Which nutrients are commonly over-consumed in a standard Western diet?

In a standard Western diet, added sugar and saturated fat are frequently over-consumed, exceeding recommended guidelines. Sodium intake also tends to be higher than public health recommendations, though its health implications are more controversial.

Are omega-6 fats and trans fats harmful, and are most people over-consuming them?

The hosts argue that concerns about omega-6 fats causing inflammation are largely overblown, and total omega-3 intake is more critical than the omega-6 to omega-3 ratio. Industrially produced trans fats have been largely phased out in most developed countries since 2021, making them less of a concern for over-consumption today.

What are the nutrients most commonly under-consumed by the general population?

The nutrients most often under-consumed include fiber, EPA and DHA (Omega-3s), Vitamin A, B6, Folate, C, K, Choline, Magnesium, Potassium, and Zinc. Vitamin E is on the list according to targets, but its true essentiality for most healthy people is questioned.

Why is Vitamin E intake often high in recommendations but potentially less critical for most people?

The recommended adequate intake for Vitamin E is quite high, leading many to appear to under-consume it. However, the essentiality for this function has never been demonstrated in humans, and generally healthy individuals don't experience symptoms of deficiency even with low intake, leading to skepticism about how closely it needs to be monitored.

Which micronutrients should vegans pay close attention to?

Vegans should particularly monitor their intake of EPA and DHA (often requiring algae oil supplements), Vitamin B12 (almost always requiring supplementation), calcium, iron, zinc, and selenium. Consuming a varied diet with plenty of mushrooms and soy products can help cover some of these needs.

Why should individuals avoid 'micronutrient reductionism'?

Micronutrient reductionism is the trap of focusing solely on numerical micronutrient targets as the definition of a 'healthy diet.' This can lead to choices that meet targets but miss out on other beneficial bioactive compounds (like polyphenols, isothiocyanates) found in diverse whole foods, making the diet less healthy overall.

Are multivitamins effective for improving overall health and mortality?

The research on multivitamins is not very promising. Meta-analyses generally find no significant effect on all-cause mortality, cardiovascular disease, or cancer, or only very small and inconsistent effects. Some argue they might promote dietary laziness or have unquantified risks.

Why might a healthy person have low Vitamin D, and is it a cause or indicator of poor health?

Low Vitamin D in a healthy person could be due to insufficient dietary intake, limited sun exposure, or random variability. While low Vitamin D can sometimes causally contribute to disease, it's often an indicator or consequence of general poor health or disease states, rather than the primary cause.

What is the role of folic acid supplementation in family planning?

Folic acid supplementation (typically 400-800 micrograms) is widely recommended for women who are pregnant or trying to conceive. Its main purpose is to prevent neural tube defects, such as spina bifida, and has proven very effective in doing so. It is not necessary for conception itself.

What is the evidence for supplementing Vitamin K with Vitamin D for cardiovascular health?

Epidemiological evidence shows a promising association between higher Vitamin K status and lower cardiovascular disease risk. The mechanism involves Vitamin K being a cofactor for MGP, which prevents arterial calcification. However, conclusive randomized controlled trials are still needed to confirm a causal effect, and research is currently underway.

What does the evidence say about supplementing with Boron?

While there is some optimism about boron supplementation for bone health, osteoarthritis, and potentially inflammatory biomarkers, and even a small effect on testosterone levels (with nuanced data), most research is from small, short-term studies. There's a lack of robust mechanistic understanding, and the hosts recommend prioritizing a diet rich in fruits and vegetables over supplementation due to unresolved questions and potential toxicity at higher doses.

Which Micronutrients Are Worth Monitoring? (Episode 121)

Q: Are there good proxy measurements for micronutrient intake without meticulous tracking?

There isn't a single, reliable proxy measurement for overall micronutrient intake that the hosts would confidently endorse. However, a general approach of consuming a diet rich in diverse, minimally processed whole foods, including plenty of fruits, vegetables, whole grains, nuts, seeds, and mushrooms, is likely to ensure sufficient intake.

Stronger By Science

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Oct 4, 2023|3,256 views|113|26

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Key Moments

TL;DR

Key micronutrients to monitor, common deficiencies, vegan considerations, and the limits of micronutrient focus.

Key Insights

Distinguish between insufficient nutrient intake and true deficiency, noting deficiencies are rare in developed countries.

Commonly overconsumed nutrients include added sugar, saturated fat, and sodium; omega-6 intake concerns are less clear-cut.

Often underconsumed micronutrients include fiber, Omega-3s (EPA/DHA), Vitamin A, B6, folate, C, D, E, K, choline, magnesium, potassium, and zinc.

Vegans should pay particular attention to EPA/DHA, Vitamin B12, calcium, iron, zinc, and selenium due to predominantly animal-based sources.

Micronutrient targets and tracking are useful guides but should not replace the overall goal of a varied, minimally processed diet.

Multivitamins generally show limited benefits for the general population and may promote dietary laziness, though individual needs vary.

DEFINING INSUFFICIENT VS. DEFICIENT INTAKE

The discussion begins by clarifying the difference between an 'insufficient intake' and a 'deficiency' of micronutrients. While insufficient intake, falling below recommended daily allowances, is relatively common, true deficiencies, which cause noticeable health problems, are rare in developed countries. An analogy of car maintenance illustrates this: adequate intake is premium care, insufficient intake is normal care with occasional lapses, and deficiency is akin to never changing the oil, leading to severe, obvious problems.

COMMONLY OVERCONSUMED NUTRIENTS

Several nutrients are frequently overconsumed in typical Western diets. Added sugars exceed recommended limits, often comprising 8-15% of total energy intake. Saturated fat intake also commonly surpasses the guideline of keeping it below 10% of total energy, despite some online controversy. Sodium intake is also typically much higher than recommended levels, though the necessity of strict limitation for all individuals is debated, recent research suggests broader risks beyond just hypertension.

NUTRIENTS OFTEN CONSUMED INSUFFICIENTLY

The episode outlines nutrients commonly underconsumed, defined as at least 20% of the population having insufficient intake. These include fiber, Omega-3 fatty acids (EPA/DHA) primarily found in fatty fish, and various vitamins like A, B6, folate, C, D, E, and K. Minerals such as choline, magnesium, potassium, and zinc are also frequently insufficient. For many of these, rich food sources like leafy greens, fatty fish, fruits, vegetables, nuts, seeds, and liver are highlighted.

SPECIAL CONSIDERATIONS FOR VEGANS

Vegans may need to pay closer attention to specific micronutrients. EPA and DHA from Omega-3s are best obtained via algae oil supplements, as plant-based sources are less direct. Vitamin B12 is crucial and almost exclusively found in animal products, necessitating supplementation or fortified foods. Calcium, iron, and zinc can also be harder to absorb from plant-based sources due to inhibitors like oxalates and phytates. Selenium levels may also be lower in vegans, though Brazil nuts can be a rich source.

THE PITFALLS OF MICRONUTRIENT REDUCTIONISM

A key takeaway is the danger of 'micronutrient reductionism,' where meeting numerical targets for specific vitamins and minerals becomes the sole focus, overshadowing the goal of overall dietary health. Relying solely on micronutrient completeness can lead to suboptimal food choices, like eating 'junk food' supplemented with multivitamins. This overlooks the benefits of other compounds in whole foods, such as polyphenols in fruits and isothiocyanates in cruciferous vegetables, which offer health advantages beyond basic micronutrient provision.

MULTIVITAMINS AND DIETARY STRATEGIES

The evidence for the widespread benefit of multivitamins for the general population is not strong; they generally show no significant impact on mortality or major disease outcomes. While serving as a potential 'insurance policy,' they may also promote dietary laziness and potentially lead to overconsumption of certain nutrients. Focusing on a varied diet rich in whole foods, including plenty of fruits, vegetables, whole grains, nuts, seeds, mushrooms, and seaweeds, is a more effective strategy for achieving overall micronutrient sufficiency and promoting general health.

Mentioned in This Episode

●Products

●Software & Apps

●Companies

●Organizations

●Books

●Studies Cited

●Concepts

●People Referenced

Common Questions

Insufficient intake means consuming less of a nutrient than recommended, but not necessarily experiencing severe symptoms. Deficiency implies a severe lack, leading to extremely noticeable and often dangerous health problems. In most developed countries, insufficiencies are common, while true deficiencies are rare.

Topics

Nutrient Overconsumption Vitamin A Vitamin B6 Vitamin K Potassium Zinc Vegan Diet Folic Acid Boron

Mentioned in this video

conceptFat Bear Week

An annual competition at Katmai National Park where the public votes on which bear has gotten the fattest in preparation for hibernation. It raises awareness about bear conservation.

personStephanie Grace Fultz

A listener who submitted a question regarding low Vitamin D levels and whether it's indicative of other health problems.

companyBarbell Medicine

An organization or podcast that Stephanie heard mention low Vitamin D as a result of other health problems.

personJoel Phillips

A listener who submitted a question about practical proxy measurements for micronutrient intake without meticulous tracking.

mediaLove is Blind

A reality TV show that the hosts are currently watching and recommend for its dramatic and messy season.

productCrisco

A brand of shortening that used to contain trans fats but now uses inter-esterified fats after trans fats were phased out in food products.

organizationEuropean Food Safety Authority (EFSA)

The European body that sets micronutrient targets, whose publication highlights skepticism about the necessity of high vitamin E intake for generally healthy humans.

bookBMJ Narrative Review (2020)

A narrative review from 2020 that highlighted the lack of promising research on multivitamin use.

personAustin Baraki

One of the 'good doctors' from Barbell Medicine, implicitly referenced regarding Vitamin D information.

bookLancet (2022)

A medical journal where a 2022 back-and-forth discussion about folic acid food fortification was published, including a review and a letter to the editor disagreeing with it.

personJordan Feigenbaum

One of the 'good doctors' from Barbell Medicine, implicitly referenced regarding Vitamin D information.

conceptSpina Bifida

A neural tube defect that folic acid supplementation and fortification are very effective at preventing.

organizationKatmai National Park

A federally funded national park in Alaska that hosts the annual Fat Bear Week competition.

studyCochrane review (2018)

A 2018 review mentioned in the discussion on Omega-6 fats, which concluded that high intake of omega-6s has pretty neutral or small positive effects on health and mortality outcomes.

studyJAMA Meta-analysis (2022)

A 2022 meta-analysis published in JAMA that found a lower incidence of cancer in multivitamin users, though based on limited RCTs and with a small effect size.

bookNothing Boring About Boron (2015)

A 2015 paper by Pizzorno, highly cited and influential in promoting optimism about boron supplementation for various health outcomes, including bone health and testosterone levels.

conceptAlpha-tocopherol

The primary chemical compound that falls under the umbrella of Vitamin E, whose essentiality in humans for reproduction has never been demonstrated despite its classification as an essential nutrient based on animal studies.

personCharles Bose

A listener who submitted questions about supplementing Vitamin K with Vitamin D and Boron supplementation.

personAli Shah

A listener who submitted a question about multivitamins being overrated.

studyMcPherson et al. 2013

A meta-analysis published in the American Journal of Clinical Nutrition that found no effect of multivitamin supplementation on all-cause mortality, cardiovascular mortality, or cancer mortality.

conceptMatrix GLA Protein (MGP)

A protein that Vitamin K is a cofactor for, which helps prevent arterial calcification, linking K and D supplementation to cardiovascular health.