The Vitamins

1
The Vitamins

• David L. Gee, PhD
• Professor of Food Science and Nutrition
• Central Washington University
• FCSN 245 - Basic Nutrition

2
(No Transcript)
3
Dietary Supplement Use (USA)

• 4,300,000,000 for vit/min in 1995
• 1,400,000,000 for herbs
• 35-40 adults regular users
• females gt males
• 66 multi-vit/min
• 37 vitamin C
• 19 vitamin E
• Calcium supplements

4
Dietary Supplement Use Pros

• Supplements dietary deficiencies
• calcium
• folic acid
• Amounts used in some studies not attainable with
  dietary sources
• antioxidants
• Relatively low cost

5
Dietary Supplement Use Cons

• False sense of security
• folic acid and pregnancy
• Does not contain all potentially useful chemicals
  in foods
• Example compounds found in plants that may be
  health promoting (phytochemicals)
• Toxicity almost only due to supplement use
• Costs significant
• low income
• Heavy users of supplements (athletes)
• Certain supplements are expensive
• Chondroitin sulfate bone/cartilage 30-50/mo
• SAMe depression 40-50/mo

6
Exam 3 Tuesday, March 6

• Proteins and Amino Acids (chap 6)
• EAA, RDA, functions, athletes
• Genetically modified foods (p 472-480)
• Vegetarian diets
• Protein quality
• Protein deficiency (kwashiorkor/marasmus)
• Energy and Weight Loss (chap 9)
• Energy, TEE, BMR, factors affecting BMR,
  activity, TEF
• Calorimeters (bomb, direct, indirect)
• Weight loss, obesity risks, QOL, prevalence, high
  risk groups
• Healthy weight, assessment
• Calculate BMI, know cutpoints for blood pressure,
  sugar, lipids
• Dietary approaches (Balanced, Lo-Carb, restrained
  CHO, non-diet
• Exercise
• Drugs/Surgery

7
Vitamin Mineral DeficiencyA Global Progress
Report UNICEF, 2004

• 80 developing countries studied
• Accounts for 80 of world population
• 1/3rd of world population do not reach their
  physical and intellectual potential because of
  vitamin/mineral deficiency

8
Vitamin Mineral DeficiencyA Global Progress
Report UNICEF, 2004

• Vitamin A deficiency
• 40 of children lt5yrs with mild to severe
  deficiency
• Compromised immune deficiency
• blindness
• stunted growth
• Contributes to 1 million deaths of young
  children/yr
• A Solution supplementation with beta-carotene,
  2x/yr, fortification of foods

9
Vitamin Mineral DeficiencyA Global Progress
Report UNICEF, 2004

• Iodine deficiency
• Goiter enlarged thyroid gland, lethargy
• Cretinism severe mental and physical retardation
  in infants of deficient mothers
• Reduces IQ by 10-15 points
• 80 of developing countries have goiter rates of
  gt 10
• A Solution iodized salt (use declined from 75
  to 65 in last decade!)

10
Woman with iodine deficiency resulting In a
goiter.
Myxedematous endemic cretinism in the Democratic
Republic of Congo Four inhabitants aged 15-20
years a normal male and three females with
severe longstanding hypothyroidism with
dwarfism, retarded sexual development, puffy
features, dry skin and hair and severe mental
retardation.
11
Vitamin Mineral DeficiencyA Global Progress
Report UNICEF, 2004

• Iron deficiency
• Anemia fatigue, apathy in adults, poor academic
  performance in children (7-10pt drop in IQ)
• 45 of children between 6mo-2 yrs
• 20 countries over 70
• A solution
• Supplementation (bad taste, constipation)
• Fortification
• Salt with iodine and iron
• Vitamin/mineral mixes added to foods
• Fortified foods

12
The Discovery of Vitamins

• The Germ Theory of Disease
• Scurvy Disease of sailors
• Beri-Beri Disease of poor Asians

13
The Discovery of Vitamins

• The Germ Theory of Disease
• Rickets Disease of poor Northern European
  children
• Pellagra Disease of poor corn eating cultures

14
The Discovery of Vitamins

• The Vitamin Theory of Disease
• Scurvy Disease of sailors
• Vitamin C deficiency
• Beri-Beri Disease of poor Asians
• Thiamin deficiency
• Rickets Disease of poor Northern European
  children
• Vitamin D deficiency
• Pellagra Disease of poor corn eating cultures
• Niacin deficiency

15
Vitamins Definition

• Organic compound found in foods
• Required in small amounts
• Required in the diet (dietary essential)
• Proven to be required for health, growth, and
  reproduction
• deficiency syndrome identified

16
Vitamin Nomenclature

• Fat soluble A Water soluble B
• Vital amines
• vitamines vitamins
• Vitamin B complex
• collection of water soluble vitamins that
  function as enzyme co-factors
• Vitamin C
• Vitamins D and E
• Mistaken Vitamins

17
Fat and Water Soluble Vitamins

• Fat Soluble Vitamins (A, D, E, K)
• Soluble in lipids and solvents
• Excess stored and not excreted
• Excess may be toxic
• Deficiency slow to develop

18
Fat and Water Soluble Vitamins

• Water Soluble Vitamins
• B vitamins, C
• Soluble in water
• excess excreted in urine, little stored
• generally less toxic
• deficiency develops quickly

19
General Functions of Vitamins

• Hormones
• Vitamin D
• calcium homeostasis
• Vitamin A
• cell division and development

20
General Functions of Vitamins

• Non-specific chemical reactions
• Vitamin E
• antioxidant
• Vitamin C
• chemical reducing agent

21
General Functions of Vitamins

• Coenzymes or Cofactors
• chemicals that assist enzymes to function as
  catalysts
• B vitamins
• Vitamin C, A, K

22
Vitamin A types and sources

• Retinoids
• retinol, retinal, retinoic acid
• animal foods, milk fortification
• Carotenoids
• beta-carotene
• plants
• vitamin A precurser

23
Vitamin A functions

• Visual pigment rhodopsin
• night blindness
• Maintenance of epithelial cells
• regulation of keratin protein synthesis
• Xeropthlamia
• intestinal malabsorption
• Bone and Immune System Development

24
Vitamin A Deficiency

• Common in developing countries
• 3 million children with severe deficiency
• blindness, poor growth and appetite
• 275 million children with mild deficiency
• impaired immunity

25
Vitamin A Toxicity

• 10 times RDA chronically
• 100 times RDA acute dose
• hair loss, joint pain, birth defects
• carotenoids are non-toxic
• toxicity due to vitamin supplement overdose

26
Vitamin D Types and Sources

• Dietary sources animal foods, fortified milk
• Human Synthesis of Vitamin D
• Skin cholesterol sunlight
• Sunshine Vitamin UV-B rays
• Vitamin D3
• 5-10 minutes, arms and legs, mid-day sun
• Liver Kidney for activation
• 1,25-di-OH-D3

27
(No Transcript)
28
Final Exam Winter 2007

• Tuesday, March 15, noon
• 25 vitamins and minerals
• Lecture materials
• General info on vitamins/minerals
• Developing world vitamin/mineral deficiencies
• Required reading
• Chapter 7 (vitamin C vitamin A/carotenoids )
• Chapter 8 (nutrients involved in bone health)
• Chapter (iron folate B-12 )

29
Final Exam Winter 2006

• 75 comprehensive
• questions that you should know the answers to
  one or two years from now.
• Study class notes
• Review old exams

30
(No Transcript)
31
(No Transcript)
32
Vitamin D Functions

• Helps regulate blood calcium levels
• When blood calcium levels are low, vitamin D (and
  other hormones)
• Increases dietary calcium absorption
• Decreases urinary calcium excretion
• Increases bone calcium mobilization

33
Vitamin D Deficiency

• Rickets
• bone deformities in children
• Osteomalacia
• weak bones due to low calcium content
• Vitamin D deficiency
• Calcium deficiency
• multiple pregnancies

34
Vitamin D Toxicity

• 5 times the RDA chronically
• calcification of soft tissue
• toxicity due to excessive vitamin supplementation

35
Calcium

• Functions
• Bone Structure (99)
• Regulator of Metabolism (1)
• nerve impulse transmission
• muscle contraction
• blood clotting
• etc.

36
Calcium

• Regulation of Blood Calcium
• 10 mg/dl of blood
• hypocalcemia hypercalcemia
• abnormal muscle cramping
• nerve irritation
• Controlled by
• vitamin D, parathyroid hormone, calcitonin

37
Calcium RDA

• 1998 RDAs (AI)
• 1300 mg/d children teens
• 1000 mg/d adults
• 1200 mg/d older Americans
• Usual intakes are low

38
Osteoporosis

• Brittle, weak bones due to loss of total bone
  mass (minerals and protein)
• Prevalence
• 11 of gt 65 yrs
• 22 of gt 65 yrs in 20 yrs
• 24 million fractures/yr
• 200,000 hip fractures, 1/6 fatal

39
3D Visualization of data obtained by x-ray
microtomography of the bone structure of the
vertebrae of a 50 year old (left) and a 70 year
old (right)
40
This graph shows rates in the USA in 1984-87,
adapted from Jacobsen, SJ in American J Public
Health 80872, 1990.
41
An illustration of the consequence of
osteoporosis on the spinal column.
42
Elderly woman with dowagers hump, a marked
abnormal curving of the spine caused by
osteoporosis
43
Other osteoporosis factNational Osteoporosis
Foundation - 2003

• 10 million with osteoporosis
• 18 million with low bone density
• 1 in 2 women will develop osteoporosis sometime
  in their life
• (1 in 8 men)

44
Osteoporosis

• Risk Factors
• Genetics
• Family History
• Ethnicity
• Caucasian gt Asian gt Blacks

45
Osteoporosis

• Risk Factors
• Gender
• associated with declines in estrogen production
• post-menopause
• anorexia, female athletes

46
Undertreatment of Osteoporosis in Men with Hip
Fracture.Arch. Int. Med. (Oct. 2002)

• 10 million Americans with osteoporosis
• 2 million are men
• Of 110 men hospitalized with hip fracture
• 4.5 received treatment for osteoporosis
• 1 year mortality was 32
• Average age 80 yrs
• Of 253 women hospitalized with hip fracture
• 27 received treatment for osteoporosis
• 1 year mortality was 17
• Average age 81 yrs

47
Osteoporosis

• Risk Factors
• Chronic Calcium Deficiency
• Lack of Exercise

48
Prevention of Osteoporosis

• Exercise
• Dietary Calcium
• Rule of 300
• 300 mg/d from plant sources
• 300 mg/d from each serving of dairy

49
(No Transcript)
50
Prevention of Osteoporosis

• Other factors that may increase calcium loss
• high caffeine intake
• high protein intake
• high alcohol intake
• cigarette smoking

51
Prevention of Osteoporosis

• Calcium Supplements
• Calcium carbonate
• least expensive
• Tums
• poor absorption
• Calcium citrate/malate (CCM)
• expensive, well absorbed

52
Prevention of Osteoporosis

• Adequate amounts of vitamin D
• avoid excesses
• Hormonal replacement in high risk women

http//www.mhhe.com/biosci/ap/mediacentral/nutriti
on_animations/osteoporosis_final.swf
53
Folic Acid

• DRI (RDA) 1998
• 400 ug/d (180-200 old RDA)
• 600 ug/d pregnancy (400)
• Typical folate intake 200 ug/d
• Dietary Sources
• foliage fruits vegetables

54
Folic Acid

• Functions
• single carbon metabolism
• DNA synthesis (cell division)
• other reactions

55
Folic Acid

• Deficiency
• Megaloblastic Anemia
• large abnormal red blood cells
• Elevated blood homocysteine
• CHD risk factor

56
Folic Acid

• Deficiency
• Neural Tube Defects
• spina bifida - lower body paralysis
• required early in pregnancy
• Grain fortification (1998)
• will add 100-200 ug/d to diet

57
Vitamin B-12

• Cobalamine
• contains cobalt
• DRI (1998) 2.4 ug/d (old 2 ug/d)
• Dietary sources
• animal foods
• fortified cereals

58
Vitamin B-12

• Functions
• single carbon isomerization
• synthesis of DNA (folate interaction)
• nerve fiber sheath synthesis

59
Vitamin B-12

• Deficiency
• Pernicious Anemia
• megaloblastic anemia
• nerve injury
• peripheral weakness and numbness
• progressive degeneration to death
• concern among the elderly

60
Vitamin B-12

• Digestion and Absorption
• Requires functioning stomach
• intrinsic factor protein
• acid production

61
B-12 and Folic Acid

• Excessive folic acid can mask nerve degeneration
  of pernicious anemia
• FDA regulates dosage of folate supplements
• FDA limited amount of folate fortification in
  grains

62
Nutritional Antioxidants

• Oxidative Tissue Injury
• Oxygen free radicals
• unpaired electrons
• superoxide O2-.
• hydroxy free radical OH.
• hydrogen peroxide

63
Oxidative Tissue Injury

• Causes chain reactive damage to
• Cell membranes (hi PUFA)
• Proteins
• DNA

64
Oxidative Tissue Injury

• Associated with
• Coronary Heart Disease
• oxidized LDL-cholesterol
• Carcinogenesis
• Chemical Toxicity
• Auto-immune dieseases
• Aging

65
Sources of Oxygen Free Radicals

• Normal energy metabolism
• nutrient O2 --gt CO2 H2O energy
• Electron transport system
• O2 --gt H2O energy
• but O2 --gt O2-. --gt H2O energy

66
Sources of Oxygen Free Radicals

• D-amino acid metabolism
• D-AA --gt C-skeleton ammonia H2O2
• Metabolism of foreign chemicals
• drugs, pesticides, toxins, etc...
• Ozone, nitrogen oxides, UV light, smoke,
  radiation, etc...

67
Cellular Antioxidants

• Antioxidant Enzymes
• Catalase (iron)
• removes hydrogen peroxides
• Superoxide Dismutase (Cu, Zn)
• removes superoxide radicals

68
Cellular Antioxidants

• Antioxidant Enzymes
• Glutathione Peroxidase (Se)
• removes peroxides
• Mineral supplements are ineffective and may be
  toxic

69
Cellular Antioxidants

• Nutritional Antioxidants
• Vitamin E
• Carotenoids and other plant phytochemicals
• Vitamin C

70
Vitamin E

• Tocopherols
• Dietary sources
• widespread, highest in plant oils
• Deficiency
• rare in adults
• premature infants hemolytic anemia

71
Vitamin E

• Function
• free radical scavenger in membranes
• RDA 8-10 mg/d
• Research dosages 400-800 mg/d
• Toxicity rare, may be non-toxic below 1000 mg/d

72
Plant Phytochemicals

• Beta-carotene carotenoids
• Plant polyphenols
• garlic
• green tea
• grape skins
• cruciferous vegetables
• Antioxidants with specific niches

73
Vitamin C

• Ascorbic Acid
• Food Sources
• fruits
• vegetables
• Deficiency Scurvy
• poor wound healing
• impaired immune system

74
Vitamin C Functions

• Antioxidant
• water soluble free radical scavenger
• Collagen synthesis
• connective tissue protein
• Synthesis of neurotransmitters, thyroxine, etc.
• Aids in absorption of dietary iron

75
Vitamin C

• RDA 60 mg/d
• RDA (smokers) 100 mg/d
• typical intake 100 mg/d
• Effective research dosages 100-500 mg/d

76
Vitamin C

• Toxicity gt 1000 mg/d
• diarrhea
• kidney stones
• promotes iron overload toxicity
• Interfers with important lab tests
• blood in stools (colon cancer)
• urinary and blood glucose (diabetes)

77
Iron

• Functions
• Hemoglobin
• Myoglobin
• Iron enzymes
• catalase
• electron transport system

78
Iron Deficiency

• Iron deficiency anemia
• fewer, smaller, paler red blood cells
• fatigue
• 5-10 of US premenopausal women
• up to 40 of population in developing countries

79
Iron Deficiency Causes

• Blood loss
• menstrual blood loss
• parasites and bleeding ulcerations
• Inadequate dietary intake
• RDA men 10 mg/d
• RDA women 15 mg/d
• US usual intake 6 mg/1000 Cal

80
Dietary Sources of Iron

• Heme Iron
• meats (Hb Mb)
• 20-30 absorbed
• Non-heme Iron
• plants
• inorganic iron
• 1-10 absorbed
• vitamin C increases absorption
• iron cookware

81
Iron Overload Toxicity

• Children (accidental poisoning)
• Men and post-menopausal women
• Genetic defect
• improved iron absorption
• Excess iron is a pro-oxidant.
• oxidized LDL-C
• tissue injury

82
Iron Overload Toxicity

• May occur in 10 of men
• Treatment
• avoid iron containing supplements
• avoid excess vitamin C supplements
• bleeding or blood donation