ch 12 - Fluids and Minerals Required for Oral Soft Tissues and Salivary Glands

_____ is the most abundant component in the body

water

fluid % of body weight at birth

75–80%

fluid % of body weight in adults

50-60%

Body fluids are distributed between

intracellular fluid (ICF) and extracellular fluid (ECF)

ICF anf ECF are separated by

semipermeable membranes that serve as barriers, though they do not completely isolate the compartments

Physiologic Roles of Water

• Solvent for Chemical Reactions (e.g., hydrolysis)

• Stability of Body Fluids (blood, lymph, saliva, GI fluids)

• Transport of Nutrients & Excretion of Waste

the earliest sign of the body’s need for fluids

Thirst

AI for men

15–16 cups/day

3.7L

AI for women

11–12 cups/day

2.7L

Water is lost via

urination, perspiration, expiration, and defecation (~100–200 mL/day)

When as little as ___% of body water is lost, osmoreceptors are stimulated, creating a physiological desire to drink

2

_______ _______ _______ also stimulates renin release, leading to increased aldosterone release by the adrenal cortex

Decreased blood pressure

Water is transported easily in both directions across the intestinal mucosa by ______

osmosis

within an ____, 1 L can be absorbed from the small intestine

hour

The only liquid nutrient essential for hydration

water

___% to ___% of fluid intake comes from water

30-34

Coffee, Tea & Sugar-Sweetened Beverages

• Coffee/tea is the #1 beverage consumed at home

• Sugar-sweetened beverages account for up to 50% of added sugar intake, and about half of the rise in energy intake over 20 years is attributed to them

Energy & Sports Drinks

• Energy drink sales have more than doubled in 5 years; contain caffeine, guarana, and taurine (~140 cal/8 oz)

• Sports drinks are designed for highly trained endurance athletes exercising intensely for long periods

The FDA has issued warnings regarding teas that contain

senna, aloe, buckthorn, and other plant -derived laxatives

Most sports and energy drinks have a pH below

4

enamel erosion risk - greatest to least

1. energy drinks

2. sports drinks

3. regular soda

4. diet soda

_______ added to sports drinks lessens the erosive potential to teeth.

calcium

FLUID VOLUME EXCESS (FVE)

• Occurs in ECF compartments secondary to an increase in total body sodium

• Results in rapid weight gain, puffy eyelids, distended neck veins, and elevated blood pressure

• At risk: congestive heart failure, chronic renal failure, chronic liver disease, high steroid levels

FLUID VOLUME DEFICIT (FVD)

• Associated with excessive fluid loss (GI tract, urinary tract, skin)

• Classic signs: dry tongue with longitudinal fissures, xerostomia, shrinkage of oral mucous membranes, decreased skin turgor, dry skin, decreased urinary output

Cations (+)

Sodium, potassium, calcium, and magnesium. The principal cation in plasma and interstitial fluid is sodium

Anions (−)

Chloride, bicarbonate, and phosphate. The principal anion in plasma and interstitial fluid is chloride

Physiologic Roles of Sodium

• Maintains normal ECF concentration by affecting potassium/chloride concentration, excretion, and absorption, and water distribution

• regulates acid–base balance

• facilitates impulse transmission in nerve and muscle fibers

Approximately ______ of Americans have hypertension

1/3

sodium AI/day

1500mg

sodium UL/day

2300 mg

calcium sources

• Meat

• Saltwater fish

• Eggs

• Dairy products

• Some vegetables (only ~10% of sodium comes from natural food content; 75 –80% is added during processing and food preparation)

Hypernatremia

• extreme thirst

• dry, “sticky” tongue; fever

• convulsions

Hyponatremia

• water intoxication

• nausea, abdominal cramps, headache, confusion, lethargy coma

Chloride

Maintains ECF balance, osmotic equilibrium, and electrolyte balance

chloride AI/day

2300mg

primary sources of chloride

salt

Large concentrations of chloride are present in gastric secretions

• important for protein digestion and creating an acidic environment that inhibits bacterial growth and enhances iron, calcium, and vitamin B12 absorption

• Toxicity can result from excessive salt intake, dehydration, renal failure, diarrhea, and Cushing syndrome

Potassium

Directly affects cardiac muscle contraction and electrical conductivity

Potassium

• Maintains ICF concentration

• transmits nerve impulses

• regulates acid–base balance

Potassium AI

• 2,600 mg/day (women)

• 3,400 mg/day (men)

Potassium UL

No UL established

potassium sources

• Dairy

• Meat

• Grains

• Fruits

• Vegetables

• Processed foods

• Potassium supplements & salt substitutes

~92% of ingested potassium is excreted in _____

urine

a small amount is lost through feces or sweat

Dairy, meat, and grains together contribute __% of total dietary potassium

31

Hyperkalemia is life threatening due to

cardiac arrest risk

Hyperkalemia

• Causes:

  • impaired renal excretion

  • increased shift of potassium out of cells

  • increased potassium intake

• Treatment involves potassium restriction or medications to remove potassium

Hypokalemia

• Causes:

  • diuretics (furosemide, hydrochlorothiazide)

  • Cushing syndrome

  • hyperaldosteronism

  • hypomagnesemia

  • alcoholism

• Deficits can affect every body system

_____ is probably the most difficult mineral to obtain adequately in the American diet

Iron

iron

• Hemoglobin Component

• Catalyzes Oxidative Reactions Conversion

• Beta-Carotene to Vitamin A

• Purine Formation (Nucleic Acid)

• Lipid Removal from Blood

• Drug Detoxification (Liver)

• Collagen Synthesis

• Antibody Production

Iron RDA

• 8 mg/day (men & postmenopausal women)

• 18 mg/day (women 19–50)

Iron UL

45 mg/day

Iron absorption

• iron binds to transferrin for continuous transport and recycling

• Heme iron absorption parallels the body’s need

• nonheme iron absorption depends on meal composition and physiologic need

iron sources

• Heme: organ meats, meat, fish, poultry

• Nonheme: eggs, milk, whole grains/enriched cereals, green vegetables, dried fruit

iron toxicity (hemochromatosis)

organ damage, CHD, skin pigmentation, cirrhosis

iron Deficiency

microcytic anemia, angular cheilosis, pallor of lips/gingiva, glossitis, candidiasis risk

Perhaps the most important essential trace mineral for humans

zinc

zinc

• Component in 300+ enzymes affecting cell growth/replication

• collagen synthesis, bone resorption & remodeling

• sexual maturation

• night vision

• immune defenses

• taste, smell, and appetite

zinc RDA

11 mg/day (men), 8 mg/day (women)

zinc UL

40 mg/day

___ - ____% of dietary zinc is absorbed, and it is lost in feces.

~25–40

zinc sources

lamb, beef, crustaceans (especially oysters), eggs, peanuts

zinc hyper states

• High levels cause vomiting and diarrhea, epigastric pain, lethargy/fatigue, renal damage, pancreatitis, and death

• Excess zinc reduces copper status, alters iron function, decreases immune

• function

• decreases HDL

zinc hypo state

• thickening of epithelium

• impaired keratinization

• increased periodontal disease susceptibility

• flattened filiform papillae

• loss of taste/smell acuity

• poor appetite

• impaired wound healing

• At-risk groups: older adults, vegans, severe malabsorption

Iodine

Required for thyroxine production, which regulates the basal metabolic rate

iodine RDA

50 µg/day

iodine UL

1,100 µg/day

iodine Sources

• seafood

• plants grown near the ocean

• molasses

• yogurt

• milk

• iodized salt

iodine hyper states

• thyroiditis

• hypothyroidism

• hyperthyroidism

• sensitivity reactions

iodine hypo states

• goiter

• spontaneous abortions and congenital anomalies

• delayed tooth eruption

• enlarged tongue

• endemic cretinism