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Nutrient def (b12,vit d,cal,fe)

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Importance of diet to combat nutrient deficiencies like Vitamin B12, calcium, Iron.

Importance of diet to combat nutrient deficiencies like Vitamin B12, calcium, Iron.

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  • 1. Nutrient DeficienciesKnow How To Combat!
  • 2. Vitamin D  Vit. D is a fat soluble vitamin and its synthesized in the body  1 billion people worldwide have Vit D deficiency or insufficiency  96.7% Asian-Indian patients have Vitamin D deficiency and are fragile hip fracture (J Assoc Physicians India. 2010 Sep;58:539-42)
  • 3. Function Of Vitamin D  Calcium absorption in the intestines and is required for the efficient utilization of dietary calcium.  Involved in cellular growth, differentiation and apoptosis.  Simulates insulin secretion.  Modulates the immune system.  Reduces inflammation.  Muscle development
  • 4. Diagnostic Test  Measurement of 25(OH) vitamin D serum levels best reflects the vitamin D status of an individual.  Normal : >30 ng/ml (>75 nmol/L)  Insufficiency : 20-30 ng/ml (50-75 nmol/L)  Deficiency : <20 ng/ml (<50 nmol/L)
  • 5. Symptoms  Usually asymptomatic until severe  Musculoskeletal pain  Fractures  Weakness
  • 6. Causes  Decreased sun exposure/sunscreen ◦ SPF 15 decreases vitamin D3 synthesis by 99%  Decreased intake of foods rich in vitamin D  Impaired absorption due to air pollution  Chronic kidney disease
  • 7. Vit. D Deficiency Leads To….       Rickets in Children Osteoporosis Obesity Diabetes Cancer risk Cardiovascular disease (including MI)
  • 8. Recommended Dietary Allowance Age 0–12 months* 1–13 years Male 400 IU (10 mcg) 600 IU (15 mcg) Female 400 IU (10 mcg) 600 IU (15 mcg) 14–18 years 19–50 years 51–70 years >70 years 600 IU (15 mcg) 600 IU (15 mcg) 600 IU (15 mcg) 800 IU 600 IU (15 mcg) 600 IU (15 mcg) 600 IU (15 mcg) 800 IU Pregnanc y Lactation 600 IU (15 mcg) 600 IU (15 mcg) 600 IU (15 mcg) 600 IU (15 mcg)
  • 9. Sources  Regular supplementation of atleast 2000 IU/day of vit. D supplementation to maintain normal vit. D levels. JAPI • november 2011 • voL. 59
  • 10. Toxicity  Chronic ingestion of 50 to 100 times normal physiologic requirement of Vit D (> 40,000 IU/day) ie. 25 OH levels of >150 ng/ml can leads to ◦ ◦ ◦ ◦ Renal calculi Hypercalcemia Renal insufficiency Fatigue and weakness JAPI • november 2011 • voL. 59
  • 11. Vitamin B12  Vitamin B12 is a water-soluble vitamin  Vitamin b12 is one of the most important vitamin required for growth and division of cells. It is responsible in other important body functions. Recommendation: Man,women-1.0 μg Children(1-18) – 0.2-1.0 μg Lactating mothers- 1.5 μg
  • 12. Diagnostic Test  Normal : 200-900 pg/mL  Deficiency : <20o pg/mL  Toxicity : >900 pg/mL
  • 13. Symptoms      Weakness, tiredness or light-headedness Pale skin Sore tongue Easy bruising or bleeding gums Stomach upset In sever case:  Tingling or numbness in fingers and toes  Difficulty walking  Mood changes or depression  Memory loss, disorientation, and dementia
  • 14. Causes  Perenicious anemia and atrophic gastritis  Surgery of the stomach or small intestine  Crohn's disease, celiac disease, bacterial growth, or a parasite  Excessive alcohol consumption.  Graves' disease  Long-term use of acid-reducing drugs
  • 15. Vit. B12 Deficiency Leads To….  Hyperhomocysteinemia  Cognitive function  Depression  Diabetic neuropathy  Fatigue, Joint pain (elbow)  Sickle cell disease
  • 16. Recommended Dietary Allowance ge Male Female 0–6 0.4 mcg 0.4 mcg months* 7–12 0.5 mcg 0.5 mcg months* 1–3 years 0.9 mcg 0.9 mcg 4–8 years 1.2 mcg 1.2 mcg 9–13 1.8 mcg 1.8 mcg years Pregnanc y Lactation
  • 17. Sources  Fatty fishes like cod, salmon, tuna, sardines, liver, beef, chicken and eggs.  Milk and milk products.  Fortified fruit juices and cereals
  • 18. How much will meet the requirement??  Sheep liver provides 91.9μg of Vitamin B12 whereas goat liver provides 90.4 μg  100ml of cow’s and buffalo’s milk gives 0.14 μg of B12  The raw yellow part of hen eggs has got most of the vitamin B12. It provides 1.8 μg of B12 / 100gm  Mackerel is the best amongst
  • 19. Calcium  Most important mineral for Bone and teeth health  Calcium helps in normal muscle contraction, blood clotting, contraction of heart muscles  Expert groups say the number of osteoporosis patients at approximately 26 million (2003 figures) with the numbers projected to increase to 36 million by 2013 Ref: http://www.outlookindia.com 2004 Ref:Osteoporosis Society of India (2003) Action Plan Osteoporosis: Consensus statement of an expert group. New Delhi
  • 20. Requirements Daily requirement: Normal man&women400mg Children(13-18yrs)- 600mg It increases in pregnancy, adolescent age
  • 21. Dairy Products  It is world wide known that all dairy products are high in calcium.  Milk, curds, cheese, etc.Having low fat dairy products will be more beneficial for overall health.  Cheese is the highest source of calcium which gives 1376mg/100gm. Having a cheese cube in 2 weeks is accepted.
  • 22. Ragi  Amongst all Cereals Ragi is the richest source of Calcium  It provides about 344mg of calcium every 100gms  Having Ragi 2-3 times a weeks considered beneficial
  • 23. Nuts And Oilseeds  Sesame seeds provide most calcium when roasted or dried. One tea spoon of sesame gives almost 88 mg of calcium  Almonds provide around 230mg /100gm and also rich source of Omega3 acids
  • 24. Soyabean  Soy products are naturally high in calcium, it also contains boron and magnesium which are Important for bone health  Soy contains isoflavones which inhibit the breakdown of bones  Thus, soybean is beneficial in post menopausal women for their bone health  Soy milk, Tofu are good in calcium  One needs to check for soy allergy
  • 25. Fish  Enjoy having Fishes like Salmon not only for their high calcium content but also for heart healthy Omega3 fatty acids.  Having Fish 2 times a week shows wonders. Remember method of cooking is important. Try grilled, steamed instead of fried.

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