Ty Beal Profile picture
Mar 11 27 tweets 13 min read
I recently gave a few lectures on micronutrients to different graduate classes, so I thought I'd post a thread with my slides.
Here's what I'll cover. Apologies if you've seen most of the slides before.
Undernutrition like stunting and anemia––which are caused in part due to micronutrient deficiencies––are widespread in low- and middle-income countries.
Many of us, even in high-income countries, are deficient in micronutrients, including iron, zinc, folate, and vitamins A, D, and B12, among others.
In lower income countries the vast majority of women are deficient in at least one micronutrient––9 in 10 women in India, Bangladesh, Pakistan, Cameroon, and Côte d'Ivoire. Even in the US and UK, 1 in 5 women are iron deficient.
This graph shows the global and regional prevalence. All regions for women and children are near 50% or higher––including high-income countries.
This graph shows the prevalence of isolated deficiencies and two or more deficiencies. Many women and children have multiple micronutrient deficiencies. In Pakistan 70% of women have two or more deficiencies.
This graph shows an example of individual deficiencies for children and adolescent girls in India. Over half are folate deficient folate. A third are iron deficient.
The data on estimated prevalence of inadequate intakes don't align perfectly with micronutrient deficiencies. But it's clear there are inadequacies in all countries. Current diets are not dense enough in micronutrients to meet requirements.
In the US, iron & zinc deficiency are common among women. Choline intake is below the adequate intake for 9 in 10 adults. Vitamin E, magnesium, & calcium intake is inadequate for much of the population. If we had inadequate intake for potassium it would also be inadequate.
In higher income countries micronutrient deficiencies are due in part to the high intakes of ultraprocessed foods, which are low in micronutrients, not to mention their effect on noncommunicable diseases.
Here we can see where purchase of ultraprocessed foods are highest: North America, much of Europe, Japan, Australia, and New Zealand.
In lower income countries micronutrient deficiencies are due in part to people not having access to diverse diets. They want healthy, nutrient dense foods but can't afford them or access them in markets.
Here we can see that minimum dietary diversity, an indicator of micronutrient adequacy is very low in India and many countries in Sub-Saharan Africa.
For a specific example, access to, and consumption of, fruit is very low in Africa and South Asia.
For pulses (beans, peas, lentils), consumption is low in most countries, including in the US.
Two points here: Animal source food intake is very low in South Asia and Sub-Saharan Africa; and unprocessed red meat intake is lower in high-income countries than the global average (it's highest in Central and Eastern Europe, Central Asia, Southeast Asia, and East Asia).
Current diets low in animal source foods are highly inadequate in micronutrients. Any efforts to restrict animal source foods need to ensure micronutrient adequacy.
Animal source foods are a particularly good source of omega 3, vitamins A and B12, iron, and zinc. Highly plant-based diets––even diverse diets––are often inadequate in omega 3, iron, zinc, and vitamin B12 due to low bioavailability.
The top sources of micronutrients commonly lacking worldwide, particularly in lower income countries are:
• Organs
• Small fish
• Dark leafy greens
• Bivalves
• Crustaceans
• Beef and goat
• Eggs
• Dairy
• Canned fish with bones and skin
Looking specifically at iron, the top sources are:
• Organs
• Bivalves
• Small dried fish
• Beef and goat
• Teff
For folate, the top sources are:
• Liver
• Dark leafy greens
• Pulses
• Quinoa
• Eggs
• Orange, yellow, and red fruits & vegetables
• Kidney
• Other fruits
• Teff
• Seeds
Here you can see the aggregate scores, which show animal source foods, dark leafy greens, and to a lesser extent pulses and certain traditional grains with the highest densities overall.
What's really interesting is to see a healthy plant-based planetary health diet fall short on certain nutrients, especially iron for women of reproductive age. We need to be careful that any diet we recommend for any reason meets basic requirements.
Increasing animal source foods and reducing phytate (from the baseline planetary health diet) are necessary to make the diet micronutrient adequate.
To conclude, dietary micronutrient inadequacies and corresponding deficiencies are widespread globally. The cause of this is different in higher income countries vs lower income countries. Consuming adequate plant and animal source foods helps ensure micronutrient adequacy.
Thanks for reading!
Initial thread 👇


• • •

Missing some Tweet in this thread? You can try to force a refresh

Keep Current with Ty Beal

Ty Beal Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!


Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @TyRBeal

Jan 26
Animal source foods, especially ruminant livestock, typically perform poorly on environmental impact assessments.

Is this because they are inherently unsustainable?

Are crops inherently more sustainable?

Or are the metrics used to quantify the impact of livestock flawed?
First, much of the current approach to livestock production is unsustainable and urgently needs to change. The same is true for crop production. But there are ways to produce livestock sustainably, and the current metrics used to quantify their impact have important flaws.
What are the typical metrics used? Most commonly we see greenhouse gas (GHG) emissions. Ruminants get a bad wrap because they burp methane that enters the atmosphere. But there are important nuances to understanding the impact of livestock on climate change.
Read 18 tweets
Jan 19
What are the health and environmental benefits and risks of animal source foods? Experts with personal diets ranging from fully plant-based to vegetarian and omnivore came together to answer this question by reviewing the latest evidence. What did we find?
There are health benefits of animal source foods
• Dense in bioavailable nutrients commonly lacking globally
• Support healthy growth and development of infants, young children, and adolescents
• Support healthy aging of older adults
There are also health risks of animal source foods when consumed in excess
• Processed meat
• Unprocessed red meat
• Saturated fat
Read 8 tweets
Jan 6
There is a video on @FoxNews with @JesseBWatters and @bigfatsurprise circulating about Food Compass and the scandal of the dietary guidelines. I made the Chart that is displayed and have a few clarifying comments to add context to this issue.
First, this chart was not created by Tufts researchers. I made the chart using examples where I think the system gets things wrong to highlight its flaws. The chart is used in a preprint that is under review that raises concerns about Food Compass.
All these examples are directly from the Food Compass paper. I am concerned about these because I think it gives a pass to many foods that are contributing to obesity and chronic diseases, like sugary breakfast cereals, candy and ice cream with nuts, etc.
Read 9 tweets
Jan 6
When I first became interested in nutrition I ate a mostly paleo diet. This helped me improve my health substantially because I limited highly processed foods and shifted to whole foods. But whole grains and legumes are healthy foods for most people. I now eat these regularly.
Yes, there are exceptions. And yes, some people do better with more or less. For many people, I think going from zero to regular consumption of grains may spike blood glucose and of legumes may cause bloating and gas. But our body, including our microbiome, needs time to adjust.
And for the record, I do not mean junk food sources of whole grains like cinnamon rolls and lucky charms. I mean whole grains with an intact food matrix like plain oatmeal.
Read 4 tweets
Jan 4
New study finds a person's Food Compass Score is correlated with a better Healthy Eating Index, BMI, blood pressure, HDL-C, HbA1c, fasting plasma glucose, overall metabolic health & lower prevalence of metabolic syndrome, CVD, cancer, lung disease & death.
Multrivariable models adjusted for age, sex, race/ethnicity, household income, education level, smoking status, total physical activity, average total energy intake, and alcohol consumption.
Most effect sizes were relatively small, but still potentially meaningful. Image
Read 7 tweets
Dec 21, 2022
I promised I would post a thread on my presentation on animal vs alternative protein products and their environmental and economic sustainability. So here it goes...
If you have the patience, here's what I'll cover. Apologies if you've seen some of the slides before.
Many people in lower income countries don't consume enough protein. But it's important to realize that most of these people also don't consume enough calories. We don't know how many would not get enough protein if they were able to eat enough food.
Read 55 tweets

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!


0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy


3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us on Twitter!