1. Chapter 7
Vitamins

2. Objectives Of the 13 vitamins discussed:
State one or more functions of each vitamin
Identify at least two food sources of each vitamin
Identify some symptoms of or diseases caused by vitamin deficiencies

3. Facts Organic (carbon-containing) compounds
Essential in small amounts for body processes
Do not provide energy
Enable body to use energy provided by fats, CHO, and proteins
Megadoses can be toxic

4. Thirteen Vitamin Types
Four fat-soluble:
Vitamin A
Vitamin D
Vitamin E
Vitamin K
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5. Thirteen Vitamin Types
Nine water-soluble:
Vitamin B complex, including the following:
Thiamine (B1), riboflavin (B2), niacin, vitamin B6, folate, vitamin B12 (cobalamin), pantothenic acid, and biotin
Vitamin C

6. Requirements
Vitamin allowances given by weight in mg or micrograms (mcg or g)
DRIs have replaced RDAs
Tolerable upper limits (UL)
Maximum level of daily intake unlikely to cause adverse effects

7. 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

8. Deficiency of Fat-Soluble Vitamins
Chronic malabsorption diseases:
Cystic fibrosis
Celiac disease
Crohn’s disease

9. Stop and Share
Match the following terms with their correct definition:
1. Avitaminosis
A. Concentrated form of vitamins
2. Hypervitaminosis
B. Without vitamins
3. Vitamin supplement
C. Condition caused by ingestion of excess vitamins
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10. Stop and Share
Answers:
1  B
2  C
3  A

11. Preserving Vitamin Content in Food
Buy fresh, unbruised vegetables and fruits
Use them raw when possible
Prepare fresh vegetables and fruits just before serving
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12. Preserving Vitamin Content in Food
Heat canned vegetables quickly and in their own liquid
Follow package directions when cooking frozen vegetables or fruit

13. Avoiding Vitamin Loss Steam or use as little water as possible
Cover pan and cook vegetables until bright in color and crisp-tender
Save any cooking liquid for soups, stews, and gravy
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14. Avoiding Vitamin Loss Store fruits and vegetables in cool, dark place
Microwave produce in 1 to 2 tablespoons (tbsp) of water

15. Fat-Soluble Vitamins Vitamin A, vitamin D, vitamin E, and vitamin K
Not lost easily in cooking
Lost when mineral oil ingested
Excess amounts stored in liver
Deficiencies slow to appear

16. Vitamin A Preformed Provitamin A carotenoids Retinol
Active form of vitamin A
Provitamin A carotenoids
Beta carotene, lutein, lycopene, and zeaxanthin
Inactive form of vitamin A found in plants
Converted to retinol

17. Functions of Vitamin A Maintains healthy eyes and skin
Maintains normal bone growth and reproduction
Sustains healthy immune system
Has antioxidants that protect cells from free radicals

18. Sources of Vitamin A Preformed vitamin A (retinol): Beta carotene:
Fat-containing animal foods
Liver, butter, cream, whole milk, cheese, and egg yolk
Beta carotene:
Carrots, sweet potatoes, spinach, broccoli, pumpkin, squash, mango, and cantaloupe

19. Vitamin A Requirements
Commonly listed as retinol equivalents (RE)
1 g retinol or 6 g beta carotene

20. Stop and Share Consider the following questions:
What are the signs and symptoms you would expect to observe with too much vitamin A?
What are the signs and symptoms you would expect to observe with too little vitamin A?
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21. Stop and Share Excess Deficit Birth defects Hair loss Dry skin
Headaches
Nausea
Dry mucous membranes
Liver damage
Bone and joint pain
Deficit
Night blindness
Dry, rough skin
Increased susceptibility to infections
Blindness or xerophthalmia

22. Vitamin D Prohormone D2 D3 Values given in mcg or International Units
Converted to hormone in body D2
Ergocalciferol
Formed in plants D3
Cholecalciferol
Formed in humans from cholesterol in skin
Values given in mcg or International Units

23. Functions of Vitamin D Promotes calcium and phosphorus absorption
Building and maintenance of normal bones and teeth
Prevention of tetany

24. Sources of Vitamin D Sunlight Food sources:
Changes provitamin to vitamin D3
People with little sun exposure must get sufficient intake from diet
Food sources:
Milk, fish liver oils, egg yolk, butter, and fortified margarine
Most milk in U.S. has 10 g vitamin D concentrate added per quart

25. Stop and Share Consider the following questions:
What are the signs and symptoms you would expect to observe with too much vitamin D?
What are the signs and symptoms you would expect to observe with too little vitamin D?
(continues)

26. Stop and Share Excess Deficit
Deposits of calcium and phosphorus in soft tissues
Kidney and heart damage
Bone fragility
Deficit
Poor bone and tooth formation
Rickets
Causes malformed bones and pain in infants
Osteomalacia
Soft bones
Osteoporosis
Brittle, porous bones

27. Vitamin E Tocopherols Tocotrienols
Alpha
Most biologically active
Beta, delta, and gamma
Tocotrienols
Given as -TE (alpha-tocopherol equivalents)
1 mg of -TE = 1 International Unit

28. Functions of Vitamin E Serves as antioxidant
Prevents hemolytic anemia among premature infants
Enhances immune system
Retards spoilage of commercial foods

29. Sources of Vitamin E Vegetable oils:
Corn, soybean, safflower, cottonseed, and products made from them
E.g., margarine
Wheat germ, nuts, and green leafy vegetables
U.S. diet typically contains sufficient amount

30. Stop and Share Consider the following questions:
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?
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31. Stop and Share Excess Deficit Relatively nontoxic, fat-soluble vitamin
Stored in adipose tissue
Avoid long-term megadoses
Deficit
Serious neurological defects can occur from malabsorption

32. Vitamin K Made up of several compounds essential to blood clotting
Phylloquinone
Vitamin K2
Menaquinone
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33. Vitamin K Synthetic vitamin K Destroyed by light and alkalies
Menadione
Destroyed by light and alkalies
Must be ingested daily
Measured in mcg

34. Functions of Vitamin K Forms prothrombin for blood clotting
Candidates likely to receive vitamin K:
Newborns immediately after birth
Clients with faulty fat absorption
People who have had extensive antibiotic therapy
People who need antidote for overdose of anticoagulant or treatment of hemorrhage

35. Sources of Vitamin K Green leafy vegetables
E.g., broccoli, cabbage, spinach, kale
Dairy products, cow’s milk, eggs, meats, fruits, and cereals
Bacteria in small intestine synthesizes some, but must be supplemented by dietary sources

36. Stop and Share Consider the following questions:
What are the signs and symptoms you would expect to observe with too much vitamin K?
What are the signs and symptoms you would expect to observe with too little vitamin K?
(continues)

37. Stop and Share Excess Deficit Anemia Defective blood coagulation
From synthetic form
Deficit
Defective blood coagulation
Increases clotting time
Makes client prone to hemorrhage

38. Water-Soluble Vitamins
Vitamin B complex and vitamin C
Dissolve in water
Easily destroyed by air, light, and cooking

39. Vitamin B Complex: Thiamine (B1)
Essential for the following:
Nerve and muscle action
Metabolism of carbohydrates and some amino acids
Sources:
Unrefined and enriched cereals, whole grains, lean pork, liver, seeds, nuts, and legumes
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40. Vitamin B Complex: Thiamine (B1)
Deficiency rare
Symptoms:
Loss of appetite, fatigue, nervous irritability, and constipation
Beriberi
Disease caused by extreme deficiency

41. Vitamin B Complex: Riboflavin (B2)
Necessary for the following:
Metabolism of carbohydrates, protein, and fats
Tissue maintenance
Especially skin around mouth
Healthy eyes
Sources:
Milk, meats, poultry, fish, enriched breads, cereals, broccoli, spinach, and asparagus
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42. Vitamin B Complex: Riboflavin (B2)
Deficiency symptoms:
Cheilosis
Sores on lips and cracks at corners of mouth
Glossitis
Inflammation of tongue
Dermatitis
Eye strain
Itching, burning, and eye fatigue

43. Vitamin B Complex: Niacin
Generic name for nicotinic acid and nicotinamide
Coenzyme in energy metabolism
Sources:
Meats, poultry, fish, peanuts, and legumes
Sources of tryptophan, precursor of niacin:
Milk and eggs
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44. Vitamin B Complex: Niacin
Measured in niacin equivalents (NE)
Excessive amounts can cause flushing
Due to vascular dilation, gastrointestinal problems, itching, and liver damage
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45. Vitamin B Complex: Niacin
May be used as cholesterol-lowering agent under close supervision of physician
Due to adverse side effects:
Liver damage
Peptic ulcers
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46. Vitamin B Complex: Niacin
Deficiency symptoms:
Weakness, anorexia, indigestion, anxiety, and irritability
Pellagra
Disease caused by extreme deficiency
Symptoms:
Sores on skin, diarrhea, anxiety, confusion, irritability, poor memory, dizziness, and untimely death

47. Vitamin B Complex: B6 Pyridoxine, pyridoxal, and pyridoxamine
Essential for the following:
Protein metabolism and absorption
Aiding release of glucose from glycogen
Catalyst in conversion of tryptophan to niacin
Helps synthesize neurotransmitters
E.g., serotonin, dopamine
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48. Vitamin B Complex: B6 Sources: Measured in mg Deficiency symptoms:
Poultry, fish, liver, kidney, potatoes, bananas, spinach, and unrefined whole grains (oats and wheat)
Measured in mg
Deficiency symptoms:
Irritability, depression, and dermatitis
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49. Vitamin B Complex: B6
Deficiency in infants can cause various neurological symptoms and abdominal problems
Toxicity rare
May cause temporary neurological problems

50. Vitamin B Complex: B12 Cobalamin Involved in the following:
Contains mineral cobalt
Involved in the following:
Folate metabolism
Maintenance of myelin sheath
Preservation of healthy RBCs
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51. Vitamin B Complex: B12
To be absorbed, must bind with intrinsic factor in stomach
Sources:
Animal foods
Especially organ meats, lean meats, seafood, eggs, and dairy products
Increased need during pregnancy and lactation
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52. Vitamin B Complex: B12 Deficiency rare
May be due to congenital problems of absorption or years of vegetarian diet with no animal foods
Symptoms:
Megaloblastic anemia, pernicious anemia (if intrinsic factor absent), anorexia, glossitis, sore mouth, tongue, pallor, depression, dizziness, and weight loss

53. Vitamin B Complex: Folate
Folate, folacin, and folic acid
Chemically similar compounds
Names used interchangeably
Necessary for the following:
Deoxyribonucleic acid (DNA) synthesis
Protein metabolism
Formation of hemoglobin
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54. Vitamin B Complex: Folate
Sources:
Cereals fortified with folate, green leafy vegetables, legumes, sunflower seeds, and fruits (e.g., oranges, strawberries)
Measured in mcg
Average adult requires 400 g per day
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55. Vitamin B Complex: Folate
One month before conception through first six weeks of pregnancy requires 600 g per day
Excess can mask vitamin B12 deficiency and inactivate phenytoin
Anticonvulsant drug used by epileptics
Important role in some cancer prevention
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56. Vitamin B Complex: Folate
Deficiency linked to neural tube defects in fetus:
Spina bifida
Spinal cord or spinal fluid bulge through back
Anencephaly
Absence of brain
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57. Vitamin B Complex: Folate
Other deficiency symptoms:
Inflammation of mouth and tongue, poor growth, depression and mental confusion, problems with nerve functions, and megaloblastic anemia

58. Vitamin B Complex: Biotin
Coenzyme in synthesis of fatty acids and amino acids
Sources:
Egg yolks, milk, poultry, fish, broccoli, spinach, and cauliflower
Also synthesized in intestine by micro-organisms
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59. Vitamin B Complex: Biotin
Toxicity from excess unknown
Deficiency symptoms:
Nausea, anorexia, depression, pallor, dermatitis, and increase in serum cholesterol

60. Vitamin B Complex: Pantothenic Acid
Involved in metabolism of carbohydrates, fats, and proteins
Essential for the following:
Synthesis of neurotransmitter acetylcholine
Synthesis of steroid hormones
Sources:
Meats, poultry, fish, eggs, whole-grain cereals, and legumes
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61. Vitamin B Complex: Pantothenic Acid
Considered synthesized by body
Toxicity from excess unknown
Natural deficiencies unknown
Deficiencies produced experimentally
Symptoms include weakness, fatigue, burning sensation in feet

62. Vitamin C: Ascorbic Acid
Antioxidant properties
Protects food from oxidation
Role in formation of collagen and absorption of nonheme iron
Prevents scurvy
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63. Vitamin C: Ascorbic Acid
May be involved with formation or functioning of norepinephrine, some amino acids, folate, leukocytes, immune system, and allergic reactions
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64. Vitamin C: Ascorbic Acid
Sources:
Citrus fruits, melons, strawberries, tomatoes, potatoes, red and green peppers, cabbage, and broccoli
Stress and cigarette smoking increase need

65. Stop and Share Consider the following questions:
What disease results from a deficiency in vitamin C?
What are the associated signs and/or symptoms?
What results from an excess of vitamin C?
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66. Stop and Share
Scurvy
Disease characterized by gingivitis, easy bruising, pinpoint hemorrhages of skin, poor wound healing, sore joints and muscles, and weight loss
Extreme cases result in death
Found in sailors who have lived without fresh fruits and vegetables
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67. Stop and Share Excess Deficit Diarrhea Nausea Cramps
Excessive absorption of food iron
Deficit
Bleeding gums
Loose teeth
Tendency to bruise easily
Poor wound healing
Scurvy
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68. Stop and Share Excess Rebound scurvy (when megadoses abruptly stopped)
Possibly oxalate kidney stones
Generally considered nontoxic

69. Vitamin Supplementation
Balanced diet provides nutritional needs of healthy people
No amount of vitamins will build muscles
Vitamins do not provide energy
Help release energy provided by nutrients
Supplements should not exceed 100 percent of DRI for each vitamin

70. Conclusion
Vitamins:
Organic compounds that regulate body functions and promote growth
Each has specific function
Well-balanced diet provides sufficient vitamins to fulfill body requirements
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71. Conclusion Fat-soluble vitamins: Water-soluble vitamins:
Vitamin A, vitamin D, vitamin E, and vitamin K
Water-soluble vitamins:
Vitamin B complex and vitamin C