NUTRITION

DEFINATION OF COMMON TERMS IN NUTRITION

Nutrition

Is the process by which food (solid and liquid) is ingested, digested and absorbed by the body to
provide for normal growth, development and health?

Or

A process of ingestion, digestion and absorption of food by the body that uses the food for
growth, development, reproduction, immunity, breathing, work and health storing nutrient and
energy in appropriate parts of the body.

Optimal nutrition

The best possible nutrition that is distinct from merely adequate nutrition, which is characterized
by no signs or symptoms of deficiency. This term describes people free from marginal
deficiencies, imbalances, and toxicities, and who are not at risk for such.

Nutrients

Nutrients are substances that the body needs to function properly.

Or

Substances obtained from food and used in the body to provide energy and structural materials
and to serve as regulating agents to promote growth, maintenance and repair.

Macronutrients

Are nutrients needed by the body in large quantities and they include carbohydrates, protein and
fats

Micronutrients

Are nutrients needed by the body in very small amount and these includes, vitamins and minerals

Essential nutrients

Nutrients a person must obtain from food because the body cannot make them for itself in
sufficient quantity to meet the body’s physiological need

Energy yielding nutrients

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Nutrients that is broken down to yield energy the body can use. These are carbohydrates, protein
and fats

Organic nutrients

Carbon containing nutrients these are, CHO, protein and fats

Inorganic Nutrient

Not containing carbon or pertaining to living things

Nutrient density

A measure of the nutrients a food provides relative to the energy it provides

The more nutrient and fewer kcalories, the higher the nutrient density.

Nutrition status

Is a measurement of the extent to which an individual’s physiological needs for nutrients are met.

Foods

Is anything (solid or liquid) edible which when taken provides the body with nutrients

Diet

The kinds of food that a person, animal, or community habitually eats.

Therapeutic diet
A diet used as part of treatment for a disease or clinical condition, or to eliminate, decrease, or
increase specific nutrients in the diet.

Balanced diet

Eating appropriate foods that provides all nutrients needed by the body in right
proportion/amount and quality to ensure body nourishment

Meal

Food served or eaten at a standard time of the day e.g. breakfast, lunch and supper.

Snacks

Food that is readily available and usually eaten between meals e.g. roasted ground nuts, maize,
soya, cake or bread ,mangoes and others.

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Beverage

Any liquid suitable for drinking

Dish

A particular variety or preparation of food served as part of a meal

Health

A state of complete physical, social and mental wellbeing

Bioactive food components

Components in foods either nutrients or phytochemicals that alters physiological process in the
body.

Phytochemical

Compounds in plants the confer colour, taste and other characteristics of food.

Some phytochemicals are bioactive food components in functional foods.

Food ways

The eating habits and culinary practices of people, region or historical practices.

Ethnic diets

Food ways and cuisines typical of national origins, races,cultural heritage or geographical
locations.

Functional foods

Whole or modified foods that contain bioactive food components believed to provide health
benefits,such as, reduced disease risk,beyond the benefits that their nutrients contribute

Calories

Units by which energy is measured.

Foodenergy is measured in kilocalories(kcal) 1000calories=1kcal

Energy density

A measure of energy a food provides relative to the amount of food

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Malnutrition

Any condition caused by deficient or excess energy or nutrient or by an imbalance of nutrients

Over nutrition

Over consumption of food energy or nutrients sufficient to cause disease or increase

susceptibility to disease, a form of malnutrition

Under nutrition

Under consumption of food energy or nutrients severe enough to cause disease or increase
susceptibility to disease, a form of malnutrition

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 FOODS AND THEIR NUTRITIONAL VALUE
VEGETABLES
Introduction
These are edible parts of plants. They have a high content of fibre, water, vitamins

and minerals.

Classification of vegetables
Vegetables are classified according to which part is eaten:

Leafy vegetables: These include cabbage, nakati, malakwang, dodo, pumpkin leaves, spinach,
lettuce, pigeon pea leaves, etc

Roots and tubers: Include carrots, turnips, beetroots, radishes, parsnip, potatoes, yam, etc

Legumes: Include beans, peas, g. nuts, simsim

Fruits: These are fleshy and contain seeds. Examples include eggplants, tomatoes, green pepper,
pumpkin, okra, capsicum, etc

Bulbs: Onions, garlic, leek and shallot

Stems: Edible stalks of plants. e.g asparagus, celery

Flowers: cauliflower, brocolli, broccoflower

Nutritive value of vegetables

Minerals
Vegetables are a good source of minerals. Ca, I, K and Fe are present in many vegetables. Fe is
particularly found in DGLV.

Vitamins
Most vegetables contain high levels of vitamins such as vitamin A (all green, yellow and orange
vegetables contain beta-carotene, vitamin B and ascorbic acid

Fats
They are very low in fat though most vegetables don’t contain any fat.

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Proteins
Proteins are low in most vegetables with the exception of legumes that are a good source

Carbohydrates
They are present mainly in the form of sugars

Fibre
Vegetables are a good source of both soluble and insoluble dietary fibre known as non-starch
polysaccharides like cellulose and pectin that absorb excess water in the colon and retain a good
amount of water in the faecal matter.

Water

Vegetables have ahigh water content

FRUITS
Fruits are generally high in fibre, water, vitamins and sugars. Fruits also have phyto-chemicals
that are essential for proper long-term cellular health and disease prevention. Regular
consumption of fruits with reduced risks of cancer, CVDs, Alzheimer disease, cataracts among
others

Nutritive value of fruits

Carbohydrates
They are high in CHOs in the form of sugar, cellulose and pectin. All fruits contain sugar as
sucrose and fructose. Unripe fruits have a greater proportion of starch. Cellulose is mainly found
in the skin. Fruits also contain fiber.

Vitamins
Fruits are valued for their vitamin C content. Brightly coloured vegetables are especially high in
vitamin A (Beta-carotene and pro-vitamin A)

Water
Most fruits have high water content (over 80%)

Fats

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Fruits do not contain fats apart from olives and avocado.

Minerals

Fruits are a good source of minerals. They contain K, Mg, I and calcuim

MEAT

Nutritive value of meat

Proteins

It is an excellent source of protein. Myosin and globlin are present in meat fibres. Collagen and
elastin are present in connective tissues

CHOs

Meat contains no carbohydrates. Liver may have small amount of glycogen

Vitamins

It contains a high source of vitamins especially vitamin B12

Minerals

Meat is a good source of iron. Iron is particulary found in liver and kidney. Other minerals found
in meat are magnesium and zinc.

Fat

The amount of fat in meat varies from animal to animal. Some meat products contain high
amounts of healthy unsaturated fat.

Water

Raw meat contains about 70% water

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EGGS

They are the most versatile of cooking ingredients. They are a good source of protein and
essential vitamins and minerals.

Structure of an egg

Shell (10%)

Egg shell is made up of CaCO3. The shell is also lined with a membrane

Yolk (30%)

It contains fat especially cholesterol. It held in the centre of the egg by the chalazae. If storesd
uncorrectly or if it breaks, the egg goes stale

Egg white (60%)

It contains mainly water with proteins and minerals. Water soluble vitamins (vitamin B) are
dissolved in the egg white.

Nutritive value of eggs

Protein

Eggs are agood source of protein. Eggs also contain essential amino acids.

Fat

They are a good source of easily digestible fat. Cholesterol is highly concentrated in the yolk.

Vitamins

With the sole exception of vitamin C, eggs contain almost all vitamins in particular eggs are a
rich source of vitamin B especiall B12 and B2. Vitamin A, D and some amounts of vitamin E are
also found in eggs.

Minerals

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Eggs in particular are a rich source of iodine and phosphorus. Calcium, sulphur and iron are also
present in eggs

MILK

It the primary source of nutrition for young mammals. Early lactation milk contains colostrum
which contains the antibodies.

Nutritive value of milk

Protein

It contains about 30-35g of protein per liter. It contains protein of high biological value.

Lipids

Fat is present in a fine emulsion making it easy to digest. When left to stand for sometime, the fat
globules will rise and to the top and form cream. Cholesterol is also present in milk.

Water

The water content of milk is approximately 87%

Carbohydrates

Milk contains several different carbohydrates including lactose, galactose and glucose. Lactose
gives milk its sweet taste and contributes approximately 40% of whole cow’s milk calories.

Minerals

Calcium, phosphorus, iron, magnesium, sodium, potassium, are present in milk.

Vitamins

Milk is a good source of vitamin A, vitamin B6, B12, C, D, K, thiamine, folic acid, pantothenic
acid and E.

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CEREALS

These are edible seeds and grains. Examples include rice, wheat, oats, maize, millet and
sorghurm

Nutritive value of cereals

Proteins

They contain useful amount of proteins of low biological value. Several amino acids such as
lysine are deficient in cereals. Gluten is mostly found in wheat and rye.

Lipids

A small amount is found in the germ of some cereals

Vitamins

They are an excellent source of B-group vitamins. However, due to processing most cereals are
deficirnt in vitamins. Vitamin E may be present in some cereals.

Water

The low content of cereals makes it easy to store them.

Carbohydrates

They are main consituent of cereals eapecially in form of starch. All unprocesses cereals are also
a good source of fibre.

Minerals

Cereals contain calcium, phosphorus, potassium

FISH

Nutritive value of fish

Proteins

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 IMPORTANCE OF GOOD NUTRITION

 Growth, development, replacement and repair of body cells and tissues

 Production of energy used for various activities such as warmth, movements and work
 Carry out chemical processes such as digestion, metabolism and body maintenance.
 Protection of body against illness and recovery from illness.

ESSENTIAL FOOD NUTRIENTS AND THEIR FUNCTION

For the body to function properly, it must maintain a proper balance of macronutrients and
micronutrients.

The major six nutrients are,

1. Carbohydrates
2. Proteins
3. Fats
4. Vitamins
5. Minerals
6. Water

CARBOHYDRATES

Carbohydrates is the preferred energy source for many body functions

As long as the CHO is available, the human brain depends exclusively on it as an energy source.

Dietary CHO includes sugar, starch and fibers.

Sugars are:

i. Monosaccharides (single sugar)

ii. Disaccharides (double sugar)
iii. Starch and fibers are polysaccharides, compound composed of chains of monosaccharides
units

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i. MONOSACCHARIDE

There are three monosaccharides and they have the same number and kind of atoms but in
different arrangements

These are;glucose,fructose and galactose

Glucose

Most cells depends on glucose for theier fuel to some extent and the the cells of the brain and the
rest of the nervous system depends almost exclusively on glucosecfor their energy.

The body can obtain this glucose from from CHO.

To function normally the body must maintain blood glucose within limits that allows the cells to
nourish themselves.

Blood glucose homeostasis is regulated primarily by two hormones,insulin and glucagon.

Fructose

It is the sweetest of the sugars.

It occurs naturally in fruits, honey and saps

Other sources includes soft drinks,ready to eat cereals and other products sweetened with high
fructose corn syrap.

Galactose

The third single sugar

Occurs mostly as part of lactose,a disaccharide also known as milk sugar.

During digestion, galactose is freed as single sugar

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ii. DISACCHARIDES

In disaccharides,pairs of sinfle sugars are linked together

These arre maltose,sucrose and lactose.

Allt he three has glucose as one of their single sugars.

Sucrose

It is a pair of glucose and fructose

It is the most familiar of the three disaccharides and is what people mean when they speak of
‘’sugar’’.

This sugar is usually obtained by refining the juice from sugarcane or sugar beets to provide the
brown, white and powdered sugar available in supermarkets but it occurs naturally in many fruits
and vegetables.

The enzymes in digestive tract split the sucrose into glucose and fructose component, when a
person eats a food containing sucrose.

Because the body can also convert fructose to glucose, one molecule of sucrose can ultimately
yield two molecules of glucose.

Lactose

It is a combinationof glucose and galactose

Lactose is the principal carbohydrate of milk.

Most human infants are born with the digestive enzymes necessary to split lactose into its two
monosaccharide parts.

Maltose

The third disaccharide

Maltose is a plant sugar that consist of two glucose units

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 It is produced whenever starch is broken down.

iii. POLYSACCHARIDES

Unlike the sugars which contains the three monosaccharide in different combinations, the
polysaccharides are composed almost entirely of glucose (and in some cases some
monosaccharides)

Three important polysaccharide in nutrition areglycogen, starch and fibers

Glycogen

Glycogen is a storage form of energy for human being and animals

It is found in meat only to a limited extent and not at all in plants

For this reason,glycogen is not significant food source of carbohydrate, but it does play an
important role in the body.

The human body stores much of its glucose as glycogen in the liver and muscle.

After meals, as the blood glucose rises,the pancrease releases the hormone insulin,which signals
the the body tissue to take up supplus glucose.

Muscles and liver uses some of this excess glucose to build glycogen

The muscles hoards two thirds of the body’s total glycogen and use it just for them selves during
physical activities.

The brain stores a tiny fraction of the total thought to provide an emergency glucose reserve
sufficient to fuel the brain for an hour or two in severe glucose deprivation.

The liver stores the remainder and is generous with its glycogen, making it available as blood
glucose for the brain or other tissue when supply runs low.

Starch

Starch is along straight or branched chain of hundreds of thousands of glucose units linked
together.

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These giant molecules are packed side by side in grains such as rice or wheat ,in roots crops and
tubers such as yams and potatoes and in legumes such as peas and beans

When a person eats the plant, the body splits the starch into glucose units and use the glucose for
energy

All starchy foods come from plants and grains are the richest food source of starch followed by
legumes and roots, vegetables, tubers respectively.

Grains legumes and tubers are not only rich in starch but may also contain abundant dietary
fibers, proteins and other nutrients

Fibers

Dietary fibers are the structural parts of plants and thus are found in all plant-derived foods,
vegetables, fruits, grains and legumes.

Most dietary fibers are polysaccharide chain of sugar just as starch but in fibers the sugar units
are held together by bonds that human digestive enzymes cannot break.

Consequently, most dietary fibers pass through the body providing little or no energy for its use.

Fibers are divided into two general groups by their chemical and physical properties.

1. Soluble fibers

These forms gel (are viscous) and are easily digested by bacteria in the human large intestines.

Commonly found in barley, legumes, fruits, oats and vegetables

These fibers are often associated with lower risk of chronic diseases

2. Insoluble fibers

Do not form gel, are less readily fermented

Insoluble fibers like cellulose and hemicelluloses are found in outer layers of whole grains
(brand),the hulls of seeds and skin of corn kernels

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These fibers retain their structure and rough texture even after hours of cooking

In the body, aids the digestive system by easing elimination

PROTEINS

Introduction

Proteins are polymer chains made of amino acids linked together by peptide bonds. Proteins and
carbohydrates contain 4 kcal per gram as opposed to lipids which contain 9 kcal per gram.

Amino acids
Amino acids can be divided into either essential amino acids or non-essential amino acids.

The essential amino acids, which must be obtained from food sources, are leucine, isoleucine,
valine, lysine, threonine, tryptophan, methionine, phenylalanine and histidine.

Non-essential amino acids can be made by the body from other amino acids. The non-essential
amino acids are arginine, alanine, asparagine, aspartic acid, cysteine, glutamine, glutamic acid,
glycine, proline, serine, and tyrosine.

Each amino acid has special characteristic that attracts it to, or repel it from the surrounding
fluids and other amino acids.

Proteins are broken down in the stomach during digestion by enzymes known as proteases into
smaller polypeptides to provide amino acids for the body, including the essential amino acids
that cannot be biosynthesized by the body itself. Thus, protein from one's diet should provide
both essential and non-essential amino acids for protein synthesis.

Most animal and certain vegetable proteins are considered complete proteins with a full
complement of essential amino acids in adequate proportions. People who avoid animal products
may practice protein combining to get the essential amino acids in their diet.

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Proteins are very important molecules in our cells. They are involved in virtually all cell
functions. Each protein within the body has a specific function. Some proteins are involved in
structural support, while others are involved in bodily movement, or in defense against germs.

Protein Functions

Antibodies - are specialized proteins involved in defending the body from antigens (foreign
invaders). One way antibodies destroy antigens is by immobilizing them so that they can be
destroyed by white blood cells.

Contractile Proteins - are responsible for movement. Examples include actin and myosin. These
proteins are involved in muscle contraction and movement.

Enzymes - are proteins that facilitate biochemical reactions. They are often referred to as
catalysts because they speed up chemical reactions. Examples include the enzymes lactase and
pepsin. Lactase breaks down the sugar lactose found in milk. Pepsin is a digestive enzyme that
works in the stomach to break down proteins in food.

Hormonal Proteins - are messenger proteins that help to coordinate certain bodily activities.
Examples include insulin, oxytocin, and somatotropin. Insulin regulates glucose metabolism by
controlling the blood-sugar concentration. Oxytocin stimulates contractions in females during
childbirth. Somatotropin is a growth hormone that stimulates protein production in muscle cells.

Structural Proteins - are fibrous and stringy and provide support. Examples include keratin,
collagen, and elastin. Keratins strengthen protective coverings such as hair, quills, feathers,
horns, and beaks. Collagens and elastin provide support for connective tissues such as tendons
and ligaments.

Storage Proteins - store amino acids. Examples include ovalbumin and casein. Ovalbumin is
found in egg whites and casein is a milk-based protein.

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Transport Proteins - are carrier proteins that move molecules from one place to another around
the body. Examples include hemoglobin and cytochromes. Hemoglobin transports oxygen
through the blood. Cytochromes operate in the electron transport chain as electron carrier
proteins.

BIOLOGICAL VALUE (BV)

Is a measure of the proportion of absorbed protein from a food which becomes incorporated into
the proteins of the organism's body. It summarizes how readily the broken down protein can be
used in protein synthesis in the cells of the organism. Proteins are the major source of nitrogen in
food, unlike carbohydrates and fats. This method assumes protein is the only source of nitrogen
and measures the proportion of this nitrogen absorbed by the body which is then excreted. The
remainder must have been incorporated into the proteins of the organisms body. A ratio of
nitrogen incorporated into the body over nitrogen absorbed gives a measure of protein 'usability'
- the BV.

Unlike some measures of protein usability, biological value does not take into account how
readily the protein can be digested and absorbed (largely by the small intestine). This is reflected
in the experimental methods used to determine BV.

BV uses two similar scales:

1. The true percentage utilization (usually shown with a percent symbol).

2. The percentage utilization relative to a readily utilizable protein source, often egg (usually
shown as unitless).

Common Protein Deficiency signs and Symptoms

Even with a wide variety of protein sources available, some people experience protein deficiency
symptoms due to a lack of protein intake. Severely restrictive diets, lack of knowledge about
nutrients, and even poverty can contribute to protein deficiency. Here are some of the most
common symptoms:

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 Oedema  General weakness and lethargy

 Weight loss  Muscle soreness and weakness, cramps

 Thinning or brittle hair, hair loss  Slowness in healing wounds, cuts,

scrapes, and bruises
 Ridges or deep lines in finger and toe
nails  Bedsores and other skin ulcers

 Skin becomes very light, burns easily in  Difficulty sleeping

the sun  Headache
 Reduced pigmentation in the hair on  Nausea and stomach pain
scalp and body
 Fainting
 Skin rashes, dryness, flakiness

Other Symptoms

Not all of the symptoms of protein deficiency are physical. Some are emotional or mental, and
include:

 Crankiness, moodiness  Anxiety

 Severe depression  General body weakness

LIPIDS

Lipids in foods and in human body include, triglycerides (fats and oils), phospholipids and
sterols.

Lipids perform many task in the body, but most importantly, they provide energy.

A constant flow of energy is vital to life, that in a pinch, any other function is sacrificed to
maintain it.

The body’s capacity to store fat for energy is virtually unlimited due to the fat-storing cells of the
adipose tissue.

The fat cells of the adipose tissue readily takes up and store fat, growing in sizes as they do so.

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Fat cells secrete hormones that help to regulate the appetite and influence other body functions.

FUNCTION OF FAT IN THE BODY

1. Energy store
Fat is the body’s chief form of stored energy
2. Muscle fuel

Fat provides most of the energy to fuel muscular work

3. Padding

Protects internal organs from shock through fat pads inside the body cavity.

4. Insulation

Fat insulates against temperature extremes through a fat layer/deposit under the skin.

5. Component of cell membrane

Fat forms major material of cell membranes, i.e. the phospholipids and cholesterol are cell
membrane constituents that helps maintain the structure and health of cells.
6. Raw materials

Fats are converted to other compounds such as hormones, bile and vitamin D, as needed.

7. Natural oils in the skin provides a radiant complexion in scalp,nourishes hair and make it
glossy.

TRIGLYCERIDES

This is when three fatty acids iare attached to a glycerol

Fatty Acids

These are organic compound composed of a chain of carbon atoms with hydrogen atoms
attached and acid group at one end.

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Glycerols

An organic compound,three carbon long that can form a back bone of triglyceride and
phospholipids

FATTY ACIDS

These are chains of fragments of energy yielding nutrients.

Fatty acids may differ from one another in two ways,

1. The chain length

The number of carbon atoms in a fatty acid

2. The degree of saturation(also refers to its chemical structure)

Specifically to the number of hydrogen atoms the carbons in fatty acids are holding

 saturated fatty acid

If every available carbon is filled to capacity with hydrogen atom in the fatty acid chain
Saturated fatty acid is fully loaded with hydrogen atoms and has only a single bond between the
carbons

 Unsaturated fatty acids, when the hydrogen atoms are missing in the fatty acid chain

It has at least one double bond between its carbon, that is, monounsaturated fatty acid,when there
is one point of unsaturation and polyunsaturated fatty acid,when there is two or more points of
unsaturation (e.g. olive oil,canola oil, peanut oil and avocado)

The degree of saturation of the fatty acid in a fat influences the health of the body and
characteristics of foods.

Fats that contain the shorter chain or the more unsaturated fatty acids are softer at room
temperature and melt more readily.

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Polyunsaturated fatty acid spoils most readily because their double bonds are unstable.

Oxidation of unsaturated fat produces variety of compounds that smells and taste rancid. (e.g.
vegetable oils, sunflower oil, simsim, soya, corn, nuts and seeds)

Saturated fats are more resistant to oxidation and thus less likely to become rancid, other types
spoilage can occur due to microbial growth.

Manufacturer can protect fat- containing products against rancidity in three ways

 Sealed airtight and refrigerated

 Addition of antioxidant to compete for oxygen
 Hydrogenation, saturation of some or all of the points of unsaturation, this protects against
oxidation and alters the texture of foods by increasing the solidity of fats.

ESSENTIAL FATTY ACID

a. Linoleic acid
b. Linolenic acid

They are both polyunsaturated fatty acid

Essential fatty acid are found in small amount in plant oils and body readily stores them making
deficiency unlikely

The body makes important substances from essential fatty acids and helps regulate blood
pressure, clot formation, blood lipid concentration and immune response, inflammatory response
to injury.

They also serve as structural components of cell membranes.

LINOLEIC ACID, AN OMEGA-6 FATTY ACID

Found in seeds of plants and in the oil products of the seeds

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Any diet that contains vegetable oils, seeds, nuts and whole grains food provide enough lonoleic
acid to meet the body’s needs.

LINOLENIC ACID, AN OMEGA-3 FATTY ACID

This belongs to a family of polyunsaturated fatty acid known as Omega-3 fatty acid, a family
that also includes EPA (EICOSAPENTAENOIC ACID) AND DHA (DOCOSAHEXAENOIC
ACID).

EPA and DHA are found primarily in fish oil.

DHA and EPA are needed for normal brain development

DHA is also specifically active in rods and cones of the retina of the eye.

Omega-3 fatty acids are essential for normal growth and development and that they play an
important role in the prevention and treatment of heart disease, diabetes, hypertension, arthritis
and cancer.

PHOSPHOLIPIDS

Among other phospholipids, Lecithins are of particular interest.

Like triglycerides, the Lecithins and other phospholipids have a backbone of glycerol

They have two fatty acids attached to the glycerol

In the place of the third fatty acid they have phosphate group (phosphorus containing acid) acd a
molecule of choline or a similar compound.

The fatty acid makes the phospholipids soluble in fat and the phosphate group enables them
soluble in water.

These virtually help the food processing industries to use lipids as emulsifier to mix fats with
water. In such products as mayonnaise and candy bars

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Phospholipids are also found naturally in foods

Food sources

Eggs, liver soya beans wheat germ and peanuts

Functions

Lecithin and other phospholipids are important constituents of cell membranes

Acts as emulsifiers in the body, helping to keep other fats in solution in the watery blood and
body fluids

STEROLS

These are large, complex molecules consisting of interconnected rings of carbon

Cholesterol is the most familiar sterol, but others such as vitamin D and sex hormones (e.g.
testosterone) are important too.

Food sources

Foods derived from both plans and animal contains sterols, but only those from animal, meat,
eggs, fish, poultry and dairy products contain significant amount of cholesterol.

Organ meat such as liver and kidney and eggs are the richest in cholesterol, cheese and meat has
less.

Shellfish contain many sterols but much less cholesterol.

Sterols other than cholesterol are found naturally in plants.

Plant sterol lower blood cholesterol levels because they have similar structure.

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VITAMINS

Are potent, essential non kcaloric organic nutrients needed from food in trace amounts to
perform specific functions that promote growth, reproduction and maintenance of health and life.

BIOAVAILABILITY

Amount of vitamin available from foods depends on, quantity provided, amount absorbed and
used by the body

Bioavailability is also determined by;

 Efficiency of digestion and time of transit through GIT

 Previous nutrient intake and nutrition status
 Other foods eaten at the same time
 Methods of food preparation (raw or cooked)
 Source of nutrient (natural, synthetic or fortified)

PREVENTION OF NUTRIENT LOSSES

 Prevent enzymatic destruction

 Refrigerate fruits, vegetables and juices to slow breakdown of vitamins
 Protect from light and air
 Store milk and grain products in an opaque container to protect Riboflavin
 Store cut fruits and vegetable refrigerated in airtight wrappers, reseal opened juice container
before refrigerating
 Prevent heat destruction or losses in water
 Wash intact fruits and vegetables before cutting or peeling to prevent losses during washing
 Cook fruits and vegetable in a microwave oven or quick stir fry, or steam them over a small
amount of water to prevent vitamin loss in cooking water.
 Recapture dissolved vitamins by using cooking water for soup, stews or gravies.
 Avoid high temperature long cooking time.

Vitamins are mainly divided in to two groups

1. Fat soluble vitamins

2. Water soluble vitamins

FAT SOLUBLE VITAMINS

These include, A, D, E and K

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Fat soluble vitamins occur together in fats and oil foods

Anything that interferes with fat absorption can precipitate a deficiency of the fat soluble
vitamins.

They are stored in the liver and fatty tissues until the body needs them.

VITAMIN A

Vitamin A is a fat soluble vitamin required by the body is small quantities. . The dietary needs
for vitamin A are normally provided for as preformed retinol (mainly as retinyl ester) and
provitamin A carotenoids or beta-carotene. Preformed vitamin A in animal foods occurs as
retinyl esters of fatty acids are found in membrane-bound cellular lipid and fat-containing
storage cells. Provitamin A carotenoids in foods of vegetable origin are also found in cellular
lipids but are embedded in complex cellular structures such as the cellulose containing matrix of
chloroplasts or the pigment containing portion of chromoplasts. During digestion, the retinyl
esters and provitamin A carotenoids are hydrolysed to retinols and free carotenoids and
incorporated into lipid-containing, water-miscible micellar solutions. Vitamin A is re-esterified
and stored in the liver and fatty tissues around the body. Other nutrients such as protein, zinc
and energy are essential for the transport and utilization of vitamin A.

There are three active forms of vitamin A in the body, i.e. Retinol, Retinal and Retinoic acid

Functions of vitamin A

1. Gene expression regulates activities of genes,genes directs the synthesis of proteins,

including enzymes and enzymes performs the metabolic work of the tissue.
2. Vision

Maintains a healthy, crystal- clear outer window of the cornea

Light detection at the retina with help of photosensitive cells containing pigment rhodopsin
(contains opsin, bonded to a molecule of the retinol)

In the visual system, retinol is transported to ocular tissue and to the retina by intracellular
binding and transport proteins. Rhodopsin, the visual pigment critical to dim-light vision, is
formed in rod cells after conversion of all-trans-retinol to retinaldehyde, isomerization to the 11-

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cis-form, and binding to opsin. Alteration of rhodopsin through a cascade of photochemical
reactions results in the ability to see objects in dim light. The speed at which rhodopsin is
regenerated is related to the availability of retinol.

3. Protein synthesis and cell differentiation

Vitamin A is also important for the growth and differentiation of epithelial cells. Cells lining
protective tissue surfaces fail to regenerate and differentiate, hence they flatten and accumulate
keratin.

Much more vitamin A in the skin and lining of organs, where it works behind the scene at the
genetic level to promote protein synthesis and cell differentiation

4. Immunity

Regulates genes involved in immunity and insufficient vitamin A alters genetic interaction and
response to infection that weakens the body’s defenses.

5. Reproduction growth and development

In men, vitamin A participates in sperm development

In women, promotes normal fetal growth and development

During pregnancy, essential in development of nervous system, lungs, heart, kidneys, skeleton,
eyes and ears.

Vitamin A deficiency (VAD)

Diets critically low in dietary fat (under about 5–10g daily) or disease conditions that interfere
with normal digestion and absorption leading to steatorrhoea (e.g. pancreatic and liver diseases
and frequent gastroenteritis) can therefore impede the efficient absorption of retinol and
carotenoids and thus cause VAD.

Night blindness

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This is the earliest sign of vitamin A deficiency. Night blindness is usually an indicator of
inadequate available retinol, but it can also be due to a deficit of other nutrients that are critical to
the regeneration of rhodopsin, such as protein and zinc.

Decreased immunity

Vitamin A deficiency leads to a reduction of goblet cells in the epithelial tissues and as a
consequence, mucous secretions (with their antimicrobial components) diminish. A decline in
mucous secretions and loss of cellular integrity reduce the body’s ability to resist invasion from
potentially pathogenic organisms. Pathogens can also compromise the immune system by
directly interfering with the production of some types of protective secretions and cells

Conjuctival and cornea Xerosis

This is characterized by abnormal dryness of the eyes.

Bitot’s spots

These are foamy deposits in the conjunctiva.

Xerophthalmia fundus

These are characterized by white deposits on the retina. With treatment, the whiteness goes away
but the damage to the retina remains.

Signs and symptoms of VAD

• Night blindness • Poor reproductive health

• Bitot’s spots • Increases morbidity and mortality

• Corneal xerosis and corneal ulceration • Poor reproductive growth

• Increased susceptibility to infection

• Conjunctival xerosis

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VITAMIN D

Vitamin D is a member of large cooperative bone making and maintenance team composed of
nutrients and other compounds including vitamin A, C AND K, hormones parathormone and
calcitonin in protein synthesis.

The liver manufacture vitamin D precursor, which migrates to the skin, it is then converted to a
second precursor with the help of sun’s ultraviolet rays.

Then the liver and the kidney alter the second precursor to produce the active vitamin D.

Function of vitamin D

• It’s required to maintain normal blood levels of calcium and phosphate, that are in turn
needed for the normal mineralization of bone, muscle contraction, nerve conduction, and
general cellular function in all cells of the body.

• Vitamin D also modulates the transcription of cell cycle proteins, that decrease cell
proliferation and increase cell differentiation of a number of specialized cells of the body
(e.g., osteoclastic precursors, enterocytes, keratinocytes, etc.).

Deficiency

Vitamin D deficiency can be cause to the following;

• Rickets, characterized by bowed legs and beaded ribs

• Osteomalacia • Delayed wound healing

• osteoporosis

• Increased susceptibility to infections

Population at risk

• Infants: Infants constitute a population at risk for vitamin D deficiency because of

relatively large vitamin D needs brought about by their high rate of skeletal growth.

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 • Adolescents: Another period of rapid growth of the skeleton occurs at puberty and
increases the need the vitamin D

Food sources

Eggs, liver butter and some fatty fish, fortified milk, fortified margarine.

VITAMIN E

Like beta-carotene, vitamin E is fat soluble antioxidant. It protects other substances from
oxidation being oxidized itself.

Function of vitamin E

• It an anti-oxidant that helps protect the body against stroke, cataracts, cancers and heart
disease. It prevents low density lipoproteins from being oxidizing and hence preventing
clogging of the arteries.

• It’s essential for proper functioning of the brain. It protects the myelin sheath that surrounds
neuron in the brain. It may also help prevent Alzheimer's disease.

• Vitamin E capsules help enhance the action of insulin and hence improves blood glucose
function

• contributes

Vitamin E deficiency

Vitamin E can be associated to the following signs and symptoms;

• Ataxia
• Peripheral neuropathy
• Retinopathy
• Anemia, especially haemolytic anaemia in premature newborn caused by erythrocyte
hemolysis

Vitamin E is transferred from mother to the fetus in the last weeks of pregnancy

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Food sources

Anti oxidant rich fruits, avocado, green leafy vegetables, wheat germ whole grain and nuts.

NB

Vitamin E is readily destroyed by heat, processing and oxidation, so, fresh or slightly processed
foods are the best source for vitamin E.

VITAMIN K

Vitamin K can be synthesized by the bacteria in the intestinal tract other than the food sources,
but the body cannot depend on this source alone.

Functions of vitamin K

• Necessary for blood clotting, by activating protein prothrombin, the precursor of thrombin.
• It converts glumutate in proteins to gamma-carboxyglutamate
• Helps in synthesis of several bone protein and without vitamin k, the bone produces an
abnormal protein that cant bind to the minerals that normally form bones resulting in low
bone density.

Food sources vitamin K

Spinach, cauliflower, kale, wheat bran, organ meats, diary products and eggs

Vitamin K deficiency

 Haemorrhage

Deficiency is rare but can occur in fat malabsorption and some medication like antibiotics that
destroy the bacteria that synthesize vitamin K in the intestines.

Vitamin K deficiency is usually common in alcoholics, persons with cystitic fibrosis,

inflammatory bowel diseases or persons who have recently had abdominal surgeries. Some
medications are also known to causes vitamin K deficiency.

Signs and symptoms of vitamin K deficiency include the following; heavy menstrual bleeding in
women, anemia, bruising and bleeding of the gums or nose. Osteoporosis and CHDs are also
associated with low levels of vitamin K

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Note:

A single dose of vitamin K usually in a water soluble form is recommended at birth to prevent
haemorrhage and haemorrhagic diseases in new born.

This is because an infant’s digestive tract does not have fully established bacteria to synthesize
vitamin K and at the same time, plasma concentration of prothrombin is still low.

WATER SOLUBLE VITAMINS

These mainly include B-complex vitamins and vitamin C.

They are found in the watery compartments of foods and distributed in water filled
compartments of the body

B COMPLEX VITAMINS

B vitamins are a group of water soluble vitamins that play an important role in cell metabolism.
Supplements containing all the eight B vitamins are known as B-complex vitamins. The B
vitamins include vitamin B1 (thiamine), vitamin B2 (riboflavin), vitamin B3 (niacin), vitamin B5
(pantothenic acid), vitamin B6 (pyridoxine), vitamin B7 (biotin), vitamin 9 (folic acid), vitamin
B12 (cobalamine)

THIAMINE, B1

Facilitates energy metabolism

All cells uses thiamine but it also occupies special site on the nerve cells and muscles.

Empty kcalories foods like sugar and alcohol, risk thiamin deficiency.

Alcohol impairs absorption of thiamine from GIT and hastens its excretion in urine.

Compounds called anti thiamine factors or thiamine antagonists that alter the structure of
thiamine such as tea, coffee, raw fermented fish, e.t.c inhibits thiamine absorption

Functions in the body

• Co-enzyme in metabolism of carbohydrates and branched-chain amino acids

Food sources include: Pork, organ meats, whole grains, un-processed cereals and legumes

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Thiamine deficiency

Thiamin deficiency results in a disease known as beriberi. It has been classically considered to
exist in 3 forms i.e. dry, wet and infantile beriberi.

Non specific signs and symptoms of beriberi include malaise, weight loss, irritability and
confusion

Signs and symptoms of wet beriberi (oedematous)

• Muscle wasting
• Mental confusion
• Peripheral neuropathy
• Heart failure and weakening of the capillary walls that causes the peripheral tissues to
become oedematous
• Vasodilatation leading to increased arterio-venous shunt
• Peripheral oedema
• Increased heart rate
• Swelling of the lower limbs

Dry beriberi (paralytic)

Signs and symptoms

• Wasting
• Partial paralysis that mainly results from peripheral nerves especially in the hands and feet
• Difficulty in walking
• Tingling
• Mental confusion and speech difficulties
• Pain
• Involuntary eye movements
• Vomiting

Infantile beriberi

This type of beriberi is mainly found in infants especially in those whose mothers are deficient in
the vitamin. If untreated it can be fatal within 24 hours

A physical examination may show the following;

• Congestive Heart failure characterized by difficulty in breathing with neck veins that stick
out, enlarged heart, fluid in the lungs, rapid heart beat

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• Swelling in both the lower limbs
• Confusion, memory loss and delusions

A neurological exam may show the following;

• Changes in gait • Decreased reflexes

• Coordination problems • Drooping of the eyelids
Wernicke-korsakoff syndrome

Wernicke’s encephalopathy and korsakoff syndrome are different conditions that are both due to
brain damage. Wernicke’s encephalopathy causes brain damage in the lower parts of the brain
called the thalamus and hypothalamus. Korsakoff psychosis results from damage to areas of the
brain involved in memory. It’s mainly caused by a deficiency in vitamin B1 and the most
affected group of people are alcoholics.

Symptoms of wernicke encephalopathy:

• Confusion • Abnormal eye movement

• Loss of muscle coordination (ataxia) • Vision changes
• Leg tremor • Eyelid drooping
Korsakoff syndrome

Signs and symptoms

• Inability to form new memories • Confabulation (making up stories)

• Loss of memory can be severe • Hallucinations
Note: There may also be signs of alcohol withdrawal

• Examination of the nervous and muscular systems may show damage to many nerve systems
that include the following signs:
• Abnormal eye movement
• Decreased or abnormal reflexes
• Fast pulse
• Low blood pressure
• Hypothermia
• Muscle weakness and loss of tissue mass (atrophy)
• Problems with walking and coordination

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Conditions that may cause vitamin B1 deficiency

• HIV\AIDS
• Cancer
• Extreme or severe vomiting during pregnancy
• Long periods of intravenous therapy without receiving thiamine supplements
• Long term dialysis

Thiamine absorption

Thiamine absorption is affected by the following:

• Alcohol

Risk populations

• Individuals who consume polished food products and highly refined products such as rice,
maize flour
• Alcoholics
• Refugees and displaced persons
• Infants especially those whose mothers are deficient in the vitamin

VITAMIN B2 (RIBOFLAVIN)

Functions of riboflavin

• Co-enzyme functions in numerous oxidation and reduction reactions.

Deficiency of riboflavin

Deficiency of Vitamin B2 results in a condition known as hypo- or ariboflavinosis

Signs and symptoms of riboflavin deficiency

• Sore throat, hyperaemia oedema of the pharyngeal and oral mucous membranes, cheilosis,
angular stomatitis, glossitis, seborrheic dermatitis, and normochromic and normocytic bone
marrow.

Food sources

Milk and dairy products, meats and green vegetables

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Populations at risk

• Individuals with certain medical conditions such as tropical sprue, celiac disease, malignancy
and resection of the small bowel, and decreased gastrointestinal passage time.
• Deficiencies are more prevalent in children with gastrointestinal infections.
• Also at risk are those receiving phototherapy for neonatal jaundice and perhaps those with
inadequate thyroid hormone.
• Some cases of riboflavin deficiency are also found in children infected with hookworms.

NB:

Riboflavin is light sensitive, ultraviolet rays of the sun or fluorescent lamp can destroy it.

It is heat stable, ordinary cooking does not destroy it.

NIACIN, B3

Niacin can be made from the protein in the body. i.e.amino acid tryptophan can be converted to
niacin in the body.

NB:

Physicians sometimes use diet and large doses of a form of niacin (nicotinic acid) to lower blood
cholesterol in the treatment of atherosclerosis.

Functions of niacin

• Co-substrate/co-enzyme for hydrogen transfer with numerous dehydrogenases.

• Niacin (nicotinic acid) deficiency classically results in pellagra

Deficiency of niacin

Signs and symptoms of pellagra

• Diarrhea resulting from inflammation of the intestinal mucous surfaces

• Dementia

• Chronic wasting

• characteristic erythematous dermatitis that is bilateral and symmetrical

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Prevalence of niacin deficiency

• Pellagra mainly occurs in individuals with chronic alcoholism.

• Cases of niacin deficiency have been found in people suffering from Crohn’s disease

Toxicity

• Although therapeutically useful in lowering serum cholesterol, administration of chronic

high oral doses of nicotinic acid can lead to hepatotoxicity as well as dermatologic
manifestations.

Food sources

• Liver, lean meats, grains, and legumes Co-enzyme functions in the metabolism of amino
acids and glycogen.

VITAMIN B6, PYRIDOXINE

Functions of vitamin B6

• Deficiency of vitamin B6

• A deficiency of vitamin B6 alone is uncommon because it usually occurs in association with

a deficit in other B-complex vitamins

• Infants are especially susceptible to insufficient intakes, which can lead to peripheral
neuropathy (epileptic like convulsions)

Vitamin B6 deficiency

• Other signs may include Skin changes include dermatitis with cheilosis and glossitis.

Toxicity

• Use of high doses of pyridoxine for treatment of pre-menstrual syndrome, carpal tunnel
syndrome, and some neurologic diseases has resulted in neurotoxicity.

• Food sources include: Meats, vegetables, and whole-grain cereals

VITAMIN B5, PANTOTHENIC ACID

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Function of pantothenic acid

• Constituent of co-enzyme A and phosphopantetheine involved in fatty acid metabolism.

Deficiency of Pantothenic acid

• Fatigue, sleep disturbances, impaired coordination, nausea, rapid heart rate, epigastric
distress with anorexia and constipation, numbness and tingling of the hands and feet
("burning feet" syndrome); and have hyperactive deep tendon reflexes and weakness of
finger extensor muscles.

Food sources

These include the following:

• Animal tissues

• whole-grain cereals

• Legumes

VITAMIN B7, BIOTIN

INTRODUCTION

• Biotin is a B-complex vitamin, also known as Vitamin B-7 or vitamin H. It is important in a

number of metabolic functions in the human body, including cell growth, the synthesis of
fatty acids, and the metabolism of the amino acid leucine. Biotin also assists in the Krebs
cycle, through which the body converts food into energy, and in the transfer of carbon
dioxide within the body. Intestinal bacteria naturally produce biotin, and deficiency is
consequently rare.

Function of Biotin

• Co-enzyme functions in bicarbonate dependent carboxylations.

Deficiency of biotin

Signs and symptoms

• Fatigue, depression, nausea, Dermatitis and muscular Pains. Conjunctivitis, alopecia,and

central nervous system abnormalities such as hypotonia, lethargy, and developmental delay
in infants and depression, hallucinations, and paresthesia of the extremities in adults.

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Prevalence of biotin deficiency

• Biotin deficiency in humans has been clearly documented with prolonged consumption of
raw egg whites, which contain biotin-binding avidin.

• Biotin deficiency was also observed in cases of parenteral nutrition with solutions lacking
biotin given to patients with short-gut syndrome and other causes of mal-absorption.

• Some cases of biotin deficiency are found in infants with intractable diaper dermatitis and in
those fed special formulas

Food sources

• Liver, yeast, egg, yolk, soy flour, and cereals

VITAMIN B9, FOLATE

Introduction

• Folate is a generic term for a water-soluble group of B vitamins including folic acid and
naturally occurring folates. Folic acid is a synthetic folate compound used in vitamin
supplements and fortified food because of its increased stability. The name comes from
folium, which is the Latin word for leaves, because folates were first isolated from spinach in
1941. In 1962 Herbert consumed a folate-deficient diet for several months and recorded his
development of deficiency symptoms. His findings set the criteria for the diagnosis of folate
deficiency.

Function of folic acid

• Plays a role in reducing blood homosysteine levels

• Formation of red blood cells

• Protein metabolism

• Cell growth and division

• Prevention of neural tube defects and anencephaly. To prevent these defects adequate folate
should be obtained in the first month of pregnancy. All neural tube defects occur between
the 17th and 30th days following conception.

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Food sources

• Grains e.g. Fortified breakfast cereal, Whole wheat products

• Meat, beans, liver, eggs, sunflower seeds, leafy green vegetables, Oranges and Strawberries

• Milk, Yogurt, Cheese, Fats, Oils, and Sweets are poor sources of folate.

Factors affecting absorption of folic acid

• Medicines such as antiacids • Ascorbic acid and vitamin b12

• Manner in which it’s taken • Certain birth control methods

• Alcohol • Poor diets

Deficiency of folic acid

• Folate deficiency is one of the commonest vitamin deficiencies. It can result from inadequate
intake, defective absorption, abnormal metabolism or increased requirements.

• Early symptoms of folate deficiency are non-specific and may include tiredness, irritability
and loss of appetite.

• Severe folate deficiency leads to megaloblastic anemia, a condition in which the bone
marrow produces giant, immature red blood cells. At an advanced stage of anemia, the
symptoms of weakness, fatigue, shortness of breath, irritability, headache, and palpitations
appear. If left untreated, megaloblastic anemia may be fatal.

• Gastrointestinal symptoms also result from severe folate deficiency.

• Deficiency during pregnancy may result in premature birth, infant low birth weight and foetal
growth retardation. In children, growth may be retarded and puberty delayed.

VITAMIN B12

Introduction

• Vitamin B12, sometimes referred to as cobalamin, is one of the eight B vitamins. As a water
soluble vitamin, the human body cannot store it, so it should be consumed on a daily basis.
Vitamin B12 assists the nervous system and boosts brain functioning. It is most commonly
found in animal products such as shellfish, meat, poultry, eggs and milk.

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Function of vitamin B12

• Vitamin B12 is involved in a number of key body processes, but is especially key to red
blood cell production, nervous system function, sperm production, normal growth and the
proper function of the immune system. It has also been shown to improve memory and
concentration, help prevent cancer and also protect against allergies and toxins (especially
the cyanide found in cigarette smoke and some foods).

• Vitamin B12 is also closely involved in the production of melatonin, which controls the
release of many hormones in the body and is involved with the sleep/wake cycle.

Deficiency of vitamin B12

• The most commonly acknowledged sign of Vitamin B12 deficiency is pernicious anemia,
caused by the production of large, immature red blood cells. Many other problems can be
associated with Vitamin B12 deficiency though, including heart disease, diarrhea, mental
disturbances and various other nervous system dysfunctions. Chronic Vitamin B12
deficiency results in severe and permanent nerve damage.

Signs and symptoms

• Anemia

• Fatigue or exhaustion

• Heart disease

• Paraesthesia (pins & needles)

• Diarrhea

• Depression and dementia (especially in the elderly)

• Nerve damage

Absorption of vitamin B12

• Vitamin B12 is absorbed best in the presence of several other vitamins, namely Vitamins A,
C, E and the other B-complex vitamins. It is therefore best taken as part of a balanced multi-
mineral and vitamin supplement.

• Certain medical conditions can affect the absorption of vitamin B12 making a person prone
to vitamin B12 deficiency. Those who lack the nutrient in their daily diet like vegetarians
won’t be able to take in vitamin B12 since they’re diet strictly include vegetables only which
lack cobalamin

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Factors affecting absorption of vitamin B12

• Another factor that can affect the absorption of vitamin B12 is improper digestion of food
proteins. When this happens, gastric acid isn’t properly released by the body during
digestion.

• Absorption can also fail when there are no intrinsic factors present. Intrinsic factors aid in the
formation of IF-cobalamin complex and without them, no absorption will take place. This
can lead to vitamin B12 deficiency and eventually fall to anemia or gastrectomy.

Food sources

• The best sources of vitamin B12 are poultry, fish, eggs, and dairy products. They can supply
the body with adequate amount of the said vitamin daily. Meanwhile, vegetarians can eat
fortified foods with vitamin B12 or similar brands containing nutritional yeast or soy. These
can help them prevent deficiency even though they have a purely vegan diet.

MINERALS

MAJOR MINERALS

SODIUM

Function

 It is a principal electrolyte in the extracellular fluid

 Primary regulator of the extracellular fluid volume
 Helps maintain acid-bas balance
 Essential to muscle contraction and nerve transmission.

Toxicity

Too mucc sodium however can contribute to high blood pressure, hypertension, heart diseases,
cerebral haemorrhage, hypertension related stroke.

CHLORIDE

Function

 Chloride ion is the major negative ion of the extracellular fluid

 It’s also critical to maintaining fluid, electrolyte and acid base balance in the body.
 Chloride is part of the hydrochloric acid (HCl) in the stomach, which maintains the strong
acidity of the gastric fluids

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Food source

The major source is salt

POTASSIUM

Functions

 Principal positively charged intracellular ion

 Maintains fluid and electrolyte balance and cell integrity.
 Keeps heart beats steady (sudden death that occurs in diarrhea and children with kwashiorkor
or people with eating disorders and likely due to heart failure caused by potassium lost)

Deficiency signs and symptoms

 Increased blood pressure  Bone weakness

 Salt sensitivity  Glucose intolerance.
 Kidney stone  Muscle weakness
CALCIUM

Calcium is an essential bulk mineral. Approx 99% of the body’s calcium is found in the bones
and teeth and approx 1% is found in the teeth.

Importance of calcium in the body

• Calcium salts provide rigidity to the skeleton

• Essential for the transmission of information along the nerves
• Used in contraction of the muscles
• Maintaining body health, normal growth and development
• Keeping teeth and bones strong and healthy
• Helps in blood clotting
• Regulating blood pressure

Calcium deficiency

Some of the signs and symptoms of calcium include skeletal abnormalities such as osteopenia,
osteomalacia, osteoporosis and rickets.

1. Rickets

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Signs of rickets include:

• Bow like legs

• Beaded ribs
• Large fore-heads
• Sunken chest
• Hyper-extendable joints

Other signs and symptoms include the following:

• Insomnia
• Tetany (Tetany is a medical sign consisting of the involuntary contraction of muscles,
which may be caused by disease or other conditions that increase the action potential
frequency. Muscle cramps that are caused by the disease tetanus are not classified as
tetany)
• Premenstrual cramps
• Hypertension
• Premature births
• Cancer e.g. colon and breast cancer

2. Osteomalacia

It is defined as softening of bone, particularly in the sense of bone weakened by demineralization

(the loss of mineral) and most notably by the depletion of calcium from bone.
Osteomalacia may be caused by poor dietary intake or poor absorption of calcium and other
minerals needed to harden bones. Osteomalacia is a characteristic feature of vitamin D
deficiency in adults.
3. Osteoporosis
It is defined as reduced bone density ant its more common in women than men. There mainly
three types of osteoporosis i.e. primary osteoporosis or post-menopausal osteoporosis especially
in women, senile osteoporosis in adults above 75 years and secondary osteoporosis that can
affect any age group is mainly due to an underlying condition.

Estrogen is a major female hormone that improves your body's ability to absorb calcium from
your digestive tract. Estrogen also helps maintain calcium levels in your skeleton. Menopausal
women and women who do not produce sufficient estrogen can suffer from decreased bone
density because lack of estrogen impairs calcium absorption, resulting in resorption from the
skeleton to meet the body's calcium needs.

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Osteoporosis is the breakdown of bone tissue. It is caused by the body's inability to maintain and
utilize calcium. Estrogen helps to strengthen bone and maintain the necessary amounts of
calcium to keep bones healthy. When a woman reaches menopause, estrogen production is
reduced. Hormone replacement therapy is prescribed to help keep bone density at normal levels
by decreasing the amount of calcium that is lost. Estrogen in adequate amounts is necessary to
maintain healthy bones and tissue and can prevent bone loss.

Calcium absorption

Ingested calcium mixes with digestive juice in the proximal small intestine from where it is
absorbed by a process, which has an active saturable component and a diffusion component.

At low calcium intakes calcium is mainly absorbed by active (trans-cellular) transport, but at
higher intakes an increasing proportion of calcium is absorbed by simple (para-cellular)
diffusion. The unabsorbed component appears in the faeces together with the unabsorbed
component of digestive juice calcium known as endogenous faecal calcium. Thus, the faeces
contain unabsorbed dietary calcium and un-reabsorbed digestive juice calcium.

Factors that facilitate Ca absorption include:

• Vitamin D and vitamin K

• Hydrochloric acid in the stomach
• Small amounts of fat (high fat reduces the availability of Ca)
• Mg and hormones including the parathyroid and estrogen
• Phosphorus

Factors that inhibit Ca absorption

• Pancreatic insufficiency
• Celiac disease
• Chronic intestinal infections such as worms
• Caffeine
• High fiber diets
• Oxalic acid
• Phytates found in legumes and cereals. Can be reduced by baking, sprouting and
fermentation
• Excessive amounts of fat
• Alcohol

Food sources

• Dairy products, Legumes and Leafy green vegetables

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PHOSPHORUS

Functions of phosphorus

• Essential component of bones and teeth

• Essential part of cell membranes
• Required to activate b-complex vitamins
• Required for all major biochemical path ways in the body such as energy production, cell
division among others
• Contributes to the function of many enzymes
• Needed to enable communication between cells

Phosphorus deficiency

Phosphorus deficiency is rare but it may be precipitated by severe medical conditions

Symptoms and signs include the following:

• Osteomalacia • Speech problems

• Loss of appetite • Increased susceptibility to infection
• Debility • General body weakness
• Anemia • Lack of energy
• Mental confusion
Sources of dietary phosphorus

• Nuts, meat, fish, cheese, soy products and whole grains.

MAGNESIUM

Functions of magnesium

• A co-factor of many enzymes involved in energy metabolism, protein synthesis, RNA and
DNA synthesis, and maintenance of the electrical potential of nervous tissues and cell
membranes.
• Contraction and relaxation of muscles
• Production of protein
• Production and transport of energy

Food sources

Most dietary magnesium comes from DGLV, fruits, bananas, avocadoes, dried apricots, nuts,
legumes, soy products, whole grains such as rice and millet.

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Populations at risk

Mg deficiency is more common individuals who abuse alcohol or those who absorb less Mg due
to the following: Burns, certain medications, low levels of calcium and surgery.

Magnesium deficiency

Symptoms due to lack of magnesium have three categories

Early symptoms: Anorexia, Apathy, Confusion, Fatigue, Insomnia, Irritability, muscle twitching,
poor memory and reduced ability to learn

Moderate deficiency symptoms: Cardiovascular changes such as rapid heartbeat.

Severe deficiency: Delirium, numbness, hallucinations, tingling

Magnesium absorption

Magnesium absorption appears to be greatest within the duodenum and ileum and occurs by both
passive and active processes.

Factors that affect Mg absorption

 High intakes of dietary fibre (40-50 g/day) lower magnesium absorption

 Consumption of phytate- and cellulose-rich products (usually containing high
concentrations of magnesium)
 High intakes of zinc (142 mg/day) decrease magnesium absorption

SULPHATE

It is an oxidized form of sufur as in food and water.

Sulfur containing amino acids helps to shape strands of protein.

The particular protein shape enables it perform its job, such as enzymes that work on skin, hair
and nail

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TRACE MINIRAL

IRON

Functions of iron

• Serves as a carrier for oxygen from the lungs to the tissues: Most of the iron in the body is
present in the RBCs as Hb. The structure of hemoglobin allows it to be fully loaded with
oxygen in the lungs. The iron-containing oxygen storage protein in the muscles, myoglobin,
is similar in structure to hemoglobin but has only one heme unit and one globin chain

• Its transport medium for electrons in the cells. Several iron containing enzymes such as the
cytochromes also have one heme group and one globin protein chain and act as electron
carriers within the cell and their structures do not permit reversible loading and unloading of
oxygen. Their role in the oxidative metabolism is to transfer energy within the cell and
specifically in the mitochondria.

• Iron is an integrated part of important enzymes in various tissues for example cytochrome
plays a role in the oxidative metabolism is to transfer energy within the cell and specifically
in the mitochondria. Other key functions for the iron-containing enzymes (e.g., cytochrome
P450) include the synthesis of steroid hormones and bile acids; detoxification of foreign
substances in the liver; and signal controlling in some neurotransmitters, such as the
dopamine and serotonin systems in the brain.

• Iron is required in the production of red blood cells in a process known as haemotopoiesis

• The immune system is dependent on iron for its efficient functioning. Iron is necessary for
immune cell proliferation and maturation particularly of the lymphocytes associated with the
generation of a specific response to infection.

• Iron is particularly important for mental growth and physical development especially in
childhood and pregnancy where the fetus solely depends on its mother’s iron supplies

Basal iron losses

Iron is not actively excreted from the body in urine or in the intestines. Iron is only lost with cells
from the skin and the interior surfaces of the body - intestines, urinary tract, and airways.
Bleeding contributes to further loss of iron which is why women have a higher demand for iron
than men.

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Iron absorption

There are two kinds of dietary iron: heme iron and non-heme iron. The primary sources of heme
iron in the diet are the hemoglobin and myoglobin from consumption of meat, poultry, and fish
whereas non-heme iron is obtained from cereals, pulses, legumes, fruits, and vegetables. Heme
iron is more easily absorbed compared to non-heme iron

Factors that influence iron absorption

 Iron status of the client

 Amount and type of dietary iron in the diet
 Content of calcium in meal (e.g., milk, cheese)
 Food preparation (time, temperature)
 Ascorbic acid found in fruits and vegetables
 Phytates e.g. bran products, bread made from high-extraction flour, breakfast cereals, oats,
rice [especially unpolished rice], pasta products, cocoa, nuts, soya beans, and peas)
 Iron-binding phenolic compounds (e.g. tea, coffee, cocoa, certain spices, certain vegetables,
and most red wines)
 Calcium (e.g., milk, cheese)

Iron balance and regulation of iron absorption

The body has three unique mechanisms for maintaining iron balance and preventing iron
deficiency and iron overload. The first is the continuous re-utilization of iron from catabolised
erythrocytes in the body. When an erythrocyte dies after about 120 days, it is usually degraded
by the macrophages of the reticular endothelium. The iron is released and delivered to transferrin
in the plasma, which brings the iron back to red blood cell precursors in the bone marrow or to
other cells in different tissues. Uptake and distribution of iron in the body is regulated by the
synthesis of transferrin receptors on the cell surface. This system for internal iron transport not
only controls the rate of flow of iron to different tissues according to their needs but also
effectively prevents the appearance of free iron and the formation of free radicals in the
circulation.

The second mechanism is the access of the specific storage protein, ferritin, which can store and
release iron to meet excessive iron demands. This iron reservoir is especially important in the
third trimester of pregnancy.

The third mechanism involves the regulation of absorption of iron from the intestines, with
increased iron absorption in the presence of decreasing body iron stores and decreased iron
absorption when iron stores increase. Iron absorption decreases until equilibrium is established
between absorption and requirements. For a given diet this regulation of iron absorption,
however, can only balance losses up to a certain critical point beyond which iron deficiency will

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develop. About half of the basal iron losses are from blood, primarily in the gastrointestinal tract.
Both these losses and the menstrual iron losses are influenced by the hemoglobin level; during
the development of an iron deficiency, menstrual and basal iron losses will successively decrease
when the hemoglobin level decreases. In a state of more severe iron deficiency, skin iron losses
may also decrease. Iron balance (absorption equals losses) may be present not only in normal
subjects but also during iron deficiency and iron overload.

Iron deficiency anemia (IDA)

This is an advanced stage of iron deficiency. Iron deficiency is defined as a low level of iron in
the body i.e. below 15µg. Iron is stored in the body as ferritin. When the body has sufficient iron
to meet the physiological needs of the body, the remainder is stored for later use in all the cells,
but most especially in the bone marrow, liver and spleen. These stores are known as ferritin
stores. Ferritin stores carry approximately 4500 iron atoms.

Signs and symptoms of iron deficiency anemia

Fatigue, general body weakness, fainting, increased susceptibility to infection, swelling of the
tongue, glossitis (an inflamed tongue), pallor i.e. reduced oxy-hemoglobin in the skin or mucous
membranes, dyspnea i.e. difficulty in breathing, anxiety often resulting in OCD, irritability,
angina, depression, twitching of the muscles, numbness or burning sensation, angular cheilitis
(inflammatory lesions at the mouth’s corner and poor appetite

Populations at risk

• Young children and pregnant women are at higher risk of iron deficiency because of rapid
growth and higher iron needs.
• Adolescent girls and women of childbearing age are also at risk due to menstruation.

Dietary sources of iron

• Meat, milk, eggs, DGLV, beans, dried fruits, legumes, liver and whole grains

IODINE

Functions of iodine

 Synthesis of thyroid hormone by the thyroid gland

 Development of proper functioning of the brain and nervous system

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Deficiency of iodine

Effects during the fetal stage

• Abortions • Increased perinatal mortality

• Still births • Increased infant mortality
• Congenital abnormalities
• cretinism: mental deficiency, deaf-mutism, spastic diplegia, squint (eyes don’t look in the
same direction) and dwarfism
• Psychomotor defects

Effects on neonate

• Neonatal goitre
• Neonatal hypothyroidism

Children and adolescents

• Goitre
• Retarded physical development
• Impaired mental function
• Juvenile hypothyroidism

Adults

• Goitre with it complications

• Impaired mental function
• Hypothyroidism

Populations at risk

Iodine deficiency affects all stages of human life, from the intra-uterine stage to old age.
However, pregnant women, lactating women, women of reproductive age, and children younger
than 3 years are considered to be at high risk. During fetal and neonatal growth and development,
iodine deficiency leads to irreversible damage to the brain and central nervous system.

Causes of iodine deficiency

• Low dietary iodine

• Selenium deficiency
• Pregnancy

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• Increased intake of goitrogens (Goitrogens are substances that suppress the function of the
thyroid gland by interfering with iodine uptake)
• Gende r(higher occurrence in women)
• Alcohol
• Tobacco
• Age

Dietary sources

The iodine content of food depends on the iodine content of the soil in which it is grown. The
amount of iodine in food therefore varies with geographic location.

Sources of iodine include

Salt, vegetables, cereals, milk, eggs, fruits, legumes and sea food

ZINC

Functions of zinc in the body

• Its needed by the body's immune system to function properly

• Plays a role in cell division and cell growth
• It also helps during wound healing
• Needed for digestive enzyme formation
• Vitamin A metabolism
• Normal development of male organs
• Antioxidant
• Component of insulin
• It’s essential in the breakdown of carbohydrates, lipids and proteins
• Zinc is also needed for the sense of smell and taste

Food sources

Animal sources, meat liver, fish, poultry, eggs, milk, yoghurt, sea foods including shell fish and
oysters

Plant sources, cabbage, carrots, spinach, beets, green peas, legumes, burley, whole grains,
cereals, peanuts

Zinc absorption

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Zinc absorption occurs throughout the small intestine. Zinc administered in aqueous solutions to
fasting subjects is absorbed efficiently (60-70 percent), whereas absorption from solid diets is
less efficient and varies depending on zinc content and diet composition. Zinc is lost from the
body through the kidneys, skin, and intestine. The endogenous intestinal losses can vary from7
mmol/day (0.5 mg/day) to more than 45 mmol/day (3 mg/day), depending on zinc intake.
Urinary and skin losses are of the order of 7-10 mmol/day (0.5-0.7 mg/day) each and depend less
on normal variations in zinc intake. Starvation and muscle catabolism increase zinc losses in
urine.

Factors that affect zinc absorption

• The amount and form of zinc consumed

• Dietary factors such as phytates and animal protein
• Physiological state of individual such as lactation, pregnancy and early infancy

Populations at a risk

The central role of zinc in cell division, protein synthesis, and growth makes infants, children,
adolescents, and pregnant women especially at risk for an inadequate zinc intake. Zinc-
responsive stunting has been identified in several studies, and a more rapid body weight gain in
malnourished children supplemented with zinc.

Zinc deficiency

Symptoms of zinc deficiency include

• Frequent infections • Problems with sense of taste and smell

• Hypogonadism in males • Skin sores
• Loss of hair • Slow growth
• Poor appetite • Wounds that take a long time to heal
Effects of large intake of zinc intake

• Diarrhea • Vomiting
• Abdominal cramps

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SELENIUM

Functions

 It’s an antioxidant, prevents oxidation and breakdown of fat and other body cells.
 Works primarily as part of protein, notably, enzyme glutathione peroxidase
 Are necessary for proper functioning of the iodine-containing thyroid hormones that
regulates metabolism.

Deficiency

It’s associated with heart diseases in children and young women living in in regions of china
where soil/foods lacks selenium (“KESHAN DISEASE”)

Sign and symptoms

 Weakness  Impaired growth

 Pancreatitis  Impaired hearing
Toxicity

Vomiting, diarrhea, loss of hair and nail, lesion of skin and nervous system.

COPPER

Functions

 Constituent of enzyme
 Catalyze formation of haemoglobin
 Manufacture protein collagen
 Healing of wounds
 Maintain sheaths around nerve fibers.
 Help cell use ions.

Deficiency

Rare but seen in premature and malnourished infants

NB high intake of zinc interfere with absorption on copper

Food source

Legumes, whole grains, sea foods, nuts and seeds

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MANGANESE

Function

 It’s contained in bones and metabolically active organs such as liver, kidneys and pancrease.
 Co-factor for many enzymes

Food sources

Nuts, green leafy vegetables and whole grains.

FLUORIDE

Functions

 Protection of bone and dental tissues protection against tooth decay

 Wound healing

Food source

Fish and seawed bone meal, meat, and dairy products, grains, vegetables and nuts.

Deficiency sign and symptoms

 Dental caries

WATER

Water is constitutes about 60% of an adults body weight and higher percentages of a child’s.

Every cell in the body is bathed in a fluid of the exact composition that is best for that cell.

Functions/roles of water in the body

 Carries nutrients and wastes products throughout the body

 Maintain structures of large molecules such as proteins and glycogen
 Participates in metabolic reactions
 Serves as a solvent for minerals, vitamins, amino acids, glucose and many other small
molecules
 Maintain blood volume
 Aids in regulation of normal body temperature, as the evaporation of sweat from skin
removes excess heat from the body

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 Acts as a lubricant and cushion around joints and inside the eyes, spinal cord and amniotic
sac

NB:

To support these functions, the body regulates its water balance.

Recommended amount of water depends on food eaten, environmental temperature, humidity,

person’s activity and others.