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    Maintaining Digestive Health: Key Nutrients

    Vitamins and minerals are substances that are required in very small amounts by our bodies for specific metabolic tasks. Hence, they are called micronutrients. Since micronutrients cannot be made by the body, they must be acquired from the diet and/or supplements. In a healthy population, vitamin and mineral needs can usually be met by eating a well-rounded diet from a variety of food sources. However, in the presence of digestive disease there are a few micronutrients that require special attention.
    Key Nutrients
    Folate Folate (also called folic acid) is one of the B vitamins. Folate is important in the formation of red blood cells. It is also involved in maintaining the cells' genetic code, regulating cell division and transferring inherited traits from one cell to another. Folate is also involved in the production of neurotransmitters such as serotonin, which regulates sleep, mood and appetite.

    In folate deficiency, cell function is limited and the growth and repair of all cells and tissues in the body are negatively affected, especially the cells with the fastest rate of replacement. These include the cells of the gastrointestinal tract.

    Good sources of folate include green leafy vegetables, orange juice, wheat germ, sunflower seeds and fortified breakfast cereals.

    Some concern exists that too much folate can mask pernicious anemia, a form of vitamin B12 deficiency, making it difficult to diagnose. Red blood cells appear normal if folate intake is adequate. Unless the possibility of vitamin B12 deficiency is ruled out, large doses of folate should not be taken. Strict vegetarians who get little or no vitamin B12 are at highest risk. According to the FDA, the safe upper limit of folic acid is one mg per day.
    Iron This important mineral helps blood carry oxygen to all of your muscles. It helps your brain function and helps your immune system fight disease, which is important for those with digestive disorders. Iron can easily become deficient in people who experience consistent blood loss such as those with ulcers and women during menstruation. Green vegetables, dried fruits, whole grains, eggs and beans contain iron. However, the best sources of iron are lean meat, fish and poultry where iron is present in a form called 'heme' iron. Heme iron is two to three times better absorbed than 'non-heme' iron. Eating foods rich in vitamin C can help you absorb the iron in your foods. Oranges, grapefruit, broccoli, kiwi and bell peppers are great sources of vitamin C.


    Vegetarians and women who eat very little meat need to pay extra attention to iron needs. The non-heme iron that is present in whole grains, dried beans and peas, green vegetables and dried fruits is absorbed at less than half the rate of heme iron. Vitamin C can enhance the absorption of iron. Maximize your absorption of non-heme iron by including orange juice, peppers, kiwi or other foods rich in vitamin C with meals.

    Avoid high doses (30 mg or more) of iron, which can cause nausea, vomiting or constipation. In women, iron overload is very rare. However, in cases of hemachromatosis (a genetic disorder in men that causes iron accumulation in soft tissues of the body, resulting in heart problems and other abnormalities), iron overload is a serious problem. Also, both high body stores and high intakes of iron have been associated with increased risk of cancer, especially colon cancer, in human and animal studies.

    Since 1986, U.S. poison control centers have received reports of more than 110,000 incidents of children under six years old accidentally swallowing iron tablets. Some were hospitalized and 35 died. Iron poisoning is recognized as a leading cause of poisoning deaths in young children. Since January of 1997 in response to concerns, the FDA has required all iron-containing supplements to carry a standard warning on labels about the risk of acute iron poisoning in children under six years of age.
    Vitamin B12 This vitamin, like folate, is required for red blood cell production, to maintain central nervous system function and for energy metabolism. Deficiency of vitamin B12 is rare with a varied and well-balanced diet easily meeting the body's needs. However, deficiency is more common in persons with digestive diseases.

    Deficiency occurs as a result of poor dietary intake or inadequate absorption. Inadequate amounts of intrinsic factor, a substance in digestive juices that binds to vitamin B12 and assists in its digestion in the lower small intestine, is a cause of decreased absorption. Causes of poor absorption are intestinal infections or surgeries where part of the small intestine has been removed at the site of B12 absorption, or removal of the part of the stomach that secretes intrinsic factor. In addition, persons consuming a strict vegetarian diet may be at risk for inadequacy.

    Vitamin B12 supplementation appears to be safe -- no known toxic effects have been shown in adults who consume several times the recommended daily amount.
    Zinc Zinc is important for the synthesis of DNA and is active in a number of enzyme pathways required for cell division and growth. Zinc can easily become deficient in people who experience digestive irritation and inflammation as well as vomiting and diarrhea. Major dietary sources of zinc include meat, liver, shellfish, milk, whole grains and wheat germ.

    In amounts up to 45 milligrams (mg) per day, zinc is relatively nontoxic. In amounts beyond 45 mg per day, copper absorption has been shown to be reduced in the body. Very large doses of zinc, more than 150 mg, may reduce normal immune function, inhibiting the body's defenses to disease or infection. Research evidence suggests that a regular intake of 80 mg to 150 mg of zinc may lower HDL cholesterol and therefore increase one's risk for heart disease


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