🍽️nutrition assessment review
9.3 Micronutrient Deficiency Screening
4 min read•Last Updated on July 30, 2024
Micronutrient deficiencies can seriously impact health, causing symptoms like fatigue, weakened immunity, and impaired growth. Common deficiencies include iron, vitamin A, and iodine, often resulting from poor diet, malabsorption, or increased nutritional needs during pregnancy.
Screening for micronutrient deficiencies involves dietary assessment, physical exams, and lab tests. Strategies to prevent and treat deficiencies include promoting balanced diets, food fortification, targeted supplementation, and addressing underlying health issues that affect nutrient absorption.
Micronutrient Deficiencies: Symptoms and Causes
Common Micronutrient Deficiencies and Their Symptoms
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- Iron deficiency is the most common micronutrient deficiency worldwide
- Characterized by fatigue, weakness, pale skin, and shortness of breath
- Severe iron deficiency can lead to anemia
- Vitamin A deficiency is prevalent in developing countries
- Causes night blindness, xerophthalmia (dry eyes), and increased susceptibility to infections
- Iodine deficiency disorders include goiter (enlarged thyroid gland), hypothyroidism, and impaired cognitive development in children
- Zinc deficiency is associated with growth retardation, delayed wound healing, and compromised immune function
- Vitamin D deficiency can lead to rickets in children and osteomalacia in adults
- Characterized by soft, weak bones and muscle weakness
- Vitamin B12 deficiency, common in vegetarians and the elderly
- Can cause megaloblastic anemia, neurological symptoms, and glossitis (inflamed tongue)
- Folate deficiency during pregnancy increases the risk of neural tube defects in the developing fetus
Risk Factors and Causes of Micronutrient Deficiencies
- Inadequate dietary intake is the primary cause of micronutrient deficiencies
- Often due to limited access to nutrient-rich foods or restrictive diets
- Malabsorption disorders can impair the absorption of micronutrients
- Celiac disease and inflammatory bowel disease are examples
- Certain medications can interfere with micronutrient absorption
- Proton pump inhibitors and metformin are examples
- Pregnancy and lactation increase the demand for micronutrients, making women more susceptible to deficiencies
- Chronic alcohol abuse can lead to micronutrient deficiencies
- Due to poor dietary intake and impaired absorption
- Vegetarian and vegan diets may lack essential micronutrients if not properly planned
- Vitamin B12, iron, and zinc are common deficiencies
- Older adults are at higher risk of micronutrient deficiencies
- Due to decreased absorption, reduced dietary intake, and polypharmacy
Dietary Intake of Essential Micronutrients
Dietary Assessment Methods
- 24-hour recalls, food frequency questionnaires, and food diaries can help identify inadequate micronutrient intake
- These methods provide insight into an individual's eating habits and nutrient intake over a specified period
Food Sources of Essential Micronutrients
- Animal-based foods are rich sources of iron, zinc, and vitamin B12
- Meat, poultry, fish, and eggs are examples
- Dairy products and fortified foods are important sources of calcium and vitamin D
- Fruits and vegetables provide vitamin A, folate, and vitamin C
- Dark leafy greens and orange-colored produce are particularly nutrient-dense
- Whole grains and legumes are good sources of B vitamins and minerals
- Magnesium and zinc are examples
- Iodized salt is a crucial source of iodine in many countries
- Fortified foods can help meet micronutrient needs
- Breakfast cereals and plant-based milk alternatives are examples
Micronutrient Deficiency Diagnosis: Lab Tests
Iron Deficiency
- Serum ferritin is the most sensitive and specific test for diagnosing iron deficiency
- Low serum ferritin levels (<15 μg/L) indicate depleted iron stores
Vitamin A Deficiency
- Serum retinol levels <0.7 μmol/L suggest vitamin A deficiency
Iodine Deficiency
- Urinary iodine concentration (UIC) is used to assess iodine status at the population level
- Median UIC <100 μg/L indicates insufficient iodine intake
Zinc Deficiency
- Serum zinc levels <70 μg/dL may indicate zinc deficiency
- Zinc status is difficult to assess due to homeostatic regulation
Vitamin D Deficiency
- Serum 25-hydroxyvitamin D [25(OH)D] levels <20 ng/mL (50 nmol/L) indicate vitamin D deficiency
Vitamin B12 Deficiency
- Serum vitamin B12 levels <150 pmol/L and elevated methylmalonic acid levels suggest vitamin B12 deficiency
Folate Deficiency
- Red blood cell folate levels <340 nmol/L indicate folate deficiency
Strategies for Preventing and Treating Deficiencies
Dietary Interventions
- Encourage a balanced diet with a variety of nutrient-dense foods
- Fruits, vegetables, whole grains, lean proteins, and dairy products are examples
- Fortify staple foods with essential micronutrients to improve population-wide intake
- Flour, salt, and cooking oil are common vehicles for fortification
Supplementation
- Supplement with specific micronutrients when dietary intake is insufficient or deficiencies are diagnosed
- Iron supplements are often prescribed for iron deficiency anemia
- Vitamin A supplements are used to treat and prevent vitamin A deficiency in high-risk populations
- Iodine supplementation, through iodized salt or capsules, is effective in preventing iodine deficiency disorders
Education and Screening
- Implement targeted nutrition education programs
- Promote awareness of micronutrient-rich foods and the importance of a balanced diet
- Screen high-risk populations for micronutrient deficiencies to enable early intervention
- Pregnant women, children, and the elderly are examples
Monitoring and Evaluation
- Address underlying causes of malabsorption to improve micronutrient absorption
- Celiac disease or inflammatory bowel disease are examples
- Monitor and evaluate the effectiveness of prevention and treatment strategies
- Regular assessments of micronutrient status and dietary intake are important