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NTR 108: Exam 3
Hematopoietic System (2 parts) |
Blood and Bone Marrow |
Blood Cells (in Plasma) |
Red Blood Cells
Immune Cells (lymphocytes)
Platelets |
Plasma |
Albumin
Lipoproteins
Hormones
Nutrients
Waste products |
Bone Marrow |
where blood cells originate |
Function of Hematopoietic System |
Carry waste
Carry Nutrients |
Nutrients Involved in Hematopoietic |
Iron, Zinc, Copper, Folate, Vitamin B12, Vitamin K |
Iron: Definition/classification |
trace mineral, cation (2 different charges) |
Iron: Function |
1) component of hemoglobin (in RBC)
2) component of myoglobin (in muscle)
3) cofactor for energy metabolism |
Iron: Deficiency signs/symptoms |
low iron stores
low cognitive function
low energy level
pica (eating non food items) |
Anemia |
(classic iron deficiency)
small red blood cells
fatigue
low work capacity
poor immune function |
assessment of iron status |
2 ways - 1) measure stores
liver and marrow biopsy
2) blood cell measurements
hematocrit and hemoglobin |
Iron: Groups at Risk |
-People in developing countries
-menstruating women (30% iron deficient, 8% anemic)
-growing individuals (pregnant women, infants)
-athletes
-people with excessive blood loss
-vegetarians with poor diets |
Iron: Dietary sources |
1) heme iron
- good iron comes from meat, fish, poultry
- bad source - milk
2) nonheme iron
- Fair source - tofu, whole grains, dried fruits
- poor source - iron cookware, enriched flour |
Factors that increase Iron Absorption |
heme iron is better
Meat Factor Protein
Vitamin C (changes charge of Iron, makes it more water soluble)
stomach acid
sugars and other chelators (makes iron more soluble) |
Factors that decrease iron absorption |
lack of physiological need
excess dietary calcium, zinc, and phosphate
dietary fiber
antacids
intestinal damage
Tannins (black tea, red wine, herbal teas) |
Iron Toxicity |
- too much iron will cause oxidative damage
Acute Toxicity - large dose at one time
- causes intestinal damage, liver failure, shock
- can be chronic too
- mainly in males
-causes liver damage
- associated with cardiovascular disease, cancer, hemochromatosis |
Zinc: Definition/classification |
trace mineral, found naturally in food |
Zinc: function/metabolism |
Cofactor in immune system, energy system, and a component of antioxidant enzyme |
Zinc: Deficiency Symptoms/signs |
- loss of taste
- failure to grow
- impaired vision
- impaired immune function |
Groups at Risk for Zinc Deficiency |
- people taking an excess of
- iron, copper, dietary fiber
- poor
-elderly
-pregnant women
-children |
Dietary Sources for Zinc |
found in foods high in protein |
Special Notes for Zinc |
excess Zinc will decrease copper absorption |
Copper Definition/Classification |
- trace mineral
- cation - 2 charge states |
Copper Function/metabolism |
iron metabolism
energy metabolism
antioxidant enzyme |
Copper Deficiency Signs/Symptoms |
Anemia (microcytic, like iron deficiency) |
Groups at Risk for Copper deficiency |
if you have too much zinc |
Dietary sources for Copper |
- Beans
- seeds
- nuts
- organ meat
- water (if from copper pipes) |
Special notes for Copper |
excess copper decreases zinc absorption |
Folate: definition/classification |
- water soluble vitamin (B-Vitamin) |
Functions for Folate |
- coenzyme for
- amino acid metabolism
- DNA synthesis (cell replication) (important to know) |
Deficiency signs/symptoms for Folate |
- Depression
- Low DNA synthesis
- lower immune function
- macrocytic anemia (very large RBCs)
- neural tube defects (classic Folate deficiency) |
Groups at Risk for Folate Deficiency |
smokers
alcoholics
people who use oral contraceptives
pregnant women
some chemotherapy
some antibiotics |
Dietary sources for Folate |
good source
- leafy green vegetables
- fruit
- beans
- breakfast cereals
- liver
poor source
- meat
- milk and milk products |
Special Notes on Folate |
- very important in preventing neural tube defects in fetus
- easily destroyed by heat and air |
Vitamin B12: definition/classification |
- water soluble vitamin
- largest vitamin |
Vitamin B12 Functions |
- Folate metabolism
- amino acid metabolism
- energy metabolism
- hormone production |
Vitamin B12: Deficiency signs/symptoms |
macrocytic anemia - same as folate, different than iron
- fatigue
- staggering (neural problem, irreversible) |
Vitamin B12 Groups at risk |
- people with stomach dysfunction
- pernacious anemia (classic deficiency) lack of an absorption factor
- elderly, lack of stomach acid
- vegans
- people with ileum problems (Crohn's disease) |
Vitamin B12: Dietary Sources |
1) Primary Sources - microbial bacteria/algae
- soil contamination
- fermented foods
- nutritional yeast
2) Secondary Sources
- meat
- eggs
- milk |
Vitamin B12: special notes |
1) Absorption
- active in ileum
- requires many factors
- small amount of passive absorption in large intestine |
Vitamin B12: special notes |
2) Deficiency
- may take 20 years without any intake to develop
- develops in 3 to 7 years without intrinsic factor
- dietary folate can hide symptoms until damage is irreversible |
Vitamin K: definitiona/classification |
fat soluble vitamin (some forms are water soluble) |
Vitamin K: functions |
- formation of blood clotting factors
- formation of bone matrix proteins |
Vitamin K: deficiency signs/symptoms |
- blood does not clot
- bones don't mineralize |
Vitamin K: groups at risk |
- people with fat malabsorption
- infants usually given injection at birth
- people taking large amounts of antibiotics |
Vitamin K: Dietary sources |
- bacterial synthesis in large intestine
- liver
- green vegetables
- milk |
Vitamin K: special notes |
- warfarin, a rat poison, blocks vitamin k action
- warfarin (also known as Coumadin) is used after strokes and heart attacks |
Water |
Common sense, most essential thing to have
major component of living things
involved in transport of both waste and nutrients
acid base balance |
Total Body Water |
- extracellular fluid - 40% of total body water , outside of cells
- intracellular fluid - inside cells |
Electrolytes (think of gatorade) |
Sodium (Na+), Potassium (K+), Chloride (Cl-) |
Sodium: definitons/classifications (Na+) |
-major cation
- single positive charge
-very water soluble |
Sodium: Functions |
-primary extracellular ion
- regulator of fluid volume
- muscle and nerve contractions
- transports nutrients |
Sodium: deficiency signs/symptoms |
- muscle cramps
- apathy
- loss of appetite |
Sodium: Groups at risk |
-loss occurs from sweating and vomiting
-people on low sodium diet
- excessive vomiting (bulimia)
- excess sweating |
Sodium: Dietary sources |
-processed foods (75% US intake)
- table salt
- soft water
- soy sauce and MSG |
Potassium: definitions/classification (K+) |
major cation
single charge
very water soluble |
Potassium: functions |
primary intracellular ion
fluid and electrolyte balance
muscle and nerve function |
Potassium: deficiency signs/symptoms |
muscle weakness
cardiac arrhythmius |
Potassium: groups at risk |
loss occurs from large intestine and kidney (diarrhea and urine)
uncontrolled diabetics
dehydration
diarrhea
drugs |
Potassium: dietary sources |
fresh foods, bananas
milk
whole foods |
Potassium: notes |
toxic in high levels
don't eat too many bananas |
Chloride ion (Cl-) |
major extracellular anion
follows sodium and potassium
moves easily across membranes
lost in sweat and vomit
component of stomach acid |
Osmosis |
-passing of solutions across semi-permeable membrane
-attempt to equal concentration on both side of membrane |
Renal Regulation of body fluids |
kidney is major organ responsible for retention and excretion of body fluids
urine |
Insensible losses |
respiration
perspiration |
Fluid requirements |
apprx 1 ml water/kcal expended expended or 30 ml/kg body weight adult (2 L per 2000 kcal/day) |
recommended urine volume |
1-2 liters per day |
Water balance |
intake = output |
intake per day |
1L fluid
1L food
0.2L metabolism |
output per day |
0.5L through perspiration
0.5L breath respiration
0.2L feces
1.0L Urine |
Dehydration Effects |
thirst
fatigue and reduced cardiovascular efficiency
reduce mental function
inability to regulate body temperature
circulatory collapse and death |
Dehydration contributing factors |
physical activity (sweat loss)
diet
- high protein
- high sodium intake
- caffeine and alcohol |
Dehydration Symptoms |
headache
lack of concentration
lethargy
dark urine |
Hypertension (high blood pressure) |
higher the blood pressure, the greater the chance of cardiovascular disease, stroke, and kidney disease |
hypertension risk factors |
obesity
cardiovascular disease
age
heredity
race |
recommendations to lower blood pressure |
eat better
exercise
use common sense
don't be lazy |
DASH |
Dietary Approaches to Stop Hypertension
basically, eat better |
Why is nutrition important before and during pregnancy? |
to make the baby healthier |
What is the best predictor of a successful birth? |
Maternal weight gain |
Maternal weight gain |
weight gain should be between 25-35 pounds |
low weight gain during pregnancy (less than 15 pounds) |
general problems with birth include
- increased risk of birth asphyxia
- infections
- illness
- an infant with difficulty regulating blood glucose and blood calcium |
low weight gain can also lead to premature babies |
lung and liver immaturity |
High weight gain during pregnancy |
associated with high birth weights (greater than 9 pounds)
complications during delivery
increased maternal blood pressure |
Factors that affect pregnancy outcome |
maternal weight gain, dieting, nutritional status, closely spaced pregnancies, drug use |
What is one of the most important nutrients involved in pregnancy? |
folate - an absence of folate can cause neural tube defects |