Module 9 - Vitamins-1 PDF

3/2/202 0 VITAMIN S Learning Objectives 1. List the general functions of vitamins and minerals....

3/2/202 0 VITAMIN S Learning Objectives 1. List the general functions of vitamins and minerals. 2. Identify vitamins that are fat soluble and water soluble. 3. Vitamin A: a. List the functions of vitamin A. b. Discuss the differences between preformed vitamin A and provitamin A. c. Identify dietary sources of preformed vitamin A and provitamin A. d. Describe the deficiency and toxicity conditions associated with vitamin A. Rebecca A Creasy, PhD, 1  3/2/202 0 Learning Objectives 4. Vitamin D: a. Discuss the role of vitamin D in calcium metabolism. b. Identify reasons for increased requirements in elderly. c. List dietary and non-dietary sources of vitamin D. d. Outline synthesis and activation of vitamin D in body. e. Identify individuals at risk for inadequate stores. f. Identify chronic conditions associated with insufficiency. 5. Vitamin E: a. List the primary functions of vitamin E. b. Identify population(s) at greatest risk for vitamin E deficiency. Learning Objectives 6. Vitamin K: a. List the primary function(s) of vitamin K. b. Identify the population(s) at greatest risk for K deficiency and discuss why they are at risk. 7. Vitamin C: b. List and describe the functions of vitamin C. c. Define scurvy and identify symptoms of scurvy. d. Identify individuals who have an increased requirement for vitamin C. e. List dietary sources of vitamin C. Rebecca A Creasy, PhD, 2  3/2/202 0 Learning Objectives 8. B Vitamins: a. Discuss the deficiency and toxicity conditions associated with the individual B-vitamins b. List the functions of vitamin B6, vitamin B12, and folate. c. List unique sources of vitamin B12, folate, and folic acid. d. Discuss the process of vitamin B12 absorption. e. Identify individuals at risk for vitamin B12 deficiency and describe why individuals are at risk. Key Terms Rickets Collagen Osteomalacia Coenzyme Free radical Beriberi Antioxidant Wernicke-Korsakoff Syndrome Fibrin Flushing Scurvy Pellagra Rebecca A Creasy, PhD, 3  3/2/202 0 Key Terms Macrocytic anemia Anencephaly Pernicious anemia Fortification Intrinsic factor Enrichment Neural tube defects Homocysteine Spina bifida Introduction to vitamins Micronutrients Not energy yielding Involved in metabolic processes Assist in providing energy Categories of micronutrients: Vitamins Organic Minerals Inorganic Rebecca A Creasy, PhD, 4  3/2/202 0 Water soluble and fat soluble vitamins Fat Soluble vs. Water Soluble Vitamins Fat Soluble Water Soluble Storage in body Storage in body longer period of time short period of time larger amounts not generally stored in in liver and fat cells large quantities likelihood likelihood of toxicity of adverse effects or Greater risk of deficiency toxicity Rebecca A Creasy, PhD, 5  3/2/202 0 Vitamin A Occurs in three different chemical forms: 1. Retinol Most active form of vitamin A; stored in the liver 2. Retinal 3. Retinoic acid Functions integrity of epithelial cells bone growth cell membrane stability gene regulation vision immune function Forms of Vitamin A Rebecca A Creasy, PhD, 6  3/2/202 0 Recommended Intakes for Vitamin A RDA: 900 µg RAE per day for men 700 µg RAE per day for women Increased needs for: Women who are pregnant and breastfeeding May also be listed in International Units (IU) Food Sources of Vitamin A 1. Preformed vitamin A – ready to use ◆Found in animal-based or fortified foods Ex: Fortified milk, cheese, cream, butter, eggs, liver 2. Provitamin A ♦ Converted to active form as needed ♦ Ex: beta-carotene ♦ Found in plant-based foods: Green leafy vegetables Orange and red produce ◆Apricots, cantaloupe, carrots, sweet potatoes, and pumpkins. Rebecca A Creasy, PhD, 7  3/2/202 0 Functions of vitamin A 1. Crucial to normal vision Early stages of deficiency Night blindness Reversible Maintenance of healthy cornea tissue (outer layer of eye) Short term vitamin A deficiency: Cornea becomes dry and damaged Long-term vitamin A deficiency Xerophthalmia Permanent loss of vision Functions of vitamin A 3. Immune function: Disease resistance, particularly for children Production of white blood cells 4. Integrity of epithelial cells: Found in the skin, lungs, and lining the gastrointestinal tract 5. The process by which specialized cells develop that are capable of performing specific functions: Cell differentiation Rebecca A Creasy, PhD, 8  3/2/202 0 Functions of vitamin A 6. Gene regulation: Role in turning genes on and off Indirect role in the regulation of metabolism 7. Bone metabolism Stimulates the bone cells that break down the inner part of bone Can lead to poor growth in children Vitamin A Toxicity Vitamin A stored in fat tissue and liver ♦Stored in the body for a long time Symptoms of vitamin A toxicity include ♦Liver damage ♦ Birth defects Rebecca A Creasy, PhD, 9  3/2/202 0 Should you take beta-carotene supplement? Provitamin A is not toxic Beta-carotene may help prevent heart disease and cancer Increased risk of lung cancer in smokers Health professionals do not recommend beta- carotene supplementation for the general public Vitamin D Another name for vitamin D is cholecalciferol classified as vitamin, hormone and steroid Functions of Vitamin D Regulation of calcium metabolism ◆stimulates cells of small intestine to produce calbindin: −a calcium-binding protein −🡹 calcium absorption ◆stimulates kidneys to conserve calcium − 🡻 urinary calcium excretion ◆stimulates calcium release from bone to🡹 blood levels Rebecca A Creasy, PhD, 1  3/2/202 0 Recommended Intakes of Vitamin D Food and Nutrition Board of Institute of Medicine recommends ◆400 IU (10 µg) per day - infants (AI) ◆600 IU (15 µg) per day - ages 1 to 70 yrs. (RDA) The requirement 🡹 as we age. ♦ 800 IU (20 µg) per day for adults > 70 yrs. (RDA) ♦Why? 🡻 ability to convert vitamin D into its active form 🡻 likelihood of adequate exposure to sunlight Food Sources for Vitamin D Very few foods are naturally concentrated in vitamin D. ◆Cod liver oil ◆Sardines, salmon, shrimp ◆Liver ◆Mushrooms exposed to UV light Fortified foods provide majority of dietary vitamin D. ◆milk or margarine ◆cereals ◆juices ◆Cheese and yogurt are not often fortified with vitamin D Rebecca A Creasy, PhD, 1  3/2/202 0 Making Your Own Vitamin D Human body makes vitamin D with adequate exposure to sunlight through a series of steps. ◆Cholesterol in skin combines with ultraviolet rays ◆Converted into precursor of vitamin D ◆Eventually makes it way to the kidneys − Converted to active form D3 Rebecca A Creasy, PhD, 1  3/2/202 0 Making Your Own Vitamin D Factors that influence vitamin D synthesis ◆Distance from equator ◆Amount of clothing coverage on body ◆Sun block use ◆Cloud cover or smog ◆Skin color ◆Age Vitamin D Deficiency and Bone Effects Children ◆Rickets a disease characterized by softening and deformity of long bone inability to deposit calcium in newly formed bone ◆Malformation of skull, rib cage, and ends of long bones Adults ◆Osteomalacia softening of bone caused by decalcification Rebecca A Creasy, PhD, 1  3/2/202 0 Vitamin D Deficiency and Bone Effects Vitamin D Toxicity Toxicity is not common. Occurs from overuse of supplements Symptoms of vitamin D toxicity Nausea, vomiting, and diarrhea May also lead to the calcification of soft tissues Food fortification with vitamin D is strictly regulated. Rebecca A Creasy, PhD, 1  3/2/202 0 To Supplement or Not? High rates of vit. D insufficiency in U.S. ◆90% of ethnic populations with dark skin ◆75% of and caucasian population Possible link between vit. D insufficiency and chronic disease: ◆Heart disease ◆Respiratory infections ◆Diabetes ◆Hypertension Vitamin E Fat soluble vitamin ♦ Primarily found in cell membrane Not a single compound, but is a group of compounds called tocopherols ◆four different types of tocopherols ◆alpha, beta, gamma, and delta Rebecca A Creasy, PhD, 1  3/2/202 0 Functions of Vitamin E 1. Acts as an antioxidant ◆Neutralize free radicals that can damage cells membranes, DNA, proteins 2.Enhances immune function 3.Required for nerve cell development In past, use of vit. E supplements recommended to protect against cancer and CVD Vitamin E and Free Radicals As an antioxidant, vitamin E fights against: ◆Free radicals −Unstable compounds with an unpaired electron −Attack other molecules with electrons Initiates a chain reaction Damages cell membranes, proteins, enzymes, and DNA Vitamin E donates electron to neutralize free radicals Rebecca A Creasy, PhD, 1  3/2/202 0 Free radicals from multiple sources damage cells. Recommended Intakes for Vitamin E 15 mg per day for adults (RDA) Tolerable Upper Intake Level (UL) is 1,000 mg per day for adults UL may be lower for some populations ◆Increased incidence of brain hemorrhage among smokers who take vitamin E supplements Rebecca A Creasy, PhD, 1  3/2/202 0 Vitamin E Deficiency Vitamin E deficiency is rare. Most likely to occur in: premature infants Insufficient stores Condition resulting from vitamin E deficiency: Anemia due to red blood cell fragility and subsequent rupture Other symptoms: Loss of muscle coordination and reflexes, muscle weakness, reproductive failure, and impaired vision Vitamin E Toxicity As a fat soluble vitamin, vitamin E can be toxic. Signs of toxicity: ◆headache, nausea and blurred vision ◆reduced sexual function in men ◆accelerated signs of aging ◆inflammation of the mouth ◆chapped lips ◆fatigue ◆GI disturbances ◆muscle weakness ◆increased bleeding Rebecca A Creasy, PhD, 1  3/2/202 0 Vitamin K ⮚ Primary function: Blood clotting activates proteins required to make: Fibrin forms blood clots ⮚ Also required for synthesis of bone protein: Osteocalcin Vitamin K and blood clotting Rebecca A Creasy, PhD, 1  3/2/202 0 DRIs for Vitamin K Vitamin K Deficiency ⮚ Primary deficiency is rare in adults ⮚ Population at highest risk for deficiency: Newborns Due to several factors: − Relatively sterile GI tract at birth − Breast milk is a poor source of vitamin K Single dose of vitamin K given at birth ⮚ Other potential risk factor: Prolonged antibiotic use Rebecca A Creasy, PhD, 2  3/2/202 0 Vitamin K Sources ⮚ Nonfood source Bacteria in large intestine Most significant source for humans ⮚ Food sources Green vegetables − Spinach, kale, and cruciferous vegetables Green fruits −Avocado, kiwi Some vegetable oils Vitamin K Content of Selected Foods Rebecca A Creasy, PhD, 2  3/2/202 0 Water soluble and fat soluble vitamins Water-Soluble Vitamins ⮚ Water-soluble vitamins include: Vitamin C and B vitamins ⮚ Less toxic than fat soluble vitamins ⮚ Adverse effects still possible when taken in large quantities (3x-4x RDA) Extreme supplement use Ex: using excess vit. C supplement to treat cold Rebecca A Creasy, PhD, 2  3/2/202 0 Vitamin C ⮚ Also known as ascorbic acid ⮚ Importance in diet noted in sailors in 1800s Death of sailors from scurvy −disease caused by Vitamin C deficiency Scurvy is characterized by: −Bleeding gums −Tooth loss −Poor wound healing −Small hemorrhages on skin Scurv y Rebecca A Creasy, PhD, 2  3/2/202 0 Roles of Vitamin C ⮚ Acts as an antioxidant immune system health ⮚ Synthesis of collagen: Protein that forms connective tissue of tendons, bone, teeth, and skin o Functions of collagen Wound healing Maintenance of blood vessel structure ⮚ Facilitates iron absorption in GI Dietary Reference Intakes for Vitamin C ⮚ RDA 90 mg per day for males 75 mg per day for females Increased needs for: −Smokers vitamin C used to protect body against damaging compounds in tobacco smoke −Require additional 35 mg per day Rebecca A Creasy, PhD, 2  3/2/202 0 Food Sources of Vitamin C ⮚ Fruits and vegetables Orange juice – best known source Other good sources: −other citrus fruits – limes, lemons −kiwis −strawberries −sweet potatoes −brussels spouts ⮚ Vitamin C is vulnerable to heat and oxygen Food preparation affects levels in food Food Serving Size (kcalories) Food Group Approximate Amount (Best Source per of Vitamin C kclalorie) (milligrams) Bread, whole wheat 1 oz slice (70 kcal) Grains 0 Cornflakes, fortified 1 oz (110 kcal) Grains 0 Spaghetti pasta ½ c cooked (99 kcal) Grains 0 Tortilla, flour 1 10"-round (234 kcal) Grains 0 Broccoli ½ c cooked (22 kcal) Vegetables 58 Carrots ½ c shredded raw (24 kcal) Vegetables 5 Potato 1 medium baked w/skin (133 kcal) Vegetables 15 Tomato juice ¾ c (31 kcal) Vegetables 33 Banana 1 medium raw (109 kcal) Fruits 11 Orange 1 medium raw (62 kcal) Fruits 70 Strawberries ½ c fresh (22 kcal) Fruits 41 Watermelon 1 slice (92 kcal) Fruits 28 Milk 1 c reduced-fat 2% (121 kcal) Milk and milk products 3 Yogurt, plain 1 c low-fat (155 kcal) Milk and milk products 2 Cheddar cheese 1½ oz (171 kcal) Milk and milk products 0 Cottage cheese ½ c low-fat 2% (101 kcal) Milk and milk products 0 Pinto beans ½ c cooked (117 kcal) Legumes, nuts, seeds 2 Peanut butter 2 tbs (188 kcal) Legumes, nuts, seeds 0.5 Sunflower seeds 1 oz dry (165 kcal) Legumes, nuts, seeds 0.5 Tofu (soybean curd) ½ c (76 kcal) Legumes, nuts, seeds 0 Ground beef, lean 3 oz broiled (244 kcal) Meats, poultry, seafood 0 Chicken breast 3 oz roasted (140 kcal) Meats, poultry, seafood 0 Tuna, canned in water 3 oz (99 kcal) Meats, poultry, seafood 0 Egg 1 hard cooked (78 kcal) Meats, poultry, seafood 2 0 Rebecca A Creasy, PhD, Excellent, and sometimes unusual, sources:  3/2/202 0 Vitamin C Deficiency ⮚ Scurvy Severe deficiency Improper formation of collagen ⮚ Anemia due to poor iron absorption ⮚ Signs of deficiency include: Bleeding gums Loss of appetite Small hemorrhages on skin Impaired growth Weakness Scorbutic rosary in infants Symptoms of Vitamin C Deficiency Rebecca A Creasy, PhD, 2  3/2/202 0 Symptoms of Vitamin C Deficiency: Scorbutic Rosary Vitamin C Toxicity ⮚ UL 2,000 mg per day Supplementing at greater than 1,000 mg per day −diarrhea and bloating Rebecca A Creasy, PhD, 2  3/2/202 0 B Vitamins ⮚ B vitamins include: Thiamin - B1 Riboflavin - B2 Niacin - B3 Vitamin B6 Folate Vitamin B12 Pantothenic acid Biotin ⮚ Common function of all B vitamins coenzymes or cofactors in energy metabolism −assist enzymes with energy release −without coenzyme, enzyme cannot function The role of coenzymes in biochemical reactions Rebecca A Creasy, PhD, 2  3/2/202 0 Thiamin (B1) ⮚First individual B vitamin identified ⮚Part of coenzyme thiamin pyrophosphate (TPP) Assists in metabolism of carbohydrates and some amino acids −Conversion of pyruvate to acetyl CoA −Kreb’s cycle ⮚Assists in function of nerve and muscle cell activity Dietary Reference Intakes and Food Sources for Thiamin ⮚ RDA 1.2 mg per day for males 1.1 mg per day females ⮚ No UL no adverse effects observed with excess consumption ⮚ Food sources: Pork, whole grains, fortified breakfast cereals, enriched grains, peanuts Rebecca A Creasy, PhD, 2  3/2/202 0 Food Serving Size (kcalories) Food Group Approximate Amount (Best Source per of Thiamin (milligrams) kclalorie) Bread, whole wheat 1 oz slice (70 kcal) Grains 0.10 Cornflakes, fortified 1 oz (110 kcal) Grains 0.35 Spaghetti pasta ½ c cooked (99 kcal) Grains 0.12 Tortilla, flour 1 10"-round (234 kcal) Grains 0.35 Broccoli ½ c cooked (22 kcal) Vegetables 0.05 Carrots ½ c shredded raw (24 kcal) Vegetables 0.06 Potato 1 medium baked w/skin (133 kcal) Vegetables 0.15 Tomato juice ¾ c (31 kcal) Vegetables 0.10 Banana 1 medium raw (109 kcal) Fruits 0.07 Orange 1 medium raw (62 kcal) Fruits 0.12 Strawberries ½ c fresh (22 kcal) Fruits 0.01 Watermelon 1 slice (92 kcal) Fruits 0.23 Milk 1 c reduced-fat 2% (121 kcal) Milk and milk products 0.12 Yogurt, plain 1 c low-fat (155 kcal) Milk and milk products 0.13 Cheddar cheese 1½ oz (171 kcal) Milk and milk products 0.01 Cottage cheese ½ c low-fat 2% (101 kcal) Milk and milk products 0.03 Pinto beans ½ c cooked (117 kcal) Legumes, nuts, seeds 0.18 Peanut butter 2 tbs (188 kcal) Legumes, nuts, seeds 0.05 Sunflower seeds 1 oz dry (165 kcal) Legumes, nuts, seeds 0.04 Tofu (soybean curd) ½ c (76 kcal) Legumes, nuts, seeds 0.07 Ground beef, lean 3 oz broiled (244 kcal) Meats, poultry, seafood 0.04 Chicken breast 3 oz roasted (140 kcal) Meats, poultry, seafood 0.07 Tuna, canned in water 3 oz (99 kcal) Meats, poultry, seafood 0.04 Egg 1 hard cooked (78 kcal) Meats, poultry, seafood 0.04 Excellent, and sometimes unusual, sources: Thiamin Pork chop, lean 3 oz broiled (169 kcal) Meats, poultry, seafood 0.96 Soy milk 1 c (81 kcal) Legumes, nuts, seeds 0.40 Squash, acorn ½ c baked (69 kcal) Vegetables ⮚Deficiency 0.20 Occurs in malnourished individuals and alcoholics ⮚ Malnourished individuals Beriberi − A condition in which heart becomes enlarged, fluid accumulates beneath skin and muscles weaken and atrophy If condition primarily affects CVD system: − Wet beriberi If condition primarily affects nervous system: − Dry beriberi ⮚ Severe thiamin deficiency in alcoholics Wernicke–Korsakoff syndrome Rebecca A Creasy, PhD, 3  3/2/202 0 Riboflavin (B2) ⮚Part of the coenzymes: Flavin mononucleotide (FMN) Flavin adenine dinucleotide (FAD) ⮚Functions in energy release from macronutrients FAD is an “electron shuttle” Riboflavin Coenzyme Rebecca A Creasy, PhD, 3  3/2/202 0 DRIs and Food Sources of Riboflavin ⮚ RDA 1.3 mg per day for males 1.1 mg per day for females ⮚ No UL What is the effect of excess riboflavin from supplements? ⮚ Good food sources Milk Enriched breads, cereals, and pasta ⮚ Riboflavin destroyed by ultraviolet light and irradiation Food Serving Size (kcalories) Food Group Approximate Amount (Best Source per of Riboflavin kclalorie) (milligrams) Bread, whole wheat 1 oz slice (70 kcal) Grains 0.05 Cornflakes, fortified 1 oz (110 kcal) Grains 0.43 Spaghetti pasta ½ c cooked (99 kcal) Grains 0.06 Tortilla, flour 1 10"-round (234 kcal) Grains 0.21 Broccoli ½ c cooked (22 kcal) Vegetables 0.09 Carrots ½ c shredded raw (24 kcal) Vegetables 0.03 Potato 1 medium baked w/skin (133 kcal) Vegetables 0.04 Tomato juice ¾ c (31 kcal) Vegetables 0.05 Banana 1 medium raw (109 kcal) Fruits 0.12 Orange 1 medium raw (62 kcal) Fruits 0.06 Strawberries ½ c fresh (22 kcal) Fruits 0.06 Watermelon 1 slice (92 kcal) Fruits 0.07 Milk 1 c reduced-fat 2% (121 kcal) Milk and milk products 0.40 Yogurt, plain 1 c low-fat (155 kcal) Milk and milk products 0.53 Cheddar cheese 1½ oz (171 kcal) Milk and milk products 0.18 Cottage cheese ½ c low-fat 2% (101 kcal) Milk and milk products 0.21 Pinto beans ½ c cooked (117 kcal) Legumes, nuts, seeds 0.09 Peanut butter 2 tbs (188 kcal) Legumes, nuts, seeds 0.08 Sunflower seeds 1 oz dry (165 kcal) Legumes, nuts, seeds 0.06 Tofu (soybean curd) ½ c (76 kcal) Legumes, nuts, seeds 0.03 Ground beef, lean 3 oz broiled (244 kcal) Meats, poultry, seafood 0.15 Chicken breast 3 oz roasted (140 kcal) Meats, poultry, seafood 0.12 Tuna, canned in water 3 oz (99 kcal) Meats, poultry, seafood 0.07 3 Egg 1 hard cooked (78 kcal) Meats, poultry, seafood Rebecca A Creasy, PhD, 0.26  3/2/202 0 Riboflavin Deficiency ⮚Frequently occurs in conjunction other water- soluble vitamin deficiencies ⮚ Results in: Inflammation of membranes −sore throat −cracks in the corner of the mouth −swollen, glossy tongue −skin rashes −hypersensitivity to light Niacin (B3) ⮚ Found in two chemical forms: Nicotinamide and nicotinic acid ⮚ Used to release energy from macronutrients Almost every metabolic pathway in body uses one of the two niacin-containing coenzymes: −nicotinamide adenine dinucleotide (NAD) −nicotinamide adenine dinucleotide phosphate (NADP) ⮚ Used in synthesis of fatty acids Rebecca A Creasy, PhD, 3  3/2/202 0 DRIs for Niacin ⮚ RDA: 16 mg per day for males 14 mg per day for females ⮚ UL 35 mg per day Based on adverse effects of excess intake from supplements −Flushing Redness of faces, arms, chest −Tingling sensation Sources of Niacin ⮚ Food Sources milk eggs meat poultry fish whole-grain and enriched breads and cereals ⮚Also synthesized by body from the essential amino acid tryptophan Rebecca A Creasy, PhD, 3  3/2/202 0 Food Serving Size (kcalories) Food Group Approximate Amount (Best Source per of Niacin (milligrams) kclalorie) Bread, whole wheat 1 oz slice (70 kcal) Grains 1.1 Cornflakes, fortified 1 oz (110 kcal) Grains 5.1 Spaghetti pasta ½ c cooked (99 kcal) Grains 1.9 Tortilla, flour 1 10"-round (234 kcal) Grains 3.9 Broccoli ½ c cooked (22 kcal) Vegetables 0.8 Carrots ½ c shredded raw (24 kcal) Vegetables 0.5 Potato 1 medium baked w/skin (133 kcal) Vegetables 2.8 Tomato juice ¾ c (31 kcal) Vegetables 1.3 Banana 1 medium raw (109 kcal) Fruits 0.9 Orange 1 medium raw (62 kcal) Fruits 0.5 Strawberries ½ c fresh (22 kcal) Fruits 0.2 Watermelon 1 slice (92 kcal) Fruits 1.0 Milk 1 c reduced-fat 2% (121 kcal) Milk and milk products 2.0 Yogurt, plain 1 c low-fat (155 kcal) Milk and milk products 1.4 Cheddar cheese 1½ oz (171 kcal) Milk and milk products 2.1 Cottage cheese ½ c low-fat 2% (101 kcal) Milk and milk products 2.8 Pinto beans ½ c cooked (117 kcal) Legumes, nuts, seeds 1.8 Peanut butter 2 tbs (188 kcal) Legumes, nuts, seeds 5.7 Sunflower seeds 1 oz dry (165 kcal) Legumes, nuts, seeds 3.2 Tofu (soybean curd) ½ c (76 kcal) Legumes, nuts, seeds 2.8 Ground beef, lean 3 oz broiled (244 kcal) Meats, poultry, seafood 7.6 Chicken breast 3 oz roasted (140 kcal) Meats, poultry, seafood 16.7 Tuna, canned in water 3 oz (99 kcal) Meats, poultry, seafood 15.4 Egg 1 hard cooked (78 kcal) Meats, poultry, seafood 1.3 Excellent, and sometimes unusual, sources: Liver 3 oz fried (184 kcal) Meats, poultry, seafood 12.2 Peanuts 1 oz roasted (165 kcal) Legumes, nuts, seeds 4.0 Mushrooms ½ c cooked (21 kcal) Vegetables 3.5 Niacin Deficiency ⮚Leads to a condition called: Pellagra Symptoms referred to as “the four Ds” −diarrhea, dermatitis, dementia, death ⮚Major problem in southeastern US in early 1900s through the 1930s diet void of niacin −Fat back, grits and molasses Rebecca A Creasy, PhD, 3  3/2/202 0 Niacin Toxicity ⮚One of the few water-soluble vitamins to have toxicity symptoms ⮚ Overconsumption of supplements or fortified foods “Niacin flush” −consumption of 3x to 4 x RDA −redness of face, arms and legs −temporary condition High doses of nicotinic acid prescribed for cholesterol reduction results in niacin flush ⮚ Other toxicity concerns: liver injury Vitamin B6 ⮚Vitamin B6 participates in diverse biochemical reactions ⮚ Key function synthesis of nonessential amino acids - Transamination ⮚ Other functions: Synthesis of glucose and some types of lipids Production of the neurotransmitter serotonin Hemoglobin synthesis - Vitamin B6 deficiency can lead to anemia Rebecca A Creasy, PhD, 3  3/2/202 0 DRIs and Food Sources of Vitamin B6 ⮚ RDA 1.3 mg per day for adults (19-50 yrs. of age) ⮚ UL 100 mg per day ⮚ Good food sources beef liver meats, poultry and salmon baked potatoes bananas and watermelon navy and pinto beans Vitamin B6 in Selected Foods Food Serving Size (kcalories) Food Group Approximate Amount (Best Source per of Vitamin B 6 kclalorie) (milligrams) Bread, whole wheat 1 oz slice (70 kcal) Grains 0.05 Cornflakes, fortified 1 oz (110 kcal) Grains 0.51 Spaghetti pasta ½ c cooked (99 kcal) Grains 0.01 Tortilla, flour 1 10"-round (234 kcal) Grains 0.03 Broccoli ½ c cooked (22 kcal) Vegetables 0.10 Carrots ½ c shredded raw (24 kcal) Vegetables 0.08 Potato 1 medium baked w/skin (133 kcal) Vegetables 0.42 Tomato juice ¾ c (31 kcal) Vegetables 0.20 Banana 1 medium raw (109 kcal) Fruits 0.70 Orange 1 medium raw (62 kcal) Fruits 0.08 Strawberries ½ c fresh (22 kcal) Fruits 0.04 Watermelon 1 slice (92 kcal) Fruits 0.41 Milk 1 c reduced-fat 2% (121 kcal) Milk and milk products 0.10 Yogurt, plain 1 c low-fat (155 kcal) Milk and milk products 0.12 Cheddar cheese 1½ oz (171 kcal) Milk and milk products 0.03 Cottage cheese ½ c low-fat 2% (101 kcal) Milk and milk products 0.09 Pinto beans ½ c cooked (117 kcal) Legumes, nuts, seeds 0.14 Peanut butter 2 tbs (188 kcal) Legumes, nuts, seeds 0.15 Sunflower seeds 1 oz dry (165 kcal) Legumes, nuts, seeds 0.24 Tofu (soybean curd) ½ c (76 kcal) Legumes, nuts, seeds 0.07 Ground beef, lean 3 oz broiled (244 kcal) Meats, poultry, seafood 0.21 Chicken breast 3 oz roasted (140 kcal) Meats, poultry, seafood 0.52 Rebecca A Creasy, PhD, Egg Tuna, canned in water 3 oz (99 kcal) Meats, poultry, seafood 1 hard cooked (78 kcal) 0.30 Meats, poultry, seafood 3  3/2/202 0 Vitamin B6 Deficiency and Toxicity Deficiency occurs with deficiency of other B vitamins ⮚ Deficiency symptoms are diverse: anemia depression dermatitis convulsions weakened immune response ⮚ Toxicity symptoms: numb feet loss of sensation in the hands nerve damage that progresses to the inability to walk many of symptoms are not reversible Folate (B9) ⮚ Consumed in two forms: 1. Folate −Naturally occurring form 2.Folic acid −Synthetic form −Easier to absorb in GI ⮚ One important function of folate: Cell division −DNA replication requires folate during cell division Affects: −Red blood cell synthesis −Central nervous system formation during fetal development Rebecca A Creasy, PhD, 3  3/2/202 0 DRIs for Folate ⮚ Folic acid is easier to absorb than folate Dietary folate equivalent or DFE −unit of measure used to represent the conversion of folic acid to folate RDA: 400 µg DFE per day for adults (≥19 yrs. of age) Increased requirements: −Women planning on becoming pregnant −Pregnant and lactating women UL: 1 mg folic acid per day Food Sources of Folate ⮚ Dietary sources of folate Orange juice Green leafy vegetables Legumes ⮚ Dietary sources of folic acid Supplements Enriched grains Rebecca A Creasy, PhD, 3  3/2/202 0 Folate in Selected Foods Food Serving Size (kcalories) Food Group Approximate Amount (Best Source per of Folate (micrograms) kclalorie) Bread, whole wheat 1 oz slice (70 kcal) Grains 15 Cornflakes, fortified 1 oz (110 kcal) Grains 100 Spaghetti pasta ½ c cooked (99 kcal) Grains 49 Tortilla, flour 1 10"-round (234 kcal) Grains 85 Broccoli ½ c cooked (22 kcal) Vegetables 40 Carrots ½ c shredded raw (24 kcal) Vegetables 10 Potato 1 medium baked w/skin (133 kcal) Vegetables 15 Tomato juice ½ c (31 kcal) Vegetables 38 Banana 1 medium raw (109 kcal) Fruits 23 Orange 1 medium raw (62 kcal) Fruits 40 Strawberries ½ c fresh (22 kcal) Fruits 15 Watermelon 1 slice (92 kcal) Fruits 8 Milk 1 c reduced-fat 2% (121 kcal) Milk and milk products 15 Yogurt, plain 1 c low-fat (155 kcal) Milk and milk products 25 Cheddar cheese 1½ oz (171 kcal) Milk and milk products 10 Cottage cheese ½ c low-fat 2% (101 kcal) Milk and milk products 15 Pinto beans ½ c cooked (117 kcal) Legumes, nuts, seeds 158 Peanut butter 2 tbs (188 kcal) Legumes, nuts, seeds 30 Sunflower seeds 1 oz dry (165 kcal) Legumes, nuts, seeds 70 Tofu (soybean curd) ½ c (76 kcal) Legumes, nuts, seeds 55 Ground beef, lean 3 oz broiled (244 kcal) Meats, poultry, seafood 10 Chicken breast 3 oz roasted (140 kcal) Meats, poultry, seafood 5 Tuna, canned in water 3 oz (99 kcal) Meats, poultry, seafood 5 Egg 1 hard cooked (78 kcal) Meats, poultry, seafood 20 Excellent, and sometimes unusual, sources: Lentils ½ c cooked (115 kcal) Legumes, nuts, seeds 180 Asparagus ½ c cooked (22 kcal) Vegetables 130 Orange juice ¾ c fresh (84 kcal) Fruits 56 Folate Deficiency ⮚ Inability to synthesize DNA during folate deficiency ⮚ Results in large, immature red blood cells that are fewer in number: Macrocytic anemia ⮚ Deficiency during pregnancy Failure of spinal cord to close completely Spina bifida Lack of or incomplete development of brain and skull Anencephaly Together, these are known as Neural tube defects Rebecca A Creasy, PhD, 4  3/2/202 0 Spina bifida Spina Bifida – a Neural Tube Defect Rebecca A Creasy, PhD, 4  3/2/202 0 Anencephal y http://www.cdc.gov/ncbddd/birthdefects/anencephaly.html Decreasing Prevalence of NTDs since Folate Fortification Rebecca A Creasy, PhD, 4  3/2/202 0 Vitamin B12 ⮚Vitamin B12 is unique: Contains the mineral cobalt as part of its structure Synthesized by bacteria and other microorganisms Found naturally only in foods of animal origin - In protein Stored in body in significant amounts Requires intrinsic factor for absorption Vitamin B12 ⮚ Functions: Essential in converting folate into active form Maintains the insulating lining that covers nerve fibers known as: - myelin sheath Rebecca A Creasy, PhD, 4  3/2/202 0 DRIs and Food Sources of Vitamin B12 ⮚ RDA: 2.4 µg per day for adults ⮚ No UL ⮚Sources of naturally occurring vitamin B12 Animal-based foods: −Milk, cheese, meat (especially organ meats), poultry, and seafood Some foods fortified with vitamin B12: −Ready-to-eat cereals −Soy products −Supplements Vitamin B12 Absorption ⮚B12 must be released from dietary protein before it can be absorbed: Occurs in the stomach Hydrochloric acid and pepsin ⮚After release, vitamin B12 is bound by protein secreted in stomach: Intrinsic factor Protects B12 from degradation until absorption ⮚ Absorption occurs in lower ileum Rebecca A Creasy, PhD, 4  3/2/202 0 Source: Oh RC, Brown DL. Vitamin B12 deficiency. AFP; 2003: 979 Absorption of vitamin B12 Aging and Vitamin B12 Absorption ⮚ Vitamin B12 absorption decreases during aging Why? intrinsic factor hydrochloric acid secretion − ability to release vit. B12 from dietary protein. ⮚Adults >50 yrs. of age are recommended to take B12 supplement Rebecca A Creasy, PhD, 4  3/2/202 0 Vitamin B12 Deficiency ⮚Vitamin B12 deficiency can result in: Macrocytic anemia If due to lack of intrinsic factor: Pernicious anemia ⮚ Conditions in which reduced intrinsic factor occur: Genetic defect Aging Portion of stomach removed Roux-en-Y surgery Stomach cancer Rebecca A Creasy, PhD, 4