Vitamin- An Essential Nutrient (Vitamin A, C and D) Part-1

 

Vitamin- An Essential Nutrient (Vitamin A, C and D)

Part-1

Hello Friends!

                        Hope you all are doing well and getting benefits from my previous posts. Today we will talk about Vitamins and their role in our day to day life. We all know that “If forgiveness is Medicine for the soul, then gratitude is Vitamins”. Vitamins are essential nutrients because they help to covert food into energy and repair cellular damage. Let’s talk about Vitamins, their ‘deficiencies’ cause which type of ‘disease’ and ‘sources’ from where we can get vitamins.

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Vitamins:

Vitamins were invented by ‘Sir F.G.Hopkins’. The term Vitamins was coined by ‘Funk’. Vitamins are organic compound required in minute quantities. No calories are obtained from it. Vitamins are very important in regulating chemical reactions in metabolism of body.

Types of Vitamins: (on basis of solubility)

1. Vitamins soluble in water: Vitamin B and Vitamin C.

2. Vitamins soluble in fat: Vitamin A, Vitamin E, Vitamin D and Vitamin K.

Vitamin	Chemical Name	Functions	Deficiency Diseases	Sources
Vitamin A	Retinol	Needed for Vision, Healthy Skin, Immune System, Skin Cancer (Squamous cell Skin cancer)	Color Blindness, Xeropthalmia	Milk, Egg, Cheese, Green Vegetables, Fish Liver Oil, Carrot, Broccoli, Spinach, Blackeyed Peas
Vitamin C	Ascorbic Acid	Antioxidant, Protein metabolism enzyme, Immune system, Iron absorption, Diabetes (Type 2)	Scurvy, Swelling of gums	Lemon, Orange, Tomato, Sour substances, Chilly Sprouted Grain
Vitamin D	Calciferol	Absorption of calcium, Stored in bones	Rickets (In children), Osteomalacia (In adults)	Fish liver oil, Milk, Eggs

Functions of Vitamins:

1. Vitamins play an important role in metabolism of body.

2. Vitamins are essential for brain development and growth.

3. Vitamins help in healing wounds, repair cellular damage.

4. Vitamins help in formation of ‘Red Blood Cells (RBC)’.

5. Vitamins are part of enzyme needed for making ‘DNA’ and new cells.

Vitamin A:

Vitamin A is soluble in fat. According to report of ‘WHO’ (World Health Organization) 1.25 million deaths are due to deficiency of Vitamin A in 40 countries since 1998. In the developing countries Vitamin A deficiency is higher among poor people. Approximately 250,000 to 500,000 malnourished children become blind each year due to deficiency of Vitamin A.

Types of Vitamin A:

1. Preformed Vitamin A: It is also known as Retinol. It is mainly found in meat, fish, eggs and dairy products.

2. ProVitamin A: In this Vitamin body converts Carotenoids in plant foods such as green vegetables, oranges.

Functions of Vitamin A:

1. Vision: Vitamin A helps to keep our eyes healthy. It is related to retinol form. ‘Rhodopsin’ in retina is only regenerated when retina is attached to retinal pigmented epithelium which provides retinal. Deficiency in Vitamin A will inhibit reformation of rhodopsin and lead to night blindness.

2. Healthy Skin: Vitamin A moisturizes skin by differentiating between immature skin cells into mature epidermal cells. Vitamin A prevents us from acne by reducing size and secretion of ‘Sebaceous Gland’.

3. Immune System: Vitamin A makes our immune system strong specifically in T cell differentiation and proliferation. Vitamin A also dominates regulation of Hematopoietic stem cell dormancy.

4. Vitamin A and Skin Cancer: According to Article published in ‘Journal Jama Dermatology’ it has been found that intake of Vitamin A may be associated with lower risk of skin cancer. Intake of Vitamin A lowers the risk of ‘Squamous Cell Skin Cancer’ by around 15%.

Deficiency Diseases:

1. Color Blindness: Deficiency of Vitamin A damages the retina which results in color blindness.

2. Xeropthalmia: Deficiency of Vitamin A causes dryness in Eyes that is ‘Dry Eye Syndrome’. It also leads to inflammation in eyes that is ‘Superior Limbic Keratoconjunctivitis’.

3. Corneal Ulcers: Lack of Vitamin A causes dryness to cornea thus leads to clouding of front of eye that is Corneal Ulcers.

Symptoms of Vitamin A deficiency:

1. Dry Skin.

2. Dry Eyes.

3. Night Blindness.

4. Infertility.

5. Infection in chest and throat.

6. Delayed growth.

  

Who is at higher risk of Vitamin A deficiency?

1. Pregnant woman.

2. Breast feeding mothers.

3. Infants and children.

4. Patients suffering from Cystic Fibrosis and Chronic Diarrhea.

Sources of Vitamin A:

 

 1. Food of Animal Origin: Milk, Egg, Cheese, Fish Liver Oil, Beef. Vitamin A derived from food of Animal origin is called ‘retinol’. It can be used directly by body.

2. Green Leafy Vegetables and Fruits: Fennel Seeds, Carrot, Sweet Potato, Spinach, Kale etc. In these fruits and vegetables ‘Carotenoid’ is present which is converted to retinol by body after the digestion of food.

Daily intake of Vitamin A:

Sources	Quantity (International Unit)
1. Milk Shake	16 fluid ounces (1012)
2. Butter	1 Table spoon (355)
3. Whole Milk	1 Glass (395)
4. Carrot Juice	1 Cup (45133)
5. Sweet Potato	1 Potato (28058)
6. Spinach Juice	1 Cup (2813)

Note: Adults should not consume more than 10,000 International Units of preformed Vitamin A daily.

Tests to Diagnose Deficiency of Vitamin A:

1. Complete Blood Count (CBC).

2. Level of Retinol in Blood.

Factors associated with too much consumption of Vitamin A:

More the consumption of preformed Vitamin A that is food of animal origin increases the risk of Osteoprosis and Hip fractures.

Vitamin A and Drug interaction:

Vitamin A is absorbed only in presence of fat. But cholesterol lowering medications remove fats from gastrointestinal tract thus decreases absorption of Vitamin A.

2. Vitamin C:

Vitamin C is soluble in water. Vitamin C functions as a cofactor for protein metabolism enzyme. It acts as an antioxidant by donating electrons to various enzymatic and non enzymatic reactions.

Functions of Vitamin C:

1. Immune System: Vitamin C is antioxidant in nature. Vitamin C contributes to immune system by supporting various cellular functions of both innate and adaptive immune system.

2. Antioxidant: Vitamin C acts as an antioxidant by donating electrons to various enzymatic and non enzymatic reactions. Vitamin C supports epithelial barrier function against pathogens and promotes oxidant scavenging activity of skin thereby potentially protecting against environmental oxidative stress.

3. Protein Metabolism: Vitamin C is required for biosynthesis of collagen. Vitamin C is involved in metabolism of protein. Collagen is important component of connective tissue thus helps in healing of wounds.

  

4. Iron Absorption: Vitamin C improves absorption of nonheme iron. Nonheme iron is form of iron present in plant based foods.

5. Diabetes: According to article published in Journal ‘Diabetes, Obesity and Metabolism’ Vitamin C helps in prevention of Type 2 Diabetes. This is due to antioxidant properties of Vitamin C. It is also helpful in state of ‘Hyperglycaemia’.

6. Lowered Blood Pressure: Vitamin C is antioxidant in nature. Thus it helps in state of ‘Hypertension’ with ‘systolic’ and ‘diastolic’ blood pressure levels maintenance.

Deficiency Diseases:

1. Scurvy: Scurvy is caused due to deficiency of Vitamin C. Its early symptoms are Bruising, Bleeding Gums, Weakness, Fatigue and Rash etc.

2. Swelling of gums: Due to deficiency of Vitamin C gum tissue becomes weakened and inflammation and blood vessels bleed more easily. Gums may appear purple and rotten.

Causes of Deficiency of Vitamin C:

1. Poor Diet.

2. Consumption of Alcohol.

3. Anorexia: Lack of appetite for food.

4. Mental illness.

5. Smoking.

6. Dialysis (In case of Kidney failure).

Symptoms of Vitamin C Deficiency:

1. Bumpy Skin: A common skin conditions that affects the arms and thighs. It is caused due to build up of protein Keratine in body.

2. Coiled Shape body hair.

3. Bright red hair follicles.

4. Red spots on nails.

5. Dry Skin.

6. Easy Bruising: An injury or mark where the skin has not been broken but is darker in color due to hit by something.

7. Slowly healing Wounds.

Sources of Vitamin C:

1. Citrus fruits: Orange, Kiwi, Lemon, Guava, Grapefruit.

2. Vegetables: Broccoli, Cauliflower, Brussel Sprouts, Capsicum.

3. Other fruits: Papaya, Cantaloupe and Strawberries.

Daily intake of Vitamin C:

Sources	Quantity (mg)
1. Orange Juice	1 cup (124)
2. Grapefruit Juice	1 cup (93.9)
3. Orange fruit	1 medium size (69.7)
4. Spinach (cooked)	1 cup (17.6)
5. Tomato (raw)	1 medium size (15.6)
6. Banana	1 medium size (10.3)
7. Apple	1 medium size (8.4)
8. Peach	1 medium size (9.9)

Note: Smokers need 35 mg more Vitamin C per day than non smokers due to increased oxidative stress.

Tests to diagnose deficiency of Vitamin C:

1. Plasma.

2. Leukocyte.

3. Urinary Vitamin C level.

Factors associated with too much consumption of Vitamin C:

1. Diarrhea.

2. Nausea.

3. Abdominal cramps.

4. Gastrointestinal disturbance.

5. Uric acid.

6. Kidney Stone.

Vitamin C and Drug interaction:

Oral use of Vitamin C may reduce effect of anti viral drugs.

3. Vitamin D:

 

Vitamin D is soluble in fat. Vitamin D is obtained from sunlight. Serum concentration is best indicator of Vitamin D. Genes encoding proteins that regulate cell proliferation, differentiation and apoptosis are modulated in part by Vitamin D. It is also known as ‘Sunshine Vitamin’. Vitamin D deficiency is affecting 13% of world’s population.

Types of Vitamin D:

1. Vitamin D2: It is also known as ‘Ergocalciferol’. It is found in mushrooms.

2. Vitamin D3: It is also known as ‘Cholecalciferol’. It is found in fish liver oil and egg yolk.

Functions of Vitamin D:

1. Absorption of Calcium: Vitamin D promotes absorption of calcium in gut and maintains adequate serum calcium and phosphate concentration to enable normal mineralization of bone and to prevent hypocalcemic tetancy.

2. Modulation of cell growth.

3. Neuromuscular and Immune function.

4. Reduction of Inflammation.

Deficiency Diseases:

1. Rickets (in children): Lack of Vitamin D results in reduced absorption of calcium and phosphorous. It causes weakness in bones and causes rickets in children. Symptoms of Rickets are:

(a) Delayed Growth.

(b) Delayed Motor Skills.

(c) Muscle weakness.

(d) Pain in spine, pelvis and legs.

2. Skeletal Deformities: Bowed legs or knock knees, Thickened wrists and ankles, Breast bone projection.

3. Osteomalacia (in adults): It is also caused due to deficiency of Vitamin D. It can lead to bowing during growth especially in weight bearing bones of legs. Its symptoms are pain in bones, muscle weakness and slight cracks in bone.

Causes of Deficiency of Vitamin D:

1. Less consumption of food of animal origin like fish oil, fish, egg yolk, milk and beef liver.

2. Limited exposure to sunlight mainly in northern latitude.

3. Dark skin: The pigment melanin reduces skins ability to make Vitamin D in response to sunlight exposure. For example: older adults.

4. Unhealthy kidneys: Unhealthy Kidneys cannot convert Vitamin D to its active form thus increase the risk of Vitamin D deficiency.

5. Improper digestion: Inadequate digestive tract cannot absorb Vitamin D. It happens in many diseases that affect ability of intestine like Crohn’s disease, Cystic Fibrosis and Celiac disease.

6. Obesity.

Symptoms of Vitamin D deficiency:    

1. Cognitive impairment in older adults.

2. Cancer.

3. Cardiovascular Disease.

4. Asthma in Children.

Sources of Vitamin D:

1. Sunlight: Sun is important source of Vitamin D. Our skin hosts a type of cholesterol that functions as a precursor to Vitamin D. When this compound is exposed to UV-B radiation from the sun, it becomes Vitamin D.

2. Fish: Fish is natural source of Vitamin D. Fish is also enriched in omega-3 fatty acid like tuna fish, shrimp, sardines etc.

3. Mushroom: Mushrooms are plant based source of Vitamin D. Mushrooms produce D2 or Ergocalciferol.

4. Eggs: Eggs are another source of Vitamin D.

5. Milk.

6. Orange Juice.

7. Soy, Almond Milk.

    

Daily intake of Vitamin D:

 

Source	Quantity (IUs)
Cod Liver Oil	1 tablespoon (1360)
Salmon Fish (cooked)	3 ounces (447)
Orange Juice	1 cup (137)
Milk	1 cup (115-124)
Yogurt	1 large (41)
Egg Yolk	1 large (41)
Chesse	1 ounce (6)

Test to Check deficiency of Vitamin D:

1. Vitamin D3 Test.

Factors associated with too much consumption of Vitamin D:

1. Anorexia.

2. Weight loss.

3. Heart arrhythmia: Improper beating of heart whether irregular, too fast or too slow. It occurs when electrical impulses in the heart do not work properly.

4. Polyuria: Production of abnormally large volume of dilute urine.

5. Damage to heart muscle and kidney.

6. Both calcium and Vitamin D use in post menopausal women causes kidney stone.

 Vitamin D and Drug interaction:

1. Steroids can reduce calcium absorption.

2. Cholesterol lowering drug reduce absorption of fat soluble Vitamin.

3. Epileptic seizures prevention drug.

In the end we can say that Vitamins are micro-nutrients essential for normal cellular and molecular functions, growth and maintenance of body tissues. Ignoring the deficiency of Vitamins can have serious consequences. Deficiency mainly results from inadequate diet. The major component of an Indian Diet consists of cereal/pulse based foods. Less consumption of foods rich in Vitamins such as vegetables, fruits and dairy products result in deficiencies. We should add Vitamin supplements to nutrients that are found in food. National Institute of Nutrition recommends consumption of 400 grams of fruits and vegetables daily for normal people, of which 100 grams should be fruit.  

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