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Chapter 9: Water Chapter 9: Water and the Major and the Major MineralsMinerals
Water: Essential Water: Essential NutrientNutrient Death occursDeath occurs
– Without foodWithout food– Without vitamins, mineralsWithout vitamins, minerals– Without waterWithout water
WaterWater Comprises 50-70% of the bodyComprises 50-70% of the body Muscle contains 73% water (fat Muscle contains 73% water (fat
contains ~20%)contains ~20%) Intracellular fluidIntracellular fluid
– Fluid within the cell (2/3 of total)Fluid within the cell (2/3 of total) Extracellular fluidExtracellular fluid
– Outside the cells (1/3 of total)Outside the cells (1/3 of total)
Water Content Varies Water Content Varies By TissueBy Tissue Lean muscleLean muscle FatFat BonesBones
Water Content Varies: Water Content Varies: By AgeBy Age NewbornNewborn AdultAdult ElderlyElderly
Water Content Varies Water Content Varies DailyDaily Salt intakeSalt intake HormonalHormonal 2 cups fluid = 1 2 cups fluid = 1
poundpound Kidneys excrete Kidneys excrete
excessexcess
Functions of WaterFunctions of Water
Almost universal solventAlmost universal solvent DissolvesDissolves
– NutrientsNutrients– WastesWastes– UreaUrea– Carbon dioxideCarbon dioxide
Functions of WaterFunctions of Water Removal of body wasteRemoval of body waste
– Via urineVia urine– Excrete 1-2 quarts/dayExcrete 1-2 quarts/day– Urea excretionUrea excretion– Sodium excretionSodium excretion– Avoid concentrated urineAvoid concentrated urine
21/2 cups --- dark yellow21/2 cups --- dark yellow Can promote kidney stonesCan promote kidney stones
Functions of WaterFunctions of Water
Body temperature regulationBody temperature regulation– Metabolism generates heatMetabolism generates heat– Buildup is dangerousBuildup is dangerous– Water absorbs any excess heatWater absorbs any excess heat– Body secretes fluid via perspirationBody secretes fluid via perspiration– Skin is cool as perspiration Skin is cool as perspiration
evaporatesevaporates
Functions of WaterFunctions of Water
LubricantLubricant– JointsJoints– Synovial fluidSynovial fluid
Shock absorberShock absorber– Amniotic fluidAmniotic fluid– Cerebrospinal fluidCerebrospinal fluid
Are You Drinking Are You Drinking Enough?Enough? Recommend 1ml per 1kcalRecommend 1ml per 1kcal ½ oz / pound body weight½ oz / pound body weight
Daily Water LossesDaily Water Losses
Urine – largest lossUrine – largest loss Skin –ongoing evaporationSkin –ongoing evaporation Lungs – vaporLungs – vapor FecesFeces
Sources of WaterSources of Water
FluidsFluids– WaterWater– Other beveragesOther beverages
FoodFood– Fruits and vegetablesFruits and vegetables– MeatMeat– All but dried foodsAll but dried foods
MetabolismMetabolism– Energy nutrients Energy nutrients → →
carbon dioxide, carbon dioxide, energy, waterenergy, water
The Thirst MechanismThe Thirst Mechanism
Not reliableNot reliable Concerns for infants, older adults, athletesConcerns for infants, older adults, athletes Athletes need to monitor their fluid statusAthletes need to monitor their fluid status Weigh themselves before and after Weigh themselves before and after
trainingtraining Goal is to consume 3 cups for every pound Goal is to consume 3 cups for every pound
lostlost Illness (vomiting, diarrhea, fever)Illness (vomiting, diarrhea, fever)
Ignoring ThirstIgnoring Thirst
Shortage of water in the bodyShortage of water in the body Increase fluid conservationIncrease fluid conservation Antidiuretic hormone Antidiuretic hormone
– From the pituitary gladFrom the pituitary glad– Forces the kidney to conserve water Forces the kidney to conserve water
(reduce urine flow)(reduce urine flow) AldosteroneAldosterone
– Responds to the drop in blood pressureResponds to the drop in blood pressure– Signals the kidney to retain sodium (water)Signals the kidney to retain sodium (water)
ThirstThirst
Signal is not triggered until person Signal is not triggered until person loses 1%-2% of body weight in fluidloses 1%-2% of body weight in fluid
Lost of 4% causes muscle to lose Lost of 4% causes muscle to lose significant strength and endurancesignificant strength and endurance
Lost of 10%-12% causes heat Lost of 10%-12% causes heat intoleranceintolerance
Lost of 20% results in coma and deathLost of 20% results in coma and death Dark yellow urine is a sign of Dark yellow urine is a sign of
inadequate fluidsinadequate fluids
Water SafetyWater Safety Most municipal tap water is safeMost municipal tap water is safe The Environmental Protection The Environmental Protection
Agency and local municipalities Agency and local municipalities look for contaminantslook for contaminants
Power to local and state authorities Power to local and state authorities to advise publicto advise public
Water SafetyWater Safety
Chlorine and ammonia are added Chlorine and ammonia are added to kill most microbesto kill most microbes
Small cancer risk (2/1 million Small cancer risk (2/1 million people)people)
Chlorine can be evaporated via Chlorine can be evaporated via boiling or standingboiling or standing
Much higher risk in using Much higher risk in using untreated wateruntreated water
Water SafetyWater Safety Rural areas may need to have their water Rural areas may need to have their water
tested due to well contamination due to tested due to well contamination due to agricultural runoffagricultural runoff
Estimated that 10 million Americans may Estimated that 10 million Americans may drink water that doesn’t meet EPA guidelinesdrink water that doesn’t meet EPA guidelines
Cryptosporidium, a parasite, sickened Cryptosporidium, a parasite, sickened 400,000 people in Milwaukee; not killed by 400,000 people in Milwaukee; not killed by chlorinechlorine
High risk people are advised to boil their High risk people are advised to boil their drinking water for one minute prior to use for drinking water for one minute prior to use for drinking (HIV-AIDS, chemotherapy patients)drinking (HIV-AIDS, chemotherapy patients)
Alternatives to Alternatives to Chlorinated Tap WaterChlorinated Tap Water
BoilBoil Store overnightStore overnight
FiltersFilters Activated carbonActivated carbon Reverse osmosisReverse osmosis DistillationDistillation UV sterilizationUV sterilization OzoneOzone
Bottled WaterBottled Water
ExpensiveExpensive Environmental impactEnvironmental impact
– ManufactureManufacture– TransportTransport– LandfillLandfill
Bottled Water SourcesBottled Water Sources
75% springs/wells75% springs/wells– OzoneOzone
25% municipal tap water25% municipal tap water– Carbon filteredCarbon filtered
Bottled WaterBottled Water
Independent testingIndependent testing– 1/3 was contaminated1/3 was contaminated– BacteriaBacteria– ArsenicArsenic– Organic elementsOrganic elements
Check labelCheck label Source Source TreatmentTreatment State-interstate FDA regulatedState-interstate FDA regulated
Water SafetyWater Safety
Let cold water run for a Let cold water run for a minute or two before minute or two before drinking or using in cooking; drinking or using in cooking; will reduce risk of lead will reduce risk of lead exposureexposure
Don’t use hot water for food Don’t use hot water for food preparationpreparation
Water and MineralsWater and Minerals
Related 3 waysRelated 3 ways– Hard/soft waterHard/soft water– Fluid balanceFluid balance– Acid base balanceAcid base balance
Fluid BalanceFluid Balance
Water shifts freely in and out of the cellsWater shifts freely in and out of the cells Controlled by the electrolyte concentrationControlled by the electrolyte concentration ““Where ions go, water is sure to follow”Where ions go, water is sure to follow” Intracellular water volume depends on Intracellular water volume depends on
intracellular potassium and phosphate intracellular potassium and phosphate concentrationsconcentrations
Extracellular water volume depends on Extracellular water volume depends on extracellular sodium and potassium extracellular sodium and potassium concentrationsconcentrations
Na+, K+, Cl-Na+, K+, Cl-
Attract waterAttract water Dissolve in waterDissolve in water Electrical charge = electrolytesElectrical charge = electrolytes
Cell MembranesCell Membranes
Water permeableWater permeable Impermeable to mineralsImpermeable to minerals
OsmosisOsmosis The passage of a solvent The passage of a solvent
such as water through a such as water through a semi-permeable membrane semi-permeable membrane from a less concentrated from a less concentrated compartment to a more compartment to a more concentrated compartmentconcentrated compartment
OsmosisOsmosis
Water moves across membraneWater moves across membrane– Low concentration to highLow concentration to high– Equalizes solute concentrationEqualizes solute concentration
Minerals do not moveMinerals do not move– Draw water across membraneDraw water across membrane
Acid-Base BalanceAcid-Base Balance
Blood pH 7.35-7.45Blood pH 7.35-7.45 DeathDeath
– pH 8.0 alkalosispH 8.0 alkalosis– pH 6.8 acidosispH 6.8 acidosis
BuffersBuffers– ProteinProtein– ElectrolytesElectrolytes– Gather/release hydrogen ionsGather/release hydrogen ions
Minerals: DefinitionMinerals: Definition
Inorganic (contain no carbon)Inorganic (contain no carbon) Separate elementsSeparate elements Required in small amountsRequired in small amounts
Functions of MineralsFunctions of Minerals
CofactorsCofactors Bone and Bone and
connective tissueconnective tissue BloodBlood MetabolismMetabolism Growth & Growth &
reproductionreproduction Function/Function/
formation nerves formation nerves & muscles& muscles
Cell membrane Cell membrane transporttransport
Minerals function Minerals function together:together:– Bone formationBone formation– ElectrolytesElectrolytes– BloodBlood
Minerals in the BodyMinerals in the Body
Mineral ClassificationMineral Classification
Major mineralsMajor minerals– Require >100 mg /day (1/50 of a Require >100 mg /day (1/50 of a
teaspoon)teaspoon)– Calcium, phosphorusCalcium, phosphorus
Trace mineralsTrace minerals– Require < 100 mg/dayRequire < 100 mg/day– Iron, zincIron, zinc
Bioavailability of Bioavailability of MineralsMinerals Not all ingested minerals can be Not all ingested minerals can be
absorbedabsorbed Example: only 5% of the calcium Example: only 5% of the calcium
in spinach is absorbed because in spinach is absorbed because spinach contains oxalic acidspinach contains oxalic acid
About 25% of dietary iron is About 25% of dietary iron is absorbed (better absorbed from absorbed (better absorbed from dairy products)dairy products)
Bioavailability of Bioavailability of MineralsMinerals Presence of binders and Presence of binders and
dietary fiberdietary fiber Minerals in animal products are Minerals in animal products are
better absorbedbetter absorbed The more refined a food is, the The more refined a food is, the
fewer mineralsfewer minerals Only iron is added back to Only iron is added back to
enriched grain productsenriched grain products
Fiber-Mineral Fiber-Mineral InteractionsInteractions Phytic acid (phytate) in grain Phytic acid (phytate) in grain
fibers can limit absorption of fibers can limit absorption of some minerals by binding to themsome minerals by binding to them
Oxalic acid: substance in plants Oxalic acid: substance in plants (spinach) that binds minerals(spinach) that binds minerals
High fiber diets can decrease the High fiber diets can decrease the absorption of iron, zinc, absorption of iron, zinc, magnesium, and other mineralsmagnesium, and other minerals
Bioavailability of Bioavailability of MineralsMinerals Mineral content of plant foods Mineral content of plant foods
reflects the soil in which is it grown reflects the soil in which is it grown Mineral/mineral competition: too Mineral/mineral competition: too
much of one mineral can interfere much of one mineral can interfere with the absorption of anotherwith the absorption of another– Zinc interferes with copper absorptionZinc interferes with copper absorption
Presence of vitamins: example, Presence of vitamins: example, vitamin C enhances absorption of vitamin C enhances absorption of ironiron
Toxicity of MineralsToxicity of Minerals
Trace minerals are more toxicTrace minerals are more toxic Result of supplementationResult of supplementation Presence of contaminants in Presence of contaminants in
supplementssupplements Look for the United States Look for the United States
Pharmacopeia (USP)-approved Pharmacopeia (USP)-approved brandsbrands
Iron ToxicityIron Toxicity
Men in general and older Men in general and older women should avoid women should avoid multivitamin-mineral multivitamin-mineral supplements with iron supplements with iron because of the risk of iron because of the risk of iron toxicitytoxicity
Major MineralsMajor Minerals
SodiumSodium
Table salt (NaCl): 40% Table salt (NaCl): 40% sodium, 60% chloridesodium, 60% chloride
SodiumSodium
95% of ingested sodium is absorbed95% of ingested sodium is absorbed Major positive ion in Major positive ion in extracellularextracellular
fluidfluid AldosteroneAldosterone regulates sodium regulates sodium
balancebalance Key for retaining body waterKey for retaining body water Excretion regulated by the kidneysExcretion regulated by the kidneys Muscle contractionMuscle contraction Conduction of nerve impulsesConduction of nerve impulses
Deficiency of SodiumDeficiency of Sodium
RareRare Persistent vomiting/ diarrheaPersistent vomiting/ diarrhea Excessive perspiration (losing 2-3% Excessive perspiration (losing 2-3%
of body weight)of body weight) Depletion of sodium in the bodyDepletion of sodium in the body Muscle cramp, nausea, vomiting, Muscle cramp, nausea, vomiting,
dizziness, shock, comadizziness, shock, coma Normally kidney will respond by Normally kidney will respond by
conserving sodiumconserving sodium
Correcting DeficiencyCorrecting Deficiency
Pedialyte for Pedialyte for childrenchildren
Gatorade for Gatorade for adultsadults
Salt foodsSalt foods
Dietary Sources of Dietary Sources of SodiumSodium Average American eats 4-6 grams Average American eats 4-6 grams
sodium in foods and softened watersodium in foods and softened water 20% comes from salt added in 20% comes from salt added in
cooking or at the tablecooking or at the table 35-80% comes from processed foods35-80% comes from processed foods 4-27% comes from water (issue at 4-27% comes from water (issue at
500 mg level if water contains more 500 mg level if water contains more than 40 ppm (40 mg or 2 mEq/liter)than 40 ppm (40 mg or 2 mEq/liter)
Sodium Content of Sodium Content of Fresh FoodsFresh Foods
Plain pasta or rice
<10 mg
Fruit (any) <10 mg
Vegetables, unsalted
<75 mg
Milk 1 cup 125 mg
Meat, poultry, fish unsalted
<90 mg
Sodium Content of Sodium Content of Processed FoodsProcessed Foods
Potato chips 1 oz 180 mg
American cheese 1 sl 300 mg
Italian dressing 2 T 510 mg
Instant noodle soup 1170 mg
KFC chicken pot pie 2160 mg
Meat lover’s stuffed pizza 2 slices
2850 mg
Sodium NeedsSodium Needs
Body only needs 100-200 mg/dayBody only needs 100-200 mg/day Minimum requirement is 500 Minimum requirement is 500
mg/daymg/day Daily ValueDaily Value is 2400 mg/day is 2400 mg/day Typical intake is 4000-7000 Typical intake is 4000-7000
mg/daymg/day
Sodium AdaptationSodium Adaptation
Today’s salt is tomorrow’s Today’s salt is tomorrow’s urineurine
People can adjust to the People can adjust to the lower salt tastelower salt taste
““Salt Sensitive”Salt Sensitive”
10%-15% of adults are (particularly 10%-15% of adults are (particularly African Americans)African Americans)
High sodium intake leads to fluid High sodium intake leads to fluid retention and high blood pressureretention and high blood pressure
Recommend 2-3 gm sodium per dayRecommend 2-3 gm sodium per day Recommended for all individualsRecommended for all individuals High intake of sodium (>2000 mg) High intake of sodium (>2000 mg)
increases calcium lossincreases calcium loss Check your blood pressure regularlyCheck your blood pressure regularly
PotassiumPotassium
Positive ion in thePositive ion in the intracellular intracellular fluidfluid
Functions in fluid balance and nerve Functions in fluid balance and nerve impulse transmissionimpulse transmission
Associated with lowering blood Associated with lowering blood pressurepressure
90% of potassium consumed is 90% of potassium consumed is absorbedabsorbed
Food Sources and Food Sources and Need for PotassiumNeed for Potassium
Found in fruits, vegetables, milk, Found in fruits, vegetables, milk, grains, meats, dried beansgrains, meats, dried beans
Minimum requirement is 2000 Minimum requirement is 2000 mg/daymg/day
Daily ValueDaily Value is 3500 mg/day is 3500 mg/day Typical intake is 2000-3000 mg/dayTypical intake is 2000-3000 mg/day Excess potassium is excreted by the Excess potassium is excreted by the
kidneyskidneys
Potassium PyramidPotassium Pyramid
High Potassium FoodsHigh Potassium Foods
Baked potato: Baked potato: 844 mg844 mg
Milk: 377 mgMilk: 377 mg Raisins: 825 mgRaisins: 825 mg Spinach: 419 mgSpinach: 419 mg Sweet potato: Sweet potato:
397 mg397 mg Tomato: 254 mgTomato: 254 mg
Tomato Juice: 400 Tomato Juice: 400 mgmg
Beer: 128 mgBeer: 128 mg Coffee: 96 mgCoffee: 96 mg Chocolate: 174 mgChocolate: 174 mg Waffle: 146 mgWaffle: 146 mg Eggnog: 420 mgEggnog: 420 mg Vegetable soup: Vegetable soup:
337 mg337 mg
Potassium DeficiencyPotassium Deficiency
RareRare Use of diuretics Use of diuretics Alcoholic, anorexia nervosa, Alcoholic, anorexia nervosa,
bulimia nervosabulimia nervosa Loss of appetite, muscle cramps, Loss of appetite, muscle cramps,
confusion, constipation, irregular confusion, constipation, irregular heart beatheart beat
ChlorideChloride
Negative ion for the Negative ion for the extracellular fluidextracellular fluid
Components of hydrochloric acid Components of hydrochloric acid (HCl), immune response, nerve (HCl), immune response, nerve functionfunction
Excess is excreted by the Excess is excreted by the kidneys/perspirationkidneys/perspiration
ChlorideChloride
Minimum requirement is 700 Minimum requirement is 700 mg/daymg/day
Much is obtained from salt Much is obtained from salt consumption (table salt is 60% consumption (table salt is 60% chloride)chloride)
High intake may cause high blood High intake may cause high blood pressurepressure
HypertensionHypertension
Systolic blood pressure/diastolic Systolic blood pressure/diastolic blood pressureblood pressure
Optimal is less than 120 / 80 mm Optimal is less than 120 / 80 mm HgHg
HTN is a sustained systolic HTN is a sustained systolic pressure of >140mm Hg or >90 pressure of >140mm Hg or >90 mm Hg for diastolicmm Hg for diastolic
HypertensionHypertension
95% of all HTN 95% of all HTN have no clear have no clear cause (primary or cause (primary or essential HTN)essential HTN)
Secondary HTN: Secondary HTN: related to other related to other conditions, like conditions, like kidney diseasekidney disease
Why Control Blood Why Control Blood Pressure?Pressure? Silent disease (may have no Silent disease (may have no
symptoms)symptoms) Causes cardiovascular disease, Causes cardiovascular disease,
kidney disease, stroke, kidney disease, stroke, retinopathy, declining brain retinopathy, declining brain functionfunction
African Americans most at riskAfrican Americans most at risk
Causes of HTNCauses of HTN
AgingAging AtherosclerosisAtherosclerosis Obesity (increased fat mass and Obesity (increased fat mass and
circulation)circulation) Elevated insulin (insulin resistant Elevated insulin (insulin resistant
adipose cells)adipose cells) InactivityInactivity Excess alcohol (usually reversible)Excess alcohol (usually reversible)
Sodium and Blood Sodium and Blood PressurePressure Unclear if it is sodium or chloride Unclear if it is sodium or chloride
that is responsiblethat is responsible Increases blood pressure with intakeIncreases blood pressure with intake Consume no more than 2400 mg/dayConsume no more than 2400 mg/day Increased blood pressure to excrete Increased blood pressure to excrete
sodium needed for sensitive people?sodium needed for sensitive people? Fluid retention leads to increased Fluid retention leads to increased
blood volumeblood volume
Lifestyle Interventions Lifestyle Interventions in Hypertensionin Hypertension Weight loss of as little as 10-15 Weight loss of as little as 10-15
pounds may normalize blood pounds may normalize blood pressurepressure
Regular physical activityRegular physical activity Avoid excess alcoholAvoid excess alcohol
Other Minerals and Other Minerals and HTNHTN >1000 mg calcium a day lowers >1000 mg calcium a day lowers
blood pressureblood pressure 2-4 gm of potassium a day lowers 2-4 gm of potassium a day lowers
blood pressureblood pressure Magnesium may lower blood Magnesium may lower blood
pressurepressure DASH diet: low in sodium, high in DASH diet: low in sodium, high in
fruits, vegetables, whole grains, fruits, vegetables, whole grains, includes lowfat dairy productsincludes lowfat dairy products
Medication and HTNMedication and HTN
DiureticDiuretic– Reduce blood volumeReduce blood volume– Increase urine outputIncrease urine output
Slows heart rateSlows heart rate– relaxation of the blood vesselsrelaxation of the blood vessels
CalciumCalcium
99% is in bones and teeth99% is in bones and teeth Makes up 40% of all the Makes up 40% of all the
minerals present in theminerals present in the
bodybody
Absorption of CalciumAbsorption of Calcium
Amount in the body is dependent on Amount in the body is dependent on amount absorbedamount absorbed
Requires a slightly acidic environmentRequires a slightly acidic environment Presence of dietary glucose and lactosePresence of dietary glucose and lactose Increased needIncreased need Upper part of the small intestine is the Upper part of the small intestine is the
site of absorptionsite of absorption Availability of vitamin DAvailability of vitamin D
Absorption of Calcium Absorption of Calcium
Normally absorb 25% of calcium Normally absorb 25% of calcium in foodin food
Increase to ~60% during time of Increase to ~60% during time of need (pregnancy, infancy)need (pregnancy, infancy)
Estrogen increases absorptionEstrogen increases absorption Parathyroid hormoneParathyroid hormone
Factors Decreasing Factors Decreasing Calcium AbsorptionCalcium Absorption Rapid intestinal motilityRapid intestinal motility High fiber intakeHigh fiber intake Excess phosphorusExcess phosphorus Fat malabsorptionFat malabsorption
Factors Decreasing Factors Decreasing Calcium AbsorptionCalcium Absorption Vitamin D deficiencyVitamin D deficiency Polyphenols (tannins) in teaPolyphenols (tannins) in tea MenopauseMenopause AgingAging AchlorhydriaAchlorhydria
Blood Calcium is Blood Calcium is RegulatedRegulated
Blood level is maintained at Blood level is maintained at the price of bone calciumthe price of bone calcium
Blood level will be Blood level will be maintained despite maintained despite inadequate calcium intake inadequate calcium intake (by drawing from bones)(by drawing from bones)
Setting stage for future bone Setting stage for future bone fracturesfractures
Functions of CalciumFunctions of Calcium
Blood clotBlood clot Nerve impulse transmissionNerve impulse transmission Muscle contractionMuscle contraction Cell metabolismCell metabolism
–Activates various enzymesActivates various enzymes
Building Higher Bone Building Higher Bone MassMass Adequate dietAdequate diet Healthy body weightHealthy body weight Normal mensesNormal menses Weight-bearing physical activityWeight-bearing physical activity Moderate intakes of protein, Moderate intakes of protein,
phosphorus, sodium, caffeinephosphorus, sodium, caffeine Non-smokerNon-smoker Lower the use of certain medicationsLower the use of certain medications
Other Roles of CalciumOther Roles of Calcium
May lower blood pressureMay lower blood pressure May reduce colon cancerMay reduce colon cancer May reduce PMS symptomsMay reduce PMS symptoms May lower blood cholesterolMay lower blood cholesterol May reduce kidney stonesMay reduce kidney stones Reduce lead absorptionReduce lead absorption
OsteoporosisOsteoporosis
Calcium deficiencyCalcium deficiency ““A pediatric disease with A pediatric disease with
geriatric consequences”geriatric consequences” Leads to ~1.3 million fractures Leads to ~1.3 million fractures
/ year/ year Slender, inactive women who Slender, inactive women who
smoke are most at risksmoke are most at risk ““Less bones”Less bones”
OsteoporosisOsteoporosis
Bone StructureBone Structure
Bone StrengthBone Strength
Dependent on bone mass and Dependent on bone mass and bone mineral densitybone mineral density
The more there is, the stronger The more there is, the stronger the bonethe bone
Bone Growth and MassBone Growth and Mass
Rapid and continual throughout Rapid and continual throughout adolescenceadolescence
Peak bone mass: highest attainable Peak bone mass: highest attainable densitydensity– First 3 decades of lifeFirst 3 decades of life
Determined by gender, race, Determined by gender, race, familial pattern, other genetic familial pattern, other genetic factorsfactors
Bone Growth and MassBone Growth and Mass
Bone loss begin ~age 30 Bone loss begin ~age 30 Women experience increased Women experience increased
bone loss after menopausebone loss after menopause DEXA bone scanDEXA bone scan No noticeable symptomsNo noticeable symptoms
Types of OsteoporosisTypes of Osteoporosis
Type I (postmenopausal)Type I (postmenopausal)–Occurs after menopauseOccurs after menopause
Type II (senile)Type II (senile)–Occurs with age in men Occurs with age in men and womenand women
Risk Factors for Risk Factors for OsteoporosisOsteoporosis AgeAge GenderGender RaceRace InactivityInactivity Low body weightLow body weight Diet low in calciumDiet low in calcium Family historyFamily history Early menopause; Early menopause;
absence of mensesabsence of menses
Low testosterone Low testosterone levels in menlevels in men
Anorexia, bulimiaAnorexia, bulimia Some medicationsSome medications Cigarette smokingCigarette smoking Excessive alcohol Excessive alcohol
consumptionconsumption Caffeine, sodiumCaffeine, sodium High protein dietHigh protein diet
Diet and Lifestyle Diet and Lifestyle FactorsFactors Adequate diet (Ca, vitamin D)Adequate diet (Ca, vitamin D) Healthy body weightHealthy body weight Correct hormonal irregularitiesCorrect hormonal irregularities Normal mensesNormal menses Weight-bearing and resistance Weight-bearing and resistance
physical activityphysical activity Don’t smokeDon’t smoke Limit excessive intake of protein, Limit excessive intake of protein,
phosphorus, sodium, caffeine, wheat phosphorus, sodium, caffeine, wheat bran, and alcoholbran, and alcohol
PreventionPrevention
Regular menstruationRegular menstruation Weight-bearing exercise (but does Weight-bearing exercise (but does
not compensate for lack of not compensate for lack of menstruation)menstruation)
Smoking lowers estrogen Smoking lowers estrogen concentration in the bloodconcentration in the blood
Alcohol is toxic to bone cellsAlcohol is toxic to bone cells Estrogen replacement therapiesEstrogen replacement therapies Accurate measurement of heightAccurate measurement of height
MedicationMedication
EstrogenEstrogen– Slows bone turnoverSlows bone turnover
Fosamax (bisphosphonates)Fosamax (bisphosphonates)– Slows bone breakdownSlows bone breakdown
Evista (selective estrogen receptor Evista (selective estrogen receptor modulators)modulators)– Slows bone turnoverSlows bone turnover
CalcitoninCalcitonin– Inhibits bone breakdownInhibits bone breakdown
Side effectsSide effects
Diet and Lifestyle Diet and Lifestyle FactorsFactors Adequate diet (Ca, vitamin D)Adequate diet (Ca, vitamin D) Healthy body weightHealthy body weight Normal mensesNormal menses Weight-bearing physical activityWeight-bearing physical activity Don’t smokeDon’t smoke Limit excessive intake of protein, Limit excessive intake of protein,
phosphorus, sodium, caffeine, phosphorus, sodium, caffeine, wheat bran, and alcoholwheat bran, and alcohol
Food Sources of Food Sources of CalciumCalcium
Dairy productsDairy products Kale, collard, mustard greensKale, collard, mustard greens Calcium fortified foodsCalcium fortified foods Tofu (Tofu (ifif made with calcium made with calcium
carbonate)carbonate) Canned fishCanned fish
Food Sources of Food Sources of CalciumCalcium Dairy foods Dairy foods
provide 75% of provide 75% of the calcium in the calcium in the American the American dietdiet
Calcium SupplementCalcium Supplement
Recommended for people who cannot Recommended for people who cannot incorporate Ca+ into their dietsincorporate Ca+ into their diets
Not recommended with high iron mealNot recommended with high iron meal Calcium carbonate (40% calcium)Calcium carbonate (40% calcium)
– For those with ample stomach acidFor those with ample stomach acid– Found in antacidsFound in antacids
Calcium citrate (21% calcium)Calcium citrate (21% calcium)– Enhanced absorption due to acidity contentEnhanced absorption due to acidity content– Recommended for elderlyRecommended for elderly
Risk With Calcium Risk With Calcium SupplementsSupplements Lead contamination Lead contamination No FDA regulationNo FDA regulation Oyster shellOyster shell BonemealBonemeal Look for Look for United States United States
PharmacopoeiaPharmacopoeia seal of approval seal of approval
Calcium NeedsCalcium Needs
Daily ValueDaily Value is 1000 mg/day is 1000 mg/day Adequate Intake is 1000 -1200 Adequate Intake is 1000 -1200
mg/day for adultsmg/day for adults Adequate Intake is 1300 mg/day Adequate Intake is 1300 mg/day
for adolescents (9-18 yrs. old)for adolescents (9-18 yrs. old) Average intake range from 600-Average intake range from 600-
800 mg/day for women and 800-800 mg/day for women and 800-1000 mg/day for men1000 mg/day for men
PhosphorusPhosphorus Body absorption is based on body’s Body absorption is based on body’s
need (70%-90%)need (70%-90%) No disease associated with No disease associated with
deficiencydeficiency May contribute to bone loss in May contribute to bone loss in
elderly womenelderly women Vitamin D enhances absorption Vitamin D enhances absorption Component of ATP, cell membrane, Component of ATP, cell membrane,
and boneand bone
Food Sources of Food Sources of PhosphorusPhosphorus
Widely available in foodsWidely available in foods Dairy, bakery products, sodas, and meatsDairy, bakery products, sodas, and meats Some from food additivesSome from food additives Most difficult to limit intake Most difficult to limit intake RDA is 700 mg/day for adultsRDA is 700 mg/day for adults Daily Value is 1000 mgDaily Value is 1000 mg Current intake exceeds RDACurrent intake exceeds RDA Deficiency highly unlikelyDeficiency highly unlikely
Toxicity of PhosphorusToxicity of Phosphorus
Problem for individuals with Problem for individuals with inefficient kidney functioninefficient kidney function
Phosphate ions bind calciumPhosphate ions bind calcium Chronic imbalance may lead to Chronic imbalance may lead to
bone loss (Ca+/phos ratio)bone loss (Ca+/phos ratio) Upper Level is 3-4 g/dayUpper Level is 3-4 g/day
MagnesiumMagnesium
Primarily in green leafy plantsPrimarily in green leafy plants Absorption based on body’s needs Absorption based on body’s needs
(40%-60%)(40%-60%) Absorption enhanced by vitamin DAbsorption enhanced by vitamin D Kidneys regulate blood concentration Kidneys regulate blood concentration
of magnesiumof magnesium Alcohol increases loss in the urineAlcohol increases loss in the urine Much stored in the bones Much stored in the bones
Functions of Functions of MagnesiumMagnesium Aids in many enzyme reactions Aids in many enzyme reactions Potassium and calcium metabolismPotassium and calcium metabolism Proper nerve and cardiac functionsProper nerve and cardiac functions Insulin release from the pancreasInsulin release from the pancreas May dilate arteriesMay dilate arteries May prevent heart rhythm May prevent heart rhythm
abnormalitiesabnormalities
Deficiency of Deficiency of MagnesiumMagnesium Develops slowlyDevelops slowly Irregular heartbeatIrregular heartbeat Decreased blood pressureDecreased blood pressure Weakness, muscle spasms, Weakness, muscle spasms,
disorientation, nausea, vomiting, disorientation, nausea, vomiting, seizuresseizures
Food Sources of Food Sources of MagnesiumMagnesium Plant products: Whole grains, Plant products: Whole grains,
vegetables, nuts, seedsvegetables, nuts, seeds Hard tap waterHard tap water Dairy, chocolate, meatDairy, chocolate, meat RDA for women is 320 mg/day RDA for women is 320 mg/day RDA for men is 400 mg/dayRDA for men is 400 mg/day Daily Value is 400 mgDaily Value is 400 mg Average intake is lower than the RDAAverage intake is lower than the RDA
Magnesium PyramidMagnesium Pyramid
Too Much or Too Little Too Much or Too Little MagnesiumMagnesium
Magnesium loss Magnesium loss – Heavy perspirationHeavy perspiration– Long-standing diarrhea or vomitingLong-standing diarrhea or vomiting– AlcoholismAlcoholism– Disorientation, weakness, muscle pain, poor Disorientation, weakness, muscle pain, poor
heart functionheart function Toxicity Toxicity
– Caused by medicationCaused by medication
SulfurSulfur
Found in amino acids and Found in amino acids and vitaminsvitamins
Acid-base balanceAcid-base balance Drug detoxifying pathwaysDrug detoxifying pathways Part of a natural diet, primarily Part of a natural diet, primarily
from proteinfrom protein Used to preserve foodsUsed to preserve foods