Lecture 1 Introduction Review Jan2023

FNH
351 2022/2023W YL
FNH 351
Vitamins, Minerals, and Health
Lecture 1 – Introduction/Review
D r. Yv o n n e L a m e rs , A s s o c i a t e P r o fe s s o r
T h e U n i v e rs i t y o f B r i t i s h C o l u m b i a
2022/2023W J a n u a r y 1 0 , 2 0 2 3
FNH 351 2022/2023W YL LECTURE 1 ‐ INTRODUCTION/REVIEW 1
In gratitude for the land we live and work on.
UBC and my place are located on the

traditional, ancestral, unceded territory of the
Musqueam people, a land that has always been
a place of learning for the Musqueam people,
who for millennia have passed on in their
culture, history, and traditions from one
generation to the next on this site.
Lecture 1 ‐ Introduction/Review 1
FNH 351 2022/2023W YL
Today’s Lecture
Welcome and Introduction of the Team
Relevance and Significance of Micronutrient Metabolism… and FNH 351
Syllabus:
Learning Objectives
Course Material
Class Format
Evaluation Scheme
Introduction: Micronutrients
Review: Dietary Reference Intakes
Dr Lamers’ research program:
Vitamin Adequacy Across the Lifespan
Adverse pregnancy outcomes
Meta‐ Fetal/infant growth restriction
Cardiovascular disease
bolism Cancer
Mental health
FNH 351 2022/2023W YL
Dr Lamers’ research program:
Maternal and Child Nutrition and Health
• Food security
• Socioeconomic status
• Environmental factors
• Maternal health
UBC Nutritional
Genetic factors
Biomarker Laboratory
FNH 351
Vitamins, Minerals, and Health
Relevance and Significance
FNH 351 2022/2023W YL
The Latest
The Latest
FNH 351 2022/2023W YL
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468929/
https://www.grandviewresearch.com/industry‐analysis/dietary‐supplements‐market https://www.statista.com/outlook/cmo/food/canada
FNH 351 2022/2023W YL
The Latest
Significance
“Why we care”
Hook
“KNOWNS”
• Chemical structures
• Most biochemical and physiologic function
• Clinical deficiency symptoms
• Dietary guidelines for prevention of chronic
What we deficiencies
know and
don’t know MANY UNKNOWNS
• What are the consequences of marginal
deficiency / suboptimal micronutrient status?
• How to define optimal nutrient intake?
• How to identify and validate sensitive and
reliable biomarkers for early diagnosis of
micronutrient inadequacy?
• What are genetic variants that may be
associated with impaired micronutrient status?
• Nutrient‐nutrient interactions
• Effective and efficient prevention strategies
FNH 351 2022/2023W YL
METABOLISM as key concept to
understand nutrient‐disease relationships
Adverse pregnancy outcomes
Meta‐ Fetal/infant growth restriction
Cardiovascular disease
bolism Cancer
Mental health
Course Content – Vitamins and Minerals
Digestion
Absorption
Transport
Chemical Forms
Excretion
Metabolism
Nutrient‐Nutrient Interactions
Nutrient‐Gene Interactions
Biomarkers and methods
Health Implications of for status assessment
Inadequacy/Excess
FNH 351 2022/2023W YL
Significance of Content
At the end of the course, you should be able to discuss
and answer public health related questions such as:
 In what instances can the chemical form of a micro‐
nutrient matter when selecting supplements?
 Which dietary patterns may challenge individuals to meeting their
micronutrient requirements, and why?
 How can the inadequate, simultaneous, or excess intake of a
micronutrient impact the uptake and/or function of other
micronutrients?
Significance of Content
 How commonly do micronutrient
deficiencies occur in Canada, and
which micronutrients are more
commonly a public health concern?
 Which population groups are more
vulnerable to micronutrient deficiencies and why?
 What are efficient strategies, in an individual versus population‐based
approach, to combat and/or prevent micronutrient deficiencies?
FNH 351 2022/2023W YL
Course Outcomes/Learning Objectives
1. List the metabolic functions of the micronutrients and explain how the
micronutrients exert their physiological roles.
2. Explain the processes of digestion and absorption of the micronutrients.
3. Describe the ways in which the micronutrients are transported, stored,
metabolized, and excreted by the body.
4. Critically evaluate and discuss various factors, including genetic and
dietary factors, that affect micronutrient digestion, absorption, and
metabolism.
5. Explain how inadequate and excessive intake of micronutrients may
cause adverse effects to health.
6. Critically discuss possible nutrient‐nutrient interactions.
7. Discuss the strengths and limitations of available methods for assessing
the nutritional status of micronutrients in humans.
FNH 351 in the FNH Curriculum
FNH 451 – Nutrient FNH 477 – Nutrition FNH 470 –

Metabolism and Disease Prevention Clinical Dietetics
FNH 350 – FNH 351 –
Fundamentals of Vitamins, Minerals
Nutrition and Health
FNH 250 – Definition, BIOL 201/BIOC 202 – Biology

Function, Food Sources Biochemistry and basic Chemistry
of Macronutrients metabolism Biochemistry
FNH 351 2022/2023W YL
Course Outline
DATE TOPICS ASSIGNMENTS
Jan 10 Introduction / Review Dietary Reference Intakes
Jan 12 – Jan 19 Nutrients for Blood Health – Iron and Vitamin K
Jan 24 – Feb 7 Methyl Nutrients – Folate, Vitamin B12, and Choline
Vitamins and Energy Metabolism – Thiamin,
Feb 9 – Feb 16
Riboflavin, Niacin, and Vitamin B6
Feb 19 and 21 Reading Week – NO CLASS
Feb 26 Iodine, and other trace elements
Mar 2 Midterm exam
Antioxidants – Zinc, Copper, Vitamin C, Vitamin E,
Mar 7 – 23
Selenium and Vitamin A
Nutrients for Bone Health – Vitamin D, Calcium,
Mar 28 – Apr 11
Phosphorus and Magnesium
Apr 13 Review lecture
LECTURE 1 ‐ SLIDE 30
Nutrients for Blood Health
VITAMIN K IRON
Reticuloendo-
thelial system
Spleen, liver,
bone marrow
other 20 mg/d
tissues 20 mg/d
Serum
iron pool
1-2 mg/d 1-2 mg/d
Iron intake Iron loss
(modified by Pietrangelo NEJM 2004)
FNH 351 2022/2023W YL
Methyl Nutrients
FOLATE, VITAMIN B12, CHOLINE
Folate One-carbon metabolism

Vitamin B-12
DNA synthesis and DNA methylation
Choline
synthesis of neurotransmitters,
Vitamin B6
sphingomyelin and phosphatidylcholine
Riboflavin
Vitamins in Energy Metabolism
Vitamin B6, Riboflavin, Thiamin, Niacin
Thiamin deficiency disease = Beriberi
• Meaning “weakness”
• First organs to be affected:
nervous system and heart
FNH 351 2022/2023W YL
Antioxidants
Zinc, Copper, Selenium, and Vitamin C, E, A
Nutrients for Bone Health
Vitamin D, Calcium, Phosphorus, Magnesium
FNH 351 2022/2023W YL
Evaluation/Assignments
and
How to do well in this course?
Study
Definition: “the devotion of time
and attention to acquiring
knowledge on an academic subject,
especially by means of readings
and discussions”
Apply the knowledge gained in the
Application of knowledge
solving of case studies
Explain the concepts and new
knowledge independent of your Test your knowledge
notes
Read and review your notes, the
lecture notes and additional Creation of foundational
readings knowledge
FNH 351 2022/2023W YL
Class Format
Lectures and review of case studies
Class participation is encouraged.
Clicker questions during lectures shall support your learning.
Highly recommended to review the course notes and related
book chapters.
Material covered in midterm and final exam include
information presented and discussed at lectures. Course
notes are only an outline of the lecture.
Usage of CANVAS
Not an online‐based course
CANVAS used to post course notes; assignments/case studies;
quizzes; and content related questions
Questions related to course content:
Post questions on PIAZZA Discussion Board (link
available through Canvas); discussion board not graded
or evaluated!
Please answer each others questions the best you can.
Teaching assistants will participate as they are available.
Confidential questions: Email to instructor using CANVAS
FNH 351 2022/2023W YL
Course Material
TEXTBOOK:
Gropper SS, Smith JL, Carr TP (2021)
Advanced Nutrition and Human Metabolism
Wadsworth CENGAGE Learning. 7th Edition
‐ on reserve in Woodward Library
‐ available for purchase in UBC bookstore
Outline of course notes – posted on CANVAS
Additional readings:
Dietary Reference Intakes by Institute of Medicine
(online book; see course syllabus or PubMed)
NIH ODS (Office of Dietary Supplements)
Health Professional Fact Sheets (available online)
https://ods.od.nih.gov/factsheets/VitaminD‐HealthProfessional/
Evaluation
Participation
(clicker), 3%
Case studies, 20% Final exam, 30%
Review
Quiz, 2%
Quizzes, 20%
Midterm exam,
25%
FNH 351 2022/2023W YL
Case Studies
Four case studies throughout the term;
5 marks each
Assignments posted on Canvas
Submission deadlines:
11AM before the class used
to review the case studies
Evaluation
Review Quiz (Jan 10 ‐ Jan 17)
15 questions in 30 minutes
Quizzes (dates posted on CANVAS):

 Five quizzes conducted
online on CANVAS
 20% of total marks  your best 4 quizzes count!
 Format of the quizzes = multiple choice, true/false
FNH 351 2022/2023W YL
Evaluation
Midterm exam
Thursday, March 2, 2023 (in‐class)
Final exam
Date and location TBA (April 17‐28, 2023)
 Both exams will cover materials posted on CANVAS
as well as those presented and discussed in class
 Format:
multiple choice, true/false, short answer questions
Course Outline
DATE TOPICS ASSIGNMENTS
Jan 10 Introduction / Review Dietary Reference Intakes
Jan 12 – Jan 19 Nutrients for Blood Health – Iron and Vitamin K Quiz, Case Study
Jan 24 – Feb 7 Methyl Nutrients – Folate, Vitamin B12, and Choline Quiz, Case Study
Vitamins and Energy Metabolism – Thiamin, Quiz
Feb 9 – Feb 16
Riboflavin, Niacin, and Vitamin B6
Feb 19 and 21 Reading Week – NO CLASS
Feb 26 Iodine, and other trace elements
Mar 2 Midterm exam
Antioxidants – Zinc, Copper, Vitamin C, Vitamin E, Quiz, Case Study
Mar 7 – 23
Selenium and Vitamin A
Nutrients for Bone Health – Vitamin D, Calcium, Quiz, Case Study
Mar 28 – Apr 11
Phosphorus and Magnesium
Apr 13 Review lecture
FNH 351 2022/2023W YL
Micronutrients Basics
Learning Objectives
1. Define the terms nutrient, essential nutrient &
micronutrient
2. Define vitamin & mineral
3. List the fat soluble vitamins and water soluble vitamins
4. Describe the biological significance of vitamin
solubility
5. Differentiate between essential and non‐essential
minerals
6. Comment on the potential toxicity of minerals
FNH 351 2022/2023W YL
Basics and Definition
• Nutrients are substances obtained from foods that are necessary for
growth and development, and maintenance of health.
• Essential nutrients: either not synthesized by the human body, or not
synthesized in adequate amounts, and must be obtained from the diet.
• Micronutrients are essential nutrients and defined as:
A chemical element or substance required in small amounts for normal
growth, development and maintenance of health of living organisms
that does not provide energy.
Vitamins Fat soluble vitamins
Water soluble vitamins
Minerals Macrominerals
Microminerals/Trace Elements
History of Nutrition
Suggestion of nutrients by Anaxagoras (475 BC):

Because food is absorbed by the human body, it
must contain "homeomerics" (i.e., generative
components)
Hippocrates (400 BC):
“Let food be your medicine,
and medicine your food”
(http://en.wikipedia.org/wiki/Nutrition)
FNH 351 2022/2023W YL
First vitamin deficiency to be prevented
 Scurvy in 1747 by Dr. James Lind ‐
a physician of the British navy
 First reported controlled experiment:
(published in 1753 ‘Treatise on the Scurvy’)
Group 1: three pieces of citrus fruit per day
Group 2: traditional treatment w/ cider, vinegar, or seawater
(http://en.wikipedia.org/wiki/Nutrition)
 Vitamin C isolated by Szent‐Györgyi (1928);
its structure determined by Haworth (1932);
both received Nobel Prize in medicine and chemistry
for their vitamin C work (1937)
(Gropper et al. 2009)
20th century became the era of the
Golden Age of Nutrition
when most nutrients were discovered,
isolated and their structure described.
Presence of critical nutrients in very small quantities
proposed by F. G. Hopkins and C. Eijkman (Nobel Prize 1912)
Animal feeding experiments to show that animals fail to grow under
diets consisting of pure proteins, fats, carbohydrates, minerals, and water.
 “accessory food factors” (later renamed vitamins)
FNH 351 2022/2023W YL
Casimir Funk: Vitamin theory
“Four diseases – scurvy, rickets, pellagra, and beriberi, due to a lack of four
different vital ‘amines’ in the diet.”
“I must admit that when I chose the name ‘vitamine’ I was well aware that these
substances* might later prove not all to be an amine nature. However, it was
necessary for me to use a name that would sound well and serve as a ‘catch‐
word’.”
*Funk’s ‘vitamines’: anti‐beriberi vitamine
anti‐scurvy vitamine
anti‐rickets vitamine
anti‐pellagra vitamine
History
Vitamins named in the order of their discovery:
 Vitamin A
“Fat‐soluble factor A“ affecting reproduction; 1913
 Vitamin B
Heat‐labile water‐soluble factor B with anti‐beriberi function; 1915
 Vitamin C
the “unknown“ compound affecting scurvy; 1928
 Vitamin B12
the “animal protein factor”; in 1948
 Choline only added to DRI in 1998
FNH 351 2022/2023W YL
Definition of Vitamins
= miscellaneous group of
structurally and functionally unrelated organic compounds required in
the diet in small amounts
for normal growth, development, and maintenance of health of living
organisms
thiamin
vitamin A
vitamin B6 (pyridoxine)
organisms
 Vitamin A: night vision
 Vitamin E: antioxidant defense system
 Vitamin B2: electron transfer reactions (FAD/FMN)
 Vitamin B6: energy and amino acid metabolism
FNH 351 2022/2023W YL
organisms
 Carbon atoms, covalent bonds
 Degradable:
Oxidation (e.g., vitamin C, folate)
Heat (e.g., thiamin/B1, pantothenic acid)
UV light (e.g., riboflavin/B2)
organisms
Adult men aged 31‐50 years require
 Protein: about 56 gday (depending on body weight)
 Riboflavin/B2: 1.3 mg/day
 Vitamin B12: 2.4 µg/day
FNH 351 2022/2023W YL
Vitamins categorized by solubility
Textbook 7th Edition
Page X, Figure 9.1
Micronutrients ‐ Minerals
• In nutrition, a “mineral” refers to any element other than carbon (C),
oxygen (O), hydrogen (H), or nitrogen (N)
• Minerals = inorganic material
• Majority of elements in the periodic table exist in the body
NOTE:
In nutrition,
“minerals” and
“elements”
are used
interchangeably
FNH 351 2022/2023W YL
Minerals ‐ critical elements of our body
Content of Various Minerals in an Adult Human
Mineral Total Content (g)
Calcium (Ca) 1,760
Phosphorus (P) 960
Potassium (K) 290
macrominerals Sulfur (S) 150
Sodium (Na) 144
Chlorine (Cl) 90
Magnesium (Mg) 40
Iron (Fe) 6
Zinc (Zn) 2
microminerals Copper (Cu) 0.16
(trace elements) Manganese (Mn) 0.02
Iodine (I) 0.01
Chromium (Cr) <0.005
Mineral Nutrition
• Minerals classified by level of requirements:
Macromineral: required in amounts >100 mg/day
Trace element: required in amounts < 100 mg/d
Ultratrace element: required in amounts < 1 mg/d
• Minerals of interest in nutrition
‐ Essential minerals
‐ Potentially essential minerals
‐ Potentially toxic minerals
in the food chain
FNH 351 2022/2023W YL
Toxicity of Minerals
Both essential and non‐essential minerals are toxic at some level.
Adverse physiological response
Adverse physiological response
non‐toxic levels safe intake levels
0 0
non‐essential mineral intake essential mineral intake
Of particular concern, minerals with very narrow range of safe intake levels.
FNH 351 2021/2022 LECTURE 1 ‐ INTRODUCTION/REVIEW 76
REVIEW – Dietary Reference Intakes
History and terminology
 Recommended Dietary Allowances, USA, 1941
“to serve as a guide for planning adequate
nutrition for the civilian population”
 Reference Nutrient Intake, UK Committee on
Medical Aspects of Food Policy, 1979
 Recommended Daily Nutrient Intakes, 1983,
Canada
 Population Reference Intakes from the European
Union Scientific Committee for Food
Not examinable
FNH 351 2022/2023W YL
REVIEW – Dietary Reference Intakes
REVIEW – Dietary Reference Intakes (DRIs)
Reference values / recommendations used for the

planning and assessing of diets for healthy people
References values include:

- Estimated Average Requirement (EAR)
- Recommended Dietary Allowance (RDA)
- Adequate Intake (AI)
- Tolerable Upper Intake Level (UL)
FNH 351 2022/2023W YL
Estimated Average Requirement (EAR)
Average daily nutrient intake level estimated to meet the

requirement of 50% of all healthy individuals in a given life stage
and gender group
 EAR used to
derive the RDA
Nutrient requirements vary among individuals
Require lower Require higher
amounts amounts
# of people
Average Daily Requirement for Nutrient X
FNH 351 2022/2023W YL
The EAR is set at the average daily intake that will meet the
requirements of half of the people in a given age and gender group
EAR
At this intake level, 50% of the
population will meet their
requirements
# of people
Recommended Dietary Allowance (RDA)
Average daily nutrient intake level that is sufficient to meet the
nutrient requirements of nearly all (97.5%) healthy individuals in a
specified life stage and gender group.
If the requirement is normally distributed:
RDA = EAR + 2SDEAR
FNH 351 2022/2023W YL
Recommended Dietary Allowance (RDA)
The RDA is set at the average daily intake that will meet the
requirements of almost all people in a given age and gender group.
EAR RDA
# of people
Adequate Intake (AI)
 Used when evidence is insufficient to determine a requirement
(and thus an EAR)
 Often based on median intakes of groups of apparently healthy
individuals
 Expected to meet or exceed the needs for most individuals in a
specific life stage or gender group
 Nutrients with AIs:
all age groups:
fluoride, biotin, choline, pantothenic acid
infants aged 0‐12 mo:
magnesium, phosphorus, selenium, folate, niacin, riboflavin,
thiamin, vitamin B6, vitamin B12, vitamin C, vitamin E
FNH 351 2022/2023W YL
Recommendations for Individuals
For planning diets use: RDA or AI
‐ Recommended intake levels for individuals
‐ Associated with reduced risk of adverse
functional outcome (deficiency)
Be mindful about the difference
between recommendation and requirement.
Tolerable Upper Intake Level (UL)
The highest level of daily nutrient intake that is likely to
pose no risks of adverse health effects in almost all
individuals in a specified life stage group.
FNH 351 2022/2023W YL
Dietary Reference Intakes (DRIs)
Risk of Inadequacy
Risk of Adverse Effects

EAR RDA UL
1.0 1.0
0.5 0.5
0 0
Observed Level of Intake
Increasing intakes
DRIs for Healthy Individuals
DRIs do not cover
 Malnourished individuals
 Individuals with certain diseases
 Individuals with other criteria requiring
additional nutrient intakes (i.e. those on certain
medications)
FNH 351 2022/2023W YL
Next lecture / Announcement
Next class: Nutrients for Blood Health: Vitamin K
To Do:
1. Read syllabus & explore Canvas site
2. Introduce yourselves on Piazza discussion board
3. ***Review Quiz on basics of GI tract and DRIs will be online today, from
Tuesday, January 10, 2PM, until Tuesday January 17, 11AM
Topics covered: Gastrointestinal tract and digestion/absorption mechanism,
Dietary Reference Intakes (DRIs)

Lecture 1 Introduction Review Jan2023

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FNH

FNH 351 2022/2023W YL LECTURE 1 ‐ INTRODUCTION/REVIEW 1

In gratitude for the land we live and work on.

UBC and my place are located on the

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FNH 451 – Nutrient FNH 477 – Nutrition FNH 470 –

FNH 250 – Definition, BIOL 201/BIOC 202 – Biology

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Iron intake Iron loss

(modified by Pietrangelo NEJM 2004)

Folate One-carbon metabolism

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Quizzes (dates posted on CANVAS):

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Suggestion of nutrients by Anaxagoras (475 BC):

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Reference values / recommendations used for the

References values include:

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Average daily nutrient intake level estimated to meet the

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