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CHAPTER 7 VITAMINS Vitamin: - is a component of all natural foods - are organic compounds - essential for: Growth Reproduction & The maintenances of health - NON-CALORIC - Needed in minute quantity - Lack of it in the diet results in specific deficiency symptoms that are relieved by its additional to the diet. Some vitamins occur in food in a form known as “precursor” or “provitamins.” IMPORTANT PRECURSORS, PROVITAMINS Compounds that can be converted into active vitamins, are called provitamins or precursors - The term “Vitamin” was coined in 1912 by Polish Biochemist Casmir Funk. Originally used word “VITAMINE” to refer to substances that are “AMINE” and are “VITAL” to life (VITAL-AMINE) Today we know vitamins are vital for life but they are not all amines so “e” has been removed Initially, the vitamins were named alphabetically in approximately in the same order in which they were identified such as A ,B, C, D and E. He B-Vitamins were first thought to be one chemical substance VITAMINS FALLS INTO TWO GROUPS Vitamins have traditionally been grouped based on their solubility in water or fat Water soluble vitamins include: The B-Vitamins and Vitamin C Fat soluble vitamin include Vitamin A Vitamin d Vitamin E and Vitamin K Solubility determines how they are - Absorbed - Transported by the bloodstream - Stored - How they are lost from the body FAT SOLUBLE VITAMINS - Dissolve in lipids - Are stored in liver& with other lipids in the body - Can build up to toxic level - Absorbed into the lymph & travel in the blood in association with protein carriers WATER SOLUBLE VITAMINS - Dissolve in water - Easily absorbed & excreted - Not stored extensively in tissues - Seldom reach toxic levels VITAMINS IN DIET - Almost all foods contain some vitamins for example: o Grains provide thiamin, niacin, riboflavin, biotin etc o Meat and fish provide all of B-vitamin including B12 o Milk provide riboflavin and vitamin A and D o Leafy Greens provide folate, vitamin A, E and K o Citrus fruits provide Vitamin C - Vitamin content of the food can be affected by: Cooking Exposure to light and Oxygen Storage and Processing - The Vitamins naturally found in foods can be washed away during prepararion or destroy by cooking Important FORTIFICATION: The added nutrients may or may not nave been present in the original food Food that are staples, are often fortified to prevent deficiencies and promote health Example: Milk fortified with Vitamin D ENRICHMENT: Is a type of fortification in which nutrients are added for the purpose of restoring those lost in processing to the same or higher level than original foods. Vitamins in the Body - Vitamins promote and regulate body functions - For Instance: o Vitamin C – Essential for the synthesis of neurotransmitters hormones and Connective tissues o Vitamin – Antioxidant o Vitamin A – need for vision, gene expression and cell maturation o o o Vitamin D – Bone formation Vitamin K – Blood clotting B-Vitamins – Act as coenzyme in the metabolism of Carbohydrates, lipids and proteins Delivering Vitamins to Cells - Once absorbed, vitamin must be transported to the cells - Despite their solubility in water most of the water-soluble vitamins bound to blood proteins for transport - Fat-soluble vitamins must be incorporated into lipoproteins or bound to transport proteins, for example: Vitamin A, D, E and K all incorporated into Chylomicrons in small intestinal cells. Excretion of the Vitamins - the ability to store and excrete vitamins helps to regulate the amount present in the body - With the exception of Vitamin B12, the water-soluble vitamins are easily excreted - They are not stored in great extent, so supplies of water-soluble vitamins are rapidly depleted - However, it takes few days to develop deficiency symptoms, even when these vitamins completely eliminated from the diet. - Fat-soluble vitamins are stored in the liver and fatty tissues, and cannot be excreted on the urine - Because they are stored to a larger extent, it takes longer to develop a deficiency of fat-soluble vitamins. The Water Soluble Vitamins - B- Vitamins and vitamin C dissolve in water easily absorbed and excreted not stored extensively seldom reach toxic levels cooking and washing can leach then out of foods food never deliver toxic doses large of vitamin supplements can reach toxic levels The B- Vitamins Thiamin B1 Riboflavin B2 Niacin Folate Pyridoxine B6 B12 Biotin Pantothentic Acid Coenzyme (important) A small molecule that works with an enzyme to promote that enzyme activity. The B Vitamins Act as part of Coenzymes Help the body Metabolize Carbohydrates, Lipids and protein. - Five of the B- vitamins B1, B2, Niacin, Pantothentic acid, and Biotin help releasing energy from Carbohydrates, Lipids and Proteins. B6- Protein syntheses Folate and B12- cell multiplication i.e. blood cells, digestive tract B-VITAMIN DEFICIENCES - As long as B-vitamins are present their presence is not felt - When they are missing, their absence manifest itself in a lack of energy and a multitude of other symptoms - B-Vitamins facilitate energy release in every cell - Thus, in a B-vitamin deficiency, every cell is effected - Cell renewal depends on energy and protein which in turn depend on B-Vitamins - In general, single B-Vitamin deficiency never occur Thiamin and Riboflavin - Thiamin (B1) plays critical role in the energy metabolism of all cells o Very vital role in maintaining NERVOUS SYSTEM Nerve processes and their responding tissues, such as the muscles depends heavily on B1 vitamin The classic thiamin- deficiency disease “beriberi.” - Also involve in the production of sugar “RIBOSE” - May be destroyed by: Heat Oxygen Light & Acid Conditions - Also affected by Anti-Thiamin factors in Raw Fish & Shell fish B vitamin Deficiencies The deficiency of thiamin affects: - NERVES - MUSCLES - HEART & - OTHER VITAL ORGANS - A SEVER DEFICIENCY DISEASE IS CALLED “BARIBARI” CAUSES: o Extreme Loss of Muscles o Swelling all over the body o Enlargement of heart o Irregular heart beat o Paralysis and o Death - Alcohol – impairs absorption Excrete in urine B1- sources and Recommendations DRI 1.2mg/day men 1.1 mg/day women sources - All notorious food - Liver - Whole grains - Legumes - Nuts - Fruits B2- Riboflavin - Also act as Coenzyme in energy released reactions - Also helps to prepare - Fatty Acid & - Amino Acids for breakdown - Can be destroyed by UV Light or Fluorescent light Part of coenzyme used in energy metabolism, support normal vision and skin health Deficiency symptoms Mostly undetected because B1 deficiency symptoms are more severe. - Rare - Crack at corners of mouth - Sore throat - Hypersensitivity to light - Reddening of cornea - Skin rash B2- Sources Same as B1 - Milk, milk products - Meat - Liver - Leafy green vegetable - Whole grain Riboflavin destroyed by exposure to light, therefore, milk is stored in cloudy plastic containers Niacin (B3) Nicotinic Acid, Nicotinamind and Niacinamide Like B1 & B2- Niacin participates in the energy metabolism of every body cell. As coenzyme - Niacin deficiency disease “pellagra” appeared in Europe in 1700 when corn become a staple food - Cure is niacin - Amino acid tryptophan - Well fed people never get “pellagra” NIACIN IN THE BODY - Niacin is important in the production of energy as well as in reactions that synthesize other molecules Niacin Deficiency Symptoms - Diarrhea ] - Dermatitis ] - Dementia ] - Death ] “4D Disease” - Abdominal pain - Black or bright red swollen smooth tongue - Weakness - Dizziness - Flaky skin rash on area exposed to sun “4ds” diarrhea, dermatitis, dementia and death Niacin Sources - Tryptophan—60 mg Tryptophan = 1 mg Niacin - Milk - Egg - Meat - Poultry - Fish - Whole grain - Nuts Toxicity Nausea, vomiting, painful flush and rush, sweating Liver damage, impaired glucose tolerance Vitamin B6 INVOLVE IN: - Protein Metabolism. Tryptophan = Niacin Ammonia Urea Synthesis of Neurotransmitters Synthesis of hemoglobin Synthesis of non-essential amino acids Maintaining immune function Also critical in the development of brain & nervous system of a fetus A person’ s requirement of Vitamin B6 is proportion to protein intakes VITAMIN B6 AND HEALTH B6 Deficiency symptoms - weakness -depression -confusion -irritability -insomnia -anemia -greasy dermatitis – numbness & tingling -convulsions - may weaken immune system - heart disease - Seizures - Deficiency cause Neurological symptoms such as o Depression, o Headache o Confusion o Numbness and Tingling of fingers n toes o Seizers - These may be related to the role of Vitamin B6 in Neurotransmitter synthesis - Anemia occur due to impaired Hemoglobin synthesis - RBC are small and pale due to lack of Hemoglobin - Since Vitamin B6 is needed for amino acid metabolism, the onset of deficiency can be hastened by a diet that is low in B6 but high in protein Vitamin B6 and CVD - Vitamin B6 reduces the risk of heart disease through its role in the breakdown of Homocysteine - Large doses of Vitamin B6 (100-1000mg/day) have been successfully used to reduces elevated Homocysteine - It has been proposed that a deficiency of: Vitamin B6 Vitamin B12 and Folate May cause Homocysteine accumulation VITAMIN B6 SUPPLEMENTATIONS - Vitamin B6 supplements are marketed to help a wide variety of ailments such as: Carpal Tunnel Syndrome Premenstrual Syndrome (PMS) Poor immune Function - Some of these claims are found in science others are exaggerated - Carpal Tunnel Syndrome- No treatment - Premenstrual Syndrome causes: Mood swing Food craving Tension Depression Headaches Breast tenderness Anxiety Temper Out Burst and over 100 other symptoms Vitamin B6 is needed for Neurotransmitters Serotinin and Dopamine Decrease of serotinin and dopamine levels are associated with PMS B6 Toxicity B6- can be toxic Tolerable upper intake level 100 mg/day Requirement Roughly proportional to protein intake. DV 2mg/day Sources Meat, fish, and poultry potatoes, leafy green vegetables. fruits Folate Come from word Foliage - Folate and Vitamin B12 have overlapping role in the synthesis of DNA, which is requires for cells division - Therefore, some of the same symptoms are seen in sever deficiency of either Vitamin (folate and vitamin B12)--- most notably is ANEMIA - Developing Red Blood Cells cannot divide - To make new cells, tissue must have the vitamin folate. - Act as a part of a coenzyme important in the manufacture of new cell - Most vulnerable cells are RBC, WBC, and Digestive tract Deficiency Folate easily lost when foods are overcooked, canned, dehydrated or otherwise processed. - Anemia - diminished immunity - Cervical cancer - Colon cancer - Abnormal digestive functions -Neutral tube defects Folate and Anemia - In U.S, folate- deficiency anemia is common – but that is due to B12 malabsorption Anemia results when Folate in deficient Bone marrow cells that develop into blood cells cannot duplicate their DNA and so cannot divide Instead, they just grow bigger\these large immature cells are known as MAGALOBLASTS and can be converted into large RBC called MACROCYTES That caused fewer mature RBC It is called Megaloblastic or Macrocytic Anemia Folate and B12 work as teammates Folate deficiency may also increase chances of o CVD o Colon cancer o Cervical cancer in women DRI for women of childbearing age to consume 400 mg/ day in addition to that occurs in food Folate deficiency cause group of devastating birth defects as “neutral tube defects” - effects on thousands of births in U.S each year. Neural Tube Defect Ranges From - slight problems in the Spine - mental retardation - severely diminished brain size - death shortly after birth - It arise in the first few days or weeks of pregnancy, long before most women suspect that they are pregnant. - 3000 infants born in the US each year with neural tube defect. FOLATE AND HEART DISEASE - Folate’s effect on heart disease risk is related to its role in the metabolism of amino acid Methionine. When Folate is lacking, Homocysteine produced during methionine metabolism accumulated The risk of CVD increases with elevated Homocysteine Homocysteine levels and risk of CDV are reduced by increase intake of Folate Folate – Foliage - Leafy green vegetables i.e. spinach - Fresh, uncooked veg and fruits - Eggs - Orange juice and legumes also contain folate but less available - Tolerable upper intake level of synthetic folic acid 100mg/day - Dietary folate equivalent (DFE)=mg food+ (1.7mg synthetic folate) Folate Interact with Medication Ten major groups - Antacid - Aspirin - Oral conceptive - Anticonvulsant Cynocobalamine Vitamin B12 - unique vitamin - found exclusive in animal products - can be made by bacteria & fungi, but not by plant - Diet that do not include animal products, must include supplement. B12 and folate- depend on each other for activation - B12 maintain the sheaths that protect nerve fibers - Also help folate to do its blood building work - Involve in DNA synthesis - Pernicious anemia - Large, immature RBC - Creeping paralysis - Malfunction of nerves and muscles - high dose of folate often clear up blood conditions but other B12 deficiencies continue undetected - B12 absorption require an “intrinsic factor” - A compound made in stomach - Stomach acid liberate B12 - Attach with intrinsic B12 - Attach with intrinsic factor - Absorb through S. intestine - Some people have inherited defect - Diagnosing B12 problems is difficult - Body store up to 6 yrs worth of vitamin B12 Sources Animal products -meat, fish, poultry milk, cheese, eggs synthesize only by microorganism. - Biotin Act as Coenzyme Biotin requires for: o Cell Growth o DNA Synthesis o Fat Synthesis o Energy Metabolism o Amino Acid metabolism o Glycogen Synthesis - Biotin was discovered when rats fed protein derived from raw egg white Rats developed a syndrome of : o Hair loss o Dermatitis and o Neuromuscular dysfunction - those symptoms were caused by protein “ADVIN” that present in raw egg white and tightly bind biotin and prevent its absorption. Biotin in the Diet - Good sources of biotin include: Liver Egg Yolk Yogurt and Nuts `- Fruits and meat are poor sources of Biotin. How much Biotin do we need - It is difficult to estimate biotin requirements - Because some Biotin is produced by bacteria - No RDA but AI of 30 micro grams per day has been established for adult men and women Biotin in the Body Is a cofactor for several enzymes use in: - energy metabolism - fat synthesis - amino acid metabolism - glycogen synthesis Deficiency symptoms - abnormal heart action - loss of appetite, nausea weakness, depression, dry around eyes, nose and mouth Pantothenic Acid - as Coenzyme involve in energy metabolism Also help: o Maintain Blood glucose o Synthesis of Lipids Steroid Hormones Hemoglobin - Got its name from Greek word pantos meaning “ From Everywhere” - Is widely distributed in foods - Particularly abundant in: Meat Egg Whole grains and Legumes o Lesser amount in : Milk Vegetables and Fruits - No RDA but and AI of 5 mg/day has been recommended Pantotenic Acid in Body Is a component of a key coenzyme that makes possible release of energy from nutrients - also help synthesis of lipids, neurotransmitters steroid hormones hemoglobin Deficiency Symptoms Vomiting, insomnia, fatigue hypoglycemia, sensitivity to insulin. - - Vitamin C Known as Ascorbic Acid or Ascorbate Ascorbic Acid- “no- scurvy Acid” Act as Antioxidant Help maintain immune system Also help in absorption of iron Help specific enzymes perform their job__ Such as, enzymes involved in formation and maintenance of, tissue protein, collagen. Involve in release of stress hormone. also act as cofactor in the production of carnitine protect and recycle vitamin E In times of stress, the body does use more vitamin C than usual because of vitamin is involve in the release of stress hormone- but that is usually very small and that requirement can be met easily by food. Reactions Requiring Vitamin C Connective Tissue: - Vitamin C require in reactions where (OH) hydroxyl group is added to other molecules - Two such reactions are essential for the formation of Collagen, the protein that forms the base of all connective tissues Vitamin C also serves in reactions needed for the synthesis of other cell compounds including: o Neurotransmitters o Hormones such as Thyroids and Steroid Hormones o Bile acids and o Carnitine ( needed for fatty acid synthesis) Vitamin C as a General Antioxidant - Vitamin C also function as an antioxidant o Oxidative stress refers to a serious imbalance between the amount of reactive Oxygen molecules and the amounts of antioxidant defenses available - Oxidative stress has been related to: Aging process Development of cancer and Heart diseases Vitamin C, Vitamin E, carotenoids and mineral selenium help to fight free radicals The Role of Vitamin C: - Vitamin C acts as an antioxidant in the blood and other body fluids - It can destroy Superoxide Redicals and Free Radicals before they can damage Lipids and DNA - Vitamin C has also been shown to scavenge reactive oxygen molecules in WBC The Lungs The Stomach Mucosa - It also regenerates the active antioxidant form of Vitamin E Vitamin C requirement DRI for men 90 mg women 75 mg Smoker and “passive smoker” Need higher amount 125 mg/ man 110 mg/women Deficiency symptoms Anemia, pinpoint hemorrhages frequent infections, bleeding gums, loosen teeth, hysteria bone fragility, joint pain failure of wounds to heal. - When Vitamin C intake is below 10mg/day the symptoms of SCURVY may appear. These symptoms reflect the role of Vitamin C in the maintenance of collagen and blood vessel integrity - Without vitamin C, bond holding collagen molecules can not be formed and maintained - Resulting in poor wound healing - Reopening of previously healed wounds - Bone and joint aches - Bone fractures - Improperly formed and loose teeth - Due to weakened blood vessels ruptured capillaries: o Small skin discoloration appears o The gums bleed and o Bruising occurs easily - Anemia may occur from impaired iron absorption The Psychological manifestations of Scurvy include depression and hysteria High vitamin C Doses and Toxicity - Generally considered nontoxic - Percentage of dose absorbed decreases as the size of the dose increases - Besides, Vitamin c absorbed in excess of need is excreted by the kidney - Most common symptoms with doses of 1 gram or more are: Diarrhea Nausea and Abdominal cramps - These are caused when unabsorbed Vitamin C draws water into the intestine - Another concern with Vitamin c supplements is damage to tooth enamel - Vitamin C is an Acid that is strong enough to dissolve tooth enamel - High intake of Vitamin C should be avoided by individuals: Prone to kidney stones Who are unable to regulate iron absorption Those with sikle-cell anemia - insulin response - kidney stone - alter acid/ base balance - interfere in Vitamin E actions Vitamin C Supplements - 1/3 U.S population take Vitamin C supplement in hope to prevent Common cold or As an antioxidant Vitamin C and Common Cold - Vitamin C do not reduce the incidence of Cold - But do cause a reduction in duration and severity of cold symptoms - The effect of vitamin C on cold symptoms may be due to: o Its direct antiviral effect o Its antioxidant effect o Its role in immune system or o Its ability to increase breakdown of Histamine Vitamin C and CVD - Vitamin C supplements have been suggested to reduce the risk of CVD by: o Reducing Blood pressure o Reducing Blood cholesterol o Protecting LDL from Oxidation The Need For Vitamin C - Adult DRI for Men 90 mg Women 75 mg o For cigarette smokers Men 125 mg Women 110 mg Vitamin Sources - citrus fruits - Cabbage type veg. - dark green veg. - cantaloupe - strawberries - pepper - lettuce - tomatoes - potatoes - mangoes FREE RADICAL - Is a molecule with one or more unpaired electrons - An electron without a partner is unstable and highly reactive - To regain stability, free radical finds a stable but vulnerable compound from which to steel an electron - With the loss of an electron formerly stable molecules become a “FREE RADICAL” itself - And steals an electron from some other nearby molecule - Setting off an electron snatching chain reaction - Free radicals are like spark - Starting wildfires that leads to widespread damage by Oxidative Stress - Free-radical damage commonly disrupts unsaturated fatty acids in cell membranes - Damaging the membranes ability to transport substances into or out of cell - Free-radicals also cause damage to cell proteins and DNA - And disrupting all cells that inherit the damaged DNA - More than 200 diseases are linked with oxidative stress among them are: Age related blindness Arthritis Cancers CVD Cataracts Kidney diseases and Other complications of diabetes The Body’s Defenses against Free Radicals - Two main systems o Reserves of Antioxidants o Enzyme Systems - These are not 100% efficient o If insufficient Radical-Fighting Agents are present o If Free-Radicals become excessive or o The body repair systems cannot undo all of the damage Serious health problems can develops - Antioxidant Nutrients Vitamin E & C actively scavenge & destroy free radicals in body Once oxidized, some vitamin E & C can be reactivated as antioxidants again, some are discarded Supplies of dietary antioxidants must be replenished as rapidly as they are used up. Vitamin E defends lipids in cell membrane Vitamin C neutralize free radicals from polluted air o Also restore vitamin E to active form FAT SOLUBLE VITAMINS VITAMIN A - First fat- soluble vitamin to be recognized - Still very much a focus of research - Vitamin A found in two forms IN PLANTS AS CAROTENOIDS –(inactive or precursors) IN ANIMALS AS RETINOIDS – (active or preformed) Retinol—involve in reproduction, Bone formation and store in Livers Retinal—involve in night and color vision Retionic Acid—involve in cell growth and cell differentiation - Retinol store in liver - Cells converts retinol into other two forms as needed - 90% vitamin A store in the liver. - PREFOREMD are found in animal food such as: Liver Fish Egg yolk and Dairy products - PROVITAMINS are found in plant food o About 50 out of 600 carotenoids provide some levels of vitamin A activity o Beta-carotene is the most potent precursor o It found plentiful on Carrots, squash, leafy greens and other red and yellow vegetables and fruits Vitamin A in the Digestive Tract - Both RETINOIDS and CAROTENOIDS are bound to proteins in food - To be absorbed, PEPSIN and other protein digesting Enzymes must release them from protein. - Than released carotenoids and retinoids must combine with bile acids - That facilitate their diffusion into mucosal cells - Absorption of PREFORMED vitamin A is efficient (70% to 90%) - CAROTENOIDS are less well absorbed and absorption decreases as intake increases. - Once inside mucosal cell, much of the Beta-carotene in converted to RETINAL and than RETINOL - Insufficient fat intake (less than 10g/day) can reduce Vitamin A absorption - Diseases that cause fat malabsorption can also interfere with Vitamin A absorption Vitamin A in the Body - RETINOIDS and carotenoids are transported from the intestine in CHYLOMICRONS - These Lipoproteins deliver retinoids and carotenoids to the tissues. - In Liver some CARODINOIDS can be converted in to RETINOL - To move from liver store to the tissues vitamin A must be bound to Retinol_Binding Proteins - Different forms of Vitamin A have different function - Retinol and retinal can be inter-converted - RETINAL is the form that is important fro vision - Retinoic Acid important in gene expression and cell differentiation, growth and reproduction - Carotenoids, that are not converted in to Retinoids may act as Antioxidants or provide other biological functions ROLE OF VITAMIN A Versatile vitamin role in: - Vision - Cell differentiation - Cell maturation - Immune system o T-Cells - o Epithelial Layers Maintenance of body linings & skin Bone Normal growth Reproduction Normal development of fetus Production of sperms Hearing Taste MOST FAMILIAR FUNCTION IS IN EYE SIGHT Vitamin a play indispensable role in roles in two areas - In the perception of light at the retina - Maintenance of a healthy & crystal clear outer window, the cornea Light pass through the cornea & strikes the cells retina, bleach many molecules of the pigments rhodopsin that lie with in those cells. - When bleach occurs, the vitamin. A broken off, initiating the signal that conveys the sensation of sight to the optic center in the brain. - Vitamin A reunites with the pigment Little vitamin. A destroyed each time Fresh vitamin. A is needed to replenish the supply If supply begins to run low, a lag occurs before eye can see again after a flesh or bright light at night called night blindness. In advance stage of deficiency a protein keratin accumulate at cornea called keratinization. If deficiency is not corrected it can worsen to xerosis. Then to thickening & permanent blindness called xerophthalomia. VITAMIN A IS ALCO NEEDED BY ALL EPITHELIAL TISSUES Skin & all the protective linings of: The lungs (respiratory tract) - Intestine (digestive tract) - Vagina - Urinary tract & - Bladder - Skin Vitamin A help Cell differentiation e.g. goblet cells Bones dismantling CELL DIFFERENTIATION The process by which immature cells are stimulated to mature and gain the ability to perform function characteristic of their cell type. Gained a reputation as an -“Anti-infective vitamin” - Emerging area of research concern the role of vitamin A in the regulation of the genes that produce proteins immunity. REGULATING GENE EXPRESSION AND CELL DIFFERENTIATION Cell differentiation is the process whereby immature cells change in structure and function to become specialized, for example: In bone marrow, some cells differentiate in to WBC, whereas other differentiate to form RBC. - Vitamin A affect cell differentiation through its effect on GENE EXPRESSION It means that it can turn on or off the production of certain proteins that regulate function within cells. MAINTENANCE OF EPITHELIAL TISSUES - Vitamin A is necessary for the maintenance of epithelial tissues - This type of tissue cover external body surfaces and linings of internal cavities and tubes such as: Skin Linings of eye Intestine Lungs Vagina and Bladder - When Vitamin A is deficient, epithelial cells do not differentiate normally - For example, the epithelial tissue of many body surfaces contain cells to produce mucus - When mucus-secreting cells die, new cells do not differentiate properly and instead become cells that produce a protein called KERATIN - Keratin is a hard protein that make up hair, finer nails etc - That make epithelial surface hard and dry - This process is known as KERATINIZATION - That increases the chances of infection - The risk of infection compounded by the fact that vitamin A deficiency also decrease immune function - All epithelial tissues are affected by Vitamin A deficiency but eyes are particularly susceptible to damage. - The mucus in the eye normally provides lubrication, washed away dirt and other particles, also help destroy bacteria When vitamin A is deficient, the lack of mucus and build up of Keratin cause Cornea to dry and leave the eye open to infection REPRODUCTION, GROWTH AND IMMUNITY - The ability to Vitamin A to regulate the growth and differentiation of cells make it essential through out life - In reproduction, Vitamin A is hypothesize to play a role during early embryonic development by directing cells to form the shapes and pattern needed - Poor overall growth is an early sign of Vitamin A deficiency in children - Vitamin A affects the activity of cell form and break bones - In immune system Vitamin A needed for the differentiation than produce different types of immune cells VITAMIN A DEFICIENCY About 10 million children suffer- sever vitamin A deficiency About 300 million suffer- milder deficiency SYMPTOMS - Anemia ( microcytic anemia) - Cessation of bone growth - Painful joints - Impaired enamel formation - Cracks in teeth - Changes in intestinal & other body linings - Night blindness - Keratinization, xerosis to xerophthalmia - Kidney stones, impaired growth - Frequent infections of respiratory, digestive system. - VITAMIN A TOXICITY Hair loss Stunted growth Joint pain Bone & muscle soreness Cessation of menstruation Nausea Diarrhea Rashes Abdominal pain Serious damage to the liver Pregnant women- 3-4 time caused malformation of the fetus Children- chewable vitamins as candy Adolescents- massive vitamin A dose is a mistaken belief- correct acne. Accutane- derived from vitamin A but chemically altered. - EARLIER SYMPTOMS OF VITAMIN A OVERDOSE Loss of appetite - Blurred vision Growth failure in children Headache Fever Itching of the skin Irritability VITAMIN A RECOMMENDATIONS Proportional to the body weight DRI- 900 ug man 700 ug woman Tolerable upper level 3000 ug BETA- CAROTENE 12 ug of B-Carotene =1 ug retinol B-Carotene—Non Toxic 24 ug other carotenoids =1 ug retinol RETINOL ACTIVEITY EQUIVALENTS (RAE) Measure of vitamin A activity of B-Carotene & other vitamin A precursors that reflects the amount of retinol that the body will derive from that precursors. SOURCES OF VITAMIN A Active vitamin A source - Liver - Fish oil - Milk & milk products - Butter - Egg & fortified cereals Vegetables & fruits contain vitamin A- Precursor B- Carotene i.e. Carrots, mango, apricots, spinach, etc. VITAMIN D Different from all other nutrients- Can be synthesized in body. Also known as SUN SHINE VITAMIN ROLE OF VITAMIN D - As a member of a large group of nutrients & hormones that interact to maintain blood Ca & P levels & bone integrity. Those including: o Vitamin C o Vitamin K o Hormones o Protein Collagen a the minerals Magnesium Fluoride - Many of these interactions take place at genetic level - Vitamin D is Indispensable for all body tissue, i.e. Muscles Nerves Glands ALSO PLAY ROLE IN THE WORKING OF: - Brain - Heart - Pancreas - Skin - Reproductive organs - Cell maturation - Immune system VITAMIN D FUNCTIONS AS A HORMONE: - Act on bones - Intestine & - Kidney Only a few foods are natural source of Vitamin D - Liver - Fatty Fish such as Salmon - Egg Yolk These food contain Vitamin D3, same type as made in our skin Foods like milk and margarine are fortified with vitamin D3 or Vitamin D2 VITAMIN D IN THE BODY - Vitamin D from diet and from synthesis in the skin is “INACTIVE” - Liver and than kidney alter it chemically to make it ACTIVE - In Liver an Hydroxyl group (OH) is added to form 25-Hydroxy vitamin D3 - Than kidney add an other “OH” group to make ACTIVE form of Vitamin D3, called 1, 25 – dihydroxy Vitamin D3 - The principal function of vitamin D is to maintain normal blood level of Ca and P. - When blood Ca level drops too low the parathyroid gland releases Parathyroid Hormone (PHT) - PHT stimulate enzymes in the kidney to convert 25-Hydroxy Vitamin D3 to the ACTIVE form - Active Vitamin D regulate Ca and P balance by altering GENE EXPRESSION in cells at the intestine and bone - At the intestine, vitamin D increases the absorption of Ca and P - This occurs because Vitamin D increases the expression of GENE that code for intestinal calcium-transport-protein - At the bone. Vitamin D works with PHT to increase bone breakdown Vitamin D also acts with PHT to increase the amount of Ca retained by the kidney Vitamin D simultaneously act on: Small intestine Bones and Kidney VITAMIN D DEFICIENCY Any disease affecting either the liver or kidneys may upset vitamin D production and may lead to bone deterioration, RICKETS IN CHILDRENS: - Bowed legs - Knock knees - Beaded ribs - Protruding (pigeon) chest - Lax abdominal muscles Osteomalacia or adult rickets occurs in women with low Ca intake & little exposure to sun. - Repeated pregnancies & breast feeding FACTORS AFFECTING SUN EXPOSURE & VITAMIN D SYNTHESIS - Air pollution - City living- Tall buildings - Clothing - Homebound - Season - Time of day UV Rays of sun that promote vitamin D synthesis cannot penetrate: - Clouds - Smoke - Smog - Heavy clothing - Window glass - Sunscreens VITAMIN D OVERDOSE Most toxic of all vitamins chronic ingestion of excesses may be directly toxic to the bone, kidneys, brain, nerves, heart & arteries SYMTOMS: - Appetite loss - Nausea - Vomiting - Increase urination & thirst - Sever psychological depression - Kidney stone - VITAMIN D IF OVERDOSES CONTINUE Raises blood mineral level to dangerous level Ca deposit in soft tissues such as: o Heart o Blood vessels o Lungs o Kidneys VITAMIN D RECOMMENDATION 19- 50 years of age 5 ug 51- 70 years of age 10 ug 71> years of age 15 ug TOLERABLE UPPER INTAKE 50 ug in 2000 iu - SUMMARY VITAMIN D Raises mineral level in blood Ca & P. Bone formation & maintenance. Deficiency can cause ricket & osteomalacia. Most toxic of all vitamins. Sun exposure makes vitamin D in skin. VITAMIN D SOURCES - Sunlight Fortified milk 1c= 2.5 ug Salmon 3oz=4.3 ug Shrimp 3oz=3.0 ug Egg VITAMIN E Discovered 80 years ago in vegetable oils- Necessary for reproduction in rats. Named “Tocopherol” “Tokos” means “Off Spring” “Pherein” means “To Bear” Later on it was named vitamin E. - 4 tocopherol compounds have been identified- Each designated as alpha, beta, gamma & delta. Alpha- tocopherol is the standard of vitamin E activity in the body. DRI recommendations are based on Alpha- tocopherol In 1968 Vitamin E was officially recognized as an essential nutrient Vitamin E has been promoted as: A cure of infertility An anti-scar medication Defense against air pollution and A fountain of youth VITAMIN E IN DIET The majority of vitamin E in the diet comes from: - Vegetable Oils - Products such as: - Margarine - Salad dressing - Shortenings - Soybean, Corn and Safflower Oils ROLE OF VITAMIN E Act as an antioxidant - By being oxidized itself, it protects the PUFA and other vulnerable components of the cells. - Protects all the cells lipids & related compounds i.e. vitamin A. - Specially play vital role in tissues where cells are exposed to high oxygen concentration o Lungs o RBC o WBC etc. - VITAMIN E ALSO TAKE PARTS IN: Normal nerve development Normal immune system May also defend against heart disease. Also inhibit an enzyme that allows the buildup of Atherosclerotic plaque Increase the synthesis of enzyme needed to produce eicosinoides that help reduce blood pressure and reduce blood clot formation Also defend cells from damage by heavy metals, such as lead and mercury and toxins such as benzene Also protects against environmental pollutants such as OZONE RESEARCH HAS DISCREDITED ALL CLAIMS THAT VITAMINE IMPROVES - Athletic endurance & skill - Enhances sexual performance or - - Cures sexual dysfunction in males. VITAMIN E DEFICIENCY Vitamin E deficiency is rare in human Because: o It is wide spread o It is store in liver o Recycle Vitamin E deficiency in human occurs in premature babies Without vitamin E infants RBC rapture (Erythrocyte hemolysis)- Infant become anemic In adult deficiency associated with disease that cause malabsorption of fat. i.e. disease or injury of liver, gallbladder or pancreas DEFIENCY OF VITAMIN E ALSO CAN BE CAUSED BY: - Extremely low fat diet - Fat replacer - Highly processed or convenience food - VITAMIN E DEFICIENCY SYMPTOMS Loss of coordination & reflexes with impaired movement RBC breakage, anemia Leg cramps Vitamin E sources Vegetable oils Fruits Vegetables (especially leafy green veg.) Grains Wheat germ Meat, poultry, fish, egg, milk, nuts, seed contribute smaller percentage. Animal fat have almost none Vitamin E- Requirement and Toxicity DRI 15mg/day With high intake of PUFA Can take up to 800mg Toxicity - No real toxicity from VITE in natural food- but supplemtn - May cause mental and physical retardation - Blured vision - Fatgue - Large doses may increases the effect of anticoagulant medications - 50% in brain hemorrhage in smoker-50mg - Vitamin E summary act as an antioxidant- specially important for those cells that are exposed to high O2 concentration Vitamin- E deficiency is rare in human being Widely distributed in plant food Destroyed by high heat Toxicity is rare Vitamin K - One of the few Vitamins about which extravagant clams are not made Found in several form Phylloquinone- found in plants Menaquinone- found in: Fish oils Meats and Synthesized by bacteria - Only small number of foods provide significant amount of Vitamin K Liver, leafy green vegetables and some vegetable oils are good source VITAMIN K IN BODY - Vitamin K is neede for the production of the blood-clotting protein called prothrombin and other specific Blood-clotting factors - These proteins are needed to produce FIBRIN - FIBRIN form the structure of blood clot - Several Vitamin-K dependent proteins are involve in bone mineralization and demineralization, with Vitamin D - Vitamin k may also reduce Hip fructure Sources - Intestinal bacteria Dark green leafy Vegetables. i.e. spinach, 300 mg/3oz Lettuce, broccoli, cabbage family 100 mg/3oz - Canola and soybean oil Vitamin K Deficiency and Toxicity Deficiency - Rare Exceptions are: -antibiotic -new born Tolerable upper intake level- not yet set Toxicity - Rare - Can result when supplement of synthetic vitamin K are given - It causes o breakage of RBC o releases the blood cell pigment (bilirubin) leads to jaundice o brain damage Vitamin Supplements - Higher amount of Vitamin leave the category of nutrition and enter Pharmacology Can have side effects like other drugs Acute overdoses are the potential for chronic, low-level nutrient toxicity - These people might need vitamin supplements people with nutrients decency women in their child bearing age pregnant or lactating women newborn/ infants elderly people victims of aids etc. drugs and alcohol user Selection of A Multinutrient Supplement - An appropriate supplement provide all Vitamins and Minerals in amount: Smaller than or Equal to or Very close to the Intake Recommendations - Avoid any preparation that, in a daily dose, provides more than the DRI intake, specially of: Vitamin A Vitamin D or Any Mineral AVOID THESE: - High dose of Iron - Labeled as “ORGANIC” or “NATURAL” preparations with added substances - “HIGH POTENCY” or “ THERAPEUTIC DOSE” supplements- More is not better - Items not needed in Human nutrition, such as Carnitine and inostol - “TIME RELEASE”- Nutrients are incorporated into the tissues where they are needed whenever they arrive - “STRESS FORMULA”- although the stress response depends on certain B-Vitamins and Vitamin C-Recommended amount provide all - Pills containing extract of Parsley, alfalfa and other vegetables components - “TONICS”- They are generally poor in Vitamins and Minerals and high in alcohol If you decide to take a supplement examine the ingredients on supplement labels and choose one that satisfy you needs NUTRITION AND CANCER PREVENTION - 35% CANCER CASES ARE RELATED TO DIET CANCER SITE RISK FACTOR Breast High calorie and or alohol intake, obesity, low fruit and vege. intake, low physical avtivity Colon or rectum High red meat, excessive alcohol, low fiber, low calcium & vitamin D, obesity & low physical activity Esophagus Excessive alcohol intakes, low intake of fruitand vegetable, obesity Lungs Low fruit and vegetable, lowlevel of physical activity Ovary High fat diet,obesity,low fruit and vegetable, low physical activity Prostate High saturated fat, obesity, low physical activity Stomach Regular consumption of smoked foods, and food cures with salt or nitrite compounds, low fruits & vegetables Liver aflatoxin-conatining grains,smoked food and foods cures with salt or nitrite compunds Mouth & Throat Excessive alcohol, low fruit and vegetables