This is a three-part series focusing on the role vitamin and mineral supplements can play in supplementing essential vitamins and minerals Americans may not be getting from diet alone.
As a healthful, balanced diet becomes an even stronger focus for physicians and their patients, data consistently show most Americans fall short in fulfilling the Estimated Average Requirements (EARs) for one or more vitamins and minerals from their diet alone. This “vitamin and mineral gap” has been shown over the years, for example, in the National Health and Nutrition Examination Survey (NHANES). Begun in the 1960s, NHANES is a program of studies by the National Center for Health Statistics that assesses the health and nutritional status of a nationally representative sample of American adults and children each year.
An analysis of NHANES data from 2007-2010 in more than 16,000 Americans four or more years of age showed that nutrient intakes were below the EAR in 94% of Americans for vitamin D, 88% for vitamin E, 43% for vitamin A, 39% for vitamin C, 44% for calcium, and 52% for magnesium.1 The findings were similar to those previously reported based on NHANES data from 2003-2006.2 The 2010 Guidelines for Americans specifically mention Americans’ low intakes of vitamin D and calcium.3 Year after year, Americans are falling short on the essential nutrients they need.
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Helping Fill the Gap
How can this vitamin and mineral gap be filled? Most nutritionists and other health professionals advise patients to get the nutrients they need from the food they eat. Unfortunately, research shows that relying on food alone is creating a deficit for many Americans. While their diets might be adequate in caloric intake, it may not be providing required daily levels of many essential nutrients.
Nutritional data also support the use of multivitamin and mineral supplements (MVMS) in helping to fill common nutrient gaps. The same NHANES 2007-2010 analysis reported that, among the 51% of Americans in the survey who said they took a MVMS, fewer had vitamin and mineral intakes below the EAR values compared to those who did not take a MVMS1:
- 20% fewer for vitamin D
- 28% fewer for vitamin E
- 8% fewer for vitamins A and vitamin C
- 5% fewer for calcium
6% fewer for magnesium
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EAR values are the estimated nutrient requirements needed by half of most healthy individuals. Most nutritional health experts follow RDA, which is the daily recommended intake needed by most people for supporting general health and immunity. The RDA, which is what healthcare professionals typically follow, is higher than the EAR. Based on the data, we know that most Americans are not coming close to meeting the RDA for select nutrients.
Dietary supplements are considered useful in helping to fill nutritional health gaps, and are supported by the Dietary Guidelines for Americans which state, “In some cases… dietary supplements may be useful in providing one or more nutrients that otherwise may be consumed in less than recommended amounts.”3 Early in 2015, the Dietary Guidelines scientific advisory committee reported nutrients of public health concern for Americans: calcium, fiber, vitamin D, potassium, and iron (in young women). 4 The forthcoming 2015 Dietary Guidelines for Americans will likely include a similar statement.
Vitamin and Mineral Supplements in Practice
Over the past several years, a number of studies have fueled a debate over the role of dietary supplements in helping to prevent cardiovascular disease, cancer and other chronic diseases. Because of media hype on these study results, patients and healthcare professionals alike might be confused about the general health benefits associated with vitamins and minerals.
Research has proven that vitamins and minerals play a critical role in supporting health, including major discoveries of their roles in preventing rare, but serious vitamin deficiency diseases in the U.S. such as vitamin C and scurvy, thiamin (a B vitamin) and beriberi (a wasting type disease), and Vitamin D and rickets. Research also has established that folate (folic acid) may reduce a woman’s risk of having a child with a brain or spinal cord birth defect.
Also, nutrition research has identified specific populations and diet patterns as being vulnerable to vitamin and mineral inadequacies:
- Weight Management (Obese, Bariatric, Diabetes, etc…)
- Dietary Choices (Vegetarians/Vegans, Gluten Free)
- Life-stage specific (children, pregnant, elderly)
While negative headlines and positive research may cause confusion, it is important not to lose sight of what vitamins and minerals are: essential nutrients. Solid and accumulated scientific evidence have established the indispensable biochemical and physiological functions of vitamins and minerals in the body, as well as the specific amounts needed.
As some continue to debate what this data means, let’s not lose sight of the fundamental purpose and importance of MVMS: to provide nutritional support and help supplement essential vitamins and minerals Americans may not be getting enough of from their diet alone.
Part 2 of this 3-part series will provide basic background on the functions of various vitamins and minerals, especially those that many Americans are not obtaining in adequate amounts. Part 3 of the series will explore the vitamin-mineral gap in more detail, as well as the effect of MVMS on nutrient intakes.
The Campaign for Essential Nutrients is comprised of Bayer HealthCare LLC, DSM Nutritional Products, PHARMAVITE, LLC. and Pfizer Inc.
References
1. Wallace TC, McBurney M, Fulgoni VL 3rd. Multivitamin/mineral supplement contribution to micronutrient intakes in the United States, 2007-2010. J Am Coll Nutr. 2014;33(2):94-102.
2. Fulgoni VL 3rd, Keast DR, Bailey RL, Dwyer J. Foods, fortificants, and supplements: Where do Americans get their nutrients? J Nutr. 2011 Oct;141(10):1847-54.
3. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2010. 7th Edition, Washington, DC: U.S. Government Printing Office, December 2010.
4. 2015 Dietary Guidelines Advisory Committee. Scientific report of the 2015 Dietary Guidelines Advisory Committee: Advisory report to the Secretary of Health and Human Services and the Secretary of Agriculture. February, 2015. Available at: http://health.gov/dietaryguidelines/2015-scientific-report/PDFs/ScientificReport-of-the-2015-Dietary-Guidelines-Advisory-Committee.pdf.