3 macro and micro-Vitamins for students.pptx

3 macro and micro-Vitamins for students.pptx

1. Micro-nutrients: Vitamins 1

2. What are micronutrients? Micronutrients are nutrients that do not have to be broken down to smaller units for use by the body. Are vitamins and minerals which our body only needs in small amounts. Vitamins are organic and can be affected by extremes of physical and chemical environment Minerals are inorganic. 2

3. Without vitamins thousands of chemical reactions do not occur. Most vitamins cannot be synthesized in the body. Vitamins K ( Menaquinone ) and B12 are synthesized by intestinal microorganisms though not in adequate amounts . Other vitamins like niacin, vitamin D are synthesized in the body from their precursors. 3 Cont …

4. Group characteristics of vitamins Characteristics Water soluble Lipid soluble Names Vitamin C and B-complexes (B1,B2,B3,B5,B6,B9,B12) Vitamins A, D, E and K Solubility In Water In organic compounds like chloroform, benzene and ether Storage Not stored very much Stored in different organs Absorption Directly With lipids through the lymphatic system Transport in the blood Freely Need to be bound to carrier protein Deficiency Apt to develop following acute shortages Deficiency does not develop following acute shortage of the vitamins Toxicity upon intake of mega dose in the form of treatment Unlikely to occur Likely to occur 4

5. Thiamine (Vitamin B1) Functions Forms thiamine pyrophosphate (TPP), a combination of two molecules of phosphoric acid and B1, is the coenzyme form of this vitamin. TPP is critical in several metabolic functions , including the removal of carbon dioxide reactions, which in turn are important in the conversion of amino acids, carbohydrates and fats to energy. It is also necessary for the conversion of carbohydrates to fat . TPP is needed for the synthesis of acetylcholine , a lack of which causes inflammation of the nerves and memory loss . 5

6. Food source Plant sources whole-wheat, cereals,, vegetables, beans Animal Source Salmon steak , Pork meat, Beef kidney Beef liver, fish NB : whole grains contain great amount

7. Deficiency causes Beriberi , Impairment of the Nervous System and the Cardiovascular System. Such a deficiency in alcoholics results in brain problems known as Wernicke-Korsakoff syndrome . This can result in memory impairment, motor problems, and psychosis. 7

8. Vitamin B1 deficiency Dry beriberi Involves the pheripheral nerves Paralysis & sensory loss 2. Wet Beriberi Involve heart and circulatory system High output heart failure Gradually develops edema and ascites 3. Infantile beriberi 3/15/2021 8

9. Risk factors for the deficiency Over processing of grains Alcoholism Inhibit absorption of thiamine Prevention Avoid over milling (over processing ) of the staple cereal Fortify staple cereal with Vitamin B1 Avail adequate amounts of alternative foods rich in thiamine On average adult need about 1.1mg to 1.5 mg depending on situation. 9

10. Riboflavin (Vitamin B2) Function Maintains healthy mucous membranes lining respiratory, digestive, circulatory and excretory tracts when used in conjunction with Vitamin A Preserves integrity of nervous system, skin, eyes. Necessary for the regeneration of glutathione Activates pyridoxine- vitamin B 6 10

11. Deficiency Cracks and sores in corners of mouth ( angular Stomatitis/ Cheilitis ) Inflammation of tongue and lips Eyes too sensitive to light and easily tired Itching, burning and reddening ( Drunkard’s eye ) Itching and scaling of skin around nose, mouth, scrotum, forehead, ears, scalp Dizziness Insomnia Slow learning 11

12. Cont… Food source Dairy products, eggs, meat, green leafy vegetables, liver, whole-wheat cereals, nuts Recommended Daily Allowance Intake of 0.6 mg/1000 Kilocalorie is sufficient. It varies from little as 0.4 mg for infants up to 1.8 mg for lactating mothers 12

13. Niacin (Vitamin B3) Has two forms namely nicotinic acid and nicotinamide Functions participates in more than 50 metabolic functions, all of which are important in the release of energy from carbohydrates: NADP/H Niacin also assists in antioxidant and detoxification functions Maintains normal function of skin, nerves, and digestive system 13

14. Deficiency (a disease of 4 Ds: Diarrhea , Dematitis , Dementia & Death) Early Symptoms: Muscle weakness General fatigue Loss of appetite Skin lesions, Nausea and vomiting Dermatitis (affecting the sun exposed areas) Late consequences of severe deficiency called pellagra: Diarrhea Dementia Death 14

15. A pellagra signs: Casals necklace and skin features 15

16. RDA for niacin in food varies from 5 mg to 20 mg per day Need varies with age 6.6mg/1000kcal is enough for adults. Food Sources Plant Brewer's yeast Peanuts Sunflower seeds Animal Salmon, Pork Chicken, white meat Beef liver Tuna 16

17. Pyridoxine (Vitamin B6) Functions It is particularly indispensable to the action of amino acid neurotransmitters, like serotonin, dopamine, and norepinephrine , Gama amino butyric acid (GABA) which effect brain function. Participate in amino acids deamination and transamination reaction Promotes conversion of tryptophan to serotonin It is also involved in the metabolism of selenium, calcium and magnesium. Helps the body to convert tryptophan, an amino acid, into niacin 17

18. Pyridoxine deficiency Peripheral neuropathy ( pins and needles in the palms and heels ) Weakness, Mental confusion , Irritability, Nervousness, Insomnia Poor coordination walking , Hyperactivity, Muscle twitching Convulsion 18

19. Folic Acid (Vitamin B9) FUNCTIONS It is critical to cellular division because it is necessary for DNA synthesis . Maintains the cell’s genetic code and transfer inherited traits from one cell to another Promotes normal red blood cell formation . Regulates embryonic and fetal development of nerve cells . . 19

20. Food sources Are called foliages. Barley, beans, brewer's yeast Calves' liver Green, leafy vegetables, Fruits Lentils, peas, rice wheat and wheat germ Orange juice

21. Deficiency Without adequate folic acid, DNA synthesis and repair is impaired. Unrepaired DNA leads to diseases like cancer Megalobastic anemia Impaired cell division and protein synthesis, which affects rapidly growing tissues Folic acid deficiency during pregnancy has been linked to several birth defects (Neural tube defect) 21

22. Effects It prevents neural tube defects , So folic acid acid supplementation of high risk women with folate 1 month before and the first 3 months after the onset of pregnancy is recommended Along with vitamins B6 and B12, supplemental folic acid may help those with inadequate intake to prevent a rise in blood levels of homocysteine Believed to be a risk factor for heart disease. Folic acid may counterbalance the effect of alcohol on breast cancer risk. 22

23. RDA and prevention methods RDA for folic acid varies but pregnant need high amount about 400microgram Prevention methods: Folic acid supplementation Encourage eating folic acid rich foods Nutrition education and counseling

24. Cyanocobalamin (Vitamin B12) Parietal cells secrete a special digestive hormone that increases the absorption of vitamin B-12 in the terminal ileum called intrinsic factor . For this reason vitamin B-12 is called extrinsic factor . Unlike other water-soluble vitamins , this vitamin is stored in the body tissues, so a deficiency can take years to appear. 24

25. 25

26. Food sources Vitamin B-12 is found from foods of animal origin which include: Milk, milk products Sardines Liver, Beef, Beef liver Eggs, Kidney NB. Plant products lack vitamin B 12

27. FUNCTION Conversion of homocysteine to methionine ( methyl group added to homocysteine) Prevents folate deficiency Promotes red blood cell development DNA synthesis of covering to nerve cells, Maintenance of normal function of nervous system . 27

28. Deficiency Deficiency is not common Pernicious anemia (megaloblastic anemia) Impaired brain and nervous system function; demylination of nerve fibers in Central Nervous System (Brain and Spinal cord ) Numbness and tingling in hands and feet , difficulty maintaining balance, pale lips, pale tongue, pale gums , confusion and dementia, headache, poor memory . 28

29. Risk factors for B12 deficiency An inadequate diet as in the case of vegans (absolute vegetarians) Disease like infection with fish tapeworm called Diphyllobothyrium latum Lack of intrinsic factor in the small intestine as in the case of surgical removal of the parietal cells of the stomach Surgical removal of the terminal ileum Gastrectomy 29

30. RDA for vitamin B12 is about 2.4µg Prevention methods Avoid being strict vegetarian Increased intake of animal source foods Nutritional counseling

31. VITAMIN C (ASCORBIC ACID) Humans are one of a very few species that cannot manufacture vitamin C and must depend on food for this vital nutrient . Functions Helps to form collagen in connective tissue and tissue repair. Increases iron absorption from intestines ( converts non hem iron in to hem iron ). It is antioxidant Bone density Wound healing and connective tissue metabolism 31

32. Food Sources: Common sources vitamin C are citrus fruits and green leafy vegetables Oranges, papayas Potatoes, spinach Strawberries Sweet and hot peppers Cabbage, grapefruit, mangos, lemons Tomatoes, broccoli Kale, green peppers 32

33. Deficiency Scurvy: muscle weakness, swollen gums, loss of teeth, tiredness, depression, bleeding under skin , Spongy bleeding gums Easy bruising, bleeding tendency Nose bleeding ( epistaxis ) Swollen or painful joints Anaemia: weakness, tiredness, paleness Slow healing of wound and reopening of surgical wounds 33

34. Scurvy: RDA For adults average intake of 30mg to 80 mg is enough but, If intake below 10mg/day it may cause scurvy Bleeding around the bases of the hair on the legs (Perifollicular hemorrhage) and the gums in between the teeth are signs of scurvy. There may be areas of bruising as seen in second picture. There may also be swelling of the bone joints. 34

35. Lipid (fat) Soluble Vitamins Vitamin A, D, E and K

36. Vitamin A (retinol) Beta-carotene is a pro-vitamin A, fat-soluble compound found in plants, Beta-carotene has the greatest pro-vitamin A activity The body converts beta-carotene to Vitamin A. Retinol is the precursor to active forms of Vitamin A, found from animals. These forms include retinal , which is used in vision and reproduction, and retinoic acid, needed in growth and genetic differentiation. 36

37. Food Sources Plant sources : Vitamin A is generally found in deep green leafy vegetables(GLV), yellow orange fruits in the form of B-carotene[ Papaya, Mango, broccoli , Carrots , Kale, fresh Red palm oil, Pumpkin , Spinach, Orange fleshy Sweet potatoes ) Animal sources : found in the form of retinole Liver Fish liver oil Milk and milk products Egg 37

38. Function Forms visual pigment : combines with purple pigment of retina (opsin ) form rhodopsin , which is necessary for sight in partial darkness . Necessary for growth of bone, testicular function, ovarian function Embryonic development Regulation of growth, differentiation of tissues Helps form and maintain healthy skin, hair, and mucous membranes Resistance to infection Antioxidant vitamin 38

39. Night blindness Bitot’s Spots Deficiency Xeropthamlmia (dryness of the eyes)- due to Lack of mucus secretion Night blindness Changes in eyes with eventual blindness if deficiency is severe and untreated Susceptibility to infection and mortality Dry, rough skin 39

40. WHO Classification of Xerophthalmia 2B 1N Night blindness 2B Bitot’s spots X3 Corneal xerosis X4 Corneal ulcerations -Keratomalacia X5 Corneal scars - permanent blindness X3 X5 X4 40

41. Bitot’s Spot Bitot’s spots Changes in mucous membranes Poor bone growth & Weak tooth enamel Diarrhea Slow growth Infertility 41

42. Keratomalacia RDA: 2000 IU to 5000 IU 42

43. Over dosage toxicity Toxicity occurs if a person takes mega dose==10XRDA Signs and symptoms Bulging soft spot on head in babies (infants), sometimes hydrocephaly (" water on brain") , confusion or unusual excitement, diarrhea, dizziness, Double vision , headache, irritability, dry skin, It is teratogen 43

44. Prevention and control of Vitamin A deficiency 1. High Dose vitamin A Supplementation a) Universal Supplementation Schedule Children 6-11 moths = 100,000 IU every 6 months Children 12-59 months 200,000 IU every 6 month Lactating women within 6 week after delivery = 200,000IU A single dose Diseases Targeted Supplementation Schedule Measles, diarrhea and xeropthalmia 44

45. 2 . Breast feeding = Colustrum has high concentration of vitamin A, it is called the first immunization of the baby 3. Dietary Modification : Fortification of oil, flour 4. Dietary Diversification – Behavior change communication on the consumption of vitamin A friendly foods eg . Growing and consuming Orange fleshy sweet potatoes 5.Nutrition education and counseling 45

46. Vitamin D (1,25, Dihydroxychole Calciferol) The two most important are D-2 and D-3. Vitamin D-2 ( Ergocalciferol ) exists in fungi and yeast and is the form generally added to milk, food, and vitamin supplements. Vitamin D-3 ( Cholecalciferol ) is found in fish oils, egg yolks, and milk. The body produces Vitamin D-3 in the presence of ultraviolet sunlight . 7-dehydrocholesterol reacts with ultraviolet light of UVB to produce active Vitamin D 46

47. Functions Regulates growth, hardening and repair of bone by controlling absorption of calcium and phosphorus from small intestine. Promotes normal growth and development of infants and children, particularly bones and teeth . Increases Ca++ uptake from the gut Increase transcription and translation of Ca++ transport proteins in gut epithelium Minor role: also stimulates osteoclasts Increase Ca++ resorption from the bone 47

48. Deficiency Short term problems Rickets (a childhood deficiency disease): Rachitic Rosary, Bowed legs and knocked knees, delayed Fontanel closure, craniotabes Osteomalacia (adult rickets): pain in ribs, lower spine, pelvis and legs, muscle weakness and spasm, brittle, easily broken bones. Muscle diseases ( myopathies) Birth defects Post menopausal bone loss : osteoporosis Long-term Problems Shortness Pelvic deformity Bowed leg- cosmetic /health problem 48

49. Rib beading (rachitic Rosary) Chest deformity Scoliosis Complications of Rickets 49

50. Prevention and control methods Early exposure of neonates to sun light Promoting sun light exposure Consuming Vitamin D rich foods NB dietary intake of Vit D is low as 4µg/day

51. Vitamin E Two forms Tocopherol and tocotrienol The four major forms of Vitamin E are designated alpha (α), beta (ß), delta (△), and gamma (ϒ), on the basis of the chemical structure. Alpha- tocopherol , commonly known as Vitamin E , is the form found most in nature and the most biologically active. 51

52. Functions Antioxidant Terminates chain-propagation reactions Becomes oxidized and must be regenerated prevents oxidation of PUFA in phospholipids Tocotrienols have been shown to suppress cholesterol synthesis Suppression of tumor growth and cell proliferation Involved in reproduction *Vitamin E is an antioxidant that also profits from its interaction with other antioxidants, like Vitamin C and selenium . 52

53. Deficiency Rare Premature infants & persons with fat malabsorption syndromes are “at risk”. Symptoms Degeneration of the retina Hemolytic anemia Muscle weakness, neuromuscular degeneration 53

54. It is widely distributed, especially vegetable oils from plants Vitamin E correlates with level of PUFA 54

55. Vitamin K Vitamin K is somewhat unique because it has both fat- or water-soluble forms. K1 ( phylloquinone ), is found in many plants and animals, and K2 ( menaquinone ), is manufactured by microorganisms, such as bacteria, in the intestinal tract of many animals. K3 ( menadione ) is a synthetic version with the basic structure of the naturally occurring vitamins and is twice as active biologically. This version is soluble in boiling water Fifty percent of the requirement of the vitamin by most individuals is met by intestinal bacterial synthesis 55

56. Functions Promotes production of active prothrombin which are necessary for normal blood clotting. Prevents hemorrhagic disease of the newborn Components of bone protein Osteocalcin and gla protein 56

57. Deficiency Infants: Hemorrhagic disease of the newborn characterized by vomiting blood and bleeding from intestine, umbilical cord, circumcision site. Symptoms begin 2 or 3 days after birth. Adults: Abnormal blood clotting that can lead to nosebleeds , blood in urine, stomach bleeding, bleeding from capillaries or skin causing spontaneous black-and-blue marks. Prolonged clotting time 57

58. Food sources Normal diet contains 300-500 ug vitamin K per day Primarily from plants – broccoli, kale, cabbage, lettuce Soy is also rich sources Bacteria in the colon provide menaquinone Newborn infants – injection at birth recommended (0.5-1 mg im .) 58

59. Risk factors Newborns (no bacteria in intestinal tract to synthesize vitamin K ) People on antibiotics (kills intestinal bacteria ) Liver disease (  absorption of vitamin K) Fat malabsorption 59