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What is the Nutrition Gap?

Published on Apr 30, 2015
Authored by Alpa Shah, MS, RD

With the way most Americans eat today there is a troublesome gap between the nutrients we need and those we actually consume. In fact, most diets today are lacking in many essential vitamins and minerals.

The typical American diet exceeds recommendations for things like refined grains, sodium (salt), saturated fats and calories and falls short of important nutrients such as fiber, potassium, vitamin D, and calcium leading to what we call the “nutrition gap”. So, while we may get plenty of calories and look well fed, over time the absence of essential nutrients may ultimately lead to negative consequences. Nutritional deficiencies can also occur due to lifestyle behaviors or the presence of a chronic disease or condition.

Some call this lack of nutrition in our diets the “nutrition gap”; others call it “hidden hunger” or “micronutrient deficiency”. Whatever the name, the nutrition gap is a public health concern because it occurs across all age groups, and can negatively affect health.

Are You Getting Enough Essential Nutrients?

Every 5 years the U.S. Department of Agriculture (USDA) and U.S. Department of Health and Human Services (HHS) updates Dietary Guidelines for Americans that provide recommendations on eating patterns and food sources for adults and children aged 2 and older. The most recent dietary guidelines encourage Americans to:

  • Balance calories with physical activity to manage weight.
  • Consume more of certain foods and nutrients such as fruits, vegetables, whole grains, low-fat dairy products, and seafood.
  • Consume fewer foods with sodium, saturated fats, trans fats, cholesterol, added sugars, and refined grains.

If you could follow the dietary guidelines perfectly, you would get closer to the kind of nutritional intake needed for optimal health. But the reality is that most people eat differently every day, meaning that you might eat a well-balanced diet one day but not the next. In some cases, dietary supplements, such as vitamins, and fortified foods, may be a good way to make sure you are consistently getting all the nutrients you need. Supplements should not be used as a substitute for eating a balanced diet.

Always consult your doctor before you take any supplements or change your diet. Dietary supplements are not intended to treat, diagnose, mitigate, prevent, or cure disease.

What Am I Missing?

There are four particular nutrients that are lacking in the typical American diet and have been deemed nutrients of public health concern by the Dietary Guidelines. These include potassium, vitamin D, calcium and dietary fiber. The absence of these nutrients is directly related to people not eating the recommended amounts of foods such as whole grains, fruits, vegetables, seafood, and dairy. Here’s why these nutrients are so important:

  • Potassium contributes to maintaining healthy blood pressure. The typical American diet is high in sodium and low in potassium—an unhealthy balance since high sodium levels can be unhealthy for blood pressure. Potassium can reduce the negative effects of sodium. High potassium foods from natural food sources include beans, dark leafy greens, potatoes, squash, white beans, yogurt, bananas, and fish such as halibut, yellow fin tuna, cod, rockfish and rainbow trout.

  • Vitamin D is thought to have a role in many vital health systems, most notably with bone, muscle, and immune health. While vitamin D can actually be made by your body, sunlight on the skin is needed to make it, and several factors can impact our ability to produce it in sufficient amounts to meet the body’s needs. Such factors include use of sunscreen, age, and environmental factors such as time of day for sun exposure, cloud cover, and amount of smog. For example, as we age, the ability to produce vitamin D on the skin decreases. To further complicate the issue, vitamin D is found in very few foods naturally (certain types of fish and egg yolks) and hence 90% of the U.S. population does not get enough of this nutrient through diet even if it might include fortified and enriched foods. Look at it this way; a cup of milk contains about 100 IU of vitamin D—adults would have to drink 6-8 cups of milk daily to meet the RDA (Recommended Dietary Allowance) of 600-800 IU. Thus, considering a multivitamin containing vitamin D or other supplement may be a good way to be sure to get adequate vitamin D.

  • Calcium is needed for bone health and plays an important role in the function of nerves, blood vessels, and muscles. It can be found in milk and milk products, and foods fortified with calcium. Many plant foods, such as green leafy vegetables also contain calcium, but consumption of enough plant foods to get the recommended amount of calcium may be difficult to do.

  • Dietary fiber is an important substance for keeping digestion and bowel movements regular. Fiber is the non-digestible part of the food plants we eat, and can be found in fruits and vegetables. Other good sources of fiber include beans, peas, nuts, and whole grains.

Learn More About It

Getting the right nutrients for your body is a very individual formula. It is based on your dietary habits, health, age and medical history. To find out more about your own nutritional needs and how well your body absorbs the nutrients, speak with your doctor. He or she should be able to give you a referral to a nutritionist or registered dietitian who can help. These are qualified healthcare professionals who will understand your specific situation, medical history and background, and guide you through the nutrition gap.

Alpa Shah, MS, RD is a Director, US Medical Affairs, Wellness Lead, Global Clinical Development & Medical Affairs at Pfizer Inc.

[1] [2] [3] [4]


  • 1. Otten JJ, Hellwig JP, Meyers LD, eds. Dietary reference intakes: the essential guide to nutrient requirements.Washington (DC). The National Academies Press; 2006. Accessed February 10, 2015.
  • 2. National Institutes of Health. Vitamin D: fact sheet for health professionals. Accessed February 11, 2015.
  • 3. US Department of Agriculture. Dietary Guidelines for Americans, 2015-2020. 8th ed. Washington, DC: US Department of Agriculture, US Department of Health and Human Services; 2015.
  • 4. Ward E. Addressing nutritional gaps with multivitamin and mineral supplements. Nutr J. 2014;13:72. doi:10.1186/1475-2891-13-72.
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