The first call on nutrients by our body is for immediate and acute needs – those needed for short-term survival – for example energy production or “fright and flight”. It is only if nutrients are ingested in excess of these immediate ‘short-term’ needs that there will be sufficient left for ‘housekeeping’ processes or in other words to support long-term health.
In this week’s blog, we discuss factors that may contribute to low intakes of micronutrients and thus to what we at Cytoplan refer to as ‘the nutrition gap’ which can create hidden hunger. This is unlike the hunger that comes from a lack of food. It is a chronic lack of vitamins and minerals and often has no visible warning signs, so that those experiencing it may not even be aware of it.
“Natural selection favours short term survival at the expense of long-term health.”
Professor Bruce Ames, 20061
Professor Bruce Ames, an American biochemist and Professor of Biochemistry and Molecular Biology Emeritus at the University of California, Berkeley proposed the theory that, through evolution, the body has developed a rationing response to shortages of micronutrients (vitamins and minerals). When a particular micronutrient is in short supply, Professor Ames proposes that its use will be prioritised to processes that are critical to short-term survival, at the expense of long-term health. Professor Ames proposes that limiting these micronutrient deficiencies is key to preventing the onset of the diseases of ageing, and we can do this by supplementing these vitamins and minerals.
Thus, in his 2006 paper, he concludes:1
“I hypothesize that short-term survival was achieved by allocation of scarce micronutrients by triage. If this hypothesis is correct, micronutrient deficiencies that trigger the triage response would accelerate cancer, ageing and neural decay but would leave critical metabolic functions such as ATP production intact. A multivitamin-mineral supplement is one low-cost way to ensure intake of the Recommended Dietary Allowance of micronutrients throughout life.”
So, it is only if micronutrients are ingested in excess of immediate needs that there will be sufficient left for protection and to be put into store (or reserve) for future times of extra need.
More recently Professor Ames published a new paper2 extending his triage theory to other nutrients required for the function of longevity proteins. Thus, he discusses other dietary compounds including lutein, zeaxanthin, lycopene, astaxanthin, taurine and pyrroloquinoline quinone (PQQ) where a triage response may occur.
The nutrition gap
The nutrition gap describes the difference between the levels of nutrients the average person, eating a reasonable Western diet, is obtaining from food, and those nutrient levels identified by research as being needed for optimal health in the population. The nutritional status of our bodies is dependent on a number of factors, including:
- Our food choices
- The nutrient content of the food we eat
- The ability of our bodies to assimilate these nutrients
- Lifestyle factors, such as smoking, stress, alcohol intake, medications etc. which give rise to increased nutrient requirements
- Our level of activity; and
- Our genetics
A significant factor in the nutrition gap is our food choices. Many people’s diets are high in refined, processed foods that offer low nutrient density and empty calories. There is often an emphasis on how many calories we should be eating – but calories are not all created equal. For example, nuts and donuts are both high calorie and high fat foods. However, nuts contain fibre and also provide phytonutrients along with vitamins and minerals. Donuts on the other hand are high in sugar and refined carbohydrate, inflammatory fats and lacking in nutrition and micronutrients – they provide empty calories.
The most recently published National Nutrition and Diet Survey (2019)3 concluded that “there was a downward trend in intakes of most vitamins and minerals over the 9-year period for many age/sex groups”. In particular, all age/sex groups showed a significant reduction in vitamin A and folate. Furthermore, the survey showed vitamin D deficiency continues to be a problem, levels are lowest in January to March, with 19% of children aged 4 to 10 years, 37% aged 11 to 18 years and 29% of adults with 25-hydroxyvitamin D below the deficiency threshold.
The nutrient content of the food we eat
Early forms of agriculture were ‘sustainable’ as plants were grown in soil to which excess plant waste and waste from the animals (who had also consumed the plants) were returned. This process naturally re-mineralised and replenished the ground for the next crop. Early ploughing techniques also helped to evenly distribute the plentiful and natural fertiliser ‘mycorrhiza’. The mycorrhiza is a ground fungus that ‘biotransforms’ inorganic minerals into an organic form that makes the minerals readily useable by plants, thus ensuring good mineral uptake. However, with modern farming techniques (that have been in use for decades) the grown plants are harvested and shipped all over the world and deep ploughing destroys the mycorrhiza. In addition, the standard use of ‘NPK’ fertiliser (containing nitrogen, phosphorus and potassium) does not provide the soil with the sixty plus other nutrients that would normally be present.
Studies have shown that the levels of nutrients in our foods have changed. So even those who aim to eat a diet focussed on wholefoods may not be achieving optimal intake of certain nutrients. A government study between 1940 and 1991 determined the mineral content of a number of foods – 27 varieties of vegetable, 17 varieties of fruit, 10 cuts of meat and some milk and cheese products. The results “demonstrate that in every subgroup of foods investigated there has been a substantial loss in their mineral content”. For example, between 1978 and 1991 in vegetables there was an average loss of zinc of 59%.4
Pesticides and fungicides have resulted in the reduction of phytonutrients in plants – like flavonoids and carotenoids. These flavonoids and carotenoids not only protect the plant from disease, UV light and other damage but have the same beneficial action in our bodies when we eat them. Plants that are sprayed have less requirement to produce high levels of phytonutrients.
Climate change is also affecting the nutrient content of our food, reducing levels of protein, zinc, iron and B vitamins, for example. Scientists have compared nutrient levels in field crops grown in current ambient CO2 levels with those grown in the elevated CO2 levels expected by 2050. They compared a number of crops in different locations and continents. Wheat grown in high CO2 levels had 9% less zinc and 5% less iron, as well as 6% less protein, while rice had 3% less iron, 5% less iron and 8% less protein. Maize saw similar falls and soybeans lost similar levels of zinc and iron.5
At first this might seem counterintuitive as carbon dioxide actually stimulates photosynthesis and growing and so might be considered to have a positive effect on food production. The precise biological mechanism by which climate change causes nutrient levels to fall is not well understood, however, research shows that increased carbon dioxide creates plants with higher carbohydrate concentrations and reductions in minerals and protein content – in effect creating a natural ‘junk food’.6
The ability of our bodies to digest, absorb and assimilate these nutrients
Ageing is associated with reduced gastric acid output and production of the digestive enzyme pepsin (secreted in the stomach and responsible for the digestion of protein). Exposure to factors such as Helicobacter pylori infections, smoking, other conditions and medications can all affect acid production by the stomach. Unfortunately, some conditions are treated with proton pump inhibitors which then further reduce gastric acid output.
The consequences of compromised gastric function, in relation to nutritional status, may include:
- A reduced ability to absorb nutrients, particularly nutrients that require stomach acid in order for them to be cleaved from their carrier molecules. It has been established that B12, iron, magnesium, calcium and zinc absorption, in particular, are affected by low hydrochloric acid in the stomach7
- Reduced protein digestion (due to low hydrochloric acid and pepsin secretion) and therefore absorption. This may also mean that larger protein molecules are present in the small intestine, this can be a trigger for inflammation and leaky gut and is associated with food intolerances, atopic conditions and autoimmune diseases8
Smoking, stress, medications and other lifestyle factors can increase requirements for micronutrients. For example, some prescription medications can have a significant impact on nutrient status by reducing absorption of certain nutrients, increasing excretion or inhibiting the body’s own production.
For example, according to US website www.mytavin.com, taking a combination of diclofenac (for pain), omeprazole (an antacid) and simvastatin (a statin) could lead to depletion of the following nutrients: folate, zinc, iron, B12, calcium, selenium, magnesium, omega-3, native bacteria and coenzyme Q10.
A study published in September 2017 found that more than 49% of people aged over 65, were taking at least five medications a day,9 this has led to concerns over the impacts of taking multiple medications long term.
Our level of activity
Our sedentary lifestyle means that we do not need to eat as much as we used to. Our physiology developed in the Paleolithic era 10,000 years ago and our physiology is relatively unchanged from that time. But our lifestyle is very different now. Our ancestors, hunter-gatherer man, ate 4,000+ calories per day and needed every one as he was a lean and active being. Our sedentary lifestyle means we eat 2,000 calories per day and even that is too much for some, but we still need the micronutrients – the vitamins and minerals – in 4,000 calories.
Bizarrely, we are not eating enough food to get the vitamins and minerals we need. We are over fed and under-nourished.
NRVs (Nutrient Reference Values) are not enough
When the National Academy of Science drew up the Nutrient Reference Values (NRVs), formerly called RDAs, it never claimed these represented nutrient intakes to achieve optimum health. They were never intended as any more than a ‘safety net’ with the specific purpose of preventing diseases of overt deficiency. The real mystery is why so many people mistakenly believe NRVs are levels of intake that will give rise to optimum health.
The Committee on Food and Nutrition of the National Research Council was established in 1940 to advise on nutrition problems in connection with national defence. One of its first concerns was to work out NRVs for the various dietary essentials for people of different ages. The first NRVs were set in 1941 to prevent scurvy (vitamin C deficiency), pellagra (niacin deficiency) and beriberi (vitamin B1 deficiency) and, indeed, these new NRVs were very effective. For example, obtaining 30mg of vitamin C per day will prevent scurvy – but we now know that we need a much higher amount of vitamin C for optimal health, tissue repair and antioxidant activity.
- The nutrition gap describes the difference between the levels of nutrients the average person, eating a reasonable Western diet, is obtaining from food, and those nutrient levels identified by research as being needed for optimal health in the population.
- Nutrient shortfalls are caused by a number of different factors including our food choices, modern farming methods, climate change, lifestyle factors and genetics.
- The National Nutrition and Diet Survey (2019) concluded that “there was a downward trend in intakes of most vitamins and minerals over the 9-year period for many age/sex groups”. In particular, all age/sex groups showed a significant reduction in vitamin A and folate. Vitamin D deficiency continues to be a problem.
- Surveys have shown that the nutrient content of our foods has reduced since the 1940s. For example, between 1978 and 1991 there was an average loss of 59% of zinc in vegetables.
- Climate change will also have an impact on the quality of our food – higher carbon dioxide levels are predicted to result in lower minerals and protein content and a higher carbohydrate content.
- Medications can have a significant effect on our nutrient status and increase nutrient requirements, for example by reducing the absorption of certain nutrients, increasing their
If you have questions regarding the topics that have been raised, or any other health matters, please do contact me (Helen) by phone or email at any time.
Amanda Williams and the Cytoplan Editorial Team
- Ames, B. (2006) ‘Low micronutrient intake may accelerate the degenerative diseases of aging through allocation of scarce micronutrients by triage’. PNAS, 103, 47, 17589-94
- Ames, B. (2018) ‘Prolonging healthy aging: longevity vitamins and proteins. PNAS, 115, 45, 10836-44
- National Nutrition and Diet Survey (2019) Years 1 to 9 of the Rolling Programme (2008/2009 – 2016/2017): Time trend and income analyses. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/772434/NDNS_UK_Y1-9_report.pdf
- Thomas, D. (2003) ‘A Study on the mineral depletion of the foods available to us as a nation over the period 1940 to 1991’. Nutrition and Health, 17, pp. 85-115 0260-1060
- Samuel, S.M. et al. (2014) ‘Increasing CO2 threatens human nutrition.’, Nature, 510, 139-142.
- Gazell, K.A. (2019) ‘Climate change and food quality. How a changing climate impacts the nutritional value of food.’ Natural Medicine Journal, Vol. 11, Issue 8.
- Champagne, E.T. (1989) ‘Low gastric hydrochloric acid secretion and mineral bioavailability.’ Adv Exp Med Biol, 249:173-84.
- Textbook of functional medicine. 2008. Institute for Functional Medicine.
- Gao, Lu. et al. (2017). ‘Medication usage change in older people (65+) in England over 20 years: findings from CFAS I and CFAS II’. Age and Ageing, 1-6, 10.