Nutrition 3

Ions:

Charged atoms

Extracellular:

Fluid outside of cells

Interstitial:

Fluid between cells

Intracellular:

Fluid inside cells

Thirst mechanism:

1. A 10% decrease in plasma volume (amount of liquid in blood)

2. OR a 1-2% increase in plasma particles causes a dry mouth

If you don’t drink the hypothalamus communicates with the cerebrum to have thoughts of getting a drink

If you can’t get a drink, the hypothalamus will stimulate from various hormones that regulate water balance

ADH:

Hormone released by the pituitary when salt concentration is too high or blood volume or blood pressure are too low

Causes kidney to reabsorb water instead of leaving the body

Renin Angiotensin system:

Renin is released by the kidneys when BP or BV is low

Renin activates the blood protein (angiotensin)

Angiotensin constricts blood vessels and your pressure will go up and cause the kidneys to reabsorb sodium and water

Aldosterone:

Hormone made by the adrenal glands

Causes kidneys to reabsorb water and sodium

Obligatory Water Loss:

Minimum amount of water required to dispose of wastes, which is half a liter

Dehydration:

Excessive water loss

Symptoms: Thirst, weakness, delirium, exhaustion, dry mouth and skin, dizziness, spasms, headache, difficulty concentrating

Water intoxication:

Excessive water intake in a short period of time

Sometimes people have this because of a kidney problem

Symptoms: starts off with confusion → convulsions → death

Osmosis:

Movement of water from high to low water concentrations

Cation:

Positive atom

Anion:

Negative atom

Electrolytes:

Salts that break apart in water and conduct electricity

Acidosis

Blood pH less than 7.35

This depresses the nervous system

Alkalosis

Blood pH greater than 7.45

Overexcites the nervous system

Bicarbonate Buffer System:

Made of 3 parts:

1. H+

2. HCO3-

3. H2CO3

ONLY HCO3- will neutralize an acid

HCO3- + H+ → H2CO3

Bases will interact with all 3 components. H+ + OH- → H2O

Na:

Sodium

Main ion outside cells

Needed for muscle contraction, required by nerves, regulates extracellular fluid and acid-base balance

Deficiency: headaches, confusion, cramps, seizures

Toxicity: swelling, high BP, and weaker bones

Good sources: table salt and processed foods

Cl:

Chlorine

Needed in stomach acid and regulates extracellular fluid

Deficiency: usually loss of appetite and weakness

Because it is in everything, we rarely see it

Toxicity: causes vomiting

Good sources: table salt and processed foods

K:

Potassium

Main positive atom inside of cells

Need for muscles, nerves, and fluid balance

Deficiency: weakness, arrhythmia

Toxicity: weakness, vomiting, and cardiac arrest

Almost impossible to find a potassium pill (very easy to jump into the toxic stage if you take one)

Good sources: fruits, vegetables, meats, beans, milk

Ca:

Calcium

Required for bones, teeth, muscles, and blood clotting

Acidity, vit. D, and lactose (the sugar) will improve its absorption

Fiber, high phosphorus, and oxalates interfere with its absorption

Deficiency: slow growth, bone loss, and tetany

Toxicity: constipation, kidney stones, and rigor

Good sources: milk and sardines

Tetany:

Intermittent muscle spasms

Rigor:

Hard or stiff muscles that are cramped up

Parathyroid hormone:

Moves calcium from the bones into the blood

Calcitonin:

Moves calcium from the blood into bones

P:

Phosphorus

Need it in ATP, DNA, RNA, and cell membranes

Forms hydroxyapatite in bones/teeth (hard crystal)

Deficiency: weakness and bone pain

Toxicity: calcium to be excreted in urine

Good sources: dairy, meat, nuts, and legumes

Mg:

Magnesium

Needed in bones, holds calcium inside tooth enamel, required by over 300 enzymes

Deficiency: weakness, confusion, difficulty swallowing, convulsions, and hallucinations

Toxicity: diarrhea, dehydration, and alkalosis (high pH)

Good sources: green vegetables, nuts, chocolate, beans, seafood, and potatoes

S:

Sulfur

Stabilizes proteins and used to make insulin and biotin and thiamin

Deficiency: weakness, rash, vertical nail ridges, joint pain

Toxicity: suppresses growth

Good sources: meat, milk, nuts, beans

Osteoporosis:

Loss of bone

52 million Americans have it

Protective factors are African American heritage, no smoking, no ROH, exercise, estrogen therapy

Ferrous and Ferric Iron:

Iron flips back and forth between two different charges

Ferrous: +2 charge

Ferric: +3 charge

Fe:

Chemical symbol for iron

Needed for electron transport proteins

Required in hemoglobin and myoglobin

Needed to make amino acids, hormones, and neurotransmitters

Can be stored inside intestinal cells, attached to the protein called mucosal ferritin

Carried in the body by the protein transferrin

Also can be stored in the liver, bone marrow, and spleen

Usually recycled when RBC are degraded

Hepcidin (hormone made by the liver that regulates iron)

Deficiency: anemia, restlessness, fatigue, headache, feeling cold, pica, concave nails, pallor

Toxicity: weakness, hair loss, joint pain, enlarged liver, impotence, infections, GI distress, rapid pulse, dizziness, organ damage, shock

Good sources: meat, green vegetables, and potatoes

Absorption is enhanced by vitamin C, organic acids, and sugar

Can be inhibited by fiber, soybeans, nuts, Ca, P, EDTA, tannic acid

Hemochromatosis:

Genetic defect in which the intestine excessively absorbs iron

Causes arthritis, loss of body hair, amenorrhea (no menstrual period), impotence (males), heart failure, liver cancer

Treatment: chelation (giving a patient a molecule that binds to iron and carries it out of the body through fecal material or urine)

Zn:

Zinc

Required by over 100 enzymes

Stabilizes cell membranes and helps the immune system

Needed for: growth, insulin, blood clotting, thyroid hormones, learning and behavior, taste, wound healing, sperm production, and fetal development

Participates in enteropancreatic circulation (moves from the intestine → to the blood→ to the pancreas → and the pancreas works it back to the intestine)

Can be stored attached to the protein, metallothionein

Transmitted in the blood by the protein, albumin

Deficiency: slow growth, decreased pancreatic function, thyroid function, immune function, vit. A metabolism, hair loss, eye and skin damage, loss of appetite, nerve damage

Toxicity: atherosclerosis, Copper and Fe deficiencies, degeneration of muscle, vomiting, diarrhea, headache, exhaustion

Good sources: meat, dairy, eggs, whole grains, nuts

I:

Iodine

Required for thyroid hormones

Thyroid controls entire metabolism and energy

Deficiency: goiter (enlarged thyroid), fatigue, weight gain, goitrogen (substance that enlarges the thyroid)

Deficiency in babies: cretinism (mental retardation and physical defects b/c of iron deficiency in mother)

Toxicity: goiter

Good sources: seafood, iodized salt, dairy, bread

Cu:

Copper

Required by enzymes that deal with oxygen radicals

Required to absorb and transport Fe

Needed to make collagen and to inactivate histamine

Needed to degrade serotonin

Deficiency: anemia, bone problems, slow growth and metabolism

Toxicity: vomiting, diarrhea, liver damage

Good sources: nuts, whole grains, seafood, legumes

Mn:

Manganese

Required by enzymes in metabolism and bone formation

Deficiency: slow growth

Toxicity: brain disorders and nerve damage

Good sources: nuts, grains, leafy green vegetables, and tea

F:

Fluorine or Fluoride

Strengthens bones and teeth

Deficiency: tooth decay

Toxicity: tooth discoloration, itching, nausea, diarrhea, chest pain

Good sources: tap water, seafood, and tea

Cr:

Chromium

Required for carbohydrate and lipid metabolism

Works with insulin

Deficiency: high blood glucose

Toxicity: none reported yet, but the last 10-15 years, ppl have been taking chromium supplements so we don’t know

Good sources: meat, whole grains, nuts, and cheese

Se:

Selenium

Helps prevent the oxidation of unsaturated fatty acids

Helps activate thyroid hormones

Deficiency: heart disease

Toxicity: vomiting, diarrhea, hair loss, brittle nails, halitosis (bad breath), rash, fatigue, irritability, nerve damage

Good sources: meat, grains, fruits and vegetables

Mo:

Molybdenum

Required by enzymes

Deficiency: unknown

Toxicity: reproductive problems, kidney damage, and gout-like (crystals in joints) symptoms

Good sources: breads, milk, nuts, legumes, leafy green vegetables, cottage cheese, black beans, yogurt

Symptoms of Pb toxicity:

Poor coordination, hearing, concentration, memory

Slow reaction time and growth

Learning disabilities

Behavior problems

Anemia

Hi BP

Seizures

Bone meal:

Ground up bone

Minerals are poorly absorbed and often contains contaminates

Kelp and nori:

Seaweeds

High in iodine, but usually contain contaminants

Can take pills and eat a salad of them

Super blue green algae:

Freeze-dried ponds gum

Source of trace minerals

Phytochemicals:

Compounds in plants that have positive or good biological activity

Most of the time it’s colors, odors, or flavors

Nutritional facts about pregnancy:

Both underweight and overweight people (males and females) have lower fertility

Unsaturated fats, less animal protein and more complex carbohydrates - increases fertility in women

Men who eat antioxidant vitamins (ACE) and more phytochemicals make more sperm

Poor nutrition at any stage in pregnancy decreases the baby’s health

Most women do not return to their pre-pregnancy weight

Underweight women tend to have lower birth weight babies and the babies’ tend to have health problems

Overweight women tend to have larger babies and tend to have complications within themselves (the mother)

Early malnutrition affects the placenta which causes a small baby, birth defects, and a poorly developed reproductive system in the baby

Describe embryonic development:

Usually within a few days after the baby is made it implant in the uterus → placenta forms → amniotic sac surrounds the baby → umbilical cord forms connecting the baby to the placenta → embryo doubles every 24h for about 2 months → all organs develop in first 2 months

Energy and protein requirements during pregnancy:

For the first 3 months, you don’t need any extra calories

The next 3 months, you need 300 more calories a day

Then the next 3 months, you need 450 more calories a day

Protein - about 10g more

Vitamins required during pregnancy:

Extra folate and slightly more B vitamins

Minerals required during pregnancy:

Extra iron, zinc, and iodine

Recommended weight gain during pregnancy:

If overweight before pregnancy: 15-25 lb

If normal before pregnancy: 25-35 lb

If underweight before pregnancy: 30-40 lb

Problems associated with pregnancy:

Cravings: eat what you crave within reason

Nausea: eat bland foods

Constipation: eat more fiber

Hemorrhoids or varicose veins: mild exercise

Most important indicator of a baby’s future health:

Birth weight should be between 6-9 pounds

Hypertension:

Causes low birth weight and placenta abruptio

Also causes heart attacks and strokes on the mother

Diabetes:

Increases the chance for abortion and the baby’s size and can produce some defects

Gestational diabetes:

Caused by hormones from the placenta that disrupt the mother’s glucose levels

Usually can control this with a diet or insulin

Pre-eclampsia:

Swelling and high BP and increased fluid

Can lead to heart attacks and stroke

Adolescent pregnancy:

Decreased adult health for the rest of their life

Develop high BP and have a longer labor

Babies have lower birth weights and more of them are stillbirths (born dead)

Larger weight gain is recommended for teenagers, even if they are normal weight

Teratogens:

Compounds that cause birth defects (viruses, radiations)

Various practices incompatible with pregnancy:

Alcohol - concentrates in the baby 10x that of the mother

Nearly all drugs pass through the placenta to the baby (doesn’t matter what it is)

Most herbal products are toxic to the embryo

Aspirin causes iron deficiency, decreased fetal circulation, and uterine contractions

Smoking - causes a low birth weight, reduces fetal circulation and breathing, and increases the chance for SIDS (sudden infant death syndrome), and decreases the baby’s intelligence

Vitamin and mineral megadoses

Caffeine lowers the baby’s weight

Weight loss or dieting by the mother, damages the baby’s brain

Foodborne illnesses can kill the baby

Lactation:

Breastfeeding

Requires 500-650 cal/day depending on mother’s weight

Milk quality is maintained at the expense of the mother

Too little water will reduce milk volume

Alcohol, caffeine, and some drugs enter the breastmilk

Smoking reduces milk volume

Caffeine decreases iron in the baby and makes it irritable

Breastfeeding reduces food allergies

Very few illnesses pass through breastfeeding

Strong flavors can enter the breastmilk

Breast milk:

Breast milk content is lower than cow’s milk, but its protein is easier to digest

Human protein has alpha-lactalbumin

Also contains lactoferrin, bifidus factors, lactobacillus

High in Vit. C but low in Vit. D

Also contains antibodies, bifidus factors that promote the growth of lactobacillus, and zinc binding protein

Sterile

Contains lactadherin which binds to intestinal viruses

Decreases future obesity and increases intelligence

Breast feeding is recommended for 6-12 months on demand (8-12 times a day)

Colostrum:

Watery secretion of protein, antibodies, vitamins, and minerals released from the mother’s breast the first few days after birth

Infant formulas:

Should not contain antibodies

Fortified

Increase the chance of ear and tooth infections

Nutritional considerations of preterm infants:

Breast milk adapts and increases its nutrients

Formula should be designed by pre-mature babies

Fetal alcohol syndrome:

Mental retardation and physical defects in a baby

Brain damage

Caused by a pregnant mother drinking alcohol while she’s pregnant or alcohol consumption by the father in the month before conception

Describe nutritional

Marijuana use:

Marijuana is absorbed and stored in the lungs, liver, brain, ovaries, and testes

Then slowly excreting over time

Increases the desire for munching

Decreases the immune system and memory

Cocaine use:

Cravings for the drug replace hunger

Causes irritability, insomnia, arrythmias, and heart attacks

Tobacco use:

Decreases hunger

Interferes with vitamins A and C and folate

Causes cancer

Smokeless tobacco causes sores, stained teeth, loss of taste and smell, tooth loss, and cancer

Concerns related to childhood obesity:

1/3 of US children that are overweight get diabetes

A child’s fast food meal contains more than the entire stay amount of fat that they should have

End up developing atherosclerosis and high BP begin before 20

describe some nutritional considerations for infants and children

• should grow 10 inches long the first year

• Newborn’s require 450 cal a day

• Intestines too immature for cow milk

• nothing low fat for three years

• Birthweight should double by 4 months and triple by one year

• Solid food when birth weight doubles or sit without support or 4 to 5 months of age

• no honey or corn Syrup contains botulism spores

• Feed vegetables before fruit

• at age 1 appetite will fluctuate up and down

• Do not force child to eat when they’re not hungry

• Never withhold normal meals for any reason

• Discourage unacceptable behavior

• Children one to 13 should grow 5 to 6 pounds a year

• Should engage in 60 minutes of physical activity every day

two most common deficiencies in young children

Iron and zinc

food intolerances

adverse reactions that do not involve the immune system

food allergies

when whole proteins are engulfed by intestinal cells move into the bloodstream and stimulate the immune system

Immediate: Few minutes to few hours caused by mass cells releasing histamine

Delayed: Happens in one to two days later depends on macrophages and T cells migrating to the area

Most kids are allergic to nuts, wheat milk, fish, and eggs

tension fatigue syndrome

hyperactivity due to a combination of lack of sleep, overstimulation, and anxiety

nutritional deficiencies and behavior:

causes irritability, aggressiveness, sadness, depression, moodiness, decreased attention, and ability to learn hyperactivity

describe brain glucose requirements

Brain needs 120 g a day, children under 10 need to eat every 4 to 5 hours while awake to support brain activity

nutritional considerations for puberty and adolescence

A child grows 6 to 8 inches, gains 35 pounds, needs 2000 to 4000 cal a day, females need extra iron and both need extra calcium and vitamin D

Physiological age:

A person’s estimated age based on body health

6 factors that affect physiological age:

1. Drinking little or no alcohol

2. Regular meals

3. Weight control

4. Adequate sleep

5. No smoking

6. Regular physical activity

Elderly:

Foods rich in antioxidants help slow aging and improve cognition

2/3 of elderly are overweight due to decreased basal metabolism and activity

Some are underweight usually due to loss of appetite

Muscles and bones decrease, immune system weakens so inflammation and infections increase

Intestinal muscles slow which leads to constipation and difficulty swallowing

1/3 have atrophic gastritis = inflamed stomach, increased bacterial growth, decreased HCl, decreased intrinsic factor, increased nutrient deficiencies

Many suffer tooth loss which affects eating

Many have sensory losses which reduce healthy eating

Often have low incomes

Vit. A absorption is more efficient

Zinc and iron absorptions are less efficient

Many are dehydrated

The calorie requirement is less so they should limit fat rather than carb or protein

There are food assistance programs for the elderly

Cataracts:

Cloudy lenses

Caused by nutritional deficiencies and obesity

Can be reduced by vitamins C, E, and A (carotenoids)

Arthritis:

Inflammation of the joints

Good nutrition reduces it

Macular degeneration:

Deterioration of the retina

Increased by sunlight

Decreased by docosahexanoic acid, lutein, and zeaxanthin

Gout

Uric acid crystals in the joint

Helped by reducing meat and increasing milk

Alzheimer’s:

Degeneration of the brain

Things that are healthy for the heart help

More fruits and veg., less sodium, less fats

Hunger and community nutrition:

Worldwide 1 out of 7 is constantly hungry

1 child every 5 sec dies of hunger

in the US 35 million people cannot afford enough food

Problems: Society wastes too much food and poor choices by ppl in the community

Factors involved in nutrition care:

1. Assessment

2. Diagnosis

3. Intervention

4. Monitoring and evaluating

Describe 5 factors that comprise a nutrional assessment:

history = medical conditions, medicines, supplements, drugs, alcohol, culture, economics, ethnic, religous

Food intake = which can be assessed by:

• 24 hr recall

• Food frequency questionnaire

• Food record/diet analysis

• Direct observation in facility

Anthropometrics = body measurements

• Height/length

• Weight

• Head circumference

• Waist or limb circumference

• Body fat

Biochemical/lab tests = usually blood and urine

Physical exam = skin, eyes, hair, nails, mouth, BP, temp., pulse, respirations

Lymphoid tissue:

Contains tonsils, spleen, lymph nodes, bone marrow, Peyer’s patches (lymph nodes in intestine)

All contain immune cells that help fight disease and signaling molecules called cytokines

Cytokine storm:

A massive release of immune chemicals overstimulating the immune system caused organ failure, can be fatal

Elderberry:

Causes you to make more cytokines

Innate immunity:

Generic defenses that don’t require the immune system

1. Skin - contains the tough protein keratin to repel microbes

2. Mucus - traps microbes and cilia move them to another location to be dealt with

3. HCl in the stomach - degrades microbes

4. Lysozyme - enzyme in tears and saliva that kill microbes

5. Complement - proteins in blood that join and punch holes in cells

6. Acute phase protein - made by the liver to fight bacteria

7. Phagocytes - scattered all over body and engulf germs

Adaptive immunity:

Requires immune cell

Primary Immune Response

Occurs the first time a microbe enters the body

Takes about a week to complete

1. A macrophage eats the microbe then displays pieces of the microbe on its surface

2. Uses those pieces to turn on a T cell in the immune system

3. T cell divides forming an active T cell and a memory cell

4. Active T cell stimulates a B cell

5. B cell divides into a plasma cell and memory cell

6. Plasma cell secretes antibodies

7. Antibodies bind to a microbe

8. Many different cells plus complement now recognize that the microbe is foreign and they attack and destroy the microbe

Secondary Immune Response:

Occurs with reexposure to a microbe

Memory cells reproduce within a few hours and the microbe is killed within 2 days

Translocation:

Movement of bacteria from the intestine to the blood and body tissues

Effects of malnutrition on body defense:

• Causes the skin to thin and easier for germs to get in

• GI tract cells to shrink

• Lymphatic organs shrink

• T cells to be reduced

• Phagocytes are slower

• More susceptible to bed sores