Water and Minerals

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Water and Minerals
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Water

• 60 of adult body weight is water
• is higher in kids
• More muscle, more water
• Changes in water level can quickly and
  dramatically impact weight

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Water

• Functions
• Carries nutrients through the body
• Blood and lymph systems
• Carries wastes out of the body
• urine
• Lubricant and cushion around joints, eyes, spinal
  cord, fetus
• Component of secretions
• Mucus, digestive secretions

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Water

• Functions contd
• Aids in regulation of body temp.
• Needed for many metabolic reactions
• Digestion of proteins, fats and starches
• All hydrolysis reactions require the input of
  water

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Water

• Maintaining water balance
• Goal is to balance water output and input
• Water Loss
• Urine
• Feces
• Sweat (kids and elderly sweat less)
• Exhale moist air

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Water

• Water Input
• Water
• Other fluids
• Water in foods
• Water made in metabolism

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Water Sources

• Good sources of water
• Water
• Juice
• Sports drinks
• Soups
• Fruits and vegetables

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Water Sources

• Poor Sources all are diuretics
• Caffeine containing coffee, tea, sodas
• Alcohol

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Water Intake

• Recommend 8-12 cups/day
• text 11-15 cups
• Amount needed depends upon
• Calories eaten, more calories, more water
• Level of exercise
• Impacts ______ and _______
• Recommend 3 cups water/lb loss sweating
• Climate

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Blood Volume

• Blood volume is regulated by the brain and
  kidneys
• When blood volume is low
• Ion concentrations rise

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Decreased Blood Volume

• Consequences low blood volume
• Urine production is reduced
• Dark yellow urine
• Blood vessels narrow to raise blood pressure
• Hypothalamus triggers thirst response
• Thirst response ALWAYS lags behind the need for
  water
• Thirst response diminished in elderly

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Dehydration

• When a water deficiency develops slowly thirst
  usually takes care of it
• When water deficiency occurs quickly dehydration
  occurs ? VERY SERIOUS

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Dehydration

• Symptoms of mild dehydration
• Thirsty
• Tired and weak
• Impaired performance
• Impatient and irritable
• Flushed skin
• Decreased urine output
• Dry mouth

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Dehydration

• Severe Dehydration SERIOUS
• Skin pale and dry
• Headache, cant concentrate
• Shallow rapid breathing
• Increased heart rate
• Dizziness, delirium, collapse
• Stop sweating
• Overheat .VERY SERIOUS

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Dehydration and Over-Heating

• Over-heating athletes and babies die from this
  every year (others too)
• Symptoms, in addition to dehydration
• Shock
• Seizures
• Coma
• Death

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Hyponatremia

• Water intoxication
• Fairly rare
• Most often occurs with rapid water consumption
  combined with heavy sweating
• Results in a potentially deadly drop in blood
  levels of sodium.

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Electrolytes

• Electrolytes are dissolved ions in body fluids
• Ion charged particle
• Ions attract water

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Electrolytes

• Major extracellular ions
• Sodium Na Na
• Chloride Cl -
• Major intracellular ion
• Potassium K
• Cl -

K
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Sodium Na

• Major ion outside of cells
• Functions
• Primary regulator of extracellular fluid volume
• Helps maintain acid-base balance
• Essential for nerve and muscle contraction

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Sodium Na

• Absorption
• Absorbed in SI into capillaries
• Recommended intake
• Minimum 500 mg/day
• Maximum 2400 mg/day
• A little more than 1 teaspoon

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Sodium Na

• Food sources
• Primary sources of sodium are processed foods,
  not the salt shaker
• Examples of high sodium foods

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Sodium Na

• Control of high blood Na levels
• Goal is to readjust the sodium to water levels to
  normal
• Thirst mechanism triggered
• Drink more water
• Kidneys filter the Na out and excrete it in the
  urine (if enough water)

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Sodium Na

• Low blood Na levels
• First ion (with Cl-) to be lost with sweating,
  bleeding, vomiting, diarrhea.
• In response to low Na levels, kidneys keep Na
  and excrete more K
• When Na levels drop in these ways you need to
  replace both the ions and the water

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Sodium Na

• Can raise levels of Na and water by
• Ingesting sports drinks
• Drinking dilute juices (add a little salt)
• Combining salt containing foods with fluids
• Rehydration fluid see page 392
• Salt pills are never recommended
• Pure water may not be the answer either.

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Sodium Na

• Sodium and Hypertension
• High sodium intake is associated w/ hypertension
  in many people (salt sensitive)
• Populations at risk
• African descent
• Family or personal history of hypertension
• Over 50
• Diabetic or obese
• Chronic kidney disease

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Sodium Na

• Lowering blood pressure
• Reduce sodium intake and increase potassium
  intake
• Reduce intake of processed foods, increase intake
  of fresh foods
• DASH Diet
• Lose weight

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Sodium Na

• High Na intake is associated with increased
  calcium excretion
• May contribute to osteoporosis

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Potassium - K

• Major electrolyte inside cells
• Functions
• Plays a major role in maintaining fluid and
  electrolyte balance
• Needed for nerve and muscle contraction
• Required for a steady heart beat
• Plays a role in carb and protein metabolism

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Potassium - K

• Absorption occurs in SI ? blood
• Recommended intake
• Minimum 4700 mg/day

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Potassium - K

• Food sources
• Fresh foods (intact cells)
• Fresh fruits and vegetables
• See page 397
• Processing lowers K levels and raises Na levels

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Potassium - K

• Potassium and Health
• Low K intake is associated with increased blood
  pressure
• High K intake may reduce or help prevent
  hypertension
• High K intake may lower risk of stroke

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Potassium - K

• Potassium deficiency
• Most common electrolyte imbalance
• Occurs most often due to excessive losses not a
  low intake
• Symptoms
• Muscular weakness (first symptom)
• Confusion
• Paralysis
• Heart failure may occur

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Potassium - K

• Potassium Toxicity
• Body excretes excess in urine
• Any toxicity will come from supplements, not
  foods
• Muscle weakness and vomiting
• A shot of potassium into a vein can cause the
  heart to STOP death

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Calcium Ca2

• Ca is the most abundant mineral in the body
• 99 in bones and teeth as hydroxyapatite
• On a collagen matrix
• 1 in blood as Ca2
• Blood level of calcium is tightly controlled

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Calcium

• Absorption
• Occurs in the SI
• Occurs best in an acidic environment
• Best absorption in first section of SI
• To be absorbed the Ca must bind to a Ca binding
  protein
• Vit D activates the binding protein

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Calcium

• Absorption
• Adults 30
• Kids 50-60
• Pregnancy 50

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Calcium Ca2

• Functions
• Bones
• Key component (along with P) of bone structure
• Serve as a calcium bank for the blood

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Calcium Ca2

• Functions - In Blood
• Regulates muscle contraction
• Needed for nerve function
• Plays a role in blood clotting

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Calcium Ca2

• Functions In Blood
• Plays a role in hormone secretion
• Activates some enzyme reactions
• Activates protein (calmodulin) that helps
  regulate blood pressure

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Calcium Balance

• Calcium Balance
• Calcium is constantly moving in and out of bones
• Intake must be adequate to replace all Ca taken
  out of bones

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Calcium Balance

• When blood calcium levels go up
• Hormones and vit D promote deposition of Ca into
  bones
• Key hormone for lowering blood Ca is calcitonin
• Page 401

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Calcium Balance

• Calcitonin lowers blood Ca
• Inhibits vit D activation
• Less Ca absorbed
• Prevents Ca reabsorption in kidneys
• More Ca excreted in the urine
• Slows breakdown of bones

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Calcium Balance

• When blood calcium levels are low
• Key hormone in raising Ca levels is parathyroid
  hormone
• Calcium absorption goes up in SI
• assuming Ca in diet and vit D present
• Bones release more Ca into blood
• Kidneys excrete less Ca

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Calcium Requirements

• Calcium Adequate Intake
• Adults 19-50 1000 mg/day
• Adults 51 1200 mg/day
• Pregnant or lactating 1000 mg/day
• Kids/teens 1300 mg/day

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Calcium Sources

• Food Sources page 403
• Dairy products great source of Ca
• Many also contain vitamin D
• Drawback - many are high in fat and cholesterol

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Calcium Sources

• Food Sources
• Dark green leafy vegetables
• Fairly good mustard greens, kale, broccoli
• Not as good spinach and Swiss chard
• Contain oxalates and phytates which lower the
  bioavailability of the Ca
• 8 cups of spinach 1 glass milk

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Calcium Sources

• Food Sources
• Nuts and legumes (limited calcium)
• Soy milk is often Ca enriched
• Calcium fortified products
• Orange juice
• Soy and rice milk
• Cereals..

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Calcium Sources

• Food Sources
• Other sources
• Sardines (eat the bones!)
• Oysters
• Molasses
• ??? Maple sugar water

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Calcium Sources

• Food Sources
• Asians cook with a stock made by boiling bones in
  vinegar
• 1 T 100 mg Ca
• Navajo use juniper ash in cooking
• 1 t 300 mg Ca (wow)

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Calcium

• Acute low/high blood levels of Ca is generally
  vitamin D related
• Acute low blood Ca ? tetany
• Uncontrolled muscle contraction
• Acute high blood Ca ? rigor
• Muscles contract and wont relax

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Calcium Deficiency

• Chronic low calcium intake
• Blood calcium levels are maintained at a safe
  level
• Bones serve as a source of Ca to keep blood
  levels safe
• Overtime this leads to osteoporosis
• porous bones
• pages 402

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Osteoporosis
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Osteoporosis

• Peak bone mass is reached by age 30
• Impacted by intake of Ca and vitamin D
• Bone loss begins after age 30
• Bone loss accelerates
• First 6-8 years after menopause
• Estrogen reduces bone loss

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Osteoporosis

• In general, lower bone density in
• Women vs. men
• Asians, Hispanics, Mexican Americans
• Caucasians vs. African American
• Smokers
• Alcoholics
• Low body weight
• Over age 50

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Maximizing Bone Mass

• Adequate intake
• Especially during peak bone building years
• Weight bearing exercise

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Calcium Supplements

• Good supplements
• Contain no more than 500 mg Ca
• An Intake of over 500 mg reduces absorption
• Also contain vitamin D
• Dissolve well

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Calcium Supplements

• Good supplements include
• Calcium carbonate
• Calcium citrate
• Calcium gluconate,
• Calcium acetate
• Calcium chelated amino acids
• Others.

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Calcium Supplements

• Avoid
• Bone meal (dolomite)
• May contain heavy metals
• Oyster shell
• Calcium is not well absorbed
• Antacids with magnesium or aluminum

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Phosphorus

• Second most abundant mineral in the body
• 85 in bones and teeth
• Found in ALL cells

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Phosphorus

• Functions
• Structural component of bones and teeth
• Part of DNA and RNA
• Need to make new cells
• Part of phospholipids
• Part of ATP
• Activates many enzymes and B vitamins
• Plays a role in acid/base balance

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Phosphorus

• Recommended Intake
• 700 mg/day
• Most meet this easily
• Food Sources
• Foods rich in proteins
• Animal proteins are the best sources
• Seeds, legumes
• Processed foods (from additives)

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Iron

• Trace mineral
• Other trace minerals include
• Zinc
• Iodine
• Selenium
• Fluoride
• Chromium.

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Iron

• Functions
• Every cell contains iron
• Need to make new cells
• Part of enzymes involved in energy metabolism

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Iron

• Functions
• Oxygen carrying component of hemoglobin
• Need to make RBC
• Component of the protein myoglobin
• Holds oxygen in muscle cells

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Iron

• Most iron is recycled by the liver and the spleen
• Therefore, needs are low.
• Needs go up when
• Significant blood loss
• During pregnancy

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Iron

• Recommended Intakes
• Adult males 8 mg/day
• Females 19-50 18 mg/day
• Females 51-70 8 mg/day
• Pregnant 30 mg/day
• UL 45 mg/day

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Iron

• Sources of iron 2 forms
• Heme iron from animal sources
• Absorbed better than nonheme iron
• Up to 25 absorbed
• Meat, poultry, fish
• All contain MFP
• MFP enhances iron absorption

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Iron

• Nonheme sources
• All plant sources of iron are in the nonheme form
• Animal sources contain both heme and nonheme iron
• Nonheme iron is poorly absorbed
• 2-20 (10 on average)

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Iron

• Nonheme food sources include
• Grains
• Legumes
• Fortified cereals and grains
• Dried fruits
• Vegetables
• Many are poor sources due to phytates and
  oxalates (same issue as seen w/ calcium)
• Cooking in iron pans enhances iron content of
  food!

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Iron

• Iron Absorption
• Vitamin C enhances Fe absorption
• MFP factor raises Fe absorption
• --------------------------------------------------
  ------
• Oxalates and phytates decrease absorption
• In dark green leafy vegetables
• High calcium intake interferes with absorption

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Iron Deficiency

• Iron deficiency reduced iron stores
• Not detected with a simple blood test
• Occurs often in children
• Affects their ability to be successful in school
• Easily corrected through diet
• Often overlooked
• Associated with pica

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Iron

• Symptoms of iron deficiency
• Weak, tired
• low energy
• apathetic
• Restless
• Irritable
• Less productive

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Iron

• Iron Anemia
• More serious than iron deficiency
• Iron stores depleted
• Not enough iron to make hemoglobin
• Symptoms of Iron Anemia
• All symptoms of Fe deficiency are intensified

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Iron Anemia

• Other symptoms
• Pale
• Can be hard to see in dark skinned individuals
• Cold
• Headaches
• Exhausted, listless
• Weak

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Anemia

• DO NOT self diagnose/treat iron anemia
• May be a sign of a more serious underlying health
  issue

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Iron Toxicity

• Often occurs when a child ingests too many iron
  supplements
• CAN BE LETHAL
• SEEK IMMEDIATE MEDICAL HELP

Do not call vitamins/medicine candy
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Iron Toxicity

• Symptoms acute iron poisoning
• Nausea, vomiting, diarrhea
• Rapid heartbeat
• Dizziness
• Confusion
• Death

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Iron Overload

• Iron overload is more common in males than
  females
• Deficiency is more common in females

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Iron Overload

• A common genetic disease called hemochromatosis
  results in over-absorption of iron
• ? iron toxicity

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Iron Overload (toxicity)

• Symptoms
• Apathy, lethargy, fatigue
• Same symptoms as in deficiency
• Liver damage
• May also become enlarged
• Increased infection
• Bacteria love iron
• Hair loss

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Iron Overload (toxicity)

• Symptoms
• Amenorrhea
• Impotence
• Increases risk of
• Diabetes
• Liver cancer
• Heart disease (?)

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Anemia

• Many nutritional deficiencies can lead to anemia
• Nutritional anemia is a HUGE problem worldwide