Granularity does bring clarity. Increasing lens resolution can bring insight. This concept was driven home as I listened to pundits discuss the 2012 voting patterns by county within Florida. It becomes clear that it is an oversimplification to characterize states as a single color—red or blue. Clearly, voting patterns differ by district. One size does not fit all.
 
The same can be said when it comes to evaluating the nutritional health of a nation. The CDC Second Nutrition Report presents information on 58 biochemical indicators, which were measured in blood and urine of people who took part in the National Health and Nutrition Evaluation Survey (NHANES) from 2003 to 2006. The prevalence of nutrient deficiencies (yes nutrient deficiencies, not inadequacies) has not changed much over the preceding eight years at a national level:


Two points need to be considered. First, this is national data. Second, this is deficiency. In other words, 6% of Americans over 6 years of age have sufficiently low vitamin C concentrations that they could have scurvy. The report indicates that vitamin D deficiency is more common in men (7%) than women (5%). Non-Hispanic blacks are more likely to be vitamin D deficient (31%) than Mexican-Americans (12%) and non-Hispanic white people (3%).
 
Disparities are caused by many factors—genetics, socioeconomic status, education, diet and health behaviors. Katrina Armstrong writes, “A common hypothesis is that advances in human genomics will reduce disparities by identifying genetic causes of disparities.” While this may be true, the elucidation of nutrition genomic interactions is limited by the reality that race and ethnicity are self-reported characteristics (e.g., NHANES). And since the 1997 “Revision of the Race and Ethnic Standards for Federal Statistics and Administrative Reporting,” more than one race can be coded per individual. This fact, coupled with genetic intermingling among racial and ethnic groups, increases statistical uncertainty (e.g., National Vital Statistics Report 59, No. 10 “Deaths: Final Data for 2008”).
 
While the idea of spending $5.8 billion on elections seems outrageous, most of that money was spent campaigning in 14 battleground states. Maybe it is time for nutrition to adopt a similar approach. Rather than focusing on the small percentage that exceeds the UL, resources should be concentrated where nutrient excesses and inadequacies are the worst. It is time to build maps, like the vitamin D maps by the International Osteoporosis Foundation and the CDC obesity maps to identify geographies where malnutrition exists. But this isn’t enough. Just like understanding how county electoral maps can yield insights into elections, we need to map data, like that for obesity prevalence among adults from rural and urban areas by Befort and colleagues, to get the “visual resolution” needed to solve micronutrient deficiencies and inadequacies.
 
Let’s use electioneering strategies to map the nutrient gaps locally and divert campaign spending to fortify nutrition policies and energy to areas most needed.

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The ideas and opinions expressed in this article are those of the author and do not necessarily reflect views held by Nutraceuticals World.