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Chapter 10

The Water-Soluble Vitamins:
  B Vitamins and Vitamin C




         © 2009 Cengage - Wadsworth
The Vitamins--An
           Overview
• Vitamins differ from carbohydrate,
  fat and protein in structure, function
  and food contents.
• Vitamins are similar to the energy-
  yielding nutrients in that they are
  vital to life, organic and available
  from foods.
• Both deficiencies and excesses of the
  vitamins can affect health.

               © 2009 Cengage - Wadsworth
The Vitamins--An
           Overview
• Bioavailability is the rate and extent
  that a nutrient is absorbed and used.

• Precursors, also known as
  provitamins, are consumed in an
  inactive form and become active
  vitamins in the body.



               © 2009 Cengage - Wadsworth
The Vitamins--An
            Overview
• The organic nature of vitamins means they
  can be destroyed by exposure to light,
  oxidation, cooking, and storage.
• There are methods used to minimize
  nutrient losses.
   Refrigerate fruits and vegetables.
   Store cut fruits and vegetables in airtight wrappers
    or closed containers and refrigerate.
   Clean fruits and vegetables before they are cut.
   Use a microwave, steam, or simmer in small
    amounts of water.
   Save cooking water for other uses.
   Avoid high temperatures and long cooking times.

                    © 2009 Cengage - Wadsworth
The Vitamins--An
            Overview
• Solubility and storage
   Water-soluble vitamins (B vitamins and
    vitamin C) are absorbed directly into the
    blood and travel freely.
     • Circulate freely
     • Excreted in urine
   Fat-soluble vitamins (vitamins A, D, K and
    E) are absorbed first into the lymph, then
    the blood.
     • Many require protein carriers.
     • Stored in cells associated with fat
     • Less readily excreted


                    © 2009 Cengage - Wadsworth
The Vitamins--An
           Overview
• Toxicity
  Water-soluble vitamins can reach
   toxic levels with supplement use.
  Fat-soluble vitamins are likely to
   reach toxic levels with supplement
   use.
  DRI Committee has established
   Tolerable Upper Intake Levels for
   niacin, vitamin B6, folate, choline and
   vitamin C.

               © 2009 Cengage - Wadsworth
The B Vitamins--As
          Individuals
• The B vitamins are very active in the body.
  Several of the B vitamins form part of the
  coenzymes that assist enzymes in the
  release of energy.
• Other B vitamins participate in metabolism
  and cell multiplication.
• Recommendations for the B vitamins come
  from RDA, AI, and Tolerable Upper Intake
  Levels.
• There are deficiencies, toxicities and food
  sources that are unique for each vitamin.

                © 2009 Cengage - Wadsworth
© 2009 Cengage - Wadsworth
Thiamin (Vitamin B1)

• Thiamin is involved in energy
  metabolism as part of the coenzyme
  thiamin pyrophosphate (TPP).
• Thiamin Recommendations (1998
  RDA)
  RDA Men: 1.2 mg/day
  RDA Women: 1.1 mg/day



             © 2009 Cengage - Wadsworth
Thiamin (Vitamin B1)

• Thiamin Deficiency and Toxicity
  Deficiency Symptoms
    • Enlarged heart and possible cardiac
      failure
    • Muscular weakness
    • Apathy, poor short-term memory,
      confusion, and irritability
    • Anorexia and weight loss




                © 2009 Cengage - Wadsworth
© 2009 Cengage - Wadsworth
Thiamin (Vitamin B1)

• Thiamin Deficiency and Toxicity
   Wernicke-Korsakoff syndrome is a severe
    deficiency that develops in those who abuse
    alcohol.
   Deficiency results in the disease beriberi.
     • Wet beriberi presents with edema.
     • Dry beriberi presents with muscle wasting.
   No reported toxicities




                   © 2009 Cengage - Wadsworth
Thiamin (Vitamin B1)

• Thiamin Food Sources
  Whole-grain, fortified or enriched
   grain products
  Moderate amounts in all foods
  Pork




               © 2009 Cengage - Wadsworth
© 2009 Cengage - Wadsworth
Thiamin (Vitamin B1)

• 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.


              © 2009 Cengage - Wadsworth
Riboflavin (Vitamin B2)

• Riboflavin is involved in energy
  metabolism.
• Flavin mononucleotide (FMN) and
  flavin adenine dinucleotide (FAD) are
  the coenzyme forms.
• Riboflavin Recommendations (1998
  RDA)
  RDA Men: 1.3 mg/day
  RDA Women: 1.1 mg/day


              © 2009 Cengage - Wadsworth
© 2009 Cengage - Wadsworth
Riboflavin (Vitamin B2)

• Riboflavin Deficiency and Toxicity
  Deficiency Symptoms
    • Inflamed eyelids, sensitivity to light, and
      reddening of the cornea
    • Sore throat and cracks and redness at
      the corners of the mouth
    • Painful, smooth and purplish red tongue
    • Skin lesions covered with greasy scales
  Deficiency disease is ariboflavinosis
  No reported toxicities

                 © 2009 Cengage - Wadsworth
Riboflavin (Vitamin B2)

• Riboflavin Food Sources
  Milk products, including yogurt and
   cheese
  Enriched and whole grains
  Liver




              © 2009 Cengage - Wadsworth
© 2009 Cengage - Wadsworth
Riboflavin (Vitamin B2)

• Other information
  Easily destroyed by ultraviolet light
   and irradiation
  Not destroyed by cooking




               © 2009 Cengage - Wadsworth
Niacin (Vitamin B3)
• Niacin is involved in the metabolism of
  glucose, fat, and alcohol.
• Nicotinamide adenine dinucleotide (NAD), and
  NADP, the phosphate form of NAD, are the
  coenzyme forms.
• Niacin Recommendations (1998 RDA)
   The body can obtain niacin from dietary niacin and
    dietary tryptophan (60 mg of dietary tryptophan = 1
    mg niacin); therefore niacin intake is measured in
    niacin equivalents (NE).
   RDA Men: 16 NE/day
   RDA Women: 14 NE/day
   Upper level of 35 mg/day for adults


                   © 2009 Cengage - Wadsworth
Niacin (Vitamin B3)

• Niacin Deficiency
  A deficiency of niacin results in the
   disease pellagra.
  Deficiency Symptoms
    • Diarrhea, abdominal pain, and vomiting
    • Inflamed, swollen, smooth and bright red
      tongue
    • Depression, apathy, fatigue, loss of
      memory, and headache
    • Rash when exposed to sunlight


                © 2009 Cengage - Wadsworth
© 2009 Cengage - Wadsworth
Niacin (Vitamin B3)

• 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


                © 2009 Cengage - Wadsworth
Niacin (Vitamin B3)

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




              © 2009 Cengage - Wadsworth
© 2009 Cengage - Wadsworth
Niacin (Vitamin B3)

• Other Information
  Also called nicotinic acid,
   nicotinamide, and niacinamide
  The amino acid tryptophan is the
   precursor.
  The vitamin can be lost from foods
   when is leaches into water.
  Resistant to heat


              © 2009 Cengage - Wadsworth
Biotin

• As part of a coenzyme used in
  energy metabolism, biotin assists in
  glycogen synthesis, fat synthesis,
  and amino acid metabolism.
• Biotin Recommendations (1998
  Adequate Intake)
  AI Adults: 30 μg/day



              © 2009 Cengage - Wadsworth
Biotin
• Biotin Deficiency and Toxicity
   Deficiencies are rare.
   Deficiency Symptoms
     •   Depression, lethargy, and hallucinations
     •   Numb or tingling sensation in the arms and legs
     •   Red, scaly rash around the eyes, nose and mouth
     •   Hair loss
   Biotin can be bound with an egg-white
    protein called avidin.
   No reported toxicities


                     © 2009 Cengage - Wadsworth
Biotin

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



              © 2009 Cengage - Wadsworth
Pantothenic Acid

• Pantothenic acid is involved in
  energy metabolism as a part of
  coenzyme A.
• Pantothenic Acid Recommendations
  (1998 Adequate Intake)
  AI Adults: 5 mg/day




              © 2009 Cengage - Wadsworth
Pantothenic Acid
• Pantothenic Acid Deficiency and Toxicity
   Deficiency is rare.
   Deficiency Symptoms
     •   Vomiting, nausea, and stomach cramps
     •   Insomnia and fatigue
     •   Depression, irritability, restlessness, and apathy
     •   Hypoglycemia and increased sensitivity to insulin
   No reported toxicities




                      © 2009 Cengage - Wadsworth
Pantothenic Acid

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



              © 2009 Cengage - Wadsworth
Vitamin B6

• The coenzyme forms of vitamin B6
  (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.
• Vitamin B6 Recommendations (1998 RDA)
   RDA Adults 19-50 years: 1.3 mg/day



                © 2009 Cengage - Wadsworth
Vitamin B6

• Vitamin B6 Deficiency
  Deficiency Symptoms
    • Scaly dermatitis
    • Anemia – small cell type
    • Depression, confusion, abnormal brain
      wave pattern, and convulsions
  Alcohol destroys the vitamin
  INH drug used for tuberculosis acts as
   an antagonist.

                © 2009 Cengage - Wadsworth
Vitamin B6

• Vitamin B6 Toxicity
  Toxicity Symptoms
    • Depression, fatigue, irritability, and
      headaches
    • Nerve damage causing numbness and
      muscle weakness leading to inability to
      walk
    • Convulsions
    • Skin lesions
  Upper level for adults: 100 mg/day


                © 2009 Cengage - Wadsworth
Vitamin B6

• Vitamin B6 Food Sources
  Meats, fish, poultry and liver
  Legumes and soy products
  Non-citrus fruits
  Fortified cereals




               © 2009 Cengage - Wadsworth
© 2009 Cengage - Wadsworth
Vitamin B6

• Other Information
  Easily destroyed by heat
  Vitamin B6 is ineffective in curing
   carpal tunnel syndrome and sleep
   disorders.




               © 2009 Cengage - Wadsworth
Folate

• Folic acid, folacin, pteroylglutamic
  acid-PGA
• Folate is involved in the synthesis of
  DNA and the formation of new cells.
• The coenzymes THF
  (tetrahydrofolate) and DHF
  (dihydrofolate) require vitamin B12 to
  function correctly.


               © 2009 Cengage - Wadsworth
© 2009 Cengage - Wadsworth
Folate

• Folate Recommendations (1998 RDA)
  RDA Adults: 400 μg/day
  Dietary Folate Equivalents (DFE) is a
   calculation that accounts for the
   bioavailability differences between
   folate from foods and folate from
   supplements.
  There are higher recommendations
   for pregnant women.

               © 2009 Cengage - Wadsworth
Folate
• 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.

              © 2009 Cengage - Wadsworth
© 2009 Cengage - Wadsworth
Folate

• Folate and Heart Disease
  High levels of homocysteine and low
   levels of folate increase risk of heart
   disease.
  Folate breaks down homocysteine.
• Folate may help to prevent cancer.




               © 2009 Cengage - Wadsworth
Folate
• 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


                    © 2009 Cengage - Wadsworth
Folate

• Folate Toxicity
  Masks vitamin B12 deficiency
   symptoms
  Upper level for adults: 1000 μg/day




               © 2009 Cengage - Wadsworth
Folate

• Folate Food Sources
  Fortified grains
  Leafy green vegetables
  Legumes and seeds
  Liver
• Other Information
  Easily destroyed by heat and oxygen



              © 2009 Cengage - Wadsworth
© 2009 Cengage - Wadsworth
Vitamin B12 (Cobalamin)

• Vitamin B12 is involved in the synthesis of
  new cells, maintains nerve cells, reforms
  folate coenzymes, and helps break down
  some fatty acids and amino acids.
• Methylcobalamine and
  deoxyadenosylcobalamin are the coenzyme
  forms.
• Vitamin B12 Recommendations (1998 RDA)
   RDA Adults: 2.4 μg/day


                © 2009 Cengage - Wadsworth
Vitamin B12 (Cobalamin)

• Vitamin B12 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

                   © 2009 Cengage - Wadsworth
© 2009 Cengage - Wadsworth
Vitamin B12 (Cobalamin)

• Vitamin B12 Food Sources
  Meat, fish, poultry, and shellfish
  Milk, cheese and eggs
  Fortified cereals




               © 2009 Cengage - Wadsworth
Vitamin B12 (Cobalamin)

• Other Information
  Binds with intrinsic factor in the small
   intestine for absorption
  Easily destroyed by microwave
   cooking




               © 2009 Cengage - Wadsworth
Non-B Vitamins

• Choline
  Choline is involved in the synthesis of
   acetylcholine and lecithin.
  Choline Recommendations (1998
   Adequate Intake)
    • AI Men: 550 mg/day
    • AI Women: 425 mg/day




               © 2009 Cengage - Wadsworth
Non-B Vitamins
• Choline Deficiency and Toxicity
  Deficiencies are rare.
  Deficiency symptom is liver damage
  Toxicity Symptoms
    • Body odor and sweating
    • Salivation
    • Reduced growth rate
    • Low blood pressure
    • Liver damage
  Upper level for adults: 3500 mg/day

               © 2009 Cengage - Wadsworth
Non-B Vitamins

• Choline Food Sources
  Milk
  Liver
  Eggs
  Peanuts




             © 2009 Cengage - Wadsworth
Non-B Vitamins
• Inositol and Carnitine
   Inositol is made from glucose and is part of
    the cell membrane structure.
   Carnitine is made from lysine and
    transports long-chain fatty acids to be
    oxidized.
• Vitamin imposters are substances needed
  by other forms of life but not human
  beings.
• They can be potentially dangerous when
  used by humans.

                 © 2009 Cengage - Wadsworth
The B Vitamins--In
           Concert
• The B Vitamins are interdependent.
  The presence of one may affect the
  absorption, metabolism and
  excretion of another.
• A deficiency of one may affect the
  functioning or deficiency of another.
• A variety of foods from each food
  group will provide an adequate
  supply of all the B vitamins.

               © 2009 Cengage - Wadsworth
The B Vitamins--In
          Concert
• B Vitamin Roles
  Coenzymes involved directly or
   indirectly with energy metabolism
  Facilitate energy-releasing reactions
  Build new cells to deliver oxygen and
   nutrients for energy reactions




              © 2009 Cengage - Wadsworth
© 2009 Cengage - Wadsworth
The B Vitamins--In
           Concert
• B Vitamin Deficiencies
  Deficiencies rarely occur singly except
   for beriberi and pellagra.
  Can be primary or secondary causes
  Glossitis and cheilosis are two
   symptoms common to B vitamin
   deficiencies.
• B vitamin toxicities can occur with
  supplements.

               © 2009 Cengage - Wadsworth
© 2009 Cengage - Wadsworth
The B Vitamins--In
          Concert
• B Vitamin Food Sources
  Grains group provides thiamin,
   riboflavin, niacin and folate.
  Fruits and vegetables provide folate.
  Meat group provides thiamin, niacin,
   vitamin B6 and vitamin B12.
  Milk group provides riboflavin and
   vitamin B12.


               © 2009 Cengage - Wadsworth
Vitamin C

• Antiscorbutic factor is the original
  name for vitamin C.
• Vitamin C serves as a cofactor to
  facilitate the action of an enzyme and
  also serves as an antioxidant.




              © 2009 Cengage - Wadsworth
© 2009 Cengage - Wadsworth
Vitamin C

• Vitamin C Roles
  As an Antioxidant
    • Defends against free radicals
    • Protects tissues from oxidative stress
  As a Cofactor in Collagen Formation
    • Collagen is used for bones and teeth,
      scar tissue, and artery walls.
    • Works with iron to form hydroxiproline
      which is needed in collagen formation


                © 2009 Cengage - Wadsworth
Vitamin C
• Vitamin C Roles
   As a Cofactor in Other Reactions
     • Hydroxylation of carnitine
     • Converts tryptophan to neurotransmitters
     • Makes hormones
   Vitamin C needs increase during body
    stress, i.e. infections, burns, extremely high
    or low temperatures, heavy metal intakes,
    certain medications, and smoking.
   As a Cure for the Common Cold
     • Some relief of symptoms
     • Vitamin C deactivates histamine like an
       antihistamine.
   Disease prevention is still being researched.
                 © 2009 Cengage - Wadsworth
Vitamin C

• Vitamin C Recommendations
  (1998 RDA)
  RDA Men: 90 mg/day
  RDA Women: 75 mg/day
  Smokers: +35 mg/day




               © 2009 Cengage - Wadsworth
Vitamin C
• Vitamin C Deficiency
   Deficiency disease is called scurvy
   Deficiency Symptoms
     • Anemia – small cell type
     • Atherosclerotic plaques and pinpoint hemorrhages
     • Bone fragility and joint pain
     • Poor wound healing and frequent infections
     • Bleeding gums and loosened teeth
     • Muscle degeneration and pain, hysteria, and
       depression
     • Rough skin and blotchy bruises


                   © 2009 Cengage - Wadsworth
© 2009 Cengage - Wadsworth
Vitamin C
• Vitamin C Toxicity
  Toxicity Symptoms
    • Nausea, abdominal cramps, diarrhea,
      headache, fatigue and insomnia
    • Hot flashes and rashes
    • Interference with medical tests, creating
      a false positive or a false negative
    • Aggravation of gout symptoms, urinary
      tract infections, and kidney stones
  Upper level for adults: 2000 mg/day


                © 2009 Cengage - Wadsworth
Vitamin C
• Vitamin C Food Sources
   Citrus fruits, cantaloupe, strawberries,
    papayas and mangoes
   Cabbage-type vegetables, dark green
    vegetables like green peppers and broccoli,
    lettuce, tomatoes and potatoes
• Other Information
   Also called ascorbic acid
   Easily destroyed by heat and oxygen



                 © 2009 Cengage - Wadsworth
© 2009 Cengage - Wadsworth
Vitamin and Mineral
    Supplements




      © 2009 Cengage - Wadsworth
Vitamin and Mineral
          Supplements
• Many people take dietary supplements for
  dietary and health insurance.
• Some take multinutrient pills daily.
• Others take large doses of single nutrients.
• A valid nutrition assessment by
  professionals determines the need for
  supplements.
• Self-prescribed supplementation is not
  advised.
• There are many arguments for and against
  supplements.

                 © 2009 Cengage - Wadsworth
Arguments for
           Supplements
•   Correct Overt Deficiencies
•   Support Increased Nutrient Needs
•   Improve Nutrition Status
•   Improve the Body’s Defenses
•   Reduce Disease Risks




                © 2009 Cengage - Wadsworth
Arguments for
         Supplements
• Who Needs Supplements?
  People with nutritional deficiencies
  People with low energy intake – less
   than 1600 kcalories per day
  Vegans and those with atrophic
   gastritis need vitamin B12
  People with lactose intolerance, milk
   allergies, or inadequate intake of
   dairy foods

               © 2009 Cengage - Wadsworth
Arguments for
             Supplements
• Who Needs Supplements?
   People in certain stages of the life cycle
     •   Infants need iron and fluoride
     •   Women of childbearing age need folate
     •   Pregnant women need folate and iron
     •   Elderly need vitamins B12 and D
   People with diseases, infections, or injuries,
    and those who have had surgery that
    affects nutrient digestion, absorption or
    metabolism
   People taking medications that interfere
    with the body’s use of specific nutrients

                     © 2009 Cengage - Wadsworth
Arguments against
           Supplements
•   Toxicity
•   Life-Threatening Misinformation
•   Unknown Needs
•   False Sense of Security




                © 2009 Cengage - Wadsworth
Arguments against
          Supplements
• Other Invalid Reasons:
   Belief that food supply and soil contain
    inadequate nutrients
   Belief that supplements provide energy
   Belief that supplements enhance athletic
    performance or lean body mass without
    physical work or faster than work alone
   Belief that supplements will help a person
    cope with stress
   Belief that supplements can prevent, treat
    or cure conditions
• Bioavailability and Antagonistic Actions
                 © 2009 Cengage - Wadsworth
Selection of Supplements

• What form do you want?
• What vitamins and minerals do you
  need?
  Do not exceed Tolerable Upper Intake
   Levels.
  Be careful about greater that 10 mg
   of iron.



              © 2009 Cengage - Wadsworth
Selection of Supplements
• Are there misleading claims?
     Ignore organic or natural claims.
     Avoid products that make high potency claims.
     Watch fake preparations.
     Be aware of marketing ploys.
     Be aware of preparations that contain alcohol.
     Be aware of the latest nutrition buzzwords.
     Internet information is not closely regulated.
• What about the cost?
   Local or store brands may be just as good
    as nationally advertised brands.

                     © 2009 Cengage - Wadsworth
Regulation of Supplements
• Nutritional labeling for supplements is
  required.
• Labels may make nutrient claims according
  to specified criteria.
• Labels may claim that lack of a nutrient
  can cause a deficiency disease and include
  the prevalence of that disease.
• Labels may make health claims that are
  supported by significant scientific
  agreement.

                © 2009 Cengage - Wadsworth
© 2009 Cengage - Wadsworth
Regulation of Supplements
• Labels may claim to diagnose, treat, cure,
  or relieve common complaints but not
  make claims about specific diseases.
• Labels may make structure-function claims
  if accompanied by Food And Drug
  Administration (FDA) disclaimer.
   Role   a nutrient plays in the body
   How    the nutrient performs its function
   How    consuming the nutrient is associated
    with   general well-being


                   © 2009 Cengage - Wadsworth

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Plus de Michael Hart

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Chapter 10 NUTR

  • 1. Chapter 10 The Water-Soluble Vitamins: B Vitamins and Vitamin C © 2009 Cengage - Wadsworth
  • 2. The Vitamins--An Overview • Vitamins differ from carbohydrate, fat and protein in structure, function and food contents. • Vitamins are similar to the energy- yielding nutrients in that they are vital to life, organic and available from foods. • Both deficiencies and excesses of the vitamins can affect health. © 2009 Cengage - Wadsworth
  • 3. The Vitamins--An Overview • Bioavailability is the rate and extent that a nutrient is absorbed and used. • Precursors, also known as provitamins, are consumed in an inactive form and become active vitamins in the body. © 2009 Cengage - Wadsworth
  • 4. The Vitamins--An Overview • The organic nature of vitamins means they can be destroyed by exposure to light, oxidation, cooking, and storage. • There are methods used to minimize nutrient losses.  Refrigerate fruits and vegetables.  Store cut fruits and vegetables in airtight wrappers or closed containers and refrigerate.  Clean fruits and vegetables before they are cut.  Use a microwave, steam, or simmer in small amounts of water.  Save cooking water for other uses.  Avoid high temperatures and long cooking times. © 2009 Cengage - Wadsworth
  • 5. The Vitamins--An Overview • Solubility and storage  Water-soluble vitamins (B vitamins and vitamin C) are absorbed directly into the blood and travel freely. • Circulate freely • Excreted in urine  Fat-soluble vitamins (vitamins A, D, K and E) are absorbed first into the lymph, then the blood. • Many require protein carriers. • Stored in cells associated with fat • Less readily excreted © 2009 Cengage - Wadsworth
  • 6. The Vitamins--An Overview • Toxicity Water-soluble vitamins can reach toxic levels with supplement use. Fat-soluble vitamins are likely to reach toxic levels with supplement use. DRI Committee has established Tolerable Upper Intake Levels for niacin, vitamin B6, folate, choline and vitamin C. © 2009 Cengage - Wadsworth
  • 7. The B Vitamins--As Individuals • The B vitamins are very active in the body. Several of the B vitamins form part of the coenzymes that assist enzymes in the release of energy. • Other B vitamins participate in metabolism and cell multiplication. • Recommendations for the B vitamins come from RDA, AI, and Tolerable Upper Intake Levels. • There are deficiencies, toxicities and food sources that are unique for each vitamin. © 2009 Cengage - Wadsworth
  • 8. © 2009 Cengage - Wadsworth
  • 9. Thiamin (Vitamin B1) • Thiamin is involved in energy metabolism as part of the coenzyme thiamin pyrophosphate (TPP). • Thiamin Recommendations (1998 RDA) RDA Men: 1.2 mg/day RDA Women: 1.1 mg/day © 2009 Cengage - Wadsworth
  • 10. Thiamin (Vitamin B1) • Thiamin Deficiency and Toxicity Deficiency Symptoms • Enlarged heart and possible cardiac failure • Muscular weakness • Apathy, poor short-term memory, confusion, and irritability • Anorexia and weight loss © 2009 Cengage - Wadsworth
  • 11. © 2009 Cengage - Wadsworth
  • 12. Thiamin (Vitamin B1) • Thiamin Deficiency and Toxicity  Wernicke-Korsakoff syndrome is a severe deficiency that develops in those who abuse alcohol.  Deficiency results in the disease beriberi. • Wet beriberi presents with edema. • Dry beriberi presents with muscle wasting.  No reported toxicities © 2009 Cengage - Wadsworth
  • 13. Thiamin (Vitamin B1) • Thiamin Food Sources Whole-grain, fortified or enriched grain products Moderate amounts in all foods Pork © 2009 Cengage - Wadsworth
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  • 15. Thiamin (Vitamin B1) • 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. © 2009 Cengage - Wadsworth
  • 16. Riboflavin (Vitamin B2) • Riboflavin is involved in energy metabolism. • Flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD) are the coenzyme forms. • Riboflavin Recommendations (1998 RDA) RDA Men: 1.3 mg/day RDA Women: 1.1 mg/day © 2009 Cengage - Wadsworth
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  • 18. Riboflavin (Vitamin B2) • Riboflavin Deficiency and Toxicity Deficiency Symptoms • Inflamed eyelids, sensitivity to light, and reddening of the cornea • Sore throat and cracks and redness at the corners of the mouth • Painful, smooth and purplish red tongue • Skin lesions covered with greasy scales Deficiency disease is ariboflavinosis No reported toxicities © 2009 Cengage - Wadsworth
  • 19. Riboflavin (Vitamin B2) • Riboflavin Food Sources Milk products, including yogurt and cheese Enriched and whole grains Liver © 2009 Cengage - Wadsworth
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  • 21. Riboflavin (Vitamin B2) • Other information Easily destroyed by ultraviolet light and irradiation Not destroyed by cooking © 2009 Cengage - Wadsworth
  • 22. Niacin (Vitamin B3) • Niacin is involved in the metabolism of glucose, fat, and alcohol. • Nicotinamide adenine dinucleotide (NAD), and NADP, the phosphate form of NAD, are the coenzyme forms. • Niacin Recommendations (1998 RDA)  The body can obtain niacin from dietary niacin and dietary tryptophan (60 mg of dietary tryptophan = 1 mg niacin); therefore niacin intake is measured in niacin equivalents (NE).  RDA Men: 16 NE/day  RDA Women: 14 NE/day  Upper level of 35 mg/day for adults © 2009 Cengage - Wadsworth
  • 23. Niacin (Vitamin B3) • Niacin Deficiency A deficiency of niacin results in the disease pellagra. Deficiency Symptoms • Diarrhea, abdominal pain, and vomiting • Inflamed, swollen, smooth and bright red tongue • Depression, apathy, fatigue, loss of memory, and headache • Rash when exposed to sunlight © 2009 Cengage - Wadsworth
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  • 25. Niacin (Vitamin B3) • 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 © 2009 Cengage - Wadsworth
  • 26. Niacin (Vitamin B3) • Niacin Food Sources Milk Eggs, meat, poultry and fish Whole-grain and enriched breads and cereals Nuts and all protein-containing foods © 2009 Cengage - Wadsworth
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  • 28. Niacin (Vitamin B3) • Other Information Also called nicotinic acid, nicotinamide, and niacinamide The amino acid tryptophan is the precursor. The vitamin can be lost from foods when is leaches into water. Resistant to heat © 2009 Cengage - Wadsworth
  • 29. Biotin • As part of a coenzyme used in energy metabolism, biotin assists in glycogen synthesis, fat synthesis, and amino acid metabolism. • Biotin Recommendations (1998 Adequate Intake) AI Adults: 30 μg/day © 2009 Cengage - Wadsworth
  • 30. Biotin • Biotin Deficiency and Toxicity  Deficiencies are rare.  Deficiency Symptoms • Depression, lethargy, and hallucinations • Numb or tingling sensation in the arms and legs • Red, scaly rash around the eyes, nose and mouth • Hair loss  Biotin can be bound with an egg-white protein called avidin.  No reported toxicities © 2009 Cengage - Wadsworth
  • 31. Biotin • Biotin Food Sources Widespread in foods Organ meats, egg yolks and fish Soybeans Whole grains • Biotin can also be synthesized by intestinal bacteria. © 2009 Cengage - Wadsworth
  • 32. Pantothenic Acid • Pantothenic acid is involved in energy metabolism as a part of coenzyme A. • Pantothenic Acid Recommendations (1998 Adequate Intake) AI Adults: 5 mg/day © 2009 Cengage - Wadsworth
  • 33. Pantothenic Acid • Pantothenic Acid Deficiency and Toxicity  Deficiency is rare.  Deficiency Symptoms • Vomiting, nausea, and stomach cramps • Insomnia and fatigue • Depression, irritability, restlessness, and apathy • Hypoglycemia and increased sensitivity to insulin  No reported toxicities © 2009 Cengage - Wadsworth
  • 34. Pantothenic Acid • Pantothenic Acid Food Sources Widespread in foods Organ meats Mushrooms, avocados, and broccoli Whole grains Can be destroyed by freezing, canning, and refining © 2009 Cengage - Wadsworth
  • 35. Vitamin B6 • The coenzyme forms of vitamin B6 (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. • Vitamin B6 Recommendations (1998 RDA)  RDA Adults 19-50 years: 1.3 mg/day © 2009 Cengage - Wadsworth
  • 36. Vitamin B6 • Vitamin B6 Deficiency Deficiency Symptoms • Scaly dermatitis • Anemia – small cell type • Depression, confusion, abnormal brain wave pattern, and convulsions Alcohol destroys the vitamin INH drug used for tuberculosis acts as an antagonist. © 2009 Cengage - Wadsworth
  • 37. Vitamin B6 • Vitamin B6 Toxicity Toxicity Symptoms • Depression, fatigue, irritability, and headaches • Nerve damage causing numbness and muscle weakness leading to inability to walk • Convulsions • Skin lesions Upper level for adults: 100 mg/day © 2009 Cengage - Wadsworth
  • 38. Vitamin B6 • Vitamin B6 Food Sources Meats, fish, poultry and liver Legumes and soy products Non-citrus fruits Fortified cereals © 2009 Cengage - Wadsworth
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  • 40. Vitamin B6 • Other Information Easily destroyed by heat Vitamin B6 is ineffective in curing carpal tunnel syndrome and sleep disorders. © 2009 Cengage - Wadsworth
  • 41. Folate • Folic acid, folacin, pteroylglutamic acid-PGA • Folate is involved in the synthesis of DNA and the formation of new cells. • The coenzymes THF (tetrahydrofolate) and DHF (dihydrofolate) require vitamin B12 to function correctly. © 2009 Cengage - Wadsworth
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  • 43. Folate • Folate Recommendations (1998 RDA) RDA Adults: 400 μg/day Dietary Folate Equivalents (DFE) is a calculation that accounts for the bioavailability differences between folate from foods and folate from supplements. There are higher recommendations for pregnant women. © 2009 Cengage - Wadsworth
  • 44. Folate • 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. © 2009 Cengage - Wadsworth
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  • 46. Folate • Folate and Heart Disease High levels of homocysteine and low levels of folate increase risk of heart disease. Folate breaks down homocysteine. • Folate may help to prevent cancer. © 2009 Cengage - Wadsworth
  • 47. Folate • 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 © 2009 Cengage - Wadsworth
  • 48. Folate • Folate Toxicity Masks vitamin B12 deficiency symptoms Upper level for adults: 1000 μg/day © 2009 Cengage - Wadsworth
  • 49. Folate • Folate Food Sources Fortified grains Leafy green vegetables Legumes and seeds Liver • Other Information Easily destroyed by heat and oxygen © 2009 Cengage - Wadsworth
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  • 51. Vitamin B12 (Cobalamin) • Vitamin B12 is involved in the synthesis of new cells, maintains nerve cells, reforms folate coenzymes, and helps break down some fatty acids and amino acids. • Methylcobalamine and deoxyadenosylcobalamin are the coenzyme forms. • Vitamin B12 Recommendations (1998 RDA)  RDA Adults: 2.4 μg/day © 2009 Cengage - Wadsworth
  • 52. Vitamin B12 (Cobalamin) • Vitamin B12 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 © 2009 Cengage - Wadsworth
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  • 54. Vitamin B12 (Cobalamin) • Vitamin B12 Food Sources Meat, fish, poultry, and shellfish Milk, cheese and eggs Fortified cereals © 2009 Cengage - Wadsworth
  • 55. Vitamin B12 (Cobalamin) • Other Information Binds with intrinsic factor in the small intestine for absorption Easily destroyed by microwave cooking © 2009 Cengage - Wadsworth
  • 56. Non-B Vitamins • Choline Choline is involved in the synthesis of acetylcholine and lecithin. Choline Recommendations (1998 Adequate Intake) • AI Men: 550 mg/day • AI Women: 425 mg/day © 2009 Cengage - Wadsworth
  • 57. Non-B Vitamins • Choline Deficiency and Toxicity Deficiencies are rare. Deficiency symptom is liver damage Toxicity Symptoms • Body odor and sweating • Salivation • Reduced growth rate • Low blood pressure • Liver damage Upper level for adults: 3500 mg/day © 2009 Cengage - Wadsworth
  • 58. Non-B Vitamins • Choline Food Sources Milk Liver Eggs Peanuts © 2009 Cengage - Wadsworth
  • 59. Non-B Vitamins • Inositol and Carnitine  Inositol is made from glucose and is part of the cell membrane structure.  Carnitine is made from lysine and transports long-chain fatty acids to be oxidized. • Vitamin imposters are substances needed by other forms of life but not human beings. • They can be potentially dangerous when used by humans. © 2009 Cengage - Wadsworth
  • 60. The B Vitamins--In Concert • The B Vitamins are interdependent. The presence of one may affect the absorption, metabolism and excretion of another. • A deficiency of one may affect the functioning or deficiency of another. • A variety of foods from each food group will provide an adequate supply of all the B vitamins. © 2009 Cengage - Wadsworth
  • 61. The B Vitamins--In Concert • B Vitamin Roles Coenzymes involved directly or indirectly with energy metabolism Facilitate energy-releasing reactions Build new cells to deliver oxygen and nutrients for energy reactions © 2009 Cengage - Wadsworth
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  • 63. The B Vitamins--In Concert • B Vitamin Deficiencies Deficiencies rarely occur singly except for beriberi and pellagra. Can be primary or secondary causes Glossitis and cheilosis are two symptoms common to B vitamin deficiencies. • B vitamin toxicities can occur with supplements. © 2009 Cengage - Wadsworth
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  • 65. The B Vitamins--In Concert • B Vitamin Food Sources Grains group provides thiamin, riboflavin, niacin and folate. Fruits and vegetables provide folate. Meat group provides thiamin, niacin, vitamin B6 and vitamin B12. Milk group provides riboflavin and vitamin B12. © 2009 Cengage - Wadsworth
  • 66. Vitamin C • Antiscorbutic factor is the original name for vitamin C. • Vitamin C serves as a cofactor to facilitate the action of an enzyme and also serves as an antioxidant. © 2009 Cengage - Wadsworth
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  • 68. Vitamin C • Vitamin C Roles As an Antioxidant • Defends against free radicals • Protects tissues from oxidative stress As a Cofactor in Collagen Formation • Collagen is used for bones and teeth, scar tissue, and artery walls. • Works with iron to form hydroxiproline which is needed in collagen formation © 2009 Cengage - Wadsworth
  • 69. Vitamin C • Vitamin C Roles  As a Cofactor in Other Reactions • Hydroxylation of carnitine • Converts tryptophan to neurotransmitters • Makes hormones  Vitamin C needs increase during body stress, i.e. infections, burns, extremely high or low temperatures, heavy metal intakes, certain medications, and smoking.  As a Cure for the Common Cold • Some relief of symptoms • Vitamin C deactivates histamine like an antihistamine.  Disease prevention is still being researched. © 2009 Cengage - Wadsworth
  • 70. Vitamin C • Vitamin C Recommendations (1998 RDA) RDA Men: 90 mg/day RDA Women: 75 mg/day Smokers: +35 mg/day © 2009 Cengage - Wadsworth
  • 71. Vitamin C • Vitamin C Deficiency  Deficiency disease is called scurvy  Deficiency Symptoms • Anemia – small cell type • Atherosclerotic plaques and pinpoint hemorrhages • Bone fragility and joint pain • Poor wound healing and frequent infections • Bleeding gums and loosened teeth • Muscle degeneration and pain, hysteria, and depression • Rough skin and blotchy bruises © 2009 Cengage - Wadsworth
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  • 73. Vitamin C • Vitamin C Toxicity Toxicity Symptoms • Nausea, abdominal cramps, diarrhea, headache, fatigue and insomnia • Hot flashes and rashes • Interference with medical tests, creating a false positive or a false negative • Aggravation of gout symptoms, urinary tract infections, and kidney stones Upper level for adults: 2000 mg/day © 2009 Cengage - Wadsworth
  • 74. Vitamin C • Vitamin C Food Sources  Citrus fruits, cantaloupe, strawberries, papayas and mangoes  Cabbage-type vegetables, dark green vegetables like green peppers and broccoli, lettuce, tomatoes and potatoes • Other Information  Also called ascorbic acid  Easily destroyed by heat and oxygen © 2009 Cengage - Wadsworth
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  • 76. Vitamin and Mineral Supplements © 2009 Cengage - Wadsworth
  • 77. Vitamin and Mineral Supplements • Many people take dietary supplements for dietary and health insurance. • Some take multinutrient pills daily. • Others take large doses of single nutrients. • A valid nutrition assessment by professionals determines the need for supplements. • Self-prescribed supplementation is not advised. • There are many arguments for and against supplements. © 2009 Cengage - Wadsworth
  • 78. Arguments for Supplements • Correct Overt Deficiencies • Support Increased Nutrient Needs • Improve Nutrition Status • Improve the Body’s Defenses • Reduce Disease Risks © 2009 Cengage - Wadsworth
  • 79. Arguments for Supplements • Who Needs Supplements? People with nutritional deficiencies People with low energy intake – less than 1600 kcalories per day Vegans and those with atrophic gastritis need vitamin B12 People with lactose intolerance, milk allergies, or inadequate intake of dairy foods © 2009 Cengage - Wadsworth
  • 80. Arguments for Supplements • Who Needs Supplements?  People in certain stages of the life cycle • Infants need iron and fluoride • Women of childbearing age need folate • Pregnant women need folate and iron • Elderly need vitamins B12 and D  People with diseases, infections, or injuries, and those who have had surgery that affects nutrient digestion, absorption or metabolism  People taking medications that interfere with the body’s use of specific nutrients © 2009 Cengage - Wadsworth
  • 81. Arguments against Supplements • Toxicity • Life-Threatening Misinformation • Unknown Needs • False Sense of Security © 2009 Cengage - Wadsworth
  • 82. Arguments against Supplements • Other Invalid Reasons:  Belief that food supply and soil contain inadequate nutrients  Belief that supplements provide energy  Belief that supplements enhance athletic performance or lean body mass without physical work or faster than work alone  Belief that supplements will help a person cope with stress  Belief that supplements can prevent, treat or cure conditions • Bioavailability and Antagonistic Actions © 2009 Cengage - Wadsworth
  • 83. Selection of Supplements • What form do you want? • What vitamins and minerals do you need? Do not exceed Tolerable Upper Intake Levels. Be careful about greater that 10 mg of iron. © 2009 Cengage - Wadsworth
  • 84. Selection of Supplements • Are there misleading claims?  Ignore organic or natural claims.  Avoid products that make high potency claims.  Watch fake preparations.  Be aware of marketing ploys.  Be aware of preparations that contain alcohol.  Be aware of the latest nutrition buzzwords.  Internet information is not closely regulated. • What about the cost?  Local or store brands may be just as good as nationally advertised brands. © 2009 Cengage - Wadsworth
  • 85. Regulation of Supplements • Nutritional labeling for supplements is required. • Labels may make nutrient claims according to specified criteria. • Labels may claim that lack of a nutrient can cause a deficiency disease and include the prevalence of that disease. • Labels may make health claims that are supported by significant scientific agreement. © 2009 Cengage - Wadsworth
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  • 87. Regulation of Supplements • Labels may claim to diagnose, treat, cure, or relieve common complaints but not make claims about specific diseases. • Labels may make structure-function claims if accompanied by Food And Drug Administration (FDA) disclaimer.  Role a nutrient plays in the body  How the nutrient performs its function  How consuming the nutrient is associated with general well-being © 2009 Cengage - Wadsworth