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Providing perspectives on recent research into vitamins and nutritionals


Nutritional Supplements help fill Nutrient Gaps

By Michael McBurney

A new report finds that adults are eating better. We are making healthier food choices. US diets aren’t great but they are improving. The question is: have diets improved enough?

Wang and colleagues investigated dietary quality trends from 1990 to 2010 in the US using National Health and Nutrition Examination Survey (NHANES) data. They used the Alternate Healthy Eating Index 2010 (AHEI-2010) to measure diet quality. The AEHI-2010 assesses 11 characteristics. In general, adults are consuming less trans fats, less sugar-sweetened beverages and juices, and more whole grains and polyunsaturated fats.

Education and socioeconomic status was positively associated with the AEHI-2010. Unfortunately, the gap between low and high socioeconomic status is widening. According to data from the US Census Bureau (CRS Report for Congress Table 1), economic disparities have increased since 1990. For those whose income and financial picture isn’t improving in recent years, this report doesn’t bode well for overall diet quality.

Vitamin D intake continues to be a nutrient of concern because few foods are naturally rich and fortification regulations have not changed between 1990 to 2010.  Most people have to rely on sun exposure, or more likely, dietary supplementation to meet vitamin D requirements. Weyland and colleagues evaluated the evidence between low vitamin D status and non-communicable chronic diseases using Hill’s criteria for biological causality (except for specificity and coherence). The stronger the association, the more likely the relationship is causal but meeting the criteria is not an affirmation of causality. Hill’s criteria were satisfied for overall cancer risk, breast cancer risk, periodontal disease, multiple sclerosis and cardiovascular disease. In the end, Weyland, Grant and Howie-Esquival concluded:

 ‘Current scientific evidence supports a causal association between serum 25(OH)D levels and increased risk for CVD on the basis of Hill’s criteria for causality in biological systems. Only RCTs starting with low serum 25(OH)D levels found significant beneficial effects of vitamin D supplementation in reducing risk factors associated with CVD. However, evidence to date suggests that raising serum 25(OH)D levels to at least 30 ng/mL will reduce the risk of CVD.

So take a moment today and enjoy the sunshine. Reflect upon your dietary choices over the past 10 years. If you have misgivings about the nutritional quality of your food and beverage choices (and research suggests most of us should), a nutritional supplement can fill nutritional gaps. They are a form of nutritional insurance and the most common reason they are used is for overall health.

Main Citation

Wang DD, Leung CW, Li Y, Ding EL, Chiuve SE, Hu FB, Willett WC. Trends in dietary quality among adults in the United States, 1999 through 2010. JAMA Intern Med doi: 10.1001/jamainternmed.2014.3422

Other Citations

Levine L. The US Income distribution and mobility: Trends and international comparisons. 2012 CRS Report for Congress, Congressional Research Service, 7-5700, R42400

Weyland PG, Grant WB, Howie-Esquivel J. Does sufficient evidence exist to support a causal association between vitamin D status and cardiovascular disease risk? An assessment using Hill’s criteria for adequacy. 2014 Nutrients doi: 10.3390/nu6093403

Fulgoni III VL, Keast DR, Bailey RL, Dwyer J. Foods, fortificants, and supplements: Where do Americans get their nutrients? 2011 J Nutr doi: 10.3945/jn.111.142257

Dickinson A, Blatman J, El-Dash N, Franco JC. Common usage and reasons for using dietary supplements: Report of a series of surveys. 2014 J Am Coll Nutr doi: 10.1080/07315724.2013.875423