Have often have you heard, if you eat a balanced diet, you will obtain all of the nutrients that you need? But what is a balanced diet? And in an age where our food quality is often poorer than that of our ancestors due to loss of nutrients with shipping and storage, modern agricultural practices and lower soil quality (low nutrient soil), how many of us can really derive optimal levels of nutrients from our food? Many leading experts in the integrative medical and nutrition fields suggest that we no longer can rely on our diets alone to obtain sufficient micronutrients (vitamins and minerals) and that modern diets are often low in Omega 3 fatty acids as well. The nutrition focused physical exam can help to determine if we are getting enough (or absorbing enough) nutrients our diet, from a multivitamin with minerals or from Omega 3 fatty acids in our diet/supplements? A number of signs are discussed below with the nutrient insufficiencies that may be causing them. A common example is the use of nutrients for dandruff treatment.
Just to complete our discussion on nutrient assessment, let me provide some context on methods commonly used:
- Dietary Analysis
- Laboratory testing
- Nutrition Focused Physical Exam
Ideally all three methods would be employed and would help in both diagnosing nutrient deficiencies as well as in monitoring one’s response to dietary changes and supplementation. There are a few physical exam findings you can readily detect yourself if you are curious how your nutrient status might be. I will go over these below. Please note that these findings are best considered as part of your overall medical history and with a full exam to narrow down the findings and to rule out serious diseases which may co-occur or contribute to a deficiency of one or more nutrient.
- Do you have half moons (lunula) at the base of each of your nails? (If not you may be deficient in protein and/or zinc.)
- Do you have white spots that are not due to a recent trauma to the nail? (These spots can occur with zinc deficiency.)
- Do you have ragged cuticles? (This may be due to a deficiency of boron and/or iron.)
- Do you get swelling, redness and even pus around the nail (without any inciting cause)? (This may be due to a deficiency of zinc, vitamin A and/or vitamin C or from insufficient intake of essential fatty acids.)
- Do you get redness or cracking at the corners of your mouth? (This may be due to deficiencies of B vitamins, iron or zinc.)
- Do you get canker sores fairly often? (This can result from food allergies.)
- Do you suffer from dandruff? (This may be due to a deficiency (or deficiencies) of vitamin A, D, E, K, B vitamins, selenium or calcium in which case supplementation with these nutrients would provide effective dandruff treatment.)
- If you are a man and have baldness, the type of baldness can give an indication of coronary heart disease risk. (With this information natural health interventions can be directed at minimizing risk and optimizing heart function.)
- Do you frequently have little raised bumps on the backs of your arms? (This can be due to vitamin A and/or essential fatty acid deficiency.)
- Do you have dry eyes? (This can be due to Vitamin A or vitamin B2 (riboflavin) deficiency and may be related to blood glucose control.)
- Do you have decreased night vision? (This can be due to Vitamin A and/or zinc deficiency.)
- Do you have increased sensitivity to light? (This can be due to zinc deficiency.)
These are just some of the many signs one can detect from a physical exam focused on assessing nutritional health. If an at-home evaluation reveals some possible deficiencies, it is recommended to see a practitioner who is trained to assess nutrient status and who can optimize nutrient status (which involves optimizing diet and supplemental intake and examining digestion and absorption function and other medical signs and history which may impact nutrient status). Consuming a diet that is nutrient-dense and capable of maintaining optimal nutrient status is not as simple as it might have been for our ancestors. Make sure that you are getting the nourishment that you need to function at your best!
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Mary Fry, ND completed a National Institute of Health post-doctorate in the Department of Psychiatry at Oregon Health & Science University. She is an Associate Professor in the Nutrition & Integrative Health Department at Maryland University of Integrative Health, lectures and writes on topics of Nutrition, Naturopathic and Functional Medicine and practices in Oregon.