Kat Barefield, MS, RD, CPT

In this post, you’re going to learn about the different things that happen in the body as a result of not consuming adequate amounts of micronutrients on a regular basis.

This article will also cover:

•       The key functions of various micronutrients
•       The most common under-consumed micronutrients in the U.S.
•       Recommended daily amounts for each under-consumed vitamin and mineral
•       Food sources that are rich in vitamins and minerals
•       Evidence related to multivitamins and other supplements
•       How weight loss and popular diets affect the amounts of micronutrients you get

 If any of these topics interest you, keep reading.

Overview of Metabolism

“Metabolism” is a commonly used term by trainers and fitness enthusiasts alike. Have you ever stopped to think about what it really is? 

There are six classes of nutrients that are essential for human health, meaning we can’t live without them without negatively impacting our health and our bodies don’t make them. Therefore, we must obtain them from our diet. They are as follows:

•       Carbohydrates
•       Protein
•       Fats
•       Vitamins
•       Minerals
•       Water

Carbohydrates, protein, and fats are collectively named macronutrients because we need them in large quantities. They provide calories, or energy in the form of ATP to run all metabolic reactions, which are jumpstarted by proteins called enzymes. Enzymes need cofactors to work, and that is where vitamins and minerals, referred to as micronutrients, come in. We need these in smaller quantities. Listed below are some examples.

Key Functions of Selected Micronutrients:

•       B vitamins are needed to extract energy (calories) from food
•       Vitamin B12 is required for proper nerve function and to make red blood cells
•       Vitamin A is needed for good vision, immunity, and healthy skin
•       Vitamin D is required to form bone and strong immune function. It is involved in numerous reactions throughout the body, functioning as a hormone
•       Vitamin E is an antioxidant and helps protect cells from damage
•       Vitamin K is needed to form blood clots and to shuttle calcium into bone
•       Calcium is needed for muscle contraction and bone formation
•       Iron is required to transport oxygen throughout the body
•       Magnesium regulates muscle contraction and nerve transmission. It helps form teeth and bones and is needed in over 300 metabolic reactions.
•       Potassium is needed for muscle contraction, proper nerve conduction, and maintenance of fluid and electrolyte balance

There are approximately 30 vitamins and minerals we need to consume regularly. Each one has multiple functions and works synergistically to run your metabolism to keep you alive and healthy.

How Much Do You Need?

Scientists at the Institute of Medicine have established amounts of micronutrients to consume daily, referred to as RDAs (Recommended Dietary Allowances) based on age, gender, and life stage. It is important to note that these recommended values aim to prevent deficiencies and their related diseases and conditions and are not necessarily optimal for longevity.  

*Should be in fortified foods or supplemental free form due to age-related food-bound malabsorption

As a registered dietitian, my advice is to eat a wide variety of colorful and minimally processed foods from all major food groups to maximize your nutrient intake, while staying within your calorie needs to either maintain a healthy body weight or achieve one.

Here’s what a micronutrient-rich diet looks like for someone who needs 2,200 calories per day:

3 cups of vegetables a day, distributed as follows

1. 2 cups per week of dark-green vegetables
2. 6 cups per week of red and orange vegetables
3. 2 cups per week of legumes (beans and peas)
4. 6 cups per week of starchy veggies (potatoes, green peas, corn, plantains)
5. 5 cups per week of other veggies (iceberg lettuce, mushrooms, onions, cabbage)

2 cups a day of fruit

3 ½ ounces of whole grains (whole wheat bread, brown rice, oatmeal, quinoa)

3 ½ ounces of other refined enriched grains (white rice, refined grain cereals, pasta)

3 cups of dairy

6 ounces of protein broken down as follows:

9 ounces per week of seafood

28 ounces per week of meats, poultry, eggs

5 ounces per week of nuts, seeds, soy

29 grams of oils

How do you suppose Americans measure up to the recommendations above for getting sufficient vitamins and minerals?

Put another way, the top six sources of calories in the U.S diet identified by the Dietary Guidelines Committee include:

1.     Desserts (grain-based, i.e. cakes, cookies, donuts, etc.)
2.     Bread
3.     Chicken and chicken mixed dishes
4.     Soda
5.     Pizza
6.     Alcoholic beverages

It’s safe to say that most Americans are not eating a micronutrient-rich diet.  In the United States and other developed countries, overt deficiencies and their related diseases are rare. However, insufficiencies, or intakes below the RDAs, are common. The 2015-2020 Dietary Guidelines for Americans report identified 9 nutrients that are widely under-consumed. These include:

•       Calcium
•       Magnesium
•       Potassium
•       Vitamin D
•       Vitamin A
•       Vitamin C
•       Vitamin E
•       Choline
•       Fiber

So, What Happens When You Don’t Get Enough Micronutrients?

Since vitamins and minerals are required for numerous physiological processes in the body, chronic shortages will negatively impact various aspects of health and metabolism. There is evidence that micronutrient insufficiencies are linked to a variety of age-related chronic diseases, including cancer, osteoporosis, and heart disease.[3][4]’[5]

Folate and the birth of the prenatal vitamin (pun intended)

Folate (vitamin B9) is naturally present in legumes and leafy greens. It is required for the synthesis of DNA and supports cell growth and repair.  Insufficient folate in the body is linked to neural tube defects and there’s evidence for its role in preventing strokes.[6]

The bioavailability of folate in food is limited, meaning the body isn’t able to extract it and use it, whereas the synthetic form, folic acid has much greater stability and bioavailability and is more effective at raising the body’s stores. Multivitamin and mineral formulas with folic acid have proven to decrease neural tube defects and the prenatal vitamin is currently a worldwide recommendation during pregnancy and for women of childbearing age.[7]   

In 1998, folic acid was added to the U.S. food supply through the fortification of refined grain products, and the prevalence of newborns with neural tube defects has dropped. Whether you realize it or not, you’ve been supplementing your diet for quite some time.  

Calcium and bone-building micronutrients

Let’s take a look at calcium. Most Americans do not reach the daily recommended amounts of bone-building nutrients calcium, magnesium, vitamin K, and vitamin D due to poor food choices, food preferences, access, and other factors. In the case of calcium, 99% is stored in the skeletal structure and 1% is tightly maintained in the blood at 8.4 to 9.5 mg/dL to keep essential functions running so that you stay alive, reproduce and propagate the species.

When you don’t consume adequate amounts of calcium, the body will break down bones to maintain blood levels to keep your heart beating. Over time, chronic shortages of calcium and synergistic nutrients lead to weakened bones and eventually osteoporosis.

You survive in the short term at the expense of long-term health.

 Insufficient amounts of micronutrients lead to undetectable damage which can speed up age-related disease. And because people don’t see or feel the damage occurring, they don’t realize there’s a problem until it’s too late.

 For example, in Vitamin K, the clotting proteins get it first… and
only after they’re satisfied do you prevent calcification of the arteries, or prevent cancer, or prevent bone fractures. It’s all insidious damage that you get that’s a long-term consequence. In fact, we call these the diseases of aging. – Bruce Ames

How Multivitamins and Other Supplements Can Help

Take a moment to answer the following questions:

•       Do you have medical insurance?
•       Do you have dental insurance?
•       Do you have car insurance?
•       Do you have renters or mortgage insurance?
•       What about life insurance?
•       And pet insurance?
•       Why do you have all these types of insurance?
•       Now, do you have nutritional insurance?

Nutritional insurance, in the form of a low-dose multivitamin and mineral containing a broad range of under-consumed micronutrients and is suitable for your age, gender, life stage, and activity level covers your vitamin and mineral needs “just in case” you aren’t getting them all from food on a daily basis.[8] As discussed, most don’t get everything they need from food alone.

A properly made multivitamin certainly doesn’t replace a well-rounded diet but rather complements your food intake to ensure you’re getting the micronutrients you need.

Supplements everyone should take if they don’t consume enough due to dietary preferences, access, climate, allergies, etc. include calcium, iron, vitamin D, or omega-3 fish oils. Doing so would help reach recommended levels and would also serve as nutritional insurance.  

Survey data consistently shows that people who use supplements have fewer micronutrient insufficiencies and/or higher micronutrient intakes. For instance, compared to food alone, taking a multivitamin and mineral was associated with a lower prevalence of inadequacies for 15 of 17 micronutrients examined. [9]

Another study showed that multivitamin and mineral supplements significantly reduced the prevalence of insufficient intakes of calcium, magnesium, and vitamins A, C, D, and E. [10]

Similar findings in other countries have been published.

The Impact of Weight Loss Diets on Micronutrient Intakes

For those attempting weight loss or are avoiding one or more food groups as is the case with vegan or vegetarian diets, Paleo diets, gluten-free diets, and ketogenic diets, nutritional insurance is even more important since you’re eliminating micronutrients that are contained in the foods you’re avoiding.

A study analyzing four popular diet plans including Atkins for Life, the Best Life diet, The South Beach Diet, and the DASH diet, found that each one failed to provide sufficient amounts of several essential micronutrients.[11]

•       The South Beach diet was deficient in 21 micronutrients (modified low-carb)
•       The Atkins for Life diet was deficient in 15 micronutrients (low carb)
•       The DASH diet was deficient in 13 micronutrients and (low fat)
•       The Best Life diet was deficient in 12 micronutrients. (Oprah endorsed)

Another study looked at three popular diets which included a vegan weight loss diet, a low carb/high protein weight loss diet, and a whole food, plant-based diet for weight maintenance. Seven menu plans from each diet were analyzed for 20 different micronutrients and compared to the RDAs for adult males. [12]

•       The Eat to Live vegan diet for aggressive weight loss diet restricts you from eating dairy, refined grains, sugars, and oils and limits starchy veggies, dried fruits, grains, nuts, and seeds.
•       The Fast Metabolism Diet, which is low in carbs and high in animal protein limits wheat, corn, dairy, soy, dried fruit, fruit juices, refined sugar, alcohol, artificial sweeteners, and “diet” foods.
•       The Eat, Drink, and Be Healthy Diet for weight maintenance limits red meat, potatoes, refined grains, soft drinks, candies, desserts, and saturated fats.

 Here’s what the study revealed:

•       The Eat to Live vegan diet failed to provide sufficient amounts of seven micronutrients including B3, B12, vitamin D, vitamin E, calcium, selenium, and zinc
•       The Fast Metabolism low-carb diet failed to provide six micronutrients including B1, vitamin D, vitamin E, calcium, magnesium, and potassium
•       The Eat Drink and Be Healthy Diet failed to provide three micronutrients including vitamin D, calcium, and potassium.

It’s risky and counterproductive to follow a weight loss diet to improve your health while simultaneously increasing the risk for chronic diseases.  If you’re following a weight loss diet, be sure to get the nutrients you’re missing to support your health and longevity.

Summary

The human body is programmed for survival and has sophisticated mechanisms for addressing chronic shortages of micronutrients by rationing their use for proteins and functions that are essential to keep you alive while sacrificing vitamin and mineral-dependent proteins that are critical for long-term health.

Therefore, meeting daily recommended amounts of the ~30 micronutrients is equally important as hitting your daily macros.

To maximize your micronutrient intake, you will need to consistently eat a variety of food sources from all the major food groups. Dieting for weight loss, avoiding entire food groups, or eating the same foods with little variety limits your micronutrient intake and leads to greater vitamin and mineral insufficiencies.

Despite a plethora of healthy eating guidelines,  the data clearly and repeatedly shows that most Americans fall short of several key micronutrients, setting themselves up for chronic disease and other health issues. Keep in mind, that overweight and obese individuals, who make up approximately 70% of the U.S. adult population, tend to consume obesogenic diets which are high in calories and low in micronutrients. The obese have the highest rates of chronic disease.

Using a low-dose multivitamin and mineral has proven to help raise intakes to the recommended amounts needed to support physiological functions to meet the immediate demands of the body while supporting long-term health.

Nothing replaces a good diet along with other healthy behaviors such as adequate sleep, regular exercise, managing stress, and maintaining a healthy body weight. In the case of micronutrients, a little insurance goes a long way.

 References

[1] National Academies of Sciences, Engineering, and Medicine. 2019. Dietary Reference Intakes for Sodium and Potassium. Washington, DC: The National Academies Press. https://doi.org/10.17226/25353.

[2] Ames BN. Prolonging healthy aging: Longevity vitamins and proteins. Proceedings of the National Academy of Sciences Oct 2018, 115 (43) 10836-10844; DOI: 10.1073/pnas.1809045115

[3] McCann JC, Ames BN. Vitamin K, an example of triage theory: is micronutrient inadequacy linked to diseases of aging?. Am J Clin Nutr. 2009;90(4):889-907. doi:10.3945/ajcn.2009.27930. PMID: 19692494

[4] McCann JC, Ames BN. Adaptive dysfunction of selenoproteins from the perspective of the triage theory: why modest selenium deficiency may increase risk of diseases of aging. FASEB J. 2011;25(6):1793-1814. doi:10.1096/fj.11-180885. PMID: 21402715

[5] McNulty H, Pentieva K, Hoey L, Strain J, Ward M. Nutrition throughout life: folate. Int J Vitam Nutr Res. 2012;82(5):348-354. doi:10.1024/0300-9831/a000130. PMID: 23798054

[6] Czeizel AE, Dudás I. Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med. 1992;327(26):1832-1835. doi:10.1056/NEJM199212243272602. PMID: 1307234

[7] Blumberg JB, Cena H, Barr SI, et al. The Use of Multivitamin/Multimineral Supplements: A Modified Delphi Consensus Panel Report. Clin Ther. 2018;40(4):640-657. doi:10.1016/j.clinthera.2018.02.014. PMID: 29573851

[8] Blumberg JB, Frei BB, Fulgoni VL, Weaver CM, Zeisel SH. Impact of Frequency of Multi-Vitamin/Multi-Mineral Supplement Intake on Nutritional Adequacy and Nutrient Deficiencies in U.S. Adults. Nutrients. 2017;9(8):849. Published 2017 Aug 9. doi:10.3390/nu9080849. PMID: 28792457

[9] 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. doi:10.1080/07315724.2013.846806. PMID: 24724766

[10] Calton JB. Prevalence of Micronutrient Deficiency in Popular Diet Plans. JISSN. 7:24, 2010. PMID: 20537171

[11] G Engel M, J Kern H, Brenna JT, H Mitmesser S. Micronutrient Gaps in Three Commercial Weight-Loss Diet Plans. Nutrients. 2018;10(1):108. Published 2018 Jan 20. doi:10.3390/nu10010108. PMID: 29361684