Niacin
      Niacin (nicotinic acid or nicotinamide) is essential 
      in the form of the coenzymes nicotinamide adenine dinucleotide (NAD) and NAD 
      phosphate (NADP) in which the nicotinamide moiety acts as an electron acceptor 
      or hydrogen donor in many biological redox reactions. NAD functions as an 
      electron carrier for intracellular respiration, as well as a codehydrogenase 
      with enzymes involved in the oxidation of fuel molecules. NADP functions as 
      a hydrogen donor in reductive biosyntheses such as in fatty acid and steroid 
      syntheses and, like NAD, as a codehydrogenase. 
      Nicotinic acid and nicotinamide are rapidly absorbed 
      from the stomach or the intestine. Nicotinamide, the major form in the bloodstream, 
      arises from enzymatic hydrolysis of NADP in the intestinal mucosa and liver. 
      It is transported to tissues that synthesize their own NAD as needed. Niacin 
      and NAD are biosynthesized from dietary tryptophan via the kynurenine pathway 
      and quinolinic acid. Excess niacin is excreted in the urine primarily as N1-methylnicotinamide and N1-methyl-2-pyridone-5-carboxamide.
      
      Deficiencies: Pellagra, the classic niacin 
      deficiency disease, is characterized by bilateral dermatitis in sun exposed 
      areas, glossitis, diarrhea, and dementia. Often associated with a largely 
      cereal diet such as maize or sorghum, the disease is now rarely seen in industrialized 
      countries but still appears in India, China, and Africa. Pellagra is often 
      associated with other micronutrient deficiencies and may also develop in cases 
      of disturbed tryptophan metabolism (carcinoid syndrome, Hartnup's). 
      
      Clinical uses: Nicotinic acid (but not nicotinamide) 
      given as a drug in doses of 1.5-4 g/day improves the blood cholesterol profile. 
      Nicotinamide acts as a tumor-specific radiosensitizer, possibly due to its 
      effect on vasorelaxation and increased tumor oxygenation. 
      Diet recommendations: The Recommended Dietary 
      Allowances (RDAs) are expressed in niacin equivalents (NE) in which 1 NE = 
      1 mg niacin or 60 mg tryptophan. The RDA ranges from 13-19 NE/day for adults 
      or 6.6 NE per 4.186 MJ (1000 kcal). There is an additional allowance of 2 
      NE/day for pregnancy and 5 NE/day for lactation. The RDA for infants to 1 
      year ranges from 5-6 NE/day and 9-13 NE/day for children ages 9-13 years.
      
      Food sources: Niacin is widely distributed 
      in plant and animal foods, mainly as the pyridine nucleotides NAD and NADP. 
      Good sources are yeast, meats including liver, cereals, legumes, seeds, milk, 
      green leafy vegetables, and fish. 
      Toxicity: Large doses of nicotinic acid given 
      to lower cholesterol may produce flushing of the skin, hyperuricemia, and 
      hepatic abnormalities. These effects are reversed if the drug is reduced in 
      amount or discontinued. 
      Recent research: NAD is the substrate for 
      three classes of enzymes that transfer ADP-ribose units to proteins involved 
      in DNA processing, cell differentiation, and cellular calcium mobilization. 
      Nicotinamide is under investigation for helping prevent and control diabetes.
      
      For further information: 
      Swendseid, M.E., & Jacob, R.A. (1994) Niacin. In: 
      Modern Nutrition in Health and Disease (Shils, M.E., Olson, J.A. & Shike, 
      M., eds.), 8th ed., pp. 376-382. Lea & Febiger, Philadelphia, PA.
      
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