Vitamins Presented by Janice Hermann, PhD, RD/LD OCES Adult and Older Adult Nutrition Specialist

Vitamins Vitamins are essential to life Vitamins are required for: Growth Maintenance Regulation of body processes

Vitamins Unlike carbohydrates, proteins and fats; vitamins are individual units, they are not linked together.

Vitamins Vitamins are organic compounds that perform chemical functions in the body

Vitamins Most metabolic processes require vitamins Many coenzymes are composed of vitamins that help enzymes function

Vitamins Vitamins do not supply energy However, some vitamins do function as coenzymes in the release of energy from carbohydrates, proteins and fats Some vitamins available from foods in inactive forms known as precursors Once inside the body, precursors are converted into an active form of the vitamin

Vitamins Because vitamins are organic, they can be destroyed and left unable to function Heat – keep refrigerated, dont over cook Light (ultraviolet) – store in opaque containers Oxygen – after cut, keep airtight Some water soluble – cook with less water The body needs vitamins in small amounts Milligrams (mg) or micrograms (µg) instead of grams (g) Although needed in small amounts, vitamins are needed on a regular basis.

Vitamins 13 different vitamins, each with its own roles Vitamins grouped into two major categories: Fat-soluble (4 fat soluble) Vitamin A Vitamin D Vitamin E Vitamin K Water-soluble (9 water soluble: 8 B vitamins & C) Thiamin Riboflavin Niacin Biotin Pantothenic acid Vitamin B 6 Folate Vitamin B 12 Vitamin C

Vitamins Fat-soluble vitamins Found in fats and oils of foods After absorbed enter lymph, then blood Protein carriers for transport Stored (fatty tissue/liver) Doesnt need as regularly - weekly, monthly; because stored Deficiencies slow to develop; because stored Toxicities more likely; because stored (mostly from supplements) Precursors Fecal excretion Water-soluble vitamins Found in watery parts of foods After absorbed move directly into blood Transported freely in blood Not stored Needed more regularly – every 1-3 days; because not stored Deficiencies fast to develop; because not stored Toxicities less likely (large amounts can overwhelm) Usually no precursors Urine excretion

Vitamins Consuming vitamins in the right amount is important Inadequate amounts can cause harm and excessive amounts can cause harm More is not better The fact a compound can be essential and harmful is true of most nutrients

The effect of a vitamin depends on the dose A normal nutrient dose Can have a physiological effect, which can result in normal blood concentrations A large nutrient dose Can have pharmacological or drug effect, which can result in nutrient toxicities Relationship Between Intake and Effect

Vitamins The DRI is the recommended intake level Some vitamin DRIs are an RDA (Recommended Dietary Allowance) some are an AI (Adequate Intake) The Tolerable Upper Intake Level (UL) is the highest amount that is likely not to cause harm for most healthy people when consumed daily

Vitamins The DRI (Dietary Recommended Intake) is the recommended intake level Some nutrient DRIs are an RDI (Recommended Dietary Intake) some are an AI (Adequate Intake) DRI addresses possibility of adverse effects from high doses of nutrients by establishing Tolerable Upper Intake Levels UL highest amount that is likely not to cause harm for most healthy people when consumed daily

Getting The Variety of Vitamins Normally, a well balanced diet based on the USDA Daily Food Plan and a variety of foods will provide enough vitamins. No singe food can supply all the nutrients in the right amount. A variety of foods is needed to have a healthy diet.

Vitamin A Other Names Retinol Retinal Retinoic acid Precursors are carotenoids such as beta-carotene

Vitamin A RDA 900 µg RAE/day 700 µg RAE/day Upper Level 3,000 ug/day

Vitamin A Functions Vision Maintenance of cornea, epithelial cells, mucous membranes, skin Bone and tooth growth Reproduction Immunity.

Vitamin A Food Source Retinol: fortified milk, cheese, cream, butter, fortified margarine, eggs, liver. Beta-carotene: spinach and other dark leafy greens; broccoli, deep orange fruits (apricots, cantaloupe) and vegetables (squash, carrots, sweet potatoes, pumpkin)

Vitamin A Deficiency Disease Hypovitaminosis A Deficiency Symptoms Night blindness Corneal drying (xerosis), softening of the cornea (keratomalacia), corneal degeneration and blindness Triangular gray spots on eye (Bitots spots) Impaired immunity Plugging hair follicies with keratin, forming white lumps (hyperkeratosis)

Vitamin A Toxicity Disease Hypervitaminosis A Toxicity Symptoms Chronic toxicity Increased activity of osteoclasts causing reduced bone density Liver abnormalities Birth defects Acute toxicity Blurred vision Nausea, vomiting, vertigo Headaches, increased pressure inside the skull mimicking a brain tumor

Vitamin D Other Names Calciferol, 1,25-dihydroxy vitamin D (calcitriol) The animal version is vitamin D3 or cholecalciferol The plant version is vitamin D2 or ergocalciferol Body cholesterol is a precursor

Vitamin D Recommended Dietary Allowance Adults: 600 IU/day (19-50 yr) Adults: 600 IU/day (51-70 yr) Adults: 800 IU/day (71 + yr) Upper Level Adults: 4,000 IU/day

Vitamin D Functions Mineralization of bones (raises blood calcium and phosphorus by increasing absorption from digestive tract, withdrawing calcium from bones, stimulating retention by kidneys)

Vitamin D Food Sources Synthesized in the body with the help of sunlight Fortified milk, margarine, butter, cereals and chocolate mixes Veal, beef, egg yolk, liver, fatty fish (herring, salmon, sardines) and their oils

Vitamin D Deficiency Diseases Rickets Osteomalacia

Vitamin D Rickets in Children Deficiency Symptoms Inadequate calcification, resulting in misshapen bones (bowing of legs) Enlargement of ends of long bones (knees, wrists) Deformities of ribs (bowed, with beads or knobs) Delayed closing of fontanel, resulting in rapid enlargement of head Lax muscles resulting in protrusion of abdomen Muscle spasms

Vitamin D Osteomalacia in Adults Deficiency Symptoms Loss of calcium resulting in soft, flexible, brittle, and deformed bones Progressive weakness Pain in pelvis, lower back and legs

Vitamin D Toxicity Disease Hypervitaminosis D Toxicity Symptoms Elevated blood calcium Calcification of soft tissues (blood vessels, kidneys, heart, lungs, tissues around joints) Frequent urination

Vitamin E Other Names Alpha-tocopherol RDA Adults: 15 mg/day Upper Limit Adults: 1,000 mg/day

Vitamin E Functions Antioxidant (stabilization of cell membranes, regulation of oxidation reactions, protection of polyunsaturated fatty acids and vitamin A

Vitamin E Food Sources Polyunsaturated plan oils (margarine, salad dressings, shortenings Leafy green vegetables Wheat germ and whole grains Liver, egg yolk, nuts and seeds

Vitamin E Deficiency Symptoms Red blood cell breakage Nerve damage Toxicity Symptoms Augments the effect of anti-clotting medication

Vitamin K Other Names Phylloquinone, menaquinone, menadione, naphthaquinone Adequate Intake Men: 120 µg/day Women: 90 µg/day

Vitamin K Function Synthesis of blood-clotting proteins and bone proteins Food Sources Bacterial synthesis in the digestive tract Milk, Liver Leafy green vegetables, cabbage-type vegetables

Vitamin K Deficiency Symptoms Hemorrhaging Toxicity Symptoms None known

Vitamin C Other Names Ascorbic acid RDA Men: 90 mg/day Women: 75 mg/day Smokers: +35 mg/day Upper Level Adults: 2,000 mg/day

Vitamin C Functions Collagen synthesis (strengthens blood vessels walls, farms scar tissue, provides matrix for bone growth) Antioxidant Thyroxin synthesis Amino acid metabolism Strengthens resistance to infection Helps in absorption of iron

Vitamin C Food Sources Citrus fruits (oranges, grapefruits, tangerines, lemons, limes). Cabbage-type vegetables; Dark green vegetables (such as bell peppers and broccoli) Strawberries and other berries, cantaloupe and other melons, papayas, mangoes, potatoes, and tomatoes Destruction Easily destroyed by heat and oxygen

Vitamin C Deficiency Disease Scurvy Deficiency Symptoms Anemia, atherosclerotic plaques, pinpoint hemorrhages Bone fragility, joint pain Poor wound healing, frequent infections Bleeding gums, loosened teeth Muscle degeneration and pain Hysteria, depression Rough skin, blotchy bruises

Vitamin C Toxicity Symptoms Nausea, abdominal cramps, diarrhea Headache, fatigue, insomnia Hot flashed, rashes Interference with medical tests Aggravation of gout symptoms Urinary tract problems, kidney stones

Thiamin Other Names Vitamin B1 RDA Men: 1.2 mg/day Women: 1.1 mg/day

Thiamin Function Part of coenzyme TPP (thiamin pyrophosphate) used in energy metabolism Food Sources Whole-grain, fortified, or enriched grain products Moderate amounts in all nutritious food Pork Destruction Easily destroyed by heat

Thiamin Deficiency Disease Beriberi (wet with edema; dry with muscle wasting) Deficiency Symptoms Enlarged heart, cardiac failure Muscular weakness Apathy, poor short-term memory, confusion, irritability Anorexia, weight loss Toxicity Symptoms None reported

Riboflavin Other Names Vitamin B2 RDA Men: 1.3 mg/day Women: 1.1 mg/day

Riboflavin Function Part of coenzymes FMN (flavin mononucleotide) and FAD (flavin adenine dinucleotide) used in energy metabolism

Riboflavin Food Sources Milk and dairy products (yogurt, cheese). Enriched or whole grains Liver Destruction Easily destroyed by ultraviolet light and irradiation

Niacin Other Names Vitamin B3 Nicotinic acid, nicotinamide, niacinamide Precursor : amino acid tryptophan RDA Men: 16 mg NE/day Women: 14 mg NE/day Upper Limit Adults: 35 mg/day

Riboflavin Deficiency Disease Ariboflavinosis Deficiency Symptoms Sore throat Cracks and redness at corners of mouth (cheilosis) Painful smooth, purplish red tongue (glossitis) Inflammation characterized by skin lesions covered with greasy scales Toxicity Symptoms None reported

Niacin Functions Part of coenzymes NAD (nicotinamide adenine dinucleotide) and NADP (its phosphate form) used in energy metabolism

Niacin Food Sources Milk, eggs, meat, poultry, fish Whole-grain and enriched breads and cereals Nuts All protein-containing foods

Niacin Toxicity Symptoms Painful flush, hives, and rash (niacin flush) Nausea, vomiting Liver damage Impaired glucose tolerance

Niacin Deficiency Disease Pellagra Deficiency Symptoms Diarrhea, abdominal pain, vomiting Inflamed, swollen, smooth, bright red tongue (glossitis) Depression, apathy, fatigue, loss of memory, headache Bilateral symmetrical rash on areas exposed to sunlight

Pyridoxine Other Names Pyridoxine, pyridoxal, pyridoxamine B6 RDA Adults: 1.3 mg/day (19-50 yr) Upper Level Adults: 100 mg/day

Pyridoxine Functions Part of coenzymes PLP (pyridoxal phosphate) and PMP (pyridoxamine phosphate) used in amino acid and fatty acid metabolism Helps convert tryptophan to niacin and to serotonin Helps to make red blood cells

Pyridoxine Food Sources Meats, fish, poultry, liver Potatoes, legumes, soy products Non-citrus fruits Fortified cereals Destruction Easily destroyed by heat

Pyridoxine Deficiency Symptoms Scaly dermatitis Anemia (small-cell type) Depression, confusion, convulsions

Pyridoxine Toxicity Symptoms Depression, fatigue, irritability, headaches, nerve damage causing numbness and muscle weakness leading to an inability to walk and convulsions Skin lesions

Folate Other Names Folic acid, folacin, pteroylglutamic acid (PGA) RDA Adults: 400 µg/day Upper Limit Adults: 1,000 µg/day

Folate Function Part of coenzymes THF (tetrahydrofolate) and DHF (dihydrofolate) used in DNA synthesis and therefore important in new cell formation Activates vitamin B12; Works with vitamin B12 to form hemoglobin in red blood cells Helps prevent neural tube defects, such as spina bifida.

Folate Food Sources Fortified grains Leafy green vegetables Legumes, seeds Liver Destruction Easily destroyed by heat and oxygen

Folate Deficiency Anemia (large-cell type) Smooth, red tongue (glossitis) Mental confusion, weakness, fatigue, irritability, headache Toxicity Mask B12 deficiency symptoms

Vitamin B 12 Other Names Cobalamin RDA Adults: 2.4 µg/day

Vitamin B 12 Functions Part of coenzymes methylcobalamin and deoxyadenosylcobalamin used in new cell synthesis Helps to maintain nerve cells Reforms folate coenzyme Helps to break down some fatty acids and amino acids

Vitamin B 12 Food Sources Animal products (meat, poultry, fish, shellfish, milk, cheese, eggs) Fortified cereals Destruction Easily destroyed by microwave cooking

Vitamin B 12 Deficiency Disease Pernicious anemia Deficiency Symptoms Anemia Fatigue Degeneration of peripheral nerves progressing to paralysis Toxicity Symptoms None reported

Biotin Adequate Intake Adults: 30 µg/day Functions Part of coenzyme used in energy metabolism Part of coenzyme used in fat synthesis, amino acid metabolism, and glycogen synthesis

Biotin Food Sources Widespread in foods Liver, egg yolks, soybeans, fish, whole grains Also produced by GI bacteria

Biotin Deficiency Symptoms Depression, lethargy, hallucinations, numb or tingling sensation in the arms and legs Red scaly rash around the eyes, nose, and mouth Hair loss Toxicity Symptoms None reported

3/22/2017 Pantothenic Acid Adequate Intake Adults: 5 mg/day Functions Part of coenzyme A used in energy metabolism

3/22/2017 Pantothenic Acid Food Sources Widespread in foods Chicken, beef, potatoes, oats, tomatoes, liver, egg yolk, broccoli, whole grains Destruction Easily destroyed by food processing

3/22/2017 Pantothenic Acid Deficiency Symptoms Vomiting, nausea stomach cramps Insomnia, fatigue, depression, irritability, restlessness, apathy Hypoglycemia, increased sensitivity to insulin Numbness, muscle cramps, inability to walk Toxicity Symptoms None reported

3/22/2017 Choline Adequate Intake Men: 550 mg/day Women: 425 mg/day Upper Level Adults: 3,500 mg/day

3/22/2017 Choline Functions Needed for the synthesis of the neurotransmitter acetylcholine and the phospholipids lecithin Food Sources Milk, liver, eggs, peanuts.

3/22/2017 Choline Deficiency Symptoms Liver damage Toxicity Symptoms Body odor, sweating, salivation Reduced growth rate Low blood pressure Liver damage

3/22/2017 Inositol and Carnitine Essentiality Inositol and carnitine can be made by the body, but no recommendations have been established. Research continue s to determine if they may be essential. Availability is widespread in foods.