Our nutritional requirements can vary from one life stage to the next and can alter according to specific reasons such as pregnancy, health problems such as infection or disease, or ageing and medications. Recent nutritional surveys indicate however that many of us, across all age groups, are not even obtaining the most basic level of certain nutrients.1-4
In this weeks’ blog we look at some of the different life stages we go through, the increased nutrient requirements we may need during these stages, and why it is important to take into account the extra demands placed on the body by these changes.
Adequate nutrient intake and a suitable nutritional status of the mother are essential for the optimal development of the foetus. A pregnant lady on average needs to increase her intake of micronutrients by 50% but her calorie intake by only 30% – from this you can see that it is quite easy for pregnancy to cause or increase the micronutrient gap in individuals.
The body uses nutrients in a hierarchy of importance, and during pregnancy the baby will have first call on the mother’s resources and stores. This time can become a nutrient steal for the mother and result in weakened bones, hair loss, anaemia, and other manifestations of insufficient nutrient intake.
For the baby, the first 1,000 days of life (from conception to the second year of life) is extremely important and if the supply of micronutrients are inadequate this may have consequences for physical and cognitive development.5
Consuming a well-balanced diet and ensuring overall adequate nutrient intake is important during pregnancy. However, several nutrients during pregnancy deserve particular attention.
Folate (folic acid) – surveys have shown that a large proportion of women of child-bearing age now have such low levels of folate that if they became pregnant their child would be at increased risk of neural tube defects.6 The best and most bio-effective form of folate is methylfolate, which is better absorbed and utilised than standard folic acid, most particularly for carriers of the MTHFR 677T polymorphism, thought to be in over 40% of the population.
Vitamin D3 – is especially important during pregnancy as it helps allow optimal skeletal, teeth, heart, and nervous system development of the foetus. A deficiency can also limit the accumulation of vitamin D stores for the early months of the infant’s life. Most needs however cannot be met through diet alone and supplementation is recommended. The current prevalence of vitamin D insufficiency during pregnancy is estimated as high as 70% in western countries.5
Iron – deficiency in pregnancy increases the risk of premature delivery and having a low-birth weight baby – it can also lead to problems with the baby’s mental development. A significant proportion of younger women have intakes below the LRNI (lower reference nutrient intake). The growing foetus uses high levels of iron for growth and development and if a mother is low at the onset of pregnancy it is almost impossible for her to get back to even adequate status during pregnancy.
Calcium – is in great demand during pregnancy – in fact, intestinal absorption of calcium doubles in early pregnancy. Calcium is important to help build the baby’s teeth and bones. It may also help to reduce the risk of pregnancy-related complications, like pre-eclampsia or hypertension.
Essential Fatty Acids – offer many health benefits and are associated with supporting normal hormone production. DHA is particularly important for the cognitive and visual development of the growing foetus.
Iodine – is involved in nerve development, as well as thyroid follicle growth and the synthesis of thyroid hormones, which are of essential importance for the development of the foetal central nervous system.5
Young children grow and develop rapidly and are highly active. Optimal energy and nutrients are therefore essential for children at this stage of life, although current reports indicate that the nutritional intake of many young children does not comply with national recommendations.7,8
Ensuring that children eat a wide and varied diet is important at this age but may also be challenging. Below are some nutrients that are of particular importance at this stage in life.
Vitamin A – is vital to support rapid growth and to help combat infections.
Vitamin D – insufficient intake can cause rickets in children and can also increase the risk of infection as it plays an important role in immune system competence.
Vitamin C – supports the immune system and helps to fight infection. Vitamin C is also needed to form and strengthen collagen in bones, cartilage and muscles, helps with the healing of minor wounds, and keeps teeth and gums stay healthy.
Iron – anaemia is seen in about 12% of toddlers and is most present between 18 – 24 months, when physical and mental growth requires large amounts of iron. Causes of iron deficiency in young children may be due to weaning and refusal of new foods, poor diet offered by parent, low intake of bioavailable haem iron, or consumption of food/drinks that interfere with the absorption of iron.
Zinc – plays an important role in the growth, development, and repair of the body. Fussy eaters and those who do not eat animal products and wholegrains are at an increased risk of deficiency.9
Omega 3 – supports brain growth and function, mood, and the immune system.
Probiotics – infants acquire and develop their gut microflora during their first year of life, followed by a transitional phase to reach a stable microflora at two to three years old. A balanced gut microbiome has been shown to help protect against atopic conditions such as allergy, eczema and asthma.10,11 Children that have taken antibiotics or that have been born via caesarean may benefit from taking a probiotic.
During this timeframe, there is a transition from childhood to adulthood, which is an important time for physical, emotional and mental growth and development. Adolescents are a vulnerable group with respect to adequate nutrition and the nutritional status of this age group has caused concern for many years.5,12
Evidence from the National Diet and Nutrition Survey (NDNS) shows that most teenagers in the UK are not eating a healthy diet and significant proportions had intakes below the LRNI for all eleven vitamins and minerals evaluated.3,7,8
Iron – requirements rise during adolescence to aid growth and muscle development. Girls also require more iron after menstruation begins. Data from the NDNS shows mean intakes of iron remain low with 49% having intakes below the LRNI.1
Vitamin D – many children aged 11 to 18 years have low vitamin D status. This is of concern because of the important role of vitamin D for bone development and accrual of peak bone mass.
Calcium – intake of recommended calcium levels are crucial as the bones are developing and strengthening during this timeframe. Calcium contributes to the achievement of optimal peak bone mass, and shortfalls in intake at this life stage can increase the risk of bone disease in later life.3
Omega 3 – helps with brain development and learning.
Probiotics – can help with many physical and emotional aspects of this age group such as alleviating stress, balancing hormones, and producing B-vitamins for energy.
Vitamin D – helps the body to absorb and use calcium for healthy bones and muscles.
Magnesium – a large proportion of adults are not getting enough. Magnesium helps maintain healthy blood sugar and blood pressure levels, helps covert food to energy and keeps muscles and nerves working. Magnesium is used in more than 300 enzyme reactions and for the structural function of proteins.
Selenium – supports the immune and reproductive systems and protects cells and tissues from free radical damage. 50.3% of females and 25.8% of males having total intakes beneath the LRNI.7,8
Probiotics – there are a host of factors that can disturb the ratio of good-to-bad bacteria in this age group in particular, including food choices, stress, poor sleep, disease, medications, antibiotics – the list goes on. Extensive studies have shown connections between the health of the gut and chronic disease, immune system function, mental health conditions, autoimmune diseases, skin conditions, and more.13-16
Antioxidants – vitamins C, E, and other antioxidants help to fend off harmful free radicals. Free-radical damage is thought to contribute to ageing and the development of chronic disease. Upping your intake of antioxidant rich foods can therefore help to safeguard future health.
Zinc – men who plan to have children should get plenty of zinc, as a deficiency may affect the quality and motility of sperm.
Selenium – is equally important for sperm health and motility.
Iron – menstruating women may have low levels of iron due to heavy periods or too little from the diet.
Calcium – due to the hormonal changes associated with menstruation and childbearing, women are more susceptible than men to weakened bones and osteoporosis.
Folate – younger women are at increased risk of developing folate-deficiency anaemia. It is important to include enough folate as up to 50% of pregnancies are unplanned. A growing baby needs this important nutrient in the early weeks of pregnancy before many women realise they are pregnant, most particularly for the development of the neural tubes, which form in the first 6 weeks after conception.
Ageing is related to a range of changes in the body, which can include muscle loss, thinning of the skin and a decrease in stomach acid. Low stomach acid can affect the absorption of important nutrients such as B12, iron, calcium, and magnesium.17 Disease, medication, decreased appetite, social isolation and reduced cognitive function can impair dietary quality and subsequently micronutrient intake.
B12 – as people age, the ability to absorb vitamin B12 decreases. The major reason for this is atrophic gastritis, which affects 10% to 30% of people over 60 years of age.5 Intakes above recommendations may therefore be required in older adults to maintain adequate status.
Calcium – important to maintain bone strength and to keep bones and muscles healthy during older age.
Vitamin D3 – older people typically spend less time outdoors and their skin is less efficient at synthesising vitamin D from sunlight.
Selenium – surveys show that between 34-76% of adults aged 65+ had intakes below the LRNI.7,8 This is worrying as adequate selenium has an important role in safeguarding health.
Omega-3 – may help lower heart disease risk factors such as high blood pressure and triglycerides. They may also help reduce the intensity of joint symptoms like stiffness, tenderness and swelling.18-21
Probiotics – older people often have a much lower number of friendly bacteria in their gut than other age groups and are much more prone to gastrointestinal infections and bowel conditions.
Disease and Illness
Micronutrient deficiencies are a recognised global public health issue, and poor nutritional status predisposes to disease and infection. Chronic diseases now afflict 15 million people in the UK and 58% of people over 60 are estimated to have at least one long-term condition.22 Our requirements for micronutrients are likely to change and increase when experiencing health problems. Below are a couple of examples of diseases and some of the associated increased requirements.
Type 2 Diabetes
More than 4.9 million people in the UK have diabetes and a large proportion of the population are undiagnosed.23
Magnesium – may help in the management of blood sugar levels. Increased glucose levels may also cause the body to get rid of more magnesium than it should. Magnesium deficiency has been associated with diabetes and Metabolic Syndrome.
Zinc – helps with the production and secretion of insulin.
Chromium – helps to facilitate blood glucose regulation via the uptake of glucose from blood into tissue.
Antioxidants – high levels of oxidative stress caused by hyperglycaemia can increase antioxidant requirements.
Antioxidants – free radical damage is likely a fundamental mechanism underlying many neurological diseases. Antioxidants therefore have the potential to help delay or ameliorate neurological disorders. Antioxidants such as vitamin C, E, selenium and glutathione have shown to be protective against excitotoxicity and neuroinflammation.24
Omega 3 – both DHA and EPA are critical for optimal brain health.
B vitamins – play a key role in the proper functioning of processes in the nerves and brain.
CoQ10 – widely used for mitochondrial and neurodegenerative disorders.25
The nutritional status of someone who is ill may also be affected by diarrhoea, malabsorption, loss of appetite, and diversion of nutrients for the immune response, so it is important to be mindful of this. In addition, fever increases both energy and micronutrient requirements.26
Medications are likely to further exacerbate micronutrient depletion. Half of women and 43% of men in England are now regularly taking prescription drugs, according to the comprehensive Health Survey for England.27 Estimates from Age UK also show that nearly 2 million people over 65 are likely to be taking at least 7 prescribed medicines and 95% of over 65’s take at least one medication.28
Outlined below are some common medications and the associated nutrient depletions. Please note that this list is not exhaustive, and you should always cross-check any medication you are taking for nutrient interactions.
Proton Pump Inhibitors – magnesium, calcium, zinc, folic acid, vitamin B6, B12 and C
Statins – CoQ10
Thyroxine (thyroid medication) – calcium
NSAID’s (ibuprofen, naproxen) – folic acid, iron, vitamin C.
Antibiotics – B vitamins, vitamin K, native friendly gut bacteria
Benzodiazepines (anxiety/sleep) – melatonin
Bronchodilators (asthma) – potassium
Oral contraceptives – folic acid, B vitamins, C and zinc.
Requirements for micronutrients change throughout the life cycle and for specific reasons as mentioned. Good nutrition is one of the keys to a healthy life and being mindful of these changes can help you make informed and conscious decisions to stay on top of your health.
- Nutritional requirements vary from one life stage to the next and can alter according to reasons such as pregnancy, disease, ageing and medications.
- A suitable nutritional status of the mother is essential for the optimal development of the foetus. Important nutrients include iron, iodine, calcium, folic acid, D3, and essential fatty acids.
- Young children – optimal energy and nutrients are essential for children at this stage of life including vitamins A, C and D, iron and zinc.
- Adolescents are a vulnerable group with respect to adequate nutrition. Evidence from the NDNS shows that most teenagers had significant intakes below the LRNI. Important nutrients for this age group include iron ,D3, calcium and omega 3.
- For adults – selenium, antioxidants, magnesium, omega 3 and probiotics are often in extra need. For men – selenium and zinc for reproductive health. For women, folate and iron.
- Ageing is related to a range of changes in the body, which can include muscle loss, thinning of the skin and a decrease in stomach acid. Disease, medication, decreased appetite, social isolationand reduced cognitive function can impair dietary quality.
- Increased B12, calcium, D3, selenium, probiotics, omega 3 may be beneficial in older ages.
- Half of women and 43% of men in England are now regularly taking prescription drugs. Medications are likely to further exacerbate micronutrient depletion