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. 2017 Jun 24;9(7):655.
doi: 10.3390/nu9070655.

Risk of Deficiency in Multiple Concurrent Micronutrients in Children and Adults in the United States

Julia K Bird  1 , Rachel A Murphy  2 , Eric D Ciappio  3 , Michael I McBurney  4
Affiliations

Risk of Deficiency in Multiple Concurrent Micronutrients in Children and Adults in the United States

Julia K Bird et al. Nutrients. .

Abstract

Certain population sub-groups in the United States are vulnerable to micronutrient malnutrition. Nationally representative data from the National Health and Nutrition Examination Survey (NHANES) describing the biochemical status of vitamins A, B6, B12, C, D, E, folate, and anemia, were aggregated to determine the overall risk of multiple concurrent deficiencies in U.S. children and adults (n = 15,030) aged >9 years. The prevalence of deficiency risk according to socio-demographic, life-stage, dietary supplement use, and dietary adequacy categories was investigated. Thirty-one percent of the U.S. population was at risk of at least one vitamin deficiency or anemia, with 23%, 6.3%, and 1.7% of the U.S. population at risk of deficiency in 1, 2, or 3-5 vitamins or anemia, respectively. A significantly higher deficiency risk was seen in women (37%), non-Hispanic blacks (55%), individuals from low income households (40%), or without a high school diploma (42%), and underweight (42%) or obese individuals (39%). A deficiency risk was most common in women 19-50 years (41%), and pregnant or breastfeeding women (47%). Dietary supplement non-users had the highest risk of any deficiency (40%), compared to users of full-spectrum multivitamin-multimineral supplements (14%) and other dietary supplement users (28%). Individuals consuming an adequate diet based on the Estimated Average Requirement had a lower risk of any deficiency (16%) than those with an inadequate diet (57%). Nearly one-third of the U.S. population is at risk of deficiency in at least one vitamin, or has anemia.

Keywords: NHANES; deficiency; dietary adequacy; dietary supplement; multivitamin-mineral; nutritional epidemiology; nutritional status.

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Conflict of interest statement

At the time that the research plan was conceived and initial data analyses were conducted, all authors were employees of DSM Nutritional Products, a global producer and supplier of vitamins, carotenoids, omega-3 long chain fatty acids and other ingredients to the feed, food, pharmaceutical and personal care industries.

Figures

Figure 1
Figure 1
Risk of biochemical vitamin deficiency or anemia, by DS use and dietary vitamin/mineral inadequacy/insufficiency. Dietary inadequacy score reflects the combined number of vitamins and/or minerals for which intake is below the (A) Estimated Average Requirement (EAR) or (B) Recommended Dietary Allowance (RDA) for vitamins A, B6, B12, C, E, folate, and the mineral iron. Proportions are a percentage of the US population at risk of deficiency in one or more vitamin or with anemia according to biochemical measurements of nutritional status, and error bars reflect the SE. NHANES, National Health and Nutrition Examination Survey; DS, dietary supplement; FSMV, full-spectrum multivitamin-multimineral supplement containing 12 or more vitamins and 7 to 16 minerals.
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