Fat Soluble Vitamins – Water Soluble vitamin

Vitamin

Tim Departemen Gizi Kesehatan– FKM Universitas Airlangga 1

 About Me
- Nama: Triska Susila Nindya, SKM., MPH (Nutr)
- Pendidikan terakhir: S2 – The University of
Queensland Australia
- Alamat Kantor: Departemen Gizi Fakultas
Kesehatan Masyarakat Universitas Airlangga
- Alamat Rumah: Pakis Tirtosari XVII / 9 Surabaya
- Mobile phone: 085852968680
- Email: triska.nindya@fkm.unair.ac.id atau
triskasnindya@yahoo.com
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Fat Soluble vitamins Slide 1 of

Pengantar

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The Vitamins

Copyright 2008 Wadsworth Group, a division of Thomson Learning

Fat Soluble vitamins Slide 1 of

Pengantar
VITAMIN LARUT LEMAK
 Dpt larut dlm lemak & hrs terlarut dlm lemak
spy dpt diserap & diangkut
 Terdiri dari vitamin A, D, E & K
 Di dlm tubuh tersimpan dlm jumlah besar,
shg dpt menyebabkan keracunan jika
dikonsumsi dlm jumlah berlebihan & jangka
panjang, terutama vitamin A & D
 Berbeda dg vit B dan C, vitamin larut lemak
sgt stabil  tahan terhadap proses
pemasakan (panas)
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Pengantar

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Pengantar
Micelles membawa
vit larut lemak &
lemak diet menuju
brush border utk
Vit larut air diserap ke dlm diserap
aliran darah. Kelebihan vit
larut air, disaring oleh ginjal
& dikeluarkan mll urin Vit larut lemak,
Pencernaan di lambung di dlm kilomikron
& usus halus, melepaskan diangkut melalui
vitamin dr makanan limfe menuju aliran
darah & hati
Microvilli
Villus

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 Vitamin A D E K
• Vitamin larut lemak bekerja bersama
sebagaimana keluarga
• Mereka terdapat dalam membran
Fat Soluble vitamins Slide 1 of

Vitamin A

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Fat Soluble vitamins Slide 1 of

Gambaran umum:

 Merupakan vit larut lemak yg pertama kali

teridentifikasi  th 1913 oleh McCollum & Davis
 Bisa rusak oleh oksidasi
 Vit. E membantu melindungi vit A dr oksidasi
 Bisa rusak oleh pengeringan, tetapi tdk mudah
rusak dlm proses pengalengan & pembekuan
 Proses pemasakan bisa saja merusak vit A, ttpi
hanya stlh proses perebusan dlm wkt yg sgt lama
 Bentuk aktif vit A hanya terdpt dlm pangan hewani

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Bentuk

Secara garis besar, ada 2 bentuk vit A:

1. Retinoid
2. Provitamin A (carotenoid)

Retinoids
 Terdiri dr retinol, retinal, dan retinoic acid.
Retinol: Struktur alkohol, yg ditemukan pd jaringan
hewani dlm bentuk retinyl ester dg as lemak rantai pjg
Retinal: Struktur aldehid yg diturunkan dr oksidasi
retinol
Retinoic acid: Btk asam, diturunkan dr oksidasi retinal
 Mrpk btk vit A yg aktif di dalam tubuh
 Sensitif thd panas, cahaya, dan oksidasi
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Bentuk

Provitamin A (carotenoids)
 Terdiri dr beta karoten. Supaya aktif, di dlm tubuh
dikonversi menjadi retinoid
 Aktivitas biologisnya sangat kecil, hanya 1/6 dari
retinol
 Plant source food

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Fat Soluble vitamins Slide 1 of

Satuan

Satuan vit A & equivalennya:

1 g RE = 1 μg retinol
= 6 μg beta karoten
= 12 μg karotenoid lain
= 3,3 SI retinol
= 9,9 SI beta karoten

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Fat Soluble vitamins Slide 1 of

Absorbsi, Transportasi, Metabolisme

 Di dlm lambung:
Vit A dari makanan (ester retinil & karotenoid) bercampur
dg lipida lain
 Di dlm sel2 mukosa usus halus:
Ester retinil dihidrolisis oleh enzim pankreas esterase menjadi
retinol
 Di dlm sitoplasma sel mukosa usus halus:
Sebagian karotenoid (beta karoten) dipecah mjd retinol
 Di dlm mukosa usus halus:
 Retinol bereaksi dg as lemak, membentuk ester
 Dg bantuan cairan empedu, ester menyebrangi sel2 vili
dinding usus halus, kemudian diangkut kilomikron melalui
sistem limfe ke dalam aliran darah menuju hati
 Di dlm hati
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Vit A disimpan & siap dimobilisasi jika tubuh memerlukan
Fat Soluble vitamins Slide 1 of

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Fat Soluble vitamins Slide 1 of

Fungsi

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Fungsi

Penglihatan
 Di dlm mata, retinol dioksidasi mjd retinal
 Retinal mengikat protein opsin & membentuk rodopsin
 Rodopsin terdpt di dlm rod cell (sel khusus di dlm retina mata)
 Bila cahaya mengenai retina, retinal dipisahkan dr opsin & tjd
rangsangan elektrokimia yg merambat spjg saraf mata ke
otak  tjd bayangan visual
 Selama proses tsb, sebagian vit A dipisahkan dr protein &
diubah jd retinol
 Sebagian besar retinol diubah kembali jd retinal, yg kmudian
mengikat opsin lg membentuk rodopsin
 Selama proses ini, sebagian kecil retinol hilang & harus
diganti dr darah
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Fungsi

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Fat Soluble vitamins Slide 1 of

Fungsi

Diferensiasi sel
 Secara normal, terjadi
diferensiasi sel di dlm tubuh
(diferensiasi normal), yg
dibantu oleh vitamin A
 Kekurangan vitamin A 
diferensiasi sel tdk normal 
sel mengalami perubahan
dari sifat dan fungsi semula

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Fat Soluble vitamins Slide 1 of

Fungsi

Fungsi Kekebalan
 Retinol berpengaruh thd pertumbuhan & diferensiasi limfosit B
(leukosit yg berperan dlm kkebalan)
 Kekurangan vit A menurunkan respon antibodi
 Pemberian vitamin A, mempercepat penyembuhan penyakit
infeksi: infeksi pernafasan, diare, campak, dsb

Fungsi Reproduksi
 Kebutuhan vit A selama hamil meningkat utk janin &
persiapan menyusui
 Penelitian pd hewan:
 Retinol diperlukan untuk pmbentukan sperma & sel telur,
serta pd masa perkembangan janin
 Hewan dg status vit A rendah, mampu hamil tp bermasalah
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(keguguran/ sulit melahirkan)
Fat Soluble vitamins Slide 1 of

Fungsi

Fungsi Pertumbuhan
 Vit A mempengaruhi sintesa protein  pemegang peranan
penting dlm pertumbuhan
 Vit A diperlukan utk perkembangan tulang& sel epitel yg
membentuk email dlm pertumbuhan gigi
 Anak kekurangan vit A  pertumbuhan terhambat

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Fat Soluble vitamins Slide 1 of

Fungsi

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Kebutuhan

 Pria dewasa : 700 RE

 Wanita dewasa : 500 RE
 Remaja (Pria/ wanita) : 500 RE
 Anak usia sekolah : 400 RE
 Bayi dan balita : 350 RE
 Ibu hamil : + 200 RE
 Ibu menyusui 0-6 bln : + 350 RE
 Ibu menyusui 7-12 bln : + 300 RE

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Fat Soluble vitamins Slide 1 of

Sumber

 Retinoid : pangan hewani

Hati, kuning telur, susu, mentega
 Provitamin A (carotenoid) : pangan
nabati
 Sayuran hijau tua (daun singkong,
daun kacang, kangkung, bayam,
kacang panjang, dsb)
 Buah/ sayur kuning-jingga (wortel,
tomat, pepaya, mangga, dsb)

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Fat Soluble vitamins Slide 1 of

Kekurangan & kelebihan

Kekurangan
 Primer : kurang konsumsi
 Sekunder : gangguan penyerapan oleh tubuh,
kebutuhan meningkat, gangguan konversi karoten mjd
vit A (retinoid)

Akibat kekurangan
1. Buta senja
Penglihatan td mampu sesuaikan dr cahaya terang ke
remang2 (senja)
2. Perubahan2 / gangguan pd mata:
a. Xerosis konjunctiva (konjungtiva kering)
b. Bittot’s spot
c. Keratomalasia 25
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Fat Soluble vitamins Slide 1 of

Kekurangan & kelebihan

3. Infeksi
- Fungsi kekebalan tubuh
menurun
- Lap sel pd sal pernafasan
mengalami keratinisasi (kering,
tdk mengeluarkan lendir) shg
mudah dimasuki m.o  infeksi sal
pernafasan.
- Kekurangan vit A pd anak 
sebabkan komplikasi pd campak

4. Perubahan & gangguan pd kulit

Kulit kering & kasar, folikel rambut
kasar, mengeras (keratinisasi) 
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hiperkeratosis folikular
Fat Soluble vitamins Slide 1 of

Kekurangan & kelebihan

5. Gangguan pertumbuhan
Kekurangan vit A hambat pertumbuhan sel2, trmasuk
tulang

Kelebihan
 Disebut: Hipervitaminosis A
 Hanya tjd jika mengonsumsi vit A dlm btk suplemen
dosis tinggi (> 15.000 RE), & jangka panjang
 Gejala: sakit kepala, pusing, mual, rambut rontok, kulit
mengering, loss of appetite/ anoreksia

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Fat Soluble vitamins Slide 1 of

Vitamin D

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Fat Soluble vitamins Slide 1 of

Gambaran umum:

 Pertama kali teridentifikasi  th 1922  selain vit

A, minyak ikan mengandung faktor lain yg bersifat
anti rakitis
 Vit D dapat dibentuk tubuh dg bantuan sinar
matahari
 Bila cukup sinar matahari, tubuh tdk perlu vit D dari
makanan

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Fat Soluble vitamins Slide 1 of

Bentuk

Secara garis besar, ada 2 macam

1. Dari makanan:
1. Vit D2 (ergocalciferol)  nabati
2. Vit D3 (Cholecaciferol)  hewani
2. Prekursor vitamin D3 di dlm tubuh:
7-dehidrocholesterol

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Fat Soluble vitamins Slide 1 of

Absorbsi, Transportasi, Metabolisme

 Vit D3 dibentuk di dlm kulit oleh sinar UV dari 7-

dehidrokolesterol
 Vit D diabsorbsi di dlm usus halus bersama lemak dg
bantuan cairan empedu
 Vit D dr bag. Atas usus halus, diangkut oleh D-plasma
binding protein (DBP) ke tempat-tempat penyimpanan di
hati, kulit, otak, tulang & jaringan lain

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Fat Soluble vitamins Slide 1 of

Fungsi

Membantu pembentukan & pemeliharaan tulang

Vit D berperan membantu pengerasan tulang
 Mengatur spy kalsium & fosfor tersedia di dlm
darah utk diendapkan pd proses pengerasan
tulang

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Fat Soluble vitamins Slide 1 of

Kebutuhan

 Pria dewasa : 5 μg
 Wanita dewasa : 5 μg
 Remaja (Pria/ wanita) : 10 μg
 Anak usia sekolah : 10 μg
 Bayi : 7,5 μg
 Balita : 10 μg
 Ibu hamil : 10 μg
 Ibu menyusui : 10 μg

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Fat Soluble vitamins Slide 1 of

Sumber

 Sinar matahari – berperan mengkonversi vit D bentuk tdk

aktif (provitamin D) menjadi bentuk aktif (5-15 menit)
 Pangan hewani
 Beberapa sumber vit A, jg sumber vit D:
– telur
– susu
– Margarine
 Udang & seafod lain
 Minyak ikan

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Fat Soluble vitamins Slide 1 of

Vitamin D & Sinar Matahari

 Vitamin D dapat diperoleh dg memaparkan lengan

selama 10-20 menit pd cahaya matahari pagi selama
2-3 kali per minggu
 !! Gelombang UV-B selain dpt membantu
pembentukan vit D, jg berkontribusi thd tjdnya ca kulit
 Sun block dpt menghambat pembentukan vitamin D
 Proses penuaan juga menurunkan pembentukan vit D
dr sinar matahari

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Fat Soluble vitamins Slide 1 of

Kekurangan & kelebihan

Kekurangan
Gejala:
 Gangguan kalsifikasi tulang
 Pd ujung tulang panjang, tjd pemanjangan (tdk padat)
 Menurunkan kadar kalsium darah
 Menurunkan kadar fosfor darah
 Erupsi gigi secara perlahan
 Otot lemah
 Sekresi berlebihan parathyroid hormone
 2 penyakit akibat kekurangan: riketsia (anak2) &
osteomalacia & osteoporosis (dewasa)
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Fat Soluble vitamins Slide 1 of

Kekurangan & kelebihan

Rickets
 Gangguan pertumbuhan
& pengerasan tulang  tl
jd lembek
 Kaki bengkok
 Ujung tl panjang
membesar
 Tulang dada tdk normal
 Gigi terlambat keluar, tdk
teratur & mudah rusak
 Terapi: suplementasi vit
D
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Fat Soluble vitamins Slide 1 of

Kekurangan & kelebihan

Osteomalacia
 Bnyk tjd pd wanita yg konsumsi kalsium
rendah, tdk banyak mendapat sinat mthr,
mengalami banyak kehamilan & menyusui
 Defisiensi Vitamin D yg tjd stlh pertumbuhan
tulang
– Demineralisasi hilangnya struktur
pembentuk tulang, shg menyebabkan:
 Tulang lemah
 Kesulitan berjalan
 Nyeri kaki & punggung
 Kejang otot
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 Menurunnya Ca-Ph dlm serum
Fat Soluble vitamins Slide 1 of

Kekurangan & kelebihan

Kelebihan
 Vitamin D adalah yg paling toxic di antra vitamin2
lain
 Toksisitas dpt tjd pd konsumsi hingga > 5 AKG (>
5μg/hr)
 Kelebihan: hypervitaminosis D
– Kalsifikasi berlebihan pd tulang & jar tubuh
(ginjal, paru, dll)
– Tanda khas: Nafsu makan menurun, Mudah
haus, Diarrhea, lemah, Nyeri kepala, muntah,
pengeluaran urin berlebihan

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 Vitamin A D E K
• Vitamin larut lemak bekerja bersama
sebagaimana keluarga
• Mereka terdapat dalam membran
 Vitamin E
• Tocopherols (more active compounds)
– α, β, γ & δ
• Tocotrienols
– α, β, γ & δ
 Fungsi Vitamin E
• Vitamin E adalah anti oksidan
• Penting untuk menjaga
membran syaraf dan sel darah
merah
– Keadaan defisiensi dapat
menyebabkan kerusakan
syaraf dan hemolytic anemia
• Salah satu dari zat yang
membantu mengurangi
oxidative stress
 Semakin Banyak Semakin
Baik?
• Tubuh tidak bergantung
sepenuhnya pada vitamin E
untuk perlindungan
antioksidan
• Perlindungan yang lebih baik
nampaknya diberikan pada
kombinasi antioksidan dan
molekul penting lainnya
• Penelitian menggunakan
suplementasi Vitamin E untuk
menurunkan resiko CVD
memberikan hasil yang
mengecewakan
 Fungsi Lain Vitamin E
• Meningkatkan fungsi imunitas.
• Mengatur fungsi platelet (pembekuan
darah)
• Membantu pembentukan sel darah merah
• Ikut serta dalam pemanfaatan vitamin K.
• Berfungsi sebagai molekul pemberi sinyal
 Ada Yang Mau Vitamin E?
• Minyak tanaman adalah
sumber pangan kaya
vitamin E
Sumber Vitamin E
Pangan SumberVitamin E
 Anjuran Konsumsi
• Vitamin E
– DRI 15 milligrams/hari (alpha-tocopherol)
– Sumber: lihat slide berikutnya
 Vitamin Larut Lemak
• Vitamin E
– Defisiensi (turunnya absorpsi lemak - liver
disease, diet rendah lemak)
• Bayi Premature – rentan hemolysis
• Hilangnya koordinasi otot, penglihatan dan fungsi
imunitas
– Toksisitas (lebih dari 1000 milligrams/hari)
• Meningkatnya efek antikoagulan
 Toksisitas Vitamin E
• Vitamin E relatif non-toksik, namun jumlah
yang berlebihan dapat mengganggu
kinerja vitamin K untuk pembekuan darah
• UL –nya 1.000 mg α-tocopherol dari
sumber alami
– 1500 IU (sumber alami)
– 1100 IU (sumber sintetis)
 Vitamin Larut Lemak
• Vitamin K – diproduksi oleh bakteri dalam
usus besar
– Fungsi:
• Merangsang sintesis protein pembekuan darah
(blood clotting proteins)
• Pembentukan tulang
– Defisiensi jarang terjadi namun pernah
dijumpai pada bayi, pasien yang mengalami
antibiotic therapy lama, dan pasien yang
kekurangan produksi asam empedu.
– Toksisitas (>1000 mg/hari): kerusakan sel
 Jenis Vitamin K
• Phylloquinones
(K1) dari sumber
nabati
– Main dietary form &
more biologically
active
• Menaquinones (K2)
dari ikan, daging
dan bakteri usus
besar
 Vitamin K
• Vitamin K essential untuk
pembekuan darah secara
normal
• Penting untuk kesehatan
tulang
 Vitamin Larut Lemak
• Vitamin K
– DRI: 90(wanita) – 120(pria) micrograms/hari
– Sumber lihat slide berikutnya
Vitamin K dalam Pangan
 Go Green for K!
• Salad sayur hijau tua
menyediakan sumber
vitamin K yang melimpah
 Pembekuan Darah
• Proses pembekuan darah
memerlukan partisipasi
vitamin K
• Vitamin K secara spesifik
memberikan calcium-
binding capacity pada
protein darah dengan
carboksilasi residu
glutamat
 Vitamin Larut Lemak
Vitamin DRI (& UL) Asupan Kepadatan Kandungan
Dalam Bahan Pangan
700-900 μg Meets HD: Veggie/Fruit Groups
(3000 μg) RDA MD: Fat/Meat/Milk Groups
A
LD: Bread Group
5 μg ~50% of HD: Fatty fish (salmon,
(50 μg) AI sardine) & fortified milk &
D
cereals. Some foods have MD
but most foods have LD
15 mg ~70% of HD: Fat Group
(1000 mg) RDA MD: Veggie/Bread Groups
E
LD: Milk/Meat/Fruit Groups
90-120 μg ~ AI HD: Veggie Group (dark-green
(None) veggies) & liver
K
Vitamin Larut Air
Vitamin B
Vitamin C

Copyright 2008 Wadsworth Group, a division of Thomson Learning

 Vitamins
• Vitamin: a potent, important compound that
performs various functions in the body that
promote growth and reproduction and maintain
health.
– Vitamins are organic, meaning that they
contain or are related to carbon compounds.
– Vitamins do not supply calories.
They are essential to helping the body make use
of the calories consumed via foods.

© 2007 Thomson - Wadsworth

 Vitamin B
Fungsi utama – sebagai koenzim

- Thiamin (B1), riboflavin (B2),

niacin, pantothenic acid & biotin:
terlibat pada metabolisme energi

- Vitamin B-6 (Pyridoxine):

metabolisme protein

- Folate & Vitamin B-12: replikasi sel

 The B Vitamins
• Coenzymes

Copyright 2008 Wadsworth Group, a division of Thomson Learning

 Thiamin
• Other names: Vitamin B1
• Chief functions in the body
– Part of coenzyme TPP (thiamin
pyrophosphate) used in energy
metabolism

Copyright 2008 Wadsworth Group, a division of Thomson Learning

 Thiamin
Sources
-Whole grain,
fortified, or
enriched grain
products
-Moderate
amounts in all
nutritious food
-Easily
destroyed by
heat

Copyright 2005 Wadsworth Group, a division of Thomson Learning

 Thiamin
• Deficiency disease
– Beriberi
• Wet, with edema
• Dry, with muscle wasting
• problem in SE Asia
where diet is high in polished rice
• Deficiency symptoms
– Enlarged heart, cardiac failure
– Muscular weakness
– Apathy, poor short-term memory,
confusion, irritability
– Anorexia, weight loss
• Toxicity symptoms: none reported
Copyright 2005 Wadsworth Group, a division of Thomson Learning
 Riboflavin
• Other names: Vitamin B2
• Chief functions in the body
– Part of coenzymes FMN (flavin
mononucleotide) and FAD (flavin
adenine dinucleotide) used in energy
metabolism.

Copyright 2005 Wadsworth Group, a division of Thomson Learning

 Riboflavin
Sources
-Milk products
(yogurt,
cheese)
-Enriched or
whole
grains
-Liver
-Easily destroyed
by ultraviolet light
and irradiation
Copyright 2005 Wadsworth Group, a division of Thomson Learning
 Riboflavin
• Deficiency symptoms
– Inflamed eyelids and sensitivity to
light, reddening of cornea
– Sore throat
– Cracks and redness at corners of
mouth
– Painful, smooth, purplish red tongue
– Inflammation characterized by skin
lesions covered with greasy scales
• Toxicity symptoms: none reported

Copyright 2005 Wadsworth Group, a division of Thomson Learning

Ariboflavinosis
 Niacin
• Other names
– Nicotinic acid
– Nicotinamide
– Niacinamide
– Vitamin B3
• Precursor: dietary tryptophan
• Chief functions in the body
– Part of coenzymes NAD (nicotinamide
adenine dinucleotide) and NADP (its
phosphate form) used in energy
metabolism
Copyright 2005 Wadsworth Group, a division of Thomson Learning
 Niacin
Sources
Milk, eggs,
meat, poultry,
fish
Whole-grain
and enriched
breads and
cereals
Nuts
All protein-
containing foods
Copyright 2005 Wadsworth Group, a division of Thomson Learning
 Niacin
• Deficiency disease: pellagra
where diet is high in corn & low in
protein
• Deficiency symptoms
– Diarrhea, abdominal pain, vomiting
– Inflamed, swollen, smooth, bright red
tongue
– Depression, apathy, fatigue, loss of
memory, headache
– Bilateral symmetrical rash on areas
exposed to sunlight

Copyright 2005 Wadsworth Group, a division of Thomson Learning

 Niacin
• Toxicity symptoms
– Painful flush, burning, tingling
sensation, hives, and rash (“niacin
flush”)
– Excessive sweating
– Blurred vision
– Liver damage, impaired glucose
tolerance

Copyright 2005 Wadsworth Group, a division of Thomson Learning

 Biotin
• adequate intake (AI)
– Adults: 30 g/day
• Chief functions in the body
– Part of a coenzyme used in energy
metabolism, fat synthesis, amino acid
metabolism, and glycogen synthesis
• Significant sources
– Widespread in foods
– Organ meats, egg yolks, soybeans,
fish, whole grains
– Also produced by GI bacteria
Copyright 2005 Wadsworth Group, a division of Thomson Learning
 Biotin
• Deficiency symptoms
– Depression, lethargy, hallucinations,
numb or tingling sensation in the
arms and legs
– Red, scaly rash around the eyes,
nose, and mouth
– Hair loss
• Toxicity symptoms: none reported

Copyright 2005 Wadsworth Group, a division of Thomson Learning

 Pantothenic Acid
• Adequate intake (AI)
– Adults: 5 mg/day
• Chief functions in the body
– Part of coenzyme A, used in energy
metabolism
• Significant sources
– Widespread in foods
– Organ meats, mushrooms, avocados,
broccoli, whole grains
• Easily destroyed by food processing
Copyright 2005 Wadsworth Group, a division of Thomson Learning
 Pantothenic Acid
• Deficiency symptoms
– Vomiting, nausea, stomach cramps
– Insomnia, fatigue, depression,
irritability, restlessness, apathy
– Hypoglycemia, increased sensitivity to
insulin
• Toxicity symptoms: none reported

Copyright 2005 Wadsworth Group, a division of Thomson Learning

 Vitamin B6
• Other names
– Pyridoxine
– Pyridoxal
– Pyridoxamine
• Chief functions in the body
– Part of coenzymes PLP (pyridoxal
phosphate) and PMP (pyridoxamine
phosphate) used in amino acid and
fatty acid metabolism
– Helps to convert tryptophan to niacin
and to serotonin
– Helps to make red blood cells
Copyright 2005 Wadsworth Group, a division of Thomson Learning
 Vitamin
B6
Sources
Potatoes,
legumes,
noncitrus
fruits
Fortified
cereals
Liver
Soy products
Meats, fish,
poultry
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 Vitamin B6
• Deficiency symptoms
–Scaly dermatitis
–Anemia (small-cell type)
–Depression, confusion,
abnormal brain wave
pattern, convulsions

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 Vitamin B6
• Toxicity symptoms
–Depression, fatigue, irritability,
headaches
–Nerve damage causing
numbness and muscle weakness
leading to an inability to walk
and convulsions (progressive
sensory ataxia)
–Skin lesions
Copyright 2005 Wadsworth Group, a division of Thomson Learning
 Folate
• Other names
– Folic acid
– Folacin
– Pteroylglutamic acid (PGA)
• Chief functions in the body
– Part of coenzymes THF
(tetrahydrofolate) and DHF
(dihydrofolate) used in DNA synthesis
and therefore important in new cell
formation

Copyright 2005 Wadsworth Group, a division of Thomson Learning

 Folate
Sources
Fortified grains
Leafy green
vegetables,
legumes, seeds
Liver

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 Folate
• Deficiency symptoms
–Anemia (macrocytic or large-cell
type)
–Smooth, red tongue
–Mental confusion, weakness,
fatigue, irritability, headache
• Toxicity symptoms
–Masks vitamin B12-deficiency
symptoms (nerve damage)

Copyright 2005 Wadsworth Group, a division of Thomson Learning

 Folate
Protective effect
• Heart Disease
• Cancer
• Spina bifida
 Folate
• Neural tube defects in pregnancy
–Spina bifida

Copyright 2005 Wadsworth Group, a division of Thomson Learning

 Vitamin B12
• Other names: cobalamin (and
related forms)
• Chief functions in the body
– Part of coenzymes methylcobalamin
and deoxyadenosylcobalamin used in
new cell synthesis
– Helps to maintain nerve cells
– Reforms folate coenzyme
– Helps to break down some fatty acids
and amino acids

Copyright 2005 Wadsworth Group, a division of Thomson Learning

 Vitamin B12
• Absorption
–HCl
–Pepsin
–Intrinsic factor

Copyright 2005 Wadsworth Group, a division of Thomson Learning

 Vitamin B12
• Significant sources
–Animal products (meat, fish,
poultry, shellfish, milk, cheese,
eggs)
• Easily destroyed by microwave
cooking
• Deficiency due to vegan diet or
lack of intrinsic factor

Copyright 2005 Wadsworth Group, a division of Thomson Learning

 Vitamin B12
• Deficiency disease: pernicious
anemia
• Deficiency symptoms
–Anemia (large-cell type)
–Fatigue, degeneration of
peripheral nerves progressing
to paralysis
• Toxicity symptoms: none
reported
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 Vitamin B12
• Deficiency of folate or B12 produces
pernicious anemia

Copyright 2005 Wadsworth Group, a division of Thomson Learning

 Vitamin C
• Other name: ascorbic acid
• Chief functions in the body
– Collagen synthesis
• Strengthens blood vessel walls, forms
scar tissue, provides matrix for bone
growth
– Antioxidant
– Thyroxin synthesis
– Amino acid metabolism
– Strengthens resistance to infection
– Helps in absorption of iron
Copyright 2005 Wadsworth Group, a division of Thomson Learning
 Vitamin C
• AKG Indonesia
– Men: 90 mg/day
– Women: 75 mg/day
– Smokers: + 35 mg/day
(RDA USA)
• Upper level for adults:
2000 mg/day
• Needs increase with
infection, burns,
surgery & smokers
• Easily destroyed by
heat and oxygen
Copyright 2005 Wadsworth Group, a division of Thomson Learning
 Vitamin C
Sources
Citrus fruits
Cabbage-type
vegetables, dark
green vegetables
(such as bell peppers
and broccoli)
Cantaloupe,
strawberries
Lettuce, tomatoes,
potatoes
Copyright 2005 Wadsworth Group, a division of Thomson Learning
 Vitamin C
• Deficiency disease: scurvy
• Deficiency symptoms
– Anemia (small-cell type)
– Atherosclerotic plaques
– Pinpoint hemorrhages under the skin,
bone fragility, joint pain
– Poor wound healing, frequent
infections, bleeding gums, loosened
teeth
– Muscle degeneration and pain,
hysteria, depression, rough skin,
blotchy bruises
Copyright 2005 Wadsworth Group, a division of Thomson Learning
 Vitamin C
• Toxicity symptoms - >2 gms/day
–Nausea, abdominal cramps,
diarrhea
–Headache, fatigue, insomnia
–Hot flashes, rashes
–Interference with medical tests
(false-negative urine glucose
test), aggravation of gout
symptoms, urinary tract
problems, kidney stones
(oxalate)
Copyright 2005 Wadsworth Group, a division of Thomson Learning
 Vitamin And
Mineral Supplements
• Who needs supplements?

Copyright 2005 Wadsworth Group, a division of Thomson Learning

 Vitamin And
Mineral Supplements
• Arguments for supplements
–Correct overt deficiencies
–Improve nutrition status
–Reduce disease risks
–Support increased nutrient needs
–Improve the body’s defenses

Copyright 2005 Wadsworth Group, a division of Thomson Learning

 Vitamin And
Mineral Supplements
• Arguments against supplements
–Toxicity
–Life-threatening misinformation
–Unknown needs
–False sense of security
–Other invalid reasons

Copyright 2005 Wadsworth Group, a division of Thomson Learning

 Vitamin Supplements
1. Healthy people who eat healthy
diets do not require supplements
2. Many B vitamins are lost when
grains are refined but some added
back (enrichment or fortification);
now deficiency usually only occurs
due to poverty, illness, alcohol
abuse
3. Toxicities – usually results from
misuse of supplements
 Vitamin Supplements
4. Unless a specific nutritional problem
exists, a single, balanced multi-
vitamin/mineral preparation that
provides 100% Daily Value should
suffice
5. The only disease a vitamin will cure
is the one caused by a deficiency of
that vitamin
 Vitamin Supplements
Some individuals who may benefit:
1. Low energy intake
2. Illness/injury
3. Absorption problems
4. Certain medications
5. Strict vegetarian
6. Pregnant/lactating
7. Newborn & breastfed infants