1. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Vitamins Chapter 8

2. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Vitamins–An Overview Potent, essential, nonkcaloric, and organic nutrients needed from foods in trace amounts to perform specific functions –Promote growth, reproduction, and the maintenance of health and life

3. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

4. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Vitamins–An Overview (cont’d.) How do vitamins differ from carbohydrates, fats, and proteins? –Structure –Function –Dietary intakes What is a vitamin’s bioavailability? Vitamin content in food (Appendix A)

5. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Vitamins–An Overview (cont’d.) Factors affecting the bioavailability of a vitamin –Digestion efficiency and GI tract transit time –Previous nutrient intake and nutrition status –Other foods consumed at the same time –Method of food preparation –Nutrient source

6. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Vitamins–An Overview (cont’d.) Precursors or provitamins –Tables 8-4 and 8-5 Organic nature –Can be destroyed during processing Classes of vitamins –Fat soluble: vitamins A, D, E, and K –Water soluble: vitamins B and C

7. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

8. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

9. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Fat-Soluble Vitamins Overview –Vitamins A, D, E, and K –Usually occur together in fats and oils –Absorbed in the same manner as lipids –Stored in the liver and fatty tissues

10. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Fat-Soluble Vitamins Vitamin A and beta-carotene –How is beta-carotene related to vitamin A? –Vitamin A functions Gene regulation: retinoic acid Vision: cornea and retina health Protein synthesis and cell differentiation Immunity: “anti-infective” vitamin Reproduction, growth, and development

11. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

12. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Fat-Soluble Vitamins (cont’d.) Beta-carotene: antioxidant –Food forms: may prevent cancer Vitamin A deficiency –Major cause of preventable blindness –All epithelial surfaces: cells harden and flatten –Susceptibility to infection

13. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Fat-Soluble Vitamins (cont’d.) Vitamin A toxicity –Teratogenic risk –Weakens bones Sources –Vitamin A: liver, fish oil, milk, cheese, etc. –Beta-carotene: carrots, apricots, spinach, etc.

14. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

15. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Fat-Soluble Vitamins (cont’d.) Vitamin D –Body can synthesize with help of sunlight –Active vitamin form Requires conversions by the liver and kidneys –Why is vitamin D actually a hormone? –Roles Bone growth How does vitamin D raise blood concentrations of bone minerals?

16. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Fat-Soluble Vitamins (cont’d.) Vitamin D deficiency –U.S. population: almost 10 percent deficient –Contributing factors Dark skin, breastfeeding without supplementation, lack of sunlight, and not using fortified milk –Diseases Rickets Osteomalacia Osteoporosis

17. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Fat-Soluble Vitamins (cont’d.) Vitamin D toxicity –Excess blood calcium: calcification Maintain adequate vitamin D –Sunlight –Foods sources Eggs, liver, butter, some fatty fish, and fortified milk Why do DRI vitamin D dietary recommendations increase with age?

18. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Fat-Soluble Vitamins (cont’d.) Vitamin E –Tocopherol –Antioxidant Protects the lungs Vitamin E deficiency –Erythrocyte hemolysis: in premature infants

19. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Fat-Soluble Vitamins (cont’d.) Vitamin E deficiency –Adult symptoms Loss of muscle coordination and reflexes Impaired movement, vision, and speech Vitamin E toxicity –Interferes with blood clotting Vitamin E in foods –Vegetable oils, wheat germ, whole grains, etc.

20. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Fat-Soluble Vitamins (cont’d.) Vitamin K –Roles: blood clotting and bone protein synthesis –Intestinal tract bacteria: synthesize vitamin K Insufficient as a sole source Causes of vitamin K deficiency –Fat malabsorption –Antibiotics

21. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

22. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Fat-Soluble Vitamins (cont’d.) Vitamin K nutrition for newborn –Single dose given a birth Vitamin K toxicity –Tolerable Upper Intake Level: not established Vitamin K in foods –Green leafy vegetables, cabbage, some vegetable oils, etc.

23. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

24. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

25. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Water-Soluble Vitamins Overview –B vitamins and vitamin C –Easily absorbed into the bloodstream –Easily excreted when blood concentrations rise too high

26. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Water-Soluble Vitamins (cont’d.) The B vitamins –Functions Help the body use energy-yielding nutrients Component in coenzymes Help cells multiply Assist enzymes in performing molecular conversions

27. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

28. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Water-Soluble Vitamins (cont’d.) B vitamin deficiencies –Thiamin ► beriberi –Niacin deficiency ► pellagra How do fortification and enrichment protect people against deficiencies?

29. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Water-Soluble Vitamins (cont’d.) Thiamin –All cells: critical role in energy metabolism –Necessary for normal nerve and muscle functioning –Who is most likely to develop a thiamin deficiency? –Food sources Pork, whole grain or enriched bread and cereals; small amounts in nearly all nutritious foods

30. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Water-Soluble Vitamins (cont’d.) Riboflavin –Serves as a coenzyme: energy metabolism –Deficiency Cracks at corners of mouth and sore throat –Food sources Milk, enriched breads and cereals, green vegetables, meats, etc. –Notes Light sensitive, but heat stable

31. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Water-Soluble Vitamins (cont’d.) Niacin –Needed by every cell: energy metabolism –Body can produce niacin from protein Niacin equivalents (NE) –Tolerable Upper Intake Level: 35 mg NE –Medicinal uses Lower blood cholesterol Treat atherosclerosis

32. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Water-Soluble Vitamins (cont’d.) Niacin –Food sources Meat, poultry, fish, legumes, enriched and whole grains, etc. Pantothenic acid and biotin –Important in energy metabolism –Food sources Widespread in foods

33. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Water-Soluble Vitamins (cont’d.) Vitamin B 6 –Roles Protein and amino acid metabolism, amino acid conversion to other lacking amino acids, synthesis of hemoglobin and neurotransmitters, etc. –Deficiency symptoms Weakness, depression, confusion, irritability, etc. –Toxicity Recovery after discontinuing supplements

34. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Water-Soluble Vitamins (cont’d.) Vitamin B 6 –Recommendations Adults (19–50): 1.3 mg/day –Food sources Protein-rich meat, fish, poultry, etc. –Heat sensitive: lost in heated foods

35. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Water-Soluble Vitamins (cont’d.) Folate –Active in cell division –Negative impact on folate status Alcohol Medications: aspirin, oral contraceptives, and anticonvulsants Smoking

36. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Water-Soluble Vitamins (cont’d.) Folate –Prevents neural tube defects (NTD) –Tolerable Upper Intake Level 1000 µg/day from fortified foods and supplements –Best food sources Liver, legumes, beets, and leafy green vegetables –“How to” Estimate Dietary Folate Equivalents

37. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

38. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Water-Soluble Vitamins (cont’d.) Vitamin B 12 –Needed for cell division –What dangers are associated with folate supplementation masking a vitamin B 12 deficiency? –Requires intrinsic factor for absorption –Food sources Found exclusively in animal-derived foods

39. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Water-Soluble Vitamins (cont’d.) Non-B vitamins –Serve as coenzymes in metabolism Inositol, choline, and carnitine –Others Para-aminobenzoic acid (PABA), bioflavonoids (vitamin P or hesperidin), and ubiquinone

40. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Water-Soluble Vitamins (cont’d.) Vitamin C –Antiscurvy factor: ascorbic acid –Multiple roles and modes of action Collagen formation Antioxidant Amino acid metabolism Possible antihistamine Cancer prevention and treatment

41. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Water-Soluble Vitamins (cont’d.) Vitamin C deficiency –Affect on blood vessels Bleeding gums and pinpoint hemorrhages –What are symptoms of scurvy? Vitamin C toxicity –Megadoses: toxic effects unconfirmed Vitamin C RDA –Men: 90 mgWomen: 75 mg

42. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Water-Soluble Vitamins (cont’d.) Increased need for vitamin C –Infections, burns, surgery, extremely high or low temperatures, toxic doses of heavy metals, smoking, etc. Safe limits –100 to 300 mg per day

43. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014 The Water-Soluble Vitamins (cont’d.) Vitamin C food sources –Many fruits and vegetables How does vitamin C impact iron absorption?

44. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

45. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014

46. Nutrition for Health and Health Care, 5th Edition DeBruyne ■ Pinna © Cengage Learning 2014