Vitamins and Minerals Lecture PDF

Lecture 6: Vitamins and Minerals Prepared by: Joseph Karlo P. Joven, RND  VITAMINS Aka “accessory growth factors” Noncaloric organic compounds needed in trace amounts to help facilitate body processes Essential for normal health and growth Specific deficiency disease can develo...

Lecture 6: Vitamins and Minerals Prepared by: Joseph Karlo P. Joven, RND  VITAMINS Aka “accessory growth factors” Noncaloric organic compounds needed in trace amounts to help facilitate body processes Essential for normal health and growth Specific deficiency disease can develop when they are not adequately supplied by the diet or improperly absorbed from the food  VITAMINS Vitamin precursors in foods are converted into active form in the body They serve as coenzymes They can be readily destroyed during processing Each vitamin is a singular unit  BIOAVAILABILITY The rate and extent to which a nutrient is absorbed and used The amount of vitamins available from foods depends on two factors The quantity provided by a food Amount absorbed and used by the body (bioavailability)  FAT-SOLUBLE VS. WATER SOLUBLE VITAMINS FAT-SOLUBLE VITAMINS WATER-SOLUBLE VITAMINS Vit. A, D, E, K Vit. C and B-complex Soluble in fat and fat solvents Soluble in water; Absorbed directly into the blood Must travel with protein carrier in Travel freely in water fluids; most are water body fluids; stored in the liver or not stored in the body fatty tissues Not readily excreted; tend to build up Readily excreted in the urine in the tissues; small amounts are excreted in the bile Toxicities are likely from supplements Toxicities are unlikely but possible with but occur rarely from food high doses from supplements Needed in periodic doses (perhaps Needed in frequent doses (perhaps weekly or even monthly) because the every 1 to 3 days) because the body body can draw on its stores. does not store most of them to any extent)  FAT-SOLUBLE VS. WATER SOLUBLE VITAMINS FAT-SOLUBLE VITAMINS WATER-SOLUBLE VITAMINS Vit. A, D, E, K Vit. C and B-complex Have precursors or provitamins Generally do not have precursors Contains only C, H, O Contains C, H, O, N and other elements such as Cobalt or Sulfur Absorbed into intestinal cells in Absorbed through the portal vein the form of micelle and travel through the lymphatic system together with chylomicrons Some are toxic at relatively low Toxic only at megadose levels levels (6-10x the RNI) (>10x the RNI)  RELATED SUBSTANCES Provitamins (Precursors) Compounds that can be converted into active vitamins. Ex. Beta-carotene Antivitamins (Antagonist) Chemically related to true vitamins but cannot perform the biological function of the true vitamins Ex. Avidin in raw & dry egg whites that prevents the utilization of biotin (B7)  VITAMIN A All naturally occurring compounds with the biological activity of retinol, the alcohol form of vitamin A Aka the anti-infective vitamin Beta-carotene – carotenoid with the greatest vitamin A activity Vitamin A activity – a term referring to both the active forms of Vit. A and the precursor forms in foods without distinguishing between them  VITAMIN A Retinoids – chemically related compounds with biological activity similar to that of retinol Retinol-binding protein – the specific protein responsible for transporting retinol FORMS OF VITAMIN A Retinol The alcohol form Transport and storage form Retinal The aldehyde form Active in vision Intermediate in the conversion of retinol to retinoic acid Retinoic acid The acid form Acts like a hormone, regulating cell differentiation, growth, and embryonic development  CONVERSION OF VITAMIN A COMPOUNDS IN FOODS: RETINOIDS CAROTENOIDS (In animal (In plant foods) foods) IN THE BODY: RETINOL RETINAL RETINOIC (Supports (Participates in ACID reproduction) vision) (Regulates growth) FUNCTION OF VITAMIN A Promote normal vision Helps maintain cornea Participates in the conversion of light energy into nerve impulses at the retina Participates in protein synthesis and cell differentiation Supports immune system Supports reproduction, promotes growth, and bone remodeling FUNCTION OF VITAMIN A Promote cell differentiation Maintain health of epithelial tissues and skin Vit. A and beta-carotene help to protect against skin damage from sunlight Vit. A promote differentiation of goblet cells, one celled glands that secrete mucus that protects epithelial cells. FUNCTION OF VITAMIN A Supports immune system Maintaining epithelial tissues helps prevent the invasion of bacteria and viruses In women, vit. A supports normal fetal development during pregnancy Participates in removing parts not needed as bone grows Ex. A fetus has a tail and loses it VITAMIN A DEFICIENCY Impaired growth and development Keratinization (hardening and sloughing) of mucous membranes or epithelial linings forming keratin Decreased resistance to infection  RHODOPSIN CYCLE Also referred to as Wald’s Visual Cycle or Dark Adaptation In order to maintain the ability to detect light, the rods must reconvert the all-trans retinal into 11-cis retinal Occurs in dark environment  RHODOPSIN CYCLE Also referred to as Wald’s Visual Cycle or Dark Adaptation In order to maintain the ability to detect light, the rods must reconvert the all-trans retinal into 11-cis retinal Occurs in dark environment VITAMIN A DEFICIENCY EYES 1. Symptoms of mild deficiency poor dark adaptation or night blindness Conjunctival xerosis (drying of the conjunctiva and cornea) Bitot’s spots (white cheesy appearance) Corneal ulcerations VITAMIN A DEFICIENCY EYES 2. Symptoms of severe deficiency Xeropthalmia – progressive blindness caused by Vit. A deficiency Keratomalacia – softening of the cornea leads to irreversible blindness Total blindness  VITAMIN A DEFICIENCY The different eye signs of vitamin A deficiency (VAD) in children, as graded by the WHO, are: Night blindness (XN) Conjunctival xerosis (X1A) Bitot's spots (X1B) Corneal xerosis (X2) Corneal ulcer covering less than 1/3 of the cornea (X3A) Corneal ulcer covering at least 1/3 of the cornea, defined as keratomalacia (X3B) Corneal scarring (XS)  VITAMIN A TOXICITY Hypervitaminosis (Vit. A ≥15,000) Manifestations: headaches, dizziness, nausea, dry and itchy skin, hemoglobin losses, cessation of menstruation, induced bleeding Hypercarotenemia Yellow pigmentation of the skin VITAMIN A TOXICITY Bone Defects Increased risk is possible, resulting in weakened bones, and contributes to osteoporosis and fractures Birth Defects Teratogenic risk is possible, resulting in abnormal fetal development and birth defects (e.g. spina bifida and cleft palate) Vitamin A supplements are not recommended the first trimester of pregnancy  VITAMIN A RECOMMENDATIONS Retinol activity equivalents (RAE): a measure of vitamin A activity; the amount of retinol that the body will derive from a food containing preformed retinol or its precursor betacarotene RAE = preformed vitamin A + the amount obtained by converting the precursor to the active form  VITAMIN A RECOMMENDATIONS 1 retinol equivalent (R.E.) =1 ug retinol =6 ug beta-carotene =12 other mixed carotenes =3.33 I.U. retinol =10 I.U. Beta-carotene FOOD SOURCES OF VITAMIN A Preformed All animal sources; in fatty portions of the food; dairy products; eggs; meat; liver; fortified skim milk and margarine; fish liver oils FOOD SOURCES OF VITAMIN A Betacarotene All plant sources: yellow/orange/red fruits and vegetables; dark green leafy vegetables, spinach, kale, broccoli, golden rice  VITAMIN D Nonessential nutrient that acts like a hormone in the body Body can make vit. D with help from sunlight – precursor is the body’s own cholesterol Antirachitic factor – cures or prevents rickets FORMS OF VITAMIN D Ergocalciferol (vit. D2) – derived from plants in the diet Cholecalciferol (vit. D3 or calciol) – derived from animals in the diet or made in the skin Calcidiol (25-hydroxyvitamin D) - found in the blood that is made from the hydroxylation of calciol in the liver Calcitriol (1,25-dihyrdroxyvitamin D) – made from the hydroxylation of calcidiol in the kidneys; the biologically active hormone, sometimes called active vitamin D. FORMS OF VITAMIN D  FUNCTIONS OF VITAMIN D Promotes normal bone and teeth formation Stimulate calcium uptake for deposition as calcium phosphate (Osteoblasts: bone-forming cells) Helps to maintain blood levels of calcium and phosphorus Bone mineralization  VITAMIN D DEFICIENCY Factors that contribute to deficiency: Dark skin Breastfeeding without supplementation Lack of sunlight Use of nonfortified milk VITAMIN D DEFICIENCY Rickets (in children) – characterized by soft and fragile bones, enlarged joints, bowed legs and deformities of the chest, spine and pelvis Delayed closure of the fontanels Osteomalacia (in adults) – aggravated by calcium deficiency, characterized by softening of the bones Osteopenia and Osteporosis – loss of calcium from the bones causing reduced bone density  VITAMIN D TOXICITY Hypervitaminosis D – elevated blood calcium; calcification of soft tissues (blood vessels, kidneys, heart, lungs, tissues around joints) Vitamin D from sunlight and food is not likely to cause toxicity High-dose supplements may cause toxicity FOOD SOURCES OF VITAMIN D Chocolate mixes, veal, beef, egg yolks, liver, fatty fish (herring, salmon, sardines) and their oils Cheese, butter, margarine, fortified milk, fish and fortified cereals  VITAMIN E Aka alpha-tocopherol Consists of two subgroups – the tocopherols and the tocotrienols. All are made up of a complex ring structure with a long saturated (in tocopherols) or unsaturated (in tocotrienols) side chain. The number of positions of methyl groups (CH3) distinguish the members within each subgroup  VITAMIN E Describes a family of 8 antioxidants 4 tocopherols 4 tocotrienols A-tocopherol – active form of vitamin E in the human body (other forms have very limited bioavailability)  FUNCTIONS OF VITAMIN E Antioxidant – main function Stabilization of cell membranes Regulation of oxidation reactions Protection of PUFA and vitamin A Preserves the integrity of red blood cells  VITAMIN E DEFICIENCY Red blood cell breakage (hemolysis) Anemia Degeneration weakness Severe pain in the calf muscle Retinopathy (defective functioning of the retina) among premature infants  VITAMIN E TOXICITY Gastrointestinal distress Nausea Diarrhea Problems with blood clotting if Vitamin D is also marginal VITAMIN E: FOOD SOURCES Plant sources: sunflower seeds and oils, germ oils of wheat, corn, cottonseed, soybean; products from such oils: mayonnaise, salad dressings, margarine Animal sources: egg yolks, liver, butter, milk  VITAMIN K The generic term for several fat soluble substances belonging to a group of chemicals known as quinones Other names: Phylloquinone (vitamin K1) Menaquinone (vitamin K2) Menadione (in supplements)  VITAMIN K Stable to heat but easily destroyed by light, oxidizing agents and alkalis Stored in the liver Synthesized by bacteria in the intestine Dicumarol – Interferes with the metabolism of vit. K Antibiotics and sulfa drugs interfere with vit. K synthesis  FUNCTION OF VITAMIN K Synthesis of blood-clotting proteins; prevents hemorrhage Participates in metabolism of bone proteins (osteocalcin)  VITAMIN K DEFICIENCY Hemorrhaging Bone health, i.e. osteoporosis  VITAMIN K TOXICITY Hemolytic anemia (red blood cell hemolysis) Hyperbilirubinemia (accumulation of bilirubin in the blood) Kernicterus (bile pigments accumulates in the gray matter of central nervous system leading to brain damage) FOOD SOURCES OF VITAMIN K Liver, dark green leafy vegetables, cabbage type vegetables, milk, avocado, kiwi, soybean oil WATER-SOLUBLE VITAMINS  THIAMIN Vitamin B1, Anti-beriberi vitamin, antineuritic or aneurin vitamin, morale vitamin Easily destroyed by heat Readily lost by leeching Destroyed by sulfites  FUNCTIONS OF THIAMIN Helps maintain normal appetite Regulates muscle tone of the GIT necessary for digestion Normal function of nerves Combines with phosphorous to form thiamine pyrophosphate (TPP) which functions as a decarboxylase and cocarboxylase Assists in the conversion of tryptophan to niacin Thiamin as coenzymes helps in carbohydrate metabolism  THIAMIN Generally, thiamin needs will be met if a person eats enough food to meet energy needs-if that energy comes from nutritious foods Requirement increases with alcohol consumption, use of sulfonamide drugs, and antibiotics, severe diarrhea, pregnancy and lactation, fever, surgery and an excessive intake of sugars and starches Requirement for thiamin decreases with an increased consumption of fats FOOD SOURCES OF THIAMIN Organ meats, lean pork, egg yolk, whole grain cereals, enriched rice, enriched bread, munggo beans, nuts (pili, peanut, cashew), legumes THIAMIN DEFICIENCY Dry beriberi – damage to the nervous system; characterized by muscle weakness in the arms and legs Wet beriberi – damage to the cardiovascular system; characterized by dilated blood vessels, edema Infantile beriberi – seen mostly in breast-fed infants whose mothers are deficient in thiamin Wernick-Korsakoff Syndrome – a vitamin B1 deficiency disease particularly associated with chronic alcoholics THIAMIN TOXICITY None reported  RIBOFLAVIN Vitamin B2, Lactoflavin, Hepatoflavin, Ovoflavin, Yellow enzymes, Vitamin G Coenzyme forms Flavin mononucleotide (FMN) Flavin adenine dinucelotide (FAD) FUNCTIONS OF RIBOFLAVIN As part of flavoprotein, involved in the metabolism of CHO, PRO, FATS Control agent in both energy production and tissue building and rebuilding Involved in the conversion of vitamin B6 and folic acid to their active coenzyme and storage forms FUNCTIONS OF RIBOFLAVIN Normal growth and development Normal skin tone, vision, and light adaptation Production of hormones in the adrenal gland Formulation of red blood cells (RBCs) in the bone marrow Participates in glutathione redox cycle FOOD SOURCES OF RIBOFLAVIN Liver, kidney, heart, milk and cheese, egg yolk, alimango, aligue, tahong, talangka, dried mushroom, seaweed, dark green leafy vegetables, enriched flour, and bread Ultraviolet light and irradiation destroy riboflavin RIBOFLAVIN DEFICIENCY Ariboflavinosis – lesions in the corners of the mouth (angular stomatitis), lips (cheilosis), around the nose and eyes, malaise; weakness; weight loss; anemia; corneal or other eye changes; seborrheic dermatitis RIBOFLAVIN DEFICIENCY Ariboflavinosis – lesions in the corners of the mouth (angular stomatitis), lips (cheilosis), around the nose and eyes, malaise; weakness; weight loss; anemia; corneal or other eye changes; seborrheic dermatitis RIBOFLAVIN TOXICITY None reported symptoms  NIACIN Vitamin B3, Nicotinic Acid, Nicotinamide or niacinamide, Pellagra-preventive factor Stable in heat, light, alkali, acid, and oxidation Coenzyme forms: NAD (nicotinamide adenine dinucleotide) NADP (nicotinamide adenine dinucleotide phosphate) Can be eaten preformed or made in the body from its precursor tryptophan  NIACIN Stated in niacin equivalents (NE) Approximately 60 mg of L-tryptophan yield 1 mg of niacin Nicotinic acid can lower cholesterol at pharmacologic dose (>1-3 g) FUNCTIONS OF NIACIN Constituent of coenzyme I and II, NAD, NADP Functions in CHO, protein, and lipid metabolism Central in energy-transfer reactions, especially the metabolism of glucose, fat, and alcohol FUNCTIONS OF NIACIN Synthesis of rhodopsin and in CO2 fixation in photosynthesis Used therapeutically to lower blood cholesterol levels NAD protects against neurological degeneration  FOOD SOURCES OF NIACIN Protein-containing foods such as liver, milk, eggs, meat, poultry, fish, beans, nuts and seeds, legumes, whole grain cereals, avocado, figs, dates, and prunes  NIACIN DEFICIENCY Early stages: muscular weakness, anorexia, indigestion, and skin eruptions Severe deficiency leads to pellagra characterized by dermatitis, diarrhea, dementia, and eventually death, if not remedied  NIACIN TOXICITY “Niacin flush” – nicotinic acid intake of 3-4X RDA; characterized by temporary burning, tingling, and itching sensation accompanied by a headache and reddened face, arms and chest Nicotinamide form does not produce this effect PANTOTHENIC ACID Vitamin B5, Pantotheine, Pantothenol Stable in moist heat and in neutral solutions Easily destroyed in dry heat, unstable in acid and alkali Calcium panthothenate is a synthetic derivative available in crystalline form; used in nutritional supplements  ANTAGONISTS OF PANTOTHENIC ACID Omega-methylpantothenic acid Pantoyltaurine phenylpantothenate  FUNCTIONS OF PANTOTHENIC ACID Precursor of Coenzyme A (CoA) Acetylation and acylation reactions Oxidation of keto acids and fatty acids Synthesis of triglycerides, sterols, cholesterol, phospholipids and fatty acids Formation of acetylcholine  FUNCTIONS OF PANTOTHENIC ACID Involved in the synthesis of lipids, nerotransmitters, steroid hormones, and hemoglobin Metabolism of CHO, PRO, FATS Maintenance and repair of tissues and cells of the skin and hair; helps in healing wounds and lesions Pantethine: a form of vit. B5, normalizes blood lipid profiles  FOOD SOURCES OF VIT. B5 Liver, kidneys, chicken meat, beef, egg yolk, milk, fish, whole grain cereals, potatoes, tomatoes, broccoli, and mushroom Pantothenic acid is widely distributed in nature; present in all plant and animal foods  PANTOTHENIC ACID DEFICIENCY Vomiting Intestinal distress Insomnia Fatigue Burning feet syndrome: numbness of toes and a sensation of burning in the feet; corrected with calcium pantothenate PANTOTHENIC ACID TOXICITY No adverse effects have been reported with high intakes of vitamin B5 Some experience occasional diarrhea  PYRIDOXINE Vitamin B6, Pyridoxol (alcohol), pyridoxal (aldehyde), pyridoxamine (amine) Unlike other water-soluble vitamins, vitamin B6 is stored in the muscle fibers FUNCTIONS OF PYRIDOXINE In the form of pyridoxal phosphate, it acts as a coenzyme in a number of reactions involved in protein metabolism Helps to convert tryptophan to niacin and to serotonin Helps to make red blood cells Plays a role in CHO metabolism FUNCTIONS OF PYRIDOXINE Conversion of essential fatty acids Production of antibodies Synthesis of acetylcholine in the metabolism of the CNS Therapeutically used to control nausea and vomiting in pregnancy and to alleviate the peripheral neuritis of INH medication NEUROTRANSMITTERS FROM B6 Dopamine: good mood/feeling (being an inhibitory neurotransmitter); low levels associated with Parkinson’s Disease Norepinephrine: Stress hormone Serotonin: Key to mood regulation (gives a sense of well-being and happiness); pain perception; appetite and weight gain FOOD SOURCES OF B6 Meats, fish, poultry, potatoes, and other starchy vegetables, legumes, noncitrus fruits, fortified cereals, liver, soy products PYRIDOXINE DEFICIENCY Scaly dermatitis: anemia (small-cell type), depression, confusion, convulsions, smooth tongue, cracked corners of the mouth, irritability, muscle twitching, irritation of sweat glands, and kidney stones Low levels of B6 are associated with increased risk of some cancers and cardiovascular diseases PYRIDOXINE TOXICITY Depression, fatigue, irritability, headaches, nerve damage causing numbness and muscle weakness leading to an inability to walk and convulsions; skin lesions  FOLATE Folacin, citrovorum factor, pteroylglutamic acid, lactobacillus casei factor, Vitamin M, Vitamin B9 Latin word – “follum” meaning leaf Italian word “folate” means foliage (plant leaves) Easily oxidized by acids Sensitive to light Coenzyme forms: DHF (dihydrofolate) and THF (tetrahydrofolate)  FORMS OF FOLATE Folate – in foods and biological tissues Folic acid – in fortified foods and supplements Tetrahydrofolate – active form of folate; also the coenzyme form  FUNCTIONS OF FOLATE THF serves as part of an enzyme complex that transfers 1-carbon compounds during metabolism Needed to convert vitamin B12 to one of its coenzyme forms Synthesis of purines: guanine and adenine; and pyrimidine: thymine which are utilized in the formation of nucleoproteins  FUNCTIONS OF FOLATE Helps regenerate the amino acid methionine from homocysteine and choline from ethanolamine Conversion of histidine to glutamic acid Conversion of nicotinamide to N- methyl nicotinamide by the addition of methyl group  FUNCTIONS OF FOLATE Oxidation of phenylalanine to tyrosine Necessary for regeneration of RBC together with vitamin B12 and Vitamin C  RECOMMENDED INTAKE OF FOLATE Bioavailability: 50% (foods) to 100% (supplements) taken on an empty stomach FOOD SOURCES OF FOLATE Dark green leafy vegetables like alugbati, gabi, malunggay, saluyot, sitao, talinum; wheat germ, legumes, seeds, oranges, strawberries, and organ meats like liver, fortified cereals INTERACTION WITH OTHER NUTRIENT/DRUGS Vitamin C – protects the folate coenzyme from oxidative destruction Folate supplement – decreases zinc absorption Aspirin – Inhibits the action of folate- regulating enzyme Antacids – limit the absorption of folate  FOLATE DEFICIENCY Macrocytic or megalobastic anemia – characterized by large, immature red blood cells Neural tube defects – malformations of the brain, spinal cord, or both during embryonic development that often result in lifelong disability or death  FOLATE TOXICITY Masks vitamin B12 Deficiency symptoms  COBALAMIN Vitamin B12, Cyanocobalamin, Anti- pernicious anemia factor, Hydroxycobalamin, Erythrocyte maturation factor, Animal protein factor Contains a metal: ion cobalt Stable in heat Methylcobalamin or 5- deoxyadenosylcobalamin (forms in food, active form) Cyanocobalamin (form in supplements/fortified foods) FUNCTIONS OF COBALAMIN Promotes growth Normal development and maturation of red blood cells Normal function of nervous tissue, bone marrow, and GIT Participates in nucleic acid synthesis Needed in single carbon metabolism and in the metabolism of CHO, protein, fat FUNCTIONS OF COBALAMIN Generation of methionin from homocysteine using 5- methyltetrahydrofolate as a methyl group donor Helps folate coenzyme to participate in DNA synthesis by converting folate to its active form. DIGESTION AND ABSORPTION Digested by HCL and pepsin in the stomach Binds with a stomach secretion called intrinsic factor Absorbed in the small intestine (Ileum)  FOOD SOURCES OF B12 Foods of animal origin (meat, fish, poultry, shellfish, milk, cheese, eggs), Fortified cereals Streptomyces griseus, a bacterium once thought to be a yeast, was the commercial sources of vitamin B12 for many years COBALAMIN DEFICIENCY Deficiency Disease: Pernicious anemia Treatment: 1 mg/day of vitamin B12 orally Deficiency symptoms: macrocytic or megaloblastic anemia, fatigue, degeneration of peripheral nerves, progressing to paralysis, sore tongue, loss of appetite, constipation With increased risk of B12 deficiency: elderly, alcoholics, gastrectomy patients, vegans COBALAMIN TOXICITY None reported  BIOTIN Anti-eggwhite injury factor, Bios I, Vitamin H, coenzyme R, Vitamin B7 Biotinidase – enzyme to digest biotin; found on the intestinal brush border, pancreatic and intestinal juices FUNCTIONS OF BIOTIN Part of a coenzyme used in energy metabolism, fat synthesis, amino acid metabolism, and glycogen synthesis  FOOD SOURCES OF BIOTIN Widespread in foods: liver, egg yolks, soybeans, fish, whole grains, also produced by GI bacteria  BIOTIN DEFICIENCY Depression, lethargy, hallucinations, numb or tingling sensation in the arms and legs, red scaly rash around the eyes, nose, and mouth, hair loss  BIOTIN TOXICITY None reported  VITAMIN C Ascorbic acid, Antiscorbutic factor, Cevitamic acid, Hexuronic Acid Easily destroyed by oxidation: light, alkali, and heat, especially in the presence of iron and copper Most unstable vitamin Synthesis is impossible Exists in two forms: reduced and oxidized Renal threshold is 100 mg/day; excess and unmetabolized vitamin is excreted in the urine  FUNCTIONS OF VITAMIN C An antioxidant Formation of collagen, the fibrous structural protein in connective tissues Synthesis of carnitine, a compound which participates in the transport of fatty acids into mitochondria  FUNCTIONS OF VITAMIN C Hormone and neurotransmitter synthesis (stress hormone, serotonin) Facilitates the utilization of iron, calcium, and folic acid Immune function effector: supports epithelial barrier function against pathogens and promotes the oxidant scavenging activity of the skin  ABSORPTION AND UTILIZATION Absorbed in the jejunum Transported in the blood, moving freely into body cells Concentration is found in the adrenal glands and the retina The body maintains a plasma vitamin C level of 1.2 – 1.5 mg/100 mL Excess is secreted in the urine  RELATIONSHIP W/OTHER NUTRIENTS Prevents the oxidation of vit. A, C, and folic acid, and polyunsaturated fatty acid (PUFA) Prevents the oxidation of tetrahydrofolate (THF) Promotes the absorption of iron and calcium Facilitates the utilization of iron, calcium, and folic acid  FOOD SOURCES Citrus fruits, cabbage-type vegetables (such as brussels sprouts and cauliflower), dark green vegetables (such as bell peppers and broccoli), cantaloupe, strawberries, tomatoes, potatoes, papayas, mangoes  VITAMIN C DEFICIENCY Scurvy – symptoms include lethargy, petechiae, swelling, bleeding of gums Other deficiency symptoms include anemia, infection, and depression  VITAMIN C TOXICITY Nausea, abdominal cramps, diarrhea, headaches, fatigue, insomnia, hot flashes, rashes, interference with medical tests, aggravation of gout symptoms, urinary tract problems, kidney stones  ROLES OF VITAMINS IN PROMOTING HEALTH Metabolic Function Vitamins That Play a Role Antioxidants Vitamin C and Vitamin E Blood clotting and red blood Folate, Vitamin B6, Vitamin cell synthesis B12, Vitamin K Bone health Vitamin A, Vitamin C, Vitamin D, Vitamin K Energy B-complex vitamins except folate Growth and reproduction Vitamin A, Vitamin D Immune function Vitamin A, Vitamin C, Vitamin D Protein metabolism Folate, Vitamin B6, Vitamin B12 VITAMIN SUPPLEMENTS Available in concentrated forms in tablets, capsules, and drops Vitamin concentrates are sometimes termed natural or synthetic (manufactured) Some people believe that natural are far superior in quality to the synthetic vitamins Body cannot distinguish between a vitamin of plant or animal origin and one manufactured in a laboratory because once they have been dismantled by the digestive system, the two types of the same vitamin are chemically identical (US FDA)  HOW TO PREVENT VITAMIN LOSS? Buying the freshest, unbruised vegetables, and fruits locally and using them raw Preparing fresh vegetables and fruits just before serving Heating canned vegetables quickly and in their own liquid Following package directions when using frozen vegetables or fruit HOW TO PREVENT VITAMIN LOSS? Using as little water as possible when cooking and having it boiling before adding vegetables or, preferably steaming them Covering the pan when cooking vegetables until bright in color and crisp tender Saving any cooking liquid for later use in soups, stews, and gravies HOW TO PREVENT VITAMIN LOSS? Storing fresh vegetables and most fruits in a cool, dark place Microwave fruits and vegetables in 1 to 2 tablespoons of water MINERALS  MINERALS Essential inorganic nutrients Needed in small amounts Elements that remain as ash when food is burned Non-caloric Not destroyed by heat, acid, O2, or UV light Found in body tissues and fluids Make up about 4 to 5% of body weight  MINERALS Generally do not change shape or structure when performing biological function Remains intact during digestion Requirements based on age, gender physiological state (e.g. pregnancy) Two groups: Major and Trace  MAJOR MINERALS Essential mineral nutrients the human body requires in relatively large amounts (greater than 100 mg per day); sometimes called macrominerals Found in adult reference body in greater than 5 grams MAJOR MINERALS (7) Calcium (Ca) Sodium (Na) Phosphorus (P) Potassium (K) Sulfur (S) Chloride (Cl) Magnesium (Mg)  TRACE MINERALS Essential mineral nutrients the human body requires in relatively small amounts (less than 100 mg per day); sometimes called microminerals Found in adult reference body in less that 5 grams  TRACE MINERALS Iron (Fe) Molybdenum Zinc (Zn) (Mo) Iodine (I) Cobalt (Co) Selenium (Se) Chromium (Cr) Manganese (Mn) Copper (Cu)  BINDERS Chemical compounds in foods that combine with nutrients (especially minerals) to form complexes the body cannot absorb Example: phytates and oxalates  MAJOR MINERALS  CALCIUM (Ca) 1-2% of body weight (1200 g of calcium in adult) 99% of the mineral is present in bones and teeth as a componenet of hydroxyapatite crystals and amorphous calcium phosphate 1% is distributed through the blood and soft tissues (muscle, liver, heart)  CALCIUM (Ca) Maintained within the range of 9-11 mg/dL for the proper functioning of the cells FUNCTIONS OF CALCIUM Mineralization of bones and teeth Nerve functioning Acetylcholine (neurotransmitter that is necessary for transmission of impulse) require calcium Blood pressure Troponin C and Calmodulin (proteins in the heart muscle that regulates heart muscle contraction) requires calcium FUNCTIONS OF CALCIUM Activation of certain extracellular (prothrombin, amylase, trypsin) and intracellular (phosphofructokinase, pyruvate kinase, pyruvate carboxylase) enzymes Regulation of ion transport across cell membranes Involved in muscle contraction and relaxation Myosin and Actin (proteins that regulates muscle contraction) require calcium for activation  ABSORPTION OF CALCIUM Mostly occurs in the small intestine Two routes of absorption: Transcellular route – active transport of calcium by the mucosal calcium transport protein, Calbindin; Saturable and subject to physiological and nutritional regulation via vitamin D Paracellular route – passive transport through the tight junction between mucosal cells; nonsaturable, essentially independent of nutritional and physiological regulation and concentration dependent * On average, between 10% and 30% of the calcium absorbed from a mixed diet by healthy adults CALCIUM HOMEOSTASIS Parathyroid hormone – a hormone from the parathyroid glands that regulated blood calcium by raising it when levels fall too low; also known as parathormone Calcitonin – a hormone secreted by the thyroid gland that regulates blood calcium by lowering it when levels rise too high RECOMMENDED INTAKE Calcium recommendations are based on the amount needed to retain the most calcium in bones Bones can develop to their fullest potential in size density – their peak bone mass – within genetic limits Most people achieve a peak bone mass by their late 20s FOOD SOURCES OF CALCIUM Milk and milk products, small fish (with bones), calcium-set tofu (bean curd), greens (bok choy, broccoli, chard, kale), legumes, alamang (dried and fresh), dried fish, shellfish, and crustaceans, soybeans, mongo, other dried beans CALCIUM DEFICIENCY Children: stunted growth; retarded calcification of bones and teeth Adults: bone loss Osteoporosis – bones become more porous and fragile due to a loss of minerals; also called adult bone loss Osteomalacia – softening of the bones Calcium tetany – intermittent spasm of the extremities due to nervous and muscular excitability caused by low blood calcium concentration CONDITIONS WITH INCREASED RISK FOR CALCIUM DEFICIENCY Vitamin D deficiency Achlorhydria Long-term dietary Immobilization inadequacy Decreased GI transit High-protein diets time High-fiber diets Stress Fat malabsorption/steator rhea POPULATIONS WITH INCREASED RISK FOR CALCIUM DEFICIENCY Teenagers Older women Pregnant and lactating  CALCIUM TOXICITY Constipation Hypercalcemia – a condition characterized by an excess of Ca in the blood and soft tissues; occurs in infants with high intake of vitamin D Hypercalcuria/renal calculi Interference with absorption of other minerals  INTERRELATIONSHIP WITH OTHER NUTRIENTS Vitamin D, phosphorus, sodium, protein, and fiber affect Ca absorption and metabolism Magnesium competes with Ca for absorption and is needed for the secretion of PTH Malabsorption of fat can interfere with Ca absorption due to the formation of soaps.  PHOSPHORUS Never found free in nature Most commonly found in nature in its pentavalent form in combination with oxygen as phosphate (PO43-) Second most abundant mineral in the body About 85% of it is found combined with calcium in the hydroxyapatite crystals of bones and teeth 15% is distributed in soft tissues FUNCTION OF PHOSPHORUS Mineralization of bones and teeth Part of every cell (part of a major buffer system) An essential component of nucleic acid (DNA and RNA), adenosine triphosphate (ATP), adenosine diphosphate (ADP), coenzymes, and some vitamins FUNCTION OF PHOSPHORUS A major component of cell membranes and intracellular organelles (phospholipids) Assist in energy metabolism; used in energy transfer Used in buffer systems that maintain acid-base balance  ABSORPTION AND METABOLISM OF PHOSPHORUS Released by the action of intestinal enzymes phosphatases Absorbed into the blood with the help of vitamin D. Blood phosphorus level is regulated by the parathyroid gland that interacts with vitamin D to control the absorption of the mineral Lack of vitamin D will reduce both Ca and P absorption.  ABSORPTION AND METABOLISM OF PHOSPHORUS On a mixed diet, absorption of total phosphorus ranges from 55% to 70% in adults Factors affecting Ca absorption and metabolism are the same with phosphorus. Some minerals such as aluminum and strontium may bind with phosphorus, forming insoluble phosphates unavailable for absorption  FOOD SOURCES OF PHOSPHORUS Meat, fish, poultry, glandular organs, egg yolk, milk, cheese, beans, nuts and seeds, whole grain cereals  PHOSPHORUS DEFICIENCY Hypophosphatemia – inadequate phosphorus intake; anorexia, anemia, muscle weakness, bone pain, rickets, and osteomalacia, general debility, increased susceptibility to infection, paresthesia, ataxia, confusion, and even death CONDITIONS AND POPULATIONS WITH INCREASED RISK FOR PHOSPHORUS DEFICIENCY Those with celiac disease, sprue, hyperparathyroidism, and insulin injections, alcoholics, premature infants PHOSPHORUS TOXICITY Hyperphosphatemia – associated with certain disease states such as hypoparathyroidism or chronic renal failure. Hypocalcemia is often associated with hyperphosphatemia, since excessive phosphate interferes with calcium utilization. Signs may include tetany and convulsions. Calcification of nonskeletal tissues, particularly the kidneys  INTERRELATIONSHIP WITH OTHER NUTRIENTS Na is essential to ensure optimum phosphorus absorption An increase in Mg consumption decreases phosphorus absorption  MAGNESIUM Second most common cation found in the body (about 25 g) Skeleton: 50-60% of total Soft tissues: 40-50% of total About 1/3 of the Mg is on the surface of bone Only 1% of total body Mg is extracellular FUNCTION OF MAGNESIUM Bone mineralization Building of protein Enzyme action Supports energy production (found in the mitochondria) Important in photosynthesis (at the core of chlorophyll) FUNCTION OF MAGNESIUM Nerve impulse transmission Maintenance of teeth Supports normal functioning of immune system Together with calcium, magnesium is involved in muscle contraction and blood clotting; calcium promotes the processes whereas magnesium inhibits them.  ABSORPTION AND METABOLISM OF MAGNESIUM Absorption of Mg from food ranges from 20-70% Occurs by active transport at low concentrations and passive diffusion at high concentrations (happens in the jejunum and ileum) Transported by specific carrier and vitamin D-sensitive transport system Rate of absorption is decreased by the same factors that affect Ca. Absorption is influenced by PTH  FOOD SOURCES OF MAGNESIUM Nuts, legumes, whole grains, dark green vegetables, seafood, chocolate, cocoa MAGNESIUM DEFICIENCY May exacerbate inflammation and contribute to chronic diseases such as heart disease, stroke, hypertension, diabetes, and cancer Tetany Hallucination, during alcohol withdrawal Weakness Confusion; if extreme convulsions Bizarre muscle movements (especially of eye and face muscles) Difficulty in swallowing In children, growth failure CONDITIONS AND POPULATIONS WITH INCREASED RISK FOR MAGNESIUM DEFICIENCY Vomiting Diarrhea Alcoholism Protein malnutrition Diuretic use Malabsorption MAGNESIUM TOXICITY Rare, but it can be fatal From non-food sources only: diarrhea alkalosis, dehydration Severe cases may lead to paralysis, cardiac arrest, and death  INTERRELATIONSHIP WITH OTHER NUTRIENTS Mg is antagonistic to Ca (competes with absorption) Mg can influence the balance between extracellular and intracellular K.  SODIUM Principal cation of the extracellular fluid 50% is found in the extracellular fluid 40% in the skeleton 10% in the cells FUNCTION OF SODIUM Maintains normal fluid and electrolyte balance (Na+/K+ Pump) Aids in nerve impluse transmission and muscular contraction ABSORPTION AND EXCRETION Absorbed in the small intestine and is transported by the blood throughout the body Blood passes the kidneys and is filtered out and then partially reabsorbed into the blood to maintain normal blood sodium levels ABSORPTION AND EXCRETION Concentration of sodium in the extracellular fluid is determined by renin-angiotensin-aldosterone system (RAAS) and sympathetic nervous system Aside from urinary losses, sodium is also lost via the skin RECOMMENDED INTAKE Diets rarely lack sodium and even when intakes are low, the body adapts by reducing sodium losses in urine and sweat, thus making deficiencies unlikely Recommendations are set low enough to protect against high blood pressure, but high enough to allow an adequate intake of other nutrients with a typical diet. FOOD SOURCES OF SODIUM Table salt Seafood Soy sauce Poultry Processed foods Eggs Milk and milk products Meat Fish  SODIUM DEFICIENCY Hyponatremia – symptoms include headache, confusion, stupor, seizures, coma, muscle cramps, loss of appetite  SODIUM TOXICITY Edema and high blood pressure due to acute sodium toxicity Hypertension due to prolonged excessive sodium intake may contribute to osteoporosis  CHLORIDE Essential nutrient Major anion of the extracellular fluids Comprises about 0.15% of adult body weight Concentration is high in cerebrospinal fluids, GI secretions, and gastric juices  FUNCTIONS OF CHLORIDE Maintains normal fluid and electrolyte balance Constituent of hydrochloric acid which maintains the strong acidity of the stomach Helps maintain acid-base balance to body fluids  ABSORPTION AND EXCRETION Readily absorbed in the GI tract Excreted in the urine and sweat FOOD SOURCES OF CHLORIDE Table salt, soy sauce, meat, seafood, milk, eggs, and processed foods  CHLORIDE DEFICIENCY A diet deficient in chloride does not normally occur  CHLORIDE TOXICITY Some symptoms include vomiting, causing dehydration  POTASSIUM Concentrated in intracellular fluids Major intracellular cation Involved in regulating water and acid- balance together with sodium FUNCTIONS OF POTASSIUM Maintains normal fluid and electrolyte balance Participates in many biochemical reactions inside the cell, particularly those involved in the release of energy from food and the synthesis of protein and glycogen Supports cell integrity FUNCTIONS OF POTASSIUM Assists in nerve impulse transmission and muscle contractions Acts along with Mg as a muscle relaxant opposing the muscle contracting stimulus of Ca Important in the release of insulin by the pancreas  ABSORPTION AND METABOLISM Absorbed in the intestine by diffusion Distributed in the blood from the intestine mainly by diffusion Enters the cell against a concentration gradient and therefore requires an active transport mechanism The level of potassium in the blood is carefully maintained because if it rises more than 3 or 4 times above normal, the beating of the heart will cease and may lead to death  FOOD SOURCES OF POTASSIUM Meat; poultry, fish; organ meats, milk and milk products, certain fresh foods particularly fruits like avocado, banana, apricot, dried fruit, melons, and oranges, vegetables like broccoli, brussel sprouts, squash, potatoes, dry beans, peas, and legumes POTASSIUM DEFICIENCY Increase in blood pressure Kidney stones Bone turnover Irregular heartbeats Muscle weakness Glucose intolerance  POTASSIUM TOXICITY Hyperkalemia Muscular weakness Vomiting Cardiac arrest If potassium is injected directly into a vein, it could stop the heart  SULFUR Present in every cell in the body, particularly in cartilage and keratin of skin, nails, and hair Occurs in a number of forms in the body: Sulfur – a mineral present in the body as part of some proteins Sulfate ion – produced from the oxidation of sulfur Any excess sulfur is excreted in the urine FUNCTION OF SULFUR Constituent of the sulfur-containing amino acids (methionine, cysteine, and cystine) Constituent of vitamins thiamin, pantothenic acid and biotin, vitamin-like lipoic acid, insulin, heparin, glutathione, and coenzyme A Participates in detoxification reaction Constituent of structural tissues mucopolysaccharides and sulfate in lipids Needed in energy metabolism and enzyme activation RECOMMENDED INTAKE Needs are easily met with normal protein intake FOOD SOURCES OF SULFUR All protein-containing foods (meats, fish, poultry, eggs, milk, legumes, nuts) SULFUR DEFICIENCY No known Occurs only when there is severe protein deficiency  SULFUR TOXICITY Toxicity occurs only if sulfur- containing amino acids are taken in excessive amounts  TRACE MINERAL Iron Chromium Iodine Fluoride Zinc Cobalt Selenium Manganese Molybdenum Copper  TRACE MINERAL Contents in foods depend on soil and water composition and on how foods are processed Most are toxic at >2 ½ to 11x current recommendations Excessive intake of dietary supplements may cause toxicity Interactions among the trace minerals are common and often well coordinated to meet the body’s needs. Interactions may lead to nutrient imbalances if excessive intake of one mineral causes a deficiency of another  IRON Essential trace mineral that is needed for the transport of oxygen and the metabolism of energy nutrients An adult male contains 40-50 mg of iron per kg BW, while the adult female contains 30-50 mg per kg BW Stored primarily in the liver; found also in spleen and bone marrow  IRON Ferritin - iron storage protein in liver Hemosiderin – iron-storage protein; primarily made in times of iron overload Transferrin – Iron transport protein in the blood  FUNCTIONS OF IRON Plays a key role in oxygen transport and cellular respiration As part of the protein Hb and myoglobin. Iron binds to oxygen molecules and transports O2 through the blood (in Hb) or stores O2 within muscles (in myoglobin)  FUNCTIONS OF IRON As part of Hb, it is involved in the formation of red blood cells (RBCs) Hemoglobin – the globular protein of the RBCs that transports oxygen from the lungs to tissues throughout the body; accounts for 80% of the body’s iron Myoglobin – the oxygen-holding protein of the muscle cells  FUNCTIONS OF IRON A cofactor of non-heme enzymes and other proteins Required in making enzymes involved in making amino acids, collagen, hormones, and neurotransmitters  ABSORPTION AND METABOLISM OF IRON Available to the body either in the heme form or non-heme form Heme iron – the iron in foods that is bound to the hemoglobin and myoglobin proteins; found only in meat, fish, and poultry Nonheme iron – the iron in foods that is not bound to proteins; found in both plant-derived and animal-derived foods  ABSORPTION AND METABOLISM OF IRON the higher the intake of iron, the lower the percentage of iron absorbed Those deficient in iron absorb more of the mineral After absorption, iron is carried to the blood bound to the protein transferrin  ABSORPTION AND METABOLISM OF IRON Iron is stored in the liver in the form of ferritin and hemosiderin Ninety percent (90%) of iron is released in the breakdown of cells  IRON BALANCE HEPCIDIN A hormone produced by the liver that regulates iron balance Maintain blood iron within the normal range by limiting absorption from the small intestine and controlling release from the liver, spleen, and bone marrow Production increases in iron overload and decreases in iron deficiency  RECOMMENDED INTAKE OF IRON For infants, it is assumed that the iron provided by breast milk is adequate to meet the iron needs of infants exclusively fed human milk from birth to six (6) months The consumption of iron-rich foods and iron-fortified foods is recommended for women from adolescence onwards Iron supplementation is recommended to meet the needs of pregnant and lactating women FOOD SOURCES OF IRON Red meats, fish, poultry, shellfish, eggs, legumes, dried fruits, iron- fortified foods  IRON DEFICIENCY Microcytic, hypochromic anemia results in low Hb stores, fatigue, weakness, pallor, poor resistance to cold temperature, and apathy Pica – a curious behavior seen in some iron-deficient people, especially in women and children of low-income groups; the craving and consumption of ice, chalk, starch, and other non-food substances  IRON DEFICIENCY Iron-deficiency anemia – refers to the severe depletion of iron stores that results in a low hemoglobin concentration  IRON TOXICITY Hemosiderosis/siderosis – a condition with large deposit, hemosiderin in the liver Hemachromatosis – Genetic disorder that enhances iron absorption  IODINE Essential trace mineral that is needed for the synthesis of thyroid hormones Converted to iodide in the GI tract The body contains 20-30 mg of iodine that is concentrated in the thyroid gland  FUNCTIONS OF IODINE Components of two thyroid hormones that help to regulate growth, development, and metabolic rate Thyroxine and triiodothyronine are required for normal energy metabolism, thermoregulation, and intermediary metabolism  FUNCTIONS OF IODINE Essential in the conversion of carotene to vitamin A Protein synthesis Carbohydrate absorption RBC production Nerve muscle function  ABSORPTION AND METABOLISM OF IODINE Iodine (as an iodide or iodate compound) in food and water is rapidly absorbed in the intestine and circulate in the blood to all tissues in the body 1/3 of the absorbed iodide is taken up by the thyroid gland for synthesis of the T4 and T3 iodide is excreted mainly in the urine, while some amounts are lost via the skin and feces.  ABSORPTION AND METABOLISM OF IODINE Uptake, synthesis, and release of iodine by the thyroid gland is stimulated by thyroid stimulating hormone (TSH) released by the anterior pituitary gland  INTERRELATIONSHIP WITH OTHER NUTRIENTS Goitrogens – are substances that interfere with iodine metabolism, inhibiting hormonogenesis INTERRELATIONSHIP WITH OTHER NUTRIENTS Goitrogens – are substances that interfere with iodine metabolism, inhibiting hormonogenesis  IODINE DEFICIENCY Goiter – an enlargement of the thyroid gland due to an iodine deficiency, malfunction of the gland, or overconsumption of a goitrogen Cretinism – a congenital disease characterized by mental and physical retardation and commonly caused by maternal iodine deficiency during pregnancy. Myxedema – characterized by a dry, waxy type swelling, with abnormal deposits of mucoproteins under the skin  IODINE TOXICITY Hyperthyroidism – (also known as Grave’s disease or exophthalmic goiter); characterized by increased basal metabolism, goiter and disturbances in the autonomic nervous systems, causes hyperirritability and increased creatinine metabolism.  ZINC An essential trace mineral that is part of many enzymes and a constituent of insulin Component of all cells Highest concentrations are found in muscle and bone FUNCTIONS OF ZINC Part of many enzymes Interacts with insulin to facilitate the uptake of glucose by cells of the adipose tissues Needed for the normal development and maintenance of the body’s immune system Component of more than 200 enymes; participating in a wide variety of catalytic, regulatory, and structural function including metabolic reactions such as synthesis and/or degradation of carbohydrates, lipids, proteins, and nucleic acids FUNCTIONS OF ZINC Important in stabilizing membrane structure and guarding it against peroxidative damage Important in night vision and in mobilizing vitamin A from liver stores Facilitates wound healing and blood clotting FUNCTIONS OF ZINC Supports work of transcription factors – regulates gene expression Influences thyroid hormone function Necessary for visual pigments, taste perception Involved in sperm production and fetal development  ABSORPTION AND METABOLISM OF ZINC Absorbed in the small intestine is carried into the blood, and goes to the pancreas where it is used in the formation of some digestive enzymes Absorbed zinc binds to metallothionein, a sulfur-rich protein that binds with metals Binds with another protein (cysteine-rich intestinal protien) to transport the mineral to the blood Rate of absorption: 15-40%  ABSORPTION AND METABOLISM OF ZINC Zinc that is carried within blood plasma is bound with different carrier proteins such as albumin and transferrin The liver takes up some 30-40% of absorbed zinc, while the rest is distributed throughout the different organs and tissues Zinc loss from the body is via body surfaces, kidney and GI tract. Most of the zinc is excreted in the feces.  INTERRELATIONSHIP WITH OTHER NUTRIENTS Zinc2+ absorption is impaired by the following divalent cations: Cd2+, Cu2+, Ca2+ and Fe2+ The cations compete with one another for: Facilitating binding ligands in the intestinal lumen, Receptor sites in the enterocytes, or intracellular binding ligands within mucosal cells  ZINC DEFICIENCY Growth retardation Impaired immune Delayed sexual function maturation Delayed wound Hair loss healing Eye and skin lesions Decreased dark Dermatitis and skin adaptation (night changes blindness) Impaired taste Immunologic acuity abnormalities Loss of appetite  ZINC TOXICITY Loss of appetite Impaired immunity Low HDL, high LDL Copper and iron deficiencies FOOD SOURCES OF ZINC Protein-containing foods: red meats, shellfish, milk, cheese, whole grains, some fortified cereals  SELENIUM One of the body’s antioxidant nutrients, protecting the body against oxidative stress Found in minute amounts in the body; concentrated in other glandular organs, blood and muscles  SELENIUM One of the body’s antioxidant nutrients, protecting the body against oxidative stress Found in minute amounts in the body; concentrated in other glandular organs, blood and muscles  FUNCTIONS OF SELENIUM Defends against oxidation Component of glutathione peroxidase which destroys peroxides in the cytosol Regulates thyroid hormones  INTERRELATIONSHIP WITH OTHER NUTRIENTS Vitamin E spares Protects against the toxicity of Cd, Hg, and Ag The potency of selemethionine is reduced in methionine deficiency  SELENIUM DEFICIENCY Keshan disease Heart disease associated with selenium deficiency Characterized by heart enlargement and insufficiency; fibrous tissue replaces the muscle tissue that normally composes the middle layer of the walls of the heart  SELENIUM TOXICITY Loss and brittleness of hair and nails; skin rash, fatigue, irritability and nervous system disorders; garlic breath odor Selenosis – Selenium poisoning also may happen, that can be caused by an excessive intake of selenium usually provided by supplements FOOD SOURCES OF SELENIUM Seafood, meat, whole grains, fruits, and vegetables (depending on soil content)  MANGANESE An essential trace mineral that acts as a cofactor for many enzymes Human body contains a mere 20 mg; most of it can be found in the bones and metabolically active organs such as the liver, kidneys, and pancreas FUNCTION OF MANGANESE Cofactor for several enzymes that facilitate the metabolism of carbohydrates, lipids, and amino acids Required for the normal development of the skeleton and connective tissues  INTERRELATIONSHIP WITH OTHER NUTRIENTS Phytates inhibit its absorption High intakes of iron and calcium limit manganese absorption  MANGANESE DEFICIENCY Rare as requirements are low Significant amount in plants  MANGANESE TOXICITY Exposure to dust-containing manganese causes extreme weakness, apathy, anorexia, and fatigue  FOOD SOURCES OF MANGANESE Nuts, whole grains, leafy vegetables, tea  MOLYBDENUM Essential trace minerals that acts as a cofactor for many enzymes  FUNCTIONS OF MOLYBDENUM Cofactor for the iron- and flavin- containing enzymes that catalyze the hydroxylation of various substrates  INTERRELATIONSHIP WITH OTHER NUTRIENTS Molybdenum has an antagonistic effect on copper Mn, Zn, Fe, Pb, Vitamin C, methionine, cystine, and protein might affect Mo availability MOLYBDENUM DEFICIENCY Unknown MOLYBDENUM TOXICITY None reported; reproductive effects in animals  FOOD SOURCES OF MOLYBDENUM Legumes, breads, and other grain products, leafy green vegetables, milk, and liver  COPPER About 100 mg copper is in the body Highest concentration found in the liver, brain, heart, bone, hair, and nails; over 25% in the muscle Occurs in the cuprous (Cu+) and cupric (Cu2+) states At birth, infant liver concentrations is 5- 10x the adult concentrations; these stores are used during early life when copper intakes from milk are low FUNCTIONS OF COPPER A constituent of several enzymes: Cytochrome c oxidase Ceruloplasmin Superoxide dismutase Lysyl oxidase Dopamine betahydroxylases Tyrosine oxidase  INTERRELATIONSHIP WITH OTHER NUTRIENTS High intake of iron or vitamin C decreases the absorption of copper Zinc decreases copper absorption Calcium is antagonistic to copper Copper forms complexes with molybdenum and sulfur, decreasing copper absorption  COPPER DEFICIENCY Frequent symptoms: anemia, neutropenia, and bone factures Less frequent symptoms: hypopigmentation, impaired growth, increased incidence of infections, and abnormalities of glucose and cholesterol metabolism and of electrocardiograms Seen among children with protein-deficiency and iron-deficiency anemia Reported in premature infants (born with low copper reserves) fed with modified cow’s milk  COPPER DEFICIENCY Menkes disease A genetic disorder of copper transport that creates a copper deficiency and results in mental retardation, poor muscle tone, seizures, brittle kinky hair, and failure to thrive  COPPER TOXICITY Acute copper toxicity in humans is rare Causes: contaminated drinking water, beverages, and food stuffs from copper pipes or containers, or from accidental or deliberate ingestion of large amounts Symptoms: vomiting, diarrhea, hemolytic anemia, renal and liver damage, sometimes (at about 100 g or more) followed by coma and death  COPPER TOXICITY Acute copper toxicity in humans is rare Symptoms: hepatitis, liver cirrhosis and jaundice Wilson’s disease A genetic disorder of copper metabolism that creates a copper toxicity and results in neurologic symptoms such as tremors, impaired speech, inappropriate behaviors, and personality changes FOOD SOURCES OF COPPER Legumes, whole grains, nuts, shellfish, and seeds  CHROMIUM Essential mineral that participates in carbohydrate and lipid metabolism Cr+++ ion – most stable and most commonly found in foods FUNCTIONS OF CHROMIUM As a part of GTF, chromium enhances the action of insulin May improve glucose tolerance Functions in carbohydrate, lipid, and nucleic acid metabolism CHROMIUM DEFICIENCY Marginal chromium – impaired glucose tolerance  CHROMIUM TOXICITY None reported  FOOD SOURCES OF CHROMIUM Meats (especially liver), whole grains, brewer’s yeast  FLUORIDE Essential trace mineral that makes teeth stronger and more resistant to decay Present in virtually all soils, water supplies, plants, and animals Only a trace of fluoride can be found in the body  FUNCTIONS OF FLUORIDE Involved in the mineralization of teeth and bones Replaces the hydroxyl (OH) portions of hydroxyapatite crystal forming fluorapatite; makes the teeth stronger and more resistant to decay Helps prevent dental caries INTERRELATIONSHIP WITH OTHER NUTRIENTS Aluminum, calcium, magnesium, and chloride reduce the uptake and utilization of fluoride Phosphate and sulfate increase the uptake of fluoride  FLUORIDE DEFICIENCY Susceptibility to tooth decay  FLUORIDE TOXICITY Fluorosis – mottled enamel due to high doses of fluoride Mild cases: the teeth develop small white flecks Severe cases: enamel becomes pitted and permanently stained FOOD SOURCES OF FLUORIDE Drinking water (if fluoride containing or fluoridated), tea, seafood, marine fish  COBALT Highly concentrated in spleen, kidneys, and pancreas as a component of vitamin B12  FUNCTIONS OF COBALT Essential component of vitamin B12 that is essential for the maturation of the RBCs Cofactor for energy metabolism Activates arginase that converts arginine to urea  COBALT DEFICIENCY No documented cases; except for its association with vitamin B12  COBALT TOXICITY Goiter, hypothyroidism, hypotension, and heart failure Polycythemia (an increase in the number of RBCs) is typical in Co toxicity related with excessive beer drinking FOOD SOURCES OF COBALT Liver, kidneys, oysters, and clams