We all know that certain nutrients are essential for life and good health. Failure to consume adequate amounts of these essential nutrients results in consequences that range from low energy to death, depending on the specific nutrient, the individual, and the severity and duration of the deficiency. There is a lot of information about nutrient deficiencies and it is often contradictory and inconsistent. At one end there are people who wish to convince the public that we are all deficient in almost everything. At the other end are people who claim that nutrient deficiencies of any sort are rare in our country. Let’s take a look at the evidence and decide.
One of the most common problems with the health in the United States is that we do not get the proper essential nutrients that our bodies need to function and grow properly. Many of us live in a fast paced world where people rarely have free time. Some people are perpetually busy. Often times this means we are feeding on the run and quick food becomes breakfast, lunch and dinner on a regular basis. Many even skip meals. Unfortunately, this type of diet does not give our children or ourselves the proper nutrients and can quickly lead to a variety of health problems.
Poor or inadequate diets are linked to four of the top 10 causes of death: heart disease, cancer, stroke, and diabetes. In The Healthy Eating Index for 1999-2000, researchers for the Center for Nutrition Policy and Promotion noted that only 10% of the U.S. population had an adequate diet, 74% had in-adequate nutrient intake, and 16% were rated to have a poor diet, markedly increasing the risk for major health problems. And as it turns out, most of us have less-than-ideal diets that essentially leave our bodies starving for more nutrients. 9 out of 10 people in our country are deficient in essential nutrients!
Along with poor diets, studies have found that key nutrients in foods have declined from 1909 to 1994. This is due to the soil’s decrease in nutrient-density, combined with the processing of foods. So not only are we eating fewer healthy foods, but the food we do eat contain fewer nutrients than they once did. As a result, many Americans, even those who think they are eating relatively healthy, may be suffering from a nutritional deficiency. Also, recent research shows that certain deficiencies are not only common, they’re also on the rise.
To be clinically significant, a deficiency needs to be common and the adverse impact of that deficiency needs to be strong. But identifying deficiencies is challenging, as controversy exists as to whether nutritional deficiencies should be based on “optimal intake” and, if so, what optimal intake should be. The recommended daily allowances (RDAs) the government has established do not clarify optimal nutritional intake. Instead, they are calculated to estimate levels necessary to prevent a disease state in 98% of healthy people, depending on their age and gender.
Optimal nutrient intake for proper immune function and health are clearly higher than the RDAs. The intention of this article is not to argue about the optimal dosage, but to spread awareness about deficiencies that can be corrected and would result in improvements in our health.
The following is a brief overview of the most commonly deficient nutrients and information about how each deficiency is affecting people in our country. The top 5 clinically important deficiencies listed below are ranked in an order approximately reflecting magnitude of benefit if they were to be corrected. An important point to observe is that the top five deficiencies cannot be remedied by simply adding a multivitamin.
- Vitamin D – 8 out of 10 people are deficient. Vitamin D functions as a hormone, and every cell in the human body appears to have vitamin D-receptor sites. Vitamin D is well known to enhance calcium absorption and is essential for maintaining bone density. Less well understood is the role of vitamin D in immune function, but low levels of vitamin D are strongly associated with an increased risk for both autoimmune diseases and cancer. Vitamin D inhibits proliferation of benign and malignant tumor cells, such as those that may occur in the colon, prostate, or breast. Compounding dietary deficiency is the reduction of sun exposure for many Americans. Adequate sun allows the skin to synthesize vitamin D from cholesterol, but sunblock prevents this production and concerns regarding both skin cancer risk and skin aging have kept many out of the sun. Enormous controversy surrounds the current recommended intake for vitamin D of 200 IU has been shown to prevent rickets and is the amount noted on nutrition food labels. However, at this intake level, rates for MS, severe osteoporosis, and many forms of cancer increase substantially. Most data suggest that 2,000 IU daily is the intake to minimize disease risk, and up to 5,000 IU daily has an excellent safety record. The good news is that vitamin D deficiencies can be easily eradicated at minimal expense if patients ensure adequate intake. Daily intake of 2,000 IU of vitamin D can be achieved by combining dietary sources and including a multivitamin with adequate intake of other commonly deficient nutrients, in particular calcium and omega fatty acids. Adding limited sunshine exposure also helps. There are times when vitamin D levels should be measured to clarify a diagnosis or to optimize dosing. To measure vitamin D levels, a 25-hydroxyvitamin D level (not 1,25-dihydroxyvitamin D) should be ordered. Many laboratories now list 30 ng/mL as normal, although the most common expert-opinion goal is at least 50-90 ng/mL, with 100 being the upper end of the normal range. Sources: Shrimp, milk, cod liver oil, eggs and sunshine exposure. Symptoms: Burning sensation in mouth, diarrhea, insomnia, myopia, nervousness, osteomalacia, osteoporosis, rickets, scalp sweating
Fiber – One of the most clinically important deficiency in the American diet is fiber. Fiber intake in the United States averages 12-15 g daily, while nearly all recommendations suggest 30-50 g. Fiber comes in two forms—insoluble and soluble. Both forms are essential. They reduce calorie intake by improving satiety with eating and are associated with good weight control. Insoluble fiber (good sources are whole grains) enhances GI function and is packed with nutrients. Soluble fiber (found in fruits, vegetables, oats, nuts, and beans) lowers cholesterol and blood sugar levels and is also loaded with nutrients. Also, fiber is an important tool your body uses to eliminate toxins from your body. Sources: At least half of the 30 g of fiber intake daily should come from fruits and vegetables. Individuals should consume at least five cups of fruits and vegetables (two pieces of fruit, a salad, a couple cups of colorful vegetables for lunch, dinner, and snacks). Otherwise, you may want get a supplement form. Symptoms: Constipation, hemorrhoids if related to straining from constipation, high blood sugar levels, high cholesterol levels. Adequate fiber is needed for healthy cholesterol levels, reduced colon cancer risk, and weight control. Fiber consumption is inversely associated with insulin levels, weight gain, GI function and disease, and many cardiovascular disease risk factors.
- Essential Fatty Acids (EFA) – 8 out of 10 people show sign of deficiency. Long-chain omega-3 fats, like eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) come from seafood and have been shown to have multiple clinical benefits. They reduce triglyceride levels and clot formation, improve insulin sensitivity, and lower inflammation in patients with Crohn’s disease and rheumatoid arthritis. Research has shown that long-chain fatty acids decrease the risk for cardiovascular events and reduce mortality. In terms of reducing cardiovascular events, increasing omega-3 fat intake is more important than cutting saturated fat intake. Omega-3 fats also appear to decrease the incidence of Alzheimer’s disease. Not only is the brain 40% omega-3 fat by weight, making fish oil an essential brain nutrient, but inflammation and abnormal blood sugar regulation increase the risk for AD and both are improved with regular omega fatty acid intake. It has also been shown to enhance brain cell formation and synaptic function. Medium-chain omega-3 fatty acids from plants will lower cholesterol levels, but they do not have the same proven benefits as marine-derived long-chain omega-3 fatty acids. Soy-based foods, ground flax seed, and nuts are all healthy sources of fiber and nutrients. Good sources of marine omega-3 fats include salmon, sardines, sole, herring, and trout, plus cold-water oysters and mussels. Wild salmon and herring are the healthiest and least expensive sources. Symptoms: Diarrhea, dry skin and hair, hair loss, acne, eczema, psoriasis, immune weakness, infertility, poor wound healing, premenstrual syndrome, gall stones, liver degeneration, ADD/ADHD, and depression.
Magnesium– 8 out of 10 patients show clinical signs of magnesium deficiency. The average American diet only contains 50% to 60% of the Recommended Daily Allowance (RDA). According to some studies, half the population of industrialized countries have a magnesium deficit, which increases with aging. 75 to 85% of diets in the US are deficient Magnesium is required for more than 300 chemical reactions in the human body, affecting cardiac function, bowel function, blood sugar control, blood pressure and bone health. Not surprisingly, then, magnesium deficiency plays a role in cardiac deaths, poor blood pressure control, and GI problems, in particular constipation. About half of magnesium stores are intracellular, and half are combined with calcium and phosphorus in bone. Only 1% of magnesium is found in blood; thus serum magnesium levels are a poor reflection of magnesium stores, and the simplest measure would be RBC magnesium levels. Sources of magnesium are green leafy vegetables, whole grains, nuts and seeds, wheat and oat bran, and soy products. Not only are 75%-85% of U.S. diets deficient in magnesium, but several common factors lead to magnesium depletion including diuretic use, elevated glucose levels, diarrhea, alcohol intake, and malabsorption related to GI diseases. Complicating magnesium deficiency is that adding calcium supplements alone blocks magnesium absorption and worsens what is already a national magnesium deficiency problem. This problem is made worse by the lack of quality clinical outcome studies identifying the optimal calcium/magnesium supplement recommendation, but expert opinion regarding combining these supplements ranges from a 1:1 to 3:1 calcium/magnesium ratio. Magnesium is commonly supplemented in the form of magnesium oxide, but this frequently acts as a GI irritant and many people complain of GI upset with adequate dosing. Better-absorbed and better-tolerated forms of magnesium would include chelated magnesium (protein-bound rather than salt-bound), magnesium citrate, or magnesium glycinate. Symptoms-Because magnesium helps maintain the health and functioning of the nervous system, being deficient can cause everything from muscle spasms and weakness to heart attacks and hyperactivity. Symptoms associated with magnesium deficiency include muscle cramps, muscular irritability, restlessness, tingling, numbness, abnormal heart rhythms, heart attack, coronary spasm, seizures, anxiety, confusion, disorientation, hyperactivity, insomnia, nervousness, loss of appetite, and depression.
- Calcium – 75 percent do not meet recommendations for calcium intake. Calcium is well established as essential for bone health and is associated with membrane stability, impacting BP control and cardiac function. More recently, calcium deficiency has also been associated with decreased weight control and slow metabolic rate. Calcium deficiency is of high clinical importance, as the average diet contains only 40%-50% of the RDA (800-1,200 mg daily, varying with age and gender). Daily intake of 1,500 mg is recommended for people with osteopenia or osteoporosis. More than 2,000 mg of calcium daily is excessive and has been associated with an increased cancer risk. Too often, physicians recommend calcium supplementation without assessing dietary calcium intake, which leads to inappropriate calcium dosing. Subtracting the amount of calcium in foods ingested from the patient’s calcium-intake goal will yield the amount of calcium that must be provided from either a supplement or a daily food source. Sources: Spinach, turnip greens, mustard greens, collard greens, yogurt, milk, mozzarella cheese. Symptoms:If you fall short of your daily dose of calcium, you increase your risk of developing menstrual problems, brittle nails, cramps, delusions, depression, insomnia, irritability, osteoporosis, palpitations, peridontal disease, rickets, tooth decay.
Water – The most important nutrient for the human body is water. An average person can live for about forty to forty-five days without food but only three to five days without water. Approximately two-thirds of a person’s body weight is water–our blood is 82 percent water and both our brain and muscles, are 75 percent water. The major ingredient of all fluids in the body is water, including saliva, gastric juice, bile, pancreatic juices, and intestinal secretions. Water is necessary for practically every bodily function. It helps carry essential nutrients to all our cells, aids in circulation and digestion, and helps carry away the metabolic waste products, such as lactic acid, urea, uric acid, and ammonia. Water is an important detoxifying agent in your body. It helps clean us through our skin and kidneys, and it improves our sweating with exercise. Eight, eight-ounce, glasses (i.e., 64 ounces) a day (depending on our size, air temperature, and activity level) of clean water is suggested. The average-sized person requires 2 to 3 quarts of water a day (that’s 64 to 96 ounces). A good rule to go by is to take your body weight, divide it by two, and that’s the number of ounces of water you should be drinking daily. If you are eating adequate amounts of fresh fruits and vegetables daily, then you’re getting about one quart of water already. But stay away from drinks with caffeine, such as coffee, tea, and sodas. Caffeine is a diuretic and actually causes you to lose water, so it does more harm than good. People who drink adequate amounts of water have improved blood pressure, as well as a reduction or elimination of headaches, arthritis, and back and neck pain. In general, patients with chronic illnesses have fewer symptoms and better overall health as they increase their water intake.
Many people are dehydrated without realizing it. If you drink only when you feel thirsty, it is too late. You are already dehydrated. In addition, as you get older, your sense of thirst does not work properly. It is only when you start to hydrate your body that you will begin to realize how bad you felt before. Most of us are chronically dehydrated. We have to discipline ourselves to drink enough water. The key to proper hydration is that you must schedule your water intake. Most of us do not naturally drink the amount of water necessary for good hydration. We go about life with chronic borderline dehydration. Thus, we suffer poor detoxification and a variety of global health conditions. Remember that you must make a consistent, conscientious effort to drink more water to properly detox. Athletes who live and train in the heat are at risk of chronic dehydration due large daily sweat losses and failure to adequately replenish these losses with fluid intake. To prevent this condition, which wreaks havoc on exercise performance, you need to not only consume a sports drink during exercise but also drink water frequently throughout the day. A simple guideline for water intake is the urine test: if your urine is consistently pale yellow or clear in color, you are consuming enough water.
Antioxidants– Antioxidants aren’t actually a nutritional deficiency, because your body can produce them. When your body doesn’t produce enough, you become deficient and nutritional changes can supplement where your body is lacking. Antioxidants have been the center of conversation in healthy circles for a few years now, which increase the amount of oxygen in the blood. But there is more that antioxidants can do for you, including reducing the free radicals in the body and by doing so, addressing one of the primary causes of fatigue. Antioxidants can be found in certain foods as well as nutritional supplements. It’s the job of antioxidants to neutralize free radicals that can harm our cells. Poor diet, smoking and pollution can all reduce the amount of antioxidants your body can produce.