The truth about nutrient deficiencies

Strolling past drugstore shelves teeming with dietary supplements might make you wonder: Am I getting enough nutrients? The supplement industry feeds this curiosity with splashy labels and claims, hoping to fuel the belief that we all need to fill a few dietary gaps.

"People tend to ask about different supplements, but we want them to focus on an overall balanced eating pattern," says Emily Blake, a registered dietitian at Harvard-affiliated Brigham and Women’s Hospital. "Quick fixes are often promoted as a gateway to health, when more sustainable changes are what’s going to move the needle."

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A few of us face nutrient deficiencies unless we intentionally avoid entire food groups or otherwise drastically limit our diet, says Teresa Fung, an adjunct professor of nutrition at the Harvard T.H. Chan School of Public Health. If anything, "we’re a country of excess consumption," she says. While food insecurity is a significant problem in the United States, if you are eating several meals each day, and a variety of different types of food, it is unlikely that you are deficient in calories or nutrients.

That said, women are indeed vulnerable to coming up short for a handful of vitamins and minerals due to age, hormone changes, or other factors. Here are nutrients that are most likely to be deficient.

Vitamin D: Vitamin D deficiency is especially common as we get older, since few foods are naturally rich in it. Getting enough sunlight for our skin to convert to vitamin D may be easier in the summer months, but we need to balance that benefit against skin cancer concerns. Signs of deficiency include fatigue, bone pain, mood changes, muscle aches, and weakness.

Foods high in vitamin D include fortified cow’s milk and cereals, soy milk, mushrooms, canned tuna, shrimp, and salmon. Daily recommended intake is 600 IU for adults up to age 70 and 800 IU for those 71 and older; a daily 1,000-IU vitamin D supplement provides ample coverage.

Iron: Red blood cells, which carry oxygen throughout the body, rely on adequate iron stores. But pregnancy or heavy menstrual periods can take a toll, potentially leaving us lacking. So can increasingly popular plant-based diets, since animal products provide higher amounts of iron, and our bodies absorb iron more easily from animal sources.

If you’re low on iron, you may feel cold, tired, or short of breath. You may have headaches more frequently. Meat and seafood typically offer plenty of iron, and plant-based sources include beans, lentils, grains, spinach, and fortified cereals. Women over 50 need 8 milligrams (mg) of iron per day; younger women, 18 mg daily.

Vitamin B12: B12 is crucial to healthy nerve signaling and red blood cell production, but we get progressively less efficient at absorbing it as we age. Vegans and vegetarians are also at higher risk of deficiency, since plants don’t contain the vitamin.

Signs of a B12 shortfall include fatigue from anemia; numbness in hands, legs, and feet; or trouble with balance and walking. Memory can also suffer. Vitamin B12 is readily found in fish, chicken, milk, and yogurt. If you prefer plant-based options, try fortified non-dairy milks and cereals. Adults need 2.4 micrograms of B12 each day.

Calcium. Most of us know that calcium keeps bones strong; it also helps control muscle and nerve function and regulate our heartbeat. As estrogen drops, our ability to absorb calcium diminishes, and those on vegan diets can compound the risk by avoiding dairy products.

Calcium-rich foods include cow’s milk, fortified soy or almond milks, yogurt, cheese, fortified cereals, and dark green vegetables like kale and broccoli. Most adults need 1,000 mg each day, but women over 50 need 1,200 mg.

To test or not to test?

Don’t count on symptoms — or their absence — to clue you in to a possible nutritional deficit. Most deficiencies are subtle, with few glaring signs, Blake says. And it’s not something you can diagnose on your own.

"The term ‘deficiency’ is really a medical term," says Fung. "Even if you enter your diet into an app that shows its nutrient composition, it will not tell you if you have a deficiency. That requires medical testing."

Additionally, our bodies store small amounts of extra vitamins and minerals that would tide us over several weeks of poor eating, meaning our levels would have to be extremely low before a problem even shows up. A vitamin D deficiency, for instance, might only announce itself in a broken bone.

Calcium levels can’t be accurately gauged from a blood test, Fung says. Typically, however, blood tests can reveal whether you’re lacking in key nutrients, including vitamin D, iron, or B12. While there’s "no need to test for every deficiency under the sun," Fung advises asking your doctor if she feels your risk factors warrant a closer look. "If you’re concerned or even curious, it’s absolutely worth a conversation with your doctor," says Blake.

The following factors, however, make it more likely someone will benefit from taking multivitamins:

Age. With advanced age may come trouble chewing and swallowing or a drop in desire to eat adequate meals.

Pregnancy. Since many pregnancies are unplanned, women of childbearing age should consider a daily multivitamin containing the B vitamin folate, also called folic acid, which — if taken early in pregnancy — can lower the risk of brain and spinal cord defects in the developing embryo.

Digestive challenges. Some conditions, such as celiac disease, ulcerative colitis, and cystic fibrosis, can interfere with normal digestion. So can gastric bypass, a weight-loss surgery that removes parts of the digestive tract.

Certain medications. Proton-pump inhibitors for acid reflux and heartburn can prevent us from properly absorbing vitamin B12. Some Parkinson’s disease medications also inhibit B vitamin absorption, and diuretics, taken to lower blood pressure, can deplete your stores of magnesium, potassium, and calcium.

By Hariharan. V

DYOFITXⓇ Instructor

DYOFITXⓇ does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a substitute for medical advice, and you should not take any action before consulting with a healthcare professional.

Credits

https://www.health.harvard.edu/nutrition/the-truth-about-nutrient-deficiencies

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