Water & Minerals - Learning Objectives PDF

LEARNING OBJECTIVES Water and 1. Calculate a person’s uid requirement. Minerals 2. Evaluate the adequacy of uid intake in a healthy adult....

LEARNING OBJECTIVES Water and 1. Calculate a person’s uid requirement. Minerals 2. Evaluate the adequacy of uid intake in a healthy adult. 3. Give examples of mechanisms by which the body maintains mineral homeostasis. Dr. Ann C. Nery 4. Identify sources of minerals. 5. Predict potential consequences of mineral de ciencies or toxicities. 6. Compare characteristics of minerals to those of vitamins. OVERVIEW OF WATER Water Balance Water balance is the dynamic state between water output and water Water is a vital component of the body, occupying every cell and intake. Under normal conditions, output and intake are approximately playing a signi cant role in various bodily functions. equal It provides structure to cells, regulates body temperature, aids in nutrient digestion and absorption, and transports nutrients and oxygen to cells. Water also serves as a solvent for vitamins, minerals, glucose, and amino acids, participates in metabolic reactions, and eliminates waste products. It is a major component of mucus and lubricating uids, reducing friction in joints and cushioning contacts between internal organs. Men generally have a higher percentage of body water than women. Presentation 7 - September 26, 2024 fi fl fl fi  Water Intake Water Output The average daily water intake is 21⁄2 liters, with 80% coming from Adults lose 1750-3000 mL of water daily due to extreme uids and 20% from solid food. temperatures, high altitude, low humidity, strenuous exercise, and skin evaporation. Fruits and vegetables are the most water-rich foods. Urine and feces contribute to the remaining water loss. The body also produces a small amount of water from normal metabolism, ranging from 250 to 350 mL daily. To maintain water balance, intake should approximate output, as the body excretes 500 mL daily. Method Insensible water loss —-measurable 30 mL/kg body weight Sensible water loss —-immeasurable Example: A 70-kg person needs 2100 mL/day. (70 kg 30 mL/kg 2100 mL/d) The average daily water intake is 21⁄2 liters, with 80% coming from uids and 20% from solid food. Fruits and vegetables are the most water-rich foods. The body also produces a small amount of water from normal metabolism, ranging from 250 to 350 mL daily. MAJOR ELECTROLYTES Sodium, chloride, and potassium are major minerals that are also major electrolytes in the body. Salient features for each electrolyte are presented in the following paragraphs. Sodium, a key component of the human body, is primarily obtained from salt or sodium preservatives added to food. In the American diet, 75% of sodium comes from salt, while only 12% comes from naturally occurring sodium in foods like milk, meat, poultry, vegetables, and tap water. Presentation 7 - September 26, 2024 fl  Potassium is a crucial cation in the body, found in cells and extracellular uids. It maintains uid balance, aids in metabolic reactions, and controls skeletal muscle contractility. It is naturally present in most foods, but processed foods have a higher sodium-to- potassium ratio. Chloride, a major anion in MAJOR MINERALS extracellular uid, maintains uid and electrolyte balance The remaining major minerals are calcium, phosphorus, magnesium, and alongside sodium. It's essential sulfur. in digestion and acid-base balance. Calcium, the most abundant mineral, makes up half of the Most cells have low chloride body's total mineral content. 99% concentration. is found in bones and teeth, providing rigidity and structure. The AI for chloride is equivalent to sodium, with younger adults Bones release calcium when having 2.3 g/day. Sodium and serum levels drop, maintaining chloride share dietary sources. blood calcium levels. The remaining 1% is found in plasma and uids. Presentation 7 - September 26, 2024 fl fl fl fl fl  Magnesium, the fourth most abundant mineral, is deposited in bone with Phosphorus is the most calcium and phosphorus, and is a abundant mineral in the body, cofactor for over 300 enzymes. with 85% combined with calcium in bones and teeth. Its role in preventing hypertension, managing cardiovascular disease, and It regulates acid-base balance, diabetes is growing. metabolizes energy, and provides cell membrane structure. Sulfur is a component of biotin, thiamin, and amino acids methionine and cysteine, making Phosphorus is essential for proteins in skin, hair, and nails more rigid. RNA and DNA, enzyme activation, and B vitamins. There is no RDA or AI for sulfur, and de ciency Absorption is enhanced by symptoms are unknown. vitamin D and regulated by PTH. Intake of sulfur amino acids is necessary for sulfur. TRACE MINERALS Trace mineral content in foods is highly variable, largely in uenced by soil mineral content. For example, grains, vegetables, and meat grown in certain states have higher selenium content, while those in southern states and the US coasts have less. Other factors like water supply quality and food processing also a ect the content. Food composition tables typically include data on iron, zinc, manganese, selenium, and copper, but not iodine, chromium, and molybdenum. Presentation 7 - September 26, 2024 fi  Bioavailability of trace elements Iron is found in the heme portion of hemoglobin, transferrin, and enzyme varies based on the total diet and is systems. It is stored in the liver, bone marrow, and spleen. in uenced by mineral interactions and other dietary factors. Iron is found in heme iron in meat, sh, and poultry, and nonheme iron in plants. The majority of iron in the diet is nonheme iron. Excessive intake of one trace mineral can hinder another's absorption, Iron absorption typically ranges from 10% to 15% of total intake, but during while de ciency can intensify toxic growth, pregnancy, or iron de ciency, it can increase to 50%. e ects. Heme and nonheme iron bioavailability is signi cantly di erent. Heme iron Reliable indicators of trace element absorption is about 15% and is in uenced by need, not dietary factors. status, such as serum levels or balance studies, are not always Nonheme iron absorption is enhanced or inhibited by various factors, such as available for all trace minerals, consumption with heme iron or vitamin C-rich foods, co ee, calcium, phytates, making it di cult to assess their or oxalates. status. Tea is a potent inhibitor that can reduce nonheme iron absorption by 60%. Zinc, a small nutrient found in cells, plays a crucial role in various bodily When plant foods are consumed as a single food, only 1% to 7% of nonheme functions and immune system function. iron is absorbed. Iron requirements vary among individuals, with the It is essential for growth, metabolism, reproduction, and taste perception. RDA set at 8 mg for men and postmenopausal women and 18 mg for premenopausal women. Zinc de ciency is not easily diagnosed due to lack of a single test. Vegetarians have higher iron recommendations due Risk factors include poor calorie intake, alcoholism, and malabsorption to lower bioavailability. syndromes. Most adults consume adequate iron, but women of Vegetarians are at higher risk due to plant-based absorption. In childbearing age, pregnant women, and developing countries, iron de ciency is exacerbated by diseases like HIV breastfeeding women generally do not. Iron and tuberculosis. de ciency anemia, a microcytic, hypochromic anemia, a ects over 30% of the world's population and is exacerbated in developing countries by worm infections, malaria, and infectious diseases. Presentation 7 - September 26, 2024 ff fl fi fi fi ff ffi fi fi fl fi fi  Iodine is essential for thyroid hormone Selenium, a key component of glutathione regulation and is found in various peroxidases, is an antioxidant that disarms free tissues and organs. It is found in radicals during normal oxygen metabolism. vegetables, grains, milk, bread, and seafood. It regulates thyroid hormone actions and has potential roles in preventing cardiovascular disease, However, most foods are naturally neurodegenerative diseases, and certain cancers. low in iodine, with some being iodized for sanitization. Iodine Although the average American adult consumes de ciency is a major global issue, more than the recommended daily intake, many leading to mental retardation and consume high amounts through supplements. disorders like goiter, hypothyroidism, cretinism, stillbirths, and delayed Adverse e ects can occur even when selenium cognitive development. intake is below toxic levels. The e ect of goitrogens on iodine Selenium de ciency is rare in the US, often due to balance is clinically insigni cant severe gastrointestinal problems or surgical removal. except when iodine de ciency exists. Copper, found in muscles, liver, brain, bones, kidneys, and blood, plays a Fluoride aids in the mineralization of tooth enamel and remineralization of crucial role in hemoglobin synthesis, collagen formation, wound healing, nerve surface enamel in erupted teeth by inhibiting cariogenic bacteria's ber maintenance, and energy metabolism. metabolization of carbohydrates. Excess zinc intake can cause copper de ciency Fluoridation of municipal water in the second half of the 20th century has signi cantly reduced dental caries prevalence and severity in the U.S. Manganese, American adults consume a high amount of manganese, with no dietary The National Institute of Dental Health, the Academy of Nutrition and de ciencies. Dietetics, the American Medical Association, the National Cancer Institute, and the Centers for Disease Control and Prevention endorse Manganese toxicity is a risk for miners, uoridation. leading to central nervous system abnormalities similar to Parkinson's The CDC estimates that for every $1 spent on uoridation, $38 or more is disease. saved in treatment costs. Drinking water may also cause neuromotor Children under 8 years are susceptible to mottled tooth enamel if they de cits. The UL for adults is 11 mg/day, ingest more uoride than recommended, due to swallowing uoridated four times the usual intake. toothpaste. Presentation 7 - September 26, 2024 fi fl fi fi fi fi ff ff fi fl fi fi fi fl  Chromium, found in foods, helps regulate blood glucose levels and is essential for insulin action. Other Trace Elements A de ciency results in high blood glucose and Although de nitive evidence is lacking, future research may reveal that other impaired insulin response. trace elements are essential for human nutrition. However, evidence is di cult to obtain, and quantifying human need is even more formidable. In addition, as Despite its widespread presence, many foods with all trace minerals, the potential for toxicity exists. Consider the following: provide less than 1 to 2 μg per serving. Unre ned foods are higher in chromium than Nickel, silicon, vanadium, and boron have been demonstrated to have processed ones. bene cial health e ects in some animals and may someday be classi ed as essential for humans. Molybdenum, a crucial component of red blood cell Cobalt is an essential component of vitamin B12, but it is not an essential synthesis and enzymes, is widely nutrient and does not have an RDA. consumed in the American diet, but its potential dietary It is possible that minute amounts of cadmium, lithium, tin, and even arsenic de ciencies and toxicities remain are also essential to human life. unknown. WATER AND MINERALS IN HEALTH PROMOTION WATER The Dietary Guidelines for Americans, 2010 recommend consumers to drink water instead of sugary drinks, as they are linked to poor diet quality, weight gain, obesity, and type 2 diabetes. The American Heart Association recommends no more than 450 calories per week from sugar-sweetened beverages, or fewer than three 12-oz cans per week. Sugar-sweetened beverages are linked to poor diet quality, weight gain, obesity, and type 2 diabetes in adults. Soft drink consumption has increased over the last 30 years, with males and females consuming 175 and 94 calories per day, respectively. Presentation 7 - September 26, 2024 fi fi fi fi fi ff  The Beverage Guidance Panel MINERALS agrees that the current high intake of sweetened beverages The Dietary Guidelines for Americans, contributes to excess calorie 2010 recommend reducing daily sodium intake and obesity development. intake to less than 2300 mg and 1500 mg among individuals aged 51 and older, While naturally calorie-free plain water can satisfy uid needs, African American, or those with other beverages o er nutrients, hypertension, diabetes, or chronic kidney phytochemicals, and interest to disease. This recommendation applies to the diet. about half of the U.S. population, including children and adults. Additionally, the guidelines recommend choosing foods with more potassium and calcium to prevent low levels of certain nutrients, which could pose a public health concern. SODIUM & POTASSIUM High potassium intake can counteract the e ects of high sodium intake, leading to a stronger association between cardiovascular disease and sodium High sodium or low potassium intake and potassium consumption ratios. increases blood pressure, a risk factor for coronary heart disease, stroke, congestive heart failure, and renal diseases. A diet rich in potassium, calcium, magnesium, and ber combined with reduced sodium intake can lower blood pressure in hypertensive and normotensive individuals. Blood pressure increases progressively and continuously over the continuum of sodium intake without an obvious threshold. Public health bene ts from increasing potassium include greater health bene ts than simply restricting sodium. The Daily Value (DV) for sodium used on Food sources, such as fruits and vegetables, are recommended over food labels does not reliably re ect a supplements, as potassium is better absorbed from these sources. food's contribution to recommended sodium intake levels. The Daily Reference Value for sodium on the "Nutrition Facts" label is 2400 mg, exceeding the current UL set at 2300 mg. Presentation 7 - September 26, 2024 fi fl ff fi fl ff CALCIUM is crucial for bone health and prevents chronic diseases. Consuming milk and milk products is linked to a lower risk of cardiovascular disease, type 2 diabetes, and lower blood pressure in adults. Studies show a decrease in colorectal cancer and adenomas at higher calcium and vitamin D intake. Dairy calcium intake may also help regulate weight and prevent obesity. Despite Americans being advised to meet their RDA for calcium through food, 43% of adults take calcium supplements, raising concerns about their safety. Presentation 7 - September 26, 2024