The Fat-Soluble Vitamins A, D, E, and K

The Fat-Soluble Vitamins

Vitamin A And Beta-Carotene Retinoids and carotenoidsRetinoids and carotenoids –Vitamin A activity

Vitamin A And Beta-Carotene

Retinol-binding protein (RBP)Retinol-binding protein (RBP)

Vitamin A And Beta-Carotene Roles in the bodyRoles in the body –Vitamin A in vision

Roles in the bodyRoles in the body –Vitamin A in protein synthesis and cell differentiation

Vitamin A And Beta-Carotene Roles in the bodyRoles in the body –Vitamin A in reproduction and growth –Beta-carotene as an antioxidant

Vitamin A And Beta-Carotene RecommendationsRecommendations –Retinol activity equivalents (RAE)

Vitamin A And Beta-Carotene Vitamin A in foodsVitamin A in foods –The colors of vitamin A foods –Vitamin A-poor fast foods –Vitamin A-rich liver

In Summary Other namesOther names –Retinol –Retinal –Retinoic acid –Precursors are carotenoids such as beta-carotene 2001 RDA2001 RDA –Men: 900 g RAE/day –Women: 700 g RAE/day

In Summary Upper level for adults:Upper level for adults: 3000 g/day Chief functions in the bodyChief functions in the body –Vision –Maintenance of cornea, epithelial cells, mucous membranes, skin –Bone and tooth growth –Reproduction –Immunity

In Summary Significant sourcesSignificant sources –Retinol: fortified milk, cheese, cream, butter, fortified margarine, eggs, liver –Beta-carotene: spinach and other dark leafy greens; broccoli, deep orange fruits (apricots, cantaloupe) and vegetables (squash, carrots, sweet potatoes, pumpkin)

In Summary Deficiency disease: hypovitaminosis ADeficiency disease: hypovitaminosis A Deficiency symptomsDeficiency symptoms –Night blindness, corneal drying (xerosis), triangular gray spots on eye (Bitot’s spots), softening of the cornea (keratomalacia), and corneal degeneration and blindness (xerophthalmia)

In Summary Deficiency symptoms (continued)Deficiency symptoms (continued) –Impaired immunity (infections) –Plugging of hair follicles with keratin, forming white lumps (hyperkeratosis)

Deficiency Symptom: Keratinization

In Summary Toxicity disease: hypervitaminosis AToxicity disease: hypervitaminosis A Chronic toxicity symptomsChronic toxicity symptoms –Increased activity of osteoclasts causing reduced bone density –Liver abnormalities –Birth defects

In Summary Acute toxicity symptomsAcute toxicity symptoms –Blurred vision –Nausea, vomiting, vertigo –Increase of pressure inside skull, mimicking brain tumor –Headaches

Vitamin D Other namesOther names –Calciferol –1,25-dihydroxy vitamin D (calcitriol) –Animal version: vitamin D 3 or cholecalciferol –Plant version: vitamin D 2 or ergocalciferol –Precursor is the body’s own cholesterol

Vitamin D 1997 adequate intake (AI)1997 adequate intake (AI) –19-50 years: 5 g/day –51-70 years: 10 g/day –more than 70 years: 15 g/day Upper level for adults:Upper level for adults: 50 g/day

Vitamin D Chief functions in the bodyChief functions in the body –Mineralization of bones (raises blood calcium and phosphorus by increasing absorption from digestive tract, withdrawing calcium from bones, stimulating retention by kidneys)

Vitamin D Significant sourcesSignificant sources –Synthesized in the body with the help of sunlight –Fortified milk, margarine, butter, cereals, and chocolate mixes –Veal, beef, egg yolks, liver, fatty fish (herring, salmon, sardines) and their oils

Vitamin D Deficiency diseasesDeficiency diseases –Rickets –Osteomalacia

Vitamin D Deficiency symptoms: rickets in childrenDeficiency symptoms: rickets in children –Inadequate calcification, resulting in misshapen bones (bowing of legs) –Enlargement of ends of long bones (knees, wrists) –Deformities of ribs (bowed, with beads or knobs)

Vitamin D Deficiency symptoms: rickets in children (continued)Deficiency symptoms: rickets in children (continued) –Delayed closing of fontanel, resulting in rapid enlargement of head

Vitamin D Deficiency symptoms: rickets in children (continued)Deficiency symptoms: rickets in children (continued) –Lax muscles resulting in protrusion of abdomen –Muscle spasms Deficiency symptoms: osteomalacia in adultsDeficiency symptoms: osteomalacia in adults –Loss of calcium, resulting in soft, flexible, brittle, and deformed bones

Vitamin D Deficiency symptoms: osteomalacia in adults (cont.)Deficiency symptoms: osteomalacia in adults (cont.) –Progressive weakness –Pain in pelvis, lower back, and legs Toxicity disease: hypervitaminosis DToxicity disease: hypervitaminosis D

Vitamin D Toxicity symptomsToxicity symptoms –Elevated blood calcium –Calcification of soft tissues (blood vessels, kidneys, heart, lungs, tissues around joints) –Frequent urination

Vitamin E Other name: alpha-tocopherolOther name: alpha-tocopherol 2000 RDA2000 RDA –Adults: 15 mg/day Upper level for adults:Upper level for adults: 1000 mg/day Chief function in the bodyChief function in the body –Antioxidant (stabilization of cell membranes, regulation of oxidation reactions, protection of polyunsaturated fatty acids and vitamin A)

Vitamin E

Significant sourcesSignificant sources –Polyunsaturated plant oils (margarine, salad dressings, shortenings) –Leafy green vegetables, wheat germ, whole grains, liver, egg yolks, nuts, seeds

Vitamin E Easily destroyed by heat and oxygenEasily destroyed by heat and oxygen Deficiency symptomsDeficiency symptoms –Red blood cell breakage –Nerve damage Toxicity symptomsToxicity symptoms –Augments the effects of anticlotting medication

Vitamin K Other namesOther names –Phylloquinone –Menaquinone –Menadione –Naphthoquinone 2001 AI2001 AI –Men: 120 g/day –Women: 90 g/day

Vitamin K Chief functions in the bodyChief functions in the body –Synthesis of blood-clotting proteins and bone proteins that regulate blood calcium

Vitamin K Significant sourcesSignificant sources –Bacterial synthesis in the digestive tract –Liver –Leafy green vegetables, cabbage-type vegetables –Milk

Vitamin K Deficiency symptomsDeficiency symptoms –Hemorrhaging Toxicity symptomsToxicity symptoms –None known

The Fat-Soluble Vitamins - In Summary Interactions with each otherInteractions with each other Interactions with mineralsInteractions with minerals

Antioxidant Nutrients In Disease Prevention Free radicals and diseaseFree radicals and disease –Oxidative stress Defending against free radicalsDefending against free radicals –Oxidants and antioxidants

Antioxidant Nutrients In Disease Prevention

Defending against cancerDefending against cancer Defending against cardiovascular diseaseDefending against cardiovascular disease

Antioxidant Nutrients In Disease Prevention Foods, supplements, or both?Foods, supplements, or both? –Prooxidants

Water And The Major Minerals

Water And The Body Fluids Functions of water:Functions of water: –Transport –Structural support for molecules –Participates in metabolic reactions –Solvent –Lubricant –Body temperature regulation –Maintains blood volume

Water And The Body Fluids Water balance and recommended intakesWater balance and recommended intakes –Intracellular fluid –Extracellular fluid Interstitial fluidInterstitial fluid

One Cell And Its Associated Fluids

Water And The Body Fluids Water balance and recommended intakesWater balance and recommended intakes –Water intake DehydrationDehydration Water intoxicationWater intoxication

Water And The Body Fluids Water balance and recommended intakesWater balance and recommended intakes –Water sources –Water losses –Water recommendations

Water balance and recommended intakesWater balance and recommended intakes –Health effects of water Hard water vs. soft waterHard water vs. soft water Bottled waterBottled water

How The Body Regulates Blood Volume

Fluid And Electrolyte Balance Dissociation of salt in waterDissociation of salt in water –Ions CationsCations AnionsAnions –Electrolyte solution

Water Dissolves Salts And Follows Electrolytes

Fluid And Electrolyte Balance Electrolytes attract waterElectrolytes attract water Water follows electrolytesWater follows electrolytes –Solutes –Osmosis –Osmotic pressure

Vegetables “sweat” when sprinkled with salt Raisins plump up when immersed in water

Fluid And Electrolyte Balance Proteins regulate flow of fluids and ionsProteins regulate flow of fluids and ions Regulation of fluid and electrolyte balanceRegulation of fluid and electrolyte balance

Fluid And Electrolyte Imbalance Sodium and chloride most easily lostSodium and chloride most easily lost Different solutes lost by different routesDifferent solutes lost by different routes

Fluid And Electrolyte Imbalance Replacing lost fluids and electrolytesReplacing lost fluids and electrolytes –Oral rehydration therapy (ORT)

Acid-Base Balance pHpH

Acid-Base Balance Regulation by the buffersRegulation by the buffers –Bicarbonate –Carbonic acid Regulation by the lungsRegulation by the lungs Regulation by the kidneysRegulation by the kidneys

The Minerals - An Overview

Inorganic elementsInorganic elements The body’s handling of mineralsThe body’s handling of minerals

The Minerals - An Overview Variable bioavailabilityVariable bioavailability –Binders PhytatesPhytates OxalatesOxalates

The Minerals - An Overview Nutrient interactionsNutrient interactions Varied rolesVaried roles

Sodium Roles in the bodyRoles in the body –Principal extracellular cation

Sodium HypertensionHypertension –Salt sensitivity OsteoporosisOsteoporosis FoodsFoods

Sodium

Sodium: In Summary 1989 estimated minimum requirement for adults:1989 estimated minimum requirement for adults: 500 mg/day Chief functions in the bodyChief functions in the body –Maintains normal fluid and electrolyte balance –Assists in nerve impulse transmission and muscle contraction

Sodium: In Summary Deficiency symptomsDeficiency symptoms –Muscle cramps, mental apathy, loss of appetite Toxicity symptomsToxicity symptoms –Edema, acute hypertension Significant sourceSignificant source –Table salt, soy sauce –Moderate amounts in meats, milks, breads, and vegetables –Large amounts in processed foods

Chloride Chlorine (Cl 2 ) vs. chloride ion (Cl - )Chlorine (Cl 2 ) vs. chloride ion (Cl - ) Roles in bodyRoles in body –Principal extracellular anion

Chloride: In Summary 1989 estimated minimum requirement for adults:1989 estimated minimum requirement for adults: 750 mg/day Chief functions in the bodyChief functions in the body –Maintains normal fluid and electrolyte balance –Part of hydrochloric acid found in the stomach, necessary for proper digestion

Chloride: In Summary Deficiency symptomsDeficiency symptoms –Do not occur under normal circumstances Toxicity symptomToxicity symptom –Vomiting Significant sourcesSignificant sources –Table salt, soy sauce –Moderate amounts in meats, milks, eggs –Large amounts in processed foods

Potassium Principal intracellular cationPrincipal intracellular cation

Potassium: In Summary 1989 estimated minimum requirement for adults:1989 estimated minimum requirement for adults: 2000 mg/day Chief functions in the bodyChief functions in the body –Maintains normal fluid and electrolyte balance –Facilitates many reactions –Supports cell integrity –Assists in nerve impulse transmission and muscle contractions

Potassium: In Summary Deficiency symptomsDeficiency symptoms –Muscular weakness –Paralysis –Confusion Toxicity symptomsToxicity symptoms –Muscular weakness –Vomiting –If given into a vein, can stop the heart

Potassium: In Summary Significant sourcesSignificant sources –All whole foods –Meats, milks, fruits, vegetables, grains, legumes

Calcium Balance

Calcium Calcium rigor vs. calcium tetanyCalcium rigor vs. calcium tetany

Calcium

Calcium: In Summary 1997 adequate intake (AI)1997 adequate intake (AI) –Adults years: 100 mg/day –Adults 51 and older: 1200 mg/day Upper level for adults:Upper level for adults: 2500 mg/day

Calcium: In Summary Chief functions in the bodyChief functions in the body –Mineralization of bones and teeth –Involved in muscle contraction and relaxation, nerve functioning, blood clotting –Blood pressure, immune defenses

Calcium: In Summary Deficiency symptomsDeficiency symptoms –Stunted growth in children –Bone loss (osteoporosis) in adults

Calcium: In Summary Toxicity symptomsToxicity symptoms –Constipation –Increased risk of urinary stone formation and kidney dysfunction –Interference with absorption of other minerals

Calcium: In Summary Significant sourcesSignificant sources –Milk and milk products –Small fish (with bones) –Tofu (bean curd), greens (broccoli, chard), legumes

Phosphorus 1997 RDA for adults:1997 RDA for adults: 700 mg/day Upper level for adults (19-70 years): 4000 mg/dayUpper level for adults (19-70 years): 4000 mg/day Chief functions in the bodyChief functions in the body –Mineralization of bones and teeth –Part of every cell –Important in genetic material, part of phospholipids

Phosphorus Chief functions in the body (continued)Chief functions in the body (continued) –Used in energy transfer and in buffer systems that maintain acid-base balance Deficiency symptomsDeficiency symptoms –Muscular weakness, bone pain

Phosphorus Toxicity symptomsToxicity symptoms –Calcification of nonskeletal tissues, particularly the kidneys Significant sourcesSignificant sources –All animal tissues (meat, fish, poultry, eggs, milk)

Magnesium 1997 RDA1997 RDA –Men (19-30 years): 400 mg/day –Women (19-30 years): 310 mg/day Upper level for adults: 350 mg nonfood magnesium/dayUpper level for adults: 350 mg nonfood magnesium/day Chief functions in the bodyChief functions in the body –Bone mineralization, building of protein, enzyme action, normal muscle contraction, nerve impulse transmission, maintenance of teeth, and functioning of immune system

Magnesium Deficiency symptomsDeficiency symptoms –Weakness –Confusion –If extreme, convulsions, bizarre muscle movements (especially of eye and face muscles), hallucinations, and difficulty in swallowing –In children, growth failure

Magnesium Toxicity symptomsToxicity symptoms –From nonfood sources only –Diarrhea, alkalosis, dehydration Significant sourcesSignificant sources –Nuts, legumes –Whole grains –Dark green vegetables –Seafood –Chocolate, cocoa

Sulfur RolesRoles

Osteoporosis And Calcium Bone development and disintegrationBone development and disintegration –Cortical bone –Trabecular bone

Healthy vs. Osteoporotic Trabecular Bones

Osteoporosis And Calcium Bone development and disintegrationBone development and disintegration –Bone density

Osteoporosis And Calcium Age and bone calciumAge and bone calcium Maximizing bone massMaximizing bone mass

Osteoporosis And Calcium

Minimizing bone lossMinimizing bone loss Gender and hormonesGender and hormones Genetics and ethnicityGenetics and ethnicity

Osteoporosis And Calcium Physical activity and body weightPhysical activity and body weight Smoking and alcoholSmoking and alcohol

Osteoporosis And Calcium Dietary calcium is the key to preventionDietary calcium is the key to prevention Other nutrients play a supporting roleOther nutrients play a supporting role

Osteoporosis And Calcium

A perspective on supplementsA perspective on supplements –Antacids –Bone meal –Oyster shell –Dolomite (limestone)

The Trace Minerals

Food sourcesFood sources DeficienciesDeficiencies ToxicitiesToxicities InteractionsInteractions

Iron Ferrous (Fe ++ )Ferrous (Fe ++ ) –Reduced Ferric (Fe +++ ) Ferric (Fe +++ ) –Oxidized

Iron Absorption

Iron: Heme vs. Nonheme

Iron Factors enhance nonheme iron absorptionFactors enhance nonheme iron absorption –MFP factor –Vitamin C –Citric acid from foods

Iron Factors enhance nonheme iron absorptionFactors enhance nonheme iron absorption –Lactic acid from foods –HCl from stomach –Sugars

Iron Factors inhibit nonheme iron absorptionFactors inhibit nonheme iron absorption –Phytates –Fibers –Oxalates

Iron Factors inhibit nonheme iron absorptionFactors inhibit nonheme iron absorption –Calcium –Phosphorus –EDTA –Tannic acid

Iron Recycling

Iron High risk for iron deficiencyHigh risk for iron deficiency –Women in their reproductive years –pregnant women –Infants and young children –Teenagers

Iron Stages of iron deficiencyStages of iron deficiency –Iron stores diminish –Transport iron decreases –Hemoglobin production declines

Both size and color are normal in these blood cells Blood cells in iron-deficiency anemia are small and pale because they contain less hemoglobin

Iron Contamination ironContamination iron Iron supplementsIron supplements

Iron: In Summary 2001 RDA2001 RDA –Men: 8 mg/day –Women (19-50 years): 18 mg/day –Women (51+ years): 8 mg/day Upper level for adults: 45 mg/dayUpper level for adults: 45 mg/day

Iron: In Summary Chief functions in the bodyChief functions in the body –Part of the protein hemoglobin, which carries oxygen in the blood –Part of the protein myoglobin in muscles, which makes oxygen available for muscle contraction –Necessary for the utilization of energy as part of the cells’ metabolic machinery

Iron: In Summary Significant sourcesSignificant sources –Red meats, fish, poultry, shellfish, eggs –Legumes, dried fruits

Iron: In Summary Deficiency symptomsDeficiency symptoms –Anemia: weakness, fatigue, headaches –Impaired work performance and cognitive function –Impaired immunity –Pale skin, nailbeds, mucous membranes, and palm creases –Concave nails –Inability to regulate body temperature –Pica

Iron: In Summary Toxicity symptomsToxicity symptoms –GI distress –Iron overload: infections, fatigue, joint pain, skin pigmentation, organ damage

Zinc RolesRoles –Metalloenzymes AbsorptionAbsorption –Metallothionein

Zinc Enteropancreatic circulationEnteropancreatic circulation

Zinc Zinc supplementationZinc supplementation

Zinc: In Summary 2001 RDA2001 RDA –Men: 11 mg/day –Women: 8 mg/day Upper level for adults: 40 mg/dayUpper level for adults: 40 mg/day

Zinc: In Summary Chief functions in the body –Part of many enzymes –Associated with the hormone insulin –Involved in making genetic material and proteins, immune reactions, transport of vitamin A, taste perception, wound healing, the making of sperm, and the normal development of the fetus

Zinc Significant sourcesSignificant sources –Protein- containing foods –Red meats, shellfish –Whole grains

Zinc Deficiency symptomsDeficiency symptoms –Growth retardation, delayed sexual maturation, impaired immune function, hair loss, eye and skin lesions, loss of appetite

Zinc: In Summary Toxicity symptomsToxicity symptoms –Loss of appetite, impaired immunity, low HDL, copper and iron deficiencies

Iodine Iodine vs. iodideIodine vs. iodide DeficiencyDeficiency –Goitrogens

Iodine: In Summary 2001 RDA for adults: 150 g/day2001 RDA for adults: 150 g/day Upper level: 1100 g/dayUpper level: 1100 g/day Chief functions in the bodyChief functions in the body –A component of two thyroid hormones that help to regulate growth, development, and metabolic rate

Iodine: In Summary Significant sourcesSignificant sources –Iodized salt, seafood, bread, dairy products, plants grown in iodine-rich soil and animals fed those plants Deficiency diseaseDeficiency disease –Simple goiter –Cretinism

Iodine: In Summary Deficiency symptomsDeficiency symptoms –Underactive thyroid gland, goiter –Mental and physical retardation in infants (cretinism) Toxicity symptomsToxicity symptoms –Underactive thyroid gland, elevated TSH, goiter

Selenium 2000 RDA for adults: 55 g/day2000 RDA for adults: 55 g/day Upper level for adults: 400 g/dayUpper level for adults: 400 g/day Chief functions in the bodyChief functions in the body –Defends against oxidation –Regulates thyroid hormone Significant sourcesSignificant sources –Seafood, meat –Whole grains, vegetables (depending on soil content)

Selenium Deficiency symptomsDeficiency symptoms –Predisposition to heart disease characterized by cardiac tissue becoming fibrous (Keshan disease) Toxicity symptomsToxicity symptoms –Loss and brittleness of hair and nails –Skin rash, fatigue, irritability, and nervous system disorders –Garlic breath odor

Copper 2001 RDA for adults: 900 g/day2001 RDA for adults: 900 g/day Upper level for adults:Upper level for adults: 10,000 g/day (10 mg/day) Chief functions in the bodyChief functions in the body –Necessary for absorption and use of iron in the formation of hemoglobin –Part of several enzymes

Copper Significant sourcesSignificant sources –Seafood –Nuts, whole grains, seeds, legumes Deficiency symptomsDeficiency symptoms –Anemia, bone abnormalities Toxicity symptomsToxicity symptoms –Liver damage

Manganese 2001 AI2001 AI –Men: 2.3 mg/day –Women: 1.8 mg/day Upper level for adults: 11 mg/dayUpper level for adults: 11 mg/day Chief functions in the bodyChief functions in the body –Cofactor for several enzymes

Manganese Significant sourcesSignificant sources –Nuts, whole grains, leafy vegetables, tea Deficiency symptomsDeficiency symptoms –Rare Toxicity symptomsToxicity symptoms –Nervous system disorders

Fluoride 1997 AI1997 AI –Men: 3.8 mg/day –Women: 3.1 mg/day Upper level for adults: 10 mg/dayUpper level for adults: 10 mg/day Chief functions in the bodyChief functions in the body –Involved in the formation of bones and teeth –Helps to make teeth resistant to decay

U.S. Population With Fluoridated Water

Fluoride Significant sourcesSignificant sources –Drinking water (if fluoride containing or fluoridated) –Tea, seafood Deficiency symptomsDeficiency symptoms –Susceptibility to tooth decay Toxicity symptomsToxicity symptoms –Fluorosis (pitting and discoloration of teeth)

Chromium 2001 AI2001 AI –Men: 35 g/day –Women: 25 g/day Chief functions in the bodyChief functions in the body –Enhances insulin action Significant sourcesSignificant sources –Meats (especially liver) –Whole grains, brewer’s yeast

Chromium Deficiency symptomsDeficiency symptoms –Diabetes-like condition Toxicity symptomsToxicity symptoms –None reported

Molybdenum 2001 AI for adults: 45 g/day2001 AI for adults: 45 g/day Upper level for adults: 2 mg/dayUpper level for adults: 2 mg/day Chief functions in the bodyChief functions in the body –Cofactor for several enzymes Significant sourcesSignificant sources –Legumes, cereals –Organ meats

Molybdenum Deficiency symptomsDeficiency symptoms –Unknown Toxicity symptomsToxicity symptoms –None reported –Reproductive effects in animals

Other Trace Minerals NickelNickel SiliconSilicon VanadiumVanadium

Other Trace Minerals CobaltCobalt BoronBoron ArsenicArsenic

Contaminant Minerals Heavy metalsHeavy metals –Lead

Phytochemicals And Functional Foods

Defending against cancerDefending against cancer Defending against heart diseaseDefending against heart disease

Functional foods...Functional foods... –from nature –from manufacturers

Phytochemicals And Functional Foods Functional foods –Inconclusive research –Food labels –Safety –Overall healthfulness of products