Victor Tambunan Fiastuti Witjaksono Erwin Christianto

Department of Nutrition Faculty of Medicine Universitas Indonesia

References
• Mahan LK, Escott-Stump S. Food & Diet Therapy 12th ed., 2008 • Gropper SS, et al. Advanced Nutrition and Human Metabolism 4th ed., 2005 • Shils ME, et al. Modern Nutrition in Health and Disease 10th ed., 2006

• Bowman BA, Russell RM. Present Knowledge in Nutrition 9th ed., 2006
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     Organic substances Needed in small amounts Function in specific metabolic processes Maintain health & secure growth Should come from diet (plants & animals) 5 .

Natural vs. Synthetic Vitamins • Chemically identical • Bioavailability  same Bioavailability: the degree to which a substance becomes available to the target tissue 6 .

Megadoses Vitamin a dose at least 10 times greater than the recommended intake Seldom obtained from food alone Readily available in pills 7 .

E. D.• Fat soluble: Vitamins A. and K • Water soluble: Vitamins B group and C 8 .

Fat Soluble • Soluble in fat Water Soluble  Soluble in water  Minimal storage of dietary excesses  Excreted in urine  Deficiency symptoms often develop rapidly  Must be supply in diet every day  Do not have precursor 9 • Excess intake need to be stored • Excreted in urine & bile (little) • Deficiency symptoms slow to develop • Not absolutely necessary in diet every day • Have precursor .

THIAMIN Functions • Thiamin pyrophosphate (thiamin diphosphate. cocarboxylase): coenzyme in energy metabolism & transketolation (HMP shunt) • Involve in the production & release of acetylcholine 10 .

Glucose NAD+ Piruvate CoA TPP NADH + H+ FAD CO2 acetyl-CoA Oxidative decarboxylation TPP: thiamin pyrophosphate FAD: flavin adenine dinucleotide NAD: niacin adenine dinucleotide Citric acid cycle 11 Oxidation of glucose .

Deficiency symptoms • • • • Wet beri-beri: edema. cor bovinum Dry beri-beri: paresthesia Infantile beri-beri: 2–5 months of age Cerebral: in alcoholism  Wernicke-Korsakoff syndrome 12 .

etc.) • Legumes • Whole-grain and enriched cereals & breads • Wheat germ • Potatoes 13 .Food Sources • Organ meats (liver. kidney.

and amino acids 14 .RIBOFLAVIN Functions • Part of two coenzymes: Flavin mono-nucleotide (FMN)  Flavin adenine dinucleotide (FAD)  • Coenzyme in energy production from oxidation of glucose. fatty acids.

Fatty acyl-CoA FAD FADH2 NAD NAD + H+ acetyl-CoA Citric acid cycle FAD: flavin adenine dinucleotide NAD: niacin adenine dinucleotide 15 .

Deficiency • • • • Stomatitis angularis Seborrheic dermatitis Cheilosis Glossitis (magenta tongue) 16 .

Food Sources • • • • • Milk and dairy foods Organ meats Green leafy vegetables Eggs Enriched cereals and breads 17 .

and amino acids metabolism 18 . fatty acids.NIACIN • Nicotinic acid. NADPH in carbohydrates. nicotinamide • Can be synthesised from tryptophan Function Coenzymes: NADH.

dermatitis. dementia. and death) • Tremors • Sore tongue (‘beef tongue’) • Low blood or urine nicotinamide 19 .4 Ds (diarrhea.Deficiency • Pellagra ---.

Food Sources • • • • • • Fish Liver Meat Poultry Milk Eggs • Many grains • Peanuts • Legumes 20 .

VITAMIN B6 Forms: pyridoxine. pyridoxamine Functions Coenzyme pyridoxal phosphate (PLP) in amino acid metabolism (transamination) Synthesis of neurotransmitters:  Serotonin  Norepinephrine  Epinephrine  g-amino butyric acid (GABA) Synthesis of heme 21 . pyridoxal.

a-keto acid 1 Amino acid 2 PLP Amino acid 1 a-keto acid 2 PLP: pyridoxal phosphate Transamination 22 .

cheilosis.Deficiency symptoms Deficiency may be precipitated by medications e. stomatitis Seborrheic dermatitis PLP << Tryptophan Niacin 23 . isoniazid (INH) • • • • • Anemia Impaired cell-mediated immunity Niacin deficiency Glossitis. antituberculosis drug. g.

Food Sources • • • • • • • Chicken Liver Fish Egg yolks Whole grain cereals Potato Banana 24 .

and serine • Formation of heme • Catabolism of histidine 25 .FOLIC ACID Functions • Biosynthesis of purine & pyrimidine • Synthesis of the amino acids methionine. histidine.

Deficiency symptoms • • • • • Megaloblastic anemia Glossitis GI disturbances General weakness Neural tube defects (NTD) 26 .

Food Sources • • • • • • Asparagus Spinach Wheat germ Yeast Legumes Nuts • Liver • Kidney 27 .

and single carbon (C) 28 . amino acids.VITAMIN B12 Functions • • • • DNA synthesis Growth & cell division Coenzyme: homocysteine  methionine Metabolism of propionate.

FH4: tetrahydrofolate SAM: S-adenosyl methionine CH3: methyl PLP: pyridoxal phosphate Metabolism of homocysteine 29 .

Deficiency Can develop in vegans (true vegetarians) • • • • Pernicious anemia Enlarge bone marrow cells (megaloblastic) Neurologic disorders Hyperhomocysteinemia  coronary heart disease risk 30 .

Food Sources • • • • • Liver Kidney Milk & dairy foods Meat Eggs 31 .

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MINERAL • • • • • • Inorganic substances. includes 60 minerals Exist as free ion or bound 33 . growth. & reproduction Balance among them is crucial for health Ash constituents  when food is burned 4% of human body. essential Vital to maintain life.

Macronutrient minerals (major minerals): required in the diet in relatively large amounts • Micronutrient minerals (trace elements): required in relatively small amounts 34 .

Minerals essential for human nutrition Major minerals Calcium (Ca) Phosphorous (P) Potassium (K) Sulfur (S) Sodium (Na) Chloride (Cl) Magnesium (Mg) Trace elements Iron (Fe) Zinc (Zn) Copper (Cu) Iodine (I) Selenium (Se) Manganese (Mn) Chromium (Cr) Molybdenum (Mo) Cobalt (Co) 35 .

& transport 4. digestion. Cofactors in biological reactions 3. Transmission of nerve impulses 7.General Functions 1. Maintenance of water balance 6. Regulation of muscle contraction 36 . Components of essential body compounds 2. Maintenance of acid-base balance 5. Facilitation of absorption.

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The most abundant mineral in the body Functions     Bone & tooth formation Growth Blood clotting Influences many biochemical reactions 38 .

)  Second messenger in signal transductions Ca2+ is an integral part of the signaling systems  facilatated by calmodulin Calmodulin: an intracellular calcium-dependent regulatory protein (Ca2+ receptor protein) Ca is required for nerve transmission & regulation of heart muscle function 39 .Functions ………………………… (cont.

Food Sources • • • • • • Milk and milk products Sardines Clams Oysters Green leafy vegetables Tofu 40 .

Functions
• Mineralisation of bones & teeth

• Energy released in CHOs, fats & proteins oxidation  adenosine triphosphate (ATP)
• Integral part of DNA & RNA

• Component of essential body compounds: coenzyme thiamin pyrophosphate (TPP)
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Food Sources
In general, good food sources of protein are also good sources of P • • • • • • • • Meat Poultry Fish Eggs Milk & milk products Cereals Legumes Nuts
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Major cation of intracellular fluid

Functions
Required:
• For cell growth

• In biochemical reactions, esp. those involved in the release of energy from food
• In the synthesis of glycogen & protein
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Food Sources • • • • • • Fruits (especially banana) Milk Meat Cereals Vegetables Legumes 44 .

Phosphorylation of glucose • Muscle relaxation 45 .Functions • Stabilise the structure of ATP in ATP-dependent enzyme reactions • Cofactor for >300 enzymes involved in the metabolism of food components & synthesis of metabolic products: e.Synthesis of fatty acids & proteins . .g.

HEXOKINASE GLUCOKINASE Glucose Mg2+ Glucose 6-phosphate ATP ADP Phosphorylation of glucose 46 .

Food Sources • • • • • • Nuts Legumes Cereals Dark green vegetables Milk Tofu 47 .

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& bone marrow:  Ferritin  Hemosiderin  Transferrin 49 . spleen.Functional Iron • • • • Hemoglobin Myoglobin Heme enzymes Nonheme enzymes Nonfunctional Iron  Iron storage compounds within the liver.

neurotransmitters dopamine. collagen. & norepinephrine • Formation of erythrocytes 50 .Functions • Oxygen transport • Cofactor of enzymes:  Involved in energy release during nutrients oxidation  Conversion of b-carotene → retinol  Synthesis of purine. carnitine. serotonin.

Citric acid cycle (Krebs cycle) 51 .

Deficiencies • • • • • Anemia Low productivity Low cognitive function Prone to infection Body temperature regulation is disturbed Excess  Hemosiderosis (liver)  Hemochromatosis (other tissues) 52 .

Heme iron • Iron that is combined within heme groups • Largely derived from hemoglobin & myoglobin molecules within foods of animal origin • Absorbed 25% of dietary iron Nonheme iron  Iron that is not bound within the structure of heme  Found predominantly in plant foods  Absorbed only 5% Heme iron has higher bioavailability than nonheme iron 53 .

Food Sources • • • • • • • Liver Meat Egg yolk Legumes Dark green vegetables Shrimp Oysters Milk & milk products are devoid of iron 54 .

& carbonic anhydrase  Normal growth. & immune system  Taste buds  healthy appetite  Involved in stabilisation of protein & nucleic acid structure 55 .Functions  Catalytic functions: required for the biological function of >300 enzymes (zinc metalloenzymes) e. alkaline phosphatase.g. RNA polymerases. reproduction.

Linking of zinc fingers to corresponding sites on DNA  initiates the transcription process & gene expression C. Cys: cysteine H. Antioxidant: constituent of superoxide dismutase (SOD) SOD (superoxide) O2 (peroxide) H2O2  Structural functions: in structural zinc sites. or zinc fingers. His: histidine 56 . Zn2+ is coordinated by 4 amino acid side chains.

Deficiencies  Growth retardation  Delayed sexual maturation  Hypogonadism & hypospermia  Skin lesions  Delayed wound healing  Immune deficiencies  Impaired taste (hypogeusia) Patients with type 1 & 2 diabetes: hyperzincuria  tends to  with the severity of the disease 57 .

Food Sources • • • • • • • Oysters & shellfish Fish Meat Liver Legumes Milk Wheat bran 58 .

Functions Roles in mitochondrial in energy production involve in Cu-containing electron transport protein Part of Cu-containing enzyme SOD Promotes synthesis of melanin & catecholamines Cu in ceruloplasmin  role in oxidising iron Synthesis of collagen & elastin 59 .

Respiratory chain components in mitochondria 60 .

Deficiency • • • • • • Anemia Neutropenia Skeletal demineralisation Hair & skin depigmentation Failure of erythropoiesis Menkes’ syndrome (kinky-hair syndrome): hereditary. hypothermia. Affected infants: retarded growth. defective hair keratinisation & pigmentation. & progressive mental deterioration 61 . degenerative changes in aortic elastin.

Food Sources • • • • • • • • Shellfish Liver. kidney Meats Chocolate Nuts Cereal grains Dried legumes Dried fruits Cow’s milk: poor source of Cu 62 .

catalysed by Se-containing 5’-deiodinases The metabolic action is through T3 in tissues • Thyroid hormones promote synthesis of enzymes & other proteins to  metabolic activity in tissues • Thyroid hormones is essential for proper maturation of the central nervous system (CNS) 63 .Functions • Synthesis of triiodothyronine (T3) & thyroxine (T4) Conversion of T4 T3.

hearing & speech loss. and spasticity  Intellectual impairment  low IQ • • • • Reproductive damage Hypothyroidism Goiter  enlargement of thyroid gland Less energetic & inefficient 64 .Deficiencies • Fetal & infant mortality • Neurologic deficit  Cretinism: mental retardation. short stature.

lobsters. oysters.Food Sources • Iodized table salt • Seafoods: clams. sardines & other saltwater fish The iodine content of cow’s milk & eggs is determined by the iodides in the diet of the animal The iodides content in of vegetables varies according to the iodine content of the soil 65 .

Functions Antioxidant: integral part of glutathione peroxidase (GSHPx)  break down H2O2 Constituent of the enzyme 5’-deiodinases which convert T4 (thyroxine)  T3 (triiodothyronine) T3 is the active thyroid hormone 66 .

glutathione peroxidase (GSHPx) 67 .GSSG 2H20 Se Glutathione peroxidase 2GSH GSH: reduced glutathione GSSG: oxidised glutathione H202 Enzymatic reaction catalysed by Se-containing enzyme.

Deficiency • Keshan disease  cardiomyopathy in children • Kashin-Beck disease  preadolescent or adolescent osteoarthritis 68 .

Food Sources • • • • • • Brazil nuts Seafood Kidney Liver Meat Poultry • Grains Selenium content in food depends on Se content in the soil & water 69 .

including:  Enzyme in energy release metabolism  Mitochondrial SOD  Enzymes in CHO & lipid metabolism Mn is associated with: • Formation of connective & skeletal tissues • Growth & reproduction 70 .Functions Component of many enzymes.

Citric acid cycle (Krebs cycle) 71 .

Food Sources • • • • • • Blueberries Whole grains Legumes Nuts Tea Fruit 72 .

lipid. & protein metabolism Deficiency Insulin resistance & a few lipid abnormalities 73 .Functions Potentiates insulin action influences CHO.

Food Sources • • • • • • • • Brewer’s yeast Broccoli Oyster Liver Potatoes Whole grains Chicken Bran 74 .

Glucose Niacin Potassium Magnesium Fatty acids Riboflavin Niacin Sulfur Magnesium Amino acids Vitamin B6 Magnesium Potassium Citric acid cycle Niacin Manganese Thiamin Iron Riboflavin Magnesium Copper CO2 + H2O + Energy 75 .

Recommended Dietary Allowances (RDA) Indonesian RDA: Angka Kecukupan Gizi (AKG) 2004 76 .

com .erwin.081310733442 dr.christianto@gmail.

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