Abstract
BackgroundThis 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).MethodsEmploying 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.ResultsThe 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.ConclusionsThe 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.Clinical trial registration(No. ISRCTN58987177). Registration date 9 October 2019.
Highlights
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
In the 18th and 19th centuries, many sailors in the British Royal Navy were disabled by scurvy until it was discovered the disease was caused by a diet lacking fresh fruits and vegetables, thereby resulting in ships being provisioned with these foods [1]
The highest overall rate for a single deficiency was for vitamin D, followed by other Bcomplex deficiency, vitamin B12 anemia, deficiencies of “other vitamins”, and vitamin A deficiency
Summary
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). Information from medical records on the incidence of clinically-diagnosed dietary deficiencies and hypervitaminoses in a representative sample of the United States (US) population is not available. With improved knowledge of the importance of nutrition, enrichment of certain foods, and dramatic increases in living standards, diseases resulting from nutritional deficiencies or excess and other nutrition-related maladies have been greatly reduced in civilian and military populations in developed countries, but can still be present, and affect health and performance [4,5,6,7]
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