A SEMINAR REPORT ON

NUTRIENT ABSORPTION

IN PARTIAL FULFILMENT OF AWARD OF

NATIONAL DIPLOMA(ND)

BY

FATOMIDE TAOFEEK OLUSOLA

FPA/ST/18/2-0358

DEPARTMENT OF SCIENCE OF TECHNOLOGY

SCHOOL OF SCIENCE AND COMPUTER STUDIES
THE FEDERAL POLYTHECNIC, P.M.B, OF ADO EKITI 5351 ADO- EKITI, EKITI
STATE.

SUPERVISOR: MR AWONEGAN

ABSTRACT
Nutrient Absorption aims to describe the effect of a sequence of metabolic events on
nutrient utilization. The supply of nutrients to the human body not only depends on
the amount of the nutrient in a food, but also on its bioavailability. The bioavailability
of nutrients is highly variable and can be influenced by numerous factors. Different
nutrients (including protein, iron and vitamin A), and the forms in which they exist in
the ingested medium, will reacting different ways to inhibitors and enhancers and the
hosts’ nutritional status, all contributing to the complex variability of nutrient
absorption.

INTRODUCTION
The correct assessment of the adequacy of dietary intakes of nutrients requires not
only knowledge of the nutrient content of the foods ingested, but also the extent to
which the nutrient present in the diet is available for absorption and utilization in the
human body. Bioavailability is the technical term used to convey the fact that not
100% of nutrients ingested will be absorbed, irrespective of whether consumed in the
form of food or supplements. Bioavailability aims to describe the effect of a sequence
of metabolic events, including digestion, solubilization, absorption, organ uptake and
release, enzymatic transformation, secretion and excretion, on nutrient utilization. The
supply of nutrient to the human body thus not only depends on the amount of the
nutrient in a food, but also on its bioavailability. Understanding nutrient
bioavailability helps to optimize diets and set appropriate nutrient recommendations.
The nutrient absorption of macronutrients, i.e. carbohydrates, proteins and fats, is
usually high with more than 90% of the amount ingested being absorbed and utilized
in the human body. On the other hand, micronutrients such as vitamins and minerals,
and bioactive phytochemicals such as flavonoids, carotenoids can vary widely in the
extent to which they are absorbed and utilized after ingestion.

Nutrient absorption, Until a nutrient passes from the digestive system into the
bloodstream, it has little or no value. Bioavailability can be explained as the amount of
a nutrient absorbed from the gut which becomes available for normal physiological
functions or storage.

The variability of nutrient absorption

The bioavailability of nutrients is highly variable and can be influenced by
numerous factors, including physio chemical properties such as chemical binding
form; the matrix in which the nutrient is incorporated; the presence or absence of other
food components that enhances or inhibits absorption; metabolization after absorption;
host related factors (including state of health, genetic factors, age and lifestyle); as
well as other individual factors.

Enhancers and inhibitors Nutrients can interact with one another or with other
dietary components at the site of absorption, resulting in either a change in
bioavailability or –if enhancers and inhibitors cancel each other out –a nil effect.
Enhancers can act in different ways such as keeping a nutrient soluble or protecting it
from interaction with inhibitors. For example, since carotenoids are fat-soluble,
adding small quantities of fat or oil to the meal (3to 5g per meal) improves their
bioavailability. Similarly, meat, fish and poultry, while containing highly bioavailable
iron themselves, are also known to enhance the absorption of iron from other foods
ingested at the same time. Although this ‘meat factor’ has yet to be identified, it has
been suggested that muscle protein exerts an influence. Inhibitors, on the other hand,
may reduce nutrient bioavailability by binding the nutrient in question into a form that
is not recognized by the uptake systems on the surface of intestinal cells, rendering the
nutrient insoluble and thus unavailable for absorption, or competing for the same
uptake system. As an example, phytic acid is highly abundant in certain plant foods
(e.g. pulses, whole-grain cereals, seeds, nuts) and strongly binds minerals such as
calcium, iron and zinc in soluble or insoluble complexes that are unavailable for
absorption. Ways to reduce the phytic acid content of foods include fermentation (e.g.
extensive leavening of whole meal bread dough) or the soaking and germination of
pulses. The inhibitory effect of food constituents can also be used advantageously, as
is done in the case of phytosterols. These natural compounds are extracted from
certain plant foods and added in higher doses (about 2g per portion) to various other
foods (for example enriched spreads, fermented milk drinks) to lower the absorption
of cholesterol, be it from dietary sources or produced in the human body.

Nutrient absorption of specific nutrients Protein-energy malnutrition, vitamin A

and iron deficiencies are of the most common forms of malnutrition experienced
globally and often co-exist. For effective interventions and dietary guidelines,
consideration of the bioavailability of these nutrients as supplied from different food
sources is particularly imortant. The bioavailability of these nutrients is also distinct
and influenced by different factors, which offers good examples of the complexity of
nutrient bioavailability.

Protein and amino acids:

Although protein is a macronutrient which is considered to be easily absorbed into the
human body, its bioavailability is directly linked to its digestibility. To be most
bioavailable, a meal needs to supply all the required essential amino acids in the
correct proportions. Amino acids are the central units in protein metabolism. They are
incorporated into various proteins and converted to metabolically essential compounds
such as nucleic acids, creatine and porphyrins. Of the 20 amino acids building human
proteins, 12 are manufactured by the body and are known as nonessential amino acids.
The remaining eight (8)(isoleucine, leucine, lysine, methionine, phenylalanine,
threonine, tryptophan, and valine) must be obtained from the diet and are thus termed
essential or indispensable amino acids .A sufficient intake of essential amino acids
and adequate amount of nitrogen for the body to produce the nonessential amino acids
is important for protein metabolism

Protein quality
The nutritional quality of food proteins varies and depends on essential amino acid
composition. Foods that contain essential amino acids at levels that facilitate tissue
growth and repair are known as complete protein foods, supplying high quality
proteins. Amino acids containing Sulphur (including methionine and cysteine) most
commonly limit the nutritive values (quality) of proteins in the human diet. These
sulphur containing amino acid concentrations are generally considered lower in
legumes and fruits than in animal foods.

The roles of these amino acids in the human body are crucial, as for example
methionine is the initiating amino acid in the synthesis of almost all eukaryotic
proteins, and cysteine (due to its ability to form sulphur bonds), plays an important
role in protein structure. Other indispensable amino acids, lysine and tryptophan, are
also consistently found at lower concentrations in plant-based foods, than in animal
foods, e.g. tryptophan and lysine are limiting in corn, lysine in wheat, sorghum and
other cereals, and methionine is limiting in soybeans and other legumes. For further
reading on the global protein quality debate, refer to the 2011 report of the FAO
Expert Consultation on dietary protein quality evaluation in human nutrition(FAO,
2011). addition to protein quality, digestibility (absorption), chemical integrity and
inhibitors are three key properties of food that can influence the bioavailability of
amino acids.

AMINO ACID INDIGESTIBILITY

Amino acid digestibility explains the proportion of consumed amino acids that is
absorbed. It is not a fixed attribute but reflects an interaction between the food and the
host consuming it and therefore may be subjected to individuals variation. Although
the digestibility (absorption) of macronutrients, including protein, is relatively high,
protein utilization is influenced by total dietary energy intake and by the quality of the
protein in terms of its ability to meet the metabolic demand.

Chemical integrity
Chemical integrity describes the proportion of the amino acid that, if absorbed, is in an
utilizable form. Some amino acids present in foods may be in a structural form that is
unavailable (i.e.the amino acid may be absorbed in a form that cannot be utilized).
This is most likely to be encountered in foods that are heat-treated, oxidized or
subjected to other severe processes that can limit amino acid bioavailability. Heat
treatment leads to the formation of Maillard compounds and a loss of lysine
availability. Oxidization leads to oxidized Sulphur containing amino acids and the
subsequent loss of bioavailability of tryptophan and threonine. High pH induces
racemization of L-amino acid residues to D-isomers and formation of cross-linked
amino acids such as lysinoalanine, which also reduces nutrient absorption.

Inhibitors Many foods contain bioactive (protein or non-protein) substances that may
inhibit amino acid bioavailability either by affecting digestibility or post-absorptive
utilization. These inhibitors may be naturally occurring (e.g. tannins, phytates, trypsin
inhibitors, glucosinolates, isothiocyanates), formed during processing (e.g. D-amino
acids, lysinoalanine), or formed during genetic modification of crops (e.g. lectinsin
lentils).(Lectins depressed growth at low levels in the diet and are toxic at high levels).

Vitamin A
Vitamin A is a generic term used for a group of structurally related chemical
compounds known as retinoids. to both naturally occurring and synthetic compounds
with, or without, the biological activity of vitamin A. Figure 1shows the chemical
structures of
some retinoids. The term vitamin A is often used as a general term for all compounds
that exhibit the biological activity of retinol. Vitamin A activity in the diet derives
from two sources: preformed vitamin A as retinyl esters or retinoids and provitamin A
carotenoids, such as β-carotene, α-carotene, and β-cryptoxanthin. Although an
essential nutrient needed in only small amounts, vitamin A is necessary for normal
functioning of the visual system; growth and development; and maintenance of
epithelial cellular integrity, immune function and reproduction.

Retinol (preformed vitamin A)

vitamin A is generally found as the free alcohol form (retinol) or esterified with a fatty
acid (retinyl ester). The vitamin is available in pure form by chemical synthesis or as
vitamin A palmitate or acetate. It is a pale. yellow solid, which dissolves freely in oils
and fats, but is insoluble in water. When vitamin A intake is adequate, more than 90%
of total body vitamin A is located in the liver, which releases the nutrient into the
circulation as needed. The major dietary forms of preformed vitamin A are long-chain
fatty acid esters of retinol, commonly found in foods of animal origin, such as
glandular meats, liver and fish liver oils (especially), egg yolk, and whole milk and
dairy products. Preformed vitamin A is absorbed in the small intestine. The
bioavailability of retinol is generally high, ranging from 70% to 90%. Factors such as
dietary fat and intestinal infections can affect the absorption of vitamin A by the body.
Products of fat digestion (e.g., fatty acids, monoglycerides, cholesterol, and
phospholipids) and secretions in bile (e.g., bile salts and hydrolytic enzymes) are
essential for the efficient solubilization of retinol. Absorption of retinol appears to be
reduced in individuals with diarrhea, intestinal infections and infestations.

Carotenoids:
Carotenoids are lipid-soluble plant pigments found in photosynthetic plants and
animal tissues. About 600 carotenoids have been isolated and characterized in nature,
and about 10% of these can be metabolized to vitamin A in a variety of animal
species, including humans. Both provitamin A carotenoids such as α-and β-carotenes
and cryptoxanthins and non pro vitamin A carotenoids such as lutein, zeaxanthin, and
lycopene are present in the blood and tissues of humans and have a variety of
functions. Structures of these carotenoids are shown in Figure 2.Pro vitamin A
carotenoids are an important source of dietary vitamin A that are found primarily in
dark-green leafy vegetables, such as spinach, and in orange and Yellow vegetables
and fruit, such as carrots, mango, and papaya, although their bioavailabilityis
significantly more variable than that of preformed vitamin A (retinol). The
bioavailability of carotenoids is affected by various factors. Different carotenoids have
different levels of vitamin A activity depending upon the efficiency of their absorption
and the rate of their conversion to vitamin A. Recent research has shown that the
bioavailability of traditional dietary sources of ß-carotene is considerably lower (by
one-half to one-fourth) than was previously assumed. Conversion factors for
estimating vitamin A obtained from plant foods were revised from 6:1 to 12:1 (μg ß-
carotene:retinol activity equivalent (RAE)) and 24:1 for other provitamin A
carotenoids in a mixed diet.

A wide variation in vitamin A equivalency ratios are found and can be affected
by food-and diet-related factors and health, nutritional, and genetic characteristics of
human populations.There are various diet related and host related factors affecting the
bioavailability of carotenoids. These factors have been evaluated and extensively
reported on by Castenmiller and West, and De Pee et al.in 1998, Van Het Hof et al.in
2000, as well as Yeum and Russell in 2002.

Nutrient absorption of carotenoids:

The main diet-related factors that influence bioavailability are the food matrix
in which ß-carotene is incorporated, the amount ingested and the habitual diet type.

The nutritional status, health, and genetic characteristics of human populations

can also affect the absorption and bioavailability of carotenoids. Release of the
carotenoids from the food matrix is an important first step in the absorption process.
The rupture of the plant cell walls by processing (e.g. heating or pureeing) promotes
the release of ß-carotene from cells before and during digestion, and therefore it
facilitates solubilization and absorption. The bioavailability of ß-carotene from fruits
is generally higher than for vegetables, as the cell wall structure in fruits is usually
weaker than that in most vegetables and leaves. Furthermore, inhibitors of carotenoid
absorption present in fruit are also less than that of inhibitors present in leafy
vegetables. The composition of the diet(due to nutrient-to-nutrient interactions)affects
to a large extent the absorption of carotenoids. The second step in the absorption
process that may affect bioavailability involves the incorporation of released
carotenoids into mixed micelles. Among other factors, formation of these micelles is
dependent on the presence of fat in the intestine. Therefore, ingestion of fat along with
carotenoids is thought to be crucial. It was found that only a small amount of fat is
sufficient to enhance carotenoid absorption.

As expected, unabsorbable fat-soluble compounds such as sucrose polyester(a

fat replacer),reduces carotenoid absorption. Also, as dietary fiber content increases,
the absorption of ß-carotene decreases. Dietary fiber reacts with bile acids and thereby
decreases the absorption of fat and fat soluble nutrients. The presence of dietary fiber
in vegetables and fruits may explain in part the lower bioavailability of carotenoids
from plant foods. Simultaneous ingestion of various carotenoids may also reduce
absorption of either of the carotenoids due to interactions at the intestinal level.
Studies on simultaneous ingestion of carotenoids indicate that lutein may interfere
with absorption of ß-carotene resulting in reduced bioavailability. It has also been
found that with pharmaceutical doses of ß-carotene, conversion of ß-carotene to
vitamin A decreases as the oral dose of ß-carotene increases. Further research is
required to identify the mechanisms behind these interactions. The absorption of
carotenoids is furthermore highly likely to be dependent on vitamin A status of the
host. Feeding ß-carotene–rich foods to humans leads to an increase in serum retinol
levels only when these are initially low. The serum response to ß-caroteneis higher in
women than in men; however, part of this effect could be attributed to differences in
body weight and body composition. Intestinal helminthic infections are associated
with malnutrition, and their effects are possibly mediated through impaired fat
absorption and reduced vitamin absorption, particularly of vitamin A.

IronMinerals (and other nutrients)

They exist in different chemical forms in food and this can influence their
bioavailability. A classic example is iron. There are two primary forms of dietary iron,
namely heme and non-heme iron. The former is only found in animal products such as
red meat, fish and poultry. The heme iron content of animal source foods is estimated
at 40% of total iron, but data suggest that considerably more heme iron is provided by
a portion of red meat than by a portion of white fish for example. Heme iron is a
component from hemoglobin and myoglobin this explains why it is only found in
animal tissue. Non-heme iron is found mostly in plant-based foods and makes up the
remaining estimated 60% of iron found in animal products. The type of iron (heme or
non-heme) notably influence nutrient absorption. Approximately 90% of dietary iron
is consumed in the non-heme form, however, due to a low nutrient absorption
constitutes only approximately 50% of iron actually absorbed into the human body.
The absorption of non-heme iron is usually much lower than that of heme iron. In
general, the rate of non-heme iron absorption is related to its solubility in the upper
part of the small intestine.

The presence of soluble enhancers such as ascorbic acid and inhibitors such as
phytates, polyphenols and calcium, consumed during the same meal will have a
notable effect on the amount of non-heme iron absorbed. Heme iron is much less
affected by other dietary factors and contributes more significantly to absorbable iron.

Inhibitors and enhancers of iron bioavailability

Non-heme food iron that enters the common iron pool in the digestive tract is
absorbed to the same extent, which depends on the balance between the absorption
inhibitors and enhancers and the iron status of the individuals. Phytate and
polyphenols in plant-based diets is the main inhibitors of non-heme iron absorption.

The negative effect of phytate on iron bioavailability is dose-dependent and

any food processing and preparation methods, such as milling, heating, soaking,
germination and fermentation that degrade phytate to a varying extent, will have a
positive effect on iron absorption. Controversies exist on the inhibitory effect of oxalic
acid in spinach and cabbage and non-digestible carbohydrates in beans on iron
absorption, as these foods are also good sources of ascorbic acid which enhances iron
absorption. Calcium and dairy products have also been shown to have a negative
effect on non-heme iron absorption, but what separates it from other inhibitors is its
ability to also inhibit heme iron absorption. Single meal studies show a negative effect
of calcium on iron absorption, but multi-meal studies with a variety of other inhibitors
and enhancers indicate that calcium has only a limited negative effect on iron
absorption. In a recent study the two major milk protein fraction, casein and whey,
and egg protein, albumin, were reported to have a negative effect on iron absorption in
humans. Although phytate was shown to be the major inhibitor in soy, even after
complete phytate digestion in soy protein isolates significant inhibition of iron
absorption was still observed. It was concluded that both phytate and a protein fraction
were the main inhibitors of iron absorption in so. Ascorbic acid has convincingly been
shown to enhance iron nutrient absorption in a dose-dependent manner. This effect is
largely due to ascorbic acid’s ability to reduce ferric to ferrous iron. Ascorbic acid has
also been shown to, at least partially counteract the inhibitory effect of both phytate
and polyphenols on non-heme iron absorption. Small amounts of meat are recognized
to enhance the absorption of non-heme iron from plant foods, although the mechanism
for the enhancing effect of meat on non-heme iron absorption is unknown. Studies
support the enhancing effect of cysteine-containing peptides following the proteolysis
of meat muscle. Vitamin A and β-carotene can also enhance non-heme iron absorption
and improve hemoglobin levels, although several studies suggest that it is only
observed in iron deficient individuals. Host related factors that influence the
absorption of heme and non-heme iron
includes mainly iron status, other nutritional deficiencies, infection, genetic disorders
and physiological state. As with inhibitors and enhancers, the iron status of an
individual mainly influences on the absorption of non-heme iron, while heme iron
absorption is less affected. There is an inverse relationship between iron status and
iron absorption. Protein-energy malnutrition, riboflavin and vitamin A deficiencies
have also been shown to impair iron metabolism and absorption.
 The correction of nutritional deficiency will improve iron absorption iron
deficiency often co-exists in a double burden of disease in seemingly well-fed,
overweight populations. This can be partially due to iron absorption being decreased
by the peptide, hepcidin. Hepcidin secretion is increased due to chronic inflammation
and obesity. It is a regulatory hormone secreted by the liver and inhibits iron
absorption. Achlorhydria might also be a substantial cause of iron deficiency, mainly
in elderly people in whom atrophic gastritis is common, and gastric acid secretion is
low. Gastric acid is needed to maintain ferric iron forms in solution and bioavailable.
However, heme iron does not appear to be affected by lack of acid and is normally
absorbed in individuals with atrophic gastritis. Other common causes of lowered iron
absorption and iron deficiency are mucosal atrophy in coeliac disease and, possibly,
Helicobacter Pylori infection, although no consensus has been reached. For further
reading on iron bioavailability, refer to Heath and Fairweather (2002), Zimmerman
and Hurrel (2007), and Hurrel and Egli (2010).
CONCLUSIONS
Different nutrients react differently once ingested into the human gastro-
intestinal tract, and can be influenced by various factors including the quality of the
food source and the matrix in which it is consumed, the composition of the whole
meal, inhibitors, enhancers and the status of the host. Although bioavailability is only
a partial measure of the body’s ability to benefit from a nutrient, this factor quantifies
the amount of a substance that successfully enters the bloodstream. Once in the
bloodstream, the nutrient must cross cellular membranes before it can nourish body
cells. In addition to considering the nutrient content of foods, nutrient bioavailability
should also be taken into consideration when nutrition-sensitive policies, nutrition
interventions and dietary guidelines are developed. It should however be noted that
bioavailability can’t attain a constant calculated value, and needs to be considered
with caution as multiple factors, both intrinsic and extrinsic, can notably affect the
bioavailability of nutrients present in food-, and non-food sources of nutrients.
REFRENCE
Castenmiller, J.J.M. and West, C.E. (1998). Bioavailability and bioconversion of
carotenoids. Annual Review of Nutrition18, 19-38
Castenmiller, J.J.M., West, C.E., Linssen, J.P.H., van het Hof, K.H. and Voragen,
A.G.J. (1999). The food matrix of spinachis a limiting factor in determining the
bioavailability of ß-carotene and to a lesser extent of lutein in humans. Journal of
Nutrition129, 349-355.
Dary, O. and Mora, J.O. (2002). Food fortification to reduce vitamin A deficiency:
International Vitamin A Consultative Group Recommendations. Journal of Nutrition
132, 2927S-2933S
De Pee, S., West, C.E., Permaesih, D., Martuti, S., Muhilal and Hautvast, J.G.A.J.
(1998). Orange fruit is more effective than are dark-green leafy vegetables in
increasing serum concentrations of retinol and ß-carotene in schoolchildren in
Indonesia. American Journal of Clinical Nutrition 68, 1058-1067
FAO. (2011). Dietary protein quality evaluation in human nutrition. Report of an FAO
Expert Consultation. 31 March -2 April, Auckland, New Zealand. FAO Food and
Nutrition Paper 92', Food and Agricultural Organisation, Rome.
Friedman, M. (1996). Nutritional value of proteins from different food sources.
Journal of Agricultural and Food Chemistry 44, 6-29.
Harrison, E.H. (2012). Mechanisms involved in the intestinal absorption of dietary
vitamin A and provitamin A carotenoids.
Biochimica et Biophysica Acta 1821, 70-77.
Haskell, M.J. (2012).The challenge to reach nutritional adequacy for vitamin A: ß-
carotene bioavailability and conversion -evidence in humans. American Journal of
Clinical Nutrition96(suppl), 1193S-1203S.
Millward, D.J., Layman, D.K., Tomé, D. and Schaafsma, G. (2008). Protein quality
assessment: impact of understanding of protein and amino acid needs for optimal
health. American Journal of Clinical Nutrition87(suppl), 1576S-1581S.
Packer, L., Kraemer, K., Obermüller-Jevic, U. and Sies, H. (ed.)(2005). Carotenoids
and Retinoids: Molecular aspects and health issues, Illinois: AOCS Press.
Otten, J.J., Hellwig, J.P.andMeyers, L.D.(2006). Dietary Reference Intakes: The
essential guide to nutrient requirements, Institute of Medicine. ISBN 0-309-10091-7,
Washington.
van het Hof, K.H., West, C.E., Weststrate, J.A. andHauvast, J.G.A.J.(2000). Dietary
factors that affect the bioavailability of carotenoids. Journal of Nutrition130(3), 503-
506.

Cross References
Castenmiller, J.J.M. and West, C.E. (1998). Bioavailability and bioconversion of
carotenoids. Annual Review of Nutrition18, 19-38.
De Pee, S., West, C.E., Permaesih, D., Martuti, S., Muhilal and Hautvast, J.G.A.J.
(1998). Orange fruit is more effective than are dark-green leafy vegetables in
increasing serum concentrations of retinol and ß-carotene in schoolchildren in
Indonesia. American Journal of Clinical Nutrition68, 1058-1067.
Heath, A.-L. and Fairweather-Tait, S.J. (2002). Clinical implications of changes in the
modern diet: iron intake, absorption and status. Best Practice & Research Clinical
Haematology15(2), 225-241.
Hurrell, R. and Egli, I. (2010). Iron bioavailability and dietary reference values.
American Journal of Clinical Nutrition91(suppl), 1461S-1467S.
van het Hof, K.H., West, C.E., Weststrate, J.A. and Hauvast, J.G.A.J. (2000). Dietary
factors that affect the bioavailability of carotenoids. Journal of Nutrition130(3), 503-
506.
Yeum, K.J.andRussell, R.M.(2002). Carotenoids bioavailability and bioconversion.
Annual Reviews of Nutrition22, 483-504.
Zimmermann, M.B. and Hurrell, R.F. (2007). Nutritional iron deficiency. Lancet370,
511-520