1. UNIT 5 SEMINAR NS 220 Module 5: Vitamins and Health

3. Overview  Vitamin Supplementation  Vitamin deficiency diseases & food fortification  Beneficial vitamins for specific populations  Vitamin toxicities  Multivitamins

4. Position of American Dietetic Assoc.  To promote health and reduce risk of chronic disease, choose variety of foods.  Food provides all vitamins you need.  Fortified foods and supplements can help some meet their nutrition needs.

5. Vitamin Types  Vitamin C  B Vitamins:  Folate  B12  Thiamin  Riboflavin  Niacin  Biotin  Pantothentic Acid  Vitamin A  Vitamin D  Vitamin E  Vitamin K Water-SolubleFat-Soluble

6. Vitamin Deficiencies  Vitamin A: may result in xerophthalmia  Vitamin D: rickets and osteomalacia  Vitamin K: deficiency in newborns; made in intestines by good bacteria  Vitamin C: scurvy; delayed wound healing; decrease in iron absorption; capillary bleeding  Thiamin: beriberi; heavy alcohol consumption can lead to poor absorption of thiamin

7. Dietary Guidelines  Nutrients consumed should come primarily from food.  Beneficial Vitamins for Specific Populations:  Women and Folic Acid  Special Groups and Vitamin D  People Over 50 and Vitamin B 12

8. Women and Folic Acid  Necessary for all women of childbearing age and women who are pregnant.  Reduces the risk of neural tube defects and Spina Bifida.  Food fortification & food sources (green leafy vegetables)  RDA: 400 mcg (adults/women childbearing age); 600 mcg (pregnancy)

9. Special Groups & Vitamin D Fat-soluble; obtain from food and sun Sun source activated in liver & kidney Deficiency diseases: Rickets & Osteomalacia Food sources: fortified milk most reliable source High risk of deficiency: Breastfed infants Older adults Limited sun exposure Individuals with dark skin

10. People >50 & Vitamin B 12  Most adults meeting recommended amounts  Deficiency most likely to occur as a result of an inability to absorb B 12 from food.  B 12 needs stomach acid & Intrinsic Factor to be absorbed; less gastric secretions over age 50, so decrease in absorption.  Recommend for >50 years old to eat fortified B 12 foods or take supplement.  Natural source B12 only in animal foods.

11. Toxicities  >100% of RDA could be harmful to health for specific vitamins, esp from supplements.  Fat-soluble more risk of toxicity than water- soluble.  Vit. A toxicity more likely from high dosage vit A supplements.  UL’s established.

12. Multivitamins  NIH Consensus and State-of-the-Science Conference on Multivitamin/Mineral Supplements and Chronic Disease Prevention (2006) with results indicating:  There is not strong evidence for beneficial health- related effects of supplements.  There is insufficient evidence to recommend either for or against the use of multivitamin/mineral supplements by the American public to prevent chronic disease. NIH State-of-the-Science Conference Statement on Multivitamin/Mineral Supplements and Chronic Disease Prevention. Ann Intern Med. 2006;145:364–371.

13. MVI Use & Risk of CA and CVD  161, 808 post-menopausal women; 8 year study  41.5% participants used MVI’s  Results: convincing evidence that MVI use has little or no influence on the risk of common cancers, CVD, or total mortality Marian L. Neuhouser et al. Multivitamin Use and Risk of Cancer and Cardiovascular Disease in the Women's Health Initiative Cohorts. Archives of Internal Medicine, Feb 9, 2009.