Copyright © 2003 Delmar Learning, a Thomson Learning company Section 1 Fundamentals of Nutrition

Copyright © 2003 Delmar Learning, a Thomson Learning company Chapter 7 Vitamins

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company3 Objectives  State one or more functions of each of the thirteen vitamins discussed  Identify at least two food sources of each of the vitamins discussed  Identify some symptoms of, or diseases caused by, deficiencies of the vitamins discussed

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company4 Facts Organic (carbon-containing) compounds that are essential in small amounts for body processes. Do not provide energy. Enable the body to use the energy provided by fats, carbohydrates, and proteins. Megadoses can be toxic.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company5 Vitamin types (13) Fat soluble (4): A, D, E, K Water soluble (9): Vitamin C Vitamin B complex which includes: thiamin (B 1 ), riboflavin (B 2 ), niacin, vitamin B 6, folate, vitamin B 12 (cobalamin), pantothenic acid, biotin

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company6 Requirements Vitamin allowances given by weight in milligrams (mg) or micrograms (mcg or  g) Dietary reference intake (replacing recommended dietary allowance) UL–tolerable upper limits–maximum level of daily intake unlikely to cause adverse effects

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company7 Vitamin Deficiency People prone to vitamin deficiency Alcoholics Poor and incapacitated elderly Clients with serious diseases that affect appetite Mentally retarded Children receiving inadequate care

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company8 Deficiency of Fat-soluble Vitamins Chronic malabsorption diseases Cystic fibrosis Celiac disease Crohn’s disease

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company9 1. Avitaminosisa. Concentrated form of vitamins 2. Hypervitaminosisb. Without vitamins 3. Vitamin supplementc. Condition caused by ingestion of excess vitamins Match the following terms with the correct definition.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company10 Answers: 1. b 2. c 3. a

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company11 Avoiding Vitamin Loss Buy fresh, unbruised vegetables and fruits and use them raw when possible. Prepare fresh vegetables and fruits just before serving. Heat canned vegetables quickly and in their own liquid.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company12 Avoiding Vitamin Loss Follow package directions when cooking frozen vegetables or fruit. Steam, or use as little water as possible. Cover pan and cook for a short period of time. Save cooking liquid for soups, stews, and gravy. Store in a cool, dark place.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company13 Fat-Soluble Vitamins  Vitamins A, D, E, K

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company14 Vitamin A Preformed (retinol) Active form of vitamin A Carotenoids Inactive form of vitamin A found in plants

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company15 Functions of Vitamin A Antioxidant; protects cells from destruction by oxygen. Maintains healthy eyes and skin, normal growth and reproduction, and a healthy immune system. Helps prevent infection.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company16 Sources of Vitamin A Preformed vitamin A (retinol) Carotenoids (provitamin A or beta-carotene) Fat-containing animal foods: liver, butter, cream, whole milk, cheeses Green leafy vegetables & fruits, carrots, sweet potatoes, squash, spinach, broccoli, mango, cantaloupe, pumpkin

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company17 Vitamin A Requirements Commonly listed as retinol equivalents (RE) A retinol equivalent is 1  g retinol or 6  g beta-carotene

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company18 What are the signs and symptoms you may expect to see with too much vitamin A? …too little?

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company19 Excess Birth defects, hair loss, dry skin, headaches, nausea, dryness of mucous membranes, liver damage, and bone and joint pain Deficit Night blindness; dry, rough skin; increased susceptibility to infections; and blindness or xerophthalmia

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company20 Vitamin D Prohormone–converted to a hormone in the body. D 2 (ergocalcifenol) is formed in plants. D 3 (cholecalciferol) is formed in humans from cholesterol in the skin.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company21 Sources of Vitamin D Sunlight Milk, fish liver oils, egg yolk, butter, fortified margarine Most milk in the U.S. has 10  g of vitamin D concentrate added per quart.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company22 Vitamin D Requirements Newborns through 51 years 5.0  g (200 IU) years 10.0  g (400 IU) 70+ years 15.0  g (600 IU) Pregnant and lactating women 5.0  g (200 IU)

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company23 What are the signs and symptoms you may expect to see with too much vitamin D? …too little?

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company24 Excess Deposits of calcium and phosphorus in soft tissues, kidney and heart damage, and bone fragility Deficit Poor bone and tooth formation, rickets which causes malformed bones and pain in infants

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company25 Deficit Osteomalacia (softening of bones) Osteoporosis (brittle, porous bones)

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company26 Vitamin E Tocopherols Alpha (most biologically active) Beta, delta, gamma Tocotrienols

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company27 Functions of Vitamin E Antioxidant Prevention of hemolytic anemia among premature infants Enhance immune system Retard spoilage of commercial foods

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company28 Sources of Vitamin E Vegetable oils: corn, soybean, safflower, and cottonseed, and products made from them such as margarine Wheat germ, nuts, green leafy vegetables

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company29 Vitamin E Requirements Given as  -TE (alpha-tocopherol equivalents) 1 mg of  -TE = 1 IU

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company30 Your client asks you if it is possible to take too much vitamin E. How would you advise the client? What signs and/or symptoms can result from too little vitamin E?

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company31 Excess Relatively nontoxic, fat- soluble vitamin. Excess stored in adipose tissue. Avoid long-term megadoses. Deficit Serious neurological defects can occur from malabsorption.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company32 Vitamin K Made up of several compounds essential to blood clotting. Vitamin K 1 (phylloquinone) Vitamin K 2 (menaquinone) Synthetic Vitamin K (menadione) Vitamin K is destroyed by light alkalis.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company33 Functions of Vitamin K Formation of prothrombin; clotting of blood Candidates likely to receive Vitamin K Newborns immediately after birth Clients who suffer from faulty fat absorption After extensive antibiotic therapy Antidote for an overdose of anticoagulant Clients being treated for hemorrhage

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company34 Sources of Vitamin K Green leafy vegetables such as broccoli, cabbage, spinach, and kale. Dairy products such as eggs, meats, fruits, and cereals. Bacteria in small intestine synthesizes some vitamin K but must be supplemented by dietary sources.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company35 Vitamin K Requirements Measured in micrograms. 0-6 months 2  g/day 6-12 months 2.5  g/day Men 120  g/day Women (same during pregnancy or lactation) 90  g/day

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company36 What signs and/or symptoms can result from too much vitamin K? … too little?

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company37 Excess Anemia can result from excessive amounts of synthetic vitamin K Deficit Defective blood coagulation, which increases clotting time and makes client prone to hemorrhage

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company38 Water-soluble Vitamins  Vitamin B complex  Vitamin C

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company39 Vitamin B Complex: Thiamin Thiamin B 1 Essential for nerve and muscle action, and metabolism of carbohydrates and some amino acids. Sources include unrefined and enriched cereals, yeast, wheat germ, lean pork, organ meats, and legumes.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company40 Vitamin B Complex: Thiamin Average adult female requires 1.1 mg/day. Average adult male requires 1.2 mg/day. Deficiency symptoms include loss of appetite, fatigue, nervous irritability, and constipation. Beriberi is a disease caused by extreme deficiency of vitamin B 1.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company41 Vitamin B Complex: Riboflavin Riboflavin B 2 Necessary for: the metabolism of carbohydrates, protein, and fats; tissue maintenance (especially the skin around the mouth); and healthy eyes. Sources include milk, meats, poultry, fish, enriched breads, cereals, broccoli, spinach, and asparagus.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company42 Vitamin B Complex: Riboflavin Average adult female requires 1.1 mg/day. Average adult male requires 1.3 mg/day. Deficiency can result in cheilosis (a condition characterized by sores on the lips and cracks at the corners of the mouth); glossitis (inflammation of the tongue); dermatitis; and eye strain in the form of itching, burning, and eye fatigue.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company43 Vitamin B Complex: Niacin Generic name for nicotinic acid and nicotinamide. A coenzyme in energy metabolism. Sources include meats, poultry, fish, peanuts, legumes. Milk and eggs are sources of tryptophan (precursor).

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company44 Vitamin B Complex: Niacin Measured in niacin equivalents (NE). 1 NE = 1 mg of niacin or 60 mg of tryptophan (an amino acid that is a precursor of niacin). Average adult female requires 14 mg/NE. Average adult male requires 16 mg/NE.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company45 Vitamin B Complex: Niacin Excessive amounts of niacin may cause flushing due to vascular dilation, GI problems, itching, and liver damage. May be used as a cholesterol-lowering agent under close supervision of a physician due to adverse side effects, which include liver damage and peptic ulcers.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company46 Vitamin B Complex: Niacin Deficiency symptoms include weakness, anorexia, indigestion, anxiety, and irritability. Pellagra is an extreme deficiency causing sores on the skin, diarrhea, anxiety, confusion, irritability, poor memory, dizziness, and untimely death.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company47 Vitamin B Complex: B 6 Pyridoxine, pyridoxal, pyridoxamine Essential for protein metabolism and absorption, and aids in release of glucose from glycogen. Serves as catalyst in conversion of tryptophan to niacin; helps synthesize neurotransmitters such as serotonin and dopamine.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company48 Vitamin B Complex: B 6 Sources include poultry, fish, liver, kidney, potatoes, bananas, spinach, and unrefined whole grains (oats and wheat). Deficiency symptoms include irritability, depression, and dermatitis. Deficiency in infants can cause various neurological symptoms and abdominal problems. Toxicity is rare; may cause temporary neurological problems.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company49 Vitamin B Complex: B 6 Measured in milligrams. Average adult female requires mg/day. Average adult male requires mg/day. Need increases as protein increases. Oral contraceptives interfere with metabolism of vitamin B 6 and can result in a deficiency.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company50 Vitamin B Complex: Folate Folate, folacin, and folic acid are chemically similar compounds, and names are used interchangeably. Needed for DNA synthesis, protein metabolism, formation of hemoglobin. Sources include cereals fortified with folate, green leafy vegetables, legumes, sunflower seeds, fruits such as orange juice and strawberries.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company51 Vitamin B Complex: Folate Measured in micrograms. Average adult female requires 400  g/day. Average adult male requires 400  g/day. Increased need during pregnancy and growth. 600  g/day required one month before conception through first six weeks of pregnancy.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company52 Vitamin B Complex: Folate Deficiency linked to neural tube defects in fetus such as spina bifida (spinal cord or spinal fluid bulge through the back) and anencephaly (absence of the brain). Other signs include inflammation of mouth and tongue, poor growth, depression and mental confusion, problems with nerve functions, megaloblastic anemia.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company53 Vitamin B Complex: Folate Excess can mask vitamin B 12 deficiency and inactivates phenytoin, an anticonvulsant drug used by epileptics. FDA limits amount in over-the-counter supplements to: 100  g for infants 300  g for children 400  g for adults

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company54 Vitamin B Complex: B 12 Cobalamin–contains mineral cobalt. Stored in body three to five years. Involved in folate metabolism, maintenance of the myelin sheath, and healthy red blood cells. To be absorbed, must bind with intrinsic factor in stomach. Pernicious anemia may result from loss of intrinsic factor.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company55 Vitamin B Complex: B 12 Sources include animal foods, especially organ meats, lean meat, seafood, eggs, dairy products. Average adult requires 2.4  g/day. Increased need during pregnancy and lactation. Amount absorbed will depend on current need.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company56 Vitamin B Complex: B 12 Deficiency is rare and may be due to congenital problems of absorption or years of a vegetarian diet with no animal foods. Symptoms inclued megaloblastic anemia, pernicious anemia (if intrinsic factor absent), anorexia, glossitis, sore mouth, tongue, pallor, depression, dizziness, weight loss, neurological system damage.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company57 Vitamin B Complex: Pantothenic Acid Involved in metabolism of carbohydrates, fats, proteins. Essential for synthesis of neurotransmitter acetylcholine and steroid hormones. Sources include meats, poultry, fish, eggs, whole grain cereals, and legumes. Thought to be synthesized by the body.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company58 Vitamin B Complex: Pantothenic Acid Food and Nutrition Board has provided an estimated intake of 5 mg a day for normal adults. Toxicity from excess not confirmed. Natural deficiencies unknown. Signs include weakness, fatigue, burning sensation in feet (deficiencies produced experimentally).

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company59 Vitamin B Complex: Biotin Coenzyme in synthesis of fatty acids and amino acids. Sources include liver, egg yolk, soy flour, cereals, yeast. Synthesized in intestine by microorganisms, amount available for absorption unknown. Food and Nutrition Board suggests adequate intake of 30  g for adults.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company60 Vitamin B Complex: Biotin Toxicity from excess unknown. Deficiency symptoms include nausea, anorexia, depression, pallor, dermatitis, increase in serum cholesterol.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company61 Vitamin C Ascorbic acid Has antioxidant properties and protects food from oxidation. Role in formation of collagen. Aids in absorption of nonheme iron. May be involved with formation or functioning of norepinephrine, some amino acids, folate, leukocytes, the immune system, allergic reactions.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company62 Vitamin C Sources include citrus fruits, melon, strawberries, tomatoes, potatoes, red and green peppers, cabbage, broccoli. Average female adult requires 75 mg/day. Average male adult requires 90 mg/day. Stress and cigarette smoking increase need.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company63 What disease results from a deficiency in vitamin C? What are the associated signs and/or symptoms? What results from excess?

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company64 Scurvy: disease characterized by gingivitis, easy bruising, pinpoint hemorrhages of the skin, poor wound healing, sore joints and muscles, weight loss. Extreme cases result in death. Found in sailors who lived without fresh fruits and vegetables.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company65 Deficiency of Vitamin C: bleeding gums, loose teeth, tendency to bruise easily, poor wound healing, scurvy. Excess: diarrhea, nausea, cramps, excessive absorption of food iron, rebound scurvy (when megadoses are stopped abruptly) and possibly oxalate kidney stones. Generally considered nontoxic.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company66 Vitamin Supplementation Balanced diet provides nutritional needs of healthy people. No amount of vitamins will build muscles. Vitamins do not provide energy; they help to release the energy provided by nutrients. Heart disease, cancer and the common cold cannot be cured by vitamin supplements.

Chapter 7Copyright © 2003 Delmar Learning, a Thomson Learning company67 Conclusion Organic compounds that regulate body functions and promote growth. Each vitamin has a specific function. Well-balanced diet provides sufficient vitamins to fulfill body requirements. Fat-soluble vitamins: A, D, E, K Water-soluble vitamins: B complex, C