Vitamin D, Vitamin B12, and iron are the top micronutrients indians are deficient. Journal of nutritional science study reveals

According to the World Health Organization (WHO), micronutrients are required in trace amounts of <100 mg/d in the human body. These comprise the standard list of vitamins and minerals, including iron, iodine, Vitamin D, B12, etc.

Not only do they contribute to growth and development, but micronutrients also play a crucial role in hormone balance and enzyme production in the body.

India is currently in a nutritional transition with two facets to one’s physical wellness, either being overweight or underweight. However, irrespective of these two predicaments, it isn’t surprising that micronutrient deficiency, especially Vitamin D, B12, and Iron is prevalent in India.

Even reports suggest that around 0.5% of deaths in India in 2016 resulted from micronutrient deficiencies. The Food Safety and Standards Authority of India (FSSAI) highlights that preventable micronutrient deficiency in Indian citizens is a rising concern.

India also leads as the highest-burden of anemia, which results from iron deficiency, in the world. The prevalence of anemia is the maximum in children (58.6%), followed by non-pregnant (53.2%) and pregnant women (50.4%).

Besides iron, the Comprehensive National Nutrition Survey of children (CNNSC) also recorded stark deficiencies in other micronutrients, including zinc and Vitamin B12, vitamin A and vitamin D deficiencies (VDDs), especially in the pre-school population.

The Government of India has launched a range of schemes and food drives to educate and help people in need to address these alarming complications about micronutrient deficiencies. Some of the notable measures include:

• Food Fortification
• Dietary Diversification
• Nutritional Education
• Micronutrient Supplementation
• Maintenance Of Environmental Sanitation and Hygiene

Despite these ongoing measures, the deficiencies and the ropes of concern are still quite prevalent. Therefore, to better address the concern, the government emphasizes the importance and need for better and mass-scaled food fortification.

The food fortification of the essential foods includes the addition of essential micronutrients, including iron, iodine, folic acid, Vitamin B12, Vitamin D, and even Vitamin A.

To further address the ongoing risks and the prevalence of the preventable micronutrient deficiency in India, a study was launched on 26 July 2020 to check through the available studies and abstracts published in PubMed and GIM from 2015 to 2020 that look into the micronutrient deficiencies in several parts of India.

The study also included a statistical analysis wherein the title and abstract were screened, and two individual research members then checked the extracted data via an Excel sheet. Besides checking the prevalence of the preventable micronutrient deficiencies, the analysis also reviewed the different age groups affected by the deficiency in the country.

Based on the detailed analysis, the researchers concluded the following results for each micronutrient deficiency in India:

Iodine – pooled analysis suggests the overall prevalence of iodine deficiency in India was 17% in individuals above 18 years and 12% in subjects under 18. The rate for the non-specific age group was 59%.

Folic acid – pooled analysis indicates the overall prevalence of folic acid deficiency at 37%. It was recorded at 39% for subjects under 18 and 41% for subjects over 18, and 25% for the non-specific age group.

Vitamin B12 – overall deficiency of B12 was recorded at 57% for subjects under 18 and 48% for subjects over 18. The rate for the non-specific age group was recorded at 68%.

Vitamin A – prevalence of Vitamin A deficiency was recorded at 19% in subjects under five years and 13% in subjects over the age of 5. The non-specific age group had 28% VAD.

Iron – overall, iron deficiency in India was recorded at 54%. It was highest with 61% in pregnant women, 53% in ages between 3-18, and 54% in subjects less than 5 years.

Vitamin D – overall, vitamin D deficiency was recorded at 61%. It was both 60% for subjects aged under and over 18 years. The non-specific age subjects contributed to 63% of the deficiency.

This is the very first meta-analysis of the prevalent yet preventable micronutrient deficiency. The results from the present meta-analysis found that the iron deficiency in India is 54%, which is more than the standard Vitamin and Mineral Nutrition Information System (VMNIS-2005) reports.

The reports from the present meta-analysis also highlight that children under 18 are suffering the most from prevalent Vitamin deficiencies while pregnant women showed signs of maximum iron deficiencies.

Vitamin B12 is also widespread in India, affecting 47% of the north Indian population, primarily diabetes patients. A community-based study recorded the same at 55% in the south Indian population.

The meta-analysis collects the relevant data to answer further the widespread preventable micronutrient deficiencies in India that need immediate interventions along with region-specific strategies.