Nutritional Deficiencies

Nutritional Deficiencies updated: 24 November 2008

Voeding in Nederland: geconstateerde inname-tekorten en marginale innames in tabel-vorm

SOE pugblicatie

Op deze SOE-pagina vindt u 8 tabellen die een schematisch overzicht geven van de inname-tekorten en marginale innames van essentiële voedingsstoffen, die bij de verschillende bevolkingsgroepen in Nederland zijn geconstateerd

Publication Types:

• Review

Vitamine weg uit groenten

Bron: Telegraaf

Gepubliceerd op 16 april 2008

De kwaliteit van onze andijvie, bloemkool en wortelen gaat sterk achteruit. In de afgelopen twintig jaar is de aanwezigheid van vitaminen en mineralen in de zogeheten vollegrondsgroente fors teruggelopen, soms met meer dan vijftig procent.

Publication Types:

• Article

Nutrition disorder

From Wikipedia, the free encyclopedia

Many diseases in humans are directly or indirectly caused by improper eating habits and malnutrition. These include, but are not limited to, deficiency diseases, caused by a lack of essential nutrients. Additionally, several diseases are directly or indirectly impacted by dietary habits, and require very close attention to the nutrient content of food.

Publication Types:

• Article

Dietary advice for illness-related malnutrition in adults.

Cochrane Database Syst Rev. 2008 Jan 23;(1):CD002008

Baldwin C, Weekes CE.

This review highlights the lack of evidence for the provision of dietary advice in managing illness-related malnutrition. Dietary advice plus nutritional supplements may be more effective than dietary advice alone or no advice in enhancing short-term weight gain, but whether this is sustainable, or whether survival and morbidity are improved remains uncertain. A large adequately-powered randomised controlled trial is needed comparing the efficacy of different therapies to increase dietary intake in people with illness-related malnutrition and examining the impact of this on clinical function and surviva

Publication Types:

• Review

Safe addition of vitamins and minerals to foods: setting maximum levels for fortification in the Netherlands

Eur J Nutr. 2007 Jun;46(4):220-9. Epub 2007 May 3

Kloosterman J, Fransen HP, de Stoppelaar J, Verhagen H, Rompelberg C.

BACKGROUND: In 2004, the European Court of Justice decided that the prohibition of fortification with vitamin A, vitamin D, folic acid, selenium, copper, and zinc in the Netherlands conflicts with the principle of free movement of goods in the European Union. This decision led to a change in the Dutch policy, resulting in a more flexible handling of requests for exemption from this prohibition to fortify.
Therefore, an investigation was proposed in which it would be determined whether a general exemption could be granted for food fortification with a certain maximum safe amount per micronutrient. AIM OF THE STUDY: To develop a risk assessment model to estimate maximum safe fortification levels (MSFLs) of vitamins and minerals to foods on the Dutch market, and to evaluate these levels to derive allowed fortification levels (AFLs), which can be used for a general exemption. METHODS: We developed a risk assessment model to estimate MSFLs of vitamins and minerals to foods on the basis of existing models. We used European tolerable upper intake levels in combination with national food consumption data to estimate MSFLs for fortification of foods for several age groups. Upon extensive stakeholder dialogue, the risk manager considered these estimated MSFLs and the final AFLs for a general exemption were set. RESULTS: For folic acid, vitamin A, and vitamin D, the MSFLs were calculated in the risk-assessment model. Children up to 6-years old were the group most sensitive to folic acid fortification, and they had an MSFL of 0 microg/100 kcal, but following a risk management evaluation, this was upgraded to an AFL of 100 microg/100 kcal. The MSFL for vitamin D was 3.0 microg/100 kcal (children 4-10 years old), and the risk manager increased this to an AFL of 4.5 microg/100 kcal. Children up to 10 years old, men, and postmenopausal women were the groups most sensitive to vitamin A fortification (MSFL = 0 microg/100 kcal). Because these groups represent a large part of the population and because of the seriously harmful effects of excessive vitamin A, the risk manager did not allow a general exemption. CONCLUSIONS: The combination of a risk assessment model and risk manager evaluation led to the setting of AFLs for general exemption of fortification with folic acid and vitamin D. This model is also applicable for other micronutrients, for which an UL is derived, and in other countries.

Publication Types:

• Study

Relationships between micronutrient intake and biochemical indicators of nutrient adequacy in a "free-living' elderly UK population

Br J Nutr. 1997 Feb;77(2):225-42

Bailey AL, Maisey S, Southon S, Wright AJ, Finglas PM, Fulcher RA.

Nutritional assessments are frequently based on amounts of nutrients consumed. In the present paper the usefulness of nutrient intake data for assessing nutrient adequacy is examined in an elderly British population. Subjects were "free-living' elderly aged 68-90 years (sixty men, eighty-five women) in Norwich. Forty-two of forty-nine surviving males and sixty-seven of seventy-nine surviving females were reassessed after 2 years. With few exceptions, estimated micronutrient intake was not statistically predictive of biochemical measures of nutrient adequacy. Initial biochemical measures of nutritional adequacy were compared with those found 2 years later in an attempt to assess whether initial biochemical assessment was predictive of the "longer term' situation. Biochemical measurements at the start of the study were correlated to the same measurements made 2 years later for: serum ferritin, haemoglobin and erythrocyte count, whole-blood Se-glutathione peroxidase (EC 1.11.1.9; males only), plasma Cu, alkaline phosphatase (EC 3.1.3.1), ascorbic acid, vitamin B6 (pyridoxal-5-phosphate), folate and vitamin B12, total erythrocyte thiamin (males only), riboflavin (erythrocyte glutathione reductase (EC 1.6.4.1) activation coefficient): but not for: erythrocyte Cu-superoxide dismutase (EC 1.15.1.1) or plasma Zn. Either only small changes, or no changes, in mean values were seen over the 2 years for most of the biochemical measures. One exception was a large increase in plasma folate. The only important "negative' features seen at 2-year follow up were a large fall in serum ferritin concentration and a large increase in the activity of two antioxidant defence enzymes, superoxide dismutase and glutathione peroxidase. As judged by currently accepted biochemical deficiency threshold values, a small proportion of subjects were possibly at risk of Fe (3% men; 1% women), folate (7%, 3%), thiamin (12%; 3%) and vitamin C (15%; 17%) deficiency. Many more appeared to be at risk of vitamin B6 (42%; 47%) and riboflavin (77%; 79%) deficiency. It was concluded that the requirements of the elderly for vitamins B1, B2 and C, and the biochemical deficiency threshold values used to indicate vitamin B6 deficiency, need review.

Publication Types:

• Study

Longitudinal changes in the intake of vitamins and minerals of elderly Europeans. SENECA Investigators

Eur J Clin Nutr. 1996 Jul;50 Suppl 2:S77-85

Amorim Cruz JA, Moreiras O, Brzozowska A.

OBJECTIVE: To assess longitudinal changes in intake of vitamins and minerals in elderly Europeans. DESIGN: Longitudinal study including the collection of dietary intake data in 1988/1989 and in 1993. SETTING: Baseline and follow-up data were collected from nine European towns: Belgium: Hamme (H/B); Denmark: Roskilde (R/DK); France: Haguenau (H/F) and Romans (R/F); Italy: Padua (P/I); the Netherlands: Culemborg (C/NL); Portugal: Vila Franca de Xira (V/P); Spain: Betanzos (B/E) and Switzerland: Yverdon (Y/CH). In four other towns dietary intake data were collected in 1993 only: Portugal: Coimbra (C/P); Poland: Marki (M/PL); Northern Ireland: Ballymoney-Limavady-Portstewart (BLP/NI/UK) and United States: Mansfield (Connecticut) (M/CT/USA). SUBJECTS AND METHODS: Using standardized methods, data were collected from a random sample of 658 elderly men and 731 women born between 1913 and 1918. Dietary intake data were collected by a validated modified dietary history method. RESULTS: A significant decrease in the median intake of vitamin B1, vitamin B2, vitamin B6, vitamin C or iron was observed in several towns and for most of these nutrients in H/B, R/DK, R/F and V/P. Over the 4-y follow-up period, the proportion of elderly people with nutrient intakes below the lowest European RDI's increased for various nutrients in most towns, whereas the nutrient density of the diet, especially for iron and vitamin C, decreased significantly only in a few towns. The proportion of elderly people taking nutrient supplements varied from less than 5% in H/B to 60% in R/DK. CONCLUSION: The observed decrease in intake of some vitamins and minerals in most of the participating towns, indicates an increased risk for malnutrition in elderly Europeans.

Publication Types:

• Study

Vitamin and mineral inadequacy in the French population: estimation and application for the optimization of food fortification

Int J Vitam Nutr Res. 2006 Nov;76(6):343-51

Touvier M, Lioret S, Vanrullen I, Boclé JC, Boutron-Ruault MC, Berta JL, Volatier JL.

The objective was to assess the prevalence of inadequate micronutrient intake in a representative sample of the French population, which to our knowledge, had never been done before, and to use this concept to optimize efficiency and safety of food fortification. The INCA survey collected food intake data using a 7-day record, for 2373 subjects (4-92 years). The prevalence of inadequacy for calcium, magnesium, iron, vitamins C, A, B6, and B12, thiamin, riboflavin, niacin, pantothenic acid, and folate was estimated by the proportion of subjects with intake below the Estimated Average Requirement (EAR). We also calculated daily consumption of 44 food groups by age and gender. This paper shows how the combination of both data sets, i.e., inadequacy and food consumption data, allows a preliminary screening of potential food vehicles in order to optimize fortification. The prevalence of inadequacy was particularly high for the following groups: for calcium, females aged 10-19 years (73.5%) or aged 55-90 years (67.8%), and males aged 15-19 years (62.4%) or aged 65-92 years (65.4%); for magnesium, males aged 15-92 years (71.7%) and females aged 10-90 years (82.5%); for iron, females aged 15-54 years (71.1%); and for vitamin C, females aged 15-54 years (66.2%). Two examples are provided to illustrate the proposed method for the optimization of fortification.

Publication Types:

• The INCA survey 2373 subjects (4-92 years)

Publication Types:

• Review