5/08/2010

Overview
„ Introduction
Assessing micronutrient status
Vitamins & Minerals „
„ Vitamins & Minerals:
… Classification & functional groups
… Focus on Anti-oxidants, Iron & Calcium
… Deficiencies
HMB172: Week 3
… Absorption
… Recommended Dietary Intakes
… Practical implications & supplementation

Learning Outcomes Introduction

„ To know how the micronutrient status of an
individual can be identified „ Micronutrients (vitamins & minerals)
„ To know how vitamins can be classified are essential to life
„ To understand the relationship between anti
anti- „ A well
ell balanced diet pro
provides
ides all
oxidants & athletes
„ To understand the different levels of iron micronutrient needs in healthy humans
depletion „ However, supplements are widely
„ To understand the factors impacting on
absorption of iron & calcium used by many people, including
„ To know & understand the Recommended athletes (C, B-complex, E, iron)
Dietary Intakes & practical implications

Vitamins Minerals
„ organic compounds
„ inorganic substances found naturally on
„ required in small amounts to prevent
Earth
clinical deficiencies & deterioration in
health growth & reproduction
health, „ ~4%
4% body weight
„ the human body is unable to synthesise „ optimal body function when present within
„ classification is based on solubility specific range
„ 13 known vitamins, each has a specific „ continued absence causes a distinct
function deficiency
… one cannot replace another but some overlap in
function

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Minerals (cont’d) Athletes & Micronutrients

„ Classification is based on daily requirements for „ It is often reported that athletes’ intakes of
them (i.e. macro-minerals & trace elements):
some vitamins & minerals are below RDI
„ Macrominerals: levels,, however:
… Needed in amounts > 100mg/d e.g. Ca, P, Mg, K … reported intakes may underestimate the true
„ Microminerals: dietary intake of these athletes
… Needed in amounts < 100mg/d e.g. Fe, Zn, I, Se … RDIs are calculated with a margin of safety &
„ Ultratrace elements: generally cover all requirements even with
… eg. boron, cobalt heavy exercise.

Assessing Micronutrient Status Assessing Micronutrient Status

„ The measurement of sub-optimal intakes „ Biochemical &/or haematological tests
& therefore nutrient deficiency can only be … include blood tests & urine assays
assessed usingg information from: „ Training & competition history
… Biochemical &/or haematological tests … emphasis on training program
… Training & competition history „ Medical history
… Medical history … record of recent & current illnesses/injuries
… Diet history
„ Diet history
… analysis of current & recent eating habits

Vitamin Classification

„ The vitamins can be divided into groups

Vitamins based on their solubility:
… Fat-soluble
Fat soluble vitamins (A
(A, D
D, E
E, K)
…A = retinol, D = calciferols, E = tocopherols
… Water soluble vitamins (C, B1, B12, folate, B6,
niacin, B2)
… B1 = thiamin, B12 = cobalamin, B6 = pyridoxine,
B2 = riboflavin

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Fat-soluble Vitamins Water-soluble Vitamins

… AÆ involved in vision …C Æ involved in connective tissue
Æ found in carrots, dairy products Æ found in oranges, spinach, tomatoes, etc
… B1 Æ involved in carbohydrate metabolism
… DÆ involved in bone mineral
Æ found in unrefined cereal grains
Æ found in eggs, margarine, sunlight … B12 Æ involved prevention of anaemia
… E Æ involved in antioxidant status Æ found in animal products mainly
Æ found in fats & oils … Folate Æ involved prevention of anaemia &
… K Æ involved in clotting neural tube defects
Æ found in green leafy vegetables
Æ found in broccoli, spinach

Water-soluble Vitamins (cont’d) Biological

functions
… B6 Æ involved in amino acid metabolism
of vitamins
Æ found in poultry, fish, pork, eggs etc
… Ni
Niacin
i Æ involved in production of energy co- factors
Æ found in dairy products
… B2 Æ involved in involved in production of energy
co-factors
Æ found in dairy products, poultry, meat, fish etc

Meeting Requirements Vitamin Functional Groups

„ In a well balanced eating plan the RDIs for these
vitamins are easily met
… e.g. the RDI for Vit. C is 45mg, this amount can
be found in ~3/4 an orange
„ There are, however, people at risk of
micronutrient deficiency, especially those who:
…
…
„ Vitamins can also be divided into a number of
functional groups related to:
… energy metabolism (thiamin, riboflavin, niacin)
… amino acid metabolism (vit. B6)
… tissue synthesis (B12, folate, C)
… anti-oxidant status (C, E)
„ We will only consider the anti-oxidants in more
depth.

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Anti-oxidants
„ Currently considerable interest in the
potential advantages of anti-oxidant
supplements – particularly vitamins C & E,
& the
th β-carotenes
β t
„ Athletes MAY be considered a target
group for anti-oxidant supplementation
because of the oxygen free-radicals that
are produced during exercise.
Anti-oxidants & Free Radicals
„ Methods used to assess oxygen free-
radical production & oxidative damage are
not sensitive, or specific
p
„ An acute bout of exercise may increase
oxidative damage to the muscle tissue
„ Training increases the anti-oxidant status
of the athlete.
Questions about vitamins?
5/08/2010
Free Radicals
„ Free radical production is caused via:
… reactions initiated by drugs, alcohol & other
foreign toxins
… reactions of normal energy metabolism
where oxidative enzymes are involved.
„ Free radical formation causes:
… deterioration of membrane lipids
… changes in membrane protein structure &
therefore, enzyme activity.
Anti-oxidant Supplementation
„ There is some evidence that anti-oxidant
supplementation may decrease oxidative
damage which follows exercise
… may only apply to a single or unusually heavy bout of
exercise
„ The association with performance enhancement
is even more difficult to establish:
… benefits most likely to seen in athletes who are not
well trained or have not yet adapted to a new training
stress.
Minerals
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Mineral Functional Groups Iron

„ Minerals have many important roles in the body
„ Functions with relevance to activity include:
… blood formation & function (iron, copper)
… bone mineralisation (calcium, fluoride,
phosphate)
… muscle contraction (calcium, magnesium)
… nerve excitability (calcium)
„ We will concentrate on iron & calcium.
„ Functions
…↑ blood’s oxygen-carrying capacity by binding
with haemoglobin (Hb)
… serves as a structural
t t l componentt off myoglobin
l bi
… facilitates cellular energy transfer
… stored forms of iron replenish iron lost from
functional compounds & provide the iron reserve
during insufficient dietary iron intake
… transports iron from ingested food & damaged
red blood cells to tissues in need

Iron Deficiency Anaemia Iron & the Athlete

Symptoms „ Optimal iron status for an athlete difficult to define
„ „ It is still not known whether low iron status, in the
„ absence of anaemia,
anaemia lowers exercise performance
„ When anaemia is present, performance is affected
„
because of:
„
… È Hb production & therefore È maximal oxygen
„ uptake
… È ability of the muscle to use oxygen

Sports Anaemia The Paradox of Iron

„ Low iron status in an athlete is not necessarily „ Iron is the most abundant trace mineral &
indicative of genuine iron depletion or deficiency yet iron deficiency is one of the most
„ Many
a y cases o of reduced
educed b
blood
ood Hb b levels
e e s reflect
e ect aan common nutritional p problems worldwide
acute response to training, & not a true
reduction in iron status
„ WHY??
„ This is called sports anaemia & does not impair
exercise performance

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Iron Absorption
„ Haem iron:
… occursin animal foods
… ~25% absorption
„ Non-haem iron:
… mainly found in plant sources
…~ < 8% absorpton
… add vitamin C to enhance absorption
Factors Affecting Iron Absorption cont’d
„ Factors that decrease iron absorption
… Phytic acid (cereals & legumes)
… Oxalic acid
… Polyphenols
… High body iron stores
… Excess of other minerals
… Reduction in stomach acid
… Antacids
Reasons for Low Iron Status (cont’d)
„ Low intakes of available iron
…
…
…
…
„ A combination of the above
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Factors Affecting Iron Absorption
„ Factors that increase iron absorption:
… Acid in the stomach
… Ironin haem form
… High body demand for red blood
… Low body iron stores
… Presence of mean protein factor
… Presence of vitamin C in small intestine
Reasons for Low Iron Status
„ Increased iron needs
… strenuous exercise
„ Increased losses
… sweating
… menstruation
… gastrointestinal bleeding
… foot-strike haemolysis
Practical Implications
„ Assessment & management of iron deficiency
is a clinical issue
„ Many people need nutrition education to
increase intake of efficiently-absorbed iron and
to integrate these strategies into their diet
„ Iron supplements?
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Iron Recommended Dietary Intakes Food Sources of Iron (mg/100g)

(mg/day)
HIGH MEDIUM LOW
Children 1-3y 9
Liver, kidney (10) Beef (3-5) Whole fruit
Children 4-8y 10 Mussels (8) Lamb, pork (2) Most vegetables
Children 9-13yy 8 Oysters (6) Chicken turkey (1) Dairy
Chicken,
Boys 14-18y 11 Wheat bran (13) Fish (1)
Girls 14-18y 15 Fortified BF cereal (9) Egg (2)
Men ≥ 19y 8 Muesli (11) Bread B, W (3,2)
Curry powder (58) Nuts (2-5)
Women 19-50y 8
Ginger powder (17) Legumes (3)
Women > 50y 8 Mustard powder (11) Spinach (4)
Pregnancy 27 Cocoa powder (11) Broccoli (1)

Calcium Calcium & Bone Mineral Density

„ Body’s most abundant mineral
„ Bone mineral density (BMD) increases
„ Combines with phosphorus to form bones & throughout adolescence & early
teeth adulthood ((when p peak BMD is reached))
„ Functions in: „ As well as an adequate calcium intake,
… Muscle stimulation
exercise is critical for gaining &
… Blood clotting
maintaining the architecture & mass of
… Nerve impulse transmission
… Activation of several enzymes
the skeleton
… Synthesis of calcitriol
… Transport of fluids across cell membranes

Osteopaenia vs Osteoporosis Osteoporosis Risk Factors

„
„ Osteopaenia
… midway condition where bones weaken with ↑ „
risk of fractures „
„ Osteoporosis „
… develops progressively as bone loses its „
calcium mass & concentration, causing bone to
„
progressively become more porous & brittle
„

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Osteoporosis Risk Factors cont’d

Factors that
„ affect bone
„ mass
„
„
„
„

Calcium & Dairy Products Calcium RDIs

„ Dairy products are the most readily (mg/day)

Children 1-3y 500
absorbed & dense source of calcium
Children 4-8y 700
„ Often excluded from the diet because of Children 9 13y
9-13y 1000 1300
1000-1300
real or perceived allergic reactions Children 14-18y 1300
„ Often perceived to contribute adversely Adults 19-50y 1000
Men 51-70y 1000
to fat intake:
Women 51-70y 1300
… Thoughts? Adults >70y 1300
? Amenorrheic athletes 1500

Food Sources of Calcium Practical Implications

Source of calcium mg
Reduced fat milk (1 cup) 352 „ Excessive intakes of sodium, protein,
Skim milk (1 cup) 320 caffeine & alcohol increase urinary
Calcium fortified milk (1 cup) 415
losses of calcium,, especially
p y when
Y h t low-fat
Yoghurt, l f t (200g)
(200 ) 316
Cheese, cheddar, red-fat (1 slice) 160 calcium intake is low
Ricotta cheese (100g) 245 „ Supplementation may be necessary in
Custard (1 cup) 250 people unwilling or unable to increase
Salmon with bones (100g) 220
Tahini, sesame butter (20g) 65
their calcium intake.
Bean curd (tofu), calcium-set (100g) 150
Almonds (1 cup) 352

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Phosphorus
„ Functions:
…combines with calcium to form
compounds that give rigidity to bones &
teeth
…serves as an essential component of the
intracellular mediator cAMP &
intramuscular ATP & PCr
Magnesium
„ Functions:
… facilitates muscle & liver glycogen formation
from blood-borne glucose
g functioning
… serves as a cofactor in glucose, fatty acid, &
amino acid breakdown during energy
metabolism
… affects lipid & protein synthesis
Sodium, Potassium, & Chlorine
„ Also known as electrolytes
„ Modulate fluid exchange within the body’s fluid
compartments, promoting a constant, well-
regulated
l t d exchange
h off nutrients
t i t & wastet
products between the cell & its external fluid
environment
„ Remain dissolved in the body fluids as ions
„ Sodium & chlorine represent the chief minerals
contained in blood plasma & extracellular fluid
„ Potassium is the chief intracellular mineral
5/08/2010
Phosphorus cont’d
„ Functions:
… combines with lipids to form phospholipid
compound
p
… regulates cellular metabolism
… buffers acid end products of energy
metabolism
„ Dietary sources of phosphorus include
meat, fish, poultry, milk products, &
cereals
Magnesium cont’d
„ Functions:
… contributes to optimal neuromuscular
… acts as an electrolyte to maintain blood
pressure
… affects cell growth, reproduction, & plasma
membrane integrity
„ Dietary sources include green leafy
vegetables, legumes, nuts, bananas,
mushrooms, & whole grains
Mineral Loss in Sweat
„ Excessive sweating during exercise produces a
considerable loss of body water & related minerals
… can impair heat tolerance & exercise performance,
leading to heat cramps, heat exhaustion, or heat
stroke
… both need to be replaced during & following exercise
„ Sweat loss during exercise usually does not
increase the mineral requirement above
recommended values
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Questions about minerals?

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