Vitamin B3
Vitamin B3 | |
---|---|
A11H | |
Biological target | enzyme cofactor |
Clinical data | |
Drugs.com | Niacin |
External links | |
MeSH | D009536 |
Legal status | |
In Wikidata |
Vitamin B3, colloquially referred to as niacin, is a
Niacin (the nutrient) can be manufactured by plants and animals from the
The
Mechanism of action
Vitamin deficiency
Severe vitamin B3 deficiency in the diet causes the disease pellagra, characterized by diarrhea, sun-sensitive dermatitis involving hyperpigmentation and thickening of the skin (see image), inflammation of the mouth and tongue, delirium, dementia, and if left untreated, death.[6] Common psychiatric symptoms include irritability, poor concentration, anxiety, fatigue, loss of memory, restlessness, apathy, and depression.[13] The biochemical mechanisms for the observed deficiency-caused neurodegeneration are not well understood, but may rest on A) the requirement for nicotinamide adenine dinucleotide (NAD+) to suppress the creation of neurotoxic tryptophan metabolites; B) inhibition of mitochondrial ATP generation resulting in cell damage; C) activation of the poly (ADP-ribose) polymerase (PARP) pathway, as PARP is a nuclear enzyme involved in DNA repair, but in the absence of NAD+ can lead to cell death; D) reduced synthesis of neuro-protective brain-derived neurotrophic factor or its receptor tropomyosin receptor kinase B; or, E) changes to genome expression directly due to the niacin deficiency.[14]
Niacin deficiency is rarely seen in developed countries, and it is more typically associated with poverty, malnutrition or malnutrition secondary to chronic alcoholism.[15] It also tends to occur in areas where people eat maize (corn) as a staple food, as maize is low in digestible niacin.[5] A cooking technique called nixtamalization, that is, pretreating with alkali ingredients, increases the bioavailability of niacin during maize meal or flour production.[16] For this reason, people who consume corn as tortillas or hominy are at less risk of niacin deficiency.
For treating deficiency, the World Health Organization (WHO) recommends administering niacinamide (i.e. nicotinamide) instead of niacin, to avoid the flushing side effect commonly caused by the latter. Guidelines suggest using 300 mg/day for three to four weeks.[10] Dementia and dermatitis show improvement within a week. Because deficiencies of other B-vitamins may be present, the WHO recommends a multi-vitamin in addition to the niacinamide.[10]
Measuring vitamin status
Plasma concentrations of niacin and niacin metabolites are not useful markers of niacin status.[3] Urinary excretion of the methylated metabolite N1-methyl-nicotinamide is considered reliable and sensitive. The measurement requires a 24-hour urine collection. For adults, a value of less than 5.8 μmol/day represent deficient niacin status and 5.8 to 17.5 μmol/day represents low.[3] According to the World Health Organization, an alternative mean of expressing urinary N1-methyl-nicotinamide is as mg/g creatinine in a 24-hour urine collection, with deficient defined as <0.5, low 0.5-1.59, acceptable 1.6-4.29, and high >4.3[10] Niacin deficiency occurs before the signs and symptoms of pellagra appear.[3] Erythrocyte nicotinamide adenine dinucleotide (NAD) concentrations potentially provide another sensitive indicator of niacin depletion, although definitions of deficient, low and adequate have not been established. Lastly, plasma tryptophan decreases on a low niacin diet because tryptophan converts to niacin. However, low tryptophan could also be caused by a diet low in this essential amino acid, so it is not specific to confirming vitamin status.[3]
Dietary recommendations
|
The U.S. Institute of Medicine (renamed
The European Food Safety Authority (EFSA) refers to the collective set of information as Dietary Reference Values (DRV), with Population Reference Intake (PRI) instead of RDA, and Average Requirement instead of EAR. For the EU, AIs and ULs have the same definition as in the US, except that units are milligrams per megajoule (MJ) of energy consumed rather than mg/day. For women (including those pregnant or lactating), men and children the PRI is 1.6 mg per megajoule. As the conversion is 1 MJ = 239 kcal, an adult consuming 2390 kilocalories should be consuming 16 mg niacin. This is comparable to US RDAs (14 mg/day for adult women, 16 mg/day for adult men).[22]
ULs are established by identifying amounts of vitamins and minerals that cause adverse effects, and then selecting as an upper limit amounts that are the "maximum daily intake unlikely to cause adverse health effects".[21] Regulatory agencies from different countries do not always agree. For the US, 30 or 35 mg for teenagers and adults, less for children.[3] The EFSA UL for adults is set at 10 mg/day – about one-third of the US value. For all of the government ULs, the term applies to niacin as a supplement consumed as one dose, and is intended as a limit to avoid the skin flush reaction. This explains why for EFSA, the recommended daily intake can be higher than the UL.[23]
Both the DRI and DRV describe amounts needed as niacin equivalents (NE), calculated as 1 mg NE = 1 mg niacin or 60 mg of the essential amino acid tryptophan. This is because the amino acid is utilized to synthesize the vitamin.[3][22]
For U.S. food and dietary supplement labeling purposes, the amount in a serving is expressed as a percent of
Sources
Niacin is found in a variety of
Source[29] | Amount (mg / 100g) |
---|---|
Nutritional yeast[30] Serving = 2 Tbsp (16 g) contains 56 mg |
350 |
Tuna, yellowfin | 22.1 |
Peanuts | 14.3 |
Peanut butter | 13.1 |
Bacon | 10.4 |
Tuna, light, canned | 10.1 |
Salmon | 10.0 |
Turkey depending on what part, how cooked | 7-12 |
Chicken depending on what part, how cooked | 7-12 |
Source[29] | Amount (mg / 100g) |
---|---|
Beef depending on what part, how cooked | 4-8 |
Pork depending on what part, how cooked | 4-8 |
Sunflower seeds |
7.0 |
Tuna, white, canned | 5.8 |
Almonds | 3.6 |
Mushrooms, white | 3.6 |
Cod fish | 2.5 |
Rice, brown | 2.5 |
Hot dogs | 2.0 |
Source[29] | Amount (mg / 100g) |
---|---|
Avocado | 1.7 |
Potato, baked, with skin | 1.4 |
Corn (maize) | 1.0 |
Rice, white | 0.5 |
Kale | 0.4 |
Eggs |
0.1 |
Milk | 0.1 |
Cheese | 0.1 |
Tofu | 0.1 |
Vegetarian and vegan diets can provide adequate amounts if products such as nutritional yeast, peanuts, peanut butter, tahini, brown rice, mushrooms, avocado and sunflower seeds are included. Fortified foods and dietary supplements can also be consumed to ensure adequate intake.[5][31]
Food preparation
Niacin naturally found in food is susceptible to destruction from high heat cooking, especially in the presence of acidic foods and sauces. It is soluble in water, and so may also be lost from foods boiled in water.[32]
Food fortification
Countries fortify foods with nutrients to address known deficiencies.[7] As of 2020, 54 countries required food fortification of wheat flour with niacin or niacinamide; 14 also mandate fortification of maize flour, and 6 mandate fortification of rice.[33] From country to country, niacin fortification ranges from 1.3 to 6.0 mg/100 g.[33]
As a dietary supplement
In the United States, niacin (the acid) is sold as a non-prescription dietary supplement with a range of 100 to 1000 mg per serving. These products often have a Structure/Function health claim[34] allowed by the US Food & Drug Administration (FDA). An example would be "Supports a healthy blood lipid profile." The American Heart Association (AHA) strongly advises against the use of non-prescription dietary supplement niacin rather than prescription niacin because of potentially serious side effects. For this reason and because the manufacture of dietary supplement niacin is not as well-regulated by the FDA as is prescription niacin, the AHA advises that supplemental niacin only be used under the supervision of a health care professional.[35] More than 30 mg niacin consumed as a dietary supplement can cause skin flushing. Face, arms and chest skin turns a reddish color because of vasodilation of small subcutaneous blood vessels, accompanied by sensations of heat, tingling and itching. These signs and symptoms are typically transient, lasting minutes to hours; they are considered unpleasant rather than toxic.[5]
Toxicity
The daily limit for vitamin B3 has been set at 35 mg. At daily doses of as low as 30 mg, flushing has been reported, always starting in the face and sometimes accompanied by skin dryness, itching, paresthesia, and headache.
History
Corn (maize) became a staple food in the southeast United States and in parts of Europe. A disease that was characterized by dermatitis of sunlight-exposed skin was described in Spain in 1735 by Gaspar Casal. He attributed the cause to poor diet.[37] In northern Italy it was named pellagra from the Lombard language (agra = holly-like or serum-like; pell = skin).[38][39] In time, the disease was more closely linked specifically to corn.[40] In the US, Joseph Goldberger was assigned to study pellagra by the Surgeon General of the United States. His studies confirmed a corn-based diet as the culprit, but he did not identify the root cause.[41][42]
In 1942, when flour
J. Laguna and K.J. Carpenter found in 1951, that niacin in corn is biologically unavailable and can be released only in very alkaline
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- ^ a b "Nutrient reference values for Australia and New Zealand" (PDF). National Health and Medical Research Council. September 9, 2005. Archived from the original (PDF) on January 21, 2017. Retrieved June 19, 2018.
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- ^ a b "Overview on Dietary Reference Values for the EU population as derived by the EFSA Panel on Dietetic Products, Nutrition and Allergies" (PDF). 2017.
- ^ "Tolerable Upper Intake Levels For Vitamins And Minerals" (PDF). European Food Safety Authority. 2006.
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- ^ "Industry Resources on the Changes to the Nutrition Facts Label". U.S. Food and Drug Administration (FDA). December 21, 2018. Retrieved May 16, 2020. This article incorporates text from this source, which is in the public domain.
- ^ "Niacin content per 100 grams; select food subset, abridged list by food groups". United States Department of Agriculture, Agricultural Research Service, USDA Branded Food Products Database v.3.6.4.1. January 17, 2017. Archived from the original on February 2, 2017. Retrieved January 23, 2017.
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- ^ "Nutritional Yeast Flakes (two tablespoons = 16 grams". NutritionData.Self.com. Retrieved May 13, 2020.
- ^ "Vitamin B3 (Niacin)". VivaHealth.org. 2000. Archived from the original on August 4, 2020. Retrieved May 12, 2020.
- ^ "Effects of Cooking on Vitamins (Table)". Beyondveg. Archived from the original on October 16, 2012. Retrieved April 30, 2019.
- ^ a b "Map: Count of Nutrients In Fortification Standards". Global Fortification Data Exchange. Retrieved July 4, 2020.
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- ^ Casal G (1945). "The natural and medical history of the principality of the Asturias". In Major RH (ed.). Classic Descriptions of Disease (3 ed.). Springfield: Charles C Thomas. pp. 607–12.
- ^ F. Cherubini, Vocabolario Milanese-Italiano, Imp. Regia Stamperia, 1840-43, vol. I, III.
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- ISBN 978-0-9710541-9-6"Men of the Year, outstanding in comprehensive science were three medical researchers who discovered that nicotinic acid was a cure for human pellagra: Drs. Tom Douglas Spies of Cincinnati General Hospital, Marion Arthur Blankenhorn of the University of Cincinnati, Clark Niel Cooper of Waterloo, Iowa."
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