Vitamin A Nutritional Guidelines Quiz
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Questions and Answers

What is the Recommended Dietary Allowance (RDA) of vitamin A for males?

  • 800 μg RAE
  • 900 μg RAE (correct)
  • 1000 μg RAE
  • 700 μg RAE

Which of the following foods is NOT a good source of vitamin A?

  • Pumpkin, canned
  • Carrots, cooked
  • Broccoli, cooked
  • White rice, cooked (correct)

What is the upper limit (UL) for vitamin A intake in μg RAE?

  • 3000 μg RAE
  • 6000 μg RAE
  • 4000 μg RAE
  • 5000 μg RAE (correct)

Which food provides the highest carotenoid content among the listed options?

<p>Sweet potato, canned (A)</p> Signup and view all the answers

How should one consider their total vitamin A intake?

<p>Combined dietary and supplement sources (B)</p> Signup and view all the answers

What is a potential effect of high Vitamin A intake on bone health?

<p>Decreased bone mineral density (D)</p> Signup and view all the answers

Which of the following symptoms is NOT associated with excessive Vitamin A intake?

<p>Increased appetite (C)</p> Signup and view all the answers

What is a known teratogenic effect of high Vitamin A intake during pregnancy?

<p>Birth defects (C)</p> Signup and view all the answers

What daily intake level of Vitamin A defines the upper limit (UL) for adults?

<p>12,000 μg/day (D)</p> Signup and view all the answers

In the study by Dudas in 1992, what was the daily Vitamin A dose compared among subjects?

<p>1,800 μg/day (A)</p> Signup and view all the answers

What is the primary acute sign of vitamin A poisoning in dogs?

<p>Vomiting (B)</p> Signup and view all the answers

Which of the following is a chronic sign of vitamin A poisoning in dogs?

<p>Constipation (D)</p> Signup and view all the answers

What bioavailability can be expected when consuming cooked forms of carotenoids?

<p>30-50% (B)</p> Signup and view all the answers

Which carotenoid converts to vitamin A at the highest efficiency?

<p>β-carotene (C)</p> Signup and view all the answers

How many servings of fruits and vegetables are recommended per day for optimal carotenoid intake?

<p>5+ servings (D)</p> Signup and view all the answers

What do β-apocarotenoids derive from during the synthesis of vitamin A?

<p>Non-central cleavage (C)</p> Signup and view all the answers

What is the ratio of β-carotene to retinol equivalency?

<p>12:1 (D)</p> Signup and view all the answers

Which sign is NOT typically associated with vitamin A poisoning in dogs?

<p>Lean muscle gain (A)</p> Signup and view all the answers

What was the primary endpoint of the clinical trials evaluating β-carotene supplementation?

<p>Lung cancer incidence (B)</p> Signup and view all the answers

What was the average age of participants in the CARET study?

<p>57 years (A)</p> Signup and view all the answers

What was the increase in lung cancer risk observed in the β-carotene group of the CARET study?

<p>28% (D)</p> Signup and view all the answers

How many participants were enrolled in the ATBC study?

<p>29,133 (A)</p> Signup and view all the answers

What was the treatment dose of β-carotene in the CARET study?

<p>30 mg/day (B)</p> Signup and view all the answers

Which group showed an 18% increase in lung cancer risk according to the ATBC study?

<p>β-Carotene group (B)</p> Signup and view all the answers

What was the treatment compliance assessed by in both studies?

<p>Serum β-carotene levels (B)</p> Signup and view all the answers

What was the primary population at risk in these β-carotene trials?

<p>Heavy smokers and asbestos exposed individuals (A)</p> Signup and view all the answers

What effect does β-apo-14′-carotenal have on RXR?

<p>It functions as a transcriptional repressor of RXR. (B)</p> Signup and view all the answers

What is a potential consequence of high intakes of β-carotene?

<p>Development of hypercarotenemia. (D)</p> Signup and view all the answers

What was the finding related to intakes of Vitamin A over 3,000 μg/d in the studies mentioned?

<p>Increased risk of CNC defects (B)</p> Signup and view all the answers

Which transcription factors are repressed by β-apo-13-carotenone?

<p>RXR and CYP26A1. (D)</p> Signup and view all the answers

Which case report demonstrated severe hepatotoxicity from a Vitamin A dose of 7,600 μg/d?

<p>Hatoff 1982 (B)</p> Signup and view all the answers

Among the studies listed, which reported no increased risk of CNC defects?

<p>Khoury, 1996 (A)</p> Signup and view all the answers

Which of the following is true regarding the function of β-carotene?

<p>It inhibits cell proliferation. (D)</p> Signup and view all the answers

What relationship exists between retinol levels and CYP expression?

<p>High levels of retinol decrease CYP expression. (D)</p> Signup and view all the answers

What is the established tolerable upper intake level (UL) of Vitamin A for adults?

<p>3,000 μg/d (D)</p> Signup and view all the answers

What is implied by the modest inhibition of nuclear receptors by various β-apocarotenoids?

<p>They can influence a range of transcription factors. (D)</p> Signup and view all the answers

What condition was observed in multiple cases where the Vitamin A intake was notably high?

<p>Severe fibrosis (A)</p> Signup and view all the answers

In observational studies, higher carotenoid intakes are associated with what outcome?

<p>Decreased risk of cancer. (A)</p> Signup and view all the answers

At what intake level did the study by Mills, 1997, identify cranial neural crest defects?

<p>≥ 4,500 μg/d (D)</p> Signup and view all the answers

How does β-carotene circulate in the blood?

<p>In VLDL/LDL particles. (B)</p> Signup and view all the answers

What was the lowest intake range examined in the cohort studies related to cranial neural crest defects?

<p>&lt; 1,500 μg/d (C)</p> Signup and view all the answers

What condition was reported to occur from Vitamin A ingestion through fish liver curry?

<p>Hypervitaminosis A (A)</p> Signup and view all the answers

Which study reported the highest dose with adverse outcomes of 30,000 μg/d?

<p>Farrell 1977 (B)</p> Signup and view all the answers

For what population was the tolerable upper intake level of 600-900 μg/d established?

<p>Infants and children (C)</p> Signup and view all the answers

Flashcards

Vitamin A RDA

The Recommended Dietary Allowance (RDA) for vitamin A varies based on gender. Females require 700 mcg Retinol Activity Equivalents (RAE) daily, while males need 900 mcg RAE.

What is RAE?

Retinol Activity Equivalents (RAE) is a measurement used to standardize the amount of vitamin A activity from different sources, which might be preformed (retinol) or provitamin A (beta-carotene).

Dietary Sources of Vitamin A

Foods like beef liver, pumpkin, carrots, sweet potatoes, and fortified cereals are excellent sources of vitamin A, particularly preformed retinol and provitamin A carotenoids.

Vitamin A UL

The Tolerable Upper Intake Level (UL) for vitamin A is 3,000 mcg RAE. Consuming excessive vitamin A above this limit can lead to adverse health effects.

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EAR (Estimated Average Requirement)

The amount of a nutrient that meets the needs of 50% of the population.

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RDA (Recommended Dietary Allowance)

The amount of a nutrient that meets the needs of 97-98% of the population.

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UL (Tolerable Upper Intake Level)

The highest amount of a nutrient that is unlikely to cause adverse effects in practically all healthy people.

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Adverse effects of high Vitamin A intake

A vitamin A intake exceeding the UL can lead to various health issues, such as bone weakness, skin problems, nausea, liver toxicity, and birth defects.

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Risk of Vitamin A Inadequacy

A deficiency in Vitamin A can lead to problems like decreased bone density, increased fracture risk, and hair loss.

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Vitamin A poisoning in dogs

A condition in dogs caused by excessive vitamin A intake, characterized by symptoms such as vomiting, drowsiness, and peeling skin.

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Dehydrated liver and vitamin A storage

A crucial storage site for vitamin A in dogs, located within the liver.

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What are carotenoids?

Carotenoids, particularly beta-carotene, are precursors to vitamin A found in plants. They are red, orange, and yellow pigments.

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β-carotene to vitamin A conversion

Beta-carotene is the most prevalent carotenoid and can be converted into vitamin A in the body. Its conversion rate is 12 micrograms of beta-carotene equals 1 microgram of retinol (vitamin A).

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How is β-carotene converted?

The process of how beta-carotene is converted into vitamin A (retinol) involves two major enzymatic cleavage pathways: central cleavage and non-central cleavage.

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Products of central and non-central cleavage

Central cleavage of beta-carotene produces two molecules of retinal, while non-central cleavage yields products like β-apo-10’-carotenal and β-ionone.

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β-apocarotenals and β-apocarotenones: unknown mechanisms

The exact mechanisms of action for β-apocarotenals and β-apocarotenones, produced during non-central cleavage of beta-carotene, are still being studied and are not fully understood.

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Bioavailability of vitamin A from food

The bioavailability of vitamin A from food sources can vary. Cooked or heat-processed forms of carotenoids are more readily absorbed than raw forms.

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What is the UL for vitamin A?

The Tolerable Upper Intake Level (UL) for vitamin A is 3000 mcg RAE (Retinol Activity Equivalents) per day, meaning consuming more than that may lead to adverse health effects.

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Are there different ULs for vitamin A based on age?

The upper limit for Vitamin A intake is lower for children and infants compared to adults, ranging from 600-900 mcg RAE per day.

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How does excessive vitamin A intake affect pregnancy?

High intakes of vitamin A, specifically exceeding 3000 mcg RAE daily, have been linked to an increased risk of birth defects, particularly those affecting the cranial neural crest (CNC). CNC defects involve abnormalities in the development of facial structures and the brain.

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Is there scientific evidence for the link between high vitamin A and birth defects ?

Studies have consistently shown that consuming high levels of vitamin A, particularly over 3000 mcg RAE per day, is associated with an increased risk of birth defects, particularly those affecting the cranial neural crest.

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What are Cranial Neural Crest (CNC) defects?

Cranial neural crest (CNC) defects are birth defects that result from abnormalities in the development of the neural crest cells, which contribute to the formation of facial structures and the brain. These defects include conditions like cleft palate and cleft lip.

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What are the effects of excessive vitamin A on the liver?

High doses of vitamin A, especially above 3000 mcg RAE daily, can have adverse effects on the liver. These effects range from fibrosis and inflammation to more severe conditions such as cirrhosis and even death.

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Is there evidence showing the link between high vitamin A and liver damage?

Studies have shown that long-term intake of high doses of vitamin A, exceeding 3000 mcg RAE daily, can lead to serious liver abnormalities, including fibrosis, cirrhosis, and even death.

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Why is there a UL for vitamin A?

The tolerable upper intake level (UL) for vitamin A is set to 3000 mcg RAE per day for adults. This limit is based on scientific research and aims to minimize the risk of adverse health effects.

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Why are children's ULs for vitamin A lower than adults?

The tolerable upper intake level (UL) for vitamin A is set at a lower level for children compared to adults, ranging from 600-900 mcg RAE per day. This is because children are more sensitive to the effects of high vitamin A intake.

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What is the significance of the UL for vitamin A in terms of nutrition?

The information on the ULs and adverse effects of vitamin A highlights the importance of consuming a balanced diet with sufficient vitamin A from various sources, but staying within the recommended daily limits to avoid potential health problems.

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What are β-apocarotenoids?

β-apocarotenoids are a group of compounds derived from carotenoids, acting as ligands for transcription factors like RXR, PPARα, PPARγ, LXRα, and LXRβ. They can bind to these receptors and influence gene expression, often exhibiting inhibitory effects.

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How does β-apo-14′-carotenal function?

β-apo-14′-carotenal, a specific β-apocarotenoid, acts as a transcriptional repressor of RXR, PPARα, PPARγ, LXRα, and LXRβ. This means it can hinder the activity of these receptors, potentially affecting gene expression.

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What are the roles of β-apo-13-carotenone?

β-apo-13-carotenone, another β-apocarotenoid, functions as a transcriptional repressor of RXR. Additionally, it inhibits the expression of CYP26A1, an enzyme involved in vitamin A metabolism.

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How is β-carotene transported and stored?

β-carotene, a precursor to vitamin A, is transported in the bloodstream within VLDL and LDL particles. It is stored in subcutaneous adipose tissue, and excessive intake can lead to hypercarotenemia, causing an orange/yellow skin discoloration.

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What are the functions of β-carotene?

β-carotene exhibits antioxidant properties, protecting against LDL cholesterol oxidation, which is linked to atherosclerosis. It can also inhibit cell proliferation, potentially contributing to anti-cancer effects.

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What evidence supports the potential cancer-protective effects of carotenoids?

Observational studies have linked higher carotenoid intakes with a reduced risk of developing various cancers. Specifically, higher blood levels of β-carotene have been associated with a lower risk of lung cancer.

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What is the relationship between retinol levels and CYP expression?

High retinol levels can decrease CYP expression. This is because retinol is a substrate for CYP enzymes, and its high abundance can potentially downregulate the expression of these enzymes.

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How does β-carotene affect CYP1A1 and CYP1A2?

β-carotene can increase the expression of CYP1A1 and CYP1A2. This increased expression is linked to β-carotene's role as an inducer of these specific CYP enzymes.

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Randomized, Double-Blind, Placebo Controlled Trial

A type of study that uses random assignment to groups receiving either the treatment or placebo, where neither the participants nor the researchers know who gets what.

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Primary Intervention Trial

A study that aims to prevent disease by testing the effects of an intervention (like a vitamin) on a large group of people at risk of the disease.

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Relative Risk (RR)

A measurement of how much the risk of a disease increases or decreases after exposure to something. A value of 1 means no effect, greater than 1 means increased risk, and less than 1 means decreased risk.

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Incidence Study

A study that focuses on the incidence (new cases) of a disease in a specific group of people.

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High-Risk Cohort Study

A study where participants with a specific risk factor (like heavy smoking) are monitored to see if they develop a disease.

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CARET and ATBC Studies

The CARET Study (Carotene and Retinol Efficacy Trial) and the ATBC Study (Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study) were two independent, large-scale clinical trials that explored the relationship between beta-carotene supplementation and lung cancer.

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Beta-Carotene Supplementation and Lung Cancer Risk

Both the CARET and ATBC studies found that beta-carotene supplementation actually increased the risk of developing lung cancer in smokers.

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Importance of Evidence-Based Research

The results of the CARET and ATBC studies highlight the importance of considering the complex interplay of factors that influence health outcomes, and the potential for unexpected consequences of dietary interventions.

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Study Notes

Vitamin A Adverse Effects

  • Vitamin A's Tolerable Upper Intake Level (UL) is not a recommended intake level, but rather the highest daily intake likely causing no adverse effects in most.
  • Risk of adverse effects increases with intakes above the UL.
  • UL is based on total intake from foods, fortified foods and supplements.
  • The Therapeutic Index (TI) is the margin of safety between the Recommended Dietary Allowance (RDA) and the UL.
  • Vitamin A has a narrow TI compared to other nutrients.
  • High Vitamin A intakes can easily lead to adverse effects.
  • High intakes may lead to bone mineral density loss, progressive liver toxicity, skin disorders, alopecia (hair loss), nausea, vomiting, and teratogenesis (birth defects).

Vitamin A DRI Table

  • The DRI table provides Recommended Dietary Allowances (RDA/AI) and Tolerable Upper Intake Levels (UL) for various age groups (infants, children, adult males, adult females, pregnancy, lactation).
  • Retinol Activity Equivalents (RAE) are used to measure Vitamin A intake.
  • Values vary according to age and sex.
  • The table presents Daily Allowances for Vitamin A in µg/day (RAE) for different age groups categorized as infants, children, adult males, adult females, pregnancy and lactation.

Dietary Sources of Vitamin A

  • Dietary sources of vitamin A include beef liver, pumpkin, carrots, sweet potatoes, raisins bran cereal, oatmeal, cheese, ricotta, whole milk, broccoli, asparagus.
  • High in carotenoids (provitamin A) such as pumpkin, sweet potato, carrots, and cantaloupe.

Birth Defect Data for Vitamin A UL

  • Studies examined the relationship between vitamin A intake and birth defects.
  • Several studies analyzed cases of birth defects in relation to vitamin A intake levels.
  • Birth defects, especially craniofacial malformations (cleft palate and cleft lip), are linked to high vitamin A intake during pregnancy.
  • Increased risk of birth defects with intakes over 3000 µg/day for women of childbearing age

Liver Abnormalities and Vitamin A UL

  • High intake of Vitamin A can cause liver abnormalities such as fibrosis, marked cirrhosis, and liver cell hypertrophy.
  • Several case reports indicated liver abnormalities in subjects with unusually high vitamin A intake levels.
  • The case studies show a dose-response relationship.
  • The values reflect the relationship between intake of Vitamin A and liver abnormalities.

Adverse Effects: Hypervitaminosis A

  • Ingesting large amounts of fish liver curry can lead to acute vitamin A toxicity.
  • Symptoms include nausea, vomiting, blurred vision, superficial peeling of skin, and symptoms lasting several days.
  • Chronic intake of high amounts of Vitamin A can cause damage to the liver, skin, and other organ systems.
  • Liver fibrosis and lipid accumulation in stellate cells are frequent side effects of excessive vitamin A intake over many years.

Canine Hypervitaminosis A

  • All dietary sources of vitamin A should be carefully considered for dogs.
  • Dehydrated Liver is a common source of Vitamin A.
  • Acute symptoms include vomiting, drowsiness, irritability, and skin peeling.
  • Chronic signs include poor hair coat, skin issues, weakness, weight loss, constipation, excessive bone growth, and impaired movement.
  • Other signs include appetite loss, lethargy, joint and bone pain, jaundice, excessive thirst and urination, and eye irritation.

Carotenoids (Provitamin A)

  • Carotenoids are red, orange, and yellow pigments found in plants that can be converted into vitamin A.
  • 5 or more servings of fruits and vegetables are recommended for obtaining 3–6 mg of β-carotene daily.
  • Cooked and heat processed forms of carotenoids are more bioavailable than raw versions.
  • Supplements of carotenoids are typically more bioavailable than dietary sources.
  • β-carotene plays an important role as an antioxidant.

β-carotene

  • β-carotene circulates in blood within VLDL/LDL particles.
  • High intakes can lead to hypercarotenemia (orange/yellowing of the skin).
  • Evidence suggests protective, antioxidant functions.
  • β-carotene can inhibit cell proliferation, showing potential anti-cancer effects.

β-Carotene and Cancer

  • Observational studies suggest a lower risk of lung cancer with higher β-carotene intake.
  • However, randomized controlled trials showed an increased risk of lung cancer and mortality among participants taking supplemental β-carotene.
  • Timing of β-carotene intake might play a role in its effect on lung cancer development.
  • β-carotene metabolites can have cytotoxic and genotoxic effects in animal models.
  • Supplemental β-carotene can induce lung CYP1A1 and CYP1A2, leading to increased activation of carcinogens from cigarette smoke.

The Research Pyramid for B-Carotene in Lung Cancer

  • The Research Pyramid illustrates the hierarchy of scientific evidence regarding health topics.
  • Randomized controlled trials are the gold standard for determining cause-and-effect relationships, as opposed to observational studies.

Adverse Effects of Beta-Carotene: CARET & ATBC studies detailed

  • CARET and ATBC trials examined the effect of beta-carotene supplementation on lung cancer risk.
  • Significant findings in both RCTs showed an unexpected increase in lung cancer risk and mortality in beta-carotene supplementation groups compared to placebo.
  • The increased risk was more significant than risk reduction found in previous observational studies.

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Test your knowledge of vitamin A dietary recommendations and food sources with this quiz. Explore questions on the Recommended Dietary Allowance (RDA), upper intake limits, and effects of vitamin A on health. Ideal for students and nutrition enthusiasts alike.

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