Vitamins and Minerals

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1 Vitamins and Minerals Delivering the best in care UHB is a no smoking Trust To see all of our current patient information leaflets please visit

2 Crown copyright material is reproduced with the permission of the Controller of HMSO and Queen s Printer for Scotland. Vitamin and mineral supplements are not a replacement for good eating habits. Most people can get all the nutrients their body needs by choosing a variety of foods, in the proportions shown, from the main four food groups in the eatwell plate. It is important you speak to your doctor, pharmacist or dietitian before taking supplements or herbal remedies. This is to ensure they will not interact with your medications and therefore impact on your treatment.

3 Roles, recommended levels and sources of vitamins and minerals Name Role Reference nutrient intake (RNI) for adults Food sources Male Female Vitamin A (Retinol) Vitamin A is a fat soluble vitamin used for vision, growth, development, strengthening our immunity to infections. 0.7mg 0.6mg If you are pregnant avoid eating liver as it has large quantities of vitamin A. Liver, oily fish (mackerel, sardines, salmon), dairy products, carrots, red pepper, dried fruit. Vitamin D Calcium absorption and regulates phosphate in the body. Produced as a result of exposure to sunlight and found in foods. If you are pregnant, elderly or have dark skin tones, or have your skin covered it is advisable to take a taking 10 micrograms (0.01mg) of vitamin D. Liver, dairy products, Salmon, Sardines (tinned), egg yolk, oysters. It can also be found in fortified foods such as margarine, breakfast cereals and powdered milk. Vitamin E Vitamin E is an antioxidant and helps protect cell membranes. 4mg a day. 3mg a day. Olive oil, sunflower oil, safflower oil, palm oil, corn oil, soya oil, butter, Polyunsaturated margarine, peanuts, almonds, Brazil nuts and wheatgerm (found in cereals and cereal products).

4 Name Role Reference nutrient intake (RNI) for adults Food sources Vitamin K Blood coagulation (clotting). It is a coenzyme in metabolic pathways. Not quantified as some is produced by bacteria in the gut. Green leafy vegetables such as broccoli and spinach, also in vegetable oils and cereals. Small amounts can also be found in meat (such as pork), and dairy foods such as cheese. Vitamin C (ascorbic acid) Helps, absorb iron from food, protect cells and keeps them healthy. Adults need 40mg a day. Taking large amounts of vitamin C can cause stomach pain, diarrhoea and flatulence. Brightly coloured fruit and vegetables such as peppers, broccoli, Brussels sprouts, sweet potatoes, oranges and kiwi fruit. Vitamin B1 (thiamine) Helps with the metabolism of food; works with other B-group vitamins to help break down and release energy from the food we eat. Helps keep nerves and muscle tissue healthy. 1mg a day for men. 0.8mg a day for women. Pork, vegetables, milk, cheese, peas, fresh and dried fruit, eggs, wholegrain breads and some fortified breakfast cereals.

5 Name Role Reference nutrient intake (RNI) for adults Food sources Vitamin B (Riboflavin) Used by your metabolism. Helps produce steroids and red blood cells, may help absorb iron from the food we eat. Helps keep skin, eyes, nervous system and mucous membrane healthy. 1.3mg/day 1.1mg/day Milk, eggs, fortified breakfast cereals, rice and mushrooms. Other sources include green vegetables, liver, some lean meat, fish, chocolate, yeast extract (Marmite). UV light can destroy riboflavin, so ideally these foods should be kept out of direct sunlight. Vitamin B3 (niacin) Vitamin B6 (pyridoxine) Used in the release of energy including keeping both the nervous and digestive system healthy. Allows the body to use and store protein and carbohydrates from the food we eat. Helps haemoglobin form. 17mg/day 13mg/day Beef, pork, chicken, fish, wheat flour, maize flour, eggs and milk. 1.4mg/day 1.2mg/day Pork, chicken, turkey, cod, bread, whole cereals (such as oatmeal, wheatgerm and rice), eggs, vegetables, soya beans, peanuts, milk, potatoes and some fortified breakfast cereals.

6 Name Role Reference nutrient intake (RNI) for adults Food sources B12 (cobalamin) Needed for the nervous system and helps release energy from the food we eat mg a day for both males and females Meat, salmon, cod, milk, cheese, eggs, yeast extract, and some fortified breakfast cereals and bread. Algae and seaweed, fortified soya and milk. Folate Works with vitamin B12 to form healthy red blood cells. Reduces risk of neural tube defects in unborn babies. 0.2mg a day 0.2mg a day If you are pregnant take a 0.4mg (400 microgram) folic acid supplement until the 12th week of pregnancy. Broccoli, Brussels sprouts, asparagus, peas, chickpeas and brown rice. Other useful sources include fortified breakfast cereals, some bread and some fruit such as oranges and bananas. **Fat soluble vitamins include Vitamin A, D, E and K you do not need to include these in your diet daily. **Water soluble vitamins include Vitamin C and all of the B vitamins they need to be consumed daily.

7 Other nutrients important in a healthy well-balanced diet include Iron Calcium Selenium Fortified breakfast cereal Milk Brazil nuts Liver Soya milk Meat Red meat Dried milk powder Dairy Eggs Cheese Cereals Pulses Soya cheese Eggs Dried fruit Yoghurt Fish Dark green leafy vegetables Fromage frais Zinc Cashew nuts Fish with bones Fortified breakfast cereal Black treacle Nuts Shellfish Black pudding Tofu Meat Cocoa powder Tahini (sesame paste) Fish Tahini (sesame paste) Pesto sauce Seeds It is important to take caution when choosing vitamin and mineral supplements, as mega doses of vitamins and minerals have been linked with unpleasant side-effects some of which can be dangerous. Vitamin A Large amounts can cause liver damage and bone damage. If you are pregnant large amounts of vitamin A can harm your unborn child. Vitamin C Mega doses of vitamin C can (above 1000mg per day) can lead to kidney stones. It is also linked with diarrhoea. Vitamin E Doses more than 800mg a day can interfere with immune function. Zinc Doses more than 75mg a day have been linked with copper deficiency, anaemia and a shortage of immune cells. New studies have found that

8 zinc supplementation is helpful in diarrhoea but only if there is a deficiency. Selenium Doses of more than 750 micrograms a day have been associated with immune suppression. Vitamin B6 More than 2g a day can cause nerve damage, but doses as low as 50mg a day have been associated peripheral neuropathy (tingling sensation in hands and feet). Whilst herbal remedies are widely used there are some which are known to interact with medications. African potato Garlic capsules St. John s Wort Sutherlandia Echinacea Ginseng, or ginkgo biloba Milk thistle Please speak with your pharmacist or dietitian about these. The Trust provides free monthly health talks on a variety of medical conditions and treatments. For more information visit or call HIV Clinic Queen Elizabeth Hospital Birmingham Mindelsohn Way, Edgbaston Birmingham, B15 2WB Telephone: PI11_1156_01 UHB/PI/1156 (Edition 1) Author: Rosaleen McDermott Date: September 2012 Review date: January 2014

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