NTR 108 1st EditionFinal Exam Study GuideModule X. Nutrients Involved in the Hematopoietic System A. Introduction -Hematopoietic system o Blood (two major fractions Blood cells (in plasma)- Red blood cells (RBC) - Immune cells (lymphocytes)- Platelets- for blood clotting  Plasma- Albumin- Lipoproteins- Hormones- Nutrients- glucose, amino acids- Waste products- ammonia, ureao Bone Marrow- origin of blood cells -Functiono Carry waste- CO2 and urea o Carry nutrients- O2, glucose, amino acids, lipoproteins B. Nutrients Involved -Iron o Trace mineral o Cation- two different charges (2+ and 3+) o Water soluble- not that much o Functions: Component of hemoglobin (in RBC) Component of myoglobin (in muscle) Cofactor for energy metabolism) o Metabolism  Very tightly controlled metabolic pathways Active absorption by small intestine - 2 to 35% of eaten - If the body has enough then stored in small intestine and lost in feces- Stored in:o Liver o Bone marrowo Special proteins Ferritin (stored form of iron), transferrin (iron transporter) o Deficiency signs/symptoms Two levels:- Iron Deficiencyo Low iron storeso Low cognitive functiono Low energy levelo Pica  eating non food items- Anemia (microcytic) o Small red blood cellso Fatigueo Low work capacity o Poor immune function  Assessment of iron status:- Measurement of storeso Blood transport proteins Amount, iron content, liver and bone marrow biopsy- Blood cell measurementso Hematocrit (# of RBC)o Hemoglobin o Groups at risk: People in developing countries Women (menstruating)- 30% iron deficient, 8% anemic- Growing individualso Pregnant women, infants children- Athleteso May not be real but b/c of increase in blood volumeo Damage to RBC’so Sweet losso To much blood loss (intestinal)- People with excessive blood losso Ulcerso Woundso Surgery - Vegetarians with poor nutritional education or habits o Dietary Sources: Heme iron- Good: meat, fish, poultry- Poor: milk products  Nonheme iron - Fair: tofu, whole grains, dried fruits, leafy green vegetables - Poor: iron cookware and enriched flour o Special Notes Factors that affect absorption (2 to 35%)- Increase:o Need- absorption goes up when body stores are lowo Heme iron is bettero Meat factor protein (MFP): meat, fish, poultry Helps nonheme iron absorption o Vitamin C Changes charge or ion and makes it more water solubleo Stomach acido Sugars and other chelators- makes iron more water soluble - Decrease:o Lack of physiological need Absorption down when body stores are high o Excess dietary calcium, zinc, phosphorus o Dietary fibers (phytates)o Tannins Tea, red wine, coffeeo Anti-acidso Intestinal damage  Iron Toxicity (sometimes looks like deficiency)- Acute (large dose at one time)o Intestinal damageo Liver failureo Shock - Chronico Mainly with maleso Liver damageo Associated with: Cardiovascular disease: pro-oxidant  LDL damage Cancer: pro-oxidant, DNA damage Hemochromatosis- hereditary defect - Zinc:o Trace mineralo Cationo Only one charge (2+)o Function/metabolism: Cofactor for immune system, energy system, component of antioxidant enzymeo Deficiency Signs/symptoms: Loss of taste Failure to grow Impaired vision Impaired immune function o Groups at risk: People taking an excess of iron, copper, dietary fiver Poor Elderly Pregnant women Childreno Dietary Sources: Found in foods high in proteino Special Notes: Excess will decrease copper absorption -Coppero Trace mineralo Function/metabolism Cofactor for iron metabolism, energy metabolism and antioxidant enzyme Wont compete with iron for absorption but will enhance it o Deficiency signs/symptoms Anemia- microcytic, like iron deficiency o Groups at risk: Too much zinco Dietary Sources Beans, seeds, nuts, organ meat, watero Special Notes Excess copper decreases zinc absorption -Folateo Water soluble, B-vitamin o Functions: Coenzyme for amino acid metabolism and DNA synthesis (cell replication Red blood cell synthesis o Deficiency signs/symptoms  Macrocytic anemia (large RBCs) Low DNA synthesis- Neural tube defectso Groups at risk Pregnant women o Dietary Sources Enriched products Good: green leafy vegetables, fruit, beans, liver, breakfast cereal  Poor: meat and milk o Special Notes Very important in preventing neural tube effects in fetus Easily destroyed by heat and air -Vitamin B12o Water solubleo Largest vitamino Functions Folate metabolism Formation of RBC Helped maintain myelin sheath of nerve fiber  Hormone production o Deficiency Signs/Symptoms  Macrocytic anemia Fatigue Staggering (neural problem)o Groups at risk People with stomach dysfunction- Pernicious anemia- lack of an absorption factor- Elderly, lack of stomach acid and absorption factor- Vegans- People with ileum problemso Surgical removal of ileumo Crohn’s diseaseo Second site of active transport o Dietary Sources: Primary source:- Soil contaminations- Fermented foods- Nutritional yeast  Secondary sources:- Meat, milk, eggs o Special Notes: Absorption:- Requires many factors- intrinsic factor produced in stomach - Active in the ileum (last segment of small intestine)- Small amount of passive absorption in large intestine- important for those with pernicious anemia) Deficiency- Dietary folate can hide deficiency until irreversible neurological problems develop - Individual who lack intrinsic factor- periodic B12 injections- Many take 20 years without any intake to develop- Develops in 3-7 years without instinct factor -Vitamin Ko Fat soluble vitamino Functions: Formation of blood clotting factors Formation of bone matrix proteins- for calcium depositiono Deficiency signs/symptoms Blood does not clot- at all, very slow  Bone don’t mineralize o Groups at risk: Infants- usually given injection at birth (newborns)o Dietary Sources Bacterial synthesis in large intestine Liver, green vegetables, milko Special Notes Warfarin, a rat poison, blocks vitamin K action Warfarin (Coumadin) is used commonly after strokes and heart attacksModule XI. Water, Electrolytes, Acid-Base Balance A. Water- Essential- Major component of all living things-Involved in:o Nutrient transporto Waste transport Ketones and CO2 from fat Urea and CO2 from protein Lactate and CO2 from carbohydrates o Excretion of waste through urine and fecal watero Lubricate tissueso