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Dietary Reference Intakes (DRI) 19/09/2007

09:00:00
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DRIs
• Replace and expand on the Recommended Dietary Aowance
• Intended to prevent nutritional deficiencies as well as reduce the
risk of chronic diseases
• Specific for gender, age (infants to 70+ years), and
pregnancy/lactation
• Consists of several types of reference intakes
• RDA – Recommended Dietary Allowance
• AI – Adequate Intake
• UL – Tolerable Upper Intake Level
• EER – Estimated Energy Requirement
• DV – Daily Value, for food labels (Not the same as the rest, RDA for
worst case scenerio)
RDA
• Average daily dietary intake level that is sufficient to meet the
nutrient requirement of nearly all (97 – 98 percent) healthy
individuals in a particular life stage and gender group
o Not the minimum requrement
o You can be below RDA and not have deficiency
• Developed to prevent nutrient deficiency diseases
• Age and gender specific
• Deficiency: intakes below 70% of RDA over and extended period
o 2/3 of RDA is ok for a few days

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• Toxicity: intakes above 3 times RDA
Adequate Intake (AI)
• Recommended intake value based on observed or experimentally
determined approximations or estimates of nutrient intake by a
group of healthy people
• Used when an RDA cannot be determined
o Not as definitive as RDA; more research needed
Tolerable Upper Intake Level (UL)
• The highest level of daily nutrient intake that is likely to pose no
risk of adverse health effects for almost all individuals in the
general population. As intake increases above the UL, the potential
risk of adverse effects increases.
o Adverse effects over a long time of eating bad
Estimated Energy Requirement (EER)
• An estimate of the calorie needs of the average person based on
gender, age, height, weight, and physical activity level
o Energy = calories
Range of Intake
• Upper Level (UL) met or exceeded
• RDA/AI/EER (good)
• Deficient State
Daily Value (DV)
• Used on food labels (%DV)
• Based on 2,000 kcal diet
• Rough guide for comparing food nutrient content to requirements

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Vitamins: Fat Soluble (A, D, E, K) 19/09/2007
09:00:00
What are Vitamins?
• Essential organic compounds
o Essential – important to proper growth
o Organic - carbon
• Needed in very small amounts
• Do not provide energy
• Function as coenzymes: B vitamins and vitamin K
o Work with enzymes
• Fat soluble: vitamins A, D, E, and K
o Soluble in non polar things
• Water soluble: B vitamins and vitamin C
o Soluble in polar things
Why are they essential?
• Vitamins either cannot be synthesized in the body or are not
synthesized in adequate amounts
o We are one of the few animals that do not make vitamin C
o We didn’t make some vitamins we needed as infants
• Must be supplied in the diet
• Exceptions: vitamins D, K, niacin, and biotin
• Produce deficiency symptoms when missing from the diet
Function of vitamins
• Participate in energy-yielding reactions

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• Contribute to blood formation, clotting, bone health, protein
metabolism, antioxidant defense
Sources and storage
• Plant and animal foods in diet
• Supplements
• Fat-soluble vitamins (except vitamin K) are stored in body – not
readily excreted
o Hard to get deficiency
• Water-soluble vitamins (except vitamins B6 and B12) are not stored
– readily excreted via urine
Deficiency and toxicity
• Deficiency: vitamin is lacking in the diet and the body stores are
depleted, loss of function
o Not often seen in our country
• Toxicity: excessive intake can cause damage to the body
o Upper limit – line at where toxicity begins
Toxicity
• Fat-soluble vitamins accumulate in the body most readily and can
cause toxic effects (3x RDA for vitamin A-most extreme and easy to
overtake)
• Water-soluble vitamins are toxic only in very large amounts (15-
100x RDA)
• Toxicity most likely from supplementation
Preservation of vitamins
• Eat foods soon after harvesting
• Tore properly (avoid heat, light, air)
o Cold/dark
• Avoid excessive cooking

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o Boiling in water causes vitamins to go into water
• Frozen frouts and vegetables are as nutritious as fresh
Absorption of fat-soluble vitamins (A, D, E, K)
• Absorbed along with dietary fat
o Some drugs block absorption
• Transported with fat through the bloodstream inside lipoproteins
• Usually 40-90% of fat-soluble vitamins are absorbed
• Fat malabsorption (diseases or weight loss during orlistat) may
cause deficiency
Vitamin A
• Found in several forms of foods
o carrots
• Retinoids in foods of animal origin
• Carotenoids (pigments) in vegetables, can be converted into
vitamin A
o Pre- or pro- vitamin A
• Vitamin A Functions
o Promotes vision
 Night blindness
o Promote growth, development, reproduction
o Prevents drying of the skin and eyes
 Xerophthalmia (dry eye)
 Need to maintain skin

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o Promotes immune function and infection resistance
o Cardiovascular disease prevention
o Cancer prevention
o Acne medication (vitamin a derivatives)
• Vitamin A recommendations
o Measured in Retinol Activity Equivalents (RAE) = vitamin A +
carotenoids (beta-carotene)
o RDA is 900 ug RAE for men, 700 ug RAE for women
o DV is 1000 ug RAE
o Average intakes in the us meet the RDA
o Much of vitamin A is stored in the liver
• Vitamin A Deficiency
o Leading cause of preventable blindness in children
o Night blindness
o Xerophthalmia
o Dry skin
o Poor growth
• Vitamin A Toxicity
o Highly toxic
o Enlarged liver
o Fetal malformations and spontaneous abortions (why
Accutane is not prescribed during pregnancy)
o Bone/muscle pain, fractures

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o Headaches
o Hair loss
o Skin changes
o Eating polar bear liver – toxicity, makes person blind.
• Vitamin A sources
o Yellow-orange vegetables (beta-carotene), dark green leafy
vegetables (lutein and zeaxanthin) and tomatoes (lycopene)
o Liver
o Fish oils
o Eggs
o Fortified milk and yogurt
Vitamin D
• Prohormone: activated by enzymes in the liver and kidneys
• Derived from cholesterol (like a hormone
• Synthesized from sunlight
• 80-100% of vitamin D needs can be provided by sunlight
• Deficiency causes bone diseases
• Functions
o Calcium metabolism and bone health
o Regulates absorption of calcium and phosperos from intake
o Regulates deposition of cacium in bones
o Influences cell development

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o Immune function and cancer prevention
o Immune system modulator
• Reccomendations
o 5 ug/day for adults under 51
o Sun
• Deficiency
o Rickets, deficiency in children
 Bowed legs
 Rib “beads” at sternum
 Slow growth
 Bowed spine
o Osteonalacia – deficiency in adults
“soft bones”
bones lose minerals and become
pourous
• Toxicity
o Toxic in high amounts, especially for infants and children
o Over-absorption of calcium, calcium deposits in organs
o Weakness, appetite loss, diahrea, vomiting, mental
confustion, increased urine
• Sources
o Fortified milk/milk products
o Fortified breakfast cereals

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o Fish oils
o Sardines
o Salmon
o Sunlight
Vitamin E
• The fat soluble antioxidant vitamin
• Protects unsaturated fats from oxidization
• Donates electron to electron seeking compounds, “free radicals”
• Found mostly in cell membranes
• Improves vitamin A absorption
• Recommendations
o 15 mg/day for adults
o many adults get recommended
• Deficiency and toxicity
o Deficiency
 Breakdown of cell membranes
 Hemolytic anemia
 Nerve degeneration
o Toxicity (not likely)
 Muscle weakness
 Headaches

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 Nausea
 Inhibition of vitamin K metabolism
• Sources
o Plant oils and products made from plant oils
o Green leafy vegetables
o Some fruits
o Nuts and seeds
o Fortified breakfast foods
Vitamin K
• Supplied by diet as well as intestinal bacteria
• Synthesized by bacteria in the colon, 10% of Vitamin K needs
• Functions
o Coenzyme with major role in coagulation process (blood
clotting)
o Activates proteins invoved in bone metabolism
• Deficiency
o Hemorrhage
o Fractures
o Most at risk: patient with long standing fat malabsorption,
person taking antibiotics fro long periods, infants
• Toxicity
o Unknown
• Sources
o Green leafy vegetables
o Liver
o Broccoli
o Peas
o Green beans
o Fresh oils
o Meats

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Water Soluble Vitamins 19/09/2007 09:00:00
Water-Soluble Vitamins

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• Dissolve in water
• Very little is stored in body
• Excreted from body if consumed in excessive amounts
• Include all essential B vitamins, Vitamin C, and choline (vitamin-like
compund)
• Large amounts can be lost during cooking
B Vitamin Functions
• Coenzymes in energy metabolism
o Pathways used by carbohydrates (CHO), amino acids, and fats
• Red Blood Cell formation and functions
• Neurological function
• Nearly 50-100% of B vitamins in the diet are absorbed
Thiamin (B1)
• Coenzyme form used in CHO metabolsm
• Nerve function
• RDA
o 1.1 to 1.2 mg/day
o most diets exceed RDA
• Thiamin Deficiecy and Toxicity
o Deficiency
 Beriberi

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 Sinhalese: “I cannot, I cannot”
 Dry: wasting, peralisys
 Wet: edema, heart failure
 Seen in areas where white rice is a staple
o Non-Toxic
• Thiamin Sources
o Lean pork products
o Organ meats
o Whole and enriched grain products
o Dried beans
o Seeds
o Peanuts
o Peas
Riboflavin
• Coenzyme form participate in energy-yielding metabolic pathways
(aerobic energy)
• RDA
o 1.1 to 1.3 mg/day
o nutrient-poor diets are usually low in riboflavin, i.e. alcoholics
• Riboflavin deficiency and toxicity
o Deficiency
 Cheilosis (cracking on outside of lips), angular stomaitis
(cracks or sores at corners of mouth, inflimation of
mouth and tounge, and dermatitis)

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o Non-toxic
• Sources
o Milk and milk products
 Destroyed by light
o Enriched and whole grains
o Meat, liver, eggs, spinach, oysters
Niacin
• Coenzyme forms in energy metabolism
• RDA
o 14 mg/day for women
o 16 mg/day for men
• Deficiency and Toxicity
o Deficiency
 Pellagra – 4 D’s
 Dermatitis
 Diarriha
 Dementia
 Death
o Toxicity with intakes >100 mg/day
 Vasodilation, itching, headaches, flushing
• Sources

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o Poultry, beef, tuna, and other fish (high protein foods)
o Enrichd prducts
o Wheat bran
o Asparagus
o Peanuts
o Can be synthesized from tryptophan (essential amino acid)
Vitamin B6
• Coenzyme form
o Activates enzymes needed for metabolism of CHO, fat, and
protein
o Synthesizes non-essential amino acids
o Synthesizes neurotransmitters
o Synthesizes hemoglobin & WBC
o Role in homocysteine metabolism
o PROTIEN METABOLISM
• RDA
o Avg daily intake is more than RDA
o Alcoholics at risk for deficiency
• B6 Deficiency and Toxicity
o Deficiency
 Irritability, nervousness, depression/moodiness,
vomiting, skin disorders, and impaired immune
response
o Toxicity >200 mg/day can lead to irreversible nerve damage

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 Risk with using megadoses to reduce the symptoms of
PMS
• Sources
o Animal products
o Dairy products
o Bananas
o Potatoes
o Widely available
Folate
• Coenzymes help form DNA and metabolize various amino acids
• Red blood cell formation and maturation
• RDA
o 400 ug/day adults
o 600 ug/day pregnant women
• Deficiency and Toxicity
o Deficiency
 Results in neural tube defects in fetus
 Results in megaloblastic anemia in adults (large
immature RBC in the blood, fewer mature RBC,
decreased ability to carry O2)
o Toxicity
 Excess can mask B12 deficiency
• Sources
o Foliage

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o Liver
o OJ
o Enriched products
o Grains, legumes
 Heat and microwave can destroy some forms
VitaminB12
• Coenzyme form
• Role in folate metabolism
• Maintaining myelin sheaths
o Transfer electrical pulse
• RBC formation
• RDA
o 2.4 mg/day for adults
o stored in liver
• Absorption
o Requires a protein from salivary gland
o Requires stomach acid
o Requires intrinsic factor
 Protein-like compund produced by the stomach that
enables B12 absorption
o Absorbed in the last part of small intestine
 About 50% absorbed

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• Deficiency and Toxicity
o Deficiency
 Pernicious anemia: (“deadly, fatal”) duue to lack of
intrinsic factor  inability to absorb B12
 Megaloblastic anemia
 Nerve degerneration & peralysis
o Non-toxic
• Sources
o ONLY in foods from ANIMAL SOURCES
o Animal products
o Organ meats
o Seafood
o Eggs, milk
o Hot dogs
o Synthesized by bacteria, fungi, and lower organism
Pantothenic Acid
• Coenzyme form essential for metabolism of CHO, fat, and protein
• RDA
o 5 mg/day
• Deficiency
o Rare, however usually in combination with other deficiencies
• Toxicity unknown

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• Sources
o Found everywhere
o Wheat, milk, veggies, sunflower seeds, mushrooms, peanuts,
eggs
Biotin
• Coenzyme form aids in fat and CHO metabolism
• Helps break down certain amino acids
• RDA
o 30 ug/day
• Deficiency
o Rare. Scaly/inflamed skin, changes in tounge and lips,
decreased appetite, nausea/vomiting
• Non-toxic
• Sources
o Caluflower
o Egg yolk
o Peanuts, cheese
o Intestinal bacteria can synthesize and supply some biotin
o More than a dozen raw egg whites a day can cause absorption
to be inhibited
Vitamin C
• Synthesis of callogen
o Makes up connective tissue
• Iron absorption

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• Immune function
• Antioxitant
• RDA
o More for smokers
• Deficiency of Vitamin C
o Scurvy: bleeding gums, pin-point hemorrhaging, poor wound
healing, wakness
• Toxicity
o Stomach inflammation and diarrhea
• Sources
o Citrus fruits
o Potatoes
o Green peppers
o Cauliflower
o Broccoli
o Strawberries
o Lettuce
o spinach
Choline 8-3
• Essential nutrient, however it is not considered a vitamin
• All tissues contain choline
• Precursor for acetylcholine (neurotransmitter)

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• Precursor for phospholipids
o Good for tying things together
• RDA
o 425-550 mg/day for adults
Choline Deficiency (never the right answer)
• Deficiency
o Rare
• Toxicity
o In high doses: associated with fishy body odor, vomiting,
salivation, sweating, hypotension, GI effects
Choline Sources
• Widely distributed in foods
• Milk
• Liver
• Eggs
• Peanuts
• Lecithin added to foods

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Major/Macro Minerals 19/09/2007 09:00:00
Minerals
• Various functions in the body
• Do not provide energy
• Major/macro minerals
• Micro/trace minerals
• Bioavailability depends on interactions with fiber, vitamins, and
other minerals
o Sometimes 10% absorbed
o Fiber keeps some from being absorbed
o Compete for absorption
• Toxic in excessive amounts, especially trace minerals
Major/Macro Minerals
• Calcium (Ca)
• Magnesium (Mg)
• Sodium (Na)
• Sodium (Na)
• Chloride (Cl)
• Potassium (K)
• Phosphorus (P)
• Sulfur (S)
Calcium
• 99% in bones and teeth

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• makes up 40% of all the minerals present in the body
• Functions
o Forming and maintaining bones
o Blood, nerve, muscles, and cells
• RDA
o 1000 to 1200 mg/day for adults
o 1300 mg/day for children
o Avg intake is NOT enough
• Absorption of calcium
o Normally 25% absorbed from food
o Vitamin D and acidic gut help absorption
o Absorbed in upper part of small intestine
o Absorption increased to 60% in time of need, i.e. pregnancy,
infancy
• Decreased Absorption of Calcium
o High fiber intake
o Excess phosphorus
 soda
o Vitamin D deficiency
o Polyphenols (tannins) in tea
o Diarrhea
o Aging

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• Calcium Deficiency
o Deficiency
 Osteoporosis: loss of bone mass
 Most at risk
• Post-menopausal women
• Slender, inactive women who smoke
 Previntion
• Build peak bone mass when young with
adequate calcium and vitamin D intake
• Weight-bearing physical activity
o Calcium Toxicity
 Not common
 Risk of kidney stones and other problems
o Sources
 Dairy products
 Canned fish
 Ca-fortified orange juice
 Supplements
Magnesium
• 60% is found/stored in the bones
• Functions
o Bone formation

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o Enzyme function
o Nerve and heart function
• RDA
o 310-320 mg/day for women
o 400 to 420 mg/day for men
• Deficiency
o Unlikely unless diurectic use or alcoholism
o Weakness, muscle pain, poor heart function
• Toxicity
o Overuse of antacids, laxatives, or supplements
o Causes diarrhea and weakness in patients with kidney failure
• Sources
o Whole grains
o Nuts, beans, green vegetables

Sodium
• Major positive ion in extracellular fluid
• Blood Na levels controlled by the kidneys
• Functions
o Water balance
o Nerve and muscle function

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• RDA
o 1500 mg/day age 19-50
o 1300 mg/day age 51-70
o 1200 mg/day age 71 years and older
• Deficiency
o Hyponatremia
 Rare, only with persistent vomiting, diarrhea, or
excessive perspiration (losing 2-3% body weight-
marathon runners)
 Muscle cramps, nausea, vomiting, dizziness, shock,
coma
• Toxicity
o Contributes to hypertension in susceptible
 Increases Ca loss in the urine
• Sodium Sources
o Table salt (40% Na)
o Processed foods
o Condiments
o Chips
o Added to flavor foods
Chloride
• Major negative ion for extracellular fluid
• Functions
o Hydrochloric acid in stomach

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o Nerve function
o Water balance
• RDA
o 2300 mg/day
• Deficiency
o Rare, convulsions in infants
• Toxicity
o Unlikely, linked to hypertension in susceptible people when
combined with Na
• Sources
o Table salt (60% Cl)
o Some vegetables
o Processed foods

Potassium
• Major positive ion in intracellular fluid
• Functions
o Water balance
o Nerve and muscle function
• RDA
o 4700 mg/day
• Deficiency

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o Rare, only with persistent vomiting or prolonged diuretic
usage
o Irregular heart beat, muscle cramps
• Toxicity
o Unlikely, seen only in kidney failure
• Sources
o Fruits, vegetables, milk, grains, meats, dried beans
o Bananas
o Orange juice

Phosphorus
• Major negative ion of intracellular fluid
• Bone and tooth component
• Component of cell membranes, DNA
• Acid/base balance
• RDA
o 700 mg/day for adults
o 1250 mg/day for children
o Average intake exceeds RDA
• Deficiency
o Unlikely, possible bone loss
• Toxicity

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o Impairs bone health in people with kidney failure or low Ca
intake
• Sources
o Wide variety of foods
o Dairy products
o Breads and cereals
o Meats and fish
o Soft drinks

Sulfur
• Dietary proteins supply all we need
• Functions
o Part of amino acids and vitamins
o Drug detoxification
• No deficiency if protein is adequate
• No toxicity
• Sources
o Protein foods

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Minerals: Micro/Trace 19/09/2007 09:00:00
Micro/Trace Minerals
• Needed in much smaller amounts than macro minerals
• Essential for health
• Difficult to study
o Only trace amounts in the body
• Animal sources of mineral are generally better absorbed
Minerals
• Iron (Fe)
• Iodine (I)
• Zinc (Zn)
• Copper (Cu)
• Chromium (Cr)
• Fluoride (F)
• Selenium (Se)

Iron
• ~ 18% is absorbed, determined by body’s need
• Heme iron vs. nonheme iron (heme as in hemoglobin which iron is
part of)
o Heme iron found in animal products, better absorbed that
nonheme iron
 No hemoglobin in plants
 Redder the better

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o Meat protein factor my aid in nonheme absorption
• Vitamin C enhances absorption of nonheme iron
• Functions
o Component of hemoglobin in RBC transport of oxygen and
carbon dioxide
o Energy metabolism
o Immune function
 Need iron to fight off disease
o Cognitive development (brain)
• RDA
o 8 mg/day men
o 18 mg/day women
o Average intakes for men exceed the recommendation, most
women’s intakes are low
• Deficiency
o Microcytic hypochromic anemia, low levels of hemoglobin
and hematocrit, insufficient intake and stores
o At risk: infants, toddlers, chronic blood loss, vgans, runners,
and women of childbearing years
o Signs: paleness, brittle nails, fatigue, poor temperature
control, poor growth
• Toxicity
o Fairly rare (1/250 have both hemochromatosis genes)
o Liver and heart damage (extreme cases of Fe overload)
o GI upset with Fe supplements
o Infants/children at risk of Fe poisoning

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 Vitamins and mineral supplements can poison children
• Iron Sources
o Med (redder the better)
o Seafood
o Broccoli
o Peas
o Whole and enriched grains
Iodine
• 70-80% of Iodine in the body is found in the thyroid gland
• Functions
o Supports thyroid hormone synthesis
o Regulates metabolic rate, growth, and development
• RDA
o 150 ug/day
• Deficiency
o Goiter: thyroid gland enlarges
 Mountainous areas
o Cretinism: stunting of fetal growth and mental development
as a result of low iodine in maternal diet
• Toxicity
o Thyroid hormone synthesis is inhibited
o Looks like iodine deficiency, swelling of thyroid gland

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o Consumption of seaweed poses risk
• Sources
o Iodized salt
o White bread
o Saltwater fish
o Dairy products
Zinc
• Involved in many areas of metabolism
• 40% of Zn in absorbed, competes with copper and iron for
absorption
• Functions
o Required for nearly 200 enzymes
o Normal growth and sexual development
o Immune function
o Protein and nucleic acid metabolism
o Wound healing
• RDA
o 8mg/day for women
o 11 mg/day for men
• Deficiency
o Dwarfism
 Groth retardation and poor sexual development

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 Decreased appetite and taste sensation
 Poor wound healing
o Toxicity
 Excessive intakes reduce copper absorption
 Diarrhea
 Depressed immune function
• Zinc Sources
o Seafood
o Meats
o milk
o legumes
o Whole grains
Copper
• Function
o Aids in Fe metabolism
o Hemoglobin formation and Fe transport
o Elastin and collagen synthesis
 Proteins that hold everything together
o Antioxidant enzymes
o Immune function
• RDA

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o 900 ug/day
• Deficiency and Toxicity
o Deficiency
 Anemia
 Low WBC count
 Poor growth
 Bone loss
 Some forms of cardiovascular disease
o Toxicity
 Vomiting
 Wilson’s Disease: A genetic deficit that causes an
accumulation of Cu in the brain or liver  brain
damage, liver failure, death
• Copper sources
o Organ meats
o Whole grains
o Legumes
o Nuts
Chromium
• Recently discovered essential trace element (1959)
• Functions
o Maintenance of glucose uptake into cells
o Aiding insulin function

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• RDA
o 25 to 35 ug/day
• Chromium Deficiency and Toxicity
o Deficiency
 Impaired glucose control
 Diabetes like symptoms
 Elevated blood cholesterol and triglycerides
o Toxicity
 Caused by industrial contamination, not by food sources
 Liver damage and lung cancer
• Chromium Sources
o Egg yolks
o Whole grains
o Pork
o Nuts
o Mushrooms
o Beer
Fluoride
• Functions
o Strengthens tooth enamel
o Decreases the risk of dental caries

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o Inhibits tooth demineralization and enhances tooth
remineralization
• RDA
o 3.1 mg/day for women
o 3.8 mg/day for men
• Fluoride Deficiency and Toxicity
o Deficiency
 Increased risk for dental caries
o Toxicity
 Fluorosis: mottling (staining) of teeth during tooth
development
 Bone pain
 Stomach upset
• Sources
o Fluoridated water
o Toothpaste
o Tea
Selenium
• Functions
o Antioxidant enzymes (glutathione peroxidase)
o May help prevent cancer
• RDA
o 55 ug/day
• Selenium Deficiency and Toxicity
o Deficiency
 Muscle pain and weakness
 In China a while back
 Form of heart disease
o Toxicity
 Hair loss, nausea/vomiting, weakness, rashes, cirrhosis
of the liver
• Selenium Sources
o Meats
o Eggs
o Fish
o Seafood
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Review 19/09/2007 09:00:00
Functions of B-Vitamins

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• Fat, CHO, and Energy metabolism
o Thiamin
o Riboflavin
o Niacin
o Pantothenic Acid
o Biotin
• Protein and Amino Acid Metabolism
o Vitamin B6
• Red Blood Cell formation
o Folate,
o Vitamin B12 (& Vitamin B6)
Functional Roles
• Coenzymes
o B-Vitamins
o Vitamin K
• Antioxidants
o Vitamin E
o Vitamin C
o Selenium
• Bone Health

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o Vitamin D
o Vitamin K
o Calcium
o Phosphorus
o Magnesium
• Red Blood Cells
o Folate
o Vitamin B12
o Iron
o Copper (& Vitamin B6)
Water Balance Minerals
• H2O Balance
o Sodium (Na), Potassium (K), Chloride (Cl), Phosphorus (P) as
Phosphates
• Extracellular: Na (+) Cl (-) (Salt)
• Intracellular: K (+) P(-)
Notable Deficiencies
• Xerophthalmia
o Vitamin A
• Rickets
o Vitamin D
• Beriberi

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o Thiamin
• Cheilosis
o Riboflavin
• Pellagra
o Niacin
• Scurvy
o Vitamin C
• Goiter
o Iodine
• Dwarfism
o Zinc
• Night Blindness
o Vitamin A
• Osteomalacia
o Vitamin D
• Neural tube defect
o Folate
• Osteoporosis
o Calcium
• Weakness, muscle pain
o Magnesium

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• Creinism
o Iodine
• High Blood Glucose
o Chromium
• Dental Caries
o Fluoride
Deficiency Anemias
• Megaloblastic Anemia
o Folate
• Pernicious Anemia
o Vitamin B12
• Microcytic, Hypochromic Anemia
o Iron (Copper)
Deficiency and Toxicity
• Most likely to be deficient in US diet
o Vitamins
 Vitamin E
 Folate
o Minerals
 Calcium, Iron
• High potential for toxicity

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o Vitamins
 Vitamin A
o Minerals
 Iron
 Chromium
Enriched/Fortified Foods
• Flour and other refined grains
o Thiamin
o Riboflavin
o Niacin
o Folate
o Iron
• Milk and dairy products
o Vitamin A
o Vitamin D
• Salt
o Iodine
• Water and toothpaste
o flouride

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