Magnesium: A major cofactor in over 300 enzymatic reactions in the body! It is necessary in adequate levels for energy production, insulin function, protein synthesis and blood pressure regulation and muscle/nerve function. That is every major system in the body!
Oh and by the way you need it to make DNA/RNA and glutathione (my personal favorite). Magnesium is located about half in our bones and the other half in tissues. Our blood has less than 1%. Our kidneys keep the blood level of magnesium in tight control.
It is obvious that this mineral is insanely important to us! Where can we get it? The best HEALTHY sources of mag are spinach, nuts, beans, oatmeal, avocado, soy, potato and banana. Fish, chicken and beef have reasonable amounts as well.
Insufficiency and deficiency occurs primarily in people with gastroenterological disorders (Crohns, celiac and ulcerative colitis), alcoholism, type 2 diabetes and a poor quality diet. Medicines like antacid proton pump inhibitors, certain antibiotics and diuretics will lower magnesium levels.
Magnesium deficiency causes problems with blood pressure control and heart function. Osteoporosis is a long term consequence of chronic magnesium insufficiency. Migraine headaches are associated with low magnesium levels. Diabetics lose more magnesium in their urine because of elevated blood sugar levels. The low magnesium in turn worsens insulin sensitivity. A vicious cycle!
We use it frequently in the emergency setting to save a life when someone is dying from a cardiac arrhythmia or asthma attack.
Insufficiency is also a problem for neurological function. Low magnesium levels are associated with increased anxiety, insomnia, constipation, ADD, IBS, chronic fatigue and a laundry list of other issues.
In order to absorb magnesium well, you need vitamin D and B6 as well as selenium and the amino acid taurine. This of course happens naturally when we eat vegetables, fruits and get sun exposure.
Take home point: if you feel mentally or physically tight, you are likely low in magnesium. Load up the nuts, organic spinach, salmon, organic soy and beans. Get out in the sun for 20 minutes daily without sunscreen. If that does not work, take magnesium supplements like magnesium taurate or glycinate. Watch out for citrate - it can give you a nasty bout of #3.
Dr. M
Zinc: Second on my list of imprortant minerals.
A mineral involved in over 100 enzymatic reactions in the body! It is necessary in adequate levels for cellular metabolism.
It is critical for the function of our immune system, our skin and our gut lining.
At the cellular level zinc is necessary for protein synthesis, DNA synthesis and cellular repair in wound healing.
Zinc is primarily found in the brain, muscles, bones, kidney, liver and prostate. It is yolked to copper in serum concentrations. Low zinc is associated with elevated copper and this is associated with neurological abnormalities.
Deficiency of zinc occurs with a disease known as Acrodermatitis Enteropathica and also inadequate dietary zinc intake. Deficiency can lead to severe diarrhea, severe immune dysfunction, rashes, depression and growth failure.
Some common symptoms and diseases related to insufficient zinc include: recurrent infections, chronic mild diarrhea and diaper rashes, macular degeneration, worsening atopic diseases like eczema and asthma.
Food sources of zinc: Oysters are the bounty with 74mg per serving. Meats, fish, beans, nuts and dairy contain 7 mg or less per serving.
Zinc supplements can interact certain antibiotics and diuretics. Ask your pharmacist if you are taking zinc and prescribed one of these medicines.
Take home point: if you have chronic diarrhea or get sick frequently, you may be low in zinc. Load up the meats, fish, beans, nuts and dairy.
Dr. M
Calcium: Third on my list of imprortant minerals.
A mineral involved in many reactions in the body! It is found primarily in our bones and teeth as a storage site. The body carefully regulates calcium levels by stealing from the bones when the system needs more.
It is critical for the function of blood vessels, muscles, neurologic and intracellular signal transmission. It is also critical for hormone secretion. This covers every aspect of feeling good and moving with fluidity.
Based on age, we need roughly 1000mg daily. This should be derived primarily by diet. Current evidence suggests that supplementing above 500mg for a 70 kg human is not a good idea. Calcium supplements require acid to absorb and therefore should be taken with food. Supplemental absorption decreases with age and is poor in adulthood at 15-20%.
Phytic and oxalic acid decrease absorption. Foods loaded with phytic acid like unsoaked beans will reduce the absorption of calcium in food or supplements.
Food sources of calcium are primarily dairy, fish with bones (salmon/sardines/smelt/anchovies), organic soy/tofu and leafy greens.
Vitamin D is necessary for gut absorption of calcium. Diets high in sodium and caffeine will decrease calcium absorption.
Deficiency states occur with disease. Kidney disease, vitamin D deficiency, GI absorption disease and certain medications (diuretics/antacids/steroids) all can lead to a deficiency state.
Symtoms of deficiency include muscle twitching and cramps, numbness in your extremities and eventually abnormal heart beats, seizures and death.
My real concern about calcium is rooted in insufficiency states. The long term consequences are bad. Osteoporosis or bone weakness is the major side effect of chronic insufficiency which in turn leads to excessive fractures.
I do not recommend supplements unless advised by a provider. Work hard to get adequate calcium through your diet (roughly 1000mg daily for adults) and make sure that you are getting adequate sun exposure daily. Daily exercise is also critical for laying down new bone (osteogenesis). If you do need a supplement, take calcium citrate 250mg twice daily for an adult and less for children based on provider recommendations.
Most of your bone is laid down before the third decade of life is completed. This is important for parents to pay attention to as inadequate calcium intake can set a child up for osteoporosis as an adult.
Take home point: Make sure that your kids are active, eating a balanced calcium rich diet and getting 20 minutes of daily sun exposure.
Dr. M
Iron: Fourth on my list of imprortant minerals. Could be first actually!
A mineral primarily necessary for carrying oxygen around our body via hemoglobin proteins on our red blood cells. It is also found in a storage form called ferritin in our liver, spleen and bone marrow or as myoglobin in our muscles.
It is critical for the function of oxygen transport, muscles metabolism, neurologic and intracellular signal transmission. It is also critical for hormone function growth and development. Critical to learning and developing as a baby/toddler.
Infants and teenagers need the most iron daily at 11 grams per day for males and more for females that menstruate. Most people may actually need more than this to support optimal function.
Dietary sources of iron come in two forms, heme and non heme. Heme iron is found primarily in animal muscles including fish. Non heme is found in vegetables, beans, nuts and grains. The distinction is important from a utilization perspective. Heme iron is more bioavailable than the vegetable based non heme. Vegetarians need 2X more non heme iron to get the same effect.
Vitamin C is critical for enhancing the absorption and utilization of non heme iron. Eating vegetables along with meats also enhances the non heme iron utilization. Hence the reason for a balanced diet at all meals.
Phytic acid decreases absorption. Foods loaded with phytic acid like unsoaked beans and grains will reduce the absorption of non heme iron in food or supplements. Certain polyphenols found in tea and vegetables are also inhibitory.
Calcium can inhibit iron absorption. Keep these supplements away from each other.
Deficiency states occur with inadequate intake and certain diseases. Acute or chronic blood loss is a common cause of iron deficiency. GI malabsorption diseases like celiac, Crohns and ulcerative colitis are common causes of concern with iron. People from third world countries can experience iron deficiency from parasitic disease.
Symtoms of deficiency include fatigue, anemia(pallor), mental fog, restless sleep, temperature regulation issues and immune system depression. ADHD and other neurologic problems are worsened by low levels of iron.
My real concern with iron is the insufficiency state. Many children suffer from learning dysfunction, sleep parasomnias, attention issues, fatigue, and general weakness. Checking a ferritin level and aiming for 50 ng/ml is optimal.
Iron in the supplemental form is very useful but dangerous in overdose. All iron supplements should be stored clear of children. Acute iron toxicity will cause vomiting, stomach pains, organ failure, seizers and death. Iron and zinc should not be taken at the same time as iron reduces the zinc's absorption.
Iron supplements affect drugs including thyroid and antacid medicines. Consult your pharmacist when using these medicines and taking iron supplements.
If you have any of the above symptoms, I recommend a standard CBC and a ferritin level. I do not recommend supplements unless advised by a provider. Iron is an oxidant and can promote inflammation in an excessive state and as stated earlier can cause severe liver disease.
Work hard to get adequate heme and non heme iron through your diet (roughly 11 gm daily for adults) and make sure that you are taking vitamin C rich foods as well. These include citrus fruits and red, yellow and orange vegetables as well as cabbages. Cooking in a cast iron skillet will also help increase iron levels.
Dr. M
Selenium: a trace mineral found in some foods and the earth.
A mineral primarily necessary as a cofactor in cellular reactions related to reproduction, hormone synthesis, DNA synthesis and immune function. It specifically helps protect against toxic oxygen radicals and oxidative damage.
I love selenium because it helps to recycle the most important antioxidant/chemical clearance molecule that we have called glutathione. Without adequate selenium, glutathione levels will drop and you will be much more prone to xenobiotic chemical damage from our chemically polluted world.
Dietary sources of selenium come in two forms, organic and inorganic. The inorganic form is found in the soil while the organic form is produced when plants uptake the inorganic form and convert it. It is stored in our bodies primarily in our muscles.
Food sources are primarily in the fish and animal meats. Brazil nuts are exceptionally high in selenium. Spinach, whole grains and beans are a good source for vegetarians.
Selenium needs are roughly 40-55 mcg daily for teens and adults and less for growing children.
Deficiency states are exceedingly rare in the United States.
Selenium insufficiency is associated with increased risks of cancer especially GI types as it is protective against DNA damage. Low levels of selenium also increase the lipid oxidation events that lead to coronary heart attacks and high blood pressure.Neurocognitive decline in adults is also associated with low selenium.
Selenium is very useful but dangerous in overdose. Selenium toxicity will cause brittle hair and nails, diarrhea and neurologic dysfunction. Exercise caution when consuming brazil nuts that contain high amounts of selenium.
Selenium supplements affect drugs iinvolved in cancer therapy. Consult your pharmacist when using these medicines and taking iron supplements.
Work hard to get adequate selenium through your diet.
Dr. M
Potassium: a mineral found abundantly in some foods and the earth as a white salt. It gets its name from potash or plant ash which is loaded with potassium.
Every cell in the body utilizes potassium in some way. It is necessary for signal transduction in all nerves and muscles including the heart. It is critical for kidney and hormone function. Your intestines require it to move and your blood requires it to keep acid/base balance. We use it in carbohydrate metabolism and much more.
Potassium like sodium has an electron by itself in an outer atomic ring that allows it to give away the electron easily forming a positive ion that is used by the body readily in reactions.
Sources of potassium in food include all meats including fish. Soy and other legumes as well as broccoli are loaded. Potatoes with skins, banana, kiwi, citrus fruit, prune/plum, avocado, apricot, dairy and all nuts round out the list.
Deficiencies in potassium are very dangerous and occur primarily with acute and chronic diseases like excessive vomiting or diarrhea, kidney impairment and adrenal gland dysfunction. The symptoms of deficiency include bowel movement dysfunction, high blood pressure, weakness, and cardiac rhythm disturbances.
Insufficiency is often associated with constipation, fatigue, muscle weakness and cramping.
Potassium overload is generally related to disease and medicine use. It is rare in children except in kidney or heart disease patients. Too much potassium presents with heart rhythm abnormalities and can lead to death.
Children taking kidney diuretics or heart medicines are at the greatest risk for low and high potassium levels.
Overall, a regular diet filled with vegetables, meat and fruit will supply adequate potassium for function. If your child has any of the above symptoms of insufficiency consider increasing the intake of apricots, nuts and meats in their diet.
Dr. M
Sodium: a metal mineral found abundantly in some foods and the earth as a white metal/salt.
It is necessary for maintaining normal blood volumes and pressure. Cells in our body utilizes sodium in conjunction with chloride and potassium to set up an electrochemical gradient across the cells membrane. This is critical in the function of nerve signals and muscular activity.
Our body uses the kidneys to increase sodium concentrations to raise blood volume and the reverse as well.
Sodium, like potassium, has an extra electron in the outer most atomic ring making it a perfect donor that allows it to give away the electron easily forming a positive ion that is used by the body readily in reactions.
We most commonly derive sodium in the form of sodium chloride or salt. The powdery white substance that is ubiquitous in our kitchens.
From a medical perspective, sodium is almost never a dietary deficiency or insufficiency concern because of the change in the American diet over the last 30 years. However, certain diseases of the kidneys, adrenal and pituitary gland can lower sodium levels. Persistent vomiting, diarrhea or excessive sweating with endurance athletes can cause a low sodium level. Low sodium levels will cause the following symptoms: fatigue, cramping, nausea, vomiting, fainting and mental disorientation. Severe sodium depletion will cause seizures, brain swelling and ultimately death.
Drugs that can cause low blood sodium include kidney diuretics, certain antidepressants and NSAID's like ibuprofen or naprosyn.
The truth is that the bigger concern is too much sodium. We consume large quantities of sodium through our processed food appetite. Chips, crackers, soups and fast food all pack a monstrous punch in terms of sodium content. Too much sodium is associated with high blood pressure, osteoporosis, stomach cancer and kidney stones.
If we consume a whole foods non processed diet and do not add significant amounts of table salt to our food, we are at very low risk for any of these issues.
Aim for avoiding processed foods and canned soups as much as possible. Know the symptoms of low sodium if your child has kidney disease, heart disease
Dr. M
Manganese: a metal found in combination with other metals on earth.
It is necessary for many enzymatic processes, especially detoxification of oxygen radicals. It is important in developmental neurologic processes and metabolism. We need it for bone and connective tissue growth and repair.
Manganese is stored primarily in our bones but also in our liver and kidneys.
Manganese's major role is as a cofactor for superoxide dismutase in our cell's energy center, the mitochondria. It helps the body clear out nasty oxygen radical species that can damage our DNA and cells. It also is necessary for the metabolic functions of cholesterol synthesis, carbohydrate and amino acid metabolism. It is necessary for glucose production in the liver as well as clearing ammonia out of our system.
Manganese is important for the production of GABA, an inhibitory neurotransmitter, that helps keep the brain calm.
Manganese deficiency is extremely rare. Insufficiency states can result from poor nutritional habits. Consequences of inadequate manganese are fatigue, inflammation, oxidative cellular stress, sugar and fat metabolism problems, impaired bone, nail, hair and tissue growth.
We most commonly derive manganese from whole grains, legumes, dried fruits, nuts, dark green leafy vegetables, liver, kidney and tea.
Manganese absorption can be disrupted by excessive supplemental iron, folic acid, calcium or phosphorus. Checking a manganese level is not a bad idea if on high doses of these supplements.
Children need 1-2 mg per day which is easily obtained from a quality diet. Adults need closer to 2.5mg per day.
Manganese overdose or unknown ingestion can be neurotoxic and cause a Parkinson like disorder with muscle rigidity. High risk groups are drug users who get exposed to manganese laced drugs.
Dr. M
Thiamine: also known as vitamin B1 is a water soluble compound that is necessary for cellular metabolism of fats, sugars and branched chain amino acids. It is involved in major cardiovascular and neurologic pathways.
Thiamine pyrophosphate is the active form that is necessary for many enzymatic processes important in developmental neurology and metabolism. It requires magnesium to be produced from ingested thiamine.
Thiamine is stored primarily in our bones, heart, brain, liver and kidneys. It is bound to albumin proteins in our blood for circulation around the body.
Thiamine deficiency is known as beri beri. It presents with peripheral neuropathy sometimes called "burning feet syndrome". As it progresses, patients develop weakness and poor sensory function. Optic nerve dysfunction can present as visual loss. The next shoe to drop is on the heart: an increased heart rate, feet swelling and an enlarged heart ultimately lead to congestive heart failure. Eventually, the brain takes a hit and the symptoms are abnormal eye movements, wobbly gait and cognitive impairment. The end stage is irreversible brain damage and dementia.
Insufficiency states can result from poor nutritional habits. Consequences of inadequate thiamine are worsening blood sugar control, increased risk of cataracts and Alzheimer's disease and other minor metabolic irritations.
We most commonly derive thiamine from whole grain wheat or rice, wheat germ, lentils, spinach, pork, pecans, orange, oatmeal, flax, eggs, asparagus and milk.
Thiamine activity can be disrupted by excessive anti-thiamine factors found in coffee and tea. Alcoholism can disrupt the absorption of B1 in the intestines. I distinctly remember my days at the Grady Memorial Hospital ER on a friday night where most of the gurneys had a patient with a yellow thiamine IV bag hanging over them. These were called rally packs or banana bags for the color. That was the obvious sign of an alcoholic.
Children need 500 mcg per day which is easily obtained from a quality diet. Adults need closer to 1200 mcg per day.
Thiamine overdose is not possible as it is water soluble and will be excreted in the urine in excess.
As we go through the B vitamins, look at your child's diet and make sure that they are replete with adequate volumes of many of these vitamin rich foods.
Yellow banana bags are hanging somewhere as I write,
Dr. M
Riboflavin: also known as vitamin B2, is an essential nutrient for energy and methylation pathways in our system.
It is a water soluble vitamin that we use in the production of FAD, flavin adenine dinucleotide, and FMN, flavin mono nucleotide. These two chemicals are critical in the pathways of inner cell mitochondrial energy production.
Methylation of your DNA via an enzyme known as MTHFR, methyl tetrahydrofolate reducatase, occurs with the help of riboflavin. Think of this as putting sticky notes on your genes that tell your cells to read or not read critical segments of DNA. This process helps us regulate what genes get read and turned on or more importantly silenced. Among other things, dysfunctional MTHFR enzyme activity because of low B2 is associated with preeclampsia in pregnant women leading to prematurity or more problematic condition called eclampsia. One of the critical reasons behind the recommendations for prenatal vitamins.
Riboflavin helps prevent migraine headaches in patients that suffer from them. Supplements like Migrelief combine B2 and other herbs to control migraine symptoms. I find that the most powerful tool for migraine prevention is an elimination diet based on IgG4 food sensitivity testing.
Glutathione is the most powerful chemical clearing substance in our body. Riboflavin is necessary to recycle it for reuse. A problem called oxidative stress where toxic oxygen molecules damage our cells is related to low riboflavin levels and poor recycling of glutathione.
We need B2 to metabolize three other critical B vitamins, B3/B6/B9. The whole system is linked and functions ideally with good volumes of all water soluble B vitamins.
Low B2 alters iron absorption which can lead to mild anemia.
Riboflavin deficiency presents with cracked lips, red irritated corners of the mouth, red tongue and scaly skin.
There are no known side effects of excessive riboflavin intake.
Food sources of riboflavin green leafy vegetables, broccoli, asparagus, eggs, almonds, liver, dairy, legumes, fish, meat and mushrooms. The US government has been fortifying breads and cereals for years.
Most adults need 1.1 to 1.3 mg/day. Incrementally less for kids. This nutrient is easily obtained from a anti inflammatory diet.
People at risk for insufficiency or deficiency have: alcoholism, inflammatory bowel disease, HIV, eating disorders, celiac disease, heart disease and certain drugs including oral contraceptives, phenobarbitol, cancer and anti psychotic drugs.
(The yellow color of the IV bags hanging over gurneys of alcoholics in the emergency department referenced last week comes from vitamin B2. It is poorly soluble in water and is yellow.)
Dr. M
Niacin: also known as vitamin B3, is an essential nutrient for energy, longevity and DNA repair pathways in our system.
It is a water soluble vitamin that we use in the production of NAD, nicotinomide adenine dinucleotide that is phosphorylated and reduced into actionable forms in the body.
NAD is a critical coenzyme in over 400 reactions in the body. The most important of which is the oxidative phosphorylation cascade to produce energy in the cell. As we break down fats, sugars and proteins into energy, NAD donates electrons to make the reaction go. It is also used in the production of fatty acids and cholesterol.
NAD is involved in the activity of PARP enzymes that are essential for DNA repair and programmed cell death. This all leads to the knowledge that niacin is critical for cancer prevention. There is preliminary data that niacin protects our skin from sunlight damage.
Niacin is most famous for its lipid lowering effects to prevent coronary artery disease. It has been shown in many studies to help alter our fat carrying molecule profile towards a more favorable type of large and fluffy lipoproteins.
Newer research is showing that NAD is involved in a class of genes called sirtuins, anti aging genes. These genes encode for enzymes that alter proteins during production and thus cause age prolonging effects. This activity is enhanced during intermittent fasting. ( I highly recommend this type of fasting - see this podcast).
Niacin deficiency is deadly and called pellagra. It presents with digestive, skin and neurologic dysregulation. The 3 D's of dermatitis, dementia and diarrhea. Skin rashes are on sun exposed areas and are thick, scaly and brown pigmented. Patients get a bright red tongue and complain of vomiting and abdominal pain. The symptoms progress to headaches, memory loss and fatigue.
There are no known serious side effects of excessive niacin intake. Many people flush, fell hot and turn red, when consuming high doses for cardiac cholesterol control. Taking the metabolite nicotinamide will avert the flush symptoms.
Food sources of B3 are predominantly from animal flesh and legumes. The US government has been fortifying breads and cereals for years as an added source.
Most adults need 12 to 16 mg/day. Incrementally less for kids. This nutrient is easily obtained from a anti inflammatory diet.
People at risk for insufficiency or deficiency have: alcoholism, inflammatory bowel disease, cancer, HIV, eating disorders, celiac disease, heart disease and certain drugs including isoniazid, anti cancer immunosuppressants like 6MP.
Dr. M
Pantothenic acid: also known as vitamin B5, is an essential nutrient for energy production.
It is a water soluble vitamin that we use in the production of Coenzyme A.
Coenzyme A is a critical coenzyme in the synthesis as well as the degradation of fats, carbohydrates and proteins. You may remember HMG CoA and Acetyl CoA from previous articles discussing cholesterol synthesis and fat break down.
Acetyl CoA and Succinyl CoA are critical for steroid and hormone production as well as energy cycles like the infamous citric acid cycle.
Vitamins A and D require pantothenic acid for production as does the sleep hormone melatonin.
Acetyl CoA is a donor for acetylation reactions that are epigenetic and alter the function of proteins encoded by our DNA.
Finally, this amazing vitamin is involved in many cell signaling pathways.
That list of hard science reactions boils down to the knowledge that pantothenic acid is necessary for many life giving reactions in our body and cannot be taken lightly. The good news is that it is rarely missing in most humans because the vitamin is found in many food sources.
B5 deficiency although rare can happen in extreme cases of malnutrition and presents with headache, fatigue, insomnia, intestinal disturbances, and numbness and tingling of their hands and feet.
Clinical applications of higher doses of pantothenic acid have centered around its lipid lowering effects in hypercholesterolemia. It has been found to lower LDL and triglyceride levels.
It has been used for wound healing as well as troublesome acne. Combining pantothenic acid and L carnitine as a shuttle has been successful in controlling acne for many of my friend's patients.
B5 is one of the few vitamins that can be synthesized by intestinal bacteria.
Food sources of B5 are predominantly from animal flesh, eggs, dairy, avocado, sweet potatoes, whole grain wheat and legumes. The US government has been fortifying breads and cereals for years as an added source.
Toxicity from supplements is almost unheard of. There are exceedingly rare cases of diarrhea and skin irritation.
Most adults need 5 mg/day. Incrementally less for kids. This nutrient is easily obtained from a anti inflammatory diet.
People at risk for insufficiency or deficiency have: alcoholism, inflammatory bowel disease, cancer, HIV, eating disorders, celiac disease, heart disease and certain drugs including isoniazid, anti cancer immunosuppressants like 6MP.
Know the vitamin insufficiency symptoms and you can treat many issues safely,
Dr. M
Pyridoxine: also known as vitamin B6, is an essential nutrient for the metabolism of carbohydrates, fats and proteins.
It is a water soluble vitamin with a version known as pyridoxal 5 phosphate, P5P or PLP, that is required for 100 enzymatic reactions related to protein metabolism.
We need B6 to release glucose from stored glycogen as well as making glucose from amino acids, gluconeogenesis. Fatty acid metabolism is also a B6 dependent process. B6 is clearly critical for energetic cellular activity.
Neurotransmitters that are involved in mood, specifically Serotonin and Dopamine, are pyridoxine dependent. GABA, an inhibitory neurotransmitter has been shown in clinical studies to be calming. Insufficient volumes of P5P can have adverse effects on mood and agitation.
We need B6 as a cofactor for an enzyme to make heme, the oxygen carrying part of hemoglobin of a red blood cell. Microcytic or small red blood cell anemia is a side effect of low B6 levels.
PLP is also a critical cofactor in the methylation pathways of folate. Remember that this pathway is necessary for appropriate DNA function and the downstream effects of proper DNA reading.
Pyridoxine deficiency is not common. It presents with irritability, depression, mood dysregulation and seizures in certain genetically susceptible individuals. Oral ulcers and cracking lips at the corners can occur. A swollen red tongue is also noted in deficiency states. Fatigue and anemia occur after energy and heme systems are depleted.
Insufficiency is the greater concern in our population. Current literature is showing that inadequate levels of B6 will cause your immune system to function suboptimaly. It is also associated with coronary artery disease where people with the lowest levels of B6 have a higher risk of myocardial infarction.
(I believe that the truth when it comes to heart disease is that all of these B micronutrients are critical for the whole system to work right. After we make it through them all, go back and see how tightly they are all intertwined to protect the heart.)
We know that low B6 levels hamper the function of the transulfuration pathway enzymes and cause elevations in homocysteine which is associated with coronary artery disease. If homocysteine is not converted to glutathione, we have a major problem with detoxifying our system. B2 is also critical in this detox system.
Keeping B6 levels adequate should be a first line therapy coupled with a sleep regimen for anyone with mood issues
In adult populations, there are no known serious side effects of excessive PLP intake below 200 mg daily(200,000 mcg). Mega dosing has been shown to cause peripheral nerve damage and should be avoided.
Food sources of B6 are predominantly from poultry, salmon, spinach, potatoes, nuts and fortified foods. The US government has been fortifying breads and cereals for years as an added source.
Most adults need 1200 to 1600 mcg/day. Incrementally less for kids. This nutrient is easily obtained from a anti inflammatory diet.
People at risk for insufficiency or deficiency have: alcoholism, inflammatory bowel disease, cancer, HIV, eating disorders, celiac disease or consume the following drugs: oral contraceptives, anti tuberculous and anti parkinson drugs, non steroidal anti inflammatory medicines.
Dr. M
Biotin: also known as vitamin B7, is an essential nutrient for the expression of genes as well as as a cofactor in some enzymatic reactions discussed over the past few weeks with regard to fat, sugar and protein biosynthesis and degradation.
It is a water soluble vitamin that is used to produce a group of carboxylase enzymes. These enzymes are utilized throughout the cycles of fat oxidation, protein and carbohydrate degradation and biosynthesis. As opposed to the previously discussed B vitamins that are direct cofactors, B7 is an indirect need for these reactions.
We need B7 in a reaction called biotinylation. This is when our DNA is compacted around histone proteins to protect it from damage as well as shield it from expressing hidden genes.
Biotin deficiency is not common. It presents with hair loss and a facial rash characterized by red scaly bumps on the forehead, nose and cheeks and genitals. Neurologically, depression, mood dys-regulation, numbness/tingling of extremities, difficulty walking and seizures develop.
Babies born with genetic defects in biotin metabolism present with similar rash patterns and progress rapidly to neurologic and immune dysfunction with devastating consequences. Multiple carboxylase deficiency is the most devastating type with more minor variants occurring in other enzymes like biotinidase. In the United States, all children are screened for these defects at birth. This is a blessing as the treatment with biotin can change the outcome dramatically.
Insufficiency is not of great concern in our population. Current literature is showing that inadequate levels of B7 will cause mood problems, hair loss/thinning, dermatitis and increased infectious disease risk to fungal and bacterial species.
B7 shows promise in the treatment of multiple sclerosis and diabetes mellitus.
Keeping B7 and all B vitamin levels adequate should be a first line therapy coupled with a sleep regimen for anyone with mood issues.
In adult and child populations, there are no known serious side effects of excessive B7 intake.
Food sources of B7 are peanuts, swiss chard, liver, egg yolks, yeast, pork, avocado, salmon, cauliflower, raspberries and fortified foods. The US government has been fortifying breads and cereals for years as an added source.
Our gut bugs can synthesize biotin. Dysbiosis or abnormal gut bacterial flora can adversely affect the natural endogenous production of biotin and put you at risk for insufficiency. Consuming raw eggs repeatedly can affect biotin levels negatively.
Most adults need 30 mcg/day. Incrementally less for kids. This nutrient is easily obtained from a anti inflammatory diet. Pregnancy and infancy are times of increased B vitamin needs.
People at risk for insufficiency or deficiency have: alcoholism, intestinal dysbiosis, inflammatory bowel disease, eating disorders, celiac disease or take the following drugs: anti seizure drugs. Smoking continuously is a risk factor as it increases the catabolism of B7.
Dr. M
Folate: also known as vitamin B9, is an essential nutrient for the expression of genes as well as as a cofactor for one carbon metabolism of nucleic acids and amino acids. This B vitamin is the focus of much study right now as it is critical to human health.
It is a water soluble vitamin that is used as a cofactor in gene expression systems as well as the production of our book of life pieces, DNA/RNA, as well as certain amino acids.
We need B9 to help a reaction occur in the body called methylation that allows a carbon atom group called a methyl group to be transferred to certain locations on the DNA sequence that puts a silencing sticky note in place. B12 and B3 are necessary for the completion of this function. Other methylation reactions are also dependent on folate. These events help prevent abnormal DNA transcription made famous by Randy Jirtle's Agouti mouse. Inappropriate function at this methylation level is linked to cancer and many other disorders. It is part of the basis of the exploding field of epigenetics.
We need folate to make DNA from its precursors. We use it to make and repair the DNA of cells throughout the body. It is critical during periods of rapid cell growth including pregnancy, infancy and puberty.
Folate deficiency is uncommon. It presents megaloblastic anemia which is a large red blood cell anemia. Patients are fatigued, pale, have a swollen red tongue and diarrhea . Neurologically, depression, mood dys-regulation, numbness/tingling of extremities and other emerging associated neurologic diseases.
Babies born with neural tube spine defects are known to have prenatal maternal folic acid deficiency.
Insufficiency is of great concern in our population. Current literature is showing that inadequate levels of B9 will cause mood problems, hair greying, diarrhea and other issues based on genetic risks.
Polymorphisms of certain genes including MTHFR, methyltetrahydrofolate reductase, are being heavily studied with regard to cardiovascular disease, cancer and dementia. Most integrative providers are testing for these genetic variants and supplementing with methylated folate to reduce homocysteine and other metabolites associated with disease. The hallmark paper on Alzheimers treatment by Dr. Bredenesen in California has treatment of MTHFR SNP's as part of a comprehensive and successful approach to Alzheimers.
Homocysteine is an amino acid that builds up in humans with SNP's of MTHFR. Getting the level to a recommended range is the current target for anti cardiac and cancer risk stratification protocols. I personally have dealt with this SNP in my genome and have successfully lowered my homocysteine out of the believed risk range through diet and targeted supplements.
Keeping B9 and all B vitamin levels adequate should be a first line therapy coupled with a sleep regimen for anyone with mood issues.
In adult and child populations, there are no known serious side effects of excessive B9 intake.
Food sources of B9 are beans and leafy greens. The US government has been fortifying breads and cereals for years as an added source.
Most adults need 400 mcg/day. Incrementally less for kids. This nutrient is easily obtained from a anti inflammatory diet. Pregnancy and infancy are times of increased B vitamin needs. We highly stress the need for adequate B vitamin stores for all females of child bearing age.
People at risk for insufficiency or deficiency have: alcoholism, smokers, intestinal dysbiosis, inflammatory bowel disease, eating disorders, celiac disease and people using sulfasalazine for inflammatory bowel disease, methotrexate for autoimmune disease and seizure medicine phenytoin.
Dr. M
B12: also known as cobalamin because it contains cobalt, is an essential nutrient for the expression of genes as well as as a cofactor in folate related cycles. It is a cofactor for methionine synthase and methyl malonyl CoA mutase. This B vitamin is also the focus of much study right now as it is critical to human health.
It is a water soluble vitamin that cannot be made by mammals. It is used as a cofactor in gene expression systems as well as the production of neurotransmitters, nucleic acids and hemoglobin for red blood cells. This is a vitamin that is profoundly necessary for your nervous system.
We need B12 to help folate's methylation reaction occur in the body. It allows a carbon atom group called a methyl group to be transferred to certain locations on the DNA sequence that puts a silencing sticky note in place. B9 and B3 are necessary for the completion of this function. These events help prevent abnormal DNA transcription made famous by Randy Jirtle's Agouti mouse. Inappropriate function at this methylation level is linked to cancer and many other disorders. It is part of the basis of the exploding field of epigenetics.
We need B12 to make methionine from its precursors. The amino acid homocysteine builds up when this enzyme function is not working. It is critical during periods of rapid cell growth including pregnancy, infancy and puberty.
B12 is also critical for the development of succinyl CoA via methyl malonyl CoA mutase. Succinyl CoA is the precursor to the citric acid cycle via fat and protein metabolism. It is also necessary to produce hemoglobin for red blood cells to carry oxygen around the body.
B12 deficiency is uncommon except in groups that avoid meat including vegans and some rare vegetarians. Diets deficient in cobalamin present the same way as B9 as B12 is necessary for folate function. They present with megaloblastic anemia which is a large red blood cell anemia. Patients are fatigued, pale, have a swollen red tongue and diarrhea . Neurologically, depression, mood dys-regulation, numbness/tingling of extremities and other emerging associated neurologic diseases.
A disease known as pernicious anemia occurs when antibodies attack the stomach reducing acid production which prevents food bound B12 from being liberated. B12 is also low due to a lack of intrinsic factor that is produced in the stomach and attacked by autoantibodies. Treatment is intramuscular cobalamin.
Babies born with neural tube spine defects are known to have prenatal maternal B12 deficiency.
Insufficiency is of great concern in our population. Current literature is showing that inadequate levels of B12 will cause mood problems, hair greying, diarrhea and other issues based on genetic risks.
Homocysteine and methylmalonic acid are amino acids that build up in humans with cobalamin deficiency. Getting the level to a recommended range is the current target for neurobehavioral/degenerative, anti cardiac and cancer risk stratification protocols.
Methylated versions of B9 and B12 are being used to bypass problems with single nucleotide polymorphisms of genes like MTHFR.
Keeping B12 and all B vitamin levels adequate should be a first line therapy coupled with a sleep regimen for anyone with mood issues.
In adult and child populations, there are no known serious side effects of excessive B12 intake.
Food sources of B12 are meats, eggs and dairy products. The US government has been fortifying breads and cereals for years as an added source.
Most adults need 2.4 mcg/day. Incrementally less for kids. This nutrient is easily obtained from a anti inflammatory diet. Pregnancy and infancy are times of increased B vitamin needs. We highly stress the need for adequate B vitamin stores for all females of child bearing age.
People at risk for insufficiency or deficiency have: atrophic gastritis, h. pylori infection, alcoholism, pancreatic enzyme dysfunction, intestinal dysbiosis, inflammatory bowel disease, eating disorders, celiac disease and people using antacid medicines for GERD/reflux gastritis. There are many other drugs that interfere with B12.
That concludes our tour through the B complex of vitamins. It is beyond important to maintain adequate levels of these nourishing chemicals. Eat right and supplement where necessary.
Dr. M
A: Vitamin A is one of four essential fat soluble vitamins. This means that it can be stored for months in fat cells after consumption. This is primarily done in the liver with vitamin A. There are three basic types of vitamin A found in circulation in humans: retinol, retinoid acid and retinal.
Vitamin A is best known as the vision vitamin, but also is critical to healthy functioning immune and reproductive systems. Vitamin A is necessary for cell growth and differentiation. As a human develops, grows and later repairs, vitamin A is necessary for our cells to become the correct type like a heart cell or liver cell.
In the retina of the eye, vitamin A serves as a cofactor in a reaction with the protein opsin to form rhodopsin. When stimulated by light, the opsin protein is released from vitamin A and causes an electrical signal cascade through the optic nerve that our brain senses as light and vision. There are colored opsin proteins that allow light spectrum analysis. Thus a deficiency of vitamin A will initially present with low light and color visual loss. Over time complete visual loss occurs. A lack of adequate vitamin A is the number one cause of preventable night blindness in the world.
Vitamin A is involved in gene expression. Retinoic acid enters the nucleus of a cell and has the ability to bind to vitamin A specific gene promoter regions. This allows for retinoic acid to turn on and off some specific genes necessary for human health. It turns out that Vitamin D, thyroid hormone, steroid hormones are influenced by vitamin A.
There are hundreds of genes that are regulated by vitamin A. The effects range from cellular proliferation to fat metabolism to critically necessary immune cell function.
Zinc deficiency can affect vitamin A metabolism by multiple methods as it is a cofactor for enzymes that work on vitamin A.
Vitamin A deficiency will exacerbate iron deficiency anemia as it is necessary for iron metabolism. Therefore, consuming vitamin A rich foods while on iron supplementation is a good idea.
Vitamin A deficiency presents with night blindness, recurrent infections, thyroid hormone dysfunction (weight gain, fatigue, hair loss, cold body temperature and constipation) and has associations with certain cancer risks.
Immune cells called T killer cells need vitamin A to proliferate and in the low vitamin A state this does not happen dramatically increasing a persons risk for infection.
For the population that is unvaccinated, vitamin A sufficiency is critical to avoiding a severe measles outcome. Children with low vitamin A levels in their blood have worse morbidity from measles infections.
Food sources of Vitamin A are as beta carotene in bright red, orange, green and yellow colored vegetables and fruits or preformed retinol in animal meats including liver, all dairy, eggs and fish.
Most adults need 900 mcg/day. Incrementally less for kids. This nutrient is easily obtained from a anti inflammatory diet. Pregnancy and infancy are times of increased vitamin needs. We highly stress the need for adequate vitamin A stores for all females of child bearing age. Max dosing of vitamin A for all adults appears to be 2500mcg of preformed retinol per day before toxicity develops. See Linus Pauling Institute link for more information.
People at risk for insufficiency or deficiency have: issues with intestinal fat malabsorption (vitamin A is a fat soluble vitamin like D/E/K), intestinal dysbiosis, inflammatory bowel disease, eating disorders, celiac disease and disorders of bile production or pancreatic enzyme production.
Patients that take cholesterol lowering agents are at risk for low vitamin A levels. Alcoholics and women that take oral contraceptives are two other at risk groups.
Over consumption of vitamin A can be toxic as it is fat soluble and can accumulate in our fat cells. Only the preformed retinol form can be toxic not the vegetable beta carotene type. Signs of toxicity include headache, nausea, vomiting, dry skin, fatigue and bone pain. Anemia and brain swelling will occur with chronic overdose.
Dr. M
D: Vitamin D is arguably the most important micronutrient. It is one of the four fat soluble vitamins and has the added benefit of being synthesized in our skin via the sun's UVB rays.
We all love sunny days and the effect the sun has on our psyche and feelings of wellness. For centuries humans have lived by the sun whether by regulating our sleep cycle or producing our natural foods. Yet, recently we have shunned the sun's direct effects on our bodies by avoiding it and overusing sun-blocking agents and lotions. Skin cancer during the 60's and 70's ushered in a period of phobia. True to our nature, we chose the extremist way of dealing with the problem, total avoidance.
This campaign has helped produce a generation of Vitamin D deficient Americans. In the recent past the medical community believed that Vitamin D simply controlled calcium and phosphorus metabolism and bone health. Recent evidence has shown this to be the tip of the iceberg. Vitamin D stimulates the immune system from birth and plays a role in natural immune system function. Inadequate levels of Vitamin D are being linked to autoimmune disease, like multiple sclerosis and cancers. Vitamin D is also known to be involved in the function of over 80 nuclear genes and many aspects of cell differentiation.
Vitamin D associated diseases are noted to be more common at northern latitudes on the globe where sun exposure is limited by temperature and the sun's height in the sky. After much review the link appears to be Vitamin D deficiency and limited UVB sun exposure. Our lifestyles have increased sedentary indoor work and recreation thereby reducing sun exposure. Sunscreens also effectively reduce the suns beneficial effects. According to the National Institutes of Health there is an inverse relationship between Vitamin D levels in the body and cancer. It is time for everyone to pay attention to this ever important hormone made in our skin.
The goal of prevention of skin cancer should be to avoid sunburns which are noted to be a risk factor for cancer. Exposure to 15 to 30 minutes of direct sun a day has never been shown in any way to be dangerous. However, the beneficial effects on Vitamin D levels are well known at roughly 10 to 15,000 IU of Vitamin D during this brief exposure. You would need 100 cups of milk to equal this amount!! Not being a calf, I will pass on the milk in deference to the sun.
The esteemed Dr. Holick, a dermatologist and Vitamin D specialist from Boston University, has espoused prudent sun exposure and the evaluation of your Vitamin D status especially if one suffers from bone pain, muscle weakness, chronic fibromyalgias, osteoporosis, irritable bowel syndrome and other non specific inflammatory diseases. The recommendations for supplemental Vitamin D are also increasing especially as one ages. The skin of the elderly is less able to synthesize Vitamin D through sun exposure.
Part of this diet includes eating fish where 3 ounces of salmon will provide 400IU of Vitamin D. Weight bearing exercise is also a part of a healthy aging plan. The axial loading on the skeleton has a beneficial effect of the prevention of bone loss and also improves mental wellness.
Children who are exclusively breastfed may require Vitamin D supplementation. The American Academy of Pediatrics recommends 400IU of vitamin D per day in these infants.
Food sources of Vitamin D are dairy, fish, eggs, mushrooms and fortified foods like orange juice and cereals.
As we age we know that we have a harder time synthesizing vitamin D via our skin surface making supplementation necessary. Remember that your skin color dictates how fast you can make D. Darker skin = more time to generate adequate D and lighter skin is the converse. Between the months of November and April, it is quite difficult for most individuals to generate adequate D from the sun in the mid to northern United States.
Most adults need 2000-5000 IU/day. Incrementally less for kids. This nutrient is easily obtained from the sun for most individuals. Your place of residence and skin color will effect the ability to obtain D from sun exposure. The farther north you live in the United States, the more time in the sun you will need to produce vitamin D. If you you have dark skin tones that reflect the sun back, you will need more exposure for adequate D development. Dark skin color is an advantage for preventing skin cancer, but a disadvantage for developing D.
Pregnancy and infancy are times of increased vitamin needs. We highly stress the need for adequate vitamin D stores for all females of child bearing age. Max dosing of vitamin D for all adults appears to be 5000 IU per day before toxicity develops.
Over consumption of vitamin D can be toxic as it is fat soluble and can accumulate in our fat cells. Symptoms and findings of toxicity include hypercalcemia, bone pain, kidney stones, calcium deposits in the body. Diseases that could increase the risk of toxicity include: sarcoidosis, hyperparathyroidism, tuberculosis, lymphoma and other cancers. There is only one way to be sure that you are not in the toxic range and that is to test blood levels. I highly recommend this test, if you are taking 5000IU or more daily for adults and incremental less for kids. See Linus Pauling Institute link for more information.
People at risk for insufficiency or deficiency have: sun avoidance behavior, issues with intestinal fat malabsorption (vitamin D is a fat soluble vitamin like D/E/K), intestinal dysbiosis, inflammatory bowel disease, eating disorders, celiac disease and disorders of bile production or pancreatic enzyme production, chronic kidney disease, magnesium deficiency and older age.
There are many drugs that interfere with vitamin D. See the Linus Pauling link for details.
Dr. M
E: Vitamin E is number three of the four fat soluble vitamins. It has eight isoforms, four tocotrienols and four tocopherols for our system to utilize.
The main function of vitamin E is to be an antioxidant. This means that it plays a role in cleaning up reactive oxygen species that are DNA damaging in high volume. Many things promote excessive amounts of reactive oxygen species (ROS) formation including exogenously ingested chemicals like smoke, toxins, drugs, as well as inflammatory food. We naturally make ROS during day to day cellular metabolism, intense exercise or to kill microbes.
ROS are chemically reactive molecules that have an unpaired electron. In the normal state, most electrons are paired off to keep them stable in the oxygen molecule. When they are unpaired they are unstable, dangerous and looking for an electron to steal. Dr. Chris Nagy has a great analogy for ROS. Imagine a amoral single guy being invited to a couple's party. He meanders around the crowd and doesn't care with whom he hooks up with as long as he does.
In the cellular world the unpaired electron will attack any cell stealing its electron causing stress and damage. Cells suffer DNA and protein dysfunction, which in turn causes the cell to not perform properly or flat out die.
Vitamin E is your best friend watching your amoral guest meander around the party eyeing your wife or your friend's wife. Once he sees his true intent is damage, he grabs him by the arm and goes Bruce Lee on him taking him out of circulation.
Vitamin E is especially good at preventing fat cell damage or what is called lipid peroxidation. LDL particles are the infamous low density lipoprotein particles that are associated with heart attacks. When excessive amounts of ROS are in a human soup of excessive sugar and thus fat, lipid (LDL) peroxidation occurs making the oxidized LDL particle a target for immune macrophage cell ingestion. The end result is a foam cell and the first stage of atherosclerosis.
Vitamin C, another antioxidant, is necessary to regenerate the cleaning capacity of vitamin E via a chemical called glutathione. Maintaining adequate volumes of vitamin C is critical.
Vitamin E defiency is rare and usually due to serious GI malabsorption issues and severe malnutrition. Symptoms are mostly neurological with peripheral sensory nerve damage, coordination issues, visual damage and muscle weakness.
Chronic vitamin E insufficiency associated diseases are mainly related to poor antioxidant repair. Cancer and heart disease are the two most common and dangerous diseases associated with poor vitamin E status. Macular degeneration of the eye, type 2 diabetes, dementia and sugar induced fatty liver disease are all worsened by an insufficient vitamin E status.
Food sources of Vitamin E are nuts, nut butters, seeds, certain fish, avocados and fortified foods like cereals.
Most adults need 22.5 IU/day. Incrementally less for kids. This nutrient is easily obtained by a healthy anti inflammatory diet.
Pregnancy and infancy are times of increased vitamin E needs. We highly stress the need for adequate vitamin E stores for all females of child bearing age. Max dosing of vitamin E for all adults appears to be 1100 IU per day before toxicity develops.
Over consumption of vitamin E can be toxic as it is fat soluble and can accumulate in our fat cells in large supplemented doses. Symptoms and findings of toxicity include bleeding issues.
People at risk for insufficiency or deficiency have: issues with intestinal fat malabsorption (vitamin E is a fat soluble vitamin like A/D/K), intestinal dysbiosis, inflammatory bowel disease, eating disorders, celiac disease and disorders of bile production or pancreatic enzyme production and older age.
Vitamin E can interact with vitamin K dependent enzymes increasing the risk of bleeding in patients taking blood thinners like warfarin.
Anticonvulsant drugs may interfere with vitamin E. See the Linus Pauling link for details.
Dr. M
K: Vitamin K is number four of four fat soluble vitamins. It has two forms, K1 phylloquinone and K2 menaquinone. The K stands for koagulation, german for coagulation.
The main function of vitamin K is as a cofactor for proteins involved in blood clotting and bone mineralization. These proteins are known as vitamin k dependent proteins, VKDP.
Our bones need calcium, osteocalcin and vitamin K to lay down mineralization crystals. Osteocalcin needs vitamin D for synthesis by bone cells.
K1 is made by plants and can be obtained by consuming the plant. K2 on the other hand is made in our intestines by bacteria that reside within us (healthy micro biome). K2 can also be found in fermented foods and animal meats.
Vitamin K is the only fat soluble vitamin that humans do not store well. We must consume it or make it to stay sufficient. We have a recycling mechanism in place called the vitamin k oxidation reduction cycle that allows us to reuse vitamin K many times. Why we don't have this for other vitamins is a mystery.
Vitamin K sufficiency is especially critical in newborns. If a newborn has insufficient amounts of vitamin K in their body, they can suffer from a bleeding disorder called hemorrhagic disease of the newborn or vitamin K deficiency bleeding of the newborn. This deadly disease is easily prevented by a vitamin K injection after a child is born.
Vitamin K defiency is rare and usually due to liver disease and severe malnutrition. Inflammatory bowel disorders, intestinal dysbiosis, fat malabsorption disorders, eating disorders, celiac disease and disorders of bile production or pancreatic enzyme production and older age increase the risk of deficiency and insufficiency.
Symptoms are easy bruising and bleeding.
Chronic vitamin K insufficiency may be associated with diseases like osteoporosis, artery calcifications and heart disease.
Food sources of Vitamin K are leafy greens, animal livers and fortified foods like cereals.
Most adults need 75-90 micrograms/day. Incrementally less for kids. This nutrient is easily obtained by a healthy anti inflammatory diet.
Pregnancy and infancy are times of increased vitamin K needs. We highly stress the need for adequate vitamin K stores for all females of child bearing age.
There is no toxic level for vitamins K1 or K2.Vitmain K3, a synthetic version, has been associated with toxicity and should be avoided.
Vitamin A and E can interact with vitamin K dependent enzymes increasing the risk of bleeding in patients taking blood thinners like warfarin.
Anti-clotting or anti-coagulant drugs will interfere with vitamin K function and thus are a risk for chronic artery calcifications and acute bleeding. See the Linus Pauling link for details.
Dr. M
The micronutrient tour is over. It is hopefully very clear now how many minerals and vitamins are necessary for ideal human cellular function. It is no longer about the RDA or recommended dietary allowance. The RDA is based on deficiency states that are rare and truly not what optimum health is about.
We believe that all children should aim for an optimum macro- and micronutrient status to achieve health and longevity. This is in my experience not happening.
We are currently testing blood levels of many of these fats, proteins, carbohydrates, vitamins and minerals and finding major insufficiency states. These states are associated with a myriad of clinical disorders especially related to neurologic and immune function.
I encourage you to go back through all 4+ months of reviewed micronutrients in relation to your diet and see where your children may have holes in their diet as it relates to health. I have done this with my family and was surprised to find holes despite my wife's fabulously diverse cooking. Selenium deficiency was a surprise for all of us. Since learning this, we have made adjustments by adding a few brazil nuts here and there.
After looking at the micronutrients, make plans to work on home cooking in a diverse and micronutrient packed way. The anti-inflammatory diet is a great starting point. See the link in the Quick Links 3.
Remember that power foods like dark leafy greens, broccoli, brussel sprouts, avocado, nuts, beans and cold water fish should be in your child's diet. The days of daily chicken nuggets, burgers, hot dogs, fries, sugar cereal, milk and snack foods being an acceptable daily norm should disappear like the the Dodo!
I am going to ruffle some feathers now (offense alert). If you are the kind of parent who has excuses like: I am too busy to cook, it is too expensive to eat healthy, my kid won't eat it!, you are fooling yourself and hurting your child. There I said it!
I have had parents tell me that I do not understand because I can afford good food, or my kids listen, etc... Well the truth is this. I grew up wanting for much but never eating poorly. My parents made it a point to save and spend what they had on food and school. I am grateful to them everyday for their choices because they gave me a framework to parent my children. Maybe it was growing up in war torn Europe that changed their behavior maybe not. I don't actually know as I write this. I may ask.
I was raised to eat what was served or wait for the next meal. And I waited many a time. And I waited. You get the picture. My parents won these battles, period. I was not indulged because of my bad behavior.
My kids have two parents who have a set of rules that are non negotiable until they leave our roof. They will study. They will eat well. They will be respectful to others. They will know that they are loved and that God is with them.
Back to the diet. Parenting without arguing is key. Your rules, your house and so much love that you won't let them eat junk. Aim for a lot more vegetables and fruits and way less processed foods like bread, pasta, chips, cakes, processed meats and any kids food with a cartoon character on it! This is an amazing way to shift their micro- and macro- nutrient profile.
Look to the food lists on the weekly micronutrient articles for ideas on filling in your child's diet for completeness.
Oh and by the way this is the same diet that feeds your good gut bugs.
Dr. M
