Fat Soluble and Water Soluble Vitamins

“Many people think that taking a daily cocktail of vitamins, minerals, antioxidants and other supplements is a prescription for a healthy diet. But it's also likely that they don’t know whether the nutrients they're taking are fat soluble, water soluble, or if they are getting more of some nutrients than they need.”

http://www.webmd.com/vitamins-and-supplements/nutrition-vitamins-11/fat-water-nutrient?page=1

“Vitamins are classified as either fat soluble (vitamins A, D, E and K) or water soluble (vitamins B and C). This difference between the two groups is very important. It determines how each vitamin acts within the body.”

“The fat soluble vitamins are soluble in lipids (fats). These vitamins are usually absorbed in fat globules (called chylomicrons) that travel through the lymphatic system of the small intestines and into the general blood circulation within the body. These fat soluble vitamins, especially vitamins A and E, are then stored in body tissues.”

“Fat soluble vitamins, once they have been stored in tissues in the body, tend to remain there. This means that if a person takes in too much of a fat soluble vitamin, over time they can have too much of that vitamin present in their body, a potentially dangerous condition called hypervitaminosis (literally, too much vitamin in the body).”

“Persons can be also be deficient in the fat soluble vitamins if their fat intake is too low or if their fat absorption is compromised, for example, by certain drugs (that interfere with the absorption of fat from the intestine) or by certain diseases such as cystic fibrosis (in which there is a deficiency of enzymes from the pancreas which similarly interferes with the absorption of fat from the intestine).”

 “There is a big difference between the water soluble vitamins and the fat soluble vitamins and this is absolutely a critical distinction.”

http://www.medicinenet.com/script/main/art.asp?articlekey=10736

Fat-Soluble Vitamins: A, D, E, and K

“Quick Facts...”

• “Small amounts of vitamin A, vitamin D, vitamin E and vitamin K are needed to maintain good health.”
• “Fat-soluble vitamins will not be lost when the foods that contain them are cooked.”
• “The body does not need these vitamins every day and stores them in the liver and adipose (fat) tissue when not used.”
• “Most people do not need vitamin supplements.” (This is debatable, and I don’t agree, but I do want to admonish people to respect the upper intake limits for all vitamins, especially the fat soluble ones, and for minerals, such as calcium and magnesium.)
• “Megadoses of vitamins A, D, E or K can be toxic and lead to health problems.”
• “Requirements for vitamins may be expressed in different mathematical units. Close attention should be paid to ensure that similar units are being compared.”

http://www.ext.colostate.edu/pubs/foodnut/09315.html

Water-Soluble Vitamins and Nutrients

“Water-soluble nutrients work best when you get them in the proper amounts. When you eat or take more than your body needs, the body adapts by absorbing just what it needs, and then it usually excretes the excess in your urine -- but not always. A study in the August 2010 Journal of Nutrition Science and Vitaminology found that urinary excretion of certain vitamins and other nutrients was reduced when study participants fasted.”

“The field of nutrition is ever-changing, and experts used to think that taking excess amounts of a water-soluble nutrient was harmless because the excesses would just be eliminated in urine. Today, we know that’s not the case, and that some water-soluble vitamins and nutrients are handled differently by the body than others.”

“Just because most water-soluble vitamins are not stored by the body, you can’t assume that it is safe or effective to take more than the safe upper limit. In addition, you need to account for the vitamins and nutrients you get from the food you eat, says Ruth Frenchman, MS, RD, a spokesperson for the American Dietetic Association.”

"Certain water-soluble vitamins in excess can cause problems, such as too much vitamin B6 can cause nerve problems, too much niacin can cause flushing, and excess vitamin C can cause kidney stones," Frenchman observes. Excess folic acid may also mask a vitamin B12 deficiency, which is more common in people over age 50.”
http://www.webmd.com/vitamins-and-supplements/nutrition-vitamins-11/fat-water-nutrient?page=2

 

 

Vitamin B12 Deficiency in the Elderly

"Vitamin B12 deficiency is estimated to affect 10%-15% of people over the age of 60, and the laboratory diagnosis is usually based on low serum vitamin B12 levels or elevated serum methylmalonic acid and homocysteine levels. Although elderly people with low vitamin B12 status frequently lack the classical signs and symptoms of vitamin B12 deficiency, e.g. megaloblastic anemia, precise evaluation and treatment in this population is important. Absorption of crystalline vitamin B12 does not decline with advancing age. However, compared with the younger population, absorption of protein-bound vitamin B12 is decreased in the elderly, owing to a high prevalence of atrophic gastritis in this age group. Atrophic gastritis results in a low acid-pepsin secretion by the gastric mucosa, which in turn results in a reduced release of free vitamin B12 from food proteins. Furthermore, hypochlorhydria in atrophic gastritis results in bacterial overgrowth of the stomach and small intestine, and these bacteria may bind vitamin B12 for their own use. The ability to absorb crystalline vitamin B12 remains intact in older people with atrophic gastritis. The 1998 recommended daily allowance for vitamin B12 is 2.4 micrograms, but elderly people should try to obtain their vitamin B12 from either supplements or fortified foods (e.g. fortified ready-to-eat breakfast cereals) to ensure adequate absorption from the gastrointestinal tract. Because the American food supply is now being fortified with folic acid, concern is increasing about neurologic exacerbation in individuals with marginal vitamin B12 status and high-dose folate intake."

http://www.ncbi.nlm.nih.gov/pubmed/10448529

 The recommended daily allowance (RDA) for B12 for adults of all ages is still 2.4 micrograms (mcg) in 2015. My personal opinion is that the RDA should be revised upward by a large amount.

When high doses of vitamin B12 are given orally, only a small percentage can be absorbed, which may explain the low toxicity. Because of the low toxicity of vitamin B12, no tolerable upper intake level (UL) has been set by the US Food and Nutrition Board.

Because vitamin B12 malabsorption and vitamin B12 deficiency are more common in older adults, the Linus Pauling Institute recommends that adults older than 50 years take 100 to 400 mcg/day of supplemental vitamin B12.

http://lpi.oregonstate.edu/mic/vitamins/vitamin-B12

B Vitamins and Homocysteine and Fracture Risk

“Some studies suggest high blood levels of the amino acid homocysteine may be linked to lower bone density and higher risk of hip fracture in the elderly. Vitamins B6 and B12, as well as folic acid, play a role in changing homocysteine into other amino acids for use by the body, so it is possible that they might play a protective role in osteoporosis. Research is ongoing as to whether supplementation with these B vitamins might reduce fracture risk^4,5.”

4. McLean RR, Jacques PF, Selhub J, et al. (2004) Homocysteine as a predictive factor for hip fracture in older persons. N Engl J Med 350:2042-49
 

5. Morris MS, Jacques PF, Selhub J (2005) Relation between homocysteine and B-vitamin status indicators and bone mineral density in older Americans. Bone 37:234-42

http://www.iofbonehealth.org/nutrition

WebMD ranks the effectiveness of vitamin B12 for various uses. The rankings are “effective for,” “likely effective for,” “possibly effective for,” “possibly ineffective for,” and “insufficient evidence for.”

According to webMD, vitamin B12 is likely effective for “high level of homocysteine in the blood (Hyperhomocysteinemia).” “Taking vitamin B12 by mouth, along with folic acid and sometimes pyridoxine (vitamin B6), can lower blood levels of homocysteine.”

 
http://www.webmd.com/vitamins-supplements/ingredientmono-926-vitamin%20b12.aspx?activeingredientid=926&activeingredientname=vitamin%20b12

Treating Sarcopenia

Sarcopenia is, in its most literal sense, the loss of muscle mass, strength and function related to aging.  Most commonly seen in inactive people, sarcopenia also affects those who remain physically active throughout their lives. This indicates although a sedentary lifestyle contributes to this disease, it's not the only factor. In addition, as we age:

• hormone levels change
• protein requirements alter
• motor neurons die
• and we tend to become more sedentary 

 

These factors in combination are thought to cause sarcopenia. The figure shows normal muscle mass on left, muscle wasting on right.

 

There are currently no approved drug treatments for sarcopenia. Research is now focusing on the role of physical activity, nutrition, supplements, and potential future medications that may be used to treat or prevent sarcopenia.

In a review of literature, worsening sarcopenia followed trends in losses of muscle strength as well as impairment of daily functioning. In one study, the prevalence of sarcopenia increased dramatically with age from 4 % of men and 3 % of women aged 70-75 to 16 % of men and 13 % of women aged 85 or older.

More importantly, when sarcopenia is coupled with other diseases associated with aging, its effects can be even more pronounced. Loss of muscle mass and strength is a significant risk factor for disability in the aging population. When patients suffer from both sarcopenia and osteoporosis, the risk of falling and subsequent fracture incidence is higher. Therefore, treating sarcopenia will in turn help to lessen its burden on co-existing diseases.

 Exercise

After a program of resistance training is introduced, research shows that motor neuron firing and protein synthesis (both of which are needed in building muscle mass) increase even in the elderly. These changes indicate it is possible to rebuild muscle strength even at an advanced age.

Aerobic exercise also appears to aid in the fight against sarcopenia.

Nutrition

Adequate nutrition plays a major role in treating sarcopenia. Research has shown older adults may need more protein per kilogram than their younger counterparts to maintain proper levels that reinforce muscle mass. Protein intake of 1.0-1.2 g/kg of body weight per day is probably optimum for older adults. This theory, coupled with the fact that older adults tend to take in fewer calories in general, may lead to pronounced protein deficiency as well as deficiency of other important nutrients. Therefore, maintaining adequate protein intake as well as adequate caloric intake is an important facet of the treatment of this disease.

Diets rich in acid producing foods (meat and cereal grains) and low in non-acid producing foods (fruits and vegetables) have been shown to have negative effects on muscle mass. As mentioned above, protein is important, but a diet high in meat and cereal grains should be balanced with a diet high in fruits and vegetable (nonacid-producing foods) in order to be effective in treating sarcopenia.

Supplements

There is some evidence to support that creatine supplements can also aid in muscle development for older adults that are following a resistance training program.

Maintaining appropriate blood levels of vitamin D may also aid in maintaining muscle strength and physical performance.

http://www.iofbonehealth.org/what-sarcopenia

http://www.iofbonehealth.org/preventing-sarcopenia