Sunday, February 2, 2014

Vitamins and IBD - Other Common Deficiencies

Vitamin and Mineral Deficiencies and IBD


The previous two posts dealt with the general deficiencies that occur with IBD and dietary supplementation of iron.  This post deals with the other deficiencies and what nutritional supplementation may help.  Unlike iron, most of the vitamins and minerals noted below are only necessary in trace amounts. Those amounts may be higher with those suffering from Crohn’s Disease and Ulcerative Colitis, but are still on the low side.  Most of the impacted absorption involves B complex vitamins.  The US RDI* for the various vitamins and minerals are listed below ((the numbers are regularly tweaked):

Vitamin/Mineral
USRDI (in mg unless noted)
Thiamine (B1)
1.2
Niacin (B3)
16
Vitamin B6
1.3
Biotin (B7)
30 micrograms
Folate (B9)
400 micrograms
Vitamin B12
2.4 micrograms
Vitamin A
900 micrograms
Vitamin C
90
Copper
900 micrograms
Magnesium
400
Selenium
55 micrograms
Zinc
11
(1)

Being deficient in the various areas above can have different symptoms.  Depending on the time and amount of deficiency, they can range from a minor nuisance to severe.  Similarly, high doses of each can lead to toxicity.  A useful discussion of everything from Beriberi (thiamin deficiency) to scurvy (vitamin C deficiency) to hypozincemia (zinc deficiency) is the subject of a different post.  This one is about good sources of the vitamins and minerals.  The table below lists some food sources and their RDI percentage:

Vitamin
Sources

















Thiamine (B1)
Food
Bread
Cereals
















% RDI
17.1
11.8















Niacin (B3)
Food
Poultry
Bread
Cereals















% RDI
10.8
10.7
10.9














Vitamin B6
Food
Chickpeas, canned, 1 cup
Beef liver, pan fried, 3 ounces
Tuna, yellowfin, fresh, cooked, 3 ounces
Salmon, sockeye, cooked, 3 ounces
Chicken breast, roasted, 3 ounces
Breakfast cereals, fortified with 25% of the DV for vitamin B6
Potatoes, boiled, 1 cup
Turkey, meat only, roasted, 3 ounces
Banana, 1 medium
Marinara (spaghetti) sauce, ready to serve, 1 cup








% RDI
55
45
45
30
25
25
20
20
20
20







Biotin (B7)
Food
Brewer's yeast - dried
Chicken liver, fried
Kidney, fried
Egg, raw














% RDI
667
283
140
83













Folate (B9)
Food
Beef liver, braised, 3 ounces
Spinach, boiled, ½ cup
Black-eyed peas (cowpeas), boiled, ½ cup
Breakfast cereals, fortified with 25% of the DV†
Rice, white, medium-grain, cooked, ½ cup†
Asparagus, boiled, 4 spears
Spaghetti, cooked, enriched, ½ cup†
Brussels sprouts, frozen, boiled, ½ cup










% RDI
54
33
26
25
23
22
21
20









Vitamin B12
Food
Clams, cooked, 3 ounces
Liver, beef, cooked, 3 ounces
Breakfast cereals, fortified with 100% of the DV for vitamin B12, 1 serving
Trout, rainbow, wild, cooked, 3 ounces
Salmon, sockeye, cooked, 3 ounces
Trout, rainbow, farmed, cooked, 3 ounces
Tuna fish, light, canned in water, 3 ounces
Cheeseburger, double patty and bun, 1 sandwich
Haddock, cooked, 3 ounces
Breakfast cereals, fortified with 25% of the DV for vitamin B12, 1 serving
Beef, top sirloin, broiled, 3 ounces







% RDI
1,402
1,178
100
90
80
58
42
35
30
25
23






Vitamin A
Food
Sweet potato, baked in skin, 1 whole
Beef liver, pan fried, 3 ounces
Spinach, frozen, boiled, ½ cup
Carrots, raw, ½ cup
Pumpkin pie, commercially prepared, 1 piece
Cantaloupe, raw, ½ cup
Peppers, sweet, red, raw, ½ cup
Mangos, raw, 1 whole
Black-eyed peas (cowpeas), boiled, 1 cup
Apricots, dried, sulfured, 10 halves
Broccoli, boiled, ½ cup
Ice cream, French vanilla, soft serve, 1 cup






% RDI
1,403
6,582
573
459
488
135
117
112
66
63
60
278





Vitamin C
Food
561
444
229
184
249
54
47
45
26
25
24
20
Cantaloupe, ½ cup
Cabbage, cooked, ½ cup
Cauliflower, raw, ½ cup
Potato, baked, 1 medium
Tomato, raw, 1 medium

% RDI
158
155
117
117
107
100
85
82
80
65
65
55
48
47
43
28
28
Copper
Food
Legumes
Potato and potato products
Nuts and seeds
Beef
Pasta and pasta dishes
Ready-to-eat and hot cereals
Rice
Breads
Ground beef
Chocolate desserts
Fruit juices
Poultry
Fish
Dark green and deep yellow vegetables




% RDI
30
22
17
16
16
15
14
13
13
12
11
11
11
10



Magnesium
Food
Almonds, dry roasted, 1 ounce
Spinach, boiled, ½ cup
Cashews, dry roasted, 1 ounce
Peanuts, oil roasted, ¼ cup
Cereal, shredded wheat, 2 large biscuits
Soymilk, plain or vanilla, 1 cup
Black beans, cooked, ½ cup
Edamame, shelled, cooked, ½ cup
Peanut butter, smooth, 2 tablespoons
Bread, whole wheat, 2 slices
Avocado, cubed, 1 cup
Potato, baked with skin, 3.5 ounces
Rice, brown, cooked, ½ cup
Yogurt, plain, low fat, 8 ounces
Breakfast cereals, fortified with 10% of the DV for magnesium



% RDI
20
20
19
16
15
15
15
13
12
12
15
11
11
11
10


Selenium
Food
Brazil nuts, 1 ounce (6–8 nuts)
Tuna, yellowfin, cooked, dry heat, 3 ounces
Halibut, cooked, dry heat, 3 ounces
Sardines, canned in oil, drained solids with bone, 3 ounces
Ham, roasted, 3 ounces
Shrimp, canned, 3 ounces
Macaroni, enriched, cooked, 1 cup
Beef steak, bottom round, roasted, 3 ounces
Turkey, boneless, roasted, 3 ounces
Beef liver, pan fried, 3 ounces
Chicken, light meat, roasted, 3 ounces
Cottage cheese, 1% milkfat, 1 cup
Rice, brown, long-grain, cooked, 1 cup
Beef, ground, 25% fat, broiled, 3 ounces
Egg, hard-boiled, 1 large
Puffed wheat ready-to-eat cereal, fortified, 1 cup


% RDI
777
131
67
64
60
57
53
47
44
40
31
29
27
26
21
21

Zinc
Food
Oysters, cooked, breaded and fried, 3 ounces
Beef chuck roast, braised, 3 ounces
Crab, Alaska king, cooked, 3 ounces
Beef patty, broiled, 3 ounces
Breakfast cereal, fortified with 25% of the DV for zinc, ¾ cup serving
Lobster, cooked, 3 ounces












% RDI
493
47
43
35
25
23











Legumes
Potato and potato products
Nuts and seeds
Beef
Pasta and pasta dishes
Ready-to-eat and hot cereals
Rice
Breads
Ground beef
Chocolate desserts
Fruit juices
Poultry
Fish
Dark green and deep yellow vegetables





30
22
17
16
16
15
14
13
13
12
11
11
11
10





 (2-5)

The numbers above are not quite as simple as they appear.  Some minerals, like zinc, are excreted in different amounts by the kidneys based on intake.  Others, like Vitamin A, tend to accumulate in the liver to toxic levels if taken in on an erratic basis.  This is yet another reason to consult a Registered Dietician when doing your dietary planning – the complexities involved are fairly high.

One way that individuals with IBD can track their nutrition intake more accurately is with software (which doubles as a food diary, if symptoms are recorded).  LifeHack reviewed the major vendors, and recommended MyFitnessPal as a top choice.  They recommend four other programs as well – check out their reviews to see which may fit your platform best: http://lifehacker.com/five-best-food-and-nutrition-tracking-tools-1084103754.

Bottom Line


·         Nutrient levels are non-linear with consumption
·         Getting all of the right nutrients is difficult – having Crohn’s or Ulcerative Colitis-specific deficiencies makes it more difficult
·         Registered dieticians or software may help for tracking purposes

* The US Reference Daily Intake (RDI) is the Daily Value (DV) that is needed to ensure 99% of the population has an adequate amount of a vitamin and/or mineral.  This system replaced the old Recommended Daily Allowance (RDA) number.  The actual RDI is even more complicated as there aren’t daily allowances calculated for everything and other measures are used as substitutes.  The actual DV needed varies by sex, pregnancy status, age, and weight.  For IBD, it also varies by impact to absorption.

1.       -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------http://iom.edu/Activities/Nutrition/SummaryDRIs/~/media/Files/Activity%20Files/Nutrition/DRIs/RDA%20and%20AIs_Vitamin%20and%20Elements.pdf

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