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Ch11 Energy Metabolism and Blood Health
 

Ch11 Energy Metabolism and Blood Health

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Ch11 Energy Metabolism and Blood Health Ch11 Energy Metabolism and Blood Health Presentation Transcript

  • Chapter 11 Nutrients Involved with Energy Metabolism and Blood Health Lecture and Animation PowerPoint Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. To run the animations you must be in Slideshow View . Use the buttons on the animation to play, pause, and turn audio/text on or off. Please Note : Once you have used any of the animation controls , you must click in the white background before advancing to the next slide.
  • Nutrients Involved in Energy Metabolism & Blood Health: Lecture Overview
    • B vitamins:
      • Role in energy metabolism
      • Intakes in N. America
    • Preserving vitamin content of foods
    • Energy Metabolism:
      • Thiamin (B 1 )
      • Riboflavin (B 2 )
      • Niacin (B 3 )
      • Pantothenic Acid (B 5 )
      • Biotin (B 7 )
      • Pyridoxine (B 6 )
    • Blood Health:
      • Vitamin K
      • Anemias
      • Folate (B 9 )
      • B 12
      • Iron (Fe)
      • Copper (Cu)
  • B Vitamins: Coenzymes
    • B vitamins function as coenzymes
    • Coenzymes help unlock energy from macronutrients
    • After eating, B vitamins breakdown from coenzyme form -> free vitamins
    • Relatively bioavailable: 50-90% absorption
    • Coenzymes resynthesized in cells
    • Your body makes all the coenzymes it needs from vitamin precursors
  • B Vitamin Intakes
    • Plentiful in diets containing variety of foods
    • Refined grain supply is fortified with B vits
    • Water soluble = very little storage in body
  • Thiamin: Functions
    • Helps release energy from carbohydrate
    • First B-vitamin discovered
    • Important in ATP-producing pathways
  • Thiamin Deficiency: Beriberi
    • Symptoms:
      • Weakness
      • Loss of appetite
      • Irritability
      • Tingling
      • Loss of muscle coordination
      • Deep muscle pain
      • Enlarged heart
      • Edema
    • Occurs when glucose can ’t be metabolized to yield energy
    • Found in areas where refined grains predominate (ex: white vs. brown rice)
    • Refining grains -> ↓ thiamin content unless it is enriched
  • Thiamin: Nutrient Needs
    • RDA: 1.1-1.2 mg/day
    • DV on food labels based on 1.5 mg/day
    • Men: exceed RDA by 50% or more
    • Women: just meet RDA
  • Thiamin: Dietary Sources
    • Pork products
    • Whole grains & wheat germ
    • Ready-to-eat breakfast cereals
    • Refined grains
    • Green beans, milk, orange juice, organ meats, peanuts, dried beans, seeds
  • Riboflavin (Vitamin B 2 ): Functions
    • Riboflavin coenzymes participate in energy-yielding pathways (ex: fatty acid breakdown)
    • Assists some vitamin & mineral metabolism
    • Antioxidant role: supports glutathione peroxidase enzyme
  • Riboflavin Deficiency: Ariboflavinosis
    • Inflammation of the mouth and tongue
    • Dermatitis
    • Cracking on tongue & corners of mouth (cheilosis)
    • Eye disorders
    • Sensitivity to sun
    • Confusion
    • Occur jointly with deficiencies of niacin, thiamin & vitamin B 6
  • Riboflavin Deficiency: Ariboflavinosis
  • Riboflavin: Excess
    • No UL
    • No evidence of toxicity from megadosing
    • Riboflavin supplementation can -> bright yellow urine
      • Name riboflavin derived from Latin “flavus” – meaning yellow
  • Riboflavin: Nutrient Needs
    • RDA: 1.1-1.3 mg/day
    • DV on food labels is 1.7 mg/day
    • Average intakes slightly > than RDA
    • Alcoholics at ↑ risk for deficiency because of ↓ nutrient-dense diets
  • Riboflavin: Dietary Sources
    • Ready to eat breakfast cereals
    • Dairy foods
    • Enriched grains
    • Meat
    • Eggs
    • Asparagus, broccoli & greens (ex: spinach)
    • Easily destroyed by light; opaque milk containers
  • Niacin (Vitamin B 3 ): Functions
    • Functions as nicotinic acid or nicotinamide
    • Coenzyme niacin form used in many cellular pathways
    • Energy being used = niacin coenzyme being used
    • Fatty acid synthesis require niacin coenzymed
    • Involved as coenzyme in 200+ reactions
  • Niacin Deficiency: Pellagra
    • Means rough or scaly skin
    • Symptoms characterized by “4 D’s”:
      • Dermatitis
      • Diarrhea
      • Dementia
      • Death
    • Occurs most commonly in alcoholics
  • Niacin: Excess
    • UL is 35 mg/day nicotinic acid form
    • Megadosing nicotinic acid is used supplementally for ↑ blood lipids
    • Long term can -> GI tract & liver damage
    • Niacin flush:
      • Usually when intakes > 100 mg/day
      • Headache, itching, ↑ blood flow to skin -> flushing
  • Niacin: Nutrient Needs
    • Adult RDA: 14-16 mg/day
    • RDA expressed in Niacin Equivalents (NE)
    • DV on food labels is 20 mg
    • Average American intake doubles RDA
  • Niacin: Dietary Sources
    • Heat stable: little lost in cooking
    • Can synthesize from tryptophan:
      • 60 mg tryptophan can -> 1 mg tryptophan
    • Found in foods:
      • Poultry, fish, tuna & beef
      • Peanuts
      • Ready-to-eat cereals
      • Asparagus
      • Coffee & tea
  • Pantothenic Acid (Vitamin B 5 )
    • Coenzyme in chemical reactions
    • Widespread in foods: deficiency is rare but can occur in alcoholics
    • Toxicity unknown: no UL
    • Sunflower seeds, mushrooms, peanuts, eggs, milk, meat, vegetables
    • AI: 5 mg/day for adults
    • DV based on 10 mg/day
  • Biotin (Vitamin B 7 )
    • As coenzyme: aids in chemical reactions
    • Egg yolks, peanut butter, cheese
    • AI: 30 mcg/day for adults
    • Food supply gives 40-60 mcg/day average
    • DV on food & supplement labels: 300 mcg
    • No UL; relatively nontoxic
  • Biotin (Vitamin B 7 )
    • Intestinal bacteria can synthesize biotin – makes deficiency rare
    • Deficiency: scaly skin inflammation, changes in tongue & lips, ↓ appetite, N/V, anemia, depression, muscle pain, weakness, poor growth
    • Raw egg whites bind biotin and ↓ its absorption; ↑↑ raw egg white intake can -> biotin deficiency
  • Vitamin B 6 (Pyridoxine): Functions
    • Coenzyme in many metabolic reactions
    • Acts as coenzyme in 100+ amino acid and protein reactions
    • Synthesizes neurotransmitters
    • Converts tryptophan -> niacin
    • Breaks down stored glycogen -> glucose
    • Synthesizes hemoglobin and WBC
    • Aids in homocysteine metabolism
  • Vitamin B 6 (Pyridoxine): Deficiency
    • Widespread symptoms: depression, vomiting, skin disorders, nerve problems, impaired immunity
    • B 6 helps synthesize heme portion of hemoglobin:
      • B 6 deficiency -> small RBCs with ↓ hemoglobin concentration (microcytic hypochromic anemia)
      • Cell can ’t produce ATP when aerobic metabolism limited
  • Vitamin B 6 (Pyridoxine): Excess
    • UL: 1000 mg/day
    • Excess -> nerve damage
    • 2-6 g/day X 2 or more months -> irreversible nerve damage
    • Symptoms: gait abnormality, tingling in extremities, numbness
  • Vitamin B 6 (Pyridoxine): Nutrient Needs
    • Adult RDA: 1.3-1.7 mg/day
    • DV on food labels: 2 mg
    • Average adult intake is > RDA
    • Athletes ’ needs > than sedentary adults
      • ↑ needs required by ↑ processing of protein and glycogen
  • Vitamin B 6 (Pyridoxine): Dietary Sources
    • Animal products
    • Fortified ready-to-eat breakfast cereals
    • Potatoes, spinach, bananas, cantaloupe
    • B 6 in animal foods and fortified foods is better absorbed than B 6 from plant foods
  • RBC Overview
    • Erythropoiesis: formation of RBCs
    • RBC functions
      • Primary: carry O 2 from lungs -> tissues
      • Secondary: carry CO 2 from tissues -> lungs
    • Hemoglobin: large iron-containing protein
      • Iron in Hgb binds & carries 4 molecules of O 2
  • Anemia
    • Inadequate healthy RBCs -> anemia
    • Anemia can be caused by:
      • ↓ RBC production or ↓ Hgb production in RBCs
      • Loss or destruction of blood
    • Symptoms result from inadequate O 2 -> organs
    • Normal RBCs: normocytic & normochromic
    • Nutrient deficiencies -> changes in RBC size and color
  • Vitamins & Minerals Involved in Blood Health
    • Vitamin K (Quinone)
    • Folate (B 9 )
    • B 12
    • Iron (Fe)
    • Copper (Cu)
  • Vitamin K (Quinone): Functions
    • Can be synthesized by colonic bacteria
    • Blood clotting:
      • Activates prothrombin -> thrombin
      • Converts soluble fibrinogin -> insoluble fibrinogin
  • Vitamin K (Quinone): Deficiency
    • In infants:
      • Infant ’s gut at birth is sterile: GI tract doesn’t have bacteria
      • Can ’t synthesize vitamin K needed for clotting if infant injured or needs surgery
      • Vitamin K routinely administered by injection shortly after birth
    • In adults: deficiency after long-term antibiotic use & when fat malabsorbed
  • Vitamin K (Quinone): Excess
    • No reports of toxicity
    • No UL
  • Vitamin K (Quinone): Nutrient Needs
    • AI: 90-120 mcg/day for adults
    • DV on food labels: 80 mcg
    • Elderly adults have ↓ vitamin K intake due to ↓ intake of vegetables
  • Vitamin K (Quinone): Dietary Sources
    • Resistant to cooking losses
    • Absorption requires dietary fat & adequate pancreatic secretions
    • Food sources: Liver, Dark green leafy vegetables, Broccoli, Asparagus, Peas
    • Patients on Coumadin (warfarin) should keep dietary Vitamin K intake constant
  • Folate (Vitamin B 9 ): Functions
    • Cell division
    • As a coenzyme: supplies or accepts single carbon compounds
    • Helps form DNA
    • Helps metabolize amino acids & their derivatives (ex: homocysteine)
  • Folate (Vitamin B 9 ): Deficiency
    • In early RBC synthesis:
      • Immature cells can ’t divide because they can’t form new DNA
      • Cells grow larger because insufficient DNA for nuclei to divide
      • Large immature form: megaloblast
      • Folate deficiency -> megaloblastic anemia (aka macrocytic anemia)
    • Symptoms:
      • Tongue inflammation, diarrhea, poor growth, mental confusion, depression, nerve dysfunction
  • Folate (Vitamin B 9 ): Maternal Deficiency
    • ↓ folate levels in pregnant woman -> neural tube defects in fetus (ex: spina bifida)
    • Neural tubes close within first 28 days of pregnancy
    • Recommended that 6 weeks before pregnancy all women have 400 mcg/day
  • Folate (Vitamin B 9 ): Excess
    • UL: 1 mg/day (1,000 mcg)
    • Large doses of folate can mask vitamin B 12 deficiency symptoms
  • Folate (Vitamin B 9 ): Nutrient Needs
    • RDA: 400 mcg/day
    • Pregnancy RDA: 600 mcg/day
    • DV: based on 400 mcg/day
    • Very susceptible to heat: cooking destroys 50-90% folate
  • Folate (Vitamin B 9 ): Dietary Sources
    • Green leafy vegetables
    • Orange juice
    • Dried beans
    • Fortified ready-to-eat breakfast cereals
    • Bread
    • Milk
  • Vitamin B 12 : Functions
    • AKA cobalmin or cyanocobalmin
    • Functions in folate metabolism
    • Maintaining myelin sheath that insulates neurons from each other
    • Requires Intrinsic Factor (IF) for absorption
  • Vitamin B 12 : Deficiency
    • Destruction of parts of myelin sheath
    • Neurological symptoms:
      • Irregular muscle actions
      • Impaired reflexes
      • Eventual paralysis and perhaps, death
    • Pernicious anemia: anemia from lack of B12 absorption (as opposed to inadequate folate absorption)
    • Vegans at risk for deficiency
  • Vitamin B 12 : Nutrient Needs
    • Adult RDA: 2.4 mcg/day
    • DV on food labels & supplements: 6 mcg
    • Adults consume 2 X RDA on average/day
    • Elderly encouraged to have synthetic form because of ↓ IF production with ↑ age
  • Vitamin B 12 : Dietary Sources
    • Concentrated sources found only in animal foods
    • Organ meats: liver, kidneys, heart
    • Meat, salmon, seafood
    • Ready-to-eat fortified breakfast cereals
    • Milk
    • Eggs
  • Iron (Fe): Functions
    • Iron is part of:
      • Hemoglobin in RBCs
      • Myoglobin in WBCs
    • Used as part of many enzymes, proteins
    • Needed for brain & immune function
    • Helps detoxify drugs in the liver
    • Contributes to bone health
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  • Iron (Fe): Deficiency
    • Iron deficiency caused when:
      • When hematocrit (% of RBCs) and hemoglobin concentration ↓
    • Iron deficiency anemia caused when:
      • Hgb and Hct levels fall so low that O 2 carried in bloodstream is ↓
  • Iron (Fe): Iron Deficiency Anemia
    • Stage 1: Depleted body stores but no physical symptoms
    • Stage 2: Depleted circulating iron and some physiological impairment
    • Stage 3: RBCs are small (microcytic) and pale (hypochromic) and ↓ in number
  • Iron (Fe): Iron Deficiency Anemia
    • Most common micronutrient deficiency worldwide
    • Can be caused by:
      • Growth & ↑ blood volume (ex: pregnancy)
      • Blood loss during menstruation
      • Blood loss from ulcers, colon cancer, hemorrhoid
    • Symptoms: fatigue, pale skin, always cold, loss of appetite, ↓ work capacity
  • Iron (Fe): Excess
    • UL: 45 mg/day
    • ↑↑ iron can -> stomach irritation
    • Iron pills are common cause of iron toxicity in children who accidentally overdose
    • Vitamin C ↑ iron absorption: problematic in people with hemochromatosis
  • Iron (Fe): Nutrient Needs
    • Male & menopausal female RDA: 8 mg/day
    • Female RDA: 18 mg/day for 18-50 y.o.
    • DV based on 18 mg/day
  • Iron (Fe): Dietary Sources
    • Heme:
    • Meat
    • Fish
    • Poultry
    • Non-heme:
    • Fruits & vegetables
    • Fortified foods
    • Supplements
  • Copper (Cu)
    • Component of blood
    • Needed by enzymes
    • Immune system function: blood clotting, blood lipoprotein metabolism
    • Sources: liver, legumes, seeds, whole grain breads and cereals, cocoa
    • RDA: 900 mcg/day for adults
    • UL: 10 mg/day