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clinical nutrition > chapter 9 book notes > Flashcards

chapter 9 book notes Flashcards

1
Q

How much water does the adults body weight constitute?

A

-60%
-& it is higher in a childs body weight

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2
Q

How much water in lean tissue? How much water in fat?

A

-lean=75%
-fat=25%

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3
Q

What influences how much a person body weight is water?

A

-body composition

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4
Q

Proportion of water is generally smaller in who?

A

-Females, people with obesity, and older adults because of their smaller proportion of lean tissue.

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5
Q

Functions of water in body fluids (7):

A

-carries nutrients & waste products throughout body
-maintains the structure of large molecules such as proteins and glycogen
-participates in metabolic reactions
-serves as the solvent for minerals, vitamins, amino acids, glucose, and other molecules
-maintains blood volume
-aids in regulation of body temp.
-acts as lubricant and cushion around joints and inside eyes, spinal cord, and amniotic sac surrounding fetus

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6
Q

Water balance

A

-balance between water intake and water excretion that keeps the body’s water content constant.

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7
Q

Imbalances of water can lead to:

A

-dehydration
-water intoxication

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8
Q

Mild dehydration (loss of less than 5% of body weight) symptoms:

A

-thirst
-sudden weight loss
-rough, dry skin
-dry mouth, throat

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9
Q

Severe dehydration (loss of more than 5% of body weight) symptoms:

A

-pale skin
-bluish lips and fingertips
-confusion
-rapid shallow breathing

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10
Q

In healthy people, what governs water intake?

A

-thirst and satiety

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11
Q

When blood becomes too concentrated( having lost water but not salt and other dissolved substances), what happens to the body?

A

-the mouth becomes dry
-the brain center (hypothalamus) initiates drinking behavior

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12
Q

With aging what diminishes?

A

-thirst sensations

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13
Q

Water intoxication

A

-rare
-excessive water consumption
-kidney disorders that reduce urine production

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14
Q

Symptoms of water intoxication:

A

-severe headaches
-confusion
-convulsions
-and even death in extreme cases

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15
Q

What does excessive water ingestion (several gallons) within a few hours do the the blood?

A

-dilutes sodium concentration of the blood and contributes to dangerous condition (hyponatremia)

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16
Q

What two organs regulate water excretion?

A

-the brain and kidneys

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17
Q

The brain & its role in regulation of water excretion when blood is high in sodium, or bp and blood volume is low:

A

-cells in brains hypothalamus, which monitor blood salts, stimulate the pituitary gland to release antidiuretic hormone (ADH). whenever salts are too concentrated.
-ADH stimulates the kidneys to reabsorb water rather than excrete it.

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18
Q

The more water you need…

A

-the less you excrete.

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19
Q

The kidneys and their role in water excretion regulation:

A

-cells in kidneys respond to low bp by releasing renin. (through complex events of hormone aldosterone).
-this enzyme causes the kidneys to retain more water.

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20
Q

On average a person loses how much water daily?

A

-2.5 liters

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21
Q

The more a person drinks, the more ? their urine becomes:

A

-dilute

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22
Q

Besides urine, how else is water lost?

A

-from lungs as vapor
-some excreted in feces
-and some evaporates from the skin

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23
Q

Water needs depend on these factors:

A

-environmental temp. & humidity
-activity level
-what a person eats

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24
Q

In the past how was water intake expressed?

A

-in proportion to the amount of energy expended under normal environmental conditions
EX: person expends 2000kcal a day, meaning they are to drink 2-3 liters of water (8-12 cups).

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25
Q

DRI adequate intake (AI) for total water for men & women:

A

-men=3.7
-women=2.7

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26
Q

What kind of urine reflects appropriate dilution?

A

-pale, yellow

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27
Q

How much water does veggies and fruits have? What about in meats and cheeses?

A

-95%
-50%

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28
Q

DRI insight on caffeinated drinks and water intake:

A

“caffeinated beverages contribute to the daily total water intake similar to that contributed by non-caffeinated beverages”

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29
Q

Electrolytes

A

-a salt that dissolves in water and dissociates into charged particles called ions

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30
Q

Body fluids contain:

A

-water and partly dissociated salts
-AKA electrolyte solutions

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31
Q

Bodys electrolytes are..:

A

-vital to life of cells
-must be closely regulated to help maintain appropriate distribution of body fluids

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32
Q

major minerals form salts that dissolve in the body fluid;

A

-the cells direct where these salts go
-movement of salts determines where the fluids flow because water follows salt

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33
Q

Cells use what force to move fluids back and forth across their membranes:

A

-Osmosis
-movement of water across membrane toward the side where concentration of dissolved particles is greater.

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34
Q

Protein pumps & concentration of potassium, sodium, and chloride inside cells:

A

-sodium and chloride are concentrated outside of cell
-potassium is concentrated inside cell

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35
Q

The kidneys filter what out of the blood?

A

-sodium, then they return to the bloodstream the exact amount the body needs to retain.

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36
Q

Sudden loss of fluid and electrolyte requires…

A

-medical intervention
-severe stresses include vomiting, diarrhea, heavy sweating, fever, burns, and wounds.

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37
Q

Electrolytes and acid-base balance:

A

-act as buffers (substances that accommodate excess acids or bases)

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38
Q

what organ plays the primary role in maintaining acid-base balance?

A

-the kidneys

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39
Q

Major minerals:

A

-essential mineral nutrients required in the adult diet in amounts greater than 100 milligrams per day.

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40
Q

What are the major minerals? (7)

A

-calcium
-chloride
-magnesium
-phosphorus
-potassium
-sodium
-sulfur

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41
Q

Trace minerals:

A

essential mineral
nutrients required in the adult diet
in amounts less than 100 milligrams
per day.

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42
Q

What are the trace minerals (9)

A

-chromium
-copper
-fluoride
-iodine
-iron
-manganese
-molybdenum
-selenium
-zinc

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43
Q

Difference between trace and major minerals?

A
  • major minerals are named so because they are present, and needed, in
    larger amounts in the body than the trace minerals.
    -NOT BECAUSE THEY ARE MORE IMPORTANT
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44
Q

Which two minerals are not eaten enough and are linked to chronic diseases?

A

-calcium & potassium

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45
Q

What mineral is overconsumed?

A

-sodium

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46
Q

Which minerals are most noted for their role in the body’s fluid balance?

A

-sodium. chloride, and potassium

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47
Q

Which minerals are critical for nerve transmission & muscle contractions?

A

-sodium
-potassium
-calcium
-magnesium

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48
Q

Minerals involved in energy metabolism?

A

-phosphorous and magnesium

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49
Q

Minerals that contribute to structure of bones:

A

-calcium, phosphorus and magnesium

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50
Q

Which mineral helps determine shape of proteins?

A

-sulfur

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51
Q

Sodium:

A

-principle electrolyte in the extracellular fluid (fluid outside cells)
-primary regulator of extracellular fluid volume
-helps maintain acid-base balance and muscle contraction and nerve transmission

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52
Q

When blood concentration of sodium rises, as a person eats salty foods:

A

-thirst prompts the person to drink water until sodium-water ratio is restored.

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53
Q

Too much sodium can lead to

A

-high blood pressure (hypertension)

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54
Q

Average US sodium intake is:

A

3400 milligrams per day

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55
Q

Chronic disease risk reduction intake for adults is set at ? to prevent high blood pressure:

A

-2300 milligrams per day
=1 teaspoon of salt

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56
Q

What % of the US adult population meets or exceeds this amount daily?

A

-90%

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57
Q

Top food contributors of sodium in diet:

A

-breads and rolls
-cold cut and cured meats
-pizza
-chicken
-soups

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58
Q

Which organ system regulates sodium in the body?

A

-gastrointestinal

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59
Q

Nearly what % of US adults have hypertension? What race is the highest?

A

-50%
-with african americans adults the highest in the world at 54%

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60
Q

DASH (Dietary Approaches to Stop Hypertension):

A

-dietary pattern proven to help people reduce sodium and increase potassium intake to reduce blood pressure

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61
Q

DASH food choices:

A

potassium-rich fruits and vegetables and fat-free or low-fat dairy products;
includes whole grains, nuts, poultry, and fish

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62
Q

Chlroide

A

-major negative ion of the extracellular fluids, where it occurs primarily in association with sodium
-critical in maintaining fluid, electrolyte, and acid-base balances in body.

63
Q

Chloride in the stomach:

A

-the chloride ion is part of
hydrochloric acid, which maintains the strong acidity

64
Q

Salt & chloride:

A

-Salt is a major food source of chloride, and, as with sodium, processed foods are a
major contributor of this mineral to people’s diets.

65
Q

Which mineral is high in weight in salt? SODIUM OR CHLORIDE?

A

-chloride
-chloride recommended intakes are higher than sodium

66
Q

Potassium functions:

A

-produces proteins
-maintenance of fluid-electrolyte balance
-supports cells integrity
-transmission of nerve pulses and muscles contraction (including heart)

67
Q

During nerve impulse what happens with potassium and sodium?

A

-During nerve impulse transmission and muscle contraction, potassium and sodium trade places briefly across. the cell membrane.
-The cell then quickly pumps them back into place.

68
Q

Excess potassium loss through severe diarrhea can cause:

A

-heart failure

69
Q

Potassium deficiency usually happens due to:

A

-excessive lost rather than not enough being taken in
-diuretics

70
Q

Severe potassium deficiency:

A

-cardiac arrhythmias, muscle weakness, and glucose intolerance.

71
Q

Potassium toxicity:

A

-results from overconsumption of potassium salts or supplements, certain disease or medications.

72
Q

Potassium toxicity symptoms:

A

-muscular weakness
-vomiting
-if given directly in vein, can stop the heart.

73
Q

Potassium food sources

A

-fruits, vegetables, meats, milk
-BANANAS

74
Q

Potassium and hypertension

A

-regular intake of potassium helps maintain a normal BP thus reducing risk of hypertension, heart disease, and stroke.

75
Q

Calcium:

A

-develops a healthy skeleton and prevents bone disease
-most abundant mineral in body (99% is stored in bones and teeth).

76
Q

2 roles calcium plays in bones:

A

-integral part of bone structure
-serves as calcium bank available to body fluids should a drop in blood calcium occur.

77
Q

Active growth phase of bone:

A

-from birth to age 20
-bones are actively growing by modifying length, width, and shape.

78
Q

Peak bone mass development:

A

-ages 12-30
-skeletal mass increases
-bones grow thicker and denser

79
Q

Bone loss development:

A

-30 to 40 years of age and continues throughout remainder of life
-bone loss exceeds new bone formation.

80
Q

When blood calcium is too high:

A

-a system of hormones,
including vitamin D, promotes its deposition into bone.

81
Q

When blood calcium falls too low, 3 locations in the body act to rise it:

A

1)small intestine absorbs more calcium
2)bones release more calcium into blood
3)kidneys excrete less calcium

82
Q

A deficiency of calcium only affects:

A

-the bones not the calcium in blood

83
Q

Calcium deficiency symptoms:

A

-stunted growth in children
-osteoporosis (adult bone loss)

84
Q

In the US about ? of all adults 50 years or older develop osteoporosis:

A

-1/4
-most are women, due to be smaller, consume less calcium, and menopause causes 20% bone loss

85
Q

? million of people break a hip, leg, hand, etc. due to osteoporosis:

A

-2 million

86
Q

How much calcium does each person absorb?
Infants & children=
Adults=
Pregnant women=

A

-60%
-20-30%
-50%

87
Q

Calcium in foods:

A

-dairy products (most abundant)
-oysters
-tofu

88
Q

Phosphorus function:

A

SECOND MOST IMPORTANT MINERAL IN BODY
-mineralization of bones & teeth
-cell’s genetic material
-phospholipids
-energy transfer
-buffer system

89
Q

phosphorus deficiency:

A

NONE

90
Q

Phosphorus is part of what in genetic material?

A

DNA & RNA

91
Q

Phosphorus foods:

A

animal sources (meat, fish, eggs, milk)

92
Q

Magnesium function:

A

-bone mineralization
-production of proteins
-enzyme action
-nerve impulses

93
Q

how much magnesium is present in a 130lb person?

A

1 ounce, more than half in bones

94
Q

Magnesium and calcium in muscle action:

A

-work together for proper functioning of the muscles: calcium promotes contraction, and
magnesium helps relax the muscles afterward.

95
Q

Magnesium deficiency:

A

-low blood calcium
-cramps, confusion
-seizures, hallucinations

96
Q

magnesium food sources:

A

-nuts, legumes, whole grains, chocolate, seafood

97
Q

Sulfate is the oxidized form of

A

-sulfur

98
Q

Sulfate functions:

A

-shape proteins
-component of amino acids biotin & thiamin and insulin

99
Q

Sulfate deficiency:

A

-NONE

100
Q

Sulfate foods:

A

-all protein containing foods

101
Q

IF all trace minerals were removed from body..

A

-you would only have a bit a dust, hardly enough to fill a teaspoon.

102
Q

Iron function:

A

-hemoglobin
-myoglobin
-utilizes energy

103
Q

Protein hemoglobin

A

-in red blood cells
-iron in hemoglobin helps carry oxygen from lungs to tissues throughout the body.

104
Q

Protein myoglobin:

A

-hold oxygen for muscles to use when they contract

105
Q

When a red blood cell dies…

A

-the liver saves the iron and returns it to bone marrow, which uses it to build new red blood cells.

106
Q

The body loses iron from..

A

-tiny amounts:
-digestive tract
-nail and hair trimmings
-shed skin cells
-BLEEDING=EXCESSIVE LOST IN IRON

107
Q

Iron is a powerful:

A

-oxidant that increases oxidative stress and inflammation that can damage body tissues.
-SO NEEDS TO BE MAINTAINED

108
Q

Because the body does not excrete excess iron..

A

-regulation of adsorption plays a critical role in iron homeostasis.

109
Q

How much of dietary iron is absorbed?

A

10-15%

110
Q

Transferrin

A

-a special protein in intestinal cells captures iron and holds it in reserve for release into body as needed.
-carries iron in blood to tissues around body
-more iron =more transferrin

111
Q

Additional iron storage proteins:

A

-ferritin
-hemosiderin

112
Q

hepcidin

A

-a hormone secreted by the liver in response to elevated blood iron.
-Hepcidin reduces iron’s absorption from
the intestine and its release from
storage.

113
Q

What is the most common nutrient deficiency?

A

-iron deficiency; small, pale red blood cells

114
Q

Iron intake is especially important to

A

-women in their reproductive years
-pregnant women
-infants & toddlers
-adolescents

115
Q

Causes of iron deficiency:

A
  • intake of iron-poor food choices
    -lack of food
116
Q

3 stages of iron deficiency:

A

1) iron stores and ferritin levels diminish
2)decrease in transport iron
3)lack of iron limits hemoglobin production

117
Q

most common tests used to evaluate iron status:

A

-hemoglobin and hematocrit tests

118
Q

Iron deficiency and iron deficiency anemia are:

A

-not the same thing
-some people may be iron deficient without being anemic

119
Q

Iron deficiency

A

refers to depleted body iron stores without regard to the degree of depletion or to the
presence of anemia.

120
Q

iron deficiency anemia

A

refers to the severe depletion of
iron stores that results in a low hemoglobin concentration
-cant carry enough oxygen from lungs to tissues

121
Q

people with anemia only feel fatigue when they..

A

-exert themselves

122
Q

iron defiency symptoms:

A

-weakness, pallor, headaches, inability to concentrate, lower cold tolerance
-impaired cognitive function (children)

123
Q

Pica

A

-curious behavior in some iron deficient people
-craving for and consumption of ice, chalk, clay.

124
Q

Iron toxicity:

A

-iron overload

125
Q

Most likely cause of iron overload:

A

-disorder known as hemochromatosis: genetic failure to prevent unneeded iron in the diet from being absorbed.

126
Q

Symptoms of iron overload

A

-similar to those if iron deficiency
-infections, liver injury, bloody stools

127
Q

Iron poisoning

A

-rapid ingestion of massive amounts of iron can cause death
-as few as 5 iron tablets have caused death in a child

128
Q

Iron occurs in two forms of food:

A

-heme (10x more absorbable and bound to hemoglobin and myoglobin in meat fish and poultry)
-nonheme (absorbed at a lower rate and found in meats and plants

129
Q

Iron absorption can be maximized by two substances:

A

-MFP factor
-Vitamin C

130
Q

cooking in a iron skillet can

A

add iron to the diet

131
Q

Zinc function

A

-part of insulin & enzymes
-makes genetic material
-transports vitamin A
-taste/smell
-sperm production & fetal development

132
Q

Zincs main transport vehicle: in blood:

A

-protein albumin

133
Q

When was zinc deficiency first reported?

A

-1960s
-children and males in egypt, turkey, and iran
-dwarfism and severe growth restriction

134
Q

Zinc deficiency symptoms:

A

-delayed growth
-delayed sexual maturation
-loss of taste
-poor wound healing

135
Q

Zinc foods:

A

-protein containing foods (meat, fish shellfish)

136
Q

selenium function:

A

-assists groups of enzymes that break down reactive chemicals that harm cells.
-ANTIOXIDANT NUTRIENT

137
Q

Selenium deficiency:

A

-Keshan disease (heart disease in children and women in China where soil and foods lack selenium)

138
Q

Iodine function

A

-component of two thyroid hormones which regulate body temp, reproduction, growth, etc.

139
Q

iodine defciency:

A

-goiter, cretinism

140
Q

Goiter

A

-earliest and most obvious sign
-enlargement of thyroid gland due to the cells wanting to trap iodide.
-become sluggish and gain weight

141
Q

Cretinism

A

-severe iodine deficiency during pregnacy
-causes extreme and irreversible intellectual disabilities and physical stunting.

142
Q

What is the worlds major source of iodine?

A

-the ocean

143
Q

Iodine food sources:

A

-iodized salt
-seafood
-bread

144
Q

copper function:

A

-necessary for absorption and use of iron in formation of hemoglobin
-part of several enzymes

145
Q

body contains about ? milligrams of copper:

A

-100
-1/4 is in muscles
-1/4 is in liver, brain and blood

146
Q

copper deficency

A

-RARE
-anemia, bone abnormalities

147
Q

Consuming too much of what mineral will block coppers absorption?

A

Zinc

148
Q

Fluoride function:

A

-element involved in formation of bones and teeth
-prevents dental carries

149
Q

fluoride deficiency:

A

-dental problems/carries

150
Q

fluoride toxicity:

A

fluorosis (pitting and discoloration of teeth)

151
Q

Fluoride food:

A

-drinking water (if fluoride containing)
-tea
-seafood

152
Q

chromium function:

A

-carb and lipid metabolism
-enhances activity of insulin and improves glucose tolerance

153
Q

chromium deficiency:

A

-diabetes like condition

154
Q

chromium foods:

A

-meats, whole grains

clinical nutrition (26 decks)

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