Vitamins, Minerals, and Their Health Impacts

Vitamin A

A fat-soluble vitamin with two main forms: Retinoids and Carotenoids.

Retinoids

Preformed Vitamin A that exists only in animal products, with three active forms: Retinol, retinal, and retinoic acid.

Carotenoids

Plant-based pigments such as Beta Carotene that the body can convert into Vitamin A.

• Exist only in plant foods

• Lycopene & Zeaxanthin are 2 carotenoids which support eye health

• The body can make Vitamin A from Beta Carotene as needed

• High in antioxidants

Antioxidants

Substances that donate an electron to free radicals to prevent cellular damage.

Vitamin A Deficiency and Blindness

• Vitamin A deficiency is the leading cause of preventable blindness worldwide

• Worldwide, 1/3 of children suffer from deficiency (most common in SE Asia)

• Night blindness

• Vitamin A deficiency causing loss of the ability to see under low-light conditions

• There's a retinoid compound in your eye that reacts to light and sends a nervous signal to your brain to allow you to see

RDA for Vitamin A (Adult Male)

900 mcg per day.

RDA for Vitamin A (Adult Female)

700 mcg per day.

UL for Vitamin A RDA

3000 mcg.

Rich foods in vitamin A

• Orange or green vegetables (the chlorophyl covers up the orange color)

• Dairy products & meat supply preformed Vitamin A (but when you take the fat out of milk, you also remove the Vit A)

Excessive vitamin A can cause

 severe birth defects & miscarriage in pregnant women (or those trying to get pregnant)

Hypercarotenemia

A condition caused by excessive intake of carrots or beta-carotene supplements that turns skin yellow/orange.

Rickets

A childhood disease resulting from Vitamin D deficiency, leading to soft bones and deformities.

Osteomalacia

A condition in adults characterized by soft bones due to Vitamin D deficiency.

Vitamin K

A fat-soluble vitamin essential for blood coagulation (clotting).

Vitamin A Storage

Vitamin A is stored in the liver for many months, indicating a long half-life.

Retinoid compound in the eye

A compound that reacts to light and sends signals to the brain, allowing vision.

Bow legs

A deformity in children caused by Rickets, resulting from Vitamin D deficiency.

Vitamin B-12

Only vitamin which contains mineral (i.e. cobalt).

Cobalamin

Another name for Vitamin B-12.

Function of Vitamin B-12

folate metabolism & myelin sheath development (which insulates neurons)

• Absorption is complicated because the body has to produce enough Intrinsic Factor (a protein released by stomach cells) in order for B-12 to be absorbed

• As we age, we produce less IF, thus older people are more likely to be deficient in B12

Sources of vitamin B-12

 found only in animal sources (meat, salmon, fish, milk); B-12 also found in fortified grains & cereals

• If you are a vegan, you need to supplement or rely on fortified sources such as soy milk and/or nutritional yeast

Pernicious Anemia

Disease caused when the body can't absorb B-12, resulting in paralysis and eventual death.

Xerophthalmia

Hardening of the cornea and drying of the surface of the eye, which can result in blindness.

Epithelial Cells

Cells that line internal and external surfaces of the body, important barriers to infection.

Retinoic Acid

Vitamin A required for immature epithelial cells to develop into mature, functional cells.

Hyperkeratosis

Condition where skin cells produce too much keratin, causing skin hardening.

Vitamin D

Fat-soluble vitamin that acts as a hormone and regulates blood levels of calcium and phosphorus.

• only vitamin that’s a hormone

7-dehydrocholesterol

Cholesterol precursor converted into inactive Vitamin D when skin is exposed to UV light.

Vitamin D Activation

Occurs in the liver and kidneys after Vitamin D is consumed or synthesized.

Vitamin D Deficiency

Leads to bone health problems and a depressed immune system.

Dietary Vitamin D Recommendations

Adults need 15 micrograms, elderly need 20 micrograms, and kids need 10 micrograms.

Upper Limit of Vitamin D

100 micrograms daily; toxicity can increase blood calcium levels leading to lethargy and GI issues.

Main Function of Vitamin D

regulate blood levels of calcium & phosphorus

• You can theoretically get all your Vit D from sun exposure

• Vit D is involved in gene expression, cell growth, and immune function

• May decrease cancer risk

• People that have enough Vit D are typically sick less often and are less likely to have an auto-immune disease

Vitamin D deficiency

•Deficiency leads to bone health problems & depressed immune system

•If blood levels of vitamin D are low the body will ‘take’ calcium from the bones to use as Vitamin D

•High deficiency risk in dark-skinned people, exclusively breastfed infants, elderly, and those who aren’t outside much

More than ___ of adults over 19 dont consume enough vitamin D

90%

Kids need ___ micrograms of vitamin D

10

Adults need ___ micrograms of Vitamin D

15

Elderly need ___ micrograms of Vitamin D

20

Upper limit for Vitamin D

100 micrograms daily

Sun Exposure

needed to activate vitamin D affected by:

• Skin color: darker skinned people need more time in the sun

• Age: older adults have trouble making Vit D

• Time of day & season & latitude

Folate (B9)

Naturally occurring vitamin in foods and in the body, important for DNA synthesis.

Folic Acid

Synthetic form of Folate.

Megaloblastic Anemia

- Condition caused by Folate deficiency, resulting in macrocytic anemia.

- Occurs when red blood cells are unable to divide, leaving large, immature red blood cells.

Neural Tube Defects

Defects such as spina bifida in developing in utero babies due to Folate deficiency.

Neural tube closes first 28 days of pregnancy, so prenatal vits are key

(B9)

RDA for Folate (B9)

400 micrograms, especially critical during early pregnancy.

Rich Food Sources of Folate (B9)

Green leafy foliage, strawberries, oranges, nuts, and beans.

Homocysteine

A specific amino acid that Folate helps break down.

Megaloblastic anemia

when red blood cells are unable to divide, leaving large, immature red blood cells

• Either a folate or vitamin B-12 deficiency may cause this condition

• Measurements of blood concentrations of both vitamins are taken to help determine the cause of the anemia

Bioavailability

- How much of a drug (or substance) actually enters your bloodstream and is available for your body to use.

- Affected by age, gender, prescription drugs, fiber content of diet.

Vitamin E

Fat-soluble vitamin with alpha-tocopherol as the active form in our bodies.

Functions of Vitamin E

• Antioxidant- donates an electron to a free radical

• protects cell membranes

• improves Vitamin A absorption

• supports immune system

• assists with iron metabolism.

Vitamin E role in cell membranes

Inserts itself into cell membranes to stop free-radical chain reactions.

 This function is especially important in areas of high oxygen levels (RBCs/lungs)

• If Vit E isn’t inserted, extensive oxidative damage (and cell death) can occur

Vitamin E deficiency

Rare; populations at risk include preterm infants due to late transfer from mother.

• Populations at risk: preterm infants as transfer of vitamin E from mother occurs late in pregnancy (this is why Vit E fortified formula is given to premature babies)

Potential problems of Vitamin E deficiency

Hemolysis, nerve damage, smoking destroys vitamin E in lungs, fat-malabsorption disorders.

Getting enough Vitamin E

Best sources include plant oils, nuts, seeds, quinoa, fortified cereal

• Animal products such as beef, eggs, and dairy have almost no Vit

• Avocado in guacamole and the oil in tortilla chip are good sources of Vitamin E 

• Joe T garcias example 

RDA Vitamin E for adults

15 milligrams

Vitamin E Toxicity

Can cause excessive bleeding, interfere with Vitamin K, leads to muscle weakness and GI distress;

Upper limit for Vitamin E

1000 mg per day

Vitamin K production

Gut bacteria in the large intestine produces 10% of the Vitamin K your body needs.

Vitamin K function

• Biggest job of Vitamin K: blood clotting

• Activates prothrombin, increases thrombin

• Bone health:

• Osteocalcin depends upon vitamin K for function in bone mineralization (hardening) and bone development in early life

Vitamin K Deficiency in infants

Moms don't transfer much Vitamin K to babies in utero; infants are given a Vitamin K shot right after birth.

Getting Enough Vitamin K

• Even though Vit K is fat soluble, it is broken down very quickly and excreted in urine or stool

• Thus, we have NEVER seen toxicity

• No upper limit (UL) needed

Intake for Vitamin K

• Adequate Intake (AI): 90 micrograms for women/ 120 men

• Daily Value: 120 micrograms

Food sources of Vitamin K

Liver, dark green leafy vegetables, broccoli, asparagus, peas.

• Vegetable oil Older adults: have lower vitamin K intake due to lower vegetable intake

Circumcision on the 8th Day

Males are circumcised on the 8th day due to elevated prothrombin levels.

Homeostasis: Blood Clotting Process

Involves vasoconstriction, platelet plug formation, and coagulation.

• Changes from liquid to solid

• Results is reinforcement of platelet plug with protein, fibrin

• Vitamin K binds to calcium which makes various clotting factors ‘active’

• This process is crucial for hemostasis

• If Vit K deficient, your blood won’t clot correctly (i.e. possible hemorrhage)

• Normally, clotting factors are ‘inactive’ because we DO NOT want blood clotting unless there is an injury

Coenzymes & B-vitamins

B-vitamins function as coenzymes needed by enzymes to activate.

Coenzymes

micronutrients needed by enzymes in order to activate

• break down carbs, fats, and amino acids so that the body can produce energy (ATP- adenosine triphosphate)

B Vitamins and Energy Metabolism

Essential components of many coenzymes involved in energy metabolism. (little yellow bubbles)

B vitamin intakes

• Deficiency is rare because we fortify cereal, breads, pasta

• Most common B vitamins to be added back into a grain food item: thiamin, riboflavin, niacin, folic acid

• B Vitamins are water-soluble; the body stores only a very small amount and the rest leaves the body via urine

• Alcoholics are often deficient

• If deficient, your skin, GI tract, and brain will show symptoms first (e.g. low serotonin levels in the brain)

• Cooking vegetables in minimal water such as steaming, preserves vitamin content 

Thiamin

Beriberi & Wernicke-Korsakoff syndromes

 Function: helps release energy (i.e. ATP) from carbs

• Coenzyme form: thiamin pyrophosphate (TPP)

• First B-vitamin discovered (1910)

• Thiamin is also involved in making DNA, RNA, & neurotransmitters

• No Upper Limit (toxicity doesn’t happen b/c it is water-soluble

• RDA: 1.2 milligrams for men, 1.1 milligrams for women

• Richest food sources: pork, whole grains, and fortified breakfast cereals

thiamin deficiency (beriberi syndrome)

• The body can’t break down carbs into ATP (because they lack the coenzyme from Thiamin)

• Symptoms: weakness, loss of appetite, irritability, loss of muscle coordination, deep muscle pain, enlarged heart, edema

• ‘Beriberi’ means I can not, I can not in a Sri Lankan language

• Often found in places who have a heavy diet of refine grains (like rice)

Wernicke- Korsakoff syndrome: Beriberi associated with alcohol use disorders

Riboflavin (Vitamin B2)

• Function: Coenzymes: flavin dinucleotide (FAD) and flavin mononucleotide (FMN)

• Participates in energy-yielding pathways such as fatty acid breakdown

• Antioxidant role: supports glutathione peroxidase enzyme (which helps get rid of free radicals)

• No Upper Limit

• RDA: 1.3 milligrams for men, 1.1 milligrams for women

• Richest food sources: meats (especially liver), dairy products, and fortified breakfast cereals

ribofllavin deficiency (B2 ariboflavinosis)

• Inflammation of the tongue/skin

• Symptoms: cracks on the corners of the mouth, dermatitis, cataracts, confusion

• Flavis means yellow

• If you take too much riboflavin your urine will turn bright yellow and glow under a black light

Niacin (Vitamin B3)

• Function: critically important for energy metabolism and making fat

• When you’re storing fat in your adipose tissue or converting carbs into fat for storage, niacin is involved in fatty acid biosynthesis

• Tryptophan can be converted to Niacin

• RDA: 16 milligrams for men, 14 women 

Richest food sources: chicken, other protein, and fortified breakfast cereals

Electrolytes

Charged ions that regulate the fluid balance in the cells.

•  Called electrolytes b/c they have a charge (think electricity)

•  Ion concentration controls how much water is inside vs. outside of cells

Main extracellular ions

Sodium (Na+) and Chloride (Cl-).

Main intracellular ions

Potassium (K+) and Phosphate (PO4-).

Electrolyte deficiency

Occurs when athletes do not replace lost electrolytes, leading to imbalances.

• Consuming a banana (K+), a salty snack (NaCl) or an electrolyte sports drink is recommended

Dehydration

A condition characterized by insufficient fluid in the body.

• Urine color & skin turgor

•  Skin turgor is the ability of healthy skin to ‘spring back’ after being pinched. If dehydrated, you will have decreased skin turgor. (This is less reliable in the elderly)

• If thirsty, you are already dehydrated! Thirst lags behind in exercise, illness, etc.

• Athletes should consume 2 to 3 cups fluid or water for each pound lost during exercise otherwise cramping, heat stroke, etc. can occur

Fluid replacement for athletes

Athletes should consume 2 to 3 cups of fluid for each pound lost during exercise.

Hypernatremia

A condition where sodium levels become dangerously high.

Hyponatremia

(Water intoxication) where water intake exceeds kidneys' processing ability, leading to dangerously low sodium levels.

Sports drinks help maintain electrolyte and sodium levels

Muscle contains ___% water, while fat contains __-__%.

73%, 10-20%.

Water intake rule of thumb

Drink approximately half of your body weight in ounces per day.

Recommended water intake for women

9 cups per day.

Recommended water intake for men

13 cups per day.

Human body water percentage

50% to 70% of the human body is water.

Sodium depletion during workouts

Na and Cl are depleted during workouts, causing sweat to taste 'salty'.

ultrace

trace amounts in diet, not essential.

Major minerals

Need 100mg+ daily: calcium, phosphorus, magnesium, sulfur, sodium, potassium, chloride.

Trace minerals (need less than 100 mg daily)

Iron, zinc, copper, iodine, selenium, molybdenum, fluoride, manganese, chromium.

Higher fiber diets

Can lower absorption of iron & zinc.

Vitamin C intake

Increases iron absorption.

Vitamin D intake

Increases calcium absorption.

Potassium (K)

Maintains water balance, assists with nerve impulse transmission

• Potassium & sodium are both + ion electrolytes, but they stay on separate sides of the cell (Potassium is inside).

Hypokalemia

Low blood potassium.

Symptoms of Hypokalemia

Muscle cramps, confusion, constipation.

High sodium intake

Higher blood pressure.

High potassium intake

Lower blood pressure.