Fat-soluble vitamins (A, D,

E, K).

Lecture 28
Ms Maraura
 The two types of vitamins are
classified by the materials in
which they will dissolve.

Fat-soluble vitamins -- vitamins A, D, E

and K -- dissolve in fat before they are
absorbed in the blood stream to carry
out their functions. Excesses of these
vitamins are stored in the liver. Because
they are stored, they are not needed
every day in the diet.

By contrast, water-soluble vitamins dissolve in water and are not

stored; they are eliminated in urine. We need a continuous supply of
them in our diets. The water-soluble vitamins are the B-complex
group and vitamin C.
 VITAMINS A, D, E, & K.
Vitamins are organic substances
in food, that are needed in very
small amounts for growth and for
maintaining good health. There are
vitamins that dissolve in water, and
4 vitamins that dissolve in fat:
A, D, E, & K

The 4 fat soluble vitamins are absorbed

by fat globules, allowing them to travel
through the intestinal walls and into the
bloodstream. Largest amounts of fat-
soluble vitamins are found in fatty
foods and fish-liver oils.
 Absorption of fat-soluble Fat malabsorption
vitamins takes place in the syndromes or bowel
small intestine and diseases (e.g., cystic
depends on the presence fibrosis, ulcerative
of bile and pancreatic colitis, cholestatic
juices. Excess vitamins liver disease,
are stored in the liver and Crohn's disease) are
adipose (fatty) tissues of associated with poor
the body. Fat-soluble absorption of these
vitamins are generally vitamins.
excreted more slowly than
water-soluble vitamins.

Fat-soluble vitamins are not destroyed by normal

cooking methods. They are stable to heat and
light. They are destroyed by alkalis, such as
baking soda. Some cooks add small amounts of
baking soda when cooking vegetables to mellow
harsh flavors and brighten colors.
 Vitamin A – AKA “The Beauty Vitamin”

• Forms healthy epithelial tissue which keeps skin and hair

healthy

• Helps keep the eyes free from dryness and infection

• Maintains healthy eyesight

FOOD SOURCES OF VITAMIN A
 Beta carotene
• Is found in plant foods and is the “precursor” or
provitamin of Vitamin A

• The deeper the color of the food, the more Beta

Carotene it contains
 Vitamin A Deficiencies
• Symptoms include dry, scaly skin, and fatigue
• Night Blindness – eyes adapt slowly to darkness and
night vision becomes poor
• Deficiency is one of the leading causes of blindness
in the world
 Vitamin A Toxicity
• Severe headaches
• Dry skin
• Hair loss
• Liver damage
 Vitamin A is also known as retinol.
It is present in many
Plants do not contain vitamin A, animal products, and is
but many dark-green or dark- readily absorbed from
yellow plants contain those dietary sources in
carotenoids that are ‘precursors’ the small intestine.
of Vitamin A. They can be
converted to Vitamin A (retinol)
within the intestinal mucosa just
prior to absorption. Carotenoids
are yellow, orange, and red
pigments present in plants.
Green vegetables also contain
carotenoids, though the pigment
is masked by the green pigment
of chlorophyll. Beta-carotene is
the name of a carotenoid.
Vitamin A can be artificially added to milk
and fortified cereals.
 Carotenoids are less easily absorbed than retinol and must be converted
to retinol by the body. The most recent international standard of measure
for vitamin A is retinol activity equivalents (RAE).
Life Stage Age Males Females
Adolescents 14 years 900 mcg RAE /day 700 mcg RAE /day
and adults and older 3,000 IU/day 2,333 IU/day

Type of Food Amount Vit A per serv. Vit A per serv.

Cod liver oil 1 tsp. 1350 mcg RAE 4,500 IU
Fortified breakfast cereal 1 serving 150-230 mcg RAE 500-767 IU
Egg 1 large 91 mcg RAE 303 IU
Whole milk 1 cup 68 mcg RAE 227 IU
2% fat Vit. A enriched milk 1 cup 134 mcg RAE 447 IU
Sweet potato, canned ½ cup mashed 555 mcg RAE 1,848 IU
Pumpkin, canned ½ cup 953 mcg RAE 3,177 IU
Carrot, raw and chopped ½ cup 538 mcg RAE 1,793 IU
Cantaloupe ½ med melon 467 mcg RAE 1,555 IU
Spinach, cooked ½ cup cooked 472 mcg RAE 1,572 IU
Broccoli, cooked ½ cup cooked 60 mcg RAE 200 IU
 1. Maintains and strengthens the skin

2. Maintains health of specialized

tissues such as the retina of the eye

3. Maintenance of the mucosal

tissues and secretions, which in turn
are responsible for normal
functioning of the immune system;
4. Normal bone development

5. Maintenance of the reproductive system:

required for sperm production in the male and
regulate reproductive cycles in the female.
 Excess Vitamin A is stored in
the liver. In a well-nourished
person, there may be a 2 - 12
month supply stored at any
given time. A large surplus will
accumulate in the liver and
may be harmful. Such
excessive intakes are less
likely to result from over- Side effects of vitamin A
eating than through the over- excess/overdose include nausea,
use of manmade vitamin pills itchiness, irritability, vomiting,
headaches, menstrual problems,
or dietary supplements. dizziness, pimples, and birth
Overdoses of manmade defects. Long term vitamin A
Vitamin A is called overdose can lead to liver
‘Hypervitaminosis A’. damage, pain in the muscles and
bone, and headaches.
 Xerophthalmia (zîr'əf-thăl'mē-ə) is a
major cause of preventable blindness in
children, especially in developing
countries. It is an inflammation of the
cornea (the clear covering of the eye).
Bitot's Spots (′bē·tōs ′späts) are
distinct elevated white patches on the
conjunctiva, the membrane that covers
most of the visible part of the eye.
Night Blindness or Nyctalopia
(nĭk'tə-lō'pē-ə) or is a condition making
it difficult or impossible to see in dim
Zinc deficiencies interfere with light.
Vitamin A metabolism. Vitamin A deficiency causes
Vitamin A deficiencies exacerbates hardening and roughening of the
iron-deficiency-anemia. Chronic skin, acne, birth defects, and
alcohol consumption depletes liver degeneration of mucous
stores of vitamin A. membranes.
 Normal (on the right) and vitamin A-deficient rat (on the
left). Deficiencies result in a dryness and soreness which
causes the eye lid to cake and to stick together.
 Vitamin D – The Sunshine Vitamin
• Helps Calcium form strong bones

• Helps regulate blood calcium levels

Sources of Vitamin D
 Vitamin D Deficiencies
• Rickets
• Osteomalacia
 Vitamin D Excess
• Can be poisonous

• Toxicity occurs from consuming too many supplements

• Raises blood calcium levels and the excess is absorbed

into the kidneys and other soft organs
 Vitamin D is another fat-soluble
vitamin. It is essential for
maintaining normal calcium
metabolism. Vitamin D can be
synthesized by humans in the
epidermis of the skin upon
exposure to ultraviolet-B (UVB)
radiation from sunlight, or it can
be obtained from the diet.

Vitamin D works hand-

in-hand with calcium.
Neither can work alone.
 As little as 5-10 minutes of sun
exposure on arms and legs or face and
arms three times weekly between 11:00
am and 2:00 pm during the spring,
summer, and fall should provide a
light-skinned individual with adequate
vitamin D and allow for storage of any
excess for use during the winter with
minimal risk of skin damage.
Vitamin D is found naturally
in very few foods: some fatty fish
(mackerel, salmon, sardines), fish liver
oils, and eggs. In the U.S. and Canada,
it is a common nutritional additive to
milk, orange juice, and cereals. Check
product labels. The “vitamin D winter”
extends from mid-October to mid-March
in the midwest, and this is the time to
take Vitamin D supplements.
 The issue of sunlight exposure confounds the existing data on vitamin D
requirements, making it impossible to accurately calculate daily needs. The
Recommended Dietary Allowances, therefore, have be set with the assumption
that no vitamin D is being synthesized in the skin through exposure to sunlight.
Life Stage Age Males Females
Adolescents 14-50 5 mcg /day 5 mcg /day
and adults years 200 IU/day 200 IU/day
Adults 51-70 10 mcg /day 10 mcg /day
years 400 IU/day 400 IU/day

Food Serving Size Vitamin D (mcg) Vitamin D (IU)

Pink Salmon 3 ounces 13.3 530

Cow’s milk, 8ounces 2.5 98

fortified
with Vitamin D
Cereal, enriched 1 serving 1.0-1.3 40-50

Egg yolk 1 large 0.53 21

1. Vitamin D is essential for the efficient
metabolism and utilization of calcium by
the body. Maintenance of calcium levels
within a narrow range is vital for normal
functioning of the nervous system.

2. Works with calcium for bone growth

and maintenance of bone density.

3. Adequate vitamin D levels may be

important for decreasing the risk of high
blood pressure.

4. Plays a role in insulin secretion

under conditions of increased insulin
demand.
 Vitamin D toxicity, known as Hypervitaminosis D, induces
abnormally high calcium levels (Hypercalcemia), which
could result in bone loss, kidney stones, and calcification of
organs like the heart and kidneys if untreated over a long
period of time. Excessive exposure to sunlight does not
lead to vitamin D toxicity. Excesses are usually attributed to
overdoses of dietary supplements.
Like Vitamin A, a
surplus of Vitamin D
is stored in the liver
and body fat.

An individual experiencing vitamin D poisoning

may complain of weakness, fatigue, loss of
appetite, nausea, and vomiting. In infants and
children there may be growth failure.
 In infants and children, severe
vitamin D deficiency results in the
failure of bone to mineralize, a disease
called Rickets. Rapidly growing bones
are most severely affected by rickets.
The growth plates of bones continue to
enlarge, but in the absence of adequate
mineralization, weight-bearing limbs
(arms and legs) become bowed.

Vitamin D deficiency causes muscle weakness and pain in

children and adults. In adults it may develop into osteomalacia, a
disease characterized by poorly calcified, softened bones.
Vitamin D deficiencies increase the risk of osteoporosis, which is a
progressive loss of bone density.
 There are numerous factors that place people at a
higher risk of having a vitamin D deficiency:
1. Infants that are exclusively breast-fed
2. Individuals with dark skin, as they don’t synthesize
Vitamin D as well as those with light skin
3. Elderly individuals, as they have reduced ability to
synthesize Vitamin D when exposed to UVB
radiation and they stay indoors more.
4. Individuals covering all exposed skin or using
sunscreen whenever outside
5. People with malabsorption syndromes such as
cystic fibrosis or cholestatic liver disease
6. People with inflammatory bowel disease, like
Crohn’s disease
7. People who are obese.
8. People who live in cloudy climates or cities with The application of
contaminated air that may lack sufficient amounts sunscreen with an
of ultraviolet rays. SPF factor of 8
9. Individuals who consume mineral oil, and the fat reduces production
substitute Olestra, as they interfere with of vitamin D by 95%.
absorption of Vitamin D.
 Vitamin E
• Helps break down polyunsaturated fats

• Antioxidant – helps protect blood cell membranes from

overexposure to oxygen
Food sources of Vitamin E
 The term vitamin E describes a
family of eight antioxidants.
Alpha-tocopherol (ăl'fə-tō-kŏf'ə-rôl‘) is the only form of
vitamin E that is actively maintained in the human body.
Alpha-tocopherol is the
form of vitamin E that
appears to have the
greatest nutritional
significance, and is found
in the largest quantities in
the blood and tissue.
The acai berry (ah-sī-ē) is
a source of omega 6 fatty
acids and alpha-
tocopherol.
The value of Vitamin E for topical skin care has not been verified. It may have
some moisturizing qualities, but frequently causes an allergic reaction.
 Major sources of alpha-
tocopherol in the American
diet include vegetable oils
(corn, olive, sunflower,
safflower oils), nuts, whole
grains, dark berry juices, and
green leafy vegetables.

Cooking foods at high

temperatures destroys vitamin E.
 Life Stage Age Males Females
Adolescents 14-18 15 mg /day 15 mg /day
years 22.5 IU/day 22.5 IU/day
Adults 19 years 15 mg /day 15 mg /day
and older 22.5 IU/day 22.5 IU/day

Food Size of serving Alpha-tocopherol in mg

Olive oil 1 Tbsp 1.9
Soybean oil 1 Tbsp 1.2
Corn oil 1 Tbsp 1.9
Canola oil 1 Tbsp 2.4
Sunflower oil 1 Tbsp 5.6
Almonds 1 Tbsp 7.3
Hazelnuts 1 Tbsp 4.3
Peanuts 1 Tbsp 2.4
Spinach 1 Tbsp 1.8
Avocado 1 medium 3.4
 The main function of Vitamin E (alpha-tocopherol) is that of
an antioxidant. An antioxidant is a substance that reduces or
prevents damage.
Free radicals are very reactive
atoms or molecules that
typically possess a single
unpaired electron. They are
formed in the body during
normal metabolism and also
upon exposure to
environmental factors such as
cigarette smoke, stress,
alcohol, lack of sleep, poor
diet, or pollutants. These free Fats and some proteins are the target of
radicals cause destruction by
free radical destruction. The result is
trying to remove electrons
from other molecules so they damage to the cell membranes and
will have a matched pair. This accelerated aging. It is also linked to
destruction is called Alzheimer’s disease, cataracts, heart
oxidation. disease, Vitamin K usage, and cancer.
 This is a free Now that the radical
radical with one This is the
antioxidant named has two electrons, he
unpaired electron. is no longer free to do
Vitamin E. He
He is destroying prevents the free harm.
fat and some radical from More free radicals may
proteins, and continuing his be created as a result
accelerating aging destruction, by of tobacco, alcohol,
in a process called giving him an extra stress, lack of sleep,
oxidation… while electron to hold poor diet, and
trying to find a onto. pollution.
second electron.
 The risk of too much Vitamin E is low. Excess amounts
are stored or most likely excreted. Doses of over 800 IU a
day of vitamin E may interfere with the body's ability to
clot blood, posing a risk to people taking blood thinners
(anticoagulants).

Many surgeons
recommend the
discontinuation of
Vitamin E
supplements prior
to surgery, to avoid
the risk of
uncontrolled
hemorrhage.
 Vitamin E deficiency has been
observed in individuals with severe
malnutrition, some genetic defects,
and fat malabsorption syndromes
such as cystic fibrosis or
cholestatic liver disease. Severe
vitamin E deficiency results mainly
in neurological symptoms,
including impaired balance and
coordination, injury to the sensory
nerves, muscle weakness, and
damage to the retina of the eye.

Vitamin E deficiencies are rare. In fact, a symptomatic

vitamin E deficiency in healthy individuals who consume
diets low in vitamin E has never been reported. Excess
Vitamin E can be stored in fatty tissues of the body.
 People in some European
countries consume diets high in
saturated fats. The French, for
example, enjoy meals that
include heavy sauces made with
cream and butter. Their
incidence of heart disease,
however, is not nearly as high as
people in the United States. How
might you account for that?
One idea relates to the amount of
red wine they consume with their
meals. It would contain an anti-
oxidant… and perhaps
counteracts the effects of the
saturated fats.
 Vitamin K is a fat-soluble vitamin. The "K" is derived
from the German word "koagulation." Coagulation
refers to the process of blood clot formation.

Vitamin K is essential for the

functioning of several
proteins involved in blood
clotting.
When an injury occurs, the
protein molecules (with
names like Factor II or
prothrombin, Factor VII,
Factor IX, and Factor X)
rapidly assemble and form
the blood clot.
The term thrombus or thrombosis refers to a blood clot.
 Life Stage Age Males Females
mcg/day mcg/day
Adolescents 14-18 yrs 75 75
Adult 19 years 120 90
and older

1 cup dark green or green leafy vegetables per day would provide an
adequate supply of vitamin K.
Food Serving Vitamin K (mcg)

Olive oil 1Tbsp 8.1

Soybean oil 1 Tbsp 25.0
Canola oil 1 Tbsp 16.6
Broccoli, cooked 1 cup, chopped 220
Spinach, raw 1 cup 145
Parsley ¼ cup 246
Leaf lettuce, raw 1 cup, shredded 62.5
 The best dietary sources of
vitamin K are green leafy
vegetables such as spinach,
broccoli, Brussels sprouts,
cabbage and lettuce. Other rich
sources are certain vegetable oils.
Good sources include oats,
potatoes, tomatoes, asparagus
and butter. Lower levels are found
in beef, pork, ham, milk, carrots,
corn, most fruits and many other
vegetables.

A portion of the body's vitamin K

is produced by bacteria living in
the jejunum and ileum of the
intestine rather than by dietary
sources.
Although allergic reaction is possible, there is
no known toxicity associated with high doses
of the dietary (K1) or intestinally-produced
Vitamin K (K2).
You can overdose on
synthetic Vitamin K (K3).
Large doses of this form
break down red blood cells
and can lead to a jaundice
condition and possibly even
brain damage when given to
infants or pregnant women.
Vitamin K deficiencies are rare for two reasons... 1. part of the body’s
needs of this vitamin are produced in the intestinal tract 2. Vitamin K
is “conserved” in the body. That means it is recycled… it can be used
over and over. The process is called the Vitamin K cycle.

Easy bruising
associated with
Vitamin K
deficiency.

Adults at risk of vitamin K deficiency include those taking vitamin K

anticoagulant drugs (warfarin, coumadin, heparin) that may be
prescribed for blood clots in the legs and lungs. Individuals with
significant liver damage or disease, and individuals with disorders of
fat malabsorption may also be at increased risk of vitamin K
deficiency. Large doses of vitamin A and vitamin E have been found to
counteract the function of vitamin K and interfere with Vitamin K
absorption. Long-term use of antibiotics may destroy the bacteria in
the intestine that produce Vitamin K.

Spontaneous subcutaneous hemorrhages in a
chick fed a vitamin K deficient diet for 15 days.
The bottom chick was fed an adequate diet and
is the same age.
Symptoms of a Vitamin K
deficiency include easy
bruising and bleeding that may
be manifested as nosebleeds,
bleeding gums, blood in the
urine, blood in the stool, tarry
black stools, or extremely
heavy menstrual bleeding.
Vitamin K deficiency
frequently occurs in newborn
infants. Many babies in the U.S.
get an injection of vitamin K at
birth to avoid hemorrhagic
disease, which is characterized
by uncontrolled bleeding within
the skull. Babies depend on
this long-lasting injection until
vitamin K-producing bacteria
become established in their
digestive tracts.
 Excessive intake of vitamin K rarely
occurs. Excess doses, those greater
than 1000 times the requirement, can
promote thrombogenesis (formation of
blood clots) and hemolysis (red blood
cells are destroyed faster than bone
marrow can produce new ones). These
doses of vitamin K can also increase
risk of jaundice.
Unless medically prescribed, Vitamin K
should be consumed only from food
sources to prevent toxic levels.
Blood clot pictures:
Top: Swelling and discoloration of the leg are signs of deep vein
thrombosis, also known as a blood clot.
Bottom: A blood clot that travels to the lungs is called pulmonary embolism,
and can be fatal without emergency treatment.
 Hypervitaminosis -
Excess vitamins A and D
• Hypervitaminosis A - Excess Vitamin A is stored in
the liver. In extreme cases can cause dry skin,
enlarged liver, fatigue, hair loss, headaches,
appetite loss, vomiting, risk of birth defects and
miscarriage.
• Hypervitaminosis D - More common in young
children than adults. Results in high concentration
of calcium in blood. Symptoms - nausea, mental
confusion, vomiting and thirst.
 Hand in Hand –
How vitamins help each other
• Vitamin E keeps Vitamin A from being destroyed in
the intestines

• Vitamin D enables the body to absorb calcium and

phosphorous

• Vitamin C helps folate build proteins

• Vitamin B1 works in the digestive system with

niacin, pantothenic acid and magnesium