Nutrion 3

• Calcium
• Phosphorus
• Magnesium
• Sodium
• Potassium
• Chloride
• Sulfur

Most abundant mineral in the body

• 99%= structure of bones and teeth
• 1%= dissolved in blood for:
• - Muscle Contraction
• - Nerve Transmission
• - Blood Clotting
• - Blood Pressure Regulation

• Milk and milk products
• Soy milk
• Broccoli
• Fortified orange juice
• Fish with bones (sardines)

• Osteoporosis- silent disease until elderly
• - Porous and fragile bones
• - Rickets= Childhood form of Osteoperosis

• To decrease bone loss:
• - Exercise (walking and weight bearing)
• - Adequate calcium
• - Adequate vitamin D
• - Estrogen replacement after menopause
• - Bone mass peaks= 35 years
• ~ After this, women can only prevent loss

2nd most abundant mineral in the body

• Bone and teeth structure
• Major buffer
• Part of DNA and RNA
• Role in metabolism
• Phospholipids

• Soft drinks
• Animal protein
• Legumes
• Dairy products
• Fish

Deficiency is rare

High amounts decreases Calcium absorption

• Component of bones
• Important to enzymes
• ATP metabolism
• Inhibits muscle contraction, blood clotting
• Prevents dental caries
• Protects against hypertension

• Dark green foods
• Legumes
• Whole grains
• Nuts
• Chocolate

• Deficiency is rare
• - Weakness
• - Muscle pain
• - Poor heart function

• Principal cation (+) outside of cell
• Fluid/electrolyte balance
• Nerve transmission
• Muscle contraction
• If "salt sensitive," intake increases risk of hypertension

• Processed foods (= 75% of intake)
• Table salt
• Condiments
• Sauces
• Soups

Muscle cramps

• Salt pills are not recommended for endurance athletes (use sports drinks)
• Diets rarely lack this mineral

• Principal cation (+) within the body cells
• Fluid/electrolyte balance
• Nerve transmission
• Muscle contraction

• Fresh fruits and vegetables
• Meat
• Milk
• Whole grains

• Deficiency is rare
• - Muscle weakness

• Toxicity: overuse of this mineral salt (heart patients)
• As processing increases, this mineral decreases while Sodium increases

• Major anion (-) outside the cell
• Fluid/electrolyte balance
• HCl in stomach

• Table salt
• Processed foods
• Some vegetables

Deficiency is rare

• Is not used as a nutrient by itself, but is part of other compounds
• "Bridges" in proteins, stabilizes shape
• Acid/Base balance

All protein containing foods

Deficiency is unknown

Is maintained at the expense of bones

• Depends on soil, water, and processing
• Deficiencies are typically failure to thrive and grow: used in all body systems
• Toxic at intakes not far above estimated requirements
• FDA cannot limit amounts in supplements
• Interactions among them are common
• - If take too much, can lead to deficiencies of others

• Iodine
• Iron
• Zinc
• Selenium
• Fluoride
• Chromium
• Copper

Component of thyroid hormone

• Goiter= enlargement of Thyroid Gland
• Cretinism= occurs during pregnancy- retardation

• Iodized salt
• Seafood
• Ocean mist (= world's major source)

• Part of hemoglobin and myoglobin
• Carry and release oxygen

• Nonheme
• Heme

Found in plant and animal foods and is absorbed poorly

Found in animal foods and is better absorbed than nonheme

• Most common nutrient deficiency in the US and worldwide
• Depleted of this mineral stores with low hemoglobin concentration

• Increased by pregnancy, vitamin C, and childhood
• Decreased by tannic acid and calcium

• Hemochromatosis (the most common genetic disease in the US)
• Iron poisoning- children accidentally take iron pills leading
• - Leading cause in accidental poisoning in kids (as few as 5 pills)

• Meat
• Fish
• Enriched grains/cereals
• Green leafy vegetables

• Important in:
• Many enzymes, insulin, DNA/RNA, immune system, vitamin A, taste perception, wound healing, sperm development

• Growth retardation
• Arrested sexual maturation
• Impaired:
• - Immune function
• - Brain function
• - Thyroid
• - Taste
• - Wound healing
• - Vitamin A

• Shellfish
• Meat
• Poultry
• Liver
• Whole grains

• Works as an antioxidant
• Makes thyroid hormone active

May increase risk for heart disease

• Meats
• Other animal products
• Whole grains

Forms crystal structure of teeth

Increased risk of dental caries (most widespread health problem)

In communities where water Fluoride is too high, you see fluorosis (darkened teeth)

Drinking water (75% of US has access to Fluoride drinking water)

• Associated with insulin to facilitate glucose uptake into cells
• - These supplements do not help lose fat and build muscle, but does help with diabetes

• Meat
• Egg yolks
• Whole grains
• Vegetable oils
• Nuts

• Helps form hemoglobin
• Collagen synthesis
• Works with many antioxidant enzymes

Deficiency is rare

• Legumes
• Whole grains
• Nuts
• Organ meats
• Seeds
• Dried fruits

Aldasterone (from Adrenal Glands) and Antidiruetic Hormone (ADH) from pituitary act on kidneys to retain water

• Salts that dissolve in water and dissociate (separate)
• Attract water
• Examples: Sodium, Potassium, Chloride
• Create osmotic pressure- pressure caused by water following electrolytes within or between cells

• Health status of children has improved over the last thirty years
• - Less infant mortality
• - Less nutrient deficiencies
• BUT:
• - Overweight has increased
• - 2x in kids age 2-5
• - 3x in kids age 6-11

• Energy and Protein
• - Getting the right balance
• 11% of households are food insecure

• Impacts child's motor and mental development
• - Infancy to childhood is big feeding transition
• - Typically goes from rich to poor diet

• Adequate amounts are needed, with physical activity to maximize bone growth and mineralization
• Lowers risk of Osteoporosis as an adult

• Intake should= child's age + 5 grams
• For digestive health and overall healthy diet

• 30-40% of calories for children 1-3
• 25-35% of calories for children 4-18
• Limit saturated fat
• - Impacts LDL cholesterol, even in childhood, increasing the lifetime risk for heart disease

• Hyperactivity= ADHD
• Occurs in 3-5% of school aged kids
• - Not related to food allergies
• - Not related to sugar intake
• - Possibly related to caffeine, iron deficiency or living with chronic hunger

• Parent decides what to eat
• - Offer healthy snacks
• - Don't force feed
• - Don't bribe or threaten
• - Discourage eating with the TV on
• Child decides when and how much to eat

• TV watching leads to
• - More snacking
• - Higher intake of high calorie foods
• - Obesity?
• - Watching > 4 hours/day led to a higher risk of obesity
• - 65% of 8-18 year old in the US have a TV in their bedrooms

• Treatment
• - Slow the rate of gain, let child grow into his/her weight
• - Diet restriction for weight loss can interfere with normal growth
• - Weight loss not recommended
• - Get "junk food" out of the house and increase activity

• Risk: Living in old homes (pre 1978)
• Functional Impairment
• - Impaired thinking, hearing, growth
• - Decreased academic performance
• Decreases in blood lead due to bans on
• - Leaded paint
• - Leaded gas
• - Lead-soldered food cans
• Nation-Whide monitoring
• - Many Pediatricians screen at age 1
• - Increased risk if have low iron or calcium status

• Needs of teens vary with gender, body size, and activity level
• Growth patterns vary widely

Provide nutritious snacks to help meet needs

• No foods have been proven to aggravate it
• - Though low blood zinc is associated with it
• Stress can worsen it

• Boys:
• - Elevated needs due to increased lean body mass
• - Requirements drop after puberty
• Girls:
• - Elevated needs to support menstruation
• - Requirements high during childbearing years

• Cartilage strip of bone tissue responsible for longitudinal growth of bones
• Disappears (calcifies) around age 17, or when puberty stops

• Physical Activity and calcium are important during this
• - 85% of females and 64% of males do not receive adequate calcium from age 12-19

• Only 35% met activity guidelines
• 10% reported no moderate to vigorous activity
• Activity declines throughout adolescence
• More males than females meet daily activity guidelines

• High levels of activity combined with growth and development increase needs for energy, protein, and certain vitamins and minerals
• Nutrient needs are higher during intense training and competition seasons
• Competitive athlete may need 500-1500 additional calories per day
• Protein should supply no more than 30% of calories in the diet

• Caloric expenditure declines 20% during adulthood
• - Due to decrease in metabolic rate and decrease in activity level
• Energy expenditure remains constant IF fat-free body mass stays constant

• 1994- 3.5 million Americans were 85+
• 2024- 9 million Americans will be 85+
• Life expectancy
• - Males: 74.1 years
• - Females: 79.5 years

• Oral health status
• Decreased production in saliva (xerostoma)
• Atrophic Growth: decreased HCl and intrinsic factor secretion
• Lactose intolerance
• Decreased absorption of some nutrients
• - Vitamin B12, calcium, iron

• Taste
• Smell
• Hear
• Touch
• See

• Decrease in lean body mass
• Although calorie needs may decrease as muscle mass decreases, requirements for a lot of vitamins and minerals increase
• - Need to eat more nutrient dense foods
• Physical activity, especially weight bearing activities, will slow muscle atrophy

• Needs may stay the same or slightly increase
• Good protein sources include:
• - Meat, poultry, fish, eggs, cheese, milk, soybeans

• Carbs is needed to spare protein
• - Keeps protein from being used as energy
• Whole grain carbs should be emphasized because of high fiber content
• Fiber and water intake can alleviate constipation

• Dehydration among older adults
• - Lack of thirst
• - Do not notice dry mouth
• - Do not want to go to the bathroom often
• 1 oz/kg actual body weight, with a minimum of 50 oz (6 1/4 cups) daily

• Vitamin B12
• - Deficiency is common among older adults
• - Decreased absorption
• - RDA 2.4 a day
• - May need to be as high as 10-25 a day
• Vitamin D
• - Loss of efficiency to synthesize in the skin
• - Decreased intestinal absorption
• - Low intake of vitamin D rich foods

• Calcium
• - Low intake of calcium rich roods
• - Osteoporosis
• Iron
• - Decreased absorption due to low stomach acid or use of antacid
• - Iron-deficiency anemia

• Good for:
• - Heart
• - Bones
• - Sparing muscle mass
• - Decrease constipation
• - Better flexibility, endurance, balance
• - Improve physiological processes
• - Preserves mental ability (increase blood flow)

• Congregate Meals- meals served in a social congregate setting. Serves 25% of the elderly poor
• Meals on Wheels- volunteers deliver meals to the doors
• Compared to non-participants, participants had up to 31% higher intake of recommended nutrients

• Placenta- placenta, amniotic acid, umbilical cord
• Fetal growth and development
• - Zygote- 1st 2 weeks
• - Embryo- weeks 2-8
• - Fetus- 8 weeks to birth

• Energy needs: +300 calories day, need 1 extra serving from each of 5 food groups
• Increase in other nutrients:
• - Iron
• - Protein
• - Folate & Vitamin B12: for blood production and cell growth
• - Vitamin D & Calcium: for bone development

• Started in 1972 by the USDA
• Target Population: pregnant women, lactating women, and children up to 5
• Eligibility Criteria: nutritionally at risk and low income families
• Requires agencies to offer nutrition education and vouchers for nutritious foods

• More likely to have prenatal care
• Children had regular medical care
• Mothers had better nutritional intake
• Mothers had longer gestation, less preterm deliveries
• Infants had bigger head circumferences

• Early pregnancy is the most critical: especially for folate deficiency
• Main internal organs, along with major external organs are formed
• Limited organ development (brain and heart) due to nutrient deficiency is irreversible
• This is not the time that most women realize they are pregnant

• Spina bifida: one of the most common NTD; caused by failure of neural tube to close completely
• Critical period for neural tube: 17-30 digestion
• Folate supplementation
• - Will cut NTD incidence in half

• Weight for height prior to conception
• - Underweight- gain extra weight
• - Overweight- no weight loss, just gain less
• Weight gain DURING pregnancy
• - Normal: 25-35 lbs
• - Underweight: 28-40 lbs
• - Overweight: 15-25 lbs
• Weight gain within recommended range decrease surgical births and increases healthy birth rates

• Maternal fat stores only 7 of 30 lbs of weight gain
• Fetus: 7 1/2 lbs
• Increased breast size, fluid volume, blood supply, uterus, placenta, and amniotic fluid
• Weight loss after pregnancy
• Blood volume and fluids decrease
• Some weight remains
• Breast feeding will help with weight deduction
• Exercise
• Low impact, swimming is ideal
• Avoids saunas and hot tubs- raises body temperature

• Nausea- sometimes requires hospitalization if can't keep water down
• Constipation and hemorrhoids
• Heartburn
• Food cravings and aversions
• Non-food cravings- "Pica"

• Low oxygen to fetus, causes low birth weight
• Associated with sudden infant death syndrome (SIDS)

• Check with physician
• Especially avoid aspirin and ibuprophen
• Illegal drugs

Only have 1 can of tuna per week (mercury is too high)

Especially Vitamin A causes birth defects ("teratogenic")

Never diet during pregnancy

• 1 cup of coffee or 2 cokes per day is ok
• Sugar substitutes: 1 diet drink per day is ok

• Limits oxygen delivery to the fetus, slows cell division and reduces the number of cells organs produce
• Fetal Alcohol Syndrome
• Birth defects arise from severe damage to the fetus caused by alcohol. A lesser condition, fetal alcohol effect, may be harder to diagnose, but also robs the child of a normal life
• Abstinence of alcohol is critical to prevent irreversible damage to the fetus

Fetal growth is retarded, birth defects, spontaneous abortion

• Biggest predictor of infant mortality
• Low birthweight <5.5 lbs or 2500 grams

• (Preexisting) Diabetes- lots of complications
• Gestational Diabetes- diabetes during pregnancy
• - 1/3 mothers develop diabetes later in life
• Pregnancy Induced Hypertension ("Pre-eclampsia")
• - High blood pressure protein in urine and fluid retention (edema), sometimes death
• - Treated with low sodium and high calcium injections

• Teens: In the US, 1/4 born to teenagers
• - Low birth rate, stillborn, deformities
• - Need to gain extra weight
• Older women:
• - Mothers often hypertensive or diabetic
• - 1/50 births have genetic defects

• Breastfeeding- a learned behavior
• - Can be successful in a supportive environment
• - Most women are physically able to breastfeed
• - Extra fluid and enough energy and nutrients to make sufficient milk each day
• - Need +500 calories a day
• - Malnutrition most often diminishes the quantity of the milk produced without altering quality

• When milk is contaminated with alcohol, drugs, or other environmental pollutants
• Most ordinary infections such as colds have no effect

• Provides antibodies (decreases respiratory and GI infections)
• Nutrients are very absorbable
• Decreases risk of allergies
• Decreases risk of childhood obesity
• Promotes correct development of jaws

• Postpartum Amenorrhea- ovulation is delayed during lactation, spaces out the pregnancies
• Decrease in Breast and Uterine cancer- risk decreases the longer the woman breastfeeds

• Infants have a 21% higher post-neonatal infant mortality rate in the US
• Higher rates of:
• - SIDS
• - Type 1 and type 2 diabetes
• - Lymphoma, leukemia, Hodgkin's disease (cancers)
• - Overweight and obesity
• - High cholesterol
• - Asthma
• Are sick more often and have more doctor's visits
• Formula has a chance of being contaminated due to poor sterilization of bottles or nipples

• Must meet AAp standards for nutrient composition
• Must use formula if stop breastfeeding before 1 year
• Composition: companies try to mimic composition of breast milk
• Nursing bottle tooth decay ("Bottle Mouth")
• - Caused by going to sleep with bottle in mouth

• Generally weighs from 7-9 lbs
• Length is 19-21 in
• Head is relatively large and has a soft spot on top
• Startles and sneezes easily
• Trembling jaw
• Hiccups and spit up

• Birth weight doubles by 4 months
• Triples by 1 year
• Nutrient RDAs are based on amount that breastfeeding babies get

• American Academy Pediatrics recommends single injection of Vitamin K at birth
• Many Physicians give vitamin D, iron, and fluoride supplements

• Can begin at 4-6 months
• Iron fortified infant cereal is first
• Have less fluid, need to keep fluid intake high
• Food allergies: introduce single ingredient foods, 4-5 days apart
• Choice of food: variety, balance, and moderation
• No low fat milk until age 2

• Fortified cereals
• Meat
• Legumes

• Fruits
• Vegetables

• Concentrated sweets
• Canned veggies
• Honey
• Popcorn
• Whole grapes
• Whole beans
• Hot dog slices
• Hard candies
• Nuts
• No regular milk until 1 year

• Cow's milk
• Eggs
• Nuts, peanuts
• Wheat

• Sexual health: SHHUGA
• Anonymous: HIV testing
• Violence Prevention: RSVP
• Dietitian/Nutritionist

• Freshman
• Greeks
• Atheletes

79%

70%

• Personality, attitude, beliefs
• Family
• Media
• Culture and society

• Metabolized in the liver
• - 1 drink per hour
• Oxidation process
• Alcohol is diuretic

Happens before physical impairments

Depends on individual tolerance signs of physical impairment

Point to which body handles alcohol consumption

Level for alcoholism

• Digestion
• Storage
• Utilization
• Excretion of nutrients

Low blood sugar level

High blood sugar level

• Calcium
• Magnesium
• Potassium
• Zinc

• B1
• B6
• B12
• Folate
• Vitamin A
• Vitamin D

Build up of fat cells in liver

Inflammation of liver

Replacement of normal liver tissue with scar tissue

• Only calories
• No minerals or vitamins
• 7 calories per gram

• Ounces x % Alcohol x 1.6 (beer/wine)
• Ounces x Proof x 0.8 (hard liquor)

• 1-2 Standard drinks per day
• Good for heart health
• - Reduces risk of coronary heart disease
• - Linked to the antioxidants

• Alcoholics
• Family History
• Individuals with high tolerance

• Not just about quantity
• Other risks that affect impairment
• - Gender, body size, body fluid, empty stomach, illness/tiredness, drugs, medicine, BC pill or menstruation, mood and expectations

• Health
• - Fatty liver, neurological damage, cancer, alcoholism
• Academic
• Social
• Impairment

12 oz beer, 1.25 oz liquor (80 proof), 4 oz of wine—ALL alcohol contains 0.5 oz of pure alcohol

• Use a DD
• Get a MOCKtail not a COCKtail
• Set limits
• Friend “check up”
• Avoid drinking games
• Eat before drinking