Most people don’t get enough micronutrients. Are you one of them?
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Micronutrients are essential vitamins and minerals that play critical roles in many processes in the body that help maintain health and prevent disease. They are involved in pathways that support fundamental cellular functions like energy production, DNA synthesis, and oxygen transport.1 Vitamins like A, C, D, E, and K, as well as minerals like calcium, iron, zinc, magnesium, and phosphorus, are vital for maintaining immune function, bone health, and overall metabolic balance. For example, vitamin D and calcium are essential for bone health. Vitamins A, C, and E, along with minerals like zinc and selenium, have antioxidant properties that protect cells from oxidative stress and support immune function.2–4
Deficiencies in these micronutrients can lead to significant health issues. For example, iron deficiency can result in anemia, which can have several consequences, like fatigue, hair loss, poor sleep quality, and decreased fertility. Vitamin D deficiency is associated with increased risk of bone disorders—in severe cases, people can develop something develop a condition called Rickets, which is a bone disease in children associated with bone deformities and impaired growth. The treatment for this is giving vitamin D!5 Inadequate vitamin A and C can affect your immune function, which can lead to increased risk of infections infections.6
So getting enough micronutrients is key to maintaining overall health and preventing disease. But here’s the problem. The percentage of the U.S. population that meets the Recommended Dietary Allowance (RDA) for all vitamins and minerals is actually very low. For example, data from the National Health and Nutrition Examination Survey (or NHANES), which looked at data from over 26,000 individuals from 2005 to 2016, found that 45% of the population didn’t get enough vitamin A, 46% didn’t get enough vitamin C, 84% didn’t get enough vitamin E, and 95% didn’t get enough vitamin D.7 These findings show just how widespread the prevalence of micronutrient inadequacy is in the US.
Why is this? There are a lot of reasons.
First, a significant portion of the population eats calorie dense but nutrient-poor diets, which tend to be high in processed foods and low in fruits, vegetables, and whole grains. This might be because of time, money, or availability of nutrient-dense foods. But regardless of the reason, it is common. For example, according to one survey by the CDC, one third of adults in the US consume fast food on given day.8 This dietary pattern leads to insufficient intake of essential micronutrients..
But even if you eat what seems to be a healthy and well-balanced diet, it may not be as healthy and well balanced as it used to be, because the micronutrient density of food has changed significantly over time. A study of foods in the UK between 1940 and 2019 showed substantial declines in micronutrients in food over this period—for example, a 50% decrease in iron, and a 49% decrease in copper. A similar trend has been seen in the US—USDA data from 43 garden crops between 1950 and 1999 revealed reliable declines in micronutrients like calcium, phosphorus, iron, riboflavin, and ascorbic acid.9,10 This decline happens for a few reasons, but the primary drivers are industrialized agriculture, which prioritizes high yield crops over nutrient density, and changes in soil management practices—nutrients come from the soil, after all.
Second, poor absorption of micronutrients from the gut is common. This can happen in people with celiac disease, or inflammatory bowel disease. But increasingly, we’re finding that the gut microbiome itself plays a critical role in how easily vitamins and minerals are processed and absorbed.11 An imbalance in the microbiome is something called dysbiosis, and it is probably very common—increasingly, it has been associated with a huge range of conditions, from irritable bowel syndrome to allergies.12,13 Dysbiosis may actually be the rule, not the exception.
Third, a number of chronic illnesses, like obesity, diabetes, and cardiovascular disease can alter nutrient metabolism and increase the risk of deficiencies, whether dysbiosis is present or not. For example, obesity is associated with lower vitamin D levels because vitamin D gets stored in adipose tissue and is not available for use.14
Fourth, different lifestyle choices can affect vitamin absorption and metabolism. These include things like smoking, alcohol, and a number of medications. Smoking is a classic example – it increases oxidative stress in the body, which decreases vitamin C levels.
Fifth, where you live, the time of year, and who you are matters. For example, season and climate can affect vitamin D levels, as one main source of vitamin D is sun exposure. But age, sex, and genetics can affect micronutrient needs as well.15
So what can you do about this? And how do you know if you are missing out on key micronutrients? Well, you can take a hard look at your diet. Are you getting a variety of fresh fruits and vegetables? Do you know where they come from, and how they were grown? You are more likely to get nutrient-dense foods from a local, small-scale farmer that you meet at the farmer’s market than at Walmart or Costco. This is part of what has inspired the modern farm to table movement. You can look at your lifestyle practices. Are you smoking? Do you have any other chronic diseases? These may affect your micronutrient needs. You can also look at your micronutrients by working with an integrative medicine practitioner. Testing these levels is straightforward and can provide helpful insights into what you might be missing.
In summary, micronutrients are crucial to overall health and wellness. Many people don’t get enough of them, and it may be getting harder to get them based on changes in the food supply. Looking closely at your diet and other risk factors for low levels is important, and measuring your micronutrient levels to get a sense of your current status can be very helpful.
References
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2. Mitra S, Paul S, Roy S, et al. Exploring the Immune-Boosting Functions of Vitamins and Minerals as Nutritional Food Bioactive Compounds: A Comprehensive Review. Mol Basel Switz. 2022;27(2):555. doi:10.3390/molecules27020555
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8. Products - Data Briefs - Number 320 - September 2018. Published June 7, 2019. Accessed June 13, 2024. https://www.cdc.gov/nchs/products/databriefs/db322.htm
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11. Gut microbiome–micronutrient interaction: The key to controlling the bioavailability of minerals and vitamins? - Barone - 2022 - BioFactors - Wiley Online Library. Accessed June 13, 2024. https://iubmb.onlinelibrary.wiley.com/doi/full/10.1002/biof.1835
12. Gut Microbial Dysbiosis in the Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Case-Control Studies - PubMed. Accessed June 13, 2024. https://pubmed.ncbi.nlm.nih.gov/31473156/
13. Saeed NK, Al-Beltagi M, Bediwy AS, El-Sawaf Y, Toema O. Gut microbiota in various childhood disorders: Implication and indications. World J Gastroenterol. 2022;28(18):1875-1901. doi:10.3748/wjg.v28.i18.1875
14. Berger MM, Amrein K, Barazzoni R, et al. The science of micronutrients in clinical practice - Report on the ESPEN symposium. Clin Nutr Edinb Scotl. 2024;43(1):268-283. doi:10.1016/j.clnu.2023.12.006
15. Carr AC, Rowe S. Factors Affecting Vitamin C Status and Prevalence of Deficiency: A Global Health Perspective. Nutrients. 2020;12(7):1963. doi:10.3390/nu12071963