Nutrients/Supplements 101 Flashcards

1
Q
  1. List five, relatively common reasons as to why someone may not get all the nutrition their body needs to run optimally.
A

● High intake of process/refined foods. These present lower opportunities for nutrition simply because processing has removed or damaged nutrients e.g. canned/sweetened apple juice instead of a whole apple, french fries instead of whole, russet potatoes. More atypically, someone may simply not consume enough food overall and will actually struggle with insufficient macronutrients or calories in aggregate.
● Insufficient dietary variety. Even for those choosing healthy, whole foods, this might include those who consciously choose a more limited diet (e.g. zinc for vegans, protein for raw foodists, essential fats for fruitarians, antioxidants for Atkins enthusiasts)
● The nutrient drain. Even with a diverse diet, the level of nutrition in whole foods is much less than it once was. This is especially true for minerals, such as magnesium. The use of fertilizers can also dilute the concentration of nutrients present in a serving of food.
● Maldigestion. Without adequate digestion (e.g. stomach acid, digestive enzymes, bile), nutrients cannot be isolated from foods to allow for absorption, and nutrients are lost in the stool.
● Malabsorption. Damage to the intestinal lining (e.g. parasite infection, yeast overgrowth, SIBO) can impair nutrient absorption (even if there is adequate digestion) e.g. essential fats and fat-soluble vitamins.This may also be due to frequent/chronic diarrhea or other causes of fast transit time (poor eating hygiene, anxiety, lactose intolerance, fructose intolerance).
● Genetics cause a need for more nutrition. There are many genetic variations that drive the need for more nutrition, perhaps due to poor uptake or retention of certain nutrients or impaired enzyme function that requires a certain nutrient (e.g. MTHFR requiring more folate, GSTP requiring more glutathione support (e.g. selenium, alpha lipoic acid, NAC), MTR/MTRR requiring more Vitamin B12)
● Lifestyle/Disease causes a need for more nutrition. Certain disease states and lifestyle choices require a need for higher levels of certain nutrients in order to retain optimal (or even acceptable) functioning (e.g. magnesium for insulin resistance, thiamine (B1) for
high/daily alcohol intake, B vitamins for high-stress states, more water for low humidity climates, lower carbohydrate or ketogenic diet for those struggling with seizures, more antioxidants for smokers)
● Medication causes a need for more nutrition. Certain medications impair the body’s ability to make or use a certain nutrient or increase the body’s need for specific nutrients (e.g. Vitamin B12 for metformin, CoQ10 for statins, Folate (B9) for methotrexate, magnesium and potassium for diuretics)
● Body structure or post-surgery anatomy causes a need for more nutrition. This includes gastric-bypass or other surgery that creates rerouting of normal, gastrointestinal digestion/absorption routes, especially those which reduce active stomach surface area (impairing production of optimal levels of digestive substances) or intestinal surface area (impairing absorption and also perhaps impairing normal hormonal signaling that triggers release of digestive substances).

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2
Q
  1. Full-spectrum vitamin E includes four tocopherols and four tocotrienols. Vitamin E is a fat-soluble vitamin with strong antioxidant properties. A common, synthetic form of these nutrients included in low-end supplements is l-alpha tocopherol.
A

FOUR TOCOPHEROLS
FOUR TOCOTRIENOLS

L-ALPHA TOCOPHEROL

The presence of the letter “l” is what you should note; this synthetic form is often found in the succinate or acetate or other form.

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3
Q
  1. Name three important and beneficial roles of Vitamin D in the body which were explicitly covered during your SAFM coursework. Acceptable answers include the following:
A

● Help prevent intestinal permeability. Ensure tight junctions between microvilli in the small intestines. Low vitamin D increases the risk of intestinal permeability and the downstream development of inappropriate immune reactions e.g. food sensitivities, chronic inflammation.
● Promote absorption of calcium from the GI tract into the blood.
● Increase immune system strength or responsiveness by promoting greater macrophage activity and increasing the activity of toll-like receptors to engage the innate immune system.
● Help prevent autoimmune disease, especially by increasing T-regulatory cells and promoting an appropriate balance between innate and adaptive immune system reactions.
● As a steroid prohormone Vitamin D affects other hormone levels in the body (e.g. estrogen).
● Vitamin D controls the expression of over 200 genes, including many which may increase predisposition for autoimmune diseases.
● Excessive levels of Vitamin D may be immunosuppressive.

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4
Q
  1. Besides protein (and the essential amino acids we acquire from it), name three nutrients that are most likely to be deficient in those who eat an adequate diet yet have insufficient stomach acid.
A

● Vitamin B12. Which requires the release and binding with intrinsic factor in the stomach to allow intestinal absorption later on in the GI tract.
● Iron. Ditto above. Iron is also one of the most poorly absorbed minerals in the intestinal tract, so maximum availability from digestion further up in the GI tract is important.
● Magnesium. Strong stomach acid is required to separate minerals from their strong bonds with amino acids in our dietary proteins.
● Zinc. Or other key minerals such as selenium or copper.

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5
Q
  1. Vitamin D, Vitamin K2, and Magnesium are three nutrients which are at least as important as
    calcium for long-term bone density retention.
A

Adequate protein intake and digestion are also important for retaining the collagen structure of bone (for flexibility) into which the minerals fit (for strength). Remember that bones are alive and active tissue! Hormones play a critical role in the balance of old bone breaking down and new bone being formed. Both estrogen and progesterone play particularly important roles.

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6
Q
  1. The two omega-3 essential fatty acids found most abundantly in fish oil are EPA (Eicosapentaenoic
    acid) and DHA (Docosahexaenoic acid) . Both can be quite beneficial in supplement form, with higher proportions of EPA likely being the best choice for systemic inflammation (e.g. arthritis) and higher proportions of DHA likely being the best choice for neurological concerns (e.g. dementia, depression). For vegan clients, one of these omega-3s is readily available in algae oil (or algal oil); however, to obtain the other omega-3, conversion will have to be considered (a few high-end brands contain notable levels of both).
A

EPA - EICOSAPENTAENOIC ACID,
DHA- DOCOSAHEXAENOIC ACID

EPA - SYSTEMIC INFLAMMATION - ARTHRITIS
DHA - NEUROLOGICAL CONCERNS - DEMENTIA, DEPRESSION

AVAILABLE IN ALGEA OIL

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7
Q
  1. Name four factors/circumstances that may cause nutritional supplements to be poorly absorbed in the gut and thus less available to the body for benefits.
A

● Gastrointestinal disease that impairs nutrient absorption through the intestinal lining e.g. celiac disease, candida/parasite, Crohn’s disease.
● Impaired digestion, in particular low stomach acid, but also perhaps insufficient digestive enzymes or bile e.g. those who use PPI acid-suppressing medications, those who have had gastric bypass surgery, those without a gallbladder, those with low enzyme output e.g. some Type 2 diabetes patients.
● Supplements formulated with binders, especially magnesium stearate. Fillers such as this are used in order to improve “flow” within a manufacturing line and allow the equipment to be used at a faster production rate.
● Taking supplements with binding substances from foods/beverages e.g. tannins from tea, oxalates from spinach/chard, phytates from quickly-prepared whole grains.
● Taking supplements in tablets vs. capsules, liquid, or loose powder form. In addition to the presence of binding agents (as above), tablets are highly compressed to prevent breakdown in the bottle. These require particularly strong digestive action in order to dissolve and in some cases can pass through the GI tract partially intact and unabsorbed.
● Taking supplemental nutrients at once that compete for absorption e.g. calcium blocks iron absorption, zinc and copper compete for absorption, several essential amino acids compete for absorption.

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8
Q
  1. Your clients/patient which struggles with constipation, headaches, anxiety, and/or muscle
    cramps may have a need for supplemental magnesium.

A common side effect of taking too much of
this supplement is diarrhea (over-urination is possible too). This supplement is contraindicated in people who have kidney (renal) failure to any degree. A particularly well-absorbed form of this
nutrient that can alleviate constipation is Magnesium citrate.

A

MAGNESIUM
TOO MUCH PRODUCE DIARRHEA, (OVER-URINATION, POSS, TOO)

CONTRAINDICATED- KIDNEY (RENAL) FAILURE TO ANY DEGREE

MAGNESIUM CITRATE- CONSTIPATION

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