Posted on 28 August 2020
We all know that it is important to eat lots of fruits and vegetables so that we can get all the necessary vitamins and minerals. We also know that vitamin deficiencies can result in sickness, frailty, and eventually death.
The most common diseases resulting from vitamin deficiency are beriberi, rickets, scurvy and pellagra. Severe vitamin deficiencies have been mostly overcome in developed countries. However, there is a milder but less studied version of vitamin deficiency known as vitamin insufficiency. Vitamin insufficiency happens as we get older and do not get enough vitamins through our food, or cannot absorb enough vitamins due to our ageing gut.
Vitamin insufficiency increases the risk of various diseases – Vitamin D insufficiency leads to bone fractures and a reduction in bone and muscle mass, while B12 insufficiency increases our risk for cardiovascular diseases and cognitive impairment. However, as vitamin insufficiencies don’t cause obvious symptoms in the way deficiencies do, they are not diagnosed and receive little attention.
In this review paper researchers from Japan analysed the complete list of clinical outcomes that are associated with vitamin B and D insufficiencies in people as they grow older.
Researchers found that as we get older, vitamin D insufficiency increases our risk of fracture, falls, coronary heart disease, cancer, and respiratory tract infections. Researchers also found that vitamin B1 insufficiency increases risk of heart failure, while vitamin B6 insufficiency increases risk of impaired physical function and cognitive decline. Finally, vitamin B9 (folate), and B12 insufficiencies are linked to increased risk of cardiovascular diseases, especially strokes, and fractures. The researchers suggest that much higher doses of vitamins are required to treat vitamin insufficiencies as we get older.
Correcting insufficiency requires a much higher vitamin dosage than preventing deficiency does, but its prevention could have significant clinical implications. For example, the authors of the paper note that in Japan, most fractures occur in the medium to low risk population (since even though their individual risk is low, there are many more people at medium or low risk). Treating this population with drugs is not a viable strategy considering the poor cost-effectiveness and risk of side effects.
Vitamin supplementation could provide a solution in these types of situations by addressing insufficiencies and reducing the risk of various chronic diseases.
Insufficiency of B vitamins with its possible clinical implications: doi: 10.3164/jcbn.20-56
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