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Chapter 9 Notes Chapter 9 Notes Presentation Transcript

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