The Fat-Soluble Vitamins (A, D, E, and K

)
Vitamin A (Retinol)
      Foods from animal source provide various retinoids that are easily converted to retinol in the body Foods from plant source provide carotenoids Over 500 carotenoids are found in nature Less than 10% with provitamin A activity -carotene highest activity Must be acted upon in the gut or by the liver to form retinol

Sources of Vitamin A  Animal sources  Liver  Milk  Egg yolk  Plant sources  Alfalfa  Green leafy vegetables The Retinoids  3 forms of vitamin A important for health  Retinal  Retinoic acid  Retinol (key player; can be converted to other forms)  β-carotene (a carotenoid or pigment) in yellow/orange foods is a potent provitamin A Carotenoid Cleavage and Storage  β-carotene is converted to vitamin A in the intestinal mucosa  90% is stored in liver, mainly as the ester, retinyl palmitate (~ 6 months storage)  Small amounts in adipose and blood  Carotenoids can be stored in adipose tissue  Retinol binding protein acts to transport vitamin A from the liver and in the blood

Carotenoids  Additional physiologic effects beyond vitamin A  Antioxidant  Remove excess “electrons” from cell system  Electrons (free radicals) damage cells and DNA Vitamin A Roles in the Body  Promote vision (retinal)  Participate in protein synthesis and cell differentiation  Support reproduction and growth  Support immunity (retinoic acid and carotenoids)  Involved in bone growth and remodeling  Synthesis of glycoproteins  Antioxidant activity (β-carotene) Immune Functions  Carotenoids  Lycopene, -carotene  Serve as antioxidants  Antibody response to infections Vitamin A – Deficiency  Night blindness  Leading cause of blindness in third world countries  Cell keratinization  Dry skin  Xerophthalmia (dryness of cornea & conjunctiva)  Reproductive failure  Abnormal skeletal development/maintenance  Immune dysfunction

Vitamin A Toxicity  Skeletal malformations, spontaneous fractures, internal hemorrhages  Overconsumption of beta carotene from food sources may cause skin to turn yellow but is not harmful  Birth defects and miscarriage  Decalcification, joint pain, fragility  Dry itchy skin (caution about acne treatments)  Hair loss  Liver damage

Vitamin D (The Sunshine Vitamin)
 Body can make it if exposed to enough sunlight  Made from cholesterol in the skin  Vitamin D = calciferol  Vitamin D2 = ergocalciferol  Completely synthetic form produced by the irradiation of the plant steroid ergosterol  Vitamin D3 = cholecalciferol  Produced photochemically by the action of sunlight or ultraviolet light from the precursor sterol 7dehydrocholesterol Vitamin D – Sources  Not found naturally in many foods  Synthesized in body  Plants (ergosterol)  Fluid milk products are fortified with vitamin D  Oily fish  Egg yolk  Butter  Liver  Difficult for vegetarians Vitamin D – Functions  Bone development

Calcium absorption (small intestine)  Calcium resorption (bone and kidney)  Maintain blood calcium levels  Phosphorus absorption (small intestine)  Hormone  Regulation of gene expression  Cell growth

Vitamin D – Deficiency  Children  Rickets  Failure of bones to grow properly  Results in “bowed” legs or knock-knees, outward bowed chest and knobs on ribs  Adults  Osteomalacia: Adult form of rickets  Softening of bones, bending of spine, and bowing of legs  Osteoporosis (porous bones):  Vitamin D plays a major role along with calcium  Loss of vitamin D activity with advancing age  Associated with fractures  very serious for geriatrics Vitamin D Toxicity  Calcification of soft tissue  Lungs, heart, blood vessels  Hardening of arteries (calcification)  Hypercalcemia  Lack of appetite  Excessive thirst and urination

Osteomalacia

Normal Pelvis

Vitamin E (Tocopherol)
Alpha-tocopherol is most active form  Vitamin E is very unstable

Vitamin E – Sources  Plant sources  Cereal grains (Especially in germ)  Vegetable and seed oils  Little in animal sources  Beef fed high levels of vitamin E right before slaughter to improve shelf life can be source Vitamin E – Functions  Antioxidant  Free radical scavenger  Protects: cell membranes, LDL from oxidation, and double bonds in polyunsaturated fatty acids  Prevention of rancidity  Works in conjunction with selenium  Protects: lungs from pollutants, DNA, and heart Vitamin E – Deficiency  Rare – typically associated with fat malabsorption or excessive intake of polyunsaturated fatty acids (PUFAs)  Erythrocyte hemolysis and hemolytic anemia  Prolonged deficiency causes neuromuscular dysfunction; affects the spinal cord and the retina Vitamin E – Deficiency  Reproductive failure  Embryonic degeneration  Ovarian failure  Testes degeneration  Fetal resorption  Derangement of cell permeability  Liver, brain, kidney, or blood capillaries  Muscular lesions  Failure to growth, unthriftiness

Vitamin E Toxicity  Vit. E toxicity is rare  Extreme high doses (50- to 100-fold above recommended intakes) may affect the blood clotting effects of vitamin K and may lead to increased risk of hemorrhage

Vitamin K (The Clotting Vitamin)
Dicoumarol and warfarin are antagonists of vitamin K  Dicoumarol found in moldy sweet clover  Warfarin  Rat Poison

Vitamin K – Sources  Bacteria in the large intestine (10-15%) or rumen  Plant sources  Green leafy vegetables  Some oils  Broccoli  Animal sources  Liver  Milk Forms of Vitamin K  K1, phylloquinone  Chloroplasts in plants  K2, menaquinone  Bacterial synthesis  K3, menadione  Synthetic, water soluble form  Complexed to improve stability Functions of Vitamin K  Clotting factors are synthesized in the liver as inactive precursors - vitamin K converts them to their active forms  Conversion of prothrombin to thrombin, an active enzyme  Formation of fibrinogen to fibrin, leading to clot formation

Stimulates bone formation and decreases bone resorption

Vitamin K – Deficiency  Primary deficiency rare; secondary deficiency occurs when fat absorption is impaired (e.g., cystic fibrosis, Crohn’s disease) or following long-term or high-dose administration of antibiotics (they kill the bacteria in large intestine)  Newborn babies with sterile GI tract; single vitamin K dose given to prevent hemorrhage  Generalized hemorrhages (Prolonged clotting time) Vitamin K – Toxicity  Not common except with over-supplementation  Phylloquinone and menaquinone are relatively nontoxic  Jaundice; brain damage  Menadione toxic to skin and respiratory tract in high doses

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