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M: DS > Lecture 16 > Flashcards

Lecture 16 Flashcards

1
Q

What factors affect bioavailability?

A
  • Efficiency of digestion/transit time
  • Previous nutrient intake and nutritional status
  • Other foods consumed simultaneously
  • Food preparation method
  • Source of nutrient - synthetic or natural
  • Health status
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2
Q

What does fat malabsorption limit?

A

Ability to absorb fat-soluble vitamins

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3
Q

What food preparation methods should we avoid?

A

Cooking to high temperatures and cooking in water

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4
Q

Out of natural and supplement folate, which is more bioavailable?

A

Folate in supplement (monoglutmate) is more bioavailable than natural sources (polyglutamate).

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5
Q

When does most of the nervous system develop?

A

Within 4-8 weeks of pregnancy

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6
Q

What are the MoH guidelines for folic acid in pregnancy?

A
  • 800 micrograms per day 4 weeks prior to 12 weeks

- 5000 micrograms per day previous history

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7
Q

Who needs vitamin and mineral supplements?

A

People who have:

  • poor nutrient intake (elderly, dieters, adolescents)
  • Increased nutrient requirements (children, pregnancy, lactation)
  • Increased metabolic demands (surgery, trauma, fracture)
  • Maldigestion or malabsorption (liver disease, GI, diarrhoea)
  • Drug-nutrient interactions (prednisone/vitamin D, diuretics/K,Mg)
  • Medical treatment interactions (chemo/radiation)
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8
Q

What causes deficiency of folate?

A
  • Low dietary intake
  • less intestinal absorption
  • Anticonvulsant drug and some lipid lowering drugs
  • Folate antagonists - methotrexate
  • High alcohol intake - leading to decreased absorption, increased catabolism, often accompanied by poor diet
  • Pregnancy
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9
Q

What are vitamins?

A

Organic molecules that function in a wide variety of capacities within the body.

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10
Q

What is the most prominent function of vitamins?

A

As cofactors for enzymatic reactions

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11
Q

What are the properties of the water-soluble vitamins?

A
  • Absorbed directly into the blood
  • Travel freely
  • Circulate freely in water-filled parts of the body
  • Kidneys detect and remove excess in urine
  • Possible to reach toxic amounts when consumed from supplements
  • Needed in frequent doses (1-3 days)
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12
Q

List the water-soluble vitamins

A
  • Vitamin C

- B vitamins

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13
Q

What are the alternative names for vitamin B1, 2, 3, 5, 6, 7, 9, 12

A 
B1: Thiamine
B2: Riboflavin
B3: Niacin
B5: Pantothenic acid
B6: Pyroxidine
B7: Biotin
B9: Folate
B12: Cobalamin
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14
Q

What is the active form of vitamin C?

A

Ascorbic acid

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15
Q

What are the major functions of vitamin C?

A

Connective tissue synthesis
Hormone synthesis
Neurotransmitter synthesis
Anti-oxidant

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16
Q

What is the primary deficiency of vitamin C? Describe its symptoms

A

Scurvy: poor wound healing, bleeding gums, haemorrhages

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17
Q

What are the common food sources of vitamin C?

A

Citrus fruits, strawberries, dark green vegetables, tomatoes, potatoes, tropical fruits

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18
Q

What is the active form of thiamine?

A

Thiamine pyrophosphate

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19
Q

What is the major function of thiamine?

A

Coenzyme of carb metabolism.

  • Oxidative decarboxylations
  • Transketolases (Pentose Phosphate Pathway)
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20
Q

What are the primary deficiencies of thiamine?

A

Wet and dry Beriberi

Wernicke’s encephalopathy

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21
Q

Describe wet beriberi

A

Oedema, lung congestion, increased heart rate, congestive heart failure

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22
Q

Describe dry beriberi

A

Wasting, neuropathy (tingling or loss of sensation), pain, brain damage

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23
Q

What is the main cause of thiamine deficiency in the Western World?

A

Alcoholism

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24
Q

What is Wernicke’s encephalopathy related to? What are the symptoms?

A

Related to thiamine deficiency. Alcohol related brain damage. Language problems, walking difficulty, unusual eye movemnt

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25
Q

What is Korsakoff syndrome related to? What are the symptoms?

A

Related to thiamine deficiency. Anaemia, inability to learn, confabulation

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26
Q

Where are thiamine deficiencies seen in elevated levels?

A

In countries with heavy reliance on refined grains

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27
Q

What are the common food sources of thiamine?

A

Whole grain cereals, fortified cereals, pork, sunflower seeds, legumes

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28
Q

What is the active form of riboflavin?

A

FMN FAD

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29
Q

What is the major function of riboflavin?

A
  • Coenzyme of carb metabolism
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30
Q

What are the primary deficiencies of riboflavin?

A
  • Inflammation of mouth and tongue - ariboflavinosis, cracks at corner of mouth, eye disorders
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31
Q

What are the common food sources of riboflavin?

A

Milk products, fortified cereals, liver, mushrooms

32
Q

What is the active form of Niacin?

A

NAD+ NADP+

33
Q

What are the major functions of niacin?

A
  • Coenzyme of energy metabolism
  • Coenzyme of fat synthesis
  • Coenzyme of fat breakdown
34
Q

What is the primary deficiency of niacin?

A

Pellagra: diarrhoea, dermatitis, dementia, death

35
Q

What are the common food sources of niacin?

A

Milk, eggs, meat, poultry, tuna, salmon, fortified cereals

36
Q

What is the active form of pyridoxine?

A

Pyridoxal phosphate

37
Q

What are the major functions of pyridoxine?

A
  • Coenzyme of protein metabolism
  • Phosphorylase modification
  • Neurotransmitter synthesis
  • Haemoglobin synthesis
38
Q

What are the primary deficiencies of pyridoxine?

A
  • Scaly dermatitis
  • Microcytic anaemia
  • Headache
  • Convulsions
  • Nausea
  • Vomiting
  • Sore tongue
39
Q

What are the common food sources of pyridoxine?

A

Meat, fish, poultry, potatoes, legumes, non-citrus fruits, salmon, seeds, spinach

40
Q

What is the active form of biotin?

A

Amide link to lysine

41
Q

What are the major functions of biotin?

A
  • Coenzyme of glucose production
  • Coenzyme of fat production
  • Carboxylations (ATP dependent)
42
Q

What are the primary deficiencies of biotin?

A

Depression, lethargy, dermatitis, anaemia

43
Q

What are the common food sources of biotin?

A

Cheese, organ meats, egg yolks, soybeans, fish, wholegrain cereals, GI bacteria

44
Q

What is the active form of folate?

A

Tetrahydrofolate

45
Q

What are the major functions of folate?

A

Coenzyme involved in DNA synthesis (one carbon transfers)

Methylation cycle

46
Q

What are the primary deficiencies of folate?

A
  • Macrocytic (megaloblastic) anaemia
  • Homocysteinuria
  • Poor growth
  • Inflammation
  • Neural tube defects during fetal development (spina bifida)
  • Increased risk of cancer, heart disease, and mental abnormalities
47
Q

What are the common food sources of folate?

A

Leafy green vegetables, legumes, seeds, liver, fortified cereals

48
Q

What is the active form of cobalamin?

A

Cobalamin (methyl- or 5’deoxyadenosyl-)

49
Q

What are the major functions?

A
  • Coenzyme of folate metabolism

Methylmalonyl CoA -> Succinyl CoA -> Homocysteine -> Methionine (THF dependent)

50
Q

What are the primary deficiencies of cobalamin?

A
  • Macrocytic anaemia
51
Q

What are the common food sources of cobalamin?

A

Animal products (meat, fish, poultry, milk, cheese, eggs), fortified cereals

52
Q

What are the properties of fat-soluble vitamins?

A
  • Absorption first into lymph then blood
  • Many require protein carriers
  • Stored in the cells associated with fat
  • Less readily excreted and tends to remain in fat-storage sites
  • Likely to reach toxic levels when consumed from supplements
  • Needed in periodic doses (weeks or months)
53
Q

List the fat-soluble vitamins

A

A, D, E, K

54
Q

What is the active form of vitamin A?

A

11-cis retinal - amide link to lysine in rhodopsin

All-trans retinol and retinoic acid

55
Q

What are the functions of vitamin A?

A
  • Photoreception, promote vision especially night colour
  • Health of cornea
  • Promote growth
  • Prevent drying of skin and eyes
  • Promote resistance to bacterial infection and overall -immune
  • Protein synthesis and cell differentiation
56
Q

What are the deficiencies associated with Vitamin A?

A

Night-blindness as part of Xerothalmia
Keratomalacia
Developmental defects
Keratinisation (chicken skin): topical treatments with vitamin A

57
Q

What are the ways in which vitamin A toxicity can occur?

A 
Beta carotene:
- Inefficient conversion
- Overconsumption from food
Retinol:
- Overconsumption from supplements
58
Q

What are the common sources of vitamin A?

A

Milk, cheese, eggs, liver, some acne treatments

59
Q

What are the common food sources of beta carotene?

A

Dark green leafy vegetables, deep orange fruit and vegetables

60
Q

What is the animal version of vitamin D?

A

Vitamin D3/Cholecalciferol

61
Q

What is the plant version of vitamin D?

A

Vitamin D2/Ergocalciferol

62
Q

What is the active form of vitamin D?

A

1,25 dihydroxycholecalciferol/Calcitriol (Steroid-like hormone)

63
Q

What is another name for Vitamin D?

A

Calciferol

64
Q

What are the funcitons of vitamin D?

A

Increases absorption of calcium and phosphorus
Maintains optimal blood calcium and calcification of bone
Regulates BP, insulin production, cell growth and division, immune function

65
Q

What are the deficiencies associated with vitamin D?

A

Rickets in children: long bones poorly formed resulting in bowed legs
Osteomalacia in adults: poor formation of bones and unable to weight bear

66
Q

What are the common sources of Vitamin D?

A

Sunlight

Liver, fatty fish, cod liver oil, milk (fortified), sardines in oil, mushrooms (raw), egg

67
Q

What is the role that sunlight plays in vitamin D absorption?

A

Causes reaction under skin that converts cholesterol to 1,25 dihydroxyvitamin D3 (active form)

68
Q

What is the active form of vitamin E?

A

Alpha-tocopherol

69
Q

What is the function of vitamin E?

A

General cell antioxidant (regenerated by interaction with vitamin C)

70
Q

What is the deficiency associated with Vitamin E?

A

Haemolysis of RBC’s

71
Q

What are the common food sources of Vitamin E?

A

Polyunsaturated oil, leafy green vegetables, liver, egg yolks, nuts, seeds

72
Q

What is the active form of Vitamin K?

A

Hydroquinone form of vitamin

73
Q

What are the functions of Vitamin K?

A
  • Activation of blood clotting factors
  • Carboxylation of glutamate to gamma-carboxyglutamate
  • Activation of proteins involved in bone metabolism
74
Q

What are the deficiencies associated with vitamin K?

A

Clotting defects
Foetal Warfarin syndrom
Fractures

75
Q

What are the common food sources of vitamin K?

A

GI bacteria, liver, leafy green vegetable, cabbage type vegetables

M: DS (29 decks)

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