Transcript (I) Deficiency - HCC Learning Web

Water
Module 5.3
Water: Chemical Form
 Water is an inorganic compound composed of two
hydrogen atoms and one oxygen atom.
 It is abbreviated chemically as H2O.
Water
 Water is an inorganic compound (H2O)
 Is a unique among nutrients
 Most Indispensable of all
 Body need more water each day than any other
nutrient.
 We can survive a deficiency of any of the other
nutrient for a long time – But not in case of water.
Water—
The Most Essential Nutrient
 Nutrient most needed by
the body.
 Makes up part of every cell,
tissue, and organ in the
body.
 Accounts for about 60% of
body weight:
 Bone is more than 20%
 Muscle is 75%
 Teeth are about 10%
Functions of Water in the Body
 - Maintain body temperature
 - Act as transporter
 - Cleanses the tissue
 - Solvent
 - Actively participate in chemical reactions
 - Provide media for chemical reactions
 - Act as a lubricant
 - Serve as a shock absorber
Water Distribution
 - Blood/plasma
8%
 - Intracellular Fluid 67%
 - Extracellular Fluid 25%
Fluid Balance: Intake Needs
 Adult DRI: ♂ 3.7 liters/day ♀ 2.7 liters/day
There is no UL for water
 Another recommend level is 1 ml/Calorie
♂ : 2900 Calories = 2.9 Liters (12 C)
♀: 2200 Calories = 2.2 Liters (9 C)
Fluid Balance
Fluid Balance: Input & Output
 Enough fluid should be taken in to produce a clear
urine output every 2 hours while awake.
 With insufficient intake and obligatory output,
dehydration results.
FACTORS THAT INCREASE WATER NEED
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Alcohol consumption
Diseases such as diabetes
Physical activity
Heated environments
Hot weather
Increased dietary fiber, protein, salt or sugar
Medication (diuretics)
Pregnancy & breast feeding
Diarrhea, vomiting or fever
Surgery, blood lose or burns
Very young or old age
How to Become Dehydrated
 Intake of caffeine
 Intake of alcohol
 Diuretic medications
 Sweating
 Heat exposure
Water Intoxication
 Rare, usually from forced water intake,
 Serious life threatening consequences.
 Associated with low blood levels of sodium
(hyponatremia)
 CNS edema
 lung congestion
 muscle weakness
MINERALS
Minerals
 Minerals are inorganic elements
 Needed by the body as structural components and
regulators of body processes
 Minerals may combine with other elements in the body,
but they retain their identity
 Unlike vitamins, they are not destroyed by heat, oxygen
or acid.
Minerals
 Minerals are divided into 2 groups.
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Major minerals
Trace Minerals or Trace Elements
 Major Minerals – are those, needed greater than 100 mg/
day or
 Trace Minerals – needed less than 100 mg/day
Minerals
• MINERALS IN DIET
–
minerals come from both Plant and animal sources
In some food, the amounts of mineral is predictable, such as:
Iron in meat or
Magnesium in green leaves (chlorophyll)
Amounts of some trace minerals in food vary depending on the
mineral concentration in the soil and water such as:
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Iodine higher near oceans
Food processing and refining also affect the mineral contents of
food.
Some minerals are added unintentionally through
contamination.
Major Minerals
in Bone and Protein
Module 5.4
CALCIUM
 Most abundant mineral
 99% store in bones
 Calcium in bone give support to soft tissues as skeleton
 Bones also act as reservoir.
 Less than 1% calcium is in blood
 Play role as cofactor
Calcium
 less than 1% Calcium in blood is vital to life. It is
required for:
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Transmission of never impulses
Heart Beat
Muscle contraction
Maintain cell membranes
Maintain Blood pressure
Blood clotting
Act as cofactor for several enzymes
 Therefore, Blood calcium is tightly controlled
 DRI: 1,000-1,200 mg/day
Calcium
 Milk and milk products
typically contain more
calcium than other food
sources.
 Milk also contains vitamin D
and lactose which can
enhance calcium absorption
Factors effecting Calcium
Absorption
 Some foods contain binders such as :
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PHYTIC ACID
OXALIC ACID
High fiber
High protein
Calcium in Dairy Foods
~ 30% bioavailability
Calcium in Non Dairy Foods
<5 to >50% bioavailability
Kidney Beans (1 c)
35
Blackstrap Molasses (1 T)
172
Cooked Broccoli (1 c)
62
Cooked Spinach (1 c)
244
Canned Salmon (1 oz)
60
Fortified Tofu (1 c)
94
Fortified Soymilk (1 c)
300
Fortified Cereal (1 c)
1333
0
200
400
Calcium (mg)
600
800 1000 1200 1400
Calcium Supplements
 Calcium carbonate. Better absorbed when taken with food.
 40% Calcium
 500 mg tablet provides 300 mg Carbonate & fillers
 200 mg Calcium
 Calcium citrate. Can be taken on an empty stomach.
 21% Calcium
 500 mg tablet provides 394 mg Citrate & fillers
 105 mg Calcium
 Avoid:
 Oyster shell, coral, bone meal, calcium phosphate, anti-acids
supplements due to poor absorption, non-optimal design, and/or
possible contamination.
BONE: A LIVING TISSUE
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Bone is a living metabolically active tissue
Constantly being broken down and reformed in a
process called Bone Remodeling
Bone is formed by cells called Osteoblast
And broken down or resorbed by cells called
Osteoclast
During bone formation Osteoblast’s activity exceeds
During bone breakdown activity of Osteoclast
exceeds
BONE: A LIVING TISSUE
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Most bones are formed early in life.
In children, bone formation occur more rapidly than
breakdown
Even after growth stop, MASS continue to increase into
young adulthood when Peak Bone Mass is achieved
(Between 16 to 30)
In Healthy Adults, bone breakdown and formation
are in balance, so bone mass remain constant
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After age 32 to 45, the amount of breakdown begin to
increase than which is formed.
If enough bone is lost, skeleton is weakened and
fracture _ this is called Osteoporosis
Peak Bone Mass
OSTEOPOROSIS
– Bones explodes into fragments
– Many elderly people with hip fracture never able to walk
– Osteoporosis occurs during the later years but
– Develop silently much earlier and after 30 or 40 years,
the hip gives way.
– Causes are not fully understood, but risk depends on:
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The level of peak bone mass
The rate at which bone is lost
Life style factors that affect bone mass
include
– Smoking
– Alcohol consumption
– Exercise &
– Diet
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High protein diet
High sodium diet
Caffeine
Soft drinks
And insufficient Ca and Vitamin D
OSTEOPOROSIS
 To prevent osteoporosis higher Ca intake in early
life are recommended- that help achieving
maximum Peak Bone Mass
Osteopenia
 Osteopenia refers to bone mineral density (BMD) that
is lower than normal peak BMD but not low enough to be
classified as osteoporosis.
 Bone mineral density is a measurement of the level of
minerals in the bones, which shows how dense and strong
they are.
 If your BMD is low compared to normal peak BMD, you are
said to have osteopenia.
 Having osteopenia means there is a greater risk that, as
time passes, you may develop osteoporosis
Phosphorus
Phosphorus (P)
• Combined with calcium to form calcium phosphate; gives
rigidity to bones and teeth.
• Part of DNA and RNA; necessary for all growth; genetic
code.
• Phospholipids in cell membranes
• Plays major role in energy production as a component of
enzymes and B vitamins.
• Transports nutrients.
• ATP
• Maintaining pH
The Electrolytes
BODY FLUIDS & MINERALS
 Salt: Compounds composed of charged particles (ions) i.e.
K+ Cl Ions: Electrically charged particles, such as Na + or Cl Electrolytes: Compounds that partly dissociate in water to
form ions i.e. potassium Ion (K+) & chloride Ion (Cl-)
 Electrolytes function in Fluid/Water balance & acid-base
balance (excessive vomiting can cause alkalosis)
Fluid and Electrolytes
 Drinking water & eating regular foods restores fluid &
electrolyte balance.
 With excessive sweating, bleeding, vomiting, or
diarrhea special drinks may be used to restore
electrolytes
Sodium: Toxicity
Cardio-Vascular:
increased blood
pressure with increased
risk for heart attack and
stroke
Other:
fluid retention (edema)
Toxicity
(>UL)
>2,300 mg/day
Sodium (Na)
– Found naturally in many foods.
– Component of sodium chloride (table salt), a food
seasoning and preservative.
– The use of highly salted foods can contribute to high
blood pressure (hypertension) in those who are
genetically susceptible.
– upper limit of 2300 mg of sodium per day.
Sodium
Sodium
 Many whole foods are low in sodium
 Whole foods = < 10% of sodium in the U.S. diet
 Salt added during cooking or at the table = 15% of the
sodium
 Sodium added by food manufacturers to processed
foods = 75% of sodium in the U.S. diet
Processing & Sodium Contents
Food Processing and Sodium
Sodium and Blood pressure
 - more than 2400 mg/ day causes blood pressure
 - Increase intake of salt Increase rate of:
o
hypertension
o
CVD
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Cerebral hemorrhage AND
o
Hypertension- related stroke
 As blood pressure increases the risk of death from CVD
also increases.
Chloride (Cl)
 From chlorine – a deadly green gas
 In body chloride ion play important role a major – ive
ion
 outside the cell it accompanies Na & inside accompanies
K so maintain fluid balance
 also part of HCl in stomach principle source is SALT
(NaCl)
Chloride: Deficiency
Bone & tooth:
growth failure in children
Central Nervous System:
mental apathy
GI System:
loss of appetite
Neuro-Musccular:
muscle cramps
Adequacy
DRI: 2,300 mg/day
(3,800 mg NaCl)
Deficiency
(<66% of DRI)
Approx. <1520 mg/day
Potassium (K)
• K is the principal positive(+) charged ion inside
body cell
• Play major role:
– Maintaining fluid & electrolyte balance
– Cell integrity
– Critical to maintain heart beat
• Sudden death occur during
–
Are caused by the loss of Potassium.
Potassium: Deficiency
(<66% of DRI)
Approx. <990 mg/day
Bone & tooth:
bone turnover
Cardio-Vascular:
cardiac arrhythmia
increased blood pressure with increased risk
for heart attack and stroke
Neuro-Musccular:
muscle weakness
Other:
glucose intolerance
risk of kidney stones
Potassium: Toxicity
 (UL is Not Established)
In renal (kidney) failure only.
Cardio-Vascular:
Cardiac arrest
Potassium in Whole Foods (DRI 4700mg/day)
Magnesium (Mg)
Magnesium
 Is needed to build bone, & teeth
 Acts in all cells of muscle, liver, heart and other soft
tissues.
 Helps relax muscles after contraction.
 Needed for nerve impulse transmission.
 Deficiency not likely but can occur in certain
conditions
Magnesium(Mg): Deficiency
• Magnesium Deficiency
• Symptoms
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weaknes
muscle twitches
confusion
In extreme deficency:
- Convulsions
- Hallucinations
- in children growth failure
-CVD & heart attacks
- bizarre movement (eye,
face)
Adequacy
DRI: 310-420 mg/day
Deficiency
(<66% of DRI)
Approx. <205-280
mg/day
Magnesium (Mg): Toxicity
• Mostly reported in older people
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May caused by Mgcontaining
laxatives
antacids &
other medications
Symptoms
diarrhea
electrolyte imbalance
acid base imbalance
dehydration
Toxicity
(>UL from supplements)
>350 mg/day
Sources of Magnesium
• Most Americans receive ¾ of recommendation
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nuts
whole grains
sea food
cocoa
legumes
dark green veg. chocolate
avocado
 ~80% lost in grain processing.
 Is not added back to processed foods.
• Magnesium easily washed away or peeled away
Magnesium in Foods
Sulfur
Sulfur Functions
• Needed for the biosynthesis of sulfur
and sulfate containing compounds
• Helps stabilize protein shape and
structure by forming disulfide
bridges.
Sulfur (S)
 Present in some amino acids and all proteins.
 No recommended intake.
 No known deficiencies
 Body does not use S by itself as a nutrient- but
present in Amino Acids (Methionine & Cysteine),
and in vitamins
 it is also part of Thiamin & biotin
Sulfur (S)
 S. plays most important role in helping strands of
protein in to assume a functional shape.
 -skin ---- rigid proteins contain high contents
 - hair
 -nails
 also part of insulin
Trace Minerals
 Module 5.5
The Trace Minerals
• Iodine I
• Iron
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Fe
Zinc Z
Selenium Se
Florid F
Chromium Cr
Copper Cu
Magnesium Mn
Molybdenum Mo
Iron (Fe)
 Every living cell- plant or animal contain iron
 Most of the iron in the body is part of two proteins:
hemoglobin
myoglobin
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 also help enzymes needed to make:
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new cells
amino acids
hormones and
neurotransmitters
 75% world population have inadequate intake of iron
 Body treat Iron as a precious mineral – liver & spleen
break RBC & salvage iron for recycle- body losses very
little iron usually as nail clippings, hair cuts and skin.
 75% world population have inadequate intake of iron.
Iron (Fe)
 Iron in Diet
 Comes from both plant and animal sources
 Much of the iron in animal product is HEME IRON—
absorption 25%
 Leafy green vegetables, legumes and whole grains are
source of NON-HEME IRON—absorption between 2 to
20%
Iron (Fe)
 Iron Deficiency
 Most common nutritional deficiency
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iron- deficiency anemia
smaller & lighter color cells – 40% worlds population
weakness
headaches
inability to concentrate
 Children deprived of Iron Become
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restless
irritable
unwilling to play or work
unable to pay attention
 PICA- craving for non-food substances i.e. clay, ice,
toothpaste etc.
Iron (Fe) Toxicity
Unlikely from food. Most
likely from supplements and
a genetic disorder
damages the cardiovascular
system
damages the central
nervous system
Deficiency
(<66% of DRI)
Approx. <5-12 mg/day
Toxicity
(>UL)
>45 mg/day
Iron absorption
 Tannins in tea & coffee- decrease
 Ca &P in milk- decrease
 Phytates in plants – decrease
 Vitamin C -- Increase
Iron Sources
-
-
red meat
fish
poultry
shell fish
egg
legumes
dried fruits
spinach
Iron DRI Values
 Men
 Women childbearing age
-
-
51 yrs & older
pregnancy
8mg
18mg
8mg
27mg
Iodine (I)
 Influences energy metabolism iodine is a part of Thyroxin-
:

Responsible for based metabolic rate
Growth and development
Promote protein synthesis
Influences the function of:
brain
muscles
heart, and
kidneys.
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Deficiency disease is called Goiter
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Iodine
 200 million people are
affected with this disease
worldwide.
Deficiency disease is called Goiter
 Severe lower secretion of
THYROID by women during
pregnancy causes irreversible
mental and physical
retardation called cretinism.
Adequacy
DRI: 150 μg/day
Deficiency
(<66% of DRI)
Approx. <100 μg/day
IODINE IN THE DIET
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Seafood and sea water high in Iodine
Plants grown close to sea are high in iodine
Plants grown inland, Iodine contents depends on the Iodine
in the soil
Iodized salt (1/2 teaspoon provide full day requirement)
Iodine (I)
 Deficiency
 During pregnancy cause irreversible mental and physical
retardation in the infant – known as Cretinism
o
can be averted if treated with in first 6 months
 Iodine deficiency is one of the world most common and
most preventable cause of mental retard
Iodine (I): Toxicity
Hypothyroidism
Weak pulse and cardiac
irritability
Coma,
Burning of the mouth,
throat, and stomach
Aabdominal pain, fever,
nausea, vomiting, and
diarrhea, and cyanosis
Toxicity
(>UL)
>1,100 μg/day
Iodine: Food Sources
 Seafood.
 Iodine is found in the soil where sea water once covered the
earth so plants grown in this soil contain some iodine.

 In areas that do not have iodine in the soil, the
development of iodine deficiency has been very common.

 Iodized salt.
 Processed foods containing iodized salt provide iodine.
Iodine in Foods
Zinc (Zn)
 Very small quantity – But work in every cell with
protein – helping nearly 100 enzymes
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make parts of the cell’s genetic material
make heme in hemoglobin
help pancreas with its digestive function
help metabolize CH2O, protein & pat
liberate Vitamin A. from storage in the liver
dispose of damaging free radical
regulate gene expression in protein synthesis
Zinc (Zn)
 Other Functions Of Zn
-
-
Zn also affects behavior & learning
Assist in immune function
Wound healing
Sperm production
Taste perception
Fetal development
Growth & development of children
Needed to produce the active form of vitamin A in
visual pigments
Zinc (Zn)
Adequacy

-
Sources
meat
legumes
shellfish
grains
poultry
vegetables
DRI: 8-11 mg/day
Deficiency
(<66% of DRI)
Approx. <5-7 mg/day
Toxicity
(>UL)
>40 mg/day
Selenium (Se)
 Assists a group of enzymes that defend against oxidation
(Glutathione peroxidase)
Also play role
 in activating thyroid hormones
 may protect against some forms of cancers
 Deficiency may cause specific type of heart disease
known as Keshan Disease
 Widely distributed in foods i.e. meat, shellfish, fruits &
vegetables grown in Se- rich soil
 Tolerable upper intake level 400mg
Selenium (Se): Toxicity
Selenosis
Fatigue
Irritability, and
Nervous system
abnormalities
Garlic breath odor
Skin rash
Hair and nail brittleness and
loss
Adequacy
DRI: 55 µg/day
Deficiency
(<66% of DRI)
Approx. <36 µg/day
Toxicity
(>UL)
>400 µg/day
Selenium: Food Sources
 Most reliable sources:
 Meat
 Seafood
 Dairy
 Plant foods (grains, fruits, vegetables), depending
on soil selenium content.
Fluoride
 Not essential for life but
beneficial in diet because
 Inhibit the development of
dental caries
 also act on the bacteria which
causes plaque on teeth.
 Source
Drinking Water
 If fluoride 2-8 ppm cause
discoloration of teeth, or
“fluorosis”

Fluoride (F): Toxicity
Cardiac arrhythmias
Seizures and coma
Nausea, vomiting, diarrhea,
and excessive salivation
Fluorosis (tooth & skeletal),
Stiffness or pain in the joints
Hypercalcification
Muscle wasting, and
neurological defects
Adequacy
DRI: 3-4 mg/day
Deficiency
(<66% of DRI)
Approx. <2-2.6 mg/day
Toxicity
(>UL)
>10 mg/day
Chromium (Cr)
 Work closely with the hormone insulin
 when Cr lacking- insulin function is impaired –
cause diabetes- like condition- that resolve with
Cr
 high sugar diet deplete the body supply of Cr.
Chromium (Cr)
 Cr will not build extra muscle tissue or melt off fat”
 Cr does not reduce blood cholesterol
 Chromium compound used in various industries are know
Carcinogens
 Chromium is widely distributed recommend minimum
intake 50mg 90% U.S adults consume less
 Best source are

liver, whole grains, nuts, cheese
Copper (Cu)
 Most vital role is to help form hemoglobin &
collagen
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many enzymes depends on Cu for its O2- handling
ability
Cu assists in reaction leading to energy release
Regulate the activity of certain genes
 Cu dependent enzymes “Superoxide dismutase”
helps control damage from free radical activity in
the tissue.
born infants
Osteoporosis in infants and
children
Normocytic hypochromic
anemia
leukopenia and
neutropenia
Adequacy
DRI: 900 µg/day
Deficiency
(<66% of DRI)
Approx. <600 µg/day
Toxicity
(>UL)
>10,000 µg/day
Manganese (Mn)
 Manganese:

Bone Formation

Amino acid, Cholesterol, and carbohydrate
metabolism.
 Sources: Grains, Tea, Vegetables
Molybdenum (Mo)
 Cofactor for molybdoenzymes needed for the
catabolism of sulfur containing amino acids and
some RNA compounds
 Food Sources: Legumes, Grain products, Nuts
Cobalt
 Cobalt is the central component vitamin B12
(cobalamin).
 See vitamin B12 for functions, food sources,
deficiency, and toxicity information.