Dietary intakes in relation to nutrition recommendations and dietary quality in an Iranian adult population: the results of the Food and Nutrition Surveillance (FNS).

Background: The Iranian population faces a dual burden of overconsumption and nutrient insufficiency. Considering recent socioeconomic changes due to severe sanctions and the impact of the COVID-19 crisis, this research aimed to assess the energy, macronutrient, and micronutrient intakes of Iranian adults (19-60 years) and elderly individuals (> 60 years), based on the Food and Drug Administration dietary intake recommendations, through a survey.

Methods: This was a cross-sectional survey conducted from 2021 to 2022. The study included 1697 adults aged over18 years, selected from 11 geographical zones of Iran based on socio-economic and geographic similarities. All participants underwent dietary assessment using a validated 65-item Food Frequency Questionnaire (FFQ). Macronutrient and micronutrient intakes were compared with Dietary Reference Intakes (DRI). The Dietary Quality Index- International (DQI-I) was also calculated.

Results: In the adults aged 19-60 years, the mean usual energy intake was 2,321.64 ± 33.16 kcal/day. Carbohydrates, fat, and protein constituted 50.4%, 38.3%, and 13.45% of total energy intake, respectively. About 64.0% of women and 78.0% of men consumed fiber in amounts lower than recommended. The percentage of insufficiency was approximately 100% for retinol and vitamin D in both genders. Insufficient folate intake was 90.1% in women and 89.9% in men (p = 0.038). Excess sodium intake was more prevalent in men (p = 0.003). In the elderly (> 60 years), the mean usual energy intake was 1,987 kcal/day. Carbohydrates, fat, and protein constituted 52.98%, 35.88%, and 13.9% of total energy intake, respectively. The percentage of insufficiency for vitamin D, retinol, folate, selenium, and potassium intake was high (more than 80%) in both genders. Zinc insufficiency and excess sodium intake were significantly more prevalent in men.

Conclusions: This study indicated that carbohydrate and protein intakes were within the recommended ranges, while fat consumption was elevated in both adults and the elderly. Widespread micronutrient insufficiencies- especially in retinol, folate, vitamin D, potassium, and selenium- were evident across both genders and age groups. Excessive sodium consumption was more prevalent in men, along with a higher prevalence of zinc deficiency. These findings highlight the need for targeted dietary interventions to address nutritional gaps and promote healthier eating habits.