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Medical Nutrition Therapy Nutrient- Nickel 1. What is the nutrient? Nickel is classified as an “ultratrace” mineral, meaning that it is present in very low quantities in human tissues (Mahan & Escott-Stump, 2004). 2. What is the RDA/DRI for the nutrient? There is no specified RDA/DRI for this nutrient, as it is needed in uncertain amounts in the human body (Mahan & Escott-Stump, 2004). It has been hypothesized to be essential for the breakdown of amino acids leucine, valine, and isoleucine and oddchain-length fatty acids (Medeiros & Wildman, 2000). 3. How is the nutrient metabolized? The nutrient is absorbed in the gut, and absorption depends on the amounts of copper, iron, and zinc present (Medeiros & Wildman, 2000). It binds to form ligands and is then transported throughout the body. It is best absorbed through the lungs, GI tract, and the skin, and is then excreted in the urine and feces (Das, Das, & Dhundasi, 2008). 4. What are food sources of the nutrient? Food sources of nickel include mainly plants as more concentrated sources. Nuts are the best source of nickel, as well as grains, cured meats, and vegetables. Fish, milk, and eggs also contain nickel, but in smaller amounts (Medeiros & Wildman, 2000). Nickel can also be obtained in varying amounts from drinking water (Das, Das, & Dhundasi, 2008). 5. What disease states alter the nutrient’s metabolism? Myocardial infarctions and acute strokes, as well as burn injuries have been shown to alter the transport and serum concentration of nickel in the body (Das, Das, & Dhundasi, 2008). 6. What are the tests or procedures to assess the nutrient level in the body? Nickel is assessed for toxicity by testing the urine for nickel concentration. A serum nickel concentration can also be obtained from a blood sample (Mayo Medical Laboratories, 2014). 7. What are the drug–nutrient interactions? Zinc may affect the amounts of copper, iron, and zinc that are absorbed into the gut (Medeiros & Wildman, 2000). 8. How is the nutrient measured? The nutrient is measured in micrograms, with a level of 1,000 micrograms specified as the tolerable upper limit (Medeiros & Wildman, 2000). 9. What is the Upper Tolerable Limits? For adults ages 19-70, the Tolerable Upper Intake Level for Nickel is 1.0 mg/day (Nelms, Sucher, Lacey, & Roth, 2011). 10. What are the physical signs of deficiency? Based on the current evidence, there are no known signs of nickel deficiency, due to the very low requirements for humans (Anke, Groppel, Kronemann, & Grun, 1984). 11. What are physical signs of toxicity? Physical signs of toxicity include nausea, vomiting, diarrhea, abdominal pain, headache, cough, shortness of breath, and giddiness (Young, 1995). References Anke, M., Groppel, B., Kronemann, H., & Grun, M. (1984). Nickel- an essential element. JARC Sci Publ. , 53, 339-65. Das, K. K., Das, S. N., & Dhundasi, S. A. (2008). Nickel, its adverse health effects & oxidative stress. Indian J Med Res (128), 412-425. Mahan, L. K., & Escott-Stump, S. (2004). Krause's Food, Nutrition, and Diet Therapy (11th Edition ed.). Philadelphia, PA: Saunders. Mayo Medical Laboratories. (2014). Nickel, Serum. Retrieved April 21, 2014, from Mayo Clinic: Mayo Medical Laboratories: http://www.mayomedicallaboratories.com/testcatalog/Clinical+and+Interpretive/8622 Medeiros, D. M., & Wildman, R. E. (2000). Advanced Human Nutrition (2nd Edition ed.). Sudbury, MA, United States of America: Jones & Bartlett Learning. Nelms, M., Sucher, K. P., Lacey, K., & Roth, S. L. (2011). Nutrition Therapy & Pathophysiology (2nd Edition ed.). Belmont, CA, USA: Wadsworth. Young, R. A. (1995, July). Formal toxicity summary for nickel and nickel compounds. Retrieved April 21, 2014, from The Risk Assessment Information System: http://rais.ornl.gov/tox/profiles/nickel_and_nickel_compounds_f_V1.html#t31