Vitamin Information Center

Vitamin B12 (Cobalamin)
•Required for nerve function, synthesis of DNA and RNA, metabolism of energy,
enzyme reactions, and production of red blood cells.
•Used therapeutically for heart health (lowers homocysteine), male infertility, pre-
vention of neural tube defects, asthma, and cancer prevention.
•Defi ciency is common among the elderly and those with poor diets, pernicious ane-
mia, depression, Alzheimer’s, or malabsorption conditions (celiac disease).
•Defi ciency symptoms: anemia, appetite loss, constipation, numbness and tingling
in the extremities, and confusion. Pregnant women with defi ciency have increased
risk of giving birth to a child with neural tube defects.
•Drugs that deplete B12: acid-lowering drugs (omeprazole, lansoprazole, ranitidine),
oral contraceptives, antibiotics, cholestyramine, and metformin.
•Supplements are recommended for those over age 50, vegetarians, women planning
to become pregnant, those with poor diets, and those at risk of heart disease.

Vitamin B3 (Niacin) •Required for energy metabolism, enzyme reactions, skin and nerve health, and digestion. •High doses of nicotinic acid (3 g daily) can lower cholesterol (reduce LDL and tri- glycerides and increase HDL) and reduce the risk of heart attack and stroke; high dosages should be supervised by a physician. •Defi ciency causes pellagra, the symptoms of which are skin rash, diarrhea, demen- tia, and death. •Defi ciency may be caused by poor diet, malabsorption diseases, dialysis, and HIV. •Drugs that deplete vitamin B3: antibiotics, isoniazid, and 5-Fluorouracil (chemo- therapy). •High-dose niacin, taken along with statin drugs (i.e., lovastatin), may increase the risk of rhabdomyolysis (muscle degeneration and kidney disease). •Most people get adequate niacin from diet and/or a multivitamin; supplements may be recommended for those with high cholesterol.

Vitamin B2 (Riboflavin)
•Required for energy metabolism, enzyme reactions, vision, and skin/hair/nail
health; functions as an antioxidant; activates vitamin B6, niacin, and folate.
•May play a role in preventing migraine headaches and cataracts.
•Defi ciency occurs in alcoholics, the elderly, and those with poor diets.
•Symptoms of defi ciency include sore throat; redness/swelling of the mouth, throat,
tongue, lips, and skin; decreased red blood cell count; and blood vessel growth over
the eyes. Defi ciency may impair iron absorption and increase risk of pre-eclampsia
in pregnant women.
•Drugs that deplete vitamin B2: antibiotics, chlorpromazine, amitriptyline, adriamy-
cin, and phenobarbitol.
•Most people get adequate ribofl avin from diet and/or a multivitamin.

Vitamin B1 (Thiamine)
•Drugs that deplete vitamin B1: furosemide, antibiotics, oral contraceptives, and
phenytoin.
•Most people get adequate thiamine from diet and/or a multivitamin.Vitamin B1 (Thiamine)
•Required for energy production, nerve and muscle function, enzyme reactions, and
fatty acid production.
•Defi ciency causes beriberi, a disease that affects cardiovascular, nervous, muscular,
and gastrointestinal systems.
•Defi ciency is common in developing countries; in North America it occurs in alco-
holics, those with kidney disease, malabsorption syndromes (celiac disease), and
in those with poor diets.
•Drugs that deplete vitamin B1: furosemide, antibiotics, oral contraceptives, and
phenytoin.
•Most people get adequate thiamine from diet and/or a multivitamin

Vitamin A
•Found in animal foods and converted from beta-carotene in plant foods.
•Required for vision, gene expression, reproduction, embryonic development, red
blood cell production, and immune function.
•Prescription vitamin A derivatives are used to treat skin conditions (acne) and reti-
nitis pigmentosa (genetic eye disease).
•Defi ciency is rare in Canada, but common in developing countries due to malnutri-
tion. It causes night blindness, dry eyes and skin, and impaired growth.
•Drugs that deplete vitamin A: cholestyramine, colestipol, mineral oil, and neomycin.
•Supplements should be avoided by those at risk of lung cancer (smokers) or liver
toxicity (alcoholics, liver disease).
•Doses greater than 10,000 IU daily should be avoided by pregnant women due to the
risk of birth defects. Most prenatal vitamins provide 5,000 IU.
•Doses greater than 5,000 IU may increase risk of osteoporosis.
•Supplements of vitamin A beyond what is provided in a multivitamin are not rec-
ommended due to risk of toxicity. To avoid this risk, choose a multivitamin that
contains beta-carotene, which is converted to vitamin A in the liver, but is not as-
sociated with health risks.

TRIGLYCERIDES
Triglycerides (TG) are the chemical form in which most fats exist in food (both animal
and plant fats). They are also present in the blood along with cholesterol.
A diet that is high in fat, sugar, refi ned carbohydrates, and alcohol can elevate
TGs. Overeating also raises TG because excess calories are converted to fat in the
liver and then into TG to be transported in the blood. High levels of triglycerides are
associated with heart disease and diabetes. It is possible for triglycerides to be high
even when blood cholesterol is normal, so get your levels checked regularly. In most
cases, TG levels can be effectively managed with diet and exercise.
SUMMARY
In this section we learned that our bodies need a balance of quality protein, carbo-
hydrates, and fats. These macronutrients provide us with the energy and nutrients
needed for proper growth, development, and many body processes. In a later chapter
I will outline principles for a healthy diet—my top recommendations for a nutritional
plan for optimal health and disease prevention.

CHOLESTEROL
Cholesterol is a waxy substance found in the fats (lipids) in our blood. It is manu-
factured in the liver and also obtained from consuming saturated and trans fats.
Cholesterol is not all bad—the body requires it to produce sex hormones, maintain
cell membranes, and for a healthy nervous system. 12 | Chapter 1
Aside from diet, cholesterol levels can be elevated by family history, lack of ac-
tivity, and liver disorders, and cholesterol consumption increases the risk of heart
disease.
As with fats, there is good and bad when it comes to cholesterol. The good
cholesterol is HDL (high-density lipoproteins) and the bad is LDL (low-density li-
poproteins). LDL cholesterol can build up in the artery walls of the brain and heart,
narrowing the passageways for blood fl ow, a process known as atherosclerosis, the
precursor to heart disease and stroke.
HDL cholesterol is called good cholesterol because it picks up the LDL deposited
in the arteries and transports it to the liver to be broken down and eliminated.
To lower LDL and raise HDL levels, exercise regularly, minimize saturated fats,
avoid trans fats, and don’t smoke (smoking lowers HDL).

TRANS FATS
Trans fatty acids are naturally found in small amounts in animal products; however,
the majority of trans fats in our diet come from the artifi cial form. Trans fats are cre-
ated when oils undergo a chemical process called hydrogenation, which solidifi es
them. This is the process that makes vegetable oil into margarine. Trans fat is also
found in cookies, crackers, french fries, baked goods, and other snack foods.
When trans fats were fi rst introduced into our food supply, they were thought
to be a healthier alternative to saturated fats. Many years later this was found to be
false. Trans fats elevate cholesterol levels, increasing the risk for heart disease and
heart attack, and are also linked to cancer, particularly breast cancer. The Institute
of Medicine has stated that there is no safe limit for trans fats in the diet and that
we should reduce consumption of these dangerous fats. Food companies have been
making efforts in this area. You will now see many packaged foods labelled “trans
fat free.”

For years margarine was considered to be a healthier alternative to butter, however
most margarines contain hydrogenated oils (trans fats), which are artifi cial processed
fats linked to heart disease and cancer. The exception is non-hydrogenated margarines,
such as Becel, which contain benefi cial plant sterols that can help lower cholesterol.
While butter contains saturated fats, they are short-chain saturates, which are easily
digested and pBUTTER VERSUS MARGARINErovide a source of useable energy. Butter also contains nutrients: lecithin,
vitamins A and E, and selenium. So the bottom line is: Choose butter or a non-hydroge-
nated margarine.

SATURATED FATS
Saturated fats are found in animal products such as meat, poultry, milk, cheese, but-
ter, and lard, as well as in tropical oils (such as palm, palm kernel, and coconut oil)
and foods made from these oils. These fats are high in cholesterol and linked to heart
disease, high cholesterol, obesity, and cancers of the breast, colon, and prostate.
Most people get 38 percent or more of the day’s calories from fat while health
authorities suggest no more than 20–35 percent of which less than 10 percent comes
from saturated fat. To cut your intake of saturated fat, trim fat and skin from meat,
choose lean poultry over red meat, and low-fat cheese and dairy (cottage cheese, feta,
and hard cheeses have less fat). Butter is fi ne in moderation (see sidebar)