Micronutrients - Vitamins PDF

MICRONUTRIENTS MICRONUTRIENTS Vitamins Minerals MICRONUTRIENTS VITAMINS  VITAMINS Comes from the Latin word - Vita – means life - amine – nitrogen compound - it was discovered later that not all vitamins contain nitrogen. ...

MICRONUTRIENTS MICRONUTRIENTS Vitamins Minerals MICRONUTRIENTS VITAMINS  VITAMINS Comes from the Latin word - Vita – means life - amine – nitrogen compound - it was discovered later that not all vitamins contain nitrogen.  VITAMINS It was coined by Casimir Funk in 1912 – when he was searching for the cure of beriberi – the missing substanc called vitamine. (vitamin)  VITAMINS It do not give energy to the body, it merely help convert food into energy, Shortage of vitamin may lead to fatigue, Long term deficiency leads to deterioration of health, Vitamin D and niacin – produced by the body,  VITAMINS Shortage of Vitamins A,B, & C – results to loss of appetite, Do not have a caloric value. Terms Associated with Vitamins Terms Associated with Vitamins — Precursurs or Provitamins – compounds that can be changed to active vitamins. — Preformed Vitamins – naturally occurring vitamins that are in inactive form and ready for biological use. — Avitaminosis – a condition resulting from lack of vitamin. Terms Associated with Vitamins Hypervitaminosis – referred as vitamin toxicity – a result of excessive accumulation of a vitamin in the body. Vitamin Malnutrition – “mal” – means bad, it denotes that too much or too little vitamin is not good for the health. Terms Associated with Vitamins Vitamin-like compounds – have physiological roles like vitamins. Antivitamin or Vitamin Antagonists – substances that interfere with the normal functioning of a vitamin. Classification of Vitamins on the basis of solubility  Classification of Vitamins on the basis of solubility The fat soluble vitamins A, D, E, & K in association with lipids are found in foods. The water-soluble vitamins are B complex and vitamin C.  VITAMINS A. Fat-soluble Vitamins  A. Fat-soluble Vitamins — Vitamin A (Retinol) — Vitamin D (Calciferol) — Vitamin E (Tocopherol) — Vitamin K (Phylloquinone, menadione) A. Fat-soluble Vitamins Vitamin A (Retinol)  Vitamin A (Retinol) Function - necessary component of visual purple (rhodopsin) – light sensitive pigment in the retina enabling it to make adjustments to light and darkness  Vitamin A (Retinol) Function responsible for the proper synthesis and maintenance of epithelial cells for skin integrity and internal mucosa and growth and formation of tooth buds. helps normal bone development.  Vitamin A (Retinol) Deficiency Poor adaptation or night blindness cannot adjust to light resulting to night blindness – it can be corrected with an injection of vit. A within minutes. Cannot correct color blindness and other visual defects  Vitamin A (Retinol) Deficiency Avitaminosis A Eye lesion - Bitot’s spot (mild) where in the lacrimal gland fails to function, followed by keratinization then rupture of the corneal tissues thus infection sets in – pus develops leading to eye hemorrhages. - Xeropgthalmia (severe) abnormal dryness of the conjunctiva and cornea of the eye.  Vitamin A (Retinol) Deficiency retarded growth of the eye lower resistance to infection faulty skeletal and dental development keratinization of epithelial lining hardening or sloughing  Vitamin A (Retinol) Deficiency disturbance in the respiratory, GI, and genitourinary tracts skin lesion – phrynoderma skin lesion appears as dry, and rough skin with popular eruptions occurring around the hair follicles and it is commonly appears in: thighs, abdomen, upper arm and back.  Vitamin A (Retinol) Toxicity - violent headache - nausea and vomiting - thickening of the skin with peeling off - swollen, painful long bones - coarse sparse hair  Vitamin A (Retinol) Toxicity - enlargement of the spleen and liver - cessation of menstruation for girls - hypercarotenimia – ingestion of large amounts of food containing carotene results a disturbing yet harmless orange appearance (skin, and eyes).  Vitamin A (Retinol) Food Source - preformed vitamin A – animal sources (liver, egg yolk, milk, cream, butter, and cheese)  Vitamin A (Retinol) Food Source - fortified margarine or skim milk fortified with vitamin A - fishes – dilis, clams, mussels or tahong, and other shellfish  Vitamin A (Retinol) Food Source - precursors or provitamin A – green and yellow vegetables (dark leaves of malunggay, sweet potatoes, or kamote, kangkong, pechay, squash or kalabasa, spinach, alugbati, gabi, saluyot, and bitter gourd or ampalaya. (apricots, peaches and nectarines in foreign country) A. Fat-soluble Vitamins Vitamin D (Calciferol)  Vitamin D (Calciferol) Functions absorbs calcium and phosphorus essential for normal growth and development and important in the formation of normal bones and teeth.  Vitamin D (Calciferol) Deficiency - tetany – a syndrome characterized by abnormal muscle twitching, cramps, and sharp bilateral spasms of joints in the wrist and ankles.  Vitamin D (Calciferol) Deficiency - infants – delayed closing of the fontanels and dentition (the arrangement or condition of the teeth)  Vitamin D (Calciferol) Fontanels - The posterior fontanelle generally closes 2 to3 mos. after birth; - The sphenoidal fontanelle is the next to close 6 mos. after birth; - The mastoid fontanelle closes next from 6 to 18 mos. after birth; - The anterior fontanelle the last to close between 10 to 24 mos.  Vitamin D (Calciferol) Deficiency - children – Rickets - a severe form manifested in defective bones and retarded growth becomes soft, fragile, and deformed such as: * pigeon-breasted, * knock-kneed, * bow-legged, * malformed teeth, and * rachitic rosary-like chest – the end of the ribs are rounded or beaded. pigeon-breasted - a deformity of the chest marked by sharp projection of the sternum knock-kneed - having legs that curve inwards so that the feet are apart when the knees are touching. bow-legged - having legs that curve outward at the knee. malformed teeth Rachitic rosary-like chest  Vitamin D (Calciferol) Deficiency - adult – osteomalacia – softening of the bones which leads to skeletal deformities, fragility of the bones “adult rickets” and, rheumatic-like pains of joints.  Vitamin D (Calciferol) Toxicity - nausea - diarrhea - polyuria - weight loss in the early stages - demineralization of bones and deposits of minerals in the soft tissues in later stage  Vitamin D (Calciferol) Toxicity - renal damage and uremia – in severe cases - hypersensitivity to vit. D leads to hypercalcemia – excessive quantities of vit. D (1,000- 3,000IU/kg/day)  Vitamin D (Calciferol) Food Sources Fatty fish, like tuna, mackerel, and salmon Foods fortified with vitamin D, like some dairy products, orange juice, soy milk, and cereals.  Vitamin D (Calciferol) Food Sources - Beef liver - Cheese - Egg yolks A. Fat-soluble Vitamins Vitamin E (Tocopherol)  Vitamin E (Tocopherol) Function - antioxidant function – lipid antioxidant - prevents the formation of peroxides from polyunsaturated fatty acids preventing the oxidation of unsaturated fats.  Vitamin E (Tocopherol) Function - helps enhance the activity of Vit.A – by preventing its oxidation and loss of activity in the intestinal tract - protects vit.C - helps sustain tissue integrity  Vitamin E (Tocopherol) Deficiency - hemolysis of RBC - the rupture or destruction of red blood cells, - low levels of tocopherols in the blood, - increased urinary excretion of creatinine and decreased excretion of creatinine  Vitamin E (Tocopherol) Toxicity - none  Vitamin E (Tocopherol) Food sources - plant sources - germ oils of wheat, corn, cottonseed or soybean; - mayonnaise, salad dressing, and margarine; - nuts and some legumes  Vitamin E (Tocopherol) Food sources - Animal sources – eggyolk, liver, butter and milk  A. Fat-soluble Vitamins Vitamin K (Phylloquinone, Menadione)  Vitamin K (phylloquinone, menadione) Function - necessary for the maintenance of prothrombin level in the blood plasma, - needed in the synthesis of proconvertin - is one of the proteins that causes blood to clot in the coagulation cascade,  Vitamin K (phylloquinone, menadione) Function - needed for phosphorylation – A biochemical process that involves the addition of phosphate to an organic compound, - resistant to heat but can be destroyed by sunlight.  Vitamin K (phylloquinone, menadione) Deficiency - hemorrhagic disease in newborn - delayed blood clotting time (adults) *Normal value of clotting time is 8 to 15 minutes  Vitamin K (phylloquinone, menadione) Toxicity - Vomiting - hemolysis - the rupture or destruction of red blood cells. - albuminuria - the presence of albumin in the urine - kennicterus – a condition resulting from the accumulation of bile pigments in the gray matter of the central nervous system.  Vitamin K (phylloquinone, menadione) Food sources - Liver - dark green leaves - wheat bran – outer layer - vegetable oils – soybean oil wheat germ oil - tomatoes, tubers, seeds and legumes and yolk  VITAMINS B. Water-soluble Vitamins  B. Water- Water-soluble Vitamins - Vitamin C (ascorbic acid) - Vitamin B Complex  B. Water- Water-soluble Vitamins Vitamin C (ascorbic acid) Vitamin B Complex also called “fresh food vit.” - it Thiamine, riboflavin, vitamin is found in growing parts of B6, vitamin B12, niacin-folic plants. Raw fresh fruits and acid, pantothenic acid, choline, vegetables have ascorbic acid inositol and biotin - they are found together content in varying amounts. Have related functions but Serves as anti oxidant chemically unrelated B. Water- Water-soluble Vitamins Vitamin C (ascorbic acid)  Vitamin C (ascorbic acid) Functions - needed in the formation and maintenance of intercellular cementing substance – is a binder that holds cells in proper relation to each other as cellular fluids which bathe and nourish them, - converts folic acid into its active form – folinic acid,  Vitamin C (ascorbic acid) Functions - aids in the healing of wounds and bone fractures, - prevents megaloblastic anemia and pinpoint hemorrhages – petechiae hemorrhages - helps build body resistance against infections.  Vitamin C (ascorbic acid) Functions - helps produce steroid hormones, particularly adrenocortical hormones under severe stress as well as aids in insulin synthesis. - necessary for tyrosine and phenylalanine metabolism  Vitamin C (ascorbic acid) Functions - it improves iron absorption – it makes iron more available for hemoglobin and maturation of RBC, - play a vital role in brain metabolism, - has an antioxidant action.  Vitamin C (ascorbic acid) Stability - avoid cooking, bruising, cutting and exposing fruit and vegetables to air it can cause loss of ascorbic acid - when cooking use less water and must be covered tightly, - quick freezing of food preserves the vitamin and refrigeration aids retention,  Vitamin C (ascorbic acid) Stability - using sodium bicarbonate in cooking vegetables (preserve and improve their color) is destructive to vitamin.  Vitamin C (ascorbic acid) Deficiency - Irritability - general weakness - lack of appetite - lowered resistance to infections - pallor  Vitamin C (ascorbic acid) Deficiency - scurvy - is a disease resulting from a lack of vitamin C - s/sx: bleeding, swollen gums, loose teeth, swollen and tender joints, internal hemorrhages underneath the skin, capillary fragility, and megaloblastic anemia  Vitamin C (ascorbic acid) Toxicity - no toxicity or hypervitaminosis C – vitamin C cannot be stored in the body.  Vitamin C (ascorbic acid) Requirement - males need more vitamin C than females, - increase intake during growth period and during pregnancy and lactation as well as when stress like: surgery, illness, infection, shock and injuries.  Vitamin C (ascorbic acid) Food sources: Vegetables with the highest sources of vitamin C - Broccoli, Brussels sprouts, and cauliflower - Green and red peppers - Spinach, cabbage, turnip greens, and other leafy greens - Sweet and white potatoes - Tomatoes and tomato juice - Winter squash  Vitamin C (ascorbic acid) Food sources: Fruits with the highest sources of vitamin C - Cantaloupe - Citrus fruits and juices, such as orange and grapefruit - Kiwi fruit - Mango - Papaya - Pineapple - Strawberries, raspberries, blueberries, and cranberries - Watermelon  VITAMINS B. Water-soluble Vitamins B. Water- Water-soluble Vitamins Vitamin B Complex  Vitamin B Complex consist of: - vitamin B1 water-soluble vitamin - vitamin B6 needs to be continually - vitamin B12 replaced due to short - niacin “life” - pantothenic acid - folic acid - biotin they belong in 1 group but they have its own unique functions  Vitamin B Complex they transform increase amount of proteins, carbohydrates, and fats into extra energy, they provide energy necessary for muscle contraction, during exertion – they are involved in the production and repair of tissues (muscular tissues),  Vitamin B Complex vit. B is lost when: boiling (meat) – 15%- 40% frying – 40%- 50% roasting – 30%- 60% will blend with the cooking liquids – might as well turn them into sauces and gravies  Vitamin B Complex A. Group 1: Classic Disease Factors B. Group II: More Recently Discovered Coenzyme Factors C. Group III: Cell Growth and Blood- forming Factors D. Group IV: Other Related Factors (pseudo-vitamins)  Vitamin B Complex A. Group 1: Classic Disease Factors  Vitamin B Complex A. Group 1: Classic Disease Factors - Thiamine (B1) - Riboflavin (B2) - Niacin (nicotinic acid) A. Group 1: Classic Disease Factors Thiamine (B1)  A. Group 1: Classic Disease Factors Thiamine (B1) an integral part of the coenzyme factor (thiamine Function pyrophosphate or TPP) – needed for carbohydrate metabolism helps maintain healthy appetite, good muscle tone (GI tract) and normal functioning of nerves.  A. Group 1: Classic Disease Factors Thiamine (B1) - loss of vitamin in cooking is highly variable depending on the: Stability - pH of the food - time - temperature - quantity of water used and discarded - use of sodium bicarbonate (enhance the green color of vegetables) - freezing has no effect  A. Group 1: Classic Disease Thiamine (B1) Factors Deficiency - severe constipation -Loss of appetite - poor reflexes and irritability - weakness - retarded growth - easy fatigability - numbness of extremities - indigestion - beriberi (nutritional poly- neuritis) - gastric atony Beriberi - a disease causing inflammation of the nerves and heart failure, caused by a deficiency of vitamin B1.  Types of Beriberi Infantile beriberi – occurs in infants 2 to 5 mos. whose main food is from a mother’s milk suffering from beriberi sx: * loss of voice (Aphonia) * whining cry * bluish discoloration of infant (cyanosis) * difficulty in breathing and death after a few hours  Types of Beriberi Wet beriberi – evidence by edema of both lower extremeties which progress upwards – body cavities (abdomen and chest), enlarge heart and irregular heart beat leads to difficulty in breathing.  Types of Beriberi Dry beriberi - it involves peripheral nerves - feeling of “pins and needles” (paresthesia) in toes, gradual loss of touch sensation, muscle weakness then leads to paralysis.  Prevention - To prevent beriberi, eat a healthy, balanced diet that includes foods rich in thiamine - beans and legumes, seeds. - Limit alcohol consumption to reduce the risk of developing beriberi. - A person who abuses alcohol should be checked routinely for a B-1 vitamin deficiency.  Treatment Increase thiamine levels in the body. Oral supplements or injections to deliver thiamine, depending on a person's overall health.  A. Group 1: Classic Disease Thiamine (B1) Factors Toxicity no toxic reaction  A. Group 1: Classic Disease Thiamine (B1) Factors Food sources - lean pork, - pork liver - other grandular organs of pork - some shellfish  A. Group 1: Classic Disease Thiamine (B1) Factors Food sources other food sources: - liver - organ meats of other animal - eggyolk and unpolished rice, whole grain, legumes (mongo, kadyos, and soybeans) and nuts A. Group 1: Classic Disease Factors Riboflavin (B2)  A. Group 1: Classic Disease Factors Riboflavin (B2) - essential component of Functions coenzyme – flavin - helps maintain mononucleotide (FMN) healthy skin, and flavin adenine tongue, mouth dinucleotide (FAD) - and normal essential for protein, fat, vision; and proper and carbohydrates growth and metabolism, development. - needed for conversion of tryptophan into niacin,  A. Group 1: Classic Disease Riboflavin (B2) Factors Stability - it is stable to heat, oxidation - sensitive to alkali, destroyed and acid by baking soda - very little B2 will lost during (soften dried cooking and processing peas or beans due to its stability and for faster cooking) water solubility.  A. Group 1: Classic Disease Riboflavin (B2) Factors Deficiency skin – develops seborrheic - ariboflavin – dermatitis (scaly, characterized by tissue greasy skin with burning changes sensation particularly in the:  A. Group 1: Classic Disease Riboflavin (B2) Factors Deficiency * eyes - corneal vascularization or extra blood vessels in the cornea. When gets severe, there is accompanying photophobia and dimness of vision.  A. Group 1: Classic Disease Riboflavin (B2) Factors Deficiency * mouth – corners are cracked and lips are swollen (cheilosis)  A. Group 1: Classic Disease Riboflavin (B2) Factors Deficiency * tongue – becomes swollen and turns magenta red (glossitis - inflammation of the tongue.)  A. Group 1: Classic Disease Riboflavin (B2) Factors Toxicity - oral doses – no toxicity - by injection – possible on massive doses but not serious  A. Group 1: Classic Disease Riboflavin (B2) Factors Food sources animal sources: cheese, milk, eggs, liver and other grandular organs plant sources: whole grains, legumes, leafy green vegetables and seaweeds A. Group 1: Classic Disease Factors Niacin (nicotinic acid)  Niacin (nicotinic A. Group 1: Classic Disease acid) Factors Functions important in energy metabolism, fatty acid acts as synthesis/oxidation, hydrogen and and protein synthesis catabolism, electron also needed for acceptor, photosynthesis in plants and fixation of CO2 in animal cells.  Niacin (nicotinic A. Group 1: Classic Disease acid) Factors Stability - more stable than thiamine and riboflavin, - resistant to heat, light, air, acids, and alkali, - small amount may lost in discarded cooking water.  Niacin (nicotinic A. Group 1: Classic Disease acid) Factors Deficiency - anorexia - Indigestion - skin changes – blackish or dark, scaly patches – appear symmetrically in areas exposed to sunlight – called bilateral dermatitis  Niacin (nicotinic A. Group 1: Classic Disease Factors acid) characterized by: dermatitis, Deficiency dementia, diarrhea and death Pelagra – a * tongue – beefy red swollen deficiency (glossitis) disease caused * mouth – corners are cracked ( by a lack of angular stomatitis) nicotinic acid or Prevention: its precursor - primary prevention is an tryptophan in adequate diet. the diet  9 Health Benefits of Niacin Lowers LDL Cholesterol. Increases HDL Cholesterol Lowers Triglycerides May Help Prevent Heart Disease May Help Treat Type 1 Diabetes Boosts Brain Function Improves Skin Function May Reduce Symptoms of Arthritis Treats Pellagra https://www.healthline.com/nutrition/niacin-benefits#section4  Niacin (nicotinic A. Group 1: Classic Disease acid) Factors Toxicity - hypermotility- abnormal or excessive movement of GIT - acidity of the stomach - paralysis in the respiratory center  Niacin (nicotinic A. Group 1: Classic Disease acid) Factors Food Sources - animal sources: liver, Glandular organs, lean meat, fish and poultry, milk and cheese, eggs - plant sources: legumes, nuts, whole grains, enriched cereals and green vegetables  Vitamin B Complex B. Group II: More Recently Discovered Coenzyme Factors B. Group II: More Recently Discovered Coenzyme Factors - Pyridoxine (Vitamin B6) - Pantothenic acid - Lipoic acid - Biotin B. Group II: More Recently Discovered Coenzyme Factors Pyridoxine (Vitamin B6)  Pyridoxine (Vitamin B6) Functions - plays an essential role in many complex biochemical processes by which foods are metabolized by the body, - Pyridoxal phosphate (PLP) – a coenzyme that functions in protein, fat, and carbohydrate metabolism.  Pyridoxine (Vitamin B6) Functions - a coenzyme for many chemical reactions related to protein metabolism, - essential for the formation of tryptophan and for the conversion of tryptophan into nicotinic acid.  Pyridoxine (Vitamin B6) Deficiency - induced experimental deficiency resulting to: nausea, vomiting, seborrheic or oily dermatitis, glossitis, conjunctivitis and depressive moods; - in infants – feeding formula lacking in pyridoxine for several weeks – causes irritability, poor growth, anemia and convulsions.  Pyridoxine (Vitamin B6) Food sources: corn oil cottonseed linseed olive Peanut wheat and rice germ wheat germ - a nutritious foodstuff of a dry floury consistency consisting of the extracted embryos of grains of wheat. rice germ - is the fraction of the grain with the richest nutrient content. Rice germ contains 95% of the total tocopherols of the entire grain, a third of the oil content and most of the vitamins and minerals. The germ is only 1% of the total weight but contains 30% of the nutrients.  Pyridoxine (Vitamin B6) Food sources: - lard - fat from the abdomen of a pig that is rendered and clarified for use in cooking.  Pyridoxine (Vitamin B6) Food sources: - legumes (soybeans and nuts) B. Group II: More Recently Discovered Coenzyme Factors Pantothenic acid  Pantothenic acid Functions - essential for carbohydrate, protein and fat metabolism, - helps maintain normal growth, healthy skin and integrity of the central nervous system, - has metabolic role in the cells since it is part of coenzyme A.  Pantothenic acid Deficiency - insomnia - muscle cramps - tingling sensation of the extremeties - vomiting  Pantothenic acid Food Sources - liver, other grandular organs, - meats, - eggs, - milk, - cheese, and - legumes B. Group II: More Recently Discovered Coenzyme Factors Lipoic acid  Lipoic Acid - it is a sulfur containing fatty acid and is not a true vitamin - is a coenzyme in energy metabolism. - found in yeast and liver B. Group II: More Recently Discovered Coenzyme Factors Biotin  Biotin Functions - serves as coenzyme factor in CO2 fixation - it helps in the synthesis of purines, pyrimidines, fatty acid, and carboxylation reactions together with active acetate. - Purines - a colorless crystalline compound with basic properties, forming uric acid on oxidation. - Pyrimidines - a colorless crystalline compound with basic properties. - Carboxylation - is a chemical reaction in which a carboxylic acid group is produced by treating a substrate with carbon dioxide.  Biotin Food sources - liver and other grandular organs, meats, egg yolk, milk, molasses, whole grains, legumes and nuts thick, dark brown syrup obtained from raw sugar during the refining process, a version of which is used in baking  Vitamin B Complex C. Group III: Cell Growth and Blood-forming Factors C. Group III: Cell Growth and Blood- forming Factors - Folic acid - Cobalamin (B12) C. Group III: Cell Growth and Blood--forming Factors Blood Folic acid  Folic Acid Functions - responsible in the transfer of one carbon units to appropriate metabolites in the synthesis of DNA, RNA, methionine and serine, -required for one step conversion of histidine into glutamic acid, - essential for the formation of both RBC and WBC in the bone marrow and for their maturation.  Folic Acid Stability - unstable to heat in acid media - stable to sunlight when in solution - there is folic acid loss in vegetables during storage at room temperature. - folic acid is destroyed when food is processed in high temperature.  Folic Acid Deficiency - poor growth - megaloblastic anemia (results from inhibition of DNA synthesis during red blood cell production) and other blood disorders - glossitis - inflammation of the tongue. - GIT disturbances arising form inadequate dietary intake  Folic Acid Deficiency - impaired absorption - excessive demand by tissues of the body - metabolic derangement - primary disturbances in adipose tissue.  Folic Acid Food Sources: Best sources: liver kidney beans lima beans fresh, dark green leafy vegetables Spinach asparagus broccoli  Folic Acid Food Sources: *good sources: - lean beef, potatoes, whole-wheat bread, & dried beans  Folic Acid Food Sources: * Poor sources: - most meats, milk, eggs, most fruits, and root vegetables Refer to page 89 Table 19 for the RNI C. Group III: Cell Growth and Blood--forming Factors Blood Cobalamin (B12)  Cobalamin (B12) Functions - it is essential for normal metabolism and growth of cells (GI tract, bone marrow and nervous tissue), - together with folic acid, choline and methionine they aids in the transfer of methyl groups in the synthesis of nucleic acid, purines and pyramidine intermediates, - involved in myelin formation.  Cobalamin (B12) Functions - it is essential for carbohydrate, protein, and fat metabolism and is associated with folic acid absorption and metabolism.  Choline is an essential nutrient that is naturally present in some foods and available as a dietary supplement. Methionine is an amino acid Purines - a colorless crystalline compound with basic properties, forming uric acid on oxidation. Pyrimidine is an aromatic heterocyclic organic compound similar to pyridine Myelin - a mixture of proteins and phospholipids forming a whitish insulating sheath around many nerve fibers, increasing the speed at which impulses are conducted  Cobalamin (B12) Stability - approximately 70% of the vitamin activity is retained during cooking.  Cobalamin (B12) Deficiency - Demyelination of the large nerve fibers of the spinal cord. A degenerative process that erodes away the myelin sheath that normally protects nerve fibers. - Pernicious anemia- is a decrease in red blood cells that occurs when the intestines cannot properly absorb vitamin B12  Cobalamin (B12) Toxicity - no known toxic effect  Cobalamin (B12) Food Sources - animal protein  Vitamin B Complex D. Group IV: Other Related Factors (pseudo-vitamins) D. Group IV: Other Related Factors (pseudo--vitamins) (pseudo - Inositol - Choline D. Group IV: Other Related Factors (pseudo--vitamins) (pseudo Inositol  Inositol - It occurs in meat and meat extractives, muscle and glandular organs, brain legumes and nuts, fruits, vegetables and grains. - It is abundant in the diet; minimum requirements for inositol are not known - its chemistry is closely similar to glucose - called “muscle sugar” - it is lipotropic agent– help in the transport and metabolism of fats. D. Group IV: Other Related Factors (pseudo--vitamins) (pseudo Choline  Choline - it is a lipotropic agent – it mobilizes fat and prevents the build-up of fatty acids, - needed for fat transport as a constituent of phospholipids, namely lecithin, cephalin, and sphingomyelin, - deficiency – results in fatty livers as seen in chronic alcoholism and kwashiorkor Kwashiorkor - also known as “edematous malnutrition” because of its association with edema (fluid retention), is a nutritional disorder most often seen in regions experiencing famine. It is a form of malnutrition caused by a lack of protein in the diet.  The symptoms of kwashiorkor include: change in skin and hair damaged immune system, color (to a rust color) and which can lead to more texture frequent and severe Fatigue infections Diarrhea irritability Loss of muscle tone flaky rash failure to grow or gain shock weight edema (swelling) of the ankles, feet, and belly Treatment - eat more protein and more calories - long-term vitamin and mineral supplementation to your diet.  Food Sources: - egg yolk - Nuts - liver - Yeast - brain - wheat germ - kidney - heart - meats - legumes