Nutrient deficiencies call for extra help

You know better than anyone that your customers are focused on health and nutrition. They go out of their way to stay abreast of new health research, and design their diets to keep their bodies and minds in tip-top shape. But even the most conscientious consumers can come up short when it comes to certain nutrients.

The American Dietetic Association holds that the first line of defense against a nutrient deficiency should be a balanced diet. But sometimes perfect balance just isn't possible—and that's when dietary supplements step in. But how do you know what to recommend?

The Natural Foods Merchandiser queried a handful of leading dietitians to find out which nutrients are most commonly missing from American diets—and why. Here's what they said, and how you can help your customers:

Coming up short
"There are a lot of barriers to eating the foods that provide good health," says David Grotto, a registered dietitian and ADA spokesman, whose background is in the natural foods industry.

The ADA gives a litany of examples. Hectic lifestyles can keep people from consuming the necessary number of servings from each food group. Weight-loss diets can cut out certain nutrients, and declining appetites due to aging can limit intake. Restrictions like vegetarian and vegan diets or food allergies and intolerances can cut off entire food groups from people who consume otherwise healthy diets. And even your most sophisticated customer might admit to an aversion to certain types of nutritious foods. But short of hiring a registered dietitian, how can you help a customer determine when supplementation is needed?

Registered dietitian and ADA spokeswoman Jeannie Gazzaniga-Moloo stands by the U.S. Department of Agriculture's MyPyramid Plan. Retailers can refer shoppers to www.mypyramid.gov, where they can enter personal diet information and receive a customized food guide. "You can create a user ID and enter what you eat," Gazzaniga-Moloo explains. "And it will shoot back feedback to help you find areas you're deficient in."

The usual suspects
Wading through the slew of nutrients necessary for health, the dietitians NFM surveyed came to a clear consensus over two of the most important, most commonly missed nutrients in Americans' diets: calcium and vitamin D.

"With calcium, bone health is the main concern," says dietitian and ADA spokeswoman Melinda Johnson. With the most common sources being dairy and leafy greens, calcium often gets overlooked by busy people who tend to consume more processed foods and often replace milk with soda.

Men tend to be particularly unaware of their need for calcium, Grotto says. "Guys also perceive that osteoporosis is a women's thing," he says, pointing out that men tend to consume fewer dairy products than women.

Calcium is one of the few nutrients that all our dietitians agreed would probably require supplementation. If someone does not consume enough calcium through food, or loses the mineral rapidly from the body, it is drawn from the bones to maintain calcium levels in the blood.

Vitamin D, also commonly lacking, helps maintain normal levels of calcium. It's produced by the body after exposure to sunlight, and is found mostly in foods derived from animals, putting vegetarians and vegans at greater risk of insufficiency. A July article in the New England Journal of Medicine reported that vitamin D deficiency is one of the most commonly unrecognized medical conditions in the United States, leaving millions at risk for developing health problems such as osteoporosis, fractures, cancers and heart disease.

Allergies and intolerances
Whether it's the result of better screening or an actual increase in sensitivities, the number of shoppers with food intolerances and allergies is on the rise, Grotto says. "Consequently, folks will take out an entire food group, like for a dairy allergy," Gazzaniga-Moloo says.

People who shun gluten due to an allergy or intolerance can often wipe out major sources of B vitamins, Grotto says. And, obviously, those who avoid dairy products should supplement with calcium and vitamin D, Gazzaniga-Moloo says.

Supplements for the sexes
When it comes to the sexes, different deficiencies emerge: zinc in men and folate in women. However, most multivitamins formulated for men and women are designed with these in mind.

Zinc, found in meat, eggs and whole-grain cereals, is important for growth and develop?ment, from wound healing to cognitive function and memory. "Guys are really focused in on performance," Grotto says, from physical to mental to sexual. "Zinc cuts across all of them." But many foods that contain zinc tend to be off men's dietary radar screens, Grotto says, and he often sees men with insufficient intake.

For women, folate deficiencies can spell trouble. Folate is needed for general health, including immune function and DNA repair. During pregnancy, it helps prevent neural-tube defects in developing fetuses. But some current weight-loss trends are putting women's folate intake at stake. Roberta Anding, a registered dietitian and ADA spokeswoman, points out that a low-carb diet that leaves out grains can eliminate valuable sources of folic acid.

Augmentation is OK
"I know registered dietitians, as a generality, like to start with a grandiose plan that's idealistic about getting all their nutrients from food on a daily basis," Grotto says. "But the reality is that doesn't actually happen. There's a place for supplements, used wisely, where they can augment a diet and give nutritional adequacy." To help decide whether a supplement is necessary, the ADA formulated a quiz (see sidebar below) for shoppers to easily determine which areas their diets might be deficient in.

Natural Foods Merchandiser volume XXVIII/number 10/p. 32, 34