water soluble vitamins

Question 1

Signs for risk of water soluble vit deficiency

Answer 1

poverty (poor diet quality), chronic disease states, esp. those impacting absorption (e.g. bariatric surgery) , advanced age, dietary restrictions (celiac disease, food allergies, vegans), high requirements (infants/children/pregnancy/lactation)

Question 2

List alternate names for Vit B1, B2 and B3

Answer 2

B1: thiamine. B2: riboflavin. B3: niacin

Question 3

Functions of Vits B1, B2, and B3

Answer 3

All involved in glycolysis/Krebs cycle. TPP, FAD, NAD; decarboxylation, oxidation-reduction

Question 4

Food sources of Vits B1, B2 and B3

Answer 4

1. Thiamin: whole grains (whole germ), pork, legumes; (decreased in polished rice). 2. Riboflavin: dairy, eggs, meats. 3. Niacin: meat/poultry; tryptophan = precursor

Question 5

Thiamine deficiency Sx

Answer 5

Beriberi: Dry- peripheral neuropathy, muscle tenderness, weakness and atrophy, foot drop. Wet- edema, CHF. Wernicke-Korsakoff: confusion, ataxia, memory loss, ophthalmoplegia. Infantile- vomiting, ophthalmoplegia, acidosis

Question 6

Who is at risk for thiamin deficiency

Answer 6

Alcoholics, bariatric surgery,infants (formula w/o thiamine) anorexia, weight loss, re feeding, polished rice diet (SO Asia), limited diet

Question 7

Riboflavin deficiency Sx

Answer 7

Cheilosis (cracking of skin on lips) and angular stomatitis (sores at corners of mouth), increased vascularization of conjuctiva, scrotal dermatitis

Question 8

Riboflavin deficiency cause

Answer 8

low dairy or animal products

Question 9

Niacin deficiency

Answer 9

Pellagra- 4 D’s: Diarrhea, dermatitis (symmetric scaling w/ de and hyperpigmentation, aggravated by sun exposure “Casals necklace”), dementia, death

Question 10

Niacin deficiency predisposing factors

Answer 10

cornmeal diet, food restriction (rice diet), breastfed infant of deficient mother, malabsorption, alcoholism, metabolic shunting (carcinoid tumor causes increased seretonin and decreased tryptophan)

Question 11

Folic acid functions

Answer 11

Single C transfers: nucleic acid synthesis, amino acid metabolism, DNA Methylation - epigenetics

Question 12

Folic acid food sources

Answer 12

“foliage,” deep green veg, orange juice, whole grains, (Grains enriched in US since 1998), (Easily destroyed in prolonged cooking)

Question 13

Risk of folate deficiency

Answer 13

Inadequate intake or  destruction in food. Alcoholics. Pregnancy – globally, high rates deficiency; WHO: routine supplementation. Hematopoietic conditions. Drug/nutrient interactions

Question 14

Folate deficiency Sx

Answer 14

*Macrocytic anemia *Hypersegmented neutrophils *Glossitis, irritability Homocysteinemia
, Neural tube defects (occurrence/recurrence). * Reversible with correction of deficiencyMacrocytic anemia *Hypersegmented neutrophils *Glossitis, irritability *Homocysteinemia
, Neural tube defects (occurrence/recurrence). * Reversible with correction of deficiency

Question 15

How much folate is recommended for child bearing women

Answer 15

400-800ug/day to prevent neural tube defects which can occur as early as 4-6 weeks gestation

Question 16

Vit B12 alternate name

Answer 16

cobalamin

Question 17

Vit B12 functions

Answer 17

1. Reform tetrahydrafolate from methylfolate (synthesis of methionine) . 2. Catabolism of odd chain length fatty acids. 3. Catalyze isomerization of methylmalonyl Co-A to succinyl Co-A (lipid & CHO metabolism). 4. Metabolism intimately related to folate- One carbon transfers (methylation). Interactions essential for homocysteine > methionine, protein synthesis, nucleic acid syn

Question 18

B12 absorption

Answer 18

Cleave Vitamin from dietary protein in stomach > Binds intrinsic factor from stomach > cobalamin-IF absorbed in distal ielum > transported in circulation as transcobalamin II

Question 19

B12 storage and excretion

Answer 19

Stored in liver, excreted via Bile

Question 20

B12 food sources

Answer 20

Found only in animal products- synthesized by soil bacteria.

Question 21

B12 deficiency risks

Answer 21

Inadequate IF secretion, gastric atrophy, ileal resection, breastfed infant of vegan mother.

Question 22

B12 deficiency sx

Answer 22

Macrocytic anemia & hypersegmented neutrophils- reversible. Neurologic disturbances (not reversible): depression, paresthesias, gait disturbances, burning tongue, dizziness

Question 23

Rule for treating megaloblastic anemia

Answer 23

ushould not be treated w/ folate unless have ruled out Vitamin B-12 deficiency b/c folate will reverse the anemia but neuro effects can occur if the original insult was B12 deficit.

Question 24

Vit C functions

Answer 24

Reversible antioxidant, Vitamin E sparing
Provides reducing equivalents to enzymes: reduction of iron to increase absorption, leukocyte function. Co-sbustrate in hydroxylation (collagen synthesis and conversion of trp to seretonin). Donversion of Dopamine > NE

Question 25

Vit C sources

Answer 25

fruits and veggies

Question 26

Ascorbic acid absorption

Answer 26

100% if low doses, but absorption increases with large doses. Best to take <1g/dose for maximal absorption

Question 27

ascorbic acid excretion

Answer 27

At intakes 80mg/day urine excretion increases. If intake of 400-500mg per day, there is no additional increase in plasma conc.

Question 28

Recommended daily allowance of Vit C

Answer 28

75-90mg/day- provides a pool size of 1500mg and can prevent scurvy for 30-45 days with no intake

Question 29

Vit C deficiency

Answer 29

Scurvy- Hemorrhagic signs, hyperkeratosis of hair follicles and perifollicular hemorrhages, hypochondriasis (depression, weakness), anemia (bleeding, iron/folate deficiency), aching joints/bones/muscles

Question 30

Vitamin C toxicity

Answer 30

Diarrhea, renal stones (oxalate), iron toxicity, rebound scurvy