Food Rich, Nutrient Poor: Food Quality

Micronutrient Deficiency in the UK: What You Need to Know

Micronutrients — including vitamins and minerals such as vitamin D, iron, folate, vitamin B12, iodine, and magnesium — play a crucial role in maintaining good health. Yet, many people in the UK are unknowingly living with deficiencies that can affect energy, immune function, and long-term wellbeing.

This article offers clear guidance for the general UK population and includes specific notes for those with chronic respiratory conditions, such as aspergillosis.

Understanding Micronutrient Deficiency in the UK

Prevalence: Micronutrient deficiency is more widespread than many assume:

• Vitamin D: About 20% of UK adults are deficient, with up to 60% having suboptimal levels, especially during the winter months.
• Iron: Nearly half of girls aged 11–18 and one in four women aged 19–64 have iron intakes below the Lower Reference Nutrient Intake.
• Folate (Vitamin B9): Levels have dropped by 25–28% in recent years, with 89% of women of childbearing age below the threshold for neural tube defect prevention.
• Vitamin B12: Around 6% of people under 60 and 20% of those over 60 are deficient.
• Iodine: Affects about 21% of women of childbearing age.
• Magnesium: Around 50% of women fall short of recommended intake levels.

Hospital Admissions: Cases of hospital admissions linked to micronutrient deficiency have tripled in the past decade, with over 800,000 reported in England and Wales last year.

Food Rich, Nutrient Poor: Although the UK has abundant access to food, modern dietary patterns often prioritise convenience over quality. Highly processed foods, which dominate many diets, are typically energy-dense but nutrient-poor. This means that while caloric intake may be sufficient—or even excessive—essential vitamins and minerals can still be lacking.

Common contributors include:

• Overconsumption of refined carbohydrates, sugars, and fats.
• Underconsumption of whole foods like fruits, vegetables, legumes, and whole grains.
• Loss of nutrients during industrial food processing.
• Soil depletion affecting nutrient content in produce.

This paradox—being food rich but nutrient poor—helps explain the persistence of deficiencies even in economically developed countries like the UK.

Signs and Symptoms to Watch For: Micronutrient deficiencies often develop gradually, and symptoms may be mistaken for other issues. Common signs include:

• Vitamin D deficiency: Fatigue, muscle weakness, bone pain, frequent infections, low mood.
• Iron deficiency: Tiredness, pale skin, shortness of breath, headaches, cold hands and feet, dizziness.
• Folate deficiency: Fatigue, irritability, mouth sores, poor growth, cognitive issues.
• Vitamin B12 deficiency: Pins and needles, tiredness, mouth ulcers, difficulty walking, memory problems.
• Iodine deficiency: Swelling in the neck (goitre), fatigue, weight gain, sensitivity to cold, sluggish thinking.
• Magnesium deficiency: Muscle cramps, tremors, nausea, poor appetite, abnormal heart rhythms.

Government & NHS Guidance

The UK government and NHS offer reliable, science-backed guidance:

• NHS Vitamins and Minerals Portal provides information on sources, daily needs, and deficiency symptoms.
• Eatwell Guide helps you structure a healthy diet visually.
• SACN (Scientific Advisory Committee on Nutrition) publishes nutrient intake recommendations.
• Healthy Start Scheme offers free supplements to low-income pregnant women and young children.

Key Nutrient Recommendations

• Vitamin D: 10 micrograms (400 IU) daily, especially from October to March.
• Iron: 14.8 mg daily for women aged 19–49; 8.7 mg for others.
• Folate: 400 micrograms daily for women trying to conceive or pregnant.
• Vitamin B12: Found in meat, dairy, and fortified foods; vegans and older adults may need supplements.
• Iodine: Required for healthy thyroid and fetal brain development; found in dairy, seafood, and fortified products.
• Magnesium: Present in nuts, whole grains, leafy greens; supplements may help if dietary intake is low.

Micronutrient Deficiencies in Men

While women and children are often highlighted in discussions about nutrient shortfalls, men in the UK are also at risk of micronutrient deficiencies. These can have serious effects on energy, immune health, cardiovascular function, and hormone balance.

Common issues in men include:

• Vitamin D: Deficiency is common due to limited sun exposure. Affects bone health, mood, and immune function.
• Magnesium: Often low in men with high stress levels, poor diets, or frequent alcohol intake. Symptoms include muscle cramps, fatigue, and heart irregularities.
• Vitamin B12: Particularly affects older men due to reduced stomach acid. May cause memory problems, numbness, and fatigue.
• Zinc: Important for testosterone production, immune health, and wound healing. Often low in men with poor diets or high alcohol consumption.
• Selenium: Essential for sperm production and thyroid health. UK soil is low in selenium, contributing to overall low intake.
• Iron: Though less common than in women, iron deficiency can affect men—especially due to gastrointestinal conditions, chronic illness, or vegetarian/vegan diets.

Men should be encouraged to eat a varied diet, monitor symptoms of deficiency, and consider blood tests if experiencing fatigue, mood changes, or unexplained physical symptoms.

Tips for the General Population

• Balanced Diet: Focus on fruits, vegetables, whole grains, dairy or fortified alternatives, and lean protein.
• Supplement Wisely: Consider supplements for vitamin D, iron, folate, and B12 if you’re at risk.
• Check Labels: Fortified foods can help meet requirements, especially for B12 and iodine.
• Regular Health Checks: Blood tests can identify deficiencies early, particularly for at-risk groups.

Special Advice for People with Aspergillosis

Aspergillosis, especially chronic and allergic forms like CPA or ABPA, often affects individuals with compromised lung function and immune vulnerability. Micronutrient status plays a key role in immune resilience and respiratory health.

Important considerations:

• Vitamin D: Has immunomodulatory properties and may reduce susceptibility to infections. Deficiency is common in those with chronic lung conditions.
• Iron: Chronic inflammation can alter iron metabolism. Iron supplementation should be guided by lab results to avoid promoting fungal growth.
• Magnesium & Vitamin B12: Long-term antifungal or corticosteroid use may impact absorption or levels.
• Antioxidant Nutrients: A diet rich in vitamins A, C, and E may support lung tissue integrity.

Patients with aspergillosis should work closely with their healthcare team, including dietitians if available, to ensure optimal nutrient support as part of their long-term management plan.

Final Thoughts

Micronutrient deficiency is a growing but preventable concern in the UK. Simple actions like eating a varied diet, being aware of individual risk factors, and using targeted supplements can make a substantial difference. Those living with chronic respiratory illnesses, such as aspergillosis, should be particularly proactive in managing their nutritional status to help support better outcomes.

For more information, visit:

• www.nhs.uk/conditions/vitamins-and-minerals/
• www.gov.uk/government/publications/eatwell-guide
• www.gov.uk/government/publications/sacn-reports