Clinically-diagnosed vitamin deficiencies and disorders in the entire United States military population, 1997–2015
Nutrition Journal Vol 20, # 55 (2021), https://doi.org/10.1186/s12937-021-00708-2
Joseph J. Knapik, Emily K. Farina, Victor L. Fulgoni III & Harris R. Lieberman
Note: Average deficiency rate over 17 years =53
D deficiency for 2015 = 220
By 2021 the rate is is probably >400
Incidence Rate (cases/100,000 person-yr)
This article uses the now disbanded Institute of Medicine definition of deficiency: < 20 ng
Vitamin D levels have been crashing has the following chart
Is 50 ng of vitamin D too high, just right, or not enough
Note: Some US military had 60 ng
Vitamin D titles containing military OR soldiers (29 titles as of June 2021)
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Background
This study examined incidence rates, temporal trends, and demographic factors associated with vitamin deficiencies/disorders in all United States military personnel from 1997 to 2015 (mean N = 1,382,266/year).
Methods
Employing an ecological study design, the Defense Medical Epidemiological Database and specific International Classification of Diseases codes were used to determine incidence rates for clinically-diagnosed vitamin deficiencies/disorders. Associations with demographic factors were examined.
Results
The overall incidence rate of vitamin deficiencies/disorders was 92.7 cases/100,000 person-years (p-yr). Highest rates were for vitamin D (53.7 cases/100,000 p-yr), other B-complex vitamins (20.2 cases, 100,000 p-yr), vitamin B12 anemia (7.6 cases/100,000 p-yr), deficiencies of “other vitamins” (5.9 cases/100,000 p-yr), and vitamin A (2.5 cases/100,000 p-yr). Thiamin, riboflavin, niacin, pyridoxine, folate, vitamin C, and vitamin K deficiencies and hypervitaminoses A and D had < 1 case/100,000 p-yr. Rates for vitamin D, other B-complex, “other vitamin”, and thiamin deficiencies increased over time, while vitamin A and C deficiencies decreased. Women had higher incidence rates for all examined deficiencies/ disorders except niacin and vitamin C. Incidence rates rose with age in 8 of 15 deficiency/disorder categories and blacks had higher incidence rates in 9 of 15 deficiency/disorder categories.
Conclusions
The overall rate of clinically-diagnosed vitamin deficiencies and disorders was low but higher in women and minority subgroups. As for most illnesses, the diagnosed incidence of such disorders may be an underestimate of the actual incidence. These findings can guide clinical decision making with regard to testing for nutritional deficiencies and delivering public health information to at risk populations.