H.E.R Institute

Nutritional inadequacies are commonplace in Australia.[1] It is therefore not surprising that approximately 47%[2] of adults take nutritional supplements, reflecting a growing awareness of the importance of adequate nutrition to support health. However, according to 2019 data[3], almost half of vitamin and mineral supplementation is self-prescribed. This highlights an opportunity for clinicians to fill a crucial gap in education to ensure the safety and efficacy of supplement choice for their patients.   The risks of self-selection While convenient, the self-select approach has its shortfalls. Poor quality supplements can hinder health outcomes as patients may choose inappropriate forms, dosages, or combinations of nutrients that fail to address their individual needs. Furthermore, certain vitamins and minerals can interfere with medications. According to 2018 data[4], 1 in 3 Australians[5] are taking a prescription medication, making drug-nutrient interactions a growing cause of concern. Women are more likely than men to take almost all types of medications, including VMS, making this patient demographic an important focus for education and guidance. [6]     Education gaps cause confusion In today’s fast-paced healthcare environment, practitioners are not only tasked with symptom management but also supporting patients toward achieving optimal health. However, many clinicians feel inadequately trained in nutrition and/or overwhelmed by product choice, resulting in prescribing hesitancy.[7],[8]  Supplement education is therefore crucial to break through the confusion, with the goal of minimising risk and improving health outcomes for patients.[9] What to look for in a vitamin and mineral supplement  When guiding patients on nutritional supplements, clinicians should assess several key factors to determine product appropriateness. This can include: ·         Reviewing ingredient composition and dosing in alignment with current clinical guidelines ·         Evaluating the quality and relevance of evidence cited by the manufacturer ·         Confirming product safety through certification of third-party testing and regulatory compliance. Supplement manufacturers that provide transparent and accessible access to this information can significantly support informed clinical decision-making.   Factors to consider when assessing supplement appropriateness Safe and compliant dosing Clinicians must remain vigilant in identifying both excessive and insufficient nutrient dosing in vitamin and mineral supplements (VMS), as deviations from the Recommended Daily Intake (RDI) may negatively impact health outcomes. [10]  Although micronutrients are often perceived as inherently safe, excessive intake - such as vitamin B6 - has been associated with adverse effects. In Australia, increasing reports of vitamin B6–associated peripheral neuropathy have led the Therapeutic Goods Administration (TGA) to implement stricter regulatory controls, with products exceeding 10mg now requiring a warning label and doses above 50mg per day will require pharmacist oversight by 2027. [11] These changes will help to reduce risk, but do not negate the need for clinician guidance, due to potential accumulative exposure to high vitamin B6 from supplement combining. Brands that factor in safe supplement combining when formulating their products can assist clinicians with navigating safer supplement combinations. Conversely, underdosing also presents risks, particularly when supplements fail to meaningfully contribute to dietary shortfalls. Notably, many leading pregnancy supplement brands in Australia do not meet the TGA requirement to provide at least 25% of the RDI[12] for calcium, despite evidence that many Australian women do not achieve adequate calcium intake through diet alone.[13] In this context, clinicians play a critical role in evaluating supplement composition, identifying clinically relevant gaps or excesses relative to RDI, and guiding patients toward safe, effective, and compliant supplementation strategies.   Bioavailability Bioavailability is central to the effectiveness of supplements because only the fraction of a nutrient that is absorbed and utilised by the body can deliver a physiological benefit. Simply increasing the dose does not guarantee improved outcomes, as many nutrients are absorbed via mechanisms that limit uptake and increase competition at higher intakes. Bioavailability can be affected by factors such as dosing, nutrient competition and format. For example, larger single doses of calcium can compete with iron for intestinal transport, whereas calcium doses below approximately 800 mg do not appear to significantly inhibit iron absorption.[14] Additionally, lower, split doses of iron have shown superior absorption and gastrointestinal tolerability compared with large doses.[15] Different formats can also affect bioavailability. For instance, calcium citrate has shown superior bioavailability in those with low stomach acid[16], and powder forms of calcium carbonate have shown superior bioavailability to tablet forms of citrate.[17] Clinicians can optimise bioavailability through appropriate dosing, nutrient formats, and synergy between complementary nutrients, supporting supplement efficacy and patient outcomes.   Palatability and tolerability Palatability and tolerability are important considerations when recommending nutritional supplements, as they directly influence patient adherence and sustained use.[18] Unpleasant taste or gastrointestinal side effects - such as nausea or constipation - can significantly reduce compliance, particularly among women with increased sensitivity, such as during pregnancy.[19] Formulation plays a key role; for example, micronised iron preparations have been shown to improve gastrointestinal tolerability and compliance compared to conventional iron salts, while also offering a neutral taste profile.19 Selecting products that are optimised for palatability and tolerability can help support patient outcomes through improved adherence.    TGA listing In Australia, TGA-listed medicines - identified by an AUST L number on the label - apply to therapeutic products containing pre-approved, low-risk ingredients and making limited health claims.[20]  Although these products are not individually assessed for efficacy prior to market entry, sponsors are legally required to hold supporting evidence and comply with established quality and safety standards. Brands that transparently provide access to this documentation enable clinicians to more easily evaluate product credibility, regulatory compliance, and suitability for patient care.18   Independent testing Independent testing provides an objective check that a supplement contains what it claims on the label, in the stated dose, and without harmful contaminants. Unlike in-house testing, independent third-party analysis reduces conflicts of interest and increases confidence in product quality, purity, and consistency between batches. For clinicians and consumers, independent testing helps identify issues such as under- or overdosing, heavy metals, undeclared ingredients, or degradation over time, all of which can directly affect safety and efficacy. In a crowded supplement market, independent verification is a key marker of transparency, accountability, and trust.   Cost and Accessibility Cost should be considered alongside quality and safety when recommending nutritional supplements, as it can also influence adherence and clinical effectiveness. Accessibility is equally important in this context, with both retail and online availability offering distinct benefits. While retail offers immediacy, online access supports convenience, continuity of supply, and improved reach for patients in remote or rural settings, while enabling access to detailed product information to support informed choices. Clinicians can help guide patients toward options that balance affordability, formulation quality, and accessible purchasing pathways to support sustained, effective supplementation.   In summary: By identifying high-quality, evidence-backed brands and products, clinicians can help patients effectively address nutritional gaps, support overall health and wellbeing, and minimise the risk of adverse effects from supplementation. Consideration of dosing, formulation quality, palatability, tolerability, accessibility, and cost is essential to personalised care, sustained adherence, and the maintenance of patient trust.   [1] Starck CS, Cassettari T, Beckett E, Marshall S, Fayet-Moore F. Priority nutrients to address malnutrition and diet-related diseases in Australia and New Zealand. Frontiers in Nutrition. 2024 Mar 13;11:1370550. [2] O’Brien SK, Malacova E, Sherriff JL, Black LJ. The prevalence and predictors of dietary supplement use in the Australian population. Nutrients. 2017 Oct 21;9(10):1154. [3] Harnett JE, McIntyre E, Steel A, Foley H, Sibbritt D, Adams J. Use of complementary medicine products: a nationally representative cross-sectional survey of 2019 Australian adults. BMJ open. 2019 Jul 1;9(7):e024198. [4] Roy Morgan Research. Almost 9-in-10 Australians take medication of some kind [Internet]. Melbourne: Roy Morgan; 2018 May 21 [cited 2026 Jan 24]. Available from: https://www.roymorgan.com/findings/almost-9-in-10-australians-take-medication-of-some-kind. [5] Wylie CE, Daniels B, Brett J, Pearson SA, Buckley NA. A national study on prescribed medicine use in Australia on a typical day. Pharmacoepidemiology and drug safety. 2020 Sep;29(9):1046-53. [6] O’Brien SK, Malacova E, Sherriff JL, Black LJ. The prevalence and predictors of dietary supplement use in the Australian population. Nutrients. 2017; 9 (10): 1154 [Internet]. [7] Carter C, Harnett JE, Krass I, Gelissen IC. A review of primary healthcare practitioners’ views about nutrition: implications for medical education. International journal of medical education. 2022 May 26;13:124. [8] Koe T. Maintaining momentum: Australian supplements sector secures domestic and exports growth [Internet]. NutraIngredients. 2020 Jun 9 [cited 2026 Jan 24]. Available from: https://www.nutraingredients-asia.com/Article/2020/06/09/Maintaining-momentum-Australian-supplements-sector-secures-domestic-and-exports-growth/ [9] Furness D, Hancock L, Wurth J, Wakefield TA, Stosic R, Mazza D. Factors associated with Australian preconception and pregnant women's nutrition and nutrient supplement knowledge. Reproductive, Female and Child Health. 2023 Sep;2(3):188-202. [10] Intakes IR. Nutrient Reference Values for Australia and New Zealand. Commonwealth Department of Health and Ageing: Australia. 2005. [11] Therapeutic Goods Administration (TGA). Stronger safety controls to be introduced for products containing vitamin B6 [Internet]. 25 Nov 2025 [cited 2026 Jan 25]. Available from: https://www.tga.gov.au/news/media-releases/stronger-safety-controls-be-introduced-products-containing-vitamin-b6 [12] Therapeutic Goods Administration (TGA). Understanding quality requirements for listed medicines [Internet]. 1 May 2020 [cited 2026 Jan 25]. Available from: https://www.tga.gov.au/resources/guidance/understanding-quality-requirements-listed-medicines [13] Australian Bureau of Statistics. Australian Health Survey: Usual nutrient intakes, 2011–12 financial year [Internet]. Canberra: ABS; released 6 March 2015 [cited 2025 Aug 26]. Available from: https://www.abs.gov.au/statistics/health/health-conditions-and-risks/usual-nutrient-intakes/latest-release [14] Gaitán D, Flores S, Saavedra P, Miranda C, Olivares M, Arredondo M, de Romana DL, Lönnerdal B, Pizarro F. Calcium does not inhibit the absorption of 5 milligrams of nonheme or heme iron at doses less than 800 milligrams in non-pregnant women. The Journal of nutrition. 2011 Sep 1;141(9):1652-6. [15] Stoffel NU, von Siebenthal HK, Moretti D, Zimmermann MB. Oral iron supplementation in iron-deficient women: How much and how often?. Molecular aspects of medicine. 2020 Oct 1;75:100865. [16] Trailokya A, Srivastava A, Bhole M, Zalte N. Calcium and calcium salts. Journal of the Association of Physicians of India. 2017 Feb 1;65(1):1-2. [17] Wang H, Bua P, Capodice J. A comparative study of calcium absorption following a single serving administration of calcium carbonate powder versus calcium citrate tablets in healthy premenopausal women. Food & nutrition research. 2014 Jan 1;58(1):23229. [18] Delompré T, Guichard E, Briand L, Salles C. Taste perception of nutrients found in nutritional supplements: A review. Nutrients. 2019 Sep 2;11(9):2050. [19] Patki A, Jyothi GS, Thobbi V, Srivastav A, Ganu G, Shah AS. Efficacy and safety of emulsified microsomal ferric pyrophosphate vs. Ferrous Ascorbate in pregnancy with iron-deficiency anemia-a randomized, comparative study. Scientific Reports. 2025 Nov 12;15(1):39671. [20] Therapeutic Goods Administration (TGA). Listed medicines [Internet]. Canberra: Australian Government Department of Health and Aged Care; 2026 [cited 2026 Jan 26]. Available from: https://www.tga.gov.au/products/medicines/listed-medicines

Nutritional deficiencies remain prevalent in Australia, despite widespread food availability and food fortification strategies. Common nutrient deficiencies, including calcium, iron, and vitamin D, are well recognised by healthcare professionals and therefore form part of routine testing.[1],[2] However, historical nutrient deficiency disorders, such as scurvy, appear to be making a come-back, indicating that the drivers of nutrient deficiencies in today’s patient are becomingly increasingly complex.[3] In addition to poor dietary intake, nutrient deficiency can be caused by a range of environmental, socio-economic, dietary, and pharmacological factors that contribute to inadequate nutrient intake and/or absorption. This article examines the not-so-obvious drivers of nutrient deficiency, the implications for patient health and clinical tips to help convert this knowledge into improved nutritional health outcomes for your patients. Inadequate dietary intake Australians consume 42% of daily energy from ultra processed foods, which can result in nutritional short falls Diet is the cornerstone of nutritional health and inadequate intake remains a significant contributor to nutritional deficiency in Australia.[4] Despite Government strategies, Australian diets remain largely deficient in nutrient-dense foods (e.g., fruits, vegetables, meat and dairy), and excessive in energy-dense, discretionary foods - such as ultra-processed foods (UPFs).[5],[6] UPFs consist of multiple ingredients that undergo a sequence of industrial processes. Examples include mass produced breads, breakfast cereals, soft drinks, flavoured milks, fast foods, and confectionary.[7] They are often low cost, high in artificial additives and highly palatable; qualities that are conducive to overconsumption. UPFs currently account for 42% of energy consumption in Australian diets. 7 Increased consumption of UPFs can exacerbate nutritional shortfalls. Processing techniques, including milling, heating, and chemical preservation, contribute to significant losses of essential vitamins and minerals and disrupt the natural food matrix. For example, refining grains removes fibre and B vitamins, while heat processing degrades vitamin C.[8] Global studies on high UPF diets have shown reduced consumption of vitamins A, C, D, E, B12, B6, β-carotene, thiamine, riboflavin, niacin, folate, zinc, potassium, phosphorus, magnesium, calcium, and iron.[9] Clinical considerations: Dietary strategies that are personalised to address individual barriers to healthy eating patterns, including socio-economic status, food addictions and aversions, can help inform meaningful education and dietary change to help resolve nutritional inadequacies.[10] Vitamin and mineral supplementation may be required where diet is inadequate.   Drug-nutrient interactions Up to 29% of drug-nutrient interactions can have clinically significant health outcomes Many physicians may not be aware that the medications they prescribe are negatively affecting their patient’s micronutrient status. Recent statistics show that 33% of Australian’s are currently taking a prescribed medication, and 45% of those aged 75 years and over are prescribed polypharmacy (5 or more medications).[11] Up to 29% of drug-nutrient interactions can have clinically significant health outcomes, including the interference of nutrient metabolism and absorption (see Figure 1).[12]  Fig 1: Drug-Nutrient Interactions Drug type Micronutrient affected Protein pump inhibitors B12, calcium, iron Antacids Folate, iron, phosphorous Antibiotics Biotin, vitamin K, zinc, calcium, magnesium, iron Metformin B12 ACE inhibitors Zinc Diuretics Magnesium Oral contraceptives B6, B12, folate, vitamins E, C, magnesium, zinc [13],[14] Clinical Considerations: Clinicians should assess medication-related nutrient depletion risks and implement appropriate nutritional testing and support strategies as required, with particular consideration for those exposed to polypharmacy who are at higher risk of deficiency.   Malabsorption Syndromes Malabsorption syndromes such as small intestinal overgrowth, are notoriously underdiagnosed Malabsorption syndromes occur in response to the disruption of the normal digestive, absorptive or nutrient transport process. Malabsorption syndromes vary in prevalence, from 0.3% for inflammatory bowel disease (IBD), to up to 22% for small bacterial overgrowth (SIBO); the latter being notoriously underdiagnosed.[15],[16]    Symptoms can present as overt, subclinical or asymptomatic, and depend on whether the malabsorption is partial, affecting selective nutrients, or global, affecting most nutrients.[17] Severe nutrient deficiencies occur in advanced malabsorption states, however iron deficiency anaemia may be the only symptom of mild malabsorption.[18] Figure 2: Malabsorption syndromes and associated nutrient deficiencies Malabsorption syndrome Micronutrient/s affected Small intestinal bacterial overgrowth (SIBO) B12 Ceoliac disease Iron, folate, zinc, vitamin D, B12, copper Chron’s disease Iron, calcium, vitamin D, B12, copper, zinc, selenium Infectious diarrhoea Vitamin A, thiamin, B12, folate, iron [19],[20],[21] Clinical Considerations: Clinicians should routinely assess the nutritional status of those at risk of malabsorption, including those with SIBO, inflammatory bowel disease and elderly patients. Additionally, those with that present with asymptomatic nutritional deficiency of non-dietary cause should be investigated for malabsorption disorders, including hydrogen breath testing for SIBO, which is a notoriously mis- and under-diagnosed malabsorption condition.   Anti-nutrient compounds Plant food diets are high in anti-nutrient compounds Anti-nutrients compounds (ANCs) are found naturally in foods and are responsible for reducing the absorption and bioavailability of nutrients in the body. ANC’s such as phytates, oxalates, saponins, lectins and tannins, are typically found in plant foods and are produced by plants as a protective mechanism to avoid being eaten. While ruminant animals possess the digestive capacity to process ANCs, humans do not.[22],[23] For humans to better access the nutritional value of plant foods, these anti-nutrient compounds should be removed or inactivated. Often this is achieved by the cooking process, however some ANCs may require additional techniques, like soaking or fermenting.[24] Research has shown that those following vegan and/or vegetarian diets may be at risk of reduced mineral absorption from plant foods due to high phytate and oxalate consumption.[25],[26] Figure 3: Anti-Nutrients Compounds and their health impacts Anti-nutrients Effects on body Food sources Deactivation methods Phytates Reduce calcium, magnesium, zinc, copper, iron, potassium, molybdenum and copper Pulses (e.g., soy), oil seeds (e.g., rapeseed, cotton seed), wheat, maize, rice, barley Soaking, cooking, milling, germinating, fermentation, ascorbic acid Oxalates Reduce calcium absorption, promote kidney stone formation Spinach, soy bean, amaranth Cooking (e.g., boiling) Lectins (Hemagluten) Loss of protein utilization, disruption of intestinal epithelial barrier function Legumes, seeds, tubers, raw kidney beans, peanuts Cooking Goitrogens Inhibit iodine uptake from thyroid gland, health risk increased in low iodine diets Soy bean, ground nut Cooking (e.g., boiling) Saponins High doses reduce protein digestion, low doses can support cardiovascular health Pulses, beans, peas, seeds Cooking, fermentation Tannins Reduce iron absorption Tea, cocoa, mango, berries, walnuts, packaged juices Soaking, germinating, fermentation Protease inhibitors Reduce protein digestion Legumes Cooking [27],[28], [29] In Summary: There are multiple contributing factors to nutritional deficiencies. Despite access to an abundant food supply, many Australians are still at risk of nutritional gaps. Clinicians can help minimise this risk by taking a holistic approach to their patients’ health by implementing the following practices: ü  Routine nutritional assessments ü  Thorough investigations into underlying causes (e.g., hydrogen breath testing) ü   Personalised dietary advice ü  Nutritional supplementation as required   [1] Wilson RL, Leviton AJ, Leemaqz SY, Anderson PH, Grieger JA, Grzeskowiak LE, Verburg PE, McCowan L, Dekker GA, Bianco-Miotto T, Roberts CT. Vitamin D levels in an Australian and New Zealand cohort and the association with pregnancy outcome. BMC Pregnancy Childbirth. 2018 Jun 20;18(1):251. doi: 10.1186/s12884-018-1887-x. PMID: 29925344; PMCID: PMC6011374. [2] Australian Bureau of Statistics. Australian Health Survey: Usual Nutrient Intakes [Internet]. Canberra: ABS; 2011 December [cited 2025 April 10]. Available from: https://www.abs.gov.au/statistics/health/health-conditions-and-risks/australian-health-survey-usual-nutrient-intakes/latest-release. [3] Uddin MA, Robson C, Dotel R. Disease of the past re-emerging in modern Australian society. BMJ Case Reports CP. 2019 Apr 1;12(4):e228448. [4] Australian Bureau of Statistics. Australian Health Survey: Usual Nutrient Intakes [Internet]. Canberra: ABS; 2011 December [cited 2025 April 10]. Available from: https://www.abs.gov.au/statistics/health/health-conditions-and-risks/australian-health-survey-usual-nutrient-intakes/latest-release. [5] Australian Institute of Health and Welfare. Diet [Internet]. Canberra: Australian Institute of Health and Welfare, 2024 [cited 2025 Apr. 10]. Available from: https://www.aihw.gov.au/reports/food-nutrition/diet [6] Starck CS, Cassettari T, Beckett E, Marshall S, Fayet-Moore F. Priority nutrients to address malnutrition and diet-related diseases in Australia and New Zealand. Frontiers in Nutrition. 2024 Mar 13;11:1370550. [7] Marchese L, Livingstone KM, Woods JL, Wingrove K, Machado P. Ultra-processed food consumption, socio-demographics and diet quality in Australian adults. Public Health Nutr. 2022 Jan;25(1):94-104. doi: 10.1017/S1368980021003967. Epub 2021 Sep 13. Erratum in: Public Health Nutr. 2022 Jan;25(1):205. doi: 10.1017/S1368980021004067. PMID: 34509179; PMCID: PMC8825971. [8] MOYO HN. The Impact of Food Processing Techniques on Nutrient Retention and Bioavailability. [9] Houshialsadat Z, Cediel G, Sattamini I, Scrinis G, Machado P. Ultra-processed foods, dietary diversity and micronutrient intakes in the Australian population. European Journal of Nutrition. 2024 Feb;63(1):135-44. [10] Harshman SG, Wons O, Rogers MS, Izquierdo AM, Holmes TM, Pulumo RL, Asanza E, Eddy KT, Misra M, Micali N, Lawson EA. A diet high in processed foods, total carbohydrates and added sugars, and low in vegetables and protein is characteristic of youth with avoidant/restrictive food intake disorder. Nutrients. 2019 Aug 27;11(9):2013. [11] Wylie CE, Daniels B, Brett J, Pearson SA, Buckley NA. A national study on prescribed medicine use in Australia on a typical day. Pharmacoepidemiology and drug safety. 2020 Sep;29(9):1046-53. [12] Prescott JD, Drake VJ, Stevens JF. Medications and Micronutrients: Identifying Clinically Relevant Interactions and Addressing Nutritional Needs. J Pharm Technol. 2018 Oct;34(5):216-230. doi: 10.1177/8755122518780742. Epub 2018 Jun 20. PMID: 34860982; PMCID: PMC6109862. [13] Basciani S, Porcaro G. Counteracting side effects of combined oral contraceptives through the administration of specific micronutrients. European Review for Medical & Pharmacological Sciences. 2022 Jul 1;26(13). [14] Prescott JD, Drake VJ, Stevens JF. Medications and Micronutrients: Identifying Clinically Relevant Interactions and Addressing Nutritional Needs. J Pharm Technol. 2018 Oct;34(5):216-230. doi: 10.1177/8755122518780742. Epub 2018 Jun 20. PMID: 34860982; PMCID: PMC6109862. [15] Iuliano, S., et al., Dairy food supplementation may reduce malnutrition risk in institutionalised elderly. The British journal of nutrition, 2017. 117(1): p. 142-147. [16] Sroka N, Rydzewska-Rosołowska A, Kakareko K, Rosołowski M, Głowińska I, Hryszko T. Show Me What You Have Inside—The Complex Interplay between SIBO and Multiple Medical Conditions—A Systematic Review. Nutrients. 2022 Dec 24;15(1):90. [17] Bai JC. Malabsorption syndromes. Digestion. 1998 May;59(5):530-46. [18] Malik Z. Overview of Malabsorption. MSD Manual: Professional; 2025 Mar. Retrieved from: https://www.msdmanuals.com/professional/gastrointestinal-disorders/malabsorption-syndromes/overview-of-malabsorption#Diagnosis_v893754 [19] Montoro-Huguet MA, Belloc B, Domínguez-Cajal M. Small and large intestine (I): malabsorption of nutrients. Nutrients. 2021 Apr 11;13(4):1254. [20] Lamjadli S, Oujamaa I, Souli I, Eddehbi FE, Lakhouaja N, M’raouni B, Salami A, Guennouni M, Belghali MY, Hazime R, Admou B. Micronutrient deficiencies in patients with celiac disease: A systematic review and meta-analysis. International journal of immunopathology and pharmacology. 2025 Jan;39:03946320241313426. [21] Lebovits J, Lee AR. Micronutrient Considerations for Celiac Disease. Pract. Gastroenterol. 2023 Oct;27:26-42. [22] https://d1wqtxts1xzle7.cloudfront.net/88224885/7--1-201-135-libre.pdf?1656958314=&response-content-disposition=inline%3B+filename%3DAn_overview_of_anti_nutritional_factors.pdf&Expires=1739868468&Signature=dGX2BycYTM4fU5pum1gafqjbR5AgIoP3-V08oN-h6P8oEtSaeDOztlAU-xvPrRBWmaapRAQml9dbK7thI4xoQ2cM87kCGmtIQQwIpdo5h-9Stk7qUwy0SsOc89Dsx1PeHxnoOF4-PWRUbPKmrYYgb0wib9C8V1jrJZH91KDJZtg1zfDrFZ852OCt96U4j-ufTuB~B0ubLQMD4Hw8VZQ7ylG6rQAY6gyyWESSiFrg2LF0NSeadqYLl2vYInsF8v5-0ZTMichU5lPN3Ej31VTHfWJH-XfzjAB3DT6qxM6hiEWkEjqHnYAy3PZaSwwqP-cdhGvkxTYtfBU9n5JqFp5SOg__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA [23] https://www.sciencedirect.com/science/article/pii/S266614972200010X [24] Petroski W, Minich DM. Is there such a thing as “anti-nutrients”? A narrative review of perceived problematic plant compounds. Nutrients. 2020 Sep 24;12(10):2929. [25] Weaver CM, Proulx WR, Heaney R. Choices for achieving adequate dietary calcium with a vegetarian diet. The American journal of clinical nutrition. 1999 Sep 1;70(3):543S-8S. [26] Hunt JR. Bioavailability of iron, zinc, and other trace minerals from vegetarian diets. The American journal of clinical nutrition. 2003 Sep 1;78(3):633S-9S. [27] Salgado N, Silva MA, Figueira ME, Costa HS, Albuquerque TG. Oxalate in foods: extraction conditions, analytical methods, occurrence, and health implications. Foods. 2023 Aug 25;12(17):3201. [28] López-Moreno M, Garcés-Rimón M, Miguel M. Antinutrients: Lectins, goitrogens, phytates and oxalates, friends or foe?. Journal of Functional Foods. 2022 Feb 1;89:104938. [29] Samtiya M, Aluko RE, Dhewa T. Plant food anti-nutritional factors and their reduction strategies: an overview. Food Production, Processing and Nutrition. 2020 Dec;2:1-4.