Nutrition and Wellness - Vitamins and Minerals

Cobalamin (Vitamin B12)

- Absorption: Requires acid and intrinsic factor (protein in stomach) - Functions: Acts as coenzyme for deriving energy from amino acids and for converting homocysteine to methionine (activates Folate*, therefore B12 needed in DNA synthesis and cell division); maintains neural sheats; - Sources: Skim milk, low-fat yogurt, Meat, eggs, clams/mussels/oyster (shellfish), liver, beef - Stored in significant quantity in the liver - Deficiency: Megaloblastic anemia (called Pernicious Anemia if because of lack of intrinsic factor); cognitive impairment and problems with motor control

Hypertension

- Along with accompanying atherosclerosis can cause heart attacks and strokes - Weight control most effective dietary strategy for treating hypertension - Blood flow to the kidneys is reduced so the kidneys expand blood volume and constrict peripheral blood vessels, resulting in peripheral resistance and thus raising blood pressure - Cardiac output increases, increasing the work of the heart.

Factors Affecting Bioavailibility (and def.)

- Bioavailibility: The degree to which nutrients can be absorbed and utilized by the body; - Minerals cannot be synthesized in the body - Affected by: - Deficiency in a mineral - Increased need for a mineral - Decreased by binders: - Phytates (whole cereal grains) - Oxalates (spinach and some vegetables) - Polyphenols (coffee and tea) - Mineral competition (i.e. excess iron consumption interfering with zinc absorption) - Concerns of deficiency in minerals: calcium, potassium, magnesium, and iron

Minerals for Bone Formation and Maintenance

- Calcium - Magnesium - Phosphorus

Sulfur (S)

- Component of protein -> present in cysteine and methionine - Function: Cartilage* and Keratin* - Present in thiamine and biotin - Deficiency unknown - Toxicity Rare -> excrete excess in urine

DASH Diet

- Dietary Approach to Stop Hypertension (DASH) - Helps lower sodium intake and increases potassium, calcium, and magnesium intake

Functions of Minerals

- Diverse and regulatory and structural functions, many act with enzymes as cofactors - Have an electrical charge and are, therefore, ions*

Sodium (Na)

- Major positively charged ion in extracellular fluid; - Functions: Electrolyte Balance, Regulating fluid balance, regulating blood pressure, transmitting nerve impulses**, electrolyte balance, contracting muscles**, helping nutrient transport - Sources: Table Salt and processed foods - Overconsumption can cause hypertension

Oxidation

A loss of electrons; in the body, this results in damage to cells

How to preserve Vitamins

Cook fruit/vegetables on low heat, leave skin on fruit/vegetables, eat fresh, freeze/refrigerate, prevent soaking of vegetables for long periods, refrigerate milk

Major Minerals

Requirement greater than 100 mg/day

Trace Minerals

Requirement less than 100 mg/day

Hypertension Risk Factors/Treatment

Risk factors: - Age: increases with age - Genetics: family history, African American - Obesity: 60% of those with hypertension are obese - Salt sensitivity - Alcohol may raise blood pressure and associated with strokes

Iron (Fe)

Sources: Heme iron (meats, seafoods and) & Nonheme iron (enriched bakery products) Function: Hemoglobin, Myoglobin, Iron-containing enzymes, reproduction, growth, healing Absorption: Ferritin, lysosome Factors Affecting Iron Absorption: physiological status, meal composition, food sources Storage: Ferritin, Hemosiderin Transport: Transferrin, Ferroportin Deficiency: Iron Deficiency Anemia** ^At Risk: premature infants, children, females of child bearing age, vegetarians; Symptoms: Pallor (pale skin), fatigue, weakness, dyspnea (trouble breathing), hair loss, and obsessive food cravings (pica: cravings for ice, clay, and chalk) - Hemochromatosis: Iron overload resulting in hepatic cirrhosis. It is a hereditary disorder which accelerates the rate of intestinal iron absorption ; typically begins to be expressed in the third to fifth decades of life - Most abundant trace mineral deficiency, affects 80% of world population - Athletes 30% higher iron requirement, vegans doubled RDA

Water Soluble Vitamins

The Eight B Vitamins, Vitamin C, and Choline: Absorbed via small intestine, Organic Compounds - Coenzymes/Involved in Energy Metabolism

Fat Soluble Vitamins

Vitamins A, D, E, K; Absorption: Small intestine, to lymph vessels* into bloodstream, Organic Compounds - Mixed functions - Stored in liver and fatty (adipose) tissue

Magnesium (Mg)

- Function: Cofactor in more than 300 chemical reactions, 50% to 60% found in bones, role in the transport of ions across cell membranes for muscle contraction***/nerve impulse conduction/heart rhythm, involved in extracting energy from carbohydrates/fats/proteins, role in protein production, necessary in activating***, counter cation for ATP, metabolic reactions Vitamin D***, Bone health***; - Sources: Quinoa (grains), green leafy vegetables, fruits (banana/avocado), nuts and beans, chicken breast, milk, dark chocolate; - Deficiency: Kidneys will excrete less and body will absorb more, Osteoporosis; increases risk for atherosclerosis, cancer, diabetes, hypertension; - Toxicity: Rare from diet, some toxicity from supplement misuse

Folate

- Functions: Acts as a coenzme in metabolism of certain amino acids, helps in DNA and RNA synthesis, helps with normal cell division and development; - Sources: Green leafy vegetables, avocado, broccoli, beans, enriched pasta/bread, legumes, fortified grains and cereals; - Deficiency: Megaloblastic anemia (larger than normal red blood cells caused by folate or vitamin B12 deficiency); in pregnancy there is increased risk of neural tube defects; - Alcoholics/those with malabsorptive conditions/take certain medications at risk of deficiencies; - Masks vitamin B12 deficiency symptoms

Pyridoxine (Vitamin B6)

- Functions: Acts as a coenzyme in the release of glucose from glycogen*, metabolizes tryptophan to niacin, helps in production of hemoglobin and neurotransmitters; - Sources: Corn flakes, Baked Potato, Beans, Nuts, Meats, bananas; - Deficiency: Anemia, Impaired immune function, weakness, dermatitis, neurological disorders; - Toxicity: Supplements above UL -> pain and numbness, sometimes irreversible neurological effects

Thiamin (Vitamin B1)

- Functions: Coenzyme form in energy metabolism, synthesis of RNA and DNA, production of neurotransmitters* - Sources: Pork and fortified grain products, seeds and some nuts, fish - Deficiency: - Beriberi (causes muscle wasting, fatigue, and mental disturbances) - Wernicke-Korsakoff syndrome (causes severe neurological disturbances; alcohol decreases thiamin absorption, increases excretion in the urine, decreases storage in the liver, and decreases conversion of thiamin into its coenzyme)

Vitamin C

- Functions: Coenzyme in biological reactions, aids in hormone production, involved in collagen synthesis (builds bone, teeth, scar tissue, and arterial walls, and enhances iron absorption** -> helps with absorb iron lost from oxylates), is an antioxidant; - Does not reduce chance of common cold (except for regular use) - Sources: Guava, peppers, kiwi, broccoli, tomatoes (Citrus Fruits); - Deficiency: Scurvy (Bleeding gums, bruising, joint pain, impaired wound heeling) - Destroyed by storage and cooking

Niacin

- Functions: Energy metabolism; synthesis of glucose***, fatty acids, cholesterol, and steroid hormones; DNA repair***; Cell signaling; Regulation of gene expression; - Sources: Rich in meats, (synthesized from the amino acid tryptophan), fortified cereals, peanuts, mushrooms - Dietary recommendations given in niacin equivalents (NE) - Fortified and enriched in our foods - Deficiency: Pellagra (symptoms: fatigue, diarrhea, mental deterioration, death) - Supplements: Flushing, gastrointestinal effects, liver damage - Therapeutic: Lowers cholesterol, but needs monitoring by medical provider to ensure no liver problems or glucose intolerance

Riboflavin

- Functions: Helps with energy metabolism, metabolism of proteins, lipids, and carbohydrates - Sources: Found in milk and diary products, liver, almonds, clams, pork; - Destroyed by UV Light (why we have milk cartons/opaque plastic containers); - Deficiency: Ariboflavinosis (symptoms: cracks and redness of the lips and corners of the mouth, swelling of the mouth and sore throat). May be seen with chronic alcohol abuse or malabsorptive conditions and seldom occurs by itself (occurs with deficiencies in other B vitamins).

Pantothenic Acid

- Functions: Helps with energy metabolism; synthesizes fatty acids, cholesterol, steriod hormones, and two neurotransmitters**; - Food sources: Widespread in virtually all foods, highest in liver, deficiency rare

Choline

- Functions: Intertwined with function of folate and vitamin B12, forms neurotransmitter (acetylcholine), is part of phospholipids in cell membranes - Deficiency: Liver Damage - Excessive Intake: Only through supplementation, fishy body odor - Sources: Naturally synthesize choline, eggs, liver, and peanuts, meat

Water (H20)

- Functions: Regulates body temperature, Transports nutrients and oxygen, lubricates joints, present in mucus and saliva, cushions tissue, acts as solvent, removes waste, chemical reactions - Water Balance: 2/3rd of water intracellular, 1/3rd of water extracellular, water moves by osmosis* (based on the concentration of solutes) - Deficiency: Dehydration, nausea, dizziness, elevated temperature - Body's response to deficiency: Anti-diuretic hormone, renin-angiotension system, aldosterone; - Excess Water consumption without electrolytes: Hyponatremia, confusion, nausea, vomiting, bloating, swelling in the brain

Chloride (Cl)

- Half of the mineral composition of table salt (NaCl); - Found primarily in extracellular fluids; - Involved in fluid balance, acid-base balance; - Half of hydrochloric acid (HCl) - Abundant in the diet with sodium - Overconsumption increase blood pressure

Phosphorus (P)

- In every cell in the body - Function: Component of bone and cartilage**/phospholipids**/DNA and RNA**, Involved in energy metabolism, Regulates many enzymes, Helps maintain acid-base balance*** - Deficiency: Rare, as found in protein-rich food and food additives - Overconsumption: Increased levels associated with cardiovascular, particular in people with kidney disease

Vitamin D

- Made in skin from cholesterol and UV light; - Activated in the kidneys and liver; - Sources: Fortified dairy products, Mushrooms, Eggs, Fish - Functions: Acts as hormone, helps bone growth/maintenance*, regulates calcium/protein synthesis*, regulates cardiovascular function; - Calcitriol: Fully activated Vitamin D form from the kidney, increase absorption of calcium in the intestine, active vitamin D and parathyroid hormone decreases calcium exertion by the kidneys - Deficiencies: Rickets (in children), Osteomalacia (in adults), Cancer, Autoimmune disease, Kidney disease, Type 2 Diabetes, Cardiovascular disease

Calcium (Ca)

- Most abundant mineral in the body (99% in bone/teeth, 1% in body cells and fluids) - Functions: Strengthening bone/teeth, blood clotting, hormone secretion, muscle contraction, nerve transmission, bone remodeling**; - When calcium levels fall: parathyroid gland releases parathyroid hormone (PTH), PTH stimulates production of active vitamin D (calcitriol) -> increases calcium absorption in the intestine. PTH and activated vitamin D mobilize calcium from the bone and decrease calcium excretion from the kidneys - Sources: Milk (fortified), yogurt, cheese, some legumes and dark-green leafy vegetables (these vegetables low in oxalates leading to high bioavailibility (~50% absorption) - Peak bone density around ~30 years old, maintain adequate calcium/Vitamin D/weight-bearing exercise throughout life - Toxicity: Constipation, Interference with iron absorption, hypercalcemia (excess calcium in blood)

Potassium (K)

- Primary electrolyte in cells - Functions: Regulating fluid balance, acting as a cofactor, for certain enzymes, helping nutrient transport, helping maintain electrical activity in the heart***; - May counter effects of excess sodium on blood pressure; - Sources: Fruits and vegetables (i.e. apricots***, baked potato) and milk - Deficiency: Mild forms (increase risk of hypertension, stroke, and heart attacks) - Severe depletion causes hypokalemia**; usually from excessive fluid loss through vomiting, diarrhea, use of diuretics, or kidney disorders -> fatigue, muscle weakness, abnormal heart rhythms, increased calcium excretion, reduced insulin production - Toxicity: Only from supplement misuse, symptoms: low heart rate, abnormal heart rhythm. Hyperkalemia, results from advanced renal disease - Supplementation should be prescribed and monitored by a health care provider

Sodium-Potassium Pump

- Required to maintain cellular osmotic pressure

Vitamin A

- Retinoids: Retinol (active/present in our diet), retinal (critical for vision) and retinoic acid (growth and development) active forms vitamin A; - Carotenoids: Provitamin (not in active form), Beta-carotene primary carotenoid; - Sources: Preformed (Retinol) = Animal foods (beef liver, salmon) and fortified foods (milk) - Carotenoids: Yellow/Orange/Red pigmented fruits and vegetables (i.e. sweet potatoes, carrots, squash); - Absorption of carotenoids from food is poor, slicing, chopping, cooking, juicing, cooking can improve bioavailibitility; - Functions: Vision, cell development, immune function, growth, bone health, reproduction (all functions except vision, controls synthesis of many proteins in our genes as a hormone*); - In Vision: Key component of rhodospin*(key component in absorbing light and triggering nerve impulses to the brain); - Anti-Oxidant: Plant forms of vitamin A (carotenoids and beta-carotene); - Deficiency (Hypovitaminosis A): Night/permanent blindness, impaired immunity, rough, dry, or scale skin, keratinization (epithelial and line body cavities cannot develop properly, filling of fibrous structural protein called keratin. - Vitamin A Toxicity: Can cause osteoporosis, comes mostly from supplements, pregnant women need to be cautious, birth defects - excess of plant sources does not cause toxicity, beta-carotene can turn skin yellow;

Electrolytes

- Sodium - Potassium - Chloride - Functions: Maintain fluid balance***, transmit nerve impulses, muscle contraction, transport nutrients - Cations and anions

Flouride

- Sources: Flouridated water, tea, seafood, and seaweed - Function: Promotes bone and dealth - Deficiency: Associated with an increase in dental caries - Toxicity: Mottling and Flourosis

Chromium

- Sources: Nutrient databases inadequate; Processed meats, liver, eggs, and whole grain products - Function: May enhance insulin function*** - Deficiency: Not well established - Toxicity: No UL

Vitamin K

- Sources: Produced by bacteria in the intestine, green leafy vegetables, some cheeses (blue and jasberg), fruits (blue berries, avocado), vegetable oils; - No RDA, only AI; Functions: Blood clotting (needed for synthesis of several proteins in blood that cause the blood to clot), bone metabolism (by modifying blood proteins, which allows them to bind to calcium and regulate bone formation); - Does NOT lower risk of hip fractures in aging adults - Deficiencies: Hemorrhaging* (uncontrolled bleeding) due to antibiotics that destroy intestinal bacterial/use of medications that prevent clotting (anti-coagulants) and interfere with the metabolism of Vitamin K.

Zinc

- Sources: Protein rich meat and seafood - Absorption and Transportation: Metallothionein and Transferrin when in excess - Excretion: feces - Function: At least 300 different enzymes (900 different possible reactions) require zinc; Zinc finger enzymes (DNA and RNA synthesis**, DNA repair), Alcohol dehydrogenase, metalloproteinases, antioxidants, anti-inflammatory enzymes, and many more; - Deficiency: Common in poor; 800,00 deaths a year in children worldwide ^ Causes: phytic acid, high non-heme iron and zinc intake - Toxicity: Supplementation or ingesting a post 1982 penny; - Symptoms: ataxia (lack of coordination of muscle movements), lethargy (fatigue) and copper deficiency - Growth retardation and delayed sexual maturation - Phytates inhibit absorption - At-risk groups: Alcoholics, Vegetarians, Elderly

Iodine

- Sources: Saltwater seafood, seaweed, iodized salt, molasses and dairy products; - Function: Component of thryoxine (T4) and triodothyronine (T3) (Thyroid hormone, TSH***). responsible for regulation of metabolism, critical in the development of the fetal skeleton and brain***. Thyroid-stimulating hormone secreted from the pituitary gland, regulates the thyroid - Deficiency: - Hypothyroidism/Endemic goiter**: increased cellular growth and proliferation causing swelling, slow metabolic rate, elevated TSH - Endemic cretenism**: leading causes of preventable mental handicaps worldwide, mental illness, - Toxicity: Enlarged thyroid gland

Selenium

- Sources: Seafood, meats, cereal grains and nuts - Function: Anti-oxidant defense network***, Thyroid metabolism*** (activates thyroid hormone), essential for normal growth, development, and metabolism - Deficiency: Not established, May increase risk of some cancers, decreases immune function

Copper

- Sources: Shellfish, Liver, nuts, seeds, mushrooms, soy, and dark chocolate - Absorption and Transportation: bound to albumin to the liver, then ceruloplasmin - Function: electron transport**, synthesis of neurotransmitters**, brain function**, antioxidant (Superoxide dismutase enzymes), elasticity of blood vessels**, collagen formation** - Deficiency: Anemia-like symptoms, neutropenia (abnormally low number of neutrophils which fight bacterial infections), bone abnormalities, hypopigmentation, impaired growth, increased incidence of infections, osteoporosis, and abnormalities in glucose and cholesterol metabolism - Deficiency caused by: malabsorption from other conditions, gastric bypass surgery, excessive zinc intake - Toxicity: Resulting in excessive deposition of copper in the liver, brain, and other tissues; from supplementation and Wilson's disease

Manganese

- Sources: Whole-grain cereals, nuts, legumes, and tea; - Function: Shares functional similarities with Zinc and Copper, manganese-containing polypeptides such as Mn-containing superoxide dismutase (Mn-SOD) - Deficiency: rare - Toxicity: Persons employed in the processing of manganese alloys, patients receiving total parenteral nutrition - Symptoms: psychiatric and motor disturbances

Pectin

- Structural heteropolysaccharide contained in the primary cell walls of terrestrial plants

Carcinogens

- Substance that an individual is exposed to that can lead to cancer - Carcinogenesis is the development of cancer from mutated cells and can result in the formation of an abnormal mass, or tumor - Tumors can metastasize, or spread to other areas of the body - Environmental Factors: Exposure to radiation and sun, water and air pollution, and smoking are known to cause cancer; Physical activity may protect against certain types of cancer; Obesity increases risk for cancer

Mineral Sources

- Tap Water: Hard water contains calcium and magnesium, Soft water contains sodium; - Plants: Reflect mineral content of the soil; - Animal foods better sources than plants (animals eat plants and concentrate nutrients); - Processing/refining foods generally reduces mineral content (some nutrients like iron can be added back through enrichment to increase mineral intake) - Whole/Unprocessed Foods maximize intake - Cooking does not destroy minerals, but boiling can leach minerals into cooking water

Vitamin E

- Tocopherols: A group of fat-soluble vitamin E molecules (only alpha-tocopherlos reduce vitamin E deficiency), related to preventing sterility; - Sources: Vegetable oils (i.e. Wheat Germ, Avocado, black berries, jalepeno pepper, almonds, sunflower oil); - Functions: Antioxidant*, prevents oxidative changes in LDLs that may play a role in reducing plaque formation in blood vessels, protects white blood cells (better immune system), prevent damage to nerve tissue; - Hemolytic Anemia***: a condition in which red blood cells are destroyed and removed from the bloodstream before their normal lifespan is over - Toxicity: Caused by high supplement intake, increases tendency to bleed;