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) -carotene (a carotenoid or pigment) in yellow/orange foods is a potent provitamin A Carotenoid Cleavage and Storage -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 (-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, Crohns 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