Chapter 9 Lecture Outline Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display
Water <ul><li>50%-70% of body weight </li></ul><ul><li>Muscle   contains 73% water   </li></ul><ul><ul><li>Fat contains ~2...
 
Fluid Balance <ul><li>Water shifts freely in and out of cells </li></ul><ul><li>Controlled by electrolyte concentration </...
 
Functions of Water <ul><li>Body temperature regulation </li></ul><ul><ul><li>Water absorbs excess heat </li></ul></ul><ul>...
Are You Drinking Enough? <ul><li>Fluid recommendation: 9 cups for women and 13 cups for men as a starting point </li></ul>
Thirst Mechanism <ul><li>Not reliable </li></ul><ul><li>Concerns for infants, older adults, athletes </li></ul><ul><li>Ath...
Ignoring the Thirst Signal <ul><li>Shortage of water increases fluid conservation </li></ul><ul><li>Antidiuretic hormone  ...
Hydration <ul><li>Loss of 1%-2% of body weight in fluid </li></ul><ul><ul><li>Thirst signal </li></ul></ul><ul><li>Loss of...
 
Too Much Water <ul><li>Overburden the kidneys </li></ul><ul><li>Low blood electrolyte concentrations </li></ul><ul><li>Blu...
Minerals <ul><li>Various functions in the body </li></ul><ul><li>Major Minerals </li></ul><ul><ul><li>Require >100 mg /day...
 
Bioavailability of Minerals <ul><li>Degree of absorption </li></ul><ul><li>Presence of binders and fiber </li></ul><ul><li...
Mineral Toxicity  <ul><li>Trace minerals are more toxic </li></ul><ul><li>Result of supplementation </li></ul><ul><ul><li>...
Sodium <ul><li>Table salt (NaCl): 40% sodium, 60% chloride </li></ul><ul><li>95% of ingested sodium is absorbed </li></ul>...
Sodium Deficiency <ul><li>Deficiency is rare </li></ul><ul><li>Persistent vomiting/ diarrhea </li></ul><ul><li>Excessive p...
Food Sources of Sodium <ul><li>Most sodium is added by food manufacturers and restaurants </li></ul><ul><li>Milk and dairy...
 
Sodium Needs <ul><li>Adequate Intake is 1500 mg for adults </li></ul><ul><li>Body only needs 200 mg to function </li></ul>...
Potassium <ul><li>Positive ion in intracelluar fluid </li></ul><ul><li>Functions  </li></ul><ul><ul><li>Fluid balance  </l...
Potassium Sources and Needs <ul><li>Fruits, vegetables, milk, grains, meats, dried beans </li></ul><ul><li>Adequate Intake...
 
Chloride <ul><li>Negative ion for extracellular fluid </li></ul><ul><li>Component of   </li></ul><ul><ul><li>NaCl </li></u...
Chloride Needs <ul><li>Excess excreted by the kidneys </li></ul><ul><li>Adequate Intake is 2300 mg/day </li></ul><ul><li>D...
Calcium <ul><li>99% is in bones and teeth </li></ul><ul><li>Makes up 40% of all the minerals present in the body </li></ul>
Absorption of Calcium <ul><li>Amount in body is dependent on amount absorbed </li></ul><ul><li>Requires slightly acidic en...
Decreased Absorption of Calcium <ul><li>Rapid intestinal motility </li></ul><ul><li>High fiber intake </li></ul><ul><li>Ex...
Blood Calcium is Regulated <ul><li>Blood level is maintained at the price of bone calcium </li></ul><ul><li>Blood level ca...
Functions of Calcium <ul><li>Bone formation and maintenance </li></ul><ul><li>Blood clotting </li></ul><ul><li>Nerve impul...
Building Higher Bone Mass <ul><li>Adequate diet </li></ul><ul><li>Healthy body weight </li></ul><ul><li>Normal menses </li...
Other Roles of Calcium <ul><li>May lower blood pressure </li></ul><ul><li>May reduce colon cancer </li></ul><ul><li>May re...
Food Sources of Calcium
Bone Strength <ul><li>Dependent on bone mass and bone mineral density </li></ul><ul><li>The more there is, the stronger th...
Calcium Needs <ul><li>Daily Value is 1000 mg/day  </li></ul><ul><li>Adequate Intake is 1000 -1200 mg/day for adults </li><...
Calcium Supplements <ul><li>Recommended for people who cannot incorporate Ca into their diets </li></ul><ul><li>Not recomm...
Phosphorus <ul><li>Major ion of intracellular fluid </li></ul><ul><li>Bone and tooth strength </li></ul><ul><li>Component ...
Phosphorus Sources and Needs  <ul><li>Wide variety of foods </li></ul><ul><li>Dairy, bakery products, eggs, sodas, meats <...
Phosphorus Toxicity  <ul><li>Problem for individuals with inefficient kidney function </li></ul><ul><li>Phosphate ions bin...
Magnesium <ul><li>Absorption based on body’s needs (normally 40%-60%) </li></ul><ul><li>Kidneys regulate blood concentrati...
Functions of Magnesium <ul><li>Aids in many enzyme reactions  </li></ul><ul><li>Potassium and calcium metabolism </li></ul...
Magnesium Deficiency <ul><li>Develops slowly </li></ul><ul><li>Irregular heartbeat </li></ul><ul><li>Weakness, muscle spas...
Too Much or Too Little Magnesium <ul><li>Magnesium loss  </li></ul><ul><ul><li>Heavy perspiration </li></ul></ul><ul><ul><...
Magnesium Sources and Needs <ul><li>Whole grains, vegetables, nuts, seeds </li></ul><ul><li>Hard tap water </li></ul><ul><...
Sulfur <ul><li>Found in amino acids and vitamins </li></ul><ul><li>Acid-base balance </li></ul><ul><li>Drug detoxifying pa...
The Trace Minerals <ul><li>Needed in much smaller amounts </li></ul><ul><li>Essential for health </li></ul><ul><li>Difficu...
Iron <ul><li>Found in minute amounts in every cell </li></ul><ul><li>18% is absorbed </li></ul><ul><li>Heme iron vs. Nonhe...
Absorption of Iron <ul><li>Determined by body’s need </li></ul><ul><li>Iron storage in intestinal cells </li></ul><ul><li>...
Functions of Iron <ul><li>Hemoglobin in red blood cells </li></ul><ul><ul><li>Transports oxygen and carbon dioxide </li></...
Iron-Deficient Anemia <ul><li>Most common form of anemia </li></ul><ul><li>Low levels of hemoglobin and hematocrit  </li><...
Iron Deficiency Anemia <ul><li>Most at risk: </li></ul><ul><ul><li>Infant, toddler, chronic blood loss, vegans, runners, a...
Food Sources of Iron
Iron Needs <ul><li>RDA is 8 mg/day for adult male </li></ul><ul><li>RDA is 18 mg/day for female age 19 to 50 </li></ul><ul...
Iron Toxicity <ul><li>Serious, especially for children </li></ul><ul><li>Signs: </li></ul><ul><ul><li>Diarrhea, constipati...
Zinc <ul><li>Absorption  </li></ul><ul><ul><li>Influenced by the foods consumed </li></ul></ul><ul><ul><li>Animal sources ...
Functions of Zinc <ul><li>Cofactor to many enzymes </li></ul><ul><li>DNA synthesis and function </li></ul><ul><li>Growth, ...
Food Sources of Zinc
Zinc Needs  <ul><li>RDA 8 mg for adult female </li></ul><ul><li>RDA 11 mg for adult male </li></ul><ul><li>Daily Value is ...
Zinc Toxicity <ul><li>Inhibits copper metabolism </li></ul><ul><li>Possibly increases risk for prostate cancer  </li></ul>...
Selenium <ul><li>Readily absorbed </li></ul><ul><li>Excreted through the urine and feces </li></ul><ul><li>Functions: </li...
Selenium Deficiency <ul><li>Muscle pain </li></ul><ul><li>Muscle wasting </li></ul><ul><li>Weakness </li></ul><ul><li>Dete...
Selenium Sources and Needs  <ul><li>Fish, meat (organ meats), egg, milk, shellfish </li></ul><ul><li>Grains, seeds, nuts  ...
Selenium Toxicity <ul><li>Upper Level is 400  µ g/day </li></ul><ul><li>Garlicky breath </li></ul><ul><li>Hair loss </li><...
Iodide <ul><li>Iodine in foods – fortified salt </li></ul><ul><li>Functions: </li></ul><ul><ul><li>Supports thyroid hormon...
Iodide Sources and Needs  <ul><li>Iodized salt  ̶   ½  tsp. meets RDA  </li></ul><ul><li>Saltwater fish, seafood, dairy, g...
Iodide Toxicity <ul><li>Upper Level is 1.1 mg/day </li></ul><ul><li>Thyroid hormone synthesis is inhibited </li></ul><ul><...
Copper <ul><li>Aids in iron metabolism </li></ul><ul><li>Absorption: </li></ul><ul><ul><li>Dependent on body’s needs </li>...
Functions of Copper <ul><li>Increases iron absorption </li></ul><ul><li>Aids in formation of connective tissue </li></ul><...
Copper Deficiency <ul><li>Anemia </li></ul><ul><li>Decreased WBC </li></ul><ul><li>Bone loss </li></ul><ul><li>Inadequate ...
Copper Sources and Needs <ul><li>Organ meats, seafood, cocoa </li></ul><ul><li>Mushrooms, legumes, seeds, nuts, whole grai...
Fluoride <ul><li>Role in prevention of dental caries </li></ul><ul><ul><li>Helps tooth enamel resist acid  </li></ul></ul>...
Fluoride Sources and Needs <ul><li>Fluoridated water  </li></ul><ul><ul><li>~0.2 mg/cup </li></ul></ul><ul><ul><li>1 ppm <...
Fluoride Toxicity <ul><li>Mottling of teeth in children </li></ul><ul><li>Limit toothpaste to pea size for children </li><...
Chromium <ul><li>Enhances insulin action </li></ul><ul><li>Role in Type 2 diabetes? </li></ul><ul><li>Low intake: </li></u...
Chromium Sources and Needs <ul><li>Little information </li></ul><ul><li>Egg yolk, bran, whole grain, cereal, organ meat, m...
Chromium Toxicity <ul><li>No toxicity from foods </li></ul><ul><li>No Upper Level </li></ul><ul><li>Exposure to chromium i...
Manganese <ul><li>Cofactor in carbohydrate metabolism </li></ul><ul><li>Component of  superoxide dimutase </li></ul><ul><l...
Molybdenum <ul><li>Required by several enzymes </li></ul><ul><li>Deficiency rare </li></ul><ul><ul><li>Increased heart and...
Mineral Functions
 
Other Minerals  <ul><li>Boron </li></ul><ul><li>Nickel </li></ul><ul><li>Silicon </li></ul><ul><li>Vanadium </li></ul><ul>...
Hypertension (HTN) <ul><li>Systolic blood pressure/Diastolic blood pressure </li></ul><ul><li>Optimal BP: less than 120/80...
Why Control Blood Pressure? <ul><li>Silent disease </li></ul><ul><li>To prevent  </li></ul><ul><ul><li>Cardiovascular dise...
Causes of HTN <ul><li>Aging </li></ul><ul><li>Family history </li></ul><ul><li>Atherosclerosis </li></ul><ul><li>Obesity (...
Sodium and Blood Pressure <ul><li>Blood pressure increases with intake </li></ul><ul><li>Fluid retention leads to increase...
Other Minerals and HTN <ul><li>>1000 mg calcium per day lowers blood pressure </li></ul><ul><li>2-4 gm of potassium per da...
Medications and HTN <ul><li>Diuretics </li></ul><ul><ul><li>Reduce blood volume </li></ul></ul><ul><ul><li>Increase urine ...
Osteoporosis <ul><li>Calcium deficiency </li></ul><ul><li>“ A pediatric disease with geriatric consequences” </li></ul><ul...
Osteoporosis
Bone Structure
Bone Growth and Mass <ul><li>Rapid and continual throughout adolescence </li></ul><ul><li>Peak bone mass  </li></ul><ul><l...
 
Bone Mineral Density
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  1. 1. Chapter 9 Lecture Outline Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display
  2. 2. Water <ul><li>50%-70% of body weight </li></ul><ul><li>Muscle contains 73% water </li></ul><ul><ul><li>Fat contains ~20% </li></ul></ul><ul><li>Intracellular fluid </li></ul><ul><ul><li>Fluid within the cells </li></ul></ul><ul><li>Extracellular fluid </li></ul><ul><ul><li>Fluid outside the cells </li></ul></ul>
  3. 4. Fluid Balance <ul><li>Water shifts freely in and out of cells </li></ul><ul><li>Controlled by electrolyte concentration </li></ul><ul><li>Osmosis </li></ul><ul><li>Intracellular water volume </li></ul><ul><ul><li>Depends on intracellular potassium and phosphate concentrations </li></ul></ul><ul><li>Extracellular water volume </li></ul><ul><ul><li>Depends on extracellular sodium and potassium concentrations </li></ul></ul>
  4. 6. Functions of Water <ul><li>Body temperature regulation </li></ul><ul><ul><li>Water absorbs excess heat </li></ul></ul><ul><ul><li>Body secretes fluid via perspiration </li></ul></ul><ul><ul><li>Skin is cooled as perspiration evaporates </li></ul></ul><ul><li>Removal of body waste via urine </li></ul><ul><ul><li>Urea excretion </li></ul></ul><ul><ul><li>Sodium excretion </li></ul></ul><ul><ul><li>Avoid concentrated urine </li></ul></ul><ul><li>Amniotic fluid, joint lubricants, saliva, bile </li></ul>
  5. 7. Are You Drinking Enough? <ul><li>Fluid recommendation: 9 cups for women and 13 cups for men as a starting point </li></ul>
  6. 8. Thirst Mechanism <ul><li>Not reliable </li></ul><ul><li>Concerns for infants, older adults, athletes </li></ul><ul><li>Athletes </li></ul><ul><ul><li>Weigh before and after training session </li></ul></ul><ul><ul><li>Consume 3 cups for every pound lost </li></ul></ul><ul><li>Illness (vomiting, diarrhea, fever) </li></ul>
  7. 9. Ignoring the Thirst Signal <ul><li>Shortage of water increases fluid conservation </li></ul><ul><li>Antidiuretic hormone </li></ul><ul><ul><li>Released by the pituitary gland </li></ul></ul><ul><ul><li>Forces kidneys to conserve water (reduce urine flow) </li></ul></ul><ul><li>Aldosterone </li></ul><ul><ul><li>Responds to drop in blood pressure </li></ul></ul><ul><ul><li>Signals the kidney to retain sodium (water) </li></ul></ul>
  8. 10. Hydration <ul><li>Loss of 1%-2% of body weight in fluid </li></ul><ul><ul><li>Thirst signal </li></ul></ul><ul><li>Loss of 2% or more of body weight causes muscle weakness </li></ul><ul><ul><li>Lose significant strength and endurance </li></ul></ul><ul><li>Loss of 10%-12% </li></ul><ul><ul><li>Heat intolerance </li></ul></ul><ul><li>Loss of 20% </li></ul><ul><ul><li>Coma and death </li></ul></ul>
  9. 12. Too Much Water <ul><li>Overburden the kidneys </li></ul><ul><li>Low blood electrolyte concentrations </li></ul><ul><li>Blurred vision </li></ul>
  10. 13. Minerals <ul><li>Various functions in the body </li></ul><ul><li>Major Minerals </li></ul><ul><ul><li>Require >100 mg /day </li></ul></ul><ul><ul><li>Calcium, phosphorus </li></ul></ul><ul><li>Trace Minerals </li></ul><ul><ul><li>Require < 100 mg/day </li></ul></ul><ul><ul><li>Iron, zinc </li></ul></ul>
  11. 15. Bioavailability of Minerals <ul><li>Degree of absorption </li></ul><ul><li>Presence of binders and fiber </li></ul><ul><li>Animal products are better absorbed </li></ul><ul><li>Plants depend on mineral content of soil </li></ul><ul><li>Refinement lowers mineral content </li></ul><ul><li>Mineral-mineral competition </li></ul><ul><li>Vitamins-mineral competition </li></ul>
  12. 16. Mineral Toxicity <ul><li>Trace minerals are more toxic </li></ul><ul><li>Result of supplementation </li></ul><ul><ul><li>Presence of contaminants </li></ul></ul><ul><ul><li>Look for the United States Pharmacopeia (USP)-approved brands </li></ul></ul>
  13. 17. Sodium <ul><li>Table salt (NaCl): 40% sodium, 60% chloride </li></ul><ul><li>95% of ingested sodium is absorbed </li></ul><ul><li>Positive ion in extracellular fluid </li></ul><ul><li>Aldosterone regulates sodium balance </li></ul><ul><li>Key for retaining body water </li></ul><ul><li>Excretion regulated by the kidneys </li></ul><ul><li>Muscle contraction </li></ul><ul><li>Conduction of nerve impulses </li></ul>
  14. 18. Sodium Deficiency <ul><li>Deficiency is rare </li></ul><ul><li>Persistent vomiting/ diarrhea </li></ul><ul><li>Excessive perspiration </li></ul><ul><ul><li>Losing 2-3% of body weight </li></ul></ul><ul><li>Depletion of sodium in the body </li></ul><ul><li>Signs of deficiency: </li></ul><ul><ul><li>Muscle cramp, nausea, vomiting, dizziness, shock, coma </li></ul></ul><ul><li>Normally kidney will respond by conserving sodium </li></ul>
  15. 19. Food Sources of Sodium <ul><li>Most sodium is added by food manufacturers and restaurants </li></ul><ul><li>Milk and dairy products </li></ul><ul><li>Processed foods </li></ul><ul><li>Sodium content listed on the labels </li></ul>
  16. 21. Sodium Needs <ul><li>Adequate Intake is 1500 mg for adults </li></ul><ul><li>Body only needs 200 mg to function </li></ul><ul><li>Daily Value is 2400 mg/day </li></ul><ul><li>Upper Level is 2300 mg </li></ul><ul><li>Typical intake is 4700 mg/day </li></ul><ul><li>Sodium-sensitive individuals should restrict intake </li></ul>
  17. 22. Potassium <ul><li>Positive ion in intracelluar fluid </li></ul><ul><li>Functions </li></ul><ul><ul><li>Fluid balance </li></ul></ul><ul><ul><li>Nerve impulse transmission </li></ul></ul><ul><li>Associated with lowering blood pressure </li></ul><ul><li>90% of potassium consumed is absorbed </li></ul><ul><li>Low blood potassium </li></ul><ul><ul><li>Muscle cramps, confusion, constipation, irregular heart beat, heart failure </li></ul></ul>
  18. 23. Potassium Sources and Needs <ul><li>Fruits, vegetables, milk, grains, meats, dried beans </li></ul><ul><li>Adequate Intake is 4700 mg/day </li></ul><ul><li>Daily Value is 3500 mg/day </li></ul><ul><li>Typical intake is 2000-3000 mg/day </li></ul><ul><li>Diuretics may deplete potassium </li></ul><ul><li>Excess potassium is excreted by the kidneys; no Upper Level </li></ul>
  19. 25. Chloride <ul><li>Negative ion for extracellular fluid </li></ul><ul><li>Component of </li></ul><ul><ul><li>NaCl </li></ul></ul><ul><ul><li>Hydrochloric acid (HCl) </li></ul></ul><ul><li>Functions </li></ul><ul><ul><li>Immune response, nerve function </li></ul></ul>
  20. 26. Chloride Needs <ul><li>Excess excreted by the kidneys </li></ul><ul><li>Adequate Intake is 2300 mg/day </li></ul><ul><li>Daily Value is 3400 mg </li></ul><ul><li>Upper Level is 3600 mg </li></ul><ul><li>High Intake may cause high blood pressure </li></ul>
  21. 27. Calcium <ul><li>99% is in bones and teeth </li></ul><ul><li>Makes up 40% of all the minerals present in the body </li></ul>
  22. 28. Absorption of Calcium <ul><li>Amount in body is dependent on amount absorbed </li></ul><ul><li>Requires slightly acidic environment and vitamin D </li></ul><ul><li>Absorbed in upper part of small intestine </li></ul><ul><li>Normally absorb 25% of calcium in food </li></ul><ul><li>Increase to ~60% during time of need (pregnancy, infancy) </li></ul><ul><li>Parathyroid hormone </li></ul>
  23. 29. Decreased Absorption of Calcium <ul><li>Rapid intestinal motility </li></ul><ul><li>High fiber intake </li></ul><ul><li>Excess phosphorus </li></ul><ul><li>Vitamin D deficiency </li></ul><ul><li>Polyphenols (tannins) in tea </li></ul><ul><li>Menopause </li></ul><ul><li>Aging </li></ul>
  24. 30. Blood Calcium is Regulated <ul><li>Blood level is maintained at the price of bone calcium </li></ul><ul><li>Blood level can be maintained despite inadequate calcium intake </li></ul><ul><li>Setting stage for future bone fractures </li></ul>
  25. 31. Functions of Calcium <ul><li>Bone formation and maintenance </li></ul><ul><li>Blood clotting </li></ul><ul><li>Nerve impulse transmission </li></ul><ul><li>Muscle contraction </li></ul><ul><li>Cell metabolism </li></ul><ul><ul><li>Activates various enzymes </li></ul></ul>
  26. 32. Building Higher Bone Mass <ul><li>Adequate diet </li></ul><ul><li>Healthy body weight </li></ul><ul><li>Normal menses </li></ul><ul><li>Weight-bearing physical activity </li></ul><ul><li>Moderate intakes of protein, phosphorus, sodium, caffeine </li></ul><ul><li>Non-smoker </li></ul><ul><li>Lower use of certain medications </li></ul>
  27. 33. Other Roles of Calcium <ul><li>May lower blood pressure </li></ul><ul><li>May reduce colon cancer </li></ul><ul><li>May reduce PMS symptoms </li></ul><ul><li>May lower blood cholesterol </li></ul><ul><li>May reduce kidney stones </li></ul><ul><li>Reduces lead absorption </li></ul><ul><li>Promotes weight loss? </li></ul>
  28. 34. Food Sources of Calcium
  29. 35. Bone Strength <ul><li>Dependent on bone mass and bone mineral density </li></ul><ul><li>The more there is, the stronger the bone </li></ul>
  30. 36. Calcium Needs <ul><li>Daily Value is 1000 mg/day </li></ul><ul><li>Adequate Intake is 1000 -1200 mg/day for adults </li></ul><ul><li>Adequate Intake is 1300 mg/day for adolescents (9-18 yrs. old) </li></ul><ul><li>Average intake: 800 mg/day for women and 1000 mg/day for men </li></ul><ul><li>Upper Level is 2500 mg/day </li></ul>
  31. 37. Calcium Supplements <ul><li>Recommended for people who cannot incorporate Ca into their diets </li></ul><ul><li>Not recommended with high-zinc meal </li></ul><ul><li>Calcium carbonate (40% calcium) </li></ul><ul><ul><li>For those with ample stomach acid </li></ul></ul><ul><ul><li>Found in antacids </li></ul></ul><ul><li>Calcium citrate (21% calcium) </li></ul><ul><ul><li>Enhances absorption due to acidity content </li></ul></ul><ul><ul><li>Recommended for older adults </li></ul></ul>
  32. 38. Phosphorus <ul><li>Major ion of intracellular fluid </li></ul><ul><li>Bone and tooth strength </li></ul><ul><li>Component of various compounds </li></ul><ul><ul><li>ATP, cell membrane, enzymes, DNA </li></ul></ul><ul><li>Role in acid/base balance </li></ul><ul><li>Absorption is based on body’s need (70%-90%) </li></ul><ul><li>No disease associated with deficiency </li></ul><ul><li>May contribute to bone loss in older women </li></ul><ul><li>Vitamin D enhances absorption </li></ul>
  33. 39. Phosphorus Sources and Needs <ul><li>Wide variety of foods </li></ul><ul><li>Dairy, bakery products, eggs, sodas, meats </li></ul><ul><li>Some from food additives </li></ul><ul><li>Difficult to limit intake </li></ul><ul><li>RDA is 700 mg/day for adults </li></ul><ul><li>Daily Value is 1000 mg </li></ul><ul><li>Current intake exceeds RDA </li></ul><ul><li>Deficiency unlikely </li></ul>
  34. 40. Phosphorus Toxicity <ul><li>Problem for individuals with inefficient kidney function </li></ul><ul><li>Phosphate ions bind calcium </li></ul><ul><ul><li>Chronic imbalance may lead to bone loss </li></ul></ul><ul><li>Upper Level is 3-4 g/day </li></ul>
  35. 41. Magnesium <ul><li>Absorption based on body’s needs (normally 40%-60%) </li></ul><ul><li>Kidneys regulate blood concentration of magnesium </li></ul><ul><li>60% is stored in the bones </li></ul>
  36. 42. Functions of Magnesium <ul><li>Aids in many enzyme reactions </li></ul><ul><li>Potassium and calcium metabolism </li></ul><ul><li>Proper nerve and cardiac functions </li></ul><ul><li>Insulin release from the pancreas </li></ul><ul><li>May dilate arteries </li></ul><ul><ul><li>Decrease blood pressure </li></ul></ul><ul><li>May prevent heart rhythm abnormalities </li></ul>
  37. 43. Magnesium Deficiency <ul><li>Develops slowly </li></ul><ul><li>Irregular heartbeat </li></ul><ul><li>Weakness, muscle spasms, disorientation, nausea, vomiting, seizures </li></ul>
  38. 44. Too Much or Too Little Magnesium <ul><li>Magnesium loss </li></ul><ul><ul><li>Heavy perspiration </li></ul></ul><ul><ul><li>Long-standing diarrhea or vomiting </li></ul></ul><ul><ul><li>Alcoholism </li></ul></ul><ul><ul><li>Disorientation, weakness, muscle pain, poor heart function </li></ul></ul><ul><li>Toxicity </li></ul><ul><ul><li>Caused by medications </li></ul></ul>
  39. 45. Magnesium Sources and Needs <ul><li>Whole grains, vegetables, nuts, seeds </li></ul><ul><li>Hard tap water </li></ul><ul><li>Dairy, chocolate, meat </li></ul><ul><li>RDA for women is 310 mg/day </li></ul><ul><li>RDA for men is 400 mg/day </li></ul><ul><li>Daily Value is 400 mg </li></ul><ul><li>Average intake is lower than the RDA </li></ul><ul><li>Upper Level is 350 mg (nonfood source) </li></ul>
  40. 46. Sulfur <ul><li>Found in amino acids and vitamins </li></ul><ul><li>Acid-base balance </li></ul><ul><li>Drug detoxifying pathways </li></ul><ul><li>Part of a natural diet, primarily from protein </li></ul><ul><li>Used to preserve foods </li></ul><ul><li>No deficiency or toxicity </li></ul>
  41. 47. The Trace Minerals <ul><li>Needed in much smaller amounts </li></ul><ul><li>Essential for health </li></ul><ul><li>Difficult to study </li></ul><ul><ul><li>Only trace amounts in the body </li></ul></ul><ul><li>Animal sources of mineral are generally better absorbed </li></ul>
  42. 48. Iron <ul><li>Found in minute amounts in every cell </li></ul><ul><li>18% is absorbed </li></ul><ul><li>Heme iron vs. Nonheme iron </li></ul><ul><ul><li>Heme found in animal products better absorbed than nonheme </li></ul></ul><ul><ul><li>Meat protein factor may aid in nonheme absorption </li></ul></ul><ul><li>Vitamin C enhances absorption (nonheme iron) </li></ul>
  43. 49. Absorption of Iron <ul><li>Determined by body’s need </li></ul><ul><li>Iron storage in intestinal cells </li></ul><ul><li>Absorbed in an acidic environment </li></ul><ul><li>Hindered by phytic acid, oxalic acid, high fiber, high calcium, polyphenols </li></ul>
  44. 50. Functions of Iron <ul><li>Hemoglobin in red blood cells </li></ul><ul><ul><li>Transports oxygen and carbon dioxide </li></ul></ul><ul><ul><li>High turnover, high demand for iron </li></ul></ul><ul><li>Myoglobin in muscle cells </li></ul><ul><li>Electron transport chain </li></ul><ul><li>Enzyme cofactor </li></ul><ul><li>Immune function </li></ul><ul><li>Drug-detoxification pathway </li></ul>
  45. 51. Iron-Deficient Anemia <ul><li>Most common form of anemia </li></ul><ul><li>Low levels of hemoglobin and hematocrit </li></ul><ul><li>Insufficient intake and stores </li></ul><ul><li>Reduction in </li></ul><ul><ul><li>Production of red blood cells </li></ul></ul><ul><ul><li>Oxygen-carrying capacity </li></ul></ul>
  46. 52. Iron Deficiency Anemia <ul><li>Most at risk: </li></ul><ul><ul><li>Infant, toddler, chronic blood loss, vegans, runners, and women of childbearing years </li></ul></ul><ul><ul><li>Pica in women and children </li></ul></ul><ul><li>Signs: </li></ul><ul><ul><li>Paleness, brittle nails, fatigue, poor temperature control, poor growth </li></ul></ul>
  47. 53. Food Sources of Iron
  48. 54. Iron Needs <ul><li>RDA is 8 mg/day for adult male </li></ul><ul><li>RDA is 18 mg/day for female age 19 to 50 </li></ul><ul><li>Daily Value is 18 mg </li></ul><ul><li>Average intake exceeds RDA for men; low for some women </li></ul><ul><li>Upper Level is 45 mg/day </li></ul>
  49. 55. Iron Toxicity <ul><li>Serious, especially for children </li></ul><ul><li>Signs: </li></ul><ul><ul><li>Diarrhea, constipation, nausea, abdominal pain </li></ul></ul><ul><ul><li>Causes death due to respiratory collapse (shock) </li></ul></ul><ul><li>Hemochromatosis </li></ul><ul><ul><li>Genetic disease </li></ul></ul><ul><ul><li>Iron deposit that can lead to organ damage </li></ul></ul><ul><ul><li>May go undetected until organ damage at 50-60 </li></ul></ul>
  50. 56. Zinc <ul><li>Absorption </li></ul><ul><ul><li>Influenced by the foods consumed </li></ul></ul><ul><ul><li>Animal sources are better absorbed </li></ul></ul><ul><ul><li>Dependent on body’s need </li></ul></ul><ul><li>Factors that decrease absorption </li></ul><ul><ul><li>Presence of phytic acid </li></ul></ul><ul><ul><li>Competes with copper and iron for absorption </li></ul></ul>
  51. 57. Functions of Zinc <ul><li>Cofactor to many enzymes </li></ul><ul><li>DNA synthesis and function </li></ul><ul><li>Growth, protein metabolism, wound healing </li></ul><ul><li>Immune function </li></ul><ul><li>Cell membrane structure and function </li></ul><ul><li>Development of sexual organs and bones </li></ul><ul><li>Insulin function </li></ul><ul><li>Component of superoxide dismutase </li></ul>
  52. 58. Food Sources of Zinc
  53. 59. Zinc Needs <ul><li>RDA 8 mg for adult female </li></ul><ul><li>RDA 11 mg for adult male </li></ul><ul><li>Daily Value is 15 mg </li></ul><ul><li>Average intake meets RDA </li></ul><ul><li>Upper Level is 40 mg/day </li></ul>
  54. 60. Zinc Toxicity <ul><li>Inhibits copper metabolism </li></ul><ul><li>Possibly increases risk for prostate cancer </li></ul><ul><li>Causes diarrhea, cramps, nausea, vomiting </li></ul><ul><li>Depresses immune function </li></ul>
  55. 61. Selenium <ul><li>Readily absorbed </li></ul><ul><li>Excreted through the urine and feces </li></ul><ul><li>Functions: </li></ul><ul><ul><li>Co-factor for glutathione peroxidase </li></ul></ul><ul><ul><li>Protects the heart and other cells from oxidative damage </li></ul></ul><ul><ul><li>Works together with vitamin E </li></ul></ul><ul><ul><li>Aids in cancer prevention? </li></ul></ul><ul><li>Thyroid hormone metabolism </li></ul>
  56. 62. Selenium Deficiency <ul><li>Muscle pain </li></ul><ul><li>Muscle wasting </li></ul><ul><li>Weakness </li></ul><ul><li>Deterioration of heart muscle </li></ul>
  57. 63. Selenium Sources and Needs <ul><li>Fish, meat (organ meats), egg, milk, shellfish </li></ul><ul><li>Grains, seeds, nuts (dependent on soil content) </li></ul><ul><li>RDA for adults is 55 µ g/day </li></ul><ul><li>Daily Value is 70 µ g </li></ul><ul><li>Average intake exceeds RDA (and Daily Value) </li></ul>
  58. 64. Selenium Toxicity <ul><li>Upper Level is 400 µ g/day </li></ul><ul><li>Garlicky breath </li></ul><ul><li>Hair loss </li></ul><ul><li>Nausea, vomiting </li></ul><ul><li>Weakness </li></ul><ul><li>Rashes </li></ul><ul><li>Cirrhosis of the liver </li></ul>
  59. 65. Iodide <ul><li>Iodine in foods – fortified salt </li></ul><ul><li>Functions: </li></ul><ul><ul><li>Supports thyroid hormone synthesis </li></ul></ul><ul><ul><li>Regulates metabolic rate, growth, development </li></ul></ul><ul><li>Deficiency: </li></ul><ul><ul><li>Thyroid gland enlarges ( goiter ) due to low intake </li></ul></ul><ul><ul><li>Cretinism, stunting of fetal growth and mental development as a result of low iodide in maternal diet </li></ul></ul>
  60. 66. Iodide Sources and Needs <ul><li>Iodized salt ̶ ½ tsp. meets RDA </li></ul><ul><li>Saltwater fish, seafood, dairy, grains </li></ul><ul><li>Sea salt is poor source </li></ul><ul><ul><li>Iodide lost during processing </li></ul></ul><ul><li>Plant source dependent on soil content </li></ul><ul><li>RDA and Daily Value are 150 µ g/day </li></ul><ul><ul><li>Only 50 µ g needed to prevent goiter </li></ul></ul><ul><li>Average intake exceeds RDA </li></ul>
  61. 67. Iodide Toxicity <ul><li>Upper Level is 1.1 mg/day </li></ul><ul><li>Thyroid hormone synthesis is inhibited </li></ul><ul><li>“Toxic goiter” results </li></ul><ul><li>Consumption of seaweed poses risk </li></ul>
  62. 68. Copper <ul><li>Aids in iron metabolism </li></ul><ul><li>Absorption: </li></ul><ul><ul><li>Dependent on body’s needs </li></ul></ul><ul><ul><li>Decreases with high intakes of vitamin C, phytic acid, fiber, zinc, iron, certain amino acids </li></ul></ul>
  63. 69. Functions of Copper <ul><li>Increases iron absorption </li></ul><ul><li>Aids in formation of connective tissue </li></ul><ul><li>Found in superoxide dismutase </li></ul><ul><li>Assists immune system, blood clotting, brain development, cholesterol metabolism </li></ul>
  64. 70. Copper Deficiency <ul><li>Anemia </li></ul><ul><li>Decreased WBC </li></ul><ul><li>Bone loss </li></ul><ul><li>Inadequate growth </li></ul>
  65. 71. Copper Sources and Needs <ul><li>Organ meats, seafood, cocoa </li></ul><ul><li>Mushrooms, legumes, seeds, nuts, whole grains </li></ul><ul><li>RDA is 900 µ g/day for adults </li></ul><ul><li>Daily Value is 2 mg </li></ul><ul><li>Average intake is near the RDA </li></ul><ul><li>Upper Level is 10 mg </li></ul>
  66. 72. Fluoride <ul><li>Role in prevention of dental caries </li></ul><ul><ul><li>Helps tooth enamel resist acid </li></ul></ul><ul><ul><li>Inhibits bacterial growth </li></ul></ul>
  67. 73. Fluoride Sources and Needs <ul><li>Fluoridated water </li></ul><ul><ul><li>~0.2 mg/cup </li></ul></ul><ul><ul><li>1 ppm </li></ul></ul><ul><li>Tea, seafood, seaweed </li></ul><ul><li>Toothpaste </li></ul><ul><li>Adequate Intake is 3.1 -3.8 mg/day for adults </li></ul>
  68. 74. Fluoride Toxicity <ul><li>Mottling of teeth in children </li></ul><ul><li>Limit toothpaste to pea size for children </li></ul><ul><ul><li>High amounts can weaken teeth </li></ul></ul><ul><li>Upper Level is 1.3-2.2 mg/day for children </li></ul><ul><li>Upper Level is 10 g/day for older children and adults </li></ul>
  69. 75. Chromium <ul><li>Enhances insulin action </li></ul><ul><li>Role in Type 2 diabetes? </li></ul><ul><li>Low intake: </li></ul><ul><ul><li>Impaired glucose tolerance </li></ul></ul><ul><ul><li>Elevated blood cholesterol and triglycerides </li></ul></ul>
  70. 76. Chromium Sources and Needs <ul><li>Little information </li></ul><ul><li>Egg yolk, bran, whole grain, cereal, organ meat, meat, beer </li></ul><ul><li>Plant sources dependent on soil content </li></ul><ul><li>Adequate Intake is 25 - 35 µ g/day for adults </li></ul><ul><li>Daily Value is set at 120 µ g </li></ul><ul><li>Average intake is ~30 µ g/day </li></ul>
  71. 77. Chromium Toxicity <ul><li>No toxicity from foods </li></ul><ul><li>No Upper Level </li></ul><ul><li>Exposure to chromium in environmental waste sites </li></ul><ul><li>Lung and liver damage </li></ul>
  72. 78. Manganese <ul><li>Cofactor in carbohydrate metabolism </li></ul><ul><li>Component of superoxide dimutase </li></ul><ul><li>Role in bone formation </li></ul><ul><li>No deficiency symptoms observed in humans </li></ul><ul><li>Adequate Intake is 1.8-2.3 mg/day </li></ul><ul><li>Average intake meets AI </li></ul><ul><li>Daily Value is 2 mg </li></ul><ul><li>Toxicity in individuals working in manganese mines </li></ul><ul><ul><li>Psychiatric abnormalities, violence, impaired muscle control </li></ul></ul><ul><li>Upper Level is 11 mg/day </li></ul>
  73. 79. Molybdenum <ul><li>Required by several enzymes </li></ul><ul><li>Deficiency rare </li></ul><ul><ul><li>Increased heart and respiration rates </li></ul></ul><ul><ul><li>Night blindness, mental confusion </li></ul></ul><ul><ul><li>Edema, weakness, coma </li></ul></ul><ul><li>RDA is 45 µ g/day </li></ul><ul><li>Daily Value is 75 µ g </li></ul><ul><li>Average intake is 75-110 µ g/day </li></ul><ul><li>Upper Level is 2 mg/day </li></ul>
  74. 80. Mineral Functions
  75. 82. Other Minerals <ul><li>Boron </li></ul><ul><li>Nickel </li></ul><ul><li>Silicon </li></ul><ul><li>Vanadium </li></ul><ul><li>Arsenic </li></ul>
  76. 83. Hypertension (HTN) <ul><li>Systolic blood pressure/Diastolic blood pressure </li></ul><ul><li>Optimal BP: less than 120/80 mm Hg </li></ul><ul><li>HTN </li></ul><ul><ul><li>Sustained systolic pressure >139mm Hg or diastolic pressure >89 mm Hg </li></ul></ul><ul><li>95% of all HTN have no clear cause (primary or essential HTN) </li></ul><ul><li>Secondary HTN </li></ul>
  77. 84. Why Control Blood Pressure? <ul><li>Silent disease </li></ul><ul><li>To prevent </li></ul><ul><ul><li>Cardiovascular disease </li></ul></ul><ul><ul><li>Poor circulation </li></ul></ul><ul><ul><li>Kidney disease </li></ul></ul><ul><ul><li>Stroke, decline in brain functions </li></ul></ul><ul><li>African Americans most at risk </li></ul>
  78. 85. Causes of HTN <ul><li>Aging </li></ul><ul><li>Family history </li></ul><ul><li>Atherosclerosis </li></ul><ul><li>Obesity (increased fat mass and circulation) </li></ul><ul><li>Elevated insulin (insulin resistant adipose cells) </li></ul><ul><li>Inactivity </li></ul><ul><li>Excess alcohol (usually reversible) </li></ul>
  79. 86. Sodium and Blood Pressure <ul><li>Blood pressure increases with intake </li></ul><ul><li>Fluid retention leads to increased blood volume </li></ul>
  80. 87. Other Minerals and HTN <ul><li>>1000 mg calcium per day lowers blood pressure </li></ul><ul><li>2-4 gm of potassium per day lowers blood pressure </li></ul><ul><li>Magnesium may lower blood pressure </li></ul><ul><li>DASH diet </li></ul><ul><li>Diet rich in fruits,vegetables (vitamin C) </li></ul>
  81. 88. Medications and HTN <ul><li>Diuretics </li></ul><ul><ul><li>Reduce blood volume </li></ul></ul><ul><ul><li>Increase urine output </li></ul></ul><ul><li>Other medications </li></ul><ul><ul><li>Slow heart rate </li></ul></ul><ul><ul><li>Relax blood vessels </li></ul></ul>
  82. 89. Osteoporosis <ul><li>Calcium deficiency </li></ul><ul><li>“ A pediatric disease with geriatric consequences” </li></ul><ul><li>Leads to ~1.5 million fractures / year </li></ul><ul><li>Slender, inactive women who smoke are most at risk </li></ul><ul><li>“Less bones” </li></ul>
  83. 90. Osteoporosis
  84. 91. Bone Structure
  85. 92. Bone Growth and Mass <ul><li>Rapid and continual throughout adolescence </li></ul><ul><li>Peak bone mass </li></ul><ul><li>Determined by gender, race, familial pattern, other genetic factors </li></ul><ul><li>Bone loss begins ~age 30 </li></ul><ul><li>Women experience increased bone loss after menopause </li></ul><ul><li>DEXA bone scan </li></ul>
  86. 94. Bone Mineral Density

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