Emerging nutrition gaps in a world of affluence
Studies undertaken in a number of European countries and in North American reveal that adult intakes for a significant number of vitamins and minerals, including vitamins A, E, D and folate, are well below the recommended intakes. Soon to be published data from the HELENA study, that investigated the micronutrient status of European adolescents, also shows that there is reason for concern amongst the younger generation. “For many living in industrialized countries, deficiencies of vitamins and minerals only occur in the poor and developing world, but new research is showing that this is not the case” said Dr Manfred Eggersdorfer, Senior Vice President of Nutritional Science & Nutrition and Health Advocacy of DSM Nutritional Products at a forum organized by DSM. “What is both surprising and alarming” he continued, “is that despite a relatively healthy diet and access to a wide variety of foods, research shows low intakes of many of the vital vitamins and minerals in many developed countries”.
What does this mean in terms of health? Based on the Triage Theory hypothesized by Prof Bruce Ames, an adequate micronutrient intake is not only required to prevent deficiency symptoms today, but also to reduce the risk of age-related problems in the future. And it is possible that the deficiency effects are not just those commonly read about in nutrition text books. Research by Dr Heike Bischoff-Ferrari of the Centre on Aging and Mobility at the University of Zurich, shows that a deficiency of vitamin D does not only result in the well recognized increase in bone fractures due to its role in bone growth and preservation, but may also cause muscular impairment (weakness, pain and a waddling gait) even before adverse effects on bone occur. A recent meta-analysis shows that vitamin D supplementation, at a dose of 700 to 1000 IU vitamin D per day, can reduce falls by as much as 19% and the Zurich hip fracture trial showed that supplemental vitamin D at a dose of 2000IU, reduced the rate of hospital re-admission significantly (39%) by primarily reducing fall related injuries (60%) and reducing severe infections by as much as ninety percent. This could have important consequences for already stretched health systems. It also means that the current reviews of the recommended daily intake of vitamin D are both timely and potentially important for public health.
It is not only for vitamin D that researchers are finding new and interesting functions. Dr Mary Ward of the Northern Ireland Centre for Food and Health of the University of Ulster also presented at the congress research showing that vitamin B2 or riboflavin might have a clinically important impact on lowering hypertension. Hypertension is a major global public health challenge accounting for 14% of deaths worldwide and an estimated 10% of global healthcare expenditure. The evidence suggests that there is a specific genetic polymorphism (TT genotype) affecting 10% of western populations that may be linked to blood pressure. The link between the genetic variation and hypertension is vitamin B2 as these individuals appear to be particularly sensitive to supplemental vitamin B2. Recent research shows that in patients with the polymorphism and diagnosed with premature cardiovascular disease, giving a 1.6mg/day dose of vitamin B2 over a 16 week period resulted in a 9mmHg decrease in systolic blood pressure. Current literature shows that as little as a 2mmHg decrease in systolic blood pressure could lead to a 10% decrease in stroke mortality, emphasising the clinically significant impact vitamin B2 could have on this group of hypertensive individuals. According to Dr Eggersdorfer, “This highlights the important, exciting and emerging science of nutrient gene interactions – a field that DSM is extremely interested in going forward.”
So although micronutrient malnutrition is especially important in developing countries, where urgent attention is required to save lives each year, this ‘hidden hunger’ also appears in the developed world and should not be ignored as its public health impact into the future will undoubtedly be significant.