KEMAMPUAN AKHIR YANG DIHARAPKAN

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PENGANTAR METABOLISME ZAT GIZI MIKRO PERTEMUAN 1

DUDUNG ANGKASA

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VISI DAN MISI UNIVERSITAS ESA

UNGGUL

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Materi Sebelum UTS

02. Vitamin A

07. Vitamins Interaction 03. Vitamin D

04. Vitamin E dan K

05. Vitamin Larut Air- C

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Materi Setelah UTS

09. Mineral-Fe, Zn, I

14. Review

10. Mineral-Mn, Cr, Cl

11. Mineral-Co, Mo, Cu, F

12. Mineral Interactions

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KEMAMPUAN AKHIR YANG

DIHARAPKAN

• _{Mahasiswa dapat menjelaskan metabolisme zat gizi mikro}

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Topik Perkuliahan (1/2)

TEMU Topik Bahasan

1

Why study the micronutrient

metabolism and what its relationship with other courses?

1. History of micronutrient problem 2. Night blindness, Anemia, Scurvy, IDD 3. Metabolism, diet and research

2 Fat-soluble vitamin-1

1. Vitamin A (digestion, absorption, storage and utilization)

2. Factors afecting the metabolism 3. Dietary Requirement and Toxicity

1. Vitamin D (digestion, absorption, storage and utilization)

1. Vitamin E and K (digestion, absorption, storage and utilization)

5 Water-soluble vitamin-1 1. Vitamin C (digestion, absorption, storage and utilization)

6 Water-soluble vitamin-2

1.Vitamin B1, B2, B6, B12

7 Water-soluble vitamin-3

1. Vitamin PP, pantothenic acid, folic acid, biotin, lipoic acid

8 Vitamin-Vitamin Interaction Synergy vs Antagonist

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TEMU Topik Bahasan

9 Mineral-1

1. Macro Mineral (Calsium, Mg, Na, K, P, S) (digestion, absorption, storage and

utilization)

10 Mineral-2

1. Fe, Zn, I (digestion, absorption, storage and utilization)

11 Mineral-3

1. Mn, Cr, Cl (digestion, absorption, storage and utilization)

12 Mineral-4

1. Co, Mo, Cu, F (digestion, absorption, storage and utilization)

13 Mineral-Mineral Interaction Synergy vs Antagonist

14 Vitamin-Mineral Interaction Synergy vs Antagonist

15 UJIAN Akhir Semester

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Penilaian

•

Presensi

: 10%

•

Tugas Terstruktur : 30%

•

UTS

: 30%

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Why do we study micronutrient?

History: 1. Scurvy 2. Beri-beri 3. Pellagra 4. Rickets

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Abstract

Micronutrients are essential to sustain life and for optimal physiological function. Widespread global micronutrient deficiencies (MNDs) exist, with pregnant women and their children under 5 years at the highest risk. Iron, iodine, folate, vitamin A, and zinc deficiencies are the most widespread MNDs, and all these MNDs are common contributors to poor growth, intellectual impairments, perinatal complications, and increased risk of morbidity and mortality. Iron deficiency is the most common MND worldwide and leads to microcytic anemia, decreased capacity for work, as well as impaired immune and endocrine

function. Iodine deficiency disorder is also widespread and results in goiter, mental retardation, or reduced cognitive function. Adequate zinc is necessary for optimal immune function, and deficiency is associated with an increased incidence of diarrhea and acute respiratory infections, major causes of death in those <5 years of age. Folic acid taken in early pregnancy can prevent neural tube defects. Folate is essential for DNA synthesis and repair, and deficiency results in macrocytic anemia. Vitamin A deficiency is the leading cause of blindness worldwide and also impairs immune function and cell differentiation. Single MNDs rarely occur alone; often, multiple MNDs coexist. The long-term consequences of MNDs are not only seen at the individual level but also have deleterious impacts on the economic development and human capital at the country level. Perhaps of greatest concern is the cycle of MNDs that persists over generations and the intergenerational consequences of MNDs that we are only beginning to understand. Prevention of MNDs is critical and traditionally has been accomplished through supplementation,

fortification, and food-based approaches including diversification. It is widely accepted that intervention in the first 1,000 days is critical to break the cycle of malnutrition; however, a coordinated, sustainable

commitment to scaling up nutrition at the global level is still needed. Understanding the epidemiology of MNDs is critical to understand what intervention strategies will work best under different conditions.

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Iron Deficiency

• _{A few salient facts (WHO, accessed 2017)}

• _{In developing countries every second pregnant woman and}

about 40% of preschool children are estimated to be anaemic.

• _{In many developing countries, iron deficiency anaemia is}

aggravated by worm infections, malaria and other infectious diseases such as HIV and tuberculosis.

• _{The major health consequences include poor pregnancy}

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Iodine (CDC, accessed 2017)

• _{Iodine is one of the most important minerals required by a}

fetus for brain and cognitive development, though the iodine content in most foods and beverages is low3.

• _{18 million babies are born mentally impaired because of}

maternal iodine deficiency and 38 million are born at risk of iodine deficiency9. Globally it is estimated that 2 billion

people have insufficient iodine intake10.

• _{Fortification of salt with iodine has been one of the most}

successful nutrition interventions to date--71% of global households have access to iodized salt11.

• _{Salt iodization has led to an increase in IQ points and}

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Vitamin A (CDC, accessed 2017)

• _{Vitamin A is necessary to support healthy eyesight and}

immune system functions; children who are deficient face an increased risk of blindness and death from infections such as measles and diarrhea7.

• _{Globally, 1 in 3 pre-school aged children and 1 in 6}

pregnant women are vitamin A deficient due to inadequate dietary intake.7

• _{Vitamin A supplementation of children 6-59 months has}

been shown to be highly effective in reducing mortality from all causes in countries where vitamin A deficiency is a

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Vitamin A (WHO, accessed 2017)

• _{A few salient facts}

• _{An estimated 250 million preschool children are vitamin A}

deficient and it is likely that in vitamin A deficient areas a substantial proportion of pregnant women is vitamin A deficient.

• _{An estimated 250 000 to 500 000 vitamin A-deficient}

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Zinc (CDC, accessed 2017)

• _{Zinc is a mineral that promotes immunity, resistance to}

infection, and proper growth and development of the nervous system3, and is integral to healthy pregnancy outcomes12

• _{17.3% of the global population is at risk for zinc deficiency}

due to dietary inadequacy, though up to 30% of people are at risk in some regions of the world12.

• _{Zinc supplementation reduces the incidence of premature}

birth, decreases childhood diarrhea and respiratory

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Folate (CDC, accessed 2017)

• _{Folate is a vitamin that is essential in the earliest days of}

fetal growth for healthy development of the brain, spinal cord, and skull13

• _{Ensuring sufficient levels of folate in women prior to}

conception can reduce neural tube defects (a serious birth defect) by up to 50%13

• _{Supplementations of women 15-49 years with folic acid,}

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MICRONUTRIENTS VERSUS MACRONUTRIENTS

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vitamin

Definition

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Vitamin Structure and Function

•

All vitamins contain carbon, hydrogen, and oxygen

– _{Some vitamins contain nitrogen and sulfur}

•

Chemical structure of each vitamin is unique

•

Vitamins are absorbed intact

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Classification of Vitamins

•

Classification is based on solubility

– _{Eight water-soluble: B vitamin complex and vitamin C} – _{Four fat-soluble: vitamins A, D, E, and K}

•

Solubility influences a vitamin’s

– _Digestion – _Absorption

– _{Transportation} – _Storage

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Slide 24 of 27

Fat-soluble vitamins can be stored by the body

Fat-Soluble Vitamins

Sources of fat-soluble vitamins are vegetable oils

liver eggs

certain vegetables

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Slide 26 of 27

Water-soluble vitamins cannot be stored by the body.

Water-Soluble Vitamins

Examples of water-soluble vitamins are C and all of the B vitamins.

Sources of water-soluble vitamins are fruits

vegetables

whole-grain foods

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14

Essential Vitamins For Human Being

vitamins

water -soluble

lipid-soluble

Vit C

Vit B

A,D,E,K

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Vitamin Absorption and Storage

•

All absorption takes place in the small intestine

•

Fat-soluble vitamins

– _{Are absorbed in the duodenum} – _Storage

• _{Vitamin A is mainly stored in the liver}

• _{Vitamins K and E are partially stored in the liver}

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Vitamin Absorption and Storage

•

Water-soluble vitamins

– _{Absorbed with water and enter directly into the blood}

stream

– _{Most absorbed in the duodenum and jejunum} – _{Most are not stored in the body}

– _{Excess intake excreted through the urine}

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Water-Soluble

Vitamins

Fat-Soluble

Vitamins

Absorbed in

the

Small Intestine Small Intestine

Hydrophobic or

Hydrophilic

Hydrophobic

Absorbed into

the

Blood

Lymph

Stored in the

body

Not Generally

Yes

Can build up

and become

toxic

Not Generally

Yes

Need to

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Bioavailability

•

Varies based on

– _{Amount in food} – _Preparation

– _{Efficiency of digestion and absorption of food} – _{Individual nutritional status}

– _{Natural or synthetic}

•

Fat-soluble vitamins are generally less

bioavailable than water-soluble vitamins

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Destruction of Vitamins

•

Water-soluble vitamins can be destroyed by

– _{Exposure to air}

– _{Exposure to ultraviolet light} – _Water

– _{Changes in pH} – _Heat

– _{Food preparation techniques}

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Toxicity with Overconsumption

•

Vitamin toxicity, hypervitaminosis

– _Rare

– _{Results from ingesting excess vitamins and tissue}

saturation

– _{Can damage cells}

•

Dietary Reference Intakes include tolerable upper

intake limits (UL) for most vitamins to prevent

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Provitamins and Preformed Vitamins

•

Provitamins

– _{Substances found in foods that are not in a form directly}

usable by the body

– _{Converted to the active form once absorbed}

•

Preformed vitamins

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Antioxidants

•

Group of compounds that neutralizes free radicals,

helping to counteract the oxidation that takes place

in cells

– _Includes

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Quick Review

Vitamins

•

Essential nutrients

•

Needed in small amounts for growth, reproduction,

and overall health

•

Classified by solubility

– _{Fat-soluble (A, D, E, and K)} – _{Water-soluble (B and C)}

•

Destroyed by

– _{Exposure to air, water, UV light, pH changes, and heat}

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• _{Some participate with}

enzymes in metabolic processes (cofactors)

• _{Some have structural}

functions (Ca, P in bone; S in keratin)

• _{Acid-base and water balance}

(Na, K, Cl)

• _{Nerve & muscle function (Ca,}

Na, K)

• _{Unique functions (e.g., heme,}

B12, thyroid hormones)

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Macro or Major minerals: present in body tissues at concentrations > 50 mg/kg (50 ppm)

sodium (Na), potassium (K), magnesium (Mg), calcium (Ca), phosphorus (P), sulfur (S)

Micro or Trace minerals (body needs relatively less): present in body tissues at concentrations < 50 mg/kg (50 ppm)

chromium (Cr), manganese (Mn), chloride (Cl), iron (Fe), cobalt (Co), molybdenum (Mo), copper (Cu), zinc (Zn), fluoride (F), iodine (I), selenium (Se), silicon (Si), tin (Sn), arsenic (As), nickel (Ni) …

MINERALS CLASSIFICATION

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Golongan Mineral % Berat badan Jumlah dalam tubuh Mineral makro

(> 0,005 % Berat badan) Ca P K S Na Cl Mg 1,5-2,2 0,8-1,2 0,35 0,25 0,15 0,15 0,05 1,02 kg 0,68 kg 0,27 kg 0,20 kg 0,14 kg 0,025 kg Mineral mikro

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• Physiological state

• _{Interactions with other minerals}

• _{Tissue storage}

Bone, Liver

Specific proteins to hold and transport • _{Form fed}

Inorganic vs organic forms Na selenite vs Na selenate vs selenomethionine

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Most minerals have an optimal range

• _{Below leads to deficiency symptoms} • _{Above leads to toxicity symptoms}

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BIOAVAILABILITY & REGULATION OF TRACE

MINERALS

•

Bioavailability influenced by:

–

Genetics

–

Nutritional status

–

Nutrient interactions

–

Aging

•

Absorbed in small intestine

•

Circulated in blood

•

Deficiencies & toxicities rare

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Transferrin –

Fe

, Cr, Mn, Zn

Albumin – Cu, Zn

Amino acids – Cu, (Fe)

Trancobaltamin - Co

Globulins - Mn

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NORMAL ROUTES OF EXCRETION OF TRACE

ELEMENTS

Bile –

Cu

,

Mn

, Cr, Zn,

Urine –

Co

,

Cr

, Mo, Zn

Pancreatic juice –

Zn

Sweat

–

Zn

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11/13/18 _{Mineral Interaction} 55

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11/13/18 _{Interaksi Vitamin-Mineral} 56

Mekanisme Interaksi Vitamin-Mineral:

(1) Satu mikro-nutrien secara langsung mempengaruhi penyerapan micro-nutrien lain

(2) Defisiensi atau ekses satu mikro-nutrien di dalam tubuh mempengaruhi metabolisme mikro-nutrien lain

Contoh: (1) asam askobat dgn Fe; asam folat dgn Zn

(2) defisiensi Zn thd retinol binding protein (RBP) dan

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