Medical Compass: Reversing the nutrient deficit

Can increasing your nutrient consumption improve your quality of life?

By David Dunaief, M.D.

What percent of U.S. adults do you think meet the daily requirements for vegetable intake? How about for fruit intake?

According to a 2022 report by the Centers for Disease Control and Prevention (CDC), an average of 10 percent of U.S. adults meet vegetable intake recommendations, and only 12.3 percent meet the daily requirements for fruit intake (1). That’s abysmal. As you might expect, it follows that we are deficient in many key micronutrients (2).

Why should we care? Fruits and vegetables include fiber, along with critical nutrients and micronutrients that reduce our risks of developing chronic diseases.

Many chronic diseases can be prevented, modified and even reversed by focusing on increasing our nutrients.

Do you want another stunning statistic? More than 50 percent of American adults have one chronic disease, and 27 percent have more than one (3). This is a likely contributor to the slowing pace of life expectancy increases in the U.S., which have plateaued in the past decade.

How do you know if you’re getting enough nutrients? One indicator that we can measure is carotenoid levels. Carotenoids are incredibly important for tissue and organ health. I measure my patients’ levels regularly, because they give me a sense of whether the patient might be low in potentially disease-fighting nutrients. A high nutrient intake dietary approach can increase both carotenoid and other critical nutrient levels.

What is a high nutrient intake diet?

A high nutrient intake diet focuses on micronutrients, which literally means “small nutrients.” Micronutrients are bioactive compounds found mostly in foods and in some supplements. They interact with each other in synergistic ways, meaning the sum of them is greater than their parts. Diets that are plant-rich can raise your micronutrient levels considerably.

While fiber is not considered a micronutrient, it also has significant disease modifying effects. A high nutrient intake diet will also increase your fiber intake, adding to the benefits.

A 2017 study included 73,700 men and women who were participants in the Nurses’ Health Study and the Health Professionals Follow-up Study. During the study, participants’ diets were rated over a 12-year period using three established dietary scores: the Alternate Healthy Eating Index–2010 score, the Alternate Mediterranean Diet score, and the Dietary Approaches to Stop Hypertension (DASH) diet score (4).

A 20 percent increase in diet scores, which indicated improved diet quality, was significantly associated with reducing total mortality by 8 to 17 percent, depending on whether two or three scoring methods were used. Participants who maintained a high-quality diet over a 12-year period reduced their risk of death by 9 to 14 percent more than participants with consistently low diet scores. By contrast, worsening diet quality over 12 years was associated with an increase in mortality of 6 to 12 percent. As expected, longer periods of healthy eating had a greater effect than shorter periods.

This study reinforces the findings of the Greek EPIC trial, a large, prospective cohort study, where the Mediterranean-type diet decreased mortality significantly — the greater the participants’ compliance, the greater the effect (5).

Can diet improve your quality of life?

Quality of life is as important as longevity. Let’s examine some studies that consider the impact of diet on diseases that may reduce our quality of life as we age.

A study showed olive oil reduces the risk of stroke by 41 percent (6). The authors attribute this effect partially to oleic acid, a bioactive compound found in olive oil. While olive oil is important, I recommend limiting consumption to one tablespoon a day. If you eat too much of even good fat, it can be counterproductive. The authors commented that the Mediterranean-type diet had only recently been used in trials with neurologic diseases and results suggest benefits in several disorders, such as Alzheimer’s disease.

In a case-control study that compared those with and without disease, high intake of antioxidants from food was associated with a significant decrease in the risk of early Age-related Macular Degeneration (AMD), even when participants had a genetic predisposition for the disease (7). AMD is the leading cause of blindness in those over age 54 (7).

Of the 2,167 people enrolled in the study, representing several different genetic variations that made them high risk for AMD, those with the highest nutrient intake, including B-carotene, zinc, lutein, zeaxanthin, EPA and DHA- substances found in fish, had an inverse relationship with risk of early AMD. Nutrients, thus, may play a role in modifying how their genes were expressed. 

Though many Americans are malnourished, increasing our nutrient consumption can improve our outcomes. With a focus on a high nutrient intake diet, we can improve life expectancy and, on an individual level, improve our quality of life.

References:

(1) cdc.gov. Morb Mortal Wkly Rep 2022;71:1–9. (2) cdc.gov/nutritionreport (3) cdc.gov. (4) N Engl J Med 2017; 377:143-153. (5) BMJ. 2009;338:b2337. (6) Neurology June 15, 2011. (7) Arch Ophthalmol. 2011;129(6):758-766.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.