HOW MUCH IS ENOUGH?
Vitamins are vital to our health. Here’s what you need every day and why.
Vitamins are vital to our health. Here’s what you need every day and why.
IN 2013, Sandra McDowell had been having memory problems and dizzy spells for weeks. But it wasn’t until she noticed her heart pounding one night that she became concerned enough to see her doctor. “What went through my mind was: heart condition,” recalls Sandra, who lives in British Columbia, Canada. Her physician, however, suspected a different problem that was confirmed by a blood test. “I was low in iron,” McDowell says, who is in her mid-40s.
The previous year, McDowell had gone from eating meat twice a week to a complete plant-based diet. But she’d failed to replace the iron contained in meats that was now missing from her diet. “I had no idea that my health was deteriorating,” she says.
IT MIGHT SEEM surprising that people who have access to an abundant food supply can lack essential nutrients in their diets. However, it does happen more often than we think, and there are a variety of reasons. “As
people age, for example, diets aren’t always balanced, or people eliminate food groups because they can’t tolerate them,” says Dr. Shanthi Johnson, a registered dietitian and a professor of kinesiology at the University of Regina, Saskatchewan, Canada.
In younger people, trendy diets or convenience foods can take the place of healthy eating. “The more we compromise on food groups, the higher the chances of becoming deficient in certain nutrients.” Johnson says. Individuals with malabsorption conditions, like Crohn’s disease and cystic fibrosis, may also have trouble getting enough nutrients.
Whatever the reasons, studies find that Europeans generally don’t consume enough of the basic vitamins and minerals—and they may not know it. Here are five nutrient deficiencies to watch for, and the daily amounts recommended by the European Food Safety Authority, an independent agency funded by the EU that scientifically evaluates nutrition guidelines and other food safety issues. Remember, these vitamins and minerals are important to your body’s health, either through diet, supplements or both.
Iron, like other vitamins and minerals, has multiple purposes in our bodies. It’s needed to produce hemoglobin, the protein in red blood cells that helps the blood carry oxygen. People who are low in iron may develop a type of anemia, which means there aren’t enough healthy red cells in the blood. They may feel weak and dizzy, like Sandra McDowell, or tired because their cells aren’t properly supplied with oxygen.
On her doctor’s advice, Sandra started taking iron supplements and eating foods rich in the nutrient. It took six weeks for her iron to reach a healthy level and six months before her symptoms finally eased up. Since then, she has gone for a blood test to check her iron levels every six months or so.
A person is at risk of iron deficiency if they aren’t eating enough iron-rich foods. Plant-based iron is harder to absorb than meat sources. If you’re a vegetarian or vegan, you should aim for almost twice the recommended daily intake. You can boost iron absorption by adding a vitamin C food, such as a citrus fruit, to your meal. Red wine, coffee, tea and high calcium levels all interfere with absorption if taken at the same time as iron.
Supplementation can compensate for dietary shortcomings, and IV infusions may be used if iron is severely low or pills aren’t effective or well tolerated. Some people find that supplements can cause nausea or constipation. If that’s the case, try taking yours with meals, dividing the dose through the day or experimenting with different types, as it’s very individual. Iron is available in different formulas,
although the liquid form has been known to stain teeth, so drink it with a straw or mixed with juice. EUROPE’S RDA: 11 milligrams for men 18 and older, and postmenopausal women; 16 milligrams for premenopausal women 18 and older.
It’s not unusual to be unaware of a vitamin D deficiency, as symptoms are rare, but a simple blood test can tell you if you’re low on this vitamin.
IT IS CHALLENGING TO GET ENOUGH VITAMIN D THROUGH FOOD SOURCES ALONE, UNLESS THEY’VE BEEN FORTIFIED.
The vitamin is essential for good health, especially for the function of muscles, nerves and the immune system. “Every tissue in the body has receptors for vitamin D,” says Dr. Linda Rapson, Medical Director of the Rapson Pain and Acupuncture Clinic in Toronto. When these receptors are activated, they affect many systems in the body by either the presence or absence of vitamin D. Severely low vitamin D can lead to thinning bones or rickets. Insufficient vitamin D has also been linked to heart disease, muscle weakness, chronic pain and even dementia.
It can be challenging to get sufficient vitamin D through food sources alone. It’s hard to find the nutrient in foods, unless they’ve been fortified (such as dairy in Canada, Finland and Sweden, as well as other countries).
Although a compound in our bodies can produce the vitamin when our bare skin is exposed to UVB rays from the sun, we’re often indoors, living too far north, wearing sunscreen to prevent cancer or covered up with clothing. Obese people are also at higher risk of a deficiency (because the vitamin is fat-soluble, it becomes locked away in tissues), as are those over 65 (we’re less able to absorb vitamin D with age) and individuals with darker skin (pigmentation interferes with UVB absorption).
Also, many common prescription drugs, including certain corticosteroids and seizure medications, can interfere with how we process vitamin D. Fortunately, supplements are inexpensive.
EUROPE’S RDA: 15 milligrams (600 International Units) for adults age 18 and older.
VITAMIN B9 (FOLATE)
One of folate’s main functions is to help in cell division, which means our immune system and red blood cells rely on getting enough. It’s also important for healthy fetal development and preventing birth defects, so pregnant women require more folic
acid (folate) than what typically get from their diets.
Several studies suggest this nutrient, which is also called vitamin B9, can protect against colon, breast and other cancers. This deficiency can also cause certain cells to become abnormally large—if red blood cells are affected, you might experience anemia
VITAMIN B9 DEFICIENCY IS COMMON. INTAKE IS TOO LOW IN NORWAY, SWEDEN, DENMARK AND THE NETHERLANDS.
(fatigue and weakness) and weight loss, while expanding mucous membrane cells can cause a sore tongue.
Fortified food is a foolproof way to ensure getting enough Vitamin B9, but in most European countries, there’s no mandate to add this nutrient, so deficiency is common in many areas. A research review in the European Journal of Clinical Nutrition, for instance, found that the average folate intake was too low in Norway, Sweden, Denmark and the Netherlands.
EUROPE’S RDA: 330 micrograms daily for adults age 18 and older. Pregnant and lactating women should get 600 and 500 micrograms a day, respectively. “When people get older, we start losing bone mass,” says Dr. Hope Weiler, associate professor at the School of Dietetics and Human Nutrition at McGill University. “It’s a small percentage, but it’s meaningful in terms of functionality and strength.” Calcium is essential for bone health and a deficiency increases the risk of osteoporosis and broken bones.
Calcium is abundant in dairy products and is often added to dairy alternatives. It’s also in other foods. After age 50, we should be aiming for the equivalent of three dairy products a day. Non-dairy include tofu, tinned pink salmon with bones and a calcium-enriched rice or almond milk. Another way to up your calcium intake is to ensure you’re taking vitamin D. When taken in tandem, the two nutrients work more efficiently.
If you’re concerned about your calcium intake or have been diagnosed with osteoporosis, talk to your doctor. “There are medications to slow the loss of bone and in some cases add a bit of bone,” says Weiler.
EUROPE’S RDA: 950 milligrams of calcium for adults age 25 and older.
As we age, our ability to absorb this nutrient diminishes, so seniors are the most likely to develop a vitamin B12 deficiency, and B12 is important to healthy brain function.
“We have found that low-normal
B12 is associated with more rapid shrinkage of the brain in the elderly. In a trial we showed that this could be prevented by taking B12 supplements,” said Professor A. David Smith, professor emeritus of pharmacology, University of Oxford, UK. As well as age, medications that reduce stomach acid, such as famotidine (Pepsid) and omeprazole (Olex), can interfere with B12 absorption.
Vegans, too, can be low in B12, since the vitamin is only available in animal products such as eggs, dairy and meat. Our bodies also rely on B12 to produce enough red blood cells, so people low in this vitamin can develop a type of anemia. They may have trouble with coordination or concentration and notice tingling or numbness in their extremities—nerves are another part of the body that can’t function properly without B12.
This was the experience of Miranda Thyssen of London, England, who had experienced shooting pains and the occasional loss of feeling in her fingers and hands for a number of years. She didn’t realize her symptoms could be related to a lack of vitamins until her doctor diagnosed her with a B12 deficiency in October 2016.
“I was surprised the deficiency had that much of an impact,” says Thyssen, 26. “You’re always told vitamins are good for you, but you’re not really aware of what they do.”
If B12 deficiency symptoms are severe, a doctor may recommend injections. But in most cases, supplements will treat a deficiency—Rapson recommends tablets that dissolve and are absorbed under the tongue, noting that the nutrient travels more immediately into the bloodstream with this formulation. Note: The vitamin is particularly effective if consumed alongside vitamin B9, or folate, as the two run on the same molecular pathways.
EUROPE’S RDA: 4 micrograms for adults age 18 and older.