{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:40:35Z","timestamp":1792806035432,"version":"4.5.0"},"reference-count":55,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2020,5,22]],"date-time":"2020-05-22T00:00:00Z","timestamp":1590105600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","award":["T32ES007069"],"award-info":[{"award-number":["T32ES007069"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005185","name":"Millennium Challenge Corporation","doi-asserted-by":"publisher","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}],"id":[{"id":"10.13039\/100005185","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Sight and Life","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}],"id":[{"id":"https:\/\/ror.org\/01htfbe02","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004415","name":"Vitamin D Society","doi-asserted-by":"publisher","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}],"id":[{"id":"10.13039\/501100004415","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}],"id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Harvard T.H. Chan School of Public Health Nutrition Round Table","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>(1) Background: Aspects of the Mongolian food supply, including high availability of animal-source foods and few plant foods, are plausibly associated with disease in the population. Data on Mongolian diets are lacking, and these risks are poorly quantified. The purpose of this study was to provide a multifaceted nutritional analysis of the modern Mongolian diet. (2) Methods: The study population consisted of 167 male and 167 female healthy non-pregnant urban and nomadic adults (22\u201355 years) randomly selected from lists of residents in 8 regions. From 2011\u20132016, 3-day weighed diet records and serum were collected twice from each participant in summer and winter; anthropometry was collected once from each participant. Serum was analyzed for biomarkers, and nutrient intake computed using purpose-built food composition data and adjusted for within-person variation. Exploratory dietary patterns were derived and analyzed for associations with diet and nutrition measurements. (3) Results: We collected 1838 of an expected 1986 diet records (92.5%), 610\/658 serum samples (92.7%), and 315\/334 height and weight measurements (94.3%). Sixty-one percent of men and 51% of women were overweight or obese. Consumption of red meat, refined grains, and whole-fat dairy was high, while that of fruits, non-tuberous vegetables, eggs, nuts and seeds, fish and poultry, and whole grains was low. Dairy and red meat were more consumed in summer and winter, respectively. Dietary inadequacy of 10 of 21 assessed nutrients, including fiber, folate, and vitamin D were &gt;50% prevalent, while protein, zinc, and vitamin B12 inadequacy were low. Biochemical evidence of iron and vitamin A deficiency was also low. Three dietary patterns (Urban, Transitional, Nomadic) explained 41% of variation in food consumption. The Urban pattern was positively associated with BMI in multivariate analysis. (4) Conclusions: Results indicate a high prevalence of key dietary inadequacies and overweight among Mongolian adults. Prior studies by our group have suggested that expanded supplementation and food fortification would be effective in addressing micronutrient inadequacies; these strategies should be coupled with measures to mitigate the growing burden of chronic disease.<\/jats:p>","DOI":"10.3390\/nu12051514","type":"journal-article","created":{"date-parts":[[2020,5,22]],"date-time":"2020-05-22T10:18:18Z","timestamp":1590142698000},"page":"1514","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Diet and Nutrition Status of Mongolian Adults"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6552-4871","authenticated-orcid":false,"given":"Sabri","family":"Bromage","sequence":"first","affiliation":[{"name":"Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tselmen","family":"Daria","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ulm University, Ulm 89081, Germany, and Central Scientific Laboratory, Institute of Medical Sciences, Ulaanbaatar 16081, Mongolia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca L.","family":"Lander","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, CO 80045, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0730-5945","authenticated-orcid":false,"given":"Soninkhishig","family":"Tsolmon","sequence":"additional","affiliation":[{"name":"School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa A.","family":"Houghton","sequence":"additional","affiliation":[{"name":"Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enkhjargal","family":"Tserennadmid","sequence":"additional","affiliation":[{"name":"Nutrition Laboratory, National Center for Public Health, Ulaanbaatar 13381, Mongolia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0766-7030","authenticated-orcid":false,"given":"Nyamjargal","family":"Gombo","sequence":"additional","affiliation":[{"name":"Food and Agriculture Organization of the United Nations Country Office, Ulaanbaatar 14201, Mongolia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalind S.","family":"Gibson","sequence":"additional","affiliation":[{"name":"Department of Human Nutrition, University of Otago, Dunedin 9054, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davaasambuu","family":"Ganmaa","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Harvard T.H. Chan School of Public Health and Channing Division of Network Medicine, Department of Medicine, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,5,22]]},"reference":[{"key":"ref_1","unstructured":"World Bank (2020, February 02). World Bank Open Data. Available online: https:\/\/data.worldbank.org."},{"key":"ref_2","unstructured":"Food and Agriculture Organization of the United Nations (2020, February 02). FAOSTAT3 System. Available online: http:\/\/faostat3.fao."},{"key":"ref_3","unstructured":"FAO, UNICEF, and UNDP (2007). Joint Food Security Assessment Mission to Mongolia, Food and Agriculture Organization of the United Nations."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1093\/jn\/nxz010","article-title":"Global Improvement in Dietary Quality Could Lead to Substantial Reduction in Premature Death","volume":"149","author":"Wang","year":"2019","journal-title":"J. Nutr."},{"key":"ref_5","unstructured":"Institute for Health Metrics and Evaluation (2020, February 02). Global Burden of Disease Study 2017 (GBD 2017) Data Input Sources Tool. Available online: http:\/\/ghdx.healthdata.org\/gbd-2017\/data-input-sources."},{"key":"ref_6","unstructured":"Institute for Health Metrics and Evaluation (2020, February 02). GBD Compare. Available online: http:\/\/vizhub.healthdata.org\/gbd-compare."},{"key":"ref_7","unstructured":"Public Health Institute of Mongolia (2017). Nutrition Status of the Population of Mongolia\u20145th National Nutrition Survey Report."},{"key":"ref_8","unstructured":"World Health Organization (2013). Mongolian STEPS Survey on the Prevalence of Noncommunicable Disease and Injury Risk Factors-2013, World Health Organization."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Bromage, S., Rich-Edwards, J.W., Tselmen, D., Baylin, A., Houghton, L.A., Baasanjav, N., and Ganmaa, D. (2016). Seasonal Epidemiology of Serum 25-Hydroxyvitamin D Concentrations among Healthy Adults Living in Rural and Urban Areas in Mongolia. Nutrients, 8.","DOI":"10.3390\/nu8100592"},{"key":"ref_10","first-page":"845","article-title":"Dietary survey on the diet of Mongolian nomads","volume":"50","author":"Ishii","year":"1999","journal-title":"J. Home Econ. Jpn."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.atherosclerosis.2004.03.005","article-title":"Comparison of electrocardiogram findings and lifestyles between urbanized people and ger-living people in Ulaanbaatar, Mongolia","volume":"175","author":"Komatsu","year":"2004","journal-title":"Atherosclerosis"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/1743-7075-3-21","article-title":"Investigation of oxidative stress and dietary habits in Mongolian people, compared to Japanese people","volume":"3","author":"Komatsu","year":"2006","journal-title":"Nutr. Metab."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"84","DOI":"10.2174\/1874609810801020084","article-title":"Dietary habits of Mongolian people, and their influence on lifestyle-related diseases and early aging","volume":"1","author":"Komatsu","year":"2008","journal-title":"Curr. Aging Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"214","DOI":"10.2174\/1874609810902030214","article-title":"Relationship of dietary habits and obesity to oxidative stress in Palauan people: Compared with Japanese and Mongolian people","volume":"2","author":"Komatsu","year":"2009","journal-title":"Curr. Aging Sci."},{"key":"ref_15","first-page":"7","article-title":"Food and nutrient intakes among nomads living in three different areas of Inner Mongolia, China","volume":"14","author":"Ohno","year":"2005","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Bromage, S., Ganmaa, D., Rich-Edwards, J.W., Rosner, B., Bater, J., and Fawzi, W.W. (2018). Projected effectiveness of mandatory industrial fortification of wheat flour, milk, and edible oil with multiple micronutrients among Mongolian adults. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0201230"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1177\/0379572117700749","article-title":"Trained Cohorts of University Students are a Useful Resource for Conducting Dietary Surveys in Mongolia","volume":"38","author":"Bromage","year":"2017","journal-title":"Food Nutr. Bull."},{"key":"ref_18","unstructured":"WHO Expert Committee on Physical Status (1995). Physical Status: The Use of and Interpretation of Anthropometry, World Health Organization. Report of a WHO Expert Committee."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1038\/sj.ijo.0802486","article-title":"Overweight Japanese with body mass indexes of 23.0\u201324.9 have higher risks for obesity-associated disorders: A comparison of Japanese and Mongolians","volume":"28","author":"Shiwaku","year":"2004","journal-title":"Int. J. Obes. Relat. Metab. Disord."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3127","DOI":"10.1093\/jn\/134.11.3127","article-title":"Combined measurement of ferritin, soluble transferrin receptor, retinol binding protein, and C-reactive protein by an inexpensive, sensitive, and simple sandwich enzyme-linked immunosorbent assay technique","volume":"134","author":"Erhardt","year":"2004","journal-title":"J. Nutr."},{"key":"ref_21","unstructured":"Thurnham, D.I., and McCabe, G.P. (2012). Influence of infection and inflammation on biomarkers of nutritional status with an emphasis on vitamin A and iron. Report: Priorities in the Assessment of Vitamin A and Iron Status in Populations, Panama City, Panama, 15\u201317 September 2010, World Health Organization."},{"key":"ref_22","first-page":"333","article-title":"Management of elevated serum ferritin levels","volume":"4","author":"Adams","year":"2008","journal-title":"Gastroenterol. Hepatol."},{"key":"ref_23","unstructured":"Food and Agriculture Organization of the United Nations (2020, February 02). FAO\/INFOODS e-Learning Course on Food Composition Data. Available online: http:\/\/www.fao.org\/elearning\/#\/elc\/en\/Course\/FCD."},{"key":"ref_24","unstructured":"Bogn\u00e1r, A. (2002). Tables on Weight Yield of Food and Retention Factors of Food Constituents for the Calculation of Nutrient Composition of Cooked Foods (Dishes), Federal Research Centre for Nutrition and Food."},{"key":"ref_25","unstructured":"Matthews, R.H., and Garrison, Y.J. (1975). Agriculture Handbook No. 102: Food Yields Summarized by Different Stages of Preparation."},{"key":"ref_26","unstructured":"Hartmann, B.M., Bell, S., and V\u00e1squez-Caicedo, A.L. (2005). Bundeslebensmittelschl\u00fcssel II 3.1, Federal Research Centre for Nutrition and Food."},{"key":"ref_27","unstructured":"Haytowitz, D.B. (2011). USDA National Nutrient Database for Standard Reference, Release 24."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.1017\/S1368980009991856","article-title":"Poor dietary quality of complementary foods is associated with multiple micronutrient deficiencies during early childhood in Mongolia","volume":"13","author":"Lander","year":"2010","journal-title":"Public Health Nutr."},{"key":"ref_29","unstructured":"Nutrient Data Laboratory (2007). USDA Table of Nutrient Retention Factors."},{"key":"ref_30","unstructured":"Showell, B.A., Williams, J.R., Duvall, M., Howe, J.C., Patterson, K.Y., Roseland, J.M., and Holden, J.M. (2012). USDA Table of Cooking Yields for Meat and Poultry."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.3945\/jn.114.191288","article-title":"SPADE, a new statistical program to estimate habitual dietary intake from multiple food sources and dietary supplements","volume":"144","author":"Dekkers","year":"2014","journal-title":"J. Nutr."},{"key":"ref_32","unstructured":"Institute of Medicine (US) Subcommittee on Interpretation and Uses of Dietary Reference Intakes, and Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes (2000). DRI Dietary Reference Intakes: Applications in Dietary Planning, National Academies Press."},{"key":"ref_33","unstructured":"National Academy of Medicine (2020, February 02). DRI Summary Tables, Available online: https:\/\/www.nal.usda.gov\/sites\/default\/files\/fnic_uploads\/\/SummaryTables.pdf."},{"key":"ref_34","first-page":"429","article-title":"Multiple micronutrient deficiencies persist during early childhood in Mongolia","volume":"17","author":"Lander","year":"2008","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"282","DOI":"10.24079\/cajms.2017.11.009","article-title":"Osteoporosis in Mongolian Population: Prevalence and Risk Factors","volume":"3","author":"Baatar","year":"2017","journal-title":"Cent. Asian J. Med. Sci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1001\/archinte.164.4.370","article-title":"Dietary fiber and risk of coronary heart disease: A pooled analysis of cohort studies","volume":"164","author":"Pereira","year":"2004","journal-title":"Arch. Intern. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"538","DOI":"10.2337\/diacare.27.2.538","article-title":"Carbohydrate nutrition, insulin resistance, and the prevalence of the metabolic syndrome in the Framingham Offspring Cohort","volume":"27","author":"McKeown","year":"2004","journal-title":"Diabetes Care"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1093\/ajcn\/80.2.348","article-title":"Glycemic index, glycemic load, and dietary fiber intake and incidence of type 2 diabetes in younger and middle-aged women","volume":"80","author":"Schulze","year":"2004","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/j.ebiom.2018.11.060","article-title":"Randomized trial of three doses of vitamin D to reduce deficiency in pregnant Mongolian women","volume":"39","author":"Enkhmaa","year":"2019","journal-title":"EBioMedicine"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"931","DOI":"10.2471\/BLT.15.156323","article-title":"Global Burden of Diseases Nutrition; Chronic Diseases Expert Group (NutriCode). A global database of food and nutrient consumption","volume":"94","author":"Khatibzadeh","year":"2016","journal-title":"Bull. World Health Organ."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"12871","DOI":"10.3390\/ijms160612871","article-title":"Fatty Acids Composition of Vegetable Oils and Its Contribution to Dietary Energy Intake and Dependence of Cardiovascular Mortality on Dietary Intake of Fatty Acids","volume":"16","author":"Orsavova","year":"2015","journal-title":"Int. J. Mol. Sci."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Mozaffarian, D., Micha, R., and Wallace, S. (2010). Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: A systematic review and meta-analysis of randomized controlled trials. PLoS Med., 7.","DOI":"10.1371\/journal.pmed.1000252"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1093\/ajcn\/77.5.1146","article-title":"Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: A meta-analysis of 60 controlled trials","volume":"77","author":"Mensink","year":"2003","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2455","DOI":"10.1001\/jama.294.19.2455","article-title":"Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: Results of the OmniHeart randomized trial","volume":"294","author":"Appel","year":"2005","journal-title":"JAMA"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.plipres.2008.10.002","article-title":"Dietary fats and prevention of type 2 diabetes","volume":"48","author":"Riserus","year":"2009","journal-title":"Prog. Lipid Res."},{"key":"ref_46","first-page":"433","article-title":"Association of major dietary patterns with obesity risk among Mongolian men and women","volume":"18","author":"Dugee","year":"2009","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2392","DOI":"10.1056\/NEJMoa1014296","article-title":"Changes in diet and lifestyle and long-term weight gain in women and men","volume":"364","author":"Mozaffarian","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"GBD 2015 Obesity Collaborators (2017). Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N. Engl. J. Med., 377, 13\u201327.","DOI":"10.1056\/NEJMoa1614362"},{"key":"ref_49","unstructured":"McMurray, C., and Smith, R. (2001). Diseases of Globalization, Socioeconomic Transitions and Health, Earthscan."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e132","DOI":"10.1016\/S2214-109X(14)70381-X","article-title":"Dietary quality among men and women in 187 countries in 1990 and 2010: A systematic assessment","volume":"3","author":"Imamura","year":"2015","journal-title":"Lancet Glob. Health"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Chimeddamba, O., Peeters, A., Walls, H.L., and Joyce, C. (2015). Noncommunicable Disease Prevention and Control in Mongolia: A Policy Analysis. BMC Public Health, 15.","DOI":"10.1186\/s12889-015-2040-7"},{"key":"ref_52","unstructured":"World Health Organization, and United Nations Development Programme (2020, February 02). The Investment Case for Noncommunicable Disease Prevention and Control in Mongolia: Return on Investment Analysis and Institutional Context Analysis. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/259627."},{"key":"ref_53","unstructured":"Food and Agriculture Organization of the United Nations (2020, February 02). Food-Based Dietary Guidelines\u2014Mongolia. Available online: www.fao.org\/nutrition\/education\/food-dietary-guidelines\/regions\/countries\/mongolia\/en."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Bromage, S., Rosner, B., Rich-Edwards, J.W., Ganmaa, D., Tsolmon, S., Tserendejid, Z., Odbayar, T.O., Traeger, M., and Fawzi, W.W. (2018). Comparison of Methods for Estimating Dietary Food and Nutrient Intakes and Intake Densities from Household Consumption and Expenditure Data in Mongolia. Nutrients, 10.","DOI":"10.3390\/nu10060703"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.jegh.2015.12.001","article-title":"A cohort study of chronic diseases for Mongolian people: Outline with baseline data of the Moncohort study","volume":"6","author":"Davaalkham","year":"2016","journal-title":"J. Epidemiol. Glob. Health"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/12\/5\/1514\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:31:37Z","timestamp":1760175097000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/12\/5\/1514"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,22]]},"references-count":55,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,5]]}},"alternative-id":["nu12051514"],"URL":"https:\/\/doi.org\/10.3390\/nu12051514","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,22]]}}}