Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5990_Библиотеки_им_академика_М_И_Перельмана.pdf
123Nutrition and Health
Sources: Animal products, liver, kidney, meat, eggs, fish,
yeast, milk and cheese. It is also synthesized by bacteria in the
colon.
Functions:
1. It works closely with folate to make red blood cells.
2. It serves as a vital part of many body chemicals and so
occurs in each body cell.
3. It helps our body to use fatty acids and some amino
acids.
Deficiency: Megaloblastic anemia, fatigue, nerve damage, a
smooth tongue, or very sensitive skin.
Daily requirement: The RDA is 2.4 g daily for adults. The
recommendation increases to 2.6 g daily during pregnancy
and 2.8 g during breastfeeding.
Vitamin C (Ascorbic acid)
Sources: Oranges, lemon, grapefruits, guava, amla, berries,
melons, peppers, fresh green and leafy vegetables, and
tomatoes.
Functions:
1. It works as an antioxidant to inhibit damage to body
cells.
2. It helps in the formation of collagen necessary for body
growth, tissue repair, and wound healing.
3. It protects the body from bruising.
4. It helps the body to absorb iron and copper from plant
sources of food.
5. It keeps our gums healthy.
6. It helps in the synthesis of adrenaline and hydro-
cortisone.
7. It protects the body from cold and infection.
Deficiency: Severe deficiency of vitamin C leads to scurvy.
Its deficiency also causes anemia, joint pain, hemorrhages in
the skin, and other hemorrhages.
Daily requirement: The RDA for females and males ages
14–18 is 65 mg/day and 75 mg/day, respectively. Adult males
124 Social Pharmacy
Table 3.2: Major food sources, functions, and deficiency symptoms of water soluble vitamins
Vitamin Major food sources Function Deficiency symptoms
Ascorbic acid Infant formula, citrus fruits, Essential in the synthesis of collagen Scurvy, pinpoint peripheral
(Vitamin C) papaya, strawberries, vege- and thus, strengthens tissues and hemorrhages, bleeding
tables (potatoes, cabbage) improves wound healing and resis- gums, diarrhea
tance to infection; iron absorption
and transport; antioxidant
Thiamin Breast milk; infant formula; Combines with phosphorus to form Beriberi, neuritis, edema,
(Vitamin B
1
) lean pork; wheat germ; thiamin pyrophosphate (TPP) neces- cardiac failure
whole-grain and enriched sary for the metabolism of protein,
bread, cereals, and other carbohydrate, and fat; essential for
grain products; legumes; growth, normal appetite, digestion,
potatoes and healthy nerves
Riboflavin Meat; dairy products; egg Essential for growth; plays enzymatic Photophobia, cheilosis, glos-
(Vitamin B
2
) yolk; legumes; green vege- role in tissue respiration and act as a sitis, corneal vasculari-
tables; whole-grain bread, transporter of hydrogen ions; zation, poor growth
cereals, and fortified or synthesis of FMN and FAD
enriched grain products
Niacin Meat; poultry; fish; whole- Part of the enzyme system for oxida- Pellagra: dermatitis, diarr-
(Vitamin B
3
) grain bread, cereals, and tion, and energy release; necessary hoea, dementia
fortified or enriched grain for the synthesis of glycogen and the
products; egg yolk synthesis and breakdown of fatty
acids
(Contd.)
125Nutrition and Health
Vitamin Major food sources Function Deficiency symptoms
Pyridoxine Liver; meat; whole-grain Aids in the synthesis and breakdown Microcytic anemia;
(Vitamin B
6
) bread, cereals, or other grain of amino acids and unsaturated fatty convulsions; irritability
products; legumes; potatoes acids from essential fatty acids; essen-
tial for conversion of tryptophan to
niacin; essential for normal growth
Biotin Infant formula; liver; meat; Essential component of enzymes; Seborrheic dermatitis;
(Vitamin B
7
) egg yolk; yeast; bananas; important in reactions involving the glossitis; nausea; insomnia;
most vegetables; straw- lengthening of carbon chains;
berries; grapefruit; water- coenzyme carrier of carbon dioxide;
melon plays an important role in the meta-
bolism of fatty acids and amino acids
Cyanocobalamin Meat; fish; poultry; cheese; Essential for biosynthesis of nucleic Pernicious anemia; neuro-
(Vitamin B
12
) egg yolk; liver acids and nucleo-proteins; red blood logic deterioration
cell maturation; involved with folate
metabolism; central nervous system
metabolism
Folic acid Liver; green leafy vegetables; Essential in the biosynthesis of Poor growth; megaloblastic
legumes; whole-grain bread, nucleic acids; necessary for the anemia
cereals, and fortified or normal maturation of red blood cells
enriched grain products;
legumes; oranges; canta-
loupe; lean beef
126 Social Pharmacy
Table 3.3: Recommended vitamins intake for individuals
Age A C D E K Thia- Ribo- Niacin B
6
B
12
Folic Biotin
group (µg/d) C(µg/d) (µg/d) (µg/d) (µg/d) mine flavin (mg/d) (mg/d) (µg/d) acid (µg/d)
(years) (mg/d) (mg/d) (µg/d)
Males
19–70 900 90 5 15 120 1.2 1.3 16 1.3 2.4 400 30
Females
19–70 700 75 5 15 90 1.1 1.1 14 1.3 2.4 400 30
Pregnancy
19–50 770 85 5 15 90 1.4 1.4 18 1.9 2.6 600 30
Lactation
19–50 1300 120 5 19 90 1.4 1.6 17 2.0 2.8 500 35
127Nutrition and Health
need 90 mg daily; adult females, 75 mg of vitamin C daily for
everyday needs (about the amount in 3/4 cup of orange juice).
Women need somewhat more during pregnancy (80 to 85 mg)
and breastfeeding (115 to 120 mg). For people who smoke, the
RDA for vitamin C is increased by 35 mg daily to help
counteract the oxidative damage from nicotine.
Minerals
Several minerals are essential for body functions. They are
classified depending on their dietary requirement.
a. Macrominerals, e.g. calcium, phosphorus, potassium,
sodium, chloride, sulfur, and magnesium.
b. Microminerals (trace elements), e.g. copper, cobalt, chro-
mium, fluorine, iodine, iron, manganese, molybdenum,
nickel, selenium, silicon, tin, vanadium, and zinc.
Minerals may function as co-factors of enzymes, as
components of organic compounds, and as structural
components of bones and teeth and are catalysts for many
biological processes. Minerals may also participate in the
contraction and conduction of nerve impulses.
Macrominerals
Calcium
Sources: Main sources of calcium include milk and milk
products, shellfish, egg yolk, canned sardines and salmon (with
bones), soybeans, and certain green leafy vegetables such as
spinach, turnip and mustard greens, broccoli, and kale. In hard
water areas, drinking water may also be a significant source.
Functions: More than 99% of the calcium is present in bones
and teeth. Calcium is helpful in the mineralization of bones.
The remaining 1% of total body calcium is necessary for a
variety of metabolic processes including enzyme activation,
hormone function, nerve impulse transmission, muscle
contraction, blood clotting, and membrane transport.
Daily requirement: Adult: 800 mg, children: 1500 mg;
pregnancy, lactation, after menopause: 1500 mg.
128 Social Pharmacy
Deficiency: Rickets and osteomalacia. Severe calcium
deficiency in children may also result in stunted growth, muscle
weakness, parathyroid hyperplasia, hyperirritability, tetany,
and death.
Magnesium
Sources: Magnesium occurs widely in foods, particularly those
of plant origin. Sources include green vegetables, cereals,
grains, meat, milk, seafood, cocoa, and nuts. Plasma magne-
sium concentrations range from 2 to 3 mg/dL.
Functions: Magnesium performs a vital role in the enzymatic
reactions involving ATP (adenosine triphosphate). Magnesium
is required for bone and teeth formation, neuromuscular
functions activation of enzymes like glucokinase, and
hexokinase, and protein synthesis.
Daily requirement: Males: 350 mg/day; females: 300 mg/day.
Deficiency: Hypocalcemia, hypokalemia, dysphagia, anemia,
cardiac arrhythmias, tremors, weakness, psychiatric
disturbances, tachycardia, fibrillations, convulsions, and death.
Phosphorous
Sources: Protein foods of animal origin such as meat, fish,
poultry, and eggs are excellent sources of phosphorus. Milk
and cheese are good sources of phosphorus.
Functions: There is no free elemental phosphorus in the body.
It is present as a constituent of various lipids, proteins,
carbohydrates, enzymes, nucleic acid, and ATP.
1. In its ionic form, phosphorus serves to modify acid–base
balance in the blood.
2. It acts as a co-factor in several enzyme systems involved in
carbohydrate, protein, and fat metabolism.
3. It is important as a component of phospholipids in cell
membranes, lipoproteins, etc.
4. It is helpful in the formation of bones and teeth.
5. It is helpful in the synthesis of nuclear proteins.
6. It is helpful in the formation of phospholipids and possible
proteins.
129Nutrition and Health
7. It is helpful in the regulation of enzyme activity by
phosphorylation.
Daily requirement: 800 mg/day.
Deficiency: Weakness, anorexia, malaise, pain in the bones,
hemolytic anemia, granulocyte dysfunction, erythrocyte
glycolysis, neurologic and psychiatric disorders, hypercalciuria
and renal calculi.
Sodium and Potassium
Sources: Sources of sodium are table salt (sodium chloride), milk
and milk products, meat, fish (particularly ocean fish), seafood,
poultry, and eggs. Good sources of potassium are meat,
poultry, fish, organ meats, milk, milk products, and certain
fruits and vegetables. High-potassium fruits include avocado,
banana, apricot, dried fruit, melons, and oranges. Some high-
potassium vegetables are broccoli, Brussels sprouts, parsnips,
squash, potatoes, dry beans, and peas.
Functions:
1. Essential for normal growth and body functions.
2. Involved in regulating water- and acid-base balance.
3. Involved in the maintenance of plasma volume.
4. Helps in membrane permeability, nerve conduction,
and muscle action.
Daily requirement: Sodium: 5 gm/day; potassium: 3–4 gm/
day.
Deficiency: Severe vomiting, diarrhea, muscular cramps,
mental confusion, apathy, anorexia, and coma. Potassium
depletion, which occurs when using diuretics, will cause
muscular weakness, cardiac arrhythmia, and mental confusion.
Trace Elements
Fluoride
Sources: Drinking water, sea fish, tea, particularly Chinese
tea.
Functions:
i. Essential for the normal mineralization of bones and
formation of dental enamel.
130 Social Pharmacy
ii. Prevents dental caries and reduces the risk of tooth
decay.
Daily requirement: <2 ppm.
Deficiency: Mottling of teeth, deformity in bones (Hunch
back), and dental caries.
Iodine
Sources: Seafood, drinking water, iodized salt, seaweed, meat,
milk and eggs, cabbage.
Functions: Iodine is required as a component of the thyroid
hormones thyroxine (T
4
) and triiodothyronine (T
3
). Thyroxine
and triiodothyronine are required for normal energy
metabolism, thermoregulation, intermediary metabolism,
protein synthesis, reproduction, growth, physical and mental
development, hematopoiesis, and neuromuscular function.
Daily requirement: 100–150 g/day in adults, 200 g/day in
pregnancy.
Deficiency: Goiter, abortion, myxedema, infant death and
cretinism.
Iron
Sources: Liver, heart, kidney, red meats, shell fish, egg yolk,
dried beans, other legumes, dried fruits, nuts, green leafy
vegetables, dark molasses, and whole grain cereals.
Functions: It plays a key role in oxygen transport and cellular
respiration.
Daily requirement: Adult male: 10 mg; adult memale: 20 mg;
pregnancy and lactation: 40 mg.
Deficiency: Anemia, sluggishness, fatigue, weakness, poor
work performance, and changes in behavior.
The requirement for nutrients for pregnant and lactating
women is usually greater. Similarly, these requirements also
vary according to the age group of infants, children, adoles-
cents, and adults (Table 3.4).
The recommended mineral intakes for individuals are
summarized in Table 3.5.
131Nutrition and Health
Table 3.4: Major food sources, functions, and deficiency symptoms of minerals.
Mineral Major food sources Function Deficiency symptoms
Calcium Yogurt, cheese, some green leafy Builds and maintains bones and Rickets (abnormal develop-
vegetables such as collards, kale teeth; essential in the clotting ment of bones)
mustard greens, and turnip greens, of blood; influences the transmis-
tofu (if made with calcium sulfate), sion of ions across cell membranes;
salmon required in nerve transmission
Magnesium Whole-grain breads, cereals, and Required for many coenzyme oxi- Muscle tremors; convul-
other grain products; tofu; legumes; dation-phosphorylation reactions, sions; irritability; tetany;
green vegetables nerve impulse transmissions, and hyper- or hypoflexia
muscle contraction
Phosphorus Cheese; egg yolk; meat; poultry; Builds and maintains bones and Phosphate depletion may
fish; whole-grain breads, cereals, teeth; component of nucleic acids, cause unusual effects on
and other grain products; legumes phospholipids; as coenzyme func- renal, neuromuscular, and
tions in energy metabolism; buffers skeletal systems as well as
intracellular fluid blood chemistries
Sodium Sodium chloride (table salt), abun- Helps regulate acid-base equili- Nausea; cramps; vomiting;
dant in most foods except fruits brium and osmotic pressure of body dizziness; apathy; exhaus-
fluids; plays a role in normal muscle tion; possible respiratory
irritability and contractility; influ- failure
ences cell permeability
Potassium Fruits especially orange juice, Helps regulate acid-base equili- Muscle weakness; decreased
bananas, and dried fruits; yogurt; brium and osmotic pressure of body intestinal tone and disten-
potatoes; meat; fish; poultry; soy fluids; influences muscle activity, sion; cardiac arrhythmias;
products; vegetables especially cardiac muscle respiratory failure
(Contd.)
132 Social Pharmacy
Mineral Major food sources Function Deficiency symptoms
Iron Meat; liver; legumes; whole-grain Essential for the formation of hemo- Hypochromic microcytic
bread, cereals, or fortified or globin and oxygen transport; anemia; malabsorption; irri-
enriched grain products; dark increases resistance to infection; tability; anorexia; pallor,
green vegetables functions as part of enzymes invol- lethargy
ved in tissue respiration
Zinc Meat; liver; egg yolk; oysters and Component of many enzyme sys- Decreased wound healing,
other seafood; whole-grain breads, tems and insulin hypogonadism, mild ane-
cereals; legumes mia, decreased taste acuity,
hair loss, diarrhea, growth
failure, skin changes
Fluoride Fluoridated water Helps protect teeth against tooth Increased dental caries
decay; and may minimize bone loss
Iodine Seafood, iodized salt Helps regulate thyroid hormones; Endemic goiter; depressed
important in the regulation of thyroid function; cretinism
cellular oxidation and growth
Chloride Sodium chloride (table salt) Helps regulate acid-base equili- Usually accompanied by
brium and osmotic pressure of body sodium depletion
fluids; component of gastric juices