"Additionally, supplements of EPA and DHA omega-3 fatty acids may be valuable for people who don't eat at least two fish meals each week." According to the 2005 Dietary Guidelines, children and adolescents as well as adults often fall short in vitamin E, adults frequently fail to get enough vitamin C, people over age 50 should get the supplemental form of vitamin B-12, women of childbearing age need synthetic folic acid (a B vitamin), and lots of people need extra vitamin D. According to Dr. Dickinson, "The good news is that all of these supplemental nutrients can be consumed conveniently and inexpensively in the form of a daily multivitamin, for less than a dime a day."



In addition, the Dietary Guidelines point out that calcium is a critical nutrient that is in short supply for practically everybody—children, teens, and adults. A multivitamin with minerals will provide some extra calcium, but to get the full amount of calcium that is recommended, people will need to use a separate supplement containing calcium (preferably with vitamin D) or consume lots of dairy products or calcium-fortified foods. While conventional foods and fortified foods and supplements are all effective ways to obtain additional nutrients, cost and calories are also factors to consider. The cost of 1,000 mg of calcium can range from 18 cents a day to $1.38 a day, depending on whether a person uses a calcium tablet, soft calcium chews, lowfat milk, a breakfast cereal with added calcium, or calcium-fortified orange juice (listed from lowest to highest cost). The number of calories that will come along with that amount of calcium ranges from negligible to over 300.

"Multivitamins and calcium supplements can provide consumers with a major boost in their attempts to meet their nutrient needs while controlling cost and avoiding excess calories," said Dr. Dickinson. "The 2005 Dietary Guidelines flag important nutrient shortfalls, and ideally the Food Guide Pyramid (when it comes out) should feature a flag on top to remind people to use appropriate supplements in addition to improving their diets and adopting a healthier lifestyle. Supplements can be an integral part of an optimal diet and should always be viewed in the context of a healthy lifestyle."

See below for a summary of the Dietary Guidelines comments on nutrient shortfalls. The Council for Responsible Nutrition (CRN), founded in 1973, is a Washington, D.C.-based trade association representing dietary supplement industry ingredient suppliers and manufacturers. CRN members adhere to a strong code of ethics, comply with dosage limits and manufacture dietary supplements to high quality standards under good manufacturing practices. For more information on CRN, visit http://www.crnusa.org.

2005 Dietary Guidelines: Nutrient Shortfalls in the General Population Shortfalls for adults: calcium, potassium, fiber, magnesium, vitamin C, vitamin E, and carotenoids (as a source of vitamin A) Shortfalls for children and adolescents: calcium, potassium, fiber, magnesium, and vitamin E 2005 Dietary Guidelines: Recommendations for Special Needs Vitamin B-12 for People Over 50 Although a substantial proportion of individuals over age 50 have reduced ability to absorb naturally occurring vitamin B-12, they are able to absorb the crystalline form. Thus, all individuals over the age of 50 should be encouraged to meet their Recommended Dietary Allowance (RDA, 2.4 mcg/day) for vitamin B-12 by eating foods fortified with vitamin B-12 such as fortified cereals, or by taking the crystalline form of vitamin B-12 supplements.

Iron for Women Based on blood values, substantial numbers of adolescent females and women of childbearing age are iron deficient. Thus, these groups should eat foods high in heme-iron (e.g., meats) or iron-fortified foods with an enhancer of iron absorption, such as foods rich in vitamin C (e.g., orange juice). Folic Acid for Women of Childbearing Age Since folic acid reduces the risk of the neural tube defects, spina bifida and anencephaly, a daily intake of 400 mcg/day of synthetic folic acid (from fortified foods or supplements in addition to food forms of folate from a varied diet) is recommended for women of childbearing age who may become pregnant. Pregnant women should consume 600 mcg/day of synthetic folic acid (from fortified foods or supplements) in addition to food forms of folate from a varied diet. Vitamin D for the Elderly, People with Dark Skin, and People Who Avoid the Sun Adequate vitamin D status, which depends on dietary intake and cutaneous synthesis [synthesis in skin exposed to sunlight], is important for optimal calcium absorption, and it can reduce the risk for bone loss. The elderly and individuals with dark skin (because the ability to synthesize vitamin D from exposure to sunlight varies with degree of skin pigmentation) and people who get very little exposure to sunlight (e.g., housebound individuals) may need as much as 1,000 International Units per day to achieve protective blood levels of the vitamin.

Fish, EPA, and DHA Evidence suggests that consuming approximately two servings of fish per week (about 8 ounces total) may reduce the risk of mortality from coronary heart disease and that consuming EPA and DHA (two long chain polyunsaturated fatty acids in fish) may reduce the risk of mortality from cardiovascular disease in people who have already experienced a cardiac event.