Riboflavin B2

Functions primarily as Cheilosis, glossitis, None known the reactive portion of flavoproteins concerned with biologic oxidations (cellular metabolism)

photophobia, angular stomatitis, corneal vascularization, scrotal skin changes, seborrhea, magenta tongue

Meat, 1ish. poultry, whole grains, legumes, breast milk, infant formula

Severe malnutrition

Urine excretion, whole blood level (RIA/


Fish, poultry, meat, wheat, breastmilk, infant formula

Elderly, high protein intake

Red cell aminotransferase activity, plasma pyridoxal phosphate (HPLC) tryptophan loading test, urine 4-pyridoxic acid

Dairy products.

liver, almonds, lamb, pork, breast milk, infant formula

Alcoholism, starvation, chronic diarrhea, malabsorption

Red cell glutathione reductase activity, red cell flavine adenine dinucleotide, urine riboflavin:creatmine ratio

Table 3-1. continued

Nutrient and Major Physiologic Functions

Deficiency Signs Excess Signs

Important Food Sources

Potential Causes of Deficiency Laboratory or Excess Assessment

Thiamine (Bi)

Aids in energy Beriberi, neuritis. None known utilization as part of edema, cardiac coenzyme component failure, anorexia, to promote the utiliza- restlessness, tion of carbohydrate; confusion, loss of promotes normal func- vibration sense tioning of the nervous and deep tendon system; coenzyme for reflexes, calf oxidative carboxylation tenderness of 2-keto acids



Essential for Osteomalacia, Hypercalcemia calcification of bone osteoporosis vomiting,

(matrix formation); tremor, convulsions, anorexia, assists in blood clotting; hyperexcitability lethargy functions in normal (hypocalcemia muscle contraction tetany)

Pork, nuts,


Red cell whole grain and refeeding after transketolase fortified cereal products, breast milk, infant formula starvation, prolonged dialysis activity, whole blood level (HPLC), urine thiamine; creatinine ratio

Dairy products (milk, cheese), sardines, oysters, salmon, herring, greens, breast milk, infant formula

Renal disease. Plasma total liver disease, steroid use calcium, plasma free calcium in altered protein binding (eg, hypoalbuminemia), and relaxation and in normal nerve transmission


Essential part of Tremor, tingling, many enzyme weakness, systems; important for seizures, maintaining electrical arrhythmia potential in nerves and muscle membranes and for energy turnover


Important intracellular Weakness, anion; involved in anorexia, malaise, many chemical bone pain, growth reactions within the arrest body; necessary for energy turnover (ATP)

Nausea, vomiting hypertension, weakness, prolonged QT interval

Hypocalcemia (when parathyroid gland not fully functioning)

Widely distributed, PCM; refeeding especially in food of vegetable origin; breastmllk, infant formula

Dairy products, fish, legumes, pork, breast milk, infant formula

Renal disease, liver disease, refeeding syndrome acidosis, radiographs, or CT and photon densitometry

Plasma total or free magnesium, magnesium loading test

Plasma concentration, alkaline phosphatase activity, radiography densitometry, renal tubular excretion threshold

62 Part 1 Nutrition and the Well Child

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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