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9zacdhhdi Module+2+Micronutrients

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0% found this document useful (0 votes)
19 views66 pages

9zacdhhdi Module+2+Micronutrients

Uploaded by

Hecy Cristo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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MICRONUTRIENTS

DR. FELIPE A. MERANO


NCM 105 Nutrition and Diet Therapy
SY 2020-2021 first semester

© BRITISH NUTRITION FOUNDATION 2013


Learning objectives

•To understand the importance of


micronutrients.
•To explore the functions and sources
of vitamins and minerals

© BRITISH NUTRITION FOUNDATION 2013


Micronutrients are needed in the
body in tiny amounts. They do not
provide energy, but are required
for a number of important
processes in the body.

There are two main groups of


micronutrients:
•vitamins;
•minerals and trace elements.

Micronutrients are measured in


milligrams (mg) and micrograms
(μg) with 1mg = 0.001g and 1μg =
0.001mg.

© BRITISH NUTRITION FOUNDATION 2013


Vitamins

Vitamins are nutrients required


by the body in small amounts,
for a variety of essential
processes.

Most vitamins cannot be made


by the body, so need to be
provided in the diet.

Vitamins are grouped into:


• fat-soluble vitamins;
• water-soluble vitamins.

© BRITISH NUTRITION FOUNDATION 2013


Fat-soluble vitamins can be
stored in the body, i.e.
vitamins A, D, E and K;

Water-soluble vitamins
cannot be stored in the body
and are therefore required
daily, i.e. B vitamins and
vitamin C.

© BRITISH NUTRITION FOUNDATION 2013


Fat soluble vitamins

Vitamin A

Vitamin A is needed for:


•normal iron metabolism;
•the maintenance of normal skin
and mucous membranes (in eyes,
lungs and the digestive system);
•the maintenance of normal
vision;
•the normal function of the
immune system.

© BRITISH NUTRITION FOUNDATION 2013


Vitamin A

Vitamin A (retinol) can be obtained in two


forms:
•ready-made, as retinol from animal
sources;
•carotenoids (e.g. beta carotene) from plant
sources, from which retinol can be made in
the body.

Vitamin A concentration is usually


expressed as retinol equivalents (RE).

Some carotenoids can be converted to


retinol in the body.

6µg of beta carotene is equivalent to 1µg


of retinol.

© BRITISH NUTRITION FOUNDATION 2013


Vitamin A

Vitamin A is found pre-formed in liver


and whole milk. It can also be
produced from beta-carotene provided
by dark green leafy vegetables, carrots
and orange coloured fruit.

In the UK, the law states that


margarine must be fortified with
vitamin A (and vitamin D). Vitamins A
and D are also often voluntarily added
to reduced fat spreads.

© BRITISH NUTRITION FOUNDATION 2013


Vitamin A

Severe vitamin A deficiency in the UK is rare.


It can lead to night blindness (unable to adapt
to low-intensity light) and ulceration of the
eye which may cause total blindness.

Large intakes of vitamin A (>1500µg of


RE/day) can be toxic and cause liver and bone
damage.

Pregnant women should not consume liver


and liver pâté as high levels of retinol may be
present. Excess retinol during pregnancy can
lead to birth defects.

© BRITISH NUTRITION FOUNDATION 2013


Vitamin D

Vitamin D is needed for:


•the absorption and use of calcium
and phosphorus;
•normal blood calcium levels;
•the maintenance of normal bones
and teeth;
•the maintenance of normal muscle
function;
•the normal function of the
immune system.

© BRITISH NUTRITION FOUNDATION 2013


Vitamin D

Vitamin D is a pro-hormone in
the body. It can be obtained in two
forms:

•ergocalciferol (vitamin D2);


•cholecalciferol (vitamin D3)
formed by the action of sunlight.

Vitamin D is only required in very


small amounts and is measured in
micrograms.

© BRITISH NUTRITION FOUNDATION 2013


Vitamin D

Sources of vitamin D include oily fish (such as


salmon, trout, mackerel, sardines, pilchards,
herring, kipper), meat, eggs and fortified breakfast
cereals and margarine/spreads. However, these
dietary sources are relatively insignificant for most
people because the main source is synthesis in the
skin following exposure to sunlight during the
summer months in the UK (April – October).

Did you know?


The wavelength of UVB during the winter months
in the UK does not support vitamin D synthesis.

© BRITISH NUTRITION FOUNDATION 2013


Vitamin D

People who have darker skin, wear concealing


clothing or are housebound make much less vitamin
D and are at greater risk of vitamin D deficiency.
There is evidence of poor vitamin D status across the
UK population, especially during the winter months.

A lack of vitamin D in the body causes rickets in


children, where leg bones become weakened and
bent, and a related condition called osteomalacia in
adults. Poor vitamin D status has also been linked to
increased falls in elderly people, thought to be linked
to an adverse effect on muscle.

© BRITISH NUTRITION FOUNDATION 2013


Vitamin E

Vitamin E is an antioxidant and is


required to protect cells against oxidative
damage.

Generally, good sources of vitamin E are


those that also provide a large amount of
polyunsaturated fatty acids, e.g. plant oils
such as sunflower, soya, corn and olive
oils and their spreads; nuts; seeds and
wheatgerm. This is because vitamin E is
present naturally in these foods to prevent
oxidation.

© BRITISH NUTRITION FOUNDATION 2013


Vitamin K

Vitamin K is needed for:


•normal blood clotting;
•the maintenance of normal bones.

Sources of vitamin K include green leafy


vegetables, meat, dairy products and eggs.

Deficiency of vitamin K is considered to be very


rare as it is widely available in the diet and
produced to some extent in the gut by bacteria.
Newborns up to 6 weeks may have very low
vitamin K levels and so it is usual to give a
vitamin K injection to all newborn infants.

© BRITISH NUTRITION FOUNDATION 2013


Water soluble vitamins

There are a number of B vitamins. Regular


intake of each is essential as each has
specific functions in the body. They are:

• vitamin B1 (Thiamin)
• vitamin B2 (Riboflavin)
• vitamin B3 (Niacin)
• vitamin B6 (Pyridoxine)
• vitamin B12 (Cyanocobalamin)
• folate
• pantothenic acid
• biotin

© BRITISH NUTRITION FOUNDATION 2013


Thiamin (vitamin B1)

Thiamin is needed for:


•the release of energy from carbohydrate;
•normal function of the nervous system
and heart.

Sources of thiamin include whole grains,


nuts, meat, milk, fruit, vegetables and
fortified breakfast cereals. White and
brown flour in the UK are fortified with
thiamin.

Deficiency of thiamin causes the nervous


system disease beri-beri, which is rare in
the UK.

© BRITISH NUTRITION FOUNDATION 2013


Riboflavin (vitamin B2)

Riboflavin is needed for:


•the release energy from protein, carbohydrate
and fat;
•normal function of the nervous system;
•maintenance of mucous membranes and normal
skin;
•keeping red blood cells healthy;
•transport and use of iron in the body;
•protection of cells from oxidative stress;
•reduction of tiredness and fatigue.

© BRITISH NUTRITION FOUNDATION 2013


Riboflavin (vitamin B2)

Sources of riboflavin include milk, eggs, rice,


fortified breakfast cereals, liver, legumes,
mushrooms and green vegetables.
Did you know?
Legumes are the fruits or seeds of anything that
comes in a pod, e.g. beans, peas, lentils.
Deficiency of riboflavin is characterised by dryness
and cracking of the skin around the mouth and nose,
and a painful tongue that is red and dry (magenta
tongue), but this is rare in the UK. There is evidence
of low intakes and poor status in teenagers and
young adults, especially teenage girls.

© BRITISH NUTRITION FOUNDATION 2013


Niacin (vitamin B3)

Niacin (vitamin B3) is needed for:


•the release of energy from food;
•the normal functioning of the nervous
system;
•normal psychological function;
•the maintenance of normal skin and
mucous membranes;
•the reduction of tiredness and fatigue.

© BRITISH NUTRITION FOUNDATION 2013


Niacin (vitamin B3)

Sources of niacin include meat,


wheat flour, eggs, dairy products
and yeast. White and brown flour
in the UK are fortified with niacin.

Deficiency of niacin is
characterised by sun-sensitive skin
known as pellagra, but this is rare
in the UK and other westernised
countries.

© BRITISH NUTRITION FOUNDATION 2013


Vitamin B6

Vitamin B6 (pyridoxine) has many functions,


including contributing to:
• normal cysteine synthesis (an amino acid);
• normal energy-yielding metabolism;
• the normal functioning of the nervous system;
• normal homocysteine metabolism;
• normal protein and glycogen metabolism;
• normal psychological function;
• normal red blood cell formation;
• normal function of the immune system;
• reduction of tiredness and fatigue;
• the regulation of hormonal activity.

© BRITISH NUTRITION FOUNDATION 2013


Vitamin B6

Together with folate and vitamin B12, vitamin B6 is


required for the maintenance of normal blood
homocysteine levels.

A raised homocysteine level is a risk factor for


cardiovascular disease.

Sources of vitamin B6 include poultry, white fish, milk,


eggs, whole grains, soya beans, peanuts and some
vegetables, e.g. peppers and cauliflower.

Deficiency of vitamin B6 is rare because it is widely


distributed in foods; but it can occur as a complication
of disease or prolonged administration of certain drugs.

© BRITISH NUTRITION FOUNDATION 2013


Vitamin B12 (Cyanocobalamin)

Vitamin B12 is needed for:


•the producing of energy;
•formation of red blood cells;
•normal function of the immune
system and nervous system;
•normal psychological function.

Together with folate and vitamin


B6, vitamin B12 is required for the
maintenance of normal blood
homocysteine levels.

© BRITISH NUTRITION FOUNDATION 2013


Vitamin B12

Sources of vitamin B12 include foods of animal


origin and through fortification of foods. These
include meat, fish, milk, cheese, eggs, yeast
extract and fortified breakfast cereals.
Dietary deficiency of vitamin B12 in young people
is rare and usually occurs only in strict vegans.
However, blood levels of vitamin B12 (vitamin B12
status) can be low because of poor absorption,
especially in older people.
Severe vitamin B12 deficiency results in pernicious
anaemia, in which red blood cells are enlarged,
and peripheral nerve damage develops, e.g. in the
legs.

© BRITISH NUTRITION FOUNDATION 2013


Folate/Folic acid

Folate is needed for:


•production of normal red blood cells;
•normal cell division;
•normal psychological function;
•normal development of the neural tube
(which develops into the spinal cord
and skull) in the embryo.

Did you know?


Folic acid is the synthetic form of
folate. It is used in supplements and for
food fortification.

© BRITISH NUTRITION FOUNDATION 2013


Folate

Folate is found naturally in green leafy


vegetables, brown rice, peas, oranges
and bananas.

There is some evidence of low intakes


in teenage girls and in elderly people.
Poor folate status results in neural tube
defects in newborns and megaloblastic
anaemia, characterised by the release of
immature red blood cells into the blood
stream due to impairment in the normal
process of blood cell maturation in the
bone marrow.

© BRITISH NUTRITION FOUNDATION 2013


Vitamin C (ascorbic acid)

Vitamin C is needed for:


•the normal functioning of the immune
system;
•formation of collagen for normal blood
vessels, bones, cartilage, gums, skin and
teeth;
•the protection of cells from oxidative
stress.

Did you know?


Vitamin C can help with the absorption
of iron from plant foods when they are
consumed at the same meal.

© BRITISH NUTRITION FOUNDATION 2013


Vitamin C

Sources of vitamin C include citrus fruits and berries, green


vegetables, peppers, tomatoes and potatoes (especially new
potatoes).

Can you name some citrus fruit?


Lime, orange, grapefruit, tangerine, lemon, clementine.

How many different types of berries can you think of?


Blackberries, blackcurrants, strawberries, raspberries,
blueberries, cranberries.

Severe deficiency of vitamin C can cause scurvy, which is


characterised by the bleeding of gums and poor wound-
healing. It is also associated with fatigue, weakness, aching
joints and muscles.

© BRITISH NUTRITION FOUNDATION 2013


Minerals

Minerals are inorganic substances


required by the body in small
amounts for a variety of different
functions.

The body requires different


amounts for each mineral.

Some minerals are required in


larger amounts, while others are
needed in very small amounts and
are called ‘trace elements’.

© BRITISH NUTRITION FOUNDATION 2013


Calcium (Ca)

The body contains more calcium than any other


mineral. It is essential for a number of important
functions, including:
•the maintenance of normal bones and teeth;
•normal blood clotting;
•normal muscle and nervous system function;
•the production of energy;
•normal function of digestive enzymes.

Did you know?

The skeleton contains about 99% of the body’s calcium


with approximately 1kg present in adult bones.

© BRITISH NUTRITION FOUNDATION 2013


Calcium (Ca)

Sources of calcium include


milk and dairy foods, edible
soft bones of fish (e.g. in
canned salmon), green leafy
vegetables, fortified soya
bean products and bread, as
white and brown flour are
fortified with calcium in the
UK.

© BRITISH NUTRITION FOUNDATION 2013


Calcium (Ca)

Did you know?

The calcium level in blood is carefully regulated by hormones,


including vitamin D, to keep it within narrow limits. This means
that calcium balance can be maintained at different levels of
calcium intake.
However, if calcium intake is too low, calcium is withdrawn
from bones to maintain blood levels. So, a poor supply of
dietary calcium can lead to low bone density. Over time, this
will lead to osteoporosis, characterised by weak, brittle bones.
This condition may also reflect a lack of vitamin D, which is
involved in calcium absorption.
There is evidence of low calcium intakes in teenage girls in
particular.

© BRITISH NUTRITION FOUNDATION 2013


Phosphorus (P)

Phosphorus is needed for:


•the maintenance of normal bones and teeth;
•the production of energy;
•normal function of cell membranes;
•normal function of cell membranes.

Sources of phosphorus include red meat,


milk and dairy foods, fish, poultry, bread,
rice and oats.
Phosphorus is unlikely to be in short supply
in UK diets because it is present in many
foods.

© BRITISH NUTRITION FOUNDATION 2013


Iron (Fe)

Iron is needed for:


•the formation of haemoglobin in red
blood cells;
•transport of oxygen in the body;
•production of energy;
•function of the immune system;
•normal cognitive function;
•reduction of tiredness and fatigue;
•cell division.

© BRITISH NUTRITION FOUNDATION 2013


Iron (Fe)

Did you know?


There are two types of iron; one from
animals sources (haem iron) and the other
from plant sources, fortified foods and
supplements (non-haem iron).

Haem iron is readily absorbed by the body.


Vitamin C helps the absorption of non-
haem iron when eaten at the same time, as
does meat and fish.

Sources of iron include cereals, vegetables,


nuts, eggs, fish and meat.

© BRITISH NUTRITION FOUNDATION 2013


Iron (Fe)
Teenage girls and women of childbearing
age need more iron than males of the same
age. Almost half of teenage girls in the UK
do not consume enough iron and intakes
are also low in a large proportion of young
women.

A lack of iron may lead to iron deficiency


anaemia.

Did you know?


More than 2 billion people worldwide
suffer from iron deficiency anaemia,
making it the most common nutritional
deficiency.

© BRITISH NUTRITION FOUNDATION 2013


Sodium (Na)

Sodium is needed for:


•regulating body water content and electrolyte balance;
•the absorption of certain nutrients and water from the
gut.

Sodium levels in the body are under homeostatic control


and are tightly regulated by the kidneys.

Did you know?


Sodium is a component of common salt, known as
sodium chloride (NaCl).

To convert sodium to salt, multiply by 2.5.


Amount of salt = Amount of sodium x 2.5

© BRITISH NUTRITION FOUNDATION 2013


Sodium (Na)

Sodium intakes in the UK are higher


than the recommended levels. High
intakes of sodium are linked to high
blood pressure (hypertension), which
increases the risk of stroke and coronary
heart disease.

Did you know?


It is recommended that adults have a
maximum of 6g salt per day. Children
under 11 years should eat less.

© BRITISH NUTRITION FOUNDATION 2013


Sodium (Na)

Most raw foods contain very small amounts of


sodium chloride (salt).

Salt is often added during the processing,


preparation, preservation and serving of foods.
Reductions in sodium levels in foods have been
happening across the UK food industry.

About 20% of salt we eat is added at home


during cooking and at the table.

How can we reduce salt when preparing and


cooking food?

© BRITISH NUTRITION FOUNDATION 2013


Potassium (K)

Potassium is needed for:


•the normal functioning of the nervous system;
•normal muscle function;
•the maintenance of normal blood pressure.

Sources of potassium include fruit and vegetables


(especially bananas), meat, fish, shellfish, nuts,
seeds, pulses and milk.
Low blood potassium levels can be a result of severe
diarrhoea. Symptoms include weakness, mental
confusion and, if extreme, heart failure. Low dietary
potassium intakes have been found in the UK,
particularly among women.

© BRITISH NUTRITION FOUNDATION 2013


Fluoride (F)

Fluoride is needed for:


•the mineralisation of bones and teeth;
•protection of teeth from dental caries
(tooth decay).

Fluoride is now added to most


toothpastes but is also found in
fluoridated water, tea and fish.

The addition of fluoride to toothpaste


is important in those areas where the
water supply is low in fluoride.

© BRITISH NUTRITION FOUNDATION 2013


Nutrient interactions

Some nutrients work together in the body


completing different functions.

What examples can you think of?

•Vitamins A, C and E
•Calcium, phosphorus and fluoride
•Calcium and vitamin D
•Iron and vitamin C
•Carbohydrates and the B vitamins.

© BRITISH NUTRITION FOUNDATION 2013


Summary

Micronutrients do not provide energy but are


required in small amounts for health.

There are two main types of micronutrients:


vitamins and minerals.

Intakes of some micronutrients are low in the UK.

© BRITISH NUTRITION FOUNDATION 2013


Question

True or false?
Vitamin A can be made
from carotenoids in
plant sources.

True False

© BRITISH NUTRITION FOUNDATION 2013


True. Vitamin A can be made from
carotenoids in plant sources.

Next
© BRITISH NUTRITION FOUNDATION 2013
question
Question

True or false?
Vitamin D deficiency is more
common in people with darker skin
living in the UK.

True False

© BRITISH NUTRITION FOUNDATION 2013


True. Vitamin D deficiency is more
common in people with darker skin
living in the UK.

Next
© BRITISH NUTRITION FOUNDATION 2013
question
Question

At what time of the year in the UK


can vitamin D be produced in the
skin?

November to January

April to October

All year round

© BRITISH NUTRITION FOUNDATION 2013


Wrong answer.

Next
Try again
© BRITISH NUTRITION FOUNDATION 2013
question
Correct answer.

Next
© BRITISH NUTRITION FOUNDATION 2013
question
Question

Which vitamin can help our bodies


absorb iron from plant sources?

Vitamin A

Vitamin C

Vitamin E

© BRITISH NUTRITION FOUNDATION 2013


Wrong answer.

Next
Try again
© BRITISH NUTRITION FOUNDATION 2013
question
Correct answer.

Next
© BRITISH NUTRITION FOUNDATION 2013
question
Question

Why should women of child-bearing


age take a daily folic acid
supplement?

To prevent bone problems in


the baby

To prevent neural tube defects


(e.g. spina bifida) in the baby

To prevent eye problems in the


baby

© BRITISH NUTRITION FOUNDATION 2013


Wrong answer.

Next
Try again
© BRITISH NUTRITION FOUNDATION 2013
question
Correct answer.

Next
© BRITISH NUTRITION FOUNDATION 2013
question
Question

Which of the following is not a main


function of calcium?

Helps release energy from food

Contributes to the maintenance


of normal bones and teeth.

Contributes to normal blood


clotting.

© BRITISH NUTRITION FOUNDATION 2013


Wrong answer.

Next
Try again
© BRITISH NUTRITION FOUNDATION 2013
question
Correct answer.

Next
© BRITISH NUTRITION FOUNDATION 2013
question
Question

Which one of the following


conditions is most associated with
iron deficiency?

Brittle bones

Impaired night vision

Anaemia

© BRITISH NUTRITION FOUNDATION 2013


Wrong answer.

Next
Try again
© BRITISH NUTRITION FOUNDATION 2013
question
Correct answer.

Next
© BRITISH NUTRITION FOUNDATION 2013
question
Question

True or false?
Sodium is a constituent of salt. Low
intakes of salt are linked to high
blood pressure.

True False

© BRITISH NUTRITION FOUNDATION 2013


False. High intakes of salt are linked
to high blood pressure.

The end
© BRITISH NUTRITION FOUNDATION 2013
Enumerate all
Micronutrients
and their major
functions in the
body.
Submit the soft
copy it in the
NEO LMS
British Nutrition Foundation
Imperial House
15-19 Kingsway
London WC2B 6UN

Telephone: 020 7557 7930


Email: [email protected]
Web: www.nutrition.org.uk www.foodafactoflife.org.uk

© BRITISH NUTRITION FOUNDATION 2013

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