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beverages (e.g. Boost Plus, Ensure Plus)
Single
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Vitamin B12 (cobalamin)
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Red blood cell formation, neurological function, and DNA synthesis
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Megaloblastic anaemia, fatigue, weakness, loss of appetite, weight loss, neurological symptoms
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Impaired intestinal absorption from atrophic gastritis or pernicious anaemia
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Milk products, meat, fish, poultry, eggs
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Some cereals
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MVMs, single, B‐complex
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After age 50, the chemical form found in supplements or fortified foods is recommended, as it is better absorbed than the protein‐bound food form
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Folic acid (folate)
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Coenzyme or cosubstrate in single‐carbon transfers in the synthesis of nucleic acids (DNA and RNA) and metabolism of amino acids
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Megaloblastic anaemia, weakness, fatigue, difficulty concentrating, irritability, headache, heart palpitations, shortness of breath
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RDA does not change after age 19
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Vegetables (especially dark green leafy vegetables), fruits and fruit juices, nuts, beans, peas, seafood, eggs, milk products, meat, poultry, grains
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Grains, cereals
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MVMs, single, B‐complex
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Folic acid in fortified foods and supplements is better absorbed than food folates
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Iron
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In haemoglobin, myoglobin, and numerous enzymes and protein; required for growth, neurological development, and synthesis of some hormones
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Iron deficiency causes in late stages microcytic anaemia that should be distinguished from microcytic anaemia of chronic disease, exercise
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RDA decreased for women after age 50; menopausal cessation of menstrual bleeding leads to lower requirement for iron
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Heme iron in meat, poultry, fish, non‐heme in nuts, beans, vegetables, fortified grain products
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Grains, cereals
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Single, MVMs at low levels in products formulated for older adults
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Heme iron from muscle foods is more bioavailable than non‐heme iron; vegetarians and vegans have higher requirement for iron because of low availability of iron in plant‐based diets
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Magnesium
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Cofactor in >300 enzymes, e.g. for protein synthesis, muscle and nerve function, blood glucose control, and blood pressure regulation
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Numbness, tingling, muscle contractions and cramps, seizures, abnormal heart rhythms, coronary spasms; signs of severe deficiency are hypocalcemia or hypokalemia
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RDA increases at age 31; intestinal absorption decreases and renal excretion increases with age
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Yesa, b
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Many plant and animal foods, e.g. green leafy vegetables, legumes, nuts, seeds, and whole grain
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Some grains, cereals
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Some MVMs, single, complex e.g. with ‘bone’ health nutrients
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In some laxatives, e.g. Phillips’ Milk of Magnesia and some products for indigestion, e.g. Extra‐strength Rolaids
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Niacin (vitamin B3)
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Niacin as nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NDP) are coenzymes in oxidation‐reduction reactions
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Severe deficiency disease is pellagra, with symptoms of dermatitis, diarrhoea, neurologic deficits, including cognitive decline
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RDA does not change after age 19
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Meat, fish, poultry, legumes, whole grains
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Grains, cereals
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MVMs, single, B‐complex
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Dietary tryptophan can be metabolized to niacin; foods rich in tryptophan (e.g. dairy products) can compensate for inadequate dietary niacin
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Potassium
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The major intracellular cation, required for normal cellular function
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Severe deficiency is hypokalemia with cardiac arrhythmias, muscle weakness, glucose intolerance
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AI does not change after age 19
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Yesa
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Dark green leafy greens, fruits, vegetables
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A food additive in some processed foods; typically not added for nutritional benefits
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Less than 100 mg in over‐the‐counter supplements
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Amount in supplements is low to help avoid interactions with medications that alter potassium retention or excretion
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Pyridoxine (vitamin B6)
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More than 100 enzymes, mainly in metabolism of one‐carbon units, protein, carbohydrates, lipids, neurotransmitters, immune function, haemoglobin, and maintaining normal homocysteine levels
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Microcytic anaemia, EEC abnormalities, dermatitis, glossitis, depression, confusion, low immunity
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RDA higher for adults after age 50
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Fish, poultry, meat, some beans, fruits and vegetables, especially chickpeas, bananas, and potatoes
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Grains, cereals
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MVM, single, B‐complex
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Riboflavin (vitamin B2)
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In coenzymes flavin‐mononucleotide (FMN) and flavin‐adenine dinucleotide (FAD)
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Skin disorders particularly, lips, mouth, throat, degeneration of liver and nervous system
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RDA does not change after age 19
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Yesb
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Milk products, eggs, meat, poultry, fish, green vegetables
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Grains, cereals
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MVMs, single, B‐complex
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Selenium
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Selenoproteins involved in reproduction, thyroid hormone metabolism, DNA synthesis, and protection from oxidative damage and infection
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Severe deficiency diseases in specific geographical regions (e.g. China, Tibet, Siberia) are Keshan (cardiomyopathy) and Kashin‐Beck (osteoarthritis)
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RDA does not change after age 19
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Yesb
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Breads, grains, meat, poultry, fish, and eggs
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Some meal‐replacement beverages (e.g. Boost Plus, Ensure Plus)
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MVMs, single
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Food and/or supplement forms are bioavailable and include selenomethionine, selenium‐enriched yeast, selenite, selenate
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Thiamin (vitamin B1)
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Coenzyme for metabolism of carbohydrates and branched‐chain amino acids
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Severe deficiency is beriberi, which involves peripheral neuropathy and wasting; also Wernicke‐Korsakoff syndrome associated with chronic alcoholism
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RDA does not change after age 19
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Yesb
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Meat, fish, poultry, legumes, nuts, seeds
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Grains, cereals
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MVM, single, B‐complex
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Vitamin A
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Immune function, vision, reproduction, and cellular
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