1. HW205 – Unit 4 Now I know My A, C, and Bs…. Jennifer Neily, MS, RD, CSSD, LD Registered/Licensed Dietitian

2. Unit 4 – Learning Objectives w understand the primary uses of the water soluble vitamins. w learn the purpose and benefits of supplementing with these vitamins. w be able to identify food sources of the nutrient. w understand the potential safety and precaution issues.

4. The B Vitamins - As Individuals w Thiamin – vitamin B1 (RDA) w Riboflavin – vitamin B2 (RDA) w Niacin – vitamin B3 (RDA & UL) w Biotin (AI) w Pantothenic Acid (AI) w Vitamin B6 (RDA & UL) w Vitamin B12 (RDA) w Folate (RDA & UL)

5. Thiamin (Vitamin B 1 ) w Chief functions in the body: Used in energy metabolism as part of coenzyme TPP (thiamin pyrophosphate) w Other Information Steaming and microwaving are cooking methods that conserve thiamin. Thiamin leaches into water with boiling or blanching. The vitamin is easily destroyed by heat.

6. Thiamin Sources Whole grain, fortified, or enriched grain products Moderate amounts in all nutritious food Pork

7. Deficiency - “Wet” Beriberi

8. Riboflavin (Vitamin B 2 ) w Chief function in the body: Involved in energy metabolism - flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD) are the coenzyme forms. w Other information Easily destroyed by ultraviolet light and irradiation Not destroyed by cooking

9. Riboflavin Sources Milk products, including yogurt and cheese Enriched and whole grains Liver

10. Niacin (Vitamin B 3 )  AKA - nicotinic acid, nicotinamide, and niacinamide  Chief function in the body: Used in energy metabolism as part of coenzymes NAD (nicotinamide adenine dinucleotide) and NADP (its phosphate form) w Other Information The amino acid tryptophan is the precursor. The vitamin can be lost from foods when it leaches into water. Resistant to heat.

11. Pellegra

12. Images of Niacin Deficiency - Pellagra

13. Niacin (Vitamin B 3 ) w Deficiency disease Pellagra w Niacin Toxicity Niacin flush dilates the capillaries and may be painful. Toxicity Symptoms Painful flush, hives and rash Excessive sweating Blurred vision Liver damage Impaired glucose tolerance

14. Niacin Sources Milk Eggs, meat, poultry and fish Whole-grain and enriched breads and cereals Nuts and all protein-containing foods

15. Biotin w Chief function in the body As part of a coenzyme used in energy metabolism, biotin assists in glycogen synthesis, fat synthesis, and amino acid metabolism. w Biotin Deficiency and Toxicity Deficiencies are rare. Biotin can be bound with an egg-white protein called avidin. No reported toxicities

16. Biotin w Biotin Food Sources Widespread in foods Organ meats, egg yolks and fish Soybeans Whole grains w Biotin can also be synthesized by intestinal bacteria.

17. Pantothenic Acid w Chief function in the body: Involved in energy metabolism as a part of coenzyme A. w Pantothenic Acid Deficiency and Toxicity Deficiency is rare. Deficiency symptoms No reported toxicities

18. Pantothenic Acid w Pantothenic Acid Food Sources Widespread in foods Organ meats Mushrooms, avocados, and broccoli Whole grains Can be destroyed by freezing, canning, and refining

19. Vitamin B 6 w Chief functions in the body: The coenzyme forms of vitamin B 6 (pyridoxal phosphate [PLP] and pyridoxamine phosphate [PMP]) are involved in amino and fatty acid metabolism, the conversion of tryptophan to niacin or serotonin, and the production of red blood cells. w Other Information Vitamin B 6 is ineffective in curing carpal tunnel syndrome, sleep disorders and PMS.

20. Vitamin B 6 w Vitamin B 6 Deficiency Deficiency Symptoms Scaly dermatitis Anemia – small cell type Depression, confusion, abnormal brain wave pattern, and convulsions w Alcohol destroys the vitamin w INH drug used for tuberculosis acts as an antagonist.

21. Vitamin B 6 Sources Meats, fish, poultry and liver Legumes and soy products Non-citrus fruits Fortified cereals

22. Folate w AKA: Folic acid, folacin w Chief function in the body: Folate is involved in the synthesis of DNA and the formation of new cells. w Recommendations (1998 RDA) RDA Adults: 400 μg/day There are higher recommendations for pregnant women. UL – 1000 mcg /day (adults)

23. Folate w Folate and Neural Tube Defects Neural tube defects include spina bifida and anencephaly. Women of childbearing age should eat folate- rich foods and folate-fortified foods and take folate supplements containing 0.4 mg (400 microgram) of folate daily. Pregnant women should take folate supplements.

24. Decreasing Spina Bifida Rates since Folate Fortification

25. Meningomyelocele (severe form of spina bifida)

26. Folate w Folate Deficiency Deficiency Symptoms Macrocytic anemia, also called megaloblastic anemia – large cell type Smooth, red tongue Mental confusion, weakness, fatigue, irritability and headaches Most vulnerable of all the vitamins to interactions with medications Anticancer drugs Antacids and aspirin

27. Folate Sources Fortified grains Leafy green vegetables Legumes and seeds Liver

28. Vitamin B 12 (Cobalamin) w Chief functions in the body Vitamin B 12 is involved in the synthesis of new cells, maintains nerve cells, reforms folate coenzymes, and helps break down some fatty acids and amino acids.

29. Vitamin B 12 (Cobalamin) w Vitamin B 12 Deficiency and Toxicity Deficiency Symptoms Anemia – large cell type Fatigue and depression Degeneration of peripheral nerves progressing to paralysis Atrophic gastritis in older adults destroys stomach cells, which diminishes intrinsic factor and hydrochloric acid production. Deficiency disease is called pernicious anemia No known toxicities

30. Fig. 10-12, p. 344 Normal blood cells. The size, shape, and color of these red blood cells show that they are normal. Blood cells in pernicious anemia (megaloblastic). These megaloblastic blood cells are slightly larger than normal red blood cells, and their shapes are irregular.

31. Vitamin B 12 (Cobalamin) w Vitamin B 12 Food Sources Meat, fish, poultry, and shellfish Milk, cheese and eggs Fortified cereals w Other Information Binds with intrinsic factor in the stomach for absorption Easily destroyed by microwave cooking

32. Vitamin C w Other name: ascorbic acid w RDA Men: 90 mg/day Women: 75 mg/day Smokers: + 35 mg/day w Upper level for adults: 2000 mg/day

33. Vitamin C w Chief functions in the body Antioxidant Collagen synthesis Strengthens blood vessel walls, forms scar tissue, provides matrix for bone growth Thyroxin synthesis Amino acid metabolism Strengthens resistance to infection Helps in absorption of iron

34. Vitamin C Sources Citrus fruits, cantaloupe, strawberries, papayas and mangoes Cabbage-type vegetables, dark green vegetables like green peppers and broccoli, lettuce, tomatoes and potatoes

35. Vitamin C w Deficiency disease: scurvy w Deficiency symptoms Anemia (small-cell type) Atherosclerotic plaques Pinpoint hemorrhages, bone fragility, joint pain Poor wound healing, frequent infections, bleeding gums, loosened teeth Muscle degeneration and pain, hysteria, depression, rough skin, blotchy bruises

36. Images of Vitamin C Deficiency - Scurvy

37. Vitamin C Deficiency

38. Do you need vitamin supplements? w Vitamins are readily available from a variety of foods (especially fruits and vegetables) w Needs can be increased due to environmental toxins, stress, and illness w Focus on whole unprocessed foods first and supplement as warranted for health and prevention of chronic disease.

39. Summary w Heart Health: Vit C, E, B6, B12, folate, niacin w Tissue building: B6, B12, folate w Eye health: Vit A, C w Skin health: Vit A, C

40. Summary w Energy metabolism: B-vitamins w Nerve cell function: B1 (thiamin) w New cell formation: folate, B12 w Immune function/antioxidant: C, E, beta- carotene w Bone health: D, K

41. Summary w Energy metabolism: B-vitamins w Nerve cell function: B1 (thiamin) w New cell formation: folate, B12 w Immune function/antioxidant: C, E, beta- carotene w Bone health: D, K

42. Questions ?? w If you have questions please just ask: Email me at Jneily@kaplan.edu IM me at JenniferNeilyRD Post to Course Questions area w Please always read your announcements including the unit summaries and unit intros w Late policy – please review syllabus w See you on the DB!