1. Chapter 8 The Water-Soluble Vitamins

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Which statement is true?
Vitamin deficiencies are rare in the United States.
Vitamins are necessary in many biochemical reactions in the body.
It generally takes longer to develop a deficiency of a fat-soluble vitamin than a deficiency of a water soluble vitamin.
all
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3. The Vitamins (water and fat soluble)
The last 13 compounds recognized as vitamins were characterized in 1948.
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Vitamin Talk
Vitamins are organic compounds essential in the diet to promote growth and health maintenance.
Water-soluble vitamins include the B vitamins and vitamin C.
Fat-soluble vitamins include A, D, E and K.
B vitamins were originally thought to be one chemical substance but are actually many different substances. That is the reason for B1, B2, B12, etc.
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Which statement concerning vitamins is incorrect? a)
vitamins are organic compounds b)
If a vitamin is not provided by the diet, the body will synthesize it c)
vitamins are needed in small amounts than macronutrients d)
vitamins are essential for growth, reproduction and health b
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6. Fortified and Enriched Foods
Vitamins may be lost when food is processed. When these vitamins are added back to the processed food at the same or higher level, the food is said to be?
a. Enhanced
b. Fortified
c. Enriched
d. Supplemented
Fortification: process of adding nutrients to foods. The added nutrients are generally not found in the food, ie) fortifying orange juice with calcium.
Enrichment: adding nutrients back to foods that have lost nutrients due to processing. Ie) addition of B vitamins to white rice.
Sometimes this process puts people above FDA guidelines. Ie, almost all breakfast cereals are fortified with iron and calcium, and many other vitamins not deficient in the U.S. diet.
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Dietary Supplements
Dietary supplements can be another source of vitamins in the modern diet.
Dietary supplements cannot replace the benefits of a diet containing a wide variety of foods: epidemiological studies show that people who eat more fruits/veggies have a lower incidence of a host of chronic diseases.
These same benefits are not duplicated by taking supplements of nutrients found in these foods.
Dietary supplement production is not supervised by the FDA.
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8. Absorption of Vitamins
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9. Bioavailability of Vitamins
Vitamins must be absorbed by the body in order to perform their functions.
Approximately 40-90% of vitamins are absorbed in the small intestine.
Fat-soluble vitamins require fat in the diet to be absorbed and water-soluble vitamins may require transport molecules or specific molecules in the GI tract.
Some vitamins are absorbed in inactive provitamin or vitamin precursor forms that must be converted into active forms by the body.
The form in which a vitamin is presented can impact its absorption and utilization.
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Which of the following terms is used to describe how much of a vitamin is absorbed and used by the body?
Absorption
Assimilation
Bioavailability
Functionality c
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Thiamin: B1
Thiamin was the first B vitamin to be identified and is also called B1.
The disease resulting from deficiency is beri-beri and present in east Asia for over 1000 years. It came to western medical attention in colonial Asia in the 19th century. Why there?
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Thiamin deficiency
Beri-beri: a disease of the muscles and nervous system characterized by
Depression and weakness (after just 10 days on thiamin free diet).
Neuromuscular symptoms such as paresthesia (spontaneous sensations, such as itching, burning, etc.) in-coordination … explained by lack of acetylcholine.
enlargement of the heart… the reason is not well understood.
A team of scientists from the dutch east india company was sent to investigate the cause of this disease. They thought it was caused by microorganisms and a researcher spent many years trying to infect chickens with it. Finally, when he ran out of food for his chickens and instead of the their usual, brown rice, fed them white rice, they developed sx of beri beri.
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B1 :Functions
Thiamin assists in
energy production from glucose.
carbohydrate metabolism and the production of ribose (necessary for RNA)
the health of the nervous system (synthesis of acetylcholine, a neurotransmitter)
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Thiamin Deficiency
Deficiency is rare in the United States because most foods are now vitamin enriched (previously common in places with predominantly a polished rice diet).
Today, beriberi occurs mostly in patients who abuse alcohol. Drinking heavily can lead to poor nutrition, and excess alcohol makes it harder for the body to absorb and store B1
Beriberi can occur in breast-fed infants when the mother's body is lacking in thiamin
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Thiamin in foods may be destroyed with cooking, storage (senstivie to heat, oxygen alkalinity.) there are certain foods containing antithiamin factors (raw fish, etc)
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Thiamine Deficiency
Wernicke-Korsakoff syndrome
confusion, psychosis, confabulation, and impaired retentive memory. In severe cases the patient may slip into a coma.
(korsakoff syndrome refers to the retrograde amnesia)
Classic triad of delirium, nystagmus, and ataxia in its fully developed form, although this is rare in clinical practice
Nystagmus is often the first sign
Delirium typically involves disorientation in time and space together with general confusion and apathy
Untreated may lead to coma and death; survivors often have residual nystagmus, ataxia, or memory problems
Treatment with thiamine generally leads to rapid improvement, although maximum recovery may take several weeks
Carl Wernicke
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17. Alcohol: Toxicity is dose dependent
CNS depressent effects are not toxic perse
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A primary function of thiamin in the body is to:
clot blood
regulate cell differentiation
increase uptake of iron by hemoglobin
facilitate production of energy from glucose d
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Thiamin
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Riboflavin (B2)
Dairy products are a good source of riboflavin.
Why is milk often supplied in opaque containers?
Riboflavin is easily destroyed by heat and exposure to light.
Plant sources of riboflavin include mushrooms, broccoli, asparagus, whole grains and green, leafy vegetables. Animal sources include red meat, poultry and fish. Milk is the best source in the American diet.
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Flavin adenine dinucleotide (FAD)
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Riboflavin forms active coenzymes that do all the following except
help produce energy from carbohydrate, protein and fat.
function as electron carriers.
function in the citric acid cycle.
send messages between nerve cells. d.
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B2 deficiency
Deficiency leads to ariboflavinosis : injuries are slow to heal, inflammation of eyes, lips, mouth, tongue (tissues that grow most rapidly).
Deficiency develops after ~ 2 months of B2 poor diet….
Sx similar to pellagra. Usually seen in conjunction with other vitamin deficiencies.
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Riboflavin
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Niacin (B3)
Meat and fish are good sources.
The emergence of deficiency states can be traced to the cultivation of corn as the dietary staple. Today, Niacin is added to enriched flours in North America.
Carpenter found in 1951 that niacin in corn is biologically unavailable, and can be released only in very alkaline lime water of pH11.
Niacin can be synthesized in the body from the essential amino acid tryptophan if the diet is adequate in tryptophan (milk, eggs, etc).
Niacin plays an important role in the production of energy and in general metabolism. c)
decrease LDL cholesterol and increase HDL cholesterol.
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Niacin Deficiency
A niacin deficiency disease is pellagra which causes progressive mental and physical deterioration.
Advanced pellagra’s symptoms include the 3 D’s: dermatitis, diarrhea and dementia.
Niacin toxicity from overuse of niacin supplements can result in flushing of the skin, elevated blood pressure, cardiac arrhythmia, nausea, vomiting, elevated blood sugar levels and impaired liver function.
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Pellagra occurs when _____ is the staple grain in the diet and the diet does not provide adequate variety.
corn
wheat
rice
barley a
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Niacin
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30. Biotin
Discovered when rats fed protein derived from raw egg developed hair loss, dermatitis, and neuromuscular symptoms.
Avidin, a protein in raw eggs tightly binds biotin and prevents absorption.
Functions in energy production
form the citric acid cycle
Deficiency is rare, but observed
in those receiving tube feeding
or those who are malnourished.
Dose=200 mg qd

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Pantothenic Acid (B5)
Panthethinc acid from greek pantothen (meaning ‘from everywhere’)
The wide distribution makes deficiency rare.
Particularly high in meat, eggs, whole grains, legumes.
Part of acetyl-CoA (for energy production)
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Pantothenic Acid
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Pantothenic acid (B5) is abundant in:
meat
eggs
whole grains
All answer choices are correct. d
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Vitamin B6
Vitamin B6 is also called pyridoxine
Vitamin B6’s role in amino acid metabolism distinguishes it from the other B vitamins.
(needed to synthesize nonessential a.a. by transamination).
B6 is easily lost via exposure to heat, light, processing. Not usually added back.
Vitamin B6 deficiency may result in anemia due to impaired hemoglobin synthesis (pyridozil phosphate)
Both B6 and B12 are needed to synthesize the myelin coat of nerve cells. And essential for normal nerve cell transmission.
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35. Vitamin B 6 and cardiovascular risk
Individuals with high homocysteine levels develop atherosclerosis at an early age
B6 helps in the breakdown of this amino acid
Folate and B12 are also required in this important pathway.
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Vitamin B6 does not perform which of the following roles? a)
It is vital in the formation of non-essential amino acids. b)
It is required for the synthesis of hemoglobin. c)
It is necessary in collagen formation. d)
Large doses can reduce high blood homocysteine levels which is a risk factor for cardiovascular disease. c
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Vitamin B6
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Many B vitamins are essential for the metabolism of energy yielding nutrients. They perform this function by binding to and promoting the activity of enzymes. When B vitamins perform in this way, they are ____?
provitamins
transport proteins
coenzymes
hormones c
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Folate or Folic Acid
Folate coenzymes are needed for DNA synthesis and the metabolism of some amino acids.
Low folate intake in early pregnancy is associated with an increased risk of neural tube defects.
Low folate intake has been associated with an increased risk of heart disease related to the metabolism of the amino acid homocysteine.
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40. Folate Deficiency and Neural Tube Defects
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41. Macrocytic Anemia and Folate Deficiency
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Folate deficiency symptoms are less of a problem recently because:
grain products have been fortified with folate
more people are taking supplements
more people are drinking low-fat milk
green tea is more popular a
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Folate or Folic Acid
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Vitamin B12
Pernicious anemia is a form of anemia that does not respond to iron supplementation.
Vitamin B12 is necessary for the proper absorption of iron in the body.
Excessive intake of folic acid can mask B12 deficiencies.
Vitamin B12 is most readily absorbed from animal products.
Vegan diets need to be supplemented with readily-absorbable forms of B12.
Atrophic gastritis may lead to B12 deficiencies.
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45. Absorption of Vitamin B12
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Vitamin B12
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Vitamin C
Vitamin C is also known as ascorbic acid or ascorbate.
Functions include:
an antioxidant in the body
helps maintain the immune system
is important in the production of collagen
and aids in iron absorption.
Vitamin C in foods can be destroyed by oxygen, light and heat, as well as contact with copper or iron cookware.
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Deficiency Vit C leads to scurvy
Vitamin C deficiency causes the following: bleeding gums, easy bruising, depression.
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Which group is at risk for developing vitamin C deficiency?
Sailors in the in the 1300s
infants fed cow's milk
alcoholics
elderly people consuming nutrient poor diets
all
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Which is the best source of vitamin C? a)
green pepper b)
milk c)
eggs d)
beef
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Vitamin C
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How Antioxidants Work
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Which lifestyle factor increases the requirement for vitamin C?
drinking alcohol
exercising frequently and intensely
smoking cigarettes
eating a diet high in fiber
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54. Summary of Water-Soluble Vitamins and Choline
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56. Benefits and Risks of Water-Soluble Vitamin Supplements
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57. Copyright 2010, John Wiley & Sons, Inc.
Beriberi is a disease caused by lack of _____________ in the diet.
riboflavin
thiamin
vitamin C
niacin b
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Which disease is caused by a niacin deficiency? a)
ariboflavinosis b)
beriberi c)
pellagra d)
scurvy c
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Which is the TRUE statement about niacin?
It can be synthesized in the body from the amino acid, tryptophan.
Eggs are a good source of preformed niacin.
Heat and light easily destroy it.
Corn has a protective effect against niacin deficiencies. a
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Another name for vitamin B6 is a)
pantothenic acid b)
pyridoxine c)
pyruvate d)
biotin
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61. Finding Vitamins in Foods
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62. Copyright 2010, John Wiley & Sons, Inc.
Chapter 8
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