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Nutrition 1 (Semester I) > 8a. Vitamins - Fat Soluble > Flashcards

8a. Vitamins - Fat Soluble Flashcards

1
Q

Who coined the phrase ‘vitamines’?

A

Casimir Funk

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2
Q

What is a vitamer?

A

Different chemical forms of each vitamin

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3
Q

How many vitamins are there?

A

13

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4
Q

What are the key functions of vitamins?

A 
Supporting immune system
Regulating gene expression
Supporting neurological activity
Facilitating ATP production
Producing blood cells
Regulating hormones
Facilitating physiological functions
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5
Q

What are vitamins?

A

Carbon containing compounds that are essential to the body in small amounts for normal growth and function

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6
Q

In general, can the body produce vitamins?

A

No (except vit D)

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7
Q

Do supplements offer the same therapeutic advantages as consuming them in food?

A

No, as the vitamins need to work as part of a team

They can’t work in isolation

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8
Q

What are vitamins co-factors for?

A

Vitamin-dependent enzymes

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9
Q

Which are the fat-soluble vitamins?

A

A
D
E
K

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10
Q

How are fat-soluble vitamins absorbed?

A

With fat in the small intestine
Travel into the lymphatic capillaries
Then into the blood

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11
Q

Which are the water-soluble vitamins?

A

Bs

C

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12
Q

How are water-soluble vitamins absorbed?

A

In the small intestine directly into the blood

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13
Q

Which type of vitamins are more easily excreted?

A

Water-soluble

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14
Q

What’s the easiest way to maintain levels of water-soluble vitamins?

A

Little and often throughout the day

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15
Q

What is vitamin insufficiency?

A

Sub-clinical deficiency

Vague symptoms

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16
Q

What is vitamin deficiency?

A

Clinical signs and symptoms

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17
Q

How does vitamin insufficiency progress to vitamin deficiency?

A
  1. Preliminary reduction of stores
  2. Reduction in enzyme activity
  3. Physiological impairment (early signs and symptoms)
  4. Classical deficiency syndromes
  5. Terminal tissue pathology
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18
Q

Which vitamins are people more likely to be deficient in?

A

Vit B12

Vit D

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19
Q

What are the vitamers/active forms of vit A?

A

Retinol
Retinal
Retinoic Acid

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20
Q

What does retinol support?

A

Retina health

Vision

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21
Q

What does retinal support?

A

Rod and cone cells in retina

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22
Q

What does retinoic acid support?

A

Growth and differentiation of epithelial cells

Skin health

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23
Q

What is pro-vitamin A?

A

Precursor to the active form of vit A (retinol)

Found in non-animal foods

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24
Q

Where is pro-vitamin A converted into retinol?

A

SI

Liver

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25
Q

What is carotene?

A

An example of pro-vitamin A

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26
Q

What is pre-formed vit A?

A

Active form of vit A (retinol) that is ready to use by the body
Found in animal foods

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27
Q

Examples of vit A food sources

A 
Mango
Squash
Sweet potato
Carrots
Spinach
Egg yolks
Fish oils
Liver
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28
Q

Why are dietary carotenes not considered toxic?

A

They’re only converted to vit A as and when needed

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29
Q

What percentage of carotenes are absorbed in the small intestine?

A

Between 5-60%

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30
Q

What is needed in a meal to optimise the absorption of carotenes?

A

Healthy fats

Lightly steamed

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31
Q

Which gene is needed to convert carotenes to retinol in the SI/liver?

A

BCO1

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32
Q

What can reduce carotene conversion in the SI/liver?

A

Liver disorders
Hyperlipidaemia
Diabetes
Hypothyroidism

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33
Q

What can excessive intake of carotenes lead to?

A

Yellowing of skin

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34
Q

What percentage of pre-formed vit A is absorbed by the SI/liver?

A

70-90%

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35
Q

Functions of vit A

A 
Reproduction
Eye health
Differentiation of cells
Immunity
Systemic immunity
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36
Q

What are the reproductive functions of vit A?

A

Sperm synthesis

Egg development and implantation

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37
Q

What are the eye health functions of vit A?

A

Required for the light-sensitive protein (rhodopsin) that converts light into an electrical signal that goes into the brain (creating an image)

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38
Q

What are the cell differentiation functions of vit A?

A

Regulating gene expression

Synthesis of glycoproteins that support bone, teeth and skin development

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39
Q

What are the immunity functions of vit A?

A

Supports first line of defence
(skin and mucous membrane barrier)
T-cell proliferation
IL-2 secretion

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40
Q

What are the systemic immunity functions of vit A?

A

AO properties

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41
Q

What are the therapeutic uses of vit A in reproduction?

A

Infertility

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42
Q

What are the therapeutics uses of vit A in eye health?

A

Photosensitivity
Visual loss
Night blindness
Senile cataracts

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43
Q

What are the therapeutic uses of vit A in cell differentiation?

A 
Acne
Anaemia
Hair loss (women)
Fracture repair
OA
GIT ulceration
Periodontal disease
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44
Q

What are the therapeutic uses of vit A in immunity?

A

Recurrent infections

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45
Q

What are the therapeutic uses of vit A in systemic immunity?

A

Cancer prevention

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46
Q

What are the signs/symptoms of a vit A deficiency?

A 
Vision impairment at night
Hyperkeratosis of skin
Acne
Eczema
Poor wound healing
Poor bone growth
Poor sense of taste/smell
Lowered immunity
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47
Q

What states/conditions can affect the absorption of vit A?

A

Alcoholism
Poor gut health
Conditions that affect fat absorption
Zinc deficiency

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48
Q

Why is it important to optimise the intake of zinc-rich foods?

A

Required to make retinol binding protein

Without that, vit A is trapped in the liver and can’t be used

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49
Q

What is the function of retinol binding protein?

A

Moves vit A out of storage in the liver to the tissues for utilisation

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50
Q

What conditions can vit A toxicity lead to?

A

Birth defects
Dry, red scaling skin
Increased osteoclast activity/bone fractures
Damage to liver cells, causing liver disease
Hyperlipidaemia
Amenorrhoea

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51
Q

When taking which drug should you avoid vit A supplementation?

A

Warfarin

decreases vit K absorption, increasing bleeding risk

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52
Q

What are the two types of vit D?

A

Ergocalciferol D2 - plants

Cholecalciferol D3 - animals

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53
Q

Examples of vit D food sources

A

Mushrooms
Oily fish
Egg yolks

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54
Q

Where can we get vit D from other than food?

55
Q

Can vit D be used directly?

A

No, it has to be converted first

hydroxylated

56
Q

Where is vit D stored and activated?

A

Liver

Kidneys

57
Q

What is the active form of vit D called?

A

1,25-Calcitriol

58
Q

What is the optimal range for vit D?

A

75-125 nmol/L

59
Q

What vit D serum amount is considered to be deficient?

A

Below 25 nmol/L

60
Q

When are vit D serum levels usually at their highest and lowest?

A

Highest - end of summer

Lowest - end of winter

61
Q

How long can vit D be stored in the liver for?

62
Q

Which version of vit D is favoured for supplementation?

A

D3
More potent
Stays in circulation longer

63
Q

What are the functions of vit D?

A 
GIT health
Anti-cancer
Bone health
Immunity
Insulin
64
Q

What are the GIT functions of vit D?

A

Vit D receptor (VDR) regulates mucosal inflammation
Helps commensal bacterial colonies to grow
Stabilises tight junctions

65
Q

What are the anti-cancer functions of vit D?

A

Enhances anti-tumour activity of innate immune cells

Inhibits angiogenesis

66
Q

What are the bone health functions of vit D?

A

Supports bone density (with K2) by increasing intestinal Ca absorption

67
Q

What are the immunity functions of vit D?

A

Regulates T-helper cells
Produces antibacterial peptides
Reduces inflammatory cytokines

68
Q

What are the insulin functions of vit D?

A

Activates transcription of insulin gene (increasing insulin secretion)
Increases cellular sensitivity to insulin

69
Q

What are the therapeutic uses of vit D in GIT health?

A

Intestinal inflammation

70
Q

What are the therapeutic uses of vit D in anti-cancer?

A

Cancer prevention/support

71
Q

What are the therapeutic uses of vit D in bone health?

A

Osteoporosis
Osteomalacia
Rickets

72
Q

What are the therapeutic uses of vit D in immunity?

A

Allergies
AI
Infections
Musculoskeletal pain reduction

73
Q

What are the therapeutic uses of vit D in insulin?

A

Diabetes 2 and 1

74
Q

Which population groups would benefit from vit D with regards to bone health?

A

Children

Elderly

75
Q

How are the actions of vit D mediated through the body?

A

Vitamin D receptor (VDR)

76
Q

Where is the VDR found?

A

In the nucleus of each cell

77
Q

How many genes is VDR activation thought to regulate?

78
Q

Why do vits A and D need to be balanced?

A

For gene transcription

79
Q

How do vits A and D work together in gene transcription?

A

Vit D VDR and vit A RXR (Retinoid X Receptor) join to form a complex with DNA for transcription

80
Q

What are the signs/symptoms of a vit D deficiency?

A 
Osteoporosis
Osteomalacia
Rickets
Asthma
Allergies
Infections
Non-specific MSK pain/fatigue
81
Q

What can cause vit D deficiency?

A 
Inadequate sun exposure
Overuse of sunscreen
Excessive intake of animal protein/calcium
Lack of dietary fats
Lack of magnesium
Impaired liver functionality
Poor intestinal absorption
82
Q

What is a co-factor for vit D synthesis?

83
Q

Which drugs increase the need for vit D supplementation?

A

Anticonvulsants
(increase osteomalacia risk)
Barbiturates
Corticosteroids

84
Q

At what dosage can vit D toxicity occur?

A

50,000iu/day

85
Q

What are the two main types of vit E?

A

Tocopherols

Tocotrienols

86
Q

Which form of vit E is recognised for human nutrition?

A

Alpha-tocopherol

87
Q

What percentage of vit E is destroyed by freezing?

88
Q

What percentage of vit E is destroyed by heating?

89
Q

Examples of vit E food sources

A 
Avocado
Veg/seed oils
Nuts
Seeds
Dark leafy veg
90
Q

How does the liver secrete vit E (alpha-tocopherols) into the body?

A

Via lipoproteins

91
Q

Where is vit E mostly circulated to?

A

Adipose tissue

92
Q

Why does polyunsaturated fatty acid (PUFA) intake increase the requirement for vit E?

A

To protect the fatty acid double bonds from oxidation

93
Q

What is the naturally sourced version of vit E?

A

d-alpha-tocopherol

94
Q

What is the synthetically produced version of vit E?

A

dl-alpha-tocopherol

95
Q

Why should dl-alpha-tocopherol vit E be avoided?

A

Derived from petroleum oil

96
Q

What are the functions of vit E?

A 
Antioxidant
Immunity
Skin repair
Endocrine health
Anti-coagulant
97
Q

What are the therapeutic functions of vit E as an anti-oxidant?

A 
CV disease
Male fertility
Healthy ageing
Cataracts
AZD/cognitive decline
Cancer prevention
98
Q

What are the therapeutic uses of vit E in immunity?

A

Infections

HIV/AIDS

99
Q

What are the therapeutic uses of vit E in skin health?

A

Acne

Scarring

100
Q

What are the therapeutic uses of vit E in endocrine health?

A

Diabetes 2 and 1
Menopause
Dysmenorrhoea

101
Q

What are the therapeutic uses of vit E as an anti-coagulant?

A

CV disease

102
Q

What are the anti-oxidant functions of vit E?

A

Protects PUFAs, nerve sheaths and cholesterol from oxidation

103
Q

Which two nutrients support vit E activity?

A

Vit C

Selenium

104
Q

How do vit C and selenium support vit E?

A

Rejuvenates any oxidised vit E

105
Q

What are the immunity functions of vit E?

A

Increases phagocyte activity
Differentiation of mature T-cells in the thymus
Mild anti-inflammatory properties

106
Q

What are the skin repair functions of vit E?

A 
Topical use 
(but mechanism not known)
107
Q

What are the endocrine functions of vit E?

A

Improves insulin action

Modulates oestrogen receptors and activity

108
Q

What are the anti-coagulant functions of vit E?

A

Inhibits platelet aggregation

Inhibits vit K activity (reducing clotting factors)

109
Q

What are the vit E deficiency signs and symptoms?

A

Easy bruising
Slow healing
Nerve damage

110
Q

When taking which drug should you be cautious with high dose vit E supplementation?

111
Q

What are the K vitamers called?

A

K1 - Phylloquinone
K2 - Menaquinone
K3 - Menadione

112
Q

What is the dietary source of vit K1?

A

Green leafy veg

113
Q

How does vit K1 get utilised in the body?

A

Needs to be converted to K2

114
Q

How is vit K2 formed?

A

Synthesised by bacteria in SI

Found in fermented foods

115
Q

How can you support K2 production in the intestine?

A

Probiotics

116
Q

Where in the SI is K2 formed?

A

Jejunum

Ileum

117
Q

What is the active form of vit K?

118
Q

Why don’t we use K3?

A

Synthetic

Toxic

119
Q

What helps to increase the absorption of vit K?

A

Eating with healthy fats

120
Q

Why is K2 better as a supplement than K1?

A

Active form
Better absorbed
Tends to stay in body longer

121
Q

Where is vit K stored?

A

In the liver

but only small amounts

122
Q

What percentage of vit K is stored in the liver?

123
Q

What can reduce the absorption of vit K?

A

High vit A intake
Aspirin
Low bile secretion
Conditions that affect fat absorption

124
Q

Examples of vit K food sources

A

Natto
Dark green leafy veg
Fermented foods

125
Q

What are the functions of vit K?

A

Blood clotting

Bone mineralisation

126
Q

What role does vit K have in blood clotting?

A

Required for 4 of 13 clotting factors

127
Q

What role does vit K have in bone mineralisation?

A

Required to synthesise osteocalcin - a calcium binding protein in bones

128
Q

Which vitamin regulates the synthesis of osteocalcin in bone?

129
Q

What are the therapeutic uses of vit K in blood clotting?

A

Prevents bleeding

130
Q

What are the therapeutic uses of vit K in bone mineralisation?

A

Osteoporosis

Prevents calcium build up in kidneys and arteries

131
Q

What are the signs/symptoms of vit K deficiency?

A

Excessive bleeding
Bruising
Bone fractures
Soft tissue calcification

132
Q

Can vit K be toxic?

A

K1 and K2 not toxic

K3 can be

133
Q

Why might a vit K injection to new borns not be a good idea?

A

Preservatives
Synthetic chemicals
Not tested for adverse effects
Larger dose given than required

134
Q

What are the alternatives to a vit K injection to new borns?

A

Delayed cord clamping
Increase intake of vit K rich foods before due date
Nettle leaf infusions

Nutrition 1 (Semester I) (15 decks)

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