UNIT FOUR Chapters 9 10 11 12 Vitamins Minerals and Water Spotlight Complementary Medicine Pages 76 107 Overview We will NOT cover each and every vitamin and mineral in detail The ap proach will be to a present concepts about vitamins and minerals with examples of specifics and b use a sample of nutrients to allow you to see what information is available and how that information can be used Follow this guide along with lecture notes rather than the text outline for studying for the exam General questions that cover all micronutrients 1 What is the difference between a vitamin and a mineral Mineral Inorganic compound needed for growth and regulation of body processes Vitamin Organic compound necessary for reproduction growth and maintenance 2 What is the difference between water soluble vitamins and fat soluble vitamins in terms of general mode of absorption blood or lymph and amount in reserves or in storage Water soluble travel directly to bloodstream excess excreted in urine Fat soluble transported via lymph to bloodstream eventually to liver absorbed with fat 40 90 in storage 3 What are the health risks and benefits of obtaining vitamins and minerals from supple ments synthetic supplements and food sources Define toxicity hazard Toxicity excessive intake that exceeds body s storage capacity having toxic effects Excessive doses of fat soluble vitamins pose greater risk of toxicity than water soluble 4 Be able to recognize name deficiency diseases of historical importance beriberi pella gra scurvy rickets and goiter and their associated nutrient and most importantly rec ognize that these diseases are no longer prevalent in the U S because of the introduction of enriched and fortified foods and processing techniques which make these nutrients readily available Beriberi produced in 1880 chickens were served only white rice instead of brown thiamin Pellagra Scurvy condition that includes bleeding gums loss of energy Natives knew pine needles prevented it British Navy included lemon juice in sailors diets Vitamin C Rickets Bone disease in children that arises from Vitamin D deficiency Goiter chronic enlargement of thyroid gland iodine 5 Define enriched fortified supplemented Know that deficiency diseases are almost al ways seen in the context of general malnutrition PEM or Protein Energy Malnutrition and therefore treatment with a single nutrient is generally insufficient Enriched addition of vitamins minerals lost during food processing thiamin ri boflavin niacin folic acid iron 6 Identify list nutrients for which deficiencies are a concern in the U S or in the world a b Who is most at risk for iron calcium and protein deficiencies Identify vitamin mineral deficits associated with 1 strictly protein lipid diets with little or no carbohydrates ketogenic 2 in pure vegetarian vegan diets when no animal products are consumed 7 Identify list nutrients for which primary deficiencies are never or rarely seen 8 Identify list examples of secondary deficiencies and or when secondary deficiencies may occur 9 Under what circumstances would supplements be useful Useless See Highlight 10 What is the difference in risk of toxicity for water soluble vitamins and fat soluble vita mins What risks are associated with excess minerals in general terms Distinguish between pharmacological effect and physiological effect 10 Assessment of nutrition status What is the difference between a disease and a symp tom Know that for any given symptom there may be several causes It is impossible to use symptoms to diagnose deficiencies How can deficiencies be diagnosed Review assessment discussion in Chapter 1 11 Know DRI standards discussed in class Review and define the concepts of individual requirement DRI RDA and AI and upper level How are these different than the DV How do DV differ for micronutrients and macronutrients Know the units used to mea sure each vitamin or mineral e g milligram RAE microgram UNIT FOUR Chapter 9 FatSoluble Vitamins Highlight 11 Antioxidants 1 Know the names and general functions of the four fat soluble vita mins 2 A vision immune function development prevention of disease D regulates blood calcium levels cell differentiation growth E antioxidant activity enhanced by other nutrients K coagulation bone formation Vitamin A a Differentiate between provitamin A sources e g beta carotene and preformed vitamin A in terms of 1 food sources 2 biological activity and 3 potential toxicity Know three major plant sources and three major animal sources of vitamin A Retinol alcohol form convertible with retinal Retinal aldehyde form convertible with retinol active form Retinoic acid form not convertible no role in vision reproduction Preformed retinoids aka retinyl esters main storage of A 90 dietary retinol in form of esters animal sources liver fish oil milk Provitamin carotenoids plant sources converted to retinol in liver spinach cantaloupe carrots b Recognize the functions of vitamin A in cell differentiation vision especially night vision maintenance of epithelial cells mucus production and skeletal de velopment Cell differentiation retinoic acid interacts with receptor sites on DNA to begin transforming stem cells into differentiated cells Vision retinol carried in the blood to retina where it converts to retinal then combines with opsin to form pigment rhodopsin rhodopsin respon sible for sight in dim light when light hits retina rods undergo bleach ing fading color of rods causing retinal to separate from opsin chang ing from bent cis to straight trans with lack of A rhodopsin regenera tion is slow so eyes cannot adjust to dim light quick bright light night blindness Epithelial retinoic acid dependent differentiation some develop into goblet cells mucus secreting and others become mature skin Skeletal all three essential for bone health c Recognize that the current units used to express vitamin A requirements and rec ommendations are Retinol Activity Equivalents RAE Note that the DV is given in IU International Units One RAE one microgram of retinol 3 Vitamin D a Understand be able to state the function of vitamin D and its interactions with calcium Note the three ways in which vitamin D causes an increase in blood calcium levels increased calcium absorption from the intestine decreased cal cium excretion by the kidneys increased resorption of calcium from bone b Recognize that vitamin D is also considered a hormone Name the active hormone form of vitamin D When under which circumstances
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