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Nutrients like iron and calcium are crucial for blood and bone health, but more than half the world’s population doesn’t eat enough of these and five other nutrients that are also crucial for human health, a new study shows.
More than 5 billion people do not consume enough iodine, vitamin E or calcium, according to a study published August 29 in the journal The Lancet Global Health. And more than 4 billion people have inadequate intake of iron, riboflavin, folic acid and vitamin C.
“Our study is a big step forward,” said study co-leader Dr. Christopher Free, a research associate at the Marine Science Institute and Bren School of Environmental Science and Management at the University of California, Santa Barbara, in a press release. Free also specializes in human nutrition.
“Not only because this is the first time that inadequate micronutrient intake has been determined for 34 age and sex groups in almost all countries,” added Free, “but also because the methods and results are easily accessible to researchers and practitioners.”
Previous studies have identified global micronutrient deficiencies or inadequate supplies of foods containing these nutrients. However, according to the latest research, there are no global estimates of what intake is considered inadequate given nutrient needs.
For these reasons, the research team estimated that inadequate intake of 15 micronutrients is prevalent in 185 countries, or 99.3% of the population. They did this through modelling – applying a “globally harmonised set of age- and sex-specific nutrient requirements” to data from the 2018 Global Dietary Database, which provides intake estimates based on data from individual surveys, household surveys and national food stocks.
The authors also found differences between women and men. Women were more likely than men to not consume enough iodine, vitamin B12, iron and selenium. Men, on the other hand, did not get enough magnesium, zinc, thiamine, niacin and vitamins A, B6 and C.
Geographical differences were also observed. Inadequate intake of riboflavin, folic acid and vitamins B6 and B12 was particularly high in India, while inadequate calcium intake was highest in South and East Asia, sub-Saharan Africa and the Pacific.
“These findings are alarming,” study co-author Ty Beal, a senior technical specialist at the Switzerland-based Global Alliance for Improved Nutrition, said in the press release. “Most people – even more than previously thought, in all regions and countries of all income groups – do not consume enough of several essential micronutrients. These gaps are affecting health and limiting human potential on a global scale.”
Although the results are unique, they are consistent with findings from other smaller country-specific studies that have been available for years, Dr. Lauren Sastre, assistant professor of nutritional sciences and director of the Farm to Clinic program at East Carolina University in North Carolina, said by email.
“This is a valuable study,” added Sastre, who was not involved in the research.
The study has several important limitations. For one, because the research did not include the consumption of supplements and fortified foods, some of the deficiencies found in the study may not be as bad in real life if some people consume supplements and fortified foods that would theoretically increase their intake of certain nutrients, the authors said. However, supplements and fortifications with many of the other nutrients studied are uncommon worldwide, the authors said.
However, according to UNICEF, 89% of people worldwide consume iodized salt. “Therefore, iodine may be the only nutrient for which inadequate dietary intake is greatly overestimated,” the authors said, referring to their findings.
“My only criticism is that they left out potassium, saying there are no standards,” Sastre said. “We certainly have a (recommended daily amount) of potassium in the U.S., and most people don’t get nearly enough of it. And it has to be balanced with sodium. There are people who get way too much sodium and nowhere near enough potassium, which is essential for blood pressure (and) heart health.”
In addition, the researchers say there is a lack of more comprehensive information on the dietary intake of individuals worldwide, particularly datasets that are representative of an entire country or cover food intake over more than two days. This lack limits the researchers’ ability to validate their model-based estimates.
And although the team measured inadequate food intake, they had no data on whether this led to deficiencies, which must be diagnosed by a doctor or nutritionist based on blood tests and/or symptoms.
Nutritionists and doctors can help you determine whether you are getting enough of certain vitamins or minerals or whether you have a deficiency confirmed by a blood test.
“Micronutrients play a critical role in cellular function, immunity (and) metabolism,” Sastre said. “But we don’t eat fruits, vegetables, nuts, seeds or whole grains — even though they are present. We need to follow the American Heart Association’s recommendation and ‘eat the rainbow.'”
Here is a list of the reasons why the seven nutrients that are least consumed worldwide are important, as well as some foods that are rich in them:
1. calcium
● Important for strong bones and general health
● Found in dairy products and fortified soy, almond or rice-based alternatives, dark green leafy vegetables, tofu, sardines, salmon, tahini and fortified orange or grapefruit juice
2. Folic acid
● Important for the formation of red blood cells and for cell growth and function, especially during pregnancy
● Found in dark green vegetables, beans, peas, lentils and fortified cereals such as bread, pasta, rice and cereals
3. iodine
● Important for thyroid function as well as bone and brain development
● Found in fish, seaweed, shrimp, dairy products, eggs and iodized salt
4. iron
● Important for the oxygen supply to the body as well as for growth and development
● Found in oysters, duck, beef, sardines, crab, lamb, fortified cereals, spinach, artichokes, beans, lentils, dark green leafy vegetables and potatoes
5. magnesium
● Important for muscle and nerve function, blood sugar, blood pressure and the formation of proteins, bones and DNA
● Found in legumes, nuts, seeds, whole grains, green leafy vegetables and fortified cereals
6. niacin
● Important for the nervous and digestive systems
● Found in beef, chicken, marinara sauce, turkey, brown rice, pumpkin seeds, salmon and enriched cereals
7. Riboflavin
● Important for the metabolism of food for energy, the immune system and healthy skin and hair
● Found in eggs, dairy products, meat, cereals and green vegetables
