The latest National Health and Nutrition Examination Survey (NHANES) report, just released from the USDA-ARS Food Surveys Research Group (FSRG), finds what I've been saying all along, too many Americans have inadequate intake of key essential nutrients.
The new report is titled, What We Eat in America and covers the period of 2001-2002. Before I review the findings, let me first acknowledge the data is not from a tightly controlled study, but based on self-reported "24-hour recall" from those participating in the data collection. So, while this data is useful, it is not as accurate as results obtained by admitting study participants to a research ward to carefully measure everything consumed. To do such a study is simply too costly, so this type of data is what we have to work with.
The other shortfall in the data is that researchers did not measure all nutrients - the did not look at amount of fat or types of fat, amino acid type from protein sources, vitamin D, or quality of carbohydrate other than measuring fiber and total carbohydrate. So we have no really good data from this study on the quality of protein intake, the types of fat eaten (including trans-fats) or the level of added sugar in the average diet.
What the data does tell us is clear - Americans are deficient in key nutrients.
The most alarming shortfalls were found for Vitamin E, Vitamin C, Vitamin A, Selenium, Magnesium and Potassium. We can suspect severe deficiency of Vitamin D also because two of the four fat soluable vitamins - Vitamin E and Vitamin A - were deficient in a large number of participants and other studies have consistently shown Vitamin D deficiency is a problem in the United States.
Now here is the "kicker" - the reason why it is so important to strive for nutrient adequacy every single day - chronically falling short of some vitamins, minerals and trace elements has an impact on your health because all vitamins, minerals and trace elements are intricately dependent on each other in the body.
To understand how this works, let's look at the nutrients this data suggest Americans are falling short for:
- Vitamin E is is intricately connected to four other nutrients: vitamin C, glutathione, selenium, and vitamin B3.
- Vitamin C has significant interactions with several key minerals in the body - it enhances iron uptake and is required for regeneration of vitamin E. Both Vitamins C & E appear to work together as powerful antioxidants and in the survery both were found to be deficient.
- Vitamin A is a fat-soluable vitamin and the transport and utilization of vitamin A is dependent upon several vitamin A binding proteins. Adequate intake of dietary fat and zinc is necessary for the absorption and utilization of vitamin A.
- Selenium is indirectly responsible for keeping the body's supply of at least three other nutrients intact - vitamin C, glutathione, and vitamin E. The chemistry of these relationships is complicated and centers around an enzyme called glutathione peroxidase. This enzyme cannot function without selenium.
- Magensium is required for calcium uptake and maintaining balance in the body's metabolism. Magnesium also has an important relationship with potassium, and helps regulate the movement of potassium in and out of our cells.
- Potassium works in the body through a mechanism known as the "sodium-potassium" pump - sodium and potassium work together to initiate muscle contraction and nerve transmission, and to maintain the body’s normal distribution of fluid. These two minerals are dependent on each other to maintain balance in the body. Potassium is known to decrease the excretion of calcium, so adequate intake of potassium is as important as adequate intake of Vitamin D and calcium for bones.
- Vitamin D plays a major role in maintaining normal blood levels of calcium and impacts the absorption and storage of calcium. Vitamin D also stimulates the absorption of phosphorous. Vitamin D is regulates the production of certain calcium-binding proteins that function in the bones and kidneys. Because these binding proteins are dependent on vitamin K, there is an interrelationship between vitamin D and vitamin K. Vitamin D deficiency may also result in iron deficiency.
So, while some levels of nutrients were found to be adequate for intake, the very real deficiency noted in the data means that even when some nutrients are at an adeqate intake, the shortfall of another nutrient impacts the bioavailability of the adequate nutrient. This is why it is so important to strive for nutrient adequacy every single day.
You may remember last month I compared two menus - one low-fat created by the NIDDK and one I created that was controlled-carbohydrate. The NIDDK menu was nutritionally deficient. The controlled-carbohydrate menu met or exceeded all nutrient requirements.
Not only have I been saying for years that Americans are chronically malnourished because of how they eat, I've also stated again and again it is because of the dietary recommendations made to the general population. In our fat-phobic dietary dogma, we have reduced intake of nutrient-rich foods from our everyday diet and it is impacting our nutritional status as a nation.
The evidence shows we have a problem with nutrient adequacy in the diet of our population. The data also shows we have a major problems with obesity and degenerative diseases like Type II diabetes and cardiovascular disease.
These problems are interconnected and a solution is readily available to anyone, anywhere in the United States - the solution is simply REAL FOOD eaten to provide essential nutrients and not just blindly following a formula of carbohydrate-protein-fat as a percentage of the total diet.
Such an approach requires a commitment of time to educate yourself about what foods are rich with nutrients and those that are nutritionally bankrupt and nothing more than empty calories. The first step to good eating is eliminating as many packaged, processed foods as you can - these products have the highest probability of being nutritionally bankrupt. The next step is replacing the junk food with real food with heavy emphasis on non-stachy vegetables along with a good variety of whole fruit instead of juice, legumes, meats, fish, poultry, game, eggs, natural cheese, nuts, seeds and good fats.
If you eliminate some processed food from your lunch and dinner and instead exhange that for just two salads in your day, one at lunch and one at dinner - each one with 1.5-cups of romaine lettuce, 1/2 a medium tomato, 1/4 cucumber, 1/4-cup shredded red cabbage, 2-TBS grated carrots, and 11 almonds slivered with olive oil and vinegar dressing, you'll have met your requirements for Vitamin A, Vitamin E and Vitamin C (three of the vitamins that were deficient in the survey) and already be on your way to meeting your other requirements by already achieving an intake of 47% of Vitamin K, 69% of Folate, 42% of Iron, 38% of Riboflavin, 31% of B6, 29% of Magnesium, and 33% of Potassium along with small amounts of other essential nutrients. And that's just with two salads!