We are fortunate that in this day and age, as we have so many options to obtain missing nutrients. Look at all of your options when you’re in a health food store, or when you’re walking down a pharmacy supplement aisle!
However, as the same time, so many options can lead to feeling overwhelmed and confused.
I would say that just about every day that I counsel clients, I get asked about supplementation. Given that my clients ages range from 0-85, there are a variety of recommendations I give, depending on life stage, diet quality and health conditions.
Let’s focus in on lifestage.
Although nutrient deficiencies are not specific to any one point of time in a person’s life, it is important to be aware of common nutrient deficiencies at each stage of life so you can try to prevent shortages of these nutrients.
According to the 2012 Centers for Disease Control and Preventions (CDC) second report, common nutrient deficiencies in the population at various ages include:
As you can see, there are some nutrients that a large proportion of the population does not get enough of. There are common deficiencies along the entire lifespan, but there are also those that appear to be specific to age. These common deficiencies will be highlighted below and tips for how to avoid them will be presented.
Childhood is a critical time of development and as a result, nutritional deficiencies are a prime concern as they can cause significant and potentially irreversible complications. Surveys have shown that the nutrients that young children tend to fall short of are iron, vitamin E and potentially potassium, but the latter two still require further research, as the data remains unclear as to why these may show in the populations (Butte, 2010). There are also findings suggesting that hey are not receiving enough fatty acids, which is worrisome as they are critical for the development of the brain and proper cognitive functioning. Many reports of poor vitamin D status throughout childhood have been cited numerous times in the literature. (Braegger, 2013). Whether it is due to poor access to foods that provide sufficient vitamin D, such as those children in low income families, or simply due to poor intake and sun exposure, this deficiency has many health professionals concerned as lack of vitamin D places can contribute to poor development of bone mass and density (Haimi, 2014, Braegger). Finally, as children move into adolescence, it appears that calcium becomes a nutrient of concern, where very small percentages of individual in that age group meet the daily requirements (Bailey, 2010)
What Do We Do?
Despite iron-deficiency anemia decreasing to some degree in developed nations because of an increase in fortified infant formulas, cereals and other grain products, it still remains a nutrient of concern (Butte, 2010). For children, this is important for not only for energy levels and daily functioning, but it can also be a factor in poor growth and immunity (Abdullah, 2011). Due to these complications, special attention needs to be paid to iron status across the developing ages especially in those who are a particular risk, such as vegetarians, vegans and those who are ill, to ensure they are making a conscious effort to increase their intake. In addition to incorporating more iron rich foods, ensure to include foods with vitamin C with this meals to help with greater absorption.
A lowered intake of essential fatty acids has been thought by many to be derived from the low-fat trend in society where individuals perceived that that choosing reduced fat versions of various foods were required to control body weight (Butte, 2010). This, however, contrasts with the large proportion of children often exceeding the recommended intake of saturated fat. This suggests that they are not being given or choosing the best fat sources for their bodies. This unfortunately is potentially damaging for children, especially infants, as reducing their intake of the essential fatty acids can have grave consequences as both the brain and the body requires fat to properly develop. In association with fat, it is thought that a lowered fatty acid intake may be why vitamin E is suboptimal in a large number of children (Butte, 2010). This is due to the fact that vitamin E is largely found in some of the same fats that provide those essential fatty acids. So, to help children choose the best sources of fat to optimize their development and obtain the anti-oxidant benefits of vitamin E, take a peek at the infographic below.
With regards to vitamin D, studies have hypothesized that the poor intake is not the only issue (Haimi, 2017). In fact, the fact that children are more sedentary and therefore do not get as much sun exposure may also be a large contributor. Also, rapid growth may also require a greater intake of this vitamin, putting children at a higher risk of inadequacy. All in all, it has been suggested that a mixed intake of foods high in vitamin D, including fish, eggs, dairy and fortified products, and a healthy dose of sunshine should be encouraged in children of all ages (Braegger, 2013). For those who are at risk of deficiency, supplementation may also be something to consider speaking to their doctor about.
In addition, potassium has also been mentioned as a nutrient that commonly gets neglected in children and youth. This may largely be due to the poor intake of fruits and vegetables. Ensuring that children include more of these foods daily is critical for many other nutrients as well and should therefore be a priority.
Finally, calcium tends to be lacking also in the diet of most adolescents, especially females, (Greer, 2006, Bailey, 2010). It is thought that this is due to many females having the perception that milk is fattening and therefore it is removed from the diet. During adolescence, the bones are gaining critical mass and thus it is critical to obtain the recommendations for calcium as it plays a large role in bone mineral deposition (Greer, 2006). It is also important for nerve conductance, enzyme secretion and hormones as well (Bailey, 2010). Although supplementation ahs helped more adolescents reach the proper amounts, reaching the recommendations for calcium through the diet. Dairy products contain large amounts of calcium, but for those who cannot tolerate dairy, there are many fortified dairy alternatives in addition to plant-based sources such as dark leafy greens, soy products and even nuts and seeds. Fish with small edible bones, such as salmon, are also high sources of this mineral that can be considered.
For adults, there are some commonalities with children when it comes to nutritional deficits; however, there are a few that appear to present themselves more as we age (EWG, 2014). All in all, some of the most common deficiencies in adults include:
- Vitamin D
- Vitamin E
As an adult, prolonged iron deficiency can lead to complications in those who are pregnant, higher risk of mortality and co-morbidity in older adults, and overall immunity and well being deficits (Woodman, 2005, Alleyne, 2008, Allen, 2000). In reference to the diagram shown above, a mixed diet that is rich in both animal and plant based forms of iron is acceptable, but for those who are deficient, it may be benefitial to include more animal, or heme, iron sources as they are more absorbed in the body. Furthermore, it should be noted that vitamin C helps with absorption, while drinking tea with your meal inhibits absorption (Alleyne, 2008). Supplementation may also be used, but often this form of intervention causes gastric upset, including constipation and nausea. For an iron supplement that causes minimal GI upset, consider an iron polysaccharide, such as Feramax.
For vitamin D, the major concern when insufficiency is possible is bone density losses and risk of bone related diseases such as osteoporosis and osteopenia (Haimi, 2017). This is especially pertinent to the elderly as the rate of bone loss accelerates and the consequences of a fracture could be much more severe. Aside from bone related issues, there has also been research showing that a suboptimal intake of vitamin D may be related to poor immune status, chronic disorders and cancer. It has been recommended that care should be taken into getting some time in the sun in addition to incorporating foods high in Vitamin D in the daily diet. For adults, it is recommended that individuals have at least 1000 IU of vitamin D every day. It can be challenging to obtain vitamin D from food sources, so supplementation of Vitamin D3 may be necessary.
Vitamin E inadequacy is very common among adults, similar to children, and it has also been attributed to the restriction of dietary fats, particular, those that contain the essential fatty acids. It is important to know how critical fats are in the diet and that reducing the intake of fat can cause a number of health issues including deficiencies in essential micronutrients, such as vitamin E. See the above infographic for “Fatty Acid + Vitamin E Sources” for information on optimal dietary choices to increase your intake.
Although magnesium appears to be adequate in children, adolescents and adults tend to fail to meet the minimum requirements quite often. This is a problem as poor intake of this mineral plays can lead to cardiac arrhythmias, muscle tension and cramping, headaches and some psychological concerns such as confusion, dizziness and poor attention span (Vormann, 2003). In increase their intake; adults should incorporate many of the following foods into their normal diets.
It should be noted, that even in places where food is abundant, nutrient deficiencies can occur. Although the supplement industry is on the rise, it is important to consider what foods you can choose to optimize your diet and prevent the complications associated with inadequacies at every age.
Research done by Chelsea Cross, BASC(c), MAN(c)
Abdullah, K., Zlotkin, S., Parkin, P., & Grenier, D. (2011). Iron-deficiency anemia in children. Ottawa: Canadian Pediatric Surveillance Program, Canadian Pediatric Society. Retrieved from http://www.cpsp.cps.ca/ uploads/publications/RA-iron-deficiency-anemia.pdf.
Allen, L. (2000). Anemia and iron deficiency: effects on pregnancy outcome. Am J Clin Nutr, 71, 1280S-4S.
Alleyne, M., Horne, M. K., & Miller, J. L. (2008). Individualized treatment for iron deficiency anemia in adults. The American Journal of Medicine, 121(11), 943–948. http://doi.org/10.1016/j.amjmed.2008.07.012
Bailey, R. L., Dodd, K. W., Goldman, J. A., Gahche, J. J., Dwyer, J. T., Moshfegh, A. J., … Picciano, M. F. (2010). Estimation of Total Usual Calcium and Vitamin D Intakes in the United States. The Journal of Nutrition, 140(4), 817–822. http://doi.org/10.3945/jn.109.118539
Braegger, D., Campoy, C., Colomb, V., Decsi, T., Domellof, M., Fewtrell, M., Hoksal, I., Mihatsch, W., Molgaard, C., Shamir, R., Turck, D., van Goudoever, J. (2013). Vitamin D in the health European paediatric population. J Pediatr Gastroenterol Nutr, 56(6), 692-701.
Butte, N., Fox, M., Briefel, R., Siege-Riz, A., Dwyer, J., Deming, D., & Reidy, K. (2010). Nutrient intakes of US infants, toddlers, and preschoolers meet or exceed dietary reference intakes. Journal of the Academy of Nutrition and Dietetics, 110(12), S27-S37.
Centers for Disease Control and Prevention (2012). Second nutrition report at-a-glace. Retrieved from https://www.cdc.gov/nutritionreport/pdf/4page_%202nd%20nutrition%20report_508_032912.pdf
EWG. (2014). How much is too much? : appendix D: vitamin and mineral deficiencies in the U.S. Retrieved from http://www.ewg.org/research/how-much-is-too-much/appendix-b-vitamin-and-mineral-deficiencies-us
Greer, F., & krebs, N. (2006). Optimizing bone health and calcium intakes of infants, children and adolescents. Pediatrics, 117(2), 1152
Haimi, M. & Kremer, R. (2017). Vitamin D deficiency/insufficiency from childhood to adulthood: insights from a sunny country. World J Clin Pediatr, 6(1), 1-9.
Vormann, J (2003). Magnesium: nutrition and metabolism. Molecular Aspects of Medicine, 24, 27-37.