VITAMINS

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What are vitamins?

Vitamins are molecules required by the body in small amounts for a variety of essential processes in
the body. They are classified as micro nutrients because they are normally required in small
amounts: usually a few milligrams (mg) or micrograms (μg) per day. Most vitamins cannot be
synthesised by the body so must be obtained by the diet. An exception is vitamin D which can be
synthesised by the action of sunlight on the skin. Small amounts of niacin (a B vitamin) can be
made from the amino acid, tryptophan.
Vitamins have a diverse range of functions in the
body, including:
• Co-factors in enzyme activity
• Antioxidants (prevent damage from free
radicals)
• Pro-hormone (only vitamin D)
If insufficient amounts of vitamins are
available to the body because of a poor
diet or some medical condition, such as
malabsorption disorders or inborn errors
of metabolism, a deficiency disease can
develop. Vitamin deficiency diseases are
rare in the UK but still occur in some
parts of the world.

Vitamins have been grouped into two categories: fat soluble vitamins and water soluble vitamins.
Originally vitamins were given letters (A, B, C etc.) but are now more commonly referred to by
their names, e.g. fol ate, riboflavin.

Fat soluble vitamins

Vitamin A
Vitamin A can be obtained in 2 forms

1. preformed retinol (retinyl esters) found in animal derived foods

2.carotenoids which are mainly plant derived (beta carotene being the most abundant
carotenoid), some of which can be converted to retinol in the body; 6mg of beta
carotene is equivalent to 1mg of retinol.
The total vitamin A content of the diet (from both animal and plant sources) is normally expressed
as retinol equivalents (RE).
Vitamin A is essential to the normal structure and function of the skin and mucous membranes such
as in the eyes, lungs and digestive system. Therefore, it is vital for vision, embryonic development,
growth and cellular differentiation, and the immune system.

Deficiency
Vitamin A deficiency is a serious public health problem worldwide,. It can lead to night blindness
(impaired adaptation to low-intensity light) and an eye condition called xerophthalmia (dryness of
the conjunctiva and cornea) and eventually total blindness. Marginal deficiency contributes to
childhood susceptibility to infection, and therefore morbidity and mortality, in both developing and
developed countries. Vitamin A deficiency is common in many developing countries especially
among young children.

Food sources
Liver, whole milk, cheese, butter, margarine and
many reduced fat spreads are dietary sources of
retinol. Carrots, dark green leafy vegetables and
orange-coloured fruits, e.g. mangoes and
apricots are dietary sources of carotenoids.

Vitamin D
Dietary vitamin D exists as either ergocalciferol (vitamin D2) or cholecalciferol (vitamin D3).
Ergocalciferol (D2) is derived from the UV irradiation of the plant sterol ergosterol, which is widely
distributed in plants and fungi. (D3 ) is formed from the action of UV irradiation on 7-
dehydrocholesterol in the skin of animals including humans.
Vitamin D is not classically a vitamin but a pro-hormone, acting as a precursor to one of the
hormones involved in calcium homoeostasis. Cholecalciferol is metabolised to the active steroid
hormone 1,25-dihydroxyvitamin D3 in the liver and kidney. In this form it works as a hormone
regulating the amount of calcium absorbed in the intestine. It is also essential for the absorption of
phosphorus and for normal bone mineralisation. Vitamin D is also involved in the regulation of cell
proliferation and differentiation. Vitamin D is also an activator of insulin-like growth factor (IGF-1)
and, associated with this, poor vitamin D status is linked to sarcopenia (age related loss of skeletal
muscle) which affects up to 25% of those over the age of 65 years and more than half of those over

Deficiency
Deficiency of vitamin D results in poor calcification of the skeleton and hence skeletal deformity in
children (rickets) and it leads to pain and bone fragility in adults (osteomalacia).
Sources
Oily fish, eggs, fortified cereals and margarine
are the main dietary sources of vitamin D. In the
UK, the law states that margarine must be
fortified with vitamin D (and vitamin A).
Vitamin D is also often voluntarily added to
reduced fat spreads, as is vitamin A. Human
milk contains low levels of vitamin D, but infant
formula is fortified with 0.001-0.0025
mg/100kcal.

Vitamin E
Vitamin E is a group of eight lipid-soluble compounds synthesised by plants, tocopherols and
tocotrienols. Alpha-tocopherol accounts for 90% of the vitamin E in human tissues. Vitamin E acts
as an antioxidant and is required to protect cells against oxidative damage from free radicals, for
example oxidation of the lipids in cell membranes. Vitamin E content in food is expressed in terms
of mg equivalents based on the biological activities of the tocopherols present

Deficiency
Existence of dietary vitamin E deficiency is not considered to be a problem even in people
consuming a relatively poor diet. Deficiency only occurs in people with severe fat malabsorbtion
and rare genetic disorders.

Food sources
Foods containing large amount of polyunsaturated fatty acids will generally contain large amounts
of vitamin E, therefore the richest sources of vitamin E are vegetable oils, nuts and seeds. Since
vegetable oils are the richest source, deficiency is rare.

Vitamin K
Vitamin K is required for the synthesis of several of proteins required for normal blood clotting and
bone structure. Vitamin K is synthesised by bacteria in the large bowel and is also present in both
plant and animal foods.

Deficiency
Deficiency is rare as vitamin K is widely available from the diet and is also provided by gut
bacteria.
Food sources
Dietary vitamin K is obtained from green leafy
vegetables, dairy products and meat.

Water soluble vitamins

Thiamine (vitamin B1)

Thiamine is a co-enzyme for several central energy-yielding metabolic pathways, and therefore is
required to release energy from carbohydrate. As a result thiamine requirement is related to the
amount of energy consumed. Thiamine is also involved in the normal function of the nervous
system and other excitable tissues, such as skeletal muscles and the heart.

Deficiency
Deficiency of thiamine causes the peripheral nervous system disease bier-beri. This became a public
health issue in the Far East in the nineteenth century with the introduction of highly milled
(polished) rice. While beriberi is now rare, it remains a problem in some parts of the world where
rice is the staple food. A different condition due to thiamine deficiency, affecting the central nervous
system rather than the peripheral is sometimes seen in alcoholics and people with HIV, known as
Wernicke-Korsakoff syndrome. This is caused by a combination of low intake and impairment of
absorption and utilisation of the vitamin.

Food sources
Whole grains, nuts, meat (especially pork), fruit
and vegetables and fortified breakfast cereals are
sources of thiamine in the diet. In the UK, white
and brown bread flour are fortified with
thiamine by law (and also with calcium and
iron).
 Riboflavin (vitamin B2)
Riboflavin functions as a co enzyme in a wide variety of reactions that take place in the body.
Riboflavin is required to release energy from protein, carbohydrate and fat. It is also involved in the
transport and metabolism of iron in the body and is needed for the normal structure and function of
mucous membranes and the skin.

Food sources
Milk, eggs, rice, fortified breakfast cereals, liver,
legumes, mushrooms and green vegetables are
all sources of riboflavin.

Niacin (nicotinic acid)

Niacin is required for the release of energy from food. Niacin is also required for the normal
function of the skin and mucous membranes and for normal functioning of the nervous system.

Deficiency
Deficiency of niacin results in the disease pellagra. It is characterized by sun-sensitive skin
producing effects similar to severe sunburn.

Food sources
Meat, wheat and maize flour, eggs, dairy products and yeast are all dietary sources of niacin.

Vitamin B6 (Pyridoxine)
Vitamin B6 comprises 3 forms: pyridoxine, pyridoxal and pyridoxamine, and has a central role in
the metabolism of amino acids. It is involved in breaking down glycogen and has a role in the
modification of steroid hormone action. It is also essential for the formation of red blood cells and
the metabolism and transport of iron.
Deficiency
Deficiency of vitamin B6 is rare because it is widely distributed in foods and is synthesised by the
body’s gut flora.

Food sources
Poultry, white fish, milk, eggs, whole grains,
soya beans, peanuts and some vegetables are
sources of vitamin B6.

Vitamin B12 (Cyanocobalamin)

Vitamin B12 serves as normal function of the nervous system, the formation of red blood cells and
for the metabolism of fol ate. Together with fol ate and vitamin B 6, vitamin B12 is required for
maintenance of normal blood hormocysteine levels. It is also involved in energy production.

Deficiency
Dietary deficiency is rare in younger people and only occurs among strict vegans.

Food sources
Vitamin B12 is found in almost all foods of
animal origin. Green plants provide none but it
can be synthesized by some algae and bacteria,
although the bioavailability of such forms has
been disputed. Meat, fish, milk, cheese, eggs,
yeast extract and fortified breakfast cereals are
all dietary sources.
 Vitamin C (ascorbic acid)

Vitamin C has antioxidant properties, potentially protecting cells from oxidative damage. Vitamin C
is also involved in the synthesis of collagen which is required for the normal structure and function
of connective tissues such as skin, cartilage and bones. It is therefore an important nutrient for the
healing process.

Deficiency
Severe deficiency of vitamin C leads to scurvy. Signs of deficiency do not manifest until previously
adequately nourished individuals have been deprived of vitamin C for 4-6 months. Deficiency is
associated with fatigue, weakness, aching joints and muscles. Most of the other symptoms of scurvy
are due to impaired collagen synthesis and are characterized by bleeding gums, poor wound healing
and damage to bone and other tissues.

Food sources
Fresh fruits especially citrus fruits and berries;
green vegetables, peppers and tomatoes are all
sources of vitamin C. It is also found in potatoes
(especially new potatoes).

Vitamin supplements
Although most people are able to meet their requirements for vitamins by eating a varied diet, there
are certain groups of the population who have higher than normal requirements for some nutrients,
e.g. ill people, those taking certain drugs and pregnant women. Such people need to ensure they eat
foods rich in particular vitamins and sometimes supplements are advised. Infants and young
children are recommended to have supplements of vitamins A, C and D up to age 5 years. Vitamin
D supplements are also recommended for older people and pregnant and lactating women. Some
women may require additional iron if menstrual losses are high and folic acid is advised for women
planning a pregnancy and for pregnant women in the first 12 weeks of pregnancy.

Author
Gareth Williams

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