Which vitamins and minerals are you most likely to be deficient in?

On nutrition blogs you will see a lot of about the macronutrients: how to set a macronutrient-tracking based diet, the benefits of optimising muscle protein synthesis, carb cycling and lots more. You don’t see so much about micronutrients, though. This is likely because the topic isn’t all that sexy; after all, it’s not like Vitamin B6 is going to get you really lean or manganese is going to help you hit your next deadlift PR. This is a shame, though, because micronutrition could indirectly be almost as important for your gains as it is for your health in general. Micronutrients play an important role in energy production, immune function and protect against oxidative stress (1), for example. You know what causes oxidative stress? Exercise, mother-lovers!

With that in mind let’s take a look at some of the most common micronutrient deficiencies, what this means for you and what you can do to avoid them.

Common micronutrient deficiencies in athletes

Having a browse around PubMed surprisingly didn’t throw up an awful lot of research in this on healthy populations, with most information on nutrient deficiencies covering people with digestive issues or populations who are under-nourished in general. With that being said, one study (3) did show an alarmingly high rate of vitamin and mineral deficiency among Coeliac sufferers due to their poor absorption rates, so it’s not like this only impacts people in extreme situations.

One problem that contributes to micronutrient deficiencies in healthy individuals is the prevalence of fad diets. One paper (9) looked at 4 popular diet plans (Atkins, South Beach, DASH and Best Life) and the mean rate of deficiency was 56.4% with the South beach diet being the worst by far. The balance of macronutrients and Calorie intakes recommended in these diets meant that the average energy intake of 1,754 kcals (which would likely be about right to illicit fat loss in most of the people that these things are targeted towards) provided far fewer micronutrients than would be needed. In fact, the calorie level needed to be as high as 3,475 kcals per day to hit RDIs of all of the essential micronutrients if food choices stayed the same. This would then be too high to be either healthy or effective for weight loss in the vast majority of people, rendering the diets a potentially dangerous option.

What about people like you? According to medscape.com the most commonly found micronutrient deficiencies in athletically active individuals (who aren’t necessarily on restrictive diets) are as follows:

B vitamins

Thiamin, Riboflavin, Niacin, Vitamin B6, Pantothenic Acid, Biotin, Folate, Vitamin B12 are important for energy release and the repair of muscle fibres, so it stands to reason that an athlete should have plenty of these. That said, there is sparse evidence that supplementing with these improve physical performance, unless of course, supplementation simply corrected for a dietary deficiency – so don’t start superdosing expecting dramatic improvement (1).

Then, as many know – Seeing as B12 is almost impossible to source at RDI quantities in vegan diets, it is recommended that vegans (not just vegan athletes) supplement with vitamin B12 (10).

Vitamin D

This is widely reported to be deficient in many populations (1,4,5,6). Not surprisingly this is most problematic among Caucasian populations living above the equator due to the lack of direct sun exposure. Populations in the north west of Russia, for example, showed a 45.7% rate of deficiency, with obese populations at higher risk (4) primarily because Vitamin D can be absorbed into fat tissue, and an excess of adipose leads to some Vitamin D being sequestered. Those who don’t live in colder climates aren’t automatically immune, though; vitamin D deficiency has also been observed in general populations in South Asian and Middle Eastern communities (6) and non-white second-generation immigrants in Holland (5). Caucasians should exercise caution if aiming for vitamin D from sun exposure due to the risk of skin cancer, but it has been observed that exposure long enough to induce mild sunburn raised serum levels of vitamin D to between 10 and 20,000iu (6). One of the most important factors associated with vitamin D deficiency is reduced bone density, an obvious hindrance for active people. Athletes who are based in northern latitudes or who train mostly in doors should definitely supplement with vitamin D (1).

Antioxidants

Antioxidants help to reduce that previously mentioned oxidative stress from exercise and/or infection. The main antioxidants that are most useful for athletes are vitamins C and E, β-carotene, and selenium. These help to fortify and protect the cell membranes and so can prevent damage being caused (1). Evidence suggests that supplementation with high doses of these can impair muscle growth because oxidative stress is an important driver for hypertrophy – but those not getting enough of these from their diet would be extremely wise to consider correcting a deficiency. Just because too much is a bad thing, doesn’t mean that a proper amount is, too.

Minerals

The most common mineral deficiencies are calcium, iron, zinc, and magnesium, particularly among females and those on a diet low in animal products. However, adequate consumption of red meats, organ meats, dairy, shell fish, nuts, seeds and wholegrains should be good enough to avoid deficiencies (2). Although one review (11) did show a considerable issue with magnesium among adult populations in the United States, where 48% of adults tested were getting less than the RDI for magnesium a day. This was largely due to the amount of low nutritive processed foods consumed.

Something that could cause you a few problems if you sweat a lot during training is electrolyte balance. When you perspire you secrete electrolyte minerals sodium, potassium, magnesium and calcium. This is why you will see Chris Froome and co chugging down litres of coloured water during the Tour De France. Or why American footballers pour buckets of Gatorade over the coach’s head (that’s a joke, please don’t start showering yourself in sticky sports drinks).

Is food the answer?

The key thing to remember is energy balance. If you are in a negative energy balance this will likely reduce your level of performance and recovery and if anything, you should probably be eating in a very slight surplus during competition to get the best out of your body. Eating adequate protein is also necessary and then, plenty of coloured vegetables, fruit, wholegrains and pulses. It has been incorrectly stated that a moderate to high fibre diet can impair nutrient absorption but in fact, a high fibre diet is not only ‘not’ contraindicated for micronutrient absorption; it may even improve absorption of available micronutrients and help prevent deficiencies (7). Based on that, we would say eat the rainbow, in fact, eat a wide and high volume of plant foods. There is more to an athlete’s diet than chicken and rice.

Should you take a multi-vitamin and mineral supplement?

If you happen to be in an energy deficit, or under a high work load the chances of you getting enough of all the important micronutrients from just food alone, especially if you are having to consume a lot of drinks, shakes and gels then yes, use a supplement. There is a strong argument that one should only supplement with the specific nutrients that one is deficient in but this would require laboratory testing that is prohibitively expensive. With this in mind, no problems are associated with supplementation of multi vitamin and minerals that contain in excess of 10 micronutrients (8). If you are following a restrictive diet, like those mentioned earlier in this text, the authors of that study recommend the following:

In conclusion, this study recommends that all individuals, particularly those following a popular diet plan, would benefit from and should take a daily multivitamin supplement to fill the nutritional gap between where their whole food diet leaves off and micronutrient sufficiency is achieved. (Calton JB, 2010).

Further to this there is evidence that a high dose of up to six grams of omega 3 fish oils can help to reduce muscle soreness (12). Most people don’t eat more than one or two portions of oily fish per week, so a supplement is worth considering and it you want to hit that upper limit of 6g you HAVE to supplement.

Our sister company, Awesome Supplements have a great option in Daily Dose which contains evidence based dosages of all the essential vitamins and minerals including a therapeutic dose of vitamin D and 2g of high quality EPA and DHA for your omegas.

Click here to check out the product page for Awesome Supplements.

So, in summary; eat the rainbow, eat the right balance of macronutrients, eat enough fibre to ensure optimal absorption, track your calories to ensure you are in energy balance when needed, then consider a multi to support your health.

Simple!

References

1. Medscape. (2017). Nutrition and Athletic Performance. [online] Available at: https://www.medscape.com/viewarticle/717046_8 [Accessed 29 Nov. 2017].
2. nhs.uk. (2017). Vitamins and minerals. [online] Available at: https://www.nhs.uk/conditions/vitamins-and-minerals/ [Accessed 28 Nov. 2017].
3. Wierdsma NJ, van Bokhorst-de van der Schueren MAE, Berkenpas M, Mulder CJJ, van Bodegraven AA. Vitamin and Mineral Deficiencies Are Highly Prevalent in Newly Diagnosed Celiac Disease Patients. Nutrients. 2013;5(10):3975-3992. doi:10.3390/nu5103975.
4. Karonova, T., Andreeva, A., Nikitina, I., Belyaeva, O., Mokhova, E., Galkina, O., Vasilyeva, E. and Grineva, E. (2016). Prevalence of Vitamin D deficiency in the North-West region of Russia: A cross-sectional study. The Journal of Steroid Biochemistry and Molecular Biology, 164, pp.230-234.
5. Huibers, M., Visser, D., Deckers, M., van Schoor, N., van Furth, A. and Wolf, B. (2013). Vitamin D deficiency among native Dutch and first- and second-generation non-Western immigrants. European Journal of Pediatrics.
6. Alshishtawy MM. Vitamin D Deficiency: This clandestine endemic disease is veiled no more. Sultan Qaboos University Medical Journal. 2012;12(2):140-152.
7. Rattan, J., Levin, N., Graff, E., Weizer, N. and Gilat, T. (1981). A High-Fiber Diet Does Not Cause Mineral and Nutrient Deficiencies. Journal of Clinical Gastroenterology, 3(4), pp.389-394.
8. Ward E. Addressing nutritional gaps with multivitamin and mineral supplements. Nutrition Journal. 2014;13:72. doi:10.1186/1475-2891-13-72.
9. Calton JB. Prevalence of micronutrient deficiency in popular diet plans. Journal of the International Society of Sports Nutrition. 2010;7:24. doi:10.1186/1550-2783-7-24.
10. How prevalent is vitamin B(12) deficiency among vegetarians? Nutr Rev. 2013 Feb;71(2):110-7. doi: 10.1111/nure.12001. Epub 2013 Jan 2.
11. Rosanoff, A., Weaver, C. and Rude, R. (2012). Suboptimal magnesium status in the United States: are the health consequences underestimated?. Nutrition Reviews, 70(3), pp.153-164.
12. Frank, K., Patel, K., Lopez, G. and Willis, B. (2017). Fish Oil Research Analysis. [online] Examine.com. Available at: https://examine.com/supplements/fish-oil/ [Accessed 30 Nov. 2017].