Intro
Both Vitamin A and Vitamin C are necessary
for proper immune system function.
Vitamin A
Fat-soluble
“Vitamin A” is actually a term that refers to a
group of substances that include retinol
(preformed Vitamin A), retinal, retinoic acid,
retinyl esters.
“Vitamin A” can also refer to precursor
compounds known as carotenoids.
Absorbed in the small intestine (70-90%);
more than 90% located in liver
Structure of Vitamin A
Source: http://www.bio-pro.de/en/region/stern/magazin/00403/index.html
Vitamin A: Functions
Growth (production of HGH, normal functioning of osteoblasts
and osteoclasts)
Reproduction
Embryonic development (retinoic acid influences cell
differentiation)
Vision (eye uses retinal to transduce light into neural signals and
retinoic acid to maintain cornea/conjuctival membrane
differentiation which prevents xerophthalmia)
Gene expression (retinioic acid regulates expression of encoding
genes for structural proteins, enzymes, extracellular matrix
proteins, and retinol binding proteins and receptors)
Immune function (retinol regulates lymphocyte physiology)
Glycoprotein synthesis
Carotenoids
Plant pigments – deep colors
alpha-carotene, beta-carotene, lycopene,
lutein, xeaxanthin, beta-cryptoxanthin
alpha-carotene, beta-carotene, and beta-
cryptoxanthin can be converted in Vitamin A
(provitamin A)
Fat-soluble
Absorbed in the intestine and stored in
tissues
Vitamin A: Food Sources
Preformed Vitamin A (retinol) is found in
animal-based foods such as liver, dairy, and
fish.
Also prevalent in fortified grains
Carotenoids as provitamin A are found in
darkly pigmented plant products such as
spinach, broccoli, cantaloupe, carrots, and
vegetable-beef/chicken soup.
All are also found in supplement form
Vitamin A: Biochemical Indicators
Serum retinol and serum binding protein
Vitamin A Deficiency:
Causes
Absorption is enhanced by fat, and
diminished by diarrhea, intestinal infections,
and infestations.
Deficiency is rare in developed nations, but
common in developing countries
Vitamin A Deficiency:
Consequences
Most common condition is xerophthalmia
(irreversible drying of conjunctiva and cornea)
Affects 3-10 million children/year
Starts with night blindness, then continues into
conjuntival xerosis, Bitot’s spots, corneal xerosis,
corneal ulceration, and scarring)
Decreased immune function/increased risk of
infectious morbidity/mortality
No known deficiency effects from
underconsumption of carotenoids.
Vitamin A Toxicity:
Causes
>=30,000 mcg/day for months-years is
chronic toxicity
>= 150,000 mcg in single or short-term doses
is acute toxicity (less in children)
Excludes beta-carotene
Vitamin A Toxicity:
Consequences
Acute Toxicity:
Effects are transient and include:
Nausea
Vomiting
Headache
Increased cerebrospinal fluid pressure
Vertigo
Blurred vision
Loss of muscular coordination
Bulging fontanel in infants
Chronic Toxicity:
Less specific and more varied symptoms including:
Birth defects
Liver abnormality
Reduced bone mineral density
CNS disorders
Possible teratogenicity
Infants and children can also experience bone tenderness/pain, increased
intracrancial pressure, desquamation, brittle nails, mouth fissures, alopecia,
fever, headache, lethargy, irritability, weight loss, vomiting, and hepatomegaly.
Vitamin A DRI’s
Vitamin A DRI’s
Vitamin A DRI’s were based on assurance of
adequate liver stores for age 19 – 70 YO
For 1-18 YO, the adult EAR was extrapolated
For 0-6 MO, average Vitamin A intake from human milk
was used
For 7-12 MO, the infant EAR was extrapolated
Pregnancy and lactation
Lack of evidence to determine DRI for provitamin A
forms
UL was determined using risk of liver abnormalities
or teratogenocity
RAE = Retinol Activity Equivalent
RAEs
Vitamin A Summary
Vitamin A is a fat-soluble vitamin important for
immune function, growth, embryonic development,
immunity, and vision.
Vitamin A can come as a preformed version
(retinol), or as provitamin A (carotenoids).
Vitamin A DRIs are represented as Retinol Activity
Equivalents (RAEs)
Vitamin A DRIs were determined using assurance of
adequate liver stores
The RDA for adult males and females for Vitamin A
is 900 mcg and 700 mcg, respectively.
Vitamin C
Also known as ascorbic acid
Water-soluble
Absorbed in intestine by an Na+ dependent
active transport (high concentrations use
passive transport)
Also regulated by the kidneys (conservation
and excretion)
Stored in pools throughout the body
Vitamin C
Source: http://biology.clc.uc.edu/courses/bio105/vitamin.htm
Vitamin C: Functions
Antioxidant (high reducing power)
Scavenger of free radicals
Cofactor for enzymes in the biosynthesis of
carnitine, collagen, NTs, and in vitro processes
Reducing agent
Scavenging of reactive oxidants in leukocytes,
lung mucosa, gastric mucosa
Diminished lipid peroxidation
Vitamin C: Sources
Fruits and Vegetables such as citrus fruits,
tomatoes, tomato juice, potatoes, brussel
sprouts, cauliflower, strawberries, cabbage,
spinach
Fortification
Supplements
70-90% bioavailability (50% at high intakes)
Vitamin C: Biochemical Indicators
Plasma and leukocyte ascorbic acid levels
Vitamin C Deficiency:
Causes
Rare in developed countries, although is
seen in diets that lack fruits and vegetables,
older men, and lower socioeconomic status
Vitamin C Deficiency:
Consequences
Scurvy, which includes symptoms such as
follicular hyperkeratosis, petechiae,
ecchymoses, coiled hairs, inflamed and
bleeding gums, perifollicular hemorrhages,
join effusions, arthralgia, impaired wound
healing, dyspnea, edema, dry eyes and
mouth, weakness, fatigue, depression
Infantile scurvy includes bone abnormalities,
hemorrhagic symptoms, and anemia
Vitamin C Toxicity
Large doses (> 3,000 mg/day)
Diarrhea and other GI disturbances
No other adverse effects
Vitamin C DRIs
Vitamin C DRIs
DRIs were determined by estimates of body
pool or tissue Vitamin C levels that were
considered adequate for antioxidant
protection and minimal urinary loss
Women have higher blood levels
Smokers have a higher requirement
UL determined by occurrence of osmotic
diarrhea and GI disturbances
Vitamin C Summary
Vitamin C is an important antioxidant.
Vitamin C is water-soluble.
Vitamin C is found in many fruits and vegetables,
especially citrus fruits.
Vitamin C deficiency results in scurvy and its
associated symptoms.
Extremely high amounts of more than 3,000 mg/day
of Vitamin C can result in diarrhea and GI
disturbances
The RDA for adult males and females for Vitamin C
is 90 mg/day and 75 mg/day, respectively.