* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Chapter 4: The Human Body: From Food to Fuel
Survey
Document related concepts
Transcript
Vitamins Readings: – Chapters 9 & 10 1 Outline - Overview - Bioavailability - minimizing losses - Classification - Fat versus Water soluble - Function, Recommendations, Sources, Deficiency, Toxicity - Fat Soluble - A,D,E and K - Water Soluble - B vitamins and C 2 Overview Characteristics of Vitamins: “vital to life” • do not yield energy • organic • only required in small amount (mg or mg) 3 Overview What to study… • know the characteristics and functions, effects of deficiency and toxicity for each • be able to identify or list rich sources of each • need to know specific RDA for folate and Vitamin C 4 Understanding Vitamins True or False? – if a little is good, then a lot is better – vitamins are energy boosters – vitamins work exclusively of one another Vitamins in Foods – all food groups are natural sources of various vitamins – also founds in enriched and fortified foods 5 Bioavailability • the rate and extent to which a nutrient is absorbed and used Determinants • efficiency of digestion & time of transit through the digestive tract • previous nutrient intake & nutrition status • other foods consumed at the same time • method of preparation • sources of the nutrient 6 Minimizing Vitamin Losses • vitamins are organic therefore susceptible to destruction by: HEAT, UV LIGHT or OXIDATION • prevent losses through: – refrigeration of fruits and vegetables – storing cut vegetables, fruits, and juice in airtight containers to reduce oxidation – wash fruits and vegetables before cutting – steam vegetables in small amounts of water, avoid over cooking 7 Classifications of Vitamins • classified according to solubility in fat versus water Fat Soluble = Vitamins A, D, E, and K Water Soluble = B Vitamins and Vitamin C 8 Fat vs. Water Soluble Water Soluble Fat Soluble Vitamins B Vitamins, C A, D, E, & K Absorption directly into blood with lipids into lymph Transport none required require protein carriers Storage free in aqueous compartments in cells associated with fat Excretion readily via kidneys not readily Toxicity only from supplements more likely Requirement frequently (every 1- 3 days) periodically (weeks to months) 9 Vitamin Absorption 10 Vitamin A Vitamin A is found in two forms: • retinoids – derived from animal sources – preformed Vitamin A (biologically active from) – includes retinal, retinol, and retinoic acid • carotenoids – derived from plant sources – pro-vitamin form, converted to retinoid form by body as needed – examples: b-carotene (pro-vitamin), – lycopene, lutein (nonprovitamin) may have other beneficial roles (antioxidant, vision, cancer prevention) 11 Vitamin A: Functions 1. Vision • retinal forms part of molecule called rhodopsin – compound found in cells of the retina – important for converting a light stimulus to an electrical stimulus – allows brain to interpret visual information • Fig 9-7 12 Vitamin A: Functions 2. Protein Synthesis and Cell Division • promotes differentiation of: - epithelial cells - goblet cells - T lymphocytes 13 Vitamin A: Functions 3. Reproduction and Growth • retinol important for sperm development in men • required for normal fetal growth • important for bone remodeling and growth – assists osteoclasts by helping enzymes that breakdown bone 14 Vitamin A: Functions 3. Antioxidant: • carotenoids only!!! • donates an electron to oxygen free radicals to prevent OFR from stealing them from other molecules, halts the chain of free radical production Definition of free radical… – unstable and highly reactive atoms or molecules that have one or more unpaired electron – steal electrons from other molecules such as LDL, membrane lipids, proteins and others 15 Free Radicals Antioxidant DNA Vitamin A: Recommendations Recommendations • expressed as RE (retinol equivalents) or RAE (retinol activity equivalents) • 1 RAE = 1 mg of retinol – Supplemental Betacarotene - 2ug = 1 RAE – Dietary Beta-carotene - 12ug = 1 RAE – Dietary Carotenoids - 24ug = 1 RAE • Adult RDA = 700 – 900 RAE per day 17 Vitamin A: Sources 1 cup sweet potatoes ½ cup pumpkin ½ cup carrots 100% of RDA = 18 Vitamin A: Deficiency • one of most common nutrient deficiencies worldwide • leading cause of preventable blindness • deficiency due to lack of intake requires one to two years to develop to develop adults, develops more quickly in children 19 Vitamin A: Deficiency Symptoms & Consequences • first detectable sign = night blindness • increased incidence of infectious disease • xeropthalmia – total blindness due to drying and hardening of the cornea • keratinization – epithelial cells begin to secrete keratin • hard inflexible protein in finger nails and hair – decreased mucous production – skin becomes dry, rough and scaly 20 Vitamin A: Toxicity • vitamins A & D are the most toxic vitamins • only the retinoid form is toxic – Upper Limit 3000 ug RAE as retinol – Over-consumption of carotenoids is not harmful because conversion to retinoids is regulated • Carotenodermia - harmless orange coloration Symptoms • nausea, vomiting, diarrhea • loss of appetite, fatigue, insomnia • headaches, blurred vision • dry itchy skin, rashes, nose bleeds • teratogenic: causes abnormal fetal development & birth defects stored for years limit intake during child bearing years – women need be careful if on Retin-A or Accutane for acne discontinue at least 2 yrs before becoming pregnant 21 On completion of your dietary analysis, you notice that your Vitamin A intake is 4x (400%) of the DRI. - What are the potential health effects of this excess consumption? - What other information do you need in order to justify your answer above? Vitamin D: Functions • also called calciferol or cholecalciferol • regulates the concentrations of calcium & phosphate in the blood • promotes bone mineralization • supports immune system function • regulates cellular differentiation, proliferation, and apoptosis (cell death) 23 Vitamin D: Calcium Regulation • works in conjunction with parathyroid hormone and calcitonin • increases blood calcium (Ca2+) levels by three mechanisms: - stimulates Ca2+ absorption from the small intestine - reduces Ca2+ excretion from kidney - (by increasing re-absorption) - mobilizes Ca2+ from bone 24 Vitamin D: Recommendations & Sources Recommendations • Adult = 5 mg/day (200IU), requirements increase after age 50 (10 mg/day) – Current research suggests this should rise significantly (25 mg/day) Sources • can be synthesized in the body from cholesterol with exposure to UV light • rich food sources include dairy products, fatty fish, fortified margarine, fortified soy and rice 25 beverages, fortified cereals Vitamin D: Sources fatty fish, dairy, fortified cereals UV Light skin pre-vitamin D liver kidneys active Vitamin D26 Vitamin D: Synthesis 27 Vitamin D: Deficiency • in children results in the disease rickets – bones fail to calcify – legs bend out because the bones are softened and weak 28 Vitamin D: Deficiency • in adults contributes to the development of osteomalacia (soft bones) – occurs in conjunction with a low calcium intake – young women with repeated pregnancies at risk • also increases risk of osteoporosis (decreased mineral density) – also occurs in conjunction with a low calcium intake 29 Vitamin D: Toxicity • Vitamin D and Vitamin A are the most toxic vitamins • Toxicity usually only occurs with supplements • UL - 2000 IU (50mg) / day (may be conservative) • leads to increased blood calcium = hypercalcemia – tissues (kidney, heart, lungs, liver) become calcified – leads to death • other symptoms include nausea, vomiting, loss of appetite, fatigue, kidney damage 30 • Sun exposure does not result in toxicity Vitamin D & Cancer? • Canadian Cancer Society recommends Canadians consume a supplement of 1000 IU Vitamin D during fall & winter • Epidemiology: – inverse correlation between colon cancer mortality and UV exposure – mixed results from studies examining correlation between dietary Vitamin D or serum Vitamin D and cancer incidence & mortality 31 Vitamin D & Cancer • Is there biological evidence of a role of Vitamin D in cancer protection? – experimental studies have found that that colon cells express receptors for Vitamin D & calcitriol inhibits growth of cancer cells • What are the mechanisms? – – – – anti-proliferative effects stimulates cellular differentiation promotes apoptosis reduces angiogenesis 32 Vitamin E: Functions & Recommendations • also called atocopherol • acts as an antioxidant – prevents oxidation of polyunsaturated fatty acids and other lipids and Vitamin A – may reduce the oxidation of LDL and help lower risk of cardiovascular disease 33 Vitamin E: Recommendations •Adults = 15 mg TE/day (tocopherol equivalents) •Sources vegetable oils (canola, safflower, corn, olive) sunflower seeds sweet potatoes prawns & shrimp Others: salmon, almonds, pistachios, soy beans, enriched cereals 34 Vitamin E: Deficiency • rare in healthy adults – Though smoking destroys vitamin E – Also destroyed by oxygen, metals, light and repeated frying • in premature infants results in erythrocyte hemolysis (rupture of cell membrane) – leads to hemolytic anemia – red blood cells burst open – corrected with Vitamin E treatment • prolonged deficiency causes neuromuscular dysfunction – poor muscle coordination, impaired reflexes – impaired vision and speech 35 Vitamin E: Toxicity • rare, effects less severe than Vitamin A or D toxicity • usually occurs with supplements • upper limit is 65x greater that RDA • very high doses may interfere with the blood clotting actions of Vitamin K or enhance actions of anti-clotting medications • More damage if individual has a vit K deficiency as well as very high vit E intake – Risk of hemorrhage 36 Vitamin K: Functions • necessary for blood clotting – ‘koagulation’ – activates prothrombin, the precursor to thrombin – thrombin is an enzyme required for synthesis of blood clots – also important for other reactions in formation of a blood clot 37 Vitamin K: Functions • important for the synthesis of bone proteins – lack of Vitamin K results in abnormal protein production which bone minerals cannot bind to – adequate intakes may reduce risk of hip fractures 39 Vitamin K: Recommendations & Sources Recommendation • Adult RDA = 90 - 120 mg/day Sources • made by intestinal bacteria – this meets about ½ of body’s needs • significant food sources include dark green leafy vegetables (kale, spinach, turnip greens, broccoli, romaine lettuce) cauliflower, cabbage, and soybean products 40 Vitamin K Sources 41 Vitamin K: Deficiency • primary deficiencies rare as average intake is sufficient and it is resistant to cooking • secondary deficiency may result from: – conditions that disrupt fat absorption – antibiotics that destroy colonic bacteria that synthesize Vitamin K – new born infants have a sterile gut and are usually given a single dose of Vitamin K at birth to prevent hemorrhagic disease • results in hemorrhagic disease (unchecked bleeding), may be fatal 42 Vitamin K: Toxicity • rare, though may occur with supplements • reduces the effectiveness of anticoagulant drugs used to prevent blood clotting • symptoms include: – jaundice, red blood cell hemolysis, and brain damage 43 The B Vitamins • act primarily as coenzymes • work as catalysts • required for many energy-producing metabolic reactions • Often found together in foods, a lack of one may indicate others are low – Poor, elderly and alcoholics at risk for deficiency 44 Vitamin B12 Vitamin B6 Niacin Thiamin Biotin Folate Riboflavin B vitamins in concert… Pantothenic Acid 45 Thiamin (Vitamin B1): Functions • part of coenzyme TPP(thiamin pyrophosphate) – important for de-carboxylation reactions (removal of CO2) – needed to convert pyruvate to acetyl CoA glucose pyruvate TPP acetyl CoA + CO2 • found on nerve cell membranes, important for nerve cell function • RDA is roughly 1 mg per day, slightly higher during pregnancy and lactation • average intake of Canadians meets or 46 exceeds recommendation Thiamin (Vitamin B1): Sources • found in small amounts in many foods, DRI easily met with a well-balanced diet • destroyed by heat 1 slice of watermelon or ½ cup cooked peas provides about ¼ of RDA pork and pork products are exceptionally rich sources 47 Thiamin (Vitamin B1): Deficiency • deficiency results in Beri Beri (Sinhalese for “I can’t, I can’t”) Symptoms q q q q weakness and fatigue enlarged heart cardiac failure apathy q q q q poor short term memory confusion, irritability muscle paralysis nerve degeneration • can be characterized by edema (called wet Beriberi) or by muscle wasting (called dry Beriberi) • no toxicity symptoms have been reported for thiamin 48 Riboflavin (Vitamin B2): Functions • forms part of coenzymes FAD and FMN • participates in oxidation / reduction and deamination reactions • associated with antioxidant performance of enzyme glutathione peroxidase • required (with iron & Vitamin B6) to convert the amino acid tryptophan to the B vitamin niacin • required to convert Vitamin B6 to its coenzyme form • RDA about 1 mg, most Canadians meet or exceed. 49 Riboflavin (Vitamin B2): Sources • small amounts in many foods, easy to meet DRI with a well-balanced diet • destroyed by UV light 1 cup yogurt ½ RDA 3 oz liver exceeds RDA ½ cup cooked mushrooms ¼ RDA 50 Riboflavin (Vitamin B2): Deficiency • deficiency is rare, but usually occurs in combination with other nutrient deficiencies, called ariboflavinosis • causes inflammation of membranes of mouth, skin, eyes, and digestive tract – inflamed eyelids, sensitivity to light – sore throat, cracks in upper lips and at corners of mouth – Glossitis (swollen tongue) and dermatitis • no toxicity symptoms have been reported for riboflavin 51 Niacin (Vitamin B3): Functions • other names include nicotinamide & nicotinic acid • part of coenzyme NAD required for many reactions of energy metabolism, especially metabolism of glucose, fat, and alcohol 2 ATP C C C C Glucose C C C C C C C C NAD+ NADH + H+ RDA 12-16 mg NE /day 2 Pyruvate 52 Niacin (Vitamin B3): Sources • can be synthesized from amino acid tryptophan – 60 mg tryptophan = 1 mg niacin – requires Riboflavin, Iron, and Vitamin B6 • diets rich in high quality protein never lack niacin Best sources per kcal: • spinach • mushrooms • chicken breast • liver • fish (cod, halibut, tuna…) 53 Niacin (Vitamin B3): Deficiency • results in pellagra, “mal de la rosa” Symptoms (4 “D’s”) Dermatitis Diarrhea Dementia Death 54 Niacin (Vitamin B3): Deficiency Populations at risk: – alcoholics – protein poor diets centered on corn • 70% of niacin in corn unavailable for digestion and absorption • high leucine interferes with conversion of tryptophan to niacin 55 Niacin (Vitamin B3): Toxicity • non-toxic if from Niacin naturally occurring in FOOD • large doses (1,300 - 3,000 mg/day) used pharmacologically to treat high cholesterol • dose of 250 mg/day can produced side effects, including: – niacin flush – headaches, nausea, glucose intolerance, blurred vision, liver damage, and peptic ulcers • upper limit of 35 mg/day 56 Pantothenic Acid: Functions & Sources Functions • forms part of CoEnzyme A • involved in over 100 metabolic reactions including synthesis of lipids, neurotransmitters, steroid hormones, and hemoglobin Sources • “pantos” = everywhere Both deficiency and toxicity are rare. 57 Biotin: Functions Functions • forms part of a coenzyme responsible for replenishing oxaloacetate in the TCA cycle (metabolism of carbs and fat) • important for gluconeogenesis, fatty acid synthesis, and breakdown of certain fatty acids and amino acids 58 Biotin: Sources Sources • widespread in many foods: – liver, egg yolks, soy beans, fish, whole grains • protein avidin in raw egg white prevents absorption • synthesized by colonic bacteria, but not absorbed Both deficiency and toxicity are rare. 59 Vitamin B6: Functions • part of coenzyme PLP which is required for protein metabolism: – Transamination of amino acids – synthesis of niacin from tryptophan – synthesis of neurotransmitters, hemoglobin, & DNA • required for the synthesis of white blood cells • important for steroid hormone activity and cognitive function • converts homocysteine to cysteine – High homocysteine correlated with heart disease risk • RDA 1.0 - 1.5 mg / day 60 Vitamin B6: Sources • ample amounts provided by protein rich foods • easily destroyed by heat 1 medium potato or 3 oz chicken ¼ RDA Best sources per kcal: • spinach • broccoli • carrots • tomato juice • squash 1 medium banana ½ RDA 61 Vitamin B6: Deficiency • rare, alcoholics and the elderly most at risk • drugs may interfere with Vitamin B6 (e.g. INH used to treat tuberculosis) Symptoms • nerve damage, depression, confusion • impaired immune function • microcytic anemia (“micro” = small, “cytic” = cell) 62 Vitamin B6: Toxicity • stored in muscle thus can accumulate (unlike other water soluble vitamins) • only occurs with supplements – Sometimes abused by bodybuilders – taken to treat PMS, carpal tunnel syndrome or sleep disorders – no scientific evidence to support use! • symptoms include fatigue, depression, headache, numbness and muscle weakness, convulsions, and permanent nerve damage 63 Folate: Functions • also called folacin or folic acid • part of coenzymes in energy metabolism • required for synthesis of DNA, important in cell division – necessary for fetal development during pregnancy • required for synthesis and development of red blood cells and other rapidly dividing cells • activates Vitamin B12 • converts homoecystine to methionine with Vitamin B12, 64 Folate: Recommendations & Sources Know these values for the exam! Recommendations • Adult: 400 mg per day • During pregnancy: 600 mg per day Sources • abundant in legumes and many vegetables • destroyed by heat and oxygen • fortification of cereal grains required since 1998 65 Folate: Sources Best sources per kcal: • black-eyed peas • lentils • okra • asparagus • kidney beans • tomato juice • broccoli • spinach ½ cup asparagus 1/3 RDA 1 cup raw spinach ¼ RDA ½ cup navy beans 1/3 RDA 66 Folate: Deficiency • one of most common nutrient deficiencies in North America • may result from a variety of potential causes: – – – – inadequate intake inadequate folate absorption increased folate requirements impaired folate utilization (associated with Vitamin B6 deficiency) – altered folate metabolism (drug interactions) – excessive folate excretion (prolonged diarrhea) 67 Folate: Deficiency Symptoms • megaloblastic anemia – “mega” = large, “blast” = immature cell – also called macrocytic – red blood cells remain large and immature because of impaired cell division – leads to weakness, fatigue, irritability and headache • other symptoms include glossitis and mental confusion 68 Folate: Deficiency 69 Folate: Deficiency during Pregnancy • leads to neural tube defects in the developing fetus – abnormalities of the spine, brain, or skull • e.g. spina bifida, anencephaly (part of brain missing) • supplements generally recommended during pregnancy (under a physicians supervision) – synthetic form is better absorbed than food form 70 Folate: Deficiency during Pregnancy 71 Folate: Toxicity • can MASK a Vitamin B12 deficiency – early symptoms of a B12 deficiency also include megaloblastic anemia – too much folate prevents these early symptoms from developing 72 Vitamin B12: Functions • absorption of Vitamin B12 requires a substance called intrinsic factor • contains the mineral cobalt • forms part of coenzymes – assists in break down of fatty acids and amino acids • maintains myelin, a protective sheath around nerves – protects nerve fibers and promotes their normal growth • involved in bone cell activity & metabolism 73 Vitamin B12: Functions • activates folate • works with folate to synthesize red blood cells • important in synthesis of DNA and RNA • with folate converts homocysteine to methionine Folate (active) Folate (inactive) Vitamin B12 homocysteine methionine 74 Vitamin B12: Sources Recommendations • RDA = 2.4 mg per day • Daily Value = 6 mg per day Sources • only found in animal products – e.g. meats, fish, poultry, dairy, eggs • added to some fortified cereals • NOT available from fermented soy or sea algae or yeast grown on a Vitamin B12 rich medium • destroyed by microwave cooking 75 More Information: http://www.cc.nih.gov/ccc/supplements/vitb12.html Vitamin B12: Deficiency • average intake of Canadians > RDA • stored in liver and recycled – may take several years for symptoms to develop • concern for vegans: require supplements! • secondary deficiency due to lack of intrinsic factor – called pernicious anemia – common in older individuals with atrophic gastritis that have decreased production of stomach acid and intrinsic factor 76 Vitamin B12: Deficiency Symptoms • megaloblastic anemia (acute) – as with a folate deficiency – leads to fatigue, irritability, etc… – masked by a high folate intake • neurological symptoms (chronic) – creeping paralysis of nerves – begins at extremities and works up spine – may result in permanent nerve damage and paralysis • no toxicity symptoms reported for Vit. B12 77 Vitamin B12 Vitamin B6 Niacin Thiamin Biotin Folate Riboflavin B vitamins in concert… Pantothenic Acid 78 Vitamin C: Functions • acts as a water based antioxidant – re-activates Vitamin E (lipid based) – prevents oxidation of compounds in cells and body fluids – neutralizes free radicals in polluted air and cigarette smoke 79 Vitamin C: Functions • acts as a cofactor in many reactions – required for synthesis of collagen • structural protein of connective tissue and forms matrix for bones and teeth – with iron, converts amino acids proline and lysine to their hydroxy form – necessary for synthesis of carnitine, serotonin, norepinephrine, and thyroid hormone (thyroxin) 80 Vitamin C: Functions • other functions include: – facilitates function of immune cells – deactivates histamine • chemical compound of the immune system that mediates the allergy response – enhances iron absorption • captures non-heme iron and keeps it in a reduced form (ferrous iron) that is more easily absorbed Recommendations (know for exam!) 30-3581 mg mg/day smokers = +______ mg/day women = 75 men = 90 _________ _________ Vitamin C: Sources • many animals can synthesize vit C, but NOT HUMANS All of the following provide 100% of the RDA ¾ cup cooked broccoli ½ cup red bell pepper 1 kiwi 1 cup grapefruit juice 1 sweet potato 1 cup strawberries 1 large orange 1 cup Brussels sprouts Best source per kcal! 82 Vitamin C: Deficiency • results in scurvy Symptoms – – – – – – – – begin if intake drops to < 10 mg/day bleeding gums, loss of teeth pinpoint hemorrhages muscles degenerate, bones soften, skin roughens increased infections hysteria and depression microcytic anemia sudden death due to massive internal bleeding 83 Vitamin C: Deficiency 84 Vitamin C: Toxicity • 100 mg/day saturates tissues • minimal absorption or increase in blood concentrations if intake > 200 mg/day • low risk of adverse effects if intake is below 2000 mg/day • greater than 2000 mg/day may lead to: – – – – nausea, abdominal cramps, diarrhea, nosebleeds interference with anti-clotting medications gout, kidney stones pro-oxidative effect if iron intake is excessive • Hemochromatosis - over storage of iron – rebound scurvy? 85 RDA for men 90 mg supports metabolism 30 mg limited absorption 200 mg adverse effects 3000 mg female smokers 110 mg 10 mg prevents scurvy 100 mg tissues saturate 75 mg 125 mg RDA for male women smokers 2000 mg adult UL Is Vitamin C a Cure for the Common Cold? • proposed by Linus Pauling (Nobel prize winner in Physics) – claimed megadoses of Vitamin C prevented and cured the cold – also proposed that Vitamin C could prolong life of cancer patients • does research support these claims? NO! – however, a Vitamin C intake > 1 g/day MAY decrease the duration of a cold by one day • mechanisms? – anti-histamine actions? – protect from immune cell Oxygen Free Radicals? 87 Vitamin Supplements?? • Supplements may be beneficial, and improve health of population – Multivitamin has lowest risks for toxicity and good general benefits – While real food is better, population seems to be adverse to increasing fruit and vegetable intake • Most important – folate during child bearing years – B12 for vegans and those over 50 • Do not take more than recommended • Take with food, or just after a meal • Megadoses – Vit E - shown to be have minimal impact – Vit C - may reduce symptoms for common colds – Vit D - could be very beneficial, more research required. 88 Matching Exercise Vitamin C can be synthesized from the amino acid tryptophan Biotin important for the differentiation of lymphocytes, goblet cells & epithelial cells Niacin Folate Vitamin A Riboflavin excess may mask a Vitamin B12 deficiency protects against damage from oxygen free radicals enables amino acids to be used for energy needed to replenish oxaloacetate in the citric acid cycle