LECTURE Vitamin D E & K.pptx

LECTURE Vitamin D E & K.pptx

1. Dr. Anuj Singh Asst. Professor Community Medicine Dept. UIMS, Prayagraj

2. Contents:- Source Function Deficiency Prevention

3. What are vitamins Vitamins are tasteless organic substances that are indispensable to the normal metabolic processes of organisms. They are essential to maintain health and performance, and have to be supplied with the feed. Vitamins do not provide energy themselves, but a deficiency of any vitamin can cause serious complication s .

4. Hi st o r y The term vitamin was coined by biochemist ' Casimir Funk " In 1912 When scientists trying to isolate fat soluble factor B, they discovered a substance containing nitrogen which was chemically an amine , and therefore ter med as vitamin (vita = life).

5. Classification of vitamins Fat-soluble vitamins: Fat-soluble vitamins have specific functions in the development and maintenance of tissue structures . Water-soluble vitamins : Water-soluble vitamins participate in catalytic functions or act as control mechanisms in the metabolism, e.g. as co-enzymes.

6. Vitamin Differences Water Soluble Vitamins Fat Soluble Vitamins Absorption Directly into blood Along with lipids through lymphatic system Storage Circulate freely in water filled parts of body Stored with fat Excretion Excreted through urine Not as easily excreted; stored in body Toxicity Possible from supplements More easily reaches toxic levels - from supplements

7. Fat soluble vitamins The vitamins A, D, E, K and ß-carotene (precursor of vitamin A) belong to the fat-soluble vitamins. These are stored in the body for long periods of time and generally pose a greater risk for toxicity when consumed in excess. The sites of storage are such as kidneys and liver, the muscles, the brain and fat tissue .

8. Vitamin D (2 Forms: Calciferol D2, Cholecalciferol D3) Functions Bone Growth and normal mineralization Helps to maintain blood levels of calcium and phosphorus by absorbtion from intestine and reabsorption from kidney Works in combination with other nutrients and hormones

9. DEFICIENCY Rickets Failure of bones to grow properly Results in “bowed” legs or knock-knees, outward bowed chest and knobs on ribs Osteomalacia : Adult form of rickets Softening of bones, bending of spine, and bowing of legs Osteoporosis (porous bones): Vitamin D plays a major role along with calcium Loss of vitamin D activity with advancing age Associated with fractures  very serious for geriatrics

10. Vitamin D Deficiency - Rickets

11. Rickets in wrist - uncalcified lower ends of bones are porous, ragged, and saucer-shaped (A) Rickets in 3 month old infant (B) Healing after 28 days of treatment (C) After 41 days of treatment A B C

12. PREVENTION Exposure to sunshine Vitamin D supplement to children Milk in diet Food fortification

13. Vitamin - E Vitamin E was discovered 1922 in wheat germ oil. There are eight different forms of naturally occurring vitamin E, but one form, alpha-tocopherol (α- tocopherol), is most active in the body with a side chain of saturated carbons.

14. Vitamin - E What does it do? Protects cell membranes and other fat‐soluble parts of the body (LDL cholesterol) from oxidation May reduce the risk of heart disease May also discourage development of some types of cancer Promotes normal growth and development Promotes normal red blood cell formation Acts as anti‐blood clotting agent Plays some role in the body’s ability to process glucose Also been known to aid the process of wound healing

15. Natural sources and bioavailability Grass, clover, alfalfa, green meal and uncrushed oilseeds are rich in vitamin E. Humidity and long storage have an adverse effect on vitamin E stability and content. Cereals and middlings mainly contain Beta, gama and delta tocopherols (70 – 90%) with a biological activity significantly lower than that of alpha tocopherol.

16. Physiological Role Reduces the production of lipid peroxyl radicals from highly unsaturated fatty acids. Antitoxic effect in cell metabolism. Reduces the incidence of liver necrosis and muscular degeneration. Antioxidant effect . Stabilization of fat (protection against oxidation) in animal products (meat, milk, eggs).

17. Controls metabolism of the hormones via the anterior lobe of the hypophysis. Maintains membrane stability, especially of the cardiac and skeletal muscles. Controls the development and function of the gonads. Stimulates antibody production, phagocytosis and the bactericide effects of phagocytes. Protection against abortion.

18. Interaction with other nutrients Nutrients Synergistic to Vitamin E Selenium : Function closely linked to vitamin E (needed for GSH peroxidase). Vitamin C : Helps in anti oxidant property. Sulfur containing amino acids.

19. Nutrients antagonistic to Vitamin E Vitamin A : Vitamin E Inhibits carotene absorption and conversion to retinol. Vitamin K : May impair absorption. May cause vitamin -D dependent bone mineralization problems.

20. Recommended Dietary Allowance (RDA)  Adult = 7.5-10mg Tocopherol /Day (depending on edible oil used) Vit - E

21. Vitamin - E Who should take supplements? People over the age of 55 Smokers People who abuse alcohol Anyone with inadequate caloric or nutritional dietary intake or increased nutritional requirements

22. Deficiency symptoms Damage to cardiac and skeletal muscles (dystrophy, myopathy) Sudden death through damage to the heart muscle (mulberry heart disease) Liver lesions and changes in fat deposits (yellow-fat disease in mink, brown coloration of bacon). Locomotory disorders and muscle incurvation (banana disease) in pigs.

23. Stiff lamb disease and White muscle disease due to dystrophic alteration in calves and lambs. Fertility disorders Changes in the vascular and nervous system. Exudative diathesis. Nutritional encephalomalacia. Reduced hatchability and exudative diathesis (increased plasma secretion of the blood) in poultry.

24. Toxicity There isn’t any known risk of consuming too much vitamin E from natural food sources. Because vitamin E can act as an anticoagulant and interfere with blood clotting, excess amounts in the body increase the risk of hemorrhage.

25. Vitamin - K Vitamin K was discovered in 1929 in alfalfa Natural sources and bioavailability Vitamin K is a generic term for vitamin K1 (phylloquinone), K2 (menaquinone) and K3 (menadione). Green plants are rich in vitamin K1, Vitamin K2 is produced by bacteria in the lumen of large intestine.

26. Vitamin K – produced by bacteria in large intestine Roles Promotes synthesis of blood clotting proteins (**Interferes with Coumadin) Bone formation Deficiencies are rare but seen in infants, after prolonged antibiotic therapy, and in patients with decreased bile production . Toxicities (>1000 mg/day): rupture of RBCs and jaundice

27. Vitamin K3 (menadione) is an industrial form. The fat-soluble forms K1 and K2 can only be absorbed when pancreas lipase and bile acid are secreted. This is not necessary for the water-soluble vitamin K3. All three forms serve as a basis for the production of menaquinone-4, which is highly active in the metabolism.

28. Physiological role Synthesis of blood coagulation factors II (pre- thrombin), VII, IX and X. Production of the calcium transport protein osteocalcin for bone mineralization Participation in carboxylation of other proteins.

29. Interaction with other nutrients Vitamin A & Vitamin E : May reduce the absorption of Vitamin K. Vitamin E : interfere with blood clotting mechanism of Vitamin K.

30. Recommended Dietary Allowance (RDA)  Adult= 0.03mg/kg/day Vit . k

31. Toxicity Occurs rarely. Vitamin K, excessive amounts can cause the breakdown of red blood cells and liver damage.