—Thiamin (B1) is necessary for normalgrowth, normal carbohydrate metabolismand normal functioning of the heart,nerves, and muscles. Thiamin deficiencyresults in retarded growth and nervedisorders, and a condition known asberiberi. Good sources include pork, fish,eggs, and whole-grain cereals.—Riboflavin (B2) is required for normalgrowth, vigor, healthy skin and mucosa,and normal eye function. Riboflavin isfound in milk products, green leafyvegetables, and eggs. Other good sourcesof vitamin B2are the organ meats, heart,kidney, and liver.—Niacin (B3) is necessary for normalgrowth and skin health, normalfunctioning of the stomach and intestines,nervous and circulatory systems, and forcarbohydrate, fat, and proteinmetabolism. The best sources are meat,liver, poultry, and peanuts.—Pyridoxine (B6) is necessary for fat,carbohydrate, and protein metabolism,and is sometimes used to treat nausea inpregnancy. Sources include liver, yeast,wheat germ, pork, potatoes, and milk.Vitamin B6is usually prescribed withIsonizid (INH) treatment since INH oftencauses a pyridoxine deficiency.—Cyanocobalamin (B12) is necessaryfor the health of nervous tissue and assistsin iron metabolism and the maturationprocess of red blood cells. B12 is used toprevent pernicious anemia. The bestsources are liver and kidneys, milk, eggs,fish, and cheese.See Appendix IV for more information onvitamins.VITAMIN AND MINERAL SUPPLEMENTSVitamin supplements are usually not necessary if adiet includes a wide variety of foods. Exceptions mayoccur in prenatal diets in which iron is low, as well as inpatients who are deficient in a specific vitamin.Vitamin supplements should be taken only on aphysician or dietitian’s recommendation.Vitamin and mineral supplements are being widelyused by physically active people because of all theperformance-enhancing claims made by supplementmanufacturers. It is estimated that 40–50 percent ofa t h l e t e s u s e s o m e f o r m o f v i t a m i n / m i n e r a lsupplements. Some doses range from amounts similarto the Recommended Dietary Allowances (RDA) up tolevels many times the RDA. Supplements are usefulunder a variety of conditions, such as if an individualhas an existing vitamin or mineral deficiency;has poor nutrient intake and/or dietary habits; oris exposed to extreme environmental conditions,such as altitude.Often, laxatives are prescribed in conjunction withsome medical treatments and may cause decreasedabsorption of vitamins, loss of minerals and elec- trolytes, orinhibition of glucose uptake. Therefore, any patient onlaxatives should be carefully monitored, and supplementarynutritives should be administered as necessary.Taking a general multivitamin supplement appearsto be without measurable performance enhancingeffects in healthy, well-nourished, physically activepersonnel. Similarly, no improvements in musclestrength or endurance have been noted in strengthathletes, such as body builders, who tend to usemegadoses of vitamin and mineral supplements. Theindiscriminate use of high-potency vitamins andminerals is of growing concern since excessiveamounts of vitamins and/or minerals can be harmfuland may result in nutrient imbalances. Excessiveintake of some vitamin and mineral supplements canresult in adverse—and possibly toxic–side effects.WATERWater is often called the “forgotten nutrient.”Water is needed to replace body fluids lost primarily inurine and sweat. A person can survive weeks withoutfood but only days without water. Water makes up 70percent of body weight and is found in every cell in thebody. It is the medium through which nutrients aretransported from the digestive tract to the cells wherethey are needed. Water is also the medium throughwhich the by-products of cell metabolism areremoved.Water also serves as the medium in which thechemical processes of life take place. It is normallytaken into the body in beverages, soups, and in the formof solid foods. Fluid needs are increased withsweating, vomiting, diarrhea, high-protein diets, andin hot environments. An insufficient intake may causedehydration, evidenced by loss of weight, increasedbody temperature, and dizziness.9-5
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