Daily Value
Daily Value is a podcast that takes a deep dive into essential nutrients and dietary practices that fuel our bodies and minds. Hosted by Dr. William Wallace, a leading product developer in the Natural Health Product industry and a dedicated educator in health and nutrition, this show is your go-to resource for understanding the science behind the vitamins, minerals, and supplements that influence human health.
Each short, digestible episode unpacks the latest scientific findings, protocols, and insights into how specific nutrients contribute to overall well-being. Whether you're a health professional, nutrition enthusiast, or just curious about how what you consume affects your health, Daily Value offers evidence-based discussions to help you make informed decisions for a healthier life.
Join Dr. Wallace as he shares his expertise, developed from years of experience in product development and nutrition science, to advance your knowledge and awareness of dietary interventions for optimal health. Get your daily value and add meaningful insights to your day, one episode at a time.
DISCLAIMER: William Wallace holds a Ph.D. He is not a medical doctor. Content generated for this channel is strictly for educational purposes and does not constitute medical advice. The content of this channel is not meant to substitute for standard medical advice, diagnosis, or treatment. Please consult with your primary healthcare practitioner before beginning any nutrition-, or supplement-based protocols. This is especially important if you are under the age of 18, undergoing treatment for a medical condition, or if you are pregnant or nursing.
Daily Value
Hidden Vitamin Deficiencies: The Unnoticed Threats in Your Diet (The Vitamins Part 2.)
In today’s episode of Daily Value, we continue our exploration of vitamins by diving into the concept of hypovitaminosis and the importance of adequate vitamin intake for overall health. The second half of the 20th century brought critical insights into how vitamin insufficiencies, or hypovitaminosis, can impact human health, even in populations where outright deficiencies are uncommon. We’ll explore the distinction between insufficiency and deficiency, how vitamin status is assessed, and the risks associated with marginal deficiencies that may affect up to 31% of the U.S. population.
Episode Talking Points:
*The difference between vitamin insufficiency, deficiency, and clinical manifestations.
*How socioeconomic factors and dietary choices can lead to hypovitaminosis, even in developed countries.
*The role of biomarkers in diagnosing vitamin deficiencies and the limitations of current testing methods.
Hello everyone, welcome back to Daily Value. I'm William Wallace, and today we will be picking up where we left off last Friday for what will be part two and a continuation of this series on vitamins. If you have not heard Friday's episode, I encourage you to go back and listen to that one, as it helps round out and provide a good background on the topic of today. Today, we'll be talking about micronutrient deficiencies, the difference between a true deficiency and an insufficiency, how deficiencies or insufficiencies happen, which is more complex than simply not taking in enough of a certain vitamin or mineral. We'll also be discussing the role of biomarker testing for diagnosing vitamin deficiencies, as well as groups at the highest risk for vitamin deficiencies. As always, this podcast is for educational purposes only. Now let's begin by picking up from where we left off last time.
Speaker 0:The second half of the 1990s was largely characterized by new information regarding the use of vitamins to improve human and animal health, as well as optimizing efficiency and nutrient content of food. Health, as well as optimizing efficiency and nutrient content of food, this work revealed that many vitamins worldwide are not being consumed in concentrations high enough to support all the physiological needs and or stave off disease, due to what's called hypovitaminosis, meaning a state of inadequate levels of a particular vitamin in the body. This can be a state of insufficiency or, worse, deficiency. Both of those words mean different things when discussing vitamin and mineral concentrations in the body. Hypovitaminosis means that there is an inadequate level of one or more vitamins in the body, based on a criteria that is typically set by the National Academies of Sciences, engineering and Medicine's Health and Medicine Division. This was formerly known as the Institute of Medicine, before joining the other Academies of Science in 2015. Historically, the primary criterion used to set vitamin sufficiency levels was the threshold of a vitamin intake at which one would reduce their risk for specific nutrition-related disorders. For example, the sufficiency threshold set for vitamin D was established as the minimum amount of circulating vitamin D that is needed to prevent metabolic bone disorders like rickets in children or osteomalacia in adults. If you were to drop under that threshold by just a small amount, you would be in a state of what we call an insufficiency, which is not quite as bad as being in a state of deficiency. However, it might mean that you are on your way towards deficiency, if not rectified by vitamin intake. A state of insufficiency has its own range between deficiency and sufficiency, below which you wind up in a state of well deficiency. Deficiency means that you are not in supply of enough of a certain vitamin to meet your needs for either disease prevention or specific regulatory processes, or both.
Speaker 0:It's important to note that vitamin deficiency is different from disease signs or functional impairments that may be caused by a vitamin deficiency. In other words, disease symptoms are not the same thing as a vitamin deficiency, but a vitamin deficiency may be the cause of or affect disease symptoms or functional changes in the body, but it's important to be able to separate those two into different things and then assess their relationship. The early stages of deficiency are what we call subclinical and can really only be determined by biochemical indicators or biomarkers, typically through testing blood or serum and by assessing one or several markers together. This subclinical stage is usually characterized by a depletion of vitamin stores and changes happening at a cellular level. It can be difficult to detect without biomarker testing, because subclinical deficiency symptoms for many different vitamins and minerals tend to be nonspecific and include things like fatigue, irritability, brain fog, aches, pains, weakened immunity, etc. If a subclinical deficiency is not corrected, it can then progress into a clinical deficiency, and in many cases that would be more obviously observable because there would be functional defect present in the form of possibly a more specific symptom observed by a clinician. For instance, high-level muscle weakness or tingling sensations in the extremities can be caused by a vitamin B1 deficiency.
Speaker 0:It has been suggested that, although clinical deficiencies are not very prevalent in the United States, marginal deficiencies may affect up to 31% of the US population. Some people think that's a conservative estimate. Approximately 15% of children and up to 20% of people who we would classify as dieters or those being on extended hypochloric diets in the United States may be affected by at least one marginal vitamin deficiency. Studies conducted around data collected by the National Health and Examination Survey, that's also called NHANES, suggest that 50% of Americans have an adequate intake of at least one vitamin. However, an adequate intake, as noted in a survey, does not necessarily indicate a marginal deficiency, though it can lead to one.
Speaker 0:Vitamin status is defined as the balance between one's biological need and vitamin supply, as marked by body stores. It's important to note that the early perspective or way of looking at vitamin status was that a lack of any obvious signs or symptoms of clinical manifestations means good nutrition. Of course, now we know that this perspective does not always consider vitamin stores and may overlook the nutritional needs of someone who is experiencing a subclinical deficiency. Therefore, an updated perspective on nutritional adequacy should focus on the intakes of nutrients needed to maintain normal physiological functions, as well as preventing certain deficiency syndromes and diseases, and not just focusing on absence of observable clinical symptoms. In many cases, this would have us focusing on our body's storage pool of vitamins and minerals. However, if we are talking specifically about testing, there are some limitations there that we'll explore in upcoming episodes. It will also be very important to note that, although hypovitaminosis of sufficient magnitude can be causally related to clinical symptoms, someone may be experiencing.
Speaker 0:Our understanding of cause and effect relationships between specific vitamin deficiencies and specific clinical manifestations they bring about, it's not entirely complete. In some cases it can be obvious, as is the case with pellagra-aniacin deficiency. In other cases, cause and effect relationships are not so obvious. Take, for instance, vitamin A. It's been suggested that over 90% of what we know about the effects of vitamin A may only contribute to only a very few percentage points of all the functions that vitamin A actually serves in the body.
Speaker 0:So when does vitamin deficiency occur? Vitamin deficiency occurs when either of the two factors that make up vitamin status are thrown out of balance, that is, shortages in vitamin supply and or an increase in the need for one or more vitamins. An example of the latter would be athletes who consume diets high in carbohydrates possibly needing more vitamin B1, as need increases proportionally to carbohydrate ingestion to a point. If deficiency of a vitamin occurs due to a shortage of internal supply or failure to ingest adequate amounts of a vitamin, we call this a primary deficiency. If deficiency arises due to an inability to utilize or absorb a vitamin, we call this a secondary deficiency. This could be caused by a condition like irritable bowel syndrome, which might limit the absorption of select vitamins and nutrients. This can also be caused by something like alcoholism, which tends to lower the utilization of many vitamins, not to mention people who struggle with alcoholism tend to take in less vitamins overall, thereby being at a greater risk for also a primary deficiency.
Speaker 0:It's important for me to come back to the point that true vitamin deficiency is not very common in developed countries like the United States or many European countries, but, like I noted earlier, marginal deficiencies and inadequate vitamin intakes do affect a large and noteworthy percentage of people all around the world. There are factors that contribute to primary deficiency that we tend not to think about or consider if we don't fall into a particular demographic where that's relevant. For instance, socioeconomic status is often cited as a major driver of primary deficiency and a perceived barrier to sound nutritional practices by people who fall into this demographic. This includes people in low to middle income countries, but also people living in developed countries who are lower in economic status. There was a popular systematic review published in 2014 looking at two decades of data collected in Europe from 1990 to 2011 and demonstrated that diets of people in low socioeconomic standing tend to be energy rich but nutrient poor, meaning low in fruits, vegetables, high-fiber foods, fish and so on. Interestingly, obesity also disproportionately affects people in poverty in developed countries like the United States, but disproportionately affects people of higher economic standing in less economically sound countries.
Speaker 0:Why is it important to point out obesity and poor nutrient status in less economically fortunate countries? Why is it important to point out obesity and poor nutrient status in less economically fortunate people in the United States? Because this creates what we call a double burden of malnutrition, that is, a state of energy excess coupled with inadequate nutrient status. That can be disastrous to health, especially as that dual state creeps its way towards diabetes in an individual, for instance. Low socioeconomic status can also contribute to limited nutritional access due to several factors, one of which is a lack of knowledge about sound nutritional practices. We can also consider people with chronic conditions who live alone. That might be part of that demographic. They may be more likely to consume food that takes less preparation time. Such foods would be more likely to provide inadequate nutrition from a micronutrient standpoint.
Speaker 0:Other causes of primary deficiency include dietary preferences. This would be poor food habits, poor food storage, processing and different cooking methods that can lower the nutrient content of food. Eating disorders, including anorexia and bulimia, food trends like fad diets that can cause you to cut out certain foods, or regular fasting, can drive primary deficiency and are commonplace these days. Causes and drivers of secondary deficiency include poor digestion, malabsorption, as can be the case if someone has a gastrointestinal-related disorder, diarrhea, an infection affecting the intestines, and so on. Impaired nutrient utilization can be a driver of secondary deficiency. This can be the case in people taking certain medications or in people who are chronic alcohol users. An increased need for vitamins, like can be the case when dealing with an infection, or in women who are pregnant, can be causal of a secondary deficiency. And, lastly, increased vitamin excretion. This can be the case in breastfeeding women. This can also happen in athletes who lose vitamins through excessive sweating.
Speaker 0:I mentioned that vitamin deficiencies should not be self-diagnosed. If you think you may be affected by a true deficiency, or even a marginal deficiency, it's important to talk to your primary healthcare practitioner, as they should be the one giving a diagnosis. Deficiency can usually be diagnosed through a three-step analysis that includes, firstly, making connections between the signs or symptoms of possible deficiency with signs and symptoms of deficiency reported in scientific literature. It helps to also consider demographic factors and relevant environmental predictors of deficiency. Second would be the use of appropriate clinical biomarkers to find either obvious signs of deficiency or to exclude other possibilities.
Speaker 0:For instance, testing plasma or serum levels of some vitamins, like vitamin C, are usually informative enough to assess status. This is particularly the case because vitamin C is not stored in the body in large quantities. Serum levels of vitamin D, specifically 25-hydroxyvitamin D3, are also good indicators of the vitamin status in the body. Not all plasma or serum measures are good direct markers of vitamin and mineral status. For instance, circulating levels of things like vitamin A, calcium, zinc and magnesium are poor indicators of nutrient status in the body. In addition to that, no single marker accurately captures iron status by itself. Typically, you have to look at several different markers together to formulate an accurate idea as to what iron status in the body looks like. Sometimes, if a true deficiency is present, a serum measure like that of vitamin A can be reflective of that. Biomarkers are not readily available for every nutrient and some of them are affected by things like inflammation or infection. Kidney function and age can also affect biomarker readings.
Speaker 0:The third step in the analysis would be to monitor responses to treatment, that is, if signs and symptoms and biomarkers point in the direction of one or more vitamins and minerals that need to be administered. The administration of those things should, in theory, resolve symptoms, sometimes very quickly and sometimes not so immediate, depending on the deficiency and the severity of the deficiency. It's important to note here that just administering vitamins will not always address underlying causes of a deficiency. I say causes because they are usually multiple when it comes to a true deficiency in the real world. For example, vitamin A deficiency could be caused by multiple other reasons, like a zinc deficiency. Zinc is required for binding vitamin A to transport proteins in the body. Vitamin A deficiency can be caused by not getting enough protein in one's diet. Dietary protein is needed to make the proteins that transport vitamin A and so many other vitamins through the body.
Speaker 0:Nutrient deficiencies tend to be interrelated and do not typically happen in isolation outside of a laboratory setting. Root causes must be addressed to sustain prevention of vitamin deficiencies. Groups who tend to be the most vulnerable to or most likely to experience a deficiency include infants, children and adolescents, elderly people, people who follow a vegetarian or vegan-style diet, chronic dieters, smokers, alcoholics, individuals with infection of some sort, people who are of lower socioeconomic status, sometimes referred to as food insecure people, which is defined as a lack of consistent access to enough food for every person in a given household to sustain adequate nutrient status, in other words, a diet lacking in quality and or quantity. Food insecurity is highly correlated with financial status, but also one's level of education about nutrition. Other groups at risk for deficiency, and some of the more prevalent and important ones to mention, would be women who are pregnant and breastfeeding. That concludes part two of this series on the vitamins. If you found today's episode informative or just interesting, be sure to subscribe and share with others who might benefit. As always, take care of yourself and stay healthy.
