Clinical Nutrition Midterm #2

Thermoregulation

The balance of heat gain with heat loss in the body

AKA: is the ability of an organism to maintain body temperature despite changing environmental temperatures.

• Too low or too high of a temperature causes enzymes to stop functioning and halts metabolism.

• Water is good at storing heat, an attribute referred to as heat capacity,The capability of a substance to store heat. and thus helps maintain the temperature set point of the body despite changes in the surrounding environment.

How does the body regulate body temperature?(Thermoregulation)

• Hypothalamus: thermoregulatory center

  • The hypothalamus contains special protein sensors that detect blood temperature.

• The skin: contains temperature sensors that respond quickly to changes in immediate surroundings.

When Cold

• The skin: The hypothalamus also sends signals to muscles to erect hairs and shiver, and to endocrine glands like the thyroid to secrete hormones capable of ramping up metabolism.

  • Hair erection

  • Shiver

    • These actions increase heat conservation and stimulate heat production in the body in response to cooling temperatures.

• Vasoconstriction: In response to cold sensors in the skin, a neural signal is sent to the hypothalamus, which then sends a signal to smooth muscle tissue surrounding blood vessels, causing them to constrict and reduce blood flow. This reduces heat lost to the environment.

When Hot

When body temperature rises, as during exercise, the hypothalamus detects an increase in blood temperature.

• Vasodialation

  • the hypothalamus detects an increase in blood temperature. In response, the hypothalamus sends a signal to the smooth muscle of blood vessels, causing them to dilate so that more blood flows to the body’s periphery.

• Skin: sweating

  • Once on the skin, extra heat exits the body via perspiration (sweat), which is 98 to 99 percent water. Water on the skin’s surface evaporates, a process that takes energy and results in the loss of heat, thereby cooling the body.

Health Consequences of Alcohol abuse (What happens if too much alcohol)

• Weight gain

  • Alcohol contains 7 calories per gram: Alcoholic drinks in excess contribute to weight gain by substantially increasing caloric intake.

• Dehydration

  • The most common macronutrient deficiency among alcoholics is water, as it is excreted in excess.

  • Alcohol is a diuretic that results in dehydration.

  • It suppresses the release of antidiuretic hormone, and less water is reabsorbed and more is excreted.

• Hangover

  • Drinking alcohol in excess can lead to a “hangover,” of which the majority of symptoms are the direct result of dehydration.

• Alcoholic Liver Disease (ALD)

  • Liver problems linked to excessive alcohol intake including fatty liver, alcoholic hepatitis, and cirrhosis.

  • Three most common:

1. Fatty liver

2. Alcoholic hepatitis

3. Cirrhosis

Effects of Alcohol Abuse on the Brain

• the central nervous system is depressed.

• Alcohol disrupts the way nerve cells communicate with each other by interfering with receptors on certain cells.

• The immediate impact of alcohol on the brain can be seen in the awkwardly displayed symptoms of confusion, blurred vision, slurred speech, and other signs of intoxication

• Long-term effects: but abusive alcohol consumption over time can lead to long-lasting damage to the brain and nervous system. This is because alcohol and its metabolic byproducts kill brain cells.

Specific areas in the Brain: Alcohol Abuse

1. Medulla. This area controls automatic functions, such as heart rate. When alcohol first limits its functioning, people feel sleepy. With greater BAC levels, unconsciousness, coma, and death can result.( increases heart rate)

2. Cerebellum. This is where conscious movement is coordinated. With too much alcohol, balance and motor skills are impaired.

3. Cerebral cortex. Senses and thoughts are processed here, and this is where action is initiated. When BAC levels increase, the ability to think, exercise good judgment, and feel pain decreases.

4. Hypothalamus and pituitary gland. Alcohol increases sexual desire but decreases sexual performance. It also prompts signals that increase urine production.

5. Limbic system. When alcohol affects this area, individuals may become very emotional and lose memory function.

What happens when we are dehydrated?

Dehydration: refers to water loss from the body without adequate replacement.

It can result from either water loss or electrolyte imbalance, or, most commonly, both.

• decreases blood volume.

• The water in cells moves into the blood to compensate for the low blood volume, and cells shrink.

• Signs and symptoms of dehydration include thirst, dizziness, fainting, headaches, low blood pressure, fatigue, low to no urine output, and, in extreme cases, loss of consciousness and death.

• Chronic dehydration effects(usually old people suffer from it):

  • increases the risk for kidney stones and exercise-induced asthma

  • increases the risk for kidney disease, heart disease, and the development of hyperglycemia

  • increases the risk for obesity.

Electrolyte

Substances that, when dissolved in water, disassociate into charged ions.

• Positively charged electrolytes are called cations, and negatively charged electrolytes are called anions. For example, in water, sodium chloride (the chemical name for table salt) disassociates into sodium cations (Na+) and chloride anions (Cl−).

Sodium-Potassium Pump

is the primary mechanism for cells to maintain water balance between themselves and their surrounding environment.

• Sodium and glucose both move into the cell.

• Water passively follows the sodium.

• To restore balance, the sodium-potassium pump transfers sodium back to the extracellular fluid, and water follows.

• Every cycle of the sodium-potassium pump involves the movement of three sodium ions out of a cell, in exchange for two potassium ions into the cell.

• To maintain charge neutrality on the outside of cells, every sodium cation is followed by a chloride anion.

• Every cycle of the pump costs one molecule of ATP (adenosine triphosphate).

• The constant work of the sodium-potassium pump maintains the solute equilibrium and, consequently, water distribution between intracellular and extracellular fluids.

Sodium-Potassium Pump- IB Bio HL

1. Three Na⁺ attach to the sodium ion binding sites on the sodium potassium pump protein.

2. ATP attaches to the sodium potassium pump.

3. ATP is hydrolyzed, with a phosphate remaining attached to the protein pump. ADP is released.

4. The phosphate causes the pump to change shape, moving the sodium across the axon membrane, releasing Na⁺ outside the axon.

5. Two K⁺ attach to the potassium ion binding sites on the sodium potassium pump protein.

6. The phosphate is released from the pump.

7. The pump returns to its original shape moving the K⁺ into the axon.

The process can be repeated.

How would someone get hyponatremia(water intoxication)

a low blood sodium level

• Drinking too much water

  • Hyponatremia is not so much the result of excessive sodium loss in sweat, but rather of drinking too much water.

  • The excess water dilutes the sodium concentration in the blood.

• Illnesses causing vomiting, sweating, and diarrhea may also cause hyponatremia.

• The symptoms of hyponatremia, also called water intoxication since it is often the root cause, include nausea, muscle cramps, confusion, dizziness, and, in severe cases, coma and death.

Where does most sodium in the diet cone from?

Most sodium in the typical American diet comes from processed and prepared foods. Manufacturers add salt to foods to improve texture and flavor, and also as a preservative.

Ex) bacon, canned soup, sausages…

Osmosis

The movement of water through a selectively permeable membrane from an area where it is highly concentrated to an area where it is not as concentrated.

• Water is never transported actively; that is, it never requires energy for water to move between compartments (refer to “Osmosis”).

What is the DASH diet?

The DASH diet is an eating plan that is low in saturated fat, cholesterol, and total fat. Fruits, vegetables, low-fat dairy foods, whole-grain foods, fish, poultry, and nuts are emphasized, while red meats, sweets, and sugar-containing beverages are mostly avoided.

• was a clinical trial that evaluated the effects of a specified eating plan with or without reduced sodium intake.

In this study, people on the low-sodium (1,500 milligrams per day) DASH diet had average systolic blood pressures that were 7.1 mmHg lower than those of people without hypertension not on the DASH diet.

The effect on blood pressure was greatest in participants with hypertension at the beginning of the study who followed the DASH diet. Their systolic blood pressures were, on average, 11.5 mmHg lower than participants with hypertension on the control diet.

Effects of the DASH diet:

• Following the DASH diet not only reduces sodium intake, but also increases potassium, calcium, and magnesium intake.

• All of these electrolytes have a positive effect on blood pressure

Dash Diet: which nutrients are up and which ones are down

• Up (increased):

  • Potassium: Essential for easing tension in blood vessel walls and helping the body excrete excess sodium.

  • Magnesium: Works alongside potassium to help relax blood vessels and maintain healthy circulatory function.

  • Calcium: A critical mineral for vascular health, heavily provided by the diet's focus on low-fat or fat-free dairy products.

  • Dietary Fiber: Boosted through a high intake of whole grains, vegetables, fruits, and legumes.

  • Lean Protein: Sourced primarily from poultry, fish, beans, and nuts rather than fatty red meats.

• Down(decreased):

  • Sodium: The standard DASH diet limits sodium to 2,300 mg daily, while the stricter lower-sodium version drops it to 1,500 mg daily.

  • Saturated Fat: Cut down drastically by limiting full-fat dairy, butter, fatty cuts of meat, and tropical oils like palm and coconut oil.

  • Trans Fats: Minimized by avoiding highly processed snack foods, fried foods, and commercial baked goods.

  • Added Sugars: Reduced by capping sweets, soda, and sugary desserts to no more than 5 small servings per week.

  • Cholesterol: Kept low by limiting red meats and full-fat animal products.

Functions of water (4)

1. Water as a Transportation Vehicle

• Water is called the “universal solvent” because more substances dissolve in it than in any other fluid.

• Molecules dissolve in water because of the hydrogen and oxygen molecules’ ability to loosely bond with other molecules.

• The solvent action of water allows for substances to be more readily transported

• Blood is not just the primary vehicle of transport in the body, but also, as a fluid tissue, structurally supports blood vessels, which would collapse in its absence

• Similarly, the brain is 75 percent water, where it provides structure.

2. Water as a Medium for Chemical Reactions

• Water is required for even the most basic chemical reactions.

• Once formed, enzymes must conduct their specific chemical reactions in a medium, which in all organisms is water. Water is an ideal medium for chemical reactions as it can store a large amount of heat, is electrically neutral, and has a pH of 7.0, meaning it is not acidic or basic.

• Additionally, water is involved in many enzymatic reactions as an agent to break bonds or, by its removal from a molecule, to form bonds.

3. Water as a Lubricant and Shock Absorber

• sneezing is essential for removing irritants and could not take place without water.

• Mucus is composed of more than 90 percent water. Mucus is a front-line defense against injury and foreign invaders. It protects tissues from irritants, entraps pathogens, and contains immune-system cells that destroy pathogens.

• Water is the main component of the lubricating fluid between joints and eases the movement of articulated bones.

• Watery fluids surrounding organs provide both chemical and mechanical protection.

4. Water as a Temperature Regulator

• Water is good at storing heat, an attribute referred to as heat capacity,The capability of a substance to store heat. and thus helps maintain the temperature set point of the body despite changes in the surrounding environment.

• Thermoregulation (explained above)

What happens if we get too much Vitamin C?

• higher vitamin C intake may be linked to a reduced risk of some cancers

• High doses of vitamin C have been reported to cause gastrointestinal upset and diarrhea.

• At very high doses in combination with iron, vitamin C, has sometimes been found to increase oxidative stress (therefore get your antioxidants from food, not supplements as that helps regulate your intake levels.)

Oxidative process

• Free radicals: Highly reactive atoms or molecules containing an unpaired electron.

• Reactive oxygen species: free redicals containing oxygen

• Molecules containing oxygen that have unpaired electrons and are highly reactive.

• The unpaired electron in a free radical destabilizes it, making it highly reactive.

• The body creates free radicals through the normal processes of metabolism. When the amount of free radicals exceeds the body’s ability to eliminate or neutralize them, an oxidative imbalance results.

• Free radicals can cause chain reactions that ultimately damage cells. For example, a superoxide molecule may react with a fatty acid and steal one of its electrons. The fatty acid then becomes a free radical that can react with another fatty acid nearby. As this chain reaction continues, the permeability and fluidity of cell membranes change,

How does atherosclerosis happen?

Disease that is characterized by the deposition of plaques and fatty material in the walls of the body’s artery, vein, and blood vessel network. (narrowing and hardening of blood vesels)

• LDLs becomes oxidized

• LDL transports cholesterol from the liver to cells

• A deficiency of these LDL-binding mechanisms will leave a high quantity of cholesterol in the bloodstream, which can lead to heart disease or atherosclerosis. Diets rich in saturated fats inhibit the LDL receptors. Thus, LDL receptors are critical for regulating blood cholesterol levels.

• Google: When the inner lining of an artery (the endothelium) is damaged, allowing low-density lipoprotein (LDL) cholesterol, fats, and immune cells to slip in, oxidize, and form a growing, hardened deposit called plaque

Oxidative stress

refers to an imbalance in any cell, tissue, or organ between the amount of free radicals and the capabilities of the detoxifying and repair systems.

• Sustained oxidative damage results only under conditions of oxidative stress—when the detoxifying and repair systems are insufficient.

• Free radical–induced damage, when left unrepaired, destroys lipids, proteins, RNA, and DNA, and can contribute to disease.

• Oxidative stress has been implicated as a contributing factor to cancer, atherosclerosis (hardening of arteries), arthritis, diabetes, kidney disease, Alzheimer’s disease, Parkinson’s disease, schizophrenia, bipolar disorder, emphysema, cataracts, and aging.

Which minerals (5) and vitamins (3) are antioxidants?

Antioxidant: Any molecule that can block free radicals from stealing electrons.

Vitamins: E, C, and A. (ACE)

Minerals: selenium, manganese, iron, copper, and zinc.

What is the number of servings of fruits and veggies you are supposed to have in a day

The number of servings of fruits and vegetables that a person should consume every day is dependent on age, sex, and level of physical activity.

• For example, a forty-year-old male who exercises for sixty minutes per day should consume 2 cups of fruit and 3½ cups of vegetables,

• while a fifteen-year-old female who exercises for thirty minutes per day should consume 1½ cups of fruit and 2½ cups of vegetables. (One cup of a fruit or vegetable is equal to one banana, one small apple, twelve baby carrots, one orange, or one large sweet potato.)

But generally: 5-6 Servings of Fruits and vegetables

Bone mineral density (BMD)

is a measurement of the amount of calcified tissue in grams per centimeter squared of bone tissue.

• BMD can be thought of as the total amount of bone mass in a defined area. When BMD is high, bone strength will be great.

• Similar to measuring blood pressure to predict the risk of stroke, a BMD measurement can help predict the risk of bone fracture. The most common tool used to measure BMD is called dual-energy X-ray absorptiometry (DEXA) A procedure during which two X-ray beams pass through a person and calculate the amount of calcified tissue in grams per unit area of bone.

Which populations may require extra calcium intake?

Here we will take a closer look at particular groups of people who may require extra calcium intake.

1. Adolescent teens. A calcium-deficient diet is common in teenage girls as their dairy consumption often considerably drops during adolescence.

2. Women with amenorrhea and the “female athlete triad.” Amenorrhea refers to the absence of a menstrual cycle. Women who do not menstruate experience reduced estrogen levels, which can disrupt and have a negative impact on the calcium balance in their bodies. The “female athlete triad” is a combination of three conditions characterized by amenorrhea, disrupted eating patterns, and osteoporosis. Exercise-induced amenorrhea and anorexia nervosa–related amenorrhea can decrease bone mass. In female athletes, as well as active women in the military, low BMD, menstrual irregularities, and individual dietary habits together with a history of previous stress issues are related to an increased susceptibility to future stress fractures.

3. Older adults. As people age, calcium bioavailability is reduced, the kidneys lose their capacity to convert vitamin D to its most active form, the kidneys are no longer efficient in retaining calcium, the skin is less effective at synthesizing vitamin D, there are changes in overall dietary patterns, and they tend to get less exposure to sunlight. Thus, the risk for calcium inadequacy is high.

4. Postmenopausal women. Estrogen enhances calcium absorption. The decline in this hormone during and after menopause puts postmenopausal women especially at risk for calcium deficiency. Decreases in estrogen production are responsible for an increase in bone resorption and a decrease in calcium absorption. During the first years of menopause, annual decreases in bone mass range from 3 to 5 percent. After age sixty-five, decreases are typically less than 1 percent.

5. Lactose-intolerant people. Groups of people, such as those who are lactose intolerant, or who adhere to diets that avoid dairy products, may not have an adequate calcium intake.

6. Vegans. Vegans typically absorb reduced amounts of calcium because their diets favor plant-based foods that contain oxalates and phytates. In addition, because vegans avoid dairy products, their overall consumption of calcium-rich foods may be less.(Because some veggies are oxalates and phytates which decrease calcium absorption)

Which populations are more susceptible to osteoporosis

Osteoporosis makes your bones weaker and thinner by reducing your bone density.

• Therefore, any person over the age of forty has an increased probability of developing osteoporosis in comparison to a younger person

• Females, on average, have a lower peak bone mass in comparison to males and therefore can sustain less bone tissue loss than males before developing a low bone mineral density (BMD).

• Similarly, people with small frames are also at higher risk for osteoporosis.

• Other biological risk factors that are linked to an increased likelihood of developing osteoporosis are being White or Asian, having low estrogen levels, having another endocrine disorder such as hyperthyroidism, or having a family member with osteoporosis.

Minerals(4 and vitamins (2) having to do with bone remodeling

Thus, we can say that bone is a living tissue that continually adapts itself to mechanical stress through the process of remodeling. For bone tissue to remodel, certain nutrients such as calcium, phosphorus, magnesium, fluoride, vitamin D, and vitamin K are required.

compounds that could prevent someone from absorbing calcium

• Factors That Decrease Calcium Bioavailability: Chemicals that bind to calcium decrease its bioavailability. These negative effectors of calcium absorption include the oxalates in certain plants, the tannins in tea, phytates in nuts, seeds, and grains, and some fibers. Oxalates are found in high concentrations in spinach, parsley, cocoa, and beets.

• High-fiber, low-fat diets also decrease the amount of calcium absorbed, an effect likely related to how fiber and fat influence the amount of time food stays in the gut.

Compounds:

• Oxalic Acid (Oxalates)

• Phytic Acid (Phytates)

• Caffeine

• Excess Sodium (Salt)

• Alcohol (Ethanol)

Exercises good for bone building

• weight-bearing exercises, such as strength training with weights,

• aerobic weight-bearing activities: such as walking, running, and sports like soccer and basketball.

• Dancing

NOT GOOD FOR BONE BUILDING:

• biking

• swimming

osteoclasts

Large cells that break down bone tissue.

osteoblasts

Cells that build new bone tissue.

Osteocytes

Star-shaped cells that are the most abundant cell type in bone tissue.

Water soluble VS Fat soluble vitamins

Water-soluble: essential nutrients that dissolve in water, pass directly into the bloodstream, and are not stored in significant amounts by the body.

• Water-soluble vitamins: C and B vitamins, which include thiamine, riboflavin, niacin, pantothenic acid, pyridoxine, biotin, folate, and cobalamin.

Fat-soluble: a vitamin dissolves in fats and oils rather than in water

• Fat-soluble vitamins: Vitamins A, D, E, and K (KADE)

What does your blood do? What does it transport(6)

Blood transports nutrients throughout the body

• Hemoglobin in red blood cells transports oxygen to all cells in the body.

• Oxygen: Red blood cells use a protein called hemoglobin to carry oxygen from the lungs to tissues and organs throughout the body.

• Carbon Dioxide: Red blood cells and plasma pick up waste carbon dioxide from body cells and carry it back to the lungs so you can breathe it out.

• Nutrients: Blood plasma carries digested nutrients—such as sugars (glucose), amino acids, fats, vitamins, and minerals—absorbed from the small intestine to cells that need them for energy.

• Waste Products: Plasma transports metabolic waste products—such as urea, uric acid, and creatinine—to the kidneys and liver, which filter and eliminate them from the body.

• Hormones: The liquid plasma acts as a delivery system to distribute chemical hormones from endocrine glands to their target organs.

• Immune Cells and Antibodies: White blood cells and globulin proteins travel through the blood to hunt down and destroy pathogens like bacteria and viruses.

What does Vitamin K do? Vitamin K function

A vitamin that acts as a coenzyme that modifies proteins important for bone health. The dietary sources are green vegetables such as broccoli, cabbage, kale, parsley, spinach, and lettuce.

• They act as coenzymes and have long been known to play an essential role in blood coagulation.

• Without vitamin K, blood would not clot.

• Vitamin K is also required for maintaining bone health. It modifies the protein osteocalcin, which is involved in the bone remodeling process.

• Some studies do show that people who have diets low in vitamin K also have an increased risk for bone fractures.

Catabolic Vs Anabolic pathway

Catabolic: breaking down larger molecules into smaller units

• catabolic pathways are initiated to make energy.

• Glucose is the energy source preferred by most tissues, but fatty acids and amino acids can also be catabolized to the cellular energy molecule,

• The catabolism of nutrients to energy can be separated into three stages:

  • Stage 1. Glycolysis for glucose, β-oxidation for fatty acids, or amino acid catabolism

  • Stage 2. Citric acid cycle (also known as the Krebs cycle)

  • Stage 3. Electron transport chain and ATP synthesis

Anabolic: building up smaller units into larger molecules

• .Anabolic pathways are required to build new tissue such as muscle after exercise or the remodeling of bone tissue, a process involving both catabolic and anabolic pathways.

• Anabolic pathways also build energy storage molecules, such as glycogen and triglycerides.

• When there is ample energy, bigger molecules, such as protein, RNA, and DNA, will be built as needed.

• In between meals, blood glucose levels start to drop. To restore blood glucose levels to their normal range, an anabolic pathway called gluconeogenesis is stimulated. GluconeogenesisThe process of building glucose molecules from amino acids. is the process of building glucose molecules from certain amino acids, and it occurs primarily in the liver (refer to Figure 10.5). The liver exports the synthesized glucose into the blood for other tissues to use.

Function of Iron

• Primarily, it is the oxygen carrier of the protein hemoglobin, which is found in red blood cells.

  • Oxygen is essential for cellular metabolism. A reduction in the oxygen-carrying capacity of red blood cells hampers the synthesis of energy and consequently cell function.

• iron is required for energy production and enzymatic synthesis of RNA and DNA.

  • Therefore, cells that are rapidly dividing are acutely sensitive to an iron deficiency. Since red blood cells are under a constant state of renewal in the body, low iron levels impede their synthesis, eventually causing anemia.

Which nutrients help absorb iron?

DOES NOT HELP ABSORB:

• Some plants contain chemicals (such as phytate, oxalates, tannins, and polyphenols) that inhibit iron absorption.

HELPS ABORBS:

• In contrast, consuming vitamin C at the same time as iron-containing foods markedly increases iron absorption.

• Similarly, eating meat, poultry, or seafood at the same time as non-heme iron enhances the bioavailability of the non-heme iron.

What do the B vitamins do?*

• Thiamine (B1): Helps convert carbohydrates into energy and supports nerve function.

• Riboflavin (B2): Assists with cellular metabolism, energy production, and skin or eye health.

• Niacin (B3): Supports energy metabolism, repairs DNA, and helps keep skin and nerves healthy.

• Pantothenic Acid (B5): Helps break down and build fatty acids and produce hormones.

• Pyridoxine (B6): Supports brain development, immune function, and the breakdown of proteins and homocysteine.

• Biotin (B7): Aids in the metabolism of fats, carbohydrates, and proteins.

• Folate / Folic Acid (B9): Crucial for making DNA and supporting cell division, especially important for preventing birth defects during pregnancy.

• Cobalamin (B12): Essential for forming red blood cells, building DNA, and keeping nerve cells healthy.

The three components of blood

• Plasma: The liquid part of blood. and is mostly water (95 percent), but it also contains proteins, ions, glucose, lipids, vitamins, minerals, waste products, gases, enzymes, and hormones.

• protein albumin is found in high concentrations in the blood: Albumin helps maintain fluid balance between blood and tissues, and also helps to maintain a constant blood pH.

Three main types of blood cells:

• platelets/thrombocytes:

  • are fragments of cells that are always circulating in the blood in case of an emergency.

  • When blood vessels are injured, platelets rush to the site of injury to plug the wound.

  • Blood is under a constant state of renewal and is synthesized from stem cells in bone marrow.

  • Red blood cells live for about 120 days, platelets have a lifespan of about ten days, and the lifespan of white blood cells varies depending on the type of white blood cell.

• red blood cells/erythrocytes:

  • are the most numerous of the cellular components, making up about 44 percent of the blood’s volume.

  • Each drop of blood contains millions of them. Red blood cells are red because they each contain approximately 270 million hemoglobin proteins, which contain the mineral iron, which turns red when bound to oxygen.

  • The most vital role of red blood cells is to transport oxygen from the lungs to all cells in the body so that they can make energy via aerobic metabolism.

• white blood cells (also known as leukocytes)

  • are part of the immune system and survey the entire body looking for foreign invaders to destroy.

  • There are many different types of white blood cells.

  • They make up about 1 percent of blood volume.

Iron deficiency syndrome causes

is a condition that develops from having insufficient iron levels in the body, resulting in fewer and smaller red blood cells containing lower amounts of hemoglobin.

Signs and symptoms:

• Fatigue

• Weakness

• Pale skin

• Shortness of breath

• Dizziness

• Swollen, sore tongue

• Abnormal heart rate

Causes:

The main causes of iron deficiency worldwide are parasitic-worm infections in the gut (causing excessive blood loss), malaria, a parasitic disease causing the destruction of red blood cells, and insufficient iron in the diet.

Populations at risk:

Infants, children, adolescents, and women are the populations most at risk worldwide for iron deficiency anemia by all causes.

Wolff’s law

it states that bones will develop a structure that is best able to resist the forces acting upon them.

• This is why exercising, especially when it involves weight-bearing activities, increases bone strength.

Foods high in vitamin D

• Oily fish, such as salmon, is one of the best. The amount of vitamin D obtained from one 3-ounce piece of salmon is greater than the recommended intake for one day.

• fish, egg yolks, and fortified products, cod liver oil, canned tuna

• Many foods, including dairy products, orange juice, and cereals, are now fortified with vitamin D.

Vitamin D’s role in calcium homeostasis*

• activated vitamin D3 (calcitriol) regulates blood calcium levels in concert with parathyroid hormone

• The effects of calcitriol on calcium homeostasis are critical for bone health. A deficiency of vitamin D in children causes the bone disease nutritional rickets

• Nutritional rickets: A childhood bone disease caused by a lack of vitamin D. It is characterized by soft, weak bones that are susceptible to fracture.

• In adults, vitamin D deficiency causes a similar disease called osteomalaciaSimilar to nutritional rickets, in adults this disease involves softening and weakening of the bones due to a lack of vitamin D or a problem metabolizing the vitamin., which is characterized by low bone mineral density (BMD).

Google:

Vitamin D maintains calcium homeostasis primarily by increasing the efficiency of intestinal calcium absorption, while also coordinating with the kidneys and bones to keep blood calcium levels within a strict, healthy range.

• Intestinal Absorption: The active form of vitamin D (calcitriol or 1,25(OH)₂D₃) binds to the Vitamin D Receptor (VDR) inside intestinal cells. This turns on genes that make calcium transport proteins (such as TRPV6), calcium-binding proteins (calbindin), and membrane calcium pumps, raising calcium absorption from about 10–15% up to 30–40%.

• Renal Reabsorption: Calcitriol (active form of vitamin D) acts on the kidneys to promote the reabsorption of calcium, reducing how much calcium is lost in the urine.

Food sources for Selenium

• high-protein foods

• seafood

• organ meats

• Brazil nuts

• Oysters & Shellfish

Food sources for Vitamin A

Preformed vitamin A is found only in foods derived from animals, with the liver being the richest source because that is where vitamin A is stored

• Beef liver

• Fish/cod liver oil

Provitamin A Carotenoids / Beta-Carotene:

• Sweet potato including the skin

• Spinach

• Carrots, raw

When is a sports drink appropriate vs. water

• Typically, eight ounces of a sports drink provides between fifty and eighty calories and fourteen to seventeen grams of carbohydrates, mostly in the form of simple sugars.

• They recommend drinking enough water to maintain body weight

• Sports drinks are mostly sugar, and there is no indication that they are needed.

When you choose water:

• Short workouts: Use water for exercise, light jogging, or gym sessions lasting under one hour.

• Light sweating: Water efficiently replaces lost fluids when sweat and electrolyte loss are minimal.

When you choose Sports Drinks

• Long duration: Use sports drinks for continuous endurance exercise, heavy training, or tournaments lasting longer than 60 to 90 minutes.

• Heavy or salty sweat: They help replace lost electrolytes (like sodium and potassium) that prevent muscle cramps.

• Hot and humid conditions: Extreme weather increases sweat and mineral loss, making carbohydrates and electrolytes beneficial.

Difference between review article VS Original research article

Review article:

• Summary of different article and findings

• Acts as a secondary source

• To provide a comprehensive overview of existing literature, map out the current state of knowledge, and identify research gaps.

Original research article:

• Gather their own data (conduct experiments personally)

• Acts as a primary source.

• The authors design and run experiments, build surveys, or gather raw data.

Why is folate(Vitamin B9) important?

is a required coenzyme for the synthesis of the amino acid methionine, and for making RNA and DNA.

• Folate: your body needs to make and repair DNA, divide cells rapidly, and produce healthy red blood cells

• rapidly dividing cells are most affected by folate deficiency. Red blood cells, white blood cells, and platelets are continuously being synthesized in the bone marrow from dividing stem cells.

• folate deficiency: macrocytic, also called megaloblastic, anemia.

megaloblastic, anemia: A form of anemia characterized by larger and fewer red blood cells than normal.

• It is caused by red blood cells, being unable to produce DNA and RNA fast enough—cells grow but do not divide, making them large in size. These abnormal blood cells do not carry oxygen as well, and can lead to a number of symptoms, most notably fatigue.

• Folate is especially essential for the growth and specialization of cells of the central nervous system***

• Folate deficiency: is causally linked to the development of spina bifida, a neural tube defect that occurs when the spine does not completely enclose the spinal cord. Spina bifida can lead to many physical and mental disabilities.

Which B vitamins are important in converting carbs to energy

• Vitamin B1 (Thiamine) playing the most direct role

Vitamin B1 (Thiamin): Directly supports carbohydrate metabolism and the conversion of glucose into energy, acting as an essential cofactor for breaking down pyruvate.

Vitamin B2 (Riboflavin): Serves as a component of coenzymes (FAD and FMN) critical for energy production in the mitochondrial respiratory chain.

• Vitamin B3 (Niacin): Forms the coenzyme NAD, which is essential for the enzymatic reactions that turn food and carbs into usable energy.

• Vitamin B5 (Pantothenic Acid): Required to form coenzyme A, which is indispensable for breaking down and metabolizing carbohydrates and fats.

• Vitamin B7 (Biotin): Assists enzymes in metabolizing macronutrients, including the formation and processing of glucose.

• Vitamin B6 (Pyridoxine): Helps release stored glucose from the liver and muscles via glycogenolysis.

What happens when we get a B12 deficiency

contains cobalt, making it the only vitamin that contains a metal ion. It is necessary for fat and protein catabolism, for folate coenzyme function, and for hemoglobin synthesis.

• is needed by a folate-dependent enzyme to synthesize DNA

• occurs when the body lacks enough cobalamin to support red blood cell formation, DNA synthesis, and proper nervous system function

Effects:

• Megaloblastic Anemia

• Neurological Damage: Long-term deficiency impairs the protective myelin sheath around nerves.

• Similar to folate deficiency

Deficiency: similar consequences to health as folate deficiency.

• .In children and adults, cobalamin deficiency causes macrocytic anemia, and in babies born to cobalamin-deficient mothers there is an increased risk for neural tube defects.

• In order for the human body to absorb cobalamin, the stomach, pancreas, and small intestine must be functioning properly.

• Cells in the stomach secrete a glycoprotein called intrinsic factorA glycoprotein that is required for absorption of cobalamin (vitamin B12). that is necessary for cobalamin absorption, which occurs in the small intestine.

• Impairment of secretion of this protein caused either by an autoimmune disease or by chronic inflammation of the stomach (such as that occurring in some people with H. pylori infection) can lead to the disease pernicious anemiaA type of vitamin B12-deficiency anemia resulting from an insufficient amount of intrinsic factor., a type of macrocytic anemia

What do the B Vitamins do?

• Thiamine(B1): Converts Carbs into energy

• Riboflavin (B2):

  • Coenzyme in glycolysis (breaking down glucose to produce ATP)

  • In the Krebs cycle: breaks down glucose further to produce ATP

  • Electron carrier

  • Electron Transport Chain(ETC): uses electrons to make ATP

• Niacin (B3):

  • In Krebs cycle: glucose is further broken down in the mitochondria to produce ATP

  • Electron carrier

  • ETC: uses electrons to make ATP

• Pantothenic Acid (B5): Forms CoA (energy reactions need CoA to transfer carbon units)

• Pyridoxine (B6):

  • Helps amino acid metabolism: breaks down protein into amino acids)

  • Deamination/Removing Nitrogen: aids in the process of the liver removing nitrogen so amino acids can be used for energy

• Biotin (B7):

  • Gluconeogenesis: synthesizing glucose from amino acids

  • Break down fatty acids (breaking down triglycerides)

• Folate (B9):

  • DNA synthesis

  • Makes RBCs

• Cobalamin(B12):

  • Makes RBCs

Vitamin B deficiency in general

• Beriberi (Vitamin B1 deficiency): characterized by muscle weakness….

• Pellagra (Vitamin B3 deficiency): 4D’s: Dermatitis, Diarrhea, Dementia, Death