Micronutrients

Question 1

What are vitamins and micronutrients?

Answer 1

• Vitamins, minerals and trace elements are fundamental groups of nutrients to sustain life
• They have a physiological role at the cellular level
• Vitamins, organic molecules derived from plants, act as co-enzymes in metabolic pathways
• Minerals and trace elements participate in wide ranging cellular mechanisms

Question 2

•humans require adequate amounts of which 13 vitamins?

Answer 2

• four fat soluble vitamins (A, D, E, K)
• nine water soluble vitamins, which comprise vitamin C and the eight B vitamins: thiamine (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), vitamin B6, folate (B9) and vitamin B12

Question 3

What are the properties of processed foods?

Answer 3

Processed foods are considered to be nutrient light and energy dense

Question 4

Who is at risk of micronutrient deficiency in the UK?

Answer 4

•Concerns about marginalised groups, minority groups, the very young and the very old are associated with

1) Poor dietary intake
2) Excessive energy dense/nutrient light diets
3) Extreme diets (removal of one or more food groups)

Question 5

Name 3 examples of micronutrient deficiencies in the UK

Answer 5

• There is evidence of iron-deficiency anaemia (as indicated by low haemoglobin levels) and low iron stores (plasma ferritin) in a proportion of adult women and older girls. This is in line with findings from previous surveys and does have health implications for these groups.
• There is evidence of low vitamin D status in adults and older children, both male and female. This has implications for bone health, in particular increased risk of rickets and osteomalacia.
• A substantial proportion of adults and older children have functional riboflavin (B2) status values indicative of low status. However the health implications of this are not known.

Question 6

Which micronutrient deficiencies are associated with specific diseases?

Answer 6

• Alcohol liver disease – thiamine (B1), Vitamin D,
• Inflammatory Bowel disease - iron, B12, vitamin D, vitamin K, folic acid, selenium, zinc, vitamin B6, and vitamin B1
• Obesity – vitamin D, copper, zinc

Question 7

Complete the table

Answer 7

Question 8

Complete the table

Answer 8

Question 9

Complete the table

Answer 9

Question 10

Complete the table

Answer 10

Question 11

What are B vitamins co-enzymes in ?

Answer 11

Citric acid cycle

Question 12

How is B12 absorbed?

Answer 12

Question 13

What is the relationship between vitamin B12 and folate?

Answer 13

If you give a patient vitamin B12 it can block the effect of folate deficiency

Question 14

Complete the table

Answer 14

Question 15

Complete the table

Answer 15

Question 16

What are the risk factors for vitamin D deficiency and insufficency?

Answer 16

· Pigmented skin (non-white ethnicity)

· Lack of sunlight exposure

· Skin concealing garments or strict sunscreen use

· Multiple, short interval pregnancies

· Elderly or housebound

· Vegan / vegetarian or high phytate consumption such as in chapatis

· Malabsorption (e.g., inflammatory bowel disease, coeliac disease, pancreatic

insufficiency)

· Use of anticonvulsants, rifampicin, cholestyramine, anti-retrovirals

Question 17

What effect does vitamin D have on the different aspects of immunity?

Answer 17

Question 18

Complete the table

Answer 18

Question 19

Complete the table

Answer 19

Question 20

Complete the diagram on the role of calcium

Answer 20

Question 21

What are the roles of iron?

Answer 21