Eat right and the vitamins and minerals will look after themselves
When your body isn't getting the nutrients it needs it lets you know. Dandruff, acne, dry skin, easy bruising, lethargy, ice cold hands and a range of other symptoms - including bleeding gums and painful joints - can be caused by a nutritional deficiency. And despite the plethora of dietary supplements on the market the best way to ensure good health is simple.
"If you have a balanced diet you should get all the vitamins and minerals you require from that," says Carolyn Cairncross a nutritionist with the Nutrition Foundation.
A balanced diet means eating from the four food groups (fruits and vegetables, breads and cereals, milk and milk products, lean meat and alternatives) in the dietary pyramid. Our position is 'food first' and although there are a few areas where supplements are needed in most healthy people they aren't required."
She says that the three most common nutritional deficiencies in New Zealand are lack of iron, calcium and vitamin D.
"With iron it is mainly females who are menstruating, because when they lose their monthly blood they lose a lot of iron too. This is common in women under 55. If you look at the daily iron requirements for women it's 18 milligrams and for men it's 8."
Too little iron in the blood can lead to paleness, tiredness and lethargy, making it harder to concentrate, and affecting work performance and energy levels. Resistance to illness such as infections, coughs and colds is also reduced. Lean red meat is the best source of easily-absorbed haem iron and it is recommended that it be included 3-4 times per week. Other meats (chicken, poultry, pork) and fish are also good sources of easy-to-absorb iron. Vegetarians note: to increase the absorption of non-haem iron try to have vitamin C-rich foods such as kiwifruit, citrus fruits, orange juice and capsicums - at the same time. A glass of orange juice with your breakfast cereal will increase the iron absorbed from the cereal. For those who need extra iron supplements are available by prescription and in pharmacies but Ms Cairncross says that these should only be taken after consultation with your doctor or dietician.
Calcium deficiencies are most often seen in the elderly who have developed osteoporosis. Just two to three servings of dairy products each day will meet most people's calcium needs. If you avoid dairy foods try to eat calcium-rich foods like tofu, boiled broccoli, sardines and wholegrain bread.
Cairncross says that the number of people suffering from a deficiency of vitamin D is increasing. Vitamin D is created in the body when it is exposed to sunlight and is contained in a few foods such as egg yolk, fish, fish oil, some cheese, beef liver and some types of grain. Vitamin D is important as it helps the body use the calcium and phosphorus from your food and regulates normal cellular differentiation thus preventing cancer. It also promotes insulin secretion and regulates over 200 genes.
"We see this deficiency most often in infants and babies that don't see the sun and also elderly people - especially those in resthomes. We also see this in people who wear veils for religious reasons."
Additionally health messages to reduce sun exposure and encouragement to use ultraviolet (UV) sun screens have reduced the skin's ability to produce vitamin D and getting it from food is problematic.
"There are some foods which are rich in vitamin D but their vitamin D content isn't enough to get our daily requirements, so we do need sunlight. Another group often deficient in vitamin D are those with darker skins because with the vitamin D process where it's converted to how it can be used in your body is not as efficient in white skinned people. Also people in Christchurch need more sun than people in Auckland especially in winter because the sun's rays aren't as strong. Today we're starting to see doctors prescribing vitamin D far more routinely."
In winter it is recommended you spend at least around 30 minutes per day in sunlight. A low blood level of vitamin D may increase the risk of bone fractures and may be characterised by muscle pain, weak bones/fractures, low energy and fatigue. A recent study has also found that low levels of vitamin D worsens asthma symptoms.
Despite the media focus on health and food in the last few years Cairncross isn't certain that we're a healthier nation than we were twenty years ago.
"It depends which way you look at it. We have a better food supply but we also have a lot more processed foods, so we have a lot more obese people. That is often a result of poverty. For example with Coke being cheaper than milk people who are struggling financially may drink the Coke and miss out on the calcium. Ironically low socio economic people can be malnourished even though they are overweight because of their poor food choices. I'd hesitate to say as a nation that we are healthier today. I think we have a "worried well" population now who are bombarded with information and who are getting too tied up about it. It's a pretty simple message - stick to a basic healthy diet and your nutrition needs will be met."