190

Appendix C: Nutrient Chart - Function, Deficiency and Toxicity Symptoms, and Major Food Sources
INFANT NUTRITION AND FEEDING

Nutrient Function Deficiency Symptoms Toxicity Symptoms Major Food Sources

Anabolism of tissue proteins; Kwashiorkor-edema; reddish Azotemia; acidosis; hyperam- Breast milk, infant formula,
helps maintain fluid balance; pigmentation of hair and skin; monemia meat, fish, poultry, egg yolk,
energy source; formation of fatty liver; retardation of growth cheese, yogurt, legumes
Protein immunoglobulins; maintenance in children; diarrhea; dermato-
of acid-base balance; important sis; decreased T-cell lympho-
part of enzymes and hormones cytes with increased secondary
infections;
Major energy source; protein Ketosis Breast milk; infant formula;
sparing; necessary for normal whole-grain breads, cereals,
fat metabolism; glucose is the and other fortified or enriched
Carbohydrate sole source of energy for the grain products; potatoes; corn;
brain; many sources also pro- legumes; fruits; vegetables
vide dietary fiber
Concentrated energy source; Eczema; low growth rate in Breast milk, infant formula,
protein sparing; insulation for infants; lowered resistance in protein-rich foods (meats, dairy
temperature maintenance; infection; hair loss products, egg yolk, nuts), butter,
Fat supplies essential fatty acids; margarine, cream, salad oils
carries fat-soluble vitamins A, and dressings, cooking and
D, E, K meat fats
Necessary for the formation Rickets (symptoms: costo- Abnormally high blood calcium Infant formula, egg yolk, liver,
of normal bone; promotes the chondral beading, epiphyseal (hypercalcemia), retarded fatty fish, sunlight (activation
Vitamin D absorption of calcium and phos- enlargement, cranial bossing, growth, vomiting, nephrocalci- of 7-dehydrocholesterol in the
phorus in the intestines bowed legs, persistently open nosis skin)
anterior fontanelle)
Preserves integrity of epithelial Night blindness, dry eyes, poor Fatigue; night sweats; vertigo; Breast milk, infant formula,
cells; formation of rhodopsin for bone growth, impaired resis- headache; dry and fissured liver, egg yolk, dark green and
vision in dim light; necessary tance to infection, papillary skin; lips; hyperpigmentation; deep yellow vegetables and
Vitamin A for wound healing, growth, and hyperkeratosis of the skin retarded growth; bone pain; fruits
normal immune function abdominal pain; vomiting; jaun-
dice; hypercalcemia
May function as an antioxidant Hemolytic anemia in the prema- May interfere with vitamin K Breast milk; infant formula;
in the tissues; may also have a ture and newborn; hyporeflexia, activity leading to prolonged vegetable oils; liver; egg yolk;
role as a coenzyme; neuromus- and spinocerebellar and retinal clotting and bleeding time; in butter; green leafy vegetables;
Vitamin E cular function degeneration anemia, suppresses the normal whole-grain breads, cereals,
hematologic response to iron and other fortified or enriched
grain products; wheat germ
 Nutrient Function Deficiency Symptoms Toxicity Symptoms Major Food Sources
Catalyzes prothrombin synthesis; Prolonged bleeding and prothrom- Possible hemolytic anemia; hyper- Infant formula, vegetable oils,
required in the synthesis of other bin time; hemorrhagic manifesta- bilirubinemia (jaundice) green leafy vegetables, pork,
Vitamin K blood clotting factors; synthesis by tions (especially in newborns) liver
intestinal bacteria
Essential in the synthesis of col- Scurvy, pinpoint peripheral hemor- Nausea, abdominal cramps, diar- Breast milk, infant formula,
lagen (thus, strengthens tissues rhages, bleeding gums, osmotic rhea, possible formation of kidney fruits (especially citrus fruits,
and improves wound healing diarrhea stones papaya, cantaloupe, strawber-
Ascorbic Acid and resistance to infection);iron ries), vegetables (potatoes,
absorption and transport; water- cabbage)
(Vitamin C) soluble antioxidant; functions in
folacin metabolism

Essential for biosynthesis of Pernicious anemia; neurologic Infant formula, breast milk,
Vitamin B12 nucleic acids and nucleoproteins; deterioration meat, fish, poultry, cheese,
red blood cell maturation; involved egg yolk, liver
(Cobalamin, with folate metabolism; central
Cyanocobalamin) nervous system metabolism

Essential in the biosynthesis of Poor growth; megaloblastic ane- Masking of B12 deficiency symp- Breast milk; infant formula;
nucleic acids; necessary for the mia (concurrent deficiency of vi- toms in those with pernicious ane- liver; green leafy vegetables;
Folacin normal maturation of red blood tamin B12 should be suspected); mia not receiving cyanocobalamin legumes; whole-grain breads,
cells impaired cellular immunity cereals, and fortified or en-
(Folate) riched grain products; legumes;
oranges; cantaloupe; lean beef

Aids in the synthesis and break- Microcytic anemia; Sensory neuropathy with progres- Breast milk; infant formula;
down of amino acids and unsatu- convulsions; irritability sive ataxia; photosensitivity liver; meat; whole-grain breads,
Pyridoxine rated fatty acids from essential cereals, or other grain products;
fatty acids; essential for conver- legumes; potatoes
INFANT NUTRITION AND FEEDING

(Vitamin B6) sion of tryptophan to niacin; es-

sential for normal growth

Combines with phosphorus to Beriberi, neuritis, edema, Breast milk; infant formula; lean
form thiamin pyrophosphate (TPP) cardiac failure pork; wheat germ; whole-grain
Thiamin necessary for metabolism of pro- and enriched breads, cere-
tein, carbohydrate, and fat; essen- als, and other grain products;
(Vitamin B1) tial for growth, normal appetite, legumes; potatoes
digestion, and healthy nerves
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Nutrient Function Deficiency Symptoms Toxicity Symptoms Major Food Sources

INFANT NUTRITION AND FEEDING

Essential for growth; plays Photophobia, cheilosis, glossi- Breast milk; infant formula,
enzymatic role in tissue respira- tis, corneal vascularization, poor meat; dairy products; egg yolk;
Riboflavin tion and acts as a transporter of growth legumes; green vegetables;
hydrogen ions; synthesis of FMN whole-grain breads, cereals,
(Vitamin B2)
and FAD and fortified or enriched grain
products
Part of the enzyme system for Pellegra: dermatitis, diarrhea, Transient due to the vasodilat- Breast milk; infant formula;
oxidation, energy release; nec- dementia ing effects of niacin (does not meat; poultry; fish; whole-grain
essary for synthesis of glycogen occur with niacinamide)-flush- breads, cereals, and fortified or
Niacin and the synthesis and break- ing, tingling, dizziness, nausea; enriched grain products; egg
down of fatty acids liver abnormalities; hyperu- yolk
ricemia; decreased LDL and
increased HDL cholesterol
Builds and maintains bones and Rickets – abnormal develop- Excessive calcification of bone; Breast milk, infant formula,
teeth; essential in clotting of ment of bones. calcification of soft tissue; hy- yogurt, cheese, fortified or
blood; influences transmission percalcemia; vomiting; lethargy enriched grain products, some
of ions across cell membranes; green leafy vegetables (such as
Calcium required in nerve transmission collards, kale mustard greens,
and turnip greens), tofu (if
made with calcium sulfate),
sardines, salmon
Essential for the formation of Hypochromic microcytic ane- Hemochromatosis; hemosidero- Breast milk; infant formula;
hemoglobin and oxygen trans- mia; malabsorption; irritability; sis. meat; liver; legumes; whole-
port; increases resistance to anorexia; pallor, lethargy grain breads, cereals, or forti-
Iron infection; functions as part fied or enriched grain products;
of enzymes involved in tissue and dark green vegetables
respiration.
Component of many enzyme Decreased wound healing, Acute gastrointestinal upset; Breast milk; infant formula;
systems and insulin hypogonadism, mild anemia, vomiting; sweating; dizziness; meat; liver; egg yolk; oysters
decreased taste acuity, hair copper deficiency and other seafood; whole-grain
Zinc loss, diarrhea, growth failure, breads, cereals, and other forti-
skin changes fied or enriched grain products;
legumes
Helps protect teeth against Increased dental caries Mottled, discolored teeth; pos- Fluoridated water
tooth decay; may minimize bone sible increase in bone density;
Fluoride loss calcified muscle insertions and
exotosis
Helps regulate acid-base equi- Usually accompanied by sodium Breast milk, infant formula,
librium and osmotic pressure depletion; see Sodium sodium chloride (table salt)
Chloride of body fluids; component of
gastric juices
 Nutrient Function Deficiency Symptoms Toxicity Symptoms Major Food Sources
Required for normal glucose Glucose intolerance; impaired Meat; whole-grain breads, cere-
metabolism; insulin cofactor growth; peripheral neuropathy; als, and other fortified or en-
Chromium negative nitrogen balance; de- riched grain products; brewer’s
creased respiratory quotient yeast; corn oil
Facilitates the function of many Pallor, retarded growth, edema, Wilson’s disease – copper de- Liver; kidney; poultry; shellfish;
enzymes and iron; may be an anorexia posits in the cornea; cirrhosis of legumes; whole-grain breads,
Copper integral part of RNA, DNA mol- liver; deterioration of neurologi- cereals, and other grain prod-
ecules cal processes ucts
Helps regulate thyroid hor- Endemic goiter; depressed thy- Possible thyroid enlargement Breast milk, infant formula,
Iodine mones; important in regulation roid function; cretinism seafood, iodized salt
of cellular oxidation and growth
Required for many coenzyme Muscle tremors; convulsions; Diarrhea; transient Breast milk; infant formula;
oxidation-phosphorylation reac- irritability; tetany; hyper-or hypocalcemia whole-grain breads, cereals,
Magnesium tions, nerve impulse transmis- hypoflexia and other grain products; tofu;
sions, and for muscle contrac- legumes; green vegetables
tion
Essential part of several enzyme Impaired growth; skeletal abnor- In extremely high exposure from Whole-grain breads, cereals,
Manganese systems involved in protein and malities; neonatal ataxia contamination: severe psychiat- and other grain products; le-
energy metabolism ric and neurologic disorders gumes; fruits; vegetables (leafy)
Part of the enzymes xanthine Goutlike syndrome Organ meats; breads, cereals,
oxidase and aldehyde oxidase, and other grain products; dark
Molybedenum possibly helps reduce incidence green leafy vegetables; legumes
of dental caries
Builds and maintains bones and Phosphate depletion unusual Hypocalcemia (when parathy- Breast milk; infant formula;
teeth; component of nucleic ac- – effects renal, neuromuscular, roid gland not fully functioning) cheese; egg yolk; meat; poultry;
ids, phospholipids; as coenzyme skeletal systems as well as fish; whole-grain breads, cere-
functions in energy metabolism; blood chemistries als, and other grain products;
Phosphorus buffers intracellular fluid legumes
INFANT NUTRITION AND FEEDING

Helps regulate acid-base equi- Muscle weakness; decreased Breast milk; infant formula;
librium and osmotic pressure of intestinal tone and distension; fruits especially orange juice,
body fluids; influences muscle cardiac arrhythmias; respiratory bananas, and dried fruits;
activity, especially cardiac failure yogurt; potatoes; meat; fish;
Potassium muscle poultry; soy products;
vegetables
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Nutrient Function Deficiency Symptoms Toxicity Symptoms Major Food Sources

INFANT NUTRITION AND FEEDING

May be essential to tissue Myalgia; muscle tenderness; Whole-grain breads, cereals,

respiration; associated with fat cardiac myopathy; increased and other fortified or enriched
Selenium metabolism and vitamin E; acts fragility of red blood cells; de- grain products; onions; meats;
as an antioxidant generation of pancreas seafood; dependent on soil
content– vegetables
Helps regulate acid-base equi- Nausea; cramps; vomiting; Sodium chloride (table salt),
librium and osmotic pressure dizziness; apathy; exhaustion; abundant in most foods except
of body fluids; plays a role in possible respiratory failure fruit
Sodium normal muscle irritability and
contractility; influences cell
permeability
Functions in the synthesis and Fatigue; sleep disturbances; Diarrhea; water retention Breast milk; infant formula;
breakdown of many vital body nausea; muscle cramps; meat; fish; poultry; liver; egg
Pantothenic Acid compounds; essential in the impaired coordination; loss of yolk; yeast; whole-grain breads,
intermediary metabolism of antibody production cereals, and other grain prod-
carbohydrate, fat, and protein ucts; legumes; vegetables
Essential component of en- Seborrheic dermatitis; glossitis; Breast milk, infant formula, liver,
zymes; important in reactions nausea; insomnia; meat, egg yolk, yeast, bananas,
involving the lengthening of car- most vegetables, strawberries,
Biotin bon chains; coenzyme carrier of grapefruit, watermelon,
carbon dioxide; plays an impor-
tant role in the metabolism of
fatty acids and amino acids

Chart revised from first edition using following references:

Maher LK, Escott-Stump S. Krause’s Food, Nutrition, and Diet Therapy. 11th ed. USA: Elsevier, 2004.
Vitamins. In: Kleinman RE, editor. Pediatric Nutrition Handbook. 5th ed. Elk Grove Village, IL: American Academy of Pediatrics, 2004.