Micronutrient status and intake in the UK – where might we be in 10 years' time?

Abstract

Poor dietary choices not only manifest in obesity, which is currently the main public health focus in the UK, but can also lead to inadequate micronutrient intakes, with implications for health. Recent dietary survey data and measurements of status biomarkers have highlighted folate, vitamin D, calcium, iron and iodine to be amongst the micronutrients of most concern for particular subgroups of the UK population. Those most vulnerable to inadequate intakes of these micronutrients include adolescents, ethnic minorities and lower socioeconomic groups. Teenage girls and women of childbearing age are of particular concern because of their high requirements for some micronutrients and the impact poor micronutrient intakes can have on the health of their offspring. Yet, compared to other food concerns, relatively little importance seems to be given by consumers to the micronutrient density of foods. This review explores different factors that may influence micronutrient intakes and status over the following decade and beyond. Over the next few years, it is likely that the micronutrients of concern remain similar, although continuation of dietary trends could result in further decreases in iron and calcium intakes. In an obesogenic and sedentary environment, where many people are being encouraged to reduce their energy intakes, increasing the micronutrient density of the diet is essential to prevent a concurrent decrease in micronutrient intake. Investment in fortification policies/practices or sustained government programmes aimed at raising awareness of micronutrients of most concern or encouraging supplementation, for example focusing on folate and vitamin D, could considerably improve population micronutrient intakes. Over the longer term, with sufficient investment in research and support from healthcare professionals and the food industry, adequate micronutrient intakes could be achieved across the UK population. However, global food security issues, including retaining food supply in response to an increase in demand for food, energy and water, and changing climate, could potentially hamper these efforts.

Rising use of “food aid” in the United Kingdom

“…The in-depth narrative interviews conducted for Dowler and Lambie-Mumford (2014) supported these findings, identifying two key sets of triggers for food aid uptake for those interviewed: first, where people were highly vulnerable and with precarious housing circumstances; and second, where people were experiencing financial difficulty as a result of changes to their social security benefits, which involved either their experiencing a complete absence of income (because of sanctions [2] or errors), or sudden increased outgoings as a result of changes to housing benefit and council tax benefit. Indebtedness was another key factor in people's struggles to balance their budgets more generally; interviewees described juggling rent and council tax arrears and their need to take out short terms loans from so-called "loan sharks" or "payday lenders" [3].…”

The balanced diet – why so difficult to achieve?

“…National Diet and Nutrition Survey ( NDNS ) data suggest that this period is associated with an increased risk of inadequate intakes of several micronutrients, including potassium, magnesium, iodine, selenium, zinc, vitamin A and folate, as well as iron and calcium amongst some teenage girls (Miller et al . ).…”

“…As Miller et al . () observe, dietary needs are increased during adolescence, coinciding with a time when dietary quality is often poor because of developing autonomy in eating behaviour. National Diet and Nutrition Survey ( NDNS ) data suggest that this period is associated with an increased risk of inadequate intakes of several micronutrients, including potassium, magnesium, iodine, selenium, zinc, vitamin A and folate, as well as iron and calcium amongst some teenage girls (Miller et al .…”

“…Returning to the current situation in the UK, such a narrow, single ingredient focus also risks throwing the proverbial 'baby out with the bathwater'in this case, failing to embrace the very real issues of micronutrient insufficiencies that exist in the UK populationnotably for folate, vitamin D, calcium, iron and iodine, and for which public awareness is surprisingly low (Miller et al 2016). Whilst the focus on sugar as part of the government's obesity strategy in children and in particular measures to reduce sugar intake as a means of reducing overweight and obesity in young people are clearly of importance, the issue of micronutrient intake must not be overlooked.…”

“…Whilst the focus on sugar as part of the government's obesity strategy in children and in particular measures to reduce sugar intake as a means of reducing overweight and obesity in young people are clearly of importance, the issue of micronutrient intake must not be overlooked. As Miller et al (2016) observe, dietary needs are increased during adolescence, coinciding with a time when dietary quality is often poor because of developing autonomy in eating behaviour. National Diet and Nutrition Survey (NDNS) data suggest that this period is associated with an increased risk of inadequate intakes of several micronutrients, including potassium, magnesium, iodine, selenium, zinc, vitamin A and folate, as well as iron and calcium amongst some teenage girls (Miller et al 2016).…”