| Vitamins(Micronutrients | organic compounds essential in small quantities for normal metabolism and body growth and maintenance(They are not a source of energy) |
| Some vitamins are susceptible to destruction from | heat, light and air exposure |
| Classifications of vitamins | water soluble and fat soluble |
| Examples of fat soluble vitamins | A,D,E and K |
| Risks of fat soluble vitamins | They are absorbed and stored in the same way as fat so excessive intake of fat soluble vitamins may lead to toxicity |
| Examples of water soluble vitamins | B vitamins and vitamin C |
| Antioxidants | Vitamins found to delay or prevent the destruction of cell membranes in the presence of oxygen. |
| Examples of antioxidant vitamins | E,C and A |
| Benefits of Antioxiants | Decreased risk of developing cancer, inflammatory diseases, Alzheimer's and heart disease |
| Vitamin C(Ascorbic Acid) | Contributes to the healing of wounds, burns and fractures, serves as an antioxidant, enhances iron absorption, is needed to convert folic acid to its active form, and is necessary for adrenal gland function |
| DRI Vitamin C | Men:90mg/day
Women:75mg/day |
| Risks from excess Vitamin C consumption | Diarrhea and GI disturbances, may cause the body to store too much iron resulting in tissue damage |
| Risks of Vitamin C deficiency | Bleeding in bones and joints, easy bone fracture, poor wound healing, and anemia |
| Three essential B vitamins | Niacin, Folate, Cyanocobalamin |
| Role of Niacin in body | Important to to the production of energy from glucose and is involved in DNA repair |
| Sources of Niacin | Meat, poultry, fish, peanuts and enriched whole grain breads and cereals |
| DRI Niacin | Men:16mg/day
Women:14mg/day |
| Risks of Niacin | There is no risk of toxicity and deficiency is rare |
| Role of Folate in Body | Necessary for formation of DNA and proper cell division |
| Sources of folate | foods such as spinach, lentils and garbanzo beans or fortified foods and vitamins |
| Risks of Folate | Deficiency may lead to megaloblastic anemia, inadequate folic acid intake in pregnancy may lead to neural tube defects(brain, spine or spinal cord defects), |
| DRI Folate in pregnancy | 400mcg/day |
| Role of Cyanocobalamin(b12) in body | Essential role in production of hemoglobin and myelin. |
| Sources of B12 | Animal products such as lean meat, liver, seafood, eggs and dairy |
| intrinsic factor | protein secreted from stomach to break down b12. If it is missing the body is unable to break down and absorb b12 leading to pernicious anemia |
| Pernicious anemia treatments | b12 injections for life. Supplements ineffective due to stomachs lack of intrinsic factor |
| Risks involved with B12 | Strict vegetarians do not always receive adequate b12 from food and oral supplementation is needed, older adults tend to have decreased intrinsic factors therefore a oral supplement is necessary |
| DRI B12 | 2.4mcg/day |
| Role of Vitamin A in body | fat soluble antioxidant available in two forms(retinol and carotene). Important in maintaining good vision and skin and bone growth |
| Sources of Vitamin A | bright yellow and orange fruits, carrots, pumpkins and dark leafy greens |
| DRI Vitamin A | Men:900mcg/day
Women: 700mcg/day |
| Role of Vitamin D in body | Promotes calcium and phosphorous absorption, promoting healthy teeth and bones |
| Sources of Vitamin D | fortified dairy products, yeast and fish liver oils, and is synthesized by body when exposed to sunlight |
| DRI Vitamin D | Adults up to 70yo: 15mcg/day
Adults > 70yo: 20mcg/day |
| Vitamin D deficiency risks | Osteoporosis |
| Excess Vitamin D intake | GI upset, muscular weakness and calcium deposits in the kidneys, lungs and brain |
| Role of Vitamin K in Body | It is important in maintaining 4 of the 11 blood clotting factors |
| Sources of Vitamin K | Dark Leafy Greens and is made by intestinal bacteria |
| DRI vitamin K | Men: 120mcg/day
Women: 90mcg/day |
| Risks of Vitamin K | Patients of antiplatelet or anticoagulant drugs require consistent source of vitamin K to stabilize effects of drug |
| Minerals | Inorganic, single elements that help to regulate bodily functions without providing energy and are essential to good heath. |
| Major Minerals vs Trace Minerals | Major Minerals are needed in greater than 100mg/day
Trace Minerals are need in less than 100mg/day |
| major minerals(7) | Calcium, phosphorous, magnesium, sulfur, sodium, potassium and chloride |
| Trace minerals(9) | Iron, Zinc, Iodine, Selenium, Copper, Manganese, Fluoride, Chromium and Molybdenum |
| Role of Calcium in body | It plays an important role in formation of bones and teeth, aids in protecting against osteoporosis, blood clotting, transmission of nerve impulses and muscle action, and is important for metabolic reactions throughout the body. |
| How many hip fractures are associated to osteoporosis in the US annually? | 1.5 million, 15%-20% of which die from complications within 1 year |
| Causes of Osteoporosis | Calcium Intake, Genetic Influence, Gender, Hormone Levels, Physical Activity and dietary intake of vitamin D, fluoride, and other trace minerals |
| When is peak bone mass achieved? | Between 19-30 years of age |
| DRI Calcium | 1000mg/day up to age 50
1200mg/day if > age 50
Once diagnosed with osteoporosis 1500mg/day |
| Role of Sodium in the body | Functions as an electrolyte needed in small amounts for good health |
| electrolytes | a compound that can conduct electrical current |
| Risk of excess sodium | Hypertension and edema |
| DRI Sodium | 1500mg/day up to age 50
1300mg/day > age 50
Upper limit 2300mg/day |
| Signs and Symptoms to monitor for possible sodium loss | Diaphoresis, diarrhea, vomiting, renal disease and cystic fibrosis |
| Role of Potassium in body | Serves as an electrolyte necessary in conducting nerve impulses and the contraction of muscles, including the heart, helps to maintain acid-base balance, is required for conversion of glucose into glycogen and plays a role in energy production and insulin release from the pancreas |
| Risks of potassium deficiency | Hypokalemia(Blood potassium < 3.5mmol/L). Patients taking potassium-wasting diuretics and chronic laxative users are at greater risk. |
| Risks of hyperkalemia | Renal Failure, Adrenal Failure and Cardiac Arrest |
| DRI Potassium | 4700mg/day for all adults |
| Sources of Potassium | Fruits, vegetables and milk |
| Why is Potassium in a natural state better than in processed foods? | Processed foods contain added sodium while natural foods such as fruits and vegetables do not |
| Role of Iron in Body | It serves as an essential part of hemoglobin, myoglobin and many enzymes throughout the body. |
| Hemoglobin | part of the red blood cell responsible for carrying oxygen to cells |
| Myoglobin | Found in muscle tissue and is responsible for storing oxygen in the muscle |
| Iron Deficiency Anemia | Most prevalent nutritional problem in the world which may result in inadequate iron in diet, excessive blood loss, absorption problems and hemoglobin production problems. Deficiency in oxygen limits oxygen delivery to cells resulting in fatigue, weakness, headaches, skin pallor, and decreased immune function |
| Who is at greatest risk for iron deficiency anemia | children 6 months-4 years old, adolescents, menstruating women and pregnant women |
| DRI Iron | 15mg/day adolescent girls
18mg/day premenopausal adult women
8mg/day for postmenopausal women, men and children
27mg/day pregnant women |
| Sources of Iron | Meat(especially organ meat), poultry, fish, whole grains and soy as well as fortified and enriched grains |
| Heme vs nonheme dietary iron | Heme iron is found in animal tissue and is absorbed well
Nonheme iron is found in plant products and iron supplements and is not absorbed well from the GI tract |
| Factors that improve iron absorption | Meat, fish and poultry have a factor that enhances iron absorption
Vitamin C when taken with iron improves absorption |
| factors that decrease iron absorption | bran and some fibers bind iron in the GI limiting absorption
Calcium in mild and supplement form
Polyphenols in coffee tea and red wine
Antacids
Vegetable proteins(especially soy) |
| Chromium Role in body | Necessary for glucose metabolism and seems to work with insulin in regulating blood glucose levels |
| Sources of Chromium | whole grains, cheese, liver, eggs, peas, apples and nuts |
| DRI Chromium | 25mcg/day women 19-30 yo
35mcg/day men |
| What are some claims of that nutrients help to improve? | Reduce stress, prevent colds, increase sexuality, increase energy improve physical performance and reduce risk of certain diseases |
| Role of water in body | Water makes up 60% of the body and is the most vital nutrient to life. It acts as a solvent necessary for most chemical processes, provides form and structure to body tissue, transports nutrients and other substances throughout the body, lubricates and protects moving parts of the body, aids in digestion and is necessary for temperature regulation |
| s/s of dehydration | poor skin turgor, dry skin, dry mouth, cracked lips, decreased urine output, irritability and disorientation |
| Causes of dehydation | inadequate intake, vomiting, hemorrhage, burns, diaphoresis and increased urine output |
| s/s dehydration in infant | sunken fontanels, decrease in number of wet diapers, no tears when crying |
| What is the ratio of amount of water from beverages vs. food | 80% beverages, 20% food |
| What factors affect required daily water intake? | Body Size, Age, Activity Level, Metabolic Needs, and Temperature |
| DRI water | women 9 cups/day
Pregnant women up to 3L/day
men 13 cups/day |
| Why is it important to monitor elderly for dehydration? | Decreased sensitivity to thirst and greater risks for dehydration |
