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A s readily accessible health care providers who are stew- ards of appropriate medica- tion therapies and general health advi- sors, pharmacists play important roles in advising patients regarding good nutritional habits, which may include the use of supplements. According to the 2015 Pharmacy Times Survey of Pharmacists' OTC Recommendations, pharmacists provide patients with rec- ommendations regarding multivita- mins an estimated 1.4 million times per month. 1 These interactions provide many opportunities for pharmacists to advise patients and help them meet their nutritional needs. The purpose of this article is to raise awareness of unmet needs regarding nutrient intake (specifically, micronu- trient intake) and describe how phar- macists can help address these needs. About Micronutrients A complete diet includes macronutrients (carbohydrates, lipids, and proteins), as well as more than 29 essential micronu- trients (vitamins and minerals). These micronutrients, which are required to maintain the body's metabolic and developmental processes, either cannot be produced by the body or cannot be produced in sufficient quantities to meet the body's needs. 2,3 As a result, micronu- trients must be obtained from external sources, such as food or supplements, to maintain good health. 3 Micronutrient Insufficiencies Are Common Inadequate micronutrient intake is common in the United States. In a nationwide study, Wallace et al analyzed dietary patterns in more than 16,000 individuals 4 years and older using data collected by the National Center for Health Statistics of the Centers for Disease Control and Prevention through the annual National Health and Nutrition Examination Survey (NHANES) from 2007 through 2010. 4 Based on dietary interviews and 24-hour dietary recalls, investigators determined the individuals' intakes of various vitamins and minerals and the percentage who obtained the estimat- ed average requirements (EARs) from foods (Table 1). 4,5 Importantly, because EAR intake levels meet the nutritional requirements of 50% of patients in a given age and gender group, use of EARs provides a conservative estimate of the adequacy of dietary intake. 6 Results indicate that the majority (94%) of Americans have diets inad- equate in vitamin D and nearly 9 in 10 (89%) fall below recommended levels of vitamin E intake. Magnesium, cal- cium, vitamin C, and vitamin A intake levels each fell short in more than one- third of individuals, with 52%, 44%, 39%, and 43% of individuals, respec- tively, insufficient in each of these 4 micronutrients. 4 Supplements can help address the vitamin and mineral gap. Regular use of multivitamin/mineral supplements has been shown to substantially reduce the likelihood of insufficient micronu- trient intake. 4 The Wallace et al study previously described showed that dietary supplement use reduced the percentage of Americans with inad- equate EAR intake of vitamins D, E, A, and C, as well as calcium and mag- nesium, by 21%, 24%, 19%, 20%, 10%, and 11%, respectively. 4 Insufficiencies of key vitamins and minerals may lead to a variety of rare but serious adverse health consequences in the United States (Table 2). 7-11 Populations at Higher Risk of Micronutrient Insufficiencies Although the general population is at risk for inadequate intake of several key vitamins and minerals, patients with certain conditions are at an especially high risk, including patients undergo- ing regular hemodialysis, patients with malabsorption syndromes, and indi- viduals with inadequate sunlight expo- sure. 7 Chronic alcohol use, smoking, and long-term use of medications such as methotrexate, antiepileptic drugs, and isoniazid may also cause or exac- erbate vitamin insufficiencies. 8 In addition, individuals in specific life stages and those adopting certain diets may be at risk for nutrient insuf- ficiencies. According to the United States Preventive Services Task Force (USPSTF), despite broad-scale folate fortification of enriched grain prod- Closing the Vitamin and Mineral Intake Gap: How Pharmacists Can Help This article was sponsored by the Campaign for Essential Nutrients. Pharmacy Times PharmacyTimes.com December 2015 INFORMATION FOR THE PHARMACIST TABLE 1: ESTIMATED AVERAGE REQUIREMENTS FOR SELECTED VITAMINS AND MINERALS 4,5 Vitamin/Mineral Estimated Average Daily Requirement a Percentage of Population With Intake Below Estimated Average Requirement b Vitamin D 10 mcg 94% Vitamin E 5 to 15 mg 89% Magnesium 65 to 335 mg 52% Calcium 500 to 1100 mg 44% Vitamin A 210 to 900 mcg 43% Vitamin C 13 to 100 mg 39% a Estimated average requirement varies by age, gender, and pregnancy/lactation status. b Americans aged 4 years and older.