Nutrition Breakdown - Relatable Applied Nutrition for the

Nutrition Breakdown Relatable Applied Nutrition

for the Inquiring Mind

Tami Miller 720-282-1389

sagenutrioncoachinggmailcom tamisagenutrioncoachingcom

Let food be thy medicine and medicine be thy food ~ Hippocrates

NutriCon Breakdown Modules

Module 1 What is nutrion Module 2 Macronutrients Module 3 Carbohydrates Module 4 Proteins Module 5 Fats Module 6 Micronutrients Module 7 Vitamins Module 8 Minerals

At the end of the eight modules there will be a 50 queson test a score of 4550 (90) is required to pass

Module 1 NutriCon basics

1

In the first module we will be geOng a basic understanding of nutrion and why it is necessary Understanding nutrion and the funconing of the human body is key to helping clients eat in a healthier manner and live a healthier lifestyle You will learn how bad nutrion can impact health and how nutrion can impact athlec performance

Learning Goals 1 Define nutriCon 2 Understand how poor nutriCon impacts health 3 Understand how nutriCon can impact athleCc performance

Learning Goal 1 ndash Define nutriCon

2

What are nutrients and nutriCon Nutrients are the various molecules that are digested or removed from the food that we eat every day Cells need two major classes of nutrients macronutrients and micronutrients Macronutrients are needed in large quanes while micronutrients are needed in smaller oWen trace amounts In humans nutrients are obtained by the intake of food in relaon to the bodyrsquos dietary needs and is referred to as nutrion According to the WHO World Health Organizaon ldquoGood nutrion is an adequate well balanced diet combined with regular physical acvity and is the cornerstone of good health Poor nutrion can lead to reduced immunity increased suscepbility to disease impaired physical and mental development and reduced producvityrdquo1 Recently researchers have turned to how the nutrients that are ingested play a part in both health and disease

Nutrion consists of the various food items that we ingest in our diet There are various diets that are eaten throughout the world that can be extremely variable One of the keys of nutrion is the ingeson of all three of the macronutrients and all of the micronutrients that are necessary for the biochemical processes that are performed by the body to maintain life Humans need a combinaon of all three macronutrients and all of the micronutrients to maintain health With a well-balanced natural healthy diet humans do not need to take supplements to get necessary nutrients unless the diet that they are eang is not balanced The high fat high sugar processed Western diet needs to be supplemented in the food or separately as the creaon of processed foods removes the vitamins and minerals from the food that is being processed The ldquodietsrdquo that are popular on social media or among different athlec circles are not a longer term fix as they all restrict something from calories to the intake of macromolecules to achieve a short-term goal Diets that restrict certain foods or macromolecules generally cause malnutrion or require supplementaon as many of the necessary micronutrients are also restricted Diets are temporary and are not viable for the long term Any weight that is lost through diets will generally be gained back hence the term ldquoyo-yo diengrdquo Lifestyle changes are a more sustainable long-term goal for people who want to eat in a healthy manner These lifestyle changes will not restrict the types of macronutrients and micronutrients that are ingested

Good nutrion should consist of enough calories to maintain the Basal Metabolic Rate (BMR) which is what is necessary just to keep all of the cells of the body alive and healthy On top of the BMR calories need to be ingested to give us the energy to get out of bed in the morning and live our lives The average adult female needs 2000 calories a day while the average adult male needs 2500 calories a day to live There are three macronutrients that all living cells need carbohydrates fats and proteins These macronutrients must be released from the food that we ingest Each food item has a different amount of one or all of the macronutrients All three are needed to maintain the cells in our bodies Some cells need more or less of each of the nutrients but we all require the same amount of each of the macronutrients Our daily diet needs to consist of a range of each of the three macronutrients we should not go above or below these ranges if we want to maintain a healthy balanced diet that nourishes our whole body If the diets that we are eang are balanced the micronutrients that we need will be in our diet naturally

3

Table 1 Macronutrient ranges based on a 2000 calorie daily diet

Micronutrients are needed in smaller quanes oWen trace amounts Micronutrients include vitamins and minerals There are water soluble vitamins (B-vitamins and vitamin C) and fat soluble vitamins (A D E and K vitamins) Vitamin B-12 can only be found in animal proteins which can leave vegetarians who do not eat fish and eggs at risk for vitamin B-12 deficiency Vegans must take B-12 supplements or consume processed foods that are forfied with B-vitamins There are 16 essenal minerals including calcium phosphorus potassium sodium and magnesium

A well balanced diet includes lean meats vegetables fruits legumes and nuts in a combinaon that gives all three of the macronutrients as well as the micronutrients Fiber is consumed in whole grains fruits and vegetables that contain skins Many of the vitamins and minerals that we need are in the hull of the whole grains and the skins of fruits and vegetables When the outer covering of plants is removed (to make white rice for example) the fiber vitamins and minerals are also removed making whole foods a healthier opon

Learning Goal 2 ndash Understand how poor nutriCon impacts health

For the first me in human history many countries face a ldquodouble burden of malnutrionrdquo Malnutrion is caused by the inadequate intake of key nutrients which may weaken the immune system impair brain development and worsen the risk of condions such as anemia and blindness2 There is a coexistence of undernutrion and overweight obesity or non-communicable diseases such as heart disease stroke and diabetes3 It is esmated that 19 billion adults and 41 million children younger than 5 are overweight and heart disease and stroke are the number one and two causes of death respecvely4-6 Since the 1950s the focus has been on increasing producvity in a small number of staple foods such as corn and rice to help feed the undernourished people of the world While focusing on increasing these staples limited amenon was paid to the impact of consuming too much food or the wrong types of food7 Today nearly one in three persons globally suffers from at least one form of malnutrion wasng stunng vitamin and mineral deficiency overweight or obesity and diet-related non-communicable disease8

Heart disease has many risk factors including smoking high Low Density Lipoprotein (LDL or bad cholesterol) and low High Density Lipoprotein (HDL or good cholesterol) uncontrolled hypertension physical inacvity obesity uncontrolled diabetes and uncontrolled stress and anger Several of these can be reduced by a good diet and increased by a bad diet

Nutrient Percent of daily calories based on 2000 calorie diet

Grams per day based on a 2000 calorie diet

Carbohydrate 45-65 225-325g

Fat 20-35 44-78g

Protein 10-35 50-175g

4

An esmated 81 of Americans have some form of hypertension (high blood pressure) 31 are hypertensive 30 are pre-hypertensive and approximately 20 are hypertensive yet unaware of their status9 10 Unfortunately only 47 of those with known hypertension are well controlled Research has shown that diet and lifestyle modificaons can reduce blood pressure (BP) enhance anhypertensive drug efficacy and decrease cardiovascular disease (CVD) risk9 11

Last century salt was idenfied as part of the diet that can increase blood pressure Even though salt was reduced in diets the incidence of hypertension has increased Recent research shows that sugar increases blood pressure more than salt22 We will start with a discussion of how salt increases blood pressure Salt is absorbed into the bloodstream with water in the small intesne increasing the salt concentraon in the blood The salt and water balance is delicate and is called homeostasis When salt concentraon is increased in the blood stream the amount of water must increase as well to maintain balance As the amount of water in the blood increases there is more pressure that pushes outward on the blood vessels and an increase in blood pressure is seen

For decades we have been told to reduce sodium to reduce hypertension but current research is showing that the reducon of sodium has limle effect on hypertension Research is showing that the addion of sugars increases hypertension When sugars are added to the diet addional insulin is released to compensate which may lead to hypertension Since sucrose is equal parts glucose and fructose it has been shown to increase heart rate sodium retenon in the kidneys and vascular resistance23 All of this leads to higher blood pressure or hypertension Hypertension is worse with High Fructose Corn Syrup (HFCS) or other high fructose syrups The source of the high fructose syrup does not mamer and all high fructose syrups (such as tapioca syrup malt syrup or dehydrated cane juice as examples) will lead to hypertension Reducing added sugars in the diet can help to reduce insulin resistance thereby leading to a lower blood pressure24

Fructose may cause cardiometabolic harm other than high blood pressure such as increased heart rate increased triglycerides increased insulin increased LDL (the bad cholesterol) and lower HDL (the good cholesterol)25 Fructose and sucrose also lead to an increase in metabolic dysfuncon myocardial oxygen demand heart rate and inflammaon22 Compared to people who eat less than 10 of their calories from added sugars those who consume 10-249 of their calories from added sugars have a 30 increase of mortality from cardiovascular disease Those who eat 25 or more calories from added sugar have almost a threefold increase in risk 26

Processed food is very high in sugars specifically fructose and can be very high in salt The recommendaons to reduce the amount of processed food might have less to do with sodium and more to do with highly refined carbohydrates The reducon of added sugars especially fructose would help to reduce not only hypertension but may also help address the broader problems related to cardiometabolic disease Omega-3 famy acids such as EPA (Eicosapentanoic Acid) and DHA (Docosahexanoic Acid) are as effecve or more effecve than other lifestyle intervenons including increasing physical acvity and restricng alcohol and sodium in populaons not taking anhypertensive medicaon12 13 Added sugars are not form part of a balanced healthy diet but are from processed foods or adding sugar to coffee tea cereal or other food items The amount of sugar eaten in whole natural foods with a balanced diet will not cause these health problems

5

The bomom line - consumpon of typical amounts of added sugar in our foods or drinks over a lifeme is increases the risk of cardiovascular disease Even the addion of the equivalent of half a can of soda to each meal can raise the risk factors for cardiovascular disease 27

Cardiovascular disease are condions that are involved in the narrowing and blocking of blood vessels that can lead to a heart amack chest pain or stroke Age sex and genecs are important unmodifiable risk factors for heart disease but most new cases of myocardial infarcon (heart amack) can be predicted by 9 health factors Eight of the nine risk factors are influenced by diet14 Evidence now exists that an increase in insulin that accompanies insulin resistance can lead to the iniaon and perpetuaon of vascular inflammaon and deposion of famy deposits in the arteries15 Another study reported that many inflammatory genes are upregulated in white adipose ssue of mouse models of obesity induced by a high fat diet16

In addion to heart disease and stroke type 2 diabetes is increased 4-fold in obese individuals17 Despite an excess of dietary caloric intake obese individuals have relavely high rates of micronutrient deficiencies18 19 The importance of certain micronutrients as cofactors in glucose metabolism β-cell funcon (insulin producon) and insulin signaling pathways suggests that micronutrient deficiencies may play a role on the development of type 2 diabetes20 Several vitamins and minerals have been implicated in the development of type 2 diabetes Vitamin D chromium bion thiamine and anoxidant vitamin deficiencies have been suggested to have an impact on glucose metabolism and insulin signaling and are currently being studied20

We have all heard the term diabetes but what does it really mean Diabetes mellitus is a disease in which the bodyrsquos ability to produce or respond to insulin is impaired In both forms there is sugar in the urine which leads to the name diabetes mellitus means ldquosweet waterrdquo in Lan There are two forms of Diabetes Type 1 and Type 2 Type I is a genec disease that impairs the β cells of the pancreas from producing insulin Type 2 diabetes is the reducon of sensivity of receptors to insulin We will be discussing Type 2 diabetes

Type 2 diabetes is and acquired form of diabetes A person with Type 2 diabetes releases insulin as normal when sugar enters the body As our diets contain more sugar than we evolved to eat a lot more insulin is released from that pancreas in response to the onslaught of sugar Due to the connual increase in insulin the receptors for insulin on cells become red of seeing it and become resistant This means that sugar is not being used as efficiently by the body and is being lost in the urine Insulin is released by the pancreas in response to any type of monosaccharide glucose and fructose are the most common but it will also be released in the presence of galactose The pancreas cannot disnguish between the glucose the cells can use and the fructose that the liver will store as triacylglycerols (famy acids) in the adipose ssue

The increase in processed foods in our society has increased our intake of all sugars but most significantly fructose Our bodies evolved to store the small amount of fructose that we ate as triacylglycerols for protecon and storage Unfortunately not only has the significant increase in carbohydrates in our diets increased the amount of triacylglycerols that we are storing in our adipose ssue but it has significantly increased the amount of insulin in our blood The amount of insulin is more than we evolved to have in our blood because of this the receptors eventually stop recognizing the insulin This is similar to us no longer nocing white noise in the background This is called insulin

6

resistance Insulin resistance can lead to the same symptoms as Type I diabetes Unlike Type I diabetes Type 2 diabetes can be controlled by a change of diet

Learning Goal 3 ndash Understand how nutriCon can impact athleCc performance

Energy and macronutrient needs especially protein and carbohydrates must be met during mes of high physical acvity to maintain body weight replenish glycogen stores and provide adequate protein to build and repair ssue Fat intake should be sufficient enough to provide the essenal famy acids and fat-soluble vitamins as well as contribute energy for weight maintenance Athletes that consume high- or low-carbohydrate diets Western or ketogenic diets respecvely are at the greatest risk of micronutrient deficiency21

Most of us know that the daily intake of nutrients is based on a 2000 calorie diet The calorie intake is broken down into carbohydrates fats and proteins There is a range as each person is different based upon basal metabolic rate genecs exercise level and type of calories eaten Carbohydrates provide 4 calories of energy per cram of carbohydrate fats provide 9 calories per gram of fat and proteins provide 4 calories per gram of protein


Carbohydrates are needed to fuel cells for life but are unfortunately the first thing that people try to reduce when losing weight or exercising Reducon of carbohydrates will make you more red and make it harder to work out Remember that it is the type of carbohydrate that you are geOng the calories from not the number of calories You want to eat whole foods The ranges listed above need to be maintained for efficient exercise The more you exercise the more carbohydrates you need to ingest




Fat 20-35 44-78g

Protein 10-35 50-175g

Exercise Level Descripon Daily Carbohydrate Target Grams per lb body weight

Daily Carbohydrate Target Grams per kg body weight

Recreaonal 3-4 daysweek lt1 hourday

136-227 3-5

7

Table 2 Carbohydrate suggesons per body weight for different exercise types

Proteins are needed so that they can be broken down into individual amino acids by enzymes in our stomach and small intesne Individual amino acids will them be used by cells to make enzymes and other proteins Muscle is also made from amino acids that are used to make muscle fibers and proteins There are 20 amino acids 10 of which our bodies cannot make and are called essenal amino acids The 10 essenal amino acids are isoleucine leucine valine lysine methionine phenylalanine threonine tryptophan hisdine and arginine all of which must be ingested in our food Animal proteins are considered to have High Biological Value meaning that they contain all of the essenal amino acids in a proporon similar to that required by humans Plant proteins are considered Low Biological Value meaning that they are missing one or more of the essenal amino acids and there has to be a wide range of plants that are eaten on a daily basis to get all of the essenal amino acids

Protein needs of athletes and regular exercisers are higher than those of average individuals Protein needs will vary between athletes depending upon the aims of the athlete (ie muscle building vs weight loss) and the type of sport

Table 3 Protein suggesons per body weight for different exercise types

Fats are used by the body to make cell walls steroid hormones as well as other molecules that are necessary to protect the body Fats that come from lean meats and whole foods are in a quanty and type that can be used by the body Fats that are made in the lab (saturated fats and trans-fats) are in a form that our bodies cannot break down so they are stored or are deposited on vessel walls There is not

Compeve 5-6 daysweek 1-2 hoursday

227-318 6-8


318-454 8-10

Ultra-Endurance

6-7 daysweek gt4 hoursday

454-545 10-12

Group Daily Protein Target Grams per lb of body weight

Daily Protein Target Grams per kg body weight

Sedentary Individual 034g 075g

Moderate intensity athlete 054g 120g

Recreaonal Endurance athlete 036 ndash 045g 080 ndash 10g

Team sportspower sports 063 ndash 077g 140 ndash 170g

Strengthresistance athlete 068 ndash 090g 150 ndash 200g

Athlete on fat loss program 072 ndash 090g 160 ndash 200g

Athlete on weight gain program 081 ndash 090g 180 ndash 200g

Elite endurance athlete 054 ndash 090g 120 ndash 200g

8

set standard for the total fat intake of athletes instead the focus is on hiOng the carbohydrate and protein intake Fats will make up the remainder of the calories but should not fall below 15 of total energy intake so that performance is not impaired Athletes should sll aim for fat intake of 20-35 of total calorie intake

Recent research has shown that the type of calories (whole food based diet vs Western diet) is more important than the counng of calories though the percentage of each nutrient is important for healthy cells The goal of all athletes should be to maintain a well balance healthy whole food diet that has the proper amount of calories for the personal athlec level

Some athletes feel that they need to take supplements or ergogenic aids to perform bemer The regulaons specific to nutrional ergogenic aids are poorly enforced and supplements should be used with cauon21 In general no vitamin and mineral supplements are needed if adequate energy to maintain body weight is consumed from a variety of healthy whole foods However athletes who restrict energy intake use severe weight-loss pracces eliminate one or more food groups from their diet or consume unbalanced diets with low micronutrient density may require supplements21 Vegetarian and vegan athletes may be at risk for low intakes of energy protein fat and key micronutrients and it is recommended that they consult with a sports diecian to avoid these nutrion problems21 Athletes who are concerned about not having enough macro- or micronutrients should ask their physician for blood tests to determine if supplements are necessary before beginning a supplement regiment

References

1 World Health Organizaon hmpwwwwhointtopicsnutrionen

9

2 Branca F Denaoi AR and Hawkes C Double-duty acons for ending malnutrion within a decade WHO 2017 hmpwwwwhointnews-roomcommentariesdetaildouble-duty-acons-for-ending-malnutrion-within-a-decade

3 WHO The double burden of malnutrion Policy brief hmpwwwwhointnutrionpublicaonsdoubleburdenmalnutrion-policybriefen

4 Joint child malnutrion esmates key findings of the 2017 edion UNICEFWHOWorld Bank Group 2017

5 NCD Risk Factor Collaboraon Trends in adult body-mass index in 200 countries from 1975 to 2014 a pooled analysis of 1698 populaon-based measurement studies with 192 million parcipants Lancet 387 1377ndash96

6 WHO The top 10 causes of death (fact sheet) hmpwwwwhointmediacentrefactsheetsfs310en

7 Global Panel on Agriculture and Food Systems for Nutrion Food systems and diets facing the challenges of the 21st century London Global Panel on Agriculture and Food Systems for Nutrion 2016

8 Branca F Malnutrion Itrsquos about more than hunger WHO 2017 hmpwwwwhointnews-roomcommentariesdetailmalnutrion-it-s-about-more-than-hunger

9 Centers for Disease Control and Prevenon Vital signs prevalence treatment and control of hypertensionmdashUnited States 1999ndash2002 and 2005ndash2008 MMWR Morbid Mortal Wkly Rep 2011 60103ndash108

10 Roger VL Go AS Lloyd-Jones DM Benjamin EJ Berry JD Borden WB Bravata DM Dai S Ford ES Fox CS Fullerton HJ Gillespie C Hailpern SM Heit JA Howard VJ Kissela BM Kimner SJ Lackland DT Lichtman JH Lisabeth LD Makuc DM Marcus GM Marelli A Matchar DB Moy CS Mozaffarian D Mussolino ME Nichol G Paynter NP Soliman EZ Sorlie PD Sotoodehnia N Turan TN Virani SS Wong ND Woo D Turner MB Heart disease and stroke stascsmdash2012 update a report from the American Heart Associaon Circulaon 2012 125e2ndashe220

11 P Miller M Van Elswyk and DD Alexander ldquoLong Chain Omega-3 Famy Acids Eicosapentanoic Acid and Docosahexanoic Acid and Blood Pressure A Meta-Analysis of Randomized Controlled Trials ldquoAmerican Journal of Hypertension vol 27 no 7 pp 885-896 2014

12 Campbell F Dickinson HO Critchley JA Ford GA Bradburn M A systemac review of fish-oil supplements for the prevenon and treatment of hypertension Eur J Prev Cardiol 2013 20107ndash120

13 Dickinson HO Mason JM Nicolson DJ Campbell F Beyer FR Cook JV Williams B Ford GA Lifestyle intervenons to reduce raised blood pressure a systemac review of randomized controlled trials J Hypertens 2006 24215ndash233

10

14 De Caterina R Zampolli A Del Turco S Madonna R and Massaro M Nutrional mechanisms that influence cardiovascular disease Am J Clin Nutr 200683 (suppl)421Sndash 6S

15 Madonna R Pandolfi A Massaro M Consoli A De Caterina R Insulin enhances vascular cell adhesion molecule-1 expression in human cultured endothelial cells through a pro-atherogenic pathway mediated by p38 mitogen-acvated protein-kinase Diabetologia 200447532ndash 6

16 Xu H Barnes GT Yang Q et al Chronic inflammaon in fat plays a crucial role in the development of obesity-related insulin resistance J Clin Invest 20031121821ndash30

17 K Niswender ldquoDiabetes and obesity therapeuc targeng and risk reduconmdasha complex interplayrdquo Diabetes Obesity and Metabolism vol 12 no 4 pp 267ndash287 2010

18 O Kaidar-Person B Person S Szomstein and R J Rosenthal ldquoNutrional deficiencies in morbidly obese paents a new form of malnutrion Part A vitaminsrdquo Obesity Surgery vol 18 no 7 pp 870ndash876 2008

19 O Kaidar-Person B Person S Szomstein and R J Rosenthal ldquoNutrional deficiencies in morbidly obese paents a new form of malnutrion Part B mineralsrdquo Obesity Surgery vol 18 no 8 pp 1028ndash1034 2008

20 M Via ldquoThe Malnutrion of Obesity Micronutrient Deficiencies That Promote Diabetes ldquoISRN Endocrinology vol 2012 Arcle ID 103472 pp 1-8

21 The American Dietec Associaon ldquoPosion of the American Dietec Associaon Diecians of Canada and the American College of Sports Medicine Nutrion and Athlec Performanceldquo J Am Diet Assoc Vol 109 pp509-527 2009

22 DiNicolantonio JJ Lucan SC Open Heart 20141e000167 doi101136openhrt-2014-000167

23 Facchini FS Stoohs RA Reaven GM Enhanced sympathec nervous system acvity The linchpin between insulin resistance hyperinsulinemia and heart rate Am J Hypertens 19969

24 Landsberg L Insulin and the sympathec nervous system in the pathophysiology of hypertension Blood Press Suppl 1996125ndash9

25 Perez-Pozo SE Schold J Nakagawa T et al Excessive fructose intake induces the features of metabolic syndrome in healthy adult men role of uric acid in the hypertensive response Int J Obes (Lond) 201034454ndash61

26 Yang Q Zhang Z Gregg EW et al Added sugar intake and cardiovascular diseases mortality among US adults JAMA Intern Med 2014174516ndash24

27 Kimber Stanhope Nutrion Acon Newslemer JulyAugust 2015

11

Tables

Table 1 Macronutrient ranges based on a 2000 calorie daily diet Author Tami Miller License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Table 2 Carbohydrate suggesons per body weight for different exercise types Author Tami Miller License This is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Table 3 Protein suggesons per body weight for different exercise types Author Tami Miller License This is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Module 2 Macronutrients

In the second module we will be discussing what a macronutrient is and why we need them Macronutrients are the molecules that make up most of the food that we eat as our nutrients When calculang what is ingested the calculaons of calories are based upon the three macronutrients and the raos that fare ingested Understanding the basic nutrients that are necessary for the funconing of the human body is key to eang and living in the healthiest manner

12

Learning Goals 1 Define a macronutrient 2 Understand why cells and the body require macronutrients 3 Understand how an imbalance of macronutrients impacts the body

Learning Goal 1 ndash Define a macronutrient

What is a macronutrient A macronutrient is a substrate that is required by a living organism in large quanes to maintain life and to reproduce A basic way to think of a macronutrient is as an energy providing chemical Macronutrients are found on all of the foods that humans consume and provide the cells of the body with the bulk of the calories from our diets The calories that we consume in our diets are categorized into different

13

macronutrient classes The classes tell is how the macronutrients are metabolized and what funcon they serve in the cells and organs of our body The macronutrients are needed to grow develop sustain circulaon provide the brain with the energy for cognive funconing and provide cells with the energy and building blocks to make new cells

Calorie is a term used in chemistry to define the amount of energy that can be released from a substance To determine the number of calories sciensts burn a substance in a well-insulated apparatus called a bomb calorimeter Asa substance burns the amount of energy released is measured by the change in temperature The energy released can be reported as calories or kilo-calories both terms mean the same thing Daily the average adult should consume 2000 calories (2000 kcal) of food to maintain healthy cells and organs

The term macronutrient means large nutrient Macronutrients are not only large in size but are needed in large quanes The large size of a macronutrient means that it must be connually broken down into smaller pieces unl they are in the building blocks of the nutrient This is different than micronutrients that are needed in much smaller quanes are already in the smallest unit that they can be physically

Macronutrient types and sources There are three macronutrients that are consumed in the human diet carbohydrates proteins and fats Water must also be consumed to maintain life as the human body is 70 water (the brain is 90 water) Water is not a macronutrient as it cannot be broken down into smaller parts before use by the body These three macronutrients are needed by all living cells and come from the environment

Carbohydrates are sugars of various types and are found in some amount in all of the food that we consume Carbohydrates include sugars starches and dietary fiber such as glucans and cellulose Carbohydrates can typically be broken down to be used as an energy source by the cells of our bodies Starches are broken into dextrins which are broken further into disaccharides and monosaccharides

Protein is found in much of the whole foods that we eat Protein concentraon is higher in animal products than in most vegetables though there are some great sources of protein from non-animal sources Protein is broken down into its building blocks of amino acids for use by the cells of our bodies Some amino acids can be made by our cells but there are 9 essenal amino acids which must be consumed in our food

Fats are the final class of macromolecules that we ingest There are 3 main types of fats or famy acids saturated monounsaturated and polyunsaturated fats Monounsaturated and polyunsaturated fats can be further characterized as cis-unsaturated fats or trans-unsaturated fats Our bodies can best break down cis mono- and polyunsaturated fats for use The best sources of fats come from natural whole foods

Daily macronutrient requirements Most of us know that the daily intake of nutrients is based on a 2000 calorie diet The calorie intake is broken down into carbohydrates fats and proteins There is a range as each person is different based upon basal metabolic rate genecs exercise level and type of calories eaten Carbohydrates provide 4

14

calories of energy per cram of carbohydrate fats provide 9 calories per gram of fat and proteins provide 4 calories per gram of protein


Recent research has shown that the type of calories (whole food based diet vs Western diet) is more important than the counng of calories though the percentage of each nutrient is important for healthy cells

Learning Goal 2 ndash Understand why cells and the body require macronutrients

What are cells All living organisms are made of cells either single cells or cells that are grouped together to make more specific structures such as organs The first non-living cells were discovered in cork in 1665 by Robert Hooke In 1674 Anton van Leeuwenhoek was the first person to observe a cell under a microscope Later researchers observed that cells could be separated into disnct structures and that ssues were made of cells The funcon of a ssue was dependent upon the funcon of the cells from which the ssue was formed In 1850 Rudolf Virchow demonstrated that diseased cells could arise from normal cells Ever since biologists have been searching for the reason that normal cells become diseased Most modern research has been focused on the genecs that cause the change in cells

Cells are alive can reproduce and can die when they are unhealthy All cells consist of Deoxyribonucleic acids (DNA) that programs the type of cell or organism the cell will become Through biochemical reacons the DNA will be copied or transcribed to be made into proteins that keep the cell alive and allow it to reproduce to make new cells In animal cells the DNA is housed in an organelle called the nucleus Every cell in the human body has the same DNA however different parts of the DNA are used in different cells Different cell types (ie skin liver heart brain) use different parts of the DNA to make cells that contain different characteriscs and do different things




Fat 20-35 44-78g

Protein 10-35 50-175g

15

Figure 1 Eukaryoc Cell (animal)

Why do cells need nutrients To survive cells must go through complex biochemical processes to make the proteins and enzymes that are necessary for life These processes require the cells to create energy from molecules in the environment These molecules that are obtained from the environment are used by all cells for growth metabolism reproducon and repair The molecules that are obtained from the environment are called nutrients Without the proper nutrients cells will not be able to funcon opmally

Every part of our bodies are made up of cells of different cells Though all of the cells contain the same DNA they each have different requirements to survive and reproduce We cannot treat our skin cells the same way that we treat our muscle cells or brain cells We need to make sure that we are covering the necessary requirements to maintain all of the cells of our body The requirements to keep cells alive and healthy are called nutrients

Fats are needed by cells to make the cell membranes that surround and protect the cell The cell membrane is made up of a phospholipid bilayer which controls the movement of molecules into and

Figure 2 Phospholipid bilayer The circles are phosphate heads and the lines are famy acid tails

16

out of the cell The large center of the phospholipid bilayer is hydrophobic and will determine what can cross the membrane to enter the cell There are protein channels within the bilayer to help larger molecules or molecules with posive or negave charges to enter or leave the cell Fats are also stored in adipose ssue to protect the organs of the body keep the body warm and as a source of energy for the body if necessary Fats are the building blocks of the steroid hormones that our bodies need and are needed to form brain ssues and nerve cell membranes Finally fats act as carriers for the fat soluble vitamins A D E and K

Protein is required for the growth and repair of cells and ssues Proteins are made up of chains of polypepdes (mulple pepdes) Polypepdes are made up of building blocks called amino acids Amino acids are used by our cells to make their own proteins enzymes carriers and hormones Proteins are also used to make the anbodies that are used by our immune system to fight of infecons and keep us healthy The protein albumin is the major protein in the blood that maintains blood volume and balance Proteins can also be used as a form of communicaon between different cells and cell types of the body The final role of proteins is as a source of energy when the body and its cells are in starvaon mode

Carbohydrates are the primary source of energy for cells of the body especially for the brain and nervous system Maintaining the correct amount of carbohydrates is essenal to stop the body from breaking down muscles to use the protein for energy the prevenon of ketosis and the maintenance of blood glucose levels Carbohydrates can be simple sugars complex molecules such as starch or fiber such as cellulose Soluble fiber can help to lower bad cholesterol while insoluble fiber will pass through the digesve tract (gastrointesnal tract) undigested and will help to prevent conspaon

Water is not a macronutrient but is something that humans need in daily The body is mostly water we hear that it is between 60-70 water but what we rarely hear is that the brain in 90 water Water is necessary for the funconing of the body which means that we need to replenish water since we lose it through urine sweang and evaporaon We should drink a minimum of 64oz (189L) of water a day This is the amount for a sedentary person living at sea level in a humid area The amount of water needs to increase if a person is more acve lives at a higher altude or in a drier climate In Denver CO for instance a sedentary person should increase water intake to a minimum of 80oz (237L) daily Water balance in the body is necessary for normal healthy funconing of the body and is regulated by the kidneys If there is not enough water intake and humans are constantly dehydrated the kidneys will work harder than necessary and can become damaged

Learning Goal 3 ndash Understand how an imbalance of macronutrients impacts the body

What is macronutrient imbalance As menoned in Module 1 the WHO World Health Organizaon states that ldquoGood nutrion is an adequate well balanced diet combined with regular physical acvity and is the cornerstone of good health Poor nutrion can lead to reduced immunity increased suscepbility to disease impaired physical and mental development and reduced producvityrdquo1 The diet that we ingest is broken down into macronutrients in specific amounts The daily intake of nutrients is based on a 2000 calorie diet The

17

calorie intake is broken down into carbohydrates fats and proteins There is a range as each person is different based upon basal metabolic rate genecs exercise level and type of calories eaten


Any deviaon from the above percentages for macronutrients is considered an imbalance Even if a person does not eat 2000 calories in a day the ranges that are displayed in Table 1 as percentages should be maintained When a person eats or removes certain foods from his diet either through circumstances beyond his control (ie there is not food available) or by choice (ie going on a diet) once or more macronutrient classes are typically lowered or removed all together As soon as the percent ranges for macronutrients above is altered the person has a macronutrient imbalance

How does macronutrient imbalance occur There are many ways that macronutrient imbalance can occur the most common being lack of food or an overabundance of food Many people throughout the world either ingest too many or two few calories depending upon their parcular situaon Both of these situaons leads to an imbalance of the macronutrients that are ingested Recent research has shown that the type of calories (whole food based diet vs Western diet) is more important than the counng of calories though the percentage of each nutrient is important for healthy cells


Undernutrion occurs when there is not enough food ingested The most obvious way that this occurs is in areas where there just is not enough food to go around or people cannot afford the food that is available In many cases the staples such as corn products or rice is all that is available to people There are carbohydrates that are available but very limle fats or proteins The protein that is available does not


Carbohydrate 45-65

Fat 20-35

Protein 10-35

18

contain all of the 9 essenal amino acids making the person protein deficient To get the amino acids that are necessary to create the proteins that are necessary for the funconing of cells the muscles will be broken down to release the necessary amino acids The low amount of fat will make it harder for the person to protect organs make new cells and have enough energy to funcon

The less obvious way that a person can become undernourished is when he decides to purposefully go on a ldquodietrdquo that restricts one or more of the macronutrients A ldquodietrdquo is a short term change in dietary habits that is not sustainable in the long term to maintain health There have always been fad diets that people try but with the advent of social media the number of fad diets and the spread of these diets has increased Informaon can be found easily by a person from another that is praising the miracle diet that helped with weight loss Unfortunately restricng a macronutrient can have long term negave effects on the body It is true that many diets were created by physicians but not for the reason of losing weight or maintaining an unhealthy lifestyle

A great example of a current fad diet that was created for another purpose is the ketogenic (keto) diet The diet was first used in the 1920s to help reduce seizures in children with epilepsy The brain preferenally uses carbohydrates for metabolism to make energy to funcon A keto diet severely restricted the amount of carbohydrates to 5 or below of the daily calorie intake instead of the 445-65 needed for normal healthy funconing The restricon of carbohydrates worked to reduce epilepc seizures as the brain did not have enough energy The lack of energy stopped the nerve cells from over-communicang between the leW and right hemispheres of the brain stopping the seizures The lack of energy unfortunately affected all of the nerve cells in the brain and normal communicaon and funcon was reduced causing the keto diet to fall out of favor

The final way that a nutrient imbalance can occur is by over-eang The Western Diet has a high amount of added sugar specifically fructose Fructose blocks our ability to know that we are full causing us to eat more Too many carbohydrates can change the way the body metabolizes nutrients and stores fat When grains have the outer hull removed to make quick rice breads flour and other processed foods the fiber vitamins and minerals are also removed The vitamins and minerals can be added back chemically but the fiber cannot Many processed foods also have an imbalance of fats (ie 2 1 or fat free) as well as an imbalance of proteins Many people eat more protein than needed by eang protein bars and protein shakes or taking other supplements Though many people eang the Western Diet are overweight or obese due to the processing of foods and the addion of carbohydrates they are actually malnourished

What impact does macronutrient imbalance have on the human body There are many ways that macronutrient imbalance can manifest in our bodies The most researched changes in our health are problems in the cardiovascular system Type-2 diabetes (T2D) inflammaon and prevenon of cancer Last century salt was idenfied as part of the diet that can increase blood pressure Even though salt was reduced in diets the incidence of hypertension has increased Recent research shows that sugar increases blood pressure more than salt9 Salt is absorbed into the bloodstream with water in the small intesne increasing the salt concentraon in the blood The salt and water balance is delicate and is called homeostasis When salt concentraon is increased in the blood stream the amount of water must

19

increase as well to maintain balance As the amount of water in the blood increases there is more pressure that is put on the blood vessels and an increase in blood pressure is seen

For decades we have been told to reduce sodium to reduce hypertension current research is showing that the reducon of sodium has limle effect on hypertension but the addion of sugars increases hypertension The addional insulin that is released to compensate may lead to hypertension Since sucrose is equal parts glucose and fructose it has been shown to increase heart rate sodium retenon in the kidneys and vascular resistance10 All of this leads to higher blood pressure or hypertension Hypertension is worse with HFCS syrup or other high fructose syrups Reducing insulin resistance can lead to a lower blood pressure11

Fructose may cause other cardiometabolic harm such as increased blood pressure heart rate triglycerides insulin increased LDL (the bad cholesterol) and it lowers HDL (the good cholesterol) 12 Fructose and sucrose also lead to an increase in metabolic dysfuncon myocardial oxygen demand heart rate and inflammaon9 Compared to people who eat less than 10 of their calories from added sugars those who consume 10-249 of their calories from added sugars have a 30 increase of mortality from cardiovascular disease Those who eat 25 or more calories from added sugar have almost a threefold increase in risk 13

The bomom line - consumpon of typical amounts of added sugar over a lifeme is increasing your risk of cardiovascular disease Even the addion of the equivalent of half a can of soda to each meal can raise the risk factors for cardiovascular disease 14

Diabetes mellitus is a disease in which the bodyrsquos ability to produce or respond to insulin is impaired In both forms there is sugar in the urine which leads to the name diabetes mellitus means ldquosweet waterrdquo in Lan There are two forms of Diabetes Type 1 and Type 2 Type I is a genec disease that impairs the β cells of the pancreas from producing insulin Type 2 diabetes is the reducon of sensivity of receptors to insulin We will be discussing Type 2 diabetes


The increase in processed foods in our society has increased our intake of all sugars but most significantly fructose As menoned in Part 4 of my Sugar Blog Series our bodies evolved to store the small amount of fructose that we ate as triacylglycerols for protecon and storage Unfortunately not only has the significant increase in carbohydrates in our diets increased the amount of triacylglycerols that we are storing in our adipose ssue but it has significantly increased the amount of insulin in our blood The amount of insulin is more than we evolved to have in our blood because of this the receptors eventually stop recognizing the insulin This is similar to us no longer nocing white noise in

20

the background This is called insulin resistance Insulin resistance can lead to the same symptoms as Type I diabetes Unlike Type I diabetes Type 2 diabetes can be controlled by a change of diet

The human microbiome is a collecon of organisms that live on and in the human body There is an esmated 100 trillion cells which means that the microbiome outnumbers our cells by a factor of 10The complex communies of microbes consist of bacteria viruses fungi and other species that play a fundamental role in controlling most aspects of the host physiology One major part of human physiology that is controlled by the microbiome is the immune system

Inflammaon starts in our gastrointesnal (GI) tract (digesve tract) and the microbiome (bacteria) that reside in our GI tract Seventy percent of our immune system resides in our gut The microbiome plays a fundamental role in the inducon training and funcon of our immune system In return our immune system maintains the symbioc relaonship that has evolved When we think of everything that we eat and drink every day it makes sense that we need to defend ourselves from foreign parcles chemicals and pathogens that enter our system hence why seventy percent of the immune system is in our gut The microbes not only help to control the growth of pathogens but also add tags or remove something from the surface of the nutrients that we absorb to let the immune system know if what is entering the body is OK or needs to be sequestereddestroyed This is a delicate balance that has been created over human evoluon With a system that works so well why are we seeing such an increase in inflammaon and inflammatory diseases in recent years especially in high-income countries

Several reasons for the reducon in the resilience and diversity of the microbiome are to blame The first is the access and overuse of anbiocs Broad-range anbiocs do not kill only the bacteria that is causing an infecon in a paent but will also kill microbiota that we need In recent years research has shown that the appendix once thought to be a purely vesgial organ helps to replenish some of the species of bacteria that are symbioc and supposed to be in our gut Unfortunately not all of the species can be replenished Another reason is the ldquoHygiene Hypothesisrdquo which states that we are keeping our environment and ourselves too sterile as we develop The more that we use products that kill ldquo999 of the germsrdquo the less we are being exposed to the microbiota that we should be allowing to enter our bodies The decrease in the number of vaginal births and increase in the number of cesarean secons is another reason that we do not have the number of microbiota that we evolved to have15-16

Changes in diet is another reason that the human microbiome has decreased A change in diet as simple a change in fiber can impact the microbiota A decrease in fiber can alter the microbiota to make more of a chemical called butyrate which is associated with colorectal adenomas17 An increase in fiber can cause a beneficial shiW in the microbiota to increase a bacterium that has an-inflammatory properes18 A large change that has happened over the last 40 years is the creaon and ingeson of products that are made in labs to look and taste like food Since the microbiota sees these products as foreign chemicals the immune system is told that the absorbed parcles are to be amacked and destroyed This increases the inflammaon in the gut and eventually leads to systemic inflammaon as more of the parcles are ingested Aside from the immune system many of the parcles or chemicals that are being ingested cannot be used by the cells of our body and are stored or removed from the body by the kidney

A lot of research has been done on food and cancer prevenon over the last couple of decades Most of the research has been conducted in animal models and only recently has the connecon between food and cancer begun to be understood Unfortunately as with a lot of research in the early stages there are

21

many conflicng arcles being wrimen Much of the research has pointed toward foods that may help prevent or contribute to cancer These are associaons are not direct cause and effect relaonships

Nitrates and nitrites are added to processed meats and red meats to keep the meat a red color Nitrates are converted to nitrites which can then be converted by the body to cancer causing chemicals called N-nitroso compounds (NOCs) The presence of NOCs have been found in studies to increase cancers especially colorectal stomach and pancreac cancer Evidence has increased that there is not only a link to cancer with nitrites but also with a change in the enzymes that the microbiome (bacteria) in the gut make change with red meat consumpon

Fiber may help to reduce the risk of bowel or colorectal cancer An increase in fiber from fruits vegetables and whole grains can help waste from foods to move more quickly through our large intesne By liming the me that the waste stays in the intesne the me that the harmful chemicals have access to cells of the lining of the intesne is decreased Fiber also increased the size and frequency of bowel movements

Salt preserved foods may increase the risk of stomach cancer There are indicaons that salt may damage the lining of the stomach The lining of the stomach is essenal to protecng the stomach from the acid that is made to help digest food The damage to the lining of the stomach may make the cells more suscepble to cancer causing chemicals or ulcers Many ulcers are formed with the help of a bacterium called Helicobacter pylori (H pylori)

Anoxidants help to remove species of chemicals that have been oxidized These chemicals have a lone electron and are called free radicals Free radicals can cause damage to regular cells and are known to change the DNA of our cells The DNA can be changed to acvate genes that should not be acvated since they can cause cancer or deacvate genes that should be acvated to help reduce damage to cells Anoxidants have other benefits such as improved cardiovascular health

We hear from many sources that a balanced diet of fruits vegetables whole grains and white meats (chicken and fish) is a diet that can help us to lose weight to maintain a healthy body weight There is also a connecon between a high BMI and common cancers (colon gallbladder kidney and liver)19 Body fat produced hormones and inflammatory proteins that can promote tumor cell growth

22

References







23









15 Dominguez-Bello MG Blaser MJ Ley RE Knight R Development of the human gastrointesnal microbiota and insights from high-throughput sequencing Gastroenterology 20111401713ndash1719

16 Dominguez-Bello MG Costello EK Contreras M Magris M Hidalgo G Fierer N Knight R Delivery mode shapes the acquision and structure of the inial microbiota across mulple body habitats in newborns Proceedings of the Naonal Academy of Sciences of the United States of America 201010711971ndash11975

17 Chen HM Yu YN Wang JL et al Decreased dietary fiber intake and structural alteraon of gut microbiota in paents with advanced colorectal adenoma Am J Clin Nutr 2013 971044ndash1052

18 Hooda S Boler BM Serao MC et al 454 pyrosequencing reveals a shiW in fecal microbiota of healthy adult men consuming polydextrose or soluble corn fiber J Nutr 2012 1421259ndash1265

19 Arnold M et al Global burden of cancer amributable to high body-mass index in 2012 a populaon-based study The Lancet Oncology Vol 16 No1 36-46

Figures

Figure 1 Eukaryoc Cell (animal) Wikimedia Commons

24

License This image is licensed under the Creave Commons Amribuon-Share Alike 30 Unported license Figure 2 Phospholipid Bilayer Wikimedia Commons Author LadyofHats License This work has been released into the public domain by its author LadyofHats This applies worldwide In some countries this may not be legally possible if so LadyofHats grants anyone the right to use this work for any purpose without any condions unless such condions are required by law

Tables

Table 1 Macronutrient ranges based on a 2000 calorie daily diet Author Tami Miller via Power Point License This image of a simple structural formula is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Module 3 Carbohydrates

In the third module we will discuss the first macronutrient carbohydrates Carbohydrates are the highest rao of the food that is eaten and should consist of 45-65 of the daily calories The basics of how the body uses carbohydrates and what impact too much or too limle carbohydrates can have on health is important to understanding of nutrion This is also very important to the understanding of fad diets A diet fad or otherwise is any purposeful intake of food that that restricts one or more macronutrient or restricts calories

Learning Goals 1 Define a carbohydrate 2 Understand what the body does with monosaccharides 3 Understand how carbohydrate imbalance can impact the body

25

Learning Goal 1 ndash Define a carbohydrate

What is a carbohydrate Carbohydrates are sugars of various types Usually when we think of sugar we think of table sugar (white sugar) that we buy in 1 pound bags for our house Chemically a carbohydrate is a molecule that is made of a carbon backbone (3 4 5 or 6 carbon atoms hooked together in a chain) Once we have the backbone of carbon molecules hydrogen is added along with some oxygen The basic chemical formula is CH2O Most of the sugar that we eat is a hexose hex = six and ose = sugar so there are 6 carbons in the backbone of the sugar The chemical formula is then CH2O mulplied by 6 or C6H12O6

Sugar is used by cells to make energy The chemical bonds that hold the glucose molecule together can be broken re-arranged and re-made by the body to form energy fats or other molecules that the cells of the body use every day to maintain life The 3 4 5 or 6 carbon sugars are called monosaccharides and are very quickly absorbed by the body and can give us a sugar spike

Sugars that occur naturally are more likely polysaccharides which means that they need to be broken down to monosaccharides to be used by the body Eang whole foods increases the polysaccharides and the me that it takes to absorb Whole foods also increase the fiber that is necessary to reduce the speed at which sugars are absorbed A well balanced diet should contain 45-65 of our calories from carbohydrates to give the cells the energy necessary to maintain life Arficial sweeteners cannot be used by the body and are stored as fat in the adipose ssue in higher quanes than the body needs

26

Polysaccharides A polysaccharide is a molecule that contains several monosaccharides (a single sugar molecule) amached together in a chain The way that the molecules are linked determines if we can digest them into monosaccharides in our digesve tract so that they can be absorbed for use in our cells Polysaccharides that cannot be digested by humans are digested by the microbiome (bacteria) that inhabit the large intesne Some of the resulng monosaccharides are digested by the microbiome are used by the cells that line the large intesne some are used by the bacteria and the rest are insoluble fiber that makes the bulk in our stool

The polysaccharides that cannot be digested by humans are cellulose chin and β-glucan These molecules come from the grains fruits and vegetables that we ingest Cellulose is a main component of plant cell walls Chin is also found in the cell walls of plants and fungi such as yeast β-glucan is found in the cell wall of yeast and grains such as oats and barley All of these polysaccharides are chains of glucose that are amached in a manner that we cannot digest

Though humans cannot digest these molecules they are an essenal part of our nutrion Insoluble fiber is necessary to give bulk to our stools Insoluble fiber is also called dietary fiber Dietary fiber has been shown to aid in weight loss by causing a felling in fullness and saety This reduces food intake at meals This fiber can also slow digeson thereby reducing the absorpon of glucose into the bloodstream This reducon of glucose entry into the bloodstream prevents large blood glucose and insulin spikes Dietary fiber helps food to pass quickly through the stomach and the intesnes creang a soWer more easily passed stool

Polysaccharides that can be digested by humans are starch and glycogen Starch is a complex carbohydrate that comes from fruits vegetables and grains Starch can be digested into disaccharides (two sugar monosaccharides hooked together) This digeson begins in the mouth and ends in the small intesne Polysaccharides must be digested into disaccharides which are then further digested into monosaccharides for absorpon into the bloodstream Only monosaccharides can be absorbed by the cells that line the intesnal wall The disaccharides that we end up with that our body can digest further for itself are sucrose lactose and maltose The disaccharides that we cannot digest and are used as insoluble fiber are cellulose and β-glucans

Glycogen is the form in which the body stores glucose monosaccharides for fast energy producon Glucose is necessary for metabolism in the cells of our body especially the red blood cells and the brain The liver stores 12 hours of glycogen which is used when you are in between meals especially overnight when you are asleep The liver releases the glucose monosaccharides from glycogen into the bloodstream to be used by cells all over the body Muscles can also store glycogen but unlike the liver the glycogen stores in the muscle can only be used by the muscles for endurance exercises

Monosaccharides A monosaccharide is a molecule that is a single sugar molecule (carbohydrate) that contains 6 carbon molecules 12 hydrogen molecules and 6 oxygen molecules (C6H12O6) Monosaccharides can be absorbed by the cells of the small intesne so that they can enter blood to get to all of the cells of the

27

body There are many types of monosaccharides but there are only three that appear naturally in the human diet glucose fructose and galactose (structures are shown in Figure 1)

Figure 1 ndash The three most common monosaccharides

These three monosaccharides are joined together to form disaccharides that come from the breakdown of the complex carbohydrates in our food Common disaccharides in our diets are sucrose lactose and maltose Sucrose is made of a glucose monosaccharide and a fructose monosaccharide lactose is made of a glucose monosaccharide and galactose monosaccharide and maltose is made of two glucose monosaccharides Note that each of these disaccharides contains glucose this is important as glucose is the main source of energy for the human body

Once disaccharides are digested into individual monosaccharides the monosaccharides can be absorbed through the cells of the small intesne so that they can enter the blood stream to be distributed throughout the cells of the body

Learning Goal 2 ndash Understand what the body does with monosaccharides

What are the differences between the monosaccharides Though glucose fructose and galactose are all made of the same molecules 6 carbons 12 hydrogens and 6 oxygens they are different The way that the carbons hydrogens and oxygens are connected to one another is what determines the monosaccharide that is made In Figure 1 note that each molecule has a C=O and that the C=O in fructose is in a very different place than on the glucose and galactose

28

In each of the molecules there is also a HO ndash C ndash H or an H ndash C ndash OH Though the connecons here are the same they are in a different order This is a way for sciensts to show that the connected pieces are oriented in a different place in space This difference in orientaon makes the molecules different In Figure 2 note that the only difference between glucose and galactose is the orientaon of these molecules making these two monosaccharides very similar

Glucose Glucose is the most important of the three monosaccharides and comes from all three of the disaccharides that our bodies make into monosaccharides Glucose is the main source of energy for almost all of the cells and organs of the human body For some cells red blood cells is an example glucose it absolutely the only way for the cells to get any energy at all Other cell types can use different molecules for energy Skeletal muscle cells for example can use glucose fats or protein metabolism for energy The heart prefers to use the byproduct of fat metabolism ketones as an energy source one reason for this is to save glucose for the brain The brain can use ketones but prefers to use glucose for energy which is why your brain feels ldquofoggyrdquo when you have not eaten or have not eaten a well-balanced meal In addion to glucose being the preferenal source of energy for the brain glucose metabolism in the brain starts a cascade in the hypothalamus that results in the release of lepn and the suppression of food intake

When glucose enters the bloodstream insulin is released from the beta cells of the pancreas Insulin acvates cells of the body to uptake glucose or bring glucose into the cells Once the glucose is in the cells it can be made into energy for all of the acvies that the cells needs to do to maintain life and health Extra energy is also needed for the acvies that we do every day whether it is walking the dog exercising in a gym or running a marathon The more acve we are the more energy we need and therefore the more glucose that we need to take in as nutrion

Through a series of biochemical reacon mechanisms glucose can be used to make the main molecules that are used to make the energy (ATP) that our cells need to funcon ATP contains several high energy bonds that are broken by different processes in our cells to make new molecules divide and maintain cell health Without ATP cells cannot funcon and will die The highest energy bond is labelled in Figure 2

29

Energy is released

Figure 2 ATP (energy) molecule

Glucose is found in most of the whole natural foods that we eat in an amount that will keep the cells of the body energized When nutrion is received from whole natural foods there will not be an overabundance of glucose which can cause fat accumulaon or insulin imbalance An overabundance of glucose comes from the added sugars such as sucrose (table sugar) that are added to our foods either when they are made or aWerwards (remember puOng spoons of sugar on your cereal as a child)

As menoned earlier glucose is stored in the liver as the polysaccharide glycogen Glycogen is a quick way for the liver to release glucose to the body between meals when there is not enough glucose in the bloodstream for the cells of the body to use for energy Each glycogen polysaccharide contains around 30 000 glucose monosaccharides for easy release into the bloodstream by the liver In Figure 3 the small black and red pieces are each a glucose molecule The liver can store 12 hours of glucose for the body which is released when the hormone glucagon is in the bloodstream This storage of glucose is necessary when we fast Fasng is anyme that there is more than 4 hours between meals or snacks We most commonly use glycogen is overnight when we are sleeping which is why we ldquobreak-fastrdquo in the morning with our first meal By the me that we wake up and get our day going the glycogen in our liver has been depleted or is very close to being depleted

Glucose can also be stored as glycogen by muscle cells Glycogen that is stored in the muscle can only be ulized by the muscle and cannot be released to the rest of the body This is very useful for endurance athletes Muscles can be trained to store more glycogen by training for at least 3-4 hours a day 5-6 days a week The excess glycogen will be ulized by the muscles during endurance events such as marathons

Figure 3 Glycogen molecule The colored center is the protein core to which the glucose molecules are amached

30

Once the liver has stored all of the glycogen that it can it will use the glucose to make triacylglycerols This happens when there is sll glucose in the bloodstream and insulin levels are sll high telling the liver to make the triacylglycerols The triacylglycerols that are made will be sent to the adipose ssue for storage This is a way of storing high density energy for when food is very scarce Throughout human evoluon there have been periods where food is unavailable for extended periods of me Triacylglycerols give the body 9 calories per gram when they are metabolized When needed triacylglycerols are metabolized by the liver into acetyl CoA ketone bodies The ketone bodies are released into the bloodstream so that they can be used by cells of the body to make energy

Fructose As menoned earlier the difference between glucose and fructose is where the C=O is located This change in the fructose molecule makes it harder for the cells of our body to use fructose for energy Cells of the small intesne called enterocytes metabolize fructose into glucose so that it can be absorbed into the bloodstream Fructose is 12-18 mes sweeter than glucose and enters our diet in small quanes in fruits Other sources of fructose are honey (~55 fructose and 45 glucose) sucrose (50 fructose50 glucose and high fructose syrups (~55 fructose and 45 glucose) such as high fructose corn syrup tapioca syrup and any other addive that has syrup in the name In these syrups they are processed to make some of the glucose into fructose to make the syrup sweeter Somemes straight fructose is an addive There has been a substanal increase in the amount of fructose in our diets since the 1970s because fructose is so sweet it becomes a cheaper alternave since not as much needs to be added

Small amounts of fructose from fruits are converted by enterocytes into glucose for absorpon Fructose that is not converted into glucose can sll be absorbed by cells of the intesne into the bloodstream since it is a monosaccharide When fructose enters the bloodstream it is primarily metabolized by the liver and a small amount by the kidneys and muscles The liver will also convert the fructose into triacylglycerols (fats) that are then sent to the adipose ssue for storage

Galactose The difference between glucose and galactose is the locaon of the HO ndash C ndash H or an H ndash C ndash OH in space Since galactose is a monosaccharide it is absorbed by the intesne into the bloodstream Cells so not directly use galactose for energy but instead galactose is converted to glucose primarily by the liver Once the galactose conversion is complete the liver will release the glucose into the bloodstream for use by other cells of the body for energy producon

Learning Goal 3 ndash Understand how carbohydrate imbalance can impact the body

Effect of too much glucose When glucose enters the bloodstream insulin is released by the pancreas Insulin is a hormone that allows the cells of the body to take the glucose in so that it can be metabolized into energy in the form of

31

ATP Cells have receptors on the surface of the cell membrane that binds to insulin This causes a cascade of reacons to allow the uptake of glucose into the cells Without insulin glucose cannot enter the cells on its own because of its size Insulin helps to regulate glucose levels in the bloods that it does not get too high (hyperglycemia) or too low (hypoglycemia) Once cells have used the glucose necessary to make the energy for the cellular processes insulin will signal the liver and muscle cells to uptake more glucose

Muscle cells will use the glucose for energy especially during periods of exercise The muscles have the ability to store excess glucose as glycogen for quick energy Muscle glycogen can only be used by the muscles and is not released to the rest of the body The glycogen stored in the muscles is used during periods of intense or long periods of exercise Athletes that are endurance athletes can train muscle cells to store more glycogen by exercise for more than 3 hours consecuvely at least 5 days a week This is a great way to get glucose to the muscles during marathons long distance bike races triathlons etc

Liver cells will use excess glucose first to store as glycogen As menoned earlier the liver can store 12 hoursrsquo worth of glucose as glycogen The liver can very quickly remove individual glucose monosaccharides from glycogen for release into the bloodstream between meals when glucose levels begin to drop in the bloodstream The most common me that this occurs is at night when we are asleep Once the liver has stored the maximum amount of glycogen that it can the remaining glucose will be converted into triacylglycerols which will be taken by lipoproteins to adipose ssue for storage

Storage of fats in adipose ssue is necessary for the body The adipose ssue protects our internal organs and keeps them at the proper body temperature Fats are also high density energy 9 calories per gram of energy are released from fats while carbohydrates have 4 calories per gram of energy This is an evoluonary advantage for the mes that food sources are lean The removal of glucose from the bloodstream by uptake into various cells of the body will then reduce the amount of insulin that is released This system works very well when we have balanced whole food nutrion

Unfortunately the addion of extra sugar in processed foods uses this mechanism to the extreme and stores more fat than is necessary for survival in our adipose ssue The addional fats in our adipose ssue leads to weight gain The amount of sugar that is present in the Western diet is so high that there is typically hyperglycemia Since there is sll glucose in the bloodstream the pancreas will connue to release insulin to try to reduce the level of glucose When insulin is connually present in the body the cells that have receptors for insulin begin to become resistant They see insulin so oWen that either the cells down-regulate remove receptors from the cell surface or the receptors get red of the insulin and stop reacng to it This is called insulin resistance and the cells stop taking in glucose so it stays in the bloodstream When a person has insulin resistance the pancreas does not know and connues to release insulin in response to the glucose in the bloodstream This vicious cycle causes more fat accumulaon less glucose uptake and puts a large burden on the pancreas and can lead to various metabolic diseases

The most common disease besides obesity that we hear about is Type-2 Diabetes (T2D) Type 2 diabetes is and acquired form of diabetes A person with Type 2 diabetes releases insulin as normal when sugar enters the body As our diets contain more sugar than we evolved to eat a lot more insulin is released from that pancreas in response to the onslaught of sugar Due to the connual increase in insulin the receptors for insulin on cells become red of seeing it and become resistant This means that sugar is not being used as efficiently by the body and is being lost in the urine Insulin is released by the pancreas

32

in response to any type of monosaccharide the pancreas cannot disnguish between the monosaccharides

Type-2 diabetes is a known risk factor for carpal tunnel syndrome tennis elbow and shoulder pathologies such as rotator cuff tendinopathies1-3 Previous theories on tendonmuscle injury were based upon age related degenerave processes or over-use causing inflammaon and physiological changes However current research is demonstrang a correlaon between tendon muscle injury with obesity type-2 diabetes and cardiovascular risk factors such as high blood pressure Changes within the arteries can decrease blood flow causing weakened tendons Biopsies of damages muscles and tendons has shown increased fat accumulaon that is correlated with insulin resistance and could be part of the reason there is a higher level of tendon pathology in paents with T2D4

Hyperglycemia both acute (glucose level spikes in the bloodstream) and chronic (consistently high levels of glucose as with T2D) is associated with inflammaon5 The immune system has cells that are called monocytes that release inflammatory proteins called cytokines People with diabetes have higher levels of pro-inflammatory cytokines that paents without diabetes6-9 The signaling molecule that reduces the release of the cytokines that cause inflammaon is reduced in paents with hyperglycemia and T2D causing more pro-inflammatory molecules to be released10 In both clinical and experimental condion hyperglycemia has been shown to change many parameters within cells11-13 Low-level inflammaon is seen as the root of many of the disease problems that are currently so high in area with a Western diet

Effect of too much fructose Fructose in small quanes is converted into glucose in the intesne by cells called enterocytes This conversion allows the cells of our body to make the energy that they require A small amount of fructose may be absorbed into the bloodstream from the intesnal cells This is not a problem as a small amount can easily be used by the liver The liver will turn the excess fructose into triacylglycerols to be stored in adipose ssue This is an evoluonary advantage so that we have some fat to keep us warm and to use for energy if the availability of food is low

The dietary intake of fructose has increased over 40-fold since 1700 1415 especially since high fructose corn syrup (HFCS) was introduced in the 1970s as a cheap sweetener that is 12-18 mes sweeter than glucose Added sugars especially HFCS and other high fructose syrups like tapioca syrup are now in a wide variety of food products including infant formulas and foods aimed at children16 Fructose has been epidemiologically linked to obesity and metabolic syndrome19-21 which has lead the World Health Organizaon and the American Heart Associaon recommend the reducon of added sugars in the Western diet17-18 Experimental studies support fructose as the cause of metabolic syndrome especially in overweight and obese individuals22 the addion of 200g of fructose to a normal diet can induce metabolic syndrome in overweight but healthy men in only 2 weeks23 Recent studies have shown that excess fructose intake can induce several features of metabolic syndrome in normal mice including obesity visceral fat accumulaon non-alcoholic famy liver and elevated insulin levels24

The biochemical pathway used in the liver kidney and intesne can deplete cells of the ATP molecules that are used for energy Two enzymes are used to convert the fructose into a form that can enter the metabolic pathway to make energy ketohexokinase (KHK) also known as fructokinase and aldolase B There are 2 forms of KHK KHK-A (found in muscles) and KHK-C (found in the liver kidney and intesnes)

33

The fructose that goes to the muscles is used in the muscles by using ATP to make a form of fructose which can enter directly into the pathway to make energy Though this uses an ATP energy molecule not much fructose is used by the muscle cells as KHK-A is not really amracted to fructose

The fructose that is converted in the liver kidney and intesnes uses a different form of KHK KHK-C which is very amracted to fructose This is considered to be the primary enzyme and pathway for fructose metabolism Unfortunately this high amracon for fructose results in a rapid depleon of ATP from liver kidney and intesnal cells25-27 In addion there is no control mechanism to reduce the depleon of energy within cells In his book The Sugar Fix Richard J Johnson MD of the University of Colorado states this very elegantly ldquoThe act of processing this simple sugar is very taxing for cells leaving them exhausted and sick When cells are sapped for energy they canrsquot funcon properly To prevent future fructose-induced power outages they produce a dense source of energy fat This is why over me a high-fructose diet causes fat ssue to get bigger and bulkierrdquo28

In high-fructose diets the liver has access to more fructose than it can use to make ATP As menoned above Dr Johnson points out that a dense form of energy is produced to reduce power outages The liver has the ability to make the excess fructose into triacylglycerols These triacylglycerols are then sent to the adipose ssue for storage unl needed in the future Fat when metabolized in the liver to make ketone bodies for energy will make 9 calories of energy per gram of fat This is over twice the energy per gram than we get from carbohydrates or proteins which is one of the reasons why we have adipose ssue With the availability of high-fructose syrups in almost all of the processed foods to which we have access the liver is connually creang fat to be stored in the adipose ssue and not breaking the fat down for energy hence making the fat ssue ldquobigger and bulkierrdquo as stated by Dr Johnson The liver does not need to break down the fat for energy as high-fructose and high-sugar diets have a constant ingeson of carbohydrates that will be used for making energy

In addion to depleng cells of ATP that is used for energy fructose has been shown to increase food intake As menoned in the descripon of glucose in Learning Goal 1 the metabolism of glucose in the brain starts a cascade that controls our hunger There are 2 main hormones that help to control hunger ghrelin and lepn Ghrelin is released to let us know that we are hungry and we need to eat Lepn is released when we are saated and no longer need to intake nutrion When glucose is metabolized in the brain the hypothalamus releases lepn to let us know that we are full In a landmark 2005 study it was found that when glucose-sweetened drinks are given to study parcipants their lepn levels remained normal However when fructose sweetened beverages were given to parcipants the lepn levels were 35 lower than normal The parcipants also reported being hungrier and ate more high-fat foods when offered fructose-sweetened drinks Interesngly the fructose-sweetened beverages had limle effect on the ghrelin levels19 The parcipants maintained the hormone that told them they were hungry yet reduced the hormone that told then they were full Lepn resistance lepn is not recognized as being present is a characterisc of obese people29 30 Lepn resistance not only prevents the metabolic response to lepn but also is one cause of obesity31 In all high amounts of fructose leads to obesity because fructose bypasses food intake regulatory system and favors the making and storage of fat32

For decades we have been told to reduce sodium to reduce hypertension current research is showing that the reducon of sodium has limle effect on hypertension but the addion of sugars increases hypertension The addional insulin that is released to compensate may lead to hypertension Since sucrose is equal parts glucose and fructose it has been shown to increase heart rate sodium retenon

34

in the kidneys and vascular resistance33 All of this leads to higher blood pressure or hypertension Hypertension is worse with HFCS syrup or other high fructose syrups Reducing insulin resistance can lead to a lower blood pressure34

Fructose may cause other cardiometabolic harm such as increased blood pressure heart rate triglycerides insulin increased LDL (the bad cholesterol) and it lowers HDL (the good cholesterol) 35 Fructose and sucrose also lead to an increase in metabolic dysfuncon myocardial oxygen demand heart rate and inflammaon36 Compared to people who eat less than 10 of their calories from added sugars those who consume 10-249 of their calories from added sugars have a 30 increase of mortality from cardiovascular disease Those who eat 25 or more calories from added sugar have almost a threefold increase in risk 37 Note that this is an increase in added sugars sugars that are not part of a natural whole food diet but are added during processing or creaon of pre-packaged food A nutrious well-balanced diet should sll have 45-65 of calories coming from carbohydrates It is when sugar is added to the diet beyond what comes in natural foods that sugars begin to cause a problem Added sugars should be limited in the diet to maintain a healthy level of sugar for the body to metabolize

Effect of too lile glucose Too much sugar in the diet is not the only problem with sugar imbalance Too limle sugar in the diet also causes problems Low blood glucose is called hypoglycemia Symptoms of hypoglycemia include hunger shakiness anxiety sweang fast or irregular heartbeat sleepiness dizziness irritability If hypoglycemia gets worse symptoms might include confusion blurred vision passing out seizures and in extreme cases death

In a person who is eang a healthy well-balanced diet 45-65 of the calories that are eaten will come from carbohydrates As menoned above glucose will be used by various cells of the body to make energy When glucose enters the bloodstream insulin is released by the pancreas so that the cells of the body can bring in glucose to make energy Most cells of the body use glucose to make energy one notable excepon is cardiac heart muscle which prefers to use ketones thereby saving glucose for other cells and organs such as red blood cells and the brain

When we are fasng or between meals glucagon will be released by alpha cells of the pancreas Glucagon will go to the liver to tell it to convert the stored glycogen back into glucose monosaccharides The glucose will be released by the liver into the bloodstream to be used by cells of the body to make energy Usually the longest me that we have between meals is overnight which is why we break the fast when we get up with breakfast to introduce glucose back into the body If we do not eat breakfast the liver will connue to breakdown glycogen into glucose unl all of the stored glycogen is depleted Once all of the glycogen has been used energy needs to come from another source If there is no glucose introduced glucagon will connue to be released by the pancreas causing the liver to help the body get energy from another course Hormone sensive lipase will be released causing the triacylglycerols that are stored in the adipose ssue to be released The triacylglycerols will be moved to the liver where they will be made into ketone bodies to be released into the bloodstream As menoned earlier not all cells can use ketone bodies for energy red blood cells cannot use ketones and the brain prefers glucose

35

Red blood cells are the cells that carry oxygen to cells of the body do that they can make energy in a process called aerobic respiraon There are two types of metabolism or respiraon in cells anaerobic without oxygen and aerobic with oxygen Anaerobic respiraon or metabolism makes a net of 2 ATP energy molecules per glucose while aerobic respiraon (metabolism) makes 36 ATP energy molecules per glucose Ketones ketone bodies can only be used in aerobic metabolism Since red blood cells can only get energy via anaerobic metabolism they cannot get energy when ketones are the only available source of energy Red blood cells have a 120 day lifespan which is even shorter when ketones are the only energy source

The brain preferenally uses glucose for energy but can under necessity use ketones Since the brain prefers glucose it will become foggy cause confusion and generally not work as well when ketones are the only source of energy Ketones cannot cross the bloodbrain barrier so famy acids will enter the brain to undergo β-oxidaon into ketones The brain consumes 20 of the total oxygen that is consumed by the body and most of the oxygen is used by the neurons The breakdown of famy acids to ketones by β-oxidaon demands more oxygen than the metabolism of glucose which increases the risk that neurons may become hypoxic low oxygen In addion β-oxidaon of famy acids creates molecules called superoxides which puts the neurons into oxidave stress Oxidave stress is the imbalance of the producon of damaging free-radicals and the ability to counter the harmful effects Finally energy generaon based on fats from adipose ssue is slower than geOng energy from blood glucose as fuel Together this shows that using famy acids (ketones) as fuel cannot guarantee rapid energy generaon that the neurons need38

The use of ketones puts the body into ketosis a mild form of ketoacidosis We typically hear of ketoacidosis as a dangerous and potenally deadly state for people with diabetes Using fats as a fuels source can be more dangerous for people with Type 1 or Type 2 diabetes All people using fats for a source of energy should be under a physicianrsquos care to keep an eye on liver and kidney funcon There is not a lot of research on the long term effects (greater than a week) of ketosis According to Ilene Ruhoy MD PhD side effects include nausea voming conspaon fague acid reflux kidney stones elevated cholesterol and triglycerides vitamin and mineral deficiencies from not having a balanced diet and atherosclerosis39 Finally the buildup of ketones can lead to dehydraon and a change in chemical balance of the including an increase in uric acid liver enzymes and urea nitrogen

If glucose remains low in nutrion intake famy acids will become depleted Once famy acids are depleted in the body the liver and kidney will begin a process called gluconeogenesis Gluconeogenesis will occur in 2-10 days during a fasng state depending on the adiposity of the person Gluconeogenesis is a biochemical process where proteins are broken into amino acid skeletons to be used to make glucose de novo The newly made glucose will be released into the bloodstream for energy creaon throughout the body

The protein that used for gluconeogenesis can come either from nutrion protein that is being ingested or from muscle cells in our body Most commonly the protein that is broken down to make glucose will come from the protein that is being eaten This is necessary to replace the glucose that is purposely being restricted Dr Johnson has concern about the emphasis of fat and protein in low-carbohydrate diets Eang large amounts of animal proteins raises blood cholesterol levels even when weight is being lowered In addion too much protein over me can damage the liver and kidney28

36

References

1 Hegmann K T Thiese M S Kapellusch J Merryweather A S Bao S Silverstein B amp Garg A (2016) Associaon between cardiovascular risk factors and carpal tunnel syndrome in pooled occupaonal cohorts Journal of occupaonal and environmental medicine 58(1) 87-93

2 Hegmann K T Thiese M S Kapellusch J Merryweather A Bao S Silverstein B amp Garg A (2017) Associaon between Epicondylis and Cardiovascular Risk Factors in Pooled Occupaonal Cohorts BMC musculoskeletal disorders 18(1) 227

3 Applegate K A Thiese M S Merryweather A S Kapellusch J Drury D L Wood E amp Hegmann K T (2017) Associaon Between Cardiovascular Disease Risk Factors and Rotator Cuff Tendinopathy A Cross-Seconal Study Journal of occupaonal and environmental medicine 59(2) 154-160

4 von Bahr S Movin T Papadogiannakis N et al Mechanism of accumulaon of cholesterol and cholestanol in tendons and the role of sterol 27-hydroxylase (CYP27A1) Arterioscler Thromb Vasc Biol 2002 22(7)1129ndash35

5 Esposito K Nappo F Marfella R Giugliano G Giugliano F Ciotola M Quagliaro L Ceriello A Giugliano D Inflammatory cytokine concentraons are acutely increased by hyperglycemia in humans role of oxidave stress Circulaon 2002 1062067-2072

6 Temelkova-Kurktschiev T Henkel E Koehler C Karrei K Hanefeld M Subclinical inflammaon in newly detected Type II diabetes and impaired glucose tolerance Diabetologia 2002 45151

7 Morohoshi M Fujisawa K Uchimura I Numano F Glucose-dependent interleukin 6 and tumor necrosis factor producon by human peripheral blood monocytes in vitro Diabetes 1996 45954-959

8 Stentz FB Umpierrez GE Cuervo R Kitabchi AE Proinflammatory cytokines markers of cardiovascular risks oxidave stress and lipid peroxidaon in paents with hyperglycemic crises Diabetes 2004 532079-2086

9 Duncan BB Schmidt MI Pankow JS Ballantyne CM Couper D Vigo A Hoogeveen R Folsom AR Heiss G Low-grade systemic inflammaon and the development of type 2 diabetes the atherosclerosis risk in communies study Diabetes 2003 521799-1805

10 Gonzalez Y Herrera MT Soldevila G Garcia-Garcia L Fabian G Perez-Armendariz EM Bodadilla K Guzman-Beltran S Sada E and Torres M Hhigh glucose concentraon induce TNF-a producon through the down-regulaon of CD33 in primary human monocytes BMC Immunology 2012 1319-32

11 Iwata H Soga Y Meguro M Yoshizawa S Okada Y Iwamoto Y Yamashita A Takashiba S Nishimura F High glucose up-regulates lipopolysaccharidesmulated inflammatory cytokine producon via c-jun N-terminal kinase in the monocyc cell line THP-1 J Endotoxin Res 2007 13227-234

37

12 Wuensch T Thilo F Krueger K Scholze A Ristow M Tepel M High glucoseinduced oxidave stress increases transient receptor potenal channel expression in human monocytes Diabetes 2010 59844-849

13 Shanmugam N Reddy MA Guha M Natarajan R High glucose-induced expression of proinflammatory cytokine and chemokine genes in monocyc cells Diabetes 2003 521256-1264

14 Johnson RJ et al Hypothesis could excessive fructose intake and uric acid cause type 2 diabetes Endocr Rev 200930(1)96ndash116

15 Johnson RJ Saacutenchez-Lozada LG Andrews P Lanaspa MA Perspecve a historical and scienfic perspecve of sugar and its relaon with obesity and diabetes Adv Nutr 20178(3)412ndash422

16 Walker RW Goran MI Laboratory determined sugar content and composion of commercial infant formulas baby foods and common grocery items targeted to children Nutrients 20157(7)5850ndash5867

17 Vos MB et al Added sugars and cardiovascular disease risk in children a scienfic statement from the American Heart Associaon Circulaon 2017135(19)e1017ndashe1034

18 WHO guidelines approved by the guidelines review commimee Guideline sugars intake for adults children Geneva World Health Organizaon 2015

19 Havel PJ (2005) Dietary fructose Implicaons for dysregulaon of energy homeostasis and lipidcarbohydrate metabolism Nutr Rev 63133ndash157

20 Tappy L Lecirc KA (2010) Metabolic effects of fructose and the worldwide increase in obesity Physiol Rev 9023ndash46

21 Johnson RJ et al (2007) Potenal role of sugar (fructose) in the epidemic of hypertension obesity and the metabolic syndrome diabetes kidney disease and cardiovascular disease Am J Clin Nutr 86899ndash906

22 Stanhope KL et al (2009) Consuming fructose-sweetened not glucose-sweetened beverages increases visceral adiposity and lipids and decreases insulin sensivity in overweightobese humans J Clin Invest 1191322ndash1334

23 Perez-Pozo SE et al (2010) Excessive fructose intake induces the features of metabolic syndrome in healthy adult men Role of uric acid in the hypertensive response Int J Obes (Lond) 34454ndash461

24 Ishimoto T Lanaspa MA Le MT Garcia GE Diggle CP Maclean PS Jackman MR Asipu A Roncal-Jimenez CA Kosugi T Rivard CJ Maruyama S Rodrigues-Iturbe B Sanchez-Lozada LG Bonthron DT Saun YY Johnson RJ Opposing effects of fructokinase C and A isoforms on fructose induced metabolic syndrome in mice PNAS 2102 109 11 4320-4325

25 Woods HF Eggleston LV Krebs HA (1970) The cause of hepac accumulaon of fructose 1-phosphate on fructose loading Biochem J 119501ndash510

26 van den Berghe G Bronfman M Vanneste R Hers HG (1977) The mechanism of adenosine triphosphate depleon in the liver aWer a load of fructose A kinec study of liver adenylate deaminase Biochem J 162601ndash609

38

27 King MW 2018 themedicalbiochemistrypageorg LLC

28 Johnson RJ 2008 The Sugar Fix The high-fructose fallout that is making you fat and sick

29 Heymsfield SB Greenberg AS Fujioka K Dixon RM Kushner R Hunt T Lubina JA Patane J Self B Hunt P McCamish M Recombinant lepn for weight loss in obese and lean adults a randomized controlled dose-escalaon trial JAMA 282 1568ndash1575 1999

30 Proiemo J Thorburn AW The therapeuc potenal of lepn Expert Opin Invesg Drugs 12 373ndash378 2003

31 Shapiro A Mu W Roncal C Cheng K-Y Johnson RJ Scarpace PJ Fructoseindiced lepn resistance exacerbates weight gain in response to subsequent high-fat feeding 2008 295(5) R1370ndashR1375

32 Teff KL Elliom SS Tschop M et al Dietary Fructose Reduces Circulang Insulin and Lepn Amenuates Postprandial Suppression of Ghrelin and Increases Triglycerides in Women J Clin Endocrinol Metab 2004 892963-2972






38 Schonfeld P and Reiser G Why does brain metabolism not favor burning of famy acids tp provide energy ndash Reflecons on disadvantages of the use of free famy acids as fuel for brain Journal of Cerebral Blood Flow and Metabolism 2013 33 1493-1499

39 RuhoyI hmpswwwmindbodygreencomarclesa-neurologist-explains-the-ketogenic-diet-and-the-brain

Figures

Figure 1 Glucose Fructose and Galactose Author Tami Miller via Power Point

39

License This image of a simple structural formula is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Figure 2 ATP molecule Wikimedia Commons The chemical structure of wadenosine triphosphate Author ndash UserMysid Modified by Tami Miller License I the copyright holder of this work release this work into the public domain This applies worldwide In some countries this may not be legally possible if so I grant anyone the right to use this work for any purpose without any condions unless such condions are required by law

Figure 3 Glycogen molecule Wikimedia Commons 2-D cross-seconal view of glycogen A core protein of glycogenin is surrounded by branches of glucose units The enre globular complex may contain approximately 30000 glucose units Author Mikael Haggstrom License I the copyright holder of this work release this work into the public domain This applies worldwide In some countries this may not be legally possible if so I grant anyone the right to use this work for any purpose without any condions unless such condions are required by law

Suggested Reading The Sugar Fix by Richard J Johnson MD 2008 Rodale Publishing ISBN-13 978-1594866654 ISBN-10 1594866651

Module 4 Proteins

40

In the fourth module we will discuss the second macronutrient protein We will learn about amino acids the building blocks make up a protein Some amino acids are essenal in the food that we ingest while others can be made by our bodies The module will end with a discussion of how protein imbalance can be harmful to the funconing of the body

Learning Goals 1 Define proteins 2 Define essenCal amino acids 3 Understand how protein imbalance can impact the body

Learning Goal 1 ndash Define proteins

41

What is a protein Proteins are compounds that contain one or more long chains of building blocks called amino acids These polypepdes can contain a range of a few amino acids up to thousands of amino acids Proteins have many funcons throughout the body including structural enzymac hormonal and immune

The twenty amino acid building blocks all have a very similar structure There is an amino group that contains a nitrogen and a carboxyl end that contains a carbon hydrogen and two oxygens There is a central carbon between the two groups Amached to the central carbon there is another group amached that will determine the identy of the amino acid The identy will determine the property of the amino acid acidic vs basic water-loving vs water hang as examples

Figure 1 Basic amino acid structure The central carbon is in black the amino group is in blue and the carboxyl group is in red The green R is the group that will be different and will determine the identy of the amino acid

Amino acids are amached to each other to make a protein (Figure 2) The number of amino acids and order of amino acids is unique for every protein that is made by cells The unique order of the amino acids is called the sequence of the protein and will determine the type of protein as well as the funcon of the protein Some protein sequences are similar the protein that makes eye color blue or brown for instance while others are very different and will have very different funcons in the body the protein to make eye color and the protein that makes up muscle fibers for instance

Figure 2 Protein structure and structure of a single amino acid The chain of amino acids that is created is called the primary structure and can be thought of as a microscopic chain of pearls The protein will be further folded into a secondary and terary structure before being able to funcon Finally many proteins will have a quaternary structure which is two or

42

H H O

N ndash C ndash C

H R OH

more proteins in their terary structures coming together to make a funconal complex hemoglobin in blood cells is a great example Proteins can be funconal outside of a cell within the membrane or on the inside of a cell Funconal proteins can fall into several categories including enzymes hormones and signaling molecules membrane components and anbodies

Enzymes An enzyme is a protein that is made by an organism that acts as a catalyst to bring about a biochemical reacon that uses less energy A catalyst is something that increases the speed of a reacon by reducing the amount of energy needed for the reacon In the carbohydrate secon metabolism was discussed as a way to breakdown glucose to make ATP (energy) molecules This process is completed through a long series of biochemical reacons using enzymes Without the enzymes that are used the amount of energy needed to breakdown the glucose would be significantly higher than the amount of energy that is made Energy is sll used in all biochemical reacons in the body but much less is used than if there were no enzymes

Hormones and Signaling molecules Hormones are molecules that controls or regulates very specific reacons or processes in the body Most hormones are carried in the blood throughout the whole body There are three main classes of hormones steroid pepde and amino acid derived We will be focusing on pepde and amino acid derived hormones in this secon

Amino acid derived hormones are the least common type of hormone but are sll very important Amino acids derived hormones are derived from one or two amino acids that are modified to perform specific funcons Some examples are epinephrine norepinephrine thyroxine melatonin serotonin and GABA Epinephrine and norepinephrine are derived from tyrosine and are bemer known as adrenaline Adrenaline is used by the body to control the fight or flight response when we are in danger or excited Thyroxine is derived from derived from two tyrosine molecules amached together and regulate metabolism in the body Melatonin and serotonin are both made from the amino acid tryptophan Melatonin regulates sleep while serotonin is an excitatory neurotransmimer in the brain GABA is the major inhibitory neurotransmimer in the brain and is derived from glutamine

Pepde hormones are chains of amino acids which are shorter and less complex than enzymes Pepde hormones regulate many reacons and processes of the body Insulin and glucagon for instance are pepde hormones that regulate glucose metabolism in the body Insulin is released when glucose levels are high in the blood to increase the uptake of glucose into cells for metabolism or storage Glucagon on the other hand is released when glucose is low and smulates the release of glucose from storage or the creaon of glucose from fats or proteins

Membrane Components Proteins are also integral parts of the membranes that surround the cells of our body Proteins can be on the surface of cells as receptors from hormones or other signaling molecules to help the cell to understand what is happening around it and what it needs to change Surface proteins can also be used to idenfy a cell why type of cell is it or is it a foreign cell that should not be in the body Proteins can also be integrated into cell membranes to help move molecules into and out of the cell

AnCbodies

43

Anbodies are large proteins that are a necessary part of our immune system When we are exposed to foreign parcles that could make us sick our immune system trains specific cells to make anbodies Each anbody will be specific for one foreign parcle or protein and can be quickly made if we ever come into contact with that parcle again

Learning Goal 2 ndash Define essenCal amino acids

EssenCal Amino Acids There are twenty amino acids that are used in all living organisms In some cases homocysteine is listed as a twenty first amino acid Homocysteine is not an amino acid but is an intermediate in the creaon of the amino acid cysteine from the amino acid methionine Since homocysteine is an intermediate and is not an amino acid that is incorporated into proteins it will not be part of the discussion of this secon There are two types of amino acids D-amino acids and L-amino acids We can only ulize L-Amino acids and do not need to be ingesng D-amino acids

Figure 3 Essenal Amino Acids

Amino acids can be classified as essenal condionally essenal or non-essenal The body can make 11 of the 20 amino acids so there are 9 essenal amino acids Essenal amino acids are amino acids that our bodies cannot be made under any circumstances by enzymes or pathways in our bodies Without ingeson of the essenal amino acids proteins cannot be created in the body For example methionine is the first amino acid that is incorporated when a protein is being created in cells If methionine is not present no other amino acids will be added to the chain since the first link in the chain is not present therefore proteins will not be made Another example is tryptophan As we saw above not only is tryptophan incorporated into larger proteins but the brain signaling hormones of melatonin and serotonin cannot be made in the absence of tryptophan

44

EssenCal Amino Acids 1 Isoleucine 2 Leucine 3 Valine 4 Lysine 5 Methionine 6 Phenylalanine 7 Threonine 8 Tryptophan 9 Hisdine

Since we cannot create these amino acids the only way to obtain them is by ingesng them in the proteins that we eat When we eat proteins our body will break them down into the individual amino acids for absorpon in the small intesne into the bloodstream The proteins that we eat contain a combinaon of essenal condionally essenal and non-essenal amino acids Animal protein will contain all amino acids and are considered ldquoHigh Biological Valuerdquo while plant protein sources will be missing one or more of the amino acids and are considered ldquoLow Biological Valuerdquo Different plants will contain different essenal amino acids so ingeson of different types of plants necessary especially for vegetarians and vegans If a wide range of both fruits and vegetables are not ingested a doctor may recommend protein supplementaon If you choose to take protein supplements including protein powders before or aWer a workout you should consult your physician prior to starng You should also make sure that all of the essenal amino acids are represented in the mix If all of the essenal amino acids are not represented the protein supplement is incomplete

CondiConally essenCal amino acids Some amino acids can be made by the body but they cannot be made fast enough to be used in the making of proteins Since we make proteins faster than we can make the needed amino acids we need to ingest them As menoned above a good mixture of fruits and vegetables must be eaten not only to make sure that all 9 of the essenal amino acids m but also that all 6 of the condionally essenal amino acids are ingested

Figure 4 Condionally Essenal Amino Acids

The biochemical reacons that make cysteine start with methionine If methionine is not ingested not only will proteins not be able to be produced but the body will not be able to make cysteine This is the reason that homocysteine is somemes listed as an essenal amino acid this insures that if cysteine is not ingested and there is not enough methionine in the nutrion that cysteine can be produced

45

CondiConally EssenCal Amino Acids

1 Arginine 2 Cysteine 3 Glutamine 4 Glycine 5 Proline 6 Tyrosine

Non-essenCal amino acids The non-essenal amino acids are the 9 amino acids that can quickly and easily be produced by the body for use in proteins These amino acids can also be easily recovered from the normal breakdown of proteins that occurs in our cells Even though these do not need to be ingested but usually are in the foods that we eat

Figure 5 Non-Essenal Amino Acids

The key to making sure that there are enough of all 20 of the amino acids available for use on the body is to make sure that a healthy balanced diet is ingested on a daily basis Foods that are rich in protein are meat fish eggs poultry and dairy Plants foods that are high in protein are legumes nuts and grains again with plant foods there must be a healthy mix to make sure that all of the essenal and condionally essenal amino acids are represented

Learning Goal 3 - Understand how protein imbalance can impact the body

How much protein should be eaten The first thing that we need to understand is how protein that should be ingested on a daily basis There are several consideraons that must be made when answering this queson The first is the range is the percent of the daily calorie intake that should be protein These are the ranges that are posted in the ldquoNutrion Labelsrdquo on the processed food that we buy or can be found online for natural healthy foods Note that these are ranges as every person is slightly different in age lifestyle exercise and health The table below is for healthy adults that eat a 2000 calorie diet Though this is the common measure that is seen it should not be assumed that all adults eat 2000 calories a day



46

Non-EssenCal Amino Acids 1 Alanine 2 Asparagine 3 Asparc Acid (Aspartate) 4 Glutamic Acid (Glutamate) 5 Serine


The second table is one that is based on age and gender Infants and children should not be eang as many calories as adults and therefore have a lower Recommended Daily Allowance (RDA) of protein per day Note that in general the amount of protein ingested should not change once we are adults unless the person is a pregnant or breaseeding woman

Table 2 Recommended Daily Allowance (RDA) of protein by age and gender

The final table is based on the exercise level of the person This table is broken into gender female athletes need about 15 fewer grams of protein than males It is also important to note that the chart is for athletes that exercise on a regular basis (at least 1 connual hour without breaks for at least 3 days a week) Normal acvity levels would be taking care of children walking around work walking the dog etc Most people will fall into sedentary or normal acvity levels


Fat 20-35 44-78g

Protein 10-35 50-175g

Age and gender RDA in grams per day

Infants and Children

0-6 months 91

6-12 months 110

1-3 years 130

4-8 years 190

Males

9-13 years 340

14-18 years 520

19-70 years 560

Females

9-13 years 340

14-70 years 460

Pregnant or breasaeeding women

All ages 710

47

Table 3 Protein suggesons per body weight for different exercise types in males and females

Effects of too much protein There are many fad diets that are common on TV and social media that are high-protein and low-carbohydrate the most common is the ketogenic diet Diets that restrict carbohydrates have a tendency to be high in animal proteins and low in plant foods and are typically low in fiber Low fiber intake is associated with increased risk of colon cancer1 heart disease2 diabetes34 and conspaon5 It is important to understand what could potenally happen to the body when too much protein is ingested Eang more protein than necessary can interfere with your health and fitness goals in a number of ways including weight gain extra body fat stress on your kidneys and liver cancer dehydraon and the removal of important minerals from your bones

Exercise Group - Males Daily Protein Target Grams per lb of body weight



Normal Acvity Levels 034 ndash 045g 075 ndash 100g








Exercise Group - Females Daily Protein Target Grams per lb of body weight











48

When proteins are broken down in the cells of the body or in the liver ammonia is created This nitrogenous waste can be toxic to the body in high quanes When ammonia is in the blood the liver tries to reduce the toxicity by converng the ammonia into urea which is sll a nitrogenous waste but us less toxic The increase in the breakdown of the protein and the conversion of ammonia into urea puts undue stress on the liver One of the main funcons of the kidney is to remove soluble wastes from the body When there is an increase in ammonia and urea in the blood the kidney needs to make sure that it is filtering it out Another funcon of the kidney is to reabsorb nutrients that are filtered into the kidneys that the nutrients can be returned to the blood for use in the body These nutrients include glucose amino acids and vitamins There is a maximum amount of each of these nutrients that can be reabsorbed and when that amount is exceeded the kidney connues to try to reabsorb them but we do see an increase of the nutrients in the urine Both the filtering of the wastes and the reabsorpon of the nutrients when there are too many puts stress on the kidney

According to the American Academy of Family Physicians the high prevalence of kidney stones in the Unites States and other developed countries is largely caused by high animal protein intake and recommends the reducon of protein to prevent the recurrence of kidney stones6 Protein increases renal acid secreon and the reducon of calcium reabsorpon in the kidneys Protein is also a major source of the precursor to uric acid67 The combinaon of uric acid and calcium creates kidney stones

Bone is the support and structural unit of the body Osteoporosis occurs when the amount of calcium in the bone drops below normal levels and can lead to weak or brimle bones This is something that is usually associated with older or elderly women Bone density reaches its peak in our mid-twenes and then connually decreases throughout life High protein diets increase the acidity of body fluids uric acid increases in the kidney and ketosis increases the acidity of the blood The kidneys respond by trying to excrete acid in the urine while the bones supply a buffer to reduce blood acidity by removing calcium from the bone8 The bone also reacts to the kidney not reabsorbing calcium by removing calcium that can result in bone loss910 One study showed the an increase in protein intake from 47g to 112g per day caused the increase in urinary calcium and subsequent reducon of bone calcium11

Excessive protein can smulate a biochemical pathway that has a significant role in many cancers When the pathway is smulated cancers may also be smulated Studies suggest that high protein intake is associated with a 75 increase on overall mortality in humans as well as a 4-fold increase in cancer death1213 Other studies have found that diets that restrict protein reduce the IGF-1 (Insulin-like growth factor) which is a potent acvator of this pathway The reducon of protein can keep the pathway inhibited minimizing the chances of cancer growth in a human breast cancer model14

Harvard studies have shown that regular meat consumpon increases the risk of colon cancer by roughly 300 percent1516 It is believed that this is due to the reducon in plant food As menoned earlier plants are the source of insoluble fiber in the diet Insoluble fiber keeps food moving through the intesnes and gives bulk to the stool Fiber facilitates the movement of wastes including carcinogens that are introduced by the cooking of food out of the digesve tract and promotes an environment that seems to be protecve against cancer1

49

Effects of too lile protein Protein deficiency is rare in the Unites States it is more common that too much protein is a problem Protein deficiency can occur when not enough protein is ingested to maintain normal body funcon Protein deficiency is seen the most in gravely ill hospitalized paents but can be seen in older adults Research has shown that approximately one third of adults over the age of 50 are failing to meet the RDA for protein intake17 There could be several reasons for this including the change in eang habits and the taste of food as we age Individuals following a restricve diet in weight class sports like boxing wrestling and body-building may use self-starvaon methods to reach a parcular weight which could leave them protein deficient Finally vegetarians and vegans may not get enough protein if their diets are not well balanced Protein deficiency could lead to muscle wasng skin and hair problems fluid retenon poor wound healing and infecons

All of the problems that can be caused by protein deficiency are due to all of the funcons of proteins and amino acids that were menoned earlier Missing the essenal amino acids and the condionally essenal amino acids make the funconing maintenance and division of cells difficult Before supplementaon of the diet with protein your physician should be consulted

References

50

1 World Cancer Research FundAmerican Instute for Cancer Research Food Nutrion and the Prevenon of Cancer A Global Perspecve World Cancer Research FundAmerican Instute for Cancer Research Washington DC 1997 pp 216ndash51

2 Report of a Joint WHOFAO Expert Consultaon Diet Nutrion and the Prevenon of Chronic Diseases WHO Technical Report Series 916 2003

3 Anderson JW OrsquoNeal DS Riddell-Mason S Floore TL Dillon DW Oeltgen PR Postprandial serum glucose insulin and lipoprotein responses to high- and lowfiber diets Metabolism 199544848ndash54

4 Salmeron J Ascherio A Rimm EB et al Dietary fiber glycemic load and risk of NIDDM in men Diabetes Care 199720545ndash50

5 Mahon KL Escom-Stump Krausersquos Food Nutrion and Diet Therapy 9th ed WB Saunders Co 1996

6 Goldfarb DS Coe FL Prevenon of recurrent nephrolithiasis Am Fam Physician 1999602269ndash76

7 Wiederkehr M Krapf R Metabolic and endocrine effects of metabolic acidosis in humans Swiss Med Wkly 2001131127ndash32

8 Barzel US and L K Massey LK Excess dietary protein may can adversely affect bone Journal of Nutrion 1998128(6) 1051ndash1053

9 Goldfarb DS and Coe FL Prevenon of recurrent nephrolithiasis American Family Physician 1999 60(8) 2269ndash2276

10 Goldfarb DS Dietary factors in the pathogenesis and prophylaxis of calcium nephrolithiasis Kidney Internaonal1988 34(4) 544ndash555

11 Schueme SA Zemel MB and Linkswiler HM Studies on the mechanism of protein-induced hypercalciuria in older men and women Journal of Nutrion 1980 110(2) 305ndash315

12 Solon-Biet SM McMahon AC Ballard JW Ruohonen K Wu LE Cogger VC Warren A Huang X Pichaud N Melvin RG Gokarn R Khalil M Turner N Cooney GJ Sinclair DA Raubenheimer D et al The rao of macronutrients not caloric intake dictates cardiometabolic health aging and longevity in ad libitum-fed mice Cell Metab 2014 19418ndash430

13 Levine ME Suarez JA Brandhorst S Balasubramanian P Cheng CW Madia F Fontana L Mirisola MG Guevara- Aguirre J Wan J Passarino G Kennedy BK Wei M Cohen P Crimmins EM Longo VD Low protein intake is associated with a major reducon in IGF-1 cancer and overall mortality in the 65 and younger but not older populaon Cell Metab 2014 19407ndash417

14 Lamming DW Cummings NE Rastelli AL Gao F Cava E Bertossi B Spelata F Pili R Fontana L Restricon of dietary protein decreases mTORC1 in tumors and somac ssues of a tumor-bearing mouse xenograW model Oncotarget 2015 6(31)31233 ndash 31240

51

15 Giovannucci E Rimm EB Stampfer MJ Colditz GA Ascherio A Willem WC Intake of fat meat and fiber in relaon to risk of colon cancer in men Cancer Res 994(54)2390ndash2397

16 Willem WC Stampfer MJ Colditz GA Rosner BA Speizer FE Relaon of meat fat and fiber intake to the risk of colon cancer in a prospecve study among women N Engl J Med 19903231664ndash1672

17 Paddon-Jones D Campbell WW Jacques PF Kritchevsky SB Moore LL Rodrigues NR and van Loon LJC Protein and healthy aging Am J Clin Nut 2015 101(6) 1339S-1345S

d Fontana L Weiss EP Villareal DT Klein S Holloszy JO Long-term effects of calorie or protein restricon on serum IGF-1 and IGFBP-3 concentraon in humans Aging Cell 2008 7681ndash687

e Thissen JP Ketelslegers JM Underwood LE Nutrional regulaon of the insulin-like growth factors Endocr Rev 1994 1580ndash101

Figures

Figure 1 Structure of an amino acid Author Tami Miller License This image of a simple structural formula is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Figure 2 The primary structure of a protein File Protein primary structuresvg Author Naonal Human Research Instute License This work is in the public domain in the United States because it is a work prepared by an officer or employee of the United States Government as part of that personrsquos official dues under the terms of Title 17 Chapter 1 Secon 105 of the US Code Note This only applies to original works of the Federal Government and not to the work of any individual US state territory commonwealth county municipality or any other subdivision This template also does not apply to postage stamp designs published by the United States Postal Service since 1978 (See sect 3136(C)(1) of Compendium of US Copyright Office Pracces) It also does not apply to certain US coins see The US Mint Terms of Use

Figure 3 Essenal amino acids Author Tami Miller License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Figure 4 Condionally essenal amino acids Author Tami Miller License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Figure 5 Non-essenal amino acids

52

Author Tami Miller License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Tables


Table 2 Recommended Daily Allowance (RDA) of protein by age and gender Author Tami Miller License This is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Table 3 Protein suggesons per body weight for different exercise types in males and females Author Tami Miller License This is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Module 5 Fats

In the Module 5 we will discuss the third macronutrient fats There are several different types of dietary fat that will be discussed Some of these are good for our bodies and are natural while others are made in labs to make food more palatable or longer lasng on the shelf and are not good to ingest We will discuss how the dietary fats that we eat are used by our bodies and what could happen when there is an imbalance of fats

53

Learning Goals 1 Define fats 2 Understand how fats are used by the body 3 Understand how fat imbalance can impact the body

Learning Goal 1 ndash Define fats

What is a fat Fats are natural oily or greasy substances that occur in all cells and animal bodies that have various funcons The main funcon of fat is as the major storage form of energy in the body Carbohydrates and proteins each provide 4 calories of energy per gram fats on the other hand provide 9 calories of energy per gram Fat also has other important funcons in the body such as cell structure and signaling When fats are used in the body they are referred to as lipids There are several types or structures of fats the main categories are saturated and unsaturated All fats have a long chain of carbons and hydrogens this

54

structure makes fats hydrophobic (water-hang) In the body the long chains will arrange themselves to be away from or protected from the water

Dietary fat generally contains a mix of saturated and unsaturated fats Dietary fats are converted into cholesterol by the liver which is then released into the blood stream As stated above animal fats contain a higher amount of saturated fats A healthy mix of animal and plant based foods should be eaten to reduce the amount of saturated fats Most oils contain both saturated and unsaturated fats in different proporons A healthy balanced diet should contain 20-35 fat


Saturated fats Saturated fats have a long chain made of carbons and hydrogens The carbons have the maximum number of hydrogens amached to them These fats can get very close together and stack making them solid or semi-solid at room temperature Bumer is made mostly of saturated fats which is why it can be stored in a bumer dish outside of the refrigerator Animal fats are usually saturated or mostly saturated think about bacon grease or other types of lard High amounts of saturated fats can be found in palm oil coconut oil cheese and red meat

Figure 1 Free saturated famy acid (Stearic acid)

Hydrogenated fats are fats that are made in a lab These fats have hydrogens chemically added to make then saturated Fats are hydrogenated to make sure that the processed foods that they are added to maintain their shape on the shelves Some examples are solid baking grease the centers of sandwich cookies the covering on cookies cakes and other desserts

Saturated fats are very difficult for the enzymes in our bodies to break down and use Saturated fat can cause cholesterol buildup in arteries and can raise the LDL (bad) cholesterol which in turn can increase the risk for heart disease or stroke




Fat 20-35 44-78g

Protein 10-35 50-175g

55

Unsaturated fats Unsaturated fats also have a long chain made of carbons and hydrogens Instead of having the maximum number of hydrogens on all of the carbons two or more of the carbons will have double bonds to each other These fats have a harder me stacking so they stay liquid at room temperature Many of these are considered healthier oils such as olive oil grapeseed and sunflower oils An unsaturated fat can be monounsaturated has one double bond or polyunsaturated having two or more double bonds

Figure 2 Free unsaturated famy acid (Linoleic acid)

Figure 3 Cis-unsaturated famy acid

Most natural unsaturated fats are cis fats where the hydrogens are placed side by side Figure 3 is an example of a cis unsaturated famy acid noce that the double bond causes a kink or a bend in the chain Cis-unsaturated fats are easier for the body to break down because of the bends in the chain Trans-fats are fats that have the hydrogens posioned across from each other Small amounts of rans-fats occur naturally in dairy and other animal food products and are fine in the diet Polyunsaturated fats can help to lower the level of LDL (bad) cholesterol in the blood There are two main types of polyunsaturated fats omega-3 and omega-6 fats some of which cannot be made by the body and should be ingested in small quanes Omega-3 fats are found in oily fish such as mackerel herring trout sardines and salmon Most people do not get enough omega-3 in their diet and should eat at least 2 porons of fish a week Omega-6 fats are found in oils such as rapeseed corn and sunflower oils

When trans-fats are listed on a food label it means that the fat was made in a lab When fats are made to be unsaturated in a lab the reacon causes many trans-double bonds The increase in the number of trans-double bonds makes the fats very difficult to break down in our digesve tract and may will go through causing diarrhea Most trans-unsaturated famy acids have been removed from processed foods due to the side-effects Healthy unsaturated fats are found in a vegetarian diet As always a good diet is varied whole natural food diet When fats are used in the body they are called lipids

56

Learning Goal 2 ndash Understand how fats are used by the body

Structural Lipids Lipids are the major component of the membranes that surround all of the cells in our bodies The lipids that make up the cell membrane are called phospholipids which means that they contain a hydrophilic or water-loving head containing a phosphate as well as the hydrophobic famy tail


The cell membrane is semi-permeable which means that it controls what can enter and leave the cell The phospholipids that make up the cell membrane are a combinaon of saturated and unsaturated so that the cells membrane can maintain fluidity and is not to rigid Cells of the body can have many shapes and need to be soW enough that they can divide but rigid enough that the cell contents do not leak

Other phospholipids contain an addional group on the surface that can be used as cell recognion so that the immune system knows what type of cell it is and that it should not be amacked These phospholipids can also be used for signaling between cells or binding of cells to one another Without the ability to communicate cells could not work together throughout the body and especially in cells that are grouped into organs A very important type of phospholipid that has a surface protein are on the surface of red blood cells The presence or absence of certain proteins on the phospholipid determines blood type Most people have either A B AB or O blood types

Lipids are also used as waxes in our bodies The most common wax is ear wax which is connually being produced from the lipids that we eat This is a protecve wax that stops things from entering the ear canal and damaging the hearing apparatus There is also a light layer of lipids on the surface of our sking to stop water from entering our bodies through the skin

Signaling Lipids Lipids can take an acve role in how the body works The largest acve signaling role that lipids take in the body are steroid hormones The term steroid indicates that the hormone is made from cholesterol or fats in the body Since steroid hormones are made from cholesterol or lipids they are hydrophobic and can easily enter cells to change how the DNA in the cell is used This is important in many mes of life such as puberty Without estrogen progesterone and testosterone our bodies would never mature to

57

the adult state Steroid hormones are made in specific areas of the body but are taken to all cells of the body through the blood stream

Another signaling lipid is prostaglandin and act as signaling molecules so that cells can talk to each other Prostaglandins can wither signal nearby cells through a space or can signal the cell that released it The effects of these signaling molecules are varied and include effects on smooth muscle movement the sleep-wake cycle and body temperature Fat-soluble vitamins (A D E and K) are also made of lipids Fat-soluble vitamins are necessary for many of the biochemical reacons in the body for instance vitamin K is necessary for blood cloOng

Energy Storage Fats in the form of triacylglycerols are stored in adipose ssue as what we typically term as body fat Adipose ssue and triacylglycerols storage is necessary and an evoluonary advantage The storage of fats maintains body temperature protects organs and most importantly stores energy Fats are a high-density form of energy storage for when food cannot be obtained and the body is in a starvaon state Triacylglycerols when broken down by cells releases 9 calories of energy per gram just more than double the amount of energy is released by carbohydrates or proteins This is one of the most important funcons of fats in the body

Learning Goal 3 ndash Understand how fat imbalance can impact the body

Too much fat Too many dietary fats especially saturated fats can raise total blood cholesterol which can increase the risk of heart disease LDL cholesterol delivers cholesterol to cells so that they can uptake it and use it in cell membranes or steroid hormones When LDL cholesterol is high it starts to deposit cholesterol on the walls of arteries which can reduce blood flow through the arteries The deposion on arteries if leW untreated can completely block the artery causing heart amacks or strokes HDL cholesterol (omega-3 and omega-6) can pick the cholesterol from the arteries and deliver it to the liver to be made into triacylglycerols that will be stored in adipose ssue

Arficial trans-fats are added to margarine and other processed spreads as well as some package products to help extend shelf life Arficial trans-fats are linked to inflammaon unhealthy cholesterol changes impaired artery funcon insulin resistance and excessive belly fat1-6

Too lile fat Essenal famy acid deficiency is rare in people who consume varied diets People with gastrointesnal diseases such as Crohnrsquos disease ulcerave colis or celiac disease have lower famy acids7 People on extremely low-fat diets usually for medical purposes can show symptoms of essenal famy acid deficiency8-10 Not having enough dietary fat can reduce the amount of fat-soluble vitamins that are

58

absorbed with the fat in the intesnes Fat-soluble vitamins are necessary for various funcons such as eye health and blood cloOng

Eang too limle fat can affect appete control To manage appete incorporate fat into balance meals and snacks For instance a tablespoon or two of nuts or full-fat salad dressing usually enough to help with appete Many ldquolow-fatrdquo foods contain high amounts of added sugars to make it taste bemer Not only does this reduce appete control but increases the amount of carbohydrates in the diet The problems associated with increased carbohydrate intake was discussed in Module 3

Fats help the brain the produce the neurotransmimers that make us feel good such as serotonin and dopamine An omega-3 famy acid deficiency can cause mood swings and depression11 Other problems that can come from reduced dietary fat intake is dry skin and soW spliOng or brimle finger nails

References

1 Iwata NG Pham M Rizzo NO Cheng AM Maloney E et al (2011) Trans Famy Acids Induce Vascular Inflammaon and Reduce Vascular Nitric Oxide Producon in Endothelial Cells PLoS ONE 6(12) e29600 doi101371journalpone0029600

2 Mozaffarian D Pischon T Hankinson SE Rifai N Joshipura K Willem WC and Rimm EB Dietary intake of trans famy acids and systemic inflammaon in Women Am J Clin Nutr 2004 79(4) 606ndash612

3 Baer DJ Judd JT Clevidence BA Tracy RP Dietary famy acids affect plasma markers of inflammaon in healthy men fed controlled diets a randomized crossover study Am J Clin Nutr 2004 79(6)969ndash973

59

4 de Roos NM Bots ML and Katan MB Replacement of dietary saturated famy acids by trans famy acids lowers serum HDL cholesterol and impairs endothelial funcon in healthy men and women Aterioscler Thromb Vasc Biol 2001 21 (7) 1233-1237

5 Chrisansen E Schnider S Palmvig B Tauber-Lassen E Pedersen O Intake of a diet high in trans monounsaturated famy acids or saturated famy acids Effects on postprandial insulinemia and glycemia in obese paents with NIDDM Diabetes Care 199720(5)881-7

6 Kavanagh K Jones KL Sawyer J Kelley K Carr JJ Wagner JD Rudel LL Trans fat diet induces abdominal obesity and changes in insulin sensivity in monkeys Obesity (Silver Spring) 200715(7)1675-84

7 Siguel EN Lerman RG Prevalence of essenal famy acid deficiency in paents with chronic gastrointesnal disorders Metabolism 19964512-23

8 Piper CM Carroll PB Dunn FL Diet-induced essenal famy acid deficiency in ambulatory paent with type I diabetes mellitus Diabetes Care 19869291-293

9 McCray S Parrish CR Nutrional management of chyle leaks an update Praccal Gastro 20119412 32

10 Sriram K Meguid RA Meguid MM Nutrional support in adults with chyle leaks Nutrion 201632281-286

11 Grosso G Galvano F Marventano S Malaguarnera M Bucolo C Drago F and Caraci F Omega-3 Famy Acids and Depression Scienfic Evidence and Biological Mechanisms Oxid Med Cell Longev 2014 2014 313570-313585

Figures

Figure 1 Free Saturated Famy Acid File Stearic acid shorthand formulaPNG Author Wolfgang Schaefer License I the copyright holder of this work release this work into the public domain This applies worldwide In some countries this may not be legally possible if so I grant anyone the right to use this work for any purpose without any condions unless such condions are required by law

Figure 2 Free Unsaturated Famy Acid File Linoleic acid shorthand formulaPNG Author Wolfgang Schaefer License I the copyright holder of this work release this work into the public domain This applies worldwide In some countries this may not be legally possible if so I grant anyone the right to use this work for any purpose without any condions unless such condions are required by law

Figure 3 Cis Unsaturated Famy Acid File Cis-vaccenic acidsvg Author Yikrazuul

60

License This image of a simple structural formula is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property and contains no original authorship

Figure 4 Phospholipid Bilayer Wikimedia Commons Author LadyofHats License This work has been released into the public domain by its author LadyofHats This applies worldwide In some countries this may not be legally possible if so LadyofHats grants anyone the right to use this work for any purpose without any condions unless such condions are required by law

Tables


Module 6 Micronutrients

Module 6 will cover micronutrients We will discuss what a micronutrient is where they come from and how the body uses them We will also discuss the problems that can occur with micronutrient deficiency

Learning Goals 1 Define a micronutrient 2 Understand why cells and the body require micronutrients 3 Understand how micronutrient deficiency impacts the body

61

Learning Goal 1 ndash Define a micronutrient

What is a micronutrient Micronutrients are nutrients that are needed in very small amounts by the body which enable the body to produce and acvate enzymes hormones and other substances that are essenal for proper growth and development disease prevenon and wellbeing Micronutrients play a central role in metabolism and ssue funcon Micronutrients are not produced in the body and must be obtained in food

Micronutrients are classified as either vitamins or minerals (also referred to as trace elements) Minerals are referred to as inorganic and have a very simple structure and are made of a single element from the periodic table such as iron or magnesium Vitamins are larger organic structures that are made of several elements that are amached together in organic molecules that include carbon hydrogen and oxygen

Where are micronutrients found Micronutrients are found in the foods that we ingest in small quanes A well balanced healthy diet is necessary to gain access to all of the micronutrients that are needed by the body Micronutrients are found in a variety of plant and animal foods that are part of our diet Micronutrients in plants will differ depending upon where they are grown and if the soil has been depleted of nutrients A variety of fruit

62

and vegetables in the diet will help to make sure that most micronutrients are represented Micronutrients in animals may differ depending upon what they were fed It is important to note that cobalamin (vitamin B12) can only be found in food from animals and will be absent in a vegan diet and will likely be deficient in a vegetarian diet

Learning Goal 2 ndash Understand why cells and the body require micronutrients

Cofactors Cofactors are minerals that are single metal elements from the periodic table Cofactors are used to acvate enzymes and to help make proteins Some are highly used zinc is needed to help the acvity of over 100 different enzymes while others are not used as oWen selenium is required for a class of enzymes called anoxidants which protects cells from oxidaon by free radicals

Each cofactor will be discussed in Module 8

Coenzymes Coenzymes are vitamins or metabolites of vitamins that have been broken down by the body Coenzymes can be part of major processes such as metabolism such as riboflavin (B2) and niacin (B3) Vitamins can also be used to increase wound healing the proper metabolism of proteins and fats and to help reduce the risk of diseases such as cardiovascular disease

Each coenzyme will be discussed in Module 7

Learning Goal 3 ndash Understand how micronutrient deficiency impacts the body

Iodine and Vitamin A are the most important micronutrients for global health concerns Vitamin A deficiency claims the lives of around 670000 children under 5 around the world every yeara Iron deficiency anemia during pregnancy is associated with 115 000 deaths each year and accounts for a fiWh of total maternal deathsa

Research has shown that micronutrient deficiency increases the likelihood of being overweight or obeseb-e According to the Centers for Disease Control and Prevenon (CDC) more than 67 of the US adult populaon and 16 of children are overweight or obese with more than 34 of American adults obese These numbers have caused a sharp increase in the number of dieng amempts According to a survey by the Calorie Counng Council more than 65 million Americans (approximately 25) are on a diet of some kindf Subopmal intake of certain macronutrients is a factor in a multude of health

63

condions including resistance to infecon birth defects cancer cardiovascular disease and osteoporosisg-i The World Health Organizaon (WHO) has shown that malnutrion occurs not only in underweight people but also in overweight and obese peoplej The Western diet is unbalanced and leads to the overabundance of certain macronutrients while simultaneously reducing other macronutrients

Restricon of calories generally means the restricon of macronutrients through the restricon of certain foods The restricon of macronutrients can inadvertently lead to micronutrient deficiencies Four popular ldquodietsrdquo were evaluated to determine if the met the Reference Daily Intake (RDI) of micronutrients RDI is the daily intake level of a micronutrient that is sufficient to meet the requirements of 97-98 of healthy individuals in every demographic in the Unites States The four diets that were evaluated were South Beach Atkins for Life DASH diet and Best Life It was found that none of the diets met the RDI of all micronutrients that are needed In addion to meet the RDI for all of the micronutrients an unrealisc range of 18800-37500 calories a day would need to ingestedf To understand the need for each micronutrient and the problems with deficiencies Module 7 and 8 will discuss the funcon of each micronutrient

References

a hmpwwwunitedcalltoaconorg The report was prepared by the Micronutrient Iniave in partnership with the Flour Forficaon Iniave USAID GAIN WHO The World Bank and UICEF

b Asfaw A Micronutrient deficiency and the prevalence of mothers overweightobesity in Egypt Economics and Human Biology 2007 5471-483

c Smotkin-Tangorra M Purushothaman R Gupta A Neja G Anhalt H Ten S Prevalence of vitamin D insufficiency in obese children and adolescents Journal of Pediatric Endocrinology amp Metabolism 2007 20817-823 [hmpwwwncbinlmnihgovpubmed17849744]

d Dzieniszewski J Jorosz M Szczygie B Diugosz J Marlicz K Linke K Lachowicz A Ryko-Skiba M Orzeszko M Nutrional status of paent hospitalized in Poland European Journal of Clinical Nutrion 2005 59552-560

e Koleva M Kadiiska A Markovska V Nacheva A Boev M Nutrion nutrional behavior and obesity Central European Journal of Public Health 2000 810-13

f Calton JB Prevelance of micronutrient deficiency in popular diet plans 2010 J Intern Soc Sports Nutri 7 (24) 1-9

g Fletcher R Fairfield K Vitamins for Chronic Disease Prevenon in Adults The Journal of the American Medical Associaon 2002 2873127-3129

64

h Field C Johnson I Schley P Nutrients and their role on host resistance to infecon Journal of Leukocyte Biology 2002 7116-32

i Combs G Jr Status of selenium in prostate cancer prevenon Brish Journal of Cancer 2004 91195-199

j WHO The double burden of malnutrion Policy brief hmpwwwwhointnutrionpublicaonsdoubleburdenmalnutrion-policybriefen

Module 7 Vitamins

Module 7 will cover water-soluble and fat-soluble vitamins The funcon of each vitamin in the body will be discussed as well as the problems that can arise from deficiencies of the vitamin

Learning Goals 1 Define a vitamin 2 Water-soluble vitamins 3 Fat-soluble vitamins 4 Understand how vitamin deficiencies impact the body

65

Learning Goal 1 ndash Define a vitamin

What is a vitamin A vitamin is an organic molecule that can be used for various funcons within the body Vitamins all have a backbone of carbons hydrogens and oxygens Vitamins can be classified as either water-soluble or fat-soluble

Define Water-soluble A water-soluble vitamin will be absorbed in the small intesne directly into the bloodstream The vitamin can flow freely in the blood which is water based and will be readily available to cells of the body In general water-soluble vitamins cannot become toxic as they are consistently being removed from the body via the kidney

Define Fat-soluble A fat soluble vitamin will be absorbed with fats into the lymph system and will be taken to the lymph nodes to make sure that there are no foreign parcles that were absorbed with the fats Fat-soluble vitamins cannot flow in the blood but must be carried though the blood by protein carriers Fat-soluble vitamins in high concentraons can become toxic as they are stored in the adipose ssue with fats and are not readily removed from the body

Learning Goal 2 ndash Water-soluble vitamins

66

Vitamin C Vitamin C is the key nutrient for the stability of blood vessels the heart and all other organs in our bodies Vitamin C is responsible for the opmum producon and funcon of collagen elasn and other connecve ssue molecules that give stability to our blood vessels carlage muscle and bones Vitamin C is important for fast wound healing throughout our bodies including the healing of millions of ny wounds and lesions inside our blood vessel walls

It is the most important anoxidant in the body Anoxidants help to protect your cells against free radicals which are produced in small quanes when your body breaks down food and in higher quanes when the body is exposed to tobacco smoke or radiaon Free radicals may play a role in the progression of heart disease cancer and other diseases Oxidave damage to cells is a major cause of cardiovascular disease People who eat a lot of fruits and vegetables have a lower risk of cardiovascular disease and researchers believe that the anoxidant content of fruits and vegetables might be partly responsible1-3

Figure 1 Vitamin C

Vitamin C is also a cofactor for a series of biological catalysts (enzymes) which are important for the improved metabolism of cholesterol triglycerides and other risk factors This helps to decrease the risk for cardiovascular disease It is an important energy molecule needed to recharge the high energy electron carriers inside the cells that help to make energy Vitamin C helps the body to increase iron absorpon in the gastrointesnal tract and helps to store iron that is used by the red blood cells to carry oxygen

Age in Years Aim for an intake of mgday Stay below the intake of mgday

Birth to 6 months 40 Not established

Infants 7-12 months 50 Not established

Children 1-3 years 15 400



Teen boys 14-18 years 75 1800

Teen girls 14-18 years 65 1800

Males 19 and older 90 2000

Females 19 and older 75 2000

67

Table 1 Vitamin C Recommended daily allowances

According to the Mayo Clinic research has shown that eang a diet high in vitamin C can reduce the risk of many types of cancer including breast colon and lung cancer Vitamin C in conjuncon with zinc vitamin E beta-carotene and copper may prevent age-related macular degeneraon 4 and some studies suggest that higher levels of vitamin C may reduce the risk of developing cataracts Finally though vitamin C will not stop you from geOng a cold it may reduce the symptoms and the length of the cold

Vitamin B1 Vitamin B1 (thiamine) plays a crical role in energy metabolism growth development and the funcon of cells The acve form of thiamine is thiamin diphosphate which serves as an essenal cofactor for five enzymes involved in glucose amino acid and fat metabolism56 Thiamine also funcons as the cofactor of a catalyst involved in phosphate metabolism in our cells Phosphate metabolism is another key energy source that opmizes millions of reacons in cardiovascular and other cells

Figure 2 Vitamin B1

Bacteria in the large intesne make free thiamine and thiamin diphosphate but how much this contributes to the vitamin B1 that we use is unknown7

Pregnant women 19 and older 85 2000

Breaseeding women 19 and older

120 2000

Age in Years Aim for an intake of mgday

Stay below the intake of mgday


7-12 months 03 Not established

1-3 years 05 Not established



14-18 years (males) 12 Not established

14-18 years (females) 10 Not established

68

Table 2 Vitamin B1 Recommended Daily Allowances

Vitamin B2 Vitamin B2 (riboflavin) is an essenal component of flavin adenine dinucleode (FAD) and flavin mononucleode (FMN) These two coenzymes play major roles in energy producon cellular funcon growth and development and the metabolism of fats drugs and steroids 8-10 FAD is one of the two major electron carriers in the electron transport chain in the mitochondria FAD helps to make 11 of the energy molecules for every glucose molecule that is used by a cell for energy Not only are FAD and FMN necessary to make energy for the body but FAD is necessary for the creaon of vitamin B3 and FMN is necessary for our bodies to use vitamin B6 Ninety percent of dietary vitamin B2 is in the form of FAD or FMN 810

Bacteria produce vitamin B2 but the amount is dependent upon to food that was eaten More Vitamin B2 is made when vegetables are eaten than when meat is eaten 10

Figure 3 Vitamin B2

Men 19 and older 12 Not established

Women 19 and older 11 Not established

Pregnant Women 19 and older 14 Not established

Breaseeding Women 19 and older 14 Not established




69


Vitamin B3 Vitamin B3 is also known as niacin or niacinamide Niacin is an important nutrient essenal as the cofactor of niconamide adenine dinucleode (NAD) and related energy carrier molecules This energy carrier molecule is one of the most important energy transport systems in the enre body called the electron transport chain Eighty nine percent (89) of the energy made by a single glucose molecule is made with the help of NAD Millions of these carriers are created and recharged (by vitamin C) inside the cellular energy centers of the cardiovascular system and the body Cell life and life in general would not be possible without this energy carrier

Figure 4 Vitamin B3












Age in Years Aim for an intake of Niacin Equivalents (NE)day

Stay below the intake of NEday

Men 19 and older 16 35

Women 19 and older 14 35

Pregnant Women 19 and older 18 35

Breaseeding Women 19 and older 17 35

70

Vitamin B5 Vitamin B5 (pantothenic acidpantothenate) is the cofactor of coenzyme A the central fuel molecule in the metabolism of our heart cells blood vessel cells and all other cells 1112 The metabolism of carbohydrates proteins and fats inside each cell all lead to a single molecule acetyl-coenzyme A (acetyl-CoA) This molecule is the key molecule that helps to convert all food into energy for cells This important molecule is actually composed in part of vitamin B5 and the importance of this vitamin is evident

Figure 5 Vitamin B5

Vitamin B5 is found in various amounts in almost all plant and animal cells Limited data is available on the content of some foods but chicken beef potatoes tomato products liver kidney yeast egg yolk broccoli and whole grains are reported to be among the highest sources Unfortunately processing methods including freezing and canning of vegetables fish meat and dairy as well as the refining of grains have been reported to reduce the pantothenic acid content of the foods Bacteria in the intesne also produces pantothenic acid but its contribuon to the total amount of pantothenic acid that the body absorbs is not known 13









19 and older 5 Not established



71


Vitamin B6 Vitamin B6 (pyridoxine) is involved in more than 100 enzyme reacons mostly concerned with protein metabolism 8 especially the metabolism of amino acids and proteins in cardiovascular and other cells Vitamin B6 is needed for the producon of red blood cells which are the carriers of oxygen to the cells of the cardiovascular system and all other cells in the body

Figure 6 Vitamin B6

Vitamin B6 is also essenal for the opmum structure and funcon of collagen fibers which provide strength and cushion to the body Collagen is found in connecve ssues such as carlage tendons bones and ligaments Collagen is also found in the skin Finally vitamin B6 plays a role in cognive development through the synthesis of neurotransmimers and increases immune funcon








14-18 years (males) 13 100

14-18 years (females) 12 100

72


Vitamin B7 Bion (B7) is a cofactor for five different enzymes that are involved in the metabolism of the famy acids glucose and amino acids 814-17 Bion also plays roles in gene regulaon and cell signaling Most bion is stored in the liver

Figure 7 Vitamin B7

There is limle data on the bion content of foods and it is not included in most nutrient databases such as the USDA Nutrient Database for Standard References Even though it is not listed bion is found in most natural foods Liver contains high amounts of bions while other meats and fruit contain low quanes Bion is synthesized by bacteria in the microbiome of our intesnes There is no clear evidence if this bion is absorbed by the intesnes It is known that bion absorpon is prevented by a protein in raw egg whites which is inacvated upon cooking

19-50 13 100

Men 51+ 17 100

Women 51+ 15 100



Age in Years Aim for an intake of micrograms (mcg)day

Stay below the intake of mcgday







73


It is important to note that maximum daily intake is unlikely to cause adverse health effects

Vitamin B9 Vitamin B9 is also known as folic acid or folate Vitamin B9 is essenal for human growth and development Vitamin B9 encourages normal nerve and proper brain funconing and help slow memory decline associated with aging

Folate funcons as a coenzyme in the synthesis of DNA and RNA in the nucleus of all cells of the body DNA and RNA are necessary for the proper funcon and division of cells Increased levels of folic acid or folate may also help protect against several cancers including cancers of the lung colon esophageal stomach breast ovarian and cervix18-21The reducon in cancer risk with the increase in folic acid may be due to folic acids effect on DNA and cell division21-22

Figure 8 Vitamin B9

Folate is also a coenzyme in the metabolism of amino acids 818 The most important reacon is the reducon in blood-levels of homocysteine the precursor to the amino acid cysteine Elevated levels of homocysteine have been implicated in increased risk of cardiovascular disease and stroke18 Sciensts hypothesize that elevated homocysteine levels might have a negave effect on the brain via many mechanisms

19+ years 30 Not established






74


Pregnant women have an increased need for folic acid it supports the growth of the placenta and fetus and helps to prevent several types of birth defects especially those of the brain and spine Pregnant women and women of child-bearing age should take extra cauon to get enough folic acid

Folic acid is synthesized by the bacteria of the microbiome in the intesnes and can be absorbed into the bloodstream but the extent that this folic acid contributes to the amount in the body is unclear23

Vitamin B12 Vitamin B12 (cyanocoalbumin) is needed for the proper metabolism of famy acids and certain amino acids in the cells of our bodies Vitamin B12 is also required for the producon of red blood cells and in turn oxygen supply to cells Vitamin B12 is also required for proper neurological funcon and DNA synthesis

Vitamin B12 is involved in homocysteine metabolism along with folate (vitamin B9) and vitamin B6 As menoned earlier high levels of homocysteine is implicated in cardiovascular disease By keeping the amount of homocysteine in the bloodstream low the risk for cardiovascular disease and stroke is reduced24-25


1-3 years 150 300

4-8 years 200 400

9-13 years 300 600

14-18 years 400 800

19+ years 400 1000



75

Figure 9 Vitamin B12


Cyanocobalamin can only be found in food from animals and is not found in plant foods Vegans will be deficient in B12 and vegetarians are likely deficient in B12












76

Learning Goal 3 ndash Fat-soluble vitamins

Vitamin A Vitamin A is a group of fat-soluble compounds including renol renal and renyl esters Vitamin A may also be called beta-carotene or provitamin A carotenoids Vitamin A is an important fat-soluble anoxidant vitamin It is transported primarily in lipoprotein parcles in the bloodstream to millions of body cells

Vitamin A prevents the fat parcles that carry it through the bloodstream from rusng and damaging the cardiovascular system and is documented in a rapidly growing number of clinical studies as another protecve agent against cardiovascular disease Similarly to vitamin E beta (β)-carotene has been shown to decrease the risk of blood cloOng Vitamin A is crical in maintaining normal vision as an essenal component of rhodopsin a protein that absorbs light in the eye In addion vitamin A supports the normal growth differenaon and funconing of the cornea and the membranes in the eye

Finally vitamin A supports cell growth and differenaon It plays a crical role in the formaon and maintenance of many organs including the heart lungs and kidneys Vitamin A keeps your skin and eyes and immune system healthy

Carotenoids such as beta-carotene are converted to vitamin A in the body Vitamin A is a fat-soluble vitamin that is stored in your body

Figure 10 Vitamin A



Birth to 6 months 400 600

7-12 months 500 600

1-3 years 300 600

4-8 years 400 900

9-13 years 600 1700

14-18 years (male) 900 2800

14-18 years (female) 700 3000

77

Table 10 Vitamin A Recommended Daily Allowances

Vitamin D Vitamin D is essenal for opmum calcium and phosphate metabolism in the body It is important to get enough vitamin D from your diet because it helps our bodies absorb and use calcium and phosphorous for strong bones and teeth Vitamin D can help protect older adults against osteoporosis Vitamin D is needed for the growth and stability of the bones and teeth Vitamin D plays a role in neuromuscular funcon and health because calcium is necessary for muscle contracon

Vitamin D can also protect against infecons by keeping your immune system healthy It may help reduce the risk of developing chronic diseases such as mulple sclerosis and certain types of cancer such as colorectal cancer but this is sll being studied

Figure 11 Vitamin D

19+ years (male) 900 3000

19+years (female) 700 3000



Age in Years Aim for an intake of IU or micrograms (mcg)day


Birth to 6 months 400 IU or 10mcg 1000 IU or 25mcg

7-12 months 600 IU or 15mcg 1500 IU or 38mcg

1-3 years 600 IU or 15mcg 2500 IU or 63mcg




78

Table 11 Vitamin D Recommended Daily Allowances

Vitamin D is a fat-soluble vitamin This means that your body can store extra amounts of vitamin D

Vitamin E Vitamin E is the most important fat-soluble anoxidant vitamin the form that is recognized to meet human requirements is Alpha (α)-tocopherol It protects parcularly the membranes of the cells in our cardiovascular systems Vitamin E is an anoxidant that helps protects cells from damage by free radicals Free radicals can damage ssues and organs in the body

Vitamin E is carried in low-density lipoproteins (LDL) and other cholesterol and fat-transporng parcles Taken in opmum amounts vitamin E can prevent these fat parcles from oxidizing (biological rusng) and damaging the inside of blood vessel walls Vitamin E has been shown to render the platelets in blood circulaon less scky and thereby keep the blood thin and decrease the risk of blood cloOng

Vitamin E is a fat soluble vitamin that may improve immune funcon It may play a role in prevenng chronic disease such as heart disease and cancer but this is sll being studied

Figure 12 Vitamin E


70+ years 800 IU or 20mcg 4000 IU or 100mcg

Pregnant Women 19 and older 600 IU or 15mcg 4000 IU or 100mcg

Breaseeding Women 19 and older 600 IU or 15mcg 4000 IU or 100mcg

Age in Years Aim for an intake of milligrams (mg)day




1-3 years 6 200

4-8 years 7 300

9-13 years 11 600

79

Table 12 Vitamin E Recommended Daily Allowances

Vitamin K Vitamin K helps your blood to clot when you are bleeding People who take warfarin (Coumadinreg) blood thinning medicaon should aim for about the same amount of vitamin K each day and need to have blood monitoring for the level of vitamin K

Vitamin K helps to build strong bones as it may reduce abnormal calcificaon Vitamin K may help to reduce the risk of osteoporosis Abnormal calcificaon may also present as calcificaon of the blood vessels making them less elasc thus increasing the risk of coronary heart disease

There are two forms of vitamin K vitamin K1 and vitamin K2 Vitamin K1 is mostly found in plants and is our main dietary source of vitamin K Vitamin K2 is found in fermented foods and in some meats and cheeses It is also made by our body from the vitamin K1 in the food we eat The bacteria in our gut microbiome synthesizes vitamin K that we can absorb in the large intesne

Figure 13 Vitamin K

14-18 years 15 800

19+ years 15 1000













80

Table 13 Vitamin k Recommended Daily Allowances

An upper limit of Vitamin K has not been established because of its low potenal for toxicity

Learning Goal 4 ndash Understand how vitamin deficiencies impact the body

Vitamin C Vitamin C deficiency is characterized by bleeding gums joint pain bruising and poor wound healing The blood vessels are unable to heal small wounds which will connue to get larger The lack of vitamin C will also reduce the amount of iron in the body causing anemia These condion together are defined as scurvy Though rare in the Unites States and Canada scurvy is fatal if it goes untreated

Vitamin B1 In the early stages of thiamine deficiency weight loss confusion short-term memory loss muscular weakness and cardiovascular symptoms can occur 8 In rare cases in the United States and other developed countries a condion called beriberi may be seen in which there is impaired sensory motor and reflex funcons

More commonly in the United States thiamine deficiency is seen as Wenicke-Korsakoff syndrome26 The first stage of the disease is Wernickersquos encephalopathy which is characterized by peripheral neuropathy (weakness numbness and pain) and up to 20 of the paents die 627 The chronic stage is Korsakoffrsquos psychosis which is associated with severe short-term memory loss disorientaon and confusion between real and imagined memories 5 6 10 Wernicke-Korsakoff is 8-10 mes more likely in people with chronic alcoholism but can be seen with other syndromes such as severe gastrointesnal disorders or AIDS

Vitamin B2 Riboflavin deficiency is rare in the United States but can be caused by inadequate intake The symptoms of deficiency include skin disorders hyperemia (excess blood volume) edema in the mouth and throat lesions at the corner of the mouth swollen cracked lips hair loss reproducve problems and degeneraon of the liver and nervous system 5627 Many of these symptoms may be caused by the fact that people who are vitamin B2 deficient are typically also deficient in other nutrients

Vitamin B3


81

Niacin deficiency would reduce the amount of NAD available to be used as an electron carrier to make energy The lack of niacin reduces the amount of energy that can be created in cells In certain cells that get energy only from glycolysis red blood cells for example no energy will be made

Vitamin B5 Pantothenic acid is present in some amount in almost all foods so deficiency is rare except in cases of severe malnutrion Usually pantothenic acid deficiency is accompanied by other nutrient deficiencies making it difficult to determine the effects that are specific to vitamin B5

Vitamin B6 Vitamin B6 deficiency is uncommon and is usually associated with low concentraon of B-complex vitamin such a vitamin B12 and vitamin B9 (Folic acid) Q Vitamin B6 deficiency is associated with anemia low electrical acvity in the brain dermas depression and confusion and weakened immune funcon 8 In infants vitamin B6 deficiency can cause irritability abnormally acute hearing and convulsive seizures

Vitamin B7 The symptoms of bion deficiency appear slowly over me and include thinning hair or loss of hair on the body scaly red rashes around body openings pink eye ketolacc acidosis high acid in the urine seizures brimle nails depression lethargy and hallucinaons in adults and developmental delays in infants 141528 Bion deficiency is rare and severe bion deficiency has never been reported

Vitamin B9 Folate deficiency is uncommon by itself and usually is seen in conjuncon with other nutrient deficiencies It is associated with poor diet alcoholism and malabsorpon disorders 29 Folic acid deficiency can cause anemia characterized by large red blood cells soreness and ulceraons on the tongue Changes in skin hair or fingernail pigmentaon gastrointesnal problems and high levels of homocysteine in the blood 81829

Women with folic acid deficiency have an increased risk of giving birth to infants with neural tube deficiencies8 In addion folic acid deficiency has been associate with low birth weight premature birth and retardaon of fetal growth1830

Vitamin B12 Vitamin B12 deficiency is characterized by enlarged red blood cells (megaloblasc anemia) fague weakness conspaon loss of appete and weight loss31-33 Neurological changes due to B12 deficiency can also occur including ngling in hands and feet difficulty maintaining balance depression confusion demena and poor memory83435 During infancy B12 deficiency can cause failure to thrive movement disorders developmental delays and megaloblasc anemia36

82

Vitamin A Vitamin A deficiency is rare in the United States One of the early signs of deficiency is night-blindness or the inability to see in low light or the dark Vitamin A deficiency can cause preventable blindness and increase in the likelihood of severe illness such as measles in children Deficiency can cause diarrhea and increase the risk of infecons at all ages

Vitamin D Vitamin D deficiency can occur due to low amounts in nutrients or lack of sunlight People get vitamin D through food and by exposure to sunlight The most common occurrence of vitamin D deficiency in children is rickets thin brimle or misshapen bones and skeletal deformies

In older adults vitamin D deficiency can lead to osteomalacia weak bones bone pain and muscle weakness

Vitamin E Paents with vitamin E deficiency may show signs of muscle weakness and symptoms of ataxia the loss of control of body movements including limitaons in upward gaze Vitamin E deficiency may result in the early decrease of cellular immunity with aging Severe prolonged vitamin E deficiency may develop complete blindness cardiac arrhythmia and demena

Vitamin K A vitamin K deficiency in adults can lead to heart disease weakened bones tooth decay and cancer A warning sign of a vitamin K deficiency is bleeding and bruising easily severe deficiency could lead to hemorrhaging Bleeding can begin as an oozing from the gums or nose caused by an interrupon of the cascade that creates blood clots

83

References

1 Joshipura KJ Hu FB Manson JE Stampfer MJ Rimm EB Speizer FE Colditz G Ascherio A Rosner B Spiegelman D et al The Effect of Fruit and Vegetable Intake on Risk for Coronary Heart Disease Ann Intern Med 2001 134 1106ndash1114

2 Holmberg S Thelin A Sernstroumlm E-L Food choices and coronary heart disease A populaon based cohort study of rural Swedish men with 12 years of follow-up Int J Environ Res Public Health 2009 6 2626ndash2638

3 He FJ Nowson CA Lucas M MacGregor GA Increased consumpon of fruit and vegetables is related to a reduced risk of coronary heart disease Meta-analysis of cohort studies J Hum Hypertens 2007 21 717ndash728

4 A Randomized Placebo-Controlled Clinical Trial of High-Dose Supplementaon with Vitamins C and E Beta Carotene and Zinc for Age-Related Macular Degeneraon and Vision Loss Arch Ophthalmol 2001 1191417-1436

5 Said HM Thiamin In Coates PM Betz JM Blackman MR et al eds Encyclopedia of Dietary Supplements 2nd ed London and New York Informa Healthcare 2010748-53

6 Bemeur C Bumerworth RF Thiamin In Ross AC Caballero B Cousins RJ Tucker KL Ziegler TR eds Modern Nutrion in Health and Disease 11th ed Balmore MD Lippincom Williams amp Wilkins 2014317-24

7 Nabokina SM Said HM A high-affinity and specific carrier-mediated mechanism for uptake of thiamine pyrophosphate by human colonic epithelial cells Am J Physiol Gastrointest Liver Physiol 2012303G389-95

8 Instute of Medicine Food and Nutrion Board Dietary Reference Intakes Thiamin Riboflavin Niacin Vitamin B6 Folate Vitamin B12 Pantothenic Acid Bion and Choline Washington DC Naonal Academy Press 1998

9 Rivlin RS Riboflavin In Coates PM Betz JM Blackman MR et al eds Encyclopedia of Dietary Supplements 2nd ed London and New York Informa Healthcare 2010691-9

84

10 Said HM Ross AC Riboflavin In Ross AC Caballero B Cousins RJ Tucker KL Ziegler TR eds Modern Nutrion in Health and Disease 11th ed Balmore MD Lippincom Williams amp Wilkins 2014325-30

11 Miller JW Rucker RB Pantothenic acid In Erdman JW Macdonald IA Zeisel SH eds Present Knowledge in Nutrion 10th ed Washington DC Wiley-Blackwell 2012375-90

12 Sweetman L Pantothenic acid In Coates PM Betz JM Blackman MR et al eds Encyclopedia of Dietary Supplements 2nd ed London and New York Informa Healthcare 2010604-11

13 Trumbo PR Pantothenic acid In Ross AC Caballero B Cousins RJ et al eds Modern Nutrion in Health and Disease 11th ed Balmore MD Lippincom Williams amp Wilkins 2014351-7

14 Mock DM Bion In Ross AC Caballero B Cousins RJ Tucker KL Ziegler TR eds Modern Nutrion in Health and Disease 11th ed Balmore MD Lippincom Williams amp Wilkins 2014390-8

15 Zempleni J Wijeratne SSK Kuroishi T Bion In Erdman JW Macdonald IA Zeisel SH eds Present Knowledge in Nutrion 10th ed Washington DC Wiley-Blackwell 2012359-74

16 Pacheco-Alvarez D Soloacuterzano-Vargas RS Del Riacuteo AL Bion in metabolism and its relaonship to human disease Arch Med Res 200233439-47

17 Staggs CG Sealey WM McCabe BJ Teague AM Mock DM Determinaon of the bion content of select foods using accurate and sensive HPLCavidin binding Journal of food composion and analysis an official publicaon of the United Naons University Internaonal Network of Food Data Systems 200417767-76

18 Bailey LB Caudill MA Folate In Erdman JW Macdonald IA Zeisel SH eds Present Knowledge in Nutrion 10th ed Washington DC Wiley-Blackwell 2012321-42

19 Bailey LB Stover PJ McNulty H et al Biomarkers of nutrion for development-folate review J Nutr 20151451636S-80S

20 He H Shui B Folate intake and risk of bladder cancer a meta-analysis of epidemiological studies Int J Food Sci Nutr 201465286-92

21 Kim YI Will mandatory folic acid forficaon prevent or promote cancer Am J Clin Nutr 2004801123-8

22 Kim YI Folate and carcinogenesis evidence mechanisms and implicaons J Nutr Biochem 19991066-88

23 Lakoff A Fazili Z Aufreiter S et al Folate is absorbed across the human colon evidence by using enteric-coated caplets containing 13C-labeled [6S]-5-formyltetrahydrofolate Am J Clin Nutr 20141001278-86

85

24 Refsum H Nurk E Smith AD Ueland PM Gjesdal CG Bjelland I et al The Hordaland Homocysteine Study a community-based study of homocysteine its determinants and associaons with disease J Nutr 2006136(6 Suppl)1731S-40S

25 American Heart Associaon Nutrion Commimee Lichtenstein AH Appel LJ Brands M Carnethon M Daniels S et al Diet and lifestyle recommendaons revision 2006 a scienfic statement from the American Heart Associaon Nutrion Commimee Circulaon 200611482-96

26 Bemendorff L Thiamin In Erdman JW Macdonald IA Zeisel SH eds Present Knowledge in Nutrion 10th ed Washington DC Wiley-Blackwell 2012261-79

27 Agabio R Thiamine administraon in alcohol-dependent paents Alcohol Alcohol 200540155-6

28 Mock DM Bion In Coates PM Betz JM Blackman MR et al eds Encyclopedia of Dietary Supplements 2nd ed London and New York Informa Healthcare 201043-51

29 Carmel R Folic acid In Shils M Shike M Ross A Caballero B Cousins RJ eds Modern Nutrion in Health and Disease 11th ed Balmore MD Lippincom Williams amp Wilkins 2005470-81

30 Scholl TO Johnson WG Folic acid influence on the outcome of pregnancy Am J Clin Nutr 2000711295S-303S

31 Herbert V Vitamin B12 in Present Knowledge in Nutrion 17th ed Washington DC Internaonal Life Sciences Instute Press 1996

32 Combs G Vitamin B12 in The Vitamins New York Academic Press Inc 1992

33 Bernard MA Nakonezny PA Kashner TM The effect of vitamin B12 deficiency on older veterans and its relaonship to health J Am Geriatr Soc 1998461199-206

34 Healton EB Savage DG Brust JC Garrem TF Lindenbaum J Neurological aspects of cobalamin deficiency Medicine 199170229-44

35 BoOglieri T Folate vitamin B12 and neuropsychiatric disorders Nutr Rev 199654382-90

36 Monsen ALB Ueland PM Homocysteine and methylmalonic acid in diagnosis and risk assessment from infancy to adolescent Am J Clin Nutr 2003787-21

Figures

Figure 1 Vitamin C File Ascorbic acid structurepng Author enuserMykhal enuserCacycle UserJrockley

86

License I the copyright holder of this work release this work into the public domain This applies worldwide In some countries this may not be legally possible if so I grant anyone the right to use this work for any purpose without any condions unless such condions are required by law

Figure 2 Vitamin B1 File Thiaminsvg Author Pjemer License Permission is granted to copy distribute andor modify this document under the terms of the GNU Free Documentaon License Version 12 or any later version published by the Free SoWware Foundaon with no Invariant Secons no Front-Cover Texts and no Back-Cover Texts A copy of the license is included in the secon entled GNU Free Documentaon License

Figure 3 Vitamin B2 File VitamineB2png Author Yohan License Permission is granted to copy distribute andor modify this document under the terms of the GNU Free Documentaon License Version 12 or any later version published by the Free SoWware Foundaon with no Invariant Secons no Front-Cover Texts and no Back-Cover Texts A copy of the license is included in the secon entled GNU Free Documentaon License

Figure 4 Vitamin B3 File Niconamidpng Author NEUROker License This image of a simple structural formula is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property and contains no original authorship

Figure 5 Vitamin B5 File VitaminB5png Author Yohan License Permission is granted to copy distribute andor modify this document under the terms of the GNU Free Documentaon License Version 12 or any later version published by the Free SoWware Foundaon with no Invariant Secons no Front-Cover Texts and no Back-Cover Texts A copy of the license is included in the secon entled GNU Free Documentaon License

Figure 6 Vitamin B6 File Pyridoxinepng Author License Permission is granted to copy distribute andor modify this document under the terms of the GNU Free Documentaon License Version 12 or any later version published by the Free SoWware Foundaon with no Invariant Secons no Front-Cover Texts and no Back-Cover Texts A copy of the license is included in the secon entled GNU Free Documentaon License

Figure 7 Vitamin B7 File Bion structurepng Author UserMysid

87



Figure 9 Vitamin B12 File Vitamin_B12png Author Azazell0 License Permission is granted to copy distribute andor modify this document under the terms of the GNU Free Documentaon License Version 12 or any later version published by the Free SoWware Foundaon with no Invariant Secons no Front-Cover Texts and no Back-Cover Texts A copy of the license is included in the secon entled GNU Free Documentaon License

Figure 10 Vitamin A File Vitamin Apng Author Sergiy O Bukreyev License This image of a simple structural formula is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property and contains no original authorship

Figure 11 Vitamin D File Vitamin D structurejpg Author Nwanneka123 License I the copyright holder of the work hereby publish it under the following license This file is licensed under the Creave Commons Amribuon-Share Alike 30 Unported license

Figure 12 Vitamin E File VitaminEpng Author userAnnabel License Permission is granted to copy distribute andor modify this document under the terms of the GNU Free Documentaon License Version 12 or any later version published by the Free SoWware Foundaon with no Invariant Secons no Front-Cover Texts and no Back-Cover Texts A copy of the license is included in the secon entled GNU Free Documentaon License

Figure 13 Vitamin K File Vitamin K reduziertsvg Author NEUROker

88


Tables

Table 1 Recommended Daily Allowances of Vitamin C Author Tami Miller License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Table 2 Recommended Daily Allowances of Vitamin B1 Author Tami Miller License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property







89


Table 10 Recommended Daily Allowances of Vitamin A Author Tami Miller License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Table 11 Recommended Daily Allowances of Vitamin D Author Tami Miller License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Table 12 Recommended Daily Allowances of Vitamin E Author Tami Miller License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Table 13 Recommended Daily Allowances of Vitamin K Author Tami Miller License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

90

Module 8 Minerals

Module 8 will cover minerals and trace elements These are needed in small quanes by the body

Learning Goals 1 Define a mineral 2 Understand the minerals the minerals the body needs 3 Understand how mineral deficiencies impact the body

91

Learning Goal 1 ndash Define a mineral

What is a mineral A mineral is a chemical element from the periodic table that is essenal to organisms to perform the funcons that are necessary to life There are five major minerals that humans require calcium magnesium phosphorus potassium and sodium Minerals are used to acvate enzymes in the body and aid in the making of proteins

Difference between mineral and trace element A trace element is also a chemical element from the periodic table that is essenal to an organism to perform the funcons necessary to life The difference between a mineral and a trace element is that trace elements are needed in smaller quanes The trace elements that are needed are chromium copper iodine iron manganese molybdenum selenium and zinc

Learning Goal 2 ndash Understand the minerals that the body needs

Calcium (Ca) Calcium is important for the proper contracon of muscle cells including millions of heart muscle cells Vascular contracon and vasodilaon needs calcium It is needed for the conducon of nerve impulses throughout the enre nervous system

Calcium is also essenal for the hardening and stability of our bones and teeth It is also needed for the proper biological communicaon among the cells and hormone secreon




7-12 months 260 1500

1-3 years 700 2500

4-8 years 1000 2500

9-13 years 1300 3000

14-18 years 1300 3000

19-50 years 1000 2500

51-70 years (males) 1000 2000

51-70 years (females) 1200 2000

71+ years 1200 2000

92

Table 1 Calcium Recommended Daily Allowances

Magnesium (Mg) Magnesium is a cofactor in over 300 enzyme reacons It helps in the regulaons of biochemical reacons including protein synthesis muscle and nerve funcon blood glucose control blood pressure regulaon and energy producon

Magnesium is naturersquos calcium antagonist and its benefit for the cardiovascular system is similar to the calcium antagonist drugs that are prescribed except that magnesium is produced by nature itself Clinical studies have shown that magnesium is parcularly important for helping to normalize elevated blood pressure moreover it can help normalize irregular heartbeat

Table 2 Magnesium Recommended Daily Allowances







1-3 years 80 140

4-8 years 130 240

9-13 years 240 350

14-18 years (males) 410 350


19-30 years (males) 400 350


31-50 years (males) 420 350


51+ years (males) 420 350

51+ years (females) 320 350

Pregnant Women 19-30 years 350 350


Breaseeding Women 19-30 years 360 350


93

Phosphorus (P) Phosphorus is present in every cell of our bodies with most of it being found in the bones and teeth Phosphorus plays an important role in the bodyrsquos use of carbohydrates and fats and is needed to make protein for the growth maintenance and repair of cells and ssues It also helps the body make adenosine triphosphate (ATP) a molecule used to store energy Phosphorus is a component of every building block of the DNA (genec material) of each cell of our bodies Phosphorus works with the B vitamins and also helps with kidney funcon muscle contracons normal heartbeat and nerve signaling

Table 3 Phosphorus Recommended Daily Allowances

Potassium (K) Potassium is the most important posively charged electrical parcle in our body cells It is important for the generaon of energy in the cell metabolism and is needed for the synthesis of acetyl-coenzyme-A Potassium is also necessary for the normal contracon of muscles including the heart muscle It plays a part in the electrical processes that are needed for the regulaon of nerve impulses and acvaon of the muscles Potassium also helps to maintain fluid volume in cells as well as fluid volume in the blood





1-3 years 460 140

4-8 years 500 240

9-18 years 1250 350

19-70 years 700 4000

71+ years 700 3000

Pregnant Women 700 3500

Breaseeding Women 700 4000








94

Table 4 Potassium Recommended Daily Allowances

Chromium (Cr) Chromium plays an important role in carbohydrate metabolism especially in connecon with glucose and insulin Chromium enhances the acon of insulin In most industrialized countries chromium deficiency is a secondary contributor to the growing incidence of diabetes

Table 5 Chromium Recommended Daily Allowances

Copper (Cu) Copper is needed for the formaon of a web structure of collagen in the blood vessel walls which provides extra strength It also smulates the absorpon of iron and the producon of hemoglobin the




Pregnant Women 19-50 years 4700 Not established

Breaseeding Women 19-50 years 5100 Not established













50+ years (males) 30 Not established

50+ years (females) 20 Not established



95

red colored substance that is important for the red blood cells Copper is also part of an enzyme that is needed for the producon of the dark pigment melanin It helps to keep nerves the immune system and bones healthy Copper is necessary to make energy in the cells

Table 6 Copper Recommended Daily Allowances

In large amounts copper is poisonous

Iodine (I) Iodine is mainly used to make the thyroid hormones thyroxine (T4) and triiodothyronine (T3 ndash the more acve form) The thyroid helps to regulate the rate at which your body uses energy or your metabolic acvity They thyroid hormones are also necessary for proper skeletal muscle and nervous system acvity in fetuses and infants

You only need very small amounts of iodine for good health Without iodine your health can be affected over the long term Your body does not make iodine so it needs to come from the foods you eat To help with iodine intake many salts are iodized








14-18 years 890 10000 (10mg)

19+ years 900 10000 (10mg)

Pregnant Women 19 and older 1000 10000 (10mg)

Breaseeding Women 19 and older 1300 10000 (10mg)





1-3 years 90 200

4-8 years 90 300

9-13 years 120 600

14-18 years 150 900

96

Table 7 Iodine Recommended Daily Allowances

Iron (Fe) Iron is an essenal component of hemoglobin the oxygen carrying molecule in red blood cells It is also a component of myoglobin the protein that provides oxygen to skeletal muscle cells Iron is necessary for proper growth and development normal cellular funconing and synthesis of some hormones and connecve ssues It is a component of the biochemical reacons within cells that produce energy

Table 8 Iron Recommended Daily Allowances

Manganese (Mn) Manganese is an important secondary factor for bio-catalysts For example it acvates enzymes that play a part in DNA metabolism the molecules that contain hereditary informaon Manganese is also involved in the processing of cholesterol carbohydrates and protein and may be involved in bone formaon

19+ years 150 1100






7-12 months 11 40

1-3 years 7 40

4-8 years 10 40

9-13 years 8 40

14-18 years (males) 11 45




50+ years 8 45





Birth to 6 months 0003 No established

97

Table 9 Manganese Recommended Daily Allowances

Molybdenum (Mo) Molybdenum is involved in the breakdown of amino acids containing sulfur as well as the breakdown of DNA

Too much molybdenum can cause fatal copper deficiency

Table 10 Molybdenum Recommended Daily Allowances

Selenium (Se) Selenium acvates enzymes that play crical roles in reproducon thyroid hormone metabolism and DNA synthesis Selenium is an important anoxidant that protects the body against damage by free

7-12 months 06 2

1-3 years 12 3

4-8 years 15 6












1-3 years 17 300

4-8 years 22 600

9-13 years 34 1100

14-18 years 43 1700

19+ years 45 2000



98

radicals and assists its defense systems Clinical studies have established that selenium plays an important role in the fight against cancer and cardiovascular diseases

Table 11 Selenium Recommended Daily Allowances

Zinc (Zn) Zinc is used by numerous enzymes in cellular metabolism It is necessary for the acvity of over 100 enzymes and helps with the immune system protein synthesis wound healing DNA synthesis and cell division Zunc supports normal growth and development during pregnancy and through adolescence IT is necessary for our senses of taste and smell




7-12 months 20 400

1-3 years 20 400

4-8 years 30 400

9-13 years 40 400

14-18 years 55 400

19-50 years 55 400

51+ years 55 400






7-12 months 3 5

1-3 years 3 7

4-8 years 5 12

9-13 years 8 23






99

Table 12 Zinc Recommended Daily Allowances

Learning Goal 3 ndash Understand how mineral deficiencies impact the body

Calcium (Ca) Calcium is a vital mineral Your body uses it to build strong bones and teeth Calcium is also needed for your heart and other muscles to funcon properly When you donrsquot get enough calcium you increase your risk of developing disorders like osteoporosis (larger pores and weak bones) osteopenia (low bone density) calcium deficiency disease (hypocalcemia)

Children who donrsquot get enough calcium may not grow to their full potenal height as adults

Magnesium (Mg) Magnesium deficiency can cause a wide variety of features including hypocalcaemia (low blood calcium) hypokalaemia (high blood potassium) and cardiac and neurological manifestaons Chronic low magnesium state has been associated with a number of chronic diseases including diabetes hypertension coronary heart disease and osteoporosis

Phosphorus (P) A reduced concentraon of phosphate in the blood serum is a disorder known as hypophosphatemia Clinical features include muscle weakness respiratory failure and heart failure seizures and coma can occur Phosphorus deficiency may cause bone diseases such as rickets (the soWening and weakening of bones) in children and osteomalacia (soWening of the bones typically through a deficiency of vitamin D or calcium) in adults An improper balance of phosphorus and calcium may cause osteoporosis

Potassium (K) Insufficient potassium can increase blood pressure the risk of kidney stones bone turnover calcium excreon in the urine and salt sensivity Low blood potassium causes conspaon fague muscle weakness and general feeling of illness Moderate to severe low blood potassium can cause and increase in urine volume muscle paralysis poor respiraon and cardiac arrhythmia

Some chronic condions can cause low potassium levels So can voming and diarrhea along with long-term kidney disease alcoholism and eang disorders like bulimia which involve forced voming and excessive use of laxaves

Chromium (Cr) Because adequate dietary chromium helps to maintain insulin sensivity chromium deficiency can contribute to the development of diabetes and metabolic syndrome Even mild deficiencies of chromium can produce problems in blood sugar metabolism and contribute to other symptoms such as anxiety or fague


100

Copper (Cu) Copper deficiency is a very rare and may lead to anemia and osteoporosis

Iodine (I) Iodine deficiency has adverse effects on growth and development and according to the Internaonal Council for the Control of Iodine Deficiency Disorders is the most common cause of preventable mental retardaon in the world Lack of iodine during pregnancy can cause neurodevelopmental deficits slow growth of the fetus as well as miscarriage During infancy iodine deficiency can cause irreversible effects and increases the risk of hyperacvity disorder in children

Iodine deficiency reduces the amount of thyroid hormones which can reduce the basal metabolism rate and increase weight gain Chronic deficiency may be associated with an increased risk of thyroid cancer

Iron (Fe) Though iron deficiency is the most widespread nutrional disorder in the world it is uncommon in the United States Iron deficiency is associated with other nutrient deficiencies

There are several stages of iron deficiency In the first mild deficiency stage iron levels in the blood and bone decrease In marginal deficiency the second stage though red blood cells are sll made they are deficient in iron in the hemoglobin and the capacity to carry oxygen drops In the stage where iron stores are depleted red blood cells are small and have low hemoglobin concentraon which is termed anemia Iron deficiency is the most common form of anemia though there are deficiencies in other nutrients (such as B vitamins) that can cause anemia

Females of child bearing years require more iron as blood is lost during menstruaon

Manganese (Mn) Manganese deficiency in humans results in a number of medical problems Manganese is a vital element of nutrion in very small quanes A long-term serious shortage of manganese will result in growth inhibions inferlity and other serious disorders However in greater amounts manganese like most metals is poisonous when eaten or inhaled

Molybdenum (Mo) Molybdenum deficiency has not been seen except for one case of a paent with Crohnrsquos disease

101

Selenium (Se) Selenium is also necessary for the conversion of the thyroid hormone thyroxine (T4) into its more acve

counterpart triiodothyronine and as such a deficiency can cause symptoms of hypothyroidism

including extreme fague mental slowing goiter crenism and recurrent miscarriage

Zinc (Zn) Zinc deficiency causes the slowing of growth loss of appete and impaired immune system funcon In more severe cases it could cause hair loss diarrhea delayed sexual maturaon weight loss delayed wound healing taste abnormalies and metal fague

Tables

102

Table 1 Recommended Daily Allowances of Calcium Author Tami Miller License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Table 2 Recommended Daily Allowances of Magnesium Author Tami Miller License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Table 3 Recommended Daily Allowances of Phosphorus Author Tami Miller License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Table 4 Recommended Daily Allowances of Potassium Author Tami Miller License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Table 5 Recommended Daily Allowances of Chromium Author Tami Miller License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Table 6 Recommended Daily Allowances of Copper Author Tami Miller License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Table 7 Recommended Daily Allowances of Iodine Author Tami Miller License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Table 8 Recommended Daily Allowances of Iron Author Tami Miller License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Table 9 Recommended Daily Allowances of Manganese Author Tami Miller License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Table 10 Recommended Daily Allowances of Molybdenum Author Tami Miller

103

License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Table 11 Recommended Daily Allowances of Selenium Author Tami Miller License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Table 12 Recommended Daily Allowances of Zinc Author Tami Miller License This image is ineligible for copyright and therefore in the public domain because it consists enrely of informaon that is common property

Appendices

Appendix 1 Common vitamin sources Appendix 2 Common mineral sources

104

Appendix 1 ndash Common vitamin sources

Vitamin C

105

Food Serving size Vitamin C (mg)

Vegetables and Fruit

Vegetables

Peppers (red yellow) raw 125 mL (frac12 cup) 101-144

Peppers (red green) cooked 125 mL (frac12 cup) 121-132

Peppers green raw 125 mL (frac12 cup) 63

Broccoli cooked 125 mL (frac12 cup) 54

Cabbage red raw 250 mL (1 cup) 42

Brussels sprouts cooked 125 mL (4 sprouts) 38-52

Kohlrabi cooked 125 mL (frac12 cup) 47

Broccoli raw 125 mL (frac12 cup) 42

Snow peas cooked 125 mL (frac12 cup) 41

Cabbage cooked 125 mL (frac12 cup) 30

Cauliflower raw or cooked 125 mL (frac12 cup) 27-29

Kale cooked 125 mL (frac12 cup) 28

Rapini cooked 125 mL (frac12 cup) 24

Potato with skin cooked 1 medium 14-31

Bok Choy cooked 125 mL (12 cup) 23

Sweet potato with skin cooked 1 medium 22

Asparagus frozen cooked 6 spears 22

Balsam pearbimer melon 125 mL (frac12 cup) 22

Turnip greens cooked 125 mL (frac12 cup) 21

Snow peas raw 125 mL (frac12 cup) 20

Collards cooked 125 mL (frac12 cup) 18

106

Tomato raw 1 medium 14

Tomato sauce canned 125 mL (frac12 cup) 8-9

Tomatoes canned stewed 125 mL (frac12 cup) 11-12

Fruit

Guava 1 fruit 206

Papaya frac12 fruit 94

Kiwifruit 1 large 84

Orange 1 medium 59-83

Lychee 10 fruits 69

Strawberries 125 mL (frac12 cup) 52

Pineapple 125 mL (frac12 cup) 42-49

Grapefruit pink or red frac12 fruit 38-47

Clemenne 1 fruit 36

Cantaloupe 125 mL (frac12 cup) 31

Mango frac12 fruit 38

Avocado Florida frac12 fruit 26

Soursop 125 mL (frac12 cup) 25

107

Table 1 Common Sources of vitamin C Source Canadian Nutrient File 2015

Vitamin B1

Tangerine or mandarin 1 medium 24

Persimmon 125 mL (frac12 cup) 17

Berries (raspberries blueberries blackberries)

125 mL (frac12 cup) 14-17

Juice

Juice (orange grapefruit apple pineapple grape) Vitamin C added

125 mL (frac12 cup) 23 - 66

Fruit and vegetable cocktail 125 mL (frac12 cup) 35 - 73

Guava nectar 125 mL (frac12 cup) 26

Grain Products This food group contains very limle of this nutrient

Milk and AlternaCves This food group contains very limle of this nutrient

Meats and AlternaCves This food group contains very limle of this nutrient

Food Serving size Thiamin (mg)


Vegetables

Soybean sprouts cooked 125 mL (12 cup) 028

Edamamebaby soybeans cooked

125 mL (12 cup) 025

108

Green peas cooked 125 mL (12 cup) 022 - 024

Lima beans cooked 125 mL (12 cup) 022

Squash acorn cooked 125 mL (12 cup) 018


Grain Products

Grains

Wheat germ raw 30 g (frac14 cup) 050

Corn flour 20 g (2 Tbsp) 029

Pasta white enriched cooked 125 mL (12 cup) 021- 029

Pasta egg noodles enriched cooked

125 mL (12 cup) 016 - 021

Cereals

Oatmeal instant cooked 175 mL (frac34 cup) 072

Cereal dry all types 30 g (check product label for serving size)

060

Hot oat bran cereal cooked 175 mL (frac34 cup) 040

Muesli and granola 30 g (check product label for serving size)

022

Oatmeal (1 minute) cooked 175 mL (frac34 cup) 021

Other Grain Products

Breakfast bar corn flake crust with fruit

1 bar (37 g) 037

Bagel plain frac12 bagel 030

Breakfast bar oatmeal 1 bar (47 g) 024

Granola bar oat fruits and nut 1 bar (43 g) 021

Waffle frozen cooked 1 waffle 019

Bread (white whole wheat rye mixed grain)

1 slice (35 g) 008 ndash 017

Milk and AlternaCves

Soy beverage 250 mL (1 cup) 010

109

Meat and AlternaCves

Meat

Pork various cuts cooked 75 g (2 frac12 oz) 043- 105

Pork ground cooked 75 g (2 frac12 oz) 075-077

Pork ham cooked 75 g (2 frac12 oz) 041

Venisondeer various cuts cooked

75 g (2 frac12 oz) 019 ndash 038

Liver (chicken pork) cooked 75 g (2 frac12 oz) 013-022

Fish and Seafood

Tunayellowfinalbacore cooked 75 g (2 frac12 oz) 010

Trout cooked 75 g (2 frac12 oz) 011-032

Salmon Atlanc cooked 75 g (2 frac12 oz) 011 - 026

Pickerelwalleye cooked 75 g (2 frac12 oz) 023

Mussels cooked 75 g (2 frac12 oz) 023

Tuna bluefin cooked 75 g (2 frac12 oz) 021

Meat Alternaves

Meatless luncheon slices 75 g (2 frac12 oz) 300

Soy burger vegetarian meatloaf or pamy cooked

75 g (2 frac12 oz) 200

Meatless (chicken fish scks meatballs) cooked

75 g (2 frac12 oz) 070-096

Legumes (dried beans peas and lenls)

Beans (soybeans black pinto adzuki kidney lima navy roman) cooked

175 mL (frac34 cup) 022 - 035

Lenls cooked 175 mL (frac34 cup) 025-028

Baked beans canned 175 mL (frac34 cup) 018

Nuts and Seeds

Sunflower seeds without shell 60 mL (frac14 cup) 054

110

Table 2 Common Sources of vitamin B1 Source Canadian Nutrient File 2015

Vitamin B2

ChineseJapanese chestnuts without shell

60 mL (frac14 cup) 016 - 032

Nuts (pistachio macadamia brazil nuts hazelnuts pecans peanuts) without shell

60 mL (frac14 cup) 017 - 024

Tahinisesame seed bumer 15mL (1 Tbsp) 019

Soy nuts 60 mL (frac14 cup) 012

Others

Yeast extract spread (marmitevegemite)

15mL (1 Tbsp) 429

Food Serving Size Riboflavin (mg)

Vegetables and Fruits

Vegetables

Mushroom (white portabello crimini) raw or cooked

125 mL (frac12 cup) 02-06

Spinach cooked 125 mL (frac12 cup) 02

Grain Products

Cereal corn flakes 30 g (check product label for serving size)

11

Cereal muesli 30 g (check product label for serving size)

02

Waffle 1 small (35g) 02


Milk (33 homo 2 1 skim) 250 mL (1 cup) 04-05

Comage cheese 250 mL (1 cup) 04-06

Bumermilk 250 mL (1 cup) 04

Cheese feta 50 g (1frac12 oz) 04

Yogurt beverage 200 mL 04

111

Yogurt (fruit plain Greek) all types

175 g (frac34 cup) 02-04


Cheese (cheddar monterey edam colby blue brie camembert)

50 g (1frac12 oz) 02

Ricoma cheese 125 mL (frac12 cup) 02


Meat

Pork various cuts cooked 75 g (2frac12 oz) 02-03

Beef various cuts cooked 75 g (2frac12 oz) 02-03

Chicken or turkey dark meat cooked

75 g (2frac12 oz) 02

Organ Meats

Liver (chicken turkey pork beef) cooked

75 g (2frac12 oz) 16-27

Fish and Seafood

Cumlefish cooked 75 g (2frac12 oz) 13

Salmon cooked 75 g (2frac12 oz) 04

Mackerel cooked 75 g (2frac12 oz) 03-04

Squid cooked 75 g (2frac12 oz) 03

Trout cooked 75 g (2frac12 oz) 03

112


Vitamin B3

Shellfish (clams mussels) cooked

75 g (2frac12 oz) 02-03

Herring cooked 75 g (2frac12 oz) 02

Sardines canned in oil 75 g (2frac12 oz) 02

Meat Alternaves

Vegetarian meatloaf or pamy cooked

75 g (2frac12 oz) 05

Tempehfermented soy product cooked

150 g (34 cup) 05

Egg cooked 2 large 04-05

Almonds without shell 60 mL (frac14 cup) 03-04

Soy nuts 60 mL (14 cup) 02

Meatless chicken cooked 75 g (2frac12 oz) 02

Other

Yeast extract spread (marmite or vegemite)

30 mL (2 Tbsp) 53

Food Serving size Niacin (NE)

113


Mushrooms portabello 125 mL (frac12 cup) 6

Potato cooked 1 medium 3-4

Grain Products

Cereal (100 Bran All Bran bran flakes)

30 g (check product label for serving size)

3-6

Oatmeal instant cooked 175 mL (frac34 cup) 3-5

Cereal wheat germ toasted 30 g (14 cup) 4

Pasta enriched cooked 125 mL (12 cup) 2-3

Bread whole wheat 1 slice (35 g) 2



Cheese (cheddar gruyere Swiss blue gouda mozzarella edam provolone brie)

50 g (1 frac12 oz) 3-4

Processed cheese slices (cheddar swiss)

50 g (1 frac12 oz) 2-3

Milk 33 homo 250 mL (1 cup) 3


Meats and AlternaCves

Meat

Liver (beef pork chicken turkey) cooked

75 g (2frac12 oz) 10-17

Chicken various cuts cooked 75 g (2frac12 oz) 8-15

Pork beef or lamb various cuts cooked

75 g (2frac12 oz) 6-14

Turkey various cuts cooked 75 g (2frac12 oz) 6-9

Back bacon cooked 75 g (2frac12 oz) 8

Fish and Seafood

Anchovies canned 75 g (2frac12 oz) 19

Tuna cooked or canned 75 g (2frac12 oz) 10-20

114

Salmon cooked or canned 75 g (2frac12 oz) 11-17


Rainbow trout cooked 75 g (2frac12 oz) 8-10


Herring haddock cooked 75 g (2frac12 oz) 6-7

Crab shrimp lobster cooked 75 g (2frac12 oz) 4-5

Scallops cooked 75 g (2frac12 oz) 3

Meat alternaves

Meatless fish scks cooked 75 g (2 frac12 oz) 12

Soy burgervegetarian meatloaf or pamy cooked

75 g (2 frac12 oz) 10

Pumpkin squash seeds without shell

60 mL (14 cup) 8


150 g (34 cup) 8

Peanuts without shell 60 mL (14 cup) 7

Meatless (chicken meatballs) cooked

75 g (2 frac12 oz) 4-5

Tofu cooked 150 g (frac34 cup) 3-4

Egg cooked 2 large 3

Lenls cooked 175 mL (34 cup) 3-4

Sunflower seeds without shell 60 mL (14 cup) 3-4

Almonds without shell 60 mL (14 cup) 3


Beans (adzuki navy cranberry great northern kidney) cooked

175 mL (34 cup) 3

Peas black-eyedcowpeas cooked

175 mL (34 cup) 3

Other

115


Vitamin B5


5 mL (1 tsp) 8

Food Serving size Milligrams (mg) per serving


Mushrooms shitake cooked 125 mL (frac12 cup) 26

Mushrooms white sr-fried 125 mL (frac12 cup) 08

Avocado raw frac12 fruit 10

Potato russet with skin cooked 1 medium 07

Broccoli boiled 125 mL (frac12 cup) 05

Carrots raw chopped 125 mL (frac12 cup) 02

Cabbage boiled 125 mL (frac12 cup) 01

Tomatoes raw chopped or sliced

125 mL (frac12 cup) 01

Clemenne raw 1 clemenne 01

Grain Products

Cereal forfied with 100 daily allowance


10

Whole Wheat pita 1 large 05

Oats regular and quick cooked 125 mL (frac12 cup) 04


Greek Yogurt vanilla nonfat 53 oz container 06

Cheese (cheddar) 50 g (1 frac12 oz) 02

Milk 2 250 mL (1 cup) 09


116

Table 5 Common Sources of vitamin B5 Source Naonal Instutes of Health Office of Dietary Supplements

Vitamin B6

Meat

Liver (beef) cooked 85 g (3 oz) 83

Chicken breast skinless roasted 85 g (3 oz) 8-15

Ground beef 85 lean broiled 85 g (3 oz) 06

Fish and Seafood

Tuna fresh cooked 85 g (3 oz) 12

Meat alternaves

Sunflower seeds 60 mL (14 cup) 24

Peanuts roasted in oil 60 mL (14 cup) 05

Chickpeas canned 125 mL (12 cup) 04

Rice brown cooked 125 mL (12 cup) 04

Egg hard-boiled 1 large 07

Food Serving size Vitamin B6 (mg)


Vegetables


Sweet potato with skin cooked

1 medium 033

Carrot juice 125 mL (12 cup) 027

Balsam-pearbimer gourd bimer melon cooked

125 mL (12 cup) 023

Fruit

Banana 1 medium 043

Durian 125 mL (12 cup) 041

Prune juice 125 mL (12 cup) 030

117

Prunes canned 125 mL (12 cup) 025-029

Avocado frac12 fruit 026

Plantain cooked 125 mL (12 cup) 020

Grain Products

Waffle bumermilk frozen toasted

1 waffle (33 g) 037

Wheat bran 30 g (12 cup) 035

Cereal (check product label for serving size)

100 Bran 30 g 020

Oatmeal instant cooked 175 mL (34 cup) 021-030



Organ Meat

Liver (turkey beef) cooked 75 g (2 frac12 oz) 066-076

Liver chicken cooked 75 g (2 frac12 oz) 057-063

Kidney beef cooked 75 g (2 frac12 oz) 029

Meat


75 g (2 frac12 oz) 046-057

Pork various cuts cooked 75 g (2 frac12 oz) 024 - 059

Beef various cuts cooked 75 g (2 frac12 oz) 020-030

Beef ground cooked 75 g (2 frac12 oz) 014-026

Poultry

118

Chicken light meat cooked 75 g (2 frac12 oz) 025-048

Turkey light meat cooked 75 g (2 frac12 oz) 020

Fish and Seafood

Tuna yellowfinalbacore raw or cooked

75 g (2 frac12 oz) 078-084

Salmon Atlanc wild raw or cooked

75 g (2 frac12 oz) 071-074

Salmon Atlanc farmed raw or cooked

75 g (2 frac12 oz) 049-057

Fish (herring mackerel bluefish halibut trout snapper) cooked

75 g (2 frac12 oz) 029 - 047

Salmon Chinook raw or cooked

75 g (2 frac12 oz) 035-036

Tuna white canned in oil 75 g (2 frac12 oz) 032

Salmon chum with bones canned

75 g (2 frac12 oz) 029

Tuna light canned in water 75 g (2 frac12 oz) 026

Meat Alternaves



75 g (2 frac12 oz) 090

119


Vitamin B7 Very little data exists on the biotin content of foods and it is not included in most nutrient databases (eg the USDA Nutrient Database for Standard References) although it is found in varying amounts in most natural foods Liver contains high concentrations (about 100 mcg100g) compared to low quantities (about 1 mcgg) in fruit and most meats


Meatless chicken cooked 75 g (2 frac12 oz) 053


Chickpeasgarbanzo beans cooked

175 mL (34 cup) 084

Soybeans mature cooked 175 mL (34 cup) 030

Beans pinto cooked 175 mL (34 cup) 029


150 g (34 cup) 030

Refried beans 175 mL (34 cup) 020

Lenls cooked 175 mL (34 cup) 026

Nuts and Seeds

Pistachios without shell 60 mL (14 cup) 035

Sunflower seeds without shell

60 mL (14 cup) 027-048

Chinese chestnuts without shell

60 mL (14 cup) 016-026

120

Biotin is synthesized by intestinal bacteria However it is not clear whether this contributes substantively to biotin absorption in humans

Vitamin B9

Food Serving size Folate micrograms (mcg)


Vegetables

Edamamebaby soybeans cooked 125 mL (frac12 cup) 106-255

Okra frozen cooked 125 mL (frac12 cup) 97

Spinach cooked 125 mL (frac12 cup) 121-139

Archoke cooked 125 mL (frac12 cup) 79-106

Turnip greens collards cooked 125 mL (frac12 cup) 68-93


Asparagus cooked 4 spears 128-141

Brussels sprouts frozen cooked 6 sprouts 83

Lemuce (Romaine mesclun) 250 mL (1 cup) 65-80

Escarole or endive raw 250 mL (1 cup) 75

Beets cooked 125 mL (frac12 cup) 72


Spinach raw 250 mL (1 cup) 61

Fruits



Orange juice 125 mL (frac12 cup) 25-39

Grain Products

Pasta egg noodles enriched cooked 125 mL (frac12 cup) 138

121

Pasta white enriched cooked 125 mL (frac12 cup) 88-113

Bagel plain frac12 bagel (45 g) 86

Bread white 1 slice (35 g) 64




Meat Alternaves

Beans cranberryroman cooked 175 mL (frac34 cup) 271

Lenls cooked 175 mL (frac34 cup) 265

Peas (chickpeas black-eyed pigeon)cooked

175 mL (frac34 cup) 138-263

Beans (mung adzuki) cooked 175 mL (frac34 cup) 234-238

Beans (pink pinto navy black white kidney great northern) cooked

175 mL (frac34 cup) 157-218

Sunflower seeds without shell 60 mL (frac14 cup) 77-81

Meatless (fish scks meatball chicken) cooked

75 g (2 frac12 oz) 59-77


75 g (2 frac12 oz) 59

122


Vitamin B12


Organ Meats

Liver (turkey chicken) cooked 75 g (2 frac12 oz) 420-518

Liver (lamb veal) cooked 75 g (2 frac12 oz) 262-300

Liver (beef pork) cooked 75 g (2 frac12 oz) 122-195

Miscellaneous

Yeast extract spread (vegemite or marmite)

30 ml (2 Tbsp) 360

Food

Serving size Vitamin B12 micrograms (mcg)

Vegetables and Fruits This food group contains very limle of this nutrient

Grains Products This food group contains very limle of this nutrient


Milk

33 homo 2 1 250 mL (1 cup) 12-14

Skim 250 mL (1 cup) 13


Chocolate milk 250 mL (1 cup) 09

Cheese

SwissEmmental 50 g (1 frac12 oz) 17

123

Comage Cheese 250 mL (1 cup) 11-15

Feta gouda edam gruyere brie cheddar fonna mozzarella provolone

50 g (1 frac12 oz) 07-09

Processed cheese slices cheddar 50 g (1 frac12 oz) 04

Yogurt

Plain (regular low fat) 175 g (frac34 cup) 05

Fruit bomom (regular low fat) 175 g (frac34 cup) 05-06

Greek yogurt plain (regular low fat)

175 g (frac34 cup) 03-06

Greek fruit bomom (regular low fat)

175 g (frac34 cup) 05


Milk Alternaves

Soy beverage forfied 250 mL (1 cup) 10


Organ Meat

Liver (lamb veal beef) cooked 75 g (2 frac12 oz) 529-660

Kidney lamb cooked 75 g (2 frac12 oz) 592

Kidney veal cooked 75 g (2 frac12 oz) 277

Giblets turkey cooked 75 g (2 frac12 oz) 120


Liver (chicken turkey pork) cooked

75 g (2 frac12 oz) 126-234

Pate (goose liver chicken liver) 75 g (2 frac12 oz) 61-71

Poultry

Turkey duck or chicken cooked 75 g (2 frac12 oz) 02-03

Beef

Ground cooked 75 g (2 frac12 oz) 24-27

Various cuts cooked 75 g (2 frac12 oz) 13-25

124

Pork



Ham cooked 75 g (2 frac12 oz) 07

Bacon strips cooked 3 slices (24 g) 03-04

Miscellaneous

Cariboureindeer cooked 75 g (2 frac12 oz) 50

Salami (beef pork) 75 g (2 frac12 oz) or 3 slices 09-21

Sausage (pepperoni chorizo Polish Italian frankfurter)

75 g (2 frac12 oz) 04-20

Deli meat (pastrami mortadella bologna)

75 g (2 frac12 oz) or 3 slices 04-15

Fish and Seafood

Clams cooked 75 g (2 frac12 oz) 146

Oysters cooked 75 g (2 frac12 oz) 132-216


Mackerel (King Atlanc) cooked 75 g (2 frac12 oz) 135-143

HerringAtlanc kippered 75 g (2 frac12 oz) 140

Tuna bluefin raw or cooked 75 g (2 frac12 oz) 82-93

Roe raw 75 g (2 frac12 oz) 90

Crab Alaska King cooked 75 g (2 frac12 oz) 86

Sardines canned in oil or tomato sauce

75 g (2 frac12 oz) 68

Caviar (black red) 75 g (2 frac12 oz) 60


Salmon redsockeye cooked 75 g (2 frac12 oz) 44

Salmon pinkhumpback with bones canned

75 g (2 frac12 oz) 37

Salmon Atlanc wild cooked 75 g (2 frac12 oz) 23

125


Vitamin A

Tuna light canned in water

75 g (2 frac12 oz) 22

Meat Alternaves

Meatless (chicken fish scks wiener frankfurtermeatballs) cooked

75 g (2 frac12 oz) 10-38


Soy burger 75 g (2 frac12 oz) 18


Other

Almond oat or rice beverage forfied

250 mL (1 cup) 10

Red Star T6635+ Yeast (Vegetarian Support Formula)

2 grams (1 tsp powderor 2 tsp flaked)

10

Food Serving Size Vitamin A micrograms (mcg)


Vegetables


1 medium 1096

Pumpkin canned 125 mL (frac12 cup) 1007

126

Carrot juice 125 mL (frac12 cup) 966

Carrots cooked 125 mL (frac12 cup) 653-709

Squash bumernut cooked 125 mL (frac12 cup) 604

Swiss chard cooked 125 mL (frac12 cup) 566

Carrots baby raw 8 carrots (80 g) 552

Collards cooked 125 mL (frac12 cup) 406-516

Carrot raw 1 medium (61g) 509

Kale fresh or frozen cooked 125 mL (frac12 cup) 468-505


Turnip greens cooked 125 mL (frac12 cup) 290-466

Vegetable and fruit juice cocktail

125 mL (frac12 cup) 267

Lemuce romaine 250 mL (1 cup) 258

Lemuce red leaf 250 mL (1 cup) 218

Bok choy cooked 125 mL (frac12 cup) 190


Red peppers cooked 125 mL (frac12 cup) 106

Fruit

Apricots dried 60 mL (frac14 cup) 191

127

Apricot canned 125 mL (frac12 cup) 169

Cantaloupe raw 125 mL (frac12 cup) 143



Cheese

Goat hard 50 g (1 frac12 oz) 243

Processed cheddar fat free 50 g (1 frac12 oz) 220

Goat semi-soW 50 g (1 frac12 oz) 204

Muenster neufchatel gruyere cheddar Colby

50 g (1 frac12 oz) 132-158

Ricoma 125 mL (frac12 cup) 140-156

Blueroquefort 50 g (1 frac12 oz) 99-147

Processed cheese slices cheddar 125

Milk

Skim 1 2 chocolate milk 250 mL (1 cup) 137-163

33 homo 250 mL (1 cup) 119

Soy beverage 250 mL (1 cup) 103-104


Meat

Liver turkey cooked 75 g (2 frac12 oz) 16950

128

Table 9 Common Sources of vitamin A

Liver veal cooked 75 g (2 frac12 oz) 15052-15859


Liver beef cooked 75 g (2 frac12 oz) 5808-7082

Liver lamb cooked 75 g (2 frac12 oz) 5618-5836

Liver pork cooked 75 g (2 frac12 oz) 4054

Liver chicken cooked 75 g (2 frac12 oz) 3222

Fish and Seafood

Eel cooked 75 g (2 frac12 oz) 853

Tuna Bluefin raw or cooked 75 g (2 frac12 oz) 491-568

Herring pickled 75 g (2 frac12 oz) 194

Mackerel cooked 75 g (2 frac12 oz) 189


Salmon Chinook cooked 75 g (2 frac12 oz) 112 -118

Oysters cooked 75 g (2 frac12 oz) 110

Bluefish cooked 75 g (2 frac12 oz) 104

Meat Alternaves


Fats and Oils

Cod liver oil 5 mL (1 tsp) 1382

129

Source Canadian Nutrient File 2015

Vitamin D

Food Serving Size Vitamin D (IU)

Vegetables and Fruit This food group contains very limle of this nutrient

Orange juice forfied with vitamin D 125 mL (frac12 cup) 50



Soy beverage forfied with vitamin D 250 mL (1 cup) 86

Milk (33 homo 2 1 skim chocolate milk) 250 mL (1 cup) 103-105

Skim milk powdered24 g (will make 250 mL

of milk) 103

Yogurt (plain fruit bomom) forfied with vitamin D 175 g (34 cup) 58-71


Egg yolk cooked 2 large 57-88

Pork various cuts cooked 75 g (2 frac12 oz) 6-60

Deli meat (pork beef salami bologna) 75 g (2 frac12 oz) 3 slices 30-54

Beef liver cooked 75 g (2 frac12 oz) 36

Fish and Seafood

130

Salmon sockeyered canned cooked or raw 75 g (2 frac12 oz) 394-636

Salmon humpbackpink canned cooked or raw 75 g (2 frac12 oz) 392-447

Salmon coho raw or cooked 75 g (2 frac12 oz) 338-422

Snapper cooked 75 g (2 frac12 oz) 392

Salmon chinook raw or cooked 75 g (2 frac12 oz) 383-387

Whitefish lake cooked 75 g (2 frac12 oz) 135

Mackerel Pacific cooked 75 g (2 frac12 oz) 343

Salmon Atlanc raw or cooked 75 g (2 frac12 oz) 206-245

Salmon chumketa raw or cooked 75 g (2 frac12 oz) 203-221

Mackerel canned 75 g (2 frac12 oz) 219

Herring Atlanc pickled 75 g (2 frac12 oz) 202


Herring Atlanc cooked 75 g (2 frac12 oz) 161

Roe raw 30 g (1 oz) 145

Sardines Pacific canned 75 g (2 frac12 oz) 144

Halibut cooked 75 g (2 frac12 oz) 144

Tuna albacore raw or cooked 75 g (2 frac12 oz) 99-106

131

Table 10 Common Sources of vitamin D Source Canadian Nutrient File 2015

Vitamin E

Mackerel Atlanc cooked 75 g (2 frac12 oz) 78

Tuna white canned with water 75 g (2 frac12 oz) 60

Fats and Oils


Margarine 5 mL (1 tsp) 25-36

Other

Goatrsquos milk forfied with Vitamin D 250 mL (1 cup) 100

Rice oat almond beverage forfied with Vitamin D

250 mL (1 cup) 85-90

Food Serving size Vitamin E milligrams (mg)



Dandelion greens raw 250 mL (1 cup) 2

Tomato sauce canned 125 mL (frac12 cup) 2

132



Pepper red cooked 125 mL (frac12 cup) 2

Avocado frac12 fruit 1-4

Grains Products

Cereal wheat germ toasted 30 g (frac14 cup) 5




Fish and Seafood


Herring cooked 75 g (2 frac12 oz) 1-2

Sardines canned with oil 75 g (2 frac12 oz) 2

Tuna white canned with oil 75 g (2 frac12 oz) 2

Nuts and Seeds

Almonds unblanched without shell 60 mL (frac14 cup) 9-10

133

Table 11 Common Sources of vitamin E Source Canadian Nutrient File 2015

Vitamin K


Almonds blanched without shell 60 mL (frac14 cup) 2-9

Almond bumer 30 mL (2 Tbsp) 8

Hazelnuts without shell 60 mL (frac14 cup) 5

Peanuts without shell 60 mL (frac14 cup) 2

Peanut bumer 30 mL (2 Tbsp) 3

Pine nuts 60 mL (frac14 cup) 3

Brazil nuts 60 mL (frac14 cup) 2

Meat Alternaves

Meatless (fish scks wiener chicken) cooked 75 g (2 frac12 oz) 1-3


Fats and Oils

Vegetable oil wheat germ 5 mL (1 tsp) 7

Vegetable oil (sunflower safflower) 5 mL (1 tsp) 2

134

Food Serving size Vitamin K micrograms (mcg)


Kale raw chopped 250 mL (1 cup) 578





Dandelion greens cooked 125 mL (frac12 cup) 306

Collards raw chopped 250 mL (1 cup) 194


Beet Greens raw 250 mL (1 cup) 161

Beet Greens cooked 125 mL (frac12 cup) 368

Swiss chard raw chopped 250 mL (1 cup) 315



Parsley raw 60 mL (14 cup) 260

135

Mustard Greens cooked 125 mL (frac12 cup) 222

Broccoli raab cooked 125 mL (frac12 cup) 169

Lemuce spring mix raw 250 mL (1 cup) 154

Endive raw chopped 250 mL (1 cup) 122

Radicchio raw shredded 250 mL (1 cup) 108

Lemuce green leaf raw shredded 250 mL (1 cup) 103

Watercress chopped 250 mL (1 cup) 90

Cabbage shredded raw 250 mL (1 cup) 56

Cabbage Shredded cooked 125 mL (frac12 cup) 86

Lemuce romaine raw shredded 250 mL (1 cup) 61

Broccoli raw 250 mL (1 cup) 94


Brussel Sprouts cooked 4 sprouts 118

Bean Sprouts raw 125 mL (frac12 cup) 70

Green onions (Scallions) raw chopped 60 mL (14 cup) 55

Asparagus 6 spears 46

136

Table 12 Common Sources of vitamin K Source Canadian Nutrient File 2015


Rhubarb cooked 125 mL (frac12 cup) 27

Blueberry 125 mL (frac12 cup) 22


Grains Products

Spinach egg noodles cooked 125 mL (frac12 cup) 86



Pork Liver 75 g (2 frac12 oz) 66

Sausage (pork veal) 75 g (2 frac12 oz) 53


Soybeans 175 g (34 cup) 24

Other

Matcha green tea powder 2 g of powder in 1 cup tea 60

137

Appendix 2 ndash Common mineral sources

Calcium (Ca)

Food Serving Size Calcium (mg)


Vegetables

Collards frozen cooked 125 mL (frac12 cup) 189

Spinach frozen cooked 125 mL (frac12 cup) 154


Turnip greens frozen cooked 125 mL (frac12 cup) 132



Kale frozen cooked 125 mL (frac12 cup) 95

Fruit

138

Orange juice forfied with calcium

125 mL (frac12 cup) 155



Milk and Milk Alternaves


Soy beverage forfied with calcium

250 mL (1 cup) 321-324

33 homo 2 1 skim chocolate milk

250 mL (1 cup) 291-322

Dry powdered milk 24 g (4 Tbsp) of powder will make 250mL of milk

302

Cheese

Gruyere swiss goat low fat cheddar mozzarella

50 g (1frac12 oz) 396-506

Processed cheese slices (swiss cheddar low fat swiss or cheddar)

50 g (1frac12 oz) 276-386

Cheddar colby edam gouda mozzarellablue

50 g (1frac12 oz) 252-366

Ricoma cheese 125 mL (frac12 cup) 269-356


Miscellaneous

Greek yogurt plain 175 g (frac34 cup) 180-212

Yogurt plain 175 g (frac34 cup) 263-275

Yogurt fruit bomom 175 g (frac34 cup) 189-283

Yogurt soy 175 g (frac34 cup) 206

139


Kefir 175 g (frac34 cup) 198


Fish and Seafood

Sardines Atlanc canned in oil with bones

75 g (2 frac12 oz) 286

Salmon (pinkhumpback redsockeye) canned with bones

75 g (2 frac12 oz) 179-212


Sardines Pacific canned in tomato sauce with bones

75 g (2 frac12 oz) 180

Anchovies canned 75 g (2 frac12 oz) 174

Meat Alternaves

Tofu prepared with calcium sulfate

150 g (frac34 cup) 302-525

Beans (white navy) canned or cooked

175 mL (frac34 cup) 93-141

Tahinisesame seed bumer 30 mL (2 Tbsp) 130

Baked beans canned 175 mL (frac34 cup) 89-105

Almonds dry roasted unblanched


140

Table 1 Common Sources of Calcium Source Canadian Nutrient File 2015

Magnesium (Mg)

Other

Goats milk 250 mL (1 cup) 345

Cashew beverage enriched 250 mL (1 cup) 223-331

Rice beverage enriched 250 mL (1 cup) 319

Almond beverage enriched 250 mL (1 cup) 312

Coconut beverage enriched 250 mL (1 cup) 177-223

Blackstrap molasses 15 mL (1 Tbsp) 179

Food Serving Size Magnesium (mg)


Prickly pear 1 fruit 88



Tamarind 125 mL (frac12 cup) 58

Edamamebaby soy beans cooked



Okra cooked 125 mL (frac12 cup) 50

Grain Products

Cereals All Bran 30 g (check product label for serving size)

85-97

141

Wheat germ cereal toasted 30 g (frac14 cup) 96

Quinoa cooked 125 mL (12 cup) 63


Cheese soy 50 g (1frac12 oz) 114


Meats and Alternaves


Peas black-eyed peascowpeas cooked

175 mL (frac34 cup) 121


150 g (34 cup) 116

Soybeans mature cooked 175 mL (frac34 cup) 109


Beans (black lima navy adzuki white kidney pinto Great Northern cranberry chickpeas) cooked

175 mL (frac34 cup) 60-89

Tofu prepared with magnesium chloride or calcium sulfate

150 g (frac34 cup) 45-80

Baked beans with pork canned 175 mL (frac34 cup) 64

Lenls split peas cooked 175 mL (frac34 cup) 52

Nuts and Seeds

Pumpkin or squash seeds without shell


Brazil nuts without shell 60 mL (frac14 cup) 133

Sunflower seed bumer 30 mL (2 Tbsp) 101



Cashews without shell 60 mL (frac14 cup) 90

Pine nuts without shell 60 mL (frac14 cup) 70-86

Cashew bumer 30 mL (2 Tbsp) 84

142

Table 2 Common Sources of Magnesium Source Canadian Nutrient File 2015

Phosphorus (P)

Flaxseeds 30 mL (2 Tbsp) 111

Sesame seeds 30 mL (2 Tbsp) 56-68


Chinese chestnuts without shell 60 mL (frac14 cup) 54

Peanut bumer 30 mL (2 Tbsp) 52-55

Hazelnuts without shell 60 mL (frac14 cup) 52-66

Fish and Seafood

Salmon Chinook cooked 75 g (2 frac12 oz) 92



Pollock Atlanc cooked 75 g (2 frac12 oz) 64

Crab Atlanc snow cooked 75 g (2 frac12 oz) 47

Meat and Poultry These foods contain very limle of this nutrient

Other


30 mL (2 Tbsp) 66

Food Serving size Phosphorus (mg)


143


125 mL (12 cup) 138-150


Mushroom portabello raw 125 mL (12 cup) 124

Grains Products

Grains

Rice bran raw 20 g 335

Wheat bran raw 30 g (12 cup) 270

Wheat germ raw 30 g (14 cup) 225

Waffle cooked 1 waffle 135-147


Cereals

Wheat germ cereal toasted 30 g (14 cup) 344

Bran flakes 30 g 344

Bran (All Bran 100 Bran) 30 g 108- 261

Oatmeal cooked 175 mL (34 cup) 138 -177

Oat o-shaped 30 g 127-134

Oatmeal instant cooked 175 mL (34 cup) 142


Processed cheese slices cheddar 50 g (1 frac12 oz) 112-125

Cheese (cheddar gruyere swissemmental gouda mozzarella edam provolone)

50 g (1 frac12 oz) 232-302

Milk (33 homo 2 1 skim chocolate)

250 mL (1 cup) 217-272

Yogurt (fruit plain) all types 175g (34 cup) 183-217

Bumermilk 250 mL (1 cup) 212 - 230

Yogurt Greek all types 175g (34 cup) 156-246


144




Meat and Poultry


75 g (2 12 oz) 170-224

Pork various cuts cooked 75 g (2 12 oz) 130-221

Veal various cuts cooked 75 g (2 12 oz) 178-194

Bison various cuts cooked 75 g (2 12 oz) 157-193

Beef or lamb various cuts cooked

75 g (2 12 oz) 144-180

Beef ground cooked 75 g (2 12 oz) 134-174

Chicken or turkey various cuts cooked

75 g (2 12 oz) 134-163

Bacon strip cooked 75 g (2 12 oz) 87-93

Organ Meat

Liver (beef veal chicken) cooked 75 g (2 frac12 oz) 345-373


Liver (turkey pork) cooked 75 g (2 frac12 oz) 181-220

Fish and Seafood

Salmon canned 75 g (2 frac12 oz) 244-247

Sardines canned in oil 75 g (2 frac12 oz) 368

Scallops cooked 75 g (2 frac12 oz) 320


Mackerel cooked 75 g (2 frac12 oz) 120-238



145

Crab imitaonsurimi cooked 75 g (2 frac12 oz) 210

Trout rainbow cooked 75 g (2 frac12 oz) 202

Salmon cooked 75 g (2 frac12 oz) 189-192

Cod cooked 75 g (2 frac12 oz) 104-259


Meat Alternaves


150 g (34 cup) 380




Beans adzuki cooked 175 mL (34 cup) 286


Meatless (meatballs chicken) cooked

75 g (2 12 oz) 251-258


75 g (2 12 oz) 155-258

Beans (navy great northern) cooked

175 mL (34 cup) 194-216

146

Chickpeasgarbanzo beans 175 mL (34 cup) 204

Tofu 150 g (frac34 cup) 146-204


Beans (kidney black-eyedcowpeas cranberryroman) cooked

175 mL (34 cup) 177-186


Baked beans canned 175 mL (34 cup) 139

Nuts and Seeds


60 mL (14 cup) 676


Brazil nuts without shell 60 mL (14 cup) 257

Almonds without shell 60 mL (14 cup) 174-208

Pine nuts without shell 60 mL (14 cup) 197

Cashews without shell 60 mL (14 cup) 170-195

Pistachios without shell 60 mL (14 cup) 146-153

Cashew bumer 30 mL (2 tbsp) 148

Tahinisesame bumer 15 mL (1 tbsp) 111

147

Table 3 Common Sources of Phosphorus Source Canadian Nutrient File 2015

Potassium (K)

Other

Goatrsquos milk 250 mL (1 cup) 286

Food Serving Size Potassium (mg)


Vegetables

Winter Squash cubed cooked 250 mL (1 cup) 896

Sweet potato baked with skin Medium 694

Potato baked with skin Medium 610

Fruit

Orange juice 237 mL (8 oz) 496

Cantaloupe cubed 250 mL (1 cup) 431

Banana Medium 422



Milk 1 low fat 237 mL (8 oz) 366

Miscellaneous

Yogurt fat-free 250 mL (1 cup) 579


Fish and Seafood

148

Table 4 Common Sources of Potassium Source US Department of Agriculture (USDA)

Chromium (Cr)

Halibut cooked 89 g (3 oz) 490

Salmon Atlanc cooked 89 g (3 oz) 326

Tuna light canned 89 g (3 oz) 201

Meat

Pork Tenderloin cooked 89 g (3 oz) 382

Chicken Breast cooked 89 g (3 oz) 218

Meat Alternaves

White beans canned 125 mL (frac12 cup) 595

Lenls 125 mL (frac12 cup) 366

Pistachios shelled roasted 29 mL (1 oz) 295

Raisins 625 mL (14 cup) 250

Food Serving size Chromium (mcg)


Vegetables

149

Table 5 Common Sources of Chromium Source Naonal Instutes of Health Office of Dietary Supplements

Copper (Cu)

Broccoli 125 mL (12 cup) 11

Potato mashed 250 mL (1 cup) 3

Garlic dried 1 tsp 3

Basil dried 1tsp 2

Beet cubed 88 g (3 oz) 2

Green Beans 125 mL (12 cup) 1

Fruits

Grape Juice 250 mL (1 cup) 8

Orange Juice 250 mL (1 cup) 2

Apple 1 medium 1

Banana 1 medium 1

Grains Products

Grains

English Muffin whole wheat 1 4

Whole Wheat Bread 2 slices 2


Meat and Poultry

Turkey Breast 88 g (3 oz) 2

Other

Red Wine 148 mL (5 oz) 1-13

Food Serving size Copper (mg)


150

Table 6 Common Sources of Copper Source United States Department of Agriculture (USDA)

Iodine (I)

Vegetables 125 mL (12 cup) 138-150

Asparagus cooked 250 mL (1 cup) 025

Mushrooms 250 mL (1 cup) 043

Turnip Greens 250 mL (1 cup) 036

Fruits

Apricots dried 250 mL (1 cup) 069


Organ Meat

Beef Liver 88 g (3 oz) 14

Meat Alternaves

Sunflower Seeds without shell 625 mL (14 cup) 063


Nuts and Seeds


Other

Dark Chocolate 1 square 09

Blackstrap molasses 2 tsp 028

151

Food Serving Size Iodine (mcg)



Corn cooked 125 mL (12 cup) 7

Green peas cooked 125 mL (12 cup) 3-4

Grain Products


Crisped rice 30 g 20

Oat o-shaped 30 g 14

Shredded wheat 30 g 8

Raisin bran 30 g 6

Other

Soda crackers 10 crackers 44

Bread (rye whole wheat white) 1 slice (35g) 17-32

Torlla frac12 torlla (35g) 26


125 mL (12 cup) 9

Rice white cooked 125 mL (12 cup) 4


Comage cheese 250 mL (1 cup) 65

Milk (33 homo 2 skim chocolate bumermilk)

250 mL (1 cup) 52-62

Yogurt plain 175 g (34 cup) 58

Yogurt fruit 175 g (34 cup) 35

Hard cheese cheddar 50 g (1 frac12 oz) 22


Turkey light cooked 75 g (2 frac12 oz) 30

152

Deli meat (salami bologna) 75 g (2 frac12 oz) ou 3 trances 16-21


Chicken light or dark cooked 75 g (2 frac12 oz) 11-13


Lamb chop cooked 75 g (2 frac12 oz) 8

Organ Meats

Liver beef cooked 75 g (2 frac12 oz) 32

Fish and Seafood

Cod cooked 75 g (2 frac12 oz) 87

Haddock cooked 75 g (2 frac12 oz) 87

Tuna canned 75 g (2 frac12 oz) 15

Meat Alternaves

Soynuts 60 mL (14 cup) 60

Beans (navy black-eyed) cooked

175 mL (34 cup) 46-53


Beans (pinto kidney) cooked 175 mL (34 cup) 19-28

153

Table 7 Common Sources of Iodine Source Canadian Nutrient File 2015

Iron (Fe)

Food Serving size Iron (mg)



Tomato puree 125 mL (frac12 cup) 24


Lima beans cooked 125 mL (frac12 cup) 22

Asparagus raw 6 spears 21

Hearts of palm canned 125 mL (frac12 cup) 20



Turnip or beet greens cooked 125 mL (frac12 cup) 15-17

Prune juice 125 mL (frac12 cup) 16


Beets canned 125 mL (frac12 cup) 16


Green peas cooked 125 mL (frac12 cup) 13

Tomato sauce 125 mL (frac12 cup) 12

Grains Products


Cream of wheat all types cooked 175 mL (frac34 cup) 57-58


40-43

Granola bar oat fruits and nut 1 bar (32 g) 12-27

Cracker soda 6 crackers 15-23

154

Oat bran cereal cooked 175 mL (frac34 cup) 20



Yogurt soy 175 mL (frac34 cup) 21


Meat and Poultry

Duck cooked 75 g (2 frac12 oz) 18- 74

Moose or venison cooked 75 g (2 frac12 oz) 25-38


Ground meat (beef lamb) cooked 75 g (2 frac12 oz) 13-21

Lamb various cuts cooked 75 g (2 frac12 oz) 13-21

Chicken various cuts cooked 75 g (2 frac12 oz) 04-20


Ground meat (turkey chicken pork) cooked 75 g (2 frac12 oz) 07-08

Turkey various cuts cooked 75 g (2 frac12 oz) 03-08

Organ Meats


Liver (chicken turkey lamb) cooked 75 g (2 frac12 oz) 62-97



Kidney (beef veal pork) cooked 75 g (2 frac12 oz) 23-44

Fish and Seafood

Octopus cooked 75 g (2 frac12 oz) 72


Seafood (shrimp scallops crab) cooked 75 g (2 frac12 oz) 02-04

155

Crab cooked 75 g (2 frac12 oz) 06-22

Sardines canned 75 g (2 frac12 oz) 17-22

Clams canned 75 g (2 frac12 oz) 20

Fish (mackerel trout bass) cooked 75 g (2 frac12 oz) 14-17


Meat Alternaves




Beans (white kidney navy pinto black romancranberry adzuki) cooked

175 mL (frac34 cup) 26-49

Pumpkin or squash seeds roasted 60 mL (frac14 cup) 14-47

Peas (chickpeasgarbanzo black-eyed split) cooked

175 mL (frac34 cup) 19-35

Tempehfermented soy product cooked 150 g (34 cup) 32

Meatless (sausage chicken meatballs fish scks) cooked

75 g (25 oz) 15-28


156

Table 8 Common Sources of Iron Source Canadian Nutrient File 2015

Manganese (Mn)

Nuts (cashews almonds hazelnuts macadamia pistachio nuts) without shell

60 ml (frac14 cup) 13-22

Eggs cooked 2 large 12-18

Sesame seeds roasted 15 mL (1 Tbsp) 14

Meatless luncheon slices 75 g (25 oz) 14

Hummus 60 mL (frac14 cup) 15


Miscellaneous


Yeast extract spread (marmite or vegemite) 30 mL (2 Tbsp) 15

Food Serving size Manganese (mg)


Vegetables

Garlic 136 g 23

Corn 166 g 08

Beet Greens 144 g 07

Kale 67 g 05

Spinach 30 g 03

157

Green Beans 110 g 02

Fruits

Pineapple 165 g 15

Raspberries 123 g 08

Banana 1 medium 06

Strawberries 152 g 06

Grains Products

Grains

Oats cooked 156 g 77

Wheat cooked 186 g 57

Rye cooked 169 g 45

Barley cooked 184 g 36

Quinoa cooked 170 g 35

Brown Rice cooked 195 g 18

Meat Alternaves

Garbanzo Beans cooked 195 g 17

Tofu 126 g 15

Nuts and Seeds

Almonds without shell 95 g 22

Pumpkin Seeds 64 g 03

Other

Cloves 6 g 2

158

Table 9 Common Sources of Manganese Source United States Department of Agriculture (USDA)

Molybdenum (Mo)

Worlds Healthiest Foods ranked as quality sources of molybdenum

FoodServing

Size CalsAmount

(mcg)DRIDV

()NutrientDensity

Worlds Healthiest

Foods RaCng

Lenls 1 cup 2297 14850 330 259 excellent

Dried Peas 1 cup 2313 14700 327 254 excellent

Lima Beans 1 cup 2162 14100 313 261 excellent

Kidney Beans 1 cup 2248 13275 295 236 excellent

Soybeans 1 cup 2976 12900 287 173 excellent

Black Beans 1 cup 2270 12900 287 227 excellent

Pinto Beans 1 cup 2445 12825 285 210 excellent

Garbanzo Beans 1 cup 2690 12300 273 183 excellent

Oats 025 cup 1517 2886 64 76 excellent

Tomatoes 1 cup 324 900 20 111 excellent

Romaine Lemuce 2 cups 160 564 13 141 excellent

Cucumber 1 cup 156 520 12 133 excellent

Celery 1 cup 162 505 11 125 excellent

Barley 033 cup 2171 2699 60 50 very good

Eggs 1 each 775 850 19 44 very good

Carrots 1 cup 500 610 14 49 very good

Bell Peppers 1 cup 285 460 10 65 very good

Fennel 1 cup 270 435 10 65 very good

Yogurt 1 cup 1494 1127 25 30 good

Peanuts 025 cup 2069 1077 24 21 good

Sesame Seeds 025 cup 2063 1062 24 21 good

Walnuts 025 cup 1962 885 20 18 good

Green Peas 1 cup 1157 689 15 24 good

Almonds 025 cup 1322 678 15 21 good

159

Table 10 Common Sources of Molybdenum

Selenium (Se)

Cod 4 oz 964 386 9 16 good

Food Serving Size Selenium (mcg)


Mushrooms (portabella shiitake crimini) raw or cooked

125 mL (12 cup) 10-21

Grain Products

Couscous cooked 125 mL (frac12 cup) 23



Pasta (whole wheat white) enriched cooked

125 mL (frac12 cup) 19-20

Rice brown long-grain cooked 125 mL (frac12 cup) 8-10

Oat bran cooked 125 mL (frac12 cup) 10

Rice white cooked 125 mL (frac12 cup) 8



Comage cheese 0-4 MF 250 mL (1 cup) 14-28

Yogurt Greek all flavours non fat

250 mL (1 cup) 14-27

Yogurt fruit non fat 175 gmL (frac34 cup) 9

Processed cheese slices (cheddar swiss) regular low fat

50 g (1 frac12 oz) 13

Milk (homogenized 33 2 1 skim)

250 mL (1 cup) 8-10

Cheese (Swiss emmental) 50 g (1 frac12 oz) 9

Cheese mozzarella regular low fat

50 g (1 frac12 oz) 7-9


160

Meat Alternaves

Brazil nuts without shell 5 340

Mixed nuts without shell 60 mL (frac14 cup) 51-154



Tofu 150 g (frac34 cup) 13-20


Chia seeds 60 mL (frac14 cup) 24

Fish and Seafood

Oysters Pacific cooked 75 g (2 frac12 oz) 116

Fish (halibut herring bass cod mackerel orange roughy lapia) cooked

75 g (2 frac12 oz) 12-66

Tuna (light white) canned 75 g (2 frac12 oz) 45-53

Oysters farmed cooked 75 g (2 frac12 oz) 58

Pike or grayling cooked 75 g (2 frac12 oz) 45



161

Table 10 Common Sources of Selenium Source Canadian Nutrient File 2015

Zinc (Zn)


Meat and Poultry

Liver (lamb chicken turkey pork) cooked

75 g (2 frac12 oz) 51-87

Bacon strips cooked 3 slices (24 g) 12


75 g (2 frac12 oz) 12-38



Lamb Canadian various cuts cooked

75 g (2 frac12 oz) 18-27

Food Serving Size Zinc (mg)


Grain Products

Wheat germ 30 mL (2 Tbsp) 24

Cereal bran 30 g 17-19

Wild rice cooked 125 mL (frac12 cup) 12


Cheese (cheddar swiss gouda brie mozzarella) 50 g (1frac12 oz ) 12-22

162


Yogurt (plain fruit bomom) regular or low fat 175 mL (frac34 cup) 07-10

Greek yogurt (plain fruit bomom) regular or low fat


Milk (33 homo 2 1 skim chocolate bumermilk)

250 mL (1 cup) 10-11


Meats



Veal lean various cuts cooked 75 g (2 frac12 oz) 23-74

Venison or bison various cuts cooked 75 g (2 frac12 oz) 21-65

Liver (beef chicken lamb pork) cooked 75 g (2 frac12 oz) 30-60





Ground meat (pork beef turkey chicken) 75 g (2 frac12 oz) 14-48

Meat Alternaves

Pumpkin or squash seeds 60 mL (frac14 cup) 27-44

163

Baked beans cooked 175 mL (frac34 cup) 43


Nuts (pine peanuts cashews almonds) without shell 60 mL (14 cup) 11-22


Dried peas (chickpeasgarbanzo beans black- eyed split) cooked

175 mL (frac34 cup) 11-19

Sunflower seed without shell 60 mL (frac14 cup) 06-18


Tofu prepared with magnesium chloride or calcium sulphate

175 mL (frac34 cup) 12-17


Tahinisesame bumer 30 mL (2 Tbsp) 14

Soyburger 1 pamy (70 g) 13


Refried beans 175 mL (frac34 cup) 11

Fish and Seafood

Oysters Eastern wild cooked 75 g (2 frac12 oz) 458-590

Oysters eastern farmed cooked 75 g (2 frac12 oz) 334


Crab all variees cooked 75 g (2 frac12 oz) 27-57

Cumlefish cooked 75 g (2 frac12 oz) 26


164

Table 11 Common Sources of Zinc Source Canadian Nutrient File 2015


Lobster cooked 75 g (2 frac12 oz) 30




Shrimp all variees cooked 75 g (2 frac12 oz) 12

165

Module 1 What is nutrion Module 2 Macronutrients Module 3 Carbohydrates Module 4 Proteins Module 5 Fats Module 6 Micronutrients Module 7 Vitamins Module 8 Minerals

At the end of the eight modules there will be a 50 queson test a score of 4550 (90) is required to pass

Module 1 NutriCon basics

1




2




3










Fat 20-35 44-78g

Protein 10-35 50-175g

4






5







6










Fat 20-35 44-78g

Protein 10-35 50-175g




136-227 3-5

7







227-318 6-8


318-454 8-10

Ultra-Endurance


454-545 10-12











8




References


9













10















11

Tables






12




13









14










Fat 20-35 44-78g

Protein 10-35 50-175g

15






16







17








Carbohydrate 45-65

Fat 20-35

Protein 10-35

18






19








20







21







22

References







23














Figures


24


Tables





25





26







27







28





29

Energy is released






30







31







32







33






34






35






36

References












37
















38














Figures


39





Module 4 Proteins

40




41






42

H H O

N ndash C ndash C

H R OH







AnCbodies

43






44






45










46







Fat 20-35 44-78g

Protein 10-35 50-175g



0-6 months 91

6-12 months 110

1-3 years 130

4-8 years 190

Males

9-13 years 340

14-18 years 520

19-70 years 560

Females

9-13 years 340

14-70 years 460


All ages 710

47

























48






49



References

50















51






Figures






52


Tables




Module 5 Fats


53




54











Fat 20-35 44-78g

Protein 10-35 50-175g

55






56








57








58




References




59









Figures




60



Tables





61





62










63



References








64




Module 7 Vitamins



65






66



Figure 1 Vitamin C












67




Figure 2 Vitamin B1




120 2000










68




Figure 3 Vitamin B2








69



Figure 4 Vitamin B3


















70


Figure 5 Vitamin B5













71



Figure 6 Vitamin B6









14-18 years (males) 13 100


72



Figure 7 Vitamin B7


19-50 13 100

Men 51+ 17 100

Women 51+ 15 100











73





Figure 8 Vitamin B9








74







1-3 years 150 300

4-8 years 200 400

9-13 years 300 600

14-18 years 400 800

19+ years 400 1000



75















76






Figure 10 Vitamin A




7-12 months 500 600

1-3 years 300 600

4-8 years 400 900

9-13 years 600 1700

14-18 years (male) 900 2800

14-18 years (female) 700 3000

77




Figure 11 Vitamin D

19+ years (male) 900 3000












78






Figure 12 Vitamin E









1-3 years 6 200

4-8 years 7 300

9-13 years 11 600

79





Figure 13 Vitamin K

14-18 years 15 800

19+ years 15 1000













80








Vitamin B3


81








82






83

References










84















85














Figures


86








87








88


Tables









89






90

Module 8 Minerals



91










7-12 months 260 1500

1-3 years 700 2500

4-8 years 1000 2500

9-13 years 1300 3000

14-18 years 1300 3000

19-50 years 1000 2500

51-70 years (males) 1000 2000

51-70 years (females) 1200 2000

71+ years 1200 2000

92











1-3 years 80 140

4-8 years 130 240

9-13 years 240 350

14-18 years (males) 410 350


19-30 years (males) 400 350


31-50 years (males) 420 350








93








1-3 years 460 140

4-8 years 500 240

9-18 years 1250 350

19-70 years 700 4000

71+ years 700 3000










94


























95













14-18 years 890 10000 (10mg)

19+ years 900 10000 (10mg)







1-3 years 90 200

4-8 years 90 300

9-13 years 120 600

14-18 years 150 900

96





19+ years 150 1100






7-12 months 11 40

1-3 years 7 40

4-8 years 10 40

9-13 years 8 40





50+ years 8 45






97






7-12 months 06 2

1-3 years 12 3

4-8 years 15 6












1-3 years 17 300

4-8 years 22 600

9-13 years 34 1100

14-18 years 43 1700

19+ years 45 2000



98







7-12 months 20 400

1-3 years 20 400

4-8 years 30 400

9-13 years 40 400

14-18 years 55 400

19-50 years 55 400

51+ years 55 400






7-12 months 3 5

1-3 years 3 7

4-8 years 5 12

9-13 years 8 23






99











100









101





Tables

102











103




Appendices


104


Vitamin C

105



Vegetables






















106




Fruit

Guava 1 fruit 206




Lychee 10 fruits 69




Clemenne 1 fruit 36





107


Vitamin B1




125 mL (frac12 cup) 14-17

Juice


125 mL (frac12 cup) 23 - 66








Vegetables



125 mL (12 cup) 025

108





Grain Products

Grains





125 mL (12 cup) 016 - 021

Cereals



060



022




1 bar (37 g) 037






1 slice (35 g) 008 ndash 017



109


Meat





75 g (2 frac12 oz) 019 ndash 038


Fish and Seafood







Meat Alternaves



75 g (2 frac12 oz) 200


75 g (2 frac12 oz) 070-096



175 mL (frac34 cup) 022 - 035



Nuts and Seeds


110


Vitamin B2


60 mL (frac14 cup) 016 - 032


60 mL (frac14 cup) 017 - 024



Others


15mL (1 Tbsp) 429



Vegetables


125 mL (frac12 cup) 02-06


Grain Products


11


02








111


175 g (frac34 cup) 02-04



50 g (1frac12 oz) 02



Meat




75 g (2frac12 oz) 02

Organ Meats


75 g (2frac12 oz) 16-27

Fish and Seafood






112


Vitamin B3


75 g (2frac12 oz) 02-03



Meat Alternaves


75 g (2frac12 oz) 05


150 g (34 cup) 05





Other


30 mL (2 Tbsp) 53


113




Grain Products



3-6








50 g (1 frac12 oz) 3-4


50 g (1 frac12 oz) 2-3




Meat


75 g (2frac12 oz) 10-17



75 g (2frac12 oz) 6-14



Fish and Seafood



114








Meat alternaves



75 g (2 frac12 oz) 10


60 mL (14 cup) 8


150 g (34 cup) 8



75 g (2 frac12 oz) 4-5








175 mL (34 cup) 3


175 mL (34 cup) 3

Other

115


Vitamin B5


5 mL (1 tsp) 8













Grain Products



10






Milk 2 250 mL (1 cup) 09


116


Vitamin B6

Meat




Fish and Seafood


Meat alternaves








Vegetables



1 medium 033



125 mL (12 cup) 023

Fruit

Banana 1 medium 043



117




Grain Products


1 waffle (33 g) 037



100 Bran 30 g 020




Organ Meat




Meat


75 g (2 frac12 oz) 046-057




Poultry

118



Fish and Seafood


75 g (2 frac12 oz) 078-084


75 g (2 frac12 oz) 071-074


75 g (2 frac12 oz) 049-057


75 g (2 frac12 oz) 029 - 047


75 g (2 frac12 oz) 035-036



75 g (2 frac12 oz) 029


Meat Alternaves



75 g (2 frac12 oz) 090

119







175 mL (34 cup) 084




150 g (34 cup) 030



Nuts and Seeds



60 mL (14 cup) 027-048


60 mL (14 cup) 016-026

120


Vitamin B9



Vegetables














Fruits




Grain Products


121







Meat Alternaves




175 mL (frac34 cup) 138-263



175 mL (frac34 cup) 157-218



75 g (2 frac12 oz) 59-77


75 g (2 frac12 oz) 59

122


Vitamin B12


Organ Meats




Miscellaneous


30 ml (2 Tbsp) 360

Food





Milk

33 homo 2 1 250 mL (1 cup) 12-14




Cheese


123



50 g (1 frac12 oz) 07-09


Yogurt




175 g (frac34 cup) 03-06


175 g (frac34 cup) 05


Milk Alternaves



Organ Meat







75 g (2 frac12 oz) 126-234


Poultry


Beef



124

Pork





Miscellaneous




75 g (2 frac12 oz) 04-20



Fish and Seafood










75 g (2 frac12 oz) 68





75 g (2 frac12 oz) 37


125


Vitamin A


75 g (2 frac12 oz) 22

Meat Alternaves


75 g (2 frac12 oz) 10-38




Other


250 mL (1 cup) 10



10



Vegetables


1 medium 1096


126












125 mL (frac12 cup) 267






Fruit


127





Cheese





50 g (1 frac12 oz) 132-158




Milk


33 homo 250 mL (1 cup) 119



Meat


128








Fish and Seafood









Meat Alternaves


Fats and Oils


129


Vitamin D









of milk) 103







Fish and Seafood

130














Roe raw 30 g (1 oz) 145




131


Vitamin E



Fats and Oils



Other



250 mL (1 cup) 85-90






132





Grains Products





Fish and Seafood





Nuts and Seeds


133


Vitamin K









Meat Alternaves



Fats and Oils



134

















135

















136






Grains Products








Other


137


Calcium (Ca)



Vegetables








Fruit

138


125 mL (frac12 cup) 155






250 mL (1 cup) 321-324


250 mL (1 cup) 291-322


302

Cheese


50 g (1frac12 oz) 396-506


50 g (1frac12 oz) 276-386


50 g (1frac12 oz) 252-366



Miscellaneous





139




Fish and Seafood


75 g (2 frac12 oz) 286


75 g (2 frac12 oz) 179-212



75 g (2 frac12 oz) 180


Meat Alternaves


150 g (frac34 cup) 302-525


175 mL (frac34 cup) 93-141





140


Magnesium (Mg)

Other

















Grain Products


85-97

141









175 mL (frac34 cup) 121


150 g (34 cup) 116




175 mL (frac34 cup) 60-89


150 g (frac34 cup) 45-80



Nuts and Seeds










142


Phosphorus (P)







Fish and Seafood







Other


30 mL (2 Tbsp) 66



143


125 mL (12 cup) 138-150



Grains Products

Grains






Cereals










50 g (1 frac12 oz) 232-302


250 mL (1 cup) 217-272





144




Meat and Poultry


75 g (2 12 oz) 170-224





75 g (2 12 oz) 144-180



75 g (2 12 oz) 134-163


Organ Meat




Fish and Seafood








145






Meat Alternaves


150 g (34 cup) 380







75 g (2 12 oz) 251-258


75 g (2 12 oz) 155-258


175 mL (34 cup) 194-216

146


Tofu 150 g (frac34 cup) 146-204



175 mL (34 cup) 177-186



Nuts and Seeds


60 mL (14 cup) 676









147


Potassium (K)

Other




Vegetables




Fruit



Banana Medium 422




Miscellaneous



Fish and Seafood

148


Chromium (Cr)




Meat



Meat Alternaves







Vegetables

149


Copper (Cu)




Basil dried 1tsp 2



Fruits



Apple 1 medium 1

Banana 1 medium 1

Grains Products

Grains




Meat and Poultry


Other




150


Iodine (I)





Fruits



Organ Meat


Meat Alternaves



Nuts and Seeds


Other



151






Grain Products





Raisin bran 30 g 6

Other





125 mL (12 cup) 9





250 mL (1 cup) 52-62






152






Organ Meats


Fish and Seafood




Meat Alternaves



175 mL (34 cup) 46-53



153


Iron (Fe)


















Grains Products




40-43



154






Meat and Poultry










Organ Meats






Fish and Seafood




155






Meat Alternaves





175 mL (frac34 cup) 26-49



175 mL (frac34 cup) 19-35



75 g (25 oz) 15-28


156


Manganese (Mn)


60 ml (frac14 cup) 13-22






Miscellaneous





Vegetables

Garlic 136 g 23

Corn 166 g 08


Kale 67 g 05

Spinach 30 g 03

157


Fruits

Pineapple 165 g 15


Banana 1 medium 06


Grains Products

Grains



Rye cooked 169 g 45




Meat Alternaves


Tofu 126 g 15

Nuts and Seeds



Other

Cloves 6 g 2

158


Molybdenum (Mo)


FoodServing

Size CalsAmount

(mcg)DRIDV

()NutrientDensity

Worlds Healthiest

Foods RaCng



















Yogurt 1 cup 1494 1127 25 30 good

Peanuts 025 cup 2069 1077 24 21 good





159


Selenium (Se)

Cod 4 oz 964 386 9 16 good




125 mL (12 cup) 10-21

Grain Products





125 mL (frac12 cup) 19-20








250 mL (1 cup) 14-27



50 g (1 frac12 oz) 13


250 mL (1 cup) 8-10



50 g (1 frac12 oz) 7-9


160

Meat Alternaves








Fish and Seafood



75 g (2 frac12 oz) 12-66






161


Zinc (Zn)


Meat and Poultry


75 g (2 frac12 oz) 51-87



75 g (2 frac12 oz) 12-38




75 g (2 frac12 oz) 18-27



Grain Products






162






250 mL (1 cup) 10-11


Meats











Meat Alternaves


163






175 mL (frac34 cup) 11-19




175 mL (frac34 cup) 12-17






Fish and Seafood







164








165




2




3










Fat 20-35 44-78g

Protein 10-35 50-175g

4






5







6










Fat 20-35 44-78g

Protein 10-35 50-175g




136-227 3-5

7







227-318 6-8


318-454 8-10

Ultra-Endurance


454-545 10-12











8




References


9













10















11

Tables






12




13









14










Fat 20-35 44-78g

Protein 10-35 50-175g

15






16







17








Carbohydrate 45-65

Fat 20-35

Protein 10-35

18






19








20







21







22

References







23














Figures


24


Tables





25





26







27







28





29

Energy is released






30







31







32







33






34






35






36

References












37
















38














Figures


39





Module 4 Proteins

40




41






42

H H O

N ndash C ndash C

H R OH







AnCbodies

43






44






45










46







Fat 20-35 44-78g

Protein 10-35 50-175g



0-6 months 91

6-12 months 110

1-3 years 130

4-8 years 190

Males

9-13 years 340

14-18 years 520

19-70 years 560

Females

9-13 years 340

14-70 years 460


All ages 710

47

























48






49



References

50















51






Figures






52


Tables




Module 5 Fats


53




54











Fat 20-35 44-78g

Protein 10-35 50-175g

55






56








57








58




References




59









Figures




60



Tables





61





62










63



References








64




Module 7 Vitamins



65






66



Figure 1 Vitamin C












67




Figure 2 Vitamin B1




120 2000










68




Figure 3 Vitamin B2








69



Figure 4 Vitamin B3


















70


Figure 5 Vitamin B5













71



Figure 6 Vitamin B6









14-18 years (males) 13 100


72



Figure 7 Vitamin B7


19-50 13 100

Men 51+ 17 100

Women 51+ 15 100











73





Figure 8 Vitamin B9








74







1-3 years 150 300

4-8 years 200 400

9-13 years 300 600

14-18 years 400 800

19+ years 400 1000



75















76






Figure 10 Vitamin A




7-12 months 500 600

1-3 years 300 600

4-8 years 400 900

9-13 years 600 1700

14-18 years (male) 900 2800

14-18 years (female) 700 3000

77




Figure 11 Vitamin D

19+ years (male) 900 3000












78






Figure 12 Vitamin E









1-3 years 6 200

4-8 years 7 300

9-13 years 11 600

79





Figure 13 Vitamin K

14-18 years 15 800

19+ years 15 1000













80








Vitamin B3


81








82






83

References










84















85














Figures


86








87








88


Tables









89






90

Module 8 Minerals



91










7-12 months 260 1500

1-3 years 700 2500

4-8 years 1000 2500

9-13 years 1300 3000

14-18 years 1300 3000

19-50 years 1000 2500

51-70 years (males) 1000 2000

51-70 years (females) 1200 2000

71+ years 1200 2000

92











1-3 years 80 140

4-8 years 130 240

9-13 years 240 350

14-18 years (males) 410 350


19-30 years (males) 400 350


31-50 years (males) 420 350








93








1-3 years 460 140

4-8 years 500 240

9-18 years 1250 350

19-70 years 700 4000

71+ years 700 3000










94


























95













14-18 years 890 10000 (10mg)

19+ years 900 10000 (10mg)







1-3 years 90 200

4-8 years 90 300

9-13 years 120 600

14-18 years 150 900

96





19+ years 150 1100






7-12 months 11 40

1-3 years 7 40

4-8 years 10 40

9-13 years 8 40





50+ years 8 45






97






7-12 months 06 2

1-3 years 12 3

4-8 years 15 6












1-3 years 17 300

4-8 years 22 600

9-13 years 34 1100

14-18 years 43 1700

19+ years 45 2000



98







7-12 months 20 400

1-3 years 20 400

4-8 years 30 400

9-13 years 40 400

14-18 years 55 400

19-50 years 55 400

51+ years 55 400






7-12 months 3 5

1-3 years 3 7

4-8 years 5 12

9-13 years 8 23






99











100









101





Tables

102











103




Appendices


104


Vitamin C

105



Vegetables






















106




Fruit

Guava 1 fruit 206




Lychee 10 fruits 69




Clemenne 1 fruit 36





107


Vitamin B1




125 mL (frac12 cup) 14-17

Juice


125 mL (frac12 cup) 23 - 66








Vegetables



125 mL (12 cup) 025

108





Grain Products

Grains





125 mL (12 cup) 016 - 021

Cereals



060



022




1 bar (37 g) 037






1 slice (35 g) 008 ndash 017



109


Meat





75 g (2 frac12 oz) 019 ndash 038


Fish and Seafood







Meat Alternaves



75 g (2 frac12 oz) 200


75 g (2 frac12 oz) 070-096



175 mL (frac34 cup) 022 - 035



Nuts and Seeds


110


Vitamin B2


60 mL (frac14 cup) 016 - 032


60 mL (frac14 cup) 017 - 024



Others


15mL (1 Tbsp) 429



Vegetables


125 mL (frac12 cup) 02-06


Grain Products


11


02








111


175 g (frac34 cup) 02-04



50 g (1frac12 oz) 02



Meat




75 g (2frac12 oz) 02

Organ Meats


75 g (2frac12 oz) 16-27

Fish and Seafood






112


Vitamin B3


75 g (2frac12 oz) 02-03



Meat Alternaves


75 g (2frac12 oz) 05


150 g (34 cup) 05





Other


30 mL (2 Tbsp) 53


113




Grain Products



3-6








50 g (1 frac12 oz) 3-4


50 g (1 frac12 oz) 2-3




Meat


75 g (2frac12 oz) 10-17



75 g (2frac12 oz) 6-14



Fish and Seafood



114








Meat alternaves



75 g (2 frac12 oz) 10


60 mL (14 cup) 8


150 g (34 cup) 8



75 g (2 frac12 oz) 4-5








175 mL (34 cup) 3


175 mL (34 cup) 3

Other

115


Vitamin B5


5 mL (1 tsp) 8













Grain Products



10






Milk 2 250 mL (1 cup) 09


116


Vitamin B6

Meat




Fish and Seafood


Meat alternaves








Vegetables



1 medium 033



125 mL (12 cup) 023

Fruit

Banana 1 medium 043



117




Grain Products


1 waffle (33 g) 037



100 Bran 30 g 020




Organ Meat




Meat


75 g (2 frac12 oz) 046-057




Poultry

118



Fish and Seafood


75 g (2 frac12 oz) 078-084


75 g (2 frac12 oz) 071-074


75 g (2 frac12 oz) 049-057


75 g (2 frac12 oz) 029 - 047


75 g (2 frac12 oz) 035-036



75 g (2 frac12 oz) 029


Meat Alternaves



75 g (2 frac12 oz) 090

119







175 mL (34 cup) 084




150 g (34 cup) 030



Nuts and Seeds



60 mL (14 cup) 027-048


60 mL (14 cup) 016-026

120


Vitamin B9



Vegetables














Fruits




Grain Products


121







Meat Alternaves




175 mL (frac34 cup) 138-263



175 mL (frac34 cup) 157-218



75 g (2 frac12 oz) 59-77


75 g (2 frac12 oz) 59

122


Vitamin B12


Organ Meats




Miscellaneous


30 ml (2 Tbsp) 360

Food





Milk

33 homo 2 1 250 mL (1 cup) 12-14




Cheese


123



50 g (1 frac12 oz) 07-09


Yogurt




175 g (frac34 cup) 03-06


175 g (frac34 cup) 05


Milk Alternaves



Organ Meat







75 g (2 frac12 oz) 126-234


Poultry


Beef



124

Pork





Miscellaneous




75 g (2 frac12 oz) 04-20



Fish and Seafood










75 g (2 frac12 oz) 68





75 g (2 frac12 oz) 37


125


Vitamin A


75 g (2 frac12 oz) 22

Meat Alternaves


75 g (2 frac12 oz) 10-38




Other


250 mL (1 cup) 10



10



Vegetables


1 medium 1096


126












125 mL (frac12 cup) 267






Fruit


127





Cheese





50 g (1 frac12 oz) 132-158




Milk


33 homo 250 mL (1 cup) 119



Meat


128








Fish and Seafood









Meat Alternaves


Fats and Oils


129


Vitamin D









of milk) 103







Fish and Seafood

130














Roe raw 30 g (1 oz) 145




131


Vitamin E



Fats and Oils



Other



250 mL (1 cup) 85-90






132





Grains Products





Fish and Seafood





Nuts and Seeds


133


Vitamin K









Meat Alternaves



Fats and Oils



134

















135

















136






Grains Products








Other


137


Calcium (Ca)



Vegetables








Fruit

138


125 mL (frac12 cup) 155






250 mL (1 cup) 321-324


250 mL (1 cup) 291-322


302

Cheese


50 g (1frac12 oz) 396-506


50 g (1frac12 oz) 276-386


50 g (1frac12 oz) 252-366



Miscellaneous





139




Fish and Seafood


75 g (2 frac12 oz) 286


75 g (2 frac12 oz) 179-212



75 g (2 frac12 oz) 180


Meat Alternaves


150 g (frac34 cup) 302-525


175 mL (frac34 cup) 93-141





140


Magnesium (Mg)

Other

















Grain Products


85-97

141









175 mL (frac34 cup) 121


150 g (34 cup) 116




175 mL (frac34 cup) 60-89


150 g (frac34 cup) 45-80



Nuts and Seeds










142


Phosphorus (P)







Fish and Seafood







Other


30 mL (2 Tbsp) 66



143


125 mL (12 cup) 138-150



Grains Products

Grains






Cereals










50 g (1 frac12 oz) 232-302


250 mL (1 cup) 217-272





144




Meat and Poultry


75 g (2 12 oz) 170-224





75 g (2 12 oz) 144-180



75 g (2 12 oz) 134-163


Organ Meat




Fish and Seafood








145






Meat Alternaves


150 g (34 cup) 380







75 g (2 12 oz) 251-258


75 g (2 12 oz) 155-258


175 mL (34 cup) 194-216

146


Tofu 150 g (frac34 cup) 146-204



175 mL (34 cup) 177-186



Nuts and Seeds


60 mL (14 cup) 676









147


Potassium (K)

Other




Vegetables




Fruit



Banana Medium 422




Miscellaneous



Fish and Seafood

148


Chromium (Cr)




Meat



Meat Alternaves







Vegetables

149


Copper (Cu)




Basil dried 1tsp 2



Fruits



Apple 1 medium 1

Banana 1 medium 1

Grains Products

Grains




Meat and Poultry


Other




150


Iodine (I)





Fruits



Organ Meat


Meat Alternaves



Nuts and Seeds


Other



151






Grain Products





Raisin bran 30 g 6

Other





125 mL (12 cup) 9





250 mL (1 cup) 52-62






152






Organ Meats


Fish and Seafood




Meat Alternaves



175 mL (34 cup) 46-53



153


Iron (Fe)


















Grains Products




40-43



154






Meat and Poultry










Organ Meats






Fish and Seafood




155






Meat Alternaves





175 mL (frac34 cup) 26-49



175 mL (frac34 cup) 19-35



75 g (25 oz) 15-28


156


Manganese (Mn)


60 ml (frac14 cup) 13-22






Miscellaneous





Vegetables

Garlic 136 g 23

Corn 166 g 08


Kale 67 g 05

Spinach 30 g 03

157


Fruits

Pineapple 165 g 15


Banana 1 medium 06


Grains Products

Grains



Rye cooked 169 g 45




Meat Alternaves


Tofu 126 g 15

Nuts and Seeds



Other

Cloves 6 g 2

158


Molybdenum (Mo)


FoodServing

Size CalsAmount

(mcg)DRIDV

()NutrientDensity

Worlds Healthiest

Foods RaCng



















Yogurt 1 cup 1494 1127 25 30 good

Peanuts 025 cup 2069 1077 24 21 good





159


Selenium (Se)

Cod 4 oz 964 386 9 16 good




125 mL (12 cup) 10-21

Grain Products





125 mL (frac12 cup) 19-20








250 mL (1 cup) 14-27



50 g (1 frac12 oz) 13


250 mL (1 cup) 8-10



50 g (1 frac12 oz) 7-9


160

Meat Alternaves








Fish and Seafood



75 g (2 frac12 oz) 12-66






161


Zinc (Zn)


Meat and Poultry


75 g (2 frac12 oz) 51-87



75 g (2 frac12 oz) 12-38




75 g (2 frac12 oz) 18-27



Grain Products






162






250 mL (1 cup) 10-11


Meats











Meat Alternaves


163






175 mL (frac34 cup) 11-19




175 mL (frac34 cup) 12-17






Fish and Seafood







164








165




3










Fat 20-35 44-78g

Protein 10-35 50-175g

4






5







6










Fat 20-35 44-78g

Protein 10-35 50-175g




136-227 3-5

7







227-318 6-8


318-454 8-10

Ultra-Endurance


454-545 10-12











8




References


9













10















11

Tables






12




13









14










Fat 20-35 44-78g

Protein 10-35 50-175g

15






16







17








Carbohydrate 45-65

Fat 20-35

Protein 10-35

18






19








20







21







22

References







23














Figures


24


Tables





25





26







27







28





29

Energy is released






30







31







32







33






34






35






36

References












37
















38














Figures


39





Module 4 Proteins

40




41






42

H H O

N ndash C ndash C

H R OH







AnCbodies

43






44






45










46







Fat 20-35 44-78g

Protein 10-35 50-175g



0-6 months 91

6-12 months 110

1-3 years 130

4-8 years 190

Males

9-13 years 340

14-18 years 520

19-70 years 560

Females

9-13 years 340

14-70 years 460


All ages 710

47

























48






49



References

50















51






Figures






52


Tables




Module 5 Fats


53




54











Fat 20-35 44-78g

Protein 10-35 50-175g

55






56








57








58




References




59









Figures




60



Tables





61





62










63



References








64




Module 7 Vitamins



65






66



Figure 1 Vitamin C












67




Figure 2 Vitamin B1




120 2000










68




Figure 3 Vitamin B2








69



Figure 4 Vitamin B3


















70


Figure 5 Vitamin B5













71



Figure 6 Vitamin B6









14-18 years (males) 13 100


72



Figure 7 Vitamin B7


19-50 13 100

Men 51+ 17 100

Women 51+ 15 100











73





Figure 8 Vitamin B9








74







1-3 years 150 300

4-8 years 200 400

9-13 years 300 600

14-18 years 400 800

19+ years 400 1000



75















76






Figure 10 Vitamin A




7-12 months 500 600

1-3 years 300 600

4-8 years 400 900

9-13 years 600 1700

14-18 years (male) 900 2800

14-18 years (female) 700 3000

77




Figure 11 Vitamin D

19+ years (male) 900 3000












78






Figure 12 Vitamin E









1-3 years 6 200

4-8 years 7 300

9-13 years 11 600

79





Figure 13 Vitamin K

14-18 years 15 800

19+ years 15 1000













80








Vitamin B3


81








82






83

References










84















85














Figures


86








87








88


Tables









89






90

Module 8 Minerals



91










7-12 months 260 1500

1-3 years 700 2500

4-8 years 1000 2500

9-13 years 1300 3000

14-18 years 1300 3000

19-50 years 1000 2500

51-70 years (males) 1000 2000

51-70 years (females) 1200 2000

71+ years 1200 2000

92











1-3 years 80 140

4-8 years 130 240

9-13 years 240 350

14-18 years (males) 410 350


19-30 years (males) 400 350


31-50 years (males) 420 350








93








1-3 years 460 140

4-8 years 500 240

9-18 years 1250 350

19-70 years 700 4000

71+ years 700 3000










94


























95













14-18 years 890 10000 (10mg)

19+ years 900 10000 (10mg)







1-3 years 90 200

4-8 years 90 300

9-13 years 120 600

14-18 years 150 900

96





19+ years 150 1100






7-12 months 11 40

1-3 years 7 40

4-8 years 10 40

9-13 years 8 40





50+ years 8 45






97






7-12 months 06 2

1-3 years 12 3

4-8 years 15 6












1-3 years 17 300

4-8 years 22 600

9-13 years 34 1100

14-18 years 43 1700

19+ years 45 2000



98







7-12 months 20 400

1-3 years 20 400

4-8 years 30 400

9-13 years 40 400

14-18 years 55 400

19-50 years 55 400

51+ years 55 400






7-12 months 3 5

1-3 years 3 7

4-8 years 5 12

9-13 years 8 23






99











100









101





Tables

102











103




Appendices


104


Vitamin C

105



Vegetables






















106




Fruit

Guava 1 fruit 206




Lychee 10 fruits 69




Clemenne 1 fruit 36





107


Vitamin B1




125 mL (frac12 cup) 14-17

Juice


125 mL (frac12 cup) 23 - 66








Vegetables



125 mL (12 cup) 025

108





Grain Products

Grains





125 mL (12 cup) 016 - 021

Cereals



060



022




1 bar (37 g) 037






1 slice (35 g) 008 ndash 017



109


Meat





75 g (2 frac12 oz) 019 ndash 038


Fish and Seafood







Meat Alternaves



75 g (2 frac12 oz) 200


75 g (2 frac12 oz) 070-096



175 mL (frac34 cup) 022 - 035



Nuts and Seeds


110


Vitamin B2


60 mL (frac14 cup) 016 - 032


60 mL (frac14 cup) 017 - 024



Others


15mL (1 Tbsp) 429



Vegetables


125 mL (frac12 cup) 02-06


Grain Products


11


02








111


175 g (frac34 cup) 02-04



50 g (1frac12 oz) 02



Meat




75 g (2frac12 oz) 02

Organ Meats


75 g (2frac12 oz) 16-27

Fish and Seafood






112


Vitamin B3


75 g (2frac12 oz) 02-03



Meat Alternaves


75 g (2frac12 oz) 05


150 g (34 cup) 05





Other


30 mL (2 Tbsp) 53


113




Grain Products



3-6








50 g (1 frac12 oz) 3-4


50 g (1 frac12 oz) 2-3




Meat


75 g (2frac12 oz) 10-17



75 g (2frac12 oz) 6-14



Fish and Seafood



114








Meat alternaves



75 g (2 frac12 oz) 10


60 mL (14 cup) 8


150 g (34 cup) 8



75 g (2 frac12 oz) 4-5








175 mL (34 cup) 3


175 mL (34 cup) 3

Other

115


Vitamin B5


5 mL (1 tsp) 8













Grain Products



10






Milk 2 250 mL (1 cup) 09


116


Vitamin B6

Meat




Fish and Seafood


Meat alternaves








Vegetables



1 medium 033



125 mL (12 cup) 023

Fruit

Banana 1 medium 043



117




Grain Products


1 waffle (33 g) 037



100 Bran 30 g 020




Organ Meat




Meat


75 g (2 frac12 oz) 046-057




Poultry

118



Fish and Seafood


75 g (2 frac12 oz) 078-084


75 g (2 frac12 oz) 071-074


75 g (2 frac12 oz) 049-057


75 g (2 frac12 oz) 029 - 047


75 g (2 frac12 oz) 035-036



75 g (2 frac12 oz) 029


Meat Alternaves



75 g (2 frac12 oz) 090

119







175 mL (34 cup) 084




150 g (34 cup) 030



Nuts and Seeds



60 mL (14 cup) 027-048


60 mL (14 cup) 016-026

120


Vitamin B9



Vegetables














Fruits




Grain Products


121







Meat Alternaves




175 mL (frac34 cup) 138-263



175 mL (frac34 cup) 157-218



75 g (2 frac12 oz) 59-77


75 g (2 frac12 oz) 59

122


Vitamin B12


Organ Meats




Miscellaneous


30 ml (2 Tbsp) 360

Food





Milk

33 homo 2 1 250 mL (1 cup) 12-14




Cheese


123



50 g (1 frac12 oz) 07-09


Yogurt




175 g (frac34 cup) 03-06


175 g (frac34 cup) 05


Milk Alternaves



Organ Meat







75 g (2 frac12 oz) 126-234


Poultry


Beef



124

Pork





Miscellaneous




75 g (2 frac12 oz) 04-20



Fish and Seafood










75 g (2 frac12 oz) 68





75 g (2 frac12 oz) 37


125


Vitamin A


75 g (2 frac12 oz) 22

Meat Alternaves


75 g (2 frac12 oz) 10-38




Other


250 mL (1 cup) 10



10



Vegetables


1 medium 1096


126












125 mL (frac12 cup) 267






Fruit


127





Cheese





50 g (1 frac12 oz) 132-158




Milk


33 homo 250 mL (1 cup) 119



Meat


128








Fish and Seafood









Meat Alternaves


Fats and Oils


129


Vitamin D









of milk) 103







Fish and Seafood

130














Roe raw 30 g (1 oz) 145




131


Vitamin E



Fats and Oils



Other



250 mL (1 cup) 85-90






132





Grains Products





Fish and Seafood





Nuts and Seeds


133


Vitamin K









Meat Alternaves



Fats and Oils



134

















135

















136






Grains Products








Other


137


Calcium (Ca)



Vegetables








Fruit

138


125 mL (frac12 cup) 155






250 mL (1 cup) 321-324


250 mL (1 cup) 291-322


302

Cheese


50 g (1frac12 oz) 396-506


50 g (1frac12 oz) 276-386


50 g (1frac12 oz) 252-366



Miscellaneous





139




Fish and Seafood


75 g (2 frac12 oz) 286


75 g (2 frac12 oz) 179-212



75 g (2 frac12 oz) 180


Meat Alternaves


150 g (frac34 cup) 302-525


175 mL (frac34 cup) 93-141





140


Magnesium (Mg)

Other

















Grain Products


85-97

141









175 mL (frac34 cup) 121


150 g (34 cup) 116




175 mL (frac34 cup) 60-89


150 g (frac34 cup) 45-80



Nuts and Seeds










142


Phosphorus (P)







Fish and Seafood







Other


30 mL (2 Tbsp) 66



143


125 mL (12 cup) 138-150



Grains Products

Grains






Cereals










50 g (1 frac12 oz) 232-302


250 mL (1 cup) 217-272





144




Meat and Poultry


75 g (2 12 oz) 170-224





75 g (2 12 oz) 144-180



75 g (2 12 oz) 134-163


Organ Meat




Fish and Seafood








145






Meat Alternaves


150 g (34 cup) 380







75 g (2 12 oz) 251-258


75 g (2 12 oz) 155-258


175 mL (34 cup) 194-216

146


Tofu 150 g (frac34 cup) 146-204



175 mL (34 cup) 177-186



Nuts and Seeds


60 mL (14 cup) 676









147


Potassium (K)

Other




Vegetables




Fruit



Banana Medium 422




Miscellaneous



Fish and Seafood

148


Chromium (Cr)




Meat



Meat Alternaves







Vegetables

149


Copper (Cu)




Basil dried 1tsp 2



Fruits



Apple 1 medium 1

Banana 1 medium 1

Grains Products

Grains




Meat and Poultry


Other




150


Iodine (I)





Fruits



Organ Meat


Meat Alternaves



Nuts and Seeds


Other



151






Grain Products





Raisin bran 30 g 6

Other





125 mL (12 cup) 9





250 mL (1 cup) 52-62






152






Organ Meats


Fish and Seafood




Meat Alternaves



175 mL (34 cup) 46-53



153


Iron (Fe)


















Grains Products




40-43



154






Meat and Poultry










Organ Meats






Fish and Seafood




155






Meat Alternaves





175 mL (frac34 cup) 26-49



175 mL (frac34 cup) 19-35



75 g (25 oz) 15-28


156


Manganese (Mn)


60 ml (frac14 cup) 13-22






Miscellaneous





Vegetables

Garlic 136 g 23

Corn 166 g 08


Kale 67 g 05

Spinach 30 g 03

157


Fruits

Pineapple 165 g 15


Banana 1 medium 06


Grains Products

Grains



Rye cooked 169 g 45




Meat Alternaves


Tofu 126 g 15

Nuts and Seeds



Other

Cloves 6 g 2

158


Molybdenum (Mo)


FoodServing

Size CalsAmount

(mcg)DRIDV

()NutrientDensity

Worlds Healthiest

Foods RaCng



















Yogurt 1 cup 1494 1127 25 30 good

Peanuts 025 cup 2069 1077 24 21 good





159


Selenium (Se)

Cod 4 oz 964 386 9 16 good




125 mL (12 cup) 10-21

Grain Products





125 mL (frac12 cup) 19-20








250 mL (1 cup) 14-27



50 g (1 frac12 oz) 13


250 mL (1 cup) 8-10



50 g (1 frac12 oz) 7-9


160

Meat Alternaves








Fish and Seafood



75 g (2 frac12 oz) 12-66






161


Zinc (Zn)


Meat and Poultry


75 g (2 frac12 oz) 51-87



75 g (2 frac12 oz) 12-38




75 g (2 frac12 oz) 18-27



Grain Products






162






250 mL (1 cup) 10-11


Meats











Meat Alternaves


163






175 mL (frac34 cup) 11-19




175 mL (frac34 cup) 12-17






Fish and Seafood







164








165










Fat 20-35 44-78g

Protein 10-35 50-175g

4






5







6










Fat 20-35 44-78g

Protein 10-35 50-175g




136-227 3-5

7







227-318 6-8


318-454 8-10

Ultra-Endurance


454-545 10-12











8




References


9













10















11

Tables






12




13









14










Fat 20-35 44-78g

Protein 10-35 50-175g

15






16







17








Carbohydrate 45-65

Fat 20-35

Protein 10-35

18






19








20







21







22

References







23














Figures


24


Tables





25





26







27







28





29

Energy is released






30







31







32







33






34






35






36

References












37
















38














Figures


39





Module 4 Proteins

40




41






42

H H O

N ndash C ndash C

H R OH







AnCbodies

43






44






45










46







Fat 20-35 44-78g

Protein 10-35 50-175g



0-6 months 91

6-12 months 110

1-3 years 130

4-8 years 190

Males

9-13 years 340

14-18 years 520

19-70 years 560

Females

9-13 years 340

14-70 years 460


All ages 710

47

























48






49



References

50















51






Figures






52


Tables




Module 5 Fats


53




54











Fat 20-35 44-78g

Protein 10-35 50-175g

55






56








57








58




References




59









Figures




60



Tables





61





62










63



References








64




Module 7 Vitamins



65






66



Figure 1 Vitamin C












67




Figure 2 Vitamin B1




120 2000










68




Figure 3 Vitamin B2








69



Figure 4 Vitamin B3


















70


Figure 5 Vitamin B5













71



Figure 6 Vitamin B6









14-18 years (males) 13 100


72



Figure 7 Vitamin B7


19-50 13 100

Men 51+ 17 100

Women 51+ 15 100











73





Figure 8 Vitamin B9








74







1-3 years 150 300

4-8 years 200 400

9-13 years 300 600

14-18 years 400 800

19+ years 400 1000



75















76






Figure 10 Vitamin A




7-12 months 500 600

1-3 years 300 600

4-8 years 400 900

9-13 years 600 1700

14-18 years (male) 900 2800

14-18 years (female) 700 3000

77




Figure 11 Vitamin D

19+ years (male) 900 3000












78






Figure 12 Vitamin E









1-3 years 6 200

4-8 years 7 300

9-13 years 11 600

79





Figure 13 Vitamin K

14-18 years 15 800

19+ years 15 1000













80








Vitamin B3


81








82






83

References










84















85














Figures


86








87








88


Tables









89






90

Module 8 Minerals



91










7-12 months 260 1500

1-3 years 700 2500

4-8 years 1000 2500

9-13 years 1300 3000

14-18 years 1300 3000

19-50 years 1000 2500

51-70 years (males) 1000 2000

51-70 years (females) 1200 2000

71+ years 1200 2000

92











1-3 years 80 140

4-8 years 130 240

9-13 years 240 350

14-18 years (males) 410 350


19-30 years (males) 400 350


31-50 years (males) 420 350








93








1-3 years 460 140

4-8 years 500 240

9-18 years 1250 350

19-70 years 700 4000

71+ years 700 3000










94


























95













14-18 years 890 10000 (10mg)

19+ years 900 10000 (10mg)







1-3 years 90 200

4-8 years 90 300

9-13 years 120 600

14-18 years 150 900

96





19+ years 150 1100






7-12 months 11 40

1-3 years 7 40

4-8 years 10 40

9-13 years 8 40





50+ years 8 45






97






7-12 months 06 2

1-3 years 12 3

4-8 years 15 6












1-3 years 17 300

4-8 years 22 600

9-13 years 34 1100

14-18 years 43 1700

19+ years 45 2000



98







7-12 months 20 400

1-3 years 20 400

4-8 years 30 400

9-13 years 40 400

14-18 years 55 400

19-50 years 55 400

51+ years 55 400






7-12 months 3 5

1-3 years 3 7

4-8 years 5 12

9-13 years 8 23






99











100









101





Tables

102











103




Appendices


104


Vitamin C

105



Vegetables






















106




Fruit

Guava 1 fruit 206




Lychee 10 fruits 69




Clemenne 1 fruit 36





107


Vitamin B1




125 mL (frac12 cup) 14-17

Juice


125 mL (frac12 cup) 23 - 66








Vegetables



125 mL (12 cup) 025

108





Grain Products

Grains





125 mL (12 cup) 016 - 021

Cereals



060



022




1 bar (37 g) 037






1 slice (35 g) 008 ndash 017



109


Meat





75 g (2 frac12 oz) 019 ndash 038


Fish and Seafood







Meat Alternaves



75 g (2 frac12 oz) 200


75 g (2 frac12 oz) 070-096



175 mL (frac34 cup) 022 - 035



Nuts and Seeds


110


Vitamin B2


60 mL (frac14 cup) 016 - 032


60 mL (frac14 cup) 017 - 024



Others


15mL (1 Tbsp) 429



Vegetables


125 mL (frac12 cup) 02-06


Grain Products


11


02








111


175 g (frac34 cup) 02-04



50 g (1frac12 oz) 02



Meat




75 g (2frac12 oz) 02

Organ Meats


75 g (2frac12 oz) 16-27

Fish and Seafood






112


Vitamin B3


75 g (2frac12 oz) 02-03



Meat Alternaves


75 g (2frac12 oz) 05


150 g (34 cup) 05





Other


30 mL (2 Tbsp) 53


113




Grain Products



3-6








50 g (1 frac12 oz) 3-4


50 g (1 frac12 oz) 2-3




Meat


75 g (2frac12 oz) 10-17



75 g (2frac12 oz) 6-14



Fish and Seafood



114








Meat alternaves



75 g (2 frac12 oz) 10


60 mL (14 cup) 8


150 g (34 cup) 8



75 g (2 frac12 oz) 4-5








175 mL (34 cup) 3


175 mL (34 cup) 3

Other

115


Vitamin B5


5 mL (1 tsp) 8













Grain Products



10






Milk 2 250 mL (1 cup) 09


116


Vitamin B6

Meat




Fish and Seafood


Meat alternaves








Vegetables



1 medium 033



125 mL (12 cup) 023

Fruit

Banana 1 medium 043



117




Grain Products


1 waffle (33 g) 037



100 Bran 30 g 020




Organ Meat




Meat


75 g (2 frac12 oz) 046-057




Poultry

118



Fish and Seafood


75 g (2 frac12 oz) 078-084


75 g (2 frac12 oz) 071-074


75 g (2 frac12 oz) 049-057


75 g (2 frac12 oz) 029 - 047


75 g (2 frac12 oz) 035-036



75 g (2 frac12 oz) 029


Meat Alternaves



75 g (2 frac12 oz) 090

119







175 mL (34 cup) 084




150 g (34 cup) 030



Nuts and Seeds



60 mL (14 cup) 027-048


60 mL (14 cup) 016-026

120


Vitamin B9



Vegetables














Fruits




Grain Products


121







Meat Alternaves




175 mL (frac34 cup) 138-263



175 mL (frac34 cup) 157-218



75 g (2 frac12 oz) 59-77


75 g (2 frac12 oz) 59

122


Vitamin B12


Organ Meats




Miscellaneous


30 ml (2 Tbsp) 360

Food





Milk

33 homo 2 1 250 mL (1 cup) 12-14




Cheese


123



50 g (1 frac12 oz) 07-09


Yogurt




175 g (frac34 cup) 03-06


175 g (frac34 cup) 05


Milk Alternaves



Organ Meat







75 g (2 frac12 oz) 126-234


Poultry


Beef



124

Pork





Miscellaneous




75 g (2 frac12 oz) 04-20



Fish and Seafood










75 g (2 frac12 oz) 68





75 g (2 frac12 oz) 37


125


Vitamin A


75 g (2 frac12 oz) 22

Meat Alternaves


75 g (2 frac12 oz) 10-38




Other


250 mL (1 cup) 10



10



Vegetables


1 medium 1096


126












125 mL (frac12 cup) 267






Fruit


127





Cheese





50 g (1 frac12 oz) 132-158




Milk


33 homo 250 mL (1 cup) 119



Meat


128








Fish and Seafood









Meat Alternaves


Fats and Oils


129


Vitamin D









of milk) 103







Fish and Seafood

130














Roe raw 30 g (1 oz) 145




131


Vitamin E



Fats and Oils



Other



250 mL (1 cup) 85-90






132





Grains Products





Fish and Seafood





Nuts and Seeds


133


Vitamin K









Meat Alternaves



Fats and Oils



134

















135

















136






Grains Products








Other


137


Calcium (Ca)



Vegetables








Fruit

138


125 mL (frac12 cup) 155






250 mL (1 cup) 321-324


250 mL (1 cup) 291-322


302

Cheese


50 g (1frac12 oz) 396-506


50 g (1frac12 oz) 276-386


50 g (1frac12 oz) 252-366



Miscellaneous





139




Fish and Seafood


75 g (2 frac12 oz) 286


75 g (2 frac12 oz) 179-212



75 g (2 frac12 oz) 180


Meat Alternaves


150 g (frac34 cup) 302-525


175 mL (frac34 cup) 93-141





140


Magnesium (Mg)

Other

















Grain Products


85-97

141









175 mL (frac34 cup) 121


150 g (34 cup) 116




175 mL (frac34 cup) 60-89


150 g (frac34 cup) 45-80



Nuts and Seeds










142


Phosphorus (P)







Fish and Seafood







Other


30 mL (2 Tbsp) 66



143


125 mL (12 cup) 138-150



Grains Products

Grains






Cereals










50 g (1 frac12 oz) 232-302


250 mL (1 cup) 217-272





144




Meat and Poultry


75 g (2 12 oz) 170-224





75 g (2 12 oz) 144-180



75 g (2 12 oz) 134-163


Organ Meat




Fish and Seafood








145






Meat Alternaves


150 g (34 cup) 380







75 g (2 12 oz) 251-258


75 g (2 12 oz) 155-258


175 mL (34 cup) 194-216

146


Tofu 150 g (frac34 cup) 146-204



175 mL (34 cup) 177-186



Nuts and Seeds


60 mL (14 cup) 676









147


Potassium (K)

Other




Vegetables




Fruit



Banana Medium 422




Miscellaneous



Fish and Seafood

148


Chromium (Cr)




Meat



Meat Alternaves







Vegetables

149


Copper (Cu)




Basil dried 1tsp 2



Fruits



Apple 1 medium 1

Banana 1 medium 1

Grains Products

Grains




Meat and Poultry


Other




150


Iodine (I)





Fruits



Organ Meat


Meat Alternaves



Nuts and Seeds


Other



151






Grain Products





Raisin bran 30 g 6

Other





125 mL (12 cup) 9





250 mL (1 cup) 52-62






152






Organ Meats


Fish and Seafood




Meat Alternaves



175 mL (34 cup) 46-53



153


Iron (Fe)


















Grains Products




40-43



154






Meat and Poultry










Organ Meats






Fish and Seafood




155






Meat Alternaves





175 mL (frac34 cup) 26-49



175 mL (frac34 cup) 19-35



75 g (25 oz) 15-28


156


Manganese (Mn)


60 ml (frac14 cup) 13-22






Miscellaneous





Vegetables

Garlic 136 g 23

Corn 166 g 08


Kale 67 g 05

Spinach 30 g 03

157


Fruits

Pineapple 165 g 15


Banana 1 medium 06


Grains Products

Grains



Rye cooked 169 g 45




Meat Alternaves


Tofu 126 g 15

Nuts and Seeds



Other

Cloves 6 g 2

158


Molybdenum (Mo)


FoodServing

Size CalsAmount

(mcg)DRIDV

()NutrientDensity

Worlds Healthiest

Foods RaCng



















Yogurt 1 cup 1494 1127 25 30 good

Peanuts 025 cup 2069 1077 24 21 good





159


Selenium (Se)

Cod 4 oz 964 386 9 16 good




125 mL (12 cup) 10-21

Grain Products





125 mL (frac12 cup) 19-20








250 mL (1 cup) 14-27



50 g (1 frac12 oz) 13


250 mL (1 cup) 8-10



50 g (1 frac12 oz) 7-9


160

Meat Alternaves








Fish and Seafood



75 g (2 frac12 oz) 12-66






161


Zinc (Zn)


Meat and Poultry


75 g (2 frac12 oz) 51-87



75 g (2 frac12 oz) 12-38




75 g (2 frac12 oz) 18-27



Grain Products






162






250 mL (1 cup) 10-11


Meats











Meat Alternaves


163






175 mL (frac34 cup) 11-19




175 mL (frac34 cup) 12-17






Fish and Seafood







164








165






5







6










Fat 20-35 44-78g

Protein 10-35 50-175g




136-227 3-5

7







227-318 6-8


318-454 8-10

Ultra-Endurance


454-545 10-12











8




References


9













10















11

Tables






12




13









14










Fat 20-35 44-78g

Protein 10-35 50-175g

15






16







17








Carbohydrate 45-65

Fat 20-35

Protein 10-35

18






19








20







21







22

References







23














Figures


24


Tables





25





26







27







28





29

Energy is released






30







31







32







33






34






35






36

References












37
















38














Figures


39





Module 4 Proteins

40




41






42

H H O

N ndash C ndash C

H R OH







AnCbodies

43






44






45










46







Fat 20-35 44-78g

Protein 10-35 50-175g



0-6 months 91

6-12 months 110

1-3 years 130

4-8 years 190

Males

9-13 years 340

14-18 years 520

19-70 years 560

Females

9-13 years 340

14-70 years 460


All ages 710

47

























48






49



References

50















51






Figures






52


Tables




Module 5 Fats


53




54











Fat 20-35 44-78g

Protein 10-35 50-175g

55






56








57








58




References




59









Figures




60



Tables





61





62










63



References








64




Module 7 Vitamins



65






66



Figure 1 Vitamin C












67




Figure 2 Vitamin B1




120 2000










68




Figure 3 Vitamin B2








69



Figure 4 Vitamin B3


















70


Figure 5 Vitamin B5













71



Figure 6 Vitamin B6









14-18 years (males) 13 100


72



Figure 7 Vitamin B7


19-50 13 100

Men 51+ 17 100

Women 51+ 15 100











73





Figure 8 Vitamin B9








74







1-3 years 150 300

4-8 years 200 400

9-13 years 300 600

14-18 years 400 800

19+ years 400 1000



75















76






Figure 10 Vitamin A




7-12 months 500 600

1-3 years 300 600

4-8 years 400 900

9-13 years 600 1700

14-18 years (male) 900 2800

14-18 years (female) 700 3000

77




Figure 11 Vitamin D

19+ years (male) 900 3000












78






Figure 12 Vitamin E









1-3 years 6 200

4-8 years 7 300

9-13 years 11 600

79





Figure 13 Vitamin K

14-18 years 15 800

19+ years 15 1000













80








Vitamin B3


81








82






83

References










84















85














Figures


86








87








88


Tables









89






90

Module 8 Minerals



91










7-12 months 260 1500

1-3 years 700 2500

4-8 years 1000 2500

9-13 years 1300 3000

14-18 years 1300 3000

19-50 years 1000 2500

51-70 years (males) 1000 2000

51-70 years (females) 1200 2000

71+ years 1200 2000

92











1-3 years 80 140

4-8 years 130 240

9-13 years 240 350

14-18 years (males) 410 350


19-30 years (males) 400 350


31-50 years (males) 420 350








93








1-3 years 460 140

4-8 years 500 240

9-18 years 1250 350

19-70 years 700 4000

71+ years 700 3000










94


























95













14-18 years 890 10000 (10mg)

19+ years 900 10000 (10mg)







1-3 years 90 200

4-8 years 90 300

9-13 years 120 600

14-18 years 150 900

96





19+ years 150 1100






7-12 months 11 40

1-3 years 7 40

4-8 years 10 40

9-13 years 8 40





50+ years 8 45






97






7-12 months 06 2

1-3 years 12 3

4-8 years 15 6












1-3 years 17 300

4-8 years 22 600

9-13 years 34 1100

14-18 years 43 1700

19+ years 45 2000



98







7-12 months 20 400

1-3 years 20 400

4-8 years 30 400

9-13 years 40 400

14-18 years 55 400

19-50 years 55 400

51+ years 55 400






7-12 months 3 5

1-3 years 3 7

4-8 years 5 12

9-13 years 8 23






99











100









101





Tables

102











103




Appendices


104


Vitamin C

105



Vegetables






















106




Fruit

Guava 1 fruit 206




Lychee 10 fruits 69




Clemenne 1 fruit 36





107


Vitamin B1




125 mL (frac12 cup) 14-17

Juice


125 mL (frac12 cup) 23 - 66








Vegetables



125 mL (12 cup) 025

108





Grain Products

Grains





125 mL (12 cup) 016 - 021

Cereals



060



022




1 bar (37 g) 037






1 slice (35 g) 008 ndash 017



109


Meat





75 g (2 frac12 oz) 019 ndash 038


Fish and Seafood







Meat Alternaves



75 g (2 frac12 oz) 200


75 g (2 frac12 oz) 070-096



175 mL (frac34 cup) 022 - 035



Nuts and Seeds


110


Vitamin B2


60 mL (frac14 cup) 016 - 032


60 mL (frac14 cup) 017 - 024



Others


15mL (1 Tbsp) 429



Vegetables


125 mL (frac12 cup) 02-06


Grain Products


11


02








111


175 g (frac34 cup) 02-04



50 g (1frac12 oz) 02



Meat




75 g (2frac12 oz) 02

Organ Meats


75 g (2frac12 oz) 16-27

Fish and Seafood






112


Vitamin B3


75 g (2frac12 oz) 02-03



Meat Alternaves


75 g (2frac12 oz) 05


150 g (34 cup) 05





Other


30 mL (2 Tbsp) 53


113




Grain Products



3-6








50 g (1 frac12 oz) 3-4


50 g (1 frac12 oz) 2-3




Meat


75 g (2frac12 oz) 10-17



75 g (2frac12 oz) 6-14



Fish and Seafood



114








Meat alternaves



75 g (2 frac12 oz) 10


60 mL (14 cup) 8


150 g (34 cup) 8



75 g (2 frac12 oz) 4-5








175 mL (34 cup) 3


175 mL (34 cup) 3

Other

115


Vitamin B5


5 mL (1 tsp) 8













Grain Products



10






Milk 2 250 mL (1 cup) 09


116


Vitamin B6

Meat




Fish and Seafood


Meat alternaves








Vegetables



1 medium 033



125 mL (12 cup) 023

Fruit

Banana 1 medium 043



117




Grain Products


1 waffle (33 g) 037



100 Bran 30 g 020




Organ Meat




Meat


75 g (2 frac12 oz) 046-057




Poultry

118



Fish and Seafood


75 g (2 frac12 oz) 078-084


75 g (2 frac12 oz) 071-074


75 g (2 frac12 oz) 049-057


75 g (2 frac12 oz) 029 - 047


75 g (2 frac12 oz) 035-036



75 g (2 frac12 oz) 029


Meat Alternaves



75 g (2 frac12 oz) 090

119







175 mL (34 cup) 084




150 g (34 cup) 030



Nuts and Seeds



60 mL (14 cup) 027-048


60 mL (14 cup) 016-026

120


Vitamin B9



Vegetables














Fruits




Grain Products


121







Meat Alternaves




175 mL (frac34 cup) 138-263



175 mL (frac34 cup) 157-218



75 g (2 frac12 oz) 59-77


75 g (2 frac12 oz) 59

122


Vitamin B12


Organ Meats




Miscellaneous


30 ml (2 Tbsp) 360

Food





Milk

33 homo 2 1 250 mL (1 cup) 12-14




Cheese


123



50 g (1 frac12 oz) 07-09


Yogurt




175 g (frac34 cup) 03-06


175 g (frac34 cup) 05


Milk Alternaves



Organ Meat







75 g (2 frac12 oz) 126-234


Poultry


Beef



124

Pork





Miscellaneous




75 g (2 frac12 oz) 04-20



Fish and Seafood










75 g (2 frac12 oz) 68





75 g (2 frac12 oz) 37


125


Vitamin A


75 g (2 frac12 oz) 22

Meat Alternaves


75 g (2 frac12 oz) 10-38




Other


250 mL (1 cup) 10



10



Vegetables


1 medium 1096


126












125 mL (frac12 cup) 267






Fruit


127





Cheese





50 g (1 frac12 oz) 132-158




Milk


33 homo 250 mL (1 cup) 119



Meat


128








Fish and Seafood









Meat Alternaves


Fats and Oils


129


Vitamin D









of milk) 103







Fish and Seafood

130














Roe raw 30 g (1 oz) 145




131


Vitamin E



Fats and Oils



Other



250 mL (1 cup) 85-90






132





Grains Products





Fish and Seafood





Nuts and Seeds


133


Vitamin K









Meat Alternaves



Fats and Oils



134

















135

















136






Grains Products








Other


137


Calcium (Ca)



Vegetables








Fruit

138


125 mL (frac12 cup) 155






250 mL (1 cup) 321-324


250 mL (1 cup) 291-322


302

Cheese


50 g (1frac12 oz) 396-506


50 g (1frac12 oz) 276-386


50 g (1frac12 oz) 252-366



Miscellaneous





139




Fish and Seafood


75 g (2 frac12 oz) 286


75 g (2 frac12 oz) 179-212



75 g (2 frac12 oz) 180


Meat Alternaves


150 g (frac34 cup) 302-525


175 mL (frac34 cup) 93-141





140


Magnesium (Mg)

Other

















Grain Products


85-97

141









175 mL (frac34 cup) 121


150 g (34 cup) 116




175 mL (frac34 cup) 60-89


150 g (frac34 cup) 45-80



Nuts and Seeds










142


Phosphorus (P)







Fish and Seafood







Other


30 mL (2 Tbsp) 66



143


125 mL (12 cup) 138-150



Grains Products

Grains






Cereals










50 g (1 frac12 oz) 232-302


250 mL (1 cup) 217-272





144




Meat and Poultry


75 g (2 12 oz) 170-224





75 g (2 12 oz) 144-180



75 g (2 12 oz) 134-163


Organ Meat




Fish and Seafood








145






Meat Alternaves


150 g (34 cup) 380







75 g (2 12 oz) 251-258


75 g (2 12 oz) 155-258


175 mL (34 cup) 194-216

146


Tofu 150 g (frac34 cup) 146-204



175 mL (34 cup) 177-186



Nuts and Seeds


60 mL (14 cup) 676









147


Potassium (K)

Other




Vegetables




Fruit



Banana Medium 422




Miscellaneous



Fish and Seafood

148


Chromium (Cr)




Meat



Meat Alternaves







Vegetables

149


Copper (Cu)




Basil dried 1tsp 2



Fruits



Apple 1 medium 1

Banana 1 medium 1

Grains Products

Grains




Meat and Poultry


Other




150


Iodine (I)





Fruits



Organ Meat


Meat Alternaves



Nuts and Seeds


Other



151






Grain Products





Raisin bran 30 g 6

Other





125 mL (12 cup) 9





250 mL (1 cup) 52-62






152






Organ Meats


Fish and Seafood




Meat Alternaves



175 mL (34 cup) 46-53



153


Iron (Fe)


















Grains Products




40-43



154






Meat and Poultry










Organ Meats






Fish and Seafood




155






Meat Alternaves





175 mL (frac34 cup) 26-49



175 mL (frac34 cup) 19-35



75 g (25 oz) 15-28


156


Manganese (Mn)


60 ml (frac14 cup) 13-22






Miscellaneous





Vegetables

Garlic 136 g 23

Corn 166 g 08


Kale 67 g 05

Spinach 30 g 03

157


Fruits

Pineapple 165 g 15


Banana 1 medium 06


Grains Products

Grains



Rye cooked 169 g 45




Meat Alternaves


Tofu 126 g 15

Nuts and Seeds



Other

Cloves 6 g 2

158


Molybdenum (Mo)


FoodServing

Size CalsAmount

(mcg)DRIDV

()NutrientDensity

Worlds Healthiest

Foods RaCng



















Yogurt 1 cup 1494 1127 25 30 good

Peanuts 025 cup 2069 1077 24 21 good





159


Selenium (Se)

Cod 4 oz 964 386 9 16 good




125 mL (12 cup) 10-21

Grain Products





125 mL (frac12 cup) 19-20








250 mL (1 cup) 14-27



50 g (1 frac12 oz) 13


250 mL (1 cup) 8-10



50 g (1 frac12 oz) 7-9


160

Meat Alternaves








Fish and Seafood



75 g (2 frac12 oz) 12-66






161


Zinc (Zn)


Meat and Poultry


75 g (2 frac12 oz) 51-87



75 g (2 frac12 oz) 12-38




75 g (2 frac12 oz) 18-27



Grain Products






162






250 mL (1 cup) 10-11


Meats











Meat Alternaves


163






175 mL (frac34 cup) 11-19




175 mL (frac34 cup) 12-17






Fish and Seafood







164








165







6










Fat 20-35 44-78g

Protein 10-35 50-175g




136-227 3-5

7







227-318 6-8


318-454 8-10

Ultra-Endurance


454-545 10-12











8




References


9













10















11

Tables






12




13









14










Fat 20-35 44-78g

Protein 10-35 50-175g

15






16







17








Carbohydrate 45-65

Fat 20-35

Protein 10-35

18






19








20







21







22

References







23














Figures


24


Tables





25





26







27







28





29

Energy is released






30







31







32







33






34






35






36

References












37
















38














Figures


39





Module 4 Proteins

40




41






42

H H O

N ndash C ndash C

H R OH







AnCbodies

43






44






45










46







Fat 20-35 44-78g

Protein 10-35 50-175g



0-6 months 91

6-12 months 110

1-3 years 130

4-8 years 190

Males

9-13 years 340

14-18 years 520

19-70 years 560

Females

9-13 years 340

14-70 years 460


All ages 710

47

























48






49



References

50















51






Figures






52


Tables




Module 5 Fats


53




54











Fat 20-35 44-78g

Protein 10-35 50-175g

55






56








57








58




References




59









Figures




60



Tables





61





62










63



References








64




Module 7 Vitamins



65






66



Figure 1 Vitamin C












67




Figure 2 Vitamin B1




120 2000










68




Figure 3 Vitamin B2








69



Figure 4 Vitamin B3


















70


Figure 5 Vitamin B5













71



Figure 6 Vitamin B6









14-18 years (males) 13 100


72



Figure 7 Vitamin B7


19-50 13 100

Men 51+ 17 100

Women 51+ 15 100











73





Figure 8 Vitamin B9








74







1-3 years 150 300

4-8 years 200 400

9-13 years 300 600

14-18 years 400 800

19+ years 400 1000



75















76






Figure 10 Vitamin A




7-12 months 500 600

1-3 years 300 600

4-8 years 400 900

9-13 years 600 1700

14-18 years (male) 900 2800

14-18 years (female) 700 3000

77




Figure 11 Vitamin D

19+ years (male) 900 3000












78






Figure 12 Vitamin E









1-3 years 6 200

4-8 years 7 300

9-13 years 11 600

79





Figure 13 Vitamin K

14-18 years 15 800

19+ years 15 1000













80








Vitamin B3


81








82






83

References










84















85














Figures


86








87








88


Tables









89






90

Module 8 Minerals



91










7-12 months 260 1500

1-3 years 700 2500

4-8 years 1000 2500

9-13 years 1300 3000

14-18 years 1300 3000

19-50 years 1000 2500

51-70 years (males) 1000 2000

51-70 years (females) 1200 2000

71+ years 1200 2000

92











1-3 years 80 140

4-8 years 130 240

9-13 years 240 350

14-18 years (males) 410 350


19-30 years (males) 400 350


31-50 years (males) 420 350








93








1-3 years 460 140

4-8 years 500 240

9-18 years 1250 350

19-70 years 700 4000

71+ years 700 3000










94


























95













14-18 years 890 10000 (10mg)

19+ years 900 10000 (10mg)







1-3 years 90 200

4-8 years 90 300

9-13 years 120 600

14-18 years 150 900

96





19+ years 150 1100






7-12 months 11 40

1-3 years 7 40

4-8 years 10 40

9-13 years 8 40





50+ years 8 45






97






7-12 months 06 2

1-3 years 12 3

4-8 years 15 6












1-3 years 17 300

4-8 years 22 600

9-13 years 34 1100

14-18 years 43 1700

19+ years 45 2000



98







7-12 months 20 400

1-3 years 20 400

4-8 years 30 400

9-13 years 40 400

14-18 years 55 400

19-50 years 55 400

51+ years 55 400






7-12 months 3 5

1-3 years 3 7

4-8 years 5 12

9-13 years 8 23






99











100









101





Tables

102











103




Appendices


104


Vitamin C

105



Vegetables






















106




Fruit

Guava 1 fruit 206




Lychee 10 fruits 69




Clemenne 1 fruit 36





107


Vitamin B1




125 mL (frac12 cup) 14-17

Juice


125 mL (frac12 cup) 23 - 66








Vegetables



125 mL (12 cup) 025

108





Grain Products

Grains





125 mL (12 cup) 016 - 021

Cereals



060



022




1 bar (37 g) 037






1 slice (35 g) 008 ndash 017



109


Meat





75 g (2 frac12 oz) 019 ndash 038


Fish and Seafood







Meat Alternaves



75 g (2 frac12 oz) 200


75 g (2 frac12 oz) 070-096



175 mL (frac34 cup) 022 - 035



Nuts and Seeds


110


Vitamin B2


60 mL (frac14 cup) 016 - 032


60 mL (frac14 cup) 017 - 024



Others


15mL (1 Tbsp) 429



Vegetables


125 mL (frac12 cup) 02-06


Grain Products


11


02








111


175 g (frac34 cup) 02-04



50 g (1frac12 oz) 02



Meat




75 g (2frac12 oz) 02

Organ Meats


75 g (2frac12 oz) 16-27

Fish and Seafood






112


Vitamin B3


75 g (2frac12 oz) 02-03



Meat Alternaves


75 g (2frac12 oz) 05


150 g (34 cup) 05





Other


30 mL (2 Tbsp) 53


113




Grain Products



3-6








50 g (1 frac12 oz) 3-4


50 g (1 frac12 oz) 2-3




Meat


75 g (2frac12 oz) 10-17



75 g (2frac12 oz) 6-14



Fish and Seafood



114








Meat alternaves



75 g (2 frac12 oz) 10


60 mL (14 cup) 8


150 g (34 cup) 8



75 g (2 frac12 oz) 4-5








175 mL (34 cup) 3


175 mL (34 cup) 3

Other

115


Vitamin B5


5 mL (1 tsp) 8













Grain Products



10






Milk 2 250 mL (1 cup) 09


116


Vitamin B6

Meat




Fish and Seafood


Meat alternaves








Vegetables



1 medium 033



125 mL (12 cup) 023

Fruit

Banana 1 medium 043



117




Grain Products


1 waffle (33 g) 037



100 Bran 30 g 020




Organ Meat




Meat


75 g (2 frac12 oz) 046-057




Poultry

118



Fish and Seafood


75 g (2 frac12 oz) 078-084


75 g (2 frac12 oz) 071-074


75 g (2 frac12 oz) 049-057


75 g (2 frac12 oz) 029 - 047


75 g (2 frac12 oz) 035-036



75 g (2 frac12 oz) 029


Meat Alternaves



75 g (2 frac12 oz) 090

119







175 mL (34 cup) 084




150 g (34 cup) 030



Nuts and Seeds



60 mL (14 cup) 027-048


60 mL (14 cup) 016-026

120


Vitamin B9



Vegetables














Fruits




Grain Products


121







Meat Alternaves




175 mL (frac34 cup) 138-263



175 mL (frac34 cup) 157-218



75 g (2 frac12 oz) 59-77


75 g (2 frac12 oz) 59

122


Vitamin B12


Organ Meats




Miscellaneous


30 ml (2 Tbsp) 360

Food





Milk

33 homo 2 1 250 mL (1 cup) 12-14




Cheese


123



50 g (1 frac12 oz) 07-09


Yogurt




175 g (frac34 cup) 03-06


175 g (frac34 cup) 05


Milk Alternaves



Organ Meat







75 g (2 frac12 oz) 126-234


Poultry


Beef



124

Pork





Miscellaneous




75 g (2 frac12 oz) 04-20



Fish and Seafood










75 g (2 frac12 oz) 68





75 g (2 frac12 oz) 37


125


Vitamin A


75 g (2 frac12 oz) 22

Meat Alternaves


75 g (2 frac12 oz) 10-38




Other


250 mL (1 cup) 10



10



Vegetables


1 medium 1096


126












125 mL (frac12 cup) 267






Fruit


127





Cheese





50 g (1 frac12 oz) 132-158




Milk


33 homo 250 mL (1 cup) 119



Meat


128








Fish and Seafood









Meat Alternaves


Fats and Oils


129


Vitamin D









of milk) 103







Fish and Seafood

130














Roe raw 30 g (1 oz) 145




131


Vitamin E



Fats and Oils



Other



250 mL (1 cup) 85-90






132





Grains Products





Fish and Seafood





Nuts and Seeds


133


Vitamin K









Meat Alternaves



Fats and Oils



134

















135

















136






Grains Products








Other


137


Calcium (Ca)



Vegetables








Fruit

138


125 mL (frac12 cup) 155






250 mL (1 cup) 321-324


250 mL (1 cup) 291-322


302

Cheese


50 g (1frac12 oz) 396-506


50 g (1frac12 oz) 276-386


50 g (1frac12 oz) 252-366



Miscellaneous





139




Fish and Seafood


75 g (2 frac12 oz) 286


75 g (2 frac12 oz) 179-212



75 g (2 frac12 oz) 180


Meat Alternaves


150 g (frac34 cup) 302-525


175 mL (frac34 cup) 93-141





140


Magnesium (Mg)

Other

















Grain Products


85-97

141









175 mL (frac34 cup) 121


150 g (34 cup) 116




175 mL (frac34 cup) 60-89


150 g (frac34 cup) 45-80



Nuts and Seeds










142


Phosphorus (P)







Fish and Seafood







Other


30 mL (2 Tbsp) 66



143


125 mL (12 cup) 138-150



Grains Products

Grains






Cereals










50 g (1 frac12 oz) 232-302


250 mL (1 cup) 217-272





144




Meat and Poultry


75 g (2 12 oz) 170-224





75 g (2 12 oz) 144-180



75 g (2 12 oz) 134-163


Organ Meat




Fish and Seafood








145






Meat Alternaves


150 g (34 cup) 380







75 g (2 12 oz) 251-258


75 g (2 12 oz) 155-258


175 mL (34 cup) 194-216

146


Tofu 150 g (frac34 cup) 146-204



175 mL (34 cup) 177-186



Nuts and Seeds


60 mL (14 cup) 676









147


Potassium (K)

Other




Vegetables




Fruit



Banana Medium 422




Miscellaneous



Fish and Seafood

148


Chromium (Cr)




Meat



Meat Alternaves







Vegetables

149


Copper (Cu)




Basil dried 1tsp 2



Fruits



Apple 1 medium 1

Banana 1 medium 1

Grains Products

Grains




Meat and Poultry


Other




150


Iodine (I)





Fruits



Organ Meat


Meat Alternaves



Nuts and Seeds


Other



151






Grain Products





Raisin bran 30 g 6

Other





125 mL (12 cup) 9





250 mL (1 cup) 52-62






152






Organ Meats


Fish and Seafood




Meat Alternaves



175 mL (34 cup) 46-53



153


Iron (Fe)


















Grains Products




40-43



154






Meat and Poultry










Organ Meats






Fish and Seafood




155






Meat Alternaves





175 mL (frac34 cup) 26-49



175 mL (frac34 cup) 19-35



75 g (25 oz) 15-28


156


Manganese (Mn)


60 ml (frac14 cup) 13-22






Miscellaneous





Vegetables

Garlic 136 g 23

Corn 166 g 08


Kale 67 g 05

Spinach 30 g 03

157


Fruits

Pineapple 165 g 15


Banana 1 medium 06


Grains Products

Grains



Rye cooked 169 g 45




Meat Alternaves


Tofu 126 g 15

Nuts and Seeds



Other

Cloves 6 g 2

158


Molybdenum (Mo)


FoodServing

Size CalsAmount

(mcg)DRIDV

()NutrientDensity

Worlds Healthiest

Foods RaCng



















Yogurt 1 cup 1494 1127 25 30 good

Peanuts 025 cup 2069 1077 24 21 good





159


Selenium (Se)

Cod 4 oz 964 386 9 16 good




125 mL (12 cup) 10-21

Grain Products





125 mL (frac12 cup) 19-20








250 mL (1 cup) 14-27



50 g (1 frac12 oz) 13


250 mL (1 cup) 8-10



50 g (1 frac12 oz) 7-9


160

Meat Alternaves








Fish and Seafood



75 g (2 frac12 oz) 12-66






161


Zinc (Zn)


Meat and Poultry


75 g (2 frac12 oz) 51-87



75 g (2 frac12 oz) 12-38




75 g (2 frac12 oz) 18-27



Grain Products






162






250 mL (1 cup) 10-11


Meats











Meat Alternaves


163






175 mL (frac34 cup) 11-19




175 mL (frac34 cup) 12-17






Fish and Seafood







164








165










Fat 20-35 44-78g

Protein 10-35 50-175g




136-227 3-5

7







227-318 6-8


318-454 8-10

Ultra-Endurance


454-545 10-12











8




References


9













10















11

Tables






12




13









14










Fat 20-35 44-78g

Protein 10-35 50-175g

15






16







17








Carbohydrate 45-65

Fat 20-35

Protein 10-35

18






19








20







21







22

References







23














Figures


24


Tables





25





26







27







28





29

Energy is released






30







31







32







33






34






35






36

References












37
















38














Figures


39





Module 4 Proteins

40




41






42

H H O

N ndash C ndash C

H R OH







AnCbodies

43






44






45










46







Fat 20-35 44-78g

Protein 10-35 50-175g



0-6 months 91

6-12 months 110

1-3 years 130

4-8 years 190

Males

9-13 years 340

14-18 years 520

19-70 years 560

Females

9-13 years 340

14-70 years 460


All ages 710

47

























48






49



References

50















51






Figures






52


Tables




Module 5 Fats


53




54











Fat 20-35 44-78g

Protein 10-35 50-175g

55






56








57








58




References




59









Figures




60



Tables





61





62










63



References








64




Module 7 Vitamins



65






66



Figure 1 Vitamin C












67




Figure 2 Vitamin B1




120 2000










68




Figure 3 Vitamin B2








69



Figure 4 Vitamin B3


















70


Figure 5 Vitamin B5













71



Figure 6 Vitamin B6









14-18 years (males) 13 100


72



Figure 7 Vitamin B7


19-50 13 100

Men 51+ 17 100

Women 51+ 15 100











73





Figure 8 Vitamin B9








74







1-3 years 150 300

4-8 years 200 400

9-13 years 300 600

14-18 years 400 800

19+ years 400 1000



75















76






Figure 10 Vitamin A




7-12 months 500 600

1-3 years 300 600

4-8 years 400 900

9-13 years 600 1700

14-18 years (male) 900 2800

14-18 years (female) 700 3000

77




Figure 11 Vitamin D

19+ years (male) 900 3000












78






Figure 12 Vitamin E









1-3 years 6 200

4-8 years 7 300

9-13 years 11 600

79





Figure 13 Vitamin K

14-18 years 15 800

19+ years 15 1000













80








Vitamin B3


81








82






83

References










84















85














Figures


86








87








88


Tables









89






90

Module 8 Minerals



91










7-12 months 260 1500

1-3 years 700 2500

4-8 years 1000 2500

9-13 years 1300 3000

14-18 years 1300 3000

19-50 years 1000 2500

51-70 years (males) 1000 2000

51-70 years (females) 1200 2000

71+ years 1200 2000

92











1-3 years 80 140

4-8 years 130 240

9-13 years 240 350

14-18 years (males) 410 350


19-30 years (males) 400 350


31-50 years (males) 420 350








93








1-3 years 460 140

4-8 years 500 240

9-18 years 1250 350

19-70 years 700 4000

71+ years 700 3000










94


























95













14-18 years 890 10000 (10mg)

19+ years 900 10000 (10mg)







1-3 years 90 200

4-8 years 90 300

9-13 years 120 600

14-18 years 150 900

96





19+ years 150 1100






7-12 months 11 40

1-3 years 7 40

4-8 years 10 40

9-13 years 8 40





50+ years 8 45






97






7-12 months 06 2

1-3 years 12 3

4-8 years 15 6












1-3 years 17 300

4-8 years 22 600

9-13 years 34 1100

14-18 years 43 1700

19+ years 45 2000



98







7-12 months 20 400

1-3 years 20 400

4-8 years 30 400

9-13 years 40 400

14-18 years 55 400

19-50 years 55 400

51+ years 55 400






7-12 months 3 5

1-3 years 3 7

4-8 years 5 12

9-13 years 8 23






99











100









101





Tables

102











103




Appendices


104


Vitamin C

105



Vegetables






















106




Fruit

Guava 1 fruit 206




Lychee 10 fruits 69




Clemenne 1 fruit 36





107


Vitamin B1




125 mL (frac12 cup) 14-17

Juice


125 mL (frac12 cup) 23 - 66








Vegetables



125 mL (12 cup) 025

108





Grain Products

Grains





125 mL (12 cup) 016 - 021

Cereals



060



022




1 bar (37 g) 037






1 slice (35 g) 008 ndash 017



109


Meat





75 g (2 frac12 oz) 019 ndash 038


Fish and Seafood







Meat Alternaves



75 g (2 frac12 oz) 200


75 g (2 frac12 oz) 070-096



175 mL (frac34 cup) 022 - 035



Nuts and Seeds


110


Vitamin B2


60 mL (frac14 cup) 016 - 032


60 mL (frac14 cup) 017 - 024



Others


15mL (1 Tbsp) 429



Vegetables


125 mL (frac12 cup) 02-06


Grain Products


11


02








111


175 g (frac34 cup) 02-04



50 g (1frac12 oz) 02



Meat




75 g (2frac12 oz) 02

Organ Meats


75 g (2frac12 oz) 16-27

Fish and Seafood






112


Vitamin B3


75 g (2frac12 oz) 02-03



Meat Alternaves


75 g (2frac12 oz) 05


150 g (34 cup) 05





Other


30 mL (2 Tbsp) 53


113




Grain Products



3-6








50 g (1 frac12 oz) 3-4


50 g (1 frac12 oz) 2-3




Meat


75 g (2frac12 oz) 10-17



75 g (2frac12 oz) 6-14



Fish and Seafood



114








Meat alternaves



75 g (2 frac12 oz) 10


60 mL (14 cup) 8


150 g (34 cup) 8



75 g (2 frac12 oz) 4-5








175 mL (34 cup) 3


175 mL (34 cup) 3

Other

115


Vitamin B5


5 mL (1 tsp) 8













Grain Products



10






Milk 2 250 mL (1 cup) 09


116


Vitamin B6

Meat




Fish and Seafood


Meat alternaves








Vegetables



1 medium 033



125 mL (12 cup) 023

Fruit

Banana 1 medium 043



117




Grain Products


1 waffle (33 g) 037



100 Bran 30 g 020




Organ Meat




Meat


75 g (2 frac12 oz) 046-057




Poultry

118



Fish and Seafood


75 g (2 frac12 oz) 078-084


75 g (2 frac12 oz) 071-074


75 g (2 frac12 oz) 049-057


75 g (2 frac12 oz) 029 - 047


75 g (2 frac12 oz) 035-036



75 g (2 frac12 oz) 029


Meat Alternaves



75 g (2 frac12 oz) 090

119







175 mL (34 cup) 084




150 g (34 cup) 030



Nuts and Seeds



60 mL (14 cup) 027-048


60 mL (14 cup) 016-026

120


Vitamin B9



Vegetables














Fruits




Grain Products


121







Meat Alternaves




175 mL (frac34 cup) 138-263



175 mL (frac34 cup) 157-218



75 g (2 frac12 oz) 59-77


75 g (2 frac12 oz) 59

122


Vitamin B12


Organ Meats




Miscellaneous


30 ml (2 Tbsp) 360

Food





Milk

33 homo 2 1 250 mL (1 cup) 12-14




Cheese


123



50 g (1 frac12 oz) 07-09


Yogurt




175 g (frac34 cup) 03-06


175 g (frac34 cup) 05


Milk Alternaves



Organ Meat







75 g (2 frac12 oz) 126-234


Poultry


Beef



124

Pork





Miscellaneous




75 g (2 frac12 oz) 04-20



Fish and Seafood










75 g (2 frac12 oz) 68





75 g (2 frac12 oz) 37


125


Vitamin A


75 g (2 frac12 oz) 22

Meat Alternaves


75 g (2 frac12 oz) 10-38




Other


250 mL (1 cup) 10



10



Vegetables


1 medium 1096


126












125 mL (frac12 cup) 267






Fruit


127





Cheese





50 g (1 frac12 oz) 132-158




Milk


33 homo 250 mL (1 cup) 119



Meat


128








Fish and Seafood









Meat Alternaves


Fats and Oils


129


Vitamin D









of milk) 103







Fish and Seafood

130














Roe raw 30 g (1 oz) 145




131


Vitamin E



Fats and Oils



Other



250 mL (1 cup) 85-90






132





Grains Products





Fish and Seafood





Nuts and Seeds


133


Vitamin K









Meat Alternaves



Fats and Oils



134

















135

















136






Grains Products








Other


137


Calcium (Ca)



Vegetables








Fruit

138


125 mL (frac12 cup) 155






250 mL (1 cup) 321-324


250 mL (1 cup) 291-322


302

Cheese


50 g (1frac12 oz) 396-506


50 g (1frac12 oz) 276-386


50 g (1frac12 oz) 252-366



Miscellaneous





139




Fish and Seafood


75 g (2 frac12 oz) 286


75 g (2 frac12 oz) 179-212



75 g (2 frac12 oz) 180


Meat Alternaves


150 g (frac34 cup) 302-525


175 mL (frac34 cup) 93-141





140


Magnesium (Mg)

Other

















Grain Products


85-97

141









175 mL (frac34 cup) 121


150 g (34 cup) 116




175 mL (frac34 cup) 60-89


150 g (frac34 cup) 45-80



Nuts and Seeds










142


Phosphorus (P)







Fish and Seafood







Other


30 mL (2 Tbsp) 66



143


125 mL (12 cup) 138-150



Grains Products

Grains






Cereals










50 g (1 frac12 oz) 232-302


250 mL (1 cup) 217-272





144




Meat and Poultry


75 g (2 12 oz) 170-224





75 g (2 12 oz) 144-180



75 g (2 12 oz) 134-163


Organ Meat




Fish and Seafood








145






Meat Alternaves


150 g (34 cup) 380







75 g (2 12 oz) 251-258


75 g (2 12 oz) 155-258


175 mL (34 cup) 194-216

146


Tofu 150 g (frac34 cup) 146-204



175 mL (34 cup) 177-186



Nuts and Seeds


60 mL (14 cup) 676









147


Potassium (K)

Other




Vegetables




Fruit



Banana Medium 422




Miscellaneous



Fish and Seafood

148


Chromium (Cr)




Meat



Meat Alternaves







Vegetables

149


Copper (Cu)




Basil dried 1tsp 2



Fruits



Apple 1 medium 1

Banana 1 medium 1

Grains Products

Grains




Meat and Poultry


Other




150


Iodine (I)





Fruits



Organ Meat


Meat Alternaves



Nuts and Seeds


Other



151






Grain Products





Raisin bran 30 g 6

Other





125 mL (12 cup) 9





250 mL (1 cup) 52-62






152






Organ Meats


Fish and Seafood




Meat Alternaves



175 mL (34 cup) 46-53



153


Iron (Fe)


















Grains Products




40-43



154






Meat and Poultry










Organ Meats






Fish and Seafood




155






Meat Alternaves





175 mL (frac34 cup) 26-49



175 mL (frac34 cup) 19-35



75 g (25 oz) 15-28


156


Manganese (Mn)


60 ml (frac14 cup) 13-22






Miscellaneous





Vegetables

Garlic 136 g 23

Corn 166 g 08


Kale 67 g 05

Spinach 30 g 03

157


Fruits

Pineapple 165 g 15


Banana 1 medium 06


Grains Products

Grains



Rye cooked 169 g 45




Meat Alternaves


Tofu 126 g 15

Nuts and Seeds



Other

Cloves 6 g 2

158


Molybdenum (Mo)


FoodServing

Size CalsAmount

(mcg)DRIDV

()NutrientDensity

Worlds Healthiest

Foods RaCng



















Yogurt 1 cup 1494 1127 25 30 good

Peanuts 025 cup 2069 1077 24 21 good





159


Selenium (Se)

Cod 4 oz 964 386 9 16 good




125 mL (12 cup) 10-21

Grain Products





125 mL (frac12 cup) 19-20








250 mL (1 cup) 14-27



50 g (1 frac12 oz) 13


250 mL (1 cup) 8-10



50 g (1 frac12 oz) 7-9


160

Meat Alternaves








Fish and Seafood



75 g (2 frac12 oz) 12-66






161


Zinc (Zn)


Meat and Poultry


75 g (2 frac12 oz) 51-87



75 g (2 frac12 oz) 12-38




75 g (2 frac12 oz) 18-27



Grain Products






162






250 mL (1 cup) 10-11


Meats











Meat Alternaves


163






175 mL (frac34 cup) 11-19




175 mL (frac34 cup) 12-17






Fish and Seafood







164








165

Documents

Nutrition Breakdown - Relatable Applied Nutrition for the