Vitamins Chapter 8 Contemporary Nutrition

Chapter 8
Vitamins
Copyright © McGraw-Hill Education. Permission required for reproduction or display.
© Nataliia K/Shutterstock
©2019 McGraw-Hill Education. All rights reserved. Authorized only for instructor use in the classroom. No reproduction or further distribution permitted without the prior written consent of McGraw-Hill Education.

©2019 McGraw-Hill Education.
Student Learning Outcomes 1
1. Describe the general characteristics of the fat-soluble and
water-soluble groups of vitamins, the general process of
vitamin absorption and storage, the dangers of vitamin
deficiency and toxicity, and the preservation of vitamins in
foods. Explain several health benefits of phytochemicals and
identify main sources of phytochemicals.
2. Describe the functions of vitamin A and carotenoids in vision,
growth, development, reproduction, and cancer prevention,
as well as the signs and symptoms of deficiency and toxicity,
and understand its dietary requirements and how to get
enough vitamin A in the diet and avoid too much from dietary
supplements.

3. Explain the functions and sources of vitamin D, including its
synthesis by the action of ultraviolet radiation; understand its
dietary requirements; and describe the signs and symptoms
of vitamin D deficiency and toxicity.
4. Summarize the functions of vitamin E, understand its dietary
requirements, and describe its food sources and deficiency
and toxicity symptoms.
5. Describe the role of vitamin K in blood clotting and the signs
and symptoms of deficiency and toxicity, understand its
dietary requirements, and identify its food sources.

6. Describe the characteristics of the water-soluble vitamins and
the roles of the B vitamins in energy metabolism.
7. Describe the functions of thiamin in carbohydrate
metabolism, and list its sources, dietary requirements, and
deficiency symptoms.
8. Describe the functions of riboflavin in energy metabolism and
understand the dietary requirements and sources of
riboflavin that will prevent deficiency symptoms.
9. Describe the functions of niacin in energy metabolism and list
its sources, dietary requirements, and deficiency and toxicity
symptoms.

10.Describe the functions of vitamin B-6 in amino acid metabolism
and understand how to get enough vitamin B-6 in the diet to
avoid a deficiency and prevent toxicity from dietary
supplements.
11.Describe the functions of pantothenic acid and biotin in energy
metabolism, understand their dietary requirements, and list
their food sources and deficiency signs and symptoms.
12.Summarize the functions of folate in cell metabolism,
understand the dietary requirements needed to prevent
megaloblastic anemia, and identify its food sources.
13.Understand the process of vitamin B-12 absorption and its role
in folate metabolism, identify the dietary requirements for
vitamin B-12 needed to avoid deficiency, and identify its food
sources.

14.Describe the functions of vitamin C as well as its dietary
requirements, sources, and deficiency and toxicity signs and
symptoms.
15.Understand the functions and sources of choline and other
vitamin-like substances.
16.Evaluate the use of dietary supplements with respect to their
potential benefits and hazards to the body.
17.Describe how calorie and fat intakes contribute to cancer risk
and understand the role other food constituents play in
inhibiting cancer.

What Would You Choose? Energy
Since being accepted into your major, your courses are getting
tougher and you are staying up late doing homework. You also
need work experience, so you are putting in 20 hours a week at
the bookstore. Between classes, homework, work, and
socializing, you are only getting about 4 to 5 hours of sleep a
night and barely have time to eat. You are feeling exhausted and
looking for a good, quick energy source. Which of the following
would you choose to get energized?
• 5-Hour Energy® shot.
• Nature Made® B-Complex w/Vitamin C Dietary Supplement.
• Centrum® Adults Multivitamin and Mineral Supplement.
• Several small meals throughout the day and 7 to 9 hours of
sleep each night.

Section 8.1: Vitamins: Vital Dietary
Components—Concepts
• What is a megadose? Are there any negative
consequences of consuming megadoses of vitamins? Are
there any situations in which megadoses of vitamins are
useful?
• List at least three differences between fat-soluble and
water-soluble vitamins.
• List three ways to preserve vitamin content when storing,
preparing, or cooking foods.
• Give one example of a functional food.
• Which food group has the richest supply of
phytochemicals?

Figure 8-1: Vitamins Contribute to Many
Functions
© John Lund/Getty Images
Access the long description slide.

Vitamins
Carbon-containing substances needed in small
amounts by the body.
Essential: Can’t be synthesized by body.
To be a vitamin:
• Body can’t make enough to maintain health.
• Absence leads to deficiency that can be cured if
vitamin is resupplied in time.
Avoid intakes in excess of Upper Level (Megadose).
Food or synthetic sources have same health benefit
and effectiveness.

Vitamins: Classification
Fat-soluble:
• Vitamin A.
• Vitamin D.
• Vitamin E.
• Vitamin K.
Water-soluble:
• Thiamin.
• Riboflavin.
• Niacin.
• Pantothenic Acid.
• Biotin.
• Vitamin B-6.
• Vitamin B-12.
• Vitamin C.
• (Choline).

Absorption and Storage of Vitamins in the Body
Fat-soluble:
• Absorbed with
dietary fat.
• Anything interfering
with fat absorption
will impair fat-
soluble absorption.
Water-soluble:
• Absorbed primarily in
small intestine.
• Relatively high
bioavailability
• Transported to liver via
portal vein and
distributed to body
tissues.
• Inside cells: Active
coenzymes resynthesized.

Vitamin Toxicity
Fat-soluble
• Vitamins A, D, E not readily excreted from the body.
• Toxicity by vitamin A most frequently observed.
Water-soluble
• Excess excreted in urine.
• Exception: B-6 and B-12 stored in liver.
Vitamin toxicity most frequently from
supplemental sources, not foods.
• Avoid megadoses.
© Liquidlibrary/PictureQuest

Vitamin Preservation in Foods
• Vitamin content is greatest
when a fruit or vegetable is ripe.
• Freezing helps retain nutrients—
frozen foods often blanched
first, increasing vitamin content.
• Water-soluble vitamins are
particularly susceptible to
destruction by heat, light, air
exposure, cooking in water and
alkalinity.
©Jill Giardino/Getty Images

Figure 8-2: MyPlate Sources of Vitamins and Choline
Source: United States Department of Agriculture, ChooseMyPlate.Gov

Table 8-1: Tips for Preserving Vitamins
in Fruits and Vegetables 1
Preservation Methods Reason
Keep fruits and vegetables cool
until eaten.
Enzymes in fruits and vegetables begin
to degrade vitamins once they are
harvested. Chilling limits this process.
Refrigerate fruits and vegetables
(except bananas, onions,
potatoes, and tomatoes) in
moisture-proof, airtight
containers or in the vegetable
drawer.
Nutrients keep best at temperatures
near freezing, at high humidity, and
away from air.
Trim, peel, and cut fruits and
vegetables minimally—just
enough to remove inedible parts.
Oxygen breaks down vitamins faster
when more of the food surface is
exposed. Whenever possible, cook fruits
and vegetables in their skins.
Microwave, steam, or stir-fry
vegetables.
More nutrients are retained when there
is less contact with water.

Table 8-1: Tips for Preserving Vitamins
in Fruits and Vegetables 2
Preservation Methods Reason
Minimize cooking time. Prolonged cooking (slow simmering) and
reheating reduce vitamin content.
Avoid adding fats to vegetables
during cooking if you plan to
discard the liquid.
Fat-soluble vitamins will be lost in
discarded fat. If you want to add fats, do
so after vegetables are fully cooked and
drained.
Do not add baking soda to
vegetables to enhance the green
color.
Alkalinity destroys vitamin D, thiamin,
and other vitamins.
Store canned and frozen fruits and
vegetables carefully.
To protect canned foods, store them in a
cool, dry location. To protect frozen
foods, store them at 0°F (−32°C) or
colder. Eat within 12 months.

Phytochemicals
Thousands of food substances in addition to
45 essential nutrients.
Functional foods
• Have health benefits beyond basic nutrition.
Zoochemicals
• Found in animal products that have health protective actions.
Phytochemicals
• Health-promoting compounds found in plant food.
Many foods contain hundreds of phytochemicals.
Not essential nutrients, no deficiency disease when
removed from diet.

Phytochemical Functions
• Stimulate the immune
system.
• Reduce inflammation.
• Prevent DNA damage
and aid in DNA repair.
• Reduce oxidative
damage to cells.
• Regulate intracellular
signaling of hormones
and gene expression.
• Activate insulin receptors.
• Inhibit the initiation and
proliferation of cancer,
and stimulate
spontaneous cell death.
• Alter the absorption,
production, and
metabolism of cholesterol.
• Mimic or inhibit hormones
and enzymes.
• Decrease the formation of
blood clots.

Phytochemical Recommendations
Phytochemicals should be consumed as food.
• Have protective functions with minimal side effects
when consumed naturally in a variety of foods.
• No specific dietary recommendations for amount of
phytochemicals to be consumed.
Eat wide variety of whole plant foods.
• To obtain the optimum amount of macronutrients,
vitamins, minerals, fiber, and phytochemicals.
• To increase the antioxidant capacity of the total diet.

Section 8.2: Vitamin A (Retinoids) and
Carotenoids
• What are the names of two carotenoids
known to have antioxidant functions?
• How are the carotenoids related to vitamin A?
• What are the consequences of vitamin A
deficiency?
• What are some rich food sources of
carotenoids?

Forms of Vitamin A
Vitamin A: Group of compounds known as
retinoids.
Three active forms (preformed vitamin A)
• Retinol, retinal, and retinoic acid
• Exist only in animal products.
Stored retinol
• Esterified to a fatty acid and becomes retinyl.
In supplements,
• Vitamin A listed as retinyl acetate or retinyl palmitate.

Carotenoids
Plants contain pigments called carotenoids.
Carotenoids are phytochemicals with health-promoting
chemicals.
Precursors of vitamin A have antioxidant properties.
Three carotenoids are
provitamins—can be
turned into vitamin A:
• Beta-carotene.
• Alpha-carotene.
• Beta-cryptoxanthin.
Other carotenoids that
may have health benefits:
• Lycopene.
• Zeaxanthin.
• Lutein.

Functions: Health of Epithelial Cells and Immune Function
Epithelial cells
• Line internal and external surfaces of eyes, skin, lungs, intestines, stomach,
vagina, urinary tract, and bladder.
• Important barriers to infection.
• Retinoic acid required for immature epithelial cells to develop into mature,
functional cells.
Vitamin A deficiency
• Mucus-forming cells deteriorate, lose function.
• Leads to xeropthalmia (dry eye) and blindness.
• Hyperkeratosis, skin cells produce too much keratin, blocking the hair
follicles and causing “gooseflesh” or “toadskin” appearance. Excessive
keratin causes the skin to be hard and dry.
Vitamin A also supports the activity of T-lymphocytes (T-cells).

Figure 8-4: Vitamin A Deficiency and
Blindness
• Vitamin A deficiency leading
cause of blindness worldwide.
• Worldwide,
1
3
of children
suffer from deficiency.
• Hundreds of thousands
become blind each year.
• Note the severe effects of
xerophthalmia on this eye.
This problem is commonly
seen today in Southeast Asia.
Xerophthalmia: Hardening of
the cornea and drying of the
surface of the eye, which
can result in blindness.
Courtesy of Dr. Alfred Sommer

Vitamin A: Vision
Night Blindness
• Vitamin A deficiency causing loss of the ability
to see under low-light conditions.
Maternal night blindness
• An issue in developing nations.
• Leads to pregnancy-related deaths, malnutrition,
anemia, infant mortality.
Screening and supplementing is effective in
treating and preventing.

Figure 8-3: Vitamin A Functions to
Maintain Vision

Figure 8-5: Carotenoids and Vision:
Age-related Macular Degeneration
• Age-related macular
degeneration: Changes in this
macular area of the retina.
• Leading cause of blindness among
older adults.
• Lower levels of carotenoids (beta-
carotene, lutein, and zeaxanthin)
in the diet is correlated with
greater risk of age-related
macular degeneration.
• Green leafy vegetables are a rich
source of lutein.
• The blurry center of the
image simulates the vision
of a person with macular
degeneration.
©National Eye Institute

Functions: Cardiovascular Disease Prevention
• Carotenoids may inhibit oxidation of low-
density lipoproteins (LDLs).
• Consume a total of at least five servings of a
combination of fruits and vegetables per day
as part of an overall effort to reduce the risk of
cardiovascular disease.

Functions: Growth, Development, and Reproduction
Binds to receptors on DNA to increase the synthesis
of a variety of proteins.
• Required for growth.
Differentiation and maturation of cells, ultimately
forming tissues and organs.
Deficient children experience stunted growth.
Aids in male sperm production, and normal
reproductive cycle in women.

Functions: Cancer Prevention
Role in cellular differentiation and embryonic
development.
Diets rich in provitamin A carotenoids associated
with lower risk of skin, lung, bladder, breast
cancers.
• Lycopene is the red pigment found in tomatoes,
watermelon, guava, and pink grapefruit and seems to
protect against prostate cancer.
Toxicity risk in megadose of vitamin A through
supplement use.

Getting Enough Vitamin A
American dietary patterns contain plentiful sources
of preformed vitamin A.
• Preformed vitamin A (retinol, retinal, and retinoic acid), of
American diet
• Food Sources: liver, fish, fish oils, fortified milk, butter, yogurt, eggs,
margarine, and spreads
RDA: Expressed in retinol activity equivalents (RAE)
• Adult male, 900 mcg per day
• Adult Female, 700 mcg per day
• DV = 900 mcg per day
Reserves stored in liver.

Getting Enough Carotenoids
Dark green and yellow-orange vegetables and
fruits
• Beta-carotene
Green leafy vegetables, spinach, kale
• Lutein and zeaxanthin
Tomato products, juice, sauce
• Lycopene
Cooking frees carotenoids
for better absorption.
© CDC/James Gathany

Figure 8-6: Food Sources of Vitamin A and Carotenoids
* Retinol activity equivalents.
Source: Nutrition data from USDA National Database for Standard, Release 26.

Avoiding Too Much Vitamin A
UL: 3000 micrograms RAE
• 4 ounces (120 grams) of polar bear liver
will deliver a toxic dose of 1.36 million RAE
of vitamin A.
Intakes in excess of the UL for vitamin A
Liver toxicity and increased risk of hip fracture
Poor pregnancy outcomes, birth defects
• Fetal malformations and spontaneous abortions
• Women of childbearing age should limit overall
intake of preformed vitamin A from diet and
supplements to no more than of Daily Value.
©Digital Vision/Getty Images RF

Avoiding Too Much Carotenoids
Excess dietary consumption, no toxic effects.
Hypercarotenemia, too many carrots or beta-carotene
supplements/pills.
• Skin turns yellow-orange, particularly the palms of the hands
and soles of the feet.
• As little as four to five large carrots daily can produce
hypercarotenemia.
• Taking a break from carrots, squash, and pumpkins will turn
the skin back to normal.

Section 8.3: Vitamin D (Calciferol or
Calcitriol)—Concepts
• Why is vitamin D sometimes not considered an
essential nutrient?
• How is vitamin D activated in the body?
• How does vitamin D work to maintain blood
calcium levels?
• What are some rich food sources of vitamin D?
• Can vitamin D be toxic?

Vitamin D
• Fat-soluble, essential
• Vitamin D is also a hormone.
• Produced in the skin when exposed to UV
light.
• Cholesterol is vitamin D precursor.
• Activation occurs in liver and kidneys.

Forms of Vitamin D
Vitamin D2 (ergocalciferol)
• Synthetic product derived from irradiation of plant
sterols (ergosterol).
• Used in some supplements.
Vitamin D3 (cholecalciferol)
• More commonly used in supplements and to fortify
foods.

Synthesis of Vitamin D
(7-dehydrocholesterol): Precursor found in skin.
• Converted to D3 by sunlight exposure.
Vitamins D2 and D3
• Travel to liver, converted to 25-hydroxyvitamin D3
(calcidiol), main form of vitamin D found in blood.
Calcidiol
• Chemically converted in kidneys to 1, 25-
dihydroxyvitamin D3 (calcitriol), the biologically
active form of vitamin D.

Figure 8-7: Synthesis of Vitamin D

Vitamin D: Functions
Maintains calcium and
phosphorus levels in blood.
Involved in:
• Gene expression.
• Cell growth regulation.
• Neuromuscular and immune
function.
• Reduction of inflammation.
Binds to and affects cells of:
• Immune system
• Brain and nervous system
• Skin
• Muscles
• Reproductive organs
Controls growth of
parathyroid gland.
May decrease certain
types of cancer risk.

Functions: Vitamin D Regulates Calcium
Regulates absorption of calcium and phosphorus
from small intestine.
In combination with PTH and calcitonin, it
regulates calcium excretion via kidney.
• Causes the kidneys to reduce calcium excretion in the
urine.
• Releases calcium from bone by stimulating osteoclast
activity.
Through bone remodeling.

Figure 8-8: Vitamin D Regulates Blood Calcium

Vitamin D and Sun Exposure
Amount of sun exposure
needed to activate vitamin D
is affected by:
• Skin color.
• Age.
• Time of day.
• Latitude and strength of UV
light.
• Exposure time.
• Season.
©Royalty-free/Corbis

Figure 8-10: Seasonal Variations to
Sunlight Intensity

Table 8-3: Factors That Impair Vitamin D
Status
Inadequate sun exposure
• Northern latitudes
• Excess clothing (that is, robes/veils)
• Air pollution (such as, smog)
• Sunscreen with SPF >8
• Excessive time spent indoors
Age
Dark skin pigmentation
Inadequate dietary intake
Fat malabsorption
• Liver disease
• Cystic fibrosis
• Weight-loss medications
Obesity
Liver diseases
Kidney diseases

Figure 8-9: Vitamin D Deficiency
Deficiency risk in:
• Dark-skinned people.
• Low vitamin D diet.
• Exclusively breastfed
infants.
• Elderly.
• Insufficient sun
exposure.
• Diet without fortified
foods.
With lower levels
of vitamin D:
• Osteomalacia.
• Intestinal
calcium
absorption
decreases.
• Rickets.
©Jeff Rotman/Alamy

Getting Enough Vitamin D
RDA is 15 micrograms (600 IU).
• For healthy people 1 to 70 years.
• Some experts suggest 25 microgram for 70+ with limited sun
exposure.
RDA is 20 micrograms (800 IU) for age 71+.
DV on labels is based on 10 micrograms (400 IU).
Vitamin D Supplements
• 1 cup milk = 100 IU vitamin D
• American Academy of Pediatrics recommends 400 IU per day for:
• Children and adolescents with less than 400 IU per day intake.
• Exclusively breastfed infants beginning within the first few days of life.

Food Sources of Vitamin D
Dietary sources are limited.
Fatty fish (that is, salmon and sardines)
Fortified dairy foods
Fortified breakfast cereals
Mushrooms
• Only vegetable to contain ergosterol, the
precursor of vitamin D.
• Have the ability to make vitamin D when
exposed to ultraviolet light.
• Some brands are now grown in ultraviolet
light to stimulate vitamin D production.
© Purestock/SuperStock

Figure 8-11: Food Sources of Vitamin D
Source: Nutrition data from USDA National Nutrient Database for Standard, Release 26.

Avoiding Too Much Vitamin D
UL is 100 micrograms (4000 IU) per day.
High vitamin D intake results in increased blood
calcium.
Toxicity symptoms:
• Weakness.
• Loss of appetite.
• Diarrhea and vomiting.
• Confusion.
• Increased urine output.
Toxicity does not occur from sun source.

Section 8.4: Vitamin E (Tocopherols)—
Concepts
• How does vitamin E work to prevent oxidative
damage?
• What are some rich food sources in vitamin E?
• Why are preterm infants, smokers, and people
with fat malabsorption particularly susceptible
to oxidative damage to cell membranes?
• What are the possible results of vitamin E
toxicity?

Functions of Vitamin E
Tocopherol
• Identified as essential for rat fertility, 1920s.
• No corresponding fertility effect in humans.
Functions
• Development of muscles.
• Development of central nervous system.
• Antioxidant.
• Maintains nervous tissue and immune function.

Function: Antioxidant
Fat-soluble vitamin E
found in adipose tissue
and cell membrane.
Lipids in cell
membranes are
polyunsaturated fatty
acid (PUFA).
• PUFAs susceptible to
oxidative attack.
Vitamin E donates
electrons or
hydrogens to free
radicals to make cell
more stable.
Vitamin E important in
areas exposed to high
levels of oxygen.
• RBCs and lungs

Figure 8-12: Vitamin E in Cell Membranes

Vitamin E: Deficiency
• Rare because the consumption of fat, including
plant oils (primary source of vitamin E), is high.
• Preterm infants can be deficient in vitamin E
because its transfer from mother to fetus
occurs late in pregnancy.

Vitamin E Needs
Only synthesized by plants.
Plant oils are best sources.
RDA for adults:
15 mg per day of alpha-tocopheral
(the most active form of vitamin E)
DV on labels is based on 30 mg.
Good sources include:
• Salad oils.
• Fortified cereals.
• Nuts and seeds.
The avocado in
guacamole and the
oil in the tortilla
chip are good
sources of vitamin E.
©BananaStock/PunchStock

Figure 8-13: Food Sources of Vitamin E

Avoiding Too Much Vitamin E
UL is 1000 mg per day.
Megadoses do not provide significant health benefits or
prevent against oxidative damage.
Not stored in the liver—stored in fat tissue.
Excess can interfere with vitamin K and anticoagulant
medications (Coumadin and aspirin).
Dietary Supplements
• Vitamin E content given in international units (IU).
• Measure of biological activity rather than absolute quantity.
• Supplements contain variety of chemical forms.
• Usually less bioactivity than natural or dietary vitamin E.

Section 8.5: Vitamin K (Quinone)—
Concepts
• What is the role of vitamin K in blood clotting?
• Why is it important for people who take
Coumadin to monitor their dietary intake of
vitamin K?

Vitamin K: Forms and Functions
Forms:
• Phylloquinone.
• Menaquinone.
• Menadione.
Can be synthesized
by gut bacteria.
• About 10% of
requirement.
Functions:
• Blood clotting
• Activates prothrombin.
• Increases thrombin.
• Converts soluble fibrinogin
into insoluble fibrinogin.
• Important in bone health.

Figure 8-14: Clotting Cascade
Vitamin K works
to activate
clotting factors,
which are then
able to bind to
calcium.
© Science Photo Library/Getty Images RF

Vitamin K and Bone Health
Calcium-binding proteins in bone
• Includes osteocalcin.
• Depend upon vitamin K for their function in bone
mineralization.

Vitamin K Deficiency
In infants:
• Infant’s gut at birth is sterile.
• GI tract doesn’t have bacteria.
• If infant injured or needs surgery
• Can’t synthesize vitamin K needed for clotting.
• Vitamin K routinely administered by injection
shortly after birth.
In adults:
• Deficiency after long-term antibiotic use and when
fat malabsorbed.

Getting Enough Vitamin K
AI: 90 mcg per day female,
120 mcg per day male
Daily Value: 80 mcg
No UL: No reports of
toxicity.
Food sources:
• Liver, dark green leafy
vegetables, broccoli,
asparagus, peas.
• Resistant to cooking losses.
• Absorption requires dietary
fat and adequate pancreatic
secretions.
Elderly adults have lower
vitamin K intake due to
lower intake of
vegetables.
Coumadin (warfarin):
Inhibits vitamin K-
dependent coagulation
factors.
• When taking Coumadin or
similar drugs, keep dietary
Vitamin K intake consistent
from day to day.

Figure 8-15: Food Sources of Vitamin K
* Value includes phylloquinone and menaquinone.
Source: Nutrition data from USDA National Nutrient Database for Standard, Release 26; and Elder SJ and others: Vitamin K contents of meat, dairy, and fast food in the U.S. diet. Journal
of Agricultural and Food Chemistry 54: 463, 2006

Section 8.6: The Water-Soluble Vitamins
and Choline—Concepts 1
• What are the coenzymes associated with
each of the B vitamins involved in energy
metabolism?
• What body organs or tissues are most likely
to show symptoms if there is a deficiency of
B vitamins?
• Why are B vitamins lost when foods are
cooked in water?

Section 8.6: The Water-Soluble Vitamins
and Choline—Concepts 2
• What group of people is at very high risk of
deficiency of B vitamins?
• What happens during the refining of grains
that causes a decrease in nutrient density?
• What is added during the “enrichment” of
grain products, and why is it important?

Enzymes and Coenzymes
Enzymes
• Catalysts for biochemical reactions.
• Typically made of proteins.
• Require a cofactor for biological activity.
Vitamins
• Organic molecules are coenzymes.
• B vitamins function as coenzymes.

Figure 8-16: Coenzymes
Coenzymes
• Aid in the function of various
enzymes.
• Without the coenzyme, the
enzyme cannot function properly.
• Deficiency symptoms associated with
the missing vitamin eventually
appear.

ASK THE RDN: Raw Food Diet Plan
Includes consuming uncooked, unprocessed,
mostly organic fruits, vegetables, and sprouted
grains.
Strengths:
• Compatible with vegetarian, vegan, and gluten-free
dietary patterns.
• Raw food adopters often lose or maintain weight
given most of the foods allowed are low in calories
and fat.

ASK THE RDN: Raw Food Diet—Limitations
Does Cooking Destroy Key Nutrients?
Limitations:
• Highly restrictive and extremely difficult to maintain,
especially when dining out.
• Complete exclusion of food groups may lead to
nutrient deficiencies, so supplements may be
necessary.
• Cost and limited availability of organic foods may be
prohibitive.
• Many uncooked and unpasteurized products are
sources of foodborne pathogens.
• Many plant-based foods (that is , tomatoes) that
actually become more digestible once exposed to heat.

Figure 8-17: B Vitamins—Essential Components of
Many Coenzymes Involved in Energy Metabolism

B Vitamin Intakes of North Americans
Typical diet is adequate in B vitamins.
Common foods are fortified with B
vitamins.
• Ready-to-eat breakfast cereal
Water-soluble
• Excess excreted in stool and urine.
• Very little stored.
Alcoholics most likely to develop
serious B-vitamin deficiency diseases.
Manufacturing and refining reduces B
vitamin content of foods 10% to 25%.
Rapid cooking of
vegetables in minimal
fluids such as steaming,
helps to preserve
vitamin content.
©C Squared Studios/Getty Images

B Vitamins in Grains
Refined grains, such as white flour
• Nutrient rich germ, bran, husk discarded in
processing.
• Leads to loss of B vitamins, other vitamins, and
minerals.
• Enriched with thiamin, riboflavin, niacin, and folic
acid in United States.
• Reduced incidence of deficiency diseases.
• Refined grains still lower in other nutrients.

Figure 8-18: Relative Nutrient Contents
of Refined vs. Whole Grains

Section 8.7: Thiamin (Vitamin B-1)—Concepts
• How is thiamin involved in energy
metabolism?
• What body organs or tissues are most likely to
show symptoms if there is a deficiency of
thiamin?
• What group of people is at very high risk of
thiamin deficiency?
• What are some excellent sources of thiamin?

Thiamin: Functions
• First B vitamin discovered.
• Helps release energy from carbohydrate.
• Coenzyme form, thiamin pyrophosphate (TPP),
participates in reactions in which carbon
dioxide (CO2) is released.
• Important in ATP-producing energy pathways
involving breakdown of carbohydrates and
certain amino acids.

Thiamin Deficiency
Disease: 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 (that is,
white vs. brown rice).
Refining grains reduces
thiamin content unless it is
enriched.

Getting Enough Thiamin
RDA: 1.1 to 1.2
milligrams
• Men: exceed RDA by 50%
or more.
• Women: just meet RDA.
Daily Value: 1.5 milligrams
MyPlate:
• Protein and grain groups.
Food Sources
• Pork products.
• Whole grains and wheat
germ.
• Ready-to-eat cereals.
• Green beans, milk, orange
juice, organ meats, peanuts,
dried beans, seeds
©D. Fischer and P. Lyons/Cole Group/Getty Images

Figure 8-19: Food Sources of Thiamin

Section 8.8: Riboflavin (Vitamin B-2)—
Concepts
• How is riboflavin involved in energy
metabolism?
• What body organs or tissues are most likely
to show symptoms if there is a deficiency of
riboflavin?
• What types of foods are the best sources of
riboflavin?

Riboflavin: Functions
Riboflavin coenzymes participate in energy-
yielding pathways.
• For example, fatty acid breakdown.
Assists some vitamin and mineral metabolism.
Antioxidant role: supports glutathione
peroxidase enzyme.

Riboflavin Deficiency: Ariboflavinosis
• Inflammation of the mouth
and tongue.
• Cracking on tongue and
corners of mouth (cheilosis).
• Dermatitis.
• Eye disorders.
• Sensitivity to sun.
• Confusion.
• Occur jointly with niacin,
thiamin, and vitamin B-6
deficiencies.
Figure 8-20: Angular
cheilitis, also called cheilosis
or angular stomatitis, causes
painful cracks at the corners
of the mouth.
©Dr. P. Marazzi

Getting Enough Riboflavin
RDA: 1.1 to 1.3 milligrams per day
DV on labels is 1.7 milligrams.
Average intakes slightly above RDA.
Riboflavin supplementation
• Can cause bright yellow urine.
• Riboflavin name from Latin “flavus”—meaning yellow.
MyPlate: grains, dairy, and protein are riboflavin-dense
Alcoholics at increased risk for deficiency because of
diet low in riboflavin-dense food.
No UL.

Food Sources of Riboflavin
Ready-to-eat breakfast cereals
Dairy foods
• Destroyed by exposure to light.
• Milk sold in paper or opaque plastic containers to
protect from light.
Enriched grains
Meat
Eggs
Asparagus, broccoli, and greens (that is, spinach)

Figure 8-21: Food Sources of Riboflavin

Section 8.9: Niacin (Vitamin B-3)—Concepts
• How is niacin involved in energy metabolism?
• What are the three distinct signs of a niacin
deficiency?
• What are some excellent sources of niacin?
• What is the relationship between tryptophan
and niacin?

Niacin: Functions
Functions as nicotinic acid or nicotinamide.
Coenzyme form used in many cellular pathways.
• Involved in 200+ reactions.
Generating energy (ATP) from carbohydrates and fat
requires niacin coenzymes.
• Nicotinamide dinucleotide (NAD)
• Nicotinamide dinucleotide phosphate (NADP)
Fatty acid synthesis requires niacin coenzyme.
• Nicotinamide dinucleotide (NAD)

Niacin Deficiency
Pellagra:
• Means rough or scaly skin.
• Only deficiency disease, epidemic in United States.
• In late 1800s to 1930s.
• Symptoms:
• Dermatitis
• Diarrhea
• Dementia
• Death
• Occurs most commonly in alcoholics.
b: ©Gary Corbett/agefotostock/Alamy, a: ©Dr M.A.Ansary/Science Source

Getting Enough Niacin
• Adult RDA: 14 to 16
milligrams per day
• Daily Value: 20 milligrams
• Average American intake:
Double the RDA.
• MyPlate: Protein, meat,
and peanuts are niacin-
dense foods.
Corn treated in an alkaline
solution releases protein-
bound niacin making it
available in corn products
such as tortillas, taco shells,
tortilla chips, and corn flour.
Source: Scott Bauer/USDA

Food Sources of Niacin
Heat stable: Little lost in cooking.
Can synthesize from tryptophan:
• 60 milligrams of tryptophan can be converted to 1 milligram of niacin.
Found in foods:
• Poultry, fish, tuna, and beef.
• Peanuts.
• Ready-to-eat cereals.
• Asparagus.
• Coffee and tea.

Figure 8-23: Food Sources of Niacin
Source: Nutrition data from USDA National Nutrient Database for Standard Reference, Release 26.

Avoiding Too Much Niacin
UL: 35 milligrams per day for nicotinic acid form.
Nicotinic acid
Large doses
• Used to lower blood lipids, LDL cholesterol.
Use is discouraged.
Potential adverse side effects.
• Long-term: GI tract and liver damage
• Short-term: Niacin flush
• Usually when intakes >100 milligrams per day.
• Headache, itching, blood flow to skin flushing.
 

Section 8.10: Vitamin B-6 (Pyridoxine)—
Concepts
• What is the role of vitamin B-6 in energy
metabolism and other body functions?
• What are the primary sources of vitamin B-6?
• Are vitamin B-6 supplements safe?

Vitamin B-6: Functions
Coenzyme in many metabolic reactions:
• Carbohydrate, protein, and lipid metabolism.
• In 100+ amino acid and protein reactions.
• Synthesis of neurotransmitters.
• Conversion of tryptophan into niacin.
• Aids in homocysteine metabolism.
• Breakdown of stored glycogen into glucose.
• Synthesis of hemoglobin and white blood cells.

Vitamin B-6 Deficiency
Widespread
symptoms:
• Depression.
• Vomiting.
• Skin disorders.
• Nerve problems.
• Impaired immunity.
B-6 helps synthesize heme
portion of hemoglobin:
• B-6 deficiency produces small
RBCs with lower hemoglobin
concentration (microcytic
hypochromic anemia).
• Cell can’t produce ATP when
aerobic metabolism limited.
• Issue for alcoholics.

Getting Enough Vitamin B-6
Adult RDA: 1.3 to 1.7 milligrams per day
Daily Value: 2 milligrams
Average adult intake is above RDA.
Athletes
• Need more than sedentary adults.
• Due to increased processing of protein and glycogen.

Food Sources of Vitamin B-6
• Animal products
• Fortified ready-to-eat
breakfast cereals
• Potatoes, spinach,
bananas, and cantaloupe
• B-6 in animal foods and
fortified foods is better
absorbed than B-6 from
plant foods.
©lynx/iconotec.com/Glow Images

Figure 8-24: Food Sources of Vitamin B-6

Avoiding Too Much Vitamin B-6
UL: 100 milligrams per day
Concern for those using supplements.
• Some tablets contain 500 mg.
Excess leads to nerve damage.
2 to 6 grams per day for 2+ months causes
irreversible nerve damage.
Symptoms
• Gait abnormality, tingling in extremities, numbness

Section 8.11: Pantothenic Acid (Vitamin B-5)
and Biotin (Vitamin B-7)—Concepts
• What is the role of pantothenic acid in energy
metabolism?
• What are some rich sources of pantothenic acid?
• What is the role of biotin in energy metabolism?
• What are the signs and symptoms of biotin
deficiency?
• What are the best sources of biotin?
• Why does consumption of raw eggs lead to biotin
deficiency?

Pantothenic Acid (Vitamin B-5)
Coenzyme in energy release from:
• Carbohydrates, lipids, and protein.
In Greek, means “from every side.”
Widespread in foods.
Deficiency is rare but can occur in alcoholics.
Toxicity unknown: No UL.
Food sources:
• Sunflower seeds, mushrooms, peanuts, eggs, milk, meat,
and vegetables.
Adequate Intake (AI): 5 milligrams per day for adults
Daily Value: 10 milligrams

Figure 8-25: Food Sources of Pantothenic Acid

Biotin (Vitamin B-7)
Function: Coenzyme—aids in chemical
reactions.
Deficiency symptoms:
• Scaly skin inflammation.
• Changes in tongue and lips.
• Lower appetite.
• Nausea/vomiting.
• Anemia.
• Depression.
• Muscle pain.
• Weakness.
• Poor growth.

Getting Enough Biotin
Sources: egg yolks,
peanut butter, and
cheese
• Intestinal bacteria can
synthesize biotin.
• Makes deficiency rare.
• Raw egg whites bind biotin
and decrease its absorption.
• High raw egg white intake
can lead to biotin deficiency.
Needs:
• AI: 30 micrograms per
day for adults
• Food supply gives 40 to
60 micrograms per day
average.
• Daily Value: 300
micrograms
No UL; relatively
nontoxic.

Figure 8-26: Food Sources of Biotin
Source: Nutrition data from Staggs CG, et al. ‘’Determination of the biotin content of select foods
using accurate and sensitive HPLC/avidin binding,’’ J Food Compost Anal 2004; 17:767–776

Section 8.12: Folate (Vitamin B-9)—
Concepts
• Explain why macrocytic (megaloblastic)
anemia occurs.
• Why do folate needs increase from 400 to
600 micrograms per day for pregnant
women?

Folate: Functions
Cell division.
As a coenzyme: Supplies or accepts single
carbon compounds.
Folate coenzymes help form DNA.
Helps metabolize amino acids and their
derivatives (that is, homocysteine).
Folic acid
• Synthetic form added to fortified foods.

Folate: Deficiency
In early RBC synthesis:
• Immature cells cannot
form new DNA.
• Cells grow larger because
insufficient DNA for nuclei
to divide.
• Large immature form:
Megaloblast.
• Folate deficiency:
Megaloblastic anemia
(macrocytic anemia).
Symptoms:
• Tongue inflammation.
• Diarrhea.
• Poor growth.
• Mental confusion.
• Depression.
• Nerve dysfunction.

Figure 8-27: Megaloblastic Anemia
• Megaloblastic anemia
occurs when red blood
cells are unable to divide,
leaving large, immature
red blood cells.
• Either a folate or vitamin
B-12 deficiency may cause
this condition.
• Measurements of blood
concentrations of both
vitamins are taken to help
determine the cause of
the anemia.

Folate: Maternal Deficiency
• Low folate levels in pregnant
woman linked to neural tube
defects in fetus
(that is, spina bifida,
anancephaly).
• Neural tubes close within first
28 days of pregnancy.
• Recommended that 6 weeks
before pregnancy, all women
take supplements containing
400 mcg/day.
©Banana Stock/Punchstock

Getting Enough Folate
RDA: 400 mcg per day
Pregnancy RDA: 600 mcg
per day
Daily Value: 400 mcg per day
UL: 1 mg per day (1000 mcg)
• Only refers to folic acid.
• Large doses of folate can mask
vitamin B-12 deficiency.
Food Sources of Folate:
• Green leafy vegetables.
• Asparagus.
• Orange juice.
• Dried beans.
• Fortified ready-to-eat
breakfast cereals.
• Bread.
• Milk and yogurt.
Cooking (heat) destroys
50% to 90% folate.

Figure 8-28: Food Sources of Folate

Section 8.13: Vitamin B-12 (Cobalamin
or Cyanocobalamin)—Concepts
• Explain the role of specific factors required for
vitamin B-12 absorption.
• Which two nutrient deficiencies could be
responsible for macrocytic anemia?
• Identify two population groups that are at risk for
vitamin B-12 deficiency. Explain why these people
are at risk.

Vitamin B-12
Also known as: cobalamin
or cyanocobalamin.
Contains mineral as part
of structure.
Functions
• Folate metabolism.
• Maintaining myelin
sheath that insulates
neurons from each
other.
Absorption
• Bound to a protein in
food, cannot be
absorbed.
• Stomach acid releases
vitamin B-12 from
protein.
• Requires Intrinsic Factor
(IF) for absorption.
Storage: In liver

Figure 8-29: Vitamin B-12 Absorption
Absorption
requires several
compounds
produced in the
mouth, stomach,
and small
intestine.
Defects in the
stomach or small
intestine can
interfere with
absorption and
result in vitamin
B-12 deficiency.

Vitamin B-12 Deficiency
Neurological symptoms:
• From destruction of parts of myelin sheath.
• Irregular muscle actions.
• Impaired reflexes.
• Eventual paralysis and, perhaps, death.
Pernicious anemia
• Anemia from lack of B-12 absorption rather than
inadequate folate absorption.
B-12 only found in foods of animal origin.
• Vegans at risk for deficiency.

Getting Enough Vitamin B-12
Adult RDA: 2.4 mcg per day
Daily Value: 6 mcg
Adults consume 2 times the RDA on average
each day.
Older adults are encouraged to have synthetic
form.
• With age, absorption of vitamin B-12 from food
becomes less efficient, usually due to decreases in
stomach-acid and Intrinsic Factor production.

Food Sources of Vitamin B-12
Concentrated sources
found only in animal foods.
• Meat, salmon, seafood
• Milk
• Eggs
• Organ meats:
• Liver, kidneys, heart
Ready-to-eat fortified
breakfast cereals
©Michael Lamotte/Cole Group/Getty Images

Figure 8-30: Food Sources of Vitamin B-12

Section 8.14: Vitamin C (Ascorbic Acid)—
Concepts
• How does vitamin C function as an antioxidant
and regenerate vitamin E?
• How do the signs of vitamin C deficiency relate
to the many roles of the vitamin discussed in
this chapter?
• Why are fresh foods the best sources of
vitamin C?

Functions of Vitamin C
Formation of Body Proteins
• Collagen synthesis, most
abundant protein in body.
Formation of Other
Compounds
• Carnitine synthesis,
transports fatty acids.
• Neurotransmitters:
Serotonin and
norepinephrine synthesis.
Antioxidant
• May decrease formation
of carcinogen
nitrosamines in the
stomach.
Increases Iron Absorption
Immune Function
• Doesn’t prevent colds
but may decrease
severity.

Getting Enough Vitamin C
Adult RDA:
• 90 mg per day for men.
• 75 mg per day for women.
Smokers need an extra 35 mg because of
increased oxidation by tobacco smoke in lungs.
Average U.S. consumption: 70 to 100 mg per day

Vitamin C Deficiency—Scurvy
Causes scurvy
• reduced collagen synthesis, causing
bruising, bleeding gums, poor
wound healing
• In 1700s half of sailing crews on long
voyages died.
• British physician discovered citrus
fruits prevented and restored health
of sailors.
• Future food rations included limes,
resulting in nickname “limeys.”
Figure 8-31: Pinpoint
hemorrhages of the
skin—an early symptom
of scurvy from defective
collagen synthesis.
©Dr P. Marazzi/Science Source

Food Sources of Vitamin C
• Citrus fruits.
• Strawberries.
• Green peppers.
• Cauliflower and broccoli.
• Cabbage.
• Papaya.
• Romaine, darker color lettuce
• Brighter fruits and vegetables
= more vitamin C.
• Ready-to-eat breakfast cereals.
©Purestock/SuperStock

Avoiding Too Much Vitamin C
• UL is 2000 mg per day.
• Increased iron absorption may be problematic
with hemochromatosis.
• Increased kidney function and urination above
100 mg per day.
• Stomach inflammation and diarrhea.
• GI distress.

Figure 8-32: Food Sources of Vitamin C

Section 8.15: Choline and Other Vitamin-
Like Compounds—Concepts
• Describe three functions of choline in the
human body.
• List three ways to incorporate more choline
into the diet.
• Is it necessary to take dietary supplements of
vitamin-like compounds, such as carnitine and
taurine? Why or why not?

Functions of Choline
Choline recognized as an essential nutrient
in 1998.
Functions in all cells.
• Cell membrane structure.
• Single-carbon metabolism.
• Nerve function and brain development.
• Lipid transport.

Cell Membrane Structure
Precursor for several phospholipids.
• Phosphatidylcholine (lecithin) accounts for about
half of phospholipids in cell membranes.
• Contributes to membrane flexibility, allows for
presence of water-/fat-soluble compounds.

Single-Carbon Metabolism
Choline is precursor for betaine.
• Participates in reactions involving transfer of
single-carbon groups.
• Synthesis of neurotransmitters, modifications
of DNA during embryonic development.
• Metabolism of homocysteine.
• Because of this function, adequate choline
intake prevents birth defects.

Nerve Function and Brain Development
Acetylcholine: Choline-containing neurotransmitter
• Associated with attention, learning, memory, muscle control,
and other functions.
Sphingomyelin, choline-containing phospholipid
• Part of myelin sheath that insulates nerve cells.
Pregnancy, choline high in amniotic fluid
• Important for developing fetal brain.
• Low choline level: Poor brain development and decreased
learning ability.

Choline and Fetal Brain Development
© InesBazdar/Shutterstock
Choline is important
for proper
development of the
fetal brain. Milk and
other dairy products
supply some choline.

Lipid Transport
Choline is a component of lipoproteins.
• Choline deficiency leads to
• Decreased production of VLDL.
• Inability of liver to export fats to body.
• Results in fatty liver, scarring.
• Common in cirrhosis.

Getting Enough Choline
AI for adults
• Men: 550 milligrams per day.
• Women: 425 milligrams per day.
• Pregnancy: 450 milligrams per day.
• Breastfeeding: 550 milligrams per day.
• Unknown whether is essential for infants or children.
Fewer than 10% of Americans meet AI.
Wide variation in individual requirements.
UL for adults: 3.5 grams per day

Sources of Choline
Widely distributed in foods.
Soybeans, egg yolks, beef,
cauliflower, almonds, and peanuts
Found free, or as part of
compounds.
• Enzymes break down to free choline
for absorption.
Absorbed in small intestine,
to liver, also fat-soluble, some
into lymphatic system.
One egg a day.
Dairy products, soy,
almonds, and peanuts are
natural sources of choline.
© InesBazdar/Shutterstock

Figure 8-33: Food Sources of Choline

Section 8.16: Dietary Supplements—Who
Needs Them?—Concepts
• Name four types of ingredients that are
classified as dietary supplements by the
Dietary Supplement Health and Education Act.
• Identify three potential risks from use of
dietary supplements.
• Describe three situations in which use of
dietary supplements is necessary.

DSHEA: Dietary Supplement Health and
Education Act of 1994
A supplement in the United States is a product
intended to supplement the diet that bears or
contains one or more of the following
ingredients:
• Vitamin.
• Mineral.
• Herb or another botanical.
• Amino acid.
• Dietary substance to supplement the diet which
could be an extract or a combination of the first four
ingredients in this list.

Supplement Industry
• Generates about $35 billion
annually in the U.S.
• Supplements can be sold
without proof they are safe
and effective.
• FDA provides little
regulation unless shown to
be inherently dangerous, or
makes illegal claim.
©Nancy R. Cohen/Getty Images

Figure 8-34: Dietary Supplement Sales
The dietary supplement industry is a growing
multibillion-dollar business

Why Do People Take Supplements?
Reasons reported include:
• Maintain overall health and wellness.
• Fill nutrient gaps in the diet.
• Reduce susceptibility to health problems (that is, colds).
• Prevent disease (heart attacks, cancer, osteoporosis,
etc.).
• Reduce stress.
• Increase “energy.”

Should You Take a Supplement?
Only a simple back up plan to fill gaps.
The National Institutes of Health
• “Present evidence is insufficient to recommend either for or
against the use of MVMs by Americans to prevent chronic
diseases.”
A few studies of vitamin and mineral supplements
demonstrate beneficial effects for the prevention of
deficiencies or chronic diseases.
Eating recommended servings of fruits, vegetables,
and grains is the healthiest approach to ensure
nutrient adequacy.

Table 8-6: Who Is Most Likely to Benefit
from Dietary Supplements? 1
Type of
Supplement Who May Benefit
Multivitamin
and mineral
(MVM)
• People on restrictive diets (<1200 kcal per day), vegans,
vegetarians
• Older adults (over 50)
• Those with unbalanced or inadequate diets (e.g., in cases of food
insecurity, “picky” eaters)
• Pregnant women or those of childbearing age
• People with malabsorptive diseases
• People who take medications that interfere with nutrient
absorption or metabolism
B vitamins • People who abuse alcohol
Folic acid • Women of childbearing age (especially during pregnancy and
breastfeeding)
Vitamin B-12 • Older adults
• Strict vegans
Vitamin C • People who smoke

Table 8-6: Who Is Most Likely to Benefit
from Dietary Supplements? 2
Type of
Supplement Who May Benefit
Vitamin D • People with limited milk intake (due to allergies or lactose
intolerance)
• People with limited exposure to sunlight or darker skin pigment
(e.g., infants, many African-Americans, and some older adults)
Vitamin E • Newborns (given by injection shortly after birth)
Vitamin K • People who abuse alcohol
Calcium • Strict vegans
• Older adults with bone loss
Fluoride • Some older infants and children (as recommended by a dentist)
Iron • Women with excessive bleeding during menstruation
• Women who are pregnant
• Strict vegans
Zinc • Strict vegans

Figure 8-35: Supplement Savvy—An Approach
to the Use of Nutrient Supplements

Which Supplement Should You Choose?
Nationally recognized brand
Contains about DVs for nutrients present
Take with or just after meals to increase
absorption
All nutrient sources equal no more than
Upper Level, especially Vitamin A
Read labels carefully, look for USP symbol
• United States Pharmacopeial Convention.
• Reviews product strength, quality, purity, packaging,
labeling, speed of dissolution, shelf-stability.
©McGraw-Hill Education/Jill Braaten, photographer

Figure 8-36: Dietary Supplement Label

CASE STUDY: Getting the Most Nutrition from Your Food
In the dietary supplements aisle of the grocery store, the choices
are endless—and expensive. Julie, a college sophomore, just
read the Academy of Nutrition and Dietetics’ position paper on
nutrient supplementation for her class. She learned that dietary
supplements, such as a balanced multivitamin and mineral
supplement, can be a good back-up plan to ensure adequate
nutrition, but the jury is still out when it comes to demonstrating
a benefit of dietary supplements for long-term health. The
majority of Americans regularly take nutrient supplements, but it
is usually the people who already consume a healthy diet who
take them. Getting more than the recommended amount of a
nutrient does not confer additional health benefits. In fact, too
much of some vitamins and minerals can lead to toxicity.

Case Study Questions
Julie decides she would rather focus on getting her nutrients from
foods. How can she get the most vitamins and minerals out of the
foods she eats? Answer the following questions and check your
responses at the end of the chapter.
1. What factors can damage or reduce vitamins in food?
2. To maximize vitamin content, what should Julie keep in mind as
she selects fresh produce for purchase?
3. How does food processing affect vitamin and mineral content?
Does it make a difference if Julie chooses products with whole
grains or refined grains?
4. When storing fruits and vegetables in her apartment, what steps
can Julie take to minimize nutrient losses?
5. Which cooking methods are best for preserving vitamin content?

Case Study Solution
• Exposure to light, heat, oxygen, or alkalinity leads to
destruction of some vitamins, particularly the water-soluble
vitamins. In addition, some vitamins can be leached into
cooking water or fat during food preparation.
• Finding fresh, local produce at a farmer’s market decreases
the number of steps from the field to the plate, so vitamin
content will be higher.
• Choosing to make half your grains whole will help in meeting
micronutrient needs without dietary supplements.
• Foods that will not be eaten within a few days should be
frozen to maintain nutrient content.
• Steaming, microwaving, and stir-frying are the best cooking
methods for preserving vitamin content of foods.

Cancer Statistics
Second leading cause of death, North America
Estimated 1620 die each day in U.S.
Four cancers, cause over 50% of cancer deaths
• lung, colorectal, breast, prostate cancers.
Cancer is many diseases, by types of cells and
contributing factors
Treatments vary

Early Detection of Cancer
Undetected, it can spread quickly—early detection.
Use CAUTION acronym
• Change in bowel or bladder habits.
• A sore that does not heal.
• Unusual bleeding or discharge.
• Thickening or lump in the breast or elsewhere.
• Indigestion or difficulty in swallowing.
• Obvious change in a wart or mole.
• Nagging cough or hoarseness.
• Unexplained weight loss an additional warning sign.

Cancer Terminology
Tumor
• Mass of cells; cancerous or noncancerous
Malignant
• Property of spreading locally and to distant sites.
Benign
• Noncancerous; tumors that do not spread.
Metastasize
• Spreading of disease from one part of body to another, even
parts of body that are remote from site of original tumor.
• Cells spread via blood vessels, lymphatic system, or direct
growth of tumor.

Factors That Influence
Development of Cancer
• Genetics, environment, lifestyle
• Genetic role in colon, breast, and prostate
cancer.
• Experts estimate that only 5% of most cancers
can be explained by the inheritance.
• 95% related to environmental factors.

Figure 8-37: Cancer is Many Diseases
Source: American Cancer Society, Inc., Surveillance Research, 2016

Body Fatness Linked to Cancer Risk
Food constituents may contribute to cancer
development, some are protective.
Estimated one of three cancer deaths in the U.S.
linked to
• Excess body fat.
• Poor nutrition.
• Inadequate physical activity.
Increased estrogen and insulin output suspected.
Some research indicated reducing calories to 70% of
usual intake, increases longevity.

Cancer-Fighting Foods
• Include antioxidants and some
phytochemicals.
• Some help prevent DNA mutations.
• Vitamins C and E help prevent formation of
nitrosamines (carcinogens) in GI tract.
• Fruit and vegetable intake reduces risk of
nearly all types of cancer.
• Use MyPlate guidelines
to form eating pattern.
©C Squared Studios/Getty Images

FARM to FORK: Crucifers
Grow
• Most common crucifers are
broccoli, cauliflower, cabbage,
bok choy, Brussels sprouts, kale,
and arugula.
• Most nutrient dense crucifers
come straight from the garden.
Shop
• Buy broccoli with dark green
crowns and tight bud heads.
• Intact heads of broccoli are
more nutritious and less
expensive that precut florets.
Store
• Keep crucifers cool and eat within
days of harvest.
• Blanch broccoli before freezing.
Prep
• Eating the fruit with skin provides
the most fiber and nutrients.
• Cooking decreases nutrient and
phytochemical content.
• Steaming for less than 5 minutes is
recommended.
© Mary-Jon Ludy, Bowling Green State University, Garden of Hope Images

American Institute for Cancer Research
Recommendations for Cancer Prevention
Be as lean as possible without becoming underweight.
Be physically active for at least 30 minutes every day.
Avoid sugary drinks. Limit consumption of energy-dense foods.
Eat more of a variety of vegetables, fruits, whole grains, and legumes.
Limit consumption of red meats.
If consumed at all, limit alcoholic drinks to two per day (men) or one per day
(women).
Limit consumption of salty foods, foods processed with salt.
Don’t use supplements to protect against cancer.
It is best for mothers to breastfeed exclusively for up to 6 months and then
add other liquids and foods.
After treatment, cancer survivors should follow the recommendations for
cancer prevention.
• Don’t smoke or chew tobacco.

Nutrition Concerns During Cancer Treatment
Overall goals of medical nutrition therapy:
• Minimize weight loss.
• Prevent nutrient deficiencies.
• Preserve muscle mass.
Fatigue, mouth sores, dry mouth, taste
abnormalities, nausea, diarrhea lead to poor
food intake.
Best food…any patient tolerates.
Small, frequent, nutrient-dense
• Liquid nutritional supplements often needed.

What Would You Choose—Considerations
B vitamins do not contain energy. B-complex supplement
contains B vitamins that are coenzymes in energy metabolism.
Energy shots promise a quick, convenient boost of energy.
• Have as much caffeine as a 12-ounce cup of coffee.
• Do not have a source of sustained energy—calories.
To boost energy levels naturally:
• Eat several small meals throughout the day rather than three large ones.
• Avoid large amounts of sugar and fat.
• Don’t skip meals, especially breakfast.
• Take a quick exercise break, such as a short walk.
• Exercise regularly.
• Reduce stress.
• Get 7 to 9 hours sleep each night.

Appendix of Image Long Descriptions

Figure 8-1: Vitamins Contribute to
Many Functions Long Description
The following is a list of functions followed by the micronutrients that
contribute to that function. Energy metabolism: Thiamin, Riboflavin,
Niacin, Pantothenic acid, Biotin, Vitamin B-12, Iodide, Chromium,
Magnesium, Manganese, Molybdenum, and Choline. Bone Health:
Vitamin C, Vitamin D, Vitamin K, Calcium, Phosphorus, Magnesium,
Fluoride, Boron and Silicon. Fluid and Electrolyte Balance: Sodium,
Potassium, Chloride and Phosphorus. Brain Health: Thiamin,
Riboflavin, Niacin, Vitamin B-6, Vitamin B-12, Folate, Choline, Vitamin
C, Vitamin D, Vitamin E, Calcium, Iodine, Magnesium, Selenium, Iron
and Zinc. Blood Health: Vitamin B-6, Vitamin B-12, Folate, Vitamin K,
Iron, Zinc, Copper and Calcium. Body Defenses: Vitamin A, Vitamin C,
Vitamin D, Vitamin E, Carotenoids, Selenium, Copper, Iron,
Magnesium, Manganese and Zinc.
Return to slide containing original image.

Figure 8-2: MyPlate Source of Vitamins
and Choline Long Description
Grains are rich sources of thiamin, riboflavin, niacin,
and folic acid. Vegetables are rich sources of vitamin A,
vitamin K, folate, and vitamin C. Fruits are rich sources
of vitamin A and vitamin C. Dairy foods are rich sources
of vitamin D, riboflavin, vitamin B-12, and choline.
Protein foods are rich sources of thiamin, riboflavin,
niacin, biotin, vitamin B-6, vitamin B-12, and choline.

Figure 8-16: Coenzymes Long Description
An active enzyme is formed when an inactive
enzyme combines with the vitamin coenzyme.
The structure of the coenzyme permits it to join
with the inactive enzyme.

Figure 8-35: Supplement Savvy—An
Approach to the Use of Nutrient
Supplements Long Description
When considering the use of nutrient
supplements, a healthy diet rich in vitamins and
minerals is always the first option, followed by
fortified foods (example: Calcium-fortified
orange juice), followed by possible multivitamin
and mineral supplements, and finally individual
supplements in some cases.

Which Supplement Should You Choose?
Long Description
The United States Pharmacopeial Convention is
an independent, nonprofit group that reviews
products for strength, quality, purity, packaging,
labeling, speed of dissolution, and shelf stability.
The presence of the USP verified mark on a
dietary supplement label indicates that the
product has been evaluated and meets certain
standards for dietary supplement quality.

Figure 8-36: Dietary Supplement Label
Long Description
This example of a dietary supplement label has the following information:
Made to U.S. Pharmacopeia (USP) quality, purity and potency standards.
Laboratory tested to dissolve within 30 minutes. Serving Size: 1 Tablet.
Nutrients and amounts: each tablet contains 200 international units of
vitamin D, which is 50% of the Daily Value, and 600 milligrams of calcium,
which is 60% of the Daily Value. INGREDIENTS: Calcium Carbonate,
Maltodextrin, Starch, Hydroxypropyl Methylcellulose, Talc, Cellulose,
Croscarmellose Sodium, Hydroxypropyl Cellulose, Dioxide, Magnesium
Stearate, Polysorbate 80, Cholecalciferol, Polyethylene Glycol 3350, Sodium
Citrate, 6 Lake. Manufacturer: DIST. BY NUTRA-VITE ASSOC., INC. 700 WHITE
POINT RD, SKOKIE, IL 60077. Suggested use: Take one tablet one to two times
daily with a full glass of water, preferably after a meal. Structure/function
Claim: Vitamin D assists in the absorption of calcium. A healthful diet with
adequate calcium is essential. FDA disclaimer: These statements have not
been evaluated by the Food and Drug Administration. This product is not
intended to diagnose, treat, cure, or prevent any disease.

Vitamins Chapter 8 Contemporary Nutrition

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Similar to Vitamins Chapter 8 Contemporary Nutrition

Similar to Vitamins Chapter 8 Contemporary Nutrition (20)

More from Earlene McNair

More from Earlene McNair (20)

Recently uploaded

Recently uploaded (20)

Vitamins Chapter 8 Contemporary Nutrition