chapter 8; water soluble vitamins Flashcards
mal de rosa is now commonly referred to as [..]. signs and symptoms were among [..] and [..]
pellagra
children and adult
the signs and symptoms among children and adults are [..] skin; mouth [..], diarrhea; confusion; and, ultimately, mental [..]
scaly, sores, deterioration
the signs of pellagra are sometimes known as the three Ds: [..], [..]. [..]
dermatitis, diarrhea, and dementia
in 1912, south carolina, alone, reported [..] cases of this mysterious disease and [..]% of those who developed it died
30,000
40%
goldberger found that pellagra was caused by a poor nutrient based diet (consisting of cornbread, molasses, and a little pork fat) those who ate a more balanced diet, did not develop pellagra
yes,
recovered thanks to goldberger who gave them fresh meat, milk, and vegetables
if we dont get enough of a vitamin or are unable to adequately use it, we may develop signs and symptoms characteristic of an [..] of that vitamin
insufficiency
the vitamins that disperse easily in water based solutions such as [..], called [..]-soluble vitamins
blood
water
water soluble vitamins include eight [..] vitamins, vitamin [..], and the vitamin like nutrient [..]
B
C
choline
the B vitamins function primarily as […], chemical compounds that bind enzymes and are required by the enzymes to carry out their function or activity in the body’s chemical processes. as coenzymes, B vitamins participate in [..]reactions that provide the body [..], as well as myriad other types of reactions
coenzymes, chemical
energy
in addition to functioning as a coenzyme in several types of reactions, vitamin C also serves as an [..], protecting cells from free [..] damage
antioxidant
radical
properties of water soluble vitamins;
- [..] amounts are necessary for good health
- [..] in water
- not stored in [..] amounts in tissues; [..] generally does not occur
- many are easily destroyed or removed during food [..] or [..]
- most circulate freely in [..]
- all except choline function as [..]
small, dissolve, large , toxicity
storage, preparation
blood, coenzymes
unlike fat soluble vitamins, which leave the [..] intestine in [..] via the lymph and are stored in the body like [..], water soluble vitamins immediately enter the blood following [..], where most circulate freely
small, chylomicrons
fat, absorption
because the water soluble vitamins are not stored in [..] quantities, we must consume adequate amounts of them consistently to maintain sufficient levels in our [..]and [..] to support critical body function
large
blood and cells
foods must be handled with care to preserve [..] content; some vitamins (both fat and water soluble) are unstable and can be destroyed by ultraviolet light, as well as cooking and storage methods.
vitamin
side note; when you boil foods that contain water soluble vitamins, for instance, a percentage of the vitamins typically leach out into the cooking water. however, steps can be taken to help preserve vitamins in foods.
ways to preserve vitamins in foods;
- cook fresh fruits and vegetables on low heat and avoid long heat exposure, because high temperatures destroy many vitamins
- avoid peeling fruits like apples and pears because their skins contain vitamins
- eat fruit soon after peeling, because some vitamins in it break down with exposure to air (oxidize)
- eat fruits and vegetables as soon as possible after harvesting or purchase, because some vitamins are lost when these foods are stored
- try not to freeze fresh produce because freezing slows but does not stop vitamin degradation
- refrigerate foods in airtight moisture proof containers because less air contact can slow the breakdown of some vitamins
- use minimal water and time when preparing and cooking food to lose fewer minerals and water soluble vitamins
- keep milk, which contains riboflavin, refrigerated, tightly capped, and away from light, because riboflavin is very sensitive to light
- do not soak vegetables for long periods, because water soluble vitamins leach out into surrounding liquid
when we consume more of a water soluble vitamin than is needed to meet daily requirements, our body typically eliminates the excess through our [..]
urine
individuals are much [more or less] likely too experience toxic adverse effects due to overconsumption of water soluble vitamins than they are if they consume too many fat soluble vitamins. in fact, toxicity or adverse effects from high intake of the B vitamins from food sources alone has almost [..] been observed
less
never
places like in the United States and countries where there is an adequate food supply, deficiencies of water soluble vitamins are rare. however, there are circumstances when the risk of deficiency is higher - when [..] are restricted, e.g., or under conditions that affect [..], such as diarrhea, intestinal disorders, and parasites, bacterial, or viral gastrointestinal infections
calories,
absorption
excessive alcohol use is a risk factor for several vitamin deficiencies as it can lead to [..] food intake, impaired [..] and [..], and increased [..] and [..] of vitamins
decreased
absorption and utilization
degradation and excretion
in addition, the body’s need for most water soluble (and fat soluble) vitamins is higher during certain life stages, such as in the [..] and during [..] and lactation ([..]), increasing the risk of inadequate intake, potential deficiency, and the associated consequences. when we suffer from [..] or [..] and when we recover from [..], we also need higher than normal amounts of water soluble vitamins
elderly, pregnancy, breastfeeding
fever, injuries, surgery
possible causes of vitamin deficiencies;
inadequate intake, decreased absorption, deceased utilization in cells, increased requirements, increased breakdown, increased losses and excretion
- intake; calorie restriction, poverty, anorexia, food fads, difficulty swallowing, dental problems, decreased taste and smell, illness, excessive alcohol intake
- absorption; poor digestion, diarrhea, parasites, intestinal disorders, dietary anti vitamin factors, gastrointestinal infections, prescription drugs, alcohol
- utilization; deficiencies in other nutrients, prescription drugs, alcohol, or infection
- requirements; growth, pregnancy, lactation, chronic illness, infections
- breakdown; prescription drugs, alcohol
- losses, and excretion; increased urinary excreted, blood losses (gastric ulcers), parasites, infection
the B vitamins include; thiamin (b1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxin (B6), biotin (B7), cobalamin (B12), and folate (B9)
yes
all B vitamins function as [..], with most playing critical roles in [..] metabolism. energy metabolism refers to the chemical reactions that are involved in storing [..] (such as glycogen and triglycerides) or [..] them down to provide the energy necessary to drive a variety of chemical reactions and their body processes (such as active transport and muscle contractions)
coenzymes, energy
fuels, breaking
coenzymes are not actually part of the enzyme structure; rather, they [..] enzymes in carrying out their reactions, often by directly interacting with the reaction [..] (a molecule upon which an enzyme acts). in other words, the B vitamins do not provide energy to the cells, but they play a critical role in energy transformation.
assist, substrate
B vitamins are also required for amino acid, drug, and free radical metabolism as well as the synthesis of hundreds of compounds necessary to support life, such as steroid hormones, nucleic acids or DNA synthesis and cell division , and the oxygen carrying heme group that is part of hemoglobin
yes
B vitamins function as coenzymes;
- enzyme is [..] without the required coenzyme
- the enzyme activates when the coenzyme (vitamin) enters the enzyme and the substrate binds to the enzyme.
- then with the substrate and coenzyme in place, the reaction can [..]
- then the reaction occurs and the products are [..]
inactive
proceed
released
many of the B vitamins are [..] and [..], in that the successful functioning of one B vitamin often depends on the successful functioning of other B vitamins. likewise, deficiencies of B vitamins rarely occur in isolation, because several B vitamins will often occur together in the same types of foods. chances are that a diet inadequate in one B vitamin will be low in others. however, a deficiency of a single B vitamin wreaked havoc in the not too distant past
interrelated, interdependent
in the 1800s (east Asia) victims experienced terrible [..] wasting and eventual [..] failure. the disease was known as beriberi. common among populations whose diet consisted largely of [..] (lack of thiamin, vitamin B12)
muscle
heart
rice
funk named his first vitamin B1; today its commonly known as [..]. the coenzyme form is needed to provide energy from the breakdown of [..], [..] acids, and some [..] acids - where it participates in reactions that release carbon dioxide (CO2). it is also needed for the production of sugars needed for the synthesis of [..] and [..]. good sources include [..] and fortified [..] products
thiamin
glucose, fatty, amino
RNA, DNA
pork , grain
although beriberi is not common in the US today, another thiamin deficiency, called Wernicke-Korsakoff syndrome, can be found in many developed nations. [..] abuse is the leading case, with as many as [..]% of chronic alcohol abusers showing signs of deficiency often result In severe [..] disturbances.
alcohol
80%, neurological
the disruptions in metabolic that occur with a thiamin deficiency alter the production of several [..], chemical messengers released by [..] cells to send signals to other cells of the nervous system.disrupting the balance of neurotransmitters leads to [..] disturbances such as apathy, irritability, and confusion. other deficiency symptoms include fatigue and muscle weakness
neurotransmitters
nerve
mental
individuals who regularly consume excess alcohol are at high risk of thiamin deficiency because alcohol consumption displaces the [..] of nutrient rich foods, decreases thiamin [..], increases its excretion in [..], decreases its storage in the [..], and decreases conversion of thiamin into its [..]. in fact, chronic alcohol abuse increase the risk of deficiency for most the [..] soluble vitamins through several of these mechanisms
intake
absorption, urine, liver, coenzyme
water
niacin plays an important role in the conversion of the [..] in food into energy, which is why the typical first symptom of pellagra is [..]. beyond energy metabolism, niacin is required is required for the synthesis of glucose, fatty acids, cholesterol, and steroid hormones and is critically important in DNA repair, cell signaling, and the regulation of gene expression
macronutrients
fatigue
therapeutically, doctors sometimes prescribe niacin in high doses to help lower “bad” [..] cholesterol and increase “good” [..] cholesterol . however, as with most vitamins, taking high doses of niacin can cause harmful side effects, and patients on a regimen of high dose niacin must be [..] to ensure the potential benefits outweigh the risks
LDL , HDL
monitored
Niacin is rich in [..] (especially poultry) and [..], as well as peanuts, mushrooms, and fortified cereals. it can also be synthesized in the body, albeit rather [..], from the amino acid tryptophan found primarily in protein rich foods
meats, fish
inefficiently
as a precursor to niacin, it takes about [..] mg of tryptophan in food to make [..] mg of niacin. so dietary recommendations are often given in niacin equivalents (NEs). NEs are used to describe the contribution to dietary intake of the reformed niacin and that which can be synthesized from the tryptophan provided by foods
60 mg to 1 mg
historically, the term fortification technically referred to the addition of [..] to other foods, as well as the addition of nutrients to grain products beyond what had been removed by [..]
nutrients , processing
the early legal definition of the similarly term enrichment applied only to the addition of thiamin, riboflavin, niacin, and iron to refined grain products designed to [..] normal levels of these nutrients prior to further processing. today, however, the FDA allows the terms enriched and fortified to be used interchangeably - simply to indicate the addition of a vitamin, mineral, or protein to a food. the exception to this rule are that some products (such as flour and rice) are labeled as “enriched” because they meet the FDA’s definition for a food that must contain that term in its name.
grain
restore
today, bread products and fortified cereals are a primary source of niacin in our diets, along with the protein rich foods, particularly poultry. although bread products are not particularly high in niacin, they contribute significantly to our niacin intake because they are so abundant in our diet
yes
there is no evidence that consuming too much niacin from food leads to adverse effects. however, people who take high doses of niacin in supplements may suffer side effects such as flushing (episodes of skin [..] and [..]) and [..] distress. individuals who are prescribed niacin to control their cholesterol also must be [..] carefully to ensure that excessive amounts of the vitamin do not cause liver problems or glucose intolerance.
redness, warmth
gastrointestinal
monitored
the second B vitamin to be isolated was riboflavin, and its function is similar to that of [..]: riboflavin is important for the [..] of proteins, lipids, and carbohydrates.
niacin
metabolism
[..] and other [..] products are particularly good sources of riboflavin, and it is because riboflavin is destroyed by ultraviolet light that milk is kept in paper cartons or opaque plastic containers
milk, dairy
a riboflavin deficiency (known as ariboflavinosis) is characterized by cracks and redness on the [..] and corners of the [..], swelling of [..] in the mouth, and a sore throat. deficiency may be seen with chronic alcohol abuse or malabsorption conditions.
lips, mouth,
tissues
throat
no [..] with riboflavin consumption from food or supplements has been observed
toxicity
vitamin B6, often referred to by one of its chemical names pyridoxine - functions as a coenzyme in the release of [..] from [..] glycogen and in amino acid [..]. it is required for the conversion of the amino acid tryptophan to niacin.
glucose
stored, metabolism
the body also uses vitamin B6 for the productions of some neurotransmitters and hemoglobin (the iron containing protein found in red blood cells that transports oxygen throughout the body). good food sources include [..] and other meats, [..], and [..]
pork
bananas and potatoes
deficiency in vitamin B6, can cause various signs and symptoms, including [..], impaired [..] function, [..], dermatitis, and [..] disorders such as confusion and convulsions. poor vitamin B6 status has also been associated with an increased risk of [..] disease. adverse and sometimes irreversible neurological effects such as pain and numbness in the extremities can occur in people who take vitamin B6 supplements in doses above the UL
anemia, immune, weakness, neurological
cardiovascular
present in a [..] variety of foods, biotin is required as a coenzyme for only [..] human enzymes, each of which adds a carbon dioxide to the starting chemical compound. these reactions participate in the [..] of some amino acids and the [..] of fatty acids and glucose.
wide, five
breakdown , synthesis
deficiency of biotin Is rare, although mild forms have been reported in [..] women and may occur, as with many of the B vitamins, as a result of chronic [..] abuse.
pregnant
alcohol
frequent ingestion of raw [..] can result in biotin deficiency as the protein avidin in raw egg whites binds to biotin, making it unavailable for [..]
eggs
absorption
although true biotin deficiency can result in [..] loss, skin [..], and [..] nails there is no significant evidence that biotin supplementation in healthy individuals result in hair or nail growth
hair , rashes, brittle
another B vitamin, pantothenic acid, has critical functions in energy [..] and is required for the [..] of fatty acids, cholesterol, steroid hormones, and two neurotransmitters. named for the Greek word pantothenic, meaning “from [..] sides,” deficiencies of pantothenic acid are rare because of its widespread occurrence in virtually all foods
metabolism
synthesis, all
the vitamin folate and its synthetic form folic acid, used in supplements, acts as a [..] in the metabolism of certain amino acids and production of nucleic acids that are required for [..] and [..] synthesis. therefore, the vitamin is essential for normal cell [..] and [..] . Furthermore, the nervous system requires folate to carry out a number of fundamental metabolic processes
coenzyme
DNA and RNA
division and development
folate
research suggests that because nervous system function depends on folate, the vitamin may be among the most important in the early stages of [..], when the nervous system develops in the fetus
nervous
pregnancy
expectant mothers who don’t consume enough folate are at an increased risk of giving birth to children with abnormalities of the [..] cord and [..]. these abnormalities, the most common of all birth defects in newborns, are known as [..] [..] defects.
spinal
brain
neural tube
babies conceived during the famine (Dutch Hunger Winter of 1940), when mothers were unable to consume sufficient folate rich foods were [..] as likely to have birth defects as babies conceived before or after the famine
twice
data collected in the Dutch famine study and during the 50 some years since the indicate that children who are deprived of folate during their fetal development are also more likely to develop [..], autism, [..] problems, and [..] delays
schizophrenia, autism, attention, language
the folate RDA for men and women older than 19 years is [..] mcg. it is recommended by the US Centers for Disease Control and Prevention (CDC) that all women between the ages of [..]and [..] consume that at least this amount through a folate rich diet or folic acid supplementation to reduce risk of folate deficiency and associated birth defects
400
15 and 45
side note; to help women meet these requirements, in 1998, the RDA institued a mandatory fortificaiton program to common grain products (for eaxample, flours, brads, cereals, and pasta). as a result of the fortification intitiateive, risk of folate deficinecy in the US has declinde and helped prevent up to two thirds of all cases of neual defects
folic acid; many countries globally have not implemented mandatory fortification programs, a recent study among 58 nations found a [..]% decline in neural tube related birth defects when staple flours (wheat and maize) were fortified with folic acid
13.2%
once a woman becomes pregnant, the folate RDA goes up to [..] mcg to provide for increased demands of a developing fetus and to support the development of maternal tissues such as the placenta and the woman’s expanding [..] volume. food with plentiful naturally occurring folate include green leafy [..], [..], [..], and [..]
600
placenta , blood
vegetables, avocado, mango, and beans
a calculation known as the dietary folate equivalent (DFE) is used to consider the difference in [..] between the different types of folate. contrary to what you might expect, the folate found naturally in foods is [..] half as well as the folic acid added to foods, and [..] folate degrades much more readily than the synthetic folic acid
bioavailability
absorbed
natural
folate equivalents;
- food folate 1 mcg = [..] mcg DFE
- folic acid from supplements 1mcg = [..] mcg DFE
- folic acid from fortified foods 1 mcg = [..] mcg DFE
- 1; 50% of food is absorbed. folate from food is set as the standard for comparison
- 2; 100% of folic acid taken as a supplement without foods is absorbed. so two times as much is absorbed than an equal mass of food folate
- 1.7; when folic acid is consumed with food, either as a supplement or in fortified foods, there is a slight decrease in absorption com[are with its consumption without food
folate deficiency also causes megaloblastic anemia, a form of blood abnormality characterized by [small or large ], [mature or immature], and sometimes [..] shaped red blood cells . these cells fail to [..] because DNA synthesis and cell division is disrupted, resulting in the production of large red blood cells called macrocytic cells (or megaloblastic cells). symptoms of megaloblastic anemia include fatigue, pale skin, spells of lightheadedness, and muscle weakness
large, immature
irregularly, mature
folate deficiencies can also cause poor [..] and [..] tract disturbances because the rate of [..] synthesis is highest during cell growth or in rapidly dividing cells, such as those found in the brush border of the [..] intestine. people who abuse alcohol, have [..] conditions, or take certain .. are at an increased risk of developing folate deficiencies
growth, gastrointestinal
DNA. small
malabsorptive, medications
Folate may help reduce heart disease risk by lowering homocysteine levels, which are linked to heart disease. However, recent reviews of clinical trials found no evidence that folic acid or B12 supplements lower heart disease risk, so the American Heart Association does not recommend them.
heart
the UL for folate applies to synthetic forms found in supplements (folic acid) and is set at [..] mcg per day. no adverse effects are known to occur with the amounts of folate found [..] in foods, but getting too much folic acid from [..] foods or [..] can mask vitamin B12 deficiency symptoms
1000, naturally
fortified, supplements
vitamin B12 is unique among the vitamins for several reasons: it has the [..] and most [..] structure and it contains the mineral [..], which is why the vitamin is also known as cobalamin.
largest
complex
cobalt
niacin - can be synthesized in the body from the amino acid [..]
tryptophan
biotin - frequent intake of raw [..] can lead to a deficiency
eggs
choline - not a true vitamin; deficiency leads to [..] damage
liver
pantothenic acid - name means “from [..] sides”; found in many foods; deficiencies are rare
all
unlike other water soluble vitamins, vitamin B12 is stored in [..] quantities in the liver . because vitamin B12 found naturally in foods is bound to food [..], [..] acid from the stomach is required for it to be released from those proteins. it must then bind to a protein produced in the [..] called intrinsic factor. the cobalamin intrinsic factor complex is then absorbed in the small intestine
large, proteins , gastric
stomach
small
B12 acts as a coenzyme in only two reactions - one of which is important in deriving [..] from several amino acids and the other is the aforementioned reaction involving [..] and the conversion of homocysteine to methionine. this last reaction is also indispensable for activating folate; therefore, without B12, folate becomes trapped in an [..] form. for this reason, B12 is also required for DNA [..] and cell [..]
energy , folate, unusable, synthesis, division
because the metabolism of folate and vitamin B12 are closely linked, a deficiency in B12 produces the same megaloblastic anemia that is seen with a folate deficiency causing increased fatigue during physical activity. as a B12 deficiency continues, it often causes a tingling or lack of sensation in the [..] and [..] and may progress to include cognitive impairment and problems with motor control
fatigue
legs and arms
cognitive motor
the risk of developing a deficiency of vitamin B12 [..] as we age. diminished or compromised food intake, sometimes seen in the aging population, decreases the amount of B12 available through the diet. in addition, between 10% and 30% of older people don’t properly [..] the B12 that is found naturally in food because of a common condition that reduced the production of both [..] acid and [..] factor by the stomach
increases
absorb
gastric, intrinsic
individuals older than [..] years are advised to meet their B12 RDA mainly by consuming foods [..] with vitamin B12 or by taking [..] containing B12, because fortification and supplement forms of B12 are not bound to food proteins and therefore do not rely on [..] acid for absorption
50
fortified, supplements
gastric
low vitamin B12 status is associated with more rapid [..] decline as we age, adding more importance to adequate B12 intake
cognitive
animal foods such as [..], [..], [..], and [..] are the only natural sources of vitamin B12; some grain and soy products are fortified with B12. vegans (those who consume no animal products, including dairy and eggs) must either take B12 [..] or regularly consume food [..] with the vitamin to meet their RDA
meat, poultry, fish , dairy
supplements
fortified
gastric bypass patients are also at risk for B12 deficiency because [..] intrinsic factor is produced by the stomach [..] the surgery and less B12 is released in the stomach as much of the stomach is “bypassed”.
less, after
other groups at risk for developing B12 deficiencies include those with pernicious anemia - a condition caused by the failure to [..] intrinsic factor (as may often be the case in the [..], resulting in vitamin B12 malabsorption and megaloblastic anemia. in these cases, treatments may require periodic [..] of vitamin B12 or the [..] administration of very high daily doses (generally 1 mg per day) of the vitamin. very high doses can result in absorption by [..] diffusion of a small amount in the absence of intrinsic factors
produce
elderly, injections, oral
passive
choline is the most recent compound to be added to the list of [..] nutrients. although not a B vitamin, it is a [..] soluble compound and its function in the body is intertwined with that of folate and vitamin B12.
essential
water
those who would be at an increased risk for vitamin B12 deficiency without fortified foods or supplements; a person who follows a [..] diet, a person who has had [..] bypass surgery, people ages [..] and older
vegan
gastric
50
in addition, it forms the critically important [..] acetylcholine, and it is part of two of the most abundant [..] in cell membranes. the primary sign of a choline deficiency is [..] damage.
neurotransmitter, phospholipids, liver
although we are capable of synthesizing [..]., it is considered an essential nutrient because many people, particularly older [..], require dietary sources to meet their needs. excessive intake of choline, typically only through supplementation, causes a [..] body odor and a light drop in blood [..]
choline
men
fishy, pressure
scurvy is a condition that causes anemia, bleeding [..], [..], [..], joint [..], [..] bones, [..], impaired [..] healing, and [..] problems (vitamin C)
gums, weakness, fatigue, pain, fragile, bruising, wound, immunity
[..] fruits are rich in vitamin C; a deficiency of this water soluble vitamin was the cause of the malady (scurvy)
citrus
scurvy causes the subcutaneous [..] (bleeding under the [..]) visible on the legs of a person suffering from a vitamin C deficiency
bleeding
skin
vitamin C, also known as [..] acid, acts as a coenzyme in [..] reactions and aids in [..] production. its also involved in the synthesis of [..], which is used to build bone, teeth, scar tissue, and arterial walls, and it enhances iron absorption
ascorbic, biological, hormone
collagen
the majority of the signs associated with scurvy are caused by the inability to synthesize [..] appropriately, which causes blood vessels to [..], wounds to [..] poorly, and [..] to bleed. in addition, vitamin C functions as an [.], a substance that prevents damage to cells by inhibiting the oxidation caused by free radicals, which can damage DNA and tissues
collagen, leak, heal, gums
antioxidant
is vitamin C a cure of the common cold
no; regular vitamin C supplementation may result in a very slight decrease in the duration of a cold by about 8% in children and 14% in adults.
in adults experiencing short term physical stress, such as running a marathon, regular vitamin C supplementation can reduce the incidence of [..] by as much as 50%, as with some of the B vitamins, vitamin C may have a role in reducing the risk of [..] disease
colds
heart
vitamin C is found naturally in citrus fruits, tomatoes, tomato juice, potatoes, Brussel sprouts, cauliflower, broccoli, strawberries, cabbage, and squash. however, it is readily destroyed by storage and cooking. potatoes and apples lose about 50% of their vitamin C content after four or five months of storage
storage and cooking
consumption of vitamin C in excess of the UL, set at [..] mg for both men and women, may cause [..] and [..], and it may increase the risk of [..] stones in people with kidney disease. the RDA is [..] mcg for men 19 and older and [..] mg for women 19 and older.
2000
diarrhea and bloating
kidney
90
75
since smokers are exposed to greater oxidative stress and they have lower concentrations of vitamin C in the body, they are advised to increase their intake by another [..] mg over the RDA
35
