Transcript PowerPoint

Vitamins
Presented by Erica Frank and Birgit Humpert
KSC Dietetic Interns
What we will do today?
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Define and compare vitamins and
supplements
Discuss various vitamins and their
health benefits
Discuss the need for supplements
Provide information on buying
supplements
Vitamins and other micronutrients
o Needed by our body in small
amounts to grow and function
o Some vitamins are water-soluble,
some are fat-soluble
o Are found in a wide variety of foods
Supplements
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products intended to supplement the diet
include vitamins, minerals, herbs or other
botanicals, amino acids, fatty acids
come as pills, capsules, tablet, or liquids
labeled as "Dietary Supplement" on the front
panel
Enriched and Fortified Food
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to restore nutrients lost during processing
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add nutrients to prevent deficiencies
o both public health policy
o or for commercial/marketing reasons
Vitamin D
Calcium
Phosphorus
Vitamin C
Manganese
Vitamin K
Magnesium
Fluoride
Bone Health
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important for bones but also for muscles,
nerves, and blood clotting
inadequate intake contributes to osteoporosis
(loss of bone mass that leads to weak bones that
easily break)
Needs: 1000-1200 mg
Sources: Dairy, kale, broccoli, Chinese cabbage,
tofu, fish with bones, fortified orange juice or
cereal
don't consume more than 500-600 mg at a time
Calcium
Day 1
1 cup milk 305 mg
1 cup Greek
yogurt
448 mg
1/4 shredded
cheese
204 mg
--------957 mg
Day 2
1 cup soy milk
1 cup oatmeal
1 cup Bok Choy
1 cup white
beans
1 oz. almonds
1 cup canned
salmon
289 mg
26 mg
74 mg
158 mg
82 mg
324 mg
---------953 mg
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the "sunshine" vitamin
important for regulation of blood calcium
levels, muscle and nerve function, and the
immune system
very few foods naturally have vitamin D
Sources: fatty fish, fortified milk, orange juice,
and cereal
who is at risk for deficiency: breastfed infants,
older adults, people with dark skin, people with
malabsorption, obese people
Vitamin D
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usually derived from: mackerel, tuna, salmon, sturgeon,
mullet, bluefish, anchovy, sardines, herring, trout, and
menhaden.
Rich in the omega-3 Fatty Acid of Eicosapentaenoic (EPA)
3.5 ounces of fish=1 gram of omega-3 fatty acid
Docosahexaenoic acid (DHA) also found in fish-important
for proper brain development and function
Heart Healthy
Fish Oil
Toxicity concerns:
• result in a buildup of environmental poisons-i.e.mercury
• using fish oil in combination with blood lowering
medications may result in hypotension
• fish oil combined with blood thinning medications may
result in bleeding by reducing clotting factors
Other Sources Omega-3 Fatty Acids:
flax seeds, green leafy vegetables, nuts, vegetable oils
provide alpha linolenic(ALA)
• ALA=the basic form of omega-3 which the body will
convert to EPA
AI: men=1.6g/day
women=1.1g/day
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important for nerve and blood cells
deficiency leads to anemia, that makes us
feel tired and weak
depends on stomach acid to be digested
older adults and people who don't eat animal
food are at risk for deficiency
only found in animal food
Vitamin B12
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Folate is important to make genetic material
and helps cells divide and grow
especially important to prevent neural tube
defects in babies
RDA: 400 mcg
UL: 1000 mcg
Food sources: green leafy vegetables,
broccoli, asparagus, oranges, nuts, beans,
fortified grain products
Folic Acid
Antioxidants: substances that protect your
cells against free radicals-compounds your
body naturally produces from metabolism
actions, as well as compounds that come
from smoke, pollution, and radiation.
Three major players:
• Vitamin E
• Vitamin C
• Beta-carotene (Vitamin A)
Antioxidants
Minor Players:
• Zinc
• Selenium
• Preventing the growth of lipid (fat) degradation that can
lead to atherosclerosis
• Aids in cell communication
• Protects cell membranes
• Enhances immune response
• Naturally occurs in 8 different chemical forms
o Alpha-tocopherol
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Synthetic Vit E is a mixture of the 8 forms
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Natural sources have 2x the bioavailability
Vitamin E
Deficiency: rare-individuals with malabsorption issues
Toxicity: Supplement taken in >3000 IU have shown
effects such as cramps, diarrhea, fatigue, double vision,
muscle weakness
RDA: Adult: 15 mg/day=22.4 IU
Sources:
• 1 T wheat germ oil=20.3 mg
• 1 cup boiled spinach=1.9mg
• 1 oz sunflower seeds=7.4 mg
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vegetables oils, nuts
UL-1,000 mg/day
• Water Soluble
• Important for collagen structure
• Involved in neurotransmitter synthesis
• Colds?
• Enhance the absorption of
non-heme iron
Vitamin C
Deficiency: scurvy
Toxicity: rare: diarrhea, nausea, stomach cramps
-hemochromatosis
RDA: men: 90 mg/d
women: 75 mg/d
Smokers: 35 mg
UL: 2,000mg/d
• Better absorbed in lower daily intakes
• ascorbic acid = form found in food
Sources:
• 1 cup green peppers=117 mg
• 1 cup strawberries=84 mg
• 1 orange=53 mg
• 1 cup cooked kale=53 mg
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normal vision
immune system
reproduction
growth
bone metabolism
Two forms: preformed and proformed:
o proformed-plant food and supplements= beta-carotene
o preformed=meats, fish, dairy
RDA: men=900 mcg Vit A
women=700 mcg
*no RDA for beta carotene
* Beta-carotene=possibly unsafe
Vit A/Beta-Carotene
Deficiency: rare in the US-common in developing nations
o xerophthalmia=night blindness
Toxicity: dizziness, nausea, headaches, coma, death
• high intake of preformed Vit A in pregnant women may
cause birth defects
UL: 3,000 mcg vitamin A
Sources: dairy, organ meats, fruits and vegetables
• 1 cup sweet potato=16 mg beta carotene
• 1 cup cooked kale=12 mg beta carotene
• 1 cup canned pumpkin=16 mg BC; 1900 mcg Vit A
• 1 cup whole milk ricotta=~350 mcg vit A
Zinc-growth and development, immune response, wound
healing, neurological function and reproduction.
• RDA: Men=11 mg/d; women=8 mg/d
• Sources:red meats, nuts/legumes, whole grains
Selenium-maintains proper function of thyroid gland,
possible anti-cancer effects
• RDA: adults=55 mcg/d
Deficiency seen in China-soil
• Sources: animal meats, dairy
*brazil nuts-544 mcg
Zinc & Selenium
Who needs supplements?
If you are in general good health and eat a variety of foods
based on the Dietary Guidelines, you most likely don't
need supplements.
• Woman who may become pregnant - 400 mcg/day of
folic acid
• Woman who are pregnant - prenatal vitamins that
include iron
• Adults >50 years - eat foods fortified with B12, take a
multivitamin with B12, or B12 supplement
• Others: consume <1600 cal/day, follow special diets,
suffer from malabsorption or digestive issues
• genetic diseases that affect absorption
Paleo: cut out grains, dairy, diets can vary
Vegetarian: no meat based product-may include dairy, eggs,
and/or fish as exceptions
Vegan: strictly no animal products of any kind
Gluten-Free: no wheat, rye, barley
Grain-Free: no grains at all!
Special diets
Check the label - active ingredients,
nutrients includes, serving sizes, % DV
Look at the claims
Health claims,
nutrition content claims,
structure/function claims
What to look for when
buying a supplement
What else?
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Avoid mega-doses
Check Expiration Dates-may lose
potency over time, especially in hot and
humid climates. No date provided?
Don't Buy!
Watch What You Eat
Regulation of Supplements
“manufacturers do not need to register their
products with FDA or get FDA approval
before producing or selling dietary
supplements. Manufacturers must make sure
that product label information is truthful and
not misleading.”
• ConsumerLab.com
• NSF International
• US Pharmacopoeia
Independent evaluation
Finding reliable information
on the internet
• Who operates the site?
• What is the purpose of the site?
• What is the source of the information? Are
there any references?
• Is the information current?
• Does is sound “too good to be true”?
• Am I chasing the latest headline?
Food First!
References:
Dietary Supplements. (2013) U.S. Food and Drug Administration. Retrieved from
http://www.fda.gov/Food/DietarySupplements/
Fortification of food: Historical development and current practices.United Nations University. Retrieved from
http://archive.unu.edu/unupress/food/8F154e/8F154E03.htm
http://www.whfoods.com/genpage.php?tname=nutrient&dbid=111
http://ods.od.nih.gov
http://www.whfoods.com/genpage.php?tname=nutrient&dbid=106
http://www.nlm.nih.gov/medlineplus/druginfo/natural/999.html
National Osteoporosis foundation http://www.nof.org/
Nelms, M., Sucher, K.P., Lacey, K., Roth, S.L. (2011). Nutrition Therapy &
Pathophysiology (2nd ed.). Belmont, CA: Wadsworth
Insel, P. (2011) Nutrition (4th ed.) Sudbury MA: Jones and Bartlett
American Dietetic Association (2009) Position of the American Dietetic Association: Nutrient Supplementation
MedlinePlus www.nlm.nih.gov/medlineplus/druginfo/herb_All.html
National Center for Complementary and Alternative Medicine (NCCAM) http://nccam.nih.gov
Linus Pauling Institute, Oregon State University http://lpi.oregonstate.edu/infocenter/
http://www.fda.gov/Food/DietarySupplements/