"...all doctors should be able to diagnose and treat nutritional deficiencies."

Royal College of Physicians. Nutrition and Patients: A Doctor's Responsibility. London 2002

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The Four Uses of Essential Nutrients and the Consequences of Deficiency

During the course of a lifetime the body can utilise an essential nutrient in only four ways.  Disruption in nutrient supply will result eventually in a loss of one or more of these four uses, and to a clinically recognisable picture of a loss of growth, reproduction, storage or maintenance depending upon the phase of the lifecycle the person is in.

References

- Adapted from Physiological Ecology: An Evolutionary Approach to Resource Use. Blackwell Scientific Publications 1981.  (eds Townsend and Callow)
- See also Powerpoint presentation by Professor Tom Kirkwood www.nesc.ac.uk/talks/ahm2007/keynote3.pdf

Tissue Nutrient
1. Growth - mainly before birth and in the first two years, and up to the first two decades
Weight protein-energy
Height protein-energy, iodine, zinc, iron and vitamin A
Organ size many nutrients, e.g. calcium and vitamin D for skeleton
   
2. Reproduction - mainly in the third and fourth decades
Sexual maturity protein-energy and body weight/fat content
Amenorrhoea  protein-energy and zinc
Infertility vitamin B12 and probably many nutrients
Miscarriage folic acid and vitamin C
Foetal deformity folic acid, vitamin B12 and choline
Birth weight protein-energy, zinc and iron
Foetal development  calcium, vitamin D and many other nutrients, iodine, zinc, EFAs and vitamin B12
Male fertility zinc and probably other nutrients
   
3. Storage - depends on degree of supply and often on the past pattern of growth
Adipose tissue energy, vitamins A and E
Muscle protein, energy, potassium, magnesium, zinc and vitamin B6
Liver       energy, vitamins A, B12, folate, other B vitamins and iron
Bone          calcium, magnesium and sodium
Bone marrow vitamin A and iron
Thyroid iodine
Blood        vitamin D (25OH vitamin D)
   
4. Maintenance - main use of nutrients during a lifetime
Red blood cells protein, iron, vitamin B12, folate, copper, vitamins A and riboflavin
Immunity  protein-energy, zinc, selenium, vitamins A and B group
Skin       essential fatty acids, zinc, vitamins B and C
Muscle                    protein-energy, potassium, magnesium, phosphate and thiamin
Liver           protein-energy and choline
Eye vitamin A, zinc and essential fatty acids
CNS            thiamin, vitamin B12 and essential fatty acids
Skeleton                  calcium, vitamins D, K and C

 

 



Copyright Dr. Alan Stewart M.B.B.S.M.R.C.P. (UK)M.F. Hom.
47 Priory Street, Lewes, East Sussex. BN7 1HJ
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