Are there different kinds of vitamins? Do they impact us differently?

Dr. Clemens: “There are water-soluble and fat-soluble vitamins. The fat-soluble vitamins are A, D, E and K. The water-soluble vitamins encompass the classic ‘B’ vitamins, vitamin C and a few others.”

What is the most common vitamin deficiency?

Dr. Clemens: “The number one vitamin deficiency, on a global basis, is vitamin A, according to WHO. Frank vitamin A deficiency is presented by night blindness, compromised skin, increased infections and elevated mortality. Data from the NHANES suggest nearly 70% of the US population does not meet the vitamin A requirement established by the Institute of Medicine.”

According to Dr. Clemens, food processing technology and food fortification programs help to decrease the vitamin A deficiency to about 30%. He also shared that many people tend to be deficient in vitamin D, the sunshine vitamin. This deficiency leads to a condition called rickets, which is poor bone formation.

However, these vitamin A and vitamin D deficiencies in the United States tend to be rare. With respect to water-soluble vitamins, the NHANES survey data suggest significant deficiencies are unusual.

So, based on this information, are there any people who are more at risk for certain vitamin deficiencies?

Dr. Clemens: “Many at-risk populations, such as the elderly, may present nutrient insufficiencies of vitamins in the ‘B’ category, particularly vitamin B6 (needed for protein metabolism), vitamin B1 (needed for energy generation), vitamin B12 (needed for many processes, including blood cell formation) and choline (need for nerve cells).”

To help explain the commonality of vitamin deficiency, we found this graph from the Center for Disease Control.

Are there any foods that I should be eating to help prevent vitamin deficiencies?

Dr. Clemens: “Key to minimize nutrient insufficiencies is to follow a balanced, diverse dietary pattern. Those who avoid dairy products are likely to present insufficient vitamin A, vitamin D, and many other nutrients. Those who avoid grains are likely to present an array of gastrointestinal challenges.”

If you’re wondering what foods you should eat to help maintain vitamin levels, good foods to eat include:

• Mushrooms
• Dairy products such as milk, cheese and yogurt
• Carrots
• Sweet potatoes
• Spinach, kale and collard greens
• Apricots
• Grain breads and cereals
• Meat, fish, poultry and eggs
• Nuts and legumes

What are other ways, besides food, to get these vitamins?

Dr. Clemens: “There are several life-stages where nutrient insufficiencies are prevalent. The primary stages include infancy, adolescence, pregnancy & lactation and elderly. Each of these is unique with respect to needs and how vitamins are absorbed and utilized. For example, prior to pregnancy and throughout pregnancy, there is an increased need for folic acid. In fact, during each stage of pregnancy, the first two months are particularly critical for nutrient adequacy. Thus, many health professionals recommend the consumption of prenatal dietary supplements that are designed specifically for pregnant women.”

Are there health issues associated with vitamin deficiency?

Dr. Clemens: “The number of health-related issues with vitamin deficiency (and even insufficiency) is vast. For example, one of the initial injections administered to newborn infants is a form of vitamin K. Vitamin K is essential for maintaining blood clotting functions. Other health-related issues are noted above. Many organizations have compiled a simple chart of vitamins and their deficiency symptoms.

Each vitamin has an important role in keeping our bodies healthy. We are more susceptible to deficiencies at certain stages of life. Eating a diverse, balanced diet helps get all the vitamins you need.

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What exactly is vitamin D and why is it important? 

Vitamin D is both a nutrient that we eat and a hormone that our bodies produce. It is a fat-soluble vitamin that is naturally present in very few foods, added to others, and available as a dietary supplement. The body also manufactures vitamin D from cholesterol, through a process triggered by the action of sunlight on unprotected skin (be careful to avoid extended exposure to sunlight without sunscreen; 5-15 minutes — depending on skin pigment — each day is all you need). Vitamin D helps ensure that the body absorbs and retains calcium and phosphorus, which are both important for building bones and helping protect against the loss of bone mass. Vitamin D has also been shown to help with cell growth, reduction of inflammation, and neuromuscular and immune function.

How much vitamin D do you need? 

The chart below shows the recommendations put forth from the Institute of Medicine in 2010; however, many vitamin D experts argue that these recommendations are not enough. The best sources of vitamin D are from sun exposure and foods containing vitamin D.

There are also several groups who are at risk of vitamin D deficiency for a number of reasons, and they may require a dietary supplement to meet their needs. These groups include:

• breast-fed infants
• older adults
• people with limited sun exposure
• people with dark skin
• people with inflammatory bowel disease and other fat malabsorption conditions
• people who are obese or who have undergone a gastric bypass surgery

It is important to have your doctor check your vitamin D levels annually to make sure you are not deficient.

What foods contain vitamin D? 

There are three ways to get vitamin D:

1. from the sun
2. from your diet
3. from supplements

Very few foods contain vitamin D naturally, but many foods are fortified with vitamin D.

So which foods naturally have the best source of vitamin D?

• salmon
• mackerel
• mushrooms (if grown under UV lights)

Other foods that contain vitamin D include:

• cod liver oil
• canned tuna or sardines
• milk or yogurt that has been fortified with vitamin D
• beef or calf liver
• egg yolks
• cheese

Be sure to check the Nutrition Facts label for vitamin D content.

_{The image “Symetrique” by fdecomite is licensed under CC BY 2.0.}

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