CRN says 2015 dietary guidelines should include supplements

Though the dietary guidelines are food-based, research demonstrates that many Americans continue to fall short of their nutrient requirements through food consumption alone, the Council for Responsible Nutrition argued.

The Council for Responsible Nutrition urged the Dietary Guidelines Advisory Committee (DGAC) to adopt a new posture on dietary supplements in the next round of federal dietary guidelines, encouraging the use of multivitamins and supplements as a low-cost, no-calorie way to fill key nutrient gaps in most American diets. 

In two statements issued this week following last month’s public DGAC meetings on the 2015 guidelines, CRN said multivitamin or mineral supplements along with calcium and vitamin D supplements could help ensure Americans are getting enough essential nutrients, as many aren’t getting enough from their diets alone.

“Maximizing nutrition from calories consumed is a public health goal, yet government research demonstrates that many Americans continue to fall short of their nutrient requirements because consumption of vegetables, fruits, whole grains, dairy products, and seafood is lower than recommended,” CRN said in the statement, noting that 2010 DGAC flagged inefficiencies in potassium, fiber, calcium, and vitamin D in most Americans; and iron, folate and vitamin B12 for specific population groups to be significant enough to “cause public health concern.”

Citing data from the National Health and Nutrition Examination Survey, CRN argued that almost all Americans fall short of the estimated average requirement (EAR) for vitamin E, and more than half fall short of the EAR for magnesium, folate, and vitamin A. And despite that it’s relatively easy to get enough vitamin C by eating modest amounts of fruits and vegetables, almost half of Americans fall short on this common micronutrient.  

But supplementing food with fortification and dietary supplements can notably reduce the percentage of the population that falls below the EAR for all nutrients (from 51% to 4% for thiamin, 88% to 8% for folate and 93% to 60% for vitamin E), CRN argued, citing data from a 2011 Journal of Nutrition article. Moreover, supplementation with a multivitamin does not increase all-cause mortality, cancer incidence or mortality, and may even provide a modest protective benefit. 

Calcium, vitamin D supplements could result in significant health care savings

NHANES data shows that 42% and 94% of Americans 1 year of age and older consume calcium and vitamin D at levels below their respective EARs. Roughly a quarter of the US population is at risk of vitamin D inadequacy, and 8% is at risk of vitamin D deficiency.

Given that overconsumption isn’t a concern when it comes to these supplements, taking calcium and vitamin D supplements could help Americans reach adequate levels. Not only that, but the proven support for improved bone health among those who take calcium and vitamin D supplements (especially post-menopausal women) could translate to significant health care cost savings—and more specifically, ease the financial burden of osteoporosis, CRN argued.

“The annual direct health care cost of treating fractures in US women over the age of 55 with osteoporosis was over $14 billion in 2012,” CRN wrote, citing Frost & Sullivan data. “If calcium and vitamin D supplements were used at preventive daily intake levels by all US women over the age of 55 and diagnosed with osteoporosis, the net health care cost savings would average $1.52 billion per year, with cumulative potential net savings of $12.5 billion from 2013 to 2020.”

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“Enough already with the emphasis on fresh fish, fresh produce (not frozen or canned), low-fat dairy products exclusively, expensive nuts (pistachios rather than peanuts) and so on. The reality for many people is starkly different," said Adam Drewnowski, PhD, director of the Center for Public Health Nutrition at the University of Washington.

The 2015 dietary guidelines: the RD's wish list

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