Summer 2005 – Final Exam
Thursday, July 28, 12:50PM, 201 PE Gee
Lecture materials Chapter 11-Achieving and Maintaining a Healthful Body
Weight Chapter 9 – Nutrients Involved in Bone Health 20 MC/TF questions See www.cwu.edu/~geed tomorrow for study guide Take Home essay question (turn in with final)
What is the role of American Society in Addressing the US Obesity Crisis?
1 page, double space, 12 pt font, 1” margins 10 pts: grammatically perfect, well thought out, clearly states
and defends position.
Bergman/Bennett – 40 MC/TF questions
The Vitamins
David L. Gee, PhDProfessor of Food Science and Nutrition
Central Washington UniversityFCSN 245 - Basic Nutrition
Dietary Supplement Use (USA)
$ 4,300,000,000 for vit/min in 1995$ 1,400,000,000 for herbs35-40% adults regular users
females > males 66% multi-vit/min 37% vitamin C 19% vitamin E Calcium supplements
Dietary Supplement Use: Pros
Supplements dietary deficiencies calcium folic acid
Useful for those with limited caloric intake Elderly Dieters children
Amounts used in some studies not attainable with dietary sources antioxidants
Relatively low cost
Dietary Supplement Use: Cons
False sense of security folic acid and pregnancy Supplement may a marker chemical and not the actual protective agent
Does not contain all potentially useful chemicals in foods Example: compounds found in plants that may be health promoting
(phytochemicals)
Toxicity almost only due to supplement useCosts significant
low income Heavy users of supplements (athletes) Certain supplements are expensive
Chondroitin sulfate – bone/cartilage: $30-50/mo SAMe – depression: $40-50/mo
The Discovery of Vitamins
The Germ Theory of Disease Scurvy: Disease of sailors Beri-Beri: Disease of poor Asians Rickets: Disease of poor Northern
European children Pellagra: Disease of poor corn
eating cultures
The Discovery of VitaminsThe Vitamin Theory of Disease
Scurvy: Disease of sailorsVitamin C deficiency
Beri-Beri: Disease of poor AsiansThiamin deficiency
Rickets: Disease of poor Northern European childrenVitamin D deficiency
Pellagra: Disease of poor corn eating culturesNiacin deficiency
Vitamin NomenclatureFat soluble “A” & Water soluble “B”“Vital amines” = vitamines =
vitaminsVitamin B “complex”
collection of water soluble vitamins that function as enzyme co-factors
Vitamin CVitamins D and EMistaken Vitamins
Vitamins: Definition
Organic compound found in foods
Required in small amountsRequired in the diet (essential)Proven to be required for health,
growth, and reproduction deficiency syndrome identified
Fat and Water Soluble Vitamins
Fat Soluble Vitamins (A, D, E, K)
Soluble in lipids and solventsExcess stored and not excretedExcess may be toxicDeficiency slow to develop
Fat and Water Soluble Vitamins
Water Soluble VitaminsB vitamins, CSoluble in waterexcess excreted in urine, little
storedgenerally less toxicdeficiency develops quickly
General Functions of Vitamins
HormonesVitamin D
calcium homeostasisVitamin A
cell division and development
General Functions of Vitamins
Non-specific chemical reactions
Vitamin E antioxidant
Vitamin C chemical reducing agent
General Functions of Vitamins
Coenzymes or Cofactorschemicals that assist enzymes
to function as catalysts B vitamins Vitamin C, A, K
Vitamin D: Types and Sources
Dietary sources: animal foods, fortified milk
Human Synthesis of Vitamin DSkin: cholesterol + sunlight
“Sunshine Vitamin” – UV-B rays Vitamin D3
5-10 minutes, arms and legs, mid-day sun
Liver & Kidney for activation 1,25-di-OH-D3
Vitamin D: Functions
Helps regulate blood calcium levels
Dietary calcium absorptionUrinary calcium excretionBone calcium metabolism
Vitamin D: Deficiency
Rickets bone deformities in children
Osteomalacia weak bones due to low calcium content Vitamin D deficiency Calcium deficiency multiple pregnancies
Vitamin D: Toxicity
5 times the RDA chronically calcification of soft tissue toxicity due to excessive vitamin supplementation
Calcium
FunctionsBone Structure (99%)Regulator of Metabolism (1%)
nerve impulse transmission muscle contraction blood clotting etc.
Calcium
Regulation of Blood Calcium 10 mg/dl of blood
hypocalcemia & hypercalcemia abnormal muscle cramping nerve irritation
Controlled by: vitamin D, parathyroid hormone, calcitonin
Calcium RDA
1998 RDA’s 1300 mg/d : children & teens 1000 mg/d : adults 1200 mg/d : older Americans
Usual intakes are low
Osteoporosis
Brittle, weak bones due to loss of total bone mass (minerals and protein)
Prevalence 11% of > 65 yrs 22% of > 65 yrs in 20 yrs 24 million fractures/yr 200,000 hip fractures, 1/6 fatal
Normal Bone
Osteoporotic Bone
Changes in the spine with osteoporosis
Other osteoporosis fact:National Osteoporosis Foundation - 2003
10 million with osteoporosis 18 million with low bone density
1 in 2 women will develop osteoporosis sometime in their life (1 in 8 men)
Osteoporosis
Risk FactorsGenetics
Family History Ethnicity Caucasian > Asian > Blacks
Osteoporosis
Risk FactorsGender
associated with declines in estrogen production
post-menopause anorexia, female athletes
Undertreatment of Osteoporosis in Men with Hip Fracture.
Arch. Int. Med. (Oct. 2002)
10 million Americans with osteoporosis 2 million are men
Of 110 men hospitalized with hip fracture 4.5% received treatment for osteoporosis 1 year mortality was 32% Average age 80 yrs
Of 253 women hospitalized with hip fracture 27% received treatment for osteoporosis 1 year mortality was 17% Average age 81 yrs
Osteoporosis
Risk FactorsChronic Calcium Deficiency
Lack of Exercise
Prevention of Osteoporosis
ExerciseDietary Calcium“Rule of 300”
300 mg/d from plant sources 300 mg/d from each serving of dairy
Prevention of Osteoporosis
Other factors that may increase calcium loss high caffeine intake high protein intake high alcohol intake cigarette smoking
Prevention of Osteoporosis
Calcium SupplementsCalcium carbonate
least expensive Tums poor absorption
Calcium citrate/malate (CCM) expensive, well absorbed
Prevention of OsteoporosisAdequate amounts of vitamin D
avoid excessesHormonal replacement in high
risk womenIf you have a family history of
osteoporosis: Get a bone scan
Folic Acid
DRI (RDA): 1998 400 ug/d (180-200 old RDA) 600 ug/d pregnancy (400)
Typical folate intake: 200 ug/dDietary Sources
foliage: fruits & vegetables
Folic Acid
Functions“single carbon metabolism” DNA synthesis (cell division) other reactions
Folic Acid
DeficiencyMegaloblastic Anemia
large abnormal red blood cellsElevated blood homocysteine
CHD risk factor
Folic Acid
DeficiencyNeural Tube Defects
spina bifida - lower body paralysis
required early in pregnancyGrain fortification (1998)
will add 100-200 ug/d to diet
Iron
Functions:HemoglobinMyoglobinIron enzymes
catalase electron transport system
Iron Deficiency
Iron deficiency anemia fewer, smaller, paler red blood cells fatigue
5-10% of US premenopausal women
up to 40% of population in developing countries
Iron Deficiency CausesBlood loss
menstrual blood loss parasites and bleeding ulcerations
Inadequate dietary intakeRDA men = 10 mg/dRDA women = 15 mg/dUS usual intake 6 mg/1000 Cal
Dietary Sources of IronHeme Iron
meats (Hb & Mb) 20-30% absorbed
Non-heme Iron plants inorganic iron 1-10% absorbed vitamin C increases absorption iron cookware
Iron Overload Toxicity
Children (accidental poisoning) Men and post-menopausal
womenGenetic “defect”
improved iron absorptionExcess iron is a pro-oxidant.
oxidized LDL-C tissue injury
Iron Overload Toxicity
May occur in 10% of menTreatment
avoid iron containing supplements
avoid excess vitamin C supplements
bleeding or blood donation
Final Advice from Your Nutrition Professor:
Eat your vegetables! And fruits and whole grains too!
Watch your weight! Easier to maintain your weight than to
lose weight you’ve gainedEverything in moderation!
You can have your cake and eat it too!
Enjoy your food and your good health!