`BSC NURSING 11 SEMESTER MAIN EXAMINATION 2024 APPLIED BIOCHEMISTRY AND APPLIED NUTRATION AND DIETETICS

27-06-2024 B.Sc. Nursing-II Semester (Main) Examination June-2024

5011(Rajasthan University of Health Sciences)

APPLIED BIOCHEMISTRY AND APPLIED NUTRITION & DIETETICS

Instructions to the candidates:

1. Do not write anything on question paper except Roll Number, otherwise it shall be deemed as an act of indulging in unfair means and action shall be taken as per rules.

2. Use separate answer book for each section.

Duration: 3 Hours Total Marks: 75

Section-A (Applied Nutrition & Dietetics)

1. Long/Essay type questions (Attempt any one): 1x10=10

Define therapeutic diet. Prepare a diet plan (diet menu) for a patient diagnosed as Diabetes Mellitus type 2.
Enlist the National Nutritional programs of India and describe in detail about ICDS.

2. Short notes (Attempt any four): 4x5=20

Principals and methods of food preservation.
Protein Energy Malnutrition (PEM).
Fat soluble vitamins.
Explain BMR and factors affecting BMR.
Different methods to assess nutritional status.

3. Very short questions (Attempt any six): 6x2=12

Factors affecting food and nutrition.
Iodine deficiency disorder.
Classify the vitamins.
Electrolytes imbalance.
Functions of fibres..
Enlist dietary sources of fat.
Food toxicity.

4. Answer the following MCQ:

1) Obesity increases the risk of:

Hypertension
Diabetic mellitus
Cardiovascular disease
All of the above

ii) Which one is a water-soluble vitamin?

Vitamin-A
Vitamin-B
Vitamin-D
Vitamin-E

iii) How much body mass index score for obesity?

25 to 25
More than 15
More than 30
Less than 18

Iv) All are macro-nutrients except:

Protein
Fat
Vitamins
Carbohydrates

v) Requirement for iron during pregnancy is:

40mg
29mg
19mg
23mg

vi) Beri-Beri disease/disorder is caused by deficiency of vitamin:

vii) Which of these not considered a nutrition?

Fats
Minerals
Vitamins
Fiber

viii) All of the following are needed for strong bones except:

Calcium
Magnesium
Vitamin-D
Thlamine

Section-B (Applied Biochemistry)

1. Short notes (Attempt any three): 3X5=15

Enumerate lipoproteins and their function.
Write about sodium-potassium pump mechanism of antibody production.
Define gluconcogenesis and explain the pathway of gluconeogenesis.
Elaborate the liver function test.

2. Very short questions (Attempt any three): 3X26

Write about t-RNA and co-enzymes.
Define and write the indication of ELISA test.
Atherosclerosis.
Differentiate the ALT and ALP

3. Answer the following MCQ: 4x1=4

i) Bile is produced by:

Liver
Gall Bladder
Pancreas
Intestine

(i) Ketoacidosis is generally associated with the disease:

Nephrites
Pancreatitis
Edema
Diabetes mellitus

lil) What is the normal pH of blood?

6.0
6.4
7.0
7.4

iv) Breakdown of haemoglobin occurs in:

100 days
110 days
120 days
130 days

Section-A (Applied Nutrition & Dietetics)

1. Long/Essay type questions (Attempt any one): 1x10=10

Define therapeutic diet. Prepare a diet plan (diet menu) for a patient diagnosed as Diabetes Mellitus type 2.

Therapeutic diet

Introduction

Therapeutic diet are planned to maintain or restore good nutrition in patient.
In most cases the therapeutic diet are used to supplement the medical or surgical treatment of the patient, while in some instances like diabetes mellitus, a therapeutic diet is the most aspect of the patient’s treatment rather the medical therapy
Diet therapy is concerned with recovery from illness and prevention of disease.

Type 2 Diabetes

Type 2 diabetes is sometimes called a “life style” disease as it more common in people who don’t do enough exercise, have an unhealthy diet and obese.
Type 2 Diabetes was previously seen mainly in older adults, however it is becoming more common in young children due to obesity and overweight children.
Most common type 2 DM patients are overweight, and most are diagnosed as adults.
Comprises 90 to 95% of DM cases
Approximately half of the patients are unaware of their disease.

Management of Diabetes Mellitus

The major components of the treatment of diabetes are-

Medical Nutrition Therapy(Diet and Exercise)
Oral hypoglycaemic therapy
Insulin

Diet Management

Dietary treatment should aim at

Ensuring weight control.
Providing nutritional requirements.
Allowing good glycaemic control with blood glucose levels as close to normal as possible. Correcting any associated blood lipid abnormalities.

Nutrition in diabetes mellitus

Foods not allowed- Glucose, sugar, honey, all sweets, chocolates and candies
Foods to be avoided or restricted-Potatoes, jam, arvi, sweet potatoes, mangoes, grapes, bananas, alcoholic beverages, fried fruits, parathas, puri, pakoras, dal moth, mathies, deep fried vegetables, dry fruits, saturated oils.
Foods to be used freely- Green leafy vegetables, tomatoes, cucumbers, lemon, clear soups, black coffee and tea without sugar, butter milk, sour chatani, pickles without oil

Daily menu for diabetic person

Nutrients	Sedentary workers	Moderate workers	Heavy workers
Calories	1300 kcal	1600 kcal	1900 kcal
Protein	60 gm	66 gm	70 gm
CHO	170 gm	223gm	232 gm
Fats	33 gm	39 gm	39 gm

Daily diet menu for a client with DM

Diet	Menu
Break fasr	Cornflakes with milk
10 am	Tea or coffee -1 cup
Lunch	Chapaties-2, rice 1 medium bowl, oil for cooking- 1 ½ tea spoon
4 pm	Light tea without sugar, salted biscuits
Dinner	Chapaties-2, salad, vegetables,
Bed time	Skim milk
Total approximate calories	1500

Q.1. 2 Enlist the National Nutritional programs of India and describe in detail about ICDS.

In order to attain its true potential and play a role of superpower India has to focus to overcome from this under and malnutrition so we can ensure that the next generation could be healthy, having better work potential and productivity with higher potential. It is a very important factor which needs policies to overcome these problems. Various policies have been launched by the Indian government to eradicate this problem like-

Integrated Child Development Services Scheme
Midday Meal Programme
Special Nutrition Programme (SNP)
National Nutritional Anemia Prophylaxis Programme
National Iodine Deficiency Disorders Control Programme
National Goitre Control Programme
Mid Day meal programme
Applied Nutrition Programme
Akshaya Patra Programme.

The Integrated Child Development Service (ICDS)

Development Services The Integrated Child Development Service (ICDS) Scheme was launched on October 2^nd, 1975. It was brought for providing supplementary nutrition, immunization and preschool education to the children is a popular flagship programme of the government. It is one of the world’s largest programmes to provide an integrated package of services for the entire development of a child.
It is a centrally funded scheme executed by state governments and union territories. Main beneficiaries of this programme were children in the age group of 0-6 years pregnant women and lactating mothers.

Objectives

To improve the nutritional and health status of children in the age- group 0-6 years.
To lay the foundation for proper psychological, physical and social development of the child.
To reduce the incidence of mortality, morbidity, malnutrition and school dropout.
To achieve effective coordination of policy and implementation amongst the various departments to promote child development.
To enhances the capability of the mother to look after the normal health and nutritional needs of the child through proper nutrition and health education.

Services

The objectives are sought to be achieved through a package of services comprising

Supplementary nutrition- This includes supplementary feeding and growth monitoring; and prophylaxis against vitamin A deficiency and control of nutritional anaemia. All families in the community are surveyed, to identify children below the age of six and pregnant & nursing mothers.
Immunization-Immunization of pregnant women and infants protects children from six vaccine preventable diseases-poliomyelitis, diphtheria, pertussis, tetanus, tuberculosis and measles. These are major preventable causes of child mortality, disability, morbidity and related malnutrition. Immunization of pregnant women against tetanus also reduces maternal and neonatal mortality
Health check-up-This includes health care of children less than six years of age, antenatal care of expectant mothers and postnatal care of nursing mothers. The various health services provided for children by anganwadi workers and Primary Health Centre (PHC) staff, include regular health check-ups, recording of weight, immunization, management of malnutrition, treatment of diarrhoea, de-worming and distribution of simple medicines etc.
Referral services-During health check-ups and growth monitoring, sick or malnourished children, in need of prompt medical attention, are referred to the Primary Health Centre or its sub-centre. The anganwadi worker has also been oriented to detect disabilities in young children. She enlists all such cases in a special register and refers them to the medical officer of the Primary Health Centre/ Sub-centre.
Pre-school non-formal education-Anganwadi Centre (AWC) a village courtyard is the main platform for delivering of these services. These AWCs have been set up in every village in the country. PSE focuses on total development of the child, in the age up to six years, mainly from the under privileged groups.
Nutrition & health education.-Nutrition, Health and Education (NHED) is a key element of the work of the anganwadi worker. This forms part of BCC (Behaviour Change Communication) strategy. This has the long term goal of capacity-building of women especially in the age group of 15-45 years so that they can look after their own health, nutrition and development needs as well as that of their children and families.

The ICDS Team-

The ICDS team comprises-

The Anganwadi Workers
Anganwadi Helpers
Supervisors
Child Development Project Officers (CDPOs) and
District Programme Officers (DPOs).

The medical officers

Auxiliary Nurse Midwife (ANM)
Accredited Social Health Activist (ASHA)

2. Short notes (Attempt any four): 4x5=20

Principals and methods of food preservation.

Introduction

Food preservation is known as the “ science which deals with the process of prevention of decay or spoilage of food thus allowing it to be stored in a fit condition for future use”.
The state in which any food may be retained over a period of time without being contaminated by pathogenic organisms or chemicals, without losing optimum qualities of colour, texture, flavour and nutritive value”.
Preservation ensures that the quality, edibility and the nutritive value of the food remains intact.

Food Preservation

Definition

Food preservation can define as the process through which one can store the food products for longer period of time by employing different ways of food preserving techniques like, drying, salting, sugaring, freezing, canning etc. Food preservation is a branch of science, which targets food edibility and quality by preventing food decay.

Principles of food preservation

1. Prevention or delay of microbial decomposition of food

By keeping out micro-organisms (asepsis)
By removal of micro-organisms (filtration)
By hindering the growth or activity of micro-organisms (use of low temperature, drying, creating anaerobic conditions or using chemicals).
By killing the micro-organisms (using heat or irradiation).

3. Prevention or delay of self decomposition of food

By destruction or inactivation of food enzymes (blanching or boiling)
By prevention or delay of purely chemical reactions (use of antioxidants to prevent oxidation).

3. Prevention of damage by insects, animals, mechanical causes etc (use of fumigants, cushioning, packaging etc).

Preservation Methods

Food preservation technique can be categorized into two classes, namely physical and chemical means of preserving food.

A. Physical Methods

1. Drying

It is also called dehydration method, which removes the moisture content of the food naturally by the sunlight. Drying method was popular from the ancient times, where people used to dry various spices, vegetables and fruits etc. through the effective solar light.
We must have heard about the sundried tomato that has been originated from Southern Italy, which is known for its deliciously sweet taste.

2. Chilling

It is also called the refrigeration method, which is most commonly used in this modern generation. Chilling is a simple method, which makes the use of cold temperature (1-4 degrees Celsius) to store the food for a few days to a few weeks depending upon the food content, food type etc. The cold temperature holds back the microbial growth, and so minimizes the food spoilage.

3. Freezing

It is an advance method over chilling. Freezing method makes the use of freezing temperature to preserve various food items, which can increase the longevity for up to a few weeks to a month. Microorganisms rarely grow at a freezing temperature. Like chilling, freezing also uses certain measures to increase the shelf life of food items such as food storage, freezing temperature and defrosting.

4. Canning

It is also called bottling, in which different kinds of canner are used to sterilize the jars and the food material kept in it. Water bath canners are generally used to store high acid foods, and pressure canners are used for low acid foods. In the process of canning, different food items like vegetables, fruits, fish, meat etc. are first processed then stored inside a sterilized jar or can.

5. Smoking

It is a conventional method of food preservation, which makes the use of smoke released by burning a type of wood. The formaldehyde and the phenolic compounds of the wood add unique flavour to the smoked food items. The smoking method is now generally used for fish and meats. It preserves the food through the antimicrobial properties of the formaldehyde and phenolic compounds and through heating, the food product dries up.

6. Pasteurization

It is known after the name of a scientist “Louis Pasteur” who introduced that the food can be spoiled when exposed to the air. Air contains numerous microbes, which can deteriorate the physiochemical properties of the food. The process of pasteurization makes the use of high heat to destroy or deactivate the pathogenic microorganisms.

B. Chemical Methods
Food can also be preserved by chemical methods like:

1. Sugaring

It is a common method of preserving food items by the addition of sugary substances to reduce the moisture content. Sugaring is mostly used for the preservation of fruits like cranberries, mango, apricots etc. commonly called jam. The addition of sugar into the fruits increases sugar concentration, which causes the food item to release its water content and prevents against microbial attack.

2. Salting

Salting is one of the food preservation methods, which principle is very much similar to the method of sugaring. The addition of salt results into the release of water content from the desired food and so prevents against the harmful microorganisms that can make the food unappetizing. Salting can be done in two ways, namely dry and wet curing. In dry curing, the dry salt is added into the food items like fish, meat, chicken etc. to draw water out of it.

3. Pickling

It is one of the ancient time food preservation methods, which can be of two types (fermentation and chemical pickling). The pickling method makes the use of natural preservatives like salt, edible oil, sugar, and spices etc. and chemical preservatives like EDTA. Vegetables like garlic, onion, cucumber, carrot, ginger etc. can be fermented by adding them into a brine solution or vinegar

Q.2.2 Protein Energy Malnutrition (PEM)

Malnutrition

Definitions

WHO defines Malnutrition as "the cellular imbalance between the supply of nutrients and energy and the body's demand for them to ensure growth, maintenance, and specific functions.“

Malnutrition is the condition that develops when the body does not get the right amount of the vitamins, minerals, and other nutrients it needs to maintain healthy tissues and organ function.

Protein Energy Malnutrition- It is a group of body depletion disorders which include kwashiorkor, marasmus and the intermediate stages
Marasmus-Represents simple starvation . The body adapts to a chronic state of insufficient caloric intake .
Kwashiorkor- It is the body’s response to insufficient protein intake but usually sufficient calories for energy.

Protein-Energy Malnutrition

PEM is also referred to as protein-calorie malnutrition.

It is considered as the primary nutritional problem in India. Also called the 1st National Nutritional Disorder.
The term protein-energy malnutrition (PEM) applies to a group of related disorders that include marasmus, kwashiork or, and intermediate states of marasmus-kwashiorkor.
PEM is due to “food gap” between the intake and requirement.

Aetiology
Different combinations of many aetiological factors can lead to PEM in children.

They are-

Social and Economic Factors
Biological factors
Environmental factors
Role of Free Radicals & Aflatoxin
Age of the Host

Amongst the Social, Economic, Biological and Environmental Factors the common causes are

Lack of breast feeding and giving diluted formula
Improper complementary feeding
Over crowding in family
Ignorance
Illiteracy
Lack of health education
Poverty
Infection
Familial disharmony

Role of Free Radicals & Aflatoxin

Two new theories have been postulated recently to explain the pathogenesis of kwashiorkor. These include Free Radical Damage & Aflatoxin Poisoning . These may damage liver cells giving rise to kwashiorkor.

Age Of Host

Frequent in Infants & young children whose rapid growth increases nutritional requirement.
PEM in pregnant and lactating women can affect the growth, nutritional status & survival rates of their fetuses, new born and infants.
Elderly can also suffer from PEM due to alteration of GI System

Kwashiorkor

The term kwashiorkor is taken from the Ga language of Ghana and means "the sickness of the weaning”.
Williams first used the term in 1933, and it refers to an inadequate protein intake with reasonable caloric (energy) intake.
Kwashiorkor, also called wet protein-energy malnutrition, is a form of PEM characterized primarily by protein deficiency.
This condition usually appears at the age of about 12 months when breastfeeding is discontinued, but it can develop at any time during a child's formative years.
It causes fluid retention (edema); dry, peeling skin; and hair discoloration.
Kwashiorkor was thought to be caused by insufficient protein consumption but with sufficient calorie intake, distinguishing it from marasmus.
More recently, micronutrient and antioxidant deficiencies have come to be recognized as contributory.
Victims of kwashiorkor fail to produce antibodies following vaccination against diseases, including diphtheria and typhoid.
Generally, the disease can be treated by adding food energy and protein to the diet; however, it can have a long-term impact on a child's physical and mental development, and in severe cases may lead to death.

Symptoms

Changes in skin pigment.
Decreased muscle mass
Diarrhea Failure to gain weight and grow
Fatigue
Hair changes (change in color or texture)
Increased and more severe infections due to damaged immune system
Irritability
Large belly that sticks out (protrudes)
Lethargy or apathy
Loss of muscle mass
Rash (dermatitis)
Shock (late stage)
Swelling (edema)

Marasmus

The term marasmus is derived from the Greek word marasmos, which means withering or wasting.
Marasmus is a form of severe protein-energy malnutrition characterized by energy deficiency and emaciation.
Primarily caused by energy deficiency, marasmus is characterized by stunted growth and wasting of muscle and tissue.
Marasmus usually develops between the ages of six months and one year in children who have been weaned from breast milk or who suffer from weakening conditions like chronic diarrhea.

Symptoms

Severe growth retardation
Loss of subcutaneous fat
Severe muscle wasting
The child looks appallingly thin and limbs appear as skin and bone
Shriveled body
Wrinkled skin
Bony prominence
Associated vitamin deficiencies
Failure to thrive
Irritability, fretfulness and apathy
Frequent watery diarrhoea and acid stools
Mostly hungry but some are anoretic
Dehydration
Temperature is subnormal
Muscles are weak
Oedema and fatty infiltration are absent

Marasmuic-Kwashiorkor

A severely malnourished child with features of both marasmus and Kwashiorkor.

The features of Kwashiorkor are severe oedema of feet and legs and also hands, lower arms, abdomen and face. Also there is pale skin and hair, and the child is unhappy.
There are also signs of marasmus, wasting of the muscles of the upper arms, shoulders and chest so that you can see the ribs.

Nutritional Dwarfing or Stunting

Some children adapt to prolonged insufficiency of food-energy and protein by a marked retardation of growth.
Weight and height are both reduced and in the same proportion, so they appear superficially normal.

Underweight Child

Children with sub- clinical PEM can be detected by their weight for age or weight for height, which are significantly below normal. They may have reduced plasma albumin. They are at risk for respiratory and gastric infections.

Treatment

Treatment strategy can be divided into three stages.

Resolving life threatening conditions
Restoring nutritional status
Ensuring nutritional rehabilitation.

1. Hospital Treatment

The following conditions should be corrected. Hypothermia, hypoglycemia, infection, dehydration, electrolyte imbalance, anaemia and other vitamin and mineral deficiencies.

2. Dietary Management

The diet should be from locally available staple foods - inexpensive, easily digestible, evenly distributed throughout the day and increased number of feedings to increase the quantity of food.

3. Rehabilitation

The concept of nutritional rehabilitation is based on practical nutritional training for mothers in which they learn by feeding their children back to health under supervision and using local foods.

Prevention

Promotion of breast feeding
Development of low cost weaning
Nutrition education and promotion of correct feeding practices
Family planning and spacing of births
Immunization
Food fortification
Early diagnosis and treatment

Q. 2-3 Fat-soluble vitamins

Vitamins are tasteless organic substances that are indispensable to the normal metabolic processes of organisms. They are essential to maintain health and performance, and have to be supplied with the feed.
Vitamins do not provide energy themselves, but a deficiency of any vitamin can cause serious symptoms.

History

The term vitamin was coined by biochemist Casimir Funk.

In 1912 When scientists trying to isolate fat soluble factor B, they discovered a substance containing nitrogen which was chemically an amine, and which was in therefore named vitamin (vita = life).

Classification of vitamins

There are two main groups of vitamins-

A. Fat-soluble vitamins- Fat-soluble vitamins have specific functions in the development and maintenance of tissue structures.

B. Water-soluble vitamins- Water-soluble vitamins participate in catalytic functions or act as control mechanisms in the metabolism, e.g. as co-enzymes.

A. Fat soluble vitamins

The vitamins A, D, E, K and ß-carotene (precursor of vitamin A) belong to the fat-soluble vitamins.
These are stored in the body for long periods of time and generally pose a greater risk for toxicity when consumed in excess.
The sites of storage are inner organs such as the kidneys and liver, the muscles, the brain and fat tissue.
In the small intestine, the fat-soluble vitamins are transported into the intestinal cells as part of micelles.
Once inside the intestinal cells, fat-soluble vitamins are packaged with fat and other lipids into a chylomicron.
The chylomicrons travel through the lymph system to the main circulation.
Excretion normally only occurs after transformation during metabolism.

1. Vitamin A

Vitamin A was discovered in 1909 in fish liver oil
The term vitamin A refers to a family of fat-soluble retinoids that include retinol, retinal, and retinoic acid.
They contain a ring with a polyunsaturated fatty acid tail. Attached at the end of the fatty acid tail is either an alcohol group (retinol), an aldehyde group (retinal), or an acid group (retinoic acid).

Vitamin A terms

Retinoids The term used to describe the family of preformed vitamin A compounds.
Retinol The alcohol form of preformed vitamin A.
Retinal The aldehyde form of preformed vitamin A.
Retinoic acid The acid form of preformed vitamin A.
Retinyl ester The ester form of preformed vitamin A found in foods and stored in the body.
Beta-carotene One of the provitamin A carotenoids.

Functions of Vitamin A

1. Vitamin A is essential to the normal structure and functions of the skin and mucous membranes such a eyes, lungs and digestive system. It is, therefore, vital for vision, embryonic development growth and cellular differentiation, and immune system. Besides,

Retinal is essential for night and color vision.
Retinol is required in reproduction and bone health.
Retinoic acid is important for cell growth and differentiation.

2. Provitamin A (carotenoids) functions as a potent antioxidant and prevents damaging effects of fres radicals. Thus, carotenoids help to prevent damage from chemical carcinogens and lower the risk of certain types of cancer.

Dietary Sources of Vitamin A

Vitamin A- Animal foods, such as liver, cod liver oil, egg yolk and milk are rich sources of vitamin A (retinoids).
Provitamin A- Dark green and yellow-orange vegetables such as carrots, spinach and broccoli, and orange colored fruits like peaches, apricots and mango are good sources of provitamin A (carotenoids).

Recommended Daily Allowances (RDA)

Vitamin A requirement is expressed in terms of retinol equivalents (RE).
One RE represents one mg of retinal or 12 mg of ẞ-carotene.
Vitamin A intake can also be expressed in terms of international units (IU).
One IU of vitamin A is equivalent to 0.3 mg of retinal or 3.6 mg of B-carotene.
Average daily requirement (RDA) of vitamin A for adults is 600 mg. Its requirement is increased up to 950 mg during pregnancy and lactation.

Vitamin D

Vitamin D is a sterol (steroid alcohol), also called as sunshine vitamin. Although several forms of vitamin D have been shown to exhibit antirachitic properties, most important of these are

Vitamin D, (ergocalciferol) found in plant foods
Vitamin D, (cholecalciferol) found in animal foods and synthesized in the skin.

Vitamin D is classically a prohormone. It acts as a precursor to the hormone, calcitriol, involved in calcium homeostasis, that is essential for bone mineralization and neuromuscolher functions.

Functions of Vitamin D

Primary role of vitamin D is to regulate blood calcium level. Calcitriol, the hormone synthesized from vitamin D, directly as well as with parathyroid hormone (PTH) and calcitonin, regulates blood calcium levels through its action on bone, kidneys and small intestine.
Receptors for calcitriol are also found in a variety of other tissues, hence, vitamin D has also been shown to inhibit cell proliferation and enhance cell differentiation.

Dietary Sources of Vitamin D

Most of the vitamin D required by the body is obtained through the action of sunlight on skin.
Major dietary sources of vitamin D include cod liver oil, fish oil, egg yolk and liver. Other sources include fortified milk and foods.

Recommended Daily Allowances (RDA) of Vitamin D

Exclusively breast-fed infants, who receive little exposure to sunlight, need about 5 mg (200 IU) of vitamin D per day (1 mg = 40 IU).
For elder people recommended daily intake (RDA) is 400 IU

Vitamin E

Vitamin E refers to a group of several lipid soluble compounds synthesized by plantes.

Functions of Vitamin E

Vitamin E performs several functions:

Vitamin E acts as an antioxidant.
It stabilizes cell membrane and defends cells against oxidative damage from free radicals. Since cells damaged by free radicals, are prone to mutations, thus, vitamin E helps to prevent cancer.
Vitamin E also maintains antioxidant status of ẞ-carotene

Dietary Sources of Vitamin E

Wheat germ oil is the richest source of vitamin E. Foods containing large amounts of polyunsaturated fatty acids are also rich in vitamin E. Accordingly, vegetable oils such as safflower oil, cottonseed oil and sunflower oil, and nuts and seeds, are good sources of vitamin E

Recommended Daily Allowances of Vitamin E

Vitamin E requirement is expressed in terms of IU.
Normally, 0.4 mg of vitamin E is required per g of PUFA intake.
Average daily requirement (RDA) of adults, is 5-10 mg. Its requirement is increased to about 20 mg, during lactation.

Vitamin K

Vitamin K refers to a family of compounds known as naphthoquinones. These include

Vitamin K, (phylloquinone, obtained from plant sources).
Vitamin K, (menaquinone, obtained from animal sources and synthesized by intestinal bacteria) end
Vitamin K, (menadione, the water soluble form, available commercially)

Amongst the three, phylloquinone is the most biologically active form

Functions of Vitamin K

Vitamin K plays a key role in the formation of blood clot. It is required for many reactions in the blood clotting cascade, which involves the production of a series of proteins, such as prothrombin, factor VIII factor IX and factor X, and fibrin

Vitamin K also helps in bone formation, where it is required in the carboxylation of osteocalcin, which is required for mineralization and maturation of bone

Dietary Sources of Vitamin K

Intestinal bacteria can synthesize and meet about 10-15% of the daily requirement of vitamin K
Green leafy vegetables (spinach, broccoli, etc.) and vegetable oils (soybean oil, cottonseed oil, etc.) are good sources of phylloquinone.
Animal products, such as dairy products and meat, contain limited amounts of menaquinone

Recommended Daily Allowances (RDA) of Vitamin K

Average daily intake (RDA) of vitamin K (phylloquinone), for adults, is 60-100 mg.