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Micronutrients: Common Vitamin and Mineral Deficiency States

  • Vitamin B12. Vitamin B12 deficiency affects 10 to 15 percent of individuals over age 60, mainly due to poor absorption from the intestinal tract.
  • Vitamin C. Deficiency of vitamin C, which results in a disease called scurvy, occurs in a significant number elderly and hospitalized patients and in individuals who avoid fruits and vegetables. In smokers, the risk for vitamin C deficiency is much greater than in nonsmokers.
  • Vitamin D. Vitamin D deficiency can result in rickets, a disease of deformed bones that can affect infants and children. Although rickets is uncommon in the United States due to sun exposure and foods fortified with vitamin D, many people have insufficient vitamin D intake.

    The natural source of vitamin D is sun exposure. However, considerable evidence suggests that people who live in northern cities or who rarely go outdoors (e.g., elderly persons) do not meet vitamin D requirements. Vitamin D is present in few foods, which many people do not eat for reasons of preference or health (e.g., oily fish and egg yolk). As a result, the American Academy of Pediatrics recommends 400 IU of vitamin D supplements for infants, children, and adolescents who ingest less than 500 mL per day of vitamin D–fortified formula or milk. Multiple vitamin formulas typically contain some vitamin D. An additional supplement may be needed for individuals with low serum vitamin D levels and individuals with higher requirements, such as those over 70 years.
  • Iron. Deficiency of this mineral is most common in women of child–bearing age and during pregnancy. Anemia caused by iron deficiency is the most common vitamin or mineral deficiency in the world.
  • Calcium. Low calcium intake is common in parts of the U.S. population. However, the exact amount of calcium needed is uncertain. While some authorities recommend up to 1500 mg per day, some evidence suggest that lower intakes may be adequate. Further, there is some evidence that excessively high calcium intakes may increase the risk for prostate cancer and kidney stones under certain circumstances.

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