Chapter 9 vitamins and chapter 10 minerals

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Chapter 9 vitamins and chapter 10 minerals

  1. 1. CHAPTER 9: VITAMINS MEDICALBIOCHEMISTRY
  2. 2. THE WONDERFUL WORLD OFVITAMINS/MINERALS/SUPPLEMEN TSPill pushers claim thatsupplements are necessaryto guard your health,compensate for processedfoods, enhance yourathletic abilities, andpromote future “superhealth”
  3. 3. WHAT ARE VITAMINS?s VITAMINS are essential organic substances needed in minute amounts by the body to perform specific metabolic functionss When a vitamin is synthesized from existing chemicals in the body the ingredient to make the conversion are called pro- vitamins (ex: carotine--Vit A.)
  4. 4. THERE IS NO DIFFERENCE OR ADVANTAGE BETWEEN A VITAMIN OBTAINED NATURALLY FROM FOOD AND A SYNTHETIC VITAMINONLY 13 LEGITIMATE VITAMINS EXIST• ORGANIC SUBSTANCES• REQUIRED FOR SPECIFIC METABOLIC FUNCTION• NEEDED IN SMALL AMOUNTS
  5. 5. NON-VITAMINSs RUTIN (Lipoic Acid)s Bioflavonoids (Vit P)s Par-amino-benzoic acid (PABA)s Carnitine (Choline)
  6. 6. Where do Vitamins Come From?s All vitamins are found in green leaves and roots of plants except Vit B12 which is found only in animalss Man cannot synthesize Vit C and most of the fat soluble vitamins
  7. 7. VITAMINABSORPTION
  8. 8. FUNCTIONS OF VITAMINSs essential links and regulators in metabolisms tissue synthesis
  9. 9. TWO TYPES OF VITAMINSs FAT SOLUBLE - A (Retinol); D (Cholecaciferol); E (Tocopherol); K (Menadione)s WATER SOLUBLE - C (Ascorbic Acid); B-complex- Thiamin, Riboflavin, Niacin, B-6, Pantothenic Acid, Biotin, Folacin, B-12
  10. 10. FAT SOLUBLE VITAMINSA, D, E, K - Daily ingestion unnecessary, as they are stored in the liver, fat cells and subcutaneously - No mechanism to leave the body - Can be toxic in excess
  11. 11. FAT SOLUBLE VITAMINSVITAMIN DEFICIENCY EXCESSVit A night blindness headach, vomiting, anorexia swellingVit D rickets vomiting, diarrheaVit E possible anemia relatively nontoxicVit K severe bleeding relatively nontoxic, jaundice
  12. 12. VITAMIN A Carotenoidss Functions - Source of vitamin A - Antioxidants - Other health benefitss Food Sources - Yellow-orange vegetables - Orange fruits - Dark-green leafy vegetables
  13. 13. Three biologically active molecules:retinol, retinal (retinaldehyde) and retinoic acid. R Retinal Retinoic Acid Retinol
  14. 14. ß-carotene is Converted to Vitamin A ß-carotene ß-carotene O2 Dioxygenase Bile salts H C Retinaldehyde O C O H Retinaldehyde
  15. 15. Retinal is Reduced to Retinol H C Retinaldehyde O NADPH (NADH)Retinaldehyde + H+ Reductase NADP+ (NAD+) CH2OH Retinol
  16. 16. Retinal can be Oxidized to Retinoic Acid H C Retinaldehyde O NAD, FAD OH C O Retinoic acid (all-trans)
  17. 17. Cells Dependent on Vitamin As Skins Corneas Tracheas Immunocytes
  18. 18. Bitot’s Spots
  19. 19. Bitot’s Spots
  20. 20. Vitamin A in Food =Carotene + Vitamin A Esters
  21. 21. Hypervitaminosis As Vitamin A (not carotenoids)s Liver damages Hemorrhages Comas Death
  22. 22. Vitamin A Teratogenesiss Associated with > 20% rate of spontaneous abortions and birth defectss 13-cis-retinoic acids During first trimesters Accutane
  23. 23. Anti-carcinogenic Properties of Vitamin As Epidemiologic studies - Colon - Skin, breast, liver, prostate, & lungs Not replicated in basal diet separately or in combinations Other compounds in fruits & vegetables?s Mechanism? - Oxygen radical trap - A complements properties of E
  24. 24. VITAMIN EsA vitamin in search of a disease! “no known evidence of dietary deficiency of vitamin E in humans”s Anti-oxidant effects - protects polyunsaturated fats and vitamin A from destruction by oxygen
  25. 25. Vitamin E (TOCOPHEROLS)-The α-tocopherol molecule is the most potent of the tocopherols.-is absorbed from the intestines packaged in chylomicrons.- is delivered to the tissues via chylomicron transport and then to the liver through chylomicron remnant uptake. The liver can export vitamin E in VLDLs.- Due to its lipophilic nature, vitamin E accumulates in cellular membranes, fat deposits and other circulating lipoproteins.- - The major site of vitamin E storage is in adipose tissue.
  26. 26. Vitamin EMajor Function: -Act as a natural antioxidant by scavenging free radicals and molecular oxygen. In particular vitamin E is important for preventing peroxidation of polyunsaturated membrane fatty acids. The vitamins E and C are interrelated in their antioxidant capabilities.
  27. 27. Sources and Absorption of Vitamin Es Vegetable oilss Bile saltss Pancreatic secretionss Mixed micelless Chylomicrons
  28. 28. Clinical Significances of Vitamin E Deficiencys No major disease states have been found to be associated with vitamin E deficiency due to adequate levels in the average American diet. The major symptom of vitamin E deficiency in humans is an increase in red blood cell fragility. Since vitamin E is absorbed from the intestines in chylomicrons, any fat malabsorption diseases can lead to deficiencies in vitamin E intake.
  29. 29. s Neurological disorders have been associated with vitamin E deficiencies associated with fat malabsorptive disorders.s Increased intake of vitamin E is recommended in premature infants fed formulas that are low in the vitamin as well as in persons consuming a diet high in polyunsaturated fatty acids.s Polyunsaturated fatty acids tend to form free radicals upon exposure to oxygen and this may lead to an increased risk of certain cancers.
  30. 30. Vitamin E
  31. 31. Progression of Neurologic Symptoms of Vitamin E Deficiency + 19 - 25% of patients + 25 - 75% of patients + 75 - 100% of patientsHypoflexia or AreflexiaTruncal AtaxiaLimb AtaxiaPeripheral NeuropathyOphthalmoplegia0 2 4 6 8 10 12 14 16 Age intervals, Year
  32. 32. VITAMIN Ds Vitamin D is a steroid hormone that functions to regulate specific gene expression following interaction with its intracellular receptor.
  33. 33. VITAMIN Ds The biologically active form of the hormone is 1,25-dihydroxy vitamin D3 (1,25-(OH)2D3, also termed calcitriol).s Calcitriol functions primarily to regulate calcium and phosphorous homeostasis.
  34. 34. THE ROLE OF VITAMIN Ds Maintains plasma calcium & phosphorous concentrationss Supports cellular processes, neuromuscular function, & bone ossifications Enhances calcium & phosphorous absorption from small intestine & mobilization from bone
  35. 35. VITAMIN DExists as several lipids;1) D3 - made in skin exposed to sunlight.2) D2 - additive in fortified milk
  36. 36. Ergocalciferol (vitamin D2)Cholecalciferol (vitamin D3)
  37. 37. Vitamin DMetabolism
  38. 38. Bone Mineral Content in Children w/ Cholestasis Changes inBone Mineral Content
  39. 39. Bowed Legs of Rickets
  40. 40. Rachitic Rosary
  41. 41. TOXICITY OF VITAMIN Ds War-time supplementation - 2,000 IU + 50 - 100 % more - Nutritional deprivation - Lack of sunlights Epidemic of calcimias Some permanent brain damages Resultant laws in Europe
  42. 42. VITAMIN Ds Deficiency - Rickets in children - Osteomalacia and osteoporosis in adultss Toxicity - Hypercalcemia
  43. 43. VITAMIN Ks Functions - Blood clotting - Formation of bones Food sources - Green vegetables, liver, egg yolks
  44. 44. VITAMIN K(P hylloquinone)
  45. 45. Hemorrhagic Disease of the Newborns Intrauterine vitamin K deficiencys Sterile intrauterine guts Why/how would Mother Nature let this happen?
  46. 46. Water Soluble Vitaminss Transported throughout the water medium of the bodys Not stored in the body
  47. 47. Deficiency of Water Soluble Vitaminss Pathophysiology is result of reduced enzyme activities.s Multiple deficiencies are common.s Diagnostic Challenge? To recognize multiple findings.
  48. 48. Drugs may act as Vitamin Analogs (Media Serv)
  49. 49. Toxicity of Water Soluble Vitaminss Toxicity recapitulates deficiency if co-enzyme ≠ vitamins Enzyme inactivations Thiamin, Riboflavin, Niacin, Niacin, Pyridoxine, Folic acids Not Biotin or Vitamin C
  50. 50. Causes of Water Soluble Vitamin Deficiencys Decreased intakes Decreased absorption - Enhanced loss during enterohepatic circulations Requirement - Pregnancys Decreased Precursor - Inborn error of metabolism
  51. 51. B Vitamins s B vitamins act primarily as coenzymes s Work as catalysts s Function in energy- producing metabolic reactions
  52. 52. VITAMIN B1s (THIAMIN) Functions - Coenzyme in energy metabolism - Helps synthesize neurotransmitterss Food sources - Whole and enriched grains - Pork, legumes, nuts, livers Deficiency - Beriberi
  53. 53. VITAMIN B1 (THIAMIN)
  54. 54. TPP-ATP Phosphoryltransferase ATP TPPThiamine TPP Thiamine-ATP Phosphoryl Transferase
  55. 55. Clinical Significances of Thiamin Deficiencys The earliest symptoms of thiamin deficiency include constipation, appetite suppression, nausea as well as mental depression, peripheral neuropathy and fatigue.s Chronic thiamin deficiency leads to more severe neurological symptoms including ataxia, mental confusion and loss of eye coordination.s Other clinical symptoms of prolonged thiamin deficiency are related to cardiovascular and musculature defects.
  56. 56. The severe thiamin deficiency disease is known asBeriberi, is the result of a diet that is carbohydrate richandt hiamindeficient.An additional thiamin deficiency related disease isknown as Wernicke-Korsakoff syndrome. This diseaseis most commonly found in chronic alcoholics due totheir poor dietetic lifestyles.Wernicke-Korsakoff syndrome is characterized byacute encephalopathy followed by chronic impairmentof short-term memory. Persons afflicted with Wernicke-Korsakoff syndrome appear to have an inborn error ofmetabolism that is clinically important only when thediet is inadequate in thiamin.
  57. 57. Dry Beriberi
  58. 58. Wet Beriberi
  59. 59. VITAMIN B2 (RIBOFLAVIN)s Functions - Coenzyme in energy metabolism - Supports antioxidantss Food sources - Milk and dairy products - Whole and enriched grainss Deficiency - Ariboflavinosis
  60. 60. VITAMIN B2 (RIBOFLAVIN)s Riboflavin is the precursor for the coenzymes, flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD).s The enzymes that require FMN or FAD as cofactors are termed flavoproteins.
  61. 61. VITAMIN B2(RIBOFLAVIN)
  62. 62. Clinical Significances of Flavin Deficiencys Riboflavin deficiency is often seen in chronic alcoholics due to their poor dietetic habits.s Symptoms associated with riboflavin deficiency include itching and burning eyes, angular stomatitis and cheilosis (cracks and sores in the mouth and lips), bloodshot eyes, glossitis (inflammation of the tongue leading to purplish discoloration), seborrhea (dandruff, flaking skin on scalp and face), trembling, sluggishness, and photophobia (excessive light sensitivity).s Riboflavin decomposes when exposed to visible light.
  63. 63. VITAMIN B3 (NIACIN)s Functions - Coenzyme in energy metabolism - Supports fatty acid synthesiss Food sources - Whole and enriched grains - Meat, poultry, fish, nuts, and peanutss Deficiency - Pellagras Toxicity - High doses used to treat high blood cholesterol - Side effects: skin flushing, liver damage
  64. 64. VITAMIN B3 (NIACIN)•Niacin (nicotinic acid and nicotinamide) is also knownas vitamin B3. Both nicotinic acid and nicotinamidecan serve as the dietary source of vitamin B3.•Niacin is required for the synthesis of the active formsof vitamin B3, nicotinamide adenine dinucleotide(NAD+) and nicotinamide adenine dinucleotidephosphate (NADP+). Both NAD+ and NADP+ functionas cofactors for numerous dehydrogenases, e.g.,lactate dehydrogenase and malate dehydrogenase.
  65. 65. NICOTINAMIDE AND NICOTINIC ACID
  66. 66. Clinical Significances of Niacin and Nicotinic Acid•A diet deficient in niacin (as well as tryptophan) leads to glossitisof the tongue (inflammation of the tongue leading to purplishdiscoloration), dermatitis, weight loss, diarrheAdepression anddementia. The severe symptoms, depression, dermatitis anddiarrhea, are associated with the condition known as pellagra.•Nicotinic acid (but not nicotinamide) when administered inpharmacological doses of 2–4 g/day lowers plasma cholesterollevels and has been shown to be a useful therapeutic forhypercholesterolemia. The major action of nicotinic acid in thiscapacity is a reduction in fatty acid mobilization from adiposetissue. Although nicotinic acid therapy lowers blood cholesterol italso causes a depletion of glycogen stores and fat reserves inskeletal and cardiac muscle.
  67. 67. Pellagra’s Dermatitis- Hand
  68. 68. Pellagra’s Dermatitis- Foot
  69. 69. Casal’s Necklace &Hyperpigmentation ofHands:Before & After NiacinTherapy
  70. 70. Pellagra GI & CNSGI symptomsVomitingDiarrheaCNS findingsDepression, insomnia, headaches, dizzinessProgression to limb rigidity, paresis, and fatalencephalopathy
  71. 71. VITAMIN B-6s Pyridoxal, pyridoxamine and pyridoxine are collectively known as vitamin B6.s All three compounds are efficiently converted to the biologically active form of vitamin B6, pyridoxal phosphate (PLP).s This conversion is catalyzed by the ATP requiring enzyme, pyridoxal kinase.
  72. 72. VITAMIN B-6Pyridoxine Pyridoxal Pyridoxamine
  73. 73. VITAMIN B-6 Pyridoxal Phosphate
  74. 74. VITAMIN B-6s Pyridoxal phosphate functions as a cofactor in enzymes involved in transamination reactions required for the synthesis and catabolism of the amino acids as well as in glycogenolysis as a cofactor for glycogen phosphorylase and as a co-factor for the synthesis of the inhibitory neurotransmitter γ-aminobutyric acid (GABA).s The requirement for vitamin B6 in the diet is proportional to the level of protein consumption ranging from 1.4–2.0 mg/day for a normal adult. During pregnancy and lactation the requirement for vitamin B6 increases approximately 0.6 mg/day.
  75. 75. VITAMIN B-6s Deficiencies of vitamin B6 are rare and usually are related to an overall deficiency of all the B-complex vitamins.s Other symptoms that may appear with deficiency in vitamin B6 include nervousness, insomnia, skin eruptions, loss of muscular control, anemia, mouth disorders, muscular weakness, dermatitis, arm and leg cramps, loss of hair, slow learning, and water retention.
  76. 76. VITAMIN B-6s Functions - Coenzyme in protein and amino acid metabolism - Supports immune systems Food sources - Meat, fish, poultry, liver - Potatoes, bananas, sunflower seedss Deficiency - Microcytic hypochromic anemias Toxicity - Can cause permanent nerve damage in high doses
  77. 77. VITAMIN B9 (FOLATE)s Functions - Coenzyme in DNA synthesis and cell division - Needed for normal red blood cell synthesiss Food sources - Green leafy vegetables, orange juice, legumes - Fortified cereals, enriched grains
  78. 78. VITAMIN B9 (FOLATE)
  79. 79. FOLATEs Deficiency - Megaloblastic anemia - Can contribute to neural tube defects - Women of childbearing age need 400 micrograms/day of folic acids Toxicity - Can mask vitamin B12 deficiency
  80. 80. CLINICAL SIGNIFICANCE OF FOLATEFolate deficiency results in complications nearlyidentical to those described for vitamin B12 deficiency.The inability to synthesize DNA during erythrocytematuration leads to abnormally large erythrocytestermed macrocytic anemia.Certain drugs such as anticonvulsants and oralcontraceptives can impair the absorption of folate.
  81. 81. VITAMIN B-12Cobalamin is more commonly known asvitamin B12.Vitamin B12 is composed of a complextetrapyrrol ring structure (corrin ring) and acobalt ion in the center.Vitamin B12 is synthesized exclusively bymicroorganisms and is found in the liver ofanimals bound to protein as methycobalaminor 5‘deoxyadenosylcobalamin.
  82. 82. VITAMIN B-12s Functions - Needed for normal folate function • DNA and red blood cell synthesis - Maintains myelin sheath around nervess Food sources - Only animal foods: meats, liver, milk, eggss Deficiency - Pernicious anemia • Megaloblastic anemia + nerve damage
  83. 83. STRUCTURE OF VITAMIN B-12Cobalamins Corrin ring contains central cobalt atomAdenosylcobalaminMethylcobalamin
  84. 84. VITAMIN B-12VITAMIN C
  85. 85. VITAMIN B-12
  86. 86. VITAMIN B-12Pernicious anemia Megaloblastic anemia Neuropathy: particularly degeneration of spinal cord Universally fatal Extrinsic factor from liverPatients were not producing enough Gastric acid to denature R protein Intrinsic factor
  87. 87. VITAMIN Cs Increases absorption of irons Influences serum cholesterols Affects immune systems Affects synthesis of collagens Affects drug metabolisms Protects DNA in sperm
  88. 88. VITAMIN C (cont)s Megadoses - 1970 Linus Pauling - Vit C & common cold • recover more quicklys Possible effects of megadoses - Gout - Destruction of B vitamins - Breakdown of RBC
  89. 89. VITAMIN C (cont) Ascorbic Acid
  90. 90. VITAMIN Cs Deficiency in vitamin C leads to the disease scurvy due to the role of the vitamin in the post- translational modification of collagens. Scurvy is characterized by easily bruised skin, muscle fatigue, soft swollen gums, decreased wound healing and hemorrhaging, osteoporosis, and anemia.s Vitamin C is readily absorbed and so the primary cause of vitamin C deficiency is poor diet and/or an increased requirement. The primary physiological state leading to an increased requirement for vitamin C is severe stress (or trauma). This is due to a rapid depletion in the adrenal stores of the vitamin.
  91. 91. VITAMIN C (cont)
  92. 92. CHAPTER 10 MINERALSs 4%of the body’s mass is composed of 22 metallic minerals
  93. 93. Major and Minors Major Minerals Minor s Minerals Minerals (< 100 mg/day) (>100 mg/day) - iron - sodium - zinc - potassium - copper - calcium - selenium - phosphorus - iodine - magnesium - fluorine - - chromium sulfur - molybdenum - chlorine - manganese • 4% of body mass consists of minerals
  94. 94. Mineralss BIOAVAILABILITY - HOW MUCH IS ABSORBED BY THE BODY • VITAMIN/MINERAL INTERACTION • FIBER/MINERAL INTERACTION
  95. 95. Where Do Minerals Come From?s Minerals occur freely in nature (rivers, lakes, oceans, topsoil, under earth’s surfaces Minerals are found in root systems of plants and in the body structures of animals that consume plants and waters Best sources of minerals are animal products (because they are more concentrated in animal tissues than in plants)
  96. 96. Function s ofMinerals
  97. 97. Recommended Intakeand Sources of Mineralss Mineral supplements are generally not needed because most minerals are readily available in foods and the water supplys Exceptions include some geographic regions where the soil or water is deficient in a particular mineral - What regions are scarce in iodine? - What is iodized salt? - What is iron insufficiency?
  98. 98. IODINE -is required for the synthesis of thethyroid hormones - plays an important role in theregulation of energy metabolism viathyroid hormone functions.
  99. 99. Iodine- A major Deficiency Problem in the World s Swelling of thyroid gland known as goiter (iodine deficiency) s Hypothyroidism -lower metabolism, Goiter metal retardation, cretinism s 20% of world pop is
  100. 100. Vitamin-Mineral Interactionss Thereis synergism in consuming some minerals and vitamins together - Fe absorption is improved with vitamin C (drink glass orange juice with Fe containing foods) - Ca uptake is facilitated if Ca-rich foods are consumed with foods high in vitamin D
  101. 101. Fiber-Mineral Interactionss Consuming too much fiber (>35g daily) decreases absorption of Ca, Zn, Mg, and Fe These minerals become bound to dietary phytate and oxalate and are excreted in the urine and fecess What are phytate and oxalate? - fiberous compounds that bind minerals • phytates found in coffee, grain fibers • oxalates found in chocolate, tea, coffee
  102. 102. Calciums The body’s most abundant mineral (1.5 to 2.0% of body mass; 1400 g)s Ca combines with P to form hydroxyapatite, the crystalline structure of bones and teeths Ionized, Ca serves these functions: • muscle contraction • transmission nerve impulses • activation of enzymes • blood clotting • fluid movement across membranes
  103. 103. What is Osteoporosis?s When calcium is deficient, the bones “give up” their Ca to try and restore the deficit. The bones literally become “hollow” or porous, leading to breaks and fracturess The hormone estrogen is linked to osteoporosis (because estrogen enhances Ca absorption; a decrease in estrogen no longer offers a
  104. 104. OsteoporosisBone Disease of Epidemic Proportionss 1.2 million fractures yearlys 500,000 spinal fracturess 230,000 hip fracturess each year, 1.3 million osteoporetic women will fracture one or more of their boness About 1 of 6 older men & 1 of 3 older women will sustain hip fractures (death will occur in 20%)s Often, x-rays don’t detect the disease until bone loss reaches 30 to 50% of its total mineral content!
  105. 105. Progressive Diseases 30-50% bone loss by age 70 ys Shrinkage of spinal vertebrae
  106. 106. Who Gets the Disease?s By age 50, men lose about 0.4% bone each year; in women, the loss is about 0.8% starting at age 35 (double the loss 15 years sooner!)s During menopause, bone loss accelerates to between 1% to 3% each year. Thus, by age 60, a woman can lose about 15% of her bone mass, and by age 70, bone loss can be as much as 30%
  107. 107. Where Does The Bones Loss Occur? Most occurs in the vertebrae (person shrinks in stature by up to 6 inches from age 45-50 to age 70).s The “spongy” bone (trabecular bone) loses its mineral content, causing the bone to crumble. The inside of the bone becomes honeycombed (like a beehive) and porous
  108. 108. Why is Dietary Calcium Crucial?s Shockingly, about 30% of college- age females consume only 400 to 500 mg of calcium daily (RDA = 1200 mg daily)s Calcium rich foods (dairy products) contain vitamin D and this increases Ca absorption into the boness Adequate Ca intake, begun at an early age (6-14 years old), increases bone density
  109. 109. CALCIUM AND EXERCISE HELPSs 1200 to 1500 mg Ca - sardines, pink salmon, ricotta cheese, dried figs • calcium carbonate and calcium citrate can help • meat, salt, coffee, alcohol inhibit Ca absorptions Exercise -weight bearing help - weight training important for “bone fitness”
  110. 110. Sodium: How Much is Enough?s isa key circulating electrolytes functions in the regulation of ATP- dependent channels with potassium.s These channels are referred to as Na+/K+-ATPases and their primary function is in the transmission of nerve impulses in the brain.
  111. 111. Sodium: How Much is Enough?s Excessive sodium intake increases fluid volume and peripheral vascular resistance - sodium-induced hypertension (occurs in 1/3 of individuals with hypertension in U.S. and Japan)s Recommended level = 1100 to 3300 mg/day (average in U.S = 3000 to 7000 mg/day; amount actually needed = 500 mg/day)s Sodium plentiful in table salt, MSG, soy sauce, condiments, canned foods, baking soda, baking powder
  112. 112. IRONs although considered a trace element, has a critical role in the transport of oxygen. IRONs Iron is the functional center of the heme moiety found in each of the protein subunit of hemoglobin.s The function of iron is to coordinate the oxygen molecule into heme of hemoglobin so that it can be transported from the lungs to the tissues.
  113. 113. IRONs 80% of Fe is heme (heme + protein globin ---> hemoglobins Iron Deficiency Anemia - iron isufficiency (low Hb - sluggishness, loss of appetite.s Inadequate Fe intake (30-50% of females Fe
  114. 114. Other Functions of Irons Heme iron is an important component of myoglobin, a storage and transport compound of oxygen within muscle cells (myoglobin contains about 5% of the body’s total iron stores)s Heme iron a constituent of cytochromes that aids energy transfer within mitochondrias Cytochromes transfer electrons (H + ) during redox reactions in cellular respiration
  115. 115. Iron Deficiencys Anemia provides only Fact: Typical Western diet 6 mg iron per 1000 calories of food intakes Hemoglobin (Hb) reduced to low levels and produces sluggishness, loss of appetite, reduced exercise capacitys Thus, a female who consumes 1700 kCal daily only consumes 10.2 mg iron dailys Recommended intake for females: 15 mg/ds Recommended intake for males: 12 mg/
  116. 116. Sports Anemia?s Clinical anemia (12 g/100 ml blood)s Fe loss is transient and occurs in early phase of training
  117. 117. Iron Status in Femaless 30 to 50% of American women (young children, teenagers, women of child-bearing age, and “athletes” are iron deficients Consuming an additional 5 mg iron a day would would increase iron intake by 150 mg in one month. If 15-17% of this iron is absorbed, this would make an additional 15 to 25 mg available to help to counter the 5 to 45 mg iron loss during menstruation
  118. 118. Source of Iron Importants Iron absorption varies depending on the source of the iron (i.e., bioavailability depends on the source of the iron)s Vegetable sources: 2-20% of iron absorbeds Animal sources: 10-35% of iron absorbeds Are vegetarian athletes at risk for iron insufficiency?s What can you do to increase iron absorption? - add foods rich in vitamin C to iron rich foods to increase their bioavailability. - drink glass OJ with cereal; add sesame seeds to salad; add wheat germ to cereal. This produces
  119. 119. Minerals and Exercises Sweat loss during exercise (1-5 kg loss is common) - 1.5 - 8.0 g salt - Heat cramps - involuntary muscle spasms - Heat exhaustion - weak rapid pulse, low BP, headache, dizziness, sweating reduced - Heat Stroke - sweating ceases, circulatory collapse, death
  120. 120. WatersThe energy content of a food is inverselyrelated to it’s water content. What does thismean? Foods high in water content are low in calories, and foods low in water content are high in calories cheese hiExample: (cheese v watermelon) water melon lo calories
  121. 121. Foods High in Water Content (are low in calories) %Water kCals Lettuce 95.8% 3.7s Tomato, Squash, Pumpkin 93.7% 5.7s Cabbage 92.2% 6.5s Strawberries 91.5% 8.6s Watermelon 91.2% 8.9s Grapefruit 90.8% 9.1s Chocolate fudge 8.1% 115
  122. 122. Soft Drink Consumption in the United Statess The average American consumes 1 gallon of soft drinks each week (52 gallons a year), or about 1 ton of soft drinks between the ages of 20 and 50!s One-third of soft drinks are diet drinks
  123. 123. Hydrations Terminology Euhydration - Normal daily water variations Hyperhydration - Increased water contents Hypohydration - Decreased water contents Dehydration - Losing waters Rehydration - Gaining water
  124. 124. Body’s Water Compartmentss Intracellular fluid or ICF (62%)s Extracellular fluid or ECF (38%) - Blood plasma accounts for 20% of ECF (3 L) • When you sweat, the water comes from the blood plasma (i.e., the ECF) • If you don’t replace the ECF volume by consuming water on a regular basis, blood viscosity increases, placing a strain on cardiovascular function • Other components of the ECF include lymph, saliva, fluids in eyes and joints, fluids secreted by glands, fluids in the intestines, fluids excreted by kidneys and skin, and fluids bathing nerves and spinal cord
  125. 125. Electrolytes and Body Waters ICF - low concentrations of Na + and Cl- - high concentrations of K+s ECF - high concentrations of Na + and Cl- - low concentrations of K+
  126. 126. Water Absorptions 2.0 Liters ingested daily - Saliva, gastric secretions, bile and pancreatic and intestinal secretions contribute an additional 7 L each days Of the 9 Liters ingested, not all is absorbed - Ingested solutions and foods (salt, AA, sugar drinks) blunt water absorption
  127. 127. Urines pH ranges between 4.5 to 8.0s High protein diets produce acidic urines CHO rich (vegetarian) diets produce alkaline urine (is pH above or below 7.4?)s Color of urine produced by pigment urochrome, an end product of Hb breakdowns In disease states, smell of urine changes; fruity smell (acetone) in diabetes, and solutes in urine
  128. 128. Functions of Body Water systems Serves as body’s transports Gas transport and gas exchange takes place across moist surfacess Nutrients and gases are transported in aqueous solutions Waste products exit via urine and fecess Water has heat stabilizing qualities (absorbs large amounts of heat with minimal changes in Temp)s Fluids lubricate joints; prevents bone grindings Gives turgor to body tissues because
  129. 129. WaterBalance - NoExercise
  130. 130. WaterBalance withExercise
  131. 131. Defend Against Dehydrations Don’t remove “soaked” clothing— dry clothes hinder evaporative cooling - Evaporation major physiologic defense - Evaporative loss of 1 L of sweat = 600 kCal of heat energy losss Drink water regularly during physical activity, especially during events lasting 60 minutes or
  132. 132. What is thePrimary Aim of FluidReplacement?
  133. 133. To maintain plasma volumeso that circulation and sweating progress at optimal levels
  134. 134. Glucose Polymers s What is a glucose polymer? (link of 10-15 glucose molecules) s Sports drinks are popular because: - low osmolarity (maltodextrins). Polymerized glucose solutions provide water and CHO at a faster rate than a drink of similar CHO content consisting of monosaccharides Summary: Generalized and disaccharides.Drink Cool Solutions, Drink Often, Choose the Brand Wisely
  135. 135. Gastric Emptyings Fluids must be emptied from the stomach before absorption in the small intestine.s Three factors influence gastric emptying: - Fluid temperature; cold water empties fastest (41 degrees F) - Fluid volume; 8.5 oz every 15 min. Too much slows gastric emptying - Fluid osmolarity; gastric emptying slowed when fluid is concentrated >10%. Sugary solutions (4 - 8% should be goal for CHO concentration for exercise longer than 60
  136. 136. Water Intoxication (Hyponatremia )s Water intoxication refers to excessive water intake of more than 10 quarts a days Causes significant dilution of the body’s normal sodium concentrations Symptoms include head-ach, blurred vision, excessive sweating, and vomiting. In severe cases, there is cerebral edema, convulsions, comatose, and death
  137. 137. Exercise and Heats Prevention is the most effective way to control heat stress injuries - Acclimatization - Water - Salt - Know when to exercise
  138. 138. Heat DisordersHEAT CRAMPS Cause: Prolonged exer in heat; negative Na Symptom: Tightening, cramps, low Na Prevent: Salt, acclimatizationHEAT EXHAUSTION Cause: Cumulative negative water loss Symptom: Exhaustion, hypohydration, flushed skin Prevent: Hydration before, during exerciseHEAT STROKE Cause: extreme hyperthermia, circulation failure Symptom: hyperpyrexia, lack of sweat, neurologic failure Prevent: Acclimatization, water, minerals, no exercise
  139. 139. Activity And Heat
  140. 140. ACSM Position Stand: Exercise and Fluid Replacement1. Primary objective for replacing body fluid loss during exercise is to maintain normal hydration.2. Important to consume adequate fluids during the 24-h period before an event and drink about 500 ml (about 17 0z) of fluid about 2 h before exercise to promote adequate hydration and allow time for excretion of excess ingested water.
  141. 141. 3. To minimize risk of thermal injury and impairment of exercise performance during exercise, fluid replacement should attempt to equal fluid loss.4. At equal exercise intensity, the requirement for fluid replacement becomes greater with increased sweating during environmental thermal stress.5. During exercise lasting longer than 1 h, it is important to do the following: a. add CHO to the fluid replacement solution to maintain blood glucose concentration and delay the onset of fatigue
  142. 142. b. electrolytes (primarily NaCl; ) should be added to the fluid replacement solution to enhance palatability and reduce the probability for development of hyponatremia.c. During exercise fluid and CHO requirements can be met simultaneously by ingesting 600-1200 ml/hr of solutions containing 4% to 8% CHO.d. During exercise greater than 1 h, approximately 0.5 to 0.7 g of sodium per liter of water would be appropriate to replace that lost from sweating.
  143. 143. Water Loss andTemperatur e
  144. 144. SUPPLEMENTS &ERGOGENIC AIDS
  145. 145. Ergogenic-“tending to increase work”An ergogenic aid is defined as “.. Aphysical, mechanical, nutritional,psychological, or pharmacologicalsubstance or treatment that eitherdirectly improves physiological variablesassociated with exercise performance orremoves subjective restraints which maylimit physiological capacity”
  146. 146. Examples of Ergogenic Aids• Warm-up • Caffeine ingestion • Carbohydrate ingestion• Liquid ingestion • Glycerol ingestion • Phosphate ingestion • • • Creatine ingestion • Blood doping • NaHCO3- ingestion• Erythropoietin • Growth hormone • Testosterone Nutritional Ergogenic Aids• Caffeine Glycerol • Carnitine Phosphate• Sodium Bicarbonate • Dichloroacetate• Creatine • Branched chain amino acids
  147. 147. Nutritional Herbs/SupplementsDuring the last decade, the use ofherbs as nutritional supplements hasexpanded significantly. Thus,knowledge of herbs, their purportedbeneficial effects, and possiblenegative side effects takes on addedimportance for athlete and otherscontemplating their use.
  148. 148. HERBAL AGENTSCommonly used herbal compounds - Astragalus (Huang qi) - Bilberry (Vaccinium myrtillus) - Bee Pollen (Buckwheat pollen; Puhuang) - Chamomile - Echinacea (Echinacea purpurea) - Ephedra - Garlic (Allium sativum) - Ginseng, Asian (Pannax) - Ginseng, Siberian (Eleuthero Root) - Ginkgo Biloba (Maindenhair tree)
  149. 149. HERBAL AGENTSCommonly used herbal compounds (cont) Guarna (Paullinia cupana) Kava Kava (Piper methysticum) Milk Thistle (Silbum marianum) Glucosamine Sulfate Grape Seed Extract Saw Palmetto (Serenoa repens) St. John’s Wort (Hypericum perforatum) Witch Hazel (Hamamelis virginiana) Yohimbe Valerian
  150. 150. Anabolic Steroidss Structure and action - Sterol structure similar to testosterone - Promotes protein synthesiss Stacking - Combining multiple steroid preparations in oral & injectable forms Pyramiding - Progressively increasing the dosage
  151. 151. Anabolic Steroidss Drug with a considerable following - Its becoming increasingly popular with more than just strength athletess Effectiveness - Dosage is an important factor - Training volume accompanying use
  152. 152. Changes frombaseline in averageFFM, muscle, fat,and strength over10-wks oftestosteronetreatment
  153. 153. Examples of oral and injectable anabolic steroids Generic Name Commerical Form Retail $ Black Name Market $Oxymetholone Anadrol-50 Oral: 50 mg $115/100 tabs $200-500Oxandrolone Oxandrin Oral; 2.5 mg $420/100 tabs $600-1600Stanazolol Winstrol V Oral; 2 mg $100/100 tabs $200-500Nandrolone Durabolin Inject; 25 mg/ml $275/ml vial $200-500Deconate Deca-Durabolin Inject; 25 mg/ml $12/2 ml vial $400-750Androlone-D200 Neo-durabolic Inject; 50 mg/ml $12/2 ml vial $450-750
  154. 154. Life-shortening Effects of Exogenous Steroids Use in Mice
  155. 155. Anabolics Steroidsrisks Side effects and medical • Cystic acne, “road rage,” peliosis hepatis, increased plasma lipoproteins • In males: testicular atrophy & gynecomastia • In females: clitoral enlargement, squaring of the jaw, lowering of voice • ACSM Position Statement on Anabolic Steroids
  156. 156. Growth Hormones Genetic engineering comes to sports - Human growth hormone • Produced in the Pituitary gland • Stimulates bone & cartilage growth • Enhances fatty acid oxidation • Reduces glucose & amino acid breakdown - Excess GH may result in: • Gigantism • Acromegaly - No unanimity among researchers
  157. 157. DHEA: A Worrisome Trends DHEA- Dehydroepiandersterone - Steroid hormone produced by the adrenal glandss Claims for DHEA • Testosterone booster • Bolsters immune system • Preserves youth • Decreases fatigue & joint pain • Slows aging • Invigorates sex life - An unregulated compound with uncertain safety
  158. 158. Androstenediones Claims: - Stimulates production of endogenous testoterone - Enables one to train harder - Increases muscle mass - Aids healing/recovery processs Research shows no effect of supplementation on basal serum testosterone or any training response in terms of muscle size & strength
  159. 159. Amino Acid Supplements for an Anabolic EffectClaims: Boost body’s natural production of: - Testosterone - Growth hormone - Insulin-like Growth Factor – 1 Resulting in an increase in muscle mass and a reduction in fat mass
  160. 160. Creatines Supplement form - creatine monohydrate - Important component of high-energy phosphates - Documented benefits in humans • Improved muscular strength and power • Enables heavier lifting for greater overload - Creatine loading • 20 –25 g/day - Some research shows no benefit
  161. 161. Amino Acid SupplementsStimulating an anabolic effect Consuming carbohydrate and/or protein immediately after resistance training may augment hormonal response to the training
  162. 162. Branched Chain Amino AcidsThe main BCAA’s are leucine,isoleucine, and valine. Theseamino acids decrease the ability fortryptophan to cross the blood brainbarrier, impeding the formation ofseratonin and the perception offatigue (central fatigue).
  163. 163. Caffeine Improved exercise Stimulant to CNS endurance ↑ Diuresis ↑ Lipolysis ↑ Incidence of ↓ Muscle glycogenolysiscardiac arrythmias
  164. 164. Caffeine • The most highly consumed drug in North America and Europe • IOC initially banned caffeine in 1962, then removed from list in 1972 • Today, urinary caffeine > 12 mg/L is an IOC infringement • This urinary level requires > 13.5 mg/kg caffeine, where 1 cup coffee provides 80 mg (Assume 75 kg BW) IOC banned dosage Ergogenic benefit1012 mg/80 = 12.7 cups 330 mg/80 = 4.1 cups
  165. 165. Warning About Caffeines Possible side effects: • Nervous irritability • Muscle twitching • Psychomotor agitation • Elevated HR & blood pressure • Increased occurrence of PVCs • Insomnia
  166. 166. Caffeine produced significantly faster split times Effects of caffeine on high- intensity exercise results from facilitated use of fat as an exericse fuel, thus sparing CHO reserves

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