Other Chronic Diseases

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Many chronic diseases have an adverse effect on the balance of many essential nutrients because of a reduced food intake, increased losses of nutrients or alterations in nutrient metabolism.

• Liver disease may jeopardise the balance of vitamins A, D and K as well as many of the B vitamins, calcium and zinc.  www.britishlivertrust.org.uk   
• Chronic renal disease often results in anaemia as well as deficiencies of vitamin D and zinc.  www.britishkidney-pa.co.uk
• Chronic chest disease severe enough to affect day to day activity may result in both a reduced food intake as well as increased need for protein and other nutrients due to the increased effort of breathing.  www.lunguk.org
• Chronic or recurrent infection can also be associated with an increased need for protein, vitamins and minerals
• Chronic skin disease if widespread can increase the need for folate and other nutrients www.eczema.org and  www.psoriasis-association.org.uk
• Rapidly growing cancers may also increase the demand for many nutrients. www.cancerbackup.org.uk
• Osteoporosis like anaemia is a common problem which primarily reflects a loss of the mineral calcium but many other nutrients also appear to be involved www.nos.org.uk  
• Both types I and II diabetes are associated with a greatly increased loss of vitamin B1 – thiamine in the urine deficiency of which may add to some of the complications of the condition.

The risk of these deficiencies developing should be assessed by the medical specialists involved in the patients care.  Those with a low Body Mass Index < 20.0 kg/m2 and/or unintentional weight loss are most at risk.  Professional advice from an experienced dietitian may be also required and because of the risk of adverse affects of nutritional supplements and potential for drug-nutrient interactions those with any of the above conditions should not take nutritional supplements without expert advice. See "Are your supplements safe for you - contraindications".

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