VITAMINS BY William Cabot, M.D., FAAOS
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1 VITAMINS BY William Cabot, M.D., FAAOS THE VITAMIN PROTEIN CONNECTION At AMCO we deal with all types of protein products. Protein is composed of long or short chains of amino acids (1). The formation of those amino acids is dependent on an adequate supply of multiple different vitamins (2, 13). The most important in this regard are the B vitamins, Vitamin C, and Vitamin K. Some vitamins have been found to act as hormones, and antioxidants (3). Whether it is a cow producing milk, a person trying to build muscle or recovering from a severe burn, protein synthesis is necessary and vitamins must be in adequate supply for that to occur. There has always been an argument as to whether we need to take vitamin supplements or do we get everything we need in what we eat? I think the truth is somewhere in the middle. If you eat three well balanced meals you most likely do not need any additional supplementation. Very few of us eat appropriately. In the United States 40-50% of men and women over 50 years of age take vitamin/mineral supplements (4). WHAT ARE VITAMINS AND HOW MUCH DO WE NEED Vitamins are organic substances that help the body with specific metabolic functions. The only vitamin made by the body is vitamin D; the rest must be obtained from the food we eat (4).
2 In the past physicians were blissfully ignorant thinking their patients were not vitamin deficient in the United States. This all changed when studies emerged revealing that 30-50% of the general population is deficient in Vitamin D (6). The Dietary Reference Intake (DRI) of vitamins is the amount that will prevent symptoms from a deficiency of a certain substance and also prevent toxicity from over dosage. That information is readily available in print form (7) and also on the internet. The DRI is a global term that includes the Recommended Dietary Allowance (RDA), Adequate Intake (AI), and tolerable upper intake level (UL) (8). The scope of this paper does not allow for a full discussion of each vitamin. I will try to hit the highlights of each but space does not allow listing everything about each vitamin (8, 9, 10, 11, and 12). There is a plethora of information available on the internet which I encourage you to investigate. VITAMIN SUBGROUPS The two basic categories of vitamins are water-soluble vitamins and fat-soluble vitamins. That is how they will be discussed in this paper. Water Soluble Vitamins (dissolve or disperse in water) Thiamine B1 Riboflavin B2 Niacin B3 Pantothenic Acid B5 Pyridoxine B6 Folic Acid B9 Cobalamin B12 Biotin Vitamin C A D E K Fat Soluble Vitamins (dissolve in fatty tissues or substances) There is a significant difference between these two groups with regard to potential toxicity from over dosage. Taking an excess amount of water soluble vitamins is generally
3 not toxic as the excess is excreted in the urine. Chronically high levels from excessive supplementation can, but rarely do, cause problems. Fat soluble vitamins, on the other hand, are stored in fat depots in our bodies rather than excreted. The possibility of over dosage is very real from excess supplementation and is rarely associated with dietary intake (5, 8). FAT SOLUBLE VITAMINS Vitamin A (Retinol, Beta Carotene) Vitamin D Vitamin E Vitamin K Sources -Milk, liver, fish liver oils, eggs, multiple vegetables and fruits. Functions- Prevention of night blindness, promotes healthy bones, hair, teeth, and skin; enhances immunity; antioxidant. Deficiency - Night blindness, poor bones and teeth, dry skin, dry eyes, poor resistance to infection. Sources- Fish liver oils, high fat fish, sunlight, egg yolks, fortified cereals and milk. Functions- Absorption of calcium and phosphorus, maintenance of strong bones, prevention of osteoporosis. Deficiency- Rickets, osteoporosis, osteomalacia (soft bones). Sources- Margarine, vegetable oils, nuts and seeds, wheat germ, whole grain cereals. Functions- Antioxidant ( neutralizes free radicals), boosts immunity, enhances red blood cell formation. Deficiency- Rare but may include anemia, cataracts, gallbladder disorders, poor absorption of dietary fats Sources- Dark green leafy vegetables, liver, soybean, canola, and olive oils, carrots, egg yolk, cereals Functions- Protein synthesis, blood clotting, formation of cartilage and bone, helps maintain bone mass and prevent Osteoporosis. Deficiency - Frequent nosebleeds, easy bleeding from defective blood coagulation, poor bone formation.
4 WATER SOLUBLE VITAMINS Vitamin B1 (Thiamine) Vitamin B2 (Riboflavin) Vitamin B3 (Niacin) Vitamin B5 (Pantothenic Acid) Sources- Pork, sunflower seeds, bananas, fish, liver, mushrooms, tuna, vegetables. production, supports nervous system, muscles, digestion, cardiac functions, critical for carbohydrate metabolism and energy production, needed for blood cell formation and healthy nervous system, maintains normal muscle tone of stomach, heart, and intestines. Deficiency- Disease called beriberi, characterized by muscle weakness, heart abnormalities, loss of appetite, nerve damage, numbness of extremities, paralysis, lung congestion. GI disorders such as Crohn s disease, stunted growth, mental confusion and dementia. Sources- Eggs, meat, poultry, dairy products vegetables, animal liver, venison, beans. mushrooms. production, necessary for metabolism, and body growth in general, skin, nail, and hair growth, necessary for metabolism of all foods, helps prevent cracking and sores around mouth and gums, may help prevent cataracts, maintains mucous membranes of digestive tract, needed for absorption of iron and B6, helps reduce homocysteine levels and therefore is cardioprotective. Deficiency- Dermatitis, cracking and sores around lips, shiny red or purple tongue, irritability or depression, sensitivity to bright light, itching and irritation of skin and mucous membranes, visual problems. Sources- Mushrooms, tuna, salmon, almonds, liver, corn, peanuts, chicken white meat, cheese, milk, eggs, vegetables. production, important to convert food into energy, production of hydrochloric acid in stomach, production of cellular DNA, lowers cholesterol in high doses therefore is cardioprotective. Deficiency-Pellagra, a disease characterized by dermatitis, diarrhea, mouth sores. muscle weakness, mouth sores, irritability. Sources - Animal liver, cauliflower, mushrooms, whole grain cereals, alfalfa, almonds, avocado, soybeans production, constituent of coenzyme A needed for many bodily processes, production of adrenal hormones, transmission of nerve impulses, required for synthesis of fatty acids and cholesterol, instrumental in transmission of nerve impulses between neurons, formation of antibodies. Deficiency- Burning or shooting foot pain, chronic fatigue, depression, nausea, insomnia, increased susceptibility to infections.
5 Vitamin B6 (Pyridoxine) Sources- Bananas, bell peppers, chick peas, nuts, vegetables, broccoli, cantaloupe. production, important for normal peripheral nerve and brain function, production of antibodies, regulation of blood sugar, protein metabolism, hemoglobin and red blood cell formation, balance of sodium and phosphorus levels, helps control blood levels of homocysteine and therefore cardioprotective, used to treat carpal tunnel syndrome. Deficiency- Arm and leg cramps, extremity numbness, eczema and dermatitis, convulsions, peripheral nerve disorders, depression, muscle weakness. Vitamin B9 (Folic Acid) Sources- Dark green vegetables, orange juice, organ meats, sprouts production, red blood cell formation, maintains normal brain function, DNA production. Deficiency -Anemia, growth retardation, irritability, senility, dementia, smooth red tongue (glossitis), neural tube defects in fetus with severe brain and neurological defects. Vitamin B12 (Cobalamin) Sources- Animal liver, fish, dairy products, meats such as beef, lamb, poultry, pork, venison, clams, scallops, shrimp, alfalfa beans, nuts, and seeds. production, formation of red blood cells, needed to make DNA, healthy nerve function, may slow or prevent Alzheimer s disease, metabolism of fats, carbohydrates, and protein. Deficiency- Pernicious anemia characterized by numbness and tingling of extremities, ataxia (unsteady gait), weakness, diarrhea, weight loss, low blood pressure, demyelination and nerve cell death. Depression, dementia, increased risk of heart attack and stroke. CONCLUSION The population as a whole has become aware of the significance of proper nutrition and the dominant role that protein intake plays in staying healthy or recovery from illness. Vitamins play a critical role in the production of that protein.
6 VITAMINS BIBLIOGRAPHY 1. Cabot W; What s so great about protein; 2. Marfatia U et al; Effects of suboptimal and optimal intakes of B vitamins on protein utilization by the growing rat from diets containing single and mixed proteins: J of Nutrition 1960: Reichrath J et al; Vitamins as hormones: Horm Metab Res Feb; 39(2): Kamanger F. et al; Vitamin and mineral supplements: do we really need them?; Int J. Prev. Med Mar; 3(3): Germano C. Cabot W.; The Osteoporosis Solution; Kensington Books Lee JH et al; Vitamin D deficiency an important, common and easily treatable cardiovascular risk factor?; L Am Coll Cardiol 2008 Dec 9;52 (24): National Institutes of Health, NIH Clinical Center: Office of Dietary Supplements 8. Grodner M. et al; Nutritional Foundations and Clinical Applications; Elsevier Guyton and Hall; Textbook of Medical Physiology; 9 th ed; W.B. Saunders; 1996 pg Health Supplements Nutritional Guide; BalchJF, Balch PA. Prescription for nutritional healing: A practical A-Z reference to drug-free remedies using vitamins, minerals, herbs & food supplements. Garden City Park, New York: Avery Publishing; FDA Consumer Health Information; Fortify your knowledge about vitamins: Sampsona D et al; Marginal intake of vitamin B-6: Effects on protein synthesis in liver, kidney and muscle of the rat: Nutr Research vol 8 issue 3Mar 1988 p
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