CHAPTER 5
Some Key Nutrients
Much of what we know about the impact of single nutrients has been learned through the study of deficiencies. The classic investigation of a deficiency, and one of the first scientific nutrition experiments, was conducted in 1747 by a physician in the British Navy, who believed that citrus could prevent scurvy, a disease of malnutrition that was a terrible scourge for sailors who spent long periods of time at sea without fresh fruit or vegetables. It would take decades before the significance of the experiment was widely appreciated, but eventually, the consumption of citrus on ships to prevent scurvy gave rise to the slang term "limey" for British sailors.
Other common deficiencies include pellagra, caused by a niacin deficiency; kwashiorkor, a form of malnutrition caused by insufficient protein; beriberi, caused by a thiamine deficiency and often a consequence of eating only polished white rice; rickets, the result of inadequate mineralization of bone caused by a vitamin D deficiency or defect in its metabolism; and iodine deficiency, which is the most common cause of preventable mental retardation and brain damage worldwide.
Anemia caused by insufficient iron, according to international health organizations, is currently the most common deficiency overall, affecting 700 million worldwide. In some developing countries the immediate cause of the deficiency may be blood loss, a consequence of hookworm infestation, for example, but in many other countries it is caused by not getting enough of this mineral in the diet.
Iron is also a good example of the balance that must be struck in a diet, particularly an infant's diet. There is very little iron in breast milk, but what is there is easily absorbed by the infant. While iron is indeed essential for the production of red blood cells as well as the development and regulation of other organ systems, iron can also fuel the growth of pathogenic bacteria in a baby's gut. Breast milk provides enough iron to meet the infant's needs, but not enough to encourage disease-causing microbes. And in fact, there is a key protein, lactoferrin, also present in breast milk, which binds to iron in order to maintain this balance.
The more researchers learn about infant nutrition, the more examples we have of the critical role played by micronutrients. Occasionally, says registered dietitian Julie Balay, this can be the source of debate. "There are two issues with breast milk that are controversial, and those are fluoride and vitamin D. Even if the mother drinks fluoridated water, it doesn't show up in breast milk. And often we find that vitamin D is at very low levels in mothers." So this raises the question: should we fortify breastfed babies with fluoride and vitamin D?
"It's controversial, because on one hand you think, well, it's breast milk. It must be perfect," says Balay. "But on the other hand, we now know a lot more about nutrition than we used to. We didn't use to live as long as we do now; maybe we need fluoride to make our teeth last 80 years." The issue with vitamin D, explains Balay, is trickier. "We know that vitamin D has hormonal effects on the body and that it is also critical for the proper absorption of calcium. The concern is whether all babies get enough in breast milk. Well, we now we have recommendations that all breastfed babies be given vitamin D."
A pregnent woman doesn't need to eat the same diet as a newborn to assure that all the right nutrients get to the baby. Some of the necessary nutrients are going to get shifted and shunted to the fetus. The same goes for breastfeeding. Take fat, for example. A nursing mother should still eat a moderate diet, not one in which 50% of the calories come from fat. However, not all nutrient gaps can be overcome through nutritional shunting. Careful consideration of dietary choices and supplementation may be necessary to optimize the health of the mother and developing infant.
Micronutrients are clearly critical. But what is not as obvious, explains Balay, is that both mothers and developing fetuses as well as infants may absorb a higher percentage of some micronutrients than would a nonpregnant woman or older child. In other cases, an infant might absorb less of a particular micronutrient. "That's the neat thing about human bodies and nutrition. We have these safety valves. When we are low in something we will absorb a lot more of it, and by and large, when we have enough, our absorption rate will go down. It's often a protective mechanism."
While it is impossible to completely isolate the impact of a single nutrient, the USDA's Nutritional Needs of Infants offers information on some of the roles and functions that specific vitamins and minerals play in infant growth and development.
Vitamin D : essential for utilization of calcium and phosphorous, formation of bones
Vitamin A : plays role in formation and maintenance of healthy skin, hair, and mucous membranes; proper vision; growth and development; healthy immune and reproductive systems
Vitamin E : protects vitamin A and essential fatty acids in the body, prevents breakdown of tissues
Vitamin K : necessary for proper blood clotting
Vitamin C : necessary for the formation of the protein collagen found in bones, cartilage, muscle, blood vessels, and other connective tissue; helps maintain capillaries, bones, and teeth; plays role in healing of wounds and body's ability to resist infections and absorb iron
Vitamin B12 : necessary for healthy blood cells, proper functioning of the nervous system
Folate : essential for cell division, growth and development of healthy blood cells, formation of genetic material within cells throughout body
Vitamin B6 (pyridoxine) : helps the body use protein to build tissues, aids in metabolism of fat
Vitamin B1 (thiamine) : helps body release energy from carbohydrates during metabolism, plays vital role in normal functioning of nervous system
Vitamin B2 (riboflavin) : helps body release energy in the metabolism of protein, fat, and carbohydrates
Niacin : helps body release energy during protein, fat, and carbohydrate metabolism
Calcium : necessary for bone and tooth development, blood clotting, and maintenance of healthy nerves and muscles
Iron : essential for growth and formation of healthy blood cells
Zinc : plays role in the formation of protein in the body and in wound healing, necessary for growth and maintenance of all tissues, taste perception, healthy immune system
Sodium : essential for the maintenance of water balance, regulation of blood volume, proper functioning of cell membranes
Infant Nutrition (VIDEO)
Fueling Growth & Development
Milk Enters the Stomach
Milk Enters the Small Intestine
Some Key Nutrients
Gut & Immune Development
Respiratory Health
Skeletal & Muscular Development
Skin & Hair Growth
Cardiovascular Development
The Importance of Fat
DHA & ARA
Nervous System Development
Good Nutrition Builds Healthy Babies
Related Health Centers:
Infant Nutrition Health Center, Mother-Baby Bond Health Center, Mother’s Milk Health Center, Monthly Infant Development Calendar Health Center,Weekly Pregnancy Calendar Health Center
fetu fetus cancer kidney heart eye Embryo depression brain birth blood pregnancy breast cardiovascular
theVisualMD Wishes to Thank our Scientific Collaborators:
- J. Thomas Brenna, PhD
Cornell University - Julie Lichty Balay, MS, RD
New York City Department of Health & Mental Hygiene, JLB Nutrition - Connie Weaver, PhD
Purdue University - Scott Holland, PhD
University of Cincinnati - Cincinnati Children's Hospital Research Foundation
- Susumu Mori, PhD
Johns Hopkins School of Medicine - Hee-Yong Kim, PhD
National Institute of Health - Shashi Wadhwa, MS, PhD
All India Institute of Medical Sciences - Jeffrey Hellinger, MD
Children's Hospital of Philadelphia - Alan Phillips, PhD, FRCPCH
Royal Free Hospital - Eric Hassall, MBChB, FRCP, FACG
BC Children's Hospital - John Colombo, PhD
University of Kansas
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