LECTURE OUTLINE

PS KEBIDANAN POLTEKKES DENPASAR

VITAMIN & MINERAL

Made Ary Sarasmita, S.Farm, M.Farm.Klin, Apt

 KEBUTUHAN GIZI

KARBOHIDRAT

PROTEIN
MINERAL
NABATI

PROTEIN
VITAMIN
HEWANI
2
 VITAMINS
• Essential organic substances
• Produce deficiency symptoms when missing from diet
• Plant & animal foods provide vitamins
• Yield no energy
• Basic functions :
– Facilitate energy – yielding chemical reaction
– As co-enzymes
• Consist of 2 types  fat soluble & water soluble
• Fat soluble
– Not readily excreted (exc. Vit K)
• Water soluble
– Generally lost from body (ex. Vit B6 and B12)
– Excreted via urine
 Overview : Fat Soluble Vitamins
• Dissolve in organic solvent
• Not readily excreted
• Absorbed along with fat
• Fat malabsorption  may cause deficiency
• Transported with fat in lipoprotein
 Vitamin A
• Narrow optimal intake range
• Function  promote vision (especially night blindness,
growth, prevent drying of the skin & eyes, promote
immune function & bacterial infection, cardiovascular
disease prevention, cancer prevention, acne med)
• Preformed
– Retinoids
– Found in animal product
• Proformed
– Carotenoids
– Found in plant product
 Recommended Amounts of Vit A
• 900 mcg for men; 700 mcg for women
• Daily value is 1000 mcg  upper level is 3000 mcg
• Much stored in liver
• Toxicity of Vit A :
– Large intake of vit A (preformed)  sign & symptom :
bone/muscle pain, loss of appetite, skin disorders,
headache, dry skin, hair loss, increasing liver size,
vomiting, fetal malformation, permanent damage
 Vitamin D
• Prohormone
• Derived from
cholesterol
• Synthesized from sun
exposure
– Sunscreen SPF > 8 
decrease synthesis
– Expose hand, face,
arms 2-3x/week for
5-10 minutes each
time
• Activated by enzymes
in liver and kidneys
 Function of Vit D
• Regulates blood Calcium
– Along with PTH hormones
– Regulates calcium + phosphorus absorption
– Reduces kidney excretion of calcium
– Regulates calcium deposition in bone
• Influence normal cell development
– Linked to reduction of breast, colon & prostate
Cancer
 Role in Bone Formation
• Causes calcium + phosphorus to
deposit in the bones
• Strengthens bone
• Rickets  low of vit D 
breastfed infant with little sun
exposure
• Osteomalacia  ricket-like in
adult, bone lose minerals &
become porous
 Food Source of Vit D
• Fatty fish, fortified milk & cereal
• Adequate Intake for Vitamin D
– 5 mcg/day (200 IU/day) for adult under age 51
– 10-15 mcg/day (400-600 IU/day) for older
– Supplement if a breastfed infant
– Vit D can be very toxic  especially in infancy and
childhood (upper level is 50 mcg/day)
– Result in  over-absorption of Ca (hypercalcemia),
increase calcium excretion, calcium deposits in organs
and blood vessels, growth retardation
Function of Vitamin E
• Protects double bonds in unsaturated fats
• Improves vit A absorption
• Deficiency  breakdown of cell membranes, hemolysis,
nerve degeneration
• RDA for adults is 15 mg/day
• Upper level is 1.000 mg/day (supplementary of alpha
tocopherol)
• Upper level is 1500 IU (natural sources) of 1100 IU (syntetic
forms)
• Toxic effect  inhibit vit K metabolism & anticoagulants,
possible hemorrhage, muscle weakness, headaches,
nausea
 Vitamin K
• Synthesized by bacteria in the colon &
absorbed
• Role in coagulation process & calcium
binding potential
• Food sources of Vit K  liver, green leafy
vegetables, broccoli, peas, green beans,
resistant to cooking losses, limited vit K
stored in the body
• Adequate intake for vit K
– 90 mcg/day for women; 120 mcg/day for men
– Excess vit A & E  interferes with vit K, may
cause hemorrhage & fractures
– Newborn  routinely injected with Vit K,
breastmilk (poor source)
– Toxicity unlikely; readily excreted
Overview : Watur Soluble Vitamins
• Dissolve in water
• Generally readily excreted from body
• Subject to cooking losses
• Function as coenzymes
• Participate in energy metabolism
• 50-90% of B vitamins are absorbed
• Marginal deficiency more common
 Thiamin
• Sensitive to alkalinity & heat
• Coenzyme form used in energy
metabolism
• Deficiency : beri-beri
• RDA  1,1 mg/day for women;
1,2 mg/day for men, most exceed
RDA in diet
• Surplus in rapidly lost in urine,
nontoxic
 Riboflavin
• Coenzyme form participate in energy –
yielding metabolic pathways
• Deficiency : cheilosis, inflammation of mouth
& tongue, dermatitis, photosensitive
• RDA  1,1 mg/day for women; 1,3 mg/day
for men; average intake above RDA
• Nontoxic
• Food sourve of riboflavin  milk,
grains/cereals, egg, liver, spinach, oyster, yeast
 Niacin
• Coenzyme form used in energy
metabolism
• RDA  14 mg/day for women; 16
mg/day for men
• Toxicity occur when upper level is 35
mg/day
• Food sources of niacin : enriched grains,
beef, chicken, fish
• Heat stable, little cooking loss
• 60 mg tryptophan can be converted
into 1 mg niacin
 Pantothenic Acid
• Part of Coenzyme A  essential for
metabolism of carbohydrate, fat, protein
• Deficiency rare
– Adequate intake = 5 mg/day
• Food source : meat, milk, mushrooms, liver,
peanuts
 Biotin
• Free and bound form
• Coenzyme  metabolism of carbohydrate & fat, help
breakdown certain amino acids
• Deficiency rare  scaly, inflamed skin, change in
tongue, lips, decreased appetite, nausea, vomiting
• Food source : cauliflower, egg yolk, liver, peanuts,
cheese
• Intestinal synthesis of biotin contributes very little
• RDA  adequate intake is 30 mcg/day (adult)
– No upper level for biotin, relatively non toxic
 Vitamin B6
• Coenzyme forms  activate enzymes needed for
metabolism of carbohydrate, fat, protein; synthesize
nonessential amino acid via transamination, synthesize
neurotransmitter, synthesize Hb & WBC, role in
homocysteine metabolism
• RDA 
– 1,3 mg/day for adult
– 1,7 mg/day for men over 50; 1,5 mg/day for women over
50
– Daily value is 2 mg  average intake is more than RDA
– Athletes may need more
– Alcohol increase vit B6 destruction
 Vit B6 As a Medicine ?
• Pregnancy Hypertension
– 50 – 100 mg/day therapy
• Carpal tunnel syndrom
• Morning sickness
– 100 mg/day
• Toxicity potential
– More than 200 mg/day can lead to irreversible
nerve damage  upper level set as 100 mg/day
 Vitamin B12
• Synthesized by bacteria & fungi
• Coenzyme  Role in folate metabolism, maintenance of
myelin sheaths, RBC formation
• RDA  2,4 mcg/day for adult, average intake exceeds RDA,
nontoxic
• Deficiency  pernicious anemia, nerve degeneration and
paralysis
• Absorption of B12  require a protein from salivary gland,
require stomach acid, require intrinsic factor, absorbed in
the last part of small intestine about 50%
• Therapy for Ineffective Absorption  injection of vit
B12/monthly, vit B12 nasal gel
• Food source  animal product (stored primarily in liver of
animal), organ meat, seafood, egg, milk
 Vitamin C
• Synthesized by most animals  not by humans
• Decreased absorption with high intakes
• Excess excreted  diarrhea common
• Food source  citrus, broccoli, strawberry, spinach,
potatoes, etc
• RDA for Vit C  90 mg/day (adult male), 75 mg/day (adult
female), daily value is 60 mg; more 35 mg/day for smokers,
average intake 100 mg/day, upper level is 2 g / day
• Sensitive to  cooking/heat, iron, copper, O2
• Function  synthesis of collagen, iron absorption, immune
function, antioxidant
• Deficiency  scurvy
– Deficient for 20-40 days, symptoms: fatigue, pinpoint
hemorrhage, bleeding gums, weakness, fractures, associated
with poverty
 MINERAL
• Mineral adalah zat yang
berperan untuk mencukupi
kebutuhan gizi, mengatur
keseimbangan cairan
tubuh, & membantu
pertumbuhan
• Contoh : Kalsium, Zat besi,
zink, fosfor, natrium, dll
Mineral yang Penting Untuk Tubuh

• Sumber : menjaga kesehatan sel darah dalam tubuh

ZAT BESI • Guna : Hati, jantung, daging, ayam, ikan, kuning telur,
kacang-kacangan, dan sayuran berdaun hijau

KALSIUM • Sumber : Susu, keju, kacang kedelai, salmon, kacang

tanah, biji-bijian dan sayuran
• Guna : Membentuk dan mempertahankan kesehatan
& FOSFOR tulang dan gigi

SENG • Sumber : proses pertumbuhan, menjaga kesehatan

mata, usus, kekebalan tubuh, mempercepat
penyembuhan

(ZINC) • Guna : Kerang, ikan, tiram, daging merah, kacang-

kacangan, biji-bijian, dan gandum
Folate
• Coenzyme  DNA synthesis,
homocysteine metabolism, NT
formation
• Sensitive to  heat, oxidation, UV
• Deficiency  megaloblast cell,
megaloblast anemia, neural tube defect
• Food source  liver, fortified cereal &
milk, vegetable, orange, grain, legumes
• RDA 
– 400 mcg/day (adult); 600 mcg/day
(pregnancy); excess intake can mask vit
B12 deficiency, upper level is 1 mg
(synthetic form)  folate in food has
limited absorption
Folic Acid Deficiency
 Choline
• Essential nutrient, though not a vitamin
• All tissues contain choline  precursor of
acetylcholine, precursors for phospolipids, some
role in homocystein metabolism
• Widely distributed in food  milk, liver, egg,
peanut, lecithin
• Deficiency rare
– Adequate intake is 550 mg/day (male), 425 mg/day
(female), average intake 700-1000 mg/day
– High doses  fishy body odor, vomiting, salivation,
sweating, hypotension, GI effect  3,5 g/day
 BAKTI SOSIAL HUT IKATAN APOTEKER
22/06/2014 40
INDONESIA 2014 DI UBUD, GIANYAR
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