You may have heard it said that Americans are “Overfed and Undernourished” (apparently there is a 2014 film by this title; we’ll have to check it out). As a nation, we have access to abundant calories per person and obesity rates have soared to unprecedented levels.

And yet, most Americans fall short on meeting the daily required intake of multiple nutrients. A 2015 Report from the US Department of Health and Human services reveals that most Americans do not consume adequate amounts of:
• Vitamin A
• Vitamin D
• Vitamin E
• Folate
• Vitamin C
• Calcium
• Magnesium
• Fiber
• Potassium
• Iron (females from their teens through menopause).

Two things are vital to understanding this information:

1) The Recommended Daily Allowance (RDA) and Recommended Daily Intake (RDI) are values determined to prevent deficiency in 97.5% of individuals. A key phrase here is prevent deficiency. For example, consuming the RDI for Vitamin C should prevent development of vitamin-c-deficiency neutropenia (low white blood cells) in 97.5% of the population.

Note: even if 100% of a given population is achieving 100% of the RDA or RDI, 2.5% of the population would still suffer from nutritional deficiency related disease and disability.

2) The values used to identify the nutrients above were even lower than the RDI. The Estimated Average Requirement (EAR) is defined as “the nutrient intake value estimated to meet the requirement of half the health individuals in a group.
That is, if 100% of a given population achieves 100% of the EAR, HALF the population could still suffer from nutrient-deficiency-related disease.

To end up on the nutrient list above, Americans on average are consuming less than the amount required to keep just 50% of our population healthy! One has to wonder how much longer that list would be if it held our nation to higher health standards.
One more term useful to know: Tolerable Upper Intake Level. The Tolerable Upper Intake Level (UL) is like the inverse of the RDA: it is the upper daily intake level at which no risk of adverse health effects are expected for most health individuals of a specific life-stage group. So, if 100% of individuals consumed less than the UL each day, we would expect no one to have a negative reaction from too much of that nutrient.
For some nutrients, the adverse health effect is a relatively mild one. The UL for Vitamin C, for example, is set at 2000mg/day for adults. This is to prevent loose stools in 100% of individuals. Many people consume Vitamin C in excess of 2000mg per day without any adverse effects. There are many nutrients for which no UL is established because they are well tolerated even in large amounts.

Is it possible that there is a difference between the minimum nutrient intake required to prevent signs of deficiency, and the amount required in order to optimize the health and function of one’s body? We say, Yes! There is a spectrum of health between disease and optimal wellness; preventing one is not the same as achieving the other. We will look at this more closely in other articles in this series.

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