This article explains the widespread issue of micronutrient deficiencies in modern diets. It also highlights causes, consequences, and strategies to address them.

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Key causes of micronutrient deficiencies in the modern diet

1. Highly processed food intake: Processed foods are often low in micronutrients and high in calories, displacing nutrient-dense options.
2. Low fruit and vegetable consumption: Not eating enough fruits and vegetables, which are rich in vitamins, minerals, and antioxidants.
3. Restrictive diets: Vegan or vegetarian diets can sometimes lack essential nutrients like vitamin B12 or iron if not carefully planned.
4. Malabsorption issues: Conditions like celiac disease, inflammatory bowel disease, and gastric bypass surgery can impair nutrient absorption.
5. Poverty and food insecurity: Limited access to diverse foods due to financial constraints.
6. Poor dietary knowledge: Lack of awareness about the importance of micronutrients and how to obtain them through diet.

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Common micronutrient deficiencies and their potential sources

1. Iron: Deficiency can lead to anaemia, common in women of childbearing age, and can be addressed by eating red meat, leafy greens, legumes, and fortified cereals.

2. Vitamin D: Deficiency can impact bone health and can be corrected by sunlight exposure, fatty fish, and fortified dairy.

3. Vitamin B12: Primarily found in animal products, deficiency can occur in vegans and individuals with malabsorption issues.

4. Folate (Vitamin B9): Important for fetal development, can be obtained from leafy greens, legumes, and fortified grains.

5. Zinc: Essential for immune function, found in oysters, nuts, seeds, and whole grains.

6. Iodine: Crucial for thyroid hormone production, can be obtained from iodized salt and seafood.

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How to correct micronutrient deficiencies:

A. Dietary modification

1. Eat a diverse diet: Include a variety of fruits, vegetables, whole grains, lean protein, and healthy fats.
2. Prioritize nutrient-dense foods: Focus on foods rich in specific micronutrients needed based on individual needs.
3. Cooking methods: Steam or roast vegetables to preserve nutrients.
4. Food fortification: Choose fortified foods like cereals and milk when appropriate

B. Supplementation

1. Consult a healthcare provider: Get tested to identify specific deficiencies before starting supplements.
2. Targeted supplementation: Take supplements based on identified deficiencies, following recommended dosage guidelines.

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Important considerations

1. Individual needs: Nutritional requirements vary based on age, sex, health status, and lifestyle.
2. Bioavailability: Consider factors that can affect nutrient absorption, like the presence of other nutrients in the diet.
3. Medical conditions: Consult a healthcare professional if you have any underlying medical conditions that might affect nutrient absorption.

Micronutrient deficiencies can be caused by either insufficient intake or impaired absorption, which can be due to infections or chronic inflammation. Micronutrient deficiencies in babies are caused by either maternal micronutrient shortages in gestation or fast postnatal growth.

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Magnitude, causes and consequences of micronutrient malnutrition

Micronutrient deficiency is a key hurdle to socioeconomic growth and adds to a vicious cycle of underdevelopment, harming already marginalised communities. It has a long-term impact on health, learning ability, and productivity.

Micronutrient deficiency incurs enormous social and public expenditures, reduces work capacity in populations due to high rates of disease and disability, and results in the terrible loss of human potential. Overcoming micronutrient deficiency is essential for promoting speedy and optimal development.

The factors which lead to micronutrient malnutrition:

• Poverty
• Lack of access to a variety of foods
• Lack of knowledge of optimal dietary practices
• High incidence of infectious diseases

Policies and programmes must be developed to assure the availability of and access to an adequate variety and quantity of safe, good-quality foods for all people of the world.

Vitamin A deficiency (VAD)

1. Primarily affects children; worldwide, some 250 million children are at risk (WHO 1992).
2. It causes night blindness and, ultimately, irreversible blindness (xerophthalmia).
3. It also causes stunted physical growth and decreased resistance to infections, resulting in high rates of illness and death among young children.
4. Every year, a quarter to half a million children go permanently blind as a result of VAD; two-thirds of these are likely to die.
5. Regular consumption of vitamin A-rich foods such as animal products, orange and yellow fruits and vegetables, dark green edible leaves, and palm oil may help prevent VAD.
6. Vitamin A deficiency, often in association with protein-energy malnutrition, principally affects preschool children.It is predicted that almost 250 million children in underdeveloped nations are at danger, with at least 2.8-3 million being clinically deficient. 

Anaemia and iron deficiency

1. It affects more than 2 billion people in virtually all countries (WHO 1992). Those most affected are women and pre-school-age children (as many as 50 per cent of whom may be anaemic), but anaemia is also seen in older children and men.
2. Anaemia in infants and children is associated with retarded physical growth, reduced resistance to infections and slow development of learning abilities. Adults experience weariness and decreased job capability, as well as reproductive dysfunction.
3. Blood loss in childbirth is very dangerous for anaemic women and is the main cause of about 20 per cent of maternal deaths. Maternal anaemia also causes foetal growth retardation, low childbirth weight, and higher perinatal mortality (death within the first week of life).
4. Iron-rich foods include dark green leafy vegetables, lentils, and red meat, as well as iron-fortified goods. However, because iron is poorly bioavailable in plant foods and red meat is expensive, preventing and treating iron deficiency anaemia is difficult, especially in industrialised countries.
5. Preschool-aged children, adolescent girls, and women of reproductive age are particularly vulnerable to iron deficiency anaemia, which affects over 2000 million people globally.

Iodine deficiency disorder (IDD)

It is a threat to more than 1.5 billion people who live in areas where the soils are iodine deficient; more than 200 million people have goitre and 20 million suffer mental impairments (resulting in a significant reduction in IQ) caused by iodine deficiency (WHO 1992).

1. IDD is the leading cause of avoidable mental impairment.
   In severe cases, it causes deaf-mutism, cretinism, and other significant illnesses, as well as reproductive impairment, which increases the likelihood of miscarriage, stillbirth, and birth abnormalities.
2. Some seafood have high levels of iodine, and adding iodine to salt is a common and successful way to avoid IDD.
3. Despite its link to poverty, not all micronutrient deficiency will be eliminated as development progresses. Some high-income
4. European countries continue to have moderate levels of IDD because effective strategies to remove it on a long-term basis have not been implemented.
5. Iodine deficiency illness affects 1500 million individuals worldwide.

Effective strategies for overcoming micronutrient deficiency exist, but they require specific, comprehensive, and cost-effective initiatives from governments to be successful. Micronutrient deficiency causes avoidable human suffering and impedes economic development, which can be greatly reduced by enhancing the nutritional quality of the food supply and educating people about appropriate dietary practices.

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How to address micronutrient deficiencies

1. Dietary modifications: Prioritise whole foods like fruits, vegetables, legumes, nuts, and lean protein sources.
2. Food fortification: Adding essential nutrients to commonly consumed foods like cereals and flour.
3. Supplementation: Consider taking supplements based on individual needs and dietary assessment.

Dietary supplementation is one of the major solutions for managing micronutrient deficiencies, as it can increase the under-consumed nutrient intake within a population and fill the nutritional gaps.

Disclaimer- The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of M3 India.

About the author of this article:  Pallavi Dubey has done a Master's in Clinical Nutrition & Dietetics, currently working as a Senior Clinical Nutritionist at Recoup Health, Bangalore.