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Discusses the fat-soluble vitamins (A,D,E, K) and water-soluble vitamins (B complex, C). including their sources, toxicity and deficiencies

Discusses the fat-soluble vitamins (A,D,E, K) and water-soluble vitamins (B complex, C). including their sources, toxicity and deficiencies



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    Vitamins Vitamins Presentation Transcript

    • Section 1 Fundamentals of Nutrition2/16/2012 1
    • Chapter 7 Vitamins2/16/2012 2
    • Objectives State one or more functions of each of the thirteen vitamins discussed Identify at least two food sources of each of the vitamins discussed Identify some symptoms of, or diseases caused by, deficiencies of the vitamins discussed2/16/2012 3
    • Facts Organic (carbon-containing) compounds that are essential in small amounts for body processes. Do not provide energy. Enable the body to use the energy provided by fats, carbohydrates, and proteins. Megadoses can be toxic.2/16/2012 4
    • Vitamin types (13) Fat soluble (4): A, D, E, K Water soluble (9): • Vitamin C • Vitamin B complex which includes: thiamin (B1), riboflavin (B2), niacin, vitamin B6, folate, vitamin B12 (cobalamin), pantothenic acid, biotin2/16/2012 5
    • Requirements Vitamin allowances given by weight in milligrams (mg) or micrograms (mcg or µg) Dietary reference intake (replacing recommended dietary allowance) UL–tolerable upper limits–maximum level of daily intake unlikely to cause adverse effects2/16/2012 6
    • Vitamin Deficiency People prone to vitamin deficiency • Alcoholics • Poor and incapacitated elderly • Clients with serious diseases that affect appetite • Mentally retarded • Children receiving inadequate care2/16/2012 7
    • Deficiency of Fat-soluble Vitamins Chronic malabsorption diseases • Cystic fibrosis • Celiac disease • Crohn’s disease2/16/2012 8
    • Stop and Share Match the following terms with the correct definition. 1. Avitaminosis a. Concentrated form of vitamins 2. Hypervitaminosis b. Without vitamins 3. Vitamin supplement c. Condition caused by ingestion of excess vitamins2/16/2012 9
    • Stop and Share Answers: 1. b 2. c 3. a2/16/2012 10
    • Avoiding Vitamin Loss Buy fresh, unbruised vegetables and fruits and use them raw when possible. Prepare fresh vegetables and fruits just before serving. Heat canned vegetables quickly and in their own liquid.2/16/2012 11
    • Avoiding Vitamin Loss Follow package directions when cooking frozen vegetables or fruit. Steam, or use as little water as possible. Cover pan and cook for a short period of time. Save cooking liquid for soups, stews, and gravy. Store in a cool, dark place.2/16/2012 12
    • Fat-Soluble Vitamins Vitamins A, D, E, K2/16/2012 13
    • Vitamin A Preformed (retinol) • Active form of vitamin A Carotenoids • Inactive form of vitamin A found in plants2/16/2012 14
    • Functions of Vitamin A Maintains healthy eyes and skin, normal growth and reproduction, and a healthy immune system. Helps prevent infection. Antioxidant2/16/2012 15
    • Vitamin A as an antioxidant Antioxidant; protects cells from destruction by oxygen. Antioxidants are substances that may protect your cells against the effects of free radicals. Free radicals are molecules produced when your body breaks down food, or by environmental exposures like tobacco smoke and radiation.2/16/2012 16
    • Sources of Vitamin A Preformed vitamin A Carotenoids (retinol) (provitamin A or beta-carotene) Fat-containing animal Green leafy vegetables foods: liver, butter, & fruits, carrots, sweet cream, whole milk, potatoes, squash, cheeses spinach, broccoli, mango, cantaloupe, pumpkin2/16/2012 17
    • The richest in vitamin A | mg. per 100 grams. Apricot | 250 mg Melon | 220 mg Peach | 105 mg Mandarin | 44 mg Orange | 33 mg Banana | 33 mg Medlar | 27 mg2/16/2012 18 Plum | 25 mg
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    • Vitamin A Requirements Commonly listed as retinol equivalents (RE) A retinol equivalent is 1 µg retinol or 6 µg beta-carotene2/16/2012 21
    • Stop and Share What are the signs and symptoms you may expect to see with too much vitamin A? …too little?2/16/2012 22
    • Stop and Share Excess Deficit • Birth defects, hair • Night blindness; loss, dry skin, dry, rough skin; headaches, increased nausea, dryness susceptibility to of mucous infections; and membranes, liver blindness or damage, and xerophthalmia bone and joint pain2/16/2012 23
    • Hypervitaminosis A There are two types of vitamin A hypervitaminosis: Acute -- caused by taking too much vitamin A over a short period of time Chronic -- occurs when too much of the vitamin is present over a longer period Chronic vitamin A toxicity develops after taking too much vitamin A for long periods.2/16/2012 24
    • Hypervitaminosis A Abnormal Bulging fontanelle softening of the (infants) skull bone Changes in (craniotabes -- consciousness infants and Decreased appetite children) Dizziness Blurred vision Double vision Bone pain or (young children) swelling Drowsiness Headache2/16/2012 25
    • Hypervitaminosis A Increased Vision changes intracranial Vomiting pressure Irritability Liver damage Nausea Poor weight gain (infants and children)2/16/2012 26
    • Hypervitaminosis A Skin and hair changes • Cracking at corners of the mouth Hair loss Higher sensitivity to sunlight Oily skin and hair (seborrhea) Skin peeling, itching Yellow discoloration of the skin2/16/2012 27
    • Keratomalacia: Clinical photograph of cornea with keratomalacia in an eye with xerophthalmia (Courtesy of Dr. King W. To)2/16/2012 28
    • Xerophthalmia Vitamin A deficiency Alternate Names : Keratitis sicca, Xerophthalmia, Keratoconjunctivitis sicca Dry eye syndrome Dryness of the eye surfaces caused by deficiency of tears or conjunctival secretions. It may be associated with vitamin A deficiency, trauma, or any condition in which theeyelids do not close completely.http://health.allrefer.com/health/keratoconjunctivitis-sicca-eye-anatomy.html 2/16/2012 29
    • Clinical signs and symptoms of the disease • Night blindness • Eye dryness accompanied by foamy accumulations on the conjunctiva (inner eyelids), that often appear near the outer edge of the iris (Bitots spots)2/16/2012 30
    • Clinical signs and symptoms of the disease Eye dryness, dullness or clouding (milky appearance) of the cornea (corneal xerosis) Eye softening and ulceration of the cornea (keratomalacia). This is sometimes followed by perforation of the cornea, which leads to the loss of eye contents and permanent blindness2/16/2012 31
    • Populations at risk of becoming deficient Populations who have no access to fresh fruit and vegetables Children suffering from measles, diarrhoea, respiratory infections, chickenpox and other severe infections are at increased risk2/16/2012 32
    • Preventive behaviours for a healthy family Increase Vitamin A intake through consumption of yellow and orange fruits and vegetables Mothers should take Vitamin A within 8 weeks after giving birth (200,000 IU)2/16/2012 33
    • Children from 6 to 59 months should get Vitamin A supplementation orally every six months. (6 months - 1 year; 100,000 IU, >1 year; 200,000 IU) Infants should be exclusively breastfed for the first six months and continue to be breastfed up to twenty-four months http://motherchildnutrition.org/malnutrition/about-2/16/2012 malnutrition/common-micronutrient-deficiency-diseases.html 34
    • Vitamin D2/16/2012 35
    • Vitamin D Prohormone–converted to a hormone in the body. D2 (ergocalcifenol) is formed in plants. D3 (cholecalciferol) is formed in humans from cholesterol in the skin.2/16/2012 36
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    • Sources of Vitamin D Sunlight Milk, fish liver oils, egg yolk, butter, fortified margarine Most milk in the U.S. has 10 µg of vitamin D concentrate added per quart.2/16/2012 39
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    • Vitamin D Requirements Newborns through 51 years • 5.0 µg (200 IU) 51-70 years • 10.0 µg (400 IU) 70+ years • 15.0 µg (600 IU) Pregnant and lactating women • 5.0 µg (200 IU)2/16/2012 41
    • Stop and Share What are the signs and symptoms you may expect to see with too much vitamin D? …too little?2/16/2012 42
    • Stop and Share Excess Deficit • Deposits of • Poor bone and calcium and tooth formation, phosphorus in rickets which soft tissues, causes kidney and heart malformed damage, and bones and pain bone fragility in infants2/16/2012 43
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    • Stop and Share Deficit • Osteomalacia (softening of bones) • Osteoporosis (brittle, porous bones)2/16/2012 45
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    • The recommended daily intake of vitamin D for men is 2.6-3.0 µg/day and for women is 2.0-2.2 µg/day.2/16/2012 47
    • Given the toxicity of vitamin D, it is possible to have an overdose with the most common symptoms being nausea, vomiting, headache and depression, deposition of calcium into internal organs and kidney stones.2/16/2012 48
    • Vitamin E2/16/2012 49
    • Vitamin E Tocopherols • Alpha (most biologically active) • Beta, delta, gamma Tocotrienols2/16/2012 50
    • Functions of Vitamin E Antioxidant Prevention of hemolytic anemia among premature infant Enhance immune system Improve sexual function Retard spoilage of commercial foods2/16/2012 51
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    • Sources of Vitamin E Vegetable oils: corn, soybean, safflower, and cottonseed, and products made from them such as margarine Wheat germ, nuts, green leafy vegetables2/16/2012 53
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    • Vitamin E Requirements Given as α-TE (alpha-tocopherol equivalents) 1 mg of α-TE = 1 IU2/16/2012 55
    • Stop and Share Your client asks you if it is possible to take too much vitamin E. How would you advise the client? What signs and/or symptoms can result from too little vitamin E?2/16/2012 56
    • Stop and Share Excess Deficit • Relatively • Serious nontoxic, fat- neurological soluble vitamin. defects can Excess stored in occur from adipose tissue. malabsorption. Avoid long-term • Hemolytic megadoses. anemia • Erythrocyte2/16/2012 57
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    • Vitamin K Made up of several compounds essential to blood clotting. Vitamin K1 (phylloquinone) Vitamin K2 (menaquinone) Synthetic Vitamin K (menadione) Vitamin K is destroyed by light alkalis.2/16/2012 60
    • Functions of Vitamin K Formation of prothrombin; clotting of blood Candidates likely to receive Vitamin K • Newborns immediately after birth • Clients who suffer from faulty fat absorption • After extensive antibiotic therapy • Antidote for an overdose of anticoagulant • Clients being treated for hemorrhage2/16/2012 61
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    • Sources of Vitamin K Green leafy vegetables such as broccoli, cabbage, spinach, and kale. Dairy products such as eggs, meats, fruits, and cereals. Bacteria in small intestine synthesizes some vitamin K but must be supplemented by dietary sources.2/16/2012 63
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    • Vitamin K Requirements Measured in micrograms. 0-6 months • 2 µg/day 6-12 months • 2.5 µg/day Men • 120 µg/day Women (same during pregnancy or lactation) • 90 µg/day2/16/2012 66
    • Stop and Share What signs and/or symptoms can result from too much vitamin K? … too little?2/16/2012 67
    • Stop and Share Excess Deficit • Anemia can • Defective blood result from coagulation, excessive which increases amounts of clotting time synthetic and makes vitamin K client prone to hemorrhage2/16/2012 68
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    • The B vitamins are: B1 (thiamine) B2 (riboflavin) B3 (niacin) B5 (pantothenic acid) B6 (Pyridoxine) B7 (biotin) B9 (Folic acid) B12 (cobalamin)2/16/2012 70
    • Water-soluble Vitamins Vitamin B complex Vitamin C2/16/2012 71
    • Vitamin B1: Thiamin Thiamin B1 Essential for nerve and muscle action, and metabolism of carbohydrates and some amino acids.2/16/2012 72
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    • Vitamin B Complex: Thiamin Average adult female requires 1.1 mg/day. Average adult male requires 1.2 mg/day.2/16/2012 74
    • Sources Sources include unrefined and enriched cereals, yeast, wheat germ, organ meats, and legumes.2/16/2012 75
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    • Thiamine Deficiency Deficiency symptoms include loss of appetite, fatigue, nervous irritability, and constipation. Beriberi is a disease caused by extreme deficiency of vitamin B1.2/16/2012 79
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    • Beriberi Types • Wet: affect cardiovascular functioning • Dry: affect nervous system • Wernicke-korsakoff syndrome: affects CNS2/16/2012 82
    • Wet beriberi Edema affecting cardiovascular functioning2/16/2012 83
    • Symptoms of dry beriberi include: Difficulty walking Loss of feeling (sensation) in hands and feet Loss of muscle function or paralysis of the lower legs Mental confusion/speech difficulties Pain Strange eye movements (nystagmus) Tingling Vomiting Symptoms of wet beriberi include: Awakening at night short of breath Increased heart rate Shortness of breath with activity Swelling of the lower legs2/16/2012 84
    • Wernicke-korsakoff syndrome Severe thiamine def. Cerebral form of beriberi that affects CNS2/16/2012 85
    • Risk factors Alcoholism Severe GI disease Improper parenteral glucose solution Renal patients undergoing dialysis Hyperemesis gravidarum2/16/2012 86
    • Risk factors Gastrectomy Genetic disorder affecting thiamine use Gastric bypass surgery2/16/2012 87
    • Treatment The goal of treatment is to replace the thiamine your body is lacking. • thiamine supplements; given through a shot (injection) or taken by mouth. Other types of vitamins may also be recommended. Blood tests may be done after you are given thiamine supplements to see how well you are responding to the medicine.2/16/2012 88
    • Vitamin B2: Riboflavin Riboflavin B2 Necessary for: the metabolism of carbohydrates, protein, and fats; tissue maintenance (especially the skin around the mouth); and healthy eyes.2/16/2012 89
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    • Sources Sources include milk, meats, poultry, fish, enriched breads, cereals, broccoli, spinach, and asparagus.2/16/2012 91
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    • Asparagus Broccoli 2/16/2012 93
    • Spinach Spinach = Espinadas Native Spinach = Kulitis Water Spinach or River Spinach = Kangkong Malabar Spinach = Alugbati 2/16/2012 94
    • Vitamin B Complex: Riboflavin Average adult female requires 1.1 mg/day. Average adult male requires 1.3 mg/day.2/16/2012 95
    • Deficiency Deficiency can result in cheilosis (a condition characterized by sores on the lips and cracks at the corners of the mouth); glossitis (inflammation of the tongue); dermatitis; and eye strain in the form of itching, burning, and eye fatigue.2/16/2012 96
    • Cheilosis2/16/2012 97
    • Glossitis2/16/2012 98
    • Vitamin B3: Niacin Generic name for nicotinic acid and nicotinamide. A coenzyme in energy metabolism.2/16/2012 99
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    • Sources Sources include meats, poultry, fish, peanuts, legumes. Milk and eggs are sources of tryptophan (precursor).2/16/2012 101
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    • Vitamin B Complex: Niacin Measured in niacin equivalents (NE). 1 NE = 1 mg of niacin or 60 mg of tryptophan (an amino acid that is a precursor of niacin). Average adult female requires 14 mg/NE. Average adult male requires 16 mg/NE.2/16/2012 103
    • Vitamin B Complex: Niacin Excessive amounts of niacin may cause flushing due to vascular dilation, GI problems, itching, and liver damage. May be used as a cholesterol-lowering agent under close supervision of a physician due to adverse side effects, which include liver damage and peptic ulcers.2/16/2012 104
    • Vitamin B Complex: Niacin Deficiency symptoms include weakness, anorexia, indigestion, anxiety, and irritability. Pellagra is an extreme deficiency causing sores on the skin, diarrhea, anxiety, confusion, irritability, poor memory, dizziness, and untimely death.2/16/2012 105
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    • Pellagra2/16/2012 107
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    • Vitamin B5: Pantothenic Acid Involved in metabolism of carbohydrates, fats, proteins. Essential for synthesis of neurotransmitter acetylcholine and steroid hormones. Sources include meats, poultry, fish, eggs, whole grain cereals, and legumes. Thought to be synthesized by the body.2/16/2012 109
    • Vitamin B5: Pantothenic Acid Food and Nutrition Board has provided an estimated intake of 5 mg a day for normal adults. Toxicity from excess not confirmed. Natural deficiencies unknown. Signs include weakness, fatigue, burning sensation in feet (deficiencies produced experimentally).2/16/2012 110
    • Vitamin B6; Pyridoxine Pyridoxine, pyridoxal, pyridoxamine Essential for protein metabolism and absorption, and aids in release of glucose from glycogen. Serves as catalyst in conversion of tryptophan to niacin; helps synthesize neurotransmitters such as serotonin and dopamine.2/16/2012 111
    • Vitamin B6; Pyridoxine Sources include poultry, fish, liver, kidney, potatoes, bananas, spinach, and unrefined whole grains (oats and wheat). Deficiency symptoms include irritability, depression, and dermatitis. Deficiency in infants can cause various neurological symptoms and abdominal problems. Toxicity is rare; may cause temporary neurological problems.2/16/2012 112
    • Vitamin B6; Pyridoxine Measured in milligrams. Average adult female requires 1.3-1.5 mg/day. Average adult male requires 1.3-1.7 mg/day. Need increases as protein increases. Oral contraceptives interfere with metabolism of vitamin B6 and can result in a deficiency.2/16/2012 113
    • Vitamin B7: Biotin Coenzyme in synthesis of fatty acids and amino acids. Sources include liver, egg yolk, soy flour, cereals, yeast. Synthesized in intestine by microorganisms, amount available for absorption unknown. Food and Nutrition Board suggests adequate intake of 30 µg for adults.2/16/2012 114
    • Vitamin B7: Biotin Toxicity from excess unknown. Deficiency symptoms include nausea, anorexia, depression, pallor, dermatitis, increase in serum cholesterol.2/16/2012 115
    • Vitamin B9: Folate Vitamin B9 Folate, folacin, and folic acid are chemically similar compounds, and names are used interchangeably. Needed for DNA synthesis, protein metabolism, formation of hemoglobin. Sources include cereals fortified with folate, green leafy vegetables, legumes, sunflower seeds, fruits such as orange juice and strawberries.2/16/2012 116
    • Vitamin B9: Folate Measured in micrograms. Average adult female requires 400 µg/day. Average adult male requires 400 µg/day. Increased need during pregnancy and growth. 600 µg/day required one month before conception through first six weeks of pregnancy.2/16/2012 117
    • Vitamin B9: Folate Deficiency linked to neural tube defects in fetus such as spina bifida (spinal cord or spinal fluid bulge through the back) and anencephaly (absence of the brain). Other signs include inflammation of mouth and tongue, poor growth, depression and mental confusion, problems with nerve functions, megaloblastic anemia.2/16/2012 118
    • spina bifida2/16/2012 119
    • Anencephaly2/16/2012 120
    • Vitamin B9: Folate Excess can mask vitamin B12 deficiency and inactivates phenytoin, an anticonvulsant drug used by epileptics. FDA limits amount in over-the-counter supplements to: • 100 µg for infants • 300 µg for children • 400 µg for adults2/16/2012 121
    • Vitamin B12:Cobalamin Cobalamin–contains mineral cobalt. Stored in body three to five years. Involved in folate metabolism, maintenance of the myelin sheath, and healthy red blood cells. To be absorbed, must bind with intrinsic factor in stomach. Pernicious anemia may result from loss of intrinsic factor.2/16/2012 122
    • Vitamin B Complex: B12 Sources include animal foods, especially organ meats, lean meat, seafood, eggs, dairy products. Average adult requires 2.4 µg/day. Increased need during pregnancy and lactation. Amount absorbed will depend on current need.2/16/2012 123
    • Vitamin B Complex: B12 Deficiency is rare and may be due to congenital problems of absorption or years of a vegetarian diet with no animal foods. Symptoms inclued megaloblastic anemia, pernicious anemia (if intrinsic factor absent), anorexia, glossitis, sore mouth, tongue, pallor, depression, dizziness, weight loss, neurological system damage.2/16/2012 124
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    • Vitamin C2/16/2012 126
    • Vitamin C Ascorbic acid Has antioxidant properties and protects food from oxidation. Role in formation of collagen. Aids in absorption of nonheme iron. May be involved with formation or functioning of norepinephrine, some amino acids, folate, leukocytes, the immune system, allergic reactions.2/16/2012 127
    • Vitamin C Sources include citrus fruits, melon, strawberries, tomatoes, potatoes, red and green peppers, cabbage, broccoli. Average female adult requires 75 mg/day. Average male adult requires 90 mg/day. Stress and cigarette smoking increase need.2/16/2012 128
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    • Top 7 Fruits For Vitamin C Content Guava, 1 medium, 165 mg Papaya, 1 cup, 87 mg Strawberries, 1 cup, 84 mg Kiwi, 1 medium, 74 mg Cantaloupe, 1 cup, 68 mg Orange, 1 medium, 75 mg Grapefruit, half, 42 mg2/16/2012 130
    • Stop and Share What disease results from a deficiency in vitamin C? What are the associated signs and/or symptoms? What results from excess?2/16/2012 131
    • Stop and Share Scurvy: disease characterized by gingivitis, easy bruising, pinpoint hemorrhages of the skin, poor wound healing, sore joints and muscles, weight loss. Extreme cases result in death. Found in sailors who lived without fresh fruits and vegetables.2/16/2012 132
    • Scurvy2/16/2012 133
    • Scurvy is a condition characterized by general weakness, anemia, gum disease (gingivitis), and skin hemorrhages resulting from a lack of ascorbic acid (vitamin C) in the diet. Scurvy is now most frequently seen in older, malnourished adults, and is rare in the United States.2/16/2012 134
    • Stop and Share Deficiency of Vitamin C: bleeding gums, loose teeth, tendency to bruise easily, poor wound healing, scurvy. Excess: diarrhea, nausea, cramps, excessive absorption of food iron, rebound scurvy (when megadoses are stopped abruptly) and possibly oxalate kidney stones. Generally considered nontoxic.2/16/2012 135
    • Vitamin Supplementation Balanced diet provides nutritional needs of healthy people. No amount of vitamins will build muscles. Vitamins do not provide energy; they help to release the energy provided by nutrients. Heart disease, cancer and the common cold cannot be cured by vitamin supplements.2/16/2012 136
    • Conclusion Organic compounds that regulate body functions and promote growth. Each vitamin has a specific function. Well-balanced diet provides sufficient vitamins to fulfill body requirements. Fat-soluble vitamins: A, D, E, K Water-soluble vitamins: B complex, C2/16/2012 137