Micronutrients — Assessment, Requirements, Deficiencies, and Interventions

There are approximately 20 essential micronutrients, and deficiency in one or more has distinct effects on the metabolome, proteome, and genome. Since basic information about micronutrients is available in textbooks, reports on the ways in which requirements were established,1 reviews, and websites,2 the main purpose of this article is to provide an overview of current issues in micronutrient assessment, interventions, and research that are of interest to health care practitioners. In the United States, the prevalence of most micronutrient deficiencies is low. National surveys — namely, the National Health and Nutrition Examination Survey (NHANES), which assesses biochemical markers of nutritional status, as well as its interview component, What We Eat in America, which measures nutrient intakes — provide some data on micronutrient status in the general population. However, these measures are made cross-sectionally, so it is difficult both to infer causality between micronutrient deficiencies and chronic diseases and to assess the health benefits of interventions such as supplementation. In recent decades, there has been a concerted international effort to study micronutrient deficiencies and interventions in low- and middle-income countries and population groups in which the prevalence and severity of most deficiencies are highest. One third of the world’s population has one or more micronutrient deficiencies.3,4

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