Chapter 8 Minerals

Key Concepts A mixed diet of varied, colorful foods with adequate energy value is the best source of the minerals necessary for health. Of the total amount of minerals a person consumes, only a relatively limited amount is available to the body. Building blocks of life Hydrogen Carbon Nitrogen Oxygen Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved. 2

Functions of Minerals Functions of minerals Building tissue Activating, regulating, transmitting, and controlling metabolic processes Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

The Nature of Body Minerals Classes of body minerals Major minerals (>100 mg/day) Trace elements (<100 mg/day) Mineral metabolism Digestion: minerals do not require much digestion Absorption: rate determined by food form, body need, tissue health Transport: enter through portal circulation, bound to proteins Tissue uptake: controlled by hormones, excess excreted in urine Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Major Minerals Calcium - Ca Phosphorus - P Sodium - Na Potassium - K Chloride - Cl Magnesium - Mg Sulfur - Su Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Calcium Functions Bone and tooth formation Blood clotting Muscle contraction and nerve action Metabolic reactions – helps with: Absorption of B12 Activation of pancreatic lipase Secretion of insulin Cell membrane permeability Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Calcium, cont’d Requirements 1000 mg/day Deficiency states Toxicity Osteoporosis Toxicity hypercalcemia Food sources Milk is the major food source Green vegetables (broccoli, spinach, kale), fish with bones like sardines, fortified food Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Osteoporosis Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Phosphorus Functions Bone and tooth formation Energy metabolism – helps with: Oxidation of carbohydrate, fat, and protein Energy and protein metabolism Cell function and genetic inheritance Component of enzymes, thiamin, DNA/RNA Acid-base balance Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Phosphorus, cont’d Requirements: 700 mg/day Deficiency states: hypophosphatemia Toxicity- symptoms of hypocalcemia Food sources All living tissue especially meats Milk, milk products, fish, eggs Plant seeds Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Sodium Functions Water balance Muscle action Nutrient absorption Deficiency states Rare unless excessive sweating or water intake Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Sodium, cont’d Requirements Toxicity symptoms AI: 1.5 g/day UL: 2.3 g/day average no more than 2 gm per day Toxicity symptoms Salt sensitivity and hypertension Food sources Table salt, cured meat, canned soups, processed food Vegetables –carrots, leafy greens and celery Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Potassium Requirements: AI: 4.7 g/day Functions Water balance Metabolic reactions – helps with: Conversion of blood glucose to glycogen Storage of nitrogen in muscle protein Production of energy Muscle action/ cardiac contraction Insulin release Blood pressure- increasing potassium (intracellular ion) and decreasing sodium (extracellular ion) Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Potassium, cont’d Deficiency- American diet is low; eat your vegetables!! Low = muscle weakness and cardiac irregularity Toxicity with renal disease; excessive intake Food sources Oranges, bananas, tomato, leafy green vegetables, whole grains, fresh meats, milk products Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Chloride Functions Water balance Acid base balance Digestion Key element in hydrochloric acid secretion Respiration Plays a role in transport of CO2 in the blood Source: Table salt Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Chloride (cont’d) Requirements: AI: 2.3 g/day Deficiency states: through vomiting Toxicity symptoms: from severe dehydration Food sources: table salt Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Magnesium Functions General metabolism Necessary catalyst for ~300+ reactions in cells Protein synthesis activates amino acids, role in synthesis and maintenance of DNA Muscle action: cardiac contractility & used in preventing premature labor Basal metabolic rate Influences secretion of thyroxine Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Magnesium, cont’d Requirements: ~300 to 400 mg/day Deficiency states: hypomagnesemia, rare with balanced diet Toxicity symptoms: excessive supplements may produce GI symptoms. Toxicity with renal disease Food sources Nuts, soybeans, cocoa, seafood, dried beans and peas, green vegetables, whole grains Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Sulfur Functions Hair, skin, and nails General metabolic functions High-energy bond Transfer energy Vitamin structure Collagen structure Food sources Meat, nuts, soy, fish, cheese, eggs Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Key Concepts A mixed diet of varied foods and adequate energy value is the best source of the minerals necessary for health. Of the total amount of minerals a person consumes, only a relatively limited amount is bioavailable to the body. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved. 20

Trace Elements Iron Iodine Zinc Selenium Fluoride Copper Manganese Chromium Molybdenum Cobalt Boron Vanadium Nickel The recommended intake for trace minerals is less than 100 mg/day

Iron Functions Deficiency states Requirements Hemoglobin synthesis and general metabolism Deficiency states Anemia Requirements 8 to 11 mg/day for males 8 to 18 mg/day for females Toxicity symptoms- Hemochromatosis Food sources Heme (rapid absorption) – 40 % animal foods Nonheme (slow absorption )– 60% animal and all plants (increased absorption with Vit C) Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Iodine Functions Participation in thyroid gland’s synthesis of thyroxine Requirements: 150 mcg/day Deficiency states Goiter – usually a lack of iodine causes this Cretinism – hypothyroid of childhood Hypothyroidism Hyperthyroidism Food sources Iodized table salt, seafood; depends on soil content Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Goiter Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Zinc Functions Requirements Deficiency states Enzyme constituent Immune system Protects RBC from damage Requirements 11 mg/day for males & 8 mg/day for females Deficiency states Poor wound healing Impaired taste and smell Iron inhibits absorption Toxicity- Abdominal pain, nausea, vomiting and diarrhea, headache, irritability, lethargy, anemia & dizziness. Food sources- Meat, seafood, legumes, whole grains Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Selenium Functions Part of antioxidants Requirements RDA: 55 mcg/day Deficiency affects immune system Toxicity symptoms – brittle hair and nails Food sources Seafood, Organs (kidney, liver, etc.); depends on soil content where plants are grown Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Other Trace Elements Fluoride Functions by preventing dental caries Exceeding UL may cause fluorosis Copper : “Iron twin” (works the same way) Found in organ meats(liver), seafood nuts & legumes. Manganese Inhalation toxicity Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Other Trace Elements, cont’d Chromium Glucose tolerance factor Molybdenum Inadequate dietary intake improbable Other essential trace elements Aluminum, arsenic, boron, nickel, silicon, tin, vanadium Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Mineral Supplementation Life cycle needs Pregnancy and lactation Adolescence Adulthood Clinical needs Iron-deficiency - anemia Zinc deficiency – immune system weakens Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Summary Minerals are single, inorganic elements that are classified according to their relative amounts in the body. Major minerals make up 60% to 80% of all inorganic material in the body. Trace elements make up less than 1% of the body’s inorganic material. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Chapter 9 Water Balance

Key Concepts of Water Balance Water compartments inside and outside cells maintain a balanced distribution of total body water via osmosis and diffusion. The concentration of various solute particles in water determines internal shifts and movement of water. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Homeostasis Body’s state of dynamic balance Capacity of the body to maintain life systems despite what enters the system from outside Homeostatic mechanisms protect the body’s water supply Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Body Water Functions Solvent Water is the basic liquid solvent for all chemical processes within the body Transport Nutrients carried through the body in water-based fluids (e.g., blood, secretions) Thermoregulation Maintains stable body temperature Body lubricant – serous and synovial fluids

Body Water Requirements Surrounding environment Body water evaporates as sweat and must be replaced Activity level More water is needed for increased metabolic demand during physical activity Functional losses Disease process affects water requirements Metabolic needs 1000 ml of water necessary for every 1000 kcal in the diet Age Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Fluid Compartments Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Other Dietary Factors Dehydration >2% total body weight loss Special concern in the elderly Water intoxication Those at risk: Infants Psychiatric patients Patients on psychotropic drugs Endurance athletes Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Percentage of Body Weight Loss Figure information: From Mahan LK, Escott-Stumps: Krause’s food and nutrition therapy, ed 12, Philadelphia, 2008, Saunders. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Body Water Amount and Distribution Extracellular fluid Total body water outside cells One quarter of extracellular fluid is blood plasma Three quarters is water surrounding cells and bathing tissues, water in dense tissue, and water moving through the body as secretions Interstitial fluid Fluid surrounding cells in tissues Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Body Water Amount and Distribution, cont’d Intracellular fluid Total body water inside the cells Twice the volume of that outside the cells Overall water balance Average adult metabolizes 2.5 to 3 L of water/day 100 ounces per day Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Distribution of Total Body Water Figure information: From Thibodeau GA, Patton KT: Anatomy & physiology, ed 6, St Louis, 2007, Mosby. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Electrolytes Small, inorganic elements that break apart in a solution and carry an electrical charge (ions) Cations: positive charge Anions: negative charge Balance between cation and anion concentration maintains chemical neutrality necessary for life Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Plasma Proteins Mainly albumin and globulin Organic compounds of large molecular size Retained in blood vessels, does not diffuse out Controls water movement Colloids guard blood volume (colloidal osmotic pressure) Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Separating Membranes Capillary membrane Thin and porous Water molecules, electrolytes and nutrients move freely across them Cell membrane Thicker membranes Constructed to protect and nourish cell contents Uses channels for specific ions or molecules Fats merge freely Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Forces Moving Water and Solutes Across Membranes Osmosis Process or force that impels water molecules to move throughout body Moves water molecules from an area of greater concentration to an area of lesser concentration Diffusion Force by which particles in solution move outward in all directions from an area of greater concentration to an area of lesser concentration Facilitated diffusion Similar to simple diffusion Addition of transporters that assist particles across membrane

Moving Water and Solutes Across Membranes Filtration Water is forced through membrane pores when pressure outside the membrane is different Active transport Necessary to carry particles “upstream” across separating membranes Pinocytosis Larger molecules attach to thicker cell membrane, then are engulfed by cell Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Capillary Fluid Shift Mechanism Cells’ water and nutrients must move from capillaries to cells. Water and cell metabolites must return to capillaries. Uses opposing fluid pressures: Hydrostatic pressure Colloidal osmotic pressure Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Organ Systems Involved in Body Water Balance Gastrointestinal circulation Water from blood plasma is continually secreted into the gastrointestinal tract. In the latter portion of the intestine, most water and electrolytes are reabsorbed into the blood. Isotonicity: equal osmotic pressure Clinical applications: loss of isotonicity through vomiting or prolong diarrhea Renal circulation Kidney filters the blood to maintain water balance and proper solution of blood Hormonal controls: Antidiuretic hormone mechanism Renin-Angiotensin-Aldosterone mechanism

Acids and Bases Homeostatic balance of acidity or alkalinity must be maintained in body water solutions and secretions The concentration of hydrogen ions determines the acidity level Acidity expressed in terms of pH Acids and bases: refers to hydrogen ion concentration, pH of 7 is neutral Acid: compound has more hydrogen ions, can release ions when in solution Base: compound with fewer hydrogen ions, can accept ions when in solution Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Acid-Base Buffer System Handles an excess of acid or base Mixture of acid and base that protects a solution from wide variations in pH Main buffer system: carbonic acid (H2CO3- from H2O and CO2) base bicarbonate (HCO3) (seen in the chloride shift during CO2 transport)

Acid-Base Buffer System con’t Respiratory control Carbon dioxide- leaves the body raising blood pH Urinary control Kidney monitors hydrogen ions: May excrete hydrogen in urine by trading H for NA May keep hydrogen to lower the pH Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Summary Overall water balance is maintained by fluid intake and output Two types of solute particles control the distribution of body water Electrolytes Plasma protein The acid-base buffer system uses electrolytes and hydrogen ions to maintain a normal extracellular fluid pH of approximately 7.4 Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.