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The Vitamins

The Vitamins. David L. Gee, PhD Professor of Food Science and Nutrition Central Washington University FCSN 245 - Basic Nutrition. Dietary Supplement Use (USA). $ 4,300,000,000 for vit/min in 1995 $ 1,400,000,000 for herbs 35-40% adults regular users females > males 66% multi-vit/min

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The Vitamins

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  1. The Vitamins David L. Gee, PhD Professor of Food Science and Nutrition Central Washington University FCSN 245 - Basic Nutrition

  2. Dietary Supplement Use (USA) • $ 4,300,000,000 for vit/min in 1995 • $ 1,400,000,000 for herbs • 35-40% adults regular users • females > males • 66% multi-vit/min • 37% vitamin C • 19% vitamin E • Calcium supplements

  3. Dietary Supplement Use: Pros • Supplements dietary deficiencies • calcium • folic acid • Amounts used in some studies not attainable with dietary sources • antioxidants • Relatively low cost

  4. Dietary Supplement Use: Cons • False sense of security • folic acid and pregnancy • Does not contain all potentially useful chemicals in foods • Example: compounds found in plants that may be health promoting (phytochemicals) • Toxicity almost only due to supplement use • Costs significant • low income • Heavy users of supplements (athletes) • Certain supplements are expensive • Chondroitin sulfate – bone/cartilage: $30-50/mo • SAMe – depression: $40-50/mo

  5. Exam 3 – Tuesday, March 6 • Proteins and Amino Acids (chap 6) • EAA, RDA, functions, athletes • Genetically modified foods (p 472-480) • Vegetarian diets • Protein quality • Protein deficiency (kwashiorkor/marasmus) • Energy and Weight Loss (chap 9) • Energy, TEE, BMR, factors affecting BMR, activity, TEF • Calorimeters (bomb, direct, indirect) • Weight loss, obesity risks, QOL, prevalence, high risk groups • Healthy weight, assessment • Calculate BMI, know cutpoints for blood pressure, sugar, lipids • Dietary approaches (Balanced, Lo-Carb, restrained CHO, non-diet • Exercise • Drugs/Surgery

  6. Vitamin & Mineral Deficiency:A Global Progress Report UNICEF, 2004 • 80 developing countries studied • Accounts for 80% of world population • 1/3rd of world population do not reach their physical and intellectual potential because of vitamin/mineral deficiency

  7. Vitamin & Mineral Deficiency:A Global Progress Report UNICEF, 2004 • Vitamin A deficiency • 40% of children <5yrs with mild to severe deficiency • Compromised immune deficiency • blindness • stunted growth • Contributes to 1 million deaths of young children/yr • A Solution: supplementation with beta-carotene, 2x/yr, fortification of foods

  8. Vitamin & Mineral Deficiency:A Global Progress Report UNICEF, 2004 • Iodine deficiency • Goiter: enlarged thyroid gland, lethargy • Cretinism: severe mental and physical retardation in infants of deficient mothers • Reduces IQ by 10-15 points • 80% of developing countries have goiter rates of > 10% • A Solution: iodized salt (use declined from 75% to 65% in last decade!)

  9. Woman with iodine deficiency resulting In a goiter. Myxedematous endemic cretinism in the Democratic Republic of Congo : Four inhabitants aged 15-20 years : a normal male and three females with severe longstanding hypothyroidism with dwarfism, retarded sexual development, puffy features, dry skin and hair and severe mental retardation.

  10. Vitamin & Mineral Deficiency:A Global Progress Report UNICEF, 2004 • Iron deficiency • Anemia: fatigue, apathy in adults, poor academic performance in children (7-10pt drop in IQ) • ~45% of children between 6mo-2 yrs • 20 countries over 70% • A solution • Supplementation (bad taste, constipation) • Fortification • Salt with iodine and iron • Vitamin/mineral mixes added to foods • Fortified foods

  11. The Discovery of Vitamins • The Germ Theory of Disease • Scurvy: Disease of sailors • Beri-Beri: Disease of poor Asians

  12. The Discovery of Vitamins • The Germ Theory of Disease • Rickets: Disease of poor Northern European children • Pellagra: Disease of poor corn eating cultures

  13. The Discovery of Vitamins • The Vitamin Theory of Disease • Scurvy: Disease of sailors • Vitamin C deficiency • Beri-Beri: Disease of poor Asians • Thiamin deficiency • Rickets: Disease of poor Northern European children • Vitamin D deficiency • Pellagra: Disease of poor corn eating cultures • Niacin deficiency

  14. Vitamins: Definition • Organic compound found in foods • Required in small amounts • Required in the diet (dietary essential) • Proven to be required for health, growth, and reproduction • deficiency syndrome identified

  15. Vitamin Nomenclature • Fat soluble “A” & Water soluble “B” • “Vital amines” • vitamines = vitamins • Vitamin B “complex” • collection of water soluble vitamins that function as enzyme co-factors • Vitamin C • Vitamins D and E • Mistaken Vitamins

  16. Fat and Water Soluble Vitamins • Fat Soluble Vitamins (A, D, E, K) • Soluble in lipids and solvents • Excess stored and not excreted • Excess may be toxic • Deficiency slow to develop

  17. Fat and Water Soluble Vitamins • Water Soluble Vitamins • B vitamins, C • Soluble in water • excess excreted in urine, little stored • generally less toxic • deficiency develops quickly

  18. General Functions of Vitamins • Hormones • Vitamin D • calcium homeostasis • Vitamin A • cell division and development

  19. General Functions of Vitamins • Non-specific chemical reactions • Vitamin E • antioxidant • Vitamin C • chemical reducing agent

  20. General Functions of Vitamins • Coenzymes or Cofactors • chemicals that assist enzymes to function as catalysts • B vitamins • Vitamin C, A, K

  21. Vitamin A: types and sources • Retinoids • retinol, retinal, retinoic acid • animal foods, milk fortification • Carotenoids • beta-carotene • plants • vitamin A precurser

  22. Vitamin A: functions • Visual pigment: rhodopsin • “night blindness” • Maintenance of epithelial cells • regulation of keratin protein synthesis • Xeropthlamia • intestinal malabsorption • Bone and Immune System Development

  23. Vitamin A: Deficiency • Common in developing countries • 3 million children with severe deficiency • blindness, poor growth and appetite • 275 million children with mild deficiency • impaired immunity

  24. Vitamin A: Toxicity • 10 times RDA chronically • 100 times RDA acute dose • hair loss, joint pain, birth defects • carotenoids are non-toxic • toxicity due to vitamin supplement overdose

  25. Vitamin D: Types and Sources • Dietary sources: animal foods, fortified milk • Human Synthesis of Vitamin D • Skin: cholesterol + sunlight • “Sunshine Vitamin” – UV-B rays • Vitamin D3 • 5-10 minutes, arms and legs, mid-day sun • Liver & Kidney for activation • 1,25-di-OH-D3

  26. Final Exam – Winter 2007 • Tuesday, March 15, noon • 25% vitamins and minerals • Lecture materials • General info on vitamins/minerals • Developing world vitamin/mineral deficiencies • Required reading • Chapter 7 (vitamin C ; vitamin A/carotenoids ) • Chapter 8 (nutrients involved in bone health) • Chapter (iron ; folate & B-12 )

  27. Final Exam – Winter 2006 • 75% comprehensive • “questions that you should know the answers to one or two years from now.” • Study class notes • Review old exams

  28. Vitamin D: Functions • Helps regulate blood calcium levels • When blood calcium levels are low, vitamin D (and other hormones): • Increases dietary calcium absorption • Decreases urinary calcium excretion • Increases bone calcium mobilization

  29. Vitamin D: Deficiency • Rickets • bone deformities in children • Osteomalacia • weak bones due to low calcium content • Vitamin D deficiency • Calcium deficiency • multiple pregnancies

  30. Vitamin D: Toxicity • 5 times the RDA chronically • calcification of soft tissue • toxicity due to excessive vitamin supplementation

  31. Calcium • Functions • Bone Structure (99%) • Regulator of Metabolism (1%) • nerve impulse transmission • muscle contraction • blood clotting • etc.

  32. Calcium • Regulation of Blood Calcium • 10 mg/dl of blood • hypocalcemia & hypercalcemia • abnormal muscle cramping • nerve irritation • Controlled by: • vitamin D, parathyroid hormone, calcitonin

  33. Calcium RDA • 1998 RDA’s (AI) • 1300 mg/d : children & teens • 1000 mg/d : adults • 1200 mg/d : older Americans • Usual intakes are low

  34. Osteoporosis • Brittle, weak bones due to loss of total bone mass (minerals and protein) • Prevalence • 11% of > 65 yrs • 22% of > 65 yrs in 20 yrs • 24 million fractures/yr • 200,000 hip fractures, 1/6 fatal

  35. 3D Visualization of data obtained by x-ray microtomography of the bone structure of the vertebrae of a 50 year old (left) and a 70 year old (right)

  36. This graph shows rates in the USA in 1984-87, adapted from Jacobsen, SJ in American J Public Health 80:872, 1990.

  37. An illustration of the consequence of osteoporosis on the spinal column.

  38. Elderly woman with dowagers hump, a marked abnormal curving of the spine caused by osteoporosis

  39. Other osteoporosis fact:National Osteoporosis Foundation - 2003 • 10 million with osteoporosis • 18 million with low bone density • 1 in 2 women will develop osteoporosis sometime in their life • (1 in 8 men)

  40. Osteoporosis • Risk Factors • Genetics • Family History • Ethnicity • Caucasian > Asian > Blacks

  41. Osteoporosis • Risk Factors • Gender • associated with declines in estrogen production • post-menopause • anorexia, female athletes

  42. Undertreatment of Osteoporosis in Men with Hip Fracture.Arch. Int. Med. (Oct. 2002) • 10 million Americans with osteoporosis • 2 million are men • Of 110 men hospitalized with hip fracture • 4.5% received treatment for osteoporosis • 1 year mortality was 32% • Average age 80 yrs • Of 253 women hospitalized with hip fracture • 27% received treatment for osteoporosis • 1 year mortality was 17% • Average age 81 yrs

  43. Osteoporosis • Risk Factors • Chronic Calcium Deficiency • Lack of Exercise

  44. Prevention of Osteoporosis • Exercise • Dietary Calcium • “Rule of 300” • 300 mg/d from plant sources • 300 mg/d from each serving of dairy

  45. Prevention of Osteoporosis • Other factors that may increase calcium loss • high caffeine intake • high protein intake • high alcohol intake • cigarette smoking

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