NTDT200Exam #3 Review Questions (Chapters 11)Would you be concerned if you didn’t eat any fat-soluble vitamins in a day?No because fat soluble vitamins are stored in body tissues. The body will retrieve vitamins from their storesif needed so it can take days, weeks or months for deficiencies to occur.An individual consumes a large amount of vitamin A food sources and his/her skin turns yellow. Is this clinically significant? Why or Why not?There are several chemical compounds that have vitamin A activity, the most common of which are carotenoids, of which beta-carotene is most easily recognized. If an individual consumes a large amount of foods that are high in beta-carotene, the skin may turn yellow, but this is not clinically significant. Beta-carotene serves as a vitamin A precursor in the body and thus not all of it is converted into vitamin A. It is important to note the source of vitamin A compounds since if vitamin A is provided in the form of supplements, this can prove to be clinically significant. Remember that vitamin A is a fat-soluble vitamin and as such can be stored in the body, leading to toxic levels.What are the three forms of vitamin A? What protein is responsible for transporting vitamin A?3 forms: retinol, retinal, retinoic acidRetinol binding protein (RBP) is the protein that transports retinol What are risks associated with high doses of vitamin A? What types of vitamin A can cause toxicity? What groups are most vulnerable?High doses of vitamin A can be toxic. Excessive vitamin A may weaken bones and contribute to osteoporosis and fractures. During pregnancy excess vitamin A can cause birth defects.Pre-formed vitamin A is the form that is concerning in terms of toxicity. This can be found in supplements or certain animal derived foods. Also, Acutane, which is made from vitamin A but chemically different, is highly toxic. Women of childbearing age need to be very careful about taking it because of the risk of birthdefects. Beta-carotene, which is a precursor of vitamin A, can’t cause toxicity. Children and women are two groups that are particularly vulnerable to vitamin A toxicity.Why are vitamin A supplements often given to children in developing countries?Although vitamin A deficiency is not common in children in the US it’s a major nutrition problem in many developing countries. Approximately 250 million children worldwide have vitamin A deficiency, which puts them at risk for infectious diseases and blindness. Routine vitamin A supplementation can be a life saving intervention and can reduce the risk of deaths associated with infections and severe diarrhea. What are the two ways people can obtain vitamin D?From food or from exposure to sunlight (SPF of 8 or above prevents the synthesis of vitamin D from sunlight).What are the consequences of vitamin D deficiency in children? What are they in adults?1Rickets is a disease state associated with a clinical vitamin D deficiency in children. Structural integrity ofthe bones is diminished; leading to characteristic bowed legs and beaded ribs. The occurrence of a clinical vitamin D deficiency in adults is called osteomalacia. This disease processresults in deformities and painful bone disease. Osteoporosis, which is manifested by decreased bonemineral density, can result in loss of height and increased fractures. Individuals who do not consumeadequate amounts of vitamin D are at risk for bone fractures due to accompanying calcium loss.What is the major idea behind fortification of food products with vitamin D in the United States?Food products are fortified with vitamin D in the U.S. in order to provide a stable, consistent source of the vitamin for the general population. There are few natural food sources, and not everyone can maintain adequate blood levels through skin synthesis alone. Fortified food sources high in vitamin D include dairy food products. Many people do not consume adequate amounts of this vitamin because they limit their dairy intakes due to either possible intolerance issues and/or personal preferences. Consumption of dairy products has declined in recent years due to these issues, so the fortification process ensures that even with a more limited intake of these items, vitamin D levels are consistent.What fat soluble vitamin has the lowest risk of deficiency?Vitamin EWhy is vitamin K given to newborns at birth? What happens if the newborn does not get the injection? A vitamin K injection is recommended for all newborns in order to provide needed vitamin K until its intestinal production by bacteria begins. Since the infant is born with a sterile gut, there are no bacteria present to start this bodily process. A one-time injection is all that is required. If the injection is not given, then the newborn is at risk to develop a bleeding disorder resulting in hemorrhagic disease of the newborn. What are two ways that people can obtain vitamin K?1. Diet2. Bacteria in GI tract Fill in the following chart:Main role Deficiency Excess Food sourcesVitamin AVision, Protein synthesis, cell differentiation, reproduction and growth, antioxidantInfectious Diseases, night blindness, blindnessBone defects, Birth defectsFortified milk, margarines, eggs, beta-carotene found in spinach and dark green vegetables, deep orange fruits, liverVitamin Helps to maintain blood In children- ricketsToxicity Vitamin D in 2Dlevels of calcium and phosphorusIn adult- osteomalaciadisease is called hypervitaminosis DFoods-Fortified milk, butter, and margarine- Egg yolks, liverVitamin EAntioxidantPrimary deficiency rareErythrocyte hemolysisSymptoms:Loss of muscle coordination and reflexesImpaired vision and speechNerve damageErythrocyte hemolysisRareMay augment the effects of anticlotting medicationPolyunsaturated plant oils such as margarine, salad dressings, and shorteningsLeafy green vegetablesWheat germWhole grainsLiver and egg yolksNuts and seedsVitamin KSynthesis of blood-clottingproteinsSynthesis of bone proteins that regulate blood calciumHemorrhagingSecondary deficiency may occur with use of antiobioticsNewborn infants receive a single dose of vitamin K at birth because of a sterile intestinal tractUncommonHigh doses can decrease the effectiveness of anticlottingmedicationsBacterial synthesis in digestive tractLiver, milk, leafygreen