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HLTH 230 > Vitamins and Minerals > Flashcards

Vitamins and Minerals Flashcards

1
Q

What are the characteristics of vitamins (5)?

A

Organic compounds
Do not yield energy
Micronutrients
Vital to life
Indispensable to body functions

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2
Q

What do precursors, or provitamins do?

A

Transform chemically to one or more active vitamin forms.
Measure of vitamin in a food, generally includes:
- Vitamin and the vitamin activity potential from its precursors
- Example: beta-carotene

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3
Q

What is bioavailability?

A

The rate and extent to which a nutrient is absorbed and used

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4
Q

What is malnutrition?

A

any condition caused by excess or deficient food energy or nutrient intake or by an imbalance of nutrients

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5
Q

What is undernutrition?

A

deficient in energy or nutrients

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6
Q

What is overnutrition?

A

Excess energy or nutrients

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7
Q

What is a primary deficiency?

A

a nutrient deficiency caused by inadequate dietary intake of a nutrient

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8
Q

What is a secondary deficiency?

A

a nutrient deficiency caused by something other than inadequate intake such as a disease condition or drug interaction that reduces absorption, accelerates use, hastens excretion or destroys the nutrient

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9
Q

What is a subclinical deficiency?

A

a deficiency in the early stages, before the outward signs have appeared

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10
Q

What are the fat-soluble vitamins?

A

A, D, E and K

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11
Q

Name the water-soluble vitamins

A

B vitamins, C

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12
Q

What are the characteristics of fat-soluble vitamins (7)?

A

Absorbed into the lymph
Require bile for absorption
Travel in blood in association with protein carriers
Stored in tissues – Liver and fatty tissues – until needed
May be toxic in excess
Found in fats & oils of foods
Body can survive weeks without eating these vitamins (diet as a whole provides average amounts that meet requirements)

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13
Q

What are the characteristics of water-soluble vitamins?

A

Absorbed directly into bloodstream
Travel freely in bloodstream
Most are not stored to any great extent
Excess excreted in urine
Lower risk of toxicity than fat-soluble vitamins

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14
Q

Which fat-soluble vitamins can easily reach toxic levels, with supplements?

A

A and D

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15
Q

What happens with deficiency of fat-soluble vitamins?
When is it more likely to happen?

A
  • Likely if consistently low in fat-soluble vitamins
  • Fat malabsorption
  • Mineral oil laxatives can cause vitamin loss
  • Extraordinarily low-fat diets interfere with absorption
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16
Q

What are the three forms of vitamin A active in the body?

A

Retinol
Retinal
Retinoic acid

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17
Q

What is the plant-derived precursor of vitamin A?

A

Beta-carotene (found in dark orange vegetables (carrots, pumpkins))
Most abundant of the carotenoid precursors

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18
Q

What are the roles of vitamin A?

A
  • Vision
  • Cell differentiation
  • Gene expression
  • Maintenance of body linings and skin
  • Immunity
  • Growth of bones and of the body
  • Normal development of cells
  • Critical importance to reproduction
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19
Q

How does vitamin A help with eyesight in the back of the eye (describe this process)?

A

Light passes through the cornea before striking the retina
Retina contains light-sensitive nerve cells
Light bleaches the vitamin A-containing pigment rhodopsin
This breaks off the vitamin**, initiating an impulse to the optic center in the brain
The vitamin reunites with the pigment, & there is a little vitamin A destruction
Vitamin A must regenerate the supply

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20
Q

What happens if vitamin A supply runs low?

A

Night blindness

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21
Q

How does vitamin A affect eyesight (front of the eye) (deficiency)?

A
  • Keratin accumulation (keratinization) of the cornea can occur with vitamin A deficiency
  • Can lead to xerosis (drying) & then to dryness and thickening (xerophthalmia) causing permanent blindness
  • If detected early - can be reversed with vitamin A supplementation or regular consumption of vegetables and fruit
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22
Q

Which tissues need vitamin A and why?

A

All epithelial tissues
These tissues serve as protection from pathogens as well as to other damage (protective layer)

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23
Q

How does vitamin A affect the control of gene expression?

A

Retinoic acid activates or deactivates certain genes thereby affecting protein production

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24
Q

How does vitamin A affect immunity?

A
  • Plays a role in the regulation of genes that produce immune system proteins
  • Deficiency can lead to a spiral of malnutrition and infection
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25
Q

How does vitamin A have a role in growth?

A

Assists in growth of bone & teeth – needed in the dismantling step of old bone structure

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26
Q

What happens when vitamin A deficient (outside of eye sight)?

A
  • Cell differentiation & maturation are impaired
  • failure of mucus-producing cells to produce mucus
  • a subsequent increase in keratin-producing cells
  • tissues more vulnerable to infection
  • ie: respiratory infection
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27
Q

Vitamin A toxicity is not very likely from food, but what can cause this?

A

Supplements, fortified foods, liver (especially polar bear liver)

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28
Q

What happens with vitamin A toxicity?

A

May weaken bones, bone and joint pain, abdominal pain, stunted growth, liver damage
Early symptoms: loss of appetite, blurred vision, growth failure in children, headache, skin itching, irritability
Long-term symptoms: bone weakening and hip fracture

Focus: growth, bones, liver

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29
Q

What happens in vitamin A toxicity with pregnant women?

A

Fetal malformation – teratogenic. Caused either by:
- Chronic use of supplements exceeding recommendation
- Single large dose (100x need)

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30
Q

Who is most prone to toxicity of vitamin A?

A
  • Children who mistake chewable vitamin pills for candy
  • Adolescents who take large doses for acne (Accutane is derived from vitamin A but vitamin A supplements do not help with acne)
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31
Q

Beta-carotene will not cause vitamin A toxicity. What happens with excess of this?

A

Can turn yellow/orange due to deposition in subcutaneous fat

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32
Q

Vitamin A activity for vitamin A precursors is measured in what?

A

RAE – retinol activity equivalents
around 12 mcgs of beta-carotene is equal to 1 microgram of RAE

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33
Q

Does eating carrots really promote good vision?

A

Bright (deep) orange fruits & vegetables and dark green vegetables - rich in beta-carotene - have a role in healthy eyesight.
Does not improve vision if vitamin A intake is already adequate

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34
Q

What diseases is a lack of beta-carotene associated with? What can be said about supplements and smokers?

A
  • Lack of foods rich in beta-carotene increases the risk of macular degeneration
  • Beta-carotene from foods & elevated beta-carotene in the blood are associated with reduced cancer risk
  • Benefit not seen with supplements
  • Beta-carotene supplements associated with increased risk of cancer in smokers
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35
Q

What are the major dietary antioxidants?

A

Beta-carotene, Vitamin E, vitamin C, selenium, and many other phytochemicals

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36
Q

Where do we get vitamin A from?

A

Foods of animal origin
- Liver and fish oil
- Fortified milk and milk products
- Eggs
Beta-carotene is found in plants
- Dark green leafy foods (spinach, bok choy)
- Rich yellow and deep orange foods (carrots, sweet potato, pumpkin, and apricots)

Grain products have none

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37
Q

What is the tolerable upper intake level of vitamin A? What is the RDA for men and women?

A

3000 micrograms
900 for men, 700 for women

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38
Q

Which vitamin is not really essential?

A

Vitamin D – the body can make all it needs with the help of sunlight
Many people may border on vitamin D deficiency

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39
Q

What are the roles of vitamin D?

A
  • Regulation of blood calcium and phosphorous levels & therefore maintains bone integrity
  • ## Functions as a hormone
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40
Q

When more calcium is needed, vitamin D acts to raise blood calcium levels. How does it do this? *

A
  • Promotes calcium absorption
  • Promotes calcium retention by the kidneys
  • Draws calcium from bone
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41
Q

How does vitamin D function as a hormone (what does it play a role in)?

A

Plays a role in the brain, heart, stomach, pancreas, skin, reproductive organs, some cancer cells, stimulates cell maturation (including immune system cells)

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42
Q

It is possible that deficiency in vitamin D promotes what?

A
  • high blood pressure
  • some cancers
  • type 1 diabetes
  • heart disease
  • rheumatoid arthritis
  • inflammatory bowel disease
  • multiple sclerosis
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43
Q

What does deficiency in vitamin D cause in children?

A

Rickets
- Characterized by abnormal bone growth
- Bowed legs, outward-bowed chest, knobs on ribs

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44
Q

Risk for bone loss later in life due to potential lack of vitamin D is more common in who?

A
  • Adolescents who consume soft drinks rather than vitamin D-fortified milk or alternatives and prefer indoor to outdoor activities
  • Older individuals may have painful joints & muscles due to low vitamin D levels
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45
Q

What is the adult form of rickets? In who does this most often occur?

A

Osteomalacia
In women with all three of the following:
- Low calcium intake
- Little exposure to the sun
- Who go through repeated pregnancies & periods of lactation

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46
Q

Vitamin D is the most toxic vitamin in excess. What are some of these symptoms?

A
  • Toxicity symptoms include appetite loss, nausea, vomiting, increased urination and increased thirst, severe psychological depression (effects on the CNS)
  • Continued overdoses cause dangerously high blood calcium level, forcing calcium to be deposited in soft tissues
  • Such as the heart, blood vessels, lungs, kidneys
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47
Q

You cannot reach toxic levels of vitamin D in the sun. How can people make a vitamin from sunlight?

A
  • UV exposure to a cholesterol compound in the skin transforms it into a vitamin D precursor which is absorbed into the blood
    (The liver & kidneys then convert precursor to active form of vitamin D)
  • Skin synthesis of vitamin D poses no risk of toxicity
    (The sun begins breaking down excess vitamin D made in the skin)
  • Generally, just being outdoors when the sun is overhead, even in lightweight clothing, promotes sufficient skin synthesis of vitamin D

Focus: Skin, liver, and kidneys

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48
Q

What can affect vitamin D synthesis?

A
  • Skin colour, air pollution, city living, clothing, geography, indoor lifestyle, season, sunscreen, time of day
  • Sunscreens with SPFs of 8 or above can reduce sun risks, but also prevent vitamin D synthesis
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49
Q

What is vitamin D measured in?

A

International Units (IU)

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50
Q

What are the sources of vitamin D?

A
  • Sunlight
  • Small amounts from butter, cream, fortified margarine
  • Fortified milk
  • Egg yolks, liver, fatty fish and fish oil
  • Only certain fortified plant sources exist: margarines & some plant-based beverages (i.e. soy beverage)
  • Mushrooms

Milk and alternatives, meat and alternatives

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51
Q

Why do recommendations for vitamin D intake increase with age?

A
  • Organs capabilities decrease with age
  • Higher risk for bone loss
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52
Q

Vitamin E consists of 4 tocopherol compounds. What are they?

A

Alpha, beta, gamma, and delta.
We only ever talk about alpha-tocopherol

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53
Q

For vitamin E, what is its main role and why is it important?

A

Antioxidant activity
- Antioxidant defending the body against oxidative damage
- Vitamin E is preferentially oxidized, thus protecting cells
- Oxidative damage results from free radicals which are formed during normal metabolism disrupt the structure of cellular lipids, DNA and proteins. Free radical activity may lead to cancer, heart disease, or other diseases

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54
Q

What is vitamin E’s antioxidant effect especially crucial for?

A
  • In the lungs – cells are exposed to high oxygen concentrations
  • Protects red blood cells, white blood cells
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55
Q

What are some of vitamin E’s other roles?

A
  • May play other roles in immunity
  • Plays a role in nerve development
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56
Q

What happens in infants if deficient in vitamin E?

A

Infants born before transfer of vitamin E from the mother to the infant
- Erythrocyte hemolysis is a rupturing of the red blood cells which results in anemia

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57
Q

What happens in adults if deficient in vitamin E?

A

Nerve damage (loss of muscle coordination & reflexes with impaired movement, vision, and speech)
- Associated with fat malabsorption diseases: damaged liver, gallbladder or pancreas

Why:
- Low intake with extremely-low-fat diet for years
- People who rely solely on fat replacers rather than fat
- Vitamin E is destroyed by food processing & heating (even though present in many fatty foods)

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58
Q

What can be said about vitamin E toxicity?

A
  • No toxicity has been seen with natural food sources
  • Large doses may increase the effects of anticoagulant medications
  • May be an increased risk of death in those taking greater than 400 IU from a supplement
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59
Q

What are some food sources of vitamin E?

A
  • Destroyed by heat processing & oxidation
  • Vegetable oils (including salad dressing, shortening)
  • Avocados are a good source
  • Wheat germ is a good source (fatty part of the grain)
  • Smaller amounts from meat, poultry, fish, eggs, milk products, nuts, seeds
  • Animal fats have almost no vitamin E
  • Supplements generally do NOT provide health benefits unless deficient
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60
Q

What are the functions of vitamin K?

A

Synthesis of blood clotting proteins
- Does not improve clotting in those with diseases such as hemophilia
- Interferes with the function of certain anticoagulant medications (blood thinners) Warfarin/Coumadin

Synthesis of normal form of bone proteins that bind minerals to bone (hip fractures can be caused by deficiency)

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61
Q

Someone who takes drugs like Warfarin/Coumadin (blood thinners), what do they need to do?

A
  • CONSISTENT intake of vitamin K rich foods (moderate amounts)
  • Avoid drastic changes and self-prescription of vitamin K supplements
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62
Q

What are some sources of vitamin K?

A
  • Intestinal bacteria (cannot meet the body’s need)
    **Leafy green vegetables – Dark green generally richest: Spinach, collard greens, beet greens, Swiss chard
  • Lettuce, broccoli, Brussels sprouts, cabbage and other members of the cabbage family
  • Canola & soybean oils
  • Eggs and milk contain small amounts
  • Liver is the only rich animal source

(Dark green leafy is the one we need to know, not the rest)

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63
Q

Who is most at risk for deficiency for vitamin K?

A
  • Unlikely in adults
  • Newborns’ intestinal bacteria have not established themselves (sterile GI tract)
  • Antibiotic treatment (kills both the beneficial & harmful bacteria in their intestinal tract
  • Fat malabsorption
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64
Q

What can be said about toxicity in vitamin K?

A

No UL
- Rare among healthy adults
- Infants & pregnant women: toxicity can result from over-supplementation with synthetic vitamin K
- Leads to jaundice and bilirubin in the brain of an infant can cause brain damage or death

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65
Q

Water soluble vitamins can easily be leached out through cooking & washing with water, are easily absorbed, but also excess is readily excreted in urine. What are the general advice for meeting needs?

A

Choose foods daily that are rich in water-soluble vitamins to achieve the recommended intakes regularly

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66
Q

What can be said about toxicity in water-soluble vitamins?

A
  • Not from food
  • Can occur from the large doses concentrated in some vitamin supplements (expensive urine)
  • Athletes with an appropriate diet generally don’t need vitamin supplements – increased energy needs therefore more food
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67
Q

Short trips near the Mediterranean Sea didn’t lead to scurvy but there were high death rates on long voyages. Why was this?

A

Scurvy – fruits and vegetables were used up early on long trips
James Lind, a British doctor performed the first nutrition experiment on humans in the mid 1700s to find a cure for scurvy (lime juice)

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68
Q

What are the roles of vitamin C?

A

Maintenance of connective tissues
- Formation & maintenance of collagen (component of bones, teeth, skin, tendons, scar tissue, capillaries)

Antioxidant

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69
Q

What are the deficiency symptoms of vitamin C?

A
  • Most scurvy symptoms are due to collagen breakdown (Loose teeth, bleeding gums, pinpoint hemorrhages, anemia, tenderness to touch, weakness, swollen ankles & wrists, loss of appetite, growth cessation)
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70
Q

Risk of scurvy is low in North America. Who are more susceptible?

A
  • Some elderly people: Low intakes of veg/fruit and a poor appetite
  • People with food insecurity
  • People addicted to alcohol or other drugs
  • Infants fed cow’s milk who do not receive breast milk or formula - Breast milk & infant formula supply vit. C
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71
Q

What is the thing we need to know about vitamin C and colds?

A

There is no consensus as to whether it helps or not
- Vitamin C supports immune system function & so protects against infection
- Vitamin C has not been shown to prevent colds and results are inconsistent in benefitting a cold
- One group of researchers have found the following:
Some small benefit from vitamin C in high doses (1 gram) taken at the onset of a cold
- May shorten the duration of colds by about 1/2 day & reduce the severity of symptoms by about 40%
- Placebo effect has happened

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72
Q

Is too much vitamin C hazardous to health?

A
  • Vitamin C from food is safe
  • Adverse effects include digestive upsets, such as nausea, abdominal cramps, excessive gas, diarrhea
  • Massive doses may interfere with medications to prevent blood clotting
  • May be dangerous for people with an overload of iron
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73
Q

What is an interesting fact about smokers and vitamin C that you need to know?

A
  • Smoking introduces oxidants that deplete vitamin C. So, RDA set 35 mg higher for smokers
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74
Q

What are some food sources of vitamin C?

A
  • Citrus fruits, dark green vegetables (bell peppers and broccoli), cabbage type vegetables, strawberries, cantaloupe, lettuce, tomato, papaya, mangos, red bell pepper
  • Potatoes contain vit C - scurvy became evident in Ireland during the potato famine
  • Vitamin C in fruits & vegetables are prone to destruction by heat & oxygen
  • Fresh, raw & quickly cooked are best
  • Store properly & consume promptly

Mostly from vegetables and fruits

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75
Q

What are the DRI recommendations for vitamin C?

A

Women: 75 mg/day
Men: 90 mg/day
+ 35 for smokers

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76
Q

What can be said about B vitamins overall?

A

B vitamins act as part of coenzymes
- Coenzyme combines with & activates an enzyme

Role in Metabolism
- Metabolism of carbohydrates, lipids & amino acids
- Thiamin, riboflavin, niacin, pantothenic acid & biotin all help release the energy stored in the energy-yielding nutrients
- Vitamin** B6 helps the body make protein**
- Folate & vitamin B12 help cells to multiply

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77
Q

What happens with B vitamin deficiencies overall?

A

Every cell is affected
- Cell renewal depends on energy & protein which depend on the B vitamins
- Digestive tract & blood are damaged
- In children, full recovery may be impossible (A thiamin deficiency during growth can cause permanent brain damage)

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78
Q

What can be said about deficiency of any one B vitamin?

A

Rarely shows up alone, because people eat foods that contain mixtures of nutrients

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79
Q

What is the role of thiamin?

A

Energy metabolism
Nerve processes and their responding tissues (muscle)

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80
Q

What is the deficiency disease of thiamin?

A

Beriberi:
- First observed with polishing of rice in Asia
- Loss of sensation in the hands & feet, muscular weakness, advancing paralysis, abnormal heart action
- Wet beriberi (edema present)
- Dry beriberi (no edema)

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81
Q

What is the name of the deficiency disease that shows up with alcohol abuse and severe deficiency?

A

Wernicke-Korsakoff Syndrome
- Alcohol displaces food in the diet, impairs thiamin absorption, promotes thiamin excretion in the urine
- Symptoms: mental confusion, disorientation, loss of memory, jerky eye movements, staggering gait, apathy, irritability
- Treatment: thiamin by IV or orally (alcohol withdrawal protocol in hospitals)

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82
Q

What are the sources of thiamin?

A

** Widespread in healthy foods
- Pork products, sunflower seeds, whole grain cereals, legumes are rich sources

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83
Q

What is the role of riboflavin (similar to thiamin)

A

Energy metabolism of all cells

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84
Q

What is the deficiency disease of riboflavin?

A

Ariboflavinosis
- Inflammation of the membranes of the mouth, skin, eyes and GI tract; smooth, purplish red tongue
- May go undetected because thiamin def. symptoms more severe
- Children who lack milk products & meat are at risk
- Treatment: A diet that treats a riboflavin deficiency also resolves a thiamin deficiency
- Often accompanies thiamin deficiency

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85
Q

What are the sources of riboflavin?

A

** Widespread in healthy foods
- Milk & milk products
- Leafy green vegetables
- Whole-grain breads
- Enriched/fortified grain products
- Some meats & eggs

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86
Q

What is the main role of niacin?

A

Energy metabolism

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87
Q

What is the deficiency disease of niacin?

A

Pellagra – the four Ds
- Diarrhea, dermatitis (develops on skin exposed to light), dementia, and death
Came to Europe from North America

At risk for pellagra:
- Poorly nourished people living in poverty, particularly those with alcohol addiction

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88
Q

What are the sources of niacin? What can be converted to niacin?

A

** High protein foods
Tryptophan, which is abundant in almost all proteins, can be converted to niacin
If eating adequate protein, will not be deficient in niacin

  • Milk, eggs, meat, poultry, fish, whole grains, fortified and enriched grains, nuts and seeds
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89
Q

What are niacin equivalents (NE)?

A

Food containing 1 mg niacin and 60 mg tryptophan would contain 2 mg NE

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90
Q

What can be said about toxicity & niacin?

A

Caused from supplements (that aren’t that high – 2-3x the RDA)
- Large doses can cause niacin flush – painful tingling, flush and hives – niacin supplements 2-3x RDA
- Large doses of niacin can injure the liver and cause blurred vision
- Large doses of a form of niacin (nicotinic acid) may be prescribed to lower blood lipids

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91
Q

What is the role of folate?

A

DNA synthesis
Part of coenzymes for new cell synthesis

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92
Q

What does deficiency of folate lead to in adults?

A

Because immature red & white blood cells & cells of the GI tract divide rapidly, they are most vulnerable to a deficiency
- Anemia - megaloblastic anemia or macrocytic anemia (Large, immature red blood cells. Related to anemia of vitamin B12 deficiency)
- Diminished immunity
- Abnormal digestive function
- Folate deficient diet may increase risk of CVD, colon and cervical cancer

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93
Q

What are neural tube birth defects (NTDs)?

A

Problems with spinal cord, mental delay, severely diminished brain size or even death shortly after birth
Arise in the first few days or weeks of pregnancy
Most women eat too few fruits & vegetables to supply folate needed (especially since it is forming so early in pregnancy, when so many women are unaware of their pregnancy)
- Why bleaches white grain products are all fortified with folic acid since late 1990s (which has seen a significant drop after fortification)

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94
Q

What does folate toxicity look like?

A
  • Folate can mask B12 deficiency (anemia)
  • Excess folate may be antagonistic to the actions of some anticancer drugs
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95
Q

What is the unit of measure of folate?

A

Dietary Folate Equivalent (DFE) converts all forms of folate into units that are equivalent to the folate in food

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96
Q

Why is DFE important?

A

Synthetic folate in enriched foods & supplements is absorbed more readily than naturally occurring folate (so, natural is not always better)
- Bioavailability ranges from approx 50% (foods) to 100% (supplements taken on an empty stomach). So, folate from foods is given full credit & fortified foods & supplements are given extra credit (1.7 times more available)

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97
Q

What are the sources of folate?

A
  • Leafy green vegetables
  • Fresh, uncooked vegetables and fuits (the heat of cooking & oxidation occurs during storage destroy much of the folate in foods
  • Eggs
  • Orange juice and legumes
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98
Q

What is the RDA of folate?

A

Healthy adults: 400 mcg DFE/d
Pregnancy: 600 mcg DFE/d

Heath Canada recommends women who could become pregnant: 400 mcg/day of folic acid from supplements plus a healthy diet

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99
Q

What is the role of B12?

A

Close relationship with folate
- Activated by folate
- Folate is activated by B12
Maintenance of the sheaths that surround and protect nerve fibres

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100
Q

What happens with deficiency of B12?

A
  • Damaged nerve sheaths
  • Creeping paralysis (tips of finger/toes and can be permanent)
  • General malfunctioning of nerves and muscles
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101
Q

Deficiency of vitamin B12 results in failure of folate to make red blood cells. What type of anemia can be caused then?

A

Vitamin B12 deficiency same anemia as folate
Large, immature red blood cells (macrocytic or megaloblastic anemia)

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102
Q

What is not good about the relationship between folate and B12 with anemia?

A

Folate will clear up anemia but B12 deficiency continues. Give vitamin B12 as well if there is are symptoms of folate deficiency – incase of B12 deficiency

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103
Q

Who is at risk of B12 deficiency?

A
  • Elderly (absorption problems due to decreased stomach acidity and decreased intrinsic factor)
  • Atrophic gastritis (inherited gene defect for intrinsic factor production (mid-adulthood)
  • Vegans (deficiency symptoms take time: body stores up to 6 years’ worth of the vitamin. All strict vegetarians (vegans) must be sure to use B12-fortified products or supplements)
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104
Q

What can be said about absorption of B12?

A

Requires intrinsic factor, which is a compound made by the stomach. The stomach’s acid liberate vitamin B12 from food; intrinsic factor then binds to the vitamin. The complex is then absorbed from the small intestine into the blood

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105
Q

What is pernicious anemia?

A

A vitamin B12 – deficiency disease, caused by a lack of intrinsic factor and characterized by large, immature red blood cells
Treatment: B12 injections

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106
Q

What are the sources of B12?

A

Animal sources are the only significant sources
Bioavailability greatest in milk and fish
Fortified plant foods - ex - soy beverage

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107
Q

What are the roles of B6?

A
  • 100+ reactions in the tissues
  • assists in conversion of one amino acid to another needed amino acid – protein synthesis
  • Aids in the conversion of tryptophan to niacin
  • Neurotransmitter synthesis: conversion of tryptophan to serotonin
  • Hemoglobin synthesis
  • Assists in release of stored glucose from glycogen, contributing to the regulation of blood glucose
  • Immune function
  • Steroid hormonal activity
  • Fetal brain & nervous system development
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108
Q

What happens in B6 deficiency?

A

General symptoms: Weakness, Psychological depression, Confusion, Irritability, Insomnia

Other symptoms:
Anemia, Greasy dermatitis

Advanced cases of deficiency:
convulsions, May weaken the immune system

Evidence that low intakes may be related to increased risk of heart disease

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109
Q

What can be said about toxicity of B6?

A

Seen in women took 2+ g/day for 2+ months
Numb feet
Lost sensation in their hands
Eventually became unable to walk or work
Recovered after they stopped taking the supplements

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110
Q

A single B6 supplement can deliver 2g of the vitamin, the equivalent of what?

A

3,000 bananas
1,600+ servings of liver
or 3,800+ servings of chicken breast
Stick with food

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111
Q

What can be said about the need of B6?

A

Due to its roles in protein metabolism, need is proportional to protein intake

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112
Q

What is the most important thing to remember for B6 (disregard other extensive lists for this vitamin)?

A

Unlike other water soluble vitamins it is stored extensively in muscle tissues

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113
Q

What are the sources of B6?

A

Protein-rich foods: meats, fish, poultry
Legumes & peanut butter
Potatoes, leafy green vegetables, some fruits

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114
Q

What can be said about homocysteine, an amino acid?

A
  • Elevated homocysteine may be an indicator of CVD risk
  • Deficiencies of folate, vitamin B12 or vitamin B6 cause excess homocysteine to build up in the blood
  • Supplements of these vitamins lead to a significant drop in homocysteine level
  • It is unknown how this affects a person’s CVD risk
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115
Q

What is the role of biotin?

A

Energy metabolism
Cofactor for several enzymes in the metabolism of carbohydrate, fat, protein

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116
Q

What can be said about deficiency of biotin?

A

May occur with some rare diseases
Consumption of dozens of raw egg whites per day, which contain a protein that binds biotin (avidin), will result in a deficiency
- Cooking eggs denatures this protein

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117
Q

What are the sources of biotin?

A

Widespread in foods

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118
Q

What is the role of pantothenic acid?

A

Energy metabolism
Coenzyme that plays a role in the release of energy from the energy nutrients
Plays a role in 100+ steps concerned with the synthesis of lipids, neurotransmitters, steroid hormones & hemoglobin

119
Q

What are the sources of pantothenic acid?

A

Widespread in foods

120
Q

What do the experts say about taking vitamin and mineral supplements?

A
  • Some say healthy people might benefit from a multiple vitamin supplement taken every day or two
  • Others say potential risks outweigh the unproven benefits - supplements should only be taken when there is a risk of deficiency
121
Q

Who may likely need supplements?

A

**People with nutrient deficiencies
- Habitual dieters
- Vegans or those with atrophic gastritis
- Lactose intolerance or milk allergy
- People in certain stages of the life cycle (Infants need iron; Newborn- vitamin K; Women who could become pregnant need folate; Pregnant women need Iron and Folate; Elderly need B12 and Vitamin D)
- Injuries or infections that impair intake, absorption, excretion or metabolism of nutrients
- People taking medications that interfere with nutrient absorption

122
Q

What are the major minerals?

A

Calcium
Sulphur
Phosphorus
Potassium
Sodium
Chloride
Magnesium

123
Q

What is the most abundant mineral in the body?

A

Calcium

124
Q

Only 1% of calcium is in body fluids but has important roles. What are they?

A

Muscle contraction and relaxation
Nerve functioning
Blood clotting

125
Q

What are good calcium sources?

A

Milk and milk products *
Fortified soy beverage and other fortified milk alternatives
Fish with bones (ex. canned salmon, sardines)
Calcium set tofu
Broccoli, some leafy greens and legumes
Fortified juices

On average, Canadians are not consuming enough calcium

126
Q

When is peak bone mass reached?

A

By the late 20s (10 years after adult height is reached)

127
Q

After around 40, what happens to bones?

A

Begin to reduce density. Loss can be slowed by a diet rich in calcium and sufficient physical activity

128
Q

To protect against bone loss, a diet rich in calcium is recommended early in life. Why?

A

A calcium-poor diet during the growing years may prevent a person from achieving peak bone mass
Insufficient bone calcium increases the risk of osteoporosis (adult bone loss – bones become brittle and fragile)

129
Q

What happens with a calcium deficiency?

A

Adult - bone loss
Children - stunted growth and weak bones
Consumption of milk has declined
Consumption of beverages such as soft drinks has greatly increased

130
Q

What happens with toxicity of calcium?

A

Constipation
Kidney stones
Interferes with absorption of other minerals

131
Q

How much calcium is stored in bones and teeth?

A

99%

132
Q

What are the two major roles of calcium in bones?

A

Integral part of bone structure
Bone serves as a calcium reserve
- Bone minerals are in constant flux

133
Q

People who do not use milk because of lactose intolerance, preference, dislike, or allergy must obtain calcium from other sources. Children who don’t drink milk often have what?

A

Lower calcium intakes
Poorer bone health than those who drink milk regularly

134
Q

Some vegetables are good sources of calcium. Name some

A

Rutabaga, broccoli, mustard and turnip greens, collards, and kale

135
Q

Some vegetables are poor sources. Name some.

A

Spinach, Swiss chard, rhubarb * (because of the very very low absorption)

Calcium content similar to milk
Provide little calcium
Binders in some vegetables 
inhibit calcium absorption

136
Q

What can be said about the benefits of spinach and dark greens of all kinds?

A

Still a good food to eat
Iron-rich
Beta-carotene rich
Rich in phytochemical

Dark greens of all kinds:
Superb sources of riboflavin
Indispensable for the vegan or anyone else who does not drink milk

137
Q

What is osteomalacia?

A

Vitamin D deficiency disease leads to impaired mineralization of bone. Characterized by an overabundance of unmineralized bone protein.
The ratio of bone mineral to matrix is low.
Symptoms include bending of the spine and bowing of the legs

138
Q

What is osteoporosis?

A

A reduction in bone mass of older persons in which the bone becomes porous and fragile.
The bone mineral to matrix ratio is normal

139
Q

According to the Osteoporosis Society of Canada, how many Canadians suffer from osteoporosis

A

According to the Osteoporosis Society of Canada
2 million people Canadians suffer from osteoporosis
1 in 3 women - osteoporotic fracture
1 in 5 men - osteoporotic fracture
Treatment costs of osteoporosis $2.3 billion annually

140
Q

What type of fractures are the most serious?

A

Hip fractures
The break is rarely clean - the bone breaks into fragments that cannot be reassembled
Hip replacement requires major surgery
Many elderly people with hip fractures never walk or live independently again
About 1/5 die within the year of having a hip fracture

141
Q

What are the risk factors for osteoporosis (high correlation)? *

A

Advanced age
Female
Heavy drinking
Chronic steroid use
Rheumatoid arthritis
Being underweight/significant weight loss
Removal of ovaries or testes
White race
Genetics – Family history

142
Q

Why is osteoporosis called the silent thief?

A

Osteoporosis is slowly decreasing bone density until many years later, the hip gives way
Break a hip and fall

143
Q

What are some of the moderate correlation risk factors for osteoporosis?

A

Chronic thyroid hormone use
Smoking
Type 1 diabetes
Insufficient dietary calcium and vitamin D
Inadequate vitamin K
Physical inactivity/sedentary lifestyle
Excessive antacid use

144
Q

Risks of osteoporosis differ by age. What can be said about black women?

A

Black women have far fewer hip fractures than white women
Asian women also tend to have lower hip fractures (bone structure is slightly different – angle of the bones)
Black race is correlated with being protective against osteoporosis
Black women have denser bones and lose density more slowly than white women

145
Q

What can be said about gender and hormones and osteoporosis?

A

Women account for more than 2/3 of cases of osteoporosis

Men have greater bone density than women at maturity

Women experience greater bone loss during menopause
- Accelerated losses continue for 6 - 8 years following menopause & then tapers off

Men produce only a little estrogen, yet they resist osteoporosis better than women

Testosterone may play a role: Men experience more fractures with reduced testosterone ex. after removal of diseased testes or decreased function with aging

146
Q

What can be said about physical activity and osteoporosis?

A

Without physical activity, bones lose strength (swimming isn’t against gravity in the same way though, so not necessarily great for preventing it)

Muscle use seems to promote bone strength
- The bones of active people are far denser than those of sedentary people
- Hormones that promote synthesis of new muscle tissue also favour the building of bone
- Flexibility & muscle strength gained through physical activity also improve balance & help prevent falls from occuring

So, to keep bones health & to prevent falls, include weight bearing activities every day: calisthenics, dancing, jogging, vigorous walking, weight training

147
Q

What can be said about body weight and osteoporosis?

A

Being underweight or losing weight increases risk
Heavier body weights & higher body fatness stress the bones & promote their maintenance – but obesity may have negative effect

148
Q

What can be said about tobacco smoke and alcohol and osteoporosis?

A

Bones of smokers are less dense
People addicted to alcohol experience more frequent fractures

149
Q

What can be said about protein and calcium?

A

Excess dietary protein causes the body to excrete calcium in the urine
Research is not entirely clear as to whether or not a high-protein diet causes bone loss
Sufficient dietary protein is essential to bone health

150
Q

What can be said about sodium’s influence on calcium?

A

High sodium intake is associated with urinary calcium excretion
Lowering sodium intakes seems to lessen calcium losses
To lower sodium & increase potassium intake choose a diet:
- Rich in unprocessed foods such as fruits & vegetables
- Restricted in highly processed, convenience, or fast foods

151
Q

What can be said about caffeine and calcium?

A

Some evidence linking the heavy consumption of caffeinated beverages & osteoporosis but there is also contradicting evidence

Almost anything you read about caffeine is like that statement – some say negative, some say beneficial

152
Q

What can be said about soft drinks and osteoporosis?

A

May have adverse effects on calcium but why is unclear
- High concentration of fructose sweetener or phosphoric acid may cause calcium loss?
- Displace milk from the diet especially in children & adolescents?

153
Q

What can be said about vitamin K and osteoporosis?

A

Plays important roles in the production of at least one bone protein (osteocalcin) that participates in bone maintenance *
People with hip fractures often have low vitamin K intakes

154
Q

What can be said about magnesium and osteoporosis?

A

Helps maintain bone density

155
Q

What can be said about vitamin A and osteoporosis?

A

Needed in bone-remodeling process
Too much may be associated with osteoporosis (break down too much bone)

156
Q

Cells need continuous access to calcium therefore the body maintains a constant calcium concentration in the blood. How is that regulated?

A

Blood calcium is regulated by hormones not by daily intake
When calcium intake is inadequate, normal blood calcium is maintained at the expense of the bones

157
Q

When does calcium need increase?

A

Calcium absorption from the intestine increases (e.g., infants and children - around 60%, pregnant women - around 50%, and adults - around 25% of dietary calcium)

Loss of calcium via the kidneys is reduced

Percent absorbed increases as dietary intake decreases (with the help of vitamin D – helps with calcium absorption *)

158
Q

Calcium and phosphorous are essential to bone formation. Why?

A

Calcium phosphate salts crystallize on collagen, forming hydroxyapatite crystals that add rigidity to bone
Fluoride may also displace the “hydroxy” part of the crystals, making fluorapatite - A mineral that resists bone-dismantling

159
Q

Formation of teeth is similar to bone formation. What happens?

A

Fluoride hardens and stabilizes the crystals of teeth and makes the enamel resistant to decay

160
Q

What are the characteristics of major and trace minerals?

A

Major: Essential nutrients, amounts exceed 5 grams
Trace: Essential nutrients, amounts less than 5 grams

Don’t need to know what is a major vs trace mineral

161
Q

Upon death, what happens to the body?

A

The carbon in carbohydrates, fats, proteins & vitamins combine with oxygen to produce carbon dioxide
The hydrogen & oxygen combine to form water - evaporates
All that is left behind is minerals (about 2.3kg)

162
Q

What are minerals?

A

Chemical elements
Inorganic
Not energy yielding
Micronutrients

163
Q

What is hard and soft water?

A

Hard water – “Water with high calcium & magnesium concentrations”
Soft water – “Water with high sodium concentration”
may aggravate hypertension & heart disease

164
Q

What is the AI for females and males for water?

A

AI total water is 2.7L/day for females
AI total water is 3.7L/day for males

165
Q

According to the DRI committee, what does the total water intake include?

A

both caffeinated and non-caffeinated beverages
Food
About 80 percent from liquids ( 2.2 L and 3 L) – textbook incorrect

Water content of foods (approximate):
- Meat and cheese - 50%
- Vegetables and fruit - 80-95%

166
Q

Phosphorus is the second most abundant mineral in the body. Where is the majority found in the body?

A

Bones and teeth

167
Q

What are some of the roles of phosphorus?

A

Helps maintain acid–base balance (buffers)
Part of DNA and RNA
Metabolism of energy yielding nutrients
Assist many enzymes and vitamins in extracting energy
Form part of the molecules of the phospholipids

168
Q

What can be said about phosphorus need?

A

Needs are easily met by almost any diet

169
Q

What happens with toxicity of phosphorus?

A

Calcification of soft tissues

170
Q

What are some sources of phosphorus?

A

Animal proteins are best source
Also found in cola drinks

171
Q

Where is magnesium stored in the body?

A

Half of body’s magnesium is in the bones
Remainder in muscles, heart, liver and other soft tissues
Only 1% in body fluids

172
Q

To maintain concentration of magnesium in the blood, what happens?

A

Magnesium can be taken from bones
Kidneys can act to conserve magnesium

Body fights really hard to not allow low calcium, magnesium deficiency is more common

173
Q

What are some of the roles of magnesium?

A

Assists in the functioning of more than 300 enzymes

Release & use of energy from energy-yielding nutrients

Works with calcium for the proper functioning of muscles *
- Calcium promotes contraction
- Magnesium helps muscles relax afterwards

Involved in bone mineralization and promotes resistance to tooth decay by holding calcium in tooth enamel

174
Q

What are some sources of magnesium?

A

Easily washed & peeled away from foods during processing: unprocessed foods (or only slightly processed foods) are the best sources

Nuts, legumes, whole grains, dark green vegetables, seafood and chocolate.

Most Canadians reach the EAR but below RDA

175
Q

Deficiency in magnesium could occur as a result of what?

A

Inadequate intake, vomiting or diarrhea

Alcoholism, protein energy undernutrition (malnutrition)

Hospital clients who have been fed magnesium-poor TPN or using diuretics (medication to take fluid out of the body)

176
Q

What are some of the deficiency symptoms of magnesium?

A

Muscle weakness

May be related to cardiovascular disease, heart attack, high blood pressure

Even with intakes above EAR and below RDA, overt deficiency symptoms are rare in healthy people

177
Q

What happens with magnesium toxicity?

A

Magnesium laxatives and antacids can cause diarrhea and acid base imbalance

Toxicity is rare but can be fatal (very very rare)

Only occurs with high intakes from nonfood sources such as supplements or magnesium salts

178
Q

Does cooking or storing destroy minerals?

A

No. You may lose it (like if you are boiling something for a long time and it dissolves into the water or during processing, but you won’t destroy them)

179
Q

What is sodium?

A

Positive ion in sodium chloride (table salt)
40 % of the weight of sodium chloride

180
Q

What are some of the roles of sodium?

A

Fluid and electrolyte balance

Acid-base balance

Muscle contraction and nerve transmission

About 30-40% stored on bone crystals – easily accessible to maintain blood levels

181
Q

What happens with deficiency of sodium?

A

People generally eat more salt than is needed – far more. Deficiency is very rare

Occasionally a very strict low-sodium diet for hypertension, kidney disease, or congestive heart failure can deplete the body of sodium

Vomiting, diarrhea, or extremely heavy sweating could be a cause

Endurance athletes can lose so much salt and drink so much water they become hyponatremic.

Symptoms: headache, confusion, stupor, seizures, coma

182
Q

How does the body maintain sodium?

A

Body absorbs sodium freely

Kidneys filter excess sodium out of the blood into the urine

Kidneys will also conserve sodium

Small sodium losses occur in sweat

The amount of sodium excreted in a day equals the amount ingested that day

183
Q

What can be said about salt and “water weight”?

A

As blood sodium rises, a person gets thirsty. Thirst leads a person to drink until sodium-to-water ratio is restored

The kidneys then excrete the extra water which removes the excess sodium

Some dieters think too much salt or too much water will make them gain weight. Not a fat gain – it’s excess water which a healthy body then excretes. Body salt & water weight can be kept under control by controlling sodium intake & increasing water intake

184
Q

What is the AI of sodium for those 14 and up?*

A

1500 mg/day

185
Q

What is the Chronic Disease Reduction Risk (CDRR) for 14 and up?*

A

2300mg/day.

Mean Canadian Intake is above this

186
Q

What is the daily value of sodium?

A

Was 2400 mg – now 2300 mg on new food labels

187
Q

What can be said about hypertension and sodium?

A

Salt (NaCl) seems to have a greater effect on blood pressure than either sodium or chloride alone

188
Q

What age group tends to have the highest average daily sodium intake?

A

19 to 30 for both makes and females. Especially males (more food intake)

189
Q

What is the major food category to the average daily sodium intake of Canadians in 2017?

A

Bakery products
Mixed dishes

Due to the quantity – tend to have a lot of bakery products in their diet, even if they are not high individually, they add up over the day

190
Q

What can be said about sodium and blood pressure?

A

High salt intakes associated with higher rates of hypertension, cardiovascular disease & cerebral hemorrhage

There is a relationship between sodium and blood pressure
- More salt = higher blood pressure
- Increasing blood pressure= increasing risk of death from cardiovascular disease

191
Q

Some individuals are more sensitive to the blood pressure-raising effects of sodium than others. In salt-sensitive people, the more salt they eat, the higher their blood pressure. Who tends to be the most salt sensitive?

A

People with diabetes, hypertension, or kidney disease

People of African descent

Family history of high blood pressure

Anyone over the age of 50

192
Q

What is some advice for high blood pressure?

A

Can be argued that only salt-sensitive people should be advised to cut down on salt - but who is salt sensitive?

Critics: Non-salt-sensitive people with hypertension are unlikely to benefit from restricting dietary sodium & salt

Try reasonable weight loss, adding vegetables, fruits, fatty fish & milk/milk products to the diet. Reducing processed foods (without targeting sodium)

Reducing alcohol consumption

193
Q

A dietary approach that may help salt-sensitive and non-salt-sensitive people is the ___ diet

A

DASH (Dietary Approaches to Stop Hypertension) – the diet often achieves a lower blood pressure than restriction of sodium alone.

Greatly increased intake of vegetables and fruits

Adequate amounts of nuts, fish, whole grains, low-fat dairy products

Occasional small portions of red meat, butter, & other high-fat foods and sweets

Salt & sodium are greatly reduced

194
Q

When the diet changed to provide abundant magnesium, potassium, and calcium, as well as adequate protein and fibre, the average blood pressure drops even lower at each level of sodium intake. Research shows DASH diet with reduced sodium – blood pressure falls responsively (3450 mg, 2300mg, 1150mg). What are some sources?

A

whole grains, fruits, vegetables, seeds, nuts, legumes

195
Q

What can be said about what lowers or raises blood pressure (potassium and physical activity)?

A

Low potassium intake found to raise blood pressure
High potassium intake appears to both help prevent & correct hypertension
Physical activity also lowers blood pressure

196
Q

What are some other reasons for reducing salt intake?

A

Older people without clinical hypertension can die of stroke
- Reducing dietary sodium may lower their blood pressure enough to reduce stroke risks

Excessive salt may:
- stress a weakened heart (congestive heart failure)
- aggravate kidney problems
- may be potential contributor to stomach cancer

Labelling regulations also allow a health claim linking sodium & potassium to hypertension

197
Q

What happens with prolonged vomiting or diarrhea?

A

Could result in fluid and electrolyte imbalance

Life-threatening disruption of heartbeat

198
Q

What are some characteristics of water in the body (4)?

A

60% of an adult’s body weight
Found in blood, cells, tissues, and organs
Participates in many chemical reactions
Delivers nutrients and removes waste from cells

199
Q

What can be said about the body’s need for water?

A

The body needs more water per day than any other nutrient

May survive deficiency of any other nutrient for potentially months or years

May survive a few days or slightly more without water

In less than a day, a lack of water alters the body’s chemistry and metabolism

200
Q

What are some of the roles and functions of water?

A

Water is a nearly universal solvent

Water is the body’s cleansing agent

Water’s incompressibility

Water lubricates

Water plays a role in thermoregulation

201
Q

How is water a nearly universal solvent?

A

Dissolves amino acids, glucose, minerals, etc. for transport; Fatty substances get packaged with water-soluble proteins for transport in the blood & lymph

202
Q

How is water the body’s cleansing agent?

A

Nitrogen wastes dissolve in blood & must be removed; Kidneys filter these wastes from the blood, mix them with water and excrete them as urine

203
Q

What does water’s incompressibility do for the body?

A

Enables it to act as a lubricant & cushion for joints; Cushions sensitive tissues (i.e., spinal cord and fetus); Fills the eye keeping optimal pressure

204
Q

What does water lubricate?

A

The digestive tract, respiratory tract & all tissues that are moistened with mucus

205
Q

How does water play a role in thermoregulation?

A

Sweat cools the body - evaporation; Blood routed through capillaries in the skin gets rid of excess heat. The cooled blood then flows back to the body’s core

206
Q

What is water balance?

A

Water intake needs to equal water loss
Otherwise dehydration or water intoxication or overhydration can occur

207
Q

What is the progression of symptoms of dehydration and what are its effects?

A

Progression of symptoms: thirst → weakness → exhaustion & delirium → death

Loss of < 5% bodyweight: headache, fatigue, confusion, forgetfulness, and an elevated heart rate

208
Q

What may result with chronic low fluid?

A

May increase likelihood of:
Bladder and colon cancer
Heart attack
Gallstones
Kidney stones
Urinary tract infections

209
Q

How does water intoxication happen? What are its symptoms?

A

Dangerous dilution of body fluids resulting from excessive water ingestion – usually gallons or more in a few hours

Symptoms: headache, muscular weakness, lack of concentration, poor memory, loss of appetite – convulsions & death

210
Q

What can be said about body’s water content?

A

Varies by kilograms at a time

High-salt meal leads to water retention

Water is lost over a 1-2 day period as the sodium is excreted

Fluctuation in water weight does not reflect gain or loss of body fat

211
Q

Thirst lags behind lack of water. So, what can be said about water deficiency?

A

Dehydration can threaten survival

A water deficiency that develops slowly can switch on drinking behaviour in time to prevent serious dehydration

A water deficiency that develops quickly may not

Ignoring thirst leads to dehydration
Drink whenever thirsty to replace lost fluids
Older adults - thirst blunted - should drink regularly throughout the day

212
Q

How is the hypothalamus related to blood concentration?

A

Major role in monitoring blood concentration

High blood concentration (salt and other substances) or low blood pressure signals thirst

213
Q

What can affect a mineral’s bioavailability?

A

Binders, such as phytates in legumes, bind with minerals decreasing their absorption

214
Q

What are the key contributors to sodium in the diet (percentages)?

A

Unprocessed foods (15%)
Salt (10%)
Processed Foods (75%)

215
Q

1 tsp of salt has how many mg of sodium?

A

2300

216
Q

What are some processed foods known for being a source of sodium?

A

Canned soup and dried soup mixes
Cured meats, deli meats, hot dogs
Cheese – especially processed
Foods in a brine – pickles, coleslaw
TV dinners and fast food
Canned pasta sauce
Salt
Soy sauce
Onion salt
Garlic salt
Worcestershire sauce

217
Q

Chloride is a major negative ion in the body. It therefore has what roles?

A

Acid-base balance
Electrolyte balance
Component of hydrochloric acid

218
Q

What are some sources of chloride?

A

Salt: added & naturally occurring

219
Q

What can be said about chloride deficiency?

A

No known diet lacks chloride

220
Q

Potassium is known as what?

A

The principal positively charged ion inside the body’s cells

221
Q

What are some roles of potassium?

A

Maintenance of fluid balance
Maintenance of electrolyte balance (sodium potassium pump)
Maintenance of heartbeat

222
Q

What happens with deficiency of potassium?

A

Heart failure due to inadequate potassium or potassium loss may cause the sudden deaths that occur with:
- Fasting or severe diarrhea
- In children with kwashiorkor (acute protein energy undernutrition - second sibling)
- People with eating disorders

Dehydration leads to potassium loss from the cell

Some diuretics

With low potassium intake, hypertension becomes worse

223
Q

What can be said about potassium intake?

A

Generally, for healthy people, a reasonable diet provides enough potassium to prevent dangerously low blood potassium

224
Q

What is the median Canadian intake of potassium, and what can this lead to?

A

Median Canadian intake provides just under the AIs for each sex

With such a diet, blood potassium may remain normal

However, chronic diseases are more likely to occur

225
Q

What are the richest sources of potassium?

A

Fresh, whole foods
Oranges (juice), bananas, potatoes, tomatoes, avocados, strawberries, spinach and cantaloupes are particularly rich

Potassium is abundant in cells
Food processing reduces the potassium in foods

226
Q

What can happen with potassium toxicity?

A

Potassium from food is safe

Potassium injected into a vein can stop the heart (death penalty)

Over-the-counter potassium chloride pills should not be used except on a physician’s/ nurse practitioner’s advice

Salt-substitutes often contain high amounts

Usually, potassium overdoses are not life-threatening as long as the excess potassium is taken orally – vomiting reflex

227
Q

What are some of the roles of sulphate/sulphur?

A

Required for the synthesis of many important sulphur-containing compounds.
- Sulphur containing amino acids.
These help strands of protein assume their functional shape. Skin, hair, and nails proteins with high sulphur content

228
Q

What are some sources of sulphur?

A

Protein containing foods

229
Q

What happens with toxicity and deficiencies of sulphate?

A

D: Unknown
T: Diarrhea

230
Q

What are the trace minerals?

A

Iodine
Iron
Zinc
Sulphur
Selenium
Fluoride
Chromium
Copper

231
Q

What is the role of iodine?

A

Integral part of thyroxine (hormone).
Made by the thyroid gland - regulation of basal metabolic rate

232
Q

What happens with deficiency of iodine?

A

Enlarged thyroid (goiter) – enlarged to trap iodine

Sluggishness

Weight gain

Severe deficiency during pregnancy can cause congenital hypothyroidism
- Extreme irreversible mental & physical developmental delay
- Most preventable causes of intellectual delay

233
Q

What foods contain goitrogens, which inhibit iodine uptake by the thyroid?

A

Collards, kale, and brussel sprouts

234
Q

What happens with toxicity of iodine?

A

Enlarged thyroid gland (same as with deficiency)
Can be deadly in very very large amounts (supplements)

235
Q

What are some sources of iodine?

A

Amount varies with amount in soil in which plants are grown or on which animals graze

Seafood: Iodine from ocean
Iodized salt: less than a half-teaspoon meets an entire day’s recommendation

Sea salt has little iodine

Liberal use of iodized salt in fast-food & other restaurants

Bakery products: use of iodine-containing dough conditioners

Milk: 250 mL (1 cup) supplies nearly ½ of a day’s recommended intake: Most dairies use iodine to disinfect milking equipment

236
Q

What two things contain most of the body’s iron?

A

Hemoglobin and myoglobin
Hemoglobin is the oxygen-carrying protein of red blood cells
Myoglobin is the oxygen-holding protein of muscles

237
Q

What are the roles of iron?

A

Carries oxygen

Helps many enzymes use oxygen

Iron is needed to make new cells, amino acids, hormones, neurotransmitters

238
Q

How does the body try to preserve iron?

A

Liver puts iron into red blood cells sent to it from bone marrow

Red blood cells die after about 3 to 4 months and the liver & spleen break them down & recycle their iron

239
Q

Why are many people iron deficient?

A

Iron balance is maintained mainly through absorption. We are preventing ourselves from getting too much, as that can be very dangerous

240
Q

How do we lose iron?

A

Small amounts in nail clippings, hair cuttings, shed skin cells

Loss from bleeding can be significant

241
Q

How do we obtain iron?

A

Food – only ≈10%-15% absorption
Increases with diminished body supply & with need
Decreases when iron is abundant

242
Q

How is iron stored?

A

Ferritin – an iron storage protein stores iron in the mucosal cells of the small intestine

243
Q

If iron is needed, what does the body do? If it is not?

A

Iron is releasted to transferrin and travels through the blood to the body

Iron is shed with the intestinal cells which are replaced every 3 to 5 days.

244
Q

Why is free iron a powerful oxidant?

A

Can start free-radical reactions that can damage cells
Therefore, protein carries iron molecules away from vulnerable body compounds

245
Q

What is an iron deficiency?

A

Result of absorption not compensating for losses or low dietary intakes
Decreased iron stores (stage 1 deficiency)
Depleted iron stores (stage 2 deficiency)

246
Q

What is iron deficiency anemia?

A

A person can be iron deficient without being anemic
Anemia refers to depletion of iron stores resulting in low blood hemoglobin (stage 3 deficiency)

247
Q

Severe iron deprivation leads to insufficient hemoglobin production to fill new blood cells, which leads to what?

A

Anemia (red blood cells are smaller - microcytic & lighter red than normal - hypochromic) **
- Cells contain too little hemoglobin & thus deliver too little oxygen - limits cell’s energy metabolism, which leads to tiredness, apathy, and a tendency to feel cold

248
Q

What can be said about these symptoms of iron deficiency?

A

They are often mistaken for behavioural or emotional problems/
Slightly lowered iron levels cause fatigue & can impair physical work capacity & productivity
Pica (craving for non-food substances) sometimes occurs with iron deficiency. They may eat clays and soils, even though they often contain substances that inhibit iron absorption. Nonfood substances displace food substances and have contaminants.

249
Q

What are some causes of iron deficiency and anemia?

A

Malnutrition, inadequate iron intake (lack of food/high consumption of the wrong foods - rich in sugar & fat & poor in other nutrients)

Non-nutritional causes of anemia (losses or increased need)
- Most often: blood loss - 80% of body’s iron stored in blood
- Women in reproductive years - iron loss and generally less food than men
- GI bleed
- Infants over 6 months of age, young children, adolescents, pregnany women have increased iron needs to support growth of new tissue

250
Q

Worldwide, iron deficiency is the most common nutrient deficiency, affecting more than 1.2 billion people. In developing countries, what can be observed?

A

parasitic infections of the digestive tract and digestive tract ulcers and sores can cause daily blood lost

almost 1/2 of preschool children & pregnant women suffer from iron-deficiency anemia

251
Q

Can a person take in too much iron?

A

Iron is toxic in large amounts
Difficult to excrete once absorbed
The body defends against iron overload (hemochromatosis) by controlling its entry

252
Q

How does the body defend against hemochromatosis?

A

Hepcidin – a hormone secreted by the liver that limits iron absorption

Small intestine traps some of the iron & hold it within their boundaries (mucosal cells)

When these intestinal mucosal cells are shed, the excess iron they collected is lost from the body

When iron stores are filled, less iron is absorbed - protects from iron overload

253
Q

Dangers of iron overload are an argument against high-level iron fortification of foods. What can be said about this?

A

Susceptible people would have trouble following a low-iron diet if most foods were doused with iron

Many Canadians take vitamin C supplements; vitamin C enhances iron absorption

Iron-fortified foods pose no risk for healthy people

254
Q

Iron supplements can reverse iron-deficiency anemia from dietary causes. What can be said about this and children, though?

A

Iron supplements are a leading cause of fatal accidental poisonings among Canadian children under 6 years old

255
Q

What can be said about men and iron-deficiency anemia?

A

Adult men rarely experience it. May have unknown bleed if low iron

256
Q

How much iron should vegetarians obtain?

A

1.8 times the normal requirement, as iron in plant foods is not well absorbed &
their diets lack factors from meat that enhance iron absorption

257
Q

What can be said about iron supplements?

A

Food is generally best source – better absorption than supplements

Pregnant women need an iron supplement

258
Q

Iron occurs in 2 forms in foods. What are they?

A

Heme iron (bound to heme) – The iron-containing part of hemoglobin & myoglobin found in meat, poultry and fish

Nonheme iron – found in foods from plants & meat, poultry and fish

259
Q

Which is absorbed better, heme iron or nonheme iron?

A

Heme iron

Healthy people with adequate iron stores absorb heme iron at a rate of around 23%.

People absorb nonheme iron at rates of 2% to 20%, depending on dietary factors & iron stores

260
Q

What is the MFP factor?

A

Found in meat, fish & poultry

Promotes the absorption of nonheme iron from other foods eaten at the same time

261
Q

What can be said about vitamin C and iron?

A

can help absorption of iron from foods eaten in the same meal

262
Q

What impairs iron absorption?

A

Tannins - Found in tea & coffee

Calcium & phosphorus - Milk

Phytates - Found in the fibre of lightly processed legumes & whole-grain cereals

Black tea is exceptional in its efficiency in reducing iron absorption (advisable for iron overload)

263
Q

What are some general sources of iron?

A

Red meats, fish, poultry, shellfish, eggs

Legumes, green leafy vegetables, dried fruit

Cooking in an iron pan adds iron to food

264
Q

There is a very small quantity of zinc in the human body. What are some of its roles?

A

Works with proteins in every body organ

Helps more than 300 enzymes to:
Make parts of the cell’s genetic material
Make heme in hemoglobin
Assist the pancreas with its digestive functions
Help metabolize carbohydrate, protein & fat
Liberate vitamin A from storage in the liver

Assists in immune function

Regulation of gene expression in protein synthesis

Taste perception

Wound healing

Sperm production

Fetal development

Growth & development in children

Affects behaviour & learning

Produces the active form of vitamin A in visual pigments

May have a protective role in oxidative damage

265
Q

What are some zinc deficiency symptoms?

A

Adverse effects on growth*

Profoundly alters digestive function & causes diarrhea, which worsens the malnutrition already present

Drastically impairs the immune response - Increased infections

Infections of the intestinal tract worsen malnutrition - Including zinc malnutrition

Poor wound healing

Abnormal taste

Abnormal vision in the dark

Even a mild deficiency can result in impaired immunity

266
Q

What can be said about zinc deficiencies overall?

A

Deficiency often misdiagnosed as general malnutrition & sickness because symptoms are so vast

Severe zinc deficiencies are not widespread in developed countries

Pancreatic juices are rich in zinc so after a meal, the body gets zinc from the food and the pancreatic enzymes

Zinc is primarily lost in the feces

267
Q

What can happen with too much zinc?

A

Excess supplements can cause serious illness or death

May reduce blood concentrations of HDL

Can block copper absorption & lower the body’s copper content

High doses can also inhibit iron absorption

A protein that carries iron from the digestive tract to tissues also carries zinc

Lozenges with zinc are generally not an issue

268
Q

How much is zinc absorbed?

A

Varies from 15% – 40% - absorption decreases with increased intake

Absorption limited by phytates

269
Q

What are some food sources of zinc?

A

Meats, shellfish, poultry, milk & milk products (not good for iron, but good for zinc)

Plant sources of zinc are not absorbed as well as animal sources (some legumes, whole grains)

270
Q

What is the role of selenium?

A

Works to prevent the formation of free radicals and prevent oxidative harm to cells & tissues * (antioxidant)

Plays roles in activating thyroid hormone

Shares some of the characteristics of sulphur and can therefore sometimes occur in place of sulphur in amino acids

271
Q

What can happen with deficiency of selenium?

A

Cancer* (low blood selenium correlates with the development of some forms of cancer - especially prostate cancer)

Heart disease (Associated with Keshan disease*: heart enlargement and insufficiency. Keshan disease is likely caused by a virus but a selenium deficiency may predispose people to the disease. First discovered in parts of China from areas which have sodium deficient soil
Adequate selenium seems to prevent Keshan disease

272
Q

What can happen with toxicity?

A

Long-term supplementation. Symptoms: nausea, abdominal pain, hair loss, nerve abnormalities

273
Q

What are some sources of selenium?

A

Diet is adequate if mostly unprocessed foods

Widely distributed in foods such as: Meats, shellfish, vegetables & grains grown in selenium-rich soils
Selenium content of soils varies in areas of Canada and the US

No benefits seen from selenium supplements unless selenium deficient

274
Q

Is fluoride essential?

A

No, but it is beneficial

275
Q

What is the role of fluoride?

A

Crystalline deposits in bone and teeth

Forms more decay-resistant fluorapatite in developing teeth
Floride replaces the hydroxy portion of hydroxyapatite.

276
Q

What are some sources of fluoride?

A

Primary source: Fluoridated drinking water

Tea and seafood

277
Q

What happens with deficiency of fluoride?

A

Where fluoride is missing, the incidence of dental decay is very high

Fluoridation is a practical, safe & cost-effective way to help prevent dental caries in the young

278
Q

What happens with toxicity of fluoride, and who can this happen to?

A

Fluorosis - discolouration and pitting of tooth enamel caused by excess fluoride during tooth development - irreversible

279
Q

What is the role of chromium?

A

Works closely with insulin to regulate & release energy from glucose

280
Q

What happens with deficiency of chromium?

A

Impaired insulin action, resulting in a diabetes-like condition of high blood glucose & resolves with chromium supplementation

Supplements cannot cure the common forms of diabetes. Research - role of chromium supplements in the management of type 2 diabetes

281
Q

What are the sources of chromium?

A

Widely distributed in the food supply. Especially in unrefined foods & whole grains. Lost during food processing

282
Q

What are the roles of copper?

A

Formation of hemoglobin & collagen

Many enzymes depend on copper for its oxygen-handling ability

Plays a role in the body’s handling of iron

Assists in reactions leading to the release of energy

One copper-dependent enzyme (superoxide dismutase) helps control damage from free-radical activity in the tissues

283
Q

What happens with copper deficiency?

A

Rare

Excess zinc interferes with copper absorption & can cause deficiency

Menkes disease – intestinal cells absorb copper but can’t release it into circulation causing deficiency

(less important:)
Symptoms:
Can severely disturb growth & metabolism
In adults, can impair immunity and blood flow through arteries

284
Q

What happens with copper toxicity?

A

Unlikely from foods

Can be caused by supplementation

Wilson’s disease* - copper accumulates in the liver and the brain

285
Q

In Canada, copper intakes are thought to be adequate. What are some sources?

A

Organ meats
Seafood
Nuts and seeds
Whole grains
Water may supply copper, especially where copper plumbing pipes are used

286
Q

What are some other trace minerals?

A

Molybdenum, manganese, boron, nickel, silicon, and cobalt

287
Q

What is arsenic?

A

A known poison & carcinogen
May turn out to be essential in small quantities

288
Q

What can be said about toxicity of trace minerals overall?

A

All trace minerals can be toxic in excess

Overdoses are most likely to occur in those who take supplements

289
Q

What inhibits iron absorption?

A

Calcium and Phytates (bind iron)
MFP factor is found in meat fish and poultry. It increases absorption of nonheme iron

290
Q

Abnormal taste, poor wound healing, impaired growth and impaired immune response are symptoms of a deficiency in which of the following nutrients?

A

Zinc

291
Q

Menke’s disease is associated with a defiency in which of the following?

A

Copper

292
Q

Which of the following groups would generally be at the lowest risk of iron deficiency?
- Infants over 6 months
- Growing children
- Middle aged men
- Women in their reproductive years
- Pregnant women

A

Middle aged men (some of the lowest iron needs and highest caloric intake)

293
Q

How does vitamin C act as an antioxidant?

A
  • Protects substances found in foods & the body
  • Protects iron from oxidation promoting its absorption
  • Protects blood constituents from oxidation and helps protect vitamin E and return it to its active form
294
Q

What can be said about vitamin C supplements?

A
  • Research generally shows supplements have not been proven to protect against heart disease, cancer, or other diseases
  • Supplements are useful to treat a deficiency disease

HLTH 230 (7 decks)

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