DNT 200 NUTRITION FOR HEALTH SCIENCES

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DNT 200NUTRITION FOR HEALTH SCIENCES

• VITAMINS

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VITAMINS

• There are no more important ingredients of a
  properly constituted diet than fruits and
  vegetables, for they contain vitamins of every
  class, recognized and unrecognized.
• Sir Robert McCarrison 1878 -1960
• British Vitamin Researcher

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VITAMINS

• Vitamins are essential, non-caloric, organic
  nutrients needed in tiny amounts in the diet.
• Assist enzymes in the release of energy from
  carbohydrate, protein, and fat
• The only disease a vitamin will cure is one
  caused by a deficiency of that vitamin
• May be fat soluble
• May be water soluble
• 1989 RDAs coming under Dietary Reference Intakes
• Includes two sets of values that serve as goals
  for nutrient intake for individuals
• Recommended Dietary Allowances (RDAs)
• Adequate Intakes (AIs)

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VITAMINS

• Fat Soluble Vitamins

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VITAMINS

• Fat Soluble Vitamins
• Vitamins A, D, E, and K
• Usually occur together in the fats and oils of
  food
• Body absorbs them from the GI tract the same way
  it absorbs lipids
• Any condition that interferes with fat absorption
  can precipitate a deficiency of fat soluble
  vitamins
• Once absorbed, are stored in the liver and fatty
  tissues until the body needs them -- a person
  need not replenish them every single day
• Are not readily excreted and can build up to
  toxic concentrations

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VITAMINSFat Soluble VitaminsVitamin A

• Was the first to be recognized -- identified 1914
• Also known as retinol (the alcohol form of
  Vitamin A), retinal (the aldehyde form of Vitamin
  A, active in the pigments of the eye), and
  retinoic acid (the acid form of Vitamin A)

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VITAMINSFat Soluble VitaminsVitamin A

• Precursor is provitamin A carotenoids, e.g. beta
  carotene (found in plant foods)

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VITAMINSFat Soluble VitaminsVitamin A

• DIETARY REFERENCE INTAKE VALUE
• RDA
• Males over 14 -- 900 ?g/day
• Females over 14 -- 700?g/day
• UL
• 3,000 ?g/day (males and females)
• 2001 data

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VITAMINSFat Soluble VitaminsVitamin A

• A years supply can be stored in the body -- 90
  of it in the liver
• Deficiency possible 1-2 years after you stop
  eating it
• Toxicity most likely when preformed Vitamin A is
  consumed in excess amounts from animal-derived
  foods or supplements
• Use caution when taking high doses of beta
  carotene -- supplements should be used only for
  prevention and control of Vitamin A deficiency
• Beta carotene stored in fat deposits as carotene
  (an orange pigment found in plants)
• Beta carotene may turn the skin yellow

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VITAMINSFat Soluble VitaminsVitamin A

• Major Roles In The Body
• Vision
• Allows the eyes to adjust to light
• Best known
• Only 1/1000th of bodys Vitamin A is in the
  retina
• Helps maintain healthy skin and mucous membranes
• Aids in the reproductive process
• Retinoic acid is a member of the family of
  steroid and thyroid hormones that regulate
  metabolism, growth, cell differentiation, and
  embryonic development by directing the expression
  of genes

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VITAMINSFat Soluble VitaminsVitamin A

• Major Roles In The Body (cont)
• Immunity
• Its maintenance of healthy epithelial tissue
  helps to prevent invasion of bacteria and viruses
• Appears to play a direct role in the immune
  system itself
• Bone and tooth growth
• Participates in remodeling (the dismantling and
  re-formation of bone) enabling a small bone to
  convert into a large bone

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VITAMINSFat Soluble VitaminsVitamin A

• Deficiency
• Deficiency Disease -- Hypovitaminosis A
• Symptoms
• Night Blindness
• Blood bathing cells of the retina do not supply
  sufficient Vitamin A to rapidly regenerate visual
  pigments bleached by light
• Person looses the ability to recover promptly
  from the temporary blinding that occurs following
  a flash of bright light at night or simply to see
  after the lights go out

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VITAMINSFat Soluble VitaminsVitamin A

• Deficiency
• Symptoms (cont)
• Blindness
• Xerophthalmia -- the progressive blindness caused
  by Vitamin A deficiency
• Is the major cause of childhood blindness in the
  world

Cornea and tissues of the eye become dry,
thickened and wrinkled
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VITAMINSFat Soluble VitaminsVitamin A

• Deficiency
• Symptoms (cont)
• Diminished membrane integrity
• Mucous secretion in the stomach and intestine
  decreases hindering normal digestion and
  absorption of nutrients
• Infections of the respiratory tract, GI tract,
  urinary tract, vagina, and possibly the inner ear
  become likely
• Outer body surface hardens and skin becomes dry
  rough, and scaly

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VITAMINSFat Soluble VitaminsVitamin A

• Toxicity
• Toxicity Disease -- Hypervitaminosis A
• Occurs when all the binding proteins for Vitamin
  A are swamped and free Vitamin A attacks the
  cells
• Is unlikely when eating a balanced diet but is a
  possibility when taking large dose supplements
  containing the vitamin
• Beta carotene is stored in fat deposits as
  carotene and, taken in excess, may turn the skin
  yellow
• Children are most susceptible to overdoses --
  they need less

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VITAMINSFat Soluble VitaminsVitamin A

• Vitamin A in the Diet

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VITAMINSFat Soluble VitaminsVitamin A

• Significant Sources
• Retinol
• Fortified Milk
• Cheese
• Cream
• Butter
• Fortified Margarine
• Eggs
• Liver
• Beta Carotene
• Dark Leafy Greens
• Deep Orange Fruits and Vegetables

Sweet Potato 1936 REb per 1/2 c mashed Carrots
1915 REb per 1/2 c cooked Fortified Milk 150
REa per cup Beef Liver 1919 REa per 3 oz
fried Apricots 280 REb per 3 fresh
apricots Spinach 737 REb per 1/2 c
cooked aPreformed vitamin A bBeta-carotene
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VITAMINSFat Soluble VitaminsVitamin D

• Can be synthesized by the body from sunlight
• Also known as calciferol, cholecalciferol, and
  dihydroxy-vitamin D
• Precursor is the body bodys own cholesterol
• Chemical structures elucidated in 1930s

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VITAMINSFat Soluble VitaminsVitamin D

• DIETARY REFERENCE INTAKE VALUE
• (based on the absence of sunlight)
• AI
• 5 micrograms (individuals under 51 years)
• 10 micrograms (51-70 year olds)
• 15 micrograms (individuals over 70 years)
• UL
• 50 micrograms per day (males and females)
• 1998 data

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VITAMINSFat Soluble VitaminsVitamin D

• Major Role In The Body
• Promotes mineralization of the bones
• Helps to make calcium and phosphorus available in
  the blood that bathes the bones, to be deposited
  as the bones harden (mineralize)
• Stimulates absorption of calcium and phosphorus
  from the GI tract
• Helps to withdraw them from the bones into the
  blood
• Stimulates their retention by the kidneys

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VITAMINSFat Soluble VitaminsVitamin D

• Deficiency
• Deficiency Disease
• Rickets (children)
• Vitamin D deficiency disease characterized by
  inadequate mineralization of bone (manifested in
  bowed legs or knock knees, outward bowed chest,
  and knobs on ribs)

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VITAMINSFat Soluble VitaminsVitamin D
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VITAMINSFat Soluble VitaminsVitamin D

• Deficiency
• Deficiency Disease
• Osteomalacia (adults)
• A bone disease characterized by softening of the
  bones (bending of the spine and bowing of the
  legs)

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VITAMINSFat Soluble VitaminsVitamin D

• Toxicity
• Toxicity Disease -- Hypervitaminosis D
• Calcium absorption is increased
• High blood calcium results
• Excess blood calcium tends to precipitate in the
  soft tissue forming stones -- especially likely
  in the kidney
• During warm months of the year, when exposure to
  sunlight may be frequent, vitamin D supplements
  can harm healthy children and adults who drink
  two glasses of vitamin D fortified milk per day
• Sun poses no risk of toxicity
• Prolonged exposure to the sun degrades the
  vitamin D precursor in the skin, preventing its
  conversion to the active vitamin

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VITAMINSFat Soluble VitaminsVitamin D

• In most of the U.S. you cant make vitamin D from
  sunlight for four months of the year

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VITAMINSFat Soluble VitaminsVitamin D

• Significant Sources
• Self-synthesis with the ultraviolet rays of the
  sunlight
• Dark skinned people require longer sunlight
  exposure to maximize vitamin D synthesis
• Heavy clouds, smoke, or smog may filter out a
  good portion of the UV waves
• Fortified milk
• Fortified margarine
• Eggs
• Liver
• Small fish (sardines)
• Vitamin D supplements

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VITAMINSFat Soluble VitaminsVitamin E

• Also known as tocopherol
• Alpha tocopherol -- the most biologically active
  vitamin E compound
• Tocotrienol -- less active forms of vitamin E

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VITAMINSFat Soluble VitaminsVitamin E

• DIETARY REFERENCE INTAKE VALUE
• RDA
• 15 milligrams from food for males females over
  14
• 22 IUs from natural sources or
• 33 IUs from synthetic source
• UL from supplements
• 1000 mg alpha tocopherol -- greater than this
  risks hemorrhagic damage because it can act as an
  anti-coagulant
• 2000 data

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VITAMINSFat Soluble VitaminsVitamin E

• Major Role In The Body
• Antioxidant (protects other compounds from being
  oxidized by being oxidized itself)
• Protects PUFA and vitamin A from destruction
• Especially important in the lungs, where cells
  are exposed to high concentrations of oxygen and
  pollutants (which are strong oxidants)
• Helps to maintain intact cell membranes

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VITAMINSFat Soluble VitaminsVitamin E

• Deficiency
• Deficiency Disease
• Rare -- usually associated with diseases of fat
  malabsorption such as cystic fibrosis (a disease
  of the mucous glands usually developing during
  childhood and causing pancreatic insufficiency
  and pulmonary disorders)
• Prolonged deficiency causes neuromuscular
  dysfunction involving the spinal cord and retina
• Classic symptom is the breaking open of red blood
  cells (erythrocyte hemolysis)
• Toxicity
• High doses may enhance anticoagulant effects of
  drugs

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VITAMINSFat Soluble VitaminsVitamin E

• Supplementation
• May be appropriate for
• Premature infants -- transfer of vitamin E across
  the placenta becomes maximal right before full
  term delivery
• Infants, children, and adults who cant absorb
  fats and oils because of disease and surgery
• Individuals with certain blood disorders
• Abnormal blood flow that causes cramping in the
  legs (intermittent claudication)
• Non-malignant breast disease (Fibrocystic breast
  disease)

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VITAMINSFat Soluble VitaminsVitamin E

• Supplementation
• Inappropriate for
• Improving athletic skill or endurance
• Increasing sexual potency
• Prolonging the life of the heart
• Reversing the damage of atherosclerosis or heart
  attack
• Does not prevent or cure hereditary muscular
  dystrophy (Nutritional muscular dystrophy is a
  vitamin E deficiency disease in animals)

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VITAMINSFat Soluble VitaminsVitamin E

• Significant Sources
• Widespread in foods
• Readily destroyed by heat processing and
  oxidation
• Fresh or lightly processed foods are the most
  desirable sources
• Plant Oils
• Margarine
• Salad Dressings
• Shortenings
• Green and Leafy Vegetables
• Wheat Germ
• Whole Grain Products
• Liver
• Egg Yolks
• Nuts
• Seeds

• Corn Oil 2.9mg per tbsp
• Safflower Oil 4.7mg per tbsp
• Sunflower Seeds (shelled) 9mg per 2 tbsp
• Canola Oil 2.9mg per tbsp
• Sweet Potato 4.5mg per 1/2 cup mashed
• Shrimp 3.2mg per 3oz boiled

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VITAMINSFat Soluble VitaminsVitamin K

• Acts primarily in blood clotting
• Can be synthesized by bacteria in the intestinal
  tract
• Recognized in 1930s
• Also known as
• Menadione (a synthetic substance)
• Phylloquinone
• Napthoquinone

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VITAMINSFat Soluble VitaminsVitamin K

• DIETARY REFERENCE INTAKE VALUE
• AI
• Females over 19 -- 90 micrograms
• Males over 19 -- 120 micrograms
• 2001 data

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VITAMINSFat Soluble VitaminsVitamin K

• Major Role In The Body
• Synthesis of blood clotting protein (prothrombin)
• Presence can make the difference between life and
  death
• Synthesis of a blood protein that regulates
  calcium

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VITAMINSFat Soluble VitaminsVitamin K

• Deficiency
• Deficiency Disease
• New babies susceptible
• Are born with a sterile digestive tract
• May not be fed a good source of vitamin K at the
  outset
• Dose of vitamin K may be given at birth to
  prevent hemorrhagic disease in the newborn
• People taking sulfa drugs, which destroy
  intestinal bacteria may also become deficient
• Symptoms
• Hemorrhaging (blood does not clot)

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VITAMINSFat Soluble VitaminsVitamin K

• Deficiency
• Spontaneous hemorrhages in a chick fed vitamin K
  deficient diet for 15 days.
• Bottom chick was fed an adequate diet and is the
  same age

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VITAMINSFat Soluble VitaminsVitamin K

• Toxicity
• May interfere with anti-clotting medication
• Possible jaundice
• Brain damage caused by vitamin K analogues

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VITAMINSFat Soluble VitaminsVitamin K

• Significant Sources
• Bacterial synthesis in the digestive tract
• Liver
• Green leafy vegetables
• Cabbage-type vegetables
• Milk

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VITAMINS

• Water Soluble Vitamins

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VITAMINS

• Water Soluble Vitamins
• B-Complex Vitamins and Vitamin C
• Are found in the watery compartments of foods
• All B Vitamins are natural parts of brewers yeast
  (not bakers yeast) and liver
• Are distributed in the watery compartments of the
  body
• Are easily absorbed in the bloodstream
• Easily excreted if their blood concentrations are
  too high
• Can be toxic in large doses

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VITAMINS

• Water Soluble Vitamins (cont)
• Some act as co-enzymes to the enzymes that
  release energy from carbohydrate, fat, and
  protein
• Thiamin
• Riboflavin
• Niacin
• Pantothenic Acid
• Biotin
• A coenzyme is a small molecule that combines with
  an enzyme to make it active
• One assists enzymes that metabolize amino acids
• Vitamin B-6
• Some help cells to multiply
• Folate
• Vitamin B-12

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VITAMINSWater Soluble VitaminsThiamin

• Also known as vitamin B-1
• Chemical formula -- C12H17ClN4OS
• Isolated from rice polishings in 1926 by Drs.
  B.C.P. Jansen and W.F.Donath
• Prolonged heating of foods can destroy
  substantial amounts
• Leaches into water when foods are boiled or
  blanched

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VITAMINSWater Soluble VitaminsThiamin

• DIETARY REFERENCE INTAKE VALUE
• RDA
• Females over 19 -- 1.1 milligrams
• Males over 14 -- 1.2 milligrams
• Needs are proportional to the energy expended,
  not energy intake
• 1998 data

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VITAMINSWater Soluble VitaminsThiamin

• Major role in the body
• Part of PPT (thiamin pyrophosphate), a coenzyme
  used in energy metabolism
• Helps to release energy from fat and carbohydrate
• More is needed when energy expenditure is high
• Supports normal appetite
• Supports normal nervous system function
• Breaks down alcohol

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VITAMINSWater Soluble VitaminsThiamin

• Deficiency
• Prolonged deficiency can result in beriberi --
  the thiamin deficiency disease
• Deficiency symptoms
• Edema -- Painful calf muscles
• Enlarged heart -- Low morale
• Abnormal heart rhythms -- Difficulty walking
• Heart failure -- Loss of ankle and
• Degeneration knee jerk reflexes
• Wasting -- Mental confusion
• Weakness -- Paralysis

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VITAMINSWater Soluble VitaminsThiamin

• Green Peas 0.23mg per 1/2c cooked
• Pork Chop 0.87mg per 3 oz broiled chop
• Black Beans 0.21mg per 1/2c cooked
• Watermelon 0.20mg per melon wedge
• Whole Wheat Bread 0.11mg per slice
• Sunflower Seeds (shelled) 0.41mg per 2 tbsp

• Significant Sources
• In all nutritious foods in moderate amounts
• Pork
• Ham
• Bacon
• Liver
• Whole Grains
• Legumes
• Nuts

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VITAMINSWater Soluble VitaminsRiboflavin

• Also known as vitamin B-2
• Chemical formula -- C17H20N4O6
• Isolated from whey in 1933 by Dr. R. Kuhn
• Must be phosphorylated
• i.e. combined with phosphorus before it absorbed
• Both are found in milk

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VITAMINSWater Soluble VitaminsRiboflavin

• Is light sensitive
• Is destroyed by ultraviolet rays of sun or
  fluorescent light
• Cardboard or opaque plastic protects it

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VITAMINSWater Soluble VitaminsRiboflavin

• DIETARY REFERENCE INTAKE VALUE
• RDA
• Females over 19 -- 1.1 milligrams
• Males over 14 -- 1.3 milligrams
• 1998 data

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VITAMINSWater Soluble VitaminsRiboflavin

• Major roles in the body
• Part of FMN (flavin mononucleotide) and FAD
  (flavin adenine dinucleotide), coenzymes used in
  energy metabolism
• Helps to release energy from carbohydrate, fat,
  and protein
• Supports normal vision and skin health

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VITAMINSWater Soluble VitaminsRiboflavin

• Deficiency
• Ariboflavinosis -- the riboflavin deficiency
  disease
• Deficiency symptoms
• Cracks and redness at the corners of the mouth
• Magenta tongue (painful, smooth, purplish red
  tongue)
• Inflamed eyelids and sensitivity to light
• Reddening of cornea
• Skin rash (inflammation characterized by lesions
  covered with greasy scales)

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VITAMINSWater Soluble VitaminsRiboflavin

• Milk 0.34mg per cup
• Cottage Cheese 0.37mg per cup
• Yogurt 0.53mg per cup
• Spinach 0.21mg per 1/2 cup cooked
• Beef Liver 3.5mg per 3oz fried
• Mushrooms 0.23mg per 1/2 cup cooked

• Significant Sources
• Milk
• Yogurt
• Cottage Cheese
• Meat
• Leafy Green Vegetables
• Whole Grain or Enriched Breads and Cereals

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VITAMINSWater Soluble VitaminsNiacin

• Also known as vitamin B-3, Nicotinic Acid,
  Nicotinamide, Niacinamide
• Chemical formula -- C6H5NO 2
• Discovered in 1867 but shown to be a vitamin in
  1937 by Dr. Conrad Elvehjem

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VITAMINSWater Soluble VitaminsNiacin

• Precursor is dietary tryptophan (an essential
  amino acid)
• Body can make it from protein
• Diets adequate in protein are adequate in niacin
• Is soluble in water -- therefore use the cooking
  liquid

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VITAMINSWater Soluble VitaminsNiacin

• DIETARY REFERENCE INTAKE VALUE
• RDA
• Females over 14 -- 14 mg/day
• Males over 14 -- 16 mg/day
• 1998 data

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VITAMINSWater Soluble VitaminsNiacin

• Major roles in the body
• Part of NAD (nicotinamide adenine dinucleotide)
  and NADP (its phosphate form), coenzymes used in
  energy metabolism
• Helps to release energy from carbohydrate, fat,
  and protein
• Supports health of the skin, nervous system, and
  digestive system

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VITAMINSWater Soluble VitaminsNiacin

• Deficiency
• Pellagra -- the niacin deficiency disease
• Deficiency symptoms -- 4 Ds
• Dermatitis
• Diarrhea
• Dementia
• Death (if untreated)
• Toxicity
• Exert a drug-like effect on the nervous system,
  blood lipids, and blood cholesterol
• Toxicity Symptoms
• Liver Damage
• Peptic Ulcers
• Low Blood Pressure
• Painful flush, hives, and rash (niacin rush)

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VITAMINSWater Soluble VitaminsNiacin

• Baked Potato 3.3mg per whole small potato
• Mushrooms 7mg per 1/2 cup cooked
• Tuna (in water) 11.3mg per 3 oz
• Pork Chop 4.4mg per 3oz broiled chop
• Chicken Breast 11.7mg per 3oz cooked

• Significant Sources
• Meat, Seafood, Poultry
• Whole Grain Breads and Cereal
• Legumes and Nuts
• Liver and Kidney
• All protein-containing foods

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VITAMINSWater Soluble VitaminsVITAMIN B-6

• Also known as Pyridoxine, Pyridoxal, and
  Pyridoxamine
• Synthesized 1939
• Unlike other B vitamins, is stored extensively in
  muscle tissue
• Alcohol actively promotes the destruction and
  loss of Vitamin B-6 from the body

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VITAMINSWater Soluble VitaminsVITAMIN B-6

• DIETARY REFERENCE INTAKE VALUE
• RDA
• Adults to age 50 -- 1.3 mg
• Females over 50 -- 1.5 mg
• Males over 50 -- 1.7 mg
• 1998 data

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VITAMINSWater Soluble VitaminsVITAMIN B-6

• Major roles in the body
• Part of PLP (pyridoxal phosphate) and PMP
  (pyridoxamine phosphate), coenzymes used in
  amino acid and fatty acid metabolism
• Helps to convert tryptophan to niacin
• Helps to make red blood cells

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VITAMINSWater Soluble VitaminsVitamin B-6

• Deficiency
• Deficiency disease -- has no name
• Symptoms include
• Scaly dermatitis
• Depression
• Confusion
• Convulsions
• Anemia

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VITAMINSWater Soluble VitaminsVitamin B-6

• Toxicity
• First reported in 1983
• Symptoms include
• Loss of sensation in the extremities which, after
  months or years, may cause irreversible nerve
  damage

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VITAMINSWater Soluble VitaminsVitamin B-6

• Chicken Breast 0.51mg per 3oz cooked
• Navy Beans 0.15mg per 1/2 cup cooked
• Spinach 0.22 per 1/2 cup cooked
• Baked Potato 0.70mg per whole small potato
• Beef Liver 1.2mg per 3 oz fried
• Banana 0.66mg per whole banana

• Significant Sources
• Green and Leafy Vegetables
• Meats
• Fish
• Poultry
• Shellfish
• Legumes
• Fruits
• Whole Grains
• ?

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VITAMINSWater Soluble VitaminsFolate

• Also known as Folic Acid, Folacin, PTA
  (pteroylglutamic acid)
• Chemical formula -- C19 H19 N7O6
• Found in yeast and liver in 1935

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VITAMINSWater Soluble VitaminsFolate

• Need rises considerably in pregnancy and whenever
  cells are multiplying
• Folic Acid fortification could help prevent about
  half of the 2,500 spina bifida (a birth defect
  interfering with the development of the central
  nervous system) and anencephaly (congenital
  absence of part or all of the brain) cases per
  year

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VITAMINSWater Soluble VitaminsFolate

• DIETARY REFERENCE INTAKE VALUE
• RDA
• 400 micrograms DFE (males females over 14)
• DFEs (Dietary Folate Equivalents) account for
  differences in absorption
• UL -- 1,000 micrograms DFE
• 1998 data

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VITAMINSWater Soluble VitaminsFolate

• Fortification of enriched flour with 140 mcg
  folic acid per 100 grams flour required by FDA in
  January 1998

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VITAMINSWater Soluble VitaminsFolate

• Functions as a part of THF (tetrahydrofolate) and
  DHF (dihydrofolate), coenzymes used in DNA
  synthesis and therefore new cell formation
• Alcohol addicted people are at risk of folate
  deficiency
• Alcohol impairs folate absorption
• Alcohol increases folate secretion
• As peoples alcohol increases, folate intakes
  decline
• Prolonged cooking destroys most of the folate

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VITAMINSWater Soluble VitaminsFolate

• Has poor bioavailability -- about half of dietary
  folate is available for the body
• Foods deliver folate mostly in the bound form
  -- combined with a string of amino acids known as
  polyglutamate
• Intestines prefer the free form-- folate with
  only one glutamate attached known as
  monoglutamate
• Body is able to convert and store some
  polyglutamate
• Disposal of excess folate
• Liver secretes most of it into bile
• Is transported to the gall bladder
• Returns to the intestine
• Complicated transport and conversion system makes
  folate vulnerable to GI tract disturbances

73
VITAMINSWater Soluble VitaminsFolate

• Folate coenzyme (tetrahydrofolate, THF and
  dihydrofolate, DHF) functioning requires removal
  of the methyl group by enlisting the help of
  Vitamin B-12

74
VITAMINSWater Soluble VitaminsFolate

• Deficiency
• Deficiency disease -- has no name
• Impairs cell division and protein synthesis
• Red blood cell and GI tract cell replacement
  falters
• May be a result of
• Impaired absorption
• Unusual metabolic need
• Pregnancies
• Cancer
• Burns

75
VITAMINSWater Soluble VitaminsFolate

• Deficiency
• Is vulnerable to drug interactions
• Some drugs have a chemical structure similar to
  folate
• Can displace the vitamin from enzymes and block
  metabolic pathways
• Anti-cancer drugs can cause deficiency
• Aspirin and antacids may interfere with the
  bodys handling of folate
• Irritability
• Insomnia
• Toxicity
• May mask Vitamin B-12 deficiency symptoms

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VITAMINSWater Soluble VitaminsFolate

• Liver 187 mcg per 3 oz fried
• Asparagus 131 mcg per 1/2 cup
• Spinach 108 mcg per 1 cup raw
• Pinto Beans 147 mcg per 1/2 cup cooked
• Beets 45 mcg per 1/2 cup cooked

• Significant Sources
• Leafy Green Vegetables
• Legumes
• Seeds
• Liver

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VITAMINSWater Soluble VitaminsVitamin B-12

• Also known as cobalamin
• Chemical formula -- C63H90CoN14O14P
• Isolated from liver in 1948

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VITAMINSWater Soluble VitaminsVitamin B-12

• Functions
• Activates the folate coenzyme
• Part of methylcobalamin and deoxyadenosylcobalamin
  , the active forms of coenzyme B-12, coenzymes
  used in new cell synthesis
• Maintains the sheath that surrounds and protects
  nerve fibers and promotes their normal growth
• Helps to break down fatty acids and amino acids

79
VITAMINSWater Soluble VitaminsVitamin B-12

• DIETARY REFERENCE INTAKE VALUE
• RDA
• Males females over 14 -- 2.4 micrograms
• 1998 data

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VITAMINSWater Soluble VitaminsVitamin B-12

• Is unique among nutrients in being found almost
  exclusively in animal flesh and animal products
• Vitamin B-12 in plant products occurs in an
  inactive and unavailable form. After ingestion,
  requires intrinsic factor for absorption
• Intrinsic factor is a glycoprotein (a protein
  with short polysaccharide chains attached) made
  in the stomach that aids in the absorption of
  Vitamin B-12

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VITAMINSWater Soluble VitaminsVitamin B-12

• Most Vitamin B-12 deficiencies reflect inadequate
  absorption, not inadequate intake
• Pernicious anemia is a blood disorder that
  reflects a Vitamin B-12 deficiency caused by lack
  of intrinsic factor When consumption of Vitamin
  B-12 stops, deficiencies may take almost 20 years
  to develop
• The body recycles much of the vitamin,
  reabsorbing
• Even when the body fails to absorb Vitamin B-12,
  deficiency may take up to 3 years because the
  body conserves its supply

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VITAMINSWater Soluble VitaminsVitamin B-12

• Deficiency
• Deficiency disease -- pernicious anemia (B-12
  deficiency caused by lack of intrinsic factor,
  not that caused by inadequate intake)
• Characterized by
• Macrocytic anemia (the anemia of folate
  deficiency)
• Large immature red blood cells indicative of
• Slow DNA synthesis
• An inability to divide

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VITAMINSWater Soluble VitaminsVitamin B-12

• Deficiency
• Either Vitamin B-12 or Folate will clear up the
  anemia, however
• If Folate is given when B-12 is needed,
  devastating neurological symptoms result since
• B-12, not folate maintains the sheath that
  surrounds and protects nerve fibers and promotes
  their normal growth
• Folate cures the blood symptoms of Vitamin B-12
  deficiency but allows the nerve symptoms to
  progress

84
VITAMINSWater Soluble VitaminsVitamin B-12

• Deficiency
• Creeping paralysis beginning at the extremities
  and working up the spine
• Neurological symptoms can occur in the absence of
  anemia
• Early detection necessary to prevent permanent
  nerve damage and paralysis

85
VITAMINSWater Soluble VitaminsVitamin B-12

• Cottage Cheese 1.3mcg per cup
• Sirloin Steak 2.4mcg per 3 oz steak cooked
• Chicken Liver 16.5mcg per 3 oz cooked
• Tuna (in water) 1.8mcg per 3 oz
• Sardines 7.6 mcg per 3 oz

• Significant Sources
• Animal products
• Meat
• Fish
• Poultry
• Shellfish
• Milk
• Cheese
• Eggs

86
VITAMINSWater Soluble VitaminsPantothenic Acid

• Is the most commonly occurring of all the
  vitamins -- name means everywhere
• Chemical formula C9H17O5N
• Isolated from rice husks in 1939 by Dr. R.J.
  Williams
• Is readily destroyed by heat -- losses during
  food preparation can be substantial

87
VITAMINSWater Soluble VitaminsPantothenic Acid

• Functions
• Part of Coenzyme A (Acetyl coenzyme A is the
  crossroads compound in several metabolic
  pathways including the TCA cycle)
• Aids in the formation of cholesterol, hemoglobin,
  and other hormones
• Assists in synthesizing certain fatty acids
• Helps to break down fatty acids and amino acids

88
VITAMINSWater Soluble VitaminsPantothenic Acid

• DIETARY REFERENCE INTAKE VALUE
• AI
• 5.0 micrograms for males females over 14
• 1998 data

89
VITAMINSWater Soluble VitaminsPantothenic Acid

• Deficiency
• Rare -- involves a general failure of all the
  bodys systems
• Symptoms
• Vomiting
• Intestinal distress
• Insomnia
• Fatigue
• Toxicity
• Symptoms
• Occasional diarrhea
• Water retention (rare)

90
VITAMINSWater Soluble VitaminsBiotin

• Is widespread in foods
• Isolated 1936
• Chemical formula -- C10H16O3N2S
• Is synthesized by GI tract bacteria
• In foods, appears to be resistant to heat and
  light

91
VITAMINSWater Soluble VitaminsBiotin

• Functions
• Plays an important role in metabolism as a
  coenzyme that serves as a carbon dioxide carrier
• Serves crucial roles in
• Gluconeogenisis
• Fatty acid synthesis
• Breakdown of certain fatty acids and amino acids

92
VITAMINSWater Soluble VitaminsBiotin

• DIETARY REFERENCE INTAKE VALUE
• AI-- 30 micrograms (males females over 19)
• 1998 data

93
VITAMINSWater Soluble VitaminsBiotin

• Deficiency
• Rare
• Can be induced by avidin (a protein found in raw
  eggs)
• More than two dozen raw egg whites must be
  ingested to bind biotin and thus prevent its
  absorption

94
VITAMINSWater Soluble VitaminsBiotin

• Deficiency
• Symptoms
• Abnormal heart action
• Loss of appetite
• Nausea
• Depression
• Muscle pain
• Weakness
• Fatigue
• Dry skin
• Scaly dermatitis
• Loss of hair

95
VITAMINSWater Soluble VitaminsVitamin C

• Also known as ascorbic acid
• Isolated 1928
• Chemical formula -- C6H8O6
• Intakes of at least 10mg per day will prevent the
  appearance of the symptoms of scurvy

96
VITAMINSWater Soluble VitaminsVitamin C

• DIETARY REFERENCE INTAKE VALUE
• RDA
• Men over 19 -- 90mg
• Women over 19 -- 75mg
• Smokers
• Add 35mg
• More likely to suffer from biological processes
  that damage the cells and deplete Vitamin C
• UL
• 2000mg (may cause diarrhea)
• 2000 data

97
VITAMINSWater Soluble VitaminsVitamin C

• Functions
• Antioxidant
• An antioxidant is a compound that protects others
  from oxidation by being oxidized itself
• Protects cells from oxidation
• Donates electrons to (reduces) other substances
  and simultaneously becomes oxidized itself
• Manufacturers sometimes add Vitamin C to protect
  important constituents in them
• Protects other molecules
• Cells
• Body fluids
• Protects iron and promotes its absorption
• Intestines

98
VITAMINSWater Soluble VitaminsVitamin C

• Functions (continued)
• Collagen synthesis
• Vitamin C helps to form the fibrous structural
  protein collagen -- requires iron
• Collagen serves as the matrix on which the bones
  and teeth are formed
• Following wounds, collagen glues the separated
  tissue faces together, forming scars
• Cells are held together largely by collagen

99
VITAMINSWater Soluble VitaminsVitamin C

• Functions (continued)
• Assists in amino acid metabolism
• Some of these may end up being converted to
  hormones
• Epinephrine -- modulates the stress response
• Thyroxin -- regulates the bodys metabolic rate

100
VITAMINSWater Soluble VitaminsVitamin C

• Functions (continued)
• Helps in the absorption of iron
• Enhances non-heme (from sources other than meat,
  poultry and fish) iron absorption from foods
  eaten in the same meal

101
VITAMINSWater Soluble VitaminsVitamin C

• Recommendations
• 10mg per day scurvy symptoms are prevented but
  not all body tissues are saturated
• 100mg per day results in 95 of population
  reaching tissue saturation
• After tissues are saturated, all added vitamin C
  is excreted
• Physical stresses deplete the body pool and may
  make intakes in excess of the DRI desirable

102
VITAMINSWater Soluble VitaminsVitamin C

• Deficiency
• Early signs
• Blood vessel integrity degradation
• Gums around the teeth bleed easily
• Capillaries under the skin break spontaneously
  producing pinpoint hemorrhages
• Atherosclerotic plaques grow rapidly in the
  arteries
• Microcytic (small cell type) anemia

103
VITAMINSWater Soluble VitaminsVitamin C

• Deficiency
• Scurvy
• Symptoms begin to appear when the bodys Vitamin
  C pool falls to about 20 of its optimal size
  (may take several weeks on a diet lacking Vitamin
  C)
• Further hemorrhaging due to diminishing collagen
  synthesis
• Gingival Hemorrhaging Periungal Hemorrhaging

104
VITAMINSWater Soluble VitaminsVitamin C

• Deficiency
• Scurvy - Symptoms cont
• Muscle degeneration (including heart)
• Skin becomes rough, scaly, and dry
• Wounds fail to heal because scar tissue fails to
  form
• Bone re-building falters
• Ends of long bones become softened, malformed,
  and painful
• Fractures appear
• Teeth become loose as cartilage around them
  weakens
• Hysteria
• Depression
• Sudden death likely
• Severe atherosclerosis
• Massive bleeding into joints and body cavities
• Moderate doses of Vitamin C (100mg per day) will
  readily reverse scurvy

105
VITAMINSWater Soluble VitaminsVitamin C

• Toxicity
• Nausea
• Abdominal cramps
• Diarrhea
• Interference with medical regimes
• Large amounts of Vitamin C excreted in the urine
  may obscure the results of tests
• May diminish the effect of anti-clotting
  medications
• Kidney stone formation in persons
• With a tendency toward gout
• With genetic abnormalities that alter the way
  Vitamin C breaks down to its excretion products

106
VITAMINSWater Soluble VitaminsVitamin C

• Toxicity
• Rebound scurvy
• Persons who have taken large doses for a long
  time may adapt by limiting absorption and
  destroying and excreting more of the vitamin than
  usual
• When intake suddenly returns to normal, the
  accelerated disposal system is unable to adapt

107
VITAMINSWater Soluble VitaminsVitamin C

• Vitamin C in the Diet

108
VITAMINSWater Soluble VitaminsVitamin C

• Significant Sources
• Citrus fruits
• Cabbage-type vegetables
• Dark green vegetables
• Cantaloupe
• Strawberries
• Peppers
• Lettuce
• Tomatoes
• Potatoes
• Papayas
• Mangoes

• Broccoli 58 mg per 1/2 c cooked
• Sweet Red Pepper 95 mg per 1/2 c chopped fresh
• Strawberries 42 mg per 1/2 c fresh
• Grapefruit 47 mg per 1/2 grapefruit
• Orange Juice 93 mg per 3/4 cup
• Brussels Sprouts 48 mg per 1/2 cup cooked
• Green Pepper 45 mg per 1/2 cup chopped fresh