Chapter 7- The Vitamins

- Compounds in food converted to active vitamins - Ex: Beta carotene can be converted into a form of vitamin A.

Provitamin/ Precursor

Examples of the roles of vitamin B in metabolism: - *They are "helper" nutrients, they don't supply the body with energy. They directly or indirectly help the body use energy from CHO, fat and protein - Thiamin, riboflavin, niacin, pantothenic acid, biotin all participate in the release of energy from protein, CHO and fat - Vitamin B6 helps the body use AA to make protein - Folate and Vitamin B12 help cells multiply - Vit B acts as a coenzyme which is a small molecule that combines with an enzyme and activates it.

Vitamin B

- Vitamin C is an antioxidant, helps maintain collagen which is the protein of connective tissue. It also protects against functions and helps in iron absorption. The theory that vitamin C prevents or cures colds or cancer is not well supported by research. Take high vitamin C doses may be unwise as enough of it can be taken from foods

Vitamin C Key Point

-* Vitamin D is the most potential toxic vitamin of the fat-soluble vitamins - Too much can cause a loss of appetite, nausea and vomitting, severe psychological depression, calcium deposits in the heart, arteries, kidneys, brain nerves, bones. - Intakes of 5x the amount is associated with toxicity- problems with over supplementation and wrong fortification doses. - Rickets could be suffered due to inadequate food combined with a lack of sunlight (Vit D)

Vitamin D Toxicity

- DRI- 15 mg a day for adults - UL- 1000 mg/day from supplements and fortified foods - 1 a-TE= 1mg of active vitamin E vitamins. - To find IU, divide a-TE by 1.5

Vitamin E Recommendations

General symptoms of B vitamin deficiencies include: - Nausea, severe exhaustion, irritability, depression, forgetfulness, loss of appetite and weight, pain in muscle, impairment immune response- Ex: if the body is malnourished its not able to fight off diseases. - Other deficiencies: loss control of limbs, abnormal heart action - Teary or bloodshot eyes, swollen red tongue, skin problems - Cell renewal of digestive tract and the blood are affected - A deficiency of any one B vitamin rarely shows up by itself since nutrients are not eaten singly. - Many vitamin B vitamins are seen together- vit b6, b12, etc. If we have a deficiency in one of these vitamins, we have to replace the complete nutrient - Vit b 10 and vit b 12 mask each other. - Iron and B12 deficiency have some of the same symptoms such as anemia so sometimes one is unsure which deficiency they have.

B Vitamin Deficiencies

- Most abundant cartenoid precursor for vitamin A (although there are a few others) - Dietary antioxidant- can prevent cancer and other diseases - Measured in retinol activity (RAE) where it converts beta carotene into retinol and takes 12ug of beta carotene to equal 1 ug of retinol for the body (don't memorize numbers) (Carenoid= member of a group of pigments in food that range in colour from light yellow to relish, orange and are chemical relatives of beta-carotene, many have a degree of vitamin A activity in the body)

Beta- Carotene

- Excess: not toxic compared to retinol which turns people bright yellow/orange if eaten in excess - If someone has eaten a lot of carrots, oranges or green veggies, you may find your skin turning orange/yellow-ish - Rich source: carrots, sweet potatoes/yams, pumpkins, mango, cantaloupe, spinach, broccoli, red cabbage, beets, etc. - Key point: the vitamin A precursor in plants, beta-carotene is an effective antioxidant in the body. It's brightly coloured plant foods are richest in beta-carotene and diets containing these foods are associated with eye health.

Beta- Carotene in Excess and Food Sources

(A, D, E, K) - They are absorbed into the lymph, travel in the blood along with protein carriers - They are dissolved and stored in lipids - Require bile for absorption as bile is an emulsifying agent - Stored in the liver and body tissues - May be toxic in excess from supplements (A, D, K) not as much vitamin E - Deficiencies occur with low intake or fat malabsorption

Characteristics of Fat Soluble Vitamins

- Wheat flour- bleached and fortified with thiamin, riboflavin, niacin, folate and iron - In Canada, Vitamin A and D do not have to be added to cereals, but we can get these nutrients in fortified milk - Eat a variety of foods to provide nutrient needs - Remember ABCDMV principles of diet planning (Adequate, Balance, Calorie Control, D.., Moderation, Variety)

Choosing Foods Rich in Vitamins

- Vitamins A, D, E and K

FAT SOLUBLE VITAMINS

- Air pollution- clouds, smog, smoke - City living- tall buildings, window glass, window screen - Clothing- darker vs. lighter colours, the sun is more attracted to darker coloured clothing - Homebound/ institutionalized/night shift work- how much time you see the sun - Dark skin- these people need longer exposure to the sun vs. light skin - Season- warmer summers (cannot lead to toxicity of vitamin D from sunlight) - Sunscreen- SPF 8+ prevents synthesis - Time of day- mid-day hours are the best - Geography- lack of direct sunlight in Sept-March in Canada, Nov-Feb in the US - Sunbathing- risks of premature wrinkling, skin cancer

Factors Affecting Sun Exposure and Vitamin D Synthesis

- Acid, bases, oxygen, UV light, heat - Ex; when exposure to high heat we can lose some of the fat soluble vitamins

Factors that destroy vitamins

- Deficiencies may result from inadequate intake, illnesses, increased excretion, medication such as aspirin, anti-convulsants, barbiturates, antacids. - Examples of deficiencies: Anemia, diminished immunity, abnormal digestive function - Neural tube defects- spina bifida, anencephaly, mental retardation, severely diminished brain size, death shortly after birth. This occurs when there is not enough folate during pregnancy. Can lead to death, miscarriage, spontaneous abortion, etc. - Leads to elevated risk of CVD, Colon cancer, Cervical cancer in women. (Getting enough folic acid in during early years is helpful!)

Folate Deficiency

- *RDA- 400ug per day for males and females- but needs increase with pregnancy - RDA- pregnancy= 600ug per day. Those who are lactating= 500g per day of dietary folate equivalents - UL- 1000ug per day from synthetic forms only such as supplements and fortified food (individuals pregnant and currently breast feeding need to take near the UL in order to get enough) - Peri-conceptual nutrition- the period before conception= 400g per day from synthetic form reduces the risk of NTDs. - Good food sources outside of grains and supplements: "foliage", green leafy vegetables (*spinach and kale), lents, enriched grains, cantaloupe, orange juice, eggs - High intakes can mask blood symptom of vitamin b12 deficiency but will not prevent nerve damage. Intrinsic factor needed to absorb vitamin b12 -"All women who could become pregnant and those who are pregnant or breastfeeding need a multivitamin containing folic acid every day."

Folate Recommendations*

Functions: 1) Required to make all new cells. Our blood cells and digestive tract are most vulnerable to a deficiency 2) Helps metabolism of DNA and RNA (genetic material)- all new cells are equipped with new genetic material which folic acid helps with. 3) Helps Homo-Cysteine metabolize. High levels of homo-cysteine is an indicator for HD. So folic acid can reduce risk of HD by controlling the levels. 4) Prevents folate-deficiency anemia which is related to pernicious anemia of vitamin B12 malabsorption - Folic acid intake needed 3 months prior to conception for pregnant women, along with taken during pregnancy

Folic Acid/ Folate/ Folacin

300mg of vitamin C in a day can come from: - 250 ml (1 cup) of orange juice - Salad for lunch - Stalk of broccoli - A potato for dinner There is no need for vitamin C supplements as it is easy to get it into the diet.

Food Sources of Vitamin C

4) Cell Differentiation - Allows each type of cell to mature and perform a particular function. Ex: goblet cells to produce mucus in the lungs and to protect it from respiratory infections. - Without enough vitamin A, the body will not mature as well as our cells will not be able to mature as well. - Keratinization can occur in the wrong place like on the skin making it hard/ dry/ cracked increasing the risk of infection. - Links to cancer especially the role of retinoid acid in regulating genes that may suppress/put an end or even reverse malignant cell changes.

Functions of Vitamin A- Cell Differentiation

1) Eyesight: - We receive light at the retina--> pigment RHODOPSIN contains vitamin A - Maintains healthy crystal-clear outer window, the CORNEA- covering the outside of the eye. Process: - When light hits the eye, it bleaches the rhodopsin. When this is bleached, it breaks off a piece of vitamin A which transports the sensation of sight to the optic centre of the brain. - New vitamin A is then needed to replace that part that breaks off. - If vitamin A deficiency, there will be a lack in recovery of vitamin A. This can lead to night blindness.

Functions of Vitamin A- Eyesight

2) Gene Expression - Retinoic acid is involved as it regulates activities of genes that direct the synthesis of proteins and enzymes, this affecting metabolic activities of tissues. An anology: a car alone cannot take you across town, you need the key in the ignition to start the motor. Having the machinery to make genes is not enough, you need retinoic acid to activate and deactivate the genes

Functions of Vitamin A- Gene Expression

6) Growth - Supports bone growth, assists in growth of bones and teeth - Vitamin A deficiency in children shows evidence for poor growth, failure to grow - Calcium, vitamin A and D are important in bone growth and density.

Functions of Vitamin A- Growth

5) Immunity - Vitamin A is "anti-infective"= against infections due to many roles in the body's defence - Epithelial tissue - Contributes in the regulation of genes that produce proteins involved in immunity

Functions of Vitamin A- Immunity

3) Skin and body lining - Epithelial cells which are the external skin and protective linings of the lungs, intestines, vagina, urinary tract and bladder, need vitamin A. - These cells serve as protective barriers to infection by bacteria and to damage from other sources. - Beta carotene (together with vitamins C, E and selenium) helps with our overall immunity, especially cancer and heart disease

Functions of Vitamin A- Skin and Body Lining

Deficiency: - Pellagra (4DS= diarrhea, dementia, dermatitis, death). This can be prevented by adequate protein because tryptophan can be converted to niacin in the body - Adequate protein intake= no niacin deficiency - A diet of corn meal. salted pork fat, molasses= niacin deficiency - Other deficiencies: diarrhea, dermatitis, dementia, death - Seen more in 3rd world countries than in Canada. In Canada it is seen amongst elders.

Niacin Deficiency

Functions: 1) Co-enzyme for energy in CHO, protein, fat and alcohol metabolism. 2) Needed in greater than 40 reactions 3) Interacts with vitamin A in the visual cycle Excess: - 2-3 times the DRI results in: niacin flush= dilation of the capillaries of the skin with painful tingling. - very rare that toxicity occurs - Can occur from someone drinking too much vitamin water. Who might suffer from this? - Drug-like-effect- people that get large doses that are given for atherosclerosis and diabetes. This could injure your liver, cause peptic ulcers and vision loss

Niacin [B3]

- Good food sources: meats, fish, nuts, whole grains, enriched cereals, mushrooms, baked potato, tune - RDA- 14mg per day for females, 16mg per day for males - UL- 35 mg per day from fortified foods and supplements - Niacin equivalents- niacin can be made from tryptophan. This takes available tryptophan in the body, into account. - Needs increase with increased energy and fructose intakes

Niacin/ Nicotinic acid/ B3

- Good food sources- most foods of plants and animal origin - Do not need a lot of these vitamins Functions: 1) Co-enzyme for energy of CHO, fat and protein metabolism 2) Pantothenic acid also participates in the synthesis of lipids, steroid hormones, neurotransmitters and hemoglobin - AI (pantothenic acid)- 5mg per day for males and females. - AI (biotin) 30ug per day for males and females - No UL for both - Important to the body and are abundant in food

Pantothenic Acid and Biotin

Functions: 1) Co-enzyme for energy from CHO, fat and protein metabolism 2) Protects skin and eyes 3) Interacts with vitamin B6 an folic acid/folate - Good food sources: whole grains and enriched cereals, milk and milk products (yogurt), eggs, meats (beef liver), green leafy vegetables, mushrooms - RDA- 1.1 mg per day for females, 1.3 mg per day for males. Needs increase with energy intake - No UL - When thiamin is deficiency, riboflavin may also be lacking - B1 and B2 occur together with those whom have alcohol problems

Riboflavin [B2]

Beri-beri (wet or dry)- this is characterized by: - Loss of sensation in the hands and feet. - Muscles become weak, - It advances paralysis - Abnormal heart action occurs in adults - Occurs during growth - Permanent brain damage may result/occur. Wernicke- Korsakoff Syndrome: - Affects brain tissues - Associated with alcohol abuse- more commonly seen in alcoholics than non-alcoholics - Characterized by apathy, irritability, mental confusion and disorientation. - Loss of memory, jerky eye movements, staggering gait - Both of these situations can lead to death, beri-beri more than Wernicke.

Thiamin Deficiency

Functions: 1) Co-enzyme in energy from CHO and protein metabolism. 2) Affects nerve function- special site on nerve membrane 3) Needed to metabolize alcohol - Good food sources: whole grains, enriched cereals/wheat flour, pork chop and ham, legumes (black beans), green peas, sunflower seeds - Found on most ingredient lists. - Mandatory for our grains to be enriched with B vitamins - RDA: 1.1mg per day for females, 1.2 mg per day for males. A minimum of .8mg per day but the needs for thiamin increase with increased energy intake (CHO and protein). - NO UL

Thiamin [B1]

Three active forms in the body: 1) Retinol- stored in the liver 2) Retinal 3) Retinoic acid - Retinal and retinoic acid are converted by the cells from retinol - They are plant-derived precursors. Ex: beta-carotene - Good source: liver, fortified milk, fish oil, provided in foods of animal origins, deep orange fruits and dark green leafy vegetables [sweet potatoes, carrots, spinach, 'bok choy', broccoli, apricots, mango, cantaloupe]. - Eating too much liver can result in excess levels of vitamin A - Fortified milk has vitamin A and D, even skim milk has a bit.

Vitamin A

- 3-10 million children suffer from xerophthalmia (true blindness), diarrhea, reduced food intake - 275 million children suffer from milder deficiencies such as impairs immunity and promotes infections - Countries with vitamin A supplements decreases child mortality by 50% - Vitamin A supplements are recommended for the protection against measles, malaria, lung disease and HIV - WHO & UNICEF - lead international agencies fighting against Vit. A deficiency by providing people with micronutrients such as rice and corn.

Vitamin A Deficiencies in the World

If deficiency progresses: 1) Keratinization of the cornea: protein "keratin" accumulates in the cornea and clouds the eye. (keratinization= plack on the front of the eye). 2) Xerosis: drying of the cornea- worst than keratinization 3) Xerophthalmia: thickening of the cornea and permanent blindness (worst version) (These three are seen in 3rd world countries) 4) Macular degeneration- seen in elderly. This is a loss of the central focus of vision in the retina. A loss of Macula's protective yellow pigment provided by B-carotene and other carotenoids. This is preventable but something that occurs through increased likelihood of genetics. -- Prevention - capsules providing 60,000 ug 2x a year; regular intake of F & V

Vitamin A Deficiency and Eyesight

- The amount of vitamin A one needs is proportional to their body weight Recommended Daily Allowance (RDA)= 700ug per day for females, 900ug per day for males. - RAE (retinol activity equivalents)- consider amounts from beta carotene and precursors or active forms. - Stored in the body so the average intake does not need to be from daily intake but overall intake. - UL- 3000 UG from retinol, avoid supplements exceeding this for adults 18+ - IU exists - Recommendations are easily reached through food alone in a healthy balanced diet from retinol and beta-carotene. (fruits and veggies) (DO not need to know numbers, just fact that they exist)

Vitamin A Recommendations

- Occurs from supplements or fortified foods and livers - Early symptoms of overdose: loss of appetite, blurred vision, growth failure in children, headache, itching of skin due to keratinization, irritability, bone fracture - Other signs: abdominal pain, hair loss, joint pain, stunted growth, bone and muscle soreness, cessation of menstruation, nausea, diarrhea, rashes, damages to the liver, enlargement of the spleen - Signs of deficiency and overdose overlap amongst different vitamins. We look to the more specific symptoms to diagnose someone, not the main ones like nausea. - 3-4 times the RDA in pregnant women is toxic to the fetus (malformation). Single doses of 100x will cause toxic reactions- beware of heavily fortified foods! - Vitamin A will NOT cure acne. Actuate is derived from vitamin A, but chemically changes and doses are controlled - Toxicity can lead to reduced bone density

Vitamin A Toxicity

*Functions: 1) Converts folate to its active form 2) Helps make red blood cells 3) Aids in DNA and RNA metabolism (along with folate) 4) Maintains nerve fiber sheaths Deficiency: - Pernicious anemia- this is large immature RBCs, damaged nerve sheaths, creeping paralysis, general malfunctioning of nerves and muscles. (picture in slides of abnormally large RBCs) - Those at risk: Vegans and vegetarians- all vegetarians especially pregnant women must be sure to use vitamin b12 or take appropriate supplements in order to prevent deficiencies.

Vitamin B12- Function and Deficiency

- RDA- 2.4ug per day for male and females - No UL - Good food sources: foods or animal origin (chicken liver, sirloin steak, sardines, tuna) or vegetarian food that has been fortified (soy milk, almond and coconut milk) - Absorption requires an Intrinsic Factor from stomach lining - Intrinsic factor is when abnormal absorption of vitamin B12 occurs. If we take the proper vitamin b12 needed and it doesn't get absorbed and we have a deficiency then we are missing an intrinsic factor. This individual would need to get a vitamin B12 shot in order to get this vitamin in as they cannot just take it in through food.

Vitamin B12/ Cobalamin

- Vitamin E acts as an antioxidant in cell membranes and is especially important for the integrity of the cells that are constantly exposed to high oxygen concentration, namely the lungs and red and white blood cells. Vitamin E deficiency is rare in human beings but it does occur in newborn premature infants. The vitamin is widely distributed in plant foods, it is destroyed in high heat (oxidation) and toxicity is rare.

Vitamin E Key Point

- Deficiency- weakness, psychological depression, irritability, confusion, insomnia, greasy dermatitis* (skin becomes very greasy), anemia, convulsions - Continued... weakened immune system because not able to metabolize protein the same, increased incidence of HD - Together, deficiencies of folate + vitamin B12+ B6 are linked to increased H-Cys and a severe early form of CVD. Adequate intake of these B vitamins will reduce risk of HD. - Toxicity: nerve damage causing numbness of feet and hands, muscle weakness leading to inability to walk, skin lesions, depression, fatigue, impaired memory, irritability - Food sources: most high protein foods such as meats, fish and poultry. Potatoes, green leafy vegetables, banana, sweet potato - RDA- 1.3mg for males and females - UL 100mg per day - Needs related to protein intake and glycogen metabolism. The more protein, the more vitamin B6 needed.

Vitamin B6

Functions: 1) Required for more than 100 reactions in the body 2) Aids in metabolism of amino acid and protein, ex: hemoglobin and neurotransmitters 3) Synthesis of non-essential and other amino acid metabolism, ex: tryptophan to niacin or serotonin, Homo-cysteine metabolism (helps in heart disease prevention) 4) Has roles in immune function and steroid hormone activity 5) Assists in releasing stored glucose from glycogen 6) *Critical to developing brain and nervous system of fetus

Vitamin B6 Functions

- Great antioxidant - Ascorbic acid= 'no-scurvy acid' - RDA- 75 mg per day for females, 90 mg per day for males. An extra 35mg per day for smokers - UL- 2000 mg/d (acts as a pro-oxidant). If one reaches the UL then vitamin c moves from an antioxidant to a pro-oxidant making it a cancer causing agent. - Canadians consume around 100 mg per day - Maximum plasma levels reached with 60-100 mg/d, then urine levels rise sharply. - *Good food sources- citrus fruits (grapefruits), OJ, strawberries, red/green peppers, broccoli, bokchoy, sweet potato (basically fruits and vegetables only). As well, many fortified products available using Rose Hips - People with kidney disorders and those with a condition of too much iron in their blood may be more susceptible to the opposite effects of vitamin C and therefore should avoid supplements of this vitamin altogether. They should get their vitamin C from food only.

Vitamin C

Scurvy: - Vitamin C (ascorbic acid) deficiency. Ascorbic acid was a vitamin that fruit provided that helped treat scurvy. It means "no scurvy acid". - Hazard of long distance seagoing journeys of 200+ years ago - To avoid scurvy, British sailors were given lime juice, lemon juice and they were cured. Other deficiencies: - Loss of appetite - Growth cessation- stop of growth - Tenderness of touch - Weakness - *Bleeding gyms - Swollen ankles and joints - Pinpoint hemorrhages - Anemia- this can also come from an iron deficiency.

Vitamin C Deficiency

1) *Antioxidant- prevents oxidation and cell damage, protects ad recycles vitamin E to its active form 2) Keeps non-heme iron (plant source and not very absorbable) in the form needed for absorption 3) *Causes collagen formations in bones, teeth and tendons. Collagen forms scar tissues, structures to repair fractures, supporting material for capillaries (collagens prevents bruises). 4)* Affects health of teeth and gums. Ex: scurvy- we see poor mouth, teeth and gum health. 5) Co-Factor in producing carnitine, which is important for transporting fatty acid within cells 6) The thought that vitamin C can cure a cold- this is not supported by research, however, one may experience milder symptoms, shorter duration of cold. It can help with it but does not cure it. 7) Chewable forms of vitamin C help dental enamel destruction.

Vitamin C Functions

- Acts a *pro-oxidant, which activates oxidizing elements like iron and copper - Danger in cases where people have iron overload in their body - Alters the insulin response to CHO in body. - Digestive upsets- nausea, abdominal cramps, excessive gas, diarrhea - May interfere with medications that prevent blood clotting - Pro oxidant= a compound that triggers reactions involving oxygen

Vitamin C Toxicity

- 2 grams per day for two weeks seems to reduce blood histamine which is the substance responsible for sneezing, runny or stuffy nose, swollen sinuses - At these doses, vitamin C may work like a weak antihistamine (something used to treat a sickness) - Or its antioxidants or other activities may improve the body's immunity Placebo effect: - In one study, half the experimental subjects received a placebo but thought they were receiving vitamin C. This group reported having fewer colds than the group that had received vitamin C but thought they were receiving the placebo- this shows how vitamin C doesn't really make a huge difference, its more of a psychological thought that it helps.

Vitamin C and the Common Cold

- Rickets in children- this is the protruding or 'pigeon' chest, beaded ribs, protruding belly, bowed legs. - All breast-fed healthy term infants should be supplemented with 10 ug of vitamin D to prevent getting rickets. - Osteomalacia in adults, which is a form of rickets. Results in weak or soft bones in the legs and spines, bendable and weak bones that eventually break.

Vitamin D Deficiency

Populations at risk: - Those taking anti-coagulant medication (blood thinning meds) used to prevent unwanted blood clotting- vitamin E increases the effects of these blood thinning medication which can cause the blood to be too thin. - For some, long term use of even low doses of vitamin E is linked to brain hemorrhages, a form of stroke. (Omega 3 is also blood thinning)

Vitamin E Toxicity

1) Functions relate to calcium balance and bone health. 2) Helps absorption of dietary Calcium and Phosphorus in our skeleton, digestive tract and kidneys to maintain bone integrity - Diet-related health claims: "A healthy diet with adequate Calcium and vitamin D and regular physical activity helps to achieve strong bones and may reduce the risk of osteoporosis." - Another health claim: "vitamin D helps in the absorption and use of Calcium and Phosphorus" 3) Acts as a hormone to raise our levels of blood calcium when dietary calcium is lacking by pulling calcium from our bones when needed. 4) Affects health of bones and teeth by ensuring there is sufficient calcium and phosphorus available in our blood. 5) Stimulates the maturation of cells, especially cells of the immune system to fight off infections and some cancers (colon and prostate cancer). - May also play an important role in helping some forms of cancer, CVD, multiple sclerosis and immune functioning

Vitamin D Functions

- Vitamin D raises mineral levels in the blood (calcium and phosphorus), permitting bone formation and maintenance. A deficiency can cause rickets in childhood or osteomalacia in later life/elders. Vitamin D is the most toxic of all the fat-soluble vitamins and excesses are dangerous or deadly. People exposed to the sun make vitamin D from cholesterol-like compounds in their skin, and fortified milk helps make vitamin D which is an important food source.

Vitamin D Key Point

- These are new, came out in 2010!! - EAR 400 IU (10mcg) per day for males and females 1-70 years old - RDA 600 IU (15mcg) per day for males and females 1-70 years old - Tolerable Upper Limit (TUL)- 4000 IU per day- DON'T GO OVER UL! - The original DRI's used to be lower but was made higher as they found a little bit more vitamin D may be better and healthier for you. - Young adults who drink 3 cups of milk (750 mL) a day will only receive half of their daily recommended intake, other half comes from exposure to the sunlight and other food sources.

Vitamin D Recommendations

- The body can synthesize all the vitamin D it need with the help of sunlight---> therefore it is an non-essential nutrient - UV light shines on 7-dehydrocholesterol in the skin---> 7-DC transformed to inactive vitamin D3 precursor absorbed directly into the blood---> the liver and kidney convert the precursor to active 1, 25-hydroxy vitamin D3. - Good food sources: fortified milk, salmon, shrimps, fortified soy beverages, mushrooms - People over age of 50 and young infants need vitamin D supplements daily

Vitamin D- How Can We Get Vitamin D?

- 'Tokos'- Greek word for 'offspring'. A, b, g, d tocopherol - Need for vitamin E increases as intakes of PUFAs increases (anti-oxidant function) - Heat destroys Vitamin E, therefore we receive no vitamin E from oils in fried food - Good food sources: plant fats (not animal fats) such as: vegetable oils (canola, safflower), products made from these oils (salad dressings), nuts and seeds (sunflowers), fortified cereals, wheat germ. - *Animal fats are not a source. - Tocopherol is a type of alcohol. The active form of vitamin E is alpha-tocopherol

Vitamin E

- NOT many deficiencies seen from Vitamin E - No deficiencies in humans for 3 reasons: 1) Vitamin E found in many different types of food 2) Body stores readily in tissue 3) Cells recycle their working supply of vitamin E - A classic deficiency of vitamin E occurs in premature babies as they are born before the transfer of vitamin E from mother to fetus in the last few weeks of pregnancy. In this case, their red blood cells rupture and the infant becomes anemic. - Few symptoms observed in adults: loss of muscle coordination and reflexes, impaired movement, vision and speech- this is corrected by vitamin E treatments. - Vitamin E deficiency is associated with fat malabsorption due to disease or injury to the liver (affecting bile production), gall bladder (delivery of bile to intestine), pancreas. (production of lipase). - Deficiencies are most likely seen in those who for years eat diets extremely low in fat and use fat substitutes, consume diets of highly processed or 'convenience' foods - Research has discredited claims that vitamin E improves athletic endurance and skill, enhances sexual performance or cures sexual dysfunctions in males.

Vitamin E Deficiency

1) Anti-oxidant= it is the body's defender against oxidative damage from free radicals. Antoxidant acts as a brick wall that stops damage in the body. 2) Protects all the lipids and related compounds such as vitamin A, from oxidation (by itself being oxidized) 3) Special anti-oxidant effect in lungs because the cells are exposed to a high concentration of oxygen, and it protects our red blood cell membranes too. 4) Helps defend against heart disease and some cancers, assists in normal nerve development, protects white blood cells against diseases 5) Supplements are good to improve the immunity among healthy elderly - Vitamin E can also be used for healing outside and inside the body. Ex: healing cuts outside the body - It thins the blood inside the body so be cautious!

Vitamin E Functions

- K stands for the Danish word koagulation (clotting)--- vitamin K's main role is in blood clotting. Recommendations: - AI- 90ug per day for females, 120ug per day for males. NO UL!! Good food sources: - Dark green leafy vegetables (spinach), cabbage family, broccoli, cauliflower, brussels sprouts, liver, eggs, milk, canola and soybeans - For people on blood thinning diets they have to be careful about how much spinach, broccoli they take in as it can thin their blood even more - It may be synthesized from intestinal bacteria. Give infants small supplemental dose when they are born as they are not able to make their own until 2 weeks of life. - Those taking antibiotics that kill intestinal bacteria may be at risk

Vitamin K

1) Help synthesize proteins that clot blood 2) Levels of vitamin K are measured before surgery and may supplement if levels are low 3) Needed by people taking "Warfarin" or dicumarol if uncontrolled bleeding occurs. (Dicumarol used for thinning the blood to prevent formation of blood clots.) 4) It it necessary for the synthesis of protein needed in bone formation together with vitamin D. They may play a role in reducing hip fractures. (people who consume vitamin k often in form of green leafy veggies suffer lower hip fractures). - People with heart problems need to prevent the formation of clots within their circulatory system, referred to as "thinning" of the blood. One of the best known medications for this purpose is warfarin, which interferes with the action of vitamin K in promoting clotting.

Vitamin K Functions

- Vitamin k is necessary for blood to clot. Deficiencies causes uncontrolled bleeding. The bacterial inhabitants of the digestive tract produces vitamin K. Toxicity causes jaundice.

Vitamin K Key Point

- Toxicity with supplements of synthetic version is given to infants or pregnant women Symptoms: - Yellow skin due to breakage of RBC's - Jaundice- Liver releases bilirubin into the blood instead of excreting it into the bile - May result in brain damage or death of infants - Infants lacking vitamin K when born are put under this light which then will give them more vitamin K - Found that infants in hospital nursery post birth placed next to window are found with less issues of toxicity levels. Found that UV light can help with build up in certain situations.

Vitamin K Toxicity

- Non-essential, but sometimes are taken in through food. For the most part, if one eats a healthy diet then they do not need a multivitamin - Choline- nonessential nutrient used to make lecithin and other molecules - Carnitine- nonessential nutrient that functions in cellular activities - Inositol, lipoic acid- nonessential nutrients Beware of many others being marketed for profit! Most are used to make formulas appear more 'complete', but offer no physiological benefit

Vitamin-Like Bioactive Compounds

- Organic compounds - Essential to life and body functions - Needed in small amounts, some in extremely small amounts - Non-caloric essential nutrients- does not contain calories as vitamins do not give energy and calories come from energy. - Without some vitamins we will have deficiencies - The only disease a vitamin can cure is the one caused by a deficiency of that vitamin!

Vitamins

- B vitamins and C vitamins - They dissolve in water- cooking and washing with water can leach them out of foods. Ex: boiling broccoli or carrots - Easily absorbed into the blood stream and excesses excreted in urine - Not stored extensively in body tissues - Foods never deliver toxic doses of the water-soluble vitamins but large doses in vitamin supplements can reach toxic levels

WATER SOLUBLE VITAMINS

- Vitamins B ( thiamin B1, riboflavin B2, niacin B3, folate, B12, B6, biotin, pantothenic acid) - Vitamin C

Water Soluble Vitamins

This person has low vitamin B12 and vitamin D. What can we suggest? 6 am: Banana on the run 8 am: Coffee with milk and sugar 11:30 am: TH Muffin and hot chocolate 2 pm: Apple 6:30 pm: Pasta with Tomato Sauce 10 pm: Popcorn We can suggest: • Fish, beef, chicken- any source of protein or animal origin • Fish= b12 and vitamin d. • Vegetables • TH Muffin and hot chocolate- instead of hot chocolate, get hot chocolate milk so you get some vitamin D. Instead of muffin, suggest a breakfast sandwich.

What Can we Suggest?