UNIT FOUR Chapter 9: Fat-Soluble Vitamins Highlight 11: Antioxidants 1. 2.

Know the names and general functions of the four fat soluble vitamins. 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. Recognize the functions of vitamin A in: cell differentiation, vision (especially night vision), maintenance of epithelial cells (mucus production), and skeletal development. Recognize that the current units used to express vitamin A requirements and recommendations are Retinol Activity Equivalents (RAE). Note that the DV is given in IU (International Units).

b.

c.

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 calcium excretion by the kidneys, increased resorption of calcium from bone. Recognize that vitamin D is also considered a hormone. Name the active hormone form of vitamin D. When (under which circumstances) is it an essential vitamin? Identify/state the major food source of vitamin D in the American diet. Identify/state that the biological need for vitamin D can be met through the body's synthesis of vitamin D. The precursor form, 7-dehydrocholesterol, is converted to vitamin D when the skin is exposed to ultraviolet sunlight. Recognize that the body does control the amount of vitamin D synthesized and activated. List the two organs required for conversion of vitamin D to the active forms. Note that toxicities are rare from foods and impossible from self-synthesis. Note the two forms of vitamin D deficiency disease and distinguish between them in terms of whether the disease is seen in children or adults and the bone changes.

b. c. d.

e.

4. Vitamin E and Antioxidants a. Be able to identify or list tocopherols and tocotrienols as two categories of vitamin E compounds. The most active form of the vitamin is the RRR isomer of alphatocopherol.

b. Recognize that vitamin E functions as an antioxidant in cell membranes to protect the polyunsaturated fatty acids in phospholipids. Define antioxidant. Identify/list other nutrients that also function as antioxidants. Identify/list non-nutrient compounds found in foods that can also function as antioxidants. Why they are not considered vitamins? c. d. e. Identify/list the causes and effects of oxidative damage in the body. Recognize the relationship between the amount of PUFA in the diet and the amount of vitamin E needed in the diet. State two to three major food sources of vitamin E in the U.S. diet.

5. Vitamin K a. Recognize that the family of compounds known as vitamin K includes phylloquinone from green plants and menaquinones found in fish oils and meats. b. Identify/state two main functions of vitamin K. c. Recognize that vitamin K (menaquinones) can be synthesized by intestinal microorganisms and that this vitamin K can then be absorbed. d. Identify/list three major food sources of vitamin K.

Chapter 10: Water-Soluble Vitamins Highlight 13: Vitamin and Mineral Supplements 1. The B-vitamins a. b. Be able to identify/list all the B vitamins: thiamin, niacin, riboflavin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin. Define coenzyme again. (It was previously defined under the section on Energy Metabolism.) Be able to identify or list the coenzyme names and their abbreviations for thiamin, riboflavin, niacin, vitamin B6 and pantothenic acid. Match the B vitamins with the following functions: energy metabolism (glycolysis, TCA cycle & Electron Transport Chain), protein & amino acid metabolism, cell replication and growth, and nervous system function. Be able to name or list food groups that provide significant amounts of B vitamins. In addition to these general sources, be able to identify and list three foods which are good sources of vitamin B6, folate, vitamin B12, thiamin, riboflavin and niacin. What is the risk of primary deficiency of each of the B vitamins? (To answer this, ask yourself: How many food groups would have to be avoided to avoid consuming that vitamin?) List specific deficiency diseases and symptoms for thiamin, riboflavin, niacin, B6, folate and B12. How does the anemia seen with a deficiency of vitamin B6 differ from that seen with deficiencies of folate and vitamin B12? For vitamin B12, which individuals are at risk for a primary deficiency? A secondary deficiency? Know the RDA for folate is given as DFE (Dietary Folate Equivalents). The UL (upper level) for folate applies to synthetic forms obtained from supplements. Note that high folate levels can mask a B12 deficiency.

c.

d.

2. Ascorbic Acid (vitamin C) a. Be able to identify and list the functions of vitamin C. Note that vitamin C functions as an antioxidant in the blood and not in cell membranes like vitamin E does. Be able to identify or list foods which provide significant amounts. Be able to identify or list ways to protect the vitamin C in foods from destruction. What are the risks of toxicity of vitamin C? Define pharmacological vs. physiological doses of nutrients. What effect, if any, do pharmacological dosages of vitamin C have on colds? Compare the recommended intakes (RDA) for adults and children to the DV for Vitamin C. 3

b. c. d. e. f.

g. 3.

Name the deficiency disease associated with vitamin C and be able to identify and list the symptoms.

Recognize metabolically active non-vitamin compounds such as choline, carnitine, inositol, taurine and lipoic acid. a. b. Know that our bodies make these and supplementation is not needed. Recognize non-functional compounds sometimes sold as if they were vitamins: PABA, pangamic acid, laetrile.

4. a.

Dietary Supplements Define dietary supplement according to the Dietary Supplement Health and Education Act of 1994 (DSHEA). How do nutrient supplements fit into this categorization? What non-nutrients can be called dietary supplements b. Compare the Food and Drug Administration (FDA) regulations for safety of foods, additive and drugs to that of dietary supplements. Compare FDA regulations for effectiveness of drugs vs dietary supplements. Under what circumstances can FDA restrict the sale of a dietary supplement? c. d. List types of claims that are legal on dietary supplement labels and be able to identify examples of claims that are or are not allowed. Know/Be able to list reasons why a consumer should exercise caution before using a dietary supplement. Under what conditions should a person seek medical advice before using a supplement?

Chapter 11: Water and Major Minerals 1. Be able to identify or list the functions of body water and electrolytes. Define electrolytes. Name the major electrolytes and indicate whether they are chiefly found outside the cells (extracellular, plasma or interstitial) or inside the cells (intracellular). 2. Be able to identify or list four ways water is normally lost from the body and three sources of water for the body. Know several foods besides drinks like milk and juice that are high in water. Recognize that metabolic water is water produced as a result of the oxidation of energy nutrients.

3. Define osmosis. 4. Know that proteins contribute to the functions of electrolytes. (Some proteins are electrolytes.)

5. Be able to identify or list two hormones involved in water and electrolyte balance and state their functions. Sodium 1. Know major function(s) of sodium. 2. Contrast the average American sodium intake with the Dietary Guildeline for sodium. 3. Identify/list food categories high in salt content. Is there any possibility of a primary deficiency of sodium? What might cause a secondary deficiency?

4. Define hypertension. Discuss the relationship between sodium intake and hypertension in salt sensitive individuals and for the population in general. Note that potassium, magnesium, and calcium intake/excretion may be as important in hypertension control as restricting sodium intake. Calcium 1. Recognize the role of calcium in bone structure, cell regulation and blood clotting. 2. Define blood calcium homeostasis. Understand/be able to state why the regulation of blood calcium homeostasis is so important (which functions rely on blood calcium levels?) Why is a primary calcium deficiency typically asymptomatic? 3. Identify/list the hormones required to maintain blood calcium levels. Review the ways that vitamin D affects calcium levels. 4. Identify/list significant food sources of calcium. Why is butter NOT a good source when other milk products are? How does dietary calcium intake affect blood calcium levels, if at all? 5

5. Define bioavailability. Identify/list dietary factors that affect the absorption of calcium. 6. Define calcium balance. Which factors that have a positive or negative effect on calcium balance? When peak bone is mass reached? How does calcium intake affect balance? How does calcium intake affect peak bone mass? 7. 8. Define osteoporosis and be able to identify or list risk factors for development of the disease. Be able to identify or list the following other minerals involved in bone structure: phosphorous, magnesium, fluoride, sodium.

9. Be able to identify or list the following other nutrients as involved in bone metabolism and growth, but not part of the structure: vitamins A, D and K, zinc.

Chapter 12: The Trace Minerals 1. Identify/list the essential trace minerals for humans. 2. Iron a. Know major functions of iron. Define hemoglobin, myoglobin.

b. Differentiate between transferrin and ferritin. c. Know/list ways in which iron is lost from the body.

d. Know/list food sources and differentiate between heme and non-heme iron. List ways to improve the absorption of non-heme iron. State the effect that the body's need for iron has on iron absorption. Understand that in setting the RDA for iron, iron absorption is considered to average 10% of total iron consumed. e. f. 3. Zinc a. Name the conditions caused by a deficiency of iron. Recognize that iron toxicity is a common form of accidental poisoning in children. Be able to identify three to four major functions of zinc.

b. Be able to identify the major food groups that contain zinc. Recognize meat, milk and whole grains as significant sources. c. Define metallothionein. What is the effect of other minerals in large doses on zinc absorption?

d. Why would a diet deficient in zinc probably also be deficient in protein? 4. Other trace minerals: a. Know copper is needed for iron metabolism.

b. Remember iodine is needed for thyroid. c. Remember fluoride can become part of bone and teeth enamel.

d. Remember selenium is included among the antioxidant nutrients. 5. Recognize that some compounds such as flavonoids are not nutrients but are suspected as being beneficial against certain diseases such as some cancers. Note that in most cases evidence of benefits is from foods not supplements.