Chapter 7

Question 1

Organic compounds that are vital to life and indispensable to body functions but that are needed only in minute amounts; essential, noncaloric nutrients.

Answer 1

Vitamins

Question 2

Today, research hints that certain vitamins may influence the development of two major health conditions such as what?

Answer 2

CVD and Cancer

Question 3

Learn: The only disease a vitamin can “cure” is the one caused by a deficiency of that vitamin. Although, vitamin rich foods are protective in helping benefit chronic disease prevention. Cannot say the same for the vitamin supplements though.

Question 4

According to the Dietary Guidelines 2020-2025 committee, today’s US intakes of these vitamins too often fall below recommended intakes:

Answer 4

-Vitamin D
- Folic acid (pregnant women)

Question 5

Help make the processes by which other nutrients are digested, absorbed, and metabolized or built into body structures possible.

Answer 5

Vitamins

Question 6

Vitamins fall into what 2 classes?

Answer 6

fat-soluble and water-soluble

Question 7

Fat-Soluble Vitamins include:

Answer 7

• Vitamin A
• Vitamin D
• Vitamin E
• Vitamin K

Question 8

Water- Soluble Vitamins include:

Answer 8

• Vitamin B’s:
  
  • Thiamin (B1)
  • Riboflavin (B2)
  • Niacin (B3)
  • Folate
  • Vitamin B12
  • Vitamin B6
  • Biotin
  • Pantothenic acid
    Vitamin C

Question 9

Occur in foods then convert to vitamins. Once inside the body, these are transformed chemically to one or more active vitamin forms. Compounds that serve as starting material for other compounds. In nutrition, these are compounds that can be converted into active vitamins. Also called provitamins.

Answer 9

precursors

Question 10

Determines how the body absorbs, transports, stores, and excretes vitamins.

Answer 10

Solubility

Question 11

Fat-soluble vitamins - How they are Absorbed:

Answer 11

Absorbed in lymph traveling through blood and in cells associated with protein carriers –> Stored in liver and lipids in fatty tissues and can build up toxic concentrations (from supplements)

Question 12

Water-soluble vitamins - How they are Absorbed:

Answer 12

Absorbed DIRECTLY into the bloodstream to travel freely - not stored in tissues and excreted in the urine so risk for toxicities are not that high unless consumed in high doses from supplements

Question 13

When are Fat-Soluble Vitamins needed:

Answer 13

weekly or monthly depending on extent of body stores

Question 14

When are Water-Soluble Vitamins needed:

Answer 14

-daily because the body doesn’t store them

Question 15

Found in the fats and oils and require bile for absorption. Once absorbed, these vitamins are stored in the liver and fatty tissues until the body needs them. Because they are stored, you do not need to eat foods containing these every day. If a dietary pattern provides sufficient amounts of these on average over time, the body can survive for weeks at a time without consuming them.

Answer 15

Fat-Soluble Vitamins

Question 16

Deficiencies of these occur when the diet is consistently low in them. They also occur in people who undergo intestinal surgery for obesity treatment, which reduces energy nutrient absorption by design and vitamin absorption unintentionally. We also know that any disease that produces fat malabsorption (such as liver disease, which prevents bile production) can cause the loss of vitamins dissolved in undigested fat and so bring on deficiencies. In the same way, a person who uses mineral oil (which the body cannot absorb) as a laxative risks losing these because they readily dissolve into the oil and are excreted with it. Deficiencies are also likely when people follow dietary patterns that are extraordinarily low in fat because a little fat is necessary for absorption of these vitamins.

Answer 16

Fat-soluble vitamins

Question 17

What fat-soluble vitamin from high-dose supplements and highly fortified and highly fortified foods is especially likely to reach toxic levels?

Answer 17

Vitamin A

Question 18

What 2 vitamins act somewhat like hormones, directing cells to convert one substance to another, to store or release something in the body. They also directly influence the genes, helping to regulate the production of enzymes and other proteins?

Answer 18

Vitamin A and D

Question 19

What fat-soluble vitamin protects tissues all over the body from destructive oxidative reactions?

Answer 19

Vitamin E

Question 20

What fat-soluble vitamin is necessary for blood to clot and for bone health?

Answer 20

Vitamin K

Question 21

The first fat-soluble vitamin to be recognized. Has a plant-derived precursor, beta carotene, that are still very much a focus of research. There are three forms of these vitamins including retinol, that can be converted to retinal and retinoic acid. Foods derived from animals provide forms of this that are readily absorbed and put to use by the body. Foods derived from plants provide beta-carotene, which must be converted to this as an active vitamin before it can be used.

Answer 21

Vitamin A

Question 22

An orange pigment with antioxidant activity; a vitamin A precursor made by plants, present in many colorful fruits and vegetables, and stored in human fat tissue.

Answer 22

beta-carotene

Question 23

Active form of Vitamin A. Made from beta-carotene in animal and human bodies; an antioxidant nutrient. Other active forms are retinal and retinoic acid. Is stored in specialized cells of the liver. The liver makes this available to the bloodstream and thereby to the body’s cells.

Answer 23

Retinol

Question 24

Roles of Vitamin A:

Answer 24

• Gene expression
• Vision
• Maintenance of body linings and skin
• immune defenses
• growth of the body
• normal development of cells
• reproductive functions and normal development of an embryo and fetus
• maintain epithelial tissue
  –> cornea
  –> skin and the protective linings of the lungs, intestines, vagina, urinary tract, and bladder that serve as barriers to infection

Question 25

Vitamin A plays 2 indispensable roles in eyesight, what are they?

Answer 25

• maintenance of crystal clear outer window, the cornea and process of light perception at the retina

Question 26

When light falls on the eye, it passes through the clear cornea and strikes the cells of the retina, bleaching many molecules of this pigment that lies within those cells. It’s the light-sensitive pigment of the cells in the retina; it contains vitamin A. When bleaching occurs, the vitamin is broken off, initiating the signal that conveys the sensation of sight to the optic center in the brain. The vitamin then reunites with the pigment, but a little vitamin A is destroyed each time this reaction takes place, and fresh vitamin A must replenish the supply.

Answer 26

rhodopsin

Question 27

If an eye’s vitamin A supply begins to run low (deficiency), a lag occurs before the eye can see again after a flash of bright light at night. A bright flash of light can temporarily blind even normal, well-nourished eyes, but if you experience a long recovery period before vision returns, your health-care provider may want to check your vitamin A intake.

Answer 27

Night Blindness

Question 28

The normal protein of hair and nails.

Answer 28

keratin

Question 29

Accumulation of keratin in a tissue; a sign of vitamin A deficiency. Exhibited when protein keratin accumulates and clouds the eye’s outer vitamin A-dependent part, the cornea.

Answer 29

keratinization

Question 30

If the deficiency of vitamin A is not corrected, it can worsen to this. Drying of the cornea; a symptom of vitamin A deficiency. This can progress to xerophthalmia.

Answer 30

xerosis

Question 31

Progression from xerosis to this. Progress to thickening and permanent blindness. Vitamin A supplements can help children from blindness or progression to save both eyesight and lives. Better still, a child fed a variety of fruit and vegetables regularly is virtually assured protection.

Answer 31

xerophthalmia

Question 32

The process by which immature cells are stimulated to mature and gain the ability to perform functions characteristic of their cell type. Vitamin A’s health supporting work is this process. For example, when goblet cells (cells that populate the linings of internal organs) mature, they specialize in synthesizing and releasing mucus to protect delicate tissues from toxins or bacteria and other harmful elements. If vitamin A is deficient, these are impaired and goblet cells fail to mature, fail to make protective mucus, and eventually die off. Goblet cells are then displaced by cells that secrete keratin, mentioned earlier with regard to the eye. Keratin is the same protein that provides toughness in hair and fingernails, but in the wrong place, such as skin and body linings, keratin makes the tissue surfaces dry, hard, and cracked. As dead cells accumulate on the surface, the tissue becomes vulnerable to infection. In the cornea, keratinization leads to xerophthalmia; in the lungs, the displacement of mucus-producing cells makes respiratory infections likely; in the urinary tract, the same process leads to urinary tract infections.

Answer 32

cell differentiation

Question 33

Vitamin A has gained a reputation as an “anti-infective” vitamin because so many of the body’s defenses against infection depend on an adequate supply. Much research supports the need for vitamin A in the regulation of the genes involved in immunity. Without sufficient vitamin A, these genetic interactions produce an altered response to infection that weakens the body’s defenses. When defenses are weak, especially in vitamin A-deficient children, an illness such as measles can become severe. A downward spiral of malnutrition and infection sets in. The child’s body must devote its scanty store of vitamin A to the immune system’s fight against the measles virus, but this destroys the vitamin. As vitamin A dwindles further, the infection worsens. Measles takes the lives of more than 330 of the world’s children every day. Even if a child survives the infection, permanent blindness is likely to occur. The corneas, already damaged by the chronic vitamin A shortage, degenerate rapidly as their meager vitamin A supply is diverted to the immune system.

Answer 33

Immune Function

Question 34

Vitamin A is essential for this processes. In men, vitamin A participates in sperm development, and in women, it supports normal fetal development during pregnancy. In a developing embryo, vitamin A is crucial for the formation of the spinal cord, heart, and other organs. Vitamin A is also indispensable for normal growth in children. In well-fed children, bones grow longer and the children grow taller by remodeling each old bone into a new, bigger version. To do so, the body dismantles old bone structures and replaces them with new, larger bone parts. Growth cannot take place just by adding on to the original small bone; vitamin A must be present for critical bone dismantling steps. Failure to grow is one of the first signs of poor vitamin A status in a child. Restoring vitamin A to such children is imperative, but correcting dietary deficiencies may be more effective than giving vitamin A supplements alone. Many other nutrients from nutritious foods are also needed for normal growth.

Answer 34

Reproduction and Growth

Question 35

For people who take excess active vitamin A in supplements or fortified foods, toxicity is a possibility. Who should especially be wary? Can injure the heart, spinal cord, and other tissues of a developing fetus, causing birth defects.

Answer 35

Pregnant women
- Also, children too, can be easily hurt by vitamin A excesses when they mistake chewable vitamin pills and vitamin-laced gum for treats.

Question 36

Learn:
The DRI for vitamin A is based on body weight. A typical man needs a daily average of about 900 micrograms of active vitamin A; a typical woman needs about 700 micrograms. During lactation, her need is higher. Children need less.

The ability of vitamin A to be stored in the tissues means that, although the DRI is stated as a daily amount, you need not consume vitamin A every day. An intake that meets the daily need when averaged over several months is sufficient.

An ounce of ordinary beef or pork liver delivers three times the DRI for vitamin A intake, and a common portion is 4 to 6 ounces. An occasional serving of liver can provide abundant nutrients and boost nutrient status, but daily use may invite vitamin A toxicity, especially in young children and pregnant women who also routinely take supplements.

Question 37

What are foods that are rich in Vitamin A?

Answer 37

• liver and fish oil
• dairy products
• vitamin A fortified foods –> enriched cereals, energy bars, chewing gums
• butter and eggs
• beta carotene present in veggies and fruit - carrot, sweet potato, spinach, beef liver, bok choy, apricots
• most fast-food places also offer fortified milk or salads with carrots that provide vitamin A

Question 38

Key antioxidant vitamins: And what is a key antioxidant mineral?

Answer 38

-Beta carotene
- Vitamin E
- Vitamin C

Antioxidant mineral:
- Selenium

Question 39

Chemical relatives of beta-carotene, often occur with beta-carotene in plant foods and may also play roles in health. Members of a group of pigments in foods that range in color from light yellow to reddish orange and are chemical relatives of beta-carotene. Many have a degree of vitamin A activity in the body.

Answer 39

carotenoids

Question 40

A common, progressive loss of function of the part of the retina that is most crucial to focused vision, often leads to blindness. The macula, a yellow spot of pigment at the focal center of the retina, loses integrity, impairing the most important field of vision, the central focus. Supplements of carotenoids show some promise against this type of blindness in research, but they may present an increased risk of cancer in some people.

Answer 40

macular degeneration

Question 41

A new measure of the vitamin A activity of beta-carotene and other vitamin A precursors that reflects the amount of retinol that the body will derive from a food containing vitamin A precursor compounds. It takes about 12 micrograms of beta-carotene from food to supply the equivalent of 1 microgram of retinol to the body.

Answer 41

retinol activity equivalents (RAE)

Question 42

Some food tables and supplement labels express beta-carotene and vitamin A contents using this. A measure of fat-soluble vitamin activity sometimes used in food composition tables and on supplement labels. When comparing vitamin A in foods or supplements, be careful to notice whether the units are micrograms or this.

Answer 42

International Units (IU)

Question 43

Learn:

Toxicity

Beta-carotene from food is not converted to retinol efficiently enough to cause vitamin A toxicity. A steady diet of abundant pumpkin, carrots, or carrot juice, however, has been known to turn light-skinned people bright yellow because beta-carotene builds up in the fat just beneath the skin and imparts a harmless yellow cast. Likewise, red-colored carotenoids confer a rosy glow on those who consume the fruits and vegetables that contain them. Food sources of the carotenoids are safe, but concentrated supplements may have adverse effects of their own.

Question 44

Learn:
Food Sources of Beta-Carotene

Plants contain no active vitamin A, but many vegetables and fruits provide beta-carotene in abundance. Other colorful vegetables, such as red beets, red cabbage, and yellow corn, can fool you into thinking they contain beta-carotene, but these foods derive their colors from other pigments and are poor sources of beta-carotene. As for “white” plant foods such as grains and potatoes, they have none. Some confusion exists concerning the term yam. A white-fleshed Mexican root vegetable called “yam” is devoid of beta-carotene, but the orange-fleshed sweet potato called “yam” in the United States is one of the richest beta-carotene sources known.

Question 45

Not an essential nutrient. With the help of sunlight, the body can synthesize all its needs. Given sufficient sun each day, most people can make enough to meet their need from this source. Must undergo a series of chemical transformations in the liver and kidneys to be activated.

Answer 45

Vitamin D

Question 46

The best-known member of a large cast of nutrients and hormones that interact to regulate blood calcium and phosphorus concentrations—and thereby maintain bone integrity. Important for bone health. Calcium is indispensable to the proper functioning of cells in all body tissues, including muscles, nerves, and glands, which draw calcium from the blood as they need it. Inside cells, this acts at the genetic level to affect how cells grow, multiply, and differentiate. Exerts its effects all over the body, from hair follicles, to reproductive system cells, to cells of the immune system.

Answer 46

Vitamin D

Question 47

Function Group for Bone Health:
List key vitamins:
Key minerals:
Key energy nutrient:

Answer 47

List key vitamins:
- Vitamin D
- Vitamin K
- Vitamin C
Key minerals:
- Calcium
- Phosphorous
- Magnesium
- Fluoride
Key energy nutrient:
- Protein

Question 48

When the blood calcium concentration begins to fall, vitamin D acts on three body locations to raise it. Vitamin D:

Answer 48

• Stimulates the intestinal tract to increase absorption of calcium.
• Acts on the skeleton, the body’s vast warehouse of stored calcium, to release calcium into the blood.
• Triggers the kidneys to recycle calcium that would otherwise be lost in urine.
• With these actions, normal blood calcium concentration is quickly restored.

Vitamin D and calcium are inextricably linked in nutrition—no matter how much vitamin D you take in, it cannot make up for a chronic shortfall of calcium. The reverse is also true: excess calcium cannot take the place of sufficient vitamin D for bone health.

Question 49

The vitamin D–deficiency disease in children; characterized by abnormal growth of bone and manifested in bowed legs or knock-knees, outward-bowed chest deformity (pigeon chest), and knobs on the ribs. A physician linked ultraviolet light and sunlight exposure to prevention and cure of this. Many adolescents abandon vitamin D–fortified milk in favor of soft drinks and punches; they may also spend little time outdoors during daylight hours. Soon, these vitamin values decline, and they may fail to develop the bone mineral density needed to offset bone loss in later life. To prevent this and support optimal bone health, the DRI committee recommends that all infants, children, and adolescents consume the recommended amounts of vitamin D each day.

Answer 49

rickets

Question 50

The adult expression of vitamin D–deficiency disease, characterized by an overabundance of unmineralized bone protein. Symptoms include bending of the spine and bowing of the legs. The bones become increasingly soft, flexible, weak, and deformed. Older people can suffer painful joints if their vitamin D concentrations are low, a condition easily misdiagnosed as arthritis during examinations.

Answer 50

osteomalacia

Question 51

Inadequate vitamin D also sets the stage for a loss of calcium from the bones, which can result in fractures from this. A weakening of bone mineral structures caused by calcium loss that occurs commonly with advancing age. For people with a low vitamin D blood concentration, a vitamin D supplement may help to normalize the blood value and maintain bone mineral density.

Answer 51

osteoporosis

Question 52

Learn:
How can excess fat in the body cause low vitamin D in the blood? Fat-soluble vitamin D is taken up and sequestered in excess adipose tissue, thereby lowering the blood’s vitamin D concentration. Weight loss reduces excess adipose tissue and restores vitamin D to the blood.

Question 53

Concern of Vitamin D deficiency is if the following criteria is met:

Answer 53

• do not eat fish
• restrict dairy or lactose intolerant people, vegans
• live in northern areas
• lack of sunlight
• dark skinned people
• infants and children
• disordered people that impede fat absorption (because vitamin D is absorbed with fats)
• obese or overweight people
• certain meds

Question 54

What vitamin is the most potentially toxic among all the other vitamins? The intoxication of this vitamin raises the concentration of blood calcium by withdrawing bone calcium, which can then collect in the soft tissues and damage them. With high intakes, kidney and heart function decline, blood calcium spins further out of control, and, when the kidneys and heart ultimately fail, death ensues. May bring on high blood calcium, nausea, fatigue, back pain, irregular heartbeat, and increased urination and thirst. Several reports of patients with high blood calcium have emerged as more and more people self-prescribe high-dose of these in forms of supplements in response to preliminary reports of potential health benefits.

Answer 54

Vitamin D

Question 55

Supplies the needed vitamin D for most of the world’s people. Presents no risk of vitamin D toxicity because after a certain amount of vitamin D collects in the skin, the sunlight itself begins breaking it down.

Answer 55

Sunlight

Question 56

How sunlight is converted to Vitamin D in the body:

Answer 56

UV rays reach cholesterol compound in skin –> compound transforms into Vitamin D precursor and is absorbed directly into the blood –> liver and kidneys convert precursor to active form of Vitamin D
Note:
Diseases that affect either the liver or the kidneys can impair this conversion and therefore produce symptoms of vitamin D deficiency.

Question 57

Since the pigments in dark skin protect against UV radiation, they require how many hours of direct sun? However, light skinned people only need how many minutes without sunscreen or how many minutes with sunscreen?

Answer 57

• Dark skin: 3 hours
• Light skinned: 5 mins without, 10-30 with

Question 58

Factors Affecting Vitamin D Synthesis:

Answer 58

• Aging: reduces synthesis of vitamin D
• Air pollution
• City living: buildings block sunlight
• Clothing
• Cloudy skies
• Geography
• Homebound
• Season
• Skin pigment
• Sunscreen
• Time of day

Question 59

Foods that supply Vitamin D:

Answer 59

• Mushrooms
• Egg yolks along with butter and cream
• Milk
• Orang juice, cereals, margarines
• Sardines, salmon, tuna
• Cod liver oil

Question 60

Almost a century ago, researchers discovered a compound in vegetable oils essential for reproduction in rats. This compound was named tocopherol from tokos, a Greek word meaning “offspring.” A few years later, the compound was named this.

Answer 60

Vitamin E

Question 61

A kind of alcohol. The active form of vitamin E is alpha-tocopherol. The compound that is now considered vitamin E.

Answer 61

tocopherol

Four tocopherol compounds are of importance in nutrition, and each is designated by one of the first four letters of the Greek alphabet: alpha, beta, gamma, and delta. Of these, alpha-tocopherol is the gold standard for vitamin E activity, and the DRI values are expressed as alpha-tocopherol. Additional forms of vitamin E are of interest to researchers for potential roles in health.

Question 62

Crucial in the lungs, where high oxygen concentrations would otherwise disrupt vulnerable membranes. An antioxidant and thus acts as a bodyguard against oxidative damage. Red blood cell membranes also needs this vitamin’s protection as they transport oxygen from the lungs to other tissues. White blood cells that fight diseases equally depend on these vitamins antioxidant nature, as do blood vessel linings, sensitive brain tissues, and even bones. Tocopherols also perform some nonantioxidant tasks that support the body’s health.

Answer 62

Vitamin E

Question 63

Atoms or molecules with one or more unpaired electrons that make the atom or molecule unstable and highly reactive. Vitamin E protects against oxidative damage of which occurs when these highly unstable molecules go haywire and are formed during normal cell metabolism. Left unchecked, they can create a destructive chain reaction that can damage the polyunsaturated lipids in cell membranes and lipoproteins, the DNA in genetic material, and the working proteins of cells.

Answer 63

free radicals

Question 64

According to this theory, this situation creates inflammation and cell damage associated with again processes, cancer development, heart disease, diabetes, and other diseases.
In other words, a theory of disease causation involving cell and tissue damage that arises when free radical reactions exceed the capacity of antioxidants to quench them.
Vitamin E, by being oxidized itself, quenches free radicals and reduces inflammation.

Answer 64

oxidative stress

Question 65

Learn:
Vitamin E deficiency
Scientists can produce symptoms of vitamin E deficiency in laboratory animals, but such symptoms are rarely seen in healthy people who eat normally. Vitamin E deficiency arises in some conditions that impair fat absorption, such as cystic fibrosis because vitamin E dissolves in fat.

The few symptoms of vitamin E deficiency observed in adults include loss of muscle coordination, loss of normal reflexes, and impaired vision and speech. Vitamin E corrects all of these symptoms, whether obtained from vitamin-E rich foods such as oils, seeds, and nuts or from supplements of vitamin E.

Question 66

A classic vitamin E deficiency occurs in babies born prematurely, before the transfer of the vitamin from the mother to the fetus, which occurs late in pregnancy. Without sufficient vitamin E, the infant’s red blood cells rupture known as this, and the infant becomes anemic.

Answer 66

erythrocyte hemolysis

Question 67

Learn:
Vitamin E Toxicity

Vitamin E in foods is safe to consume, and reports of vitamin E toxicity symptoms are rare across a broad range of intakes. However, vitamin E in supplements augments the effects of anticoagulant medication used to oppose unwanted blood clotting, so people taking such drugs risk uncontrollable bleeding if they also take vitamin E. Supplemental doses of vitamin E prolong blood clotting times and increase the risk of brain hemorrhages, a form of stroke that has been noted among people taking supplements of vitamin E. To err on the safe side, people who use vitamin E supplements should probably keep their dosages low, not exceeding the UL of 1,000 milligrams of alpha-tocopherol per day.

Vitamin E Recommendations and U.S. Intakes

On average, U.S. intakes of vitamin E fall substantially below the recommendation. The need for vitamin E rises as people consume more polyunsaturated oil because the oil requires antioxidant protection by the vitamin. Luckily, most raw oils also contain vitamin E, so people who eat raw oils also receive the vitamin. Smokers may have higher needs.

Question 68

Foods that Supply Vitamin E:

Answer 68

• wheat germ oil
• vegetable oils
• margarine and salad dressings
• sunflower seeds

Question 69

What food doesn’t have many if any at all of Vitamin E? What destroys vitamin E?

Answer 69

Animal fats
- High temps destroy vitamin E (frying oils)

Question 70

The main function of this protein is to help activate proteins that help clot the blood. Hospitals measure the clotting time of a person’s blood before surgery and, if needed, administer this as a supplement to reduce bleeding during the operation. A supplement of this is only beneficial if a deficiency exists. This vitamin does not improve clotting in those with other bleeding disorders, such as the inherited disease hemophilia. Some people with heart problems need to prevent the formation of clots within their circulatory systems—this is popularly referred to as “thinning” the blood. One of the best-known medicines for this purpose is warfarin, which interferes with this vitamin’s clot-promoting action. Therapy with this vitamin may be needed for people warfarin if uncontrolled bleeding should occur. People taking warfarin who self-prescribe this vitamin supplements risk causing dangerous clotting of their blood; those who suddenly stop taking these vitamins risk causing dangerous excessive bleeding.

Answer 70

Vitamin K

Question 71

Also, is necessary for the synthesis of key bone proteins (bone health). With this low in blood, the bones produce abnormal protein that cannot effectively bind the minerals that normally form bones. People who consume abundant amounts of this vitamin in the diet suffer fewer hip fractures than those with lower intakes.

Answer 71

Vitamin K

Question 72

Vitamin K Deficiency and the Microbiome:

Few U.S. adults are likely to experience vitamin K deficiency, even if they seldom eat vitamin K–rich foods. This is because, like vitamin D, vitamin K can be obtained from a nonfood source—in this case, the intestinal bacteria. Billions of bacteria normally reside in the intestines, and some of them synthesize vitamin K.

Newborn infants present a unique case with regard to vitamin K because they are born with sterile intestinal tracts and the vitamin K–producing bacteria take weeks to establish themselves. To prevent hemorrhage, newborns are given a single dose of vitamin K at birth sometimes orally , but often as an injection. Some well-meaning parents refuse the injections because false social media reports claim they are risky. Sadly, by refusing a safe, effective shot they incur a real risk of vitamin K deficiency-related vomiting, lethargy, and bleeding, even bleeding of the brain, in their newborns. Parents-to-be who learn the truth—that the injection is virtually risk-free—often choose it to prevent such problems.
People who have taken antibiotics that have killed the bacteria in their intestinal tracts also may develop vitamin K deficiency. In other medical conditions, bile production falters, making lipids, including all of the fat-soluble vitamins, unabsorbable. Supplements of the vitamin are needed in these cases because a vitamin K deficiency can be fatal.

Question 73

Vitamin K and Toxicity:
Reports of vitamin K toxicity among healthy adults are rare, and the DRI committee has not set a UL for vitamin K. For infants and pregnant women, however, vitamin K toxicity can result when supplements of a synthetic version of vitamin K are given too enthusiastically. Toxicity induces breakage of the red blood cells and release of their pigment, which colors the skin yellow. A toxic dose of synthetic vitamin K causes the liver to release the blood cell pigment (bilirubin) into the blood (instead of excreting it into the bile) and leads to jaundice.

Question 74

Vitamin K food sources:

Answer 74

• dark green, leafy veggies: cooked spinach, asparagus, lettuce, broccoli, brussels sprouts
• salad greens
• soybeans
• green and black eyed peas
• canola and soybean oils (hydrogenated oils)
• fortified cereals

Question 75

What vitamins dissolve in water, which has implications for their handling in food and by the body?

Answer 75

Vitamin C and B

Question 76

In food, these types of vitamins easily dissolve and drain away with cooking water, and some are destroyed on exposure to light, heat, or oxygen during processing. In the body, these are easily absorbed and just as easily excreted in the urine. A few of these can remain in the lean issues for a month or more, but these tissues actively exchange materials with the body fluids all the time—no real storage tissues exist for any of these vitamins. At any time, the vitamins may be picked up by the extracellular fluids, washed away by the blood, and excreted in the urine. Foods never deliver toxic doses of these vitamins and their easy excretion in the urine protects against toxicity from all but the largest supplemental doses.

Answer 76

Water-soluble vitamins

Question 77

The vitamin C–deficiency disease. A disease that often killed many members of a ship’s crew on a long voyage. Ships that sailed on short voyages, especially around the Mediterranean Sea, were safe from this disease. The special hazard of long ocean voyages was that the ship’s cook used up the perishable fresh fruits and vegetables early and relied on cereals and live animals for the duration of the voyage. The first nutrition experiment to be conducted on human beings was devised more than 250 years ago to find a cure for scurvy. A physician divided some British sailors with scurvy into groups. Each group received a different test substance: vinegar, sulfuric acid, seawater, oranges, or lemons. Those receiving the citrus fruit were cured within a short time. Sadly, it took 50 years for the British navy to make use of the information and require all its vessels to provide lime juice to every sailor daily. British sailors were mocked with the term limey because of this requirement. The name later given to the vitamin, ascorbic acid (acid one of the active forms of vitamin C), literally means “no-scurvy acid.” It is more commonly known today as vitamin C, and is abundant in fruits and vegetables. With pinpoint hemorrhages, fatigue, bleeding gums, bruises; bone fragility, joint pain; poor wound healing, frequent infections.
Most symptoms of this can be attributed to the breakdown of collagen in he absence of vitamin C: loss of appetite, growth cessation, tenderness to touch, weakness, bleeding gums, loose teeth, swollen ankles and wrists, and tiny red spots in the skin where blood has leaked out of capillaries. One symptom, anemia, reflects an important role worth repeating—vitamin C helps the body absorb and use iron.

Answer 77

scurvy

Question 78

Collagen synthesis (strengthens blood vessel walls, forms scar tissue, provides matrix for bone growth), antioxidant, restores vitamin E to active form, supports immune system, boosts iron absorption. Toxicity of this vitamin can cause Nausea, abdominal cramps, diarrhea; rashes; interference with medical tests and drug therapies; in susceptible people, aggravation of gout or kidney stones.

Answer 78

Vitamin C

Question 79

Food Sources of Vitamin C:

Answer 79

*Many of these veggies should not be cooked because if they are, it can remove some of the vitamin C nutrients it provides
- White potatoes and sweet potatoes (contribute significantly)
- Red Pepper
- Brussels sprouts
- grapefruit
- orange juice
- green pepper
- broccoli
- strawberries
- bok choy

Question 80

What 2 primary functions is Vitamin C known for?

Answer 80

-maintaining connective tissues and as an antioxidant

Question 81

The enzyme involved in the formation and maintenance of the protein collagen depend on this vitamin for their activity. Also participates in other synthetic reactions, such as in the production of carnitine, an important compound for transporting fatty acids within the cells, and in the creation of certain hormones.

This vitamin acts in a more general way as an antioxidant. Protects substances found in foods and in the body from oxidation by being oxidized itself. For example, cells of the immune system maintain high concentrations of this vitamin to protect themselves from free radicals that they generate to use during assaults on bacteria and other invaders. After use, some of this vitamin is oxidized and is degraded irretrievably and must be replaced by the diet. In healthy people, most of the vitamin, is not lost but efficiently recycled back to its active form for reuse.
In the intestines, this vitamin protects iron from oxidation and so promotes its absorption. Once in the blood, this vitamin protects blood constituents from oxidation, reduces tissue inflammation, and helps to maintain the body’s supply of vitamin E by protecting it and recycling it to its active form.

Answer 81

Vitamin C

Question 82

Forms the base for all connective tissues: bones, teeth, skin, and tendons. Forms the scar tissue that heals wounds, the reinforcing structure that mends fractures, and the supporting material of capillaries that prevents bruises.

Answer 82

Collagen

Question 83

A compound that triggers reactions involving oxygen. In test tubes, a high concentration of vitamin C has the opposite effect from an antioxidant; that is, it acts as this, by activating oxidizing elements, such as iron and copper. In the body, iron and copper are tightly bound to special proteins that normally control such interactions.

Answer 83

prooxidant

Question 84

Can Vitamin C Supplements Cure a Cold?

Many people hold that vitamin C supplements can prevent or cure a common cold, but research most often fails to support this long-lived belief. In 29 trials of over 11,300 people, no relationship emerged between routine vitamin C supplementation and cold prevention. A few studies report other modest potential benefits—fewer colds and shorter duration of symptoms, especially for those exposed to physical and environmental stresses, as well as those with low vitamin C status. Sufficient vitamin C intake is critically important to certain white blood cells of the immune system that act as primary defenders against infection. Even so, taking daily vitamin C supplements doesn’t prevent colds in most well-fed people.
Experimentally, supplements of at least 1 gram of vitamin C per day and often closer to 2 grams (the UL and not recommended) may reduce blood histamine. Anyone who has ever had a cold knows the effects of histamine: sneezing, a runny or stuffy nose, and swollen sinuses. In drug-like doses, vitamin C may mimic a weak antihistamine drug, but study conditions vary, so drawing conclusions is difficult.

One other effect of taking pills might also provide relief. In one vitamin C study, some experimental subjects received a sugar pill but were told they were receiving vitamin C. These subjects reported having fewer colds than the group who had in fact received the vitamin but who thought they were receiving sugar pills. At work was the healing effect of faith in a medical treatment—the placebo effect.

Question 85

DRI recommendations for Vitamin C:
U.S. intakes of vitamin C may fall short of the DRI recommendations. People who smoke or have low incomes are particularly at risk for deficiency. The disease scurvy is seldom seen today except in a few elderly people with poor appetites, people addicted to alcohol or other drugs, hospital patients, people with eating disorders, and a few infants who are fed only cow’s milk. Breast milk and infant formula supply vitamin C, but cow’s milk does not and is not recommended for infants for many reasons.

Question 86

What depletes the body’s vitamin C?

Answer 86

• tobacco oxidants, these people who smoke need higher amounts of Vitamin C to be able to maintain blood concentrations comparable to those of nonsmokers
• Know that Vitamin C does not reverse other damage caused by tobacco use.
  -Physical stressors, including infections, burns, fever, strenuous physical activity, toxic heavy metals such as lead, and certain medications, also needs an increase in the body’s use of vitamin C.

Question 87

The B vitamins function as parts of these. They are small molecules that combines with an enzyme and activates it. The substance to be worked on is attracted to the active site (often the vitamin part) and snaps into place, enabling the reaction to proceed instantaneously. The shape of each enzyme predestines it to accomplish just one kind of job. Without this, however, the enzyme is as useless as a car without its steering wheel.

Answer 87

coenzyme

Question 88

Helps the body metabolize carbohydrates, lipids, and amino acids. Work together with enzymes in the metabolism of energy nutrients and in the creation of new cells. Is part of one or more coenzymes that make possible the body’s chemical work. They are considered “helpers” for carbohydrates, fat, and protein and help the body to use that fuel provided for the body.

Answer 88

Vitamin B

Question 89

What B vitamins are important in the energy pathways? (3)

Answer 89

• niacin, thiamin, and riboflavin

Question 90

What 2 B vitamins are necessary for making RNA and DNA and thus new cells? These help cells multiply and replace themselves including red blood cells (live for 120 days), cells that line the digestive tract (every 3 days). These cells absorb and deliver energy to all the others.

Answer 90

• folate and B12

Question 91

What B vitamin is necessary for processing amino acids and therefore protein? Helps protein build new tissues, make hormones, fight infections, and serve as fuel for energy.

Answer 91

B6

Question 92

What are the 5 active forms of B vitamins that participate in the release of energy from carbohydrates, fat, and protein?

Answer 92

-thiamin, riboflavin, niacin, pantothenic acid, and biotin

Question 93

B Vitamin Deficiencies:
As long as B vitamins are present, their presence is not felt. Only when they are missing does their absence manifest itself in a lack of energy and a multitude of other symptoms. The reactions by which B vitamins facilitate energy release take place in every cell, and no cell can do its work without energy. Thus, in a B vitamin deficiency, every cell is affected. Among the symptoms of B vitamin deficiencies are nausea, severe exhaustion, irritability, depression, forgetfulness, loss of appetite and weight, pain in muscles, impairment of the immune response, loss of control of the limbs, abnormal heart action, severe skin problems, swollen red tongue, cracked skin at the corners of the mouth, and teary or bloodshot eyes. Because cell renewal depends on energy and protein, which, in turn, depend on the B vitamins, the digestive tract and the blood are invariably damaged. In children, full recovery may be impossible. In the case of a thiamin deficiency during growth, permanent brain damage can result.

Question 94

Plays a critical role in the energy metabolism of all cells. occupies a special site on nerve cell membranes. Consequently, nerve processes and their responding tissues, the muscles, depend heavily on this B vitamin.
Food sources of this include:
enriched pasta, pork chop, green peas, waffle, enriched wheat bagel, enriched cereal, baked potato, black beans.

Answer 94

Thiamin

Question 95

The classic thiamin deficiency disease. Characterized by loss of sensation in the hands and feet, muscular weakness, advancing paralysis, and abnormal heart action. Was first observed in East Asia, where rice provided 80 to 90 percent of the total calories most people consumed and was therefore their principal source of thiamin. When the custom of polishing rice (removing its brown coat, which contained the thiamin) became widespread, this swept through the population like an epidemic. Scientists wasted years of effort hunting for a microbial cause of this before they realized that the cause was not something present in the environment but something absent from it. Takes two forms: wet beriberi, characterized by edema (fluid accumulation), and dry beriberi, without edema. A person’s ankle retains the imprint of the physician’s thumb, showing the edema of wet beriberi. Can be cured with proper diet. The physician noticed that the chickens at the prison had developed a stiffness and weakness similar to that of the prisoners who had beriberi. The chickens were being fed the rice left on prisoners’ plates. When the rice bran, which had been discarded in the kitchen, was given to the chickens, their paralysis was cured. The physician met resistance when he tried to feed the rice bran, the “garbage,” to the prisoners, but it worked—it produced a miracle cure.

Answer 95

beriberi

Question 96

In developed countries today, alcohol abuse often leads to a severe form of thiamin deficiency, known as this. Syndrome a cluster of symptoms involving nerve damage arising from a deficiency of the vitamin thiamin in alcoholism. Characterized by mental confusion, disorientation, memory loss, jerky eye movements, and staggering gait. Alcohol contributes energy but carries almost no nutrients with it and often displaces food from the diet. In addition, alcohol impairs absorption of thiamin from the digestive tract and hastens its excretion in the urine, tripling the risk of deficiency. The syndrome is characterized by symptoms almost indistinguishable from alcohol abuse itself: apathy, irritability, mental confusion, disorientation, memory loss, jerky eye movements, and a staggering gait. Responds and is cured by injection of thiamin.

Answer 96

Wernicke-Korsakoff syndrome

Question 97

Like thiamin, this plays a role as a coenzyme in the energy metabolism pathways of all cells. When thiamin is deficient, this may be lacking, too, but its deficiency symptoms, such as cracks at the corners of the mouth, sore throat, or hypersensitivity to light, may go undetected because those of thiamin deficiency are more severe. Worldwide, a deficiency of this B vitamin, has been documented among children whose diets lack milk products and meats, and researchers suspect that it occurs among some U.S. elders as well. A dietary pattern that remedies this vitamin deficiency invariably contains some thiamin and so clears up both deficiencies. Ultraviolet light (ordinary light) and irradiation destroy this B vitamin. For these reasons, milk is sold in cardboard or opaque plastic containers, and precautions are taken if milk is processed by irradiation. This B vitamin is heat stable, so cooking does NOT destroy it.
People can obtain this vitamin through foods such as enriched breads, cereals, pasta, and other grain products, while dairy products supply another 20 percent. Certain vegetables, eggs, and meats contribute most of the rest.

Answer 97

Riboflavin

Question 98

A B vitamin needed in energy metabolism. Can be eaten preformed or made in the body from tryptophan, one of the amino acids. A deficiency of this causes serious illness. Is relatively harmless, but large doses have been associated with liver injury, digestive upset, impaired glucose tolerance, serious infection, muscle weakness, and, rarely, vision disturbances. Anyone considering taking large doses of this on their own should instead consult a physician who can prescribe safe alternatives. The key nutrient that prevents pellagra is this, but any protein containing sufficient amounts of the amino acid tryptophan will serve in its place. Tryptophan, which is abundant in almost all proteins (but is limited in the protein of corn), is converted to niacin in the body, and it is possible to cure pellagra by administering tryptophan alone. Thus, a person eating adequate protein (as most people in developed nations do) will not be deficient in niacin.

Answer 98

niacin
- The amount of niacin in a diet is stated in terms of niacin equivalents (NE), a measure that takes available tryptophan into account. It is the amount of niacin present in food, including the niacin that can theoretically be made from its precursor tryptophan that is present in the food.

Question 99

Its symptoms are known as the four “Ds”: diarrhea, dermatitis, dementia, and, ultimately, death. The niacin deficiency disease that appeared in Europe in the 1700s when corn from the New World became a staple food. During the early 1900s in the United States, this was devasting lives throughout the South and Midwest. Hundreds of thousands of people suffering were thought be suffering from a contagious disease until this dietary deficiency was identified. The disease still occurs among poorly nourished people living in disadvantaged urban areas and particularly among those with alcohol addiction. Also still common in parts of Africa and Asia. Looks like “flaky paint” on skin that is exposed to light. The skin darkens and flakes away.

Answer 99

pellagra

Question 100

To make new cells, tissues must have this B vitamin. Acts as part of a coenzyme important in the manufacture of new cells. The form added to foods and supplements is folic acid. Each new cell must be equipped with new genetic material—copies of the parent cell’s DNA—and this helps synthesize DNA and regulate its activities. Also, this vitamin participates in the metabolism of vitamin B12 and several amino acids.

Answer 100

Folate

Question 101

Deficiencies of Folate:
- Anemia: Immature red and white blood cells and the cells of the digestive tract divide most rapidly and therefore are most vulnerable to folate deficiency. Deficiencies of folate cause this along with impaired immunity, and abnormal digestive function. Involves red blood cells.
- Prostate Cancer and others including Breast Cancer: particularly happens with women who drink alcohol
- Interactions with Meds (antiacids, aspirin)

Question 102

Abnormalities of the brain and spinal cord apparent at birth and associated with low folate intake in women before and during pregnancy. The neural tube is the earliest brain and spinal cord structure formed during gestation. Range from slight problems in the spine to intellectual disabilities, severely diminished brain size, and death shortly after birth. Adequate maternal folate may protect against other related birth defects, cleft lip, and miscarriages, as well.

Answer 102

neural tube defects (NTD)

Question 103

This and folate are closely related: each depends on the other for activation. Functions as part of coenzymes needed in cell replication, and it helps maintain the protective sheaths that surround and protect nerve fibers, allowing them to function properly. It is a B vitamin that helps to convert folate to its active form and also helps to maintain the sheath around nerve cells. The vitamin’s scientific name, not often used, is cyanocobalamin. Along with folate, a deficiency of this can cause anemia, presence of large, immature red blood cells. Also worsened dementia for elderly.
Foods include: -Chicken liver, sirloin, cottage cheese, pork roast, sardines, tuna, Swiss cheese, and enriched cereal

Answer 103

Vitamin B12

Question 104

For vitamin B12, deficiencies most often reflect poor absorption that occurs for one of two reasons:

Answer 104

The stomach produces too little acid to liberate vitamin
from food.

Intrinsic factor (a factor made by the stomach that is necessary for absorption of vitamin B12 and prevention of pernicious anemia.), a compound made by the stomach and needed for absorption, is lacking.

Once the stomach’s acid frees vitamin
from the food proteins that bind it, intrinsic factor attaches to the vitamin, and the complex is absorbed into the bloodstream. The anemia of the vitamin
deficiency caused by lack of intrinsic factor is known as pernicious anemia (anemia a vitamin B12 –deficiency disease, caused by lack of intrinsic factor and characterized by large, immature red blood cells and damage to the nervous system (pernicious means “highly injurious or destructive”).

In a few people, an inborn defect in the gene for intrinsic factor begins to impair vitamin
absorption by mid-adulthood. With age, many others lose their ability to produce enough stomach acid and intrinsic factor to allow efficient absorption of vitamin B12. Intestinal diseases, surgeries, certain medications, or stomach infections with an ulcer-causing bacterium can also impair absorption. In cases of malabsorption, vitamin B12
must be supplied by injection or via nasal spray to bypass the defective absorptive system.

Summary:
Vitamin
is critical for cell replication and proper nerve functioning.

Vitamin
occurs only in foods of animal origin.

Vitamin
–deficiency anemia mimics folate deficiency and arises with low intakes or, more often, poor absorption.

Folate supplements can mask a vitamin B12 deficiency.

Question 105

A B vitamin needed in protein metabolism. Its three active forms are pyridoxine, pyridoxal, and pyridoxamine. Participates in more than 100 reactions in body tissues and is needed to help convert one kind of amino acid, which cells have in abundance, to other nonessential amino acids that the cells lack. In addition, this vitamin functions in these ways:
- Aids in the conversion of tryptophan to niacin.

• Plays important roles in the synthesis of hemoglobin and neurotransmitters, the communication molecules of the brain. (For example, this vitamin assists the conversion of the amino acid tryptophan to the mood-regulating neurotransmitter serotonin.)
• Assists in releasing stored glucose from glycogen and thus contributes to the maintenance of a normal blood glucose concentration.
• Plays roles in immune function and steroid hormone activity.
• Is critical to normal development of the fetal brain and nervous system; deficiency during this stage causes behavioral problems later.

Answer 105

Vitamin B6

Question 106

A coenzyme for several enzymes in the metabolism of carbohydrate, fat, and protein. In addition, researchers are actively investigating new roles for this vitamin in gene expression. It is widespread in foods, so eating a variety of foods prevents deficiency. Also, intestinal bacteria release this vitamin that can be absorbed. No adverse effects from these high vitamin intakes have been reported, but some research indicates that high-dose of this vitamin supplementation may damage DNA.

Answer 106

Biotin

Question 107

Component of a key coenzyme that makes possible the release of energy from the energy nutrients. It also participates in more than 100 steps in the synthesis of lipids, neurotransmitters, steroid hormones, and hemoglobin.

Answer 107

Pantothenic acid

Question 108

A nutrient used to make the phospholipid lecithin and other molecules. A conditionally essential nutrient. When the diet has deficient amounts of this, the body cannot make enough of the compound to meet its needs, and this plays important roles in fetal development, particularly in the brain. Widely supplied by protein-rich foods (such as eggs), yet many US adults and pregnant women fail to consume enough to meet the recommended adequate intakes. Additionally, these needs may rise in pregnancy.

Answer 108

Choline

Question 109

What are the three nonvitamins (not an essential nutrient for human beings)?

Answer 109

• carnitine (A nonessential nutrient that functions in cellular activities. Sometimes called “vitamin BT,” assists in cellular metabolism, but it is not a vitamin.)
  -inositol (found in cell membranes)
• lipoic acid

Question 110

Places to go to for information on vitamin-rich foods:

Answer 110

USDA’s What’s in the Foods You Eat and the USDA Food Composition Databases

Question 111

Vitamins and minerals that oppose the effects of oxidants on human physical functions. The antioxidant vitamins are vitamin E, vitamin C, and beta-carotene. The mineral selenium also participates in antioxidant activities.

Answer 111

Antioxidant nutrients

Question 112

Quality Testing Symbols:

Answer 112

• Identity: product contains correct ingredients
• Quantity: ingredients are present in correct quantities
• Purity: product is free of unwanted substances
• Solubility: product dissolves readily

Avoid:
“For better metabolism.” Preparations containing extra biotin may claim to improve metabolism, but no evidence supports this.

“Organic” or “natural” preparations with added substances. They are no better than standard types, but they cost much more, and the added substances may add risks.

“High-potency” or “therapeutic dose” supplements. More is not better.

Items not needed in human nutrition, such as carnitine and inositol. These particular items won’t harm you, but they reveal a marketing strategy that makes the whole mix suspect. The manufacturer wants you to believe that its pills contain the latest “new” nutrient that other brands omit, but in fact for every valid discovery of this kind, there are 999,999 frauds.

“Time release.” Medications such as some antibiotics or pain relievers often must be sustained at a steady concentration in the blood to be effective; nutrients, in contrast, are incorporated into the tissues where they are needed whenever they arrive.

“Stress formulas.” Although the stress response depends on certain B vitamins and vitamin C, the DRI provides all that is needed of these nutrients. If you are under stress (and who isn’t?), generous servings of fruit and vegetables will more than cover your need.

Claims that today’s foods lack sufficient nutrients to support health. Plants make vitamins for their own needs, not ours. A plant lacking a needed mineral or failing to make a needed vitamin dies without yielding food for our consumption.