~ CHAPTER THREE ~
THE ESSENTIAL GUIDE TO NUTRIENTS

The Energy Nutrients

Nutrient

How Much do You Need?

What it Does

Where You Find It

Special Tips

Not Pregnant

Pregnancy

Breastfeeding

Thiamin (B1)

1.1 mg

1.4 mg

1.4 mg

Releases energy from carbs. Involved in appetite and nervous system function.

Brewer’s yeast, enriched breads & cereals, pork, wheat germ, dried beans

Unstable in heat and light. Soluble in water.

Riboflavin (B2)

1.1 mg

1.4 mg

1.6 mg

Helps release energy from all foods. Maintains normal vision and skin health.

Fortified cereals, milk, yogurt, cheese

 

Niacin (B3)

14 mg

18 mg

17 mg

Helps release energy from food. Supports health of skin, nervous system, and digestive system.

Fortified cereals, poultry, fish, meat, legumes, and nuts

 

Pantothenic Acid

5 mg

6 mg

7 mg

Helps release energy from food. Involved in antibody production.

Widespread in many foods. Salmon, trout, and avocado are good sources.

 

Biotin

30 mcg

30 mcg

35 mcg

Helps release energy from food.

Widespread in food. Oatmeal, hazelnuts, and peanuts

 

The Building Nutrients

Nutrient

How Much do You Need?

What it Does

Where You Find It

Special Tips

Not Pregnant

Pregnancy

Breastfeeding

Calcium

1,000 mg

1,000 mg

1,000 mg

Builds bones & teeth. Vital for muscle contraction, nerve function, blood clotting, blood pressure, and immune defense.

Milk and milk products, small fish with bones, blackstrap molasses, calcium-fortified soy products, broccoli, greens, legumes, some seaweed, and sea vegetables

Possible link in cancer prevention and in lowering blood pressure.

Choline

425 mg

450 mg

550 mg

As a component of lecithin, choline is important in the structure of all cell membranes, lipoproteins, and pulmonary surfactant.

Especially important for the developing memory center of the brain.

Eggs, beef, soybeans, cauliflower, and lettuce

One egg has almost half the choline you need in a day.

Vitamin B12

2.4 mcg

2.6 mcg

2.8 mcg

Helps in new red blood cell production; helps maintain health of nerve cells.

Muscle meats, fish, eggs, milk and milk products, and fortified foods.

Only foods of animal origin and certain fortified foods contain Vitamin B12. Check food labels to see whether B12 is added.

Phosphorous

700 mg

700 mg

700 mg

Used in building bones and teeth. Needed in every cell membrane, in genetic material, as part of energy production and in the body’s buffering system.

Primary sources of phosphorus in the American diet are animal protein and cola drinks.

Deficiency is rare; too much phosphorous can draw calcium out of the bones.

Magnesium

310 mg

350 mg

310 mg

Used in bone mineralization, protein building, enzyme action, muscle contraction, transmission of nerve impulses, and maintenance of teeth. Also helps in the regulation of blood sugar and insulin.

Nuts, legumes, whole grains, dark green vegetables, and seafood.

Low intakes of magnesium have been implicated in increased risk of heart disease.

Vitamin A / Beta Carotene

700 mcg RAE

750 mcg RAE

1,300 mcg RAE

Helps in cell growth and development and in formation of bones and teeth. Needed for healthy skin, mucous membranes, cornea of the eye, and reproductive health.

Vitamin A:
Fortified milk, cheese, and eggs.

Beta carotene:
Spinach and other dark leafy greens; broccoli; deep-orange fruits like apricots, peaches, and cantaloupe; and orange vegetables like squash, carrots, sweet potatoes, and pumpkin.

1 RAE = 1 mcg retinol, or 12 mcg beta carotene

Excess vitamin A is very toxic to the fetus, including drugs made with it like Retin-A.

The body converts carotenes as needed into vitamin A, so don't worry if you have a lot of carotene, your body will not produce too much vitamin A.

Vitamin K

90 mcg

90 mcg

90 mcg

Needed for blood-clotting proteins.

Seaweed (dulse and rockweed), green tea, soybean oil, turnip greens, and lettuce.

Vitamin K is made in the digestive tract.

Vitamin D

15 mcg

(600 IU)

15 mcg

(600 IU)

15 mcg

(600 IU)

Used in bone mineralization through control of calcium and phosphorus.

Sunshine, fortified milk, salmon, fortified cereals, UV exposed mushrooms and egg yolks.

Your vitamin D status may affect your child’s birthweight as well as bone mass years from now!1

Vitamin B6 (Pyridoxine)

1.3 mg

1.9 mg

2.0 mg

Used in amino acid and fatty acid metabolism; helps make red blood cells.

Beef, tuna, chicken, turkey, potatoes, cod, sunflower seeds, halibut and spinach

Vitamin B6 is needed in amounts proportional to the amount of protein in the diet.

Folate

400 mcg

600 mcg

500 mcg

Needed for all new cell production and use of amino acids. Also needed for some enzymes.

Spinach, leafy green vegetables, black-eyed peas, lentils, red kidney beans, broccoli, Brussels sprouts, beets, okra, green peas, asparagus, legumes, orange and grapefruit juice, and fortified cereals

Folate can be easily destroyed in cooking. Alcohol and smoking increases the need for folate.

Iron

18 mg

27 mg

9 mg

A star nutrient! Part of the blood protein hemoglobin, which carries oxygen in the body. Part of muscle protein. Necessary for the use of energy in the body.

Clams, lean beef, fortified cereals, tofu, lentils, eggs, chicken, legumes, and dried fruit

Pregnant women with iron-deficiency anemia are more likely to have a premature or low-birth-weight baby.

Zinc

8 mg

11 mg

12 mg

Growth of tissues and bones; fetal development, making genetic material, in immune reactions, in taste and smell, and in wound healing. Needed for sperm production.

Oysters, turkey, lean pork, wheat germ, whole grains, lima beans, and almonds

Zinc deficiency during pregnancy can cause low birthweight, increased pregnancy complications, and premature births. A zinc deficiency during fetal brain development could cause fetal brain injury.

Vitamin C

75 mg

85 mg

120 mg

Needed for thyroid hormone, collagen synthesis, and production of amino acids. Strengthens resistance to infection, helps absorption of iron, and acts as an antioxidant.

Kiwi, mango, papaya, citrus fruits, melons, peppers, berries, leafy green vegetables, tomatoes, broccoli, cauliflower, and cabbage

Smokers need more vitamin C.

The Support Nutrients

They help other nutrients function.

Nutrient

How Much do You Need?

What it Does

Where You Find It

Special Tips

Not Pregnant

Pregnancy

Breastfeeding

Vitamin E

15 mg

15 mg

19 mg

Works together with other antioxidants, vitamin C, and beta-carotene.

Wheat germ and wheat germ oil, sunflower oil, sunflower seeds, safflower oil, almond oil and almonds, hazelnuts, mayonnaise and salad dressings made with the above oils.

If you followed a low-fat diet or took cholesterol-lowering drugs before your pregnancy, your body may be partially depleted of vitamin E.

Sodium

1,500 mg

1,500 mg

1,500 mg

Maintains normal fluid balance. Needed for nerve impulse transmission.

Naturally found in vegetables according to amount in the soil. Most dietary sodium comes from what’s in processed foods.

Some people are sensitive to sodium and it can increase their blood pressure. Moderation rather than restriction is the key for pregnant women. Most Americans eat much more than the DRI.

Potassium

4,700 mg

4,700 mg

5,100 mg

Maintains fluid balance and helps maintain normal blood pressure. Helps with nerve impulses and muscle contractions.

Bananas, oranges and orange juice, watermelon, cantaloupe, avocado, potatoes, dairy products

Potassium can counteract the action of sodium and keep blood pressure at a healthy level.

Trace Elements

Zinc and Iron are also considered trace elements but they are listed above due to their importance. According to the Subcommittee on Dietary Intake and Nutrient Supplements, routine supplementation of trace elements (with the exception of iron) during pregnancy does not seem to be necessary.

Nutrient

How Much do You Need?

What it Does

Where You Find It

Special Tips

Not Pregnant

Pregnancy

Breastfeeding

Copper

900 mcg

1,000 mcg

1,300 mcg

Helps in red blood cell production; is found in nerve coverings and connective tissue. Also assists in energy production and in respiration.

Barley and whole grains, shellfish, sunflower seeds, cashews, tempeh, raisins, lentils and beans

 

Iodine

150 mcg

220 mcg

290 mcg

An essential component of the thyroid hormone thyroxin, which is responsible for regulating the amount of energy the body uses.

Seafood, iodized salt, and food grown in ocean areas that contain iodine-rich soil

Iodine deficiency during pregnancy can cause fetal disorders such as stillbirth, birth defects, and neurological impairment.

Fluoride

3 mg

3 mg

3 mg

Bonds calcium and phosphorus in bones and teeth; prevents cavities.

Water that naturally contains fluoride or water that has fluoride added. If you are not sure whether your water contains fluoride, you might want to have it tested.

Supplemental fluoride during pregnancy is controversial; prenatal fluoride doesn't appear to affect the fluoride concentration in a baby's dental enamel.

Manganese

1.8 mg

2.0 mg

2.6 mg

Part of enzymes that are active in many cell processes and a component of an important antioxidant.

Whole grains, beans, peas, and nuts

 

Chromium

25 mcg

30 mcg

45 mcg

Associated with insulin; needed for the release of energy from glucose. Inability to use glucose results in diabetes-like deficiency symptoms.

Whole grains, meat, mushrooms, asparagus, and brewer’s yeast

Eating too many refined grains can lead to decreased intake of this trace mineral.

Molybdenum

45 mcg

50 mcg

50 mcg

Part of enzymes used in many body processes.

Legumes, cereals, and organ meats.

 

An In-Depth Look

Vitamin D Deficiency—A New Public Health Problem?

It's possible that many of us are walking around with a vitamin D deficiency. The best source of vitamin D is sunlight; your skin produces its own vitamin D when exposed to sufficient sunlight. However, between fear of skin cancer and other factors it seems that few of us actually get the sun exposure we need to make adequate D. The factors below can all have an effect:

      Amount of skin exposed

      Type of clothing

o   Some clothing blocks more UV rays than others

      Time spent in the sun

      Use of sunscreen

      Pigmentation of the skin

o   Dark skinned people may need up to 10 times the sun exposure to produce the same amount of vitamin D

      Larger body mass—more body fat increases need for vitamin D

      Latitude

o   People who live in northern latitudes (above latitude of 40) and southern latitudes (below latitude of 40) are at risk for vitamin D deficiency because the amount of sunshine in winter months makes vitamin D production impossible.

      Amount of pollution

Recent research shows that vitamin D—which is actually converted to a hormone in the body, is responsible for a lot more than calcium status and bone density—it appears to affect all organ systems. Current research indicates vitamin D deficiency plays a role in causing many types of cancer as well as heart disease, stroke, hypertension, autoimmune diseases, diabetes, depression, chronic pain, osteoarthritis, osteoporosis, muscle weakness, muscle wasting, birth defects, and periodontal disease.2  Lack of the vitamin during pregnancy and infancy can have negative effects on bone development but may also have an effect on the development of type 1 diabetes. In one study, increasing vitamin D intake during pregnancy reduced the long-term risk of type1 diabetes by 80% in their infants.3

How Much D?

Researchers agree that the current Dietary Reference Intake is highly underestimated. Dr. Michael Holick, a researcher from Boston University's Vitamin D, Skin, and Bone Research Laboratory, suggests that pregnant and breastfeeding women need 1,000-2,000 IU of daily vitamin D from diet or supplements when vitamin D production from sun exposure is inadequate. The suggested Dietary Reference Intake for Vitamin D is 600 IU. The Tolerable Upper Intake of Vitamin D for adults is 4,000 IU.

How to Get Enough D—A Balance of Sun and Supplements

It's important to get some vitamin D from the sun; it's also important to not get so much unprotected sun that it increases your risk of skin cancer. The advice below is based on a position statement issued by a group of organizations in Australia4 devoted to both bone health and cancer prevention and a review of Vitamin D Deficiency in the New England Journal of Medicine.5

1.         Expose your skin to the sun without protection during times when the UV index is less than 3—this will help you avoid excessive sun exposure.

2.         Determine your weekly sun exposure—both in summer and winter.

Summer: If you are fair skinned, you only need a "few minutes" of summer sun on the face, arms and hands (or equivalent exposure) on most days. Dark skinned women could need up to 10 times as much per day.

Winter: Sun exposure is drastically reduced depending on climate and latitude. In many cities, there is not enough winter sunshine to allow adequate vitamin D production—even if you were brave enough to have some of your skin uncovered!! If you have adequate sun exposure in summer months, that can carry you a month or two into the winter.

3.         Determine your food intake of D; very few foods are naturally high in vitamin D. While most milk is fortified with it, milk products like cheese and yogurt are generally not.

Food

International Units (IU's) per serving

Cod liver oil, 1 tablespoon

1360

Salmon, 3½ ounces

360

Tuna fish, canned in oil, 3 oz.

200

Sardines, canned in oil, 1¾ oz.

250

Milk, any type, D-fortified, 1 cup

98

Margarine, fortified, 1 tablespoon

60

Fortified cereals listing 10% of Daily Value

60

Egg yolk, 1

20

If you really want to know your vitamin D status, the best way is to have a blood test of circulating 25(OH)D. 

Checklist for Vitamin D Status:

 

Vitamin D Source

Enough

Not Enough

1

Summer sun exposure (up to 30 minutes per week on arms and legs between 10 am and 3 pm) for fair skinned up to 5 hours for dark skinned)

 

 

2

Winter sun exposure (difficult even in the best climates). Inadequate at latitudes above 35 (Atlanta) from November to February

 

 

3

Average daily vitamin D intake from food: _______

 

 

4

Vitamin D in multivitamin: _______

 

 

5

Total Vitamin D Intake:  _______

 

 

4.         Determine your need for a supplement.

If you checked "not enough" for box one and two, and box 5 is less than 1,000 IU, you should definitely have your vitamin D status checked; you probably need a supplement.

5.         Have Your Vitamin D Status Checked:

It’s wise to get your vitamin D level checked, especially if you don't see much sun, you have dark skin or you live at northern latitude or if any of the other factors listed above affect you. Your health care provider just needs to order a 25(OH)D blood test. A few studies have shown that even when women took a prenatal vitamin with 400 IU of vitamin D, drank milk and ate fish regularly, 73% of the women and 80% of their infants were considered vitamin D deficient.6

 

1.         Javaid MK et al. Maternal vitamin D status during pregnancy and childhood bone mass at age 9 years: a longitudinal study. Lancet. 2006 Jan 7;367(9504):36-43.

2.         Vitamin D Council. Health ConditionsSeptember 2011. [Accessed 12-1-12]. Available from: http://www.vitamindcouncil.org/health-conditions.

3.         Hypponen E, Laara E, Reunanen A, Jarvelin M-R, Virtanen SM. Intake of vitamin D and risk of type 1 diabetes: a birthcohort study. Lancet 2001;358:1500-3.

4.         Risks and Benefits of Sun Exposure Position Statement. Approved by The Australian and New Zealand Bone and Mineral Society, Osteoporosis Australia, Australaian College of Dermatologists and the Cancer Council Australia. May 2007. [Accessed 12-1-12]Available from: http://www.cancer.org.au/cancer-control-policy/position-statements/sun-smart/#jump_3

5.         Holick MF. Vitamin D Deficiency. New England Journal of Medicine. 2007;357: 266-81

6.         Holick MF. Vitamin D Deficiency. New England Journal of Medicine. 2007;357: 266-81