Nutrient deficiency in Sweden: what the numbers actually show

Nutrient deficiency in Sweden: what the numbers actually show

In the spring of 2010, 1797 adults in Sweden started writing down everything they ate and drank for four days at a time. The result, Riksmaten vuxna 2010-11, is still the most detailed picture the country has of what people actually put on the plate. When Livsmedelsverket added up the nutrients, three of them came out consistently low: vitamin D, folate and iron. Not magnesium. Not vitamin C. Not the ones with the loudest packaging.

One caveat belongs before the numbers rather than after them. Only 36 percent of those invited took part, and the agency states in its English summary that the low participation rate may have influenced the results, especially for young men. Four day food records also tend to under-report intake.

The short version

• Riksmaten vuxna 2010-11 names four nutrients that come out low in Sweden: vitamin D, folate and iron, and selenium once the current Nordic reference values are applied. Magnesium and vitamin C are not on the list, whatever the supplement aisle shouts about loudest.

• A low intake is a statement about a group, a deficiency is something measured in one person's blood, and the two line up less neatly than people assume. Among women of childbearing age, 29 per cent had depleted iron stores but only 3 per cent had low folate. And the claim that food contains less nutrition than it used to is a plant breeding story, not the explanation for the Swedish gaps.

• Peak Performance lists 25 µg vitamin D3, 200 µg folate as Quatrefolic and 27.5 µg selenium per daily dose. Folate contributes to the reduction of tiredness and fatigue, and selenium contributes to the protection of cells from oxidative stress. A supplement is not a substitute for a varied diet, and a suspected deficiency belongs with a doctor.

Health Royals Peak Performance, supplement with vitamin D3, K2 as MenaQ7, folate as Quatrefolic and omega-3 from algal oil

Vitamin D, folate and selenium at Health Royals

Peak Performance lists 25 µg vitamin D3, 200 µg folate as Quatrefolic and 27.5 µg selenium per daily dose, alongside its other named raw materials. Folate contributes to the reduction of tiredness and fatigue, and selenium contributes to the protection of cells from oxidative stress. Iron is not included, so anyone who suspects iron deficiency should be tested through healthcare.

See Peak Performance

Which nutrients do people in Sweden actually get too little of?

Vitamin D, folate and iron, with selenium as a fourth once the current Nordic reference values are applied.

Livsmedelsverket's own short version of Riksmaten says it plainly: the nutrients that are hardest to get enough of are vitamin D, iron and folate, and intake is lowest of all among young women, who eat less fish, vegetables and fruit than average and drink more soft drinks.

The yardstick is the Nordic Nutrition Recommendations 2023, which sets 10 micrograms of vitamin D a day for adults, 330 micrograms of folate, 15 mg of iron for women aged 18 to 50 against 9 mg for men, and an adequate intake of 75 micrograms of selenium for women and 90 for men. Livsmedelsverket's Swedish summary of the same values raises vitamin D to 20 micrograms for women over 70.

What is the difference between a low intake and an actual nutrient deficiency, and what are the symptoms?

A low intake is a statement about a group, a deficiency is something measured in one person's blood, and the two do not line up neatly.

Reference values come in two forms. The recommended intake is set high enough to cover almost everyone in a healthy population, so an individual below it is not thereby deficient. The average requirement is the level around half the group would need, and a group whose median sits below that is a real signal. Most alarming headlines quietly compare individuals with the first number.

Riksmaten included a subsample who also gave blood and urine, and the results are instructive. Among women of childbearing age, 29 percent had depleted iron stores, 20 percent had insufficient vitamin D status and only 3 percent had low folate concentrations. The folate gap that looks severe in the intake data largely did not appear in the blood.

Symptoms are the weakest link in the chain. Tiredness, poor concentration, brittle nails, hair that sheds more than usual: these sit on every list of nutrient deficiency symptoms, and they are produced by dozens of other things, from short sleep to thyroid disease. They cannot tell you which nutrient is involved, or whether nutrition is involved at all. A blood test through healthcare can. Nothing here is a diagnosis, and a suspected deficiency belongs with a doctor rather than with a shopping basket.

Why is vitamin D the clearest case in Sweden?

Because two thirds of adults eat less than the average requirement, while only about one fifth show low levels in the blood.

Livsmedelsverket's 2018 risk and benefit report on vitamin D supplements gives the Riksmaten figures precisely: 67 percent of adults had an estimated dietary vitamin D intake below the average requirement of 7.5 micrograms per day, and 19 percent had an intake above the recommended 10 micrograms. Measured as blood status, around 20 percent of participants were below 50 nmol per litre.

The distance between the intake figure and the blood figure is sunlight. Skin synthesis during the Swedish summer covers part of what the diet does not, which is also why latitude and season matter more here than in most of the nutrition debate. On that basis the agency recommends supplements for defined risk groups, including young children, people over 75 and those who avoid sun exposure or do not eat fish and fortified foods, rather than for the population as a whole.

Under the EU register of health claims, vitamin D may be described as contributing to normal muscle function and to the normal function of the immune system. Our separate piece on vitamin D3 goes through the forms and the doses.

Do women of fertile age in Sweden have iron deficiency?

Close to a third of them had empty iron stores when it was measured, which is the largest confirmed shortfall in the Swedish data.

In the Riksmaten biomarker subsample, 29 percent of women aged 18 to 44 had depleted iron stores. The recommended intake of 15 mg a day for women aged 18 to 50, against 9 mg for men, exists because of menstrual losses. Iron contributes to normal formation of red blood cells and haemoglobin and to normal oxygen transport in the body, to use the authorised wording.

Folate sits beside iron in the same group, and its sources are more specific than most people assume. A study of 1657 Riksmaten participants found that vegetables and pulses were the single most important folate source for every age group and both sexes, accounting for 49.7 percent of total folate intake among women aged 45 to 64. Our article on folate covers the difference between the natural form, folic acid and the methylated forms.

Do people in Sweden get enough selenium?

No, and measured against the current reference values the gap is proportionally wider than for vitamin D.

The NNR2023 scoping review on selenium compiled national figures: selenium intake in Sweden is about 50 micrograms a day for men and 42 for women. The adequate intake in NNR2023 is 90 micrograms for men and 75 for women, and even the provisional average requirement, 70 and 60, sits above what Swedes actually eat. Across the Nordic and Baltic countries intakes range from 39 to 88 micrograms in men and 22 to 68 in women.

Two things explain that at once, and both should be said. The first is geology: Nordic soils are naturally low in selenium, Finland corrects this by adding selenium to fertiliser and the other Nordic countries add it to animal feed. The second is that NNR2023 raised the selenium reference value, so part of the apparent shortfall reflects a moved goalpost rather than a change in what people eat.

Selenium contributes to normal thyroid function and to the protection of cells from oxidative stress. We wrote about selenium and thyroid function separately.

Is it true that food contains less nutrition than it used to?

There is real data behind the claim, and it is narrower and more disputed than it sounds when repeated.

The paper usually cited is Davis and colleagues, 2004, which compared USDA food composition data for 43 garden crops between 1950 and 1999. Median declines ranged from 6 percent for protein to 38 percent for riboflavin, with calcium, phosphorus, iron and ascorbic acid also lower. The authors' own conclusion is the part that rarely survives the retelling: any real declines are most easily explained by changes in cultivated varieties between 1950 and 1999, in which there may be trade-offs between yield and nutrient content.

The older reference is Mayer, 1997, in the British Food Journal, which compared UK food composition tables published decades apart and reported lower mineral content in a number of fruits and vegetables.

The strongest single dataset is not from a composition table at all. Fan and colleagues, 2008 used archived wheat grain from the Broadbalk field experiment at Rothamsted, sampled continuously since 1845. Zinc, iron, copper and magnesium stayed stable from 1845 to the mid 1960s, then decreased significantly. Increasing yield and harvest index explained the downward trend, and the timing coincides with the introduction of semi-dwarf, high yielding cultivars. Soil mineral concentrations did not fall. This is a plant breeding story, not a soil exhaustion story, and that distinction disappears almost every time the finding is quoted.

What does this evidence not show?

It does not show that people in Sweden fall short of vitamin D, folate, iron or selenium because the crops changed.

Marles, 2017 reviewed the whole literature and pushed back hard. Comparisons of food composition data published decades apart are not reliable, because analytical methods, cultivars, sampling and moisture content all changed alongside the numbers. Natural variation between varieties of the same fruit is far larger than the reported declines. Much of what remains is the dilution effect, in which higher yielding plants spread the same minerals through more tissue, and the absolute differences are small enough to be covered by eating the recommended number of servings.

There is also a simpler explanation available for the Swedish gaps: fewer servings. In Folkhalsomyndigheten's national survey, the share of adults eating vegetables and root vegetables at least twice a day rose from 27 percent in 2004 to 37 percent in 2013 and then fell back to 31 percent in 2024. Fruit and berries at least twice a day fell from 34 percent in 2004 to 22 percent in 2024. Fish and shellfish at least twice a week fell from 30 percent in 2016 to 21 percent in 2024. Fish is a main dietary source of both vitamin D and selenium in this country.

And the step that normally follows, that because food is less nutritious you should therefore take a supplement, is not supported by anything above. Falling crop mineral concentrations and Swedish intake gaps are two separate findings with two separate causes, and neither study design was built to connect them. We found no research showing that supplement use closes the Riksmaten gaps at population level, so this article does not say it does.

Which nutrient rich foods make the most difference here?

The four nutrients that are genuinely low in Sweden come from a short and slightly unusual list, and it is not the same list as general healthy eating advice.

  • Fatty fish, twice a week, is the only ordinary food that delivers meaningful vitamin D and selenium in the same portion.
  • Eggs and fortified dairy carry most of the remaining dietary vitamin D in the Swedish diet, which is why the intake figures fall when milk consumption does.
  • Pulses and leafy greens are the main folate source, and gentle cooking keeps more of it than a long boil.
  • Iron from meat and fish is absorbed more readily than iron from plants, and a source of vitamin C in the same meal improves absorption from the plant sources.
  • Whole grains, eggs and fish supply most dietary selenium in a country whose soils supply little.

The part food cannot fix is the Swedish winter, and that is precisely where Livsmedelsverket's own risk group advice sits rather than in any general recommendation. More of our writing on that is collected under wellbeing.

Whether a supplement belongs in the picture is a separate question from whether the diet is short, and it is best answered with the label in front of you. Our Peak Performance formula lists vitamin D3 at 25 micrograms, selenium at 27.5 micrograms and folate as Quatrefolic at 200 micrograms per daily dose, alongside its other named raw materials, so that any comparison you make is a comparison of numbers rather than adjectives.

Further reading

Frequently asked questions

Which nutrients do people in Sweden actually get too little of?
Vitamin D, folate and iron according to Riksmaten, and selenium once measured against NNR 2023. Intake is lowest of all among young women, who eat less fish, vegetables and fruit than average. Magnesium and vitamin C are not among the documented shortfalls in the Swedish data.

Can symptoms tell me I have a nutrient deficiency?
No. Tiredness, poor concentration, brittle nails and hair that sheds more than usual appear on every symptom list, and are produced by dozens of other things, from short sleep to thyroid disease. A blood test through healthcare can answer the question, symptoms cannot.

Is it true that food contains less nutrition than it used to?
Partly, and more narrowly than it sounds. Archived wheat grain from Rothamsted shows zinc, iron, copper and magnesium falling from the mid 1960s, but the explanation was high yielding cultivars and rising harvest index. Soil mineral concentrations did not fall, so this is a plant breeding story rather than a soil exhaustion story.

Do I need a supplement if I already eat a varied diet?
No research shows that supplements close the Riksmaten gaps at population level, and we do not claim they do. More servings of fish, pulses and greens is the bigger lever. What food cannot fix is the Swedish winter, and that is precisely where Livsmedelsverket's risk group advice sits.

Why is selenium low in the Nordic countries?
Nordic soils are naturally low in selenium, Finland compensates by adding selenium to fertiliser and the other Nordic countries add it to animal feed. At the same time NNR 2023 raised the selenium reference value, so part of the apparent shortfall reflects a moved goalpost rather than a changed diet.

How reliable is Riksmaten?
Moderately. Only 36 per cent of those invited took part, and Livsmedelsverket itself states that the low participation rate may have influenced the results, especially for young men. Four day food records also tend to under-report intake.

Sources