Download Minerals

Water & the Minerals
Fluids
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Females 50-55% water
Males 55-60%
Less water in older adults
More in children
More in persons who
exercise
Fluids
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Main functions
 Shape and structure to cells
 normal turgor
 Aids in digestion and
absorption of nutrients
 Transports/ lubricates
 Solvent/ chemical reactions
 Stabilizes body temperature
Fluids
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Adults metabolize 2.5-3
liters water/day
Excrete 500-600 ml/day to
get rid of body wastes
7-9 liters secreted into GI
tract each day
almost all reabsorbed
Approximate Total Volume of
Digestive Secretions Produced in 24
Hours by Adult of Average Size
Secretion
Amount
Saliva
Gastric
Bile
Pancreatic
Intestinal
TOTAL
1500 ml
2500
500
700
3000
8200 ml
Fluids
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Normal losses 2.5 liters/day
Obligatory
Facultative
Thirst-not always accurate
diminished in elderly
infants can’t tell you
watch color of urine
Fluids
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ECF
water outside
cell
1/3 body H20
blood plasma
interstitial
fluids
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ICF
water inside
cells
2/3 body H20
site of basic
metabolic
activity
Dehydration
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Fluid volume deficient or
hypovolemia
Output exceeds water intake
Shift of water from ECF to
ICF
Lower blood volume
Cellular edema
Dehydration
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Hypovolemia symptoms
 intense thirst
 dry mucous membranes
 weak and rapid pulse
 orthostatic hypotension
 vomiting and confusion
 concentrated urine
 life threatening -10% weight
loss
Signs of dehydration
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Headache/ lightheadness
Fatigue
Loss of appetite
Flushed skin
Heat intolerance
Dry mouth and eyes
Dark, scanty urine
Fluid overload
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Fluid volume excess or
hypervolemia
Fluid intoxication
muscle cramps and low
BP
excessive water intake
renal failure or CHF
water shifts from cell to ECF
Fluid overload
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Peripheral edema
Rapid, bounding pulse
Distended neck veins
Pulmonary edema/SOB
Fluids
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Adequate water intake
30 ml/kg or 1-1.5 ml/1
kcalorie energy expenditure
Urine should be pale yellow
Minerals
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Inorganic elements
Classified as macro and
trace elements
by amount
by need
Functions
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Structure
Fluid Balance
Vitamin, enzyme, and
hormone activity
Nerve cell transmission
Muscle contraction
Acid -Base balance
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Determined by pH
Water regulates pH
Normal pH 7.35-7.45
Acid base buffers
carbonic acid
sodium bicarbonate
Acid -Base Balance
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Disturbances
 respiratory acidosis
 chronic lung disease
 metabolic acidosis
 ketosis
 respiratory alkalosis
 hyperventalating
 metabolic alkalosis
 vomiting
Mineral salts
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NaCl in body water
Movement directed by cells
Water follows salt
Separate into ions in
solution
Conduct electricity
Called electrolytes
Electrolytes
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Cations-NA+, K+
Anions-ClUsually balanced
Sodium
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Principle electrolyte in ECF
Primary regulator ECF volume
Maintains acid base balance
Muscular irritability
Nerve impulse transmission
Intestinal secretions
35-40% skeleton
Sodium
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1 gram sodium in 1/5 t. of NaCl
Salt is 39% sodium
Use less with HTN, CHF, and
Kidney Failure
Adjust depending on climate
and physical activity
Suggested intake 2400 mg or
1000mg/1000 kcalories
Sodium
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Increased losses with
vomiting and diarrhea
Replace both Na+ and water
Potassium
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Principle cation in ICF
Maintains cell integrity
Keeps heart beat steady
Deaths from severe diarrhea
or dieresis
Assists in CHO and protein
metabolism
Potassium
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High K foods associated
with decreased risk of
stroke and lower blood
pressure
Hypokalemia
too low=death
Hyperkalemia
too high =death
Lower Sodium Diet
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Reduce sodium gradually
Learn to read the food labels
and compare brands
Fresh is best
Balance high and low
sodium foods
Experiment with herbs,etc.
Chloride
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Principle anion of ECF
Not usually treated
separately from sodium
problems
Calcium
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Most abundant
99% bone and teeth
1% serum
Bound with P04-3 and Mg++
Calcium
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Bones replete serum
Serum Ca++
 bone
and teeth formation
 controls muscle contractions
 transmits nerve impulses
 blood clotting
 secretion of hormones
Calcium
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Calcium
Regulated very tightly
30-40% dietary calcium
absorbed
 bound
to oxalates &
phytates in plant foods
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New recommendations
Calcium
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Serum levels kept constant
Vitamin D and parathyroid
hormone raises Ca++ levels
PRN
Calcium travels with
Albumin in blood-need to do
corrected Ca++ calculation if
Albumin low
Calcium Deficiencies
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Means less bone density
 Osteoporosis-
thin, white or
Asian women most at risk
 Rickets- malabsorption
of Ca++
Calcium Deficiencies
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Sedentary lifestyle
less absorption
Low calcium diet
increased blood pressure
ETOH and smoking
increases losses
Calcium Supplements
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Carbonate
Citrate
Acetate
NO oyster shell
Supplements
No
more than 2500mg per
day
Count amounts from food
Smaller divided doses
Do not take iron and
calcium at the same time
Plenty of fluids
Calcium Excesses
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Constipation
Kidney Stones
Calcium Sources
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Milk
Cheese
Yogurt
Soy & other legumes
Whole grains
Green Leafy Vegetables
Phosphorous
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Combined with Ca++ in
bone and teeth
85% in bones
Major body buffer
Important in energy
transfers-ATP
Phosphorous
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Absorption regulated by
parathyroid hormone
Excesses excreted in urine
Renal insufficiency =
high serum levels
Phosphorous
Deficiencies
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Malnutrition
ETOH abuse
Starvation
Phosphorous
Sources
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Meats
Poultry
Fish
Eggs
Legumes
Milk and Dairy Products
Soft drinks
Magnesium
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Small amount in body
Critical to operation of
hundreds of enzymes
Smooth muscle relaxation
Necessary for release of
energy
Holds calcium in tooth
enamel
Magnesium
Deficiency
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Vomiting and diarrhea
ETOH abuse
Protein malnutrition
Causes hallucinations in
ETOH withdrawal
Prolonged muscle
contractions
Magnesium Sources
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Green leafy vegetables
Nuts
Legumes
Whole grains
Seafood
Iron
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3-5 g stored in body
2/3 as heme in hemoglobin
1/3 as ferritin
RBC carries O2 to tissues
Needed for new cells
Iron
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10-15% dietary iron
absorbed
Amount increases in
deficiency
Nonheme Fe+++ ferric
 plant
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source
Nonheme and heme Fe++
ferrous
 animal
source
Iron Toxicity
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Repeated transfusions
Polycystic disease
Iron poisoning
Symptoms
N&V
shock
convulsions and coma
Iron Deficiencies
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Most deficient nutrient in US
Nutritional Anemias
Hemorrhagic Anemias
Postgastrectomy anemia
Malabsorption anemia
Chronic disease anemia
Iron Deficiencies
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Symptoms
 weakness
and fatigue
 headaches
 apathy
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Pica-eating of non-nutrient
substances
 ice,
clay, paste, starch, kaolin
Iron Deficiency Anemia
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Increase food sources
Include iron fortified
cereals
Know heme iron sources
Add sources of Vitamin C
Drink coffee & tea between
meals, not with meals
Cook in iron pots
Iron Sources
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Liver
Lean meat
Dried beans
Fortified cereals
Iodine
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Major source is iodized salt
Thyroid hormones
body temperature
metabolic rate
reproduction/growth
nerve and muscle
functions
Zinc
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Picked up by
albumin for transport
Energy job
Healing job
Immune function
Zinc Deficiencies
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Mental disorders
Abnormal dark adaptation
in vision
Skin lesions
Hair loss
Strict vegetarians at risk
Iodine Deficiencies
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Goiter
Weight gain
Birth defects
Cretinism
Selenium
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Antioxidant
Sparing effect on Vitamin C
Research area
Toxicity
 hair
& nail loss
 skin lesions
 diarrhea
Selenium
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Rare deficiency in long
term parenteral nutrition
Other Trace Minerals
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Copper
 wound
healing
 hemoglobin
 help cells use FE++
 sheaths around nerve fibers
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Deficiency
dementia, liver failure
Other Trace Minerals
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Manganese
Fluoride
excess can mottle teeth
Chromium
CHO/lipid metabolism
works with insulin