Nutrition and Vitamins Flashcards by Liz Haywood

____ ____ is the world’s greatest cause of disease and death

Poor nutrition

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Inadequate intake of protein and/or calories; affects children, particularly after nursing stops; this describes protein-energy malnutrition where?

Developing/”Third World” countries

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Caused by inadequate intake of protein, increased protein loss, or increased body requirement; this protein-energy malnutrition occurs where?

Developed countries

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Severe protein deficiency but adequate total calorie intake

Kwashiorkor

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Why do patients w/ kwashiorkor have hepatomegaly and ascites?

Swollen abdomen b/c of protein deficiency and subcutaneous fat is still present

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Why do patients w/ kwashiorkor not burn fat?

B/c there is no calorie deficiency; they’re burning muscle to liberate free amino acids

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Deficient protein and calorie intake

Marasmus

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Why is the subcutaneous fat markedly depleted in marasmus?

To liberate calories

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Why is there severe muscle wasting in marasmus?

Muscle is depleted due to the need for calories and amino acids

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3 causes of protein-energy malnutrition in the developed world

Increased nutrient loss
Decreased intake
Increased body requirement

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3 related states associated w/ increased nutrient loss

Malabsorption
Diarrhea
Chronic hemorrhage

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3 related states associated w/ decreased intake

Senility/mental illness
Food cost
Poor dentition
Nausea
Alcoholism
Anorexia
Dysphagia

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3 related states associated w/ increased body requirement

Neoplasm
Infection
Fever
Trauma
Burns
Surgery
Lactation

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BMI level for “underweight”

< 18.5

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BMI level for normal weight

18.5-24.9

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BM level for overweight

25-29.9

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BMI level for obese

> 30

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BMI level for “severely/morbidly obese”

> 40

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Name at least 4 minerals

Sodium
Potassium
Calcium
Magnesium
Chloride
Phosphorus

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Name at least 4 essential trace elements

Cobalt
Chromium
Copper
Fluoride
Manganese
Iron
Selenium
Nickel
Molybdenum
Zinc

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Why do patients typically only suffer from deficiencies of water-soluble vitamins?

B/c any excess is excreted in the urine

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Micronutrients that are not produced endogenously and must be obtained by dietary intake; most are cofactors for enzymatic reactions

Vitamins

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3 fat-soluble vitamins

A, E, and K

Why can there be both deficiencies and toxicities in fat-soluble vitamins?

B/c they are stored in fat, there is the possibility for acute toxicity in rapid weight loss

3 reasons why a patient can be deficient in fat-soluble vitamins

Decreased in cases of... - Malabsorption - Biliary insufficiency - Pancreatic insufficiency

List at least 3 water-soluble vitamins

- B1 (thiamine) - B2 (riboflavin) - B3 (niacin) - B5 (pantothenic acid) - B6 (pyridoxine) - B7 (biotin) - B9 (folic acid) - B12 (cobalamin) - Vitamin C (ascorbic acid)

Which 5 vitamins (when lacking in human diet) are associated w/ a pandemic deficiency?

- B1 (thiamine) deficiency - B3 (niacin) deficiency - Vitamin C deficiency - Vitamin D deficiency - Vitamin A deficiency

Vitamin deficiency associated w/ beriberi

Vitamin B1 (thiamine) deficiency

Vitamin deficiency associated w/ Wenicke-Korsakoff syndrome

Vitamin B1 (thiamine) deficiency

What segment of the population is affected by this syndrome?

Associated w/ alcoholism due to thiamine's role in helping brain cells produce energy from glucose

Its phosphate derivatives are involved in being a coenzyme in the catabolism of CHOs and amino acids; used in biosynthesis of neurotransmitters acetylcholine and gamma-aminobutyric acid (GABA); in yeast it's required in the first step of alcoholic fermentation

Functions of vitamin B1 (thiamine)

Functions as coenzymes for a wide variety of oxidative enzymatic reactions; they act as oxidzing agents b/c of their ability to accept a pair of hydrogen atoms; plays various roles in intermediary metabolism; always accompanied by other vitamin deficiencies

Functions of vitamin B2 (riboflavin)

Precursor to NAD+/NADH and NADP+/NADPH, which plays an essential mtabolic role in living cells; involved in both DNA repair and the production of steroid hormones in the adrenal cortex

Functions of vitamin B3 (niacin/nicotinic acid)

Vitamin deficiency associated w/ pellagra

Vitamin B3 (niacin/nicotonic acid) deficiency

Four D's associated w/ pellagra

- Diarrhea - Dermatitis - Dementia - Death

Used in the synthesis of CoA which is also required for acylation and acetylation, which, for example, are involved in signal transduction and enzyme activation and deactivation, respectively

Functions of vitamin B5 (pantothenic acid)

What is the active form of pyridoxine

Pyridoxal phosphate (PLP)

Cofactor in many reactions of amino acid metabolism, including transamination, deamination, and decarboxylation; involved in macronutrient metabolism, neurotransmitter synthesis, histamine synthesis, Hgb synthesis and function, and gene expression; necessary for enzymaic reaction governing release of glucose from glycogen

Functions of vitamin B6 (pyridoxine)

Typical gross symptoms associated w/ vitamin B6 (pyridoxine) deficiency

- Atrophic glossitis ("smooth tongue") w/ ulceration, seborrhoeic dermatitis-erruption, angular chalets, and conjuctivitis - Neurological symptoms: somnolence, confusion, and neuropathy

Essential for amino acid catabolism, gluconeogenesis, and fatty acid metabolism; necessary for cell growth; helpful in maintaining steady blood sugar level; recommended as dietary supplement for strengthening hair and nails

Functions of vitamin B7 (biotin)

Necessary for production and maintenance of new cells, for DNA and RNA synthesis, and for preventing changes to DNA (thus, preventing cancer); important during periods of frequent cell division and growth (infancy and pregnancy)

Function of vitamin B9 (folic acid)

Why do patients w/ vitamin B9 (folic acid) deficiency demonstrate abnormal hematopoiesis leading to megaloblastic anemia?

Folate deficiency limits cell division → erythropoiesis is hindered and leads to megaloblastic anemia, which is characterized by large RBCs w/ fragile membranes

Plays a significant role in the metabolism of every cell of the body, especially affecting the DNA synthesis and regulation but also fatty acid synthesis and energy production

Functions of vitamin B12 (cobalamin)

What compound is necessary for it the absorption of vitamin B12 (cobalamin)?

Intrinsic factor from gastric parietal cells - - Complex binds to receptors in the ileum which then separates and vitamin B12 binds to transcobalamin for transport

3 general causes of vitamin B12 deficiency

- Inadequate intrinsic factor - Inadequate B12/IF complexes - Inadequate absorption

What type of anemia results from altered action of intrinsic factor in vitamin B12 deficiency?

Pernicious anemia

Essential to a healthy diet as well as being a highly effective antioxidant, acting to lessen oxidative stress and an enzyme cofactor for the biosynthesis of many important biochemicals; acts as an electron donor for important enzymes

Functions of vitamin C (ascorbic acid)

Symptoms of vitamin C deficiency

- Swollen gums/loss of teeth - Skin lesions - Petechial hemorrhage in lower extremities - Reduced wound healing - Osteoporosis

Disease associated w/ severe deficiency of vitamin C

Scurvy

Functions of vitamin A

- Vision - Gene transcription - Immune function - Embryonic development and production - Bone metabolism - Hematopoiesis - Skin and cellular health - Antioxidant activity

3 symptoms associated w/ vitamin A deficiency

- Night blindness - Disordered keratinization - impaired immunity - Hyperkeratosis - Hyperkeratosis pilaris (chicken skin) - Dental enamel hypoplasia

3 symptoms associated w/ both acute vitamin A excess and chronic vitamin A excess

- Acute: drowsiness, irritability, headaches, peeling of the skin - Chronic: coarse hair, eyebrow hair loss, skin and mucus membrane dryness, bone and joint changes, fractures

Most severe symptom associated w/ vitamin E (tocopherol) deficiency

Spinocerebellar ataxia (atrophy of the cerebellum)

Vitamin K's important function in ensuring the proper structure of vitamin K-dependent proteins

Vitamin K participated in the conversion of glutamate residue of these K-dependent proteins to y-carboxylglutamate residues by addition of a carboxyl-group (carboxylation)

Typical symptoms associated w/ bleeding if vitamin K is deficient

- Ecchymosis - Petechiae - Hematomas - Oozing of blood at surgical or puncture sites