NUTRITION 108: EXAM IIINutrients of Hematopoietic SystemHematopoietic System: blood- Blood cells (RBC, WBC, platelets); plasma (albumin, lipoprotein, hormones, nutrients, waste); bone marrow (make RBC)- Function- carry waste (CO2, urea); nutrients (O2, glucose, aminos, lipoprotein)Iron: trace mineral, cation (+2 or +3)- Function- in Hb and Mb of muscle; cofactor of energy metabolism- Metabolism- controlled, active absorption to SI (2-35% eaten, extra in feces)- Stored- liver, bone marrow, ferritin (stored iron), transferrin (iron transport)- Deficiency- low storage, low cognitive, fatigue, Pica eatingo 30% menstruating women are deficient- Anemia (Microcytic)- small RBC, fatigue, low energy, poor immunityo 8% menstruating women are anemic- Assessment- measure blood transport proteins (amount and iron content), liver biopsy, marrow biopsy, hematocrit (#RBC), hemoglobin- Risk groups- poor people, menstruating women, preggos, infants/kids, athletes via sweat loss, ulcers/wounds/surgery, lazy vegetarians- Diet sourceso Heme- good in meat, fish, poultry; bad in milko Non heme- good in tofu, beans, grains, dry fruit, leafy greens; bad in iron cookware and enriched flouro Prefer: acidy foods, long cooking time- Increase absorb- HIGH NEED, heme iron, meat factor protein, vitamin C (change charge to make soluble), stomach acid, sugars/chelators (make soluble)- Decrease absorb- LOW NEED, excess calcium/zinc/phosphorus (CZP), diet fiber, antacids, intestine damage, tannins (black or herbal tea, red wine)- Toxicityo Acute- large dose; intestine damage, liver failure, shocko Chronico Mostly maleso CVD (pro-oxidant, kill LDL); cancer (pro-oxidant, kill DNA); hemochromatosis (hereditary, increases iron absorption)Zinc: trace mineral- Function- cofactor in immunity, energy, antioxidant enzymes- Deficiency- lose taste, can’t grow, lose vision, poor immunity- Risk groups- excess iron/copper/diet fiber, poor, elderly, preggos, kids- Diet sources- high protiein foods- Excess = decrease copper absorptionCopper: trace mineral- Function- cofactor in iron, energy, antioxidant enzyme- Deficiency- anemia- Risk groups- excess zinc- Diet sources- beans, seeds, nuts, organ meat, water- Excess = decrease zinc absorptionFolate: water soluble vitamin- Function- coenzyme for amino acids, DNA synthesis, cell replication- Deficiency- depression, low DNA (low immunity, macrocytic anemia, neural tube defects)- Risk groups- smoking, alcoholics, preggos, some chemotherapies- Diet sources- enriched products; good in green leafy veggies, fruit, beans, cereal, liver; bad in meat and milk- Important for fetal neural tube development, destroyed by heat and airVitamin B12: water soluble and largest vitamin- Function- folate, amino acid, energy, RBC, hormone - Deficiency- macrocytic anemia, fatigue, staggering (neuro)- Risk groups- stomach probs (pernicious anemia- can’t absorb), elderly (low stomach acid), vegans, ileum problems (Crohn’s disease)- Diet sources- microbial (soil, fermentation, yeast); meat, milk, eggs- Absorption- active in ileum, intrinsic factor, some passive in LI- Problems- low intake (20 years), low intrinsic factor (3-7 years), hidden by dietary folate until neuro problems developVitamin K: fat soluble vitamin, some are water soluble- Function- form blood clot factors and bone matrix deposits- Deficiency- no clots, no bone mineralizing- Risk groups- fat malabsorption, infants, antibiotics- Diet sources- bacteria in LI, liver, green veggies, milk- Blocked by warfarin, used for stroke and heart attackWater, Electrolytes, and Acid-Base BalanceWater: essential, major component of anything living- Nutrient transport, waste excretion (urine, feces), acid base balance, temp, good solvent, enzyme action- Waste transport- fat (ketones, CO2), protein (urea, CO2), carbs (lactate, CO2)- Total body water- 40% extracell (blood, ISF), 60% intracello Particle concentration regulated (ions/electrolytes)Sodium: major cation (+1), water soluble- Function- extracell ion, regulate fluid volume, muscle/nerve contraction, nutrient transport- Deficiency- muscle cramps, atrophy, lose appetite- Risk groups- sweat/vomit, special diets (kidney or heart disease, hypertension), over 51, African American- Diet source- processed food, salt, soft water, soy sauce, MSG- Recommendations- 2,300 mg/day, risk groups need 1,500 mg/dayPotassium: major cation (+1), water soluble- Function- intracell ion, fluid and electrolyte balance, muscle/nerve function- Deficiency- muscle weakness- Risk groups- diarrhea, urine, uncontrolled Diabetes, dehydration, drugs- Diet sources- fresh fruits, milk, unprocessed food- High intake helps hypertension (lowers Na+), toxic at hyperkalemia (vomit, muscle weakness)Chloride: major extracell anion (-1), follows Na/K, easy transport, lost in sweat/vomit, component of HCl in stomach acidOsmosis: pass solutions across semi-permeable, water follows ions to equalize concentrationOsmotic pressure: exerted by particles to draw water across membraneRenal regulation: kidneys (excretion and retention), water balance by Na/KInsensible fluid loss: respiration, perspiration Expended: 2 L per 2000 kcal/dayConsumed: cover urine volume of 1-2 L/day; replace insensible lossExcreted: minimum 200-400 ml/day urineIntake = 1 L fluid, 1 L food, 0.2 L metabolismOutput = 0.5 L sweat, 0.5 L breath, 0.2 L feces, 1 L urineDehydration: thirst, fatigue, poor CV, low cognitive, unstable temp, no circulation- Risks- activity, protein/Na/caffeine/alcohol, low intake, environment, meds- Signs- headache, low concentration, weakness, dark urineHypertension: >140/90 BP, 1/3 adults, risk CVD, stroke, kidney disease - Risks- obesity, CVD, age, heredity, race- Needs- low Na, weightloss, exercise, low alcohol, high Ca/K/Mg/vit C- DASH diet- rich fruit/veggies/fish, low sat fat, high fiber, low saltMaternal NutritionImportance: father’s sperm sucks, low risk of pregnancy issues (folate), healthy bodyweight, avoid drugs/drinkingFactors: maternal weight gain- +11-20 (obese) +15-25 (overweight) +25-35 (normal)+35 (teens) +30-40 (underweight) +25-50 (twins)- 1st (.25 lb/week), 2nd and 3rd (1 lb/week, +300 cal/d), lactation (+500 cal/d)- Low weight gain- risk birth asphyxia, infection/illness, poor baby glucose/Ca- Premature- lung/liver immaturity- Full term, <5 lbs- low fat, poor glucose/temp, retarded growth, 40x death- High weight gain- heavy baby, complications, high BP for mom, obesity riskDiet: bad; low carbs inhibit baby glucose, low