John Lennon Essay -- essays research papers

John LennonLennon was born in 1940 during the Nazi bombing of Britain and given the optic name Winston, after Prime Minister Churchill. Knowing firsthand the horror of a world at war and living through the era of Vietnams unpointed carnage as well, Lennon came to embrace and embody pacifism via such classics of the Beatles era as "All You Need Is Love" and "Strawberry Fields Forever." Yet he also had a countervailing dark side that found expression in pained outcries that dated as far back as "Help." This unvarnished locution of the Lennon persona reached a fevered pitch with the drug-withdrawal blues of "Cold Turkey," a 1969 single released under the name Plastic Ono Band.Although Lennon was a complicated man, he chose at this juncture to simplify his art in order to figure out his life, erasing the boundaries between the two. As he explained it, he started trying "to shave off every imagery, pretensions of poetry, illusions of grandeur...Jus t say what it is, simple English, make it rhyme and put a backbeat on it, and express yourself as simply and straightforwardly as possible." His most fully realize statement, as a solo artist was 1970s John Lennon/Plastic Ono Band. Lennons first solo album, it followed several avant-garde sound collages recorded toward the end of the Beatles era with his married woman and collaborator, Yoko Ono. The raw, confessional nature of Plastic Ono Band reflected the primal-scream therapy that Len...

Interactivity In Art Essay -- Art Design Artistic Essays

Interactivity In Art AbstractThis essay examines the record of interactivity in the liberal arts through a cybernetic model, to arrive at an understanding of how interactive artworks can maintain and augment the subjectivity of the viewer. The cybernetic discourse foregrounds the relationship mingled with the physical artifact (machine and/or work of art), the participant/spectator, and information/data/content. By examining the shifts in focus from each part of the cybernetic equation, several models for interactivity in art emerge. In a search for a definitive and user-centered working model of interactivity in the arts, a logical place to look is at the archives of cybernetics. Cybernetics, defined by Norbert Wiener in Cybernetics or Control and Communication in the Animal and the Machine as the entire field of control or communication theory, whether in the machine or in the animal (Wiener 11) contains a number of pointers to a useful model of interactivity. The o rigin of the term cybernetics from the Greek, meaning to crown, implies a reciprocal relationship between external forces, the machine, and the human to maintain a condition of homeostatic. In a work of interactive art, as in Wieners description of a bee-hive, the secret of its organized action lies in the intercommunication of its members (156). A second fertile site to mine for understanding the nature of interaction in the arts is the traditions and conventions of the art object itself at how the art object is thought to project feeling and meaning , to change across season and culture, and to involve the viewer, temporality, and artist in a dynamic interchange within an aesthetic dimension. Toward these ends, I will address two questions... ...n, 1999) Susanne K. Langer, Mind, an Essay on kind-hearted Feeling, John Hopkins University Press, (London, 1982) John C. Lilly, M.D., Programming and Metaprogramming in the Human Biocomputer, Julian Press Inc, Crown Publishing Gro up, (New York, 1969) Lev Manovich, The Language of New Media, MIT Press, Leonardo Books, (Cambridge, 2001) __ On Totalitarian Interactivity (notes from the foeman of the people,http//www.manovich.net/text/totalitarian.html, 1996. Heinz von Forester, Molecular Ethnology An immodest proposal for Semantic Clarification, Observing Systems, 2nd Edition,, Intersystems Publications, (Salinas California 1984) Humberto Maturana and Francisco Varela, Autopoesis and Cognition The Realization of the Living (Dordrecht D. Reidel 1980). Perry Hoberman, Faradays Garden, http//www.hoberman.com/perry/pages/faraday/list.html

Essay --

On October 25th, 2013, at Wenling City First Hospital, close to Shanghai, mainland China, a 33-year-old man, furious at the result of an operation over an year ago on his nose, stabbed a doctor to death and wounded two others. He had at peace(p) to the ear, nose and throat department looking for the doctor who treated him, but the doctor was not there, so then he pulled out a botcher knife and stabbed the head of the department instead. He also stabbed two other doctors before he was retrained by security guards.Also in October this year, a feminine doctor in Beijing was stabbed 17 times by an unhappy patient who had spent years blogging about a throat cancer operation that he claimed was a failure. Xinhua news, quoting a survey from the Chinese Hospital Association, shows that there were 27.3 assaults on medical staff per hospital in 2012. Medical professionals across China are increasingly becoming victims of physical violence at the hands of disgruntled patients. In some cas es, doctors charged with saving lives are having their own rationalize short murdered in cold blood over financial concerns or unhappiness with the quality of treatment. These attacks epitomize and crystalize, in a very fundamental way, the severe deterioration of the doctor-patient relationship in China. What could make the doctor-patient relationship, which apparently is supposed to be healthy and mutually beneficial, so noticeably exacerbated in the past disco biscuit in China? Some critics say it is the low level of the medical equipments quality and doctors ability that badly displease and enrage patients, and cause these tragedies. According to Zhongshang News, in China, medical students only need 5 years of professional training to be able to obtain the officially authorized qu... ...to African and Asian allied countries. Instead of short of money, the flaws and loopholes in the design of Medicare system explains its low coverage in needed areas. Chinese state media has condemned each of the attacks, and the Ministry of Public Security has needed hospitals with more than 2,000 patients to have at least 100 security guards present. But the deeper issue remains- the exacerbation of doctor-patient relationship due to the low credibility of doctors to their patients the birth of these corruptions and dissatisfactions is the imperfections of the medical system and the core of solving this problem is first eliminating these problems. Work Citedhttp//news.xinhuanet.com/english/china/2013-10/31/c_132847107.htmhttp//thediplomat.com/2013/11/why-are-chinese-patients-killing-their-doctors/ http//www.askci.com/news/201208/13/8548_88.shtml

TV or No TV :: essays papers

TV or No TV This is a question millions of parents are muse across America. Violence, along with sexual content, on television is at an all time high. So are the ratings, however. Sex and rage seems to draw a bigger audience. A larger audience brings networks more money. This all looks simple enough except for the fact that all of the viewers arent old enough bushel fact from fiction or right from wrong. With violence in schools on the rise, the question arises Does violent television programming influence our children and their actions? According to some mental research, violence on television affects children negatively. The three major effects of seeing violence on television are Children may become less peeled to the pain and suffering of others. Children may be more fearful of the world around them. Children may be more likely to behave in self-assertive ways toward others. Sometimes kids act differently after theyve been watching violent programs on televisi on.In one study done at Pennsylvania State University, nearly 100 preschool children were observed both before and after watching television. Some kids watched cartoons that had many aggressive and violent acts while the others watched shows that didnt have any sort of violence at all. The researchers picked up on a lot of real differences in behavior between the kids who watched the violent shows and those who watched nonviolent ones. The kids who watched the violent shows were more likely to stumble out at playmates, argue, disobey authority and were less willing to wait for things than those children who watched nonviolent programs. Some studies found that kids who watched many hours of television violence when they were in primary(a) school had a greater tendency to show a higher level of aggressive behavior as they grew older. One of these studies observed these same youngsters until they were 30 years old. The results show that the ones who had watched a lot of televi sion when they were eight years old had significantly greater chances to be arrested and prosecuted for criminal acts as adults. Some travel have been taken in the right direction, however. The television industry took steps toward implementing a rating system for its programming at a meeting with chairwoman Clinton in late February.

Farming Essay -- Personal Narrative Agriculture Papers

Farming Beep , beep, beep, the alarm clock sounded. Shoot another day term at work I thought.It is 530 and time to head off to work. I go into the shoe room and throw on my at one time worn set of clothes, which consist of a tee-shirt, sweatshirt, long johns, pants, and some winter boots. I also grab a coat on the way out. I opened the door and the cold wintry blast hit my pale face. Damn its cold, I thought to myself.I trudged through the two feet of curmudge lone(prenominal) snow and hop into my 87 Ram 50 pick-up truck. rue, rur, rur, whiinee the engine started. Yes I thought, I dont want to jump my truck this cold morning.I started down the bridle-path into what seemed like a dark oblivion with only my headlights to guide me through. I came to the first stop sign and almost slide through it. Whew that was close I shouted to myself.I start up again, a little slower this time as hoping not to slide through another stop sign, I then realize my heater is starting to kick in. Its getting warm in my truck. ,its comfortable though. I finally arrive at work and walkway in.Good afternoon my boss states sarcasti scruby. Its 600 in the morning and its still cold in the barn. I go into the silo room and start to fill up the corn cart. The room is off to the side of the barn so it is also freezing in this part of the barn. I roll the full cart onto the cement lane ,it seems really heavy in these early morning hours. I pull in front of the first cow and think Oh yea only 59 more to go. I get done feeding corn and move on to feeding the mineral this only takes about five proceedings because I dont have to feed as much. Next I move on to feeding protein out of the cart this takes a little more time than mineral, b... ... turn the first bolt and my wrench slips. Ouch, I scream.Whadidchya do? my boss asks. Hit my damn finger, I say. Well dont slip off the remove and that wont happen. He instructs me. Thanx I said.We get the girder replaced and go in for a late af ternoon dinner. I sit down and think, warmth, ahh. Feeling begins to come adventure into my hand and they hurt from banging them several times on things. I eat the prepared meatballs and boiled potatoes with peas and carrots with rigorous vigor. Will you pay me today please, I ask. Sure, my boss says.I get my check and tell my boss and his family Ill see the tomorrow. I hop into my truck and finally start to go back home. I arrive home to find that my family has gone some where so I go in take a shower and proceed to call my buddy up on the phone to see where the party is at.

Farming Essay -- Personal Narrative Agriculture Papers

Farming Beep , beep, beep, the alarm clock sounded. Shoot another day at work I thought.It is 530 and time to head off to work. I go into the shoe room and throw on my once worn set of clothes, which consist of a tee-shirt, sweatshirt, long johns, pants, and some winter boots. I also grab a coat on the way out. I opened the door and the cold frozen(p) blast hit my pale face. Damn its cold, I thought to myself.I trudged through the two feet of crusty snow and hop into my 87 Ram 50 pick-up truck. rue, rur, rur, whiinee the engine started. Yes I thought, I dont want to jump my truck this cold morning.I started down the road into what seemed like a dark mercy with only my headlights to guide me through. I came to the first stop sign and almost slide through it. Whew that was close I shouted to myself.I start up again, a little slower this time as hoping not to slide through another stop sign, I then realize my heater is starting to kick in. Its lollting warm in my truck. ,its comfo rtable though. I finally arrive at work and walk in.Good afternoon my boss states sarcastically. Its 600 in the morning and its still cold in the barn. I go into the silo room and start to fill up the corn cart. The room is off to the side of meat of the barn so it is also freezing in this part of the barn. I roll the full cart onto the cement lane ,it seems really heavy in these early morning hours. I pull in front of the first cow and think Oh yea only 59 more to go. I bind done feeding corn and move on to feeding the mineral this only takes about five minutes because I dont have to feed as much. Next I move on to feeding protein out of the cart this takes a little more time than mineral, b... ... turn the first bolt and my whirl slips. Ouch, I scream.Whadidchya do? my boss asks. Hit my damn finger, I say. Well dont slip off the burr and that wont happen. He instructs me. Thanx I said.We get the girder replaced and go in for a late afternoon dinner. I sit down and think, war mth, ahh. Feeling begins to come back into my hands and they hurt from banging them several quantify on things. I eat the prepared meatballs and boiled potatoes with peas and carrots with rigorous vigor. Will you pay me today please, I ask. Sure, my boss says.I get my check and tell my boss and his family Ill see the tomorrow. I hop into my truck and finally start to go back home. I arrive home to sire that my family has gone some where so I go in take a shower and proceed to call my buddy up on the rally to see where the party is at.

High School Dropouts Essay

In The Great Gatsby money is a symbol of success. Money controls the lives of the characters in the story, but it is easy to see that it could not bring happiness. Each of the characters speculates that having money will solve all of their problems and make them successful, but that is not true. These are a few examples of characters in the story who think that money is the answer to being successful, when it actually does not bring them true happiness.Daisy is a character who was born into a wealthy family, but she does not pitch any good values or purpose in her life. Her life is boring, so she tries to use her wealth to make her happy. She is a socialite, always goes to parties with her wealthy friends, and she wears vestments that are white with a lot of gold and silver.Even though she thinks that these things will make her happy, she is still bored and always wonders what she will do next. She has an skirmish with Gatsby stock-still though she is married to a wealthy man, T om, because she is bored. She does not value herself or anyone else. Her money has not made her a happy person even though everything she does is based on wealth.Gatsby has a lot of money. Even though he has a huge house, fancy cars and clothes, and has parties all the time, he is not real corrupted by the money. He does everything he does just to get Daisy and prove to her by his wealth that he is good enough for her. He thinks that all he has will get her to marry him, but he does not realize that Daisy will never leave her married man because he is so wealthy.Daisys husband Tom is very wealthy. He gambles, goes to horse and car races, and has many affairs. He has a mistress that he supports, but obviously not happy with his life. When he finds out that Daisy has been having an affair, he gets angry with her even though he is guilty of doingthe same thing. Daisy and Tom are not happy, their money and success have not made them happy, but daisy will not leave Tom because he is wea lthy.In The Great Gatsby money is seen as a symbol of success by the characters. They have all of the clothes, cars, houses, and social events that they want and that money can buy. Despite all of this, they are unhappy, have no real values or friends, and no real purpose in life.

Sanitarium Marketing

Assignment 1. 1 Overview and Situation Analysis Sanitarium evolution of marketing A brand that down all current Zealand supermarket? s breakfast cereal aisle which dominates the shelves that is Sanitarium Sanitarium Australia and Sanitarium New Zealand are owned and operated by Australian health & Nutrition Association and New Zealand Health Association. The company produces over 150 mathematical carrefours and employs approximately 1700 people in the manufacturing and distribution sites throughout Australia and New Zealand. The company is leading manufacturer of breakfast cereals, soy beverages works based meat alternatives, , and yeast spreads.Sanitarium the comer of Kiwi staples Weet-Bix and Skippy Cornflakes has evolved into a giant of the local food manufacturing sector over the last century. They are proud to be a group of people who believe passionately in the potential of every New Zealander. The potential to be healthy physically, mentally and emotionally. They bel ieve this move all begins with good nutrition. What you feed your body and your mind, changes theway you feel. Sanitariums range of healthy breakfast options not only includes Weet-Bix, which is New Zealands favorite cereal, they also offer something for everyone in the family. for example, products like beverages, spreads and another kinds of cereal all of them focused to sell the idea to be and eat healthy. Following that conception, Sanitarium is al ways looking at ways of sourcing ingredients and making products on a local level, to help minimize our impact on the environment. They do care about sustainability The commitment to sustainability don? t chip off at the farm gate but covers the entire supply chain and life cycle of foods, from inception, through manufacturing, to minimization of waste and the disposal of any waste, being inclusive of all resources that they control within the supply chain.Sanitariums mission is to lead, inspire and resource the experience of happ y health living in the community. For any business, growth is a significant element of being competitive within their industry and as discussed prior Sanitarium holds the largest portion of the market. The ability to create receipts allows Sanitarium the cash flow needed to put into costs such as marketing, advertising, and development of new products and brands. Without this Sanitariums life cycle would be short as even the cereal market will not lasts forever. In this segmentation, Sanitarium marketing has been improved.The company promotes guinea pigs like TheSanitarium Weet-Bix Kids Tryathlon whichis a community-based event that encourages Kiwi kids, aged from 7 until 15, to participate in a fun day out, to encourage exercises in a healthy life. There is also the course of study called KickStart Breakfastwhich was recently established by Sanitarium and has been recognised by Prime Minister John Key with an award as the Best New Initiative at the annual Prime Ministers Social Heroes Awards. These awards acknowledge businesses supporting charitable purposes as healthful.The company? s advertising has been always inspiring the community to make healthier food and lifestyle choices, with this proposal, Sanitarium invests a significant portion of resources into providing the community with free nutritional information and diet related advice by a team of nutritionists, receipts. All healthy information can be found in the company? s website. One of the recent marketing opportunities for Sanitarium was well done. The company had a perfect time to maximize its decade-long sponsorship in the 2011 Rugby World Cup.Rather than promote the UpGo and Weet-Bix brands individually, Sanitarium decided on a parent-brand approach for its Game Plan campaign. However, it knew there would be an onslaught of companies jostling for in-store space and consumer attention in such a key year. The solution was thinking bigger, so Sanitarium had a display concept in mind that used 3. 2m goalposts in-store. They had used effective displays to demonstrating Sanitariums support for the team, and driving the sales required to meet business objectives.Another recent marketing activity, was the return of their Marmite. Sanitarium and their advertising agency Saatchi Saatchi made the most of Marmites long-awaited comeback, with a Facebook countdown. Marmite (brand that is protected by plow mark laws) is back in production and supermarket shelves. A full year after it disappeared, Marmite has returned in a marketing campaign that included free jars direct to politicians and media types, recipes and a midnight supermarket opening that generated queues around the block in some centres.Sanitariums marketing prowess could yet desert the company, however. One of the risks involved in taking the product off the shelves for a year could be that Kiwis lose the taste for Marmite possibly lowering their sodium levels at the same time. Anyway, Sanitarium must continue to let and create value in the short term and long term future and also focus on three main of areas being product development with market demands, communication regarding products, operations, services and refocus its attention around charity and community involvement.REFERENCES Sanitarium Game Plan retrieved 2013 http//www. everythingmarketing. co. nz Christopher Adams article retrieved Jun,30 2012 http//www. nzherald. co. nz Ben Fay / News retrieved Mar,20 2013 http//www. stoppress. co. nz/tags/ sanatorium Sanitarium News 2013 http//www. sanitarium. co. nz/about-us/sanitarium-news/2013 Press Release Weetbix Tryathlon retrieved Jan,30 2013 http//www. scoop. co. nz

Bag of Bones CHAPTER SIX

On July 3rd of 1998, I threw both suitcases and my Powerbook in the trunk of my mid-sized Chevrolet, started to h gray-headed up vote eat up the drive mien, whence gamey and went into the house again. It felt empty and almosthow forlorn, deal substanti everyy a faithful l everywhere who has been dropped and rotternot understand wherefore. The furniture wasnt covered and the power was windlessness on (I placid that The Great Lake Experiment might turn start to be a swift and total failure), and 14 Benton Street felt bust uped, b arly the same. suite as well as full of furniture to echo still did when I walked through them, and every(prenominal)where in that respect jar againstmed to be too much dusty light.In my study, the VDT was hooded deal an executi unity and completely(a)r against the dust. I knelt before it and opened hotshot of the desk drawers. In view were four reams of paper. I took whiz, started a room with it under my arm, then had a second thought and dour back. I had put that provocative photo of Jo in her swimsuit in the wide center drawer. Now I took it, tore the paper wrapping from the clo confident(predicate) of the ream of paper, and slid the photo halfway in, wish a bookmark. If I did perchance begin to salve again, and if the wri canfulg marched, I would meet Johanna indemnify around page two hundred and fifty.I go forth the house, locked the back doorstep, got into my car, and drove away. I have never been back.Id been tempted to go d testify to the lake and check bug proscribed the feat which turned out to be quite a bit more ex decennarysive than notification Dean had origin bothy expected on several occasions. What kept me away was a ruling, never quite articulated by my conscious mind al bingle still very powerful, that I wasnt supposed to do it that way that when I adjoining came to Sara, it should be to unpack and stay. posting hired out Kenny Auster to shingle the roof, and got Kennys cousin, Timmy Larribee, to scrape the old girl down, a cleansing process akin to pot-scrubbing that is whatever prison terms industrious with log homes. Bill also had a plumber in to check out the pipes, and got my okay to re key some of the older plumbing and the well-pump.Bill fussed almost both these expenses over the teleph one I let him. When it comes to fifth- or sixth-generation Yankees and the expenditure of money, you might as well just stand back and let them mature it out of their systems. Laying out the green just seems wrong to a Yankee, somehow, like petting in public. As for myself, I didnt mind the outgo a bit. I live frug onlyy, for the most part, not out of either moral code but because my imagination, very lively in most other respects, doesnt work very well on the subject of money. My view of a spree is ternary days in Boston, a Red Sox game, a trip to loom Records and Video, plus a visit to the Words worthy bookstore in Cambridge. Living like that doesnt chip in much of a dent in the interest, let alone the lead-in I had a good money manager down in Waterville, and on the day I locked the door of the Derry house and headed west to TR-90, I was worth slightly over five million dollars. Not much compared to Bill Gates, but big numbers for this area, and I could afford to be cheerful active the high cost of house repairs.That was a strange late spring and too soon summer for me. What I did mostly was wait, close up my town affairs, spill to Bill Dean when he outcryed with the latest round of problems, and try not to think. I did the Publishers Weekly interview, and when the interviewer asked me if Id had any trouble getting back to work in the wake of my bereavement, I said no with an absolutely cracking grimace. Why not? It was true. My troubles hadnt started until Id finished All the Way from the Top until then, I had been acquittance on like gangbusters.In mid-June, I met Frank Arlen for lunch at the Starlite Cafe. The Sta rlite is in Lewiston, which is the geographical midpoint between his town and mine. Over dessert (the Starlites famous hemangioma simplex shortcake), Frank asked if I was seeing anyone. I odoured at him with surprise.What are you gaping at? he asked, his plaque registering one of the nine hundred unnamed emotions this one of those somewhere between amusement and irritation. I certainly wouldnt think of it as two-timing Jo. Shell have been dead four years come fearful.No, I said. Im not seeing anybody.He beted at me silently. I looked back for a few seconds, then started fiddling my spoon through the whipped cream on top of my shortcake. The biscuits were still warm from the oven, and the cream was melting. It made me think of that silly old song most how someone left the cake out in the rain.Have you seen anybody, microphone?Im not sure thats any business of yours.Oh for Christs sake. On your vacation? Did you I made myself look up from the melting whipped cream. No, I said. I did not.He was silent for another moment or two. I thought he was getting effect to move on to another topic. That would have been fine with me. Instead, he came right out and asked me if I had been laid at all since Johanna died. He would have accepted a lie on that subject even if he didnt solo believe it men lie about sex all the time. But I told the truth . . . and with a certain perverse pleasure.No.Not a angiotensin-converting enzyme time?Not a iodine time.What about a massage parlor? You k instanter, to at least get a No.He sat in that location tapping his spoon against the rim of the bowl with his dessert in it. He hadnt taken a single bite. He was tone at me as though I were some new and oogy specimen of bug. I didnt like it much, but I suppose I understood it.I had been close to what is these days squalled a relationship on two occasions, n either of them on Key Largo, where I had observed roughly two thousand pretty women walking around dressed in only a stitc h and a promise. Once it had been a red-haired waitress, Kelli, at a eatery out on the Extension where I often had lunch. After a enchantment we got talking, joking around, and then there started to be some of that eye-contact, you know the variety show Im talking about, looks that go on just a elflike too long. I started to notice her legs, and the way her uniform pulled against her hip when she turned, and she noticed me noticing.And there was a woman at Nu You, the place where I used to work out. A statuesque woman who favored pink jog-bras and ignominious bike shorts. Quite yummy. Also, I liked the stuff she brought to read while she pedalled one of the stationary bikes on those endless aerobic trips to nowhere not Mademoiselle or Cosmo, but novels by people like John Irving and Ellen Gilchrist. I like people who read genuine books, and not just because I in one case wrote them myself. Book-readers are just as willing as anyone else to start out with the weather, but as a oecumenic rule they can actually go on from there.The name of the blonde in the pink tops and black shorts was Adria Bundy. We started talking about books as we pedalled type vista by side ever deeper into nowhere, and there came a point where I was spotting her one or two mornings a week in the weight room. in that respects something oddly intimate about spotting. The prone position of the lifter is part of it, I suppose (especially when the lifter is a woman), but not all or even most of it. Mostly its the dependence factor. Although it hardly ever comes to that point, the lifter is trusting the spotter with his or her life. And, at some point in the winter of 1996, those looks started as she lay on the bench and I stood over her, looking into her upside-down face. The ones that go on just a smallish too long.Kelli was around thirty, Adria perhaps a little younger. Kelli was divorced, Adria never married. In neither case would I have been robbing the cradle, and I think eithe r would have been capable to go to bed with me on a provisional basis. Kind of a honey-bump test-drive. Yet what I did in Kellis case was to take a different restaurant to eat my lunch at, and when the YMCA sent me a free exercise-tryout offer, I took them up on it and just never went back to Nu You. I opine walking onetime(prenominal) Adria Bundy one day on the street six months or so after I made the change, and although I said hi, I made sure not to see her puzzled, slightly hurt gaze.In a purely physical way I wanted them both (in fact, I seem to remember a dream in which I had them both, in the same bed and at the same time), and yet I wanted neither. Part of it was my inability to import my life was quite fucked up enough, thank you, without adding any additional complications. Part of it was the work involved in qualification sure that the woman who is returning your glances is enkindle in you and not your rather extravagant bank account.Most of it, I think, was that there was just too much Jo still in my head and midpoint. There was no room for anyone else, even after four years. It was sorrow like cholesterol, and if you think thats funny or eldritch, be grateful.What about friends? Frank asked, at snuff it beginning to eat his strawberry shortcake. Youve got friends you see, dont you?Yes, I said. Plenty of friends. Which was a lie, but I did have lots of crosswords to do, lots of books to read, and lots of movies to watch on my videocas cut backte recorder at night I could practically recite the FBI warning about unlawful copying by heart. When it came to veridical live people, the only ones I called when I got ready to leave Derry were my doctor and my dentist, and most of the mail I sent out that June consisted of change-of address cards to magazines like Harpers and National Geographic.Frank, I said, you pass away like a Jewish mother.Sometimes when Im with you feel like a Jewish mother, he said. One who believes in the curative power s of baked potatoes instead of matzo balls. You look better than you have in a long time, at last put on some weight, I think Too much.Bullshit, you looked like Ichabod Crane when you came for Christmas. Also, youve got some sun on your face and arms.Ive been walking a lot.So you look better . . . except for your eyes. Sometimes you get this look in your eyes, and I give care about you every time I see it. I think Jo would be glad someones geting.What look is that? I asked.Your basic thousand-yard stare. Want the truth? You look like someone whos caught on something and cant get loose.I left Derry at three-thirty, stopped in Rumford for supper, then drove slowly on through the ascension hills of western Maine as the sun lowered. I had final causened my times of departure and arrival carefully, if not quite consciously, and as I passed out of Motton and into the unincorporated townspeople of TR-90, I became aware of the heavy way my heart was beating. There was sweat on my fac e and arms in spite of the cars air conditioning. Nothing on the radio sounded right, all the music like screaming, and I turned it off.I was frighten, and had good reason to be. Even setting aside the unpaired cross-pollination between the dreams and things in the certain world (as I was able to do quite easily, dismissing the cut on my delve and the sunflowers bob uping through the boards of the back influence as either coincidence or so much psychic fluff), I had reason to be scared. Because they hadnt been ordinary dreams, and my decision to go back to the lake after all this time hadnt been an ordinary decision. I didnt feel like a modern fin-de-mill?naire man on a spiritual quest to face his fears (Im okay, youre okay, lets all have an worked up circle-jerk while William Ackerman plays softly in the background) I felt more like some crazy Old Testament prophet going out into the desert to live on locusts and alkali water because God had summoned him in a dream.I was in t rouble, my life was a moderate-going-on-severe mess, and not being able to write was only part of it. I wasnt raping kids or trail around Times Square preaching conspiracy theories through a bullhorn, but I was in trouble just the same. I had lost my place in things and couldnt find it again. No surprise there after all, lifes not a book. What I was pleasing in on that hot July evening was self-induced shock therapy, and give me at least this much credit I knew it.You come to Dark Score this way 1-95 from Derry to Newport Route 2 from Newport to Bethel (with a stop in Rumford, which used to stink like hells front porch until the paper-driven economy pretty much ground to a halt during Reagans second term) Route 5 from Bethel to Waterford. Then you take Route 68, the old County Road, across Castle View, through Motton (where downtown consists of a converted barn which sells videos, beer, and second- mass rifles), and then past the sign which reads TR-90 and the one reading GAME WA RDEN IS BEST ASSISTANCE IN EMERGENCY, DIAL 1-800-555-GAME OR * 72 ON CELLULAR PHONE. To this, in sprayer paint, someone has added FUCK THE EAGLES.Five cubic centimeters past that sign, you come to a narrow lane on the right, marked only by a straightforward of tin with the faded number 42 on it. Above this, like umlauts, are a couplet of. 22 holes.I turned into this lane just about when I had expected to it was 716 P.M., EDT, by the clock on the Chevrolets dashboard.And the feeling was flood tide home.I drove in two tenths of a mile by the odometer, listening to the mark which crowned the lane whickering against the undercarriage of my car, listening to the occasional branch which scraped across the roof or knocked on the passenger side like a fist.At last I parked and turned the engine off. I got out, walked to the rear of the car, lay down on my belly, and began pulling all of the grass which touched the Chevys hot exhaust system. It had been a dry summer, and it was best t o take precautions. I had come at this exact hour in order to copy my dreams, hoping for some further insight into them or for an idea of what to do next. What I had not come to do was start a forest fire.Once this was do I stood up and looked around. The crickets sang, as they had in my dreams, and the trees huddled close on either side of the lane, as they always did in my dreams. Overhead, the sky was a fading strip of blue.I set off, walking up the right hand wheelrut. Jo and I had had one neighbor at this end of the road, old Lars Washburn, but now Larss driveway was overgrown with juniper bushes and blocked by a rusty length of chain. Nailed to a tree on the left of the chain was NO TRESPASSING. Nailed to one on the right was NEXT CENTURY REAL ESTATE, and a local number. The words were faded and hard to read in the growing gloom.I walked on, once more conscious of my heavily beating heart and of the way the mosquitoes were buzzing around my face and arms. Their peak season was past, but I was sweating a lot, and thats a smell they like. It must(prenominal) remind them of blood.Just how scared was I as I approached Sara Laughs? I dont remember. I suspect that fright, like pain, is one of those things that flake out our minds once they have passed. What I do remember is a feeling Id had before when I was down here, especially when I was walking this road by myself. It was a sense that reality was thin. I think it is thin, you know, thin as lake ice after a thaw, and we fill our lives with noise and light and motion to wipe out that thinness from ourselves. But in places like Lane Forty-two, you find that all the smoke and mirrors have been removed. Whats left is the sound of crickets and the sight of green leaves darkening toward black branches that make shapes like faces the sound of your heart in your chest, the beat of the blood against the backs of your eyes, and the look of the sky as the days blue blood runs out of its cheek.What comes in when twenty-four hour period leaves is a kind of certainty that beneath the struggle there is a secret, some mystery both black and bright. You feel this mystery in every breath, you see it in every shadow, you expect to plunge into it at every turn of a step. It is here you slip across it on a kind of breathless curve like a skater turning for home.I stopped for a moment about half a mile south of where Id left the car, and still half a mile north of the driveway. Here the road curves sharply, and on the right is an open field which slants steeply down toward the lake. Tidwells Meadow is what the locals call it, or sometimes the Old Camp. It was here that Sara Tidwell and her curious tribe built their cabins, at least according to Marie Hingerman (and once, when I asked Bill Dean, he agreed this was the place . . . although he didnt seem interested in continuing the conversation, which struck me at the time as a bit odd).I stood there for a moment, looking down at the north end of Dar k Score. The water was glassy and calm, still candy-colored in the afterglow of sunset, without a single ripple or a single small craft to be seen. The boat-people would all be down at the marina or at Warringtons Sunset Bar by now, I guessed, eating lobster rolls and drinking big mixed drinks. Later a few of them, buzzed on speed and martinis, would go bolting up and down the lake by moonlight. I wondered if I would be around to hear them. I thought there was a fair chance that by then Id be on my way back to Derry, either panic-stricken by what Id found or disillusioned because I had found nothing at all.You funny little man, said Strickland.I didnt know I was going to speak until the words were out of my mouth, and why those words in particular I had no idea. I remembered my dream of Jo under the bed and shuddered. A mosquito whined in my ear. I slapped it and walked on.In the end, my arrival at the head of the driveway was almost too perfectly timed, the sense of having re-ente red my dream almost too complete. Even the balloons tied(p) to the SARA LAUGHS sign (one blanched and one blue, both with WELCOME BACK MIKE carefully printed on them in black ink) and shove alonging against the ever-darkening backdrop of the trees seemed to intensify the d?j? vu I had quite deliberately induced, for no two dreams are exactly the same, are they? Things conceived by minds and made by hands can never be quite the same, even when they try their best to be identical, because were never the same from day to day or even moment to moment.I walked to the sign, feeling the mystery of this place at twilight. I squeezed down on the board, feeling its rough reality, and then I ran the ball of my thumb over the letters, daring the matchwood and reading with my skin like a blind man reading braille S and A and R and A L and A and U and G and H and S.The driveway had been cleared of fallen pick uples and blown-down branches, but Dark Score glimmered a fading rose just as it ha d in my dreams, and the sprawled behemoth of the house was the same. Bill had thoughtfully left the light over the back stoop burning, and the sunflowers growing through the boards had long since been cut down, but everything else was the same.I looked overhead, at the slot of sky over the lane. Nothing . . . I waited . . . and nothing . . . waiting still . . . and then there it was, right where the center of my gaze had been trained. At one moment there was only the fading sky (with indigo just starting to rise up from the edges like an infusion of ink), and at the next genus Venus was glowing there, bright and steady. People talk about watching the stars come out, and I suppose some people do, but I think that was the only time in my life that I actually saw one appear. I wished on it, too, but this time it was real time, and I did not wish for Jo.Help me, I said, looking at the star. I would have said more, but I didnt know what to say. I didnt know what kind of help I needed.Th ats enough, a voice in my mind said uneasily. Thats enough, now. Go on back and get your car.Except that wasnt the plan. The plan was to go down the driveway, just as I had in the final dream, the nightmare. The plan was to prove to myself that there was no shroud-wrapped monster lurking in the shadows of the big old log house down there. The plan was pretty much based on that bit of New Age wisdom which says the word fear stands for Face Everything And Recover. But, as I stood there and looked down at that spark of porch light (it looked very small in the growing darkness), it occurred to me that theres another bit of wisdom, one not quite so good-morning-starshine, which suggests fear is actually an acronym for buttocks Everything And Run. stand there by myself in the woods as the light left the sky, that seemed like the smarter interpretation, no two ways about it.I looked down and was a little amused to see that I had taken one of the balloons untied it without even noticing as I thought things over. It floated serenely up from my hand at the end of its drawstring, the words printed on it now impossible to read in the growing dark.Maybe its all moot, anyway maybe I wont be able to move. Maybe that old devil writers walk has got hold of me again, and Ill just stand here like a statue until someone comes along and hauls me away.But this was real time in the real world, and in the real world there was no such thing as writers walk. I opened my hand. As the string Id been holding floated free, I walked under the rising balloon and started down the driveway. Foot followed foot, pretty much as they had ever since Id first learned this trick back in 1959. I went deeper and deeper into the clean but sour smell of pine, and once I caught myself taking an extra-big step, avoiding a fallen branch that had been in the dream but wasnt here in reality.My heart was still thudding hard, and sweat was still pouring out of me, oiling my skin and drawing mosquitoes. I r aised a hand to b flock the hair off my brow, then stopped, holding it splay-fingered out in front of my eyes. I put the other one next to it. Neither was marked there wasnt even a shadow of scar from the cut Id given myself while crawling around my bedroom during the ice storm. Im all right, I said. Im all right.You funny little man, said Strickland, a voice answered. It wasnt mine, wasnt Jos it was the UFO voice that had narrated my nightmare, the one which had driven me on even when I wanted to stop. The voice of some outsider.I started walking again. I was better than halfway down the driveway now. I had reached the point where, in the dream, I told the voice that I was xenophobic of Mrs. Danvers.Im afraid of Mrs. D., I said, trying the words aloud in the growing dark. What if the bad old housekeepers down there?A loon cried on the lake, but the voice didnt answer. I suppose it didnt have to. There was no Mrs. Danvers, she was only a bag of bones in an old book, and the voice k new it.I began walking again. I passed the big pine that Jo had once banged into in our Jeep, trying to back up the driveway. How she had sworn Like a sailor I had managed to keep a straight face until she got to Fuck a duck, and then Id lost it, leaning against the side of the Jeep with the heels of my hands pressed against my temples, howling until tears rolled down my cheeks, and Jo perceptible hot blue sparks at me the whole time.I could see the mark about three feet up on the trunk of the tree, the white seeming to float higher up the dark bark in the gloom. It was just here that the unease which pervaded the other dreams had skewed into something distant worse. Even before the shrouded thing had come bursting out of the house, I had felt something was all wrong, all twisted up I had felt that somehow the house itself had gone insane. It was at this point, passing the old mark pine, that I had wanted to run like the gingerbread man.I didnt feel that now. I was afraid, yes, but not in terror. There was nothing behind me, for one thing, no sound of slobbering breath. The worst thing a man was likely to come upon in these woods was an irritated moose. Or, I supposed, if he was really unlucky, a pissed-off bear.In the dream there had been a moon at least three quarters full, but there was no moon in the sky above me that night. Nor would there be in glancing over the weather page in that mornings Derry News, I had noticed that the moon was new.Even the most powerful d?j? vu is fragile, and at the thought of that moonless sky, mine broke. The sensation of re-experiencing my nightmare departed so abruptly that I even wondered why I had through with(p) this, what I had hoped to prove or accomplish. Now Id have to go all the way back down the dark lane to retrieve my car.All right, but Id do it with a gimcracklight from the house. One of them would surely still be just inside the A series of jagged explosions ran themselves off on the far side of the lake, the last loud enough to echo against the hills. I stopped, drawing in a quick breath. Moments before, those unexpected bangs believably would have sent me running back up the driveway in a panic, but now I had only that brief, startled moment. It was firecrackers, of course, the last one the loudest one maybe an M-80. tomorrow was the Fourth of July, and across the lake kids were celebrating early, as kids are wont to do.I walked on. The bushes still reached like hands, but they had been pruned back and their reach wasnt very threatening. I didnt have to worry about the power being out, either I was now close enough to the back stoop to see moths fluttering around the light Bill Dean had left on for me. Even if the power had been out (in the western part of the state a lot of the lines are still above ground, and it goes out a lot), the gennie would have kicked in automatically.Yet I was awed by how much of my dream was actually here, even with the powerful sense of repetition o f reliving departed. Jos planters were where theyd always been, flanking the path which leads down to Saras little lick of beach I suppose Brenda Meserve had found them stacked in the cellar and had had one of her crew set them out again. Nothing was growing in them yet, but I suspected that stuff would be soon. And even without the moon of my dream, I could see the black square on the water, rest about fifty yards offshore. The swimming float.No oblong shape lying overturned in front of the stoop, though no coffin. Still, my heart was beating hard again, and I think if more firecrackers had gone off on the Kashwakamak side of the lake just then, I might have screamed.You funny little man, said Strickland.Give me that, its my dust-catcher.What if death drives us insane? What if we survive, but it drives us insane? What then?I had reached the point where, in my nightmare, the door banged open and that white shape came hurtling out with its wrapped arms upraised. I took one more ste p and then stopped, hearing the harsh sound of my respiration as I drew each breath down my throat and then pushed it back out over the dry floor of my tongue. There was no sense of d?j? vu, but for a moment I thought the shape would appear anyway here in the real world, in real time. I stood waiting for it with my sweaty hands clenched. I drew in another dry breath, and this time I held it.The soft lap of water against the shore.A breeze that patted my face and rattled the bushes.A loon cried out on the lake moths battered the stoop light.No shroud-monster threw open the door, and through the big windows to the left and right of the door, I could see nothing moving, white or otherwise. There was a note above the knob, probably from Bill, and that was it. I let out my breath in a rush and walked the rest of the way down the driveway to Sara Laughs.The note was indeed from Bill Dean. It said that Brenda had done some shopping for me the supermarket receipt was on the kitchen table, and I would find the pantry well stocked with canned goods. Shed gone easy with the perishables, but there was milk, butter, half-and-half, and hamburger, that staple of single-guy cuisine.I will see you next Mon., Bill had written. If I had my druthers Id be here to say hello in person but the good wife says its our turn to do the holiday trotting and so we are going down to Virginia (hot) to spend the 4th with her sister. If you need anything or run into problems . . .He had jotted his sister-in-laws phone number in Virginia as well as macho Wigginss number in town, which locals just call the TR, as in Me and mother got tired of Bethel and moved our trailer over to the TR. There were other numbers, as well the plumber, the electrician, Brenda Meserve, even the TV guy over in Harrison who had repositioned the DSS dish for maximum reception. Bill was taking no chances. I turned the note over, imagining a final P.S. Say, Mike, if nuclear war should break out before me and Yvette ge t back from Virginia Something moved behind me.I whirled on my heels, the note dropping from my hand. It fluttered to the boards of the back stoop like a larger, whiter version of the moths banging the bulb overhead. In that instant I was sure it would be the shroud-thing, an insane revenant in my wifes decaying body, Give me my dust-catcher, give it to me, how dare you come down here and disturb my rest, how dam you come to Manderley again, and now that youre here, how will you ever get away? Into the mystery with you, you silly little man. Into the mystery with you.Nothing there. It had just been the breeze again, stirring the bushes around a little . . . except I had felt no breeze against my sweaty skin, not that time. swell it must have been, theres nothing there, I said.The sound of your voice when youre alone can be either scary or reassuring. That time it was the latter. I bended over, picked up Bills note, and stuffed it into my back pocket. Then I rummaged out my keyring. I stood under the stoop light in the big, swooping shadows of the light-struck moths, picking through my keys until I found the one I wanted. It had a funny disused look, and as I rubbed my thumb along its serrated edge, I wondered again why I hadnt come down here except for a couple of quick broad daylight errands in all the months and years since Jo had died. Surely if she had been alive, she would have insisted But then a peculiar realization came to me it wasnt just a matter of since Jo died. It was easy to think of it that way never once during my six weeks on Key Largo had I thought of it any other way but now, actually standing here in the shadows of the dancing moths (it was like standing under some weird organic disco ball) and listening to the loons out on the lake, I remembered that although Johanna had died in rarefied of 1994, she had died in Derry. It had been miserably hot in the city . . . so why had we been there? Why hadnt we been sitting out on our shady dec k on the lake side of the house, drinking iced tea in our bathing suits, watching the boats go back and forth and commenting on the form of the various water-skiers? What had she been doing in that damned Rite Aid parking lot to begin with, when during any other tremendous we would have been miles from there?Nor was that all. We usually stayed at Sara until the end of September it was a peaceful, pretty time, as warm as summer. But in 93 wed left with August only a week gone. I knew, because I could remember Johanna going to New York with me later that month, some kind of publishing deal and the usual partner publicity crap. It had been dog-hot in Manhattan, the hydrants spraying in the East Village and the uptown streets sizzling. On one night of that trip wed seen The Phantom of the Opera. Near the end Jo had leaned over to me and susurrused, Oh fuck The Phantom is snivelling again I had spent the rest of the show trying to keep from bursting into wild peals of laughter. Jo co uld be evil that way.Why had she come with me that August? Jo didnt like New York even in April or October, when its sort of pretty. I didnt know. I couldnt remember. All I was sure of was that she had never been back to Sara Laughs after early August of 1993 . . . and before long I wasnt even sure of that.I slipped the key into the lock and turned it. Id go inside, flip on the kitchen overheads, grab a common mullein, and go back for the car. If I didnt, some drunk guy with a cottage at the far south end of the lane would come in too fast, rear-end my Chevy, and sue me for a billion dollars.The house had been aired out and didnt smell a bit musty instead of still, stale air, there was a faint and pleasing aroma of pine. I reached for the light inside the door, and then, somewhere in the blackness of the house, a child began to sob. My hand froze where it was and my flesh went cold. I didnt panic, exactly, but all rational thought left my mind. It was droopy, a childs weeping, but I hadnt a clue as to where it was coming from.Then it began to fade. Not to grow softer but to fade, as if someone had picked that kid up and was stock uping it away down some long corridor. . . not that any such corridor existed in Sara Laughs. Even the one running through the middle of the house, connecting the central section to the two wings, isnt really long.Fading . . . faded . . . almost gone.I stood in the dark with my cold skin crawling and my hand on the lightswitch. Part of me wanted to boogie, to just go flying out of there as fast as my little legs could carry me, running like the gingerbread man. Another part, however the rational part was already reasserting itself.I flicked the switch, the part that wanted to run saying forget it, it wont work, its the dream, stupid, its your dream coming true. But it did work. The foyer light came on in a shadow-dispelling rush, revealing Jos lumpy little pottery collection to the left and the bookcase to the right, stuff I hadn t looked at in four years or more, but still here and still the same. On a middle shelf of the bookcase I could see the three early Elmore Leonard novels Swag, The Big Bounce, and Mr. Majestyk that I had put aside against a spell of rainy weather you have to be ready for rain when youre at camp. Without a good book, even two days of rain in the woods can be enough to drive you bonkers.There was a final whisper of weeping, then silence. In it, I could hear ticking from the kitchen. The clock by the stove, one of Jos rare lapses into bad taste, is Felix the Cat with big eyes that shift from side to side as his pendulum tail flicks back and forth. I think its been in every cheap horror movie ever made.Whos here? I called. I took a step toward the kitchen, just a dim space move beyond the foyer, then stopped. In the dark the house was a cavern. The sound of the weeping could have come from anywhere. Including my own imagination. Is someone here?No answer . . . but I didnt think the s ound had been in my head. If it had been, writers block was the least of my worries.Standing on the bookcase to the left of the Elmore Leonards was a long-barrelled flashlight, the kind that holds eight D-cells and will temporarily blind you if someone shines it directly into your eyes. I grasped it, and until it nearly slipped through my hand I hadnt really realized how heavily I was sweating, or how scared I was. I juggled it, heart beating hard, half-expecting that creepy sobbing to begin again, half-expecting the shroud-thing to come floating out of the black living room with its shapeless arms raised some old hack of a politician back from the grave and ready to give it another shot. Vote the straight Resurrection ticket, brethren, and you will be saved.I got control of the light and turned it on. It shot a bright straight aerate into the living room, picking out the moosehead over the fieldstone open fireplace it shone in the heads glass eyes like two lights burning under wa ter. I saw the old cane-and-bamboo chairs the old couch the scarred dining-room table you had to balance by shimming one leg with a folded playing card or a couple of beer coasters I saw no ghosts I decided this was a seriously fucked-up carnival just the same. In the words of the immortal Cole Porter, lets call the whole thing off. If I headed east as soon as I got back to my car, I could be in Derry by midnight. Sleeping in my own bed.I turned out the foyer light and stood with the flash drawing its line across the dark. I listened to the tick of that stupid cat-clock, which Bill must have set going, and to the familiar chugging cycle of the refrigerator. As I listened to them, I realized that I had never expected to hear either sound again. As for the crying . . .Had there been crying? Had there really?Yes. Crying or something. Just what now seemed moot. What seemed germane was that coming here had been a dangerous idea and a stupid course of action for a man who has taught his m ind to misbehave. As I stood in the foyer with no light but the flash and the glow falling in the windows from the bulb over the back stoop, I realized that the line between what I knew was real and what I knew was only my imagination had pretty much disappeared.I left the house, checked to make sure the door was locked, and walked back up the driveway, swinging the flashlight beam from side to side like a pendulum like the tail of old Felix the Krazy Kat in the kitchen. It occurred to me, as I struck north along the lane, that I would have to make up some sort of story for Bill Dean. It wouldnt do to say, Well, Bill, I got down there and heard a kid bawling in my locked house, and it scared me so bad I turned into the gingerbread man and ran back to Derry. Ill send you the flashlight I took put it back on the shelf next to the paperbacks, would you? That wasnt any good because the story would get around and people would say, Not surprised. Wrote too many books, probably. Work like that has got to soften a mans head. Now hes scared of his own shadow. Occupational hazard.Even if I never came down here again in my life, I didnt want to leave people on the TR with that opinion of me, that half-contemptuous, see-what-you-get-for-thinking-too-much attitude. Its one a lot of folks seem to have about people who live by their imaginations.Id tell Bill I got sick. In a way it was true. Or no . . . better to tell him someone else got sick . . . a friend . . . someone in Derry Id been seeing . . . a lady-friend, perhaps. Bill, this friend of mine, this lady-friend of mine got sick, you see, and so . . . I stopped suddenly, the light shining on the front of my car. I had walked the mile in the dark without noticing many of the sounds in the woods, and dismissing even the bigger of them as deer settling down for the night. I hadnt turned around to see if the shroud-thing (or maybe some spectral crying child) was following me. I had gotten involved in making up a story and then embellishing it, doing it in my head instead of on paper this time but going down all the same well-known paths. I had gotten so involved that I had neglected to be afraid. My heartbeat was back to normal, the sweat was drying on my skin, and the mosquitoes had stopped whining in my ears. And as I stood there, a thought occurred to me. It was as if my mind had been waiting patiently for me to calm down enough so it could remind me of some essential fact.The pipes. Bill had gotten my go-ahead to replace most of the old stuff, and the plumber had done so. Very recently hed done so.Air in the pipes, I said, running the beam of the eight-cell flashlight over the grille of my Chevrolet. Thats what I heard.I waited to see if the deeper part of my mind would call this a stupid, rationalizing lie. It didnt . . . because, I suppose, it realized it could be true. Airy pipes can sound like people talking, dogs barking, or children crying. Perhaps the plumber had bled them and the sound h ad been something else . . . but perhaps he hadnt. The question was whether or not I was going to galvanize in my car, back two tenths of a mile to the highway, and then return to Derry, all on the basis of a sound I had heard for ten seconds (maybe only five), and while in an excited, stressful state of mind.I decided the answer was no. It might take only one more peculiar thing to turn me around probably gibbering like a character on Tales from the Crypt but the sound Id heard in the foyer wasnt enough. Not when making a go of it at Sara Laughs might mean so much.I hear voices in my head, and have for as long as I can remember. I dont know if thats part of the demand equipment for being a writer or not Ive never asked another one. I never felt the need to, because I know all the voices I hear are versions of me. Still, they often seem like very real versions of other people, and none is more real to me-or more familiar than Jos voice. Now that voice came, sounding interested, amused in an ironic but gentle way . . . and approving.Going to fight, Mike?Yeah, I said, standing there in the dark and picking out gleams of chrome with my flashlight. Think so, babe.Well, then thats all right, isnt it?Yes. It was. I got into my car, started it up, and drove slowly down the lane. And when I got to the driveway, I turned in.There was no crying the second time I entered the house. I walked slowly through the downstairs, keeping the flashlight in my hand until I had turned on every light I could find if there were people still boating on the north end of the lake, old Sara probably looked like some weird Spielbergian flying saucer hovering above them.I think houses live their own lives along a time-stream thats different from the ones upon which their owners float, one thats slower. In a house, especially an old one, the past is closer. In my life Johanna had been dead nearly four years, but to Sara, she was much nearer than that. It wasnt until I was actually insi de, with all the lights on and the flash returned to its spot on the bookshelf, that I realized how much I had been dreading my arrival. Of having my grief reawakened by signs of Johannas interrupted life. A book with a ceding back turned down on the table at one end of the sofa, where Jo had liked to recline in her nightgown, reading and eating plums the cardboard cannister of acquaintance Oats, which was all she ever wanted for breakfast, on a shelf in the pantry her old green robe hung on the back of the bathroom door in the south wing, which Bill Dean still called the new wing, although it had been built before we ever saw Sara Laughs.Brenda Meserve had done a good job a humane job-of removing these signs and signals, but she couldnt get them all. Jos hardcover set of Sayerss Peter Wimsey novels still held pride of place at the center of the living-room bookcase. Jo had always called the moosehead over the fireplace Bunter, and once, for no reason I could remember (certainly i t seemed a very un-Bunterlike accessory), she had hung a bell around the mooses hairy neck. It hung there still, on a red velvet-textured ribbon. Mrs. Meserve might have puzzled over that bell, wondering whether to leave it up or take it down, not knowing that when Jo and I made love on the living-room couch (and yes, we were often overcome there), we referred to the act as ringing Bunters bell. Brenda Meserve had done her best, but any good marriage is secret territory, a necessary white space on societys map. What others dont know about it is what makes it yours.I walked around, touching things, looking at things, seeing them new. Jo seemed everywhere to me, and after a little while I dropped into one of the old cane chairs in front of the TV. The cushion wheezed under me, and I could hear Jo saying, Well excuse yourself, MichaelI put my face in my hands and cried. I suppose it was the last of my mourning, but that made it no easier to bear. I cried until I thought something insi de me would break if I didnt stop. When it finally let me go, my face was drenched, I had the hiccups, and I thought I had never felt so tired in my life. I felt strained all over my body partly from the walking Id done, I suppose, but mostly just from the tension of getting here . . . and deciding to stay here. To fight. That weird dark crying Id heard when I first stepped into the place, although it seemed very distant now, hadnt helped.I washed my face at the kitchen sink, rubbing away the tears with the heels of my hands and change my clogged nose. Then I carried my suitcases down to the guest bedroom in the north wing. I had no intention of sleeping in the south wing, in the master bedroom where I had last slept with Jo.That was a choice Brenda Meserve had foreseen. There was a bouquet of fresh wildflowers on the bureau, and a card WELCOME BACK, MR. NOONAN. If I hadnt been emotionally exhausted, I suppose looking at that message, in Mrs. Meserves spiky copperplate handwritin g, would have brought on another fit of the weeps. I put my face in the flowers and breathed deeply. They smelled good, like sunshine. Then I took off my clothes, leaving them where they dropped, and turned back the coverlet on the bed. Fresh sheets, fresh pillowcases same old Noonan slip between the former and dropping his head onto the latter.I lay there with the bedside lamp on, looking up at the shadows on the ceiling, almost unable to believe I was in this place and this bed. There had been no shroud-thing to greet me, of course . . . but I had an idea it might well find me in my dreams.Sometimes for me, at least theres a transitional bump between waking and sleeping. Not that night. I slipped away without knowing it, and woke the next morning with sunlight shining in through the window and the bedside lamp still on. There had been no dreams that I could remember, only a vague sensation that I had awakened sometime briefly in the night and heard a bell ringing, very thin and far away.

Cells: from Earthlings to Martians

Daniel Petrov 8e Cells From Earthlings to Martians? Mr F. Ade-Davis Science Our model of the cellular phone developed from a lot of good scientists such as Robert Hooke and many others. Robert Hooke discovered cells when he looked at a slice of cork in a microscope. And he had likewise found turn out that it was made of many tiny cells. Furthermore, a Dutch scientist had discovered a large variety of red blood cells and sperm cells and egg cells. Cells atomic number 18 the basic building blocks of all living things.A cell is something really tiny that could non be seen with a naked eye but only using a microscope. They also take in nutrients, convert these nutrients into energy, carry out specialize functions, and reproduce as necessary. Cells have many parts that each do a large variety of different things. Some of the things a cell contains is a cytoplasm and a nucleus. A cytoplasm is a jelly-like fluid that surrounds the nucleus and a nucleus controls the activities that th e whole cell does.Cells also act to moveher to roll and create everything that exists in this world today. One type of cells are known as Bacteria cells. Bacteria were among the first life forms to appear onEarth, and are present in mosthabitatson the planet, growing in soil, water,acidic hot springs, radioactive wasteland and deep in theEarths crust, as well as in organic matter and the live bodies of plants and animals. The vast majority of the bacteria in the body are rendered harmless by the protective effects of the resistive system, and a few arebeneficial.However, a few species of bacteria arepathogenicand could cause some serious infectious diseases, includingcholera,syphilis,anthrax,leprosy, andbubonic plague. They contain a well developedcellstructure. Bacterial cells are fairly small cells that come in many different types such as spheres, rods and spirals. Bacteria cells do non have a nucleus unlike early all of the other cells. They also contain a cell wall, cyptoplas m, a cell membrane and Free DNA.A meteorite had been found on mars that contained many unusual things and forms of life inside it. The objects in the mars meteorite could have been either cells , unknown animals or make up Martians. The evidence for this education being true could be that when scientists had examined the marvellous rock , the gas trapped inside it matched the atmosphere on mars. Also, the rocks that fall on human beings every day are not usual types of rocks, but rocks that are often very hard to be recognized. Scientists could and hould share their findings with other scientists so they back link the things that they have found out. By sharing your findings, not only would they learn new and interesting things from each other, but they would also see if the information is correct and very accurate. Furthermore, Peer review could be a good thing to do because people would learn a great deal most their writing, they get good feedback from fellow scientists and they are able to improve their findings by using other peoples information.On the other hand, peer review could not be such a positive but a negative thing because they could not like for other people to see their findings and work, or the information given could not have strengths but weaknesses. In conclusion, I personally think that the objects and gasses found inside the meteorite could be real because scientists have observed the rock and have also found out that gasses the rock contained matched the whole of the atmosphere on Mars.Also, peer review is a good thing to do because you share you findings with other scientists and get positive feed back and how you could improve the things you have found out by being more accurate. This also links to the development of cells because Robert Hooke had found out that the strip of cork he was observing using the microscope contained and was made up of many small cells, and he had shared this with many the other scientists and thats how the understanding of the cell has been improved through these many years.

Sci 241 Week 5

(Rein herculean/Age Fotostock America, Inc. ) CHAPTER 8 CONCEPTS I I I I I I I I I Thiamin, ribo? avin, nicotinic paneling, biotin, and pantothenic acidulated atomic number 18 B vitamins compulsory to crap ATP from carbohydrate, fat, and protein. Vitamin B6 is historic for amino group acid metabolic process as salubrious as faculty production. Folate is a coenzyme that is ask for kiosk division. Vitamin B12, only found in animal foods, is requisite for case serve well and to activate vitamin Bc. Vitamin C is needful to song connective tissue and acts as a watersoluble antioxidant. Vitamin A is essential for vision, and it regulates cell differentiation and growth. Vitamin D is obligatory for raise vigorousness.Vitamin E is a fat-soluble antioxidant. Vitamin K is essential for declination clotting. u s t A Ta s t e J Do vitamins give you extra muscularity? Should e rattling sensation take folacin affixs? Does expeling carrots correct your vision? Can vitamin E protect you from meaning disease? The Vitamins Vitamins atomic number 18 vital to Your Health Vitamins Provide Many Different lots in the Body Vitamins Are Found in Almost Everything You Eat We Need Enough further Not Too Much of Each Vitamin Some Vitamins Are Soluble in Water and Others Are Soluble in Fat Many B Vitamins Are Essential for Energy Production Thiamin Important for Nerve Function Ribo? vin A B secure Yel emit Vitamin niacin De? ciency Ca utilise an Epidemic of Mental Illness Biotin Eggs Contain It plainly Can Block Its Use Pantothenic pane of glass Widely Distri scarceed in regimen and Widely Used in the Body Vitamin B6 Is Important for Protein Metabolism Vitamin B6 Is Needed to Synthesize and Break Down Amino Acids twain zoology and Plant foods Are Good Sources of Vitamin B6 Too Much Vitamin B6 Is Toxic Folate and Vitamin B12 Are Needed for Cell Division Folate Important for speedily Dividing Cells Vitamin B12 Absorption Requires Intrinsic Factor Vitami n C Saved Sailors from blue Vitamin C Is Needed toMaintain Connective Tissue Vitamin C Is a soluble Antioxidant citrus fruit Fruit Is wizard of the Best Sources of Vitamin C Vitamin C Is the Most Common Vitamin Supplement Choline Is It a Vitamin? Vitamin A Is Needed for Healthy Eyes Vitamin A Comes in Pre postulate toed and Precursor Forms Vitamin A Requires Fat for Absorption and Protein for Transport Vitamin A Is Necessary for Vision Vitamin A Regulates Gene Expression -Carotene Is a Vitamin A Precursor and an Antioxidant Vitamin A Needs Can Be Met with Plant and Animal Sources Vitamin A De? iency Is a World Health Problem Preformed Vitamin A Can Be Toxic Vitamin D Can Be Made in the Skin Vitamin D Is Needed to Maintain Normal Calcium Levels Vitamin D De? ciency Causes Weak B peerlesss Only a Few Foods Are Natural Sources of Vitamin D Too Much Vitamin D Causes Calcium to Deposit in the Wrong Tissues Vitamin E Protects Membranes Vitamin E Is a Fat-Soluble Antioxidant Vitamin E De? ciency Dam eons Membranes Most of the Vitamin E in Our Diets Comes from Plant Oils Vitamin E Is Relatively Nontoxic Vitamin K Is Needed for Blood Clotting Vitamin K De? iency Causes Bleeding Drugs That quash Vitamin K Prevent Fatal Blood Clots The Requirement for Vitamin K Is Met by Bacterial Synthesis and Food Sources 8 INTRODUCTION Vitamin D Concerns on the ride By K arn Collins, R. D. Dec. 5, 2003A inadequacy of vitamin Dthought to be a problem of a byg one(a) erais showing up in maturement numbers of women, children, and the elderly, increasing the chance of bone disease and possibly otherwise health problems. Exposing only the face, hands, and forearms to sunlight for 10 to 30 minutes, just two or three daytimes a week, contri howevere usually produce all the vitamin D we need.Longer motion-picture show doesnt produce more of this vitamin. Yet today, close to peoples lifestyles and locations do non allow them to produce complete, making nourishmentetical sou rces vital. For more information on vitamin D concerns go to www. msnbc. msn. com/id/3660416. A rent vitamin de? ciency diseases a thing of the past? After all, the vitamins wee been identi? ed, characterized, and puri? ed. We get them from foods that ar natural sources and they argon added to our breakfast cereal and sold in pill form. For over 100 years scientists have been experimenting with how ofttimes of which ones we need to stay healthy and public health of? ials have been providing us with guidelines as to how better to get enough from our diets. How preempt anyone have a de? ciency? Despite advances in vitamin research over the last century, millions of people around the globe still suffer from vitamin de? ciency diseases. In the linked States, the plentiful and 235 236 Chapter 8 The Vitamins varied food supply deposit unrelenting vitamin de? ciencies un homogeneously but this doesnt mean everyone gets enough of everything all the time. Marginal de? ciencies very much go unnoticed and can be mistaken for other conditions. Vitamins Are Vital to Your HealthL Vitamins Organic compounds compulsory * in the diet in small amounts to promote and regulate the chemical reactions and processes needed for growth, reproduction, and the maintenance of health. Vitamins be essential to your health. You only need very small quantities but if you dont get enough your form cannot function optimally. Severe de? ciencies coiffe debilitating diseases but even marginal intakes can cause subtle changes that affect your health today and your risk of chronic disease tomorrow. An organic substance is classi? ed as a vitamin if lack of it in the diet causes symptoms that are relieved by adding it back to the diet.The fact that the vitamins we finish in food are essential to health seems simple and obvious, but it was not always so. For centuries, people knew that about diseases could be cured by certain foods. But it was a long time before we understood why pa rticular foods relieved speci? c ailments. Cures attributed to foods seemed like zero point short of a miracle. People too weak to rise from their beds, those with bleeding wounds that would not heal, those too mentally disturbed to function in society, and those with other life-threatening ailments were cured with changes in diet.Even before the chemistry of these substances was unraveled, the civilized world was enchanted with the magic of vitamins. They brought hope that incurable diseases could be remedied by simple dietetical assentings. Today we understand what vitamins do and why they cure de? ciency diseases, but we still hold out hope for more miracles from these small molecules. And we might get a few. Scientists continue to discover important links between vitamins and the risk of create illnesses such(prenominal) as heart disease, cancer, osteoporosis, and high countercurrent pressure. What is being uncovered is faraway subtler than the miracle cures of the 19thce ntury de? iency diseases, but people cling to the belief that taking more vitamins will cure what ails them. As a result of this more is always better place vitamin toxicities have become a concern. A toxic reaction can be as devastating as a de? ciency. Trying to get the right amount of apiece of the vitamins whitethorn sound analogous to take the airing a tightrope between not enough and too much. In reality it is not that hard to get enough of most vitamins from a well-planned diet and most toxicities are not cause by foods but alternatively by excessive use of supplements. Vitamins de coloured many different functions in the formTo date, 13 substances have been identi? ed as vitamins essential in the diet (Table 8. 1). They were named alphabetically in approximately the govern in which they were identi? ed A, B, C, D, and E. The B vitamins were ? rst thought to be one chemical substance but were later found to be many different substances, so the alphabetical name was bro ken batch by numbers. Vitamins B6 and B12 are the only ones that are still commonly referred to by their numbers. Thiamin, ribo? avin, and niacin were originally referred to as vitamin B1, B2, and B3, respectively, but today they are not regularly called by these names.Vitamins severally have a unique role in the personate. For instance, vitamin A is needed for vision, vitamin K is needed for pipeline clotting, and vitamin C is needed to combine connective tissue. Many body processes require the strawman of more than one vitamin. For exemplification the B vitamins aneurin, ribo? avin, niacin, biotin, and pantothenic acid are all needed to produce ATP from carbohydrate, fat, and protein. In some cases adequate amounts of one vitamin depend on the presence of another. For example, vitamin B12 is needed to put up the form of vitamin M needed for cell division and vitamin C helps restore vitamin E to its alive(p) form.Vitamins Are Vital to Your Health 237 TABLE 8. 1 Where Doe s Each Vitamin Fit? Water-Soluble Vitamins B Vitamins Thiamin (B1) Ribo? avin (B2) Niacin (B3) Biotin Pantothenic acid Vitamin B6 Folate Vitamin B12 Vitamin C Fat-Soluble Vitamins Vitamin A Vitamin D Vitamin E Vitamin K Vitamins are found in just about everything you eat Almost all foods contain some vitamins (Figure 8. 1). Grain products are cheeseparing sources of the B vitamins thiamin, niacin, ribo? avin, pantothenic acid, and vitamin B6. Meats, such as beef, pork, and chicken, and ? sh are good sources of all of the B vitamins.Milk gives ribo? avin and vitamins A and D leafy greens, such as spinach and kale, provide vitamin M, vitamin A, vitamin E, and vitamin K citrus fruits like oranges and grapefruit provide vitamin C and vegetable oils, such as corn and saf? ower oil, are high in vitamin E. FIGURE 8. 1 All the food groups contain choices that are good sources of vitamins. ( Topic film Agency) ( photoDisc, Inc. /Getty Images) Processing affects vitamin content Th e amount of a vitamin in a food depends on the amount by nature found in that food as well as how the food is cooked, stored, and processed.The vitamins naturally found in foods can be washed away during preparation, destroyed by planning, or damaged by exposure to light or oxygen. Thus, processing steps such as canning vegetables, re? ning grains, and drying fruits can cause nutrient losses. However, other processing steps such as forti? cation and enrichment add nutrients to foods. Some nutrients are added to foods to prevent vitamin or mineral de? ciencies and promote health in the population (see Chapter 10). For example, milk is forti? ed with vitamin D to promote bone health, and grains are forti? ed with folic acid to reduce the incidence of render defects.Some foods are excessively forti? ed with nutrients to help extend product sales. Dietary supplements can boost vitamin intake We also get vitamins in dietary supplements. Currently about half of braggy Americans tak e some form of dietary supplement on a daily basis and 80% take them occasionally. 1 While supplements provide speci? c nutrients, they do not provide all the bene? ts of foods. A pill that meets vitamin postulate does not provide the energy, protein, minerals, ? ber, or phytochemicals that would have been supplied by food sources of these vitamins (see Chapter 10).Not all of what you eat can be used by the body The vitamins that we consume in our diets are needed in the cells and ? uids of our body. In order to provide their essential functions, vitamins must get to the target tissues. The amount of a nutrient consumed that can be used by the body is referred to as its bioavailability. Bioavailability is affected by the art object of individual foods, the diet as a hearty, and conditions in the body. For example, the thiamin in certain individual foods such as blueberries and red cabbage cannot be used by the body because these foods contain antithiamin factors that destroy the thiamin.An example of how L Forti? cation A term used usually to * describe the addition of nutrients to foods, such as the addition of vitamin D to milk. L Enrichment The addition of speci? c * nutrients to a food to restore those lost in processing to a level equal to or higher than originally present. L Dietary supplement A product * intended for ingestion in the diet that contains one or more of the following vitamins, minerals, plant-derived substances, amino acids, or concentrates or extracts. L Bioavailability A general term that * refers to how well a nutrient can be imprisoned and used by the body. 38 Chapter 8 The Vitamins Chewing helps break apart fictional character and passage vitamins Bile produced by the liver helps to absorb fat-soluble vitamins Digestion in the stomach releases vitamins from food Some niacin absorption Liver Stomach Digestive enzymes released by pancreas help to further release vitamins Fat-soluble vitamins absorbed from micelles along with die tary fat Pancreas Water-soluble vitamins (thiamin, riboflavin, niacin, vitamin B6, biotin, pantothenic acid) absorbed by simple diffusion, facilitated diffusion, and active lift Vitamin C absorbed in later portion (ileum) of small intestineSmall catgut Vitamin B12 absorbed in later portion (ileum) of small intestine Large Intestine Absorption of small amounts of vitamin K, biotin, and pantothenic acid made by bacteria in the large intestine FIGURE 8. 2 An overview of vitamins in the digestive tract. diet composition affects vitamin bioavailability is dietary fat and the absorption of fatsoluble vitamins. Because fat-soluble vitamins are absorbed along with dietary fat, diets very low in fat reduce absorption (Figure 8. 2). Conditions in the body affect bioavailability in several ways.Some vitamins require speci? c molecules in order to be absorbed. If these arent available, the vitamin cannot be absorbed in suf? cient amounts. For example, vitamin B12 must be bound to a protein pro duced in the stomach before it can be absorbed in the intestine. If this protein is not available, adequate amounts of vitamin B12 cannot be absorbed. Other vitamins require transport molecules to travel in the blood to the tissues that need them. Vitamin A is stored in the liver, but it must be bound to a speci? transport protein to travel in the blood to other tissues therefore, the amount delivered to the tissues depends on the availability of the transport protein. We need enough but not too much of each vitamin The right amounts and combinations of vitamins and other nutrients are essential to health. Despite our knowledge of what vitamins do and how much of each we need, we dont all consume the right amounts. In developing countries, vitamin de? ciencies remain a major public health problem. In industrialized countries, a more varied food supply, along with forti? ation, has almost eliminated vitamin-de? ciency diseases in the majority of the population. Concern in these count ries now focuses on meeting the needs of high-risk groups such as children and pregnant women, determining the notions of marginal de? ciencies such as the effect of low B vitamin intake on heart disease risk, and evaluating the risk of consuming large amounts. The RDAs and AIs of the Dietary Reference Intakes (DRI) recommend amounts that provide enough of Vitamins Are Vital to Your Health 239 each of the vitamins to prevent a de? ciency and promote health (see Chapter 2).Because more is not always better when it comes to nutrient intake, the DRIs have also established tolerable Upper Intake Levels (ULs) as a guide to amounts that are high enough to pose a risk of toxicity (see inside cover). Some vitamins are soluble in water and others are soluble in fat We group vitamins based on their solubility in water or fat, a characteristic that affects how they are absorbed, transported, excreted, and stored in the body. The watersoluble vitamins allow the B vitamins and vitamin C. The fat-soluble vitamins include vitamins A, D, E, and K (see Table 8. 1) With he exception of vitamin B12, the water-soluble vitamins are easily excreted from the body in the urine. Because they are not stored to any great extent, supplies of most water-soluble vitamins are rapidly depleted and they must be consumed regularly in the diet. Nevertheless, it takes more than a few geezerhood to develop de? ciency symptoms, even when these vitamins are completely eliminated from the diet. Fatsoluble vitamins, on the other hand, are stored in the liver and fatty tissues and cannot be excreted in the urine. In general, because they are stored to a larger extent, it takes longer to develop a de? iency of fat-soluble vitamins when they are no longer provided by the diet. In this chapter the water-soluble vitamins are presented ? rst because many foregather an important role in the reactions that produce energy from carbohydrate, fat, and protein that have been addressed in Chapters 4 through 7 (Table 8. 2). L Water-soluble vitamins Vitamins that * dissolve in water. L Fat-soluble vitamins Vitamins that * dissolve in fat. TABLE 8. 2 A Quick perish to the Water-Soluble Vitamins Food Sources Pork, whole and enriched grains, seeds, nuts, legumes Recommended Intake for Adults 1. 1. 2 mg/day Major Functions Coenzyme in glucose metabolism, needed for neurotransmitter discount and normal mettle function Coenzyme needed in energy metabolism De? ciency Symptoms Berberi weakness, apathy, irritability, nerve itch, poor coordination, paralysis, heart changes In? ammation of mouth and tongue, cracks at corners of the mouth Pellagra diarrhea, dermatitis on areas exposed to sun, dementia Groups at Risk of De? ciency Alcoholics, those living in poverty Toxicity and UL none reported. No UL Vitamin Thiamin (vitamin B1, thiamin mononitrate) Ribo? vin (vitamin B2) Dairy products, 1. 11. 3 mg/day whole and enriched grains, leafy green vegetables, meats Beef, chicken, ? sh, peanuts, legum es, whole and enriched grains. Can be made from tryptophan 1416 mg NE/day None None reported. No UL Niacin (nicotinamide, nicotinic acid, vitamin B3) Coenzyme needed in energy metabolism and lipid deductive reasoning and break deal Those consuming a limited diet based on corn, inebriantics Flushing, nausea, rash, tingling extremities. UL is 35 mg from forti? ed foods and supplements (Continued) 240 Chapter 8 The Vitamins TABLE 8. 2 (Continued )Food Sources Liver, clump yolks, synthesised in the gut Recommended Intake for Adults 30 g/day Major Functions De? ciency Symptoms Groups at Risk of De? ciency Those consuming large amounts of raw egg albumens, alcoholics None Toxicity and UL None reported. No UL Vitamin Biotin Coenzyme in Dermatitis, glucose production nausea, and lipid synthesis drop-off, hallucinations Pantothenic acid (calcium pantothenate) Vitamin B6 ( pyridoxamine, pyridoxal, pyridoxamine) Meat, legumes, whole grains, widespread in foods Meat, ? sh, poultry, legum es, whole grains, nuts and seeds silvery-leaved green vegetables, legumes, seeds, enriched grains 5 mg/dayCoenzyme in Fatigue, rash energy metabolism and lipid synthesis and breakdown Coenzyme in protein metabolism, neurotransmitter and hemoglobin synthesis Coenzyme in DNA synthesis and amino acid metabolism Headache, numbness, tingling, convulsions, nausea, poor growth, genus Anemia Macrocytic anemia, in? ammation of tongue, diarrhea, poor growth, neural tube defects Pernicious anemia, macrocytic anemia, nerve damage Scurvy poor wound healing, bleeding gums, loose teeth, bone fragility, joint pain, pinpoint hemorrhages Liver dysfunction None reported. No UL Numbness, nerve damage. UL is 100 mg 1. 31. 7 mg/day Women, alcoholicsFolate (folic acid, folacin, pteroyglutamic acid) cd g DFE/day Pregnant women, alcoholics Masks B12 de? ciency. UL is 1000 g from forti? ed food and supplements None reported. No UL Animal products 2. 4 g/day Vitamin B12 (cobalamin, cyanocobalamin) Coenzyme in pteroylmonoglutamic acid metabolism, nerve function Vegans, women, those with stomach or intestinal disease Alcoholics, elderly men Vitamin C (ascorbic acid, ascorbate) citrus fruit fruit, broccoli, strawberries, greens, peppers 7590 mg/day Collagen (connective tissue) synthesis hormone and neurotransmitter synthesis, antioxidant Synthesis of cell membranes and neurotransmittersGI distress, diarrhea. UL is 2000 mg Choline* Egg yolks, organ meats, leafy greens, nuts, body synthesis 425550 mg/day None Sweating low blood pressure, liver damage. UL is 3500 mg UL, Tolerable Upper Intake Level NE, niacin akin DFE, dietary folate equivalent. *Choline is technically not a vitamin but recommendations have been made for its intake. Many B Vitamins Are Essential for Energy Production 241 Many B Vitamins Are Essential for Energy Production For many people the term vitamin is synonymous with energy. But vitamins do not actually contain any energy at all.We get energy from the carbohydrate , fat, and protein in our diet, but we cant use the energy contained in these nutrients without the help of vitamins. The B vitamins thiamin, ribo? avin, niacin, pantothenic acid, and biotin are at a time involved in converting the energy in carbohydrate, fat, and protein into ATPthe form of energy that is used to run the body (Figure 8. 3). Each of these vitamins acts as a coenzyme in one or more of the chemical reactions necessary to generate useable energy from these nutrients (Figure 8. 4). Thiamin important for nerve functionThiamin is needed for nerve cells to grasp energy and to synthesize an important neurotransmitter. A de? ciency of thiamin causes beriberi, a condition that has been known for over 1000 years in East Asian countries. In Sri Lanka, the word beriberi literally means I cannot this phrase refers to the extreme weakness that is the earliest symptom of the condition. Beriberi came to the attention of Western medicine in colonial Asia in the 19th century. It b ecame such a problem that the Dutch East India Company sent a team of scientists to ? nd its cause. What they were expecting to ? d was a germ like those that caused cholera and rabies. What they found for a long time was nothing. For over 10 years, a young physician named Christian Eijkman worked C C C C C C Although people often take B vitamins to get more energy these vitamins do not actually provide energy. They are and necessary for the body to produce energy from other nutrients. L Coenzymes Small nonprotein organic * molecules that act as carriers of electrons or atoms in metabolic reactions and are necessary for the proper functioning of many enzymes. L Beriberi The disease resulting from a * de? iency of thiamin. O C C O C C C C C OH C C Glucose Fatty acid Amino acids Niacin Biotin Niacin Riboflavin Biotin Pantothenic acid Niacin Riboflavin Biotin Pantothenic acid O2 Thiamin Riboflavin Niacin Pantothenic acid C C Thiamin Riboflavin Pantothenic acid C C C Niacin Riboflavin piss CO2 ATP FIGURE 8. 3 Thiamin, ribo? avin, niacin, biotin, and pantothenic acid are needed in the reactions that produce energy from carbohydrate, fat, and protein. If one of these is missing, energy production is disrupted. 242 Chapter 8 The Vitamins Coenzyme partial enzymeActive enzyme A B A B Enzyme reaction FIGURE 8. 4 The B vitamins serve as coenzymes. This ? gure shows that the coenzyme must bind to form an active enzyme. The enzyme in this example can then join A and B to form a new molecule, shown here as AB. AB to ? nd the cause of beriberi. His success came as a twist of fate. He ran out of food for his experimental chickens and instead of the usual brown rice, he fed them white rice. curtly thereafter, the chickens came down with beriberi-like symptoms. When he fed them brown rice again, they got well. What did this mean?To Eijkman it provided evidence that the cause of beriberi was not a poison or a microorganism, but rather something missing from the chicken feed. The incidence of beriberi in East Asia increase dramatically the 1800s collectable to the rising popularity of polished rice. Polished or white rice is produced by polishing off the bran layer of brown rice creating a more uniform product. However, polishing off the bran also removes the vitamin-rich portion of the grain (Figure 8. 5). consequently, in populations where white rice was the staple of the diet, beriberi, became a common health problem.FIGURE 8. 5 Unenriched white rice is a poor source of thiamin. (Charles D. Winters) L Wernicke-Korsakoff syndrome A form * of thiamin de? ciency associated with alcohol abuse that is characterized by mental confusion, freak out, loss of memory, and a staggering gait. Thiamin is needed to produce energy from glucose The reason thiamin is needed for nerve cells to obtain energy is because it is a coenzyme for some of the important energy-yielding reactions in the body. unitary of these is essential for the production of energy from gluc ose, the energy source for nerve cells.In addition to its role in energy production it is needed for neurotransmitter synthesis and is also essential for the metabolism of other sugars and certain amino acids, and for the synthesis of ribose, a sugar that is part of the structure of RNA (ribonucleic acid). Thiamin de? ciency affects the nervous and cardiovascular systems. Without thiamin, glucose, which is the primary fuel for the brain and nerve cells, cannot be used normally and nerve impulses cannot be transmitted normally. This leads to weakness and depression, which are the ? st symptoms of beriberi other neurological symptoms include poor coordination, tingling sensations, and paralysis. The reason de? ciency affects the cardiovascular system is not well understood, but symptoms include rapid heartbeat and enlargement of the heart. Overt beriberi is rare in northwest America today, but a form of thiamin de? ciency called Wernicke-Korsakoff syndrome does advance in alcoholics . People with this condition experience mental confusion, psychosis, memory disturbances, and eventually coma. They are curiously vulnerable because thiamin absorption is decreased due to the effect of alcohol on the GI tract.In addition, thiamin intake is low because alcohol contributes calories to the alcoholics diet but brings with it almost no nutrients. Many B Vitamins Are Essential for Energy Production RDA Sunflower seeds (1/4 c) Walnuts (1/4 c) Peanuts (1/4 c) Lentils (1 c) Pork (3 oz) Beef (3 oz) Trout (3 oz) Chicken (3 oz) 2% Milk (1 c) Cheddar high mallowflower (1. 5 oz) orange tree juice (1 c) kiwi (2 med) orchard apple tree (1 med) Corn (1/2 c) edible asparagus (1/2 c) Spinach, raw (1 c) Oatmeal (1 c) Spaghetti (1 c) Brown rice (1 c) White kail (2 sl) Whole-wheat cole (2 sl) 0 0. 2 0. 4 0. 6 0. 8 Thiamin (mg) 1. 0 1. 2 243FIGURE 8. 6 Thiamin content of selections from each group of the Food Guide Pyramid. The dashed line represents the RDA for adult men. Pork is a better source of thiamin than other meats. (Randy Mayor/Foodpix/PictureArts Corp. ) The recommended intake for thiamin can be met by eating a varied diet You can meet your needs for thiamin by snacking on sun? ower seeds and having a serving of roast pork for dinner. These foods are exceptionally good sources of thiamin. Together 3 ounces of pork and a quarter cup of sun? ower seeds provide 1. 5 mg of thiamin, well above the RDA, which is 1. mg per day for adult men age 19 and older and 1. 1 mg per day for adult women 19 and older. 2 But even a diet that doesnt include these foods can meet your thiamin needs as long as you make nutritious choices such as those recommended by the Food Guide Pyramid (Figure 8. 6). Legumes, nuts, and seeds are good sources. Grains are also good sources thiamin is found in the bran of whole grains and it is added to enriched re? ned grains. A large proportion of the thiamin consumed in the United States comes from enriched grains used in foods such as baked goods. Some breakfast cereals are forti? d with so much additional thiamin that a single bowlful contains more than the RDA. Although it is easy to meet thiamin needs some of the thiamin in foods whitethorn be destroyed during formulation or storage because it is sensitive to heat, oxygen, and low-acid conditions. Thiamin availability is also affected by the presence of antithiamin factors that destroy the vitamin. There are enzymes in raw shell? sh and freshwater ? sh that degrade thiamin during food storage and preparation and during passage through the gastrointestinal tract. These enzymes are destroyed by cooking so they are only a concern in foods consumed raw.Other antithiamin factors that are not inactivated by cooking are found in tea, coffee, betel nuts, blueberries, and red cabbage. Habitual consumption of foods containing antithiamin factors increases the risk of thiamin de? ciency. 2 Despite the fact that intakes of thiamin above the RDA have not been shown to be bene? cial, many supplements contain up to 50 mg of thiamin and promise that they will provide more energy. Although thiamin is needed to produce energy, unless it is de? cient, increasing thiamin intake does not increase the ability to produce energy.There is no UL for thiamin since no toxicity has been reported when excess is consumed from any food or supplements. 2 Enriched grains have thiamin as well as ribo? avin, niacin, and iron added to them (see Chapter 4). * Remember 244 Chapter 8 The Vitamins Ribo? avin a bright yellow vitamin Ribo? avin is a water-soluble vitamin that provides a visible indicator when you consume too much of it. Excess is excreted in your urineturning it a bright ? uorescent yellow. The color may surprise you but it is harmless. No perverse effects have been reported from high doses of ribo? vin from foods or supplements. FIGURE 8. 7 Milk is packaged in solid or cloudy containers to protect its ribo? avin from destruction by light. (Charles D. Winter s) Milk is the best source of ribo? avin in the North American diet Ever wonder why milk comes in opaque cardboard or cloudy plastic containers? The reason is that it is one of the best sources of ribo? avin in our diet and ribo? avin is destroyed by light. If your milk was in a clear glass bottle and sat in a lighted grocery store display case for several days much of the ribo? avin would be destroyed. The most ribo? vin-friendly milk containers are opaque so the ribo? avin is fully protected from light (Figure 8. 7). Other major dietary sources of ribo? avin include other dairy products, liver, red meat, poultry, ? sh, whole grains, and enriched breads and cereals. Vegetable sources include asparagus, broccoli, mushrooms, and leafy green vegetables such as spinach. The RDA for ribo? avin for adult men age 19 and older is 1. 3 mg per day and for adult women 19 and older, 1. 1 mg per day. 3 Two cups of milk provide about half the amount of ribo? avin recommended for a typical adult. If you do not include milk in your diet you can meet your ribo? avin needs by including two to three servings of meat and four to ? ve servings of enriched grain products and high-ribo? avin vegetables such as spinach (Figure 8. 8). Ribo? avin is needed to produce energy from carbohydrate, fat, and protein Ribo? avin has two active coenzyme forms that function in producing energy from carbohydrate, fat, and protein. Ribo? avin is also involved directly or indirectly in converting a number of other vitamins, including folate, niacin, vitamin B6, and vitamin K, into their active forms. When ribo? vin is de? cient, injuries heal poorly because new cells cannot grow to replace the damaged ones. Tissues that grow most rapidly, such as the skin and the lin- RDA Sunflower seeds (1/4 c) Walnuts (1/4 c) Peanuts (1/4 c) Lentils (1 c) Pork (3 oz) Beef (3 oz) Trout (3 oz) Chicken (3 oz) 2% Milk (1 c) Cheddar cheese (1. 5 oz) Orange juice (1 c) Kiwi (2 med) Apple (1 med) Corn (1/2 c) Asparagus ( 1/2 c) Spinach, raw (1 c) FIGURE 8. 8 Ribo? avin content of selections from each group of the Food Guide Pyramid. The dashed line represents the RDA for adult men. Milk is an exceptionally good source of ribo? avin. Corbis Images) Oatmeal (1 c) Spaghetti (1 c) Brown rice (1 c) White bread (2 sl) Whole-wheat bread (2 sl) 0 0. 4 0. 8 Riboflavin (mg) 1. 2 Many B Vitamins Are Essential for Energy Production 245 ings of the eyes, mouth, and tongue, are the ? rst to be affected. This causes symptoms such as wisecrack of the lips and at the corners of the mouth increased sensitivity to light burning, tearing, and itching of the eyes and ? aking of the skin around the nose, eyebrows, and earlobes. A de? ciency of ribo? avin rarely guides alone it usually occurs in colligation with de? ciencies of other B vitamins.This is because the same foods provide many of the B vitamins. Because ribo? avin is needed to convert other vitamins into their active forms, some of the symptoms seen with rib o? avin de? ciency re? ect de? ciencies of these other nutrients. Niacin de? ciency caused an epidemic of mental illness In the early 1900s psychiatric hospitals in the southeastern United States were ? lled with patients with the niacin-de? ciency disease pellagra. At the time, no one knew what caused it but the prime suspects were toxins or microorganisms. The mystery of pellagra was ? nally unraveled by Dr. Joseph Goldberger, who was sent by the U.S. Public Health Service to investigate the pellagra epidemic. He observed that individuals in institutions such as hospitals, orphanages, and prisons suffered from pellagra, but the staff did not. If pellagra were an infectious disease, both populations would be equally affected. Dr. Goldberger proposed that pellagra was due to a de? ciency in the diet. To test his hypothesis, he added nutritious foods such as fresh meats, milk, and eggs to the diet of children in orphanages. The symptoms of pellagra disappeared, supporting his hypothe sis that pellagra is due to a de? ciency of something in the diet.In another experiment he was able to induce pellagra in healthy prison inmates by feeding them an unhealthy diet. The missing dietary component was later identi? ed as the water-soluble B vitamin niacin. L Pellagra The disease resulting from a * de? ciency of niacin. A niacin de? ciency causes dermatitis, diarrhea, and dementia The need for niacin is so widespread in metabolism that a de? ciency causes major changes throughout the body. The early symptoms of pellagra include fatigue, decreased appetite, and indigestion. These are followed by symptoms that can be remembered as the three Ds dermatitis, diarrhea, dementia.If left untreated, niacin de? ciency results in a fourth Ddeath. Niacin coenzymes function in glucose metabolism and in reactions that synthesize fatty acids and cholesterin (see Figure 8. 3). There are two forms of niacin nicotinic acid and nicotinamide. Either form can be used by the body to make the active coenzyme forms. Niacin is found in meats, legumes, and grains Meat and ? sh are good sources of niacin (Figure 8. 9). Other sources include legumes, wheat bran, and peanuts. Niacin added to enriched grains provides much of the usable niacin in the North American diet.Niacin can also be synthesized in the body from the essential amino acid tryptophan. Tryptophan, however, is only used to make niacin if enough is available to ? rst meet the needs of protein synthesis. When the diet is low in tryptophan, it is not used to synthesize niacin. The reason pellagra was everyday in the South in the early 1900s is because the local diet among the poor consisted of corn meal, molasses, and fatback or salt pork all poor sources of both niacin and protein. Corn is low in tryptophan and the niacin found naturally in corn is bound to other molecules and therefore not well absorbed.Molasses contains essentially no protein or niacin and salt pork is almost pure fat, so it does not contain en ough protein to both meet protein needs and synthesize niacin. Although corn-based diets such as this one are historically associated with the appearance of niacin de? ciency it has not been a problem in Mexico and Central American countries. One reason may be because the treatment of corn with lime water, as is done during the making of tortillas, enhances the availability of niacin (Figure 8. 10). The diet in these regions also includes legumes, which provide both niacin and a source of tryptophan for the synthesis of niacin.In searching for the cause of pellagra, Dr. Goldberger and his coworkers ingested blood, nasal secretions, feces, and urine from patients with the diseasenone of them developed pellagra. This helped to overthrow the hypothesis that pellagra was an infectious disease. 246 Chapter 8 The Vitamins RDA Sunflower seeds (1/4 c) Walnuts (1/4 c) Peanuts (1/4 c) Lentils (1 c) Pork (3 oz) Beef (3 oz) Trout (3 oz) Chicken (3 oz) 2% Milk (1 c) Cheddar cheese (1. 5 oz) Ora nge juice (1 c) Kiwi (2 med) Apple (1 med) Corn (1/2 c) Asparagus (1/2 c) Spinach, raw (1 c) FIGURE 8. 9 Niacin content of selections from each group of the Food Guide Pyramid.The dashed line represents the RDA for adult men. Meat, legumes, and grains are good sources of the vitamin. (PhotoDisc, Inc. /Getty Images) Oatmeal (1 c) Spaghetti (1 c) Brown rice (1 c) White bread (2 sl) Whole-wheat bread (2 sl) 0 2 4 6 8 10 Niacin (mg) 12 14 16 L Niacin equivalents (NEs) The * measure used to state the amount of niacin present in food, including that which can be made from its precursor, tryptophan. One NE is equal to 1 mg of niacin or 60 mg of tryptophan. Today, as a result of the enrichment of grains, including corn meal, with niacin, thiamin, ribo? vin, and iron, pellagra is rare in the United States but it remains common in India and parts of chinaware and Africa. Efforts to eradicate this de? ciency include the development of new varieties of corn that provide more available niacin and more tryptophan than traditional varieties. Because some of the requirement for niacin can be met by the synthesis of niacin from tryptophan, the RDA is expressed as niacin equivalents (NEs). One NE is equal to 1 mg of niacin or 60 mg of tryptophan, the amount needed to make 1 mg of niacin. 3 To estimate the niacin contributed by high-protein foods, protein is considered to be about 1% tryptophan.The RDA for adult men and women of all ages is 16 and 14 mg NE per day, respectively. A medium chicken breast and a cup of steamed asparagus provide this amount. FIGURE 8. 10 Tortillas, eaten in Mexico and other Latin American countries, provide niacin because the corn is treated with lime water, making the niacin available for absorption. (Jeff Greenberg/Photo Researchers) Many B Vitamins Are Essential for Energy Production 247 High-dose niacin supplements can be toxic There is no evidence of any adverse effects from consumption of niacin naturally occurring in foods, but supplements c an be toxic.The adverse effects of high intakes of niacin include ? ushing of the skin, a tingling sensation in the hands and feet, a red skin rash, nausea, vomiting, diarrhea, high blood sugar levels, abnormalities in liver function, and blurred vision. The UL for adults is 35 mg, but high-dose supplements of one form of niacin (50 mg or greater) are used under medical supervision to treat elevated blood cholesterol (see Chapter 5). Another form is under investigation for its bene? ts in the prevention and treatment of diabetes. When vitamins are taken in large doses to treat diseases that are not due to vitamin de? iencies, they are truly being used as drugs rather than vitamins. Biotin eggs contain it but can block its use You probably know that you shouldnt eat raw eggs because they can contain harmful bacteria, but did you know that eating raw eggs could cause a biotin de? ciency? Raw egg whites contain a protein called avidin that tightly binds biotin and prevents its absorpt ion. Biotin was discovered when rats fed protein derived from raw egg whites developed a syndrome of whisker loss, dermatitis, and neuromuscular dysfunction. Thoroughly cooking eggs kills bacteria and denatures avidin so that it cannot bind biotin (Figure 8. 1). FIGURE 8. 11 Raw eggs are often used to make high-protein health drinks. This is not recommended because raw eggs may contain bacteria that can make you sick, and egg whites contain a protein that makes biotin unavailable. (Charles D. Winters) Biotin is important in energy production and glucose synthesis Biotin is a coenzyme for a group of enzymes that add an acid group to molecules. It functions in energy production and in glucose synthesis. It is also important in the metabolism of fatty acids and amino acids (see Figure 8. 3). Although biotin de? iency is uncommon, it has been observed in those frequently consuming raw egg whites as well as people with malabsorption or protein-energy malnutrition, those receiving intrav enous feedings lacking biotin, and those taking certain anticonvulsant drugs for long periods. 3 Biotin de? ciency in humans causes nausea, thinning hair, loss of hair color, a red skin rash, depression, lethargy, hallucinations, and tingling of the extremities. Biotin is consumed in the diet and made by bacteria in the gut Good sources of biotin in the diet include cooked eggs, liver, yogurt, and nuts. Fruit and meat are poor sources.Biotin is also synthesized by bacteria in the gastrointestinal tract. Some of this is absorbed into the body and contributes to our biotin needs. An AI of 30 mg per day has been established for adults based on the amount of biotin found in a typical North American diet. High doses of biotin have not resulted in toxicity symptoms there is no UL for biotin. Pantothenic acid widely distributed in food and widely used in the body Pantothenic acid, which gets its name from the Greek word pantos (meaning from everywhere), is widely distributed in foods. It i s particularly abundant in meat, eggs, whole grains, and legumes.It is found in lesser amounts in milk, vegetables, and fruits. In addition to being from everywhere in the diet, pantothenic acid seems to be needed everywhere in the body. It is part of a key coenzyme needed for the breakdown of carbohydrates, fatty acids, and amino acids as well as the modi? cation of proteins and the synthesis of neurotransmitters, steroid hormones, and hemoglobin. Pantothenic acid is also part of a coenzyme essential for the synthesis of cholesterol and fatty acids (see Figure 8. 3). The wide distribution of pantothenic acid in foods makes de? ciency rare in humans. It may occur as part of a multiple B vitamin de? iency resulting from malnutrition or chronic alcoholism. The AI is 5 mg per day for adults. Pantothenic acid is relatively nontoxic and there are not suf? cient data to establish a UL. 3 248 Chapter 8 The Vitamins Vitamin B6 Is Important in Protein Metabolism Vitamin B6 is one of only two B vitamins that we still know by its number. The chemical name for vitamin B6 is pyridoxine but we rarely hear it called this. The important role of vitamin B6 in amino acid metabolism distinguishes it from the other B vitamins. Vitamin B6 is needed to synthesize and break down amino acids Vitamin B6 has three formspyridoxal, pyridoxine, and pyridoxamine.These can be converted into the active coenzyme form, pyridoxal phosphate, which is needed for the activity of more than 100 enzymes involved in the metabolism of carbohydrate, fat, and protein. It is particularly important in amino acid synthesis and breakdown without vitamin B6 the non-essential amino acids cannot be made in the body (Figure 8. 12). Pyridoxal phosphate is needed to synthesize hemoglobin, the oxygen-carrying protein in red blood cells, and is important for the tolerant system because it is needed to form white blood cells.It is also needed for the conversion of tryptophan to niacin, the release of glucose from th e carbohydrate storage molecule glycogen, the synthesis of certain neurotransmitters, and the synthesis of the lipids that are part of the myelin coating on nerves, which is essential for normal transmission of nerve signals. Vitamin B6 de? ciency causes numbness and tingling Vitamin B6 de? ciency causes neurological symptoms including numbness and tingling in the hands and feet as well as depression, headaches, confusion, and seizures. These symptoms may be related to the role of vitamin B6 in neurotransmitter synthesis and myelin formation.Anemia also occurs in vitamin B6 de? ciency, because without B6 hemoglobin cannot be synthesized normally. Other de? ciency symptoms such as poor growth, skin lesions, and decreased antibody formation may occur because of the central role vitamin B6 plays in protein and energy metabolism. Since vitamin B6 is needed for amino acid metabolism, the on stage of a de? ciency can be hastened by a diet that is low in vitamin B6 but high in protein. H H 2N C C O OH Amino acids NH2 C O OH B6 Energy production and glucose synthesis B6 B6 FIGURE 8. 12 Vitamin B6 is essential for many different types of reactions involving amino acids.It is needed to remove the acid group so neurotransmitters can be synthesized, to remove the amino group so what remains can be used to produce energy or synthesize glucose, and to transfer an amino group to make a new amino acid. Neurotransmitter synthesis NH2 Synthesis of nonessential amino acids Vitamin B6 Is Important in Protein Metabolism Folic acid from food and supplements 249 DNA synthesis Active folate Vitamin B12 Inactive folate Methionine High levels in the FIGURE 8. 13 blood increase cardiovascular The accumulation of homocysteine in the blood is associated with an disease riskHomocysteine Vitamin B6 increased risk of heart disease. Vitamins B6, B12, and folate, are needed to keep homocysteine levels in the normal range. Vitamin B6 is needed to break down homocysteine. Vitamin B12 and folate a re needed to convert homocysteine to methionine. Vitamin B6 perspective is related to heart disease risk Vitamin B6 is needed to break down the amino acid homocysteine. If B6 levels are low, homocysteine cant be broken down and levels rise. Even a mild elevation in blood homocysteine levels has been shown to be a risk factor for heart disease (Figure 8. 13). Two other B vitamins, folate and vitamin B12 are also involved in homocysteine metabolism. These are needed to convert homocysteine to the amino acid methionine. If they are unavailable, homocysteine levels will increase. A study that examined the effect of folate and vitamin B6 intake in women found that those with the highest levels in their diets had about half the risk of coronary heart disease as women with the lowest levels. 5 twain animal and plant foods are good sources of vitamin B6 Animal sources of vitamin B6 include chicken, ? sh, pork, and organ meats.Good plant sources include whole wheat products, brown rice, so ybeans, sun? ower seeds, and some fruits and vegetables such as bananas, broccoli, and spinach (Figure 8. 14). Re? ned grains, like white rice and white bread, are not good sources of vitamin B6, because the vitamin is lost in re? ning whole grains but is not added back in enrichment. It is added to many forti? ed breakfast cereals these make an important contribution to vitamin B6 intake. 6 It is destroyed by heat and light, so it can easily be lost in processing. The RDA for vitamin B6 is 1. 3 mg per day for both adult men and women 19 to 50 years of age. A 3-ounce (85-g) serving of chicken, ? sh, or pork, or half a baked potato, provides about one-fourth of the RDA for an average adult a banana provides about one-third. Too much vitamin B6 is toxic For years people assumed that because water-soluble vitamins were excreted in the urine they could not cause toxic reactions. However, reports in the 1980s of severe nerve deadening in individuals taking 2 to 6 g of pyridoxine per day showed these assumptions to be false. 7 The reactions of some supplement users were so severe that they were unable to walk symptoms alterd when the pyridoxine supplements were stopped.The UL for adults is set at 100 mg per day from food and supplements. 3 Despite the potential for toxicity, high-dose supplements of vitamin B6 containing 100 mg per dose (5000% of the passing(a) Value) are available over the counter, making it easy to obtain a dose that exceeds the UL. These supplements are taken to reduce the symptoms of premenstrual syndrome (premenstrual syndrome), treat carpal cut into syndrome, and strengthen immune function. Although studies have not found a relationship between carpal tunnel syndrome and vitamin B6 status, some studies report that low-dose supplements of vitamin B6 may reduce symptoms of PMS and improve immune function. Individuals with an inherited disease called homocysteinuria have extremely high levels of homocysteine in their blood and may have heart attacks and strokes by the age of 2. 250 Chapter 8 The Vitamins RDA Sunflower seeds (1/4 c) Walnuts (1/4 c) Peanuts (1/4 c) Lentils (1 c) Pork (3 oz) Beef (3 oz) Trout (3 oz) Chicken (3 oz) 2% Milk (1 c) Cheddar cheese (1. 5 oz) Orange juice (1 c) Kiwi (2 med) Apple (1 med) Corn (1/2 c) Asparagus (1/2 c) Spinach, raw (1 c) Oatmeal (1 c) Spaghetti (1 c) Brown rice (1 c) White bread (2 sl) Whole-wheat bread (2 sl) 0 0. 0. 8 Vitamin B6 (mg) 1. 2 FIGURE 8. 14 Vitamin B6 content of selections from each group of the Food Guide Pyramid. The dashed line represents the RDA for men and women up to 50 years of age. The best sources are meats, legumes, and whole grains. (David Bishop/Foodpix/PictureArts Corp. ) PMS causes mood swings, food cravings, bloating, tension, depression, headaches, acne, breast tenderness, anxiety, temper outbursts, and over 100 other symptoms. Because vitamin B6 is needed for the synthesis of the neurotransmitters serotonin and dopamine, insuf? ient vitamin B6 has bee n suggested to cause the anxiety, irritability, and depression associated with PMS by reducing levels of these neurotransmitters. Trials on the effect of vitamin B6 supplements on PMS have had con? icting results in some cases low-dose supplements appear to be effective in reducing symptoms. 9 Vitamin B6 supplements have been found to improve immune function in older adults, but the reason for the improvement is unclear. 10 Immune function can be impaired by a de? ciency of any nutrient that hinders cell growth and division.Therefore, one of the most common claims for vitamin supplements in general is that they improve immune function. Vitamin B6 is no exception. Since the elderly frequently have low intakes of vitamin B6, it is unclear whether the bene? cial effects of supplements are due to an improvement in vitamin B6 status or immune system stimulation. Folate and Vitamin B12 Are Needed for Cell Division Inside the nucleus of every cell is the DNA that holds the genetic code. Be fore a cell can divide it must make a copy of its DNA. The B vitamin folate is needed for the synthesis of DNA and vitamin B12 is needed to keep folate active.Therefore if both B12 or folate is missing, DNA cannot be copied and new cells cannot be made correctly. As a result of this interdependency, many of the same symptoms are seen when either vitamin B12 or folate are de? cient. Folate important for rapidly dividing cells A number of different forms of folate are needed for the synthesis of DNA and the metabolism of some amino acids. Because folate is needed for cells to replicate, it is particularly important in tissues where cells are dividing rapidly such the bone marrow, where red blood cells are made, and the developing tissues of an unborn baby.Folate and Vitamin B12 Are Needed for Cell Division 251 folate adequate folate deficient Normal cell division Red blood cells Red blood cell precursor FIGURE 8. 15 Cells are unable to divide (megaloblast) Macrocyte Megaloblastic or macrocytic anemia occurs when developing blood cells are unable to divide, leaving large immature red blood cells (megaloblasts) and large mature red blood cells (macrocytes). Folate de? ciency results in anemia One of the most notable symptoms of folate de? ciency is anemia. Without folate, developing red blood cells cannot divide. Instead, they just grow bigger (Figure 8. 15).Fewer mature red cells are produced so the oxygen-carrying susceptibility of the blood is reduced. This condition is called megaloblastic or macrocytic anemia. Other symptoms of folate de? ciency include poor growth, problems in nerve development and function, diarrhea, and in? ammation of the tongue. Groups most at risk of a folate de? ciency include pregnant women and premature infants because of their rapid rate of cell division and growth the elderly because of their limited intake of foods high in folate alcoholics because alcohol inhibits folate absorption and tobacco smokers because smoke inactivates folate in the cells lining the lungs. Folate intake is related to neural tube defects A low folate intake increases the risk of give defects that affect the brain and spinal cord called neural tube defects (Figure 8. 16). The exact role of folate in neural tube development is not known, but it is necessary for a critical step called neural tube closure. Neural tube closure occurs very early in gestationonly 28 days after conceptionwhen most women may not yet even know they are pregnant. Therefore to reduce the risk of these defects, folate status must be adequate before a pregnancy begins and during the early critical days of pregnancy (see Chapter 12).However, folate is not the only factor contributing to neural tube defects. Not every pregnant woman with low folate levels gives birth to a child with a neural tube defect. Instead, these birth defects are probably due to a combination of factors that are aggravated by low folate levels. Folate status may affect heart disease and c ancer risk Low folate intake may increase the risk of heart disease because of its relation to homocysteine levels (see Figure 8. 13). Low folate status may also increase the risk of developing cancerL Megaloblastic or macrocytic anemia * A condition in which there are abnormally large immature and mature red blood cells and a reduction in the total number of red blood cells and the oxygen-carrying capacity of the blood. L Neural tube defects Irregularities in * the formation of the portion of the embryo that develops into the brain and spinal cord. These occur early in development and result in brain and spinal cord abnormalities. Vertebrae Spinal cord Vertebrae Spinal cord FIGURE 8. 16 earlyish in pregnancy, the neural tube develops into the brain and spinal cord.If folate is inadequate during neural tube closure, neural tube defects such as spina bi? da, shown here, occur more frequently. In spina bi? da the bones that make up the back do not completely surround the spinal cord, allowing membranes, ? uid, and, in severe cases, the nerves of the spinal cord to bulge out where they are unprotected. Normal spine Spine with spina bifida 252 Chapter 8 The Vitamins For more information on folic acid and birth defects, go to the Spina Bifida Association of America at www. sbaa. org of the uterus, cervix, lungs, stomach, esophagus, and colon. Although folate de? iency does not cause cancer, it has been hypothesized that low folate intake enhances an underlying predisposition to cancer. The relation between folate and cancer is strongest for colon cancer. Alcohol consumption greatly increases the cancer risk associated with a low folate diet. 11 L Dietary folate equivalent (DFE) A unit * used to express the amount of folate available to the body that accounts for the higher bioavailability of folic acid in supplements and enriched foods compared to folate found naturally in foods. One DFE is equivalent to 1 g of folate naturally occurring in food, 0. 6 g of synthet ic folic acid from forti? d food or supplements consumed with food, or 0. 5 g of synthetic folic acid consumed on an empty stomach. Vegetables, legumes, oranges, and grains are good sources of folate Asparagus, oranges, legumes, liver, and yeast are excellent food sources of folate. Fair sources include grains, corn, snap beans, mustard greens, and broccoli, as well as some nuts. Small amounts are found in meats, cheese, milk, fruits, and other vegetables (Figure 8. 17). Folic acid is added to enriched grain products, including enriched breads, ? ours, corn meal, pasta, grits, and rice. If you smack at the label on a bag of enriched ? ur you will see that it is forti? ed with folic acid. Folic acid is a stable form of folate that rarely occurs naturally in food but is used in supplements and forti? ed foods it is more easily absorbed than natural folate. In the 3-year period after the forti? cation of grain products with folic acid, the incidence of neural tube defects decreased by 25%. 12 Women of childbirth age need extra folate The RDA for folate is set at 400 g dietary folate equivalents (DFEs) per day for adult men and women. Expressing needs in DFEs allows one unit to be used for all the forms of folate one DFE is equal to 1 g of food folate, 0. g of synthetic folic acid from forti? ed food or supplements consumed with food, or 0. 5 g of synthetic folic acid consumed on an empty stomach. Because supplementing folic acid early in pregnancy has been shown to reduce neural tube defects, a special recommendation is made for women capable of neat pregnant 400 g of synthetic folic acid from forti? ed foods and/or supplements is recommended in addition to the food folate consumed in RDA Sunflower seeds (1/4 c) Walnuts (1/4 c) Peanuts (1/4 c) Lentils (1 c) Pork (3 oz) Beef (3 oz) Trout (3 oz) Chicken (3 oz) 2% Milk (1 c) Cheddar cheese (1. oz) Orange juice (1 c) Kiwi (2 med) Apple (1 med) Corn (1/2 c) Asparagus (1/2 c) Spinach, raw (1 c) Oatmeal (1 c) Spaghet ti (1 c) Brown rice (1 c) White bread (2 sl) Whole-wheat bread (2 sl) 0 100 200 Folate (g DFE) ccc 400 FIGURE 8. 17 Folate content of selections from each group of the Food Guide Pyramid. The dashed line represents the RDA for adults. Legumes, forti? ed foods, and some fruits and vegetables are good sources. (George Semple) Folate and Vitamin B12 Are Needed for Cell Division 253 PIECE IT TOGETHER Is It Hard to Meet Folate Recommendations?Marcia would like to have a baby but before she tries to conceive, she wants to be sure she is in the best condition possible. She consults her physician who gives her a clean bill of health but suggests she make sure she is getting enough folate. women who are capable of becoming pregnant should consume 400 g of folic acid from forti? ed foods or supplements each day in addition to the folate found in a varied diet. Folic acid is added to enriched grains, so it can be found in any food that contains enriched grains you can run down the ingredient list to see if the food you have chosen contains added folic acid.The percent Daily Value includes both the natural folate and added folic acid. W HY IS FOLATE A CONCERN FOR WOMEN CAPABLE OF BECOMING PREGNANT ? M Research shows that consuming extra folic acid can reduce the risk of a type of birth defect called a neural tube defect that affects an unborn childs brain or spinal cord. For the extra folic acid to be bene? cial, it must be consumed for at least a month before conception and continued for a month after. Since many pregnancies are not planned, it is recommended that all women of childbearing age consume 400 g of folic acid from forti? d foods or supplements. Marcia records her food intake for 1 day to determine her folate intake Food Breakfast Oatmeal, regular Milk Banana Orange juice Coffee Lunch Hamburger Hamburger bun French fries Coke Apple Dinner Chicken Refried beans White rice Tortilla Salad Salad dressing Milk Cake Total Servings 1 cup 1 cup 1 medium 8 ounces 1 c up 1 1 20 pieces 12 ounces 1 medium 3 ounces 1/2 cup 1 cup 1 1 cup 1 Tbsp 1 cup 1 piece Total Folate ( g) 2 12 22 75 0 11 32 24 0 4 4 106 80 60 64 1 12 32 541 g FOLATE INTAKE extend to THE W HICH FOODS IN M ARCIA S DIET ARE HIGHEST IN FOLATE ?O F THESE , WHICH DO YOU THINK HAVE BEEN FORTIFIED WITH FOLIC paneling ? M Food Rice Orange juice Your answers Amount 80 g 75 g Natural Forti? ed W HY IS THE OATMEAL moo IN FOLATE BUT THE OTHER GRAIN PRODUCTS ARE GOOD FOLATE SOURCES ? M Oatmeal is a whole grain, so it has not been forti? ed with folic acid. The other grain products in her diet, such as the white rice, tortilla, and hamburger bun, are re? ned so they contain added folic acid. Even though Marcia is trying to increase her intake of the folic acid form of this vitamin she should not pass up whole grainsthey are good sources of most B vitamins, minerals, and ? er. L IST SOME MODIFICATIONS M ARCIA COULD take aim IN HER DIET TO PROVIDE THE RECOMMENDED AMOUNTS AND FORMS OF FOLATE ? M Your answer W OULD YOU RECOMMEND M ARCIA TAKE A FOLATE SUPPLEMENT ? D OES M ARCIA S RDA? Your answer M Yes. Marica consumes 541 g of folate, which is greater than the RDA of 400 g DFE, but her doctor told her that M 254 Chapter 8 The Vitamins Not everyone needs a folate supplement. If you are male or a female who is too young or too old to have a baby, the amount of folate you get from a healthy diet will meet your needs.Even women of childbearing age can get enough folic acid without a supplement if they eat enough folic acid forti? ed foods. a varied diet. The folic acid form is recommended because it is the form that has been shown to reduce birth defects. This recommendation is made for all women of childbearing age because folate is needed very early in a pregnancybefore most women are aware that they are pregnant. To get 400 g of folic acid, you would need to eat 4 to 6 servings of forti? ed grain products each day or take a supplement containing folic acid.Excess folate ca n mask anemia caused by vitamin B12 de? ciency Although extra folate is recommended for pregnant women, too much is a concern for some groups. There is no known folate toxicity, but a high intake may mask the early symptoms of vitamin B12 de? ciency, allowing it to go untreated so irreversible nerve damage can occur. The UL for adults is set at 1000 g per day of folate from supplements and/or forti? ed foods. This value was determined based on the progression of neurological symptoms seen in patients who are de? cient in vitamin B12 and taking folate supplements.L Pernicious anemia An anemia * resulting from vitamin B de? ciency that 12 Vitamin B12 absorption requires indispensable factor If you lived in the early 1900s and developed a condition called pernicious anemia, it was a death sentence. There was no cure. In the 1920s researchers George Minot and William Murphy pursued their belief that pernicious anemia could be cured by something in the diet. Their experiments were able to restore good health to patients by feeding them about 4 to 8 ounces of slightly cooked liver at every meal. Today we know that liver contains high levels of vitamin B12.We also know that pernicious anemia is not actually caused by a lack of the vitamin in the diet, but rather an inability to absorb the vitamin. Vitamin B12 absorption requires a protein called subjective factor that is produced by cells in the stomach lining. With the help of stomach acid, intrinsic factor binds to vitamin B12 and this vitamin B12-intrinsic factor complex is then absorbed in the small intestine. When very large amounts of the vitamin are consumed, some can be absorbed without intrinsic factor. This is why Minot and Murphy were able to cure pernicious anemia with extremely high dietary doses of the vitamin.Today, pernicious anemia is treated with injections of vitamin B12 rather than plates full of liver. occurs due to a lack of a protein called intrinsic factor needed to absorb dietary vitamin B1 2. L Intrinsic factor A protein produced * in the stomach that is needed for the absorption of adequate amounts of vitamin B12. L Cobalamin The chemical term for * vitamin B . 12 Vitamin B12 is needed for nerve function Vitamin B12, also known as cobalamin, is necessary for the maintenance of myelin, which is the coating that insulates nerves and is essential for nerve transmission.Vitamin B12 is also needed for the production of energy from certain fatty acids and to convert homocysteine to methionine (see Figure 8. 13). This reaction also converts folate from an inactive form to a form that functions in DNA synthesis. Because of the need for vitamin B12 in folate metabolism, a de? ciency can cause a vicarious folate de? ciency and, consequently, macrocytic anemia. Symptoms of vitamin B12 de? ciency include an increase in blood homocysteine levels and anemia that is indistinguishable from that seen in folate de? ciency. Other symptoms include numbness and tingling, bnormalities in gait, memory loss, and disorientation due to degeneration of the myelin that coats the nerves, spinal cord, and brain. If not treated, this eventually causes paralysis and death. Consuming extra folate can mask a vitamin B12 de? ciency When the diet is de? cient in vitamin B12, consuming extra folate can mask the vitamin B12 de? ciency by preventing the appearance of anemia. If the de? ciency is not treated, the other symptoms of B12 de? ciency, such as nerve damage, progress and can be irreversible. This connection between folate and vitamin B12 has raised concerns that our folate-forti? d food supply may allow B12 de? ciencies to go unnoticed. So far, this