Fat Soluble Vitamins By Jennifer Turley and Joan Thompson © 2016 Cengage Presentation Overview • • • • Comparison of vitamins in the body. Diagnosing deficiency and toxicity. The fat soluble vitamins, A, D, E, K. Notable health implications. Chemical Forms. Intake Need. Functions. Deficiency. Toxicity. Food Sources. Comparison of Vitamins in the Body Water Soluble: absorbed into blood stream directly, circulate, travel, and stored in water compartments, excrete in urine, without intake deficiency signs and symptoms occur more quickly, toxicity is possible though shorter lived when intake is normalized. Fat Soluble: absorbed into lymph, many require protein carriers, associate with fat, not readily excreted, without intake deficiency signs and symptoms occur more slowly, toxicity is possible and longer lived even when intake is normalized. Diagnosing Nutritional Deficiency or Toxicity 1.Dietary records: Demonstrate low/high intake and/or confirm a metabolic or physiological problem that creates an altered need. 2.Clinical deficiency or toxicity symptoms: Are compatible with low/high dietary intake or altered need. 3.Biochemical tests: Such as blood levels, tissue levels & urine levels demonstrate low/high body levels of the nutrient. 4.Nutrient supplementation: Serves as biological evidence by correcting the deficiency signs & symptoms. For toxicity, removal of the excess. The Fat Soluble Vitamins Vitamin A Chemistry • A family of compounds including: – Retinol, Retinal, Retinoic acid – Pro-Vitamin A carotenoids like beta-carotene Vitamin A Functions • Vision • Internal & external surface linings (epithelial cells) • • • • • • Growth Reproduction Embryonic development Gene expression Immune function Provitamin A forms have antioxidant properties Vitamin A Deficiency vs Toxicity Deficiency Adequacy Toxicity (<66% of DRI) DRI: 700-900 µg RE/day (>UL) Approx. <500 µg RE/day RDI: 5,000 IU >3,000 µg RE/day Hypovitaminosis A Normal vision, gene expression, reproduction, Bone & tooth: Impaired embryonic development, growth epithelial cell Central Nervous System: maintenance, growth, and Night blindness, complete immune function. blindness (Xerophthalmia) GI System: Diarrhea 25 mg beta-carotene (proImmunity: Depressed vitamin A is safe to take immunity, more daily if you are not a infections smoker or drinker). Skin: Hyperkeratosis (thickened skin) Bone & tooth: Decreased bone mineral density Central Nervous System: Headache, vertigo GI System: Nausea and vomiting, liver abnormalities Neuro-Muscular: Incoordination Skin: orange color with excess beta-carotene Other: Retinoid embryopathy Adult deficient, adequate, toxic values Vitamin A: Food Sources • • • • • • • Retinol: (animal) Fortified milk, cheese, butter, margarine Eggs Liver Beta-Carotene: (Plant) dark green leafy vegetables broccoli, deep orange fruits, & vegetables Vitamin A in Foods Adult DRI: 700-900 µg RE/day Vitamin D Chemistry Synthesis & Functions REGULATES Ca-P Balance • Increases bone mineralization • Increases intestinal absorption of calcium • Increase phosphorus excretion Antiproliferative Prodifferentiation Vitamin D Deficiency vs Toxicity Deficiency Adequacy Toxicity (<66% of DRI) Approx. <3 µg/day DRI: 15 µg/day (>UL) RDI: 400 IU = 6.5 µg >50 µg/day Rickets (children) Osteomalacia (adults) Bone & tooth: poor growth, bowed legs, soft bones, pigeon chest, knocked knees, and malformed teeth in children. Porous bones in adults. Cardio-Vascular: increased circulating levels (PTH) and (AlkP) and decreased circulating levels of serum phosphorus GI System: Decreased calcium absorption Normal calcium and Hypervitaminosis D phosphorus balance and cell characterized by high levels of metabolism. 25(OH)D from supplementation Cardio-Vascular: High blood calcium Needs are based upon an Central Nervous System: inadequate exposure to Weakness sunlight. GI System: Nausea, vomiting, Sunlight not implicated in anorexia toxicity. Other: Kidney stones, increased thirst, urination, and urinary calcium. Adult deficient, adequate, toxic values Vitamin D: Sources • Fortified products like milk, margarine, & some cereals • Eggs & fatty fish • Self-synthesis with unprotected peak sunlight exposure Vitamin D in Foods Adult DRI: 15 µg/day Vitamin E Chemistry • A family of alpha, beta, gamma, delta tocopherols & tocotrienols. • Alpha-tocopherol is believed to be the most active form. Vitamin E Functions Membrane Antioxidant & Stabilizer And at the molecular level Vitamin E Deficiency vs Toxicity Deficiency Adequacy Toxicity (<66% of DRI) Approx. <10 mg/day DRI: 15 mg/day (>UL) RDI: 30 IU >1,000 mg/day Normal cell membrane integrity, reduced oxidative stress, and molecular functioning Relatively nontoxic Toxicity with supplements Interferes with vitamin K’s role in blood clotting, augmentation of antiblood clotting medication and increases hemolysis Premature infants: hemolytic anemia Adults: not well characterized Adult deficient, adequate, toxic values Vitamin E: Food Sources • • • • • • Nuts Seeds Plant oils Wheat germ Fortified cereals Vegetables Vitamin E in Foods Adult DRI: 15 mg/day Vitamin K Chemistry • Phylloquinone (K1) from plant sources & naphthaquinones (K2, multiple forms) from animal sources & gut bacteria. Vitamin K Deficiency vs Toxicity Deficiency Adequacy (<66% of DRI) DRI: 90-120 µg Approx. <60 µg/day /day Toxicity (>UL) Not Determined RDI: 90 µg Cardio-Vascular: Normal blood Increases clotting clotting & bone time, hemorrhaging metabolism with cut or injury Poorly described in adults GI System: High levels from supplemented menadione causes jaundice and liver damage in infants Cardio-Vascular: Interference with anti-blood clotting medication Adult deficient, adequate, toxic values Vitamin K: Sources • Green leafy & cruciferous vegetables • Soybeans • Some plant oils Vitamin K in Foods Adult DRI: 90-120 µg/day Some Summary Points • Diagnosing & confirming a nutrient deficiency or toxicity requires a diet analysis, clinical evaluation, biochemical analysis, & evaluating the response to corrected intake levels. • Toxicities and deficiencies take longer to develop for fat soluble vitamins as compared to water soluble vitamins. • The fat soluble vitamins are grouped by their solubility in oil. • The fat soluble vitamins have specific chemical forms & functions in the body. • DRIs exist for essential fat soluble vitamins: A, D, E, & K. • Deficiency & toxicity signs & symptoms are unique for each of these nutrients as are their food sources. References for this presentation are the same as those for this topic found in module 5 of the textbook