Podcast
Questions and Answers
What is hidden hunger primarily associated with?
What is hidden hunger primarily associated with?
Which micronutrients are associated with hidden hunger?
Which micronutrients are associated with hidden hunger?
What is a significant source of pre-formed vitamin A?
What is a significant source of pre-formed vitamin A?
What is one of the main functions of Vitamin A?
What is one of the main functions of Vitamin A?
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Which of the following foods is a rich source of carotenoids?
Which of the following foods is a rich source of carotenoids?
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What factor influences the absorption efficiency of pro-vitamin A carotenoids?
What factor influences the absorption efficiency of pro-vitamin A carotenoids?
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Which of the following is a symptom of vitamin A deficiency?
Which of the following is a symptom of vitamin A deficiency?
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Why is it significant to prevent and control vitamin D deficiency?
Why is it significant to prevent and control vitamin D deficiency?
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What is the first symptom of vitamin A deficiency?
What is the first symptom of vitamin A deficiency?
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Which symptom indicates a severe deterioration of the cornea due to vitamin A deficiency?
Which symptom indicates a severe deterioration of the cornea due to vitamin A deficiency?
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What condition is characterized by dry and thickened cornea due to vitamin A deficiency?
What condition is characterized by dry and thickened cornea due to vitamin A deficiency?
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Which of the following is a risk factor for vitamin A deficiency?
Which of the following is a risk factor for vitamin A deficiency?
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What non-specific symptom may occur due to vitamin A deficiency?
What non-specific symptom may occur due to vitamin A deficiency?
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Which population is at risk for vitamin A deficiency?
Which population is at risk for vitamin A deficiency?
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What is the main ocular manifestation associated with vitamin A deficiency?
What is the main ocular manifestation associated with vitamin A deficiency?
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What does the presence of Bitot’s spot indicate?
What does the presence of Bitot’s spot indicate?
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What is the primary function of retinol and retinoic acid in the body?
What is the primary function of retinol and retinoic acid in the body?
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Which of the following groups has the highest recommended daily allowance (RDA) of vitamin A?
Which of the following groups has the highest recommended daily allowance (RDA) of vitamin A?
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What major health issue is caused by vitamin A deficiency in children?
What major health issue is caused by vitamin A deficiency in children?
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What does vitamin A deficiency epidemiology highlight regarding the number of preschool children affected globally?
What does vitamin A deficiency epidemiology highlight regarding the number of preschool children affected globally?
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What percentage of vitamin A deficient children are likely to become blind each year?
What percentage of vitamin A deficient children are likely to become blind each year?
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What role do carotenoids play in health?
What role do carotenoids play in health?
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How is vitamin A deficiency defined by WHO?
How is vitamin A deficiency defined by WHO?
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Which condition is primarily associated with vitamin A deficiency?
Which condition is primarily associated with vitamin A deficiency?
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What is the serum retinol level indicating severe deficiency in preschool children?
What is the serum retinol level indicating severe deficiency in preschool children?
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What age group should be monitored closely for vitamin D levels during supplementation?
What age group should be monitored closely for vitamin D levels during supplementation?
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Which of the following statements regarding vitamin D is true?
Which of the following statements regarding vitamin D is true?
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What is the prevalence criterion indicating mild night blindness in children aged 27-71 months?
What is the prevalence criterion indicating mild night blindness in children aged 27-71 months?
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For obese individuals on medication affecting vitamin D, how much vitamin D should be provided?
For obese individuals on medication affecting vitamin D, how much vitamin D should be provided?
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What is the lowest serum retinol level indicating moderate deficiency in pregnant women?
What is the lowest serum retinol level indicating moderate deficiency in pregnant women?
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Which statement is true concerning vitamin A and public health significance?
Which statement is true concerning vitamin A and public health significance?
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Study Notes
Vitamins and Minerals Part 1
- Course: University of Baghdad College of Medicine, 2024-2025
- Grade: Third Grade
- Module: Nutrition, Water & Electrolytes Imbalance Module (NT)
- Speaker: Ola Hussein Jasim
- Date: 30-9-2024
Learning Objectives
- Define hidden hunger.
- Identify signs and symptoms of vitamin A deficiency.
- State methods for preventing and controlling vitamin A deficiency.
- Identify the causes of vitamin D deficiency.
- State methods for preventing and controlling vitamin D deficiency.
Hidden Hunger
- "Hidden hunger" describes vitamin and mineral deficiencies that may not be immediately obvious.
- Micronutrient malnutrition is associated with metabolic disorders, immune, endocrine, and cognitive function issues, and delayed/inadequate physical development.
- It can also be an underlying factor in chronic disease.
- Coined by WHO in 1986, pertaining to deficiencies in iron, vitamin A, iodine, and vitamin D.
Vitamin A
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Retinoids (pre-formed): Found only in animal-based foods (eggs, fatty fish, dairy, liver).
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High retinol content in animal liver, fish liver oil.
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Absorbed at approximately 90%.
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Carotenoids (provitamin A): Found in plant-based foods (carrots, mangoes, melons, apricots).
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Absorption efficiency varies.
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Function: Essential for vision, maintaining tissues in the intestinal, respiratory, and urinary tracts, skin, and eyes.
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Promotes growth, reproduction.
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Retinol and retinoic acid function as steroid hormones.
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Essential for maintaining a proper immune system.
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Carotenoids act as antioxidants and reduce cancer risk.
Vitamin A Deficiency (VAD)
- WHO defines VAD as tissue vitamin A concentration enough to cause adverse health consequences.
- Occurs most commonly with clinical xerophthalmia.
- VAD can cause preventable blindness in children.
- A major controllable public health and nutrition problem (estimated 250 million preschool children are deficient.)
- Estimated 250,000 to 500,000 vitamin A-deficient children become blind every year, half dying within 12 months of losing their sight.
Vitamin A Deficiency - Recommendations and RDA
- RDA Values (Retinol Activity Equivalents): Provided in a table.
- Risk Factors: Low vitamin A diet, suboptimal breastfeeding and weaning practices, poverty, overcrowding, poor sanitation, low educational status, infections, protein-energy malnutrition, liver problems, malabsorption issues.
Vitamin A Deficiency - Signs and Symptoms
- Ocular (Specific):
- Xerophthalmia: All ocular manifestations of VAD, leading to preventable blindness.
- Bitot's spots: Triangular, pearly white/yellowish foamy spots.
- Conjunctival xerosis: Dry, wrinkled, and thickened conjunctiva.
- Corneal xerosis: Dry and dull cornea, which may progress to corneal ulceration.
- Keratomalacia: Liquefaction of the cornea, a grave medical emergency.
- Extra-ocular (Non-specific): Follicular hyperkeratosis, dry hair/nails, acne, loss of appetite/weight loss, increased risk of anemia, fatigue, growth retardation, low immunity, increased cancer risk.
Vitamin D Deficiency
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Sources:
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Sunshine: 90% from sun exposure (UVB radiation).
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Dietary sources: Fatty fish, cod liver oil, fortified foods (dairy, orange juice, soy milk, cereals), raw milk, beef liver, egg yolks, cheese contain minimal amounts.
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Chemical Forms: Vitamin D is synthesized by the body (skin) from sunlight to Vitamin D3. This is the natural form that exists in animals, including humans.
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Functions: Supporting bone health (promoting calcium absorption), promoting muscle health, modulating the immune system, aiding in cell growth, reducing inflammation, regulating blood pressure, supporting cardiovascular health.
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Vitamin D3 is more potent than D2. D2 has a lower potency and a shorter shelf-life.
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Pathways of Vitamin D synthesis: Shown in a diagram.
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Deficiency factors: insufficient/inadequate UV radiation due to seasonal/environmental factors; skin color; pollution; barriers (e.g., clothing, sunscreen), air pollution; Northern latitudes; pigmentation, certain medical conditions, drugs, breastfeeding.
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Clinical manifestations: a lack of vitamin D in children causes rickets, characterized by bowed or bent bones, muscle weakness, bone pain, and joint deformities.
Vitamin D Deficiency - Epidemiology and Risk Factors
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Epidemiology: A significant global issue (about one billion people worldwide have deficiency, 50% have insufficiency).
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Risk Factors: Lack/inadequate UVB sunlight, air pollution, northern latitudes, pigmented skin, sunscreen with SPF 15+ (99% of V.D. synthesis is blocked), institutionalization/housebound, poor mobility, vegetarian diets.
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Maternal Vitamin D Deficiency: Vitamin D is transferred to the fetus across the placenta and poor maternal stores lead to low levels in infants. Premature infants have less time to accumulate maternal vitamin D.
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Drugs: Laxatives, cholestyramine, orlistate, glucocorticoids
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Recommended Daily Amounts (RDA): Shown in a table.
Vitamin D Deficiency - Signs and Symptoms (Adults)
- Adults suffering from V.D. may exhibit the following: Fatigue, Bone discomfort/pain, muscle weakness, muscle aches/cramps, falls, impaired physical function, osteomalacia, osteoporosis, fractures, mood changes (depression/anxiety), increased susceptibility to infection.
Vitamin D Deficiency Treatment and Prevention
- Supplementation: Recommended amounts are outlined. Specific supplementation suggestions are given for various age groups.
- Preventing factors: emphasis on proper supplementation for mothers, importance of vitamin D supplementation for breastfed infants during the period of breastfeeding. Supplementing based on individual needs (obese children, use of medications affecting vitamin levels)
- Measurement of serum 25-OH levels: Levels should be measured during or shortly after treatment.
Summary
- VAD is a leading cause of preventable blindness in children.
- Vitamin A supplementation is a preventative measure in Iraq.
- Vitamin D is a crucial hormone-like vitamin influencing nearly every cell.
- Vitamin D supplementation and monitoring are essential preventative measures.
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Description
Explore the vital roles of vitamins and minerals in nutrition as part of the Nutrition, Water & Electrolytes Imbalance Module at the University of Baghdad. This quiz will cover hidden hunger, vitamin A and D deficiencies, their causes, and methods for prevention and control. Test your understanding of these essential nutrients!
