The Quest: Using Vitamin Status, Not Dietary Creed, to Guide Health
We are what we eat. Dietary preferences are cultural and often established in childhood . Despite national recommendations since 1977, dietary patterns of the American public remain suboptimal. Worldwide, dietary patterns persist for generations. Nutritional inadequacies contribute to poor individual and population health and higher chronic disease rates.
The 2015 Dietary Guidelines Advisory Committee reported “Few, if any, improvements in consumers’ food choices have occurred in recent decades.” It is a dismal story. Eight nutrients are under-consumed by almost everyone (vitamins A, C, D, E, folate, calcium, magnesium, potassium and dietary fiber). In addition, iron is under-consumed by adolescent and premenopausal females (Part A, lines 50-58). The failure to include docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) in this section probably reflects the lack of Adequate Intake (AI) or Estimated Average Requirement (EAR) values for these long-chain polyunsaturated fatty acids. It is encouraging that the 2015 DGAC report identifies vitamin E as a shortfall nutrient. The 2010 DGAC didn’t include vitamin E as a ‘nutrient of concern’ even though >90% of the population are not consuming the EAR.
Nutrition advice should be free of prejudice about the types of foods or supplements ingested. It is nutrition status which affects health. As an example, serum α-tocopherol concentrations are related to severity of periodontitis. The greatest reduction in indices of periodontitis is found as as serum α-tocopherol concentrations increase to 40 µmol/L (a concentration above that measured in most American adults).
It isn’t constructive to argue about ‘how’ one should consume essential vitamins and minerals. Suboptimal nutrient status affects health. Low serum 25-hydroxyvitamin D concentration is associated with aberrations in glucose metabolism. Trying to estimate vitamin D intake using short-term dietary records and incomplete food databases yields crude, imprecise measures of 25-hydroxyvitamin D status. It is nutrient status, not reported food intake, which matters.
The discovery of vitamins transformed human lives. With knowledge about vitamins, governments and food companies could take action to save lives and improve health. Salt was fortified with iodine. Flours were fortified with B vitamins. Milk was fortified with vitamin D. The list of enriched and fortified products which have helped prevent deficiency diseases goes beyond staple foods. By choosing nutrient-rich foods, especially enriched and fortified foods, the cells in our body have essential vitamins and minerals to function.
Even amongst the most vulnerable (young children), it is rare to exceed vitamin or mineral intake levels (upper limit) which are clearly safe. Unless you have had your nutrient status measured, why gamble with your health by avoiding fortified foods or dietary supplements?
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