Micronutrient Deficiencies

Question 1

What are the nutrients for which there may be deficiency in the UK?

Answer 1

Iron, Vitamin D, Iodine

Question 2

What is a major factor determining the amount of iron absorbed?

Answer 2

Bioavailability

Question 3

Where is iron primarily absorbed in the body?

Answer 3

Duodenum

Question 4

What hormone regulates iron absorption?

Answer 4

Hepcidin

Question 5

What are the two forms of dietary iron?

Answer 5

• Haem
• Non-haem

Question 6

What percentage of iron in meat is in the haem form?

Answer 6

30-70%

Question 7

What is the absorption rate of haem iron?

Answer 7

20-30%

Question 8

What is the absorption rate of non-haem iron?

Answer 8

1-10%

Question 9

Fill in the blank: Non-haem iron is absorbed best in the _______ state.

Answer 9

ferrous (Fe2+)

Question 10

Name two promoting factors for iron absorption.

Answer 10

• Vitamin C
• Animal protein

Question 11

Name two inhibiting factors for iron absorption.

Answer 11

• Phytate
• Polyphenols

Question 12

What is the largest contributor to iron intake in the UK for children under 10?

Answer 12

Cereals and cereal products (52-53%)

Question 13

What are the Dietary Reference Values (DRV) for young adult females (19-49 years) for iron?

Answer 13

14.8mg/d

Question 14

What percentage of girls aged 11-18 years have a dietary intake below LRNI?

Answer 14

49%

Question 15

What are common symptoms of iron deficiency?

Answer 15

• Fatigue
• Breathlessness
• Insomnia
• Tachycardia

Question 16

What is a marker of poor iron stores?

Answer 16

Low ferritin

Question 17

What food sources are very good for iron?

Answer 17

• Meat
• Offal
• Fish
• Eggs

Question 18

What is the maximum over-the-counter iron supplement dosage?

Answer 18

14mg

Question 19

What type of iron supplements are prescribed to treat anaemia?

Answer 19

• Ferrous sulphate
• Ferrous fumarate

Question 20

True or False: Iron absorption decreases when erythropoiesis is reduced.

Answer 20

True

Question 21

What percentage of adults over 65 years have low haemoglobin indicating iron deficiency anaemia?

Answer 21

15% men, 11% women

Question 22

Fill in the blank: Fortified breakfast cereals are a form of iron _______.

Answer 22

fortification

Question 23

What are the key micronutrients to be considered for deficiencies in the UK?

Answer 23

Iron, Vitamin D, Iodine

Question 24

What is the main source of Vitamin D?

Answer 24

Action of photosynthesis on the skin following irradiation with short wavelength UV light

Question 25

List some dietary sources of Vitamin D.

Answer 25

* Oily fish * Liver * Fortified foods (e.g., cereals, margarines) * Tiny amounts in red meat and egg yolk

Question 26

What deficiency conditions are associated with Vitamin D?

Answer 26

* Rickets * Osteomalacia

Question 27

How is Vitamin D status measured?

Answer 27

Plasma levels of 25-hydroxyvitamin D (25(OH)D)

Question 28

What plasma level indicates suboptimal Vitamin D status?

Answer 28

Traditionally less than 25nmol/l

Question 29

What factors affect Vitamin D status?

Answer 29

* Genetic factors * Adiposity * Cutaneous synthesis * Liver or kidney disease * Diet

Question 30

When are 25(OH)D plasma levels highest and lowest in the UK?

Answer 30

* Highest: July-September * Lowest: January-March

Question 31

Who is at risk of Vitamin D deficiency in the UK?

Answer 31

* Asian and Afro-Caribbean populations * Housebound individuals * Older adults * Breastfed babies with low maternal Vitamin D * Young children using excessive sunscreen * Pregnant and lactating women

Question 32

What percentage of women aged 16-34 in Scotland had Vitamin D levels <25nmol/l?

Answer 32

38%

Question 33

What is the proposed RNI for Vitamin D for everyone aged over 4 years?

Answer 33

10ug/d

Question 34

What is the safe intake of Vitamin D for infants aged 0-11 months?

Answer 34

8.5-10ug

Question 35

What are the main functions of iodine in the body?

Answer 35

* Synthesis of thyroid hormones T4 and T3 * Regulation of cellular metabolism * Growth * Psychomotor development * Physical development and functioning

Question 36

What are the dietary sources of iodine?

Answer 36

* Milk and dairy * Kelp * Iodised salt (not widely used)

Question 37

What is the UK RNI for iodine intake in adults?

Answer 37

140ug/d

Question 38

What is the main method for measuring iodine status?

Answer 38

Urinary iodine excretion (UIE)

Question 39

What health issues can arise from iodine deficiency?

Answer 39

* Goitre * Growth impairment * Neurodevelopmental damage

Question 40

What is the recommended strategy to address iodine deficiency in pregnancy?

Answer 40

Fortification and supplementation

Question 41

True or False: The UK is within the top ten countries with the highest prevalence of iodine deficiency.

Answer 41

True

Question 42

Fill in the blank: Severe iodine deficiency can lead to _______.

Answer 42

goitre

Question 43

What emerging evidence is there regarding Vitamin D?

Answer 43

Possible non-skeletal health benefits

Question 44

What is a significant risk factor for iodine deficiency in teenage girls?

Answer 44

Low dairy intakes