András Benyhe MD Energetics Essential nutrientsangular stomatitis Dairy products, bananas, popcorn,...

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Energetics&

Essential nutrients

András Benyhe MD

What is Energy?

Energy

1 J = 1 N×m

1 J = 1 C×V

1 J = 1 W×s

1 J = 1 Pa×m3

0 V1 V

Heat energy

1 cal = 4.2 J 1 kg H2

O

+1 °C

1 Cal

Heat energy

1 cal = 4.2 J

1000 cal = 1 kcal

Heat energy

1 cal = 4.2 J

1000 cal = 1 Cal

ATP

7.3 kcal/mol7.3 kcal/mol

1 cal = 4.2 J

ATP

30 kJ/mol30 kJ/mol

1 cal = 4.2 J

Thermodynamic efficiency

ingested food

absorbed nutrients

metabolism

storage

ATP~40% ~50%

energy requirement of nutrient utilization

loss with indigestable

materials

heat heat heat

100%

~20%

put into external work

WORK

work that stays in the body is converted to

heat

Energy in food

Energy in food

Macronutrients + O2

→ CO2

+ H2

O

Energy

ATP

Heat

40%60%

Work

50%50%

Energy in food

Carbohydrates + O2

→ CO2

+ H2

O

Energy

ATP

Heat

40%60%

Work

50%50%

17.2 kJ/g

21.1kJ/LO2

1 cal = 4.2 J

How many ATP molecules are synthesized from breakdown of a single glucose molecule?

Energy in food

Lipids + O2

→ CO2

+ H2

O

Energy

ATP

Heat

40%60%

Work

50%50%

38.9kJ/g

19.6kJ/LO2

1 cal = 4.2 J

Energy in food

Proteins + O2

→ CO2

+ H2

O

Energy

ATP

Heat

40%60%

Work

50%50%

17.2kJ/g

18.8kJ/LO2

1 cal = 4.2 J

An average hobbit burns 150 kcals/h while climbing Mount Doom, and 10 kcals/h when sleeping. Let’s assume that two hobbits are on a journey to the top, climbing 16 hours a day and sleeping 8. 1 piece of lembas per day covers the energy needs of the two hobbits. A lembas wafer has an average weight of 10 grams.

What is the energy density of lembas in kJ/g?

1 cal = 4.2 J

Measuring energetics

Calorimetry: how much energy do we use?

Macronutrients + O2

→ CO2

+ H2

O

Energy

ATP

Heat

40%60%

Work

50%50%

Direct calorimetry (outdated)

heat insulated box

Direct calorimetry (outdated)

heat insulated box

Direct calorimetry (outdated)cold

water in

warm water out

heat insulated box

Direct calorimetry (outdated)

● Measures liberated heat

● Energy put into external work is NOT measured

cold water in

warm water out

heat insulated box

Direct calorimetry (outdated)

Macronutrients + O2

→ CO2

+ H2

O

Energy

ATP

Heat

40%60%

Work

50%50%

Indirect calorimetry

Macronutrients + O2

→ CO2

+ H2

O

Energy

ATP

Heat

40%60%

Work

50%50%

~20 kJ/LO2

energy in a balanced diet

Indirect calorimetry

● Measures oxygen used● Suitable for measuring

energetics during activity

Indirect calorimetry

● Measures oxygen used● Anaerobic metabolism is

not measured (or is it?)*

*(it probably is)

Basal Metabolic Rate (BMR)

Calorimetry under standardized conditions:

1. Not have eaten for at least 12 hours2. After a night of restful sleep3. No strenous activity for at least 1 hour4. No causes of excitement5. 20-26°C air temperature6. No physical activity

Before

During

Estimation of Basal Metabolic Rate

revised Harris–Benedict formula:

MenBMR = (10 × weight in kg) + (6.25 × height in cm) - (5 × age in years) + 5

WomenBMR = (10 × weight in kg) + (6.25 × height in cm) - (5 × age in years) - 161

in kcal/day

What is your BMR?

MenBMR = (10 × weight in kg) + (6.25 × height in cm) - (5 × age in years) + 5

WomenBMR = (10 × weight in kg) + (6.25 × height in cm) - (5 × age in years) - 161

Total energy cost of living

ingested food

absorbed nutrients

metabolism

storage

ATP~40% ~50%

energy requirement of nutrient utilization

loss with indigestable

materials

heat heat heat

100%

~20%

put into external work

WORK

work that stays in the body is converted to

heat

BMRDIT (diet induced thermogenesys)~10% of caloric intake

Work related energy

Physical Activity Level (PAL)

Lifestyle Example PAL

Extremely inactive Cerebral Palsy patient <1.40

Sedentary Office worker getting little or no exercise 1.40-1.69

Moderately active Construction worker or person running one hour daily

1.70-1.99

Vigorously active Agricultural worker (non mechanized) or person swimming two hours daily

2.00-2.40

Extremely active Competitive cyclist >2.40

Total Energy Expenditure = BMR × PAL

Energy use during activities

Extreme power outputs

Robert Förstemann

Extreme power outputs

Robert Förstemann

human work: ~20% efficiency

dynamo: ~80%860 W

4300 W

Extreme power outputs

Robert Förstemann

human work: ~20% efficiency

dynamo: ~80%860 W

4300 W

3440 W

170 W

Extreme power outputs

Robert Förstemann

human work: ~20% efficiency

dynamo: ~80%860 W

4300 Wresting dude:150W

3440 W

170 W

~150 W

Energy requirement of various activities

100W 300W 500W

1000+W

How much energy would it take you to run 20 mins at 5:00/km?

PACE min/km7:10 6:15 5:30 5:00 4:30 4:10 3:50 3:30 M

ayhe

w, J

. L. (

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Balanced DietWhere should the energy come from?

Balanced diet?

● Not wasting (medically)

● Not gaining

● Not lacking

Acceptable Macronutrient Distribution Ranges

Trumbo, P., Schlicker, S., Yates, A. A., & Poos, M. (2002). Dietary reference intakes for energy, carbohdrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. Journal of the Academy of Nutrition and Dietetics, 102(11), 1621.

Acceptable Macronutrient Distribution Ranges

Trumbo, P., Schlicker, S., Yates, A. A., & Poos, M. (2002). Dietary reference intakes for energy, carbohdrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. Journal of the Academy of Nutrition and Dietetics, 102(11), 1621.

Too little fat intake results in low HDL, too much is associated with

cardiovascular risk, due to high LDL

Acceptable Macronutrient Distribution Ranges

Trumbo, P., Schlicker, S., Yates, A. A., & Poos, M. (2002). Dietary reference intakes for energy, carbohdrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. Journal of the Academy of Nutrition and Dietetics, 102(11), 1621.

Lower limit prevents too high fat intake, too much carbs leave no room

for other macronutrients

Acceptable Macronutrient Distribution Ranges

Trumbo, P., Schlicker, S., Yates, A. A., & Poos, M. (2002). Dietary reference intakes for energy, carbohdrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. Journal of the Academy of Nutrition and Dietetics, 102(11), 1621.

Lower limit is the minimal 0.8g/kgbw/day intake, that prevents wasting.

Essential amino acids

Essential lipids

Example

Daily amount

Energy density

Daily energyCaloric

equivalentDaily O

2

used

Carbohydrates ~300g 17.2 kJ/g ~5200 kJ (52%) 21.1 kJ/LO2

~250 L

Proteins ~120g 17.2 kJ/g ~2000 kJ (20%) 18.8 kJ/LO2

~110 L

Lipids ~70g 38.9 kJ/g ~2800 kJ (28%) 19.6 kJ/LO2

~140 L

Total 10000 kJ 500 L

Example

Daily amount

Energy density

Daily energyCaloric

equivalentDaily O

2

used

Carbohydrates ~300g 17.2 kJ/g ~5200 kJ (52%) 21.1 kJ/LO2

~250 L

Proteins ~120g 17.2 kJ/g ~2000 kJ (20%) 18.8 kJ/LO2

~110 L

Lipids ~70g 38.9 kJ/g ~2800 kJ (28%) 19.6 kJ/LO2

~140 L

Total 10000 kJ 500 L

Example

Daily amount

Energy density

Daily energyCaloric

equivalentDaily O

2

used

Carbohydrates ~300g 17.2 kJ/g ~5200 kJ (52%) 21.1 kJ/LO2

~250 L

Proteins ~120g 17.2 kJ/g ~2000 kJ (20%) 18.8 kJ/LO2

~110 L

Lipids ~70g 38.9 kJ/g ~2800 kJ (28%) 19.6 kJ/LO2

~140 L

Total 10000 kJ 500 L ?

Do we really use 500L O2 during daily metabolism?

TV = 0.5L, RespRate = 14/min, inspired air has 21% of O2, expired gas has 16%.

Micronutrients:Vitamins and Trace Minerals

Vitamins

● NOT a homogenous group

Vitamins

● NOT a homogenous group

● Organic compounds

Vitamins

● NOT a homogenous group

● Organic compounds

● Necessary for normal metabolism

● Cofactor● Antioxidant● Structural role● Hormone

Vitamins

● NOT a homogenous group

● Organic compounds

● Necessary for normal metabolism

● Cannot be synthesized in human cells

Diverse diet!

Vitamins

● NOT a homogenous group

● Organic compounds

● Necessary for normal metabolism

● Cannot be synthesized in human cells

● Lack results in deficits or disease

Tissues of high activity & cell

division!

VitaminChemical

nameSolubility RDA (♂/♀) Deficiency Overdose Food sources

B1 Thiamine Water 1.2 mg/1.1 mg

Beriberi, Wernicke- Korsakoff syndrome

Drowsiness and muscle relaxation

Pork, oatmeal, brown rice, vegetables, potatoes, liver, eggs

B2 Riboflavin Water 1.3 mg/1.1 mg

Ariboflavinosis, glossitis, angular stomatitis

Dairy products, bananas, popcorn, green beans, asparagus

B3 Niacin Water 16 mg/14 mg Pellagra

Liver damage (doses > 2g/day) and other problems

Meat, fish, eggs, many vegetables, mushrooms, tree nuts

B5

Pantothenic acid

Water 5 mg Paresthesia Meat, broccoli, avocados

B6 Pyridoxine Water

1.3–1.7 mg/1.2–1.5 mg

Anemia, Peripheral neuropathy

Impairment of proprioception, nerve damage (doses > 100

mg/day)

Meat, vegetables, tree nuts, bananas

B7 Biotin Water 30 µg Dermatitis, enteritis

Raw egg yolk, liver, peanuts, leafy green vegetables

B9 Folic acid Water 400 µg

Megaloblastic anemia and deficiency during pregnancy

is associated with birth defects, such as neural tube

defects

Leafy vegetables, pasta, bread, cereal, liver

B12 Cobalamin Water 2.4 µg Pernicious anemia Meat, poultry, fish, eggs, milk

C Ascorbic acid

Water 90 mg/75 mg Scurvy Many fruits and vegetables, liver

Water soluble vitamins

VitaminChemical

nameSolubility RDA (♂/♀) Deficiency Overdose Food sources

B1

Thiamine(PDH

coenzyme)Water 1.2 mg/1.1 mg

Beriberi, Wernicke- Korsakoff syndrome

Drowsiness and muscle relaxation

Pork, oatmeal, brown rice, vegetables, potatoes, liver, eggs

B2 Riboflavin Water 1.3 mg/1.1 mg

Ariboflavinosis, glossitis, angular stomatitis

Dairy products, bananas, popcorn, green beans, asparagus

B3 Niacin Water 16 mg/14 mg Pellagra

Liver damage (doses > 2g/day) and other problems

Meat, fish, eggs, many vegetables, mushrooms, tree nuts

B5

Pantothenic acid

Water 5 mg Paresthesia Meat, broccoli, avocados

B6 Pyridoxine Water

1.3–1.7 mg/1.2–1.5 mg

Anemia, Peripheral neuropathy

Impairment of proprioception, nerve damage (doses > 100

mg/day)

Meat, vegetables, tree nuts, bananas

B7 Biotin Water 30 µg Dermatitis, enteritis

Raw egg yolk, liver, peanuts, leafy green vegetables

B9 Folic acid Water 400 µg

Megaloblastic anemia and deficiency during pregnancy

is associated with birth defects, such as neural tube

defects

Leafy vegetables, pasta, bread, cereal, liver

B12 Cobalamin Water 2.4 µg Pernicious anemia Meat, poultry, fish, eggs, milk

C Ascorbic acid

Water 90 mg/75 mg Scurvy Many fruits and vegetables, liver

memory

VitaminChemical

nameSolubility RDA (♂/♀) Deficiency Overdose Food sources

B1 Thiamine Water 1.2 mg/1.1 mg

Beriberi, Wernicke- Korsakoff syndrome

Drowsiness and muscle relaxation

Pork, oatmeal, brown rice, vegetables, potatoes, liver, eggs

B2

Riboflavin

(FAD) Water 1.3 mg/1.1 mgAriboflavinosis, glossitis,

angular stomatitisDairy products, bananas, popcorn, green

beans, asparagus

B3 Niacin Water 16 mg/14 mg Pellagra

Liver damage (doses > 2g/day) and other problems

Meat, fish, eggs, many vegetables, mushrooms, tree nuts

B5

Pantothenic acid

Water 5 mg Paresthesia Meat, broccoli, avocados

B6 Pyridoxine Water

1.3–1.7 mg/1.2–1.5 mg

Anemia, Peripheral neuropathy

Impairment of proprioception, nerve damage (doses > 100

mg/day)

Meat, vegetables, tree nuts, bananas

B7 Biotin Water 30 µg Dermatitis, enteritis

Raw egg yolk, liver, peanuts, leafy green vegetables

B9 Folic acid Water 400 µg

Megaloblastic anemia and deficiency during pregnancy

is associated with birth defects, such as neural tube

defects

Leafy vegetables, pasta, bread, cereal, liver

B12 Cobalamin Water 2.4 µg Pernicious anemia Meat, poultry, fish, eggs, milk

C Ascorbic acid

Water 90 mg/75 mg Scurvy Many fruits and vegetables, liver

VitaminChemical

nameSolubility RDA (♂/♀) Deficiency Overdose Food sources

B1 Thiamine Water 1.2 mg/1.1 mg

Beriberi, Wernicke- Korsakoff syndrome

Drowsiness and muscle relaxation

Pork, oatmeal, brown rice, vegetables, potatoes, liver, eggs

B2 Riboflavin Water 1.3 mg/1.1 mg

Ariboflavinosis, glossitis, angular stomatitis

Dairy products, bananas, popcorn, green beans, asparagus

B3

Niacin

(NAD) Water 16 mg/14 mg PellagraLiver damage (doses >

2g/day) and other problemsMeat, fish, eggs, many vegetables,

mushrooms, tree nuts

B5

Pantothenic acid

Water 5 mg Paresthesia Meat, broccoli, avocados

B6 Pyridoxine Water

1.3–1.7 mg/1.2–1.5 mg

Anemia, Peripheral neuropathy

Impairment of proprioception, nerve damage (doses > 100

mg/day)

Meat, vegetables, tree nuts, bananas

B7 Biotin Water 30 µg Dermatitis, enteritis

Raw egg yolk, liver, peanuts, leafy green vegetables

B9 Folic acid Water 400 µg

Megaloblastic anemia and deficiency during pregnancy

is associated with birth defects, such as neural tube

defects

Leafy vegetables, pasta, bread, cereal, liver

B12 Cobalamin Water 2.4 µg Pernicious anemia Meat, poultry, fish, eggs, milk

C Ascorbic acid

Water 90 mg/75 mg Scurvy Many fruits and vegetables, liver

VitaminChemical

nameSolubility RDA (♂/♀) Deficiency Overdose Food sources

B1 Thiamine Water 1.2 mg/1.1 mg

Beriberi, Wernicke- Korsakoff syndrome

Drowsiness and muscle relaxation

Pork, oatmeal, brown rice, vegetables, potatoes, liver, eggs

B2 Riboflavin Water 1.3 mg/1.1 mg

Ariboflavinosis, glossitis, angular stomatitis

Dairy products, bananas, popcorn, green beans, asparagus

B3 Niacin Water 16 mg/14 mg Pellagra

Liver damage (doses > 2g/day) and other problems

Meat, fish, eggs, many vegetables, mushrooms, tree nuts

B5

Pantothenic acid

(CoA)Water 5 mg Paresthesia Meat, broccoli, avocados

B6 Pyridoxine Water

1.3–1.7 mg/1.2–1.5 mg

Anemia, Peripheral neuropathy

Impairment of proprioception, nerve damage (doses > 100

mg/day)

Meat, vegetables, tree nuts, bananas

B7 Biotin Water 30 µg Dermatitis, enteritis

Raw egg yolk, liver, peanuts, leafy green vegetables

B9 Folic acid Water 400 µg

Megaloblastic anemia and deficiency during pregnancy

is associated with birth defects, such as neural tube

defects

Leafy vegetables, pasta, bread, cereal, liver

B12 Cobalamin Water 2.4 µg Pernicious anemia Meat, poultry, fish, eggs, milk

C Ascorbic acid

Water 90 mg/75 mg Scurvy Many fruits and vegetables, liver

VitaminChemical

nameSolubility RDA (♂/♀) Deficiency Overdose Food sources

B1 Thiamine Water 1.2 mg/1.1 mg

Beriberi, Wernicke- Korsakoff syndrome

Drowsiness and muscle relaxation

Pork, oatmeal, brown rice, vegetables, potatoes, liver, eggs

B2 Riboflavin Water 1.3 mg/1.1 mg

Ariboflavinosis, glossitis, angular stomatitis

Dairy products, bananas, popcorn, green beans, asparagus

B3 Niacin Water 16 mg/14 mg Pellagra

Liver damage (doses > 2g/day)

and other problemsMeat, fish, eggs, many vegetables,

mushrooms, tree nuts

B5

Pantothenic acid

Water 5 mg Paresthesia Meat, broccoli, avocados

B6

Pyridoxine(amino transfer

coenzyme)Water

1.3–1.7 mg/1.2–1.5 mg

Anemia, Peripheral neuropathy, Skin disorders

Impairment of proprioception, nerve damage (doses > 100

mg/day)Meat, vegetables, tree nuts, bananas

B7 Biotin Water 30 µg Dermatitis, enteritis

Raw egg yolk, liver, peanuts, leafy green vegetables

B9 Folic acid Water 400 µg

Megaloblastic anemia and deficiency during

pregnancy is associated with birth defects, such as

neural tube defects

Leafy vegetables, pasta, bread, cereal, liver

B12 Cobalamin Water 2.4 µg Pernicious anemia Meat, poultry, fish, eggs, milk

C Ascorbic acid Water 90 mg/75 mg Scurvy Many fruits and vegetables, liver

VitaminChemical

nameSolubility RDA (♂/♀) Deficiency Overdose Food sources

B1 Thiamine Water 1.2 mg/1.1 mg

Beriberi, Wernicke- Korsakoff syndrome

Drowsiness and muscle relaxation

Pork, oatmeal, brown rice, vegetables, potatoes, liver, eggs

B2 Riboflavin Water 1.3 mg/1.1 mg

Ariboflavinosis, glossitis, angular stomatitis

Dairy products, bananas, popcorn, green beans, asparagus

B3 Niacin Water 16 mg/14 mg Pellagra

Liver damage (doses > 2g/day) and other problems

Meat, fish, eggs, many vegetables, mushrooms, tree nuts

B5

Pantothenic acid

Water 5 mg Paresthesia Meat, broccoli, avocados

B6 Pyridoxine Water

1.3–1.7 mg/1.2–1.5 mg

Anemia, Peripheral neuropathy

Impairment of proprioception, nerve damage (doses > 100

mg/day)

Meat, vegetables, tree nuts, bananas

B7

Biotin(CO2transfer coenzyme)

Water 30 µg Dermatitis, enteritisRaw egg yolk, liver, peanuts, leafy green

vegetables

B9 Folic acid Water 400 µg

Megaloblastic anemia and deficiency during pregnancy

is associated with birth defects, such as neural tube

defects

Leafy vegetables, pasta, bread, cereal, liver

B12 Cobalamin Water 2.4 µg Pernicious anemia Meat, poultry, fish, eggs, milk

C Ascorbic acid

Water 90 mg/75 mg Scurvy Many fruits and vegetables, liver

VitaminChemical

nameSolubility RDA (♂/♀) Deficiency Overdose Food sources

B1 Thiamine Water 1.2 mg/1.1 mg

Beriberi, Wernicke- Korsakoff syndrome

Drowsiness and muscle relaxation

Pork, oatmeal, brown rice, vegetables, potatoes, liver, eggs

B2 Riboflavin Water 1.3 mg/1.1 mg

Ariboflavinosis, glossitis, angular stomatitis

Dairy products, bananas, popcorn, green beans, asparagus

B3 Niacin Water 16 mg/14 mg Pellagra

Liver damage (doses > 2g/day) and other problems

Meat, fish, eggs, many vegetables, mushrooms, tree nuts

B5

Pantothenic acid

Water 5 mg Paresthesia Meat, broccoli, avocados

B6 Pyridoxine Water

1.3–1.7 mg/1.2–1.5 mg

Anemia, Peripheral neuropathy

Impairment of proprioception, nerve damage (doses > 100

mg/day)

Meat, vegetables, tree nuts, bananas

B7 Biotin Water 30 µg Dermatitis, enteritis

Raw egg yolk, liver, peanuts, leafy green vegetables

B9

Folic acidC1-transfer Water 400 µg

Megaloblastic anemia and deficiency during pregnancy

is associated with birth defects, such as neural tube

defects

Leafy vegetables, pasta, bread, cereal, liver

B12

CobalaminC1-transfer Water 2.4 µg Pernicious anemia Meat, poultry, fish, eggs, milk

C Ascorbic acid

Water 90 mg/75 mg Scurvy Many fruits and vegetables, liver

VitaminChemical

nameSolubility RDA (♂/♀) Deficiency Overdose Food sources

B1 Thiamine Water 1.2 mg/1.1 mg

Beriberi, Wernicke- Korsakoff syndrome

Drowsiness and muscle relaxation

Pork, oatmeal, brown rice, vegetables, potatoes, liver, eggs

B2 Riboflavin Water 1.3 mg/1.1 mg

Ariboflavinosis, glossitis, angular stomatitis

Dairy products, bananas, popcorn, green beans, asparagus

B3 Niacin Water 16 mg/14 mg Pellagra

Liver damage (doses > 2g/day) and other problems

Meat, fish, eggs, many vegetables, mushrooms, tree nuts

B5

Pantothenic acid

Water 5 mg Paresthesia Meat, broccoli, avocados

B6 Pyridoxine Water

1.3–1.7 mg/1.2–1.5 mg

Anemia, Peripheral neuropathy

Impairment of proprioception, nerve damage (doses > 100

mg/day)

Meat, vegetables, tree nuts, bananas

B7

Biotin(CO2transfer coenzyme)

Water 30 µg Dermatitis, enteritisRaw egg yolk, liver, peanuts, leafy green

vegetables

B9 Folic acid Water 400 µg

Megaloblastic anemia and deficiency during pregnancy

is associated with birth defects, such as neural tube

defects

Leafy vegetables, pasta, bread, cereal, liver

B12 Cobalamin Water 2.4 µg Pernicious anemia Meat, poultry, fish, eggs, milk

C Ascorbic acid

Water 90 mg/75 mg Scurvy Many fruits and vegetables, liver

VitaminChemical

nameSolubility RDA (♂/♀) Deficiency Overdose Food sources

A Retinol Fat 900 µg/700 µgNight blindness, skin

problemsHypervitaminosis A

Liver, orange, ripe yellow fruits, leafy vegetables, carrots, pumpkin, squash,

spinach, fish, soy milk, milk

D Calciferol Fat 15 µg Rickets and osteomalacia Hypervitaminosis DLichen, eggs, liver, certain fish species

such as sardines, certain mushroom species such as shiitake

E Tocopherol Fat 15 mgDeficiency is very rare; mild

anemia in newbornMany fruits and vegetables, nuts and

seeds, and seed oils

K Phylloquinone Fat 110 µg/120 µg Bleeding diathesisDecreased anticoagulation

effect of warfarinLeafy green vegetables such as spinach;

egg yolks; liver

Fat soluble vitamins

VitaminChemical

nameSolubility RDA (♂/♀) Deficiency Overdose Food sources

A

Retinol(paracrine;

structural role in rhodopsin)

Fat 900 µg/700 µgNight blindness, skin

problemsHypervitaminosis A

Liver, orange, ripe yellow fruits, leafy vegetables, carrots, pumpkin, squash,

spinach, fish, soy milk, milk

D Calciferol Fat 15 µg Rickets and osteomalacia Hypervitaminosis DLichen, eggs, liver, certain fish species

such as sardines, certain mushroom species such as shiitake

E Tocopherol Fat 15 mgDeficiency is very rare; mild

anemia in newbornMany fruits and vegetables, nuts and

seeds, and seed oils

K Phylloquinone Fat 110 µg/120 µg Bleeding diathesisDecreased anticoagulation

effect of warfarinLeafy green vegetables such as spinach;

egg yolks; liver

Night blindnessNormal vision

VitaminChemical

nameSolubility RDA (♂/♀) Deficiency Overdose Food sources

A Retinol Fat900 µg/700

µgNight blindness, skin

problemsHypervitaminosis A

Liver, orange, ripe yellow fruits, leafy vegetables, carrots, pumpkin, squash,

spinach, fish, soy milk, milk

DCalciferol

(Ca-homeostatic hormone)

Fat 15 µg Rickets and osteomalacia Hypervitaminosis DLichen, eggs, liver, certain fish species

such as sardines, certain mushroom species such as shiitake

E Tocopherol Fat 15 mgDeficiency is very rare; mild

anemia in newbornMany fruits and vegetables, nuts and

seeds, and seed oils

K Phylloquinone Fat110 µg/120

µgBleeding diathesis

Decreased anticoagulation effect of warfarin

Leafy green vegetables such as spinach; egg yolks; liver

Calcification

VitaminChemical

nameSolubility RDA (♂/♀) Deficiency Overdose Food sources

A Retinol Fat 900 µg/700 µgNight blindness, skin

problemsHypervitaminosis A

Liver, orange, ripe yellow fruits, leafy vegetables, carrots, pumpkin, squash,

spinach, fish, soy milk, milk

D Calciferol Fat 15 µg Rickets and osteomalacia Hypervitaminosis DLichen, eggs, liver, certain fish species

such as sardines, certain mushroom species such as shiitake

ETocopherol

(antioxidant of lipids)

Fat 15 mgDeficiency is very rare; mild

anemia in newbornMany fruits and vegetables, nuts and

seeds, and seed oils

K Phylloquinone Fat 110 µg/120 µg Bleeding diathesisDecreased anticoagulation

effect of warfarinLeafy green vegetables such as spinach;

egg yolks; liver

VitaminChemical

nameSolubility RDA (♂/♀) Deficiency Overdose Food sources

A Retinol Fat 900 µg/700 µgNight blindness, skin

problemsHypervitaminosis A

Liver, orange, ripe yellow fruits, leafy vegetables, carrots, pumpkin, squash,

spinach, fish, soy milk, milk

D Calciferol Fat 15 µg Rickets and osteomalacia Hypervitaminosis DLichen, eggs, liver, certain fish species

such as sardines, certain mushroom species such as shiitake

E Tocopherol Fat 15 mgDeficiency is very rare; mild

anemia in newbornMany fruits and vegetables, nuts and

seeds, and seed oils

KPhylloquinone(g-carboxylation

coenzyme)Fat 110 µg/120 µg Bleeding diathesis

Decreased anticoagulation effect of warfarin

Leafy green vegetables such as spinach; egg yolks; liver

factor IIfactor VIIfactor IXfactor Xprot Cprot S

Trace elements

● Iodine - thyroid hormones

Trace elements

● Iodine

● Zinc - enzymes eg. CA, LDH, peptidases

Trace elements

● Iodine

● Zinc

● Fluorine - caries protection

Trace elements

● Iodine

● Zinc

● Fluorine

● Cu, Mn, Mo, Cr, Se, Co, W - Various enzymatic processes in both human and bacterial cells

Malnutrition

Undernourishment

Energy

Lipid

Carb

Protein

Micronutrients

Undernourishment

Energy

Lipid

Carb

Protein

Micronutrients

Quantity

Quality

Protein-Energy Malnutrition

Energy

Lipid

Carb

Protein

Micronutrients

Protein-Energy Malnutrition: Kwashiorkor

Energy

Lipid

Carb

Protein

Micronutrients

Protein-Energy Malnutrition: Marasmus

Energy

Lipid

Carb

Protein

Micronutrients

Cachexia - starvation of the cells

Energy

Lipid

Carb

Protein

Micronutrients

Thank you for your attention!