On one hand for example, Harvard Medical School advised that supplements could play an important role for high-risk groups like adults diagnosed with osteoporosis, patients with Crohn’s disease, celiac disease, or with vitamin B12 deficiency. On the other hand, chiropractor, Dr Frank Painter believes that while a healthy, balanced diet supplies the body with sufficient nutrients to carry out routine tasks: “Supplements such as vitamins, minerals, essential fatty acids, phytochemicals, and more, enrich the body's internal environment to fortify cellular protection, repair, and regeneration, and support the renewal process.” And as such, everyone can benefit from supplements.  

Professor Victoria Drake at the Linus Pauling Institute (a molecular nutrition research institute at Oregon State University) lists several individuals who may be at increased risk for micronutrient deficiencies as well as the micronutrients of concern: 

• Women of childbearing age (folate, vitamin D, iron) 
• Pregnant and lactating women (vitamin B6, folate, vitamin D, iron) 
• People who consume <1 200 calories per day (multiple micronutrients) 
• Obese individuals (multiple micronutrients) 
• Infants, children, and adolescents (vitamin D) 
• Patients with dark-coloured skin (vitamin D) 
• Those who cover all exposed skin or using sunscreen whenever outside (vitamin D) 
• Older adults (vitamin B12, vitamin D, zinc) 
• Low socioeconomic status (multiple micronutrients) 
• Patients who have had bariatric surgery (multiple micronutrients) 
• Patients with fat malabsorption syndromes (fat-soluble vitamins A, D, E, and K) 
• Alcoholics (vitamin A, B vitamins) 
• Smokers (vitamins C and E) 
• Vegans and those with limited intake of animal products (vitamin B12, vitamin D, calcium) 
• People taking medications that interfere with the absorption and/or metabolism of certain micronutrients (e.g., proton pump inhibitors used to treat heartburn may impair vitamin B12 absorption, frequent aspirin use can lower vitamin C status) 

“Micronutrient inadequacies can increase susceptibility to illness and chronic disease. Deficiencies in select micronutrients can impair immunity, thereby increasing vulnerability to infectious disease,” said Prof Drake. “Inadequate intake of certain micronutrients may increase risk for chronic diseases, such as cardiovascular disease, osteoporosis, and cancer, and may also be linked to cognitive dysfunction. Moreover, certain micronutrient deficiencies during pregnancy can cause congenital anomalies.  

“Dr Bruce Ames, a prominent biochemist at the University of California, Berkeley, has hypothesised that when intakes are lower than the recommended levels, short-term requirements for micronutrients in metabolic reactions take precedence over long-term needs, thereby resulting in long-term, cumulative oxidative damage to macromolecules (DNA, RNA, proteins), declines in mitochondrial function, and accelerated cellular aging, increasing the risk of age-related diseases,” explained Prof Drake. “In contrast, micronutrient intakes at the RDA would allow sufficient amounts for normal metabolism, and intakes of the RDA or higher may be needed for optimum health promotion and chronic disease prevention.  

“Given the fact that many people are not meeting micronutrient intake recommendations, a daily multivitamin or mineral supplement would offer insurance that most micronutrient needs are met.”