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HLTH 230 > Lecture 6 > Flashcards

Lecture 6 Flashcards

1
Q

provitamins

A

transform chemically to one or more active vitamin forms

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2
Q

bioavailability

A

the rate and extent to which a nutrient is absorbed and used

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3
Q

malnutrition

A

excess or deficient food energy or nutrient intake

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4
Q

undernutrition

A

deficient in energy or nutrients

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5
Q

overnutrition

A

excess energy or nutrients

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6
Q

primary deficiency

A

nutrient deficiency caused by inadequate dietary intake of a nutrient

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7
Q

secondary deficiency

A

nutrient deficiency cause by something other than inadequate intake such as a disease condition or drug interaction that reduces absorption, accelerates use, hastens excretion or destroys nutrient

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8
Q

fat-soluble vitamins

A

A,D,E,K

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9
Q

where are fat-soluble vitamins absorbed

A

into the lymph
- require bile for absorption

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10
Q

fat-soluble vitamins characteristics

A
  1. travel in blood with protein carriers
  2. stores in tissues (liver and fat)
  3. may be toxic in excess
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11
Q

water-soluble vitamins

A
  1. B vitmins
  2. Vitamin C
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12
Q

where are water-soluble vitamins absorbed

A

directly into the bloodstream

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13
Q

water-soluble vitamins characteristics

A
  1. travel freely in bloodstream
  2. not stored mostly
  3. excess excreted in urine
  4. lower risk of toxicity than fat-soluble vitamins
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14
Q

which vitamins have higher risk of toxicity?

A

fat-soluble vitamins

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15
Q

where are fat-soluble vitamins found?

A

in fats and oils of foods

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16
Q

how long can the body survive without fat-soluble vitamins?

A

weeks

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17
Q

excess vitamin A and D from supplements

A

can easily reach toxic levels

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18
Q

fat-soluble vitamin deficiency

A
  1. if consistently low in fat-soluble vitamins
  2. fat malabsorption
  3. mineral oil laxatives can cause vitamin loss
  4. very low-fat diets interfere with absorption
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19
Q

3 active forms of vitamin A in the body

A
  1. retinol
  2. retinal
  3. retinoic acid
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20
Q

plant-derived precursor of vitamin A

A

beta-carotene

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21
Q

vitamin A roles

A
  1. vision
  2. gene expression
  3. maintenance of body linings and skin
  4. immunity
  5. growth of bones and body
  6. normal development of cells
  7. critical importance to reproduction
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22
Q

eyesight

A
  1. light passes through cornea before striking retina
  2. retina contains cells
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23
Q

eyesight and vitamin A

A

light bleaches the vitamin A-containing pigments RHODOPSIN

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24
Q

rhodopsin

A
  1. breaks of vitamin A, initiating an impulse to optic centre in brain
  2. vitamin reunited with pigment with little destruction of the vitamin
  3. vitamin A must regenerate the supply
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25
Q

what happens if vitamin A supply runs low?

A

night blindness

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26
Q

vitamin A deficiency

A

keratin accumulation (keritinization)

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27
Q

keritinization

A

can leads to xerosis (drying) and xerophthalmia (thickening) which can cause permanent

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28
Q

skin/body linings and vitamin A

A
  1. vitamin A is needed by all epithelial tissues
  2. vitamin A promotes cell differentiation
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29
Q

epithelial tissues

A

serve as protection from pathogens as well as to other damage

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30
Q

cell differentiation

A

each type of cell develops to perform a specific function

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31
Q

control of gene expression and vitamin A

A

retinoic acid activates or deactivates certain genes thereby affecting protein production

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32
Q

immunity and vitamin A

A
  1. regulates genes that produce immune system proteins
  2. deficiency can lead to a spiral of infection
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33
Q

growth and vitamin A

A

vitamin A assists in growth of bone and teeth

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34
Q

vitamin A deficiency

A
  1. cell differentiation and malnutrition impaired
  2. failure of mucus-producing cells to produce mucus
  3. increase in keratin-producing cells
  4. vulnerable to infection
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35
Q

what worsens vitamin A deficiency

A

diarrhea and reduced food intake

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36
Q

vitamin A supplementation

A

may benefit those suffering complications from disease such as malaria, lung disease and HIV

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37
Q

vitamin A toxicity

A
  1. supplements or fortified foods
  2. may weaken bones, bone and joint pain, abdominal pain, stunted growth, liver damage
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38
Q

early symptoms of vitamin A toxicity

A
  1. loss of appetite
  2. blurred vision
  3. headache
  4. skin itching
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39
Q

long-term symptoms of vitamin A toxicity

A

bone weakening and hip fracture

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40
Q

vitamin A toxicity and pregnant women

A

fetal malformation (teratogenic)

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41
Q

accutane

A

derived from vitamin A
- but vitamin A supplements do not help with acne

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42
Q

what organ might be affected most by vitamin A toxicity?

A

the liver (especially polar bear)

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43
Q

beta-carotene and vitamin A toxicity

A

will not cause vitamin A toxicity
- can turn yellow/orange due to deposition in subcutaneous fat

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44
Q

beta-carotene

A
  1. most abundant of the carotenoid precursors
  2. major dietary antioxidants
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45
Q

how is vitamin A activity for vitamin A precursors measured?

A

retinol activity equivalents (RAE)

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46
Q

deep bright orange fruits and veggies and dark green veggies

A

rich in beta-carotene and have a role in healthy eyesight

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47
Q

does eating carrots promote good vision

A

doesn’t improve vision if vitamin A intake is already adequaete

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48
Q

carotenoids and diseases

A
  1. beta-carotene is associated with reduced cancer risk
  2. benefits not seen with supplements (only on food in blood)
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49
Q

lack of foods rich in beta-carotene

A

increases risk of macular degeneraton

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50
Q

beta-carotene supplements

A

associated with increased risk of cancer in smokers

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51
Q

where is vitamin A found?

A

foods of animal origin

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52
Q

where is beta-carotene found?

A

in plants

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53
Q

good food sources of vitamin A

A
  1. liver and fish oil
  2. fortified milk and milk products
  3. eggs
  4. beta-carotene (dark greens, rich yellow and deep orange foods)
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54
Q

vitamin D characteristics

A
  1. body can make all it needs with help of sunlight (not essential)
  2. many people may border on vitamin D insufficiency
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55
Q

roles of vitamin D

A
  1. regulation of blood calcium and phosphorus (maintains bone integrity)
  2. raises blood calcium when needed
  3. functions as a hormone
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56
Q

vitamin D and role in calcium

A
  1. promotes calcium absorption
  2. promotes calcium retention by kidneys
  3. draws calcium from the bone
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57
Q

how does vitamin D function as a hormone?

A

plays a role in brain, heart, stomach, pancreas, skin, reproductive, organs, some cancer cells, stimulates cell maturation

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58
Q

vitamin D deficiency results

A
  1. high blood pressure
  2. some cancer
  3. type I diabetes
  4. heart disease
  5. rheumatoid arthritis
  6. inflammatory bowel disease
  7. multiple sclerosis
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59
Q

rickets

A
  1. vitamin D deficiency in children
  2. characterized by abnormal bone growth
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60
Q

symptoms of rickets

A
  1. bowed legs
  2. outward-bowed chest
  3. knobs on ribs
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61
Q

risks with vitamin D deficiencies for adolescents

A

bone loss later in life

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62
Q

risks with vitamin D deficiencies for older adults

A

painful joints and muscles

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63
Q

osteomalacia

A

adult for of rickets

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64
Q

what population of women does osteomalacia typically occur for?

A
  1. low calcium intake
  2. little exposure to sun
  3. who go through repeated pregnancies and periods of lactation
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65
Q

what population of adolescents are at risk for vitamin D deficiencies?

A
  1. consume beverages with no vitamin D
  2. prefer indoor to outdoor activities
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66
Q

what vitamin is the most toxic?

A

vitamin D

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67
Q

vitamin D toxicity symptoms

A
  1. appetite loss
  2. nausea
  3. vomiting
  4. increased urination and thirst
  5. severe psychological depression (effects CNS)
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68
Q

continued overdose of vitamin D

A

causes dangerously high blood calcium level, forcing calcium to be deposited in soft tissue (heart, lungs, kidneys)

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69
Q

how can people make a vitamin from sunlight?

A
  1. UV exposure to cholesterol compound in skin transforms it into a vitamin D precursor which is absorbed in blood
  2. liver and kidneys convert precursor to active form of vitamin D
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70
Q

is there a risk of vitamin D toxicity with skin synthesis?

A

NO

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71
Q

factors effecting sun exposure and vitamin D synthesis

A
  1. skin color
  2. air pollution
  3. city living
  4. clothing
  5. geography
  6. indoor lifestyle
  7. season
  8. sunscreen
  9. time of day
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72
Q

sunscreen with SPF of 8

A

reduce sun risks, but also prevent vitamin D synthesis

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73
Q

canadian cancer society

A

believes it is better to get vitamin D from food or supplements because sun is dangerous

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74
Q

vitamin D RDA

A

400 IU
- recommendation may increase with age

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75
Q

sources of vitamin D

A
  1. sunlight
  2. small amounts from butter, cream, fortified margarine
  3. fortified milk
  4. egg yolks, liver, fatty fish, fish oil
  5. mushrooms
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76
Q

4 tocopheral compounds of vitamin E

A
  1. alpha
  2. beta
  3. gamma
  4. delta
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77
Q

what is the gold standard for vitamin E activity

A

alpha-tocopherol

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78
Q

antioxidant activity

A

defends the body against oxidative damage
- vitamin E is oxidized, protecting cells

79
Q

oxidative damage

A

results from free radicals

80
Q

free radicals

A
  1. formed during metabolism disrupt the structure of cellular lipids, DNA and proteins
  2. free radical activity may contribute to development of cancer, heart disease, etc.
81
Q

vitamin Es antioxidant effect

A
  1. crucial in the lungs - cells are exposed to high oxygen concentrations
  2. protects red and white blood cells
82
Q

vitamin E roles

A
  1. antioxidant activity
  2. roles in immunity
  3. a role in nerve development
83
Q

do vitamin E supplements provide health benefits?

A

no, only if deficient

84
Q

vitamin E deficiency in infants

A

some infants born before transfer of vitamin E from mother to infant

85
Q

erythrocyte hemolysis

A

a rupturing of the red blood cels which results in anemia

86
Q

vitamin E deficiency in adults (causes and results)

A
  1. nerve damage
  2. fat malabsorption diseases (damaged liver, gallbladder or pancreas)
  3. low intake with low fat diets for years
  4. people who rely on fat replacers rather than fat
87
Q

how is vitamin E destroyed?

A

by food processing and heating

88
Q

vitamin E toxicity

A
  1. no toxicity with natural food sources
  2. large doses may increase effects of anticoagulant medications
  3. increased risk of death for those taking greater than 400 IU from supplement
89
Q

food sources of vitamin E

A
  1. veggie oils (salad dressing, shortening)
  2. avocados
  3. wheat germ
  4. smaller amounts from meat, poultry, fish, eggs, milk products, nuts, seeds
  5. animal fats have almost no vitamin E
90
Q

functions of vitamin K

A
  1. synthesis of blood clotting proteins
  2. synthesis of normal form of bone proteins that bind minerals to bone
91
Q

blood clotting proteins

A

interferes with the function of certain anticoagulant medications (blood thinners)

92
Q

sources of vitamin K

A
  1. intestinal bacteria
  2. leafy green veggies (dark)
  3. cabbage family
  4. canola and soybean oils
  5. eggs and milk contain small amounts
  6. liver is only rich animal source
93
Q

vitamin K and newborns

A

newborns are given a dose of vitamin K
- sterile Gi tract
- vitamin K producing bacteria establish themselves

94
Q

when are you at risk for vitamin K deficiency?

A
  1. newborns
  2. antibiotic treatment (kills beneficial and harmful bacteria in intestinal tract)
  3. fat malabsorption
    - unlikely in adults
95
Q

vitamin K toxicity

A

no UL
- infants and pregnant women can result from over-supplementation with synthetic vitamin K

96
Q

what does vitamin K toxicity lead to?

A

jaundice and bilirubin in brain of an infant
- can cause brain damage or death

97
Q

water-soluble vitamins

A
  1. cooking and washing water leaches them out of food
  2. easily absorbed
  3. excess readily excreted in urine
98
Q

toxicity from water-soluble vitamins

A
  1. not from food
  2. can occur from large doses concentrated in vitamin supplements (expensive urine)
99
Q

vitamins for athletes

A

athletes with an appropriate diet don’t generally need supplements
- increased energy = more food

100
Q

vitamin C experiment

A

those who received citrus quickly recovered from scurvy

101
Q

scurvy

A
  1. vitamin C (ascorbic acid) deficiency
  2. to avoid scurvy, British sailors were given lim juice
102
Q

roles of vitamin C

A
  1. maintenance of connective tissues
  2. antioxidant
103
Q

vitamin C and connective tissue maintenance

A

formation and maintenance of collagen
- component of bones, teeth, skin, tendons, scar tissue, capillaries

104
Q

vitamin C antioxidant function

A
  1. protects substances found in food and body
  2. protects iron from oxidation
  3. protects blood constituents from oxidation and helps protect vitamin E (returns to active form)
105
Q

vitamin C supplements

A
  1. useful to treat a deficiency disease
  2. not been shown to protect against heart disease, cancer or other disease
106
Q

vitamin C deficiency symptoms

A
  1. loose teeth
  2. bleeding gums
  3. pinpoint hemorrhages
  4. anemia
  5. tenderness to touch
  6. weakness
  7. swollen ankles and wrists
  8. loss of appetite
  9. growth cessation
107
Q

how can scurvy be cured?

A

100 mg of vitamin C per day for 5 days - easily with food

108
Q

vitamin C and colds

A
  1. supports immune system function
  2. does not prevent colds or benefit cold
    - one study said if taken at high doses may shorten duration of cold about 1/2 a day and reduce symptoms by 40%
109
Q

blood histamine

A

substance responsible for sneezing, runny or stuffy nose, swollen sinuses

110
Q

what dose of vitamin C reduces blood histamine?

A

2 grams per day for 2 weeks
- acts as a weak antihistamine

111
Q

placebo effect and vitamin C

A

there is a placebo effect with vitamin C

112
Q

vitamin C toxicity

A
  1. vitamin C from food is safe
  2. may be dangerous for those with an overload of iron
  3. massive doses may interfere with medications to prevent blood clotting
113
Q

adverse effects of vitamin C

A

digestive upsets such as nausea, abdominal cramps, excessive gas and diarrhea

114
Q

smoking and vitamin C

A

smoking introduces oxidants that deplete vitamin C
- RDA set 35 mg higher for smokers

115
Q

food sources of vitamin C

A
  1. citrus fruits, strawbs, cantaloupe, lettuce, tomato, papaya, mangoes, red pepper
  2. dark green veggies
  3. cabbage veggies
  4. potatoes
116
Q

what fruits and veggies are the best source of vitamin C

A

fresh, raw, and quickly cooked

117
Q

vitamin B function

A
  1. coenzyme function
  2. metabolism
118
Q

B vitamins role as coenzymes

A

combines with and activated an enzyme

119
Q

b vitamins role in metabolism

A
  1. metabolism of carbs, lipids, amino acids
  2. thiamin, riboflaviin, niacin, pantothenic acid and biotin all help release energy
  3. B6 helps body make protein
  4. folate and B12 help cells multiply
120
Q

B vitamin deficiencies

A
  1. every cell affected
  2. cell renewal depends on energy and protein which depend on B vitamins
  3. deficiency in any B vitamin rarely shows up alone, cause people eat foods that contain mixtures of nutrients
121
Q

thiamin deficiency during growth

A

can cause permanent brain damage

122
Q

thiamin function

A
  1. energy metabolism
  2. nerve processes and their responding tissues (muscle)
123
Q

thiamin deficiency

A

beriberi and wernicke-korsakoff syndrome

124
Q

beriberi symptoms

A
  1. loss of sensation in hands and feed
  2. muscular weakness
  3. advanced paralysis
  4. abnormal heart action
125
Q

wet beriberi vs dry beriberi

A

wet: edema present
dry: no edema

126
Q

where was the first beriberi observed

A

with the polishing of rice in Asia

127
Q

wernike-korsakoff syndrome

A
  1. alcohol abuse with sever thiamin deficiency
  2. alcohol displaces food in diet, impairs thiamin absorption, and promotes thiamin excretion in urine
128
Q

symptoms of wernicke-korsakoff syndrome

A
  1. mental confusion
  2. disorientation
  3. loss of memory
  4. jerky eye movements
  5. staggering gait
  6. apathy
  7. irritability
129
Q

treatment of wernicke-korsakoff syndrome

A

thiamin by IV or orally
- alcohol withdrawal protocol in hospitals

129
Q

sources of thiamin

A

1 .widespread in healthy foods
2. pork products
3. sunflower seeds
4. whole grain cereals
5. legumes

130
Q

riboflavin function

A

energy metabolism of all cells

131
Q

riboflavin deficiency

A

ariboflavinosis
- accompanies other vitamin deficiencies due to poor diet (mostly thiamin)

132
Q

ariboflavinosis

A
  1. inflammation of membranes of the mouth, skin, eyes, and GI tract
  2. smooth, purplish, red tongue
    - may go undetected cause thiamin def. symptoms are more severe
133
Q

who are at risk for riboflavin deficiencies?

A

children who lack milk products and meat

134
Q

treatment of ariboflavinosis

A

a diet that treats a riboflavin deficiency also resolves a thiamin deficiency

135
Q

sources of riboflavin

A
  1. milk and milk products
  2. leafy green veggies
  3. whole-grain breads
  4. enriched/fortified grains
  5. some meats and eggs
136
Q

niacin function

A

energy metabolism

137
Q

niacin deficiency

A

pellagra (4’Ds)

138
Q

pellagra 4 D’s

A
  1. diarrhea
  2. dermatitis
  3. dementia
  4. death
139
Q

who is at risk for pellagra?

A

poorly nourished people living in poverty
- particularly those with alcohol addiction

140
Q

sources of niacin

A
  1. tryptophan (abundant in proteins, can be converted to niacin)
  2. milk
  3. eggs
  4. meat, poultry, fish
  5. whole grains
  6. fortified and enriched grains
  7. nuts and seeds
141
Q

niacin equivalents (NE)

A

1 mg of niacin is made from 60 mg of tryptophan
- those with adequate protein, will not be niacin deficient

142
Q

niacin toxicity

A

large doses can cause niacin flush and can injure the liver and caused blurred vision

143
Q

niacin flush

A
  1. painful tingling
  2. flush and hives
    - niacin supplements 2-3x the RDA
144
Q

large doses of niacin (nicotinin acid)

A

may be prescribed to lower blood lipids

145
Q

folate functon

A
  1. DNA synthesis
  2. part of co-enzymes for new cell synthesis
146
Q

folate deficiency

A

anemia - megaloblastic anemia or macrocytic anemia

147
Q

anemia

A
  1. large, immature red blood cells
  2. related to anemia of vitamin B12 deficiency
148
Q

what does a deficiency in folate cause

A
  1. diminished immunity
  2. abnormal digestive function
  3. increase risk of CVD, colon and cervical cancer
149
Q

folate deficiency can lead to?

A

neural tube birth defects (NTDs)

150
Q

NTDs

A

problems with spinal cord, mental delay, severely diminished brain size or even death shortly after birth
- arise in first few days or weeks of pregnancy

151
Q

fortified folate

A

all bleached white grains are fortified with folate (1990s)
- synthetic folate is better absorbed than folate in foods

152
Q

folate toxicity

A
  1. folate can mask vitamin B12 deficiency
  2. excess folate may be antagonistic to action of anticancer drugs
153
Q

dietary folate equivalent (DFE)

A

converts all forms of folate into units that are equivalent to folate in food

154
Q

bioavailability of folate

A
  1. 50% (foods)
  2. 100% (supplements taken on empty stomach)
155
Q

fortified foods and folate supplements

A

given extra credit because they are 1.7 more times available

156
Q

calculating DFE

A

100 mg from food and 100 mg from suuplemennts
= 100 + 100(1.7)

157
Q

sources of folate

A
  1. leafy green veggies
  2. fresh, uncooked veggies and fruits (heat destroys folate)
  3. eggs
  4. orange juice and legumes
158
Q

RDA for folate - healthy adults

A

400 mcg DFE/day

159
Q

RDA for folate - pregnancy

A

600 mcg DFE/day
- 400 supplement, rest healthy diet

160
Q

vitamin B12 function

A
  1. close relationship with folate
  2. maintenance of sheaths that surround and protect nerve fibers
161
Q

vitamin B12 and folate

A
  1. vitamin B12 is activated by folate
  2. folate is activated by vitamin B12
162
Q

vitamin B12 deficiency symptoms

A
  1. damaged nerve sheaths
  2. creeping paralysis
  3. general malfunctioning of nerves and muscles
163
Q

what does vitamin B12 deficiency result in?

A

failure of folate to make red blood cells
- same anemia as folate (large immature red blood cells)

164
Q

who is at risk of a vitamin B12 deficiency?

A
  1. elderly
  2. atrophic gastritis
  3. vegans
165
Q

why are the elderly at risk for vitamin B12 deficiencies?

A

absorption problems
- decreased stomach acidity and decreased intrinsic factor

166
Q

atrophic gastritis

A

inherited gene defect for intrinsic factor production (mid-adulthood)

167
Q

vegans and vitamin B12 deficiency

A
  1. deficiency symptoms take time (6 years worth is stored)
  2. must use vitamin B12-fortified products or supplements
168
Q

vitamin B 12 absorption

A

requires intrinsic factor

169
Q

intrinsic factor

A
  1. compound made by stomach
  2. stomachs acid liberated vitamin B12 from food and intrinsic factor binds to vitamin B12
  3. complex is then absorbed from small intestine into the blood
170
Q

pernicious anemia

A

a vitamin B12 deficiency disease, caused by a lack of intrinsic factor
- large, immature red blood cells

171
Q

treatment of pernicious anemia

A

B12 injections

172
Q

sources of vitamin B12

A
  1. animal sources = best
  2. bioavailability greatest in milk and fish
  3. fortified plant foods (soy beverage)
173
Q

vitamin B6 function

A
  1. 100+ reactions in tissues
  2. assists conversion of one amino acid to another (protein synthesis)
  3. aids in conversion of tryptophan to niacin
  4. neurotransmitter synthesis
  5. hemoglobin synthesis
  6. assist in release of stored glucose to glycogen
  7. immune function
  8. steroid hormonal activity
  9. fetal brain and nervous system development
174
Q

neurotransmitter synthesis

A

conversion of tryptophan to serotonin

175
Q

vitamin B6 deficiency general symptoms

A
  1. weakness
  2. psychological depression
  3. confusion
  4. irritability
  5. insomnia
176
Q

vitamin B6 deficiency weird symptoms

A
  1. anemia
  2. greasy dermatitis
177
Q

advanced cases of vitamin B6 deficiency

A
  1. convulsions
  2. may weaken the immune system
  3. increase risk of heart disease
178
Q

vitamin B6 toxicity in what population?

A

women who intake 2+g/day for 2+ months

179
Q

vitamin B6 toxicity symptoms

A
  1. numb feet
  2. loss of sensation in hands
  3. eventually unable to walk or work
  4. recovered after stopped taking supplements
180
Q

vitamin B6 suplements

A

can deliver 2 g of vitamin

181
Q

what is a 2 g vitamin B6 supplement equivalent to?

A
  1. 3000 bananas
  2. 1600 liver
  3. 3800 chicken breasts
182
Q

vitamin B6 requirement

A

need is proportional to protein intake, due to roles in protein metabolism
STICK WITH FOOD

183
Q

sources of vitamin B6

A
  1. protein-rich foods: meat, fish, poultry
  2. legumes and peanut butter
  3. potatoes, leafy greens, some fruits
184
Q

homocysteine

A

elevated homocysteine may be indicator of CVD risk

185
Q

what causes homocysteine to build up in the blood?

A

deficiencies of folate, vitamin B12, or vitamin B6

186
Q

biotin function

A
  1. energy metabolism
  2. cofactor for several enzymes in metabolism of carbs, fat, proteins
187
Q

biotin deficiency

A

may occur with some rare diseases

188
Q

what results in a biotin deficiency?

A

consumption of dozens of raw egg whites per day - contain a protein that binds biotin (avidin)
- cooking eggs denatures this protein

189
Q

sources of biotin

A

widespread in foods

190
Q

pantothenic acid function

A

1 .energy metabolism
2. coenzyme that plays a role in release of energy from energy nutrients
3. plays a role in 100+ steps concerned with synthesis of lipids, neurotransmitters, steroid hormones, and hemoglobin

191
Q

pantothenic acid deficiency

A

may occur with some rare diseases

192
Q

pantothenic acid sources

A

widespread in foods

193
Q

supplements

A

should only be taken when there is a risk of deficiency

HLTH 230 (9 decks)

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