Nutrition in a Nutshell

What makes nutrition so important and powerful when it comes to your health? The role of nutrient interaction in the body is vast and complex. The quantity of nutrients we can absorb is relative to the quality of the food, as well as, overcoming health obstacles.

Macronutrients are the nutritional components of a diet that provide energy. Protein provides the body with structural building blocks for muscle, the immune system, hormones and neurotransmitters, and enzymatic and cell membrane activity. Fats provide the starting material for hormone production, protection for organs, reduce inflammation, and are vital for the health of the brain, hair and skin. Carbohydrates provide regulation of blood glucose, spare the breakdown of protein, maintain digestive health, and can stimulate growth of good gut bacteria.

Micronutrients consist of vitamins and minerals that act as cofactors involved in prevention of disease, metabolism, growth, and normal function. They have so many roles and are in constant demand. Water soluble vitamins (B, C) are easily absorbed and not readily-stored and thus deficiency can develop rapidly. Fat soluble vitamins (A, D, E, K) require fats and bile for absorption and are stored in the liver. Minerals are required to convert food into energy, supports fluid balance, as well as, heart, skeletal muscle, and nervous system function.

Together in the prevention of disease, metabolism, growth and normal function. They are always in demand because of the many roles they play and with some deficiency can develop quickly.

Here is an abbreviated list of notable functions of some key micronutrients:

·       Vitamin A (retinol)- maintains the health of epithelial cells, supports skin, eye health, night vision, functions as an antioxidant, and regulates immune function. Deficiency of vitamin A has been linked to night blindness.

·       Vitamin B1 (thiamine)- is a cofactor for several enzymes, plays a role in energy, brain health, cardiovascular health, and red blood cell function. Thiamine deficiency causes a serious condition called beriberi, which can lead to Wernicke- Korsakoff syndrome. Deficiency is also linked to increased beta-amyloid production and plaque formation in the brain. Long term use of phenytoin, oral contraceptives, and diuretics can deplete thiamine.

·       Vitamin B2 (riboflavin)- is involved in the synthesis of ATP for energy, involved in redox (reduction-oxidation) reactions to reduce oxidative stress, is needed for iron assimilation, and is important for muscle tone, the nervous system, and eye health. Certain drugs can decrease proper use of riboflavin including: antipsychotics, tricyclics, antimalarials, and chemotherapy drugs. Oral contraceptives, alcohol, and phenobarbital can deplete it.

·       Vitamin B3 (niacin)- plays a role in the synthesis of ATP for energy, promotes cellular health and protects our DNA from damage, supports skin health and is essential for brain health, and improves lipid profiles. Niacin deficiency can lead to a serious condition called Pellagra. Certain drugs can deplete niacin, such as: anticonvulsants, Isoniazide, Azathioprine, 6-Mercatoprine, 5-Fluorouracil, and Carvidopa.

·       Vitamin B5 (pantothenic Acid)- assists in the production and storage of energy in the body, is the primary component of Coenzyme A, and is involved is several enzymatic pathways involved in the production of antibodies, hemoglobin, and hormones.

·       Vitamin B6 (pyridoxine)- is converted to the active form PLP (pyridoxal 5’ -phosphate) and is a cofactor for more than 100 different enzymes, it is critical for brain function, the nervous and immune systems, supports arterial integrity, production of hemoglobin and neurotransmitters, and plays a role in the production of fuel and energy. Oral contraceptives, anticonvulsants, Amitriptyline, Isoniazid, and Penicillamine are associated with low B6 levels.

·       Vitamin B7 (biotin)- supports skin and nail health, protects myelin that surrounds nerves, plays a role in the synthesis of fatty acids, and it’s involved in glucose utilization. Biotin plays a role in DNA replication, transcription and cellular proliferation. Long term use of anticonvulsants is associated with reduced serum biotin.

·       Vitamin B9 (folate)-plays a key role in the synthesis of DNA and RNA, it’s involved in homocysteine and B12 metabolism, supports the central nervous system and brain health, and supports immune function. Folate can prevent neural tube birth defect. Several drugs can lower folate levels, including, H2 blockers, PPI’s, NSAID’s, Sulfasalazine, Nitrofurantoin, and oral contraceptives.

·       Vitamin B12 (cobalamin)- plays a role in DNA synthesis, red and white blood cell function, neurotransmitter production, homocysteine metabolism, and is involved in the nervous system and immune health. Deficiency leads to macrocytic anemia. Multiple drugs, including H2 Blockers, PPI’s, Metformin, and Zidovudine can deplete B12 levels.

·       Vitamin C (ascorbic acid)- functions as an antioxidant, plays an important role in maintaining a healthy immune response, is essential for collagen, carnitine, and neurotransmitter synthesis, and detoxification of xenobiotic chemicals. Deficiency may lead to scurvy. Oral contraceptives, and PPI’s can deplete it.

·       Vitamin D (cholecalciferol)- functions as a steroid hormone precursor, synthesized by the skin after exposure to sunlight, it enhances the absorption of calcium and phosphorus, promotes bone mineralization and remodeling, plays a role in neuromuscular and immune function, influences cellular growth and differentiation, and appears to additionally enhances secretion and action of insulin. Deficiency can cause a condition called Rickets, and can contribute to osteomalacia (bone softening). Anticonvulsants, Isoniazid, and Hydroxychloroquine can deplete it.

·       Vitamin E (tocopherol)- it maintains the function of the reproductive, vascular, and nervous systems, functions as an antioxidant reducing oxidative DNA, stabilizes cell membranes, inhibits platelet aggregation, alters immune function, and is important for healthy skin, hair, and nails.

·       Vitamin K- it supports cardiovascular and bone health, and it is anti-hemorrhagic ensuring our blood clots when needed. Vitamin K has three different forms and K2 has several subtypes. K-dependent proteins can be both procoagulant and anticoagulant.

·       Calcium- plays a vital role in the strength of bone, teeth, and cartilage, it is involved in nerve and muscle functioning and contraction, hormone formation, and it is involved in many biological processes including regulating constriction and relaxation of blood vessels. Corticosteroid medications reduce absorption of calcium, thiazide diuretics can raise calcium levels, and loop diuretics can decrease calcium levels.

·       Iron- it is a component of hemoglobin essential for the delivery of oxygen to the tissues, involved in mitochondrial energy production, is required for the synthesis of thyroid hormone, required for the neurotransmitter conversion to dopamine, and it plays a role in immune function and DNA synthesis. Deficiency leads to microcytic anemia. Risperidone may cause depletion.

·       Magnesium- it is a cofactor for more than 300 different enzymes, essential for the synthesis of ATP for energy, involved in neuronal activity, cardiac excitability, and electric properties of cell membranes, it inhibits platelet aggregation, promotes dilation of blood vessels, and has antispasmodic effect on skeletal and smooth muscle. It also plays a role in lipid metabolism and synthesis of the glutathione antioxidant. Diuretics, PPI’s, Cisplatin, Cyclosporine, beta-2 agonists, antipsychotics, oral contraceptives, thyroid and aldosterone hormones, and caffeine increase magnesium excretion.

·       Potassium- plays a role in fluid and electrolyte balance, blood pressure regulation, membrane polarization, neuronal transmission, and muscle contraction. Potassium levels can be altered (decreased or increased) by several common medications.

·       Zinc- it has anti-inflammatory and antioxidant effects, involved in many different biochemical pathways including DNA and protein synthesis, essential for growth, plays a role in visual function, hearing, and taste, involved in spermatogenesis, sexual development, immune function, wound healing, helps stabilize cell membranes, and is involved in neurotransmitter production. ACE inhibitors, aspirin, oral contraceptives, and glucocorticoids can deplete it.

There can be challenges with absorption and depletion of certain micronutrients with underlying conditions, chronic stress, pesticides, food allergens, and inflammatory foods. Micronutrients are an integral part of immune function and necessary for proper immune response. Individuals recovering from surgery, fighting cancer or infections, or conditions associated with specific deficiencies require increased need for micronutrients to heal and repair tissues.

Nutritional therapy is complex involving supporting the function of biochemical mechanisms that direct a specific outcome, provide symptom relief, or replenishment of micronutrients that are depleted. Micronutrients can treat and prevent many different health conditions, however, must be monitored for interactions, contraindications, and tolerance. The best medicine is a diverse whole foods diet customized to your needs. Having a naturopathic doctor or nutritionist to individualize your care is optimal to prevent interactions with other micronutrients or medications, and identify specific deficiencies and optimal dosing. Multiple flawed studies and subsequent review articles have poorly analyzed the efficacy of micronutrients in medicine to the potential detriment of patients that could benefit. It's important to critically analyze literature for bias and quality. Always question, and advocate for true scientific integrity. Optimize your health through nutritional therapy. To find out how you can benefit, schedule an appointment for a full medical evaluation.

Resources:

·       Gaby, Alan R. (2017) Nutritional Medicine. 2nd Ed. Fritz Perlberg Publishing, Concord, NH.

·       Low Dog, Tieraona (2016) Fortify Your Life: your guide to vitamins, minerals, and more. National Geographic Partners, LLC, Washington, DC.

·       Gombart, A. F., Pierre, A., & Maggini, S. (2020). A review of micronutrients and the immune system–working in harmony to reduce the risk of infection. Nutrients, 12(1). https://doi.org/10.3390/nu12010236

·       Vasquez, A., & Pizzorno, J. (2019). Concerns about the integrity of the scientific research process—focus on recent negative publications regarding nutrition, multivitamins, fish oil and cardiovascular disease. Integrative Medicine (Boulder), 18(1), 8–15.