Chapter 12

Energy Metabolism

Lecture OverviewLecture Overview

•• Roles of B Vitamins in Roles of B Vitamins in Energy MetabolismEnergy Metabolism

•• Vitamins & Minerals in Vitamins & Minerals in Energy MetabolismEnergy Metabolism

•• Vitamins & Minerals in Vitamins & Minerals in Blood HealthBlood Health

Micronutrients Function in Energy Micronutrients Function in Energy Metabolism & Blood HealthMetabolism & Blood Health

•• Energy Metabolism:Energy Metabolism:

–– Iodide (I)Iodide (I)–– Thiamin (Vitamin BThiamin (Vitamin B--1)1)–– Riboflavin (Vitamin BRiboflavin (Vitamin B--2)2)–– Niacin (Vitamin BNiacin (Vitamin B--3)3)–– PantothenicPantothenic Acid (Acid (VitVit. B. B--5)5)–– Biotin (Vitamin BBiotin (Vitamin B--7)7)–– Vitamin BVitamin B--6 (Pyridoxine)6 (Pyridoxine)–– Chromium (Cr)Chromium (Cr)–– Manganese (Manganese (MnMn))–– Molybdenum (Mo)Molybdenum (Mo)

•• Blood Health:Blood Health:

–– Vitamin K (Vitamin K (QuinoneQuinone))–– FolateFolate (Vitamin B(Vitamin B--9)9)–– Vitamin BVitamin B--12 (12 (CobalaminCobalamin

or or CyanocobalaminCyanocobalamin))–– Iron (Fe)Iron (Fe)–– Copper (Cu)Copper (Cu)–– Zinc (Zn)Zinc (Zn)

B Vitamins in MetabolismB Vitamins in Metabolism

•• B vitamins are B vitamins are coenzymescoenzymes in in metabolismmetabolism

•• Minerals are Minerals are cofactorscofactors in metabolismin metabolism

•• Deficiencies affect brain, nervous & GI Deficiencies affect brain, nervous & GI systems: metabolically active tissuessystems: metabolically active tissues

•• 5050--90% B vitamins from diet are 90% B vitamins from diet are absorbed / absorbed / water solublewater soluble

B Vitamin Intakes of N. AmericaB Vitamin Intakes of N. America•• Typical diet is adequate in B vitaminsTypical diet is adequate in B vitamins

•• Common foods are Common foods are fortifiedfortified (never in food but (never in food but added) with B vitaminsadded) with B vitamins

•• WaterWater--soluble = soluble = excess in stool & urineexcess in stool & urine

•• AlcoholicsAlcoholics most likely to develop serious Bmost likely to develop serious B--vitamin deficiency diseasesvitamin deficiency diseases

•• Manufacturing and refining reduces B vitamin Manufacturing and refining reduces B vitamin content of foodscontent of foods

Grain Enrichment (i.e. replace)Grain Enrichment (i.e. replace)

•• Four B vitamins:Four B vitamins:–– ThiaminThiamin–– RiboflavinRiboflavin–– NiacinNiacin–– Folic acidFolic acid

•• Mineral: Mineral: –– IronIron

WholeWhole--Grain AdvantageGrain AdvantageCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Vitamins B-6, B-12,folate, biotin

CO2 + H2O + Energy

Riboflavin, niacinfolate, vitamin B-12

Thiamin,Vitamins B-6, B-12,

biotin, folate

Amino acids

Vitamins B-6,B-12, C, K,

niacin, folate

ProteinCarbohydrate

(glycogen in particular)

Vitamin B-6

Monosaccharides

Thiamin,pantothenic acid,

niacin, biotin

Chemical intermediates

All B vitaminsexcept B-6

Fatty acids & glycerol

Niacin

Lipid

Iodide (I)Iodide (I)

•• Regulates thyroid glandRegulates thyroid gland

•• Traps iodide from bloodstream to Traps iodide from bloodstream to support support thyroid hormonethyroid hormone synthesissynthesis

•• Regulate metabolic rate, growth Regulate metabolic rate, growth (gas peddle of body)(gas peddle of body)

•• ↓↓ iodide levels iodide levels →→ goiter goiter

•• And during pregnancy And during pregnancy →→ cretinismcretinism

CretinismCretinism

1010

Iodide: Sources, Needs, ExcessIodide: Sources, Needs, Excess

•• Soil with Soil with ↓↓ iodide content iodide content →→ foods with foods with ↓↓iodide levelsiodide levels

•• Sources: iodized salt, dairy products & grain Sources: iodized salt, dairy products & grain (sea & kosher salt not good source)(sea & kosher salt not good source)

•• RDA & DV on labels: 150 mcg/dayRDA & DV on labels: 150 mcg/day

•• UL: 1.1 mg/dayUL: 1.1 mg/day

•• ↑↑↑↑ iodide intake iodide intake →→ ↓↓ thyroid hormone thyroid hormone productionproduction

Food Sources of IodideFood Sources of Iodide

1212

RDA*

Iodized table salt, ½ tsp

Cod, haddock fillet, 3½ ounces

Plain yogurt, ½ cup

1% milk, 1 cup

Luna bar, 1

Soy protein bar, 1

Egg, 1 large

1% cottage cheese, ½ cup

Mozzarella cheese, 1 ounce

*For adults; see the DRI table in the back of this book for gender- andage-specific recommendations.

Key:

GrainsVegetablesFruitsDairyProtein

Adult Male and FemaleRDA = 150 micrograms

Daily Value = 150 micrograms%RDA

Food Itemand Amount

Iodide(micrograms)

150

195

116

87

59

38

38

35

28

10 7%

19%

23%

25%

25%

39%

56%

114%

130%

100%

ChooseMyPlate.gov

Thiamin (Vitamin BThiamin (Vitamin B--1): Functions1): Functions

•• Helps Helps release energy from release energy from carbohydratecarbohydrate

•• First BFirst B--vitamin discoveredvitamin discovered

•• Important in Important in ATPATP--producing producing pathwayspathways

Thiamin Deficiency: BeriberiThiamin Deficiency: Beriberi

•• Occurs when glucose canOccurs when glucose can’’t be t be metabolized to yield energymetabolized to yield energy

•• Found in Found in areas where refined grains areas where refined grains predominatepredominate (ex: white vs. brown rice)(ex: white vs. brown rice)

•• Refining grains Refining grains →→ ↓↓ thiamin content thiamin content unless it is enrichedunless it is enriched

Thiamin Deficiency: BeriberiThiamin Deficiency: Beriberi

•• Symptoms:Symptoms:

–– WeaknessWeakness–– Loss of appetiteLoss of appetite–– IrritabilityIrritability–– TinglingTingling–– Loss of muscle coordinationLoss of muscle coordination–– Deep muscle painDeep muscle pain–– Enlarged heartEnlarged heart–– Edema Edema

Thiamin: Nutrient NeedsThiamin: Nutrient Needs

•• RDA: 1.1RDA: 1.1--1.2 mg/day1.2 mg/day

•• DV on labels based on 1.5 mg/dayDV on labels based on 1.5 mg/day

•• Men: exceed RDA by 50% or moreMen: exceed RDA by 50% or more

•• Women: just meet RDAWomen: just meet RDA

•• No ULNo UL

Food Sources of ThiaminFood Sources of Thiamin

•• Pork productsPork products

•• Whole grains & wheat germWhole grains & wheat germ

•• ReadyReady--toto--eat breakfast cerealseat breakfast cereals

•• Refined grainsRefined grains

•• Green beans, milk, orange juice, Green beans, milk, orange juice, organ meats, peanuts, dried beans, organ meats, peanuts, dried beans, seedsseeds

Food Sources of ThiaminFood Sources of Thiamin

1818

RDA

Canned lean ham, 3 ounces

Pork chops, 4 ounces

Wheat germ, ¼ cup

Canadian bacon, 2 ounces

Acorn squash, 1 cup

Soy milk, 1 cup

Flour tortilla, 1

Ham lunch meat, 2 pieces

Watermelon, 1 slice

Fresh orange juice, 1 cup

Cooked green peas, ½ cup

Baked beans, ½ cup

Navy beans, ½ cup

Corn, ½ cup

1.1-1.2

0.9

0.6

0.5

0.5

0.4

0.4

0.4

0.3

0.2

0.2

0.2

0.2

0.2

0.2 17%

17%

17%

17%

17%

17%

25%

33%

33%

33%

42%

42%

50%

75%

100%%RDA %RDA

18%

18%

18%

18%

18%

18%

27%

36%

36%

36%

45%

45%

55%

82%

100%

ProteinDairyFruitsVegetablesGrains

Key: ChooseMyPlate.gov

Food Itemand Amount

Thiamin(milligrams)

Adult MaleRDA = 1.2 milligrams

Adult FemaleRDA = 1.1 milligrams

Daily Value = 1.5 milligrams

Riboflavin (Vitamin BRiboflavin (Vitamin B--2): Functions2): Functions

•• Riboflavin coenzymes participate in Riboflavin coenzymes participate in energyenergy--yielding pathwaysyielding pathways (ex: fatty acid (ex: fatty acid breakdown)breakdown)

•• Assists some vitamin & mineral Assists some vitamin & mineral metabolismmetabolism

•• Antioxidant roleAntioxidant role: supports glutathione : supports glutathione peroxidaseperoxidase enzymeenzyme

Riboflavin Deficiency: Riboflavin Deficiency: AriboflavinosisAriboflavinosis

•• Inflammation of the mouth and tongueInflammation of the mouth and tongue

•• DermatitisDermatitis

•• Cracking on tongue & corners of mouth Cracking on tongue & corners of mouth ((cheilosischeilosis))

•• Eye disordersEye disorders

•• Sensitivity to sunSensitivity to sun

•• ConfusionConfusion

•• Occur jointly with deficiencies of niacin, Occur jointly with deficiencies of niacin, thiamin & vitamin Bthiamin & vitamin B66

Riboflavin Deficiency: Riboflavin Deficiency: AriboflavinosisAriboflavinosis

Riboflavin: Nutrient NeedsRiboflavin: Nutrient Needs

•• RDA: 1.1RDA: 1.1--1.3 mg/day1.3 mg/day

•• DV on labels is 1.7 mg/dayDV on labels is 1.7 mg/day

•• Average intakes slightly > than Average intakes slightly > than RDARDA

•• Alcoholics at Alcoholics at ↑↑ risk for risk for deficiency because of deficiency because of ↓↓nutrientnutrient--dense dietsdense diets

Food Sources of RiboflavinFood Sources of Riboflavin

•• Ready to eat breakfast cerealsReady to eat breakfast cereals

•• Dairy foodsDairy foods

•• Enriched grainsEnriched grains

•• MeatMeat

•• EggsEggs

•• Asparagus, broccoli & greens (ex: spinach)Asparagus, broccoli & greens (ex: spinach)

•• Easily destroyed by light; opaque milk Easily destroyed by light; opaque milk containerscontainers

Food Sources of RiboflavinFood Sources of Riboflavin

ProteinDairyFruitsVegetablesGrains

Key: ChooseMyPlate.gov

Riboflavin(milligrams)

Food Itemand Amount

Adult MaleRDA = 1.3 milligrams

Adult FemaleRDA = 1.1 milligrams

Daily Value = 1.7 milligrams%RDA%RDA

RDA

Multigrain Cheerios, ¾ cup

Fried beef liver, 1 ounce

Steamed oysters, 10

Plain yogurt, 1 cup

Raw mushrooms, 5

Braunschweiger sausage, 1

Cooked spinach, 1 cup

1% milk, 1 cup

Buttermilk, 1 cup

Boiled egg, 1

Sirloin steak, 3 ounces

Feta cheese, 1 ounce

Tortilla, 1

Lean ham, 3 ounces 0.2

0.2

0.2

0.3

0.3

0.4

0.4

0.4

0.4

0.5

0.5

1.1

1.2

1.3

1.1-1.3

15%

15%

15%

23%

23%

31%

31%

31%

31%

38%

38%

85%

92%

100%

100%

18%

18%

18%

27%

27%

36%

36%

36%

36%

45%

45%

100%

109%

110%

100%

Riboflavin: ExcessRiboflavin: Excess

•• No ULNo UL

•• No evidence of toxicity from No evidence of toxicity from megadosingmegadosing

•• Riboflavin supplementation can Riboflavin supplementation can →→bright yellow urinebright yellow urine

–– Name riboflavin derived from Latin Name riboflavin derived from Latin ““flavusflavus”” –– meaning yellowmeaning yellow

Niacin (Vitamin BNiacin (Vitamin B--3): Functions3): Functions

•• Functions as nicotinic acid or Functions as nicotinic acid or nicotinamidenicotinamide

•• Coenzyme niacin form Coenzyme niacin form used in many used in many cellular pathwayscellular pathways

•• Energy being used = niacin coenzyme Energy being used = niacin coenzyme being usedbeing used

•• Fatty acid synthesis require niacin Fatty acid synthesis require niacin coenzymedcoenzymed

•• Involved as coenzyme in Involved as coenzyme in 200+ reactions200+ reactions

Niacin Deficiency: PellagraNiacin Deficiency: Pellagra

• Means rough or scaly skin

• Symptoms characterized by “4 D’s”:

– Dermatitis– Diarrhea– Dementia– Death

• Occurs most commonlyin alcoholics

Niacin: Nutrient NeedsNiacin: Nutrient Needs

•• Adult RDA: 14Adult RDA: 14--16 mg/day16 mg/day

•• RDA expressed in Niacin RDA expressed in Niacin Equivalents (NE)Equivalents (NE)

•• DV on labels is 20 mgDV on labels is 20 mg

•• Average American intake Average American intake doubles RDAdoubles RDA

Food Sources of NiacinFood Sources of Niacin

• Heat stable: little lost in cooking

• Can synthesize from tryptophan:– 60 mg tryptophan can → 1 mg tryptophan

• Found in foods:

– Poultry, fish, tuna & beef– Peanuts– Ready-to-eat cereals– Asparagus – Coffee & tea

Food Sources of NiacinFood Sources of Niacin

3030

Niacin(milligrams)

Food Itemand Amount

Adult MaleRDA = 16 milligrams

Adult FemaleRDA = 14 milligrams

Daily Value = 20 milligrams

RDA

Tuna, 3 ounces

Roasted chicken, 3 ounces

Peanuts, ½ cup

Baked salmon, 3 ounces

Turkey lunch meat, 3 ounces

Ground beef, 3 ounces

Raw mushrooms, 5

Lean steak, 4 ounces

Chunky peanut butter, 2 tablespoons

Fried beef liver, 1 ounce

Raisin Nut Bran cereal, ¾ cup

Tortilla, 1

Baked cod, 3 ounces

Potato, 1

Broiled halibut, 3 ounces 1.6

2.1

2.1

2.6

3.8

4.1

4.4

4.5

4.7

5.0

5.4

8.6

9.9

10.1

11.3

14-16

10%

13%

13%

16%

24%

26%

28%

28%

29%

31%

34%

54%

62%

63%

71%

100%

%RDA %RDA

100%

81%

72%

71%

61%

39%

36%

34%

32%

31%

29%

27%

19%

15%

15%

11%

Key:

GrainsVegetablesFruitsDairyProtein

ChooseMyPlate.gov

Niacin: ExcessNiacin: Excess

• UL is 35 mg/day nicotinic acid form

• Megadosing nicotinic acid is used supplementally for ↑ blood lipids

• Long term can → GI tract & liver damage

• Niacin flush:– Usually when intakes > 100 mg/day– Headache, itching, ↑ blood flow to skin →

flushing

MyPlateMyPlate: Sources of : Sources of Thiamin, Riboflavin & NiacinThiamin, Riboflavin & Niacin

ChooseMyPlate.gov

Fruits Grains

Protein Vegetables

Dairy

Fruits Grains

Protein Vegetables

Dairy

PantothenicPantothenic Acid (Vitamin BAcid (Vitamin B--5)5)

• Coenzyme in chemical reactions

• Widespread in foods: deficiency is rare but can occur in alcoholics

• Toxicity unknown: no UL

• Sunflower seeds, mushrooms, peanuts, eggs, milk, meat, vegetables

• AI: 5 mg/day for adults

• DV on labels is10 mg/day

Food Sources of Food Sources of PantothenicPantothenic AcidAcid

5

Protein

Dairy

Fruits

Vegetables

Grains

Key:

Cooked egg yolk, 1

Legumes, ½ cup

Baked potato, 1

Broccoli, 1 cup

Roasted chicken breast, 3 ounces

1% milk, 1 cup

Peanuts, ½ cup

Acorn squash, 1 cup

Plain yogurt, 1 cup

Raw mushrooms, 5

Fried beef liver, 1 ounce

Sunflower seeds, ¼ cup

Luna bar, 1

Power bar, 1

Total corn flakes cereal, ¾ cup

AI

0.6

0.7

0.7

0.8

0.8

0.9

1.0

1.2

1.5

1.7

1.7

2.3

9.9

10.0

11.8

46%

34%

34%

30%

24%

20%

18%

16%

16%

14%

14%

12%

198%

200%

236%

100%

Food Itemand Amount

Pantothenic Acid(milligrams)

Adult Male and FemaleAI = 5 milligrams

Daily Value = 10 milligrams%AI

ChooseMyPlate.gov

Biotin (Vitamin BBiotin (Vitamin B--7)7)

•• Intestinal bacteria can synthesize Intestinal bacteria can synthesize biotinbiotin –– makes makes deficiency raredeficiency rare

•• Deficiency: Deficiency: –– scaly skin inflammation, changes in scaly skin inflammation, changes in

tongue & lips, tongue & lips, ↓↓ appetite, N/V, anemia, appetite, N/V, anemia, depression, muscle pain, weakness, depression, muscle pain, weakness, poor growthpoor growth

•• Raw egg whites bind biotin and Raw egg whites bind biotin and ↓↓its absorption; its absorption; ↑↑↑↑ raw egg white raw egg white intake can intake can →→ biotin deficiencybiotin deficiency

Biotin: Sources, Needs, ExcessBiotin: Sources, Needs, Excess

•• As coenzyme: aids in chemical reactionsAs coenzyme: aids in chemical reactions

•• Egg yolks, peanut butter, cheeseEgg yolks, peanut butter, cheese

•• AI: 30 mcg/day for adultsAI: 30 mcg/day for adults

•• Food supply gives 40Food supply gives 40--60 mcg/day average60 mcg/day average

•• DV on labels: 300 mcgDV on labels: 300 mcg

•• No UL; relatively nontoxic No UL; relatively nontoxic

Food Sources of BiotinFood Sources of BiotinFood Item

and AmountBiotin

(micrograms)Adult Male and Female

AI = 30 micrograms

AI

Smooth peanut butter,2 tablespoons

Cooked lamb liver, 1 ounce

Boiled egg, 1

Cooked egg yolk, 1

Yogurt, 1 cup

Wheat germ, ¼ cup

Roasted peanuts, 5

Wheat bran, ¼ cup

Nonfat milk, 1 cup

Salmon, 3 ounces

Egg noodles, 1 cup

Swiss cheese, 2 ounces

Cheddar cheese, 2 ounces

Raw cauliflower, 1 cup

American cheese, 2 ounces

30.0

30.1

11.6

9.3

8.1

7.4

7.2

6.5

6.4

4.9

4.3

4.0

2.2

1.7

1.5

1.4 5%

5%

6%

7%

13%

14%

16%

21%

22%

24%

25%

27%

31%

39%

100%

100%

Daily Value = 300 micrograms%AI

Protein

Dairy

Fruits

Vegetables

Grains

Key: ChooseMyPlate.gov

Vitamin BVitamin B--6 (Pyridoxine): Functions6 (Pyridoxine): Functions

• Coenzyme in many metabolic reactions

• Acts as coenzyme in 100+ amino acid and protein reactions

• Synthesizes neurotransmitters

• Converts tryptophan → niacin

• Breaks down stored glycogen → glucose

• Synthesizes hemoglobin and WBC

• Aids in homocysteine metabolism

Vitamin BVitamin B--6: Deficiency6: Deficiency

•• Widespread symptoms: depression, Widespread symptoms: depression, vomiting, skin disorders, nerve vomiting, skin disorders, nerve problems, impaired immunityproblems, impaired immunity

•• BB6 6 helps helps synthesize synthesize hemeheme portion of portion of hemoglobin:hemoglobin:

–– BB66 deficiencydeficiency →→ small small RBCsRBCs with with ↓↓hemoglobin concentration (hemoglobin concentration (microcyticmicrocytichypochromichypochromic anemia)anemia)

–– Cell Cell cancan’’t produce ATPt produce ATP when aerobic when aerobic metabolism limitedmetabolism limited

Vitamin BVitamin B--6: Nutrient Needs6: Nutrient Needs

•• Adult RDA: 1.3Adult RDA: 1.3--1.7 mg/day1.7 mg/day

•• DV on labels: 2 mgDV on labels: 2 mg

•• Average adult intake is > RDAAverage adult intake is > RDA

•• AthletesAthletes’’ needs > than sedentary needs > than sedentary adultsadults

–– ↑↑ needs required by needs required by ↑↑ processing of processing of protein and glycogenprotein and glycogen

Food Sources of Vitamin BFood Sources of Vitamin B--66

•• Animal productsAnimal products

•• Fortified readyFortified ready--toto--eat breakfast eat breakfast cerealscereals

•• Potatoes, spinach, bananas, Potatoes, spinach, bananas, cantaloupecantaloupe

•• BB--6 in animal foods and fortified 6 in animal foods and fortified foods is better absorbed than Bfoods is better absorbed than B--6 6 from plant foodsfrom plant foods

Food Sources of Vitamin BFood Sources of Vitamin B--66Adult Male and FemaleRDA = 1.3 milligrams

Food Itemand Amount

Vitamin B-6(milligrams)

Daily Value = 2 milligrams%RDA

RDA

Baked salmon, 3 ounces

Baked potato, 1 medium

Banana, 1

Avocado, 1

Roasted chicken breast,3 ounces

Acorn squash, 1 cup

Special K cereal, ¾ cup

Fried beef liver, 1 ounce

Roasted turkey lunch meat,3 ounces

Sirloin steak, 3 ounces

Lean ham, 3 ounces

Watermelon, 1 slice

Sunflower seeds, ¼ cup

Cooked spinach, ½ cupProtein

Dairy

Fruits

Vegetables

Grains

Key:

1.3

0.2

0.3

0.3

0.4

0.4

0.4

0.4

0.5

0.5

0.5

0.6

0.7

0.7

0.8

100%

62%

54%

15%

23%

23%

31%

31%

31%

31%

38%

38%

38%

46%

54%

ChooseMyPlate.gov

MyPlateMyPlate: Sources of Vitamin B: Sources of Vitamin B--66

ProteinGrains Vegetables Fruits Dairy

• Fortifiedbreakfastcereals

• Wheat germ(whole-wheatgrains)

• Avocados• Potatoes• Spinach• Cauliflower

• Bananas

• Watermelon• Cantaloupe• Dates

• Cottage cheese• Yogurt• Milk

• Seeds• Nuts• Beans• Fish• Poultry• Meat

ChooseMyPlate.gov

Fruits Grains

Protein Vegetables

Dairy

Fruits Grains

Protein Vegetables

Dairy

(potatoes, raw chicken): © Ingram Publishing/SuperStock RF; (watermelon): © Siede Preis/Getty Images RF 4343

Vitamin BVitamin B--6: Excess6: Excess

•• UL: 100 mg/dayUL: 100 mg/day

•• Excess Excess →→ nerve damagenerve damage

•• 22--6 g/day X 2 or more 6 g/day X 2 or more months months →→ irreversible nerve irreversible nerve damagedamage

•• Symptoms: gait abnormality, Symptoms: gait abnormality, tingling in extremities, tingling in extremities, numbnessnumbness

Chromium (Cr)Chromium (Cr)

•• Aids insulinAids insulin & & required for glucose uptake into cellsrequired for glucose uptake into cells

•• Deficiency Deficiency →→ impaired glucose control & impaired glucose control & ↑↑cholesterol & triglyceridescholesterol & triglycerides

•• Cannot accurately determine Cr in foodCannot accurately determine Cr in food

•• Sources: meat, whole grain, egg, mushrooms, nuts, Sources: meat, whole grain, egg, mushrooms, nuts, beer, spicesbeer, spices

•• AI: 25AI: 25--35 mcg/day; DV on labels: 120 mcg35 mcg/day; DV on labels: 120 mcg

•• AvgAvg N. American intake: 30 mcg; No ULN. American intake: 30 mcg; No UL

Manganese (Manganese (MnMn))

•• MnMn and Mg can substitute for each other in and Mg can substitute for each other in metabolic processesmetabolic processes

•• MnMn used by enzymes & for bone healthused by enzymes & for bone health

•• Deficiency: rareDeficiency: rare

•• Sources: nuts, rice, oats, whole grains, beans, Sources: nuts, rice, oats, whole grains, beans, leafy vegetablesleafy vegetables

•• AI: 1.8AI: 1.8--2.3 mg & DV on labels: 2 mg2.3 mg & DV on labels: 2 mg

•• UL: 11 mg/day UL: 11 mg/day →→ nerve damagenerve damage

Molybdenum (Mo)Molybdenum (Mo)

•• Human enzymes need molybdenumHuman enzymes need molybdenum

•• Deficiency: rareDeficiency: rare

•• Sources: milk & dairy, beans, whole grains, Sources: milk & dairy, beans, whole grains, nutsnuts

•• RDA: 45 mcg & DV on labels: 75 mcgRDA: 45 mcg & DV on labels: 75 mcg

•• Average daily intake is > needsAverage daily intake is > needs

•• UL: 2 mg UL: 2 mg →→ toxicity in laboratory animal, toxicity in laboratory animal, weight loss and decreased growthweight loss and decreased growth

Blood Health: OverviewBlood Health: Overview

•• Blood has Blood has four distinct elementsfour distinct elements::

–– White cells (aka leukocytes)White cells (aka leukocytes)–– Red cells (aka erythrocytes)Red cells (aka erythrocytes)–– Platelets (function in clotting)Platelets (function in clotting)–– Plasma (largest part of blood, Plasma (largest part of blood, 55%55%) )

contains:contains:

•• ProteinsProteins•• CarbohydratesCarbohydrates•• LipidsLipids•• HormonesHormones•• Enzymes & electrolytesEnzymes & electrolytes

Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Bone marrow stem cells

Self-renewingcell

Pluripotentialstem cells

Plasma

White blood cellsand platelets

Red blood cells

(a) Centrifuged blood sample

Committed progenitor cells

Maturing cells

Vitamin B-12FolateProtein

Erythroblast

ReticulocyteEosinophilNeutrophilLymphocytePlatelets

MegakaryocyteBone marrow

Circulatingblood Vitamin KZinc

Multipotentialprogenitorcell

Lymphoidprogenitorcell

Vitamin B-6Iron

Vitamin CCopper

Red blood cellsWhite blood cells(b) Blood components

Platelets

Monocyte Basophil Erythrocyte

Vitamin K (Vitamin K (QuinoneQuinone): Functions): Functions

•• Can be Can be synthesized by colonic bacteriasynthesized by colonic bacteria

•• Blood clottingBlood clotting::

–– Activates Activates prothrombinprothrombin →→ thrombinthrombin

–– Converts soluble Converts soluble fibrinoginfibrinogin →→ insoluble insoluble fibrinoginfibrinogin

Vitamin K: DeficiencyVitamin K: Deficiency

• In infants:

– Infant’s gut at birth is sterile // GI tract doesn’t have bacteria

– Can’t synthesize vitamin K needed for clotting if infant injured or needs surgery

– Vitamin K routinely administered by injection shortly after birth

• In adults: deficiency after long-term antibiotic use & when fat malabsorbed

Vitamin K: Nutrient NeedsVitamin K: Nutrient Needs

•• AI: 90AI: 90--120 mcg/day for adults120 mcg/day for adults

•• DV on food labels: 80 mcgDV on food labels: 80 mcg

•• Elderly adults have Elderly adults have ↓↓ vitamin K vitamin K intake due to intake due to ↓↓ intake of intake of vegetablesvegetables

Food Sources of Vitamin KFood Sources of Vitamin K

•• Resistant to cooking lossesResistant to cooking losses

•• Absorption requires dietary fat & adequate Absorption requires dietary fat & adequate pancreatic secretionspancreatic secretions

•• Food sources: Liver, Dark green leafy Food sources: Liver, Dark green leafy vegetables, Broccoli, Asparagus, Peasvegetables, Broccoli, Asparagus, Peas

•• Patients on Coumadin (Patients on Coumadin (warfarinwarfarin) should ) should keep dietary Vitamin K intake constantkeep dietary Vitamin K intake constant

Food Sources of Vitamin KFood Sources of Vitamin K

5656

Food Itemand Amount

Vitamin K(micrograms)

Adult MaleAI = 120 micrograms

Adult FemaleAI = 90 micrograms

Daily Value = 80 micrograms%AI%AI

RDA

Cooked kale, ½ cup

Cooked turnip greens, 1 cup

Cooked spinach, 1 cup

Cooked Brussels sprouts, ½ cup

Raw spinach, 1 cup

Cooked asparagus, 1 cup

Cooked broccoli, ½ cup

Looseleaf lettuce, 1 cup

Cooked green beans, ½ cup

Raw cabbage, 1 cup

Sauerkraut, ½ cup

Green peas, ½ cup

Soybean oil, 1 tablespoon

Cooked cauliflower, 1 cup

Canola oil, 1 tablespoon

90-120

530

520

480

150

144

144

110

97

49

42

30

26

25

20

14%17

17%

21%

22%

25%

35%

41%

81%

92%

120%

120%

125%

400%

433%

442%

100% 100%

589%

578%

533%

167%

160%

160%

122%

108%

GrainsVegetablesFruitsDairyProteinOils

19%

22%

28%

29%

33%

47%

54%

Key: ChooseMyPlate.gov

Vitamin K: ExcessVitamin K: Excess

•• No reports of toxicityNo reports of toxicity

•• No ULNo UL

•• ErythropoiesisErythropoiesis: formation of : formation of RBCsRBCs

•• RBC functions RBC functions

–– PrimaryPrimary: carry O: carry O2 2 from lungs from lungs →→ tissuestissues

–– SecondarySecondary: carry CO: carry CO22 from tissues from tissues →→ lungslungs

•• Hemoglobin: large ironHemoglobin: large iron--containing proteincontaining protein

–– Iron in Iron in HgbHgb binds & carries 4 molecules of Obinds & carries 4 molecules of O22

RBCsRBCs

5959

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Oxygen (O2)Iron (Fe++)

Beta (β) chainsHeme group

Alpha (α) chains

© Getty Images / iStock Exclusive RF

AnemiaAnemia•• Inadequate healthy Inadequate healthy RBCsRBCs →→ anemiaanemia

•• Anemia can be Anemia can be caused bycaused by::

–– ↓↓ RBC production or RBC production or ↓↓ HgbHgb production in production in RBCsRBCs

–– Loss or destruction of bloodLoss or destruction of blood

•• Symptoms result from inadequate OSymptoms result from inadequate O2 2 →→ organsorgans

•• Normal Normal RBCsRBCs: : normocyticnormocytic & & normochromicnormochromic

•• Nutrient deficiencies Nutrient deficiencies →→ changes in RBC size changes in RBC size and colorand color

Vitamins & Minerals Involved Vitamins & Minerals Involved in Blood Healthin Blood Health

•• Vitamin K (Vitamin K (QuinoneQuinone))

•• FolateFolate (Vitamin B(Vitamin B--9)9)

•• Vitamin BVitamin B--12 (12 (CobalaminCobalamin, , CyanocobalaminCyanocobalamin))

•• Iron (Fe)Iron (Fe)

•• Copper (Cu)Copper (Cu)

•• Zinc (Zn)Zinc (Zn)

FolateFolate (Vitamin B(Vitamin B--9): Functions9): Functions

•• Cell divisionCell division

•• As a coenzyme: supplies or accepts As a coenzyme: supplies or accepts single carbon compoundssingle carbon compounds

•• Helps form DNAHelps form DNA

•• Helps Helps metabolize amino acidsmetabolize amino acids & their & their derivatives (ex: derivatives (ex: homocysteinehomocysteine))

FolateFolate: Deficiency: Deficiency• In early RBC synthesis:

– Immature cells can’t divide because they can’t form new DNA

– Cells grow larger because insufficient DNA for nuclei to divide

– Large immature form: megaloblast

– Folate deficiency → megaloblastic anemia (aka macrocytic anemia)

• Symptoms: – Tongue inflammation, diarrhea, poor growth, mental

confusion, depression, nerve dysfunction

FolateFolate: Maternal Deficiency: Maternal Deficiency

•• ↓↓ folatefolate levels in pregnant woman levels in pregnant woman →→ neural tube defectsneural tube defects in fetus in fetus (ex: (ex: spinaspina bifida)bifida)

•• Neural tubes close within first 28 Neural tubes close within first 28 days of pregnancy days of pregnancy

•• Recommended that 6 weeks Recommended that 6 weeks before pregnancy all women before pregnancy all women have 400 mcg/dayhave 400 mcg/day

Neural Tube DefectsNeural Tube Defects

6666

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Spine Affected by Spina BifidaHealthy Spine

Skin on backSpinal fluid

Spinal cordVertebra

Skin on back

Spinal cordSpinal fluid

Vertebra

FolateFolate: Nutrient Needs: Nutrient Needs

•• RDA: 400 mcg/dayRDA: 400 mcg/day

•• Pregnancy RDA: 600 mcg/dayPregnancy RDA: 600 mcg/day

•• DV: based on 400 mcg/dayDV: based on 400 mcg/day

•• Very Very susceptible to heatsusceptible to heat: : cooking destroys 50cooking destroys 50--90% 90% folatefolate

Food Sources of Food Sources of FolateFolate

•• Green leafy vegetablesGreen leafy vegetables•• Orange juiceOrange juice•• Dried beansDried beans•• Fortified readyFortified ready--toto--eat eat

breakfast cerealsbreakfast cereals•• BreadBread•• MilkMilk

Food Sources of Food Sources of FolateFolate

6969

Adult Male and FemaleRDA = 400 micrograms

Food Itemand Amount

Folate(micrograms)

Daily Value = 400 micrograms%RDA

RDA

Asparagus, 1 cup

Cooked spinach, 1 cup

Cooked lentils, ½ cup

Black-eyed peas, ½ cup

Romaine lettuce, 1½ cups

Great Grains cereal, ¾ cup*

Tortilla, 1*

Cooked turnips, ½ cup

Cooked broccoli, 1 cup

Sunflower seeds, ¼ cup

Fresh orange juice, 1 cup

Cooked beets, ½ cup

Kidney beans, ½ cup

Fried beef liver, 1 ounce

* Folic acid.

Protein

Dairy

Fruits

Vegetables

Grains

Key:

16%

16%

17%

19%

19%

20%

21%

22%

29%

29%

45%

45%

66%

66%

100%400

263

262

179

179

114

114

89

85

78

76

75

68

65

62

ChooseMyPlate.gov

MyPlateMyPlate: Sources of : Sources of FolateFolate

Grains*• Fortifiedbreakfastcereals

• Wheat germ(whole-wheatgrains)

• Enriched grains

• Asparagus

*Folic acid in fortified grain products.

Protein• Liver• Eggs• Beans• Sunflower

seeds

• Cottage cheese• Yogurt

• Cantaloupesand othermelons

• Strawberries• Oranges

Vegetables Fruits Dairy

ChooseMyPlate.gov

FruitsFruitsGrainsGrains

DairyDairy

VegetablesVegetablesProteinProtein

(grains): © PhotoLink/Getty Images RF; (asparagus): © Ingram Publishing RF; (beans): © Image Source/PunchStock RF

• Leafy green vegetables

FolateFolate: Excess: Excess

•• UL: 1 mg/day (1,000 mcg)UL: 1 mg/day (1,000 mcg)

•• Large doses of Large doses of folatefolate can can mask vitamin Bmask vitamin B--12 12 deficiency symptomsdeficiency symptoms

Vitamin BVitamin B--12: Functions12: Functions

•• Also known as Also known as cobalmincobalmin or or cyanocobalmincyanocobalmin (needs mineral (needs mineral cobalt)cobalt)

•• Functions in Functions in folatefolate metabolismmetabolism

•• Maintaining Maintaining myelin sheathmyelin sheath that that insulates neurons from each otherinsulates neurons from each other

•• Requires Requires Intrinsic FactorIntrinsic Factor (IF) for (IF) for absorptionabsorption

Vitamin BVitamin B--12: Deficiency12: Deficiency

•• Destruction of parts of myelin sheathDestruction of parts of myelin sheath

•• Neurological symptoms:Neurological symptoms:

–– Irregular muscle actionsIrregular muscle actions–– Impaired reflexesImpaired reflexes–– Eventual paralysis and perhaps, deathEventual paralysis and perhaps, death

•• Pernicious anemiaPernicious anemia: anemia from lack of B12 : anemia from lack of B12 absorption (as opposed to inadequate absorption (as opposed to inadequate folatefolateabsorption)absorption)

•• Vegans at risk for deficiencyVegans at risk for deficiency

Vitamin BVitamin B--12: Nutrient Needs12: Nutrient Needs

•• Adult RDA: 2.4 mcg/dayAdult RDA: 2.4 mcg/day

•• DV on food labels & DV on food labels & supplements: 6 mcgsupplements: 6 mcg

•• Adults consume 2 X RDA on Adults consume 2 X RDA on average/dayaverage/day

•• Elderly encouraged to have Elderly encouraged to have synthetic form because of synthetic form because of ↓↓ IF IF production with production with ↑↑ ageage

Food Sources of Vitamin BFood Sources of Vitamin B--1212

•• Concentrated sources found only in Concentrated sources found only in animal foodsanimal foods

•• Organ meats: liver, kidneys, heartOrgan meats: liver, kidneys, heart

•• Meat, salmon, seafoodMeat, salmon, seafood

•• ReadyReady--toto--eat fortified breakfast cerealseat fortified breakfast cereals

•• MilkMilk

•• EggsEggs

Food Sources of Vitamin BFood Sources of Vitamin B--1212Food Item

and AmountVitamin B-12(micrograms)

Adult Male and FemaleRDA = 2.4 micrograms

Daily Value = 6 micrograms%RDA

RDA

Fried beef liver, 1 ounce

Baked clams, 1 ounce

Boiled oysters, 2

Salmon, 3 ounces

Pot roast, 3 ounces

Plain yogurt, 1 cup

Corn Flakes cereal, ¾ cup

Shrimp, 3 ounces

1% milk, 1 cup

Soy milk, 1 cup

Boiled egg, 1

Lean ham, 3 ounces

Beef hot dog, 1

Ham lunch meat, 2 ounces

2.4

31.7

15.7

14.4

4.9

2.5

1.4

1.1

1.0

0.9

0.8

0.6

0.6

0.5

0.4 17%

21%

25%

25%

33%

38%

42%

46%

58%

104%

167%

600%

654%

1321%

100%

Key:GrainsVegetablesFruitsDairyProtein

ChooseMyPlate.gov

Iron (Fe): FunctionsIron (Fe): Functions

• Iron is part of:

– Hemoglobin in RBCs

– Myoglobin in skeletal muscles

• Used as part of many enzymes, proteins

• Needed for brain & immune function

• Helps detoxify drugs in the liver

• Contributes to bone health

Iron: DeficiencyIron: Deficiency

•• Iron deficiency caused when:Iron deficiency caused when:

–– HematocritHematocrit (% of (% of RBCsRBCs) and ) and hemoglobin concentration hemoglobin concentration ↓↓

•• Iron deficiency anemia caused Iron deficiency anemia caused when:when:

–– HgbHgb and and HctHct levels fall so low that levels fall so low that OO22 carried in bloodstream is carried in bloodstream is ↓↓

Iron Deficiency AnemiaIron Deficiency Anemia

•• Stage 1Stage 1: Depleted body stores but no : Depleted body stores but no physical symptomsphysical symptoms

•• Stage 2Stage 2: Depleted circulating iron and : Depleted circulating iron and some physiological impairmentsome physiological impairment

•• Stage 3Stage 3: : RBCsRBCs are small (are small (microcyticmicrocytic) and ) and pale (pale (hypochromichypochromic) and ) and ↓↓ in numberin number

Iron Deficiency AnemiaIron Deficiency Anemia

•• Most common micronutrient deficiency worldwideMost common micronutrient deficiency worldwide

•• Can be Can be caused bycaused by::

–– Growth & Growth & ↑↑ blood volume (ex: pregnancy)blood volume (ex: pregnancy)

–– Blood loss during menstruationBlood loss during menstruation

–– Blood loss from ulcers, colon cancer, hemorrhoidBlood loss from ulcers, colon cancer, hemorrhoid

•• Symptoms: fatigue, pale skin, always cold, loss of Symptoms: fatigue, pale skin, always cold, loss of appetite, appetite, ↓↓ work capacitywork capacity

Iron: Nutrient NeedsIron: Nutrient Needs

• Male & post-menopausal female RDA: 8 mg/day

• Female RDA: 18 mg/day for 18-50 y.o.

• Average intake: 13 mg for women, 18 mg for men per day

• DV based on 18 mg/day

Dietary Sources of IronDietary Sources of Iron

HemeHeme: Meat / Fish / Poultry: Meat / Fish / Poultry

NonNon--hemeheme: Fruits & vegetables / Fortified: Fruits & vegetables / FortifiedFoods / SupplementsFoods / Supplements

Dietary Iron Enhances and InhibitorsDietary Iron Enhances and Inhibitors

Food Sources of IronFood Sources of Iron

8484

Food Itemand Amount

Iron(milligrams)

Adult MaleRDA = 8 milligrams

Adult FemaleRDA = 18 milligrams

%RDADaily Value = 18 milligrams

%RDA

100%

83%

78%

9%

9%

13%

13%

13%

13%

15%

15%

20%

21%

21%

22%

29%

100%

188%

175%

66%

49%

48%

46%

45%

34%

34%

30%

30%

30%

29%

21%

20%1.6

1.7

2.3

2.3

2.4

2.4

2.7

2.7

3.6

3.7

3.8

3.9

5.3

14

15

ProteinDairyFruitsVegetablesGrains

Key:

* Contains heme iron.

Artichoke, 1

Baked potato, 1

Navy beans, ½ cup

Turkey, dark meat, 3½ ounces*

Garbanzo beans, ½ cup

Flour tortilla, 1

Braunschweiger sausage, 1 piece*

Shrimp, 3 ounces*

Fried beef liver, 2 ounces*

Parsley, 1 cup

Sirloin steak, 4 ounces*

Pot roast, 4 ounces*

Kidney beans, 1 cup

Baked clams, 3 ounces*

Oat bran cereal, 1 cup

RDA

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Iron: ExcessIron: Excess

•• UL: 45 mg/dayUL: 45 mg/day

•• ↑↑↑↑ iron can iron can →→ stomach irritationstomach irritation

•• Iron pills are common cause of Iron pills are common cause of iron toxicity in children who iron toxicity in children who accidentally overdoseaccidentally overdose

•• Vitamin C Vitamin C ↑↑ iron absorption: iron absorption: problematic in people with problematic in people with hemochromatosishemochromatosis

Copper (Cu)Copper (Cu)

•• Component of bloodComponent of blood

•• Needed by enzymesNeeded by enzymes

•• Immune system function: blood clotting, Immune system function: blood clotting, blood lipoprotein metabolismblood lipoprotein metabolism

•• Sources: liver, legumes, seeds, whole Sources: liver, legumes, seeds, whole grain breads and cereals, cocoagrain breads and cereals, cocoa

•• RDA: 900 mcg/day for adultsRDA: 900 mcg/day for adults

•• UL: 10 mg/dayUL: 10 mg/day

Food Sources of CopperFood Sources of Copper

RDA*

Fried beef liver, 3 ounces

Power bar, 1

Walnuts, ½ cup

Kidney beans, ½ cup

Lobster, 3 ounces

Molasses, 3 tablespoons

Sunflower seeds, 2 tablespoons

Shrimp, 3 ounces

Raisin Bran cereal, 1 cup

Great Grains cereal, 1 cup

Black-eyed peas, ½ cup cooked

Wheat germ, ¼ cup

Milk chocolate, 1 ounce

Whole-wheat bread, 1 slice

*For adults; see the DRI table in the back of this book for gender- andage-specific recommendations.

Protein

Dairy

Fruits

Vegetables

Grains

Key:

900

3800

700

600

500

400

300

300

300

300

300

200

200

110

80 9%

12%

22%

22%

33%

33%

33%

33%

33%

44%

56%

67%

78%

422%

100%

Daily Value = 2 milligrams%RDA

Adult Male and FemaleRDA = 900 milligrams

Food Itemand Amount

Copper(milligrams)

ChooseMyPlate.gov

Discretionarycalories

Zinc (Zn)Zinc (Zn)

• 200 enzymes require as a cofactor

• Supports functions:

– DNA synthesis and function– Protein metabolism, wound healing, growth– Immune function– Development of sexual organs and bones– Storage, release, and function of insulin– Cell membrane structure and function– Has indirect antioxidant function

Zinc: DeficiencyZinc: Deficiency

Deficiency:

• Growth retardation & sexual organ immaturity

• Acne-like rash, taste alterations,

8989

Zinc: Sources, Needs, ExcessZinc: Sources, Needs, Excess

• Sources: animal-protein foods, fortified cereals, wheat germ, some cheese

• RDA: 11 mg for men, 8 mg for women

• DV on labels & supplements: 15 mg

• UL: 40 mg/day → interferes with Cu metabolism

Food Sources of ZincFood Sources of Zinc

9191

Food Itemand Amount

Zinc(milligrams)

Adult MaleRDA = 11 milligrams

Adult FemaleRDA = 8 milligrams

RDA

Steamed oysters, 3

Sirloin steak, 4 ounces

Pot roast, 3 ounces

Special K cereal, 1 cup

Wheat germ, ¼ cup

Lamb chops, 3 ounces

Peanuts, ½ cup

Black-eyed peas, 1 cup

Plain yogurt, 1 cup

Lean ham, 3 ounces

Swiss cheese, 1.5 ounces

Ricotta cheese, ½ cup

Sunflower seeds, 1 ounce

Cheddar cheese, 1.5 ounces

Enriched white rice, ½ cupProteinDairyFruits

GrainsVegetables

Key:

Daily Value = 15 milligrams%RDA%RDA

24.9

7.4

4.6

3.8

3.5

2.7

2.4

2.2

2.2

1.9

1.7

1.7

1.5

1.3

1.1 10%

12%

14%

15%

15%

17%

20%

20%

22%

25%

32%

35%

42%

67%

226%

100% 100%

311%

93%

14%

16%

19%

21%

21%

24%

28%

28%

30%

34%

44%

48%

58%

ChooseMyPlate.gov

MyPlateMyPlate: Sources of Zinc: Sources of Zinc

ChooseMyPlate.gov

Grains ProteinVegetables Fruits Dairy

• Whole-grainbread andcereals

• Fortified break-fast cereals

• Spinach• Peas• Asparagus• Avocados

• Dried Fruit • Milk• Yogurt• Cheese

• Beef• Eggs• Beans• Nuts• Shellfish• Poultry

FruitsGrains

Protein Vegetables

Dairy Fruits

Grains

Protein Vegetables

Dairy

(milk pouring into glass): © Pixtal / SuperStock RF; (asparagus): © Brand X Pictures/PunchStock RF; (golden turkey): © Ernie Friedlander/Cole Group/Getty Images RF