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Vitamins and Supplements

vitamins

Vitamins and Supplements

A vitamin is an organic compound required as a nutrient in tiny amounts by an organism. A compound is called a vitamin when it cannot be synthesized in sufficient quantities by an organism, and must be obtained from the diet. Thus, the term is conditional both on the circumstances and the particular organism. For example, ascorbic acid functions as vitamin C for some animals but not others, and vitamins D and K are required in the human diet only in certain circumstances. The term vitamin does not include other essential nutrients such as dietary minerals, essential fatty acids, or essential amino acids, nor does it encompass the large number of other nutrients that promote health but are otherwise required less often.

Vitamins are classified by their biological and chemical activity, not their structure. Thus, each “vitamin” may refer to several vitamer compounds that all show the biological activity associated with a particular vitamin. Such a set of chemicals are grouped under an alphabetized vitamin “generic descriptor” title, such as “vitamin A,” which includes the compounds retinal, retinol, and many carotenoids. Vitamers are often inter-converted in the body.

History

The value of eating a certain food to maintain health was recognized long before vitamins were identified. The ancient Egyptians knew that feeding liver to a patient would help cure night blindness, an illness now known to be caused by a vitamin A deficiency.The advancement of ocean voyage during the Renaissance resulted in prolonged periods without access to fresh fruits and vegetables, and made illnesses from vitamin deficiency common among ships’ crews.

In 1749, the Scottish surgeon James Lind discovered that citrus foods helped prevent scurvy, a particularly deadly disease in which collagen is not properly formed, causing poor wound healing, bleeding of the gums, severe pain, and death. In 1753, Lind published his Treatise on the Scurvy, which recommended using lemons and limes to avoid scurvy, which was adopted by the British Royal Navy. This led to the nickname Limey for sailors of that organization. Lind’s discovery, however, was not widely accepted by individuals in the Royal Navy’s Arctic expeditions in the 19th century, where it was widely believed that scurvy could be prevented by practicing good hygiene, regular exercise, and by maintaining the morale of the crew while on board, rather than by a diet of fresh food. As a result, Arctic expeditions continued to be plagued by scurvy and other deficiency diseases. In the early 20th century, when Robert Falcon Scott made his two expeditions to the Antarctic, the prevailing medical theory was that scurvy was caused by “tainted” canned food.

Vitamins are essential for the normal growth and development of a multicellular organism. Using the genetic blueprint inherited from its parents, a fetus begins to develop, at the moment of conception, from the nutrients it absorbs. It requires certain vitamins and minerals to be present at certain times. These nutrients facilitate the chemical reactions that produce among other things, skin, bone, and muscle. If there is serious deficiency in one or more of these nutrients, a child may develop a deficiency disease. Even minor deficiencies may cause permanent damage.

In nutrition and diseases

For the most part, vitamins are obtained with food, but a few are obtained by other means. For example, microorganisms in the intestine—commonly known as “gut flora”—produce vitamin K and biotin, while one form of vitamin D is synthesized in the skin with the help of the natural ultraviolet wavelength of sunlight. Humans can produce some vitamins from precursors they consume. Examples include vitamin A, produced from beta carotene, and niacin, from the amino acid tryptophan.

Once growth and development are completed, vitamins remain essential nutrients for the healthy maintenance of the cells, tissues, and organs that make up a multicellular organism; they also enable a multicellular life form to efficiently use chemical energy provided by food it eats, and to help process the proteins, carbohydrates, and fats required for respiration.

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Experts urge screening for obesity in kids

Experts urge screening for obesity in kids

Doctors should screen children and teens between 6 and 18 years for extra pounds, a federal task force recommends.

For children who are found to be obese based on their body mass index (BMI), a standard measure of the relationship between height and weight, the task force also calls for referrals to a comprehensive program that includes dietary advice, physical activity, and behavioral counseling to promote weight loss.

The new recommendations update earlier ones from 2005. Skyrocketing rates of obesity have reached between 12 and 18 percent in 2- to 19-year-olds, increasing up to 6-fold since the 1970s, members of the United States Preventive Services Task Force report in the February issue of the journal Pediatrics. Obesity is linked to the early development of diabetes and high blood pressure.

For their update, the task force reviewed 13 studies of behavioral intervention in 1258 obese children and adolescents.

Moderate- to high-intensity programs, involving more than 25 hours of contact with the child and/or the family over a six-month period, resulted in a decrease in BMI 12 months after the beginning of the intervention.

In addition to dietary and physical activity counseling, effective programs included behavioral-management techniques such as self-monitoring and eating management. However, the programs only worked in children who followed through on treatment.

Harms of screening — for example, adverse effects on growth, eating-disorder pathology, or mental health issues — were judged to be minimal.

It is unclear if the recommendations can be applied to children who are overweight but not obese. And there was no convincing support for interventions that lasted less than 25 hours per six months, or for screening children below age 6.

Yet some experts take issue with what they consider the narrow age bracket of the recommendation.

“The USPSTF falls short of the mark in not recognizing the developmental trajectory of obesity in childhood,” writes Dr. Sandra G. Hassink, from the Dupont Hospital for Children in Wilmington, Delaware, in a related commentary.

Hassink urges pediatricians to screen all children. “Working with families to screen for high-risk nutrition and activity behaviors that contribute to obesity in early childhood must be part of that task,” she writes.

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For Heart Health, Focus on Risk Factors

For Heart Health, Focus on Risk Factors

Treating multiple factors that contribute to heart attack risk is better than simply focusing on lowering a patient’s cholesterol level, according to U.S. researchers.

“We’ve been worrying too much about people’s cholesterol level and not enough about their overall risk of heart disease,” Dr. Rodney A. Hayward, director of the Veterans Affairs Center for Health Services Research and Development, and a professor of internal medicine at the University of Michigan Medical School, said in a news release.

Levels of harmful LDL cholesterol should be less than 130 for most people and less than 70 for high-risk patients, according to the National Cholesterol Education Program.

In their study, Hayward and his colleagues analyzed data from Americans, aged 30 to 75, with no history of heart attack, who took part in clinical trials of cholesterol-lowering statin drugs. The researchers evaluated the benefit of five years of treatment tailored to a patient’s overall heart attack risk based on factors such as age, family history, diabetes, high blood pressure, smoking status and C-reactive protein level.

The results showed that the tailored treatment was more efficient (more benefit per person treated) and prevented substantially more heart attacks, strokes and cardiovascular deaths than simply reducing cholesterol to a certain target. The tailored treatment saved 500,000 more quality-adjusted life years than cholesterol-focused therapy, the researchers said.

“The bottom line message — knowing your overall heart attack risk is more important than knowing your cholesterol level. If your overall risk is elevated, you should probably be on a statin regardless of what your cholesterol is, and if your risk is very high, [you] should probably be on a high dose of statin,” Hayward said in the news release.

“However, if your LDL cholesterol is high, but your overall cardiac risk is low, taking a statin does not make sense for you. If your cholesterol is your only risk factor and you’re younger, you should work on diet and exercise,” he added.

The study was published online Jan. 18 in the Annals of Internal Medicine.
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