39
Vitamins
Vitamins
Vitamins
1048708 Vitamins definitionclassification
1048708 essential non-caloric organic nutrients
1048708 needed in very small amounts
1048708 cofactors (helpers) in cell functions
1048708 fat soluble Vitamins A D E K
1048708 water soluble B Vitamins Vitamin C
1048708 Note you do not need to memorize the RDA AI
or UL amounts (adult ranges given)
2
Vitamin A
1048708 RDA 700-900 ugd UL 3000 ugd
1048708 chemical forms retinol β-carotene (can be
converted to Vit A but need 6x amount)
1048708 food sources liver milk (fortified) vegetables (β-
carotene)
1048708 status determined by blood retinol concentration
1048708 lower levels indicate lower stores
1048708 primarily liver storage
3
Functions (essential for)
1048708 1 vision
2 epithelial tissue
3 growth of bone
4 reproduction
1048708 Deficiency is prevalent in developing countries
1048708 blindness sickness (1048708 immune function) death
1048708 provide Vit A supplementation develop rice with higher Vit A
4
1048708 Overdose (chronic 4x acute 100xRDA)
1048708 headaches edema fatigue anorexia skin disorders
1048708 Retinoic acid as a drug directly applied to the skin results in rapid turnover of skin cells
1048708 Retin-A acne Renova antiwrinkle
1048708 highly toxic serious birth defects if taken during pregnancy
1048708 supplementing Vit A does not help acne
5
β-carotene
1048708 Vitamin A precursor
1048708 Plant sources brightly coloured eg deep orange
dark green
1048708 effective antioxidant
1048708 may reduce risk of chronic diseases
1048708atherosclerosis
1048708cancers
1048708macular degeneration (blindness in elderly)
6
chemical name cholecalciferol
1048708 function regulation of calcium and phosphorus including bone formation and maintenance
1048708 status by blood concentration
1048708 deficiency rickets and osteomalacia (bone disease in children and adults respectively)
1048708 very toxic calcium deposits in heart amp kidneys
1048708death UL 50 ugd (10x RDA)
1048708 Enjoying a resurgence in interest especially as rickets is making a comeback
7
Vitamin D 5 ugd AI
1048708 Food sources liver eggs butter fish fortified milk and margarine
1048708 Sunlight UV radiation converts precursor molecule (cholesterol backbone) in skin
1048708 duration specific to race facial area for 15 min 3-7 xweek
10487083 h for dark-skinned
1048708 Manitoba latitude April to Oct use liver stores in winter
1048708 risk of skin cancer not Vit D toxicity
8
Chemical name tocopherol
1048708 Function antioxidant in cell membranes integrity of cells (lung RBC WBC) exposed to high oxygen concentrations
1048708 Status blood concentrations and breakability of RBC
9
Deficiency is rare
1048708 hemolytic anemia (premature infants)
1048708 weakness impaired reflexes (muscle amp nerve function)
1048708 fat absorption and storage problems
1048708 Toxicity is rare
1048708 Latest evidence is that is does not protect against heart disease
10
Vitamin E 15 mgd RDA
1048708 Food sources
1048708 plant foods eg grains
1048708 associated with linoleic content in vegetable oils
11
Vitamin K
1048708 Danish ldquokoagulationrdquo
1048708 Function blood clotting amp bone synthesis
1048708 Status by blood clotting test
1048708 dicumarol (drug) interferes with Vit K and
blood clotting test before surgery
1048708 Deficiency rare except newborns (easy bruising)
1048708 Toxic in excess (infants pregnancy) sold as single
vitamin by prescription
12
Vitamin K 90-120 ugd AI
1048708 Bacterial production in colon (~12 required)
1048708 affected by absorption problemsillness
1048708 antibiotics decrease production
1048708 Food sources (~12 required)
1048708 green leafy vegetables cabbage family
1048708 liver eggs milk
1048708 beans
13
Summary
Fat soluble vitamins
1048708 dissolve in lipid
1048708 require bile for absorption
1048708 stored in tissues eg liver adipose
1048708 may be toxic in excess
1048708caution with supplements
14
The B Vitamins (8)
1048708 Involved in energy metabolism
1048708 thiamin riboflavin niacin
1048708 biotin pantothenic acid
1048708 B6 folate B12 (amp red blood cell function)
15
Thiamin
1048708 Deficiency disease beriberi (polished rice)
1048708 depression weakness polyneuropathy
1048708 Functions
1048708 coenzyme (TPP) reactions involving CO2
1048708releasing energy from glucose amp fat
1048708 synthesis of acetylcholine (neurotransmitter)
1048708 synthesis of ribose (RNA component)
1048708 alcohol metabolism
16
Thiamin Beriberi
17
Riboflavin
1048708 Deficiency disease ariboflavinosis
1048708 2 months to evolve may exist with other B vitamin deficiencies (same food sources)
1048708 affects skin eyes mouth tongue
1048708 Functions
1048708 coenzyme (FMN FAD) in energy production releasing energy from glucose and fat
18
Niacin
1048708 Deficiency disease pellagra (4 Drsquos)
1048708 dermatitis diarrhea dementia death
1048708 diet cornmeal salted fat pork molasses
1048708 Functions
1048708 coenzyme (NAD NADP) in energy production
releasing energy from glucose and fat
1048708 synthesis of fatty acids amp steroids (cholesterol)
19
Thiamin Riboflavin Niacin
1048708 DRIs based on energy requirements
1048708 higher in growth pregnancy lactation high physical activity athletes
1048708 NE (niacin equivalents) niacin (1 mg) synthesized from tryptophan (60 mg)
1048708priority proteinneurotransmitter function
1048708 Supplements do not stimulate energy production unless one is deficient in one of these vitamins
20
Thiamin Riboflavin Niacin
1048708 Food sources (also sources of tryptophan)
1048708 enriched (added back to the natural level) amp whole grains cereals and baked products
1048708 legumes
1048708 leafy green vegetables mushrooms
1048708 meat fish eggs
1048708 milk amp milk products (especially riboflavin)
1048708 corn tortillas lime water increases bioavailability of niacin from corn
21
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Vitamins
1048708 Vitamins definitionclassification
1048708 essential non-caloric organic nutrients
1048708 needed in very small amounts
1048708 cofactors (helpers) in cell functions
1048708 fat soluble Vitamins A D E K
1048708 water soluble B Vitamins Vitamin C
1048708 Note you do not need to memorize the RDA AI
or UL amounts (adult ranges given)
2
Vitamin A
1048708 RDA 700-900 ugd UL 3000 ugd
1048708 chemical forms retinol β-carotene (can be
converted to Vit A but need 6x amount)
1048708 food sources liver milk (fortified) vegetables (β-
carotene)
1048708 status determined by blood retinol concentration
1048708 lower levels indicate lower stores
1048708 primarily liver storage
3
Functions (essential for)
1048708 1 vision
2 epithelial tissue
3 growth of bone
4 reproduction
1048708 Deficiency is prevalent in developing countries
1048708 blindness sickness (1048708 immune function) death
1048708 provide Vit A supplementation develop rice with higher Vit A
4
1048708 Overdose (chronic 4x acute 100xRDA)
1048708 headaches edema fatigue anorexia skin disorders
1048708 Retinoic acid as a drug directly applied to the skin results in rapid turnover of skin cells
1048708 Retin-A acne Renova antiwrinkle
1048708 highly toxic serious birth defects if taken during pregnancy
1048708 supplementing Vit A does not help acne
5
β-carotene
1048708 Vitamin A precursor
1048708 Plant sources brightly coloured eg deep orange
dark green
1048708 effective antioxidant
1048708 may reduce risk of chronic diseases
1048708atherosclerosis
1048708cancers
1048708macular degeneration (blindness in elderly)
6
chemical name cholecalciferol
1048708 function regulation of calcium and phosphorus including bone formation and maintenance
1048708 status by blood concentration
1048708 deficiency rickets and osteomalacia (bone disease in children and adults respectively)
1048708 very toxic calcium deposits in heart amp kidneys
1048708death UL 50 ugd (10x RDA)
1048708 Enjoying a resurgence in interest especially as rickets is making a comeback
7
Vitamin D 5 ugd AI
1048708 Food sources liver eggs butter fish fortified milk and margarine
1048708 Sunlight UV radiation converts precursor molecule (cholesterol backbone) in skin
1048708 duration specific to race facial area for 15 min 3-7 xweek
10487083 h for dark-skinned
1048708 Manitoba latitude April to Oct use liver stores in winter
1048708 risk of skin cancer not Vit D toxicity
8
Chemical name tocopherol
1048708 Function antioxidant in cell membranes integrity of cells (lung RBC WBC) exposed to high oxygen concentrations
1048708 Status blood concentrations and breakability of RBC
9
Deficiency is rare
1048708 hemolytic anemia (premature infants)
1048708 weakness impaired reflexes (muscle amp nerve function)
1048708 fat absorption and storage problems
1048708 Toxicity is rare
1048708 Latest evidence is that is does not protect against heart disease
10
Vitamin E 15 mgd RDA
1048708 Food sources
1048708 plant foods eg grains
1048708 associated with linoleic content in vegetable oils
11
Vitamin K
1048708 Danish ldquokoagulationrdquo
1048708 Function blood clotting amp bone synthesis
1048708 Status by blood clotting test
1048708 dicumarol (drug) interferes with Vit K and
blood clotting test before surgery
1048708 Deficiency rare except newborns (easy bruising)
1048708 Toxic in excess (infants pregnancy) sold as single
vitamin by prescription
12
Vitamin K 90-120 ugd AI
1048708 Bacterial production in colon (~12 required)
1048708 affected by absorption problemsillness
1048708 antibiotics decrease production
1048708 Food sources (~12 required)
1048708 green leafy vegetables cabbage family
1048708 liver eggs milk
1048708 beans
13
Summary
Fat soluble vitamins
1048708 dissolve in lipid
1048708 require bile for absorption
1048708 stored in tissues eg liver adipose
1048708 may be toxic in excess
1048708caution with supplements
14
The B Vitamins (8)
1048708 Involved in energy metabolism
1048708 thiamin riboflavin niacin
1048708 biotin pantothenic acid
1048708 B6 folate B12 (amp red blood cell function)
15
Thiamin
1048708 Deficiency disease beriberi (polished rice)
1048708 depression weakness polyneuropathy
1048708 Functions
1048708 coenzyme (TPP) reactions involving CO2
1048708releasing energy from glucose amp fat
1048708 synthesis of acetylcholine (neurotransmitter)
1048708 synthesis of ribose (RNA component)
1048708 alcohol metabolism
16
Thiamin Beriberi
17
Riboflavin
1048708 Deficiency disease ariboflavinosis
1048708 2 months to evolve may exist with other B vitamin deficiencies (same food sources)
1048708 affects skin eyes mouth tongue
1048708 Functions
1048708 coenzyme (FMN FAD) in energy production releasing energy from glucose and fat
18
Niacin
1048708 Deficiency disease pellagra (4 Drsquos)
1048708 dermatitis diarrhea dementia death
1048708 diet cornmeal salted fat pork molasses
1048708 Functions
1048708 coenzyme (NAD NADP) in energy production
releasing energy from glucose and fat
1048708 synthesis of fatty acids amp steroids (cholesterol)
19
Thiamin Riboflavin Niacin
1048708 DRIs based on energy requirements
1048708 higher in growth pregnancy lactation high physical activity athletes
1048708 NE (niacin equivalents) niacin (1 mg) synthesized from tryptophan (60 mg)
1048708priority proteinneurotransmitter function
1048708 Supplements do not stimulate energy production unless one is deficient in one of these vitamins
20
Thiamin Riboflavin Niacin
1048708 Food sources (also sources of tryptophan)
1048708 enriched (added back to the natural level) amp whole grains cereals and baked products
1048708 legumes
1048708 leafy green vegetables mushrooms
1048708 meat fish eggs
1048708 milk amp milk products (especially riboflavin)
1048708 corn tortillas lime water increases bioavailability of niacin from corn
21
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Vitamin A
1048708 RDA 700-900 ugd UL 3000 ugd
1048708 chemical forms retinol β-carotene (can be
converted to Vit A but need 6x amount)
1048708 food sources liver milk (fortified) vegetables (β-
carotene)
1048708 status determined by blood retinol concentration
1048708 lower levels indicate lower stores
1048708 primarily liver storage
3
Functions (essential for)
1048708 1 vision
2 epithelial tissue
3 growth of bone
4 reproduction
1048708 Deficiency is prevalent in developing countries
1048708 blindness sickness (1048708 immune function) death
1048708 provide Vit A supplementation develop rice with higher Vit A
4
1048708 Overdose (chronic 4x acute 100xRDA)
1048708 headaches edema fatigue anorexia skin disorders
1048708 Retinoic acid as a drug directly applied to the skin results in rapid turnover of skin cells
1048708 Retin-A acne Renova antiwrinkle
1048708 highly toxic serious birth defects if taken during pregnancy
1048708 supplementing Vit A does not help acne
5
β-carotene
1048708 Vitamin A precursor
1048708 Plant sources brightly coloured eg deep orange
dark green
1048708 effective antioxidant
1048708 may reduce risk of chronic diseases
1048708atherosclerosis
1048708cancers
1048708macular degeneration (blindness in elderly)
6
chemical name cholecalciferol
1048708 function regulation of calcium and phosphorus including bone formation and maintenance
1048708 status by blood concentration
1048708 deficiency rickets and osteomalacia (bone disease in children and adults respectively)
1048708 very toxic calcium deposits in heart amp kidneys
1048708death UL 50 ugd (10x RDA)
1048708 Enjoying a resurgence in interest especially as rickets is making a comeback
7
Vitamin D 5 ugd AI
1048708 Food sources liver eggs butter fish fortified milk and margarine
1048708 Sunlight UV radiation converts precursor molecule (cholesterol backbone) in skin
1048708 duration specific to race facial area for 15 min 3-7 xweek
10487083 h for dark-skinned
1048708 Manitoba latitude April to Oct use liver stores in winter
1048708 risk of skin cancer not Vit D toxicity
8
Chemical name tocopherol
1048708 Function antioxidant in cell membranes integrity of cells (lung RBC WBC) exposed to high oxygen concentrations
1048708 Status blood concentrations and breakability of RBC
9
Deficiency is rare
1048708 hemolytic anemia (premature infants)
1048708 weakness impaired reflexes (muscle amp nerve function)
1048708 fat absorption and storage problems
1048708 Toxicity is rare
1048708 Latest evidence is that is does not protect against heart disease
10
Vitamin E 15 mgd RDA
1048708 Food sources
1048708 plant foods eg grains
1048708 associated with linoleic content in vegetable oils
11
Vitamin K
1048708 Danish ldquokoagulationrdquo
1048708 Function blood clotting amp bone synthesis
1048708 Status by blood clotting test
1048708 dicumarol (drug) interferes with Vit K and
blood clotting test before surgery
1048708 Deficiency rare except newborns (easy bruising)
1048708 Toxic in excess (infants pregnancy) sold as single
vitamin by prescription
12
Vitamin K 90-120 ugd AI
1048708 Bacterial production in colon (~12 required)
1048708 affected by absorption problemsillness
1048708 antibiotics decrease production
1048708 Food sources (~12 required)
1048708 green leafy vegetables cabbage family
1048708 liver eggs milk
1048708 beans
13
Summary
Fat soluble vitamins
1048708 dissolve in lipid
1048708 require bile for absorption
1048708 stored in tissues eg liver adipose
1048708 may be toxic in excess
1048708caution with supplements
14
The B Vitamins (8)
1048708 Involved in energy metabolism
1048708 thiamin riboflavin niacin
1048708 biotin pantothenic acid
1048708 B6 folate B12 (amp red blood cell function)
15
Thiamin
1048708 Deficiency disease beriberi (polished rice)
1048708 depression weakness polyneuropathy
1048708 Functions
1048708 coenzyme (TPP) reactions involving CO2
1048708releasing energy from glucose amp fat
1048708 synthesis of acetylcholine (neurotransmitter)
1048708 synthesis of ribose (RNA component)
1048708 alcohol metabolism
16
Thiamin Beriberi
17
Riboflavin
1048708 Deficiency disease ariboflavinosis
1048708 2 months to evolve may exist with other B vitamin deficiencies (same food sources)
1048708 affects skin eyes mouth tongue
1048708 Functions
1048708 coenzyme (FMN FAD) in energy production releasing energy from glucose and fat
18
Niacin
1048708 Deficiency disease pellagra (4 Drsquos)
1048708 dermatitis diarrhea dementia death
1048708 diet cornmeal salted fat pork molasses
1048708 Functions
1048708 coenzyme (NAD NADP) in energy production
releasing energy from glucose and fat
1048708 synthesis of fatty acids amp steroids (cholesterol)
19
Thiamin Riboflavin Niacin
1048708 DRIs based on energy requirements
1048708 higher in growth pregnancy lactation high physical activity athletes
1048708 NE (niacin equivalents) niacin (1 mg) synthesized from tryptophan (60 mg)
1048708priority proteinneurotransmitter function
1048708 Supplements do not stimulate energy production unless one is deficient in one of these vitamins
20
Thiamin Riboflavin Niacin
1048708 Food sources (also sources of tryptophan)
1048708 enriched (added back to the natural level) amp whole grains cereals and baked products
1048708 legumes
1048708 leafy green vegetables mushrooms
1048708 meat fish eggs
1048708 milk amp milk products (especially riboflavin)
1048708 corn tortillas lime water increases bioavailability of niacin from corn
21
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Functions (essential for)
1048708 1 vision
2 epithelial tissue
3 growth of bone
4 reproduction
1048708 Deficiency is prevalent in developing countries
1048708 blindness sickness (1048708 immune function) death
1048708 provide Vit A supplementation develop rice with higher Vit A
4
1048708 Overdose (chronic 4x acute 100xRDA)
1048708 headaches edema fatigue anorexia skin disorders
1048708 Retinoic acid as a drug directly applied to the skin results in rapid turnover of skin cells
1048708 Retin-A acne Renova antiwrinkle
1048708 highly toxic serious birth defects if taken during pregnancy
1048708 supplementing Vit A does not help acne
5
β-carotene
1048708 Vitamin A precursor
1048708 Plant sources brightly coloured eg deep orange
dark green
1048708 effective antioxidant
1048708 may reduce risk of chronic diseases
1048708atherosclerosis
1048708cancers
1048708macular degeneration (blindness in elderly)
6
chemical name cholecalciferol
1048708 function regulation of calcium and phosphorus including bone formation and maintenance
1048708 status by blood concentration
1048708 deficiency rickets and osteomalacia (bone disease in children and adults respectively)
1048708 very toxic calcium deposits in heart amp kidneys
1048708death UL 50 ugd (10x RDA)
1048708 Enjoying a resurgence in interest especially as rickets is making a comeback
7
Vitamin D 5 ugd AI
1048708 Food sources liver eggs butter fish fortified milk and margarine
1048708 Sunlight UV radiation converts precursor molecule (cholesterol backbone) in skin
1048708 duration specific to race facial area for 15 min 3-7 xweek
10487083 h for dark-skinned
1048708 Manitoba latitude April to Oct use liver stores in winter
1048708 risk of skin cancer not Vit D toxicity
8
Chemical name tocopherol
1048708 Function antioxidant in cell membranes integrity of cells (lung RBC WBC) exposed to high oxygen concentrations
1048708 Status blood concentrations and breakability of RBC
9
Deficiency is rare
1048708 hemolytic anemia (premature infants)
1048708 weakness impaired reflexes (muscle amp nerve function)
1048708 fat absorption and storage problems
1048708 Toxicity is rare
1048708 Latest evidence is that is does not protect against heart disease
10
Vitamin E 15 mgd RDA
1048708 Food sources
1048708 plant foods eg grains
1048708 associated with linoleic content in vegetable oils
11
Vitamin K
1048708 Danish ldquokoagulationrdquo
1048708 Function blood clotting amp bone synthesis
1048708 Status by blood clotting test
1048708 dicumarol (drug) interferes with Vit K and
blood clotting test before surgery
1048708 Deficiency rare except newborns (easy bruising)
1048708 Toxic in excess (infants pregnancy) sold as single
vitamin by prescription
12
Vitamin K 90-120 ugd AI
1048708 Bacterial production in colon (~12 required)
1048708 affected by absorption problemsillness
1048708 antibiotics decrease production
1048708 Food sources (~12 required)
1048708 green leafy vegetables cabbage family
1048708 liver eggs milk
1048708 beans
13
Summary
Fat soluble vitamins
1048708 dissolve in lipid
1048708 require bile for absorption
1048708 stored in tissues eg liver adipose
1048708 may be toxic in excess
1048708caution with supplements
14
The B Vitamins (8)
1048708 Involved in energy metabolism
1048708 thiamin riboflavin niacin
1048708 biotin pantothenic acid
1048708 B6 folate B12 (amp red blood cell function)
15
Thiamin
1048708 Deficiency disease beriberi (polished rice)
1048708 depression weakness polyneuropathy
1048708 Functions
1048708 coenzyme (TPP) reactions involving CO2
1048708releasing energy from glucose amp fat
1048708 synthesis of acetylcholine (neurotransmitter)
1048708 synthesis of ribose (RNA component)
1048708 alcohol metabolism
16
Thiamin Beriberi
17
Riboflavin
1048708 Deficiency disease ariboflavinosis
1048708 2 months to evolve may exist with other B vitamin deficiencies (same food sources)
1048708 affects skin eyes mouth tongue
1048708 Functions
1048708 coenzyme (FMN FAD) in energy production releasing energy from glucose and fat
18
Niacin
1048708 Deficiency disease pellagra (4 Drsquos)
1048708 dermatitis diarrhea dementia death
1048708 diet cornmeal salted fat pork molasses
1048708 Functions
1048708 coenzyme (NAD NADP) in energy production
releasing energy from glucose and fat
1048708 synthesis of fatty acids amp steroids (cholesterol)
19
Thiamin Riboflavin Niacin
1048708 DRIs based on energy requirements
1048708 higher in growth pregnancy lactation high physical activity athletes
1048708 NE (niacin equivalents) niacin (1 mg) synthesized from tryptophan (60 mg)
1048708priority proteinneurotransmitter function
1048708 Supplements do not stimulate energy production unless one is deficient in one of these vitamins
20
Thiamin Riboflavin Niacin
1048708 Food sources (also sources of tryptophan)
1048708 enriched (added back to the natural level) amp whole grains cereals and baked products
1048708 legumes
1048708 leafy green vegetables mushrooms
1048708 meat fish eggs
1048708 milk amp milk products (especially riboflavin)
1048708 corn tortillas lime water increases bioavailability of niacin from corn
21
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
1048708 Overdose (chronic 4x acute 100xRDA)
1048708 headaches edema fatigue anorexia skin disorders
1048708 Retinoic acid as a drug directly applied to the skin results in rapid turnover of skin cells
1048708 Retin-A acne Renova antiwrinkle
1048708 highly toxic serious birth defects if taken during pregnancy
1048708 supplementing Vit A does not help acne
5
β-carotene
1048708 Vitamin A precursor
1048708 Plant sources brightly coloured eg deep orange
dark green
1048708 effective antioxidant
1048708 may reduce risk of chronic diseases
1048708atherosclerosis
1048708cancers
1048708macular degeneration (blindness in elderly)
6
chemical name cholecalciferol
1048708 function regulation of calcium and phosphorus including bone formation and maintenance
1048708 status by blood concentration
1048708 deficiency rickets and osteomalacia (bone disease in children and adults respectively)
1048708 very toxic calcium deposits in heart amp kidneys
1048708death UL 50 ugd (10x RDA)
1048708 Enjoying a resurgence in interest especially as rickets is making a comeback
7
Vitamin D 5 ugd AI
1048708 Food sources liver eggs butter fish fortified milk and margarine
1048708 Sunlight UV radiation converts precursor molecule (cholesterol backbone) in skin
1048708 duration specific to race facial area for 15 min 3-7 xweek
10487083 h for dark-skinned
1048708 Manitoba latitude April to Oct use liver stores in winter
1048708 risk of skin cancer not Vit D toxicity
8
Chemical name tocopherol
1048708 Function antioxidant in cell membranes integrity of cells (lung RBC WBC) exposed to high oxygen concentrations
1048708 Status blood concentrations and breakability of RBC
9
Deficiency is rare
1048708 hemolytic anemia (premature infants)
1048708 weakness impaired reflexes (muscle amp nerve function)
1048708 fat absorption and storage problems
1048708 Toxicity is rare
1048708 Latest evidence is that is does not protect against heart disease
10
Vitamin E 15 mgd RDA
1048708 Food sources
1048708 plant foods eg grains
1048708 associated with linoleic content in vegetable oils
11
Vitamin K
1048708 Danish ldquokoagulationrdquo
1048708 Function blood clotting amp bone synthesis
1048708 Status by blood clotting test
1048708 dicumarol (drug) interferes with Vit K and
blood clotting test before surgery
1048708 Deficiency rare except newborns (easy bruising)
1048708 Toxic in excess (infants pregnancy) sold as single
vitamin by prescription
12
Vitamin K 90-120 ugd AI
1048708 Bacterial production in colon (~12 required)
1048708 affected by absorption problemsillness
1048708 antibiotics decrease production
1048708 Food sources (~12 required)
1048708 green leafy vegetables cabbage family
1048708 liver eggs milk
1048708 beans
13
Summary
Fat soluble vitamins
1048708 dissolve in lipid
1048708 require bile for absorption
1048708 stored in tissues eg liver adipose
1048708 may be toxic in excess
1048708caution with supplements
14
The B Vitamins (8)
1048708 Involved in energy metabolism
1048708 thiamin riboflavin niacin
1048708 biotin pantothenic acid
1048708 B6 folate B12 (amp red blood cell function)
15
Thiamin
1048708 Deficiency disease beriberi (polished rice)
1048708 depression weakness polyneuropathy
1048708 Functions
1048708 coenzyme (TPP) reactions involving CO2
1048708releasing energy from glucose amp fat
1048708 synthesis of acetylcholine (neurotransmitter)
1048708 synthesis of ribose (RNA component)
1048708 alcohol metabolism
16
Thiamin Beriberi
17
Riboflavin
1048708 Deficiency disease ariboflavinosis
1048708 2 months to evolve may exist with other B vitamin deficiencies (same food sources)
1048708 affects skin eyes mouth tongue
1048708 Functions
1048708 coenzyme (FMN FAD) in energy production releasing energy from glucose and fat
18
Niacin
1048708 Deficiency disease pellagra (4 Drsquos)
1048708 dermatitis diarrhea dementia death
1048708 diet cornmeal salted fat pork molasses
1048708 Functions
1048708 coenzyme (NAD NADP) in energy production
releasing energy from glucose and fat
1048708 synthesis of fatty acids amp steroids (cholesterol)
19
Thiamin Riboflavin Niacin
1048708 DRIs based on energy requirements
1048708 higher in growth pregnancy lactation high physical activity athletes
1048708 NE (niacin equivalents) niacin (1 mg) synthesized from tryptophan (60 mg)
1048708priority proteinneurotransmitter function
1048708 Supplements do not stimulate energy production unless one is deficient in one of these vitamins
20
Thiamin Riboflavin Niacin
1048708 Food sources (also sources of tryptophan)
1048708 enriched (added back to the natural level) amp whole grains cereals and baked products
1048708 legumes
1048708 leafy green vegetables mushrooms
1048708 meat fish eggs
1048708 milk amp milk products (especially riboflavin)
1048708 corn tortillas lime water increases bioavailability of niacin from corn
21
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
β-carotene
1048708 Vitamin A precursor
1048708 Plant sources brightly coloured eg deep orange
dark green
1048708 effective antioxidant
1048708 may reduce risk of chronic diseases
1048708atherosclerosis
1048708cancers
1048708macular degeneration (blindness in elderly)
6
chemical name cholecalciferol
1048708 function regulation of calcium and phosphorus including bone formation and maintenance
1048708 status by blood concentration
1048708 deficiency rickets and osteomalacia (bone disease in children and adults respectively)
1048708 very toxic calcium deposits in heart amp kidneys
1048708death UL 50 ugd (10x RDA)
1048708 Enjoying a resurgence in interest especially as rickets is making a comeback
7
Vitamin D 5 ugd AI
1048708 Food sources liver eggs butter fish fortified milk and margarine
1048708 Sunlight UV radiation converts precursor molecule (cholesterol backbone) in skin
1048708 duration specific to race facial area for 15 min 3-7 xweek
10487083 h for dark-skinned
1048708 Manitoba latitude April to Oct use liver stores in winter
1048708 risk of skin cancer not Vit D toxicity
8
Chemical name tocopherol
1048708 Function antioxidant in cell membranes integrity of cells (lung RBC WBC) exposed to high oxygen concentrations
1048708 Status blood concentrations and breakability of RBC
9
Deficiency is rare
1048708 hemolytic anemia (premature infants)
1048708 weakness impaired reflexes (muscle amp nerve function)
1048708 fat absorption and storage problems
1048708 Toxicity is rare
1048708 Latest evidence is that is does not protect against heart disease
10
Vitamin E 15 mgd RDA
1048708 Food sources
1048708 plant foods eg grains
1048708 associated with linoleic content in vegetable oils
11
Vitamin K
1048708 Danish ldquokoagulationrdquo
1048708 Function blood clotting amp bone synthesis
1048708 Status by blood clotting test
1048708 dicumarol (drug) interferes with Vit K and
blood clotting test before surgery
1048708 Deficiency rare except newborns (easy bruising)
1048708 Toxic in excess (infants pregnancy) sold as single
vitamin by prescription
12
Vitamin K 90-120 ugd AI
1048708 Bacterial production in colon (~12 required)
1048708 affected by absorption problemsillness
1048708 antibiotics decrease production
1048708 Food sources (~12 required)
1048708 green leafy vegetables cabbage family
1048708 liver eggs milk
1048708 beans
13
Summary
Fat soluble vitamins
1048708 dissolve in lipid
1048708 require bile for absorption
1048708 stored in tissues eg liver adipose
1048708 may be toxic in excess
1048708caution with supplements
14
The B Vitamins (8)
1048708 Involved in energy metabolism
1048708 thiamin riboflavin niacin
1048708 biotin pantothenic acid
1048708 B6 folate B12 (amp red blood cell function)
15
Thiamin
1048708 Deficiency disease beriberi (polished rice)
1048708 depression weakness polyneuropathy
1048708 Functions
1048708 coenzyme (TPP) reactions involving CO2
1048708releasing energy from glucose amp fat
1048708 synthesis of acetylcholine (neurotransmitter)
1048708 synthesis of ribose (RNA component)
1048708 alcohol metabolism
16
Thiamin Beriberi
17
Riboflavin
1048708 Deficiency disease ariboflavinosis
1048708 2 months to evolve may exist with other B vitamin deficiencies (same food sources)
1048708 affects skin eyes mouth tongue
1048708 Functions
1048708 coenzyme (FMN FAD) in energy production releasing energy from glucose and fat
18
Niacin
1048708 Deficiency disease pellagra (4 Drsquos)
1048708 dermatitis diarrhea dementia death
1048708 diet cornmeal salted fat pork molasses
1048708 Functions
1048708 coenzyme (NAD NADP) in energy production
releasing energy from glucose and fat
1048708 synthesis of fatty acids amp steroids (cholesterol)
19
Thiamin Riboflavin Niacin
1048708 DRIs based on energy requirements
1048708 higher in growth pregnancy lactation high physical activity athletes
1048708 NE (niacin equivalents) niacin (1 mg) synthesized from tryptophan (60 mg)
1048708priority proteinneurotransmitter function
1048708 Supplements do not stimulate energy production unless one is deficient in one of these vitamins
20
Thiamin Riboflavin Niacin
1048708 Food sources (also sources of tryptophan)
1048708 enriched (added back to the natural level) amp whole grains cereals and baked products
1048708 legumes
1048708 leafy green vegetables mushrooms
1048708 meat fish eggs
1048708 milk amp milk products (especially riboflavin)
1048708 corn tortillas lime water increases bioavailability of niacin from corn
21
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
chemical name cholecalciferol
1048708 function regulation of calcium and phosphorus including bone formation and maintenance
1048708 status by blood concentration
1048708 deficiency rickets and osteomalacia (bone disease in children and adults respectively)
1048708 very toxic calcium deposits in heart amp kidneys
1048708death UL 50 ugd (10x RDA)
1048708 Enjoying a resurgence in interest especially as rickets is making a comeback
7
Vitamin D 5 ugd AI
1048708 Food sources liver eggs butter fish fortified milk and margarine
1048708 Sunlight UV radiation converts precursor molecule (cholesterol backbone) in skin
1048708 duration specific to race facial area for 15 min 3-7 xweek
10487083 h for dark-skinned
1048708 Manitoba latitude April to Oct use liver stores in winter
1048708 risk of skin cancer not Vit D toxicity
8
Chemical name tocopherol
1048708 Function antioxidant in cell membranes integrity of cells (lung RBC WBC) exposed to high oxygen concentrations
1048708 Status blood concentrations and breakability of RBC
9
Deficiency is rare
1048708 hemolytic anemia (premature infants)
1048708 weakness impaired reflexes (muscle amp nerve function)
1048708 fat absorption and storage problems
1048708 Toxicity is rare
1048708 Latest evidence is that is does not protect against heart disease
10
Vitamin E 15 mgd RDA
1048708 Food sources
1048708 plant foods eg grains
1048708 associated with linoleic content in vegetable oils
11
Vitamin K
1048708 Danish ldquokoagulationrdquo
1048708 Function blood clotting amp bone synthesis
1048708 Status by blood clotting test
1048708 dicumarol (drug) interferes with Vit K and
blood clotting test before surgery
1048708 Deficiency rare except newborns (easy bruising)
1048708 Toxic in excess (infants pregnancy) sold as single
vitamin by prescription
12
Vitamin K 90-120 ugd AI
1048708 Bacterial production in colon (~12 required)
1048708 affected by absorption problemsillness
1048708 antibiotics decrease production
1048708 Food sources (~12 required)
1048708 green leafy vegetables cabbage family
1048708 liver eggs milk
1048708 beans
13
Summary
Fat soluble vitamins
1048708 dissolve in lipid
1048708 require bile for absorption
1048708 stored in tissues eg liver adipose
1048708 may be toxic in excess
1048708caution with supplements
14
The B Vitamins (8)
1048708 Involved in energy metabolism
1048708 thiamin riboflavin niacin
1048708 biotin pantothenic acid
1048708 B6 folate B12 (amp red blood cell function)
15
Thiamin
1048708 Deficiency disease beriberi (polished rice)
1048708 depression weakness polyneuropathy
1048708 Functions
1048708 coenzyme (TPP) reactions involving CO2
1048708releasing energy from glucose amp fat
1048708 synthesis of acetylcholine (neurotransmitter)
1048708 synthesis of ribose (RNA component)
1048708 alcohol metabolism
16
Thiamin Beriberi
17
Riboflavin
1048708 Deficiency disease ariboflavinosis
1048708 2 months to evolve may exist with other B vitamin deficiencies (same food sources)
1048708 affects skin eyes mouth tongue
1048708 Functions
1048708 coenzyme (FMN FAD) in energy production releasing energy from glucose and fat
18
Niacin
1048708 Deficiency disease pellagra (4 Drsquos)
1048708 dermatitis diarrhea dementia death
1048708 diet cornmeal salted fat pork molasses
1048708 Functions
1048708 coenzyme (NAD NADP) in energy production
releasing energy from glucose and fat
1048708 synthesis of fatty acids amp steroids (cholesterol)
19
Thiamin Riboflavin Niacin
1048708 DRIs based on energy requirements
1048708 higher in growth pregnancy lactation high physical activity athletes
1048708 NE (niacin equivalents) niacin (1 mg) synthesized from tryptophan (60 mg)
1048708priority proteinneurotransmitter function
1048708 Supplements do not stimulate energy production unless one is deficient in one of these vitamins
20
Thiamin Riboflavin Niacin
1048708 Food sources (also sources of tryptophan)
1048708 enriched (added back to the natural level) amp whole grains cereals and baked products
1048708 legumes
1048708 leafy green vegetables mushrooms
1048708 meat fish eggs
1048708 milk amp milk products (especially riboflavin)
1048708 corn tortillas lime water increases bioavailability of niacin from corn
21
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Vitamin D 5 ugd AI
1048708 Food sources liver eggs butter fish fortified milk and margarine
1048708 Sunlight UV radiation converts precursor molecule (cholesterol backbone) in skin
1048708 duration specific to race facial area for 15 min 3-7 xweek
10487083 h for dark-skinned
1048708 Manitoba latitude April to Oct use liver stores in winter
1048708 risk of skin cancer not Vit D toxicity
8
Chemical name tocopherol
1048708 Function antioxidant in cell membranes integrity of cells (lung RBC WBC) exposed to high oxygen concentrations
1048708 Status blood concentrations and breakability of RBC
9
Deficiency is rare
1048708 hemolytic anemia (premature infants)
1048708 weakness impaired reflexes (muscle amp nerve function)
1048708 fat absorption and storage problems
1048708 Toxicity is rare
1048708 Latest evidence is that is does not protect against heart disease
10
Vitamin E 15 mgd RDA
1048708 Food sources
1048708 plant foods eg grains
1048708 associated with linoleic content in vegetable oils
11
Vitamin K
1048708 Danish ldquokoagulationrdquo
1048708 Function blood clotting amp bone synthesis
1048708 Status by blood clotting test
1048708 dicumarol (drug) interferes with Vit K and
blood clotting test before surgery
1048708 Deficiency rare except newborns (easy bruising)
1048708 Toxic in excess (infants pregnancy) sold as single
vitamin by prescription
12
Vitamin K 90-120 ugd AI
1048708 Bacterial production in colon (~12 required)
1048708 affected by absorption problemsillness
1048708 antibiotics decrease production
1048708 Food sources (~12 required)
1048708 green leafy vegetables cabbage family
1048708 liver eggs milk
1048708 beans
13
Summary
Fat soluble vitamins
1048708 dissolve in lipid
1048708 require bile for absorption
1048708 stored in tissues eg liver adipose
1048708 may be toxic in excess
1048708caution with supplements
14
The B Vitamins (8)
1048708 Involved in energy metabolism
1048708 thiamin riboflavin niacin
1048708 biotin pantothenic acid
1048708 B6 folate B12 (amp red blood cell function)
15
Thiamin
1048708 Deficiency disease beriberi (polished rice)
1048708 depression weakness polyneuropathy
1048708 Functions
1048708 coenzyme (TPP) reactions involving CO2
1048708releasing energy from glucose amp fat
1048708 synthesis of acetylcholine (neurotransmitter)
1048708 synthesis of ribose (RNA component)
1048708 alcohol metabolism
16
Thiamin Beriberi
17
Riboflavin
1048708 Deficiency disease ariboflavinosis
1048708 2 months to evolve may exist with other B vitamin deficiencies (same food sources)
1048708 affects skin eyes mouth tongue
1048708 Functions
1048708 coenzyme (FMN FAD) in energy production releasing energy from glucose and fat
18
Niacin
1048708 Deficiency disease pellagra (4 Drsquos)
1048708 dermatitis diarrhea dementia death
1048708 diet cornmeal salted fat pork molasses
1048708 Functions
1048708 coenzyme (NAD NADP) in energy production
releasing energy from glucose and fat
1048708 synthesis of fatty acids amp steroids (cholesterol)
19
Thiamin Riboflavin Niacin
1048708 DRIs based on energy requirements
1048708 higher in growth pregnancy lactation high physical activity athletes
1048708 NE (niacin equivalents) niacin (1 mg) synthesized from tryptophan (60 mg)
1048708priority proteinneurotransmitter function
1048708 Supplements do not stimulate energy production unless one is deficient in one of these vitamins
20
Thiamin Riboflavin Niacin
1048708 Food sources (also sources of tryptophan)
1048708 enriched (added back to the natural level) amp whole grains cereals and baked products
1048708 legumes
1048708 leafy green vegetables mushrooms
1048708 meat fish eggs
1048708 milk amp milk products (especially riboflavin)
1048708 corn tortillas lime water increases bioavailability of niacin from corn
21
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Chemical name tocopherol
1048708 Function antioxidant in cell membranes integrity of cells (lung RBC WBC) exposed to high oxygen concentrations
1048708 Status blood concentrations and breakability of RBC
9
Deficiency is rare
1048708 hemolytic anemia (premature infants)
1048708 weakness impaired reflexes (muscle amp nerve function)
1048708 fat absorption and storage problems
1048708 Toxicity is rare
1048708 Latest evidence is that is does not protect against heart disease
10
Vitamin E 15 mgd RDA
1048708 Food sources
1048708 plant foods eg grains
1048708 associated with linoleic content in vegetable oils
11
Vitamin K
1048708 Danish ldquokoagulationrdquo
1048708 Function blood clotting amp bone synthesis
1048708 Status by blood clotting test
1048708 dicumarol (drug) interferes with Vit K and
blood clotting test before surgery
1048708 Deficiency rare except newborns (easy bruising)
1048708 Toxic in excess (infants pregnancy) sold as single
vitamin by prescription
12
Vitamin K 90-120 ugd AI
1048708 Bacterial production in colon (~12 required)
1048708 affected by absorption problemsillness
1048708 antibiotics decrease production
1048708 Food sources (~12 required)
1048708 green leafy vegetables cabbage family
1048708 liver eggs milk
1048708 beans
13
Summary
Fat soluble vitamins
1048708 dissolve in lipid
1048708 require bile for absorption
1048708 stored in tissues eg liver adipose
1048708 may be toxic in excess
1048708caution with supplements
14
The B Vitamins (8)
1048708 Involved in energy metabolism
1048708 thiamin riboflavin niacin
1048708 biotin pantothenic acid
1048708 B6 folate B12 (amp red blood cell function)
15
Thiamin
1048708 Deficiency disease beriberi (polished rice)
1048708 depression weakness polyneuropathy
1048708 Functions
1048708 coenzyme (TPP) reactions involving CO2
1048708releasing energy from glucose amp fat
1048708 synthesis of acetylcholine (neurotransmitter)
1048708 synthesis of ribose (RNA component)
1048708 alcohol metabolism
16
Thiamin Beriberi
17
Riboflavin
1048708 Deficiency disease ariboflavinosis
1048708 2 months to evolve may exist with other B vitamin deficiencies (same food sources)
1048708 affects skin eyes mouth tongue
1048708 Functions
1048708 coenzyme (FMN FAD) in energy production releasing energy from glucose and fat
18
Niacin
1048708 Deficiency disease pellagra (4 Drsquos)
1048708 dermatitis diarrhea dementia death
1048708 diet cornmeal salted fat pork molasses
1048708 Functions
1048708 coenzyme (NAD NADP) in energy production
releasing energy from glucose and fat
1048708 synthesis of fatty acids amp steroids (cholesterol)
19
Thiamin Riboflavin Niacin
1048708 DRIs based on energy requirements
1048708 higher in growth pregnancy lactation high physical activity athletes
1048708 NE (niacin equivalents) niacin (1 mg) synthesized from tryptophan (60 mg)
1048708priority proteinneurotransmitter function
1048708 Supplements do not stimulate energy production unless one is deficient in one of these vitamins
20
Thiamin Riboflavin Niacin
1048708 Food sources (also sources of tryptophan)
1048708 enriched (added back to the natural level) amp whole grains cereals and baked products
1048708 legumes
1048708 leafy green vegetables mushrooms
1048708 meat fish eggs
1048708 milk amp milk products (especially riboflavin)
1048708 corn tortillas lime water increases bioavailability of niacin from corn
21
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Deficiency is rare
1048708 hemolytic anemia (premature infants)
1048708 weakness impaired reflexes (muscle amp nerve function)
1048708 fat absorption and storage problems
1048708 Toxicity is rare
1048708 Latest evidence is that is does not protect against heart disease
10
Vitamin E 15 mgd RDA
1048708 Food sources
1048708 plant foods eg grains
1048708 associated with linoleic content in vegetable oils
11
Vitamin K
1048708 Danish ldquokoagulationrdquo
1048708 Function blood clotting amp bone synthesis
1048708 Status by blood clotting test
1048708 dicumarol (drug) interferes with Vit K and
blood clotting test before surgery
1048708 Deficiency rare except newborns (easy bruising)
1048708 Toxic in excess (infants pregnancy) sold as single
vitamin by prescription
12
Vitamin K 90-120 ugd AI
1048708 Bacterial production in colon (~12 required)
1048708 affected by absorption problemsillness
1048708 antibiotics decrease production
1048708 Food sources (~12 required)
1048708 green leafy vegetables cabbage family
1048708 liver eggs milk
1048708 beans
13
Summary
Fat soluble vitamins
1048708 dissolve in lipid
1048708 require bile for absorption
1048708 stored in tissues eg liver adipose
1048708 may be toxic in excess
1048708caution with supplements
14
The B Vitamins (8)
1048708 Involved in energy metabolism
1048708 thiamin riboflavin niacin
1048708 biotin pantothenic acid
1048708 B6 folate B12 (amp red blood cell function)
15
Thiamin
1048708 Deficiency disease beriberi (polished rice)
1048708 depression weakness polyneuropathy
1048708 Functions
1048708 coenzyme (TPP) reactions involving CO2
1048708releasing energy from glucose amp fat
1048708 synthesis of acetylcholine (neurotransmitter)
1048708 synthesis of ribose (RNA component)
1048708 alcohol metabolism
16
Thiamin Beriberi
17
Riboflavin
1048708 Deficiency disease ariboflavinosis
1048708 2 months to evolve may exist with other B vitamin deficiencies (same food sources)
1048708 affects skin eyes mouth tongue
1048708 Functions
1048708 coenzyme (FMN FAD) in energy production releasing energy from glucose and fat
18
Niacin
1048708 Deficiency disease pellagra (4 Drsquos)
1048708 dermatitis diarrhea dementia death
1048708 diet cornmeal salted fat pork molasses
1048708 Functions
1048708 coenzyme (NAD NADP) in energy production
releasing energy from glucose and fat
1048708 synthesis of fatty acids amp steroids (cholesterol)
19
Thiamin Riboflavin Niacin
1048708 DRIs based on energy requirements
1048708 higher in growth pregnancy lactation high physical activity athletes
1048708 NE (niacin equivalents) niacin (1 mg) synthesized from tryptophan (60 mg)
1048708priority proteinneurotransmitter function
1048708 Supplements do not stimulate energy production unless one is deficient in one of these vitamins
20
Thiamin Riboflavin Niacin
1048708 Food sources (also sources of tryptophan)
1048708 enriched (added back to the natural level) amp whole grains cereals and baked products
1048708 legumes
1048708 leafy green vegetables mushrooms
1048708 meat fish eggs
1048708 milk amp milk products (especially riboflavin)
1048708 corn tortillas lime water increases bioavailability of niacin from corn
21
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Vitamin E 15 mgd RDA
1048708 Food sources
1048708 plant foods eg grains
1048708 associated with linoleic content in vegetable oils
11
Vitamin K
1048708 Danish ldquokoagulationrdquo
1048708 Function blood clotting amp bone synthesis
1048708 Status by blood clotting test
1048708 dicumarol (drug) interferes with Vit K and
blood clotting test before surgery
1048708 Deficiency rare except newborns (easy bruising)
1048708 Toxic in excess (infants pregnancy) sold as single
vitamin by prescription
12
Vitamin K 90-120 ugd AI
1048708 Bacterial production in colon (~12 required)
1048708 affected by absorption problemsillness
1048708 antibiotics decrease production
1048708 Food sources (~12 required)
1048708 green leafy vegetables cabbage family
1048708 liver eggs milk
1048708 beans
13
Summary
Fat soluble vitamins
1048708 dissolve in lipid
1048708 require bile for absorption
1048708 stored in tissues eg liver adipose
1048708 may be toxic in excess
1048708caution with supplements
14
The B Vitamins (8)
1048708 Involved in energy metabolism
1048708 thiamin riboflavin niacin
1048708 biotin pantothenic acid
1048708 B6 folate B12 (amp red blood cell function)
15
Thiamin
1048708 Deficiency disease beriberi (polished rice)
1048708 depression weakness polyneuropathy
1048708 Functions
1048708 coenzyme (TPP) reactions involving CO2
1048708releasing energy from glucose amp fat
1048708 synthesis of acetylcholine (neurotransmitter)
1048708 synthesis of ribose (RNA component)
1048708 alcohol metabolism
16
Thiamin Beriberi
17
Riboflavin
1048708 Deficiency disease ariboflavinosis
1048708 2 months to evolve may exist with other B vitamin deficiencies (same food sources)
1048708 affects skin eyes mouth tongue
1048708 Functions
1048708 coenzyme (FMN FAD) in energy production releasing energy from glucose and fat
18
Niacin
1048708 Deficiency disease pellagra (4 Drsquos)
1048708 dermatitis diarrhea dementia death
1048708 diet cornmeal salted fat pork molasses
1048708 Functions
1048708 coenzyme (NAD NADP) in energy production
releasing energy from glucose and fat
1048708 synthesis of fatty acids amp steroids (cholesterol)
19
Thiamin Riboflavin Niacin
1048708 DRIs based on energy requirements
1048708 higher in growth pregnancy lactation high physical activity athletes
1048708 NE (niacin equivalents) niacin (1 mg) synthesized from tryptophan (60 mg)
1048708priority proteinneurotransmitter function
1048708 Supplements do not stimulate energy production unless one is deficient in one of these vitamins
20
Thiamin Riboflavin Niacin
1048708 Food sources (also sources of tryptophan)
1048708 enriched (added back to the natural level) amp whole grains cereals and baked products
1048708 legumes
1048708 leafy green vegetables mushrooms
1048708 meat fish eggs
1048708 milk amp milk products (especially riboflavin)
1048708 corn tortillas lime water increases bioavailability of niacin from corn
21
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Vitamin K
1048708 Danish ldquokoagulationrdquo
1048708 Function blood clotting amp bone synthesis
1048708 Status by blood clotting test
1048708 dicumarol (drug) interferes with Vit K and
blood clotting test before surgery
1048708 Deficiency rare except newborns (easy bruising)
1048708 Toxic in excess (infants pregnancy) sold as single
vitamin by prescription
12
Vitamin K 90-120 ugd AI
1048708 Bacterial production in colon (~12 required)
1048708 affected by absorption problemsillness
1048708 antibiotics decrease production
1048708 Food sources (~12 required)
1048708 green leafy vegetables cabbage family
1048708 liver eggs milk
1048708 beans
13
Summary
Fat soluble vitamins
1048708 dissolve in lipid
1048708 require bile for absorption
1048708 stored in tissues eg liver adipose
1048708 may be toxic in excess
1048708caution with supplements
14
The B Vitamins (8)
1048708 Involved in energy metabolism
1048708 thiamin riboflavin niacin
1048708 biotin pantothenic acid
1048708 B6 folate B12 (amp red blood cell function)
15
Thiamin
1048708 Deficiency disease beriberi (polished rice)
1048708 depression weakness polyneuropathy
1048708 Functions
1048708 coenzyme (TPP) reactions involving CO2
1048708releasing energy from glucose amp fat
1048708 synthesis of acetylcholine (neurotransmitter)
1048708 synthesis of ribose (RNA component)
1048708 alcohol metabolism
16
Thiamin Beriberi
17
Riboflavin
1048708 Deficiency disease ariboflavinosis
1048708 2 months to evolve may exist with other B vitamin deficiencies (same food sources)
1048708 affects skin eyes mouth tongue
1048708 Functions
1048708 coenzyme (FMN FAD) in energy production releasing energy from glucose and fat
18
Niacin
1048708 Deficiency disease pellagra (4 Drsquos)
1048708 dermatitis diarrhea dementia death
1048708 diet cornmeal salted fat pork molasses
1048708 Functions
1048708 coenzyme (NAD NADP) in energy production
releasing energy from glucose and fat
1048708 synthesis of fatty acids amp steroids (cholesterol)
19
Thiamin Riboflavin Niacin
1048708 DRIs based on energy requirements
1048708 higher in growth pregnancy lactation high physical activity athletes
1048708 NE (niacin equivalents) niacin (1 mg) synthesized from tryptophan (60 mg)
1048708priority proteinneurotransmitter function
1048708 Supplements do not stimulate energy production unless one is deficient in one of these vitamins
20
Thiamin Riboflavin Niacin
1048708 Food sources (also sources of tryptophan)
1048708 enriched (added back to the natural level) amp whole grains cereals and baked products
1048708 legumes
1048708 leafy green vegetables mushrooms
1048708 meat fish eggs
1048708 milk amp milk products (especially riboflavin)
1048708 corn tortillas lime water increases bioavailability of niacin from corn
21
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Vitamin K 90-120 ugd AI
1048708 Bacterial production in colon (~12 required)
1048708 affected by absorption problemsillness
1048708 antibiotics decrease production
1048708 Food sources (~12 required)
1048708 green leafy vegetables cabbage family
1048708 liver eggs milk
1048708 beans
13
Summary
Fat soluble vitamins
1048708 dissolve in lipid
1048708 require bile for absorption
1048708 stored in tissues eg liver adipose
1048708 may be toxic in excess
1048708caution with supplements
14
The B Vitamins (8)
1048708 Involved in energy metabolism
1048708 thiamin riboflavin niacin
1048708 biotin pantothenic acid
1048708 B6 folate B12 (amp red blood cell function)
15
Thiamin
1048708 Deficiency disease beriberi (polished rice)
1048708 depression weakness polyneuropathy
1048708 Functions
1048708 coenzyme (TPP) reactions involving CO2
1048708releasing energy from glucose amp fat
1048708 synthesis of acetylcholine (neurotransmitter)
1048708 synthesis of ribose (RNA component)
1048708 alcohol metabolism
16
Thiamin Beriberi
17
Riboflavin
1048708 Deficiency disease ariboflavinosis
1048708 2 months to evolve may exist with other B vitamin deficiencies (same food sources)
1048708 affects skin eyes mouth tongue
1048708 Functions
1048708 coenzyme (FMN FAD) in energy production releasing energy from glucose and fat
18
Niacin
1048708 Deficiency disease pellagra (4 Drsquos)
1048708 dermatitis diarrhea dementia death
1048708 diet cornmeal salted fat pork molasses
1048708 Functions
1048708 coenzyme (NAD NADP) in energy production
releasing energy from glucose and fat
1048708 synthesis of fatty acids amp steroids (cholesterol)
19
Thiamin Riboflavin Niacin
1048708 DRIs based on energy requirements
1048708 higher in growth pregnancy lactation high physical activity athletes
1048708 NE (niacin equivalents) niacin (1 mg) synthesized from tryptophan (60 mg)
1048708priority proteinneurotransmitter function
1048708 Supplements do not stimulate energy production unless one is deficient in one of these vitamins
20
Thiamin Riboflavin Niacin
1048708 Food sources (also sources of tryptophan)
1048708 enriched (added back to the natural level) amp whole grains cereals and baked products
1048708 legumes
1048708 leafy green vegetables mushrooms
1048708 meat fish eggs
1048708 milk amp milk products (especially riboflavin)
1048708 corn tortillas lime water increases bioavailability of niacin from corn
21
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Summary
Fat soluble vitamins
1048708 dissolve in lipid
1048708 require bile for absorption
1048708 stored in tissues eg liver adipose
1048708 may be toxic in excess
1048708caution with supplements
14
The B Vitamins (8)
1048708 Involved in energy metabolism
1048708 thiamin riboflavin niacin
1048708 biotin pantothenic acid
1048708 B6 folate B12 (amp red blood cell function)
15
Thiamin
1048708 Deficiency disease beriberi (polished rice)
1048708 depression weakness polyneuropathy
1048708 Functions
1048708 coenzyme (TPP) reactions involving CO2
1048708releasing energy from glucose amp fat
1048708 synthesis of acetylcholine (neurotransmitter)
1048708 synthesis of ribose (RNA component)
1048708 alcohol metabolism
16
Thiamin Beriberi
17
Riboflavin
1048708 Deficiency disease ariboflavinosis
1048708 2 months to evolve may exist with other B vitamin deficiencies (same food sources)
1048708 affects skin eyes mouth tongue
1048708 Functions
1048708 coenzyme (FMN FAD) in energy production releasing energy from glucose and fat
18
Niacin
1048708 Deficiency disease pellagra (4 Drsquos)
1048708 dermatitis diarrhea dementia death
1048708 diet cornmeal salted fat pork molasses
1048708 Functions
1048708 coenzyme (NAD NADP) in energy production
releasing energy from glucose and fat
1048708 synthesis of fatty acids amp steroids (cholesterol)
19
Thiamin Riboflavin Niacin
1048708 DRIs based on energy requirements
1048708 higher in growth pregnancy lactation high physical activity athletes
1048708 NE (niacin equivalents) niacin (1 mg) synthesized from tryptophan (60 mg)
1048708priority proteinneurotransmitter function
1048708 Supplements do not stimulate energy production unless one is deficient in one of these vitamins
20
Thiamin Riboflavin Niacin
1048708 Food sources (also sources of tryptophan)
1048708 enriched (added back to the natural level) amp whole grains cereals and baked products
1048708 legumes
1048708 leafy green vegetables mushrooms
1048708 meat fish eggs
1048708 milk amp milk products (especially riboflavin)
1048708 corn tortillas lime water increases bioavailability of niacin from corn
21
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
The B Vitamins (8)
1048708 Involved in energy metabolism
1048708 thiamin riboflavin niacin
1048708 biotin pantothenic acid
1048708 B6 folate B12 (amp red blood cell function)
15
Thiamin
1048708 Deficiency disease beriberi (polished rice)
1048708 depression weakness polyneuropathy
1048708 Functions
1048708 coenzyme (TPP) reactions involving CO2
1048708releasing energy from glucose amp fat
1048708 synthesis of acetylcholine (neurotransmitter)
1048708 synthesis of ribose (RNA component)
1048708 alcohol metabolism
16
Thiamin Beriberi
17
Riboflavin
1048708 Deficiency disease ariboflavinosis
1048708 2 months to evolve may exist with other B vitamin deficiencies (same food sources)
1048708 affects skin eyes mouth tongue
1048708 Functions
1048708 coenzyme (FMN FAD) in energy production releasing energy from glucose and fat
18
Niacin
1048708 Deficiency disease pellagra (4 Drsquos)
1048708 dermatitis diarrhea dementia death
1048708 diet cornmeal salted fat pork molasses
1048708 Functions
1048708 coenzyme (NAD NADP) in energy production
releasing energy from glucose and fat
1048708 synthesis of fatty acids amp steroids (cholesterol)
19
Thiamin Riboflavin Niacin
1048708 DRIs based on energy requirements
1048708 higher in growth pregnancy lactation high physical activity athletes
1048708 NE (niacin equivalents) niacin (1 mg) synthesized from tryptophan (60 mg)
1048708priority proteinneurotransmitter function
1048708 Supplements do not stimulate energy production unless one is deficient in one of these vitamins
20
Thiamin Riboflavin Niacin
1048708 Food sources (also sources of tryptophan)
1048708 enriched (added back to the natural level) amp whole grains cereals and baked products
1048708 legumes
1048708 leafy green vegetables mushrooms
1048708 meat fish eggs
1048708 milk amp milk products (especially riboflavin)
1048708 corn tortillas lime water increases bioavailability of niacin from corn
21
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Thiamin
1048708 Deficiency disease beriberi (polished rice)
1048708 depression weakness polyneuropathy
1048708 Functions
1048708 coenzyme (TPP) reactions involving CO2
1048708releasing energy from glucose amp fat
1048708 synthesis of acetylcholine (neurotransmitter)
1048708 synthesis of ribose (RNA component)
1048708 alcohol metabolism
16
Thiamin Beriberi
17
Riboflavin
1048708 Deficiency disease ariboflavinosis
1048708 2 months to evolve may exist with other B vitamin deficiencies (same food sources)
1048708 affects skin eyes mouth tongue
1048708 Functions
1048708 coenzyme (FMN FAD) in energy production releasing energy from glucose and fat
18
Niacin
1048708 Deficiency disease pellagra (4 Drsquos)
1048708 dermatitis diarrhea dementia death
1048708 diet cornmeal salted fat pork molasses
1048708 Functions
1048708 coenzyme (NAD NADP) in energy production
releasing energy from glucose and fat
1048708 synthesis of fatty acids amp steroids (cholesterol)
19
Thiamin Riboflavin Niacin
1048708 DRIs based on energy requirements
1048708 higher in growth pregnancy lactation high physical activity athletes
1048708 NE (niacin equivalents) niacin (1 mg) synthesized from tryptophan (60 mg)
1048708priority proteinneurotransmitter function
1048708 Supplements do not stimulate energy production unless one is deficient in one of these vitamins
20
Thiamin Riboflavin Niacin
1048708 Food sources (also sources of tryptophan)
1048708 enriched (added back to the natural level) amp whole grains cereals and baked products
1048708 legumes
1048708 leafy green vegetables mushrooms
1048708 meat fish eggs
1048708 milk amp milk products (especially riboflavin)
1048708 corn tortillas lime water increases bioavailability of niacin from corn
21
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Thiamin Beriberi
17
Riboflavin
1048708 Deficiency disease ariboflavinosis
1048708 2 months to evolve may exist with other B vitamin deficiencies (same food sources)
1048708 affects skin eyes mouth tongue
1048708 Functions
1048708 coenzyme (FMN FAD) in energy production releasing energy from glucose and fat
18
Niacin
1048708 Deficiency disease pellagra (4 Drsquos)
1048708 dermatitis diarrhea dementia death
1048708 diet cornmeal salted fat pork molasses
1048708 Functions
1048708 coenzyme (NAD NADP) in energy production
releasing energy from glucose and fat
1048708 synthesis of fatty acids amp steroids (cholesterol)
19
Thiamin Riboflavin Niacin
1048708 DRIs based on energy requirements
1048708 higher in growth pregnancy lactation high physical activity athletes
1048708 NE (niacin equivalents) niacin (1 mg) synthesized from tryptophan (60 mg)
1048708priority proteinneurotransmitter function
1048708 Supplements do not stimulate energy production unless one is deficient in one of these vitamins
20
Thiamin Riboflavin Niacin
1048708 Food sources (also sources of tryptophan)
1048708 enriched (added back to the natural level) amp whole grains cereals and baked products
1048708 legumes
1048708 leafy green vegetables mushrooms
1048708 meat fish eggs
1048708 milk amp milk products (especially riboflavin)
1048708 corn tortillas lime water increases bioavailability of niacin from corn
21
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Riboflavin
1048708 Deficiency disease ariboflavinosis
1048708 2 months to evolve may exist with other B vitamin deficiencies (same food sources)
1048708 affects skin eyes mouth tongue
1048708 Functions
1048708 coenzyme (FMN FAD) in energy production releasing energy from glucose and fat
18
Niacin
1048708 Deficiency disease pellagra (4 Drsquos)
1048708 dermatitis diarrhea dementia death
1048708 diet cornmeal salted fat pork molasses
1048708 Functions
1048708 coenzyme (NAD NADP) in energy production
releasing energy from glucose and fat
1048708 synthesis of fatty acids amp steroids (cholesterol)
19
Thiamin Riboflavin Niacin
1048708 DRIs based on energy requirements
1048708 higher in growth pregnancy lactation high physical activity athletes
1048708 NE (niacin equivalents) niacin (1 mg) synthesized from tryptophan (60 mg)
1048708priority proteinneurotransmitter function
1048708 Supplements do not stimulate energy production unless one is deficient in one of these vitamins
20
Thiamin Riboflavin Niacin
1048708 Food sources (also sources of tryptophan)
1048708 enriched (added back to the natural level) amp whole grains cereals and baked products
1048708 legumes
1048708 leafy green vegetables mushrooms
1048708 meat fish eggs
1048708 milk amp milk products (especially riboflavin)
1048708 corn tortillas lime water increases bioavailability of niacin from corn
21
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Niacin
1048708 Deficiency disease pellagra (4 Drsquos)
1048708 dermatitis diarrhea dementia death
1048708 diet cornmeal salted fat pork molasses
1048708 Functions
1048708 coenzyme (NAD NADP) in energy production
releasing energy from glucose and fat
1048708 synthesis of fatty acids amp steroids (cholesterol)
19
Thiamin Riboflavin Niacin
1048708 DRIs based on energy requirements
1048708 higher in growth pregnancy lactation high physical activity athletes
1048708 NE (niacin equivalents) niacin (1 mg) synthesized from tryptophan (60 mg)
1048708priority proteinneurotransmitter function
1048708 Supplements do not stimulate energy production unless one is deficient in one of these vitamins
20
Thiamin Riboflavin Niacin
1048708 Food sources (also sources of tryptophan)
1048708 enriched (added back to the natural level) amp whole grains cereals and baked products
1048708 legumes
1048708 leafy green vegetables mushrooms
1048708 meat fish eggs
1048708 milk amp milk products (especially riboflavin)
1048708 corn tortillas lime water increases bioavailability of niacin from corn
21
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Thiamin Riboflavin Niacin
1048708 DRIs based on energy requirements
1048708 higher in growth pregnancy lactation high physical activity athletes
1048708 NE (niacin equivalents) niacin (1 mg) synthesized from tryptophan (60 mg)
1048708priority proteinneurotransmitter function
1048708 Supplements do not stimulate energy production unless one is deficient in one of these vitamins
20
Thiamin Riboflavin Niacin
1048708 Food sources (also sources of tryptophan)
1048708 enriched (added back to the natural level) amp whole grains cereals and baked products
1048708 legumes
1048708 leafy green vegetables mushrooms
1048708 meat fish eggs
1048708 milk amp milk products (especially riboflavin)
1048708 corn tortillas lime water increases bioavailability of niacin from corn
21
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Thiamin Riboflavin Niacin
1048708 Food sources (also sources of tryptophan)
1048708 enriched (added back to the natural level) amp whole grains cereals and baked products
1048708 legumes
1048708 leafy green vegetables mushrooms
1048708 meat fish eggs
1048708 milk amp milk products (especially riboflavin)
1048708 corn tortillas lime water increases bioavailability of niacin from corn
21
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Thiamin Riboflavin Niacin
1048708 Toxicity of thiamin amp riboflavin is rare
1048708 Niacin is used as a drug for lowering blood cholesterol and treating schizophrenia
1048708 Niacin toxcity (supplement linked)
1048708flushing of skin red skin rash
1048708tingling sensation in handsfeet
1048708stomach pain nausea diarrhea
1048708 Body adapts to high doses but monitor for liver damage
22
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Biotin
1048708 Deficiency feeding raw egg white protein (contains avidin) to rats resulted in hair loss dermatitis and neuromuscular dysfunction
1048708 avidin binds biotin amp denatured by cooking
1048708 rare in humans (malnutrition)
1048708 Function cofactor in
1048708 energy production from glucose and fat
1048708 gluconeogenesis
1048708 amino acid metabolism
23
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Biotin 30 ugd AI
1048708 Produced by bacteria in colon
1048708 Food sources widespread
1048708 No increased needs or toxicity described
24
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Pantothenic Acid
1048708 Deficiency rare general failure of body
1048708 Functions (100+ steps)
1048708 cofactor (CoA) in energy metabolism amp synthesis of fatty acids cholesterol steroid hormones neurotransmitters hemoglobin
1048708 AI 5 mgd linked to energy needs
1048708 Food sources widespread
25
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Vitamin B6 (Pyridoxine)
1048708 Deficiency weakness irritability convulsions microcytic anemia greasy dermatitis
1048708 eg heating infant formula amp destruction of B6
1048708 Functions (coenzyme = PLP)
1048708 NB amino acid amp protein metabolism and neurotransmitter synthesis
1048708 50+ steps in energy metabolism
1048708 synthesis of hemoglobin
1048708 synthesis of niacin from tryptophan
26
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Vitamin B6
1048708 RDA 13 mgd linked to protein intake
1048708 Food sources green leafy vegetables meat fish poultry legumes fruits whole grains
1048708 Toxicity from supplements gt1000 mgd numbness due to nerve damage reversed when quit supplements
1048708 Supplements may be some benefit in carpal tunnel syndrome
27
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Folate (Folic Acid)
1048708 Deficiency affects rapidly dividing cells
1048708 macrocytic anemia
1048708 nerve function amp neural tube defects (NTDs)
104870811000 births 2nd most common birth defect
1048708At risk
1048708 pregnant women premature infants
1048708 elderly (folate interacts with medications)
1048708 alcoholics (1048708 folate absorption)
1048708smoking (folate inactivation in lungs)
28
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Folate
1048708 Functions
1048708 coenzyme for synthesis of DNA RNA amino acids
1048708NB Growth early embryonic life and tissue turnover (intestine skin RBC)
1048708 Low folate status may contribute to hyperhomocyteinemia a risk factor for cardiovascular disease
29
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Folate (ldquofoliagerdquo)
1048708 RDA 400 ugday
1048708 additional 200 ugday during pregnancy
1048708 recommendations for folate supplementation before pregnancy
1048708 Food sources leafy green vegetables asparagus fruit legumes seeds liver
1048708 Folate fortification of flour
1048708 Potential problem masking Vitamin B12 deficiency
30
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Vitamin B12 (cobalamin)
1048708 Deficiency pernicious anemia (macrocytic) neuromuscular dysfunction
1048708 Functions
1048708 myelin in nerve fibers (nerve transmission)
1048708 coenzymes in energy amp amino acid metabolism
1048708 B12 binds intrinsic factor (IF) in stomach amp facilitates absorption in small intestine
1048708 B12 absorption in elderly
31
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Vitamin B12 (RDA 24 ugday)
1048708 If no intrinsic factor injections of B12
1048708 Food sources animal origin fermented products fungi algae fortified soymilk
1048708 Risk of deficiency breastfed infants of vegan mothers (Adults have body stores for 5 yrs)
1048708 Folate supplementation masks B12 deficiency ie improves anemia but progressive malfunctioning of nerves and muscles creeping paralysis
32
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Vitamin C (Ascorbic Acid)
1048708 Deficiency scurvy
1048708 Function
1048708 collagenconnective tissue (bones teeth skin
tendons)
1048708 antioxidant protection
1048708 promotes iron absorption
1048708 enhances immune function
1048708 synthesis of thyroxine (regulates basal metabolic rate and body temperature)
33
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Scurvy symptoms gums and skin
34
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Vitamin C
1048708 RDA 75-90 mgd (old RNI 20-40 mgday)
1048708 additional 35 mgd for smokers (and passive smoke)
1048708 Food sources citrus vegetables
1048708 Low toxicity but problems if gt2 gday eg Altered insulin response to carbohydrate
1048708 Vit C supplements amp common cold Placebo effect
35
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Summary
1048708 Water soluble vitamins
1048708 dissolve in water
1048708 are easily absorbed amp excreted
1048708 are not stored extensively in tissues
1048708 seldom reach toxic levels
36
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Controversy
1048708 Dietary Antioxidants Food or Pills
1048708 Epidemiological studies show protective effects of food sources (diets high in fruits and vegetables)
1048708 Foods contain many protective chemicals in addition to vitamins eg phytochemicals
1048708 The theory of free radicals antioxidants and disease
37
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Research on supplementation
1048708 Positive outcome (last year-now debateable)
supplementation of Vitamin E may provide additional antioxidant protection and decrease chronic disease risk eg heart disease or may increase mortality in some susceptible
Individuals
1048708 Negative outcome supplementation of β-carotene increased incidence of lung cancer in smokers
rarrresearch study stopped
38
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
Who needs a supplement
1048708 Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet
1048708 Those with special needs eg Pregnant elderly
39
