fat soluble vitamins by jennifer turley and joan thompson © 2013 cengage
TRANSCRIPT
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Fat Soluble Vitamins
By Jennifer Turley and Joan Thompson
© 2013 Cengage
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Presentation Overview
• Comparison of vitamins in the body.• Diagnosing deficiency and toxicity.• The fat soluble vitamins, A, D, E, K.• Notable health implications.
Chemical Forms. Intake Need. Functions. Deficiency. Toxicity. Food Sources.
Vitamin A Vitamin D
Vitamin E Vitamin K
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Water Soluble: absorbed into blood stream directly, circulate, travel, and stored in watercompartments, excrete in urine, without intake deficiency signs and symptoms occur more quickly, toxicity is possible though shorter lived when intake is normalized.
Fat Soluble: absorbed into lymph, many require protein carriers, associate with fat, not readily excreted, without intake deficiency signs and symptoms occur more slowly, toxicity is possible and longer lived even when intake is normalized.
Thiamin
Riboflavin
Niacin
B6
B12
Folate
Vitamin C
Pantothenic Acid
Biotin
Choline
Vitamin A Vitamin DComparison of
Vitamins in the BodyVitamin E
Vitamin K
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1. Dietary records: Demonstrate low/high intake and/or confirm a metabolic or physiological problem that creates an altered need.
2. Clinical deficiency or toxicity symptoms: Are compatible with low/high dietary intake or altered need.
3. Biochemical tests: Such as blood levels, tissue levels & urine levels demonstrate low/high body levels of the nutrient.
4. Nutrient supplementation: Serves as biological evidence by correcting the deficiency signs & symptoms. For toxicity, removal of the excess.
Diagnosing Nutritional Deficiencyor Toxicity
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The Fat Soluble Vitamins
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Vitamin A Chemistry
• A family of compounds including: – Retinol, Retinal, Retinoic acid– Pro-Vitamin A carotenoids like beta-carotene
Retinyl Esters(animal foods)
Beta-Carotene(plant foods)
Retinal(vision)
Retinol(reproduction)
Retinoic Acid(Growth Regulator)
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Vitamin A Functions• Vision• Internal & external
surface linings (epithelial cells)
• Growth• Reproduction• Embryonic development• Gene expression• Immune function• Provitamin A forms
have antioxidant properties
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Vitamin A Deficiency vs Toxicity
Deficiency(<66% of DRI)
Approx. <500 µg RE/day
Adequacy DRI: 700-900 µg RE/day
RDI: 5,000 IU
Toxicity (>UL)
>3,000 µg RE/day
Hypovitaminosis A Bone & tooth: Impaired growthCentral Nervous System: Night blindness, complete blindness (Xerophthalmia)GI System: DiarrheaImmunity: Depressed immunity, moreinfectionsSkin: Hyperkeratosis (thickened skin)
Normal vision, gene expression, reproduction, embryonic development,
epithelial cell maintenance, growth, and
immune function
Bone & tooth: Decreased bone mineral densityCentral Nervous System: Headache, vertigoGI System: Nausea and vomiting, liver abnormalitiesNeuro-Muscular: IncoordinationSkin: orange color with excess beta-caroteneOther: Retinoid embryopathy
Adult deficient, adequate, toxic values
25 mg beta-carotene (pro-
vitamin A is safe to take daily if you
are not a smoker or drinker).
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Vitamin A: Food Sources
• Retinol: (animal)• Fortified milk, cheese, butter, margarine • Eggs• Liver • Beta-Carotene: (Plant)• dark green leafy vegetables• broccoli, deep orange fruits, & vegetables
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Vitamin A in Foods
Adult DRI: 700-900 µg RE/day
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Vitamin D ChemistrySynthesis & Functions
REGULATES Ca-P Balance
• Increases bone mineralization
• Increases intestinal absorption of calcium
• Increase phosphorus excretion
AntiproliferativeProdifferentiation
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Vitamin D Deficiency vs Toxicity
Deficiency(<66% of DRI)
Approx. <3 µg/day
Adequacy DRI: 15 µg/day
RDI: 400 IU = 6.5 µg
Toxicity (>UL)
>50 µg/day
Rickets (children)Osteomalacia (adults)Bone & tooth: poor growth, bowed legs, soft bones, pigeon chest, knocked knees, and malformed teeth in children. Porous bones in adults.Cardio-Vascular:increased circulating levels (PTH) and (AlkP) and decreased circulating levels of serum phosphorus GI System: Decreased calcium absorption
Normal calcium and
phosphorus balance and
cell metabolism
Hypervitaminosis D characterized by high levels of 25(OH)D from supplementationCardio-Vascular: High blood calciumCentral Nervous System: WeaknessGI System: Nausea, vomiting, anorexiaOther: Kidney stones, increased thirst, urination, and urinary calcium
Adult deficient, adequate, toxic values
Needs are based upon an inadequate
exposure to sunlight.
Sunlight not implicated in
toxicity.
There is an
epidemic of vita
min
D deficiency
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Vitamin D: Sources
• Fortified products like milk, margarine, & some cereals
• Eggs & fatty fish• Self-synthesis with unprotected
peak sunlight exposure
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Vitamin D in Foods
Adult DRI: 15 µg/day
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Vitamin E Chemistry
• A family of alpha, beta, gamma, delta tocopherols & tocotrienols.
• Alpha-tocopherol is believed to be the most active form.
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Vitamin E Functions
And at the molecular level
And at the molecular level
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Vitamin E Deficiency vs Toxicity
Deficiency(<66% of DRI)
Approx. <10 mg/day
Adequacy DRI: 15 mg/day
RDI: 30 IU
Toxicity (>UL)
>1,000 mg/day
Premature infants: hemolytic anemiaAdults: not well characterized
Normal cell membrane
integrity, reduced oxidative stress, and molecular
functioning
Relatively nontoxicToxicity with supplements
Interferes with vitamin K’s role in
blood clotting, augmentation of
anti-blood clotting medication and
increases hemolysis
Adult deficient, adequate, toxic values
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Vitamin E: Food Sources• Nuts• Seeds• Plant oils• Wheat germ• Fortified cereals• Vegetables
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Vitamin E in Foods
Adult DRI: 15 mg/day
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Vitamin K Chemistry• Phylloquinone (K1) from plant sources &
naphthaquinones (K2, multiple forms) from animal sources & gut bacteria.
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Vitamin K Deficiency vs Toxicity
Deficiency(<66% of DRI)
Approx. <60 µg/day
Adequacy DRI: 90-120 µg /day
RDI: 90 µg
Toxicity (>UL)
Not Determined
Cardio-Vascular:Increases clotting time, hemorrhaging with cut or injury
Normal blood clotting & bone
metabolism
Poorly described in adults
GI System: High levels from supplemented menadione causes jaundice and liver damage in infantsCardio-Vascular:Interference with anti-blood clotting medication
Adult deficient, adequate, toxic values
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Vitamin K: Sources• Green leafy & cruciferous
vegetables• Soybeans• Some plant oils
Vitamin K is made by bacteria in the gastrointestinal tract
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Vitamin K in Foods
Adult DRI: 90-120 µg/day
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Summary
• Diagnosing & confirming a nutrient deficiency or toxicity requires a diet analysis, clinical evaluation, biochemical analysis, & evaluating the response to corrected intake levels.
• Toxicities and deficiencies take longer to develop for fat soluble vitamins as compared to water soluble vitamins.
• The fat soluble vitamins are grouped by their solubility in oil.• The fat soluble vitamins have specific chemical forms &
functions in the body.• DRIs exist for essential fat soluble vitamins: A, D, E, & K.• Deficiency & toxicity signs & symptoms are unique for each of
these nutrients as are their food sources.
References for this presentation are the same as those for this topic found in module 5 of the textbook