Micronutrients

(Vitamins)
Dewi Martha Indria
Vitamin
• Organic compounds (or class of compounds)
distinct from fats, carbohydrates, and proteins
• Natural components of foods, usually present in
minute amounts
• Not synthesized by the body in amounts adequate
to meet normal physiologic needs
• Essential in minute amounts for normal physiologic
function (i. e. maintenance, growth, development,
& reproduction)
• Cause a specific deficiency syndrome by their
absence or insufficiency
Categories
• WATER SOLUBLE • FAT SOLUBLE
– Thiamin (B1) – Vitamin A
– Riboflavin (B2) – Vitamin D
– Niacin (B3) – Vitamin E
– Folate (folic acid) – Vitamin K
– Vitamin B6
– Vitamin B12
– Pantothenic Acid
– Biotin
– Vitamin C (ascorbic
acid)
THE FAT SOLUBLE
VITAMINS
Vitamin A
 Physiologic Functions
Target organ Functions
Vision • Light is transformed into nerve
impulses so brain can interpret
• Transformers are pigment molecules
in retina
• Retinal is part of the pigment
• Retinal is formed from Vitamin A
Skin & epithelial cells Cell differentiation
Immunity Protective effect
Antioxidant – beta carotene
 Dietary Reference Intake
• Measured as retinol activity equivalent (RAEs)
1 RAE = 1 mc g of retinol
12 mcg of β-carotene (from food) – developed countries
21 mcg of β-carotene (from food) – developing countries
3,33 IU of vitamin A activity (from supplement label)
E. g. : 5000 IU Vitamin A = 5000/3,33 = 1500 RAE = 1500 mcg of retinol
• DRI
– Infants & young children = 400 – 500 RAE/day
– Older children & adolescents = 600 – 900 RAE/day
– Adults = 700 – 900 RAE/day
– Pregnant = 750 – 770 RAE/day
– Lactating = 1200 – 1300 RAE/day
Source
• Pre-formed vitamin A
– Only in food of animal origin (the liver or in the fat of
milk and eggs)

• Provitamin A carotenoids
– Dark green, leafy and yellow-orange vegetables & fruits
(carrots, spinach, orange juice, sweet potatoes and
cantaloupe)
Stability
• Stable in presence of light, heat, and usual
cooking methods
• Destroyed by oxidation, drying, very high
temperature, UV light.
Vitamin A Deficiency (VAD)
• Primary deficiencies  low intake of pre-
formed vitamin A/pryvitamin A carotenoids
• Secondary deficiencies:
– malabsorption caused by insufficient dietary
fat, biliary/pancreatic insufficiency
– Impaired transport from abetalipoproteinemia
– Liver disease
– Protein-energy malnutrition
– Zinc deficiency
Vitamin A Deficiency (VAD)
• Leading cause of preventable blindness among
pre-school children
– Also affects school age children and pregnant women
• Weakens the immune system and increases
clinical severity and mortality risk from measles
and diarrhoea
• Supplementation with vitamin A capsules can
reduce child mortality by 23%*
• WHO (2002) estimates that 21% of all children
suffer from VAD, mostly in Africa and Asia
Clinical Manifestation
• Impaired vision from the loss of visual pigments
(nyctalopia/night blindness) early sign
• Keratinization of the mucous membranes in respiratory
tract, alimentary canal, urinary tract, skin & epithelium of
the eye
– Blindness  xerophtalmia, corneal ulceration, occlusion the the
optic foramina
– Follicular hyperkeratosis (skin)
• Impaired embryonic development or spermatogenesis
• Spontaneous abortion
• Impaired immunocompetence (reduced numbers of
mitogenic responsiveness of T lymphocytes  increases
susceptibility to bacterial, viral or parasitic infections
• Fewer osteoclasts in bone
Impaired Vision
• Clinical deficiency is defined by:
– night blindness
– Bitot’s spots
– corneal xerosis and/ or ulcerations
– corneal scars caused by xerophthalmia
 WHO Classification of
Xerophthalmia

1N Night blindness
2B Bitot’s spots
X3 Corneal xerosis 2B X3
X4 Corneal
ulcerations -
Keratomalacia
X5 Corneal scars
- permanent
blindness
X4 X5
VAD- Treatment
• Supplementation
– Capsules given during immunization days
– Single dose of 60.000 RAE  reduced mortality
by 35 – 70%
• Food Forms
Toxicity
• Persistent large doses of vitamin A (> 100 x the
required amount)  intoxication  liver disease
• Acute hypervitaminosis A induced by:
– Single doses of retinol > 200.000 RAE (adults)
– Single doses of retinol > 100.000 RAE (child)
• Chronic hypervitaminosis A induced by:
– Greater than at least 10 times the AI
– Misuse of supplements
• Fetal malformations  daily exposures 6000 – 7500
RAE of vit A supplements
– Pregnant women max. consumption of retinol is 3000 RAE/day
• Daily intake of β-carotene excess 30 mg  no side
effect  hypercarotenodermia
Vitamin D
 Physiologic Functions
• Vitamin D  prohormone (calcitriol)
• Precursors of vitamin D:
– 7-dehydrocholesterol (animal’s lipid)  cholecalciferol (vit D3)
– Ergosterol (plants)  ergocalciferol (vit D2)  active form of
calcitriol & vitamin D3
• Roles:
– Normal growth and development of normal bones & teeth
– Help increase absorption & metabolism of phosphorus & calcium
• Enhance the active transport of calcium across the gut  stimulate
synthesis of calcium-binding proteins in the mucosal brush border
• Enhance acid phosphatase activity
• Along with pituitary hormone & estrogen  moves Ca & P from the
bone  maintain normal blood levels
• Increase renal tubular reabsorption of Ca & P  maintain plasma Ca &
P concentrations
Dietary Reference Intake
• Vitamins D2 & D3  quantify total of
vitamin D
1 IU Vitamin D3 = 0,025 mcg Vitamin D3
1 mcg Vitamin D3 = 40 IU Vitamin D3

• DRI  sets the body’s needs when a person

has inadequate exposure to sunlight
– 2,5 mcg (100 IU)/day  prevent vit D def.
– During skeletal development:
• 400 IU/day (infants)
• 600 IU/day (child)
– 800 IU/day (adults > 71 years)
Source
• Sunlight  begins the conversion of an
inactive form to active form (5 – 15 minutes)
• Animal products (butter, cream, egg yolk,
liver, seafood)
– Richest sources : fish liver oils

• Human milk & unfortified cow’s milk  poor

sources of vit D  0,4 – 1 mcg/L
• Vit D is very stable & doesn’t deteriorate
when foods are heated/stored for long period
Vitamin D Deficiency
• Children  rickets (def Vit D, Ca,
P)
– Structural abnormality of the
weight-bearing bones due to
impaired mineralization of growing
bones
• Adult:
– Osteomalacia
– Exacerbate osteoporosis & fractures
– Increased risk of common cancers,
autoimmune diseases, hypertension
& infection disease
Treatment
• Rickets
– Oral preparations of the vitamin
– Natural sources rich in vitamin D
• Osteomalacia
– Adequate consumption of vitamin D, Ca & P
– 10 – 15 minutes of sun exposure 2 – 3
times/week  prevention
– Dose effective = 25 – 125 mcg (1000 – 1250
IU/day), 1250 mcg (12.500 IU) for malabsorption
Toxicity
• The upper limit of vitamin D
– 1000 IU/day (infants – 6 months)
– 1500 IU/day (aged 6 months – 12 months)
– 2500 IU/day (aged 1 – 3 years)
– 3000 IU/day (aged 4 – 8 years)
– 4000 IU/day (aged > 8 years)
• Infants & small children are most
susceptible to hypervitaminosis D
Vitamin E
Physiologic Functions
• The most important lipid-soluble antioxidant in
cells
– Protects unsaturated phospholipids of the membrane
from oxidative degradation from highly ROS & free
radicals
– Reduce radicals into harmless metabolites by donating
a hydrogen to them  free radical scavenging
– Part of cellular antioxidant defense system
• Active substances:
– Tocopherols
– Tocotrienols
Physiologic Functions
• Vit E absorbed in the upper small intestine
• Depends on the presence od dietary fat &
adequate biliary & pancreatic function
• Esterified forms of Vit E in supp.  stable,
can be absorbed only after hydrolysis by
esterase at the duodenal mucosa.
Dietary Reference Intake
• Quantifed in terms of α-tocopherol equivalents
(α-TEs)
1 mg of R,R,R- α-tocopherol = 1 α-TE
1 mg of synthetic all-rac- α-tocopherol = 0,5 α-TE

1 IU = 0,67 mg R,R,R- α-tocopherol = 1 mg of all-rac- α-tocopherol

• DRI:
– 4 – 5 α-TE (mg)/day (infants)
– 6 – 7 α-TE (mg)/day (young children)
– 11 – 15 α-TE (mg)/day (older children & adolescents)
– 15 α-TE (mg)/day (adults & pregnancy)
– 19 α-TE (mg)/day (lactating)
Source
• Tocopherols & tocotrienols are synthesized only
by plants (α & γ-tocopherols)
– Best resources : plant oils
– Salad oils, margarines, shortenings, fruits, green leafy
vegetables, grains, nuts & seeds
• Tocopherols  stable but can be destroyed by
oxidation
– Vitamin E esters (tocopherol acetate)  very stable
even in oxidizing conditions
• Insoluble in water  not lost by cooking in
water but can be destroyed by deep-fat frying
 Vitamin E Deficiency
• Organ targets of deficiency:
– Neuromuscular
– Vascular
– Reproductive
• Developed in 5-10 years  loss of deep tendon reflexes, impaired
vibratory & position sensation, changes in balance & coordination,
muscle weakness, & visual disturbances
• Symptoms have occurred only with lipid malabsorption attributable to
diseases (biliary atresia, exocrine pancreatic insufficiency,
abetalipoproteinemia)
• Oxidant stress  rapid injury & necrosis
• Limited transplacental movement of Vit E:
– newborn infants have low tissue concentration
– Premature infants at risk for vit E deficiency
Toxicity
• The least toxic of vitamins
• The upper limit in adults is 1000 mg/day
• High doses vitamin E  decrease the body’s
ability to use other fat-soluble vitamins
Vitamin K
 Physiologic Functions
• Functions:
– Help blood clotting
– Regulate enzymes in sphingolipid metabolism in the brain
– With vitamin D make bone protein  play roles in age-related bone loss
– Decrease risk of cardiovascular disease
– Regulation of inflammation

• Forms:
– Phylloguinones (vit K1)  green plants
• Absorbed by energy-dependent process in small intestine
– Menaquinones (vit K2)  bacteria Absorbed in the small intestine &
colon by passive diffusion
– Menadione (vit K3), synthetic compound
Dietary Reference Intake
DRI
Infants 2 – 2,5 mcg/day
Young children 30 – 55 mcg/day
Older children & adolescents 60 – 75 mcg/day
Adults 90 – 120 mcg/day
Pregnant 75 – 90 mcg/day
Lactating 75 – 90 mcg/day
Source
• Bacterial intestine (normal flora)
• Found in large amounts in green leafy
vegetables
• Dairy products, meats, eggs  0 – 50 mcg/g
• Fruits & cereals  app. 15 mcg/g
• Breastmilk tends to be low in vitamin K 
doesn’t provide enough of the vitamin for
infants younger than 6 months of age
Vitamin K deficiency
• Predominant sign  hemorrhage  fatal
anemia
• Rare but associated with:
– Lipid malabsorption
– Destruction of intestinal flora (uses of chronic
antibiotic therapy)
– Liver disease
• Increase incidence of hip fractures (in
adults)
THE WATER SOLUBLE
VITAMINS
Thiamin (B1)
Physiologic Functions
• Essential roles in carbohydrate metabolism &
neural function
• Major functional form (ThDP = Thiamin
diphospate)  coenzyme for several dehydrogenase
enzyme complexes  metabolism of pyruvate &
other α-ketoacids  cycle to generate energy
• Absorbed in proximal small intestine by active
transport & passive diffusion  inhibited by alcohol
consumption & folate deficiency
• 90% thiamin is carried as ThDP by erythrocytes
– Small amount free thiamin & ThMP
Dietary Reference Intake
• Based on levels of energy intake because of
direct role of thiamin in energy metabolism
• 0,2 – 1,4 mg/day (depending on age &
gender)
Sources
• Widely distributed in many foods but in low
concentrations
– Richest source : yeast, cereal grains, liver, nut &
legumes
• Can be destroyed by heat, oxidation, &
ionizing radiation but stable when frozen
 Clinical features of Thiamin deficiency
Deficiency type Features
Early stage of deficiency • Anorexia & indigestion
• Constipation
• Malaise, heaviness & weakness of legs
• Tender calf muscles
• “Pins & needles” & numbness in legs
• Anesthesia of skin, particularly in tibia
• Increased pulse rate & palpitation
Wet beriberi • Edema of legs, face, trunk & serous cavities
• Tense calf muscles
• Fast pulse
• Distended neck veins
• High blood pressure
• Decreased urine volume
Dry beriberi • Worsening of early-stage polyneuritis
• Difficulty walking
• Wernicke-Korsakoff syndrome : possible
• Encephalopathy
Wrist & foot drop: Edema:
Dry Beri Beri Wet Beri Beri
Riboflavin (B2)
Physiologic Functions
• Coenzymes of dehydrogenases  catalyze
initial fatty acid oxidation  glucose
metabolism
• Required for biosynthesis of the Niacin
from the amino acid tryptophan
• Combat oxidative damage to the cell
Dietary Reference Intake
• RDA based on the amount required to
maintain normal tissue reserves based on :
– Urinary excretion
– Red blood cell riboflavin contents
– Erythrocyte GR activity
• Higher RDA in pregnancy & lactation
• DRI = 0,3 – 1,6 mg/day (depending on age &
gender)
Sources
• Widely distributed in many foods in a form
bound to proteins as FMN and FAD
– Green leafy vegetables
– Meats
– Dairy products
– Whole grain and enriched food
• Destroyed by UV sun and fluorescent light
and irradiation
Deficiency
• Manifest after several months of deprivation of the
vitamin
• Signs of deficiency:
– Soreness & burning of lips, mouth & tongue
– Cheilosis
– Angular stomatitis
– Glossitis
– Magenta tongue
– Hypertrophy/atrophy of tongue papillae
– Seborrheic dermatitis
– Ocular pathologies conditions (photophobia, conjuctivitis,
cornea ulceration)
Riboflavin deficiency

Angular stomatitis Glossitis

Niacin (B3)
Physiologic Functions
• Coenzymes NAD & NADPH  cosubstrates
of >200 enzymes for the metabolism of
carbohydrate, fatty acids, and amino acids
• Has important role in mechanisms of DNA
repair & gene stability
• May have roles in Alzheimer disease,
Parkinson disease, aging, diabetes, cancer, &
cerebral ischemia
Dietary Reference Intake
• RDA related to energy intake
• DRI = 2 – 18 mg/day (depending on age & gender)

Source:
• Founds in many foods:
– Lean meats, poultry, fish
– Peanuts
– Yeast
– Milk & egg  <<<  excellent sources of tryptophan
Deficiency
• Pellagra, clinical symptoms:
– Dermatitis  Reddish skin rash on the face,
hands and feet which becomes rough and dark
when exposed to sunlight
– Dementia
– Diarrhea
– Tremors
– Beefy red & sore tongue
– May also show clinical sign of riboflavin
deficiency
Pellagra Dermatitis
Folate (Folic Acid)
Physiologic Functions
• Coenzyme in metabolism of amino acids &
nucleotides
• Essential for the formation of red & white
blood cells in the bone marrow, and their
maturation
• Role in normal cell division  important in
embryogenesis
• Maintaining gene stability in synthesis and
repair of DNA
Dietary Reference Intake
• Expressed as dietary folate equivalents
(DFEs)
1 DFE
= 1 mcg of food folate
= 0,6 mcg of folic acid consumed with food
= 0,5 mcg of synthetic folic acid (supplement)

• DRI = 65 – 600 mcg (depending on age &

gender)
– Increased amount for women who could
become pregnant (preconception)
Source
• Rich sources:
– Liver, mushrooms, green leafy vegetables
(spinach, asparagus, broccoli), lean beef,
potatoes, whole-wheat bread, orange juice,
dried beans, seeds, nuts

Deficiency
• Neural tubal defect
• Anemia
• Increase risk of cancers and heart disease
Pyridoxine (B6)
Physiologic Functions
• Coenzymes in the metabolism of amino acids
• Cofactors in the synthesis or catabolism of
neurotransmitters
• Roles in metabolism of glycogen, sphingolipids,
heme & steroids
• Converts tryptophan to niacin
• May help prevent heart disease – decrease
homocysteine
Dietary Reference Intake
• DRI = 0,1 – 2,0 mg/day (depending on age &
gender)

Source:
• Two exogenous sources:
– Dietary source absorbed in the small intestine
– A bacterial source synthesized in significant quantities
by the normal microflora of the large intestines
• Food source: meats, whole-grain products,
vegetables, nuts, meat, poultry and fish, shellfish
Deficiency
• Metabolic abnormalities resulting from
insufficient production of active form of
pyridoxine
– Weakness, sleeplessness, peripheral
nbeuropathies
– Cheilosis, glossitis, stomatitis
– Impaired cell-mediated immunity
• Inadequate levels of active form of
pyridozine  neurologic dysfunction
(epilepsy)
Cobalamin (B12)
Physiologic Functions
• Roles in the metabolism of propionate and
amino acids
• Essential for normal metabolism of cells in
the GI tract, bone marrow & nervous tisues
– Maintains sheaths that surround and protect
nerves
– Works with folate to make red blood cells

DRI = 0,4 – 2,8 mcg/day (depending on age & gender)

Sources
• Animal Foods • Other
– Meat, poultry – Fortified soy
and fish beverages
– Milk and dairy – Fortified cereals
products – Supplements
– Cheese – B 12 injections
– Eggs
Deficiency
• Impaired cell division in synthesis of DNA
• Pernicious anemia
• Neurologic abnormalities  nerve
demyelination peripherally & proceeding
centrally  paralysis of nerves and muscles;
permanent
• Higher risk people:
– Strict Vegans
– Intrinsic factor
– Elderly (atrophic gastritis)
Vitamin C
Physiologic Functions
• Serves as biochemical redox system involved in
many electron transport reactions (include in
synthesis of collagen and carnitine)  production
and maintenance of collagen (connective tissue in
bones, teeth, skin and tendons)
• Antioxidant
• Promotes resistance to infection:
– involvement with the immunologic activity of leukocytes,
– the production of interferon
– The process of inflammatory reaction
– The integrity of the mucous membranes
Dietary Reference Intake
• DRI = 15 – 120 mg/day (depending on age & gender)
• Average body pool of vitamin C = 1500 mg
• Smokers need 140 mg/day

Sources :
• Fruits, vegetables, meats
• Citrus fruits / juices
• Vit C easily destroyed by oxidation, often extracted
& discarded in cooking water
Deficiency
• Scurvy
– Small blood vessels fragile
– Gums reddened and bleed easily
– Teeth loose
– Joint pains
– Dry scaly skin
– lower wound-healing, increased susceptibility
to infections, and defects in bone development
in children
 Scurvy

Bleeding around the bases of the hair on the legs

(Perifollicular hemorrhage) and the gums in
between the teeth are signs of scurvy. There may
be areas of bruising as seen in second picture.
There may also be swelling of the bone joints.
Micronutrients
(Minerals)
Dewi Martha Indria
Minerals
• Minerals: small, naturally occurring,
inorganic, chemical elements
– Serve as structural components & in
many vital processes in the body
• Inorganic: being composed of matter
other than plant or animal
Similarities to Vitamins Differences from
Vitamins
• Do not contribute • Whereas vitamins are
energy (calories) to organic compounds,
the diet minerals are
• Have diverse functions inorganic compounds
within the body • Unlike vitamins,
• Work with enzymes to some minerals
facilitate chemical contribute to the
reactions building of body
structures
• Required in the diet in
very small amounts
Calcium
• Most abundant mineral in the body
– 99% is stored in the bones
• Functions:
– Structural role in bones & teeth
– Transmission of nerve impulses
– Maintains cellular structure
– Essential for muscle contraction
– Essential for blood clotting
– Helps maintain normal blood pressure
Nutritional Problems
Deficiency Symptoms Toxicity Symptoms
• Stunted growth in • Excess is usually
children excreted so toxicity is
rare
• Bone loss
(osteoporosis) in adults • A very high intake (>
2000 mg/day) 
hypercalcemia (can be
exacerbated by high
intakes of vitamin D)
 Dietary References Intake
DRIs
Infants 200 – 260 mg/day
Children (1 – 8 years) 700 – 1000 mg/day
Children (> 9 years) & 1300 mg/day
adolescents
Adults (19 – 50) 1000 mg/day
Adults (51 – 70) 1000 mg/day (males)
1200 mg/day (females)
Adults (> 70 yrs) 1200 mg/day
Pregnant 1000 mg/day
1300 mg/day (aged 14 – 18 years)
Lactating ~ pregnant
Sources
• Foods
– Milk/milk products
– Dark green vegetables
– Some fish & shellfish
– Tofu & other legumes
– Fortified foods (i.e.: juices)
Phosphorus
• 2nd most abundant mineral in the body (85%
combined with calcium)
• Functions:
– Structure of bones & teeth
– Necessary for growth (DNA)
– Energy metabolism (ATP)
NUTRITIONAL PROBLEMS
Deficiency symptoms Toxicity symptoms
• Muscle weakness • May cause calcium
excretion and hinder
• Bone pain absorption
– Phosphorous
• High phosphorus diet
deficiency is rare
 nutritional
– Found widely in secondary
foods hyperparathroidism
 Dietary References Intake
DRIs
Infants & young children 100 – 500 mg/day
Older children & adolescents 1250 mg/day
Adults 700 mg/day
Pregnant 700 – 1250 mg/day
Lactating 700 – 1250 mg/day
Sources
• Foods
– Meat, poultry &
fish
– Dairy products
– Processed foods
– Soda
Magnesium
• Functions:
– Present in bone and teeth
– Protein synthesis
– Enzyme action (co-factor)
– Normal muscle contraction & relaxation
– Nerve transmission
 Dietary References Intake
DRIs
Infants 30 – 75 mg/day
Young children 80 – 130 mg/day
Older children & adolescents 240 – 410 mg/day
Adults 310 – 400 mg/day
Pregnant 350 – 400 mg/day
Lactating 310 – 360 mg/day
Deficiency Symptoms Toxicity Symptoms
• Weakness • Low blood pressure

• Confusion • Lack of coordination

• Depressed pancreatic • Coma or death

hormone secretion
• Growth failure
• Muscle spasms
Sources
• Nuts
• Legumes
• Whole grains
• Dark green vegetables
• Seafood
• Chocolate & cocoa
Sodium
• An electrolyte
• Electrolyte: compound that partially dissociates
in water to form ions
– Helps to maintain the body’s fluid balance
– Chief positive charged ion outside of cells
• Functions:
– Helps to maintain normal fluid and acid-base
balance
– Nerve impulse transmission
– Contraction of muscle
Intake & Sources
• NO DRI
• Minimum requirements = 500 mg
• Daily Value = 2400 mg
• Table salt (Sodium Chloride)
– 1 tsp = 2300 mg sodium

• Processed foods- those that are canned, cured,

pickled & boxed
– 75% of dietary intake
Deficiency & Toxicity Symptoms
• Deficiency symptoms:
– Muscle cramps
– Mental apathy
– Loss of appetite
• Toxicity symptoms:
– High blood pressure
Potassium
• An electrolyte (Chief positive ion inside cells)
• Functions:
– May lower blood pressure
– Protein synthesis
– Fluid balance
– Nerve transmission
– Contraction of muscles
– Critical for maintaining heartbeat
Deficiency Symptoms Toxicity Symptoms
• Muscle weakness • Causes muscular
• Paralysis weakness
• Confusion • Triggers vomiting
• Can cause death
• Accompanies
dehydration
• Unlikely but can occur
with increase in sodium
intake
Intake & Sources
• Estimated minimum requirement = 2000
mg
• Whole foods- including meats, milk, fruits,
vegetables, grains, legumes
• The more processed a food, the less
potassium it contains
Chloride
• An electrolyte
• Functions:
– Part of hydrochloric acid found in
the stomach
– Necessary for proper digestion
– Fluid balance
Deficiency Symptoms Toxicity Symptoms
• Growth failure in • Normally harmless
children
• Disturbed acid-base
• Muscle cramps balance
• Mental apathy
• Loss of appetite
Sulfur
• Functions:
– Present in all proteins (structure)
– Part of biotin & thiamin
– Part of insulin
• Sources:
– All protein- containing foods
• Deficiency symptoms:
– None known because protein
deficiency would occur first
• Toxicity symptoms:
– Rare, but when occurs depresses
growth
Iron
 Iron Molecules in the Body
Molecule Functions
Metabolic Proteins
Heme proteins
Hemoglobin Oxygen transport from lungs to tissue
Myoglobin Transport & storage of oxygen in muscle
Enzymes: Heme
Cytochromes Electron transport
Cytochromes P-450 Oxidative degradation of drugs
Catalase Conversion of hydrogen peroxide to oxygen & water
Enzymes: Nonheme
Iron-sulfur & metalloproteins Oxidative metabolism
Enzymes: Iron dependent
Tryptophan pyrolase Oxidation of tryptophan
Transport & Storage
Transferrin Transport of iron & other minerals
Ferritin & Hemosiderin Storage
 Dietary Reference Intakes
DRIs
Infants & young children 7 – 11 mg/day
Older children & adolescents 8 – 15 mg/day
Adults 8 – 18 mg/day
Pregnant 27 mg/day
Lactating 9 – 10 mg/day
Food Sources
• Red meat
• Poultry
• Fish & shellfish
• Eggs
• Legumes
• Dried fruits
• Fortified cereals
Deficiency Symptoms
• Anemia: a reduction of the number & size
of RBC’s and a loss of their color
– Characterized by weakness, paleness,
headaches, reduced immunity, inability
to concentrate, cold intolerance
• Blood loss
Toxicity Symptoms
• Iron overload
– Infections
– Liver injury
– Acidosis
– Shock
Zinc
• Functions:
– Needed for protein & enzyme function
– Immunity & wound healing
– Vitamin A transport
– Taste
– Fetal development
 Dietary Reference Intakes
DRIs
Infants & young children 2 – 5 mg/day
Older children & adolescents 8 – 11 mg/day
Adults 8 – 11 mg/day
Pregnant 11 – 13 mg/day
Lactating 12 – 14 mg/day
Food Sources
• Protein-containing foods:
– Meat
– Fish & shellfish
– Poultry
– Grains
– Vegetables
Deficiency Symptoms
• Growth failure in children
• Loss of taste
• Poor wound healing
• Poor appetite
Zinc Deficiency- Signs & Symptoms
• Hair loss
• Skin lessions
• Diarrhea
• Poor growth
• Acrodermatitis enteropathica
• Death
Zinc Deficiency- Treatment
• Regular zinc supplements can greatly reduce common
infant morbidities in developing countries
• Adjunct treatment of diarrhea  20mg /day x 10 days
• Pneumonia
• Stunting
• Zinc deficiency commonly coexists with other
micronutrient deficiencies including iron, making
single supplements inappropriate
• Dietary diversification
• Animal protein (oysters, red meat)
Toxicity Symptoms
• Fever
• Nausea
• Vomiting
• Diarrhea
• Kidney failure
Iodine
• Amount of iodine in food is reflected
in the soil
• Functions:
– Part of thyroxine, which regulates
metabolism
 Dietary Reference Intakes
DRIs
Infants 110 – 130 mcg/day
Children (1 – 8 years) 90 mcg/day
Children (9 – 13 years) 120 mcg/day
Adolescents & Adults 150 mcg/day
Pregnant 220 mcg/day
Lactating 290 mcg/day
Food Sources
• Food & drinking water
• Seafood (clams, lobsters, oysters,
sardines, and other saltwater fish) 
300 – 3000 mcg/kg of flesh
• Freshwater fish  20 – 40 mcg/kg
• Iodized salt (app. 60 mcg of iodine/g
of salt)
Deficiency symptoms
• Goiter: decreased blood iodine causes
thyroid cells to enlarge
• Cretinism: severe mental & physical
retardation of an infant caused by severe
iodine deficiency in the mother during
pregnancy
• Iodization of salt has all but eliminated
goiter & cretinism
• In some parts of the world, these deficiency
diseases still exist
Iodine Deficiency Disorders (IDD)
• Significant cause of preventable brain damage in
children
• Health effects:
– Increased perinatal mortality
– Mental retardation
– Growth retardation
• Preventable by consumption of adequately iodized
salt
 Iodine Deficiency Affects the Brain

Cretinism

Goiter

Reduced
intellectual
performance

*Goiter manifests only a small portion of IDD

IDD- Risk Factors
• Low iodine level in food
– products grown on iodine-poor soil
• erosion, floods
• mountainous areas

– distance from sea (low fish intake)

• Non-availability of iodized food (salt)
Toxicity Symptoms:
• Depressed thyroid activity
accompanied by an enlarged thyroid
gland
Flouride
• Functions:
– Formation of bones & teeth
– Helps make teeth resistant to decay
– Helps make bones resistant to
mineral loss
 Dietary Reference Intakes
DRIs
Children (1 – 8 years) 0,7 – 1 mg/day
Children & adolescents 2 – 3 mg/day
Adults 4 mg/day (man)
3 mg/day (woman)

Food Sources
• Drinking water
• Seafood
• Tea
Deficiency & Toxicity
Symptoms
• Deficiency Symptoms:
– Tooth decay
• Toxicity Symptoms: (rare in humans)
– Fluorosis: discoloration of teeth
• The first symptom of excess fluoride
– Nausea
– Vomiting
– diarrhea
Copper
• Functions:
– Helps make hemoglobin
– Part of several enzymes
• Food Sources:
– Meats
– Drinking water

DRI = 0,2 – 1,3 mg/day (depending on age & gender)

Deficiency & Toxicity Symptoms
• Deficiency Symptoms: (rare in
humans)
– Anemia
– Bone changes
• Toxicity Symptoms:
– Nausea
– Vomiting
– Diarrhea
Manganese
• Functions:
– Along with enzymes, facilitates
many cell processes
• Food Sources:
– Widely distributed in foods
DRI
2,3 mg/day (man), 1,8 mg/day (woman)
1,9 – 2,2 mg/day (children >9 years, boy)
1,6 mg/day (children >9 years, girl)
1,2 – 1,5 mg/day (children < 9 years)
Deficiency & Toxicity Symptoms
• Deficiency Symptoms:
– Poor growth
– Nervous system disorders
– Abnormal reproduction
• Toxicity Symptoms:
– Poisoning
– Nervous system disorders
Chromium
• Functions:
– Works with insulin
– Required for release of energy from
glucose
• Food Sources:
– Meat
– Unrefined foods
– Vegetable oils
 Dietary Reference Intakes
DRIs
Infants 0,2 – 5,5 mcg/day
Young children 11 – 15 mcg/day
Older children & adolescents 21 – 35 mcg/day
Adults 20 – 35 mcg/day
Pregnant 29 – 30 mcg/day
Lactating 44 – 45 mcg/day
Deficiency & Toxicity
Symptoms
• Deficiency symptoms:
– Abnormal glucose metabolism
• Toxicity symptoms:
– Occupational exposures damage
skin & kidneys
Selenium
• Functions:
– Protects body from oxidation
– Works with vitamin E
• Food Sources:
– Seafood
– Meats
– Grains
– Vegetables (depends on soil conditions)
 Dietary Reference Intakes
DRIs
Infants 15 – 20 mcg/day
Young children 20 – 30 mcg/day
Older children & adolescents 40 – 55 mcg/day
Adults 55 mcg/day
Pregnant 60 mcg/day
Lactating 70 mcg/day
Deficiency Symptoms
• Deficiency Symptoms:
– Fragile red blood cells
– Cataracts
– Growth failure
– Heart damage
Toxicity Symptoms
• Nausea
• Abdominal pain
• Nail & hair changes
• Liver & nerve damage