VitaminsPresented by Erica Frank and Birgit Humpert

KSC Dietetic Interns

What we will do today?• Define and compare vitamins and

supplements • Discuss various vitamins and their

health benefits • Discuss the need for supplements• Provide information on buying

supplements

Vitamins and other micronutrientso Needed by our body in small

amounts to grow and functiono Some vitamins are water-soluble,

some are fat-solubleo Are found in a wide variety of foods

Supplements• products intended to supplement the diet

• include vitamins, minerals, herbs or other botanicals, amino acids, fatty acids

• come as pills, capsules, tablet, or liquids

• labeled as "Dietary Supplement" on the front panel

Enriched and Fortified Food

• to restore nutrients lost during processing

• add nutrients to prevent deficiencies

o both public health policy

o or for commercial/marketing reasons

Bone Health

Calcium

Vitamin D

Vitamin K

Vitamin CPhosphorus

Magnesium

Manganese

Fluoride

Calcium

• important for bones but also for muscles, nerves, and blood clotting

• inadequate intake contributes to osteoporosis (loss of bone mass that leads to weak bones that easily break)

• Needs: 1000-1200 mg

• Sources: Dairy, kale, broccoli, Chinese cabbage, tofu, fish with bones, fortified orange juice or cereal

• don't consume more than 500-600 mg at a time

Day 1

1 cup milk 305 mg1 cup Greek

yogurt 448 mg1/4 shredded

cheese 204 mg

---------

957 mg

Day 2

1 cup soy milk 289 mg

1 cup oatmeal 26 mg

1 cup Bok Choy 74 mg1 cup white

beans 158 mg

1 oz. almonds 82 mg

1 cup canned salmon 324 mg

----------

953 mg

Vitamin D

• the "sunshine" vitamin

• important for regulation of blood calcium levels, muscle and nerve function, and the immune system

• very few foods naturally have vitamin D

• Sources: fatty fish, fortified milk, orange juice, and cereal

• who is at risk for deficiency: breastfed infants, older adults, people with dark skin, people with malabsorption, obese people

Fish Oil

• usually derived from: mackerel, tuna, salmon, sturgeon, mullet, bluefish, anchovy, sardines, herring, trout, and menhaden.

• Rich in the omega-3 Fatty Acid of Eicosapentaenoic (EPA)

• 3.5 ounces of fish=1 gram of omega-3 fatty acid

• Docosahexaenoic acid (DHA) also found in fish-important for proper brain development and function

• Heart Healthy

Toxicity concerns:• result in a buildup of environmental poisons-i.e.mercury

• using fish oil in combination with blood lowering medications may result in hypotension

• fish oil combined with blood thinning medications may result in bleeding by reducing clotting factors

Other Sources Omega-3 Fatty Acids:flax seeds, green leafy vegetables, nuts, vegetable oils provide alpha linolenic(ALA)• ALA=the basic form of omega-3 which the body will

convert to EPA AI: men=1.6g/day women=1.1g/day

Vitamin B12

• important for nerve and blood cells

• deficiency leads to anemia, that makes us feel tired and weak

• depends on stomach acid to be digested

• older adults and people who don't eat animal food are at risk for deficiency

• only found in animal food

Folic Acid

• Folate is important to make genetic material and helps cells divide and grow

• especially important to prevent neural tube defects in babies

• RDA: 400 mcg

• UL: 1000 mcg

• Food sources: green leafy vegetables, broccoli, asparagus, oranges, nuts, beans, fortified grain products

Antioxidants

Antioxidants: substances that protect your cells against free radicals-compounds your body naturally produces from metabolism actions, as well as compounds that come from smoke, pollution, and radiation.

Three major players:• Vitamin E• Vitamin C• Beta-carotene (Vitamin A)

Minor Players:• Zinc• Selenium

Vitamin E

• Preventing the growth of lipid (fat) degradation that can lead to atherosclerosis

• Aids in cell communication• Protects cell membranes• Enhances immune response

• Naturally occurs in 8 different chemical formso Alpha-tocopherol

o Synthetic Vit E is a mixture of the 8 forms

o Natural sources have 2x the bioavailability

Deficiency: rare-individuals with malabsorption issues

Toxicity: Supplement taken in >3000 IU have shown effects such as cramps, diarrhea, fatigue, double vision, muscle weakness

RDA: Adult: 15 mg/day=22.4 IU UL-1,000 mg/day

Sources:• 1 T wheat germ oil=20.3 mg• 1 cup boiled spinach=1.9mg• 1 oz sunflower seeds=7.4 mg

o vegetables oils, nuts

Vitamin C

• Water Soluble

• Important for collagen structure

• Involved in neurotransmitter synthesis

• Colds?

• Enhance the absorption of non-heme iron

Deficiency: scurvy

Toxicity: rare: diarrhea, nausea, stomach cramps -hemochromatosis

RDA: men: 90 mg/d Smokers: 35 mgwomen: 75 mg/d UL: 2,000mg/d

• Better absorbed in lower daily intakes• ascorbic acid = form found in food

Sources: • 1 cup green peppers=117 mg• 1 cup strawberries=84 mg• 1 orange=53 mg• 1 cup cooked kale=53 mg

Vit A/Beta-Carotene

• normal vision• immune system• reproduction• growth• bone metabolism

Two forms: preformed and proformed:o proformed-plant food and supplements= beta-caroteneo preformed=meats, fish, dairy

RDA: men=900 mcg Vit A *no RDA for beta carotene women=700 mcg * Beta-carotene=possibly unsafe

Deficiency: rare in the US-common in developing nations o xerophthalmia=night blindness

Toxicity: dizziness, nausea, headaches, coma, death• high intake of preformed Vit A in pregnant women may

cause birth defects

UL: 3,000 mcg vitamin A

Sources: dairy, organ meats, fruits and vegetables• 1 cup sweet potato=16 mg beta carotene• 1 cup cooked kale=12 mg beta carotene• 1 cup canned pumpkin=16 mg BC; 1900 mcg Vit A• 1 cup whole milk ricotta=~350 mcg vit A

Zinc & Selenium

Zinc-growth and development, immune response, wound healing, neurological function and reproduction.

• RDA: Men=11 mg/d; women=8 mg/d• Sources:red meats, nuts/legumes, whole grains

Selenium-maintains proper function of thyroid gland, possible anti-cancer effects

• RDA: adults=55 mcg/dDeficiency seen in China-soil

• Sources: animal meats, dairy *brazil nuts-544 mcg

Who needs supplements?

If you are in general good health and eat a variety of foods based on the Dietary Guidelines, you most likely don't need supplements.

• Woman who may become pregnant - 400 mcg/day of folic acid

• Woman who are pregnant - prenatal vitamins that include iron

• Adults >50 years - eat foods fortified with B12, take a multivitamin with B12, or B12 supplement

• Others: consume <1600 cal/day, follow special diets, suffer from malabsorption or digestive issues

• genetic diseases that affect absorption

Special diets

Paleo: cut out grains, dairy, diets can vary

Vegetarian: no meat based product-may include dairy, eggs, and/or fish as exceptions

Vegan: strictly no animal products of any kind

Gluten-Free: no wheat, rye, barley

Grain-Free: no grains at all!

What to look for when buying a supplement

Check the label - active ingredients, nutrients includes, serving sizes, % DV

Look at the claimsHealth claims,

nutrition content claims,

structure/function claims

What else?• Avoid mega-doses

• Check Expiration Dates-may lose potency over time, especially in hot and humid climates. No date provided? Don't Buy!

• Watch What You Eat

Regulation of Supplements

“manufacturers do not need to register their products with FDA or get FDA approval before producing or selling dietary supplements. Manufacturers must make sure that product label information is truthful and not misleading.”

Independent evaluation

• ConsumerLab.com

• NSF International

• US Pharmacopoeia

Finding reliable information on the internet• Who operates the site?• What is the purpose of the site?• What is the source of the information? Are

there any references?• Is the information current?• Does is sound “too good to be true”?• Am I chasing the latest headline?

Food First!

References:Dietary Supplements. (2013) U.S. Food and Drug Administration. Retrieved from

http://www.fda.gov/Food/DietarySupplements/

Fortification of food: Historical development and current practices.United Nations University. Retrieved from

http://archive.unu.edu/unupress/food/8F154e/8F154E03.htm

http://www.whfoods.com/genpage.php?tname=nutrient&dbid=111

http://ods.od.nih.gov

http://www.whfoods.com/genpage.php?tname=nutrient&dbid=106

http://www.nlm.nih.gov/medlineplus/druginfo/natural/999.html

National Osteoporosis foundation http://www.nof.org/

Nelms, M., Sucher, K.P., Lacey, K., Roth, S.L. (2011). Nutrition Therapy &

Pathophysiology (2nd ed.). Belmont, CA: Wadsworth

Insel, P. (2011) Nutrition (4th ed.) Sudbury MA: Jones and Bartlett

American Dietetic Association (2009) Position of the American Dietetic Association: Nutrient Supplementation

MedlinePlus www.nlm.nih.gov/medlineplus/druginfo/herb_All.html

National Center for Complementary and Alternative Medicine (NCCAM) http://nccam.nih.gov

Linus Pauling Institute, Oregon State University http://lpi.oregonstate.edu/infocenter/

http://www.fda.gov/Food/DietarySupplements/