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Vitamins, Minerals, and YouSaturday, April 2, 2016

WelcomeStudents at the University of Arizona (Class of 2016)

From the College of Agriculture and Life Sciences

Studying Nutritional Sciences

Currently taking a course in Community Nutrition

Micronutrients

Micronutrients● Vitamins (Vitamins A, D, E, K, B, C)

● Minerals (calcium, iron, potassium, magnesium)

● Calcium

● Vitamin D

● Iron

● Vitamin B12

Why are Micronutrients Important to You?

Normal GI tract Roux-en-Y Sleeve

Calcium and Vitamin D

Why are They Important?

Calcium-Bone Health-Muscle Function-Nerve Transmission

Vitamin D-Calcium Absorption-Bone Health-Immune Function-Reduced Inflammation

What If You Don’t Get Enough?

CalciumOsteoporosis

Vitamin DOsteomalaciaOsteoporosis

How Much Do YOU Need?

CalciumMen/Premenopausal Women: 1200

mg/dayPostmenopausal Women: 1500 mg/day

Vitamin D3,000 IU/day

Calcium→ 200-300 mg more!

Vitamin D→ 3-4 times more!

And the Question of the Day is...

What is osteoporosis?A. Falling

B. Thinning of bones

C. Type of vitamin

D. Type of fish

And the Question of the Day is...

What is osteoporosis?A. Falling

B. Thinning of bones

C. Type of vitamin

D. Type of fish

What Foods?Calcium Both Vitamin D

-Yogurt -Fortified OJ -Salmon

-Sardines -Fortified Yogurt -Tuna

-Cheddar Cheese -Milk -Fortified OJ

-Milk -Fortified Almond Milk -Milk

-Fortified Almond Milk -Fortified Almond Milk

-Fortified OJ -Fortified Yogurt

-Kale -Egg Yolks

And the Question of the Day is...

Identify 2 good sources of calcium:A. Butter, banana

B. Cream cheese, broccoli

C. Yogurt, fortified OJ

D. Walnuts, dark chocolate

And the Question of the Day is...

Identify 2 good sources of calcium:A. Butter, banana

B. Cream cheese, broccoli

C. Yogurt, fortified OJ

D. Walnuts, dark chocolate

And the Question of the Day is...

Identify 2 good sources of vitamin D:A. Salmon, fortified almond milk

B. Green beans, chicken

C. Rice, chocolate

D. Oranges, asparagus

And the Question of the Day is...

Identify 2 good sources of vitamin D:A. Salmon, fortified almond milk

B. Green beans, chicken

C. Rice, chocolate

D. Oranges, asparagus

All in a Day’s Diet--Calcium

What Do 1200 mg of Calcium Look Like?

8 oz. Yogurt 415 mg

1.5 oz. Cheddar Cheese 307 mg

8 fl. oz. Soymilk 299 mg

6 fl. oz. Fortified OJ + 261 mg ------------- 1282 mg

All in a Day’s Diet--Vitamin DWhat Do 3,000 IU of Vitamin D Look Like?

6 oz. Swordfish 1132 IU

6 oz. Salmon 894 IU

8 Sardines 184 IU

12 oz. Fortified Yogurt 160 IU

6 oz. Tuna Fish 154 IU

8 fl. oz. Fortified OJ 137 IU

8 fl. oz. Milk 124 IU

6 oz. Beef Liver 84 IU

2 cups Fortified Cereal 80 IU

1 Egg + 41 IU --------------

2990 IU

In Summary...

Calcium and Vitamin D = Necessary for Health-Especially bone health!

Food + Supplementation-Calcium from food-Vitamin D from supplements

Iron

Why is iron important?

Carries oxygen in our red blood cells

Oxygen is necessary for our cells to produce energy

= Iron Molecule

Why is iron important?

Carries oxygen in our red blood cells

Oxygen is necessary for our cells to produce energy

= Iron Molecule = Oxygen

Cells

Iron and Weight Loss Surgery

Iron is absorbed in first part of small intestine

Higher risk of iron malabsorption after Roux-en-Y gastric bypass

Roux-en-Y Sleeve

What If You Don’t Get Enough?

- Iron-deficiency anemia

- Iron-deficiency anemia can be asymptomatic

Mild Symptoms Severe Symptoms

FatigueWeaknessHeadachesFeeling “grumpy”

Pale skinBrittle nailsShortness of breathFeeling lightheaded when standing up

How Much Iron Do You Need?

General Guidelines for Adults:

Men*:- Ages 19+ = 8 mg/day

Women*: - Premenopausal (Ages 18+) = 18 mg/day

→ May be advised to consume up to 60 mg/day after weight loss surgery

- Postmenopausal = 8 mg/day

*Specific needs following weight loss surgery are very individualized.

*Be sure to visit your physician annually to test for iron deficiency (blood test) or if you experience any symptoms of anemia.

Identify two iron-rich sources:

A) Bell Peppers and PotatoesB) Oranges and Ice CreamC) Celery and MilkD)Chicken and Cereal

D) Chicken and Cereal

A)Bell Peppers and Potatoes

B)Oranges and Ice Cream

C)Celery and MilkD)Chicken and Cereal

Iron-rich food sources

Heme Iron

Beef

Chicken

Pork

Salmon

Liver

Non-Heme Iron

Fortified breakfast cereals

Pumpkin seeds

Whole grains

Dark green vegetables

Dried beans (i.e. kidney, black, lentils)

Enriched rice

How can I get enough each day?Men (ages 19+) and Postmenopausal Women

8 milligrams:

1 slice whole wheat toast = 1 mg

1 cup raw or ½ cup cooked spinach = 3 mg

3 ounces beef = 2 mg

1 ounce dark chocolate = 2 mg

Premenopausal Women (Ages 18+)

18 milligrams:

1 serving of iron-fortified cereal = 18 mgOR3 oz cooked turkey = 4 mg½ cup lentils = 3 mg

1 cup raw or ½ cup cooked spinach = 3 mg

3 ounces chicken = 2 mg

2 ounces of dark chocolate = 5 mg

¼ cup raisins = 1 mg

Which method is used to diagnose iron-deficiency anemia?

A) X-ray

B) Blood test

C) MRI

D) Throat swab

B) Blood test

A) X-ray

B) Blood test

C) MRI

D) Throat swab

What are symptoms of iron deficiency anemia?

A) Fatigue and headaches

B) Coughing and congestion

C) Tingling sensation in hands and feet

D) Abdominal pain and cramping

A)Fatigue and headaches

A) Fatigue and headaches

B) Coughing and congestion

C) Tingling sensation in hands and feet

D) Abdominal pain and cramping

Iron Summary

Iron delivers oxygen to our cells

Roux-en-Y gastric bypass procedure → higher risk for anemia

Inadequate iron intake → Iron-deficiency anemia

Get blood work done annually

Iron needs can be met through diet AND supplements

Iron-rich foods: meat, fish, dark leafy greens, fortified breakfast cereals, whole grains, pumpkin seeds, and dark chocolate

Vitamin B12

What is Vitamin B12?

Vitamin B12 is a member of the vitamin B complex.

It contains cobalt, and is often known as cobalamin.

Cobalamin is found primarily in meats, eggs and dairy products.

Why is Vitamin B12 important for you?

Keeps the body’s nerve and blood cells healthy.

It also helps make your genetic information (your DNA).

Lowers level of homocysteine in the blood.

High levels = easier for blood cells to form clots

How much Vitamin B12 do I need?

Recommended Dietary Allowances (RDAs) for Vitamin B12

Adults 2.4 mcg

Adults post-weight loss surgery

350-500 mcg

What happens if I don’t get enough B12?

Similar to iron, you can become anemic

Common symptoms: dizziness, paleness of skin, lack of feeling in hands and feet to poor muscle coordination and memory

With prolonged deficiency, nerve damage is irreversible.

Nexium (for GERD) or Metformin (for Type II DM) increases risk of deficiency

Overall, becoming deficient takes time (~3-5 years).

Question 1:

Why is Vitamin B12 important for you?A.It keeps our body’s nerve and blood cells healthy.

B.It helps makes your genetic information (DNA).

C.It decreases your risk of a blood clot or stroke.

D.All of the above.

Question 1:

Why is Vitamin B12 important for you?A.It keeps our body’s nerve and blood cells healthy.

B.It helps makes your genetic information (DNA).

C.It decreases your risk of a blood clot or stroke.

D.All of the above.

Question 2:

True or False: Post-weight loss surgery patients need 2.4 mcg/d of Vitamin B12?

A.True

B.False

Question 2:

True or False: Post-weight loss surgery patients need 2.4 mcg/d of Vitamin B12?

A.True

B.False

You need 350-500 mcg/d of Vitamin B12!

Question 3:

True or False: Developing a Vitamin B12 deficiency usually takes 3 to 5 years?

A.True

B.False

Question 3:

True or False: Developing a Vitamin B12 deficiency usually takes 3 to 5 years?

A.True

B.False

Food Serving Size Micrograms per Serving

Mollusks, cooked clam 3 oz 84.1

Liver 3 oz 47.9

Fortified breakfast cereals ¾ cup 6.0

Rainbow trout 3 oz 5.4

Salmon 3 oz 4.9

Plain yogurt (skim) 1 cup 1.4

Tuna (canned) 3 oz 1.0

Milk 1 cup 0.9

Egg 1 0.6

Chicken breast 3 oz 0.3

Question 4:

Which food has the highest amount of Vitamin B12?A.Chicken and Mashed Potatoes

B.Eggs and Cheese

C.Clams and Liver

D.Milk and Yogurt

Question 4:

Which food has the highest amount of Vitamin B12?A.Chicken and Mashed Potatoes

B.Eggs and Cheese

C.Clams and Liver

D.Milk and Yogurt

Mindful Eating & Behavior Change

What is mindful eating?

Eating with the intention of caring for yourself

Eating with the attention necessary for noticing and enjoying your food and its effects on your body

Mindful Eating - How Am I Hungry?

Why When What How How much Where

Mindful Eating Cycle

Why do I eat?

Why do I eat when I’m not hungry?

When do I feel like eating?

When do I think about eating?

Mindful Eating Cycle

What do I eat?

What type of food do I eat?

What health issue should I think about?

How do I eat?

Mindful Eating Cycle

How much do I eat?

How do I feel when I’m done eating?

Where does the energy I consumed go?

Mindful eating includes the entire process of eatingMindful eating is much more than “eating

slowly, without distraction.”

Awareness of our actions

Awareness of our thoughts

Awareness of our feelings

Awareness of our motivations

How they influence the way we choose to eat

Practicing Mindful Eating

Let’s practice mindful eating together now If you have not yet progressed to the regular diet stage, then you should not participate

Mindful Eating Practice 1. Wash your hands.

2. Pick up the Cutie and smell it.

3. Peel the Cutie slowly, taking time to enjoy the smell, texture, and color.

4. Separate one piece of it, place it in your mouth, close your eyes, and bite down. Pay attention to how the juice bursts into your mouth and fills it with orange flavor.

5. Chew slowly and experience the texture. How is this different than drinking a glass of orange juice?

Do you usually eat Cuties in this way?

What would happen if you ate food this way more often?

I encourage you to think about mindful eating and practice it to help you lose weight.

In Summary...● Increased Micronutrient Needs: Calcium, Vitamin D, Iron, Vitamin

B12

● Deficiencies = Osteoporosis and Anemia

● Micronutrients in Food and Supplements

● Mindful Eating = Helps to Ensure Adequate Micronutrient Intake

Questions?

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