nutrient def (b12,vit d,cal,fe)
DESCRIPTION
Importance of diet to combat nutrient deficiencies like Vitamin B12, calcium, Iron.TRANSCRIPT
Nutrient Deficiencies- Know How To Combat!
Vitamin D
Vit. D is a fat soluble vitamin and its synthesized in the body
1 billion people worldwide have Vit D deficiency or insufficiency
96.7% Asian-Indian patients have Vitamin D deficiency and are fragile hip fracture (J Assoc Physicians India. 2010 Sep;58:539-42)
Function Of Vitamin DCalcium absorption in the intestines and is
required for the efficient utilization of dietary calcium.
Involved in cellular growth, differentiation and apoptosis.
Simulates insulin secretion.
Modulates the immune system.
Reduces inflammation.
Muscle development
Diagnostic Test
Measurement of 25(OH) vitamin D serum levels best reflects the vitamin D status of an individual.
Normal : >30 ng/ml (>75 nmol/L)
Insufficiency : 20-30 ng/ml (50-75 nmol/L)
Deficiency : <20 ng/ml (<50 nmol/L)
Symptoms
Usually asymptomatic until severe
Musculoskeletal pain
Fractures
Weakness
Causes
Decreased sun exposure/sunscreen ◦ SPF 15 decreases vitamin D3 synthesis by
99%
Decreased intake of foods rich in vitamin D
Impaired absorption due to air pollution
Chronic kidney disease
Vit. D Deficiency Leads To….
Rickets in ChildrenOsteoporosis ObesityDiabetesCancer risk Cardiovascular disease (including MI)
Recommended Dietary Allowance
Age Male FemalePregnan
cyLactatio
n
0–12 months*
400 IU(10 mcg)
400 IU(10
mcg)
1–13 years
600 IU(15 mcg)
600 IU(15
mcg)
14–18 years
600 IU(15 mcg)
600 IU(15
mcg)
600 IU(15 mcg)
600 IU(15 mcg)
19–50 years
600 IU(15 mcg)
600 IU(15
mcg)
600 IU(15 mcg)
600 IU(15 mcg)
51–70 years
600 IU(15 mcg)
600 IU(15
mcg)
>70 years
800 IU(20 mcg)
800 IU(20
mcg)
Sources
Regular supplementation of atleast 2000 IU/day of vit. D supplementation to maintain normal vit. D levels.
JAPI • november 2011 • voL. 59
Toxicity
Chronic ingestion of 50 to 100 times normal physiologic requirement of Vit D (> 40,000 IU/day) ie. 25 OH levels of >150 ng/ml can leads to
◦ Renal calculi◦ Hypercalcemia◦ Renal insufficiency◦ Fatigue and weakness
JAPI • november 2011 • voL. 59
Vitamin B12
Vitamin B12 is a water-soluble vitamin
Vitamin b12 is one of the most important vitamin required for growth and division of cells.
It is responsible in other important body functions.
Recommendation: Man,women-1.0 μg Children(1-18) – 0.2-1.0 μg Lactating mothers- 1.5 μg
Diagnostic Test
Normal : 200-900 pg/mL
Deficiency : <20o pg/mL
Toxicity : >900 pg/mL
Symptoms
Weakness, tiredness or light-headedness Pale skinSore tongueEasy bruising or bleeding gumsStomach upset
In sever case: Tingling or numbness in fingers and toes Difficulty walking Mood changes or depression Memory loss, disorientation, and dementia
CausesPerenicious anemia and atrophic gastritis
Surgery of the stomach or small intestine
Crohn's disease, celiac disease, bacterial growth, or a parasite
Excessive alcohol consumption.
Graves' disease
Long-term use of acid-reducing drugs
Vegetarian
Vit. B12 Deficiency Leads To….
Hyperhomocysteinemia
Cognitive function
Depression
Diabetic neuropathy
Fatigue, Joint pain (elbow)
Sickle cell disease
Recommended DietaryAllowance
ge Male FemalePregnancy
Lactation
0–6 months*
0.4 mcg 0.4 mcg
7–12 months*
0.5 mcg 0.5 mcg
1–3 years
0.9 mcg 0.9 mcg
4–8 years
1.2 mcg 1.2 mcg
9–13 years
1.8 mcg 1.8 mcg
14+ years
2.4 mcg 2.4 mcg 2.6 mcg 2.8 mcg
SourcesFatty fishes like cod,
salmon, tuna, sardines, liver, beef,
chicken and eggs.
Milk and milk products.
Fortified fruit juices and cereals
How much will meet the requirement??Sheep liver provides
91.9μg of Vitamin B12 whereas goat liver provides 90.4 μg
100ml of cow’s and buffalo’s milk gives 0.14 μg of B12
The raw yellow part of hen eggs has got most of the vitamin B12. It provides 1.8 μg of B12 / 100gm
Mackerel is the best amongst all, providing 19μg per 100gm of b12
CalciumMost important mineral for Bone and teeth
health
Calcium helps in normal muscle contraction, blood clotting, contraction of heart muscles
Expert groups say the number of osteoporosis patients at approximately 26 million (2003 figures) with the numbers projected to increase to 36 million by 2013
Ref: http://www.outlookindia.com 2004
Ref:Osteoporosis Society of India (2003) Action Plan Osteoporosis: Consensus statement of an expert group. New Delhi
RequirementsDaily requirement:Normal man&women400mgChildren(13-18yrs)- 600mg It increases in pregnancy, adolescent age
Dairy Products It is world wide known that all dairy products
are high in calcium.
Milk, curds, cheese, etc.Having low fat dairy products will be more beneficial for overall health.
Cheese is the highest source of calcium which gives 1376mg/100gm.
Having a cheese cube in 2 weeks is accepted.
Ragi Amongst all Cereals Ragi is
the richest source of Calcium
It provides about 344mg of calcium every 100gms
Having Ragi 2-3 times a weeks considered beneficial
Nuts And OilseedsSesame seeds provide most calcium when
roasted or dried. One tea spoon of sesame gives almost 88 mg of calcium
Almonds provide around 230mg /100gm and also rich source of Omega3 acids
SoyabeanSoy products are naturally high in calcium, it
also contains boron and magnesium which are Important for bone health
Soy contains isoflavones which inhibit the breakdown of bones
Thus, soybean is beneficial in post menopausal women for their bone health
Soy milk, Tofu are good in calcium
One needs to check for soy allergy
FishEnjoy having Fishes like Salmon not only for
their high calcium content but also for heart healthy Omega3 fatty acids.
Having Fish 2 times a week shows wonders. Remember method of cooking is important. Try grilled, steamed instead of fried.