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Providing perspectives on recent research into vitamins and nutritionals


Think Nutrient Deficiencies are History in US? Think Again

By Eric Ciappio

Nutrient deficiencies are often thought of as a thing of the past. You often hear that Americans are quite well nourished, despite the fact that inadequate intake of nutrients like vitamin D from the diet is nearly ubiquitous in America today. In 2012, the CDC released figures demonstrating the prevalence of individual deficiencies based on nationally representative biochemical assessment data from the latest round of NHANES showing that, contrary to popular belief, deficiencies are very much present in the modern day United States. Nearly 16 million Americans have serum vitamin C concentrations consistent with scurvy, and nearly 23 million Americans have a serum vitamin D concentrations that indicate deficiency. We may have a good handle of how many Americans have a specific vitamin or mineral deficiency, but overall, how many Americans are currently walking around with any deficiency? And how many have multiple vitamin or mineral deficiencies?

At this week’s 2015 Experimental Biology meeting in Boston, MA, we will be presenting a new analysis of NHANES data (Poster 586.2 at 12:45-2:45 EST, Boston Convention and Exhibition Center). We aimed to determine the prevalence of any deficiency among American adults using biochemical assessment data. In this recent analysis, we found that about 24% of adults had one nutrient deficiency, about 6% of Americans had 2 nutrient deficiencies,  and another 2% of adults had 3 or more vitamin/mineral deficiencies. In total, that means that roughly 1 out of 3 American adults has at least one vitamin or mineral deficiency.

So, is there anything we can do about these deficiencies? We know that dietary supplement users have significantly greater intakes of essential vitamins and minerals compared to non-users. And we know that multivitamin/mineral  supplements are the most common type of dietary supplement used by adults. But the definition of multivitamins can be a bit tough to nail down. The definition of a multivitamin is somewhat of a moving target, but for research purposes they have been defined as having ≥3 vitamins and at least one mineral.  However, that’s not what most consumers picture when they think of a multivitamin, and in fact the most popular brands of multivitamins contain much more than just 4 nutrients.

We created a classification of “full spectrum multivitamin”, which contain 12+ vitamins and 6-14 minerals, in order to better capture the impact of this popular type of multivitamin supplement on deficiencies. Turns out full spectrum multivitamins are quite impactful: while about 31% of supplement non-users have at least one vitamin or mineral deficiency, only about 23%% of users of any dietary supplement had one deficiency and just 12.1% of full-spectrum multivitamin users had one nutrient deficiency. Think about that for one more second: that means non-users of dietary supplements are 2.5 times more likely to have a nutrient deficiency compared to a full spectrum multivitamin user. Talk about nutritional insurance!

The moral of this story is that the data show that nearly one out of 3 American adults have a nutrient deficiency. And  despite arguments that multivitamins are a waste of money, these data also show that adult users of dietary supplements, particularly full-spectrum multivitamins, have a significantly lower prevalence of vitamin or mineral deficiencies compared to non-users. Multivitamins remain the best insurance around that you’re filling any nutrient gaps present in the diet, and the data continue to show just how powerful of a nutritional tool these little pills can be.

Main Citation:

Bird J, Ciappio ED, Murphy RM. Adult full spectrum multivitamin/multimineral supplement users have a lower prevalence of vitamin and mineral deficiencies. Presented at: Experimental Biology 2015, Boston MA; March 29, 2015.

Supporting Citations:

Fulgoni VL III, et al. Foods, fortificants, and supplements: where do Americans get their nutrients? J Nutr 2011; 141: 1847-1854.

Yetley EA. Multivitamin and multimineral dietary supplements: definitions, characterization, bioavailability, and drug interactions. Am J Clin Nutr 2007; 85(suppl): 269S-276S.

Guellar E, et al. Enough is enough: stop wasting money on vitamin and mineral supplements. Ann Intern Med 2013; 159(12): 850-851.

Bailey RL, et al. Why US adults use dietary supplements. JAMA Intern Med 2013; 173(5): 355-361.