As you read this lecture, you should consider how this information affects you personally and how the person whose diet you tracked compares to this information...
Vitamins are generally defined as “organic molecules which are required in the
diet, because they are essential to normal function, yet the body does not manufacture
them,” or does not make them in sufficient quantities to meet the need for them.
Vitamins are not digested, but absorbed whole [if they could be digested, and
reassembled by the body, they would not be vitamins by the above definition]. They
are not metabolized for energy capture, because their function is too important.
    Some vitamins have been shown to function as co-enzymes, and it
is possible that all of the vitamins will eventually be found to serve as co-enzymes.
We can begin to understand the concept of enzyme - co-enzyme complexes by analogy to
home heating systems of your great-grandparents and your grandparents. In the
19th and early 20th Centuries, many homes were heated by
free-standing, cast-iron stoves [“Ben Franklin” stoves, after the inventor]
which burned wood or coal. When the room became chilly, we would put another log on
the fire (or add a scoop of coal); and when the room became too warm, we had to open
the windows. By current standards this is highly inefficient, but was an improvement
over the fireplace, because most of the heat from a fireplace goes up the chimney. The
free-standing cast-iron stove used the fire to heat the stove [until it was too hot to
touch], then radiated most of the heat into the room in all directions [so the stoves
were placed toward the center of the room rather than being stuck in an outside wall
like the fireplace]. Around 1885, Mr Butz invented a device to regulate the damper on
the stove automatically [closing the damper slows the fire by restricting air flow,
opening the damper allows the fire to burn hotter due to higher air flow], and by
1895 these new-fangled devices were being advertized for home applications (data from
www.honeywell.com/sites/honeywell/ourhistory.htm, downloaded on February 22, 2009).
From this long winded story, the Franklin stove is the analogy of an enzyme-driven
reaction, which is not as efficient as it could be, but a great improvenment over the
non-enzyme driven reaction (the fireplace). The automatic damper control, attached to
the stove, is the analogy of the co-enzyme added to the enzyme.
The enzyme drives the reaction, while the co-enzyme helps regulate the speed of the
reaction. The following table gives an over-simplified version of the enzme versus the
enzyme - co-enzyme complex:
enzyme | ||
inactive | activated | |
enzyme alone |
X | - |
enzyme plus co-enzyme |
- | X |
There is a considerable amount of current research looking into the detailed role of
vitamins, so it becomes more important to know how to look up any vitamin which
becomes “interesting” because of its possible relationship to your health
or wellness issues than it is to waste time learning ‘facts’ that are being
revised by on-going research. Translated into English, that means that you learn
only what you need to know, as you find the need, for specific vitamin issues.
You should check for newer information each time a vitamin issue comes up. To find
updated information, you can google “vitamins” (or better the specific
interesting vitamin) and select a website ending in “.gov” (such as the
National Institutes of Health [NIH], U.S. National Library of Medicine [NLM]
www.nlm.nih.gov/medlineplus/vitamins.html)
Some websites ending in dot-edu are some professor's Nutrition class notes (like
mine). These dot-edu sites are only updated if the professor is still teaching the
course. Most dot-org websites are reasonably ‘good’ in that the information
tends to be fairly accurate and current. Many dot-com websites are selling something
other than knowledge.
    For the time being, what you need to know is the nutritional status of
the person whose diet you tracked for Quiz 1. You should, by now, already know the
average daily percentage of RDA for various vitamins (and other nutrients) for this
person. For any vitamin for which intake is too low, or too high, compared to the RDA, you will
need to know the possible consequences for the person if he/she continues their present diet for
a long time. You can find this information by clicking on the links in the table below
or by looking in the tables in Nutrition Now, 5th ed
(Table 20.2 starting on pg. 20-4). Column 5 lists primary food sources [but Table 20.4 starting
on pg 20-14 has more complete information on vitamin density of foods]; and column 6 provides
highlights and comments
[the information on food sources in my table lists only the higher density, non-enriched
foods; complete information can be found at the USDA Agricultural
Research Center.
Vitamins | ||
---|---|---|
Fat-soluable | Water-soluable | |
Vitamin A | B complex | |
Beta-carotene | Thiamin (B1) | |
Vitamin E | Riboflavin (B2) | |
Vitamin D | Niacin (B3) | |
Vitamin K | Vitamin B6 | |
Folate | ||
Vitamin B12 | ||
Biotin | ||
  | Pantothenic acid | |
Vitamin C |
For example, if your person has a low percentage of AI for Vitamin K [I chose this one because
I have observed extremely low intakes, less than 10% AI, in data submitted for this class in
the past], you can find
Vitamin K in the Table
above, where we find that deficiency leads to bruising (easily mistaken for serious physical
abuse) and decreased calcium in bones. The Nutrition Now, 5th ed. text states that
deficiency is rare, but I would note that “The incidence of osteoporosis is far less in
many other countries than in the United States” (text pg. 23-10), suggesting to me that
sub-clinical deficiency of Vitamin K is not rare [the U.S. population has an unnatural
aversion to leafy green vegetables, unlike most other countries; we are, after all,
the ones who came up with the “meat & potatoes diet” although we could blame the
British or Irish for the idea]. Since the persons, in data I have seen from students in this class,
with the lowest Vitamin K intake (such a 0% AI) were females with at least one child, they have four
out of five risk factors for developing osteoporosis:
    1. female,
    2. have had at least one successful pregnancy,
    3. will become post-menopausal, and
    4. have possible deficiency of Vitamin K.
    5. [We will look at the fifth risk factor (calcium intake) in the lecture on
Minerals].
Do you think such persons might benefit from increasing their Vitamin K intake?
    Another issue you must consider in assessing your person's diet
is overdosing. For example, if your person has a high intake (such as 230% RDA) of
Vitamin E [another number from student submitted data for this class], we need to find
Vitamin E in the
Table above to get the consequences
of overdose. In this case, Vitamin E overdosing may lead to increased blood clotting
time. If such a person were on prescription anticoagulants (due to plaque-related
arterial blockage, and possibily diagnosed angina or heart attack), or are taking
daily low-dose aspirin to prevent heart disease, the high dose Vitamin E could be a
potentially serious problem [or as prescription drug ads on TV say, “sometimes
resulting in death,” as if that was a minor problem].
    Having established the potential consequences of under-dosing and/or
over-dosing on various nutrients, you will have to decide how serious their dietary
issues are, and select the two or three issues [you will lose points for selecting
more than three, or less than two] that you feel are most important to the person's
Wellness.
Your report will provide an explanation (rationale) of why you chose the nutritional
issues you chose. Your grade will depend on how well you justify your choices, not
what you chose [unless, like one former student you address the ‘low carb’
intake of an overweight person getting 247% RDA of Calories from carbohydrates; the
student lost a full letter grade for this error]. Having identified what you consider
to be the two or three most “interesting” issues with the person's diet,
you are to suggest a plan to correct the mistakes. My expectation is that you will
recommend specific dietary (food) sources of the nutrients which need to be increased,
and specific recommendations for those which need to be decreased [written as if you
expect the person to actually change their eating habits in order to improve their
Wellness]. Again, you will be graded on how well you justify your recommendations. If
you chose to supplement the person's diet with food supplements rather than food, your
task of defending the recommendation will more difficult due to my bias toward food as
the preferred source of nutrition [I believe this bias to be a very poorly kept
secret].
    Most of the fat-soluble vitamins have overdose symptoms which
are similar in severity to the deficiency symptoms in terms of seriousness of the
consequences. For the most part (but check to be sure if the issue arises), the
water-soluble vitamins consumed in excess of dietary needs are simply rejected as
poisons by the intestines: water is dumped from blood stream (replaced in blood from
water in body tissues, leading ultimately to dehydration) into the intestines; forward
motion in the intestines is speeded up; and the anal sphincter relaxed -a condition
called diarrhea.
    There was (and still is) a problem with Vitamin C overdosing. In the
1960's or 70's, the winner of a Nobel prize in Physics [for studies on high energy
physics, I think he discovered quarks or something] went on the talk show circuit, and
promoted the idea that the common cold could be avoided by taking two daily doses of
1,000 mg Vitamin C tablets per day in addition to dietary Vitamin C from citrus fruits
and vegetables [the UL (upper limit) is 2,000 mg]. There are only a few not so minor
problems with this advice: the man was a particle Physicist, not a Medical Doctor, but
was giving medical advice; the ‘data’ in support of the claims (Vitamin C
prevents the common cold) are examples of misinterpretion of the placebo effect; and
many people taking this advice developed chronic low-grade diarrhea, yet continue
overdosing on Vitamin C in tablet form. The mythology of Vitamin C as
preventing the common cold persists in the general population; the clinical
studies have suggested (not confirmed) that Vitamin C at 100% to 200% RDA may decrease
the duration and severity of the cold symptoms, but not the frequency of
catching a cold. Because there are recurrent fads involving unusually high doses of
different vitamin supplements on the presumption that unbelievable claims might be
true, it is necessary to point out that megadosing on vitamins is only suitable for
theraputic treatment of deficiencies, and then only under continual medical
supervision.
    I may have mentioned once or twice before, Human physiology is
designed by natural selection over 1,000's of generations to acquire nutrients from
food. Any nutrient which is in a form which can be absorbed from the gut
[a technical term for gastrointestinal tract] to the blood stream, and is in a
form which can be transported into cells and utilized is called bio-available. The only ‘vitamins’ which actually
serve as vitamins are the ones which are bio-available. Vitamins in natural foods are
bio-available, because our physiology expects to get its nutrients from real food.
Some vitamins in supplements that ‘grow’ in chemical processes in factories
and mature into “'convenient, easily swallowed” tablets are not
bio-available and serve primarily to produce enriched fecal material. The original
Wonder Bread (the kind that “helps grow strong bodies 12 ways,”) was
made from highly processed, bleached wheat flour [from which all nutrients other than
carbohydrates had been removed] enriched by 12 different vitamin and mineral
supplements which were not bio-available. [I think some of the supplements used to
enrich the flour have since been altered to increase bio-availability]
Three of the vitamins have been called anti-oxidants,
which appear (un-confirmed by rigorous scientific testing) to prevent, and even repair
damage caused by free radicals (ionized chemical structures which are proven to
break bonds in vital organic molecules). These are Vitamin C (this is the basis of the
myth that Vitamin C prevents the common cold), Vitamin E, and beta-carotene (a
yellow pigment from leafy greens, the darker green in color) which is a precursor to
Vitamin A [and you can convert beta-carotene to Vitamin A]. The part about repairing
damage from free-radicals found its way into the popular press, plus the press
coverage of the French Paradox (next paragraph) led to the development of a cult-like
group of non-science people promoting anti-oxidants [Apparently, the terms “free
radical” and “anti-oxidant” sounded sufficiently ‘cool’ to
make effective slogans].
    It is well known that the French diet is not ideal: yet the
French seem able to avoid heart disease, and live long, high quality lives. This
conflict between “conventional wisdom” and apparent reality has been called
the “French Paradox” [which also sounds good when you say it out loud]. The
World record, according to the Guiness Book of Records, for life span [age at time of
death] was set by a French woman who died at the tender young age of 122 years
5 months. At a press conference in honor of her 120th birthday, she
exhibited no signs of age-related dementia (I saw clips from that interview). The
runner-up is a French-Canadian woman who died at 115 years 4 months [without signs of
age-related dementia]. If you are curious, you can google “Jeanne Louise
Calment” (the 122 year old) and “Julie Winnefred Bertrand” (the 115
year old). The French Paradox has been tentatively explained by the anti-oxidants
known to be in red wine (of which the French drink a lot). This has been supported by
examination of the Japanese diet (rich in anti-oxidants from vegetables which are a
major part of the Japanese diet, but not over-cooked) because the Japanese population
has one of the highest life expectancies [average age at which 50% of the same-aged
population dies] compared to other nationalities.
    The popularity of the anti-oxidants led to similar claims for
many other plant-derived chemicals [given the catchy name
phyto-chemicals]. Phyto-chemicals were heavily promoted by
Herbalists.
The study of “Folk remedies” from regional plants is one of the legitimate
disciplines in Botany. These scientists seek to confirm or discredit the claims of
Folk medicine by scientific investigations. They (and Nutritionists plus medical
researchers interested in wellness) are currently examining the phytochemicals. Their
results thus far have been sufficiently encouraging that the phytochemicals have
become credible enough to start appearing in Nutrition textbook and lectures, and are
the subject of our next lecture.
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