2006 ... 74 Prevalence estimates of vitamin C deficiency and of low vitamin C Figure H.1.f concentrations in the U.S. population aged 6 years and older 74 ... by age group, NHANES 2003–2006 Detailed Observations ... 75 Serum vitamin C: Concentrations Table 1.8.a.1 ... 76 Serum vitamin C: Concentrations by age group ... 77 Figure 1.8.a Serum vitamin C: Concentrations by race/ethnic group ... 78 Tables 1.8.a.2–5 Serum vitamin C: Concentrations by survey cycle ... 80 Table 1.8.b ... 81 Figure 1.8.b Serum vitamin C: Concentrations by survey cycle Serum vitamin C: Prevalence (< 11.4 μmol/L) ... 82 Table 1.8.c Serum vitamin C: Prevalence by survey cycle (< 11.4 μmol/L) ... 83 Table 1.8.d References 84 ... ... 87 2 Fat-Soluble Vitamins and Nutrients 88 ... Vitamins A and E and Carotenoids ... 88 Background Information ... 91 Highlights Age-adjusted geometric mean concentrations of serum vitamin E Figure H.2.a in the U.S. population aged 6 years and older by gender or race/ethnicity, ... 92 NHANES 1988–2006 ... Detailed Observations 92 Table 2.1.a.1 Serum vitamin A: Concentrations ... 94 Serum vitamin A: Concentrations by age group ... 95 Figure 2.1.a Tables 2.1.a.2–5 Serum vitamin A: Concentrations by race/ethnic group ... 96 Table 2.1.b ... 98 Serum vitamin A: Concentrations by survey cycle Figure 2.1.b Serum vitamin A: Concentrations by survey cycle ... 99 Table 2.1.c.1 Serum vitamin A: Prevalence (< 20 μg/dL) ... 100 Table 2.1.c.2 Serum vitamin A: Prevalence (> 100 μg/dL) ... 101 102 Serum vitamin A: Prevalence by survey cycle (< 20 μg/dL) ... Table 2.1.d.1 Serum vitamin A: Prevalence by survey cycle (> 100 μg/dL) 103 ... Table 2.1.d.2 nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population ii

4 Table 2.2.a.1 ... 104 Serum retinyl palmitate: Concentrations Serum retinyl palmitate: Concentrations by age group ... 105 Figure 2.2.a Serum retinyl palmitate: Concentrations by race/ethnic group Tables 2.2.a.2–5 ... 106 Serum retinyl palmitate: Concentrations by survey cycle ... 108 Table 2.2.b Serum retinyl palmitate: Concentrations by survey cycle ... Figure 2.2.b 109 ... 110 Table 2.3.a.1 Serum retinyl stearate: Concentrations Serum retinyl stearate: Concentrations by race/ethnic group ... 112 Tables 2.3.a.2–5 Serum retinyl stearate: Concentrations by survey cycle ... 114 Table 2.3.b Serum retinyl stearate: Concentrations by survey cycle ... 115 Figure 2.3.b Serum vitamin E: Concentrations ... 116 Table 2.4.a.1 ... 117 Figure 2.4.a Serum vitamin E: Concentrations by age group Serum vitamin E: Concentrations by race/ethnic group ... 118 Tables 2.4.a.2–5 Table 2.4.b ... 120 Serum vitamin E: Concentrations by survey cycle ... Figure 2.4.b 121 Serum vitamin E: Concentrations by survey cycle Table 2.4.c Serum vitamin E: Prevalence (< 500 μg/dL) ... 122 Table 2.4.d Serum vitamin E: Prevalence by survey cycle (< 500 μg/dL) ... 123 Table 2.5.a.1 gamma -tocopherol: Concentrations ... 124 Serum gamma -tocopherol: Concentrations by age group ... 125 Figure 2.5.a Serum Serum gamma -tocopherol: Concentrations by race/ethnic group ... 126 Tables 2.5.a.2–5 Table 2.5.b gamma -tocopherol: Concentrations by survey cycle ... 128 Serum Figure 2.5.b Serum gamma -tocopherol: Concentrations by survey cycle ... 129 Table 2.6.a.1 Serum alpha -carotene: Concentrations ... 130 Figure 2.6.a alpha -carotene: Concentrations by age group ... 131 Serum Tables 2.6.a.2–5 Serum alpha -carotene: Concentrations by race/ethnic group ... 132 Table 2.6.b Serum alpha -carotene: Concentrations by survey cycle ... 134 Figure 2.6.b Serum alpha -carotene: Concentrations by survey cycle ... 135 Table 2.7.a.1 Serum trans-beta -carotene: Concentrations ... 136 -carotene: Concentrations by age group Figure 2.7.a Serum trans-beta ... 137 Tables 2.7.a.2–5 trans-beta -carotene: Concentrations by race/ethnic group ... 138 Serum Serum -carotene: Concentrations by survey cycle ... 140 Table 2.7.b trans-beta Serum -carotene: Concentrations by survey cycle ... 141 trans-beta Figure 2.7.b Serum cis-beta -carotene: Concentrations Table 2.8.a.1 142 ... Serum cis-beta -carotene: Concentrations by race/ethnic group ... 144 Tables 2.8.a.2–5 Serum cis-beta -carotene: Concentrations by survey cycle ... 146 Table 2.8.b Figure 2.8.b cis-beta -carotene: Concentrations by survey cycle ... 147 Serum beta -cryptoxanthin: Concentrations ... 148 Table 2.9.a.1 Serum Serum beta -cryptoxanthin: Concentrations by age group ... 149 Figure 2.9.a Tables 2.9.a.2–5 beta -cryptoxanthin: Concentrations by race/ethnic group ... 150 Serum Table 2.9.b Serum beta -cryptoxanthin: Concentrations by survey cycle ... 152 Figure 2.9.b Serum beta -cryptoxanthin: Concentrations by survey cycle ... 153 Table 2.10.a.1 ... 154 Serum lutein/zeaxanthin: Concentrations Serum lutein/zeaxanthin: Concentrations by age group ... 155 Figure 2.10.a ... 156 Tables 2.10.a.2–5 Serum lutein/zeaxanthin: Concentrations by race/ethnic group Serum lutein/zeaxanthin: Concentrations by survey cycle ... Table 2.10.b 158 Figure 2.10.b Serum lutein/zeaxanthin: Concentrations by survey cycle ... 159 Figure 2.11.a.1 Serum trans -lycopene: Concentrations ... 160 Figure 2.11.a Serum trans -lycopene: Concentrations by age group ... 161 Tables 2.11.a.2–5 trans -lycopene: Concentrations by race/ethnic group ... 162 Serum Table 2.11.b Serum trans -lycopene: Concentrations by survey cycle ... 164 Figure 2.11.b Serum trans -lycopene: Concentrations by survey cycle ... 165 Table 2.12.a.1 Serum total lycopene: Concentrations ... 166 Figure 2.12.a Serum total lycopene: Concentrations by age group ... 167 Tables 2.12.a.2–5 Serum total lycopene: Concentrations by race/ethnic group ... 168 ... 170 References Table of Contents iii

5 Vitamin D ... 172 ... 172 Background Information ... 175 Highlights Figure H.2.b Age-adjusted geometric mean concentrations of serum 25-hydroxyvitamin D in the U.S. population aged 12 years and older by gender or race/ethnicity, NHANES 1988–2006 ... 175 Figure H.2.c Age-adjusted prevalence estimates of serum 25-hydroxyvitamin D concentrations < 30 and 30 to < 50 nmol/L in the U.S. population ... 176 aged 1 year and older by race/ethnicity, NHANES 2003–2006 Figure H.2.d Age- adjusted prevalence estimates of serum 25-hydroxyvitamin D concentrations < 40 nmol/L in the U.S. population aged 1 years ... and older by race/ethnicity, NHANES 2003–2006 176 ... 177 Detailed Observations Table 2.13.a.1 Serum 25-hydroxyvitamin D: Concentrations ... 178 Serum 25-hydroxyvitamin D: Concentrations by age group Figure 2.13.a ... 179 Serum 25-hydroxyvitamin D: Concentrations by race/ethnic group ... 180 Tables 2.13.a.2–5 Serum 25-hydroxyvitamin D: Concentrations by survey cycle Table 2.13.b ... 182 Figure 2.13.b Serum 25-hydroxyvitamin D: Concentrations by survey cycle ... 183 Serum 25-hydroxyvitamin D: Prevalence (< 30 nmol/L) 184 Table 2.13.c.1 ... Serum 25-hydroxyvitamin D: Prevalence (30 to < 50 nmol/L) 185 ... Table 2.13.c.2 Serum 25-hydroxyvitamin D: Prevalence (< 40 nmol/L) ... 186 Table 2.13.c.3 Serum 25-hydroxyvitamin D: Prevalence (> 125 nmol/L) ... 187 Table 2.13.c.4 ... Table 2.13.d.1 188 Serum 25-hydroxyvitamin D: Prevalence by survey cycle (< 30 nmol/L) .. 189 Table 2.13.d.2 Serum 25-hydroxyvitamin D: Prevalence by survey cycle (30 to < 50 nmol/L) Serum 25-hydroxyvitamin D: Prevalence by survey cycle (< 40 nmol/L) ... 190 Table 2.13.d.3 Serum 25-hydroxyvitamin D: Prevalence by survey cycle (> 125 nmol/L) ... 191 Table 2.13.d.4 References ... 192 193 ... Fatty Acids ... 193 Background Information 196 ... Highlights Geometric mean concentrations of plasma fatty acids in the Figure H.2.e U.S. population from fasted adults 20 years and older, 197 ... NHANES 2003–2004 Figure H.2.f Geometric mean concentrations of plasma eicosapentaenoic acid in the U.S. population from fasted adults 20 years and ... older by race/ethnicity, NHANES 2003–2004 198 Geometric mean concentrations of plasma docosahexaenoic Figure H.2.g acid in the U.S. population from fasted adults 20 years and older by race/ethnicity, NHANES 2003–2004 ... 198 Detailed Observations 198 ... Table 2.14.a.1 Plasma myristic acid (14:0): Concentrations ... 200 ... 201 Figure 2.14.a Plasma myristic acid (14:0): Concentrations by age group Plasma myristic acid (14:0): Concentrations by race/ethnic group Tables 2.14.a.2–5 ... 202 Table 2.15.a.1 Plasma palmitic acid (16:0): Concentrations ... 204 Figure 2.15.a Plasma palmitic acid (16:0): Concentrations by age group ... 205 Tables 2.15.a.2–5 ... 206 Plasma palmitic acid (16:0): Concentrations by race/ethnic group ... 208 Table 2.16.a.1 Plasma stearic acid (18:0): Concentrations Plasma stearic acid (18:0): Concentrations by age group Figure 2.16.a 209 ... Tables 2.16.a.2–5 Plasma stearic acid (18:0): Concentrations by race/ethnic group ... 210 Table 2.17.a.1 Plasma arachidic acid (20:0): Concentrations ... 212 Figure 2.17.a ... 213 Plasma arachidic acid (20:0): Concentrations by age group Tables 2.17.a.2–5 Plasma arachidic acid (20:0): Concentrations by race/ethnic group ... 214 Table 2.18.a.1 Plasma docosanoic acid (22:0): Concentrations ... 216 Figure 2.18.a Plasma docosanoic acid (22:0): Concentrations by age group ... 217 ... Plasma docosanoic acid (22:0): Concentrations by race/ethnic group 218 Tables 2.18.a.2–5 nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population iv

6 Table 2.19.a.1 ... 220 Plasma lignoceric acid (24:0): Concentrations Plasma lignoceric acid (24:0): Concentrations by age group Figure 2.19.a 221 ... Tables 2.19.a.2–5 ... Plasma lignoceric acid (24:0): Concentrations by race/ethnic group 222 224 Plasma myristoleic acid (14:1n-5): Concentrations Table 2.20.a.1 ... Figure 2.20.a ... 225 Plasma myristoleic acid (14:1n-5): Concentrations by age group Plasma myristoleic acid (14:1n-5): Concentrations by race/ethnic group ... 226 Tables 2.20.a.2–5 Plasma palmitoleic acid (16:1n-7): Concentrations Table 2.21.a.1 228 ... ... 229 Figure 2.21.a Plasma palmitoleic acid (16:1n-7): Concentrations by age group Plasma palmitoleic acid (16:1n-7): Concentrations by race/ethnic group ... 230 Tables 2.21.a.2–5 Plasma cis -vaccenic acid (18:1n-7): Concentrations ... Table 2.22.a.1 232 Plasma cis -vaccenic acid (18:1n-7): Concentrations by age group ... 233 Figure 2.22.a Plasma cis -vaccenic acid (18:1n-7): Concentrations by race/ethnic group 234 ... Tables 2.22.a.2–5 Table 2.23.a.1 Plasma oleic acid (18:1n-9): Concentrations ... 236 Plasma oleic acid (18:1n-9): Concentrations by age group ... 237 Figure 2.23.a Plasma oleic acid (18:1n-9): Concentrations by race/ethnic group ... 238 Tables 2.23.a.2–5 Plasma eicosenoic acid (20:1n-9): Concentrations ... 240 Table 2.24.a.1 Plasma eicosenoic acid (20:1n-9): Concentrations by age group ... 241 Figure 2.24.a ... 242 Tables 2.24.a.2–5 Plasma eicosenoic acid (20:1n-9): Concentrations by race/ethnic group Plasma docosenoic acid (22:1n-9): Concentrations Table 2.25.a.1 ... 244 Figure 2.25.a Plasma docosenoic acid (22:1n-9): Concentrations by age group ... 245 ... 246 Tables 2.25.a.2–5 Plasma docosenoic acid (22:1n-9): Concentrations by race/ethnic group Plasma nervonic acid (24:1n-9): Concentrations ... 248 Table 2.26.a.1 Figure 2.26.a ... 249 Plasma nervonic acid (24:1n-9): Concentrations by age group Tables 2.26.a.2–5 Plasma nervonic acid (24:1n-9): Concentrations by race/ethnic group ... 250 Table 2.27.a.1 Plasma linoleic acid (18:2n-6): Concentrations ... 252 Figure 2.27.a Plasma linoleic acid (18:2n-6): Concentrations by age group ... 253 Tables 2.27.a.2–5 ... 254 Plasma linoleic acid (18:2n-6): Concentrations by race/ethnic group Plasma -linolenic acid (18:3n-3): Concentrations ... 256 Table 2.28.a.1 alpha Plasma ... -linolenic acid (18:3n-3): Concentrations by age group 257 Figure 2.28.a alpha alpha -linolenic acid (18:3n-3): Concentrations by race/ethnic group ... 258 Tables 2.28.a.2–5 Plasma Plasma gamma -linolenic acid (18:3n-6): Concentrations ... 260 Table 2.29.a.1 Plasma gamma -linolenic acid (18:3n-6): Concentrations by age group ... 261 Figure 2.29.a gamma -linolenic acid (18:3n-6): Concentrations by race/ethnic group .. 262 Tables 2.29.a.2–5 Plasma Plasma eicosadienoic acid (20:2n-6): Concentrations ... 264 Table 2.30.a.1 Figure 2.30.a ... 265 Plasma eicosadienoic acid (20:2n-6): Concentrations by age group Tables 2.30.a.2–5 Plasma eicosadienoic acid (20:2n-6): Concentrations by race/ethnic group ... 266 Table 2.31.a.1 Plasma homo-gamma -linolenic acid (20:3n-6): Concentrations ... 268 Figure 2.31.a homo-gamma -linolenic acid (20:3n-6): Concentrations by age group ... 269 Plasma homo-gamma -linolenic acid (20:3n-6): Concentrations by race/ethnic Tables 2.31.a.2–5 Plasma ... 270 group Plasma arachidonic acid (20:4n-6): Concentrations ... 272 Table 2.32.a.1 Figure 2.32.a Plasma arachidonic acid (20:4n-6): Concentrations by age group ... 273 Tables 2.32.a.2–5 Plasma arachidonic acid (20:4n-6): Concentrations by race/ethnic group ... 274 Table 2.33.a.1 ... 276 Plasma eicosapentaenoic acid (20:5n-3): Concentrations Figure 2.33.a Plasma eicosapentaenoic acid (20:5n-3): Concentrations by age group ... 277 Tables 2.33.a.2–5 Plasma eicosapentaenoic acid (20:5n-3): Concentrations by race/ethnic group .. 278 Table 2.34.a.1 Plasma docosatetraenoic acid (22:4n-6): Concentrations ... 280 281 Plasma docosatetraenoic acid (22:4n-6): Concentrations by age group ... Figure 2.34.a 282 .. Tables 2.34.a.2–5 Plasma docosatetraenoic acid (22:4n-6): Concentrations by race/ethnic group Table of Contents v

7 Table 2.35.a.1 ... 284 Plasma docosapentaenoic-3 acid (22:5n-3): Concentrations Plasma docosapentaenoic-3 acid (22:5n-3): Concentrations by age group Figure 2.35.a 285 ... Plasma docosapentaenoic-3 acid (22:5n-3): Concentrations by race/ethnic Tables 2.35.a.2–5 group ... 286 ... 288 Table 2.36.a.1 Plasma docosapentaenoic-6 acid (22:5n-6): Concentrations ... 289 Plasma docosapentaenoic-6 acid (22:5n-6): Concentrations by age group Figure 2.36.a Tables 2.36.a.2–5 Plasma docosapentaenoic-6 acid (22:5n-6): Concentrations by race/ethnic ... group 290 ... 292 Table 2.37.a.1 Plasma docosahexaenoic acid (22:6n-3): Concentrations Plasma docosahexaenoic acid (22:6n-3): Concentrations by age group ... 293 Figure 2.37.a Tables 2.37.a.2–5 Plasma docosahexaenoic acid (22:6n-3): Concentrations by race/ethnic ... group 294 ... 296 References ... 299 3 Trace Elements ... 300 Iron-Status Indicators ... 300 Background Information ... 303 Highlights Age-adjusted prevalence estimates of low body iron in Figure H.3.a 303 U.S. children and women by race/ethnicity, NHANES 2003–2006 ... Figure H.3.b Prevalence estimates of low serum ferritin, high serum soluble transferrin receptor, and low serum body iron in U.S. women ... 303 12–49 years of age, NHANES 2003–2006 Age-adjusted prevalence estimates of low and high serum ferritin Figure H.3.c in U.S. men and women aged12–49 years, NHANES 1999–2006 ... 304 Figure H.3.d Age-adjusted geometric mean concentrations of serum ferritin in U.S. women aged 12–49 years by race/ethnicity, NHANES 1988–2006 ... 305 305 Detailed Observations ... Serum ferritin: Concentrations ... 308 Table 3.1.a.1 Serum ferritin: Concentrations by age group ... 309 Figure 3.1.a Tables 3.1.a.2–5 Serum ferritin: Concentrations by race/ethnic group ... 310 Table 3.1.b Serum ferritin: Concentrations by survey cycle ... 312 Figure 3.1.b Serum ferritin: Concentrations by survey cycle ... 313 Table 3.1.c.1 ... 314 Serum ferritin: Prevalence (< 12 ng/mL for children) Serum ferritin: Prevalence (< 15 ng/mL for women) ... 315 Table 3.1.c.2 Serum ferritin: Prevalence (> 150 ng/mL for women) ... 316 Table 3.1.c.3 Serum ferritin: Prevalence by survey cycle (< 12 ng/mL for children) ... Table 3.1.d.1 317 Serum ferritin: Prevalence by survey cycle (< 15 ng/mL for women) ... 318 Table 3.1.d.2 Serum ferritin: Prevalence by survey cycle (< 15 ng/mL for males) Table 3.1.d.3 319 ... Table 3.1.d.4 Serum ferritin: Prevalence by survey cycle (> 150 ng/mL for women) ... 320 ... 321 Table 3.1.d.5 Serum ferritin: Prevalence by survey cycle (> 200 ng/mL for males) Serum soluble transferrin receptor: Concentrations Table 3.2.a.1 322 ... Figure 3.2.a Serum soluble transferrin receptor: Concentrations by age group ... 323 Tables 3.2.a.2–5 Serum soluble transferrin receptor: Concentrations by race/ethnic group ... 324 Table 3.2.b ... 326 Serum soluble transferrin receptor: Concentrations by survey cycle ... 327 Figure 3.2.b Serum soluble transferrin receptor: Concentrations by survey cycle Serum soluble transferrin receptor: Prevalence (> 4.4 mg/L for women) Table 3.2.c 328 ... Table 3.2.d Serum soluble transferrin receptor: Prevalence by survey cycle (> 4.4 mg/L for women) ... 329 Table 3.3.a.1 Body iron: Concentrations ... 330 Figure 3.3.a ... 331 Body iron: Concentrations by age group Tables 3.3.a.2–5 Body iron: Concentrations by race/ethnic group ... 332 Table 3.3.b Body iron: Concentrations by survey cycle ... 334 Figure 3.3.b Body iron: Concentrations by survey cycle ... 335 336 Body iron: Prevalence (< 0 mg/kg for children) ... Table 3.3.c.1 Body iron: Prevalence (< 0 mg/kg for women) 337 ... Table 3.3.c.2 nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population vi

8 Table 3.3.d.1 ... 338 Body iron: Prevalence by survey cycle (< 0 mg/kg for children) Body iron: Prevalence by survey cycle (< 0 mg/kg for women) Table 3.3.d.2 339 ... 340 References ... ... 342 Iodine 342 ... Background Information ... 344 Highlights Median concentrations of urinary iodine in the U.S. population Figure H.3.e ... 344 aged 6 years and older by age group and gender, NHANES 2001–2006 Age-adjusted geometric mean concentrations of urinary iodine Figure H.3.f in the U.S. population aged 6 years and older by gender or 345 race/ethnicity, NHANES 1988–2006 ... ... 345 Detailed Observations Table 3.4.a.1 Urinary iodine: Concentrations ... 346 Urinary iodine: Concentrations by age group Figure 3.4.a ... 347 Urinary iodine: Concentrations by race/ethnic group ... 348 Tables 3.4.a.2–5 Urinary iodine: Concentrations by survey cycle 350 ... Table 3.4.b Figure 3.4.b Urinary iodine: Concentrations by survey cycle ... 351 Urinary iodine (crea corr)*: Concentrations ... 352 Table 3.5.a.1 Urinary iodine (crea corr): Concentrations by age group ... 353 Figure 3.5.a Urinary iodine (crea corr): Concentrations by race/ethnic group ... Tables 3.5.a.2–5 354 Urinary iodine (crea corr): Concentrations by survey cycle ... 356 Table 3.5.b Urinary iodine (crea corr): Concentrations by survey cycle ... Figure 3.5.b 357 References ... 358 361 ... 4 Isoflavones and Lignans ... 362 Background Information ... 364 Highlights Figure H.4.a Geometric mean concentrations of urinary isoflavones and lignans ... in the U.S. population aged 6 years and older, NHANES 2003–2006 365 Detailed Observations ... 365 Table 4.1.a.1 Urinary genistein: Concentrations ... 366 Figure 4.1.a Urinary genistein: Concentrations by age group ... 367 Table 4.1.a.2–5 ... 368 Urinary genistein: Concentrations by race/ethnic group Urinary genistein: Concentrations by survey cycle ... 370 Table 4.1.b Urinary genistein: Concentrations by survey cycle ... 371 Figure 4.1.b Urinary genistein (crea corr): Concentrations ... Table 4.2.a.1 372 Urinary genistein (crea corr): Concentrations by age group ... 373 Figure 4.2.a Urinary genistein (crea corr): Concentrations by race/ethnic group ... 374 Tables 4.2.a.2–5 Table 4.2.b ... 376 Urinary genistein (crea corr): Concentrations by survey cycle ... 377 Figure 4.2.b Urinary genistein (crea corr): Concentrations by survey cycle Urinary daidzein: Concentrations ... 378 Table 4.3.a.1 Figure 4.3.a ... 379 Urinary daidzein: Concentrations by age group Tables 4.3.a.2–5 Urinary daidzein: Concentrations by race/ethnic group ... 380 Table 4.3.b Urinary daidzein: Concentrations by survey cycle ... 382 Figure 4.3.b ... 383 Urinary daidzein: Concentrations by survey cycle ... 384 Table 4.4.a.1 Urinary daidzein (crea corr): Concentrations Urinary daidzein (crea corr): Concentrations by age group ... 385 Figure 4.4.a Tables 4.4.a.2–5 ... 386 Urinary daidzein (crea corr): Concentrations by race/ethnic group Table 4.4.b Urinary daidzein (crea corr): Concentrations by survey cycle ... 388 Figure 4.4.b Urinary daidzein (crea corr): Concentrations by survey cycle ... 389 Table 4.5.a.1 ... 390 Urinary equol: Concentrations Figure 4.5.a Urinary equol: Concentrations by age group ... 391 Tables 4.5.a.2–5 Urinary equol: Concentrations by race/ethnic group ... 392 Table 4.5.b Urinary equol: Concentrations by survey cycle ... 394 395 ... Figure 4.5.b Urinary equol: Concentrations by survey cycle Table of Contents vii

9 Table 4.6.a.1 ... 396 Urinary equol (crea corr): Concentrations Urinary equol (crea corr): Concentrations by age group ... 397 Figure 4.6.a Urinary equol (crea corr): Concentrations by race/ethnic group 398 Tables 4.6.a.2–5 ... Urinary equol (crea corr): Concentrations by survey cycle ... 400 Table 4.6.b Urinary equol (crea corr): Concentrations by survey cycle ... 401 Figure 4.6.b ... 402 Table 4.7.a.1 Urinary ODMA**: Concentrations Urinary ODMA: Concentrations by age group Figure 4.7.a 403 ... Tables 4.7.a.2–5 Urinary ODMA: Concentrations by race/ethnic group ... 404 ... 406 Table 4.7.b Urinary ODMA: Concentrations by survey cycle Urinary ODMA: Concentrations by survey cycle ... 407 Figure 4.7.b Table 4.8.a.1 ... 408 Urinary ODMA (crea corr): Concentrations Figure 4.8.a Urinary ODMA (crea corr): Concentrations by age group ... 409 Tables 4.8.a.2–5 Urinary ODMA (crea corr): Concentrations by race/ethnic group ... 410 Table 4.8.b ... 412 Urinary ODMA (crea corr): Concentrations by survey cycle Urinary ODMA (crea corr): Concentrations by survey cycle 413 Figure 4.8.b ... ... 414 Table 4.9.a.1 Urinary enterodiol: Concentrations Urinary enterodiol: Concentrations by age group Figure 4.9.a 415 ... Tables 4.9.a.2–5 Urinary enterodiol: Concentrations by race/ethnic group ... 416 Urinary enterodiol: Concentrations by survey cycle ... 418 Table 4.9.b Figure 4.9.b Urinary enterodiol: Concentrations by survey cycle ... 419 Table 4.10.a.1 ... 420 Urinary enterodiol (crea corr): Concentrations Figure 4.10.a Urinary enterodiol (crea corr): Concentrations by age group ... 421 Tables 4.10.a.2–5 Urinary enterodiol (crea corr): Concentrations by race/ethnic group ... 422 Table 4.10.b Urinary enterodiol (crea corr): Concentrations by survey cycle ... 424 Figure 4.10.b Urinary enterodiol (crea corr): Concentrations by survey cycle ... 425 Table 4.11.a.1 Urinary enterolactone: Concentrations ... 426 Figure 4.11.a ... 427 Urinary enterolactone: Concentrations by age group Urinary enterolactone: Concentrations by race/ethnic group ... 428 Tables 4.11.a.2–5 Urinary enterolactone: Concentrations by survey cycle ... 430 Table 4.11.b Urinary enterolactone: Concentrations by survey cycle ... 431 Figure 4.11.b Urinary enterolactone (crea corr): Concentrations ... 432 Table 4.12.a.1 ... 433 Figure 4.12.a Urinary enterolactone (crea corr): Concentrations by age group Urinary enterolactone (crea corr): Concentrations by race/ethnic group Tables 4.12.a.2–5 ... 434 Table 4.12.b Urinary enterolactone (crea corr): Concentrations by survey cycle ... 436 ... 437 Figure 4.12.b Urinary enterolactone (crea corr): Concentrations by survey cycle ... 438 References ... 443 5 Acrylamide Hemoglobin Adducts ... 444 Background Information ... 445 Highlights Figure H.5.a Geometric mean glycidamide-to-acrylamide hemoglobin adduct ratio in the U.S. population aged 3 years and older, NHANES 2003–2004 446 ... ... Detailed Observations 446 A ... 448 Table 5.1.a.1 crylamide hemoglobin adduct: Concentrations Figure 5.1.a crylamide hemoglobin adduct: Concentrations by age group ... 449 A Tables 5.1.a.2–5 A crylamide hemoglobin adduct: Concentrations by race/ethnic group ... 450 Table 5.2.a.1 G lycidamide hemoglobin adduct: Concentrations ... 452 Figure 5.2.a lycidamide hemoglobin adduct: Concentrations by age group ... 453 G Tables 5.2.a.2–5 G lycidamide hemoglobin adduct: Concentrations by race/ethnic group ... 454 Table 5.3.a.1 G lycidamide-to-acrylamide hemoglobin adduct ratio: Concentrations ... 456 Figure 5.3.a G lycidamide-to-acrylamide hemoglobin adduct ratio: Concentrations by age group ... 457 Tables 5.3.a.2–5 G lycidamide-to-acrylamide hemoglobin adduct ratio: Concentrations ... 458 by race/ethnic group nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population viii

10 References ... 461 Appendices ... 465 466 ... Appendix A: NHANES Reports Related to Nutritional Status ... 468 Appendix B: Information Presented in the Report ... 470 Appendix C: Cutoff Values Used to Generate Prevalence Estimates ... 471 Appendix D: References for Analytical Methods for Biochemical Indicators 473 ... Appendix E: Confidence Interval Estimation for Percentiles 478 ... Appendix F: Limit of Detection Table Appendix G: Selected References of Descriptive NHANES Papers on ... 480 Diet-and-Nutrition Biochemical Indicators * crea corr, creatinine corrected ** ODMA, O-desmethylangolensin Table of Contents ix

11 nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population x

12 Introduction Background • • Addressing Data Needs • Public Health Uses • Data Presented for Each Biochemical Indicator • Interpreting the Data • Useful Sources of Information about Using Nutrition Monitoring to Interpret Data • The National Health and Nutrition Examination Survey (NHANES) • Data Analysis • References Introduction 1

13 Introduction Background The National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population is a series of publications that provide ongoing assessment of the U.S. population’s nutritional status by measuring blood or urine concentrations of diet-and-nutrition biochemical indicators. The Centers for Disease Control and Prevention’s (CDC) Division of Laboratory Sciences at the National Center for Environmental Health (NCEH/DLS) conducted the laboratory analyses for 58 biochemical indicators presented in this 2012 report, which is the second in this series. CDC measured these indicators in specimens from a representative sample of the U.S. population during all or part of the four-year period from 2003 through 2006. Where available, data are also presented on changes of biochemical indicator concentrations over time since 1999. Similarly, data are also presented on the prevalence of low or high biochemical indicator concentrations during 2003–2006, and on changes in the prevalence over time since 1999. The first report of this series was published in July 2008 and contains information on 27 biochemical indicators from all or part of the four-year period from 1999 through 2002. Both reports can be accessed online: http://www.cdc.gov/nutritionreport. Characteristic First report, 2008 Second report, 2012 Years of NHANES covered 1999–2002 2003–2006 58 Number of indicators covered 27 Concentrations by race/ethnic group Ye s Ye s Central 95% reference intervals No Ye s Graphic representation of age patterns No Ye s Concentrations over time No Yes (1999-2006) No Ye s Prevalence estimates Prevalence estimates over time No Yes (1999-2006) CDC’s National Health and Nutrition Examination Survey (NHANES), conducted by the National Center for Health Statistics (NCHS), collected the specimens for this report. NHANES is a series of surveys designed to collect data on the health and nutritional status of the U.S. population. This report covers biochemical measurements—one important facet in the assessment of the U.S. population’s nutritional status. Other nutrition-related aspects from NHANES, such as dietary intake, supplement usage, hematologic measurements, and anthropometric body measurements are not covered. In this report, a biochemical indicator means a nutrient (e.g., vitamin, fatty acid, trace element), a metabolite (e.g., homocysteine, methylmalonic acid), or a dietary indicator with potential health relevance (e.g., isoflavone, lignan) measured in blood or urine. Although most biochemical indicators presented in this report enter the human body from foods or supplements, the body itself produces some indicators in response to dietary intake or environmental exposure. Blood and urine concentrations reflect the amount of nutrients and dietary compounds actually in the body or passing through the body from all these sources. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2

14 The biochemical indicator sections and new biochemical indicators covered in this report are: Biochemical indicator sections New biochemical indicators Water-soluble vitamins Vitamin B6 • • Fat-soluble vitamins and nutrients • • Vitamin C • Trace elements (iron indicators and iodine) • Fatty acids • Isoflavones and lignans • Iron status: Transferrin receptor and body iron • • Acrylamide hemoglobin adducts Acrylamide hemoglobin adducts Addressing Data Needs This report is the second CDC product containing reference information on NCEH/DLS measurement data for a wide range of biochemical indicators of diet and nutrition from the most recent continuous NHANES survey, starting in 1999. In this comprehensive report, information on changes in concentrations of a large number of biochemical indicators during 1999–2006 is presented for the first time. Prevalence information on low or high biochemical indicator concentrations is also presented for the first time. NCHS has historically released or commissioned a variety of products presenting NHANES results. Among these are Data Briefs, Data Tables, Advance Data, Series Reports, and Reports through the Life Sciences Research Office (LSRO). NHANES Series Reports (mainly Series 11) and LSRO Reports from surveys prior to the continuous NHANES have been of particular value to the nutrition community (see ). The NHANES Web site provides current Appendix A information on results and products from this survey: http://www.cdc.gov/nchs/about/major/ nhanes/survey_results_and_products.htm. Public Health Uses This report’s primary objective is to inform public health scientists and policy makers about the concentrations of biochemical indicators of diet and nutrition in the general U.S. population and in selected subpopulations. These data will help physicians, scientists, and public health offcials assess inadequate or excess intake and will inform analyses on the relation between biochemical indicators and health outcomes. Other objectives and potential public health uses of the information include • Establishing and improving on existing population reference levels that can be used to determine whether an individual or a group has an unusually high or low concentration of a diet-and-nutrition biochemical indicator. • Determining whether the nutritional status of special population groups, such as minorities, children, women of childbearing age, or the elderly, is different from that of other groups, or whether such nutritional status needs improvement. • Tracking trends over time in the population’s biochemical indicator concentrations. • Assessing the effectiveness of public health efforts to improve the diet and nutritional status of the U.S. population. Guide research to perform more in-depth analyses of the NHANES data and to • generate hypotheses for future nutrition and human health studies. Introduction 3

15 Data Presented for Each Biochemical Indicator This report contains tables and figures of descriptive statistics on the distribution of blood and urine concentrations during all or part of the four-year period from 2003 through 2006 for each diet-and-nutrition biochemical indicator. Statistics include unadjusted geometric means and selected percentiles with confidence intervals. For some biochemical indicators, additional information is included, as available, in the form of Tables and figures describing biochemical indicator concentrations across survey cycles • during all or part of the eight-year period from 1999 through 2006. Statistics include unadjusted geometric means and selected percentiles with confidence intervals. • Tables describing the prevalence of low or high concentrations of selected biochemical indicators during all or part of the four-year period from 2003 through 2006 and tables describing the prevalence across survey cycles during all or part of the eight-year period from 1999 through 2006. Statistics include unadjusted percentages with confidence intervals and estimated total number of persons affected. See for an overview of the type of information presented for each biochemical Appendix B indicator. The data are grouped by age, gender, and race/ethnicity. The majority of the biochemical indicators reviewed in this report, with the exception of vitamin C and body iron, have a long upper tail (skewed right). For these biochemical indicators, a geometric mean provides a better estimate of central tendency because it is less influenced by high values than is the arithmetic mean. However, the arithmetic mean is presented for vitamin C and body iron as the distributions for these biochemical indicators were reasonably symmetric. Scientists can use the presented percentile levels to determine those serum, blood, or urine indicator concentrations common to people in the U.S. population and those that are unusual. Frequently, the central th th to 97.5 percentile) is used to describe normal concentrations in 95% reference interval (2.5 a population. Concentrations outside the reference interval are considered unusual. For urine measurements, data are shown for both the concentration and for the concentration corrected for the urinary creatinine level. We present the following information for each biochemical indicator during all or part of 2003– 2006: th th , so called –97.5 A table that presents the geometric mean and selected percentile (2.5 • central 95% reference interval) concentrations by age, gender, or race/ethnicity (1-level stratified). • A figure that presents the geometric mean concentrations by age and gender or by age and race/ethnicity (2-level stratified). th th , or 10 • Four detailed tables that present the geometric mean and selected percentile (5 th th th , 90 or 95 ) concentrations by age, gender, and race/ethnicity (3-level stratified). 50 The first table is for the overall U.S. population stratified by age and gender, while the next three tables present data for each racial/ethnic group (Mexican American, non- Hispanic black, and non-Hispanic white) stratified by age and gender. If data are available for multiple two-year survey cycles from 1999–2006, we present tables with th th ) concentrations by age, gender, or race/ethnicity –95 geometric mean and selected percentile (5 for each available two-year survey cycle, as well as corresponding figures for selected percentiles (1-level stratified). nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 4

16 For biochemical indicators that have accepted cutoff values for low or high concentrations or for both (e.g., folate, vitamins A, B6, B12, C, D, E, ferritin, iodine)—suggesting deficiency or excess of certain micronutrients—we present tables with prevalence estimates by age, gender, or race/ethnicity during all or part of 2003–2006 (1-level stratified). We also present tables with prevalence estimates by age, gender, or race/ethnicity for each available two-year survey cycle from 1999–2006 to allow evaluation of changes in prevalence estimates over time (1-level stratified). See Appendix C for a complete listing of the cutoff values and populations described in this report. Background text provides general information for each indicator to aid with interpreting the data. To address sources of these nutrients, biochemical pathways in the body, and known health effects, the text contains a brief overview about each indicator. Each chapter contains highlights followed by detailed observations that are derived from this report’s data tables and figures. The highlights are presented directly after the background text. They summarize important observations and discuss them in a public health context. For example, we present figures highlighting prevalence information by demographic subgroups. Where long-term trending information beyond the continuous NHANES is available and of public health interest, we present figures showing changes in biochemical indicator concentrations from NHANES III (1988–1994) to NHANES 1999–2002 and NHANES 2003–2006. The detailed observations describe selected categorical differences between demographic subgroups derived from the data tables and figures that follow next. Each chapter is concluded by a list of pertinent references. Interpreting the Data Blood or urine concentrations of biochemical indicators can help in assessing the adequacy of intake for the U.S. population. These measurements indicate cumulative intakes from foods, some fortified with micronutrients (e.g., iron, thiamin, riboflavin, niacin, folate, vitamin A, vitamin D), and from dietary supplements that contain vitamins, minerals, or both. However, blood or urine concentrations of biochemical indicators can also be influenced by factors other than diet, such as various diseases or exposures. For those nutrients without defined adequate intakes (e.g., carotenoids, isoflavones), biochemical indicators are useful for assessing intake without regard to adequacy. Dietary deficiencies are well documented, and they have characteristic signs and symptoms. In addition, recent findings have determined that less than optimal biochemical concentrations (representing suboptimal status) have been associated with risks of adverse health effects. These health effects include cardiovascular disease, stroke, impaired cognitive function, cancer, eye diseases, poor bone health, and other conditions. Adverse health effects, including toxicity, are also possible from consuming excess amounts of certain nutrients and data to assist in the assessment of excessive intake is a feature of this report. Determining the concentrations of a biochemical indicator that may indicate risk for disease and the concentrations that are of negligible health concern requires future research studies that are separate from this report. In collaboration with other agencies and institutions, CDC encourages, and itself conducts research on the relationship between biochemical indicators and health effects. Introduction 5

17 This report contains unadjusted geometric means, selected percentiles, and prevalence estimates of low or high concentrations of diet-and-nutrition biochemical indicators for the civilian, noninstitutionalized U.S. population. A limited interpretation of relative differences between population groups is possible by identifying groups with nonoverlapping confidence intervals. However, one should be careful about interpreting the observed differences as causal. The intent is to describe the characteristics of the population and of selected subgroups, not to explain why the groups display certain characteristics or why they differ from each other. Furthermore, differences in biochemical indicator concentrations of selected subgroups do not necessarily imply health status problems. And for several reasons, one should use caution when drawing temporal conclusions from comparisons of serial cross-sectional NHANES survey cycles. One of these reasons is that different or improved methods of measurement may be employed across the NHANES survey cycles. Another reason is that there are demographic changes to the U.S. population over time. Finally, sampling differences could explain some of the observed changes from one cycle to the next. More in-depth statistical analyses, such as developing models to adjust simultaneously for many covariates and taking into consideration interactions between two or more variables, are beyond the scope of this report. Nonetheless, unadjusted geometric means, selected percentiles, and prevalence estimates provided in this report are useful to summarize reference information for blood or urine concentrations of diet-and-nutrition biochemical indicators for the civilian, noninstitutionalized population in the United States and selected subgroups. We hope that the report will stimulate scientists to examine the data further through analyzing the raw data available at: http://www.cdc.gov/nchs/nhanes.htm. Laboratories may use different methods for measuring the indicators reported here. However, different methods may result in different method-specific reference intervals. Consequently, to apply these results, health science professionals should check with their particular laboratory to be ). sure that their methods compare closely to those used in this report (see Appendix D Sources of Information on Nutrition Monitoring to Help Interpret the Data Information about dietary intake is critical to research examining the reasons for nutritional inadequacies. Such information is also critical to programs seeking to improve diet and nutritional status. Selected NCHS Advance Data Reports provide useful overviews (see Appendix A ). Also of value are the U.S. Department of Agriculture’s (USDA) databases on food surveys and food composition: What We Eat in America (WWEIA) is the dietary intake interview section of NHANES ( http:// www.ars.usda.gov/foodsurvey). The Food and Nutrient Database for Dietary Studies (FNDDS) (http://www.ars.usda.gov/ Services/docs.htm?docid=12089) is a database of foods, their nutrient values, and weights for typical food portions. This database is used to generate data for the WWEIA survey through application of the nutrient values from the National Nutrient Database for Standard Reference (http://www.ars.usda.gov/Services/docs.htm?docid=8964). nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 6

18 The National Health and Nutrition Examination Survey (NHANES) CDC laboratory scientists used biological specimens obtained from NHANES participants to measure biochemical indicators of diet and nutrition for this publication. NHANES is a series of NCHS-conducted surveys designed to collect data on the health and nutritional status of the U.S. population. This is the only national survey that collects biological samples. The NHANES surveys began in 1960 with the first Health Examination Survey (HES 1). The nutritional component was added in the early 1970s in NHANES I. In 1999, NHANES became a continuous survey, sampling the U.S. population annually and releasing the data in two-year cycles. NHANES collects information on a wide range of health-related behaviors, conducts physical examinations, and collects samples for laboratory tests. Because of physical examination and biological measures, NHANES is unique in its ability to examine public health issues in the U.S. population, such as risk factors for cardiovascular disease. To select a representative sample of the civilian, noninstitutionalized population in the United States, the survey sampling plan follows a complex, stratified, multistage, probability-cluster design. The civilian, noninstitutionalized population consists of persons who are neither in the military nor institutionalized (e.g., they are not residents of nursing homes, college dormitories, or prisons). The NHANES protocol includes a home interview followed by a standardized physical examination at a mobile examination center. As part of the examination, for participants aged 1 year and older, blood is obtained by venipuncture. Urine specimens are collected from participants aged 6 years and older. By design, approximately half of the participants are evaluated after an overnight fast; for the other half of the participants, there is approximately an equal distribution between those who fasted less than 3 hours and those who fasted between 3 and 8 hours before providing a biological sample. Because weather can adversely affect the mobile examination centers, data are collected in northern latitudes in summer and in southern latitudes in winter. This seasonal-latitude structure might indirectly affect biochemical indicators. Additional detailed information about the design and conduct of the NHANES survey is available at http://www.cdc.gov/nchs/nhanes.htm. Information about how biological specimens are collected is available at (http://www.cdc.gov/nchs/data/nhanes/blood.pdf ) and included in the Laboratory Procedures Manual at http://www.cdc.gov/nchs/data/nhanes/lab1-6.pdf and at http:// www.cdc.gov/nchs/data/nhanes/lab7-11.pdf . Data Analysis NCHS has developed a comprehensive Web-based tutorial (http://www.cdc.gov/nchs/tutorials/ Nhanes/index.htm) to help users better understand the complex survey design and to help them analyze NHANES data. Because the NHANES sample design is a complex, multistage probability sample, officials use sample weights when estimating the mean or other descriptive metrics. These weights are post-stratified to the U.S. Census Bureau estimates of the U.S. population to adjust for the unequal probability of selection into the survey and possible bias resulting from nonresponse. Demographic data files released by NCHS for each NHANES two-year survey cycle include a two-year interview weight and a medical examination weight. All estimates in this report use the appropriate medical examination weight. The selected medical examination weight depends on whether the specimens tested constitute a random subsample of all the eligible participants and how many survey cycles are combined to produce the estimate. Introduction 7

19 Combining data over multiple survey cycles can produce estimates with increased statistical reliability. In cases of combined estimates, new weights were constructed. For example, a four-year estimate for the years 2003–2006 was based on a four-year weight, which was created by assigning half the two-year weight for 2003–2004 or half the two-year weight for 2005–2006, depending when the person was sampled. Results are shown for the total population and by age group, gender, and race/ethnicity, as defined in NHANES. For these analyses, race/ethnicity is presented as Mexican American, non-Hispanic black, and non-Hispanic white. Other racial or ethnic groups are sampled, but the proportion of the total population represented by these other groups is not large enough to produce valid estimates. Thus, this report does not include separate estimates for other racial subcategories. The other racial/ethnic groups, however, are included in the overall estimates. Data were analyzed by use of the statistical software package Statistical Analysis System (SAS, Version 9.2) and SUDAAN (Release 10.0). SUDAAN uses sample weights and calculates variance estimates that account for the complex survey design. Guidelines for the analysis of NHANES data are provided by NCHS at: http://www.cdc.gov/nchs/nhanes/nhanes2003-2004/analytical_ guidelines.htm. Standard error estimates were calculated by use of the Taylor series (linearization) method within SUDAAN. The degrees of freedom for variance estimation are generated by subtracting the number of strata from the number of primary sampling units (PSUs). Geometric means were calculated by taking the log of each concentration, calculating the mean of those log values, then taking the antilog of that mean (the calculation can be done by use of any log base, such as 10 or e). The confidence interval uses the standard error and mean on the log scale and the appropriate critical value from the t-distribution to calculate upper and lower confidence limits on the log scale. The confidence intervals of geometric means in this report are based on taking the antilog of those upper and lower confidence intervals. Percentile estimates were calculated by use of linear interpolation. Confidence intervals for . This method uses the standard error percentiles were calculated by the Woodruff method (1952) of the empirical distribution function at the selected percentile and constructs a 95% confidence interval, followed by back-transforming by use of the inverse of the empirical distribution (see for more details). We used the unweighted sample size and assumed an average Appendix E design effect of 1.4 as the criteria to estimate percentiles of sufficient precision (U.S. Centers for ; Table 1 in Appendix B). In order for percentiles to be Disease for Control and Prevention 1996 th and considered reliable, at least 112 persons had to be represented to allow estimation of the 10 th th th th percentiles, 224 persons for the 5 and percentiles, and 448 persons for the 2.5 and 95 90 th percentiles. We flagged and footnoted percentiles where these requirements were not met. 97.5 Prevalence estimates for low or high concentrations of biochemical indicators are the weighted Appendix C ). The percentage of persons who fall below or above a predefined cutoff value (see confidence intervals for prevalence estimates are based on a logit transformation that ensures the confidence interval limits cannot fall outside of 0 and 1. We used the relative standard error (RSE) as a criterion for prevalence estimates of sufficient precision. The RSE is calculated as a percentage by dividing the standard error of the estimate by the estimate value and multiplying by 100. Prevalence estimates associated with a RSE between 30% and less than 40% are flagged and footnoted in this report. Estimates are not provided if they are associated with an RSE equal to or greater than 40%. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 8

20 Estimates of the total number of persons who met the definition of having low or high concentrations of biochemical indicators were generated by multiplying the weighted prevalence estimate by the population size of interest, derived from the current population survey (CPS) at the midpoint of the available two-year cycle. Confidence intervals for the estimated total, while not presented, are calculated by multiplying the population size of interest by the upper and lower limits of the 95% confidence interval for the weighted prevalence. CPS-based population tables for NHANES by age, gender, and race/ethnicity are on the NHANES Web page for a given survey cycle, available at http://www.cdc.gov/nchs/nhanes/response_rates_CPS.htm. When estimates of the total count are based on combined survey cycles (2003–2006), the 2003–2004 CPS-based population table at the above link was used. Figures in the highlight section that present age-adjusted geometric mean concentrations from NHANES III (1988–1994), NHANES 1999–2002, and NHANES 2003–2006 or age-adjusted prevalence estimates by demographic subgroups have been generated in SUDAAN by use of age- standardizing proportions from the 2000 U.S. Census population (using direct standardization). Statistically significant differences between age-adjusted geometric means and age-adjusted prevalences were assessed through pairwise comparisons. A reader should take care when interpreting these age-adjusted figures in isolation. The magnitude of an age-adjusted geometric mean or age-adjusted prevalence is completely arbitrary, and it depends upon the chosen standard population. Additionally, age-adjusted geometric means or age-adjusted prevalences can mask important information about trends if age-specific rates do not have a consistent relationship. It is worth noting that while NHANES 1999–2004 provided a race/ethnicity variable that was an analytic link to the NHANES III race/ethnicity variable called RIDRETH2, this variable is not included in the NHANES 2005–2006 demographics file. Therefore, the codes of the race/ ethnicity variable called RIDRETH1 were used in displaying age-adjusted geometric means by race/ethnicity for NHANES 1999–2002 and NHANES 2003–2006. RIDRETH1 includes all multi-racial responses in the Other category; whereas, RIDRETH2 includes multi-racial responses for Non-Hispanics with primary race White or Black in the Non-Hispanic White or Non-Hispanic Black categories. This means that there are slightly fewer people coded as non- Hispanic white and non-Hispanic black through RIDRETH1 than for RIDRETH2; however, this difference does not affect the Mexican American category. The limit of detection (LOD) is the level at which the measurement has a 95% probability of (Taylor 1987) . For calculation of geometric means, concentrations less being greater than zero than the LOD were assigned a value equal to the LOD divided by the square root of 2. If the proportion of results less than the LOD (< LOD) was greater than 40%, geometric means were not calculated. Percentile estimates less than the LOD were reported as “< LOD”. Most of the indicators had very few results below the LOD value, so that the choice of statistical analysis to handle these results makes little practical difference. There were a few exceptions, however (e.g., serum cis - beta -carotene, retinyl palmitate and retinyl stearate; urinary O-desmethylangolensin and equol), where a larger proportion of results were < LOD. Appendix F contains a table of LOD values for each biochemical indicator, as well as the unweighted percent of data values that were < LOD for each survey cycle. LOD values may change over the time period of the report as a result of changes in analytical methods. We used the higher of the two LOD values for the analysis of the combined four-year data for 2003–2006. Introduction 9

21 Due to changes to analytical methods for plasma total homocysteine, serum 25-hydroxyvitamin D, and serum ferritin, an adjustment equation was applied to the data, as described in the NHANES documentation: • http://www.cdc.gov/nchs/nhanes/nhanes1999-2000/LAB06.htm#Component_ Description • http://www.cdc.gov/nchs/nhanes/nhanes2003-2004/L06VID_C.htm • http://www.cdc.gov/nchs/nhanes/nhanes2003-2004/L06TFR_C.htm#Analytic_Notes. For biochemical indicators measured in urine, we present separate tables for the concentration of the indicator expressed as “per volume of urine” (uncorrected table) and the concentration of the indicator expressed as “per gram of creatinine” (creatinine-corrected table). Comparison of an individual participant’s result to population data in the tables requires correction for urinary dilution; thus, an individual creatinine-corrected result is needed and should be compared to the creatinine-corrected data tables. Otherwise, health scientists may compare means and percentiles from other studies to the tables having either of the corresponding units. We used the uncorrected tables to compare urine concentrations across groups. Because instrument responses are measured in units of weight per volume, LOD calculations were performed by use of the concentration of the indicator expressed as per volume of urine. For this reason, LOD results for urine measurements in Appendix F are in weight per volume of urine. In the creatinine-corrected tables, a result for a geometric mean or a percentile was reported as < LOD if the corresponding geometric mean or percentile was < LOD in the uncorrected table. Thus, for example, if the th percentile for males was < LOD in the uncorrected table, it would also be < LOD in the 5 creatinine-corrected table. References Taylor JK. Quality assurance of chemical measurements. Chelsea (MI): Lewis Publishing; 1987. U.S. Centers for Disease Control and Prevention. NHANES analytic guidelines, the Third National Health and Nutrition Examination Survey, NHANES III (1988–94). Hyattsville (MD): National Center for Health Statistics; October 1996 [cited 2011]. Available at: http://www.cdc.gov/nchs/data/nhanes/nhanes3/nh3gui.pdf . Woodruff RS. Confidence intervals for medians and other position measures. J Am Stat Assoc. 1952;57:622–627. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 10

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24 1. Water-Soluble Vitamins B Vitamins and Related Biochemical Compounds • Folate (serum and red blood cell) • Vitamin B6 » Pyridoxal-5’-phosphate » 4-Pyridoxic acid • Vitamin B12 • Homocysteine • Methylmalonic acid Vitamin C (Ascorbic Acid) 1. Water-Soluble Vitamins 13

25 B Vitamins and Related Biochemical Compounds Background Information Sources and Physiological Functions. Folate, vitamins B6, and B12 belong to the group of water-soluble B vitamins that occur naturally in food. Leafy green vegetables (such as spinach and turnip greens), fruits (such as citrus fruits and juices), and dried beans and peas are all natural sources of folate. Folic acid is the synthetic form of folate found in supplements and added to fortified foods. Because of wide consumption of fortified foods in the United States, these products have become an important contributor of folic acid to the U.S. diet. Folate functions as a coenzyme in single-carbon transfers in the metabolism of nucleic and amino acids. It is therefore especially important during periods of rapid cell division and growth, such as occurs during pregnancy and infancy. The most abundant dietary sources of vitamin B6 are meats, whole grains (with the highest concentrations of B6 in the germ and aleuronic layer), vegetables, and nuts. Vitamin B6 is used as a cofactor for nearly 200 biochemical reactions in the human body, mostly related to amino acid metabolism. Its three major forms are pyridoxine (the major form in plants) and pyridoxal and pyridoxamine (the two most abundant forms in humans and animals); pyridoxal-5’-phosphate (PLP) is the most biologically active coenzyme form. 4-Pyridoxic acid (4PA) is the end product of vitamin B6 catabolism. Vitamin B12 (cobalamin) is found naturally in animal foods, including fish, meat, poultry, eggs, milk, and milk products. For vegetarians, fortified breakfast cereals are a particularly valuable source of vitamin B12. The current Dietary Guidelines for Americans list vitamin B12 as a nutrient of concern for specific population groups. The guidelines recommend that persons 50 years and older consume foods fortified with vitamin B12 or dietary supplements ( U.S. Department of Agriculture and U.S. Department of Health and Human Services 2010 ). Vitamin B12 functions as a coenzyme for a critical methyl transfer reaction that converts homocysteine to methionine and for a separate reaction that converts L-methylmalonyl-coenzyme A to succinyl- coenzyme A. Homocysteine (Hcy) is an amino acid naturally found in the blood. Plasma Hcy concentrations are strongly influenced by diet as well as by genetic factors. Elevated concentrations of total Hcy (tHcy; the sum of free, protein-bound, and disulfides) are found in people whose folate, vitamin B12, or vitamin B6 status is suboptimal ( Selhub 1993 ) and in people with impaired renal ). function ( Wollensen 1999 Methylmalonic acid (MMA) is a dicarboxylic acid naturally found in the blood. Plasma MMA concentrations are elevated when serum vitamin B12 concentrations are low or intermediate; such concentrations are therefore a useful diagnostic test for confirming vitamin B12 deficiency ( Baik 1999 ). As with plasma tHcy, MMA concentrations are also elevated in people with impaired renal function ( Rasmussen 1990 ). Health Effects. A chronic dietary deficiency of either folate or vitamin B12 causes macrocytic anemia, although strict dietary deficiencies are rare. Due to the wide abundance of vitamin B6 in foods, dietary deficiencies of vitamin B6 are also rare. Signs of vitamin B6 deficiency include dermatitis, glossitis (inflammation of the tongue), depression, confusion, convulsions, and anemia. Symptoms do not appear immediately, however, for ~80% of the vitamin B6 in the body is stored in muscle tissue and will remain stable until intake has been low for several weeks ). Certain drugs (e.g., alcohol, methotrexate, anticonvulsants, sulfa drugs) may ( Coburn 1990 interfere with the absorption or utilization of folate, and disorders of the small bowel that limit nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 14

26 absorption (e.g., Crohn’s disease, jejunal bypass surgery) can cause folate deficiency ( Halsted ). Drugs that react with carbonyl groups have the potential to interact with PLP. Isoniazid— 1990 used in the treatment of tuberculosis—and L-DOPA have been shown to reduce plasma PLP concentrations, and a small decrease in vitamin B6 status has been seen in women taking high- dose oral contraceptives ( Institute of Medicine 1998 ). Most people who develop a vitamin B12 deficiency have an underlying stomach or intestinal disorder that limits the absorption of vitamin B12. Subtly reduced cognitive function resulting from early vitamin B12 deficiency is sometimes the only symptom of these intestinal disorders. Severe vitamin B12 deficiency can cause permanent nerve damage and dementia. Hematologic signs, however, are not always present in vitamin B12 deficiency, and hematologic signs and neurologic abnormalities can be inversely correlated ( Baik 1999 ). Clinical trials have shown that folic acid supplementation effectively reduces the number of neural tube birth defects (NTDs) ( Czeizel 1992; MRC Vitamin Study Research Group 1991 ). Thus, the U.S. Public Health Service recommended that every woman who could become pregnant consume at least 400 micrograms (μg) of folic acid each day ( U.S. Centers for Disease Control and Prevention 1992 ). This recommendation has also been incorporated into the current Dietary Guidelines for Americans, which list folate as a nutrient of concern for specific population groups ( U.S. Department of Agriculture 2010 ). Since 1998, the U.S. Food and Drug Administration (FDA) has required the addition of folic acid to enriched breads, cereals, flours, corn meals, pastas, rice, and other grain products ( U.S. Food and Drug Administration 1996 ). After the introduction of fortification, NTD rates have decreased by 36% ( U.S. Centers for Disease Control and Prevention 2010 ); nevertheless, in the era of folic acid fortification, NTD rates are still highest among Hispanic women ( Williams 2005 ). The higher prevalence in Hispanics could be due to their lower consumption of total folic acid, which is specifically true for less acculturated populations ( ). This suggests that there may be factors in addition to folate status, Hamner 2011 such as genetic or environmental factors, that modulate NTD prevalence and possibly lead to higher folate requirements for some population groups. Recent observational studies have also suggested other potential benefits of the U.S. folic acid fortification, such as decreased prevalence of inadequate serum and RBC folate concentrations ( Pfeiffer 2007 ), and declines in the Yang 2006 ) and neuroblastoma ( incidence of stroke ( ). Potential roles of B vitamins French 2003 in modulating the risk for diseases (e.g., heart disease, cancer, and cognitive impairment) are currently being studied. Two national health objectives that relate to folate and maternal, infant, and child health are part of the objectives for Healthy People 2020: Objective MICH HP2020-14 (increase the proportion of women of childbearing potential with intake of at least 400 μg of folic acid from fortified foods or dietary supplements) and Objective MICH HP2020-15 (reduce the proportion of women of childbearing potential who have low red blood cell folate concentrations) (http://www.healthypeople.gov/HP2020/). The recommended dietary allowance (RDA) for both men and Intake Recommendations. women is 400 μg per day of dietary folate equivalents (DFEs). DFEs adjust for the nearly 50% lower bioavailability of dietary folate compared to the bioavailability of folic acid: 1 mg of dietary folate equivalent equals 0.6 mg of folic acid from fortified food or from a supplement taken on an empty stomach ( Institute of Medicine 1998 ). The RDA for vitamin B6 is 1.3 mg for both men and women (19–50 years), 1.7 mg for men and 1.5 mg for women aged 51 years and older, and 1.9 mg for pregnant women (2.0 mg if lactating) ( Institute of Medicine 1998 ). The RDA for vitamin B12 for adults is 2.4 μg per day. Because as many as 10 to 30% of older people may be unable to absorb naturally occurring vitamin B12, it is advisable for people older than 50 years to meet their RDA mainly by consuming foods fortified with vitamin B12 or by taking a supplement containing vitamin B12. People with vitamin B12 deficiency caused by a lack of intrinsic factor or intestinal ). Institute of Medicine 1998 malabsorption require parenteral B12 treatment ( 1. Water-Soluble Vitamins 15

27 Prolonged consumption of very high daily intakes of folic acid has the potential to delay the diagnosis of anemia among adults with vitamin B12 deficiency. This may result in increased risk of progressive, unrecognized neurological damage from untreated vitamin B12 deficiency. Consequently, the Institute of Medicine ( 1998 ) set the Tolerable Upper Intake Level (UL) for folic acid intake for adults (aged 19 years and older) at 1000 μg per day. The UL is defined as the “maximum daily intake levels at which no risk of adverse health effects is expected for almost all individuals in the general population—including sensitive individuals—when the nutrient is consumed over long periods of time” ( Institute of Medicine 2000) . Because no data were available for children, the Institute of Medicine used the UL for adults adjusted by weight: 300–800 m g per day, depending on the age group. Folate intake from food is not associated with any health risk. The UL for vitamin B6 for adults is 100 mg per day ( Institute of Medicine 1998 ). If more is ingested through supplements, sensory neuropathy, dermatological lesions, and reversible nerve damage to the arms and legs can occur. No adverse effects have been seen, however, from getting large amounts of vitamin B6 through food sources ( Institute of Medicine 1998 ). No adverse effects have been associated with excess vitamin B12 intake from food or supplements in healthy individuals, and no UL has been set Institute of Medicine 1998) ( . Biochemical Indicators and Methods. Folate status can be assessed by measuring serum or plasma folate, which provides information on recent intake, and red blood cell (RBC) folate, indicative of body folate stores and long-term nutritional status. Vitamin B6 status is typically assessed by measuring the level of one or more of the B6 vitamers in serum or plasma. Serum PLP is generally viewed as the best single indicator of status. Serum or urinary 4PA, the end product of vitamin B6 catabolism, is an indicator of recent intake. Vitamin B12 status can be assessed by measuring serum or plasma total cobalamins or serum holo-transcobalamin II, the transport protein of absorbed cobalamin. Urinary or serum MMA is a specific functional indicator of vitamin B12 status. Plasma tHcy is a functional indicator of folate, vitamin B6, and/or B12 status, but it is not specific for either vitamin. As B vitamin concentrations decrease, plasma tHcy concentrations increase. Clinical laboratories typically use conventional units for measuring concentrations of folate (nanograms per milliliter [ng/mL]) and vitamin B12 (picograms [pg]/mL) and international system (SI) units for vitamin B6 (nanomole per liter [nmol/L]), tHcy (micromole [ m mol]/L), and MMA (nmol/L). Conversion factors to SI units are as follows: 1 ng/mL = 2.266 nmol/L for folate and 1 pg/mL = 0.738 picomol (pmol)/L for vitamin B12. Traditionally, folate has been measured by microbiologic assay; however, in clinical settings, radioprotein-binding assays or commercial non-radio-protein-binding assays on automated clinical analyzers offering high throughput are used ( Shane 2011 ). In research settings, chromatography-based methods, nowadays coupled to tandem mass spectrometry (LC-MS/MS), ). Pfeiffer 2010 are often used to measure individual forms of folate in serum or whole blood ( International reference materials for serum folate from the U.S. National Institute of Standards and Technology (NIST) and the United Kingdom National Institute for Biological Standards and Control (NIBSC), with certified or reference values by higher-order reference methods (LC-MS/ MS), have been available only for the last few years: NIST SRM 1955 and 1950, and NIBSC 03/178. A reference material for whole blood folate has been available from the NIBSC (95/528) nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 16

28 for several years; however, the value assignment for this material was by consensus of various protein-binding and microbiological assays. Because of observed method differences in measuring Gunter 1996, Pfeiffer 2010 folate concentrations ( ), caution should be used in comparing other datasets to the tables in this report. Method-specific cutoff values and reference intervals for use in medical diagnostics have been suggested previously ( Life Sciences Research Office 1994, Gunter ) and may be required until clinical assays have been standardized. 1996 Vitamin B6 forms in serum are most commonly measured by high performance liquid chromatography (HPLC) with fluorometric detection; chemical derivatization (sample, online, or post-column) is almost always used to enhance PLP fluorescence ( Rybak 2004 ). Enzymatic (radioactive or nonradioactive) and microbiological methods have also been employed ( Coburn 2000 ). LC-MS/MS methods are emerging ( Midttun 2005 ). The comparability of methods could be improved ( ); such improvement is expected to occur in the future due to the new Rybak 2005 availability of NIST SRM 1950 and 3950 (certified concentrations for serum PLP by LC-MS/MS). Serum vitamin B12 is commonly measured by competitive protein-binding assay ( Carmel 2011 ). Research methods for tHcy determination are HPLC with fluorescence detection or coupled to tandem mass spectrometry; clinical methods are based on immunoassay or enzymatic principle ( Refsum 2004 ). MMA is measured by gas chromatography coupled to mass spectrometry (GC- MS) or by LC-MS/MS ( Pedersen 2011 ). The comparability among methods for serum vitamin B12, plasma Hcy, and MMA is superior to that for folate. The following international reference materials are available: NIBSC 03/178 for serum vitamin B12 (consensus value); and NIST SRM 1955 and 1950 for plasma tHcy (certified concentration by LC-MS/MS or GC-MS). Data in NHANES. Folate and vitamin B12 data presented in this report were generated by use of the commercial BioRad Quantaphase II radio-protein-binding assay kit. This is the same method used during the first four years of the continuous NHANES survey (1999-2002) and Yetley 2011 ). The BioRad assay measures approximately during NHANES III (1988-1994) ( 35% lower than the traditional microbiologic assay ( Life Sciences Research Office 1994 ). As a result, the conventional cutoff values of less than 3 ng/mL for low serum folate concentrations, representing a negative folate balance at the time the blood sample was drawn, and less than Life Sciences Research Office 1984 ) should 140 ng/mL for low RBC folate concentrations ( (Wright 1998) . A 2005 be adjusted to less than 2 ng/mL and less than 95 ng/mL, respectively WHO Technical Consultation on folate and vitamin B12 deficiencies estimated blood folate and vitamin B12 concentrations below which plasma metabolite concentrations (tHcy for folate and MMA for vitamin B12) became elevated. It arrived at the following consensus cutoff values: 4 ng/mL (10 nmol/L) for serum folate, 151 ng/mL (340 nmol/L) for RBC folate, and 203 pg/mL (150 pmol/L) for serum vitamin B12 ( ). Because the folate data used to derive de Benoist 2008 these cutoff values were generated with the microbiologic assay, the cutoff values are not directly applicable to data generated with the BioRad radio-protein-binding assay. For this report, we used cutoff values of 2 ng/mL and 95 ng/mL, respectively, to estimate the prevalence of low serum and RBC folate concentrations. To estimate the prevalence of low serum vitamin B12 concentrations, we used a cutoff value of 200 pg/mL. This cutoff value is very close to the WHO consensus cutoff value and has been widely used in previous studies ( Carmel 2011 ). Vitamin B6 data presented in this report include serum PLP and 4PA. They were generated by use of HPLC with post-column derivatization and fluorometric detection ( Rybak 2004; Rybak 2009 ). We used a cutoff value of 20 nmol/L to indicate low serum PLP concentrations. This cutoff value was used by the Institute of Medicine as the basis for the Estimated Average Requirement (EAR) ); it may overestimate the vitamin B6 requirement for health maintenance of more than half ( 1998 the group. 1. Water-Soluble Vitamins 17

29 tHcy data presented in this report were generated by use of the commercial Abbott fluorescence polarization immunoassay kit. MMA data were generated through a GC-MS method. Frequently used cutoff values for elevated concentrations of Jacques 1999 ) and 271 plasma tHcy and MMA are 13 μmol/L ( Allen 1990 nmol/L ( ), respectively. Monitoring the folate status of the U.S. population over time has been a priority ( Yetley 2011 ). It has been so first because serum and RBC folate results from NHANES II (1976–1980) ( Senti 1985 ) and NHANES III (1988–1994) ( Wright 1998 ) suggested that the folate status of some population groups might be of public health concern; a second reason was to assess the impact of folic acid fortification ( Pfeiffer 2007 ). Vitamin B12 status of the U.S. population has been monitored during the second phase of NHANES III (1991–1994) ( Wright 1998 ) and during eight years of the continuous survey (1999–2006). Plasma metabolite concentrations have also been monitored during several years of the continuous survey (tHcy 1999–2006; MMA 1999–2004). Pfeiffer et al. ( ) showed that the introduction of folic acid 2007 fortification has substantially increased serum and RBC folate concentrations in each age group. Serum vitamin B12 concentrations, however, did not change appreciably. Circulating tHcy concentrations from prefortification to postfortification decreased by approximately 10% in a national sample of the U.S. population ( Pfeiffer 2008 ). For more information on B vitamins and related biochemical indicators , see the Institute of Medicine’s Dietary Reference Intake reports ( Institute of Medicine 1998 ) and fact sheets from the National Institutes of Health (NIH), Office of Dietary Supplements (http://ods.od.nih.gov/ Health_Information/Information_About_Individual_Dietary_Supplements.aspx). Highlights Blood concentrations of water-soluble B vitamins (folate, vitamins B6 and B12) in the U.S. population showed the following demographic patterns and characteristics: • The highest concentrations were generally found in the youngest age group, except for RBC folate and the vitamin B6 catabolite 4-pyridoxic acid where the highest concentrations were found in the oldest age group. • No consistent pattern was observed with regard to gender. • A specific race/ethnic pattern was observed: non-Hispanic blacks had the lowest folate and the highest vitamin B12 status, non-Hispanic whites had the highest folate and the lowest vitamin B12 status, and Mexican Americans had intermediate folate and vitamin B12 status. In the era of folic acid fortification, the prevalence of folate deficiency was very low • throughout the population. The likelihood of being vitamin B6 and B12 deficient was higher in persons 40 years • and older compared to younger persons. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 18

30 Monitoring the continued effect of the U.S. folic acid fortification program of enriched grains and cereal products on serum and RBC folate concentrations is of great public health interest. Serum folate concentrations more than doubled and RBC folate concentrations increased by approximately 50% after the introduction of fortification in 1998. Regardless of gender or race/ ethnicity, we observed small decreases (< 10%) in serum and RBC folate concentrations from the ). earlier (1999–2002) to the later (2003–2006) post-fortification period ( Figures H.1.a and H.1.b However, during the first eight years post-fortification covered in this report (1999–2006), the prevalence of low serum (< 2 ng/mL) and RBC folate (< 95 ng/mL) concentrations was less than 1% in the U.S. population, including women of childbearing age, regardless of race/ethnicity (data not shown). Folate deficiency was virtually non-existent in the general population, and it may be limited to persons with malabsorption, alcohol abusers, or consumers of certain drugs. 20 1988-1994 1999-2002 2003-2006 1999-2002 1988-1994 2003-2006 350 18 b b b c b 300 c 16 b c c b b c b c b c 14 b b 250 c c c b c 12 a c a a a 200 a 10 a 150 8 a a a a a a 6 100 Serum folate (ng/mL) 4 50 2 Red blood cell folate (ng/mL) 0 0 Non- Non- Mexican Females Total Males Non- Total Females Mexican Non- Males Hispanic American population Hispanic Hispanic population Hispanic American white black white black Age-adjusted geometric mean concentrations of RBC folate Age-adjusted geometric mean concentrations of serum Figure H.1.a. Figure H.1.b. folate in the U.S. population aged 4 years and older by gender or in the U.S. population aged 4 years and older by gender or race/ethnicity, National Health and Nutrition Examination Survey, 1988–2006. race/ethnicity, National Health and Nutrition Examination Survey, 1988–2006. Error bars represent 95% confidence intervals. Within a demographic group, bars not sharing a common letter differ (p < 0.05). Age-adjustment was done using Error bars represent 95% confidence intervals. Within a demographic group, bars direct standardization. not sharing a common letter differ (p < 0.05). Age adjustment was done using direct standardization. Because of the close relationship of folate and vitamin B12 in one-carbon metabolism, it is of interest to see whether serum vitamin B12 concentrations changed since the introduction of folic acid fortification and whether there are differences among race/ethnic groups. We observed a small increase in serum vitamin B12 concentrations from pre- (1991–1994) to post-fortification (1999– 2002). We then found similar concentrations during 2003–2006 for the total population and for males and females ( ). The increase from pre- to post-fortification was observed for Figure H.1.c non-Hispanic whites, but not for non-Hispanic blacks and Mexican Americans; the latter two groups had higher serum vitamin B12 concentrations than non-Hispanic whites during both pre- and post-fortification. Assessing the extent of inadequate vitamin B12 status in the older U.S. population is challenging because serum vitamin B12 is not sensitive enough, plasma tHcy is not specific, and both plasma MMA and tHcy are artificially elevated when renal function is impaired, which is common in older persons. As expected, we found a higher prevalence of elevated plasma MMA (17%) or tHcy (19%) concentrations, potentially indicating suboptimal vitamin B12 status, than we found in the prevalence of low serum vitamin B12 concentrations (4%) in older persons ( Figure H.1.d ). Defining better ). Bailey 2011 cutoff values for vitamin B12 status biomarkers remains a continued area of research ( 1. Water-Soluble Vitamins 19

31 25 1991-1994 1999-2002 2003-2006 a a a 20 600 a a a b b b b b b b b a a a a 500 15 400 300 10 Prevalence (%) 200 Serum vitamin B12 (pg/mL) 5 100 0 Non- Non- Mexican Females Males Total 0 Hispanic Hispanic American population Serum B12 Plasma tHcy Plasma MMA white black mol/L > 271 nmol/L > 13 < 200 pg/mL Prevalence estimates of low serum vitamin B12 (B12), Figure H.1.d. Age-adjusted geometric mean concentrations of serum Figure H.1.c. vitamin B12 in the U.S. population aged 4 years and older by gender high plasma methylmalonic acid (MMA), and high plasma total or race/ethnicity, National Health and Nutrition Examination Survey, homocysteine (tHcy) concentrations in U.S. persons 60 years and older, 1991–2006. National Health and Nutrition Examination Survey, 2003–2006. Data shown for plasma MMA are from NHANES 2003–2004 only. Error bars Error bars represent 95% confidence intervals. Within a demographic group, bars represent 95% confidence intervals. not sharing a common letter differ (p < 0.05). Age adjustment was done using direct standardization. Detailed Observations The selected observations mentioned below are derived from the tables and figures presented next. Statements about categorical differences between demographic groups noted below are based on non-overlapping confidence limits from univariate analysis without adjusting for demographic variables (e.g., age, gender, race/ethnicity) or other blood concentration determinants (e.g., dietary intake, supplement usage, smoking, BMI). A multivariate analysis may alter the size and statistical significance of these categorical differences. Furthermore, additional significant differences of smaller magnitude may be present despite their lack of mention here (e.g., if confidence limits slightly overlap or if differences are not statistically significant before covariate adjustment has occurred). For a selection of citations of descriptive NHANES papers related to these biochemical indicators of diet and nutrition, see Appendix G . Geometric mean concentrations (NHANES 2003–2006): • Serum and RBC folate concentrations followed a U-shaped age pattern, with the lowest concentrations seen in adolescents and young adults, respectively (Tables 1.1.a.1 and 1.2.a.1; Figures 1.1.a and 1.2.a). • Serum PLP concentrations declined from childhood to adolescence, then stabilized in older age groups (Table 1.3.a.1 and Figure 1.3.a). Serum 4PA concentrations were lowest in adolescence and increased steadily through the oldest age group (Table 1.4.a.1 and Figure 1.4.a). • Serum vitamin B12 concentrations declined from childhood to adolescence and then stabilized in older age groups (Table 1.5.a.1), while plasma MMA concentrations were relatively stable through young adulthood, and then increased with age (Table 1.7.a.1 and Figure 1.7.a). • Plasma tHcy concentrations in adults increased with age (Table 1.6.a.1 and Figure 1.6.a). Females had higher serum and RBC folate concentrations than males (Tables 1.1.a.1 • and 1.2.a.1); males had higher serum PLP and plasma tHcy concentrations than females (Tables 1.3.a.1 and 1.6.a.1); males and females had similar serum 4PA (Table 1.4.a.1), nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 20

32 vitamin B12 (Table 1.5.a.1) and plasma MMA (Table 1.7.a.1) concentrations. Non-Hispanic whites had the highest concentrations of serum and RBC folate (Tables • 1.1.a.1 and 1.2.a.1), serum 4PA (Table 1.4.a.1), and plasma MMA (Table 1.7.a.1). They also had the lowest concentrations of serum vitamin B12 (Table 1.5.a.1). Non- Hispanic blacks had the lowest concentrations of RBC folate (Table 1.2.a.1) and serum PLP (Table 1.3.a.1). Mexican Americans had the lowest concentrations of plasma tHcy (Table 1.6.a.1). Changes in geometric mean concentrations across survey cycles: • Serum folate concentrations decreased slightly (< 10%) between the 1999–2000 and 2001–2002 survey cycles; however, concentrations stabilized over the next two survey cycles (Table 1.1.b). • RBC folate concentrations were similar across all survey cycles except for a < 10% decrease between the 2001–2002 and 2003–2004 survey cycles (Table 1.2.b). • We observed no changes in serum vitamin B12 (Table 1.5.b), plasma tHcy (Table 1.6.b), or plasma MMA (Table 1.7.b) concentrations over time. Prevalence estimates of low or high biochemical indicator concentrations: • In 2003–2006, less than 1% of the population aged 1 year and older had RBC folate concentrations < 95 ng/mL (Table 1.2.c). Similarly, less than 1% of the population had low serum folate concentrations < 2 ng/mL; however, the estimates had large variances and we do not present a prevalence table for this indicator. • Of the population aged 1 year and older, approximately 11% had serum PLP concentrations < 20 nmol/L in 2005–2006 (Table 1.3.c). Compared to the prevalence of low PLP concentrations in persons 20–39 years of age, the prevalence of low PLP concentrations was lower in all younger age groups and higher in all older age groups. • Approximately 2% of the population aged 1 year and older and 4% of persons 60 years and older had serum vitamin B12 concentrations < 200 pg/mL in 2003-2006 (Table 1.5.c). • We found elevated plasma tHcy concentrations (> 13 μmol/L) in 2003–2006 in approximately 8% of the population aged 20 years and older and in 19% of persons 60 years and older (Table 1.6.c). • Approximately 7% of the population aged 3 years and older and 17% of persons 60 years and older had plasma MMA concentrations > 271 nmol/L in 2003-2004 (Table 1.7.c). Between 1999 and 2006 (2004 for MMA), we did not observe any change in the • prevalence of low RBC folate (Table 1.2.d), low serum vitamin B12 (Table 1.5.d), high plasma tHcy (Table 1.6.d), and high plasma MMA (Table 1.7.d) concentrations. 1. Water-Soluble Vitamins 21

33 size 8,361 4,212 8,050 1,690 1,749 4,297 6,633 4,028 3,242 2,649 3,053 16,411 Sample (33.6 – 37.8) (30.6 – 34.8) (37.7 – 77.7) (24.3 – 28.8) (32.5 – 36.0) (32.3 – 46.3) (25.6 – 29.3) (23.4 – 25.8) (34.2 – 38.5) (23.1 – 29.9) (29.2 – 37.1) (42.1 – 49.6) 97.5th 32.2 25.9 50.8 34.0 27.0 35.9 35.6 24.6 36.0 26.1 32.8 45.7 (20.8 – 23.4) (25.6 – 27.8) (32.0 – 41.9) (27.5 – 29.5) (28.8 – 31.2) (27.5 – 35.0) (21.4 – 23.5) (19.9 – 21.8) (29.2 – 31.5) (19.5 – 22.9) (24.1 – 28.1) (34.2 – 37.7) 95th 22.2 36.0 26.4 28.5 29.7 29.9 22.6 20.9 30.1 20.5 25.2 35.7 (95% conf. interval) s (15.5 – 16.5) (10.8 – 11.4) (11.3 – 11.9) (11.9 – 12.5) (15.3 – 16.2) (9.94 – 10.8) (12.5 – 13.2) (12.5 – 13.3) (10.9 – 11.6) (10.1 – 10.9) (11.3 – 11.9) (15.2 – 16.3) 50th 11.6 11.1 16.0 12.2 12.9 10.3 15.7 12.9 11.3 10.5 11.6 15.8 Selected percentile (5.00 – 5.55) (5.17 – 5.68) (6.92 – 8.24) (5.26 – 5.66) (5.33 – 5.91) (8.63 – 9.58) (4.56 – 5.07) (5.45 – 5.83) (5.36 – 5.98) (4.75 – 5.09) (4.57 – 5.42) (5.95 – 6.61) 5th 7.61 5.49 5.32 5.46 5.61 9.04 4.83 5.62 5.72 4.93 5.09 6.32 (5.51 – 6.93) (4.29 – 4.60) (4.52 – 4.92) (4.36 – 4.61) (4.41 – 4.81) (7.82 – 8.58) (4.01 – 4.36) (4.57 – 5.11) (4.40 – 4.81) (4.08 – 4.46) (3.70 – 4.40) (4.83 – 5.57) 2.5th 4.39 6.29 4.67 4.51 8.21 4.19 4.56 4.58 4.86 4.24 4.23 5.31 n (15.5 – 16.9) (11.4 – 12.0) (10.7 – 11.4) (12.0 – 12.6) (10.1 – 10.7) (12.5 – 13.3) (15.6 – 16.6) (12.5 – 13.4) (11.0 – 11.5) (10.1 – 10.7) (11.2 – 12.0) (15.0 – 16.1) 11.1 16.2 11.7 12.3 10.4 16.1 12.9 11.2 13.0 10.4 11.6 15.6 (95% conf. interval) Geometric mea 1–5 years Race/ethnicity Age group Males Total, 1 year and older Gender Mexican Americans Non-Hispanic Blacks 6–11 years Females 12–19 years Non-Hispanic Whites 20–39 years 40–59 years 60 years and older National Health and Nutrition Examination Survey, 2003–2006. Geometric mean and selected percentiles of serum concentrations (in ng/mL) for the total U.S. population aged 1 year and older, Table 1.1.a.1. Serum folate: Concentrations nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 22

34 Figure 1.1.a. Serum folate: Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2006 Overall Mexican Americans 20 Females Males 15 10 (ng/mL) Serum folate 5 0 12−19 6−11 1−5 6−11 1−5 20−39 40−59 60+ 12−19 20−39 40−59 60+ Non−Hispanic Blacks Non−Hispanic Whites 20 15 10 (ng/mL) Serum folate 5 0 1−5 12−19 20−39 40−59 60+ 6−11 1−5 6−11 12−19 20−39 40−59 60+ Females Males 20 Mexican Americans 15 Non−Hispanic Blacks 10 Non−Hispanic (ng/mL) Whites Serum folate 5 0 1−5 6−11 12−19 12−19 20−39 40−59 60+ 20−39 40−59 60+ 6−11 1−5 Age (years) Age (years) 1. Water -Soluble Vitamins 23

35 Table 1.1.a.2. Serum folate: Total population Geometric mean and selected percentiles of serum concentrations (in ng/mL) for the total U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 50th 5th 95th Males and Females 28.5 (5.26 – 5.66) 12.3 (11.9 – 12.5) 5.46 (27.5 – 29.5) 16,411 Total, 1 year and older (12.0 – 12.6) 12.2 (15.5 – 16.9) 7.61 1–5 years 16.0 (15.5 – 16.5) 36.0 (32.0 – 41.9) 1,690 16.2 (6.92 – 8.24) 16.1 9.04 (8.63 – 9.58) 15.7 (15.6 – 16.6) 29.9 (27.5 – 35.0) 1,749 6–11 years (15.3 – 16.2) 11.2 (11.0 – 11.5) 5.62 (5.45 – 5.83) 11.3 (10.9 – 11.6) 20.9 (19.9 – 21.8) 12–19 years 4,028 20–39 years (10.1 – 10.7) 4.93 (4.75 – 5.09) 10.5 (10.1 – 10.9) 20.5 (19.5 – 22.9) 3,242 10.4 11.6 5.09 (4.57 – 5.42) 11.6 (11.3 – 11.9) 25.2 (24.1 – 28.1) 2,649 40–59 years (11.2 – 12.0) 15.6 (15.0 – 16.1) 6.32 (5.95 – 6.61) 15.8 (15.2 – 16.3) 35.7 (34.2 – 37.7) 3,053 60 years and older Males Total, 1 year and older (11.4 – 12.0) 5.32 (5.00 – 5.55) 11.6 (11.3 – 11.9) 26.4 (25.6 – 27.8) 8,050 11.7 16.2 (15.3 – 17.1) 7.56 (6.40 – 8.53) 15.8 (15.2 – 16.3) 36.2 (32.0 – 46.5) 854 1–5 years 6–11 years 15.8 (15.2 – 16.4) 9.10 (8.37 – 9.77) 15.3 (14.8 – 16.0) 29.1 (26.2 – 34.9) 854 12–19 years 11.2 5.45 (4.94 – 5.82) 11.3 (10.9 – 11.6) 20.5 (19.8 – 21.9) 2,041 (10.9 – 11.5) 9.83 4.84 (4.66 – 5.03) 9.89 (9.53 – 10.3) 18.3 (17.6 – 20.0) 1,462 (9.51 – 10.2) 20–39 years 1,305 (20.5 – 25.8) 22.7 (10.4 – 11.4) 11.0 4.84 (10.4 – 11.3) 10.8 40–59 years (4.39 – 5.26) 14.7 (14.0 – 15.6) 6.12 (5.81 – 6.42) 14.7 (13.7 – 15.7) 34.9 60 years and older 1,534 (32.5 – 41.9) Females 12.9 (12.5 – 13.3) 5.61 (5.33 – 5.91) Total, 1 year and older (12.5 – 13.2) 29.7 (28.8 – 31.2) 8,361 12.9 1–5 years 16.3 (15.6 – 17.0) 7.65 (6.80 – 8.30) 16.3 (15.8 – 17.0) 34.6 (30.2 – 46.5) 836 6–11 years 16.5 9.01 (8.62 – 9.59) 16.2 (15.5 – 16.9) 30.8 (28.2 – 36.6) 895 (15.8 – 17.2) 12–19 years (10.9 – 11.7) 5.76 (5.57 – 6.04) 11.2 (10.9 – 11.7) 21.3 (19.6 – 23.4) 1,987 11.3 20–39 years 11.0 (10.6 – 11.5) 5.05 (4.63 – 5.27) 11.1 (10.7 – 11.6) 23.1 (21.1 – 26.1) 1,780 12.4 40–59 years (11.9 – 12.8) 5.37 (4.56 – 5.96) 12.3 (11.9 – 12.9) 27.6 (25.2 – 32.1) 1,344 (6.05 – 6.92) 60 years and older 16.2 (15.7 – 16.8) 6.57 (34.4 – 38.5) 16.5 (15.9 – 17.2) 36.1 1,519 Table 1.1.a.3. Serum folate: Mexican Americans Geometric mean and selected percentiles of serum concentrations (in ng/mL) for Mexican Americans in the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 50th 5th 95th Males and Females 22.2 (5.17 – 5.68) 11.1 (10.8 – 11.4) 5.49 (20.8 – 23.4) 4,212 Total, 1 year and older (10.7 – 11.4) 11.1 (13.4 – 14.7) 7.56 1–5 years 14.0 (13.3 – 14.8) 26.2 (23.8 – 29.4) 542 14.1 (6.85 – 8.17) 15.4 9.03 (8.32 – 9.67) 15.2 (14.7 – 16.2) 28.2 (26.2 – 32.2) 586 6–11 years (14.2 – 16.0) 10.9 (10.6 – 11.2) 5.89 (5.43 – 6.28) 11.1 (10.8 – 11.5) 19.1 (18.2 – 19.8) 12–19 years 1,281 20–39 years (9.24 – 9.96) 5.04 (4.70 – 5.19) 9.62 (9.07 – 10.2) 18.1 (16.8 – 19.6) 781 9.60 10.4 5.13 (4.59 – 5.67) 10.1 (9.51 – 11.0) 21.0 (18.7 – 23.7) 469 40–59 years (9.76 – 11.1) 12.4 (11.6 – 13.2) 5.36 (4.61 – 6.41) 12.1 (11.6 – 12.6) 27.1 (24.6 – 37.1) 553 60 years and older Males Total, 1 year and older (10.3 – 11.0) 5.35 (4.99 – 5.65) 10.7 (10.3 – 11.0) 20.2 (19.5 – 22.4) 2,042 10.6 13.7 (13.1 – 14.5) 8.03 (6.22 – 8.33) 13.5 (12.7 – 14.5) 23.9 (21.2 – 31.4) 263 1–5 years 6–11 years 15.1 (14.3 – 16.0) 8.68 (7.46 – 9.86) 14.9 (13.7 – 16.0) 28.3 (25.4 – 32.3) 285 12–19 years 10.9 5.62 (4.99 – 5.94) 11.1 (10.6 – 11.4) 19.1 (17.7 – 20.6) 638 (10.5 – 11.3) 9.11 4.90 (4.47 – 5.37) 9.09 (8.68 – 9.70) 15.6 (14.7 – 18.7) 347 20–39 years (8.67 – 9.57) 10.1 (9.43 – 10.8) 5.11 (4.48 – 5.91) 10.0 40–59 years 19.1 (9.19 – 10.7) 237 (18.1 – 22.5) (9.85 – 12.1) 11.4 5.27 60 years and older 10.5 (10.7 – 12.1) 26.0 (22.9 – 36.9) 272 (4.61 – 6.23) Females Total, 1 year and older 11.5 (11.1 – 12.0) 5.64 (5.15 – 5.87) 11.6 (11.3 – 11.8) 23.3 (21.8 – 25.6) 2,170 1–5 years 14.4 7.34 (6.41 – 8.10) 14.4 (13.7 – 15.9) 26.5 (24.5 – 31.9) 279 (13.6 – 15.2) 6–11 years (14.9 – 16.5) 9.13 (8.01 – 10.2) 15.5 (14.8 – 16.3) 27.8 (25.9 – 34.2) 301 15.7 12–19 years 11.0 (10.7 – 11.3) 6.23 (5.78 – 6.54) 11.2 (10.8 – 11.6) 19.0 (18.2 – 21.0) 643 20–39 years (9.62 – 10.8) 5.11 (4.74 – 5.38) 10.4 (9.53 – 11.0) 19.3 (18.1 – 21.8) 434 10.2 232 10.7 (10.0 – 11.5) 5.16 (3.80 – 5.85) 10.4 (9.57 – 11.4) 22.4 (19.1 – 40.0) 40–59 years 29.7 281 (25.3 – 64.8) (12.1 – 13.7) 60 years and older 13.3 (12.0 – 14.7) 5.62 (4.00 – 6.65) 13.0 nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 24

36 Table 1.1.a.4. Serum folate: Non-Hispanic blacks Geometric mean and selected percentiles of serum concentrations (in ng/mL) for non-Hispanic blacks in the U.S.population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 95th 5th Males and Females (21.4 – 23.5) 10.3 4.83 22.6 (4.56 – 5.07) 4,297 (10.1 – 10.7) 10.4 Total, 1 year and older (9.94 – 10.8) 7.08 (5.99 – 7.80) 1–5 years (14.3 – 15.6) 32.9 (28.0 – 40.7) 481 15.0 (14.0 – 16.0) 14.9 (14.2 – 15.3) (7.91 – 9.03) 14.6 (14.0 – 15.2) 8.62 (23.9 – 29.4) 554 14.8 6–11 years 25.3 (9.63 – 10.4) 5.19 (4.98 – 5.39) 9.91 (9.59 – 10.3) 18.3 (17.7 – 19.1) 1,417 12–19 years 9.98 (8.56 – 9.29) 20–39 years (4.26 – 4.81) 8.73 (8.34 – 9.23) 17.7 (16.7 – 19.1) 711 8.92 4.56 (9.28 – 10.4) (3.93 – 4.99) 9.75 (9.04 – 10.3) 20.0 (18.8 – 26.0) 621 9.81 40–59 years 4.34 (10.8 – 12.3) 4.88 (4.48 – 5.29) 11.3 (10.7 – 11.9) 27.2 (24.5 – 36.0) 513 60 years and older 11.5 Males Total, 1 year and older 4.67 (4.34 – 4.94) 10.1 (9.76 – 10.5) 21.1 (19.7 – 23.2) 2,141 10.1 (9.84 – 10.4) (13.7 – 16.2) 6.69 (5.91 – 7.81) 14.7 (13.9 – 15.5) 36.5 (29.0 – 51.9) 238 1–5 years 14.9 14.4 (13.8 – 15.1) 8.87 (8.20 – 9.55) 14.3 (13.6 – 14.9) 24.3 (21.2 – 30.8) 273 6–11 years 10.2 12–19 years (4.75 – 5.19) 10.3 (9.82 – 10.8) 19.0 (17.9 – 19.8) 742 (9.85 – 10.6) 5.02 (8.07 – 8.91) (4.01 – 4.81) 8.35 (7.82 – 8.89) 15.4 (14.5 – 17.7) 339 20–39 years 4.33 8.48 291 (17.3 – 32.9) 18.7 (8.49 – 10.1) 9.38 4.11 (8.82 – 10.0) 9.41 (3.42 – 4.99) 40–59 years (10.4 – 11.8) 4.73 (3.87 – 5.82) 10.7 (9.77 – 11.3) 29.0 (23.9 – 32.7) 60 years and older 11.1 258 Females (10.2 – 11.0) 5.00 (4.62 – 5.23) 10.5 10.6 23.3 (22.0 – 24.9) 2,156 Total, 1 year and older (10.0 – 11.1) 15.1 (14.0 – 16.4) 7.33 (5.00 – 8.42) 15.1 (14.2 – 16.3) 28.8 (26.7 – 40.8) 243 1–5 years 15.1 6–11 years (7.24 – 8.98) 14.9 (14.0 – 15.9) 26.0 (24.3 – 33.6) 281 (14.1 – 16.1) 8.03 9.76 5.42 (4.98 – 5.57) 9.67 (9.21 – 10.0) 17.7 (16.9 – 18.4) 675 12–19 years (9.35 – 10.2) 9.30 (8.78 – 9.86) 4.68 (4.44 – 5.01) 9.00 (8.52 – 9.59) 19.1 (17.8 – 20.8) 372 20–39 years (9.24 – 10.7) 10.2 4.48 (4.07 – 5.18) 10.1 (9.56 – 10.8) 22.1 (19.2 – 27.7) 330 40–59 years 11.6 11.8 (10.8 – 12.9) 4.95 (4.26 – 5.65) 255 (11.0 – 12.8) 26.8 (23.9 – 45.8) 60 years and older Table 1.1.a.5. Serum folate: Non-Hispanic whites Geometric mean and selected percentiles of serum concentrations (in ng/mL) for non-Hispanic whites in the U.S.population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 50th 5th 95th Males and Females 30.1 (5.36 – 5.98) 13.0 (12.5 – 13.3) 5.72 (29.2 – 31.5) 6,633 Total, 1 year and older (12.5 – 13.4) 12.9 (16.2 – 18.6) 7.94 1–5 years 17.0 (16.0 – 17.8) 37.9 (34.7 – 56.0) 478 17.4 (6.77 – 8.99) 16.8 9.54 (8.59 – 10.0) 16.5 (16.1 – 17.5) 31.7 (28.0 – 37.6) 449 6–11 years (15.9 – 17.2) 11.7 (11.3 – 12.1) 5.83 (5.57 – 6.19) 11.6 (11.3 – 12.2) 22.1 (21.2 – 23.4) 12–19 years 1,048 20–39 years (10.6 – 11.5) 5.22 (4.82 – 5.54) 11.1 (10.7 – 11.5) 22.9 (20.6 – 26.2) 1,453 11.0 12.0 5.14 (4.55 – 5.61) 12.1 (11.7 – 12.6) 26.1 (24.3 – 31.7) 1,357 40–59 years (11.5 – 12.6) 16.3 (15.7 – 17.0) 6.55 (6.19 – 6.92) 16.7 (16.1 – 17.2) 36.8 (34.9 – 39.4) 1,848 60 years and older Males Total, 1 year and older (11.8 – 12.7) 5.56 (5.04 – 5.93) 12.1 (11.7 – 12.6) 28.0 (26.4 – 29.8) 3,268 12.3 17.3 (16.0 – 18.8) 8.02 (5.84 – 9.82) 16.5 (15.7 – 17.9) 36.3 (32.6 – 55.8) 259 1–5 years 6–11 years 16.4 (15.5 – 17.5) 8.91† (7.81 – 10.0) 16.2 (15.1 – 16.9) 30.4† (26.1 – 52.6) 216 12–19 years 11.6 5.58 (4.93 – 6.17) 11.6 (11.2 – 12.1) 21.8 (20.4 – 23.3) 528 (11.2 – 12.0) 10.4 5.30 (4.75 – 5.82) 10.5 (9.93 – 11.0) 19.5 (18.1 – 22.9) 638 20–39 years (9.94 – 10.9) 11.2 (10.6 – 11.9) 4.95 (4.36 – 5.35) 11.5 40–59 years 22.9 (10.9 – 12.1) 689 (20.9 – 26.8) (14.5 – 16.6) 15.5 6.35 60 years and older 15.6 (14.5 – 16.5) 37.0 (32.7 – 45.3) 938 (5.91 – 6.72) Females Total, 1 year and older 13.7 (13.2 – 14.1) 5.88 (5.45 – 6.20) 13.7 (13.2 – 14.2) 31.6 (30.3 – 32.9) 3,365 1–5 years 17.4 7.79† (6.32 – 8.79) 17.1 (15.9 – 18.0) 42.7† (30.9 – 73.2) 219 (16.0 – 18.9) 6–11 years (16.4 – 18.1) 9.71 (8.72 – 10.2) 17.0 (15.9 – 17.7) 31.7 (28.3 – 38.2) 233 17.2 12–19 years 11.8 (11.3 – 12.4) 5.90 (5.64 – 6.67) 11.8 (11.1 – 12.5) 22.2 (20.5 – 25.1) 520 20–39 years (11.1 – 12.4) 5.19 (4.54 – 5.60) 11.8 (11.1 – 12.5) 25.7 (22.8 – 30.7) 815 11.7 668 12.9 (12.3 – 13.5) 5.40 (4.54 – 6.22) 13.1 (12.3 – 13.7) 30.9 (25.5 – 34.0) 40–59 years (34.9 – 39.7) 60 years and older 17.1 (16.5 – 17.7) 6.85 (6.21 – 7.22) 17.6 (16.8 – 18.4) 36.6 910 † Estimate is subject to greater uncertainty due to small cell size. 1. Water-Soluble Vitamins 25

37 Table 1.1.b. Serum folate: Concentrations by survey cycle Geometric mean and selected percentiles of serum concentrations (in ng/mL) for the U.S. population, National Health and Nutrition Examination Survey, 1999–2006. n Selected percentile s (95% conf. interval) Sample Geometric mea 50th 5th 95th (95% conf. interval) size Total, 3 years and older 33.1 14.2 14.0 (13.4 – 14.8) (31.6 – 34.9) 7,526 5.74 (5.35 – 6.10) 1999–2000 (13.4 – 15.0) 5.73 (5.36 – 6.05) 13.0 (12.7 – 13.4) 27.2 (26.4 – 28.5) 8,386 2001–2002 12.9 (12.5 – 13.3) 5.40 12.1 11.9 (11.5 – 12.4) 28.2 (27.1 – 29.7) 7,836 2003–2004 (11.7 – 12.6) (5.12 – 5.69) 7,774 5.47 12.3 (11.9 – 12.7) 28.5 (26.5 – 30.2) (11.9 – 12.9) 2005–2006 12.4 (5.10 – 5.80) Age group 3-5 years (18.8 – 21.4) 10.5 1999–2000 19.1 (17.9 – 21.6) 38.2 (34.0 – 45.1) 361 20.1 (7.89 – 12.2) 17.3 9.44 (7.08 – 10.6) 17.1 (16.1 – 18.3) 31.9 (29.5 – 38.5) 438 2001–2002 (16.3 – 18.4) (15.1 – 18.2) (5.22 – 9.61) 16.2 (15.2 – 17.0) 34.5 (29.4 – 57.9) 448 16.6 2003–2004 8.59 (16.5 – 18.8) 9.56 (8.34 – 10.3) 16.7 (16.1 – 17.9) 37.6 (31.3 – 77.2) 441 2005–2006 17.6 6–11 years 1999–2000 11.0 (10.6 – 11.4) 19.3 (18.4 – 19.9) 33.4 (31.6 – 36.3) 885 19.3 (18.4 – 20.3) (16.6 – 17.9) 9.31 (8.75 – 9.78) 17.1 (16.3 – 17.8) 32.7 (29.9 – 37.9) 1,023 2001–2002 17.2 15.6 (14.9 – 16.3) 27.4 (8.66 – 9.85) 15.2 (14.7 – 16.0) 2003–2004 (24.4 – 34.0) 843 9.39 2005–2006 (15.9 – 17.5) 8.77 (8.26 – 9.60) 16.3 (15.5 – 17.1) 32.4 (29.5 – 36.9) 906 16.7 12–19 years 1999–2000 6.26 (5.72 – 6.61) 13.3 (12.7 – 14.0) 27.6 (25.6 – 31.3) 2,124 13.3 (12.6 – 14.0) (11.6 – 12.8) (5.29 – 6.28) 12.5 (11.9 – 13.3) 22.1 (21.2 – 23.4) 2,208 12.2 5.91 2001–2002 (10.5 – 11.5) 5.56 (5.20 – 6.02) 11.0 (10.5 – 11.4) 2003–2004 (19.1 – 22.1) 2,058 11.0 19.7 11.5 5.65 (5.39 – 5.90) 11.6 (11.1 – 12.1) (11.2 – 11.8) (21.1 – 22.6) 1,970 2005–2006 21.8 20–39 years 11.8 (11.0 – 12.7) 5.15 (4.40 – 5.55) 11.6 (10.6 – 12.8) 28.6 (25.6 – 30.8) 1,470 1999–2000 11.1 2001–2002 5.27 (4.78 – 5.59) 11.1 (10.6 – 11.6) 22.6 (20.6 – 24.3) 1,714 (10.6 – 11.6) 10.2 4.83 (4.62 – 5.01) 10.2 (9.59 – 10.8) 20.0 (19.1 – 22.9) 1,555 2003–2004 (9.78 – 10.6) 10.6 (10.2 – 11.1) 5.07 (4.76 – 5.33) 10.8 (10.3 – 11.2) 21.1 (19.2 – 25.9) 1,687 2005–2006 40–59 years 1999–2000 (12.7 – 14.5) 5.37 (4.37 – 6.08) 13.6 (12.7 – 14.7) 31.6 (30.0 – 35.4) 1,199 13.6 12.2 (11.7 – 12.7) 5.63 (4.86 – 6.06) 12.5 (11.9 – 13.1) 24.0 (22.4 – 25.3) 1,475 2001–2002 2003–2004 11.6 (11.0 – 12.3) 5.20 (4.57 – 5.60) 11.6 (11.1 – 11.9) 26.0 (23.8 – 32.8) 1,276 11.6 2005–2006 (11.0 – 12.2) 4.85 (4.39 – 5.57) 11.7 (11.1 – 12.1) 24.4 (22.8 – 29.0) 1,373 60 years and older 1999–2000 (16.7 – 18.1) 7.09 (6.48 – 7.51) 17.4 (16.5 – 18.2) 42.3 (39.2 – 44.8) 1,487 17.4 (5.75 – 7.09) 16.6 (15.4 – 17.5) 37.3 (34.2 – 40.7) 1,528 16.1 (15.4 – 16.8) 2001–2002 6.50 (15.1 – 16.4) (6.13 – 7.00) 15.6 (14.8 – 16.4) 34.9 (32.9 – 37.7) 1,656 15.7 6.53 2003–2004 (14.5 – 16.4) 6.06 (5.40 – 6.58) 15.8 (15.0 – 16.8) 36.4 2005–2006 1,397 15.4 (34.4 – 41.9) Gender Males (12.7 – 14.0) 5.53 (4.73 – 6.13) 1999–2000 (12.7 – 14.2) 30.6 (29.0 – 32.2) 3,684 13.3 13.4 12.3 (11.8 – 12.8) 5.64 (5.17 – 6.00) 12.5 (12.1 – 13.0) 25.0 (23.7 – 27.0) 4,063 2001–2002 11.6 2003–2004 5.31 (4.93 – 5.69) 11.5 (11.1 – 11.9) 26.2 (24.7 – 28.1) 3,871 (11.1 – 12.1) 26.2 11.7 (4.74 – 5.59) 11.6 (11.2 – 12.0) 5.24 (25.2 – 28.5) 3,780 2005–2006 (11.2 – 12.1) Females 14.8 (14.0 – 15.6) 5.94 (5.60 – 6.18) 14.8 (14.1 – 16.0) 35.3 (33.7 – 37.5) 3,842 1999–2000 13.5 2001–2002 5.80 (5.39 – 6.35) 13.6 (13.2 – 14.0) 29.3 (27.3 – 31.6) 4,323 (13.1 – 13.9) 2003–2004 (12.1 – 13.1) 5.51 (5.12 – 5.84) 12.5 (12.0 – 13.0) 29.5 (28.3 – 31.6) 3,965 12.6 2005–2006 13.1 (12.5 – 13.7) 5.66 (5.25 – 6.14) 13.2 (12.6 – 13.8) 29.9 (28.2 – 32.2) 3,994 Race/ethnicity Mexican Americans 13.2 (12.8 – 13.7) (5.49 – 6.51) 13.5 (12.9 – 14.0) 28.4 (27.1 – 30.2) 2,571 1999–2000 6.10 11.6 5.48 (4.66 – 6.08) 11.8 (11.1 – 12.5) 22.5 (20.0 – 26.1) 2,124 2001–2002 (10.9 – 12.4) (19.2 – 23.4) 20.9 5.20 (5.09 – 5.50) 11.1 1,919 (10.7 – 11.6) (10.4 – 11.5) 2003–2004 10.9 11.1 2,012 5.56 (5.18 – 5.79) 11.0 (10.6 – 11.5) 23.1 (21.6 – 25.0) 2005–2006 (10.7 – 11.5) Non-Hispanic Blacks 1999–2000 (11.1 – 12.4) 5.15 (4.67 – 5.42) 11.7 (10.9 – 12.4) 27.3 (24.9 – 31.5) 1,712 11.6 2001–2002 10.9 (10.2 – 11.6) 5.06 (4.47 – 5.39) 10.7 (10.1 – 11.4) 23.6 (21.7 – 25.2) 2,004 2003–2004 10.1 4.65 (4.28 – 5.11) 10.1 (9.37 – 10.8) 21.9 (19.9 – 23.7) 2,057 (9.66 – 10.6) (9.92 – 11.2) 2005–2006 4.95 (4.68 – 5.15) 10.5 (10.1 – 11.1) 22.9 (21.4 – 24.0) 2,040 10.6 Non-Hispanic Whites 1999–2000 14.8 (13.8 – 15.8) 6.11 (5.52 – 6.55) 15.0 (13.9 – 16.2) 34.2 (32.6 – 36.0) 2,557 2001–2002 (13.0 – 13.9) 5.90 (5.62 – 6.21) 13.6 (13.2 – 14.1) 28.4 (27.2 – 29.9) 3,590 13.4 3,272 12.9 (12.2 – 13.5) 5.76 (5.31 – 6.08) 12.7 (12.1 – 13.3) 30.0 (28.5 – 32.1) 2003–2004 3,120 (12.4 – 13.5) (28.3 – 32.2) 29.9 2005–2006 13.0 (12.4 – 13.6) 5.62 (4.96 – 6.04) 12.9 nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 26

38 Figure 1.1.b. Serum folate: Concentrations by survey cycle Selected percentiles in ng/mL (95% confidence intervals), National Health and Nutrition Examination Survey, 1999–2006 80 60 40 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 95th Percentile 1 1 1 1 1 1 20 0 25 20 1 1 1 1 1 1 1 1 1 15 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 50th Percentile 1 1 1 10 5 14 12 1 1 10 1 1 1 1 1 1 8 5th Percentile 1 1 1 1 6 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 12−19y Males Females MA NHB NHW 20+y 6−11y 3−5y Total (3+y) 1. Water -Soluble Vitamins 27

39 size 8,498 4,304 8,172 1,861 4,404 1,779 4,050 6,675 3,262 2,649 3,069 16,670 Sample (576 – 642) (521 – 668) (506 – 558) (529 – 588) (566 – 604) (419 – 449) (457 – 511) (398 – 471) (594 – 653) (483 – 547) (519 – 605) (724 – 860) 97.5th 551 560 529 581 428 470 604 436 617 512 554 768 (453 – 489) (436 – 531) (434 – 465) (487 – 515) (400 – 456) (367 – 398) (508 – 535) (355 – 390) (510 – 537) (421 – 480) (461 – 510) (622 – 705) 95th 483 469 452 501 430 522 382 529 370 449 481 656 (95% conf. interval) s (250 – 259) (261 – 272) (237 – 246) (256 – 265) (262 – 273) (210 – 216) (254 – 264) (224 – 233) (269 – 282) (235 – 247) (266 – 279) (315 – 338) 50th 241 266 255 261 259 268 213 229 276 241 273 327 Selected percentile (138 – 155) (144 – 153) (169 – 178) (146 – 152) (172 – 184) (146 – 153) (120 – 130) (134 – 146) (154 – 165) (136 – 144) (143 – 154) (157 – 166) 5th 149 149 174 149 125 180 149 160 140 140 149 161 (149 – 160) (125 – 138) (128 – 138) (129 – 136) (127 – 136) (152 – 171) (107 – 116) (137 – 149) (123 – 130) (119 – 131) (126 – 137) (140 – 151) 2.5th 152 133 133 133 132 164 112 144 126 126 132 147 n (253 – 264) (265 – 279) (242 – 252) (261 – 270) (210 – 218) (258 – 268) (267 – 277) (225 – 234) (274 – 288) (238 – 250) (264 – 276) (317 – 332) 259 247 272 265 263 214 272 281 229 244 270 324 (95% conf. interval) Geometric mea Race/ethnicity Mexican Americans Gender Total, 1 year and older 1–5 years Age group Males Females 6–11 years Non-Hispanic Blacks Non-Hispanic Whites 12–19 years 20–39 years 40–59 years 60 years and older National Health and Nutrition Examination Survey, 2003–2006. Geometric mean and selected percentiles of red blood cell concentrations (in ng/mL) for the total U.S. population aged 1 year and older, Table 1.2.a.1. Red blood cell folate: Concentrations nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 28

40 Figure 1.2.a. Red blood cell folate: Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2006 Overall Mexican Americans 400 Females 300 Males 200 (ng/mL) 100 Red blood cell folate 0 20−39 6−11 12−19 12−19 40−59 60+ 6−11 20−39 40−59 1−5 60+ 1−5 Non−Hispanic Whites Non−Hispanic Blacks 400 300 200 (ng/mL) 100 Red blood cell folate 0 12−19 40−59 40−59 20−39 1−5 6−11 60+ 20−39 12−19 60+ 1−5 6−11 Females Males 400 Mexican 300 Americans Non−Hispanic Blacks 200 Non−Hispanic (ng/mL) Whites 100 Red blood cell folate 0 1−5 12−19 20−39 40−59 6−11 60+ 40−59 20−39 1−5 6−11 12−19 60+ Age (years) Age (years) - 1. Water Soluble Vitamins 29

41 Table 1.2.a.2. Red blood cell folate: Total population Geometric mean and selected percentiles of red blood cell concentrations (in ng/mL) for the total U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 50th 5th 95th Males and Females 501 (146 – 152) 265 (256 – 265) 149 (487 – 515) 16,670 Total, 1 year and older (261 – 270) 261 (265 – 279) 174 1–5 years 266 (261 – 272) 483 (436 – 531) 1,861 272 (169 – 178) 263 180 (172 – 184) 259 (258 – 268) 430 (400 – 456) 1,779 6–11 years (254 – 264) 229 (225 – 234) 140 (134 – 146) 229 (224 – 233) 370 (355 – 390) 12–19 years 4,050 20–39 years (238 – 250) 140 (136 – 144) 241 (235 – 247) 449 (421 – 480) 3,262 244 270 149 (143 – 154) 273 (266 – 279) 481 (461 – 510) 2,649 40–59 years (264 – 276) 324 (317 – 332) 161 (157 – 166) 327 (315 – 338) 656 (622 – 705) 3,069 60 years and older Males Total, 1 year and older (253 – 264) 149 (144 – 153) 255 (250 – 259) 469 (453 – 489) 8,172 259 281 (271 – 290) 176 (170 – 185) 271 (264 – 281) 507 (460 – 560) 941 1–5 years 6–11 years 265 (259 – 271) 182 (173 – 188) 257 (251 – 264) 439 (414 – 468) 867 12–19 years 229 142 (135 – 148) 229 (223 – 233) 361 (353 – 385) 2,051 (225 – 234) 235 140 (131 – 148) 235 (226 – 244) 397 (379 – 429) 1,467 (228 – 242) 20–39 years 1,309 (431 – 513) 463 (256 – 275) 265 149 (256 – 271) 263 40–59 years (140 – 154) 313 (302 – 324) 159 (154 – 163) 311 (297 – 328) 651 60 years and older 1,537 (595 – 709) Females 272 (267 – 277) 149 (146 – 153) Total, 1 year and older (262 – 273) 522 (508 – 535) 8,498 268 1–5 years 263 (255 – 270) 173 (161 – 177) 262 (254 – 267) 436 (395 – 531) 920 6–11 years 261 176 (162 – 183) 260 (253 – 267) 402 (379 – 459) 912 (254 – 269) 12–19 years (223 – 234) 138 (130 – 146) 229 (223 – 234) 373 (354 – 398) 1,999 229 20–39 years 253 (246 – 261) 139 (134 – 145) 248 (239 – 258) 486 (461 – 529) 1,795 278 40–59 years (269 – 284) 149 (139 – 157) 276 (271 – 288) 501 (467 – 536) 1,340 (157 – 172) 60 years and older 334 (324 – 344) 162 (616 – 744) 338 (325 – 352) 661 1,532 Table 1.2.a.3. Red blood cell folate: Mexican Americans Geometric mean and selected percentiles of red blood cell concentrations (in ng/mL) for Mexican Americans in the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample size (95% conf. interval) 50th 95th 5th Males and Females 149 (138 – 155) 241 Total, 1 year and older 452 (434 – 465) 4,304 247 (242 – 252) (237 – 246) (257 – 275) 1–5 years (152 – 177) 258 (249 – 266) 477 (441 – 507) 610 266 170 259 170 (156 – 183) 256 (252 – 266) 443 (396 – 483) 595 6–11 years (249 – 262) 231 (225 – 237) 144 (136 – 154) 225 (221 – 232) 402 (386 – 423) 12–19 years 1,288 20–39 years (228 – 246) 139 (125 – 154) 232 (223 – 241) 437 (402 – 463) 787 237 254 149 (132 – 157) 249 (235 – 264) 451 (415 – 520) 471 40–59 years (245 – 264) 277 (263 – 292) 147 (130 – 156) 271 (258 – 290) 565 (483 – 646) 553 60 years and older Males Total, 1 year and older (231 – 245) 146 (133 – 153) 234 (230 – 239) 413 (388 – 445) 2,087 238 276 (263 – 289) 171 (151 – 189) 267 (260 – 275) 481 (445 – 553) 298 1–5 years 6–11 years 263 (253 – 274) 171 (151 – 189) 258 (249 – 265) 466 (422 – 523) 289 12–19 years 226 139 (134 – 147) 223 (214 – 230) 378 (340 – 455) 639 (219 – 233) 221 136 (106 – 153) 220 (211 – 231) 367 (333 – 406) 350 20–39 years (211 – 231) 245 (235 – 255) 149 (122 – 158) 234 40–59 years 429 (226 – 250) 238 (373 – 538) (234 – 268) 257 146 60 years and older 248 (243 – 271) 478 (438 – 542) 273 (121 – 150) Females Total, 1 year and older 257 (252 – 263) 154 (140 – 161) 250 (246 – 256) 477 (460 – 505) 2,217 1–5 years 255 165 (139 – 177) 248 (240 – 258) 445 (398 – 506) 312 (245 – 265) 6–11 years (245 – 263) 170 (153 – 180) 253 (246 – 261) 405 (358 – 477) 306 254 12–19 years 237 (230 – 243) 153 (135 – 158) 230 (224 – 237) 420 (398 – 450) 649 20–39 years (247 – 267) 149 (135 – 161) 250 (236 – 267) 490 (458 – 587) 437 256 233 264 (249 – 281) 144 (110 – 159) 263 (244 – 287) 486 (424 – 746) 40–59 years (267 – 329) (550 – 682) 587 280 60 years and older 295 (269 – 322) 148 (91.6 – 168) 306 nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 30

42 Table 1.2.a.4. Red blood cell folate: Non–Hispanic blacks Geometric mean and selected percentiles of red blood cell concentrations (in ng/mL) for non–Hispanic blacks in the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 95th 5th Males and Females (367 – 398) 213 125 382 (120 – 130) 4,404 (210 – 218) 214 Total, 1 year and older (210 – 216) 143 (132 – 152) 1–5 years (221 – 231) 350 (330 – 371) 525 225 (218 – 232) 226 (225 – 235) (146 – 165) 231 (224 – 238) 156 (321 – 370) 572 230 6–11 years 336 (190 – 199) 118 (111 – 124) 195 (191 – 200) 312 (299 – 319) 1,432 12–19 years 194 (199 – 210) 20–39 years (115 – 122) 203 (193 – 209) 370 (350 – 406) 717 204 119 (208 – 225) (107 – 132) 215 (209 – 221) 386 (359 – 436) 630 216 40–59 years 124 (231 – 254) 131 (125 – 137) 237 (221 – 252) 449 (423 – 508) 528 60 years and older 242 Males Total, 1 year and older 122 (119 – 129) 208 (204 – 213) 355 (344 – 375) 2,189 209 (205 – 213) (219 – 238) 143 (122 – 152) 227 (220 – 235) 359 (333 – 418) 259 1–5 years 228 231 (225 – 237) 164 (146 – 170) 231 (222 – 239) 337 (319 – 386) 282 6–11 years 195 12–19 years (110 – 131) 198 (190 – 204) 305 (289 – 320) 750 (190 – 201) 123 (188 – 201) (113 – 121) 192 (184 – 204) 309 (298 – 337) 339 20–39 years 116 195 295 (355 – 435) 375 (201 – 218) 209 120 (202 – 220) 211 (95.7 – 133) 40–59 years (222 – 245) 128 (123 – 134) 224 (211 – 240) 461 (413 – 541) 60 years and older 233 264 Females (214 – 224) 127 (119 – 131) 216 219 397 (374 – 416) 2,215 Total, 1 year and older (212 – 221) 221 (214 – 228) 146 (124 – 158) 224 (218 – 232) 334 (301 – 361) 266 1–5 years 230 6–11 years (142 – 161) 230 (219 – 242) 334 (314 – 388) 290 (221 – 239) 149 193 113 (109 – 119) 194 (190 – 200) 314 (299 – 341) 682 12–19 years (188 – 200) 213 (204 – 221) 121 (108 – 132) 210 (199 – 219) 406 (371 – 428) 378 20–39 years (211 – 232) 221 128 (99.8 – 133) 219 (210 – 233) 389 (353 – 494) 335 40–59 years 245 248 (232 – 267) 135 (104 – 150) 264 (220 – 275) 445 (421 – 521) 60 years and older Table 1.2.a.5. Red blood cell folate: Non–Hispanic whites Geometric mean and selected percentiles of red blood cell concentrations (in ng/mL) for non–Hispanic whites in the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample size (95% conf. interval) 50th 95th 5th Males and Females 160 (154 – 165) 276 Total, 1 year and older 529 (510 – 537) 6,675 281 (274 – 288) (269 – 282) (277 – 304) 1–5 years (179 – 201) 278 (267 – 293) 528 (484 – 598) 523 290 191 274 191 (187 – 197) 268 (267 – 281) 439 (411 – 464) 454 6–11 years (261 – 275) 239 (233 – 246) 152 (145 – 158) 238 (231 – 246) 376 (356 – 407) 12–19 years 1,046 20–39 years (250 – 267) 152 (143 – 159) 254 (246 – 262) 464 (435 – 504) 1,460 258 281 159 (150 – 165) 285 (275 – 293) 494 (466 – 532) 1,346 40–59 years (273 – 290) 339 (330 – 348) 173 (162 – 183) 340 (328 – 350) 673 (645 – 732) 1,846 60 years and older Males Total, 1 year and older (267 – 281) 161 (153 – 167) 269 (262 – 278) 493 (473 – 524) 3,294 274 299 (284 – 316) 200 (173 – 208) 283 (268 – 312) 537 (498 – 659) 286 1–5 years 6–11 years 277 (268 – 286) 193† (188 – 202) 269 (258 – 278) 447† (425 – 517) 218 12–19 years 241 152 (139 – 158) 238 (231 – 249) 374 (355 – 437) 527 (234 – 248) 250 154 (141 – 165) 248 (238 – 258) 414 (395 – 447) 641 20–39 years (240 – 260) 275 (265 – 286) 160 (148 – 165) 280 40–59 years 474 (266 – 292) 688 (433 – 534) (306 – 340) 326 170 60 years and older 322 (314 – 338) 660 (609 – 716) 934 (161 – 184) Females Total, 1 year and older 288 (280 – 296) 158 (153 – 164) 282 (273 – 290) 546 (531 – 569) 3,381 1–5 years 280 183 (152 – 196) 272 (263 – 286) 486 (428 – 584) 237 (264 – 296) 6–11 years (261 – 280) 188 (170 – 198) 267 (259 – 276) 390 (373 – 456) 236 270 12–19 years 238 (231 – 245) 149 (136 – 160) 237 (230 – 244) 381 (350 – 447) 519 20–39 years (257 – 278) 149 (139 – 155) 263 (251 – 272) 502 (473 – 557) 819 267 658 287 (277 – 298) 158 (148 – 167) 289 (276 – 302) 506 (477 – 545) 40–59 years (630 – 796) 60 years and older 350 (337 – 362) 177 (158 – 186) 352 (338 – 370) 689 912 † Estimate is subject to greater uncertainty due to small cell size. 1. Water-Soluble Vitamins 31

43 Table 1.2.b. Red blood cell folate: Concentrations by survey cycle Geometric mean and selected percentiles of red blood cell concentrations (in ng/mL) for the U.S. population, National Health and Nutrition Examination Survey, 1999–2006. n Selected percentile s (95% conf. interval) Sample Geometric mea 50th 5th 95th (95% conf. interval) size Total, 3 years and older 522 277 281 (269 – 293) (499 – 556) 7,614 153 (144 – 162) 1999–2000 (266 – 288) 155 (148 – 160) 274 (265 – 282) 519 (500 – 540) 8,488 2001–2002 277 (269 – 285) 146 258 254 (246 – 262) 483 (464 – 506) 7,849 2003–2004 (251 – 266) (139 – 151) 7,906 152 267 (263 – 270) 517 (497 – 534) (267 – 277) 2005–2006 272 (148 – 155) Age group 3–5 years (282 – 306) 198 1999–2000 290 (283 – 301) 446 (397 – 608) 380 293 (182 – 206) 284 188 (163 – 201) 283 (270 – 296) 468 (394 – 522) 460 2001–2002 (273 – 296) (253 – 273) (172 – 187) 258 (245 – 268) 385 (364 – 583) 453 263 2003–2004 181 (269 – 295) 191 (181 – 197) 271 (265 – 281) 463 (432 – 598) 493 2005–2006 282 6–11 years 1999–2000 190 (177 – 202) 282 (274 – 292) 423 (389 – 502) 898 284 (275 – 293) (266 – 287) 183 (171 – 189) 272 (260 – 283) 444 (422 – 512) 1,040 2001–2002 276 258 (251 – 265) 414 (170 – 183) 255 (246 – 264) 2003–2004 (372 – 447) 849 176 2005–2006 (260 – 277) 182 (173 – 189) 263 (257 – 271) 434 (396 – 494) 930 269 12–19 years 1999–2000 152 (146 – 158) 244 (238 – 255) 415 (391 – 456) 2,136 247 (237 – 256) (231 – 253) (138 – 157) 238 (228 – 249) 406 (381 – 446) 2,226 242 148 2001–2002 (217 – 230) 137 (129 – 145) 223 (215 – 230) 2003–2004 (338 – 386) 2,063 223 356 235 145 (133 – 151) 234 (228 – 240) (229 – 241) (358 – 414) 1,987 2005–2006 380 20–39 years 256 (244 – 268) 141 (130 – 150) 254 (237 – 270) 460 (439 – 515) 1,474 1999–2000 254 2001–2002 144 (134 – 152) 251 (240 – 262) 448 (432 – 471) 1,721 (246 – 263) 236 138 (131 – 143) 234 (221 – 245) 426 (403 – 461) 1,555 2003–2004 (228 – 245) 252 (244 – 261) 143 (138 – 150) 249 (242 – 256) 462 (428 – 525) 1,707 2005–2006 40–59 years 1999–2000 (279 – 311) 156 (144 – 167) 292 (274 – 309) 538 (502 – 613) 1,213 294 289 (280 – 298) 163 (155 – 170) 287 (281 – 295) 526 (484 – 585) 1,496 2001–2002 2003–2004 264 (253 – 275) 148 (137 – 156) 270 (258 – 279) 465 (430 – 514) 1,273 276 2005–2006 (270 – 282) 150 (145 – 155) 277 (270 – 284) 495 (465 – 544) 1,376 60 years and older 1999–2000 (328 – 352) 169 (154 – 182) 343 (323 – 363) 667 (629 – 701) 1,513 340 (158 – 178) 336 (325 – 349) 654 (608 – 721) 1,545 334 (323 – 345) 2001–2002 167 (310 – 329) (154 – 171) 321 (310 – 337) 642 (589 – 725) 1,656 320 162 2003–2004 (316 – 342) 161 (155 – 168) 332 (312 – 347) 662 2005–2006 1,413 329 (618 – 733) Gender Males (262 – 286) 153 (144 – 161) 1999–2000 (259 – 280) 499 (478 – 526) 3,721 274 270 269 (259 – 278) 155 (147 – 160) 265 (254 – 276) 485 (465 – 520) 4,106 2001–2002 252 2003–2004 147 (138 – 153) 248 (239 – 257) 452 (431 – 485) 3,874 (244 – 260) 481 264 (144 – 157) 259 (255 – 264) 151 (459 – 508) 3,845 2005–2006 (257 – 271) Females 288 (275 – 301) 154 (142 – 164) 286 (272 – 298) 549 (515 – 590) 3,893 1999–2000 285 2001–2002 155 (148 – 159) 282 (274 – 291) 540 (518 – 575) 4,382 (276 – 294) 2003–2004 (256 – 273) 146 (138 – 151) 261 (251 – 271) 502 (483 – 530) 3,975 264 2005–2006 280 (273 – 287) 153 (148 – 157) 274 (267 – 282) 538 (528 – 557) 4,061 Race/ethnicity Mexican Americans 261 (253 – 268) (151 – 166) 256 (251 – 262) 452 (429 – 465) 2,592 1999–2000 159 256 146 (132 – 161) 252 (241 – 265) 458 (434 – 497) 2,134 2001–2002 (244 – 268) (398 – 462) 414 149 (136 – 157) 236 1,919 (231 – 244) (234 – 251) 2003–2004 242 250 2,057 148 (129 – 158) 244 (239 – 249) 461 (452 – 482) 2005–2006 (244 – 256) Non-Hispanic Blacks 1999–2000 (218 – 233) 125 (113 – 135) 225 (221 – 234) 386 (366 – 427) 1,738 226 2001–2002 216 (210 – 222) 122 (119 – 124) 214 (208 – 220) 376 (355 – 412) 2,045 2003–2004 209 119 (114 – 127) 209 (204 – 214) 366 (349 – 389) 2,091 (203 – 214) (212 – 221) 2005–2006 131 (124 – 136) 217 (215 – 224) 402 (376 – 422) 2,084 220 Non-Hispanic Whites 1999–2000 298 (281 – 315) 165 (147 – 175) 293 (275 – 309) 555 (527 – 592) 2,585 2001–2002 (286 – 300) 166 (160 – 172) 289 (283 – 295) 542 (524 – 566) 3,625 293 3,256 273 (262 – 285) 158 (146 – 166) 269 (258 – 280) 504 (485 – 531) 2003–2004 3,149 (276 – 289) (527 – 567) 539 2005–2006 288 (281 – 295) 162 (155 – 167) 282 nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 32

44 Figure 1.2.b. Red blood cell folate: Concentrations by survey cycle Selected percentiles in ng/mL (95% confidence intervals), National Health and Nutrition Examination Survey, 1999–2006 700 600 i i i i i i i i i i i i i i i i 500 i i i i i i i i i i i i i i 95th Percentile i i i i 400 i i i i i i 300 350 300 i i i i i i i i i i i i i i i i i i i i i i i i i i i i i 250 i i i 50th Percentile i i i i i i i i 200 250 200 i i i i i i i i i i i i i i i i i i i i i i i i i i i 150 i i i i i i 5th Percentile i i i i i i i 100 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 Total 3−5y 6−11y 12−19y 20+y Males Females MA NHB NHW (3+y) - 1. Water Soluble Vitamins 33

45 Table 1.2.c. Red blood cell folate: Prevalence Prevalence (in percent) of low red blood cell folate concentration (< 95 ng/mL) for the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Estimated total Prevalenc e Sample (95% conf. interval) number of persons size 16,670 0.2 (0.2 – 0.4) 704,000 Total, 1 year and older Age group 1–5 years § § 1,861 6–11 years 1,779 § § 12–19 years 4,050 0.2 (0.1 – 0.4) 76,000 § 20–39 years 3,262 § 331,000 (0.2 – 0.7) 40–59 years 0.4 2,649 60 years and older § § 3,069 Gender Males 8,172 0.2 (0.1 – 0.4) 301,000 0.3 Females 8,498 (0.2 – 0.5) 404,000 Race/ethnicity 72,000‡ 4,304 0.3‡ (0.1 – 0.6) Mexican Americans Non-Hispanic Blacks 4,404 0.9 (0.6 – 1.5) 313,000 6,675 § Non-Hispanic Whites § ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. § Estimate suppressed: RSE ≥ 40% for the prevalence estimate. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 34

46 Table 1.2.d. Red blood cell folate: Prevalence by survey cycle Prevalence (in percent) of low red blood cell folate concentration (< 95 ng/mL) for the U.S. population, National Health and Nutrition Examination Survey, 1999–2006. Sample size (95% conf. interval) Estimated total number of persons Prevalenc e Total, 3 years and older 7,614 § 1999–2000 § 0.2‡ (0.1 – 0.4) 562,000‡ 2001–2002 8,488 7,849 (0.2 – 0.6) 947,000 2003–2004 0.3 2005–2006 7,906 0.2 (0.1 – 0.3) 434,000 Age group 3–5 years 1999–2000 § § 380 460 § 2001–2002 § 2003–2004 453 § § 493 § 2005–2006 § 6–11 years 1999–2000 898 § § 2001–2002 1,040 § § 2003–2004 849 § § 2005–2006 930 § § 12–19 years 1999–2000 § § 2,136 2001–2002 2,226 § § 2,063 2003–2004 (0.1 – 0.5) 88,000‡ 0.3‡ 2005–2006 1,987 0.2‡ (0.1 – 0.4) 64,000‡ 20–39 years 1999–2000 1,474 § § 2001–2002 1,721 § § 1,555 § 2003–2004 § 2005–2006 1,707 § § 40–59 years 1999–2000 1,213 § § 2001–2002 1,496 § § 2003–2004 1,273 0.7‡ (0.3 – 1.5) 555,000‡ (0.1 – 0.3) 2005–2006 1,376 0.1‡ 118,000‡ 60 years and older 1999–2000 § § 1,513 1,545 0.3‡ 147,000‡ 2001–2002 (0.1 – 0.7) § 1,656 2003–2004 § § § 2005–2006 1,413 Gender Males 1999–2000 3,721 0.2‡ (0.1 – 0.4) 217,000‡ 4,106 § § 2001–2002 2003–2004 3,874 (0.1 – 0.6) 378,000‡ 0.3‡ 3,845 (0.1 – 0.2) 201,000 2005–2006 0.1 Females 3,893 § § 1999–2000 2001–2002 0.1‡ (0.1 – 0.3) 161,000‡ 4,382 2003–2004 3,975 0.4‡ (0.2 – 0.9) 570,000‡ 2005–2006 4,061 § § Race/ethnicity Mexican Americans 2,592 § 1999–2000 § 2001–2002 2,134 § § 1,919 § § 2003–2004 2,057 § § 2005–2006 Non-Hispanic Blacks 1999–2000 1,738 1.0 (0.5 – 1.7) 318,000 2001–2002 2,045 0.7‡ (0.3 – 1.5) 238,000‡ 2003–2004 2,091 (0.5 – 1.9) 333,000 1.0 2005–2006 0.8‡ (0.3 – 1.8) 261,000‡ 2,084 Non-Hispanic Whites 1999–2000 2,585 § § 2001–2002 § § 3,625 2003–2004 3,256 § § 2005–2006 3,149 0.0 (0.0 – 0.1) 85,000 ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. § Estimate suppressed: RSE ≥ 40% for the prevalence estimate. 1. Water-Soluble Vitamins 35

47 915 922 size 4,256 2,212 4,055 8,311 2,157 1,985 3,285 1,699 1,381 1,409 Sample (266 – 323) (190 – 262) (176 – 202) (282 – 352) (279 – 330) (169 – 223) (183 – 302) (140 – 206) (289 – 344) (279 – 379) (297 – 399) (281 – 385) 97.5th 185 320 212 302 188 291 238 174 319 322 342 324 (147 – 174) (191 – 254) (148 – 182) (199 – 245) (137 – 185) (210 – 249) (129 – 212) (118 – 150) (212 – 269) (194 – 273) (212 – 302) (217 – 311) 95th 157 160 209 214 157 155 222 127 234 219 262 262 (95% conf. interval) s (44.9 – 48.3) (52.0 – 56.0) (63.1 – 70.4) (46.9 – 51.2) (55.3 – 65.5) (40.8 – 47.0) (35.9 – 41.7) (44.9 – 51.0) (49.5 – 54.6) (43.9 – 50.5) (41.5 – 50.3) (41.9 – 53.5) 50th 66.1 53.9 46.4 49.3 60.0 39.0 44.1 47.8 51.7 47.3 45.6 46.9 Selected percentile (14.5 – 19.5) (21.3 – 29.9) (15.2 – 18.9) (13.3 – 15.3) (23.3 – 28.2) (11.7 – 13.9) (11.3 – 13.2) (19.2 – 21.6) (12.9 – 15.3) (13.6 – 17.0) (11.2 – 13.8) (9.96 – 12.9) 5th 25.4 17.1 17.5 14.3 25.5 12.9 12.7 20.7 14.1 15.6 12.8 11.6 (10.8 – 14.7) (18.2 – 23.6) (11.7 – 14.5) (10.0 – 12.5) (20.0 – 24.1) (8.45 – 10.5) (9.46 – 11.2) (16.4 – 18.4) (9.84 – 12.8) (10.3 – 13.7) (8.61 – 11.3) (8.70 – 9.95) 2.5th 13.3 20.7 12.9 11.3 22.9 10.2 9.41 17.4 11.3 11.8 9.84 9.13 n (61.2 – 69.0) (53.6 – 58.5) (47.2 – 51.4) (49.1 – 53.8) (56.9 – 64.4) (44.7 – 50.3) (37.4 – 44.0) (46.7 – 52.3) (50.8 – 57.0) (47.7 – 54.6) (45.1 – 53.3) (46.7 – 54.5) 65.0 56.0 49.3 51.4 60.5 47.4 40.5 49.4 53.8 51.0 49.0 50.4 (95% conf. interval) Geometric mea Age group Gender Race/ethnicity Males Total, 1 year and older Mexican Americans 1–5 years 6–11 years Non-Hispanic Blacks Females 12–19 years Non-Hispanic Whites 20–39 years 40–59 years 60 years and older Health and Nutrition Examination Survey, 2005–2006. Geometric mean and selected percentiles of serum concentrations (in nmol/L) for the total U.S. population aged 1 year and older, National Table 1.3.a.1. Serum pyridoxal-5’-phosphate: Concentrations nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 36

48 Figure 1.3.a. Serum pyridoxal−5'−phosphate: Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2005–2006 Overall Mexican Americans Females Males Serum pyridoxal− 5'−phospate (nmol/L) 0 20 40 60 80 40−59 6−11 12−19 20−39 12−19 60+ 1−5 20−39 40−59 60+ 1−5 6−11 Non−Hispanic Whites Non−Hispanic Blacks 80 Serum pyridoxal− 5'−phospate (nmol/L) 0 20 40 60 60+ 20−39 12−19 1−5 6−11 40−59 20−39 40−59 60+ 1−5 6−11 12−19 Females Males Mexican Americans Non−Hispanic Blacks Non−Hispanic Whites Serum pyridoxal− 5'−phospate (nmol/L) 0 20 40 60 80 60+ 60+ 20−39 12−19 6−11 1−5 40−59 40−59 1−5 6−11 12−19 20−39 Age (years) Age (years) - 1. Water Soluble Vitamins 37

49 Table 1.3.a.2. Serum pyridoxal-5’-phosphate: Total population Geometric mean and selected percentiles of serum concentrations (in nmol/L) for the total U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 90th 10th Males and Females (49.1 – 53.8) 19.5 (18.2 – 20.6) 49.3 (46.9 – 51.2) 154 (139 – 162) 8,311 Total, 1 year and older 51.4 (61.2 – 69.0) 1–5 years (29.2 – 35.0) 66.1 (63.1 – 70.4) 126 (116 – 140) 915 65.0 31.7 60.5 30.7 (28.0 – 33.5) 60.0 (55.3 – 65.5) 126 (110 – 138) 922 6–11 years (56.9 – 64.4) 49.4 (46.7 – 52.3) 24.8 (23.3 – 26.3) 47.8 (44.9 – 51.0) 105 (92.9 – 114) 1,985 12–19 years 51.0 20–39 years (18.0 – 21.6) 47.3 (43.9 – 50.5) 153 (130 – 183) 1,699 (47.7 – 54.6) 20.0 49.0 16.5 (14.3 – 19.0) 45.6 (41.5 – 50.3) 166 (147 – 192) 1,381 40–59 years (45.1 – 53.3) 50.4 (46.7 – 54.5) 15.1 (13.0 – 17.5) 46.9 (41.9 – 53.5) 187 (173 – 209) 1,409 60 years and older Males Total, 1 year and older 22.6 (20.3 – 24.6) 53.9 (53.6 – 58.5) 149 (136 – 162) 4,055 56.0 (52.0 – 56.0) 65.3 (61.2 – 69.6) 31.6 (26.3 – 35.2) 66.8 (63.2 – 71.9) 127 (117 – 135) 455 1–5 years 6–11 years 62.0 (57.4 – 66.9) 31.6 (30.5 – 33.4) 60.8 (54.8 – 68.4) 130 (113 – 143) 454 12–19 years 55.4 28.9 (27.0 – 30.6) 54.8 (51.3 – 57.9) 110 (101 – 122) 991 (52.4 – 58.6) 61.6 26.8 (24.8 – 28.8) 55.3 (52.7 – 58.3) 165 (139 – 202) 741 20–39 years (58.0 – 65.4) (43.7 – 56.9) (125 – 188) 158 680 51.0 52.1 19.1 (46.4 – 58.5) 40–59 years (14.8 – 22.6) (40.0 – 54.4) 49.3 60 years and older (13.5 – 19.3) 45.9 (44.7 – 54.3) 171 (156 – 196) 734 16.1 Females Total, 1 year and older 47.4 (44.7 – 50.3) 17.2 (15.2 – 18.8) 44.1 (40.8 – 47.0) 156 (141 – 165) 4,256 1–5 years 64.6 32.1 (28.5 – 36.1) 65.2 (60.9 – 71.1) 124 (106 – 156) 460 (59.3 – 70.5) 6–11 years (54.9 – 63.6) 29.7 (25.3 – 33.6) 58.3 (52.0 – 64.0) 118 (104 – 156) 468 59.1 12–19 years 43.7 (40.5 – 47.2) 21.8 (21.0 – 22.8) 41.4 (39.0 – 45.1) 90.6 (78.4 – 111) 994 20–39 years 42.4 (38.8 – 46.3) 16.5 (14.6 – 18.4) 37.6 (35.1 – 41.8) 132 (111 – 166) 958 701 40–59 years 46.4 (42.5 – 50.6) 14.4 (13.0 – 17.6) 41.6 (36.3 – 46.6) 172 (161 – 207) 206 (176 – 246) 675 60 years and older 51.4 (46.6 – 56.7) 14.1 (12.7 – 16.2) 47.6 (39.8 – 57.1) Table 1.3.a.3. Serum pyridoxal-5’-phosphate: Mexican Americans Geometric mean and selected percentiles of serum concentrations (in nmol/L) for Mexican Americans in the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 10th 50th 90th Males and Females 49.3 (47.2 – 51.4) 22.3 (19.8 – 23.9) 46.4 (44.9 – 48.3) 121 (105 – 136) Total, 1 year and older 2,212 1–5 years (60.1 – 68.7) 32.4 (28.0 – 34.2) 65.0 (59.0 – 71.1) 126 (115 – 142) 322 64.2 58.3 (52.5 – 64.6) 30.3 (24.0 – 34.9) 56.4 (50.8 – 65.8) 116 (98.9 – 137) 321 6–11 years 12–19 years 46.0 (44.4 – 47.6) 24.7 (23.0 – 26.6) 44.4 (42.5 – 47.6) 91.1 (83.7 – 100) 657 20–39 years 47.1 20.4 (15.7 – 24.8) 42.9 (40.1 – 45.6) 127 (97.0 – 143) 453 (44.1 – 50.4) 40–59 years (42.4 – 54.1) 20.2 (14.5 – 23.3) 42.2 (38.5 – 49.4) 141 (115 – 170) 249 47.9 60 years and older 42.0 (34.9 – 50.5) 15.0 (13.1 – 17.2) 38.6 (30.2 – 50.1) 142 (101 – 184) 210 Males Total, 1 year and older (53.7 – 59.1) 27.9 (23.5 – 30.6) 56.4 (51.2 – 55.8) 124 (108 – 140) 1,056 53.7 1–5 years 67.0 (61.3 – 73.3) 30.4 (22.2 – 38.5) 67.7 (60.0 – 76.3) 129 (108 – 180) 153 61.4 6–11 years (27.9 – 35.2) (55.5 – 67.9) 32.0 57.5 (52.4 – 65.7) 126 (97.0 – 151) 157 12–19 years 53.0 28.2 (26.7 – 32.3) 51.6 (47.7 – 55.8) 104 (87.7 – 113) 318 (50.2 – 55.9) 57.2 29.4 (22.0 – 32.5) 51.9 (46.1 – 60.9) 135 (108 – 152) 200 20–39 years (51.9 – 63.1) 56.7 (46.6 – 68.9) 24.0 (16.0 – 34.1) 53.3 40–59 years 122 (45.1 – 59.2) 123 (91.1 – 478) (26.8 – 50.9) 37.8 14.7† 60 years and older 35.6 (30.0 – 47.6) 95.5† (71.3 – 209) 105 (10.7 – 18.6) Females Total, 1 year and older 42.6 (40.8 – 44.6) 19.1 (16.4 – 20.8) 39.4 (38.2 – 40.3) 111 (96.5 – 130) 1,156 1–5 years 61.5 33.2 (28.9 – 34.9) 61.2 (55.2 – 68.8) 120 (97.3 – 176) 169 (55.9 – 67.7) 6–11 years (47.2 – 64.3) 27.6 (17.6 – 34.7) 54.3 (44.6 – 68.7) 105 (87.9 – 133) 164 55.1 12–19 years 39.6 (37.6 – 41.7) 20.7 (19.0 – 22.6) 38.8 (37.2 – 39.7) 76.8 (69.9 – 87.9) 339 20–39 years (34.3 – 40.4) 17.7 (11.8 – 19.6) 34.1 (31.7 – 36.1) 89.7 (71.6 – 134) 253 37.3 126 40.2 (35.0 – 46.3) 14.9 (10.3 – 18.9) 33.2 (29.7 – 39.1) 155 (110 – 199) 40–59 years 105 160† (106 – 212) 60 years and older 45.7 (36.9 – 56.6) 16.6† (12.6 – 19.8) 39.3 (30.7 – 53.3) † Estimate is subject to greater uncertainty due to small cell size. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 38

50 Table 1.3.a.4. Serum pyridoxal-5’-phosphate: Non-Hispanic blacks Geometric mean and selected percentiles of serum concentrations (in nmol/L) for non-Hispanic blacks in the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 50th 10th 90th Males and Females 104 (15.4 – 17.2) 40.5 (35.9 – 41.7) 16.3 (90.5 – 132) 2,157 Total, 1 year and older (37.4 – 44.0) 39.0 (49.4 – 58.9) 25.2 1–5 years 51.2 (46.4 – 58.8) 115 (99.1 – 138) 226 54.0 (22.3 – 29.5) 50.6 27.2 (25.0 – 29.8) 46.4 (45.4 – 56.4) 97.1 (90.0 – 123) 254 6–11 years (41.9 – 55.9) 41.0 (38.1 – 44.1) 21.6 (19.8 – 22.7) 39.5 (37.1 – 43.2) 82.8 (73.6 – 90.9) 12–19 years 676 20–39 years (36.8 – 44.5) 16.3 (13.2 – 18.1) 38.5 (35.3 – 43.5) 105 (94.0 – 142) 371 40.5 39.9 14.9 (13.2 – 17.4) 36.3 (31.1 – 41.7) 132 (82.8 – 204) 339 40–59 years (33.5 – 47.5) 31.3 (26.8 – 36.6) 10.7 (8.73 – 12.6) 29.1 (24.5 – 35.7) 104 (79.0 – 152) 291 60 years and older Males Total, 1 year and older (40.5 – 48.6) 19.0 (17.3 – 20.1) 43.7 (39.3 – 47.3) 104 (92.0 – 137) 1,071 44.3 55.4 (49.5 – 61.9) 24.6† (19.3 – 32.2) 53.6 (46.6 – 60.4) 120† (103 – 147) 109 1–5 years 6–11 years 53.5 (47.2 – 60.7) 29.6 (26.0 – 31.8) 52.5 (41.9 – 61.7) 100 (92.0 – 124) 133 12–19 years 44.6 22.9 (21.1 – 25.1) 44.5 (38.8 – 49.5) 89.2 (74.9 – 103) 348 (40.6 – 48.9) 47.5 19.7 (14.5 – 23.5) 45.2 (37.7 – 53.5) 130 (95.2 – 185) 170 (41.2 – 54.8) 20–39 years 157 (79.6 – 203) 102 (31.6 – 46.6) 40.7 16.0 (34.9 – 48.7) 41.2 40–59 years (9.17 – 20.7) 33.0 (27.9 – 39.1) 12.4 (10.2 – 13.4) 27.9 (24.1 – 38.1) 103 60 years and older 154 (79.1 – 194) Females 37.5 (34.2 – 41.1) 14.8 (13.4 – 16.1) Total, 1 year and older (32.3 – 39.2) 103 (85.9 – 128) 1,086 35.6 1–5 years 52.5 (46.3 – 59.4) 26.0 (11.1 – 30.5) 51.1 (42.8 – 59.8) 109 (88.7 – 149) 117 6–11 years 47.9 25.0 (22.9 – 29.8) 42.9 (38.0 – 52.0) 93.0 (84.6 – 128) 121 (42.4 – 54.2) 12–19 years (35.2 – 40.3) 20.7 (18.7 – 21.6) 36.8 (33.7 – 39.1) 73.6 (68.9 – 85.6) 328 37.7 20–39 years 35.4 (32.2 – 38.9) 14.4 (9.31 – 16.8) 33.8 (28.4 – 37.9) 99.7 (80.0 – 141) 201 33.8 40–59 years (30.8 – 48.9) 14.4 (13.0 – 16.1) 38.8 (26.5 – 41.0) 145 (81.3 – 261) 182 (8.20 – 11.2) 60 years and older 30.2 (24.5 – 37.2) 9.48 137 29.9 (22.4 – 37.0) 95.0 (74.2 – 157) † Estimate is subject to greater uncertainty due to small cell size Table 1.3.a.5. Serum pyridoxal-5’-phosphate: Non-Hispanic whites Geometric mean and selected percentiles of serum concentrations (in nmol/L) for non-Hispanic whites in the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea Sample n (95% conf. interval) size 10th 90th 50th Males and Females (50.8 – 57.0) 19.2 (17.7 – 20.7) 51.7 (49.5 – 54.6) 167 (156 – 181) 3,285 Total, 1 year and older 53.8 (63.0 – 74.4) (30.5 – 37.3) 68.5 68.4 (63.3 – 77.5) 130 (114 – 157) 263 1–5 years 34.0 63.9 31.6 (29.2 – 34.2) 63.3 (54.9 – 72.7) 133 (117 – 170) 251 6–11 years (58.7 – 69.5) 52.7 (48.7 – 57.1) 25.7 (23.8 – 27.2) 51.5 (47.4 – 56.8) 109 (96.0 – 127) 12–19 years 505 20–39 years (48.9 – 60.3) 20.9 (17.7 – 22.7) 50.6 (44.9 – 55.8) 168 (133 – 211) 718 54.3 50.6 16.2 (13.7 – 19.0) 47.9 (42.7 – 52.8) 173 (153 – 199) 691 40–59 years (45.6 – 56.1) 53.2 (49.0 – 57.9) 15.7 (13.3 – 18.2) 50.6 (44.0 – 57.5) 196 (177 – 215) 857 60 years and older Males Total, 1 year and older (55.1 – 62.7) 22.8 (20.2 – 25.5) 57.4 (53.8 – 60.6) 166 (147 – 183) 1,636 58.8 68.7 (62.9 – 74.9) 34.9 (30.2 – 37.2) 70.8 (65.3 – 78.3) 126 (115 – 137) 146 1–5 years 6–11 years 63.9 (57.3 – 71.4) 31.6 (29.3 – 33.7) 64.7 (50.1 – 75.8) 135 (106 – 190) 121 12–19 years 60.3 29.5 (27.3 – 33.8) 59.7 (54.7 – 65.2) 117 (105 – 148) 255 (55.5 – 65.5) 65.9 27.9 (25.3 – 30.8) 58.4 (53.9 – 66.8) 183 (152 – 228) 310 20–39 years (60.4 – 72.0) 54.7 (47.4 – 63.2) 19.1 (14.6 – 22.8) 53.1 40–59 years 173 (43.6 – 61.7) 356 (140 – 194) (42.2 – 59.3) 52.0 16.7 60 years and older 50.4 (46.4 – 58.2) 174 (157 – 204) 448 (13.7 – 20.5) Females Total, 1 year and older 49.4 (45.8 – 53.2) 16.4 (14.4 – 18.7) 46.4 (42.5 – 50.4) 170 (161 – 182) 1,649 1–5 years 68.3 32.6 (26.5 – 40.3) 66.6 (59.0 – 79.5) 141 (105 – 183) 117 (59.0 – 79.0) 6–11 years (56.8 – 71.8) 31.3 (23.7 – 35.9) 62.7 (51.7 – 74.6) 126 (108 – 175) 130 63.8 12–19 years 45.6 (41.0 – 50.8) 21.8 (19.7 – 23.9) 42.1 (39.0 – 47.8) 94.0 (80.0 – 126) 250 20–39 years (39.3 – 50.7) 16.5 (14.4 – 18.8) 38.4 (34.5 – 45.7) 156 (112 – 216) 408 44.6 335 46.8 (42.2 – 52.0) 13.9 (12.6 – 16.4) 44.4 (35.8 – 48.3) 174 (155 – 221) 40–59 years (184 – 254) 409 60 years and older 54.3 (48.6 – 60.6) 14.6 (12.5 – 17.0) 50.6 (41.6 – 62.5) 213 1. Water-Soluble Vitamins 39

51 Table 1.3.c. Serum pyridoxal-5’-phosphate: Prevalence Prevalence (in percent) of low serum pyridoxal-5’-phosphate concentration (< 20 nmol/L) for the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2005–2006. Prevalenc e Sample Estimated total (95% conf. interval) number of persons size 10.5 8,311 30,146,000 (9.1 – 12.0) Total, 1 year and older Age group 1–5 years 915 2.1‡ (1.1 – 4.2) 435,000‡ 6–11 years 922 1.2‡ (0.5 – 2.7) 280,000‡ 1,529,000 12–19 years 1,985 4.6 (3.6 – 5.7) 9.9 (7.7 – 12.6) 20–39 years 7,877,000 1,699 1,381 13.9 (11.2 – 17.1) 11,371,000 40–59 years 1,409 16.0 (13.1 – 19.5) 7,741,000 60 years and older Gender 10,305,000 4,055 7.3 (5.7 – 9.4) Males Females 13.5 (11.7 – 15.5) 19,830,000 4,256 Race/ethnicity Mexican Americans 2,212 7.5 (5.3 – 10.4) 2,031,000 Non-Hispanic Blacks 2,157 15.7 (13.6 – 18.0) 5,459,000 (9.1 – 12.5) 20,588,000 10.7 Non-Hispanic Whites 3,285 ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 40

52 1. Water-Soluble Vitamins 41

53 917 922 size 4,257 2,213 4,055 8,312 2,157 1,985 3,285 1,698 1,381 1,409 Sample (349 – 712) (271 – 427) (127 – 355) (104 – 214) (329 – 505) (92.4 – 133) (159 – 493) (79.4 – 131) (370 – 717) (184 – 447) (278 – 2,150) (557 – 1,700) 97.5th 169 334 130 385 111 232 465 498 271 705 873 94.5 (146 – 212) (75.6 – 125) (74.7 – 136) (174 – 223) (64.3 – 115) (188 – 255) (89.8 – 196) (59.8 – 84.4) (203 – 265) (125 – 198) (162 – 344) (355 – 611) 95th 171 194 119 214 224 160 212 464 90.9 96.9 85.6 70.5 (95% conf. interval) s (22.2 – 25.8) (24.9 – 27.4) (18.1 – 20.1) (24.6 – 26.5) (19.8 – 23.9) (23.4 – 26.1) (16.3 – 19.3) (18.2 – 20.1) (27.8 – 30.6) (20.4 – 23.9) (25.8 – 29.1) (45.0 – 52.3) 50th 19.0 24.2 26.0 25.5 21.6 17.8 24.7 19.0 29.3 22.2 27.3 47.6 Selected percentile (8.66 – 9.55) (9.91 – 11.2) (9.07 – 11.3) (9.53 – 10.2) (8.57 – 10.2) (9.15 – 9.76) (7.72 – 8.44) (8.28 – 9.47) (10.6 – 11.5) (8.78 – 9.53) (9.90 – 11.4) (12.3 – 14.1) 5th 10.5 9.13 10.6 9.87 9.46 9.50 8.04 8.85 11.1 9.16 10.7 13.1 (7.09 – 8.46) (8.00 – 9.22) (8.43 – 9.77) (8.19 – 9.06) (7.12 – 8.98) (7.89 – 8.65) (6.78 – 7.57) (7.17 – 8.22) (9.04 – 10.1) (7.49 – 8.47) (8.56 – 10.0) (10.2 – 12.4) 2.5th 9.24 8.90 7.90 8.73 8.11 8.21 7.21 7.74 9.65 8.02 9.36 11.6 n (23.8 – 28.2) (21.0 – 24.1) (30.0 – 34.2) (30.3 – 33.7) (21.8 – 25.5) (19.4 – 24.0) (30.2 – 33.5) (19.9 – 22.0) (35.1 – 39.1) (24.3 – 29.5) (31.9 – 37.7) (54.7 – 62.9) 22.5 25.9 32.1 31.9 23.5 31.8 21.6 20.9 37.1 26.8 34.7 58.6 (95% conf. interval) Geometric mea Race/ethnicity Males Gender Total, 1 year and older Age group 1–5 years Mexican Americans 6–11 years Non-Hispanic Blacks Females 12–19 years Non-Hispanic Whites 20–39 years 40–59 years 60 years and older Geometric mean and selected percentiles of serum concentrations (in nmol/L) for the total U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2005–2006. Table 1.4.a.1. Serum 4-pyridoxic acid: Concentrations nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 42

54 Figure 1.4.a. Serum 4−pyridoxic acid: Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2005–2006 Overall Mexican Americans Females Males (nmol/L) Serum 4−pyridoxic acid 0 20 40 60 80 60+ 6−11 12−19 20−39 40−59 12−19 1−5 20−39 40−59 60+ 1−5 6−11 Non−Hispanic Whites Non−Hispanic Blacks 80 (nmol/L) Serum 4−pyridoxic acid 0 20 40 60 60+ 40−59 20−39 1−5 6−11 12−19 20−39 40−59 60+ 1−5 6−11 12−19 Females Males Mexican Americans Non−Hispanic Blacks Non−Hispanic (nmol/L) Whites Serum 4−pyridoxic acid 0 20 40 60 80 1−5 6−11 12−19 20−39 40−59 60+ 1−5 6−11 12−19 20−39 40−59 60+ Age (years) Age (years) 1. Water -Soluble Vitamins 43

55 Table 1.4.a.2. Serum 4-pyridoxic acid: Total population Geometric mean and selected percentiles of serum concentrations (in nmol/L) for the total U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 90th 10th Males and Females (30.3 – 33.7) 11.7 (11.4 – 12.2) 25.5 (24.6 – 26.5) 116 (105 – 128) 8,312 Total, 1 year and older 31.9 (23.8 – 28.2) 1–5 years (11.4 – 13.3) 24.2 (22.2 – 25.8) 59.8 (49.8 – 79.6) 917 25.9 12.5 23.5 11.2 (10.2 – 12.0) 21.6 (19.8 – 23.9) 56.7 (48.4 – 71.5) 922 6–11 years (21.8 – 25.5) 20.9 (19.9 – 22.0) 10.2 (9.88 – 10.6) 19.0 (18.2 – 20.1) 48.1 (44.1 – 54.5) 1,985 12–19 years 26.8 20–39 years (10.0 – 11.1) 22.2 (20.4 – 23.9) 90.9 (73.2 – 115) 1,698 (24.3 – 29.5) 10.7 34.7 12.6 (11.8 – 13.6) 27.3 (25.8 – 29.1) 117 (105 – 138) 1,381 40–59 years (31.9 – 37.7) 58.6 (54.7 – 62.9) 16.4 (14.9 – 18.3) 47.6 (45.0 – 52.3) 248 (208 – 321) 1,409 60 years and older Males Total, 1 year and older 12.9 (12.1 – 13.6) 26.0 (30.0 – 34.2) 103 (92.2 – 118) 4,055 32.1 (24.9 – 27.4) 26.7 (23.7 – 30.0) 11.9 (10.5 – 14.1) 25.2 (22.8 – 27.0) 63.6 (48.5 – 111) 456 1–5 years 6–11 years 24.0 (22.1 – 26.1) 11.6 (9.92 – 12.4) 21.9 (20.2 – 24.1) 56.4 (46.0 – 83.0) 454 12–19 years 23.3 11.9 (10.9 – 12.6) 20.8 (19.7 – 21.9) 55.0 (46.8 – 67.0) 991 (21.9 – 24.7) 29.0 12.0 (10.9 – 13.2) 24.3 (22.5 – 26.0) 89.5 (65.9 – 124) 740 20–39 years (26.1 – 32.2) (24.4 – 30.2) (76.3 – 124) 101 680 26.5 33.0 13.8 (29.3 – 37.2) 40–59 years (11.8 – 15.2) (41.8 – 53.3) 56.7 60 years and older (15.1 – 18.9) 46.8 (50.7 – 63.5) 220 (178 – 292) 734 17.2 Females Total, 1 year and older 31.8 (30.2 – 33.5) 11.1 (10.9 – 11.3) 24.7 (23.4 – 26.1) 133 (116 – 151) 4,257 1–5 years 25.1 12.6 (11.9 – 13.0) 22.7 (20.8 – 25.4) 59.2 (48.3 – 76.4) 461 (23.3 – 27.1) 6–11 years (20.5 – 25.8) 10.7 (9.57 – 11.5) 20.8 (18.6 – 24.2) 54.9 (44.7 – 90.5) 468 23.0 12–19 years 18.7 (17.7 – 19.8) 9.59 (9.31 – 9.88) 17.1 (16.3 – 18.0) 42.9 (35.5 – 52.2) 994 20–39 years 24.8 (22.3 – 27.5) 9.74 (9.31 – 10.4) 19.2 (17.3 – 22.1) 92.5 (77.5 – 118) 958 701 40–59 years 36.4 (33.3 – 39.8) 12.1 (11.3 – 12.7) 28.1 (25.2 – 31.1) 145 (116 – 192) 257 (219 – 328) 675 60 years and older 60.2 (56.1 – 64.8) 15.6 (14.0 – 17.9) 48.7 (43.5 – 56.9) Table 1.4.a.3. Serum 4-pyridoxic acid: Mexican Americans Geometric mean and selected percentiles of serum concentrations (in nmol/L) for Mexican Americans in the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample size (95% conf. interval) 10th 50th 90th Males and Females 22.5 (21.0 – 24.1) 10.7 (10.0 – 11.2) 19.0 (18.1 – 20.1) 57.9 (48.0 – 66.1) Total, 1 year and older 2,213 1–5 years (20.7 – 24.8) 11.9 (10.7 – 12.8) 20.3 (19.1 – 22.2) 52.3 (41.3 – 62.3) 324 22.7 19.6 (17.7 – 21.7) 9.67 (8.75 – 10.7) 18.5 (16.0 – 20.3) 44.2 (36.3 – 58.1) 321 6–11 years 12–19 years 17.1 (16.4 – 17.8) 9.29 (8.70 – 9.81) 15.8 (14.8 – 16.8) 34.6 (31.5 – 42.8) 657 20–39 years 21.6 10.7 (9.33 – 11.4) 18.3 (16.8 – 19.9) 53.3 (43.8 – 76.4) 452 (19.3 – 24.1) 40–59 years (24.6 – 31.6) 11.7 (10.1 – 12.7) 22.4 (20.5 – 24.6) 71.1 (60.0 – 114) 249 27.9 60 years and older 33.8 (27.9 – 41.0) 12.5 (11.0 – 14.7) 27.3 (23.6 – 31.2) 117 (75.3 – 311) 210 Males Total, 1 year and older (21.9 – 25.6) 11.5 (10.8 – 12.0) 23.6 (19.4 – 21.7) 58.1 (45.6 – 68.9) 1,057 20.7 1–5 years 23.3 (20.4 – 26.5) 11.8 (10.7 – 13.7) 20.9 (18.9 – 22.9) 48.8 (38.0 – 78.1) 155 20.7 6–11 years (8.64 – 11.4) (18.2 – 23.6) 10.3 18.9 (16.5 – 20.9) 47.4 (39.5 – 59.3) 157 12–19 years 19.4 10.3 (9.71 – 10.8) 17.3 (16.8 – 18.4) 41.6 (34.1 – 59.2) 318 (18.2 – 20.6) 23.0 11.2 (9.36 – 12.7) 19.5 (17.6 – 22.2) 55.0 (42.2 – 85.5) 199 20–39 years (20.1 – 26.2) 29.7 (24.2 – 36.4) 12.9 (12.5 – 13.9) 24.2 40–59 years 65.1 (21.2 – 28.4) 123 (45.1 – 230) (19.9 – 33.3) 28.2 11.6† 60 years and older 26.0 (22.0 – 36.1) 72.5† (50.8 – 193) 105 (5.00 – 14.6) Females Total, 1 year and older 21.4 (20.1 – 22.7) 9.91 (9.35 – 10.6) 17.3 (16.4 – 18.3) 57.0 (49.5 – 70.1) 1,156 1–5 years 22.0 11.9 (9.70 – 12.5) 20.2 (17.5 – 22.6) 52.3 (38.6 – 64.8) 169 (19.9 – 24.4) 6–11 years (16.3 – 21.1) 9.60 (7.35 – 10.7) 17.3 (15.1 – 20.4) 41.2 (31.1 – 53.4) 164 18.5 12–19 years 15.0 (14.3 – 15.8) 8.55 (7.66 – 9.16) 14.1 (13.2 – 15.1) 28.2 (25.2 – 33.6) 339 20–39 years (17.6 – 22.8) 9.73 (7.90 – 11.1) 16.3 (14.7 – 18.6) 49.5 (41.4 – 81.1) 253 20.0 126 26.1 (22.4 – 30.3) 10.9 (9.79 – 11.6) 19.1 (14.7 – 25.2) 90.5 (54.6 – 289) 40–59 years 105 162† (78.4 – 3,380) 60 years and older 39.2 (30.0 – 51.4) 13.9† (11.1 – 15.7) 28.0 (23.3 – 35.2) † Estimate is subject to greater uncertainty due to small cell size. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 44

56 Table 1.4.a.4. Serum 4-pyridoxic acid: Non-Hispanic blacks Geometric mean and selected percentiles of serum concentrations (in nmol/L) for non-Hispanic blacks in the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 50th 10th 90th Males and Females 60.5 (8.85 – 9.59) 21.6 (16.3 – 19.3) 9.28 (51.3 – 81.9) 2,157 Total, 1 year and older (19.4 – 24.0) 17.8 (19.2 – 25.8) 10.1 1–5 years 19.5 (17.6 – 22.5) 61.7 (44.0 – 96.8) 226 22.2 (8.17 – 11.2) 17.8 9.03 (8.25 – 9.53) 15.3 (16.0 – 19.8) 43.9 (32.5 – 67.1) 254 6–11 years (14.3 – 17.4) 14.8 (14.0 – 15.7) 8.28 (7.64 – 8.65) 13.9 (13.1 – 14.6) 28.9 (25.7 – 34.0) 12–19 years 676 20–39 years (18.1 – 20.7) 8.89 (8.39 – 9.47) 15.4 (14.2 – 17.6) 51.4 (45.3 – 60.6) 371 19.3 25.3 9.62 (8.24 – 10.8) 19.2 (17.6 – 21.2) 103 (57.1 – 164) 339 40–59 years (21.3 – 30.0) 33.8 (26.3 – 43.4) 12.2 (9.71 – 14.1) 27.4 (23.1 – 30.6) 113 (81.9 – 246) 291 60 years and older Males Total, 1 year and older (19.7 – 24.3) 9.68 (9.16 – 10.3) 18.5 (17.3 – 20.0) 55.7 (44.4 – 82.8) 1,070 21.8 24.5 (20.6 – 29.1) 10.3† (6.27 – 12.2) 20.9 (17.7 – 24.4) 83.7† (48.8 – 152) 108 1–5 years 6–11 years 18.4 (16.2 – 21.0) 9.50 (8.53 – 10.3) 15.9 (14.5 – 18.5) 44.1 (33.3 – 66.5) 133 12–19 years 16.2 9.11 (8.59 – 9.35) 15.5 (14.1 – 16.5) 30.9 (26.8 – 39.1) 348 (15.0 – 17.5) 19.7 9.68 (8.96 – 10.9) 17.4 (14.3 – 20.4) 44.3 (32.7 – 68.2) 170 (17.6 – 22.2) 20–39 years 157 (52.9 – 134) 71.2 (17.7 – 20.8) 19.3 9.58 (21.7 – 29.0) 25.1 40–59 years (7.97 – 10.6) 33.2 (27.1 – 40.7) 12.5 (11.8 – 13.4) 24.3 (22.7 – 30.2) 109 60 years and older 154 (80.8 – 246) Females 21.3 (18.7 – 24.3) 8.88 (8.38 – 9.44) Total, 1 year and older (15.0 – 19.1) 64.9 (52.5 – 94.0) 1,087 17.1 1–5 years 20.1 (16.7 – 24.2) 8.59 (7.62 – 11.1) 19.0 (16.1 – 22.5) 42.6 (34.5 – 65.2) 118 6–11 years 17.2 8.50 (7.72 – 9.43) 14.8 (13.1 – 17.4) 40.6 (31.1 – 86.4) 121 (15.1 – 19.7) 12–19 years (12.6 – 14.4) 7.56 (6.46 – 8.33) 12.7 (11.8 – 13.4) 25.6 (22.0 – 32.8) 328 13.5 20–39 years 19.0 (16.9 – 21.5) 8.42 (7.62 – 8.98) 14.3 (12.7 – 16.9) 57.7 (45.3 – 85.7) 201 18.8 40–59 years (19.2 – 33.7) 9.64 (7.95 – 11.0) 25.4 (15.5 – 25.8) 107 (53.1 – 217) 182 (8.02 – 15.3) 60 years and older 34.2 (24.3 – 48.1) 11.6 137 28.0 (21.9 – 33.8) 116 (75.1 – 431) † Estimate is subject to greater uncertainty due to small cell size. Table 1.4.a.5. Serum 4-pyridoxic acid: Non-Hispanic whites Geometric mean and selected percentiles of serum concentrations (in nmol/L) for non-Hispanic whites in the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample size (95% conf. interval) 50th 90th 10th Males and Females (35.1 – 39.1) 13.2 (12.6 – 13.8) 29.3 (27.8 – 30.6) 138 (120 – 154) 3,285 Total, 1 year and older 37.1 (25.2 – 31.8) 13.6 (11.9 – 15.1) 26.7 (24.2 – 29.2) 59.9 (49.8 – 104) 263 1–5 years 28.4 26.7 12.6 (11.8 – 13.3) 24.5 (22.4 – 26.0) 63.5 (50.7 – 96.3) 251 6–11 years (24.1 – 29.5) 24.1 (22.4 – 26.0) 11.5 (10.6 – 12.8) 21.5 (21.0 – 22.2) 55.9 (47.7 – 74.7) 12–19 years 505 20–39 years (27.5 – 35.4) 11.5 (10.7 – 12.6) 25.2 (22.6 – 28.1) 113 (89.1 – 155) 718 31.2 37.7 13.7 (12.5 – 14.8) 30.2 (27.9 – 32.2) 130 (111 – 148) 691 40–59 years (34.1 – 41.6) 64.4 (58.5 – 70.9) 18.2 (15.3 – 20.2) 53.7 (48.7 – 57.9) 257 (220 – 328) 857 60 years and older Males Total, 1 year and older (34.1 – 39.6) 14.9 (13.7 – 15.7) 29.5 (27.7 – 31.3) 116 (105 – 136) 1,636 36.8 29.0 (24.9 – 33.7) 14.0 (9.91 – 16.0) 27.2 (24.5 – 31.1) 59.8 (47.3 – 130) 146 1–5 years 6–11 years 26.4 (23.7 – 29.5) 12.5 (11.7 – 13.9) 24.9 (21.6 – 26.0) 66.7 (45.2 – 92.9) 121 12–19 years 27.1 14.2 (13.4 – 15.5) 23.5 (21.4 – 26.1) 64.0 (54.7 – 80.3) 255 (25.0 – 29.4) 33.6 14.4 (12.0 – 15.6) 26.9 (24.2 – 29.4) 105 (71.2 – 187) 310 20–39 years (29.4 – 38.4) 35.5 (30.7 – 41.1) 14.9 (12.5 – 17.5) 29.3 40–59 years 102 (26.0 – 33.1) 356 (81.5 – 141) (44.8 – 60.1) 62.6 18.8 60 years and older 52.3 (54.1 – 72.5) 232 (195 – 344) 448 (15.9 – 21.2) Females Total, 1 year and older 37.3 (35.4 – 39.4) 12.4 (11.6 – 12.7) 29.2 (26.8 – 31.4) 155 (136 – 176) 1,649 1–5 years 27.7 13.1 (11.1 – 15.1) 25.4 (20.8 – 29.9) 59.9 (49.8 – 99.2) 117 (24.5 – 31.3) 6–11 years (22.4 – 32.3) 12.5 (10.7 – 13.7) 24.3 (20.7 – 29.2) 62.1 (47.7 – 189) 130 26.9 12–19 years 21.2 (19.2 – 23.5) 10.2 (9.58 – 11.0) 19.8 (18.0 – 21.1) 47.3 (40.3 – 69.4) 250 20–39 years (25.5 – 33.0) 10.6 (9.87 – 11.0) 23.1 (19.3 – 26.9) 117 (90.2 – 161) 408 29.0 335 39.9 (35.9 – 44.5) 12.8 (12.1 – 13.6) 30.5 (26.6 – 34.8) 155 (128 – 223) 40–59 years (242 – 343) 409 60 years and older 65.9 (60.1 – 72.4) 17.6 (14.1 – 20.4) 54.9 (47.4 – 63.8) 270 1. Water-Soluble Vitamins 45

57 size 8,317 1,678 4,205 7,999 4,285 1,747 6,571 4,013 3,214 2,629 3,035 16,316 Sample (1,330 – 1,410) (1,600 – 1,810) (1,150 – 1,240) (1,370 – 1,950) (1,250 – 1,340) (1,360 – 1,570) (1,370 – 1,540) (1,020 – 1,140) (1,170 – 1,310) (962 – 1,060) (1,110 – 1,350) (1,280 – 1,570) 97.5th 1,710 1,600 1,200 1,300 1,370 1,440 1,430 1,050 1,230 1,010 1,180 1,380 (994 – 1,060) (1,470 – 1,630) (1,110 – 1,240) (1,050 – 1,110) (1,100 – 1,180) (1,240 – 1,350) (1,200 – 1,320) (901 – 975) (999 – 1,080) (859 – 904) (934 – 1,100) (1,020 – 1,190) 95th 938 884 1,030 1,170 1,520 1,090 1,280 1,240 1,140 1,040 1,020 1,070 (95% conf. interval) s (513 – 547) (783 – 858) (484 – 505) (483 – 505) (707 – 747) (537 – 576) (480 – 508) (465 – 491) (495 – 526) (441 – 462) (446 – 475) (466 – 499) 50th 494 527 814 495 556 495 724 478 509 451 460 481 Selected percentile (238 – 259) (248 – 274) (344 – 432) (227 – 244) (367 – 431) (258 – 276) (216 – 236) (222 – 239) (264 – 277) (223 – 243) (214 – 237) (202 – 217) 5th 249 397 260 236 266 396 227 229 271 231 226 210 (280 – 368) (210 – 222) (212 – 241) (201 – 212) (342 – 363) (189 – 206) (210 – 233) (224 – 250) (194 – 209) (201 – 214) (177 – 210) (151 – 179) 2.5th 216 327 224 206 223 354 200 201 238 210 197 166 n (490 – 509) (776 – 833) (530 – 569) (489 – 511) (487 – 514) (550 – 580) (713 – 743) (470 – 495) (499 – 521) (443 – 465) (451 – 482) (468 – 496) 804 500 549 500 565 500 728 482 510 454 466 482 (95% conf. interval) Geometric mea Males Gender Race/ethnicity Total, 1 year and older Mexican Americans Age group 1–5 years Non-Hispanic Blacks 6–11 years Females Non-Hispanic Whites 12–19 years 20–39 years 40–59 years 60 years and older and Nutrition Examination Survey, 2003–2006. Geometric mean and selected percentiles of serum concentrations (in pg/mL) for the total U.S. population aged 1 year and older, National Health Table 1.5.a.1. Serum vitamin B12: Concentrations nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 46

58 Figure 1.5.a. Serum vitamin B12: Concentr ations by age group Geometric mean (95% condence interval), National Health and Nutrition Examination Survey, 2003–2006 Mexican Americans Overall 1000 males Fe Males 500 (pg/mL) m vitamin B12 Seru 0 40−59 6−11 12−19 1−5 20−39 60+ 40−59 60+ 12−19 1−5 6−11 20−39 Non−Hispanic Blacks Non−Hispanic Whites 1000 500 (pg/mL) m vitamin B12 Seru 0 12−19 20−39 40−59 60+ 1−5 6−11 12−19 20−39 40−59 60+ 1−5 6−11 Males Females 1000 Mexican cans Ameri Non−Hispanic Blacks 500 Non−Hispanic Whites (pg/mL) m vitamin B12 Seru 0 12−19 20−39 40−59 60+ 60+ 6−11 20−39 40−59 1−5 1−5 6−11 12−19 Age (years) Age (years) 1. Water-Soluble Vitamins 47

59 Table 1.5.a.2. Serum vitamin B12: Total population Geometric mean and selected percentiles of serum concentrations (in pg/mL) for the total U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 50th 5th 95th Males and Females 1,090 (227 – 244) 500 (483 – 505) 236 (1,050 – 1,110) 16,316 Total, 1 year and older (489 – 511) 495 (776 – 833) 397 1–5 years 814 (783 – 858) 1,520 (1,470 – 1,630) 1,678 804 (344 – 432) 728 396 (367 – 431) 724 (713 – 743) 1,280 (1,240 – 1,350) 1,747 6–11 years (707 – 747) 510 (499 – 521) 271 (264 – 277) 509 (495 – 526) 938 (901 – 975) 12–19 years 4,013 20–39 years (443 – 465) 231 (223 – 243) 451 (441 – 462) 884 (859 – 904) 3,214 454 466 226 (214 – 237) 460 (446 – 475) 1,020 (934 – 1,100) 2,629 40–59 years (451 – 482) 482 (468 – 496) 210 (202 – 217) 481 (466 – 499) 1,070 (1,020 – 1,190) 3,035 60 years and older Males Total, 1 year and older (490 – 509) 249 (238 – 259) 494 (484 – 505) 1,030 (994 – 1,060) 7,999 500 796 (761 – 832) 379 (302 – 423) 816 (775 – 862) 1,470 (1,430 – 1,520) 844 1–5 years 6–11 years 722 (701 – 744) 411 (363 – 439) 735 (713 – 761) 1,220 (1,140 – 1,270) 853 12–19 years 513 292 (272 – 309) 510 (494 – 534) 904 (866 – 951) 2,031 (500 – 526) 469 258 (242 – 270) 469 (454 – 485) 856 (820 – 893) 1,451 (456 – 483) 20–39 years 1,296 (825 – 985) 896 (442 – 469) 456 226 (440 – 472) 456 40–59 years (212 – 246) 461 (447 – 475) 210 (193 – 223) 458 (442 – 480) 990 60 years and older 1,524 (937 – 1,100) Females 500 (487 – 514) 227 (216 – 236) Total, 1 year and older (480 – 508) 1,140 (1,100 – 1,180) 8,317 495 1–5 years 813 (781 – 847) 401 (343 – 444) 810 (772 – 863) 1,560 (1,470 – 1,740) 834 6–11 years 734 393 (362 – 421) 714 (687 – 748) 1,360 (1,290 – 1,460) 894 (710 – 758) 12–19 years (492 – 520) 254 (243 – 266) 507 (487 – 526) 973 (928 – 1,050) 1,982 506 20–39 years 439 (425 – 453) 217 (206 – 227) 431 (420 – 446) 909 (868 – 980) 1,763 467 40–59 years (455 – 499) 223 (200 – 241) 476 (444 – 489) 1,090 (1,020 – 1,160) 1,333 (200 – 218) 60 years and older 499 (479 – 521) 210 (1,050 – 1,310) 504 (477 – 530) 1,140 1,511 Table 1.5.a.3. Serum vitamin B12: Mexican Americans Geometric mean and selected percentiles of serum concentrations (in pg/mL) for Mexican Americans in the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample size (95% conf. interval) 50th 95th 5th Males and Females 260 (248 – 274) 527 Total, 1 year and older 1,170 (1,110 – 1,240) 4,205 549 (530 – 569) (513 – 547) (802 – 866) 1–5 years (417 – 468) 842 (811 – 880) 1,480 (1,390 – 1,670) 540 833 450 730 409 (367 – 441) 729 (708 – 753) 1,210 (1,150 – 1,290) 587 6–11 years (704 – 762) 508 (493 – 524) 270 (250 – 295) 505 (486 – 525) 909 (873 – 951) 12–19 years 1,280 20–39 years (463 – 503) 249 (225 – 260) 467 (449 – 493) 955 (883 – 1,150) 778 483 535 248 (207 – 274) 483 (457 – 515) 1,310 (996 – 3,160) 468 40–59 years (491 – 582) 496 (465 – 528) 220 (193 – 239) 458 (435 – 489) 1,240 (1,070 – 2,490) 552 60 years and older Males Total, 1 year and older (510 – 543) 258 (251 – 267) 513 (492 – 533) 1,060 (1,010 – 1,110) 2,036 526 801 (766 – 838) 423 (364 – 467) 805 (776 – 844) 1,450 (1,330 – 1,630) 261 1–5 years 6–11 years 724 (696 – 752) 386 (345 – 462) 735 (705 – 771) 1,150 (1,080 – 1,250) 285 12–19 years 498 271 (239 – 305) 494 (476 – 516) 866 (810 – 920) 637 (478 – 519) 467 252 (217 – 264) 459 (431 – 494) 855 (794 – 978) 345 20–39 years (443 – 492) 493 (460 – 529) 249 (191 – 263) 463 40–59 years 1,050 (446 – 494) 236 (915 – 2,230) (376 – 448) 456 224 60 years and older 404 (412 – 505) 1,210 (929 – 5,710) 272 (195 – 237) Females Total, 1 year and older 574 (548 – 602) 263 (241 – 288) 550 (522 – 573) 1,290 (1,180 – 1,630) 2,169 1–5 years 869 456 (420 – 500) 887 (834 – 910) 1,590 (1,400 – 1,890) 279 (824 – 916) 6–11 years (704 – 772) 413 (370 – 441) 716 (690 – 762) 1,280 (1,160 – 1,620) 302 738 12–19 years 519 (502 – 536) 269 (255 – 291) 518 (495 – 549) 951 (892 – 1,060) 643 20–39 years (476 – 528) 248 (220 – 271) 476 (452 – 509) 1,190 (984 – 2,080) 433 501 232 582 (500 – 678) 243 (182 – 306) 520 (464 – 574) 1,950 (1,010 – 6,830) 40–59 years (459 – 537) (1,110 – 2,950) 1,370 280 60 years and older 531 (475 – 594) 210 (169 – 258) 494 nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 48

60 Table 1.5.a.4. Serum vitamin B12: Non-Hispanic blacks Geometric mean and selected percentiles of serum concentrations (in pg/mL) for non-Hispanic blacks in the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 95th 5th Males and Females (1,200 – 1,320) 556 266 1,240 (258 – 276) 4,285 (550 – 580) 565 Total, 1 year and older (537 – 576) 431 (340 – 479) 1–5 years (827 – 965) 1,770 (1,550 – 2,020) 476 885 (835 – 938) 899 (800 – 854) (398 – 470) 817 (800 – 842) 448 (1,440 – 1,670) 553 827 6–11 years 1,560 (557 – 584) 284 (270 – 297) 571 (551 – 585) 1,110 (1,050 – 1,160) 1,415 12–19 years 570 (483 – 516) 20–39 years (227 – 277) 497 (480 – 512) 941 (894 – 1,050) 706 499 259 (506 – 543) (220 – 286) 515 (494 – 544) 1,120 (1,070 – 1,200) 622 524 40–59 years 264 (504 – 558) 225 (199 – 252) 531 (505 – 565) 1,240 (1,100 – 1,510) 513 60 years and older 530 Males Total, 1 year and older 267 (257 – 282) 546 (533 – 571) 1,230 (1,140 – 1,320) 2,136 564 (549 – 580) (821 – 977) 418 (293 – 494) 910 (822 – 1,010) 1,800 (1,570 – 2,150) 236 1–5 years 896 799 (762 – 837) 428 (350 – 466) 811 (743 – 840) 1,540 (1,370 – 1,780) 272 6–11 years 567 12–19 years (268 – 322) 567 (541 – 585) 1,040 (993 – 1,140) 742 (550 – 585) 294 (488 – 536) (256 – 290) 507 (482 – 527) 950 (872 – 1,160) 337 20–39 years 277 512 292 (863 – 1,250) 988 (488 – 541) 509 241 (482 – 539) 510 (204 – 269) 40–59 years (472 – 533) 211 (142 – 241) 494 (459 – 521) 1,220 (998 – 1,770) 60 years and older 502 257 Females (545 – 587) 265 (233 – 282) 563 565 1,250 (1,200 – 1,340) 2,149 Total, 1 year and older (531 – 597) 874 (829 – 922) 431 (257 – 489) 880 (798 – 957) 1,650 (1,470 – 2,050) 240 1–5 years 856 6–11 years (383 – 501) 834 (801 – 887) 1,570 (1,430 – 1,710) 281 (815 – 899) 468 574 272 (259 – 288) 576 (551 – 595) 1,160 (1,110 – 1,210) 673 12–19 years (558 – 590) 489 (464 – 515) 231 (207 – 271) 487 (460 – 518) 938 (880 – 1,080) 369 20–39 years (492 – 568) 536 273 (219 – 295) 527 (507 – 566) 1,170 (1,100 – 1,400) 330 40–59 years 576 551 (514 – 590) 232 (187 – 265) 256 (524 – 613) 1,280 (1,110 – 1,620) 60 years and older Table 1.5.a.5. Serum vitamin B12: Non-Hispanic whites Geometric mean and selected percentiles of serum concentrations (in pg/mL) for non-Hispanic whites in the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample size (95% conf. interval) 50th 95th 5th Males and Females 229 (222 – 239) 478 Total, 1 year and older 1,040 (999 – 1,080) 6,571 482 (470 – 495) (465 – 491) (730 – 810) 1–5 years (298 – 411) 777 (730 – 830) 1,470 (1,410 – 1,560) 476 769 375 707 392 (345 – 435) 703 (686 – 729) 1,230 (1,170 – 1,350) 448 6–11 years (674 – 734) 496 (484 – 509) 269 (253 – 276) 498 (481 – 517) 887 (833 – 952) 12–19 years 1,042 20–39 years (426 – 455) 226 (215 – 238) 438 (424 – 452) 853 (814 – 889) 1,434 440 453 225 (208 – 236) 448 (434 – 465) 980 (867 – 1,090) 1,340 40–59 years (435 – 471) 476 (461 – 492) 209 (200 – 217) 477 (460 – 499) 1,050 (990 – 1,170) 1,831 60 years and older Males Total, 1 year and older (475 – 498) 244 (228 – 256) 483 (471 – 496) 981 (946 – 1,030) 3,235 487 764 (720 – 811) 353 (261 – 416) 799 (739 – 861) 1,380 (1,320 – 1,500) 254 1–5 years 6–11 years 708 (678 – 740) 405† (343 – 441) 715 (680 – 753) 1,160† (1,080 – 1,250) 216 12–19 years 507 293 (271 – 316) 505 (486 – 535) 847 (803 – 941) 523 (492 – 522) 468 263 (230 – 275) 469 (448 – 493) 826 (786 – 900) 631 20–39 years (448 – 488) 447 (430 – 465) 226 (199 – 248) 448 40–59 years 879 (435 – 464) 682 (781 – 984) (434 – 481) 454 208 60 years and older 455 (439 – 469) 952 (887 – 1,050) 929 (181 – 221) Females Total, 1 year and older 478 (462 – 494) 220 (210 – 230) 471 (454 – 488) 1,080 (1,040 – 1,140) 3,336 1–5 years 774 381† (325 – 431) 763 (700 – 835) 1,530† (1,450 – 1,760) 222 (721 – 831) 6–11 years (671 – 743) 377 (316 – 421) 679 (648 – 742) 1,340 (1,180 – 1,490) 232 706 12–19 years 485 (470 – 501) 246 (226 – 259) 486 (468 – 508) 913 (842 – 1,030) 519 20–39 years (398 – 431) 211 (197 – 223) 405 (387 – 427) 874 (797 – 936) 803 414 658 458 (432 – 485) 220 (199 – 236) 447 (419 – 483) 1,040 (900 – 1,180) 40–59 years (1,030 – 1,320) 60 years and older 494 (471 – 519) 210 (199 – 217) 500 (470 – 523) 1,090 902 † Estimate is subject to greater uncertainty due to small cell size. 1. Water-Soluble Vitamins 49

61 Table 1.5.b. Serum vitamin B12: Concentrations by survey cycle Geometric mean and selected percentiles of serum concentrations (in pg/mL) for the U.S. population, National Health and Nutrition Examination Survey, 1999–2006. n Selected percentile s (95% conf. interval) Sample Geometric mea 50th 5th 95th (95% conf. interval) size Total, 3 years and older 993 483 487 (481 – 494) (970 – 1,040) 7,524 240 (234 – 245) 1999–2000 (474 – 494) 236 (232 – 241) 485 (474 – 494) 1,000 (971 – 1,040) 8,390 2001–2002 488 (479 – 497) 238 489 486 (467 – 500) 1,020 (979 – 1,080) 7,837 2003–2004 (472 – 507) (225 – 252) 7,694 231 497 (482 – 511) 1,100 (1,060 – 1,130) (489 – 516) 2005–2006 502 (221 – 242) Age group 3–5 years (682 – 839) 441 1999–2000 735 (663 – 827) 1,380 (1,300 – 1,730) 361 757 (321 – 459) 804 471 (426 – 518) 815 (783 – 836) 1,380 (1,250 – 1,560) 439 2001–2002 (773 – 837) (716 – 824) (285 – 422) 775 (716 – 852) 1,550 (1,310 – 1,800) 449 768 2003–2004 393 (841 – 913) 482 (437 – 507) 894 (826 – 950) 1,470 (1,430 – 1,660) 444 2005–2006 877 6–11 years 1999–2000 362 (330 – 401) 704 (676 – 738) 1,250 (1,170 – 1,340) 885 695 (659 – 733) (669 – 714) 386 (340 – 412) 696 (672 – 724) 1,270 (1,190 – 1,330) 1,022 2001–2002 691 711 (689 – 733) 1,240 (344 – 419) 714 (679 – 736) 2003–2004 (1,190 – 1,360) 843 375 2005–2006 (721 – 769) 418 (381 – 442) 741 (710 – 768) 1,290 (1,230 – 1,370) 904 745 12–19 years 1999–2000 263 (235 – 280) 506 (494 – 518) 954 (905 – 1,010) 2,123 501 (491 – 511) (495 – 528) (256 – 289) 516 (496 – 536) 934 (899 – 983) 2,208 511 269 2001–2002 (483 – 518) 267 (255 – 282) 504 (481 – 528) 2003–2004 (871 – 949) 2,059 500 911 519 273 (269 – 281) 519 (496 – 544) (505 – 534) (907 – 1,040) 1,954 2005–2006 966 20–39 years 445 (438 – 451) 234 (219 – 240) 448 (432 – 459) 807 (791 – 824) 1,470 1999–2000 445 2001–2002 230 (217 – 239) 445 (432 – 457) 822 (776 – 893) 1,715 (432 – 458) 451 240 (225 – 253) 449 (431 – 465) 826 (787 – 888) 1,555 2003–2004 (434 – 468) 457 (443 – 472) 227 (214 – 239) 452 (440 – 468) 913 (889 – 964) 1,659 2005–2006 40–59 years 1999–2000 (447 – 474) 234 (208 – 256) 447 (432 – 466) 909 (861 – 952) 1,198 460 460 (450 – 471) 232 (221 – 238) 456 (443 – 465) 942 (879 – 1,020) 1,478 2001–2002 2003–2004 460 (435 – 486) 226 (215 – 243) 456 (438 – 479) 957 (833 – 1,110) 1,276 472 2005–2006 (452 – 493) 223 (195 – 244) 464 (444 – 485) 1,060 (984 – 1,130) 1,353 60 years and older 1999–2000 (467 – 496) 228 (212 – 243) 470 (460 – 483) 1,030 (950 – 1,130) 1,487 482 (204 – 231) 479 (465 – 493) 1,000 (962 – 1,030) 1,528 473 (455 – 491) 2001–2002 220 (459 – 496) (198 – 221) 477 (454 – 494) 1,060 (967 – 1,310) 1,655 477 208 2003–2004 (466 – 508) 211 (197 – 219) 495 (464 – 511) 1,070 2005–2006 1,380 487 (1,030 – 1,220) Gender Males (479 – 495) 255 (235 – 264) 1999–2000 (478 – 498) 956 (901 – 1,020) 3,682 487 488 490 (476 – 505) 247 (235 – 257) 485 (468 – 497) 963 (919 – 1,010) 4,059 2001–2002 490 2003–2004 250 (229 – 266) 486 (469 – 499) 971 (944 – 1,020) 3,871 (476 – 505) 1,040 500 (226 – 259) 497 (482 – 512) 247 (987 – 1,110) 3,740 2005–2006 (487 – 514) Females 488 (481 – 495) 233 (222 – 241) 478 (465 – 495) 1,030 (981 – 1,090) 3,842 1999–2000 486 2001–2002 230 (219 – 237) 485 (474 – 495) 1,040 (998 – 1,090) 4,331 (476 – 496) 2003–2004 (467 – 509) 228 (212 – 245) 486 (463 – 504) 1,080 (1,010 – 1,160) 3,966 488 2005–2006 504 (486 – 523) 224 (208 – 236) 497 (476 – 516) 1,150 (1,110 – 1,190) 3,954 Race/ethnicity Mexican Americans 551 (523 – 581) (259 – 281) 527 (509 – 542) 1,200 (1,140 – 1,310) 2,571 1999–2000 268 516 249 (227 – 271) 496 (468 – 535) 1,050 (1,010 – 1,120) 2,124 2001–2002 (491 – 543) (994 – 1,210) 1,080 285 (264 – 304) 520 1,919 (504 – 538) (513 – 575) 2003–2004 543 536 2,009 245 (223 – 257) 515 (487 – 554) 1,180 (1,110 – 1,280) 2005–2006 (512 – 561) Non-Hispanic Blacks 1999–2000 (565 – 599) 286 (261 – 304) 582 (569 – 603) 1,220 (1,150 – 1,270) 1,712 583 2001–2002 556 (542 – 570) 269 (250 – 282) 554 (544 – 568) 1,160 (1,100 – 1,220) 2,000 2003–2004 561 281 (262 – 294) 553 (523 – 584) 1,150 (1,090 – 1,310) 2,058 (538 – 585) (528 – 575) 2005–2006 256 (231 – 270) 546 (540 – 579) 1,250 (1,200 – 1,340) 2,032 559 Non-Hispanic Whites 1999–2000 468 (460 – 476) 235 (231 – 240) 467 (454 – 478) 916 (890 – 951) 2,556 2001–2002 (462 – 485) 233 (227 – 237) 473 (460 – 486) 959 (899 – 1,020) 3,594 474 3,272 470 (452 – 489) 228 (216 – 244) 469 (449 – 488) 966 (920 – 1,050) 2003–2004 3,062 (462 – 502) (1,010 – 1,100) 1,050 2005–2006 487 (470 – 504) 228 (217 – 239) 482 nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 50

62 Figure 1.5.b. Serum vitamin B12: Concentr ations by sur ve y cy cle Selected percentiles in pg/mL (95% conence intervals), National Health and Nutrition Examination Survey, 1999–2006 2000 1500 1000 95th Percentile 500 1000 800 600 50th Percentile 400 600 500 400 5th Percentile 300 200 01−02 03−04 99−00 05−06 05−06 01−02 99−00 01−02 03−04 05−06 99−00 03−04 99−00 01−02 03−04 03−04 05−06 05−06 99−00 01−02 03−04 05−06 99−00 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 01−02 05−06 03−04 01−02 99−00 05−06 03−04 01−02 99−00 20+y Males NHB 12−19y 6−11y NHW MA Females Total 3−5y (3+y) 1. Water-Soluble Vitamins 51

63 Table 1.5.c. Serum vitamin B12: Prevalence Prevalence (in percent) of low serum vitamin B12 concentration (< 200 pg/mL) for the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Prevalenc e Sample Estimated total (95% conf. interval) number of persons size 16,316 (1.6 – 2.4) 2.0 5,563,000 Total, 1 year and older Age group 1–5 years 1,678 § § 6–11 years 1,747 § § 210,000 12–19 years 4,013 0.6 (0.4 – 1.0) (1.2 – 2.0) 1,211,000 1.5 20–39 years 3,214 40–59 years 2.6 (1.8 – 3.7) 2,057,000 2,629 60 years and older 3,035 3.9 (3.1 – 4.9) 1,815,000 Gender Males 7,999 1.6 (1.3 – 2.0) 2,165,000 Females 8,317 2.3 (1.9 – 2.9) 3,402,000 Race/ethnicity 265,000 4,205 1.0 (0.7 – 1.5) Mexican Americans Non-Hispanic Blacks 4,285 1.2 (0.8 – 1.8) 398,000 (1.8 – 2.7) 4,289,000 2.2 Non-Hispanic Whites 6,571 § Estimate suppressed: RSE ≥ 40% for the prevalence estimate. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 52

64 Table 1.5.d. Serum vitamin B12: Prevalence by survey cycle Prevalence (in percent) of low serum vitamin B12 concentration (< 200 pg/mL) for the U.S. population, National Health and Nutrition Examination Survey, 1999–2006. Sample size (95% conf. interval) Estimated total number of persons Prevalenc e Total, 3 years and older 7,524 (1.5 – 2.3) 4,933,000 1999–2000 1.9 1.8 (1.5 – 2.2) 4,762,000 2001–2002 8,390 7,837 1.6 4,506,000 2003–2004 (1.2 – 2.2) 2.4 7,694 6,642,000 2005–2006 (1.9 – 3.0) Age group 3–5 years 1999–2000 § § 361 2001–2002 § § 439 449 § 2003–2004 § 2005–2006 444 § § 6–11 years 885 1999–2000 § § 2001–2002 1,022 § § 2003–2004 843 § § 2005–2006 904 § § 12–19 years 1999–2000 0.8‡ (0.4 – 1.7) 251,000‡ 2,123 2,208 (0.5 – 1.6) 276,000 2001–2002 0.9 2,059 0.6‡ (0.3 – 1.3) 214,000‡ 2003–2004 2005–2006 1,954 (0.3 – 1.2) 209,000‡ 0.6‡ 20–39 years 1,470 2.2 (1.4 – 3.3) 1,683,000 1999–2000 2001–2002 1,715 1.8 (1.2 – 2.8) 1,436,000 2003–2004 1,555 (0.5 – 2.0) 805,000‡ 1.0‡ 2005–2006 2.0 (1.6 – 2.7) 1,636,000 1,659 40–59 years 1999–2000 1,198 2.4 (1.5 – 4.0) 1,708,000 2001–2002 1.8 (1.1 – 3.1) 1,399,000 1,478 2003–2004 1,276 1.9 (1.3 – 2.9) 1,508,000 2005–2006 1,353 3.3 (1.9 – 5.5) 2,695,000 60 years and older 1999–2000 1,487 (1.9 – 3.8) 1,159,000 2.7 1,528 3.6 1,590,000 2001–2002 (2.7 – 4.6) 3.9 1,806,000 (2.9 – 5.3) 1,655 2003–2004 3.9 (2.8 – 5.5) 1,895,000 2005–2006 1,380 Gender Males 1999–2000 3,682 1.7 (1.2 – 2.4) 2,113,000 4,059 1.3 (1.0 – 1.8) 1,699,000 2001–2002 3,871 2003–2004 (0.9 – 1.9) 1,727,000 1.3 3,740 (1.4 – 2.5) 2,615,000 2005–2006 1.9 Females 3,842 2.1 (1.7 – 2.6) 2,824,000 1999–2000 4,331 2.2 (1.7 – 3.0) 3,063,000 2001–2002 2003–2004 3,966 2.0 (1.4 – 2.8) 2,787,000 2005–2006 3,954 2.8 (2.0 – 3.9) 4,024,000 Race/ethnicity Mexican Americans 2,571 (0.4 – 1.5) 154,000‡ 1999–2000 0.8‡ 2001–2002 2,124 1.8 (1.0 – 3.3) 419,000 1,919 0.7‡ (0.3 – 1.4) 166,000‡ 2003–2004 2,009 2005–2006 (0.8 – 2.5) 376,000 1.5 Non-Hispanic Blacks 1999–2000 1,712 § § 2001–2002 2,000 § § 2003–2004 2,058 0.7‡ (0.3 – 1.6) 239,000‡ 2005–2006 2,032 (1.0 – 2.6) 551,000 1.6 Non-Hispanic Whites 2,556 2.1 (1.6 – 2.7) 3,858,000 1999–2000 2001–2002 3,594 2.0 (1.6 – 2.5) 3,733,000 2003–2004 3,272 1.9 (1.3 – 2.7) 3,572,000 2005–2006 3,062 2.6 (2.0 – 3.5) 4,978,000 ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. § Estimate suppressed: RSE ≥ 40% for the prevalence estimate. 1. Water-Soluble Vitamins 53

65 size 8,999 4,670 3,267 1,814 4,329 4,670 2,651 1,871 3,081 Sample (16.5 – 18.3) (16.4 – 18.1) (12.1 – 13.0) (12.3 – 13.9) (16.6 – 19.7) (15.8 – 17.9) (15.8 – 18.3) (17.0 – 20.0) (20.1 – 22.7) 97.5th 17.2 17.0 12.4 12.9 18.0 16.8 18.2 16.8 21.2 (13.9 – 15.0) (14.2 – 15.6) (11.2 – 12.2) (10.9 – 11.6) (13.3 – 14.5) (13.1 – 14.8) (14.4 – 15.7) (17.1 – 18.9) (14.0 – 15.2) 95th 14.3 11.2 11.7 14.8 14.8 13.9 13.8 14.5 17.9 (95% conf. interval) s (7.91 – 8.17) (8.56 – 8.84) (6.99 – 7.22) (6.87 – 7.18) (8.02 – 8.29) (7.13 – 7.47) (7.82 – 8.22) (8.07 – 8.37) (9.57 – 10.1) 50th 8.04 8.68 7.02 7.09 7.30 8.00 8.13 9.79 8.21 Selected percentile (4.85 – 5.12) (4.30 – 4.52) (4.20 – 4.50) (5.86 – 6.08) (4.61 – 5.05) (4.40 – 4.69) (5.15 – 5.36) (6.07 – 6.50) (5.03 – 5.34) 5th 5.00 5.96 4.44 4.35 5.25 4.89 4.52 6.37 5.18 (4.35 – 4.57) (5.48 – 5.73) (3.76 – 4.01) (3.77 – 4.05) (3.94 – 4.20) (4.20 – 4.58) (4.61 – 5.02) (4.43 – 4.85) (5.56 – 5.99) 2.5th 4.48 3.93 5.64 3.91 4.12 4.84 4.42 5.79 4.65 n (8.06 – 8.37) (8.83 – 9.18) (7.04 – 7.24) (6.95 – 7.23) (8.17 – 8.50) (7.36 – 7.74) (8.03 – 8.42) (8.22 – 8.57) (9.85 – 10.4) 8.21 9.00 7.09 7.14 7.55 8.22 8.33 10.1 8.39 (95% conf. interval) Geometric mea Total, 20 years and older Race/ethnicity Males Gender Age group 20–39 years Mexican Americans 40–59 years Females Non-Hispanic Blacks 60 years and older Non-Hispanic Whites Health and Nutrition Examination Survey, 2003–2006. Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the total U.S. population aged 20 years and older, National Table 1.6.a.1. Plasma total homocysteine: Concentrations nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 54

66 Figure 1.6.a. Plasma total homocysteine: Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2006 Overall Mexican Americans 15 Females 10 Males (μmol/L) 5 Plasma homocysteine 0 20−39 40−59 60+ 60+ 20−39 40−59 Non−Hispanic Whites Non−Hispanic Blacks 15 10 (μmol/L) 5 Plasma homocysteine 0 40−59 20−39 40−59 60+ 20−39 60+ Males Females 15 Mexican 10 Americans Non−Hispanic Blacks (μmol/L) 5 Non−Hispanic Whites Plasma homocysteine 0 20−39 60+ 20−39 60+ 40−59 40−59 Age (years) Age (years) 1. Water -Soluble Vitamins 55

67 Table 1.6.a.2. Plasma total homocysteine: Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the total U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 5th 95th 50th Males and Females (8.06 – 8.37) 5.00 Total, 20 years and older 8.04 (7.91 – 8.17) 14.3 (13.9 – 15.0) 8,999 8.21 (4.85 – 5.12) 7.14 (7.04 – 7.24) 4.44 20–39 years 7.09 (6.99 – 7.22) 11.2 (10.9 – 11.6) 3,267 (4.30 – 4.52) 40–59 years (8.17 – 8.50) 5.25 (5.15 – 5.36) 8.13 (8.02 – 8.29) 13.9 (13.3 – 14.5) 2,651 8.33 (9.57 – 10.1) 60 years and older 6.37 (6.07 – 6.50) 9.79 (9.85 – 10.4) 17.9 (17.1 – 18.9) 3,081 10.1 Males Total, 20 years and older 9.00 (8.83 – 9.18) 5.96 (5.86 – 6.08) 8.68 (8.56 – 8.84) 14.8 (14.2 – 15.6) 4,329 20–39 years 8.05 5.65 (5.47 – 5.76) 7.94 (7.80 – 8.05) 11.9 (11.5 – 12.5) 1,473 (7.90 – 8.20) 9.21 (8.61 – 9.08) 6.28 (6.15 – 6.43) 8.86 40–59 years 14.3 (13.6 – 15.9) 1,306 (8.96 – 9.47) (10.0 – 10.8) 60 years and older 6.89 (6.52 – 7.10) 10.4 (10.3 – 10.9) 18.0 (16.9 – 19.0) 1,550 10.6 Females Total, 20 years and older 7.55 (7.36 – 7.74) 4.52 (4.40 – 4.69) 7.30 (7.13 – 7.47) 13.8 (13.1 – 14.8) 4,670 20–39 years (6.21 – 6.46) 3.96 (3.79 – 4.11) 6.31 (6.17 – 6.46) 9.87 (9.47 – 10.5) 1,794 6.33 40–59 years 7.58 (7.38 – 7.78) 4.90 (4.67 – 5.07) 7.30 (7.11 – 7.53) 13.0 (12.1 – 15.1) 1,345 (5.75 – 6.27) 60 years and older 9.72 (9.40 – 10.1) 6.02 (16.7 – 19.2) 9.43 (9.05 – 9.69) 17.8 1,531 Table 1.6.a.3. Plasma total homocysteine: Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 5th 95th 50th Males and Females (6.95 – 7.23) 4.35 Total, 20 years and older 7.02 (6.87 – 7.18) 11.7 (11.2 – 12.2) 1,814 7.09 (4.20 – 4.50) 6.61 (6.48 – 6.74) 4.05 20–39 years 6.61 (6.47 – 6.73) 10.6 (9.97 – 11.1) 789 (3.88 – 4.31) 40–59 years (7.21 – 7.52) 4.77 (4.38 – 4.92) 7.33 (7.20 – 7.47) 10.9 (10.5 – 12.3) 470 7.36 (8.82 – 9.88) 60 years and older 6.07 (5.48 – 6.41) 9.32 (9.14 – 9.98) 16.0 (15.2 – 18.0) 555 9.55 Males Total, 20 years and older 7.85 (7.70 – 8.01) 5.50 (5.33 – 5.69) 7.74 (7.56 – 7.90) 12.2 (11.6 – 12.6) 866 20–39 years 7.47 5.38 (5.05 – 5.59) 7.38 (7.15 – 7.68) 11.3 (10.9 – 11.9) 353 (7.30 – 7.64) 8.03 (7.67 – 8.25) 5.71 (4.81 – 6.08) 7.91 40–59 years 11.8 (10.7 – 13.4) 239 (7.80 – 8.26) 60 years and older (9.78 – 10.8) 6.79 (5.75 – 7.27) 10.0 (9.44 – 10.5) 16.0 (15.1 – 18.4) 274 10.3 Females Total, 20 years and older (6.17 – 6.51) 3.91 (3.76 – 4.02) 6.28 (6.10 – 6.50) 10.6 (10.1 – 11.5) 948 6.34 20–39 years 5.73 (5.57 – 5.91) 3.67 (3.41 – 3.82) 5.77 (5.57 – 5.99) 8.52 (8.11 – 9.49) 436 40–59 years 6.71 (6.49 – 6.94) 4.39 (3.91 – 4.78) 6.68 (6.36 – 6.86) 10.1 (9.32 – 12.2) 231 15.9 281 (8.07 – 9.07) (14.2 – 19.8) 60 years and older 8.98 (8.49 – 9.49) 5.67 (4.83 – 6.08) 8.50 nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 56

68 Table 1.6.a.4. Plasma total homocysteine: Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 5th 95th 50th Males and Females (8.03 – 8.42) 4.89 Total, 20 years and older 8.00 (7.82 – 8.22) 14.8 (14.4 – 15.7) 1,871 8.22 (4.61 – 5.05) 7.14 (6.95 – 7.34) 4.46 20–39 years 7.14 (6.98 – 7.36) 11.2 (10.8 – 11.8) 720 (4.20 – 4.61) 40–59 years (8.31 – 8.79) 5.28 (5.10 – 5.39) 8.42 (8.14 – 8.70) 14.7 (13.9 – 17.1) 626 8.55 (10.1 – 10.7) 60 years and older 6.45 (6.00 – 6.95) 10.3 (10.4 – 11.0) 20.7 (18.8 – 23.6) 525 10.7 Males Total, 20 years and older 9.09 (8.91 – 9.27) 5.93 (5.73 – 6.16) 8.78 (8.58 – 8.96) 15.3 (14.5 – 16.4) 896 20–39 years 8.19 5.72 (5.42 – 5.88) 8.04 (7.80 – 8.25) 12.1 (11.6 – 13.1) 340 (7.95 – 8.44) 9.40 (8.82 – 9.41) 6.17 (5.70 – 6.41) 9.11 40–59 years 15.3 (14.2 – 18.2) 292 (9.12 – 9.70) (10.3 – 11.3) 60 years and older 6.76 (6.39 – 7.30) 10.9 (10.7 – 11.6) 21.1 (17.5 – 24.9) 264 11.1 Females Total, 20 years and older 7.59 (7.34 – 7.85) 4.52 (4.23 – 4.74) 7.23 (7.07 – 7.53) 14.7 (13.5 – 15.9) 975 20–39 years (6.19 – 6.58) 4.19 (3.80 – 4.38) 6.43 (6.25 – 6.72) 9.79 (9.22 – 10.6) 380 6.38 40–59 years 7.90 (7.56 – 8.25) 4.98 (4.46 – 5.23) 7.73 (7.22 – 8.08) 13.7 (11.9 – 16.1) 334 (5.74 – 6.83) 60 years and older 10.4 (9.98 – 10.9) 6.15 261 9.93 (9.50 – 10.5) 20.7 (18.7 – 24.7) Table 1.6.a.5. Plasma total homocysteine: Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 5th 95th 50th Males and Females (8.22 – 8.57) 5.18 Total, 20 years and older 8.21 (8.07 – 8.37) 14.5 (14.0 – 15.2) 4,670 8.39 (5.03 – 5.34) 7.26 (7.13 – 7.40) 4.51 20–39 years 7.26 (7.07 – 7.39) 11.2 (10.9 – 11.9) 1,458 (4.33 – 4.79) 40–59 years (8.21 – 8.60) 5.36 (5.19 – 5.51) 8.24 (8.09 – 8.44) 13.6 (13.1 – 14.9) 1,353 8.40 (9.57 – 10.1) 60 years and older 6.38 (6.09 – 6.59) 9.82 (9.82 – 10.4) 17.6 (16.7 – 18.4) 1,859 10.1 Males Total, 20 years and older 9.15 (8.94 – 9.36) 6.13 (5.95 – 6.24) 8.80 (8.61 – 8.99) 14.9 (14.2 – 16.0) 2,274 20–39 years 8.11 5.69 (5.47 – 5.85) 8.00 (7.85 – 8.14) 11.8 (11.2 – 12.7) 641 (7.91 – 8.32) 9.28 (8.61 – 9.16) 6.35 (6.21 – 6.55) 8.89 40–59 years 14.2 (13.4 – 16.0) 687 (8.98 – 9.59) 60 years and older (10.3 – 10.9) 6.95 (6.65 – 7.15) 10.4 (10.0 – 10.8) 17.8 (16.6 – 19.0) 946 10.6 Females Total, 20 years and older (7.54 – 7.96) 4.72 (4.49 – 4.93) 7.53 (7.34 – 7.70) 14.0 (13.3 – 15.2) 2,396 7.75 20–39 years 6.50 (6.35 – 6.65) 3.98 (3.77 – 4.13) 6.46 (6.29 – 6.59) 10.2 (9.55 – 11.0) 817 40–59 years 7.63 (7.40 – 7.87) 4.99 (4.70 – 5.18) 7.38 (7.16 – 7.62) 13.0 (11.8 – 15.8) 666 913 (16.3 – 18.7) 60 years and older 9.69 (9.34 – 10.0) 6.03 (5.71 – 6.28) 9.48 (9.05 – 9.73) 17.1 1. Water-Soluble Vitamins 57

69 Table 1.6.b. Plasma total homocysteine: Concentrations by survey cycle Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the U.S. population, National Health and Nutrition Examination Survey, 1999–2006. Geometric mea n Selected percentile s (95% conf. interval) Sample 5th 50th 95th (95% conf. interval) size Total, 20 years and older 14.3 (4.65 – 5.02) 1999–2000 (7.82 – 8.04) (7.95 – 8.18) (13.5 – 15.0) 4,192 8.07 4.82 7.94 (8.04 – 8.38) 5.01 2001–2002 8.01 (7.84 – 8.17) 14.4 (13.9 – 15.1) 4,759 8.21 (4.86 – 5.15) 8.56 5.31 (5.15 – 5.40) 8.33 (8.32 – 8.81) 14.9 (14.2 – 15.9) 4,509 2003–2004 (8.14 – 8.55) 7.88 (7.73 – 8.04) 4.78 (4.60 – 4.94) 7.76 (7.60 – 7.90) 13.7 (13.1 – 14.5) 4,490 2005–2006 Age group 3–5 years 4.21 (4.05 – 4.39) (2.56 – 2.98) 4.19 (4.02 – 4.42) 6.31 (5.75 – 7.70) 376 1999–2000 2.81 4.31 2.95 (2.65 – 3.21) 4.28 (4.20 – 4.44) 6.15 (5.89 – 6.50) 454 2001–2002 (4.16 – 4.46) 4.36 (4.18 – 4.55) 3.10 (2.87 – 3.19) 4.42 2003–2004 6.28 (5.72 – 6.66) 454 (4.14 – 4.65) 6–11 years 4.35 2.91 (2.55 – 3.09) 4.36 (4.20 – 4.50) 6.49 (6.21 – 6.78) 899 1999–2000 (4.18 – 4.54) 2001–2002 (4.58 – 4.77) 3.27 (3.04 – 3.44) 4.61 (4.53 – 4.73) 6.94 (6.60 – 7.21) 1,034 4.67 2003–2004 4.65 (4.53 – 4.78) 3.22 (2.99 – 3.37) 4.68 (4.51 – 4.82) 6.62 (6.44 – 6.77) 852 12–19 years 1999–2000 (5.70 – 6.05) 3.65 (3.37 – 3.81) 5.83 (5.70 – 6.01) 9.58 (9.23 – 10.6) 2,132 5.87 6.03 3.96 (3.64 – 4.14) 5.90 (5.73 – 6.11) 9.48 (9.30 – 10.1) 2,225 (5.88 – 6.19) 2001–2002 2,073 (9.43 – 10.7) 4.26 (4.08 – 4.36) 6.21 (6.02 – 6.43) 10.0 (6.14 – 6.47) 2003–2004 6.30 20–39 years 7.19 (7.04 – 7.35) 4.23 (4.06 – 4.42) 7.26 (7.03 – 7.43) 11.9 (11.3 – 12.5) 1999–2000 1,474 2001–2002 (7.12 – 7.42) 4.42 (4.21 – 4.67) 7.27 (7.08 – 7.25) 12.0 (11.6 – 12.8) 1,720 7.16 2003–2004 7.47 (7.33 – 7.62) 4.71 (4.47 – 4.99) 7.42 (7.30 – 7.58) 11.3 (11.0 – 12.0) 1,561 2005–2006 6.81 4.21 (3.99 – 4.42) 6.72 (6.61 – 6.84) 11.0 (10.4 – 11.5) 1,706 (6.67 – 6.95) 40–59 years 1999–2000 (8.07 – 8.48) 5.18 (5.05 – 5.27) 8.27 (7.94 – 8.26) 13.5 (12.4 – 15.6) 1,209 8.08 2001–2002 8.30 (8.17 – 8.43) 5.35 (5.16 – 5.48) 8.17 (8.02 – 8.31) 13.4 (12.7 – 14.1) 1,494 2003–2004 (8.42 – 8.93) 5.60 (5.33 – 5.74) 8.44 (8.20 – 8.61) 14.4 (13.6 – 16.2) 1,280 8.67 2005–2006 8.01 (7.84 – 8.18) 5.13 (4.82 – 5.25) 7.90 (7.70 – 8.07) 12.8 (12.5 – 14.1) 1,371 60 years and older (9.53 – 10.0) 1999–2000 9.78 (9.23 – 9.75) 6.10 (6.03 – 6.17) 9.45 17.6 (16.9 – 18.7) 1,509 2001–2002 10.2 6.36 (6.12 – 6.64) 9.79 (9.33 – 10.2) 18.6 (17.7 – 19.6) 1,545 (9.76 – 10.6) 10.6 (10.2 – 10.9) (6.33 – 6.99) 10.3 (9.93 – 10.6) 19.0 (17.6 – 20.2) 1,668 2003–2004 6.62 1,413 (9.36 – 10.0) 9.40 (9.05 – 9.75) 17.5 (16.2 – 18.5) (5.75 – 6.29) 6.01 9.69 2005–2006 Gender (20 years and older) Males (8.69 – 9.11) 5.77 (5.57 – 5.92) 1999–2000 (8.42 – 8.92) 15.0 (14.2 – 16.6) 1,959 8.90 8.65 9.06 6.08 (5.86 – 6.24) 8.74 (8.89 – 9.23) 14.9 (14.3 – 15.8) 2,255 2001–2002 (8.53 – 8.96) 9.35 (9.06 – 9.65) 6.28 (6.09 – 6.42) 8.92 (8.67 – 9.17) 15.3 (14.5 – 16.7) 2,177 2003–2004 8.67 2005–2006 5.82 (5.70 – 5.92) 8.42 (8.25 – 8.59) 14.2 (13.2 – 15.2) 2,152 (8.49 – 8.84) Females (7.14 – 7.42) 4.31 (4.07 – 4.53) 7.30 (7.23 – 7.52) 13.1 (12.7 – 14.3) 2,233 1999–2000 7.37 7.50 (7.32 – 7.68) 4.53 (4.32 – 4.73) 7.23 (7.06 – 7.36) 13.6 (12.9 – 14.8) 2,504 2001–2002 7.89 2003–2004 4.86 (4.51 – 5.03) 7.60 (7.39 – 7.87) 14.3 (13.4 – 15.8) 2,332 (7.61 – 8.18) 2005–2006 (7.00 – 7.45) 4.40 (4.19 – 4.51) 6.98 (6.80 – 7.15) 13.1 (12.1 – 14.9) 2,338 7.22 Race/ethnicity (20 years and older) Mexican Americans 7.28 (7.06 – 7.50) (3.96 – 4.58) 7.08 (6.88 – 7.36) 12.5 (11.8 – 13.9) 1,146 1999–2000 4.22 7.18 4.27 (4.00 – 4.47) 7.10 (6.80 – 7.34) 12.4 (11.8 – 13.7) 1,009 2001–2002 (6.85 – 7.53) 7.30 (7.11 – 7.49) 4.49 (4.25 – 4.57) 7.31 2003–2004 11.9 (11.3 – 12.7) 904 (7.17 – 7.42) 2005–2006 (6.74 – 7.05) 4.31 (3.99 – 4.44) 6.75 (6.62 – 6.94) 11.2 (10.8 – 12.2) 910 6.90 Non-Hispanic Blacks 1999–2000 (7.87 – 8.41) 4.71 (4.25 – 4.87) 8.14 (7.51 – 8.34) 15.3 (14.7 – 16.6) 773 7.91 2001–2002 8.29 (8.03 – 8.55) 4.64 (4.40 – 5.08) 7.93 (7.72 – 8.17) 15.4 (14.4 – 17.9) 872 2003–2004 8.53 5.04 (4.84 – 5.24) 8.29 (7.99 – 8.59) 14.9 (14.4 – 16.6) 869 (8.24 – 8.83) (7.50 – 7.95) 2005–2006 4.73 (4.50 – 4.90) 7.74 (7.72 – 8.17) 14.7 (14.0 – 15.5) 1,002 7.94 Non-Hispanic Whites 1999–2000 8.19 (8.07 – 8.30) 5.09 (4.82 – 5.19) 8.03 (7.93 – 8.22) 14.3 (13.5 – 14.8) 1,874 2001–2002 (8.21 – 8.54) 5.18 (5.04 – 5.26) 8.14 (7.98 – 8.28) 14.6 (14.0 – 15.7) 2,514 8.37 2,406 8.74 (8.50 – 8.99) 5.46 (5.37 – 5.57) 8.53 (8.29 – 8.72) 15.1 (14.2 – 16.1) 2003–2004 13.9 2,264 (13.2 – 14.8) (7.83 – 8.04) 2005–2006 8.06 (7.89 – 8.24) 4.97 (4.70 – 5.15) 7.94 nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 58

70 cle y cy ve ations by sur steine: Concentr cy Figure 1.6.b. Plasma total homo Selected percentiles in μmol/L (95% con dence intervals), National Health and Nutrition Examination Survey, 1999–2006 20 15 10 95th Percentile 5 10 8 6 50th Percentile 4 7 6 5 4 5th Percentile 3 2 05−06 99−00 01−02 03−04 03−04 05−06 03−04 99−00 05−06 99−00 01−02 01−02 99−00 01−02 03−04 05−06 03−04 99−00 99−00 01−02 03−04 05−06 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 01−02 05−06 03−04 01−02 99−00 05−06 03−04 01−02 99−00 20+y NHB 6−11y Total MA NHW Females Males 1−5y 12−19y (20+y) (20+y) (20+y) (20+y) (20+y) (20+y) 59

71 Table 1.6.c. Plasma total homocysteine: Prevalence Prevalence (in percent) of high Plasma total homocysteine concentration (> 13 μmol/L) for the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2006. Prevalenc e Sample Estimated total (95% conf. interval) number of persons size 8,999 7.7 (6.8 – 8.8) 15,825,000 Total, 20 years and older Age group 20–39 years 3,267 1.9 (1.4 – 2.4) 1,482,000 5,553,000 40–59 years 2,651 7.0 (5.6 – 8.7) 60 years and older 8,620,000 18.5 (16.3 – 21.0) 3,081 Gender 9,021,000 4,329 9.2 (7.9 – 10.6) Males Females 4,670 6.4 (5.2 – 7.7) 6,796,000 Race/ethnicity Mexican Americans 1,814 2.1 (1.5 – 2.9) 336,000 Non-Hispanic Blacks 1,871 8.9 (7.7 – 10.2) 2,005,000 12,066,000 4,670 8.3 Non-Hispanic Whites (7.1 – 9.6) nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 60

72 Table 1.6.d. Plasma total homocysteine: Prevalence by survey cycle Prevalence (in percent) of high Plasma total homocysteine concentration (> 13 μmol/L) for the U.S. population, National Health and Nutrition Examination Survey, 1999–2006. Sample size (95% conf. interval) Estimated total number of persons Prevalence Total, 20 years and older 4,192 13,319,000 6.9 1999–2000 (6.0 – 8.1) (6.5 – 9.2) 7.8 2001–2002 15,479,000 4,759 (7.9 – 11.3) 19,421,000 2003–2004 4,509 9.5 (5.1 – 6.9) 12,553,000 6.0 2005–2006 4,490 Age group 3–5 years § 1999–2000 376 § 454 § 2001–2002 § § 454 2003–2004 § 6–11 years § § 1999–2000 899 1,034 § 2001–2002 § 2003–2004 852 § § 12–19 years 2,132 1.5‡ (0.8 – 2.8) 466,000‡ 1999–2000 2,225 2001–2002 (0.5 – 1.6) 294,000 0.9 2,073 1.1‡ 358,000‡ 2003–2004 (0.5 – 2.1) 20–39 years 1,474 (1.6 – 4.3) 2,058,000 1999–2000 2.6 3.2 (2.2 – 4.6) 2001–2002 1,720 2,505,000 1,561 2.4 (1.7 – 3.4) 1,923,000 2003–2004 1,706 1.3 (0.8 – 2.2) 1,034,000 2005–2006 40–59 years 1999–2000 5.9 (4.3 – 8.1) 4,188,000 1,209 1,494 (4.4 – 7.5) 4,378,000 2001–2002 5.8 1,280 9.4 (7.0 – 12.4) 7,396,000 2003–2004 2005–2006 1,371 (3.6 – 6.2) 3,894,000 4.7 60 years and older 1,509 17.3 (14.8 – 20.3) 7,441,000 1999–2000 2001–2002 1,545 20.5 (17.1 – 24.5) 9,180,000 2003–2004 1,668 (19.2 – 24.2) 10,039,000 21.6 1,413 15.6 7,527,000 2005–2006 (12.3 – 19.5) Gender (20 years and older) Males 1,959 8.6 (7.0 – 10.4) 7,854,000 1999–2000 9.6 2001–2002 9,136,000 2,255 (7.8 – 11.7) 2,177 11.4 (9.4 – 13.7) 11,197,000 2003–2004 2,152 7.0 (5.6 – 8.7) 2005–2006 7,036,000 Females 2,233 (4.5 – 6.6) 5,459,000 1999–2000 5.4 2001–2002 2,504 6.1 (4.9 – 7.5) 6,342,000 2,332 2003–2004 (6.0 – 9.8) 8,202,000 7.7 2005–2006 2,338 5.1 (3.8 – 6.8) 5,525,000 Race/ethnicity (20 years and older) Mexican Americans 1999–2000 1,146 4.4 (3.3 – 5.9) 542,000 2001–2002 1,009 (2.5 – 5.5) 542,000 3.8 904 (1.8 – 4.0) 426,000 2003–2004 2.7 910 1.6 (1.0 – 2.5) 263,000 2005–2006 Non-Hispanic Blacks 1999–2000 8.6 (6.7 – 10.8) 1,872,000 773 872 9.6 (7.8 – 11.8) 2,120,000 2001–2002 2003–2004 869 10.8 (8.7 – 13.2) 2,435,000 2005–2006 1,002 (6.0 – 8.2) 1,640,000 7.0 Non-Hispanic Whites 1,874 7.0 (6.0 – 8.1) 9,938,000 1999–2000 2001–2002 2,514 8.4 (6.9 – 10.3) 12,142,000 2003–2004 2,406 10.1 (8.3 – 12.2) 14,718,000 2005–2006 2,264 6.5 (5.4 – 7.7) 9,541,000 ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. § Estimate suppressed: RSE ≥ 40% for the prevalence estimate. 1. Water-Soluble Vitamins 61

73 421 806 size 3,825 7,544 3,719 1,834 1,993 1,979 3,152 1,496 1,230 1,612 Sample (328 – 403) (359 – 428) (364 – 526) (271 – 516) (248 – 387) (229 – 461) (249 – 298) (247 – 326) (360 – 480) (279 – 368) (324 – 572) (536 – 822) 97.5th 387 300 406 258 270 362 280 393 303 387 628 299† (277 – 320) (277 – 339) (209 – 254) (235 – 307) (204 – 253) (272 – 315) (206 – 246) (210 – 263) (283 – 340) (231 – 275) (252 – 338) (392 – 482) 95th 293 269 299 230 228 287 224 222 308 246 275 429 (95% conf. interval) s (122 – 132) (100 – 112) (109 – 124) (123 – 132) (109 – 118) (99.3 – 111) (120 – 132) (110 – 118) (129 – 141) (110 – 123) (124 – 138) (156 – 170) 50th 127 106 117 127 113 105 126 115 135 116 130 163 Selected percentile (67.3 – 72.8) (58.6 – 64.4) (69.4 – 75.4) (56.6 – 72.1) (61.0 – 72.6) (65.2 – 71.3) (57.7 – 64.1) (64.8 – 70.0) (73.1 – 79.9) (64.2 – 69.6) (66.6 – 75.0) (83.6 – 94.5) 5th 70.0 65.2 61.9 72.4 67.5 68.1 61.1 67.3 76.9 67.3 70.9 89.9 (60.5 – 65.6) (63.0 – 67.9) (53.3 – 58.0) (54.6 – 63.4) (56.9 – 64.4) (52.3 – 57.9) (58.2 – 63.9) (56.8 – 64.4) (65.1 – 72.9) (57.0 – 64.4) (59.2 – 67.8) (73.5 – 83.6) 2.5th 63.2 56.2 65.0 60.6 55.3 61.3 62.4 69.4 61.4 62.9 79.7 61.1† n (128 – 140) (110 – 130) (108 – 114) (130 – 142) (111 – 123) (104 – 114) (125 – 138) (115 – 122) (136 – 150) (116 – 127) (129 – 144) (169 – 186) 134 111 120 136 117 131 109 118 143 122 137 177 (95% conf. interval) Geometric mea † Estimate is subject to greater uncertainty due to small cell size. Total, 3 years and older Race/ethnicity Males Gender Age group 3–5 years Mexican Americans 6–11 years Non-Hispanic Blacks Females 12–19 years Non-Hispanic Whites 20–39 years 40–59 years 60 years and older Geometric mean and selected percentiles of plasma concentrations (in nmol/L) for the total U.S. population aged 3 years and older, National Health and Nutrition Examination Survey, 2003–2004. Table 1.7.a.1. Plasma methylmalonic acid: Concentrations nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 62

74 Figure 1.7.a. Plasma methylmalonic acid: Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Overall Mexican Americans 200 Females Males 150 100 (nmol/L) 50 0 Plasma methylmalonic acid 12−19 6−11 12−19 20−39 40−59 60+ 3−5 20−39 40−59 60+ 3−5 6−11 Non−Hispanic Whites Non−Hispanic Blacks 00 d 2 150 100 (nmol/L) 50 0 Plasma methylmalonic aci 3−5 40−59 12−19 20−39 60+ 3−5 6−11 12−19 20−39 40−59 60+ 6−11 Females Males 200 Mexican Americans 150 Non−Hispanic Blacks Non−Hispanic 100 Whites (nmol/L) 50 0 Plasma methylmalonic acid 6−11 60+ 20−39 12−19 6−11 3−5 60+ 40−59 3−5 40−59 12−19 20−39 Age (years) Age (years) 1. Water -Soluble Vitamins 63

75 Table 1.7.a.2. Plasma methylmalonic acid: Total population Geometric mean and selected percentiles of plasma concentrations (in nmol/L) for the total U.S. population aged 3 years and older, National Health and Nutrition Examination Survey, 2003–2004. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 90th 10th Males and Females (128 – 140) 79.6 (76.4 – 82.4) 127 (122 – 132) 231 (218 – 249) 7,544 Total, 3 years and older 134 (110 – 130) 3–5 years (67.8 – 79.0) 117 (109 – 124) 198 (169 – 269) 421 120 74.5 117 77.6 (72.5 – 79.9) 113 (109 – 118) 184 (168 – 205) 806 6–11 years (111 – 123) 118 (115 – 122) 75.1 (72.5 – 78.2) 115 (110 – 118) 189 (179 – 201) 1,979 12–19 years 122 20–39 years (71.7 – 79.2) 116 (110 – 123) 201 (188 – 219) 1,496 (116 – 127) 75.5 137 82.3 (77.2 – 86.3) 130 (124 – 138) 223 (209 – 238) 1,230 40–59 years (129 – 144) 177 (169 – 186) 102 (96.8 – 106) 163 (156 – 170) 328 (312 – 358) 1,612 60 years and older Males Total, 3 years and older 82.8 (79.4 – 85.3) 127 (130 – 142) 231 (217 – 253) 3,719 136 (123 – 132) 122 (110 – 135) 71.6 (65.1 – 78.7) 118 (103 – 129) 239 (180 – 272) 223 3–5 years 6–11 years 117 (109 – 126) 75.9 (69.5 – 79.4) 112 (107 – 119) 191 (167 – 223) 385 12–19 years 123 79.2 (76.7 – 81.4) 119 (112 – 125) 197 (179 – 210) 1,016 (118 – 129) 126 78.7 (72.6 – 85.9) 119 (111 – 125) 209 (194 – 223) 705 20–39 years (120 – 133) (128 – 141) (206 – 266) 224 608 134 141 86.2 (132 – 151) 40–59 years (79.9 – 93.2) (155 – 174) 178 60 years and older (93.0 – 103) 162 (168 – 189) 351 (328 – 373) 782 99.0 Females Total, 3 years and older 131 (125 – 138) 77.5 (73.7 – 81.0) 126 (120 – 132) 231 (217 – 250) 3,825 3–5 years 117 75.5 (65.7 – 79.7) 117 (109 – 122) 169 (155 – 276) 198 (107 – 127) 6–11 years (111 – 122) 78.7 (73.9 – 81.4) 115 (109 – 119) 177 (164 – 207) 421 116 12–19 years 113 (110 – 116) 71.4 (67.8 – 74.1) 109 (106 – 113) 181 (171 – 203) 963 20–39 years 117 (112 – 123) 73.0 (68.4 – 76.5) 113 (106 – 120) 197 (180 – 218) 791 622 40–59 years 132 (123 – 142) 79.0 (71.2 – 85.3) 126 (119 – 136) 222 (208 – 236) 315 (291 – 357) 830 60 years and older 177 (165 – 189) 106 (97.3 – 111) 164 (155 – 170) Table 1.7.a.3. Plasma methylmalonic acid: Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in nmol/L) for Mexican Americans in the U.S. population aged 3 years and older, National Health and Nutrition Examination Survey, 2003–2004. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 10th 50th 90th Males and Females 111 (108 – 114) 69.4 (67.1 – 72.4) 106 (100 – 112) 186 (174 – 201) Total, 3 years and older 1,834 3–5 years (94.2 – 122) 74.1† (65.1 – 76.9) 106 (87.8 – 118) 150† (133 – 279) 111 107 105 (96.7 – 113) 70.8 (61.5 – 77.1) 101 (92.6 – 112) 152 (142 – 192) 258 6–11 years 12–19 years 107 (102 – 112) 65.8 (62.4 – 69.8) 104 (98.3 – 109) 167 (160 – 184) 599 20–39 years 108 67.7 (65.0 – 70.6) 103 (92.6 – 116) 181 (156 – 242) 322 (99.2 – 117) 40–59 years (110 – 119) 71.7 (65.4 – 75.8) 108 (102 – 115) 201 (178 – 220) 216 115 60 years and older 152 (138 – 168) 87.6 (81.1 – 92.8) 138 (125 – 159) 272 (245 – 368) 328 Males Total, 3 years and older (114 – 119) 74.3 (69.8 – 77.3) 116 (106 – 114) 199 (185 – 217) 911 109 3–5 years 108 (93.9 – 124) 72.6† (57.0 – 81.5) 105 (87.6 – 119) 145† (131 – 307) 59 104 6–11 years (50.9 – 79.4) (96.1 – 113) 70.2 105 (90.5 – 113) 148 (138 – 232) 124 12–19 years 118 72.9 (67.6 – 78.7) 111 (104 – 119) 198 (171 – 242) 306 (111 – 126) 113 75.6 (64.0 – 81.1) 106 (99.5 – 113) 189 (157 – 363) 149 20–39 years (104 – 124) 123 (114 – 133) 73.4 (65.2 – 76.6) 116 40–59 years 218 (103 – 131) 113 (173 – 330) (119 – 158) 153 89.1 60 years and older 137 (130 – 181) 268 (234 – 411) 160 (80.1 – 95.3) Females Total, 3 years and older 105 (99.3 – 112) 67.0 (61.7 – 68.7) 102 (92.6 – 110) 176 (157 – 201) 923 3–5 years 106 74.1† (57.0 – 81.0) 105 (80.4 – 127) 152† (124 – 228) 52 (87.6 – 128) 6–11 years (94.3 – 117) 72.4 (58.9 – 77.7) 99.7 (89.6 – 115) 160 (145 – 218) 134 105 12–19 years 96.2 (91.3 – 101) 61.6 (55.1 – 66.5) 95.5 (90.0 – 102) 150 (142 – 156) 293 20–39 years (91.2 – 113) 65.4 (56.5 – 68.0) 99.5 (81.5 – 119) 170 (147 – 208) 173 102 103 106 (95.2 – 117) 69.8† (58.0 – 75.4) 101 (95.6 – 109) 181† (137 – 247) 40–59 years 168 279 (243 – 333) 60 years and older 151 (135 – 170) 83.4 (77.3 – 96.5) 140 (120 – 171) † Estimate is subject to greater uncertainty due to small cell size. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 64

76 Table 1.7.a.4. Plasma methylmalonic acid: Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in nmol/L) for non-Hispanic blacks in the U.S. population aged 3 years and older, National Health and Nutrition Examination Survey, 2003–2004. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 50th 10th 90th Males and Females 177 (65.1 – 71.0) 109 (99.3 – 111) 68.4 (167 – 188) 1,993 Total, 3 years and older (104 – 114) 105 (87.4 – 104) 62.7 3–5 years 99.4 (86.5 – 106) 139 (125 – 159) 146 95.4 (54.6 – 72.2) 98.7 65.9 (56.1 – 71.0) 96.6 (92.9 – 105) 147 (139 – 159) 290 6–11 years (92.1 – 103) 96.0 (90.6 – 102) 63.9 (60.0 – 66.4) 93.2 (89.7 – 97.7) 147 (135 – 160) 12–19 years 721 20–39 years (96.5 – 108) 66.7 (56.2 – 70.0) 99.3 (91.3 – 107) 161 (151 – 177) 328 102 117 74.1 (63.5 – 78.1) 114 (99.8 – 122) 193 (161 – 246) 275 40–59 years (108 – 126) 148 (137 – 159) 91.8 (76.6 – 105) 142 (131 – 147) 245 (217 – 299) 233 60 years and older Males Total, 3 years and older (107 – 117) 69.6 (67.8 – 72.6) 108 (101 – 113) 184 (171 – 199) 992 112 95.4 (87.4 – 104) 65.2† (< LOD – 73.4) 101 (87.6 – 107) 125† (121 – 140) 76 3–5 years 6–11 years 99.0 (90.5 – 108) 64.3 (50.7 – 69.3) 97.4 (86.2 – 109) 150 (138 – 177) 135 12–19 years 102 69.5 (64.4 – 72.8) 97.9 (92.3 – 103) 154 (143 – 179) 381 (95.5 – 109) 107 69.3 (64.1 – 72.9) 102 (97.0 – 114) 157 (149 – 182) 161 (99.9 – 114) 20–39 years 130 (179 – 280) 226 (104 – 124) 117 (61.4 – 77.4) (110 – 136) 122 40–59 years 71.5 145 (133 – 158) 85.0† (77.2 – 98.7) 138 (125 – 150) 237† (212 – 322) 60 years and older 109 Females 107 (100 – 114) 66.9 (62.2 – 70.8) Total, 3 years and older (95.7 – 110) 172 (161 – 187) 1,001 104 3–5 years 95.4 (84.0 – 108) 59.3† (< LOD – 71.8) 95.6 (80.0 – 108) 141† (126 – 268) 70 6–11 years 98.4 68.7 (57.1 – 74.3) 95.9 (89.5 – 105) 145 (135 – 155) 155 (92.6 – 105) 12–19 years (84.7 – 96.2) 59.4 (56.1 – 64.1) 89.6 (85.8 – 94.5) 139 (128 – 151) 340 90.3 20–39 years 98.5 (91.3 – 106) 64.5 (52.6 – 68.2) 92.9 (85.7 – 101) 162 (142 – 197) 167 40–59 years (104 – 123) 75.0 (62.0 – 82.2) 110 (97.7 – 120) 169 (151 – 211) 145 113 60 years and older 150 (137 – 163) 96.5 (72.9 – 107) 143 (129 – 152) 247 (216 – 334) 124 < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. † Estimate is subject to greater uncertainty due to small cell size. Table 1.7.a.5. Plasma methylmalonic acid: Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in nmol/L) for non-Hispanic whites in the U.S. population aged 3 years and older, National Health and Nutrition Examination Survey, 2003–2004. Selected percentile s (95% conf. interval) Geometric mea n Sample size (95% conf. interval) 10th 50th 90th Males and Females (136 – 150) 86.7 (82.8 – 89.9) 135 (129 – 141) 242 (229 – 266) Total, 3 years and older 143 3,152 133 80.5 (64.1 – 94.6) 128 (119 – 140) 246 (200 – 274) 115 3–5 years (123 – 145) (122 – 139) 87.3 (77.5 – 95.7) 122 (114 – 135) 213 (189 – 232) 196 6–11 years 130 128 (122 – 133) 79.9 (77.7 – 83.3) 122 (119 – 127) 203 (188 – 217) 525 12–19 years 128 20–39 years (76.3 – 87.1) 123 (115 – 132) 204 (194 – 228) 708 (121 – 136) 82.7 142 86.6 (80.6 – 92.9) 136 (128 – 145) 227 (210 – 258) 642 40–59 years (134 – 152) 182 (173 – 192) 105 (99.1 – 109) 167 (161 – 176) 341 (316 – 365) 966 60 years and older Males Total, 3 years and older 91.0 (85.8 – 94.2) 134 (137 – 152) 240 (224 – 274) 1,535 144 (127 – 142) 139 (121 – 160) 73.7† (63.0 – 99.4) 130 (118 – 155) 267† (242 – 279) 62 3–5 years 132 120 (120 – 146) 91.6† (72.1 – 101) 6–11 years (111 – 141) 207† (184 – 266) 91 12–19 years 131 83.4 (78.2 – 89.6) 125 (119 – 133) 204 (179 – 256) 266 (122 – 141) 130 88.1 (69.7 – 93.3) 123 (113 – 137) 205 (186 – 231) 319 20–39 years (120 – 141) 145 (135 – 157) 95.7 (82.6 – 99.6) 40–59 years 138 (130 – 145) (203 – 275) 321 224 (159 – 187) 182 101 60 years and older 168 (171 – 195) 364 (330 – 390) 476 (95.8 – 104) Females Total, 3 years and older 141 (135 – 148) 84.1 (79.2 – 88.1) 135 (129 – 141) 246 (231 – 261) 1,617 3–5 years 126 80.7† (54.0 – 103) 122 (113 – 140) 168† (151 – 311) 53 (113 – 141) 6–11 years (121 – 136) 86.5† (71.3 – 92.4) 122 (116 – 129) 209† (170 – 251) 105 128 12–19 years 124 (119 – 129) 77.6 (73.9 – 80.2) 119 (115 – 127) 202 (179 – 231) 259 20–39 years (119 – 133) 80.0 (75.3 – 84.5) 121 (114 – 132) 203 (187 – 239) 389 126 321 140 (128 – 152) 82.8 (71.4 – 90.2) 135 (122 – 147) 231 (219 – 259) 40–59 years 490 60 years and older 183 (170 – 196) 109 (103 – 116) 166 (161 – 175) 318 (299 – 360) † Estimate is subject to greater uncertainty due to small cell size. 1. Water-Soluble Vitamins 65

77 Table 1.7.b. Plasma methylmalonic acid: Concentrations by survey cycle Geometric mean and selected percentiles of plasma concentrations (in nmol/L) for the U.S. population, National Health and Nutrition Examination Survey, 1999–2004. n Selected percentile s (95% conf. interval) Sample Geometric mea 50th 5th 95th (95% conf. interval) size Total, 3 years and older 280 123 132 (129 – 136) (266 – 298) 7,597 64.9 1999–2000 (62.8 – 67.0) (119 – 126) 63.8 (61.3 – 66.4) 2001–2002 (116 – 123) 276 (263 – 293) 8,451 130 (126 – 133) 119 (128 – 140) (67.3 – 72.8) 127 (122 – 132) 70.0 (277 – 320) 7,544 134 2003–2004 293 Age group 3–5 years 124 67.4 (61.8 – 71.6) 116 (111 – 122) 237 (197 – 332) 376 1999–2000 (118 – 131) (112 – 121) (61.8 – 66.0) 108 (104 – 113) 219 (195 – 244) 453 116 63.9 2001–2002 (110 – 130) 65.2 (56.6 – 72.1) 117 (109 – 124) 2003–2004 (235 – 307) 421 120 269 6–11 years (117 – 134) 66.9 (63.5 – 70.3) 117 125 210 (191 – 319) 898 1999–2000 (107 – 130) 118 (114 – 122) 200 (57.7 – 66.8) 113 (109 – 118) 2001–2002 (187 – 224) 1,031 62.6 2003–2004 (111 – 123) 67.5 (61.0 – 72.6) 113 (109 – 118) 228 (204 – 253) 806 117 12–19 years 1999–2000 60.2 (55.1 – 63.5) 109 (103 – 117) 231 (206 – 291) 2,132 118 (112 – 125) (112 – 119) 228 (54.6 – 59.1) 107 (104 – 110) 115 (216 – 264) 2,220 2001–2002 56.9 222 118 (64.8 – 70.0) 115 (110 – 118) 67.3 (210 – 263) 1,979 2003–2004 (115 – 122) 20–39 years 124 (119 – 129) 62.4 (59.7 – 64.9) 1999–2000 (110 – 121) 259 (235 – 295) 1,474 116 2001–2002 (116 – 125) 59.5 (55.9 – 61.8) 112 (107 – 117) 239 (226 – 268) 1,715 121 122 (110 – 123) 67.3 (64.2 – 69.6) 116 2003–2004 246 (231 – 275) 1,496 (116 – 127) 40–59 years 1999–2000 (130 – 137) 65.4 (62.6 – 68.1) 133 (122 – 127) 251 (239 – 277) 1,210 124 2001–2002 131 (127 – 135) 71.2 (66.4 – 73.4) 120 (117 – 124) 264 (231 – 302) 1,491 137 2003–2004 (129 – 144) 70.9 (66.6 – 75.0) 130 (124 – 138) 275 (252 – 338) 1,230 60 years and older 1999–2000 (163 – 174) 80.3 (67.7 – 89.1) 149 (145 – 155) 423 (392 – 458) 1,507 168 172 (164 – 180) (74.1 – 79.8) 156 (150 – 162) 487 (413 – 604) 1,541 2001–2002 76.9 (169 – 186) (392 – 482) (83.6 – 94.5) 163 (156 – 170) 429 177 1,612 2003–2004 89.9 Gender Males (123 – 131) 67.2 (64.5 – 70.0) 127 1999–2000 288 (265 – 309) 3,708 (132 – 141) 136 133 (129 – 138) 66.4 (62.7 – 70.1) 2001–2002 (120 – 127) 273 (258 – 294) 4,091 123 2003–2004 (130 – 142) 72.4 (69.4 – 75.4) 127 (123 – 132) 299 (277 – 339) 3,719 136 Females 1999–2000 (124 – 132) 63.3 (61.1 – 65.5) 118 (114 – 122) 276 (262 – 294) 3,889 128 126 (123 – 130) 62.3 (59.9 – 64.7) 115 (111 – 119) 277 (261 – 301) 4,360 2001–2002 2003–2004 131 (125 – 138) 68.1 (65.2 – 71.3) 126 (120 – 132) 287 (272 – 315) 3,825 Race/ethnicity Mexican Americans 110 56.2 (54.9 – 57.5) 100 (97.3 – 103) 225 (198 – 270) 2,595 1999–2000 (106 – 114) 111 (107 – 115) 53.7 (51.0 – 56.5) 103 2001–2002 225 (218 – 235) 2,131 (99.0 – 108) 2003–2004 (108 – 114) 61.9 (58.6 – 64.4) 106 111 230 (209 – 254) 1,834 (100 – 112) Non-Hispanic Blacks 1999–2000 108 (103 – 113) 57.5 (52.6 – 60.7) 98.3 (91.5 – 105) 217 (192 – 250) 1,732 2001–2002 112 55.6 (53.0 – 58.2) 102 (98.3 – 107) 220 (200 – 258) 2,036 (108 – 116) 2003–2004 (104 – 114) 61.1 (57.7 – 64.1) 105 (99.3 – 111) 224 (206 – 246) 1,993 109 Non-Hispanic Whites 1999–2000 (136 – 144) 72.0 (69.8 – 74.2) 131 (126 – 135) 290 (272 – 311) 2,573 140 3,605 137 (133 – 141) 70.6 (66.8 – 72.7) 126 (122 – 130) 288 (272 – 304) 2001–2002 3,152 (129 – 141) (283 – 340) 308 2003–2004 143 (136 – 150) 76.9 (73.1 – 79.9) 135 nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 66

78 Figure 1.7.b. Plasma methylmalonic acid: Concentr cle ations by sur ve y cy Selected percentiles in nmol/L (95% condence intervals), National Health and Nutrition Examination Survey, 1999–2004 350 300 250 95th Percentile 200 150 160 140 120 50th Percentile 100 80 80 70 60 5th Percentile 50 99−00 01−02 03−04 03−04 99−00 01−02 99−00 03−04 01−02 03−04 01−02 99−00 01−02 03−04 01−02 03−04 01−02 99−00 99−00 99−00 99−00 01−02 03−04 03−04 01−02 03−04 99−00 99−00 01−02 03−04 20+y NHW MA Total Females Males NHB 12−19y 6−11y 3−5y (3+y) 1. Water-Soluble Vitamins 67

79 Table 1.7.c. Plasma methylmalonic acid: Prevalence Prevalence (in percent) of high plasma methylmalonic acid concentration (> 271 nmol/L) for the U.S. population aged 3 years and older, National Health and Nutrition Examination Survey, 2003–2004. Sample Prevalence Estimated total (95% conf. interval) number of persons size 7,544 6.5 (5.3 – 7.9) 18,411,000 Total, 3 years and older Age group 3–5 years 421 4.5‡ (2.0 – 9.7) 916,000‡ 6–11 years 806 § § 12–19 years 1,979 3.2 (2.2 – 4.6) 1,054,000 (2.9 – 5.1) 20–39 years 3.8 1,496 3,066,000 40–59 years 4,557,000 (4.1 – 8.1) 5.8 1,230 60 years and older 16.7 (13.7 – 20.1) 7,748,000 1,612 Gender Males 3,719 6.8 (5.4 – 8.6) 9,439,000 3,825 Females (5.0 – 7.7) 6.2 8,965,000 Race/ethnicity 722,000 1,834 2.8 (1.7 – 4.4) Mexican Americans Non-Hispanic Blacks 1,993 2.5 (1.8 – 3.4) 846,000 14,546,000 7.6 3,152 Non-Hispanic Whites (6.1 – 9.4) ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. § Estimate suppressed: RSE ≥ 40% for the prevalence estimate. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 68

80 Table 1.7.d. Plasma methylmalonic acid: Prevalence by survey cycle Prevalence (in percent) of high plasma methylmalonic acid concentration (> 271 nmol/L) for the U.S. H ealth and Nutrition Examination Survey, 1999–2004. population, National Estimated total number of persons Sample size (95% conf. interval) Prevalence Total, 3 years and older 5.5 (4.8 – 6.3) 1999–2000 7,597 14,367,000 8,451 5.3 (4.6 – 6.0) 14,218,000 2001–2002 7,544 6.5 (5.3 – 7.9) 2003–2004 17,887,000 Age group 3–5 years 1999–2000 § § 376 2001–2002 453 § § 421 2003–2004 (2.0 – 9.7) 553,000‡ 4.5‡ 6–11 years 1999–2000 898 2.5‡ (1.1 – 5.6) 623,000‡ 2001–2002 1,031 1.5‡ (0.7 – 3.0) 372,000‡ 2003–2004 806 § § 12–19 years 1999–2000 3.3 (2.1 – 5.3) 1,061,000 2,132 2,220 3.3 2001–2002 1,079,000 (2.1 – 5.3) 2003–2004 1,979 3.2 (2.2 – 4.6) 1,054,000 20–39 years 1999–2000 1,474 4.5 (3.2 – 6.1) 3,496,000 2001–2002 1,715 (2.6 – 5.0) 2,888,000 3.7 2003–2004 3.8 (2.9 – 5.1) 3,066,000 1,496 40–59 years 1999–2000 1,210 4.0 (3.0 – 5.2) 2,803,000 2001–2002 1,491 4.7 (3.6 – 6.1) 3,557,000 5.8 2003–2004 1,230 (4.1 – 8.1) 4,557,000 60 years and older 1999–2000 13.9 (11.7 – 16.6) 5,986,000 1,507 1,541 13.9 6,225,000 2001–2002 (12.0 – 16.1) 16.7 7,748,000 1,612 2003–2004 (13.7 – 20.1) Gender Males 1999–2000 5.7 (4.7 – 6.9) 7,231,000 3,708 4,091 5.1 (4.3 – 6.0) 6,671,000 2001–2002 2003–2004 3,719 (5.4 – 8.6) 9,157,000 6.8 Females 1999–2000 5.3 (4.5 – 6.3) 7,133,000 3,889 4,360 5.5 2001–2002 7,546,000 (4.6 – 6.5) 2003–2004 3,825 6.2 (5.0 – 7.7) 8,723,000 Race/ethnicity Mexican Americans 1999–2000 2,595 (2.0 – 5.0) 632,000 3.2 2,131 (2.2 – 3.8) 656,000 2001–2002 2.9 1,834 2.8 (1.7 – 4.4) 2003–2004 687,000 Non-Hispanic Blacks 1999–2000 1,732 2.5 (1.6 – 3.7) 803,000 2001–2002 2,036 2.6 (1.7 – 3.9) 842,000 2003–2004 1,993 (1.8 – 3.4) 817,000 2.5 Non-Hispanic Whites 2,573 6.1 (5.3 – 7.1) 11,346,000 1999–2000 2001–2002 3,605 5.9 (5.2 – 6.8) 11,036,000 2003–2004 3,152 7.6 (6.1 – 9.4) 14,198,000 ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. § Estimate suppressed: RSE ≥ 40% for the prevalence estimate. 1. Water-Soluble Vitamins 69

81 References Allen RH, Stabler SP, Savage DG, Lindenbaum J. Diagnosis of cobalamin deficiency I: Usefulness of serum methylmalonic acid and total homocysteine concentrations. Am J Hematol. 1990;34:90–98. Baik HW, Russel RM. Vitamin B12 deficiency in the elderly. Annu Rev Nutr. 1999;19:357–377. Bailey RL, Carmel R, Green R, Pfeiffer CM, Cogswell ME, Osterloh JD, et al. Monitoring of vitamin B-12 nutritional status in the United States by using plasma methylmalonic acid and serum vitamin B-12. Am J Clin Nutr. 2011;94:552-561. Carmel R. Biomarkers of cobalamin (vitamin B-12) status in the epidemiologic setting: a critical overview of context, applications, and performance characteristics of cobalamin, methylmalonic acid, and holotranscobalamin II. Am J Clin Nutr. 2011;94:348S–358S. Coburn SP. Location and turnover of vitamin B6 pools and vitamin B6 requirements of humans. Ann NY Acad Sci 1990;585:76–85. Coburn SP. Vitamin B6. In: Song WO, Beecher GR, Eitenmiller RR, editors. Modern Analytical Methodologies in Fat- and Water-Soluble Vitamins. New York: John Wiley & Sons, Inc.; 2000. pp. 291–311. Czeizel AE, Dudas I. Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med. 1992;327:1832–1835. de Benoist B. Conclusions of a WHO technical consultation on folate and vitamin B12 deficiencies. Food Nutr Bull. 2008;29:S238–244. French AE, Grant R, Weitzman S, Ray JG, Vermeulen MJ, Sung L, et al. Folic acid food fortification is associated with a decline in neuroblastoma. Clin Pharmacol Ther. 2003;74:288–294. Gunter EW, Bowman BA, Caudill SP, Twite DB, Adams MJ, Sampson EJ. Results of an international round robin for serum folate and whole-blood folate. Clin Chem. 1996;42:1689–1694. Halsted CH. Intestinal absorption of dietary folates. In: Picciano MF, Stokstad ELR, Gregory JF, editors. Folic acid metabolism in health and disease. New York: Wiley-Liss, Inc.; 1990. pp. 23–45. Hamner HC, Cogswell ME, Johnson MA. Acculturation factors are associated with folate intakes among Mexican American women. J Nutr. 2011;141:1889–1897. Institute of Medicine, Food and Nutrition Board. Dietary reference intakes: Thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. Washington, D.C.: National Academy Press; 1998. Institute of Medicine, Food and Nutrition Board. Applications in dietary assessment. Washington, D.C.: National Academy Press; 2000. Jacques PF, Selhub J, Bostom AG, Wilson PF, Rosenberg IH. The effect of folic acid fortification on plasma folate and total homocysteine concentrations. N Engl J Med. 1999;340:1449–1454. Life Sciences Research Office, Center for Food Safety and Applied Nutrition. Assessment of the folate nutritional status of the U.S. population based on data collected in the Second National Health and Nutrition Survey, 1976– 1980. Washington, D.C.: U.S. Food and Drug Administration, Department of Health and Human Services; 1984. Life Sciences Research Office, Center for Food Safety and Applied Nutrition. Assessment of folate methodology used in the Third National Health and Nutrition Survey (NHANES 1988–1994). Washington, D.C.: U.S. Food and Drug Administration, Department of Health and Human Services; 1994. Midttun O, Hustad S, Solheim E, Schneeded J, Ueland PM. Multianalyte quantification of vitamin B6 and B2 species in the nanomolar range in human plasma by liquid chromatography-tandem mass spectrometry. Clin Chem. 2005;51:1206–1216. MRC Vitamin Study Research Group. Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. Lancet. 1991;338:131–137. Pedersen TL, Keyes WR, Shahab-Ferdows S, Allen LH, Newman JW. Methylmalonic acid quantification in low serum volumes by UPLC–MS/MS. J Chrom B. 2011;879:1502–1506. Pfeiffer CM, Johnson CL, Jain RB, Yetley EA, Picciano MF, Rader JI, et al. Trends in blood folate and vitamin B12 concentrations in the United States, 1988–2004. Am J Clin Nutr. 2007;86:718–727. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 70

82 Pfeiffer CM, Osterloh JD, Kennedy-Stephenson J, Picciano MF, Yetley EA, Rader JI, et al. Trends in circulating concentrations of total homocysteine among US adolescents and adults: findings from the 1991–1994 and 1999–2004 National Health and Nutrition Examination Surveys. Clin Chem. 2008;54:801–813. Pfeiffer CM, Fazili Z, Zhang M. Folate analytical methodology. In: Bailey LB, editor. Folate in Health and Disease. nd ed. Boca Raton: CRC Press, Taylor & Francis Group; 2010. pp. 517–574. 2 Rasmussen K, Vyberg B, Pedersen KO, Brochner-Mortensen J. Methylmalonic acid in renal insufficiency: Evidence of accumulation and implications for diagnosis of cobalamin deficiency. Clin Chem. 1990;36:1523–1524. Refsum H, Smith AD, Ueland PM, Nexo E, Clarke R, McPartlin J, et al. Facts and recommendations about total homocysteine determinations: an expert opinion. Clin Chem. 2004;50:3–32. Rybak ME, Pfeiffer CM. Clinical analysis of vitamin B6: Determination of pyridoxal 5’-phosphate and 4-pyridoxic acid in human serum by reversed-phase high-performance liquid chromatography with chlorite postcolumn derivatization. Anal Biochem. 2004;333:336–344. Rybak ME, Jain RB, Pfeiffer CM. Clinical vitamin B analysis: an inter-laboratory comparison of pyridoxal 6 5’-phosphate measurements in serum. Clin Chem. 2005;51:1223–1231. Rybak ME, Pfeiffer CM. A simplified protein precipitation and filtration procedure for determining serum vitamin B6 by high-performance liquid chromatography. Anal Biochem. 2009;388:175–177. Selhub J, Jacques PF, Wilson PWF, Rush D, Rosenberg IH. Vitamin status and intake as primary determinants of homocysteinemia in an elderly population. JAMA. 1993;270:2693–2698. Senti FR, Pilch SM. Analysis of folate data from the Second National Health and Nutrition Examination Survey (NHANES II). J Nutr. 1985;115:1398–1402. Shane B. Folate status assessment history: implications for measurement of biomarkers in NHANES. Am J Clin Nutr. 2011;94:337S–342S. U.S. Centers for Disease Control and Prevention. Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects. Morb Mort Wkly Rep. 1992;41(No. RR-14):001. U.S. Centers for Disease Control and Prevention. CDC Grand Rounds: Additional opportunities to prevent neural tube defects with folic acid fortification. Morb Mort Wkly Rep. 2010;59:980-984. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for th Edition, Washington, DC: U.S. Government Printing Office, December 2010. [cited 2011]. 7 Americans, 2010. Available at: http://www.cnpp.usda.gov/DGAs2010-PolicyDocument.htm. U.S. Food and Drug Administration. Food standards: amendment of standards of identity for enriched grain products to require addition of folic acid. Final rule. Fed Regist. 1996;61(44):8781–8797. Williams LJ, Rasmussen SA, Flores A, Kirby RS, Edmonds LD. Decline in the prevalence of spina bifida and anencephaly by race/ethnicity: 1995–2002. Pediatrics. 2005;116:580–586. Wollensen F, Brattstrom L, Refsum H, Ueland PM, Berglund L, Berne C. Plasma total homocysteine and cysteine in relation to glomerular filtration rate in diabetes mellitus. Kidney Int. 1999;55:1028–1035. Wright JD, Bialostosky K, Gunter EW, Carroll MD, Najjar MF, Bowman BA, et al. Blood folate and vitamin B12: United States, 1988–1994. National Center for Health Statistics. Vital Health Stat Series No. 11(243), 1998. Yang Q, Botto LD, Erickson JD, Berry RJ, Sambell C, Johansen H, et al. Improvement in stroke mortality in Canada and the United States, 1990 to 2002. Circulation. 2006;113:1335–1343. Yetley EA and Johnson CL. Folate and vitamin B-12 biomarkers in NHANES: history of their measurement and use. Am J Clin Nutr. 2011;94:322S–331S. 1. Water-Soluble Vitamins 71

83 Vitamin C (Ascorbic Acid) Background Information Vitamin C, a water-soluble vitamin, is a collective term Sources and Physiological Functions. used to refer to L-ascorbic acid (the functional form of the vitamin), dehydro-L-ascorbic acid (the oxidized form, DHA), and monodehydro-L-ascorbic acid (the free radical form). Greater than Jacob 1990 ). The most abundant 95% of vitamin C in human plasma exists as ascorbic acid ( dietary sources of vitamin C are orange juice, grapefruit juice, peaches, sweet red peppers, and papayas, followed by a variety of other fruits, vegetables, and fortified cereals. Vitamin C is a powerful antioxidant and a cofactor in various reduction reactions; it is a known electron donor for at least eight human enzymes involved in the hydroxylation of collagen and the biosynthesis of carnitine, hormones, and amino acids. Humans and a few other mammals, such as monkeys and guinea pigs, are unable to biosynthesize vitamin C from glucose and must obtain the vitamin from outside sources. Approximately 70–90% of the ascorbic acid consumed is absorbed by the human body at usual intakes of 30–180 milligrams per day (mg/d). Bioavailability of vitamin C from food or supplemental sources is equivalent. Vitamin C administered after the plasma has reached a point of saturation (approximately 70 μmol/L) will likely be excreted as unmetabolized ascorbic acid in the urine ( Institute of Medicine 2000 ). The clinical manifestation of vitamin C deficiency is scurvy. Scurvy can occur if Health Effects. intake is below 10 mg/d for many weeks. Important signs and symptoms of scurvy include coiled hairs, follicular hyperkeratosis, fatigue, bleeding gums, and delayed wound-healing ( Institute of Medicine 2000 ). Too much vitamin C can cause gastrointestinal upset, but such upset is generally seen only at an intake exceeding 2 gram/d, and it usually disappears within one to two weeks of discontinuation. High intakes of vitamin C supplements have the potential to increase urinary oxalate excretion, which is a risk factor for the formation of calcium oxalate kidney stones, but evidence is conflicting. Vitamin C, in combination with other supplements, including vitamin E, zinc, and beta - AREDS carotene, has been shown to slow the progression of age-related macular degeneration ( Research Group 2001 ). There is conflicting evidence for the reduction of risk of cardiovascular disease mortality by vitamin C supplementation and its effect on cardiovascular health in general ( Shekelle 2003 ). More research is also needed to determine the role vitamin C plays in cancer prevention and treatment. The recommended daily allowance (RDA) of vitamin C for adults Intake Recommendations. is 120% of the EAR (estimated average requirement), which was determined by the maximally protective neutrophil vitamin C concentration. For men, this equates to 90 mg/d, with 75 mg being the appropriate daily amount for women ( Institute of Medicine 2000 ). RDAs range from 15–25 mg/d for children one to eight years of age, 45–75 mg/d for boys aged nine to 18 years, and 45–65 mg/d for girls aged nine to 18 years. For infants aged 0 to 12 months, the RDA is set at the amount of vitamin C commonly received through regular breastfeeding and the additional amount obtained through solid foods during the seven to 12 month period (an average of 45 mg/d). A number of factors, such as bioavailability, interactions with other nutrients, smoking status, age, and gender, affect the amount of vitamin C required by humans. For example, people who smoke require an additional 35 mg/d of vitamin C due to the increased ascorbic acid needed to repair oxidant damage ( ). Institute of Medicine 2000 nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 72

84 Biochemical Indicators and Methods. Vitamin C status can be assessed by measuring total ascorbic acid (oxidized and reduced) in serum or plasma, buffy- coat, or leucocytes. Ascorbic acid in plasma is considered an index of the circulating vitamin available to tissues, and in leucocytes (particularly polymorphonuclear) it is believed to be a good indicator of tissue stores. Vitamin C deficiency is generally defined as plasma or serum concentrations less than 11.4 micromoles per liter (μmol/L), or the level at which signs and symptoms of scurvy may appear. Serum ascorbic acid concentrations between 11.4–23 μmol/L are considered low ( Gibson 2005 ). Clinical laboratories generally use international system (SI) units for vitamin C ( μmol/L); however, some use conventional units (mg per deciliter [mg/dL]). The conversion factor to conventional units is: 1 μmol/L = 0.0176 mg/dL. High-performance liquid chromatography (HPLC) methods with electrochemical detection, which provide necessary sensitivity and specificity, are generally used to quantitate serum vitamin C concentrations. Older spectrophotometric assays were susceptible to interferences from a number of substances, such as riboflavin and aspirin. A multi-level standard reference material (SRM 970) is available from the National Institute of Standards and Technology (NIST) for human serum with certified values for ascorbic acid. The Micronutrients Measurement Quality Assurance Program (MMQAP) sponsored by NIST hosts inter-laboratory comparison studies directed at assuring high quality measurements of serum vitamin C. An HPLC method with electrochemical detection was used to determine Data in NHANES. McCoy 2005 ). Because of the serum vitamin C concentrations in NHANES 2003–2006 ( incorporation of an internal standard, improved accuracy and precision was achieved with this method compared to the previous method used during NHANES III (1988–1994). An analysis of NHANES 2003–2004 data showed that the highest serum concentrations of vitamin C were found in children and older persons. Mean concentrations among adult smokers were one-third lower than those of nonsmokers. In NHANES 2003–2004, the prevalence of vitamin C deficiency was significantly lower than that during NHANES III, but smokers and low-income persons were among those at increased risk of deficiency ( Schleicher 2009 ). For more information about vitamin C , see the Institute of Medicine’s Dietary Reference Intake ) and fact sheets from the National reports ( Institute of Medicine, Food and Nutrition Board 2000 Institutes of Health, Office of Dietary Supplements (http://ods.od.nih.gov/factsheets/VitaminC_ pf.asp). 1. Water-Soluble Vitamins 73

85 Highlights Serum vitamin C concentrations in the U.S. population showed the following demographic patterns and characteristics: • The highest concentrations were generally found in the youngest age group and higher concentrations were found in females compared to males. The likelihood of being vitamin C deficient or having low serum vitamin C • concentrations varied by demographic subgroup. Serum vitamin C concentrations less than 11.4 μmol/L may indicate vitamin C deficiency. Compared to non-Hispanic whites, Mexican Americans and non-Hispanic blacks had a lower risk of deficiency; compared to females, males had a higher risk of deficiency ( Figure H.1.e) . A number of important variables that impact vitamin C status are not addressed in this analysis, including smoking, overweight/obesity, socioeconomic status, and supplement use ( Schleicher 2009 Olmedo ). Considering that manifest vitamin C deficiency is rare in the United States ( ), persons categorized as vitamin C deficient may more likely experience latent scurvy, which 2006 is characterized by fatigue, irritability, vague, dull aching pains and weight loss ( ). Prinzo 1999 Serum vitamin C concentrations between 11.4 – 23 μmol/L are considered low. The prevalence of deficient (< 11.4 μmol/L) and of low (11.4 – 23 μmol/L) serum vitamin C concentrations was significantly lower in children than in persons 20 years and older ( ). Figure H.1.f 14 10 a b 12 8 10 a b a 6 8 4 6 Prevalence (%) 2 Prevalence (%) * 4 0 * 2 Male Female Non- Non- Mexican Hispanic Hispanic American 0 white black 60 60 6-11 12-19 20-39 40-59 12-19 20-39 40-59 6-11 Gender Race/ethnicity Age in years mol/L μ < 11.4 11.4–23 μmol/L < 11.4 μmol/L Prevalence estimates of vitamin C deficiency (serum Figure H.1.e. Age-adjusted prevalence estimates of vitamin C deficiency Figure H.1.f. μ mol/L) in the U.S. population (serum concentrations less than 11.4 concentrations less than 11.4 μ mol/L) and of low vitamin C mol/L) in the U.S. population aged 6 years μ concentrations (11.4–23 aged 6 years and older by race/ethnicity or gender, National Health and Nutrition Examination Survey, 2003–2006 and older by age group, National Health and Nutrition Examination . . Survey, 2003–2006 Error bars represent 95% confidence intervals. Bars not sharing a common letter differ by race/ethnicity or gender (p < 0.05). Age-adjustment was done using direct Error bars represent 95% confidence intervals. *Prevalence in children is standardization. significantly lower than prevalence in persons 20 years and older (p < 0.05). nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 74

86 Detailed Observations The selected observations mentioned below are derived from the tables and figures presented next. Statements about categorical differences between demographic groups noted below are based on non-overlapping confidence limits from univariate analysis without adjusting for demographic variables (e.g., age, sex, race/ethnicity) or other blood concentration determinants (e.g., dietary intake, supplement usage, smoking, BMI). A multivariate analysis may alter the size and statistical significance of these categorical differences. Furthermore, additional significant differences of smaller magnitude may be present despite their lack of mention here (e.g., if confidence limits slightly overlap or if differences are not statistically significant before covariate adjustment has occurred). For a selection of citations of descriptive NHANES papers related to these biochemical Appendix G . indicators of diet and nutrition, see Arithmetic mean concentrations (NHANES 2003–2006): • The distribution of serum vitamin C concentrations was reasonably symmetric and for that reason we present arithmetic means. • Serum vitamin C concentrations followed a U-shaped pattern, with the lowest concentrations seen in 20–59 year old persons (Table 1.8.a.1 and Figure 1.8.a). Females had higher serum vitamin C concentrations than males (Table 1.8.a.1). • • We observed no differences in serum vitamin C concentrations among race/ethnic groups (Table 1.8.a.1). Changes in arithmetic mean concentrations across survey cycles: • No changes in the serum vitamin C concentrations (Table 1.8.b) were observed between 2003–2004 and 2005–2006. Prevalence estimates of low or high biochemical indicator concentrations: • Six percent of the population aged 6 years and older had serum vitamin C concentrations < 11.4 μmol/L (Table 1.8.c). • Children (<1%) and adolescents (3%) had a lower prevalence of low serum vitamin C concentrations than older age groups (5–8%). • Non-Hispanic whites (7%) had a higher prevalence of low serum vitamin C concentrations than non-Hispanic blacks (4%) and Mexican Americans (3%). 1. Water-Soluble Vitamins 75

87 size 3,628 1,703 7,155 3,784 3,984 7,424 6,089 3,233 2,635 3,024 14,579 Sample (113 – 120) (97.6 – 107) (128 – 153) (107 – 115) (101 – 110) (105 – 115) (117 – 128) (115 – 125) (98.0 – 107) (105 – 117) (127 – 142) 97.5th 116 101 138 110 104 109 121 120 102 111 131 (101 – 105) (115 – 131) (96.4 – 102) (90.7 – 96.0) (92.7 – 97.5) (94.5 – 103) (103 – 111) (103 – 108) (89.4 – 96.9) (94.3 – 101) (112 – 121) 95th 103 123 106 105 117 98.9 93.7 95.2 98.9 92.9 97.2 (95% conf. interval) s (54.9 – 57.6) (72.6 – 76.5) (51.2 – 54.0) (52.8 – 57.7) (52.2 – 55.9) (55.9 – 60.7) (58.1 – 61.2) (54.9 – 58.7) (49.2 – 53.9) (50.6 – 53.9) (61.1 – 63.9) 50th 56.3 74.5 52.6 55.1 54.0 58.6 59.6 56.9 51.4 52.4 62.5 Selected percentile (8.17 – 10.9) (25.0 – 33.7) (7.09 – 9.70) (11.6 – 18.7) (10.0 – 14.0) (11.9 – 17.0) (9.61 – 12.9) (7.26 – 9.92) (7.48 – 10.3) (5.91 – 8.77) (8.16 – 13.6) 5th 9.61 29.0 8.38 15.1 11.9 15.2 11.2 8.56 9.00 7.41 10.7 (5.47 – 6.91) (16.1 – 24.2) (4.89 – 6.48) (7.64 – 12.1) (5.75 – 9.18) (7.68 – 11.9) (5.74 – 8.15) (5.05 – 6.36) (4.60 – 7.31) (4.06 – 5.69) (5.53 – 7.90) 2.5th 6.12 21.3 5.80 9.49 7.38 10.2 7.06 5.75 6.01 4.92 6.91 n (54.6 – 57.6) (73.0 – 77.2) (50.9 – 54.0) (52.7 – 57.7) (52.7 – 56.0) (55.9 – 60.2) (57.9 – 61.4) (54.6 – 58.4) (48.8 – 53.2) (49.7 – 53.4) (61.5 – 64.6) 56.1 75.1 52.4 55.2 54.3 58.0 59.7 56.5 51.0 51.6 63.0 (95% conf. interval) Arithmetic mea 6–11 years Total, 6 years and older Age group Gender Males Mexican Americans Race/ethnicity Non-Hispanic Blacks 12–19 years Females Non-Hispanic Whites 20–39 years 40–59 years 60 years and older and Nutrition Examination Survey, 2003–2006. Arithmetic mean and selected percentiles of serum concentrations (in μmol/L) for the total U.S. population aged 6 years and older, National Health Table 1.8.a.1. Serum vitamin C: Concentrations nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 76

88 Figure 1.8.a. Serum vitamin C: Concentr ations by age group dence interval), National Health and Nutrition Examination Survey, 2003–2006 Arithmetic mean (95% con fi Overall Mexican Americans 0100 Females Males (μmol/L) 040608 Serum vitamin C 02 6−1112−1920−3940−5960+ 6−1112−1920−3940−5960+ Non−Hispanic Blacks Non−Hispanic Whites 0100 (μmol/L) 040608 Serum vitamin C 02 6−1112−1920−3940−5960+ 6−1112−1920−3940−5960+ Females Males 0100 Mexican Americans Non−Hispanic Blacks (μmol/L) Non−Hispanic 040608 Whites Serum vitamin C 02 6−1112−1920−3940−5960+ 6−1112−1920−3940−5960+ Age (years) Age (years) 1. Water-Soluble Vitamins 77

89 Table 1.8.a.2. Serum vitamin C: Total population Arithmetic mean and selected percentiles of serum concentrations (in μmol/L) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. n Arithmetic mea Sample (95% conf. interval) s Selected percentile 50th 95th 5th (95% conf. interval) size Males and Females (54.6 – 57.6) 9.61 (8.17 – 10.9) Total, 6 years and older (54.9 – 57.6) 103 (101 – 105) 14,579 56.1 56.3 75.1 29.0 (25.0 – 33.7) 74.5 (73.0 – 77.2) 123 (115 – 131) 1,703 6–11 years (72.6 – 76.5) 58.0 (55.9 – 60.2) 15.2 (11.9 – 17.0) 58.6 (55.9 – 60.7) 98.9 (94.5 – 103) 3,984 12–19 years 51.0 20–39 years (7.48 – 10.3) 51.4 (49.2 – 53.9) 92.9 (89.4 – 96.9) 3,233 (48.8 – 53.2) 9.00 51.6 7.41 (5.91 – 8.77) 52.4 (50.6 – 53.9) 97.2 (94.3 – 101) 2,635 40–59 years (49.7 – 53.4) 63.0 (61.5 – 64.6) 10.7 (8.16 – 13.6) 62.5 (61.1 – 63.9) 117 (112 – 121) 3,024 60 years and older Males (51.2 – 54.0) (50.9 – 54.0) 8.38 (7.09 – 9.70) 52.6 52.4 98.9 (96.4 – 102) 7,155 Total, 6 years and older (73.1 – 79.5) 76.3 (72.5 – 78.7) 30.4 (21.7 – 37.7) 76.2 6–11 years 123 (113 – 138) 837 12–19 years 55.8 14.7 (11.2 – 16.5) 56.0 (53.4 – 58.5) 94.0 (91.2 – 100) 2,022 (53.6 – 58.1) 47.9 8.58 (6.68 – 9.87) 48.4 (45.2 – 50.8) 87.5 (82.8 – 95.4) 1,463 20–39 years (45.3 – 50.4) 46.7 (44.5 – 48.9) 6.38 (4.89 – 7.94) 48.2 40–59 years 88.4 (84.8 – 96.3) 1,305 (46.1 – 50.2) 60 years and older (54.9 – 59.4) 7.92 (6.72 – 10.1) 57.2 (54.7 – 59.4) 110 (105 – 118) 1,528 57.2 Females Total, 6 years and older 59.7 11.2 (9.61 – 12.9) 59.6 (58.1 – 61.2) 106 (103 – 111) 7,424 (57.9 – 61.4) 6–11 years (71.1 – 76.6) 28.5 (20.3 – 35.9) 72.4 (69.2 – 75.9) 123 (115 – 131) 866 73.8 12–19 years 60.4 (57.8 – 62.9) 15.7 (11.0 – 18.8) 61.4 (58.6 – 63.9) 102 (98.2 – 110) 1,962 20–39 years 54.1 (51.5 – 56.7) 9.90 (7.73 – 11.5) 55.3 (51.9 – 58.6) 96.1 (91.9 – 101) 1,770 1,330 40–59 years 56.2 (53.7 – 58.7) 9.34 (6.29 – 12.0) 56.4 (53.6 – 58.2) 103 (97.4 – 110) 121 1,496 (116 – 129) 60 years and older 67.8 (65.9 – 69.7) 14.3 (10.9 – 16.4) 67.0 (65.1 – 69.0) Table 1.8.a.3. Serum vitamin C: Mexican Americans Arithmetic mean and selected percentiles of serum concentrations (in μmol/L) for Mexican Americans in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) Arithmetic mea n Sample (95% conf. interval) size 5th 50th 95th Males and Females 55.2 (52.7 – 57.7) 15.1 Total, 6 years and older 55.1 (52.8 – 57.7) 93.7 (90.7 – 96.0) 3,628 (11.6 – 18.7) 6–11 years (69.4 – 77.4) 28.3 (20.7 – 37.8) 73.4 (71.7 – 76.4) 113 (107 – 130) 563 74.2 12–19 years 58.5 (56.4 – 60.5) 20.3 (14.9 – 23.9) 59.0 (57.4 – 60.7) 92.7 (90.6 – 95.2) 1,266 20–39 years 52.2 15.9 (12.2 – 20.6) 52.4 (49.9 – 54.5) 85.7 (80.9 – 90.6) 782 (49.4 – 54.9) 40–59 years (46.9 – 52.1) 9.55 (7.54 – 14.0) 51.0 (47.5 – 54.7) 83.6 (80.0 – 85.2) 470 49.5 60 years and older 51.8 (47.8 – 55.8) 9.48 (2.78 – 14.5) 50.5 (46.0 – 55.9) 93.6 (88.9 – 103) 547 Males 53.3 52.7 (50.0 – 55.5) 13.6 (8.67 – 17.5) Total, 6 years and older (50.4 – 55.7) 90.8 (87.6 – 94.5) 1,762 (71.4 – 77.2) 6–11 years 73.4 (69.0 – 77.8) 28.2 (20.8 – 37.5) 74.6 275 113 (108 – 134) 12–19 years 56.7 18.9 (10.6 – 23.3) 57.4 (55.2 – 59.5) 90.1 (86.9 – 93.0) 628 (54.3 – 59.1) 49.6 14.2 (7.50 – 22.1) 50.8 (47.7 – 54.4) 79.5 (73.6 – 86.6) 351 20–39 years (46.2 – 53.1) 46.2 (42.8 – 49.7) 8.27 (4.43 – 13.6) 46.3 40–59 years 76.5 (73.9 – 87.2) 239 (43.5 – 53.5) 60 years and older (41.6 – 47.9) 7.27 (1.70 – 10.0) 44.0 44.8 86.3 (78.5 – 94.2) 269 (38.1 – 48.9) Females Total, 6 years and older 58.0 (55.4 – 60.6) 18.6 (14.1 – 21.5) 58.1 (54.8 – 60.8) 95.1 (92.4 – 99.2) 1,866 6–11 years 73.4 26.5 (18.0 – 41.2) 73.3 (70.7 – 76.2) 113 (103 – 129) 288 (69.1 – 77.7) 12–19 years (57.8 – 62.8) 22.4 (18.8 – 24.7) 60.7 (58.4 – 62.7) 95.1 (90.9 – 104) 638 60.3 20–39 years 55.1 (51.7 – 58.6) 18.5 (12.8 – 22.6) 54.0 (50.6 – 58.0) 90.0 (84.3 – 102) 431 40–59 years 53.1 (49.9 – 56.3) 10.6 (7.49 – 18.2) 54.5 (50.0 – 58.9) 85.2 (83.9 – 92.9) 231 (93.4 – 116) 278 97.9 60 years and older 57.7 (51.6 – 63.8) 14.3 (1.10 – 23.2) 58.7 (48.3 – 64.2) nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 78

90 Table 1.8.a.4. Serum vitamin C: Non-Hispanic blacks Arithmetic mean and selected percentiles of serum concentrations (in μmol/L) for non-Hispanic blacks in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) Arithmetic mea n Sample (95% conf. interval) size 50th 5th 95th Males and Females (92.7 – 97.5) 54.0 (52.2 – 55.9) 95.2 (10.0 – 14.0) 3,784 54.3 11.9 (52.7 – 56.0) Total, 6 years and older 39.7 (34.0 – 43.0) 72.8 (69.0 – 75.9) 6–11 years (103 – 118) 544 73.4 (70.8 – 75.9) 107 (59.7 – 63.2) (25.9 – 30.3) 61.3 (59.1 – 63.2) 28.1 (91.7 – 98.3) 1,400 61.5 12–19 years 95.0 (49.4 – 53.5) 14.7 (11.2 – 16.9) 50.4 (48.1 – 53.2) 87.3 (83.4 – 91.3) 20–39 years 51.5 711 49.2 8.58 (4.80 – 11.2) 48.9 (45.3 – 52.7) 93.1 (83.9 – 101) 619 40–59 years (46.3 – 52.1) (90.8 – 101) (46.8 – 52.8) 50.8 (47.0 – 54.1) 95.9 (4.99 – 8.42) 510 6.69 49.8 60 years and older Males (51.0 – 54.1) 10.2 (7.77 – 12.6) 52.1 Total, 6 years and older 92.8 (90.2 – 97.3) 1,895 52.6 (50.4 – 54.2) 75.3 42.4 (34.1 – 44.3) 75.8 (71.0 – 79.6) 108 (104 – 118) 272 6–11 years (69.8 – 79.9) 59.6 (58.0 – 61.2) 28.6 12–19 years 58.8 (56.4 – 61.0) 91.6 (89.5 – 96.1) 735 (24.2 – 30.2) 20–39 years (46.3 – 51.2) 12.4 (6.93 – 16.2) 48.0 (44.0 – 50.9) 81.5 (76.6 – 91.0) 337 48.7 46.7 (43.3 – 50.1) (4.00 – 10.4) 46.6 (42.2 – 51.3) 82.8 (77.1 – 97.4) 291 40–59 years 7.24 (41.0 – 50.3) 93.0 (2.96 – 6.19) 45.6 (38.6 – 50.9) 45.6 (89.0 – 106) 260 60 years and older 5.02 Females (53.5 – 58.1) 13.5 (11.3 – 15.8) 55.8 (53.7 – 58.0) 95.9 (94.1 – 99.8) 1,889 Total, 6 years and older 55.8 71.3 (68.9 – 73.7) 36.8 (30.8 – 41.4) 68.8 (67.0 – 73.1) 106 (102 – 114) 272 6–11 years 63.4 12–19 years 27.6 (25.9 – 30.8) 63.8 (60.6 – 67.0) 96.0 (92.8 – 102) 665 (60.7 – 66.1) 53.7 15.7 (11.5 – 21.5) 52.7 (49.4 – 56.3) 90.5 (86.6 – 95.8) 374 20–39 years (50.9 – 56.6) 51.3 (47.8 – 54.8) 9.84 (4.02 – 14.5) 50.4 40–59 years 95.9 (86.6 – 106) 328 (47.2 – 55.2) 60 years and older (48.8 – 56.7) 9.64 (4.66 – 11.2) 52.7 (50.1 – 58.2) 96.5 (90.0 – 108) 250 54.0 Table 1.8.a.5. Serum vitamin C: Non-Hispanic whites Arithmetic mean and selected percentiles of serum concentrations (in μmol/L) for non-Hispanic whites in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) n Sample Arithmetic mea (95% conf. interval) size 50th 5th 95th Males and Females 105 (7.26 – 9.92) 56.5 (54.9 – 58.7) 8.56 (103 – 108) 6,089 Total, 6 years and older (54.6 – 58.4) 56.9 (72.5 – 78.8) 25.7 6–11 years 74.8 (70.9 – 77.7) 128 (118 – 144) 436 75.6 (18.7 – 31.8) 57.2 12.3 (9.88 – 15.7) 58.0 (54.0 – 60.4) 101 (95.4 – 107) 1,037 12–19 years (53.2 – 61.5) 50.6 (47.8 – 53.3) 7.99 (6.39 – 8.99) 20–39 years (47.7 – 55.1) 96.2 (91.2 – 102) 1,442 51.2 40–59 years (49.7 – 54.3) 6.80 (5.56 – 8.33) 52.8 (51.2 – 55.2) 99.8 (96.0 – 103) 1,346 52.0 118 64.8 (8.22 – 14.7) 63.9 (62.4 – 65.3) 11.7 (114 – 123) 1,828 60 years and older (63.0 – 66.7) Males 52.3 (50.4 – 54.1) 7.71 (6.50 – 8.82) Total, 6 years and older (50.5 – 54.5) 101 (98.2 – 104) 2,990 52.4 6–11 years (71.7 – 81.4) 25.4† (14.0 – 34.1) 76.5 (69.2 – 80.6) 127† (117 – 155) 210 75.8 12–19 years 54.9 (51.7 – 58.1) 12.6 (9.73 – 16.2) 54.8 (51.4 – 59.1) 94.4 (91.6 – 104) 524 20–39 years 47.2 7.92 (6.52 – 8.79) 47.5 (44.1 – 50.7) 93.8 (85.8 – 98.7) 636 (44.2 – 50.3) 47.0 6.19 (4.90 – 7.44) 48.5 (46.4 – 51.0) 90.2 (86.4 – 101) 687 40–59 years (44.3 – 49.8) 58.5 (56.0 – 61.1) 8.15 (6.84 – 11.5) 58.4 60 years and older 112 (106 – 119) 933 (55.6 – 60.7) Females 60.5 (58.2 – 62.8) 9.92 (8.18 – 11.7) Total, 6 years and older (58.5 – 62.8) 110 (106 – 114) 3,099 60.7 6–11 years 74.7 (70.3 – 79.0) 25.2 (9.65 – 36.1) 72.8 (68.7 – 78.2) 129 (115 – 145) 226 12–19 years 59.6 12.0 (8.98 – 15.7) 61.1 (56.9 – 64.7) 104 (98.6 – 120) 513 (55.8 – 63.5) 20–39 years (50.4 – 57.4) 8.06 (5.40 – 9.86) 56.0 (50.2 – 60.7) 99.0 (93.1 – 106) 806 53.9 40–59 years 57.0 (53.9 – 60.0) 8.63 (5.81 – 11.1) 57.4 (53.5 – 59.8) 105 (98.0 – 113) 659 60 years and older 70.0 (67.7 – 72.3) 15.0 (10.9 – 17.9) 69.1 (66.5 – 72.6) 123 (117 – 131) 895 † Estimate is subject to greater uncertainty due to small cell size. 1. Water-Soluble Vitamins 79

91 Table 1.8.b. Serum vitamin C: Concentrations by survey cycle Arithmetic mean and selected percentiles of serum concentrations (in μmol/L) for the U.S. population, National Health and Nutrition Examination Survey, 2003–2006. Arithmetic mea n Selected percentile s (95% conf. interval) Sample 5th 95th 50th (95% conf. interval) size Total, 6 years and older (53.1 – 58.5) 8.55 2003–2004 56.3 (53.4 – 58.8) 103 (101 – 108) 7,277 55.8 (6.57 – 10.2) 56.4 (54.8 – 58.0) 11.1 (9.22 – 12.4) 2005–2006 (55.0 – 57.6) 102 (99.2 – 105) 7,302 56.3 Age group 6–11 years (70.8 – 76.8) 27.8 (16.6 – 35.5) 73.7 (70.9 – 77.8) 126 (112 – 139) 823 2003–2004 74.3 2005–2006 (73.1 – 78.7) 32.0 (26.2 – 36.6) 75.0 (72.4 – 78.1) 121 (114 – 130) 880 75.9 12–19 years 2003–2004 56.3 (52.9 – 59.8) 13.6 (10.2 – 16.2) 56.2 (52.1 – 60.0) 98.4 (93.6 – 106) 2,016 2005–2006 59.7 17.0 (13.4 – 20.8) 60.3 (57.3 – 63.5) 99.3 (93.0 – 107) 1,968 (57.0 – 62.4) 20–39 years 2003–2004 (46.0 – 53.5) 7.34 (5.42 – 9.22) 49.7 (45.7 – 54.1) 95.0 (87.9 – 102) 1,540 50.0 2005–2006 52.2 (49.7 – 54.8) 11.3 (9.71 – 12.5) 52.8 (49.7 – 55.7) 91.9 (87.8 – 97.1) 1,693 40–59 years 1,266 52.6 (49.4 – 55.8) 6.71 (5.02 – 8.71) 53.5 (51.2 – 56.6) 100 (95.5 – 105) 2003–2004 2005–2006 50.6 (48.3 – 52.9) 7.92 (5.51 – 10.9) 51.3 (48.9 – 53.4) 94.4 (90.1 – 100) 1,369 60 years and older 2003–2004 63.2 1,632 (114 – 124) 119 (60.8 – 65.6) 10.3 (7.88 – 13.3) 62.5 (60.2 – 64.7) 2005–2006 62.9 (6.99 – 15.1) 62.6 (60.7 – 64.5) 113 (108 – 119) 1,392 (60.7 – 65.1) 11.8 Gender Males (50.1 – 55.2) 7.32 (5.74 – 9.08) 52.7 2003–2004 100 (97.7 – 103) 3,590 (49.4 – 54.9) 52.2 52.7 (51.0 – 54.3) 9.74 (7.88 – 11.0) 52.4 (50.9 – 53.9) 97.3 (93.7 – 102) 3,565 2005–2006 Females 59.3 (56.4 – 62.3) 9.76 (7.89 – 11.4) 2003–2004 (56.7 – 62.5) 108 (102 – 115) 3,687 59.8 2005–2006 60.0 (57.9 – 62.1) 13.1 (11.1 – 15.6) 59.4 (57.7 – 61.4) 105 (101 – 111) 3,737 Race/ethnicity Mexican Americans 55.4 2003–2004 (50.6 – 60.2) 14.0 (7.30 – 20.1) 55.6 (51.7 – 60.0) 93.1 (89.3 – 97.1) 1,766 2005–2006 55.1 17.1 (10.8 – 20.6) 54.6 (51.7 – 57.5) 94.2 (90.8 – 97.3) 1,862 (52.8 – 57.5) Non-Hispanic Blacks 2003–2004 (50.3 – 55.4) 11.1 (7.65 – 13.5) 52.9 (49.7 – 55.5) 93.7 (90.5 – 99.1) 1,880 52.0 2005–2006 55.7 (53.6 – 57.9) 13.0 (9.49 – 16.8) 55.4 (53.5 – 57.6) 95.6 (94.0 – 99.2) 1,904 Non-Hispanic Whites 3,103 56.7 (53.1 – 60.3) 7.82 2003–2004 57.4 (53.1 – 60.6) 108 (103 – 115) (6.24 – 9.09) (54.7 – 58.0) (100 – 106) 2,986 2005–2006 56.3 (54.5 – 58.0) 10.0 (7.77 – 11.7) 56.4 103 nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 80

92 . Serum vitamin C: C Figure 1.8.b oncentr ations by sur ve y cy cle Selected percentiles in μmol/L (95% condence intervals), National Health and Nutrition Examination Survey, 2003–2006 140 120 100 95th Percentile 80 80 70 60 50th Percentile 50 40 40 30 20 5th Percentile 10 0 05−06 03−04 03−04 05−06 05−06 03−04 03−04 05−06 03−04 05−06 03−04 05−06 03−04 03−04 05−06 05−06 05−06 05−06 03−04 03−04 6−11y MA Females 12−19y Males Total NHB 3−5y 20+y NHW (6+y) 1. Water-Soluble Vitamins 81

93 Table 1.8.c. Serum vitamin C: Prevalence Prevalence (in percent) of low serum vitamin C concentration (< 11.4 μmol/L) for the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. Estimated total Prevalence Sample (95% conf. interval) number of persons size 14,579 6.0 15,757,000 (4.9 – 7.3) Total, 6 years and older Age group 6–11 years 1,703 0.8‡ (0.4 – 1.7) 191,000‡ 12–19 years 3,984 2.8 (1.9 – 4.2) 931,000 5,533,000 20–39 years 3,233 6.9 (5.4 – 8.9) 2,635 6,435,000 (6.3 – 10.5) 40–59 years 8.1 60 years and older 5.1 (3.8 – 6.8) 2,362,000 3,024 Gender Males 7,155 7.3 (5.9 – 9.0) 9,258,000 7,424 Females (3.8 – 6.0) 4.8 6,476,000 Race/ethnicity 715,000 3,628 3.1 (2.1 – 4.6) Mexican Americans Non-Hispanic Blacks 3,784 4.3 (3.2 – 5.7) 1,341,000 12,807,000 (5.8 – 8.7) 7.1 Non-Hispanic Whites 6,089 ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 82

94 Table 1.8.d. Serum vitamin C: Prevalence by survey cycle Prevalence (in percent) of low serum vitamin C concentration (< 11.4 μmol/L) for the U.S. population, National Health and Nutrition Examination Survey, 2003–2006. Sample size (95% conf. interval) Estimated total number of persons Prevalence Total, 6 years and older 2003–2004 7.3 (5.5 – 9.6) 19,054,000 7,277 7,302 4.8 2005–2006 12,746,000 (3.7 – 6.1) Age group 6–11 years 2003–2004 1.5‡ (0.7 – 3.6) 372,000‡ 823 880 § § 2005–2006 12–19 years 2003–2004 2,016 3.3 (1.9 – 5.7) 1,090,000 2005–2006 1,968 (1.2 – 4.5) 783,000‡ 2.3‡ 20–39 years 1,540 9.3 (6.7 – 12.8) 7,437,000 2003–2004 2005–2006 1,693 4.5 (3.2 – 6.4) 3,618,000 40–59 years 1,266 9.2 (6.5 – 13.0) 7,294,000 2003–2004 2005–2006 1,369 7.1 (4.7 – 10.5) 5,815,000 60 years and older 1,632 2003–2004 5.5 (3.9 – 7.5) 2,543,000 2005–2006 1,392 (2.8 – 7.8) 2,272,000 4.7 Gender Males 3,590 8.4 (6.0 – 11.8) 10,772,000 2003–2004 3,565 6.1 (4.8 – 7.7) 7,914,000 2005–2006 Females 2003–2004 6.1 (4.6 – 8.0) 8,247,000 3,687 2005–2006 3.5 (2.4 – 5.1) 4,827,000 3,737 Race/ethnicity Mexican Americans 2003–2004 1,766 3.7 (2.0 – 6.7) 840,000 2005–2006 1,862 (1.6 – 4.2) 627,000 2.6 Non-Hispanic Blacks 1,880 4.8 (3.4 – 6.8) 1,510,000 2003–2004 2005–2006 1,904 3.8 (2.3 – 6.2) 1,199,000 Non-Hispanic Whites 3,103 8.6 (6.4 – 11.5) 15,534,000 2003–2004 2005–2006 2,986 5.6 (4.2 – 7.4) 10,186,000 ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. § Estimate suppressed: RSE ≥ 40% for the prevalence estimate. 1. Water-Soluble Vitamins 83

95 References Age-Related Eye Disease Study Research Group. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E and beta carotene for age-related cataract and vision loss: AREDS report no. 9. Arch Ophthalmol. 2001;119:1439–1452. nd Gibson RS. Principles of nutritional assessment (2 edn.). New York: Oxford University Press; 2005. Institute of Medicine, Food and Nutrition Board. Dietary reference intakes for vitamin C, vitamin E, selenium, and carotenoids. Washington, D.C.: National Academy Press; 2000. Jacob RA. Assessment of human vitamin C status. J Nutr. 1990;120 Suppl 11:1480–1485. McCoy LF, Bowen MB, Xu M, Chen H, Schleicher RL. Improved HPLC assay for measuring serum vitamin C with 1-methyluric acid used as an electrochemically active internal standard. Clin Chem. 2005;51:1062–1064. Olmedo JM, Yiannias JA, Windgassen EB, Gornet MK. Scurvy: a disease almost forgotten. Int J Dermatol. 2006;45:909–913. Prinzo ZW. Scurvy and its prevention and control in major emergencies. Geneva, Switzerland: World Health Organization, 1999. (WHO publication WHO/NHD/99.11.) Schleicher RL, Carroll MD, Ford ES, Lacher DA. Serum vitamin C and the prevalence of vitamin C deficiency in the United States: 2003–2004 National Health and Nutrition Examination Survey (NHANES). Am J Clin Nutr. 2009;90:1252–1263. Shekelle P, Morton S, Hardy M. Effect of Supplemental Antioxidants Vitamin C, Vitamin E, and Coenzyme Q10 for the Prevention and Treatment of Cardiovascular Disease. Evid Report Tech Asses No. 83. AHRQ Publication No. 03-E043. Rockville, MD: Agency for Healthcare Research and Quality. July 2003. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 84

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98 2. Fat-Soluble Vitamins and Nutrients Vitamins A and E and Carotenoids Vitamin A • Retinyl palmitate • stearate • Retinyl E Vitamin • -Tocopherol • gamma -Carotene • alpha - -Carotene • beta trans - • -Carotene cis beta beta -Cryptoxanthin • • zeaxanthin and Lutein • trans -Lycopene • lycopene (cis - and trans -) Total Vitamin D D 25-Hydroxyvitamin • Fatty Acids Saturated Myristic acid (14:0) Polyunsaturated • • • acid (16:0) Linoleic acid Palmitic (18:2n-6) -Linolenic acid (18:3n-3) alpha • (18:0) acid • Stearic • Arachidic (20:0) • gamma acid -Linolenic acid (18:3n-6) Docosanoic • acid (20:2n-6) (22:0) • acid Eicosadienoic acid acid homo-gamma • (24:0) • Lignoceric -Linolenic (20:3n-6) Monounsaturated • Arachidonic acid (20:4n-6) • acid Myristoleic (14:1n-5) • (20:5n-3) acid Eicosapentaenoic • (16:1n-7) acid Palmitoleic (22:4n-6) Docosatetraenoic acid • acid -Vaccenic cis • (18:1n-7) • (22:5n-3) acid Docosapentaenoic • acid (18:1n-9) Oleic (22:5n-6) acid Docosapentaenoic • • (20:1n-9) Eicosenoic acid Docosahexaenoic • acid (22:6n-3) acid (22:1n-9) Docosenoic • (24:1n-9) acid Nervonic • 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 87 87

99 Vitamins A, E and Carotenoids Background Information Sources and Physiological Functions. (retinol) and E ( alpha -tocopherol) and the A Vitamins micronutrients found in many foods, including some vegetables, are carotenoids fat-soluble and animal products. Fish-liver oils, liver, egg yolks, butter, and cream are known fruits, meats, content their of vitamin A. Nuts and seeds are particularly rich sources of vitamin E higher for ). At least 700 carotenoids—fat-soluble red 2006 and yellow pigments—are found in Thomas ( ( Britton 2004 ). Americans consume 40–50 of these carotenoids, nature in fruits and primarily Khachik 1992 ), and smaller amounts in poultry products, including egg yolks, as well vegetables ( are in ( Boylston 2007 ). Eight different carotenoids seafoods easily measured in human serum: as cis - and trans-beta -carotene, beta -cryptoxanthin, lutein, cis - and trans -lycopene, alpha -carotene, zeaxanthin. Main sources of carotenes are orange-colored fruits and vegetables such as carrots, and found mangos. Lutein and zeaxanthin are also in dark green leafy vegetables, pumpkins, and any orange coloring is overshadowed by chlorophyll. Trans -lycopene is obtained primarily where tomatoes and tomato products and some fruits. For information on the carotenoid content from U.S. foods, see the 1998 carotenoid database created by the U.S. Department of Agriculture of the Nutrition Coordinating Center at the University of Minnesota ( http://www.nal.usda.gov/ and fnic/foodcomp/Data/car98/car98.html). Vitamin found in foods that come from animal sources, is called preformed vitamin A. A, are carotenoids found in colorful fruits and vegetables called provitamin A because they Some metabolized in the body to vitamin A. Among the carotenoids, beta -carotene, a retinol are of two linked retinol molecules, dimer has the most significant provitamin A activity. consisting micrograms (μg) of dietary beta -carotene can provide the equivalent of 1 μg Approximately 12 retinol. Other provitamin A carotenoids, such of alpha -carotene and beta -cryptoxanthin, are as half as active as beta -carotene ( Institute of Medicine 2000 ) . The bioconversion of carotenoids to vitamin A is highly variable from person to person ( Krinsky 2005 ). Retinyl esters serve as the storage of vitamin A and are mostly concentrated in the liver. form gastrointestinal of fat-soluble micronutrients from the The tract depends on processes absorption people fat absorption or metabolism. Thus, responsible with conditions resulting in fat for malabsorption (e.g., celiac disease, Crohn’s disease, pancreatic disorders) can develop vitamin A over time. V itamin A also has deficiency interactions with other nutrients. Iron and zinc can affect vitamin A metabolism and transport of vitamin A stores from the liver to deficiency of body tissues ( Institute Medicine 2001 ). The absorption of carotenoids from foods is highly dependent cooking techniques that break down plant cell walls and release carotenoids; it is on on the availability of dietary fat to enhance carotenoid uptake ( Krinsky 2005 ). also dependent liver regulates the concentration of vitamin A in The circulation by releasing stored retinyl the esters as needed; only when liver reserves are nearly exhausted does serum vitamin A fall into the deficient range ( Napoli 2006 ). The variation in serum carotenoid concentrations among people in the States is relatively large, primarily reflecting wide-ranging differences in dietary intake United Lacher 2005 ). ( E activity is derived from at Vitamin least eight naturally occurring tocopherols, the most potent of which is alpha -tocopherol. Other less active forms of vitamin E are plentiful in the U.S. diet, with -tocopherol being the predominant form. gamma The most commonly consumed sources of alpha -tocopherol in the diet of American adults are mixed foods (spaghetti sauce, pizza and are sources Other important chili), fried potatoes, salad dressings, and bakery goods ( Ahuja 2004 ). nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 88 88

100 tomatoes, nuts and seeds, and snack foods. Plasma concentrations of tocopherols vary widely eggs, healthy among and are highly correlated with plasma lipid concentrations ( Ford 1999; individuals ). Ford 2006 or excessive intake of vitamins A or E can lead to various disorders. Inadequate Health Effects. vitamin A deficiency, considered to be For main cause of childhood blindness in example, the countries ( Roodhooft 2002 ), is a rare condition in the United States. Prominent signs low-income vitamin A deficiency include night blindness, corneal thinning, and conjunctival of metaplasia. is also essential for proper immune function, epithelial growth and repair, bone Vitamin A ( reproduction, normal embryonic and fetal development and West 2006 ). Acute toxicity growth, from single or short-term large doses of preformed vitamin A is characterized by nausea, resulting vertigo, blurred vision, increased cerebrospinal fluid pressure, and lack of vomiting, headache, er coor Central ner vous system effects, liv abnormalities, bone and skin changes, muscular dination. other nonspecific adverse effects can be indicative of chronic hypervitaminosis A. Consuming and amounts of vitamin A during early pregnancy may lead to serious birth defects ( Institute of excess 2001 Medicine ). or plasma concentrations of carotenoids considered among the best biological markers Serum are fruit and vegetable intake. The strongest dietary predictors of serum carotenoid concentrations for fruits (for sources of beta -cryptoxanthin), carrots and root vegetables (for sources of carotenes), are ( tomato products (for sources of trans -lycopene) Al-Delaimy 2005 ). Research studies have and inconsistencies in the relation between carotenoid intake and protection from cancer. shown not foods, even when consumed over long periods and in large amounts are Carotenoids in produce adverse health effects. However, results of intervention studies of smokers known to used 20–30 milligrams (mg) of beta -carotene per day showed that this group who more lung had cancers than placebo-treated groups ( Albanes 1996; Redlich 1998 ). deficiency Vitamin only rarely in people, E and overt deficiency symptoms in people occurs consuming low-vitamin E diets have never been described ( Institute of Medicine 2000 ). The main of vitamin E deficiency is peripheral neuropathy characterized by the manifestation degeneration the large-caliber axons of sensory neurons of ( Institute of Medicine 2000 ). The upper limit (UL) for vitamin E intake (1000 mg/day) is based on hemorrhagic effects; however, intake a association between excess alpha -tocopherol causal in apparently healthy individuals and adverse health outcomes has not consistently been shown ( Institute of Medicine 2000 ). Studies to evaluating tocopherols reduce the risk for cardiovascular disease demonstrated inconsistent findings Agency for Healthcare Research and Quality 2003 ). The American Heart Association ( that antioxidant supplements (such as vitamins E and C and beta -carotene) currently advises not be used for primary or secondary prevention of cardiovascular disease ( Lichtenstein should ). Association Nevertheless, the American Heart 2006 recommends consuming food sources of principally from a variety of plant-derived antioxidant foods such as fruits, vegetables, nutrients, whole and vegetable oils. grains, Sciences The National Intake Recommendations. of has established dietary-requirement Academy intake values for vitamins A and E by determining the Adequate Intake (AI) for infants and the recommended allowance (RDA) for older age groups ( Institute of Medicine 2000 and 2001 ). dietary The vitamin A in retinol equivalents is 900 RDA μg/day for men and 700 μg/day for women; for for children and adolescents (1–18 years), the RDA ranges from 300–900 μg/day. For infants (0–12 months), AI is set at 400–500 μg/day of the retinol equivalents. The T olerable Upper Intake Level (UL) for / is set at 3,000 μ g /day of preformed vitamin A, whereas the UL for infants (600 μ g adults and /day), day), younger children 1–8 years (600-900 μ g /day), older children 9–13 years (1700 μ g 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 89 89

101 adolescents years (2800 μ g /day) are age-dependent. For adults, the RDA for vitamin E is 15 14–18 of mg/day -tocopherol; for children and adolescents (1–18 years), the RDA ranges from 6–15 alpha no RDA for other forms of vitamin E, There such as gamma -tocopherol. The UL for mg/day. is alpha applies to all eight stereoisomers of which -tocopherol is 1000 mg/day for adults; E vitamin UL for infants could not be established and thus only food and a sources of dietary intake formula The UL for children and adolescents ranges from 200-800 mg/day of vitamin are recommended. the Although quantitative recommendations are available for no intake of carotenoids, existing E. support increased consumption of carotenoid-rich fruits and recommendations Current vegetables. guidelines advise that people consume at least health cups of fruits and vegetables a day, public 2.5 on caloric need, to ensure adequate nutrient intake ( U.S. Department of Agriculture and depending Department of Health and Human Services 2010 ). U.S. Biochemical Indicators and Methods. The way to determine inadequate best vitamin A status through hepatic biopsy, but this invasive procedure is unsuitable is population studies. Serum for retinol is measured by use of plasma high performance liquid chromatography (HPLC) with or (UV) detection after separation from its carrier retinol binding protein (RBP). Because ultraviolet closely correlated with RBP, the measurement of this transport protein through enzyme- retinol is immunosorbent assay (ELISA) has also been used to assess vitamin A status. In most linked plasma RBP has been shown to be a suitable surrogate for retinol. Serum or populations, serum nm) carotenoids are measured by use of HPLC and visible light (450 concentrations absorbance. of for typically use conventional units Clinical serum concentrations of these fat-soluble laboratories to micronutrients per deciliter [dL]). Conversion factors ( international system (SI) units are 1 μg μg /dL = 0.0349 micromole per liter ( m mol/L) for vitamin A and 1 μ g/dL = 0.02322 m mol/L for vitamin Depending on its molecular weight, each carotenoid has a specific conversion factor. E. from materials for vitamins International and E and carotenoids are available reference the U.S. A National Institutes of Standards T echnology ( https://www-s.nist.gov/srmors/view_detail. and cfm?srm=968e ). Among most laboratories participating in an external quality assurance program, standardized methods for measuring fat-soluble micronutrients show HPLC consistent agreement of values ( Duewer 2000 ). The diagnosis of vitamin A or E deficiency is supported by measuring these concentrations in the body. People with serum retinol concentrations of less than 20 μg/dL are considered vitamin A deficient deficient, and those with serum concentrations of less than 10 μg/dL are considered severely ( West 2006 ). Serum retinol values do not always reflect total body status because of homeostatic therefore are often not useful for assessing control and vitamin A status of individuals. Additional tests the A required to confirm vitamin may deficiency be μg/dL is used as a when cutoff ( Gibson 2005 ). 20 The distribution of serum retinol in a population values together with the prevalence of individuals with serum retinol below a given cutoff point provide values about the vitamin important A status of information a WHO ( 2011 ) population. recommends using the prevalence of serum retinol concentrations of less than or to 20 μg/dL to equal define public health problems involving vitamin A deficiency as mild (2–9%), moderate (10–19%) or severe (≥20%). In chronic concentrations hypervitaminosis A, serum are generally ( Bendich Carotenoid ). 1989 greater than 100 μg/dL nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 90 90

102 deficiency no defined serum concentrations. The laboratory diagnosis of vitamin E deficiency is has on concentrations of alpha-tocopherol (less than 500 μg/dL or less than 0.8 mg of alpha- based serum of total lipids) (Beers 2006). Such per concentrations are associated with in vitro tocopherol gram blood cell lysis, not with clinical deficiency peroxide-induced symptoms ( Institute of hydrogen red 2000 ). Medicine The fat-soluble micronutrients vitamin A, E, and carotenoids presented in Data in NHANES. report were measured by a single assay panel employing HPLC separation and detection by this same of or visible light (HPLC-UV/vis). This is the UV method used during the first four use of the continuous NHANES survey (1999-2002). years 1971, various fat-soluble micronutrients have been measured in the serum of NHANES Since concentrations In NHANES III (1988–1994), clinically low of serum retinol were participants. in U.S. residents aged 4 years and older, although racial/ethnic and socioeconomic uncommon existed ( Ballew 2001 ). V ariations in serum carotenoid concentrations by ethnicity differences et sex were found for adults, children, and adolescents ( Ford 2000; Ford 2002 ). Ford al. also and variations in serum concentrations sociodemographic alpha -tocopherol among U.S. found of in NHANES III ( 1999 ) and alpha - and gamma -tocopherol in NHANES 1999–2000 adults 2006 Application of the most common cut-off value for serum alpha -tocopherol concentrations ( ). NHANES 1999–2000 (500 μg/dL), demonstrated a low prevalence of vitamin E deficiency, in Agriculture-estimated fact that the U.S. Department of dietary intakes of vitamin E despite the low and that most of the U.S. population did not meet dietary intake recommendations. were , see the For more information on these fat-soluble micronutrients Institute of Medicine’s Intake reports ( Institute of Medicine 2000 and 2001 ) Dietary the vitamin fact Reference and sheets from the National Institutes of Health, Office of Dietary Supplements ( http://ods.od.nih. gov/Health_Information/Vitamin_and_Mineral_Supplement_Fact_Sheets.aspx). Highlights Serum concentrations of fat-soluble micronutrients (vitamin A, E, and carotenoids) in the U.S. population the following demographic patterns and characteristics: showed With exceptions, the highest concentrations few of fat-soluble micronutrients were • in persons 60 found and older. years • consistent pattern was observed No regard to gender or race/ethnicity. with • The likelihood of being vitamin A or E deficient was very low throughout the population. • very of vitamin A excess was also The likelihood low, but it increased with increasing age. more than 20 years, the majority of the U.S. population (greater than 95%) has had adequate For vitamin serum concentrations of vitamin A ( > 20 μg/dL) and E ( > 500 μg/dL). Despite 2001–2002 dietary intake data demonstrating that 93% of the U.S. NHANES Requirement less than the Estimated Average population (EAR) for vitamin E consumed vitamin Moshfegh 2005 ), for decades mean serum ( E concentrations have remained consistently adequate ( Figure H.2.a ), with less than 1% of the population vitamin E deficient. Analyses of adults NHANES showed that in 1999–2000, 52% of data ( Rock 2007 ) and in 2003–2006, 49% of the total U.S. population ( Bailey 2011 ) used dietary supplements; thus, the intake data (food and supplements) for vitamin E seem to be inconsistent with the biomarker data. Several fats (and explanatory possibilities have been raised, including a suggestion that the intake of 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 91 91

103 and nutrients) is under-reported in overweight fat-soluble obese subjects, the database of food intake without values is not accurate, and/or that the EAR for vitamin E needs adjustment. Low manifestation of deficiency suggests the widespread need for further evaluations to determine intake. dietary whether improved estimates are necessary, either in the nutrient tables or in 2005-2006 1988-1994 1999-2002 b b 1200 c b b b c b b c a a a a a b b a 1000 800 600 400 Serum vitamin E (μg/dL) 200 0 Non- Total Females Mexican Males Non- Hispanic population American Hispanic black white vitamin E (alpha-tocopherol) concentrations in the U.S. population mean serum geometric Age-adjusted aged 6 years of Figure H.2.a. Survey, Examination Nutrition and Health National 1988–2006. race/ethnicity, or gender by older and (p < 0.05). Age adjustment was Error bars represent 95% confidence intervals. W ithin a demographic group, bars not sharing a common letter differ done using direct standardization. Detailed Observations next. derived The selected observations mentioned below are from the tables and figures presented about categorical differences between demographic Statements groups noted below are based on univariate for demographic analysis without adjusting from limits confidence non-overlapping (e.g., determinants concentration blood other dietary or race/ethnicity) age, (e.g., variables gender, smoking, BMI). A multivariate analysis may alter the size and statistical intake, supplement usage, Furthermore, significance of differences significant additional differences. categorical these of be may magnitude smaller their of mention here (e.g., if confidence limits despite present lack if slightly has adjustment covariate overlap or differences are not statistically significant before of descriptive NHANES citations papers related to these biochemical a For occurred). of selection . see nutrition, Appendix G diet of indicators and Geometric mean concentrations (NHANES 2005–2006): with 2.1.a). Figure and 2.1.a.1 (Table age increased concentrations A vitamin Serum • similar across age ranges, with a slight were concentrations palmitate retinyl Serum • and Figure 2.2.a). decrease in the adolescent years (Table 2.2.a.1 Serum vitamin E concentrations decreased throughout childhood, then increased with • to seen early childhood (Table 2.4.a.1and in those than higher concentrations age Figure -tocopherol serum while 2.4.a), gamma concentrations constant relatively remained decreasing slightly in older persons (Table 2.5.a.1 and Figure throughout the life cycle, 2.5.a). nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 92 92

104 • Serum -carotene, trans - beta -carotene, and lutein/zeaxanthin concentrations alpha to throughout then increased with age childhood, concentrations higher than decreased seen in early childhood (Tables 2.6.a.1, 2.7.a.1, those 2.10.a.1 and Figures 2.6.a, and 2.7.a, 2.10.a). early -cryptoxanthin concentrations decreased Serum in beta childhood and then • steady (Table 2.9.a.1 and Figure 2.9.a). remained were Serum -lycopene and total lycopene concentrations trans highest in young adults • lowest in older persons (Tables 2.11.a.1 and 2.12.a.1 and Figures 2.11.a, 2.12.a). and males, Females had higher serum vitamin E than while males had higher serum vitamin • A concentrations than females (Tables 2.4.a.1 and 2.1.a.1). • Females had higher serum alpha -carotene and trans - beta -carotene concentrations than males had higher serum total lycopene concentrations males, than females (Tables and and 2.6.a.1, 2.12.a.1). 2.7.a.1, of Non-Hispanic whites had the highest • concentrations serum vitamin A and vitamin E, and the lowest concentrations of serum gamma -tocopherol. Non-Hispanic whites had lowest concentrations of serum the lutein/zeaxanthin. Non-Hispanic blacks had the lowest concentrations of serum alpha -carotene. Mexican Americans had the highest concentrations of serum beta -cryptoxanthin and the lowest concentrations of serum trans -lycopene and total lycopene. (Tables 2.1.a.1, 2.4.a.1, 2.5.a.1, 2.10.a.1, 2.6.a.1, 2.11.a.1, 2.9.a.1, 2.12.a.1). and Changes in geometric mean concentrations across survey cycles: • vitamin A concentrations increased between 1999–2000 and 2001–2002, then Serum steady survey through the 2005–2006 period (Table 2.1.b). held concentrations E and gamma -tocopherol Serum held steady between 1999– • vitamin and 2005–2006 (Tables 2.4.b and 2.5.b). 2000 Serum alpha -carotene, trans - beta -carotene, beta -cryptoxanthin, lutein/zeaxanthin, • -lycopene concentrations did not change appreciably across the survey and cycles trans 2.7.b, (Tables 2.9.b, 2.10.b, and 2.11.b). 2.6.b, Prevalence • of low or high biochemical indicator concentrations: estimates • In 2005–2006, less than 1% of the population aged 6 years and older had a vitamin A or vitamin E deficiency, defined as < 20 μg/dL and < 500 μg/dL, respectively (Tables excess 2.1.c.1 2.4.c). About 2%, however, were at risk for an and of vitamin A, or > 100 μg/dL (Table 2.1.c.2). • Between 1999 and 2006, the prevalence of low serum vitamin A was less than 1% of all serum persons 2.1.d.1), and the prevalence of high (Table vitamin A was 1–2% of all persons (Table 2.1.d.2). • 1999 and 2006, the prevalence of low Between serum vitamin E was 2% or less for (Table almost all groups except for adolescents, for whom the prevalence was 2–4% 2.4.d). 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 93 93

105 860 size 1,844 7,254 3,547 1,891 1,954 3,707 2,973 1,688 1,365 1,387 Sample (76.2 – 88.4) (93.1 – 101) (53.3 – 57.3) (93.3 – 104) (86.1 – 93.6) (71.4 – 82.9) (89.8 – 103) (95.6 – 104) (87.2 – 93.3) (94.7 – 107) (105 – 115) 97.5th 100 100 100 108 82.1 96.7 54.4 89.7 75.7 94.8 89.1 (71.9 – 77.0) (85.6 – 90.5) (49.1 – 54.3) (86.5 – 93.0) (78.4 – 85.5) (66.9 – 73.1) (83.3 – 88.7) (87.6 – 93.3) (81.9 – 87.9) (87.2 – 94.3) (96.2 – 102) 95th 87.8 52.4 89.0 73.7 82.0 69.6 85.9 89.8 84.4 90.3 99.8 (95% conf. interval) s (54.2 – 56.1) (35.9 – 37.3) (57.1 – 59.0) (46.8 – 50.2) (47.0 – 49.5) (44.6 – 47.5) (50.8 – 53.8) (56.8 – 59.0) (53.5 – 55.6) (58.1 – 60.4) (63.1 – 67.0) 50th 55.2 36.6 58.0 48.8 48.1 46.0 52.4 57.9 54.7 59.5 64.9 Selected percentile (31.8 – 33.2) (24.3 – 26.9) (32.7 – 34.8) (29.3 – 31.2) (27.6 – 29.8) (30.6 – 33.0) (31.2 – 32.6) (33.0 – 36.2) (32.2 – 35.1) (36.0 – 38.0) (38.2 – 43.0) 5th 32.5 25.6 33.6 30.3 28.8 32.0 31.9 34.8 33.9 36.8 40.2 (28.7 – 30.5) (19.9 – 24.8) (29.2 – 31.2) (26.2 – 28.6) (23.8 – 27.5) (28.6 – 29.6) (27.7 – 30.1) (30.6 – 32.4) (29.2 – 32.1) (31.4 – 34.2) (31.6 – 38.8) 2.5th 29.6 22.8 30.3 27.8 25.7 28.9 28.9 31.5 31.2 33.1 36.4 n (53.8 – 55.6) (35.6 – 37.2) (56.3 – 58.2) (47.3 – 49.5) (47.3 – 49.3) (45.4 – 47.7) (51.3 – 53.5) (56.4 – 58.4) (53.3 – 55.3) (57.7 – 59.7) (62.8 – 66.1) 54.7 36.4 57.2 48.4 48.3 46.5 52.4 57.4 54.3 58.7 64.4 (95% conf. interval) Geometric mea Total, 6 years and older 6–11 years Age group Males Gender Race/ethnicity Mexican Americans Non-Hispanic Blacks 12–19 years Females Non-Hispanic Whites 20–39 years 40–59 years 60 years and older Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Table 2.1.a.1. Serum vitamin A: Concentrations nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 94 94

106 Figure 2.1.a. Serum vitamin A: Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2005–2006 Overall Mexican Americans Females Males (μg/dL) Serum vitamin A 0 20 40 60 80 60+ 20−39 40−59 20−39 40−59 60+ 6−11 6−11 12−19 12−19 Non−Hispanic Whites Non−Hispanic Blacks 80 (μg/dL) Serum vitamin A 0 20 40 60 60+ 20−39 40−59 6−11 12−19 20−39 12−19 40−59 60+ 6−11 Females Males Mexican Americans Non−Hispanic Blacks (μg/dL) Non−Hispanic Whites Serum vitamin A 0 20 40 60 80 60+ 40−59 20−39 20−39 40−59 60+ 6−11 12−19 12−19 6−11 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 95 95

107 Table 2.1.a.2. Serum vitamin A: Total population Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 90th 10th Males and Females (53.8 – 55.6) 36.6 (35.8 – 37.4) Total, 6 years and older (54.2 – 56.1) 80.0 (78.1 – 82.2) 7,254 54.7 55.2 36.4 28.0 (27.5 – 29.1) 36.6 (35.6 – 37.2) 47.5 (45.7 – 50.1) 860 6–11 years (35.9 – 37.3) 46.5 (45.4 – 47.7) 35.2 (33.9 – 35.9) 46.0 (44.6 – 47.5) 63.2 (60.7 – 66.9) 1,954 12–19 years 54.3 20–39 years (36.5 – 39.2) 54.7 (53.5 – 55.6) 77.7 (74.1 – 81.6) 1,688 (53.3 – 55.3) 38.1 58.7 41.2 (39.5 – 43.0) 59.5 (58.1 – 60.4) 81.0 (79.0 – 85.2) 1,365 40–59 years (57.7 – 59.7) 64.4 (62.8 – 66.1) 46.4 (44.7 – 47.9) 64.9 (63.1 – 67.0) 88.4 (86.0 – 91.7) 1,387 60 years and older Males (57.1 – 59.0) (56.3 – 58.2) 38.5 (37.8 – 39.2) 58.0 57.2 81.8 (79.7 – 85.0) 3,547 Total, 6 years and older (35.4 – 37.3) 36.4 (35.0 – 37.2) 28.1 (26.4 – 29.1) 36.3 6–11 years 47.5 (45.7 – 51.6) 427 12–19 years 48.2 36.4 (35.3 – 37.7) 48.1 (46.3 – 49.8) 64.5 (62.9 – 67.4) 980 (46.9 – 49.6) 59.1 44.4 (42.3 – 46.0) 58.4 (56.8 – 60.2) 80.9 (76.8 – 84.5) 738 20–39 years (57.7 – 60.5) 61.8 (60.7 – 63.0) 44.2 (41.6 – 47.1) 63.2 40–59 years 84.5 (80.1 – 92.0) 673 (62.4 – 64.2) 60 years and older (63.9 – 68.1) 48.4 (46.0 – 50.0) 66.0 (63.7 – 68.7) 90.4 (86.3 – 97.2) 729 66.4 Females Total, 6 years and older 52.4 35.6 (34.3 – 36.4) 52.4 (50.8 – 53.8) 77.5 (75.0 – 79.0) 3,707 (51.3 – 53.5) 6–11 years (35.3 – 37.8) 28.0 (27.5 – 29.4) 36.9 (35.9 – 38.0) 47.0 (45.1 – 52.3) 433 36.5 12–19 years 44.7 (43.5 – 45.9) 33.7 (33.3 – 35.0) 43.8 (42.7 – 45.1) 60.7 (57.0 – 66.6) 974 20–39 years 50.0 (48.7 – 51.3) 34.5 (32.7 – 36.1) 49.3 (48.3 – 50.9) 72.6 (69.5 – 75.9) 950 692 40–59 years 55.9 (54.1 – 57.7) 39.9 (36.9 – 41.2) 55.8 (53.8 – 58.5) 78.4 (74.2 – 82.8) (43.0 – 47.2) (84.0 – 91.2) (62.5 – 65.7) 63.9 45.1 87.7 658 60 years and older 63.2 (61.3 – 65.2) Table 2.1.a.3. Serum vitamin A: Mexican Americans Geometric mean and selected percentiles of serum concentrations (in μg/dL) for Mexican Americans in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 10th 50th 90th Males and Females 48.4 (47.3 – 49.5) 33.4 Total, 6 years and older 48.8 (46.8 – 50.2) 68.6 (66.7 – 70.3) 1,844 (32.6 – 34.2) 6–11 years (34.4 – 37.0) 27.6 (24.8 – 28.9) 35.6 (33.8 – 37.6) 46.2 (45.0 – 48.2) 295 35.8 12–19 years 44.9 (43.3 – 46.4) 34.1 (33.4 – 35.0) 44.4 (43.2 – 46.1) 58.8 (55.6 – 64.7) 646 20–39 years 50.1 36.0 (33.3 – 37.3) 50.3 (48.7 – 53.3) 69.1 (66.8 – 72.7) 449 (49.1 – 51.2) 40–59 years (52.4 – 54.8) 39.0 (36.6 – 41.0) 52.6 (50.7 – 55.6) 71.7 (67.2 – 85.3) 246 53.6 60 years and older 55.5 (52.8 – 58.3) 40.8 (37.3 – 42.8) 57.0 (54.7 – 58.4) 78.1 (72.9 – 85.4) 208 Males 53.3 51.9 (50.0 – 53.9) 36.5 (33.7 – 38.5) Total, 6 years and older (50.2 – 55.9) 70.7 (68.8 – 73.3) 883 46.8 6–11 years 35.6 (33.9 – 37.4) 27.2 (24.0 – 28.8) 35.4 (33.0 – 38.7) (45.6 – 49.1) 145 12–19 years 47.4 36.1 (33.8 – 38.0) 47.0 (45.0 – 48.6) 60.9 (58.7 – 65.7) 313 (45.6 – 49.3) 54.8 41.3 (36.6 – 43.9) 56.0 (54.0 – 59.0) 70.6 (68.0 – 74.3) 198 20–39 years (52.4 – 57.3) 59.1 (56.0 – 62.3) 45.8 (42.9 – 47.4) 57.9 40–59 years 77.7 (70.5 – 110) 122 (53.9 – 63.1) 60 years and older (53.3 – 62.3) 42.6† (19.8 – 47.4) 57.6 57.6 79.5† (70.6 – 93.0) 105 (55.1 – 62.0) Females Total, 6 years and older 44.7 (44.0 – 45.5) 32.1 (31.3 – 32.7) 43.7 (42.7 – 45.2) 64.2 (62.1 – 67.0) 961 6–11 years 35.7 28.0 (24.0 – 29.4) 36.0 (34.3 – 37.6) 45.7 (42.2 – 52.7) 150 (34.6 – 36.8) 12–19 years (41.0 – 43.7) 33.3 (32.2 – 33.8) 41.6 (40.2 – 43.0) 55.9 (52.3 – 61.5) 333 42.3 20–39 years 45.0 (43.9 – 46.2) 31.9 (29.8 – 33.8) 43.2 (41.7 – 46.6) 66.6 (61.2 – 69.5) 251 40–59 years 48.4 (47.1 – 49.7) 35.6 (32.4 – 37.4) 49.1 (46.5 – 50.2) 63.9 (57.7 – 81.3) 124 (51.4 – 58.9) 75.9† (72.9 – 83.0) (50.9 – 56.9) 53.5 103 39.4† 60 years and older 53.8 (32.9 – 42.3) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 96 96

108 Table 2.1.a.4. Serum vitamin A: Non-Hispanic blacks Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic blacks in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 10th 90th 50th Males and Females (47.3 – 49.3) 32.0 (31.2 – 32.8) 48.1 (47.0 – 49.5) 72.1 (70.0 – 75.1) Total, 6 years and older 48.3 1,891 35.6 26.6 (24.0 – 28.5) 35.7 (34.0 – 37.3) 47.3 (44.6 – 51.8) 240 6–11 years (34.5 – 36.8) 41.1 (40.0 – 42.2) 30.5 (29.4 – 31.3) 40.9 (39.7 – 42.6) 54.2 (52.8 – 57.5) 12–19 years 665 20–39 years (45.8 – 48.9) 32.3 (29.8 – 35.3) 47.9 (44.9 – 50.5) 67.7 (63.6 – 71.6) 368 47.3 53.2 35.4 (33.3 – 37.2) 53.7 (50.3 – 57.2) 77.1 (72.8 – 85.7) 335 40–59 years (51.4 – 55.0) 59.9 (56.3 – 63.7) 40.1 (36.2 – 45.6) 60.7 60 years and older 85.1 (78.8 – 91.4) 283 (56.6 – 64.5) Males 51.2 (49.9 – 52.5) 34.0 (32.9 – 35.2) Total, 6 years and older (50.2 – 53.6) 74.8 (70.9 – 79.0) 949 51.9 6–11 years 35.4 (34.1 – 36.8) 26.2 (23.2 – 28.7) 35.3 (33.5 – 36.6) 46.2 (43.7 – 51.9) 128 12–19 years 42.2 30.6 (28.8 – 32.0) 42.0 (39.7 – 44.7) 58.1 (55.1 – 60.7) 343 (40.8 – 43.7) 53.3 38.9 (35.7 – 40.4) 54.1 (52.3 – 55.5) 71.2 (65.9 – 77.7) 170 20–39 years (52.1 – 54.5) 57.3 (54.9 – 59.8) 39.0 (35.8 – 42.6) 58.4 40–59 years 84.8 (74.8 – 92.7) 156 (54.0 – 62.9) 60 years and older (57.0 – 64.9) 40.0 (33.9 – 46.7) 62.5 60.8 86.0 (78.4 – 110) 152 (59.9 – 64.7) Females Total, 6 years and older 45.9 (44.7 – 47.1) 31.1 (29.4 – 32.1) 44.9 (43.5 – 46.7) 70.1 (65.9 – 74.6) 942 6–11 years 35.8 26.7 (19.8 – 28.8) 36.1 (33.0 – 38.8) 47.6 (44.2 – 54.2) 112 (33.0 – 39.0) 12–19 years (38.7 – 41.2) 30.1 (29.4 – 30.8) 40.2 (38.7 – 41.7) 51.1 (49.9 – 53.1) 322 39.9 20–39 years 42.7 (41.1 – 44.3) 29.2 (24.3 – 32.0) 42.4 (40.4 – 44.5) 60.4 (57.4 – 63.5) 198 48.8 40–59 years (46.8 – 53.3) 33.4 (31.9 – 34.3) 49.9 (45.9 – 53.5) 73.3 (68.1 – 84.7) 179 (36.7 – 43.8) 60 years and older 59.3 (55.4 – 63.4) 39.8 (77.9 – 90.2) 60.3 (54.6 – 64.5) 84.9 131 Table 2.1.a.5. Serum vitamin A: Non-Hispanic whites Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic whites in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 10th 90th 50th Males and Females (56.4 – 58.4) 39.0 (37.8 – 40.0) 57.9 (56.8 – 59.0) 82.0 (79.8 – 85.3) Total, 6 years and older 57.4 2,973 36.8 28.6 (26.6 – 30.1) 37.1 (35.5 – 38.2) 47.6 (45.3 – 53.0) 231 6–11 years (35.4 – 38.2) 48.5 (46.8 – 50.2) 37.0 (35.5 – 38.4) 48.3 (45.9 – 50.0) 66.2 (63.1 – 69.3) 12–19 years 499 20–39 years (55.9 – 59.1) 41.4 (39.1 – 43.0) 57.1 (56.0 – 58.6) 81.4 (77.1 – 85.6) 714 57.5 60.4 43.3 (41.2 – 45.6) 60.5 (59.3 – 62.6) 81.9 (79.2 – 88.0) 683 40–59 years (59.2 – 61.6) 65.4 (63.8 – 67.0) 47.1 (45.3 – 48.8) 66.0 60 years and older 89.5 (86.7 – 92.6) 846 (63.8 – 67.9) Males 59.7 (58.5 – 60.9) 40.9 (39.4 – 41.9) Total, 6 years and older (58.9 – 62.1) 84.1 (80.7 – 87.8) 1,472 60.4 6–11 years 37.0 (35.6 – 38.6) 28.6 (25.1 – 30.3) 37.0 (35.1 – 38.4) 47.4 (45.3 – 53.2) 112 12–19 years 50.2 38.5 (35.2 – 40.4) 49.8 (47.5 – 52.0) 66.8 (64.3 – 69.7) 254 (48.3 – 52.2) 61.8 47.1 (45.1 – 48.4) 60.8 (58.3 – 63.5) 83.8 (79.8 – 87.8) 309 20–39 years (59.9 – 63.8) 63.3 (61.5 – 65.2) 45.3 (40.1 – 49.9) 64.0 40–59 years 85.0 (80.0 – 101) 351 (62.7 – 66.1) 60 years and older (64.6 – 69.0) 49.7 (46.1 – 50.4) 67.1 66.8 90.6 (87.3 – 99.0) 446 (63.8 – 70.2) Females Total, 6 years and older 55.3 (54.1 – 56.4) 37.6 (36.2 – 39.2) 55.6 (54.4 – 56.6) 79.8 (78.2 – 82.4) 1,501 6–11 years 36.6 28.2 (26.0 – 30.5) 37.1 (34.9 – 38.9) 48.1 (44.3 – 54.7) 119 (34.5 – 38.9) 12–19 years (44.6 – 48.8) 35.9 (33.4 – 37.4) 45.5 (43.1 – 48.5) 63.7 (59.5 – 70.1) 245 46.6 20–39 years 53.5 (51.6 – 55.3) 36.7 (34.2 – 39.7) 53.1 (51.2 – 54.9) 76.1 (72.8 – 83.1) 405 40–59 years 57.7 (56.0 – 59.4) 41.6 (40.2 – 43.5) 57.7 (55.6 – 59.6) 79.1 (75.6 – 83.9) 332 87.9 400 (62.7 – 67.4) (84.1 – 95.0) 60 years and older 64.3 (62.2 – 66.5) 46.4 (44.5 – 48.3) 64.8 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 97 97

109 Table 2.1.b. Serum vitamin A: Concentrations by survey cycle Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the U.S. population, National Health and Nutrition Examination Survey, 1999–2002 and 2005–2006. n Selected percentile s (95% conf. interval) Sample Geometric mea 50th 95th 5th (95% conf. interval) size Total, 6 years and older (51.8 – 53.8) 30.7 (29.8 – 31.6) 1999–2000 (52.2 – 54.9) 85.6 (83.9 – 87.2) 7,102 52.8 53.5 55.2 32.6 (31.8 – 33.5) 56.0 (54.1 – 56.4) 88.4 (86.6 – 91.6) 7,935 2001–2002 (54.7 – 57.3) 54.7 (53.8 – 55.6) 32.5 (31.8 – 33.2) 55.2 (54.2 – 56.1) 87.8 (85.6 – 90.5) 7,254 2005–2006 Age group 3–5 years (31.6 – 33.1) (19.0 – 23.1) 33.1 (31.5 – 34.6) 46.2 (41.1 – 66.3) 352 32.3 22.0 1999–2000 2001–2002 24.3 (16.5 – 25.5) 34.0 (33.1 – 35.2) 47.1 (44.3 – 50.3) 430 33.8 (33.1 – 34.6) 6–11 years 35.1 25.3 (23.6 – 26.1) 35.4 (35.0 – 35.8) 48.5 (46.1 – 52.3) 866 (34.5 – 35.6) 1999–2000 51.6 (36.2 – 38.5) 26.5 (25.8 – 27.4) 37.3 (36.2 – 39.0) 2001–2002 (50.1 – 54.0) 1,014 37.3 2005–2006 36.4 (35.6 – 37.2) 25.6 (24.3 – 26.9) 36.6 (35.9 – 37.3) 52.4 (49.1 – 54.3) 860 12–19 years 1999–2000 (44.7 – 46.6) 30.1 (29.1 – 30.9) 45.8 (45.0 – 46.9) 69.4 (66.9 – 71.8) 2,111 45.7 48.0 (47.6 – 49.3) 31.8 (30.4 – 33.3) 48.5 2001–2002 71.2 (69.0 – 74.2) 2,206 (47.1 – 48.9) (44.6 – 47.5) 2005–2006 32.0 (30.6 – 33.0) 46.0 (45.4 – 47.7) 69.6 (66.9 – 73.1) 1,954 46.5 20–39 years 1999–2000 52.1 (50.8 – 53.4) 33.0 (31.1 – 34.3) 52.8 (51.2 – 54.5) 80.3 (77.9 – 83.0) 1,461 2001–2002 (53.3 – 56.3) 34.2 (32.6 – 35.3) 55.8 (54.4 – 57.5) 83.4 (80.9 – 86.6) 1,716 54.8 2005–2006 54.3 (53.3 – 55.3) 33.9 (32.2 – 35.1) 54.7 (53.5 – 55.6) 84.4 (81.9 – 87.9) 1,688 40–59 years 1,191 59.0 (57.6 – 60.6) 35.9 1999–2000 59.8 (57.9 – 61.5) 90.4 (86.4 – 96.8) (34.2 – 38.1) 1,474 2001–2002 60.3 (59.2 – 61.5) 37.5 (34.8 – 39.9) 61.2 (59.8 – 62.7) 94.6 (90.3 – 97.8) (57.7 – 59.7) (87.2 – 94.3) 90.3 59.5 (36.0 – 38.0) (58.1 – 60.4) 1,365 2005–2006 58.7 36.8 60 years and older 1999–2000 (61.1 – 64.0) 39.7 (36.3 – 41.9) 63.0 (61.3 – 65.0) 94.3 (90.1 – 99.5) 1,473 62.5 65.0 102 40.3 (38.0 – 41.4) 65.4 (64.1 – 67.4) 2001–2002 (98.6 – 108) 1,525 (63.6 – 66.5) 99.8 64.4 40.2 (38.2 – 43.0) 64.9 (63.1 – 67.0) 2005–2006 (96.2 – 102) 1,387 (62.8 – 66.1) Gender (6 years and older) Males 1999–2000 55.8 (54.4 – 57.3) 31.9 (30.1 – 33.8) 57.5 (55.8 – 58.8) 86.3 (84.6 – 90.6) 3,450 2001–2002 58.5 34.4 (33.4 – 35.5) 59.8 (58.0 – 61.7) 91.5 (88.7 – 93.7) 3,841 (57.2 – 59.8) (57.1 – 59.0) 2005–2006 33.6 (32.7 – 34.8) 58.0 (56.3 – 58.2) 89.0 (86.5 – 93.0) 3,547 57.2 Females 1999–2000 50.1 (49.1 – 51.1) 30.2 (28.7 – 31.2) 50.0 (48.8 – 51.0) 84.1 (81.2 – 87.0) 3,652 52.5 2001–2002 (51.1 – 53.5) 31.7 (30.9 – 32.4) 52.3 (51.0 – 53.9) 86.6 (84.0 – 88.3) 4,094 52.4 2005–2006 52.4 (51.3 – 53.5) (31.2 – 32.6) 31.9 (50.8 – 53.8) 85.9 (83.3 – 88.7) 3,707 Race/ethnicity (6 years and older) Mexican Americans (45.5 – 48.3) 29.0 (28.0 – 29.7) 46.9 (46.1 – 47.8) 75.6 (73.6 – 79.0) 2,410 1999–2000 47.0 48.6 (47.2 – 50.0) 29.8 (28.8 – 30.7) 48.8 2001–2002 76.6 (73.4 – 82.1) 1,991 (47.4 – 50.4) 2005–2006 (47.3 – 49.5) 30.3 (29.3 – 31.2) 48.8 48.4 73.7 (71.9 – 77.0) 1,844 (46.8 – 50.2) Non-Hispanic Blacks 1999–2000 45.8 (44.2 – 47.4) 27.8 (26.4 – 28.3) 45.4 (43.1 – 47.6) 75.7 (72.5 – 81.1) 1,590 2001–2002 47.2 28.2 (27.4 – 28.9) 47.0 (45.3 – 48.6) 80.2 (77.3 – 85.7) 1,864 (46.1 – 48.3) 2005–2006 (47.3 – 49.3) 28.8 (27.6 – 29.8) 48.1 (47.0 – 49.5) 82.0 (78.4 – 85.5) 1,891 48.3 Non-Hispanic Whites 1999–2000 (54.2 – 57.1) 33.4 (31.2 – 34.7) 56.8 (55.0 – 58.2) 87.3 (85.4 – 90.5) 2,456 55.6 3,455 57.9 (56.4 – 59.5) 34.7 (33.1 – 36.2) 58.9 (56.8 – 60.7) 91.3 (88.9 – 93.5) 2001–2002 (87.6 – 93.3) 2,973 34.8 (56.8 – 59.0) (33.0 – 36.2) 89.8 57.9 2005–2006 57.4 (56.4 – 58.4) nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 98 98

110 Figure 2.1.b. Serum vitamin A: Concentrations by survey cycle Selected percentiles in μg/dL (95% confidence intervals), National Health and Nutrition Examination Survey, 1999–2002 and 2005–2006 100 i i i i i i i i i i i i i i i i i 80 i i i i i i i 60 95th Percentile i i i i i 40 70 i i 60 i i i i i i i i i i i i i 50 i i i i i i i i i 50th Percentile 40 i i i i i 30 40 i i i i 35 i i i i i i i i i i i i i i i i 30 i i i i i i i 25 i 5th Percentile i 20 15 99−00 01−02 05−06 99−00 01−02 05−06 99−00 01−02 05−06 99−00 01−02 05−06 99−00 01−02 05−06 99−00 01−02 05−06 99−00 01−02 05−06 99−00 01−02 05−06 99−00 01−02 05−06 99−00 01−02 05−06 Total 6−11y 12−19y 20+y Males Females MA NHB NHW 3−5y (6+y) (6+y) (6+y) (6+y) (6+y) (6+y) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 99 99

111 Table 2.1.c.1. Serum vitamin A: Prevalence Prevalence (in percent) of low serum vitamin A concentration (< 20 μg/dL) for the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Sample Estimated total Prevalenc e (95% conf. interval) size number of persons 0.3 711,000 7,254 (0.1 – 0.5) Total, 6 years and older Age group 6–11 years 860 1.0 (0.6 – 1.5) 231,000 12–19 years 1,954 § § § § 20–39 years 1,688 § § 1,365 40–59 years 60 years and older 1,387 § § Gender Males 3,547 § § 3,707 317,000‡ Females (0.1 – 0.4) 0.2‡ Race/ethnicity Mexican Americans 1,844 § § 145,000 (0.3 – 0.7) Non-Hispanic Blacks 1,891 0.5 386,000‡ 0.2‡ (0.1 – 0.5) Non-Hispanic Whites 2,973 ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. § Estimate suppressed: RSE ≥ 40% for the prevalence estimate. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 100 100

112 Table 2.1.c.2. Serum vitamin A: Prevalence Prevalence (in percent) of high serum vitamin A concentration (> 100 μg/dL) for the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Sample Prevalence Estimated total (95% conf. interval) number of persons size 2.1 7,254 5,573,000 (1.6 – 2.7) Total, 6 years and older Age group 6–11 years 860 § § 12–19 years 1,954 § § 847,000‡ 20–39 years 1,688 1.1‡ (0.5 – 2.3) (1.8 – 3.9) 2.7 2,182,000 40–59 years 1,365 60 years and older (3.8 – 6.0) 2,301,000 4.8 1,387 Gender 3,547 2.5 (1.8 – 3.4) 3,265,000 Males 1.7 3,707 2,306,000 (1.0 – 2.9) Females Race/ethnicity 129,000‡ 1,844 0.5‡ (0.3 – 1.1) Mexican Americans Non-Hispanic Blacks 1,891 1.1 (0.6 – 2.0) 348,000 (2.0 – 3.5) Non-Hispanic Whites 2,973 2.6 4,752,000 ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. § Estimate suppressed: RSE ≥ 40% for the prevalence estimate. 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 101 101

113 Table 2.1.d.1. Serum vitamin A: Prevalence by survey cycle Prevalence (in percent) of low serum vitamin A concentration (< 20 μg/dL) for the U.S. population, National Health and Nutrition Examination Survey, 1999–2002 and 2005–2006. Prevalence (95% conf. interval) Estimated total number of persons Sample size Total, 6 years and older 0.1 1999–2000 360,000 7,102 (0.1 – 0.2) 7,935 0.3 (0.2 – 0.4) 698,000 2001–2002 7,254 0.3 (0.1 – 0.5) 711,000 2005–2006 Age group 3–5 years 352 § § 1999–2000 430 § § 2001–2002 6–11 years (0.6 – 1.6) 866 1.0 243,000 1999–2000 2001–2002 1,014 § § (0.6 – 1.5) 860 231,000 2005–2006 1.0 12–19 years 2,111 1999–2000 § § 2001–2002 2,206 § § 2005–2006 1,954 § § 20–39 years 1,461 § § 1999–2000 2001–2002 1,716 § § 2005–2006 1,688 § § 40–59 years § 1999–2000 1,191 § § § 1,474 2001–2002 § 2005–2006 § 1,365 60 years and older 1999–2000 § § 1,473 2001–2002 1,525 § § 1,387 § § 2005–2006 Gender (6 years and older) Males 0.1‡ 3,450 179,000‡ (0.1 – 0.3) 1999–2000 2001–2002 0.4 (0.2 – 0.7) 456,000 3,841 2005–2006 3,547 § § Females 1999–2000 3,652 0.1 (0.1 – 0.2) 181,000 242,000‡ 2001–2002 4,094 0.2‡ (0.1 – 0.4) 3,707 317,000‡ 2005–2006 0.2‡ (0.1 – 0.4) Race/ethnicity (6 years and older) Mexican Americans (0.2 – 0.8) 1999–2000 2,410 0.4‡ 75,000‡ 1,991 § § 2001–2002 1,844 § § 2005–2006 Non-Hispanic Blacks 1999–2000 1,590 0.5 (0.3 – 0.8) 153,000 2001–2002 0.7 (0.3 – 1.2) 201,000 1,864 2005–2006 1,891 0.5 (0.3 – 0.7) 145,000 Non-Hispanic Whites § 1999–2000 2,456 § (0.1 – 0.5) 0.2‡ 398,000‡ 2001–2002 3,455 (0.1 – 0.5) 0.2‡ 2,973 386,000‡ 2005–2006 ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. § Estimate suppressed: RSE ≥ 40% for the prevalence estimate. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 102 102

114 Table 2.1.d.2. Serum vitamin A: Prevalence by survey cycle Prevalence (in percent) of high serum vitamin A concentration (> 100 μg/dL) for the U.S. population, National Health and Nutrition Examination Survey, 1999–2002 and 2005–2006. Sample size (95% conf. interval) Estimated total number of persons Prevalence Total, 6 years and older 7,102 1999–2000 3,312,000 (1.0 – 1.8) 1.3 2.0 (1.6 – 2.5) 5,242,000 2001–2002 7,935 7,254 2.1 (1.6 – 2.7) 2005–2006 5,573,000 Age group 3–5 years 1999–2000 § § 352 2001–2002 430 § § 6–11 years 866 § § 1999–2000 2001–2002 1,014 § § 2005–2006 860 § § 12–19 years 1999–2000 § § 2,111 2,206 § 2001–2002 § 1,954 § 2005–2006 § 20–39 years 1999–2000 1,461 § § 2001–2002 1,716 0.6‡ (0.2 – 1.3) 437,000‡ 2005–2006 1.1‡ (0.5 – 2.3) 847,000‡ 1,688 40–59 years 1999–2000 1,191 2.4 (1.4 – 4.0) 1,688,000 2001–2002 1,474 2.9 (2.0 – 4.4) 2,222,000 2005–2006 1,365 2.7 (1.8 – 3.9) 2,182,000 60 years and older 1,473 3.2 1999–2000 1,381,000 (2.1 – 4.8) 2001–2002 5.9 1,525 (4.3 – 8.0) 2,628,000 4.8 2,301,000 1,387 2005–2006 (3.8 – 6.0) Gender (6 years and older) Males 3,450 1.4 (0.9 – 2.4) 1,741,000 1999–2000 (1.9 – 3.0) 2.4 3,013,000 2001–2002 3,841 3,547 (1.8 – 3.4) 3,265,000 2.5 2005–2006 Females 3,652 1.2 (0.7 – 2.0) 1,570,000 1999–2000 4,094 1.7 (1.2 – 2.4) 2,226,000 2001–2002 2,306,000 3,707 1.7 (1.0 – 2.9) 2005–2006 Race/ethnicity (6 years and older) Mexican Americans 1999–2000 § § 2,410 1,991 § 2001–2002 § 1,844 0.5‡ (0.3 – 1.1) 2005–2006 129,000‡ Non-Hispanic Blacks 1999–2000 1,590 1.2 (0.7 – 2.2) 376,000 2001–2002 1,864 1.7‡ (0.8 – 3.7) 519,000‡ 2005–2006 1.1 (0.6 – 2.0) 348,000 1,891 Non-Hispanic Whites 1999–2000 2,456 1.7 (1.2 – 2.4) 2,962,000 2001–2002 3,455 2.4 (1.9 – 2.9) 4,296,000 (2.0 – 3.5) 4,752,000 2005–2006 2,973 2.6 ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. § Estimate suppressed: RSE ≥ 40% for the prevalence estimate. 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 103 103

115 827 size 6,946 2,838 3,397 1,746 1,865 3,549 1,842 1,620 1,315 1,319 Sample (6.93 – 7.96) (7.04 – 8.74) (5.67 – 8.84) (6.78 – 8.26) (5.19 – 7.49) (5.77 – 6.77) (6.53 – 8.14) (5.70 – 7.56) (5.70 – 7.62) (6.74 – 9.10) (7.86 – 11.7) 97.5th 7.35 7.82 6.18 7.26 5.69 6.19 7.45 6.36 6.31 7.58 8.80 (5.35 – 6.03) (5.60 – 6.49) (4.70 – 5.81) (5.50 – 6.32) (4.40 – 5.18) (4.51 – 5.37) (4.96 – 6.12) (4.65 – 5.76) (4.67 – 5.36) (5.46 – 6.80) (6.04 – 8.01) 95th 5.67 6.02 5.01 5.89 4.77 4.78 5.51 5.00 5.00 6.15 6.87 (95% conf. interval) s (1.99 – 2.17) (2.04 – 2.27) (1.93 – 2.27) (2.04 – 2.24) (1.69 – 1.88) (1.74 – 1.94) (1.94 – 2.11) (1.84 – 2.20) (2.03 – 2.29) (2.00 – 2.24) (1.88 – 2.23) 50th 2.08 2.17 2.14 2.14 1.78 1.83 2.01 2.03 2.18 2.12 2.04 Selected percentile 5th < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD 2.5th < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD n (2.05 – 2.17) (2.01 – 2.29) (2.08 – 2.23) (1.78 – 1.91) (1.84 – 1.97) (2.01 – 2.12) (1.90 – 2.19) (2.04 – 2.23) (2.10 – 2.25) (2.04 – 2.25) (2.01 – 2.28) 2.11 2.15 2.15 1.85 1.90 2.07 2.04 2.13 2.17 2.14 2.14 (95% conf. interval) Geometric mea < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. Total, 6 years and older 6–11 years Age group Males Gender Race/ethnicity Mexican Americans 12–19 years Females Non-Hispanic Blacks 20–39 years Non-Hispanic Whites 40–59 years 60 years and older and Nutrition Examination Survey, 2005–2006. Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health Table 2.2.a.1. Serum retinyl palmitate: Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 104 104

116 Figure 2.2.a. Serum retinyl palmitate: Concentrations by age group Geometric Mean (95% confidence interval), National Health and Nutrition Examination Survey, 2005–2006 Overall Mexican Americans 4 3 Females Males 2 (μg/dL) 1 Serum retinyl palmitate 0 12−19 20−39 40−59 60+ 60+ 6−11 40−59 6−11 20−39 12−19 Non−Hispanic Whites Non−Hispanic Blacks 4 3 2 (μg/dL) 1 Serum retinyl palmitate 0 20−39 60+ 60+ 40−59 12−19 6−11 12−19 6−11 40−59 20−39 Females Males 4 3 Mexican Americans 2 Non−Hispanic (μg/dL) Blacks 1 Non−Hispanic Whites Serum retinyl palmitate 0 12−19 20−39 40−59 60+ 6−11 60+ 40−59 6−11 12−19 20−39 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 105105

117 Table 2.2.a.2. Serum retinyl palmitate: Total population Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 90th 10th Males and Females (2.05 – 2.17) < LOD Total, 6 years and older (1.99 – 2.17) 4.40 (4.28 – 4.54) 6,946 2.11 2.08 2.15 (2.01 – 2.29) < LOD 2.14 (1.93 – 2.27) 4.19 (4.02 – 4.62) 827 6–11 years 1.90 (1.84 – 1.97) < LOD 1.83 (1.74 – 1.94) 3.79 (3.60 – 4.10) 1,865 12–19 years 2.13 20–39 years 2.18 (2.03 – 2.29) 4.16 (3.86 – 4.43) 1,620 (2.04 – 2.23) < LOD 2.14 < LOD 2.12 (2.00 – 2.24) 4.57 (4.23 – 5.15) 1,315 40–59 years (2.04 – 2.25) 2.14 (2.01 – 2.28) < LOD 2.04 (1.88 – 2.23) 4.99 (4.54 – 5.60) 1,319 60 years and older Males (2.04 – 2.24) (2.08 – 2.23) < LOD 2.14 2.15 4.52 (4.39 – 4.69) 3,397 Total, 6 years and older 2.26 (2.02 – 2.36) (2.05 – 2.48) < LOD 2.22 6–11 years 4.56 (4.13 – 5.45) 411 12–19 years 1.93 < LOD 1.85 (1.72 – 2.02) 3.84 (3.55 – 4.26) 935 (1.82 – 2.05) 2.24 < LOD 2.30 (2.14 – 2.43) 4.42 (4.04 – 4.69) 714 20–39 years (2.09 – 2.39) 2.15 (2.01 – 2.30) < LOD 2.14 40–59 years 4.66 (4.29 – 5.53) 650 (2.01 – 2.27) 60 years and older 2.14 (2.01 – 2.28) < LOD 2.03 (1.87 – 2.25) 5.04 (4.47 – 5.60) 687 Females Total, 6 years and older 2.07 < LOD 2.01 (1.94 – 2.11) 4.29 (4.13 – 4.44) 3,549 (2.01 – 2.12) 416 6–11 years (1.86 – 2.25) < LOD 2.03 (1.81 – 2.25) 4.02 (3.76 – 4.41) 2.05 12–19 years 1.88 (1.80 – 1.95) < LOD 1.82 (1.69 – 1.92) 3.69 (3.44 – 4.31) 930 20–39 years 2.02 (1.94 – 2.11) < LOD 2.03 (1.91 – 2.18) 3.87 (3.65 – 4.31) 906 665 40–59 years 2.13 (2.03 – 2.24) < LOD 2.10 (1.97 – 2.24) 4.48 (4.00 – 5.50) 2.05 632 4.95 (1.78 – 2.31) < LOD (4.36 – 6.43) 60 years and older 2.14 (1.97 – 2.33) < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. Table 2.2.a.3. Serum retinyl palmitate: Mexican Americans Geometric mean and selected percentiles of serum concentrations (in μg/dL) for Mexican Americans in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. (95% conf. interval) Selected percentile s Sample n Geometric mea (95% conf. interval) size 10th 50th 90th Males and Females 1.85 Total, 6 years and older < LOD 1.78 (1.69 – 1.88) 3.84 (3.60 – 4.09) 1,746 (1.78 – 1.91) 6–11 years 1.79 (1.67 – 1.91) < LOD 1.68 (1.58 – 1.80) 3.66 (3.09 – 4.25) 275 12–19 years 1.65 (1.56 – 1.74) < LOD 1.62 (1.57 – 1.67) 3.11 (2.87 – 3.51) 614 20–39 years 1.90 < LOD 1.87 (1.68 – 2.04) 3.94 (3.68 – 4.49) 432 (1.77 – 2.04) 40–59 years (1.78 – 2.02) < LOD 1.81 (1.67 – 2.00) 4.08 (3.50 – 4.79) 233 1.89 60 years and older 1.95 (1.78 – 2.14) < LOD 1.79 (1.63 – 2.06) 4.57 (3.78 – 5.89) 192 Males 1.84 1.91 (1.80 – 2.03) < LOD Total, 6 years and older (1.69 – 2.00) 3.99 (3.70 – 4.70) 832 (1.51 – 1.79) 6–11 years 1.73 (1.56 – 1.91) < LOD 1.60 3.68 (2.85 – 5.04) 136 12–19 years 1.69 < LOD 1.64 (1.56 – 1.75) 3.12 (2.70 – 3.94) 294 (1.56 – 1.83) 1.99 < LOD 1.95 (1.67 – 2.27) 4.21 (3.82 – 5.31) 193 20–39 years (1.74 – 2.27) 2.05 (1.86 – 2.26) < LOD 1.98 (1.55 – 2.44) 40–59 years (3.76 – 5.44) 114 4.35 60 years and older (1.56 – 2.22) < LOD† 1.76 1.86 4.45† (3.55 – 5.43) 95 (1.35 – 2.41) Females Total, 6 years and older 1.78 (1.70 – 1.85) < LOD 1.72 (1.63 – 1.83) 3.56 (3.44 – 3.71) 914 6–11 years 1.85 < LOD 1.76 (1.63 – 1.94) 3.64 (3.14 – 4.87) 139 (1.70 – 2.02) 12–19 years (1.52 – 1.70) < LOD 1.60 (1.47 – 1.69) 3.09 (2.79 – 3.66) 320 1.61 20–39 years 1.79 (1.63 – 1.98) < LOD 1.77 (1.53 – 2.03) 3.56 (3.32 – 3.89) 239 40–59 years 1.75 (1.63 – 1.88) < LOD 1.72 (1.52 – 1.95) 3.52 (3.24 – 4.47) 119 97 (1.58 – 2.24) < LOD† (1.77 – 2.32) 4.59† (3.30 – 8.50) 60 years and older 2.02 1.79 < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 106 106

118 Table 2.2.a.4. Serum retinyl palmitate: Non-Hispanic blacks Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic blacks in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 90th 10th Males and Females (1.90 – 2.19) < LOD 2.03 (1.84 – 2.20) 4.13 (3.85 – 4.48) Total, 6 years and older 2.04 1,842 2.49 < LOD 2.49 (2.13 – 3.01) 4.82 (4.58 – 5.44) 238 6–11 years (2.19 – 2.82) (1.88 – 2.21) < LOD 1.99 (1.84 – 2.23) 4.05 (3.58 – 4.59) 643 12–19 years 2.03 2.12 (1.92 – 2.35) < LOD 2.10 (1.91 – 2.27) 4.23 (3.81 – 4.67) 363 20–39 years 1.96 40–59 years 1.94 (1.73 – 2.21) 3.88 (3.59 – 4.61) 326 (1.82 – 2.12) < LOD 1.77 < LOD 1.65 (1.44 – 1.89) 3.95 (3.26 – 4.67) 272 60 years and older (1.60 – 1.96) Males 2.15 (1.99 – 2.32) < LOD 2.16 (2.00 – 2.30) 4.45 (3.88 – 5.02) 921 Total, 6 years and older 2.66 (2.34 – 3.03) < LOD 2.71 6–11 years 5.34 (4.54 – 6.33) 127 (2.35 – 2.96) 12–19 years 2.17 (1.98 – 2.38) < LOD 2.13 (1.88 – 2.36) 4.49 (3.67 – 5.39) 330 20–39 years 2.29 < LOD 2.28 (2.05 – 2.56) 4.45 (3.73 – 5.85) 168 (2.05 – 2.56) 1.99 3.84 < LOD 2.12 (1.69 – 2.30) 40–59 years (3.42 – 7.34) 153 (1.80 – 2.21) 60 years and older (1.59 – 2.01) < LOD 1.62 (1.32 – 1.99) 4.64 (3.40 – 5.35) 143 1.79 Females Total, 6 years and older 1.95 (1.79 – 2.12) < LOD 1.92 (1.74 – 2.14) 3.93 (3.80 – 4.22) 921 111 6–11 years < LOD† 2.37 (1.87 – 2.87) 4.60† (4.24 – 5.12) 2.32 (1.94 – 2.77) 12–19 years (1.71 – 2.12) < LOD 1.91 (1.65 – 2.19) 3.55 (3.39 – 4.26) 313 1.90 20–39 years 1.99 (1.75 – 2.25) < LOD 2.01 (1.73 – 2.24) 3.92 (3.70 – 4.67) 195 40–59 years 1.94 (1.76 – 2.14) < LOD 1.88 (1.69 – 2.11) 3.92 (3.61 – 4.47) 173 129 60 years and older 1.76 (1.52 – 2.03) < LOD 1.66 (1.43 – 2.02) 3.54 (3.07 – 4.22) < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. † Estimate is subject to greater uncertainty due to small cell size. Table 2.2.a.5. Serum retinyl palmitate: Non-Hispanic whites Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic whites in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 10th 50th 90th Males and Females 2.17 Total, 6 years and older < LOD 2.17 (2.04 – 2.27) 4.54 (4.39 – 4.71) 2,838 (2.10 – 2.25) 6–11 years 2.18 (1.97 – 2.41) < LOD 2.16 (1.87 – 2.30) 4.19 (3.82 – 4.82) 224 12–19 years 1.93 (1.84 – 2.03) < LOD 1.85 (1.70 – 2.01) 3.92 (3.56 – 4.47) 475 20–39 years 2.21 < LOD 2.30 (2.12 – 2.44) 4.32 (3.85 – 4.66) 676 (2.07 – 2.36) 40–59 years (2.08 – 2.33) < LOD 2.21 (2.02 – 2.34) 4.66 (4.33 – 5.45) 658 2.20 60 years and older 2.20 (2.05 – 2.37) < LOD 2.12 (1.91 – 2.35) 5.16 (4.63 – 5.86) 805 Males 2.21 2.22 (2.12 – 2.32) < LOD Total, 6 years and older (2.08 – 2.30) 4.66 (4.45 – 4.99) 1,407 2.22 6–11 years 2.28 (1.97 – 2.63) < LOD† 107 (1.95 – 2.61) 4.52† (3.80 – 5.92) 12–19 years 1.94 < LOD 1.87 (1.68 – 2.10) 3.80 (3.40 – 4.67) 245 (1.79 – 2.10) 2.35 < LOD 2.40 (2.22 – 2.59) 4.49 (4.09 – 5.04) 293 20–39 years (2.14 – 2.57) 2.21 (2.06 – 2.36) < LOD 2.20 (2.02 – 2.35) 40–59 years (4.35 – 6.02) 339 4.77 60 years and older (2.04 – 2.38) < LOD 2.10 2.20 5.16 (4.50 – 5.79) 423 (1.89 – 2.36) Females Total, 6 years and older 2.13 (2.05 – 2.21) < LOD 2.13 (1.96 – 2.26) 4.41 (4.25 – 4.65) 1,431 6–11 years 2.07 < LOD 2.10 (1.75 – 2.39) 4.05 (3.50 – 4.51) (1.77 – 2.43) 117 12–19 years (1.81 – 2.04) < LOD 1.81 (1.67 – 1.98) 3.98 (3.30 – 4.57) 230 1.92 20–39 years 2.08 (1.94 – 2.23) < LOD 2.21 (1.91 – 2.36) 4.07 (3.57 – 4.65) 383 40–59 years 2.20 (2.06 – 2.34) < LOD 2.21 (1.97 – 2.40) 4.54 (4.05 – 5.85) 319 382 (4.45 – 6.71) 60 years and older 2.20 (1.99 – 2.42) < LOD 2.15 (1.80 – 2.41) 5.15 < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. † Estimate is subject to greater uncertainty due to small cell size. 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 107 107

119 Table 2.2.b. Serum retinyl palmitate: Concentrations by survey cycle Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the U.S. population, National Health and Nutrition Examination Survey, 1999–2002 and 2005–2006. n Selected percentile s (95% conf. interval) Sample Geometric mea 50th 95th 5th (95% conf. interval) size Total, 6 years and older (1.04 – 1.46) < LOD 1999–2000 (1.27 – 1.70) 4.95 (4.58 – 5.83) 5,589 1.23 1.47 1.92 .690 (.537 – .696) 1.93 (1.83 – 2.02) 5.49 (5.16 – 5.86) 7,641 2001–2002 (1.85 – 2.01) 2.11 (2.05 – 2.17) < LOD 2.08 (1.99 – 2.17) 5.67 (5.35 – 6.03) 6,946 2005–2006 Age group 3–5 years (1.16 – 1.84) 1.67 (1.33 – 1.97) 5.39 (4.82 – 8.78) 278 1.46 < LOD 1999–2000 2001–2002 .482 (< LOD – .710) 1.82 (1.69 – 2.02) 5.62 (4.79 – 8.77) 412 1.88 (1.71 – 2.06) 6–11 years 1.33 < LOD 1.64 (1.29 – 2.02) 5.75 (4.55 – 8.88) 651 (1.07 – 1.67) 1999–2000 (2.03 – 2.25) (1.90 – 2.15) .700 (.462 – .801) 2.15 2001–2002 5.32 (4.79 – 5.85) 967 2.02 2005–2006 2.15 (2.01 – 2.29) < LOD 2.14 (1.93 – 2.27) 5.01 (4.70 – 5.81) 827 12–19 years 1999–2000 (.963 – 1.41) < LOD 1.41 (1.12 – 1.68) 4.11 (3.71 – 4.77) 1,620 1.17 1.71 (1.66 – 1.87) .560 (.500 – .692) 1.77 2001–2002 4.21 (3.98 – 4.47) 2,122 (1.61 – 1.80) 2005–2006 (1.84 – 1.97) < LOD 1.83 (1.74 – 1.94) 4.78 (4.51 – 5.37) 1,865 1.90 20–39 years 1999–2000 1.14 (.928 – 1.39) < LOD 1.40 (1.21 – 1.62) 4.58 (4.14 – 5.67) 1,201 2001–2002 (1.77 – 2.06) .643 (.543 – .720) 1.91 (1.79 – 2.03) 5.14 (4.65 – 5.79) 1,655 1.91 2005–2006 2.13 (2.04 – 2.23) < LOD 2.18 (2.03 – 2.29) 5.00 (4.67 – 5.36) 1,620 40–59 years 1999–2000 1.30 (1.06 – 1.59) < LOD 1.55 (1.30 – 1.84) 5.49 (4.61 – 6.83) 959 1,429 2001–2002 1.99 (1.87 – 2.11) .623 (.529 – .698) 1.96 (1.89 – 2.06) 5.70 (5.19 – 6.53) 2.14 2.12 < LOD (2.00 – 2.24) 1,315 (5.46 – 6.80) 6.15 2005–2006 (2.04 – 2.25) 60 years and older 1999–2000 (1.11 – 1.62) < LOD 1.54 (1.29 – 1.89) 5.78 (4.87 – 6.47) 1,158 1.34 1.96 6.79 .522 (.453 – .580) 1.91 (1.75 – 2.13) 2001–2002 (6.11 – 7.83) 1,468 (1.82 – 2.11) (6.04 – 8.01) 2.14 < LOD 2.04 (1.88 – 2.23) 6.87 2005–2006 1,319 (2.01 – 2.28) Gender (6 years and older) Males 1999–2000 1.38 (1.17 – 1.63) < LOD 1.61 (1.40 – 1.82) 5.22 (4.65 – 5.94) 2,676 2001–2002 2.01 .636 (.544 – .687) 2.01 (1.91 – 2.12) 5.71 (5.31 – 6.20) 3,698 (1.90 – 2.12) 2005–2006 (2.08 – 2.23) < LOD 2.14 (2.04 – 2.24) 5.89 (5.50 – 6.32) 3,397 2.15 Females 1999–2000 1.11 (.922 – 1.33) < LOD 1.36 (1.16 – 1.61) 4.79 (4.47 – 5.80) 2,913 1.84 2001–2002 (1.76 – 1.95) .582 (.515 – .695) 1.85 (1.75 – 1.92) 5.11 (4.78 – 5.68) 3,943 2.01 2005–2006 2.07 (2.01 – 2.12) < LOD (1.94 – 2.11) 5.51 (4.96 – 6.12) 3,549 Race/ethnicity (6 years and older) Mexican Americans .945 (.808 – 1.14) 3.69 (3.32 – 4.35) 1,463 1999–2000 (.635 – .906) < LOD .759 1.62 (1.47 – 1.78) .503 (.398 – .575) 1.65 2001–2002 4.28 (3.95 – 4.80) 1,980 (1.50 – 1.85) 2005–2006 (1.78 – 1.91) < LOD 1.78 1.85 4.77 (4.40 – 5.18) 1,746 (1.69 – 1.88) Non-Hispanic Blacks 1999–2000 1.18 (.848 – 1.64) < LOD 1.48 (1.07 – 1.99) 5.06 (4.41 – 5.81) 1,422 2001–2002 1.92 .628 (.390 – .709) 1.96 (1.88 – 2.06) 5.44 (4.71 – 6.44) 1,734 (1.82 – 2.02) 2.04 (1.90 – 2.19) < LOD 2.03 (1.84 – 2.20) 5.00 (4.65 – 5.76) 1,842 2005–2006 Non-Hispanic Whites 1999–2000 (1.08 – 1.60) < LOD 1.57 (1.33 – 1.84) 5.12 (4.60 – 6.48) 2,121 1.32 3,318 1.97 (1.87 – 2.08) .636 (.584 – .684) 1.95 (1.86 – 2.06) 5.57 (5.14 – 5.99) 2001–2002 < LOD 6.02 2.17 (5.60 – 6.49) 2,838 (2.04 – 2.27) (2.10 – 2.25) 2005–2006 2.17 < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 108 108

120 Figure 2.2.b. Serum retinyl palmitate: Concentrations by survey cycle Selected percentiles in μg/dL (95% confidence intervals), National Health and Nutrition Examination Survey, 1999–2002 and 2005–2006 10 8 ( 6 ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( 95th Percentile ( ( ( 4 ( 2 2.5 ( ( ( ( ( ( ( ( ( 2.0 ( ( ( ( ( ( ( ( ( ( ( ( ( ( 1.5 ( ( ( ( ( 50th Percentile 1.0 ( 0.5 0.8 ( 0.7 ( ( ( ( ( 0.6 ( ( ( 0.5 5th Percentile 0.4 0.3 99−00 01−02 05−06 99−00 01−02 05−06 99−00 01−02 05−06 99−00 01−02 05−06 99−00 01−02 05−06 99−00 01−02 05−06 99−00 01−02 05−06 99−00 01−02 05−06 99−00 01−02 05−06 99−00 01−02 05−06 Total 6−11y 12−19y 20+y Males Females MA NHB NHW 3−5y (6+y) (6+y) (6+y) (6+y) (6+y) (6+y) Values in the graph are suppressed if either the point estimate or the lower 95% confidence limit is noted as “< LOD” in the accompanying table. 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 109109

121 792 size 6,698 3,276 1,739 1,801 3,422 1,699 1,555 2,747 1,262 1,288 Sample (1.79 – 2.09) (1.65 – 4.08) (1.86 – 2.05) (1.08 – 2.07) (1.18 – 2.00) (1.62 – 2.34) (1.10 – 1.71) (1.14 – 1.76) (1.93 – 2.36) (1.68 – 2.31) (2.26 – 3.58) 97.5th 1.95 1.97 1.94 1.35 1.48 1.99 1.38 1.32 2.06 2.00 2.77 (1.23 – 1.48) (1.08 – 1.97) (1.29 – 1.54) (.792 – 1.19) (.743 – 1.14) (1.09 – 1.48) (.829 – 1.10) (.850 – 1.09) (1.36 – 1.64) (1.23 – 1.63) (1.59 – 2.58) 95th 1.31 1.33 1.40 .933 .911 1.25 .896 .947 1.50 1.35 1.93 (95% conf. interval) s 50th < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD Selected percentile 5th < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD 2.5th < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD n * * * * * * * * * * * (95% conf. interval) Geometric mea < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. * Not calculated. Proportion of results below limit of detection was too high to provide a valid result. Total, 6 years and older 6–11 years Age group Gender Males Race/ethnicity Mexican Americans 12–19 years Females Non-Hispanic Blacks 20–39 years Non-Hispanic Whites 40–59 years 60 years and older and Nutrition Examination Survey, 2005–2006. Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health Table 2.3.a.1. Serum retinyl stearate: Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 110 110

122 by No serum retinyl stearate figure for concentrations age group is presented because the geometric means were not calculated due to the proportion of results below the limit of able 2.3.a.1). T detection being too high for valid results (see 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 111 111

123 Table 2.3.a.2. Serum retinyl stearate: Total population Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 90th 10th Males and Females Total, 6 years and older < LOD .894 (.794 – 1.02) 6,698 * < LOD * < LOD < LOD .972 (.730 – 1.21) 792 6–11 years * < LOD < LOD < LOD 1,801 12–19 years * 20–39 years < LOD 1,555 < LOD < LOD * < LOD .944 (.810 – 1.16) 1,262 40–59 years < LOD * < LOD < LOD 1.32 (1.13 – 1.58) 1,288 60 years and older Males Total, 6 years and older * < LOD < LOD .964 3,276 (.871 – 1.08) 6–11 years * < LOD < LOD 1.03 (< LOD – 1.76) 394 12–19 years * < LOD < LOD 898 < LOD * < LOD .813 (.709 – .968) 682 20–39 years < LOD * < LOD < LOD 40–59 years (.842 – 1.17) 624 .993 60 years and older * < LOD < LOD 1.33 (1.16 – 1.53) 678 Females Total, 6 years and older < LOD < LOD .839 (.741 – .960) 3,422 * 6–11 years * < LOD < LOD .896 (< LOD – 1.17) 398 12–19 years < LOD < LOD < LOD 903 * 873 * < LOD < LOD < LOD 20–39 years 638 40–59 years * < LOD < LOD .903 (.764 – 1.21) 60 years and older 1.32 610 (1.06 – 1.74) < LOD < LOD * < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. * Not calculated. Proportion of results below limit of detection was too high to provide a valid result. Table 2.3.a.3. Serum retinyl stearate: Mexican Americans Geometric mean and selected percentiles of serum concentrations (in μg/dL) for Mexican Americans in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. (95% conf. interval) s Selected percentile Sample n Geometric mea (95% conf. interval) size 50th 90th 10th Males and Females Total, 6 years and older * < LOD < LOD < LOD 1,739 6–11 years * < LOD < LOD < LOD 272 12–19 years * < LOD < LOD 604 < LOD 20–39 years < LOD < LOD < LOD 428 * 40–59 years * < LOD < LOD .766 (< LOD – 1.23) 238 60 years and older * < LOD < LOD .902 (.707 – 1.32) 197 Males 832 Total, 6 years and older * < LOD < LOD .736 (< LOD – .877) 6–11 years * < LOD < LOD 135 < LOD * < LOD < LOD 290 12–19 years < LOD * < LOD < LOD .700 20–39 years 190 (< LOD – .965) 40–59 years * < LOD < LOD .851 (< LOD – 1.95) 118 60 years and older * < LOD† < LOD .780† (< LOD – 3.26) 99 Females Total, 6 years and older < LOD < LOD < LOD 907 * * < LOD < LOD < LOD 137 6–11 years 12–19 years * < LOD < LOD < LOD 314 20–39 years < LOD < LOD < LOD 238 * 120 * < LOD < LOD < LOD 40–59 years 60 years and older < LOD 98 < LOD† (< LOD – 1.97) 1.02† * < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. * Not calculated. Proportion of results below limit of detection was too high to provide a valid result. † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 112 112

124 Table 2.3.a.4. Serum retinyl stearate: Non-Hispanic blacks Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic blacks in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 10th 90th 50th Males and Females < LOD < LOD < LOD Total, 6 years and older * 1,699 * < LOD < LOD < LOD 219 6–11 years * < LOD < LOD < LOD 12–19 years 597 20–39 years < LOD < LOD < LOD 322 * * < LOD .781 (< LOD – .931) 301 40–59 years < LOD * < LOD < LOD .770 60 years and older 260 (< LOD – 1.39) Males Total, 6 years and older * < LOD < LOD .746 (< LOD – .868) 849 6–11 years * < LOD < LOD < LOD 118 12–19 years * < LOD < LOD 300 < LOD * < LOD < LOD 152 20–39 years < LOD * < LOD < LOD .813 (< LOD – 1.06) 141 40–59 years 60 years and older * < LOD 1.06 (< LOD – 1.55) 138 < LOD Females * < LOD < LOD < LOD 850 Total, 6 years and older 6–11 years * < LOD† < LOD < LOD† 101 12–19 years * < LOD < LOD 297 < LOD 20–39 years < LOD < LOD < LOD 170 * 40–59 years * < LOD < LOD .701 (< LOD – .962) 160 60 years and older * < LOD < LOD < LOD 122 < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. * Not calculated. Proportion of results below limit of detection was too high to provide a valid result. † Estimate is subject to greater uncertainty due to small cell size. Table 2.3.a.5. Serum retinyl stearate: Non-Hispanic whites Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic whites in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 10th 90th 50th Males and Females < LOD < LOD 1.01 (.932 – 1.10) Total, 6 years and older * 2,747 * < LOD < LOD 1.06 (.756 – 1.99) 212 6–11 years * < LOD < LOD < LOD 465 12–19 years * 20–39 years .727 (< LOD – .878) 660 < LOD < LOD * < LOD 1.00 (.869 – 1.20) 627 40–59 years < LOD * < LOD < LOD 1.40 (1.17 – 1.73) 783 60 years and older Males Total, 6 years and older * < LOD < LOD 1.09 (.967 – 1.18) 1,370 < LOD * < LOD† 103 1.09† (< LOD – 7.58) 6–11 years 12–19 years * < LOD .740 (< LOD – 1.05) 244 < LOD * < LOD .927 (.740 – 1.16) 283 20–39 years < LOD * < LOD < LOD 1.07 40–59 years 324 (.862 – 1.24) 60 years and older * < LOD < LOD 1.39 (1.19 – 1.65) 416 Females Total, 6 years and older * < LOD < LOD .948 (.855 – 1.07) 1,377 6–11 years * < LOD 1.04† (.755 – 2.95) 109 < LOD† * < LOD < LOD < LOD 221 12–19 years 20–39 years * < LOD < LOD < LOD 377 40–59 years * < LOD < LOD .953 (.798 – 1.31) 303 (1.08 – 2.01) 60 years and older * < LOD < LOD 1.41 367 < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. * Not calculated. Proportion of results below limit of detection was too high to provide a valid result. † Estimate is subject to greater uncertainty due to small cell size. 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 113 113

125 Table 2.3.b. Serum retinyl stearate: Concentrations by survey cycle Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the U.S. population, National Health and Nutrition Examination Survey, 1999–2002 and 2005–2006. n Selected percentile s (95% conf. interval) Sample Geometric mea 50th 95th 5th (95% conf. interval) size Total, 6 years and older 1999–2000 < LOD 1.12 (.983 – 1.44) 4,148 * < LOD * < LOD < LOD 1.08 (.988 – 1.19) 7,690 2001–2002 * < LOD < LOD 1.31 (1.23 – 1.48) 6,698 2005–2006 Age group 3–5 years * < LOD† < LOD 2.43† (1.72 – 3.65) 212 1999–2000 * < LOD < LOD 1.75 (1.37 – 3.49) 416 2001–2002 6–11 years 1999–2000 * < LOD < LOD 1.74 (1.09 – 10.3) 434 < LOD * (.964 – 1.34) < LOD 1.14 2001–2002 981 2005–2006 * < LOD 1.33 (1.08 – 1.97) 792 < LOD 12–19 years 1999–2000 < LOD < LOD .829 (< LOD – 1.30) 1,194 * * < LOD < LOD 2001–2002 2,145 < LOD 2005–2006 * < LOD < LOD .911 (.743 – 1.14) 1,801 20–39 years 1999–2000 * < LOD < LOD .928 (.651 – 1.36) 872 2001–2002 < LOD < LOD .721 (.693 – .893) 1,658 * 2005–2006 * < LOD < LOD .947 (.850 – 1.09) 1,555 40–59 years 1999–2000 * < LOD < LOD 1.32 (.944 – 2.40) 716 1,422 2001–2002 * < LOD < LOD 1.15 (1.04 – 1.46) 2005–2006 1,262 (1.23 – 1.63) 1.35 < LOD * < LOD 60 years and older 1999–2000 < LOD < LOD 1.83 (1.39 – 2.90) 932 * * (1.52 – 2.08) < LOD 1.77 2001–2002 1,484 < LOD * 2005–2006 < LOD 1.93 (1.59 – 2.58) 1,288 < LOD Gender (6 years and older) Males 1999–2000 * < LOD < LOD 1.13 (.987 – 1.66) 2,008 2001–2002 * < LOD 1.19 (1.09 – 1.42) 3,710 < LOD 2005–2006 < LOD < LOD 1.40 (1.29 – 1.54) 3,276 * Females 1999–2000 * < LOD < LOD 1.10 (.951 – 1.42) 2,140 2001–2002 * < LOD < LOD .953 (.856 – 1.09) 3,980 < LOD 2005–2006 * < LOD 1.25 (1.09 – 1.48) 3,422 Race/ethnicity (6 years and older) Mexican Americans 1999–2000 < LOD < LOD .695 (< LOD – 2.14) 1,002 * * < LOD < LOD 2001–2002 (< LOD – .880) 1,921 .587 2005–2006 * < LOD < LOD .933 (.792 – 1.19) 1,739 Non-Hispanic Blacks 1999–2000 * < LOD < LOD .962 (.590 – 15.0) 1,060 2001–2002 * < LOD .733 (.619 – .963) 1,827 < LOD 2005–2006 < LOD < LOD .896 (.829 – 1.10) 1,699 * Non-Hispanic Whites 1999–2000 < LOD < LOD 1.27 (1.00 – 1.81) 1,608 * 3,331 * < LOD < LOD 1.13 (1.02 – 1.30) 2001–2002 2005–2006 < LOD 2,747 1.50 (1.36 – 1.64) < LOD * < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. * Not calculated. Proportion of results below limit of detection was too high to provide a valid result. † Estimate is subject to greater uncertainty due to cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 114 114

126 ations by sur Figure 2.3.b . Serum retin cle y cy ve yl stear oncentr ate: C fi Selected percentiles in μg/dL (95% con dence intervals), National Health and Nutrition Examination Survey, 1999–2002 and 2005–2006 15 10 5 95th Percentile 0 10 8 6 50th Percentile 4 2 10 8 6 5th Percentile 4 2 05−06 01−02 99−00 05−06 99−00 01−02 05−06 99−00 01−02 99−00 01−02 99−00 99−00 01−02 05−06 99−00 01−02 05−06 01−02 05−06 05−06 01−02 99−00 05−06 99−00 01−02 05−06 05−06 01−02 99−00 MA 12−19y Females Males 3−5y NHW 20+y 6−11y NHB Total (6+y) (6+y) (6+y) (6+y) (6+y) (6+y) dence limit is noted as “< LOD” in the accompanying table. fi Values in the graph are suppressed if either the point estimate or the lower 95% con 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 115 115

127 860 size 7,254 1,844 3,547 1,891 1,954 3,707 2,973 1,688 1,365 1,387 Sample (2,310 – 2,600) (1,960 – 2,330) (2,160 – 2,520) (1,230 – 1,510) (1,740 – 2,080) (2,370 – 2,660) (1,240 – 1,450) (2,420 – 2,690) (1,810 – 2,380) (2,260 – 3,110) (2,710 – 3,130) 97.5th 2,120 2,460 2,360 1,360 1,800 2,510 1,320 2,520 1,940 2,510 2,900 (2,010 – 2,180) (1,930 – 2,090) (1,750 – 1,870) (1,120 – 1,370) (1,560 – 1,750) (1,130 – 1,200) (2,080 – 2,260) (2,090 – 2,270) (1,620 – 1,900) 95th (2,080 – 2,400) (2,510 – 2,660) 2,090 2,010 1,200 1,790 1,660 1,160 2,170 2,170 1,730 2,210 2,600 (95% conf. interval) s (1,030 – 1,080) (788 – 826) (945 – 1,000) (1,010 – 1,070) (884 – 918) (749 – 767) (1,050 – 1,100) (1,080 – 1,140) (980 – 1,020) (1,160 – 1,240) (1,330 – 1,430) 50th 976 806 903 759 1,060 1,030 1,080 1,110 1,000 1,200 1,390 Selected percentile (620 – 642) (563 – 601) (602 – 637) (594 – 625) (581 – 601) (516 – 541) (639 – 664) (624 – 658) (621 – 668) (724 – 769) (733 – 835) 5th 631 583 610 623 588 527 653 643 645 749 783 (563 – 587) (518 – 573) (553 – 599) (543 – 575) (530 – 559) (466 – 519) (585 – 612) (566 – 596) (559 – 619) (656 – 721) (611 – 750) 2.5th 578 546 581 559 548 596 497 584 590 702 704 n (1,070 – 1,120) (800 – 841) (1,040 – 1,090) (980 – 1,040) (915 – 951) (757 – 783) (1,090 – 1,140) (1,110 – 1,160) (998 – 1,040) (1,190 – 1,260) (1,360 – 1,440) 820 933 770 (95% conf. interval) 1,090 1,060 1,010 1,120 1,140 1,020 1,230 1,400 Geometric mea 6–11 years Race/ethnicity Total, 6 years and older Males Gender Age group Mexican Americans Non-Hispanic Blacks 12–19 years Females Non-Hispanic Whites 20–39 years 40–59 years 60 years and older Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Table 2.4.a.1. Serum vitamin E: Concentrations nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 116 116

128 ations by age group Figure 2.4.a. Serum vitamin E: Concentr dence interval), National Health and Nutrition Examination Survey, 2005–2006 fi Geometric mean (95% con Mexican Americans Overall Females Males (μg/dL) Serum vitamin E 0500100015002000 6−1112−1920−3940−5960+ 6−1112−1920−3940−5960+ Non−Hispanic Blacks Non−Hispanic Whites (μg/dL) Serum vitamin E 0500100015002000 6−1112−1920−3940−5960+ 6−1112−1920−3940−5960+ Females Males Mexican Americans Non−Hispanic Blacks (μg/dL) Non−Hispanic Whites Serum vitamin E 0500100015002000 6−1112−1920−3940−5960+ 6−1112−1920−3940−5960+ Age (years) Age (years) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 117 117

129 Table 2.4.a.2. Serum vitamin E: Total population Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 90th 10th Males and Females (1,070 – 1,120) 702 (686 – 716) Total, 6 years and older (1,030 – 1,080) 1,790 (1,730 – 1,840) 7,254 1,090 1,060 820 629 (621 – 638) 806 (800 – 841) 1,070 (1,040 – 1,180) 860 6–11 years (788 – 826) 770 (757 – 783) 578 (557 – 587) 759 (749 – 767) 1,050 (1,000 – 1,070) 1,954 12–19 years 1,020 20–39 years (683 – 727) 1,000 (980 – 1,020) 1,520 (1,410 – 1,610) 1,688 (998 – 1,040) 710 1,230 824 (799 – 848) 1,200 (1,160 – 1,240) 1,870 (1,790 – 2,040) 1,365 40–59 years (1,190 – 1,260) 1,400 (1,360 – 1,440) 897 (828 – 949) 1,390 (1,330 – 1,430) 2,190 (2,130 – 2,270) 1,387 60 years and older Males (1,010 – 1,070) (1,040 – 1,090) 682 (664 – 704) 1,030 1,060 1,730 (1,640 – 1,770) 3,547 Total, 6 years and older (789 – 847) 817 (766 – 843) 629 (593 – 642) 807 6–11 years 1,070 (1,030 – 1,180) 427 12–19 years 753 553 (527 – 580) 747 (733 – 759) 1,030 (986 – 1,070) 980 (739 – 768) 1,030 699 (671 – 728) 1,010 (984 – 1,030) 1,570 (1,440 – 1,730) 738 20–39 years (1,010 – 1,050) 1,210 (1,180 – 1,250) 798 (767 – 848) 1,190 40–59 years 1,820 (1,740 – 1,950) 673 (1,160 – 1,240) 60 years and older (1,230 – 1,370) 827 (762 – 887) 1,300 (1,220 – 1,330) 2,070 (1,950 – 2,310) 729 1,290 Females Total, 6 years and older 1,120 717 (705 – 723) 1,080 (1,050 – 1,100) 1,840 (1,790 – 1,910) 3,707 (1,090 – 1,140) 6–11 years (792 – 856) 628 (608 – 647) 805 (784 – 837) 1,090 (1,020 – 1,230) 433 823 12–19 years 788 (772 – 804) 594 (570 – 611) 771 (755 – 788) 1,050 (991 – 1,120) 974 20–39 years 1,010 (981 – 1,040) 717 (679 – 738) 997 (956 – 1,030) 1,470 (1,360 – 1,580) 950 692 40–59 years 1,240 (1,200 – 1,290) 841 (818 – 860) 1,210 (1,160 – 1,240) 1,920 (1,820 – 2,120) (926 – 987) (2,190 – 2,470) (1,430 – 1,540) 1,500 966 2,260 658 60 years and older 1,490 (1,440 – 1,540) Table 2.4.a.3. Serum vitamin E: Mexican Americans Geometric mean and selected percentiles of serum concentrations (in μg/dL) for Mexican Americans in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 10th 50th 90th Males and Females 1,010 (980 – 1,040) 671 Total, 6 years and older 976 (945 – 1,000) 1,580 (1,530 – 1,630) 1,844 (656 – 695) 6–11 years (770 – 816) 623 (599 – 644) 793 (755 – 800) 1,010 (977 – 1,110) 295 779 12–19 years 760 (740 – 781) 587 (578 – 597) 750 (723 – 773) 991 (970 – 1,050) 646 20–39 years 1,020 727 (676 – 755) 997 (968 – 1,020) 1,520 (1,420 – 1,640) 449 (991 – 1,060) 40–59 years (1,200 – 1,280) 836 (808 – 861) 1,220 (1,160 – 1,270) 1,790 (1,730 – 1,950) 246 1,240 60 years and older 1,360 (1,250 – 1,470) 913 (816 – 996) 1,300 (1,240 – 1,370) 2,000 (1,720 – 3,120) 208 Males 972 1,010 (970 – 1,050) 671 (640 – 701) Total, 6 years and older (925 – 999) 1,570 (1,510 – 1,610) 883 989 6–11 years 786 (762 – 811) 622 (598 – 643) 763 (745 – 802) (962 – 1,060) 145 12–19 years 748 591 (573 – 603) 733 (690 – 775) 978 (930 – 1,060) 313 (718 – 778) 1,040 753 (703 – 772) 990 (967 – 1,020) 1,590 (1,460 – 1,700) 198 20–39 years (1,010 – 1,080) 1,270 (1,190 – 1,350) 863 (814 – 908) 1,260 40–59 years 1,670 (1,610 – 2,030) 122 (1,140 – 1,350) 60 years and older (1,140 – 1,390) 845† (650 – 931) 1,240 1,260 1,970† (1,570 – 3,130) 105 (1,100 – 1,340) Females Total, 6 years and older 1,010 (984 – 1,030) 670 (649 – 696) 985 (949 – 1,020) 1,610 (1,530 – 1,670) 961 6–11 years 800 625 (514 – 658) 787 (760 – 799) 1,050 (958 – 1,240) 150 (763 – 838) 12–19 years (750 – 798) 583 (570 – 597) 763 (748 – 784) 1,020 (960 – 1,090) 333 774 20–39 years 1,000 (955 – 1,050) 700 (634 – 742) 1,000 (947 – 1,060) 1,490 (1,340 – 1,650) 251 40–59 years 1,210 (1,170 – 1,260) 808 (778 – 859) 1,200 (1,110 – 1,240) 1,840 (1,710 – 2,100) 124 (1,240 – 1,540) 2,040† (1,720 – 4,610) (1,300 – 1,610) 1,410 103 1,000† 60 years and older 1,450 (872 – 1,090) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 118 118

130 Table 2.4.a.4. Serum vitamin E: Non-Hispanic blacks Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic blacks in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 90th 10th Males and Females (915 – 951) 644 (630 – 656) Total, 6 years and older (884 – 918) 1,400 (1,360 – 1,470) 1,891 933 903 771 587 (550 – 634) 762 (743 – 801) 1,010 (941 – 1,090) 240 6–11 years (735 – 800) 731 (715 – 748) 575 (551 – 591) 727 (717 – 736) 945 (913 – 990) 665 12–19 years 926 20–39 years (620 – 686) 893 (865 – 933) 1,340 (1,250 – 1,450) 368 (896 – 957) 665 1,040 736 (688 – 779) 1,010 (998 – 1,050) 1,540 (1,420 – 1,670) 335 40–59 years (1,010 – 1,070) 1,110 (1,060 – 1,160) 752 (709 – 791) 1,080 (993 – 1,150) 1,680 (1,560 – 1,780) 283 60 years and older Males (870 – 895) (897 – 933) 636 (618 – 651) 882 915 1,390 (1,310 – 1,460) 949 Total, 6 years and older (740 – 799) 768 (726 – 799) 588 (558 – 634) 752 6–11 years 1,030 (928 – 1,110) 128 12–19 years 732 582 (558 – 606) 727 (712 – 737) 940 (904 – 981) 343 (714 – 751) 937 650 (603 – 687) 896 (862 – 939) 1,400 (1,240 – 1,670) 170 20–39 years (888 – 989) 1,010 (972 – 1,050) 718 (632 – 743) 988 40–59 years 1,520 (1,390 – 1,640) 156 (960 – 1,020) 60 years and older (1,000 – 1,100) 726 (580 – 770) 1,050 (894 – 1,080) 1,680 (1,410 – 2,250) 152 980 Females Total, 6 years and older 949 651 (638 – 673) 916 (897 – 944) 1,450 (1,350 – 1,560) 942 (923 – 976) 6–11 years (735 – 817) 579 (400 – 643) 776 (746 – 803) 1,000 (931 – 1,140) 112 775 12–19 years 731 (706 – 757) 567 (517 – 596) 726 (712 – 750) 957 (906 – 1,050) 322 20–39 years 917 (893 – 941) 677 (613 – 704) 892 (862 – 925) 1,270 (1,190 – 1,490) 198 179 40–59 years 1,070 (1,030 – 1,110) 761 (707 – 808) 1,040 (1,000 – 1,110) 1,540 (1,400 – 1,740) 1,670 131 (1,560 – 1,770) 60 years and older 1,150 (1,080 – 1,230) 774 (650 – 848) 1,130 (1,040 – 1,230) Table 2.4.a.5. Serum vitamin E: Non-Hispanic whites Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic whites in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 10th 50th 90th Males and Females 1,140 (1,110 – 1,160) 718 Total, 6 years and older 1,110 (1,080 – 1,140) 1,870 (1,810 – 1,940) 2,973 (706 – 729) 6–11 years (815 – 866) 627 (612 – 642) 840 (805 – 854) 1,120 (1,060 – 1,260) 231 826 12–19 years 779 (761 – 797) 579 (544 – 589) 765 (751 – 784) 1,060 (1,010 – 1,140) 499 20–39 years 1,040 711 (671 – 741) 1,030 (1,000 – 1,060) 1,550 (1,410 – 1,710) 714 (1,010 – 1,070) 40–59 years (1,220 – 1,300) 846 (817 – 866) 1,230 (1,190 – 1,260) 1,910 (1,800 – 2,100) 683 1,260 60 years and older 1,430 (1,390 – 1,480) 919 (856 – 976) 1,430 (1,390 – 1,480) 2,230 (2,170 – 2,330) 846 Males 1,080 1,100 (1,070 – 1,130) 703 (671 – 725) Total, 6 years and older (1,050 – 1,120) 1,770 (1,740 – 1,850) 1,472 (791 – 880) 6–11 years 839 (801 – 879) 629 (562 – 680) 830 112 1,080 (1,030 – 1,300) 12–19 years 757 542 (523 – 572) 754 (730 – 783) 1,060 (1,000 – 1,110) 254 (737 – 778) 1,040 687 (640 – 735) 1,030 (1,020 – 1,060) 1,590 (1,430 – 1,770) 309 20–39 years (1,020 – 1,070) 1,240 (1,200 – 1,270) 818 (769 – 865) 1,230 40–59 years 1,840 (1,750 – 2,040) 351 (1,180 – 1,260) 60 years and older (1,240 – 1,420) 862 (733 – 930) 1,300 1,330 2,100 (1,970 – 2,460) 446 (1,250 – 1,360) Females Total, 6 years and older 1,170 (1,150 – 1,200) 727 (718 – 746) 1,140 (1,100 – 1,170) 1,930 (1,870 – 2,050) 1,501 6–11 years 841 624 (597 – 656) 819 (774 – 878) 1,160 (1,050 – 1,470) 119 (792 – 892) 12–19 years (780 – 827) 601 (562 – 641) 779 (750 – 805) 1,060 (985 – 1,200) 245 803 20–39 years 1,040 (1,000 – 1,080) 720 (699 – 754) 1,020 (978 – 1,060) 1,510 (1,360 – 1,630) 405 40–59 years 1,270 (1,230 – 1,320) 862 (842 – 894) 1,240 (1,190 – 1,280) 2,000 (1,850 – 2,190) 332 (2,240 – 2,500) 400 2,320 60 years and older 1,530 (1,480 – 1,590) 985 (964 – 1,020) 1,530 (1,470 – 1,590) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 119 119

131 Table 2.4.b. Serum vitamin E: Concentrations by survey cycle Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the U.S. population, National Health and Nutrition Examination Survey, 1999–2002 and 2005–2006. n Selected percentile s (95% conf. interval) Sample Geometric mea 50th 95th 5th (95% conf. interval) size Total, 6 years and older (1,040 – 1,110) 597 (575 – 612) 1999–2000 (986 – 1,040) 2,350 (2,280 – 2,500) 7,054 1,070 1,010 1,110 637 (623 – 649) 1,050 (1,090 – 1,140) 2,380 (2,260 – 2,520) 7,935 2001–2002 (1,010 – 1,090) 1,090 (1,070 – 1,120) 631 (620 – 642) 1,060 (1,030 – 1,080) 2,090 (2,010 – 2,180) 7,254 2005–2006 Age group 3–5 years (752 – 820) (514 – 585) 772 (734 – 829) 1,160 (1,120 – 1,400) 347 785 559 1999–2000 2001–2002 577 (553 – 601) 796 (760 – 824) 1,200 (1,090 – 1,670) 430 814 (780 – 850) 6–11 years 783 545 (519 – 557) 781 (749 – 824) 1,130 (1,090 – 1,210) 859 (754 – 814) 1999–2000 1,140 (788 – 821) 576 (560 – 591) 798 (780 – 819) 2001–2002 (1,090 – 1,220) 1,014 804 2005–2006 820 (800 – 841) 583 (563 – 601) 806 (788 – 826) 1,200 (1,120 – 1,370) 860 12–19 years 1999–2000 (717 – 756) 513 (491 – 530) 729 (712 – 744) 1,100 (1,020 – 1,240) 2,108 736 782 (761 – 786) 550 (540 – 559) 771 2001–2002 1,170 (1,110 – 1,280) 2,206 (768 – 796) (749 – 767) 2005–2006 527 (516 – 541) 759 (757 – 783) 1,160 (1,130 – 1,200) 1,954 770 20–39 years 1999–2000 973 (952 – 995) 615 (590 – 630) 938 (911 – 972) 1,750 (1,640 – 1,860) 1,452 2001–2002 (987 – 1,030) 646 (627 – 661) 979 (960 – 1,000) 1,720 (1,620 – 1,880) 1,716 1,010 2005–2006 1,020 (998 – 1,040) 645 (621 – 668) 1,000 (980 – 1,020) 1,730 (1,620 – 1,900) 1,688 40–59 years 1,181 1,300 (1,250 – 1,360) 753 1999–2000 1,230 (1,200 – 1,280) 2,670 (2,470 – 2,940) (716 – 791) 1,474 2001–2002 1,310 (1,270 – 1,340) 776 (751 – 793) 1,260 (1,220 – 1,300) 2,530 (2,380 – 3,030) (1,190 – 1,260) (2,080 – 2,400) 2,210 1,200 (724 – 769) (1,160 – 1,240) 1,365 2005–2006 1,230 749 60 years and older 1999–2000 (1,470 – 1,560) 788 (749 – 825) 1,450 (1,390 – 1,510) 3,020 (2,920 – 3,290) 1,454 1,510 1,540 3,290 830 (763 – 869) 1,500 (1,440 – 1,550) 2001–2002 (3,030 – 3,540) 1,525 (1,490 – 1,590) 2,600 1,400 783 (733 – 835) 1,390 (1,330 – 1,430) 2005–2006 (2,510 – 2,660) 1,387 (1,360 – 1,440) Gender (6 years and older) Males 1999–2000 1,050 (1,010 – 1,090) 580 (557 – 604) 993 (976 – 1,020) 2,280 (2,130 – 2,470) 3,426 2001–2002 1,090 623 (607 – 646) 1,030 (986 – 1,080) 2,300 (2,160 – 2,470) 3,841 (1,060 – 1,130) (1,010 – 1,070) 2005–2006 610 (594 – 625) 1,030 (1,040 – 1,090) 2,010 (1,930 – 2,090) 3,547 1,060 Females 1999–2000 1,100 (1,070 – 1,140) 605 (580 – 627) 1,030 (990 – 1,070) 2,450 (2,300 – 2,690) 3,628 1,060 2001–2002 (1,110 – 1,150) 646 (629 – 660) 1,130 (1,040 – 1,100) 2,480 (2,280 – 2,700) 4,094 1,080 2005–2006 1,120 (1,090 – 1,140) (639 – 664) 653 (1,050 – 1,100) 2,170 (2,080 – 2,260) 3,707 Race/ethnicity (6 years and older) Mexican Americans (895 – 947) 572 (558 – 587) 918 (932 – 994) 1,810 (1,740 – 2,010) 2,410 1999–2000 962 994 (954 – 1,040) 606 (584 – 625) 949 2001–2002 1,810 (1,690 – 2,080) 1,991 (917 – 979) 2005–2006 (980 – 1,040) 623 (602 – 637) 976 1,010 1,790 (1,750 – 1,870) 1,844 (945 – 1,000) Non-Hispanic Blacks 1999–2000 904 (869 – 941) 566 (539 – 580) 869 (835 – 910) 1,700 (1,620 – 1,910) 1,584 2001–2002 930 601 (573 – 617) 897 (883 – 915) 1,690 (1,540 – 1,940) 1,864 (907 – 953) 2005–2006 (915 – 951) 588 (581 – 601) 903 (884 – 918) 1,660 (1,560 – 1,750) 1,891 933 Non-Hispanic Whites 1999–2000 (1,100 – 1,170) 618 (600 – 634) 1,060 (1,040 – 1,100) 2,540 (2,380 – 2,720) 2,414 1,130 3,455 1,160 (1,130 – 1,200) 653 (626 – 674) 1,110 (1,060 – 1,150) 2,510 (2,380 – 2,690) 2001–2002 (2,090 – 2,270) 2,973 643 (1,080 – 1,140) (624 – 658) 2,170 1,110 2005–2006 1,140 (1,110 – 1,160) nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 120 120

132 cle ations by sur ncentr Co ve y cy . Serum vitamin E: Figure 2.4.b Selected percentiles in μg/dL (95% con dence intervals), National Health and fi Nutrition Examination Survey, 1999–2002 and 2005–2006 3000 2500 2000 95th Percentile 1500 1000 1200 1000 800 50th Percentile 600 800 700 600 5th Percentile 500 400 99−00 01−02 05−06 05−06 05−06 01−02 99−00 01−02 99−00 99−00 05−06 99−00 01−02 99−00 01−02 05−06 05−06 01−02 99−00 99−00 01−02 01−02 05−06 05−06 01−02 99−00 01−02 99−00 05−06 05−06 Males NHB MA Total Females NHW 20+y 12−19y 6−11y 3−5y (6+y) (6+y) (6+y) (6+y) (6+y) (6+y) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 121 121

133 Table 2.4.c. Serum vitamin E: Prevalence Prevalence (in percent) of low serum vitamin E concentration (< 500 μg/dL) for the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Sample Estimated total Prevalenc e (95% conf. interval) size number of persons 7,254 1,835,000 0.7 (0.5 – 0.9) Total, 6 years and older Age group 6–11 years 860 0.9‡ (0.4 – 2.0) 221,000‡ 12–19 years 1,954 2.6 (1.6 – 4.3) 885,000 § 1,688 20–39 years § 1,365 237,000‡ (0.1 – 0.6) 0.3‡ 40–59 years 209,000 1,387 0.4 (0.3 – 0.7) 60 years and older Gender 1,110,000 Males 3,547 0.9 (0.6 – 1.2) Females 725,000 (0.3 – 0.8) 3,707 0.5 Race/ethnicity Mexican Americans 1,844 § § 396,000 (0.9 – 1.7) Non-Hispanic Blacks 1,891 1.2 Non-Hispanic Whites (0.4 – 0.8) 2,973 1,059,000 0.6 ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. § Estimate suppressed: RSE ≥ 40% for the prevalence estimate. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 122 122

134 Table 2.4.d. Serum vitamin E: Prevalence by survey cycle Prevalence (in percent) of low serum vitamin E concentration (< 500 μg/dL) for the U.S. population, National Health and Nutrition Examination Survey, 1999–2002 and 2005–2006. Prevalence (95% conf. interval) Estimated total number of persons Sample size Total, 6 years and older 1.0 1999–2000 2,558,000 7,054 (0.7 – 1.6) 7,935 0.4 (0.3 – 0.6) 1,108,000 2001–2002 7,254 0.7 (0.5 – 0.9) 1,835,000 2005–2006 Age group 3–5 years § § 347 1999–2000 2001–2002 § § 430 6–11 years 859 2.0‡ (1.0 – 4.1) 492,000‡ 1999–2000 1,014 § § 2001–2002 2005–2006 860 0.9‡ (0.4 – 2.0) 221,000‡ 12–19 years 1999–2000 3.8 (2.1 – 6.8) 1,202,000 2,108 2,206 (1.0 – 2.6) 2001–2002 509,000 1.6 2005–2006 2.6 (1.6 – 4.3) 885,000 1,954 20–39 years 1999–2000 1,452 0.9‡ (0.5 – 1.8) 730,000‡ 2001–2002 § § 1,716 2005–2006 1,688 § § 40–59 years 1999–2000 1,181 0.1‡ (0.1 – 0.2) 80,000‡ 2001–2002 1,474 § § 237,000‡ 2005–2006 1,365 0.3‡ (0.1 – 0.6) 60 years and older 1999–2000 § § 1,454 2001–2002 1,525 § § 0.4 209,000 1,387 2005–2006 (0.3 – 0.7) Gender (6 years and older) Males 3,426 1.4 (0.8 – 2.3) 1,660,000 1999–2000 3,841 0.6 (0.4 – 1.0) 781,000 2001–2002 3,547 2005–2006 (0.6 – 1.2) 1,110,000 0.9 Females 1999–2000 0.7 (0.4 – 1.1) 895,000 3,628 4,094 0.2 (0.1 – 0.5) 325,000 2001–2002 725,000 (0.3 – 0.8) 0.5 3,707 2005–2006 Race/ethnicity (6 years and older) Mexican Americans 1999–2000 2,410 (0.9 – 1.8) 227,000 1.3 1,991 (0.4 – 1.5) 156,000‡ 2001–2002 0.7‡ 1,844 § 2005–2006 § Non-Hispanic Blacks 1999–2000 1,584 1.7 (0.9 – 3.2) 520,000 2001–2002 1,864 0.7 (0.4 – 1.1) 207,000 2005–2006 1.2 (0.9 – 1.7) 396,000 1,891 Non-Hispanic Whites 1999–2000 2,414 0.8 (0.5 – 1.3) 1,491,000 2001–2002 3,455 0.3 (0.2 – 0.5) 556,000 (0.4 – 0.8) 1,059,000 2005–2006 2,973 0.6 ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. § Estimate suppressed: RSE ≥ 40% for the prevalence estimate. 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 123 123

135 858 size 1,841 7,217 3,528 1,865 1,942 3,689 2,965 1,675 1,358 1,384 Sample (463 – 585) (464 – 519) (367 – 455) (478 – 564) (457 – 550) (344 – 413) (444 – 497) (454 – 531) (447 – 553) (492 – 604) (461 – 539) 97.5th 489 504 505 392 509 376 464 485 489 545 486 (408 – 446) (411 – 471) (390 – 503) (333 – 390) (408 – 488) (311 – 343) (400 – 441) (407 – 445) (401 – 460) (437 – 498) (403 – 462) 95th 424 434 353 437 429 324 419 423 423 452 422 (95% conf. interval) s (187 – 204) (195 – 222) (169 – 193) (189 – 206) (204 – 235) (175 – 194) (183 – 203) (179 – 200) (192 – 209) (203 – 221) (161 – 192) 50th 196 198 179 209 219 184 194 190 200 213 176 Selected percentile (62.9 – 75.4) (71.3 – 99.2) (84.0 – 102) (62.4 – 80.8) (67.4 – 106) (79.8 – 93.8) (60.1 – 73.5) (57.4 – 72.3) (75.3 – 93.8) (56.1 – 80.0) (49.7 – 57.5) 5th 70.4 74.5 93.8 91.5 92.0 89.0 67.7 65.1 81.9 69.0 52.4 (49.6 – 59.9) (48.6 – 63.3) (64.2 – 86.3) (55.2 – 85.2) (52.2 – 85.5) (62.0 – 81.8) (49.4 – 58.5) (46.7 – 55.0) (50.6 – 76.7) (46.5 – 61.2) (41.4 – 49.8) 2.5th 53.5 80.4 68.1 54.9 70.6 75.5 52.4 51.2 65.4 53.0 45.1 n (180 – 196) (192 – 217) (171 – 193) (184 – 200) (198 – 231) (171 – 188) (175 – 194) (173 – 191) (184 – 205) (192 – 212) (154 – 177) 188 182 204 192 214 179 184 182 194 201 165 (95% conf. interval) Geometric mea 6–11 years Race/ethnicity Total, 6 years and older Males Gender Age group Mexican Americans Non-Hispanic Blacks 12–19 years Females Non-Hispanic Whites 20–39 years 40–59 years 60 years and older Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Table 2.5.a.1. Serum gamma-tocopherol: Concentrations nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 124 124

136 ations by age group opherol: Concentr Figure 2.5.a. Serum gamma−toc dence interval), National Health and Nutrition Examination Survey, 2005–2006 fi Geometric mean (95% con Overall Mexican Americans Females Males (μg/dL) 0100200300 Serum gamma−tocopherol 6−1112−1920−3940−5960+ 6−1112−1920−3940−5960+ Non−Hispanic Blacks Non−Hispanic Whites (μg/dL) 00200300 01 Serum gamma−tocopherol 6−1112−1920−3940−5960+ 6−1112−1920−3940−5960+ Males Females Mexican Americans Non−Hispanic Blacks Non−Hispanic (μg/dL) Whites 0100200300 Serum gamma−tocopherol 6−1112−1920−3940−5960+ 6−1112−1920−3940−5960+ Age (years) Age (years) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 125 125

137 Table 2.5.a.2. Serum gamma-tocopherol: Total population Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 90th 10th Males and Females (180 – 196) 93.2 (86.8 – 98.0) Total, 6 years and older (187 – 204) 361 (347 – 385) 7,217 188 196 182 106 (102 – 111) 179 (171 – 193) 311 (298 – 341) 858 6–11 years (169 – 193) 179 (171 – 188) 106 (98.1 – 114) 184 (175 – 194) 288 (276 – 304) 1,942 12–19 years 194 20–39 years (94.7 – 114) 200 (192 – 209) 353 (330 – 393) 1,675 (184 – 205) 106 201 95.2 (84.4 – 102) 213 (203 – 221) 400 (376 – 423) 1,358 40–59 years (192 – 212) 165 (154 – 177) 68.6 (60.9 – 73.4) 176 (161 – 192) 358 (340 – 397) 1,384 60 years and older Males (189 – 206) (184 – 200) 98.7 (89.3 – 107) 198 192 359 (349 – 389) 3,528 Total, 6 years and older (166 – 189) 177 (163 – 189) 105 (94.0 – 109) 176 6–11 years 304 (276 – 349) 425 12–19 years 173 103 (89.6 – 114) 177 (168 – 188) 284 (266 – 306) 974 (162 – 184) 202 113 (105 – 119) 203 (194 – 215) 386 (349 – 414) 732 20–39 years (193 – 211) 207 (194 – 221) 99.0 (86.0 – 113) 215 40–59 years 403 (365 – 442) 669 (202 – 230) 60 years and older (157 – 185) 73.7 (66.9 – 77.2) 171 (159 – 204) 354 (336 – 396) 728 184 Females Total, 6 years and older 184 88.2 (80.0 – 93.8) 194 (183 – 203) 362 (338 – 388) 3,689 (175 – 194) 6–11 years (174 – 201) 110 (93.6 – 122) 183 (169 – 199) 323 (299 – 346) 433 187 12–19 years 187 (177 – 197) 110 (101 – 119) 191 (184 – 201) 292 (274 – 313) 968 20–39 years 187 (173 – 202) 97.2 (79.9 – 110) 196 (180 – 207) 331 (312 – 383) 943 689 40–59 years 197 (186 – 208) 90.5 (75.5 – 99.0) 207 (195 – 223) 398 (377 – 423) (53.9 – 72.6) (328 – 405) (155 – 188) 168 63.9 375 656 60 years and older 161 (148 – 175) Table 2.5.a.3. Serum gamma-tocopherol: Mexican Americans Geometric mean and selected percentiles of serum concentrations (in μg/dL) for Mexican Americans in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 10th 50th 90th Males and Females 204 (192 – 217) 113 Total, 6 years and older 209 (195 – 222) 363 (343 – 403) 1,841 (106 – 117) 6–11 years (178 – 221) 114 (91.6 – 122) 199 (181 – 234) 323 (303 – 388) 293 202 12–19 years 189 (179 – 200) 115 (106 – 124) 197 (183 – 207) 292 (279 – 316) 645 20–39 years 203 111 (107 – 116) 209 (190 – 223) 366 (333 – 429) 449 (190 – 217) 40–59 years (202 – 237) 114 (91.7 – 125) 226 (213 – 240) 410 (357 – 478) 246 218 60 years and older 210 (196 – 225) 99.7 (90.1 – 117) 211 (194 – 224) 406 (365 – 464) 208 Males 210 206 (196 – 216) 114 (109 – 118) Total, 6 years and older (193 – 224) 363 (339 – 417) 881 329 6–11 years 196 (175 – 219) 116 (90.6 – 128) 189 (171 – 221) (290 – 448) 143 12–19 years 180 109 (97.9 – 115) 187 (166 – 208) 282 (264 – 310) 313 (169 – 191) 207 112 (107 – 118) 216 (191 – 228) 375 (316 – 522) 198 20–39 years (195 – 221) 226 (199 – 256) 118 (96.4 – 141) 227 40–59 years 376 (345 – 582) 122 (201 – 265) 60 years and older (187 – 242) 100† (83.3 – 119) 205 213 412† (353 – 496) 105 (182 – 266) Females Total, 6 years and older 202 (185 – 220) 112 (96.2 – 120) 207 (194 – 221) 363 (334 – 407) 960 6–11 years 201 113 (80.8 – 128) 219 (172 – 262) 322 (303 – 373) 150 (171 – 237) 12–19 years (187 – 213) 128 (113 – 137) 202 (191 – 212) 308 (286 – 375) 332 199 20–39 years 197 (177 – 219) 109 (93.8 – 118) 202 (180 – 219) 362 (315 – 443) 251 40–59 years 211 (187 – 237) 103 (61.5 – 121) 223 (184 – 259) 423 (351 – 515) 124 (192 – 224) 398† (315 – 506) (188 – 229) 213 103 98.8† 60 years and older 208 (85.1 – 120) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 126 126

138 Table 2.5.a.4. Serum gamma-tocopherol: Non-Hispanic blacks Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic blacks in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 90th 10th Males and Females (198 – 231) 119 (98.4 – 135) Total, 6 years and older (204 – 235) 383 (357 – 407) 1,865 214 219 198 128 (96.7 – 141) 198 (183 – 214) 317 (291 – 360) 240 6–11 years (189 – 210) 197 (180 – 215) 126 (105 – 142) 198 (180 – 215) 308 (279 – 338) 654 12–19 years 213 20–39 years (93.5 – 137) 216 (202 – 231) 379 (334 – 420) 359 (196 – 231) 114 221 115 (72.3 – 140) 233 (208 – 254) 404 (378 – 476) 331 40–59 years (198 – 247) 231 (204 – 261) 109 (60.6 – 139) 255 (216 – 286) 413 (392 – 466) 281 60 years and older Males (195 – 225) (192 – 227) 120 (102 – 136) 210 209 362 (335 – 402) 935 Total, 6 years and older (171 – 213) 191 (182 – 205) 116 (69.0 – 142) 193 6–11 years 297 (263 – 360) 128 12–19 years 192 127 (111 – 141) 187 (170 – 208) 302 (278 – 335) 337 (176 – 210) 218 119 (101 – 136) 220 (195 – 240) 386 (326 – 500) 166 20–39 years (197 – 241) 209 (182 – 241) 109 (71.2 – 141) 213 40–59 years 401 (311 – 526) 153 (187 – 239) 60 years and older (193 – 259) 122 (53.9 – 147) 223 (202 – 276) 393 (341 – 498) 151 234 Females Total, 6 years and older 218 116 (93.3 – 134) 228 (213 – 242) 396 (375 – 410) 930 (203 – 234) 6–11 years (191 – 221) 131 (99.5 – 143) 204 (189 – 229) 327 (292 – 433) 112 205 12–19 years 202 (183 – 223) 123 (98.5 – 147) 205 (195 – 218) 314 (279 – 354) 317 20–39 years 209 (188 – 231) 110 (81.8 – 141) 213 (195 – 236) 377 (329 – 426) 193 178 40–59 years 231 (210 – 255) 116 (72.3 – 134) 249 (217 – 285) 404 (399 – 443) 448 130 (393 – 505) 60 years and older 236 (207 – 270) 103 (54.5 – 145) 261 (219 – 299) Table 2.5.a.5. Serum gamma-tocopherol: Non-Hispanic whites Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic whites in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 10th 50th 90th Males and Females 182 (173 – 191) 86.4 Total, 6 years and older 190 (179 – 200) 356 (340 – 387) 2,965 (79.6 – 92.0) 6–11 years (159 – 192) 105 (99.7 – 109) 175 (157 – 191) 304 (272 – 349) 231 170 12–19 years 174 (165 – 184) 102 (90.8 – 108) 179 (171 – 188) 284 (274 – 301) 499 20–39 years 191 105 (83.6 – 116) 196 (183 – 207) 349 (320 – 401) 710 (178 – 205) 40–59 years (184 – 207) 91.6 (80.3 – 97.8) 207 (195 – 220) 396 (368 – 424) 680 196 60 years and older 158 (148 – 169) 65.9 (59.4 – 72.1) 168 (154 – 183) 353 (326 – 392) 845 Males 194 187 (178 – 197) 94.7 (81.7 – 104) Total, 6 years and older (184 – 204) 355 (344 – 388) 1,469 (150 – 192) 6–11 years 174 (153 – 197) 105 (82.6 – 111) 170 112 307 (269 – 378) 12–19 years 167 95.0 (76.7 – 113) 173 (163 – 181) 280 (250 – 314) 254 (155 – 180) 200 117 (105 – 126) 201 (188 – 212) 370 (346 – 414) 307 20–39 years (190 – 210) 201 (185 – 218) 95.5 (80.3 – 106) 214 40–59 years 398 (350 – 448) 350 (195 – 230) 60 years and older (151 – 180) 71.6 (62.2 – 76.5) 177 165 351 (331 – 380) 446 (150 – 199) Females Total, 6 years and older 177 (167 – 188) 79.9 (73.8 – 87.5) 186 (173 – 197) 359 (324 – 391) 1,496 6–11 years 177 104 (86.4 – 114) 171 (155 – 197) 300 (260 – 349) 119 (160 – 195) 12–19 years (171 – 195) 103 (89.6 – 118) 187 (175 – 200) 289 (270 – 312) 245 182 20–39 years 183 (163 – 204) 92.8 (71.4 – 110) 191 (169 – 210) 323 (296 – 403) 403 40–59 years 190 (178 – 204) 83.6 (68.1 – 98.3) 203 (186 – 217) 392 (373 – 427) 330 (319 – 400) 399 357 60 years and older 153 (141 – 165) 61.1 (53.5 – 69.6) 161 (148 – 174) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 127 127

139 Table 2.5.b. Serum gamma-tocopherol: Concentrations by survey cycle Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the U.S. population, National Health and Nutrition Examination Survey, 1999–2002 and 2005–2006. n Selected percentile s (95% conf. interval) Sample Geometric mea 50th 95th 5th (95% conf. interval) size Total, 6 years and older (184 – 216) 65.1 (58.2 – 71.7) 1999–2000 (197 – 230) 464 (432 – 529) 6,129 199 215 199 67.1 (59.4 – 73.8) 212 (191 – 207) 461 (436 – 485) 7,879 2001–2002 (204 – 220) 188 (180 – 196) 70.4 (62.9 – 75.4) 196 (187 – 204) 424 (408 – 446) 7,217 2005–2006 Age group 3–5 years (140 – 206) (16.2 – 90.8) 180 (158 – 200) 363 (308 – 455) 301 170 50.0 1999–2000 2001–2002 63.3 (52.2 – 82.2) 194 (178 – 205) 365 (342 – 430) 429 181 (170 – 193) 6–11 years 202 93.3 (72.3 – 107) 213 (184 – 231) 407 (356 – 569) 725 (183 – 223) 1999–2000 380 (203 – 219) 102 (95.4 – 109) 218 (211 – 227) 2001–2002 (361 – 414) 1,005 211 2005–2006 182 (171 – 193) 91.5 (71.3 – 99.2) 179 (169 – 193) 353 (333 – 390) 858 12–19 years 1999–2000 (183 – 211) 99.0 (80.4 – 112) 198 (186 – 214) 372 (363 – 389) 1,821 197 197 (191 – 209) 99.4 (90.2 – 107) 201 2001–2002 368 (346 – 391) 2,188 (190 – 205) (175 – 194) 2005–2006 89.0 (79.8 – 93.8) 184 (171 – 188) 324 (311 – 343) 1,942 179 20–39 years 1999–2000 205 (189 – 222) 75.6 (60.5 – 87.3) 220 (199 – 237) 438 (414 – 477) 1,299 2001–2002 (197 – 216) 85.6 (73.5 – 95.3) 217 (205 – 227) 445 (425 – 474) 1,706 206 2005–2006 194 (184 – 205) 81.9 (75.3 – 93.8) 200 (192 – 209) 423 (401 – 460) 1,675 40–59 years 1,028 208 (185 – 232) 59.8 1999–2000 231 (204 – 253) 549 (507 – 631) (51.9 – 70.0) 1,463 2001–2002 204 (192 – 217) 60.4 (52.2 – 68.3) 221 (208 – 238) 507 (463 – 576) (192 – 212) (437 – 498) 452 213 (56.1 – 80.0) (203 – 221) 1,358 2005–2006 201 69.0 60 years and older 1999–2000 (160 – 197) 47.6 (42.9 – 54.4) 196 (171 – 216) 496 (443 – 573) 1,256 178 172 497 48.2 (43.8 – 52.0) 185 (170 – 201) 2001–2002 (469 – 534) 1,517 (162 – 184) 422 165 52.4 (49.7 – 57.5) 176 (161 – 192) 2005–2006 (403 – 462) 1,384 (154 – 177) Gender (6 years and older) Males 1999–2000 199 (184 – 217) 65.3 (55.9 – 74.7) 213 (197 – 230) 462 (426 – 532) 2,974 2001–2002 202 66.5 (56.0 – 77.1) 213 (207 – 222) 472 (445 – 499) 3,815 (193 – 211) (189 – 206) 2005–2006 74.5 (62.4 – 80.8) 198 (184 – 200) 434 (411 – 471) 3,528 192 Females 1999–2000 200 (184 – 217) 64.8 (57.6 – 71.8) 217 (196 – 232) 468 (433 – 536) 3,155 210 2001–2002 (187 – 205) 67.6 (60.6 – 74.7) 196 (200 – 220) 447 (420 – 483) 4,064 194 2005–2006 184 (175 – 194) (60.1 – 73.5) 67.7 (183 – 203) 419 (400 – 441) 3,689 Race/ethnicity (6 years and older) Mexican Americans (213 – 236) 104 (89.1 – 113) 225 (210 – 235) 468 (414 – 504) 1,772 1999–2000 222 198 (190 – 206) 89.8 (80.5 – 92.6) 203 2001–2002 422 (390 – 458) 1,987 (190 – 214) 2005–2006 (192 – 217) 93.8 (84.0 – 102) 209 204 437 (390 – 503) 1,841 (195 – 222) Non-Hispanic Blacks 1999–2000 213 (200 – 226) 94.5 (73.1 – 104) 217 (201 – 238) 437 (417 – 473) 1,515 2001–2002 235 107 (83.5 – 118) 248 (233 – 261) 450 (426 – 478) 1,843 (222 – 248) 2005–2006 (198 – 231) 92.0 (67.4 – 106) 219 (204 – 235) 429 (408 – 488) 1,865 214 Non-Hispanic Whites 1999–2000 (179 – 219) 61.3 (52.8 – 70.1) 217 (192 – 234) 477 (439 – 542) 2,240 198 3,426 193 (183 – 205) 60.4 (51.4 – 68.0) 209 (198 – 220) 472 (442 – 495) 2001–2002 (407 – 445) 2,965 65.1 (179 – 200) (57.4 – 72.3) 423 190 2005–2006 182 (173 – 191) nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 128 128

140 opherol: Concentr ations by sur . Serum gamma−toc Figure 2.5.b ve cle y cy dence intervals), National Health and Selected percentiles in μg/dL (95% con fi Nutrition Examination Survey, 1999–2002 and 2005–2006 600 500 400 95th Percentile 300 300 250 200 50th Percentile 150 150 100 50 5th Percentile 0 99−00 01−02 05−06 99−00 01−02 05−06 05−06 99−00 01−02 01−02 99−00 05−06 99−00 99−00 01−02 99−00 01−02 05−06 05−06 01−02 05−06 01−02 99−00 05−06 05−06 05−06 01−02 99−00 01−02 99−00 Males NHB MA Total Females NHW 20+y 12−19y 6−11y 3−5y (6+y) (6+y) (6+y) (6+y) (6+y) (6+y) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 129 129

141 860 size 7,246 2,966 3,544 1,844 1,950 3,702 1,890 1,684 1,365 1,387 Sample (17.6 – 23.7) (18.1 – 24.2) (11.6 – 34.7) (13.2 – 20.9) (13.9 – 16.6) (8.96 – 15.2) (19.4 – 30.0) (12.4 – 33.1) (12.7 – 23.6) (20.3 – 35.9) (19.3 – 25.9) 97.5th 19.5 20.2 15.7 16.1 14.8 10.8 23.9 15.2 16.3 27.1 21.6 (12.4 – 16.5) (12.8 – 16.7) (9.30 – 15.1) (9.92 – 13.9) (10.5 – 12.5) (6.65 – 10.2) (14.6 – 18.4) (8.83 – 14.8) (10.1 – 14.7) (14.5 – 21.9) (14.0 – 19.8) 95th 14.1 14.4 11.5 11.5 10.8 7.91 16.4 11.0 11.3 17.0 17.0 (95% conf. interval) s (2.40 – 2.84) (2.47 – 2.89) (2.31 – 2.90) (2.06 – 2.39) (2.61 – 3.21) (1.53 – 1.91) (2.74 – 3.32) (1.49 – 1.99) (2.06 – 2.69) (2.72 – 3.36) (2.86 – 3.86) 50th 2.63 2.67 2.59 2.23 2.87 1.72 3.01 1.71 2.36 3.01 3.33 Selected percentile (.749 – .889) (< LOD – .811) 5th .824 .711 < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD 2.5th < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD n (2.54 – 2.99) (2.60 – 3.02) (2.32 – 3.01) (2.20 – 2.55) (2.79 – 3.21) (1.69 – 2.03) (2.89 – 3.50) (1.74 – 2.26) (2.24 – 2.74) (2.85 – 3.47) (3.05 – 3.83) 2.76 2.80 2.64 2.37 2.99 1.85 3.18 1.98 2.48 3.15 3.42 (95% conf. interval) Geometric mea < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. Total, 6 years and older 6–11 years Age group Males Gender Race/ethnicity Mexican Americans 12–19 years Females Non-Hispanic Blacks 20–39 years Non-Hispanic Whites 40–59 years 60 years and older and Nutrition Examination Survey, 2005–2006. Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health Table 2.6.a.1. Serum alpha-carotene: Concentrations nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 130 130

142 Figure 2.6.a. Serum alpha−carotene: Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2005–2006 Overall Mexican Americans 6 Females 4 Males (μg/dL) 2 Serum alpha−carotene 0 60+ 20−39 40−59 20−39 40−59 60+ 6−11 6−11 12−19 12−19 Non−Hispanic Whites Non−Hispanic Blacks 6 4 (μg/dL) 2 Serum alpha−carotene 0 12−19 6−11 60+ 6−11 40−59 60+ 20−39 12−19 20−39 40−59 Females Males 6 Mexican 4 Americans Non−Hispanic Blacks (μg/dL) 2 Non−Hispanic Whites Serum alpha−carotene 0 60+ 6−11 20−39 40−59 12−19 6−11 12−19 20−39 40−59 60+ Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 131131

143 Table 2.6.a.2. Serum alpha-carotene: Total population Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 10th 50th 90th Males and Females 2.76 (2.54 – 2.99) .772 Total, 6 years and older 2.63 (2.40 – 2.84) 9.48 (8.58 – 10.6) 7,246 (.718 – .823) 6–11 years (2.32 – 3.01) .865 (.766 – .966) 2.64 (2.31 – 2.90) 8.34 (6.74 – 10.9) 860 2.59 12–19 years 1.85 (1.69 – 2.03) < LOD 1.72 (1.53 – 1.91) 5.55 (4.98 – 6.67) 1,950 20–39 years 2.48 .702 (< LOD – .793) 2.36 (2.06 – 2.69) 8.65 (7.55 – 9.72) 1,684 (2.24 – 2.74) 40–59 years (2.85 – 3.47) .836 (< LOD – .963) 3.01 (2.72 – 3.36) 11.8 (10.0 – 13.3) 1,365 3.15 60 years and older 3.42 (3.05 – 3.83) 1.02 (.832 – 1.17) 3.33 (2.86 – 3.86) 10.8 (9.64 – 13.1) 1,387 Males 2.23 2.37 (2.20 – 2.55) < LOD Total, 6 years and older (2.06 – 2.39) 7.74 (6.73 – 9.37) 3,544 8.27 6–11 years 2.68 (2.32 – 3.10) .885 (.780 – .985) 2.59 (2.36 – 2.91) (5.98 – 12.0) 427 12–19 years 1.60 1.40 (1.29 – 1.61) 4.51 (3.69 – 5.54) 979 (1.46 – 1.76) < LOD 2.10 < LOD 2.00 (1.79 – 2.19) 6.91 (6.14 – 7.26) 736 20–39 years (1.95 – 2.27) 2.66 (2.38 – 2.96) .711 (< LOD – .910) 2.47 (2.24 – 2.76) 8.79 (7.13 – 11.5) 673 40–59 years 9.76 3.01 .838 (.754 – .923) 3.09 (2.55 – 3.54) (2.61 – 3.46) (7.73 – 12.9) 729 60 years and older Females 3,702 3.18 (2.89 – 3.50) .895 (.807 – .983) 3.01 (2.74 – 3.32) 10.8 (9.83 – 12.3) Total, 6 years and older 6–11 years 2.60 .854 (.712 – .972) 2.59 (2.14 – 2.97) 8.39 (6.99 – 11.1) 433 (2.26 – 2.99) 12–19 years (1.98 – 2.39) .709 (< LOD – .777) 2.08 (1.89 – 2.30) 6.43 (5.53 – 7.15) 971 2.17 20–39 years 2.92 (2.51 – 3.39) .859 (< LOD – .969) 2.74 (2.41 – 3.31) 9.80 (8.53 – 11.9) 948 40–59 years 3.69 (3.25 – 4.17) .992 (.764 – 1.23) 3.54 (3.07 – 3.97) 13.7 (11.7 – 16.7) 692 3.50 (1.01 – 1.32) (2.94 – 4.36) 658 (10.2 – 15.0) 11.6 60 years and older 3.80 (3.33 – 4.32) 1.18 < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. Table 2.6.a.3. Serum alpha-carotene: Mexican Americans Geometric mean and selected percentiles of serum concentrations (in μg/dL) for Mexican Americans in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Sample Geometric mea n (95% conf. interval) size 10th 50th 90th Males and Females 2.99 (2.79 – 3.21) 1.07 Total, 6 years and older 2.87 (2.61 – 3.21) 7.96 (7.58 – 8.67) 1,844 (.952 – 1.21) 6–11 years (2.21 – 2.89) .918 (.702 – 1.14) 2.53 (2.03 – 3.00) 6.79 (5.10 – 9.28) 295 2.47 12–19 years 2.06 (1.82 – 2.33) .847 (.723 – .952) 1.89 (1.70 – 2.22) 5.19 (4.56 – 5.91) 646 20–39 years 3.09 1.22 (1.07 – 1.33) 2.88 (2.56 – 3.37) 7.74 (7.18 – 8.74) 449 (2.78 – 3.42) 40–59 years (3.31 – 4.19) 1.44 (.784 – 1.77) 3.57 (3.24 – 4.21) 10.5 (8.26 – 14.0) 246 3.72 60 years and older 3.76 (3.31 – 4.27) 1.28 (.767 – 1.60) 3.60 (3.22 – 4.31) 9.80 (8.51 – 16.0) 208 Males 2.57 2.72 (2.50 – 2.95) .997 (.890 – 1.09) Total, 6 years and older (2.22 – 3.00) 7.27 (6.99 – 7.73) 883 5.58 6–11 years 2.46 (2.16 – 2.81) .904 (< LOD – 1.25) 2.49 (1.94 – 3.20) (4.47 – 10.7) 145 12–19 years 1.92 .785 (< LOD – .874) 1.75 (1.50 – 2.05) 5.16 (3.85 – 6.20) 313 (1.68 – 2.19) 2.71 1.08 (.902 – 1.24) 2.47 (2.01 – 3.18) 7.32 (6.06 – 8.64) 198 20–39 years (2.30 – 3.20) 3.49 (2.95 – 4.13) 1.43 (< LOD – 1.76) 3.35 40–59 years 9.79 (7.00 – 15.0) 122 (2.71 – 4.08) 60 years and older (2.73 – 3.83) .939† (< LOD – 1.50) 3.18 3.23 8.07† (6.41 – 20.8) 105 (2.62 – 4.23) Females Total, 6 years and older 3.33 (3.07 – 3.61) 1.20 (1.06 – 1.30) 3.26 (2.95 – 3.50) 9.08 (8.35 – 9.84) 961 6–11 years 2.60 .923 (< LOD – 1.15) 2.43 (1.99 – 3.17) 7.44 (5.70 – 9.89) 150 (2.17 – 3.12) 12–19 years (1.95 – 2.53) .937 (.732 – 1.09) 2.08 (1.81 – 2.51) 5.21 (4.55 – 6.57) 333 2.22 20–39 years 3.61 (3.16 – 4.13) 1.47 (1.16 – 1.62) 3.45 (2.84 – 4.13) 9.06 (6.93 – 13.2) 251 40–59 years 3.99 (3.38 – 4.70) 1.39 (< LOD – 1.83) 3.82 (3.37 – 4.47) 10.6 (7.74 – 33.5) 124 (3.36 – 5.44) 1.52† (8.65 – 22.5) 9.87† 103 (3.70 – 4.93) 4.13 60 years and older 4.27 (< LOD – 2.02) < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 132 132

144 Table 2.6.a.4. Serum alpha-carotene: Non-Hispanic blacks Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic blacks in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 10th 50th 90th Males and Females 1.98 (1.74 – 2.26) Total, 6 years and older 1.71 (1.49 – 1.99) 6.99 (5.49 – 9.49) 1,890 < LOD 6–11 years (1.68 – 2.30) .782 (< LOD – .865) 1.97 (1.47 – 2.11) 4.97 (3.84 – 7.31) 240 1.73 12–19 years 1.33 (1.22 – 1.46) < LOD 1.17 (1.08 – 1.27) 3.23 (2.79 – 4.25) 664 20–39 years 1.76 < LOD 1.54 (1.27 – 1.85) 5.49 (3.81 – 10.9) 368 (1.47 – 2.10) 40–59 years (2.18 – 3.10) < LOD 2.40 (1.86 – 3.11) 9.63 (7.77 – 12.4) 335 2.60 60 years and older 2.28 (2.05 – 2.54) .727 (< LOD – .860) 2.09 (1.72 – 2.38) 7.35 (6.25 – 9.09) 283 Males 1.55 1.79 (1.56 – 2.06) < LOD Total, 6 years and older (1.30 – 1.84) 6.12 (4.82 – 7.67) 948 (.761 – 1.00) 6–11 years 2.11 (1.80 – 2.46) .934 128 1.90 (1.51 – 2.50) 5.11 (4.03 – 6.81) 12–19 years 1.28 < LOD 1.18 (1.10 – 1.27) 2.65 (2.27 – 3.64) 342 (1.17 – 1.40) 1.51 < LOD 1.26 (1.08 – 1.43) 4.23 (3.53 – 10.1) 170 20–39 years (1.27 – 1.80) 2.34 (1.84 – 2.96) < LOD 2.10 (1.65 – 3.05) 40–59 years (6.39 – 18.0) 156 8.08 60 years and older (1.78 – 2.34) < LOD 1.75 2.04 6.11 (5.37 – 7.68) 152 (1.48 – 2.32) Females Total, 6 years and older 2.17 (1.91 – 2.47) < LOD 1.91 (1.61 – 2.24) 8.09 (6.12 – 10.9) 942 (1.31 – 2.06) 4.55 (3.38 – 34.6) 112 6–11 years < LOD 1.56 1.84 (1.47 – 2.30) 12–19 years (1.24 – 1.57) < LOD 1.16 (1.01 – 1.35) 3.98 (3.08 – 4.95) 322 1.40 20–39 years 2.00 (1.63 – 2.45) < LOD 1.83 (1.46 – 2.17) 7.48 (3.92 – 14.8) 198 40–59 years 2.85 (2.40 – 3.37) .763 (< LOD – .998) 2.59 (1.91 – 3.59) 10.2 (7.96 – 12.8) 179 (5.57 – 13.9) 131 60 years and older 2.47 (2.08 – 2.94) .778 (< LOD – .932) 2.28 (1.69 – 3.06) 8.43 < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. Table 2.6.a.5. Serum alpha-carotene: Non-Hispanic whites Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic whites in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Sample Geometric mea n (95% conf. interval) size 10th 90th 50th Males and Females (2.60 – 3.02) .770 (< LOD – .835) 2.67 (2.47 – 2.89) 9.64 (8.79 – 10.7) Total, 6 years and older 2.80 2,966 2.78 .860 (.769 – .988) 2.77 (2.38 – 3.24) 8.80 (7.05 – 11.7) 231 6–11 years (2.37 – 3.15) 1.95 (1.78 – 2.13) < LOD 1.85 (1.65 – 2.02) 6.10 (5.30 – 7.19) 496 12–19 years 2.39 < LOD 20–39 years 2.31 (1.97 – 2.65) 8.10 (7.23 – 9.64) 710 (2.16 – 2.65) 3.12 .832 (< LOD – .971) 2.95 (2.63 – 3.36) 11.9 (10.1 – 13.5) 683 40–59 years (2.84 – 3.44) 3.44 (3.05 – 3.88) 1.05 (.832 – 1.24) 3.34 60 years and older 10.7 (9.59 – 12.9) 846 (2.82 – 3.89) Males 2.38 (2.20 – 2.56) < LOD Total, 6 years and older (2.08 – 2.42) 7.73 (6.50 – 9.42) 1,470 2.27 6–11 years 2.80 (2.34 – 3.35) .853 (.749 – 1.02) 2.80 (2.40 – 2.99) 8.52 (5.74 – 23.7) 112 12–19 years 1.62 (1.47 – 1.78) < LOD 1.46 (1.26 – 1.72) 4.33 (3.63 – 5.81) 254 20–39 years 2.02 < LOD 1.90 (1.65 – 2.22) 6.23 (5.68 – 7.29) 307 (1.87 – 2.18) 2.60 < LOD 2.42 (2.19 – 2.68) 8.71 (6.82 – 10.2) 351 40–59 years (2.33 – 2.90) 3.00 (2.57 – 3.49) .844 (.761 – .959) 3.09 (2.46 – 3.54) 60 years and older (7.53 – 12.8) 446 9.36 Females 3.28 (3.00 – 3.59) .920 (.790 – 1.04) Total, 6 years and older (2.82 – 3.39) 11.2 (10.4 – 12.7) 1,496 3.10 6–11 years 2.75 (2.29 – 3.31) .864 (< LOD – 1.10) 2.76 (1.93 – 3.26) 9.09 (7.10 – 12.4) 119 12–19 years (2.19 – 2.60) .723 (< LOD – .838) 2.22 (2.06 – 2.49) 6.93 (6.25 – 8.87) 242 2.39 20–39 years 2.83 (2.38 – 3.37) .826 (< LOD – .962) 2.69 (2.20 – 3.36) 9.45 (7.82 – 11.8) 403 40–59 years 3.73 (3.27 – 4.26) .964 (< LOD – 1.23) 3.57 (3.04 – 4.01) 14.4 (12.6 – 16.7) 332 (10.4 – 15.9) 12.0 400 60 years and older 3.86 (3.34 – 4.47) 1.24 (1.05 – 1.42) 3.54 (2.85 – 4.47) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 133 133

145 Table 2.6.b. Serum alpha-carotene: Concentrations by survey cycle Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the U.S. population, National Health and Nutrition Examination Survey, 2001–2002 and 2005–2006. n Selected percentile s (95% conf. interval) Sample Geometric mea 5th 50th 95th (95% conf. interval) size Total, 6 years and older (2.22 – 2.77) < LOD 2.39 2001–2002 12.2 (10.7 – 14.1) 7,929 2.48 (2.10 – 2.70) 2.76 (2.54 – 2.99) < LOD 2.63 (2.40 – 2.84) 14.1 (12.4 – 16.5) 7,246 2005–2006 Age group 3–5 years (2.13 – 2.74) < LOD 2.14 2.41 12.2 (10.3 – 14.6) 430 2001–2002 (1.89 – 2.48) 6–11 years 2.24 (2.00 – 2.51) < LOD 2.04 2001–2002 8.54 (6.94 – 13.3) 1,014 (1.84 – 2.28) 2005–2006 2.64 (2.32 – 3.01) < LOD 2.59 (2.31 – 2.90) 11.5 (9.30 – 15.1) 860 12–19 years 2001–2002 (1.52 – 1.86) < LOD 1.50 (1.37 – 1.74) 7.68 (6.61 – 9.52) 2,206 1.68 1.85 (1.69 – 2.03) < LOD 1.72 (1.53 – 1.91) 7.91 (6.65 – 10.2) 1,950 2005–2006 20–39 years 2001–2002 (1.93 – 2.56) < LOD 2.11 (1.82 – 2.49) 9.80 (8.96 – 12.6) 1,716 2.22 2005–2006 2.48 (2.24 – 2.74) < LOD 2.36 (2.06 – 2.69) 11.3 (10.1 – 14.7) 1,684 40–59 years 1,470 2001–2002 2.98 (2.60 – 3.42) < LOD 2.85 (2.47 – 3.28) 16.0 (12.8 – 20.7) < LOD 3.01 (2.85 – 3.47) 17.0 1,365 (14.5 – 21.9) (2.72 – 3.36) 2005–2006 3.15 60 years and older (2.74 – 3.46) < LOD 3.14 (2.71 – 3.61) 12.7 (12.0 – 13.7) 3.08 1,523 2001–2002 17.0 3.42 .711 (< LOD – .811) 3.33 (2.86 – 3.86) 2005–2006 (14.0 – 19.8) 1,387 (3.05 – 3.83) Gender (6 years and older) Males 2001–2002 2.22 (1.98 – 2.49) < LOD 2.07 (1.87 – 2.44) 10.3 (9.30 – 12.3) 3,835 2005–2006 (2.20 – 2.55) < LOD 2.23 (2.06 – 2.39) 11.5 (9.92 – 13.9) 3,544 2.37 Females 2001–2002 2.76 (2.47 – 3.07) < LOD 2.67 (2.35 – 2.97) 13.3 (11.8 – 16.2) 4,094 (2.74 – 3.32) 2005–2006 3.18 (2.89 – 3.50) 3.01 < LOD 16.4 (14.6 – 18.4) 3,702 Race/ethnicity (6 years and older) Mexican Americans (2.38 – 2.99) .726 (< LOD – .805) 2.63 (2.38 – 3.14) 10.1 (8.46 – 14.1) 1,990 2001–2002 2.73 2005–2006 (2.79 – 3.21) .824 (.749 – .889) 2.87 (2.61 – 3.21) 10.8 (10.5 – 12.5) 1,844 2.99 Non-Hispanic Blacks 2001–2002 1.77 (1.50 – 2.09) < LOD 1.58 (1.36 – 1.91) 10.1 (7.64 – 14.5) 1,864 2005–2006 (1.74 – 2.26) < LOD 1.71 (1.49 – 1.99) 11.0 (8.83 – 14.8) 1,890 1.98 Non-Hispanic Whites 2001–2002 2.57 (2.25 – 2.95) < LOD 2.48 (2.11 – 2.86) 12.8 (11.2 – 15.5) 3,450 14.4 (12.8 – 16.7) 2.67 2,966 (2.60 – 3.02) 2.80 (2.47 – 2.89) 2005–2006 < LOD < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 134 134

146 cle y cy ve ations by sur Figure 2.6.b. Serum alpha−carotene: Concentr dence intervals), National Health and fi Selected percentiles in μg/dL (95% con Nutrition Examination Survey, 2001–2002 and 2005–2006 20 15 10 95th Percentile 5 3.5 3.0 2.5 2.0 50th Percentile 1.5 1.0 0.90 0.85 0.80 5th Percentile 0.75 05−06 01−02 05−06 01−02 05−06 01−02 01−02 01−02 05−06 05−06 01−02 01−02 05−06 05−06 01−02 05−06 05−06 01−02 01−02 05−06 NHB MA Females NHW 20+y Total 12−19y 6−11y 3−5y Males (6+y) (6+y) (6+y) (6+y) (6+y) (6+y) fi Values in the graph are suppressed if either the point estimate or the lower 95% con dence limit is noted as “< LOD” in the accompanying table. 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 135 135

147 860 size 7,254 1,844 3,547 1,891 1,954 3,707 2,973 1,688 1,365 1,387 Sample (68.1 – 83.3) (46.2 – 59.4) (39.6 – 100) (49.4 – 66.2) (51.4 – 73.5) (31.3 – 41.8) (75.9 – 102) (72.3 – 93.3) (48.7 – 85.1) (73.3 – 97.9) (85.9 – 143) 97.5th 102 74.1 48.6 47.6 54.3 57.4 35.3 84.7 76.2 59.5 79.2 (49.1 – 59.3) (29.9 – 49.2) (36.8 – 46.4) (35.1 – 46.5) (38.3 – 53.7) (26.3 – 30.7) (58.3 – 73.6) (50.4 – 64.9) (36.9 – 53.3) (53.5 – 73.8) (66.3 – 83.4) 95th 53.3 37.7 40.8 39.2 45.0 28.3 64.5 56.9 41.6 63.0 74.6 (95% conf. interval) s (11.1 – 12.3) (11.8 – 13.6) (9.62 – 10.9) (10.4 – 12.4) (9.31 – 11.4) (8.30 – 9.66) (12.0 – 14.4) (11.2 – 12.6) (9.14 – 10.9) (11.6 – 13.4) (14.5 – 17.8) 50th 11.6 12.7 10.3 11.3 10.5 8.96 13.2 11.8 9.97 12.4 15.9 Selected percentile (2.92 – 3.42) (4.11 – 5.61) (2.28 – 3.06) (3.15 – 3.86) (2.57 – 3.36) (2.87 – 3.52) (3.51 – 4.05) (2.80 – 3.41) (2.79 – 3.23) (2.15 – 3.41) (3.43 – 4.17) 5th 3.18 5.15 2.77 3.49 3.02 3.20 3.77 3.06 3.01 2.69 3.90 (1.98 – 2.67) (2.67 – 5.05) (1.40 – 2.25) (2.19 – 3.06) (2.00 – 2.54) (2.05 – 2.96) (2.45 – 3.23) (1.90 – 2.65) (1.40 – 2.81) (1.36 – 2.20) (2.64 – 3.20) 2.5th 2.32 4.14 1.96 2.67 2.29 2.59 2.93 2.20 2.41 1.94 2.80 n (11.5 – 12.8) (12.1 – 14.0) (9.89 – 10.8) (10.5 – 12.7) (9.72 – 12.0) (8.76 – 9.75) (13.3 – 15.1) (11.6 – 13.1) (9.63 – 11.3) (11.9 – 13.9) (15.1 – 17.7) 12.1 13.0 10.3 11.5 10.8 9.24 14.2 12.3 10.4 12.8 16.4 (95% conf. interval) Geometric mea Total, 6 years and older 6–11 years Age group Males Gender Race/ethnicity Mexican Americans Non-Hispanic Blacks 12–19 years Females Non-Hispanic Whites 20–39 years 40–59 years 60 years and older Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Table 2.7.a.1. Serum trans-beta-carotene: Concentrations nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 136 136

148 Figure 2.7.a. Serum tr ans−beta−carotene: Concentr ations by age group dence interval), National Health and Nutrition Examination Survey, 2005–2006 Geometric mean (95% con fi Mexican Americans Overall 0 Females Males (μg/dL) 0203 01 Serum trans−beta−carotene 6−1112−1920−3940−5960+ 6−1112−1920−3940−5960+ Non−Hispanic Whites Non−Hispanic Blacks 0 (μg/dL) 0203 01 Serum trans−beta−carotene 6−1112−1920−3940−5960+ 6−1112−1920−3940−5960+ Males Females 0 Mexican Americans Non−Hispanic (μg/dL) 0203 Blacks Non−Hispanic Whites 01 Serum trans−beta−carotene 6−1112−1920−3940−5960+ 6−1112−1920−3940−5960+ Age (years) Age (years) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 137 137

149 Table 2.7.a.2. Serum trans-beta-carotene: Total population Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 90th 10th Males and Females (11.5 – 12.8) 4.26 (4.02 – 4.53) Total, 6 years and older (11.1 – 12.3) 37.1 (34.2 – 40.7) 7,254 12.1 11.6 13.0 6.21 (5.49 – 6.89) 12.7 (12.1 – 14.0) 27.4 (25.1 – 31.7) 860 6–11 years (11.8 – 13.6) 9.24 (8.76 – 9.75) 4.21 (3.86 – 4.52) 8.96 (8.30 – 9.66) 20.3 (18.9 – 22.7) 1,954 12–19 years 10.4 20–39 years (3.50 – 4.19) 9.97 (9.14 – 10.9) 30.4 (26.5 – 35.8) 1,688 (9.63 – 11.3) 3.85 12.8 4.12 (3.59 – 4.55) 12.4 (11.6 – 13.4) 42.7 (39.1 – 47.5) 1,365 40–59 years (11.9 – 13.9) 16.4 (15.1 – 17.7) 5.27 (4.47 – 6.08) 15.9 (14.5 – 17.8) 51.0 (45.9 – 59.1) 1,387 60 years and older Males (9.62 – 10.9) (9.89 – 10.8) 3.76 (3.48 – 4.02) 10.3 10.3 28.2 (26.4 – 31.4) 3,547 Total, 6 years and older (12.6 – 15.0) 13.7 (12.1 – 14.3) 6.93 (5.62 – 7.94) 13.1 6–11 years 27.4 (23.5 – 34.7) 427 12–19 years 8.46 3.82 (3.27 – 4.29) 8.26 (7.75 – 8.90) 17.8 (17.2 – 18.7) 980 (7.93 – 9.03) 8.89 3.36 (3.02 – 3.80) 8.51 (7.91 – 9.14) 23.9 (22.2 – 26.7) 738 20–39 years (8.36 – 9.46) 10.5 (9.38 – 11.7) 3.43 (2.20 – 4.20) 10.8 40–59 years 31.8 (27.9 – 36.0) 673 (9.45 – 12.3) 60 years and older (11.9 – 14.8) 4.47 (3.75 – 5.33) 13.3 (11.5 – 14.4) 41.5 (33.8 – 51.1) 729 13.0 Females Total, 6 years and older 14.2 5.00 (4.60 – 5.30) 13.2 (12.0 – 14.4) 43.9 (41.2 – 48.9) 3,707 (13.3 – 15.1) 6–11 years (11.3 – 13.5) 5.61 (4.56 – 6.75) 11.8 (10.5 – 13.6) 27.4 (24.6 – 33.5) 433 12.4 12–19 years 10.1 (9.48 – 10.9) 4.73 (4.26 – 4.95) 9.76 (8.95 – 10.7) 24.6 (20.9 – 29.1) 974 20–39 years 12.2 (10.7 – 13.9) 4.39 (3.79 – 5.08) 11.4 (10.2 – 12.9) 37.0 (28.6 – 50.2) 950 692 40–59 years 15.5 (14.2 – 17.0) 5.07 (4.61 – 5.33) 14.5 (12.7 – 16.2) 53.2 (44.0 – 64.4) (5.12 – 7.04) (50.5 – 75.2) (16.5 – 23.1) 19.4 6.30 62.3 658 60 years and older 19.5 (17.4 – 21.8) Table 2.7.a.3. Serum trans-beta-carotene: Mexican Americans Geometric mean and selected percentiles of serum concentrations (in μg/dL) for Mexican Americans in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Sample Geometric mea n (95% conf. interval) size 10th 50th 90th Males and Females 11.5 (10.5 – 12.7) 4.48 Total, 6 years and older 11.3 (10.4 – 12.4) 29.7 (25.9 – 35.0) 1,844 (4.14 – 4.81) 6–11 years (10.6 – 12.4) 5.74 (4.57 – 6.28) 11.4 (9.92 – 12.0) 24.2 (21.0 – 31.1) 295 11.0 12–19 years 9.02 (8.39 – 9.70) 4.07 (3.59 – 4.64) 9.05 (8.35 – 10.1) 18.6 (17.3 – 22.7) 646 20–39 years 11.5 4.45 (4.01 – 4.85) 11.3 (9.45 – 13.7) 29.9 (23.5 – 37.2) 449 (9.84 – 13.3) 40–59 years (11.1 – 14.8) 4.15 (3.63 – 5.03) 12.7 (11.1 – 14.7) 32.5 (27.7 – 47.1) 246 12.8 60 years and older 14.8 (13.2 – 16.5) 5.31 (3.02 – 7.79) 14.7 (12.7 – 15.6) 43.1 (37.9 – 47.4) 208 Males 10.3 10.4 (9.29 – 11.6) 4.15 (3.63 – 4.46) Total, 6 years and older (9.20 – 11.5) 25.3 (22.6 – 30.4) 883 23.1 6–11 years 12.0 (11.2 – 12.8) 6.15 (4.40 – 7.62) 11.5 (10.4 – 12.6) (19.7 – 34.4) 145 12–19 years 8.18 3.71 (3.32 – 4.25) 8.34 (6.90 – 9.63) 17.7 (15.3 – 19.6) 313 (7.37 – 9.07) 10.3 4.20 (3.00 – 4.71) 9.64 (7.83 – 12.8) 26.6 (22.0 – 36.9) 198 20–39 years (8.45 – 12.6) 10.9 (8.97 – 13.2) 3.82 (2.55 – 4.31) 11.3 40–59 years 26.3 (21.6 – 35.9) 122 (9.45 – 13.4) 60 years and older (10.6 – 14.6) 4.47† (2.51 – 6.70) 12.0 12.4 35.7† (19.8 – 154) 105 (9.45 – 15.9) Females Total, 6 years and older 12.9 (11.9 – 14.1) 5.08 (4.51 – 5.60) 12.5 (11.6 – 13.7) 34.4 (30.2 – 39.3) 961 6–11 years 10.9 5.10 (3.98 – 5.96) 10.2 (8.54 – 11.9) 24.3 (19.4 – 32.8) 150 (9.63 – 12.3) 12–19 years (9.35 – 10.7) 4.83 (4.12 – 5.13) 10.2 (9.47 – 10.6) 20.9 (18.0 – 28.7) 333 10.0 20–39 years 13.0 (11.1 – 15.3) 5.15 (3.69 – 6.18) 12.6 (11.2 – 15.5) 33.8 (24.6 – 45.8) 251 40–59 years 15.3 (12.6 – 18.5) 5.06 (3.42 – 6.68) 14.4 (12.2 – 18.3) 41.2 (29.2 – 108) 124 (14.3 – 19.4) 44.5† (39.3 – 50.9) (14.7 – 19.7) 15.1 103 5.97† 60 years and older 17.0 (3.10 – 8.19) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 138 138

150 Table 2.7.a.4. Serum trans-beta-carotene: Non-Hispanic blacks Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic blacks in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 10th 90th 50th Males and Females (9.72 – 12.0) 4.00 (3.53 – 4.34) 10.5 (9.31 – 11.4) 31.2 (26.5 – 38.3) Total, 6 years and older 10.8 1,891 11.9 6.30 (4.86 – 7.03) 11.6 (10.6 – 13.3) 23.0 (18.3 – 37.7) 240 6–11 years (10.9 – 12.6) 8.46 (7.85 – 9.11) 4.09 (3.71 – 4.35) 8.13 (7.88 – 8.42) 17.9 (15.7 – 21.3) 12–19 years 665 20–39 years (8.28 – 10.5) 3.85 (3.27 – 4.22) 8.49 (7.61 – 10.2) 23.4 (19.5 – 30.8) 368 9.32 12.1 3.46 (2.33 – 4.66) 12.3 (10.3 – 15.2) 40.9 (34.3 – 50.2) 335 40–59 years (10.3 – 14.1) 14.7 (12.8 – 16.9) 4.60 (3.81 – 5.04) 15.3 60 years and older 44.8 (37.0 – 51.5) 283 (12.1 – 18.7) Males 9.49 (8.62 – 10.4) 3.48 (3.00 – 3.95) Total, 6 years and older (8.05 – 9.95) 26.5 (23.0 – 32.4) 949 8.92 6–11 years 12.7 (11.1 – 14.5) 6.79 (5.53 – 7.49) 12.7 (10.7 – 14.9) 22.9 (18.7 – 55.1) 128 12–19 years 8.47 4.15 (3.18 – 4.70) 8.23 (7.85 – 8.76) 17.3 (15.8 – 19.7) 343 (7.78 – 9.21) 8.00 3.39 (2.51 – 3.99) 7.16 (6.35 – 7.95) 22.0 (19.3 – 26.4) 170 20–39 years (7.09 – 9.02) 9.83 (8.14 – 11.9) 2.65 (1.98 – 3.42) 9.46 40–59 years 36.7 (26.2 – 66.7) 156 (7.15 – 13.1) 60 years and older (11.3 – 14.5) 3.77 (3.46 – 4.61) 12.4 12.8 35.3 (29.1 – 52.0) 152 (10.7 – 15.1) Females Total, 6 years and older 12.1 (10.7 – 13.6) 4.49 (4.05 – 4.88) 11.5 (10.3 – 13.4) 35.5 (27.7 – 46.1) 942 6–11 years 11.1 5.32 (3.52 – 6.63) 11.3 (9.67 – 12.5) 22.3 (16.9 – 37.0) 112 (9.52 – 13.0) 12–19 years (7.74 – 9.22) 4.00 (3.50 – 4.37) 8.03 (7.59 – 8.49) 18.6 (15.5 – 24.3) 322 8.45 20–39 years 10.6 (9.08 – 12.4) 4.27 (3.46 – 5.15) 10.8 (8.50 – 12.2) 25.4 (18.6 – 46.1) 198 14.5 40–59 years (12.1 – 17.1) 4.85 (2.70 – 6.42) 14.4 (11.6 – 18.4) 44.9 (39.3 – 49.0) 179 (3.86 – 5.68) 60 years and older 16.3 (13.5 – 19.7) 4.83 (38.7 – 55.7) 17.6 (11.6 – 25.6) 46.5 131 Table 2.7.a.5. Serum trans-beta-carotene: Non-Hispanic whites Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic whites in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Sample Geometric mea n (95% conf. interval) size 10th 90th 50th Males and Females (11.6 – 13.1) 4.21 (3.81 – 4.60) 11.8 (11.2 – 12.6) 39.0 (34.8 – 43.4) Total, 6 years and older 12.3 2,973 13.6 6.31 (5.42 – 7.09) 13.2 (12.4 – 14.9) 27.8 (24.9 – 36.2) 231 6–11 years (12.1 – 14.3) 9.58 (8.94 – 10.3) 4.36 (3.85 – 4.71) 9.14 (8.12 – 10.5) 20.9 (19.0 – 26.6) 12–19 years 499 20–39 years (9.08 – 11.1) 3.53 (3.18 – 3.94) 9.78 (8.70 – 10.6) 30.5 (25.2 – 39.1) 714 10.1 12.9 4.10 (3.54 – 4.59) 12.4 (11.4 – 13.5) 43.4 (39.4 – 48.4) 683 40–59 years (11.8 – 14.0) 16.3 (14.9 – 17.8) 5.29 (4.22 – 6.19) 15.9 60 years and older 50.9 (44.8 – 64.2) 846 (14.2 – 18.1) Males 10.4 (9.87 – 11.0) 3.71 (3.35 – 4.02) Total, 6 years and older (9.56 – 11.4) 28.6 (26.0 – 33.0) 1,472 10.5 6–11 years 14.3 (12.7 – 16.1) 7.16 (4.60 – 9.03) 13.4 (12.1 – 14.7) 26.3 (23.2 – 48.8) 112 12–19 years 8.77 3.91 (2.92 – 4.60) 8.49 (7.53 – 9.58) 17.9 (16.6 – 20.4) 254 (8.14 – 9.46) 8.65 3.13 (2.85 – 3.48) 8.30 (7.47 – 9.44) 23.8 (20.9 – 26.9) 309 20–39 years (8.03 – 9.32) 10.6 (9.34 – 12.0) 3.45 (2.06 – 4.26) 11.0 40–59 years 30.6 (26.6 – 35.9) 351 (9.61 – 12.4) 60 years and older (11.5 – 14.7) 4.39 (3.31 – 5.39) 12.6 13.0 41.0 (32.8 – 51.7) 446 (11.0 – 14.3) Females Total, 6 years and older 14.5 (13.5 – 15.6) 4.95 (4.33 – 5.45) 13.4 (12.2 – 15.0) 46.4 (41.5 – 53.3) 1,501 6–11 years 12.9 5.61 (2.70 – 7.13) 12.6 (9.76 – 15.1) 27.7 (24.8 – 40.6) 119 (11.2 – 14.8) 12–19 years (9.71 – 11.5) 4.86 (4.27 – 5.37) 9.87 (8.71 – 11.3) 26.8 (21.8 – 30.1) 245 10.5 20–39 years 11.7 (9.95 – 13.8) 4.15 (3.18 – 4.99) 10.9 (9.35 – 12.7) 36.5 (26.6 – 60.7) 405 40–59 years 15.6 (14.1 – 17.2) 5.00 (4.17 – 5.44) 14.2 (12.0 – 17.1) 57.1 (44.0 – 69.2) 332 64.3 400 (16.2 – 23.5) (50.2 – 75.5) 60 years and older 19.7 (17.4 – 22.3) 6.35 (5.12 – 7.18) 19.5 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 139 139

151 Table 2.7.b. Serum trans-beta-carotene: Concentrations by survey cycle Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the U.S. population, National Health and Nutrition Examination Survey, 2001–2002 and 2005–2006. n s (95% conf. interval) Sample Geometric mea Selected percentile 50th 95th 5th (95% conf. interval) size Total, 6 years and older (2.95 – 3.46) (11.5 – 12.9) 3.21 12.0 (11.3 – 12.6) 47.7 (44.2 – 52.1) 7,929 12.2 2001–2002 (2.92 – 3.42) (49.1 – 59.3) (11.5 – 12.8) 11.6 (11.1 – 12.3) 53.3 12.1 7,254 3.18 2005–2006 Age group 3–5 years 13.6 (12.5 – 14.6) 4.60 (3.79 – 5.00) 13.6 (12.1 – 15.2) 45.1 (35.8 – 56.3) 429 2001–2002 6–11 years 13.2 (12.7 – 13.9) 5.44 (5.00 – 5.96) 13.3 (12.5 – 13.9) 2001–2002 (30.4 – 38.8) 1,012 32.9 2005–2006 13.0 (12.1 – 14.0) 5.15 (4.11 – 5.61) 12.7 (11.8 – 13.6) 37.7 (29.9 – 49.2) 860 12–19 years 2001–2002 (9.20 – 10.2) 3.34 (2.97 – 3.59) 9.63 (8.97 – 10.4) 28.2 (25.4 – 32.5) 2,206 9.69 9.24 (8.76 – 9.75) 3.20 (2.87 – 3.52) 8.96 (8.30 – 9.66) 28.3 (26.3 – 30.7) 1,954 2005–2006 20–39 years 2001–2002 (9.38 – 11.2) 2.90 (2.13 – 3.20) 9.81 (9.10 – 10.8) 39.8 (35.2 – 42.6) 1,716 10.3 2005–2006 10.4 (9.63 – 11.3) 3.01 (2.79 – 3.23) 9.97 (9.14 – 10.9) 41.6 (36.9 – 53.3) 1,688 40–59 years 1,471 2001–2002 13.3 (12.1 – 14.7) 3.30 (2.74 – 3.65) 13.0 (12.0 – 14.2) 60.0 (49.9 – 79.7) (11.9 – 13.9) (53.5 – 73.8) 63.0 12.4 (2.15 – 3.41) (11.6 – 13.4) 1,365 2005–2006 12.8 2.69 60 years and older 2001–2002 (14.9 – 18.3) 3.51 (2.88 – 4.13) 17.5 (15.3 – 19.6) 61.4 (56.0 – 66.1) 1,524 16.5 74.6 16.4 3.90 (3.43 – 4.17) 15.9 (14.5 – 17.8) 2005–2006 (66.3 – 83.4) 1,387 (15.1 – 17.7) Gender (6 years and older) Males 2001–2002 10.9 (10.2 – 11.6) 3.01 (2.68 – 3.25) 11.0 (10.3 – 11.6) 42.1 (37.5 – 45.5) 3,837 (9.62 – 10.9) 2005–2006 2.77 (2.28 – 3.06) 10.3 (9.89 – 10.8) 40.8 (36.8 – 46.4) 3,547 10.3 Females 2001–2002 13.6 (12.7 – 14.6) 3.57 (3.37 – 3.83) 13.1 (12.2 – 14.2) 54.1 (47.6 – 62.0) 4,092 13.2 2005–2006 14.2 (13.3 – 15.1) (3.51 – 4.05) 3.77 (12.0 – 14.4) 64.5 (58.3 – 73.6) 3,707 Race/ethnicity (6 years and older) Mexican Americans (11.6 – 13.9) 3.56 (3.12 – 3.83) 12.9 (11.6 – 13.4) 38.5 (34.5 – 47.5) 1,990 2001–2002 12.5 2005–2006 (10.5 – 12.7) 3.49 (3.15 – 3.86) 11.3 (10.4 – 12.4) 39.2 (35.1 – 46.5) 1,844 11.5 Non-Hispanic Blacks 2001–2002 10.8 (9.90 – 11.8) 2.83 (2.42 – 3.22) 10.7 (9.93 – 11.6) 40.3 (35.4 – 45.6) 1,864 2005–2006 (9.72 – 12.0) 3.02 (2.57 – 3.36) 10.5 (9.31 – 11.4) 45.0 (38.3 – 53.7) 1,891 10.8 Non-Hispanic Whites 2001–2002 12.5 (11.5 – 13.6) 3.35 (3.06 – 3.61) 12.1 (11.3 – 13.0) 50.8 (45.8 – 56.9) 3,450 56.9 11.8 (50.4 – 64.9) 2,973 3.06 (11.2 – 12.6) (2.80 – 3.41) 2005–2006 12.3 (11.6 – 13.1) nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 140 140

152 Figure 2.7.b . Serum tr ans−beta−carotene: Concentr ations by sur ve y cy cle fi dence intervals), National Health and Selected percentiles in μg/dL (95% con Nutrition Examination Survey, 2001–2002 and 2005–2006 80 60 40 95th Percentile 20 16 14 12 50th Percentile 10 8 6 5 4 5th Percentile 3 2 05−06 05−06 05−06 01−02 01−02 01−02 01−02 05−06 05−06 01−02 01−02 05−06 01−02 05−06 05−06 01−02 05−06 01−02 05−06 01−02 NHB Females 20+y 3−5y NHW Total Males 12−19y MA 6−11y (6+y) (6+y) (6+y) (6+y) (6+y) (6+y) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 141 141

153 779 size 6,616 3,204 1,707 1,785 3,412 1,673 1,528 2,725 1,254 1,270 Sample (3.93 – 5.11) (2.16 – 4.22) (2.67 – 3.91) (2.48 – 3.46) (1.58 – 2.39) (4.71 – 6.32) (3.17 – 4.61) (2.88 – 5.09) (4.11 – 5.20) (4.34 – 5.50) (5.17 – 8.65) 97.5th 4.48 2.67 3.09 2.80 1.87 5.27 3.51 3.74 4.71 4.84 6.53 (2.87 – 3.64) (1.63 – 2.68) (1.99 – 2.60) (1.97 – 2.59) (1.33 – 1.81) (3.60 – 4.48) (2.37 – 3.38) (2.08 – 3.19) (3.06 – 3.82) (3.21 – 4.44) (3.93 – 5.32) 95th 3.20 1.95 2.26 2.26 1.47 3.88 2.81 2.51 3.44 3.73 4.59 (95% conf. interval) s (.708 – .816) (< LOD – .783) (.811 – .992) 50th .759 .730 .903 < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD Selected percentile 5th < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD 2.5th < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD < LOD n (.985 – 1.17) * * * * * * * * * * 1.08 (95% conf. interval) Geometric mea < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. * Not calculated. Proportion of results below limit of detection was too high to provide a valid result. Total, 6 years and older 6–11 years Age group Males Gender Race/ethnicity Mexican Americans 12–19 years Females Non-Hispanic Blacks 20–39 years Non-Hispanic Whites 40–59 years 60 years and older and Nutrition Examination Survey, 2005–2006. Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health Table 2.8.a.1. Serum cis-beta-carotene: Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 142 142

154 No cis-beta -carotene figure for concentrations by age group is presented because the geometric means due were not calculated to the proportion of results below the limit of detection being T able 2.8.a.1). too high for valid results (see 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 143 143

155 Table 2.8.a.2. Serum cis-beta-carotene: Total population Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 10th 50th 90th Males and Females Total, 6 years and older < LOD < LOD 2.10 (1.92 – 2.39) 6,616 * 6–11 years * < LOD < LOD 1.47 (1.28 – 1.78) 779 12–19 years * < LOD < LOD 1.12 (.995 – 1.26) 1,785 20–39 years * < LOD 1.78 (1.55 – 2.03) 1,528 < LOD 40–59 years < LOD .730 (< LOD – .783) 2.49 (2.18 – 2.86) 1,254 * 60 years and older 1.08 (.985 – 1.17) < LOD .903 (.811 – .992) 3.09 (2.62 – 3.64) 1,270 Males Total, 6 years and older * < LOD < LOD 1.59 (1.43 – 1.86) 3,204 < LOD 6–11 years * .704 (< LOD – .757) 1.52 (1.26 – 2.33) 386 12–19 years * < LOD .935 (.878 – 1.02) 886 < LOD * < LOD 1.37 (1.23 – 1.59) 652 20–39 years < LOD * < LOD < LOD 1.75 40–59 years 616 (1.50 – 2.05) 60 years and older * < LOD .726 (< LOD – .817) 2.37 (1.91 – 2.99) 664 Females Total, 6 years and older * < LOD .759 (.708 – .816) 2.70 (2.35 – 3.10) 3,412 6–11 years * < LOD 1.44 (1.21 – 1.74) 393 < LOD 12–19 years < LOD < LOD 1.35 (1.13 – 1.59) 899 * 20–39 years * < LOD < LOD 2.15 (1.77 – 3.04) 876 (2.72 – 3.78) 638 40–59 years 1.04 (.954 – 1.13) < LOD .827 (.745 – .963) 3.30 (.904 – 1.36) 1.15 606 3.69 (3.23 – 4.71) 60 years and older 1.26 (1.11 – 1.41) < LOD < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. * Not calculated. Proportion of results below limit of detection was too high to provide a valid result. Table 2.8.a.3. Serum cis-beta-carotene: Mexican Americans Geometric mean and selected percentiles of serum concentrations (in μg/dL) for Mexican Americans in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. (95% conf. interval) Selected percentile s Geometric mea Sample n (95% conf. interval) size 10th 50th 90th Males and Females * Total, 6 years and older < LOD 1.70 (1.52 – 1.91) 1,707 < LOD 6–11 years < LOD < LOD 1.34 (1.09 – 1.67) 269 * 12–19 years * < LOD < LOD .975 (.899 – 1.15) 609 20–39 years * < LOD 1.73 (1.42 – 2.02) 402 < LOD .880 40–59 years < LOD .751 (< LOD – .864) 1.97 (1.65 – 2.75) 228 (.780 – .992) 60 years and older .964 (.878 – 1.06) < LOD .854 (.778 – .919) 2.48 (2.05 – 3.55) 199 Males Total, 6 years and older * < LOD < LOD 1.47 (1.21 – 1.71) 814 < LOD 6–11 years * < LOD 1.34 (1.06 – 1.98) 131 12–19 years * < LOD .900 (.833 – 1.09) 299 < LOD * < LOD 1.58 (1.16 – 2.07) 171 20–39 years < LOD * < LOD < LOD 1.57 40–59 years 114 (1.29 – 2.19) 60 years and older * < LOD† .718 (< LOD – .904) 1.61† (1.08 – 10.8) 99 Females Total, 6 years and older * < LOD .720 (< LOD – .789) 1.95 (1.76 – 2.24) 893 6–11 years * < LOD 1.35 (1.06 – 1.72) 138 < LOD 12–19 years < LOD < LOD 1.10 (.944 – 1.46) 310 * 20–39 years * < LOD .774 (< LOD – .960) 1.88 (1.57 – 2.36) 231 40–59 years 1.00 (.839 – 1.19) < LOD .870 (.703 – 1.06) 2.23 (1.71 – 6.40) 114 2.85† (2.37 – 4.06) 100 .923 < LOD† (.959 – 1.24) 1.09 60 years and older (.853 – 1.06) < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. * Not calculated. Proportion of results below limit of detection was too high to provide a valid result. † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 144 144

156 Table 2.8.a.4. Serum cis-beta-carotene: Non-Hispanic blacks Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic blacks in the U.S population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 10th 50th 90th Males and Females Total, 6 years and older < LOD < LOD 1.87 (1.59 – 2.49) 1,673 * 6–11 years * < LOD < LOD 1.33 (1.12 – 2.11) 208 12–19 years * < LOD < LOD 1.05 (.916 – 1.20) 580 20–39 years * < LOD 1.41 (1.24 – 1.84) 327 < LOD 40–59 years < LOD .778 (< LOD – .937) 2.54 (2.16 – 3.11) 298 * 60 years and older 1.04 (.906 – 1.19) < LOD .965 (.778 – 1.09) 2.80 (2.23 – 3.45) 260 Males Total, 6 years and older * < LOD < LOD 1.61 (1.33 – 1.94) 827 < LOD 6–11 years .807 (.695 – .937) (1.13 – 6.80) .738 (< LOD – .876) 1.45 112 12–19 years * < LOD .997 (.882 – 1.17) 290 < LOD * < LOD 1.27 (.962 – 1.84) 149 20–39 years < LOD * < LOD < LOD 2.28 40–59 years 136 (1.51 – 3.29) 60 years and older * < LOD .784 (< LOD – .927) 1.95 (1.64 – 3.14) 140 Females Total, 6 years and older * < LOD .717 (< LOD – .832) 2.20 (1.83 – 2.77) 846 6–11 years * < LOD 1.19† (1.03 – 1.99) 96 < LOD† 12–19 years < LOD < LOD 1.08 (.914 – 1.42) 290 * 20–39 years * < LOD < LOD 1.62 (1.25 – 2.76) 178 2.82 (2.25 – 3.43) 162 40–59 years 1.01 (.886 – 1.16) < LOD .877 (.765 – 1.03) 120 (2.59 – 3.84) 60 years and older 1.17 (.947 – 1.44) < LOD 1.10 (.720 – 1.58) 3.16 < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. * Not calculated. Proportion of results below limit of detection was too high to provide a valid result. † Estimate is subject to greater uncertainty due to small cell size. Table 2.8.a.5. Serum cis-beta-carotene: Non-Hispanic whites Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic whites in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea Sample n (95% conf. interval) size 50th 90th 10th Males and Females < LOD Total, 6 years and older 2.17 (1.92 – 2.55) 2,725 * < LOD * < LOD 1.46 (1.21 – 2.42) 212 6–11 years < LOD * < LOD < LOD 1.16 (.979 – 1.39) 462 12–19 years * 20–39 years 1.74 (1.44 – 2.15) 653 < LOD < LOD * .720 (< LOD – .779) 2.50 (2.11 – 3.14) 634 40–59 years < LOD 1.07 (.967 – 1.18) < LOD .892 (.783 – 1.00) 3.09 (2.57 – 3.70) 764 60 years and older Males Total, 6 years and older * < LOD < LOD 1.59 (1.42 – 1.92) 1,336 * 1.49† < LOD† < LOD 6–11 years (1.16 – 5.17) 102 12–19 years * < LOD .926 (.842 – 1.19) 231 < LOD * < LOD 1.35 (1.18 – 1.59) 278 20–39 years < LOD * < LOD < LOD 1.69 40–59 years 324 (1.46 – 1.99) 60 years and older * < LOD < LOD 2.39 (1.82 – 3.14) 401 Females Total, 6 years and older * < LOD .761 (.704 – .828) 2.79 (2.34 – 3.48) 1,389 6–11 years * < LOD 1.43† (1.19 – 1.98) 110 < LOD† 12–19 years < LOD < LOD 1.39 (1.12 – 1.85) 231 * 20–39 years * < LOD < LOD 2.14 (1.62 – 3.70) 375 40–59 years 1.03 (.941 – 1.13) < LOD .795 (.718 – .966) 3.55 (2.73 – 3.96) 310 (3.16 – 4.80) 60 years and older 1.26 (1.10 – 1.45) < LOD 1.16 (.875 – 1.38) 3.70 363 < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. * Not calculated. Proportion of results below limit of detection was too high to provide a valid result. † Estimate is subject to greater uncertainty due to small cell size. 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 145 145

157 Table 2.8.b. Serum cis-beta-carotene: Concentrations by survey cycle Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the U.S. population, National Health and Nutrition Examination Survey, 2001–2002 and 2005–2006. n Sample Selected percentile s (95% conf. interval) Geometric mea 5th 50th 95th (95% conf. interval) size Total, 6 years and older * < LOD < LOD 2.64 (2.41 – 2.87) 7,929 2001–2002 * < LOD 3.20 (2.87 – 3.64) 6,616 < LOD 2005–2006 Age group 3–5 years * < LOD < LOD 2.07 (1.88 – 2.62) 430 2001–2002 6–11 years < LOD * (1.50 – 1.84) < LOD 1.64 2001–2002 1,014 2005–2006 * < LOD 1.95 (1.63 – 2.68) 779 < LOD 12–19 years * < LOD < LOD 1.39 (1.30 – 1.55) 2,206 2001–2002 2005–2006 * < LOD < LOD 1.47 (1.33 – 1.81) 1,785 20–39 years * < LOD < LOD 2.05 (1.82 – 2.46) 1,716 2001–2002 2005–2006 * < LOD < LOD 2.51 (2.08 – 3.19) 1,528 40–59 years 1,470 2001–2002 * < LOD < LOD 3.30 (2.77 – 4.39) < LOD (3.21 – 4.44) (< LOD – .783) .730 3.73 1,254 2005–2006 * 60 years and older 2001–2002 (.943 – 1.11) < LOD .899 (.803 – 1.02) 3.50 (3.11 – 3.94) 1,523 1.02 (3.93 – 5.32) 1.08 < LOD .903 (.811 – .992) 4.59 2005–2006 1,270 (.985 – 1.17) Gender (6 years and older) Males 2001–2002 * < LOD < LOD 2.13 (1.94 – 2.41) 3,835 2005–2006 < LOD < LOD 2.26 (1.99 – 2.60) 3,204 * Females 2001–2002 * < LOD < LOD 3.08 (2.73 – 3.70) 4,094 < LOD * 2005–2006 .759 (.708 – .816) 3.88 (3.60 – 4.48) 3,412 Race/ethnicity (6 years and older) Mexican Americans 2001–2002 < LOD < LOD 2.06 (1.85 – 2.42) 1,990 * 2005–2006 < LOD < LOD 2.26 (1.97 – 2.59) 1,707 * Non-Hispanic Blacks 2001–2002 * < LOD < LOD 2.29 (1.96 – 2.69) 1,864 2005–2006 < LOD < LOD 2.81 (2.37 – 3.38) 1,673 * Non-Hispanic Whites 2001–2002 * < LOD < LOD 2.79 (2.48 – 3.28) 3,450 3.44 * < LOD (3.06 – 3.82) < LOD 2,725 2005–2006 < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. * Not calculated. Proportion of results below limit of detection was too high to provide a valid result. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 146 146

158 cle Figure 2.8.b. Serum cis−beta−carotene: Concentr ations by su rv cy ey dence intervals), National Health and fi Selected percentiles in μg/dL (95% con Nutrition Examination Survey, 2001–2002 and 2005–2006 5 4 3 95th Percentile 2 1 0.85 0.80 0.75 50th Percentile 0.70 0.85 0.80 0.75 5th Percentile 0.70 01−02 05−06 01−02 05−06 05−06 01−02 05−06 01−02 05−06 05−06 01−02 05−06 01−02 01−02 05−06 01−02 01−02 05−06 01−02 05−06 Males 12−19y 6−11y NHB Females 3−5y MA NHW Total 20+y (6+y) Values in the graph are suppressed if either the point estimate or the lower 95% con dence limit is noted as “< LOD” in the accompanying table. fi 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 147 147

159 855 size 7,195 1,842 3,514 1,848 1,924 3,681 2,960 1,679 1,357 1,380 Sample (28.7 – 33.2) (40.7 – 63.0) (27.1 – 42.3) (26.4 – 30.9) (26.9 – 35.6) (23.6 – 27.2) (30.0 – 37.1) (23.3 – 28.2) (28.8 – 38.0) (27.7 – 41.1) (27.8 – 35.2) 97.5th 30.5 46.2 30.4 28.4 29.8 25.5 32.5 25.5 31.7 30.3 31.9 (22.5 – 26.4) (23.0 – 28.7) (21.5 – 25.0) (32.4 – 45.4) (20.8 – 27.8) (18.8 – 23.4) (23.4 – 28.1) (19.7 – 21.9) (21.7 – 28.8) (21.5 – 29.2) (22.7 – 27.6) 95th 24.1 24.9 22.8 36.2 23.6 20.3 25.5 20.5 24.5 24.8 24.2 (95% conf. interval) s (7.24 – 7.99) (8.52 – 9.66) (7.12 – 7.88) (11.9 – 14.2) (7.80 – 8.81) (7.01 – 7.99) (7.28 – 8.14) (6.62 – 7.38) (7.31 – 8.18) (6.50 – 7.82) (7.03 – 8.13) 50th 7.62 9.14 7.49 12.9 8.23 7.49 7.74 6.96 7.81 7.03 7.48 Selected percentile (2.26 – 2.63) (3.32 – 4.23) (2.10 – 2.70) (3.87 – 4.86) (2.59 – 3.11) (2.91 – 3.50) (2.24 – 2.69) (2.07 – 2.44) (2.50 – 2.97) (1.80 – 2.40) (1.62 – 2.25) 5th 2.46 3.90 2.41 4.42 2.89 3.20 2.54 2.26 2.78 2.16 1.98 (1.63 – 2.06) (2.68 – 3.69) (1.42 – 2.14) (3.15 – 3.89) (2.02 – 2.51) (2.13 – 2.97) (1.68 – 2.10) (1.47 – 1.92) (1.84 – 2.53) (1.14 – 1.92) (1.38 – 1.62) 2.5th 1.90 3.41 1.86 3.45 2.32 2.56 1.93 1.66 2.33 1.48 1.52 n (7.34 – 8.08) (8.88 – 10.1) (7.10 – 7.94) (11.8 – 14.3) (7.88 – 8.84) (7.42 – 8.23) (7.53 – 8.27) (6.59 – 7.32) (7.52 – 8.40) (6.60 – 7.94) (6.86 – 7.97) 7.70 9.47 7.51 13.0 8.34 7.82 7.89 6.94 7.95 7.24 7.39 (95% conf. interval) Geometric mea Total, 6 years and older 6–11 years Age group Males Gender Race/ethnicity Mexican Americans Non-Hispanic Blacks 12–19 years Females Non-Hispanic Whites 20–39 years 40–59 years 60 years and older Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Table 2.9.a.1. Serum beta-cryptoxanthin: Concentrations nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 148 148

160 Figure 2.9.a. Serum beta−cryptoxanthin: Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2005–2006 Overall Mexican Americans 20 Females 15 Males 10 (μg/dL) 5 0 Serum beta−cryptoxanthin 12−19 20−39 40−59 60+ 60+ 6−11 40−59 6−11 20−39 12−19 Non−Hispanic Whites Non−Hispanic Blacks 20 15 10 (μg/dL) 5 0 Serum beta−cryptoxanthin 40−59 60+ 60+ 40−59 20−39 6−11 12−19 20−39 12−19 6−11 Females Males 20 Mexican 15 Americans Non−Hispanic Blacks 10 Non−Hispanic (μg/dL) Whites 5 0 Serum beta−cryptoxanthin 12−19 20−39 40−59 60+ 6−11 60+ 40−59 6−11 12−19 20−39 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 149149

161 Table 2.9.a.2. Serum beta-cryptoxanthin: Total population Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 90th 10th Males and Females (7.34 – 8.08) 3.17 (2.95 – 3.36) Total, 6 years and older (7.24 – 7.99) 18.5 (17.5 – 19.7) 7,195 7.70 7.62 9.47 4.47 (3.95 – 5.23) 9.14 (8.88 – 10.1) 19.5 (17.8 – 21.7) 855 6–11 years (8.52 – 9.66) 7.82 (7.42 – 8.23) 3.86 (3.64 – 4.01) 7.49 (7.01 – 7.99) 16.5 (15.2 – 17.8) 1,924 12–19 years 7.95 20–39 years (3.06 – 3.76) 7.81 (7.31 – 8.18) 18.2 (16.7 – 20.0) 1,679 (7.52 – 8.40) 3.42 7.24 2.76 (2.48 – 3.06) 7.03 (6.50 – 7.82) 19.3 (17.2 – 21.2) 1,357 40–59 years (6.60 – 7.94) 7.39 (6.86 – 7.97) 2.82 (2.40 – 3.01) 7.48 (7.03 – 8.13) 19.0 (17.4 – 20.7) 1,380 60 years and older Males (7.12 – 7.88) (7.10 – 7.94) 3.13 (2.87 – 3.38) 7.49 7.51 18.0 (17.1 – 19.3) 3,514 Total, 6 years and older (8.87 – 10.6) 9.70 (8.48 – 10.2) 4.86 (3.91 – 5.70) 9.33 6–11 years 19.2 (17.3 – 21.7) 426 12–19 years 7.89 3.95 (3.55 – 4.37) 7.65 (7.02 – 8.42) 16.9 (15.0 – 18.6) 961 (7.36 – 8.46) 7.86 3.49 (3.11 – 3.88) 7.74 (7.16 – 8.22) 17.9 (16.0 – 19.5) 735 20–39 years (7.38 – 8.38) 6.84 (6.09 – 7.69) 2.58 (2.16 – 2.91) 6.74 40–59 years 18.8 (16.7 – 21.9) 668 (6.12 – 7.68) 60 years and older (6.37 – 7.70) 2.87 (2.36 – 3.05) 7.01 (6.44 – 7.89) 17.6 (16.7 – 20.5) 724 7.16 Females Total, 6 years and older 7.89 3.21 (2.99 – 3.40) 7.74 (7.28 – 8.14) 19.1 (17.9 – 20.2) 3,681 (7.53 – 8.27) 6–11 years (8.67 – 9.83) 4.21 (3.49 – 4.98) 8.82 (8.30 – 9.60) 19.7 (17.8 – 23.4) 429 9.23 12–19 years 7.73 (7.26 – 8.23) 3.77 (3.48 – 3.96) 7.32 (6.78 – 8.01) 16.3 (14.9 – 17.8) 963 20–39 years 8.04 (7.52 – 8.59) 3.32 (2.93 – 3.81) 7.87 (7.27 – 8.51) 19.3 (17.0 – 23.4) 944 689 40–59 years 7.63 (6.94 – 8.39) 3.08 (2.66 – 3.33) 7.35 (6.62 – 8.25) 19.7 (17.2 – 20.9) (2.34 – 3.03) (18.1 – 22.9) (7.23 – 8.79) 7.73 2.79 20.0 656 60 years and older 7.73 (7.04 – 8.48) Table 2.9.a.3. Serum beta-cryptoxanthin: Mexican Americans Geometric mean and selected percentiles of serum concentrations (in μg/dL) for Mexican Americans in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Sample Geometric mea n (95% conf. interval) size 10th 50th 90th Males and Females 13.0 (11.8 – 14.3) 5.53 Total, 6 years and older 12.9 (11.9 – 14.2) 29.7 (25.9 – 34.0) 1,842 (5.21 – 5.91) 6–11 years (11.4 – 13.5) 6.01 (4.82 – 6.78) 12.4 (11.0 – 14.0) 24.8 (23.0 – 27.8) 295 12.3 12–19 years 11.1 (10.3 – 12.1) 5.77 (5.11 – 6.34) 11.0 (10.2 – 12.1) 22.8 (19.2 – 26.1) 646 20–39 years 13.6 5.47 (4.92 – 6.41) 13.5 (11.7 – 15.7) 31.9 (26.5 – 45.3) 448 (11.7 – 16.0) 40–59 years (11.7 – 15.2) 5.34 (4.80 – 5.81) 13.6 (11.9 – 15.8) 29.8 (25.8 – 35.3) 245 13.3 60 years and older 13.3 (11.4 – 15.6) 5.60 (2.79 – 7.53) 13.4 (11.3 – 15.8) 29.7 (24.7 – 42.9) 208 Males 12.7 12.6 (11.2 – 14.1) 5.38 (4.94 – 5.92) Total, 6 years and older (11.4 – 14.4) 27.9 (24.5 – 32.7) 881 24.3 6–11 years 12.5 (11.3 – 13.8) 6.02 (3.82 – 6.86) 12.5 (11.2 – 14.4) (22.2 – 32.0) 145 12–19 years 10.7 6.00 (5.02 – 6.51) 10.5 (9.42 – 11.6) 21.7 (18.5 – 26.0) 313 (9.74 – 11.9) 13.5 5.38 (4.43 – 6.71) 13.8 (11.6 – 16.0) 29.6 (22.6 – 45.6) 197 20–39 years (11.1 – 16.4) 12.6 (10.5 – 15.0) 5.06 (3.45 – 5.65) 13.0 40–59 years 30.6 (25.0 – 45.0) 121 (10.4 – 15.5) 60 years and older (9.50 – 15.1) 4.24† (1.40 – 7.66) 11.4 12.0 26.9† (21.1 – 37.5) 105 (9.88 – 15.0) Females Total, 6 years and older 13.4 (12.2 – 14.6) 5.64 (5.31 – 6.10) 13.1 (12.2 – 14.2) 30.8 (26.8 – 39.3) 961 6–11 years 12.3 5.87 (4.89 – 6.83) 11.8 (10.9 – 13.3) 26.0 (21.9 – 28.8) 150 (11.3 – 13.5) 12–19 years (10.6 – 12.7) 5.49 (4.35 – 6.31) 12.1 (10.9 – 13.0) 23.4 (19.9 – 30.4) 333 11.6 20–39 years 13.8 (11.7 – 16.2) 5.49 (4.69 – 6.54) 13.0 (11.0 – 16.0) 34.7 (29.7 – 47.2) 251 40–59 years 14.2 (12.2 – 16.4) 5.67 (3.59 – 7.24) 13.7 (12.5 – 16.3) 29.5 (24.9 – 36.5) 124 (12.2 – 17.4) 30.1† (25.5 – 59.9) (11.8 – 18.0) 15.4 103 5.79† 60 years and older 14.5 (3.11 – 7.70) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 150 150

162 Table 2.9.a.4. Serum beta-cryptoxanthin: Non-Hispanic blacks Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic blacks in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 90th 10th Males and Females (7.88 – 8.84) 3.72 (3.51 – 4.02) Total, 6 years and older (7.80 – 8.81) 18.1 (17.2 – 19.3) 1,848 8.34 8.23 11.9 6.05 (5.13 – 6.76) 11.7 (11.1 – 12.8) 22.8 (19.7 – 25.0) 237 6–11 years (10.6 – 13.2) 8.69 (7.99 – 9.46) 4.54 (4.16 – 4.92) 8.47 (7.65 – 9.40) 17.4 (15.7 – 19.0) 637 12–19 years 8.26 20–39 years (3.62 – 4.26) 7.95 (7.47 – 8.71) 16.3 (15.0 – 18.9) 363 (7.76 – 8.78) 3.97 7.89 2.90 (2.54 – 3.55) 7.98 (6.88 – 9.10) 18.8 (17.2 – 22.3) 332 40–59 years (6.95 – 8.97) 7.38 (6.55 – 8.31) 3.16 (2.61 – 3.71) 7.31 (6.35 – 8.23) 16.8 (15.5 – 21.8) 279 60 years and older Males (7.38 – 8.90) (7.64 – 8.87) 3.58 (3.20 – 3.89) 8.03 8.23 19.0 (17.7 – 20.9) 922 Total, 6 years and older (11.2 – 14.0) 12.5 (10.6 – 14.7) 6.69 (4.92 – 7.69) 12.6 6–11 years 23.9 (21.5 – 25.6) 127 12–19 years 8.80 4.43 (3.92 – 4.96) 8.50 (7.75 – 9.40) 18.2 (15.8 – 20.7) 325 (8.01 – 9.67) 8.26 4.00 (3.65 – 4.31) 7.41 (7.04 – 7.98) 18.2 (15.3 – 21.6) 168 20–39 years (7.73 – 8.83) 7.49 (6.22 – 9.03) 2.63 (2.42 – 2.81) 7.64 40–59 years 19.0 (17.1 – 24.6) 153 (6.42 – 9.09) 60 years and older (6.08 – 7.45) 2.92 (2.43 – 3.29) 6.73 (5.09 – 7.20) 17.0 (15.6 – 17.8) 149 6.06 Females Total, 6 years and older 8.44 3.87 (3.56 – 4.40) 8.39 (8.01 – 8.86) 17.3 (16.4 – 18.5) 926 (8.04 – 8.86) 6–11 years (9.74 – 13.0) 5.33† (4.18 – 6.55) 10.8 (9.90 – 12.2) 19.6† (17.8 – 30.0) 110 11.2 12–19 years 8.59 (7.79 – 9.46) 4.66 (4.22 – 5.04) 8.46 (7.40 – 9.63) 16.6 (14.9 – 18.0) 312 20–39 years 8.25 (7.69 – 8.86) 3.73 (3.50 – 4.18) 8.14 (7.80 – 8.94) 15.6 (13.7 – 20.1) 195 179 40–59 years 8.24 (7.42 – 9.14) 3.64 (2.54 – 4.52) 8.22 (6.90 – 9.23) 18.5 (16.3 – 21.5) (14.7 – 26.2) 130 16.5 60 years and older 7.89 (6.67 – 9.33) 3.67 (2.29 – 4.00) 7.96 (6.64 – 9.20) † Estimate is subject to greater uncertainty due to small cell size. Table 2.9.a.5. Serum beta-cryptoxanthin: Non-Hispanic whites Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic whites in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. (95% conf. interval) Selected percentile s Sample n Geometric mea (95% conf. interval) size 10th 50th 90th Males and Females 6.94 (6.59 – 7.32) Total, 6 years and older (2.72 – 3.14) 6.96 (6.62 – 7.38) 16.3 (15.3 – 17.4) 2,960 2.93 6–11 years (7.73 – 8.89) 4.21 (3.43 – 4.88) 8.29 (7.60 – 8.69) 15.7 (14.5 – 17.9) 230 8.12 12–19 years 7.12 (6.60 – 7.68) 3.72 (3.31 – 3.93) 6.82 (6.07 – 7.64) 14.2 (13.1 – 16.1) 497 20–39 years 6.90 3.01 (2.73 – 3.40) 6.93 (6.69 – 7.24) 15.1 (13.3 – 16.5) 711 (6.60 – 7.21) 40–59 years (5.99 – 7.33) 2.63 (2.35 – 2.88) 6.61 (6.11 – 7.28) 17.2 (14.6 – 20.0) 679 6.63 60 years and older 7.05 (6.51 – 7.64) 2.75 (2.28 – 2.96) 7.26 (6.66 – 7.79) 17.7 (16.8 – 19.6) 843 Males 6.90 6.83 (6.42 – 7.28) 2.92 (2.50 – 3.23) Total, 6 years and older (6.58 – 7.29) 15.9 (14.6 – 17.5) 1,468 7.99 6–11 years 8.45 (7.44 – 9.60) 4.43 (3.50 – 5.65) 112 (7.29 – 9.15) 15.9 (14.0 – 21.0) 12–19 years 7.38 3.87 (3.20 – 4.40) 7.10 (6.14 – 8.39) 14.5 (12.6 – 17.5) 253 (6.60 – 8.26) 6.94 3.15 (2.80 – 3.53) 7.06 (6.75 – 7.53) 14.0 (12.1 – 16.7) 309 20–39 years (6.51 – 7.40) 6.39 (5.62 – 7.26) 2.42 (1.99 – 2.82) 6.31 40–59 years 17.6 (14.6 – 21.6) 350 (5.75 – 6.96) 60 years and older (6.02 – 7.37) 2.78 (2.23 – 3.04) 6.94 6.66 17.0 (15.2 – 18.8) 444 (5.82 – 7.73) Females Total, 6 years and older 7.05 (6.69 – 7.43) 2.94 (2.70 – 3.20) 7.04 (6.59 – 7.55) 16.6 (15.4 – 18.1) 1,492 6–11 years 8.11 3.85 (3.04 – 4.45) 8.14 (7.69 – 8.60) 15.0 (13.3 – 22.0) 118 (7.34 – 8.95) 12–19 years (6.25 – 7.48) 3.57 (2.93 – 3.86) 6.57 (5.73 – 7.38) 14.0 (12.8 – 16.4) 244 6.84 20–39 years 6.86 (6.45 – 7.28) 2.92 (2.53 – 3.38) 6.73 (6.29 – 7.41) 15.7 (13.5 – 18.2) 402 40–59 years 6.87 (6.18 – 7.64) 2.84 (2.52 – 3.24) 6.84 (6.09 – 7.85) 16.5 (14.4 – 19.9) 329 399 (6.74 – 8.69) (17.0 – 21.2) 60 years and older 7.39 (6.69 – 8.17) 2.73 (2.26 – 2.94) 7.50 19.5 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 151 151

163 Table 2.9.b. Serum beta-cryptoxanthin: Concentrations by survey cycle Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the U.S. population, National Health and Nutrition Examination Survey, 2001–2002 and 2005–2006. n s (95% conf. interval) Sample Geometric mea Selected percentile 50th 95th 5th (95% conf. interval) size Total, 6 years and older (2.20 – 2.68) (7.06 – 7.87) 2.45 7.40 (7.00 – 7.82) 23.0 (20.9 – 25.5) 7,890 7.46 2001–2002 (2.26 – 2.63) (22.5 – 26.4) (7.34 – 8.08) 7.62 (7.24 – 7.99) 24.1 7.70 7,195 2.46 2005–2006 Age group 3–5 years 9.43 (8.40 – 10.6) 3.30 (1.88 – 3.96) 9.09 (7.81 – 10.4) 30.7 (25.3 – 43.1) 427 2001–2002 6–11 years 9.05 (8.71 – 10.2) 3.92 (3.28 – 4.22) 9.40 (8.29 – 10.2) 2001–2002 (21.9 – 31.6) 1,006 26.1 2005–2006 9.47 (8.88 – 10.1) 3.90 (3.32 – 4.23) 9.14 (8.52 – 9.66) 24.9 (23.0 – 28.7) 855 12–19 years 2001–2002 (7.20 – 8.08) 3.05 (2.58 – 3.31) 7.45 (7.00 – 7.99) 19.8 (18.5 – 22.3) 2,199 7.63 7.82 (7.42 – 8.23) 3.20 (2.91 – 3.50) 7.49 (7.01 – 7.99) 20.3 (18.8 – 23.4) 1,924 2005–2006 20–39 years 2001–2002 (6.57 – 7.69) 2.40 (2.04 – 2.73) 6.83 (6.25 – 7.50) 22.9 (20.0 – 26.6) 1,707 7.11 2005–2006 7.95 (7.52 – 8.40) 2.78 (2.50 – 2.97) 7.81 (7.31 – 8.18) 24.5 (21.7 – 28.8) 1,679 40–59 years 1,459 2001–2002 7.28 (6.75 – 7.86) 2.39 (2.02 – 2.71) 7.16 (6.66 – 7.77) 23.2 (20.4 – 26.1) (6.60 – 7.94) (21.5 – 29.2) 24.8 7.03 (1.80 – 2.40) (6.50 – 7.82) 1,357 2005–2006 7.24 2.16 60 years and older 2001–2002 (6.84 – 8.09) 1.94 (1.71 – 2.22) 7.64 (7.06 – 8.28) 23.5 (20.9 – 27.8) 1,519 7.44 24.2 7.39 1.98 (1.62 – 2.25) 7.48 (7.03 – 8.13) 2005–2006 (22.7 – 27.6) 1,380 (6.86 – 7.97) Gender (6 years and older) Males 2001–2002 7.28 (6.89 – 7.69) 2.41 (2.10 – 2.66) 7.32 (6.82 – 7.81) 22.3 (20.4 – 25.0) 3,815 (7.12 – 7.88) 2005–2006 2.41 (2.10 – 2.70) 7.49 (7.10 – 7.94) 22.8 (21.5 – 25.0) 3,514 7.51 Females 2001–2002 7.63 (7.20 – 8.08) 2.48 (2.29 – 2.75) 7.45 (7.05 – 7.84) 23.8 (21.1 – 26.2) 4,075 7.74 2005–2006 7.89 (7.53 – 8.27) (2.24 – 2.69) 2.54 (7.28 – 8.14) 25.5 (23.4 – 28.1) 3,681 Race/ethnicity (6 years and older) Mexican Americans (10.9 – 13.5) 4.14 (3.71 – 4.53) 12.1 (11.2 – 13.2) 34.5 (32.1 – 38.5) 1,988 2001–2002 12.1 2005–2006 (11.8 – 14.3) 4.42 (3.87 – 4.86) 12.9 (11.9 – 14.2) 36.2 (32.4 – 45.4) 1,842 13.0 Non-Hispanic Blacks 2001–2002 8.03 (7.38 – 8.74) 2.99 (2.66 – 3.27) 7.92 (7.32 – 8.55) 23.0 (19.9 – 27.7) 1,859 2005–2006 (7.88 – 8.84) 2.89 (2.59 – 3.11) 8.23 (7.80 – 8.81) 23.6 (20.8 – 27.8) 1,848 8.34 Non-Hispanic Whites 2001–2002 6.80 (6.43 – 7.19) 2.36 (2.05 – 2.53) 6.71 (6.29 – 7.16) 19.6 (18.2 – 22.2) 3,422 20.5 6.96 (19.7 – 21.9) 2,960 2.26 (6.62 – 7.38) (2.07 – 2.44) 2005–2006 6.94 (6.59 – 7.32) nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 152 152

164 Figure 2.9.b. Serum beta−cryptoxanthin: Concentrations by survey cycle Selected percentiles in μg/dL (95% confidence intervals), National Health and Nutrition Examination Survey, 2001–2002 and 2005–2006 50 40 1 1 1 30 1 1 1 1 1 1 1 1 1 1 1 1 95th Percentile 1 1 1 20 1 10 16 14 1 1 12 10 1 1 1 50th Percentile 1 1 8 1 1 1 1 1 1 1 1 1 1 1 1 6 5 1 1 4 1 1 1 1 1 1 3 1 1 1 1 1 1 1 1 1 1 1 5th Percentile 2 1 01−02 05−06 01−02 05−06 01−02 05−06 01−02 05−06 01−02 05−06 01−02 05−06 01−02 05−06 01−02 05−06 01−02 05−06 01−02 05−06 Total 6−11y 12−19y 20+y Males Females MA NHB NHW 3−5y (6+y) (6+y) (6+y) (6+y) (6+y) (6+y) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 153153

165 860 size 7,254 1,844 3,547 1,891 1,954 3,707 2,973 1,688 1,365 1,387 Sample (37.0 – 40.0) (33.2 – 40.8) (27.3 – 30.2) (33.3 – 39.0) (34.8 – 41.7) (21.4 – 25.1) (38.4 – 41.5) (34.4 – 39.9) (31.7 – 40.0) (38.5 – 46.1) (39.7 – 51.2) 97.5th 38.5 35.5 29.0 35.7 38.0 22.7 39.9 37.5 35.2 40.8 42.5 (30.3 – 33.2) (23.5 – 27.4) (28.7 – 31.4) (29.2 – 34.1) (29.4 – 35.1) (19.1 – 21.1) (31.0 – 35.7) (29.1 – 32.8) (27.7 – 32.1) (33.3 – 37.8) (32.8 – 40.3) 95th 31.3 24.5 30.7 31.3 31.5 20.0 32.8 30.9 29.3 35.7 35.9 (95% conf. interval) s (13.2 – 14.1) (12.8 – 13.9) (13.0 – 14.1) (14.4 – 15.6) (15.0 – 15.8) (10.0 – 11.1) (13.3 – 14.4) (12.5 – 13.4) (12.9 – 14.4) (13.7 – 15.2) (15.0 – 16.5) 50th 13.7 13.3 13.5 15.0 15.4 10.6 13.8 12.9 13.6 14.5 15.7 Selected percentile (5.68 – 6.18) (5.50 – 7.67) (5.42 – 6.35) (6.79 – 7.83) (6.33 – 7.71) (5.21 – 5.91) (5.69 – 6.13) (5.33 – 5.88) (5.19 – 6.41) (5.28 – 6.13) (6.02 – 6.69) 5th 5.90 6.70 5.93 7.41 7.03 5.67 5.89 5.70 5.91 5.82 6.44 (4.69 – 5.19) (4.13 – 6.47) (4.48 – 5.30) (5.62 – 6.79) (5.20 – 6.37) (4.39 – 5.18) (4.62 – 5.26) (4.46 – 4.96) (4.24 – 5.46) (4.02 – 5.31) (4.72 – 5.83) 2.5th 4.95 5.74 4.92 6.36 5.88 4.91 4.98 4.74 4.94 4.62 5.27 n (13.4 – 14.2) (12.6 – 13.7) (13.1 – 14.0) (14.5 – 15.8) (14.8 – 15.8) (10.3 – 11.1) (13.5 – 14.4) (12.8 – 13.6) (13.1 – 14.1) (13.8 – 15.2) (14.9 – 16.2) 13.8 13.1 13.6 15.1 15.3 10.7 14.0 13.2 13.6 14.5 15.5 (95% conf. interval) Geometric mea Total, 6 years and older Age group 6–11 years Males Gender Race/ethnicity Mexican Americans Non-Hispanic Blacks 12–19 years Females Non-Hispanic Whites 20–39 years 40–59 years 60 years and older Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Table 2.10.a.1. Serum lutein/zeaxanthin: Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 154 154

166 Figure 2.10.a. Serum lutein/zeaxanthin: Concentrations by age group Geometric Mean (95% confidence interval), National Health and Nutrition Examination Survey, 2005–2006 Overall Mexican Americans Females Males (μg/dL) Serum lutein/zeaxanthin 0 10 20 30 60+ 20−39 40−59 20−39 40−59 60+ 6−11 6−11 12−19 12−19 Non−Hispanic Whites Non−Hispanic Blacks 30 (μg/dL) Serum lutein/zeaxanthin 40−59 60+ 20−39 6−11 12−19 20−39 40−59 60+ 6−11 12−19 Females Males Mexican Americans Non−Hispanic (μg/dL) Blacks Non−Hispanic Whites Serum lutein/zeaxanthin 0 10 20 30 0 10 20 20−39 60+ 20−39 12−19 6−11 60+ 40−59 6−11 12−19 40−59 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 155155

167 Table 2.10.a.2. Serum lutein/zeaxanthin: Total population Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 90th 10th Males and Females (13.4 – 14.2) 7.24 (6.91 – 7.49) Total, 6 years and older (13.2 – 14.1) 26.5 (25.7 – 27.3) 7,254 13.8 13.7 13.1 7.93 (6.84 – 8.54) 13.3 (12.6 – 13.7) 20.7 (20.1 – 22.0) 860 6–11 years (12.8 – 13.9) 10.7 (10.3 – 11.1) 6.50 (6.19 – 6.74) 10.6 (10.0 – 11.1) 17.6 (16.9 – 18.4) 1,954 12–19 years 13.6 20–39 years (6.64 – 7.83) 13.6 (12.9 – 14.4) 25.1 (23.4 – 27.1) 1,688 (13.1 – 14.1) 7.40 14.5 7.23 (6.70 – 7.58) 14.5 (13.7 – 15.2) 29.4 (27.5 – 31.0) 1,365 40–59 years (13.8 – 15.2) 15.5 (14.9 – 16.2) 7.89 (7.52 – 8.13) 15.7 (15.0 – 16.5) 29.0 (27.3 – 31.9) 1,387 60 years and older Males (13.0 – 14.1) (13.1 – 14.0) 7.22 (6.78 – 7.61) 13.5 13.6 25.6 (24.5 – 26.2) 3,547 Total, 6 years and older (12.7 – 14.1) 13.4 (12.5 – 14.2) 8.08 (7.62 – 8.69) 13.6 6–11 years 20.5 (19.0 – 22.5) 427 12–19 years 10.5 6.49 (6.06 – 6.86) 10.3 (9.91 – 10.9) 17.3 (16.7 – 18.3) 980 (10.1 – 10.9) 13.4 7.26 (6.51 – 7.96) 13.4 (12.8 – 14.2) 23.8 (22.4 – 26.0) 738 20–39 years (12.8 – 14.0) 14.2 (13.4 – 15.0) 7.22 (5.99 – 7.90) 14.1 40–59 years 27.6 (26.6 – 31.0) 673 (13.1 – 15.1) 60 years and older (14.7 – 16.4) 7.94 (7.26 – 8.26) 15.5 (15.2 – 17.0) 27.8 (26.2 – 31.2) 729 15.9 Females Total, 6 years and older 14.0 7.27 (6.77 – 7.56) 13.8 (13.3 – 14.4) 27.5 (26.7 – 28.5) 3,707 (13.5 – 14.4) 6–11 years (12.1 – 13.7) 7.63 (5.98 – 8.50) 13.1 (12.6 – 13.7) 21.4 (19.9 – 23.6) 433 12.9 12–19 years 10.9 (10.3 – 11.4) 6.52 (5.98 – 6.93) 10.8 (10.1 – 11.5) 18.0 (16.9 – 19.1) 974 20–39 years 13.8 (13.2 – 14.5) 7.42 (6.59 – 7.80) 13.8 (12.9 – 14.8) 25.7 (23.9 – 28.0) 950 692 40–59 years 14.7 (13.9 – 15.6) 7.17 (6.76 – 7.56) 15.0 (13.8 – 16.2) 29.6 (28.9 – 32.2) (7.40 – 8.17) (28.0 – 32.8) (14.1 – 16.7) 15.6 7.80 29.8 658 60 years and older 15.6 (14.8 – 16.4) Table 2.10.a.3. Serum lutein/zeaxanthin: Mexican Americans Geometric mean and selected percentiles of serum concentrations (in μg/dL) for Mexican Americans in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Sample Geometric mea n (95% conf. interval) size 10th 50th 90th Males and Females 15.1 (14.5 – 15.8) 8.60 Total, 6 years and older 15.0 (14.4 – 15.6) 26.8 (25.2 – 28.6) 1,844 (8.07 – 9.17) 6–11 years (12.4 – 14.0) 8.43 (6.89 – 9.35) 13.2 (12.2 – 14.1) 21.1 (19.3 – 23.5) 295 13.3 12–19 years 12.1 (11.5 – 12.7) 7.64 (7.22 – 8.01) 12.3 (11.7 – 12.9) 18.9 (18.0 – 20.0) 646 20–39 years 15.4 8.96 (8.09 – 9.65) 15.4 (14.2 – 17.3) 26.2 (23.4 – 30.5) 449 (14.3 – 16.6) 40–59 years (16.0 – 18.5) 9.78 (7.36 – 11.0) 17.2 (16.2 – 18.5) 30.4 (27.3 – 36.3) 246 17.2 60 years and older 18.6 (16.7 – 20.7) 9.96 (7.59 – 12.0) 18.7 (16.9 – 20.3) 32.2 (30.1 – 34.4) 208 Males 15.1 15.4 (14.5 – 16.3) 8.81 (8.00 – 9.51) Total, 6 years and older (14.4 – 16.0) 28.1 (25.6 – 31.1) 883 19.6 6–11 years 13.0 (12.1 – 13.9) 8.75 (6.33 – 9.71) 13.1 (12.1 – 13.9) (17.5 – 22.0) 145 12–19 years 11.7 7.62 (6.85 – 8.20) 12.0 (10.9 – 12.9) 18.2 (17.4 – 19.2) 313 (11.0 – 12.5) 16.0 9.47 (8.02 – 10.1) 15.8 (14.9 – 17.4) 28.5 (24.2 – 33.1) 198 20–39 years (14.6 – 17.5) 17.7 (15.7 – 19.9) 8.69 (5.55 – 11.6) 17.6 40–59 years 31.1 (27.0 – 52.1) 122 (16.1 – 19.9) 60 years and older (16.0 – 22.7) 10.7† (6.38 – 12.2) 18.5 19.1 34.1† (29.9 – 45.4) 105 (14.5 – 25.4) Females Total, 6 years and older 14.9 (14.2 – 15.6) 8.46 (7.68 – 9.34) 14.7 (14.1 – 15.5) 24.4 (23.3 – 27.0) 961 6–11 years 13.4 7.94 (6.66 – 8.97) 13.6 (11.9 – 14.4) 23.4 (19.8 – 27.1) 150 (12.5 – 14.4) 12–19 years (11.9 – 13.1) 7.61 (7.08 – 8.14) 12.8 (12.3 – 13.1) 19.7 (18.3 – 20.8) 333 12.5 20–39 years 14.7 (13.7 – 15.9) 8.18 (7.42 – 9.74) 14.7 (13.1 – 16.9) 23.1 (22.2 – 27.0) 251 40–59 years 16.7 (15.6 – 18.0) 10.1 (7.40 – 10.9) 16.6 (14.5 – 18.4) 28.6 (23.7 – 44.2) 124 (16.2 – 21.7) 30.6† (28.3 – 33.6) (16.1 – 20.7) 18.8 103 9.82† 60 years and older 18.2 (7.45 – 11.7) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 156 156

168 Table 2.10.a.4. Serum lutein/zeaxanthin: Non-Hispanic blacks Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic blacks in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 10th 90th 50th Males and Females (14.8 – 15.8) 8.61 (8.21 – 9.04) 15.4 (15.0 – 15.8) 26.6 (25.2 – 28.4) Total, 6 years and older 15.3 1,891 15.8 10.5 (9.30 – 11.0) 16.2 (15.3 – 16.4) 23.9 (22.5 – 27.4) 240 6–11 years (15.6 – 16.8) 12.9 (12.3 – 13.5) 7.94 (7.37 – 8.38) 13.0 (12.1 – 13.7) 20.9 (19.5 – 22.1) 12–19 years 665 20–39 years (13.7 – 15.3) 8.29 (6.74 – 9.45) 14.4 (13.5 – 15.4) 25.3 (24.0 – 28.3) 368 14.5 16.4 8.77 (7.81 – 9.51) 17.0 (15.8 – 18.2) 28.6 (26.6 – 30.2) 335 40–59 years (15.5 – 17.4) 17.4 (16.0 – 19.1) 8.99 (8.24 – 10.1) 17.7 60 years and older 31.5 (27.1 – 36.5) 283 (16.0 – 19.1) Males 15.4 (14.9 – 15.9) 8.69 (8.26 – 9.42) Total, 6 years and older (14.9 – 16.3) 26.6 (25.6 – 28.4) 949 15.6 6–11 years 15.9 (14.9 – 16.9) 11.1 (10.3 – 11.9) 15.9 (15.0 – 17.2) 23.1 (21.9 – 26.9) 128 12–19 years 13.1 8.08 (7.27 – 8.68) 13.3 (12.2 – 14.6) 20.8 (19.6 – 21.9) 343 (12.4 – 13.8) 14.6 8.48 (6.56 – 9.65) 14.2 (13.1 – 15.7) 26.3 (23.2 – 29.1) 170 20–39 years (13.8 – 15.5) 16.9 (15.8 – 18.1) 9.21 (7.66 – 9.97) 18.2 40–59 years 30.6 (27.5 – 36.0) 156 (15.6 – 19.3) 60 years and older (16.2 – 18.1) 8.83 (7.79 – 9.64) 17.9 17.1 29.0 (25.9 – 34.0) 152 (17.2 – 18.8) Females Total, 6 years and older 15.2 (14.5 – 15.8) 8.51 (7.69 – 9.12) 15.3 (14.8 – 15.9) 26.4 (24.6 – 29.1) 942 6–11 years 15.8 9.57 (7.86 – 10.7) 16.5 (14.8 – 17.1) 24.0 (22.3 – 28.9) 112 (15.1 – 16.5) 12–19 years (11.9 – 13.6) 7.70 (6.62 – 8.68) 12.7 (11.4 – 13.6) 21.1 (19.1 – 23.5) 322 12.7 20–39 years 14.4 (13.4 – 15.5) 8.03 (5.21 – 9.63) 14.7 (13.6 – 15.4) 24.6 (23.2 – 28.5) 198 16.6 40–59 years (15.0 – 17.1) 8.72 (7.23 – 9.34) 16.0 (15.6 – 17.6) 26.9 (24.6 – 29.9) 179 (7.95 – 10.6) 60 years and older 17.7 (15.2 – 20.5) 9.08 (26.3 – 57.9) 17.3 (15.1 – 20.2) 33.2 131 Table 2.10.a.5. Serum lutein/zeaxanthin: Non-Hispanic whites Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic whites in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Sample Geometric mea n (95% conf. interval) size 10th 90th 50th Males and Females (12.8 – 13.6) 6.80 (6.48 – 7.16) 12.9 (12.5 – 13.4) 25.8 (25.1 – 26.9) Total, 6 years and older 13.2 2,973 12.5 7.68 (6.04 – 8.34) 12.7 (11.8 – 13.3) 19.8 (18.3 – 23.1) 231 6–11 years (12.2 – 13.6) 9.88 (9.46 – 10.3) 6.16 (5.75 – 6.48) 9.80 (9.34 – 10.3) 16.2 (15.0 – 17.1) 12–19 years 499 20–39 years (12.2 – 13.1) 6.56 (5.93 – 7.39) 12.4 (11.7 – 13.2) 23.6 (22.1 – 26.9) 714 12.7 13.8 6.87 (6.26 – 7.25) 13.7 (12.6 – 15.1) 27.9 (26.7 – 30.2) 683 40–59 years (13.0 – 14.6) 15.0 (14.4 – 15.7) 7.59 (7.25 – 7.97) 15.2 60 years and older 28.5 (26.4 – 31.4) 846 (14.2 – 15.8) Males 13.0 (12.5 – 13.4) 6.87 (6.45 – 7.22) Total, 6 years and older (12.2 – 13.5) 24.4 (23.5 – 25.7) 1,472 12.8 6–11 years 12.9 (11.8 – 14.2) 7.95 (5.77 – 8.67) 13.0 (12.2 – 14.1) 18.9 (17.1 – 31.9) 112 12–19 years 9.75 6.23 (5.55 – 6.75) 9.71 (9.33 – 10.0) 15.6 (14.3 – 16.9) 254 (9.24 – 10.3) 12.4 6.55 (5.75 – 7.69) 12.3 (11.7 – 13.0) 22.7 (21.8 – 24.8) 309 20–39 years (11.9 – 12.9) 13.6 (12.8 – 14.4) 6.96 (5.83 – 7.71) 13.4 40–59 years 26.6 (24.5 – 29.9) 351 (12.3 – 14.9) 60 years and older (14.2 – 15.9) 7.59 (7.11 – 8.05) 15.4 15.0 26.6 (25.5 – 30.6) 446 (14.4 – 16.5) Females Total, 6 years and older 13.4 (12.9 – 13.8) 6.75 (6.20 – 7.26) 13.0 (12.4 – 13.7) 27.4 (26.0 – 28.1) 1,501 6–11 years 12.1 6.73 (5.07 – 8.32) 12.4 (11.1 – 13.2) 19.9 (18.2 – 28.1) 119 (11.1 – 13.2) 12–19 years (9.21 – 10.9) 6.08 (5.23 – 6.57) 9.90 (9.18 – 11.1) 16.5 (15.3 – 18.1) 245 10.0 20–39 years 12.9 (12.2 – 13.6) 6.60 (5.82 – 7.42) 12.6 (11.2 – 14.4) 25.0 (22.3 – 28.5) 405 40–59 years 14.0 (13.0 – 15.0) 6.78 (5.98 – 7.28) 14.0 (12.5 – 15.7) 29.2 (27.5 – 30.7) 332 29.2 400 (13.6 – 16.2) (27.6 – 32.6) 60 years and older 15.1 (14.3 – 15.9) 7.58 (6.96 – 8.05) 14.7 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 157 157

169 Table 2.10.b. Serum lutein/zeaxanthin: Concentrations by survey cycle Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the U.S. population, National Health and Nutrition Examination Survey, 2001–2002 and 2005–2006. n s (95% conf. interval) Sample Geometric mea Selected percentile 50th 95th 5th (95% conf. interval) size Total, 6 years and older (5.53 – 6.00) (12.5 – 13.6) 5.77 12.9 (12.2 – 13.5) 30.4 (28.6 – 32.2) 7,923 13.1 2001–2002 (5.68 – 6.18) (30.3 – 33.2) (13.4 – 14.2) 13.7 (13.2 – 14.1) 31.3 13.8 7,254 5.90 2005–2006 Age group 3–5 years 12.5 (11.8 – 13.2) 6.38 (5.82 – 7.04) 12.5 (12.0 – 13.1) 24.6 (22.2 – 31.5) 430 2001–2002 6–11 years 12.3 (11.9 – 13.2) 6.61 (5.88 – 7.06) 12.5 (11.6 – 13.1) 2001–2002 (22.4 – 26.0) 1,014 24.8 2005–2006 13.1 (12.6 – 13.7) 6.70 (5.50 – 7.67) 13.3 (12.8 – 13.9) 24.5 (23.5 – 27.4) 860 12–19 years 2001–2002 (9.91 – 11.0) 4.99 (4.64 – 5.54) 10.4 (9.80 – 11.0) 20.9 (19.4 – 23.2) 2,205 10.4 10.7 (10.3 – 11.1) 5.67 (5.21 – 5.91) 10.6 (10.0 – 11.1) 20.0 (19.1 – 21.1) 1,954 2005–2006 20–39 years 2001–2002 (11.5 – 12.9) 5.47 (5.16 – 5.73) 12.0 (11.2 – 12.7) 27.1 (25.7 – 30.7) 1,714 12.1 2005–2006 13.6 (13.1 – 14.1) 5.91 (5.19 – 6.41) 13.6 (12.9 – 14.4) 29.3 (27.7 – 32.1) 1,688 40–59 years 1,468 2001–2002 14.4 (13.6 – 15.2) 6.47 (5.69 – 7.04) 14.1 (13.5 – 14.9) 32.6 (31.0 – 35.5) (13.8 – 15.2) (33.3 – 37.8) 35.7 14.5 (5.28 – 6.13) (13.7 – 15.2) 1,365 2005–2006 14.5 5.82 60 years and older 2001–2002 (14.3 – 16.2) 6.14 (5.54 – 6.68) 15.3 (14.3 – 16.6) 35.1 (33.3 – 41.0) 1,522 15.2 35.9 15.5 6.44 (6.02 – 6.69) 15.7 (15.0 – 16.5) 2005–2006 (32.8 – 40.3) 1,387 (14.9 – 16.2) Gender (6 years and older) Males 2001–2002 13.0 (12.5 – 13.6) 5.67 (5.35 – 6.01) 13.0 (12.4 – 13.6) 29.8 (28.3 – 31.7) 3,832 (13.0 – 14.1) 2005–2006 5.93 (5.42 – 6.35) 13.5 (13.1 – 14.0) 30.7 (28.7 – 31.4) 3,547 13.6 Females 2001–2002 13.1 (12.5 – 13.7) 5.87 (5.59 – 6.03) 12.7 (12.1 – 13.5) 31.4 (28.8 – 33.0) 4,091 13.8 2005–2006 14.0 (13.5 – 14.4) (5.69 – 6.13) 5.89 (13.3 – 14.4) 32.8 (31.0 – 35.7) 3,707 Race/ethnicity (6 years and older) Mexican Americans (13.2 – 14.1) 6.58 (6.15 – 6.84) 13.6 (13.3 – 14.2) 28.5 (26.8 – 30.7) 1,988 2001–2002 13.7 2005–2006 (14.5 – 15.8) 7.41 (6.79 – 7.83) 15.0 (14.4 – 15.6) 31.3 (29.2 – 34.1) 1,844 15.1 Non-Hispanic Blacks 2001–2002 14.2 (13.1 – 15.5) 6.80 (6.20 – 7.20) 14.1 (12.8 – 15.5) 30.7 (28.5 – 34.6) 1,864 2005–2006 (14.8 – 15.8) 7.03 (6.33 – 7.71) 15.4 (15.0 – 15.8) 31.5 (29.4 – 35.1) 1,891 15.3 Non-Hispanic Whites 2001–2002 12.6 (12.0 – 13.2) 5.60 (5.14 – 5.90) 12.4 (11.7 – 13.1) 28.8 (27.2 – 31.8) 3,447 30.9 12.9 (29.1 – 32.8) 2,973 5.70 (12.5 – 13.4) (5.33 – 5.88) 2005–2006 13.2 (12.8 – 13.6) nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 158 158

170 Figure 2.10.b. Serum lutein/zeaxanthin: Concentrations by survey cycle Selected percentiles in μg/dL (95% confidence intervals), National Health and Nutrition Examination Survey, 2001–2002 and 2005–2006 40 35 i i i i i i i i i i i i 30 i i i 25 i i 95th Percentile i i 20 15 16 i i i i 14 i i i i i i i i i i i i i 12 i i 50th Percentile 10 8 8 i i 7 i i i i i 6 i i i i i i i i i i i 5th Percentile i 5 4 05−06 01−02 05−06 01−02 05−06 01−02 05−06 01−02 05−06 01−02 05−06 01−02 05−06 01−02 05−06 01−02 05−06 01−02 05−06 01−02 20+y Males Females MA NHB NHW Total 3−5y 6−11y 12−19y (6+y) (6+y) (6+y) (6+y) (6+y) (6+y) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 159159

171 860 size 7,254 1,844 3,547 1,891 1,954 3,707 2,973 1,688 1,365 1,387 Sample (47.5 – 49.8) (39.8 – 49.9) (44.0 – 54.8) (49.0 – 55.7) (51.0 – 57.3) (44.4 – 52.7) (45.1 – 48.8) (47.3 – 50.6) (48.9 – 53.5) (47.2 – 55.9) (40.7 – 46.5) 97.5th 48.4 42.5 46.1 52.1 53.5 46.8 46.3 48.5 51.6 50.0 44.4 (42.4 – 44.9) (40.0 – 46.0) (43.7 – 47.0) (36.4 – 40.2) (44.7 – 49.5) (40.2 – 45.1) (41.2 – 43.9) (42.4 – 45.2) (44.1 – 47.2) (42.5 – 47.1) (37.3 – 40.7) 95th 43.6 42.8 44.7 38.0 47.0 42.6 42.3 43.8 46.1 44.6 38.8 (95% conf. interval) s (22.2 – 23.2) (21.1 – 23.7) (22.6 – 24.3) (19.6 – 20.9) (22.6 – 24.7) (21.8 – 22.9) (21.5 – 22.6) (22.4 – 23.5) (24.3 – 25.6) (22.1 – 24.4) (16.8 – 19.0) 50th 22.7 22.5 23.4 20.2 23.5 22.3 22.2 23.0 25.1 23.2 17.8 Selected percentile (7.33 – 8.40) (7.38 – 10.9) (6.99 – 8.89) (7.83 – 9.29) (7.39 – 8.77) (8.98 – 11.0) (7.09 – 8.40) (7.04 – 8.47) (8.97 – 11.4) (6.02 – 8.98) (4.32 – 5.97) 5th 7.81 9.48 7.85 8.80 8.11 9.91 7.76 7.69 10.7 7.69 5.19 (4.99 – 6.25) (5.27 – 9.29) (4.54 – 6.70) (6.09 – 7.33) (5.46 – 6.99) (7.31 – 8.78) (4.93 – 6.39) (4.83 – 6.26) (7.38 – 8.96) (3.76 – 6.34) (2.69 – 4.36) 2.5th 5.64 7.67 5.79 7.04 6.29 8.42 5.47 5.46 8.24 5.13 3.75 n (20.7 – 21.7) (20.5 – 22.9) (21.0 – 22.6) (19.1 – 20.0) (20.9 – 23.2) (21.1 – 22.6) (20.0 – 21.2) (20.8 – 21.9) (23.3 – 24.4) (20.4 – 22.8) (15.4 – 17.4) 21.2 21.7 21.8 19.5 22.0 21.9 20.6 21.3 23.9 21.6 16.4 (95% conf. interval) Geometric mea Total, 6 years and older 6–11 years Age group Males Gender Race/ethnicity Mexican Americans Non-Hispanic Blacks 12–19 years Females Non-Hispanic Whites 20–39 years 40–59 years 60 years and older Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Table 2.11.a.1. Serum trans-lycopene: Concentrations nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 160 160

172 Figure 2.11.a. Serum trans−lycopene: Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2005–2006 Overall Mexican Americans Females Males (μg/dL) Serum trans−lycopene 0 10 20 30 60+ 20−39 40−59 20−39 40−59 60+ 6−11 6−11 12−19 12−19 Non−Hispanic Whites Non−Hispanic Blacks 30 (μg/dL) Serum trans−lycopene 40−59 60+ 20−39 6−11 12−19 20−39 12−19 40−59 60+ 6−11 Females Males Mexican Americans Non−Hispanic Blacks Non−Hispanic (μg/dL) Whites Serum trans−lycopene 0 10 20 30 0 10 20 60+ 40−59 20−39 20−39 40−59 60+ 6−11 12−19 12−19 6−11 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 161161

173 Table 2.11.a.2. Serum trans-lycopene: Total population Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 90th 10th Males and Females (20.7 – 21.7) 10.7 (10.1 – 11.3) Total, 6 years and older (22.2 – 23.2) 38.9 (37.7 – 39.8) 7,254 21.2 22.7 21.7 11.6 (10.5 – 12.9) 22.5 (20.5 – 22.9) 38.3 (36.3 – 40.3) 860 6–11 years (21.1 – 23.7) 21.9 (21.1 – 22.6) 12.9 (12.2 – 13.6) 22.3 (21.8 – 22.9) 37.2 (35.8 – 39.1) 1,954 12–19 years 23.9 20–39 years (11.8 – 14.8) 25.1 (24.3 – 25.6) 40.2 (39.5 – 41.2) 1,688 (23.3 – 24.4) 13.4 21.6 11.0 (9.50 – 11.9) 23.2 (22.1 – 24.4) 39.9 (38.4 – 41.8) 1,365 40–59 years (20.4 – 22.8) 16.4 (15.4 – 17.4) 7.14 (6.48 – 7.69) 17.8 (16.8 – 19.0) 33.7 (32.3 – 36.1) 1,387 60 years and older Males (22.6 – 24.3) (21.0 – 22.6) 11.2 (10.3 – 11.8) 23.4 21.8 39.6 (38.1 – 41.0) 3,547 Total, 6 years and older (21.4 – 23.9) 22.6 (21.8 – 24.3) 12.8 (11.0 – 14.4) 23.1 6–11 years 38.6 (36.9 – 40.8) 427 12–19 years 22.2 13.4 (11.5 – 14.2) 22.7 (22.0 – 23.6) 37.2 (36.3 – 38.7) 980 (21.4 – 23.0) 25.1 14.6 (11.9 – 15.8) 26.2 (24.9 – 27.4) 41.4 (40.0 – 43.7) 738 20–39 years (24.0 – 26.2) 21.9 (20.1 – 23.9) 10.9 (8.58 – 12.4) 23.9 40–59 years 40.6 (37.3 – 43.9) 673 (22.3 – 25.6) 60 years and older (15.1 – 17.6) 7.44 (6.33 – 7.78) 16.3 (16.4 – 19.1) 33.5 (31.3 – 36.8) 729 17.8 Females Total, 6 years and older 20.6 10.3 (9.56 – 11.1) 22.2 (21.5 – 22.6) 38.2 (36.7 – 39.5) 3,707 (20.0 – 21.2) 6–11 years (18.9 – 22.8) 10.4 (8.68 – 12.8) 21.7 (20.3 – 23.5) 37.3 (35.2 – 41.9) 433 20.8 12–19 years 21.5 (20.1 – 23.0) 12.8 (10.7 – 13.7) 21.9 (21.0 – 23.2) 37.1 (34.6 – 40.6) 974 20–39 years 22.7 (22.1 – 23.3) 12.9 (11.1 – 14.2) 23.7 (23.0 – 24.6) 39.0 (35.9 – 41.3) 950 692 40–59 years 21.3 (20.1 – 22.5) 11.0 (9.50 – 11.9) 22.4 (21.0 – 24.3) 39.3 (38.6 – 40.8) (6.29 – 7.73) (31.5 – 38.3) (16.6 – 19.3) 17.9 6.89 34.2 658 60 years and older 16.4 (15.3 – 17.6) Table 2.11.a.3. Serum trans-lycopene: Mexican Americans Geometric mean and selected percentiles of serum concentrations (in μg/dL) for Mexican Americans in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Sample Geometric mea n (95% conf. interval) size 10th 50th 90th Males and Females 19.5 (19.1 – 20.0) 10.7 Total, 6 years and older 20.2 (19.6 – 20.9) 33.7 (32.8 – 34.4) 1,844 (10.1 – 11.2) 6–11 years (18.5 – 20.8) 11.0 (9.47 – 13.0) 19.6 (19.1 – 21.2) 32.4 (31.2 – 34.0) 295 20.1 12–19 years 20.0 (19.2 – 20.9) 12.0 (10.1 – 12.8) 20.9 (19.8 – 22.1) 33.5 (32.3 – 35.2) 646 20–39 years 20.9 11.6 (9.65 – 13.5) 22.0 (21.0 – 23.3) 34.7 (33.4 – 38.1) 449 (19.7 – 22.1) 40–59 years (17.3 – 19.5) 10.0 (9.04 – 11.0) 18.8 (18.2 – 19.4) 32.8 (30.6 – 37.0) 246 18.4 60 years and older 15.5 (14.0 – 17.1) 7.71 (5.24 – 8.87) 16.1 (14.7 – 17.7) 28.6 (26.1 – 33.2) 208 Males 21.1 20.1 (19.4 – 20.8) 11.0 (9.96 – 12.0) Total, 6 years and older (20.1 – 22.2) 34.4 (32.2 – 37.6) 883 32.1 6–11 years 19.0 (17.8 – 20.2) 10.9 (9.33 – 12.7) 19.5 (18.2 – 20.5) (28.9 – 36.1) 145 12–19 years 20.6 12.3 (8.72 – 13.6) 22.1 (19.9 – 23.4) 34.0 (32.7 – 35.5) 313 (19.2 – 22.1) 21.9 13.2 (8.92 – 15.1) 23.1 (21.5 – 24.9) 35.1 (32.1 – 44.4) 198 20–39 years (20.0 – 23.9) 18.6 (17.1 – 20.2) 10.1 (7.36 – 11.3) 19.3 40–59 years 32.7 (28.9 – 39.9) 122 (17.8 – 20.7) 60 years and older (12.9 – 18.6) 7.41† (2.71 – 8.77) 16.2 15.5 31.3† (25.2 – 56.0) 105 (13.9 – 19.3) Females Total, 6 years and older 19.0 (18.4 – 19.5) 10.5 (10.0 – 11.0) 19.4 (18.5 – 20.2) 33.3 (32.1 – 34.1) 961 6–11 years 20.4 11.4 (9.53 – 13.4) 21.2 (19.3 – 23.0) 32.5 (31.2 – 35.0) 150 (18.9 – 22.0) 12–19 years (18.6 – 20.3) 11.8 (10.1 – 12.2) 20.0 (19.4 – 20.9) 32.9 (31.5 – 35.7) 333 19.4 20–39 years 19.7 (18.6 – 20.8) 10.8 (9.95 – 12.7) 20.0 (18.5 – 23.4) 34.1 (32.5 – 36.7) 251 40–59 years 18.1 (16.8 – 19.6) 10.0 (9.01 – 11.0) 18.0 (16.9 – 19.1) 32.8 (30.5 – 34.5) 124 (13.3 – 18.1) 26.7† (25.0 – 31.2) (14.0 – 17.2) 16.0 103 7.98† 60 years and older 15.5 (5.24 – 10.5) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 162 162

174 Table 2.11.a.4. Serum trans-lycopene: Non-Hispanic blacks Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic blacks in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 90th 10th Males and Females (20.9 – 23.2) 10.8 (9.77 – 11.8) Total, 6 years and older (22.6 – 24.7) 40.0 (39.1 – 41.7) 1,891 22.0 23.5 25.6 13.7 (11.1 – 17.0) 27.0 (23.3 – 28.2) 41.8 (38.7 – 45.9) 240 6–11 years (24.6 – 28.9) 24.8 (23.5 – 26.2) 14.3 (12.9 – 15.4) 25.8 (23.6 – 27.4) 41.6 (39.1 – 44.9) 665 12–19 years 25.7 20–39 years (12.4 – 15.6) 26.3 (25.0 – 27.8) 42.4 (39.6 – 47.1) 368 (24.2 – 27.2) 14.5 20.4 9.89 (8.68 – 10.8) 21.3 (19.9 – 23.3) 38.6 (36.2 – 43.4) 335 40–59 years (19.1 – 21.8) 14.3 (13.1 – 15.7) 6.20 (4.94 – 6.93) 15.3 (14.5 – 16.5) 31.2 (27.5 – 35.7) 283 60 years and older Males (23.3 – 26.4) (21.9 – 24.3) 11.2 (9.87 – 12.4) 24.9 23.1 41.8 (39.8 – 44.9) 949 Total, 6 years and older (23.4 – 29.2) 26.2 (23.4 – 29.8) 16.4 (10.4 – 18.0) 27.0 6–11 years 40.1 (38.4 – 46.3) 128 12–19 years 25.5 14.9 (13.5 – 16.1) 26.2 (23.9 – 27.8) 43.2 (39.5 – 51.7) 343 (24.1 – 27.0) 28.0 15.3 (13.6 – 16.8) 27.9 (26.2 – 30.2) 47.8 (42.5 – 52.7) 170 20–39 years (26.5 – 29.6) 20.5 (18.3 – 22.9) 9.19 (6.70 – 10.9) 22.1 40–59 years 38.6 (35.6 – 51.3) 156 (18.9 – 26.4) 60 years and older (13.3 – 15.9) 5.56 (4.94 – 6.14) 14.6 (15.0 – 17.1) 32.1 (30.0 – 38.1) 152 15.5 Females Total, 6 years and older 21.2 10.6 (9.30 – 11.6) 22.5 (21.1 – 23.7) 39.0 (37.2 – 41.0) 942 (19.8 – 22.7) 6–11 years (22.4 – 28.1) 12.4 (9.15 – 15.1) 26.7 (24.9 – 28.9) 42.1 (38.4 – 49.7) 112 25.1 12–19 years 24.1 (21.9 – 26.6) 13.9 (10.5 – 15.5) 24.8 (22.1 – 27.6) 39.8 (36.6 – 43.9) 322 20–39 years 23.8 (21.8 – 26.1) 13.6 (10.9 – 15.7) 25.0 (22.1 – 27.2) 39.1 (37.4 – 41.6) 198 179 40–59 years 20.3 (19.2 – 21.6) 9.99 (9.03 – 11.3) 20.9 (18.1 – 23.3) 39.0 (34.8 – 44.3) 28.1 131 (24.6 – 39.1) 60 years and older 14.1 (12.1 – 16.5) 6.71 (3.54 – 7.89) 15.0 (13.0 – 17.4) Table 2.11.a.5. Serum trans-lycopene: Non-Hispanic whites Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic whites in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Sample Geometric mea n (95% conf. interval) size 10th 50th 90th Males and Females 21.3 (20.8 – 21.9) 10.8 Total, 6 years and older 23.0 (22.4 – 23.5) 39.1 (37.5 – 40.6) 2,973 (10.1 – 11.3) 6–11 years (19.6 – 23.4) 11.1 (9.63 – 12.9) 21.4 (20.4 – 24.0) 37.5 (33.7 – 42.4) 231 22.1 12–19 years 21.6 (20.6 – 22.6) 13.0 (11.1 – 13.7) 22.1 (21.4 – 22.7) 37.0 (35.0 – 39.9) 499 20–39 years 24.6 13.7 (11.4 – 16.4) 25.6 (24.8 – 26.4) 40.7 (39.6 – 42.3) 714 (23.6 – 25.6) 40–59 years (20.9 – 23.9) 11.7 (9.54 – 13.0) 24.2 (22.9 – 25.3) 40.5 (38.3 – 42.2) 683 22.3 60 years and older 16.6 (15.6 – 17.6) 7.32 (6.45 – 8.11) 18.0 (16.9 – 19.2) 34.2 (32.3 – 37.0) 846 Males 23.6 21.9 (21.0 – 22.9) 11.3 (10.3 – 11.9) Total, 6 years and older (22.7 – 24.8) 39.6 (37.9 – 41.6) 1,472 (21.1 – 24.8) 6–11 years 22.6 (20.7 – 24.6) 12.8 (8.41 – 14.9) 23.0 112 38.3 (33.4 – 43.2) 12–19 years 21.8 13.2 (10.0 – 14.3) 22.5 (21.1 – 24.3) 36.6 (35.8 – 38.4) 254 (20.6 – 23.2) 25.7 14.8 (11.8 – 17.1) 26.5 (25.1 – 28.4) 41.5 (39.6 – 46.1) 309 20–39 years (24.2 – 27.2) 22.8 (20.6 – 25.2) 11.8 (8.02 – 14.0) 25.0 40–59 years 41.2 (38.1 – 44.0) 351 (23.2 – 27.0) 60 years and older (15.0 – 17.8) 7.49 (6.36 – 8.08) 17.7 16.3 33.7 (31.3 – 37.0) 446 (16.0 – 19.2) Females Total, 6 years and older 20.8 (20.0 – 21.7) 10.2 (9.48 – 11.1) 22.4 (21.5 – 23.1) 38.5 (36.5 – 40.3) 1,501 6–11 years 20.1 9.66 (4.60 – 12.9) 20.7 (19.2 – 23.2) 36.7 (30.8 – 50.0) 119 (17.6 – 23.1) 12–19 years (19.4 – 23.3) 12.7 (9.21 – 14.2) 21.6 (20.3 – 23.5) 37.2 (33.9 – 41.5) 245 21.3 20–39 years 23.5 (22.5 – 24.5) 13.0 (10.2 – 16.2) 24.6 (23.3 – 25.3) 40.2 (35.9 – 42.7) 405 40–59 years 21.8 (20.3 – 23.6) 11.7 (9.46 – 12.9) 23.4 (21.4 – 25.3) 39.7 (37.9 – 41.1) 332 (32.1 – 38.5) 400 34.4 60 years and older 16.9 (15.8 – 18.0) 7.00 (6.17 – 8.28) 18.3 (17.1 – 20.1) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 163 163

175 Table 2.11.b. Serum trans-lycopene: Concentrations by survey cycle Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the U.S. population, National Health and Nutrition Examination Survey, 2001–2002 and 2005–2006. n Selected percentile s (95% conf. interval) Sample Geometric mea 50th 95th 5th (95% conf. interval) size Total, 6 years and older (19.9 – 21.3) 7.87 (7.49 – 8.27) 22.2 (21.3 – 23.1) 42.5 (41.0 – 43.9) 7,921 20.6 2001–2002 21.2 (20.7 – 21.7) 7.81 (7.33 – 8.40) 22.7 (22.2 – 23.2) 43.6 (42.4 – 44.9) 7,254 2005–2006 Age group 3–5 years (15.2 – 17.1) 6.16 (3.73 – 7.47) 17.3 16.1 33.9 (32.8 – 37.9) 427 2001–2002 (16.2 – 18.1) 6–11 years 21.6 (20.7 – 22.5) 9.31 (8.20 – 9.83) 22.7 (21.4 – 23.6) 2001–2002 (37.7 – 47.0) 1,012 40.5 2005–2006 21.7 (20.5 – 22.9) 9.48 (7.38 – 10.9) 22.5 (21.1 – 23.7) 42.8 (40.0 – 46.0) 860 12–19 years 2001–2002 (21.1 – 22.1) 10.5 (9.69 – 11.1) 22.2 (21.8 – 22.7) 40.5 (38.1 – 43.2) 2,205 21.6 21.9 (21.1 – 22.6) 9.91 (8.98 – 11.0) 22.3 (21.8 – 22.9) 42.6 (40.2 – 45.1) 1,954 2005–2006 20–39 years 2001–2002 (21.5 – 23.9) 10.3 (9.02 – 11.5) 23.7 (22.5 – 24.9) 44.9 (42.4 – 47.1) 1,714 22.7 2005–2006 23.9 (23.3 – 24.4) 10.7 (8.97 – 11.4) 25.1 (24.3 – 25.6) 46.1 (44.1 – 47.2) 1,688 40–59 years 1,468 2001–2002 21.1 (20.1 – 22.1) 7.82 (7.02 – 8.61) 22.7 (21.4 – 24.1) 42.6 (41.2 – 43.8) (20.4 – 22.8) (42.5 – 47.1) 44.6 23.2 (6.02 – 8.98) (22.1 – 24.4) 1,365 2005–2006 21.6 7.69 60 years and older 2001–2002 (14.6 – 16.3) 4.15 (2.92 – 5.13) 17.1 (16.1 – 17.9) 39.0 (36.4 – 41.3) 1,522 15.4 38.8 16.4 5.19 (4.32 – 5.97) 17.8 (16.8 – 19.0) 2005–2006 (37.3 – 40.7) 1,387 (15.4 – 17.4) Gender (6 years and older) Males 2001–2002 21.4 (20.6 – 22.3) 8.02 (7.31 – 8.80) 23.3 (22.3 – 24.2) 44.2 (42.8 – 46.3) 3,832 (22.6 – 24.3) 2005–2006 7.85 (6.99 – 8.89) 23.4 (21.0 – 22.6) 44.7 (43.7 – 47.0) 3,547 21.8 Females 2001–2002 19.8 (19.2 – 20.5) 7.82 (7.13 – 8.34) 21.2 (20.4 – 22.0) 40.3 (38.9 – 42.1) 4,089 22.2 2005–2006 20.6 (20.0 – 21.2) (7.09 – 8.40) 7.76 (21.5 – 22.6) 42.3 (41.2 – 43.9) 3,707 Race/ethnicity (6 years and older) Mexican Americans (20.1 – 21.7) 8.89 (7.84 – 9.62) 20.7 (19.2 – 20.8) 39.8 (38.1 – 42.0) 1,987 2001–2002 20.0 2005–2006 (19.1 – 20.0) 8.80 (7.83 – 9.29) 20.2 (19.6 – 20.9) 38.0 (36.4 – 40.2) 1,844 19.5 Non-Hispanic Blacks 2001–2002 21.7 (21.0 – 22.3) 8.03 (6.83 – 9.11) 23.4 (22.2 – 24.3) 46.6 (44.9 – 49.0) 1,864 2005–2006 (20.9 – 23.2) 8.11 (7.39 – 8.77) 23.5 (22.6 – 24.7) 47.0 (44.7 – 49.5) 1,891 22.0 Non-Hispanic Whites 2001–2002 20.8 (20.1 – 21.6) 8.17 (7.55 – 8.72) 22.4 (21.3 – 23.5) 42.5 (40.9 – 44.0) 3,446 43.8 23.0 (42.4 – 45.2) 2,973 7.69 (22.4 – 23.5) (7.04 – 8.47) 2005–2006 21.3 (20.8 – 21.9) nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 164 164

176 Figure 2.11.b. Serum trans−lycopene: Concentrations by survey cycle Selected percentiles in μg/dL (95% confidence intervals), National Health and Nutrition Examination Survey, 2001–2002 and 2005–2006 50 i i 45 i i i i i i i i i i i i i i 40 i i 95th Percentile 35 i 30 25 i i i i i i i i i i i i i i i i i i 20 50th Percentile i 15 12 i 10 i i i i i i i i i 8 i i i i i i i i i 6 5th Percentile 4 2 05−06 05−06 01−02 05−06 01−02 05−06 01−02 05−06 01−02 05−06 01−02 05−06 01−02 05−06 01−02 05−06 01−02 05−06 01−02 01−02 12−19y 20+y Males Females MA NHB NHW Total 3−5y 6−11y (6+y) (6+y) (6+y) (6+y) (6+y) (6+y) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 165165

177 851 size 7,149 1,818 3,493 1,846 1,907 3,656 2,943 1,667 1,346 1,378 Sample (87.9 – 94.7) (74.1 – 91.3) (80.6 – 105) (89.9 – 103) (91.5 – 107) (78.1 – 93.4) (81.9 – 92.1) (87.2 – 94.8) (87.4 – 99.3) (90.7 – 103) (76.3 – 89.4) 97.5th 90.7 79.3 83.0 95.2 97.2 82.8 86.0 89.7 92.7 97.2 81.7 (78.8 – 82.5) (74.8 – 82.5) (81.6 – 86.9) (67.0 – 74.0) (83.0 – 89.5) (71.5 – 79.0) (75.1 – 80.5) (78.9 – 82.9) (81.4 – 86.1) (79.9 – 89.2) (69.5 – 76.4) 95th 80.8 78.4 84.5 70.5 86.4 73.9 77.6 81.1 83.3 84.1 72.8 (95% conf. interval) s (41.0 – 42.6) (38.5 – 44.1) (42.2 – 44.7) (36.1 – 38.9) (41.1 – 45.5) (39.6 – 42.0) (38.9 – 41.6) (41.3 – 43.3) (43.8 – 46.6) (41.1 – 45.3) (31.4 – 35.9) 50th 41.8 40.9 43.5 37.4 43.1 40.6 40.1 42.4 45.2 43.1 33.5 Selected percentile (14.6 – 16.1) (15.1 – 19.9) (13.9 – 17.3) (15.3 – 17.9) (14.3 – 18.0) (17.2 – 20.9) (14.2 – 16.4) (14.2 – 16.0) (17.0 – 21.8) (12.4 – 17.1) (9.50 – 12.4) 5th 15.4 18.8 15.6 16.6 16.7 19.1 15.3 15.1 20.0 15.0 10.7 (10.4 – 12.6) (10.7 – 17.8) (9.28 – 13.2) (11.8 – 14.3) (10.9 – 14.2) (12.9 – 17.4) (10.3 – 12.9) (9.72 – 12.5) (14.0 – 17.8) (7.35 – 13.2) (6.96 – 9.57) 2.5th 11.3 14.9 11.4 13.7 12.9 15.4 11.1 10.9 15.9 10.6 8.08 n (38.5 – 40.2) (37.5 – 42.0) (39.3 – 42.0) (35.3 – 37.1) (39.2 – 43.5) (38.2 – 40.8) (37.1 – 39.3) (38.6 – 40.6) (42.7 – 44.9) (38.2 – 42.9) (29.8 – 33.2) 39.4 39.7 40.6 36.2 41.3 39.5 38.2 39.6 43.8 40.5 31.5 (95% conf. interval) Geometric mea Total, 6 years and older 6–11 years Age group Males Gender Race/ethnicity Mexican Americans Non-Hispanic Blacks 12–19 years Females Non-Hispanic Whites 20–39 years 40–59 years 60 years and older Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Table 2.12.a.1. Serum total lycopene: Concentrations nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 166 166

178 Figure 2.12.a. Serum total lycopene: Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2005–2006 Overall Mexican Americans Females Males (μg/dL) Serum total lycopene 0 20 40 60 60+ 20−39 40−59 20−39 40−59 60+ 6−11 6−11 12−19 12−19 Non−Hispanic Whites Non−Hispanic Blacks 60 (μg/dL) Serum total lycopene 40−59 60+ 20−39 6−11 12−19 20−39 12−19 40−59 60+ 6−11 Females Males Mexican Americans Non−Hispanic Blacks Non−Hispanic (μg/dL) Whites Serum total lycopene 0 20 40 60 0 20 40 60+ 40−59 20−39 20−39 40−59 60+ 6−11 12−19 12−19 6−11 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 167167

179 Table 2.12.a.2. Serum total lycopene: Total population Geometric mean and selected percentiles of serum concentrations (in μg/dL) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 90th 10th Males and Females (38.5 – 40.2) 20.5 (19.5 – 21.3) Total, 6 years and older (41.0 – 42.6) 71.2 (69.5 – 72.7) 7,149 39.4 41.8 39.7 21.5 (19.3 – 25.4) 40.9 (37.5 – 42.0) 67.6 (63.5 – 74.9) 851 6–11 years (38.5 – 44.1) 39.5 (38.2 – 40.8) 23.5 (21.8 – 24.6) 40.6 (39.6 – 42.0) 66.3 (63.1 – 69.6) 1,907 12–19 years 43.8 20–39 years (21.9 – 27.2) 45.2 (43.8 – 46.6) 74.0 (72.5 – 75.8) 1,667 (42.7 – 44.9) 24.6 40.5 21.0 (18.6 – 22.9) 43.1 (41.1 – 45.3) 72.8 (70.3 – 77.1) 1,346 40–59 years (38.2 – 42.9) 31.5 (29.8 – 33.2) 14.3 (13.3 – 15.9) 33.5 (31.4 – 35.9) 62.8 (60.2 – 67.5) 1,378 60 years and older Males (42.2 – 44.7) (39.3 – 42.0) 21.2 (20.1 – 22.2) 43.5 40.6 72.9 (70.9 – 75.6) 3,493 Total, 6 years and older (39.2 – 43.8) 41.4 (39.7 – 44.9) 23.7 (20.3 – 26.4) 42.1 6–11 years 69.5 (63.4 – 78.2) 421 12–19 years 40.1 23.8 (21.3 – 26.0) 41.1 (40.0 – 42.5) 66.3 (64.6 – 69.4) 955 (38.5 – 41.8) 46.4 26.8 (22.9 – 30.6) 48.3 (45.5 – 51.0) 78.5 (74.6 – 81.9) 730 20–39 years (44.5 – 48.5) 41.2 (37.7 – 45.0) 20.9 (15.2 – 23.9) 44.9 40–59 years 75.0 (71.0 – 81.4) 663 (42.6 – 47.1) 60 years and older (29.1 – 33.7) 14.3 (12.6 – 15.9) 31.3 (31.6 – 36.4) 62.0 (59.0 – 69.3) 724 34.4 Females Total, 6 years and older 38.2 19.9 (18.8 – 21.1) 40.1 (38.9 – 41.6) 69.3 (67.0 – 71.7) 3,656 (37.1 – 39.3) 6–11 years (34.8 – 41.3) 19.4 (16.3 – 24.7) 39.8 (35.7 – 43.9) 66.2 (59.8 – 74.0) 430 37.9 12–19 years 38.8 (36.2 – 41.5) 23.4 (20.0 – 24.6) 40.1 (37.8 – 42.7) 65.3 (60.1 – 72.6) 952 20–39 years 41.3 (40.2 – 42.4) 22.6 (20.7 – 26.2) 42.7 (41.5 – 43.7) 71.6 (66.4 – 74.0) 937 683 40–59 years 39.8 (37.6 – 42.1) 20.9 (18.9 – 22.8) 41.1 (37.8 – 45.0) 71.3 (68.8 – 75.6) (12.9 – 16.4) (58.0 – 69.7) (30.8 – 35.8) 33.0 14.2 64.6 654 60 years and older 31.6 (29.7 – 33.5) Table 2.12.a.3. Serum total lycopene: Mexican Americans Geometric mean and selected percentiles of serum concentrations (in μg/dL) for Mexican Americans in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 10th 50th 90th Males and Females 36.2 (35.3 – 37.1) 20.5 Total, 6 years and older 37.4 (36.1 – 38.9) 61.5 (58.8 – 63.5) 1,818 (19.5 – 21.7) 6–11 years (33.8 – 37.3) 21.0 (18.7 – 22.5) 35.5 (33.8 – 37.3) 58.4 (55.7 – 63.1) 292 35.5 12–19 years 35.7 (34.5 – 37.0) 21.8 (19.6 – 23.4) 37.4 (36.0 – 38.7) 58.5 (55.6 – 61.8) 639 20–39 years 38.8 22.7 (18.7 – 24.7) 41.0 (39.1 – 42.5) 63.8 (58.8 – 71.2) 441 (36.5 – 41.1) 40–59 years (32.7 – 37.1) 19.6 (17.4 – 21.1) 35.1 (32.6 – 38.5) 60.7 (57.3 – 65.5) 240 34.8 60 years and older 29.9 (27.3 – 32.8) 14.7 (11.9 – 17.9) 30.1 (27.9 – 33.8) 54.7 (48.8 – 65.8) 206 Males 39.2 37.6 (36.3 – 39.0) 21.4 (19.9 – 23.0) Total, 6 years and older (36.9 – 40.8) 63.1 (59.5 – 68.0) 867 57.4 6–11 years 34.4 (32.6 – 36.4) 20.2 (17.8 – 22.4) 34.3 (31.7 – 36.1) (50.5 – 73.4) 142 12–19 years 36.9 22.5 (19.2 – 24.6) 39.1 (36.8 – 40.7) 59.7 (55.9 – 63.9) 310 (34.6 – 39.4) 41.3 24.6 (16.6 – 27.7) 42.6 (40.6 – 45.6) 66.1 (58.3 – 94.4) 192 20–39 years (37.8 – 45.1) 35.6 (32.6 – 38.8) 19.0 (14.4 – 22.6) 36.4 40–59 years 58.7 (56.0 – 74.3) 120 (33.4 – 40.5) 60 years and older (25.1 – 35.7) 14.5† (5.80 – 18.2) 30.2 29.9 61.9† (48.0 – 86.3) 103 (26.0 – 36.1) Females Total, 6 years and older 34.8 (33.8 – 35.8) 20.0 (18.7 – 21.4) 35.3 (33.5 – 37.3) 59.5 (56.8 – 62.0) 951 6–11 years 36.7 21.1 (17.7 – 24.4) 36.7 (34.3 – 40.4) 58.8 (56.3 – 62.2) 150 (34.4 – 39.1) 12–19 years (33.2 – 35.8) 20.6 (19.0 – 22.6) 34.8 (33.8 – 36.8) 57.8 (51.9 – 62.0) 329 34.5 20–39 years 35.9 (33.9 – 38.1) 20.2 (17.5 – 22.7) 37.4 (33.3 – 41.9) 61.4 (56.1 – 68.6) 249 40–59 years 34.0 (31.6 – 36.7) 19.6 (16.1 – 21.4) 33.0 (30.2 – 38.3) 61.0 (55.9 – 67.8) 120 (26.6 – 35.7) 52.7† (48.0 – 59.9) (27.3 – 32.8) 29.2 103 16.1† 60 years and older 29.9 (12.1 – 20.5) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 168 168

180 Table 2.12.a.4. Serum total lycopene: Non-Hispanic blacks Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic blacks in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 90th 10th Males and Females (39.2 – 43.5) 21.4 (19.5 – 23.1) Total, 6 years and older (41.1 – 45.5) 75.5 (72.1 – 79.6) 1,846 41.3 43.1 47.9 27.4 (20.5 – 31.8) 49.6 (43.3 – 52.9) 78.5 (73.9 – 84.4) 236 6–11 years (44.6 – 56.3) 44.3 (42.3 – 46.4) 26.9 (23.9 – 29.0) 45.8 (42.8 – 47.8) 73.1 (69.2 – 78.2) 636 12–19 years 47.0 (44.2 – 50.1) 26.4 (23.2 – 29.6) 49.0 (45.5 – 52.3) 79.6 (76.1 – 82.9) 363 20–39 years 39.2 20.0 (17.1 – 21.4) 40.8 (37.7 – 43.4) 73.7 (66.9 – 84.2) 331 40–59 years (36.4 – 42.2) 28.2 (26.0 – 30.6) 12.7 (10.4 – 15.4) 29.1 60 years and older 59.0 (53.0 – 68.4) 280 (26.6 – 32.7) Males 43.6 (41.0 – 46.3) 22.9 (19.5 – 24.5) Total, 6 years and older (42.8 – 48.4) 81.2 (76.4 – 87.8) 922 45.8 6–11 years 49.5 (44.4 – 55.1) 30.6 (15.3 – 35.9) 50.4 (42.4 – 58.7) 76.8 (70.9 – 91.8) 126 12–19 years 45.7 (43.1 – 48.6) 28.9 (25.6 – 30.2) 46.7 (43.6 – 50.4) 76.3 (69.3 – 90.2) 324 20–39 years 51.6 29.7 (25.9 – 31.9) 51.4 (48.1 – 54.9) 86.3 (81.2 – 90.5) 169 (48.4 – 55.1) 40.0 (36.8 – 47.4) 18.4 (13.2 – 22.9) 41.1 40–59 years 82.9 (67.2 – 97.5) 153 (35.3 – 45.3) (28.3 – 34.7) 60 years and older 12.5 (11.1 – 13.0) 31.1 (26.5 – 31.6) 59.5 (52.9 – 66.0) 150 28.9 Females Total, 6 years and older 39.3 (37.0 – 41.8) 20.8 (18.5 – 22.2) 41.0 (39.4 – 43.0) 71.4 (68.7 – 74.1) 924 6–11 years 46.3 24.6† (17.9 – 27.5) 48.5 (44.6 – 54.8) 78.5† (72.8 – 84.6) 110 (41.2 – 52.1) 12–19 years (39.5 – 46.4) 25.6 (20.1 – 28.1) 44.1 (39.8 – 48.0) 70.4 (67.3 – 75.3) 312 42.9 20–39 years 43.4 (39.8 – 47.3) 23.6 (21.0 – 28.0) 44.5 (40.4 – 50.6) 72.6 (68.4 – 76.7) 194 40–59 years 38.6 (36.3 – 41.0) 20.1 (17.1 – 21.5) 40.2 (36.7 – 43.0) 68.6 (63.6 – 75.8) 178 (45.4 – 82.2) 130 60 years and older 27.7 (24.1 – 31.9) 12.8 (8.09 – 17.2) 28.6 (24.8 – 32.4) 57.6 † Estimate is subject to greater uncertainty due to small cell size. Table 2.12.a.5. Serum total lycopene: Non-Hispanic whites Geometric mean and selected percentiles of serum concentrations (in μg/dL) for non-Hispanic whites in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2005–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 90th 10th Males and Females (38.6 – 40.6) 20.4 (19.4 – 21.3) Total, 6 years and older (41.3 – 43.3) 71.5 (69.4 – 73.8) 2,943 39.6 42.4 39.3 20.7 (18.9 – 24.9) 40.6 (35.9 – 43.1) 64.8 (58.7 – 78.0) 230 6–11 years (37.7 – 44.9) 39.2 (37.5 – 40.9) 23.3 (20.8 – 24.8) 40.7 (39.3 – 42.1) 66.2 (62.8 – 70.2) 489 12–19 years 44.8 (43.2 – 46.5) 25.3 (21.5 – 29.3) 45.9 (44.0 – 48.4) 75.4 (72.5 – 77.8) 706 20–39 years 41.6 22.2 (17.8 – 24.4) 44.7 (42.6 – 47.0) 73.9 (70.4 – 78.5) 674 40–59 years (38.8 – 44.6) 31.7 (30.0 – 33.5) 14.4 (13.3 – 16.2) 33.9 60 years and older 62.9 (60.2 – 67.4) 844 (31.7 – 36.7) Males 40.7 (39.2 – 42.3) 21.0 (19.7 – 22.0) Total, 6 years and older (42.5 – 45.2) 73.2 (70.9 – 76.0) 1,461 43.9 6–11 years 41.5 (38.1 – 45.3) 23.6† (19.7 – 26.4) 42.3 (39.5 – 45.7) 66.0† (58.8 – 81.5) 111 12–19 years 39.8 (37.1 – 42.6) 23.2 (19.9 – 27.0) 41.0 (38.4 – 43.0) 66.3 (63.5 – 69.8) 251 20–39 years 47.2 26.8 (21.7 – 31.6) 49.4 (45.9 – 52.3) 78.7 (73.9 – 85.0) 308 (44.7 – 49.8) 42.6 (44.0 – 49.0) 22.4 (15.0 – 27.3) 46.3 40–59 years 75.3 (70.9 – 82.7) 346 (38.4 – 47.1) (30.8 – 36.5) 60 years and older 14.4 (12.3 – 16.1) 33.9 (28.6 – 34.0) 62.0 (58.8 – 69.7) 445 31.2 Females Total, 6 years and older 38.5 (36.9 – 40.1) 19.7 (18.2 – 21.3) 40.7 (38.9 – 42.5) 69.6 (66.8 – 72.6) 1,482 6–11 years 37.0 19.1 (13.7 – 25.3) 39.1 (33.8 – 43.3) 61.9 (54.6 – 78.0) 119 (32.7 – 41.8) 12–19 years (35.1 – 42.3) 23.6 (18.0 – 25.6) 40.4 (37.0 – 43.4) 64.4 (57.9 – 75.6) 238 38.6 20–39 years 42.5 (40.6 – 44.4) 22.9 (19.9 – 28.7) 43.2 (41.9 – 44.2) 72.1 (66.5 – 77.0) 398 40–59 years 40.7 (37.6 – 44.0) 21.6 (17.5 – 24.5) 42.4 (39.0 – 47.4) 72.1 (68.7 – 78.7) 328 399 (59.0 – 68.7) 64.5 60 years and older 32.2 (30.3 – 34.2) 14.3 (12.9 – 16.6) 33.8 (31.6 – 37.1) † Estimate is subject to greater uncertainty due to small cell size. 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 169 169

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183 Vitamin D Background Information V itamin D (calciferol) comprises a group of fat soluble Sources and Physiological Functions. fish-liv in only a fe w foods, such as er oils, fatty fishes, mushr ooms, egg found seco-sterols naturally liver. The two major physiologically relevant forms of vitamin D are D yolks, (ergocalciferol) and 2 D (cholecalciferol). V itamin D and is photosynthesized in the skin of vertebrates by the action 3 3 present ultraviolet (UV) B radiation on 7-dehydrocholesterol of in the skin ( Fieser 1959 ). solar D is Vitamin pr oduced b y UV irradiation of ergoster ol, which occurs in molds, y east, and higher- 2 plants. Under conditions of regular sun exposure, dietary vitamin D intake is of minor order However, season, aging, sunscreen use, and latitude, skin pigmentation influence the importance. of vitamin D ). by the skin ( Institute of Medicine 2011 production In the United States, most 3 dietary intake of vitamin D comes from the fortified milk products and other fortified foods of as breakfast cereals and orange juice ( Institute of Medicine 2011 ). Both vitamin D such and D 3 2 used in nonprescription vitamin D supplements, but vitamin D are is the form available by only 2 in the United ( Holick 2007 ). prescription States D without a subscript represents either D Vitamin or D or both. V itamin D, per se , is 3 2 inert. Whether derived from the skin or vitamin D is only short-lived in biologically diet, (with a half-life of 1–2 days), as it is either stored in fat cells or metabolized in the liver circulation Mawer and 1972 ). In circulation, vitamin D is bound to vitamin D-binding protein ( transported liver, where it is converted to 25-hydroxyvitamin D [25(OH)D] ( DeLuca 1984 ). This to the circulating form of vitamin D is a good major reflection of cumulative effects of exposure to sunlight and dietary intake of vitamin D Haddad 1973; Holick 1995 ) and is therefore ( used by clinicians to determine vitamin D status. T o be biologically activated at physiologic concentrations, must be converted in the kidneys to 1,25-dihydroxyvitamin D 25(OH)D most, which is [1,25(OH) thought to be responsible for D], if not all, of the biologic functions 2 of vitamin D ( DeLuca 1988; Reichel 1989 ). The production of 25(OH)D in the liver is a function vitamin D availability from dietary intake of and sun exposure whereas production of 1,25(OH) D in the kidney is tightly regulated by mineral requirements. In the liver, vitamin 2 D-25-hydroxylase is down-regulated by vitamin D and its metabolites, thereby limiting any increase the circulating concentration of 25(OH)D following intakes or following production in D after exposure to sunlight. In the kidney, in response to serum calcium and of vitamin the production of 1,25(OH) phosphorus D concentrations, regulated through the action of is 2 hormone (PTH) ( DeLuca 1988; Reichel 1989 ). parathyroid vitamin Active D (1,25-dihydroxyvitamin D) functions as a hormone, and its Health Effects. main biologic function in people is to maintain serum calcium and phosphorus concentrations of normal range by enhancing the efficiency within the small intestine to absorb these the minerals from the diet ( DeLuca 1988; Reichel 1989 ). When dietary calcium intake is inadequate to the body’s calcium requirement, 1,25(OH) satisfy D, along with PTH, mobilizes calcium 2 stores from the bone. In the kidney, 1,25(OH) D increases calcium reabsorption by the distal 2 renal tubules. Apart from these traditional calcium-related actions, 1,25(OH) D and its synthetic 2 analogs are increasingly recognized for their potent anti-proliferative, pro-differentiative, and immunomodulatory activities ( Nagpal 2005 ). Vitamin D deficiency is characterized by inadequate mineralization or by demineralization of is the skeleton. Among children, vitamin D deficiency a common cause of bone deformities defect skeleton, the in known as rickets. V itamin D deficiency in adults leads to a mineralization nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 172 172

184 causing and it induces secondary hyperparathyroidism with consequent bone loss osteomalacia, osteoporosis. roles for vitamin D beyond bone health, such as effects on muscle and Potential 2 the for cancer, and the risk for type risk diabetes, are under intense investigation. The strength, for Healthcare Research and Quality (AHRQ) reviewed the effectiveness and safety of Agency D on outcomes related to bone health ( Cranney 2007 ). The report suggests that vitamin vitamin supplementation health has positive effects on bone in postmenopausal women and older men. D and systematic review of vitamin D status health outcomes found no significant Another AHRQ between vitamin D status and total cancer mortality, nor did it find any conclusive associations evidence the association of vitamin D status with cancer risk or cancer outcome ( Chung for outcomes also found no clear ). association between vitamin D status and cardiometabolic It 2009 glucose, blood pressure, myocardial fasting or stroke. Randomized trials including infarction no clinically significant consistent effects of vitamin D supplementation at the dosages showed given 2010 ). ( Pittas vitamin What constitutes the optimal of D remains a matter intake Intake Recommendations. some disagreement. Current recommendations from the Institute of Medicine ( 2011 ) call for of [10 international units (IU) micrograms ( μ g)] of vitamin D daily from birth through age 400 1 for adequate intake (AI)]. The Recommended Dietary Allowance (RDA) for those aged year μ is 600 IU (15 μ g) and 800 IU (20 g) for those older than 70 years. According to 1–70 years Dietary Guidelines for Americans ( U.S. Department of Agriculture and U.S. Department of the evidence Services 2010 ), moderate Health shows that intake of milk and milk products is Human improved bone health, especially in children linked and adolescents. In the United States, most to D is obtained from fortified foods, vitamin especially milk. The T olerable Upper Intake dietary Level for vitamin D is 4000 IU (100 μ g) per day in North America for individuals 9 years of age and and ranges from 1000 IU to 3000 IU for infants and children less than 9 older years of age; as intake increases above this amount, the risk for adverse consequences increases. potential Biochemical Indicators and Methods. T o assess vitamin D status, one measures the concentration 25(OH)D in serum, using either of antibody-based methods such as radioisotope-, enzyme-linked- or chemiluminescence- immunoassays, or using chemistry-based methods such mass as HPLC separation with UV or tandem spectrometry detection. Studies have shown that chemistry-based standardized methods are equivalent but that antibody-based methods may show significant Some clinical laboratories use conventional units for 25(OH)D (nanogram per bias. [ng/mL]), whereas other laboratories use milliliter system (SI) units (nanomole per liter international The conversion factor to SI units is: [nmol/L]). 1 = 2.5 nmol/L. ng/mL committee of Medicine ( 2011 ) The to Institute review reference intakes for dietary vitamin D and calcium suggested that persons with serum 25(OH) D of less than 30 nmol/L (12 ng/mL) concentrations with risk for deficiency; those are concentrations at least of 30 but less than at 50 nmol/L (12 to less than 20 ng/mL) are at risk for inadequacy; and those with between 50–75 concentrations nmol/L (20–30 ng/mL) are considered sufficient. The Committee indicated that concentrations greater than 125 nmol/L interest Of (50 ng/mL) may be reason for concern. 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 173 173

185 to health scientists, the report indicated that a serum 25(OH)D level consistent with the public 30 Average for dietary intake (EAR) lies between Requirement and 50 nmol/L and that Estimated nmol/L was selected from the middle of the range to serve as the targeted level for median dietary 40 ( 2011 of Medicine ). requirements Institute for number external quality assurance programs exist of serum or plasma 25(OH)D A measurements, including those sponsored by concentration DEQAS (Vitamin D External Scheme), College of American Pathologists Assessment (Bone and Growth Survey and Quality V itamin D Survey), and NIST/NIH (Vitamin D Metabolites Quality Assurance Accuracy-Based Standard reference materials (SRM 972) with certified values for 25(OH)D Program). , 25(OH) 2 and C3-epimer of 25(OH)D are available from D the U.S. National Institute of Standards and 3 3 (NIST). An additional solvent-based reference material set (SRM 2972) with certified Technology for 25(OH)D and 25(OH)D https://www-s.nist.gov/srmors/view_detail. is values also available ( 3 2 improvement in the agreement between laboratories and ). Further is methods cfm?srm=972 as more laboratories use these SRMs. expected The data in this report were obtained by use of an antibody-based method, Data in NHANES. radioimmunoassay (DiaSorin, Stillwater, MN). a The manufacturer reformulated the specifically in the late 1990s, resulting in data that were on average 12% lower than kit those generated with the kit. T o make NHANES III data (original kit) comparable to data from 2001–2006 original of we followed the recommendations of a panel experts ( Yetley 2010 ) to use (reformulated kit), published adjustment equation for the NHANES III data (see Analytic Note at http://www. a ). The Analytic Note also reported that cdc.gov/nchs/nhanes/nhanes2005-2006/VID_D.htm the reformulated kit showed some assay drifts between 2001 and 2006. T o generate 2003–2004 public and tables and figures, we used the 2005–2006 release data files from November 2010. Using data that were already adjusted for these assay drifts was the most appropriate way to make comparisons survey cycles. across NHANES has monitored the vitamin D status of the U.S. population. By Since design, 1988, the this collects information and biological samples in survey summer from people living at higher latitudes and in the winter from people living at lower latitudes. Because the different racial and geographic ethnic are not evenly distributed across all groups regions in the United States, the structure of the survey can affect comparisons by race or ethnicity. In two seasonal season-latitude subpopulations from NHANES III (1988–1994), Looker et al . ( 2002 ) showed that in the winter 25–57% and lower latitude subpopulation, 1–5% and had 25(OH)D concentrations less than the and and summer 25 nmol/L (10 ng/mL) less than 62.5 nmol/L (25 ng/mL), respectively. In higher subpopulation, 1–3% and 21–49% had 25(OH)D concentrations below these latitude in cutoffs. 25(OH)D concentrations were highest Mean non-Hispanic whites, intermediate in Mexican Americans, and lowest in non-Hispanic blacks. A more recent analysis of NHANES III and NHANES 2000–2004 ( Looker 2008 ) demonstrated that overall, mean serum 25(OH) D were 5–9 nmol/L lower in 2000–2004 than in 1988–1994 in most males, but not in most status females. related to changes in vitamin D Factors were increased body mass index, decreased milk intake, and increased usage of sun protection in the more recent surveys. of For more information about vitamin D see the Institute , Medicine’s Dietary Reference Intake of Health, of reports ( Institute of Medicine 2011 ), fact sheets from the National Institutes Office Supplements Dietary (http://ods.od.nih.gov/Health_Information/Information_About_Individual_Dietary_ Supplements.aspx). nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 174 174

186 Highlights Serum D [25(OH)D] concentrations in the U.S. population showed the 25-hydroxyvitamin demographic following and characteristics: patterns increasing generally decreased with age. Concentrations • consistent pattern was observed with • regard to gender. No Among the three race/ethnic groups, non-Hispanic had the lowest 25(OH)D • blacks and non-Hispanic whites had the highest concentrations. concentrations The of being vitamin D deficient likelihood was significantly influenced by race/ • ethnicity. the past several years, the vitamin D status of the U.S. population was under intensive During determine whether a downward trend was to investigation In the analysis below, we apparent. used data that were adjusted for radioimmunoassay reformulation and assay drifts according to recommendations by a panel of experts ( Yetley 2010) . The age-adjusted mean 25(OH)D made concentrations in the U.S. population decreased approximately 10% between NHANES III by and the periods 2001–2002 and 2003–2006 ( Figure H.2.b ). Decreases were seen in all groups shown (total or stratified by gender or race/ethnicity). Similarly, a recent report found that the of age- and season-adjusted prevalence at risk deficiency (serum 25(OH)D concentrations less than 30 nmol/L) increased between 1988–1994 and 2001–2002 from 4% to 7% for males aged ). years and older and from 7% to 11% 12 for females aged 12 years and older ( Looker 2011 1988-1994 2003-2006 2001-2002 80 a a 70 b b a a b b b b 60 b b a b b 50 a c 40 b 30 20 10 Serum 25-hydroxyvitamin D (nmol/L) 0 Total Non- Males Mexican Females Non- population Hispanic American Hispanic black white concentrations Figure H.2.b. 12 aged population U.S. the and Age-adjusted geometric mean years of serum 25-hydroxyvitamin D in 1988–2006. Survey, Examination Nutrition and Health race/ethnicity, or gender by older National Age adjustment was Error bars represent 95% confidence intervals. W ithin a demographic group, bars not sharing a common letter differ (p < 0.05). using standardization. direct done older and year one blacks non-Hispanic prevalence that note to interesting is It highest the had less than 30 of ( Figure H.2.c ), vitamin D deficiency (serum 25(OH)D concentrations nmol/L) clinical data showing superior bone health despite with greater density and fewer fractures than finding ( Aloia 2008 ). to explain this unusual other race/ethnic groups; further research is needed bone lower and mass muscle greater turnover rates, obesity higher mass, bone peak Higher are have been suggested to protect African Americans against fracture that factors the of some 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 175 175

187 Aloia 2008 ). Non-Hispanic blacks and Mexican ( Americans had the highest prevalence of low categorized less serum 25(OH)D concentrations at risk for inadequacy (30 to nmol/L) than 50 whites to non-Hispanic compared ). ( Figure H.2.c 45 b a 40 b 35 30 25 c 20 a Prevalence (%) 15 10 c 5 0 Non- Mexican Non- Non- Mexican Non- Hispanic American Hispanic American Hispanic Hispanic black white black white < 30 nmol/L 30 to < 50 nmol/L 50 less Figure H.2.c. Age-adjusted prevalence estimates of serum 25-hydroxyvitamin D concentrations less than than 30 and 30 to Examination Survey, 2003– nmol/L in the U.S. population aged 1 year and older by race/ethnicity, National Health and Nutrition 2006. category common letter differ (p < 0.05). Age not bars , status D vitamin each Within intervals. confidence 95% represent bars Error sharing a direct standardization. adjustment was done using concluded Institute of Medicine ( 2011 ) report The that serum 25(OH)D levels of 40 nmol/L are at a level consistent with a desirable median intake of vitamin D. Non-Hispanic blacks had higher prevalence of serum concentrations less significantly than 40 nmol/L ( Figure H.2.d ) which to targeted level for the median dietary requirement. The median meets the the corresponds concentrations of approximately half than less requirement with individuals thus population the 40 adverse health outcomes. increased risk of are nmol/L at 70 b 60 50 40 a 30 Prevalence (%) 20 c 10 0 Mexican American Non-Hispanic white Non-Hispanic black < 40 nmol/L Figure H.2.d. U.S. the in nmol/L 40 than Age-adjusted less concentrations D 25-hydroxyvitamin serum of estimates prevalence National Health and Nutrition Examination Survey, 2003–2006. older race/ethnicity, and years 1 aged by population Error bars represent 95% confidence intervals. Bars not sharing a common letter differ (p < 0.05). Age adjustment was done using direct standardization. nd nd 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 176 176 < 30 nmol/L 30 to < 50 nmol/L

188 Detailed Observations The selected observations mentioned below are derived from the tables and figures presented next. about categorical differences between demographic groups noted below are based on Statements without confidence limits from univariate analysis adjusting for demographic non-overlapping (e.g., age, gender, race/ethnicity) or other blood variables concentration determinants (e.g., dietary intake, supplement usage, smoking, BMI). A multivariate analysis may alter the size statistical and significance of these categorical differences. additional significant differences of Furthermore, smaller magnitude may be present despite their lack of mention here (e.g., if confidence limits slightly or if differences are not statistically significant before covariate adjustment has overlap a selection of occurred). of descriptive NHANES papers related to For these biochemical citations indicators of diet and see Appendix G . nutrition, Geometric mean concentrations (NHANES 2003–2006): • Serum 25(OH)D concentrations decreased through adolescence and then stabilized (Table 2.13.a.1). Non-Hispanic blacks had the lowest • of serum 25(OH)D (Table concentrations 2.13.a.1). Changes in geometric mean concentrations across surveys: • Geometric mean 25(OH)D concentrations remained steady across the survey cycles from 2001–2006 (Table 2.13.b). Prevalence estimates of low or high biochemical indicator concentrations: • 2003 Between and 2006, 8% of the population aged 1 year and older were at risk for vitamin deficiency, as defined by a serum concentration < 30 nmol/L, whereas 24% D concentrations between 30 and less than 50 nmol/L, levels that placed had serum at risk for inadequacy (Tables 2.13.c.1 and 2.13.c.2). Approximately 17% of the them population concentrations < 40 nmol/L which is considered the level associated had 1% intake (Tables 2.13.c.3). Less than with had serum concentrations > 125 desirable nmol/L, a level that may be reason for concern about excess (Tables 2.13.c.4). • Less than 2% of children (1–11 years) were at risk for vitamin D deficiency (Table 2.13.c.1). at females (10%) than males (6%) were More risk for vitamin D deficiency (Table • 2.13.c.1). non- More non-Hispanic blacks (31%) were at risk for vitamin D deficiency than • Hispanic whites (4%) or Mexican Americans (11%) (Table 2.13.c.1). • The prevalence of risk for vitamin D deficiency remained steady across the 2001–2006 (Table 2.13.d.1). survey cycles 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 177 177

189 size 8,459 8,145 1,799 4,275 4,349 1,768 4,044 6,698 3,262 2,660 3,071 16,604 Sample (108 – 117) (105 – 112) (85.4 – 92.0) (98.6 – 109) (102 – 121) (98.4 – 122) (74.9 – 82.2) (106 – 123) (110 – 117) (110 – 122) (98.0 – 110) (96.6 – 106) 97.5th 108 107 103 105 112 113 111 115 103 100 88.2 79.0 (93.9 – 101) (95.7 – 107) (90.7 – 97.7) (79.2 – 84.7) (92.5 – 108) (96.1 – 106) (68.5 – 73.7) (94.3 – 108) (97.8 – 106) (97.2 – 108) (90.5 – 98.3) (89.5 – 95.0) 95th 102 102 96.6 81.8 99.6 94.0 70.9 99.4 97.2 98.4 94.3 91.9 (95% conf. interval) s (56.3 – 59.9) (57.1 – 60.7) (66.9 – 70.6) (47.7 – 53.4) (55.2 – 59.2) (63.0 – 66.1) (34.2 – 39.1) (55.3 – 60.1) (61.8 – 64.6) (54.4 – 58.9) (54.1 – 58.1) (55.4 – 58.5) 50th 58.0 68.8 49.9 58.9 64.5 57.2 36.6 57.6 63.2 56.6 56.0 56.9 Selected percentile (21.4 – 25.0) (23.8 – 27.3) (19.6 – 23.3) (39.5 – 43.4) (19.8 – 22.5) (32.0 – 38.7) (13.5 – 15.1) (29.1 – 32.6) (19.8 – 25.1) (20.3 – 23.3) (19.8 – 23.6) (21.6 – 24.6) 5th 23.2 41.6 25.8 21.5 35.3 21.2 14.3 31.0 22.7 21.8 21.7 23.1 (17.4 – 19.7) (32.9 – 38.8) (16.8 – 19.4) (18.6 – 22.3) (27.3 – 31.6) (11.0 – 12.8) (16.2 – 18.5) (23.3 – 25.9) (15.6 – 20.1) (15.9 – 19.0) (16.3 – 18.9) (18.1 – 20.1) 2.5th 18.5 20.7 36.9 18.2 30.5 12.0 17.6 18.0 24.9 17.6 17.8 19.1 n (53.6 – 57.6) (46.3 – 51.2) (66.7 – 70.5) (54.7 – 58.7) (61.6 – 66.1) (52.5 – 56.6) (34.3 – 38.0) (60.3 – 63.4) (52.4 – 58.0) (52.1 – 57.0) (51.3 – 56.0) (52.4 – 55.8) 55.6 48.7 56.7 68.6 54.5 63.8 36.1 61.9 55.1 54.5 53.6 54.1 (95% conf. interval) Geometric mea Total, 1 year and older 1–5 years Race/ethnicity Males Gender Age group Mexican Americans Females Non-Hispanic Blacks 6–11 years 12–19 years Non-Hispanic Whites 20–39 years 40–59 years 60 years and older and Nutrition Examination Survey, 2003–2006. Geometric mean and selected percentiles of serum concentrations (in nmol/L) for the total U.S. population aged 1 year and older, National Health Table 2.13.a.1. Serum 25-hydroxyvitamin D: Concentrations nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 178 178

190 Figure 2.13.a. Serum 25−hydroxyvitamin D: Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2006 Overall Mexican Americans Females Males (nmol/L) 0 20 40 60 80 Serum 25−hydroxyvitamin D 40−59 6−11 12−19 20−39 12−19 60+ 1−5 20−39 40−59 60+ 1−5 6−11 Non−Hispanic Whites Non−Hispanic Blacks 80 (nmol/L) 0 20 40 60 Serum 25−hydroxyvitamin D 60+ 20−39 60+ 1−5 6−11 12−19 20−39 40−59 40−59 1−5 6−11 12−19 Females Males Mexican Americans Non−Hispanic Blacks Non−Hispanic (nmol/L) Whites 0 20 40 60 80 Serum 25−hydroxyvitamin D 6−11 20−39 12−19 6−11 1−5 60+ 60+ 40−59 1−5 40−59 12−19 20−39 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 179179

191 Table 2.13.a.2. Serum 25-hydroxyvitamin D: Total population Geometric mean and selected percentiles of serum concentrations (in nmol/L) for the total U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 95th 5th Males and Females (53.6 – 57.6) 23.2 (21.4 – 25.0) 58.0 (56.3 – 59.9) 96.6 (93.9 – 101) 16,604 Total, 1 year and older 55.6 (66.7 – 70.5) 1–5 years (39.5 – 43.4) 68.8 (66.9 – 70.6) 99.6 (95.7 – 107) 1,799 68.6 41.6 63.8 35.3 (32.0 – 38.7) 64.5 (63.0 – 66.1) 97.2 (92.5 – 108) 1,768 6–11 years (61.6 – 66.1) 55.1 (52.4 – 58.0) 22.7 (19.8 – 25.1) 57.6 (55.3 – 60.1) 98.4 (94.3 – 108) 4,044 12–19 years 54.5 20–39 years (20.3 – 23.3) 56.6 (54.4 – 58.9) 102 (97.2 – 108) 3,262 (52.1 – 57.0) 21.8 53.6 21.7 (19.8 – 23.6) 56.0 (54.1 – 58.1) 94.3 (90.5 – 98.3) 2,660 40–59 years (51.3 – 56.0) 54.1 (52.4 – 55.8) 23.1 (21.6 – 24.6) 56.9 (55.4 – 58.5) 91.9 (89.5 – 95.0) 3,071 60 years and older Males Total, 1 year and older 25.8 (23.8 – 27.3) 58.9 (54.7 – 58.7) 94.0 (90.7 – 97.7) 8,145 56.7 (57.1 – 60.7) 69.2 (67.0 – 71.5) 41.7 (40.1 – 43.5) 69.3 (66.7 – 71.6) 101 (96.7 – 106) 904 1–5 years 6–11 years 65.5 (63.2 – 67.9) 36.9 (32.5 – 40.3) 65.8 (64.3 – 67.6) 98.0 (92.4 – 116) 862 12–19 years 56.6 25.3 (22.5 – 28.0) 58.7 (56.4 – 61.2) 95.2 (88.8 – 105) 2,049 (54.0 – 59.3) 53.7 23.6 (20.9 – 25.7) 55.9 (53.7 – 57.8) 90.6 (87.7 – 96.7) 1,472 20–39 years (51.4 – 56.1) (55.8 – 60.8) (88.1 – 98.7) 92.4 1,311 58.0 55.8 25.3 (53.3 – 58.4) 40–59 years (22.4 – 27.0) (55.6 – 59.7) 55.6 60 years and older (23.8 – 27.9) 57.5 (53.7 – 57.7) 91.9 (89.1 – 97.2) 1,547 26.0 Females Total, 1 year and older 54.5 (52.5 – 56.6) 21.2 (19.8 – 22.5) 57.2 (55.2 – 59.2) 99.4 (96.1 – 106) 8,459 1–5 years 67.9 41.3 (37.4 – 44.3) 68.4 (66.3 – 70.3) 98.1 (93.3 – 113) 895 (65.8 – 70.0) 6–11 years (59.6 – 64.4) 34.0 (31.4 – 37.6) 62.8 (60.1 – 65.3) 96.4 (92.5 – 103) 906 61.9 12–19 years 53.6 (50.6 – 56.9) 20.6 (18.0 – 22.9) 56.4 (53.1 – 59.5) 106 (96.5 – 114) 1,995 20–39 years 55.3 (52.4 – 58.3) 20.5 (19.1 – 21.8) 57.6 (54.4 – 60.7) 110 (106 – 116) 1,790 1,349 40–59 years 51.6 (49.2 – 54.2) 19.4 (18.3 – 20.6) 54.1 (50.8 – 57.0) 95.1 (91.5 – 99.2) 21.7 (89.1 – 95.8) 92.0 56.4 (20.2 – 23.2) (54.5 – 58.2) 1,524 60 years and older 52.9 (51.1 – 54.7) Table 2.13.a.3. Serum 25-hydroxyvitamin D: Mexican Americans Geometric mean and selected percentiles of serum concentrations (in nmol/L) for Mexican Americans in the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 5th 50th 95th Males and Females 48.7 (46.3 – 51.2) 21.5 (19.6 – 23.3) 49.9 (47.7 – 53.4) 81.8 (79.2 – 84.7) Total, 1 year and older 4,275 1–5 years (63.1 – 66.6) 42.5 (39.4 – 44.7) 64.3 (62.3 – 66.1) 93.8 (89.5 – 99.7) 584 64.8 56.9 (55.0 – 58.8) 32.7 (30.9 – 34.9) 58.2 (56.3 – 59.8) 82.9 (80.7 – 86.9) 589 6–11 years 12–19 years 46.8 (44.2 – 49.6) 22.0 (20.2 – 23.4) 47.8 (45.6 – 50.7) 74.8 (71.2 – 83.6) 1,288 20–39 years 46.6 20.6 (17.6 – 23.5) 48.0 (45.4 – 51.5) 78.0 (75.6 – 83.1) 789 (43.6 – 49.7) 40–59 years (41.4 – 47.7) 19.4 (17.4 – 21.2) 45.8 (41.9 – 49.0) 79.8 (72.4 – 87.7) 472 44.4 60 years and older 45.0 (42.4 – 47.8) 20.1 (17.6 – 21.4) 45.9 (43.6 – 48.1) 79.5 (73.4 – 89.5) 553 Males Total, 1 year and older (48.7 – 53.7) 24.5 (21.7 – 26.6) 51.1 (49.4 – 55.5) 81.7 (79.0 – 85.2) 2,073 52.7 1–5 years 65.2 (63.9 – 66.5) 44.6 (40.5 – 45.8) 64.4 (63.1 – 65.6) 94.9 (88.6 – 109) 282 (56.8 – 60.8) 58.8 6–11 years 36.0 (32.3 – 38.8) 59.7 (57.8 – 62.3) 83.3 (80.5 – 92.2) 286 12–19 years 49.5 23.8 (21.5 – 26.2) 50.0 (47.4 – 54.0) 78.0 (72.7 – 85.8) 641 (46.6 – 52.6) 49.1 24.3 (19.7 – 26.2) 49.8 (47.1 – 54.1) 77.0 (73.1 – 86.5) 353 20–39 years (45.5 – 52.8) 47.4 (44.0 – 51.0) 20.9 (15.3 – 25.9) 47.4 40–59 years 79.8 (44.6 – 54.3) 239 (72.2 – 92.8) (43.6 – 54.3) 48.0 21.4 60 years and older 48.3 (44.0 – 52.2) 81.2 (74.4 – 96.7) 272 (18.3 – 25.0) Females Total, 1 year and older 46.2 (43.7 – 48.8) 19.8 (18.9 – 20.6) 47.7 (45.4 – 50.3) 82.1 (78.6 – 85.4) 2,202 1–5 years 64.5 40.5 (36.0 – 44.3) 64.2 (59.9 – 67.5) 92.9 (89.1 – 98.6) 302 (61.8 – 67.2) 6–11 years (52.3 – 57.5) 31.1 (25.0 – 33.7) 56.6 (54.0 – 58.8) 82.3 (74.5 – 93.8) 303 54.8 12–19 years 44.1 (41.4 – 47.1) 20.4 (17.3 – 22.5) 45.6 (42.4 – 48.0) 73.2 (67.7 – 80.3) 647 20–39 years (40.7 – 47.3) 18.5 (16.4 – 20.4) 44.9 (41.6 – 48.2) 80.2 (74.8 – 87.1) 436 43.9 233 41.5 (37.9 – 45.3) 18.7 (17.5 – 20.0) 42.8 (37.3 – 46.8) 79.6 (70.9 – 85.0) 40–59 years 78.0 (15.4 – 21.1) (71.5 – 88.9) 281 44.3 19.1 (40.5 – 47.0) 60 years and older 42.7 (39.6 – 46.1) nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 180 180

192 Table 2.13.a.4. Serum 25-hydroxyvitamin D: Non-Hispanic blacks Geometric mean and selected percentiles of serum concentrations (in nmol/L) for non-Hispanic blacks in the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) n Sample Geometric mea (95% conf. interval) size 50th 95th 5th Males and Females (34.3 – 38.0) 14.3 (13.5 – 15.1) 36.6 (34.2 – 39.1) 70.9 (68.5 – 73.7) 4,349 Total, 1 year and older 36.1 (52.7 – 58.5) 1–5 years (21.0 – 33.4) 57.5 (54.5 – 59.6) 86.6 (82.1 – 91.3) 503 55.5 29.4 48.1 24.8 (23.4 – 25.7) 49.4 (47.3 – 52.2) 73.8 (71.5 – 80.2) 561 6–11 years (45.7 – 50.6) 34.2 (31.4 – 37.2) 13.8 (13.0 – 14.6) 34.6 (31.3 – 38.2) 68.3 (64.2 – 72.2) 1,421 12–19 years 32.5 20–39 years (12.7 – 14.8) 31.5 (29.2 – 34.2) 64.0 (61.1 – 70.4) 716 (30.4 – 34.8) 13.7 34.1 13.3 (11.6 – 14.8) 34.7 (32.4 – 37.7) 66.2 (62.0 – 71.6) 626 40–59 years (32.0 – 36.3) 36.2 (34.1 – 38.3) 15.0 (13.2 – 15.9) 36.3 (33.8 – 39.7) 72.9 (67.6 – 80.3) 522 60 years and older Males Total, 1 year and older 15.5 (14.0 – 16.6) 38.6 (35.9 – 40.3) 71.8 (69.0 – 78.6) 2,166 38.0 (35.9 – 41.4) 56.5 (52.5 – 60.7) 30.0 (21.7 – 34.0) 58.4 (54.3 – 61.6) 89.1 (81.9 – 98.4) 248 1–5 years 6–11 years 51.0 (48.1 – 54.1) 26.0 (23.0 – 28.4) 53.0 (49.3 – 56.5) 75.0 (70.5 – 88.7) 277 12–19 years 36.9 14.6 (13.2 – 15.9) 38.1 (34.9 – 41.0) 70.8 (66.6 – 75.9) 745 (34.0 – 40.0) 32.4 13.8 (11.6 – 15.2) 30.5 (28.4 – 33.3) 64.9 (59.0 – 82.3) 339 20–39 years (29.8 – 35.1) (34.2 – 42.2) (62.4 – 77.2) 69.6 293 38.2 37.4 15.9 (34.8 – 40.2) 40–59 years (14.0 – 17.1) (34.7 – 42.7) 37.5 60 years and older (12.8 – 16.6) 38.5 (34.9 – 40.3) 72.3 (66.1 – 79.2) 264 15.0 Females Total, 1 year and older 34.5 (32.7 – 36.3) 13.6 (12.9 – 14.3) 34.9 (32.4 – 37.7) 69.6 (65.9 – 73.0) 2,183 1–5 years 54.6 28.4 (13.2 – 35.2) 56.0 (53.3 – 58.8) 83.1 (79.7 – 94.4) 255 (51.2 – 58.2) 6–11 years (42.3 – 48.4) 23.6 (19.4 – 25.3) 46.0 (42.4 – 49.7) 73.0 (71.0 – 76.9) 284 45.3 12–19 years 31.5 (28.8 – 34.5) 13.3 (12.5 – 14.2) 31.3 (27.7 – 34.3) 64.7 (59.3 – 71.5) 676 20–39 years 32.7 (30.4 – 35.1) 13.7 (11.8 – 15.1) 32.4 (29.3 – 36.2) 63.0 (60.6 – 70.6) 377 333 40–59 years 31.5 (29.2 – 34.0) 12.2 (10.5 – 13.2) 32.5 (28.6 – 35.2) 63.2 (58.7 – 75.3) 73.5 (64.4 – 96.3) 258 60 years and older 35.3 (32.8 – 37.9) 15.0 (13.0 – 15.8) 34.7 (31.6 – 39.3) Table 2.13.a.5. Serum 25-hydroxyvitamin D: Non-Hispanic whites Geometric mean and selected percentiles of serum concentrations (in nmol/L) for non-Hispanic whites in the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Selected percentile s (95% conf. interval) Geometric mea n Sample (95% conf. interval) size 5th 50th 95th Males and Females 61.9 (60.3 – 63.4) 31.0 (29.1 – 32.6) 63.2 (61.8 – 64.6) 102 (97.8 – 106) Total, 1 year and older 6,698 1–5 years (71.3 – 76.0) 49.0 (44.1 – 51.7) 72.3 (70.7 – 74.2) 105 (97.8 – 118) 516 73.6 71.1 (68.2 – 74.1) 46.1 (43.5 – 48.1) 69.6 (67.5 – 71.8) 103 (96.1 – 119) 457 6–11 years 12–19 years 65.2 (63.0 – 67.4) 37.4 (35.6 – 40.1) 64.7 (62.9 – 66.6) 107 (100 – 113) 1,050 20–39 years 64.1 33.3 (29.8 – 36.3) 64.3 (61.8 – 66.6) 110 (107 – 115) 1,458 (61.8 – 66.5) 40–59 years (56.8 – 61.0) 27.4 (25.9 – 30.2) 60.4 (58.0 – 63.2) 96.7 (92.5 – 103) 1,360 58.9 60 years and older 57.4 (55.9 – 58.9) 26.0 (24.2 – 27.7) 59.7 (58.3 – 61.1) 92.9 (90.8 – 97.2) 1,857 Males Total, 1 year and older (60.8 – 64.1) 33.7 (31.8 – 35.4) 62.4 (62.1 – 65.0) 97.4 (93.9 – 103) 3,303 63.6 1–5 years 74.1 (71.7 – 76.6) 47.1 (41.5 – 52.3) 72.7 (70.4 – 74.8) 105 (99.2 – 116) 279 72.6 6–11 years (41.6 – 52.5) (69.1 – 76.3) 47.1† 70.9 (68.0 – 74.8) 105† (96.4 – 136) 219 12–19 years 65.4 40.6 (37.3 – 42.7) 65.3 (63.5 – 67.1) 99.6 (93.5 – 112) 528 (63.2 – 67.7) 61.6 33.5 (30.7 – 36.5) 62.3 (59.6 – 64.7) 96.8 (90.9 – 104) 641 20–39 years (59.5 – 63.8) 60.7 (58.5 – 63.0) 31.8 (28.4 – 34.0) 62.6 40–59 years 96.1 (59.9 – 64.8) 691 (90.0 – 104) (58.1 – 61.5) 58.7 30.5 60 years and older 60.0 (56.9 – 60.5) 92.7 (90.1 – 98.7) 945 (26.7 – 33.3) Females Total, 1 year and older 61.3 (59.6 – 63.1) 27.9 (25.6 – 30.3) 62.9 (61.0 – 64.5) 107 (102 – 111) 3,395 1–5 years 73.1 49.8 (45.5 – 52.8) 71.9 (69.3 – 75.8) 105 (94.9 – 122) 237 (69.8 – 76.5) 6–11 years (66.6 – 72.4) 45.6 (42.7 – 47.6) 68.3 (65.6 – 70.8) 99.9 (94.8 – 109) 238 69.4 12–19 years 64.9 (61.7 – 68.3) 34.9 (31.1 – 37.5) 63.9 (61.4 – 67.0) 112 (106 – 127) 522 20–39 years (63.5 – 70.0) 33.0 (26.4 – 37.1) 66.6 (63.5 – 69.6) 117 (112 – 128) 817 66.7 669 57.1 (54.6 – 59.7) 24.8 (19.9 – 27.0) 58.4 (55.6 – 61.9) 97.2 (93.4 – 105) 40–59 years 912 93.1 (90.0 – 99.8) 60 years and older 56.3 (54.6 – 58.0) 23.9 (22.0 – 25.7) 59.5 (57.8 – 61.2) † Estimate is subject to greater uncertainty due to small cell size. 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 181 181

193 Table 2.13.b. Serum 25-hydroxyvitamin D: Concentrations by survey cycle Geometric mean and selected percentiles of serum concentrations (in nmol/L) for the U.S. population, National Health and Nutrition Examination Survey, 2001–2006. n Selected percentile s (95% conf. interval) Sample Geometric mea 50th 95th 5th (95% conf. interval) size Total, 6 years and older (52.6 – 56.8) 22.6 (20.4 – 24.9) 2001–2002 (55.1 – 59.3) 96.8 (92.4 – 105) 7,807 54.7 57.1 55.5 24.2 (20.9 – 26.3) 57.5 (52.5 – 58.7) 97.2 (92.8 – 104) 7,403 2003–2004 (54.7 – 60.6) 54.3 (51.5 – 57.3) 21.8 (20.1 – 23.5) 57.2 (54.8 – 59.7) 95.9 (91.9 – 103) 7,402 2005–2006 Age group 1–5 years (65.9 – 70.5) (37.6 – 44.4) 68.7 (66.8 – 70.6) 97.8 (96.3 – 101) 895 68.2 41.3 2003–2004 2005–2006 41.8 (39.3 – 44.0) 69.1 (64.7 – 72.1) 103 (94.2 – 121) 904 69.0 (65.7 – 72.5) 6–11 years 63.8 36.9 (31.9 – 39.7) 63.7 (60.4 – 66.8) 101 (90.1 – 138) 991 (60.5 – 67.3) 2001–2002 94.3 (60.2 – 66.7) 34.8 (31.2 – 40.5) 64.5 (61.8 – 66.9) 2003–2004 (87.5 – 109) 846 63.4 2005–2006 64.2 (60.8 – 67.7) 35.8 (31.9 – 38.6) 64.4 (62.6 – 66.8) 98.8 (92.5 – 129) 922 12–19 years 2001–2002 (52.5 – 57.8) 24.5 (20.8 – 27.2) 56.7 (54.2 – 59.1) 96.1 (91.8 – 102) 2,167 55.1 56.2 (53.9 – 61.8) 24.8 (21.0 – 27.3) 57.9 2003–2004 101 (94.1 – 112) 2,059 (52.2 – 60.6) (54.0 – 60.7) 2005–2006 21.2 (17.6 – 23.9) 57.3 (50.1 – 58.3) 96.3 (88.6 – 111) 1,985 54.0 20–39 years 2001–2002 54.1 (51.8 – 56.5) 21.2 (19.4 – 23.1) 56.4 (54.0 – 59.0) 102 (94.8 – 110) 1,691 2003–2004 (50.9 – 58.1) 22.5 (19.0 – 25.4) 56.1 (51.9 – 59.9) 104 (95.9 – 110) 1,559 54.4 2005–2006 54.6 (51.1 – 58.4) 21.1 (19.0 – 23.3) 57.0 (54.2 – 60.1) 99.2 (95.5 – 113) 1,703 40–59 years 1,449 54.0 (51.4 – 56.6) 21.4 2001–2002 56.8 (54.6 – 59.8) 94.9 (90.5 – 104) (18.7 – 24.4) 1,278 2003–2004 54.7 (51.1 – 58.5) 23.6 (18.7 – 26.9) 56.5 (53.6 – 60.2) 94.5 (89.0 – 102) (49.6 – 55.9) (88.9 – 100) 94.1 55.5 (18.8 – 22.8) (52.9 – 58.4) 1,382 2005–2006 52.6 20.8 60 years and older 2001–2002 (49.9 – 55.3) 23.1 (21.1 – 24.4) 55.1 (52.4 – 57.7) 91.8 (88.4 – 95.0) 1,509 52.5 55.2 94.1 24.2 (21.8 – 25.8) 57.6 (55.2 – 59.7) 2003–2004 (90.1 – 102) 1,661 (52.9 – 57.5) 90.4 53.1 22.3 (20.4 – 24.3) 56.4 (54.1 – 58.9) 2005–2006 (87.5 – 93.9) 1,410 (50.4 – 55.9) Gender (6 years and older) Males 2001–2002 56.5 (54.5 – 58.6) 25.8 (23.8 – 27.2) 58.3 (56.3 – 60.7) 96.0 (91.2 – 105) 3,782 2003–2004 56.8 27.0 (23.7 – 29.4) 58.6 (55.8 – 61.7) 92.1 (88.8 – 98.2) 3,638 (53.6 – 60.2) (55.7 – 60.1) 2005–2006 23.8 (21.5 – 25.6) 57.7 (52.4 – 58.0) 94.1 (88.1 – 102) 3,603 55.1 Females 2001–2002 53.0 (50.6 – 55.5) 20.5 (18.0 – 22.7) 55.8 (53.5 – 58.1) 98.4 (92.6 – 108) 4,025 56.3 2003–2004 (51.4 – 57.3) 21.3 (19.2 – 23.5) 54.3 (53.3 – 59.5) 103 (97.3 – 109) 3,765 56.6 2005–2006 53.6 (50.5 – 56.9) (18.6 – 22.3) 20.5 (53.8 – 59.5) 97.1 (93.1 – 107) 3,799 Race/ethnicity (6 years and older) Mexican Americans (47.1 – 52.7) 23.0 (21.3 – 24.5) 50.1 (46.2 – 51.8) 81.6 (77.3 – 91.2) 1,961 2001–2002 48.9 48.7 (46.0 – 51.6) 22.8 (19.4 – 25.5) 50.2 2003–2004 80.5 (77.2 – 84.1) 1,802 (47.1 – 53.4) 2005–2006 (41.9 – 50.2) 20.0 (16.3 – 22.6) 47.3 45.9 78.5 (73.0 – 84.5) 1,889 (43.3 – 52.8) Non-Hispanic Blacks 2001–2002 32.6 (31.3 – 34.0) 13.3 (10.9 – 14.4) 32.5 (31.1 – 34.2) 66.2 (63.9 – 68.5) 1,821 2003–2004 36.3 14.3 (12.8 – 15.6) 37.0 (34.0 – 40.7) 69.1 (65.8 – 73.9) 1,914 (33.5 – 39.4) 2005–2006 (31.6 – 36.2) 13.9 (13.0 – 14.8) 33.4 (30.7 – 37.1) 68.4 (64.5 – 71.1) 1,932 33.8 Non-Hispanic Whites 2001–2002 (58.7 – 63.1) 29.9 (28.2 – 31.2) 62.2 (60.2 – 64.2) 102 (95.9 – 110) 3,416 60.9 3,155 61.7 (59.3 – 64.2) 30.2 (27.0 – 33.6) 63.2 (60.8 – 65.2) 103 (97.3 – 109) 2003–2004 (95.9 – 108) 3,027 31.0 (60.3 – 64.1) (27.5 – 32.4) 99.0 62.3 2005–2006 61.0 (59.0 – 63.1) nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 182 182

194 Figure 2.13.b. Serum 25−hydroxyvitamin D: Concentrations by survey cycle Selected percentiles in nmol/L (95% confidence intervals), National Health and Nutrition Examination Survey, 2001–2006 140 120 100 95th Percentile 80 60 80 70 60 50 50th Percentile 40 30 50 40 30 5th Percentile 20 10 01−02 01−02 05−06 01−02 03−04 05−06 01−02 03−04 05−06 01−02 03−04 05−06 01−02 03−04 05−06 03−04 03−04 05−06 01−02 03−04 05−06 01−02 03−04 05−06 01−02 03−04 05−06 01−02 03−04 05−06 6−11y 12−19y 20+y Males Females MA NHB NHW Total 1−5y (6+y) (6+y) (6+y) (6+y) (6+y) (6+y) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 183183

195 Table 2.13.c.1. Serum 25-hydroxyvitamin D: Prevalence Prevalence (in percent) of low serum 25-hydroxyvitamin D concentration (< 30 nmol/L) for the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Sample Estimated total Prevalence (95% conf. interval) size number of persons 8.1 23,004,000 16,604 (6.7 – 9.8) Total, 1 year and older Age group 1–5 years 1,799 0.7 (0.4 – 1.3) 146,000 6–11 years 1,768 1.8 (1.3 – 2.6) 442,000 4,044 (6.5 – 11.2) 2,823,000 8.5 12–19 years (7.6 – 11.8) 20–39 years 9.5 3,262 7,538,000 40–59 years 2,660 9.3 (7.4 – 11.7) 7,343,000 60 years and older 3,071 8.8 (7.3 – 10.5) 4,084,000 Gender Males 8,735,000 (5.0 – 7.9) 8,145 6.3 (8.1 – 11.9) Females 8,459 9.9 14,288,000 Race/ethnicity (8.7 – 14.6) 2,919,000 Mexican Americans 4,275 11.3 4,349 10,623,000 Non-Hispanic Blacks (27.4 – 35.1) 31.1 3.6 Non-Hispanic Whites 6,929,000 (3.0 – 4.4) 6,698 nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 184 184

196 Table 2.13.c.2. Serum 25-hydroxyvitamin D: Prevalence Prevalence (in percent) of low serum 25-hydroxyvitamin D concentration (between 30–50 nmol/L) for the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Sample Prevalence Estimated total (95% conf. interval) number of persons size 16,604 23.6 (21.6 – 25.8) 66,859,000 Total, 1 year and older Age group 1–5 years 1,799 8.9 (7.1 – 11.0) 1,799,000 6–11 years 1,768 14.1 (11.5 – 17.2) 3,407,000 12–19 years 4,044 24.2 (21.3 – 27.3) 8,005,000 (23.6 – 29.0) 20–39 years 26.2 3,262 20,908,000 19,729,000 (22.2 – 28.0) 40–59 years 25.0 2,660 60 years and older 25.5 (23.7 – 27.4) 11,879,000 3,071 Gender Males 8,145 23.1 (20.8 – 25.6) 31,909,000 8,459 Females (22.1 – 26.3) 24.1 34,955,000 Race/ethnicity 8,514,000 4,275 32.9 (29.6 – 36.4) Mexican Americans Non-Hispanic Blacks 4,349 39.5 (37.3 – 41.7) 13,483,000 34,769,000 18.1 6,698 Non-Hispanic Whites (16.2 – 20.2) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 185 185

197 Table 2.13.c.3. Serum 25-hydroxyvitamin D: Prevalence Prevalence (in percent) of low serum 25-hydroxyvitamin D concentration (< 40 nmol/L) for the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Sample Estimated total Prevalence (95% conf. interval) size number of persons 17.2 49,431,000 16,604 (14.7 – 20.0) Total, 1 year and older Age group 1–5 years 1,799 2.7 (1.8 – 4.0) 541,000 6–11 years 1,768 5.7 (4.2 – 7.7) 1,358,000 4,044 (13.8 – 21.0) 5,729,000 17.1 12–19 years (16.4 – 23.4) 20–39 years 19.7 3,262 15,722,000 40–59 years 2,660 20.0 (16.6 – 23.9) 16,400,000 60 years and older 3,071 17.8 (15.5 – 20.4) 8,602,000 Gender Males 20,576,000 (12.3 – 17.4) 8,145 14.6 (16.9 – 22.7) Females 8,459 19.6 28,869,000 Race/ethnicity (20.1 – 29.3) 6,635,000 Mexican Americans 4,275 24.4 4,349 17,968,000 Non-Hispanic Blacks (46.7 – 56.5) 51.6 9.4 Non-Hispanic Whites 18,114,000 (7.9 – 11.2) 6,698 nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 186 186

198 Table 2.13.c.4. Serum 25-hydroxyvitamin D: Prevalence Prevalence (in percent) of high serum 25-hydroxyvitamin D concentration (> 125 nmol/L) for the U.S. population aged 1 year and older, National Health and Nutrition Examination Survey, 2003–2006. Estimated total Prevalence Sample (95% conf. interval) number of persons size 16,604 0.9 (0.6 – 1.2) 2,449,000 Total, 1 year and older Age group 1–5 years § § 1,799 6–11 years 1,768 § § 12–19 years 4,044 1.4 (0.9 – 2.1) 450,000 (0.9 – 2.4) 20–39 years 1.5 3,262 1,193,000 40–59 years 498,000‡ (0.3 – 1.2) 0.6‡ 2,660 3,071 0.3‡ (0.1 – 0.6) 134,000‡ 60 years and older Gender 587,000 Males 8,145 0.4 (0.3 – 0.7) 1.3 (0.9 – 1.9) Females 8,459 1,867,000 Race/ethnicity Mexican Americans 4,275 § § Non-Hispanic Blacks 4,349 § § 2,283,000 (0.8 – 1.7) Non-Hispanic Whites 6,698 1.2 ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. § Estimate suppressed: RSE ≥ 40% for the prevalence estimate. 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 187 187

199 Table 2.13.d.1. Serum 25-hydroxyvitamin D: Prevalence by survey cycle Prevalence (in percent) of low serum 25-hydroxyvitamin D concentration (< 30 nmol/L) for the U.S. population, National Health and Nutrition Examination Survey, 2001–2006. Prevalence (95% conf. interval) Estimated total number of persons Sample size Total, 6 years and older 8.4 2001–2002 21,467,000 7,807 (6.8 – 10.3) 7,403 7.6 (5.5 – 10.5) 20,049,000 2003–2004 7,402 (7.3 – 12.2) 2005–2006 25,318,000 9.5 Age group 1–5 years 2003–2004 § § 895 904 0.7‡ 2005–2006 137,000‡ (0.3 – 1.5) 6–11 years 2001–2002 991 § § 2003–2004 846 1.5 (0.8 – 2.6) 350,000 2005–2006 922 2.2 (1.4 – 3.5) 524,000 12–19 years 2001–2002 7.0 (4.4 – 11.1) 2,266,000 2,167 2,059 (4.6 – 10.7) 2003–2004 2,327,000 7.0 2005–2006 10.0 (6.8 – 14.5) 3,353,000 1,985 20–39 years 2001–2002 1,691 9.5 (7.7 – 11.5) 7,498,000 2003–2004 9.3 (6.6 – 12.8) 7,391,000 1,559 2005–2006 1,703 9.6 (6.9 – 13.3) 7,700,000 40–59 years 2001–2002 1,449 9.4 (7.2 – 12.2) 7,125,000 (4.8 – 11.4) 5,910,000 2003–2004 1,278 7.5 1,382 (8.3 – 14.5) 11.0 2005–2006 9,054,000 60 years and older 2001–2002 (6.7 – 11.3) 3,921,000 1,509 8.8 8.3 (6.1 – 11.1) 3,841,000 2003–2004 1,661 1,410 9.3 (7.2 – 11.8) 4,488,000 2005–2006 Gender (6 years and older) Males 3,782 6.2 2001–2002 (4.9 – 7.9) 7,774,000 2003–2004 5.3 (3.5 – 8.1) 6,830,000 3,638 2005–2006 3,603 8.0 (6.0 – 10.6) 10,419,000 Females 2001–2002 4,025 10.4 (8.2 – 13.0) 13,726,000 13,254,000 2003–2004 3,765 9.8 (7.3 – 13.1) 2005–2006 14,894,000 (8.2 – 14.2) 3,799 10.9 Race/ethnicity (6 years and older) Mexican Americans 2001–2002 1,961 8.9 (6.7 – 11.6) 1,863,000 2003–2004 1,802 9.7 (7.1 – 13.3) 2,218,000 2005–2006 1,889 15.0 (10.2 – 21.5) 3,604,000 Non-Hispanic Blacks 2001–2002 1,821 37.8 (34.5 – 41.2) 11,654,000 2003–2004 28.5 (22.6 – 35.2) 8,872,000 1,914 2005–2006 1,932 37.4 (32.2 – 42.9) 11,915,000 Non-Hispanic Whites 2001–2002 3,416 3.7 (2.9 – 4.7) 6,654,000 (2.6 – 4.9) 6,423,000 2003–2004 3,155 3.6 (3.1 – 5.1) 7,240,000 4.0 3,027 2005–2006 ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. § Estimate suppressed: RSE ≥ 40% for the prevalence estimate. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 188 188

200 Table 2.13.d.2. Serum 25-hydroxyvitamin D: Prevalence by survey cycle Prevalence (in percent) of low serum 25-hydroxyvitamin D concentration (between 30–50 nmol/L) for the U.S. population, National Health and Nutrition Examination Survey, 2001–2006. Prevalence Estimated total number of persons Sample size (95% conf. interval) Total, 6 years and older 7,807 (21.7 – 26.4) 61,533,000 2001–2002 24.0 24.5 (21.2 – 28.1) 64,338,000 2003–2004 7,403 7,402 24.5 (21.7 – 27.5) 65,423,000 2005–2006 Age group 1–5 years 2003–2004 (6.4 – 11.5) 1,741,000 895 8.6 904 (6.5 – 12.8) 1,857,000 2005–2006 9.2 6–11 years 991 14.7 (10.9 – 19.6) 3,639,000 2001–2002 846 13.3 2003–2004 3,199,000 (9.4 – 18.4) 2005–2006 922 15.0 (11.5 – 19.3) 3,558,000 12–19 years 2001–2002 23.6 (20.4 – 27.1) 7,638,000 2,167 2,059 (19.4 – 28.9) 2003–2004 7,881,000 23.8 2005–2006 24.6 (20.8 – 28.8) 8,214,000 1,985 20–39 years 2001–2002 1,691 24.8 (21.8 – 28.1) 19,655,000 2003–2004 27.5 (23.1 – 32.4) 21,959,000 1,559 2005–2006 1,703 24.9 (21.9 – 28.1) 19,866,000 40–59 years 2001–2002 1,449 24.3 (21.3 – 27.5) 18,368,000 19,828,000 2003–2004 1,278 25.1 (21.0 – 29.6) 24.8 (20.8 – 29.4) 20,365,000 2005–2006 1,382 60 years and older 2001–2002 26.9 (23.0 – 31.2) 12,040,000 1,509 1,661 11,054,000 (21.6 – 26.0) 2003–2004 23.8 1,410 2005–2006 (24.1 – 30.6) 13,167,000 27.3 Gender (6 years and older) Males 2001–2002 3,782 22.8 (20.4 – 25.4) 28,420,000 2003–2004 3,638 (19.8 – 27.9) 30,162,000 23.6 2005–2006 24.3 (21.2 – 27.8) 31,683,000 3,603 Females 2001–2002 4,025 25.1 (22.5 – 27.9) 33,130,000 2003–2004 3,765 25.4 (22.1 – 28.9) 34,190,000 3,799 2005–2006 24.6 (21.6 – 27.8) 33,739,000 Race/ethnicity (6 years and older) Mexican Americans 2001–2002 35.6 (31.0 – 40.5) 7,496,000 1,961 1,802 34.9 2003–2004 7,963,000 (30.6 – 39.5) 2005–2006 1,889 35.5 (30.0 – 41.3) 8,515,000 Non-Hispanic Blacks 2001–2002 1,821 40.0 (37.5 – 42.6) 12,350,000 2003–2004 42.2 (38.1 – 46.3) 13,140,000 1,914 2005–2006 1,932 39.0 (36.1 – 42.0) 12,422,000 Non-Hispanic Whites 2001–2002 3,416 18.7 (16.6 – 21.0) 33,627,000 2003–2004 3,155 18.6 (15.6 – 22.1) 33,594,000 34,271,000 (16.0 – 22.2) 18.9 2005–2006 3,027 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 189 189

201 Table 2.13.d.3. Serum 25-hydroxyvitamin D: Prevalence by survey cycle Prevalence (in percent) of low serum 25-hydroxyvitamin D concentration (< 40 nmol/L) for the U.S. population, National Health and Nutrition Examination Survey, 2001–2006. Sample size (95% conf. interval) Estimated total number of persons Prevalence Total, 6 years and older 7,807 2001–2002 (15.5 – 21.3) 46,723,000 18.2 2003–2004 7,403 17.2 (13.3 – 21.9) 45,025,000 2005–2006 7,402 18.9 (15.3 – 23.1) 50,461,000 Age group 1–5 years 2003–2004 895 3.0 (1.6 – 5.5) 612,000 2005–2006 904 2.3 (1.4 – 3.7) 467,000 6–11 years 2001–2002 991 5.3 (3.2 – 8.7) 1,313,000 5.8 2003–2004 846 (3.4 – 9.7) 1,399,000 2005–2006 922 (4.0 – 7.9) 1,338,000 5.6 12–19 years 2001–2002 17.5 (13.2 – 22.8) 5,660,000 2,167 2,059 15.3 2003–2004 5,078,000 (11.2 – 20.6) 2005–2006 1,985 18.9 (13.8 – 25.4) 6,325,000 20–39 years 2001–2002 19.7 (16.2 – 23.6) 15,557,000 1,691 2003–2004 1,559 19.9 (15.1 – 25.6) 15,829,000 2005–2006 1,703 19.5 (14.9 – 25.2) 15,587,000 40–59 years 2001–2002 1,449 19.1 (16.0 – 22.7) 14,488,000 (13.6 – 24.6) 14,620,000 2003–2004 1,278 18.5 2005–2006 21.5 17,595,000 (16.8 – 27.0) 1,382 60 years and older 2001–2002 20.9 (16.9 – 25.7) 9,371,000 1,509 1,661 7,646,000 (13.4 – 20.0) 2003–2004 16.4 1,410 2005–2006 (15.5 – 23.4) 9,241,000 19.1 Gender (6 years and older) Males 2001–2002 3,782 14.8 (12.6 – 17.3) 18,450,000 2003–2004 14.2 (10.4 – 19.1) 18,138,000 3,638 2005–2006 3,603 16.6 (13.4 – 20.4) 21,606,000 Females 2001–2002 4,025 21.4 (18.1 – 25.3) 28,325,000 3,765 2003–2004 (15.9 – 24.8) 20.0 26,932,000 2005–2006 3,799 (16.8 – 26.0) 28,849,000 21.0 Race/ethnicity (6 years and older) Mexican Americans 1,961 23.3 (19.0 – 28.2) 2001–2002 4,904,000 2003–2004 1,802 24.5 (19.1 – 30.8) 5,582,000 2005–2006 1,889 28.9 (21.3 – 37.9) 6,943,000 Non-Hispanic Blacks 1,821 60.6 (57.1 – 64.1) 18,708,000 2001–2002 2003–2004 1,914 51.0 (43.9 – 58.1) 15,900,000 2005–2006 1,932 57.7 (50.3 – 64.7) 18,374,000 Non-Hispanic Whites 18,638,000 10.4 2001–2002 3,416 (8.6 – 12.4) 2003–2004 (7.0 – 12.8) 9.5 3,155 17,121,000 2005–2006 18,342,000 (8.1 – 12.6) 10.1 3,027 nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 190 190

202 Table 2.13.d.4. Serum 25-hydroxyvitamin D: Prevalence by survey cycle Prevalence (in percent) of high serum 25-hydroxyvitamin D concentration (> 125 nmol/L) for the U.S. population, National Health and Nutrition Examination Survey, 2001–2006. Prevalenc (95% conf. interval) Estimated total number of persons Sample size e Total, 6 years and older 0.8 2001–2002 1,998,000 7,807 (0.5 – 1.2) 7,403 1.0 (0.5 – 1.7) 2,547,000 2003–2004 7,402 0.8 (0.6 – 1.2) 2,224,000 2005–2006 Age group 1–5 years 895 § § 2003–2004 2005–2006 904 § § 6–11 years 991 § § 2001–2002 2003–2004 846 § § 2005–2006 922 § § 12–19 years 2001–2002 § § 2,167 2,059 427,000 (0.7 – 2.3) 2003–2004 1.3 2005–2006 1.4‡ (0.7 – 2.9) 478,000‡ 1,985 20–39 years 2001–2002 1,691 1.0 (0.6 – 1.8) 821,000 2003–2004 1.7‡ (0.8 – 3.4) 1,334,000‡ 1,559 2005–2006 1,703 1.3 (0.7 – 2.4) 1,050,000 40–59 years 2001–2002 1,449 0.8‡ (0.4 – 1.6) 616,000‡ § 2003–2004 1,278 § 1,382 § 2005–2006 § 60 years and older 2001–2002 § § 1,509 1,661 § 2003–2004 § 1,410 § § 2005–2006 Gender (6 years and older) Males 2001–2002 3,782 § § 2003–2004 3,638 § § 2005–2006 0.5‡ (0.2 – 1.0) 649,000‡ 3,603 Females 2001–2002 4,025 1.1 (0.7 – 1.7) 1,395,000 2003–2004 3,765 1.5 (0.8 – 2.9) 2,071,000 3,799 2005–2006 (0.7 – 1.9) 1.1 1,574,000 Race/ethnicity (6 years and older) Mexican Americans 2001–2002 § § 1,961 1,802 § 2003–2004 § 2005–2006 1,889 § § Non-Hispanic Blacks 2001–2002 1,821 § § 2003–2004 § § 1,914 2005–2006 1,932 § § Non-Hispanic Whites 2001–2002 3,416 1.0 (0.7 – 1.5) 1,859,000 2003–2004 3,155 1.3 (0.7 – 2.5) 2,391,000 2,047,000 (0.7 – 1.7) 2005–2006 3,027 1.1 ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. § Estimate suppressed: RSE ≥ 40% for the prevalence estimate. 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 191 191

203 References Aloia JF. African Americans, 25-hydroxyvitamin D, and osteoporosis: a paradox. Am J Clin Nutr. 2008;88(2):545S–550S. M, Balk EM, Brendel M, Ip S, Lau J, Lee J, et al . V itamin D and calcium: Systematic review of health Chung Rep T echnol Assess No. 183. AHRQ Evid No. 09-E015, Rockville, MD: Agency for outcomes. Publication Research and Quality. August 2009. Healthcare A, Horsley T , O’Donnell S, W eiler HA, Puil L, Ooi DS, et al . Effectiveness and safety of vitamin D in Cranney No. relation bone health. Evid Rep T echnol Assess No. 158 AHRQ Publication to 07-E013, Rockville, MD: Agency for Healthcare Research Quality. August 2007. and DeLuca HF. The metabolism, physiology, and function of vitamin D. In: Kumar R, editor. V itamin D: basic and clinical Boston (MA): M. Nijhoff Publishers; 1984. pp. 1–68. aspects. The vitamin D story: a collaborative effort of basic science and clinical DeLuca medicine. FASEB J. HF. 1988;2:224–236. st ork: ed. New Y Reinhold Publishing Corporation;1959. pp. Fieser M. V itamin D. In: Steroids. 1 Fieser LF, 90–168. Haddad JG, Hahn TJ. Natural and synthetic sources of circulating 25-hydroxy-vitamin D in man. Nature. 1973;244:515–517. Holick MF. V itamin D: photobiology, metabolism, and clinical applications. In: DeGroot LJ, editor. rd V ol 2, 3 Endocrinology, ed. Philadelphia (PA): WB Saunders; 1995. pp. 990–1013. Holick MF. V itamin D deficiency. N Engl J Med. 2007;357:266–281. Institute of Medicine. Food and Nutrition Board. Dietary reference intakes for calcium and vitamin D. Washington, National Academies Press; 2011. D.C.: AC, Dawson-Hughs B, Calvo MS, Gunter EW, Sayhoun NR. Serum 25-hydroxyvitamin D status of Looker and adults in two seasonal subpopulations from NHANES III. Bone. 2002;30:771–777. adolescents MF, AC, Pfeiffer CM, Lacher DA, Schleicher RL, Picciano Y etley EA. Serum 25-hydroxyvitamin D status Looker the US population: 1988–1994 compared with 2000–2004. Am J of Clin Nutr. 2008;88:1519–1527. Looker AC, Johnson CL, Lacher DA, Pfeiffer CM, Schleicher RL, Sempos CT. V itamin D status: United States, MD: Data Brief, No 59. Hyattsville, 2001–2006. National Center for Health Statistics. 2011. NCHS Blackhouse Mawer J, Holman CA, Lumb GA, Stanbury DW. EB, The distribution and storage of vitamin D and its metabolites in human tissues. Clin Sci. 1972;43:413–431. Nagpal Na S, Rathnachalam R. Noncalcemic actions of vitamin D receptor ligands. Endocr Rev. 2005;26:662– S, 687. AG, Chung M, T rikalinos Pittas , Mitri J, Brendel M, Patel K, et al . Systematic review: V itamin D and T cardiometabolic outcomes. Ann Med. 2010;152:307–314. Intern Reichel H, Koeffler HP, Norman AW. The role of vitamin D endocrine system in health and disease. N Engl J Med. 1989;320:980–991. U.S. Department of Agriculture and U.S. Department of and Human Services. Dietary Guidelines for Health th 2010. 7 Americans, Edition, W ashington, DC: U.S. Government Printing Office, December 2010 [cited 2011]. Available at: http://www.cnpp.usda.gov/DGAs2010-PolicyDocument.htm. Yetley EA, Pfeiffer CM, Schleicher RL, Phinney KW, Lacher DA, Christakos S, et al . NHANES monitoring of summary. 2010;140:2030S–2045S. Nutr. J serum 25-hydroxyvitamin D: a roundtable nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 192 192

204 Fatty Acids Background Information Fatty Nomenclature. are organic acids characterized by long unbranched aliphatic tails (4- acids possess to a carboxyl group. Fatty acids usually an even number of carbon carbons) attached 28 the carbon chain may contain several unsaturated atoms; or exclusively saturated bonds. Thus, and acids differ in chain length, degree of saturation, of the double bond(s) along the fatty location and whether the orientation of hydrogen atoms adjacent to the double chain, is cis or trans . bond with no double bonds are referred to as saturated fatty acids (SFA) while those with Fatty acids acids double are monounsaturated fatty acids (MUFA). Fatty bond with two or more double one are termed polyunsaturated fatty acids (PUFA). PUFA are bonds often categorized into two most by a difference in location of the distinguished double bond from the methyl end of groups first acyl chain, namely, n-6 and n-3. Linoleic acid (18:2n-6) and alpha-linolenic acid (18:3n-3) the representatives of these two groups. Each contains 18 carbon atoms but differs in the number are double bonds (18: 2 n-6 vs 18: 3 n-3) and the location of the first double bond (18:2 n-6 vs of ). In this report, unless marked, all unsaturated fatty acids n-3 are assumed to be in the cis 18:3 configuration. Good sources of PUFA include soybean, corn and Sources and Physiological Functions. Agriculture ( U.S. Department of cottonseed and U.S. Department of Health and Human oils Oils that are rich in MUFA include ). olive, canola and safflower oils ( U.S. Services 2010 of Agriculture and U.S. Department of Health and Human Services 2010 ). Recent Department NHANES provide information on the major food sources of various fatty acids consumed data United States ( U.S. National Institutes of in Health 2010a and 2010b ). Chicken dishes, the desserts, salad dressings, chips, nuts, seeds and pizza are the main sources of n-6 PUFA. The main sources n-3 PUFA (C18:3n-3) in the American diet are salad dressings, chicken dishes, desserts, of mayonnaise and pasta dishes; whereas, the pizza, main sources of long-chain n-3 PUFA bread, dishes. C22:6n-3) are fish and fish mixed (C20:5n-3 The chief dietary sources of MUFA and (C18:1) are desserts, meats, nuts, seeds, pizza, French fries and Mexican foods. The main sources of in the American diet are full-fat cheese, pizza and desserts; SFA other sources include chicken dishes, cured meats, and burgers. ribs Triacylglycerols (triglycerides), the basic building blocks of fats and oils, are made up of three fatty acids esterified to a glycerol molecule ( Lichtenstein 2005 ). They are usually composed of 2–3 different kinds of fatty acids per molecule. During digestion, dietary triglycerides from animal and fats are hydrolyzed in the small intestine to release free fatty acids. These acids vegetable intestinal cells and are used to resynthesize triglycerides, which become incorporated enter the large lipoprotein particles called chylomicrons; these in turn are released into the lymph into plasma. entering the prior Fatty acids with 10 or fewer carbon atoms can be absorbed from to bound the directly into the bloodstream where they are gut to albumin in the plasma. At distal sites, triglycerides are again hydrolyzed by lipases before fatty acids can enter cells for further metabolism. inside peripheral cells, free fatty acids provide an immediate source of energy Once act (fatty the body’s major fuel source) or acids as substrate for the biosynthesis of signaling are molecules such as eicosanoids. Free fatty acids are also incorporated into other lipid classes, or such phospholipids, sphingolipids, and cholesteryl esters, as they may be resynthesized into triglycerides and stored for later use. Phospholipids, which are critical structural components of cellular membranes, tend to incorporate unsaturated fatty acids and so serve as a reservoir for and PUFA. MUFA 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 193 193

205 Humans incapable of de novo synthesis of n-6 and n-3 PUFA because they lack the ability to are a insert bond any closer than 9 carbons from the methyl end. Thus, linoleic (18:2n-6) double acid are called “essential” PUFA in that they are required for good alpha-linolenic and (18:3n-3) be derived from food sources but rather than through endogenous biosynthesis or health must to these fatty acids are metabolized of longer-chain, more highly unsaturated metabolism. Both Note that SFA and MUFA in plasma are not forms. to closely reflect dietary intake expected two classes of fatty acids can be endogenously synthesized from carbohydrates. The because these correlations dietary intake are provided by plasma with concentrations of n-3 PUFA and strongest acids ( Sun 2007 ). trans -fatty The most common MUFA is oleic acid (C18:1n-9); although humans can Health Effects. this fatty acid, it is obtained largely through the diet. Evidence suggests that replacing synthesize carbohydrates with MUFA decreases LDL-cholesterol concentration, but there is little dietary that MUFA are associated with coronary heart disease ( Astrup 2011 ). Currently, intense evidence surrounds the question whether reduction in dietary SFA reduces risk of cardiovascular debate ( Zelman 2011 ). A t pr esent, the D ietary G uidelines for Americans r ecommend r educed intake disease SFA ( U.S. Department of Agriculture and U.S. Department of Health and Human Services of ). fat intake and replacing SFA with Restricting other nutrients has revealed added complexity 2010 the diet-heart issue. According to evidence from human studies, replacing SFA with PUFA lowers in disease risk, whereas replacing SFA with carbohydrate coronary either has no benefit ( Micha heart ) may be harmful or beneficial depending upon or the quality of the carbohydrate ( Jakobsen 2010 Jakobsen 2010 ). Carbohydrates either rapidly or 2009; slowly increase blood glucose; highly refined carbohydrates are amongst the former, and higher intake these is associated with greater risk for of development of diabetes. Replacing SFA with highly refined carbohydrates and added sugars may be increasing disease risk through promotion of obesity and diabetes ( Hu 2010 ). heart healthy effects of PUFA are most often The based on their effects on the heart concentrations assessed of total cholesterol, HDL- and LDL-cholesterol, cholesterol ratios and/or triglycerides. Intake of n-6 PUFA helps to lower total cholesterol and LDL-cholesterol, however, high intake of n-6 fatty acids may suppress levels. In contrast, n-3 fatty acid HDL-cholesterol consumption has been shown to maintain and increase HDL status ( International Life Sciences Institute 2001 ). In the United States, the even FDA permits qualified health claims to be made about a diet-disease relationship for cardiovascular disease; 6 of the 7 permitted claims for cardiovascular disease are related to the MUFA or currently, content of nuts, oils and spreads, or fish oil supplements. PUFA in the fatty acids is determined by use of a plasma triene-to-tetraene ratio Deficiency essential [C20:3n-9]:arachidonic [C20:4n-6] acid); a ratio greater than 0.2 indicates deficiency (eicosatrienoic Institute 2005 of Medicine ( ). (Note: eicosatrienoic was not part of the plasma fatty acid profile NHANES 2003-2004.) PUFA deficiency measured may manifest with neuropathy and skin for problems, as rough or scaly skin and such dermatitis ( International Life Sciences Institute 2001 ). Because the body makes more than enough SFA to meet metabolic Intake Recommendations. needs, people have no requirement for these fatty acids. Evidence suggests that SFA are positively total cholesterol and LDL-cholesterol concentrations associated and thus with cardiovascular with more Lowering dietary disease intake of SFA to no risk. than 10% of caloric intake and replacing them with MUFA and PUFA is recommended to reduce the risk of cardiovascular disease; moreover, 7% lowering percentage of calories derived from SFA to the of calories, can further reduce risk of cardiovascular disease ( U.S. Department of Agriculture and U.S. Department of Health and Human Services 2010; Cleeman 2001 ). The National Cholesterol Education Program Expert Panel on (ATP Adults recommends III) Detection, Evaluation, and T reatment of High Blood Cholesterol in nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 194 194

206 that not exceed 20% of calories ( Cleeman 2001 ). Guidance about adequate intake (AI) is MUFA for essential fatty acids. The AI of linoleic acid is 17 g/d for men and 12 g/d for women. the available the AI is 1.6 g/d for men and acid, 1.1 g/d for women. Moderate evidence shows alpha-linolenic For consumption of about 8 oz of seafood per week, which provides an average of 250 mg per day that eicosapentaenoic acid (C20:5n-3) and docosahexaenoic acid (C22:6n-3), reduces cardiac deaths of persons and without cardiovascular disease ( U.S. with Department of Agriculture and U.S. among of Health and Human Services 2010 ). This amount of seafood is also associated with Department infant improved health outcomes such as visual and cognitive development, when consumed by or lactating women ( U.S. Department of Agriculture and U.S. Department of Health and pregnant Services 2010 ). Currently, there is not enough evidence to establish upper tolerable limits Human n-3 or n-6 PUFA ( Institute of Medicine 2005 ). for to American Heart Association, patients with the coronary heart disease should According to increase their consumption be of eicosapentaenoic acid (C20:5n-3) and encouraged (C22:6n-3) to about 1 gram per acid preferably from oily fish. The docosahexaenoic day Heart Association Dietary Guidelines recommend at least two servings American of fish per week fish) for patients without documented coronary heart disease. In (particularly addition, fatty vegetable oils (e.g., soybean, canola, of walnut, flaxseed) and food sources (e.g., walnuts, inclusion in alpha-linolenic acid (C18:3n-3) is recommended in high a healthy diet for the general flaxseeds) ( Kris-Etherton 2002 ). The American population Association recommends 5-10% of energy Heart from n-6 fatty acids ( Harris 2009 ) while Adult T reatment Panel III recommends up to 10% of total calories may be consumed from polyunsaturated fats ( Cleeman 2001 ). The long term fatty acid content of the diet is best Biochemical Indicators and Methods. represented by the adipose tissue triglyceride content owing to the two-year half-life of adipose tissue Erythrocytes, due to their fatty 120 day half-life, reflect acids. (weeks-to-months) dietary intermediate intake, although term has this been challenged by idea data demonstrating large changes in the fatty acid composition of erthyrocytes within days of altering fat intake ( Hodson 2008 ). Serum or dietary plasma concentrations represent more intake (days-to-weeks). recent Few studies have compared the fatty acid composition of plasma with red blood cells to assess which substrate best reflects dietary acid intake. In one study, fatty correlations with food frequency only questionnaire data were slightly stronger for erythrocytes than plasma ( Sun 2007 ). The triglyceride fraction of plasma for to demonstrate the greatest day-to-day variation of any appears fraction. Thus, whenever serum or plasma is circulating lipid for fatty acid analysis, fasting is preferred to collected minimize the within- and between-person variability at the time of specimen collection. gas chromatography (GC) is the technique Capillary most frequently used to separate fatty acids for quantitative analysis. Detection methods include flame ionization or electron capture negative during chemical mass spectrometry. Internal standards are used to correct for losses ionization sample preparation and improve the and precision of measurements. accuracy Data in NHANES. The data in this report were generated for fasted (≥ 8 hours) adults (≥ 20 (GC-MS) years) by use of gas chromatography-mass spectrometry based on a modification of the units. mol/L method of Lagerstedt et al . ( 2001 ). Plasma fatty acid concentrations are reported in μ 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 195 195

207 Generally, acid data are expressed as percentage by weight of total fatty acids (wt%) although fatty The mole (mol%) would be more meaningful. possible advantages of using absolute percentage by of individual fatty acids have not been well concentrations investigated ( Hodson 2008 ). No data exist on plasma concentrations of fatty acids in prior to 2003. This report shows first- NHANES time NHANES data for 24 plasma fatty acids including 6 SFA, 7 MUFA, and 11 PUFA; these data acquired using surplus plasma from NHANES 2003-2004. The serum specimens were were stored ° C until fatty acids were measured at during the period 2010–2011. Based on limited -70 information in the literature about absolute concentrations, these 24 fatty acids are estimated to circulating comprise at least 90% of the total fatty acids in the plasma in all lipid classes (fatty acyls, glycerolipids, glycerophospholipids, sphingolipids and sterols). All unsaturated fatty acids are to be in the cis configuration; trans -fatty acids were not measured. assumed the information about polyunsaturated fatty acids, see Institute of Medicine’s Dietary Refer - For more Intake reports (Institute of Medicine 2005) and fact ence from the National Institutes of Health, sheets Office of Dietary Supplements ( http://ods.od.nih.gov/FactSheets/Omega3FattyAcidsandHealth.asp). Highlights saturated first-time plasma These concentrations of (SFA), monounsaturated (MUFA), and polyunsaturated (PUFA) fatty acids in the U.S. population showed the following demographic patterns characteristics: and lower In fatty acids circulated at general, concentrations in younger adults. • Plasma • of individual fatty acids were generally similar in men and women. concentrations • No consistent race/ethnic pattern was observed for plasma fatty acid concentrations, acids however polyunsaturated fatty heart-healthy showed race/ethnic differences. All three classes of fatty acids contained representatives at low (< 100 μmol/L) and high μmol/L) ). H.2.e Figure ( concentrations (> 1,000 nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 196 196

208 10,000 Polyunsaturated Monounsaturated Saturated 1,000 mol/L) 100 Geometric mean ( 10 1 16:0 22:1n-9 20:0 24:0 18:2n-6 24:1n-9 22:0 18:1n-7 14:0 14:1n-5 16:1n-7 18:0 20:1n-9 18:1n-9 22:5n-6 20:2n-6 22:4n-6 22:5n-3 20:5n-3 18:3n-6 18:3n-3 22:6n-3 20:3n-6 20:4n-6 20 years mean of individual fatty acids in the U.S. population from fasted plasma Figure H.2.e. Geometric concentrations adults aged Survey, Examination Nutrition Health 2003-2004. National race/ethnicity, by older and and represent 95% confidence intervals. The y-axis is displayed on the logarithmic scale. Error bars Saturated (SFA) Polyunsaturated (PUFA) Monounsaturated (MUFA) 22:1n-9 Docosenoic acid 22:5n-6 Docosapentaenoic acid 20:0 Arachidic acid 24:0 Lignoceric acid 20:2n-6 Eicosadienoic acid 14:1n-5 Myristoleic acid 22:0 Doconsanoic acid 20:1n-9 Eicosenoic acid 22:4n-6 Docosatetraenoic acid 14:0 Myristic acid 24:1n-9 Nervonic acid 22:5n-3 Docosapentaenoic acid 18:0 Stearic acid 18:1n-9 cis -Vaccenic acid 20:5n-3 Eicosapentaenoic acid 16:0 Palmitic acid 16:1n-9 Palmitoleic acid 18:3n-6 gamma -Linolenic acid alpha -Linolenic acid 18:1n-9 Oleic acid 18:3n-3 22:6n-3 Docosahexaenoic acid -Linolenic acid 20:3n-6 homo-gamma 20:4n-6 Arachidonic acid 18:2n-6 Linoleic acid differences. race/ethnic showed PUFA heart-healthy of concentrations Plasma mean Geometric acid (EPA), which is typically derived from seafood and concentrations of eicosapentaenoic whites higher in fasted non-Hispanic blacks and were compared with Mexican- supplements, American adults (Figure H.2.f ). long-chain polyunsaturated docosahexaenoic In plasma addition, concentrations of the related compared non- acid (DHA) were higher and Mexican-American with black non-Hispanic in Hispanic white adults (Figure H.2.g). fatty acid concentrations over time will show progress toward more heart-healthy Tracking plasma diets. 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 197 197

209 A. 180 60 a 160 a 50 140 b a b 120 40 b 100 30 80 EPA ( mol/L) DHA ( mol/L) 60 20 40 10 20 0 0 Non-Hispanic white Non-Hispanic black Mexican American Mexican American Non-Hispanic white Non-Hispanic black Figure H.2.g. (FPNFUSJDNFBOQMBTNBDPODFOUSBUJPOTPGEPDPTBIFYBFOPJD (FPNFUSJDNFBOQMBTNBDPODFOUSBUJPOTPGFJDPTBQFOUBFOPJD Figure H.2.f. BDJE %)" JOUIF64QPQVMBUJPOGSPNGBTUFEBEVMUTBHFEZFBSTBOE BDJE &1" JOUIF64QPQVMBUJPOGSPNGBTUFEBEVMUTBHFEZFBSTBOE PMEFSCZSBDFFUIOJDJUZ /BUJPOBM)FBMUIBOE/VUSJUJPO&YBNJOBUJPO PMEFSCZSBDFFUIOJDJUZ /BUJPOBM)FBMUIBOE/VUSJUJPO&YBNJOBUJPO4VSWFZ  4VSWFZ   &SSPSCBSTSFQSFTFOUDPOíEFODFJOUFSWBMT#BSTOPUTIBSJOHBDPNNPOMFUUFS &SSPSCBSTSFQSFTFOUDPOíEFODFJOUFSWBMT#BSTOPUTIBSJOHBDPNNPOMFUUFSEJìFS EJìFS Q  Q  Detailed Observations TFMFDUFE PCTFSWBUJPOT NFOUJPOFE CFMPX BSF UBLFO GSPN UIF UBCMFT BOE ëHVSFT QSFTFOUFE OFYU ɨF OPUFE DBUFHPSJDBM EJêFSFODFT CFUXFFO EFNPHSBQIJD HSPVQT CFMPX BSF CBTFE PO BCPVU 4UBUFNFOUT DPOëEFODF MJNJUT GSPN VOJWBSJBUF BOBMZTJT XJUIPVU BEKVTUJOH GPS EFNPHSBQIJD OPOPWFSMBQQJOH BHF HFOEFS SBDFFUIOJDJUZ PS PUIFS FH CMPPE DPODFOUSBUJPO EFUFSNJOBOUT WBSJBCMFT EJFUBSZ FH JOUBLF TVQQMFNFOU VTBHF TNPLJOH #.*  " NVMUJWBSJBUF BOBMZTJT NBZ BMUFS UIF TJ[F BOE TUBUJTUJDBM TJHOJëDBODF UIFTF DBUFHPSJDBM EJêFSFODFT 'VSUIFSNPSF BEEJUJPOBM TJHOJëDBOU EJêFSFODFT PG PG PG NBZ TNBMMFS QSFTFOU EFTQJUF UIFJS MBDL NBHOJUVEF NFOUJPO IFSF FH JG DPOëEFODF MJNJUT CF TMJHIUMZ PWFSMBQ PS JG EJêFSFODFT BSF OPU TUBUJTUJDBMMZ TJHOJëDBOU CFGPSF DPWBSJBUF BEKVTUNFOU IBT UP PDDVSSFE  'PS B TFMFDUJPO PG DJUBUJPOT PG EFTDSJQUJWF /)"/&4 QBQFST SFMBUFE UIFTF CJPDIFNJDBM OVUSJUJPO JOEJDBUPST PG EJFU BOE TFF Appendix G  Geometric mean concentrations (NHANES 2003–2004): PG t ɨF NBKPSJUZ GBUUZ BDJET DJSDVMBUFE JO QMBTNB BU MPXFS DPODFOUSBUJPOT JO ZPVOHFS BEVMUT  Z DPNQBSFE XJUI UIPTF JO UIF PMEFS BHF HSPVQT  BOEPS  Z BB  5BCMFT XPNFO t 8IJMF JO HFOFSBM QMBTNB DPODFOUSBUJPOT PG GBUUZ BDJET XFSF TJNJMBS JO NFO BOE UIFSF XFSF B GFX MPOH DIBJO $$ FYDFQUJPOT JO XIJDI DPODFOUSBUJPOT XFSF IJHIFS JO XPNFO UIBO JO NFO 5BCMFT BB  PG t DPODFOUSBUJPOT PG BQQSPYJNBUFMZ POFUIJSE 1MBTNB 4'" BOE UISFFRVBSUFST PG XFSF GPVOE BU MPXFS DPODFOUSBUJPOT JO OPO)JTQBOJD CMBDLT DPNQBSFE XJUI .6'" OPO)JTQBOJD XIJUFT BOEPS .FYJDBO "NFSJDBOT /PUBCMZ OPO)JTQBOJD CMBDLT IBE TVCTUBOUJBMMZ QMBTNB DPODFOUSBUJPOT PG NZSJTUJD MPXFS 4'" BOE NZSJTUPMFJD .6'" "NFSJDBOT BDJE OPO)JTQBOJD XIJUFT PS .FYJDBO UIBO 5BCMFT B BOE B  'PS 16'" UIF QJDUVSF XBT NJYFE XJUI FBDI SBDFFUIOJD HSPVQ IBWJOH IJHIFS PSMPXFS DPODFOUSBUJPOT BU MFBTU POF 16'" DPNQBSFE XJUI PG POF PS CPUI SBDFFUIOJD HSPVQT nd nd ion 2 2 ion opulat Nat Nat ional R ional R epor epor t on Biochemic t on Biochemic al Indic al Indic ator ator s of Diet and Nutr s of Diet and Nutr it ition in the U ion in the U .S. .S. P Populat 198 198

210 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 199 199

211 982 603 856 375 514 309 940 679 size 1,796 Sample (360 – 438) (358 – 464) (330 – 533) (349 – 1,810) (366 – 508) (383 – 481) (229 – 410) (325 – 434) (307 – 426) 97.5th 392 396 414 370 410 365 329 408† 261† (282 – 353) (285 – 384) (252 – 370) (304 – 470) (258 – 359) (178 – 283) (287 – 401) (243 – 366) (286 – 364) 95th 308 301 320 342 329 223 303 310 300 (95% conf. interval) s (108 – 123) (105 – 129) (99.0 – 118) (108 – 144) (109 – 132) (72.0 – 95.0) (107 – 121) (110 – 127) (112 – 127) 50th 116 106 118 124 115 120 120 119 84.3 Selected percentile (46.2 – 50.5) (42.5 – 46.8) (44.8 – 52.6) (40.6 – 52.3) (47.2 – 56.4) (30.2 – 43.5) (45.9 – 50.8) (46.5 – 55.8) (46.3 – 54.5) 5th 48.1 45.0 47.6 48.5 39.8 48.3 51.8 50.2 50.9 (39.9 – 45.1) (34.0 – 45.1) (31.1 – 42.5) (39.1 – 47.5) (27.9 – 38.3) (41.4 – 47.9) (39.5 – 45.9) (37.9 – 47.5) (38.4 – 47.8) 2.5th 42.5 39.0 40.6 46.2 44.6 45.6 44.5 41.6† 32.8† n (113 – 125) (110 – 144) (112 – 129) (104 – 117) (111 – 124) (117 – 136) (78.9 – 93.3) (116 – 131) (112 – 131) 119 110 126 120 117 126 121 123 85.8 (95% conf. interval) Geometric mea † Estimate is subject to greater uncertainty due to small cell size. Age group Race/ethnicity Males Gender Total, 20 years and older Mexican Americans 20–39 years Females Non-Hispanic Blacks 40–59 years Non-Hispanic Whites 60 years and older Health and Nutrition Examination Survey, 2003–2004. Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Table 2.14.a.1. Plasma myristic acid (14:0): Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 200 200

212 Figure 2.14.a. Plasma myristic acid (14:0): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Mexican Americans Overall 200 Females 150 Males 100 (μmol/L) 50 Plasma myristic acid 0 60+ 20−39 20−39 40−59 60+ 40−59 Non−Hispanic Whites Non−Hispanic Blacks 200 150 100 (μmol/L) 50 Plasma myristic acid 0 60+ 40−59 60+ 20−39 40−59 20−39 Females Males 200 Mexican 150 Americans Non−Hispanic Blacks 100 Non−Hispanic (μmol/L) Whites 50 Plasma myristic acid 0 20−39 40−59 60+ 60+ 40−59 20−39 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 201201

213 Table 2.14.a.2. Plasma myristic acid (14:0): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (113 – 125) 57.9 (55.2 – 61.1) 116 (108 – 123) 248 (237 – 266) 1,796 119 Total, 20 years and older 110 (104 – 117) 52.8 (49.4 – 55.9) 106 (99.0 – 118) 240 (209 – 260) 603 20–39 years 126 61.8 (56.1 – 66.0) 120 (109 – 132) 266 (248 – 294) 514 (117 – 136) 40–59 years 121 (112 – 131) 61.4 (54.6 – 67.0) 120 (112 – 127) 238 (224 – 256) 679 60 years and older Males (112 – 129) 120 (105 – 129) 58.8 (54.7 – 61.5) 118 Total, 20 years and older 260 (243 – 272) 856 20–39 years 112 53.4 (47.6 – 57.8) 106 (93.5 – 122) 245 (209 – 284) 277 (102 – 122) 40–59 years (120 – 147) 61.8 (57.5 – 70.6) 124 (109 – 154) 279 (265 – 336) 247 133 60 years and older 115 (106 – 126) 58.2 (47.3 – 67.9) 119 (112 – 123) 226 (201 – 244) 332 Females 940 117 (111 – 124) 56.6 (53.6 – 61.5) 115 (107 – 121) 242 (225 – 270) Total, 20 years and older 20–39 years 109 (101 – 117) 51.3 (49.2 – 55.4) 106 (95.9 – 119) 226 (193 – 308) 326 267 40–59 years 120 (111 – 131) 61.5 (51.6 – 64.9) 115 (107 – 123) 249 (226 – 301) 64.1 (227 – 302) 244 121 (51.0 – 73.7) (109 – 143) 347 60 years and older 126 (114 – 139) Table 2.14.a.3. Plasma myristic acid (14:0): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample Selected percentile s (95% conf. interval) 90th 10th 50th (95% conf. interval) size Males and Females 126 (110 – 144) 54.6 Total, 20 years and older 124 (108 – 144) 277 (244 – 352) 375 (49.2 – 62.0) 20–39 years 122 (95.1 – 155) 51.0 (45.4 – 56.1) 123 (83.9 – 158) 259 (212 – 1,990) 132 40–59 years (112 – 159) 61.2† (46.5 – 76.0) 130 (95.3 – 155) 313† (248 – 387) 93 133 60 years and older 135 (124 – 146) 68.0 (64.2 – 75.1) 133 (112 – 160) 252 (224 – 315) 150 Males 282 Total, 20 years and older 126 (102 – 156) 56.3 (49.6 – 62.4) (95.9 – 153) 123 (228 – 410) 188 20–39 years 123 51.8† (46.6 – 57.2) 123 (67.8 – 214) 274† (202 – 556) 67 (86.4 – 175) 136 (90.5 – 177) 68.5† (54.1 – 82.7) 125 40–59 years 305† (201 – 721) 48 (104 – 179) 60 years and older (104 – 131) 65.6† (48.2 – 71.4) 117 (104 – 135) 199† (164 – 390) 73 117 Females Total, 20 years and older (110 – 145) 51.4 (40.7 – 65.3) 127 (108 – 152) 268 (240 – 339) 187 126 20–39 years 119 (92.9 – 153) 50.5† (39.7 – 66.1) 121 (93.6 – 150) 245† (173 – 2,410) 65 40–59 years 130 (99.5 – 169) 50.0† (36.9 – 74.6) 134 (83.1 – 193) 313† (248 – 460) 45 274† (228 – 391) 77 153 (54.5 – 95.1) 81.6† (120 – 195) 60 years and older 154 (131 – 180) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 202 202

214 Table 2.14.a.4. Plasma myristic acid (14:0): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (78.9 – 93.3) 44.8 (38.0 – 50.1) 84.3 (72.0 – 95.0) 161 (146 – 201) 309 85.8 Total, 20 years and older 81.9 (72.7 – 92.2) 43.6 (33.7 – 48.1) 76.7 (66.9 – 92.1) 149 (128 – 249) 125 20–39 years 91.9 44.5† (28.4 – 51.6) 93.4 (82.5 – 106) 184† (150 – 249) 98 (82.8 – 102) 40–59 years 84.9 (76.3 – 94.5) 46.9† (36.2 – 58.7) 79.7 (71.8 – 95.2) 154† (129 – 188) 86 60 years and older Males (76.6 – 99.4) 87.3 (67.2 – 98.7) 40.9 (31.8 – 46.6) 85.3 Total, 20 years and older 170 (148 – 270) 142 20–39 years 82.7 39.7† (28.5 – 47.0) 71.6 (61.5 – 101) 167† (128 – 466) 57 (67.7 – 101) 40–59 years (78.8 – 124) 41.2† (29.2 – 55.7) 97.8 (84.0 – 115) 229† (148 – 479) 42 98.8 60 years and older 78.0 (64.2 – 94.6) 43.7† (36.0 – 52.8) 67.4 (58.9 – 104) 143† (121 – 187) 43 Females 167 84.7 (76.2 – 94.2) 46.5 (39.2 – 51.8) 83.0 (69.2 – 99.1) 153 (135 – 189) Total, 20 years and older 20–39 years 81.2 (72.4 – 91.2) 44.2† (33.9 – 51.5) 78.8 (64.6 – 98.7) 144† (110 – 259) 68 56 40–59 years 87.0 (72.2 – 105) 46.6† (27.8 – 51.5) 86.5 (64.8 – 106) 160† (123 – 690) 158† 43 (120 – 194) 60 years and older 89.6 (78.3 – 103) 53.5† (39.8 – 63.8) 82.6 (73.5 – 103) † Estimate is subject to greater uncertainty due to small cell size. Table 2.14.a.5. Plasma myristic acid (14:0): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 119 (116 – 131) 61.6 Total, 20 years and older 123 (110 – 127) 250 (236 – 280) 982 (56.2 – 65.5) 20–39 years 118 (110 – 126) 56.9 (50.1 – 64.0) 115 (103 – 123) 244 (216 – 303) 294 40–59 years (115 – 140) 63.8 (56.4 – 69.1) 120 (108 – 136) 266 (238 – 299) 279 127 60 years and older 124 (114 – 136) 61.8 (53.5 – 70.8) 121 (116 – 134) 241 (225 – 301) 409 Males 121 Total, 20 years and older 126 (115 – 137) 61.5 (56.0 – 67.2) (243 – 273) (107 – 141) 263 465 20–39 years 119 58.3 (35.4 – 67.0) 115 (98.2 – 140) 245 (206 – 337) 124 (107 – 133) 134 (108 – 163) 65.6 (57.8 – 72.3) 124 40–59 years 272 (264 – 317) 139 (120 – 151) 60 years and older (108 – 134) 58.8 (46.7 – 72.3) 121 (115 – 127) 229 (203 – 262) 202 120 Females Total, 20 years and older (114 – 128) 61.5 (55.6 – 64.2) 118 (110 – 123) 247 (223 – 303) 517 121 20–39 years 116 (104 – 129) 55.5 (48.9 – 63.3) 114 (97.3 – 128) 240 (197 – 361) 170 40–59 years 121 (108 – 135) 62.2 (48.3 – 69.0) 115 (104 – 123) 237 (195 – 399) 140 (229 – 314) 207 248 60 years and older 128 (114 – 145) 64.1 (47.6 – 74.7) 124 (110 – 146) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 203 203

215 991 609 374 863 514 942 310 682 size 1,805 Sample (5,180 – 5,630) (4,930 – 5,640) (4,740 – 6,860) (5,090 – 6,090) (5,640 – 6,380) (4,970 – 5,500) (5,260 – 5,760) (4,050 – 8,480) (4,830 – 5,790) 97.5th 5,370 5,350 5,630 5,340 5,410 5,350 5,220 5,980† 4,570† (4,500 – 5,030) (4,000 – 5,330) (4,580 – 6,310) (4,400 – 5,320) (4,450 – 5,270) (3,610 – 4,510) (4,560 – 5,320) (4,390 – 5,160) (4,430 – 5,270) 95th 4,710 4,550 5,430 4,730 4,750 4,020 4,660 4,720 4,630 (95% conf. interval) s (2,540 – 2,730) (2,500 – 2,710) (2,620 – 2,970) (2,380 – 2,540) (2,530 – 2,800) (2,240 – 2,480) (2,540 – 2,760) (2,550 – 2,730) (2,740 – 2,940) 50th 2,630 2,610 2,750 2,450 2,330 2,640 2,650 2,820 2,650 Selected percentile 5th (1,610 – 1,770) (1,500 – 1,830) (1,480 – 1,670) (1,570 – 1,790) (1,660 – 1,780) (1,650 – 1,910) (1,320 – 1,730) (1,760 – 1,970) (1,600 – 1,780) 1,690 1,750 1,670 1,590 1,710 1,830 1,590 1,910 1,690 (1,420 – 1,610) (1,380 – 1,650) (1,310 – 1,710) (1,330 – 1,550) (1,250 – 1,580) (1,400 – 1,610) (1,330 – 1,750) (1,380 – 1,610) (1,610 – 1,860) 2.5th 1,570 1,440 1,560 1,570 1,600 1,570 1,750 1,500† 1,540† n (2,640 – 2,780) (2,710 – 3,050) (2,590 – 2,810) (2,470 – 2,610) (2,640 – 2,800) (2,680 – 2,880) (2,340 – 2,570) (2,630 – 2,810) (2,790 – 2,990) 2,710 2,700 2,540 2,880 2,720 2,450 2,780 2,720 2,890 (95% conf. interval) Geometric mea † Estimate is subject to greater uncertainty due to small cell size. Age group Race/ethnicity Males Gender Total, 20 years and older Mexican Americans 20–39 years Females Non-Hispanic Blacks 40–59 years Non-Hispanic Whites 60 years and older Health and Nutrition Examination Survey, 2003–2004. Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Table 2.15.a.1. Plasma palmitic acid (16:0): Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 204 204

216 Figure 2.15.a. Plasma palmitic acid (16:0): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Mexican Americans Overall 4000 Females Males 3000 2000 (μmol/L) 1000 Plasma palmitic acid 0 60+ 20−39 20−39 40−59 60+ 40−59 Non−Hispanic Whites Non−Hispanic Blacks 4000 3000 2000 (μmol/L) 1000 Plasma palmitic acid 0 60+ 40−59 60+ 20−39 40−59 20−39 Females Males 4000 Mexican Americans 3000 Non−Hispanic Blacks 2000 Non−Hispanic (μmol/L) Whites 1000 Plasma palmitic acid 0 20−39 40−59 60+ 60+ 40−59 20−39 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 205205

217 Table 2.15.a.2. Plasma palmitic acid (16:0): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (2,640 – 2,780) 1,890 (1,820 – 1,930) 2,630 (2,540 – 2,730) 3,990 (3,820 – 4,360) 1,805 2,710 Total, 20 years and older 2,540 (2,470 – 2,610) 1,750 (1,660 – 1,810) 2,450 (2,380 – 2,540) 3,790 (3,540 – 4,260) 609 20–39 years 2,780 1,950 (1,910 – 1,990) 2,650 (2,530 – 2,800) 4,160 (3,840 – 4,570) 514 (2,680 – 2,880) 40–59 years 2,890 (2,790 – 2,990) 2,050 (1,960 – 2,140) 2,820 (2,740 – 2,940) 4,050 (3,840 – 4,430) 682 60 years and older Males (2,590 – 2,810) 2,700 (2,500 – 2,710) 1,880 (1,760 – 1,920) 2,610 Total, 20 years and older 4,010 (3,790 – 4,430) 863 20–39 years 2,540 1,740 (1,580 – 1,820) 2,470 (2,340 – 2,600) 3,690 (3,420 – 4,540) 282 (2,400 – 2,690) 40–59 years (2,690 – 3,000) 1,950 (1,890 – 2,010) 2,700 (2,480 – 2,870) 4,420 (4,030 – 4,760) 247 2,840 60 years and older 2,750 (2,640 – 2,860) 1,960 (1,820 – 2,070) 2,730 (2,620 – 2,830) 3,790 (3,530 – 4,380) 334 Females 942 2,720 (2,640 – 2,800) 1,920 (1,820 – 1,970) 2,640 (2,540 – 2,760) 3,960 (3,810 – 4,370) Total, 20 years and older 20–39 years 2,530 (2,440 – 2,640) 1,760 (1,670 – 1,840) 2,440 (2,350 – 2,580) 3,870 (3,510 – 4,530) 327 267 40–59 years 2,730 (2,620 – 2,840) 1,960 (1,820 – 2,090) 2,590 (2,530 – 2,760) 3,850 (3,620 – 4,630) 2,180 (4,000 – 4,570) 4,340 2,950 (2,050 – 2,230) (2,760 – 3,150) 348 60 years and older 3,010 (2,870 – 3,150) Table 2.15.a.3. Plasma palmitic acid (16:0): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample Selected percentile s (95% conf. interval) 90th 10th 50th (95% conf. interval) size Males and Females 2,880 (2,710 – 3,050) 1,900 Total, 20 years and older 2,750 (2,620 – 2,970) 4,540 (4,130 – 5,550) 374 (1,720 – 2,050) 20–39 years 2,730 (2,510 – 2,970) 1,820 (1,390 – 1,970) 2,700 (2,350 – 2,890) 4,410 (3,700 – 5,680) 131 40–59 years (2,820 – 3,380) 2,000† (1,480 – 2,330) 2,840 (2,610 – 3,290) 4,940† (4,130 – 6,470) 93 3,090 60 years and older 3,140 (3,010 – 3,280) 2,250 (1,970 – 2,420) 3,150 (3,010 – 3,300) 4,530 (3,910 – 5,350) 150 Males 4,500 Total, 20 years and older 2,850 (2,580 – 3,160) 1,890 (1,570 – 2,010) (2,510 – 3,180) 2,690 (4,020 – 5,950) 188 20–39 years 2,730 1,770† (1,460 – 1,940) 2,540 (2,090 – 3,270) 4,400† (3,600 – 6,350) 67 (2,320 – 3,220) 3,110 (2,580 – 3,400) 1,950† (1,790 – 2,530) 2,830 40–59 years 4,580† (3,880 – 7,970) 48 (2,670 – 3,630) 60 years and older (2,740 – 3,080) 2,090† (1,500 – 2,420) 2,900 (2,580 – 3,230) 3,810† (3,500 – 5,010) 73 2,910 Females Total, 20 years and older (2,660 – 3,170) 1,930 (1,330 – 2,180) 2,790 (2,450 – 3,280) 4,570 (4,060 – 5,360) 186 2,900 20–39 years 2,730 (2,430 – 3,070) 1,840† (1,300 – 2,150) 2,740 (2,230 – 3,080) 4,330† (3,560 – 6,760) 64 40–59 years 3,060 (2,650 – 3,530) 2,050† (1,480 – 2,330) 2,890 (2,460 – 3,500) 4,950† (3,540 – 6,010) 45 5,020† (4,210 – 6,170) 77 3,370 (2,060 – 2,540) 2,370† (2,780 – 3,790) 60 years and older 3,370 (3,050 – 3,740) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 206 206

218 Table 2.15.a.4. Plasma palmitic acid (16:0): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (2,340 – 2,570) 1,750 (1,600 – 1,830) 2,330 (2,240 – 2,480) 3,430 (3,330 – 3,630) 310 2,450 Total, 20 years and older 2,350 (2,170 – 2,530) 1,680 (1,410 – 1,810) 2,190 (2,070 – 2,480) 3,390 (3,140 – 3,730) 126 20–39 years 2,520 1,790† (1,620 – 1,890) 2,350 (2,270 – 2,590) 3,430† (3,370 – 4,090) 98 (2,370 – 2,680) 40–59 years 2,620 (2,490 – 2,760) 2,030† (1,870 – 2,180) 2,510 (2,430 – 2,760) 3,450† (3,280 – 3,770) 86 60 years and older Males (2,280 – 2,640) 2,450 (2,180 – 2,500) 1,690 (1,550 – 1,810) 2,340 Total, 20 years and older 3,550 (3,170 – 4,270) 143 20–39 years 2,320 1,570† (1,310 – 1,770) 2,140 (1,930 – 2,710) 3,410† (2,940 – 9,940) 58 (2,080 – 2,600) 40–59 years (2,330 – 2,940) 1,770† (1,380 – 1,950) 2,370 (2,290 – 2,620) 4,060† (2,900 – 8,390) 42 2,620 60 years and older 2,520 (2,260 – 2,820) 1,740† (1,640 – 1,910) 2,440 (2,150 – 2,980) 3,290† (3,000 – 4,330) 43 Females 167 2,450 (2,300 – 2,620) 1,800 (1,690 – 1,870) 2,330 (2,230 – 2,570) 3,380 (3,210 – 3,680) Total, 20 years and older 20–39 years 2,370 (2,170 – 2,580) 1,700† (1,390 – 1,850) 2,230 (2,030 – 2,590) 3,350† (3,110 – 4,210) 68 56 40–59 years 2,450 (2,230 – 2,680) 1,780† (1,260 – 1,940) 2,330 (2,140 – 2,650) 3,370† (2,930 – 6,230) 3,510† 43 (3,260 – 4,220) 60 years and older 2,690 (2,520 – 2,870) 2,180† (1,950 – 2,240) 2,530 (2,400 – 2,790) † Estimate is subject to greater uncertainty due to small cell size. Table 2.15.a.5. Plasma palmitic acid (16:0): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 2,650 (2,630 – 2,810) 1,900 Total, 20 years and older 2,720 (2,550 – 2,730) 3,960 (3,810 – 4,420) 991 (1,800 – 1,950) 20–39 years 2,550 (2,450 – 2,640) 1,720 (1,600 – 1,810) 2,450 (2,370 – 2,590) 3,790 (3,510 – 4,490) 300 40–59 years (2,630 – 2,870) 1,950 (1,900 – 1,990) 2,640 (2,500 – 2,800) 4,040 (3,790 – 4,700) 279 2,750 60 years and older 2,910 (2,790 – 3,030) 2,040 (1,950 – 2,140) 2,840 (2,730 – 2,990) 4,150 (3,840 – 4,520) 412 Males 2,630 Total, 20 years and older 2,700 (2,580 – 2,840) 1,890 (1,750 – 1,940) (3,770 – 4,500) (2,500 – 2,740) 3,960 471 20–39 years 2,530 1,680 (1,540 – 1,800) 2,460 (2,350 – 2,620) 3,630 (3,260 – 5,810) 128 (2,360 – 2,720) 2,810 (2,460 – 2,930) 1,950 (1,890 – 2,010) 2,700 40–59 years 4,280 (3,850 – 4,740) 139 (2,630 – 2,990) 60 years and older (2,640 – 2,920) 1,950 (1,760 – 2,070) 2,750 (2,600 – 2,930) 3,830 (3,530 – 4,690) 204 2,780 Females Total, 20 years and older (2,640 – 2,820) 1,920 (1,810 – 1,970) 2,650 (2,550 – 2,770) 3,970 (3,810 – 4,500) 520 2,730 20–39 years 2,560 (2,410 – 2,710) 1,740 (1,600 – 1,870) 2,440 (2,280 – 2,690) 3,890 (3,490 – 4,960) 172 40–59 years 2,690 (2,570 – 2,830) 1,940 (1,720 – 2,110) 2,580 (2,530 – 2,710) 3,780 (3,510 – 4,690) 140 (4,030 – 4,660) 208 4,440 60 years and older 3,020 (2,860 – 3,200) 2,140 (2,010 – 2,250) 2,960 (2,750 – 3,210) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 207 207

219 992 609 374 864 310 515 942 682 size 1,806 Sample (1,090 – 1,270) (1,130 – 1,270) (1,170 – 1,360) (1,030 – 1,470) (1,170 – 1,330) (998 – 2,010) (1,130 – 1,350) (1,080 – 1,190) (1,040 – 1,310) 97.5th 1,170 1,180 1,280 1,150 1,140 1,210 1,130 1,210† 1,130† (1,020 – 1,100) (922 – 1,120) (1,030 – 1,200) (1,030 – 1,320) (901 – 1,130) (975 – 1,080) (1,040 – 1,160) (1,020 – 1,090) (976 – 1,120) 95th 998 961 1,040 1,150 1,090 1,100 1,030 1,040 1,030 (95% conf. interval) s (663 – 705) (644 – 711) (666 – 748) (624 – 659) (682 – 733) (645 – 693) (667 – 712) (663 – 709) (697 – 763) 50th 684 673 710 638 669 689 711 686 731 Selected percentile 5th (440 – 484) (434 – 492) (422 – 468) (440 – 483) (433 – 489) (426 – 524) (435 – 495) (430 – 485) (473 – 534) 471 475 472 444 462 481 473 465 511 (411 – 444) (408 – 469) (411 – 467) (362 – 437) (356 – 471) (399 – 441) (383 – 473) (408 – 441) (430 – 489) 2.5th 432 420 433 421 430 421 471 440† 440† n (678 – 706) (677 – 745) (671 – 710) (635 – 664) (677 – 712) (698 – 738) (655 – 697) (676 – 709) (703 – 746) 692 690 649 710 694 676 718 692 724 (95% conf. interval) Geometric mea † Estimate is subject to greater uncertainty due to small cell size. Age group Race/ethnicity Males Gender Total, 20 years and older Mexican Americans 20–39 years Females Non-Hispanic Blacks 40–59 years Non-Hispanic Whites 60 years and older Health and Nutrition Examination Survey, 2003–2004. Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Table 2.16.a.1. Plasma stearic acid (18:0): Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 208 208

220 Figure 2.16.a. Plasma stearic acid (18:0): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Overall Mexican Americans 1000 Females Males 500 (μmol/L) Plasma stearic acid 0 60+ 20−39 40−59 60+ 20−39 40−59 Non−Hispanic Whites Non−Hispanic Blacks 1000 500 (μmol/L) Plasma stearic acid 0 20−39 60+ 20−39 60+ 40−59 40−59 Females Males 1000 Mexican Americans Non−Hispanic Blacks 500 Non−Hispanic (μmol/L) Whites Plasma stearic acid 0 60+ 40−59 40−59 60+ 20−39 20−39 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 209209

221 Table 2.16.a.2. Plasma stearic acid (18:0): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (678 – 706) 515 (489 – 531) 684 (663 – 705) 939 (914 – 963) 1,806 692 Total, 20 years and older 649 (635 – 664) 484 (468 – 498) 638 (624 – 659) 870 (831 – 932) 609 20–39 years 718 545 (520 – 557) 711 (682 – 733) 989 (955 – 1,030) 515 (698 – 738) 40–59 years 724 (703 – 746) 552 (538 – 567) 731 (697 – 763) 930 (893 – 976) 682 60 years and older Males (671 – 710) 690 (644 – 711) 509 (483 – 527) 673 Total, 20 years and older 967 (930 – 1,010) 864 20–39 years 660 484 (469 – 504) 643 (615 – 672) 888 (831 – 1,010) 282 (636 – 686) 40–59 years (697 – 761) 548 (520 – 571) 711 (646 – 752) 1,020 (997 – 1,040) 248 728 60 years and older 679 (656 – 703) 514 (472 – 546) 679 (659 – 718) 874 (825 – 960) 334 Females 942 694 (677 – 712) 522 (484 – 543) 689 (667 – 712) 916 (892 – 951) Total, 20 years and older 20–39 years 639 (620 – 658) 483 (454 – 504) 635 (622 – 658) 849 (817 – 919) 327 267 40–59 years 709 (685 – 733) 532 (478 – 566) 710 (687 – 733) 934 (900 – 990) 617 (914 – 1,020) 971 763 (573 – 628) (735 – 786) 348 60 years and older 763 (736 – 790) Table 2.16.a.3. Plasma stearic acid (18:0): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample Selected percentile s (95% conf. interval) 90th 10th 50th (95% conf. interval) size Males and Females 710 (677 – 745) 503 Total, 20 years and older 710 (666 – 748) 997 (921 – 1,160) 374 (485 – 528) 20–39 years 678 (632 – 727) 492 (464 – 510) 664 (594 – 755) 971 (801 – 1,330) 131 40–59 years (710 – 806) 534† (457 – 587) 746 (714 – 770) 1,060† (915 – 1,470) 93 756 60 years and older 776 (735 – 820) 602 (491 – 646) 767 (720 – 815) 1,060 (961 – 1,180) 150 Males 1,030 Total, 20 years and older 705 (651 – 764) 501 (480 – 522) (611 – 766) 690 (919 – 1,210) 188 20–39 years 682 492† (456 – 508) 647 (540 – 805) 1,040† (830 – 1,330) 67 (596 – 779) 753 (656 – 815) 529† (469 – 595) 725 40–59 years 1,010† (911 – 1,490) 48 (675 – 841) 60 years and older (678 – 776) 593† (457 – 610) 720 (658 – 783) 896† (832 – 1,300) 73 726 Females Total, 20 years and older (677 – 758) 514 (443 – 559) 730 (669 – 777) 996 (885 – 1,140) 186 716 20–39 years 673 (620 – 732) 481† (340 – 555) 678 (629 – 751) 835† (791 – 1,140) 64 40–59 years 759 (696 – 828) 519† (439 – 624) 756 (700 – 819) 1,070† (859 – 1,410) 45 1,100† (1,050 – 1,250) 77 810 (541 – 652) 624† (736 – 903) 60 years and older 826 (760 – 897) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 210 210

222 Table 2.16.a.4. Plasma stearic acid (18:0): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (655 – 697) 509 (458 – 540) 669 (645 – 693) 886 (835 – 941) 310 676 Total, 20 years and older 645 (610 – 682) 483 (435 – 514) 641 (587 – 672) 887 (808 – 945) 126 20–39 years 706 542† (477 – 567) 693 (664 – 710) 908† (833 – 1,120) 98 (675 – 738) 40–59 years 705 (681 – 729) 561† (511 – 615) 711 (692 – 753) 834† (806 – 886) 86 60 years and older Males (645 – 713) 678 (618 – 696) 483 (455 – 524) 663 Total, 20 years and older 925 (854 – 1,110) 143 20–39 years 651 461† (422 – 517) 619 (569 – 687) 897† (803 – 2,540) 58 (602 – 704) 40–59 years (665 – 792) 544† (475 – 557) 676 (621 – 738) 1,010† (877 – 1,670) 42 726 60 years and older 662 (608 – 720) 503† (334 – 555) 673 (615 – 738) 830† (782 – 974) 43 Females 167 674 (649 – 699) 514 (354 – 567) 674 (644 – 702) 834 (789 – 1,030) Total, 20 years and older 20–39 years 639 (604 – 677) 496† (446 – 515) 645 (594 – 667) 833† (715 – 1,090) 68 56 40–59 years 691 (651 – 733) 526† (353 – 589) 693 (643 – 710) 826† (774 – 2,490) 842† 43 (800 – 885) 60 years and older 733 (710 – 757) 638† (558 – 668) 718 (696 – 779) † Estimate is subject to greater uncertainty due to small cell size. Table 2.16.a.5. Plasma stearic acid (18:0): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 686 (676 – 709) 515 Total, 20 years and older 692 (663 – 709) 940 (913 – 973) 992 (484 – 533) 20–39 years 648 (627 – 669) 481 (441 – 507) 635 (614 – 661) 853 (823 – 953) 300 40–59 years (689 – 733) 540 (494 – 565) 705 (675 – 727) 969 (946 – 1,020) 280 710 60 years and older 726 (700 – 753) 546 (524 – 566) 733 (695 – 770) 940 (900 – 1,020) 412 Males 678 Total, 20 years and older 691 (669 – 715) 512 (480 – 533) (919 – 1,010) (644 – 720) 959 472 20–39 years 662 484 (433 – 513) 654 (615 – 675) 844 (810 – 1,250) 128 (629 – 696) 723 (640 – 749) 558 (513 – 576) 709 40–59 years 1,020 (975 – 1,040) 140 (691 – 757) 60 years and older (653 – 711) 508 (471 – 545) 687 (652 – 726) 880 (819 – 1,030) 204 681 Females Total, 20 years and older (673 – 713) 516 (481 – 537) 689 (664 – 713) 923 (899 – 954) 520 693 20–39 years 636 (607 – 666) 460 (427 – 510) 627 (608 – 658) 874 (818 – 1,000) 172 40–59 years 698 (672 – 725) 519 (441 – 554) 699 (675 – 730) 934 (902 – 966) 140 (911 – 1,050) 208 981 60 years and older 766 (733 – 801) 611 (543 – 630) 767 (735 – 801) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 211 211

223 962 592 367 843 500 914 307 665 size 1,757 Sample (35.0 – 39.1) (35.6 – 39.5) (32.4 – 36.6) (32.5 – 36.4) (33.2 – 41.0) (36.4 – 42.2) (34.2 – 43.6) (33.6 – 76.6) (36.5 – 42.2) 97.5th 36.7 37.5 33.8 33.9 36.9 38.5 38.6 35.1† 35.9† (32.5 – 35.9) (30.3 – 34.0) (31.2 – 35.5) (31.4 – 32.8) (33.6 – 38.4) (31.2 – 40.8) (32.4 – 36.8) (33.8 – 38.6) (32.6 – 36.9) 95th 33.6 31.6 32.7 32.0 34.0 33.4 35.7 34.1 36.1 (95% conf. interval) s (22.9 – 23.6) (21.7 – 22.3) (21.1 – 23.7) (21.4 – 23.0) (21.9 – 23.5) (22.9 – 24.2) (23.7 – 25.1) (22.9 – 24.0) (23.8 – 25.7) 50th 23.2 22.4 22.1 22.0 23.5 22.7 24.3 24.9 23.5 Selected percentile (15.4 – 16.7) (14.5 – 16.3) (12.7 – 16.8) (15.0 – 16.2) (16.1 – 17.7) (15.6 – 17.5) (13.6 – 16.7) (15.6 – 18.0) (15.3 – 16.8) 5th 16.2 15.6 15.5 15.6 16.9 16.8 15.4 16.7 16.3 (14.4 – 15.5) (12.7 – 15.2) (11.4 – 15.6) (13.3 – 15.2) (9.41 – 15.3) (15.0 – 16.5) (14.4 – 16.3) (14.1 – 15.8) (13.7 – 16.3) 2.5th 15.1 14.8 14.4 15.9 15.4 15.3 15.6 13.5† 14.6† n (23.0 – 23.9) (21.3 – 23.8) (21.8 – 22.8) (21.6 – 22.9) (23.9 – 25.1) (23.3 – 24.5) (22.1 – 24.3) (23.0 – 24.2) (24.1 – 25.4) 23.4 22.3 22.2 22.5 24.5 23.2 23.9 23.6 24.8 (95% conf. interval) Geometric mea † Estimate is subject to greater uncertainty due to small cell size. Total, 20 years and older Age group Race/ethnicity Males Gender Mexican Americans 20–39 years Females Non-Hispanic Blacks 40–59 years Non-Hispanic Whites 60 years and older Health and Nutrition Examination Survey, 2003–2004. Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Table 2.17.a.1. Plasma arachidic acid (20:0): Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 212 212

224 Figure 2.17.a. Plasma arachidic acid (20:0): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Overall Mexican Americans Females Males (μmol/L) Plasma arachidic acid 0 10 20 30 20−39 60+ 20−39 40−59 60+ 40−59 Non−Hispanic Whites Non−Hispanic Blacks 30 (μmol/L) Plasma arachidic acid 40−59 60+ 20−39 20−39 40−59 60+ Females Males Mexican Americans Non−Hispanic Blacks Non−Hispanic (μmol/L) Whites Plasma arachidic acid 0 10 20 30 0 10 20 60+ 60+ 20−39 40−59 40−59 20−39 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 213213

225 Table 2.17.a.2. Plasma arachidic acid (20:0): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (23.0 – 23.9) 17.6 (16.9 – 18.1) 23.2 (22.9 – 23.6) 31.2 (30.4 – 32.1) 1,757 23.4 Total, 20 years and older 22.2 (21.6 – 22.9) 16.6 (16.0 – 17.2) 22.1 (21.4 – 23.0) 29.5 (28.7 – 30.6) 592 20–39 years 23.9 18.3 (17.5 – 18.8) 23.5 (22.9 – 24.2) 31.4 (30.2 – 32.9) 500 (23.3 – 24.5) 40–59 years 24.8 (24.1 – 25.4) 18.5 (18.0 – 19.1) 24.9 (23.8 – 25.7) 32.9 (31.9 – 34.2) 665 60 years and older Males (21.8 – 22.8) 22.3 (21.7 – 22.3) 16.8 (16.0 – 17.5) 22.0 Total, 20 years and older 29.6 (29.0 – 31.0) 843 20–39 years 21.4 16.4 (15.2 – 17.1) 21.0 (20.5 – 21.8) 28.1 (26.1 – 31.6) 275 (20.6 – 22.3) 40–59 years (22.2 – 23.9) 17.4 (16.6 – 18.0) 22.7 (22.0 – 23.8) 31.1 (29.2 – 32.1) 241 23.1 60 years and older 22.6 (22.1 – 23.0) 16.8 (15.8 – 18.1) 22.4 (21.8 – 23.0) 29.4 (28.9 – 30.4) 327 Females 914 24.5 (23.9 – 25.1) 18.7 (18.0 – 19.0) 24.3 (23.7 – 25.1) 32.3 (31.2 – 33.6) Total, 20 years and older 20–39 years 23.1 (22.3 – 23.9) 16.9 (16.2 – 18.5) 23.4 (22.6 – 23.8) 30.1 (29.2 – 31.2) 317 259 40–59 years 24.6 (24.1 – 25.2) 18.9 (18.3 – 19.3) 24.2 (23.5 – 25.3) 32.6 (30.7 – 34.4) 20.1 (33.2 – 38.1) 35.4 26.9 (18.8 – 21.2) (25.7 – 28.1) 338 60 years and older 26.7 (25.8 – 27.7) Table 2.17.a.3. Plasma arachidic acid (20:0): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample Selected percentile s (95% conf. interval) 90th 10th 50th (95% conf. interval) size Males and Females 22.5 (21.3 – 23.8) 16.9 Total, 20 years and older 22.4 (21.1 – 23.7) 29.6 (27.9 – 33.1) 367 (15.3 – 18.2) 20–39 years 22.2 (20.8 – 23.6) 16.5 (12.4 – 18.3) 21.8 (20.6 – 23.6) 29.5 (27.1 – 36.1) 130 40–59 years (21.1 – 25.0) 16.9† (13.9 – 18.7) 23.0 (21.4 – 25.2) 30.6† (27.4 – 41.6) 91 23.0 60 years and older 22.7 (21.2 – 24.4) 17.4 (14.6 – 18.7) 22.9 (21.8 – 24.2) 29.3 (27.4 – 34.1) 146 Males 28.3 Total, 20 years and older 22.1 (20.6 – 23.7) 16.8 (9.37 – 18.3) (20.5 – 23.8) 22.4 (26.9 – 32.7) 185 20–39 years 21.9 16.6† (11.7 – 19.0) 21.7 (19.6 – 23.9) 27.6† (24.5 – 36.3) 66 (20.2 – 23.9) 22.4 (19.4 – 25.4) 15.9† (12.5 – 19.1) 23.0 40–59 years 29.3† (26.8 – 31.9) 47 (19.9 – 25.3) 60 years and older (19.5 – 24.0) 15.8† (9.37 – 18.7) 21.9 (20.2 – 24.7) 27.8† (25.5 – 32.7) 72 21.6 Females Total, 20 years and older (21.6 – 24.5) 16.8 (15.9 – 18.5) 22.5 (21.3 – 24.0) 31.0 (28.3 – 43.0) 182 23.0 20–39 years 22.5 (20.6 – 24.5) 16.4† (12.9 – 18.5) 21.8 (20.2 – 23.9) 29.7† (27.3 – 43.7) 64 40–59 years 23.6 (21.6 – 25.8) 17.3† (15.6 – 19.2) 22.8 (21.3 – 25.3) 31.8† (27.5 – 41.6) 44 30.2† (27.2 – 40.1) 74 23.9 (13.1 – 20.6) 18.5† (22.2 – 24.5) 60 years and older 23.8 (21.9 – 25.9) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 214 214

226 Table 2.17.a.4. Plasma arachidic acid (20:0): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (22.1 – 24.3) 17.4 (15.9 – 18.4) 22.7 (21.9 – 23.5) 31.0 (29.3 – 33.1) 307 23.2 Total, 20 years and older 22.5 (21.3 – 23.8) 17.0 (13.7 – 18.5) 22.0 (21.4 – 22.8) 30.5 (28.0 – 34.0) 124 20–39 years 24.2 17.0† (15.3 – 19.1) 23.5 (22.5 – 25.2) 31.9† (29.4 – 35.9) 98 (22.6 – 25.8) 40–59 years 23.2 (21.7 – 24.7) 18.3† (15.4 – 18.8) 22.9 (21.1 – 25.6) 29.5† (28.3 – 35.6) 85 60 years and older Males (21.2 – 23.7) 22.4 (20.7 – 22.8) 15.9 (11.7 – 18.2) 21.5 Total, 20 years and older 31.2 (29.0 – 35.8) 142 20–39 years 21.4 14.9† (11.3 – 18.3) 20.7 (18.6 – 22.4) 31.2† (23.2 – 71.3) 57 (19.2 – 23.9) 40–59 years (21.7 – 27.1) 16.1† (14.7 – 19.7) 23.1 (21.3 – 26.5) 31.7† (29.4 – 48.6) 42 24.3 60 years and older 21.6 (20.2 – 23.1) 15.5† (8.59 – 18.4) 21.2 (20.3 – 24.1) 27.9† (25.6 – 33.8) 43 Females 165 23.8 (22.6 – 25.1) 18.4 (16.2 – 19.9) 23.4 (22.2 – 25.1) 30.3 (28.7 – 34.8) Total, 20 years and older 20–39 years 23.4 (22.0 – 25.0) 18.7† (14.9 – 20.5) 22.8 (21.9 – 25.3) 29.5† (27.8 – 32.5) 67 56 40–59 years 24.1 (22.7 – 25.6) 17.0† (14.8 – 20.5) 23.6 (21.8 – 25.8) 31.8† (27.7 – 54.9) 29.9† 42 (29.3 – 37.1) 60 years and older 24.2 (21.5 – 27.1) 18.6† (14.3 – 20.6) 23.9 (19.8 – 29.5) † Estimate is subject to greater uncertainty due to small cell size. Table 2.17.a.5. Plasma arachidic acid (20:0): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 23.5 (23.0 – 24.2) 17.6 Total, 20 years and older 23.6 (22.9 – 24.0) 31.6 (30.6 – 32.6) 962 (16.7 – 18.4) 20–39 years 22.2 (21.3 – 23.1) 16.5 (15.4 – 17.0) 22.0 (20.9 – 23.5) 29.6 (28.3 – 31.3) 290 40–59 years (23.1 – 24.6) 18.4 (17.4 – 19.3) 23.4 (22.9 – 24.1) 31.5 (29.9 – 34.3) 270 23.8 60 years and older 25.2 (24.6 – 25.9) 19.0 (18.0 – 19.4) 25.3 (24.4 – 26.4) 33.5 (32.2 – 35.6) 402 Males 22.0 Total, 20 years and older 22.4 (21.7 – 23.0) 16.7 (16.1 – 17.6) (29.0 – 31.2) (21.7 – 22.4) 29.8 460 20–39 years 21.2 16.3 (13.6 – 17.0) 20.8 (19.9 – 22.0) 28.5 (25.8 – 32.1) 125 (20.1 – 22.4) 23.0 (21.9 – 23.8) 17.6 (15.6 – 18.6) 22.5 40–59 years 31.1 (28.9 – 32.4) 136 (21.9 – 24.2) 60 years and older (22.3 – 23.5) 16.9 (16.1 – 18.3) 22.8 (22.1 – 23.5) 29.6 (29.0 – 31.6) 199 22.9 Females Total, 20 years and older (24.0 – 25.7) 18.7 (17.7 – 19.1) 24.8 (23.8 – 25.7) 32.9 (31.4 – 35.6) 502 24.8 20–39 years 23.0 (21.9 – 24.3) 16.7 (15.9 – 17.7) 23.6 (22.3 – 24.4) 30.1 (29.3 – 31.3) 165 40–59 years 24.7 (24.0 – 25.5) 18.9 (18.2 – 19.7) 24.2 (23.3 – 25.5) 32.7 (30.5 – 37.1) 134 (33.6 – 38.6) 203 36.0 60 years and older 27.4 (26.4 – 28.4) 20.9 (19.1 – 21.7) 27.6 (26.5 – 28.8) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 215 215

227 947 496 367 834 654 905 589 306 size 1,739 Sample (108 – 121) (94.9 – 129) (98.2 – 111) (106 – 134) (111 – 128) (106 – 117) (108 – 128) (98.3 – 104) (107 – 123) 97.5th 111 113 110 111 115 105 99.9 115† 97.9† (94.4 – 98.7) (99.2 – 110) (94.9 – 98.2) (105 – 114) (87.1 – 129) (99.0 – 108) (102 – 111) (99.0 – 111) (104 – 107) 95th 109 105 102 104 106 106 96.4 95.3 97.4 (68.1 – 73.4) (60.9 – 67.4) (70.7 – 75.6) (68.3 – 76.6) (68.0 – 71.4) (69.4 – 72.8) (64.2 – 68.3) (65.0 – 68.5) (64.3 – 74.7) 50th 64.4 73.7 70.9 69.5 66.2 74.0 70.9 66.5 69.4 (37.4 – 46.5) (45.1 – 50.3) (39.7 – 45.1) (40.1 – 46.2) (43.4 – 48.5) (42.9 – 47.6) (40.2 – 49.5) (43.0 – 48.1) (34.5 – 51.1) 5th Selected percentiles (95% conf. interval) 42.0 46.9 43.0 48.4 43.0 46.4 45.2 46.1 46.3 (35.4 – 41.8) (38.1 – 43.2) (20.1 – 45.2) (31.7 – 42.9) (39.4 – 43.7) (40.5 – 47.0) (34.2 – 42.4) (38.0 – 44.3) (20.8 – 47.2) 2.5th 43.4 39.3 39.2 41.6 41.5 42.6 42.6 39.0† 41.1† (67.7 – 71.0) (61.3 – 67.7) (70.4 – 75.2) (68.5 – 75.2) (68.2 – 72.4) (68.9 – 72.0) (64.0 – 67.7) (65.1 – 67.9) (66.5 – 73.0) 69.3 71.8 72.8 70.2 65.8 70.4 64.4 66.5 69.6 (95% conf. interval) Geometric mean † Estimate is subject to greater uncertainty due to small cell size. Non-Hispanic Whites Age group Females Males Gender Race/ethnicity 20–39 years 60 years and older 40–59 years Mexican Americans Total, 20 years and older Non-Hispanic Blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Table 2.18.a.1. Plasma docosanoic acid (22:0): Concentrations nd nd 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 216 216

228 Figure 2.18.a. Plasma docosanoic acid (22:0): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Overall Mexican Americans Females Males (μmol/L) Plasma docosanoic acid 0 20 40 60 80 100 20−39 60+ 20−39 40−59 60+ 40−59 Non−Hispanic Whites Non−Hispanic Blacks 100 (μmol/L) Plasma docosanoic acid 0 20 40 60 80 60+ 20−39 60+ 20−39 40−59 40−59 Females Males Mexican Americans Non−Hispanic Blacks (μmol/L) Non−Hispanic Whites Plasma docosanoic acid 0 20 40 60 80 100 60+ 60+ 20−39 40−59 40−59 20−39 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 217217

229 Table 2.18.a.2. Plasma docosanoic acid (22:0): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (67.7 – 71.0) 50.1 (48.7 – 51.5) 69.5 (68.0 – 71.4) 95.3 (93.0 – 97.7) 1,739 69.3 Total, 20 years and older 66.5 (65.1 – 67.9) 49.7 (48.9 – 51.0) 66.5 (65.0 – 68.5) 89.5 (86.7 – 93.6) 589 20–39 years 71.8 51.9 (47.5 – 55.9) 74.0 (68.3 – 76.6) 96.4 (93.8 – 100) 496 (68.5 – 75.2) 40–59 years 70.2 (68.2 – 72.4) 49.1 (46.2 – 50.7) 70.9 (68.1 – 73.4) 100 (96.1 – 105) 654 60 years and older Males (64.0 – 67.7) 65.8 (64.2 – 68.3) 48.1 (45.1 – 49.7) 66.2 Total, 20 years and older 90.5 (88.2 – 92.5) 834 20–39 years 64.7 49.3 (46.8 – 51.2) 63.7 (61.0 – 66.2) 88.7 (82.6 – 93.6) 274 (62.6 – 66.8) 40–59 years (65.3 – 72.2) 48.3 (43.0 – 51.4) 70.9 (66.0 – 74.5) 92.2 (89.0 – 96.9) 238 68.7 60 years and older 63.1 (60.8 – 65.5) 43.6 (40.8 – 47.0) 64.3 (60.6 – 67.9) 88.2 (85.2 – 91.7) 322 Females 905 72.8 (70.4 – 75.2) 52.4 (50.4 – 55.1) 73.7 (70.7 – 75.6) 98.7 (96.1 – 102) Total, 20 years and older 20–39 years 68.3 (66.2 – 70.6) 50.9 (48.4 – 51.7) 69.4 (66.8 – 71.6) 91.4 (86.0 – 97.4) 315 258 40–59 years 74.9 (70.9 – 79.1) 56.6 (48.1 – 58.3) 76.5 (70.1 – 80.6) 99.0 (94.7 – 108) 54.1 (103 – 112) 107 75.7 (49.1 – 58.5) (73.2 – 80.1) 332 60 years and older 76.6 (73.8 – 79.6) Table 2.18.a.3. Plasma docosanoic acid (22:0): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample Selected percentile s (95% conf. interval) 90th 10th 50th (95% conf. interval) size Males and Females 64.4 (61.3 – 67.7) 47.8 Total, 20 years and older 64.4 (60.9 – 67.4) 87.1 (81.5 – 95.4) 367 (41.7 – 51.6) 20–39 years 64.0 (60.8 – 67.4) 48.4 (42.0 – 50.6) 63.1 (59.7 – 66.8) 85.7 (80.1 – 95.4) 129 40–59 years (61.6 – 71.8) 48.1† (35.5 – 55.5) 67.7 (64.3 – 71.7) 87.9† (80.6 – 106) 91 66.5 60 years and older 61.4 (56.4 – 66.9) 42.7 (38.6 – 47.2) 61.4 (59.8 – 64.2) 85.0 (74.6 – 120) 147 Males 85.2 Total, 20 years and older 64.0 (60.5 – 67.7) 48.2 (38.9 – 52.7) (60.8 – 67.1) 64.4 (80.7 – 90.4) 185 20–39 years 65.2 49.6† (31.7 – 55.2) 63.8 (60.7 – 66.9) 86.8† (77.5 – 116) 65 (62.2 – 68.3) 63.1 (55.7 – 72.0) 44.8† (35.5 – 55.6) 65.0 40–59 years 81.4† (74.8 – 97.7) 47 (56.3 – 70.6) 60 years and older (53.5 – 66.3) 38.8† (35.0 – 43.0) 61.3 (55.7 – 65.1) 87.6† (68.0 – 112) 73 59.6 Females Total, 20 years and older (60.6 – 69.6) 46.5 (41.2 – 50.7) 64.5 (59.9 – 71.3) 92.9 (79.5 – 120) 182 64.9 20–39 years 62.5 (57.1 – 68.4) 42.2† (38.2 – 50.3) 61.3 (55.1 – 70.9) 83.6† (76.3 – 97.3) 64 40–59 years 70.7 (65.1 – 76.6) 53.4† (37.4 – 57.1) 68.7 (65.7 – 76.7) 93.5† (85.0 – 106) 44 82.9† (75.2 – 116) 74 62.0 (34.0 – 54.2) 47.0† (57.9 – 66.5) 60 years and older 63.1 (56.5 – 70.6) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 218 218

230 Table 2.18.a.4. Plasma docosanoic acid (22:0): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (66.5 – 73.0) 52.1 (46.8 – 53.9) 69.4 (64.3 – 74.7) 94.2 (91.4 – 101) 306 69.6 Total, 20 years and older 67.3 (63.9 – 70.8) 52.3 (42.4 – 54.1) 65.0 (62.8 – 71.2) 89.8 (86.7 – 97.6) 124 20–39 years 75.2 53.1† (42.9 – 59.2) 78.6 (71.7 – 82.9) 104† (91.6 – 118) 98 (70.9 – 79.7) 40–59 years 65.6 (61.9 – 69.5) 47.9† (27.8 – 53.2) 65.4 (61.9 – 68.1) 91.3† (81.1 – 118) 84 60 years and older Males (62.1 – 70.3) 66.1 (61.6 – 68.4) 47.6 (33.1 – 53.2) 64.6 Total, 20 years and older 90.2 (87.9 – 98.0) 141 20–39 years 63.5 49.2† (34.5 – 53.7) 61.5 (57.0 – 66.1) 86.6† (76.7 – 119) 57 (58.3 – 69.1) 40–59 years (64.3 – 83.0) 44.8† (39.5 – 59.2) 74.5 (62.0 – 85.4) 93.5† (86.7 – 171) 42 73.0 60 years and older 59.6 (54.0 – 65.7) 41.2† (20.8 – 47.8) 60.2 (53.4 – 67.0) 81.3† (73.0 – 95.8) 42 Females 165 72.5 (69.2 – 76.0) 53.8 (50.3 – 56.1) 73.9 (66.3 – 78.4) 99.7 (91.4 – 106) Total, 20 years and older 20–39 years 70.6 (65.5 – 76.0) 53.0† (40.9 – 57.0) 71.3 (63.1 – 79.9) 91.5† (88.3 – 96.2) 67 56 40–59 years 76.8 (72.5 – 81.4) 55.8† (43.3 – 61.0) 80.4 (72.4 – 84.5) 105† (91.6 – 117) 100† 42 (79.0 – 123) 60 years and older 69.7 (62.7 – 77.4) 53.1† (41.5 – 55.8) 67.8 (59.0 – 76.7) † Estimate is subject to greater uncertainty due to small cell size. Table 2.18.a.5. Plasma docosanoic acid (22:0): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 70.9 (68.9 – 72.0) 50.8 Total, 20 years and older 70.4 (69.4 – 72.8) 96.4 (94.6 – 98.5) 947 (49.4 – 51.7) 20–39 years 67.1 (65.4 – 68.8) 49.9 (48.6 – 51.2) 68.1 (65.9 – 69.5) 90.6 (85.6 – 96.6) 288 40–59 years (68.7 – 76.0) 52.1 (48.5 – 56.3) 74.3 (68.3 – 76.9) 96.5 (93.4 – 103) 267 72.3 60 years and older 72.3 (70.5 – 74.1) 50.1 (47.1 – 53.0) 72.5 (70.4 – 74.6) 102 (98.0 – 108) 392 Males 67.8 Total, 20 years and older 66.9 (64.8 – 69.0) 49.2 (46.5 – 51.0) (88.7 – 94.5) (65.4 – 69.6) 92.0 453 20–39 years 65.3 49.5 (44.6 – 51.7) 64.4 (61.8 – 68.6) 89.1 (80.8 – 97.3) 125 (62.5 – 68.2) 69.6 (66.0 – 75.2) 49.9 (41.9 – 55.0) 72.3 40–59 years 93.1 (90.8 – 96.8) 134 (66.0 – 73.4) 60 years and older (61.6 – 67.7) 46.9 (43.1 – 49.4) 65.3 (62.4 – 69.7) 88.4 (85.6 – 92.0) 194 64.6 Females Total, 20 years and older (71.2 – 76.8) 52.8 (49.8 – 56.8) 74.4 (71.7 – 76.5) 99.3 (96.1 – 108) 494 73.9 20–39 years 68.8 (66.0 – 71.7) 51.0 (47.5 – 52.1) 69.4 (67.8 – 72.6) 92.8 (85.6 – 98.1) 163 40–59 years 75.0 (69.9 – 80.4) 56.4 (44.8 – 59.1) 76.5 (67.5 – 81.7) 98.6 (94.6 – 110) 133 (105 – 113) 198 109 60 years and older 79.5 (77.1 – 81.9) 57.0 (49.9 – 62.1) 78.5 (75.6 – 83.3) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 219 219

231 966 583 355 836 495 907 302 665 size 1,743 Sample (84.9 – 90.2) (85.1 – 92.1) (76.0 – 88.3) (84.5 – 93.1) (76.9 – 117) (83.8 – 91.9) (83.6 – 94.4) (79.0 – 112) (89.1 – 97.5) 97.5th 87.0 87.2 86.1 82.0 86.8 87.3 92.3 80.7† 83.9† (79.0 – 83.6) (71.8 – 78.6) (71.1 – 83.0) (76.4 – 84.9) (78.7 – 84.5) (73.3 – 84.2) (77.4 – 88.0) (81.9 – 91.9) (79.1 – 85.0) 95th 80.9 73.6 76.4 80.8 81.1 79.0 80.7 81.4 86.9 (95% conf. interval) s (52.6 – 55.6) (51.6 – 55.8) (47.2 – 53.8) (49.8 – 52.9) (49.6 – 57.0) (54.1 – 59.6) (52.7 – 56.1) (53.0 – 56.5) (52.4 – 57.5) 50th 53.8 50.1 51.3 53.7 56.6 53.1 53.8 54.8 54.8 Selected percentile (32.7 – 36.8) (30.7 – 37.7) (28.7 – 36.0) (32.4 – 36.6) (32.6 – 37.0) (32.9 – 39.6) (27.0 – 38.0) (30.0 – 34.2) (33.1 – 37.2) 5th 35.3 32.4 34.6 35.6 35.8 37.8 34.8 31.6 35.8 (29.5 – 33.0) (28.5 – 33.0) (19.2 – 32.6) (26.8 – 35.2) (24.0 – 35.4) (29.8 – 35.0) (28.7 – 37.6) (28.7 – 33.6) (21.7 – 31.0) 2.5th 31.2 31.8 30.6 32.4 33.2 31.5 29.1 29.9† 30.8† n (52.8 – 55.3) (47.3 – 53.7) (52.2 – 55.2) (50.3 – 53.0) (52.6 – 56.2) (54.2 – 58.7) (50.5 – 56.2) (53.4 – 56.0) (52.7 – 56.0) 54.0 53.7 51.6 50.4 54.4 53.3 56.4 54.7 54.3 (95% conf. interval) Geometric mea † Estimate is subject to greater uncertainty due to small cell size. Total, 20 years and older Age group Race/ethnicity Males Gender Mexican Americans 20–39 years Females Non-Hispanic Blacks 40–59 years Non-Hispanic Whites 60 years and older Health and Nutrition Examination Survey, 2003–2004. Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Table 2.19.a.1. Plasma lignoceric acid (24:0): Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 220 220

232 Figure 2.19.a. Plasma lignoceric acid (24:0): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Overall Mexican Americans Females Males (μmol/L) Plasma lignoceric acid 0 20 40 60 80 20−39 60+ 20−39 40−59 60+ 40−59 Non−Hispanic Whites Non−Hispanic Blacks 80 (μmol/L) Plasma lignoceric acid 0 20 40 60 60+ 20−39 60+ 20−39 40−59 40−59 Females Males Mexican Americans Non−Hispanic Blacks (μmol/L) Non−Hispanic Whites Plasma lignoceric acid 0 20 40 60 80 60+ 60+ 20−39 40−59 40−59 20−39 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 221221

233 Table 2.19.a.2. Plasma lignoceric acid (24:0): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (52.8 – 55.3) 39.0 (37.4 – 40.6) 53.8 (52.6 – 55.6) 74.2 (72.2 – 76.4) 1,743 54.0 Total, 20 years and older 51.6 (50.3 – 53.0) 37.9 (36.6 – 39.6) 51.3 (49.8 – 52.9) 69.0 (66.5 – 71.8) 583 20–39 years 56.4 41.4 (37.9 – 43.7) 56.6 (54.1 – 59.6) 76.0 (72.9 – 79.2) 495 (54.2 – 58.7) 40–59 years 54.3 (52.7 – 56.0) 37.1 (33.6 – 39.5) 54.8 (52.4 – 57.5) 77.9 (76.4 – 81.4) 665 60 years and older Males (52.2 – 55.2) 53.7 (51.6 – 55.8) 39.1 (37.1 – 41.0) 53.7 Total, 20 years and older 72.6 (70.8 – 74.8) 836 20–39 years 53.1 39.5 (37.9 – 42.3) 52.1 (50.1 – 55.5) 70.9 (67.6 – 74.9) 272 (51.2 – 55.1) 40–59 years (53.6 – 59.0) 41.1 (34.7 – 44.2) 56.1 (53.5 – 60.5) 75.1 (71.7 – 83.1) 238 56.3 60 years and older 50.3 (48.3 – 52.4) 33.6 (30.2 – 37.8) 50.4 (47.1 – 55.0) 70.2 (68.5 – 74.4) 326 Females 907 54.4 (52.6 – 56.2) 39.0 (36.5 – 41.6) 53.8 (52.7 – 56.1) 76.1 (72.5 – 78.4) Total, 20 years and older 20–39 years 50.1 (48.7 – 51.6) 36.6 (34.8 – 37.9) 50.2 (48.9 – 51.9) 67.3 (64.9 – 69.6) 311 257 40–59 years 56.5 (53.9 – 59.3) 42.2 (39.0 – 43.6) 57.0 (53.5 – 60.0) 76.0 (72.2 – 79.6) 39.9 (78.9 – 89.0) 82.8 58.5 (35.3 – 42.3) (55.2 – 61.3) 339 60 years and older 57.8 (55.5 – 60.2) Table 2.19.a.3. Plasma lignoceric acid (24:0): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample Selected percentile s (95% conf. interval) 90th 10th 50th (95% conf. interval) size Males and Females 50.4 (47.3 – 53.7) 37.1 Total, 20 years and older 50.1 (47.2 – 53.8) 69.4 (66.9 – 73.7) 355 (31.5 – 39.5) 20–39 years 50.1 (46.5 – 53.9) 37.1 (30.6 – 38.8) 49.2 (44.7 – 56.1) 68.7 (63.7 – 76.3) 120 40–59 years (47.5 – 58.0) 38.8† (21.0 – 44.5) 53.3 (47.1 – 59.6) 71.6† (65.8 – 81.4) 89 52.5 60 years and older 46.7 (41.5 – 52.7) 33.0 (19.2 – 36.9) 47.1 (40.1 – 53.9) 66.4 (58.7 – 97.3) 146 Males 72.2 Total, 20 years and older 52.9 (49.2 – 56.9) 39.3 (33.0 – 43.1) (48.7 – 56.2) 52.4 (67.8 – 77.5) 176 20–39 years 54.0 40.7† (37.8 – 44.4) 52.3 (48.1 – 57.7) 69.7† (63.8 – 84.8) 61 (50.3 – 58.1) 52.7 (46.0 – 60.5) 36.7† (28.8 – 45.9) 53.2 40–59 years 72.4† (65.3 – 81.2) 45 (45.9 – 60.5) 60 years and older (40.9 – 53.4) 32.2† (19.2 – 36.7) 48.2 (38.4 – 54.3) 69.1† (55.8 – 89.1) 70 46.7 Females Total, 20 years and older (44.6 – 50.7) 32.6 (30.3 – 36.7) 46.5 (43.4 – 51.0) 67.8 (61.8 – 71.1) 179 47.6 20–39 years 45.3 (41.0 – 50.0) 32.0† (29.8 – 36.6) 43.2 (37.9 – 52.6) 64.6† (57.6 – 78.7) 59 40–59 years 52.2 (47.3 – 57.7) 39.2† (21.0 – 43.4) 53.3 (44.8 – 60.2) 69.6† (61.1 – 83.2) 44 63.8† (54.4 – 97.3) 76 45.3 (25.4 – 38.0) 34.7† (39.4 – 54.7) 60 years and older 46.7 (39.8 – 54.8) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 222 222

234 Table 2.19.a.4. Plasma lignoceric acid (24:0): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (50.5 – 56.2) 38.6 (35.4 – 40.9) 53.1 (49.6 – 57.0) 71.8 (70.3 – 74.3) 302 53.3 Total, 20 years and older 51.2 (48.2 – 54.5) 37.2 (29.9 – 41.6) 49.9 (48.0 – 55.7) 67.9 (65.1 – 74.2) 123 20–39 years 57.6 40.9† (33.9 – 46.2) 58.1 (54.2 – 63.3) 73.0† (71.0 – 85.7) 95 (54.6 – 60.8) 40–59 years 50.9 (46.1 – 56.2) 37.3† (29.8 – 40.2) 50.8 (43.5 – 55.2) 74.1† (63.0 – 94.8) 84 60 years and older Males (50.0 – 56.9) 53.4 (49.1 – 58.6) 38.8 (27.0 – 43.3) 52.8 Total, 20 years and older 71.8 (68.1 – 80.6) 140 20–39 years 51.3 38.8† (26.2 – 43.5) 49.9 (46.3 – 55.9) 66.5† (63.1 – 83.8) 57 (47.2 – 55.7) 40–59 years (52.1 – 65.9) 40.9† (32.2 – 48.9) 60.1 (50.6 – 70.1) 73.8† (70.1 – 112) 41 58.6 60 years and older 49.2 (44.5 – 54.4) 30.6† (24.0 – 40.9) 49.5 (44.5 – 54.7) 70.7† (62.3 – 79.1) 42 Females 162 53.2 (50.1 – 56.6) 38.2 (35.3 – 40.8) 53.3 (49.2 – 57.7) 72.0 (69.6 – 78.2) Total, 20 years and older 20–39 years 51.2 (47.7 – 54.8) 36.8† (28.1 – 41.1) 49.7 (46.0 – 57.4) 69.3† (65.3 – 72.9) 66 54 40–59 years 56.8 (53.8 – 60.1) 39.9† (34.9 – 46.2) 56.6 (51.9 – 61.3) 72.2† (70.3 – 85.2) 78.2† 42 (62.0 – 95.2) 60 years and older 52.0 (45.0 – 60.1) 39.7† (31.4 – 40.4) 52.4 (40.8 – 62.0) † Estimate is subject to greater uncertainty due to small cell size. Table 2.19.a.5. Plasma lignoceric acid (24:0): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 54.8 (53.4 – 56.0) 39.6 Total, 20 years and older 54.7 (53.0 – 56.5) 75.3 (73.0 – 77.3) 966 (37.7 – 41.6) 20–39 years 51.8 (50.1 – 53.6) 37.9 (35.9 – 41.2) 51.5 (49.4 – 53.9) 68.9 (66.0 – 72.6) 293 40–59 years (54.2 – 59.3) 42.0 (38.6 – 43.2) 57.0 (53.6 – 60.8) 76.4 (72.8 – 80.8) 270 56.7 60 years and older 55.7 (54.1 – 57.3) 38.2 (33.4 – 41.0) 56.3 (54.0 – 58.6) 78.7 (76.9 – 82.3) 403 Males 54.7 Total, 20 years and older 54.1 (52.5 – 55.8) 39.4 (36.1 – 41.8) (70.5 – 77.2) (51.8 – 56.5) 72.8 461 20–39 years 53.2 39.4 (35.8 – 42.8) 52.5 (49.5 – 56.8) 70.5 (66.0 – 82.9) 126 (50.5 – 56.0) 56.9 (53.1 – 61.8) 42.1 (35.0 – 44.7) 57.1 40–59 years 76.6 (71.7 – 85.9) 135 (53.9 – 60.0) 60 years and older (48.6 – 53.8) 34.8 (29.7 – 39.0) 51.4 (47.1 – 56.4) 70.2 (68.4 – 75.8) 200 51.1 Females Total, 20 years and older (53.1 – 57.4) 39.7 (36.6 – 42.5) 55.1 (53.0 – 57.3) 76.6 (74.2 – 79.2) 505 55.2 20–39 years 50.6 (48.5 – 52.8) 36.7 (32.4 – 41.2) 51.3 (48.6 – 53.2) 67.3 (64.8 – 69.9) 167 40–59 years 56.5 (53.2 – 59.9) 41.8 (38.2 – 43.1) 56.9 (53.0 – 62.0) 76.4 (71.8 – 81.2) 135 (79.9 – 91.5) 203 85.4 60 years and older 59.9 (57.8 – 62.0) 40.9 (36.7 – 44.9) 60.4 (58.3 – 62.5) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 223 223

235 992 610 376 865 515 943 310 683 size 1,808 Sample (27.0 – 40.2) (27.0 – 43.6) (24.8 – 67.0) (29.4 – 40.6) (27.4 – 68.4) (23.9 – 48.1) (27.0 – 52.9) (13.7 – 31.3) (23.4 – 40.7) 97.5th 32.1 32.7 33.0 31.9 34.6 30.7 26.9 33.1† 20.3† (21.4 – 29.3) (19.3 – 32.6) (21.1 – 35.6) (22.8 – 29.7) (19.9 – 31.2) (11.5 – 21.4) (21.4 – 34.6) (19.3 – 30.9) (22.3 – 31.8) 95th 23.9 24.0 26.1 24.9 25.8 12.8 23.4 24.9 23.3 (95% conf. interval) s (5.90 – 6.99) (5.47 – 7.28) (5.44 – 8.30) (5.34 – 6.75) (3.17 – 4.49) (6.20 – 7.62) (5.96 – 6.96) (6.22 – 7.46) (5.53 – 7.45) 50th 6.50 6.83 6.05 6.47 6.87 3.78 6.51 6.40 6.84 Selected percentile (1.68 – 1.96) (1.41 – 1.82) (1.51 – 2.05) (1.64 – 2.01) (1.71 – 2.32) (1.63 – 2.02) (1.06 – 1.42) (1.56 – 1.99) (1.80 – 2.33) 5th 1.79 1.82 1.70 1.76 1.94 1.86 1.18 1.73 2.06 (1.31 – 1.56) (1.05 – 1.39) (1.02 – 1.80) (1.17 – 1.64) (.703 – 1.17) (1.46 – 1.75) (1.11 – 1.69) (1.42 – 1.79) (1.17 – 1.67) 2.5th 1.45 1.47 1.25 1.59 1.44 1.65 1.40 1.53† 1.06† n (6.08 – 7.09) (5.89 – 8.20) (5.70 – 7.07) (5.67 – 6.80) (6.26 – 7.32) (6.30 – 7.90) (3.50 – 4.38) (6.45 – 7.74) (5.61 – 7.26) 6.57 6.35 6.21 6.95 6.77 3.91 7.06 7.07 6.39 (95% conf. interval) Geometric mea † Estimate is subject to greater uncertainty due to small cell size. Total, 20 years and older Age group Race/ethnicity Males Gender Mexican Americans 20–39 years Females Non-Hispanic Blacks 40–59 years Non-Hispanic Whites 60 years and older Health and Nutrition Examination Survey, 2003–2004. Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Table 2.20.a.1. Plasma myristoleic acid (14:1n-5): Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 224 224

236 Figure 2.20.a. Plasma myristoleic acid (14:1n–5): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Overall Mexican Americans 15 10 Females Males (μmol/L) 5 Plasma myristoleic acid 0 60+ 20−39 40−59 40−59 60+ 20−39 Non−Hispanic Whites Non−Hispanic Blacks 15 10 (μmol/L) 5 Plasma myristoleic acid 0 40−59 40−59 60+ 20−39 20−39 60+ Females Males 15 10 Mexican Americans Non−Hispanic (μmol/L) 5 Blacks Non−Hispanic Whites Plasma myristoleic acid 0 20−39 40−59 60+ 60+ 40−59 20−39 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 225 225

237 Table 2.20.a.2. Plasma myristoleic acid (14:1n-5): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (6.08 – 7.09) 2.41 (2.26 – 2.59) 6.50 (5.90 – 6.99) 18.5 (16.7 – 20.5) 1,808 6.57 Total, 20 years and older 6.21 (5.67 – 6.80) 2.33 (2.08 – 2.52) 6.05 (5.34 – 6.75) 16.9 (14.8 – 20.4) 610 20–39 years 7.06 2.53 (2.20 – 2.94) 6.87 (6.20 – 7.62) 19.6 (18.0 – 22.2) 515 (6.30 – 7.90) 40–59 years 6.39 (5.61 – 7.26) 2.43 (2.04 – 2.89) 6.40 (5.53 – 7.45) 17.3 (13.1 – 23.4) 683 60 years and older Males (5.70 – 7.07) 6.35 (5.47 – 7.28) 2.20 (2.01 – 2.35) 6.47 Total, 20 years and older 18.5 (16.5 – 21.2) 865 20–39 years 6.08 2.10 (2.03 – 2.33) 6.09 (5.00 – 7.32) 16.9 (14.5 – 23.9) 282 (5.23 – 7.08) 40–59 years (6.06 – 8.12) 2.27 (1.80 – 2.81) 6.98 (5.49 – 8.66) 21.0 (18.5 – 26.2) 248 7.02 60 years and older 5.74 (5.08 – 6.48) 2.26 (1.68 – 2.61) 5.82 (5.44 – 6.42) 13.7 (10.9 – 20.0) 335 Females 943 6.77 (6.26 – 7.32) 2.73 (2.52 – 2.96) 6.51 (5.96 – 6.96) 18.4 (15.3 – 21.6) Total, 20 years and older 20–39 years 6.34 (5.67 – 7.08) 2.62 (2.06 – 2.94) 5.91 (5.31 – 6.92) 17.2 (13.9 – 22.4) 328 267 40–59 years 7.09 (6.37 – 7.90) 2.87 (2.39 – 3.40) 6.81 (6.29 – 7.17) 18.7 (13.8 – 23.3) 2.91 (16.1 – 23.8) 20.0 6.89 (1.76 – 3.22) (5.55 – 8.06) 348 60 years and older 6.97 (5.87 – 8.26) Table 2.20.a.3. Plasma myristoleic acid (14:1n-5): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample Selected percentile s (95% conf. interval) 90th 10th 50th (95% conf. interval) size Males and Females 6.95 (5.89 – 8.20) 2.26 Total, 20 years and older 6.83 (5.44 – 8.30) 19.4 (17.2 – 22.5) 376 (1.82 – 2.82) 20–39 years 6.79 (5.03 – 9.17) 2.11 (1.71 – 2.75) 6.39 (4.79 – 9.10) 18.7 (15.2 – 32.7) 132 40–59 years (5.73 – 8.97) 2.48† (1.66 – 2.92) 6.96 (5.46 – 9.72) 20.0† (16.1 – 32.0) 93 7.17 60 years and older 7.30 (6.27 – 8.49) 3.03 (2.65 – 3.26) 7.48 (5.22 – 9.67) 16.7 (14.6 – 24.9) 151 Males 20.0 Total, 20 years and older 6.79 (5.24 – 8.79) 2.27 (1.79 – 2.93) (4.63 – 8.66) 6.58 (15.8 – 24.9) 189 20–39 years 6.79 2.15† (1.85 – 2.42) 6.56 (3.74 – 11.8) 20.2† (15.3 – 42.7) 67 (4.48 – 10.3) 7.08 (3.71 – 12.3) 2.69† (1.87 – 3.06) 6.77 40–59 years 18.8† (14.0 – 52.0) 48 (4.81 – 10.4) 60 years and older (4.57 – 7.62) 2.72† (1.76 – 3.30) 5.60 (3.54 – 8.59) 13.6† (9.90 – 18.3) 74 5.90 Females Total, 20 years and older (6.00 – 8.55) 2.03 (1.53 – 3.55) 6.86 (5.60 – 9.13) 18.7 (16.3 – 23.9) 187 7.16 20–39 years 6.78 (4.95 – 9.30) 1.96† (1.51 – 3.90) 6.02 (4.64 – 9.28) 16.3† (12.9 – 156) 65 40–59 years 7.27 (5.08 – 10.4) 1.93† (1.62 – 2.55) 7.32 (3.75 – 13.4) 22.2† (16.4 – 30.1) 45 17.4† (14.8 – 43.2) 77 9.24 (2.33 – 4.14) 3.63† (7.46 – 12.9) 60 years and older 8.88 (7.36 – 10.7) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 226 226

238 Table 2.20.a.4. Plasma myristoleic acid (14:1n-5): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample (95% conf. interval) Selected percentile s 10th 50th 90th (95% conf. interval) size Males and Females Total, 20 years and older 1.48 (1.28 – 1.69) 3.78 (3.17 – 4.49) 10.4 (8.24 – 12.7) 310 3.91 (3.50 – 4.38) 3.95 (3.33 – 4.70) 1.68 20–39 years 3.54 (3.05 – 4.70) 10.2 (7.80 – 12.7) 126 (1.29 – 1.90) 40–59 years (3.55 – 4.66) 1.44† (1.07 – 1.66) 4.21 (2.82 – 4.90) 11.7† (8.28 – 21.4) 98 4.07 (2.94 – 4.54) 60 years and older 1.30† (1.07 – 1.63) 3.37 (3.15 – 3.92) 9.13† (7.34 – 11.4) 86 3.51 Males Total, 20 years and older 3.95 (3.24 – 4.80) 1.23 (1.06 – 1.46) 4.23 (2.79 – 4.93) 11.3 (8.12 – 21.6) 143 20–39 years 3.99 1.37† (.992 – 1.92) 3.41 (2.61 – 5.34) 10.7† (7.65 – 61.3) 58 (2.96 – 5.36) 4.30 (4.11 – 6.89) 1.08† (.703 – 1.28) 4.74 40–59 years 12.4† (8.22 – 24.7) 42 (3.03 – 6.10) (1.60 – 5.17) 60 years and older 1.30† (1.16 – 1.49) 2.53 (2.27 – 4.32) 8.55† (6.21 – 14.2) 43 3.13 Females Total, 20 years and older 3.89 (3.46 – 4.37) 1.70 (1.43 – 2.07) 3.60 (3.10 – 4.46) 8.84 (7.45 – 12.7) 167 20–39 years (3.38 – 4.56) 1.77† (1.45 – 1.94) 3.65 (3.11 – 4.77) 8.32† (6.65 – 12.6) 68 3.93 40–59 years 3.90 (3.15 – 4.82) 1.66† (1.44 – 2.21) 3.42 (2.47 – 4.70) 8.90† (7.34 – 19.3) 56 (.999 – 2.33) 60 years and older 3.78 (3.23 – 4.42) 1.25† (5.98 – 19.5) 3.54 (3.09 – 4.69) 9.24† 43 † Estimate is subject to greater uncertainty due to small cell size. Table 2.20.a.5. Plasma myristoleic acid (14:1n-5): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample (95% conf. interval) Selected percentile s 10th 50th 90th (95% conf. interval) size Males and Females 7.07 2.83 (2.49 – 3.02) 6.84 (6.22 – 7.46) 19.5 (16.9 – 23.0) 992 Total, 20 years and older (6.45 – 7.74) 6.97 (6.26 – 7.77) 2.79 20–39 years 6.61 (5.91 – 7.53) 18.5 (15.1 – 24.6) 300 (2.35 – 3.08) 40–59 years (6.43 – 8.48) 2.87 (2.24 – 3.54) 6.97 (6.17 – 7.94) 19.8 (17.0 – 26.7) 280 7.39 (5.74 – 7.72) 60 years and older 2.63 (2.26 – 3.01) 6.72 (5.80 – 7.78) 17.9 (13.8 – 23.5) 412 6.72 Males Total, 20 years and older 6.84 (6.01 – 7.79) 2.47 (2.07 – 2.86) 6.77 (5.68 – 7.91) 18.7 (16.9 – 22.7) 472 20–39 years 6.84 2.39 (2.03 – 2.95) 6.53 (5.25 – 8.27) 17.0 (14.4 – 31.7) 128 (5.71 – 8.20) 7.31 (4.70 – 10.4) 2.49 (1.82 – 2.96) 7.03 40–59 years 21.0 (18.1 – 27.6) 140 (6.16 – 8.67) 60 years and older (5.25 – 7.15) 2.43 (1.75 – 2.89) 6.36 (5.73 – 6.86) 15.9 (11.0 – 23.9) 204 6.13 Females Total, 20 years and older (6.68 – 7.93) 3.16 (2.81 – 3.49) 6.86 (6.52 – 7.22) 19.6 (15.9 – 23.8) 520 7.28 20–39 years 7.09 (5.99 – 8.39) 2.94 (2.37 – 3.49) 6.67 (5.66 – 8.11) 19.0 (14.7 – 28.0) 172 40–59 years 7.46 (6.48 – 8.59) 3.56 (2.06 – 4.04) 6.84 (6.33 – 7.23) 18.9 (13.4 – 43.3) 140 208 (5.55 – 8.67) (17.0 – 25.2) 20.7 60 years and older 7.27 (5.90 – 8.94) 3.01 (1.59 – 3.69) 7.09 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 227 227

239 990 610 375 863 514 942 310 681 size 1,805 Sample (657 – 806) (615 – 831) (611 – 840) (578 – 926) (699 – 1,110) (630 – 846) (671 – 837) (433 – 755) (589 – 763) 97.5th 727 722 682 685 770 729 676 769† 523† (526 – 664) (450 – 674) (594 – 780) (495 – 683) (528 – 679) (352 – 529) (525 – 772) (528 – 649) (522 – 661) 95th 563 539 692 562 572 429 567 554 559 (95% conf. interval) s (196 – 230) (182 – 225) (204 – 281) (173 – 194) (206 – 251) (204 – 243) (142 – 162) (216 – 263) (201 – 237) 50th 213 239 203 185 151 228 226 221 241 Selected percentile (79.0 – 89.6) (75.0 – 84.1) (68.8 – 84.0) (64.2 – 95.4) (89.1 – 104) (71.3 – 96.8) (64.2 – 73.2) (79.3 – 96.5) (87.9 – 113) 5th 100 84.0 87.0 77.7 82.0 93.4 70.3 82.4 88.9 (65.1 – 78.1) (53.4 – 74.7) (60.0 – 86.2) (60.4 – 78.7) (71.2 – 88.4) (47.2 – 68.9) (45.2 – 78.1) (65.4 – 94.1) (53.0 – 83.5) 2.5th 73.3 72.5 69.0 83.2 69.3 74.9 84.8 78.6† 64.8† n (205 – 229) (185 – 205) (190 – 225) (209 – 277) (148 – 167) (214 – 239) (210 – 248) (208 – 236) (220 – 259) 217 195 240 207 226 157 228 221 238 (95% conf. interval) Geometric mea † Estimate is subject to greater uncertainty due to small cell size. Total, 20 years and older Age group Race/ethnicity Males Gender Mexican Americans 20–39 years Females Non-Hispanic Blacks 40–59 years Non-Hispanic Whites 60 years and older Health and Nutrition Examination Survey, 2003–2004. Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Table 2.21.a.1. Plasma palmitoleic acid (16:1n-7): Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 228 228

240 Figure 2.21.a. Plasma palmitoleic acid (16:1n–7): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Overall Mexican Americans 400 Females Males 300 200 (μmol/L) 100 Plasma palmitoleic acid 0 60+ 20−39 40−59 40−59 60+ 20−39 Non−Hispanic Whites Non−Hispanic Blacks 400 300 200 (μmol/L) 100 Plasma palmitoleic acid 0 60+ 20−39 40−59 60+ 40−59 20−39 Females Males 400 Mexican Americans 300 Non−Hispanic Blacks 200 Non−Hispanic (μmol/L) Whites 100 Plasma palmitoleic acid 0 20−39 40−59 60+ 60+ 40−59 20−39 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 229 229

241 Table 2.21.a.2. Plasma palmitoleic acid (16:1n-7): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (205 – 229) 105 (97.7 – 109) 213 (196 – 230) 454 (424 – 497) 1,805 217 Total, 20 years and older 195 (185 – 205) 92.3 (86.5 – 98.3) 185 (173 – 194) 411 (357 – 472) 610 20–39 years 228 106 (92.9 – 118) 228 (206 – 251) 475 (444 – 549) 514 (210 – 248) 40–59 years 238 (220 – 259) 122 (111 – 135) 241 (216 – 263) 467 (429 – 540) 681 60 years and older Males (190 – 225) 207 (182 – 225) 92.6 (84.0 – 98.9) 203 Total, 20 years and older 456 (400 – 525) 863 20–39 years 192 83.9 (76.9 – 93.8) 185 (169 – 211) 410 (344 – 542) 282 (171 – 215) 40–59 years (198 – 251) 97.4 (78.0 – 108) 218 (184 – 273) 501 (450 – 594) 248 223 60 years and older 207 (191 – 224) 112 (92.6 – 121) 206 (186 – 228) 386 (339 – 450) 333 Females 942 226 (214 – 239) 114 (108 – 123) 226 (204 – 243) 453 (421 – 525) Total, 20 years and older 20–39 years 197 (185 – 211) 108 (92.2 – 111) 184 (170 – 199) 406 (352 – 495) 328 266 40–59 years 233 (217 – 250) 126 (99.4 – 133) 231 (213 – 256) 455 (395 – 534) 137 (493 – 585) 537 271 (115 – 150) (242 – 297) 348 60 years and older 267 (240 – 298) Table 2.21.a.3. Plasma palmitoleic acid (16:1n-7): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample Selected percentile s (95% conf. interval) 90th 10th 50th (95% conf. interval) size Males and Females 240 (209 – 277) 101 Total, 20 years and older 239 (204 – 281) 571 (498 – 645) 375 (64.3 – 131) 20–39 years 223 (181 – 274) 95.2 (60.0 – 129) 221 (175 – 274) 498 (386 – 737) 132 40–59 years (232 – 307) 117† (79.8 – 143) 250 (233 – 272) 639† (545 – 804) 93 267 60 years and older 277 (262 – 292) 144 (136 – 158) 281 (250 – 308) 510 (446 – 587) 150 Males 578 Total, 20 years and older 237 (192 – 292) 96.0 (61.6 – 134) (178 – 290) 226 (489 – 687) 188 20–39 years 225 92.8† (61.6 – 130) 215 (153 – 314) 519† (406 – 844) 67 (169 – 300) 267 (190 – 353) 111† (79.8 – 150) 240 40–59 years 715† (438 – 942) 48 (194 – 367) 60 years and older (192 – 276) 131† (64.1 – 158) 223 (180 – 280) 375† (309 – 876) 73 230 Females Total, 20 years and older (207 – 291) 110 (61.1 – 132) 248 (188 – 316) 558 (421 – 749) 187 245 20–39 years 220 (172 – 281) 98.4† (60.0 – 130) 225 (161 – 293) 449† (352 – 1,110) 65 40–59 years 267 (204 – 350) 119† (88.5 – 144) 252 (148 – 396) 613† (517 – 766) 45 528† (469 – 739) 77 353 (120 – 215) 166† (281 – 398) 60 years and older 328 (284 – 378) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 230 230

242 Table 2.21.a.4. Plasma palmitoleic acid (16:1n-7): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Selected percentile s (95% conf. interval) Sample n Geometric mea 90th size 50th 10th (95% conf. interval) Males and Females (148 – 167) 78.0 (72.0 – 84.1) 151 (142 – 162) 326 (270 – 421) 310 157 Total, 20 years and older 149 (136 – 164) 78.7 (71.8 – 85.0) 148 (126 – 164) 309 (221 – 430) 126 20–39 years 161 72.4† (65.0 – 82.5) 149 (135 – 175) 333† (288 – 508) 98 (144 – 180) 40–59 years 171 (155 – 189) 89.5† (61.4 – 102) 171 (152 – 193) 316† (265 – 397) 86 60 years and older Males (138 – 172) 154 (132 – 174) 74.0 (53.3 – 82.4) 157 Total, 20 years and older 323 (267 – 437) 143 20–39 years 146 71.0† (47.0 – 79.4) 145 (122 – 168) 305† (220 – 863) 58 (126 – 169) 40–59 years (128 – 206) 72.7† (42.6 – 81.3) 168 (115 – 204) 371† (231 – 814) 42 163 60 years and older 164 (130 – 205) 98.3† (60.8 – 114) 152 (123 – 206) 280† (222 – 430) 43 Females 167 159 (142 – 178) 84.4 (71.0 – 90.6) 149 (134 – 172) 331 (254 – 494) Total, 20 years and older 20–39 years 152 (132 – 175) 85.4† (75.5 – 94.4) 147 (121 – 167) 314† (190 – 543) 68 56 40–59 years 160 (134 – 190) 71.3† (58.4 – 86.2) 144 (112 – 205) 317† (255 – 1,360) 322† 43 (251 – 548) 60 years and older 176 (150 – 205) 89.4† (49.9 – 104) 178 (142 – 235) † Estimate is subject to greater uncertainty due to small cell size. Table 2.21.a.5. Plasma palmitoleic acid (16:1n-7): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 221 (208 – 236) 109 Total, 20 years and older 221 (201 – 237) 453 (411 – 498) 990 (99.2 – 116) 20–39 years 199 (184 – 215) 95.5 (84.0 – 109) 191 (174 – 207) 406 (348 – 496) 300 40–59 years (208 – 251) 107 (96.8 – 126) 230 (214 – 253) 462 (409 – 525) 279 229 60 years and older 243 (221 – 267) 125 (114 – 136) 247 (219 – 272) 484 (415 – 556) 411 Males 202 Total, 20 years and older 208 (189 – 229) 95.8 (81.2 – 108) (386 – 520) (182 – 231) 447 471 20–39 years 190 83.9 (69.1 – 97.2) 185 (159 – 215) 359 (319 – 554) 128 (164 – 221) 222 (175 – 277) 98.2 (74.3 – 111) 223 40–59 years 470 (410 – 582) 140 (196 – 252) 60 years and older (192 – 232) 113 (92.1 – 124) 201 (182 – 241) 392 (343 – 481) 203 211 Females Total, 20 years and older (219 – 249) 122 (108 – 133) 232 (220 – 250) 455 (408 – 538) 519 234 20–39 years 206 (187 – 228) 109 (91.9 – 118) 194 (173 – 221) 414 (346 – 644) 172 40–59 years 235 (216 – 256) 130 (99.9 – 146) 239 (220 – 257) 452 (362 – 532) 139 (460 – 661) 208 550 60 years and older 273 (238 – 314) 138 (108 – 165) 274 (243 – 303) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 231 231

243 958 589 373 845 501 917 305 672 size 1,762 Sample (283 – 344) (275 – 337) (248 – 344) (277 – 390) (326 – 384) (273 – 345) (298 – 533) (251 – 429) (278 – 344) 97.5th 303 298 325 269 333 301 301 336† 295† (251 – 274) (214 – 259) (258 – 378) (242 – 301) (240 – 282) (206 – 354) (251 – 309) (258 – 297) (242 – 275) 95th 262 235 304 265 282 237 260 260 266 (95% conf. interval) s (139 – 148) (135 – 148) (136 – 164) (122 – 137) (139 – 150) (139 – 151) (117 – 134) (162 – 172) (139 – 149) 50th 143 146 141 129 125 144 145 144 166 Selected percentile (76.2 – 89.7) (63.3 – 82.7) (70.4 – 90.3) (58.0 – 93.1) (75.4 – 92.0) (75.1 – 95.5) (68.0 – 80.3) (75.1 – 93.1) (93.4 – 109) 5th 103 83.6 80.9 83.4 76.9 85.8 74.8 86.6 86.7 (65.1 – 81.0) (62.4 – 81.2) (55.7 – 82.7) (58.6 – 75.3) (61.8 – 81.7) (54.5 – 74.7) (64.4 – 85.5) (85.3 – 102) (62.1 – 85.4) 2.5th 75.3 65.6 71.5 77.7 76.4 77.0 94.1 65.9† 69.5† n (141 – 150) (126 – 138) (139 – 151) (138 – 166) (120 – 138) (141 – 153) (143 – 154) (140 – 152) (162 – 173) 146 131 152 145 147 129 148 146 168 (95% conf. interval) Geometric mea † Estimate is subject to greater uncertainty due to small cell size. Total, 20 years and older Age group Race/ethnicity Males Gender Mexican Americans 20–39 years Females Non-Hispanic Blacks 40–59 years Non-Hispanic Whites 60 years and older Health and Nutrition Examination Survey, 2003–2004. Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Table 2.22.a.1. Plasma cis-vaccenic acid (18:1n-7): Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 232 232

244 Figure 2.22.a. Plasma cis−vaccenic acid (18:1n–7): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Overall Mexican Americans 300 200 Females Males (μmol/L) 100 0 Plasma cis−vaccenic acid 60+ 20−39 40−59 40−59 60+ 20−39 Non−Hispanic Whites Non−Hispanic Blacks 300 200 (μmol/L) 100 0 Plasma cis−vaccenic acid 40−59 40−59 60+ 20−39 20−39 60+ Females Males 300 200 Mexican Americans Non−Hispanic (μmol/L) Blacks 100 Non−Hispanic Whites 0 Plasma cis−vaccenic acid 20−39 40−59 60+ 60+ 40−59 20−39 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 233 233

245 Table 2.22.a.2. Plasma cis-vaccenic acid (18:1n-7): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (141 – 150) 95.1 (89.2 – 99.8) 143 (139 – 148) 225 (216 – 234) 1,762 146 Total, 20 years and older 131 (126 – 138) 87.0 (78.0 – 93.7) 129 (122 – 137) 200 (190 – 215) 589 20–39 years 148 99.9 (92.1 – 104) 144 (139 – 150) 229 (211 – 262) 501 (143 – 154) 40–59 years 168 (162 – 173) 113 (107 – 119) 166 (162 – 172) 242 (231 – 259) 672 60 years and older Males (139 – 151) 145 (135 – 148) 95.1 (87.8 – 102) 141 Total, 20 years and older 222 (210 – 241) 845 20–39 years 132 87.9 (73.4 – 94.8) 129 (123 – 138) 197 (184 – 222) 273 (126 – 139) 40–59 years (139 – 160) 99.8 (85.5 – 105) 146 (133 – 159) 240 (208 – 301) 242 149 60 years and older 160 (153 – 167) 109 (97.2 – 117) 161 (150 – 168) 226 (215 – 258) 330 Females 917 147 (141 – 153) 95.0 (88.5 – 99.8) 145 (139 – 151) 227 (213 – 238) Total, 20 years and older 20–39 years 131 (123 – 139) 85.8 (78.0 – 92.8) 129 (119 – 138) 203 (190 – 222) 316 259 40–59 years 147 (140 – 154) 99.8 (87.5 – 105) 144 (139 – 147) 219 (187 – 301) 117 (237 – 273) 248 172 (107 – 127) (163 – 182) 342 60 years and older 174 (166 – 181) Table 2.22.a.3. Plasma cis-vaccenic acid (18:1n-7): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample Selected percentile s (95% conf. interval) 90th 10th 50th (95% conf. interval) size Males and Females 152 (138 – 166) 97.2 Total, 20 years and older 146 (136 – 164) 240 (222 – 324) 373 (66.3 – 108) 20–39 years 140 (125 – 157) 83.4 (55.7 – 108) 140 (125 – 154) 226 (188 – 347) 130 40–59 years (146 – 192) 102† (90.0 – 110) 157 (145 – 183) 270† (240 – 375) 92 168 60 years and older 179 (171 – 187) 123 (73.1 – 139) 177 (169 – 184) 277 (247 – 310) 151 Males 255 Total, 20 years and older 151 (130 – 176) 94.6 (58.1 – 111) (127 – 178) 144 (217 – 331) 187 20–39 years 139 83.3† (58.1 – 108) 136 (117 – 168) 224† (179 – 350) 66 (117 – 166) 175 (139 – 212) 103† (88.8 – 127) 159 40–59 years 321† (229 – 454) 47 (142 – 216) 60 years and older (142 – 197) 101† (68.8 – 140) 155 (140 – 209) 263† (217 – 634) 74 167 Females Total, 20 years and older (142 – 162) 97.2 (72.8 – 104) 153 (137 – 167) 235 (222 – 261) 186 152 20–39 years 141 (124 – 160) 87.7† (57.9 – 102) 144 (113 – 169) 221† (186 – 410) 64 40–59 years 159 (133 – 191) 98.6† (81.2 – 109) 151 (125 – 188) 246† (197 – 421) 45 284† (228 – 375) 77 187 (110 – 142) 130† (165 – 214) 60 years and older 190 (173 – 210) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 234 234

246 Table 2.22.a.4. Plasma cis-vaccenic acid (18:1n-7): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (120 – 138) 82.6 (74.8 – 88.4) 125 (117 – 134) 202 (186 – 225) 305 129 Total, 20 years and older 119 (107 – 134) 80.5 (63.7 – 84.9) 112 (99.8 – 134) 184 (155 – 395) 124 20–39 years 133 80.1† (69.5 – 89.8) 124 (118 – 135) 204† (187 – 266) 96 (121 – 146) 40–59 years 151 (145 – 157) 108† (99.6 – 115) 143 (141 – 147) 218† (191 – 303) 85 60 years and older Males (119 – 139) 129 (117 – 134) 79.8 (71.9 – 84.8) 124 Total, 20 years and older 205 (185 – 235) 141 20–39 years 118 72.2† (54.1 – 82.8) 114 (89.0 – 136) 185† (136 – 435) 57 (104 – 133) 40–59 years (117 – 158) 80.3† (69.7 – 90.3) 121 (117 – 132) 221† (188 – 409) 41 136 60 years and older 151 (136 – 168) 108† (89.1 – 116) 147 (136 – 168) 217† (179 – 250) 43 Females 164 129 (116 – 143) 84.9 (67.1 – 94.9) 126 (111 – 139) 197 (165 – 284) Total, 20 years and older 20–39 years 121 (102 – 142) 82.6† (56.8 – 94.3) 111 (99.1 – 140) 177† (153 – 284) 67 55 40–59 years 130 (117 – 145) 76.7† (66.9 – 92.1) 128 (115 – 136) 197† (163 – 575) 214† 42 (180 – 323) 60 years and older 150 (139 – 162) 108† (102 – 124) 141 (136 – 148) † Estimate is subject to greater uncertainty due to small cell size. Table 2.22.a.5. Plasma cis-vaccenic acid (18:1n-7): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 144 (140 – 152) 95.8 Total, 20 years and older 146 (139 – 149) 222 (211 – 234) 958 (89.8 – 102) 20–39 years 131 (123 – 139) 88.8 (70.0 – 95.5) 127 (120 – 138) 200 (183 – 218) 285 40–59 years (139 – 153) 100 (89.1 – 104) 144 (137 – 149) 219 (199 – 244) 270 145 60 years and older 168 (162 – 174) 113 (106 – 117) 167 (162 – 172) 247 (231 – 261) 403 Males 141 Total, 20 years and older 144 (138 – 150) 96.3 (89.6 – 103) (205 – 240) (132 – 149) 217 456 20–39 years 131 92.8 (67.7 – 97.1) 125 (117 – 139) 185 (173 – 229) 121 (122 – 140) 145 (127 – 158) 99.8 (84.1 – 105) 144 40–59 years 224 (203 – 276) 136 (135 – 156) 60 years and older (153 – 169) 109 (95.0 – 116) 163 (151 – 170) 229 (216 – 260) 199 161 Females Total, 20 years and older (141 – 154) 95.6 (87.9 – 103) 147 (141 – 152) 226 (209 – 240) 502 148 20–39 years 131 (122 – 141) 87.7 (61.8 – 95.4) 130 (121 – 139) 204 (187 – 234) 164 40–59 years 146 (137 – 155) 100 (86.2 – 105) 144 (139 – 148) 212 (180 – 322) 134 (235 – 279) 204 253 60 years and older 174 (166 – 183) 116 (103 – 128) 171 (162 – 183) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 235 235

247 986 608 375 858 512 940 308 678 size 1,798 Sample (4,230 – 4,940) (4,160 – 4,930) (3,770 – 8,650) (4,500 – 5,530) (4,400 – 6,640) (4,030 – 4,400) (4,290 – 5,320) (3,350 – 8,200) (4,120 – 4,930) 97.5th 4,480 4,380 4,930 4,190 4,790 4,240 4,410 4,940† 3,760† (3,590 – 4,220) (3,120 – 4,140) (3,850 – 5,240) (3,560 – 4,930) (3,490 – 4,020) (2,890 – 3,760) (3,610 – 4,800) (3,490 – 4,410) (3,580 – 4,190) 95th 3,850 3,710 4,280 4,110 4,150 3,180 3,810 3,840 3,850 (95% conf. interval) s (2,000 – 2,150) (2,010 – 2,200) (1,990 – 2,470) (1,750 – 1,970) (2,010 – 2,190) (1,620 – 1,830) (1,940 – 2,140) (2,020 – 2,180) (2,290 – 2,450) 50th 2,070 2,100 2,170 1,840 1,710 2,020 2,120 2,380 2,120 Selected percentile 5th (1,170 – 1,270) (987 – 1,340) (1,080 – 1,170) (1,160 – 1,300) (1,130 – 1,270) (1,180 – 1,350) (1,010 – 1,180) (1,340 – 1,550) (1,140 – 1,320) 1,220 1,270 1,230 1,130 1,200 1,280 1,150 1,430 1,230 (1,030 – 1,170) (1,040 – 1,210) (871 – 1,240) (955 – 1,080) (892 – 1,080) (972 – 1,140) (993 – 1,220) (990 – 1,210) (1,290 – 1,400) 2.5th 1,110 1,020 1,140 1,090 1,160 1,120 1,330 1,110† 1,020† n (2,050 – 2,150) (2,060 – 2,430) (2,060 – 2,220) (1,840 – 1,980) (2,000 – 2,140) (2,100 – 2,230) (1,730 – 1,890) (2,060 – 2,200) (2,290 – 2,440) 2,100 2,140 1,910 2,240 2,070 1,810 2,160 2,130 2,360 (95% conf. interval) Geometric mea † Estimate is subject to greater uncertainty due to small cell size. Age group Race/ethnicity Males Gender Total, 20 years and older Mexican Americans 20–39 years Females Non-Hispanic Blacks 40–59 years Non-Hispanic Whites 60 years and older Health and Nutrition Examination Survey, 2003–2004. Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Table 2.23.a.1. Plasma oleic acid (18:1n-9): Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 236 236

248 Figure 2.23.a. Plasma oleic acid (18:1n–9): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Overall Mexican Americans 4000 3000 Females Males 2000 (μmol/L) 1000 Plasma oleic acid 0 60+ 20−39 40−59 40−59 60+ 20−39 Non−Hispanic Whites Non−Hispanic Blacks 4000 3000 2000 (μmol/L) 1000 Plasma oleic acid 0 40−59 60+ 20−39 40−59 20−39 60+ Females Males 4000 3000 Mexican Americans Non−Hispanic 2000 Blacks (μmol/L) Non−Hispanic 1000 Whites Plasma oleic acid 0 20−39 40−59 60+ 60+ 40−59 20−39 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 237 237

249 Table 2.23.a.2. Plasma oleic acid (18:1n-9): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (2,050 – 2,150) 1,360 (1,310 – 1,400) 2,070 (2,000 – 2,150) 3,230 (3,090 – 3,440) 1,798 2,100 Total, 20 years and older 1,910 (1,840 – 1,980) 1,240 (1,200 – 1,300) 1,840 (1,750 – 1,970) 2,900 (2,710 – 3,160) 608 20–39 years 2,160 1,410 (1,350 – 1,530) 2,120 (2,010 – 2,190) 3,380 (3,100 – 3,660) 512 (2,100 – 2,230) 40–59 years 2,360 (2,290 – 2,440) 1,630 (1,550 – 1,690) 2,380 (2,290 – 2,450) 3,360 (3,200 – 3,640) 678 60 years and older Males (2,060 – 2,220) 2,140 (2,010 – 2,200) 1,360 (1,310 – 1,410) 2,100 Total, 20 years and older 3,340 (3,060 – 3,660) 858 20–39 years 1,960 1,240 (1,220 – 1,310) 1,890 (1,770 – 2,060) 2,950 (2,640 – 3,700) 281 (1,850 – 2,080) 40–59 years (2,120 – 2,400) 1,410 (1,310 – 1,550) 2,200 (1,970 – 2,350) 3,580 (3,180 – 4,480) 247 2,250 60 years and older 2,310 (2,220 – 2,400) 1,600 (1,400 – 1,730) 2,340 (2,170 – 2,420) 3,310 (3,040 – 3,850) 330 Females 940 2,070 (2,000 – 2,140) 1,380 (1,300 – 1,410) 2,020 (1,940 – 2,140) 3,180 (2,960 – 3,370) Total, 20 years and older 20–39 years 1,860 (1,790 – 1,940) 1,220 (1,140 – 1,300) 1,780 (1,700 – 1,940) 2,820 (2,570 – 3,620) 327 265 40–59 years 2,080 (2,000 – 2,160) 1,400 (1,330 – 1,520) 2,000 (1,920 – 2,140) 3,100 (2,830 – 3,700) 1,660 (3,260 – 3,820) 3,410 2,430 (1,480 – 1,740) (2,270 – 2,530) 348 60 years and older 2,410 (2,280 – 2,530) Table 2.23.a.3. Plasma oleic acid (18:1n-9): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample Selected percentile s (95% conf. interval) 90th 10th 50th (95% conf. interval) size Males and Females 2,240 (2,060 – 2,430) 1,410 Total, 20 years and older 2,170 (1,990 – 2,470) 3,680 (3,330 – 4,270) 375 (1,250 – 1,500) 20–39 years 2,080 (1,850 – 2,350) 1,320 (882 – 1,470) 2,020 (1,710 – 2,390) 3,330 (2,900 – 4,590) 132 40–59 years (2,220 – 2,730) 1,610† (1,140 – 1,790) 2,330 (2,090 – 2,670) 4,210† (3,520 – 5,160) 93 2,460 60 years and older 2,630 (2,460 – 2,820) 1,800 (1,740 – 1,820) 2,650 (2,320 – 2,900) 3,730 (3,570 – 4,720) 150 Males 3,940 Total, 20 years and older 2,240 (1,970 – 2,540) 1,410 (1,150 – 1,510) (1,820 – 2,570) 2,160 (3,120 – 4,880) 188 20–39 years 2,080 1,340† (989 – 1,480) 1,930 (1,530 – 2,550) 3,390† (2,640 – 5,270) 67 (1,720 – 2,500) 2,560 (2,000 – 3,090) 1,550† (1,280 – 1,980) 2,490 40–59 years 4,270† (3,570 – 5,640) 48 (2,160 – 3,040) 60 years and older (2,160 – 2,800) 1,790† (1,030 – 1,830) 2,350 (1,900 – 3,040) 3,440† (3,270 – 4,860) 73 2,460 Females Total, 20 years and older (2,060 – 2,450) 1,400 (859 – 1,680) 2,160 (2,020 – 2,500) 3,500 (3,280 – 3,970) 187 2,240 20–39 years 2,090 (1,810 – 2,410) 1,240† (831 – 1,570) 2,020 (1,750 – 2,330) 3,210† (2,850 – 4,200) 65 40–59 years 2,350 (2,020 – 2,730) 1,590† (1,080 – 1,770) 2,200 (1,990 – 2,730) 3,760† (2,920 – 5,280) 45 4,260† (3,660 – 5,490) 77 2,730 (1,600 – 2,040) 1,890† (2,320 – 3,420) 60 years and older 2,800 (2,470 – 3,180) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 238 238

250 Table 2.23.a.4. Plasma oleic acid (18:1n-9): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (1,730 – 1,890) 1,210 (1,170 – 1,260) 1,710 (1,620 – 1,830) 2,750 (2,610 – 2,990) 308 1,810 Total, 20 years and older 1,680 (1,560 – 1,810) 1,170 (1,050 – 1,210) 1,540 (1,470 – 1,760) 2,470 (2,310 – 3,740) 125 20–39 years 1,900 1,240† (1,060 – 1,310) 1,790 (1,640 – 1,970) 2,840† (2,610 – 3,590) 97 (1,750 – 2,050) 40–59 years 2,000 (1,870 – 2,150) 1,400† (1,190 – 1,570) 1,960 (1,800 – 2,190) 2,800† (2,670 – 3,020) 86 60 years and older Males (1,720 – 1,990) 1,850 (1,570 – 1,920) 1,200 (1,140 – 1,240) 1,720 Total, 20 years and older 2,930 (2,470 – 4,190) 142 20–39 years 1,710 1,140† (887 – 1,230) 1,560 (1,380 – 1,830) 2,480† (2,400 – 6,770) 57 (1,540 – 1,910) 40–59 years (1,730 – 2,310) 1,290† (1,010 – 1,410) 1,850 (1,600 – 2,060) 3,160† (2,570 – 8,560) 42 2,000 60 years and older 1,980 (1,730 – 2,270) 1,350† (1,080 – 1,620) 1,960 (1,700 – 2,140) 2,870† (2,440 – 4,520) 43 Females 166 1,770 (1,670 – 1,890) 1,210 (1,150 – 1,280) 1,700 (1,600 – 1,840) 2,660 (2,460 – 2,960) Total, 20 years and older 20–39 years 1,650 (1,510 – 1,810) 1,160† (1,080 – 1,250) 1,540 (1,470 – 1,710) 2,430† (2,130 – 3,240) 68 55 40–59 years 1,820 (1,640 – 2,030) 1,200† (863 – 1,280) 1,760 (1,620 – 2,010) 2,620† (2,360 – 6,740) 2,780† 43 (2,640 – 3,030) 60 years and older 2,010 (1,880 – 2,160) 1,410† (1,280 – 1,590) 1,930 (1,700 – 2,400) † Estimate is subject to greater uncertainty due to small cell size. Table 2.23.a.5. Plasma oleic acid (18:1n-9): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 2,120 (2,060 – 2,200) 1,390 Total, 20 years and older 2,130 (2,020 – 2,180) 3,240 (3,100 – 3,430) 986 (1,320 – 1,480) 20–39 years 1,940 (1,820 – 2,050) 1,260 (1,140 – 1,360) 1,870 (1,750 – 2,040) 2,820 (2,630 – 3,710) 299 40–59 years (2,070 – 2,220) 1,400 (1,320 – 1,550) 2,140 (2,030 – 2,180) 3,320 (3,020 – 3,600) 279 2,150 60 years and older 2,390 (2,310 – 2,470) 1,650 (1,530 – 1,730) 2,420 (2,330 – 2,480) 3,410 (3,250 – 3,700) 408 Males 2,150 Total, 20 years and older 2,170 (2,070 – 2,280) 1,380 (1,290 – 1,520) (3,030 – 3,630) (2,040 – 2,240) 3,300 468 20–39 years 1,990 1,250 (1,070 – 1,380) 1,960 (1,760 – 2,130) 2,830 (2,610 – 4,110) 128 (1,830 – 2,170) 2,230 (1,950 – 2,370) 1,390 (1,220 – 1,570) 2,200 40–59 years 3,460 (3,020 – 4,000) 140 (2,080 – 2,380) 60 years and older (2,240 – 2,460) 1,600 (1,390 – 1,730) 2,400 (2,320 – 2,470) 3,340 (3,070 – 4,100) 200 2,350 Females Total, 20 years and older (2,010 – 2,180) 1,390 (1,320 – 1,470) 2,080 (1,970 – 2,160) 3,200 (2,910 – 3,660) 518 2,090 20–39 years 1,880 (1,770 – 2,000) 1,260 (1,120 – 1,360) 1,790 (1,670 – 2,010) 2,810 (2,530 – 3,860) 171 40–59 years 2,070 (1,980 – 2,170) 1,410 (1,100 – 1,560) 2,010 (1,890 – 2,160) 3,100 (2,720 – 3,910) 139 (3,220 – 4,060) 208 3,470 60 years and older 2,430 (2,300 – 2,560) 1,670 (1,470 – 1,810) 2,430 (2,250 – 2,540) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 239 239

251 989 608 376 865 514 940 310 683 size 1,805 Sample (29.9 – 38.3) (26.5 – 39.3) (26.3 – 45.2) (31.8 – 42.5) (33.2 – 45.9) (26.1 – 35.3) (27.6 – 47.0) (25.1 – 51.3) (28.1 – 39.5) 97.5th 33.1 31.7 37.1 34.7 31.8 30.1 31.1 38.7† 29.4† (24.2 – 30.5) (22.7 – 37.3) (27.9 – 40.8) (24.6 – 33.4) (23.2 – 26.6) (21.3 – 28.1) (23.6 – 31.7) (24.4 – 30.4) (23.5 – 30.1) 95th 25.9 25.8 33.1 28.7 25.7 23.4 24.9 24.9 26.0 (95% conf. interval) s (12.8 – 13.8) (12.9 – 14.2) (13.7 – 16.4) (11.4 – 12.9) (10.2 – 12.1) (12.3 – 13.8) (12.6 – 13.6) (12.9 – 13.8) (14.7 – 15.8) 50th 13.3 14.7 12.1 13.5 13.2 11.1 13.0 15.1 13.4 Selected percentile (6.83 – 7.98) (6.72 – 8.27) (6.33 – 9.25) (6.35 – 7.49) (6.83 – 7.84) (7.00 – 8.25) (6.08 – 6.85) (8.98 – 10.3) (6.70 – 8.15) 5th 7.56 8.65 7.68 6.82 7.48 7.59 6.39 9.74 7.63 (6.33 – 7.03) (6.12 – 7.50) (6.00 – 8.62) (5.53 – 6.66) (5.11 – 6.37) (5.98 – 7.01) (4.20 – 7.54) (5.83 – 7.46) (7.50 – 9.41) 2.5th 6.69 6.35 6.70 6.66 6.96 6.83 8.94 6.86† 6.11† n (13.2 – 14.1) (14.4 – 16.5) (13.3 – 14.5) (12.0 – 13.3) (12.8 – 14.0) (13.0 – 14.1) (11.0 – 12.4) (13.1 – 14.2) (15.1 – 16.1) 13.6 13.9 12.6 15.4 13.4 11.7 13.5 13.6 15.6 (95% conf. interval) Geometric mea † Estimate is subject to greater uncertainty due to small cell size. Total, 20 years and older Age group Race/ethnicity Males Gender Mexican Americans 20–39 years Females Non-Hispanic Blacks 40–59 years Non-Hispanic Whites 60 years and older Health and Nutrition Examination Survey, 2003–2004. Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Table 2.24.a.1. Plasma eicosenoic acid (20:1n-9): Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 240 240

252 Figure 2.24.a. Plasma eicosenoic acid (20:1n–9): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Mexican Americans Overall 25 20 Females Males 15 10 (μmol/L) 5 Plasma eicosenoic acid 0 60+ 20−39 20−39 40−59 60+ 40−59 Non−Hispanic Whites Non−Hispanic Blacks 25 20 15 10 (μmol/L) 5 Plasma eicosenoic acid 0 20−39 40−59 20−39 60+ 40−59 60+ Females Males 25 20 Mexican Americans 15 Non−Hispanic Blacks 10 (μmol/L) Non−Hispanic Whites 5 Plasma eicosenoic acid 0 20−39 40−59 60+ 60+ 40−59 20−39 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 241241

253 Table 2.24.a.2. Plasma eicosenoic acid (20:1n-9): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (13.2 – 14.1) 8.46 (7.94 – 8.95) 13.3 (12.8 – 13.8) 22.2 (21.4 – 23.2) 1,805 13.6 Total, 20 years and older 12.6 (12.0 – 13.3) 7.85 (6.91 – 8.20) 12.1 (11.4 – 12.9) 21.6 (20.3 – 23.2) 608 20–39 years 13.5 8.71 (7.75 – 9.34) 13.2 (12.3 – 13.8) 22.3 (20.3 – 24.2) 514 (13.0 – 14.1) 40–59 years 15.6 (15.1 – 16.1) 10.7 (10.3 – 10.9) 15.1 (14.7 – 15.8) 23.1 (21.8 – 24.6) 683 60 years and older Males (13.3 – 14.5) 13.9 (12.9 – 14.2) 8.77 (8.41 – 8.97) 13.5 Total, 20 years and older 22.8 (21.2 – 24.7) 865 20–39 years 12.7 7.88 (6.97 – 8.43) 12.2 (11.6 – 13.0) 21.2 (17.8 – 25.8) 282 (11.9 – 13.5) 40–59 years (13.3 – 15.3) 8.96 (8.39 – 9.70) 13.9 (12.7 – 14.7) 23.2 (20.5 – 31.5) 248 14.2 60 years and older 15.6 (15.0 – 16.2) 10.5 (10.2 – 10.9) 14.9 (14.4 – 16.1) 23.5 (21.8 – 24.8) 335 Females 940 13.4 (12.8 – 14.0) 8.18 (7.55 – 8.94) 13.0 (12.6 – 13.6) 21.8 (21.0 – 22.9) Total, 20 years and older 20–39 years 12.6 (11.8 – 13.4) 7.74 (6.79 – 8.08) 12.0 (10.8 – 13.2) 21.7 (20.6 – 23.4) 326 266 40–59 years 12.9 (12.3 – 13.6) 8.31 (7.29 – 9.14) 12.5 (11.9 – 13.1) 19.9 (18.5 – 23.0) 10.8 (21.6 – 25.1) 22.6 15.1 (9.70 – 11.4) (14.6 – 15.9) 348 60 years and older 15.6 (14.9 – 16.4) Table 2.24.a.3. Plasma eicosenoic acid (20:1n-9): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample Selected percentile s (95% conf. interval) 90th 10th 50th (95% conf. interval) size Males and Females 15.4 (14.4 – 16.5) 9.39 Total, 20 years and older 14.7 (13.7 – 16.4) 26.9 (22.7 – 33.2) 376 (8.68 – 10.3) 20–39 years 14.6 (13.2 – 16.2) 8.93 (7.04 – 9.80) 14.1 (12.1 – 16.5) 23.5 (20.3 – 40.8) 132 40–59 years (14.8 – 18.2) 10.2† (7.11 – 11.7) 15.2 (14.6 – 16.8) 28.4† (25.1 – 32.9) 93 16.4 60 years and older 17.6 (16.3 – 19.1) 12.0 (10.4 – 12.6) 16.7 (14.6 – 19.8) 27.7 (24.8 – 37.1) 151 Males 26.1 Total, 20 years and older 15.4 (13.7 – 17.3) 9.18 (8.78 – 10.6) (13.3 – 16.8) 14.7 (21.8 – 39.8) 189 20–39 years 14.5 8.87† (7.99 – 9.35) 14.2 (11.5 – 16.7) 22.7† (17.5 – 40.9) 67 (12.0 – 17.7) 17.0 (14.5 – 17.7) 10.5† (7.01 – 12.6) 15.3 40–59 years 30.7† (24.6 – 44.8) 48 (14.8 – 19.6) 60 years and older (14.6 – 19.7) 11.7† (5.88 – 13.3) 16.4 (12.8 – 21.4) 25.3† (21.4 – 59.6) 74 17.0 Females Total, 20 years and older (14.4 – 16.5) 9.59 (6.32 – 10.4) 15.0 (13.6 – 16.6) 27.1 (22.6 – 35.3) 187 15.4 20–39 years 14.7 (13.2 – 16.4) 9.04† (6.32 – 10.1) 14.0 (11.6 – 16.6) 23.8† (21.5 – 38.7) 65 40–59 years 15.7 (13.3 – 18.6) 9.79† (6.66 – 11.9) 14.9 (12.8 – 18.8) 26.4† (19.1 – 38.4) 45 32.3† (24.3 – 38.0) 77 16.8 (9.58 – 13.0) 11.9† (14.6 – 21.4) 60 years and older 18.3 (15.9 – 21.0) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 242 242

254 Table 2.24.a.4. Plasma eicosenoic acid (20:1n-9): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (11.0 – 12.4) 7.28 (6.35 – 7.86) 11.1 (10.2 – 12.1) 20.0 (17.7 – 22.1) 310 11.7 Total, 20 years and older 10.9 (9.78 – 12.1) 6.75 (6.07 – 7.51) 9.90 (9.05 – 11.4) 19.7 (15.0 – 25.9) 126 20–39 years 12.1 7.40† (5.83 – 8.31) 11.4 (10.1 – 12.4) 20.0† (16.8 – 33.4) 98 (10.9 – 13.3) 40–59 years 13.4 (12.7 – 14.1) 9.43† (8.18 – 9.88) 13.1 (12.2 – 14.6) 19.7† (17.7 – 24.3) 86 60 years and older Males (11.1 – 12.8) 11.9 (9.88 – 12.3) 7.12 (6.18 – 7.71) 11.0 Total, 20 years and older 21.2 (17.6 – 35.8) 143 20–39 years 10.9 6.33† (5.90 – 7.47) 9.97 (8.73 – 12.2) 17.2† (14.7 – 35.2) 58 (9.62 – 12.4) 40–59 years (10.5 – 15.6) 7.86† (5.24 – 8.80) 11.1 (9.28 – 14.0) 21.3† (16.6 – 61.1) 42 12.8 60 years and older 13.6 (12.4 – 15.0) 9.07† (6.71 – 10.5) 12.3 (11.2 – 15.0) 22.3† (18.9 – 25.7) 43 Females 167 11.5 (10.4 – 12.7) 7.29 (6.37 – 7.99) 11.3 (9.96 – 12.5) 19.0 (15.8 – 25.1) Total, 20 years and older 20–39 years 10.9 (9.36 – 12.6) 6.88† (5.96 – 7.70) 9.60 (8.86 – 11.9) 20.2† (14.6 – 26.0) 68 56 40–59 years 11.5 (10.2 – 12.9) 7.20† (5.09 – 7.95) 11.6 (9.98 – 12.5) 17.6† (14.1 – 40.8) 18.0† 43 (15.3 – 24.3) 60 years and older 13.3 (12.4 – 14.2) 9.42† (8.21 – 9.77) 13.3 (12.6 – 14.6) † Estimate is subject to greater uncertainty due to small cell size. Table 2.24.a.5. Plasma eicosenoic acid (20:1n-9): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 13.4 (13.1 – 14.2) 8.60 Total, 20 years and older 13.6 (12.9 – 13.8) 22.0 (20.7 – 23.3) 989 (7.88 – 9.22) 20–39 years 12.6 (11.8 – 13.6) 7.88 (6.83 – 8.26) 12.1 (11.4 – 13.0) 21.6 (19.4 – 24.2) 298 40–59 years (12.7 – 13.9) 8.71 (7.53 – 9.56) 13.0 (11.9 – 13.7) 21.7 (19.0 – 23.1) 279 13.3 60 years and older 15.8 (15.2 – 16.3) 10.8 (10.4 – 11.1) 15.2 (14.7 – 15.9) 23.1 (21.7 – 25.4) 412 Males 13.6 Total, 20 years and older 13.9 (13.2 – 14.5) 8.91 (8.24 – 9.44) (20.4 – 24.2) (12.9 – 14.2) 22.2 472 20–39 years 12.5 7.92 (6.33 – 8.95) 11.9 (11.4 – 13.0) 18.2 (15.7 – 42.2) 128 (11.5 – 13.7) 13.9 (11.9 – 14.7) 8.97 (7.92 – 9.80) 13.8 40–59 years 22.2 (19.9 – 25.5) 140 (12.9 – 15.0) 60 years and older (15.1 – 16.6) 10.6 (10.2 – 11.2) 15.3 (14.7 – 16.4) 23.4 (21.7 – 26.6) 204 15.8 Females Total, 20 years and older (12.8 – 14.1) 8.17 (7.57 – 9.08) 13.1 (12.6 – 13.7) 21.8 (20.5 – 23.4) 517 13.4 20–39 years 12.7 (11.7 – 13.8) 7.83 (5.75 – 8.15) 12.3 (10.7 – 13.7) 21.7 (20.6 – 25.6) 170 40–59 years 12.6 (11.9 – 13.4) 8.42 (6.89 – 9.47) 12.1 (11.7 – 13.0) 19.0 (17.2 – 22.9) 139 (21.2 – 26.1) 208 22.8 60 years and older 15.7 (14.9 – 16.5) 10.9 (10.5 – 11.4) 15.1 (14.5 – 15.9) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 243 243

255 767 345 533 280 454 837 617 863 size 1,604 Sample (11.8 – 16.6) (12.4 – 20.1) (10.9 – 14.0) (8.78 – 23.8) (11.9 – 17.7) (10.8 – 16.6) (11.0 – 20.1) (9.74 – 15.5) (11.4 – 16.8) 97.5th 13.6 14.7 12.9 12.6 14.7 11.2 13.6 13.3† 13.4† (9.50 – 12.2) (7.40 – 23.0) (9.32 – 16.7) (9.39 – 11.9) (8.62 – 13.4) (9.41 – 15.0) (8.65 – 14.7) (8.60 – 10.9) (9.13 – 12.6) 95th 10.3 11.6 10.5 10.1 9.45 11.0 10.8 9.69 10.1 (95% conf. interval) s (3.30 – 4.07) (3.24 – 4.04) (3.10 – 4.06) (3.32 – 4.29) (3.46 – 4.50) (3.16 – 4.23) (3.33 – 4.23) (3.55 – 4.47) (3.16 – 4.23) 50th 3.62 3.69 3.46 3.54 3.51 3.83 3.66 3.93 3.54 Selected percentile (< LOD – 1.25) (< LOD – 1.11) (< LOD – 1.38) (< LOD – 1.46) (< LOD – 1.72) (< LOD – 1.41) (< LOD – 1.15) (< LOD – 1.46) (< LOD – 1.15) 5th .712 .692 .620 .612 .729 1.43 .941 .831 .613 (< LOD – .677) (< LOD – 1.47) (< LOD – .936) (< LOD – .890) 2.5th .310 .334 .421 .673† < LOD < LOD < LOD < LOD < LOD† n (2.97 – 3.99) (2.83 – 4.03) (2.75 – 4.11) (2.85 – 3.92) (3.04 – 4.12) (3.39 – 4.29) (2.89 – 3.97) (2.79 – 4.05) (3.18 – 4.24) 3.44 3.34 3.38 3.36 3.54 3.81 3.39 3.67 3.36 (95% conf. interval) Geometric mea < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. † Estimate is subject to greater uncertainty due to small cell size. Total, 20 years and older Age group Race/ethnicity Males Gender Mexican Americans 20–39 years Females Non-Hispanic Blacks 40–59 years 60 years and older Non-Hispanic Whites Health and Nutrition Examination Survey, 2003–2004. Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Table 2.25.a.1. Plasma docosenoic acid (22:1n-9): Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 244 244

256 Figure 2.25.a. Plasma docosenoic acid (22:1n–9): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Overall Mexican Americans 6 Females Males 4 (μmol/L) 2 Plasma docosenoic acid 0 60+ 20−39 40−59 40−59 60+ 20−39 Non−Hispanic Whites Non−Hispanic Blacks 6 4 (μmol/L) 2 Plasma docosenoic acid 0 60+ 40−59 60+ 20−39 20−39 40−59 Females Males 6 Mexican Americans 4 Non−Hispanic Blacks Non−Hispanic (μmol/L) 2 Whites Plasma docosenoic acid 0 20−39 40−59 60+ 60+ 40−59 20−39 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 245 245

257 Table 2.25.a.2. Plasma docosenoic acid (22:1n-9): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Sample Geometric mean Selected percentiles (95% conf. interval) 10th 50th 90th size (95% conf. interval) Males and Females (2.97 – 3.99) 1.38 (.670 – 1.82) 3.62 (3.30 – 4.07) 8.15 (7.41 – 9.51) 1,604 Total, 20 years and older 3.44 3.36 (2.75 – 4.11) 1.38 (< LOD – 1.87) 3.46 (3.10 – 4.06) 8.64 (7.27 – 11.3) 533 20–39 years 3.39 1.21 (.624 – 1.79) 3.51 (3.16 – 4.23) 8.03 (7.04 – 9.44) 454 (2.89 – 3.97) 40–59 years 3.67 (3.18 – 4.24) 1.55 (.813 – 1.94) 3.93 (3.55 – 4.47) 7.86 (7.43 – 8.68) 617 60 years and older Males 1.22 3.34 (2.85 – 3.92) (7.59 – 9.60) (.372 – 1.85) 3.54 (3.24 – 4.04) 8.37 Total, 20 years and older 767 249 20–39 years 1.11 (< LOD – 1.89) 3.38 (2.94 – 4.18) 9.18 (7.58 – 12.3) 3.33 (2.63 – 4.20) 40–59 years (2.85 – 3.86) 1.21 (.324 – 1.87) 3.68 (3.16 – 4.39) 8.06 (6.79 – 9.60) 219 3.32 60 years and older 3.42 (2.95 – 3.95) 1.33 (.641 – 1.75) 3.65 (3.35 – 3.95) 7.93 (7.45 – 9.69) 299 Females 837 3.54 (3.04 – 4.12) 1.47 (.937 – 1.84) 3.66 (3.33 – 4.23) 7.82 (7.24 – 9.41) Total, 20 years and older 20–39 years 3.40 (2.83 – 4.08) 1.44 (.483 – 1.70) 3.58 (2.95 – 4.23) 7.58 (6.98 – 14.6) 284 235 40–59 years 3.46 (2.85 – 4.19) 1.16 (.666 – 1.76) 3.44 (3.03 – 4.43) 7.92 (7.18 – 11.5) (3.69 – 5.32) 318 (7.38 – 8.54) 7.69 4.25 (.727 – 2.27) 60 years and older 3.89 (3.33 – 4.54) 1.77 < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. Table 2.25.a.3. Plasma docosenoic acid (22:1n-9): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Sample Geometric mean Selected percentiles (95% conf. interval) 90th 50th 10th size (95% conf. interval) Males and Females 3.38 (2.83 – 4.03) 1.47 Total, 20 years and older 3.69 (3.32 – 4.29) 7.40 (6.31 – 12.3) 345 (.698 – 1.86) 20–39 years 3.70 (2.96 – 4.62) 1.58 (< LOD – 2.35) 3.97 (3.54 – 4.50) 7.41 (6.18 – 16.2) 117 40–59 years (2.04 – 4.31) 1.20† (< LOD – 1.85) 3.45 (2.09 – 4.69) 7.48† (5.26 – 12.2) 91 2.97 60 years and older 3.04 (2.44 – 3.79) 1.48 (< LOD – 1.90) 3.41 (2.89 – 3.83) 6.86 (5.67 – 12.0) 137 Males (3.52 – 4.30) Total, 20 years and older 3.57 (2.84 – 4.49) 1.51 (< LOD – 1.96) 3.93 8.15 (6.07 – 23.8) 170 58 20–39 years 1.38† (< LOD – 2.15) 4.00 (3.27 – 4.92) 7.88† (6.00 – 23.8) 3.72 (2.68 – 5.16) 3.47 (2.77 – 4.66) 1.47† (< LOD – 2.04) 3.82 40–59 years 8.18† (5.28 – 11.5) 47 (2.50 – 4.81) 60 years and older (1.75 – 5.14) 1.47† (< LOD – 2.17) 3.41 (1.76 – 5.76) 7.10† (5.04 – 13.1) 65 3.00 Females Total, 20 years and older (2.54 – 3.92) 1.43 (< LOD – 1.87) 3.55 (2.85 – 4.70) 6.83 (5.85 – 7.88) 175 3.16 20–39 years 3.67 (3.03 – 4.43) 1.68† (< LOD – 2.49) 3.76 (3.30 – 4.88) 7.10† (5.69 – 18.2) 59 40–59 years 2.48 (1.54 – 3.98) .740† (< LOD – 1.71) 2.87 (1.88 – 4.31) 6.29† (4.79 – 12.2) 44 72 1.48† (4.82 – 10.8) (2.65 – 3.84) 6.46† (< LOD – 2.10) 60 years and older 3.08 (2.53 – 3.75) 3.39 < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 246 246

258 Table 2.25.a.4. Plasma docosenoic acid (22:1n-9): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Sample Geometric mean Selected percentiles (95% conf. interval) 10th 50th 90th size (95% conf. interval) Males and Females (3.39 – 4.29) 1.76 (.712 – 2.22) 3.83 Total, 20 years and older 8.37 (7.02 – 13.4) 280 3.81 (3.46 – 4.50) 3.52 1.68 (< LOD – 2.11) 3.54 (2.85 – 4.34) 8.10 (5.61 – 23.4) 116 20–39 years (3.15 – 4.17) 4.04 (3.53 – 4.64) 1.64† (< LOD – 2.46) 4.52 (3.73 – 5.02) 8.15† (7.20 – 11.6) 82 40–59 years 8.49† 4.28 (.542 – 2.55) 4.19 (3.30 – 5.58) 2.24† (7.12 – 19.0) 82 (3.65 – 5.01) 60 years and older Males 3.66 (3.11 – 4.30) 1.82 (< LOD – 2.26) 3.63 (3.08 – 4.53) 9.58 (7.05 – 13.4) 130 Total, 20 years and older 54 3.31 (2.46 – 4.44) 1.50† (< LOD – 2.27) 3.28 (2.35 – 4.53) 7.50† (5.46 – 23.8) 20–39 years 40–59 years 3.95 1.76† (< LOD – 2.60) 4.00 (3.07 – 5.03) 9.73† (6.86 – 14.6) 35 (3.14 – 4.96) (3.28 – 6.41) 60 years and older 1.86† (< LOD – 2.52) 3.87 (3.73 – 5.05) 9.45† (8.02 – 19.0) 41 4.34 Females Total, 20 years and older 3.94 (3.40 – 4.56) 1.75 (1.28 – 2.16) 4.14 (3.39 – 4.92) 8.10 (6.84 – 16.2) 150 20–39 years (2.87 – 4.77) 1.68† (< LOD – 2.25) 3.57 (3.18 – 4.43) 8.27† (5.30 – 19.7) 62 3.70 40–59 years 4.12 (3.48 – 4.89) 1.57† (.381 – 2.46) 4.86 (3.40 – 6.24) 8.08† (6.93 – 11.9) 47 60 years and older 4.24 (3.22 – 5.58) 2.30† (1.77 – 2.61) 4.23 (2.58 – 6.59) 7.56† (6.37 – 11.8) 41 < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. † Estimate is subject to greater uncertainty due to small cell size. Table 2.25.a.5. Plasma docosenoic acid (22:1n-9): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Sample Geometric mean Selected percentiles (95% conf. interval) 10th 50th 90th size (95% conf. interval) Males and Females (2.79 – 4.05) 1.18 (.420 – 1.78) 3.54 (3.16 – 4.23) 8.12 (7.40 – 9.59) 863 Total, 20 years and older 3.36 3.21 (2.41 – 4.27) 1.09 (< LOD – 1.87) 255 (2.71 – 4.30) 8.51 (7.27 – 11.9) 20–39 years 3.37 40–59 years (2.77 – 4.01) 1.11 (.402 – 1.71) 3.44 (2.98 – 4.49) 8.10 (6.96 – 11.0) 242 3.33 (3.52 – 4.55) 60 years and older 1.49 (.647 – 1.90) 3.93 (3.07 – 4.29) 7.77 (7.44 – 8.50) 366 3.63 Males Total, 20 years and older 3.21 (2.64 – 3.91) 1.09 (< LOD – 1.85) 3.48 (3.05 – 4.20) 8.14 (7.22 – 9.56) 412 110 20–39 years 3.10 .749† (< LOD – 1.86) 3.20 (2.56 – 4.88) 8.97† (7.37 – 12.8) (2.19 – 4.39) 40–59 years 3.21 1.08 (< LOD – 1.91) 3.52 (3.01 – 4.38) 7.62 (5.91 – 9.68) 122 (2.69 – 3.82) (3.33 – 4.15) 60 years and older 1.37 (.534 – 1.82) 3.63 (2.85 – 4.02) 7.79 (6.98 – 9.24) 180 3.38 Females Total, 20 years and older 3.51 (2.89 – 4.25) 1.36 (.604 – 1.76) 3.66 (3.21 – 4.30) 7.92 (7.38 – 10.4) 451 20–39 years (2.57 – 4.24) 1.37 (< LOD – 1.89) 3.61 (2.73 – 4.30) 7.62 (6.64 – 16.9) 145 3.31 120 3.46 (2.74 – 4.36) 1.09 (.381 – 1.71) 3.43 (2.89 – 5.00) 8.43 (7.34 – 13.9) 40–59 years 186 (7.39 – 8.61) 60 years and older 3.85 (3.20 – 4.63) 1.54 (.484 – 2.18) 4.22 (3.61 – 5.48) 7.71 < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. † Estimate is subject to greater uncertainty due to small cell size. 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 247 247

259 914 573 373 816 492 880 288 631 size 1,696 Sample (122 – 134) (122 – 135) (112 – 126) (113 – 127) (108 – 157) (124 – 141) (113 – 140) (124 – 161) (129 – 161) 97.5th 126 127 118 118 123 131 137 115† 129† (112 – 121) (103 – 115) (101 – 121) (105 – 114) (116 – 126) (115 – 131) (105 – 121) (121 – 138) (111 – 122) 95th 116 109 108 109 109 123 121 117 128 (95% conf. interval) s (72.0 – 77.7) (69.8 – 74.4) (71.1 – 77.9) (67.8 – 77.2) (72.6 – 81.8) (71.4 – 77.6) (74.3 – 80.0) (71.0 – 77.4) (77.2 – 84.8) 50th 75.0 76.0 72.1 71.9 74.1 77.5 77.6 79.9 74.0 Selected percentile (45.9 – 52.0) (44.5 – 50.9) (43.8 – 54.3) (44.5 – 51.6) (47.0 – 55.3) (46.2 – 53.2) (38.9 – 53.8) (44.6 – 53.2) (45.4 – 51.8) 5th 49.8 51.4 47.0 47.8 51.6 51.2 49.3 50.7 49.2 (42.9 – 47.8) (40.3 – 45.9) (32.6 – 52.8) (40.1 – 45.9) (23.7 – 49.2) (44.6 – 50.0) (34.9 – 50.4) (42.5 – 46.4) (41.8 – 49.9) 2.5th 45.6 44.5 44.3 47.9 46.4 45.0 44.1 46.4† 44.4† n (72.4 – 77.4) (71.0 – 78.0) (69.5 – 74.5) (68.7 – 75.8) (74.8 – 80.7) (71.5 – 77.1) (72.1 – 82.8) (71.3 – 77.0) (77.7 – 84.6) 74.9 72.0 72.2 74.4 77.7 77.3 74.3 74.1 81.0 (95% conf. interval) Geometric mea † Estimate is subject to greater uncertainty due to small cell size. Total, 20 years and older Age group Race/ethnicity Males Gender Mexican Americans 20–39 years Females Non-Hispanic Blacks 40–59 years Non-Hispanic Whites 60 years and older Health and Nutrition Examination Survey, 2003–2004. Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Table 2.26.a.1. Plasma nervonic acid (24:1n-9): Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 248 248

260 Figure 2.26.a. Plasma nervonic acid (24:1n–9): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Overall Mexican Americans 150 100 Females Males (μmol/L) 50 Plasma nervonic acid 0 60+ 20−39 40−59 40−59 60+ 20−39 Non−Hispanic Whites Non−Hispanic Blacks 150 100 (μmol/L) 50 Plasma nervonic acid 0 40−59 40−59 60+ 20−39 20−39 60+ Females Males 150 100 Mexican Americans Non−Hispanic (μmol/L) 50 Blacks Non−Hispanic Plasma nervonic acid Whites 0 20−39 40−59 60+ 60+ 40−59 20−39 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 249 249

261 Table 2.26.a.2. Plasma nervonic acid (24:1n-9): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (72.4 – 77.4) 54.4 (51.9 – 56.6) 75.0 (72.0 – 77.7) 103 (99.6 – 108) 1,696 74.9 Total, 20 years and older 72.2 (68.7 – 75.8) 53.0 (48.3 – 56.2) 72.1 (67.8 – 77.2) 97.3 (94.2 – 103) 573 20–39 years 74.3 55.0 (52.8 – 57.6) 74.1 (71.4 – 77.6) 98.7 (94.9 – 105) 492 (71.5 – 77.1) 40–59 years 81.0 (77.7 – 84.6) 55.9 (51.8 – 60.0) 79.9 (77.2 – 84.8) 118 (110 – 124) 631 60 years and older Males (69.5 – 74.5) 72.0 (69.8 – 74.4) 52.8 (49.8 – 54.8) 71.9 Total, 20 years and older 98.6 (95.6 – 102) 816 20–39 years 70.9 52.5 (46.1 – 55.4) 69.2 (64.8 – 76.3) 99.1 (94.0 – 106) 267 (67.0 – 75.0) 40–59 years (69.4 – 74.9) 53.1 (47.3 – 57.2) 72.6 (71.1 – 74.6) 96.2 (88.9 – 104) 240 72.1 60 years and older 73.9 (70.9 – 77.0) 51.4 (46.3 – 55.2) 74.2 (71.1 – 78.3) 103 (98.0 – 112) 309 Females 880 77.7 (74.8 – 80.7) 56.9 (52.7 – 59.5) 77.6 (74.3 – 80.0) 107 (101 – 115) Total, 20 years and older 20–39 years 73.4 (70.0 – 77.0) 53.9 (48.4 – 58.2) 74.9 (71.5 – 77.6) 96.9 (92.9 – 104) 306 252 40–59 years 76.4 (73.2 – 79.8) 57.4 (51.9 – 59.8) 76.8 (70.4 – 81.2) 101 (97.7 – 109) 62.0 (119 – 135) 123 86.3 (55.7 – 65.4) (80.7 – 92.6) 322 60 years and older 87.3 (82.8 – 92.0) Table 2.26.a.3. Plasma nervonic acid (24:1n-9): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample Selected percentile s (95% conf. interval) 90th 10th 50th (95% conf. interval) size Males and Females 74.4 (71.0 – 78.0) 55.3 Total, 20 years and older 76.0 (71.1 – 77.9) 99.1 (93.7 – 107) 373 (50.7 – 58.6) 20–39 years 73.9 (69.6 – 78.6) 55.3 (43.9 – 58.9) 75.8 (70.4 – 77.8) 96.1 (93.3 – 108) 129 40–59 years (69.3 – 78.6) 54.3† (46.6 – 58.8) 74.0 (69.0 – 81.3) 96.6† (89.4 – 122) 93 73.9 60 years and older 78.6 (74.8 – 82.7) 58.7 (50.2 – 62.1) 80.2 (76.6 – 82.5) 105 (98.7 – 115) 151 Males 99.6 Total, 20 years and older 74.2 (71.0 – 77.6) 55.5 (52.7 – 57.7) (70.5 – 77.7) 73.5 (93.4 – 107) 187 20–39 years 74.0 54.5† (46.3 – 58.7) 72.2 (69.5 – 78.7) 94.9† (91.2 – 107) 65 (70.5 – 77.6) 74.1 (66.9 – 80.6) 55.7† (46.0 – 59.9) 70.1 40–59 years 102† (89.0 – 127) 48 (68.4 – 80.2) 60 years and older (69.3 – 84.7) 53.2† (39.5 – 63.4) 78.0 (66.3 – 88.3) 104† (97.5 – 157) 74 76.6 Females Total, 20 years and older (69.7 – 79.9) 55.2 (45.9 – 59.3) 77.2 (67.2 – 82.0) 96.6 (90.8 – 116) 186 74.6 20–39 years 73.9 (67.3 – 81.2) 55.3† (43.1 – 59.1) 77.1 (63.6 – 79.7) 98.6† (89.2 – 129) 64 40–59 years 73.6 (67.1 – 80.8) 50.9† (44.5 – 59.4) 78.4 (63.4 – 85.5) 92.1† (86.2 – 121) 45 104† (92.5 – 159) 77 80.6 (32.6 – 67.0) 60.5† (73.5 – 88.3) 60 years and older 80.5 (74.5 – 87.0) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 250 250

262 Table 2.26.a.4. Plasma nervonic acid (24:1n-9): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (72.1 – 82.8) 54.4 (49.3 – 57.4) 77.5 (72.6 – 81.8) 110 (102 – 121) 288 77.3 Total, 20 years and older 73.1 (67.2 – 79.6) 50.9 (44.3 – 55.8) 74.1 (67.5 – 79.8) 101 (93.6 – 128) 116 20–39 years 79.9 56.3† (50.0 – 61.9) 78.7 (72.8 – 81.6) 112† (99.6 – 137) 93 (74.1 – 86.2) 40–59 years 84.1 (74.8 – 94.6) 55.3† (43.3 – 59.2) 87.7 (77.2 – 94.2) 122† (114 – 131) 79 60 years and older Males (67.7 – 81.8) 74.4 (67.4 – 81.1) 53.3 (45.2 – 55.5) 74.4 Total, 20 years and older 111 (97.0 – 128) 133 20–39 years 69.3 45.2† (23.7 – 53.9) 67.4 (60.3 – 80.6) 104† (81.7 – 129) 54 (58.5 – 82.0) 40–59 years (72.2 – 86.3) 56.7† (53.9 – 66.2) 76.6 (68.8 – 81.4) 109† (94.2 – 133) 40 78.9 60 years and older 82.3 (73.6 – 92.0) 54.7† (49.6 – 62.2) 84.5 (59.7 – 104) 117† (104 – 129) 39 Females 155 79.6 (73.4 – 86.4) 55.7 (50.1 – 60.1) 79.3 (73.1 – 88.6) 109 (101 – 123) Total, 20 years and older 20–39 years 76.6 (68.7 – 85.4) 55.6† (48.6 – 61.3) 75.4 (70.3 – 86.2) 98.9† (92.0 – 123) 62 53 40–59 years 80.6 (72.3 – 90.0) 55.5† (43.4 – 62.9) 79.2 (71.0 – 89.5) 112† (101 – 160) 123† 40 (101 – 167) 60 years and older 85.3 (71.6 – 102) 51.8† (39.7 – 62.8) 89.2 (75.8 – 95.2) † Estimate is subject to greater uncertainty due to small cell size. Table 2.26.a.5. Plasma nervonic acid (24:1n-9): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 74.0 (71.3 – 77.0) 53.5 Total, 20 years and older 74.1 (71.0 – 77.4) 102 (98.6 – 109) 914 (51.3 – 56.2) 20–39 years 70.5 (66.5 – 74.8) 51.9 (45.2 – 56.2) 70.7 (64.8 – 76.2) 94.0 (88.1 – 109) 281 40–59 years (70.1 – 76.5) 53.9 (51.0 – 57.6) 73.6 (69.8 – 77.6) 97.6 (91.9 – 108) 265 73.2 60 years and older 81.0 (77.1 – 85.1) 55.4 (51.8 – 58.7) 79.9 (75.7 – 85.4) 118 (109 – 132) 368 Males 71.0 Total, 20 years and older 70.6 (68.1 – 73.1) 52.1 (48.1 – 54.1) (90.7 – 101) (68.4 – 73.4) 97.2 437 20–39 years 68.4 52.0 (43.7 – 55.7) 66.3 (61.7 – 73.0) 92.2 (84.4 – 109) 120 (64.3 – 72.7) 71.0 (70.9 – 74.2) 52.8 (46.3 – 54.4) 72.3 40–59 years 93.2 (86.4 – 107) 135 (67.8 – 74.5) 60 years and older (70.0 – 76.1) 50.9 (43.5 – 54.8) 73.7 (68.5 – 78.8) 102 (93.9 – 113) 182 73.0 Females Total, 20 years and older (73.8 – 81.3) 56.2 (51.9 – 59.2) 77.4 (72.4 – 81.0) 108 (101 – 119) 477 77.5 20–39 years 72.5 (67.9 – 77.5) 51.9 (45.2 – 57.6) 74.1 (68.9 – 78.3) 96.1 (90.0 – 115) 161 40–59 years 75.5 (71.7 – 79.4) 57.2 (51.9 – 59.3) 74.7 (68.4 – 80.7) 100 (94.7 – 109) 130 (119 – 137) 186 126 60 years and older 88.4 (83.1 – 94.1) 61.8 (53.5 – 68.4) 88.3 (79.8 – 96.5) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 251 251

263 991 375 863 515 681 310 943 610 size 1,806 Sample (5,050 – 5,780) (5,140 – 5,840) (5,810 – 7,000) (4,910 – 6,260) (5,090 – 5,810) (4,640 – 8,680) (5,110 – 5,880) (5,100 – 5,900) (5,160 – 5,890) 97.5th 5,190 5,410 5,500 5,440 5,250 5,240 5,550 6,320† 4,960† (4,800 – 5,080) (4,810 – 5,190) (4,830 – 5,610) (4,640 – 5,360) (4,630 – 5,230) (4,870 – 5,220) (5,270 – 6,570) (4,880 – 5,280) (4,460 – 4,810) 95th 4,980 4,810 5,090 5,800 5,040 4,900 5,060 4,610 4,950 (3,370 – 3,520) (3,360 – 3,540) (3,410 – 3,620) (3,240 – 3,370) (3,510 – 3,900) (3,240 – 3,450) (3,450 – 3,600) (3,030 – 3,230) (3,480 – 3,640) 50th 3,430 3,440 3,310 3,130 3,660 3,500 3,530 3,360 3,570 5th Selected percentiles (95% conf. interval) (2,310 – 2,450) (2,330 – 2,610) (2,300 – 2,540) (2,270 – 2,500) (2,110 – 2,360) (2,280 – 2,490) (2,310 – 2,410) (2,250 – 2,570) (2,200 – 2,460) 2,370 2,250 2,360 2,420 2,420 2,340 2,340 2,360 2,490 (2,070 – 2,300) (1,960 – 2,320) (1,850 – 2,200) (1,830 – 2,290) (1,740 – 2,360) (2,020 – 2,300) (1,840 – 2,480) (2,120 – 2,310) (1,910 – 2,340) 2.5th 2,210 2,150 2,210 2,230 2,170 2,250 2,240 2,320† 2,140† (3,390 – 3,510) (3,090 – 3,340) (3,570 – 3,900) (3,440 – 3,600) (3,300 – 3,470) (3,430 – 3,580) (3,370 – 3,510) (3,430 – 3,600) (3,260 – 3,410) 3,450 3,210 3,500 3,340 3,520 3,440 3,380 3,730 3,520 (95% conf. interval) Geometric mean † Estimate is subject to greater uncertainty due to small cell size. Total, 20 years and older Age group Race/ethnicity Females Males Gender Non-Hispanic Whites Non-Hispanic Blacks 60 years and older 40–59 years 20–39 years Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Table 2.27.a.1. Plasma linoleic acid (18:2n-6): Concentrations nd nd 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 252 252

264 Figure 2.27.a. Plasma linoleic acid (18:2n–6): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Overall Mexican Americans 6000 Females 4000 Males (μmol/L) 2000 Plasma linoleic acid 0 60+ 20−39 40−59 40−59 60+ 20−39 Non−Hispanic Whites Non−Hispanic Blacks 6000 4000 (μmol/L) 2000 Plasma linoleic acid 0 60+ 40−59 60+ 20−39 20−39 40−59 Females Males 6000 Mexican 4000 Americans Non−Hispanic Blacks (μmol/L) 2000 Non−Hispanic Whites Plasma linoleic acid 0 20−39 40−59 60+ 60+ 40−59 20−39 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 253 253

265 Table 2.27.a.2. Plasma linoleic acid (18:2n-6): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (3,390 – 3,510) 2,610 (2,550 – 2,700) 3,430 (3,370 – 3,520) 4,570 (4,410 – 4,730) 1,806 3,450 Total, 20 years and older 3,340 (3,260 – 3,410) 2,570 (2,470 – 2,610) 3,310 (3,240 – 3,370) 4,410 (4,280 – 4,670) 610 20–39 years 3,520 2,700 (2,520 – 2,780) 3,500 (3,410 – 3,620) 4,700 (4,510 – 4,830) 515 (3,440 – 3,600) 40–59 years 3,520 (3,430 – 3,600) 2,690 (2,480 – 2,790) 3,570 (3,480 – 3,640) 4,580 (4,410 – 4,870) 681 60 years and older Males (3,300 – 3,470) 3,380 (3,240 – 3,450) 2,590 (2,480 – 2,680) 3,360 Total, 20 years and older 4,510 (4,240 – 4,720) 863 20–39 years 3,280 2,510 (2,420 – 2,600) 3,210 (3,150 – 3,320) 4,380 (4,030 – 4,910) 282 (3,190 – 3,380) 40–59 years (3,430 – 3,620) 2,710 (2,600 – 2,790) 3,490 (3,350 – 3,640) 4,610 (4,350 – 4,860) 248 3,530 60 years and older 3,320 (3,220 – 3,420) 2,420 (2,320 – 2,570) 3,370 (3,180 – 3,510) 4,310 (4,160 – 4,680) 333 Females 943 3,500 (3,430 – 3,580) 2,640 (2,580 – 2,740) 3,530 (3,450 – 3,600) 4,660 (4,490 – 4,820) Total, 20 years and older 20–39 years 3,390 (3,270 – 3,510) 2,590 (2,530 – 2,630) 3,390 (3,280 – 3,520) 4,420 (4,270 – 4,860) 328 267 40–59 years 3,510 (3,390 – 3,630) 2,630 (2,350 – 2,860) 3,530 (3,420 – 3,620) 4,790 (4,380 – 5,030) 2,870 (4,540 – 5,080) 4,820 3,700 (2,770 – 2,940) (3,600 – 3,790) 348 60 years and older 3,690 (3,580 – 3,800) Table 2.27.a.3. Plasma linoleic acid (18:2n-6): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample Selected percentile s (95% conf. interval) 90th 10th 50th (95% conf. interval) size Males and Females 3,730 (3,570 – 3,900) 2,700 Total, 20 years and older 3,660 (3,510 – 3,900) 5,170 (4,740 – 5,900) 375 (2,500 – 2,900) 20–39 years 3,630 (3,350 – 3,920) 2,620 (2,350 – 2,730) 3,530 (3,280 – 3,960) 5,120 (4,570 – 6,320) 132 40–59 years (3,720 – 4,130) 2,900† (2,410 – 3,150) 3,810 (3,690 – 4,100) 5,370† (4,730 – 7,050) 93 3,920 60 years and older 3,860 (3,540 – 4,210) 2,910 (2,120 – 3,360) 3,840 (3,530 – 4,250) 5,050 (4,590 – 6,170) 150 Males 5,100 Total, 20 years and older 3,700 (3,460 – 3,950) 2,630 (2,330 – 2,910) (3,280 – 4,140) 3,640 (4,650 – 6,350) 188 20–39 years 3,600 2,490† (2,310 – 2,860) 3,500 (3,030 – 4,300) 5,020† (4,440 – 6,640) 67 (3,220 – 4,040) 3,890 (3,600 – 4,150) 3,010† (2,020 – 3,250) 3,860 40–59 years 5,050† (4,530 – 7,450) 48 (3,610 – 4,200) 60 years and older (3,490 – 4,030) 2,750† (2,170 – 3,290) 3,760 (3,580 – 3,990) 4,960† (4,330 – 5,580) 73 3,750 Females Total, 20 years and older (3,610 – 3,960) 2,710 (2,260 – 3,040) 3,680 (3,530 – 3,920) 5,260 (4,810 – 5,960) 187 3,780 20–39 years 3,660 (3,320 – 4,030) 2,710† (1,840 – 3,050) 3,550 (3,470 – 3,910) 5,130† (4,350 – 6,500) 65 40–59 years 3,950 (3,680 – 4,250) 2,720† (2,350 – 3,130) 3,780 (3,580 – 4,330) 5,440† (4,800 – 6,970) 45 5,080† (4,570 – 6,220) 77 3,930 (2,120 – 3,520) 2,920† (3,450 – 4,570) 60 years and older 3,970 (3,440 – 4,580) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 254 254

266 Table 2.27.a.4. Plasma linoleic acid (18:2n-6): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (3,090 – 3,340) 2,430 (2,350 – 2,490) 3,130 (3,030 – 3,230) 4,250 (4,120 – 4,540) 310 3,210 Total, 20 years and older 3,140 (2,940 – 3,340) 2,360 (2,150 – 2,460) 3,050 (2,860 – 3,230) 4,200 (4,030 – 4,570) 126 20–39 years 3,280 2,540† (2,240 – 2,690) 3,160 (3,040 – 3,260) 4,330† (4,100 – 5,000) 98 (3,110 – 3,470) 40–59 years 3,290 (3,080 – 3,510) 2,470† (1,190 – 2,710) 3,410 (3,090 – 3,550) 4,210† (3,930 – 5,080) 86 60 years and older Males (3,070 – 3,320) 3,190 (2,980 – 3,190) 2,350 (2,180 – 2,480) 3,070 Total, 20 years and older 4,380 (3,940 – 4,840) 143 20–39 years 3,120 2,320† (1,800 – 2,450) 3,030 (2,790 – 3,290) 4,110† (3,750 – 7,040) 58 (2,900 – 3,350) 40–59 years (3,190 – 3,570) 2,610† (2,200 – 2,750) 3,160 (2,990 – 3,280) 4,570† (4,110 – 8,980) 42 3,370 60 years and older 3,050 (2,750 – 3,380) 2,300† (1,190 – 2,500) 3,070 (2,730 – 3,650) 4,010† (3,800 – 4,250) 43 Females 167 3,230 (3,050 – 3,410) 2,460 (2,390 – 2,560) 3,180 (2,970 – 3,380) 4,210 (4,040 – 5,050) Total, 20 years and older 20–39 years 3,160 (2,920 – 3,410) 2,410† (2,220 – 2,470) 3,100 (2,820 – 3,340) 4,230† (3,900 – 5,030) 68 56 40–59 years 3,220 (3,000 – 3,440) 2,490† (2,160 – 2,630) 3,100 (2,910 – 3,410) 4,120† (3,720 – 7,490) 4,350† 43 (4,100 – 5,080) 60 years and older 3,450 (3,190 – 3,720) 2,640† (2,420 – 2,910) 3,430 (3,050 – 3,750) † Estimate is subject to greater uncertainty due to small cell size. Table 2.27.a.5. Plasma linoleic acid (18:2n-6): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 3,440 (3,370 – 3,510) 2,620 Total, 20 years and older 3,440 (3,360 – 3,540) 4,520 (4,340 – 4,720) 991 (2,530 – 2,710) 20–39 years 3,330 (3,250 – 3,420) 2,580 (2,520 – 2,620) 3,310 (3,250 – 3,380) 4,360 (4,130 – 4,730) 300 40–59 years (3,370 – 3,580) 2,690 (2,360 – 2,830) 3,480 (3,340 – 3,620) 4,560 (4,300 – 4,820) 280 3,470 60 years and older 3,530 (3,430 – 3,630) 2,680 (2,420 – 2,800) 3,590 (3,490 – 3,690) 4,600 (4,440 – 4,930) 411 Males 3,370 Total, 20 years and older 3,360 (3,260 – 3,470) 2,580 (2,440 – 2,690) (4,130 – 4,740) (3,210 – 3,500) 4,330 471 20–39 years 3,250 2,530 (2,420 – 2,600) 3,210 (3,130 – 3,330) 4,150 (3,860 – 5,070) 128 (3,140 – 3,370) 3,480 (3,290 – 3,650) 2,710 (2,430 – 2,830) 3,480 40–59 years 4,430 (4,200 – 4,930) 140 (3,340 – 3,630) 60 years and older (3,210 – 3,450) 2,420 (2,300 – 2,580) 3,370 (3,090 – 3,600) 4,320 (4,110 – 4,780) 203 3,330 Females Total, 20 years and older (3,430 – 3,590) 2,660 (2,570 – 2,770) 3,530 (3,420 – 3,610) 4,660 (4,480 – 4,820) 520 3,510 20–39 years 3,410 (3,240 – 3,580) 2,610 (2,430 – 2,740) 3,390 (3,250 – 3,580) 4,390 (4,180 – 4,970) 172 40–59 years 3,470 (3,330 – 3,610) 2,570 (2,220 – 2,870) 3,480 (3,340 – 3,610) 4,720 (4,290 – 4,940) 140 (4,530 – 5,140) 208 4,860 60 years and older 3,720 (3,580 – 3,860) 2,900 (2,810 – 2,970) 3,760 (3,640 – 3,840) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 255 255

267 986 610 375 310 678 513 859 942 size 1,801 Sample (143 – 193) (153 – 192) (157 – 203) (155 – 210) (147 – 234) (121 – 362) (137 – 221) (159 – 421) (146 – 184) 97.5th 157 165 158 174 159 173 159 149† 199† (124 – 153) (128 – 151) (127 – 162) (138 – 154) (107 – 147) (135 – 246) (128 – 172) (117 – 150) (123 – 150) 95th 137 143 127 134 131 133 142 160 115 (58.9 – 63.7) (55.2 – 59.9) (64.9 – 72.3) (58.9 – 65.7) (59.9 – 65.5) (57.3 – 64.2) (58.2 – 66.9) (48.2 – 53.1) (59.6 – 73.9) 50th 61.4 57.5 61.2 62.3 62.4 59.9 68.3 50.5 66.2 (26.0 – 33.1) (27.5 – 34.7) (22.4 – 31.7) (28.4 – 36.4) (25.8 – 33.0) (25.2 – 30.3) (22.7 – 35.6) (23.7 – 30.8) (24.3 – 36.1) 5th Selected percentiles (95% conf. interval) 30.0 30.8 32.8 27.3 27.6 33.5 29.5 31.8 28.8 (21.4 – 27.5) (20.0 – 27.5) (19.9 – 26.6) (20.8 – 33.2) (17.0 – 26.2) (23.6 – 30.6) (14.3 – 30.3) (13.3 – 28.8) (20.1 – 30.7) 2.5th 25.2 25.1 23.0 29.3 27.2 24.9 25.2 24.5† 23.9† (60.5 – 65.8) (63.8 – 74.5) (61.1 – 67.2) (60.7 – 69.6) (58.8 – 65.5) (59.9 – 66.8) (50.4 – 57.4) (55.8 – 60.6) (65.2 – 73.0) 63.1 69.0 64.1 58.1 62.1 53.8 69.0 63.3 65.0 (95% conf. interval) Geometric mean † Estimate is subject to greater uncertainty due to small cell size. Total, 20 years and older Age group Race/ethnicity Females Males Gender Non-Hispanic Whites Non-Hispanic Blacks 60 years and older 40–59 years 20–39 years Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Table 2.28.a.1. Plasma alpha-linolenic acid (18:3n-3): Concentrations nd nd 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 256 256

268 Figure 2.28.a. Plasma alpha−linolenic acid (18:3n–3): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Overall Mexican Americans 150 100 Females Males 50 acid (μmol/L) Plasma alpha−linolenic 0 60+ 20−39 40−59 60+ 20−39 40−59 Non−Hispanic Whites Non−Hispanic Blacks 150 100 50 acid (μmol/L) Plasma alpha−linolenic 0 60+ 20−39 60+ 40−59 20−39 40−59 Females Males 150 100 Mexican Americans Non−Hispanic 50 Blacks acid (μmol/L) Non−Hispanic Whites Plasma alpha−linolenic 0 20−39 40−59 60+ 60+ 40−59 20−39 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 257 257

269 Table 2.28.a.2. Plasma alpha-linolenic acid (18:3n-3): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Sample Selected percentile s (95% conf. interval) n Geometric mea 50th 90th 10th (95% conf. interval) size Males and Females (60.5 – 65.8) 35.3 (33.1 – 38.0) 61.4 (58.9 – 63.7) 114 (110 – 121) 1,801 63.1 Total, 20 years and older 58.1 (55.8 – 60.6) 32.9 (30.8 – 34.2) 57.5 (55.2 – 59.9) 107 (98.2 – 116) 610 20–39 years 65.0 37.6 (31.3 – 40.5) 61.2 (58.2 – 66.9) 117 (110 – 128) 513 (60.7 – 69.6) 40–59 years 69.0 (65.2 – 73.0) 39.3 (34.8 – 43.2) 68.3 (64.9 – 72.3) 123 (112 – 137) 678 60 years and older Males (58.8 – 65.5) 62.1 (57.3 – 64.2) 33.6 (28.6 – 37.0) 59.9 Total, 20 years and older 116 (110 – 127) 859 20–39 years 56.9 31.6 (27.5 – 34.3) 55.7 (51.2 – 59.6) 107 (98.1 – 121) 282 (53.5 – 60.6) 40–59 years (61.5 – 70.6) 34.5 (23.9 – 43.7) 63.6 (58.1 – 72.9) 125 (112 – 132) 246 65.9 60 years and older 65.4 (60.1 – 71.2) 35.3 (31.7 – 39.8) 63.8 (57.2 – 73.8) 120 (107 – 147) 331 Females 942 64.1 (61.1 – 67.2) 38.1 (35.1 – 39.7) 62.4 (59.9 – 65.5) 113 (106 – 122) Total, 20 years and older 20–39 years 59.3 (56.1 – 62.7) 34.0 (30.7 – 36.2) 59.1 (56.0 – 62.6) 105 (93.4 – 125) 328 267 40–59 years 64.2 (58.4 – 70.4) 38.5 (34.1 – 40.6) 58.8 (55.3 – 65.7) 112 (103 – 125) 42.9 (109 – 141) 123 71.1 (36.5 – 47.5) (66.9 – 76.6) 347 60 years and older 72.0 (67.3 – 77.1) Table 2.28.a.3. Plasma alpha-linolenic acid (18:3n-3): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample Selected percentile s (95% conf. interval) 90th 10th 50th (95% conf. interval) size Males and Females 69.0 (63.8 – 74.5) 39.4 Total, 20 years and older 66.2 (59.6 – 73.9) 133 (117 – 159) 375 (30.2 – 43.0) 20–39 years 65.6 (56.2 – 76.6) 36.8 (25.2 – 41.3) 61.4 (54.6 – 73.8) 125 (111 – 215) 132 40–59 years (65.4 – 83.2) 43.8† (30.1 – 47.8) 70.5 (59.0 – 88.4) 133† (115 – 146) 93 73.8 60 years and older 76.1 (65.5 – 88.5) 43.6 (34.4 – 47.4) 75.9 (67.6 – 82.9) 136 (108 – 292) 150 Males 134 Total, 20 years and older 68.9 (61.1 – 77.7) 40.5 (25.8 – 43.5) (54.6 – 80.2) 65.9 (113 – 201) 188 20–39 years 66.2 39.3† (22.8 – 42.6) 58.5 (44.6 – 86.5) 130† (91.9 – 222) 67 (52.3 – 83.9) 74.4 (55.6 – 95.9) 43.7† (22.7 – 50.8) 70.4 40–59 years 133† (105 – 421) 48 (59.7 – 92.8) 60 years and older (60.3 – 82.5) 39.6† (31.8 – 47.0) 69.6 (55.1 – 79.4) 125† (94.7 – 292) 73 70.6 Females Total, 20 years and older (62.1 – 76.8) 37.5 (23.1 – 44.8) 66.2 (60.2 – 73.2) 131 (118 – 147) 187 69.1 20–39 years 64.7 (51.4 – 81.5) 32.7† (20.1 – 43.7) 63.6 (55.0 – 73.4) 125† (102 – 278) 65 40–59 years 73.0 (63.4 – 84.1) 41.4† (23.1 – 52.1) 69.0 (54.1 – 87.9) 132† (110 – 194) 45 144† (111 – 197) 77 82.0 (32.3 – 58.1) 45.2† (64.8 – 94.8) 60 years and older 81.6 (64.4 – 103) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 258 258

270 Table 2.28.a.4. Plasma alpha-linolenic acid (18:3n-3): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (50.4 – 57.4) 31.8 (29.4 – 34.0) 50.5 (48.2 – 53.1) 91.7 (81.0 – 112) 310 53.8 Total, 20 years and older 50.4 (44.6 – 56.8) 30.7 (26.4 – 33.1) 48.1 (43.0 – 53.0) 76.8 (69.0 – 142) 126 20–39 years 56.2 32.8† (23.4 – 36.2) 51.5 (47.1 – 55.1) 99.0† (81.8 – 315) 98 (52.0 – 60.6) 40–59 years 59.4 (53.3 – 66.2) 35.9† (29.4 – 40.4) 60.0 (53.5 – 63.0) 92.9† (81.4 – 142) 86 60 years and older Males (48.6 – 58.7) 53.4 (44.9 – 55.3) 29.4 (24.1 – 32.4) 51.7 Total, 20 years and older 93.3 (78.9 – 149) 143 20–39 years 49.6 28.8† (13.3 – 33.5) 45.5 (42.4 – 57.9) 75.7† (65.3 – 523) 58 (41.2 – 59.8) 40–59 years (49.9 – 67.2) 29.7† (18.1 – 35.2) 51.6 (40.9 – 63.7) 124† (97.4 – 284) 42 57.9 60 years and older 56.4 (48.8 – 65.1) 30.6† (25.3 – 39.9) 59.8 (46.2 – 72.5) 90.7† (79.0 – 105) 43 Females 167 54.1 (50.0 – 58.5) 34.4 (32.1 – 37.0) 50.3 (47.5 – 54.6) 88.9 (77.4 – 120) Total, 20 years and older 20–39 years 51.0 (45.7 – 56.9) 32.7† (28.1 – 35.9) 48.2 (41.2 – 57.7) 80.1† (67.0 – 134) 68 56 40–59 years 54.9 (47.8 – 62.9) 35.2† (23.1 – 39.9) 51.2 (44.3 – 57.6) 84.7† (75.8 – 332) 101† 43 (81.5 – 142) 60 years and older 61.4 (53.7 – 70.1) 38.8† (32.9 – 43.2) 59.2 (52.0 – 64.8) † Estimate is subject to greater uncertainty due to small cell size. Table 2.28.a.5. Plasma alpha-linolenic acid (18:3n-3): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 62.3 (59.9 – 66.8) 34.9 Total, 20 years and older 63.3 (58.9 – 65.7) 113 (109 – 120) 986 (32.3 – 38.0) 20–39 years 58.3 (55.5 – 61.3) 32.4 (30.2 – 34.1) 58.4 (56.4 – 61.9) 103 (93.8 – 116) 300 40–59 years (57.9 – 70.7) 37.5 (28.1 – 40.8) 60.5 (57.3 – 68.0) 114 (108 – 123) 278 64.0 60 years and older 69.4 (65.1 – 74.0) 39.4 (34.3 – 44.1) 69.0 (65.1 – 72.7) 125 (111 – 140) 408 Males 60.6 Total, 20 years and older 61.8 (58.1 – 65.7) 33.0 (27.5 – 36.6) (108 – 124) (57.4 – 65.4) 113 467 20–39 years 55.7 30.6 (26.4 – 33.7) 55.1 (47.7 – 60.6) 103 (95.6 – 113) 128 (52.2 – 59.5) 64.8 (58.1 – 70.8) 33.7 (16.1 – 45.7) 63.6 40–59 years 116 (108 – 132) 138 (59.6 – 70.5) 60 years and older (60.1 – 72.1) 36.0 (29.2 – 41.6) 63.8 (57.1 – 74.4) 118 (109 – 145) 201 65.8 Females Total, 20 years and older (61.0 – 68.5) 38.2 (34.6 – 40.0) 62.8 (59.8 – 67.0) 113 (106 – 121) 519 64.7 20–39 years 60.8 (56.7 – 65.1) 34.0 (30.4 – 37.3) 61.0 (56.4 – 66.1) 103 (88.8 – 128) 172 40–59 years 63.2 (55.2 – 72.3) 38.4 (33.6 – 40.7) 58.4 (52.1 – 68.1) 111 (102 – 120) 140 (108 – 154) 207 127 60 years and older 72.5 (67.0 – 78.5) 41.9 (34.7 – 48.1) 71.2 (67.3 – 76.6) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 259 259

271 981 855 375 603 513 309 940 679 size 1,795 Sample (107 – 127) (105 – 128) (105 – 129) (86.2 – 140) (96.3 – 132) (106 – 128) (86.7 – 138) (113 – 129) (104 – 142) 97.5th 117 117 120 121 110 115 99.8 116† 105† (94.2 – 106) (89.7 – 115) (79.1 – 105) (90.5 – 120) (92.8 – 106) (96.5 – 118) (76.7 – 112) (93.4 – 108) (97.4 – 119) 95th 100 100 108 101 102 85.1 99.2 94.0 84.1 (95% conf. interval) s (46.4 – 51.5) (48.0 – 52.4) (38.4 – 49.9) (38.7 – 46.5) (40.0 – 46.4) (44.0 – 50.6) (50.1 – 56.4) (47.5 – 53.2) (46.1 – 57.0) 50th 49.0 43.1 50.0 41.9 47.2 42.8 53.3 51.2 50.5 Selected percentile (19.0 – 22.0) (18.7 – 23.5) (15.1 – 21.2) (9.90 – 18.6) (18.3 – 24.0) (15.8 – 23.1) (17.0 – 21.6) (19.7 – 23.8) (20.3 – 23.6) 5th 20.2 19.3 22.0 15.1 20.6 20.4 19.5 22.0 22.1 (13.7 – 19.1) (6.25 – 15.0) (12.6 – 17.7) (13.1 – 20.3) (15.0 – 19.4) (14.9 – 18.3) (12.8 – 19.1) (14.4 – 20.3) (13.9 – 21.3) 2.5th 17.1 15.0 17.1 18.4 16.8 18.3 19.2 12.6† 16.5† n (45.0 – 49.0) (38.1 – 45.8) (39.4 – 44.1) (45.5 – 50.6) (43.7 – 48.4) (40.4 – 44.7) (48.4 – 53.8) (45.9 – 53.6) (46.1 – 51.6) 46.9 41.8 41.7 48.0 51.0 42.5 46.0 48.8 49.6 (95% conf. interval) Geometric mea † Estimate is subject to greater uncertainty due to small cell size. Total, 20 years and older Age group Race/ethnicity Males Gender Mexican Americans 20–39 years Females Non-Hispanic Blacks 40–59 years Non-Hispanic Whites 60 years and older Health and Nutrition Examination Survey, 2003–2004. Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Table 2.29.a.1. Plasma gamma-linolenic acid (18:3n-6): Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 260 260

272 Figure 2.29.a. Plasma gamma−linolenic acid (18:3n–6): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Overall Mexican Americans Females Males acid (μmol/L) 0 20 40 60 80 Plasma gamma−linolenic 20−39 40−59 60+ 60+ 20−39 40−59 Non−Hispanic Blacks Non−Hispanic Whites acid (μmol/L) 0 20 40 60 80 Plasma gamma−linolenic 60+ 40−59 60+ 40−59 20−39 20−39 Females Males Mexican Americans Non−Hispanic Blacks Non−Hispanic acid (μmol/L) Whites 0 20 40 60 80 Plasma gamma−linolenic 60+ 60+ 40−59 20−39 20−39 40−59 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 261261

273 Table 2.29.a.2. Plasma gamma-linolenic acid (18:3n-6): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (45.0 – 49.0) 24.4 (22.9 – 25.8) 49.0 (46.4 – 51.5) 85.7 (82.1 – 90.3) 1,795 46.9 Total, 20 years and older 41.7 (39.4 – 44.1) 22.5 (20.6 – 24.1) 41.9 (38.7 – 46.5) 75.2 (69.9 – 80.9) 603 20–39 years 51.0 25.7 (23.4 – 29.5) 53.3 (50.1 – 56.4) 90.5 (87.1 – 94.7) 513 (48.4 – 53.8) 40–59 years 49.6 (45.9 – 53.6) 26.7 (23.9 – 29.1) 51.2 (46.1 – 57.0) 90.8 (82.8 – 101) 679 60 years and older Males (45.5 – 50.6) 48.0 (48.0 – 52.4) 25.6 (23.8 – 27.0) 50.0 Total, 20 years and older 85.7 (81.2 – 94.4) 855 20–39 years 45.7 25.1 (21.7 – 26.9) 48.8 (44.3 – 52.1) 79.5 (68.4 – 90.5) 277 (42.7 – 48.8) 40–59 years (49.5 – 56.2) 26.3 (23.9 – 30.8) 55.7 (51.5 – 59.2) 91.9 (85.6 – 110) 246 52.7 60 years and older 44.3 (40.3 – 48.7) 24.7 (19.5 – 27.7) 44.5 (42.4 – 48.4) 79.8 (70.5 – 101) 332 Females 940 46.0 (43.7 – 48.4) 23.0 (21.5 – 24.8) 47.2 (44.0 – 50.6) 85.1 (80.4 – 89.8) Total, 20 years and older 20–39 years 38.2 (35.3 – 41.3) 21.5 (16.6 – 23.1) 37.3 (34.7 – 41.3) 73.0 (62.6 – 79.0) 326 267 40–59 years 49.5 (46.3 – 53.0) 24.5 (20.1 – 27.8) 51.7 (48.2 – 55.8) 89.7 (81.9 – 101) 29.1 (88.0 – 105) 97.2 57.9 (26.2 – 30.6) (50.7 – 64.5) 347 60 years and older 54.4 (50.0 – 59.2) Table 2.29.a.3. Plasma gamma-linolenic acid (18:3n-6): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample Selected percentile s (95% conf. interval) 90th 10th 50th (95% conf. interval) size Males and Females 41.8 (38.1 – 45.8) 19.5 Total, 20 years and older 43.1 (38.4 – 49.9) 83.5 (77.3 – 89.8) 375 (15.2 – 22.8) 20–39 years 38.5 (33.2 – 44.5) 18.1 (13.0 – 20.2) 40.4 (32.6 – 51.1) 71.2 (67.0 – 87.0) 132 40–59 years (42.9 – 52.3) 24.2† (17.3 – 27.6) 48.3 (39.6 – 55.1) 94.9† (81.5 – 123) 93 47.4 60 years and older 46.9 (40.9 – 53.7) 24.0 (13.3 – 29.1) 48.7 (41.9 – 61.0) 86.0 (79.1 – 89.7) 150 Males 87.3 Total, 20 years and older 44.2 (38.1 – 51.2) 20.6 (14.5 – 26.3) (38.4 – 54.8) 45.9 (74.0 – 91.6) 188 20–39 years 43.3 20.1† (7.22 – 25.2) 46.7 (32.8 – 60.0) 81.3† (67.1 – 107) 67 (34.6 – 54.2) 47.1 (38.0 – 55.2) 25.8† (9.42 – 31.7) 44.7 40–59 years 94.2† (70.9 – 155) 48 (37.9 – 58.6) 60 years and older (33.5 – 50.5) 21.3† (11.1 – 25.6) 42.9 (26.9 – 60.8) 71.0† (57.5 – 131) 73 41.1 Females Total, 20 years and older (34.4 – 44.1) 16.5 (10.6 – 21.9) 40.1 (33.0 – 50.6) 82.4 (72.2 – 90.6) 187 39.0 20–39 years 32.8 (26.5 – 40.6) 14.7† (6.25 – 19.3) 34.6 (29.0 – 41.4) 61.6† (50.6 – 89.6) 65 40–59 years 47.6 (41.4 – 54.8) 21.0† (15.0 – 27.4) 51.3 (35.0 – 61.6) 94.9† (81.2 – 108) 45 88.9† (86.4 – 98.2) 77 55.3 (9.56 – 39.1) 26.6† (50.3 – 62.2) 60 years and older 52.9 (46.0 – 60.7) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 262 262

274 Table 2.29.a.4. Plasma gamma-linolenic acid (18:3n-6): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (40.4 – 44.7) 23.7 (22.0 – 25.1) 42.8 (40.0 – 46.4) 73.7 (68.3 – 80.0) 309 42.5 Total, 20 years and older 38.0 (35.1 – 41.2) 22.1 (18.2 – 24.1) 37.1 (32.7 – 41.8) 67.3 (61.8 – 76.2) 125 20–39 years 49.2 27.0† (19.9 – 33.0) 50.1 (48.6 – 53.3) 82.2† (73.0 – 111) 98 (45.5 – 53.2) 40–59 years 42.9 (40.1 – 45.9) 25.3† (11.9 – 30.0) 45.8 (39.8 – 48.6) 68.5† (66.3 – 74.0) 86 60 years and older Males (41.2 – 48.4) 44.7 (38.7 – 51.2) 24.8 (22.5 – 27.5) 44.2 Total, 20 years and older 75.4 (72.8 – 88.6) 142 20–39 years 41.7 23.4† (14.7 – 26.3) 42.5 (32.5 – 52.0) 73.1† (60.3 – 181) 57 (37.3 – 46.6) 40–59 years (45.1 – 57.8) 27.9† (23.2 – 34.8) 48.8 (39.2 – 58.8) 88.5† (73.1 – 121) 42 51.1 60 years and older 40.9 (35.6 – 46.9) 23.6† (20.0 – 26.3) 39.8 (33.3 – 51.3) 69.4† (57.4 – 83.1) 43 Females 167 40.9 (38.9 – 43.0) 22.4 (18.9 – 25.2) 41.7 (37.8 – 46.2) 69.3 (65.9 – 78.6) Total, 20 years and older 20–39 years 35.3 (32.6 – 38.2) 21.2† (15.5 – 24.3) 36.7 (29.9 – 39.1) 60.0† (50.6 – 82.2) 68 56 40–59 years 47.9 (42.3 – 54.2) 21.8† (17.8 – 33.3) 50.8 (46.4 – 54.0) 78.1† (68.2 – 109) 68.3† 43 (61.7 – 78.4) 60 years and older 44.2 (39.6 – 49.4) 25.4† (11.9 – 31.0) 46.8 (36.5 – 54.0) † Estimate is subject to greater uncertainty due to small cell size. Table 2.29.a.5. Plasma gamma-linolenic acid (18:3n-6): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 50.5 (46.1 – 51.6) 25.6 Total, 20 years and older 48.8 (47.5 – 53.2) 86.9 (82.2 – 93.2) 981 (23.9 – 27.8) 20–39 years 44.1 (40.9 – 47.6) 24.0 (21.8 – 26.7) 45.3 (39.0 – 50.9) 76.3 (69.5 – 84.7) 294 40–59 years (48.1 – 56.0) 26.6 (22.8 – 32.2) 54.2 (50.0 – 58.7) 90.3 (86.4 – 94.7) 278 51.9 60 years and older 50.6 (46.1 – 55.5) 26.8 (22.8 – 29.6) 52.4 (46.2 – 58.7) 92.5 (83.2 – 104) 409 Males 51.4 Total, 20 years and older 49.6 (46.0 – 53.4) 26.3 (23.9 – 29.6) (79.7 – 101) (49.0 – 53.5) 86.1 464 20–39 years 47.7 26.3 (22.5 – 29.5) 49.8 (46.8 – 52.9) 80.5 (67.7 – 115) 124 (43.6 – 52.1) 54.4 (51.7 – 60.7) 28.5 (24.0 – 33.3) 56.9 40–59 years 92.4 (85.5 – 117) 138 (50.0 – 59.2) 60 years and older (39.8 – 50.3) 24.6 (16.3 – 28.7) 44.6 (41.8 – 49.7) 80.9 (67.4 – 119) 202 44.7 Females Total, 20 years and older (45.4 – 50.9) 24.6 (22.4 – 27.7) 49.1 (45.1 – 53.5) 87.3 (82.1 – 92.2) 517 48.1 20–39 years 41.3 (37.2 – 45.8) 23.0 (20.1 – 25.2) 39.6 (35.8 – 45.4) 75.5 (64.7 – 81.7) 170 40–59 years 49.5 (44.8 – 54.8) 25.4 (19.2 – 31.5) 50.5 (46.2 – 56.1) 88.9 (77.0 – 103) 140 (88.3 – 107) 207 97.4 60 years and older 56.1 (50.6 – 62.2) 29.6 (22.8 – 33.5) 60.6 (52.8 – 66.0) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 263 263

275 990 607 375 865 515 940 310 683 size 1,805 Sample (39.9 – 47.3) (36.9 – 46.5) (40.7 – 50.1) (35.1 – 44.9) (49.5 – 121) (40.9 – 49.6) (38.1 – 47.5) (34.6 – 51.6) (36.6 – 46.6) 97.5th 42.2 40.7 40.0 43.9 42.0 46.5 38.6 55.0† 36.3† (35.1 – 39.9) (35.8 – 43.2) (43.2 – 69.3) (31.3 – 37.1) (36.4 – 43.8) (28.4 – 40.5) (33.9 – 40.3) (33.7 – 37.4) (33.5 – 38.1) 95th 36.9 38.5 49.5 32.9 35.4 33.5 38.5 35.0 35.4 (95% conf. interval) s (20.3 – 21.6) (19.3 – 21.1) (22.8 – 26.6) (18.6 – 20.3) (18.1 – 19.7) (20.3 – 22.4) (21.0 – 22.3) (20.1 – 21.4) (22.3 – 23.6) 50th 20.9 24.9 19.4 20.2 21.2 19.0 21.7 23.1 20.7 Selected percentile (11.9 – 12.8) (11.8 – 13.0) (11.3 – 14.4) (10.7 – 12.0) (11.4 – 13.0) (11.8 – 13.7) (10.5 – 12.5) (13.1 – 15.3) (11.7 – 12.9) 5th 12.4 13.3 12.6 11.3 12.2 12.8 11.4 14.3 12.3 (10.5 – 11.6) (10.6 – 11.9) (8.60 – 13.3) (9.44 – 11.0) (9.00 – 11.2) (10.4 – 11.4) (10.3 – 12.2) (9.83 – 11.8) (10.6 – 14.0) 2.5th 11.2 10.4 11.4 11.0 11.7 11.2 12.9 11.4† 10.8† n (20.7 – 21.8) (23.5 – 27.1) (19.7 – 21.2) (19.5 – 20.9) (21.3 – 22.7) (20.6 – 22.3) (18.3 – 20.1) (20.3 – 21.5) (22.1 – 23.5) 21.2 20.4 20.2 25.2 22.0 19.2 21.5 20.9 22.8 (95% conf. interval) Geometric mea † Estimate is subject to greater uncertainty due to small cell size. Total, 20 years and older Age group Race/ethnicity Males Gender Mexican Americans 20–39 years Females Non-Hispanic Blacks 40–59 years Non-Hispanic Whites 60 years and older Health and Nutrition Examination Survey, 2003–2004. Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Table 2.30.a.1. Plasma eicosadienoic acid (20:2n-6): Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 264 264

276 Figure 2.30.a. Plasma eicosadienoic acid (20:2n–6): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Overall Mexican Americans Females Males acid (μmol/L) Plasma eicosadienoic 0 10 20 30 40 20−39 60+ 20−39 40−59 60+ 40−59 Non−Hispanic Whites Non−Hispanic Blacks 40 acid (μmol/L) Plasma eicosadienoic 0 10 20 30 60+ 20−39 60+ 20−39 40−59 40−59 Females Males Mexican Americans Non−Hispanic Blacks Non−Hispanic acid (μmol/L) Whites Plasma eicosadienoic 0 10 20 30 40 60+ 60+ 20−39 40−59 40−59 20−39 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 265 265

277 Table 2.30.a.2. Plasma eicosadienoic acid (20:2n-6): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Sample Geometric mean Selected percentiles (95% conf. interval) 10th 50th 90th size (95% conf. interval) Males and Females (20.7 – 21.8) 14.1 (13.5 – 14.6) 20.9 (20.3 – 21.6) 32.0 (30.8 – 33.8) 1,805 Total, 20 years and older 21.2 20.2 (19.5 – 20.9) 13.0 (12.0 – 13.7) 19.4 (18.6 – 20.3) 33.1 (30.9 – 36.6) 607 20–39 years 21.5 14.5 (13.2 – 15.3) 21.2 (20.3 – 22.4) 30.8 (30.0 – 33.7) 515 (20.6 – 22.3) 40–59 years 22.8 (22.1 – 23.5) 16.2 (15.2 – 16.8) 23.1 (22.3 – 23.6) 32.2 (31.0 – 33.4) 683 60 years and older Males 13.9 20.4 (19.7 – 21.2) (28.1 – 31.3) (13.0 – 14.7) 20.2 (19.3 – 21.1) 29.6 Total, 20 years and older 865 282 20–39 years 13.1 (11.6 – 13.9) 19.2 (18.1 – 19.9) 28.3 (26.4 – 31.4) 19.3 (18.4 – 20.2) 40–59 years (20.3 – 22.2) 14.5 (12.9 – 15.3) 20.9 (19.6 – 22.8) 30.3 (28.1 – 32.4) 248 21.2 60 years and older 21.4 (20.6 – 22.2) 15.3 (13.2 – 16.6) 21.0 (20.3 – 21.9) 29.5 (28.1 – 33.4) 335 Females 940 22.0 (21.3 – 22.7) 14.4 (13.7 – 14.8) 21.7 (21.0 – 22.3) 34.2 (32.5 – 36.2) Total, 20 years and older 20–39 years 21.1 (20.1 – 22.3) 12.9 (12.2 – 13.8) 20.0 (19.0 – 21.2) 36.3 (34.3 – 39.4) 325 267 40–59 years 21.7 (20.6 – 22.9) 14.6 (12.2 – 15.7) 21.4 (20.5 – 22.2) 31.5 (29.9 – 37.8) (15.6 – 17.7) 16.7 33.5 348 (32.4 – 35.7) (23.1 – 25.4) 24.0 60 years and older 24.0 (23.1 – 24.9) Table 2.30.a.3. Plasma eicosadienoic acid (20:2n-6): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Sample Geometric mean Selected percentiles (95% conf. interval) 10th 50th 90th size (95% conf. interval) Males and Females 25.2 (23.5 – 27.1) 15.7 (13.4 – 17.2) 24.9 (22.8 – 26.6) 42.1 (35.6 – 51.2) 375 Total, 20 years and older 20–39 years 24.3 (21.7 – 27.3) 14.1 (12.6 – 16.7) 23.5 (20.5 – 27.8) 43.9 (33.7 – 55.6) 131 40–59 years (24.6 – 28.8) 17.7† (12.3 – 20.2) 25.5 (24.5 – 26.5) 42.3† (35.8 – 73.3) 93 26.6 60 years and older 26.8 (25.4 – 28.3) 19.9 (18.1 – 20.4) 26.4 (24.7 – 27.6) 37.0 (35.1 – 49.3) 151 Males (31.9 – 63.7) Total, 20 years and older 24.7 (22.2 – 27.5) 14.9 (13.0 – 17.2) 24.7 (22.4 – 26.6) 39.9 189 67 20–39 years 13.7† (12.1 – 15.9) 23.9 (19.8 – 28.8) 36.5† (28.8 – 56.4) 23.8 (20.1 – 28.2) 26.4 (23.8 – 26.9) 17.6† (12.5 – 20.6) 25.2 40–59 years 41.6† (34.7 – 73.3) 48 (24.2 – 28.9) 60 years and older (23.6 – 28.2) 18.7† (10.7 – 20.5) 25.6 (22.1 – 27.9) 37.0† (31.3 – 69.2) 74 25.8 Females Total, 20 years and older (24.0 – 28.0) 16.7 (11.4 – 17.4) 25.1 (22.2 – 27.7) 45.8 (37.6 – 55.9) 186 25.9 20–39 years 25.1 (21.8 – 28.8) 14.5† (10.8 – 17.2) 22.7 (20.1 – 27.0) 48.8† (37.2 – 56.6) 64 40–59 years 26.8 (23.1 – 31.2) 18.3† (8.60 – 20.6) 25.7 (23.0 – 28.3) 42.2† (32.9 – 58.3) 45 36.1† (34.7 – 51.5) 26.9 77 20.2† (22.9 – 34.5) (24.0 – 32.2) 60 years and older 27.8 (17.8 – 20.8) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 266 266

278 Table 2.30.a.4. Plasma eicosadienoic acid (20:2n-6): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Sample Geometric mean Selected percentiles (95% conf. interval) 10th 50th 90th size (95% conf. interval) Males and Females (18.3 – 20.1) 12.8 (11.3 – 13.7) 19.0 (18.1 – 19.7) 27.8 (25.4 – 33.8) 310 Total, 20 years and older 19.2 18.3 (17.0 – 19.7) 12.2 (10.9 – 13.1) 126 (16.3 – 19.1) 26.4 (24.5 – 36.1) 20–39 years 17.9 40–59 years (18.6 – 21.1) 13.3† (10.5 – 14.9) 19.2 (17.8 – 21.1) 28.1† (26.1 – 34.9) 98 19.8 (19.7 – 22.4) 60 years and older 14.2† (12.6 – 15.4) 21.1 (19.6 – 21.3) 27.5† (25.3 – 28.2) 86 20.5 Males Total, 20 years and older 18.4 (17.3 – 19.5) 12.3 (10.9 – 13.3) 17.9 (16.5 – 19.2) 26.4 (24.3 – 31.6) 143 58 20–39 years (16.4 – 18.1) 11.3† (9.43 – 13.2) 16.4 (16.0 – 18.2) 25.1† (22.0 – 48.7) 17.2 40–59 years 20.0 13.8† (10.2 – 15.5) 18.2 (16.8 – 20.4) 31.9† (26.2 – 52.2) 42 (17.8 – 22.3) (17.1 – 21.5) 60 years and older 12.4† (8.53 – 14.5) 19.6 (16.7 – 21.3) 25.6† (23.5 – 35.0) 43 18.9 Females Total, 20 years and older 19.8 (18.3 – 21.5) 12.9 (11.2 – 14.7) 19.4 (18.3 – 21.6) 28.2 (24.8 – 40.6) 167 20–39 years (17.1 – 21.8) 12.5† (11.2 – 14.1) 18.5 (16.8 – 20.1) 32.1† (24.5 – 47.8) 68 19.3 56 19.7 (18.0 – 21.5) 12.9† (8.30 – 15.4) 19.3 (17.5 – 22.1) 27.0† (23.6 – 96.5) 40–59 years 43 (24.3 – 40.5) 60 years and older 21.5 (20.1 – 23.1) 15.9† (13.1 – 17.7) 21.9 (19.9 – 23.2) 27.7† † Estimate is subject to greater uncertainty due to small cell size. Table 2.30.a.5. Plasma eicosadienoic acid (20:2n-6): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Sample n Geometric mea Selected percentiles (95% conf. interval) 10th 90th 50th (95% conf. interval) size Males and Females (20.3 – 21.5) 14.0 (13.1 – 14.7) 20.7 (20.1 – 21.4) 31.0 (29.8 – 33.3) 990 Total, 20 years and older 20.9 19.7 (18.9 – 20.5) 12.8 298 19.3 (18.1 – 20.0) 33.1 (29.5 – 37.1) 20–39 years (11.7 – 13.6) 40–59 years (19.7 – 21.9) 13.9 (12.7 – 15.1) 20.8 (19.8 – 21.8) 30.2 (28.0 – 32.2) 280 20.8 (22.0 – 23.8) 60 years and older 16.0 (14.5 – 16.8) 23.0 (21.9 – 23.5) 31.9 (29.9 – 33.5) 412 22.7 Males Total, 20 years and older 20.0 (19.3 – 20.7) 13.7 (12.8 – 14.8) 19.9 (18.9 – 20.8) 28.2 (27.1 – 30.4) 472 128 18.4 (17.4 – 19.5) 12.7 (10.9 – 13.9) 18.3 (17.3 – 19.4) 25.7 (23.3 – 29.6) 20–39 years 40–59 years 20.5 14.1 (12.8 – 15.1) 20.4 (18.7 – 22.5) 28.2 (27.3 – 30.6) 140 (19.4 – 21.6) (20.1 – 22.1) 60 years and older 15.4 (12.9 – 16.7) 21.0 (20.4 – 22.2) 29.4 (28.0 – 33.4) 204 21.3 Females Total, 20 years and older 21.8 (20.9 – 22.7) 14.3 (13.2 – 14.8) 21.5 (20.9 – 22.2) 33.8 (31.8 – 36.2) 518 20–39 years (19.5 – 22.5) 12.8 (12.0 – 13.7) 20.0 (18.5 – 21.4) 36.9 (34.1 – 40.4) 170 20.9 140 21.1 (19.7 – 22.7) 13.8 (11.8 – 15.4) 21.1 (20.2 – 22.0) 30.9 (28.2 – 36.5) 40–59 years (32.2 – 35.2) 33.2 208 60 years and older 23.9 (22.8 – 25.1) 16.5 (15.0 – 18.1) 24.1 (23.0 – 25.5) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 267 267

279 991 942 864 514 683 375 609 310 size 1,806 Sample (275 – 324) (275 – 357) (284 – 337) (295 – 716) (287 – 321) (260 – 373) (281 – 320) (262 – 317) (206 – 276) 97.5th 287 312 304 281 288 289 281 330† 223† (250 – 281) (260 – 363) (261 – 287) (254 – 285) (258 – 286) (237 – 277) (254 – 274) (239 – 276) (196 – 230) 95th 261 272 262 297 265 252 262 251 203 (150 – 163) (147 – 164) (144 – 157) (148 – 167) (153 – 180) (135 – 153) (145 – 156) (135 – 146) (127 – 136) 50th 152 156 167 156 144 158 151 139 131 (84.9 – 92.9) (84.7 – 93.0) (76.4 – 90.0) (77.7 – 92.8) (83.1 – 94.0) (77.8 – 101) (84.6 – 89.9) (75.9 – 91.3) (70.3 – 85.5) 5th Selected percentiles (95% conf. interval) 88.3 86.1 88.5 86.6 88.9 92.0 87.5 84.9 76.7 (67.7 – 84.6) (67.7 – 86.3) (58.9 – 89.6) (62.8 – 84.0) (62.2 – 76.4) (67.9 – 84.9) (67.9 – 79.6) (57.7 – 78.3) (52.8 – 75.7) 2.5th 77.0 76.0 72.0 72.8 72.9 73.2 71.5 82.2† 70.0† (148 – 164) (147 – 163) (146 – 159) (154 – 179) (139 – 153) (152 – 162) (147 – 156) (140 – 149) (128 – 135) 166 145 157 152 155 156 151 145 131 (95% conf. interval) Geometric mean † Estimate is subject to greater uncertainty due to small cell size. Non-Hispanic Whites Age group Females Males Gender Race/ethnicity Total, 20 years and older 60 years and older 40–59 years 20–39 years Mexican Americans Non-Hispanic Blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Table 2.31.a.1. Plasma homo-gamma-linolenic acid (20:3n-6): Concentrations nd nd 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 268 268

280 Figure 2.31.a. Plasma homo−gamma−linolenic acid (20:3n–6): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Overall Mexican Americans 300 200 Females Males 100 acid (μmol/L) 0 20−39 60+ 40−59 60+ 20−39 40−59 Plasma homo−gamma−linolenic Non−Hispanic Blacks Non−Hispanic Whites 300 200 100 acid (μmol/L) 0 60+ 40−59 20−39 60+ 40−59 20−39 Plasma homo−gamma−linolenic Males Females 300 200 Mexican Americans Non−Hispanic Blacks 100 acid (μmol/L) Non−Hispanic Whites 0 40−59 20−39 60+ 40−59 20−39 60+ Plasma homo−gamma−linolenic Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 269 269

281 Table 2.31.a.2. Plasma homo-gamma-linolenic acid (20:3n-6): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (147 – 156) 98.4 (95.2 – 102) 151 (145 – 156) 232 (221 – 245) 1,806 151 Total, 20 years and older 145 (140 – 149) 95.6 (92.4 – 99.4) 139 (135 – 146) 223 (213 – 239) 609 20–39 years 155 102 (94.2 – 107) 156 (147 – 164) 240 (222 – 258) 514 (147 – 163) 40–59 years 156 (148 – 164) 100 (94.3 – 104) 158 (148 – 167) 236 (222 – 250) 683 60 years and older Males (139 – 153) 145 (135 – 153) 96.7 (93.1 – 100) 144 Total, 20 years and older 222 (210 – 246) 864 20–39 years 141 95.2 (88.2 – 97.7) 137 (131 – 145) 219 (201 – 247) 282 (134 – 149) 40–59 years (144 – 163) 101 (93.8 – 107) 155 (141 – 161) 232 (217 – 272) 247 153 60 years and older 140 (131 – 150) 92.2 (84.0 – 97.9) 141 (133 – 153) 203 (185 – 244) 335 Females 942 157 (152 – 162) 102 (96.6 – 105) 156 (150 – 163) 241 (227 – 258) Total, 20 years and older 20–39 years 148 (142 – 154) 97.3 (91.9 – 103) 142 (135 – 156) 226 (209 – 270) 327 267 40–59 years 157 (148 – 167) 104 (93.3 – 107) 157 (151 – 166) 241 (214 – 264) 107 (236 – 274) 258 175 (98.4 – 115) (159 – 185) 348 60 years and older 170 (162 – 178) Table 2.31.a.3. Plasma homo-gamma-linolenic acid (20:3n-6): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample Selected percentile s (95% conf. interval) 90th 10th 50th (95% conf. interval) size Males and Females 166 (154 – 179) 103 Total, 20 years and older 167 (153 – 180) 258 (245 – 293) 375 (90.3 – 109) 20–39 years 158 (140 – 177) 96.7 (82.8 – 104) 158 (131 – 189) 254 (239 – 295) 131 40–59 years (166 – 192) 110† (81.4 – 129) 178 (168 – 186) 289† (241 – 360) 93 178 60 years and older 177 (169 – 185) 119 (108 – 130) 185 (169 – 199) 245 (237 – 261) 151 Males 246 Total, 20 years and older 161 (143 – 181) 103 (85.0 – 114) (138 – 192) 161 (222 – 296) 189 20–39 years 157 102† (65.4 – 113) 148 (121 – 204) 248† (215 – 329) 67 (133 – 185) 171 (148 – 194) 111† (84.1 – 132) 168 40–59 years 244† (213 – 361) 48 (149 – 196) 60 years and older (146 – 176) 113† (49.9 – 123) 165 (143 – 181) 228† (188 – 288) 74 160 Females Total, 20 years and older (155 – 190) 93.0 (65.6 – 109) 175 (159 – 201) 272 (240 – 716) 186 172 20–39 years 159 (135 – 188) 89.4† (55.8 – 103) 160 (127 – 200) 269† (225 – 716) 64 40–59 years 188 (162 – 217) 106† (65.9 – 149) 190 (171 – 214) 303† (244 – 372) 45 258† (238 – 328) 77 204 (117 – 135) 128† (193 – 214) 60 years and older 194 (183 – 207) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 270 270

282 Table 2.31.a.4. Plasma homo-gamma-linolenic acid (20:3n-6): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (128 – 135) 91.5 (81.3 – 96.1) 131 (127 – 136) 187 (181 – 200) 310 131 Total, 20 years and older 129 (122 – 136) 88.0 (72.5 – 96.0) 128 (117 – 139) 186 (172 – 206) 126 20–39 years 136 98.8† (63.0 – 109) 134 (128 – 141) 198† (182 – 235) 98 (130 – 143) 40–59 years 130 (123 – 136) 85.9† (75.4 – 92.8) 134 (117 – 147) 183† (173 – 215) 86 60 years and older Males (119 – 131) 125 (112 – 130) 82.5 (73.7 – 94.9) 121 Total, 20 years and older 188 (173 – 203) 143 20–39 years 119 77.7† (53.1 – 94.7) 115 (106 – 130) 174† (168 – 196) 58 (111 – 128) 40–59 years (129 – 144) 99.7† (71.4 – 105) 128 (118 – 147) 197† (174 – 261) 42 136 60 years and older 120 (107 – 134) 76.3† (45.9 – 90.2) 118 (105 – 141) 184† (156 – 213) 43 Females 167 136 (129 – 144) 93.0 (85.4 – 103) 135 (124 – 150) 186 (180 – 206) Total, 20 years and older 20–39 years 137 (125 – 149) 92.6† (77.6 – 104) 134 (116 – 159) 193† (174 – 272) 68 56 40–59 years 136 (126 – 147) 94.2† (49.0 – 116) 135 (128 – 145) 189† (156 – 298) 182† 43 (171 – 216) 60 years and older 136 (124 – 149) 92.6† (70.7 – 102) 144 (115 – 160) † Estimate is subject to greater uncertainty due to small cell size. Table 2.31.a.5. Plasma homo-gamma-linolenic acid (20:3n-6): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 152 (146 – 159) 99.3 Total, 20 years and older 152 (144 – 157) 233 (218 – 250) 991 (94.2 – 103) 20–39 years 147 (140 – 154) 97.2 (91.2 – 103) 140 (135 – 148) 226 (215 – 245) 300 40–59 years (143 – 165) 101 (92.9 – 107) 156 (143 – 166) 232 (213 – 261) 279 154 60 years and older 158 (149 – 167) 100 (91.9 – 107) 160 (148 – 172) 242 (226 – 256) 412 Males 144 Total, 20 years and older 146 (137 – 155) 97.0 (90.8 – 101) (206 – 254) (134 – 155) 222 471 20–39 years 142 95.2 (73.6 – 101) 136 (126 – 147) 222 (187 – 279) 128 (129 – 156) 152 (134 – 165) 100 (90.4 – 107) 155 40–59 years 227 (210 – 284) 139 (139 – 165) 60 years and older (132 – 153) 93.6 (86.9 – 99.4) 141 (133 – 154) 206 (184 – 250) 204 142 Females Total, 20 years and older (152 – 165) 104 (97.0 – 106) 157 (150 – 168) 242 (224 – 261) 520 159 20–39 years 151 (143 – 160) 99.5 (93.5 – 109) 141 (135 – 160) 232 (210 – 285) 172 40–59 years 156 (144 – 169) 103 (86.2 – 107) 156 (149 – 168) 240 (210 – 264) 140 (245 – 271) 208 260 60 years and older 172 (161 – 184) 107 (88.1 – 124) 177 (161 – 191) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 271 271

283 991 943 864 514 683 376 610 310 size 1,807 Sample (1,190 – 1,480) (1,310 – 1,490) (1,260 – 1,560) (1,140 – 1,460) (1,240 – 1,420) (1,320 – 1,460) (1,160 – 1,460) (1,140 – 1,380) (1,360 – 1,770) 97.5th 1,260 1,380 1,320 1,370 1,430 1,230 1,230 1,290† 1,520† (1,120 – 1,220) (1,180 – 1,300) (1,160 – 1,360) (1,040 – 1,310) (1,180 – 1,260) (1,150 – 1,230) (1,090 – 1,220) (1,050 – 1,230) (1,260 – 1,580) 95th 1,150 1,220 1,160 1,200 1,220 1,110 1,180 1,110 1,330 (756 – 806) (785 – 829) (769 – 821) (767 – 807) (814 – 868) (772 – 805) (675 – 768) (713 – 761) (831 – 941) 50th 841 726 785 792 808 789 780 737 883 5th (446 – 511) (456 – 500) (436 – 520) (450 – 496) (455 – 495) (396 – 487) (460 – 535) (445 – 504) (493 – 611) Selected percentiles (95% conf. interval) 480 480 484 490 485 502 440 479 576 (424 – 473) (421 – 480) (372 – 470) (419 – 463) (376 – 432) (418 – 463) (386 – 465) (386 – 455) (226 – 572) 2.5th 452 429 445 445 448 445 429 419† 526† (744 – 785) (798 – 841) (678 – 768) (769 – 806) (761 – 791) (752 – 795) (772 – 814) (716 – 755) (839 – 932) 773 776 787 819 793 764 722 735 884 (95% conf. interval) Geometric mean † Estimate is subject to greater uncertainty due to small cell size. Non-Hispanic Whites Age group Females Males Gender Race/ethnicity Total, 20 years and older 60 years and older 40–59 years 20–39 years Mexican Americans Non-Hispanic Blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Table 2.32.a.1. Plasma arachidonic acid (20:4n-6): Concentrations nd nd 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 272 272

284 Figure 2.32.a. Plasma arachidonic acid (20:4n–6): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Overall Mexican Americans 1500 1000 Females Males 500 acid (μmol/L) Plasma arachidonic 0 60+ 20−39 40−59 60+ 20−39 40−59 Non−Hispanic Whites Non−Hispanic Blacks 1500 1000 500 acid (μmol/L) Plasma arachidonic 0 60+ 20−39 60+ 40−59 20−39 40−59 Females Males 1500 1000 Mexican Americans Non−Hispanic 500 Blacks acid (μmol/L) Non−Hispanic Plasma arachidonic Whites 0 20−39 40−59 60+ 60+ 40−59 20−39 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 273 273

285 Table 2.32.a.2. Plasma arachidonic acid (20:4n-6): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (761 – 791) 538 (516 – 560) 789 (772 – 805) 1,070 (1,040 – 1,110) 1,807 776 Total, 20 years and older 735 (716 – 755) 529 (510 – 542) 737 (713 – 761) 1,000 (959 – 1,080) 610 20–39 years 793 534 (488 – 569) 808 (785 – 829) 1,090 (1,050 – 1,140) 514 (772 – 814) 40–59 years 819 (798 – 841) 562 (533 – 591) 841 (814 – 868) 1,120 (1,090 – 1,140) 683 60 years and older Males (744 – 785) 764 (756 – 806) 534 (502 – 547) 780 Total, 20 years and older 1,040 (1,000 – 1,090) 864 20–39 years 739 533 (505 – 542) 736 (713 – 766) 999 (945 – 1,100) 282 (710 – 769) 40–59 years (761 – 825) 529 (487 – 566) 823 (795 – 842) 1,070 (1,020 – 1,150) 247 792 60 years and older 761 (726 – 798) 532 (453 – 570) 796 (740 – 839) 1,030 (986 – 1,100) 335 Females 943 787 (769 – 806) 549 (517 – 575) 792 (769 – 821) 1,100 (1,050 – 1,160) Total, 20 years and older 20–39 years 732 (710 – 755) 523 (497 – 552) 738 (705 – 766) 1,010 (956 – 1,120) 328 267 40–59 years 793 (755 – 833) 534 (464 – 597) 787 (753 – 864) 1,130 (1,020 – 1,230) 620 (1,120 – 1,200) 1,150 878 (551 – 654) (854 – 904) 348 60 years and older 870 (844 – 896) Table 2.32.a.3. Plasma arachidonic acid (20:4n-6): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample Selected percentile s (95% conf. interval) 90th 10th 50th (95% conf. interval) size Males and Females 722 (678 – 768) 499 Total, 20 years and older 726 (675 – 768) 1,030 (975 – 1,080) 376 (439 – 536) 20–39 years 681 (631 – 735) 483 (413 – 526) 687 (628 – 745) 993 (892 – 1,070) 132 40–59 years (718 – 844) 510† (420 – 602) 774 (749 – 835) 1,120† (948 – 1,350) 93 778 60 years and older 811 (777 – 846) 567 (496 – 592) 826 (769 – 874) 1,170 (1,050 – 1,330) 151 Males 1,030 Total, 20 years and older 719 (669 – 773) 502 (426 – 535) (674 – 788) 745 (937 – 1,090) 189 20–39 years 689 503† (380 – 540) 707 (609 – 758) 983† (851 – 1,110) 67 (637 – 746) 770 (748 – 843) 489† (377 – 606) 800 40–59 years 1,040† (881 – 1,460) 48 (675 – 878) 60 years and older (714 – 842) 527† (376 – 590) 811 (643 – 924) 1,090† (1,000 – 1,360) 74 776 Females Total, 20 years and older (659 – 796) 479 (352 – 582) 716 (653 – 782) 1,020 (945 – 1,310) 187 724 20–39 years 670 (591 – 760) 436† (352 – 539) 676 (626 – 723) 987† (856 – 1,310) 65 40–59 years 788 (711 – 874) 567† (447 – 616) 756 (652 – 885) 1,250† (964 – 1,430) 45 1,220† (987 – 1,940) 77 835 (580 – 600) 586† (810 – 873) 60 years and older 844 (790 – 902) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 274 274

286 Table 2.32.a.4. Plasma arachidonic acid (20:4n-6): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (839 – 932) 630 (588 – 670) 883 (831 – 941) 1,220 (1,160 – 1,330) 310 884 Total, 20 years and older 836 (776 – 901) 602 (542 – 635) 839 (769 – 887) 1,210 (1,040 – 1,380) 126 20–39 years 936 681† (513 – 711) 942 (827 – 1,040) 1,230† (1,170 – 1,760) 98 (858 – 1,020) 40–59 years 919 (859 – 983) 714† (534 – 744) 933 (830 – 1,030) 1,200† (1,160 – 1,330) 86 60 years and older Males (817 – 925) 870 (811 – 976) 591 (512 – 659) 859 Total, 20 years and older 1,200 (1,130 – 1,330) 143 20–39 years 811 580† (479 – 616) 812 (692 – 891) 1,120† (1,020 – 1,660) 58 (737 – 892) 40–59 years (875 – 1,040) 666† (501 – 727) 984 (780 – 1,070) 1,230† (1,110 – 2,240) 42 953 60 years and older 886 (774 – 1,010) 535† (226 – 722) 940 (833 – 1,050) 1,180† (1,130 – 1,440) 43 Females 167 895 (829 – 967) 648 (588 – 704) 884 (823 – 958) 1,230 (1,130 – 1,470) Total, 20 years and older 20–39 years 858 (773 – 952) 616† (570 – 661) 857 (746 – 955) 1,230† (1,010 – 1,390) 68 56 40–59 years 923 (818 – 1,040) 679† (468 – 714) 912 (824 – 1,020) 1,230† (1,100 – 2,020) 1,220† 43 (1,130 – 1,490) 60 years and older 940 (889 – 995) 740† (715 – 762) 916 (809 – 1,040) † Estimate is subject to greater uncertainty due to small cell size. Table 2.32.a.5. Plasma arachidonic acid (20:4n-6): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 785 (752 – 795) 539 Total, 20 years and older 773 (767 – 807) 1,050 (1,010 – 1,100) 991 (497 – 569) 20–39 years 733 (711 – 755) 533 (490 – 569) 736 (706 – 766) 971 (929 – 1,060) 300 40–59 years (749 – 817) 531 (465 – 579) 800 (777 – 830) 1,040 (1,010 – 1,120) 279 782 60 years and older 815 (788 – 843) 562 (504 – 604) 839 (811 – 870) 1,110 (1,070 – 1,140) 412 Males 783 Total, 20 years and older 760 (733 – 788) 534 (488 – 558) (981 – 1,050) (752 – 810) 1,000 471 20–39 years 731 527 (480 – 562) 735 (698 – 771) 957 (899 – 1,160) 128 (702 – 762) 789 (786 – 863) 539 (476 – 569) 823 40–59 years 1,030 (997 – 1,160) 139 (748 – 832) 60 years and older (711 – 795) 524 (444 – 573) 769 (715 – 833) 998 (962 – 1,110) 204 752 Females Total, 20 years and older (761 – 811) 552 (500 – 583) 786 (769 – 816) 1,080 (1,040 – 1,160) 520 785 20–39 years 733 (701 – 768) 532 (432 – 583) 738 (699 – 768) 997 (920 – 1,150) 172 40–59 years 776 (722 – 835) 530 (403 – 598) 780 (726 – 858) 1,060 (991 – 1,240) 140 (1,120 – 1,200) 208 1,150 60 years and older 873 (841 – 905) 610 (541 – 665) 889 (857 – 916) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 275 275

287 991 375 609 863 515 943 310 682 size 1,806 Sample (133 – 177) (136 – 176) (110 – 193) (79.1 – 98.9) (136 – 199) (134 – 200) (114 – 247) (118 – 177) (139 – 207) 97.5th 152 151 156 134 146 156 175 141† 86.5† (101 – 142) (103 – 138) (103 – 150) (84.3 – 137) (69.0 – 86.4) (99.9 – 143) (95.3 – 169) (102 – 153) (111 – 162) 95th 112 113 121 106 114 113 111 132 77.1 (38.1 – 46.0) (37.6 – 43.8) (28.4 – 35.4) (37.6 – 45.1) (32.0 – 36.2) (41.0 – 48.3) (37.5 – 43.1) (33.0 – 41.6) (43.5 – 53.8) 50th 40.9 42.6 34.2 41.4 31.4 45.0 36.1 40.1 49.4 5th (14.9 – 20.8) (15.7 – 18.6) (15.5 – 20.1) (13.6 – 16.8) (7.53 – 15.3) (17.1 – 20.8) (15.2 – 18.3) (14.4 – 18.8) (11.8 – 23.1) Selected percentiles (95% conf. interval) 18.1 17.1 17.1 15.8 10.9 16.7 19.0 16.9 20.0 (11.8 – 16.1) (11.6 – 17.3) (11.2 – 16.9) (9.10 – 14.9) (6.03 – 10.9) (10.8 – 16.1) (14.6 – 17.4) (11.2 – 15.7) (7.79 – 19.9) 2.5th 15.8 14.8 15.7 13.5 17.1 14.1 15.3 8.80† 14.9† (39.8 – 47.7) (39.5 – 45.0) (28.7 – 33.5) (33.8 – 38.1) (39.8 – 46.6) (38.7 – 44.1) (41.8 – 49.5) (34.7 – 43.4) (43.3 – 54.4) 43.5 42.1 43.1 31.0 35.9 38.8 45.5 41.3 48.5 (95% conf. interval) Geometric mean † Estimate is subject to greater uncertainty due to small cell size. Total, 20 years and older Race/ethnicity Males Gender Non-Hispanic Whites Mexican Americans 20–39 years Age group 40–59 years Females Non-Hispanic Blacks 60 years and older Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Table 2.33.a.1. Plasma eicosapentaenoic acid (20:5n-3): Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 276 276

288 Figure 2.33.a. Plasma eicosapentaenoic acid (20:5n–3): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Overall Mexican Americans Females Males acid (μmol/L) 0 20 40 60 80 Plasma eicosapentaenoic 20−39 40−59 60+ 60+ 20−39 40−59 Non−Hispanic Blacks Non−Hispanic Whites acid (μmol/L) 0 20 40 60 80 Plasma eicosapentaenoic 60+ 40−59 60+ 40−59 20−39 20−39 Females Males Mexican Americans Non−Hispanic Blacks Non−Hispanic acid (μmol/L) Whites 0 20 40 60 80 Plasma eicosapentaenoic 60+ 60+ 40−59 20−39 20−39 40−59 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 277 277

289 Table 2.33.a.2. Plasma eicosapentaenoic acid (20:5n-3): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (39.5 – 45.0) 20.8 (18.9 – 22.2) 40.9 (37.6 – 43.8) 89.9 (80.0 – 99.9) 1,806 42.1 Total, 20 years and older 35.9 (33.8 – 38.1) 18.2 (16.7 – 20.2) 34.2 (32.0 – 36.2) 74.5 (64.8 – 94.2) 609 20–39 years 45.5 22.8 (19.4 – 26.2) 45.0 (41.0 – 48.3) 92.8 (81.5 – 103) 515 (41.8 – 49.5) 40–59 years 48.5 (43.3 – 54.4) 24.4 (15.6 – 29.1) 49.4 (43.5 – 53.8) 100 (90.6 – 116) 682 60 years and older Males (39.8 – 46.6) 43.1 (37.6 – 45.1) 21.0 (18.5 – 23.0) 41.4 Total, 20 years and older 92.8 (81.4 – 104) 863 20–39 years 38.7 18.7 (16.8 – 20.6) 36.1 (34.3 – 40.5) 86.1 (70.8 – 108) 281 (35.6 – 42.0) 40–59 years (42.5 – 52.7) 23.4 (20.8 – 26.6) 45.7 (40.0 – 48.9) 97.4 (82.2 – 136) 248 47.3 60 years and older 44.2 (38.7 – 50.5) 22.1 (10.4 – 27.5) 44.6 (38.7 – 51.3) 88.7 (74.8 – 109) 334 Females 943 41.3 (38.7 – 44.1) 20.4 (18.5 – 22.2) 40.1 (37.5 – 43.1) 86.3 (76.6 – 101) Total, 20 years and older 20–39 years 33.3 (30.9 – 36.0) 17.4 (15.8 – 19.8) 31.4 (30.1 – 34.1) 64.6 (56.5 – 80.8) 328 267 40–59 years 43.9 (40.1 – 48.1) 21.9 (17.2 – 27.5) 43.4 (40.3 – 47.8) 84.6 (76.6 – 100) 25.2 (94.5 – 134) 105 51.7 (21.5 – 29.7) (49.2 – 57.1) 348 60 years and older 52.4 (47.2 – 58.1) Table 2.33.a.3. Plasma eicosapentaenoic acid (20:5n-3): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample Selected percentile s (95% conf. interval) 90th 10th 50th (95% conf. interval) size Males and Females 31.0 (28.7 – 33.5) 15.8 Total, 20 years and older 31.4 (28.4 – 35.4) 63.8 (58.1 – 70.0) 375 (11.1 – 18.4) 20–39 years 28.0 (24.9 – 31.4) 15.4 (8.96 – 18.3) 28.3 (21.7 – 35.1) 59.1 (50.9 – 68.1) 132 40–59 years (30.7 – 41.0) 17.0† (12.2 – 19.0) 35.9 (31.0 – 40.8) 76.2† (56.8 – 91.5) 93 35.5 60 years and older 38.2 (35.8 – 40.7) 17.9 (12.9 – 21.6) 40.5 (34.3 – 43.5) 72.9 (61.1 – 95.6) 150 Males 68.9 Total, 20 years and older 33.1 (29.9 – 36.8) 16.4 (15.5 – 18.4) (29.0 – 37.9) 34.3 (60.4 – 77.9) 188 20–39 years 30.6 16.1† (9.95 – 18.9) 29.4 (22.2 – 40.7) 63.9† (50.2 – 78.0) 67 (25.4 – 36.8) 39.3 (30.0 – 51.3) 16.2† (11.8 – 22.3) 37.6 40–59 years 82.2† (66.1 – 180) 48 (31.6 – 48.8) 60 years and older (29.9 – 37.8) 16.0† (12.8 – 18.3) 34.4 (24.2 – 43.5) 56.5† (48.9 – 161) 73 33.6 Females Total, 20 years and older (24.9 – 32.8) 13.8 (7.13 – 18.3) 29.1 (23.4 – 35.1) 60.2 (49.1 – 76.5) 187 28.6 20–39 years 24.8 (20.1 – 30.7) 10.8† (6.03 – 18.2) 23.5 (19.9 – 31.6) 53.1† (39.3 – 90.1) 65 40–59 years 31.6 (27.4 – 36.4) 17.1† (8.81 – 19.8) 31.3 (26.8 – 37.9) 55.9† (46.3 – 84.0) 45 85.0† (63.7 – 147) 77 43.3 (8.91 – 26.3) 22.2† (38.1 – 49.3) 60 years and older 42.9 (36.7 – 50.1) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 278 278

290 Table 2.33.a.4. Plasma eicosapentaenoic acid (20:5n-3): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (34.7 – 43.4) 19.9 (17.5 – 21.2) 36.1 (33.0 – 41.6) 80.3 (64.8 – 121) 310 38.8 Total, 20 years and older 33.9 (28.3 – 40.8) 17.9 (15.0 – 20.1) 32.6 (25.1 – 40.6) 64.8 (53.4 – 253) 126 20–39 years 42.9 20.8† (16.4 – 24.8) 39.9 (35.3 – 44.2) 96.3† (72.1 – 147) 98 (37.2 – 49.6) 40–59 years 46.0 (39.2 – 53.9) 27.2† (19.4 – 30.4) 44.5 (36.2 – 51.1) 88.6† (64.3 – 209) 86 60 years and older Males (34.4 – 46.2) 39.9 (32.4 – 41.6) 18.9 (15.3 – 22.2) 35.5 Total, 20 years and older 106 (70.6 – 134) 143 20–39 years 34.9 16.6† (12.9 – 19.5) 33.3 (24.6 – 43.0) 64.8† (51.9 – 150) 58 (26.9 – 45.3) 40–59 years (37.5 – 52.5) 21.0† (17.3 – 26.5) 36.0 (30.8 – 50.1) 117† (79.5 – 206) 42 44.4 60 years and older 48.4 (34.5 – 67.7) 26.1† (7.52 – 32.4) 44.4 (35.0 – 59.2) 102† (61.1 – 209) 43 Females 167 38.0 (34.0 – 42.4) 20.1 (18.5 – 21.4) 36.2 (30.4 – 43.9) 71.2 (61.3 – 105) Total, 20 years and older 20–39 years 33.2 (27.9 – 39.5) 18.6† (13.2 – 20.4) 29.7 (25.6 – 35.7) 64.3† (44.7 – 253) 68 56 40–59 years 41.8 (34.9 – 50.2) 19.8† (12.6 – 25.5) 41.3 (35.8 – 46.4) 71.2† (64.0 – 193) 75.9† 43 (62.8 – 104) 60 years and older 44.5 (39.7 – 50.0) 25.5† (20.0 – 30.5) 44.1 (35.2 – 51.1) † Estimate is subject to greater uncertainty due to small cell size. Table 2.33.a.5. Plasma eicosapentaenoic acid (20:5n-3): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 42.6 (39.8 – 47.7) 21.9 Total, 20 years and older 43.5 (38.1 – 46.0) 90.5 (78.4 – 102) 991 (18.6 – 24.7) 20–39 years 37.5 (34.3 – 41.0) 20.4 (16.3 – 21.9) 35.3 (32.0 – 38.3) 74.7 (63.8 – 110) 299 40–59 years (41.5 – 50.6) 23.9 (18.8 – 27.7) 45.2 (40.5 – 48.7) 89.0 (78.7 – 101) 280 45.8 60 years and older 49.0 (42.5 – 56.5) 23.5 (11.7 – 29.6) 49.9 (44.2 – 54.8) 101 (91.7 – 117) 412 Males 43.1 Total, 20 years and older 44.3 (40.1 – 48.9) 21.9 (17.3 – 25.8) (78.2 – 105) (37.6 – 47.6) 89.8 471 20–39 years 40.1 20.6 (16.9 – 22.7) 37.8 (34.8 – 42.9) 89.0 (67.8 – 119) 127 (35.9 – 44.7) 48.0 (40.0 – 50.2) 25.1 (20.7 – 27.5) 47.3 40–59 years 92.4 (80.9 – 140) 140 (42.2 – 54.6) 60 years and older (38.0 – 51.6) 21.8 (10.3 – 28.6) 44.8 (37.6 – 52.3) 87.2 (75.6 – 105) 204 44.3 Females Total, 20 years and older (39.0 – 47.2) 21.8 (18.3 – 24.6) 42.0 (37.9 – 45.6) 91.3 (76.7 – 104) 520 42.9 20–39 years 35.4 (31.7 – 39.4) 18.2 (15.8 – 21.9) 31.9 (30.2 – 37.0) 68.2 (54.3 – 112) 172 40–59 years 43.8 (39.1 – 48.9) 22.3 (12.3 – 30.0) 43.3 (37.8 – 48.4) 81.0 (74.2 – 100) 140 (96.5 – 138) 208 110 60 years and older 53.5 (46.4 – 61.6) 24.6 (18.7 – 30.9) 53.5 (49.3 – 59.7) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 279 279

291 992 610 376 865 515 943 310 683 size 1,808 Sample (45.4 – 53.5) (44.5 – 56.1) (42.8 – 58.0) (44.6 – 58.2) (48.0 – 66.9) (44.8 – 56.3) (45.0 – 63.4) (46.1 – 72.9) (44.7 – 49.5) 97.5th 47.7 47.2 46.8 47.1 50.0 48.0 47.1 58.5† 50.4† (41.6 – 44.7) (38.8 – 46.0) (45.9 – 53.3) (41.0 – 44.9) (41.4 – 45.9) (42.0 – 46.7) (42.1 – 46.2) (39.6 – 45.3) (39.6 – 44.7) 95th 43.0 41.1 47.3 42.4 44.5 45.0 43.7 41.9 42.2 (95% conf. interval) s (24.1 – 25.6) (24.3 – 26.1) (25.1 – 29.6) (23.1 – 24.9) (24.3 – 26.8) (24.3 – 26.6) (23.6 – 25.6) (23.9 – 25.6) (24.5 – 26.6) 50th 24.7 27.4 23.9 25.0 25.0 25.8 24.5 25.7 24.6 Selected percentile (13.3 – 14.9) (13.5 – 14.9) (12.9 – 16.6) (13.1 – 15.0) (13.0 – 15.1) (12.0 – 15.4) (13.2 – 16.7) (12.9 – 15.8) (13.0 – 15.1) 5th 14.4 15.8 14.5 14.3 14.3 14.3 15.0 14.8 14.5 (10.4 – 13.1) (9.72 – 13.1) (11.2 – 15.6) (10.4 – 13.8) (9.11 – 15.0) (9.93 – 13.9) (9.62 – 12.9) (10.0 – 13.5) (9.34 – 14.4) 2.5th 12.1 12.2 11.8 12.2 11.2 12.1 12.6 13.1† 13.4† n (24.4 – 25.6) (25.6 – 29.5) (24.4 – 26.2) (23.4 – 25.4) (24.0 – 25.5) (24.5 – 26.4) (25.1 – 26.8) (23.9 – 25.6) (24.6 – 26.0) 25.0 25.3 24.4 27.5 24.7 26.0 25.5 24.8 25.3 (95% conf. interval) Geometric mea † Estimate is subject to greater uncertainty due to small cell size. Total, 20 years and older Age group Race/ethnicity Males Gender Mexican Americans 20–39 years Females Non-Hispanic Blacks 40–59 years Non-Hispanic Whites 60 years and older Health and Nutrition Examination Survey, 2003–2004. Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Table 2.34.a.1. Plasma docosatetraenoic acid (22:4n-6): Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 280 280

292 Figure 2.34.a. Plasma docosatetraenoic acid (22:4n–6): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Overall Mexican Americans Females Males acid (μmol/L) 0 10 20 30 40 Plasma docosatetraenoic 20−39 40−59 60+ 60+ 20−39 40−59 Non−Hispanic Blacks Non−Hispanic Whites acid (μmol/L) 0 10 20 30 40 Plasma docosatetraenoic 60+ 40−59 60+ 40−59 20−39 20−39 Females Males Mexican Americans Non−Hispanic Blacks Non−Hispanic acid (μmol/L) Whites 0 10 20 30 40 Plasma docosatetraenoic 60+ 60+ 40−59 20−39 20−39 40−59 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 281281

293 Table 2.34.a.2. Plasma docosatetraenoic acid (22:4n-6): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (24.4 – 25.6) 16.8 (15.7 – 17.4) 24.7 (24.1 – 25.6) 37.7 (36.7 – 39.4) 1,808 25.0 Total, 20 years and older 24.4 (23.4 – 25.4) 16.7 (15.0 – 17.5) 23.9 (23.1 – 24.9) 37.1 (34.7 – 39.1) 610 20–39 years 25.5 17.0 (14.8 – 18.0) 25.0 (24.3 – 26.6) 39.4 (37.4 – 41.6) 515 (24.5 – 26.4) 40–59 years 25.3 (24.6 – 26.0) 16.7 (16.0 – 17.5) 25.7 (24.5 – 26.6) 37.0 (36.3 – 38.3) 683 60 years and older Males (24.4 – 26.2) 25.3 (24.3 – 26.1) 16.9 (15.8 – 18.0) 25.0 Total, 20 years and older 38.2 (36.5 – 40.0) 865 20–39 years 25.2 17.1 (14.8 – 18.7) 24.5 (23.6 – 26.1) 38.3 (35.5 – 40.8) 282 (23.8 – 26.6) 40–59 years (24.9 – 27.3) 17.3 (14.7 – 19.5) 25.9 (24.5 – 27.9) 39.8 (36.8 – 43.7) 248 26.1 60 years and older 24.1 (22.9 – 25.3) 16.0 (14.8 – 16.8) 24.3 (22.5 – 26.5) 35.9 (34.2 – 37.6) 335 Females 943 24.7 (24.0 – 25.5) 16.5 (15.4 – 17.4) 24.5 (23.6 – 25.6) 37.5 (36.0 – 40.6) Total, 20 years and older 20–39 years 23.6 (22.5 – 24.8) 15.8 (14.4 – 17.1) 23.1 (21.3 – 24.7) 35.9 (32.7 – 38.8) 328 267 40–59 years 24.9 (23.4 – 26.5) 15.6 (14.5 – 17.5) 24.6 (23.4 – 26.4) 38.3 (35.3 – 43.3) 17.6 (36.3 – 43.9) (24.9 – 27.8) 26.2 (16.4 – 18.5) 38.3 348 60 years and older 26.3 (25.1 – 27.6) Table 2.34.a.3. Plasma docosatetraenoic acid (22:4n-6): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 27.4 (25.6 – 29.5) 17.9 Total, 20 years and older 27.5 (25.1 – 29.6) 43.1 (40.6 – 46.6) 376 (15.5 – 19.6) 20–39 years 26.3 (24.0 – 28.8) 16.4 (12.1 – 19.5) 26.1 (21.9 – 29.9) 41.1 (36.6 – 47.8) 132 40–59 years (26.8 – 31.6) 18.2† (13.2 – 20.2) 28.4 (26.2 – 31.2) 45.6† (42.2 – 59.9) 93 29.1 60 years and older 30.5 (29.3 – 31.8) 20.6 (17.6 – 22.4) 30.2 (28.3 – 32.1) 43.6 (40.4 – 48.5) 151 Males (24.4 – 31.1) Total, 20 years and older 27.7 (25.0 – 30.8) 18.4 27.3 (13.6 – 20.3) 41.5 (39.1 – 48.7) 189 20–39 years 26.9 18.5† (12.6 – 20.7) 26.2 (22.5 – 29.9) 40.4† (36.1 – 58.6) 67 (23.6 – 30.6) 29.1 (25.3 – 33.8) 17.9† (13.8 – 21.3) 28.3 40–59 years 44.6† (37.0 – 63.5) 48 (24.5 – 34.6) 60 years and older (26.2 – 32.9) 18.8† (17.0 – 21.2) 28.5 (24.6 – 34.1) 45.0† (37.4 – 67.2) 74 29.4 Females Total, 20 years and older (24.6 – 30.1) 16.9 (11.4 – 19.7) 27.6 (23.8 – 30.3) 43.5 (40.3 – 50.5) 187 27.2 20–39 years 25.5 (22.2 – 29.2) 15.6† (11.2 – 18.0) 25.1 (20.0 – 32.3) 42.9† (34.4 – 58.4) 65 40–59 years 29.0 (25.6 – 32.9) 18.5† (13.2 – 21.6) 27.2 (23.7 – 31.6) 45.8† (42.0 – 61.3) 45 (36.9 – 66.9) 77 31.1 (17.8 – 25.8) (29.8 – 33.2) 20.8† 41.7† 60 years and older 31.6 (30.2 – 33.1) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 282 282

294 Table 2.34.a.4. Plasma docosatetraenoic acid (22:4n-6): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (25.1 – 26.8) 17.4 (15.5 – 18.7) 25.8 (24.3 – 26.8) 38.6 (37.0 – 41.1) 310 26.0 Total, 20 years and older 25.3 (24.1 – 26.4) 17.5 (14.8 – 18.9) 24.0 (22.6 – 26.3) 37.8 (34.6 – 44.2) 126 20–39 years 27.2 17.4† (14.3 – 19.8) 26.7 (24.7 – 28.2) 41.1† (38.8 – 46.3) 98 (25.0 – 29.5) 40–59 years 25.6 (22.9 – 28.6) 16.8† (9.11 – 20.5) 25.8 (24.0 – 29.4) 35.7† (33.3 – 40.3) 86 60 years and older Males (24.6 – 28.9) 26.7 (23.0 – 29.1) 17.5 (13.0 – 19.5) 25.8 Total, 20 years and older 41.6 (38.0 – 46.0) 143 20–39 years 25.7 17.5† (11.3 – 19.7) 23.8 (21.7 – 27.5) 39.9† (34.0 – 75.9) 58 (24.1 – 27.5) 40–59 years (24.8 – 33.0) 18.0† (12.7 – 20.7) 26.9 (23.7 – 30.4) 41.9† (36.6 – 96.8) 42 28.6 60 years and older 25.6 (20.3 – 32.3) 15.3† (9.11 – 23.9) 26.0 (24.1 – 31.6) 37.0† (32.0 – 47.5) 43 Females 167 25.4 (24.0 – 27.0) 17.3 (15.1 – 18.7) 25.6 (23.6 – 27.2) 36.4 (34.4 – 40.4) Total, 20 years and older 20–39 years 24.9 (23.1 – 26.8) 17.5† (13.4 – 19.2) 24.5 (22.3 – 27.7) 35.9† (30.8 – 46.3) 68 56 40–59 years 26.1 (22.7 – 30.1) 15.6† (13.4 – 20.0) 26.6 (22.7 – 27.9) 39.1† (31.1 – 118) 35.5† 43 (32.5 – 36.6) 60 years and older 25.6 (23.6 – 27.6) 17.5† (13.4 – 21.3) 25.1 (23.5 – 27.4) † Estimate is subject to greater uncertainty due to small cell size. Table 2.34.a.5. Plasma docosatetraenoic acid (22:4n-6): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 24.6 (23.9 – 25.6) 16.8 Total, 20 years and older 24.8 (23.9 – 25.6) 36.8 (35.3 – 37.9) 992 (15.6 – 17.5) 20–39 years 24.1 (22.8 – 25.6) 16.4 (14.6 – 17.6) 23.8 (22.9 – 24.9) 35.5 (32.1 – 39.6) 300 40–59 years (23.5 – 26.6) 17.2 (14.5 – 18.6) 24.7 (23.6 – 26.5) 36.8 (34.8 – 41.3) 280 25.0 60 years and older 25.2 (24.3 – 26.0) 16.6 (15.6 – 17.4) 25.6 (24.1 – 27.0) 36.9 (36.3 – 38.2) 412 Males 24.7 Total, 20 years and older 24.9 (23.8 – 26.1) 16.9 (15.0 – 18.1) (35.1 – 38.3) (24.0 – 26.1) 36.7 472 20–39 years 24.8 17.0 (12.5 – 18.9) 24.3 (23.3 – 26.1) 36.3 (33.0 – 39.7) 128 (22.9 – 26.7) 25.8 (24.4 – 27.9) 17.8 (10.9 – 19.8) 25.2 40–59 years 36.9 (35.2 – 44.0) 140 (24.1 – 27.5) 60 years and older (22.5 – 25.4) 15.9 (14.5 – 16.8) 24.1 (22.1 – 26.6) 34.9 (33.5 – 37.2) 204 23.9 Females Total, 20 years and older (23.7 – 25.6) 16.6 (15.4 – 17.4) 24.4 (23.5 – 25.6) 36.9 (34.4 – 41.0) 520 24.6 20–39 years 23.6 (21.9 – 25.4) 15.8 (14.3 – 17.2) 23.0 (21.0 – 25.1) 34.6 (31.9 – 45.6) 172 40–59 years 24.4 (22.4 – 26.6) 15.9 (13.7 – 18.0) 24.3 (22.5 – 25.9) 35.5 (32.9 – 44.5) 140 (36.3 – 44.4) 208 38.7 60 years and older 26.3 (25.0 – 27.6) 17.3 (16.5 – 18.0) 26.2 (24.7 – 28.1) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 283 283

295 992 610 376 865 515 943 310 683 size 1,808 Sample (78.5 – 92.2) (75.5 – 92.7) (65.5 – 95.1) (78.7 – 97.2) (72.5 – 112) (75.5 – 89.8) (79.4 – 105) (67.0 – 108) (76.6 – 97.8) 97.5th 82.9 81.2 87.2 73.0 84.9 80.4 82.0 80.9† 85.0† (69.7 – 76.7) (58.0 – 73.3) (67.8 – 79.3) (68.1 – 81.6) (67.8 – 78.6) (62.0 – 80.1) (72.6 – 81.0) (70.7 – 81.9) (67.9 – 78.5) 95th 72.7 63.0 71.5 72.7 77.0 64.5 72.7 71.7 74.0 (95% conf. interval) s (40.0 – 42.8) (40.6 – 44.1) (36.4 – 44.1) (36.8 – 39.3) (36.2 – 40.0) (40.6 – 46.0) (38.8 – 42.0) (40.4 – 43.8) (42.8 – 49.1) 50th 41.4 40.0 38.0 42.5 43.2 38.1 40.6 45.7 42.2 Selected percentile (22.8 – 25.8) (24.7 – 27.1) (14.1 – 25.0) (20.9 – 24.4) (20.7 – 24.5) (20.6 – 26.9) (20.6 – 23.8) (23.6 – 28.5) (22.5 – 26.7) 5th 24.5 22.4 26.2 23.2 23.1 24.9 22.3 26.5 24.7 (17.2 – 23.8) (15.0 – 25.6) (12.1 – 22.3) (15.1 – 22.7) (17.5 – 21.5) (13.6 – 22.8) (13.5 – 24.3) (15.6 – 24.2) (11.7 – 26.7) 2.5th 22.1 20.0 24.2 20.5 22.2 22.8 24.5 16.9† 20.1† n (40.2 – 43.1) (37.2 – 42.9) (41.0 – 44.8) (37.1 – 39.0) (39.1 – 42.0) (41.1 – 45.3) (36.8 – 41.0) (40.1 – 44.1) (42.3 – 48.8) 41.6 42.8 38.1 39.9 40.5 38.9 43.1 42.1 45.5 (95% conf. interval) Geometric mea † Estimate is subject to greater uncertainty due to small cell size. Total, 20 years and older Age group Race/ethnicity Males Gender Mexican Americans 20–39 years Females Non-Hispanic Blacks 40–59 years Non-Hispanic Whites 60 years and older Health and Nutrition Examination Survey, 2003–2004. Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Table 2.35.a.1. Plasma docosapentaenoic-3 acid (22:5n-3): Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 284 284

296 Figure 2.35.a. Plasma docosapentaenoic−3 acid (22:5n–3): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Overall Mexican Americans Females Males acid (μmol/L) 0 20 40 60 Plasma docosapentaenoic−3 40−59 60+ 20−39 20−39 40−59 60+ Non−Hispanic Blacks Non−Hispanic Whites acid (μmol/L) Plasma docosapentaenoic−3 20−39 40−59 60+ 20−39 60+ 40−59 Males Females Mexican Americans Non−Hispanic Blacks Non−Hispanic Whites acid (μmol/L) 0 20 40 60 0 20 40 60 Plasma docosapentaenoic−3 60+ 20−39 40−59 60+ 20−39 40−59 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 285 285

297 Table 2.35.a.2. Plasma docosapentaenoic-3 acid (22:5n-3): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (40.2 – 43.1) 27.4 (26.2 – 28.4) 41.4 (40.0 – 42.8) 62.3 (60.4 – 65.4) 1,808 41.6 Total, 20 years and older 38.1 (37.1 – 39.0) 26.1 (24.8 – 26.7) 38.0 (36.8 – 39.3) 54.8 (52.4 – 59.9) 610 20–39 years 43.1 27.6 (26.0 – 29.8) 43.2 (40.6 – 46.0) 65.2 (61.6 – 69.7) 515 (41.1 – 45.3) 40–59 years 45.5 (42.3 – 48.8) 29.6 (25.8 – 33.7) 45.7 (42.8 – 49.1) 67.6 (63.0 – 72.4) 683 60 years and older Males (41.0 – 44.8) 42.8 (40.6 – 44.1) 28.8 (26.9 – 30.4) 42.5 Total, 20 years and older 63.7 (60.0 – 68.0) 865 20–39 years 40.8 27.3 (25.6 – 29.1) 40.5 (38.5 – 42.9) 59.1 (54.0 – 66.2) 282 (39.1 – 42.6) 40–59 years (41.9 – 48.0) 30.2 (28.4 – 31.6) 44.2 (40.7 – 47.8) 68.0 (63.3 – 77.9) 248 44.9 60 years and older 43.1 (39.2 – 47.4) 28.7 (23.4 – 33.1) 42.9 (40.9 – 47.2) 60.3 (58.1 – 66.1) 335 Females 943 40.5 (39.1 – 42.0) 26.2 (24.8 – 27.4) 40.6 (38.8 – 42.0) 61.4 (59.9 – 65.0) Total, 20 years and older 20–39 years 35.6 (34.4 – 36.7) 23.9 (22.8 – 25.7) 35.8 (34.2 – 37.7) 50.4 (48.4 – 56.6) 328 267 40–59 years 41.6 (39.3 – 44.1) 26.1 (23.1 – 27.7) 41.9 (39.3 – 44.7) 61.2 (58.6 – 71.2) 30.0 (67.7 – 74.5) 70.1 48.0 (26.8 – 34.2) (44.5 – 50.6) 348 60 years and older 47.5 (44.8 – 50.3) Table 2.35.a.3. Plasma docosapentaenoic-3 acid (22:5n-3): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample Selected percentile s (95% conf. interval) 90th 10th 50th (95% conf. interval) size Males and Females 39.9 (37.2 – 42.9) 25.9 Total, 20 years and older 40.0 (36.4 – 44.1) 61.2 (57.8 – 67.9) 376 (20.2 – 29.5) 20–39 years 36.9 (33.4 – 40.7) 24.4 (15.2 – 27.2) 36.8 (34.2 – 39.9) 54.9 (50.1 – 75.1) 132 40–59 years (39.4 – 50.3) 27.8† (25.5 – 30.9) 44.9 (39.4 – 48.2) 69.4† (58.3 – 127) 93 44.5 60 years and older 46.5 (45.2 – 47.9) 30.5 (25.7 – 35.6) 46.6 (44.5 – 50.8) 67.4 (57.5 – 80.9) 151 Males 67.4 Total, 20 years and older 41.6 (37.6 – 46.0) 26.8 (22.1 – 30.9) (36.3 – 46.4) 40.5 (59.1 – 74.5) 189 20–39 years 38.9 25.4† (15.2 – 30.7) 37.2 (35.5 – 40.8) 60.5† (52.3 – 73.1) 67 (34.0 – 44.4) 47.3 (33.3 – 60.1) 29.4† (26.2 – 31.9) 46.6 40–59 years 76.8† (55.8 – 127) 48 (37.9 – 59.0) 60 years and older (40.8 – 48.0) 27.9† (20.5 – 32.2) 46.4 (40.6 – 50.0) 63.3† (55.2 – 83.1) 74 44.3 Females Total, 20 years and older (34.6 – 41.6) 24.3 (13.1 – 29.6) 39.2 (34.1 – 44.9) 57.5 (52.2 – 60.8) 187 38.0 20–39 years 34.3 (29.6 – 39.9) 20.0† (12.1 – 28.3) 35.3 (30.6 – 41.1) 50.6† (47.1 – 85.4) 65 40–59 years 41.6 (38.4 – 45.0) 25.9† (17.2 – 32.5) 41.5 (36.9 – 47.2) 60.2† (55.9 – 74.8) 45 69.2† (57.4 – 90.2) 77 50.2 (27.6 – 39.2) 31.5† (44.4 – 52.9) 60 years and older 48.7 (45.6 – 52.0) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 286 286

298 Table 2.35.a.4. Plasma docosapentaenoic-3 acid (22:5n-3): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (36.8 – 41.0) 25.6 (24.6 – 26.5) 38.1 (36.2 – 40.0) 59.3 (55.1 – 62.4) 310 38.9 Total, 20 years and older 36.0 (32.7 – 39.5) 24.3 (21.5 – 25.8) 35.2 (32.0 – 38.1) 54.6 (48.6 – 63.5) 126 20–39 years 41.1 26.6† (24.3 – 28.0) 40.0 (35.2 – 44.2) 60.3† (57.2 – 84.5) 98 (37.4 – 45.2) 40–59 years 43.0 (40.4 – 45.8) 30.5† (21.3 – 34.2) 43.0 (39.5 – 47.7) 60.6† (54.6 – 63.6) 86 60 years and older Males (38.5 – 43.2) 40.8 (37.7 – 41.4) 26.1 (24.7 – 29.2) 38.7 Total, 20 years and older 60.2 (58.8 – 69.2) 143 20–39 years 38.1 25.3† (20.3 – 28.5) 37.7 (32.3 – 39.9) 59.8† (44.2 – 131) 58 (33.8 – 43.0) 40–59 years (41.7 – 45.1) 28.4† (24.7 – 30.5) 40.3 (38.6 – 42.1) 68.5† (57.2 – 108) 42 43.4 60 years and older 44.4 (41.1 – 48.0) 31.7† (17.8 – 36.7) 44.9 (40.9 – 50.5) 60.5† (58.2 – 64.6) 43 Females 167 37.4 (35.0 – 40.1) 24.4 (22.4 – 26.2) 36.8 (34.3 – 40.1) 54.4 (51.8 – 62.5) Total, 20 years and older 20–39 years 34.3 (31.2 – 37.7) 21.9† (18.8 – 25.8) 33.5 (28.9 – 38.8) 53.0† (45.4 – 64.5) 68 56 40–59 years 39.5 (33.5 – 46.5) 23.9† (20.6 – 27.1) 39.3 (33.9 – 44.8) 58.0† (48.6 – 148) 56.6† 43 (52.5 – 70.1) 60 years and older 42.2 (39.0 – 45.7) 29.5† (25.6 – 34.3) 41.7 (37.8 – 47.7) † Estimate is subject to greater uncertainty due to small cell size. Table 2.35.a.5. Plasma docosapentaenoic-3 acid (22:5n-3): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 42.2 (40.1 – 44.1) 27.7 Total, 20 years and older 42.1 (40.4 – 43.8) 62.8 (60.0 – 67.4) 992 (26.1 – 29.0) 20–39 years 38.8 (37.5 – 40.2) 26.7 (24.8 – 28.1) 38.8 (36.8 – 41.0) 54.7 (52.1 – 61.5) 300 40–59 years (40.1 – 45.7) 27.6 (24.8 – 30.1) 43.3 (39.7 – 47.0) 63.6 (60.8 – 68.0) 280 42.8 60 years and older 45.6 (41.8 – 49.8) 29.5 (25.0 – 33.7) 45.8 (42.5 – 50.1) 68.0 (64.1 – 73.0) 412 Males 43.1 Total, 20 years and older 43.1 (40.7 – 45.6) 29.2 (26.9 – 31.2) (59.6 – 66.9) (40.6 – 45.3) 63.0 472 20–39 years 41.5 27.5 (26.4 – 29.3) 42.3 (39.1 – 44.4) 56.4 (53.0 – 72.1) 128 (39.4 – 43.6) 44.5 (39.7 – 48.3) 30.8 (27.1 – 32.2) 44.2 40–59 years 66.1 (61.6 – 75.0) 140 (41.1 – 48.2) 60 years and older (38.4 – 48.1) 29.5 (14.9 – 33.9) 42.7 (39.7 – 47.5) 60.2 (57.3 – 70.0) 204 43.0 Females Total, 20 years and older (39.3 – 43.1) 26.5 (24.5 – 28.2) 41.3 (38.8 – 43.0) 62.4 (59.2 – 71.1) 520 41.2 20–39 years 36.6 (34.7 – 38.6) 24.8 (22.8 – 28.3) 36.8 (34.2 – 38.5) 50.0 (46.5 – 61.2) 172 40–59 years 41.1 (38.0 – 44.6) 26.0 (22.3 – 27.7) 42.0 (38.8 – 46.6) 60.1 (57.1 – 73.0) 140 (68.4 – 75.1) 208 72.4 60 years and older 48.0 (44.4 – 51.8) 29.5 (24.8 – 34.5) 48.4 (44.1 – 52.6) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 287 287

299 992 610 376 865 515 943 310 683 size 1,808 Sample (42.9 – 52.2) (40.7 – 51.4) (45.1 – 54.4) (38.6 – 45.2) (48.5 – 60.2) (46.4 – 59.0) (37.2 – 50.8) (45.0 – 63.2) (46.8 – 58.0) 97.5th 46.5 45.2 42.8 47.8 41.6 50.6 52.1 53.6† 50.6† (36.1 – 42.4) (35.5 – 46.3) (44.2 – 56.0) (32.2 – 40.5) (38.5 – 47.8) (40.4 – 50.4) (34.5 – 39.1) (37.9 – 48.4) (34.0 – 40.9) 95th 39.0 41.4 47.6 34.6 36.0 43.0 41.9 36.0 41.4 (95% conf. interval) s (18.6 – 20.1) (17.8 – 19.3) (19.7 – 27.1) (17.9 – 20.0) (19.7 – 22.4) (18.3 – 20.5) (19.2 – 21.7) (18.3 – 19.8) (19.5 – 21.5) 50th 19.3 22.8 18.8 18.6 19.0 20.8 20.5 20.5 18.9 Selected percentile (9.30 – 10.5) (8.83 – 10.4) (8.94 – 13.5) (9.25 – 11.1) (9.30 – 11.2) (7.79 – 11.1) (9.35 – 11.6) (8.26 – 10.8) (8.52 – 10.6) 5th 9.80 11.6 9.66 9.88 9.95 9.80 10.2 9.63 9.67 (7.60 – 9.46) (6.96 – 9.23) (6.86 – 11.5) (8.17 – 9.51) (5.89 – 10.3) (7.74 – 9.55) (4.40 – 9.67) (7.49 – 9.20) (5.88 – 8.84) 2.5th 8.56 9.15 8.11 8.92 8.37 8.15 8.00 10.4† 9.27† n (18.9 – 20.4) (21.0 – 26.2) (17.7 – 19.7) (18.6 – 20.5) (19.8 – 21.4) (18.4 – 20.4) (20.3 – 22.4) (18.3 – 19.9) (19.5 – 21.2) 19.6 18.6 19.5 23.5 20.6 21.3 19.4 19.1 20.3 (95% conf. interval) Geometric mea † Estimate is subject to greater uncertainty due to small cell size. Total, 20 years and older Age group Race/ethnicity Males Gender Mexican Americans 20–39 years Females Non-Hispanic Blacks 40–59 years Non-Hispanic Whites 60 years and older Health and Nutrition Examination Survey, 2003–2004. Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Table 2.36.a.1. Plasma docosapentaenoic-6 acid (22:5n-6): Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 288 288

300 Figure 2.36.a. Plasma docosapentaenoic−6 acid (22:5n–6): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Overall Mexican Americans Females Males acid (μmol/L) 0 10 20 30 40 Plasma docosapentaenoic−6 20−39 40−59 60+ 60+ 20−39 40−59 Non−Hispanic Blacks Non−Hispanic Whites acid (μmol/L) 0 10 20 30 40 Plasma docosapentaenoic−6 60+ 40−59 60+ 40−59 20−39 20−39 Females Males Mexican Americans Non−Hispanic Blacks Non−Hispanic Whites acid (μmol/L) 0 10 20 30 40 Plasma docosapentaenoic−6 60+ 60+ 40−59 20−39 20−39 40−59 Age (years) Age (years) 2. Fat-Soluble 1. Water Vitamins & Nutr -Soluble Vitamins ients 289 289

301 Table 2.36.a.2. Plasma docosapentaenoic-6 acid (22:5n-6): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (18.9 – 20.4) 11.8 (11.4 – 12.3) 19.3 (18.6 – 20.1) 32.5 (31.4 – 33.9) 1,808 19.6 Total, 20 years and older 19.5 (18.6 – 20.5) 11.8 (11.2 – 12.9) 18.8 (17.9 – 20.0) 32.4 (31.3 – 34.8) 610 20–39 years 19.4 11.5 (11.2 – 12.1) 19.0 (18.3 – 20.5) 31.8 (29.8 – 34.2) 515 (18.4 – 20.4) 40–59 years 20.3 (19.5 – 21.2) 12.2 (10.6 – 12.8) 20.5 (19.5 – 21.5) 33.2 (31.2 – 38.6) 683 60 years and older Males (17.7 – 19.7) 18.6 (17.8 – 19.3) 11.7 (11.0 – 12.3) 18.6 Total, 20 years and older 29.8 (28.8 – 32.1) 865 20–39 years 18.4 12.1 (10.8 – 13.1) 18.0 (17.1 – 18.7) 29.6 (27.2 – 33.4) 282 (17.3 – 19.6) 40–59 years (17.7 – 20.3) 11.8 (10.6 – 12.4) 19.0 (17.6 – 20.7) 29.4 (28.1 – 33.3) 248 19.0 60 years and older 18.4 (17.2 – 19.7) 10.4 (9.64 – 11.7) 18.7 (17.7 – 20.0) 31.2 (27.9 – 35.6) 335 Females 943 20.6 (19.8 – 21.4) 12.0 (11.3 – 12.7) 20.5 (19.2 – 21.7) 34.5 (33.0 – 36.6) Total, 20 years and older 20–39 years 20.6 (19.4 – 21.9) 11.6 (9.88 – 13.0) 20.5 (18.7 – 22.2) 35.0 (32.4 – 41.2) 328 267 40–59 years 19.8 (18.3 – 21.3) 11.3 (10.7 – 12.1) 19.1 (17.8 – 21.7) 34.3 (31.1 – 36.4) 13.7 (31.4 – 48.5) 35.5 22.0 (12.4 – 14.4) (20.7 – 23.1) 348 60 years and older 22.0 (20.7 – 23.3) Table 2.36.a.3. Plasma docosapentaenoic-6 acid (22:5n-6): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample Selected percentile s (95% conf. interval) 90th 10th 50th (95% conf. interval) size Males and Females 23.5 (21.0 – 26.2) 14.1 Total, 20 years and older 22.8 (19.7 – 27.1) 42.8 (38.9 – 46.1) 376 (11.5 – 15.0) 20–39 years 22.0 (19.6 – 24.8) 13.2 (9.09 – 14.9) 21.0 (18.0 – 25.7) 40.8 (33.5 – 45.8) 132 40–59 years (21.6 – 28.7) 14.2† (8.50 – 16.5) 24.7 (20.6 – 29.6) 43.8† (38.4 – 52.6) 93 24.9 60 years and older 28.5 (24.4 – 33.3) 17.8 (15.1 – 19.7) 28.2 (23.4 – 33.9) 45.1 (36.8 – 71.9) 151 Males 38.7 Total, 20 years and older 22.4 (19.8 – 25.4) 13.7 (10.4 – 15.7) (19.1 – 26.0) 21.2 (34.0 – 44.6) 189 20–39 years 21.1 13.3† (9.51 – 15.4) 19.8 (17.6 – 23.2) 33.4† (29.0 – 51.2) 67 (18.5 – 24.1) 24.1 (18.1 – 33.3) 13.8† (6.48 – 17.7) 24.5 40–59 years 42.5† (31.7 – 52.7) 48 (19.7 – 29.6) 60 years and older (22.9 – 31.2) 16.4† (12.7 – 19.2) 26.1 (20.7 – 33.2) 41.8† (35.3 – 56.1) 74 26.7 Females Total, 20 years and older (21.5 – 28.7) 14.1 (9.21 – 15.0) 24.5 (20.1 – 31.4) 44.7 (41.4 – 53.8) 187 24.8 20–39 years 23.4 (19.3 – 28.2) 12.0† (8.52 – 14.8) 22.1 (15.0 – 32.1) 45.5† (35.2 – 104) 65 40–59 years 25.8 (20.4 – 32.6) 14.4† (10.5 – 16.8) 24.6 (18.0 – 35.8) 43.5† (37.4 – 70.9) 45 48.8† (37.9 – 71.9) 77 28.8 (14.3 – 21.0) 19.5† (22.4 – 41.5) 60 years and older 30.3 (23.9 – 38.3) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 290 290

302 Table 2.36.a.4. Plasma docosapentaenoic-6 acid (22:5n-6): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Selected percentile s (95% conf. interval) Sample Geometric mea 50th 90th 10th (95% conf. interval) size Males and Females (20.3 – 22.4) 12.4 (10.4 – 13.5) 20.8 (19.7 – 22.4) 35.3 (33.3 – 41.5) 310 21.3 Total, 20 years and older 21.0 (19.2 – 22.8) 12.8 (11.7 – 13.4) 19.9 (18.3 – 23.5) 34.8 (31.5 – 50.8) 126 20–39 years 21.5 12.1† (9.42 – 13.5) 21.7 (19.7 – 22.6) 34.9† (30.5 – 44.0) 98 (19.4 – 23.7) 40–59 years 22.1 (18.4 – 26.6) 12.8† (5.89 – 14.9) 22.9 (17.6 – 28.4) 37.7† (32.6 – 45.7) 86 60 years and older Males (18.1 – 22.2) 20.0 (18.3 – 21.6) 11.7 (9.26 – 13.2) 19.8 Total, 20 years and older 34.8 (30.9 – 43.6) 143 20–39 years 18.8 11.4† (5.94 – 13.4) 18.9 (15.9 – 19.9) 32.8† (27.6 – 47.8) 58 (17.2 – 20.6) 40–59 years (18.2 – 25.1) 12.2† (9.72 – 13.8) 21.7 (18.1 – 23.2) 32.9† (27.0 – 89.5) 42 21.4 60 years and older 21.1 (15.6 – 28.7) 9.26† (5.89 – 15.5) 21.5 (16.0 – 31.7) 39.9† (32.2 – 50.3) 43 Females 167 22.4 (20.3 – 24.7) 13.0 (10.3 – 14.6) 22.0 (19.5 – 25.3) 35.3 (33.0 – 45.2) Total, 20 years and older 20–39 years 22.9 (19.3 – 27.2) 14.0† (9.93 – 16.1) 22.2 (18.4 – 27.0) 35.3† (31.8 – 100) 68 56 40–59 years 21.6 (18.7 – 24.9) 11.1† (8.75 – 13.5) 21.3 (18.9 – 26.4) 35.1† (28.2 – 99.4) 33.7† 43 (32.4 – 47.7) 60 years and older 22.8 (19.3 – 26.9) 13.0† (7.21 – 15.0) 23.2 (17.4 – 29.7) † Estimate is subject to greater uncertainty due to small cell size. Table 2.36.a.5. Plasma docosapentaenoic-6 acid (22:5n-6): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 18.9 (18.3 – 19.9) 11.7 Total, 20 years and older 19.1 (18.3 – 19.8) 31.1 (29.4 – 32.6) 992 (11.0 – 12.3) 20–39 years 19.0 (17.9 – 20.2) 11.6 (9.68 – 12.9) 18.5 (17.3 – 20.3) 31.3 (29.1 – 33.0) 300 40–59 years (17.3 – 20.3) 11.4 (10.1 – 12.6) 18.6 (17.6 – 19.6) 29.6 (27.6 – 33.3) 280 18.7 60 years and older 19.9 (19.2 – 20.6) 11.9 (10.4 – 12.8) 20.1 (19.3 – 21.3) 31.9 (30.5 – 35.2) 412 Males 18.3 Total, 20 years and older 18.0 (17.0 – 19.1) 11.4 (10.1 – 12.3) (26.7 – 30.8) (17.6 – 19.0) 28.3 472 20–39 years 17.7 11.5 (8.97 – 13.1) 17.5 (16.8 – 18.5) 27.4 (22.5 – 39.7) 128 (16.3 – 19.2) 18.3 (16.9 – 20.2) 11.6 (8.23 – 13.7) 18.8 40–59 years 28.7 (25.9 – 31.6) 140 (16.9 – 19.8) 60 years and older (16.8 – 19.5) 10.4 (9.64 – 11.7) 18.6 (16.9 – 20.4) 29.9 (26.7 – 33.1) 204 18.1 Females Total, 20 years and older (19.3 – 21.1) 12.1 (11.2 – 12.8) 20.2 (18.6 – 21.6) 32.9 (31.3 – 35.6) 520 20.2 20–39 years 20.3 (18.9 – 21.9) 11.5 (9.55 – 13.2) 20.5 (18.0 – 22.5) 32.6 (30.9 – 42.8) 172 40–59 years 19.2 (17.1 – 21.4) 11.4 (10.0 – 12.5) 18.4 (16.8 – 21.9) 32.3 (27.4 – 37.2) 140 (30.5 – 49.5) 208 33.6 60 years and older 21.5 (20.4 – 22.7) 13.5 (12.0 – 14.1) 21.6 (20.5 – 22.9) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 291 291

303 992 683 943 515 865 376 610 310 size 1,808 Sample (283 – 375) (315 – 385) (290 – 400) (277 – 368) (330 – 398) (218 – 342) (302 – 372) (275 – 484) (321 – 416) 97.5th 315 303 373 323 305 337 316 250† 348† (241 – 294) (191 – 251) (229 – 299) (237 – 303) (248 – 310) (268 – 358) (258 – 323) (228 – 316) (254 – 425) 95th 272 293 211 305 253 259 277 254 304 (107 – 123) (110 – 127) (114 – 128) (121 – 135) (99.8 – 123) (132 – 154) (111 – 136) (102 – 119) (118 – 152) 50th 121 142 127 121 111 117 114 111 133 5th (56.2 – 81.9) (56.2 – 65.2) (55.0 – 64.6) (53.8 – 65.6) (54.0 – 62.4) (56.1 – 72.0) (55.2 – 60.2) (53.6 – 62.5) (59.4 – 80.3) Selected percentiles (95% conf. interval) 73.5 58.8 57.9 59.5 61.1 60.6 65.2 58.1 72.5 (48.3 – 63.0) (50.2 – 58.3) (54.8 – 70.4) (46.4 – 58.0) (52.4 – 57.8) (49.3 – 55.7) (51.3 – 56.2) (45.5 – 57.3) (47.5 – 72.4) 2.5th 54.1 57.8 54.9 54.7 53.9 64.5 54.3 54.4† 64.9† (135 – 156) (105 – 119) (125 – 141) (115 – 136) (110 – 125) (113 – 130) (118 – 133) (108 – 122) (124 – 157) 125 117 133 145 125 111 122 115 140 (95% conf. interval) Geometric mean † Estimate is subject to greater uncertainty due to small cell size. Non-Hispanic Whites Females Males Gender Total, 20 years and older Race/ethnicity 60 years and older 40–59 years 20–39 years Age group Mexican Americans Non-Hispanic Blacks Health and Nutrition Examination Survey, 2003–2004. Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Table 2.37.a.1. Plasma docosahexaenoic acid (22:6n-3): Concentrations nd nd National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 292 292

304 Figure 2.37.a. Plasma docosahexaenoic acid (22:6n–3): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2004 Mexican Americans Overall 250 200 Females Males 150 100 acid (μmol/L) 50 0 Plasma docosahexaenoic 60+ 60+ 40−59 40−59 20−39 20−39 Non−Hispanic Blacks Non−Hispanic Whites 250 200 150 100 acid (μmol/L) 50 0 Plasma docosahexaenoic 40−59 20−39 60+ 20−39 60+ 40−59 Females Males 250 200 Mexican Americans 150 Non−Hispanic Blacks 100 Non−Hispanic acid (μmol/L) Whites 50 0 Plasma docosahexaenoic 60+ 20−39 40−59 60+ 40−59 20−39 Age (years) Age (years) 2. Fat-Soluble Vitamins & Nutrients 1. Water-Soluble Vitamins 293 293

305 Table 2.37.a.2. Plasma docosahexaenoic acid (22:6n-3): Total population Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for the fasted U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (118 – 133) 71.7 (67.1 – 74.9) 121 (114 – 128) 227 (208 – 244) 1,808 125 Total, 20 years and older 115 (108 – 122) 67.0 (62.3 – 71.6) 111 (102 – 119) 204 (187 – 234) 610 20–39 years 125 70.1 (62.3 – 77.7) 121 (111 – 136) 217 (201 – 244) 515 (115 – 136) 40–59 years 145 (135 – 156) 84.2 (73.5 – 94.3) 142 (132 – 154) 247 (234 – 268) 683 60 years and older Males (110 – 125) 117 (107 – 123) 67.9 (62.5 – 71.7) 114 Total, 20 years and older 206 (189 – 235) 865 20–39 years 107 62.3 (57.6 – 68.1) 102 (93.2 – 113) 186 (170 – 209) 282 (99.5 – 115) 40–59 years (110 – 135) 68.7 (61.4 – 74.4) 118 (106 – 135) 219 (189 – 296) 248 122 60 years and older 131 (119 – 143) 77.8 (53.6 – 92.8) 125 (117 – 142) 219 (194 – 256) 335 Females 943 133 (125 – 141) 75.6 (68.7 – 80.0) 127 (121 – 135) 238 (223 – 256) Total, 20 years and older 20–39 years 123 (115 – 133) 72.4 (61.8 – 78.6) 117 (110 – 127) 220 (194 – 283) 328 267 40–59 years 128 (117 – 138) 72.3 (59.3 – 79.4) 124 (112 – 143) 210 (201 – 256) 91.4 (249 – 307) 272 154 (82.5 – 99.1) (144 – 168) 348 60 years and older 158 (148 – 169) Table 2.37.a.3. Plasma docosahexaenoic acid (22:6n-3): Mexican Americans Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted Mexican Americans in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. Geometric mea n Sample Selected percentile s (95% conf. interval) 90th 10th 50th (95% conf. interval) size Males and Females 111 (105 – 119) 67.1 Total, 20 years and older 111 (99.8 – 123) 185 (165 – 199) 376 (57.8 – 73.0) 20–39 years 102 (91.1 – 114) 60.0 (55.3 – 67.6) 100 (80.6 – 122) 161 (150 – 204) 132 40–59 years (117 – 137) 84.9† (56.6 – 94.3) 125 (112 – 139) 189† (163 – 266) 93 127 60 years and older 129 (118 – 142) 81.2 (61.1 – 92.2) 131 (114 – 144) 202 (185 – 246) 151 Males 165 Total, 20 years and older 107 (99.7 – 114) 64.8 (55.1 – 69.2) (95.3 – 124) 104 (158 – 188) 189 20–39 years 96.1 59.4† (52.4 – 67.1) 99.4 (78.2 – 119) 147† (136 – 158) 67 (85.8 – 108) 129 (101 – 153) 83.3† (66.8 – 93.9) 127 40–59 years 194† (155 – 355) 48 (110 – 152) 60 years and older (109 – 132) 69.0† (46.1 – 90.1) 121 (105 – 143) 190† (159 – 272) 74 120 Females Total, 20 years and older (105 – 131) 68.8 (52.3 – 83.3) 116 (102 – 133) 191 (166 – 250) 187 118 20–39 years 110 (90.5 – 134) 60.4† (54.0 – 73.7) 109 (75.7 – 150) 191† (158 – 325) 65 40–59 years 124 (111 – 139) 87.9† (52.3 – 99.1) 119 (110 – 139) 173† (150 – 268) 45 229† (183 – 334) 77 133 (77.0 – 107) 88.9† (109 – 164) 60 years and older 139 (115 – 168) † Estimate is subject to greater uncertainty due to small cell size. nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 294 294

306 Table 2.37.a.4. Plasma docosahexaenoic acid (22:6n-3): Non-Hispanic blacks Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic blacks in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females (124 – 157) 83.4 (72.4 – 90.8) 133 (118 – 152) 251 (207 – 333) 310 140 Total, 20 years and older 128 (107 – 153) 77.2 (66.4 – 89.0) 119 (103 – 140) 237 (177 – 367) 126 20–39 years 142 84.1† (69.9 – 95.8) 133 (119 – 157) 234† (204 – 374) 98 (127 – 159) 40–59 years 173 (155 – 193) 117† (56.2 – 135) 173 (149 – 197) 258† (216 – 368) 86 60 years and older Males (114 – 147) 129 (110 – 145) 72.4 (60.4 – 82.2) 124 Total, 20 years and older 233 (198 – 361) 143 20–39 years 112 67.9† (52.5 – 76.1) 107 (84.5 – 140) 193† (143 – 367) 58 (89.9 – 141) 40–59 years (124 – 165) 77.8† (62.1 – 89.4) 131 (113 – 171) 283† (217 – 404) 42 143 60 years and older 161 (138 – 189) 113† (47.5 – 127) 159 (144 – 175) 251† (195 – 368) 43 Females 167 148 (129 – 171) 96.2 (80.8 – 104) 136 (120 – 176) 254 (203 – 442) Total, 20 years and older 20–39 years 142 (118 – 172) 93.1† (80.7 – 98.8) 127 (106 – 186) 254† (191 – 340) 68 56 40–59 years 141 (121 – 165) 90.3† (47.6 – 110) 132 (119 – 163) 208† (184 – 442) 258† 43 (222 – 351) 60 years and older 181 (162 – 201) 121† (63.8 – 136) 182 (149 – 213) † Estimate is subject to greater uncertainty due to small cell size. Table 2.37.a.5. Plasma docosahexaenoic acid (22:6n-3): Non-Hispanic whites Geometric mean and selected percentiles of plasma concentrations (in μmol/L) for fasted non-Hispanic whites in the U.S. population aged 20 years and older, National Health and Nutrition Examination Survey, 2003–2004. n Geometric mea Sample Selected percentile s (95% conf. interval) 50th 10th 90th (95% conf. interval) size Males and Females 117 (113 – 130) 69.8 Total, 20 years and older 122 (110 – 127) 215 (202 – 235) 992 (64.4 – 74.5) 20–39 years 111 (102 – 121) 65.2 (58.4 – 72.4) 110 (97.8 – 118) 201 (170 – 258) 300 40–59 years (108 – 130) 65.9 (55.3 – 75.7) 114 (106 – 128) 206 (181 – 252) 280 118 60 years and older 142 (131 – 155) 84.2 (67.8 – 95.3) 136 (125 – 154) 244 (233 – 266) 412 Males 112 Total, 20 years and older 113 (105 – 122) 65.3 (59.6 – 71.8) (178 – 229) (102 – 121) 198 472 20–39 years 102 60.8 (54.8 – 68.1) 96.1 (84.4 – 113) 180 (157 – 212) 128 (94.4 – 110) 115 (97.8 – 127) 64.9 (53.7 – 73.5) 113 40–59 years 194 (167 – 303) 140 (103 – 128) 60 years and older (116 – 142) 77.0 (49.3 – 93.0) 121 (113 – 141) 213 (188 – 254) 204 128 Females Total, 20 years and older (120 – 140) 74.4 (65.3 – 79.0) 124 (116 – 133) 229 (209 – 259) 520 130 20–39 years 121 (109 – 134) 72.4 (54.3 – 79.2) 114 (104 – 127) 204 (178 – 315) 172 40–59 years 122 (111 – 133) 68.0 (52.5 – 78.9) 120 (106 – 139) 207 (188 – 244) 140 (243 – 330) 208 274 60 years and older 156 (142 – 170) 89.5 (81.0 – 97.4) 150 (132 – 174) 1. Water-Soluble Vitamins 2. Fat-Soluble Vitamins & Nutrients 295 295

307 References Astrup Dyerberg J, Elwood P, Hermansen K, Hu FB, Jakobsen MU, et al . The role of reducing intakes of A, fat the prevention of cardiovascular disease: where does the evidence stand in 2010? Am J Clin Nutr. saturated in 2011;93:684–688. MA, Grundy SM, Becker D, Clark LT, Cooper RS, Denke et al . Executive summary of the Third Cleeman JI, of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and Report of high blood cholesterol in adults (Adult T reatment Panel III). JAMA. 2001;285(19):2486–2497 treatment WS, D, Rimm E, Kris-Etherton P, Rudel LL, Appel LJ, Mozaffarian et al . Omega-6 fatty acids and risk for Harris disease a science advisory from the cardiovascular Heart Association Nutrition Subcommittee of the American Nutrition, Physical Activity, and Metabolism; Council on Cardiovascular on and Council on Council Nursing; and Prevention. Circulation. 2009;119:902–907. Epidemiology L, Skeaff CM, Fielding BA. Fatty acid composition of adipose tissue and blood in humans and its use as a Hodson of dietary intake. Progress in Lipid Research. 2008;47:348–80. biomarker FB. Are refined carbohydrates worse than saturated fat? Am J Clin Nutr. 2010;91:1541-2. Hu intakes of Food and Nutrition Board. Dietary reference for energy, carbohydrate, fiber, fat, fatty Institute Medicine, cholesterol, protein, and amino acids. W ashington, D.C.: National Academy Press; 2005. acids, th Sciences Institute. 8 edition. Present Knowledge in Nutrition. W ashington, D.C.: ILSI Press; 2001. International Life MU, O’Reilly EJ, Heitmann BL, Pereira MA, Bälter K, Fraser GE, et al . Major types of dietary fat and Jakobsen 11 coronary heart disease: a pooled analysis of cohort studies. Am J Clin Nutr. 2009;89:1425–1432. risk of MU, Dethlefsen C, Joensen AM, Stegger J, Tjonneland A, Schmidt EB, Overvad K. Intake of Jakobsen of with intake carbohydrates saturated fatty acids and risk of myocardial infarction: importance of the compared Clin Am J glycemic Nutr. 2010; 91:1764–1768. index. Harris WS, Appel Kris-Etherton LJ, for the Nutrition PM, Committee. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation. 2002;106:2747–2757. Lagerstedt Hinrichs DR, Batt SM, Magera MJ, Rinaldo P, McConnell JP. Quantitative determination of SA, of plasma total fatty acids for the biochemical diagnosis C8-C26 nutritional and metabolic disorders. Mol Genet Metab. 2001;73:38–45. Lichtenstein AH. Fats and oils. In: Benjamin C, ed. Encyclopedia of Human Nutrition. Oxford: Elsevier 2005. pp.177–186. R, Mozaffarian D. Saturated fat and cardiometabolic risk factors, coronary heart Micha disease, stroke, and at diabetes: a fresh look the evidence. Lipids. 2010;45:893–905. Sun Q, Ma J, Campos H, Hankinson SE, Hu FB. Comparison between plasma and erythrocyte fatty acid content as of fatty acid intake in US women. Am J Clin Nutr. 2007;86:74–81. biomarkers of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Department U.S. th 2010. Edition, W ashington, DC: U.S. Government Printing Americans, Office, December 2010 [cited 2011]. 7 http://www.cnpp.usda.gov/DGAs2010-PolicyDocument.htm. Available at: National Institutes of Health. National Cancer U.S. Sources of Saturated Fat, Stearic Acid, & Cholesterol Institute. Raising Fat among the US Population, 2005–06. Risk Factor Monitoring and Methods Branch W eb site. Applied Research Updated December 21, 2010a. Available at: http://riskfactor.cancer.gov/diet/foodsources/ Program. sat_fat/. Sources National Institutes of U.S. National Cancer Institute. of Selected Fatty Acids among the US Health. Population, 2005–06. Risk Factor Monitoring and Methods Branch W eb site. Applied Research Program. Updated Available December 2010b. 21, at: http://riskfactor.cancer.gov/diet/foodsources/fatty_acids/. Zelman K. The great fat debate: A closer look at the controversy - Questioning the validity of age-old dietary 2011;111(5):655–658. oc. Ass Diet guidance. J Am nd nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 296 296

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310 3. Trace Elements Iron-Status Indicators • Ferritin Soluble transferrin receptor • • Body iron Iodine 3. Trace Elements 299

311 Iron-Status Indicators Background Information Iron Sources and Physiological Functions. as a component of proteins and enzymes. functions grams ds the ir on in the body (appr oximately 2.5 of of ir on) is found in hemoglobin, two-thir Almost in red blood cells that carries oxygen the tissues, and about 15% is in the myoglobin protein to muscle tissue. The average American diet provides 10–15 (mg) of iron daily in the of milligrams of heme and nonheme iron. Heme iron is found form in animal foods that originally contained myoglobin, such as red meat, fish, and poultry. Nonheme iron is found in plant hemoglobin and provided such lentils and beans, and also is as in iron-enriched and iron-fortified foods. foods, heme iron is absorbed better than nonheme iron, most Although iron is nonheme iron dietary Miret 2003 ). Each day the body absorbs approximately 1–2 mg of iron to compensate for the 1 ( 2 mg of iron that the (nonmenstruating) body loses ( Institute of Medicine 2001 ). The current to Dietary for Americans list iron as a nutrient of concern for specific population groups. Guidelines guidelines recommend that pregnant women an iron supplement, as recommended by an The take other health care provider ( or Department of Agriculture 2010 ). obstetrician U.S. T ransporting iron from one organ to another is accomplished by the reversible Health Effects. will iron to the transport protein, transferrin, which of then form a complex with a highly binding transferrin receptor (TfR) located on the plasma membrane surfaces of cells. Intracellular specific is regulated through the increased expression of cellular TfR concentration by iron- iron availability cells. Ferritin is the major iron-storage compound: its production increases in cells as iron deficient for The major supplies function of ferritin is to provide a store of iron which may be used increase. haem synthesis when required. Although all cells are of storing iron, the liver, spleen, and capable bone marrow cells are primary iron-storage sites in people ( Institute of Medicine 2001 ). Iron and iron overload are the two major disorders of iron metabolism. Iron-deficiency deficiency the anemia most severe form of iron deficiency. It is is linked to many adverse consequences of iron deficiency, such as reduced physical capacity ( Haas 2001 ) and poor pregnancy outcomes ( Schorr however, 1994 Iron deficiency with and without anemia, has been linked to negative effects ). on cognitive development among infants and adolescents ( Beard 1999; Grantham-McGregor iron 2001 Iron overload is the accumulation of excess ). in body tissues, and it usually occurs as a result of a genetic predisposition to absorb iron in excess of normal. However, it can also be caused excessive ingestion of iron supplements or multiple blood transfusions ( Pietrangelo by ). advanced stages of iron overload disease In (hemochromatosis), the iron accumulates in the 2004 cells of several organs, but particularly the liver, followed by the heart and pancreas; parenchymal dysfunction can lead to organ this and even death ( Pietrangelo 2004 ). condition age Recommended Dietary Allowance (RDA) for all The groups of Intake Recommendations. and postmenopausal women men is 8 mg per day; the RDA for premenopausal women is 18 mg per day. The T olerable Upper Uptake Level for adults is 45 mg per day of iron, a level based on gastrointestinal as an adverse effect ( Institute of Medicine 2001 ). distress very is present in the blood in Ferritin low concentrations. Biochemical Indicators and Methods. ferritin is Serum in equilibrium with tissue stores, and its concentration declines early in the development of iron deficiency. Low serum ferritin concentration thus is a sensitive indicator of ( iron deficiency, but it does not necessarily reflect the severity of the depletion as it progresses World Health Organization 2011 ). Ferritin is also an acute-phase protein; acute and chronic diseases can A review result in increased ferritin concentration, potentially masking an iron-deficiency diagnosis. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 300

312 article ser um ferritin written as par t of a 2004 WHO/ on T CDC Consultation on the Assessment of Iron echnical Population Level provides comprehensive Status the at this topic ( Worwood 2007 ). The information on ferritin value for serum below accepted generally cutoff stores are considered which be depleted is 15 iron to per milliliter (ng/mL) for people aged 5 years nanogram younger 12 ng/mL for people older than 5 years and and age ( World Health Organization 2001; W orld Health of ). Serum ferritin concentrations Organization 2011 200 for adult males and 150 ng/mL for above ng/mL represent considered to females severe risk of adult are 2001; World Health Organization ( W orld iron overload Organization 2011 ). Health TfR (sTfR) is the truncated form of the Soluble and TfR is cleaved that released membrane-bound the serum. The amount of into is proportional to sTfR of membrane-bound number sTfR circulates the TfR. to transferrin, and its concentration is not strongly affected by concurrent inflammation bound infection ( Beard 2007 ). Serum sTfR concentration increases when the iron functional pool is or and during activated erythropoiesis ( Kuiper-Kramer 1998 It continues to do so as the depleted ). iron-deficient erythropoiesis increases, reflecting the of increasing number of receptors on severity erythroid cells of the bone marrow. The measurement of sTfR is therefore a powerful tool for the the for iron deficiency or monitoring erythropoiesis. diagnosis of ferritin is the most sensitive index of iron status when there are residual iron stores, Serum sTfR is more sensitive when there is functional iron deficiency ( Skikne 1990 ). whereas serum is a close, linear relationship between the logarithm of the sTfR to serum ferritin ratio and There (body stored iron) expressed as mg per kg body weight ( Skikne 1990 ). Recently Cook et al. iron estimated in healthy persons body iron may be that from the ratio of sTfR to serum demonstrated ferritin (reported in microgram [μg]/mL for both assays) ( 2003 ). Body iron is in a positive balance there (≥ mg/kg) when there is residual storage iron or in a negative balance (< 0 mg/kg) when 0 is functional iron deficiency. The latter represents a in iron required to maintain a normal deficit hemoglobin concentration. The body iron methodology allows the full range of iron status of such populations be evaluated. Other iron status indicators, to as serum iron, total iron binding capacity, transferrin saturation, and erythrocyte protoporphyrin, were described in the previous not report of this series. They are included in the current report. for Clinical laboratories typically use conventional units iron-status indicators: ferritin is calculated nanograms per milliliter (ng/mL) and sTfR in milligrams per liter (mg/L). in to international system (SI) units Conversion as follows: 1 ng/mL = 2.247 factors picomole are (pmol)/L for ferritin and 1 mg/L 0.085 nanomole (nmol)/L for sTfR. = The most widely used methods to measure both serum ferritin and sTfR are immunoassay-based (ELISA, immunonephelometry) ( Worwood 2002a; W orwood 2002b ). A immuno-turbidimetry, United reference material from the WHO-supported Kingdom National Institute for international Biological Standards and Control (NIBSC) has been available for ferritin for several years (94/572); commercial it has helped to improve the comparability of kit assays. On the other hand, commercial and kit assays for sTfR produce different results, making the use of assay-specific reference intervals 3. Trace Elements 301

313 cutoff necessary ( Beard 2007 ). Recently, the WHO supported the development of a reference values for by the NIBSC, and material 07-202 was released in 2010. It is hoped that this reagent sTfR used by manufacturers to will standardize sTfR assays and promote the establishment of material be of to assess the iron status used populations ( Thorpe 2010 ). values cutoff Monitoring the iron status of the U.S. population has been an important Data in NHANES. since in the inception of NHANES 1971, and each NHANES has included a battery component Looker hematologic biochemical indicators of iron status ( and 1995 ). Since NHANES II (1976– of models that employ multiple biochemical iron-status indicators have been used to define 1980), deficiency in the population ( Pilch 1984 ). The ferritin model (also known as the three-indicator iron serum ferritin, transferrin saturation, using erythrocyte protoporphyrin, was developed model), and 1980 and applied to NHANES III (1988–1994) as well as to the first few years of the continuous in survey beginning in 1999. Prevalence estimates of iron deficiency using the three-indicator NHANES and were similar in NHANES III ( Looker 1997 ) in NHANES 1999–2000 ( Looker 2002 ). model in 2003, NHANES limited the population of interest to children (1–5 years) and women Starting age (12–49 years). Furthermore, the measurement of serum sTfR was introduced, of childbearing allows the evaluation of iron status by the body iron model developed by Cook et al. which 2003 Using data for children and non-pregnant women from NHANES 2003–2006, Cogswell ( ). al. compared the new body iron model to the previously used ferritin model ( 2009 ). The et fair the two models was agreement to good. Among non-pregnant women, the body iron between deficiency lower estimates of iron model prevalence and better predicted anemia. The produced affected body model appeared to be less iron by inflammation than the ferritin model. Two national health objectives that relate to iron deficiency reduction are part of the objectives for Healthy 2020: Objective NWS HP2020-21 (reduce iron deficiency among young children People NWS of childbearing age) and Objective and HP2020-22 (reduce iron deficiency among females pregnant females) ( http://www.healthypeople.gov/HP2020/ ). T o provide data for these objectives, status NHANES with periodic monitoring of iron continues in the population groups of interest. Ferritin and sTfR data presented in this report were generated by use of commercial assay kits. Serum (1999– ferritin was first measured by use of the BioRad QuantImune immunoradiometric assay 2003), by use of the Roche T inaQuant immunoturbidimetric assay on the Hitachi 912 clinical then (2004–2006). The public release data file for 2003–2004 has already been adjusted to the analyzer from assay. W e used adjustment equations provided in the analytical note for data 1999–2002 new the data comparable to make new assay ( http://www.cdc.gov/nchs/nhanes/nhanes2003-2004/ to the L06TFR_C.htm#Analytic_Notes Serum sTfR was measured with the Roche ). immunoturbidimetric assay on the Hitachi 912 clinical analyzer (2003–2006). W e calculated body iron by using the ( Cook 2003 ): body iron (mg/kg) = following -[log10 (sTfR * 1000 / ferritin) – 2.8229] formula / 0.1207. The sTfR concentration in this formula an adjusted concentration to make the represents Roche sTfR concentrations equivalent to the Flowers assay ( 1989 ) used in the development of the body model: Flowers sTfR = 1.5 * Roche sTfR + 0.35 mg/L ( Pfeiffer 2007 ). iron concentrations, the prevalence of low serum ferritin To we used the generally accepted estimate years cutoff above: 12 ng/mL for children 1-5 values of age and 15 ng/mL for women mentioned of childbearing age and males 6 years and older. T o estimate the prevalence of high serum ferritin above: concentrations, also used the cutoff values mentioned we 150 ng/mL for women 12-49 years of age and 200 ng/mL for men 12 years and older. Due to the lack of generally accepted cutoff to values for serum sTfR, we used the manufacturer provided assay-specific cutoff value of 4.4 mg/L in estimate the prevalence of high sTfR concentrations women of childbearing age. The prevalence population. the of low body iron (< 0 mg/kg) is indicative of the extent of iron deficiency in nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 302

314 For more information about iron TFFUIF*OTUJUVUFPG.FEJDJOFT%JFUBSZ3FGFSFODF*OUBLF *OTUJUVUFPG.FEJDJOF BOEGBDUTIFFUTGSPNUIF/BUJPOBM*OTUJUVUFTPG)FBMUI  SFQPSUT 0ïDFPG%JFUBSZ4VQQMFNFOUT IUUQPETPEOJIHPW)[email protected]*OGPSNBUJPO*[email protected]"[email protected] *[email protected]%[email protected]BTQY  Highlights 4FSVNDPODFOUSBUJPOTPGGFSSJUJOBOET5G3JOUIF64QPQVMBUJPOTIPXFEUIFGPMMPXJOH EFNPHSBQIJDQBUUFSOTBOEDIBSBDUFSJTUJDT t $IJMESFOIBEUIFMPXFTUGFSSJUJODPODFOUSBUJPOTBOEIJHIFTUT5G3DPODFOUSBUJPOT DPNQBSFEUPPUIFSBHFHSPVQT 3FHBSEMFTTPGUIFJOEJDBUPSTFMFDUFE TFSVNGFSSJUJO T5G3 PSCPEZJSPO UIFMJLFMJIPPE t PGCFJOHJSPOEFëDJFOUWBSJFECZSBDFFUIOJDHSPVQ 8IJMFDIJMESFOBOEXPNFOPGDIJMECFBSJOHBHFXFSFBUSJTLGPSJSPOEFëDJFODZ NFO t XFSFBUSJTLGPSJSPOFYDFTT /FXEBUBGSPN/)"/&4oBMMPXGPSUIFëSTUUJNFBTTFTTNFOUPGUIFJSPOTUBUVTPG DIJMESFOBOEXPNFOPGDIJMECFBSJOHBHFCZXBZPGBOFXJOEJDBUPS CPEZJSPO6TJOHUIFGFSSJUJO DPMMFBHVFT  TIPXFE NPEFMJO/)"/&4o -PPLFSBOE UIBUUIFQSFWBMFODFPGJSPO EFëDJFODZXBTIJHIFSJO.FYJDBO"NFSJDBO  BOEOPO)JTQBOJDCMBDL  XPNFOBHFE oZFBSTUIBOGPSOPO)JTQBOJDXIJUFXPNFO  8FTBXUIFTBNFQBUUFSOJO/)"/&4 oGPSXPNFOPGDIJMECFBSJOHBHFCZVTJOHMPXCPEZJSPO NHLH BTBOJOEJDBUPSPG JSPOEFëDJFODZ 'JHVSF)B 8FTBXBIJHIFSQSFWBMFODFPGMPXCPEZJSPOJO.FYJDBO"NFSJDBO DIJMESFO oZFBST UIBOJOOPO)JTQBOJDCMBDLBOEOPO)JTQBOJDXIJUFDIJMESFO 'JHVSF)B  ɨFQSFWBMFODFFTUJNBUFTPGJSPOEFëDJFODZNBZWBSZEFQFOEJOHPOXIJDIJOEJDBUPSPSTFUPG JOEJDBUPSTJTVTFE'VSUIFSNPSF UIFQSFWBMFODFNBZCFPWFSFTUJNBUFECZVTJOHPOMZBTJOHMF JOEJDBUPS*OXPNFOPGDIJMECFBSJOHBHF XFGPVOEUIFMPXFTUQSFWBMFODFCZVTJOHCPEZJSPO  JOUFSNFEJBUFQSFWBMFODFCZVTJOHMPXGFSSJUJODPODFOUSBUJPOT  BOEUIFIJHIFTU QSFWBMFODFCZVTJOHIJHIT5G3DPODFOUSBUJPOT   'JHVSF)C  a 25 20 a a 16 20 12 b 15 b b 8 10 Prevalence (%) 4 Iron deficiency prevalence (%) 5 0 Non- Mexican Non- Non- Non- Mexican Hispanic Hispanic American Hispanic Hispanic American 0 white black white black Serum body iron stores Serum ferritin Serum sTfR < 15 ng/mL < 0 mg/kg > 4.4 mg/L Women 12-49 years Children 1-5 years Figure H.3.a. Age-adjusted prevalence estimates of low body iron stores F Prevalence estimates of low serum ferritin, high serum igure H.3.b. oluble transferrin receptor, and low serum body iron in U.S. women (< 0 mg/kg) in U.S. children and women by race/ethnicity, National s Health and Nutrition Examination Survey, 2003–2006. 2–49 years of age, National Health and Nutrition Examination Survey, 1 003–2006. 2 Error bars represent 95% confidence intervals. Bars not sharing a common letter differ within children and women (p < 0.05). Age adjustment was done using rror bars represent 95% confidence intervals. E direct standardization. 3. Trace Elements 303

315 Women at risk for iron deficiency, while men were at were risk for iron excess, as can be seen from the large differences in ferritin prevalence of low and high serum the concentrations between men and women (Figure H.3.c). During NHANES 1999–2002, the prevalence of low serum ferritin concentrations (< 15 ng/mL) was much lower in 12–49 year-old men (1%) than in 12–49 year- ng/ old women (13%). Conversely, the prevalence of high serum ferritin concentrations (> 200 mL for men and > 150 ng/mL for women) was much higher in men (29%) than in women (6%). NHANES prevalence 2003–2006 showed similar 1999– estimates for women as were seen in available No data are 2002. for men in 2003–2006. 36 a 32 28 24 20 b 16 b Prevalence (%) 12 b b 8 4 a 0 Women Men Women Men Women Women 1999-2002 1999-2002 1999-2002 2003-2006 2003-2006 1999-2002 Low serum ferritin High serum ferritin Age-adjusted prevalence estimates of low (< 15 ng/mL) and high serum ferritin (> 200 ng/mL for men and > 150 ng/ Figure H.3.c. mL for women) in U.S. men and women aged 12–49 years, National Health and Nutrition Examination Survey, 1999–2006. Error bars represent 95% confidence intervals. Within each ferritin status category, bars not sharing a common letter differ (p < 0.05). Age adjustment was done using direct standardization. the evaluation Serum ferritin has been assessed as part of NHANES for many years, allowing for ferritin serum in changes minor only were there Overall, concentrations. in changes temporal of concentrations H.3.d). women of childbearing age over a period of almost two decades (Figure in Age-adjusted slightly were age childbearing of in concentrations ferritin serum mean women pattern (< 10%) in 1999–2002 and 2003–2006 than lower 1988–1994. We observed the same in women, while serum ferritin concentrations decreased further during for non-Hispanic white 2003–2006 ferritin serum lower had women Mexican-American women. black non-Hispanic for in 1988–1994, but concentrations in 2003–2006 did not than 1999–2002 in concentrations two previous time periods. differ from concentrations in the nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 304

316 60 a 50 a a b b b b b c 40 a,b a b 1988-1994 30 1999-2002 Serum ferritin (ng/mL) 20 2003-2006 10 0 Total population Non- Non- Mexican American Hispanic black Hispanic white Figure H.3.d. Age-adjusted geometric mean concentrations of serum ferritin in U.S. women aged 12–49 years by race/ethnicity, National Health and Nutrition Examination Survey, 1988–2006. Error bars represent 95% confidence intervals. Within a demographic group, bars not sharing a common letter differ (p < 0.05). Age adjustment was done using direct standardization. Detailed Observations the derived are below mentioned observations selected and figures The presented next. from tables about categorical differences between demographic Statements groups noted below are based on from for demographic limits univariate analysis without adjusting non-overlapping confidence age, sex, race/ethnicity) or other determinants of these blood concentrations (e.g., variables (e.g., A the alter may analysis multivariate size BMI). smoking, usage, supplement intake, dietary these categorical differences. Furthermore, additional significant and statistical significance of if differences of smaller magnitude may be present despite their lack of mention here (e.g., differences statistically limits slightly overlap or if confidence are not covariate before significant has occurred). For a selection of citations of descriptive NHANES adjustment papers related to diet and Appendix G see nutrition, . of indicators biochemical these Geometric/arithmetic mean concentrations (NHANES 2003–2006): present • The distribution of body iron was reasonably symmetric and for that reason we arithmetic means. Figure and 3.1.a.1 (Table age 3.1.a). increased concentrations ferritin Serum • with were highest in children than for both adolescent and adult women • sTfR concentrations (Table 3.2.a.1 and Figure 3.2.a). Body highest in women, • and iron was lowest adolescent in intermediate children, in adult women (Table 3.3.a.1 and Figure 3.3.a). than concentrations ferritin serum Mexican higher had whites Non-Hispanic • intermediate concentrations (Table 3.1.a.1). Americans, and non-Hispanic blacks had had whites had lower sTfR concentrations • Non-Hispanic than Mexican Americans, who than concentrations 3.2.a.1). lower (Table blacks non-Hispanic still whites had higher body iron than the other two race/ethnic groups • Non-Hispanic 3.3.a.1). (Table 3. Trace Elements 305

317 Changes in geometric/arithmetic mean concentrations across survey cycles: • three iron status indicators remained stable across the survey cycles measured: serum All mean concentrations (Table 3.1.b) between 1999 and 2006; sTfR ferritin geometric mean concentrations (Table 3.2.b) and body iron arithmetic geometric (Table means 3.3.b) between 2003 and 2006. Prevalence estimates of low or high biochemical indicator concentrations: (1–5 2003–2006, approximately 9% • of children In years) (Table 3.1.c.1) had serum ferritin concentrations < 12 ng/mL and 14% of women (12–49 years) had serum 3.1.c.2). ferritin < 15 ng/mL (Table concentrations Approximately 5% of women (12–49 years) (Table 3.1.c.3) had high serum ferritin concentrations (> 150 ng/mL), of indicating risk severe iron overload. • The prevalence of low serum ferritin concentrations did not change between 1999 and (Table 2006 in children (Table 3.1.d.1) and women of childbearing age 3.1.d.2), nor between and 2002 in males 6 years and older (Table 3.1.d.3). The prevalence of 1999 between ferritin concentrations also remained constant 1999 and 2006 in high serum of childbearing age (Table 3.1.d.4) and between 1999–2002 women in men 12 years and older (Table 3.1.d.5). In 2003–2006, approximately 19% • of women (12–49 years) had serum sTfR concentrations > 4.4 mg/L (Table 3.2.c), and the prevalence was the same in both survey (Table 3.2.d). cycles 5% Less than 10% of children (8% of boys • and of girls 1–5 years) and 10% of women (12–49 years) had negative body iron balance, indicative of iron deficiency (Tables the 3.3.c.1 and 3.3.c.2), and the prevalence was same in both survey cycles (Tables 3.3.d.2). and 3.3.d.1 nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 306

318 3. Trace Elements 307

319 757 759 size 5,255 1,780 1,704 1,482 1,991 6,012 2,089 1,676 Sample (180 – 219) (153 – 206) (70.2 – 91.4) (140 – 231) (91.8 – 134) (231 – 317) (67.7 – 111) (177 – 210) (172 – 233) (182 – 261) 97.5th 198 103 166 264 176 194 194 212 77.5 77.9 (136 – 165) (59.6 – 68.1) (76.7 – 92.2) (114 – 159) (184 – 262) (101 – 161) (56.9 – 70.7) (133 – 157) (133 – 201) (131 – 159) 95th 145 135 121 211 143 143 165 65.6 81.4 63.6 (95% conf. interval) s (36.0 – 39.4) (25.5 – 27.9) (40.5 – 50.7) (38.3 – 43.3) (25.1 – 28.5) (29.9 – 33.3) (31.8 – 35.8) (28.7 – 34.0) (34.7 – 38.1) (35.9 – 39.8) 50th 38.1 40.5 45.9 31.9 33.7 26.7 26.9 31.7 36.2 38.2 5th (5.96 – 7.56) (8.01 – 9.68) (4.69 – 6.46) (5.19 – 7.77) (5.66 – 8.21) (4.62 – 5.46) (4.73 – 7.10) (7.87 – 9.82) (6.15 – 7.71) (6.52 – 8.85) Selected percentile 6.80 8.90 6.83 5.81 5.49 4.87 7.19 9.14 6.99 8.07 (4.48 – 4.75) (3.31 – 4.70) (4.06 – 4.69) (4.61 – 7.90) (4.45 – 4.88) (4.31 – 4.98) (3.78 – 4.43) (5.19 – 7.72) (4.52 – 4.78) (4.66 – 5.44) 2.5th 4.62 4.18 6.68 4.13 4.38 4.67 6.90 4.64 4.65 4.89 n (35.2 – 38.1) (25.2 – 27.3) (31.4 – 35.7) (36.1 – 40.2) (27.7 – 30.9) (39.0 – 47.7) (24.9 – 27.7) (27.5 – 33.1) (34.4 – 37.1) (35.5 – 39.6) 36.6 33.5 26.2 29.3 38.1 26.2 43.2 30.2 35.7 37.5 (95% conf. interval) Geometric mea Females (1–5, 12–49 years) 12–19 years (Women) (Children 1–5 years, women 12–49 years) Race/ethnicity Non-Hispanic Blacks Males (1–5 years) Gender Total Age group 40–49 years (Women) 20–39 years (Women) Mexican Americans 1–5 years (Children) (Children 1–5 years women 12–49 years), Non-Hispanic Whites U.S. population, National Health and Nutrition Examination Survey, 2003–2006. Geometric mean and selected percentiles of serum concentrations (in ng/mL) for children aged 1–5 years and women aged 12–49 years in the Table 3.1.a.1. Serum ferritin: Concentrations nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 308

320 Figure 3.1. a . Serum ferritin: Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2006 Mexican Americans Overall Females Males (ng/mL) Serum ferritin 0 20 40 60 80 20−39 40−49 20−39 1−5 40−49 1−5 12−19 12−19 Non−Hispanic Whites Non−Hispanic Blacks 80 (ng/mL) Serum ferritin 0 20 40 60 40−49 12−19 12−19 1−5 20−39 20−39 40−49 1−5 Females Males Mexican Americans Non−Hispanic (ng/mL) Blacks Non−Hispanic Serum ferritin Whites 0 20 40 60 80 1−5 40−49 12−19 1−5 40−49 20−39 20−39 12−19 Age (years) Age (years) 3. Trace Elements 309

321 Table 3.1.a.2. Serum ferritin: Total population Geometric mean and selected percentiles of serum concentrations (in ng/mL) for children aged 1–5 years and women aged 12–49 years in the U.S. population, National Health and Nutrition Examination Survey, 2003–2006. Sample n Geometric mea (95% conf. interval) s Selected percentile 50th 95th 5th (95% conf. interval) size Males and Females Total, Children 1–5 years, 35.7 (34.4 – 37.1) 6.99 (6.15 – 7.71) 36.2 (34.7 – 38.1) 143 (133 – 157) 6,012 women 12–49 years (25.5 – 27.9) (25.2 – 27.3) 9.14 (7.87 – 9.82) 26.7 26.2 65.6 (59.6 – 68.1) 1,482 1–5 years Males 26.2 (25.1 – 28.5) (24.9 – 27.7) 8.90 (8.01 – 9.68) 26.9 1–5 years 63.6 (56.9 – 70.7) 757 Females Total, 1–5, 12–49 years (35.2 – 38.1) 6.80 (5.96 – 7.56) 36.6 (36.0 – 39.4) 145 (136 – 165) 5,255 38.1 1–5 years 26.3 (24.9 – 27.7) 9.29 (6.81 – 10.1) 26.5 (24.8 – 28.0) 67.0 (59.2 – 74.3) 725 12–19 years 29.3 (27.7 – 30.9) 6.83 (5.19 – 7.77) 31.9 (29.9 – 33.3) 81.4 (76.7 – 92.2) 1,991 1,780 20–39 years 38.1 (36.1 – 40.2) 7.19 (5.66 – 8.21) 40.5 (38.3 – 43.3) 135 (114 – 159) 211 (184 – 262) 759 40–49 years 43.2 (39.0 – 47.7) 5.81 (4.73 – 7.10) 45.9 (40.5 – 50.7) Table 3.1.a.3. Serum ferritin: Mexican Americans Geometric mean and selected percentiles of serum concentrations (in ng/mL) for Mexican-American children aged 1–5 years and women aged 12–49 years in the U.S. population, National Health and Nutrition Examination Survey, 2003–2006. n Geometric mea Sample s Selected percentile (95% conf. interval) 5th 50th 95th (95% conf. interval) size Males and Females Total, Children 1–5 years, 1,704 30.2 (27.5 – 33.1) 4.87 (4.62 – 5.46) 31.7 (28.7 – 34.0) 121 (101 – 161) women 12–49 years 25.5 24.5 (22.8 – 26.3) 6.44 (4.69 – 7.69) 1–5 years (23.5 – 27.6) 68.9 (57.7 – 83.3) 468 Males 24.6 1–5 years 23.5 (21.3 – 25.9) 6.04 (4.33 – 7.21) (52.5 – 118) (23.1 – 27.0) 63.8 225 Females Total, 1–5, 12–49 years (28.0 – 34.5) 4.84 (4.59 – 5.33) 31.0 (29.3 – 36.1) 126 (104 – 167) 1,479 33.2 1–5 years 25.5 (23.6 – 27.6) 6.81 (4.56 – 9.78) 26.7 (23.2 – 29.8) 69.6 (60.7 – 88.6) 243 12–19 years (24.8 – 28.5) 6.35 (4.85 – 7.38) 27.3 (25.5 – 29.2) 89.6 (80.6 – 97.3) 647 26.6 434 33.7 (29.2 – 38.9) 4.89 (4.62 – 5.51) 37.1 (31.6 – 43.9) 139 (106 – 213) 20–39 years 170† 155 (134 – 262) 40–49 years 33.1 (25.7 – 42.7) 4.27† (3.48 – 4.66) 34.3 (28.3 – 42.9) † Estimate is subject to greater uncertainty due to small cell size. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 310

322 Table 3.1.a.4. Serum ferritin: Non-Hispanic blacks Geometric mean and selected percentiles of serum concentrations (in ng/mL) for non-Hispanic black children aged 1–5 years and women aged 12–49 years in the U.S. population, National Health and Nutrition Examination Survey, 2003–2006. Geometric mea n Sample (95% conf. interval) s Selected percentile 50th 95th 5th (95% conf. interval) size Males and Females Total, Children 1–5 years, (31.4 – 35.7) 5.49 (4.69 – 6.46) 33.7 (31.8 – 35.8) 165 (133 – 201) 1,676 33.5 women 12–49 years 30.8 11.4 (9.51 – 14.2) 30.7 (28.7 – 32.7) 72.5 (65.8 – 88.9) 429 1–5 years (28.9 – 32.8) Males 66.2† 10.6† (5.39 – 14.4) 29.6 (26.6 – 33.4) (27.3 – 32.9) (58.1 – 96.6) 218 1–5 years 30.0 Females 33.8 (31.5 – 36.2) 5.26 (4.56 – 6.25) 34.1 (32.1 – 36.9) 171 (139 – 207) 1,458 Total, 1–5, 12–49 years 31.7 1–5 years (9.78 – 14.6) 31.6 (29.1 – 33.6) 75.8† (67.6 – 89.4) 211 (29.8 – 33.7) 12.4† 28.2 6.61 (4.97 – 7.55) 31.1 (27.4 – 33.7) 88.7 (79.4 – 104) 674 12–19 years (25.5 – 31.2) 30.1 (27.9 – 32.4) 5.02 (4.22 – 6.08) 31.1 (28.4 – 34.1) 132 (122 – 173) 375 20–39 years 49.6 (40.4 – 61.0) 4.31† (< LOD – 8.31) 53.5 40–49 years 257† (207 – 531) 198 (42.2 – 63.9) < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. † Estimate is subject to greater uncertainty due to small cell size. Table 3.1.a.5. Serum ferritin: Non-Hispanic whites Geometric mean and selected percentiles of serum concentrations (in ng/mL) for non-Hispanic white children aged 1–5 years and women aged 12–49 years in the U.S. population, National Health and Nutrition Examination Survey, 2003–2006. Sample n Geometric mea (95% conf. interval) s Selected percentile 50th 95th 5th (95% conf. interval) size Males and Females Total, Children 1–5 years, 37.5 (35.5 – 39.6) 2,089 (6.52 – 8.85) 38.2 (35.9 – 39.8) 143 (131 – 159) 8.07 women 12–49 years (24.4 – 28.1) 25.9 9.30 (8.13 – 10.0) 1–5 years (24.2 – 27.7) 61.4 (55.7 – 67.8) 416 26.3 Males 1–5 years 26.1 (23.8 – 28.6) 9.13 (4.71 – 10.5) 27.1 (24.3 – 29.7) 56.9 (53.5 – 89.4) 229 Females Total, 1–5, 12–49 years (36.3 – 40.7) 7.96 (6.36 – 8.78) 38.5 (37.2 – 41.0) 144 (135 – 167) 1,860 39.4 1–5 years 25.6 (23.4 – 27.9) 9.40† (5.96 – 10.3) 25.5 (23.4 – 27.8) 63.7† (53.8 – 87.4) 187 12–19 years (27.7 – 32.6) 6.88 (4.67 – 8.55) 33.0 (31.1 – 34.9) 78.2 (70.9 – 93.0) 520 30.0 812 41.0 (37.8 – 44.5) 8.75 (7.16 – 10.1) 42.3 (39.2 – 47.0) 134 (112 – 171) 20–39 years (164 – 266) 40–49 years 43.6 (38.3 – 49.6) 6.61 (4.82 – 8.43) 46.1 (39.7 – 51.2) 212 341 † Estimate is subject to greater uncertainty due to small cell size. 3. Trace Elements 311

323 Table 3.1.b. Serum ferritin: Concentrations by survey cycle Geometric mean and selected percentiles of serum concentrations (in ng/mL) for children aged 1–5 and women aged 12–49 years in the U.S. population, National Health and Nutrition Examination Survey, 1999–2006. Sample Geometric mean Selected percentiles (95% conf. interval) 5th 50th 95th (95% conf. interval) size Total (Children 1–5 years, women 12–49 years) 139 (5.23 – 9.99) 38.3 (34.7 – 42.5) 1999–2000 (129 – 173) 2,919 38.8 8.06 (36.7 – 41.0) (34.2 – 38.0) 5.23 ** 35.2 (33.2 – 37.2) 149 (136 – 175) 3,365 2001–2002 36.1 36.4 7.70 (5.80 – 8.58) 36.1 (34.7 – 38.3) 151 (141 – 173) 2,981 2003–2004 (34.6 – 38.6) 35.0 (32.9 – 37.2) 6.46 (5.69 – 7.19) 36.2 (33.6 – 38.7) 135 (113 – 167) 3,031 2005–2006 Age group 1–5 years (Children) (26.9 – 30.7) (5.95 – 13.5) 28.2 (26.0 – 31.6) 74.6 (57.9 – 94.2) 680 28.7 10.6 1999–2000 2001–2002 6.43 (5.23 – 9.79) 28.2 (26.2 – 30.4) 78.6 (68.5 – 105) 843 27.9 (25.6 – 30.5) 25.2 (23.7 – 26.8) 9.27 (8.08 – 9.76) 24.9 (23.2 – 26.7) 64.0 (57.0 – 67.8) 796 2003–2004 66.7 27.6 8.95 (7.95 – 9.78) 28.5 (27.4 – 30.1) (26.0 – 29.2) (63.2 – 77.2) 686 2005–2006 12–19 years (Women) 9.26 32.5 (29.6 – 35.8) 83.3 (5.23 – 10.4) 32.8 (29.6 – 37.1) 1999–2000 (79.4 – 99.7) 1,048 2001–2002 30.1 6.55 (5.23 – 8.62) 32.5 (29.9 – 33.7) 84.5 (79.3 – 95.6) 1,120 (28.5 – 31.9) 28.0 6.11 (4.43 – 7.97) 30.1 (27.9 – 32.7) 86.4 (75.6 – 102) 998 2003–2004 (25.5 – 30.7) 30.6 (28.6 – 32.8) 7.21 (5.52 – 8.79) 33.4 2005–2006 79.0 (75.0 – 94.0) 993 (30.9 – 35.7) 20–39 years (Women) 40.0 (36.0 – 44.4) 5.23 ** 1999–2000 (36.3 – 52.2) 137 (118 – 187) 838 43.5 2001–2002 37.8 (35.2 – 40.5) 5.23 ** 38.3 (34.5 – 41.7) 142 (119 – 192) 992 2003–2004 39.8 8.40 (7.52 – 9.20) 41.1 (39.2 – 44.6) 132 (111 – 172) 822 (37.1 – 42.7) 2005–2006 (33.5 – 39.9) 5.60 (4.70 – 7.17) 39.2 (34.1 – 44.6) 135 (110 – 179) 958 36.5 40–49 years (Women) 1999–2000 (43.6 – 57.9) 9.15 (5.23 – 12.1) 50.0 (42.8 – 59.8) 227 (202 – 275) 353 50.3 410 43.7 (39.3 – 48.6) 5.23 ** 46.5 (39.2 – 53.9) 221 (195 – 249) 2001–2002 365 2003–2004 46.6 (39.9 – 54.4) 5.16 (4.21 – 8.44) 47.1 (43.5 – 53.6) 227 (197 – 317) (34.5 – 46.3) 6.26 2005–2006 40.0 394 (144 – 264) (4.89 – 6.96) 41.6 (34.0 – 51.7) 169 Gender Males (1–5 years) 27.4 (25.4 – 29.6) (6.11 – 13.1) 26.6 (24.7 – 28.4) 73.7 (55.4 – 95.7) 377 1999–2000 10.8 26.1 5.23 ** 27.4 (24.4 – 30.3) 77.9 (67.2 – 112) 428 2001–2002 (23.4 – 29.0) 2003–2004 (23.1 – 27.1) 9.19 (6.68 – 10.2) 24.8 (22.5 – 27.0) 57.3 (55.3 – 67.6) 415 25.0 2005–2006 (25.8 – 29.9) 8.71 (8.18 – 9.54) 29.3 27.8 70.4 (55.8 – 105) 342 (26.9 – 31.0) Females (1–5, 12–49 years) 1999–2000 40.0 (37.7 – 42.5) 7.86 (5.23 – 9.85) 40.8 (37.0 – 45.1) 146 (132 – 179) 2,542 5.23 ** 36.3 (34.5 – 38.3) 157 (141 – 186) 2,937 (35.2 – 38.9) 2001–2002 37.0 2003–2004 (35.6 – 39.8) 7.60 (5.49 – 8.51) 38.7 (36.0 – 40.1) 158 (143 – 186) 2,566 37.7 2005–2006 35.6 (33.4 – 37.9) 6.31 (5.46 – 7.04) 37.2 (34.2 – 40.0) 137 (115 – 176) 2,689 Race/ethnicity (Children 1–5 years, women 12–49 years) Mexican Americans 1999–2000 29.0 (26.6 – 31.6) 5.23 ** 30.2 (27.9 – 32.7) 117 (81.2 – 179) 1,077 (25.6 – 30.4) 2001–2002 27.9 (26.8 – 31.3) 5.23 ** 28.9 102 (82.4 – 162) 967 2003–2004 32.0 6.36 (4.30 – 7.98) 33.2 (28.1 – 36.8) 140 (98.8 – 203) 793 (27.4 – 37.4) 106 28.4 (4.01 – 5.22) 29.7 (27.6 – 32.9) 4.57 (98.4 – 119) 911 2005–2006 (25.7 – 31.4) Non-Hispanic Blacks 38.5 (34.3 – 43.3) 5.23 ** 1999–2000 (33.1 – 44.9) 171 (130 – 382) 690 38.1 2001–2002 (31.0 – 41.3) 5.23 ** 35.8 (32.7 – 40.2) 187 (138 – 263) 855 36.1 2003–2004 34.1 (30.5 – 38.2) 5.74 (4.17 – 7.50) 33.1 (30.0 – 36.9) 172 (127 – 267) 870 2005–2006 32.7 5.35 (4.67 – 6.15) 34.3 (31.1 – 38.1) 145 (127 – 179) 806 (30.5 – 35.1) Non-Hispanic Whites 41.1 (38.4 – 44.0) 9.77 (5.23 – 12.4) 41.0 (35.1 – 47.1) 146 (131 – 181) 1999–2000 838 2001–2002 (34.2 – 40.1) 6.86 (5.23 – 8.38) 35.5 (32.8 – 38.6) 141 (124 – 188) 1,236 37.0 2003–2004 37.7 (35.1 – 40.5) 8.37 (4.79 – 10.0) 38.3 (35.6 – 39.7) 147 (136 – 190) 1,069 1,020 (113 – 176) 2005–2006 37.3 (34.1 – 40.7) 7.57 (6.33 – 8.68) 38.1 (34.4 – 41.1) 135 ** The minimum value is reported. The desired percentile does not exist because it is less than the estimated cumulative distribution evaluated at the minimum. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 312

324 Figure 3.1.b. Serum ferritin: Concentrations by survey cycle Selected percentiles in ng/mL (95% confidence intervals), National Health and Nutrition Examination Survey, 1999–2006 400 300 200 L L L L L L L L L L L L L L L L L L L L L L 95th Percentile L L 100 L L L L L L L L L L L L 0 60 50 L L L L L L 40 L L L L L L L L L L L L L L L L L L 50th Percentile L L L 30 L L L L L L L L L 20 15 L L 10 L L L L L L L L L L L L L L L L L L L L L L L L 5 5th Percentile L 0 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 12−19y Males Females MA NHB NHW 20+y Total 1−5y 6−11y (1−5y) (1−5, (M/F 1−5y, (M/F 1−5y, (M/F 1−5y, (M/F 1−5y, (F) (F) F 12−49y) F 12−49y) F 12−49y) 12−49y) F 12−49y) 3. Trace Elements 313

325 Table 3.1.c.1. Serum ferritin: Prevalence Prevalence (in percent) of low serum ferritin concentration (< 12 ng/mL) for children in the U.S. population aged 1–5 years, National Health and Nutrition Examination Survey, 2003–2006. Sample Estimated total Prevalence (95% conf. interval) size number of persons 1,482 8.9 (7.1 – 11.2) 1,810,000 Children, 1–5 years Gender (7.1 – 11.9) 953,000 9.2 Males 757 725 8.6 (6.2 – 11.8) 855,000 Females Race/ethnicity 468 Mexican Americans 11.4 (8.6 – 15.1) 348,000 Non-Hispanic Blacks 429 4.9 (3.1 – 7.8) 148,000 1,134,000 9.8 (6.9 – 13.7) Non-Hispanic Whites 416 nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 314

326 Table 3.1.c.2. Serum ferritin: Prevalence Prevalence (in percent) of low serum ferritin concentration (< 15 ng/mL) for women in the U.S. population aged 12–49 years, National Health and Nutrition Examination Survey, 2003–2006. Sample Prevalence Estimated total (95% conf. interval) size number of persons 4,530 13.6 (12.2 – 15.2) 10,748,000 Women, 12–49 years Age group 1,991 12–19 years 15.2 (12.4 – 18.4) 2,462,000 2,539 20–49 years 13.2 (11.8 – 14.8) 8,299,000 Race/ethnicity 1,236 18.6 (14.9 – 23.0) 1,427,000 Mexican Americans 1,247 Non-Hispanic Blacks 19.9 (17.9 – 22.1) 2,140,000 1,673 11.3 (9.2 – 13.9) 5,805,000 Non-Hispanic Whites 3. Trace Elements 315

327 Table 3.1.c.3. Serum ferritin: Prevalence Prevalence (in percent) of high serum ferritin concentration (> 150 ng/mL) for women in the U.S. population aged 12–49 years, National Health and Nutrition Examination Survey, 2003–2006. Estimated total Prevalence Sample (95% conf. interval) number of persons size 4,530 5.2 (4.2 – 6.4) 4,086,000 Women, 12–49 years Age group 1,991 12–19 years (0.5 – 1.8) 0.9‡ 149,000‡ 2,539 (5.0 – 7.7) 3,900,000 6.2 20–49 years Race/ethnicity 1,236 324,000 Mexican Americans 4.2 (2.5 – 7.2) 1,247 Non-Hispanic Blacks 7.1 (5.0 – 9.9) 759,000 1,673 4.9 2,495,000 Non-Hispanic Whites (3.7 – 6.3) ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 316

328 Table 3.1.d.1. Serum ferritin: Prevalence by survey cycle Prevalence (in percent) of low serum ferritin concentration (< 12 ng/mL) for children in the U.S. population aged 1–5 years, National Health and Nutrition Examination Survey, 1999–2006. Sample size (95% conf. interval) Estimated total number of persons Prevalence Children, 1–5 years 1999–2000 5.7 (3.3 – 9.6) 1,133,000 680 843 10.0 2001–2002 1,935,000 (7.0 – 13.9) 2003–2004 9.0 (6.6 – 12.3) 1,828,000 796 2005–2006 8.8 (6.0 – 12.8) 1,782,000 686 Gender Males 1999–2000 377 5.9 (3.3 – 10.4) 599,000 2001–2002 428 (8.6 – 20.1) 1,326,000 13.3 415 970,000 (6.6 – 13.3) 2003–2004 9.4 2005–2006 9.0 (5.8 – 13.8) 933,000 342 Females 1999–2000 303 5.5‡ (2.4 – 12.0) 530,000‡ 2001–2002 6.5 (4.3 – 9.6) 613,000 415 2003–2004 381 8.6 (5.6 – 12.8) 854,000 2005–2006 344 8.6 (4.8 – 14.9) 849,000 Race/ethnicity Mexican Americans 269 11.7 305,000 1999–2000 (7.7 – 17.4) 10.1 (7.4 – 13.6) 246 2001–2002 283,000 2003–2004 230 12.5 (7.6 – 19.8) 380,000 2005–2006 10.2 (8.1 – 12.8) 329,000 238 Non-Hispanic Blacks 168 4.7 (2.6 – 8.4) 1999–2000 142,000 2001–2002 247 § § 2003–2004 252 6.0 (3.1 – 11.3) 180,000 2005–2006 177 (1.7 – 6.9) 100,000‡ 3.4‡ Non-Hispanic Whites 161 2.9‡ (1.3 – 6.1) 346,000‡ 1999–2000 2001–2002 259 11.9 (7.1 – 19.2) 1,357,000 2003–2004 9.4 (5.5 – 15.5) 1,088,000 230 2005–2006 186 10.3 (6.1 – 16.7) 1,157,000 ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. § Estimate suppressed: RSE ≥ 40% for the prevalence estimate. 3. Trace Elements 317

329 Table 3.1.d.2. Serum ferritin: Prevalence by survey cycle Prevalence (in percent) of low serum ferritin concentration (< 15 ng/mL) for women in the U.S. population aged 12–49 years, National Health and Nutrition Examination Survey, 1999–2006. Prevalence (95% conf. interval) Estimated total number of persons Sample size Women, 12–49 years 11.4 (9.4 – 13.9) 8,767,000 1999–2000 2,239 2,522 13.9 (12.2 – 15.8) 10,821,000 2001–2002 2,185 (10.7 – 16.3) 10,460,000 13.2 2003–2004 11,069,000 14.0 (12.6 – 15.5) 2005–2006 2,345 Age group 12–19 years 1999–2000 11.5 (8.5 – 15.3) 1,781,000 1,048 2001–2002 1,120 13.9 (11.2 – 17.1) 2,201,000 2003–2004 998 17.4 (12.8 – 23.3) 2,825,000 2005–2006 12.9 (10.0 – 16.5) 2,119,000 993 20–49 years 1999–2000 1,191 11.4 (9.2 – 14.2) 6,986,000 8,620,000 2001–2002 1,402 13.9 (12.0 – 16.0) (9.7 – 15.2) 7,670,000 12.2 2003–2004 1,187 2005–2006 1,352 (12.8 – 15.7) 8,938,000 14.2 Race/ethnicity Mexican Americans 808 18.8 (12.3 – 27.5) 1,140,000 1999–2000 2001–2002 721 21.9 (18.8 – 25.4) 1,541,000 2003–2004 16.7 (11.7 – 23.2) 1,276,000 563 2005–2006 673 20.6 (15.3 – 27.2) 1,632,000 Non-Hispanic Blacks 1,764,000 1999–2000 522 16.4 (11.2 – 23.4) 2001–2002 608 (12.3 – 29.6) 2,091,000 19.5 618 19.1 2003–2004 2,051,000 (16.4 – 22.0) 2005–2006 629 20.7 (17.5 – 24.4) 2,256,000 Non-Hispanic Whites 1999–2000 9.1 (6.7 – 12.2) 4,741,000 677 2001–2002 977 11.6 (9.5 – 14.2) 6,025,000 2003–2004 839 11.8 (8.3 – 16.5) 6,032,000 5,500,000 10.9 (8.5 – 13.8) 2005–2006 834 nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 318

330 Table 3.1.d.3. Serum ferritin: Prevalence by survey cycle Prevalence (in percent) of low serum ferritin concentration (< 15 ng/mL) for males in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 1999–2002. Sample size (95% conf. interval) Estimated total number of persons Prevalence Males, 6 years and older 3,488 1.1 (0.6 – 2.0) 1,323,000 1999–2000 3,849 2001–2002 (0.9 – 1.7) 1,576,000 1.3 Age group 6–11 years 1999–2000 463 § § 2001–2002 509 § § 12–19 years 1999–2000 2.1‡ (1.0 – 4.2) 336,000‡ 1,078 1,094 2.8‡ (1.4 – 5.4) 463,000‡ 2001–2002 20–39 years 1999–2000 632 § § 2001–2002 724 0.5‡ (0.2 – 1.0) 176,000‡ 40–59 years 1999–2000 § 570 § 2001–2002 § § 770 60 years and older 1999–2000 745 § § 752 2.0 (1.1 – 3.4) 384,000 2001–2002 Race/ethnicity Mexican Americans 1999–2000 1,196 1.0 (0.5 – 1.8) 91,000 2001–2002 958 0.7‡ (0.3 – 1.5) 77,000‡ Non-Hispanic Blacks 781 § § 1999–2000 2001–2002 921 1.3‡ (0.7 – 2.7) 187,000‡ Non-Hispanic Whites 1999–2000 1,223 1.3‡ (0.6 – 2.7) 1,100,000‡ 1,159,000 2001–2002 1,678 1.3 (0.9 – 1.9) ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. § Estimate suppressed: RSE ≥ 40% for the prevalence estimate. 3. Trace Elements 319

331 Table 3.1.d.4. Serum ferritin: Prevalence by survey cycle Prevalence (in percent) of high serum ferritin concentration (> 150 ng/mL) for women in the U.S. population aged 12–49 years, National Health and Nutrition Examination Survey, 1999–2006. Prevalence (95% conf. interval) Estimated total number of persons Sample size Women, 12–49 years 5.3 (4.0 – 7.0) 4,069,000 1999–2000 2,239 2,522 5.6 (4.5 – 7.0) 4,374,000 2001–2002 2,185 (4.7 – 7.5) 4,711,000 6.0 2003–2004 2,345 4.4 (2.9 – 6.6) 3,470,000 2005–2006 Age group 12–19 years 1999–2000 1,048 § § 2001–2002 § § 1,120 2003–2004 998 § § 2005–2006 993 1.4‡ (0.6 – 3.2) 237,000‡ 20–49 years 3,878,000 1,191 6.3 (4.8 – 8.3) 1999–2000 2001–2002 1,402 6.8 (5.3 – 8.5) 4,196,000 4,600,000 2003–2004 1,187 7.3 (5.9 – 9.1) 1,352 5.1 2005–2006 3,202,000 (3.2 – 7.9) Race/ethnicity Mexican Americans 808 3.7‡ (1.7 – 7.9) 224,000‡ 1999–2000 721 3.5 (1.8 – 6.8) 249,000 2001–2002 2003–2004 563 5.6‡ (2.7 – 11.3) 429,000‡ 2005–2006 2.9‡ (1.4 – 5.7) 226,000‡ 673 Non-Hispanic Blacks 1999–2000 522 7.8 (5.2 – 11.6) 840,000 2001–2002 (5.0 – 11.8) 608 7.7 828,000 2003–2004 618 (4.6 – 14.7) 895,000 8.3 2005–2006 5.7 (4.2 – 7.9) 625,000 629 Non-Hispanic Whites 1999–2000 677 5.7 (4.1 – 8.0) 3,000,000 2001–2002 977 5.0 (3.4 – 7.2) 2,579,000 2003–2004 839 5.7 (4.1 – 7.8) 2,926,000 (2.5 – 6.3) 2,026,000 2005–2006 834 4.0 ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. § Estimate suppressed: RSE ≥ 40% for the prevalence estimate. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 320

332 Table 3.1.d.5. Serum ferritin: Prevalence by survey cycle Prevalence (in percent) of high serum ferritin concentration (> 200 ng/mL) for males in the U.S. population aged 12 years and older, National Health and Nutrition Examination Survey, 1999–2002. Sample size (95% conf. interval) Estimated total number of persons Prevalence Males, 12 years and older 3,025 31.8 1999–2000 34,391,000 (27.7 – 36.3) 2001–2002 3,340 32.7 (30.1 – 35.5) 36,644,000 Age group 12–19 years 1999–2000 1,078 3.3 (1.8 – 6.0) 538,000 2001–2002 1,094 (1.0 – 2.9) 283,000 1.7 20–39 years 632 33.1 (26.8 – 40.1) 12,720,000 1999–2000 2001–2002 724 31.0 (27.1 – 35.1) 12,101,000 40–59 years 1999–2000 570 39.9 (33.0 – 47.1) 13,748,000 2001–2002 770 16,443,000 44.5 (39.0 – 50.2) 60 years and older 39.1 (33.2 – 45.2) 7,336,000 745 1999–2000 752 37.2 (32.3 – 42.4) 7,219,000 2001–2002 Race/ethnicity Mexican Americans 1999–2000 998 27.4 (23.1 – 32.1) 2,155,000 25.8 819 2,430,000 (21.3 – 31.0) 2001–2002 Non-Hispanic Blacks 652 37.8 (32.8 – 43.2) 4,574,000 1999–2000 2001–2002 746 33.7 (28.7 – 39.2) 4,079,000 Non-Hispanic Whites 1999–2000 1,122 32.4 (27.5 – 37.6) 25,539,000 26,398,000 2001–2002 1,518 33.1 (29.9 – 36.5) 3. Trace Elements 321

333 698 752 size 1,375 1,761 5,158 1,643 1,968 5,856 2,048 1,634 Sample (6.50 – 7.88) (7.12 – 9.13) (6.48 – 7.45) (6.96 – 8.77) (6.45 – 7.17) (6.79 – 7.67) (5.95 – 7.32) (6.78 – 7.62) (5.96 – 7.33) (9.78 – 12.6) 97.5th 6.80 7.96 7.80 7.19 6.97 6.47 6.67 7.06 10.3 6.33 (5.94 – 6.63) (5.83 – 6.36) (6.07 – 6.98) (5.75 – 6.36) (5.92 – 7.10) (5.22 – 5.82) (5.91 – 6.42) (5.90 – 6.36) (7.31 – 9.69) (5.28 – 6.07) 95th 6.43 5.36 6.38 6.02 6.25 6.00 6.00 6.04 5.59 8.02 (95% conf. interval) s (3.15 – 3.32) (3.32 – 3.46) (3.91 – 4.04) (4.11 – 4.29) (3.17 – 3.56) (3.29 – 3.47) (4.13 – 4.41) (3.42 – 3.62) (3.37 – 3.55) (3.22 – 3.44) 50th 3.35 4.26 3.52 3.38 3.23 4.21 3.97 3.37 3.46 3.32 5th (1.97 – 2.18) (2.06 – 2.24) (2.20 – 2.35) (2.95 – 3.18) (2.91 – 3.06) (2.31 – 2.57) (1.93 – 2.05) (1.95 – 2.13) (1.99 – 2.20) (1.94 – 2.17) Selected percentile 2.16 2.02 2.07 2.47 1.97 2.98 3.06 2.27 2.11 2.02 (1.85 – 1.94) (1.97 – 2.33) (1.91 – 1.95) (1.96 – 2.21) (1.71 – 1.95) (2.73 – 2.90) (2.75 – 2.98) (1.93 – 2.03) (1.91 – 1.96) (1.89 – 1.94) 2.5th 2.17 1.91 1.91 1.93 2.12 2.84 2.93 1.97 1.94 1.92 n (4.10 – 4.29) (3.36 – 3.49) (3.45 – 3.57) (3.44 – 3.55) (3.38 – 3.65) (4.24 – 4.37) (4.28 – 4.48) (3.53 – 3.72) (3.51 – 3.63) (3.35 – 3.52) 3.50 3.42 3.51 3.52 4.19 4.30 4.38 3.62 3.57 3.43 (95% conf. interval) Geometric mea 12–19 years (Women) Non-Hispanic Blacks 20–39 years (Women) 40–49 years (Women) Females (1–5, 12–49 years) Age group Males (1–5 years) Total Gender Race/ethnicity (Children 1–5 years, women 12–49 years) Mexican Americans 1–5 years (Children) (Children 1–5 years, women 12–49 years) Non-Hispanic Whites population, National Health and Nutrition Examination Survey, 2003–2006. Geometric mean and selected percentiles of serum concentrations (in mg/L) for children aged 1–5 years and women aged 12–49 years in the U.S. Table 3.2.a.1. Serum soluble transferrin receptor: Concentrations nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 322

334 Figure 3.2.a. Serum soluble transferrin receptor: Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2006 Overall Mexican Americans 6 Females 4 Males 2 receptor (mg/L) 0 Serum soluble transferrin 40−49 20−39 40−49 1−5 1−5 12−19 12−19 20−39 Non−Hispanic Whites Non−Hispanic Blacks 6 4 2 receptor (mg/L) 0 Serum soluble transferrin 20−39 12−19 40−49 1−5 12−19 20−39 40−49 1−5 Males Females 6 Mexican 4 Americans Non−Hispanic Blacks 2 Non−Hispanic receptor (mg/L) Whites 0 Serum soluble transferrin 20−39 40−49 1−5 12−19 40−49 20−39 1−5 12−19 Age (years) Age (years) 3. Trace Elements 323

335 Table 3.2.a.2. Serum soluble transferrin receptor: Total population Geometric mean and selected percentiles of serum concentrations (in mg/L) for children aged 1–5 years and women aged 12–49 years in the U.S. population, National Health and Nutrition Examination Survey, 2003–2006. Sample n Geometric mea (95% conf. interval) s Selected percentile 50th 95th 5th (95% conf. interval) size Males and Females Total, Children 1–5 years, 3.57 (3.51 – 3.63) 2.11 (1.99 – 2.20) 3.46 (3.37 – 3.55) 6.04 (5.90 – 6.36) 5,856 women 12–49 years (4.11 – 4.29) (4.24 – 4.37) 2.98 (2.91 – 3.06) 4.21 4.30 6.00 (5.91 – 6.42) 1,375 1–5 years Males 4.38 (4.13 – 4.41) (4.28 – 4.48) 3.06 (2.95 – 3.18) 4.26 1–5 years 6.25 (5.94 – 6.63) 698 Females Total, 1–5, 12–49 years (3.45 – 3.57) 2.07 (1.97 – 2.18) 3.51 (3.29 – 3.47) 6.02 (5.83 – 6.36) 5,158 3.37 1–5 years 4.22 (4.12 – 4.31) 2.90 (2.83 – 3.00) 4.10 (3.99 – 4.27) 5.91 (5.68 – 6.16) 677 12–19 years 3.50 (3.44 – 3.55) 2.27 (2.20 – 2.35) 3.38 (3.32 – 3.46) 5.36 (5.22 – 5.82) 1,968 1,761 20–39 years 3.42 (3.36 – 3.49) 2.02 (1.95 – 2.13) 3.23 (3.15 – 3.32) 6.00 (5.75 – 6.36) (6.07 – 6.98) 6.43 752 40–49 years 3.52 (3.38 – 3.65) 1.97 (1.93 – 2.05) 3.35 (3.17 – 3.56) Table 3.2.a.3. Serum soluble transferrin receptor: Mexican Americans Geometric mean and selected percentiles of serum concentrations (in mg/L) for Mexican-American children aged 1–5 years and women aged 12–49 years in the U.S. population, National Health and Nutrition Examination Survey, 2003–2006. Geometric mea n Sample s Selected percentile (95% conf. interval) 5th 50th 95th (95% conf. interval) size Males and Females Total, Children 1–5 years, 1,643 3.62 (3.53 – 3.72) 2.16 (2.06 – 2.24) 3.52 (3.42 – 3.62) 6.38 (5.92 – 7.10) women 12–49 years 4.15 4.30 (4.17 – 4.43) 2.99 (2.94 – 3.07) 1–5 years (3.99 – 4.32) 6.40 (6.06 – 7.18) 422 Males (2.90 – 3.21) 1–5 years 4.38 (4.21 – 4.56) 3.09† 6.89† 4.18 (4.00 – 4.36) (6.00 – 8.30) 203 Females Total, 1–5, 12–49 years (3.45 – 3.65) 2.13 (2.01 – 2.22) 3.55 (3.27 – 3.54) 6.32 (5.85 – 7.25) 1,440 3.41 1–5 years 4.21 (4.08 – 4.35) 2.93† (2.58 – 3.07) 4.10 (3.94 – 4.31) 6.01† (5.66 – 7.53) 219 12–19 years (3.46 – 3.68) 2.26 (2.18 – 2.36) 3.44 (3.33 – 3.59) 5.92 (5.27 – 6.92) 637 3.57 430 3.40 (3.27 – 3.54) 2.02 (1.93 – 2.12) 3.19 (3.01 – 3.40) 5.99 (5.62 – 7.63) 20–39 years (6.29 – 11.7) 154 7.75† 40–49 years 3.63 (3.32 – 3.96) 2.22† (1.80 – 2.30) 3.34 (3.02 – 3.71) † Estimate is subject to greater uncertainty due to small cell size. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 324

336 Table 3.2.a.4. Serum soluble transferrin receptor: Non-Hispanic blacks Geometric mean and selected percentiles of serum concentrations (in mg/L) for non-Hispanic black children aged 1–5 years and women aged 12–49 years in the U.S. population, National Health and Nutrition Examination Survey, 2003–2006. Sample n Geometric mea Selected percentile s (95% conf. interval) 5th 50th 95th (95% conf. interval) size Males and Females Total, Children 1–5 years, 4.19 (4.10 – 4.29) 2.47 (2.31 – 2.57) 3.97 (3.91 – 4.04) 8.02 (7.31 – 9.69) 1,634 women 12–49 years 6.68 4.55 (3.02 – 3.29) 4.37 (4.26 – 4.56) 3.11 (6.31 – 7.16) 401 1–5 years (4.43 – 4.67) Males 1–5 years (4.56 – 4.86) 3.24† (3.06 – 3.37) 4.58 (4.30 – 4.89) 6.76† (6.42 – 7.77) 199 4.70 Females Total, 1–5, 12–49 years 4.15 (4.05 – 4.26) 2.43 (2.27 – 2.55) 3.94 (3.86 – 4.00) 8.49 (7.37 – 9.87) 1,435 1–5 years 4.40 3.05† (2.73 – 3.23) 4.26 (4.00 – 4.47) 6.49† (5.96 – 7.16) 202 (4.21 – 4.59) 12–19 years (3.77 – 4.00) 2.42 (2.25 – 2.52) 3.76 (3.66 – 3.87) 6.46 (6.14 – 7.07) 668 3.88 20–39 years 4.23 (4.08 – 4.39) 2.41 (2.06 – 2.58) 3.97 (3.85 – 4.15) 9.70 (7.33 – 10.5) 368 40–49 years 4.17 (3.89 – 4.47) 2.34† (1.94 – 2.61) 3.87 (3.51 – 4.08) 9.72† (8.28 – 13.2) 197 † Estimate is subject to greater uncertainty due to small cell size. Table 3.2.a.5. Serum soluble transferrin receptor: Non-Hispanic whites Geometric mean and selected percentiles of serum concentrations (in mg/L) for non-Hispanic white children aged 1–5 years and women aged 12–49 years in the U.S. population, National Health and Nutrition Examination Survey, 2003–2006. n Geometric mea Sample (95% conf. interval) s Selected percentile 5th 50th 95th (95% conf. interval) size Males and Females Total, Children 1–5 years, 3.43 (3.35 – 3.52) 2.02 (1.94 – 2.17) 3.32 (3.22 – 3.44) 5.59 (5.28 – 6.07) 2,048 women 12–49 years 1–5 years 2.91 (2.78 – 3.04) 4.15 (4.01 – 4.28) (4.11 – 4.32) (5.63 – 6.19) 391 4.22 5.90 Males 4.31 (4.16 – 4.46) 2.98† (2.91 – 3.15) 4.22 (3.99 – 4.48) 5.95† (5.67 – 6.83) 215 1–5 years Females Total, 1–5, 12–49 years 3.38 2.00 (1.97 – 2.05) 3.25 (3.14 – 3.37) 5.53 (5.18 – 6.08) 1,833 (3.30 – 3.47) 1–5 years (3.96 – 4.27) 2.85† (2.64 – 2.97) 4.05 (3.88 – 4.27) 5.64† (5.36 – 6.64) 176 4.11 12–19 years 3.40 (3.33 – 3.46) 2.25 (2.12 – 2.35) 3.29 (3.20 – 3.37) 4.98 (4.78 – 5.49) 514 20–39 years 3.27 (3.18 – 3.36) 1.97 (1.94 – 2.01) 3.10 (3.00 – 3.20) 5.44 (4.96 – 6.01) 806 337 40–49 years 3.42 (3.26 – 3.59) 1.96 (1.92 – 2.01) 3.31 (3.03 – 3.57) 6.02 (5.41 – 6.76) † Estimate is subject to greater uncertainty due to small cell size. 3. Trace Elements 325

337 Table 3.2.b. Serum soluble transferrin receptor: Concentrations by survey cycle Geometric mean and selected percentiles of serum concentrations (in mg/L) for children aged 1–5 and women aged 12–49 years in the U.S. population, National Health and Nutrition Examination Survey, 2003–2006. n Sample Selected percentile s (95% conf. interval) Geometric mea 5th 50th 95th (95% conf. interval) size Total (Children 1–5 years, women 12–49 years) 3.63 (3.54 – 3.71) 2.06 (1.94 – 2.36) 3.55 (3.43 – 3.66) 5.96 (5.75 – 6.41) 2,831 2003–2004 (5.77 – 6.63) 3.51 (2.00 – 2.20) 3.36 (3.28 – 3.47) 6.16 2.13 3,025 (3.42 – 3.60) 2005–2006 Age group 1–5 years (Children) 4.44 (4.34 – 4.55) 3.28 (3.13 – 3.38) 4.33 (4.21 – 4.45) 5.99 (5.83 – 6.83) 696 2003–2004 (4.04 – 4.27) 4.16 6.08 2.86 (2.79 – 2.93) 4.06 (3.89 – 4.21) 2005–2006 (5.79 – 6.48) 679 12–19 years (Women) 2003–2004 (3.48 – 3.66) 2.29 (2.15 – 2.46) 3.49 (3.32 – 3.62) 5.72 (5.26 – 6.39) 975 3.57 3.43 (3.36 – 3.49) 2.26 (2.13 – 2.35) 3.33 (3.25 – 3.38) 5.23 (5.01 – 5.81) 993 2005–2006 20–39 years (Women) 2003–2004 (3.43 – 3.56) 2.02 (1.93 – 2.27) 3.33 (3.23 – 3.41) 5.96 (5.73 – 6.32) 803 3.49 2005–2006 3.35 (3.24 – 3.47) 2.02 (1.90 – 2.13) 3.16 (3.04 – 3.31) 6.07 (5.54 – 6.57) 958 40–49 years (Women) 357 2003–2004 3.49 (3.28 – 3.71) 1.96 (1.94 – 1.99) 3.33 (2.98 – 3.63) 6.01 (5.39 – 7.56) 2005–2006 395 3.54 (6.22 – 7.89) 6.86 (3.36 – 3.74) 2.05 (1.66 – 2.23) 3.37 (3.19 – 3.65) Gender Males (1–5 years) 4.54 3.32 (3.20 – 3.41) 4.40 (4.23 – 4.56) 6.38 (5.94 – 7.23) 358 2003–2004 (4.39 – 4.70) 2005–2006 (4.05 – 4.38) 2.94 (2.74 – 3.02) 4.16 (3.90 – 4.34) 6.04 (5.69 – 6.52) 340 4.21 Females (1–5, 12–49 years) 2003–2004 3.56 (3.47 – 3.65) 2.03 (1.93 – 2.32) 3.45 (3.31 – 3.59) 5.94 (5.64 – 6.37) 2,473 (3.22 – 3.39) (3.37 – 3.55) 2.11 (1.96 – 2.19) 3.31 3.46 6.17 (5.77 – 6.69) 2,685 2005–2006 Race/ethnicity (Children 1–5 years, women 12–49 years) Mexican Americans (3.53 – 3.73) 2003–2004 3.63 3.59 2.18 (1.99 – 2.37) (3.44 – 3.80) 5.88 (5.49 – 6.42) 734 2005–2006 3.62 2.15 (2.02 – 2.24) 3.46 (3.28 – 3.62) 7.32 (6.16 – 8.70) 909 (3.46 – 3.79) Non-Hispanic Blacks 2003–2004 (4.04 – 4.33) 2.54 (2.33 – 2.65) 4.18 (3.89 – 4.06) 7.97 (6.94 – 9.88) 832 3.96 2005–2006 4.20 (4.08 – 4.33) 2.36 (2.19 – 2.56) 4.00 (3.86 – 4.13) 8.17 (7.15 – 10.4) 802 Non-Hispanic Whites (1.98 – 2.03) 3.51 (3.37 – 3.65) 1.99 2003–2004 3.44 (3.22 – 3.63) 5.68 (5.16 – 6.38) 1,026 (5.11 – 6.40) 1,022 5.55 2005–2006 3.36 (3.27 – 3.45) 2.09 (1.91 – 2.19) 3.24 (3.15 – 3.33) nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 326

338 Figure 3.2.b. Serum soluble transferrin receptor: Concentrations by survey cycle Selected percentiles in mg/L (95% confidence intervals), National Health and Nutrition Examination Survey, 2003–2006 12 10 1 1 8 1 1 1 95th Percentile 1 1 1 1 1 1 1 1 6 1 1 1 1 1 4 5.0 4.5 1 1 1 1 1 4.0 1 1 50th Percentile 1 1 3.5 1 1 1 1 1 1 1 1 1 3.0 3.5 1 1 3.0 1 1 1 2.5 1 1 1 1 1 1 1 5th Percentile 1 1 1 1 1 2.0 1 1.5 05−06 05−06 03−04 05−06 03−04 05−06 03−04 05−06 03−04 03−04 03−04 05−06 03−04 05−06 03−04 05−06 05−06 03−04 03−04 05−06 12−19y 20+y Males Females MA NHB NHW Total 1−5y 6−11y (1−5y) (M/F 1−5y, (M/F 1−5y, (M/F 1−5y, (1−5, (F) (F) (M/F 1−5y, F 12−49y) F 12−49y) F 12−49y) 12−49y) F 12−49y) 3. Trace Elements 327

339 Table 3.2.c. Serum soluble transferrin receptor: Prevalence Prevalence (in percent) of high serum soluble transferrin receptor concentration (> 4.4 mg/L) for women in the U.S. population aged 12–49 years, National Health and Nutrition Examination Survey, 2003–2006. Sample Estimated total Prevalence (95% conf. interval) size number of persons 4,481 18.9 (17.0 – 20.9) 14,918,000 Women, 12–49 years Age group 1,968 2,741,000 (14.7 – 19.3) 12–19 years 16.9 2,513 19.4 (17.3 – 21.6) 12,159,000 20–49 years Race/ethnicity 19.0 Mexican Americans 1,221 (15.5 – 23.0) 1,451,000 Non-Hispanic Blacks 1,233 34.9 (31.6 – 38.4) 3,756,000 16.0 (13.6 – 18.7) 8,177,000 Non-Hispanic Whites 1,657 nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 328

340 Table 3.2.d. Serum soluble transferrin receptor: Prevalence by survey cycle Prevalence (in percent) of high serum soluble transferrin receptor concentration (> 4.4 mg/L) for women in the U.S. population aged 12–49 years, National Health and Nutrition Examination Survey, 2003–2006. Prevalence (95% conf. interval) Estimated total number of persons Sample size Women, 12–49 years 18.8 2003–2004 14,862,000 2,135 (16.3 – 21.6) 2,346 18.9 (16.0 – 22.3) 15,017,000 2005–2006 Age group 12–19 years 2003–2004 17.4 (14.0 – 21.3) 2,818,000 975 993 16.4 (13.5 – 19.8) 2005–2006 2,694,000 20–49 years 2003–2004 1,160 19.2 12,031,000 (16.3 – 22.4) 2005–2006 1,353 19.6 (16.4 – 23.2) 12,296,000 Race/ethnicity Mexican Americans 547 (13.3 – 25.7) 1,435,000 2003–2004 18.7 2005–2006 19.2 (14.6 – 24.7) 1,516,000 674 Non-Hispanic Blacks 2003–2004 604 33.2 (28.9 – 37.7) 3,568,000 2005–2006 36.7 (31.6 – 42.1) 3,988,000 629 Non-Hispanic Whites 2003–2004 823 16.1 (12.5 – 20.5) 8,258,000 (12.6 – 19.6) 2005–2006 834 15.8 7,991,000 3. Trace Elements 329

341 695 751 size 1,633 5,845 1,641 1,369 2,041 5,150 1,967 1,758 Sample (11.3 – 13.2) (11.5 – 12.5) (6.93 – 8.12) (7.17 – 7.87) (10.8 – 12.9) (11.5 – 12.7) (11.6 – 12.6) (9.23 – 10.2) (11.0 – 12.4) (12.7 – 14.2) 97.5th 12.1 12.0 11.4 7.36 7.33 12.0 12.1 9.61 11.6 13.1 (10.3 – 11.6) (10.6 – 11.2) (9.73 – 11.2) (6.65 – 7.30) (6.72 – 7.06) (10.5 – 11.5) (10.7 – 11.4) (8.35 – 9.34) (10.2 – 11.1) (11.7 – 12.9) 95th 11.0 10.8 6.89 10.4 6.91 10.9 11.0 8.84 10.7 12.4 (95% conf. interval) s (5.32 – 5.58) (4.44 – 5.12) (3.44 – 3.79) (3.32 – 3.80) (5.49 – 5.81) (5.49 – 5.76) (4.30 – 5.05) (4.71 – 5.16) (5.69 – 6.17) (5.86 – 6.82) 50th 5.43 3.52 4.75 3.64 5.66 5.65 4.96 4.66 5.88 6.37 (-2.60 – -1.41) (-1.36 – -.262) (-3.81 – -2.03) (-1.26 – -.159) (-2.34 – -.516) (-2.70 – -1.43) (-4.61 – -2.88) (-2.69 – -.763) (-2.81 – -1.22) (-3.78 – -1.84) 5th Selected percentile -1.83 -3.16 -.715 -.648 -1.21 -2.01 -1.59 -3.79 -1.75 -2.85 (-4.05 – -3.41) (-3.06 – -1.34) (-5.27 – -3.69) (-3.30 – -1.25) (-3.99 – -2.25) (-4.06 – -3.50) (-6.99 – -4.66) (-4.28 – -2.61) (-4.09 – -3.12) (-5.33 – -3.76) 2.5th -3.75 -4.49 -1.69 -2.00 -3.17 -3.78 -3.37 -5.79 -3.76 -4.43 n (5.01 – 5.31) (3.17 – 3.59) (4.10 – 4.88) (3.31 – 3.63) (5.24 – 5.69) (5.13 – 5.46) (4.10 – 4.64) (4.26 – 4.72) (5.29 – 5.73) (5.46 – 6.30) 5.16 3.38 3.47 4.49 5.46 5.30 4.37 4.49 5.51 5.88 (95% conf. interval) Arithmetic mea 1–5 years (Children) Race/ethnicity Mexican Americans Males (1–5 years) Gender (Children 1–5 years, women 12–49 years) Total Age group Non-Hispanic Whites (Children 1–5 years, women 12–49 years) Females (1–5, 12–49 years) 12–19 years (Women) Non-Hispanic Blacks 20–39 years (Women) 40–49 years (Women) population, National Health and Nutrition Examination Survey, 2003–2006. Arithmetic mean and selected percentiles of body iron (in mg/kg) for children aged 1–5 years and women aged 12–49 years in the U.S. Table 3.3.a.1. Body iron nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 330

342 Figure 3.3.a. Body iron: by age group Arithmetic mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2006 Overall Mexican Americans 8 6 Females Males 4 (mg/kg) Body iron 2 0 40−49 1−5 40−49 12−19 12−19 20−39 20−39 1−5 Non−Hispanic Blacks Non−Hispanic Whites 8 6 4 (mg/kg) Body iron 2 0 1−5 20−39 40−49 40−49 20−39 12−19 1−5 12−19 Females Males 8 6 Mexican Americans Non−Hispanic 4 Blacks (mg/kg) Non−Hispanic Body iron 2 Whites 0 1−5 12−19 20−39 40−49 1−5 12−19 20−39 40−49 Age (years) Age (years) 3. Trace Elements 331

343 Table 3.3.a.2. Body iron: Total population Arithmetic mean and selected percentiles of body iron (in mg/kg) for children aged 1–5 years and women aged 12–49 years in the U.S. population, National Health and Nutrition Examination Survey, 2003–2006. Sample n Arithmetic mea (95% conf. interval) s Selected percentile 50th 95th 5th (95% conf. interval) size Males and Females Total, Children 1–5 years, 5.16 (5.01 – 5.31) -1.83 (-2.60 – -1.41) 5.43 (5.32 – 5.58) 10.8 (10.6 – 11.2) 5,845 women 12–49 years (3.44 – 3.79) (3.31 – 3.63) -.648 (-1.26 – -.159) 3.64 3.47 6.89 (6.72 – 7.06) 1,369 1–5 years Males (3.17 – 3.59) 3.38 (3.32 – 3.80) -.715 (-1.36 – -.262) 3.52 1–5 years 6.91 (6.65 – 7.30) 695 Females Total, Children 1–5 years, 5.30 (5.13 – 5.46) -2.01 (-2.70 – -1.43) (5.49 – 5.76) 11.0 (10.7 – 11.4) 5,150 5.65 women 12–49 years 1–5 years 3.57 (3.36 – 3.78) -.196 (-2.11 – .411) 3.70 (3.41 – 4.04) 6.89 (6.67 – 7.27) 674 12–19 years 4.49 (4.26 – 4.72) -1.59 (-2.69 – -.763) 4.96 (4.71 – 5.16) 8.84 (8.35 – 9.34) 1,967 1,758 20–39 years 5.51 (5.29 – 5.73) -1.75 (-2.81 – -1.22) 5.88 (5.69 – 6.17) 10.7 (10.2 – 11.1) (11.7 – 12.9) 751 12.4 40–49 years 5.88 (5.46 – 6.30) -2.85 (-3.78 – -1.84) 6.37 (5.86 – 6.82) Table 3.3.a.3. Body iron: Mexican Americans Arithmetic mean and selected percentiles of body iron (in mg/kg) for Mexican American children aged 1–5 years and women aged 12–49 years in the U.S. population, National Health and Nutrition Examination Survey, 2003–2006. Arithmetic mea n Sample s Selected percentile (95% conf. interval) 5th 50th 95th (95% conf. interval) size Males and Females Total, Children 1–5 years, 1,641 4.49 (4.10 – 4.88) -3.16 (-3.81 – -2.03) 4.75 (4.44 – 5.12) 10.4 (9.73 – 11.2) women 12–49 years 3.48 3.16 (2.84 – 3.48) -2.09 (-3.35 – -1.36) 1–5 years (3.13 – 3.78) 6.99 (6.57 – 7.93) 422 Males 3.34 1–5 years 2.95 (2.48 – 3.41) -2.71† (-4.72 – -1.59) (5.95 – 9.30) (2.99 – 3.77) 6.92† 203 Females Total, Children 1–5 years, 4.66 (4.23 – 5.10) -3.17 (-3.82 – -1.90) (4.60 – 5.44) 10.6 (9.79 – 11.4) 1,438 5.02 women 12–49 years 1–5 years 3.38 (3.04 – 3.72) -1.88† (-2.87 – -.828) 3.55 (3.22 – 4.15) 6.99† (6.78 – 8.13) 219 12–19 years (3.76 – 4.39) -1.76 (-3.29 – -.981) 4.46 (4.26 – 4.68) 8.99 (8.51 – 9.69) 637 4.07 429 5.07 (4.48 – 5.67) -3.15 (-4.31 – -1.66) 5.72 (4.93 – 6.28) 10.7 (9.89 – 12.0) 20–39 years 11.1† 153 (10.4 – 15.1) 40–49 years 4.89 (3.74 – 6.04) -4.89† (-6.96 – -3.40) 5.33 (4.42 – 6.59) † Estimate is subject to greater uncertainty due to small cell size. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 332

344 Table 3.3.a.4. Body iron: Non-Hispanic blacks Arithmetic mean and selected percentiles of body iron (in mg/kg) for non-Hispanic black children aged 1–5 years and women aged 12–49 years in the U.S. population, National Health and Nutrition Examination Survey, 2003–2006. Sample n Arithmetic mea Selected percentile s (95% conf. interval) 5th 50th 95th (95% conf. interval) size Males and Females Total, Children 1–5 years, 4.37 (4.10 – 4.64) -3.79 (-4.61 – -2.88) 4.66 (4.30 – 5.05) 11.0 (10.3 – 11.6) 1,633 women 12–49 years 7.51 3.83 (-.906 – .776) 3.95 (3.78 – 4.25) -.115 (6.80 – 8.03) 401 1–5 years (3.56 – 4.09) Males 1–5 years (3.25 – 4.00) -.328† (-2.15 – .070) 3.77 (3.17 – 4.19) 6.90† (6.55 – 8.03) 199 3.63 Females Total, Children 1–5 years, 4.43 -3.94 (-4.87 – -3.04) 4.80 (4.35 – 5.16) 11.0 (10.4 – 11.9) 1,434 (4.14 – 4.72) women 12–49 years 1–5 years (3.73 – 4.34) .658† (-.541 – .981) 4.17 (3.92 – 4.35) 7.71† (6.93 – 8.09) 202 4.03 12–19 years 3.99 (3.56 – 4.42) -2.53 (-3.91 – -1.71) 4.46 (4.09 – 4.79) 8.91 (8.38 – 9.43) 667 20–39 years (3.63 – 4.28) -4.12 (-5.73 – -3.46) 4.35 (4.08 – 4.86) 9.96 (9.46 – 11.2) 368 3.96 197 5.78 (4.86 – 6.69) -5.62† (-9.51 – -2.80) 6.68 (5.78 – 7.32) 12.9† (11.9 – 15.4) 40–49 years † Estimate is subject to greater uncertainty due to small cell size. Table 3.3.a.5. Body iron: Non-Hispanic whites Arithmetic mean and selected percentiles of body iron (in mg/kg) for non-Hispanic white children aged 1–5 years and women aged 12–49 years in the U.S. population, National Health and Nutrition Examination Survey, 2003–2006. n Arithmetic mea Sample (95% conf. interval) s Selected percentile 5th 50th 95th (95% conf. interval) size Males and Females Total, Children 1–5 years, 5.46 (5.24 – 5.69) -1.21 (-2.34 – -.516) 5.66 (5.49 – 5.81) 10.9 (10.5 – 11.5) 2,041 women 12–49 years 1–5 years -.264 (-1.28 – .300) 3.56 (3.34 – 3.92) (3.27 – 3.74) (6.64 – 7.00) 385 3.51 6.89 Males 3.42 (3.09 – 3.75) -.571† (-1.39 – .140) 3.50 (3.06 – 4.01) 6.91† (6.45 – 7.33) 212 1–5 years Females Total, Children 1–5 years, 5.81 (5.36 – 5.84) -1.27 (-2.60 – -.546) 5.60 (5.66 – 6.02) 11.0 (10.7 – 11.5) 1,829 women 12–49 years 1–5 years 3.61 (3.33 – 3.89) .062† (-3.13 – .791) 3.67 (3.35 – 4.03) 6.70† (6.45 – 7.27) 173 12–19 years (4.35 – 5.02) -1.48 (-3.15 – -.417) 5.17 (4.86 – 5.50) 8.84 (8.29 – 9.62) 514 4.68 805 5.93 (5.58 – 6.28) -.640 (-2.73 – .779) 6.16 (5.82 – 6.59) 10.7 (10.2 – 11.4) 20–39 years 337 40–49 years 6.01 (5.45 – 6.57) -2.26 (-3.78 – -1.01) 6.36 (5.77 – 6.99) 12.4 (11.6 – 13.0) † Estimate is subject to greater uncertainty due to small cell size. 3. Trace Elements 333

345 Table 3.3.b. Body iron: By survey cycle Arithmetic mean and selected percentiles of body iron (in mg/kg) for children aged 1–5 years and women aged 12–49 years in the U.S. population, National Health and Nutrition Examination Survey, 2003–2006. n Sample Selected percentile s (95% conf. interval) Arithmetic mea 5th 50th 95th (95% conf. interval) size Total (Children 1–5 years, women 12–49 years) 5.21 (5.03 – 5.39) -1.60 (-2.96 – -.854) 5.43 (5.32 – 5.55) 10.9 (10.7 – 11.3) 2,826 2003–2004 (10.2 – 11.5) 5.11 (-2.73 – -1.43) 5.43 (5.08 – 5.71) 10.8 -2.04 3,019 (4.85 – 5.38) 2005–2006 Age group 1–5 years (Children) 3.25 (3.01 – 3.50) -.651 (-1.73 – .144) 3.34 (2.99 – 3.66) 6.55 (6.39 – 6.73) 694 2003–2004 (3.47 – 3.94) 3.70 7.00 -.642 (-1.65 – -.080) 3.91 (3.70 – 4.14) 2005–2006 (6.92 – 7.33) 675 12–19 years (Women) 2003–2004 (3.89 – 4.66) -2.23 (-3.93 – -.653) 4.71 (4.27 – 5.11) 8.89 (8.29 – 9.73) 974 4.27 4.71 (4.45 – 4.96) -1.45 (-2.64 – -.527) 5.10 (4.85 – 5.33) 8.53 (8.31 – 9.55) 993 2005–2006 20–39 years (Women) 2003–2004 (5.33 – 5.89) -1.21 (-2.14 – -.835) 6.07 (5.69 – 6.25) 10.4 (9.92 – 11.1) 801 5.61 2005–2006 5.42 (5.04 – 5.79) -2.55 (-3.91 – -1.41) 5.83 (5.44 – 6.27) 10.8 (10.2 – 11.9) 957 40–49 years (Women) 357 2003–2004 6.22 (5.61 – 6.82) -3.28 (-3.80 – -1.85) 6.85 (6.21 – 7.33) 12.7 (12.0 – 13.4) 2005–2006 394 5.55 (11.1 – 13.1) 11.8 (4.89 – 6.21) -2.47 (-4.61 – -1.59) 5.96 (5.33 – 6.66) Gender Males (1–5 years) 3.11 -.719 (-1.89 – -.152) 3.13 (2.70 – 3.65) 6.21 (5.74 – 6.92) 358 2003–2004 (2.76 – 3.46) 2005–2006 (3.41 – 3.95) -.746 (-1.32 – -.268) 3.91 (3.48 – 4.41) 7.24 (6.81 – 8.27) 337 3.68 Females (1–5, 12–49 years) 2003–2004 5.38 (5.18 – 5.58) -1.76 (-3.18 – -.854) 5.66 (5.50 – 5.80) 11.0 (10.7 – 11.5) 2,468 (5.32 – 5.84) (4.94 – 5.49) -2.20 (-2.98 – -1.52) 5.60 5.22 10.9 (10.2 – 11.6) 2,682 2005–2006 Race/ethnicity (Children 1–5 years, women 12–49 years) Mexican Americans (4.13 – 5.35) 2003–2004 4.74 4.94 -2.05 (-3.57 – -1.13) (4.28 – 5.64) 10.6 (9.69 – 12.5) 734 2005–2006 4.26 -3.70 (-5.21 – -2.73) 4.71 (4.31 – 5.05) 9.91 (9.73 – 10.8) 907 (3.78 – 4.73) Non-Hispanic Blacks 2003–2004 (4.02 – 4.94) -3.79 (-5.06 – -2.47) 4.48 (4.15 – 5.24) 11.1 (9.95 – 12.7) 831 4.68 2005–2006 4.26 (3.94 – 4.58) -3.96 (-4.99 – -2.62) 4.66 (4.16 – 5.17) 10.6 (9.86 – 11.4) 802 Non-Hispanic Whites (-3.69 – .285) 5.45 (5.14 – 5.75) -.903 2003–2004 5.57 (5.43 – 5.76) 11.0 (10.5 – 11.6) 1,023 (10.2 – 12.0) 1,018 10.9 2005–2006 5.48 (5.12 – 5.85) -1.39 (-2.45 – -.593) 5.70 (5.42 – 6.01) nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 334

346 Figure 3.3.b. Body iron: By Survey Cycle Selected percentiles in mg/kg (95% confidence intervals), National Health and Nutrition Examination Survey, 2003–2006 14 12 j j j j j j j j j j j 10 j j j 8 j j 95th Percentile j j 6 4 7 j 6 j j j j j j j j 5 j j j j j 4 j j 50th Percentile j j 3 2 2 0 j j j j j j j j j j j j −2 j j j 5th Percentile j j j −4 −6 03−04 05−06 03−04 05−06 03−04 05−06 03−04 05−06 03−04 05−06 03−04 05−06 03−04 05−06 05−06 03−04 05−06 03−04 05−06 03−04 Males Females MA NHB NHW Total 1−5y 6−11y 12−19y 20+y (M/F 1−5y, (M/F 1−5y, (M/F 1−5y, (1−5, (1−5y) (F) (F) (M/F 1−5y, F 12−49y) 12−49y) F 12−49y) F 12−49y) F 12−49y) 3. Trace Elements 335

347 Table 3.3.c.1. Body iron: Prevalence Prevalence (in percent) of low body iron (< 0 mg/kg) for children in the U.S. population aged 1–5 years, National Health and Nutrition Examination Survey, 2003–2006. Sample Estimated total Prevalence (95% conf. interval) size number of persons 1,369 6.7 (5.0 – 8.8) 1,350,000 Children, 1–5 years Gender 695 807,000 (5.6 – 10.8) Males 7.8 674 5.4 (3.4 – 8.3) 534,000 Females Race/ethnicity 10.9 Mexican Americans 422 (8.1 – 14.6) 333,000 Non-Hispanic Blacks 401 5.1 (3.0 – 8.6) 154,000 5.8 (3.6 – 9.1) 670,000 Non-Hispanic Whites 385 nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 336

348 Table 3.3.c.2. Body iron: Prevalence Prevalence (in percent) of low body iron (< 0 mg/kg) for women in the U.S. population aged 12–49 years, National Health and Nutrition Examination Survey, 2003–2006. Sample Prevalence Estimated total (95% conf. interval) number of persons size 4,476 9.5 (8.6 – 10.5) 7,515,000 Women, 12–49 years Age group 9.3 1,967 1,508,000 (7.4 – 11.6) 12–19 years 20–49 years 9.6 (8.6 – 10.7) 6,006,000 2,509 Race/ethnicity Mexican Americans 1,219 13.2 (10.2 – 16.9) 1,007,000 Non-Hispanic Blacks 1,232 16.2 (13.9 – 18.7) 1,739,000 (5.8 – 9.4) Non-Hispanic Whites 1,656 7.4 3,803,000 3. Trace Elements 337

349 Table 3.3.d.1. Body iron: Prevalence by survey cycle Prevalence (in percent) of low body iron (< 0 mg/kg) for children in the U.S. population aged 1–5 years, National Health and Nutrition Examination Survey, 2003–2006. Sample size (95% conf. interval) Estimated total number of persons Prevalence Children, 1–5 years 694 6.5 (4.3 – 9.8) 1,321,000 2003–2004 2005–2006 675 6.8 (4.5 – 10.2) 1,377,000 Gender Males 2003–2004 358 8.3 (4.9 – 13.7) 854,000 2005–2006 337 7.3 (4.7 – 11.1) 755,000 Females (2.7 – 7.4) 449,000 4.5 2003–2004 336 2005–2006 6.3‡ (3.1 – 12.4) 620,000‡ 338 Race/ethnicity Mexican Americans 2003–2004 187 13.3 (8.4 – 20.5) 405,000 (6.0 – 12.1) 2005–2006 235 8.6 275,000 Non-Hispanic Blacks 228 6.1‡ (3.1 – 11.8) 183,000‡ 2003–2004 2005–2006 173 § § Non-Hispanic Whites 2003–2004 201 4.6‡ (2.1 – 10.0) 538,000‡ (3.8 – 12.5) 184 792,000 2005–2006 7.0 ‡ Estimate flagged: 30% ≤ RSE < 40% for the prevalence estimate. § Estimate suppressed: RSE ≥ 40% for the prevalence estimate. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 338

350 Table 3.3.d.2. Body iron: Prevalence by survey cycle Prevalence (in percent) of low body iron (< 0 mg/kg) for women in the U.S. population aged 12–49 years, National Health and Nutrition Examination Survey, 2003–2006. Prevalence (95% conf. interval) Estimated total number of persons Sample size Women, 12–49 years 8.6 2003–2004 6,773,000 2,132 (7.0 – 10.4) 2,344 10.4 (9.3 – 11.7) 8,266,000 2005–2006 Age group 12–19 years 2003–2004 9.0 (6.3 – 12.6) 1,455,000 974 993 9.6 (6.9 – 13.2) 2005–2006 1,576,000 20–49 years 2003–2004 1,158 8.5 5,322,000 (6.8 – 10.5) 2005–2006 1,351 10.6 (9.5 – 11.9) 6,681,000 Race/ethnicity Mexican Americans 547 (7.6 – 16.2) 857,000 2003–2004 11.2 2005–2006 15.1 (10.5 – 21.2) 1,193,000 672 Non-Hispanic Blacks 2003–2004 603 16.0 (12.8 – 19.8) 1,720,000 2005–2006 16.3 (13.1 – 20.1) 1,777,000 629 Non-Hispanic Whites 2003–2004 822 6.9 (4.4 – 10.6) 3,530,000 (6.0 – 10.5) 2005–2006 834 8.0 4,023,000 3. Trace Elements 339

351 References Beard JL. Iron deficiency and neural development: an update. Arch Latinoam Nutr. 1999;49(3 Suppl 2):34S–39S. J. Indicators of the iron status of the population: free erythrocyte protoporphyrin and zinc protoporphyrin; Beard and transferrin plasma iron, total iron binding capacity and saturation; and serum transferrin receptor. In: serum a the iron status of populations: report of joint World H ealth O rganization/Centers for WHO/CDC. Assessing Control and Prevention technical consultation on the assessment of iron status at the population level. Disease World H ealth O rganization; 2007 [cited 2011]. A vailable at: http://www.who.int/nutrition/publications/ Geneva: . micronutrients/anaemia_iron_deficiency/9789241596107.pdf ME, Looker AC, Pfeiffer CM, Cook JD, Lacher DA, JL, et al. Assessment of iron deficiency in Cogswell Beard preschool children and nonpregnant females of childbearing US age: National Health and Nutrition Examination Survey 2003–2006. Am J Clin Nutr. 2009;89:1334–1342. quantitative Flowers CH, Cook Skikne BS. The JD, assessment of body iron. Blood. 2003;101:3359–3364. Flowers CH, Skikne BS, Covell AM, Cook JF. The clinical measurement of serum transferrin receptor. J Lab Clin Med. 1989;114:368–377. iron Ani C. A review of studies on the effect of deficiency on cognitive development in Grantham-McGregor S, J Nutr. 2001;131(2S-2):649S–656S. children. th JD, Brownlie T 4 . Iron deficiency and reduced Haas work capacity: a critical review of the research to determine a causal relationship. J Nutr. 2001;131:691S–696S. Medicine, Food and Nutrition Institute Dietary reference of intakes: vitamin A, vitamin K, arsenic, boron, Board. chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium and zinc. Washington, D.C.: National Press; 2001. Academy Relation Coenen JLLM, Huisman CMS, Abbes A, van Raan J, van Eijk Kuiper-Kramer HG. EPA, between soluble transferrin receptors in serum and membrane-bound transferrin receptors. Acta Haematol. 1998;99:8–11. Looker AC, Gunter EW, Johnson CL. Methods to assess iron status in various NHANES surveys. Nutr Rev. 1995;53:246–254. AC, Dallman PR, Carroll M, Gunter EW, Johnson CL. Looker Prevalence of iron deficiency in the United States. JAMA. 1997;277:973–975. Looker Wkly AC, Cogswell ME, Gunter EW. Iron deficiency—United States, 1999–2000. Morb Mortal R ep. 2002;51:897–899. Miret S, Simpson RJ, McKie AT. Physiology and molecular biology of dietary iron absorption. Annu Rev Nutr. 2003;23:283–301. AC, Cook JD, Mei Z, Cogswell ME, Looker CM, Lacher DA. Evaluation of an automated soluble Pfeiffer receptor (sTfR) assay on the Roche Hitachi analyzer and its comparison to two ELISA assays. Clin transferrin Chim 2007;382:112–116. Acta old Hereditary hemochromatosis—a new look at an disease. N Engl J Med. 2004;350:2382–2397. Pietrangelo A. SM, Pilch FR, editors. Assessment of iron nutritional status of the U.S. population based on data collected Senti in the Second National Health and Nutrition Examination Survey, 1976–1980. Bethesda (MD): Federation of American for Experimental Biology; 1984. Societies J H ediger ML. Anemia and ir on-deficiency anemia: compilation of data on pr egnancy outcome. Am Schorr TO, Clin 1994;59(Suppl):492S–501S. Nutr. a Flowers CH, Cook JD. Serum transferrin Skikne BS, quantitative measure of tissue iron deficiency. receptor: Blood. 1990;75:1870–1876. Thorpe SJ. The development and role of international biological reference materials in the diagnosis of anaemia. Biologicals 2010;38:449–458. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for th overnment 7 Americans, 2010. Edition, Washington, DC: U.S. G P rinting Office, D ecember 2010 [cited 2011]. at: http://www.cnpp.usda.gov/DGAs2010-PolicyDocument.htm. Available nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 340

352 World Organization (WHO)/UNICEF/UNU. Iron deficiency anaemia: assessment, prevention, and Health WHO/NHD/01.3) guide for programme managers. Geneva: World H ealth O rganization; 2001 ( control. [cited A at: 2011]. Available http://www.who.int/nutrition/publications/micronutrients/anaemia_iron_deficiency/WHO_NHD_01.3/en/index. html. Organization (WHO)/CDC. Assessing the iron World of Health populations: report of a joint World H ealth status Organization/Centers for Disease Control and Prevention technical consultation on the assessment of iron status at 2005 the level. Geneva: World H ealth O rganization; population [cited 2011]. A vailable at: http://whqlibdoc.who. int/publications/2004/9241593156_eng.pdf . WHO. Serum ferritin concentrations for the assessment of iron status and iron deficiency in populations. Vitamin ealth and Mineral Nutrition Information System. Geneva, World H O rganization; 2011 ( WHO/NMH/NHD/ MNM/11.2). accessed February 14, 2012). (http://www.who.int/vmnis/indicators/serum_ferritin.pdf, van The measurement of ferritin. In: Rowan, Assendelft, Preston, editors. Advanced Laboratory Worwood M. in Haematology. Hodder Methods Arnold; 2002a. pp. 241–263. Worwood M. Serum transferrin receptor assays and their application. Ann Clin Biochem. 2002b;39:221–230. Worwood M. Indicators of the iron status of populations: ferritin. In: WHO/CDC. Assessing the ir on status of populations: of a joint World H ealth O rganization/Centers report for D isease Contr ol and P revention technical consultation on the assessment of iron status at the population level. Geneva: World H ealth O rganization; 2007 [cited 2011]. Available at: http://www.who.int/nutrition/publications/micronutrients/anaemia_iron_ . deficiency/9789241596107.pdf 3. Trace Elements 341

353 Iodine Background Information Iodine, Sources and Physiological Functions. trace element found in soil, is an essential a the thyroid hormones involved in regulating body’s metabolic processes of the component normal growth and development. Across the world, iodized salt and related are the to seafood dietary sources of iodine. In the United States, where addition of iodine to salt is not major the most people get their iodine from dairy products and grains (bread) ( Murray mandatory, 2008 ). United States, salt is iodized with potassium iodide at 100 parts per million (76 milligram In the of iodine per kilogram [kg] of salt). Iodized salt is chosen by about 50–60% of the U.S. [mg] ( most of Medicine 2001 ). Still, ingested salt comes from processed food population Institute the 70%), is typically not iodized in either United States or in Canada ( The (approximately which Health Committee of the American Thyroid Association 2006 ). Dairy products have been Public as another important contributor to iodine status among reproductive-age women in identified 2010 United ( Perrine States ). the Iodine deficiency disorders include mental retardation, hypothyroidism, goiter, Health Effects. varying degrees of other growth and and developmental abnormalities. Iodine deficiency cretinism, the most preventable cause of mental retardation in the world ( World Health Organization 2007 ). is (goiter) is usually the earliest clinical feature of iodine deficiency. Thyroid Thyroid enlargement is particularly important in the development of the central nervous system during the fetal hormone is postnatal periods. In areas where iodized salt common, iodine deficiency is rare. The and early critical period for iodine sufficiency is in utero through the first two years of most when thyroid life, hormones are required for normal brain development ( World Health Organization 2007 ). intake Excess may also result in goiter, as iodine well as in hyper- or hypothyroidism. High iodine intake has also been associated with increased risk for thyroid papillary cancer ( Institute of Medicine ). For most people, iodine intake from usual foods and supplements is unlikely to 2001 exceed the tolerable upper intake level (1100 g /day) ( Institute of Medicine 2001 ). μ Intake Recommendations. The Institute of Medicine recommends the following daily intake of iodine: 90 μg for children 1 to 8 years, 120 μg for children 9 to 13 years, 150 μg for adolescents μg to 18 years) and for nonpregnant adults, 220 per (14 day for pregnant women, and 290 μg per day during lactation ( Institute of Medicine 2001 ). Dietary iodine requirements are higher in pregnancy of increased thyroid hormone production, increased renal iodine excretion, because fetal iodine requirements ( Glinoer 2007 ). and Organization W orld Health (WHO) The the following daily intake of iodine: recommends 90 g for preschool children (0 to 59 months); μ g for schoolchildren (6 to 120 12 years); 150 μ g μ for adolescents (above 12 years) and adults; and 250 g for pr egnant and lactating women ( World μ 2007 ). Health The American Organization recommends Thyroid that North Association American women receive dietary supplements containing 150 μ g iodine daily during pregnancy all and and that lactation prenatal vitamins contain 150 μ g of iodine ( Becker 2006 ). An Practice Endocrine Society Clinical Guideline on during dysfunction the management of thyroid nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 342

354 pregnancy postpartum recommends an average daily intake of 250 μ g iodine for pregnant and (Abalovich 2007). These recommendations have not yet been widely adopted. A current women of multivitamins marketed in the United States showed that 49% did not contain survey prenatal ( Leung 2009 ). Furthermore, the majority of women of childbearing age (> iodine 80%) are not consuming supplements containing iodine ( Gregory 2009 ). μ deficiency develops when iodide intake is less than 20 Biochemical Indicators. g /day Iodine Beers 2006 ( Most dietary iodine absorbed in the body eventually appears in the urine; thus, ). urinary iodine excretion is recommended for assessing recent dietary iodine intake worldwide ( World Health Organization 2007 ). in for median urinary iodine concentrations school-age children and adults WHO categories pregnant and lactating women) are widely used (excluding to define iodine intake and nutrition status for populations ( World Health Organization 2007 ). An additional adequacy criterion is that not more than 20% of samples from children and non-pregnant women be below 50 categories nanograms milliliter (ng/mL) of iodine. These per are useful for classifying population risk, but they are not categories to define individual risk for adverse health outcomes. The large even day-to-day variations in urine iodine excretion, among individuals with stable iodine intake, tend offset one another when the sample includes an adequately large number (100–500 spot to samples per group or subgroup) of representative individuals ( Andersen 2008 ). urine Epidemiological criteria for assessing iodine nutrition based on median urinary iodine World Health Organization 2007 concentrations of school-age children (> 6 years)* ( ) Median Urinary Iodine Status Iodine Intake Iodine (ng/mL) Insufficient < 20 Severe iodine deficiency 20–49 Insufficient Moderate iodine deficiency 50–99 Insufficient Mild iodine deficiency Adequate iodine nutrition 100–199 Adequate Likely to provide adequate intake for pregnant/lactating Above women but may pose a slight risk of more than adequate 200–299 requirements intake in the overall population Risk for adverse health consequences (e.g., iodine-induced ≥ 300 Excessive hyperthyroidism, autoimmune thyroid diseases) * Applies to adults but not to pregnant and lactating women. pregnant women, median urinary iodine concentrations of 150–249 ng/mL represent For adequate intake ( World Health Organization 2007; Andersson 2007 ). Median urinary iodine of < 150 ng/mL represent insufficient iodine intake; 250–499 ng/mL represent concentrations an above requirements, and ≥ 500 ng/mL intake represent an excessive intake. For lactating women and children less than 2 years of age, median urinary iodine concentrations of 100 ng/ mL adequate iodine intake, but no other categories of iodine intake are defined ( World represent Organization 2007; Andersson 2007 ). Health Data in NHANES. has measured iodine since NHANES 1971. The NHANES III survey urinary (1988–1994) showed a sizable decrease in urinary iodine concentrations compared to concentrations measured NHANES I (1971–1974) ( Hollowell 1998 ). during This decline may have been due to the dairy industry’s effort in the mid-1980s to reduce the iodine residue in milk from feed supplements and iodophor sanitizing agents ( Pennington 1996 ). Decreased concentrations of iodine food in fruit-flavored breakfast cereals resulted from a ban on erythrosine (an iodine-containing 3. Trace Elements 343

355 EZF BOEDPVMEBMTPIBWFDPOUSJCVUFEUPUIFEFDMJOFJOVSJOBSZJPEJOFDPODFOUSBUJPOT 1FOOJOHUPO  4JODF VSJOBSZJPEJOFIBTCFFONFBTVSFEJOUIFDPOUJOVPVT/)"/&4TVSWFZ4UBSUJOH XJUI/)"/&4 $%$VTFEBOFXNFUIPE JOEVDUJWFMZDPVQMFEQMBTNBNBTTTQFDUSPNFUSZ $BMEXFMM ɨJTNFUIPEQSPEVDFEDPNQBSBCMFEBUB *$1.4 UPNBLFUIFTFNFBTVSFNFOUT UPUIFFTUBCMJTIFE4BOEFMM,PMUIPêTQFDUSPQIPUPNFUSJDNFUIPEVTFEJO/)"/&4*** 1JOP  8IFO$%$MBCPSBUPSZTDJFOUJTUTNFBTVSFEVSJOBSZJPEJOFDPODFOUSBUJPOTJO/)"/&4o $BMEXFMM o $BMEXFMM BOEoBOEo $BMEXFMM  UIFZGPVOEUIBUUIF64NFEJBOVSJOBSZJPEJOFDPODFOUSBUJPOIBETUBCJMJ[FETJODFUIFJOJUJBMESPQ UIBUIBEPDDVSSFEGSPN/)"/&4*UP/)"/&4***BOEUIBUJUSFQSFTFOUFEBEFRVBUFJPEJOFJOUBLF GPSUIFPWFSBMMQPQVMBUJPOZFBSTBOEPMEFSɨFNFEJBO DPOëEFODFJOUFSWBM VSJOBSZJPEJOF DPODFOUSBUJPOGPSQSFHOBOUXPNFO< o OHN->XBTCFMPXUIFDVUPêWBMVFPGOHN- JOEJDBUJOHJPEJOFEFëDJFODZ IPXFWFSUIFTBNQMFXBTTNBMM O  $POUJOVFE $BMEXFMM NPOJUPSJOHPGUIFQPQVMBUJPOGPSJPEJOFTVïDJFODZJTXBSSBOUFECFDBVTFPGHSPVQTBUSJTLGPSJPEJOF EFëDJFODZEJTPSEFST TFFUIF*OTUJUVUFPG.FEJDJOFT%JFUBSZ3FGFSFODF*OUBLF For more information about iodine SFQPSU *OTUJUVUFPG.FEJDJOF  Highlights 6SJOBSZJPEJOFDPODFOUSBUJPOTJOUIF64QPQVMBUJPOTIPXFEUIFGPMMPXJOHEFNPHSBQIJDQBUUFSOT BOEDIBSBDUFSJTUJDT ɨFMPXFTUDPODFOUSBUJPOTXFSFPCTFSWFEJOZPVOHXPNFO XIJMFUIFIJHIFTU t DPODFOUSBUJPOTXFSFPCTFSWFEJODIJMESFO /PDPOTJTUFOUQBUUFSOXBTPCTFSWFEXJUISFHBSEUPSBDFFUIOJDJUZ t $PODFOUSBUJPOTIBWFCFFOSFMBUJWFMZTUBCMFTJODFUIFMBUFT t ɨFJPEJOFJOUBLFPGUIF64QPQVMBUJPOBQQFBSFEUPCFBEFRVBUFPOUIFCBTJTPGNFEJBOVSJOBSZ JPEJOFDPODFOUSBUJPOT)PXFWFS XPNFOBHFEoZFBSTIBEUIFMPXFTUJPEJOFJOUBLF KVTU 'JHVSF)F :PVOHXPNFONFSJUTQFDJBMBUUFOUJPOUPFOTVSF TMJHIUMZBCPWFJOTVïDJFOUJOUBLF UIFCFTUQPTTJCMFCSBJOEFWFMPQNFOUPGUIFGFUVTEVSJOHQSFHOBODZ8IJMFOPBHFHSPVQIBEB NFEJBOVSJOBSZJPEJOFDPODFOUSBUJPOUIBUSFQSFTFOUFEFYDFTTJWFJPEJOFJOUBLF CPZToZFBSTPG BHFIBEUIFIJHIFTUJOUBLF BOEUIFVQQFSDPOëEFODFMJNJUPGUIFNFEJBOXBTKVTUTMJHIUMZXJUIJO UIFSBOHFPGFYDFTTJWFJOUBLF 'JHVSF)F  Males Females 400 Excessive intake 300 Above requirements 200 Adequate intake 100 Median urinary iodine (ng/mL) Insufficient intake 0 6-11 12-19 20-39 60 40-59 Age (years) Figure H.3.e. Median concentrations of urinary iodine in the U.S. population aged 6 years and older by age group and gender associated with estimated iodine intake, National Health and Nutrition Examination Survey, 2001–2006. Error bars represent 95% confidence intervals. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 344

356 Urinary concentrations have been relatively stable over almost two decades between 1988– iodine Figure H.3.f ). They increased slightly (< 20%) between 1988–1994 and 2001–2002 in ( 2006 the total population, in males, in females, and in non-Hispanic whites. However, they remained and unchanged non-Hispanic blacks in Mexican Americans. 2001-2002 1988-1994 2003-2006 b 200 c a a b a b b a b a b a b a a a 150 a 100 Urinary iodine (ng/mL) 50 0 Mexican Females Males Non- Total Non- American Hispanic population Hispanic black white Age-adjusted geometric mean concentrations of urinary iodine in the U.S. population aged 6 years and older by gender or Figure H.3.f. race/ethnicity, National Health and Nutrition Examination Survey, 1988–2006. Error bars represent 95% confidence intervals. Within a demographic group, bars not sharing a common letter differ (p < 0.05). Detailed Observations are the uncorrected below mentioned observations selected derived tables and figures from The of based comparisons group allow to size sufficient is population NHANES The next. presented demographic groups noted on uncorrected data. Statements about categorical differences between are based on non-overlapping confidence below limits from univariate analysis without adjusting or determinants of these urine race/ethnicity) other for demographic variables (i.e., age, sex, may analysis multivariate A BMI). smoking, usage, supplement intake, dietary (i.e., concentrations categorical differences. Furthermore, additional of significance statistical and size the alter these magnitude may be present despite their lack of mention here (e.g., significant differences of smaller differences if covariate before significant statistically not are if or overlap slightly limits confidence citations of descriptive NHANES papers related to For occurred). has adjustment a of selection these biochemical indicators of diet and nutrition, see Appendix G . Geometric mean concentrations (NHANES 2003–2006): the lowest • Urinary with pattern, age U-shaped a followed concentrations iodine 3.4.a). Figure and 3.4.a.1 (Table adults middle-aged and young in seen concentrations urinary iodine concentrations than males (T able 3.4.a.1 and Figur e 3.4.a). • Females had low er Non-Hispanic blacks had lower urinary • iodine concentrations than either non-Hispanic 3.4.a). whites or Mexican Americans Figure and (Table 3.4.a.1 Changes in geometric mean concentrations across survey cycles: iodine • We 2006 and 2001 between concentrations urinary in change no observed 3.4.b). (Table 3. Trace Elements 345

357 666 919 size 1,013 1,443 1,134 2,477 2,698 2,085 1,320 1,363 5,175 Sample (1,050 – 4,320) (599 – 872) (556 – 906) (808 – 1,240) (756 – 6,960) (743 – 1,260) (664 – 953) (535 – 770) (731 – 1,170) (687 – 1,130) (719 – 1,040) 97.5th 679 936 674 935 762 768 835 606 816 1,530 1,040 (616 – 1,080) (457 – 574) (644 – 903) (453 – 614) (541 – 606) (581 – 760) (631 – 1,080) (442 – 554) (570 – 714) (539 – 730) (565 – 676) 95th 515 707 741 489 673 571 764 591 634 482 603 (95% conf. interval) s (171 – 203) (136 – 156) (129 – 149) (168 – 202) (137 – 153) (208 – 270) (172 – 189) (173 – 195) (128 – 152) (156 – 176) (154 – 170) 50th 186 140 181 145 144 232 186 180 166 141 162 Selected percentile 5th (25.0 – 45.7) (21.5 – 35.2) (22.5 – 33.6) (36.9 – 49.0) (24.0 – 32.0) (37.5 – 55.9) (34.9 – 42.5) (34.0 – 49.4) (31.1 – 44.0) (27.9 – 36.6) (29.0 – 36.5) 41.9 29.4 28.4 36.7 28.5 38.1 51.6 40.2 38.2 32.0 33.0 (25.9 – 37.7) (18.0 – 30.8) (17.6 – 23.8) (13.2 – 26.0) (17.5 – 24.0) (25.8 – 43.0) (19.0 – 38.6) (22.4 – 32.9) (25.7 – 30.8) (18.9 – 25.8) (19.4 – 26.0) 2.5th 30.3 20.0 20.0 24.9 20.0 28.0 36.4 30.7 28.7 22.5 23.3 n (128 – 147) (170 – 205) (161 – 199) (126 – 144) (133 – 147) (201 – 245) (161 – 185) (164 – 185) (131 – 151) (151 – 168) (148 – 163) 179 187 137 135 140 222 174 173 141 159 156 (95% conf. interval) Geometric mea 60 years and older 20–39 years 12–19 years 40–59 years Females Males Gender (Children 1–5 years, women 12–49 years) Mexican Americans Race/ethnicity 6–11 years Age group Total Non-Hispanic Blacks Non-Hispanic Whites (Children 1–5 years, women 12–49 years) and Nutrition Examination Survey, 2003–2006. Geometric mean and selected percentiles of urine concentrations (in ng/mL) for the total U.S. population aged 6 years and older, National Health Table 3.4.a.1. Urinary iodine: Concentrations nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 346

358 Figure 3.4.a. Urinary iodine: Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2006 Overall Mexican Americans 400 Females Males 300 200 (ng/mL) Urinary iodine 100 0 40−59 20−39 20−39 60+ 60+ 6−11 40−59 6−11 12−19 12−19 Non−Hispanic Whites Non−Hispanic Blacks 400 300 200 (ng/mL) Urinary iodine 100 0 60+ 40−59 20−39 12−19 6−11 12−19 20−39 6−11 40−59 60+ Females Males 400 Mexican Americans 300 Non−Hispanic Blacks 200 Non−Hispanic (ng/mL) Whites Urinary iodine 100 0 60+ 40−59 20−39 20−39 40−59 60+ 6−11 12−19 12−19 6−11 Age (years) Age (years) 3. Trace Elements 347

359 Table 3.4.a.2. Urinary iodine: Total population Geometric mean and selected percentiles of urine concentrations (in ng/mL) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. n Geometric mea Sample (95% conf. interval) s Selected percentile 50th 90th 10th (95% conf. interval) size Males and Females (148 – 163) 47.9 (42.9 – 53.9) Total, 6 years and older (154 – 170) 444 (422 – 467) 5,175 156 162 222 77.6 (55.8 – 94.7) 232 (201 – 245) 581 (515 – 754) 666 6–11 years (208 – 270) 179 (161 – 199) 55.5 (44.3 – 68.0) 186 (171 – 203) 518 (465 – 658) 1,443 12–19 years 135 20–39 years (33.9 – 52.9) 140 (129 – 149) 368 (323 – 416) 1,134 (126 – 144) 42.0 137 40.4 (36.9 – 45.7) 145 (136 – 156) 388 (359 – 423) 919 40–59 years (128 – 147) 187 (170 – 205) 61.3 (52.0 – 68.5) 181 (168 – 202) 523 (463 – 580) 1,013 60 years and older Males (172 – 189) (164 – 185) 56.4 (48.0 – 65.2) 180 174 465 (441 – 500) 2,477 Total, 6 years and older (212 – 295) 250 (212 – 313) 94.3 (55.4 – 115) 264 6–11 years 653 (498 – 1,080) 307 12–19 years 200 73.1 (54.8 – 87.7) 198 (184 – 220) 525 (479 – 707) 693 (181 – 222) 154 53.6 (38.8 – 65.1) 160 (143 – 174) 408 (327 – 478) 512 20–39 years (142 – 167) 149 (137 – 163) 48.3 (38.6 – 59.5) 148 40–59 years 395 (363 – 458) 454 (138 – 166) 60 years and older (191 – 233) 65.1 (46.9 – 88.2) 211 (193 – 228) 538 (469 – 652) 511 205 Females Total, 6 years and older 140 41.4 (37.7 – 46.8) 144 (137 – 153) 412 (389 – 453) 2,698 (133 – 147) 6–11 years (176 – 215) 61.8 (45.8 – 81.5) 210 (174 – 232) 549 (423 – 718) 359 195 12–19 years 160 (137 – 186) 46.1 (29.2 – 59.0) 166 (143 – 191) 487 (421 – 633) 750 20–39 years 118 (107 – 131) 35.4 (30.4 – 43.8) 119 (108 – 136) 333 (300 – 406) 622 465 40–59 years 127 (116 – 139) 36.4 (28.2 – 40.1) 140 (123 – 161) 368 (333 – 418) 483 (413 – 590) 502 60 years and older 169 (151 – 189) 60.2 (48.9 – 67.7) 157 (134 – 176) Table 3.4.a.3. Urinary iodine: Mexican Americans Geometric mean and selected percentiles of urine concentrations (in ng/mL) for Mexican Americans in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. Geometric mea n Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females 173 (161 – 185) 59.9 Total, 6 years and older 186 (173 – 195) 450 (404 – 518) 1,320 (52.3 – 68.3) 6–11 years (196 – 253) 80.8 (54.8 – 98.9) 223 (208 – 265) 544 (469 – 713) 217 235 12–19 years 174 (155 – 194) 56.6 (44.9 – 62.7) 176 (163 – 203) 488 (414 – 596) 466 20–39 years 169 65.7 (55.6 – 78.5) 187 (165 – 198) 401 (352 – 547) 283 (153 – 186) 40–59 years (124 – 184) 45.4 (33.9 – 59.5) 158 (123 – 196) 382 (305 – 699) 165 151 60 years and older 175 (148 – 207) 57.2 (43.7 – 69.2) 159 (128 – 193) 444 (377 – 690) 189 Males 184 173 (162 – 185) 61.8 (56.1 – 71.9) Total, 6 years and older (165 – 199) 454 (404 – 510) 623 (209 – 271) 6–11 years 224 (187 – 269) 85.2† (41.0 – 133) 236 96 519† (422 – 836) 12–19 years 194 60.8 (46.1 – 78.1) 199 (169 – 234) 549 (432 – 747) 221 (164 – 230) 167 62.3 (58.5 – 78.1) 184 (146 – 202) 386 (334 – 591) 134 20–39 years (148 – 189) 139 (112 – 171) 45.1† (31.2 – 61.1) 122 40–59 years 369† (298 – 1,260) 77 (107 – 168) 60 years and older (166 – 232) 70.5† (30.1 – 92.3) 196 196 495† (365 – 6,920) 95 (155 – 243) Females Total, 6 years and older 172 (159 – 187) 57.0 (45.9 – 67.4) 190 (164 – 205) 444 (373 – 566) 697 6–11 years 221 75.9 (47.0 – 94.8) 226 (180 – 270) 584 (456 – 1,110) 121 (182 – 269) 12–19 years (134 – 178) 49.4 (34.7 – 61.1) 163 (142 – 188) 428 (338 – 695) 245 154 20–39 years 171 (148 – 198) 68.9 (39.1 – 81.4) 187 (145 – 219) 402 (348 – 569) 149 40–59 years 165 (128 – 212) 45.9† (20.2 – 64.8) 199 (145 – 218) 385† (295 – 1,150) 88 (283 – 1,010,900) 425† 94 60 years and older 159 (117 – 218) 52.5† (34.2 – 61.4) 128 (107 – 163) † Estimate is subject to greater uncertainty due to small cell size. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 348

360 Table 3.4.a.4. Urinary iodine: Non-Hispanic blacks Geometric mean and selected percentiles of urine concentrations (in ng/mL) for non-Hispanic blacks in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. Geometric mea n Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females 374 (47.6 – 57.0) 141 (128 – 152) (131 – 151) (322 – 423) 1,363 Total, 6 years and older 141 51.7 6–11 years 62.4 (45.7 – 76.1) 190 (168 – 217) 459 (387 – 682) 221 186 (163 – 213) 149 55.0 (47.9 – 61.0) 148 (137 – 163) 394 (351 – 475) 515 12–19 years (138 – 168) 128 (113 – 145) 57.3 20–39 years 125 (116 – 160) 283 (242 – 310) 238 (47.2 – 66.3) 40–59 years (124 – 160) 48.3 (35.7 – 59.1) 134 (122 – 144) 428 (337 – 485) 219 140 326 128 (35.0 – 50.6) 128 (102 – 146) 42.1 (259 – 529) 170 60 years and older (108 – 151) Males 158 (145 – 172) 58.1 (51.7 – 69.8) Total, 6 years and older (142 – 176) 408 (335 – 456) 663 159 6–11 years (172 – 251) 75.9† (48.1 – 102) 208 (172 – 284) 500† (393 – 952) 106 205 12–19 years 161 (145 – 178) 61.4 (47.3 – 76.3) 155 (141 – 177) 409 (342 – 588) 260 20–39 years 141 61.0† (46.8 – 72.0) 154 (117 – 185) 292† (259 – 398) 108 (125 – 160) 161 55.5† (34.1 – 77.7) 145 (125 – 198) 429† (329 – 518) 104 40–59 years (134 – 192) 145 (105 – 200) 42.6† (31.1 – 55.9) 141 60 years and older 414† (249 – 8,300) 85 (93.6 – 204) Females 127 (117 – 138) 49.0 (41.9 – 53.8) Total, 6 years and older (121 – 136) 329 (307 – 380) 700 128 6–11 years 166 (145 – 190) 44.7 (39.2 – 67.1) 168 (151 – 211) 409 (381 – 581) 115 12–19 years 139 50.9 (36.2 – 59.2) 139 (125 – 164) 387 (312 – 475) 255 (124 – 156) 20–39 years (98.4 – 142) 54.2 (27.1 – 66.6) 123 (105 – 148) 237 (212 – 342) 130 118 40–59 years 125 (107 – 147) 44.8 (30.9 – 53.4) 122 (103 – 137) 390 (290 – 516) 115 60 years and older 116 (91.7 – 148) 42.0† (12.9 – 50.6) 115 (83.6 – 146) 271† (244 – 466) 85 † Estimate is subject to greater uncertainty due to small cell size. Table 3.4.a.5. Urinary iodine: Non-Hispanic whites Geometric mean and selected percentiles of urine concentrations (in ng/mL) for non-Hispanic whites in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. n Geometric mea Sample (95% conf. interval) s Selected percentile 50th 90th 10th (95% conf. interval) size Males and Females (151 – 168) 47.0 (41.1 – 54.3) 166 (156 – 176) 461 (427 – 489) 2,085 Total, 6 years and older 159 (208 – 271) 6–11 years (55.0 – 103) 267 (202 – 315) 620 (536 – 978) 169 237 81.0 187 48.9 (36.7 – 73.4) 194 (172 – 224) 561 (481 – 744) 365 12–19 years (160 – 218) 133 (122 – 145) 39.9 (32.0 – 49.0) 139 (125 – 150) 378 (318 – 461) 494 20–39 years 140 40–59 years (35.6 – 48.7) 153 (139 – 167) 389 (361 – 424) 453 (131 – 151) 40.3 538 193 (55.5 – 74.1) 193 (172 – 211) 65.3 (460 – 598) 604 60 years and older (175 – 214) Males 182 (170 – 195) 58.0 (47.5 – 69.5) 187 (176 – 199) 481 (450 – 548) 996 Total, 6 years and older 292 (230 – 371) 112† (46.9 – 132) 315 (229 – 381) 6–11 years (503 – 1,600) 76 741† 12–19 years 213 (185 – 246) 77.2 (38.8 – 102) 208 (187 – 242) 564 (483 – 770) 174 20–39 years 159 51.0 (36.9 – 71.6) 163 (139 – 186) 413 (322 – 516) 211 (141 – 179) 153 (137 – 173) 49.7 (38.4 – 65.5) 153 40–59 years 396 (355 – 464) 229 (140 – 168) (197 – 249) 60 years and older 66.6 (45.4 – 93.4) 218 (198 – 245) 548 (483 – 666) 306 220 Females Total, 6 years and older 141 (132 – 149) 39.6 (33.9 – 44.0) 148 (137 – 157) 423 (390 – 471) 1,089 6–11 years 191 58.9† (38.5 – 81.6) 194 (150 – 251) 554† (423 – 855) 93 (166 – 221) 12–19 years (127 – 206) 36.9 (18.6 – 58.0) 171 (138 – 227) 538 (431 – 793) 191 162 20–39 years 112 (98.2 – 129) 32.3 (22.5 – 41.6) 115 (102 – 130) 327 (278 – 461) 283 40–59 years 129 (117 – 143) 33.6 (24.7 – 40.7) 150 (123 – 178) 368 (334 – 425) 224 298 60 years and older 174 (153 – 197) 63.3 (50.0 – 72.8) 166 (137 – 191) 482 (401 – 613) † Estimate is subject to greater uncertainty due to small cell size. 3. Trace Elements 349

361 Table 3.4.b. Urinary iodine: Concentrations by survey cycle Geometric mean and selected percentiles of urine concentrations (in ng/mL) for the U.S. population, National Health and Nutrition Examination Survey, 2001–2006. Geometric mea n Selected percentile s (95% conf. interval) Sample 5th 95th 50th (95% conf. interval) size Total, 6 years and older (152 – 172) 30.1 (24.9 – 35.5) 168 (158 – 177) 713 (627 – 809) 2001–2002 162 2,837 150 28.9 (24.9 – 33.7) 160 (141 – 160) 569 (493 – 660) 2,526 2003–2004 (146 – 172) 161 (150 – 174) 36.0 (29.0 – 39.1) 2005–2006 (154 – 174) 665 (580 – 762) 2,649 164 Age group 6–11 years (220 – 288) 51.8 (25.5 – 65.9) 249 (208 – 266) 771 (700 – 918) 374 2001–2002 235 209 (183 – 239) 45.7 (37.4 – 54.0) 229 2003–2004 613 (553 – 1,180) 315 (187 – 279) (197 – 279) (201 – 276) 60.2 (28.0 – 80.9) 238 235 967 (673 – 2,950) 351 2005–2006 12–19 years 2001–2002 192 (178 – 207) 38.3 (23.5 – 47.2) 205 (189 – 214) 803 (710 – 968) 831 2003–2004 166 33.5 (17.9 – 46.4) 178 (144 – 203) 645 (503 – 924) 721 (141 – 195) 797 193 (25.1 – 51.8) 194 (177 – 224) 38.2 (713 – 1,160) 722 2005–2006 (167 – 224) 20–39 years 148 (132 – 166) 27.8 (22.0 – 40.6) 2001–2002 (136 – 173) 536 (473 – 762) 627 153 2003–2004 (125 – 151) 23.8 (18.5 – 32.3) 138 (123 – 165) 564 (446 – 746) 517 146 2005–2006 132 (120 – 145) 31.9 (22.3 – 40.0) 134 (124 – 143) 483 (412 – 601) 617 40–59 years 2001–2002 (121 – 162) 24.5 (21.1 – 30.0) 140 (119 – 169) 689 (525 – 1,330) 496 141 2003–2004 132 (119 – 147) 24.9 (13.1 – 35.0) 142 (128 – 161) 478 (422 – 690) 434 2005–2006 143 (129 – 158) 34.6 (20.1 – 38.3) 148 (131 – 173) 519 (431 – 640) 485 60 years and older (30.1 – 48.7) (152 – 198) 509 2001–2002 177 (156 – 200) 40.7 (617 – 1,250) 171 744 2003–2004 169 (29.9 – 45.9) 170 (148 – 196) 635 (518 – 776) 539 (152 – 189) 39.7 (175 – 240) (620 – 4,220) (35.6 – 59.7) 195 (172 – 223) 826 205 474 2005–2006 47.9 Gender Males (179 – 209) 41.7 (35.0 – 48.0) 196 2001–2002 769 (630 – 981) 1,333 (178 – 208) 192 169 (156 – 183) 38.8 (25.9 – 44.3) 178 (164 – 193) 584 (475 – 786) 1,229 2003–2004 179 2005–2006 38.0 (32.9 – 44.8) 182 (172 – 195) 702 (595 – 960) 1,248 (163 – 197) Females 2001–2002 (127 – 148) 24.6 (21.3 – 29.2) 140 (126 – 156) 653 (576 – 736) 1,504 137 134 (125 – 145) 25.0 (23.0 – 29.0) 141 (127 – 155) 559 (493 – 584) 1,297 2003–2004 2005–2006 146 (136 – 158) 31.2 (20.6 – 39.0) 147 (137 – 155) 592 (544 – 693) 1,401 Race/ethnicity Mexican Americans 2001–2002 176 (163 – 189) 33.7 (29.0 – 42.3) 187 (168 – 206) 673 (527 – 883) 720 2003–2004 168 38.7 (19.9 – 52.0) 186 (166 – 194) 568 (444 – 1,020) 617 (152 – 187) 177 (165 – 210) 44.6 (34.7 – 54.0) 184 2005–2006 640 (531 – 1,030) 703 (161 – 195) Non-Hispanic Blacks 2001–2002 (137 – 178) 38.6 (30.6 – 45.7) 156 (124 – 172) 716 (608 – 918) 670 143 2003–2004 134 (120 – 149) 42.3 (33.6 – 44.9) 131 (121 – 146) 456 (386 – 599) 634 (137 – 164) 2005–2006 34.3 (27.8 – 42.0) 149 (133 – 163) 510 (440 – 678) 729 147 Non-Hispanic Whites 2001–2002 163 (150 – 176) 29.2 (22.7 – 35.6) 169 (160 – 181) 734 (604 – 875) 1,222 2003–2004 154 (144 – 164) 28.8 (23.9 – 33.8) 166 (151 – 181) 572 (486 – 684) 1,080 (583 – 831) 678 1,005 2005–2006 165 (151 – 180) 35.3 (26.3 – 39.1) 166 (154 – 179) nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 350

362 Figure 3.4.b. Urinary iodine: Concentrations by survey cycle Selected percentiles in ng/mL (95% confidence intervals), National Health and Nutrition Examination Survey, 2001–2006 3000 2000 1000 j 95th Percentile j j j j j j j j j j j j j j j j j j j j j j j j j j 0 300 j 250 j j j 200 j j j j j j j j j j j j j j 50th Percentile j j j j 150 j j j j j 100 100 80 j 60 j j j j j 40 j j j j j j j j j j j j j 5th Percentile j j j j j j j j 20 0 01−02 03−04 05−06 01−02 03−04 05−06 01−02 03−04 05−06 01−02 03−04 05−06 01−02 03−04 05−06 01−02 03−04 05−06 01−02 03−04 05−06 01−02 03−04 05−06 01−02 03−04 05−06 01−02 03−04 05−06 Females Total 6−11y 12−19y 20+y Males 3−5y MA NHB NHW (6+y) 3. Trace Elements 351

363 666 919 size 5,174 1,319 2,477 1,363 1,442 2,697 2,085 1,134 1,013 Sample (588 – 1,060) (663 – 932) (827 – 7,820) (584 – 1,140) (437 – 588) (528 – 835) (716 – 944) (697 – 1,060) (450 – 903) (519 – 738) (863 – 5,710) 97.5th 695 763 642 493 616 807 819 557 600 1,150 1,320 (525 – 628) (470 – 617) (479 – 591) (653 – 1,190) (325 – 395) (406 – 555) (558 – 693) (539 – 669) (347 – 485) (421 – 526) (660 – 891) 95th 572 840 523 494 360 473 617 602 392 482 727 (95% conf. interval) s (140 – 156) (129 – 149) (146 – 163) (240 – 293) (83.4 – 99.1) (115 – 137) (148 – 169) (151 – 169) (103 – 119) (132 – 158) (191 – 237) 50th 149 156 266 138 125 157 158 111 146 214 90.4 Selected percentile (44.7 – 50.0) (41.2 – 47.7) (77.6 – 92.2) (50.2 – 58.7) (30.4 – 34.6) (41.0 – 49.7) (45.4 – 55.6) (48.7 – 57.4) (37.5 – 44.9) (41.2 – 50.6) (65.6 – 71.0) 5th 46.7 44.9 54.1 84.3 33.1 45.4 49.7 53.2 40.4 45.7 67.9 (37.1 – 41.7) (56.4 – 81.6) (35.0 – 39.6) (42.1 – 49.9) (25.8 – 30.7) (35.1 – 42.1) (37.8 – 45.4) (41.4 – 46.9) (32.5 – 38.8) (34.1 – 42.0) (53.6 – 65.5) 2.5th 39.3 46.2 73.3 37.5 29.1 38.4 42.1 45.0 35.2 39.9 60.9 n (147 – 163) (137 – 153) (244 – 297) (151 – 170) (91.2 – 106) (124 – 145) (156 – 174) (161 – 174) (111 – 127) (136 – 156) (209 – 241) 155 145 160 269 134 165 167 119 145 224 98.6 (95% conf. interval) Geometric mea Mexican Americans Males Gender Race/ethnicity Total, 6 years and older Age group 6–11 years Non-Hispanic Blacks 12–19 years Females Non-Hispanic Whites 20–39 years 40–59 years 60 years and older Health and Nutrition Examination Survey, 2003–2006. Geometric mean and selected percentiles of urine concentrations (in μg/g creatinine) for the total U.S. population aged 6 years and older, National Table 3.5.a.1. Urinary iodine (creatinine corrected): Concentrations nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 352

364 Figure 3.5.a. Urinary iodine (creatinine corrected): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2006 Overall Mexican Americans 500 400 Females Males 300 200 Urinary iodine (μg/g creatinine) 100 0 40−59 20−39 20−39 60+ 6−11 40−59 60+ 6−11 12−19 12−19 Non−Hispanic Whites Non−Hispanic Blacks 500 400 300 200 Urinary iodine (μg/g creatinine) 100 0 20−39 12−19 40−59 20−39 6−11 60+ 6−11 12−19 40−59 60+ Females Males 500 400 Mexican Americans 300 Non−Hispanic Blacks 200 Non−Hispanic Urinary iodine Whites (μg/g creatinine) 100 0 12−19 20−39 40−59 60+ 6−11 60+ 40−59 6−11 12−19 20−39 Age (years) Age (years) 3. Trace Elements 353

365 Table 3.5.a.2. Urinary iodine (creatinine corrected): Total population Geometric mean and selected percentiles of urine concentrations (in μg/g creatinine) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. n Geometric mea Sample (95% conf. interval) s Selected percentile 50th 90th 10th (95% conf. interval) size Males and Females (147 – 163) 59.8 (56.4 – 64.0) Total, 6 years and older (140 – 156) 410 (391 – 438) 5,174 155 149 269 105 (92.1 – 115) 266 (244 – 297) 631 (590 – 820) 666 6–11 years (240 – 293) 134 (124 – 145) 55.9 (49.7 – 61.9) 125 (115 – 137) 346 (301 – 386) 1,442 12–19 years 119 20–39 years (46.7 – 55.0) 111 (103 – 119) 289 (271 – 324) 1,134 (111 – 127) 50.5 145 58.4 (50.9 – 63.7) 146 (132 – 158) 357 (322 – 408) 919 40–59 years (136 – 156) 224 (209 – 241) 83.6 (75.9 – 92.3) 214 (191 – 237) 552 (481 – 635) 1,013 60 years and older Males (129 – 149) (137 – 153) 56.5 (52.3 – 60.2) 138 145 382 (357 – 414) 2,477 Total, 6 years and older (248 – 323) 283 (245 – 322) 108 (83.8 – 131) 280 6–11 years 631 (589 – 1,060) 307 12–19 years 134 52.4 (46.2 – 58.2) 132 (117 – 149) 347 (300 – 413) 693 (122 – 148) 114 50.3 (44.9 – 54.6) 103 (93.8 – 114) 276 (264 – 335) 512 20–39 years (106 – 123) 129 (119 – 140) 52.1 (45.8 – 60.0) 126 40–59 years 311 (274 – 392) 454 (113 – 136) 60 years and older (183 – 215) 73.1 (67.3 – 83.9) 198 (168 – 205) 440 (407 – 481) 511 180 Females Total, 6 years and older 165 63.9 (57.9 – 69.6) 157 (148 – 169) 439 (403 – 481) 2,697 (156 – 174) 6–11 years (228 – 286) 99.9 (87.8 – 114) 247 (227 – 293) 630 (529 – 821) 359 256 12–19 years 134 (121 – 148) 59.3 (51.3 – 64.9) 121 (111 – 131) 332 (292 – 403) 749 20–39 years 123 (112 – 136) 51.0 (45.8 – 57.9) 118 (107 – 130) 292 (254 – 359) 622 465 40–59 years 162 (148 – 178) 63.8 (55.7 – 70.9) 166 (145 – 188) 408 (344 – 482) 617 (554 – 696) 502 60 years and older 247 (224 – 272) 92.2 (79.1 – 104) 243 (221 – 262) Table 3.5.a.3. Urinary iodine (creatinine corrected): Mexican Americans Geometric mean and selected percentiles of urine concentrations (in μg/g creatinine) for Mexican Americans in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. Geometric mea n Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females 160 (151 – 170) 67.5 Total, 6 years and older 156 (146 – 163) 383 (343 – 470) 1,319 (60.4 – 70.6) 6–11 years (246 – 311) 123 (103 – 138) 276 (242 – 293) 619 (468 – 925) 217 267 12–19 years 146 (131 – 163) 61.9 (53.6 – 72.7) 143 (128 – 157) 344 (285 – 468) 465 20–39 years 137 59.7 (53.7 – 71.1) 137 (120 – 147) 293 (261 – 384) 283 (125 – 149) 40–59 years (129 – 164) 66.0 (55.3 – 69.3) 148 (124 – 161) 317 (292 – 382) 165 146 60 years and older 222 (193 – 255) 85.2 (67.8 – 101) 210 (167 – 247) 459 (385 – 725) 189 Males 147 148 (137 – 159) 60.0 (56.3 – 65.7) Total, 6 years and older (131 – 163) 361 (319 – 428) 623 (226 – 318) 6–11 years 269 (236 – 307) 126† (81.6 – 166) 278 96 541† (454 – 725) 12–19 years 147 58.5 (46.3 – 72.5) 141 (121 – 168) 346 (282 – 519) 221 (125 – 173) 124 55.7 (46.1 – 64.8) 121 (109 – 146) 244 (220 – 435) 134 20–39 years (111 – 139) 133 (111 – 160) 58.9† (40.2 – 67.6) 136 40–59 years 318† (285 – 383) 77 (101 – 161) 60 years and older (167 – 213) 81.1† (67.3 – 99.9) 168 189 410† (319 – 1,020) 95 (144 – 204) Females Total, 6 years and older 174 (164 – 186) 73.4 (67.6 – 78.3) 162 (156 – 177) 416 (352 – 488) 696 6–11 years 284 116 (101 – 134) 250 (224 – 299) 656 (468 – 2,530) 121 (237 – 340) 12–19 years (129 – 162) 67.1 (55.5 – 74.4) 144 (123 – 157) 333 (267 – 492) 244 145 20–39 years 153 (139 – 168) 73.4 (51.7 – 84.7) 143 (125 – 162) 344 (293 – 446) 149 40–59 years 160 (141 – 182) 68.0† (59.1 – 82.3) 160 (141 – 181) 308† (264 – 434) 88 (415 – 2,790) 502† 94 60 years and older 253 (204 – 315) 86.1† (23.2 – 124) 232 (196 – 265) † Estimate is subject to greater uncertainty due to small cell size. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 354

366 Table 3.5.a.4. Urinary iodine (creatinine corrected): Non-Hispanic blacks Geometric mean and selected percentiles of urine concentrations (in μg/g creatinine) for non-Hispanic blacks in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. Geometric mea n Sample (95% conf. interval) s Selected percentile 10th 50th 90th (95% conf. interval) size Males and Females 264 (35.8 – 41.7) 90.4 (83.4 – 99.1) (91.2 – 106) (248 – 293) 1,363 Total, 6 years and older 98.6 39.0 6–11 years 80.2 (67.6 – 87.6) 180 (152 – 221) 448 (376 – 558) 221 188 (164 – 214) 90.8 40.5 (36.5 – 42.5) 87.0 (83.6 – 98.6) 223 (191 – 258) 515 12–19 years (78.8 – 95.5) 75.5 (67.9 – 83.9) 35.6 20–39 years 72.6 (63.6 – 80.4) 209 (137 – 254) 238 (31.1 – 38.6) 40–59 years (88.0 – 110) 38.1 (32.9 – 45.4) 90.5 (78.2 – 103) 257 (217 – 296) 219 98.3 337 123 (40.3 – 50.9) 108 (98.4 – 129) 46.0 (251 – 498) 170 60 years and older (106 – 143) Males 101 (90.7 – 112) 37.6 (33.7 – 41.2) Total, 6 years and older (80.8 – 103) 294 (254 – 360) 663 92.1 6–11 years (152 – 231) 73.7† (52.4 – 87.7) 187 (142 – 244) 447† (360 – 898) 106 178 12–19 years 90.1 (81.4 – 99.7) 37.4 (31.5 – 41.8) 84.8 (75.5 – 97.0) 224 (196 – 264) 260 20–39 years 76.2 35.3† (27.7 – 38.4) 71.7 (62.5 – 78.5) 215† (127 – 285) 108 (67.5 – 85.9) 105 34.3† (29.7 – 47.5) 93.8 (73.4 – 130) 286† (239 – 559) 104 40–59 years (87.6 – 126) 123 (89.2 – 170) 41.0† (34.7 – 49.6) 103 60 years and older 365† (242 – 4,440) 85 (78.5 – 159) Females 96.5 (89.3 – 104) 39.3 (35.7 – 44.7) Total, 6 years and older (84.3 – 97.6) 247 (218 – 285) 700 89.3 6–11 years 188 (167 – 211) 83.8 (68.1 – 98.7) 185 (152 – 220) 442 (375 – 548) 115 12–19 years 91.5 42.8 (36.5 – 46.2) 88.5 (76.0 – 99.7) 205 (164 – 311) 255 (82.1 – 102) 20–39 years (64.2 – 87.5) 36.1 (30.0 – 39.1) 72.7 (60.5 – 84.3) 196 (130 – 248) 130 74.9 40–59 years 92.9 (83.6 – 103) 39.5 (29.3 – 47.1) 88.5 (73.7 – 99.0) 217 (196 – 284) 115 60 years and older 123 (99.9 – 152) 50.2† (30.9 – 61.9) 111 (97.1 – 134) 255† (229 – 540) 85 † Estimate is subject to greater uncertainty due to small cell size. Table 3.5.a.5. Urinary iodine (creatinine corrected): Non-Hispanic whites Geometric mean and selected percentiles of urine concentrations (in μg/g creatinine) for non-Hispanic whites in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. n Geometric mea Sample (95% conf. interval) s Selected percentile 50th 90th 10th (95% conf. interval) size Males and Females (161 – 174) 67.2 (63.6 – 69.2) 158 (151 – 169) 430 (404 – 472) 2,085 Total, 6 years and older 167 (261 – 342) 6–11 years (92.8 – 132) 289 (259 – 348) 663 (616 – 1,050) 169 299 114 147 63.3 (54.3 – 69.8) 135 (122 – 155) 374 (311 – 447) 365 12–19 years (134 – 161) 125 (118 – 133) 55.5 (47.8 – 62.1) 115 (107 – 124) 298 (274 – 345) 494 20–39 years 155 40–59 years (56.4 – 69.7) 155 (140 – 174) 364 (327 – 419) 453 (145 – 166) 62.7 559 236 (82.5 – 102) 233 (196 – 248) 94.3 (481 – 657) 604 60 years and older (218 – 256) Males 157 (149 – 165) 64.0 (61.1 – 67.2) 150 (140 – 156) 396 (368 – 428) 996 Total, 6 years and older 337 (272 – 417) 131† (63.9 – 170) 326 (268 – 429) 6–11 years (610 – 2,040) 76 811† 12–19 years 149 (135 – 163) 59.4 (49.6 – 67.3) 143 (129 – 170) 378 (301 – 455) 174 20–39 years 122 57.5 (46.5 – 65.4) 104 (93.8 – 122) 292 (265 – 349) 211 (111 – 135) 137 (120 – 152) 59.3 (48.9 – 64.1) 136 40–59 years 313 (274 – 414) 229 (126 – 149) (173 – 215) 60 years and older 82.9 (70.7 – 95.2) 189 (192 – 226) 440 (402 – 522) 306 208 Females Total, 6 years and older 178 (169 – 188) 70.6 (64.9 – 74.3) 169 (156 – 183) 464 (431 – 514) 1,089 6–11 years 265 99.1† (84.0 – 118) 262 (227 – 315) 640† (474 – 1,020) 93 (225 – 311) 12–19 years (127 – 167) 65.0 (56.0 – 74.0) 127 (112 – 152) 368 (292 – 499) 191 145 20–39 years 128 (116 – 142) 51.3 (45.4 – 62.5) 123 (110 – 141) 295 (242 – 391) 283 40–59 years 175 (159 – 193) 70.6 (58.0 – 79.3) 179 (152 – 202) 433 (362 – 496) 224 298 60 years and older 261 (232 – 294) 104 (81.2 – 119) 255 (236 – 280) 630 (556 – 697) † Estimate is subject to greater uncertainty due to small cell size. 3. Trace Elements 355

367 Table 3.5.b. Urinary iodine (creatinine corrected): Concentrations by survey cycle Geometric mean and selected percentiles of urine concentrations (in μg/g creatinine) for the U.S. population, National Health and Nutrition Examination Survey, 2001–2006. Geometric mea n Selected percentile s (95% conf. interval) Sample 5th 95th 50th (95% conf. interval) size Total, 6 years and older (153 – 173) 50.0 (46.8 – 54.0) 151 (141 – 165) 620 (567 – 687) 2001–2002 163 2,835 146 45.4 (39.4 – 49.3) 142 (135 – 158) 492 (449 – 585) 2,525 2003–2004 (130 – 154) 163 (153 – 175) 50.0 (45.0 – 54.7) 2005–2006 (143 – 169) 620 (549 – 733) 2,649 155 Age group 6–11 years (220 – 319) 94.5 (75.7 – 106) 257 (246 – 304) 923 (772 – 1,140) 374 2001–2002 273 254 (228 – 283) 84.4 (71.9 – 98.7) 246 2003–2004 718 (615 – 1,210) 315 (233 – 269) 2005–2006 (242 – 339) 82.5 (64.3 – 98.9) 288 286 947 (654 – 2,300) 351 (236 – 362) 12–19 years 2001–2002 149 (137 – 161) 52.5 (47.8 – 58.9) 138 (129 – 146) 601 (450 – 721) 830 2003–2004 124 45.4 (36.3 – 49.9) 117 (104 – 132) 381 (314 – 532) 720 (109 – 141) 477 145 (39.8 – 51.9) 138 (117 – 163) 45.4 (434 – 829) 722 2005–2006 (130 – 162) 20–39 years 135 (127 – 143) 46.7 (42.2 – 49.5) 2001–2002 (118 – 136) 470 (443 – 577) 627 128 2003–2004 (104 – 127) 39.2 (33.9 – 44.9) 115 (99.3 – 119) 407 (319 – 559) 517 108 2005–2006 123 (112 – 135) 43.9 (39.1 – 49.0) 114 (97.7 – 131) 378 (339 – 592) 617 40–59 years 2001–2002 (130 – 175) 44.7 (37.9 – 54.5) 151 (120 – 176) 522 (427 – 712) 496 142 2003–2004 138 (126 – 152) 42.0 (34.9 – 49.9) 136 (126 – 150) 436 (392 – 561) 434 2005–2006 152 (137 – 170) 47.0 (40.9 – 56.5) 153 (126 – 179) 492 (429 – 544) 485 60 years and older (51.2 – 75.5) (179 – 230) 508 2001–2002 216 (192 – 244) 67.1 (632 – 1,000) 199 751 2003–2004 204 (60.3 – 74.0) 197 (178 – 233) 595 (521 – 726) 539 (188 – 222) 67.2 (218 – 277) (697 – 5,190) (65.8 – 72.8) 235 (193 – 256) 858 246 474 2005–2006 68.4 Gender Males (137 – 160) 47.0 (43.7 – 51.1) 145 2001–2002 578 (514 – 674) 1,333 (143 – 171) 156 137 (127 – 148) 41.7 (36.3 – 46.4) 132 (121 – 146) 481 (417 – 590) 1,229 2003–2004 152 2005–2006 47.8 (42.6 – 50.4) 147 (132 – 158) 540 (480 – 795) 1,248 (140 – 165) Females 2001–2002 (161 – 179) 55.2 (48.0 – 57.1) 158 (146 – 168) 670 (585 – 748) 1,502 170 155 (142 – 169) 46.9 (41.8 – 52.7) 151 (133 – 167) 532 (452 – 630) 1,296 2003–2004 2005–2006 176 (163 – 189) 54.4 (44.6 – 60.3) 164 (150 – 179) 687 (598 – 829) 1,401 Race/ethnicity Mexican Americans 2001–2002 164 (152 – 176) 56.0 (49.4 – 61.0) 154 (140 – 177) 589 (469 – 754) 720 2003–2004 152 51.3 (42.1 – 58.9) 147 (133 – 164) 481 (389 – 1,100) 616 (138 – 169) 167 (153 – 179) 56.2 (51.7 – 60.0) 163 2005–2006 544 (454 – 728) 703 (154 – 181) Non-Hispanic Blacks 2001–2002 (103 – 124) 36.8 (27.9 – 42.8) 113 (93.5 – 115) 440 (361 – 645) 669 103 2003–2004 92.1 (81.2 – 104) 33.1 (29.7 – 33.8) 84.6 (73.1 – 97.6) 336 (296 – 375) 634 (87.0 – 111) 2005–2006 33.7 (29.8 – 37.7) 96.6 (96.7 – 115) 397 (315 – 513) 729 105 Non-Hispanic Whites 2001–2002 175 (163 – 188) 55.1 (48.3 – 58.2) 164 (151 – 176) 652 (576 – 749) 1,221 2003–2004 159 (150 – 168) 50.9 (46.3 – 58.2) 153 (147 – 161) 526 (442 – 621) 1,080 (561 – 868) 656 1,005 2005–2006 177 (166 – 188) 55.0 (45.8 – 59.4) 168 (152 – 179) nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 356

368 Figure 3.5.b. Urinary iodine (creatinine corrected): Concentrations by survey cycle Selected percentiles in μg/g creatinine (95% confidence intervals), National Health and Nutrition Examination Survey, 2001–2006 2500 2000 1500 1000 1 1 1 95th Percentile 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 500 1 1 1 1 1 1 0 400 300 1 1 1 200 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 50th Percentile 1 100 1 1 0 120 100 1 1 1 80 60 1 1 1 1 1 1 1 1 1 5th Percentile 1 1 1 1 1 1 1 1 1 1 1 1 40 1 1 1 20 01−02 03−04 05−06 01−02 03−04 05−06 01−02 03−04 05−06 01−02 03−04 05−06 01−02 03−04 05−06 01−02 03−04 05−06 01−02 03−04 05−06 01−02 03−04 05−06 01−02 03−04 05−06 01−02 03−04 05−06 Total 3−5y 6−11y 12−19y 20+y Males Females MA NHB NHW (6+y) 3. Trace Elements 357

369 References Abalovich Amino N, Barbour LA, Cobin RH, De Groot LJ, Glinoer D, et al. Management of thyroid M, during and postpartum: an Endocrine Society Clinical Practice Guideline. J Clin dysfunction pregnancy 2007;92:s1–s47. & Metabol. Endocrinol Karmisholt J, Pdersen KM, Laurberg P. Reliability of studies of iodine intake Andersen recommendations S, and number of samples in groups and in individuals. Br J Nutr. 2008;99:813–818. for M, de Benoist B, Delange F, Zupan J. Prevention and control of iodine deficiency in pregnant and Andersson women and in children less than 2-years-old: conclusions and recommendations of the T echnical lactating Public Health Nutrition 2007;10(12A):1606–1611. Consultation. DV, Braverman LE, Delange F, Dunn JT, Franklyn JA, Hollowell JG, et al. Iodine supplementation for Becker and Canada: lactation—United States and recommendations of the American Thyroid Association. pregnancy 2006;16:949–951. Thyroid. MH, editor. V itamin deficiency, dependency, and toxicity. Beers Merck Manual of Diagnosis and Therapy. 18th In: Whitehouse Station (NJ): Merck & Co., Inc.; 2006 [cited 2011]. Available at: http://www.merckmanuals.com/ ed. professional/sec01/ch005/ch005e.html. Caldwell Maxwell B, Makhmudov A, Pino S, Braverman LE, Jones RL, et al. Use of inductively coupled KL, 2000: mass spectrometry to measure urinary iodine in NHANES comparison with previous method. Clin plasma 2003;49:1019–1021. Chem. KL, Jones R, Hollowell JG. Urinary iodine concentration: United States National Health and Nutrition Caldwell 2001–2002. Thyroid. 2005;15:692–699. Examination Survey KL, Miller GA, W ang RY, Jain RB, Jones RL. Iodine status of the U.S. population, National Health and Caldwell Survey 2003–2004. Thyroid. 2008;18:1207–1214. Nutrition Examination KL, Makhmudov A, Ely E, Jones RL, W ang R. Iodine status of the U.S. population, National Health and Caldwell Survey, 2005–2006 and 2007–2008. Thyroid. 2011;21:419–427. Nutrition Examination D. The importance of iodine nutrition during pregnancy. Publ Health Nutr. 2007;10:1542–1546. Glinoer iodine Gregory MK, Sullivan KM. Use of supplements with and without CO, in women of childbearing Serdula age in the United States. Thyroid. 2009;19:1019–1020. Hollowell JG, Staehling NW, Hannon WH, Flanders DW, Gunter EW, Maberly GF, et al. Iodine nutrition in the Nutrition United T rends and public health implications: iodine excretion data from National Health and States. Examination Surveys I and III (1971–1974 and 1988–1994). J Clin Endocrinol Metab. 1998;83:3401–3408. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes: vitamin A, vitamin K, arsenic, boron, and chromium, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, copper, zinc. W ashington, D.C.: National Academy Press; 2001. Murray Egan SK, Kim H, Beru N, Bolger PM. US Food and Drug Administration’s T otal Diet Study: Dietary CW, intake of perchloriate and iodine. J Exposure Sci Environ Epidem. 2008;18:571–580. Pennington Schoen SA. T otal Diet Study: estimated dietary intakes of nutritional elements, 1982–1991. Int J JAT, Res. 1996;66:350–362. Vit Nutr CG, Herrick K, Serdula MK, Sullivan KM. Some subgroups of reproductive age Perrine women in the United States may be at risk for iodine deficiency. J Nutr. 2010;140:1489–1494. Pino S, Fang SL, Braverman LE. Ammonium persulfate: a new and safe method for measuring urinary iodine by Endocrinol ammonium oxidation. Exp Clin persulfate Diabetes. 1998;106 Suppl 3:S22–S27. World Health Organization. Assessment of iodine deficiency disorders and monitoring their elimination: a guide rd (Switzerland): programme managers. 3 for ed. Geneva W orld Health Organization, 2007 (WHO/NHD/01.1) at: . http://whqlibdoc.who.int/publications/2007/9789241595827_eng.pdf [cited 2011]. Available nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 358

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372 4. Isoflavones and Lignans Isoflavones • Genistein Daidzein • • Equol • O-Desmethylangolensin Lignans • Enterodiol Enterolactone • 4. Isoavones and Lignans 361

373 Isoflavones and Lignans Background Information Isoflavones Sources and Physiological Functions. lignans are secondary plant metabolites and the diet. When ingested and metabolized, these compounds frequently in encountered potential to as phytoestrogens, a class of compounds that have weak estrogenic the have act report considers urinary concentrations effects. four isoflavones (daidzein, genistein, This of [ODMA], and equol) and two lignans (enterodiol and enterolactone). O-desmethylangolensin is source of human exposure to the phytoestrogens. Plant sources of isoflavones Diet primary legumes, with the include largest contribution coming from soy-based foods. Since soy flour and isolates may be added to processed meats, meat substitutes, breads, and protein-food soy protein these items can be a major source of isoflavones ( Lampe 1999; Grace 2004 ). However, the bars, content vary of soy protein preparations can widely, and it is affected by production isoflavone the ( 2004 ). Daidzein and genistein are Erdman main soy isoflavones. Kudzu root, techniques in some dietary supplements, also contains appreciable amounts of daidzein. Naringenin, used precursor to genistein, is found in some citrus fruits. Formononetin and biochanin A are a isoflavones in found in clover, which may be used red clover dietary supplements, and methylated genistein, are metabolized in the body to daidzein and respectively. Lignans are found in flax they whole wheat flour, tea, some fruits, and other cereal grains. Lignans include matairesinol seeds, which are transformed by intestinal bacteria into the estrogenic and secoisolariciresinol, enterolactone and enterodiol, respectively ( Rowland 2003; Cornwell 2004 ). coumpounds versa. also convert into enterolactone and vice Isoflavone intake is typically higher Enterodiol may Asian populations than in W estern populations, primarily due to the higher soy consumption in and role that such fermented food products as tempeh, miso, or natto play in Asian the significant diets ( Mortensen 2009 ). Lignan intake varies greatly from country to country because of different dietary sources; however, completeness of food composition data is also a confounding factor in interpreting data ( Peterson 2010 ). these and metabolism of phytoestrogens varies considerably among individuals. The The absorption may relate to differences in absorption, variation enterohepatic circulation, and metabolism by intestinal bacteria. Isoflavones and lignans primarily as glycosides in unfermented occur foods with a small percentage of aglycones present. Aglycones represent a larger portion of to the present in fermented foods due phytoestrogens bacterial hydrolysis of the glycosides. Glycosidic forms are hydrolyzed to their aglycones in the intestine, absorbed, and then linked acid in the intestinal wall and liver with glucuronic to make them more water-soluble, a process glucuronidated known as glucuronidation. The metabolites of isoflavones predominate in blood and ( Doerge 2000; Rowland 2003; Clavel 2006; Nielsen 2007 ). Ingested daidzein is further urine ODMA and to equol by intestinal bacteria. Equol, but not ODMA, has estrogenic metabolized to About 30 percent of adults produce equol and activity. have higher serum equol concentrations after they consume daidzein ( Setchell 2003 a ; Cassidy ). This ability to produce equol may be 2006 related to an individual’s intestinal microflora and influenced by dietary habits and genetic factors ability ( 2000; Setchell 2002; Setchell 2006 ). It is unclear whether the to produce equol Rowland results in any health-related ( Vafeiadou 2006 ). effects Generally, phytoestrogens are much less potent than endogenously produced estrogens, but phytoestrogens can be present in much greater quantities (100 to 1000 times the concentration of steroid-hormone serum- endogenous estrogens). Additionally, phytoestrogens bind less tightly to nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 362

374 transport than do endogenous estrogens proteins 1998 Equol has more potent estrogen ( Nagel ). its precursor daidzein and has been activity than be most important in explaining the proposed to of action of isoflavones in mechanism possible ( Setchell 2002 ). disease prevention The consumption of dietary Health Effects. associated to be believed with is phytoestrogens risk of hormone-dependent a reduced cancers, as breast ( Dong 2010; 2010 ) and such Buck cancer ( Yan 2009; Hamilton-Reeves prostate to ), antagonistic mechanisms related to 2010 due receptor Other health benefits hormone binding. consumption of to phytoestrogen- related the proposed: also been diets reduced rich have of menopause-related symptoms ( Howes 2006; Jacobs 2009 ); cardiovascular health ( Pan severity Peterson 2010 ); and modulation of osteoporosis ( Liu 2010 ). A report from the Agency for 2009; effects Research and Quality ( Balk 2005 ) about the of soy on health outcomes reported Healthcare there is no conclusive evidence of a dose-response effect of either soy protein or isoflavone that cardiovascular diseases, menopausal symptoms, endocrine function, cancer, bone health, on health, kidney diseases, cognitive function, or glucose metabolism. For reducing low- reproductive possibly concentrations, however, soy protein could have a dose-response effect. density lipoprotein for lignan intake, flaxseed has been shown to significantly reduce LDL- and total cholesterol As the type of intervention, sex, and lipid profiles of the subjects ( Pan 2009 ). depending on effects on fertility have been observed in animals that graze on red clover. Results of Adverse studies in pregnant animals suggest that high doses of phytoestrogens alter chronic the feeding environment ( Cornwell 2004 ). Infants who consume soy-based formula can have fetal hormonal concentrations of isoflavones that are 13,000–22,000 times plasma than concentrations of higher endogenous estrogen in infants ( Setchell 1997 ). Y et, studies of children who had been fed soy- based formula as infants and who were followed through adolescence ( Klein 1998 ) and young adulthood Strom 2001 ) found no adverse reproductive or endocrine effects. A meta-analysis of ( in which adult men consumed soy foods, 32 isolated soy protein, or isoflavone extracts studies soy (from or red clover) found that neither soy foods nor isoflavone supplements alter measures of bioavailable testosterone concentrations in men ( Hamilton-Reeves 2010 ). In vitro and animal 2002 studies also suggest that so y isoflav ones may hav e immunologic and thyr oid effects ( Doerge ). to The Center for the Evaluation of Risks Human Reproduction (CERHR) of the National reviewed Toxicology Program the developmental and reproductive toxicity of both soy formula and and concluded that available data were inadequate to determine the effects of soy genistein panel developmental or reproductive toxicity ( Rozman 2006 a ). The expert review formula on concern for adverse effects in expressed the general population of consuming dietary negligible adults sources genistein: under current exposure conditions, of would be unlikely to consume sufficient daily levels of genistein to cause adverse reproductive and/or developmental effects ( 2006 b ). A subsequent review by CERHR that included new study data from 2006– Rozman 2009 and focused specifically on the developmental toxicity of soy infant formula and its major isoflavone components found minimal concern for adverse effects on development in infants who ). 2011 consume soy infant formula ( McCarver 4. Isoavones and Lignans 363

375 Biochemical Indicators and Methods. A systematic review of intervention studies has shown urinary concentrations of daidzein, genistein, and enterolactone are good biomarkers of that intake to (Pearson r = 0.78–0.87) as compared equol, ODMA (0.38–0.40) and enterodiol dietary are ( 2010 ). Linear dose-response relations Pérez-Jiménez typically observed for the (-0.14) ( Nesbitt 1999; Hutchins 2000 ). Saturation in urine recovery lignans been observed with the has isoflavones ( Setchell 2003a) . Isoflavones and lignans have been measured in biologic matrices such serum, and urine by use as high performance liquid chromatography (HPLC) or gas plasma, of chromatography (GC) with various modes of detection ( Hoikkala 2003; Prasain 2004 ). Liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) methods that measure isoflavones lignans concentrations after deconjugation of glucuronides and sulfates are most and at present. commonly used Phytoestrogens have been measured in NHANES since 1999. In NHANES Data in NHANES. scientists detected enterolactone 1999–2000, in the highest concentration, and daidzein CDC with the highest frequency among was the six measured phytoestrogens ( Valentin- detected Blasini 2005 ). CDC’s Fourth National Report on Human Exposure to Environmental Chemicals th th th th , and selected percentiles (50 presented , 75 geometric 90 means , and 95 ) for concentrations of phytoestrogens by age, sex, or race/ethnicity for participants in NHANES 1999–2000, 2001– 2002, and 2003–2004 ( U.S. Centers for Disease Control and Prevention 2009 ). ODMA, Urinary daidzein, genistein, equol, enterolactone, and enterodiol data presented in this report generated by use of LC-MS/MS using electrospray ionization (ESI) for NHANES were ( 2008 ) and LC-MS/MS using atmospheric pressure photoionization (APPI) 2003–2004 Rybak NHANES 2005–2006 ( Parker 2011 ). Crossover studies comparing samples analyzed by for coefficients and LC-APPI-MS/MS demonstrated high correlation (r >0.99) and LC-ESI-MS/MS slopes approximately equal to 1 and intercepts close to 0 regression ( U.S. Centers for Disease Control and Prevention 2011 ). , the fact sheet from see the National Institutes of For more information about soy isoflavones Office of Dietary Supplements ( http://ods.od.nih.gov/Health_Information/Information_ Health, About_Individual_Dietary_Supplements.aspx). Highlights population and lignan concentrations in the U.S. Urinary isoflavone showed the following demographic patterns and characteristics: • No consistent patterns were observed with regard to age, gender, or race/ethnicity. • Concentrations have been relatively similar from 1999 – 2006. and lignan concentrations showed only small variations by demographic Urinary isoflavone such as age, gender , or race/ethnicity , or b y sur variables, cy cle. H owever, as r eported pr eviously vey ( 2005 ), we observed large differences Valentin-Blasini in the concentration of different urinary phytoestrogens. The enterolactone concentration was approximately one order of magnitude and higher the concentrations of genistein, daidzein, than enterodiol, which in turn were approximately one order of magnitude higher than the concentrations of equol and ODMA >99% ( H.4.a ). These phytoestrogens were detected in Figure of all samples, with the exception of all samples. ODMA, which was detected in only 93% of nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 364

376 1000 100 10 Geometric mean (μg/L) 1 Daidzein Enterolactone Genistein O-Desmethyl- Equol Enterodiol angolensin Geometric mean concentrations of urinary isoflavones and lignans in the U.S. population aged 6 years and older, Figure H.4.a. National Health and Nutrition Examination Survey, 2003–2006. Error bars represent 95 percent confidence intervals. The y-axis is displayed on the logarithmic scale. Detailed Observations derived the uncorrected tables and figures The are below mentioned observations selected from size to allow group comparisons based of is population NHANES The next. presented sufficient differences between demographic groups on uncorrected data. Statements about categorical confidence noted limits from univariate analysis without below are based on non-overlapping sex, race/ethnicity) or other determinants of these age, (i.e., variables demographic for adjusting usage, smoking, BMI). A urine concentrations (i.e., dietary intake, supplement multivariate and statistical significance of these categorical differences. Furthermore, analysis may alter the size be present despite their lack of magnitude additional significant differences of smaller may slightly overlap or if differences are not statistically mention here (e.g., if confidence limits occurred). a selection of citations of descriptive significant before covariate adjustment has For Appendix G biochemical of diet and nutrition, see indicators . NHANES these to related papers Geometric mean concentrations (NHANES 2003–2006): ( Table 4.3.a.1 and F igure 4.3.a), equol ( Table 4.5.a.1 • Urinary concentrations of daidz ein (Table and Figure 5.7.1) were highest in children ODMA and 4.5.a), Figure and 5.7.a.1 groups, while urinary concentrations of genistein other for than adolescents and age and across groups (Tables 4.1.a.1, 4.9.a.1, 5.11.a.1 similar were lignans two the and age 4.9.a, 4.11.a). Figures 4.1.a, phytoestrogen concentrations with the exception of • Males and females had similar which in females. were lower concentrations genistein and daidzein similar across • the three race/ethnic groups, Urinary concentrations of phytoestrogens were concentrations, which were lowest in Mexican Americans. with the exception of ODMA Changes in geometric mean concentrations across survey cycles: and concentrations were similar across ODMA, equol, genistein, Urinary • enterolactone (Tables 4.7.b, and 4.11.b). 4.1.b, 4.5.b, cycles survey four the in 2001–2002 than in the other three • Urinary daidzein concentrations were lower survey cycles (Table 4.3.b). three in 1999-2000 than in the other enterodiol concentrations were lower Urinary • 4.9.b). (Table cycles survey 4. Isoavones and Lignans 365

377 692 901 970 size 1,287 5,122 2,496 1,343 1,422 2,626 2,108 1,137 Sample (763 – 1,290) (706 – 1,060) (701 – 1,120) (579 – 2,730) (642 – 1,260) (659 – 1,510) (654 – 1,150) (682 – 1,100) (639 – 1,280) (631 – 1,500) (558 – 2,580) 97.5th 852 929 805 846 899 946 867 761 810 767 794 (459 – 578) (461 – 591) (434 – 695) (357 – 819) (387 – 743) (409 – 651) (398 – 618) (417 – 589) (412 – 596) (423 – 703) (341 – 559) 95th 523 414 570 544 466 514 514 502 516 589 435 (95% conf. interval) (23.8 – 28.5) (25.7 – 32.0) (26.6 – 35.8) (22.2 – 29.0) (23.0 – 34.7) (23.6 – 33.2) (20.8 – 27.0) (22.3 – 28.3) (20.4 – 27.5) (20.7 – 30.2) (22.4 – 31.7) 50th 26.1 28.5 31.7 25.8 27.8 27.6 23.8 25.3 23.7 26.2 27.5 Selected percentiles (2.14 – 2.78) (1.90 – 3.28) (2.59 – 5.15) (2.55 – 3.62) (2.34 – 3.53) (2.72 – 3.84) (1.76 – 2.31) (1.84 – 2.71) (1.68 – 3.27) (1.68 – 2.72) (1.41 – 2.69) 5th 2.45 2.47 4.20 3.22 3.03 3.33 2.01 2.18 2.27 2.17 2.16 (1.24 – 1.78) (1.06 – 3.78) (1.10 – 2.05) (1.41 – 2.35) (1.21 – 2.30) (1.92 – 2.78) (1.05 – 1.53) (1.13 – 1.65) (1.04 – 1.95) (1.04 – 1.73) (< LOD – 1.48) 2.5th 1.51 1.67 3.05 1.96 1.88 2.39 1.25 1.38 1.54 1.33 1.15 (28.0 – 31.8) (30.9 – 41.9) (30.2 – 35.7) (26.8 – 32.0) (27.1 – 37.3) (30.7 – 38.6) (24.9 – 29.9) (26.7 – 31.1) (25.0 – 32.5) (25.1 – 31.5) (26.1 – 33.3) 29.9 29.3 36.0 32.9 31.8 34.4 27.2 28.8 28.5 28.1 29.5 (95% conf. interval) Geometric mean < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. Mexican Americans Males Gender Race/ethnicity Total, 6 years and older Age group 6–11 years Non-Hispanic Blacks 12–19 years Females Non-Hispanic Whites 20–39 years 40–59 years 60 years and older Nutrition Examination Survey, 2003–2006. Geometric mean and selected percentiles of urine concentrations (in μg/L) for the total U.S. population aged 6 years and older, National Health and Table 4.1.a.1. Urinary genistein: Concentrations nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 366

378 Figure 4.1.a. Urinary genistein: Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2006 Overall Mexican Americans Females Males (μg/L) Urinary genistein 0 20 40 60 60+ 20−39 40−59 20−39 40−59 60+ 6−11 6−11 12−19 12−19 Non−Hispanic Whites Non−Hispanic Blacks 60 (μg/L) Urinary genistein 40−59 60+ 20−39 6−11 12−19 20−39 12−19 40−59 60+ 6−11 Females Males Mexican Americans Non−Hispanic Blacks Non−Hispanic (μg/L) Whites Urinary genistein 0 20 40 60 0 20 40 60+ 20−39 40−59 60+ 6−11 12−19 40−59 20−39 6−11 12−19 Age (years) Age (years) 4. Isoflavones and Lignans 367

379 Table 4.1.a.2. Urinary genistein: Total population Geometric mean and selected percentiles of urine concentrations (in μg/L) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. Sample Geometric mean (95% conf. interval) Selected percentiles 10th 50th 90th (95% conf. interval) size Males and Females (28.0 – 31.8) 4.18 (3.88 – 4.51) Total, 6 years and older (23.8 – 28.5) 274 (246 – 304) 5,122 29.9 26.1 36.0 6.11 (4.50 – 7.43) 31.7 (30.9 – 41.9) 276 (215 – 355) 692 6–11 years (26.6 – 35.8) 34.4 (30.7 – 38.6) 4.87 (4.11 – 5.91) 27.6 (23.6 – 33.2) 303 (237 – 367) 1,422 12–19 years 28.5 20–39 years (3.30 – 5.01) 23.7 (20.4 – 27.5) 237 (185 – 322) 1,137 (25.0 – 32.5) 4.25 28.1 3.76 (3.33 – 3.96) 26.2 (20.7 – 30.2) 307 (242 – 374) 901 40–59 years (25.1 – 31.5) 29.5 (26.1 – 33.3) 4.09 (3.31 – 4.77) 27.5 (22.4 – 31.7) 244 (212 – 311) 970 60 years and older Males (25.7 – 32.0) (30.2 – 35.7) 4.91 (4.35 – 5.39) 28.5 32.9 301 (247 – 337) 2,496 Total, 6 years and older (28.9 – 42.1) 34.9 215 6.44 (4.51 – 8.48) 29.8 (22.4 – 35.8) 6–11 years (177 – 369) 340 12–19 years 37.1 5.45 (4.48 – 6.96) 31.9 (24.2 – 42.5) 261 (209 – 402) 728 (31.3 – 44.0) 32.0 4.95 (3.48 – 5.71) 25.9 (21.5 – 32.0) 300 (197 – 397) 499 20–39 years (27.8 – 36.7) 32.0 (26.9 – 38.0) 4.14 (3.42 – 5.17) 29.1 40–59 years 324 (227 – 510) 451 (21.7 – 34.2) 60 years and older (26.6 – 38.3) 4.73 (3.78 – 5.83) 31.9 (20.6 – 36.6) 230 (183 – 337) 478 28.9 Females Total, 6 years and older 27.2 3.73 (3.23 – 4.07) 23.8 (20.8 – 27.0) 253 (222 – 302) 2,626 (24.9 – 29.9) 6–11 years (28.2 – 49.0) 5.55 (3.39 – 7.52) 34.9 (25.3 – 44.7) 278 (239 – 407) 352 37.2 12–19 years 31.7 (26.6 – 37.9) 3.85 (3.34 – 5.15) 24.3 (20.0 – 31.7) 321 (220 – 413) 694 20–39 years 25.5 (20.7 – 31.3) 3.81 (2.25 – 4.32) 22.1 (18.9 – 26.9) 208 (154 – 318) 638 450 40–59 years 24.9 (21.3 – 29.0) 3.14 (2.70 – 3.91) 20.4 (16.6 – 27.0) 256 (175 – 408) 243 (208 – 322) 492 60 years and older 27.7 (23.1 – 33.2) 3.34 (2.11 – 4.74) 26.6 (19.2 – 32.0) Table 4.1.a.3. Urinary genistein: Mexican Americans Geometric mean and selected percentiles of urine concentrations (in μg/L) for Mexican Americans in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. Sample Geometric mean (95% conf. interval) Selected percentiles 10th 50th 90th (95% conf. interval) size Males and Females (26.8 – 32.0) 4.38 (3.48 – 5.15) Total, 6 years and older (22.2 – 29.0) 301 (242 – 341) 1,287 29.3 25.8 32.4 5.65 (4.27 – 6.93) 27.5 (24.4 – 43.1) 293 (127 – 645) 231 6–11 years (19.2 – 35.8) 35.6 (29.8 – 42.6) 5.60 (4.70 – 6.58) 30.7 (26.9 – 36.0) 315 (171 – 493) 445 12–19 years 26.8 4.03 20–39 years (2.23 – 5.44) 21.3 (16.7 – 26.1) 325 (229 – 461) 282 (23.1 – 31.0) 29.1 4.18 (2.24 – 5.48) 27.5 (17.8 – 38.2) 253 (132 – 506) 157 40–59 years (21.9 – 38.8) 25.9 (20.6 – 32.6) 3.09 (2.42 – 3.67) 29.8 60 years and older 228 (138 – 335) 172 (17.7 – 35.2) Males 30.9 (26.4 – 36.3) 4.76 (3.89 – 5.84) Total, 6 years and older (21.4 – 31.5) 304 (200 – 457) 625 25.9 6–11 years 30.5 (22.1 – 42.0) 6.04 (3.33 – 7.64) 23.1 (17.9 – 34.9) 212 (101 – 566) 112 12–19 years 37.0 (30.3 – 45.3) 6.17 (4.86 – 7.61) 31.6 (26.1 – 40.7) 243 (160 – 424) 228 20–39 years 29.0 4.54 (2.37 – 5.97) 21.0 (15.5 – 36.1) 331 (185 – 646) 117 (21.3 – 39.5) 31.4 (13.3 – 43.9) 3.89† (1.51 – 6.76) 27.8 40–59 years 259† (86.0 – 4,840) 85 (19.5 – 50.6) (16.9 – 56.7) 60 years and older 3.47† (1.78 – 5.40) 34.5 (17.7 – 50.9) 178† (97.8 – 2,730) 83 30.0 Females Total, 6 years and older 27.5 (23.3 – 32.5) 3.76 (2.76 – 4.71) 25.2 (19.3 – 31.2) 286 (206 – 371) 662 6–11 years 34.6 5.17 (2.04 – 6.90) 34.0 (21.2 – 44.3) 303 (118 – 2,670) 119 (22.2 – 54.1) 12–19 years (26.4 – 44.3) 5.03 (3.49 – 6.31) 29.4 (19.4 – 38.1) 407 (192 – 554) 217 34.2 20–39 years 24.4 (16.8 – 35.4) 3.41 (1.71 – 4.29) 20.3 (15.3 – 34.0) 251 (97.7 – 827) 165 40–59 years 26.9 (19.9 – 36.3) 4.15† (1.15 – 5.49) 26.5 (18.5 – 43.2) 199† (79.1 – 832) 72 258† (108 – 681) 89 60 years and older 23.0 (14.2 – 37.1) 2.53† (< LOD – 4.40) 17.8 (12.5 – 36.4) < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. † Estimate is subject to greater uncertainty due to small cell size. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 368

380 Table 4.1.a.4. Urinary genistein: Non-Hispanic blacks Geometric mean and selected percentiles of urine concentrations (in μg/L) for non-Hispanic blacks in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. Geometric mean Sample Selected percentiles (95% conf. interval) 10th 50th 90th (95% conf. interval) size Males and Females 5.01 (4.16 – 5.69) 27.8 (23.0 – 34.7) (27.1 – 37.3) (206 – 331) 1,343 Total, 6 years and older 31.8 269 (29.9 – 49.4) 5.60 (3.37 – 7.09) 34.7 6–11 years 311 (215 – 640) 207 38.4 (25.1 – 46.0) 42.7 6.66 (5.91 – 7.91) 35.3 (37.0 – 49.2) 286 (227 – 400) 496 12–19 years (29.1 – 44.4) 29.0 (22.5 – 37.4) 5.04 (3.86 – 6.11) 20–39 years (17.2 – 33.2) 198 (152 – 390) 249 24.7 40–59 years (24.2 – 43.0) 4.30 (2.56 – 6.18) 29.9 (20.7 – 45.8) 318 (167 – 547) 231 32.2 171 22.9 (3.12 – 4.54) 20.6 (14.9 – 32.7) 3.42 (99.8 – 326) 160 60 years and older (17.5 – 30.0) Males 35.4 (30.1 – 41.7) 5.67 (4.64 – 6.71) Total, 6 years and older (26.5 – 36.3) 293 (214 – 401) 661 30.4 6–11 years (26.8 – 55.3) 4.06† (1.87 – 7.03) 38.5 (18.6 – 54.7) 360† (205 – 747) 99 36.7 12–19 years 44.5 (36.0 – 55.0) 6.90 (4.87 – 8.70) 35.4 (27.4 – 48.1) 282 (193 – 844) 258 20–39 years 35.4 6.47 (4.28 – 9.07) 27.4 (18.8 – 43.5) 310 (158 – 413) 116 (26.1 – 48.0) 33.1 4.50 (2.29 – 7.00) 30.7 (20.4 – 47.7) 265 (153 – 434) 114 40–59 years (24.0 – 45.8) 26.7 (20.0 – 35.6) 4.67† (3.31 – 6.20) 24.1 60 years and older 145† (110 – 525) 74 (17.1 – 35.7) Females 29.1 (23.5 – 35.9) 4.46 (3.51 – 5.35) Total, 6 years and older (19.1 – 35.1) 249 (172 – 336) 682 24.9 6–11 years 38.4 (27.0 – 54.5) 6.52† (4.22 – 7.95) 31.4 (19.2 – 45.9) 272† (170 – 1,510) 108 12–19 years 40.9 6.54 (4.59 – 8.23) 35.2 (26.4 – 47.9) 286 (223 – 376) 238 (35.2 – 47.6) 20–39 years (17.4 – 35.0) 4.47 (1.60 – 5.45) 20.2 (13.7 – 31.3) 165 (103 – 387) 133 24.6 40–59 years 31.5 (19.5 – 51.0) 3.75 (2.08 – 6.18) 27.6 (15.3 – 58.7) 349 (148 – 870) 117 60 years and older 20.8 (13.2 – 32.7) 3.22† (2.12 – 4.03) 18.2 (9.40 – 33.0) 170† (50.8 – 19,800) 86 † Estimate is subject to greater uncertainty due to small cell size. Table 4.1.a.5. Urinary genistein: Non-Hispanic whites Geometric mean and selected percentiles of urine concentrations (in μg/L) for non-Hispanic whites in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. Sample Geometric mean (95% conf. interval) Selected percentiles 10th 50th 90th (95% conf. interval) size Males and Females (26.7 – 31.1) 4.00 (3.69 – 4.23) 25.3 (22.3 – 28.3) 257 (229 – 302) 2,108 Total, 6 years and older 28.8 (28.4 – 42.9) 6–11 years (4.33 – 7.79) 29.1 (22.3 – 41.7) 247 (179 – 378) 193 34.9 5.95 32.8 4.48 (3.60 – 5.63) 24.7 (20.4 – 32.0) 298 (223 – 368) 378 12–19 years (28.4 – 37.9) 26.9 (22.6 – 32.2) 3.82 (2.28 – 4.71) 22.8 (19.1 – 27.9) 218 (163 – 319) 494 20–39 years 27.0 40–59 years (2.90 – 3.98) 26.0 (18.7 – 30.3) 307 (225 – 421) 448 (23.4 – 31.1) 3.44 242 30.2 (3.01 – 5.32) 28.0 (22.3 – 32.2) 4.23 (211 – 308) 595 60 years and older (26.6 – 34.2) Males 31.8 (28.5 – 35.5) 4.75 (4.15 – 5.31) 27.0 (22.4 – 31.9) 274 (227 – 340) 1,035 Total, 6 years and older 34.1 (25.0 – 46.4) 6.75† (4.40 – 9.87) 26.6 (18.1 – 42.0) 6–11 years (154 – 400) 99 209† 12–19 years 34.9 (27.3 – 44.7) 5.07 (4.12 – 7.35) 25.4 (19.0 – 41.1) 262 (205 – 392) 191 20–39 years 29.4 4.32 (2.26 – 5.49) 23.6 (18.7 – 32.9) 233 (155 – 418) 217 (23.6 – 36.6) 32.3 (21.1 – 37.1) 4.15 (3.03 – 5.45) 29.0 40–59 years 336 (225 – 590) 229 (26.3 – 39.7) (19.5 – 39.4) 60 years and older 4.77 (3.79 – 6.83) 28.5 (25.7 – 38.8) 220 (172 – 341) 299 31.6 Females Total, 6 years and older 26.2 (23.4 – 29.2) 3.30 (2.72 – 3.94) 23.6 (19.4 – 27.3) 243 (207 – 306) 1,073 6–11 years 35.8 4.98† (1.29 – 7.17) 39.3 (20.8 – 54.2) 271† (153 – 919) 94 (25.2 – 50.9) 12–19 years (24.1 – 39.0) 3.62 (2.73 – 5.14) 22.4 (17.2 – 33.7) 311 (207 – 416) 187 30.7 20–39 years 24.7 (19.0 – 32.1) 3.18 (1.91 – 4.28) 22.2 (16.3 – 29.1) 210 (149 – 353) 277 40–59 years 22.5 (18.4 – 27.4) 2.93 (1.90 – 3.80) 18.3 (14.9 – 26.8) 232 (154 – 472) 219 296 60 years and older 29.1 (24.0 – 35.3) 3.67 (1.76 – 5.32) 27.5 (21.6 – 32.3) 244 (197 – 336) † Estimate is subject to greater uncertainty due to small cell size. 4. Isoavones and Lignans 369

381 Table 4.1.b. Urinary genistein: Concentrations by survey cycle Geometric mean and selected percentiles of urine concentrations (in μg/L) for the U.S. population, National Health and Nutrition Examination Survey, 1999–2006. (95% conf. interval) Sample Geometric mean Selected percentiles 5th 50th 95th (95% conf. interval) size Total, 6 years and older 563 27.0 (22.5 – 32.4) (19.7 – 30.3) (437 – 727) 2,557 1999–2000 < LOD 24.4 (30.1 – 36.2) 2.64 (2.24 – 2.89) 28.9 2001–2002 619 (536 – 720) 2,794 33.0 (26.8 – 31.7) 31.1 2.63 (1.99 – 3.28) 26.2 (23.8 – 29.6) 525 (411 – 619) 2,594 2003–2004 (29.0 – 33.3) 522 28.7 (1.93 – 2.74) 25.9 (20.9 – 29.6) 2.33 (438 – 590) 2,528 2005–2006 (25.8 – 32.0) Age group 6–11 years 27.6 1999–2000 (< LOD – 3.07) 31.7 (18.4 – 42.6) 376 (287 – 712) 331 (21.1 – 36.1) .922 39.2 5.09 (3.88 – 6.13) 31.5 (25.8 – 39.2) 501 (329 – 1,150) 396 2001–2002 (33.4 – 46.0) 33.6 (27.8 – 40.6) 4.40 (3.23 – 5.98) 29.2 (22.9 – 37.8) 351 (220 – 433) 341 2003–2004 625 38.6 (< LOD – 5.12) 34.3 (25.3 – 42.4) 3.84 (402 – 2,960) 351 (29.8 – 49.9) 2005–2006 12–19 years 43.7 (34.2 – 55.7) 2.85 (1.97 – 4.17) 44.9 (34.5 – 59.5) 543 (363 – 842) 754 1999–2000 (27.2 – 42.8) 34.1 (26.0 – 32.8) 3.70 (2.00 – 5.17) 29.0 2001–2002 469 (380 – 708) 744 2003–2004 34.7 3.24 (2.06 – 4.10) 29.0 (23.3 – 37.4) 522 (367 – 675) 729 (29.3 – 41.0) 481 34.1 (2.39 – 4.19) 26.7 (20.5 – 35.4) 3.35 (404 – 1,070) 693 2005–2006 (28.8 – 40.5) 20–39 years 28.7 (21.7 – 37.8) < LOD 28.5 (23.2 – 35.8) 704 (453 – 1,540) 536 1999–2000 2001–2002 34.4 2.42 (1.37 – 3.16) 30.4 (25.3 – 38.5) 611 (489 – 797) 604 (28.2 – 41.9) 2003–2004 (24.5 – 34.6) 2.41 (1.40 – 3.83) 24.9 (21.0 – 29.6) 436 (396 – 567) 554 29.1 2005–2006 27.9 (22.7 – 34.4) 2.16 (1.42 – 3.27) 22.3 (18.6 – 29.0) 556 (412 – 938) 583 40–59 years 1999–2000 (10.1 – 23.7) < LOD 21.3 (13.0 – 28.2) 464 (313 – 1,320) 420 15.5 2001–2002 (27.6 – 39.4) 2.74 (.916 – 3.38) 29.3 (24.3 – 34.7) 719 (541 – 1,210) 531 32.9 2003–2004 32.4 (27.6 – 38.1) 2.44 (1.75 – 3.38) 27.3 (20.8 – 33.1) 664 (535 – 1,110) 452 24.9 2005–2006 (20.8 – 29.0) 2.06 (1.14 – 2.70) 24.5 (17.5 – 30.1) 466 (348 – 637) 449 60 years and older 516 1999–2000 21.7 (16.9 – 27.9) < LOD 22.5 (17.7 – 30.3) 352 (279 – 904) 2001–2002 519 26.7 (280 – 1,240) 496 (21.8 – 32.7) 1.94 (1.26 – 2.56) 25.0 (20.0 – 32.2) 2003–2004 28.6 2.13 (1.26 – 2.66) 25.9 (20.1 – 34.2) 386 (314 – 575) 518 (24.2 – 33.9) (318 – 867) 30.3 (1.17 – 3.21) 28.8 (22.1 – 33.0) 469 2.18 452 2005–2006 (25.2 – 36.5) Gender Males 29.8 (22.2 – 40.0) < LOD 31.8 (26.4 – 37.0) 684 (441 – 1,440) 1,222 1999–2000 (348 – 727) 1,375 32.2 (1.94 – 3.33) 29.3 (25.6 – 33.7) 474 2001–2002 2.61 (27.9 – 37.2) 2003–2004 (29.6 – 38.4) 3.33 (2.46 – 4.18) 27.3 (23.8 – 33.0) 561 (444 – 655) 1,244 33.7 2005–2006 32.0 (28.6 – 36.0) 2.83 (2.34 – 3.45) 29.1 (23.0 – 33.8) 488 (411 – 622) 1,252 Females 1999–2000 (17.0 – 24.2) < LOD 23.1 (20.2 – 26.2) 442 (345 – 674) 1,335 20.3 2001–2002 (30.9 – 36.8) 2.62 (2.25 – 2.87) 28.6 (26.3 – 31.9) 663 (602 – 811) 1,419 33.7 2003–2004 28.7 (25.5 – 32.4) 2.05 (1.71 – 2.65) 25.0 (22.5 – 28.4) 466 (362 – 621) 1,350 (17.8 – 27.4) 2005–2006 (22.3 – 29.9) 1.93 (1.58 – 2.34) 22.3 25.9 524 (413 – 694) 1,276 Race/ethnicity Mexican Americans (25.1 – 38.5) 1999–2000 31.1 30.0 .628 (< LOD – 2.04) (25.2 – 37.4) 572 (471 – 1,550) 819 2001–2002 28.3 2.80 (1.56 – 3.90) 25.4 (19.9 – 32.4) 423 (340 – 543) 679 (22.0 – 36.4) 31.1 3.38 (2.23 – 4.24) 25.2 (19.2 – 32.2) 643 (566 – 865) 653 2003–2004 (27.5 – 35.2) 27.6 (24.4 – 31.2) 2.11 (1.23 – 2.93) 26.3 (21.7 – 29.8) 412 (333 – 626) 634 2005–2006 Non-Hispanic Blacks 1999–2000 (19.0 – 36.9) < LOD 32.8 (24.6 – 41.4) 456 (363 – 766) 597 26.5 2001–2002 (27.3 – 52.6) 2.49 (1.53 – 4.06) 35.9 (23.9 – 51.2) 598 (446 – 1,300) 692 37.9 2003–2004 32.6 (24.2 – 44.0) 3.00 (2.00 – 4.16) 27.7 (19.4 – 44.9) 506 (334 – 875) 681 2005–2006 31.0 3.00 (2.16 – 3.55) 27.8 (23.1 – 34.9) 452 (372 – 883) 662 (26.7 – 36.1) Non-Hispanic Whites 23.7 (19.1 – 29.4) < LOD 25.6 (22.0 – 32.0) 564 (413 – 742) 901 1999–2000 2001–2002 30.9 2.43 (2.03 – 2.75) 27.3 (24.5 – 30.7) 623 (521 – 746) 1,211 (27.7 – 34.3) 1,069 30.9 (28.4 – 33.6) 2.34 (1.71 – 3.29) 26.2 (22.8 – 30.9) 501 (384 – 619) 2003–2004 1,039 500 (397 – 623) 2005–2006 26.9 (23.6 – 30.6) 2.10 (1.58 – 2.57) 23.7 (19.0 – 29.0) < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 370

382 Figure 4.1.b. Urinary genistein: Concentrations by survey cycle Selected percentiles in μg/L (95% confidence intervals), National Health and Nutrition Examination Survey, 1999–2006 3000 2000 1000 95th Percentile H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H 0 60 50 H 40 H H H H H H H 30 H H H H H H H H H H H H H H H H H H H H H H H H 50th Percentile H H H H 20 10 8 6 H H 4 H H H H H H H H H H H H H H H 5th Percentile H H H H H H H H H 2 H 0 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 MA Total 6−11y 12−19y 20+y Males Females 3−5y NHB NHW (6+y) Values in the graph are suppressed if either the point estimate or the lower 95% confidence limit is noted as “< LOD” in the accompanying table. 4. Isoflavones and Lignans 371

383 692 901 970 size 5,122 1,287 2,496 1,343 1,422 2,626 2,108 1,137 Sample (796 – 1,210) (723 – 1,330) (740 – 2,140) (629 – 1,140) (489 – 793) (439 – 1,120) (853 – 1,610) (834 – 1,250) (563 – 1,220) (779 – 1,970) (661 – 1,470) 97.5th 910 955 811 561 730 915 749 913 1,240 1,000 1,210 (438 – 627) (348 – 557) (355 – 656) (412 – 1,060) (261 – 488) (293 – 440) (448 – 778) (437 – 687) (291 – 530) (445 – 1,020) (464 – 668) 95th 534 626 441 422 319 367 617 594 355 645 576 (95% conf. interval) (21.6 – 26.1) (19.5 – 24.9) (27.4 – 38.3) (19.5 – 24.6) (15.7 – 22.2) (17.8 – 24.8) (22.9 – 28.1) (22.1 – 27.7) (17.8 – 23.6) (19.1 – 27.8) (24.5 – 32.6) 50th 23.8 22.1 34.5 22.4 19.1 20.4 25.8 24.9 20.7 23.6 28.6 Selected percentiles (2.83 – 3.45) (2.24 – 3.47) (3.51 – 6.16) (2.60 – 3.42) (2.31 – 3.16) (2.73 – 3.66) (2.80 – 3.76) (2.67 – 3.58) (2.37 – 3.50) (2.10 – 3.14) (3.36 – 4.47) 5th 3.14 2.97 5.09 3.03 2.76 3.36 3.20 3.08 2.81 2.66 3.82 (1.97 – 2.46) (1.15 – 4.62) (1.19 – 2.49) (1.80 – 2.48) (1.38 – 2.51) (1.60 – 2.74) (1.97 – 2.77) (1.84 – 2.54) (1.81 – 2.43) (1.35 – 2.35) (< LOD – 3.38) 2.5th 2.22 1.87 3.68 2.12 2.02 2.25 2.35 2.21 2.14 1.89 2.97 (26.9 – 30.2) (33.7 – 45.1) (24.0 – 28.3) (24.2 – 28.8) (19.6 – 25.5) (23.0 – 28.5) (28.3 – 34.1) (27.3 – 31.4) (21.8 – 27.1) (25.2 – 32.1) (31.4 – 38.0) 28.5 26.4 39.0 26.1 22.3 25.6 31.1 29.3 24.3 28.4 34.5 (95% conf. interval) Geometric mean < LOD means less than the limit of detection for the uncorrected urine values, which may vary for some compounds by year. See Appendix D for LOD. Mexican Americans Males Gender Race/ethnicity Total, 6 years and older Age group 6–11 years Non-Hispanic Blacks 12–19 years Females Non-Hispanic Whites 20–39 years 40–59 years 60 years and older Health and Nutrition Examination Survey, 2003–2006. Geometric mean and selected percentiles of urine concentrations (in μg/g creatinine) for the total U.S. population aged 6 years and older, National Table 4.2.a.1. Urinary genistein (creatinine corrected): Concentrations nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 372

384 Figure 4.2.a. Urinary genistein (creatinine corrected): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2006 Mexican Americans Overall Females Males (μg/g creatinine) Urinary genistein 0 20 40 60 80 60+ 40−59 20−39 40−59 60+ 6−11 6−11 12−19 20−39 12−19 Non−Hispanic Blacks Non−Hispanic Whites (μg/g creatinine) Urinary genistein 0 20 40 60 80 40−59 40−59 6−11 12−19 20−39 60+ 60+ 12−19 6−11 20−39 Males Females Mexican Americans Non−Hispanic Blacks Non−Hispanic Whites (μg/g creatinine) Urinary genistein 0 20 40 60 80 12−19 40−59 20−39 40−59 60+ 20−39 12−19 6−11 60+ 6−11 Age (years) Age (years) 4. Isoflavones and Lignans 373

385 Table 4.2.a.2. Urinary genistein (creatinine corrected): Total population Geometric mean and selected percentiles of urine concentrations (in μg/g creatinine) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. Sample Geometric mean (95% conf. interval) Selected percentiles 10th 50th 90th (95% conf. interval) size Males and Females (26.9 – 30.2) 4.53 (4.29 – 4.79) Total, 6 years and older (21.6 – 26.1) 236 (210 – 270) 5,122 28.5 23.8 39.0 6.68 (5.55 – 8.43) 34.5 (33.7 – 45.1) 271 (216 – 388) 692 6–11 years (27.4 – 38.3) 25.6 (23.0 – 28.5) 4.36 (3.90 – 4.67) 20.4 (17.8 – 24.8) 189 (151 – 236) 1,422 12–19 years 24.3 20–39 years (3.81 – 4.55) 20.7 (17.8 – 23.6) 184 (144 – 236) 1,137 (21.8 – 27.1) 4.15 28.4 4.04 (3.52 – 4.65) 23.6 (19.1 – 27.8) 270 (207 – 415) 901 40–59 years (25.2 – 32.1) 34.5 (31.4 – 38.0) 5.51 (4.85 – 6.21) 28.6 (24.5 – 32.6) 287 (226 – 398) 970 60 years and older Males (19.5 – 24.9) (24.0 – 28.3) 4.29 (4.03 – 4.56) 22.1 26.1 205 (179 – 237) 2,496 Total, 6 years and older (28.8 – 42.4) 35.0 272 6.30 (5.10 – 7.99) 29.8 (21.2 – 38.2) 6–11 years (158 – 503) 340 12–19 years 25.2 4.38 (3.66 – 4.66) 20.3 (17.0 – 29.0) 154 (128 – 256) 728 (21.1 – 30.0) 23.3 3.96 (3.39 – 4.38) 20.0 (16.0 – 24.4) 204 (149 – 244) 499 20–39 years (20.8 – 26.1) 25.4 (21.6 – 29.8) 3.68 (3.27 – 4.51) 20.2 40–59 years 228 (155 – 386) 451 (16.8 – 25.5) 60 years and older (24.8 – 34.7) 5.20 (4.11 – 6.32) 29.4 (20.0 – 30.4) 200 (151 – 259) 478 25.0 Females Total, 6 years and older 31.1 4.80 (4.35 – 5.45) 25.8 (22.9 – 28.1) 274 (230 – 320) 2,626 (28.3 – 34.1) 6–11 years (33.4 – 57.4) 8.16 (4.38 – 10.4) 37.7 (26.4 – 50.0) 270 (212 – 798) 352 43.8 12–19 years 26.1 (22.5 – 30.3) 4.35 (3.72 – 5.23) 20.6 (16.5 – 24.8) 208 (164 – 269) 694 20–39 years 25.3 (20.9 – 30.7) 4.50 (3.83 – 5.53) 21.0 (17.6 – 26.9) 170 (124 – 289) 638 450 40–59 years 31.7 (26.2 – 38.3) 4.34 (2.99 – 5.61) 26.6 (21.3 – 32.6) 340 (210 – 631) 361 (289 – 530) 492 60 years and older 39.2 (33.9 – 45.4) 5.70 (4.76 – 6.64) 31.6 (25.8 – 39.0) Table 4.2.a.3. Urinary genistein (creatinine corrected): Mexican Americans Geometric mean and selected percentiles of urine concentrations (in μg/g creatinine) for Mexican Americans in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. Sample Geometric mean (95% conf. interval) Selected percentiles 10th 50th 90th (95% conf. interval) size Males and Females (24.2 – 28.8) 4.25 (3.81 – 4.70) Total, 6 years and older (19.5 – 24.6) 212 (186 – 275) 1,287 26.4 22.4 40.7 7.48 (5.51 – 9.00) 31.6 (31.0 – 53.5) 304 (161 – 1,100) 231 6–11 years (22.8 – 44.7) 27.5 (23.7 – 32.0) 5.58 (4.31 – 6.56) 22.4 (18.9 – 26.4) 208 (139 – 366) 445 12–19 years 21.6 3.65 20–39 years (2.96 – 4.28) 16.2 (13.1 – 20.9) 204 (138 – 255) 282 (18.6 – 25.2) 26.7 3.71 (2.37 – 4.69) 25.4 (16.8 – 33.8) 229 (131 – 629) 157 40–59 years (20.1 – 35.4) 32.0 (23.9 – 42.9) 5.10 (2.91 – 6.94) 31.2 60 years and older 233 (141 – 535) 172 (22.8 – 40.4) Males 24.4 (20.6 – 28.9) 4.10 (3.50 – 4.54) Total, 6 years and older (17.2 – 26.4) 203 (136 – 275) 625 22.2 6–11 years 36.6 (25.7 – 52.1) 7.40 (5.50 – 9.04) 30.2 (19.7 – 43.0) 251 (129 – 659) 112 12–19 years 26.8 (21.9 – 32.8) 5.68 (4.54 – 6.56) 23.0 (16.8 – 30.7) 151 (116 – 347) 228 20–39 years 21.1 3.54 (2.60 – 4.32) 17.2 (12.4 – 23.3) 199 (112 – 328) 117 (15.6 – 28.5) 23.0 (8.19 – 31.2) 3.31† (1.22 – 4.36) 20.9 40–59 years 192† (92.0 – 2,070) 85 (14.4 – 36.9) (10.9 – 49.6) 60 years and older 4.18† (1.75 – 7.13) 29.0 (16.1 – 44.4) 159† (59.4 – 4,830) 83 26.7 Females Total, 6 years and older 28.7 (25.0 – 32.9) 4.59 (3.67 – 5.88) 22.9 (18.5 – 27.1) 262 (189 – 391) 662 6–11 years 45.6 7.46 (4.51 – 9.99) 37.3 (20.3 – 68.7) 311 (166 – 1,460) 119 (31.5 – 66.2) 12–19 years (23.4 – 34.1) 5.47 (2.84 – 7.19) 21.7 (17.8 – 28.9) 269 (155 – 425) 217 28.2 20–39 years 22.3 (15.8 – 31.3) 3.60 (2.14 – 6.28) 15.8 (12.0 – 23.4) 199 (116 – 728) 165 40–59 years 31.3 (24.2 – 40.4) 4.10† (.565 – 6.37) 32.5 (18.1 – 44.1) 296† (151 – 594) 72 261† (142 – 745) 89 60 years and older 37.0 (22.8 – 60.0) 5.54† (< LOD – 8.83) 31.6 (13.4 – 82.7) < LOD means less than the limit of detection for the uncorrected urine values, which may vary for some compounds by year. See Appendix D for LOD. † Estimate is subject to greater uncertainty due to small cell size. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 374

386 Table 4.2.a.4. Urinary genistein (creatinine corrected): Non-Hispanic blacks Geometric mean and selected percentiles of urine concentrations (in μg/g creatinine) for non-Hispanic blacks in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. Geometric mean Sample Selected percentiles (95% conf. interval) 10th 50th 90th (95% conf. interval) size Males and Females 3.95 (3.34 – 4.63) 19.1 (15.7 – 22.2) (19.6 – 25.5) (137 – 211) 1,343 Total, 6 years and older 22.3 159 (28.1 – 46.3) 6.36 (4.62 – 7.24) 25.2 6–11 years 325 (198 – 811) 207 36.1 (22.0 – 37.0) 24.5 4.32 (3.87 – 5.01) 22.0 (21.6 – 27.9) 150 (125 – 214) 496 12–19 years (16.7 – 25.6) 17.9 (14.7 – 21.9) 3.49 (2.75 – 4.31) 20–39 years (11.3 – 19.5) 123 (82.7 – 209) 249 14.0 40–59 years (18.7 – 29.3) 3.30 (2.54 – 4.71) 21.4 (17.4 – 26.3) 173 (128 – 458) 231 23.4 130 20.4 (3.33 – 4.93) 17.5 (11.4 – 22.8) 4.39 (84.1 – 218) 160 60 years and older (16.4 – 25.5) Males 20.7 (17.9 – 23.8) 3.40 (2.80 – 4.38) Total, 6 years and older (13.9 – 21.4) 173 (137 – 213) 661 17.6 6–11 years (25.8 – 51.2) 4.60† (3.12 – 7.24) 36.4 (19.2 – 47.2) 396† (214 – 869) 99 24.9 12–19 years 23.8 (19.6 – 28.8) 3.95 (3.32 – 4.73) 21.2 (14.5 – 25.8) 159 (122 – 246) 258 20–39 years 17.0 3.20 (2.32 – 3.87) 12.6 (9.92 – 20.3) 150 (86.4 – 209) 116 (13.0 – 22.1) 18.9 2.97 (1.59 – 4.57) 17.4 (9.55 – 25.7) 140 (86.9 – 359) 114 40–59 years (13.8 – 26.0) 19.6 (14.6 – 26.3) 3.86† (2.60 – 5.06) 18.3 60 years and older 112† (65.3 – 220) 74 (11.1 – 25.0) Females 23.8 (19.8 – 28.6) 4.65 (3.49 – 5.61) Total, 6 years and older (16.4 – 25.3) 156 (123 – 244) 682 20.4 6–11 years 35.8 (24.8 – 51.6) 6.98† (5.89 – 8.65) 25.0 (20.5 – 37.1) 261† (113 – 1,290) 108 12–19 years 25.3 4.87 (3.83 – 5.77) 22.7 (15.5 – 28.5) 143 (105 – 292) 238 (21.7 – 29.4) 20–39 years (14.2 – 24.8) 3.79 (2.53 – 5.95) 14.3 (10.5 – 21.9) 119 (77.3 – 252) 133 18.8 40–59 years 27.9 (18.7 – 41.8) 3.62 (2.57 – 5.58) 24.7 (17.9 – 34.9) 221 (114 – 570) 117 60 years and older 21.0 (14.5 – 30.3) 4.51† (2.75 – 6.49) 16.5 (9.90 – 29.0) 134† (83.9 – 254) 86 † Estimate is subject to greater uncertainty due to small cell size. Table 4.2.a.5. Urinary genistein (creatinine corrected): Non-Hispanic whites Geometric mean and selected percentiles of urine concentrations (in μg/g creatinine) for non-Hispanic whites in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. Sample Geometric mean (95% conf. interval) Selected percentiles 10th 50th 90th (95% conf. interval) size Males and Females (27.3 – 31.4) 4.55 (4.17 – 4.93) 24.9 (22.1 – 27.7) 241 (209 – 291) 2,108 Total, 6 years and older 29.3 (31.2 – 45.8) 6–11 years (5.11 – 8.41) 34.8 (24.5 – 43.0) 255 (175 – 577) 193 37.8 6.34 25.8 4.33 (3.67 – 4.93) 19.5 (16.7 – 26.0) 181 (143 – 247) 378 12–19 years (22.3 – 29.7) 24.8 (21.4 – 28.9) 4.16 (3.52 – 4.76) 21.7 (18.1 – 28.3) 181 (134 – 289) 494 20–39 years 29.0 40–59 years (3.18 – 4.90) 23.6 (17.7 – 30.3) 273 (202 – 477) 448 (25.3 – 33.2) 4.00 292 36.0 (4.85 – 6.54) 30.0 (26.4 – 34.1) 5.83 (224 – 431) 595 60 years and older (32.8 – 39.6) Males 26.6 (23.9 – 29.5) 4.40 (3.87 – 4.86) 22.7 (19.4 – 26.2) 204 (169 – 261) 1,035 Total, 6 years and older 33.0 (23.9 – 45.6) 5.93† (4.89 – 8.18) 24.8 (17.3 – 40.0) 6–11 years (126 – 945) 99 195† 12–19 years 24.9 (19.3 – 32.3) 4.34 (3.13 – 5.24) 18.9 (14.5 – 31.4) 144 (121 – 311) 191 20–39 years 23.3 3.96 (2.52 – 4.69) 20.7 (15.9 – 28.7) 189 (105 – 339) 217 (19.3 – 28.2) 27.1 (16.4 – 27.9) 3.85 (3.22 – 4.95) 21.3 40–59 years 244 (155 – 623) 229 (22.5 – 32.5) (20.0 – 33.5) 60 years and older 5.47 (3.88 – 6.92) 26.2 (24.5 – 35.4) 190 (147 – 263) 299 29.4 Females Total, 6 years and older 32.3 (29.0 – 35.9) 4.69 (4.14 – 5.40) 27.4 (23.5 – 32.6) 289 (227 – 361) 1,073 6–11 years 44.4 8.19† (2.79 – 11.4) 43.0 (26.0 – 58.2) 266† (164 – 1,300) 94 (31.3 – 62.8) 12–19 years (21.7 – 32.8) 4.15 (3.63 – 5.22) 20.5 (15.8 – 26.1) 203 (156 – 342) 187 26.7 20–39 years 26.5 (20.8 – 33.7) 4.51 (3.50 – 5.62) 22.3 (18.1 – 33.0) 172 (126 – 300) 277 40–59 years 31.1 (25.1 – 38.6) 3.92 (2.63 – 5.82) 25.6 (17.7 – 34.1) 317 (180 – 675) 219 296 60 years and older 42.2 (36.1 – 49.3) 6.05 (4.82 – 7.49) 33.7 (27.6 – 42.2) 404 (291 – 567) † Estimate is subject to greater uncertainty due to small cell size. 4. Isoavones and Lignans 375

387 Table 4.2.b. Urinary genistein (creatinine corrected): Concentrations by survey cycle Geometric mean and selected percentiles of urine concentrations (in μg/g creatinine) for the U.S. population, National Health and Nutrition Examination Survey, 1999–2006. (95% conf. interval) Sample Geometric mean Selected percentiles 5th 50th 95th (95% conf. interval) size Total, 6 years and older 380 23.8 (18.9 – 28.7) (17.7 – 28.1) (341 – 523) 2,557 1999–2000

388 Figure 4.2.b. Urinary genistein (creatinine corrected): Concentrations by survey cycle Selected percentiles in μg/g creatinine (95% confidence intervals), National Health and Nutrition Examination Survey, 1999–2006 2000 1500 H 1000 H H H H 95th Percentile H H H H H H H H H H 500 H H H H H H H H H H H H H H H H H H H H H 0 50 40 H H H H 30 H H H H H H H H H H H H H H H H H H H H H H H H H H 50th Percentile H H H 20 H H H 10 10 8 H 6 H 4 H H H H H H H H H H H H H H H H H 5th Percentile H H H H H H H H 2 0 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 20+y Total MA NHB NHW Females Males 12−19y 6−11y 3−5y (6+y) Values in the graph are suppressed if either the point estimate or the lower 95% confidence limit is noted as “< LOD” in the accompanying table. 4. Isoflavones and Lignans 377

389 692 901 970 size 1,287 5,122 2,496 1,343 1,422 2,626 2,108 1,137 Sample (1,560 – 2,450) (1,590 – 2,200) (1,520 – 2,220) (1,550 – 6,320) (1,500 – 3,390) (1,710 – 3,350) (1,490 – 2,630) (1,420 – 2,150) (1,490 – 2,430) (1,270 – 3,510) (1,210 – 2,660) 97.5th 1,800 1,850 1,750 2,250 2,220 2,180 1,910 1,600 1,860 1,510 1,600 (1,000 – 1,290) (1,060 – 1,350) (1,130 – 1,500) (996 – 1,870) (886 – 1,610) (989 – 1,760) (836 – 1,270) (930 – 1,250) (835 – 1,560) (893 – 1,340) (709 – 1,310) 95th 839 1,170 1,200 1,180 1,350 1,180 1,310 1,000 1,040 1,210 1,120 (95% conf. interval) (54.7 – 65.9) (58.0 – 73.7) (59.2 – 86.6) (44.8 – 56.8) (61.3 – 85.2) (65.0 – 94.5) (49.5 – 61.5) (52.0 – 65.3) (47.2 – 65.9) (47.0 – 65.5) (48.9 – 73.4) 50th 60.4 66.0 68.4 48.6 72.3 77.3 55.5 58.5 54.3 56.5 60.5 Selected percentiles 5th (4.25 – 6.22) (3.62 – 5.66) (7.62 – 13.1) (4.53 – 7.62) (5.74 – 7.82) (6.69 – 9.60) (3.72 – 5.61) (3.69 – 6.11) (3.43 – 6.14) (3.42 – 5.90) (2.73 – 6.34) 5.35 4.71 10.2 6.35 7.05 9.07 4.47 4.66 4.82 4.56 4.31 (2.74 – 3.72) (5.07 – 8.35) (2.14 – 3.68) (2.74 – 4.56) (3.48 – 5.77) (3.92 – 6.63) (2.39 – 3.41) (2.26 – 3.41) (1.80 – 3.99) (1.89 – 3.48) (1.47 – 3.58) 2.5th 3.31 3.07 7.38 3.63 4.48 5.85 3.04 3.03 3.32 3.04 2.24 (62.1 – 71.5) (77.7 – 103) (67.2 – 81.1) (54.1 – 64.4) (67.6 – 90.9) (80.5 – 104) (55.3 – 66.0) (58.7 – 69.6) (53.3 – 71.3) (54.9 – 67.6) (52.7 – 70.5) 66.6 59.0 89.4 73.8 78.4 91.6 60.4 63.9 61.6 60.9 60.9 (95% conf. interval) Geometric mean Total, 6 years and older Mexican Americans Males Gender Race/ethnicity Age group 6–11 years Non-Hispanic Blacks 12–19 years Females Non-Hispanic Whites 20–39 years 40–59 years 60 years and older Nutrition Examination Survey, 2003–2006. Geometric mean and selected percentiles of urine concentrations (in μg/L) for the total U.S. population aged 6 years and older, National Health and Table 4.3.a.1. Urinary daidzein: Concentrations nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 378

390 Figure 4.3.a. Urinary daidzein: Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2006 Overall Mexican Americans 200 Females 150 Males 100 (μg/L) 50 Urinary daidzein 0 40−59 20−39 20−39 60+ 60+ 6−11 40−59 6−11 12−19 12−19 Non−Hispanic Whites Non−Hispanic Blacks 200 150 100 (μg/L) 50 Urinary daidzein 0 40−59 12−19 60+ 40−59 20−39 6−11 12−19 20−39 6−11 60+ Females Males 200 Mexican 150 Americans Non−Hispanic 100 Blacks (μg/L) Non−Hispanic 50 Whites Urinary daidzein 0 12−19 20−39 40−59 60+ 6−11 60+ 40−59 6−11 12−19 20−39 Age (years) Age (years) 4. Isoflavones and Lignans 379

391 Table 4.3.a.2. Urinary daidzein: Total population Geometric mean and selected percentiles of urine concentrations (in μg/L) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. Sample Geometric mean (95% conf. interval) Selected percentiles 10th 50th 90th (95% conf. interval) size Males and Females (62.1 – 71.5) 8.65 (7.74 – 9.48) Total, 6 years and older (54.7 – 65.9) 613 (525 – 684) 5,122 66.6 60.4 89.4 15.7 (12.2 – 18.1) 68.4 (77.7 – 103) 653 (619 – 916) 692 6–11 years (59.2 – 86.6) 91.6 (80.5 – 104) 14.5 (11.8 – 15.8) 77.3 (65.0 – 94.5) 834 (659 – 969) 1,422 12–19 years 61.6 20–39 years (6.00 – 10.4) 54.3 (47.2 – 65.9) 571 (422 – 752) 1,137 (53.3 – 71.3) 8.20 60.9 7.71 (6.35 – 8.67) 56.5 (47.0 – 65.5) 572 (410 – 807) 901 40–59 years (54.9 – 67.6) 60.9 (52.7 – 70.5) 7.92 (6.54 – 9.19) 60.5 (48.9 – 73.4) 471 (399 – 618) 970 60 years and older Males (58.0 – 73.7) (67.2 – 81.1) 9.92 (8.68 – 11.9) 66.0 73.8 695 (589 – 786) 2,496 Total, 6 years and older (72.9 – 105) 87.3 874 17.5 (12.2 – 21.0) 64.0 (51.5 – 91.4) 6–11 years (497 – 1,150) 340 12–19 years 103 17.3 (13.9 – 19.4) 86.6 (64.8 – 107) 863 (526 – 1,320) 728 (85.2 – 124) 70.4 9.80 (5.43 – 12.8) 65.3 (51.7 – 75.0) 729 (544 – 968) 499 20–39 years (58.8 – 84.2) 68.4 (57.9 – 80.8) 8.55 (7.15 – 9.37) 66.2 40–59 years 671 (409 – 930) 451 (47.7 – 84.7) 60 years and older (52.0 – 79.9) 9.16 (7.75 – 11.8) 64.4 (43.8 – 78.5) 561 (417 – 749) 478 57.7 Females Total, 6 years and older 60.4 7.79 (6.41 – 8.76) 55.5 (49.5 – 61.5) 507 (431 – 619) 2,626 (55.3 – 66.0) 6–11 years (72.4 – 116) 14.3 (9.67 – 17.9) 78.1 (57.3 – 99.4) 643 (455 – 882) 352 91.6 12–19 years 81.0 (69.6 – 94.3) 11.1 (9.30 – 14.5) 71.1 (59.6 – 93.6) 812 (604 – 936) 694 20–39 years 54.0 (44.1 – 66.2) 7.31 (5.72 – 9.03) 47.9 (38.1 – 63.9) 383 (309 – 585) 638 450 40–59 years 54.6 (47.9 – 62.3) 6.98 (4.64 – 8.60) 48.2 (40.6 – 58.2) 511 (395 – 736) 403 492 (362 – 562) 60 years and older 58.3 (48.5 – 70.2) 7.04 (4.21 – 8.11) 60.9 (46.8 – 80.2) Table 4.3.a.3. Urinary daidzein: Mexican Americans Geometric mean and selected percentiles of urine concentrations (in μg/L) for Mexican Americans in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. Geometric mean Sample Selected percentiles (95% conf. interval) 10th 50th 90th (95% conf. interval) size Males and Females 59.0 (54.1 – 64.4) 7.94 Total, 6 years and older 48.6 (44.8 – 56.8) 671 (496 – 848) 1,287 (6.47 – 8.95) 6–11 years (61.0 – 100) 16.6 (11.6 – 18.1) 78.3 (51.3 – 83.2) 588 (321 – 2,270) 231 64.5 12–19 years 87.3 (72.5 – 105) 12.3 (8.90 – 16.5) 74.6 (62.2 – 96.1) 812 (558 – 1,000) 445 20–39 years 50.5 6.19 (4.34 – 8.14) 35.3 (28.1 – 47.1) 821 (468 – 1,160) 282 (42.9 – 59.3) 40–59 years (43.6 – 70.3) 7.50 (4.68 – 10.4) 48.2 (38.0 – 62.6) 475 (347 – 1,260) 157 55.4 60 years and older 42.1 (31.0 – 57.3) 5.61 (2.89 – 7.89) 40.7 (22.8 – 61.7) 366 (222 – 1,200) 172 Males 48.2 60.8 (52.2 – 70.9) 8.82 (7.42 – 9.78) Total, 6 years and older (40.1 – 56.8) 742 (484 – 1,050) 625 (41.0 – 109) 6–11 years 76.3 (57.3 – 102) 17.3 (7.01 – 20.6) 60.0 112 481 (312 – 1,370) 12–19 years 90.0 16.0 (9.79 – 17.8) 84.7 (53.8 – 129) 590 (408 – 1,270) 228 (69.7 – 116) 52.0 7.67 (3.36 – 10.2) 36.0 (27.9 – 48.7) 846 (468 – 1,330) 117 20–39 years (37.9 – 71.3) 60.4 (39.7 – 92.0) 8.25† (4.94 – 10.0) 47.8 40–59 years 790† (356 – 4,980) 85 (21.4 – 81.5) 60 years and older (23.7 – 71.4) 7.55† (1.89 – 9.13) 40.0 41.1 329† (154 – 2,020) 83 (15.3 – 84.1) Females Total, 6 years and older 57.1 (48.9 – 66.7) 6.73 (5.24 – 8.15) 49.8 (42.3 – 64.2) 556 (418 – 871) 662 6–11 years 80.5 14.4 (5.79 – 22.1) 65.4 (49.0 – 98.4) 735 (283 – 3,410) 119 (53.3 – 121) 12–19 years (67.0 – 107) 10.4 (8.24 – 13.6) 71.1 (56.2 – 97.1) 867 (623 – 1,380) 217 84.6 20–39 years 48.7 (32.2 – 73.6) 5.71 (3.33 – 8.01) 32.3 (23.7 – 67.2) 594 (295 – 1,790) 165 40–59 years 50.4 (35.6 – 71.2) 5.24† (3.72 – 11.2) 48.4 (35.4 – 84.6) 346† (267 – 484) 72 89 381† (226 – 2,270) 60 years and older 42.9 (25.7 – 71.5) 5.28† (1.79 – 7.45) 40.1 (18.6 – 73.7) † Estimate is subject to greater uncertainty due to small cell size. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 380

392 Table 4.3.a.4. Urinary daidzein: Non-Hispanic blacks Geometric mean and selected percentiles of urine concentrations (in μg/L) for non-Hispanic blacks in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. Geometric mean Sample Selected percentiles (95% conf. interval) 10th 50th 90th (95% conf. interval) size Males and Females 9.87 (8.52 – 11.6) 72.3 (61.3 – 85.2) (67.6 – 90.9) (474 – 766) 1,343 Total, 6 years and older 78.4 639 (80.6 – 129) 11.5 (8.37 – 16.0) 95.8 6–11 years 927 (487 – 2,170) 207 102 (70.0 – 129) 120 17.5 (13.5 – 20.8) 111 (104 – 139) 895 (756 – 1,160) 496 12–19 years (92.3 – 144) 68.4 (53.2 – 88.0) 11.3 (8.37 – 13.1) 20–39 years (41.3 – 76.5) 601 (408 – 893) 249 50.7 40–59 years (59.6 – 99.9) 8.40 (6.24 – 11.2) 75.0 (58.8 – 111) 457 (377 – 839) 231 77.2 361 53.5 (4.20 – 9.29) 46.9 (28.8 – 78.8) 7.55 (259 – 823) 160 60 years and older (37.7 – 75.8) Males 90.2 (75.1 – 108) 12.1 (8.49 – 14.2) Total, 6 years and older (64.7 – 110) 724 (584 – 1,050) 661 83.6 6–11 years (70.3 – 145) 11.2† (4.75 – 15.9) 101 (42.5 – 215) 1,050† (534 – 2,140) 99 103 12–19 years 132 (107 – 164) 19.4 (11.4 – 24.1) 120 (95.6 – 152) 1,140 (766 – 1,980) 258 20–39 years 94.7 13.2 (7.79 – 16.6) 67.3 (41.4 – 151) 851 (564 – 1,400) 116 (64.5 – 139) 78.7 8.53 (6.17 – 13.3) 83.2 (58.0 – 134) 390 (368 – 701) 114 40–59 years (54.4 – 114) 53.1 (37.3 – 75.7) 8.34† (7.92 – 12.2) 40.3 60 years and older 325† (169 – 1,800) 74 (27.8 – 70.4) Females 69.7 (57.7 – 84.2) 9.41 (7.40 – 11.2) Total, 6 years and older (54.2 – 77.9) 476 (427 – 675) 682 64.7 6–11 years 103 (74.2 – 142) 11.0† (7.50 – 24.0) 85.1 (58.3 – 129) 687† (398 – 7,580) 108 12–19 years 109 14.3 (9.60 – 22.6) 104 (73.9 – 142) 757 (652 – 1,140) 238 (91.8 – 129) 20–39 years (37.2 – 74.6) 9.40 (5.61 – 12.1) 43.3 (26.0 – 75.9) 408 (280 – 622) 133 52.7 40–59 years 75.9 (51.0 – 113) 7.94 (4.01 – 11.8) 69.9 (47.9 – 109) 462 (369 – 2,070) 117 60 years and older 53.7 (31.4 – 91.7) 6.06† (2.92 – 9.07) 55.3 (22.5 – 106) 368† (257 – 1,170) 86 † Estimate is subject to greater uncertainty due to small cell size. Table 4.3.a.5. Urinary daidzein: Non-Hispanic whites Geometric mean and selected percentiles of urine concentrations (in μg/L) for non-Hispanic whites in the U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. Sample Geometric mean (95% conf. interval) Selected percentiles 10th 50th 90th (95% conf. interval) size Males and Females (58.7 – 69.6) 8.36 (6.60 – 9.38) 58.5 (52.0 – 65.3) 571 (479 – 684) 2,108 Total, 6 years and older 63.9 (70.6 – 106) 6–11 years (11.4 – 20.6) 66.6 (56.0 – 93.6) 643 (450 – 985) 193 86.5 16.0 91.5 15.2 (10.6 – 17.3) 76.3 (59.5 – 100) 824 (606 – 977) 378 12–19 years (77.3 – 108) 58.5 (47.8 – 71.7) 6.75 (4.48 – 10.3) 53.0 (44.8 – 66.9) 484 (343 – 753) 494 20–39 years 57.9 40–59 years (5.29 – 8.66) 50.6 (41.9 – 65.3) 575 (407 – 893) 448 (50.4 – 66.5) 7.22 469 61.6 (6.59 – 9.36) 61.2 (49.1 – 78.5) 8.03 (396 – 662) 595 60 years and older (52.9 – 71.8) Males 70.2 (62.0 – 79.4) 9.34 (7.77 – 12.2) 63.8 (54.1 – 72.9) 680 (509 – 779) 1,035 Total, 6 years and older 83.9 (62.4 – 113) 18.4† (7.93 – 21.7) 63.1 (49.4 – 94.1) 6–11 years (271 – 1,180) 99 651† 12–19 years 102 (78.3 – 134) 16.6 (12.7 – 23.1) 80.1 (55.1 – 118) 812 (466 – 1,440) 191 20–39 years 63.4 8.03 (3.27 – 14.2) 59.0 (43.8 – 77.0) 575 (341 – 1,010) 217 (48.0 – 83.7) 66.9 (42.1 – 83.3) 8.29 (6.53 – 9.37) 63.4 40–59 years 670 (409 – 970) 229 (54.2 – 82.7) (42.2 – 88.7) 60 years and older 9.18 (6.88 – 12.0) 58.7 (50.0 – 82.9) 591 (416 – 762) 299 64.3 Females Total, 6 years and older 58.3 (52.6 – 64.7) 7.50 (5.79 – 8.68) 53.1 (47.0 – 61.0) 484 (397 – 608) 1,073 6–11 years 89.7 14.9† (5.43 – 19.0) 89.1 (50.9 – 141) 583† (352 – 7,440) 94 (67.1 – 120) 12–19 years (66.4 – 98.8) 11.8 (7.34 – 15.8) 73.3 (52.3 – 101) 817 (455 – 970) 187 81.0 20–39 years 54.0 (42.7 – 68.5) 6.43 (5.19 – 8.74) 51.1 (38.2 – 64.5) 382 (293 – 683) 277 40–59 years 50.0 (42.1 – 59.4) 5.98 (3.46 – 8.36) 43.5 (32.6 – 53.4) 514 (309 – 843) 219 296 60 years and older 59.6 (49.4 – 71.8) 7.25 (3.83 – 8.51) 61.4 (49.3 – 83.1) 401 (357 – 656) † Estimate is subject to greater uncertainty due to small cell size. 4. Isoavones and Lignans 381

393 Table 4.3.b. Urinary daidzein: Concentrations by survey cycle Geometric mean and selected percentiles of urine concentrations (in μg/L) for the U.S. population, National Health and Nutrition Examination Survey, 1999–2006. (95% conf. interval) Sample Geometric mean Selected percentiles 5th 50th 95th (95% conf. interval) size Total, 6 years and older 1,310 (3.36 – 8.12) 69.8 (58.1 – 82.4) (61.9 – 91.1) (1,030 – 1,550) 2,553 1999–2000 6.56 75.1 (46.6 – 57.5) < LOD 52.3 2001–2002 1,240 (919 – 1,850) 2,794 51.7 (49.0 – 57.5) 66.7 5.71 (4.00 – 6.43) 62.0 (54.1 – 69.7) 1,070 (924 – 1,330) 2,594 2003–2004 (60.4 – 73.7) 1,180 66.5 (3.70 – 6.58) 58.8 (51.4 – 67.7) 4.98 (1,010 – 1,380) 2,528 2005–2006 (59.7 – 74.1) Age group 6–11 years 90.5 1999–2000 (1.43 – 13.6) 100 (71.0 – 129) 1,110 (707 – 1,740) 330 (75.1 – 109) 8.59 84.9 11.3 (3.15 – 12.4) 72.1 (56.6 – 96.9) 1,050 (684 – 1,650) 396 2001–2002 (71.6 – 101) 84.9 (71.6 – 101) 13.2 (9.77 – 16.2) 65.6 (56.7 – 92.7) 788 (644 – 1,070) 341 2003–2004 1,870 94.1 (6.35 – 10.8) 73.8 (56.1 – 95.1) 7.73 (1,130 – 6,350) 351 (74.3 – 119) 2005–2006 12–19 years 123 (91.4 – 166) 14.7 (7.23 – 17.6) 124 (85.6 – 165) 1,460 (1,100 – 3,300) 753 1999–2000 (52.6 – 91.3) 69.3 (53.2 – 87.5) 2.63 (< LOD – 6.02) 69.8 2001–2002 1,330 (977 – 2,110) 744 2003–2004 89.0 9.05 (6.06 – 9.91) 77.9 (60.1 – 104) 1,190 (927 – 1,970) 729 (75.2 – 105) 1,370 94.4 (6.14 – 11.0) 76.9 (59.6 – 102) 9.14 (981 – 2,270) 693 2005–2006 (76.0 – 117) 20–39 years 80.6 (64.3 – 101) 7.55 (3.34 – 9.89) 67.1 (55.6 – 82.5) 1,730 (983 – 4,150) 534 1999–2000 51.5 2001–2002 < LOD 50.7 (40.4 – 64.9) 1,200 (763 – 1,930) 604 (42.7 – 62.1) 2003–2004 (47.6 – 75.3) 4.82 (3.21 – 6.58) 56.1 (44.9 – 69.0) 1,170 (809 – 1,480) 554 59.9 2005–2006 63.4 (51.7 – 77.6) 4.81 (2.19 – 6.27) 52.3 (44.7 – 68.5) 1,360 (737 – 2,240) 583 40–59 years 1999–2000 (39.0 – 78.6) 2.50 (< LOD – 7.77) 56.7 (40.8 – 70.7) 1,060 (801 – 1,520) 420 55.4 50.6 (40.4 – 63.3) < LOD 53.1 (39.3 – 68.2) 1,760 (859 – 3,030) 531 2001–2002 2003–2004 67.9 (58.3 – 79.2) 5.13 (3.05 – 6.43) 62.2 (46.1 – 78.7) 1,290 (840 – 3,440) 452 50.5 2005–2006 (47.3 – 63.7) 3.79 (2.99 – 5.86) 54.9 (41.4 – 61.9) 983 (665 – 1,300) 449 60 years and older (556 – 991) 1999–2000 64.6 (53.0 – 78.8) 6.47 (5.61 – 9.10) 61.5 (45.9 – 85.0) 665 516 519 (397 – 1,990) 2001–2002 636 32.0 (26.2 – 39.0) < LOD 33.8 (28.4 – 40.4) 2003–2004 55.7 4.07 (2.51 – 5.72) 56.5 (43.8 – 76.3) 780 (585 – 1,660) 518 (44.4 – 69.9) (707 – 1,600) 66.4 (1.85 – 8.24) 62.5 (43.9 – 89.5) 952 4.76 452 2005–2006 (54.6 – 80.8) Gender Males 88.9 (71.4 – 111) 7.75 (5.85 – 10.4) 80.5 (66.9 – 112) 1,540 (1,020 – 2,240) 1999–2000 1,220 (727 – 1,400) 1,375 < LOD 50.7 (46.9 – 55.6) 918 2001–2002 (42.8 – 57.9) 49.8 2003–2004 (63.4 – 85.9) 6.35 (3.20 – 8.53) 65.2 (56.4 – 76.4) 1,200 (1,020 – 1,370) 1,244 73.8 2005–2006 73.9 (65.3 – 83.6) 6.32 (4.02 – 7.91) 66.2 (53.9 – 78.3) 1,180 (1,000 – 1,430) 1,252 Females 1999–2000 (52.9 – 77.6) 5.62 (1.86 – 7.80) 57.6 (45.2 – 73.2) 1,210 (652 – 2,010) 1,333 64.1 53.6 (48.1 – 59.8) < LOD 55.4 (49.8 – 62.4) 1,440 (1,190 – 1,990) 1,419 2001–2002 2003–2004 60.7 (53.6 – 68.8) 4.61 (3.50 – 5.95) 57.4 (49.3 – 67.3) 884 (670 – 1,390) 1,350 (45.0 – 61.4) 2005–2006 (52.5 – 68.9) 4.40 (2.99 – 5.94) 52.4 60.1 1,140 (843 – 1,480) 1,276 Race/ethnicity Mexican Americans (59.8 – 104) 1999–2000 78.9 66.1 6.78 (4.37 – 8.83) (48.8 – 90.2) 1,340 (977 – 3,000) 816 2001–2002 39.2 < LOD 39.8 (28.8 – 59.7) 880 (633 – 1,770) 679 (28.5 – 54.0) 57.4 4.90 (3.74 – 5.99) 45.4 (35.3 – 53.3) 1,380 (954 – 1,720) 653 2003–2004 (50.2 – 65.7) 60.6 (53.3 – 68.9) 4.35 (2.74 – 5.80) 54.0 (44.1 – 64.5) 1,320 (981 – 1,550) 634 2005–2006 Non-Hispanic Blacks 1999–2000 (71.1 – 118) 7.48 (< LOD – 11.2) 102 (84.0 – 131) 1,030 (771 – 1,640) 596 91.5 66.3 (47.7 – 91.9) < LOD 72.9 (52.5 – 96.5) 1,410 (950 – 2,850) 692 2001–2002 2003–2004 75.5 (56.5 – 101) 7.09 (5.71 – 8.69) 67.6 (51.5 – 89.3) 1,150 (699 – 2,380) 681 (69.9 – 94.7) 81.3 6.97 (4.66 – 7.57) 76.5 (71.6 – 92.4) 1,200 (878 – 1,960) 662 2005–2006 Non-Hispanic Whites 1999–2000 74.7 (61.8 – 90.3) 7.25 (3.27 – 8.95) 66.8 (57.0 – 77.4) 1,360 (990 – 1,730) 901 2001–2002 (43.8 – 53.9) < LOD 49.8 (45.8 – 53.1) 1,140 (811 – 1,910) 1,211 48.6 1,069 65.9 (58.7 – 74.0) 5.10 (3.33 – 6.39) 62.3 (53.0 – 71.3) 1,050 (843 – 1,360) 2003–2004 (884 – 1,310) 1,039 1,030 2005–2006 62.0 (54.4 – 70.7) 4.55 (3.17 – 6.33) 54.1 (46.9 – 63.9) < LOD means less than the limit of detection, which may vary for some compounds by year. See Appendix D for LOD. nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 382

394 Figure 4.3.b. Urinary daidzein: Concentrations by survey cycle Selected percentiles in μg/L (95% confidence intervals), National Health and Nutrition Examination Survey, 1999–2006 8000 6000 4000 95th Percentile 2000 H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H 0 200 150 H H H 100 H H H H H H H H H H H H H H H H H H H H H H 50th Percentile H H H H H H H H H 50 H H 0 20 15 H H H 10 H H H H H H H H H H H H H 5th Percentile H H H H H 5 H H H H H H 0 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 05−06 99−00 01−02 03−04 12−19y Males Females MA NHB NHW 20+y Total 6−11y 3−5y (6+y) Values in the graph are suppressed if either the point estimate or the lower 95% confidence limit is noted as “< LOD” in the accompanying table. 4. Isoflavones and Lignans 383

395 692 901 970 size 5,122 1,287 2,496 1,343 2,626 1,422 2,108 1,137 Sample (1,520 – 2,820) (1,360 – 2,390) (1,190 – 2,640) (1,860 – 5,360) (1,020 – 2,320) (1,180 – 2,730) (1,630 – 3,290) (1,480 – 3,030) (1,090 – 2,480) (1,510 – 4,990) (1,120 – 2,940) 97.5th 1,890 1,750 1,550 3,010 1,360 2,100 1,330 1,890 1,360 2,760 1,770 (939 – 1,150) (812 – 1,100) (859 – 1,170) (1,000 – 2,990) (645 – 1,040) (1,010 – 1,510) (755 – 1,210) (940 – 1,200) (685 – 1,100) (895 – 2,180) (828 – 1,180) 95th 924 973 825 910 878 1,060 1,630 1,130 1,080 1,140 1,010 (95% conf. interval) (50.2 – 58.5) (45.5 – 55.2) (63.3 – 87.8) (38.6 – 56.1) (39.1 – 59.6) (47.3 – 69.0) (51.0 – 68.9) (50.6 – 60.8) (37.9 – 52.2) (46.0 – 58.2) (51.3 – 78.0) 50th 54.6 49.9 72.6 47.7 48.0 56.2 60.0 56.0 44.6 51.7 63.9 Selected percentiles (6.29 – 7.32) (4.10 – 5.41) (9.30 – 15.7) (5.09 – 7.08) (4.51 – 6.56) (6.45 – 8.14) (6.76 – 9.36) (6.49 – 7.90) (4.34 – 6.73) (4.72 – 7.17) (7.26 – 9.16) 5th 6.83 4.66 12.3 6.32 5.90 7.91 7.44 7.25 5.88 5.99 8.24 (4.17 – 5.11) (7.67 – 11.1) (2.31 – 4.18) (3.58 – 4.79) (3.43 – 4.57) (4.29 – 5.94) (4.91 – 6.71) (4.30 – 5.83) (2.80 – 4.53) (2.73 – 4.80) (4.78 – 7.05) 2.5th 4.69 3.88 9.11 4.34 3.99 5.13 5.75 4.86 3.98 4.02 5.84 (60.0 – 67.5) (85.1 – 110) (53.5 – 64.1) (47.7 – 59.3) (48.8 – 62.1) (60.0 – 77.7) (63.4 – 74.9) (60.7 – 69.7) (46.6 – 59.3) (56.1 – 67.8) (63.3 – 80.5) 63.7 53.2 96.8 58.6 55.0 68.9 68.3 65.1 52.5 61.6 71.4 (95% conf. interval) Geometric mean Males Gender Race/ethnicity Total, 6 years and older Age group 6–11 years Mexican Americans Non-Hispanic Blacks Females 12–19 years Non-Hispanic Whites 20–39 years 40–59 years 60 years and older Health and Nutrition Examination Survey, 2003–2006. Geometric mean and selected percentiles of urine concentrations (in μg/g creatinine) for the total U.S. population aged 6 years and older, National Table 4.4.a.1. Urinary daidzein (creatinine corrected): Concentrations nd 2 National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 384

396 Figure 4.4.a. Urinary daidzein (creatinine corrected): Concentrations by age group Geometric mean (95% confidence interval), National Health and Nutrition Examination Survey, 2003–2006 Overall Mexican Americans 200 150 Females Males 100 50 (μg/g creatinine) Urinary daidzein 0 40−59 20−39 20−39 60+ 60+ 6−11 40−59 6−11 12−19 12−19 Non−Hispanic Whites Non−Hispanic Blacks 200 150 100 50 (μg/g creatinine) Urinary daidzein 0 40−59 12−19 60+ 40−59 20−39 6−11 12−19 20−39 6−11 60+ Males Females 200 150 Mexican Americans 100 Non−Hispanic Blacks Non−Hispanic 50 (μg/g creatinine) Urinary daidzein Whites 0 12−19 20−39 40−59 60+ 6−11 60+ 40−59 6−11 12−19 20−39 Age (years) Age (years) 4. Isoflavones and Lignans 385

397 Table 4.4.a.2. Urinary daidzein (creatinine corrected): Total population Geometric mean and selected percentiles of urine concentrations (in μg/g creatinine) for the total U.S. population aged 6 years and older, National Health and Nutrition Examination Survey, 2003–2006. Sample Geometric mean (95% conf. interval) Selected percentiles 10th 50th 90th (95% conf. interval) size Males and Females (60.0 – 67.5) 9.68 (8.96 – 10.5) Total, 6 years and older (50.2 – 58.5) 522 (463 – 593) 5,122 63.7 54.6 96.8 19.0 (14.8 – 23.0) 72.6 (85.1 – 110) 697 (580 – 924) 692 6–11 years (63.3 – 87.8) 68.3 (60.0 – 77.7) 11.5 (9.80 – 12.7) 56.2 (47.3 – 69.0) 522 (419 – 738) 1,422 12–19 years 52.5 20–39 years (7.41 – 9.62) 44.6 (37.9 – 52.2) 424 (338 – 501) 1,137 (46.6 – 59.3) 8.66 61.6 8.59 (7.78 – 9.25) 51.7 (46.0 – 58.2) 570 (410 – 894) 901 40–59 years (56.1 – 67.8) 71.4 (63.3 – 80.5) 11.3 (10.1 – 12.0) 63.9 (51.3 – 78.0) 565 (462 – 702) 970 60 years and older Males (45.5 – 55.2) (53.5 – 64.1) 8.91 (8.16 – 9.82) 49.9 58.6 467 (421 – 543) 2,496 Total, 6 years and older (73.6 – 104) 87.5 733 15.8 (11.8 – 21.6) 68.2 (54.2 – 82.8) 6–11 years (435 – 1,190) 340 12–19 years 69.8 11.6 (9.54 – 13.5) 53.9 (43.2 – 69.7) 580 (404 – 842) 728 (57.3 – 85.0) 51.3 7.55 (6.03 – 9.50) 43.4 (36.9 – 50.3) 451 (379 – 595) 499 20–39 years (44.0 – 59.9) 54.2 (46.0 – 63.9) 7.88 (6.08 – 8.73) 47.0 40–59 years 458 (305 – 766) 451 (38.7 – 60.1) 60 years and older (49.0 – 71.