According to an eye-opening survey published in 2018, 94.3% of the U.S. population does not meet the daily requirement for vitamin D, 88.5% for vitamin E, 52.2% for magnesium, 44.1% for calcium, 43.0% for vitamin A, and 38.9% for vitamin C. Micronutrient deficiencies and inadequacies are common in the United States. According to an eye-opening survey published in 2018, 94.3% of the U.S. population does not meet the daily dietary requirement for vitamin D, 88.5% for vitamin E, 52.2% for magnesium, 44.1% for calcium, 43.0% for vitamin A, and 38.9% for vitamin C (1). The reasons for these nutrient shortfalls are multifactorial and are likely due to poor diet choices, food insecurity (2), and an overabundance of ultra-processed and nutrient-poor food options (3). Though this is a population-wide health issue that needs to be addressed by policy, at present, the best course of action for individuals involves becoming informed of our nutritional needs and mindfully nourishing our families to the best of our abilities by choosing unprocessed foods, consuming a varied diet with plenty of fruits and vegetables, and supplementing when needed. This article discusses common micronutrient deficiencies and inadequacies in the United States as well as their resulting consequences. It also outlines the recommended daily allowances of several micronutrients and lists foods that contain high amounts of each. Deficiencies vs. Inadequacies Micronutrient deficiencies and inadequacies occur when an individual consumes less than the required amount of a vitamin or mineral (1). Micronutrient deficiencies are more severe and occur when very low nutrient intake over a period of time results in a deficiency disease like scurvy, a vitamin C deficiency (4); rickets, a vitamin D deficiency (5); or anemia, an iron or vitamin B12 deficiency (6). Micronutrient inadequacies are less severe but more prevalent, especially in the United States (1). Micronutrient inadequacies are difficult to detect because they don’t have distinct clinical pictures, but rather manifest as general symptoms: Impaired focus (1) Generalized fatigue (7) Reduced ability to fight infections (8) Mood problems (8) Increased chronic disease risk (9) Common Micronutrient Deficiencies & Inadequacies in the U.S. The ten most common micronutrient deficiencies and micronutrient inadequacies in the United States are vitamin A, vitamin C, vitamin D, vitamin E, vitamin K, magnesium, calcium, potassium, choline, and iron. Each section below touches on the most important functions of the nutrient in question, proportion of the population that is not consuming enough, recommended daily intakes* for all ages, consequences of deficiency, and optimal food sources. *Nutrient intake recommendations are provided by the Food and Nutrition Board of the Institute of Medicine. In this article, we look at a nutrient’s Recommended Dietary Allowance (RDA) or Adequate Intake (AI). RDA: The average daily intake level sufficient to meet nutrient requirements of nearly all healthy individuals. AI: An intake level that is assumed to ensure nutritional adequacy and is established when there is insufficient evidence to develop an RDA (10). 1. Vitamin A Vitamin A plays many roles within our health. It helps with our immune function, supports cell growth, and is important for our eye and skin health as well as our overall development. Overall, 43% of the population doesn't get enough vitamin A. To break it down further, 51% of adults are not meeting the estimated average requirement for vitamin A intake. The good news, however, is that about 94% of children aged 2-18 years old are meeting the minimum requirements. This is due in part to cereals and milk fortified with vitamin A (1). Recommended Dietary Allowances for Vitamin A (10): Birth to 6 months: 400 mcg* RAE** 7 months to 12 months: 500 mcg* RAE 1-3 years: 300 mcg RAE 4-8 years: 400 mcg RAE 9-13 years: 600 mcg RAE 14+ years: 900 mcg RAE (male) 700 mcg RAE (female) Pregnancy: 770 mcg RAE Lactation: 1,300 mcg RAE *Adequate Intake **Retinol Activity Equivalents See Product Consequences of a vitamin A deficiency include an increased risk for respiratory diseases as well as serious complications from measles and infections (10). Skin dryness and inflammation, poor night vision, growth and fertility problems, and more may also result from vitamin A deficiency. For more information on vitamin A deficiency, please read 5 Signs of Vitamin A Deficiency. Foods that are high in vitamin A and provitamin A (vitamin A precursor) include fish such as salmon, tuna, and herring; animal products such as beef liver, eggs, and dairy; orange vegetables such as carrots, sweet potatoes, and pumpkin; and leafy greens such as spinach (10). There are also some breakfast cereals that add vitamin A. For more vitamin A sources and recipe ideas please read Top Food Sources of Vitamin A- Plus Family Friendly Recipes. 2. Vitamin C Vitamin C is an antioxidant that has a major part in keeping our immune systems strong. Research has shown that having adequate amounts of vitamin C in your diet may lower your risk of cancer and cataracts, as well as help reduce the length of a cold (11). Though this is an abundant vitamin, inadequacy is common: 38.9% of the population doesn’t consume enough. At 42.9%, adults are higher in vitamin C inadequacy than children (aged 2-18 years) at 19.2% (1). Recommended Dietary Allowances for Vitamin C (12): 0-6 months: 40 mg* 7-12 months: 50 mg* 1-3 years: 15 mg 4-8 years: 25 mg 9-13 years: 45 mg 14-18 years: 75 mg (male) 65 mg (female) 19+ years: 90 mg (male) 75 mg (female) Pregnancy: 85 mg Lactation: 120 mg *Adequate Intake See Product Consequences of low vitamin C can present as bleeding gums or fatigue. Although extremely rare nowadays, scurvy can develop from an extremely inadequate intake of vitamin C (less than 10 mg a day) (12). Foods that are high in vitamin C include fruits such as oranges, grapefruits, kiwi, and strawberries and vegetables such as red peppers, green peppers, broccoli, and brussel sprouts (12). 3. Vitamin D Vitamin D supports the immune system as well as bone health (13). According to the National Health and Nutrition Examination Survey (NHANES), 95% of adults and 81% of children aged 2-18 years are not meeting the estimated average requirement for vitamin D through diet (1). Recommended Dietary Allowances for Vitamin D (14): Birth to 12 months: 10 mcg or 400 IU* 1-70 years: 15 mcg or 600 IU 71+ years: 20 mcg or 800 IU Pregnancy & Lactation: 15 mcg or 600 IU *Adequate Intake Consequences of vitamin D deficiency have been linked to an increased risk of multiple sclerosis (15), autoimmune diseases (16), infections, diseases, and excess mortality (17). Vitamin D deficiency can also result in rickets, which is a disease where a child’s bones become soft and deformed (14). Foods that are high in vitamin D include fish such as trout, salmon, tuna, and cod; liver oil; animal products such as beef liver, egg yolk, and cheese; and mushrooms, especially when left out in the sun to absorb UV light (14). Additionally, we’re able to create our own vitamin D when our skin is exposed to adequate amounts of sunshine in the day. If you’re curious about whether or not your vitamin D levels are adequate, your physician can run a simple blood test for you. For more on Vitamin D, please read Top Sources of Vitamin D + Kid Friendly Recipes. 4. Vitamin E Vitamin E, a fat-soluble antioxidant, plays a role in immune function. It helps protect our bodies from free radicals, which are implicated in the development of many chronic diseases (18). Though dietary surveys report that 88.5% of the population is not getting enough vitamin E, bloodwork testing shows that less than 1% of US adults aged 20 or older, excluding pregnant and breastfeeding women, have insufficient levels of vitamin E (1). This discrepancy is curious, and some have suggested that the RDA for vitamin E needs to be reassessed or that dietary surveys are missing sources of vitamin E, resulting in miscalculations. In the meantime, we can ensure adequate vitamin E levels by consuming plenty of nuts, seeds, fruits, and vegetables. Recommended Dietary Allowances for Vitamin E (18): Birth to 6 months: 4 mg* 7-12 months: 5 mg* 1-3 years: 6 mg 4-8 years: 7 mg 9-13 years: 11 mg 14+ years: 15 mg Pregnancy: 15 mg Lactation: 19 mg *Adequate Intake Consequences of a vitamin E deficiency include muscle weakness, numbness or tingling, balance problems, and immune system problems. Foods that are high in vitamin E include wheat germ oil, which has the highest amount of vitamin E by far; seeds and nuts such as sunflower seeds, almonds, hazelnuts, and peanuts; vegetables such as spinach, broccoli, and tomato; and fruits such as kiwi and mango (18). 5. Vitamin K Vitamin K1 plays an important role in blood clotting, which helps prevent uncontrolled bleeding. Vitamin K2 is an important micronutrient for bone and cardiovascular health. According to the National Health and Nutrition Examination Survey, 66.9% of those ages 4+ do not consume adequate vitamin K (1). Adequate Intakes for Vitamin K (19): Birth to 6 months: 2 mcg 7-12 months: 2.5 mcg 1-3 years: 30 mcg 4-8 years: 55 mcg 9-13 years: 60 mcg 14-18 years: 75 mcg 19+ years: 120 mcg (male) 90 mcg (female) Pregnancy: 90 mcg Lactation: 90 mcg See Product Consequences of a vitamin K deficiency include blood clotting issues and reduction of bone mineralization, which could result in osteoporosis (19). Newborns who are not treated with vitamin K at birth are at an increased risk of vitamin K deficiency. This can result in vitamin K deficiency bleeding. The American Academy of Pediatrics recommends 0.5mg-1mg of injected vitamin K1 at birth (19). Signs of low vitamin K may include easy bruising and uncontrolled bleeding. Foods that are high in vitamin K include vegetables such as collard greens, turnip greens, spinach, kale, and broccoli; fruits such as pumpkin, blueberries, and grapes; and soy based foods such as natto, soybeans, and edamame (19). For more information on vitamin K, see: Better Together: Vitamins D3 & K2. 6. Magnesium Magnesium is essential for a wide variety of bodily functions that include nervous system function, inflammation balance, energy production, protein synthesis, bone health, and blood pressure regulation. Magnesium may also play a role in bowel regularity, cardiovascular health, and glucose regulation (1). NHANES research found that 52.2% of the U.S. population — 60.9% of adults and 35.5% of children — were not meeting the estimated average dietary requirement for magnesium (1). Recommended Dietary Allowances for Magnesium (20): Birth to 6 months: 30 mg* 7-12 months: 75 mg* 1-3 years: 80 mg 4-8 years: 130 mg 9-13 years: 240 mg 14-18 years: 410 mg (male) 360 mg (female) 19-30 years: 400 mg (male) 310 mg (female) 31+ years: 420 mg (male) 320 mg (female) Pregnancy (19-30 years): 350 mg Pregnancy (31-50 years): 360 mg Lactation (19-30 years): 310 mg Lactation (31-50 years): 320 mg *Adequate Intake See Product Consequences of deficiency in magnesium include a higher risk of chronic diseases, such as cardiovascular disease, migraines, and ADHD (21). There may also be a greater risk of type 2 diabetes (1). Foods that are high in magnesium include seeds and nuts such as pumpkin seeds, chia seeds, almonds, cashews, and peanuts; vegetables such as spinach, potatoes, and broccoli; grains such as rice, oatmeal, and breakfast cereals; and animal products such as salmon, halibut, milk, and beef (20). 7. Calcium Calcium is an important micronutrient that plays a role in the function of our health, nerves, and muscles. It is also critical for the development of bones and teeth, which hold 98% of the calcium in our bodies (22). More than 40% of people in the U.S. do not meet the estimated average dietary requirement for calcium (1). Recommended Dietary Allowances for Calcium (22): Birth to 6 months: 200 mg* 7-12 months: 260 mg* 1-3 years: 700 mg 4-8 years: 1,000 mg 9-18 years: 1,300 mg 19-50 years: 1,000 mg 51-70 years: 1,000 mg (male) 1,200 mg (female) 71+ years: 1,200 mg Pregnancy: 1,000 mg Lactation: 1,000 mg *Adequate Intake Consequences of calcium deficiency may include a reduction of bone strength, which can lead to osteoporosis. Osteomalacia, which is softening of the bone, can also result from calcium deficiency in adults as well as in children (22). Foods that are high in calcium include dairy products such as yogurt, mozzarella cheese, milk, and cottage cheese; fish such as sardines and salmon; soy based products such as soymilk, tofu, and soybeans; and orange juice (22). 8. Potassium Potassium is needed for our cells to function at a normal level (23). It also helps the nerves to function properly and the heart to have a normal heartbeat as well as it regulates blood pressure. NHANES found that due to high amounts of potassium found in infant formula and breastmilk, 97% of infants aged 7-11 months met the recommended intake for potassium. However, that number dropped significantly to only 5% of children aged 1-3 years and less than 1% of children aged 4 to 5 years. For adults, less than 3% consume adequate potassium (1). Adequate Intakes for Potassium (23): Birth to 6 months: 400 mg 7-12 months: 860 mg 1-3 years: 2,000 mg 4-8 years: 2,300 mg 9-13 years: 2,500 mg (male) 2,300 mg (female) 14-18 years: 3,000 mg (male) 2,300 mg (female) 19+ years: 3,400 (male) 2,600 mg (female) Pregnancy: 2,900 mg Lactation: 2,800 mg Consequences of a deficiency in potassium may include kidney stones, hypokalemia, and increased blood pressure (23). Foods that are high in potassium include fruits such as dried apricots, dried prunes, bananas, and raisins; vegetables such as squash, tomatoes, broccoli, and spinach; and legumes such as lentils and kidney beans (23). 9. Choline Choline is an important micronutrient, especially during pregnancy. It is needed to support the mother’s body as well as the development of the baby in utero. Choline is also important for metabolism and cell structural integrity, and it is crucial for making neurotransmitters (24). According to NHANES, most people do not consume adequate choline (24). Adequate Intakes for Choline (24): Birth to 6 months: 125 mg 7-12 months: 150 mg 1-3 years: 200 mg 4-8 years: 250 mg 9-13 years: 375 mg 14-18 years: 550 mg (male) 400 mg (female) 19+ years: 550 mg (male) 425 mg (female) Pregnancy: 450 mg Lactation: 550 mg See Product Consequences of choline deficiency, although rare, may include liver and muscle damage (16). One of the most at risk groups for choline inadequacy are pregnant women: 90-95% of pregnant women do not consume an adequate amount of choline. Unfortunately, most prenatal supplements do not contain choline or contain only a minimal amount of this crucial nutrient (24). Foods that are high in choline include meat such as beef liver, chicken breast, and ground beef; animal products such as eggs, milk, and cottage cheese; and vegetables such as potatoes, brussel sprouts, and broccoli (24). Note: If you are looking for a prenatal supplement that contains choline, please see our supplement Prenatal and Postnatal Daily Nutrients. To learn more about the benefits of prenatal choline, see New Study: Prenatal Choline Benefits Attention Span In Children. 10. Iron Iron is an essential micronutrient that is needed to make hemoglobin, the red blood cell protein that carries oxygen throughout the body (25). Iron also plays an important role in immune function. In the United States, about 12% of infants (6 to 11 months) do not have adequate iron intake. With toddlers, 8% are said to have iron deficiency (25). Iron deficiency is more common in adult females than males (26). When looking strictly at the pregnant population, almost 50% of global pregnancies are complicated by iron deficiency and iron deficiency anemia (27). In the United States, the percentage of women with iron deficiency during pregnancy jumps from 6.9% in the first trimester to 14.3% in the second trimester and finally to 29.7% in the third trimester (25). Recommended Dietary Allowances for Iron (25): Birth to 6 months: .27 mg* 7-12 months: 11 mg 1-3 years: 7 mg 4-8 years: 10 mg 9-13 years: 8 mg 14-18 years: 11 mg (male) 15 mg (female) 19-50 years: 8 mg (male) 18 mg (female) 51+ years: 8 mg Pregnancy: 27 mg Lactation: 9 mg *Adequate Intake See Product Consequences of iron deficiency include anemia. It is estimated by the World Health Organization that out of the 1.62 billion cases of anemia in the world, half are due to an iron deficiency (25). In the United States, it is estimated that about 700,000 toddlers and 7.8 million women have iron deficiency and within those groups it is estimated that 240,000 toddlers and 3.3 million women have iron deficiency anemia (26). Symptoms of anemia may include dizziness, pale skin, and fatigue. For information on other micronutrients that can cause anemia, please see: 9 Micronutrient Deficiencies Associated with Anemia. Foods that are high in iron include fortified breakfast cereals; animal products such as oysters, beef liver, and sardines; legumes such as white beans and lentils; and spinach (25). Note: For more information on iron, please see The Importance of Sufficient Iron Intake for Kids (Plus Kid Approved Recipes). Impact of Diet on Nutrient Adequacy Whether you consume a meat-based, vegetarian, or vegan diet, you may be lacking in micronutrients. A study found that meat-eaters had inadequate intakes of nutrients, such as magnesium, calcium, and vitamin D whereas vegetarians and vegans had lower intakes of nutrients, including vitamin D, iron, and calcium (28). A well-balanced diet seems to be the best approach to cover all the nutrient bases. However, that can be hard to accomplish; for example, only about 25% of the U.S. population intake the recommended amount of fruits and vegetables, which are an important source of micronutrients and fiber (1). Many of us are unable to meet the recommended daily allowances of each micronutrient through diet alone. To learn more about supplementing your diet, see: How to Create a Daily Supplement Protocol for Your Family. Summary Although micronutrient deficiencies and inadequacies are becoming more common in the United States, there are ways we can address them. Diet plays an important role in making sure our bodies have enough micronutrients to function optimally and feel healthy and energetic. If you are not able to achieve the recommended dietary allowance of each micronutrient through diet alone, then supplementation may be necessary to achieve optimal health. At Dr. Green Life, we offer high quality vitamin and mineral supplements for the whole family. We always recommend working with a professional to assess potential nutrient deficiencies and come up with a plan to address them. 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European journal of haematology, 109(6), 633–642. https://doi.org/10.1111/ejh.13870 Neufingerl, N., & Eilander, A. (2021). Nutrient Intake and Status in Adults Consuming Plant-Based Diets Compared to Meat-Eaters: A Systematic Review. Nutrients, 14(1), 29. https://doi.org/10.3390/nu14010029 Facebook Pinterest X Email The Connection Between Nutrient Deficiencies & Hair Loss Read more Choosing A Supplement Delivery Method For Your Family Read more How To Calculate Supplement Dosages For Kids Read more New Study: Prenatal Choline Benefits Attention Span In Children Read more What To Look For In A Prenatal Vitamin Read more