Vitamins and minerals are mainly provided by food and are necessary to maintain good health. The Anses has updated the nutritional references in this field and wishes to draw the public's attention to two vitamins whose intakes are insufficient at the population level or should be the subject of broader recommendations.

Nutrition:, covering, vitamin, D, and, B9, needs,, a, public, health, issue

The general term "nutritional reference" groups together a set of food intake values for nutrients that vary according to age and sex, but also according to the level of physical activity, physiological state (such as pregnancy) or eating habits.

Defining dietary intake benchmarks"

These measures are very useful because they are intended to become the references for professionals in the nutrition and health sector. In particular, specialists in nutrition and dietetics, to develop a varied and balanced diet covering the needs of different population groups (infants, children, adolescents, adults, pregnant women, seniors) in the context of an individualized preventive dietetic monitoring or therapeutic support.

"These nutritional references can also be used for public health purposes by health authorities, particularly to estimate the proportion of individuals who do not consume enough (insufficient) or too many vitamins or minerals or to define benchmarks for food consumption," explains the Anses, which is responsible for updating them. However, its latest update has led it to alert on the importance of two vitamins which the public is more likely to have a deficiency: vitamin D and vitamin B9. Its report thus specifies that in 2019, more than 70% of French adults still had an insufficient intake of vitamin D, or even a deficiency in 6.5% of cases.

UV and diet to cover vitamin D needs

Vitamin D deficiency leads to a decrease in bone mineral density and predisposes elderly subjects, particularly postmenopausal women, to osteoporosis, which can lead to an increased risk of fracture. "Given the great variability of the need for vitamin D depending on individuals (particularly because of age and skin color), the time spent outdoors and the latitude of the place of living, an individualized approach to the coverage of the need is preferred. ", says the Anses. According to the Anses, various management measures could be envisaged: fortification of foodstuffs with vitamin D controlled by the public authorities or personalized supplementation through the health care system.

But the Agency reminds that the coverage of the needs in vitamin D can be ensured in first place by the exposure to the sun. In fact, 15 to 20 minutes of sun exposure at the end of the morning or in the afternoon can ensure that the body has a sufficient daily intake of vitamin D. The reason is simple: in humans, vitamin D is also synthesized endogenously by the deep cells of the epidermis under the direct action of ultraviolet radiation (UV-B). However, this synthesis depends on many factors, notably the latitude of the place where we live, the season (summer VS winter), our age, the pigmentation of the skin, the clothes we wear and the use of sun cream.

This is why the consumption of foods rich in vitamin D such as fatty fish (herring, sardines, salmon, mackerel), mushrooms (chanterelles, ceps and morels), dairy products enriched in vitamin D, egg yolk, dark chocolate, butter and margarines is recommended.

Adequate vitamin B9 intake not only for pregnant women

As far as vitamin B9 (another name for folic acid) is concerned, the main health issue is the prevention of neural tube defects, congenital malformations that occur during the first month after conception. These are incomplete development of the spinal column (spina bifida) of varying degrees of severity, or even absence of the cranial vault (anencephaly). 

Folic acid supplementation during the preconceptional period plays a well-established protective role, which has led to numerous recommendations. However, the Anses considers that considering this issue only during the preconceptional period does not seem to be sufficiently protective with regard to unscheduled pregnancies. "The coverage of vitamin B9 needs of the female population likely to become pregnant must be the subject of particular attention. Indeed, to prevent any risk of malformation of the unborn child, it is essential to ensure sufficient vitamin B9 intake for any woman likely to become pregnant", she notes.

It adds that "this approach is protective because it allows to take into account the cases of unscheduled pregnancies". The Agency has retained the values of the European Food Safety Authority, and stresses that a satisfactory intake of 600 µg EFA/d should apply to women who are pregnant or likely to become pregnant, but that during the 2nd and 3rd trimesters of pregnancy, it cannot be excluded that a lower intake may be satisfactory. It should be noted that vitamin B9 needs can be covered by the consumption of legumes, green leafy vegetables, yeast flakes, wheat germ or egg yolk, which can be very good sources.