Vitamins, Minerals and Water

Whate are the primary functions of water within the body?

Provides shape/structure to cells

Regulates body temp

Aids in digestion/absorption of nutrients

Transports nutrients and O2 to the cells

Solvent for vitamins, minerals, glucose, amino acids

Participant in metabolic rxns

Eliminates waste products

Major component of mucus/lubricating fluids

What is an insensible water loss? What are some factors that may contribute to it?

Water loss that occurs without being easily noticed or measured (Sweating, breathing)

Potential contributors are: Fever, tachypnea, extensive burns.

What is a sensible water loss?

Water loss that can be observed and measured (Urine, stool, drainage from tubes, wound drainage, vomiting)

Increased salt consumption can lead to what type of water loss?

Sensible (Urination)

Total body water balance is tightly regulated within what percentage of body weight?

Around 0.2%

How is water intake primarily measured in a clinical setting?

Color of urine and skin turgor

What is the formula for determining fluid needs by weight?

Kg x 30 mL

A net loss of 1-2% body weight in water results in what adverse reactions?

Thirst, fatigue, weakness, loss of appetite

A net loss of 7-10% body weight in water results in what adverse reactions?

Dizziness, muscle spasm, hypotension, loss of balance, delirium

True or false: If the body is deficient in a micronutrient, it becomes less effective in absorbing it.

False; The body is better at absorbing a micronutrient it is deficient in

Food mineral content is dependent on which factor?

The soil in which it is grown

List the main functions of minerals in the body

Provide structure

Fluid balance

Acid base balance

Nerve cell transmission & Muscle contraction

Some play a role alongside vitamins in metabolic rxns

What vitamin promotes the absorption of calcium in the body?

Vitamin D

What vitamin promotes the absorption of iron in the body?

Vitamin C

A high dose of zinc inhibits the absorption of what mineral?

Copper

List the main functions of electrolytes

Fluid balance

Hydration

Regluate osmotic pressure

Acid-base balance

Transmission of nerve impulses & membrane permeability

Muscle contraction

List the major and minor electrolytes

Major: Sodium, Potassium, Chloride

Minor electrolytes: Calcium, Magnesium, Phosphate

Restriction of what electrolyte may increase salt sensitivity?

Potassium

What is the DGA of potassium for men and women?

Men: 3400 mg/day

Women: 2600 mg/day

What electrolytes can be adjusted to regulate blood pressure?

Sodium (Most important)

Potassium (Helps lower)

Calcium

Magnesium

What are some foods rich in potassium?

Cooked beet greens (1309 mg/cup)

Medium baked potato (929 mg)

Guava (688 mg/cup)

Plain yogurt, kiwi, banana

What is the primary function of calcium?

Bone health

Calcium balance is controlled primarily by what two regulators?

Vitamin D and PTH

True or false: Calcium deficiency is common in Americans.

False; Ca deficiency is uncommon

What is the primary function of phosphorous?

Bone health

The absorption of phosphorous is controlled by what two regulators?

Vitamin D and PTH

Phosphorous is NOT found in what food source?

Fruits

A deficiency of what major mineral results in minerals being taken from bone?

Phosphorous

What major mineral is a cofactor in over 600 enzymatic reactions?

Magnesium

Why is it difficult to get enough magnesium from consuming whole foods?

80-89% in food is lost in processing

What are the main functions of magnesium?

Component of bone

Energy production

Muscle/nerve function

Glucose control

BP

Protein synthesis

What conditions typically leave people deficient in magnesium?

Type 2 DM

Celiac dz

Intestinal bypass

Medications (PPI, ATBs, diuretics)

Where is Heme vs. Non-heme iron found?

Heme: Animal foods (15%-35% absorbed)

Non-heme: Dark leafy greens, beants, nuts/seeds, dark chocolate, broccoli (2%-20% absorbed)

True or false: We don't excrete iron, so we regulate absorption

True

What are the primary functions of iron?

Oxygen transport in the body

Hemoglobin formation

What are common manifestations of iron deficiency?

Anemia; fatigue, shortness of breath, chest pain

*Dangerous if untreated

What foods are sources of Zinc?

Oysters, meat, beans, nuts/seeds, dairy, some grains (More bioavailable in animal foods)

What are the functions of Zinc?

Immune function,

Tissue growth/wound healing

Supplementing what two vitamins/minerals at the start of an illness can reduce the duration of the illness?

Vitamin C

Zinc

What are common causes of zinc deficiency?

Malnutrition, alcoholism, malabsorption, burns, vegetarian diets.

What easily acquirable food item is enhanced to provide iodine to the average diet?

Iodized salt

What are the functions of iodine?

Essential component of thyroid hormones

Immune system

What mineral is used in some cleaners in hospitals due to its ability to fight off bacteria?

Iodine

What are the main factors contributing to mineral deficiencies in the US?

Poor soil & overconsumption of processed foods

What are the common mineral deficiencies?

Magnesium

Iron

Zinc

Iodine

Minerals like to be in __________.

Balance

What are the negative effects of long-term calcium deficiency?

Osteopenia, Osteoporosis, muscle weakness

What vitamins and minerals contribute to immune function?

Vitamin C

Vitamin A

Vitamin D

Vitamin E

Vitamin B6, Folate

Zinc

Iron

Selenium

List the major and trace minerals

Major:

Calcium

Phosphorous

Magnesium

Sulfur

Sodium

Potassium

Chloride

Trace:

Iron

Iodine

Zinc

Selenium

Copper

Manganese

Fluoride

Vitamins are organic compounds composed of what elements?

Carbon, hydrogen, oxygen. and sometimes nitrogen or other elements. (Chemically defined)

What is the general function of vitamins?

Facilitate biochemical reactions within the cells:

Coenzymes

Antioxidants

Food additives (Nutrition value & preservation)

True or false; Minerals are susceptible to destruction by sunlight or temperature.

False; Vitamins are susceptible to destruction.

Vitamins act as coenzymes in what chemical reactions?

Energy, metabolism, exercise

What are free radicals and what do they do?

Unstable molecules with an unpaired electron; They try to steal electrons from (oxidize) other molecules, ultimately damaging cells and tissues.

What protects the cells from free radicals? How?

Antioxidants give free radicals electrons to neutralize them.

What vitamins act as antioxidants?

Vitamin C

Vitamin E

List the fat-soluble and water-soluble vitamins

Fat-soluble: Vitamins A, D, E, K (More prone to toxicity)

Water-soluble: B complex, Vitamin C

Where can fat-soluble vitamins be stored?

Liver and fat tissue

Where is preformed vitamin A (Retinol) found?

Animal foods

Liver

Whole milk

Fish

Where is provitamin A (carotenoids) found? List some.

Plants with bright colors; Beta-carotene, lycopene. ;utein, zeaxanthin

Name the active and inactive forms of vitamin A: Which is prone to toxicity at high doses?

Active: Retinol (Preformed vitamin A)

Inactive: Carotenoids (Provitamin A)

Retinol is toxic at high doses

What are the functions of vitamin A?

Immune function, antioxidant, eye health/vision, reproduction & growth

Night blindness can be a deficiency related to what vitamin?

Vitamin A

Vitamin D is a prohormone, meaning that:

It is a compound synthesized in one part of the body (Skin) and promotes function elsewhere in the body (Liver & kidney)

What are the two forms of vitamin D and where are they found?

Vitamin D3 (Active): Some animal food, fatty fish, liver, eggs

Vitamin D2: Mushroom, fortified foods

What are the functions of vitamin D?

Immune function, bone health, stimulates insulin, apoptosis, cell differentiation

What are the adverse effects of Vitamin D deficiency?

Depression

Hepatic & renal failure

Muscle weakness/aches

Osteoporosis

Osteoarthritis

Osteomalacia

Rickets

What are contributing factors to vitamin D deficiency?

Poor availability in diet

Lack of sun exposure

Obesity

What values does the RDA require for vitamin D as of 2010? Are these accurate? Why or why not?

Adults: 600 i.u.

Older adults (70+): 800 i.u.

Newer studies say we may need more

What are ideal blood vitamin D levels?

Optimal is roughly 50 ng/dL

What are the two forms of vitamin K and their sources?

Vitamin K1 phylloquinone: Plants, spinach, broccoli, soybeans, lettuce, green beans, chard

Vitamin K2 menaquinones: Animal foods, dairy, eggs, synthesized in gut in small amounts

What are the main functions fo vitamin K?

Coenzyme for synthesis of prothrombin,

Needed for normal blood clotting,

Maintains bone vitamin D

True or false: Vitamin K deficiency is rare

True

What foods can increase your body's ability to produce vitamin K?

Fermented foods

Which form of vitamin K is more readily absorbed by the body?

Vitamin K2: Menaquinones

What solubility class of vitamins need to be eaten daily? Why?

Water-soluble vitamins; the body does not store them.

List some B complex vitamins

Thiamin (B1)

Riboflavin (B2)

Niacin (B3)

Pantothenic acid (B5)

Pyridoxine (B6)

Biotin (B7)

Folate (B9)

Cobalamin (B12)

Vitamin B12 is only found in what food sources?

Animal sources

Folate supplements should be used wisely because they can mask a deficiency of what other vitamin?

B12

What are the functions of folate?

DNA synthesis

Cell division

Homocysteine metabolism (Inflammatory marker for heart disease)

Define macrocytic anemia

Unusually large blood cells due to low folate and/or B12

What are good sources of folate in the diet?

Liver, leafy greens, asparagus, peas, beans, fortified foods

True or false; Elevated folate levels have been linked to increased cancer risk

False; Low folate levels are linked to increased cancer risk

What are the functions of vitamin B12?

Interdependent relationship with folate

Role in DNA synthesis

Maturation of red blood cells

Maintenance of myelin sheath

Homocysteine (Inflammatory marker for heart disease)

IS vitamin B12 deficiency common? Why or why not?

Common due to absorption issues (Vegans, elderly, gastric bypass, GI disease, medications (PPIs, metformin, antibiotics)

What vitamin has the potential to interfere with anticoagulants?

Vitamin K

What are the adverse effects of severe vitamin B12 deficiency?

Pernicious anemia (Decreased IF)

Irreversible nervous system damage

Macrocytic anemia

What food sources provide vitamin B12?

Only animal foods

What are the functions of vitamin C?

Promotes formation of collagen

Antioxidant

Iron absorption

Supports normal immune function

What stressors are known to increase the body's need for vitamin C?

Fever

Chronic illness

Infection

Wound healing

Adrenal fatigue

Meds

Smoking

What are the best sources of vitamin C?

Citrus, broccoli, red and green peppers, mustard greens, berries, cataloupe

What vitamins and minerals are most associated with deficiency?

Vitamins: A, D, K, B12, Folate, other B complex vitamins

Minerals: Magnesium, zinc, iodine, iron

What groups are most at risk for nutrient deficiencies?

People on low calorie diets

Vegans, vegetarians, specialized diets

Picky eaters/Children

Older adults

Alcoholics

High processed food diets

People with food insecurity

What medications are most commonly linked to nutrient deficiencies?

PPIs

Steroids

ATBs

Antidepressants

Statins

Birth control

Duiretics

Diabetes medications

What vitamins and minerals are absorbed poorly in patients taking PPIs?

B12

Magnesium

Calcium

Iron