Adequate Intake niacin

Pellagra Can Occur as a Result of Disease Despite an Adequate Intake of Tryptophan Niacin... 

A number of genetic diseases that result in defects of tryptophan metabolism are associated with the development of pellagra despite an apparently adequate intake of both tryptophan and niacin. Hartnup disease is a rare genetic condition in which there is a defect of the membrane transport mechanism for tryptophan, resulting in large losses due to intestinal malabsorption and failure of the renal resorption mechanism. In carcinoid syndrome there is metastasis of a primary liver tumor of enterochromaffin cells which synthesize 5-hydroxy-tryptamine. Overproduction of 5-hydroxytryptamine may account for as much as 60% of the body s tryptophan metabolism, causing pellagra because of the diversion away from NAD synthesis. 

Al, adequate intakes NE, niacin equivalents PN, parenteral nutrition RDA, recommended dietary allowances RE, retinal equivalents TE, tocopherol equivalent. 

Tree nuts can be good dietary sources (>10% of recommended dietary allowances [RDA] or adequate intake [Al]) of most vitamins except vitamins A and cobalamin (B,2). At suggested consumption level (1.5 ounces or 42.5g/day), acorn and pine nuts are excellent sources of folate and vitamin K (Table 2.7). In case of thiamin (Bj), niacin (B3), and pyridoxine (Bg), tree nuts offer alternative sources of these vitamins when more abundant animal sources are not available or are not consumed. 

A diet history showed that Eddie had a normal, and apparently adequate, intake of tryptophan and niacin. Therefore, dietary deficiency seemed improbable. 

Nicotinate (also called niacin or vitamin Bg) is derived from tryptophan. Human beings can synthesize the required amount of nicotinate if the supply of tryptophan in the diet is adequate. However, nicotinate must be obtained directly if the dietary intake of tryptophan is low. A dietary deficiency of tryptophan and nicotinate can lead to pellagra, a disease characterized by dermatitis, diarrhea, and dementia. An endocrine tumor that consumes large amounts of tryptophan in synthesizing the hormone and neurotransmitter serotonin (5-hydroxytryptamine) can lead to pellagralike symptoms. 

That nongrowing animals require niacin implies that it is lost from the body either as intact niacin or as a modified or breakdown product of the vitamin. An amount of niacin equivalent to nearly 90% of our daily intake is excreted in the forms of N-methyl-2-p)nidone-5urinary metabolites can be used to assess niacin status. Loss of the normal quantity in the urine each day indicates that the supply in the diet is adequate. In humans, the healthy adult excretes 4 to 6 mg of N-methyl-nicoti-namide per day. An abnormally low level indicates that the dietary intake is not adequate. Measurement of urinary niacin metabolites has proven useful in determining the amoimt of niacin available in a variety of foods. The body s ability to use niacin in different foods may vary even if the foods contain identical quantities of the vitamin. One contributing factor to the low availability of niacin is the occurrence of the vitamin in the "bound form," as mentioned earlier. Excretion of normal levels of pyridone, for example, depends not only on normal absorption of the vitamin from the diet, but also on its conversion to NAD or NADP, followed by catabolism to the metabolite. 

Although the nutritional aetiology of pellagra is well established, and tryptophan or niacin will prevent or cure the disease, additional factors, including deficiency of riboflavin (and hence impaired activity of kynurenine hydroxylase) or vitamin (and hence impaired activity of kynureninase), may be important when intakes of tryptophan and niacin are only marginally adequate. 

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