203

Appendix C: Nutrient Chart - Function, Deficiency and Toxicity Symptoms, and Major Food Sources

Nutrient Function Deficiency Symptoms Toxicity Symptoms Major Food Sources
Protein Anabolism of tissue
proteins; helps maintain
fluid balance; energy
source; formation of
immunoglobulins;
maintenance of acid-base
balance; important part of
enzymes and hormones
Kwashiorkor-edema;
reddish pigmentation of
hair and skin; fatty liver;
retardation of growth in
children; diarrhea;
dermatosis; decreased T-
cell lymphocytes with
increased secondary
infections;
Marasmus- muscle and fat
wasting; anemia
Azotemia; acidosis;
hyperammonemia
Breast milk, infant
formula, meat, fish,
poultry, egg yolk, cheese,
yogurt, legumes
Carbohydrate Major energy source;
protein sparing; necessary
for normal fat metabolism;
glucose is the sole source
of energy for the brain;
many sources also provide
dietary fiber
Ketosis Breast milk; infant
formula; whole-grain
breads, cereals, and other
fortified or enriched grain
products; potatoes; corn;
legumes; fruits; vegetables
Fat Concentrated energy
source; protein sparing;
insulation for temperature
maintenance; supplies
essential fatty acids;
carries fat-soluble
vitamins A, D, E, K
Eczema; low growth rate
in infants; lowered
resistance in infection;
hair loss
Breast milk, infant
formula, protein-rich
foods (meats, dairy
products, egg yolk, nuts),
butter, margarine, cream,
salad oils and dressings,
cooking and meat fats
Vitamin D Necessary for the
formation of normal bone;
promotes the absorption of
calcium and phosphorus in
the intestines
Rickets (symptoms:
costochondral beading,
epiphyseal enlargement,
cranial bossing, bowed
legs, persistently open
anterior fontanelle)
Abnormally high blood
calcium (hypercalcemia),
retarded growth, vomiting,
nephrocalcinosis
Infant formula, egg yolk,
liver, fatty fish, sunlight
(activation of 7-
dehydrocholesterol in the
skin)
Vitamin A Preserves integrity of Night blindness, dry eyes, Fatigue; night sweats; Breast milk, infant

204
epithelial cells; formation
of rhodopsin for vision in
dim light; necessary for
wound healing, growth,
and normal immune
function
poor bone growth,
impaired resistance to
infection, papillary
hyperkeratosis of the skin
vertigo; headache; dry and
fissured skin; lips;
hyperpigmentation;
retarded growth; bone
pain; abdominal pain;
vomiting; jaundice;
hypercalcemia
formula, liver, egg yolk,
dark green and deep
yellow vegetables and
fruits
Vitamin E May function as an
antioxidant in the tissues;
may also have a role as a
coenzyme; neuromuscular
function
Hemolytic anemia in the
premature and newborn;
hyporeflexia, and
spinocerebellar and retinal
degeneration
May interfere with vitamin
K activity leading to
prolonged clotting and
bleeding time; in anemia,
suppresses the normal
hematologic response to
iron
Breast milk; infant
formula; vegetable oils;
liver; egg yolk; butter;
green leafy vegetables;
whole-grain breads,
cereals, and other fortified
or enriched grain products;
wheat germ
Vitamin K Catalyzes prothrombin
synthesis; required in the
synthesis of other blood
clotting factors; synthesis
by intestinal bacteria
Prolonged bleeding and
prothrombin time;
hemorrhagic
manifestations (especially
in newborns)
Possible hemolytic
anemia;
hyperbilirubinemia
(jaundice)
Infant formula, vegetable
oils, green leafy
vegetables, pork, liver
Ascorbic Acid
(Vitamin C)


Essential in the synthesis
of collagen (thus,
strengthens tissues and
improves wound healing
and resistance to
infection);iron absorption
and transport; water-
soluble antioxidant;
functions in folacin
metabolism
Scurvy, pinpoint
peripheral hemorrhages,
bleeding gums, osmotic
diarrhea
Nausea, abdominal
cramps, diarrhea, possible
formation of kidney stones
Breast milk, infant
formula, fruits (especially
citrus fruits, papaya,
cantaloupe, strawberries),
vegetables (potatoes,
cabbage)
Vitamin B
12
(Cobalamin,
Cyanocobalamin)
Essential for biosynthesis
of nucleic acids and
nucleoproteins; red blood
cell maturation; involved
with folate metabolism;
Pernicious anemia;
neurologic deterioration
Infant formula, breast
milk, meat, fish, poultry,
cheese, egg yolk, liver

205
central nervous system
metabolism
Folacin
(Folate)
Essential in the
biosynthesis of nucleic
acids; necessary for the
normal maturation of red
blood cells
Poor growth;
megaloblastic anemia
(concurrent deficiency of
vitamin B
12
should be
suspected); impaired
cellular immunity
Masking of B
12
deficiency
symptoms in those with
pernicious anemia not
receiving cyanocobalamin
Breast milk; infant
formula; liver; green leafy
vegetables; legumes;
whole-grain breads,
cereals, and fortified or
enriched grain products;
legumes; oranges;
cantaloupe; lean beef

Pyridoxine
(Vitamin B
6
)
Aids in the synthesis and
breakdown of amino acids
and unsaturated fatty acids
from essential fatty acids;
essential for conversion of
tryptophan to niacin;
essential for normal
growth
Microcytic anemia;
convulsions; irritability
Sensory neuropathy with
progressive ataxia;
photosensitivity
Breast milk; infant
formula; liver; meat;
whole-grain breads,
cereals, or other grain
products; legumes;
potatoes
Thiamin
(Vitamin B
1
)
Combines with
phosphorus to form
thiamin pyrophosphate
(TPP) necessary for
metabolism of protein,
carbohydrate, and fat;
essential for growth,
normal appetite, digestion,
and healthy nerves
Beriberi, neuritis, edema,
cardiac failure
Breast milk; infant
formula; lean pork; wheat
germ; whole-grain and
enriched breads, cereals,
and other grain products;
legumes; potatoes
Riboflavin
(Vitamin B
2
)
Essential for growth; plays
enzymatic role in tissue
respiration and acts as a
transporter of hydrogen
ions; synthesis of FMN
and FAD
Photophobia, cheilosis,
glossitis, corneal
vascularization, poor
growth
Breast milk; infant
formula, meat; dairy
products; egg yolk;
legumes; green
vegetables; whole-grain
breads, cereals, and
fortified or enriched grain

206
products
Niacin Part of the enzyme system
for oxidation, energy
release; necessary for
synthesis of glycogen and
the synthesis and
breakdown of fatty acids
Pellegra: dermatitis,
diarrhea, dementia
Transient due to the
vasodilating effects of
niacin (does not occur
with niacinamide)-
flushing, tingling,
dizziness, nausea; liver
abnormalities;
hyperuricemia; decreased
LDL and increased HDL
cholesterol
Breast milk; infant
formula; meat; poultry;
fish; whole-grain breads,
cereals, and fortified or
enriched grain products;
egg yolk
Calcium Builds and maintains
bones and teeth; essential
in clotting of blood;
influences transmission of
ions across cell
membranes; required in
nerve transmission
Rickets abnormal
development of bones.
Osteomalacia failure to
mineralize bone matrices;
tetany; possibly
hypertension
Excessive calcification of
bone; calcification of soft
tissue; hypercalcemia;
vomiting; lethargy
Breast milk, infant
formula, yogurt, cheese,
fortified or enriched grain
products, some green leafy
vegetables (such as
collards, kale mustard
greens, and turnip greens),
tofu (if made with calcium
sulfate), sardines, salmon
Iron Essential for the formation
of hemoglobin and oxygen
transport; increases
resistance to infection;
functions as part of
enzymes involved in tissue
respiration.
Hypochromic microcytic
anemia; malabsorption;
irritability; anorexia;
pallor, lethargy
Hemochromatosis;
hemosiderosis.
Breast milk; infant
formula; meat; liver;
legumes; whole-grain
breads, cereals, or fortified
or enriched grain products;
and dark green vegetables
Zinc Component of many
enzyme systems and
insulin
Decreased wound healing,
hypogonadism, mild
anemia, decreased taste
acuity, hair loss, diarrhea,
growth failure, skin
changes
Acute gastrointestinal
upset; vomiting; sweating;
dizziness; copper
deficiency
Breast milk; infant
formula; meat; liver; egg
yolk; oysters and other
seafood; whole-grain
breads, cereals, and other
fortified or enriched grain
products; legumes
Fluoride Helps protect teeth against Increased dental caries Mottled, discolored teeth; Fluoridated water

207
tooth decay; may
minimize bone loss
possible increase in bone
density; calcified muscle
insertions and exotosis
Chloride Helps regulate acid-base
equilibrium and osmotic
pressure of body fluids;
component of gastric
juices
Usually accompanied by
sodium depletion; see
Sodium
Breast milk, infant
formula, sodium chloride
(table salt)
Chromium Required for normal
glucose metabolism;
insulin cofactor
Glucose intolerance;
impaired growth;
peripheral neuropathy;
negative nitrogen balance;
decreased respiratory
quotient
Meat; whole-grain breads,
cereals, and other fortified
or enriched grain products;
brewers yeast; corn oil
Copper Facilitates the function of
many enzymes and iron;
may be an integral part of
RNA, DNA molecules
Pallor, retarded growth,
edema, anorexia
Wilsons disease copper
deposits in the cornea;
cirrhosis of liver;
deterioration of
neurological processes
Liver; kidney; poultry;
shellfish; legumes; whole-
grain breads, cereals, and
other grain products
Iodine Helps regulate thyroid
hormones; important in
regulation of cellular
oxidation and growth
Endemic goiter; depressed
thyroid function; cretinism
Possible thyroid
enlargement
Breast milk, infant
formula, seafood, iodized
salt

Magnesium Required for many
coenzyme oxidation-
phosphorylation reactions,
nerve impulse
transmissions, and for
muscle contraction
Muscle tremors;
convulsions; irritability;
tetany; hyper-or
hypoflexia
Diarrhea; transient
hypocalcemia
Breast milk; infant
formula; whole-grain
breads, cereals, and other
grain products; tofu;
legumes; green vegetables
Manganese Essential part of several
enzyme systems involved
in protein and energy
metabolism
Impaired growth; skeletal
abnormalities; neonatal
ataxia
In extremely high
exposure from
contamination: severe
psychiatric and neurologic
disorders
Whole-grain breads,
cereals, and other grain
products; legumes; fruits;
vegetables (leafy)
Molybedenum Part of the enzymes Goutlike syndrome Organ meats; breads,

208
xanthine oxidase and
aldehyde oxidase, possibly
helps reduce incidence of
dental caries
cereals, and other grain
products; dark green leafy
vegetables; legumes

Phosphorus Builds and maintains
bones and teeth;
component of nucleic
acids, phospholipids; as
coenzyme functions in
energy metabolism;
buffers intracellular fluid
Phosphate depletion
unusual effects renal,
neuromuscular, skeletal
systems as well as blood
chemistries
Hypocalcemia (when
parathyroid gland not fully
functioning)
Breast milk; infant
formula; cheese; egg yolk;
meat; poultry; fish; whole-
grain breads, cereals, and
other grain products;
legumes
Potassium Helps regulate acid-base
equilibrium and osmotic
pressure of body fluids;
influences muscle activity,
especially cardiac muscle
Muscle weakness;
decreased intestinal tone
and distension; cardiac
arrhythmias; respiratory
failure
Breast milk; infant
formula; fruits especially
orange juice, bananas, and
dried fruits; yogurt;
potatoes; meat; fish;
poultry; soy products;
vegetables
Selenium May be essential to tissue
respiration; associated
with fat metabolism and
vitamin E; acts as an
antioxidant
Myalgia; muscle
tenderness; cardiac
myopathy; increased
fragility of red blood cells;
degeneration of pancreas
Whole-grain breads,
cereals, and other fortified
or enriched grain products;
onions; meats; seafood;
dependent on soil content
vegetables
Sodium Helps regulate acid-base
equilibrium and osmotic
pressure of body fluids;
plays a role in normal
muscle irritability and
contractility; influences
cell permeability
Nausea; cramps; vomiting;
dizziness; apathy;
exhaustion; possible
respiratory failure
Sodium chloride (table
salt), abundant in most
foods except fruit
Pantothenic Acid Functions in the synthesis
and breakdown of many
vital body compounds;
essential in the
Fatigue; sleep
disturbances; nausea;
muscle cramps; impaired
coordination; loss of
Diarrhea; water retention Breast milk; infant
formula; meat; fish;
poultry; liver; egg yolk;
yeast; whole-grain breads,

209
intermediary metabolism
of carbohydrate, fat, and
protein
antibody production cereals, and other grain
products; legumes;
vegetables

Biotin Essential component of
enzymes; important in
reactions involving the
lengthening of carbon
chains; coenzyme carrier
of carbon dioxide; plays
an important role in the
metabolism of fatty acids
and amino acids
Seborrheic dermatitis;
glossitis; nausea;
insomnia;
Breast milk, infant
formula, liver, meat, egg
yolk, yeast, bananas, most
vegetables, strawberries,
grapefruit, watermelon,

Chart revised from first edition using following references:
Maher LK, Escott-Stump S. Krauses Food, Nutrition, and Diet Therapy. 11
th
ed. USA: Elsevier, 2004.
Vitamins. In: Kleinman RE, editor. Pediatric Nutrition Handbook. 5
th
ed. Elk Grove Village, IL: American Academy of Pediatrics, 2004.