E7. Micronutrients Flashcards

(34 cards)

1
Q

what are micronutrients?

A

Substances required in small amounts for normal metabolism but which cannot be synthesised by the body in sufficient quantities.

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2
Q

what is the major division of micronutrients based on solubility?

A
  • fat soluble (ADEK)
  • water soluble (Bs,C)
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3
Q

Vitamin deficiencies?

A

-Vit A- impaired night vision
-Vit D- impaired calcium absorption and bone mineralisation
-Vit C- breakdown of connective tissue (Scurvy)
-Vit B12- megaloblastic anaemia
-Vit K- haemorrhagic disease

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4
Q

Vitamins and their sources?

A

ONE NOTE

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5
Q

Describe vitamin A

A

RNI: 600-700mg/day
Sources:
Dairy fat, eggs, liver, fatty fish, carotene in veg

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6
Q

How is vitamin D (cholecalciferol; D3) formed?

A

-Formed in skin by action of UV light on 7-dehydrocholesterol
-Pre-cursor of 1,25-dihydroxycholecalciferol (1,25-DHCC)
(also known as calcitrol)
-Produced in kidney, regulated by parathyroid hormone
-Calcitrol acts on nuclear receptors
-Stimulates gene synthesis of Ca2+ binding protein to increase Ca2+ absorption from GIT
-Enhances Ca2+ reabsorption from kidney

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7
Q

Sources of vitamin D

A

> 90% of vitamin D supply is derived from ultraviolet B light
-Oily fish including trout, salmon, mackerel, herring, sardines, anchovies, pilchards, and fresh tuna
-Cod liver oil and other fish oils
-Egg yolk
-Supplemented breakfast cereals, mainly supermarket “own brands” in the UK
-Margarine and infant formula milk

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8
Q

Vitamin D requirements?

A

-Fair skinned person: 20 minutes to 30 minutes of sunlight exposure on the face and forearms at midday 2-3 times per week should generate enough vit D in summer in UK.
-Darker skin & elderly: need increased exposure or frequency (2 to 10 fold).
-BUT, 6 months of year, 90% of UK UVB levels too low for vit D synthesis.
-Require dietary sources

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9
Q

Vitamin D deficiency leads to?

A

Rickets (increase in cases), osteoporosis
Also link to:
CVD
Diabetes (1 & 2)
Bowel cancer
Breast cancer

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10
Q

Risks of vitamin D deficiency?

A

-Caused mainly by poor exposure to sun.

-Living in Northern Latitudes
-Clothing- no exposure of skin to sunlight
-Working indoors
-Not being able to get outside
-Poor nutrition or absorption

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11
Q

Describe vitamin E

A

-Safe intake 3-4 mg/day
-Antioxidant (readily oxidised)
-Prevents damage to phospholipids

-Sources:
Vegetable oils, whole grain cereals, green leafed veg, seeds, nuts, eggs

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12
Q

Describe how vitamin K works

A

-Safe Intake 1mg/kg/day
-Required for posttranslational modification of prothrombin and clotting factors VII, IX and X
-NB warfarin blocks vit K reductase

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13
Q

what are the sources and deficiency related to vitamin K?

A

-Sources:
Liver, green leafy veg, some veg oils, milk
-NB interaction with warfarin
-Deficiency:
New born- possibility of haemorrhage.
-All new born given vit K.

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14
Q

Describe vitamin B12

A

-RNI 1.5 mg/day
-Sources:
Meat, fish, eggs, fermented foods.
-Deficiency:
Megaloblastic anaemia; degeneration of spinal cord
-Risk:
Vegan diet, poor absorption eg pernicious anaemia- inadequate production of Intrinsic Factor required for GI uptake

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15
Q

Describe folic acid

A

-RNI 200mg/day (non-pregnant)
-Sources:
Green leafy vegetables, liver
-Deficiency:
Megaloblastic anaemia; neural tube defects
-Risk:
Poor diet, malabsorption, phenytoin

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16
Q

Vit B12 and Folate Pathways?

17
Q

Folic acid deficiency?

A

-Deficiency effects cells in which there is high turn over of DNA
eg red blood cells
-Megaloblastic anaemia- large, immature blood cells
-Pernicious anaemia- impaired uptake of vit B12.
-Development of spinal cord (myelin as well)

18
Q

Describe Thiamin(e) (vit B1)- RNI, sources and risk

A

-Thiamin(e) (vit B1) required for metabolism
-RNI 1mg/day
-Sources:
Fortified breakfast cereals, fortified flour, wholegrain, pulses, vegetables, milk
-Risk:
Poor diet, alcoholics, refined flour

19
Q

Describe Thiamin(e) (vit B1) deficiency

A

-Poor metabolism of carbohydrate, accumulation of pyruvate
-Reduced lipid and myelin biosynthesis.
-Beriberi- effects on sensory and motor nerves, muscle wasting, paralysis

20
Q

Thiamine in metabolism?

21
Q

Describe nicotinic acid/ niacin(vit B3)- RNI, sources, deficiency, risk

A

-Required for metabolism
-RNI 17mg/day
-Sources:
Meat, cereals, fish
-Deficiency:
Pellagra- dermatitis, diarrhoea, dementia (eventually death)
-Risk:
Poor diet, alcoholics,

22
Q

Describe Vitamin C (Ascorbic acid)- RNI, sources, deficiency and risk

A

-RNI 40mg/day
-Sources: Fruit, salad & leafy veg.
-Deficiency: Scurvy
-Risk: Poor diet

23
Q

role of vitamin C?

A

-Antioxidant
-Required for proline hydroxylase.
Converts proline to hydroxyproline- required for collagen

24
Q

what is scurvy?

A

-bleeding gums, loose teeth, leaky blood vessels, impaired wound healing.
-Caused by impaired synthesis of collagen

25
other vitamins?
-Vit B2 -Vit B6 -Biotin -Pantothenic acid
26
minerals and trace elements?
one note
27
Describe calcium- RNI, sources, deficiency and risk
-RNI 700mg/day (pint of milk) -Sources: Milk & milk products, fish (esp. if bones eaten), green veg, pulses, supplemented flour -Deficiency: Long term- osteoporosis -Risk: Poor diet (vit D & low intake)
28
how much calcium do adults contain and what is it needed for?
-Adults contain approx. 1.2kg -Needed for: Bones (99%) Cell signalling Muscle function -Calcium laid down in bones by early-mid 20s -After menopause, calcium balance in bones becomes negative -Impairment of calcium absorption eg coeliac disease
29
Long-term use of Corticosteroids effects?
-Long-term use of Corticosteroids increase risk of osteoporosis (bone demineralisation). -Patients may require calcium supplement (up to 1500mg/day). -Also, reduced uptake in GI disease. eg Crohn’s Disease/ Coeliac disease -Increased risk of osteoporosis, therefore patient requires increase in calcium intake.
30
Describe iron- RNI, sources, deficiency and risk
-RNI 8.7mg/day (M), 14.7mg/ day (F) -Sources: Meat, fish, cereals, green veg., -Deficiency: Anaemia -Risk: Chronic blood loss, vegetarian diet low in iron
31
Iron role in metabolism?
-Component of haemoglobin, myoglobin, and enzymes. -Mostly stored as ferritin
32
Iron role in absorption?
-Haem iron absorbed better than non-haem iron. -Vitamin C aids absorption -calcium & tea inhibit absorption
33
Symptoms of iron deficiency?
-Anaemia –Fatigue, restlessness, impaired performance, thermoregulation, immunity. -Common in infants, preschool children, adolescents and women of childbearing age (menstruation) -Most common micronutrient deficiency in the world.
34
Describe vitamin/ mineral supplements
-Shouldn’t be required with healthy, balanced diet -Can cause toxicity. -Be aware of supplements containing high doses. ONE NOTE