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Iodine in Pregnancy• Many reproductive aged women in US have
marginal iodine status; salt in processed foods is not iodized.
• Deficiency associated with pregnancy loss and prematurity, and poor neurodevelopment in the baby.
• Mild to moderate iodine deficiency is associated with higher incidence of ADHD and lower IQ in the baby.
• American Thyroid Association recommends pregnant/lactating women supplement: 150 mcg/d potassium iodide.
Council on Environmental Health, et al. Pediatrics 2014; 133(6):1163-6.
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Children on ADHD Medication
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CDC 2nd National Report on Biochemical Indicators of Diet and Nutrition. The WHO recommends that the median UI in pregnancy be 150-249 mcg/L.
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B Vitamins
• The B-vitamins are important for the metabolism of carbohydrates, fats and proteins and play a vital role in the production of fuel and energy for the body.
• There are eight B-vitamins that partner together, which is why you almost always want to take them together in balanced amounts.
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Trends in prescriptions of major classes of psychiatric drugs 1998–2010.
Stephen Ilyas, and Joanna Moncrieff BJP 2012;200:393-398
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Vitamin B6 (Pyroxidal-5-Phosphate)
• Critically involved in production of serotonin, dopamine, melatonin, hemoglobin, protein metabolism, energy production, and more.
• Deficiency: depression; impaired cognition, attention, memory, and sleep. Increased risk for heart disease, stroke and colorectal cancer.
• Common OTC analgesics and oral contraceptives lower B6 levels.
• 30 MILLION Americans are deficient in B6.
• Need ~6 mg per day to maintain normal serum level. Larsson SC, et al. JAMA 2010; 303(11):107783
Morris MS, et al. Am J Clin Nutr 2008; 87(5):1446-54Ulvik A, et al. Am J Clin Nutr 2014; 100(1):250-5
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To Get 1.5mg of B6 in Food• 2.5 bananas
• 12 Tbsp. roasted sunflower seeds
• 8 ounces chicken breast
• 8 ounces sockeye salmon
• ~5 ounces cooked tuna
• ~5 ounces beef liver
• 3.5 cups raw diced avocado
• 3 cups sweet potatoes
• 15 cups of milk OR
• 20 Tbsp. peanut butter
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Vitamin B12
• Found in animal and fortified foods.
• Deficiency: sore tongue, constipation, anemia, depression, low energy, neurological disorders (numbness/tingling feet, difficulty walking, memory loss, dementia)
• Metformin is a drug commonly used to treat type 2 diabetes. It lowers vitamin B12 levels significantly within months of starting therapy.
• 18 million Americans are deficient in vitamin B12
Niafar M, et al. Intern Emerg Med 2015; 10(1):93-102.
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Vitamin C• Potent antioxidant, activates folate, needed to
convert tryptophan to serotonin, cofactor in synthesis of carnitine, thyroxin, norepinephrine, dopamine and needed for immune cell function
• Vitamin C levels decline rapidly during periods of emotional and physical strain, and illness.
• As levels fall, collagen synthesis impaired: bruise more easily, skin becomes thick and dry, wounds take longer to heal, joints hurt, fatigue.
• Recommended 200 mg 1-2 times daily.
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Figure H.1.f. Prevalence estimates of vitamin C deficiency (serum concentrations less than 11.4 µmol/L) and low vitamin C concentrations (11.4-23 µmol/L) in the U.S. population aged 6 years and older by age group, National Health & Nutrition Examination Survey, 2003-2006.
Error bars represent 95% of confidence intervals. *Prevalence in children is significantly lower than prevalence in persons 20 years and older (p <0.05).
µµ
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Zinc• Marginal zinc deficiency can diminish the activity of
important immune cells.
• WHO estimates marginal zinc status results in the deaths of > 500,000 children under the age five
• Not effectively stored, must be continuously replaced in the diet.
• Zinc concentrations high in prostate gland, testes, and sperm. Deficiency might contribute to lower testosterone and infertility in men.
• Vegetarians need 50% more zinc due to lower absorption of zinc from plant foods.
• You need ~15 mg per day.
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Vitamin D• Vitamin D interacts with more than 1000
genes
• Vitally important for calcium regulation (bones, heart, etc.)
• Studies show that higher blood levels of vitamin D improve breast cancer survival and reduce risk of colorectal cancer.
• Low vitamin D in adults causes muscle weakness and lower back and hip pain.
• Obesity increases the risk of deficiency..
Kim Y, et al. Br J Cancer 2014; 110(11):2772-84. Ma Y, et al. J Clin Oncol 2011; 29(28):3775-82
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Ca2+ InactiveOsteocalcin
ActiveOsteocalcin
Vitamin D3
Vitamin K2
Ca2+ Ca2+
Ca2+
Ca2+ Ca2+
Intestine Bone
Increases the uptake of Ca2+ and the production of osteocalin.
Co-factor for the enzymes thatactivates osteocalcin.
Calcium incorporatedinto bone.
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Vitamin DCDC found:• ~90 million Americans are vitamin D deficient
• Most individuals should take 1,000-2,000 IU vitamin D3 per day with dinner
To get 600 IU/d Vitamin D3:• 3-4 ounces sockeye salmon, cooked
• 11.4 ounces water-packed tuna
• 26 oil-packed sardines
• 15 large eggs
• 5 cups fortified milk
• 30-45 ounces yogurt
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Choline
• Water soluble nutrient in the B-vitamin family that is necessary to prevent non-alcoholic fatty liver disease.
• It is also crucial during pregnancy and the first three years of a child’s life.
• Deficiency may be associated with permanent changes in brain function that negatively impact intelligence, memory, mood regulation, and stress response.
• DV is 550 mg per day.
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Choline in Foods
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INVESTWISELY