Modern Lifestyles, Lower Energy Intake and Micronutrient Status

Malnutrition in Western Europe? The question seems incredible, yet one-fourth of the costs caused by nutrition-related illness result at least partly from micronutrient malnutrition. The experts in this book look for the answer among recently improved data about our changing lifestyles and eating habits. They suggest that reduced calorie intake is leading to critical micronutrient status in some population groups in Western Europe. The problem stems in part from the difficulty in estimating the milder stages of undernourishment, in part from the difficulty in believing that people suffer from poor nutrition in the midst of overconsumption. The chapters specifically examine the functional consequences of the present marginal nutritional deficiency. The authors are epidemiologists, nutritionists, chemists and physicians representing nine European countries. Their contributions paint a complete picture of international expertise on micronutrient malnutrition.

1. Effects of Lifestyle on Nutrient Requirements.- Lifestyle.- Lifestyle Components.- The Epidemiological Model.- Conclusion.- 2. Effects of Special Physiological Conditions on Micronutrient Status: Pregnancy, Lactation and Ageing.- Effect of Pregnancy and Lactation of Micronutrient Status.- Effect of Ageing on Micronutrient Status.- 3. Critical Appraisal of Current Approaches Towards Micronutrient Requirement.- The Analytical Logical Approach.- The Epidemiological Approach.- The Balance Approach.- The Pragmatic Approach.- Special Considerations.- Bioavailability.- The Concept of Relative Nutritional Density.- Summary.- 4. Identification of Those Micronutrients Most Likely To Be Insufficient as the Result of Habitual Low Energy Intake.- Materials and Methods.- Results.- Discussion.- Conclusion.- 5. Biochemical Markers for Micronutrient Status and Their Interpretation.- Vitamins.- Macroelements and Trace Elements.- Discussion.- 6. The Functional Significance of Marginal Micronutrient Deficiency.- Aetiology and Micronutrient Deficiency.- Functional Significance of Marginal Micronutrient Deficiencies.- Conclusion.- 7. The Functional Significance of Marginal Micronutrient Deficiency: Vitamin C.- 8. The Functional Significance of Marginal Micronutrient Status: Folate.- The Probability of Micronutrient Deficiency.- Sequence of Events in Folate Deficiency.- Haematological Findings in Marginal Folate Deficiency.- Biological Importance and Frequency of Marginal Folate Status.- Functional Significance of Marginal Folate Deficiency.- 9. Vitamin A Deficiencies and Latent Deficiencies.- Metabolism and Function of Vitamin A.- Diagnosis of Vitamin A Deficiency.- Vitamin A Deficiency.- Conclusion.- 10. Vitamin E: The Functional Significance of Suboptimal Plasma Levels.- Cancer.- Ischaemic Heart Disease (IHD).- Discussion of Prudent Doses.- Summary.- 11. Selenium and Modern Lifestyles.- 12. Calcium: The Functional Significance of Trends in Consumption.- Modern Trends in Calcium Intakes.- International Perspective of Calcium Intakes.- Calcium Deficiency.- Adaptation or Altered Requirements?.- Calcium RDAs and the Significance of Decreased Calcium Intakes.- 13. Magnesium: Clinical Forms of Primary Magnesium Deficiency.- The Neuromuscular Forms of MDI.- Other Clinical Forms of MDI.- Conclusion.- 14. The Functional Significance of Iron Deficiency.- The Main Iron Compounds in the Body and Their Function.- Iron Metabolism.- Effects of Iron Deficiency.- Thyroid Hormone Metabolism and Thermoregulation.- Concluding Comments.- 15. Zinc: The Functional Significance of Marginal Deficiency.- The Functions of Zinc.- Indices of Zinc Status.- Zinc in Food.- Experimental Restriction of Zinc Intake in Man.- Signs of Marginal Zinc Deficiency in Primates.- Indications of Marginal Zinc Deficiency in Man.- Adaptation to Low Zinc Intake.- Conclusions.- 16. Lowered Dietary Energy Consumption and Potential Consequences for Micronutrient Intake: An Overview.- Has There Really Been a Change in Total Food Intake?.- Are Data Devised from Food Intake Measurements of Misleading Accuracy?.- Can One Automatically Link Energy Intake to a Reduced Micronutrient Intake.- Practical Implications for the Immediate Future.- Metabolic Interactions between Nutrients.- The Diagnosis of Community Nutritional Status from Intake Data.- Conclusions.- Appendix 1: Report of the Vitamins Working Group.- Appendix 2: Report of the Minerals Working Group.