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Chapter 9 Lecture Outline Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display Water 50%-70% Muscle of body weight contains 73% water – Fat contains ~20% Intracellular fluid – Fluid within the cells Extracellular fluid – Fluid outside the cells 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 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 Low the kidneys 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? 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 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 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 µg/day Daily Value is 70 µg Average intake exceeds RDA (and Daily Value) Selenium Toxicity Upper Level is 400 µg/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 µg/day – Only 50 µg 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 Bone WBC loss Inadequate growth Copper Sources and Needs Organ meats, seafood, cocoa Mushrooms, legumes, seeds, nuts, whole grains RDA is 900 µg/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 µg/day for adults Daily Value is set at 120 µg Average intake is ~30 µg/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 µg/day Daily Value is 75 µg Average intake is 75-110 µg/day Upper Level is 2 mg/day 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 Fluid pressure increases with intake 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 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