Investigations carried out by Dr Paul Clayton identified the difference between the nutrients that the average population obtains from food and the levels required for optimum health. We refer to this difference as “the nutrition gap.” The nutrition gap can have a detrimental effect on health and susceptibility to disease and can increase the risk of many conditions as well as accelerating chronic disease and ageing.¹

Additionally, Professor Bruce Ames hypothesised that if you are depleted in just one nutrient, your body will go into a triage response where it will favour survival over long term health. This means that you can be at an increased risk of early ageing and chronic disease, but it would leave critical metabolic functions, such as ATP (energy) production, intact. He states that “A multivitamin-mineral supplement is one low-cost way to ensure intake of the Recommended Dietary Allowance of micronutrients throughout life.”²

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The National Nutrition and Diet Survey In 2014 by the Scientific Advisory Committee for Nutrition (SACN) reported that there were nutrient deficiencies across all groups of the population, particularly in children and the elderly.³ More recent reports have also supported this.

So, is this deficit of nutrients simply because we choose unhealthy foods? The answer is no. Unfortunately, it is very difficult to obtain optimum levels of nutrients from diet alone, even when eating healthily. There are a variety of reasons for this:

Sedentary lifestyle - Our ancestors expended about 4000 calories as opposed to an average of 2000 today therefore they consumed a greater amount of food to meet their energy requirements. As we are actually now consuming fewer calories we are also consuming fewer micro nutrients (e.g. vitamins and minerals). So, we are overfed and undernourished.

Modern farming methods – soil depletion, transport, storage, GMOs and deep ploughing all effect the nutrient content of food.

Food choices – we often choose calorie dense but nutrient poor foods. A significant factor in the nutrition gap is our food choices. Many people’s diets are high in refined, processed foods that offer low nutrient density and empty calories. In addition, studies have shown that the levels of nutrients in our foods have changed. So even those who aim to eat a diet focussed on wholefoods may not be achieving optimal intake of certain nutrients – because intensive farming and other factors has resulted in reduced nutrient content of foods.

Food processing- processing of food severely depletes nutrient content i.e. milling of flour reduces calcium, magnesium, zinc and folate or damages the structure of the nutrient e.g. high temperature and pressure, during production of food such as margarine, converts unsaturated fat to trans fats.

Lifestyle choices –many aspects of lifestyle deplete certain nutrients:

• Smoking - reduces vitamin C and beta-carotene. Cadmium (found in cigarettes) reduces the bioavailability of selenium and zinc. It is also associated with reduced levels of most B vitamins.⁴
• Alcohol – severe alcohol consumption is associated with a deficiency of most nutrients. Of most significance it inhibits the absorption and usage of vital nutrients such as thiamine (vitamin B1), vitamin B12, folic acid, and zinc. It also reduces vitamin C, magnesium, and the ability to utilise vitamin D.⁵
• Medications – medication affects absorption, usage and excretion of many nutrients, here are some of the main medications which are linked to nutrient deficiencies.⁶
  • PPPIs - B12; plus minerals, other vits
  • Statins - COQ10
  • Antibiotics – gut bacteria, vits B & K
  • NSAID’s - folic acid, iron, vit C
  • Benzodiazepines - melatonin
  • Bronchodilators (asthma) albuterol – potassium
• Stress – indirectly stress can affect levels of many nutrients but again of most significance is magnesium, vitamin C, B5, B6 and zinc.⁷

Poor digestive health- this will reduce our ability to absorb nutrients. Our nutritional status is not only reliant on what we eat but what we are able to digest and assimilate. Absorption occurs and multiple sites along the digestive tract. Adequate stomach acid is essential for cleaving mineral from its chelated molecule in order to be absorbed, it is also needed to activate proteases for protein absorption. So, if stomach acid is reduced this had a direct impact on nutrient availability. Likewise, fat soluble nutrients such as vitamins A, D, E and K need adequate bile and lipase for emulsification and absorption.

Genetic – certain genetic mutations known as single nucleotide polymorphisms (SNPs) can increase your need for certain nutrients e.g. MTHFR (methylfolate), MTRR (B12), VDR (vitamin D). The best way to determine this is through a genetic test which can be arranged by a qualified practitioner or independently.

Consequences of the nutrition gap:

We have all heard of deficiency diseases such as scurvy for vitamin C, rickets for vitamin D and anaemia for iron deficiency. However, it tends to be assumed that as long as we do not have a deficiency disease that levels of nutrients are adequate. This is not the case. There are millions (well trillions and trillions) of pathways and reactions that occur in the body every day. Each of which requires nutrients to function. Therefore, if we have suboptimal levels of even one nutrient the activity of these reactions is impaired. Optimum levels of nutrients mean that every pathway in the body has the ingredients it needs to function optimally.

As both Dr Paul Clayton and Professor Bruce Ames have stated, there is an increased risk of long-term chronic conditions with sub-optimal intake of nutrients over a lifetime. Dr Paul Clayton hypothesised that we should be living to about the age of 120,¹ but we are developing chronic conditions long before that, which shortens our life expectancy. These dysfunctions which occur over 50+ years are theorised to be due to a cumulative depletion of many micronutrients which is constantly chipping away at our body’s ability to function smoothly, eventually leading to a significant problem. A bit like running a car which is never serviced, low on oil and running on poor quality fuel, eventually it will fail.

As these suboptimal levels of essential nutrients are rarely identified in individuals (as generally only serum levels of nutrients, not cellular, are tested if they are tested at all) it is almost impossible to identify specific nutrient inadequacies which cause chronic conditions and it will differ among individuals. However, there are many associations between chronic diseases and sub optimal nutrients.

A good example of this is with the increased severity of COVID-19 infections, associated with inadequate levels of vitamin D and selenium:

Summary of vitamin D3 in relation to COVID-19^8–11

• Research suggests SARS-Cov-2 virus enters cells via ACE2 Coronavirus viral replication downregulates ACE2 dysregulating the renin-angiotensin system (RAS) and leads to a cytokine storm) in the host, causing Acute Respiratory Distress Syndrome (ARDS)
• Research shows that Vitamin D acts to rebalance RAS and attenuates lung injury
• Research shows that Vitamin D supplementation increases immunity and reduces inflammatory responses and the risk of acute respiratory tract infection
• Vitamin D deficiency is strongly associated with ARDS and poor mortality outcomes, as well as being associated with many comorbidities associated with Covid-19 case fatalities
• High dose oral Vitamin D has been shown to improve mortality in patients with severe vitamin D deficiency
• Chronic vitamin D deficiency induces lung fibrosis through the activation of the RAS
• Adequate vitamin D is critically important for the activation of T-cells from their inactive naïve state. The importance of T-cells in fighting SARS-CoV-1 and establishing immune memory has been well documented.¹²

Summary of selenium in relation to COVID-19^13-14

• Selenium is a micronutrient which is essential for normal immune function and acts as an antioxidant.
• It has shown to reduce oxidative stress damage in lung tissue when placed under excess stress.
• Studies looking at recovery from Covid-19 in different areas of China has found a strong correlation between recovery and selenium status. The areas of china with the highest selenium status were more likely to recover than those in selenium deficient areas. Researchers found that the Covid-19 cure rate was significantly associated with selenium status, as measured by the amount of selenium in hair, in 17 cities outside of Hubei.

These have the strongest evidence behind them currently, however other nutrients are important as well see our blog 'Coronavirus: a review of nutrients'.
While the Covid-19 pandemic is a good example of the impact of nutritional deficiencies on health and our ability to protect ourselves, it is relevant to all aspects of health. There has been a different epidemic across western society, for a number of years, of poor health related to long term, chronic metabolic disorders. Not only do these reduce both the quality of life and life expectancy but also put us at a greater risk of complications of Covid-19. The time is therefore overdue to start to consider how we can support our long-term wellness.

When supporting long term health and wellness it is therefore advisable to ensure that there is an optimum intake of all nutrients every day. The easiest and most efficient way of doing this is with a multi vitamin and mineral. However not all multis are made equally. It is important to ensure that a multi vitamin and mineral is formulated to elevate intake to optimum and that those nutrients are in a bioavailable form.

Cytoplan specialise in Wholefood and Food State™, the principle of this is that nutrients are presented to the body in the same form that they are found in food. These forms of nutrients have been demonstrated to be highly bioavailable and well tolerated. In addition, Cytoplan’s multi vitamin and minerals are formulated to bridge the nutrition gap, ensuring optimum intake.

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If you have questions regarding the topics that have been raised, or any other health matters, please do contact me (Helen) by phone or email at any time. helen@cytoplan.co.uk 01684 310099 Amanda Williams and the Cytoplan Editorial Team

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References

1. Clayton, P (2004) Health Défense. 2^nd
2. Ames BN (2006) ‘Low micronutrient intake may accelerate the degenerative diseases of aging through allocation of scarce micronutrients by triage’, Proc Natl Acad Sci U S A. Nov 21;103(47):17589-94.
3. https://www.gov.uk/government/collections/national-diet-and-nutrition-survey
4. Preston AM. Cigarette smoking-nutritional implications. Prog Food Nutr Sci. 1991;15(4):183-217. PMID: 1784736.
5. https://pubs.niaaa.nih.gov/publications/arh27-3/220-231.htm
6. https://www.drugs.com/drug_interactions.html
7. Martineau AR, Jolliffe DA, Hooper RL, et al. Vitamin D supplementation to prevent acute respiratory tract infections: Systematic review and meta-analysis of individual participant data. BMJ. 2017;356. doi:10.1136/bmj.i6583
8. Hoffmann M, Kleine-Weber H, Krüger N, Müller M, Drosten C, Pöhlmann S. The novel coronavirus 2019 (2019-nCoV) uses the SARS-coronavirus receptor ACE2 and the cellular protease TMPRSS2 for entry into target cells. bioRxiv. 2020:2020.01.31.929042. doi:10.1101/2020.01.31.929042
9. Jiménez-Sousa M ángeles, Martínez I, Medrano LM, Fernández-Rodríguez A, Resino S. Vitamin D in human immunodeficiency virus infection: Influence on immunity and disease. Front Immunol. 2018;9(MAR). doi:10.3389/fimmu.2018.00458
10. Mithal A, Wahl DA, Bonjour JP, et al. Global vitamin D status and determinants of hypovitaminosis D (Osteoporosis International DOI:10.1007/s00198-009-0954-6). Osteoporos Int. 2009;20(11):1821. doi:10.1007/s00198-009-1030-y
11. Covid-19 and Vitamin D Information - 2 Page Summary - Google Docs. https://docs.google.com/document/d/10peHD1jG-xAGj5Lzu6f43RB7cv5QeePasw05AGZrjKg/edit. Accessed April 27, 2020.
12. https://www.bmj.com/content/370/bmj.m3563
13. Association between regional selenium status and reported outcome of COVID-19 cases in China. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7197590/. Accessed May 13, 2020.
14. Link identified between dietary selenium and outcome of Covid-19 disease | University of Surrey. https://www.surrey.ac.uk/news/link-identified-between-dietary-selenium-and-outcome-covid-19-disease. Accessed May 13, 2020.

Further reading about alohol detox can be found here.