However, micronutrient inadequacies — defined as nutrient intake less than the
EAR — are common in the United States and other developed countries. Such inadequacies may occur when micronutrient intake is above the level associated with deficiency but below dietary intake recommendations
(17).
In contrast to micronutrient deficiencies that result in clinically overt symptoms, micronutrient inadequacies may cause covert symptoms only that are difficult to detect clinically.
For example, micronutrient inadequacies could elicit symptoms of general fatigue
(18), reduced ability to fight infections
(19), or impaired
cognitive function (i.e., attention [concentration and focus], memory, and mood)
(19). Micronutrient inadequacies may also have important implications for long-term health and increase one’s risk for
chronic diseases like
cancer (17, 20),
cardiovascular disease (20), type 2
diabetes mellitus (21),
osteoporosis (20, 22), and age-related eye disease
(23).
Many Americans are not reaching micronutrient intake requirements from food alone
(24, 25), presumably due to eating an energy-rich, nutrient-poor diet. About 75% of the US population (ages ≥1 year) do not consume the recommended intake of fruit, and more than 80% do not consume the recommended intake of vegetables
(1). Intakes of
whole grains are also well below current recommendations for all age groups, and dairy intake is below recommendations for those ages 4 years and older
(1).
The 2015-2020 Dietary Guidelines for Americans highlighted the nutrients that are underconsumed in the US population, i.e., "shortfall nutrients," labeling a few as "nutrients of public health concern" because low intake may lead to adverse health effects: Vitamin D (adverse health effect: osteoporosis), calcium (osteoporosis), potassium (
hypertension and cardiovascular disease), dietary fiber (poor colonic health), and iron (
anemia in young children, women of childbearing age, and pregnant women) were such labeled
(1). Other nutrients, including vitamins A, C, and E; choline, and magnesium, were identified as also being underconsumed by the US population.