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1 2 3 4 Nutrition General Nutrition 1320 Operations Administration Operations, Professional Standards Training Topic Communications & Marketing 3330 » to your credit Making the grade in your profession Vim, Vigor and By Dayle Hayes, MS, RD » Learn the fundamentals of everything from ascorbic acid to thiamin. M Earn 1 CEU in the designated Key area and Key Topic Code noted above Most of those who work in the dietetics and nutrition professions have studied vitamins at some point. Many who work in school nutrition, however, come from a foodservice or even a non-food background, and may not have learned the fundamentals about vitamins and other nutrients or about the role these play in our health. Whether your personal nutrition education level means you require a Vitamins 101 primer or just a simple refresh, this article can meet that need. VITAMIN VOCABULARY Let’s start with a review of some general information about vitamins. The term micronutrient is used to describe vitamins because we need such tiny amounts of them. Our daily requirements for vitamins are measured in milligrams or micrograms. This is in contrast to the grams of protein or ounces of water that we require each day. The term vitamin comes from the words vital and amine. We may need only tiny amounts, but vitamins are vital for life. They were originally thought to be a compound called amines, although science has now concluded that not all vitamins are amines. In the past, most research on the optimal intake of vitamins, through food or supplements, only looked at the prevention of symptoms that occur in the wake of deficiencies. Today, scientists are also interested in the potential for specific vitamins to prevent and treat disease, as well as to enhance health, physical performance and mental functioning. Food fortification refers to the addition of key vitamins (and minerals) to foods that are commonly consumed in order to improve their nutritional quality. This is often done to address a specific nutrient gap and effectively increase consumption to improve public health. Fortification has been used around the world in different foods since the 1920s because it improves nutrition without requiring people to make major changes in their eating habits or purchasing patterns. www.schoolnutrition.org | SN | 79 17.ToYourCreditFeature_MAR17.indd 79 2/22/17 12:30 PM stores and individuals may make false claims about the safety and effectiveness of their products. The FDA has excellent science-based information about dietary supplements, including vitamins, at http://tinyurl.com/ SN-mag-vitamin-supplements. The “big two” when it comes to vitamin fortification in the United States today are vitamin D and folic acid. Vitamin D fortification in milk became a common practice in the 1930s as a means to prevent rickets, a devastating bone disease affecting infants and children. While most milk sold in U.S. dairy cases is still vitamin D-fortified (and rickets has virtually been eliminated), the authors of the 2015 Dietary Guidelines for Americans report that vitamin D remains “a nutrient of public health concern” for both children and adults. Scientists now believe that vitamin D may have important roles beyond bone health—perhaps in the prevention of diabetes and cancer. There are ongoing discussions about the proper foods and correct amounts of vitamin D that should be used in fortification. Mandatory fortification of grainbased foods with folic acid began in this country in 1998 because this B-vitamin can prevent serious neural tube birth defects (NTDs), like spina bifida. Folic acid must be consumed very early in pregnancy, however, often before many women know that they are pregnant and can start taking a folic acid supplement. That’s what prompted the practice of adding folic acid to certain foods. The current folic acid fortification program has significantly reduced the number of U.S. pregnancies affected by NTDs, while raising promises of some other possible health benefits and only a very few potential concerns. Arguably the most frequently asked question about vitamins is: Can I get all the vitamins I need from food or should I take a supplement? But there is not a simple “either/or” answer. To make the right decision for you and your family, consider the points that follow. » Virtually every nutrition professional agrees: It is best to get vitamins from food first. This means that eating nutrient-rich meals and snacks made with a wide variety of foods (fresh, frozen, canned and prepared) and beverages is the place to start. » Few of us eat “perfectly” all the time, however, and certain populations have higher vitamin needs than what is considered easily attainable through meals. An over-the-counter multivitamin/mineral supplement can be helpful if your food intake is less than optimal. Just remember that a pill or powder will never “fix” the health and nutrition consequences of an eating style that lacks fruits, vegetables, whole grains and dairy foods. » Vitamin supplements are important for pregnant women, nursing mothers, young infants and children with picky eating habits. Be sure to check with a health care provider or a pharmacist to get the proper doses of vitamins and minerals for your individual needs. » According to the U.S. Food and Drug Administration (FDA), “many supplements contain active ingredients that have strong biological effects and their safety is not always assured in all users.” If you have a chronic health condition and take certain supplemental products, you may be putting yourself at risk for serious side effects and drug interactions. Again, check with your pharmacist or health care provider to determine if the supplements you are taking can interact with any medications or cause problems during surgery. Even over-the-counter drugs can have negative interactions with vitamins and other supplements. » Not all sales pitches for dietary supplements are accurate. Websites, THE VALUE OF VITAMINS Vitamins are critical elements for health, and they are best consumed through food, rather than supplements. Got it. Now, how does one go about making sense of the “alphabet soup” that inevitably results from a discussion about these micronutrients? Which vitamins are most important for you, your family and your customers? Let’s examine a baker’s dozen of vitamins from two perspectives. Why do we need it? What are the basic functions of this nutrient in the human body? Where is it found in food? What foods or beverages are the best sources of this nutrient? Vitamins are divided into two types. Fat-soluble vitamins can be stored in your body’s fat cells. Excess watersoluble vitamins cannot be stored in your body. In general, if you ingest more than your body can use, they are excreted in your urine. Let’s start with the fat-soluble vitamins: Vitamin A. This vitamin is also found in food and supplements as beta-carotene, a compound that can be converted to vitamin A. Its primary functions are to: » help your eyes see normally in the dark; » protect against infections by keeping skin and membranes healthy; and » act as an antioxidant to help prevent certain cancers and heart disease. Vitamin A is found in animal products (liver, fish oils, eggs, whole milk and fortified dairy foods) and as betacarotene and other carotenoids in red, yellow, orange and dark-green produce items. Vitamin D. It’s also known as the “sunshine vitamin,” because your body can make it when ultraviolet light hits the skin. 80 | SN | March 2017 17.ToYourCreditFeature_MAR17.indd 80 2/17/17 2:44 PM 1 Vitamin D promotes the absorption of calcium and phosphorus and helps deposit these minerals into bones and teeth, to make them strong and healthy. In addition to being made from ultraviolet light, vitamin D is found naturally in small amounts in fish (sardines and salmon). It is added to milk products, margarines and some cereals. Vitamin E. This has become one of the mostresearched micronutrients. It serves as an antioxidant to reduce damage to body cells over time and may reduce the risk of heart disease, cancer and other chronic health problems. The best sources of vitamin E are vegetable oils (soybean, corn, safflower, cottonseed, etc.) and products made with these oils (salad dressings, margarines, baked foods, etc.). Vitamin K. This is a vitamin that your body can and does produce on its own through bacteria in your intestinal tract. Your body uses vitamin K to make the protein that causes blood to coagulate or clot, which stops bleeding. It also helps to make parts of other proteins used by your blood, bones and kidneys. The best foods sources of vitamin K are darkgreen, leafy vegetables like spinach and broccoli. Smaller amounts can be found in dairy foods, cereals, eggs and meat. The water-soluble vitamins include vitamin C and the “B-complex” vitamins. At one time, these were thought to be one single “B factor” compound. As nutrition scientists separated the various Bs from one another, they named some B1, B2 and so on, while others were named for their chemical structure. Over the past 100 years, compounds have been named up to B17 and beyond. Most of these, however, were determined not to be true vitamins, unlike the ones that follow. Thiamin/Vitamin B1. This watersoluble vitamin helps produce energy from carbohydrates in every body cell. Pork, liver and other organ SAVE A STAMP! Nutrition General Nutrition 1320 » the test You can take this test online and pay by credit card. Go to: www.schoolnutrition.org/OnlinePDAs ”Vim, Vigor and Vitamins” Completion of this test, with a passing score, will count as 1 Continuing Education Unit (CEU) in Key Area 1, Nutrition, Code 1320. Please Print Name: ____________________________________________________________________________________________________________________________ SNA Member Number: ___________________________________________________________________________________________________ Address: _______________________________________________________________________________________________________________________ City / State / Zip: _________________________________________________________________________________________________________ Email: ___________________________________________________________________________________________________________________ 1. Vitamins are typically measured in ___. ■ ounces ■ grams ■ milligrams ■ millimeters 2. Scientists think there is potential for vitamins to prevent and treat disease. ■ True ■ False 3. Originally, milk was fortified with vitamin D to help prevent ___. ■ polio ■ tuberculosis ■ scurvy ■ rickets 4. The best source of vitamins is from ___ foods. ■ fresh ■ frozen ■ canned ■ all of the above 5. Vitamin supplements are always safe to take with over-the-counter medications. ■ True ■ False 6. ___ is effectively the same as betacarotene. ■ Vitamin C ■ Vitamin D ■ Vitamin K ■ none of the above 7. Vitamin D is also known as the ___ vitamin. ■ “dairy” ■ “fortifier” ■ “sunshine” ■ “bone-builder” 8. Which of these is not a B vitamin? ■ thiamin ■ ascorbic acid ■ riboflavin ■ niacin 9. Folic acid and folate are two different micronutrients. ■ True ■ False 10. Broccoli is a good source of vitamin C. ■ True ■ False TEST COMPLETION & SUBMISSION DETAILS To earn 1 Continuing Education Credit (CEU) toward SNA’s Certificate/Credentialing programs for this professional development article (PDA) test, you must achieve a passing score and the issue date (March 2017) must not be older than five (5) years from your Certificate/Credentialing period, A maximum of three (3) PDAs per year is allowable for SNA’s Certificate in School Nutrition program. There is no maximum of passing PDAs for those with the SNS Credential, submitted within the three-year period. To pay by check: Mail this completed form before your expiration date. Include $11 (SNA Members) or $17 (non-members) for processing to: SNA, Attn: PDA, PO Box 759297, Baltimore, MD 21275-9297. Do not send cash! To pay by credit card: Pay for and take the test online at www.schoolnutrition.org/OnlinePDAs. Processing fees for tests completed online are $9 (SNA Members) or $15 (non-members). Due to administrative costs, refunds will not be made for any reason. www.schoolnutrition.org | SN | 81 17.ToYourCreditFeature_MAR17.indd 81 2/22/17 12:30 PM meats provide significant amounts of thiamin. Whole and enriched grain products (cereal, bread, etc.) provide most of our thiamin intake today. Riboflavin/ Vitamin B2. This nutrient aids in producing energy in all the cells of your body. It also helps to change tryptophan (an amino acid) that is present in foods into niacin. Milk, dairy foods and organ meats are excellent sources of riboflavin. Whole and enriched grain products (cereal, bread, etc.) supply smaller amounts. Niacin/ Vitamin B3. Another in the B series of vitamins, it assists your body in using fats and sugars, producing energy in all the cells of your body and aiding more than 200 enzymes to function properly. You can find niacin in protein foods (meat, fish, poultry, dairy foods, nuts and legumes). Enriched grain products also contain this vitamin. Vitamin B6/ Pyroxidine. This vitamin helps your body make certain amino acids from protein. Like riboflavin, it also converts tryptophan into niacin. Where it differs is helping to convert tryptophan into the brain chemical known as serotonin. Vitamin B6 also works to produce insulin, hemoglobin and antibodies to fight infection. Chicken, fish, pork, beef and organ meats are the best sources of vitamin B6. Fortified grains, whole grains, nuts and legumes also supply smaller amounts. Folic Acid. Yet another B-complex vitamin (B9), it’s also called folacin or folate, depending on its form in food and supplements. It plays several roles in the human body. » It’s considered essential in reproduction by helping to produce DNA. » Folic acid works with vitamin B12 to form hemoglobin in red blood cells. » It can help reduce the risk of neural tube birth defects by as much as 75%. All enriched grain products in the United States today are fortified with folate. Leafy green veggies, some fruits, liver and legumes are other good sources of this B-vitamin. Vitamin B12/ Cobalamin. This is the largest and most complex vitamin compound. It works with folic acid to form hemoglobin in red blood cells. It also helps the human body to use fatty acids and certain amino acids. In addition, it serves as a vital part of many different chemicals in almost every cell of the body. Vitamin B12 is found only in animal products (meat, fish, poultry, eggs, milk and other dairy foods) and fortified foods, like breakfast cereals. Biotin. Also included as a B-complex vitamin, and sometimes referred to as B7, it plays an important role in energy production at the cellular level. Biotin also aids the body in using proteins, carbohydrates and fats that come from food. It is present in a wide variety of foods, but in relatively small amounts. Eggs, liver and cereals are among the best food sources of biotin. Pantothenic Acid/B5. The last member of the B-complex is found in most multi-vitamin preparations. It plays an important role in energy production and helps the body use proteins, carbohydrates and fats from food. It is widely available in meat, fish, poultry, whole grains and legumes. Vitamin C. This water-soluble vitamin is also known as ascorbic acid. It has dozens of functions throughout your body, such as: » helping to produce collagen, the connective tissue that holds body parts together; » helping to form and repair red blood cells, bones and other tissues; » protecting the body from bruising; » keeping gums healthy; » promoting the healing of cuts and wounds; and » keeping your immune system strong. Citrus fruits and juices (orange, grapefruit, tangerine, etc.) are excellent sources of vitamin C. Certain produce items (kiwi, berries, broccoli, peppers, etc.) also are good sources. VITAMIN VIRTUE While sometimes hyped as miracle cures for every ailment under the sun, vitamins are just essential nutrients. They are necessary in very small amounts to ensure normal growth, development and good health during every stage of the human lifecycle, from in utero to old age. Nutrition experts agree that food is the best—and certainly the best-tasting— source of vitamins for all of us! SN Dayle Hayes is a school nutrition and social media consultant based in Billings, Mont. You can reach her at [email protected]. 82 | SN | March 2017 17.ToYourCreditFeature_MAR17.indd 82 2/17/17 2:45 PM