2. Perspectives in Nutrition 5 th ed. Gordon M.Wardlaw, PhD, RD, LD, CNSD PowerPoint Presentation by Dana Wu Wassmer, MS, RD

3. Chapter 11: Water and the Major Minerals

4. Water Comprise 50-70% of the body Intracellular fluid –Fluid within the cell Extracellular fluid –Interstitial –Intravascular

5. Fluid Balance Controlled by the electrolyte concentration “Where ions go, water is sure to follow” Osmosis –Movement of water from a less concentrated to a more concentrated solution Osmotic pressure –Amount of force to prevent the dilution

6. Movement of Water (Fig. 11-1) Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

7. Functions of Water Metabolic processes Solvent Body temperature regulation –Water absorb any excess heat –Body secretes fluids via perspiration –Skin is cool as perspiration evaporates Removal of body waste –Via urine –Urea excretion –Avoid concentrated urine Amniotic fluid, joint lubricants, saliva, bile

8. Are You Drinking Enough? Recommend 1ml per 1kcal (Fig. 11-3) Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

9. The Thirst Mechanism Not reliable (Fig. 11-4) Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

10. Water Safety Most drinking water are safe The Environmental Protection Agency Power to local and state authorities to advise public Rural areas may need to have their water tested Chlorine and ammonia are added to kill most microbes—I.e. Cryptosporidium Chlorine can be evaporated via boiling or standing

11. Toxicity of Water? Too much water without sufficient electrolytes intake More water than the kidneys can handle Usually not a problem (people won’t drink that much) Overwhelms the kidneys Headaches, blurred vision, cramps, convulsions

12. Minerals Various functions Major minerals –Require >100 mg /day –Calcium, phosphorus Trace minerals –Require < 100 mg/day –Iron, zinc

13. Bioavailability of Minerals Not all ingested minerals can be absorbed Presence of binders and dietary fiber Animal products are better absorbed Mineral/mineral competition Presence of vitamins

14. Functions of Minerals Metabolic roles Cofactors Body growth and development

15. Food Sources of Minerals Plants Animals (Animals eat plants) Enrichment process adds iron

16. Risk for Mineral Deficiencies Calcium Iron Zinc

17. Toxicity of Minerals Especially with trace minerals Careful use of mineral supplements Avoid amounts above the Upper Tolerable Intake Levels

18. Sodium Table salt (NaCl): 40% sodium, 60% chloride

19. Absorption, and Excretion of Sodium 95% of ingested sodium is absorbed Absorbed from the stomach, small intestine and colon Excretion regulated by the kidneys

20. Blood Pressure and Sodium Regulator (Fig. 11-4) Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

21. Functions of Sodium Positive ion in extracellular fluid Aldosterone regulates sodium balance Key for retaining body water Participates in nutrient absorption Creates an electrical potential charge Muscle contraction Conduction of nerve impulses

22. Deficiency of Sodium Rare Persistent vomiting/ diarrhea Excessive perspiration (losing 2-3% of body weight) Depletion of sodium in the body Muscle cramps, nausea, vomiting, dizziness, shock, coma Normally kidney will respond by conserving sodium

23. Food Sources of Sodium 1/3 - ½ of intake is added to food by individual ½ - 2/3 is added by food manufacturers Lower salt products available Milk and Dairy products Breads, hot dogs, lunch meats, soups, sauces, snack foods Sodium content listed on the labels

24. Sodium Needs Body only needs 100 mg/day Minimum requirement is 500 mg/day Daily Value is 2400 mg/day Typical intake is 4000-7000 mg/day

25. “Salt Sensitive” 10%-15% of adults are High sodium intake leads to high blood pressure Recommend 2-3 gm sodium per day Recommended for all individual You will adapt to a low-sodium diet

26. Potassium Positive ion in the intracelluar fluid Associated with lowering blood pressure

27. Absorption and Excretion of Potassium 90% of potassium consumed is absorbed Regulated by aldosterone and the kidneys

28. Functions of Potassium Fluid balance, nerve-impulse transmission Muscle contraction

29. Foods Sources and Needs for Potassium Found in fruits, vegetables, milk, grains, meats, dried beans Minimum requirement is 2000 mg/day Daily Value is 3500 mg/day Typical intake is 2000-3000 mg/day Excess potassium is excreted by the kidneys

30. Potassium Deficiency Rare Use of diuretics Alcoholics, anorexia nervosa, bulimia nervosa Loss of appetite, muscle cramps, confusion, constipation, irregular heart beat

31. Chloride Negative ion for the extracellular fluid Absorbed in the small intestine and colon Excreted through the kidneys Components of hydrochloric acid (HCl), immune response, nerve function Excess is excreted by the kidneys/perspiration Minimum requirement is 700 mg/day Much is obtained from salt consumption High intake may cause high blood pressure

32. Calcium 99% is in bones and teeth Makes up 40% of all the minerals present in the body

33. Absorption of Calcium Amount in the body is dependent on amount absorbed Requires a slightly acidic environment Duodenum is the site of absorption Availability of vitamin D Normally absorb 25% of calcium in food Increase to ~60% during time of need (pregnancy, infancy) Estrogen increases absorption Parathyroid hormone

34. Decrease Absorption of Calcium Rapid intestinal motility High fiber intake Excess phosphorus Vitamin D deficiency Presence of polyphenols (tannins) in tea Menopause Aging Achlorhydria

35. How Blood Calcium is Regulated Blood level is maintained at the price of bone calcium Parathyroid hormone - increases blood calcium –Retains calcium from excretion –Increases calcium absorption via increase calcitriol –Increases calcium release from bone Lower blood calcium –Decreases parathyroid hormone and calcitriol –Calcitonin

36. Calcium Regulation (Fig. 9-9) Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

37. Functions of Calcium Blood clot –Needed to convert prothrombin to thrombin Nerve impulses transmission –Transmitted at the site of the target cell Muscle contraction Cell metabolism –Binds with calmodulin –Activates various enzymes

38. Bone Structure Hydroxyapatite (mature bone) Calcium released Supports and strengthens Collagen protein matrix parathyroid hormone + 1,25 (OH) 2 vitamin D Osteoblasts Osteoclasts

39. Bone Mass During growth, osteoblast exceeds osteoclast activity (make more than we break down) More bone mass in areas under higher stress Peak bone mass reached between the age of 20-30 Bone loss begins in mid-adulthood Significant loss at menopause

40. 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 the use of certain medications

41. Structure of Bone (Fig. 11-8) Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

42. Calcium and Blood Clotting Formation of fibrin (Fig. 9-13) Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

43. Transmission of Nerve Impulses (Fig. 11-9) Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

44. Muscle Contraction (Fig. 3-4) Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

45. Calmodulin System (Fig. 11-10) Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

46. Other Roles of Calcium May lowers blood pressure May reduce colon cancer May reduce PMS symptoms May lower blood cholesterol May reduce kidney stones

47. Osteoporosis Calcium deficiency “A pediatric disease with geriatric consequences” Leads to ~1.5 million fractures / year Factors to increase bone mass

48. Food Sources of Calcium Dairy products Kale, collard, mustard greens Calcium fortified foods Tofu (if made with calcium carbonate) Canned fish

49. Calcium Supplement Recommended for people who cannot incorporate Ca into their diets Not recommended with high iron meal Calcium carbonate (40% calcium) –For those with ample of stomach acid –Found in antacids Calcium citrate (21% calcium) –Enhance absorption due to acidity content –Recommended for elderly

50. Risk With Calcium Supplements Lead contamination No FDA regulation Oyster shell Bonemeal Look for United States Pharmacopoeia seal of approval

51. Calcium Needs Daily Value is 1000 mg/day Adequate Intake (based on 40% absorption) is 1000 -1200 mg/day for adults Adequate Intake is 1300 mg/day for adolescents (9-18 yrs. old) Average intake range from 600-800 mg/day for women and 800-1000 mg/day for men

52. Can You Get Too Much Calcium? Small intestine prevents excess from being absorbed Upper Level set at 2500 mg/day Kidney stones, calcium in the urine Hypercalcemia Calcification of tissue Less efficient absorption

53. Phosphorus Body absorption is based on body’s need (70%-90%) Absorption enhanced by calcitriol Passive absorption based on the phosphorus concentration in the lumen Excess excreted by the kidney Component of ATP, cell membrane, and bone May be needed in elderly to preserve bone

54. Functions of Phosphorus 80% found in bones and teeth Found in every cell ATP DNA, RNA Phospholipids Acid-base balance

55. Deficiency of Phosphorus Contribute to bone loss Decrease growth, tooth development Rickets Anorexia, weight loss weakness, irritability, bone pain

56. Food Sources of Phosphorus Various foods Dairy, bakery products, and meats Some from food additives Most difficult to limit intake of RDA is 700 mg/day for adults Daily Value is 1000 mg Current intake exceeds RDA Deficiency highly unlikely

57. Who is at Risk For Deficiency? Pre-mature babies Alcoholics Elderly with poor diets Long-standing diarrhea Use of aluminum-containing antacids (binds to phosphorus)

58. Toxicity of Phosphorus Problem for individuals with inefficient kidney function Phosphate ions bind calcium Calcium-phosphorus precipitates in body tissues Upper Level is 3-4 g/day May compound bone loss if calcium intake is low

59. Magnesium Primarily in green leafy plants Absorption based on body’s needs (40%- 60%) Absorption enhanced by vitamin D Kidneys regulate blood concentration of magnesium Alcohol increases loss in the urine Much stored in the body

60. Functions of Magnesium An enzyme activator Activates ATP Contributes to DNA and RNA synthesis Potassium and calcium metabolism Proper nerve and cardiac functions Insulin release from the pancreas May dilate arteries May prevent heart rhythm abnormalities

61. Deficiency of Magnesium Develops slowly Rapid heartbeat Weakness, muscle spasms, disorientation, nausea, vomiting, seizures May increase the risk of osteoporosis

62. Food Sources of Magnesium 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

63. Too Much or Too Little Magnesium Magnesium loss –Thiazide diuretic use –Heavy perspiration –Long-standing diarrhea or vomiting –Alcoholism –Disorientation, weakness, muscle pain, poor heart function Toxicity is uncommon –Associated with kidney disorder –Weakness, nausea, malaise

64. Sulfur Nonionic and ionic forms Part of an organic compound Disulfide bridges Acid-base balance Drug detoxifying pathways Part of a natural diet, primarily from protein Used to preserve foods