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Chapter7

VITAMINS

M.G.Rajanandh, Dept. of Pharmacy Practice, SRM College of Pharmacy, SRM University.

Whatarevitamins?

•Nutrientsthatourbodydoesnot makeonitsown.Thuswemust obtainthemfromthefoodsweeat, orviavitaminsupplements.

They are essential for providing

good health and are necessary for many life functions.

Supplements,whatarethey?

•Defn:syntheticornaturalsubstanceswhich canbepurchasedaspills,tablets,capsules, wafers,powders,orliquids.

Top10?'saskedaboutVitaminSupplements

ShouldIgetmyvitaminsfromfoodor

supplements? •Adiethighinfiberandlowinfatisthebestwaytomeetdailynutritionalneeds. •Ifyoucloselyfollowthe"foodpyramid"thenyoushouldmeettheRDA (RecommendedDietaryAllowances)forvitaminsandnutrients. •Supplementsarebestwhenaccompaniedbyawellbalanceddiet. •Supplementsshouldnotreplaceahealthydiet. •Foodprovidescaloriesandenergythatarerequiredfordailyactivities,vitamin supplementsdonotprovideenergyorcalories. V

DoIneedamultivitaminsupplement?

•Itdoesnothurttogetalittletotakea multivitamindailytoensurepropernutrition. •Mostcollegestudentsarenoteatingawell balanceddietandcouldusetheadded nutrition ofamultivitamin. •Whenchoosingasupplement,selectonethat meets100Ͳ300%oftheRDA.

WhatdoMultivitaminscontain?

•AmultivitaminshouldcontainfatͲsoluble vitamins

A,D,E;waterͲsolublevitaminsB1,

B2,B6,B12,niacin,pantothenicacid,biotin,

folicacid,andVitaminC. •Theywillalsousuallyhavemineralssuchas zinc, magnesium,copper,andcalciumin them.

WhatdoesRDAmean?

•RecommendedDietaryAllowances •Thesearesuggestedlevelsofessential nutrientsconsideredadequatetomeet nutritionalneedsofhealthyindividuals.

Whatareantioxidants?

•Defn:SubstancesthatfightofffreeͲradicalsin ourbodies. •Freeradicalsarecompoundswithinour bodiesthatmayleadtochronicdisease and/orareinvolvedincelltissuedamage. •Examplesofvitaminsthatcontainantioxidants are...

C,E,andBetaCarotene.

WhatisthedifferencebetweenfatͲsoluble

andwaterͲsolublevitamins? •FatͲsolublearestoredintheliverandfatty tissues.Thesearenotreadilyexcreted from thebody. •WaterͲsolublevitaminstravelintheblood andarestoredinlimitedamounts.These arereadilyexcretedfromthebodythrough urine.

WhatfactorsshouldIconsiderbefore

takingavitaminsupplement? •Doyoueatfoodshighinvitaminsand minerals? •Areyoudieting? •DoyoufollowtheFoodGuidePyramid? •Doyousmokeand/ordrinkregularly? •Areyoupregnant? •Areyouover50yearsold? •Areyoutakingprescriptiondrugs?

CanItaketoomanyvitamins?

•Forthemostpartvitaminsupplementsare safe totake. •Followtherecommendeddosagesonthe labelofthebottle. •FatͲsolublevitaminsaremorelikelytobetoxic toyourhealthiftakeninexcess,becausethey arestoredinthebody,whereaswaterͲsoluble areexcreted.

ShouldItakemyvitaminswithfood?

•Itisadvisedtotakeyourvitaminswithasnack or mealtoavoidstomachirritation. •Thepresenceofcarbohydratesandproteins stimulatedigestiveenzymesthatwillallowfor better absorptionofnutrientsforthe supplements.(Ironshouldbetakenonan emptystomach)

Stress&NutritionofYourBody

•Stresscancauseyourbodytoexcrete nutrientsratherthanusingthemtoperform vital functions. •Stresscanalsocausetheproductionoffree radicalswhichplayaroleinthedevelopment ofcancer,heartdisease,andaging.

Supplementsthataidinsuppressing

stress •Increasingserotoninlevelsinthebrainwards offstressrelatedsymptomslikedepression, irritability, andfrustration. •Themineralmagnesiumcanhelptoregulate serotoninlevels. •Antioxidantsupplementscanalsobreakup freeradicalsthatcauseharmtoyourbody.

TheBVitamins

BͲ1,BͲ2,BͲ3,BͲ6,BͲ12

BͲ1Thiamin(VitaminF)

•Importantin: -Producingenergyfromcarbohydrates -propernervefunction -stabilizingtheappetite -promotinggrowthandgoodmuscletone -ATPproduction

SourcesofBͲ1

•Pork •Fish •Liver •Legumes •Nuts •Wholegrainorenrichedbreadsandcereals

Recommendations

•Men14+ 1.2 mg/day •Women14Ͳ18 1.0 mg/day •Women19+ 1.1 mg/day•1broiledporkchop, •1.25cupscornflakes OR •1bakedpotato(w/ skin) •0.5cupoflentils •1cupraisinbran

Warnings

•BͲ1isnontoxicevenathighdosages

BͲ1Deficiency

•Lossofappetite •Weakness&Feelingtired •Insomnia •Lossofweight •Depression •Heart&Gastrointestinalproblems

Who'satRisk?

•Homeless&Malnourished •Alcoholics •Peoplewithmalabsorptionconditions

BͲ2Riboflavin

•Importantin: -energyproduction -carbohydrate,fat,andproteinmetabolism -formationofantibodiesandredbloodcells -cellrespiration -maintenanceofgoodvision,skin,nails,andhair -alleviatingeyefatigue

SourcesofBͲ2

•Largeamountsin -dairy -eggs -meats •Smallamountsin -leafygreenvegetables -enrichedgrains

Recommendations

•Men14Ͳ70 1.3 mg/day •Women14Ͳ70 1.0 mg/day •71+

Largerdoses•1cupraisinbran

•1cupmilk •1egg OR •1smallextraleanhamburger •1cupplainyogurt •0.5cupfreshcookedspinach •1cupcottagecheese

Warnings

•BͲ2isnontoxicatsupplementalanddietary levels. •Lightcandestroyriboflavin,sopurchasemilk inopaquecontainers.

BͲ2Deficiency

•Itchingandburningeyes •Cracksandsoresinmouthandlips •Bloodshoteyes •Dermatitis •Oilyskin •Digestivedisturbances

Who'satRisk?

•Peoplewithcataracts •PeoplewithSickleCellAnemia •Alcoholics

BͲ3Niacinamide&Niacin

•Importantin: -energyproduction -maintenanceofskinandtongue -improvescirculation -maintenanceofnervoussystem -healthofthedigestivetrack

BͲ3Niacinamide&Niacin

•TwoTypes -Niacinamide(Nicotinamide) •doesnotregulatecholesterol -Niacin(NicotinicAcid) •highlytoxicinlargedoses •InositalHexaniacinateisasupplementthatgivesthe cholesterolregulationwithouthightoxicity

Recommendations

•Men14+ 16 mg/day •Women14+ 14 mg/day •1cuprice •4oz.broiledsalmon •1tbsppeanutbutter •1bagel •OR •1smallextraleanhamburger •0.5cupgrapenutscereal

Warnings

•Indosesofonly50Ͳ100mgnicotinicacid cancausedilationofbloodvesselsand potentiallypainfultingling("niacinflush"), diarrhea, nausea,vomiting,andlongterm liverdamage. •Nicotinamideisalmostalwayssafetotake, althoughafewcasesofliverdamagehave been reportedindosesofover1000 mg/day.

BͲ3Deficiency

•Pellegra -diseasecausedbyBͲ3deficiency -rareinWesternsocieties •gastrointestinaldisturbance,lossofappetite •headache,insomnia,mentaldepression •fatigue,aches,andpains •nervousness,irritability

Who'satRisk?

•MostpeoplegetplentyofBͲ3fromtheirdiet because itisaddedtowhiteflour.

BͲ6Pyridoxine

•Importantin: -Productionofredbloodcells -conversionoftryptophantoniacin(BͲ3) -immunity -nervoussystemfunctions -reducingmusclespasms,cramps,andnumbness -maintainingproperbalanceofsodiumand phosphorousinthebody

Recommendations

•Men14Ͳ50 1.3 mg/day •Men50+ 1.7 mg/day •Women14Ͳ18 1.2 mg/day •Women19Ͳ50 1.3 mg/day •Women50+ 1.5 mg/day•1chickenbreast •0.5cupcookedspinach •1cupbrownrice OR •1bakedpotatowithskin •1banana •4oz.leansirloin

Warnings

•HighdosesofBͲ6mayberecommendedto treat

PMS,carpaltunnelsyndrome,andsleep

disorders,butcontinueduseofhighdoses mayresultinpermanentnervedamage. •Pregnantwomenshouldalwaysconsulttheir doctorbeforetakingthissupplementandall others.

BͲ6Deficiency

•nervousness,insomnia •lossofmusclecontrol,muscleweakness •armandlegcramps •waterretention •skinlesions

Who'satRisk?

•veryrare •alcoholics •patientswithkidneyfailure •womenusingoralcontraceptives

BͲ12Cobalamin

•Importantin: -propernervefunction -productionofredbloodcells -metabolizingfatsandproteins -preventionofanemia -DNAreproduction -energyproduction?

Recommendations

•MenandWomen 14+ 2

Ͳ3mcg/day•1chickenbreast

•1hardboiledegg •1cupplainlowfatyogurt OR •1cupmilk •1cupraisinbran

Warnings

•Vegetariansneedtolookforfortifiedsources (soy milk,supplements). •Elderlyoftenhavetroubleabsorbing.

BͲ12Deficiency

•anemia •nervedamage •hypersensitiveskin

Who'satRisk?

•perniciousanemia -BͲ12injectionsoftentakenregularly •HIV •ChronicFatigueSyndrome

VitaminA

WhatisVitaminA?

•FatͲsoluble •Retinol -Oneofthemostactive,usableforms •Foundinanimalandplantsources

Whatdoesitdo?

•Vision -Generatespigmentsfortheretina -Maintainssurfaceliningofeyes •Bonegrowth •Reproduction •Celldivisionanddifferentiation •HealthySkin •RegulateImmuneSystem

Wheredoesitcomefrom?

•AnimalSources -Eggs -Meat -Cheese -Milk -Liver -Kidney -Cod -Halibutfishoil

PlantSources

•Carrots •SweetPotatoes •Cantaloupe •PinkGrapefruit •Apricots •Broccoli •Spinach •Pumpkin

Whatdotheseplantshavein

common?? •Mostareorangeoryellowincolor •BetaͲCaroteneisprecursorofVitaminA •Maskedinsomegreenplants

Howmuchisenough?

•Children

2000- 3500I.U.

•Men

5000I.U.

•Women

4000I.U.

SignsofDeficiency

•Nightblindness •Decreasedresistanceto infections •Extremelydryskin,hairornails

WhoIsAtRiskForDeficiency?

•Youngchildren •Childrenwithinadequatehealthcare •Adultsincountrieswithhighincidencesof vitamin

Adeficiencyormeasles

•Adultsorchildrenwithdiseasesofthe pancreas, liver,intestines,orinadequatefat digestion/absorption

TooMuchCanBeToxic!!

•HypervitaminosisAleadstotoxicsymptoms: -Dry,itchyskin -Headachesandfatigue -Hairloss -Liverdamage -Blurredvision -Lossofappetite -Skincoloration

OtherSideEffects

•Severebirthdefects -WomenofchildͲbearingageshouldnotconsumemorethan8000IUperday -RetinͲA(acnecream)orAccutanecancausebirthdefects

-RetinolismostdangerousformbecausethebodywillnotconvertasmuchbetaͲcarotenetovitaminAunlessneededbutitcanstillbeharmful

•Skincantakeonayellow/orangeglow •MostcasesofvitaminAoverdoseoccurfromsupplementsbutcanoccurfromdiet •RDAisconsideringestablishinganUpperLimit

FoodsHighInVitaminA

Retinol

-Liver(3oz)

30,325IU(610%DV)

-Fortifiedmilk(1c)

1,355IU(10%DV)

...FoodsHighInVitaminA

BetaͲCarotene

-Carrot(1raw)20,250IU (410%DV) -Carrotjuice(1/2c)12,915IU(260% DV) -Mango(1raw)8,050IU (160%DV) -SweetPotatoes(1/2c)7,430IU(150% DV) -Spinach,boiled(1/2c) 7,370IU (150%DV) -Cantaloupe(1c) 5,160IU(100%DV) -VegetableSoup(1c) 3,005IU (60%DV)

PolarBearLiver

One ounceofpolarbearlivercontains enoughvitaminA(retinol)tokillaperson!

VitaminA,BetaͲCarotene,andCancer

•SurveyssuggestthatdietsrichinvitaminAandbetaͲcarotene canlowertheriskforcancer(especiallylungcancer) •However,onestudywasstoppedbecausesubjectswith increased betaͲcarotenehada46%higherriskofdyingfrom lungcancer •Anotherstudyshowedthatsmokersweremorelikelyto developlungcanceriftheytookbetaͲcarotenesupplements •BetaͲcarotenesupplementsarenotadvisableexceptinrare situations

VitaminE

VitaminE

•Fatsoluble •Antioxidant -Reducetheenergyofthefreeradical -Stopthefreeradicalfromforminginthe first place -Interruptanoxidizingchainreactionto minimize thedamageoffreeradicals

What is it?

•ProtectscellmembranesandotherfatͲsolublepartsofthe body(LDLcholesterol)fromoxidation -Mayreducetheriskofheartdisease -Mayalsodiscouragedevelopmentofsometypesofcancer •Promotesnormalgrowthanddevelopment •Promotesnormalredbloodcellformation •ActsasantiͲbloodclottingagent •Playssomeroleinthebody'sabilitytoprocessglucose •Alsobeenknowntoaidtheprocessofwoundhealing

Vitamin E

What does it do?

•TwostudiespublishedintheNewEngland

Journal

ofMedicinebyHarvardresearchers •Of127,000healthprofessionals,thosewho took largedosesofVitaminEhada40%lower risk ofheartdisease

Vitamin E

Heart disease:

VitaminE

•AlphaTocopherol •Tocopherol •Tocopheryl(Acetate,Succinate)

What's the difference?

VitaminE

•"d"=natural •"dl"=synthetic

What's the difference?

VitaminE

•wheatgermoil •vegetableoils •nutsandseeds •wholegrains •eggyolk •leafygreenvegetables

Where does it come from?

SpecificFoodSources

•vegetableoils -Corn,cottonseed,andpeanutoil •nutsandseeds -Almonds,hazelnuts,sunflowerseeds, walnuts,andmargarine •wholegrains -wholeͲwheatflour,wheatgerm •Vegetablesandfruits -Spinach,lettuce,onions,blackberries,apples, andpears

VitaminE

Children

0Ͳ12months3Ͳ4mg9Ͳ12IU

1Ͳ7years6Ͳ7mg15Ͳ21IU

11

Ͳ188mg24IU

Males

18+10mg30IU

Females

18+8mg24IU

pregnant12mg lactating11mg

3Ͳ4

6Ͳ7

8 10 8 2 3 mg mg mg mg mg mg mg

Recommended Daily Allowances (RDA):

VitaminE

•TakingmorethanRDAofvitamin E improvestheimmunesystemin theelderly -JeanMayer(USDAHumanNutritionResearch

Center)&SiminMeydani,D.V.M.,Ph.D.

(Nutritional

ImmunologyLaboratory)

-TheJournaloftheAmericanMedical

Association

Other effects:

VitaminE

•SeverevitaminEdeficienciesare rare •Lackofvitality •Lethargy •Apathy •Inabilitytoconcentrate •Muscleweakness

Who is likely to be deficient?

VitaminE

•Noharmfuleffectsat50timesRDA(1200- 1500IU) •At2,400IUperday,maycausebleedingduetoitsclotͲpreventingability •Mayreducebody'ssupplyofvitaminA •Mayalterimmunesystem •VitaminEtoxicityisrare

Can you take too much?

VitaminE

•Naturalformmorebioavailable •Easiertoobtaintheamount needed fromsupplements

Natural foods or supplements?

VitaminE

•Peopleovertheageof55 •Smokers •Peoplewhoabusealcohol •Anyonewithinadequatecaloric or nutritionaldietaryintakeor increasednutritional requirements

Who should take supplements?

VitaminE

•FreezingmaydestroyVitaminE •ExtremeheatcausesVitaminEtobreakdown •AvoiddeepͲfatfryingfoodsthatarenatural sourcesofVitaminE •ReducespotentialtoxicityofVitaminAͲ

Excessive

dosescausesVitaminAdepletion

Miscellaneous:

VitaminC

VitaminC

•Ascorbicacid(Toxictoviruses,bacteria,and somemalignanttumorcells) •Antioxidant •waterͲsoluble

WhatareC'sfunctionsinthebody?

•Protectsyoubodyfromfreeradicals •helpsformconnectivetissuethatholdyourbones,muscles,andtissues together(collagen) •aidsinthehealingofwounds •aidsthebodyinabsorbingironfromplantsources •helpstokeepyourgumshealthy •helpsyourbodytofightinfections •aidsinthepreventionofheartdisease •helpspreventsomeformsofcancer

Harmfuleffectsinlarger

doses: (over1000mg/dose) •Diarrhea •gastrointestinaldiscomfort •reboundScurvy •Avoidchewabletablets(may causedamagetoteeth) •SinceVitaminCiswaterͲsolubleexcess amountsthatthebodydoesnotneedwillbe excreted,butlargerdosescancausesome problems...

VitaminCdailyrecommendations

•LINK •http://www.womenͲofͲ faith.com/health/supplements/vitc.ht m

RecommendedDietaryIntake

•Men:60mg/day •Women:60mg/day •Pregnantwomen:

95mg/day

•Children:45mg/day •Takedivideddosesofthevitamin twice dailytogetthebestresults, and lessexcretion. •Smoking,oralcontraceptives, steroids,excessivealcohol consumption,andanalgesics increasetheneedforthisvitamin

SourcesofVitaminC

•Guava,Broccoli,Cantaloupe,RedBellPepper,

OrangeJuice,Strawberries,TomatoJuice,Raw

Tomato,SweetPotato,Tangerine,Spinach,

Leafy

Greens,Berries,CitrusFruits

•LINK(listoffruits&veggiesthataregood sourcesofC) •www.heartinfo.org/nutrition/vitc42898.htm

DeficiencyofCcauses:

•Weightloss •fatigueandjointpain •scurvy(bruisingeasily,bleedinggums,and tendency forbonestofracture) •reducedresistancetocoldsandinfections •slowhealingofwoundsandfracturedbones

FactorFiction:VitaminC

causesKidneyStoneformation •DepartmentofNutrition,HarvardSchoolof PublicHealth•Studydoneon45,251menthathadnopreviouscasesof kidneystones.Somesubjectstookupto30timestheRDA values,andshowednoincreasedriskofkidneystone formation.

Tolearnaboutmorecoolfactsabout

VitaminC,logonto:

•LINK •www.cforyourself.com

FoodorSupplement?

•TheMayoClinicstatesthat"yourbodyneedsmacronutrients(proteins, carbohydrates,andfat)forenergyandmicronutrients(vitaminsand minerals) formanyfunctions.Wholefoodsareanexcellentchoice." Theyalsostatedthat"anorangeprovidesnotonlyvitaminCbutalso carotene,calcium,andfreesugarsforenergy.AvitaminCsupplementis lackingthese." •TheAmericanHeartAssociation"recommendsthathealthyindividuals obtainadequatenutrientintakesfromfoodeateninvarietyand moderation,ratherthanfromsupplements."

CongressionalMandatefortheODS:

•Toexploretheroleofdietarysupplementstoimprovehealthcare •Topromotescientificstudyofdietarysupplementsinmaintaining healthandpreventingchronicdisease. •Toconductandcoordinateresearchondietarysupplementsatthe

NationalInstituteofHealth.

•Tocollect&compiledatabasesoffederallyfundedresearch& scientificpapersondietarysupplements. •Tocoordinatefundingforresearchondietarysupplements. •ToprovideadvicetootherHHSagenciesrelatedtodietary supplements.

ODSScientificGoals:

•1:Evaluatetheroleofdietarysupplementsinthepreventionofdisease and reductionofriskfactorsassociatedwithdisease. •2:Evaluatetheroleofdietarysupplementsinphysicalandmentalhealth and inperformance. •3:Explorethebiochemicalandcellulareffectsofdietarysupplementson biologicalsystemsandtheirphysiologicalimpactacrossthelifecycle •4:Improvescientificmethodologyasrelatedtothestudyofdietary supplements. •5:Informandeducatescientists,healthcareproviders,andthepublic aboutthebenefitsandrisksofdietarysupplements.

DefinitionandClassification

•NonͲcaloricorganicnutrients •Neededinverysmallamounts •Facilitators-helpbodyprocessesproceed; digestion,absorption,metabolism,growth etc. •Someappearinfoodasprecursorsor provitamins

DefinitionandClassification

•2classes,Table7.1 -Fatsoluble: -Watersoluble:

DefinitionandClassification

•Fatsolublevitamins -Foundinthefatsandoilsoffood. -Absorbedintothelymphandcarriedinbloodwith proteintransporters=chylomicrons . -*Storedinliverandbodyfatandcanbecometoxic iflargeamountsareconsumed.

DefinitionandClassification

•Watersolublevitamins -Foundinvegetables,fruitandgrains,meat. -Absorbeddirectlyintothebloodstream -Notstoredinthebodyandtoxicityisrare.Alcohol canincreaseelimination,smoking,etc.cause decreasedabsorption.

FatSolubleVitamins

•VitaminA(precursor-betacarotene) -3forms:retinol(storedinliver),retinal,retinoicacid -Rolesinbody: •Regulationofgeneexpression •Partofthevisualpigmentrhodopsin,maintainsclarityofcornea (yeseatingcarrotsisgoodforyoureyesight) •RequiredforcellgrowthanddivisionͲepithelialcells,bonesand teeth •Promotesdevelopmentofimmunecells,especially"NaturalKiller

Cells"

•Antioxidant

FatSolubleVitamins

•VitaminA -Deficienciescause: •Nightblindness,xerophthalmia(keratindepositsin cornea),maculardegeneration. •Skinandmucousmembranedrynessandinfection, keratindeposits. •Anemia •Developmentaldefects-bones,teeth,immunesystem, vision

FatSolubleVitamins

•VitaminA -Toxicities(RetinA/Accutaine,singlelargedosesof supplements,eatingexcessiveamountsofliver) cause: •FragileRBCs,hemorrhage •Bonepain,fractures •Abdominalpainanddiarrhea •Blurredvision •Dryskin,hairloss •Liverenlargement

FatSolubleVitamins

•VitaminA -DRI:700(women)Ͳ900(men)micrograms/day,UL

3000micrograms

-Sources,seesnapshot7.1

Snapshot 7-1, p, 219

FatSolubleVitamins

•VitaminD-precursorischolesterol, convertedbyUVfromsunlightexposure, thereforeisa"nonͲessential"vitamin. -Roles: •Increasescalciumabsorptioninbone,intestines, kidney.Promotesbonegrowthandmaintenance. •Stimulatesmaturationofcells-heart,brain,immune system,etc.

FatSolubleVitamins

•VitaminD -Deficiencies:rickets (children),osteomalacia (adults).Whataresomeofthecausesof deficiencies? -Toxicities(5XDRI) •Lossofcalciumfromboneanddepositioninsoft tissues. •Lossofappetite,nauseaandvomiting,psychological depression.

Fig. 7-5a, p. 222

Bowed legs

-

Characteristi

c of rickets

Fig. 7-5b, p. 222

Beaded ribs

-

Characterist

ic of rickets

FatSolubleVitamins

•VitaminD -DRI-5micrograms/dayforages19Ͳ50,10for ages

51Ͳ70,15forages>70.

-Sources,seesnapshot7.2

Snapshot 7-2, p, 223

FatSolubleVitamins

•VitaminE- tocopherol,*alphaͲ,betaͲ, gammaͲ,anddeltaͲ -Roles: •Antioxidant(protectspolyunsaturatedfats) •Preventionofdamagetolungs,RBCs,WBCs (immunity),heart •Necessaryfornormalnervedevelopment

FatSolubleVitamins

•VitaminE -Deficiencies(decreasedabsorptionoffatsͲliver disease,lowfatdiets) •Prematurebabies- fragileRBCs(hemolysis) •Lossofmusclecoordination,vision,immunefunctions -Toxicities(morethan1000milligrams/day) •Increasestheeffectsofanticoagulants(Coumadin,

Warfarin)

FatSolubleVitamins

•VitaminE -DRI15milligrams/day(alphaͲtocopherol) -Sources,seesnapshot7.3

Snapshot 7-3, p, 226

FatSolubleVitamins

•VitaminK- producedbybacteriainlargeintestine -Roles •Promotessynthesisofbloodclottingproteins(**Interfereswith

Coumadin)

•Boneformation -Deficienciesarerarebutseenininfants,afterprolonged antibiotictherapy,andinpatientswithdecreasedbile production. -Toxicities(>1000mg/day):ruptureofRBCsandjaundice

FatSolubleVitamins

•VitaminK -DRI:90(women)- 120(men)micrograms/day -Sources,seesnapshot7.4

Snapshot 7-4, p, 228

WaterSolubleVitamins

•8Bvitamins-T ender R omance N everF ails with 6 to12 B eautifulP earls(Thiamin,

Riboflavin,Niacin,Folate,B

6 ,B 12 ,Biotin,and

Pantothenicacid)

-Aidinmetabolismofandenergyreleasefrom carbohydrates,lipids,aminoacids. -Modeofaction- coenzymesorpartsof coenzymesthatarenecessaryfortheproper activity ofenzymes,fig7.9

Fig. 7-9a, p. 233Compounds

Active site

Enzyme

Without the coenzyme, compounds A and B

don't respond to the enzyme. AB

With the coenzyme in place, compounds A

and B are attracted to the active site on the enzyme, and they react.

EnzymeA

BVitamin

Coenzyme

The reaction is completed with the formation

of a new product. In this case, the product is AB.

Enzyme

EnzymeA

B

The product AB is released.

New productAB

Fig. 7-10, p. 234

Muscles and other tissues metabolize protein.Brain and other tissues metabolize carbohydrates.

Bone tissues

make new blood cells.

Liver and other

tissues metabolize fat.

Digestive

tract lining replaces its cells.

WaterSolubleVitamins

•ThiaminandRiboflavin -Roles-energymetabolismincells,partofnervecell membranes. -Deficiencies •Beriberi,edema&/ormuscleweakness •Alcoholabuse-WernickeͲKorsakoffsyndrome -DRIthiamin:1.1(women)-1.2(men)mg/day;riboflavin

1.1(women)

-1.3(men)mg/day -Sources:Allfoodgroupsexceptfatsandoils

Snapshot 7-6, p, 236

Snapshot 7-7, p, 237

WaterSolubleVitamins

•Niacin-canbeproducedfromtheaminoacid tryptophan. -Roles:energymetabolism -Deficiencies:Pellagra - dermatitis, diarrhea, dementia,death -Toxicities(2Ͳ3XDRI):*preventsbloodclotting, causesliverdamage,enhancesactionof

Coumadin

WaterSolubleVitamins

•Niacin -DRI14(women)Ͳ16(men)mg/day -Sources,snapshot7.8 •Meats •Somevegetablesandgrains

Snapshot 7-8, p, 238

WaterSolubleVitamins

•Folate -Role:requiredforsynthesisofDNAͲ ***pregnancy -Deficiencies(druginteractions,smoking) •Anemia •Decreasedimmunity •Decreaseddigestiveandcardiovascularfunction •Colonandcervicalcancers •*Neuraltubedefects,?otherbirthdefects

WaterSolubleVitamins

•Folate -Toxicities(>1000mg/day):rare,interfereswith anticancer drugs. -DRI400milligrams/day -Sources,snapshot7.8

Snapshot 7-9, p, 240

WaterSolubleVitamins

•VitaminB 12 (requiresintrinsicfactor for absorption) -Roles:workswithfolate,partofinsulatingsheath around nerves. -Deficiencies: •Perniciousanemia •Paralysis •Nervedamageinfetus

WaterSolubleVitamins

•VitaminB 12 -DRI2.3micrograms/day -Sources,seesnapshot7.9 •Meatanddairy •Implicationsforvegans??

Snapshot 7-10, p, 242

WaterSolubleVitamins

•VitaminB 6 -Roles: •Conversionofaminoacidstootheraminoacids -Ex.:Tryptophantoniacin •Synthesisofhemoglobinandneurotransmitters •Releaseofglucosefromglycogen •Immunefunction •Promotessteroidhormoneactivity •Developmentofnervoussystem

WaterSolubleVitamins

•VitaminB6 -Deficiencies •Anemia •Dermatitis •Muscleweakness •Behavioralproblems •?Heartdisease -Toxicities(>100mg/day)-muscleweakness, nervedamage

WaterSolubleVitamins

•VitaminB6 -DRI1.3milligrams/day -Sources,seesnapshot7.10 •Meatanddairy •Vegetablesandfruits

Snapshot 7-11, p, 243

WaterSolubleVitamins

•BiotinandPantothenicacid -Roles: •Metabolismofcarbohydrates,fatsandproteins •Synthesisoflipids,neurotransmitters,steroid hormones,hemoglobin. •"NonͲBvitamins":choline,carnitine,inositol, lipoicacid,etc.Nobeneficialeffectsproven!!

WaterSolubleVitamins

•VitaminC,ascorbicacid -historyof controversy -Roles: •Connectivetissuedevelopment,collagen •Antioxidant •Promotesironabsorption,immunity? •ProtectsvitaminE

WaterSolubleVitamins

•VitaminC -Deficiency- Scurvy (skin andmucousmembranedamage), anemia. -Toxicity(>2grams/day)-proͲoxidant,activatesoxidizing agents. -DRI- 75(w)- (90(m)milligrams/day.Increasedfor smokers. -Sources,seesnapshot7.11 -Notes:caninterferewithdiagnostictestsfordiabetes,and bloodclotting -??Preventscolds

Snapshot 7-5, p, 232

Vitamin/MineralSupplements

•Whoneedsthem? •Whodoesnotneedthem? •OyoreadͲControversy,pp257Ͳ263