Chapter 7

1. Chapter 7 Vitamins

2. Objectives • Of the 13 vitamins discussed: • State one or more functions of each vitamin • Identify at least two food sources of each vitamin • Identify some symptoms of or diseases caused by vitamin deficiencies

3. Facts • Organic (carbon-containing) compounds • Essential in small amounts for body processes • Do not provide energy • Enable body to use energy provided by fats, CHO, and proteins • Megadoses can be toxic

4. Thirteen Vitamin Types • Four fat-soluble: • Vitamin A • Vitamin D • Vitamin E • Vitamin K (continues)

5. Thirteen Vitamin Types • Nine water-soluble: • Vitamin B complex, including the following: • Thiamine (B1), riboflavin (B2), niacin, vitamin B6, folate, vitamin B12 (cobalamin), pantothenic acid, and biotin • Vitamin C

6. Requirements • Vitamin allowances given by weight in mg or micrograms (mcg or g) • DRIs have replaced RDAs • Tolerable upper limits (UL) • Maximum level of daily intake unlikely to cause adverse effects

7. Vitamin Deficiency • People prone to vitamin deficiency: • Alcoholics • Poor and incapacitated elderly • Clients with serious diseases that affect appetite • Mentally retarded • Children receiving inadequate care

8. Deficiency of Fat-Soluble Vitamins • Chronic malabsorption diseases: • Cystic fibrosis • Celiac disease • Crohn’s disease

9. Stop and Share • Match the following terms with their correct definition: (continues)

10. Stop and Share • Answers: • 1  B • 2  C • 3  A

11. Preserving Vitamin Content in Food • Buy fresh, unbruised vegetables and fruits • Use them raw when possible • Prepare fresh vegetables and fruits just before serving (continues)

12. Preserving Vitamin Content in Food • Heat canned vegetables quickly and in their own liquid • Follow package directions when cooking frozen vegetables or fruit

13. Avoiding Vitamin Loss • Steam or use as little water as possible • Cover pan and cook vegetables until bright in color and crisp-tender • Save any cooking liquid for soups, stews, and gravy (continues)

14. Avoiding Vitamin Loss • Store fruits and vegetables in cool, dark place • Microwave produce in 1 to 2 tablespoons (tbsp) of water

15. Fat-Soluble Vitamins • Vitamin A, vitamin D, vitamin E, and vitamin K • Not lost easily in cooking • Lost when mineral oil ingested • Excess amounts stored in liver • Deficiencies slow to appear

16. Vitamin A • Preformed • Retinol • Active form of vitamin A • Provitamin A carotenoids • Beta carotene, lutein, lycopene, and zeaxanthin • Inactive form of vitamin A found in plants • Converted to retinol

17. Functions of Vitamin A • Maintains healthy eyes and skin • Maintains normal bone growth and reproduction • Sustains healthy immune system • Has antioxidants that protect cells from free radicals

18. Sources of Vitamin A • Preformed vitamin A (retinol): • Fat-containing animal foods • Liver, butter, cream, whole milk, cheese, and egg yolk • Beta carotene: • Carrots, sweet potatoes, spinach, broccoli, pumpkin, squash, mango, and cantaloupe

19. Vitamin A Requirements • Commonly listed as retinol equivalents (RE) • 1 g retinol or 6 g beta carotene

20. Stop and Share • Consider the following questions: • What are the signs and symptoms you would expect to observe with too much vitamin A? • What are the signs and symptoms you would expect to observe with too little vitamin A? (continues)

21. Stop and Share • Excess • Birth defects • Hair loss • Dry skin • Headaches • Nausea • Dry mucous membranes • Liver damage • Bone and joint pain • Deficit • Night blindness • Dry, rough skin • Increased susceptibility to infections • Blindness or xerophthalmia

22. Vitamin D • Prohormone • Converted to hormone in body • D2 • Ergocalciferol • Formed in plants • D3 • Cholecalciferol • Formed in humans from cholesterol in skin • Values given in mcg or International Units

23. Functions of Vitamin D • Promotes calcium and phosphorus absorption • Building and maintenance of normal bones and teeth • Prevention of tetany

24. Sources of Vitamin D • Sunlight • Changes provitamin to vitamin D3 • People with little sun exposure must get sufficient intake from diet • Food sources: • Milk, fish liver oils, egg yolk, butter, and fortified margarine • Most milk in U.S. has 10 g vitamin D concentrate added per quart

25. Stop and Share • Consider the following questions: • What are the signs and symptoms you would expect to observe with too much vitamin D? • What are the signs and symptoms you would expect to observe with too little vitamin D? (continues)

26. Stop and Share • Excess • Deposits of calcium and phosphorus in soft tissues • Kidney and heart damage • Bone fragility • Deficit • Poor bone and tooth formation • Rickets • Causes malformed bones and pain in infants • Osteomalacia • Soft bones • Osteoporosis • Brittle, porous bones

27. Vitamin E • Tocopherols • Alpha • Most biologically active • Beta, delta, and gamma • Tocotrienols • Given as -TE (alpha-tocopherol equivalents) • 1 mg of -TE = 1 International Unit

28. Functions of Vitamin E • Serves as antioxidant • Prevents hemolytic anemia among premature infants • Enhances immune system • Retards spoilage of commercial foods

29. Sources of Vitamin E • Vegetable oils: • Corn, soybean, safflower, cottonseed, and products made from them • E.g., margarine • Wheat germ, nuts, and green leafy vegetables • U.S. diet typically contains sufficient amount

30. Stop and Share • Consider the following questions: • Your client asks you if it is possible to take too much vitamin E. How would you advise the client? • What signs and/or symptoms can result from too little vitamin E? (continues)

31. Stop and Share • Excess • Relatively nontoxic, fat-soluble vitamin • Stored in adipose tissue • Avoid long-term megadoses • Deficit • Serious neurological defects can occur from malabsorption

32. Vitamin K • Made up of several compounds essential to blood clotting • Vitamin K1 • Phylloquinone • Vitamin K2 • Menaquinone (continues)

33. Vitamin K • Synthetic vitamin K • Menadione • Destroyed by light and alkalies • Must be ingested daily • Measured in mcg

34. Functions of Vitamin K • Forms prothrombin for blood clotting • Candidates likely to receive vitamin K: • Newborns immediately after birth • Clients with faulty fat absorption • People who have had extensive antibiotic therapy • People who need antidote for overdose of anticoagulant or treatment of hemorrhage

35. Sources of Vitamin K • Green leafy vegetables • E.g., broccoli, cabbage, spinach, kale • Dairy products, cow’s milk, eggs, meats, fruits, and cereals • Bacteria in small intestine synthesizes some, but must be supplemented by dietary sources

36. Stop and Share • Consider the following questions: • What are the signs and symptoms you would expect to observe with too much vitamin K? • What are the signs and symptoms you would expect to observe with too little vitamin K? (continues)

37. Stop and Share • Excess • Anemia • From synthetic form • Deficit • Defective blood coagulation • Increases clotting time • Makes client prone to hemorrhage

38. Water-Soluble Vitamins • Vitamin B complex and vitamin C • Dissolve in water • Easily destroyed by air, light, and cooking

39. Vitamin B Complex: Thiamine (B1) • Essential for the following: • Nerve and muscle action • Metabolism of carbohydrates and some amino acids • Sources: • Unrefined and enriched cereals, whole grains, lean pork, liver, seeds, nuts, and legumes (continues)

40. Vitamin B Complex: Thiamine (B1) • Deficiency rare • Symptoms: • Loss of appetite, fatigue, nervous irritability, and constipation • Beriberi • Disease caused by extreme deficiency

41. Vitamin B Complex: Riboflavin (B2) • Necessary for the following: • Metabolism of carbohydrates, protein, and fats • Tissue maintenance • Especially skin around mouth • Healthy eyes • Sources: • Milk, meats, poultry, fish, enriched breads, cereals, broccoli, spinach, and asparagus (continues)

42. Vitamin B Complex: Riboflavin (B2) • Deficiency symptoms: • Cheilosis • Sores on lips and cracks at corners of mouth • Glossitis • Inflammation of tongue • Dermatitis • Eye strain • Itching, burning, and eye fatigue

43. Vitamin B Complex: Niacin • Generic name for nicotinic acid and nicotinamide • Coenzyme in energy metabolism • Sources: • Meats, poultry, fish, peanuts, and legumes • Sources of tryptophan, precursor of niacin: • Milk and eggs (continues)

44. Vitamin B Complex: Niacin • Measured in niacin equivalents (NE) • Excessive amounts can cause flushing • Due to vascular dilation, gastrointestinal problems, itching, and liver damage (continues)

45. Vitamin B Complex: Niacin • May be used as cholesterol-lowering agent under close supervision of physician • Due to adverse side effects: • Liver damage • Peptic ulcers (continues)

46. Vitamin B Complex: Niacin • Deficiency symptoms: • Weakness, anorexia, indigestion, anxiety, and irritability • Pellagra • Disease caused by extreme deficiency • Symptoms: • Sores on skin, diarrhea, anxiety, confusion, irritability, poor memory, dizziness, and untimely death

47. Vitamin B Complex: B6 • Pyridoxine, pyridoxal, and pyridoxamine • Essential for the following: • Protein metabolism and absorption • Aiding release of glucose from glycogen • Catalyst in conversion of tryptophan to niacin • Helps synthesize neurotransmitters • E.g., serotonin, dopamine (continues)

48. Vitamin B Complex: B6 • Sources: • Poultry, fish, liver, kidney, potatoes, bananas, spinach, and unrefined whole grains (oats and wheat) • Measured in mg • Deficiency symptoms: • Irritability, depression, and dermatitis (continues)

49. Vitamin B Complex: B6 • Deficiency in infants can cause various neurological symptoms and abdominal problems • Toxicity rare • May cause temporary neurological problems

50. Vitamin B Complex: B12 • Cobalamin • Contains mineral cobalt • Involved in the following: • Folate metabolism • Maintenance of myelin sheath • Preservation of healthy RBCs (continues)