Vitamin and Mineral Deficiency – Part A
fruits vs supplements
October’s Tip of the Month, explains the function of Vitamins and Minerals more in depth with information based on excerpts from the Harvard Medical School Special Health Report: “Making Sense of Vitamins and Minerals. Choosing the foods and nutrients you need to stay healthy.” The information is partially modified from the original Health Report. Howard D. Sesso, Sc.D., M.P.H. is the Medical Editor of Harvard Health Publications/Harvard Medical School. He is an Associate Epidemiologist at Brigham and Women’s Hospital and Associate Professor of Medicine, Division of Preventive Medicine, Harvard Medical School. Every day, the body produces thousands of rich red blood cells to carry nutrients and oxygen to every cell in the body, and creates white blood cells to fight body foreign intruders. Nerves send electrical signals skipping along brain and body pathways as tissues formulate protein and fatty acid as chemical messengers. In order to accomplish this, the body requires many different raw materials, which include nearly 30 Vitamins and Minerals that the body cannot manufacture in sufficient amounts by itself. These essential compounds perform a multitude of functions such as bolstering bones, healing wounds, boosting the immune system, converting food into energy, and repairing cell and tissue damage. These essential Vitamins and Minerals are often called micronutrients because the body needs only tiny amounts. In contrast, the body requires macronutrients such as carbohydrates, fats, and protein in larger amounts for energy, metabolism, and other functions. However, failing to get those small quantities virtually ensures disease. For example, British suffered bleeding gums and scurvy, a disease that often proves fatal. True Vitamin and Mineral deficiencies are rare in North America because of the extensive supply of inexpensive food and common foods that contain key nutrients. Still, eating less than optimal amounts of important Vitamins, Minerals, and other compounds can become a factor for a number of illnesses, such as heart disease, Type 2 diabetes, cancer, and osteoporosis. Hence, concern about the lack or shortage – although still a controversial topic – is a major factor of the US dietary guidelines, and the mass marketing of over-the-counter supplements. The Easy Fix! Dietary Supplements – including herbs, vitamins, minerals, and other products – are a $37-billion industry in the United States, and 60% of women are taking them regularly. At the same time, mounting research is suggesting that supplements – even mainstays like Calcium – may be harmful at high doses. How can one make sure to achieve nutrient needs when conflicting studies have led to general confusion and new marketing claims that may or may not be upheld by research. In reality, the best way to obtain Vitamins and Minerals is from a well-rounded diet, with plenty of fruits, vegetables, legumes, whole grains, and lean sources of protein, along with healthy fats, such as nuts and olive oil.
Vitamins vs. Minerals – Important differences and their roles in the body
What is a Vitamin?
It is an organic substance produced by a plant or an animal, required in small amounts for human life.
What is a Mineral?
It is an inorganic element that originates from rocks, soil, or water (although it may enter the diet through a plant that has absorbed it from the environment, or an animal that has eaten such a plant). There are many minerals, but only certain ones are necessary for our health.
Differences
Vitamins have complex structures that can be broken down by heat, air, or acid. Minerals are simpler elements that hold on to their chemical structures, and therefore can easily find their way into the body through plants, fish, animals, and fluids one consumes. It is more difficult to transport vitamins from food into the body because cooking, storage, and exposure to air can inactivate these more fragile compounds. Despite their differences, vitamins, minerals, and other micronutrients often work together to perform health-enhancing activities. For example, Vitamin D enables the body to remove Calcium from food passing through the digestive tract rather than harvesting it from bones. Vitamin C also helps absorb iron. However, the interplay of micronutrients is not always cooperative. Too much Vitamin C can block the body’s ability to assimilate the mineral Copper. Even a minor overload of the mineral Manganese can worsen Iron deficiency (Refer to Part B and Manganese: healthy bone structure, bone metabolism, helps to create essential enzymes for building bones). Essential micronutrients are subdivided into the following categories:
Water-soluble vitamins
Fat-soluble vitamins
Major minerals
Trace minerals
Many vitamins and some minerals are also classified as antioxidants, a term that is often misconstrued.
Water-soluble Vitamins
Water-soluble vitamins are those that can dissolve in water. They are packed into the watery portions of foods that we consume, and absorbed directly from the digestive tract into the bloodstream as food is broken down or as a supplement dissolves. Since much of the body consists of water, many water-soluble vitamins circulate easily in the body (except Vitamin B6, which is mostly stored in muscle tissue). The kidneys continuously regulate levels of water-soluble vitamins, removing any excess from the body in the urine. Therefore, the risk of harm from consuming large amounts through supplements is relatively small. However, there are exceptions. For example, very high amounts of B6 (many times the recommended daily amount) can damage nerves, causing numbness and muscle weakness. Although water-soluble vitamins tend to pass out of the body quickly, some can stay for long periods of time. There is probably several years’ supply of Vitamin B12 in the liver. Even Folic Acid and Vitamin C can be stored and last more than a couple of days. Generally, though, water-soluble vitamins should be replenished every few days. Water-soluble vitamins have many tasks in the body. One of the most important is helping to free the energy found in the food eaten. Thiamin, Riboflavin, Niacin, Pantothenic Acid, and Biotin – all B Vitamins – are involved in various aspects of energy production. Vitamins B6, B12, and Folic Acid metabolize amino acids (building blocks of proteins) and help cells multiply. One of the roles of Vitamin C is to help create collagen for healing wounds, supporting blood vessel walls, and to form a base for teeth and bones.
Water-soluble Vitamins
B Vitamins
Biotin (vitamin B7)
Folic acid (folate, vitamin B9)
Niacin (vitamin B3)
Pantothenic acid (vitamin B5)
Riboflavin (vitamin B2)
Thiamin (vitamin B1)
Vitamin B6
Vitamin B12
Vitamin C
Fat-soluble Vitamins
Fat solvents and oils can dissolve fat-soluble vitamins. In contrast, fat-soluble vitamins need special ways to move around the body. After being consumed in the diet, they enter the bloodstream via lymph channels in the intestinal wall. Most fat-soluble vitamins travel through the body only with the help of special fat-binding proteins acting as carriers to allow these vitamins to interact with water-rich blood and cells. Together the fat-soluble vitamins keep many parts of the body in good repair. For example, Vitamins A, D, and K are essential for bone formation. Vitamin A also helps keep cells healthy and protects vision – but without Vitamin E, the fourth fat-soluble vitamin, the body has difficulty absorbing and storing Vitamin A. Vitamin E also acts as an antioxidant, helping to protect cells and even DNA against damage from unstable molecules. Fat-soluble vitamins are stored in fat tissues and the liver, which together act as the main holding pens for these vitamins and release them as needed. To some extent, one can think of these vitamins as time-release nutrients. The body collects any excess one consumes and releases it gradually to meet as needed. Since these vitamins are stored for long periods dangerous levels can build up. As a result, potential toxicity from fat-soluble vitamins is much more common than for water-soluble vitamins. This is most likely to happen if high doses of supplements are taken over a prolonged period of time. It’s very rare to get too much of any vitamin just from food. Fat-soluble Vitamins
Vitamin A
Vitamin D
Vitamin E
Vitamin K
Major Minerals
The body needs and stores relatively large amounts of the major minerals such as Sodium, Chloride, Potassium, Calcium, Phosphorus, Magnesium, and Sulfur. Calcium and Phosphorus each account for more than a pound of our body weight. Despite this fact, major minerals are no more or less important to personal health than the Trace Minerals – they’re just present in the body in greater amounts. One of key tasks is to maintain proper electrical balance of all the cell membranes in the body – an essential property for cell signaling and the transport of nutrients and messengers into and out of cells. Sodium, Chloride, and Potassium are involved in this very process. Three other major minerals – Calcium, Phosphorus, and Magnesium with similar activities are important for healthy bones. Sulfur helps to stabilize protein structures, including some of those that make up hair, skin, and nails. Major minerals travel through the body in various ways. Potassium, for example, is quickly absorbed into the bloodstream, where it circulates freely and is excreted by the kidneys, much like a water-soluble vitamin. In contrast, Calcium requires a carrier for absorption and transport. Having too much of one major mineral can result in a deficiency of another. Calcium binds with excess Sodium in the body and is excreted when the body senses that Sodium levels have to be lowered. In essence, ingesting too much Sodium through table salt or processed foods, one could end up losing needed Calcium as the body rids itself of the surplus of Sodium. Likewise, too much Phosphorus can hamper the ability to absorb Magnesium. These imbalances are usually caused by overloads from supplements, not food sources. Major Minerals
Calcium
Chloride
Magnesium
Phosphorus
Potassium
Sodium
Sulfur
Trace Minerals
Trace Minerals are normally found in small amounts in the body but their contributions are equally essential as those of major minerals. They carry out a diverse set of tasks. For example, Iron is best known for carrying oxygen throughout the body, while Fluoride strengthens bones and protects from tooth decay. Zinc helps blood clotting, and is essential for taste and smell, and boosts the immune process. Copper helps form several enzymes, one of which assists with Iron metabolism and the creation of Hemoglobin, which carries oxygen in the blood. The other Trace Minerals perform equally vital jobs, such as helping to block damage to body cells and forming parts of key enzymes or enhancing their activity. Trace Minerals interact with one another, and at times in ways that can trigger certain imbalances as too much of one can cause or contribute to a deficiency of another. For example, a minor overload of Manganese can exacerbate Iron deficiency. Having too little of one of these can also cause problems. When the body has too little Iodine, thyroid hormone production slows, causing sluggishness and weight gain as well as other health concerns. The problem worsens if the body also has too little Selenium. However, the difference between ‘just enough and too much’ of the Trace Minerals is often relatively small. Generally, food is a safe source of Trace Minerals, but when adding supplements, it is important to make sure that recommended levels be not exceeded.
Understanding Antioxidants
Some Vitamins and Minerals – including Vitamins C and E, Copper, Zinc, and Selenium – serve as antioxidants, in addition to other vital roles. Antioxidant is a general term for any compound that can counteract unstable molecules called free radicals that damage DNA, cell membranes, and other parts of cells. Since free radicals lack a full complement of electrons, they steal electrons from other molecules and damage those molecules in the process. Antioxidants neutralize free radicals by giving up some of their own electrons. When a Vitamin C or E molecule makes this sacrifice, it acts as a natural off switch for free radicals. This helps break a chain reaction that can affect other molecules in the cell and other cells in the body. It is important to recognize that the term antioxidant reflects a chemical property rather than a specific nutritional property. The body generates free radicals in response to environmental insults, such as tobacco smoke, ultraviolet rays, and air pollution, but they are also a natural byproduct of energy metabolism and other normal processes in cells. When immune system cells fight intruders the oxygen they use spins off an army of free radicals that destroy viruses, bacteria, and damaged body cells in an oxidative burst. Antioxidants such as Vitamin C can then disarm the free radicals. Some normal production of free radicals also occurs during exercise. This appears to be necessary in order to induce some of the beneficial effects of regular physical activity, such as sensitizing the muscle cells to Insulin. Although free radicals are a necessary part of life, we need an adequate supply of antioxidants to keep them from doing damage. Luckily, there are many dietary sources of antioxidants. The body’s cells naturally produce some powerful antioxidants, such as Alpha Lipoic Acid and Glutathione. The foods we eat supply other antioxidants in addition to the previously named vitamins and minerals. Plants are full of compounds known as phytochemicals – literally, ‘plant chemicals’ – many of which seem to have antioxidant properties. For example, after Vitamin C has satiated a free radical with electrons, a phytochemical called Hesperetin (found in oranges and other citrus fruits) restores Vitamin C to its active antioxidant form. Carotenoids (such as lycopene in tomatoes and lutein in kale) and Flavonoids (such as flavanols in cocoa, anthocyanins in blueberries, quercetin in apples and onions, and catechins in green tea) are also antioxidants. As a rule, the best strategy is to get vitamins and minerals from foods, not supplements. A vast amount of research has shown that one can reduce the risk for chronic disease and disability by following a healthy diet, as well as by exercising regularly and not smoking (I am now more concerned about cannabis use by teen and older athletes once legalized in more US States and Canadian Provinces!). The evidence for taking high-doses of individual vitamin and mineral supplements is much less convincing. One has to keep in mind that these nutrients, while important, are simply one part of an overall plan for good health. They should be used along with other well-established health care recommendations and treatments, not in lieu of them.