Nutrition And Diet Therapy Midterm PDF

NUTRITION AND DIET THERAPY Too much intake of alcohol Food- material that contain nutrients that can be ingested Disorde...

NUTRITION AND DIET THERAPY Too much intake of alcohol Food- material that contain nutrients that can be ingested Disorder and problems on mental health INTRODUCTION Nutrients- Substances that nourish the body for growth or unable to prepare foods Energy provider foods- carbs and fats metabolism of an organism COMPOSITION OF CELLS: Body-building foods- proteins and minerals 3 Main Functions of Nutrients: Cell- basic unit of life; made up of water, inorganic ions, Protective- vitamins and minerals Source of energy and carbon containing molecules. Ions and polar Regulatory- water Regulation of body processes molecules are hydrophilic while non-polar are not Maintenance, repair, and growth of body cells WHY Nutrition is applied in Nursing? MAIN 3 COMPONENTS Role of nutrition in prevention of disease Enzyme- CHONs (proteins) that fastens the chemical Cell membrane- have proteins in them that form Attainment of good nutritional status (NS) and reaction rate pores/opening to allow passage of substances by: limitations considering foundations like cultural, Hormones- substance which the body produces that Acting as enzyme economical, and psychological factors serves as influences the way the body grows or develops Acting as antigen markers for self-identification concern for food pattern adaptation Serves as receptor sites Application of diet modification dependent on Basic Nutrition Concepts (DECADESLEC) Cytoplasm- watery solution of minerals and gases where doctor’s order Drink smart organelles are found Eat seafood Nucleus- the control center Dietetics- administration of the study/science of nutrition to Choose low fat dairy the humans Avoid trans fat Organelles: RA 2674- regulates practice of dietetics Diversify protein Endoplasmic reticulum- passageway for transport of Diet therapy- application of nutrition to avoid/cure/remedy Eat less materials in the cell occurrence of diseases. Save treats for occasion Smooth ER- has no ribosomes; for lipid synthesis and Limit sodium detoxification Principles of Diet Therapy: Eat more produce Rough ER- has ribosomes for protein synthesis To maintain good NS Consume whole grains Ribosomes- protein synthesis To correct deficiencies Nutritional Status- balance between intake of nutrients and Golgi apparatus- sac that synthesize carbs; package To afford rest to body the expenditure of these in the processes of growth, material through the release of secretory vesicles To make changes in body weight reproduction, and health maintenance. Mitochondria- ATP synthesis; have inner folds called cristae To metabolize nutrients Lysosomes- has digestive enzymes that breaks down Purpose of Therapeutic Diet: (ARMPITSA) Malnutrition- getting too little or too much of certain foreign substances and worn out organelles Assist body organs nutrients Centrioles- rod-shaped that organize spindle fibers during Regulate amt of food Overnutrition cell division Modify intervals of feedings Undernutrition Cilia- hair-like projections that increase surface area of the Promote greater resistance to specific cell conditions/prevention of supplemental tx Causes of Malnutrition: Flagella- whip-like motor aid in motility Increase or decrease body weight Lack of access to sufficient and affordable To improve specific health conditions food/food insecurity MACRONUTRIENTS: Significant useful in managing disease Digestive problems and issue with nutrient CARBOHYDRATES- organic compound composed of CHO; Aid in digestion absorption major source of energy BILAR, SEAN ASHLEY A. (BSN 202) GROUPS: POLYSACCHARIDES FATS/LIPIDS MONOSACCHARIDES- simplest sugar; sweet and requires Starch- most significant polysaccharide; include -composed of CHO. Triglycerides/ fats and oils are fatty no digestion; can be absorbed in bloodstream from small cereals, grains, potatoes, root veg. converted to acids ester of glycerol. They belong to a class of fat-related int. glucose. Requires longer time to digest but supplies compounds called lipids Glucose- AKA the “blood sugar”; abundant in fruits, energy for a longer period sweet corn, syrup. Mainly created in the body from Dextrin- not found in foods; formed as intermediate starch digestion. Fuels the body cells and lasts for product in starch break down Classification: hours; the only one that supply energy in brain and Cellulose- found in plants, unrefined grains. Non- Simple lipids- called neutral fats; chemical name is nerve cells. When a person doesn’t have enough digestible, provides bulk in diet and stimulates triglycerides (a glycerol with 3 bases of fatty acids). glucose, proteins are break down to become an peristalsis Glycerol is derived from water-soluble form of carbs alternative for energy called as gluconeogenesis Soluble fibers are found in fruits, legumes, barleys, Compound lipids- combination of fats with other If there is no enough glucose and proteins, stored and oats, which delay GIT transit and glucose components fats in our body are broken down to form ketone absorption PHOSPHOLIPIDS- fatty acid, phosphoric acid, and bodies. Excessive ketone bodies lead to ketosis that Insoluble fibers found in wheat, corn brans, whole nitrogenous bases disturbs acid-base balance. When carbs are too grain bread, which accelerates GIT transit, increase Lecithin- most widely distributed; placed in liver and much, liver break it to smaller molecules to form fat fecal weight, slow down starch hydrolysis and delay egg yolk. Added to cheese, margarine, and and be stored in the tissue glucose absorp confection to aid EMULSIFICATION Fructose- the sweetest; found in honey, fruits and Pectins- non-digestible, colloidal polysaccharide Cephalin- needed to form thromboplastin for veg having gel quality, thus a base for jellies. Used to blood-clotting process Galactose- not found free in foods; only achieved treat diarrhea as they absorb toxins and bacteria in Sphingomyelin- found in brain and nerve tissues as during lactose digestion; some infants are born with the intestine component of myelin sheath an inability to metabolize galactose called Glycogen- animal starch, stored glucose in liver galactosemia and muscle GLYCOLIPIDS- fatty acids, carbs, and nitrogenous bases Cerebrosides- component of nerve tissue and cell DISACCHARIDES- combination of 2 simple sugars DIGESTION OF CARBS: membrane. Carb component is galactose SUCROSE (GLUCOSE + FRUCTOSE)- or table sugar; Mouth- a-amylase secreted by parotid glands; acts on Gangliosides- made up of glucose, galactose, and found in fruits, veg, syrups. Converted to glucose starch to break it t dextrin and maltose complex compound containing amino sugar and galactose upon digestion In stomach- no enzyme, no action (ptyalin may constitute) LIPOPROTEINS- lipids with protein. Formed in liver. Insoluble In small intestine- enzyme pancreatin, amylopsin, converts in water and combined in protein complex for transport of LACTOSE (GLUCOSE + GALACTOSE)- found in milk starch to dextrin and maltose aqueous medium. products except cheese; converted to glucose and galactose in digestion; LESS SOLUBLE AND LESS FUNCTIONS OF CARB: (FILE ME) DERIVED LIPIDS- simple derivatives from fat digestion. SWEET than sucrose, thus stays longer in the intestine Major source of energy Produced from fat compounds and promotes growth of good bacteria. Cow’s milk Exert protein-sparing action/gluconeogenesis Saturated fats- no hydrogen can be added; contain 4.8% of lactose, while human milk has 7% For normal fat metabolism palmitic and steric acid (amino fat) MALTOSE- not found free in foods. Produce via Elimination of cellulose Monounsaturated fats- 2 carbon atoms are joined hydrolysis of starch and converted to glucose. Laxative action by double bond; oleic acid Found in malt products like cereals Integrity of nerve tissues Polyunsaturated fats- two/more double bound; HEALTHIEST; linoleic acid BILAR, SEAN ASHLEY A. (BSN 202) Steroids- fat-related substance w/ cholesterol as its main -greek word “protos:, meaning primary/ranking first. First to Threonine- fat metabolism and increase muscle member be recognized as a vital part of living tissue. Basic unit is function amino acid Leucine- skin and bone healing OMEGA 6-3 RATIO (ESSSENTIAL FATTY ACIDS) CLASSIFICATION: Isoleucine- O2 carrying pigment of RBC that makes -plants make omega 3 abd 6, but 6 is most common in SIMPLE PROTEIN- yield only amino acid only upon hydrolysis hemoglobin; control blood sugar plants. Linoleic acid for omega-6, while linolenic acid for Albumin- soluble in water, coagulated by heat Valine- increase energy, endurance, muscle tissue omega-3 Globulin- insoluble in water, soluble in dilute salt recovery solution, coagulated by heat Lysine- carnitine production that converts fatty acid DIGESTION OF FATS: Glutelin- insoluble in neutral solvents, but soluble in to energy Mouth- no enzyme; mechanical mastication weak acid and alkaline, coagulated by heat Methionine/- regulate metabolic processes, innate Stomach- no enzyme; mechanical separation of fats and Prolamin- soluble in 70-80% alcohol, insoluble in immune system protein absolute alcohol , water and salt solution Phenylalanine- production of neurotransmitter Small int-bile salts emulsify fats; pancreatic lipase Albuminoids- insoluble in all neutral solvent, dilute norepinephrine and dopamine acids and alkalis Tryptophan- found in milk that induce melatonin to FUNCTIONS: Histone and protamine- basic polypeptide soluble promote sleepiness and serotonin Sources of calories in water, but not coagulated by heat Protein-sparing COMBINE PROTEINS- combination of simple proteins and NON-ESSENTIAL AMINO ACIDS Maintain body temp prosthetic group. -can be synthesized in our body, thus not necessary in diet Provides cushion for vital organs Nucleoproteins- simple protein and nucleic acid; Glycine- antioxidant, anti-inflammatory, Absorption of fat soluble vitamins deoxyribonucleic proteins necessary for synthesis of cryoprotective Provides safety and delay hunger protein in cytoplasm Alanine- breaks down tryptophan and Vit.b6, sugar Mucoprotein and glycoprotein- protein and and acid metabolism, increase immunity EFFECTS OF LIPIDS: complex polysaccharides like mucin found in Aspartic acid- hormone production Monounsaturated fatty acids- decreased risk of heart secretion of gastric mucous membrane Glutamic acid- help nerve cells to send and disease Lipoprotein- protein and triglycerides or receive info to other cells Omega-3- increase blood cholesterol phospholipid or cholesterol Proline- component of collagen Can promote cancer Phosphoprotein- phosphoric acid joined in ester Hydroxyproline- collagen stability linkage to protein found in casein milk Cystine- Vit. B6 utilization, help speed burn recovery TRANS FAT- the UNHEALTHIEST/BAD FAT; artificial fats made Chromoprotein- protein and non-protein pigments Tyrosine- production of neurotransmitters via partial hydrogenation that lengthen shelf-life of food. food in flavoprotein, hemoglobin, and cytochromes Serine- biosynthesis of proteins May contain HDL (good cholesterol) that unblocks arteries, Metalloprotein- compound/metals attracted to Arginine- generation of nitric oxide and increase triglycerides that can lead to CVD protein found in ferritin, hemosiderin, and transferrin Histidine- repair damaged tissues Cis- 2 hydrogen atoms are on the same side, results DERIVED PROTEIN—products formed in various stages of Complete proteins- food that contain all essential amino in bonding hydrolysis of protein. The amino group of one amino acid acids Trans- 2 hydrogen atoms are on the different side joins the acid (carboxyl) group of another. The chain is Incomplete proteins- deficient in one called peptide chain. Long chains are called polypeptide PROTEINS DIGESTION OF PROTEIN: ESSENTIAL AMINO ACIDS In mouth- no enzyme, mechanical mastication -can’t be synthesized in our body, thus necessary in diet BILAR, SEAN ASHLEY A. (BSN 202) Stomach- enzyme pepsin (precursor of pepsinogen), MARASMUS- severe deprivation of food over a long period Condition needed for BMR TEST: activated by HCl of time; protein and caloric deficiency; 1 year old and Must be in fasting or post absorptive state, 15 hours Action- converts protein to proteoses and peptones below after the meal In small intestine (alkaline) S&Sx: sunken eyes, thin and bony face, poor Must be awake, lying quietly, and free from physical In pancreas- trypsin (precursor of trypsinogen) activated growth, ribs clearly visible; loss muscle mass fatigue, nervousness, or tension by enterokinase, converts protein, proteoses, and KWASHIORKOR- abrupt and recent deprivation of food; Environmental temp. should be 20 C-25 C peptones to polypeptides and peptides protein deficiency ONLY; 6months to 3 years old Chymotrypsin (precursor chymotrypsinogen) S&Sx: moon face, thin brittle hair, building FACTORS THAT AFFECT BMR activated by trypsin, converts proteoses and abdomen (ascites) Surface area peptones to polypeptides and dipeptides; Sex coagulates milk PHYSIOLOGIC VALUE OF FOOD Age Carboxypeptidase convert polypeptides to simpler Metabolism- Greek word “metabolismos”, meaning Body composition peptides change/alter. It’s a chemical process of transforming food State of nutrition Aminopeptidase converts polypeptide to peptides into complex tissue elements and transform complex body Sleep and amino acid substance to simple ones, along with the production of Endocrine gland Dipeptidase converts dipeptides to amino acids heat and energy; TOTALITY of chemical process in our Fever body FUNCTION OF PROTEIN: TYPE OF ACTIVITIES: Tissue repair (anabolism), caused by wear and tear catabolism- break down molecules and release Sedentary- reading, writing, eating, watching TV, office (catabolism) energy work Build new tissue anabolism- construct things and use energy Light activities- cooking, washing dishes, ironing, welding, Source of heat and energy burning of glucose; standing Enzyme-aid with biochemical reaction C6H12O6 + 6O2 = 6CO2 + 6H20 + energy Moderate activities- mopping, scrubbing, sweeping, Maintenance of normal osmotic relation of body gardening, carpentry, walking fast fluids Energy- source/power that enable the body to do its work. Heavy activities- heavy scrubbing, hand washing, walking Resistance of body to diseases In nutrition, it’s a chemical energy locked in food stuffs fast, bowling, golfing, heavy gardening Biologic Value (BV)- effectiveness of protein quality in brought by metabolism supporting body needs Net Protein Utilization- measures how capable protein is Calorie- unit of energy (kcal) MICRONUTRIENTS used by the body’ measure retention of nitrogen 1 carb= 4 calories/g VITAMINS Protein Efficiency Ratio (PER)- measures increase in weight 1 protein= 4 calories/g -“vita” means life, “amine” means nitrogen, but not all of growing animals 1 fat= 9 calories/g vitamins contain nitrogen -word vitamin coined by “Casimir Funk” in 1912 when he EFFECTS: Joule- measure of energy in metric system was searching for a constituent in rice brand which could Cancer- high intake of animal protein 1 calorie= 4.184 kilojoules cure beriberi. Increased osteoporosis- because of Ca excretion rises as Basal metabolism- AKA “required energy expenditure -group of unrelated organic compounds which are protein is intake (REE), is the measure of energy needed by the body at rest needed in small quantities, but essential for growth and for all internal chemical activities health maintenance PROTEIN-ENERGY MALNUTRITION (PEM) BILAR, SEAN ASHLEY A. (BSN 202) -crucial in growth, repair, and healthy functioning of body Micronutrients (amount not Si, V, Sn, Se, Mn, Ni, Mo Increased serum tissues; DO NOT give energy to the body. estimated) triglycerides in -shortage of vitamins leads to fatigue, and longer vitamin Minerals (function Sr, Au, Al, As, Br, Ag, Bi, B women deficiency results in health deterioration unknown) Decreased thyroid -human body cannot make their own vitamins EXCEPT hormone in women VIT.D & Niacin Vitamins (water-soluble) Toxicity from overdose Vitamin K Blood-clot -Shortage of Vit. A,B,C can lead to loss of appetite Vitamin C Diarrhea, Jaundice nausea/cramps, TERMS ASSOCIATED WITH VITAMINS: excess oxalic acid, Fat-soluble have precursors provitamins; they can be Precursor/Provitamins- can be changed to active urine acidity, stored in the body, thus deficiencies are slow to develop. against therapeutic Stable in cooking methods vitamins. Examples are carotene, eryptoxanthin are drugs precursors of Vit.A. Ergosterol becomes Vit.D when radiated conditioning to a Water soluble vitamins must be supplied in every diet, they higher req. for do not have precursors, can’t be stored in the body and Preformed vitamins- naturally occurring vitamins that are infants and mother easily excreted in the urine, thus deficiencies symptomps inactive and ready tor biological use intestinal delivery fast, and easily be destroyed. obstruction Avitaminosis- condition when there is a lack of vitamin. false positive urine, diabetic test FAT-SOLULBLE VITAMINS Later in this stage, nutritional deficiency occurs. Ex. Avitaminosis Vit. A leads to night blindness and bitot’s DNEUACIF VITAMIN A (RETINOL) spots. Preformed vitamins- in animals Niacin (BLUN) Burning skin, Provitamin A- precursor of carotene; pigment in Hypervitaminosis- AKA “vitamin toxicity”; excessive flushing, itching plants accumulation Liver, eye damage Absorption: aided by bile salts, pancreatic lipase, and Vitamin malnutrition- too much or too little vitamins N&V dietary fat Diarrhea Carotene is converted to Vit.A in intestinal wall Vitamin-like compounds- larger amounts and partially Vitamin B12 Allergic shock when Absorbed through lymphatic system and portal synthesized in our body such as inositol, choline, lipoic acid, injected blood to liver and ubiquinone. Large storage in liver, hence toxicity is at risk when Fat soluble Toxicity from overdose taking large amts Antivitamins/vitamin antagonists- interfere with the normal Vitamin A Liver damage Stability: functioning of vitamin. Hair loss Heating, oxidation, and UV light destroys it. Vit. E Ex. Vit.K and biotin against dicumarol, thiaminase against Bone damage thiamine/Vit.B can be combined to preserve it Birth defects Function: Vitamin D Hypercalcemia Macronutrients (essential Ca, Cl, S, K, Na, Mg, P Vision purple (rhodopsin), light sensitive pigment in Brain damage at levels of 100mg or retina. Vit.A deficiency leads to rods and cones to Heart damage more/day) not adjust in light, resulting to night blindness Birth defects Micronutrients (essential at Fe, F, Zn, Cu, I, Cm, Co Vitamin E Cramps, diarrhea Maintenance of epithelial tissue including skin levels higher than few Dizziness, blurred integrity, internal mucosa, and growth and mg/day) vision formation of tooth buds. Lack of Vit.A results to BILAR, SEAN ASHLEY A. (BSN 202)  keratinization of the mucous membrane lining of Skin lesion/ food skin/phrynoderma resp, digestive, urinary tract. Toxicity: Xeropthalmia- keratinization of eye epithelium Headache Growth and development of skeletal tissues upon Skin thickening protein synthesis and bone cell differentiation by Swollen bones retinoic acid Coarse sparse hair Reproduction and lactation Spleen and liver enlargement Deficiency: Cessation of menstruation Tetany- muscle twitching, cramps Hypercarotenimia- gives orange skin color Rickets- defective bones and retarded growth; softening of bone VITAMIN D (CALCIFEROL) Dentition and closing of fontanel in infants are Sterols- hormone-like, formed in skin by irradiation of delayed cholesterol by sunlight Osteomalacia (adult rickets) Absorption: Ca and P in small intestine; stored in liver but Toxicity: not much than Vit.A Nausea Stability: STABLE Diarrhea Functions: Polyuria Absorbs Ca and P responsible for normal growth Weight loss and development, formation of bones and teeth Demineralization of bones and mineral deposits in soft tissue Renal damage Uremia Hypercalcemia (1,000-3,000 IU/kg and hypersensitivity Sources: margarine, butter, milk, cheese, fish, sardines, egg yolk VITAMIN E (TOCOPHEROL) Resistant to oxidation (antioxidant) Absorption: aided by bile fats Functions: Deficiency: As lipid antioxidant; prevents formation of peroxides Night blindness from polyunsaturated fatty acids Eye lesion Enhance the activity of Vit.A, and protects Vit.C Bitot’s spots Stability: fairly stable to heat and acids and unstable to Xeropthalmia alkalis, UV, oxygen, rancid fats, lead, and iron. Retarded growth Deep freezing and deep-fat frying destroy Lower resistance to infection tocopherol Keratinization of epithelium BILAR, SEAN ASHLEY A. (BSN 202)  -fat-soluble, synthesized by normal intestinal bacteria Vomiting Absorption: lacteals, portal blood to liver, small amts Hemolysis Functions: Albuminuria Prothrombin maintenance level in plasma Kennicterus- accumulation of bile pigments n gray (coagulation) matter of CNS Synthesis of proconvertin needed for Sources: liver, dark green veg, wheat bran, veg.oils, phosphorylation (adds phosphate to glucose) soybean oil Stability: destroyed by sunlight, but not in ordinary cooking methods, unstable to alkalis WATER-SOLUBLE VITAMINS VITAMIN C (ASCORBIC ACID) -easily oxidized, unstable; other animals can synthesize vitamin c from glucose Absorption: easily absorbed in small int.; not sored in tissue deposits; large amt present in adrenal tissues Functions: Formation and maintenance of intercellular cementing substance. Binder that holds cell to each other. Converts folic acid to folinic acid (active form) Heal wounds and bone fractures Prevents megaloblastic anemia and petechiae hemorrhages Builds body resistance against infection Produce steroid hormones, esp. adrenocortical hormones and aids in insulin synthesis Tyrosine and phenylalanine metabolism Deficiency: Brain metabolism, has antioxidant properties Hemolysis or RBC Stability: lost in cooking, combined with water Increased excretion of creatine and decrease for Its ascorbic content is dependent to content of fruits creatinine and veg, where they have grown, ripeness, and Toxicity: condition under cooking Hypervitaminosis E Plant sources- germ oils of wheat, corn, soybean, mayonnaise, margarine, nuts and legumes Animal sources- egg yolks, butter, milk Deficiency: Hemorrhagic disease VITAMIN K (PHYLLOQUINONE, MENADIONE) Toxicity: BILAR, SEAN ASHLEY A. (BSN 202)  VITAMIN B-COMPLEX: -water-soluble vitamins that needs to be continually replaced because of their short-life. -B vitamins transform amounts of proteins, carbs, and fats to extra energy -provide energy needed for muscle contraction -during excretion, they are involved In tissue repair Boiling meat results in 15-40% loss of Vit.B In frying, 40-50% In roasting, 30-60% B-COMPLEX VITAMIINS GROUP 1: CLASSIC DISEASE FACTORS THIAMINE (B1) -part of coenzyme factor, thiamine pyrophosphate or TPP for carb metabolism; maintain healthy appetite, muscle tone, and nerves Stability: Loss of vitamin in cooking depends in the ph of the food, time, temp, water quantity, use of sodium Deficiency: bicarb Loss of appetite Weakness Fatigue Indigestion Deficiency: Consti Irritability Poor reflexes Weakness Retarded growth Lack of appetite Beriberi- nutritional polyneuritis Lowered resistance to infections TYPES: Pallor Infantile beriberi- in infants 2-5 months of age whose Scurvy- bleeding, swollen gums, teeth, joints main food is milk from a mother who has beriberi. Toxicity: Symptoms include aphonia (loss of voice), whining, No toxicity cyanosis, DOB, Requirement/allowance: Wet beriberi- edema in lower extremities Male needs more vitamin C, as req increased progressing upward. Heart enlarged, beats during growth period become irregular Pregnancy, lactation, surgery, illness requires more Vit.C BILAR, SEAN ASHLEY A. (BSN 202)  Dry beriberi- involves peripheral nerves, “pins and Toxicity: doesn’t occur Deficiency: needles” (paresthesia), loss of touch sensation, Animal sources: cheese, milks, eggs, liver Injecting agonist results in N&V, seborrheic/oily muscle weakness Plant: whole grains, legumes, leafy green veg dermatitis, glossitis, conjunctivitis Toxicity: no toxicity In infants who drank milk lacking in pyridoxine Requirements/allowances: NIACIN (B3, NICOTINIC ACID) causes irritability, poor growth, anemia, convulsions. 0.2 mg/1,000 caloric intake -acts as hydrogen and electron acceptor. For energy Toxicity- observed only in rats High req in pregnancy, lactation, fever, infections, metabolism, fatty acid synthesis/oxidation, protein Food sources: veg oil, olive, peanut, wheat germ, lard, alcoholism, hyperthyroidism, and polyneuropathies synthesis/catabolism legumes Sources: lean pork liver, shellfish, egg yolk, whole grains -needed for photosynthesis and fixation of CO in animals Stability: PANTHOTENIC ACID (B5) RIBOFLAVIN (B2) More stable than thiamine and riboflavin and -essential for carbs, protein, and fat metabolism -component of coenzyme, flavin mononucleotide (FMN), resistant to heat, light, air, acids and alkalis -maintain normal growth, healthy skin, and integrity of CNS and flavine adenine dinucleotide (FAD) Deficiency: -part of coenzyme A, has metabolic roles in cells -fat, lipid, and carbs metabolism Anorexia -needed to convert tryptophan to niacin Indigestion Stability: water-soluble; stable in moist heat -maintain skin health, tongue and mouth, normal vision, Skin changes Deficiency: growth and dvlpmnt Pellagra- characterized by 4Ds (dermatitis, Insomnia, muscle cramps, tingling sensation, Stability: stable to heat, oxidation, and acid. dementia, diarrhea, and even death. Blackish/dark vomiting patches appear in areas exposed to sunlight Toxicity: no toxicity caused bilateral dermatitis. Requirements/allowances: 5mg of pantothenic acid Glossitis Sources: liver, meats, eggs, milk, cheese. Good sources are Angular stomatitis (cracked in the mouth corners) lean beef, potatoes, whole wheat bread, and dried beans Toxicity: Hypermotility (acidity of stomach, paralysis in resp. COBALAMIN (B12) center) -normal metabolism and growth of all cells; in GI tract, Food sources: bone marrow, nerve tissue Animal sources: liver, glandular organs, lean meats, fish -aids in transfer of methyl groups in synthesis of nucleic and poultry, milk and cheese, eggs acids, purines, and pyrimidine intermediates Plant sources: legumes, nuts, whole grains, enriched -involved in myelin formation cereals, and green veg -folic acid absorption and metabolism GROUP II: MORE RECENTLY DISCOVERED COENZYME Stability: 70% retained in cooking FACTORS Deficiency: Deficiency: PYRIDOXINE (B6) Demyelination of nerve fibers Ariboflavinosis- tissue changes in skin, eyes, mouth, -active form in cells; pyridoxal phosphate (PLP) is a Pernicious anemia nose, and tongue. Develops seborrheic dermatitis coenzyme that function in protein, fat, and carbs Toxicity: no toxic effects (scaly, greasy skin w/ burning sensation) metabolism Sources: animal protein Photophobia- dimness of vision -essential for tryptophan formation and conversion from Glossitis tryptophan to nicotinic acid B-COMPLEX VITAMINS Cheilosis (swollen lips) BILAR, SEAN ASHLEY A. (BSN 202) GROUP 1V: OTHER RELATED FACTORS (PSEUDO-VITAMINS) Absorption: Increase stability of Ca Better during periods of increased body needs such Sources: nuts, soybeans, meat, milk, seafoods, peas, cocoa INOSITOL as growth, pregnancy, and lactation. Decreased in Deficiency: -In meat and extractives, muscle and glandular organs, old age Lacking- HYPOMAGNESEMIA (HIGH IN EVERYTHING) brain, legumes and nuts, fruits and veg Vit.D enhances Ca absorption by increasing -high bp, tachycardia, hyperreflexia, twitch, tetany -abundant in diet; similar to glucose called “muscle sugar” permeability of intestinal membrane and activates Excess: HYPERMAGNESEMIA (LOW IN EVERYTHING)- -a lipotropic agent active transport system hypotension, hyporeflexia, bradycardia, +TROSSEAU AND -phosphoinositols which help in transport and fat Low gastric pH (acidic) favors Ca absorption, CHVOSTEK SIGNS) metabolism whereas hypochlorhydria (alkaline medium causes mineral precipitation) SODIUM (135-145 mEql/L) CHOLINE Ca:P is 1.5:1 in infants, while in adults 1:1 -50% in ECF and ICF surrounding cells, 10% within cells, 40% -a lipotropic agent (mobilizes fats and prevents build-up of Oxalic and phytic acid interferes with Ca in skeleton of bony crystals. 1.8 mg/kg fat-free TBW fatty acids) absorption Functions: -needed for fat transport as a constituent of phospholipids Increased in GI motility like laxative may reduce Maintenance of fluid balance, acid-base balance namely lecithin, cephalin, and sphingomyelin passage of food in intestinal tract Allow passage of glucose in cell wall for muscle -helps in transmission of nerve impulses Caffeine increase Ca absorption irritability Deficiency: Sources: kuhol, cheese, seaweed, malunggay leaves, Sources: carrots, celery, beets, soy sauce, catsup, Results in fatty livers in cases of chronic alcoholism saluyot, evap.milk processed foods and kwashiorkor Deficiency: Deficiency: Source: best source- egg yolk, liver, brain, kidney, heart, Lacking: HYPOCALCEMIA (Look for CATS GO NUMB) Lacking- HYPONATREMIA (Look for SALT LOSS) meats, legumes and nuts Convulsions, arrhythmias, tetany, spasms and stridor, GO Stupor/coma, anorexia, lethargy, tachycardia, limp NUMBness in finger, face limbs; +TROSSEAU SIGN, muscles, orthostat hypotension, seizures, stomach MINERALS +CHVOSTEK SIGN; retarded growth, rickets, osteomalacia, cramping (hyperactive) -elements in their simple inorganic form; AKA “trace tetany elements” (in small amts) Excess: HYPERCALCEMIA (Look for BACK ME) Excess: HYPERNATREMIA (Look for FRIED SALT) Bone pain, arrhythmias, cardiac arrest, kidney stones, Flushed skin, restlessness, increased fluid and BP, edema GROUP 1: MAJOR MINERALS muscle weakness, excessive urination (pitting), decreased urine output, skin flushed, agitation, CALCIUM (9-11 mg/dL) low-grade fever, thirst Distribution: 1.5-2.2% in TBW. 99% are present in bones, while MAGNESIUM (1.5-2.5 mg/dL) 1% is found in soft tissue -50% in bones in combination with phosphate and calcium. Medication: Functions: 1% in ECF, mostly in muscles and RBC. Next to K as Hyper: administer IV infusions (if due to fluid loss), give Combines with P to form calcium phosphate, the predominant cation in living cells thiazide/loop diuretics to promote salt excretion, restrict hard material in bones and teeth Functions: sodium in diet Muscular contraction/relaxation Part of enzyme system for transport of energy Promotes blood coag Core of chlorophyll molecule, important in Hypo; ADD SALT Affects transport function of cell membrane as photosynthesis administer IV NaCl solution stabilizer Essential in cellular metabolism, regulates BP diuretics (if due to hypervolemic hyponatremia) Nerve transmission and regulation of heart beats Conduction of nerve impulse and allow muscle daily weights contraction safety BILAR, SEAN ASHLEY A. (BSN 202)  airway protection pH regulation as anion component of hemo and myoglobin, carrier of O2 limit water intake involves in phosphorylation for cellular respiration teach abt foods high in Na Sources: cheese, milk, dairy products, meat, poultry, fish conversion of betacarotene to Vit.A, purine Deficiency: synthesis, antibody production, collagen synthesis POTASSIUM (3.5-5 mEq/L) do not cause harm when taken in excess, as it ca NOTE: Iron in ferrous form is BETTER absorbed than in ferric -principal cation in cells and ICF. 2.6 mg/kg fat-free TBW be excreted through stool form Functions: TYPES OF IRON: Fluid and electrolyte balance SULFUR (140 mg) heme iron- found only in meat, more absorbed in Activity of skeletal and cardiac muscles -in cytoplasm, but mostly found in hair, skin, nails the body Muscle relaxant non-heme- from cereals, veg, and eggs. Non-heme Carbohydrate and protein metabolism and Vit.C increase non-heme iron absorption Sources: meat, legumes, milk, fish, juice, dark green veg Functions: Dietary req: 2-6 mg maintain protein structure -when unbound transferring is saturated with iron, iron Deficiency: activates enzyme absorption is decreased. When level of unbound Lacking: HYPOKALEMIA (Look for HOST HAPEN) detoxification transferring is high (indicates that blood freed iron), iron Hypoactive bowel sounds, orthostat hypo, shallow resp Sources: protein contain 1% of sulfur absorption is increased, just like during pregnancy and thready weak pulse, hyporeflexia, anxiety, paresthesias, Deficiency: lactation ECG changes (ST depression, inverted T waves, prominent A hereditary defect in tubular reabsorption of amino acid -increased fiber and coffee intake interferes with iron U wave), N&V cystine may lead to excessive excretion in the urine absorption causing cystinuria. NOTE: 40-50 mg of ascorbic acid intake increase iron Excess: HYPERKALEMIA (Look for MURDER) absorption from 3.7-10.4% Muscle cramps, urine abnormalities, resp distress, CHLORINE (95-105 mEq/L) decreased cardiac contractility, ECG changed (tall T -major anion in ECF; CSF has the highest chloride; found in Sources: organ meats, rice bran, sweet potato, spag, dried waves, flat P waves, wide QRS complex, prolonged PR GI secretion as HCl beans, ampalaya leaves, kulitis intervals), reflex increased Deficiency: Functions: anemia Medication: fluid and electrolyte balance, acid-base hemorrhagic anemia (excess iron) Hyper: potassium-excreting diuretics, dialysis, IV calcium acidity in stomach Inadequate RBC formation because of Vit.B12 gluconate/sodium bicarb sources: table salt deficiency Hypo: oral K supplements, liquid KCl, potassium-sparing deficiency: Hemosiderosis- excess iron diuretics, potassium-excreting diuretics (Amiloride, alkalosis- excessive loss of chloride from gastric secretions Hemochromatosis- genetically transmitted disease spironolactone, eplerenone) during continued vomiting, diarrhea, tube drainage which patients absorb large amounts of iron and store them in tissues that normally do not store iron PHOSPHORUS (2.5-4.5 mg/dL) GROUP II: TRACE MINERALS -1% in the body; 85% in the inorganic phase of bones and IRON COPPER teeth -75 mg/kg fat-free TBW; 60-75% in hemoglobin, 55 in -all tissues have traces of copper myoglobin, 26% in liver, spleen, and bone marrow. Functions: Functions: Hemoglobin formation Component of bones and teeth Functions: Promotes iron absorption in GIT BILAR, SEAN ASHLEY A. (BSN 202)  Catalyst in oxidation-reduction Functions: Req: daily intake of 50-500mg Maintain myelin sheath Constituent of Vit.B12, necessary for RBC formation Deficiency: Part of tyrosinase (involved in pigment melanin) Sources: liver, oysters, clams, lean beef, saltwater Headache Bone formation Deficiency Night blindness Sources: organ meats, shellfish, nuts, cocoa, cherries, Polycethemia- increase RBC and hyperplasia/enlargement Lethargy mushroom, leafy veg, eggs of bone marrow Coma Deficiency: Abnormal sulfur metabolism Lacking: ZINC (2-5g) Depigmentation of skin color -700-800 mg , 80% in RBC, 4% in WBC and platelets GROUP III: OTHER TRACE MINERALS CNS abnormalities -serum zinc is about 90-100 mg/100ml. human milk contains FLUORINE Hypotonia, hypothermia 3-4 mg zinc/l -found in bones and teeth and little in thyroid gland Microcytic anemia Functions: Functions: Skeletal mineralization Metalloenzymes Dentine and enamel of teeth Excess: Present in RNA Effective in osteoporosis treatment Wilson’s disease (brain and liver abnormalities) Hormone insulin, glucagons, ACTH, growth hormone, Sources: water gonadotropin, and testosterone Small amts: fruits, veg, cereals IODINE (20-30 mg) Enhances wound healing and sense of taste Large amts: seafoods and tea leaves -70-80% in thyroid gland Sources: milk, meat, liver, oyster, eggs , nuts, legumes Acc to WHO: fluoridated salt/milk Functions: Deficiency: Deficiency: Production of thyroid hormone Lacking: Lacking: dental caries Thyroxine synthesis Slow growth Excess: Sources: seafoods, seaweeds, iodized salt alopecia Dental fluorosis- melting of enamel Deficiency: disturbance in keratinization Osteosclerosis Goiter- thyroid enlargement hypospermia Growth depression Cretinism- insufficient intake of mother during pregnancy delayed sexual maturation Fetal poisoning depriving the fetus with the nutrient cretin, thus child suffer WBC defects from hypothyroidism Excess: SELENIUM Myxedema- severe hypothyroidism (enlarged thyroid, puffy N&V -in soil content where food is grown face, bradycardia, constipation, hypothermia) Abdominal cramps Functions: Diarrhea Prevents Vit.E deficiency MANGANESE (10-20mg) Fever Component of gluthatione peroxidase (inactivates -found in liver and kidneys peroxides that cause oxidation of rancid fats) Functions: MOLYBDENUM Sources: organ, muscle meats, cereals, dairy prod Catalyst in enzymes necessary for glucose and fat -9mg in our body Deficiency: metabolism Function: Muscle pain Sources: nuts, whole grain, cereals, dried legumes, tea Present in Xanthine oxidase, aldehyde oxidase, and Pancreatic degeneration Deficiency: none sulfite oxidase Hemolytic anemia Sources: dried peas, beans, lean meat, poultry COBALT CHROMIUM BILAR, SEAN ASHLEY A. (BSN 202) -fetal chromium is 6-10mg Functions: Raises low blood sugar levels Fatty acids synthesis and cholesterol Sources: corn oil, clams, whole grain, cereals, veg Req: 50-200 mcg/day in adult VANADIUM -constituent of human tissues Function: Appetite crystal formation of tooth enamel, may lead to dental decay Req: 0.1-0.3mg/day NOTHING BEATS THE PASSION AND DETERMINATION WE PUT IN EVERY ACTIONS WE MAKE. YOU WILL SOON OBTAIN THE FRUIT TO ALL OF YOUR HARDWORK AND EFFORTS IN LIFE. PADAYON LANG SA’TIN FUTURE NURSES!! BILAR, SEAN ASHLEY A. (BSN 202)