Transcript Vitamin and Mineral Deficiencies and Toxicities

Water Soluble Vitamins
By Jennifer Turley and Joan Thompson
© 2013 Cengage
Presentation Overview
• Explore chemistry, functions, deficiency,
adequacy, toxicity, and food sources of the
water soluble vitamins: thiamin, riboflavin,
niacin, B6, B12, folate, vitamin C,
panthothenic acid, biotin, and choline.
Thiamin: B1
Chemistry & Functions
• Enzyme cofactor in energy metabolism:
Carbohydrate & BCAA.
– B1 functions as the active group of thiamin pyrophosphate (TPP).
• Supports normal appetite & nervous system
function.
Thiamin: B1
Deficiency & Toxicity
Deficiency
Adequacy
(<66% of DRI)
Approx. <0.8 mg/day
DRI: 1.1-1.2 mg/day
RDI: 1.5 mg
Beriberi (wet and dry)
Cardio-Vascular: Heart rhythm changes
Central Nervous System: Mental changes,
confusion, amnesia, disturbed eye movement
GI System: Nausea, anorexia
Neuro-Muscular: Muscle weakness, tingling hands
and feet
peripheral paralysis, decreased ability to
coordinate motor movement, disturbed gait
Other: Edema, exhaustion, weight loss
Normal energy
(Glucose & BCAA)
metabolism. Normal
appetite and nervous
system functioning.
DRI is based upon
0.5 mg B1 per 1,000
Calories
Adult DRI values
Toxicity is poorly documented in humans
(UL is Not Established)
Thiamin: B1
Food Sources
• Pork
• Whole grains
• Enriched bread and cereal
products
It is added back by law to
processed grains
Thiamin in Foods
Adult DRI: 1.1-1.2
mg/day
Riboflavin: B2
Chemistry & Functions
• Enzyme cofactor in energy metabolism: fatty
acid oxidation.
– B2 functions as the active group of two coenzymes flavin
mononucleotide (FMN) and flavin adenine dinucleotide
(FAD).
Riboflavin: B2
Deficiency & Toxicity
Deficiency
Adequacy
(<66% of DRI)
Approx. <0.85 mg/day
DRI: 1.1-1.3 mg/day
RDI: 1.7 mg
Ariboflavinosis
Bone & tooth: Halts growth
GI System: Sore and swollen
throat, swollen magenta colored
tongue, cracking at the corners
of the mouth
Skin: Dandruff
Normal fatty acid
metabolism
DRI is based upon
0.6 mg B2 per 1,000
Calories
Adult DRI values
Toxicity is poorly documented in humans
(UL is Not Established)
Riboflavin: B2
Food Sources
• Milk products
It is added back by law
into processed grains
• Organ meats
• Whole and enriched grains
and products such as
bread, cereal, and pasta
Riboflavin in Foods
Adult DRI: 1.11.3 mg/day
Niacin: B3
Chemistry & Functions
1 niacin equivalent (NE) = 1 mg nicotinic acid.
60 mg tryptophan can produce 1 NE.
• Enzyme cofactor in energy metabolism: amino acids, fatty
acids, and glucose
– A part of nicotinamide adenine dinucleotide (NAD) and nicotinamide
adenine dinucleotide phosphate (NADP).
– Supports steroid synthesis, health of the skin, nervous system, and
digestive system.
Niacin: B3
Deficiency & Toxicity
Deficiency
Adequacy
Toxicity
(<66% of DRI)
Approx. <9-11 mg/day
DRI: 14-16 mg/day
RDI: 20 mg
(>UL)
>35 mg/day
Pellegra
Central Nervous System:
Depression, apathy,
headache, dementia
(including memory loss).
GI System: Bright red
tongue, diarrhea (GI
disturbances of vomiting,
diarrhea, and constipation)
Skin: Dermatitis
Other: Fatigue
Normal energy
metabolism &
steroid
synthesis.
Not from food but
rather nicotinic acid
supplements
Cardio-Vascular:
Violent flushing
reaction from
vasodilation
DRI is based upon
Central Nervous
6.6 mg B3 per 1,000
System: Blurred
Calories
vision
Adult deficient,
GI System: Nausea,
adequate, toxic values
vomiting, liver toxicity
Niacin: B3
Food Sources
It is added back by law
into processed grains
• Meats, fish, poultry
• Whole & enriched grains & products
• Bread, cereal, & pasta
• Dairy products & legumes are good sources
of tryptophan
Niacin in Foods
Adult DRI: 1416 mg/day
Vitamin B6
Chemistry & Functions
• B6 forms (PN, PL, PM, PNP, PLP, PMP) are coenzymes in
the metabolism of amino acids, glycogen, and some lipids.
• Interconversion of amino acids (AA) to carbohydrate or
carbohydrate to nonessential AA.
– Removal of N from AA: “deamination” & "transamination"
• Needed for heme synthesis & conversion of tryptophan to
niacin.
Vitamin B6
Deficiency & Toxicity
Deficiency
Adequacy
Toxicity
(<66% of DRI)
Approx. <0.85 mg/day
DRI: 1.3 mg/day
RDI: 2 mg
(>UL)
>100 mg/day
Cardio-Vascular:
Normal metabolism
Microcytic anemia
of amino acids,
Central Nervous System:
glycogen, and
confusion, depression,
some lipids. Normal
epileptic convulsions
heme synthesis &
Skin: Seborrheic (greasy)
conversion of
dermatitis
tryptophan to
niacin.
Not from food but
rather large
supplement doses
Neuro-Muscular:
Nerve damage,
sensory neuropathy,
tingly to numb hands
and feet
Skin: Dermatological
lesions
DRI is based upon 0.016 mg of B6 per gm pro consumed
Adult deficient, adequate, toxic values
Vitamin B6
Food Sources
•
•
•
•
•
Meats, Fish, Poultry
Fortified cereals
Legumes
Non-starchy vegetables
Non-citrus fruits
Vitamin B6 in Foods
Adult DRI: 1.3 mg/day
Vitamin B12
Chemistry & Functions
• Required for nucleic acid, red blood
cell & other new cell synthesis.
• Important for nerve cell maintenance.
• Cofactor in energy fatty acids & amino
acids metabolism
• Conversion of homocysteine to
methionine.
• Synergizes with folic acid.
Vitamin B12
Interesting Facts
• Needs intrinsic factor (a protein produced in
the stomach) and gastric acid.
• Is absorbed in the ileum.
• If the GI tract is not healthy, B12 must be
given by intramuscular injection.
• Nasal spray B12 supplements are available.
• With high dietary intakes, the excess can
be stored accumulatively in the liver.
Vitamin B12
Deficiency & Toxicity
Deficiency
Adequacy
(<66% of DRI)
Approx. <0.85 µg/day
DRI: 2.4 µg/day
Pernicious anemia.
Macrocytic normochromic anemia, compounded with
nerve damage.
Central Nervous System: Loss of concentration,
memory loss, disorientation, dementia, visual
disturbances
GI System: Impaired bowel (increased gas production &
constipation), sore tongue & loss of appetite
Neuro-Muscular: Nerve damage, gait disturbances,
tingling & numbness in the hands & feet
Other: Insomnia, impotency, reduced bladder control
Normal synthesis of
nucleic acids and new
cells, nerve cell
maintenance, fatty
acid and amino acid
metabolism, and
homocysteine
catabolism.
Normal synergy with
folate
RDI: 6 µg/day
Toxicity is poorly documented in humans
(UL is Not Established)
Adult deficient, adequate values
Vitamin B12
Food Sources
• Animal food sources: eggs,
milk, cheese, meats.
• Since it is commonly found
in animal products, vegans
need to supplement this
nutrient.
Vitamin B12 in Foods
Adult DRI: 2.4 µg/day
Folate, Folic Acid
Chemistry & Functions
•
•
•
•
Nucleic acid synthesis, new cell synthesis
Cofactor in amino acid metabolism
Conversion of homocysteine to methionine
Synergizes with B12
Folate
Deficiency & Toxicity
Deficiency
Adequacy
(<66% of DRI)
Approx. <260 µg/day
DRI: 400 µg/day
Cardio-Vascular: Macrocytic
normochromic anemia, heart
palpitations, shortness of breath
Central Nervous System: Weakness,
fatigue, decreased concentration,
irritability, headache
GI System: Red tongue
Normal nucleic acid
synthesis, new cell formation,
amino acid metabolism,
conversion of homocysteine
to methionine, synergy with
B12.
RDI: 400 µg/day
Hyperhomocysteinemia (heart disease risk)
In utero deficiency can cause Spina Bifida.
Toxicity is poorly documented in humans
(UL is >1000 µg/day)
Adult deficient, adequate, toxic values
Folate
Food Sources
• Raw leafy green vegetables &
green vegetables
• Legumes, oranges, liver, brewer’s
yeast, wheat germ, and some
fortified cereals
Folate in Foods
Adult DRI: 400 µg/day
Vitamin C
Chemistry & Functions
• Required for collagen synthesis
needed in skin, bones, teeth, blood,
epithelial tissue, tendons &
ligaments.
• Cofactor for carnitine &
neurotransmitter synthesis.
• Water soluble antioxidant
• Increases absorption of non-heme
iron
Vitamin C
Deficiency & Toxicity
Deficiency
Adequacy
Toxicity
(<66% of DRI)
Approx. <50-60 mg/day
DRI: 75-90 mg/day
(>UL)
>2000 mg/day
Scurvy
Central Nervous System:
Weakness, fatigue,
depression
GI System: Swollen red
bleeding gums
Skin: Follicular
hyperkeratosis, petechia,
easy bruising, impaired
wound healing
Other: Joint pain, edema,
coiled hairs
RDI: 60 mg/day
Normal collagen
synthesis &
connective tissue
formation.
Normal carnitine,
neurotransmitter,
and water soluble
antioxidant function
GI System:
Gastrointestinal
disturbances
especially diarrhea
Other: Increased
risk for kidney
stones and iron
toxicity only in
certain people
Adult deficient, adequate,
toxic values
Smokers need +35 mg/day
Vitamin C
Food Sources
• Citrus fruits, berries, kiwi, and melons
• Cabbage family vegetables, peppers,
• Vitamin C fortified foods
Vitamin C in Foods
Adult DRI: 75-90 mg/day
Pantothenic Acid
Chemistry, Functions, & Food Sources
• Essential component in Coenzyme A which is
involved in metabolism of fatty acids, cholesterol,
steroid hormones, vitamins A and D,
neurotransmitters, amino acids, & porphyrin &
corrin rings.
Pantothenic Acid
Deficiency & Toxicity
Deficiency
Adequacy
(<66% of DRI)
Approx. <3.3 mg/day
DRI: 5 mg/day
Central Nervous System: Fatigue,
apathy, irritability, restlessness
GI System: Nausea, vomiting,
abdominal cramps
Neuro-Musccular: Muscle cramps,
impaired gait
Other: Burning feet, sleep
disturbances, hypoglycemia, and
increased insulin sensitivity
Normal coenzyme A activity &
metabolism of fatty acid,
cholesterol, steroid hormones,
vitamins A and D,
neurotransmitters, amino
acids, and porphyrin and
corrin rings
Toxicity is poorly documented in humans
Adult deficient, adequate values
(UL is Not Established)
Pantothenic Acid in Foods
Widely distributed in food, highest in high protein animal
products, yeast, legumes, and whole grains
Adult DRI: 5 mg/day
Biotin
Chemistry, Functions, & Food Sources
• Coenzyme in carboxylation reactions in energy metabolism.
• Cell proliferation, gene silencing, & DNA repair.
• Widespread in foods, highest in high protein animal
products, yeast, legumes, nuts, whole grains, & chocolate.
• Small amounts made by intestinal bacteria.
Quantitative data unavailable
for graphical analysis
Biotin
Deficiency & Toxicity
Deficiency
Adequacy
(<66% of DRI)
Approx. <3.3 mg/day
DRI: 30 µg/day
Central Nervous System:
Lethargy, depression,
hallucinations, weakness, fatigue
Neuro-Muscular: Muscle pain
Skin: Scaly red rash around the
eyes, nose and mouth
Other: Conjunctivitis, hair loss
Normal energy
metabolism, cell
proliferation, gene
silencing, and DNA
repair
Toxicity is poorly documented in humans
(UL is Not Established)
Adult deficient, adequate, toxic values
Choline
Chemistry & Functions
• Is a component of the neurotransmitter acetylcholine, thus
plays a role in memory and muscle control.
• Is in the phospholipid, lecithin (phosphatidlycholine) which
is needed to maintain cell membrane stability.
• Needed for lipid and cholesterol transport and
metabolism, component of pulmonary surfactant
• Is in bile acids
Choline
Deficiency & Toxicity
Deficiency
Adequacy
Toxicity
(<66% of DRI)
Approx. <280-360
mg/day
DRI: 425-550 mg/day
(>UL)
>3,500 mg/day
Normal
acetylcholine, cell
membrane stability,
bile acids, lipid and
cholesterol transport
and metabolism,
pulmonary
surfactant
Cardio-Vascular:
Hypotension
GI System: Altered
liver function,
increased salivation
Other: Fishy body
odor
GI System:
Fatty liver and
liver damage
Adult deficient, adequate, toxic values
Choline
Food Sources
• Egg yolk, soy beans, peanuts
• High protein animal products
Quantitative data unavailable
for graphical analysis
Summary
• The water soluble vitamins have specific
functions.
• DRIs are established for all essential
water soluble vitamins.
• Deficiency and toxicity sign and
symptoms are established for most of
these nutrients.
References for this presentation are the same as those
for this topic found in module 5 of the textbook