Answer to #1Muayyads rare inherited disorder, Factor V Leiden thrombophilia, has caused him to be quite aware of foods high in vitamin K that might exacerbate his blood clotting and interfere with the effectiveness of his blood thinning medication. Muayyads blood-thinning medication is probably warfarin (Coumadin), whose mechanism is to interfere with vitamin Ks activity and thus the reactions dependent on the vitamin, including reactions necessary for activation of blood clotting factors. If Muayyad consumed too much vitamin K, there would still be enough vitamin K activity to allow dangerous clots to form in his blood despite the medications action in reducing its activity. In addition, cranberry juice and alcohol may increase the effect of the medication warfarin, an example of a food-medication interaction that should be checked for all blood thinning medications.
Answer to #2Muayyad is aware that he needs to limit foods containing more than his Dietary Reference Intake (DRI) of vitamin K (mens AI = 120 g/d and womens AI = 90 g/d). High-vitamin K foods include: leafy green vegetables (kale, collards, spinach, turnip greens, beet greens, mustard greens, dandelion greens), Brussels sprouts, broccoli, green onions, parsley, asparagus, sauerkraut, lettuce (endive and green leaf), leeks, okra, soybeans (edamame), soybean oil, rhubarb, prunes, beef liver, and green tea. Foods with less vitamin K can be consumed in small amounts (e.g., milk, meat, eggs, and cereal). Further knowledge about vitamin K can be accessed by Muayyad using the comprehensive list of the varying vitamin K content of fruits and vegetables from the USDA National Nutrient Database for Standard Reference Release 16 (
www.nal.usda.gov/fnic/foodcomp/Data/SR16/wtrank/sr16a205.pdf) and in your textbooks Figure 11.12. Muayyad does not need to be concerned about the amount of spices and herbs used as they usually contain only small amounts of vitamin K. Vitamin supplements containing vitamin K are available by prescription and may be necessary if Muayyad is unable to consume adequate amounts of dietary vitamin K each day. Besides the dietary restriction of high-vitamin K foods, it is most important that Muayyad should strive to have a consistent intake of vitamin K (DRI = 120 micrograms/day). The single most important aid that Muayyad could obtain is a large poster of foods that contain at least 60 g/d vitamin K to hang somewhere in his kitchen as a daily reminder that he either 1) consumes one or two servings of these foods only or 2) chooses not to consume the vitamin K-rich foods, allowing greater variety in his daily diet.
Answer to #3
No. In 1994, the U.S. Congress defined the term dietary supplement as any product taken by mouth that contains a dietary ingredient intended to supplement the diet. The dietary ingredients in these products may include vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes, organ tissues, glandular tissue or extracts, and metabolites.
Answer to #4
In general, the vitamins found in supplement pills are well absorbed and utilized by the body, and there is certainly no harm in taking a one-a-day type of vitamin pill. However, it is still important to eat a variety of foods from the various food groups to make sure you are getting plenty of the other important compounds in foods. These include dietary fiber and a variety of other phytochemicals that are needed for optimal health.
Answer to #5
No. Although vitamin C is needed by the skin to synthesize collagen (a protein important for skin), the vitamin C must get into cells and participate in protein synthesis for this to occur. Because skin lotions are applied to the outer surface of the skin, and most compounds such as vitamin C are not transported into cells in this way, applying these products does not stimulate protein synthesis and cell regeneration. It only makes the skin feel softer.
Answer to #6The pregnant mothers expansion of blood cells and increase in body weight demand more essential nutrients. In this case, the water-soluble vitamins are necessary for optimal protein synthesis, to meet increased energy demands of both pregnancy and fetal growth and development, and for antioxidant protection.
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