Chapter 10 NUTR

Chapter 10

The Water-Soluble Vitamins:
B Vitamins and Vitamin C

© 2009 Cengage - Wadsworth

The Vitamins--An
Overview
• Vitamins differ from carbohydrate,
fat and protein in structure, function
and food contents.
• Vitamins are similar to the energy-
yielding nutrients in that they are
vital to life, organic and available
from foods.
• Both deficiencies and excesses of the
vitamins can affect health.


The Vitamins--An
Overview
• Bioavailability is the rate and extent
that a nutrient is absorbed and used.

• Precursors, also known as
provitamins, are consumed in an
inactive form and become active
vitamins in the body.


The Vitamins--An
Overview
• The organic nature of vitamins means they
can be destroyed by exposure to light,
oxidation, cooking, and storage.
• There are methods used to minimize
nutrient losses.
 Refrigerate fruits and vegetables.
 Store cut fruits and vegetables in airtight wrappers
or closed containers and refrigerate.
 Clean fruits and vegetables before they are cut.
 Use a microwave, steam, or simmer in small
amounts of water.
 Save cooking water for other uses.
 Avoid high temperatures and long cooking times.


The Vitamins--An
Overview
• Solubility and storage
 Water-soluble vitamins (B vitamins and
vitamin C) are absorbed directly into the
blood and travel freely.
• Circulate freely
• Excreted in urine
 Fat-soluble vitamins (vitamins A, D, K and
E) are absorbed first into the lymph, then
the blood.
• Many require protein carriers.
• Stored in cells associated with fat
• Less readily excreted


The Vitamins--An
Overview
• Toxicity
Water-soluble vitamins can reach
toxic levels with supplement use.
Fat-soluble vitamins are likely to
reach toxic levels with supplement
use.
DRI Committee has established
Tolerable Upper Intake Levels for
niacin, vitamin B6, folate, choline and
vitamin C.


The B Vitamins--As
Individuals
• The B vitamins are very active in the body.
Several of the B vitamins form part of the
coenzymes that assist enzymes in the
release of energy.
• Other B vitamins participate in metabolism
and cell multiplication.
• Recommendations for the B vitamins come
from RDA, AI, and Tolerable Upper Intake
Levels.
• There are deficiencies, toxicities and food
sources that are unique for each vitamin.


Thiamin (Vitamin B1)

• Thiamin is involved in energy
metabolism as part of the coenzyme
thiamin pyrophosphate (TPP).
• Thiamin Recommendations (1998
RDA)
RDA Men: 1.2 mg/day
RDA Women: 1.1 mg/day



• Thiamin Deficiency and Toxicity
Deficiency Symptoms
• Enlarged heart and possible cardiac
failure
• Muscular weakness
• Apathy, poor short-term memory,
confusion, and irritability
• Anorexia and weight loss



• Thiamin Deficiency and Toxicity
 Wernicke-Korsakoff syndrome is a severe
deficiency that develops in those who abuse
alcohol.
 Deficiency results in the disease beriberi.
• Wet beriberi presents with edema.
• Dry beriberi presents with muscle wasting.
 No reported toxicities



• Thiamin Food Sources
Whole-grain, fortified or enriched
grain products
Moderate amounts in all foods
Pork



• Other Information
Steaming and microwaving are
cooking methods that conserve
thiamin.
Thiamin leaches into water with
boiling or blanching.
The vitamin is easily destroyed by
heat.


Riboflavin (Vitamin B2)

• Riboflavin is involved in energy
metabolism.
• Flavin mononucleotide (FMN) and
flavin adenine dinucleotide (FAD) are
the coenzyme forms.
• Riboflavin Recommendations (1998
RDA)
RDA Men: 1.3 mg/day
RDA Women: 1.1 mg/day



• Riboflavin Deficiency and Toxicity
• Inflamed eyelids, sensitivity to light, and
reddening of the cornea
• Sore throat and cracks and redness at
the corners of the mouth
• Painful, smooth and purplish red tongue
• Skin lesions covered with greasy scales
Deficiency disease is ariboflavinosis
No reported toxicities



• Riboflavin Food Sources
Milk products, including yogurt and
cheese
Enriched and whole grains
Liver



• Other information
Easily destroyed by ultraviolet light
and irradiation
Not destroyed by cooking


Niacin (Vitamin B3)
• Niacin is involved in the metabolism of
glucose, fat, and alcohol.
• Nicotinamide adenine dinucleotide (NAD), and
NADP, the phosphate form of NAD, are the
coenzyme forms.
• Niacin Recommendations (1998 RDA)
 The body can obtain niacin from dietary niacin and
dietary tryptophan (60 mg of dietary tryptophan = 1
mg niacin); therefore niacin intake is measured in
niacin equivalents (NE).
 RDA Men: 16 NE/day
 RDA Women: 14 NE/day
 Upper level of 35 mg/day for adults


Niacin (Vitamin B3)

• Niacin Deficiency
A deficiency of niacin results in the
disease pellagra.
• Diarrhea, abdominal pain, and vomiting
• Inflamed, swollen, smooth and bright red
tongue
• Depression, apathy, fatigue, loss of
memory, and headache
• Rash when exposed to sunlight


Niacin (Vitamin B3)

• Niacin Toxicity
Niacin flush dilates the capillaries and
may be painful.
Toxicity Symptoms
• Painful flush, hives and rash
• Excessive sweating
• Blurred vision
• Liver damage
• Impaired glucose tolerance


Niacin (Vitamin B3)

• Niacin Food Sources
Milk
Eggs, meat, poultry and fish
Whole-grain and enriched breads and
cereals
Nuts and all protein-containing foods


Niacin (Vitamin B3)

Also called nicotinic acid,
nicotinamide, and niacinamide
The amino acid tryptophan is the
precursor.
The vitamin can be lost from foods
when is leaches into water.
Resistant to heat


Biotin

• As part of a coenzyme used in
energy metabolism, biotin assists in
glycogen synthesis, fat synthesis,
and amino acid metabolism.
• Biotin Recommendations (1998
Adequate Intake)
AI Adults: 30 μg/day


Biotin
• Biotin Deficiency and Toxicity
 Deficiencies are rare.
 Deficiency Symptoms
• Depression, lethargy, and hallucinations
• Numb or tingling sensation in the arms and legs
• Red, scaly rash around the eyes, nose and mouth
• Hair loss
 Biotin can be bound with an egg-white
protein called avidin.


Biotin

• Biotin Food Sources
Widespread in foods
Organ meats, egg yolks and fish
Soybeans
Whole grains
• Biotin can also be synthesized by
intestinal bacteria.


Pantothenic Acid

• Pantothenic acid is involved in
energy metabolism as a part of
coenzyme A.
• Pantothenic Acid Recommendations
(1998 Adequate Intake)
AI Adults: 5 mg/day


Pantothenic Acid
• Pantothenic Acid Deficiency and Toxicity
 Deficiency is rare.
• Vomiting, nausea, and stomach cramps
• Insomnia and fatigue
• Depression, irritability, restlessness, and apathy
• Hypoglycemia and increased sensitivity to insulin


Pantothenic Acid

• Pantothenic Acid Food Sources
Widespread in foods
Organ meats
Mushrooms, avocados, and broccoli
Whole grains
Can be destroyed by freezing,
canning, and refining


Vitamin B6

• The coenzyme forms of vitamin B6
(pyridoxal phosphate [PLP] and
pyridoxamine phosphate [PMP]) are
involved in amino and fatty acid
metabolism, the conversion of tryptophan
to niacin or serotonin, and the production
of red blood cells.
• Vitamin B6 Recommendations (1998 RDA)
 RDA Adults 19-50 years: 1.3 mg/day


Vitamin B6

• Vitamin B6 Deficiency
• Scaly dermatitis
• Anemia – small cell type
• Depression, confusion, abnormal brain
wave pattern, and convulsions
Alcohol destroys the vitamin
INH drug used for tuberculosis acts as
an antagonist.


Vitamin B6

• Vitamin B6 Toxicity
• Depression, fatigue, irritability, and
headaches
• Nerve damage causing numbness and
muscle weakness leading to inability to
walk
• Convulsions
• Skin lesions
Upper level for adults: 100 mg/day


Vitamin B6

• Vitamin B6 Food Sources
Meats, fish, poultry and liver
Legumes and soy products
Non-citrus fruits
Fortified cereals


Vitamin B6

Easily destroyed by heat
Vitamin B6 is ineffective in curing
carpal tunnel syndrome and sleep
disorders.


Folate

• Folic acid, folacin, pteroylglutamic
acid-PGA
• Folate is involved in the synthesis of
DNA and the formation of new cells.
• The coenzymes THF
(tetrahydrofolate) and DHF
(dihydrofolate) require vitamin B12 to
function correctly.


Folate

• Folate Recommendations (1998 RDA)
RDA Adults: 400 μg/day
Dietary Folate Equivalents (DFE) is a
calculation that accounts for the
bioavailability differences between
folate from foods and folate from
supplements.
There are higher recommendations
for pregnant women.


Folate
• Folate and Neural Tube Defects
Neural tube defects include spina
bifida and anencephaly.
Women of childbearing age should
eat folate-rich foods and folate-
fortified foods and take folate
supplements containing 0.4 mg (400
microgram) of folate daily.
Pregnant women should take folate
supplements.


Folate

• Folate and Heart Disease
High levels of homocysteine and low
levels of folate increase risk of heart
disease.
Folate breaks down homocysteine.
• Folate may help to prevent cancer.


Folate
• Folate Deficiency
• Macrocytic anemia, also called megaloblastic
anemia – large cell type
• Smooth, red tongue
• Mental confusion, weakness, fatigue, irritability
and headaches
 Most vulnerable of all the vitamins to
interactions with medications
• Anticancer drugs
• Antacids and aspirin


Folate

• Folate Toxicity
Masks vitamin B12 deficiency
symptoms
Upper level for adults: 1000 μg/day


Folate

• Folate Food Sources
Fortified grains
Leafy green vegetables
Legumes and seeds
Liver
Easily destroyed by heat and oxygen


Vitamin B12 (Cobalamin)

• Vitamin B12 is involved in the synthesis of
new cells, maintains nerve cells, reforms
folate coenzymes, and helps break down
some fatty acids and amino acids.
• Methylcobalamine and
deoxyadenosylcobalamin are the coenzyme
forms.
• Vitamin B12 Recommendations (1998 RDA)
 RDA Adults: 2.4 μg/day



• Vitamin B12 Deficiency and Toxicity
• Anemia – large cell type
• Fatigue and depression
• Degeneration of peripheral nerves progressing to
paralysis
 Atrophic gastritis in older adults destroys
stomach cells, which diminishes intrinsic
factor and hydrochloric acid production.
 Deficiency disease is called pernicious
anemia
 No known toxicities



• Vitamin B12 Food Sources
Meat, fish, poultry, and shellfish
Milk, cheese and eggs
Fortified cereals



Binds with intrinsic factor in the small
intestine for absorption
Easily destroyed by microwave
cooking


Non-B Vitamins

• Choline
Choline is involved in the synthesis of
acetylcholine and lecithin.
Choline Recommendations (1998
Adequate Intake)
• AI Men: 550 mg/day
• AI Women: 425 mg/day


Non-B Vitamins
• Choline Deficiency and Toxicity
Deficiencies are rare.
Deficiency symptom is liver damage
• Body odor and sweating
• Salivation
• Reduced growth rate
• Low blood pressure
• Liver damage


Non-B Vitamins

• Choline Food Sources
Milk
Liver
Eggs
Peanuts


Non-B Vitamins
• Inositol and Carnitine
 Inositol is made from glucose and is part of
the cell membrane structure.
 Carnitine is made from lysine and
transports long-chain fatty acids to be
oxidized.
• Vitamin imposters are substances needed
by other forms of life but not human
beings.
• They can be potentially dangerous when
used by humans.


The B Vitamins--In
Concert
• The B Vitamins are interdependent.
The presence of one may affect the
absorption, metabolism and
excretion of another.
• A deficiency of one may affect the
functioning or deficiency of another.
• A variety of foods from each food
group will provide an adequate
supply of all the B vitamins.


The B Vitamins--In
Concert
• B Vitamin Roles
Coenzymes involved directly or
indirectly with energy metabolism
Facilitate energy-releasing reactions
Build new cells to deliver oxygen and
nutrients for energy reactions


The B Vitamins--In
Concert
• B Vitamin Deficiencies
Deficiencies rarely occur singly except
for beriberi and pellagra.
Can be primary or secondary causes
Glossitis and cheilosis are two
symptoms common to B vitamin
deficiencies.
• B vitamin toxicities can occur with
supplements.


The B Vitamins--In
Concert
• B Vitamin Food Sources
Grains group provides thiamin,
riboflavin, niacin and folate.
Fruits and vegetables provide folate.
Meat group provides thiamin, niacin,
vitamin B6 and vitamin B12.
Milk group provides riboflavin and
vitamin B12.


Vitamin C

• Antiscorbutic factor is the original
name for vitamin C.
• Vitamin C serves as a cofactor to
facilitate the action of an enzyme and
also serves as an antioxidant.


Vitamin C

• Vitamin C Roles
As an Antioxidant
• Defends against free radicals
• Protects tissues from oxidative stress
As a Cofactor in Collagen Formation
• Collagen is used for bones and teeth,
scar tissue, and artery walls.
• Works with iron to form hydroxiproline
which is needed in collagen formation


Vitamin C
• Vitamin C Roles
 As a Cofactor in Other Reactions
• Hydroxylation of carnitine
• Converts tryptophan to neurotransmitters
• Makes hormones
 Vitamin C needs increase during body
stress, i.e. infections, burns, extremely high
or low temperatures, heavy metal intakes,
certain medications, and smoking.
 As a Cure for the Common Cold
• Some relief of symptoms
• Vitamin C deactivates histamine like an
antihistamine.
 Disease prevention is still being researched.

Vitamin C

• Vitamin C Recommendations
(1998 RDA)
RDA Men: 90 mg/day
RDA Women: 75 mg/day
Smokers: +35 mg/day


Vitamin C
• Vitamin C Deficiency
 Deficiency disease is called scurvy
• Anemia – small cell type
• Atherosclerotic plaques and pinpoint hemorrhages
• Bone fragility and joint pain
• Poor wound healing and frequent infections
• Bleeding gums and loosened teeth
• Muscle degeneration and pain, hysteria, and
depression
• Rough skin and blotchy bruises


Vitamin C
• Vitamin C Toxicity
• Nausea, abdominal cramps, diarrhea,
headache, fatigue and insomnia
• Hot flashes and rashes
• Interference with medical tests, creating
a false positive or a false negative
• Aggravation of gout symptoms, urinary
tract infections, and kidney stones


Vitamin C
• Vitamin C Food Sources
 Citrus fruits, cantaloupe, strawberries,
papayas and mangoes
 Cabbage-type vegetables, dark green
vegetables like green peppers and broccoli,
lettuce, tomatoes and potatoes
 Also called ascorbic acid
 Easily destroyed by heat and oxygen


Vitamin and Mineral
Supplements


Vitamin and Mineral
Supplements
• Many people take dietary supplements for
dietary and health insurance.
• Some take multinutrient pills daily.
• Others take large doses of single nutrients.
• A valid nutrition assessment by
professionals determines the need for
supplements.
• Self-prescribed supplementation is not
advised.
• There are many arguments for and against
supplements.


Arguments for
Supplements
• Correct Overt Deficiencies
• Support Increased Nutrient Needs
• Improve Nutrition Status
• Improve the Body’s Defenses
• Reduce Disease Risks


Arguments for
Supplements
• Who Needs Supplements?
People with nutritional deficiencies
People with low energy intake – less
than 1600 kcalories per day
Vegans and those with atrophic
gastritis need vitamin B12
People with lactose intolerance, milk
allergies, or inadequate intake of
dairy foods


Arguments for
Supplements
• Who Needs Supplements?
 People in certain stages of the life cycle
• Infants need iron and fluoride
• Women of childbearing age need folate
• Pregnant women need folate and iron
• Elderly need vitamins B12 and D
 People with diseases, infections, or injuries,
and those who have had surgery that
affects nutrient digestion, absorption or
metabolism
 People taking medications that interfere
with the body’s use of specific nutrients


Arguments against
Supplements
• Toxicity
• Life-Threatening Misinformation
• Unknown Needs
• False Sense of Security


Arguments against
Supplements
• Other Invalid Reasons:
 Belief that food supply and soil contain
inadequate nutrients
 Belief that supplements provide energy
 Belief that supplements enhance athletic
performance or lean body mass without
physical work or faster than work alone
 Belief that supplements will help a person
cope with stress
 Belief that supplements can prevent, treat
or cure conditions
• Bioavailability and Antagonistic Actions

Selection of Supplements

• What form do you want?
• What vitamins and minerals do you
need?
Do not exceed Tolerable Upper Intake
Levels.
Be careful about greater that 10 mg
of iron.


Selection of Supplements
• Are there misleading claims?
 Ignore organic or natural claims.
 Avoid products that make high potency claims.
 Watch fake preparations.
 Be aware of marketing ploys.
 Be aware of preparations that contain alcohol.
 Be aware of the latest nutrition buzzwords.
 Internet information is not closely regulated.
• What about the cost?
 Local or store brands may be just as good
as nationally advertised brands.


Regulation of Supplements
• Nutritional labeling for supplements is
required.
• Labels may make nutrient claims according
to specified criteria.
• Labels may claim that lack of a nutrient
can cause a deficiency disease and include
the prevalence of that disease.
• Labels may make health claims that are
supported by significant scientific
agreement.


Regulation of Supplements
• Labels may claim to diagnose, treat, cure,
or relieve common complaints but not
make claims about specific diseases.
• Labels may make structure-function claims
if accompanied by Food And Drug
Administration (FDA) disclaimer.
 Role a nutrient plays in the body
 How the nutrient performs its function
 How consuming the nutrient is associated
with general well-being


Chapter 10 NUTR

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Chapter 10 NUTR