DNT 200 NUTRITION FOR HEALTH SCIENCES

1. DNT 200NUTRITION FOR HEALTH SCIENCES WATER & MINERALS

2. WATER & MINERALS The cows are our friends, they give food, they give strength, they likewise give a good complexion and happiness Gautama Buddha, 500 B.C.

3. WATER & MINERALS Water and Body Fluids

4. WATER & MINERALSWater • Physiological Functions • Is an essential nutrient (must be consumed from exogenous sources to satisfy metabolic demand) • Constitutes about 60% of adult body weight • Catalyst for a majority of metabolic reactions including those involves with • Nutrient digestion • Absorption • Transport • Metabolism

5. WATER & MINERALSWater • Physiological Functions (con’t) • Required for facilitation of excretion of metabolic waste by the kidneys • Inadequate intake compromises cell functioning by contributingto • Electrolyte imbalances • Concentration of plasma volume • Inability to regulate body temperature

6. WATER & MINERALSWater • Groups vulnerable to dehydration -- are either not able to adequately express thirst sensations or to detect them • Infants • Elderly adults • Athletes • With extreme heat and excessive perspiration, thirst may lag behind actual water requirements

7. WATER & MINERALSWater Overhydration • Can result in hyponatremia (because of too much water) • Less common but more dangerous than dehydration • Sports drinks -- contain some sodium but not enough to make a difference • Women at greater risk because they are smaller • International Marathon Medical Directors Association advises drinking no more than about 12 - 25 oz fluid per hour

8. Sources Water you drink Nearly all foods contain water Normal intake -- 2.5 liters per day PERCENTAGE OF WATER IN SELECTED FOODS 100% -- Water; diet sodas 90-99% -- Nonfat milk, strawberries, watermelon, lettuce, cabbage, celery, spinach, broccoli 80-89% -- Fruit juice, yogurt, apples, grapes, oranges, carrots 70-79% -- Shrimp, bananas, corn, potatoes, avocados, cottage cheese, ricotta cheese 60-69% -- Pasta, legumes, salmon, ice cream, chicken breast 50-59% -- Ground beef, hot dogs, feta cheese 40-49% -- Pizza 30-39% -- Cheddar cheese, bagels, bread 20-29% -- Pepperoni sausage, cake, biscuits 10-19% -- Butter, margarine, raisins 1-9% -- Crackers, cereals, pretzels, taco shells, peanut butter, nuts 0% -- Oils WATER & MINERALSWater and Body FluidsWater Intake

9. WATER & MINERALSWater and Body Fluids • Percent of total water intake from beverages (including drinking water) and food • Males and females 19 and older • 81% from beverages • 19% from foods • Pregnant females • 77% from beverages • 22% from foods • Lactating females • 82% from beverages • 18% from foods NHANES III 1988-1994

10. WATER & MINERALSWater and Body Fluids Water DIETARY REFERENCE INTAKE VALUE • AI • Males 19 and over -- 0.7 L/day from food and 3.0 L/day from beverages • Females 19 and over -- 0.5 L/day from food and 2.2 L/day from beverages • Pregnant women -- 0.7 L/day from food and 2.3 L/day from beverages • Lactating women -- 0.7 L/day from food and 3.1 L/day from beverages 2004 data

11. Body must excrete a certain amount of water per day as urine (approx. 500ml) Carries away waste products of metabolism Above this amount, the water you excrete adjusts to balance your intake If you drink more than you need, the urine becomes more dilute WATER & MINERALSWater and Body FluidsWater Output

12. WATER & MINERALSWater and Body FluidsFluid & Electrolyte Balance • 2/3 fluid found inside the cells • 1/3 fluid found outside the cells • Major minerals control the movement of water -- they occur in salts that dissolve in body fluids

13. WATER & MINERALSWater and Body FluidsFluid & Electrolyte Balance • Ions • When mineral salts are dissolved in water (body fluids) they separate (dissociate) into ions (cations and anions) that carry electricity • Cations carry positive charges; anions carry negative charges • Electrolytes are fluids that have ions dissolved in them such that they have electrical properties

14. WATER & MINERALSWater and Body FluidsFluid & Electrolyte Balance Water’s Attraction To Electrolytes • Electrolyte solutions • They must have a balanced charge • Can conduct electricity • Cells sort out the mineral ions • Outside the cells -- notably sodium and chloride ions • Inside the cells -- potassium, magnesium, phosphate, and sulfate ions • When electrolytes move across membranes water follows -- water follows salt

15. WATER & MINERALSWater and Body FluidsFluid & Electrolyte Balance Water’s Attraction To Electrolytes • Water moves to concentrated solutions • Osmosis -- the movement of water across a membrane to area with more solutes --solutes refer to the number of molecules in a given volume of solution • Examples of osmosis • Raisins plump in water • Vegetables sweat when salted

16. WATER & MINERALSWater and Body FluidsFluid & Electrolyte Balance Regulation • The amount of various salts in body must remain nearly constant • If salts are lost, they must be replaced from external sources -- foods and beverages • Proteins regulate the flow of fluids and ions • Cell membrane contains transport proteins that regulate the passage of positive ions and other substances from one side of the membrane to the other • Negative ions follow positive ions • Water flows toward the more concentrated solution

17. WATER & MINERALSWater and Body FluidsFluid & Electrolyte Balance

18. WATER & MINERALSWater and Body FluidsFluid & Electrolyte Balance

19. WATER & MINERALSWater and Body FluidsDehydration Signs to watch for (adults) • Consumption less than 6 cups per day • Dry mouth, cracked lips, sunken eyes, or dark urine • Needs help drinking • Has trouble swallowing • Vomiting, diarrhea, or fever • Confused or tired • Environmental factors (seasonal temperatures and room temperatures)

20. WATER & MINERALSWater and Body FluidsDehydration What to do • Report observations and warning signs • Check swallowing • Encourage drink • Including other than at meal time • Caffeinated coffee and tea to be used with caution due to natural diuretic effect • Record intake and output • Offer ice chips • Drink with client • Place light pitcher and cup near • Offer assistance

21. WATER & MINERALS Minerals

22. WATER & MINERALSMineralsOverview • Are inorganic elements • Always retain their chemical identity • Once they enter the body, they remain there until excreted • Some are required in small amounts and therefore are essential nutrients • Bioavailability varies -- some foods contain binders that combine chemically with minerals preventing absorption • Have varied roles • Major minerals are present in the largest amounts (larger than 5 grams) • Trace minerals -- found in amounts less than 5 grams

23. WATER & MINERALSMineralsOverview

24. WATER & MINERALSMineralsMajor Minerals Calcium DIETARY REFERENCE INTAKE VALUE • AI • Adults 19-50 -- 1000 mg NOTE: Values do not change with pregnancy and lactation • Adults over 50 -- 1200 mg • UL -- 2500 mg 1998 data

25. WATER & MINERALSMineralsMajor Minerals Calcium • Is the most abundant mineral in the body • Chief functions • With phosphorus, is the chief mineral of the bones and teeth • 99% stored in bones • Bones act as a bank for calcium • Formulation and dissolution takes place every minute, day and night • Blood calcium changes in response to changed regulatory control, not diet -- bones are depleted by calcium deficiency

26. WATER & MINERALSMineralsMajor Minerals Calcium • Chief functions (continued) • Calcium balance • Regulated by Vitamin D, calcitonin (from the thyroid gland), and parathormone (from the parathyroid glands)

27. WATER & MINERALSMineralsMajor Minerals Calcium • Chief functions (continued) • Calcium balance • If blood calcium is too high • Rising blood calcium signals the thyroid gland to secrete calcitonin, which --Limits calcium absorption in the intestines --Inhibits the activation of Vitamin D --Stimulates calcium excretion in the kidneys --Inhibits osteoclast cells from breaking down bone, preventing a rise in blood calcium • All of these actions lower blood calcium, which inhibits calcitonin secretion

28. WATER & MINERALSMineralsMajor Minerals Calcium • Chief functions (continued) • If blood calcium is too low • Falling blood calcium signals the parathyroid glands to secrete parathormone • Vitamin D enhances absorption in the intestines • Parathormone stimulates the activation of Vitamin D • Vitamin D and parathormone stimulate osteoclast cells to break down bone, releasing calcium into the blood • All of these actions raise blood calcium, which inhibits parathormone secretion

29. WATER & MINERALSMineralsMajor Minerals Calcium • Chief functions (continued) • Aids in normal muscle contractions and relaxations -- maintains normal heart rhythm • Above normal blood levels causes calcium rigor -- muscles contract resulting in hardness and stiffness • Below normal levels cause calcium tetany -- intermittent spasm of the extremities • Not reflective of lack of dietary calcium • Are caused by lack of Vitamin D or • Abnormal secretion of the regulatory hormones

30. WATER & MINERALSMineralsMajor Minerals Calcium • Chief functions (continued) • Blood pressure • Adequate calcium intake can lower blood pressure, superceding the effects of a high sodium diet • Assists in nerve functioning • Is involved in blood clotting • Aids in immune defenses

31. WATER & MINERALSMineralsMajor Minerals Calcium • Deficiency symptoms • Stunted growth in children • Osteoporosis (adult bone loss) • Is a reduced density of the bones • Both genetic and environmental factors can contribute • Is 8 times more prevalent in women than men • Women tend to consume less calcium than men • Women’s bone mass is lower than men (because of smaller body size) • Bone loss begins earlier in women than men accelerates after menopause • Other nutrients also are involved in preventing osteoporosis • Magnesium • Fluoride • Vitamin A

32. WATER & MINERALSMineralsMajor Minerals Calcium • Toxicity symptoms • Constipation • Increased risk of urinary stone formation and kidney dysfunction • Interference with absorption of other minerals

33. WATER & MINERALSMineralsMajor Minerals Calcium • Absorption • Adults absorb about 30% of calcium consumed • Factors that enhance absorption • Stomach acid -- helps to keep it soluble • Vitamin D -- helps the absorptive cells of the intestine make the necessary calcium-binding protein • Lactose • Phosphorus when consumed in an equal amount as calcium • Growth hormones

34. WATER & MINERALSMineralsMajor Minerals Calcium • Absorption • Factors that inhibit absorption • Lack of stomach acid • Vitamin D deficiency • High phosphorus intake • High fiber diet • Phytates, a non-nutrient component of plant seeds (in seeds, nuts, and grains) • Oxalates, a binder (in beets, rhubarb, and spinach)

35. Significant Sources Milk and milk products Small Fish (with bones) Tofu (bean curd) Greens (broccoli, chard) Legumes Broccoli: 36mg per 1/2 cup cooked Sardines: 324mg per 3 oz Milk: 316mg per cup Pork and beans: 77mg per 1/2 cup Cheddar Cheese: 305mg per 1-1/2 oz Almonds: 80mg per 2 Tbsp. WATER & MINERALSMineralsMajor MineralsCalcium

36. WATER & MINERALSMineralsMajor Minerals Phosphorus DIETARY REFERENCE INTAKE VALUE • RDA • Adults over 19 -- 700 mg • UL • 3000-4000 mg, depending on age, sex, pregnancy, or lactation status 1998 data

37. WATER & MINERALSMineralsMajor Minerals Phosphorus • After Calcium, is the second-most abundant mineral in the body • Approximately 85% is found as hydroxyapatite, the major calcium-containing crystal of the bones and teeth

38. WATER & MINERALSMineralsMajor Minerals Phosphorus • Chief functions • A chief mineral of the bones and teeth • Phosphates occur in all cells as part of a major buffer system (phosphoric acid and its salts) • Occurs as part of genetic material • DNA and RNA present in every cell • Therefore necessary for growth

39. WATER & MINERALSMineralsMajor Minerals Phosphorus • Chief functions (continued) • Assists in energy transfers during cellular metabolism • Many enzymes and the B-vitamins become active only when a phosphate group is attached • ATP, the energy carrier of the cells, uses three phosphate groups to do its work • Part of phospholipids • Helps transport other lipids in the blood • Major structural components of cell membranes

40. WATER & MINERALSMineralsMajor Minerals Phosphorus • Deficiency symptoms • Weakness, bone pain • Dietary deficiency rarely occurs • Some drugs can bind with phosphorus making it unavailable resulting in bone loss that is characterized by weakness and pain • Diets that provide enough protein and calcium will provide enough phosphorus • Toxicity symptoms • Excess phosphorus may draw calcium out of the body in being excreted

41. WATER & MINERALSMineralsMajor Minerals Phosphorus • Significant sources • All animal tissues -- best sources • Phosphorus from additives in processed foods can add significantly to people’s intakes • Vegetables and fruits are fair to poor sources

42. WATER & MINERALSMineralsMajor Minerals Magnesium DIETARY REFERENCE INTAKE VALUE • RDA • Males 19-30 -- 400 mg • Males 31 and over -- 420 mg • Females 19-30 -- 310 mg • Females 31 and over -- 320 mg • UL • 350 mg, (as a pharmacological agent only -- not from food and water) 1998 data

43. WATER & MINERALSMineralsMajor Minerals Magnesium • Bone magnesium is a “reservoir” to make sure some will be on hand for vital reactions, regardless of recent dietary intake

44. WATER & MINERALSMineralsMajor Minerals Magnesium • Chief functions • Involved in bone mineralization -- over half of the body’s magnesium is in the bones • Building of protein -- acts in all of the cells of the soft tissue • Enzyme action • Is a catalyst in the reaction that adds the last phosphate to ATP • Normal muscle contraction • Dynamic interaction with calcium (calcium promotes, magnesium inhibits) • Nerve impulse transmission • Maintenance of teeth -- holds calcium in the tooth enamel • Supports functioning of the immune system

45. WATER & MINERALSMineralsMajor Minerals Magnesium • Deficiency symptoms • Rarely occur without disease -- may develop in • Alcohol abuse • Protein malnutrition • Kidney or endocrine disorders • Prolonged vomiting or diarrhea • Characterized by • Weakness • Confusion • If extreme • Convulsions • Bizarre muscle movements • Hallucinations • Difficulty swallowing • Growth failure in children

46. WATER & MINERALSMineralsMajor Minerals Magnesium • Toxicity symptoms -- unknown

47. Significant Sources Nuts Legumes Whole Grains Dark Green Vegetables Seafood Chocolate Cocoa Oysters: 93mg per 3 oz Dried Figs: 33mg per 1/4 cup Black Eyed Peas: 45mg per 1/2 cup cooked Spinach: 78mg per 1/2 cup cooked Baked Potato: 55mg per whole small potato Sunflower Seeds(shelled): 21mg per 2 tbs. WATER & MINERALSMineralsMajor MineralsMagnesium

48. WATER & MINERALSMineralsMajor Minerals Sodium DIETARY REFERENCE INTAKE VALUE • AI • Men and women 19 - 50 -- 1500 mg daily • Men and women 51 - 70 -- 1300 mg daily • Men and women 70 and older -- 1200 mg daily • UL • Men and women 19 and over 2,300 mg daily • Typical consumption averages 3,300 mg 2004 data

49. WATER & MINERALSMineralsMajor Minerals Sodium • Chief functions • Is the principle electrolyte in the extracellular fluid and the primary regulator of extracellular fluid volume • When blood sodium rises (as when a person eats salted foods) thirst ensures that the person will drink until the appropriate sodium to water ratio is restored • With chloride and potassium, maintains the cells normal fluid balance • Maintains acid-base balance • Kidneys excrete hydrogen ions in exchange for sodium ions • Nerve impulse transmission • Muscle contraction

50. WATER & MINERALSMineralsMajor Minerals Sodium • Deficiency • Causes of depletion • Overly strict use of low sodium diets • Vomiting • Diarrhea • Heavy sweating • Symptoms • Muscle cramps • Mental apathy • Loss of appetite • When blood sodium drops, both sodium and water must be replaced to restore balance • Salt losses can be safely replaced with “regular foods” • Salt tablets are not recommended -- too muchsalt, especially with too little water can incur dehydration