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HLTH230 FINAL EXAM > week 7-10 > Flashcards

week 7-10 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

over nutrition

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 caused by something other than inadequate intake such as disease or drug interaction that reduces absorption, accelerates use

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8
Q

fat soluble vitamins

A

ADEK

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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 vitamin 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 AND 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

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15
Q

where are fat soluble vitamins found

A

fats and oils of food

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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 dat diets interfere with absorption
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19
Q

3 active forms of vit 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

vision
gene expression
maintenance of body linings and skin
immunity
growth of bones and body
normal dev of cells
critical importance to reproduction

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22
Q

eyesight

A

light passes through cornea before striking retina

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 (keratinization)

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27
Q

keratinization

A

can lead to xerosis (drying) and xerophthalmia (thickening) which can cause perm damage

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28
Q

skin/body linings and vitamin A

A
  1. needed by all epitheial tissues
  2. 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 producs immune system proteins
  2. def can lead to a spiral of infection
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33
Q

growth and vitamin a

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 complictions 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 signs of vitamin a toxicity

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

long term symptoms of vit 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

vitamin a : accutane

A

derived from vitamin a
- vitamin a supplement does not help with acne

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42
Q

what organ is most affected by vitamin a toxicity

A

liver

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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
  • most abundant of the carotenoid precursors
  • 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

which foods are rich is beta carotene and play a role in healthy eyesight

A

deep bright orange fruits
dark green veggies

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47
Q

does eating carrots promote good vision

A

does not improve vision if vitamin a intake in already adequate

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48
Q

carotenoids and disease

A
  1. beta-carotene is associated with reduced cancer risk
  2. benefits only seen with food NOT supplements
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49
Q

foods NOT rich is beta-carotene

A

increase risk of macular degeneration

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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

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)
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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 vit 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. 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 1 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 def for adults

A

bone loss later in life

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62
Q

risks with vitamin d def for older adults

A

painful joints and muscles

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63
Q

osteomalacia

A

adult form 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 the 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

consume beverages with no vitamin D
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 is vitamin d made from the sun

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 covert precursor to active form of vitamin d
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70
Q

is there any risk of vitamin d toxicity with skin synthesis

A

NO

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71
Q

factors affecting 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

suncreen that has spf of 8

A

reduce sun risks, but also prevents vitamin d synthesis

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73
Q

canadian cancer society

A

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

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74
Q

vitamn d rda

A

400 IU
rec may increase with age

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75
Q

sources of vitamin d

A
  1. sunlight

small amounts from butter,

cream, fortified margarine
fortified milk

egg yolks, liver, fatty fish, fish oil

mushrooms

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76
Q

4 tocopheral compounds of vitamin E

A
  1. alpha
    beta
    gamma
    delta
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77
Q

what is the gold standard for vitamin e activity

A

alpha-tocopheral

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78
Q

antixoidant activity

A

defends the body against oxidative damage

vitamin e is oxidied protecting cells

79
Q

oxidative damage

A

results from free radicals

80
Q

free radicals

A

formed during metabolism disrupt the structure of cellular lipids, DNA and proteins

free radical activity may contribute to development of cancer, heart disease etc

81
Q

vitamin e antioxidant effect

A
  1. cruical 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 cells which results in anemia

86
Q

vitamin e deficiency in adults

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

no toxicity with natural food sources

large doses may increase effects of anticoagulant medications

increased risk of death for those taking greater than 400 IU from supplement

89
Q

food sources of vitamin e

A

veggies oils (salad dressing)
avocados
wheat germ
smaller amounts from meat, poultry, fish, eggs, milk products, nuts seeds

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 protiens that bind mienrals to bone
91
Q

blood clotting proteins

A
  1. intestinal bacetria
  2. leafy green veggies
  3. cabbage
  4. canola and soybean oils
  5. eggs and milk (small)
  6. liver rich in animal source
92
Q

vitamin k and new borns

A

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

93
Q

when are you at risk for vitamin K deficiency?

A
  • newborns
  • antibiotic treatment (kills beneficial and harmful bacteria in intestinal tract
  • fat malabsorption (unlikely in adults)
94
Q

vitamin k toxicity

A

NO ul

onfant and preg women can result from over supplementation with synthetic vitamin k

95
Q

vitamin k toxicity lead to

A

jaundice and bilirubin in brain of an infant

can cause brain damage or death

96
Q

water soluble vitamins

A
  • cooking and washing water leaches them out of food
  • easily absorbed
  • excess readily excreted in urine
97
Q

toxicity from water soluble vitamins

A
  • not from food
  • can occur from large doses of concentrated in vitamin supplements (ie b12 urine)
98
Q

vitamins for athletes

A

atheletes with an appropriate diet do not usually need supplements
- increased energy = more food

99
Q

vitamin c experiment

A

those who recieved citrus quickly recovered from scurvy

100
Q

scurvy

A
  • vitamin c def
  • to avoid scurvy british sailors were given lime juice
101
Q

roles of vitamin c

A

1 maintenance of connective tissues
2. antioxidant

102
Q

vitamin c and connective tissue maintenance

A

formation and mainentance of collagen

  • component of bones, teeth, tendons, scar tissue, capillaries
103
Q

vitamin c antioxidant function

A
  • protects substances found in food and body
  • protects iron from oxidation
  • protects blood constituents from oxidation and helps protect vitamin E (returns to active form)
104
Q

vitamin c supplements

A
  • useful to treat a deficiency disease
  • not been show to protect against heart disease, cancer or both disease
105
Q

vitamin c deficiency symptoms

A
  • loose teeth
  • bleeding gums
  • pinpoint hemorrhages
  • anemia
  • tenderness to touch
  • weakness
  • swollen ankles and wrists
  • loss of appetite
  • growth cessation
106
Q

how can scruy be cured

A

1–mg of vitamin c per day for 5 days - easily with food

107
Q

vitamin c and colds

A
  • supports immune system functin
  • 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 40%)
108
Q

blood histamine

A

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

109
Q

what dose of vitamin c reduce blood histamine

A

2g per day for 2 weeks

110
Q

is there a placebo effect with vitamin c

A

yes

111
Q

vitamin c toxicity

A
  • vitamin c from food is safe
  • may be dangerous for those with an overload of iron
  • massive doses can interfere with meds to prevent blood clotting
112
Q

adverse effects of vitamin c

A

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

113
Q

smoking and vitamin c

A

smoking introduces oxidants that deplete citamin c

rda set 35mg higher for smokers

114
Q

food sources of vitamin c

A
  • citrus fruits, strawberries, cantaloupe, lettuce, papaya, mango, tomato, red pepper
  • dark green veggies
  • cabbage
    -potatoes
115
Q

what fruits and veg are best source of vitamin c

A

fresh, raw and quickly cooked

116
Q

vitamin b function

A
  • coenzyme function
  • metabolism
117
Q

b vitamin role as coenzymes

A

combines with an activated an enzyme

118
Q

b vitamin role in metabolism

A
  • metabolism of carbs, lipids and AA
  • thiamin, riboflavin, niacin, pantothenic acid and biotic all help release energ
  • B6 helps body make protien
  • folate and B12 help cells multiply
119
Q

b vitamin deficiences

A
  • every cell affected
  • cell renewal depends on energy and protien which depend on b vitamins
  • deficiency in any b vitamin rarely shows up alone
120
Q

thiamin deficiency during growth

A

can cause permanent brain damage

121
Q

thiamin function

A
  • energy metabolism
  • nerve processes and their corresponding tissues (muscle)
122
Q

thiamin deficiency

A

beriberi and wernicke-korsakoff syndrome

123
Q

beriberi symptoms

A

loss of sensation in hands and feed
muscular weakness
advanced paralysis
abnormal heart action

124
Q

wet beriberi vs dry beriberi

A

wet: edema present
dry: no edema

125
Q

where was the first beriberi observed

A

with the polishing of rice in Asia

126
Q

wernike-korsakoff syndrome

A

alcohol abuse with sever thiamin deficiency

alcohol displaces food in diet, impairs thiamin absorption, and promotes thiamin excretion in urine

127
Q

symptoms of wernicke-korsakoff syndrome

A

mental confusion
disorientation
loss of memory
jerky eye movements
staggering gait
apathy
irritability

128
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

inflammation of membranes of the mouth, skin, eyes, and GI tract

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

milk and milk products
leafy green veggies
whole-grain breads
enriched/fortified grains
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

diarrhea
dermatitis
dementia
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

tryptophan (abundant in proteins, can be converted to niacin)
milk
eggs
meat, poultry, fish
whole grains
fortified and enriched grains
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

painful tingling

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 function

A

DNA synthesis
part of co-enzymes for new cell synthesis

146
Q

folate deficiency

A

anemia - megaloblastic anemia or macrocytic anemia

147
Q

anemia

A

large, immature red blood cells

related to anemia of vitamin B12 deficiency

148
Q

what does a deficiency in folate cause

A
  • dimminsihed immunity
  • abnormal digestive function
  • increased risk of cvd, COLON and cervical cancer
149
Q

folate deficiency can lead to?

A

neural tube birth defects (NTDs)

150
Q

NTDS

A

problem w spinal cord, mental delay severly 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 food

152
Q

folate toxicity

A

folate can mask vitamin B12 deficiency

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

50% (foods)
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

leafy green veggies
fresh, uncooked veggies and fruits (heat destroys folate)
eggs
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

close relationship with folate

maintenance of sheaths that surround and protect nerve fibers

161
Q

vitamin B12 and folate

A

vitamin B12 is activated by folate

folate is activated by vitamin B12

162
Q

vitamin B12 deficiency symptoms

A

damaged nerve sheaths

creeping paralysis

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 cell
164
Q

who is at risk of a vitamin B12 deficiency?

A

elderly
atrophic gastritis
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

deficiency symptoms take time (6 years worth is stored)

must use vitamin B12-fortified products or supplements

168
Q

vitamin B 12 absorption

A

requires an intrinsic factor

169
Q

intrinsic factor

A

compound made by stomach

stomachs acid liberated vitamin B12 from food and intrinsic factor binds to vitamin B12

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

animal sources = best

bioavailability greatest in milk and fish

fortified plant foods (soy beverage)

173
Q

Vitamin B6 function

A

100+ reactions in tissues

assists conversion of one amino acid to another (protein synthesis)

aids in conversion of tryptophan to niacin

neurotransmitter synthesis

hemoglobin synthesis

assist in release of stored

glucose to glycogen

immune function

steroid hormonal activity

fetal brain and nervous system development

174
Q

neurotransmitter synthesis

A

conversion of tryptophan to serotonin

175
Q

vitamin B6 deficiency general symptoms

A

weakness

psychological depression

confusion

irritability

insomnia

176
Q

vitamin B6 deficiency weird symptoms

A

anemia

greasy dermatitis

177
Q

advanced cases of vitamin B6 deficiency

A

convulsions

may weaken the immune system

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

numb feet

loss of sensation in hands

eventually unable to walk or work

recovered after stopped taking supplements

180
Q

vitamin B6 suplements

A

can deliver 2 g of vitamin

181
Q

what is a 2 g of vitamin B6 supplement = to?

A

3000 bananas
1600 liver
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

protein-rich foods: meat, fish, poultry
legumes and peanut butter
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

defieicnes of folate, vitamin b12 or vitamin b6

186
Q

biotic function

A
  • energy metabolism
  • cofactor for several enzymes in metabolism of carbs, fats and 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

widspread 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 thee is a risk of deficiency

HLTH230 FINAL EXAM (4 decks)

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