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Guru Granth Sahib
Composition, Arrangement & Layout
ਜਪੁ | Jup
ਸੋ ਦਰੁ | So Dar
ਸੋਹਿਲਾ | Sohilaa
ਰਾਗੁ ਸਿਰੀਰਾਗੁ | Raag Siree-Raag
Gurbani (14-53)
Ashtpadiyan (53-71)
Gurbani (71-74)
Pahre (74-78)
Chhant (78-81)
Vanjara (81-82)
Vaar Siri Raag (83-91)
Bhagat Bani (91-93)
ਰਾਗੁ ਮਾਝ | Raag Maajh
Gurbani (94-109)
Ashtpadi (109)
Ashtpadiyan (110-129)
Ashtpadi (129-130)
Ashtpadiyan (130-133)
Bara Maha (133-136)
Din Raen (136-137)
Vaar Maajh Ki (137-150)
ਰਾਗੁ ਗਉੜੀ | Raag Gauree
Gurbani (151-185)
Quartets/Couplets (185-220)
Ashtpadiyan (220-234)
Karhalei (234-235)
Ashtpadiyan (235-242)
Chhant (242-249)
Baavan Akhari (250-262)
Sukhmani (262-296)
Thittee (296-300)
Gauree kii Vaar (300-323)
Gurbani (323-330)
Ashtpadiyan (330-340)
Baavan Akhari (340-343)
Thintteen (343-344)
Vaar Kabir (344-345)
Bhagat Bani (345-346)
ਰਾਗੁ ਆਸਾ | Raag Aasaa
Gurbani (347-348)
Chaupaday (348-364)
Panchpadde (364-365)
Kaafee (365-409)
Aasaavaree (409-411)
Ashtpadiyan (411-432)
Patee (432-435)
Chhant (435-462)
Vaar Aasaa (462-475)
Bhagat Bani (475-488)
ਰਾਗੁ ਗੂਜਰੀ | Raag Goojaree
Gurbani (489-503)
Ashtpadiyan (503-508)
Vaar Gujari (508-517)
Vaar Gujari (517-526)
ਰਾਗੁ ਦੇਵਗੰਧਾਰੀ | Raag Dayv-Gandhaaree
Gurbani (527-536)
ਰਾਗੁ ਬਿਹਾਗੜਾ | Raag Bihaagraa
Gurbani (537-556)
Chhant (538-548)
Vaar Bihaagraa (548-556)
ਰਾਗੁ ਵਡਹੰਸ | Raag Wadhans
Gurbani (557-564)
Ashtpadiyan (564-565)
Chhant (565-575)
Ghoriaan (575-578)
Alaahaniiaa (578-582)
Vaar Wadhans (582-594)
ਰਾਗੁ ਸੋਰਠਿ | Raag Sorath
Gurbani (595-634)
Asatpadhiya (634-642)
Vaar Sorath (642-659)
ਰਾਗੁ ਧਨਾਸਰੀ | Raag Dhanasaree
Gurbani (660-685)
Astpadhiya (685-687)
Chhant (687-691)
Bhagat Bani (691-695)
ਰਾਗੁ ਜੈਤਸਰੀ | Raag Jaitsree
Gurbani (696-703)
Chhant (703-705)
Vaar Jaitsaree (705-710)
Bhagat Bani (710)
ਰਾਗੁ ਟੋਡੀ | Raag Todee
ਰਾਗੁ ਬੈਰਾੜੀ | Raag Bairaaree
ਰਾਗੁ ਤਿਲੰਗ | Raag Tilang
Gurbani (721-727)
Bhagat Bani (727)
ਰਾਗੁ ਸੂਹੀ | Raag Suhi
Gurbani (728-750)
Ashtpadiyan (750-761)
Kaafee (761-762)
Suchajee (762)
Gunvantee (763)
Chhant (763-785)
Vaar Soohee (785-792)
Bhagat Bani (792-794)
ਰਾਗੁ ਬਿਲਾਵਲੁ | Raag Bilaaval
Gurbani (795-831)
Ashtpadiyan (831-838)
Thitteen (838-840)
Vaar Sat (841-843)
Chhant (843-848)
Vaar Bilaaval (849-855)
Bhagat Bani (855-858)
ਰਾਗੁ ਗੋਂਡ | Raag Gond
Gurbani (859-869)
Ashtpadiyan (869)
Bhagat Bani (870-875)
ਰਾਗੁ ਰਾਮਕਲੀ | Raag Ramkalee
Ashtpadiyan (902-916)
Gurbani (876-902)
Anand (917-922)
Sadd (923-924)
Chhant (924-929)
Dakhnee (929-938)
Sidh Gosat (938-946)
Vaar Ramkalee (947-968)
ਰਾਗੁ ਨਟ ਨਾਰਾਇਨ | Raag Nat Narayan
Gurbani (975-980)
Ashtpadiyan (980-983)
ਰਾਗੁ ਮਾਲੀ ਗਉੜਾ | Raag Maalee Gauraa
Gurbani (984-988)
Bhagat Bani (988)
ਰਾਗੁ ਮਾਰੂ | Raag Maaroo
Gurbani (889-1008)
Ashtpadiyan (1008-1014)
Kaafee (1014-1016)
Ashtpadiyan (1016-1019)
Anjulian (1019-1020)
Solhe (1020-1033)
Dakhni (1033-1043)
ਰਾਗੁ ਤੁਖਾਰੀ | Raag Tukhaari
Bara Maha (1107-1110)
Chhant (1110-1117)
ਰਾਗੁ ਕੇਦਾਰਾ | Raag Kedara
Gurbani (1118-1123)
Bhagat Bani (1123-1124)
ਰਾਗੁ ਭੈਰਉ | Raag Bhairo
Gurbani (1125-1152)
Partaal (1153)
Ashtpadiyan (1153-1167)
ਰਾਗੁ ਬਸੰਤੁ | Raag Basant
Gurbani (1168-1187)
Ashtpadiyan (1187-1193)
Vaar Basant (1193-1196)
ਰਾਗੁ ਸਾਰਗ | Raag Saarag
Gurbani (1197-1200)
Partaal (1200-1231)
Ashtpadiyan (1232-1236)
Chhant (1236-1237)
Vaar Saarang (1237-1253)
ਰਾਗੁ ਮਲਾਰ | Raag Malaar
Gurbani (1254-1293)
Partaal (1265-1273)
Ashtpadiyan (1273-1278)
Chhant (1278)
Vaar Malaar (1278-91)
Bhagat Bani (1292-93)
ਰਾਗੁ ਕਾਨੜਾ | Raag Kaanraa
Gurbani (1294-96)
Partaal (1296-1318)
Ashtpadiyan (1308-1312)
Chhant (1312)
Vaar Kaanraa
Bhagat Bani (1318)
ਰਾਗੁ ਕਲਿਆਨ | Raag Kalyaan
Gurbani (1319-23)
Ashtpadiyan (1323-26)
ਰਾਗੁ ਪ੍ਰਭਾਤੀ | Raag Prabhaatee
Gurbani (1327-1341)
Ashtpadiyan (1342-51)
ਰਾਗੁ ਜੈਜਾਵੰਤੀ | Raag Jaijaiwanti
Gurbani (1352-53)
Salok | Gatha | Phunahe | Chaubole | Swayiye
Sehskritee Mahala 1
Sehskritee Mahala 5
Gaathaa Mahala 5
Phunhay Mahala 5
Chaubolae Mahala 5
Shaloks Bhagat Kabir
Shaloks Sheikh Farid
Swaiyyae Mahala 5
Swaiyyae in Praise of Gurus
Shaloks in Addition To Vaars
Shalok Ninth Mehl
Mundavanee Mehl 5
ਰਾਗ ਮਾਲਾ, Raag Maalaa
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<blockquote data-quote="ax0547" data-source="post: 89289" data-attributes="member: 7183"><p><strong><span style="font-family: 'Arial'">Vitamin B12 : What is it?</span></strong><strong><span style="font-family: 'Arial'"></span></strong></p><p><strong><span style="font-family: 'Arial'"></span></strong><span style="font-family: 'Arial'">Vitamin B12, also called cobalamin, is important to good health. It helps maintain healthy nerve cells and red blood cells, and is also needed to make DNA, the genetic material in all cells (1-4). Vitamin B12 is bound to the protein in food. Hydrochloric acid in the stomach releases B12 from protein during digestion. Once released, B12 combines with a substance called intrinsic factor (IF) before it is absorbed into the bloodstream.</span></p><p><strong><span style="font-family: 'Arial'">What foods provide vitamin B12? </span></strong><strong><span style="font-family: 'Arial'"></span></strong></p><p><strong><span style="font-family: 'Arial'"></span></strong><span style="font-family: 'Arial'">Vitamin B12 is naturally found in animal foods including fish, milk and milk products, eggs, meat, and poultry. Fortified breakfast cereals are an excellent source of vitamin B12 and a particularly valuable source for vegetarians (5, 6, 7). The table of selected food sources of vitamin B12 suggests dietary sources of vitamin B12. </span></p><p><strong><span style="font-family: 'Arial'">What is the Recommended Dietary Allowance for vitamin B12 for adults?</span></strong><strong><span style="font-family: 'Arial'"></span></strong></p><p><strong><span style="font-family: 'Arial'"></span></strong><span style="font-family: 'Arial'">The Recommended Dietary Allowance (RDA) is the average daily dietary intake level that is sufficient to meet the nutrient requirements of nearly all (97 to 98 percent) healthy individuals in each life-stage and gender group (7). The 1998 RDAs for vitamin B12 (in micrograms) for adults (7) are: </span></p><p style="text-align: center"><strong><span style="font-family: 'Arial'">Life-Stage</span></strong></p> <p style="text-align: center"><span style="font-family: 'Arial'"> <strong>Men</strong></span></p> <p style="text-align: center"><span style="font-family: 'Arial'"> <strong>Women</strong></span></p> <p style="text-align: center"><span style="font-family: 'Arial'"> <strong>Pregnancy</strong></span></p> <p style="text-align: center"><span style="font-family: 'Arial'"> <strong>Lactation</strong></span></p> <p style="text-align: center"><span style="font-family: 'Arial'">Ages 19+</span></p> <p style="text-align: center"><span style="font-family: 'Arial'">2.4 mcg</span></p> <p style="text-align: center"><span style="font-family: 'Arial'">2.4 mcg</span></p> <p style="text-align: center"></p> <p style="text-align: center"></p> <p style="text-align: center"><span style="font-family: 'Arial'">All ages</span></p> <p style="text-align: center"></p> <p style="text-align: center"></p> <p style="text-align: center"><span style="font-family: 'Arial'">2.6 mcg </span></p> <p style="text-align: center"><span style="font-family: 'Arial'">2.8 mcg</span></p> <p style="text-align: center"><span style="font-family: 'Arial'">Results of two national surveys, the National Health and Nutrition Examination Survey (NHANES III-1988-91) (8) and the Continuing Survey of Food Intakes by Individuals (CSFII 1994-96) (7) found that most adult men and women consume recommended amounts of vitamin B12 (6-8).</span> </p> <p style="text-align: center"></p><p><strong><span style="font-family: 'Arial'">When is a deficiency of vitamin B12 likely to occur? </span></strong><strong><span style="font-family: 'Arial'"></span></strong></p><p><strong><span style="font-family: 'Arial'"></span></strong><span style="font-family: 'Arial'">Diets of most adult Americans provide recommended intakes of vitamin B12, but deficiency may still occur as a result of an inability to absorb B12 from food. It can also occur in individuals with dietary patterns that exclude animal or fortified foods (9). As a general rule, most individuals who develop a vitamin B12 deficiency have an underlying stomach or intestinal disorder that limits the absorption of vitamin B12 (10). Sometimes the only symptom of these intestinal disorders is anemia resulting from B12 deficiency.</span></p><p><span style="font-family: 'Arial'">Characteristic signs of B12 deficiency include fatigue, weakness, nausea, constipation, flatulence (gas), loss of appetite, and weight loss (1, 3, 11). Deficiency also can lead to neurological changes such as numbness and tingling in the hands and feet (7, 12). Additional symptoms of B12 deficiency are difficulty in maintaining balance, depression, confusion, poor memory, and soreness of the mouth or tongue (13). Some of these symptoms can also result from a variety of medical conditions other than vitamin B12 deficiency. It is important to have a physician evaluate these symptoms so that appropriate medical care can be given. </span></p><p><strong><span style="font-family: 'Arial'">Who may need a vitamin B12 supplement to prevent a deficiency?</span></strong><strong><span style="font-family: 'Arial'"></span></strong></p><p><strong><span style="font-family: 'Arial'"></span></strong></p><p><strong><span style="font-family: 'Arial'"><em>Individuals with pernicious anemia</em></span></strong><em><span style="font-family: 'Arial'"></span></em></p><p><em><span style="font-family: 'Arial'"></span></em><span style="font-family: 'Verdana'">Pernicious anemia is a form of anemia that occurs when there is an absence of intrinsic factor, a substance normally present in the stomach. Vitamin B12 binds with intrinsic factor before it is absorbed and used by your body (7,14,15). An absence of intrinsic factor prevents normal absorption of B12 and results in pernicious anemia. </span></p><p><span style="font-family: 'Arial'">Anyone with pernicious anemia usually needs intramuscular (IM) injections (shots) of vitamin B12. It is very important to remember that pernicious anemia is a chronic condition that should be monitored by a physician. Anyone with pernicious anemia has to take lifelong supplemental vitamin B12.</span></p><p><strong><em><span style="font-family: 'Arial'">Individuals with gastrointestinal disorders</span></em></strong><em><span style="font-family: 'Arial'"></span></em></p><p><em><span style="font-family: 'Arial'"></span></em><span style="font-family: 'Arial'">Individuals with stomach and small intestinal disorders may not absorb enough vitamin B12 from food to maintain healthy body stores (16). Sprue and celiac disease are intestinal disorders caused by intolerance to protein in wheat and wheat products. Regional enteritis, localized inflammation of the stomach or small intestine, also results in generalized malabsorption of vitamin B12 (7). Excess bacteria in the stomach and small intestine also can decrease vitamin B12 absorption. </span></p><p><span style="font-family: 'Arial'">Surgical procedures of the gastrointestinal tract such as surgery to remove all or part of the stomach often result in a loss of cells that secrete stomach acid and intrinsic factor (7, 17, 18). Surgical removal of the distal ileum, a section of the intestines, also can result in the inability to absorb B12. Anyone who has had either of these surgeries usually requires lifelong supplemental B12 to prevent a deficiency.</span></p><p><strong><em><span style="font-family: 'Arial'">Older Adults</span></em></strong><strong><span style="font-family: 'Arial'"> </span></strong></p><p><strong><span style="font-family: 'Arial'"></span></strong><span style="font-family: 'Arial'">Vitamin B12 must be separated from protein in food before it can bind with intrinsic factor and be absorbed by your body. Bacterial overgrowth in the stomach and/or atrophic gastritis, an inflammation of the stomach, contribute to vitamin B12 deficiency in adults by limiting secretions of stomach acid needed to separate vitamin B12 from protein in food (10, 20-24). Adults 50 years of age and older with these conditions are able to absorb the B12 in fortified foods and dietary supplements. Health care professionals may advise adults over the age of 50 to get their vitamin B12 from a dietary supplement or from foods fortified with vitamin B12 because 10 to 30 percent of older people may be unable to absorb vitamin B12 in food (7, 19). </span></p><p><strong><em><span style="font-family: 'Arial'">Vegetarians</span></em></strong><em><span style="font-family: 'Arial'"></span></em></p><p><em><span style="font-family: 'Arial'"></span></em><span style="font-family: 'Arial'">Vegetarians who do not eat meats, fish, eggs, milk or milk products, or B12 fortified foods consume no vitamin B12 and are at high risk of developing a deficiency of vitamin B12 (9, 25). When adults adopt a vegetarian diet, deficiency symptoms can be slow to appear because it usually takes years to deplete normal body stores of B12. However, severe symptoms of B12 deficiency, most often featuring poor neurological development, can show up quickly in children and breast-fed infants of women who follow a strict vegetarian diet (26). </span></p><p><span style="font-family: 'Arial'">Fortified cereals are one of the few plant food sources of vitamin B12, and are an important dietary source of B12 for vegetarians who consume no eggs, milk or milk products. Vegetarian adults who do not consume plant foods fortified with vitamin B12 need to consider taking a B12-containing supplement. Vegetarian mothers should consult with a pediatrician regarding appropriate vitamin B12 supplementation for their infants and children. </span></p><p><strong><span style="font-family: 'Arial'">Caution: Folic acid may mask signs of vitamin B12 deficiency</span></strong><strong><span style="font-family: 'Arial'"></span></strong></p><p><strong><span style="font-family: 'Arial'"></span></strong><span style="font-family: 'Arial'">Folic acid can correct the anemia that is caused by vitamin B12 deficiency. Unfortunately, folic acid will not correct the underlying B12 deficiency (1, 27, 28). Permanent nerve damage can occur if vitamin B12 deficiency is not treated. Folic acid intake from food and supplements should not exceed 1,000 micrograms (mcg) daily because large amounts of folic acid can hide the damaging effects of vitamin B12 deficiency (7). Adults older than 50 years are advised to consult with their physician about the advisability of taking folic acid without also taking a vitamin B12 supplement. </span></p><p><strong><span style="font-family: 'Arial'">What is the relationship between vitamin B12, homocysteine, and heart disease?</span></strong><strong><span style="font-family: 'Arial'"></span></strong></p><p><strong><span style="font-family: 'Arial'"></span></strong><span style="font-family: 'Arial'">A deficiency of vitamin B12, folate, or vitamin B6 may increase your blood level of homocysteine, an amino acid normally found in your blood. There is evidence that an elevated blood level of homocysteine is an independent risk factor for heart disease and stroke (29-38). The evidence suggests that high levels of homocysteine may damage coronary arteries (34) or make it easier for blood clotting cells called platelets to clump together and form a clot. However, there is currently no evidence available to suggest that lowering homocysteine level with vitamins will actually reduce your risk of heart disease. Clinical intervention trials are needed to determine whether supplementation with vitamin B12, folic acid, or vitamin B6 can help protect you against developing coronary heart disease. </span></p><p><strong><span style="font-family: 'Arial'">What is the health risk of too much vitamin B12?</span></strong><strong><span style="font-family: 'Arial'"></span></strong></p><p><strong><span style="font-family: 'Arial'"></span></strong><span style="font-family: 'Arial'">Vitamin B12 has a very low potential for toxicity. The Institute of Medicine states that "no adverse effects have been associated with excess vitamin B12 intake from food and supplements in healthy individuals (7)." The Institute recommends that adults over 50 years of age get most of their vitamin B12 from supplements or fortified food because of the high incidence of impaired absorption of B12 from unfortified foods in this population (7). </span></p><p><strong><span style="font-family: 'Arial'">Selected Food Sources of Vitamin B</span></strong><strong><span style="font-family: 'Arial'">12</span></strong><strong><span style="font-family: 'Arial'"> </span></strong></p><p><strong><span style="font-family: 'Arial'"></span></strong><span style="font-family: 'Arial'">As the 2000 Dietary Guidelines for Americans state, "Different foods contain different nutrients and other healthful substances. No single food can supply all the nutrients in the amounts you need" (39). As the following table indicates, vitamin B12 is found naturally in animal foods. It is also found in fortified foods such as fortified breakfast cereals. </span></p><p style="text-align: center"><p style="text-align: center"><strong><span style="font-family: 'Arial'">Table of Food Sources of Vitamin B12 (5)</span></strong></p></p> <p style="text-align: center"><strong><span style="color: black"><span style="font-family: 'Arial'"> Food</span></span></strong></p> <p style="text-align: center"></p><p style="text-align: center"><p style="text-align: center"><strong><span style="color: black"><span style="font-family: 'Arial'"> Micrograms</span></span></strong></p> </p></p> <p style="text-align: center"></p><p style="text-align: center"><p style="text-align: center"><strong><span style="color: black"><span style="font-family: 'Arial'">%DV*</span></span></strong></p> </p></p> <p style="text-align: center"><span style="font-family: 'Arial'">Beef liver, cooked, 3 oz</span></p><p style="text-align: center"><p style="text-align: center"><span style="font-family: 'Arial'">60.0</span></p> <p style="text-align: center"><span style="font-family: 'Arial'">1000</span></p> </p></p> <p style="text-align: center"><span style="font-family: 'Arial'">Fortified breakfast cereals, (100%) fortified), </span></p> <p style="text-align: center"><span style="font-family: 'Arial'">3/4 c</span></p><p style="text-align: center"><p style="text-align: center"><span style="font-family: 'Arial'">6.0</span></p> <p style="text-align: center"><span style="font-family: 'Arial'">100</span></p> </p></p> <p style="text-align: center"><span style="font-family: 'Arial'">Trout, rainbow, cooked, 3 oz</span></p><p style="text-align: center"><p style="text-align: center"><span style="font-family: 'Arial'">5.3</span></p> <p style="text-align: center"><span style="font-family: 'Arial'">90</span></p> </p></p> <p style="text-align: center"><span style="font-family: 'Arial'">Salmon, sockeye, cooked, 3 oz</span></p><p style="text-align: center"><p style="text-align: center"><span style="font-family: 'Arial'">4.9</span></p> <p style="text-align: center"><span style="font-family: 'Arial'">80</span></p> </p></p> <p style="text-align: center"><span style="font-family: 'Arial'">Beef, cooked, 3 oz</span></p><p style="text-align: center"><p style="text-align: center"><span style="font-family: 'Arial'">2.1</span></p> <p style="text-align: center"><span style="font-family: 'Arial'">35</span></p> </p></p> <p style="text-align: center"><span style="font-family: 'Arial'">Fortified breakfast cereals (25% fortified), </span></p> <p style="text-align: center"><span style="font-family: 'Arial'">3/4 c</span></p><p style="text-align: center"><p style="text-align: center"><span style="font-family: 'Arial'">1.5</span></p> <p style="text-align: center"><span style="font-family: 'Arial'">25</span></p> </p></p> <p style="text-align: center"><span style="font-family: 'Arial'">Haddock, cooked, 3 oz</span></p><p style="text-align: center"><p style="text-align: center"><span style="font-family: 'Arial'">1.2</span></p> <p style="text-align: center"><span style="font-family: 'Arial'">20</span></p> </p></p> <p style="text-align: center"><span style="font-family: 'Arial'">Clams, breaded and fried, 3/4 c</span></p><p style="text-align: center"><p style="text-align: center"><span style="font-family: 'Arial'">1.1</span></p> <p style="text-align: center"><span style="font-family: 'Arial'">20</span></p> </p></p> <p style="text-align: center"><span style="font-family: 'Arial'">Oysters, breaded and fried, 6 pieces</span></p><p style="text-align: center"><p style="text-align: center"><span style="font-family: 'Arial'">1.0</span></p> <p style="text-align: center"><span style="font-family: 'Arial'">15</span></p> </p></p> <p style="text-align: center"><span style="font-family: 'Arial'">Tuna, white, canned in water, 3 oz</span></p><p style="text-align: center"><p style="text-align: center"><span style="font-family: 'Arial'">0.9</span></p> <p style="text-align: center"><span style="font-family: 'Arial'">15</span></p> </p></p> <p style="text-align: center"><strong><span style="font-family: 'Arial'">Milk, 1 cup</span></strong></p><p style="text-align: center"><p style="text-align: center"><strong><span style="font-family: 'Arial'">0.9</span></strong></p> <p style="text-align: center"><strong><span style="font-family: 'Arial'">15</span></strong></p> </p></p> <p style="text-align: center"><span style="font-family: 'Arial'">Yogurt, 8 oz</span></p><p style="text-align: center"><p style="text-align: center"><span style="font-family: 'Arial'">0.9</span></p> <p style="text-align: center"><span style="font-family: 'Arial'">15</span></p> </p></p> <p style="text-align: center"><span style="font-family: 'Arial'">Pork, cooked, 3 oz</span></p><p style="text-align: center"><p style="text-align: center"><span style="font-family: 'Arial'">0.6 </span></p> <p style="text-align: center"><span style="font-family: 'Arial'">10</span></p> </p></p> <p style="text-align: center"><span style="font-family: 'Arial'">Egg, 1 large</span></p><p style="text-align: center"><p style="text-align: center"><span style="font-family: 'Arial'">0.5</span></p> <p style="text-align: center"><span style="font-family: 'Arial'">8</span></p> </p></p> <p style="text-align: center"><span style="font-family: 'Arial'">American Cheese, 1 oz </span></p><p style="text-align: center"><p style="text-align: center"><span style="font-family: 'Arial'">0.4 </span></p> <p style="text-align: center"><span style="font-family: 'Arial'">6</span></p> </p></p> <p style="text-align: center"><span style="font-family: 'Arial'">Chicken, cooked, 3 oz </span></p><p style="text-align: center"><p style="text-align: center"><span style="font-family: 'Arial'">0.3 </span></p> <p style="text-align: center"><span style="font-family: 'Arial'">6</span></p> </p></p> <p style="text-align: center"><span style="font-family: 'Arial'">Cheddar cheese, 1 oz</span></p><p style="text-align: center"><p style="text-align: center"><span style="font-family: 'Arial'">0.2</span></p> <p style="text-align: center"><span style="font-family: 'Arial'">4</span></p> </p></p> <p style="text-align: center"><span style="font-family: 'Arial'">Mozzarella cheese, 1 oz</span></p><p style="text-align: center"><p style="text-align: center"><span style="font-family: 'Arial'">0.2</span></p> <p style="text-align: center"><span style="font-family: 'Arial'">4</span></p> </p></p> <p style="text-align: center"><span style="font-family: 'Arial'">* DV = Daily Value. DVs are reference numbers based on the Recommended Dietary Allowance (RDA). They were developed to help consumers determine if a food contains a lot or a little of a specific nutrient. The DV for vitamin B</span><span style="font-family: 'Arial'">12</span><span style="font-family: 'Arial'"> is 6.0 micrograms (mcg). The percent DV (%DV) listed on the nutrition facts panel of food labels tells adults what percentage of the DV is provided by one serving. Percent DVs are based on a 2,000 calorie diet. Your Daily Values may be higher or lower depending on your calorie needs. Foods that provide lower percentages of the DV also contribute to a healthful diet.</span></p> <p style="text-align: center"></p></blockquote><p></p>
[QUOTE="ax0547, post: 89289, member: 7183"] [B][FONT=Arial]Vitamin B12 : What is it?[/FONT][/B][B][FONT=Arial] [/FONT][/B][FONT=Arial]Vitamin B12, also called cobalamin, is important to good health. It helps maintain healthy nerve cells and red blood cells, and is also needed to make DNA, the genetic material in all cells (1-4). Vitamin B12 is bound to the protein in food. Hydrochloric acid in the stomach releases B12 from protein during digestion. Once released, B12 combines with a substance called intrinsic factor (IF) before it is absorbed into the bloodstream.[/FONT][FONT=Times New Roman][/FONT] [B][FONT=Arial]What foods provide vitamin B12? [/FONT][/B][B][FONT=Arial] [/FONT][/B][FONT=Arial]Vitamin B12 is naturally found in animal foods including fish, milk and milk products, eggs, meat, and poultry. Fortified breakfast cereals are an excellent source of vitamin B12 and a particularly valuable source for vegetarians (5, 6, 7). The table of selected food sources of vitamin B12 suggests dietary sources of vitamin B12. [/FONT][FONT=Times New Roman][/FONT] [B][FONT=Arial]What is the Recommended Dietary Allowance for vitamin B12 for adults?[/FONT][/B][B][FONT=Arial] [/FONT][/B][FONT=Arial]The Recommended Dietary Allowance (RDA) is the average daily dietary intake level that is sufficient to meet the nutrient requirements of nearly all (97 to 98 percent) healthy individuals in each life-stage and gender group (7). The 1998 RDAs for vitamin B12 (in micrograms) for adults (7) are: [/FONT][FONT=Times New Roman][/FONT] [CENTER][B][FONT=Arial]Life-Stage[/FONT][/B][FONT=Times New Roman][/FONT] [FONT=Arial] [B]Men[/B][/FONT][FONT=Times New Roman][/FONT] [FONT=Arial] [B]Women[/B][/FONT][FONT=Times New Roman][/FONT] [FONT=Arial] [B]Pregnancy[/B][/FONT][FONT=Times New Roman][/FONT] [FONT=Arial] [B]Lactation[/B][/FONT][FONT=Times New Roman][/FONT] [FONT=Arial]Ages 19+[/FONT][FONT=Times New Roman][/FONT] [FONT=Arial]2.4 mcg[/FONT][FONT=Times New Roman][/FONT] [FONT=Arial]2.4 mcg[/FONT][FONT=Times New Roman][/FONT] [FONT=Times New Roman] [/FONT] [FONT=Times New Roman] [/FONT] [FONT=Arial]All ages[/FONT][FONT=Times New Roman][/FONT] [FONT=Times New Roman] [/FONT] [FONT=Times New Roman] [/FONT] [FONT=Arial]2.6 mcg [/FONT][FONT=Times New Roman][/FONT] [FONT=Arial]2.8 mcg[/FONT][FONT=Times New Roman][/FONT] [FONT=Arial]Results of two national surveys, the National Health and Nutrition Examination Survey (NHANES III-1988-91) (8) and the Continuing Survey of Food Intakes by Individuals (CSFII 1994-96) (7) found that most adult men and women consume recommended amounts of vitamin B12 (6-8).[/FONT][FONT=Arial] [/FONT][FONT=Times New Roman][/FONT] [/CENTER] [B][FONT=Arial]When is a deficiency of vitamin B12 likely to occur? [/FONT][/B][B][FONT=Arial] [/FONT][/B][FONT=Arial]Diets of most adult Americans provide recommended intakes of vitamin B12, but deficiency may still occur as a result of an inability to absorb B12 from food. It can also occur in individuals with dietary patterns that exclude animal or fortified foods (9). As a general rule, most individuals who develop a vitamin B12 deficiency have an underlying stomach or intestinal disorder that limits the absorption of vitamin B12 (10). Sometimes the only symptom of these intestinal disorders is anemia resulting from B12 deficiency.[/FONT][FONT=Times New Roman][/FONT] [FONT=Arial]Characteristic signs of B12 deficiency include fatigue, weakness, nausea, constipation, flatulence (gas), loss of appetite, and weight loss (1, 3, 11). Deficiency also can lead to neurological changes such as numbness and tingling in the hands and feet (7, 12). Additional symptoms of B12 deficiency are difficulty in maintaining balance, depression, confusion, poor memory, and soreness of the mouth or tongue (13). Some of these symptoms can also result from a variety of medical conditions other than vitamin B12 deficiency. It is important to have a physician evaluate these symptoms so that appropriate medical care can be given. [/FONT][FONT=Times New Roman][/FONT] [FONT=Times New Roman][/FONT][B][FONT=Arial]Who may need a vitamin B12 supplement to prevent a deficiency?[/FONT][/B][B][FONT=Arial] [I]Individuals with pernicious anemia[/I][/FONT][/B][I][FONT=Arial] [/FONT][/I][FONT=Verdana]Pernicious anemia is a form of anemia that occurs when there is an absence of intrinsic factor, a substance normally present in the stomach. Vitamin B12 binds with intrinsic factor before it is absorbed and used by your body (7,14,15). An absence of intrinsic factor prevents normal absorption of B12 and results in pernicious anemia. [/FONT][FONT=Times New Roman][/FONT] [FONT=Arial]Anyone with pernicious anemia usually needs intramuscular (IM) injections (shots) of vitamin B12. It is very important to remember that pernicious anemia is a chronic condition that should be monitored by a physician. Anyone with pernicious anemia has to take lifelong supplemental vitamin B12.[/FONT][FONT=Times New Roman][/FONT] [B][I][FONT=Arial]Individuals with gastrointestinal disorders[/FONT][/I][/B][I][FONT=Arial] [/FONT][/I][FONT=Arial]Individuals with stomach and small intestinal disorders may not absorb enough vitamin B12 from food to maintain healthy body stores (16). Sprue and celiac disease are intestinal disorders caused by intolerance to protein in wheat and wheat products. Regional enteritis, localized inflammation of the stomach or small intestine, also results in generalized malabsorption of vitamin B12 (7). Excess bacteria in the stomach and small intestine also can decrease vitamin B12 absorption. [/FONT][FONT=Times New Roman][/FONT] [FONT=Arial]Surgical procedures of the gastrointestinal tract such as surgery to remove all or part of the stomach often result in a loss of cells that secrete stomach acid and intrinsic factor (7, 17, 18). Surgical removal of the distal ileum, a section of the intestines, also can result in the inability to absorb B12. Anyone who has had either of these surgeries usually requires lifelong supplemental B12 to prevent a deficiency.[/FONT][FONT=Times New Roman][/FONT] [B][I][FONT=Arial]Older Adults[/FONT][/I][/B][B][FONT=Arial] [/FONT][/B][FONT=Arial]Vitamin B12 must be separated from protein in food before it can bind with intrinsic factor and be absorbed by your body. Bacterial overgrowth in the stomach and/or atrophic gastritis, an inflammation of the stomach, contribute to vitamin B12 deficiency in adults by limiting secretions of stomach acid needed to separate vitamin B12 from protein in food (10, 20-24). Adults 50 years of age and older with these conditions are able to absorb the B12 in fortified foods and dietary supplements. Health care professionals may advise adults over the age of 50 to get their vitamin B12 from a dietary supplement or from foods fortified with vitamin B12 because 10 to 30 percent of older people may be unable to absorb vitamin B12 in food (7, 19). [/FONT][FONT=Times New Roman][/FONT] [B][I][FONT=Arial]Vegetarians[/FONT][/I][/B][I][FONT=Arial] [/FONT][/I][FONT=Arial]Vegetarians who do not eat meats, fish, eggs, milk or milk products, or B12 fortified foods consume no vitamin B12 and are at high risk of developing a deficiency of vitamin B12 (9, 25). When adults adopt a vegetarian diet, deficiency symptoms can be slow to appear because it usually takes years to deplete normal body stores of B12. However, severe symptoms of B12 deficiency, most often featuring poor neurological development, can show up quickly in children and breast-fed infants of women who follow a strict vegetarian diet (26). [/FONT][FONT=Times New Roman][/FONT] [FONT=Arial]Fortified cereals are one of the few plant food sources of vitamin B12, and are an important dietary source of B12 for vegetarians who consume no eggs, milk or milk products. Vegetarian adults who do not consume plant foods fortified with vitamin B12 need to consider taking a B12-containing supplement. Vegetarian mothers should consult with a pediatrician regarding appropriate vitamin B12 supplementation for their infants and children. [/FONT][FONT=Times New Roman][/FONT] [B][FONT=Arial]Caution: Folic acid may mask signs of vitamin B12 deficiency[/FONT][/B][B][FONT=Arial] [/FONT][/B][FONT=Arial]Folic acid can correct the anemia that is caused by vitamin B12 deficiency. Unfortunately, folic acid will not correct the underlying B12 deficiency (1, 27, 28). Permanent nerve damage can occur if vitamin B12 deficiency is not treated. Folic acid intake from food and supplements should not exceed 1,000 micrograms (mcg) daily because large amounts of folic acid can hide the damaging effects of vitamin B12 deficiency (7). Adults older than 50 years are advised to consult with their physician about the advisability of taking folic acid without also taking a vitamin B12 supplement. [/FONT][FONT=Times New Roman][/FONT] [B][FONT=Arial]What is the relationship between vitamin B12, homocysteine, and heart disease?[/FONT][/B][B][FONT=Arial] [/FONT][/B][FONT=Arial]A deficiency of vitamin B12, folate, or vitamin B6 may increase your blood level of homocysteine, an amino acid normally found in your blood. There is evidence that an elevated blood level of homocysteine is an independent risk factor for heart disease and stroke (29-38). The evidence suggests that high levels of homocysteine may damage coronary arteries (34) or make it easier for blood clotting cells called platelets to clump together and form a clot. However, there is currently no evidence available to suggest that lowering homocysteine level with vitamins will actually reduce your risk of heart disease. Clinical intervention trials are needed to determine whether supplementation with vitamin B12, folic acid, or vitamin B6 can help protect you against developing coronary heart disease. [/FONT][FONT=Times New Roman][/FONT] [B][FONT=Arial]What is the health risk of too much vitamin B12?[/FONT][/B][B][FONT=Arial] [/FONT][/B][FONT=Arial]Vitamin B12 has a very low potential for toxicity. The Institute of Medicine states that "no adverse effects have been associated with excess vitamin B12 intake from food and supplements in healthy individuals (7)." The Institute recommends that adults over 50 years of age get most of their vitamin B12 from supplements or fortified food because of the high incidence of impaired absorption of B12 from unfortified foods in this population (7). [/FONT][FONT=Times New Roman][/FONT] [FONT=Times New Roman][/FONT][B][FONT=Arial]Selected Food Sources of Vitamin B[/FONT][/B][B][FONT=Arial]12[/FONT][/B][B][FONT=Arial] [/FONT][/B][FONT=Arial]As the 2000 Dietary Guidelines for Americans state, "Different foods contain different nutrients and other healthful substances. No single food can supply all the nutrients in the amounts you need" (39). As the following table indicates, vitamin B12 is found naturally in animal foods. It is also found in fortified foods such as fortified breakfast cereals. [/FONT][FONT=Times New Roman][/FONT] [CENTER][CENTER][B][FONT=Arial]Table of Food Sources of Vitamin B12 (5)[/FONT][/B][B][FONT=Times New Roman][/FONT][/B][/CENTER] [B][COLOR=black][FONT=Arial] Food[/FONT][/COLOR][/B][FONT=Times New Roman][/FONT] [FONT=Times New Roman] [/FONT] [CENTER][CENTER][B][COLOR=black][FONT=Arial] Micrograms[/FONT][/COLOR][/B][FONT=Times New Roman][/FONT][/CENTER][/CENTER] [FONT=Times New Roman] [/FONT] [CENTER][CENTER][B][COLOR=black][FONT=Arial]%DV*[/FONT][/COLOR][/B][FONT=Times New Roman][/FONT][/CENTER][/CENTER] [FONT=Arial]Beef liver, cooked, 3 oz[/FONT][FONT=Times New Roman][/FONT] [CENTER][CENTER][FONT=Arial]60.0[/FONT][FONT=Times New Roman][/FONT][/CENTER] [CENTER][FONT=Arial]1000[/FONT][FONT=Times New Roman][/FONT][/CENTER][/CENTER] [FONT=Arial]Fortified breakfast cereals, (100%) fortified), 3/4 c[/FONT][FONT=Times New Roman][/FONT] [CENTER][CENTER][FONT=Arial]6.0[/FONT][FONT=Times New Roman][/FONT][/CENTER] [CENTER][FONT=Arial]100[/FONT][FONT=Times New Roman][/FONT][/CENTER][/CENTER] [FONT=Arial]Trout, rainbow, cooked, 3 oz[/FONT][FONT=Times New Roman][/FONT] [CENTER][CENTER][FONT=Arial]5.3[/FONT][FONT=Times New Roman][/FONT][/CENTER] [CENTER][FONT=Arial]90[/FONT][FONT=Times New Roman][/FONT][/CENTER][/CENTER] [FONT=Arial]Salmon, sockeye, cooked, 3 oz[/FONT][FONT=Times New Roman][/FONT] [CENTER][CENTER][FONT=Arial]4.9[/FONT][FONT=Times New Roman][/FONT][/CENTER] [CENTER][FONT=Arial]80[/FONT][FONT=Times New Roman][/FONT][/CENTER][/CENTER] [FONT=Arial]Beef, cooked, 3 oz[/FONT][FONT=Times New Roman][/FONT] [CENTER][CENTER][FONT=Arial]2.1[/FONT][FONT=Times New Roman][/FONT][/CENTER] [CENTER][FONT=Arial]35[/FONT][FONT=Times New Roman][/FONT][/CENTER][/CENTER] [FONT=Arial]Fortified breakfast cereals (25% fortified), 3/4 c[/FONT][FONT=Times New Roman][/FONT] [CENTER][CENTER][FONT=Arial]1.5[/FONT][FONT=Times New Roman][/FONT][/CENTER] [CENTER][FONT=Arial]25[/FONT][FONT=Times New Roman][/FONT][/CENTER][/CENTER] [FONT=Arial]Haddock, cooked, 3 oz[/FONT][FONT=Times New Roman][/FONT] [CENTER][CENTER][FONT=Arial]1.2[/FONT][FONT=Times New Roman][/FONT][/CENTER] [CENTER][FONT=Arial]20[/FONT][FONT=Times New Roman][/FONT][/CENTER][/CENTER] [FONT=Arial]Clams, breaded and fried, 3/4 c[/FONT][FONT=Times New Roman][/FONT] [CENTER][CENTER][FONT=Arial]1.1[/FONT][FONT=Times New Roman][/FONT][/CENTER] [CENTER][FONT=Arial]20[/FONT][FONT=Times New Roman][/FONT][/CENTER][/CENTER] [FONT=Arial]Oysters, breaded and fried, 6 pieces[/FONT][FONT=Times New Roman][/FONT] [CENTER][CENTER][FONT=Arial]1.0[/FONT][FONT=Times New Roman][/FONT][/CENTER] [CENTER][FONT=Arial]15[/FONT][FONT=Times New Roman][/FONT][/CENTER][/CENTER] [FONT=Arial]Tuna, white, canned in water, 3 oz[/FONT][FONT=Times New Roman][/FONT] [CENTER][CENTER][FONT=Arial]0.9[/FONT][FONT=Times New Roman][/FONT][/CENTER] [CENTER][FONT=Arial]15[/FONT][FONT=Times New Roman][/FONT][/CENTER][/CENTER] [B][FONT=Arial]Milk, 1 cup[/FONT][/B][B][FONT=Times New Roman][/FONT][/B] [CENTER][CENTER][B][FONT=Arial]0.9[/FONT][/B][B][FONT=Times New Roman][/FONT][/B][/CENTER] [CENTER][B][FONT=Arial]15[/FONT][/B][B][FONT=Times New Roman][/FONT][/B][/CENTER][/CENTER] [FONT=Arial]Yogurt, 8 oz[/FONT][FONT=Times New Roman][/FONT] [CENTER][CENTER][FONT=Arial]0.9[/FONT][FONT=Times New Roman][/FONT][/CENTER] [CENTER][FONT=Arial]15[/FONT][FONT=Times New Roman][/FONT][/CENTER][/CENTER] [FONT=Arial]Pork, cooked, 3 oz[/FONT][FONT=Times New Roman][/FONT] [CENTER][CENTER][FONT=Arial]0.6 [/FONT][FONT=Times New Roman][/FONT][/CENTER] [CENTER][FONT=Arial]10[/FONT][FONT=Times New Roman][/FONT][/CENTER][/CENTER] [FONT=Arial]Egg, 1 large[/FONT][FONT=Times New Roman][/FONT] [CENTER][CENTER][FONT=Arial]0.5[/FONT][FONT=Times New Roman][/FONT][/CENTER] [CENTER][FONT=Arial]8[/FONT][FONT=Times New Roman][/FONT][/CENTER][/CENTER] [FONT=Arial]American Cheese, 1 oz [/FONT][FONT=Times New Roman][/FONT] [CENTER][CENTER][FONT=Arial]0.4 [/FONT][FONT=Times New Roman][/FONT][/CENTER] [CENTER][FONT=Arial]6[/FONT][FONT=Times New Roman][/FONT][/CENTER][/CENTER] [FONT=Arial]Chicken, cooked, 3 oz [/FONT][FONT=Times New Roman][/FONT] [CENTER][CENTER][FONT=Arial]0.3 [/FONT][FONT=Times New Roman][/FONT][/CENTER] [CENTER][FONT=Arial]6[/FONT][FONT=Times New Roman][/FONT][/CENTER][/CENTER] [FONT=Arial]Cheddar cheese, 1 oz[/FONT][FONT=Times New Roman][/FONT] [CENTER][CENTER][FONT=Arial]0.2[/FONT][FONT=Times New Roman][/FONT][/CENTER] [CENTER][FONT=Arial]4[/FONT][FONT=Times New Roman][/FONT][/CENTER][/CENTER] [FONT=Arial]Mozzarella cheese, 1 oz[/FONT][FONT=Times New Roman][/FONT] [CENTER][CENTER][FONT=Arial]0.2[/FONT][FONT=Times New Roman][/FONT][/CENTER] [CENTER][FONT=Arial]4[/FONT][FONT=Times New Roman][/FONT][/CENTER][/CENTER] [FONT=Arial]* DV = Daily Value. DVs are reference numbers based on the Recommended Dietary Allowance (RDA). They were developed to help consumers determine if a food contains a lot or a little of a specific nutrient. The DV for vitamin B[/FONT][FONT=Arial]12[/FONT][FONT=Arial] is 6.0 micrograms (mcg). The percent DV (%DV) listed on the nutrition facts panel of food labels tells adults what percentage of the DV is provided by one serving. Percent DVs are based on a 2,000 calorie diet. Your Daily Values may be higher or lower depending on your calorie needs. Foods that provide lower percentages of the DV also contribute to a healthful diet.[/FONT][FONT=Times New Roman][/FONT] [/CENTER] [/QUOTE]
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