Chapter 14 - Nutrients Involved in Blood Health Flashcards

1
Q

What is the percent composition of blood?

A
  • 55% plasma
  • 1% leukocytes
  • 45% RBC
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2
Q

How is bioavailability altered?

A

By presence of other substances in the diet (minerals/phytates/oxalates)

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3
Q

Why is it easy to reach the UL of trace minerals?

A
  • No regulations on the amount in supplements
  • It can be difficult to remove minerals from the body after they’re absorbed
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4
Q

Function

Vitamin K

A
  • Metabolism of osteocalcin (protein that binds calcium to form bone)
  • Blood-clotting
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5
Q

Sources of Vitamin K

A
  • Gut bacteria
  • Green vegetables
  • Vegetable oils
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6
Q

Consequences of Vitamin K deficiency

A
  • Lack of blood clotting
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7
Q

Is there a risk of Vitamin K toxicity?

A

No; it is broken down very quickly and excreted

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8
Q

Functions

Zinc

A
  • Cofactor for metalloenzymes which regulate metabolic processes and gene expression
  • Stabilizes cell membranes
  • Heme synthesis
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9
Q

What is the absorption of zinc?

A

15-40% dietary zinc is absorbed; dependant on zinc status

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10
Q

What decreases the bioavailability of zinc?

A
  • Phytates
  • High iron
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11
Q

What is the storage protein of zinc?

A

Metallothinonein

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12
Q

What are the transport proteins of zinc?

A

Albumin and transferrin

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13
Q

RDA zinc

A
  • Male: 11mg/day
  • Female: 8mg/day
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14
Q

Who is zinc supplementation recommended for?

A
  • Treatment of infectious disease/diarrhea in children
  • Treats reduction in taste
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15
Q

Food sources of zinc

A
  • Oysters
  • Beef
  • Poultry
  • Tofu
  • Pumpkin seeds
  • Lentils
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16
Q

Who is most susceptible to zinc deficiency?

A
  • Pregnant women
  • Children
  • Elderly
  • Those of low socioeconomic status
  • Low meat, high fibre/legume diets
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17
Q

Symptoms of zinc deficiency

A
  • Growth failure (dwarfism)
  • Immature sexual development
  • Cognitive and motor delay
  • Impaired vision
  • Poor wound healing
  • Thyroid dysfunction
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18
Q

How does zinc deficiency cause a downward spiral?

A
  • Digestion and absorption is inhibited which results in malnutrition
  • Impaired immune function worsen malabsorption and malnutrition
  • Altered taste decrease appetite
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19
Q

UL zinc

A

40mg

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20
Q

Consequences of zinc toxicity

A
  • Vomiting
  • Diarrhea
  • Copper and iron deficiency
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21
Q

Functions

Copper

A
  • Copper containing enzymes
  • Allows iron to bind to transferrin
  • Energy metabolism enzymes
  • Superoxide dismutase
  • Collagen synthesis
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22
Q

Food sources of copper

A
  • Fruit (avocado, pomegranate, blackberries, kiwi)
  • Seafood
  • Grains
  • Legumes
  • Dark leafy greens
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23
Q

What is the absorption of dietary copper?

A

> 50%

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24
Q

Symptoms of copper deficiency

A
  • Increased blood cholesterol, damaging vessels
  • Menkes disease
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25
What is Menkes disease?
A genetic condition where copper is absorbed but not released into blood; life-threatening
26
What is Wilson's disease?
A condition caused by copper toxicity. Copper accumulated in the liver and brain.
27
# Functions Iron
* Transport of O2 (hemoglobin and myoglobin) * Co-factor for enzymes in oxidation-reduction reactions in metabolism
28
How much of the iron in the body is found in hemoglobin?
80%
29
How is iron absorption and excretion handled?
* Absorption is regulated by specific proteins * There is no physiologic regulatory mechanis for excreting iron
30
What is the role of ferritin?
Iron storage protein * mucosal ferritin: iron from diet stored in enterocytes
31
What is the role of transferrin?
Iron transport protein * Mucosal ferritin transfer iron to transferrin to release from enterocytes if iron is needed in the body
32
What is the absorption of heme iron?
25%
33
What is the absorption of nonheme iron?
17%
34
Sources of heme iron
Red meat, fish, and poultry
35
Sources of nonheme iron
Plant foods, fortified foods, and partially animal flesh (as animals consume plants with nonheme iron)
36
What factors increase nonheme iron absorption?
* MFP factor (found in meat-fish-poultry; associated with amino acids) * Vitamin C and other acids (citric, lactic, gastric HCl) by keeping iron in reduced state * Sugars
37
What factors decrease nonheme absorption?
* Phytates and fibre * Some proteins in beans and nuts * Calcium * Polyphenols in tea, coffee, grains, and red wine
38
What is the iron absorption rate in vegan diet?
10%; nonheme iron, increased phytates, no MFP
39
What is the iron absorption rate in mixed diets?
18%
40
How does growth and pregnancy affect iron absorption?
Absorption is higher
41
Why does iron have to bind to proteins for transport and storage?
Free iron generates radicals and can form insoluble complexes
42
What is the role of transferrin?
* Transport protein * Delivers iron to tissues, which has transferrin receptors
43
What is the role of ferritin?
* Storage protein * Stores within the liver, and some bone marrow and spleen * The breakdown of protein releases iron
44
What is the role of hemosiderin?
* Storage protein when high amounts of iron are present * Stores in the liver; releases iron more slowly
45
What is hepcidin?
A hepatic hormone that regulates blood iron levels, absorption, and release from tissues
46
What is basal iron loss and how much is lost through it?
* GIT, skin, sweat, and urine * 1mg/day
47
How much iron is lost in menstrual loss?
14mg per 28 day cycle
48
Where can other iron losses occur besides basal and menstrual loss?
Pregnancy, birth, and lactation * This offset by a lack of menstruation
49
RDA Iron
Males: 8mg/day Menstruating Females: 18mg/day Pregnant: 27mg/day Menopausal Females: 8mg
50
How is the iron RDA different for vegans?
1.8 times the RDA
51
How can iron intake be maximized?
* Eating iron enriched foods * Have enhancers to increase bioavailability of nonheme (MFP, Vitamin C) * Use iron cookware
52
What is the most commom nutrient deficiency?
Iron; ~1.6 billion are deficient worldwide
53
Where is iron deficiency most prevlanet?
In low to mid income countries; 50% of children and pregnant are deficient
54
What populations are most likely to be iron deficient in high income countries?
* 10% toddlers * Adolescent girls * Women in reproductive years * Obese children and adolescents
55
Who is most at risk for iron deficiency?
* Women in reproductive years * Pregnant women * Infants and young children * Teenagers
56
What are the stages of iron deficiency? (3)
1. Iron stores diminsh 2. Transport of iron decreases 3. Decreased hemoglobin production
57
What occures in stage 1 of iron deficiency?
Serum ferritin decreases
58
What occurs in stage 2 of iron deficiency?
Transferrin saturation decreases due to decreases in serum iron
59
What occurs in stage 3 of iron deficiency?
Decreased hemoglobin and increase in erythrocyte protoporphyrin, a hemoglobin precursor. There is a decrease in hematocrit.
60
What is the difference between iron deficiency and iron deficiency anemia?
* Iron deficiency: depletion of iron stores * Anemia: depletion of iron stores + decreased hemoglobin synthesis
61
What are the symptoms of iron deficiency anemia?
* Impaired energy metabolism * Fatigue, weakness, headaches, pale, sensitivity to cold * Decreased work capacity and mental alterness
62
What is pica?
Craving and consumption of non-foods which is linked to iron deficiency anemia
63
What are the types of pica? (3)
* Geophagia: clay, dirt, chalk, paper * Pagophagia: ice * Amylophagia: flour, laundry starch, raw rice
64
Why are athletes at risk of iron deficiency?
* Increased iron losses in sweat, feces, and uring * Repeated high impact heal strikes can rupture RBC
65
What is sports anemia?
* A response to initial training or increased intensity * Increase in fluid component of blood before an increase in RBC * Not actually anemia, and has no effect on performance
66
What are the different types of anemia? (3)
* Microcytic, hypochromic: deficiency of iron which affects hemoglobin synthesis * Megoblastic/macrocytic: deficiency of B12 or folate which affects DNA synthesis * Hemolytic: deficiency of vitamin E which impaire cell membrane protection
67
What are causes of iron overload? (4)
* Hemochromatosis * Repeated blood transfusion * Excess supplement dose * Excess Vitamin C supplementation
68
What is associated with an iron overload?
An increased risk of heart disease and cancer
69
What is the UL for iron?
45mg/day
70
Symptoms of iron poisoning
* GIT distress * Respiratory distress * Heart failure
71
How can iron toxicity be assessed from deficiency?
* Increased serum ferritin * Increased transferrin saturation
72
Why is iron deficiency and toxicity hard to differentiate?
They have similar symptoms: apathy, lethargy, fatigue