Almost every German has a vitamin deficiency! How you can counteract it

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FOCUS online: A book of yours was recently published, the “Fact Check Dietary Supplements”. Please check out one of the most common theses on the subject: that we are now much better supplied with nutrients than our grandparents or great-grandparents. Many say that the dietary supplements thing is hype, completely exaggerated and unnecessary.

Martin Auerswald: I disagree about the better care compared to before. It’s true that when you enter a supermarket and see the variety in the fruit and vegetable department, you might think: everything is there.

Today it is not uncommon for this paradoxical situation to arise: we are overfed in terms of calories but undersupplied in terms of micronutrients.

So our grandparents and great-grandparents were often better supplied with nutrients, do you think?

Auerswald: Yes, there are several reasons for that. First of all: we are a predominantly sedentary society today. Our ancestors lived in a working society. You moved a lot more and therefore ate a lot more. Much more nutrients were absorbed simply through the amount of food consumed.

Overfed and still malnourished – that sounds strange…

Auerswald: I know. But the fact is: plant-based foods are now bred for yield, for mass and volume, not for nutrient content. This means that the nutrient density decreases. The soil is also becoming more and more depleted, thanks to artificial fertilizers, acid rain and the lack of fallow years. Even if you calculate the ideal amount of fruit and vegetables according to the textbook or even exceed it, you can have a nutrient deficiency. Another explanation for the often better supply of our ancestors is obvious: for our great-grandmothers, organic was normal. And according to numerous studies, organic is more nutritious.

Organic has been trending for some time now!

Auerswald: It feels like yes, but if you look closely you can see that the smallest part of the population eats this way. In addition, let’s not forget about the way food is processed. Overall, we are in a much worse position today than generations before us. In an average supermarket, over 80 percent of the products are classified as fast food and processed food.

That corresponds to the spirit of the times. Everything should always be available. Preservation is important for the modern lifestyle.

But preservation also existed in the past. Back then, foods were fermented. Fermentation makes the nutrients more accessible and bioavailable. This means that the nutrients are not only retained, they are sometimes even increased. As you can see, the topic is generally viewed far too one-sidedly. However, if you look a little further, you will notice a lot.

What else, for example?

Auerswald: In the past, the whole animal was used; today we call it “nose-to-tail”. It was normal to eat the whole animal, including bones and offal, which contain much more nutrients than the “fine parts” such as the fillet or steak. And the apples or strawberries didn’t come from Peru, but from the region. This meant that what was eaten was of course much fresher and also more nutritious.

But even these days you can pay attention to freshness when shopping and, for example, go to the market. If I buy regional, diverse and fresh, nutritional supplements are no longer necessary, right?

Auerswald: Actually not. I would go so far as to say that most of the population in Germany should take additional micronutrients to provide their bodies with everything they need.

That would mean that the vast majority of people have a deficiency? In addition, the benefits of dietary supplements must be clearly proven. But is that so? Even experts repeatedly advise against taking micronutrients. The reasons range from “doesn’t help” to “risky”.

Auerswald: It is simply not true that the benefits of dietary supplements have not been proven. This prejudice persists, I know. Unfortunately, there are many myths, half-truths and untruths circulating on the subject. The so-called national consumption study II was carried out in Germany between 2005 and 2015. For this purpose, around 2,000 people between the ages of 18 and 80 were intensively interviewed every year. It has been shown that most people do not manage to get enough nutrients through their diet. And in other studies and practice we see that almost every person has nutrient deficiencies in their blood. And that also applies to Germany: Studies show that almost everyone in this country has a deficiency.

Can you give examples? Where is the population underserved?

Auerswald: When it comes to vitamin D, 82 percent of men and 91 percent of women do not reach the recommended daily intake (National Consumption Study II and study by the Robert Koch Institute). 79 percent of men and 86 percent of women have vitamin B9 deficiencies. Even when it comes to vitamin C, the supply is insufficient for 32 percent of men and 29 percent of women. The situation is similar with magnesium and zinc.

When you talk about “recommended daily intake”: who are the recommendations coming from?

Auerswald: From the German Society for Nutrition (DGE).

The DGE has a reputation for being rather reserved with recommendations and for setting values ​​comparatively low…

Auerswald: Exactly – and even if you take these values, there are deficiencies in many places. Only very few people achieve the minimum of 300 mg of omega 3 fatty acids daily recommended by the DGE.

And how does a deficiency manifest itself? Will I get sick then?

Auerswald: Not directly: In technical language we differentiate between a so-called clinical and a subclinical deficiency. If there is a clinical deficiency, the body is massively undersupplied. Deficiency diseases occur. For example, scurvy occurs when the body does not receive enough vitamin C. Or rickets if there is too little vitamin D.

But such deficiency diseases are very rare in Germany, right?

Auerswald: Correct. And statements like “Germany is not a country with a vitamin deficiency” refer to this fact. That is too short-sighted. Because when it comes to subclinical deficiency, things often look completely different. It’s just that people don’t notice it at first, or little at all. You are more susceptible to infections, you don’t sleep as well, you are less productive, and you are tired and exhausted more often. That doesn’t sound so bad, but it actually means a loss of quality of life. And over a longer period of time, such a subclinical deficiency can make you sick and increases the risk of chronic diseases, which we know as diseases of civilization.

If the micronutrient deficiency in Germany has been proven by reputable studies and the public authorities are aware of it – will the logical consequence also be to take nutritional supplements?

Auerswald: Difficult point. The difference between what we know and what is recommended is sometimes large. When it comes to recommendations, public bodies in particular are quite cautious.

Why is that, what do you think?

Auerswald: Good question, one can only speculate about it. One reason is certainly a certain degree of caution. There’s a fear that people might do something wrong.

A lot helps a lot is a misconception, right?

Auerswald: Absolutely. Let’s take the classic, magnesium. The body takes as much as it needs from the intestines. What he doesn’t need ends up in the large intestine and draws water. Then magnesium can have a laxative effect. You get diarrhea. This isn’t dangerous, but it is unpleasant.

Can an overdose also be dangerous?

Auerswald: Yes. One example is iodine, which is often taken to treat thyroid dysfunction. If it is taken too quickly and in high doses and the thyroid lacks antioxidants at the same time, it can promote thyroid inflammation. Fat-soluble vitamins such as vitamin A or vitamin D can also be harmful if overdosed. However, you would have to take very large quantities for this.

Amounts that correspond to around a hundred times what the DGE recommends. With vitamin D, overdoses of 40,000 IU or more have been reported daily – the DGE currently recommends 800 IU daily for adults. However, for a healthy supply, the body needs around 3,000 to 5,000 IU. So there is a difference between what is publicly recommended, a healthy supply and an overdose.

It would probably be ideal to take nutritional supplements under the supervision of a doctor?

Auerswald: In fact, I would recommend that everyone check their micronutrient status. It’s even better if you do this once a year. However, this is quite expensive.

What kind of amount are we talking about?

Auerswald: An overview of the most important nutrients costs around 200 to 300 euros.

Do you do a complete blood count for this?

Auerswald: No, that’s not enough. It is important to analyze the whole blood for the most important nutrients, which are usually not included in the complete blood count.

What does a whole blood analysis mean?

Auerswald: Simplified: Whole blood contains both the cells and the blood plasma. If the micronutrients are only looked at in the serum, it is very inaccurate because most of the nutrients are stored in the cells. Many doctors do not like to measure nutrients in the blood because they typically have a limited laboratory budget. I would recommend going straight to a lab and having the status done there, on your own. This also saves you having to discuss the analysis with your doctor.

But how do I explain the result afterwards?

Auerswald: Some laboratories offer consultations; doctors usually work there too. Otherwise I can go to my family doctor or a nutrient therapist with the results. There are doctors and alternative practitioners who have additional training here. This makes sense for good advice.

Are there any nutrients that you would recommend to everyone even without analysis?

Auerswald: Vitamin D deficiency is, as I said, very common here in our latitudes. Especially between October and April, when we don’t produce enough vitamin D through the skin, 3,000 to 5,000 IU daily is useful for adults. I would also recommend taking Omega 3 (2 to 3 grams daily from good quality fish or algae oil). And magnesium (300 milligrams daily) and iodine (200-500 micrograms) are important.

Are there differences in quality depending on the provider?

Auerswald: In any case. The market should definitely be regulated better and more strictly, because unfortunately products do not always contain what is written on the package. Every now and then I send something to the analysis laboratory when I have a strange feeling. Unfortunately, the suspicion of “too good to be true” has already been confirmed several times.

How do I know whether a provider is reputable?

Auerswald: Often just googling the company in question is quite informative. How transparently will I be informed? Who is selling, are they real people who stand behind their products with their names? Are the ingredients stated? Can I find out where the raw materials are sourced from? I would always try to source from Germany or at least from Europe. We have comparatively lax rules, but in a country like the USA or China the rules are even more lax.