Identification of Priority Nutrients in the US: Targeting Malnutrition to Address Diet-Related Disease Across the Lifespan

Abstract

Background/Objectives: Poor diet is a leading modifiable cause of chronic disease in the US. In addition to targeting nutrients of concern (saturated fat, added sugars, and sodium), nutrients with both inadequate intakes and associations with major health outcomes require identification. We aimed to identify priority nutrients to address both malnutrition and diet-related disease in the US population. Methods: An established method for identifying priority nutrients across multiple demographic groups was adapted for the US population. This method evaluates and scores nutrients consumed at insufficient or excessive levels, with proposed revised requirements, and shows associations with established health priorities, based on the degree of deviation from recommendations and the number of linked health priorities. Priority nutrients were defined as those scoring in the top 25%. For each priority nutrient, a comparison of intake levels against the Dietary Reference Intake (DRI) was conducted. Results: There were 21 of 24 nutrients with consumption below recommended levels in at least one demographic group. Certain nutrients, such as dietary fiber, vitamin D, and choline, exhibited particularly high inadequacy rates, exceeding 90% throughout different life stages. The highest priority nutrients included vitamin D, vitamin E, calcium, magnesium, and dietary fiber, with vitamin D, omega-3 fatty acids, zinc, folate, and potassium showing priority for specific demographic groups. Comparing current intake levels with those known to benefit health priorities indicated that higher intakes of vitamin D, vitamin E, and calcium could be beneficial. Conclusions: Ten essential nutrients play a role in the prevention of diet-related disease, yet are consumed inadequately across the US population, suggesting that the prioritization of these nutrients can help to address the burden of chronic disease. Priority nutrients should be considered in diet and nutrition policies and guidelines.

Keywords: chronic disease; diet-related disease prevention; inadequate nutrient intake; increased nutrient requirements; malnutrition; priority nutrients.

Figure 1

Overview of the five-step methodological approach used to identify priority nutrients for the US.

Figure 2

The number of demographic groups with each of (A) inadequate intake; (B) increased needs; and (C) association with health priorities, for each identified nutrient. Both beneficial (gray bars) and adverse (red bars) health associations are presented for each applicable nutrient. Abbreviations: omega-3, omega-3 fatty acids; omega-6, and omega-6 fatty acids.

Figure 3

The priority nutrients for (A) each demographic group; and (B) the total population, including sub-scores for each of dietary intake (red), revised needs (light gray), and association with health priorities (dark gray). The highest priority nutrients for the overall population (left of dashed line, (B) are vitamin D, vitamin E, dietary fiber, calcium, and magnesium. Abbreviations: Omega-3, omega-3 fatty acids.

Figure 4

Comparison to the DRI (RDA or AI, as applicable, dashed line) for each population-level priority nutrient, for dietary intake (red bars), suggested level of revised needs (light gray bars), and minimum dose showing an association with a health priority (dark gray bars). Columns represent the mean proportional intake across all demographic groups, with error bars indicating the associated SD. Abbreviations: AI, Adequate Intake; DRI, Dietary Reference Intake; RDA, Recommended Dietary Allowance.