Chapter 15

Question 1

Mineral Facts: What are they? How many does the body contain? How many essential and what are they?

Answer 1

•Cannot be created or destroyed by living organisms
•The body contains 40 or more minerals
•15 are essential nutrients and must be in our diets
–Macrominerals: Sodium, Chloride, Phosphorus, Calcium, Potassium, Magnesium
–Microminerals: Iron, Zinc, Copper, Selenium, Iodine, Manganese, Fluoride, Chromium, Molybdenum
•Certain minerals are cofactors for enzymes
•Bound to proteins in foods

Question 2

Minerals and Electricity: Do they carry a charge? What happens?

Answer 2

•Certain minerals carry a charge
–The charge carried by minerals allows them to combine with other minerals of the opposite charge
–They then form stable compounds that become part of bones, teeth, cartilage, and other tissues
•The electrical current generated by charged minerals can be recorded by an electrocardiogram (EKG or ECG)

Question 3

Sodium: What kind of mineral? What is the most common form?

Answer 3

Sodium
•Sodium is an extremely reactive mineral
– Occurs in nature in combination with other elements
–Much of the sodium present on this planet is in the form of sodium chloride (NaCl) —table sal

Question 4

Sodium Functions: How many functions? What does high sodium intake do?

Answer 4

•Functions
–Regulates body fluid in blood & tissues
•Key for retaining body water
–Muscle contraction
•High sodium intake
–Breaks water balance
–Can cause HTN (hypertension) in those who are salt sensitive (10%-15%)

Question 5

Hypertension (High Blood Pressure): What is it? What are the consequences?

Answer 5

•Systolic blood pressure/diastolic BP
–Normal : 120/80 mmHg
–Elevated : >140-90 mmHg

•Consequences
–Artery damage
–Blood clots
–Heart attack/stroke

Question 6

Causes of HTN?

Answer 6

•Essential hypertension (primary)
–No known cause
–90–95% of all cases
•Salt sensitivity
–Genetic condition in which blood pressure rises when excess sodium is consumed
–Approximately 51% of people with hypertension and 26% of people with normal blood pressure are salt sensitive
–Salt sensitivity is most common in African Americans

Question 7

Risk Factors of HTN: There are 8

Answer 7

•Aging
•Genetic predisposition
•Atherosclerosis
•Obesity
•Inactivity
•Frequent stress, anxiety
•Excess alcohol
•High sodium intake
–Sodium pulls water
–Fluid retention leads to increase blood volume

Question 8

Sodium Reduction Tips: There are 2

Answer 8

•Avoid
–Processed foods
•Food prepared in brine
•Salted smoked meat
•Salty snacks
•Fast foods
•Try to
–Add salt after cooking
–Use vinegar, herbs, spices
–Read labels

Question 9

DASH Diet (Dietary Approach to Stop Hypertension): What is it?

Answer 9

–Low sodium
–Low fat & saturated fat
–Emphasizes calcium, magnesium, potassium
–Daily Servings
•Veggie (4-5 servings)/fruits (4-5 servings): 8-10
•Grains: 7-8
•Meats, fish, poultry: <2
•Nuts, seeds, dried beans: ~1

Question 10

HTN Treatment Options: There are 8

Answer 10

•Dietary and lifestyle changes
•The use of medications if necessary
•Weight loss and smoking cessation
•A reduced-sodium diet
•Regular exercise
•Moderate alcohol consumption
•The DASH diet – based on vegetables, fruits, low-fat dairy products, whole grains, and poultry and fish
•Food product labels – useful information

Question 11

Calcium: What is its functions? Causes of deficiency? RDA? Source of it?

Answer 11

•Function
–99%: teeth and bones
–1%: blood
–Blood clotting
–Nerve impulse transmission
–Muscle contractions

•Deficiency
–Tetany: muscle spasm
–High risk of osteoporosis later in life
•Low bone density

•RDA
–Women/men: 1000mg
–9-18 years: 1300mg

•Source
–Dairy product: milk, yogurt, cheese (NOT cottage cheese)
–Leafy greens (spinach has oxalic acid); broccoli, Chinese cabbage
–Ca fortified food: orange juice, soy milk
–Canned fish with bones

Question 12

Calcium Toxicity: 3 of them

Answer 12

–Soft tissue calcification
–Kidney stones
–Interfere w/ other mineral absorption

Question 13

Why Do Women Not Drink Enough Milk: 4 reasons

Answer 13

•Women tend to consume too little calcium because they may be
–Afraid dairy is “fattening.“
–Lactose intolerant
–Think milk is for kids
–Drink soft drinks instead

Question 14

Bone is a Living Tissue: What makes it a tissue?

Answer 14

•Bones are slightly flexible, living tissues infiltrated by blood vessels, nerves, and cells
–The solid parts of bones consist of networks of strong protein fibers (matrix) embedded with mineral crystals
–Calcium, phosphorus, magnesium, and carbon make bones slightly flexible, very strong, and capable of absorbing shocks

Question 15

Bone Metabolism Throughout Life
Peak Bone Mass (PBM)

Answer 15

•Peak bone mass (PBM), the greatest amount of bone you can reach, is attained at the end of skeletal maturation (~ 30 years old)
•After then, bones lose density with increasing age, which is accelerated after the menopause
•Insufficient intakes of calcium and vitamin D during adolescence leads to osteoporosis later in life

Question 16

What is Osteoporosis and Common Sites of Osteoporotic Fracture

Answer 16

•A disabling disease characterized by porous bone causing fractures
•It can be a “silent disease” and the first sign may be a fracture
•Caused by loss of minerals from the bones:
– Common fracture sites: hip, spine and wrist

•70% of people over 65 with osteoporosis have never been screened and don’t know they have osteoporosis

Question 17

Osteoporosis is What Kind of Disease? And What are the Risk Factors: There are 5 risk factors

Answer 17

•Pediatric disease (low PBM)
with a geriatric outcome (fracture)
•Osteoporosis Risk Factors
Things You Cannot Change
–Female
–Thin and/or small frame
–Post menopause
–Family history of osteoporosis
–Being Asian or Caucasian

Question 18

How to Know you Have a Small Frame?

Answer 18

Height
Wrist Size
< 5’2”

5’2 - 5’5”

< 5’5”

Wrist Size
< 5.5”

< 6”

<6.25”

Question 19

Osteoporosis Risk Factors That You Can Change: There are 7

Answer 19

•Low intake of calcium/ vitamin D
•Inactive lifestyle
•Smoking
•Alcohol
•Caffeine
•Low body weight (anorexia nervosa or bulimia
•Certain medications

Question 20

Osteoporosis Prevention: What can you take? Heathly lifestyles/physical activity?

Answer 20

•Adequate Calcium/Vitamin D intake
•Healthy lifestyle:
–decrease sodium, caffeine, alcohol, smoking
•Physical activity:
– increase weight bearing and strength exercises

Question 21

How to Get Enough Calcium Every Day: 4 foods

Answer 21

•Dairy product: milk, yogurt, cheese (low fat)
•Canned fish with bones
•Dark green veggies
•Calcium fortified foods

Question 22

Concerns For Calcium (2) and Sodium (1 and recommended intake)?

Answer 22

•Calcium load at one time
–Body can best handle about 500 mg at one time
–Consume calcium sources throughout day vs. all at one time

•Excessive caffeine
–Can increase urinary calcium excretion
–Recommended to limit intake to ~ 400 mg daily
•16 fl oz. coffee : about 250 mg
•16 fl oz. regular brewed tea: 100 mg
•16 fl oz. energy drinks: 80 to 500 mg
•Some soft drinks comparable to tea
•Some medications have caffeine

Question 23

Concerns for Excessive Sodium (1) and Alcohol (3)?

Answer 23

•Excessive sodium
–Can increase urinary calcium excretion

•Alcohol
–> 7 drinks per week is associated with greater risk of:
•Low bone density
•Falls
•Fractures

Question 24

Concerns for Oxalic Acid (2) and Fiber (1)?

Answer 24

•Oxalic acid
–In foods such as spinach, chard, beet greens and chocolate
–Binds calcium/decreases absorption

•Fiber
–Excessive fiber (supplement) can interfere with Ca absorption

Question 25

Concerns for High Protein (1) and Fruits/Veggies (2)?

Answer 25

•High protein –Unbalanced, excessively high protein diets could increase urinary excretion of calcium •Fruits and Vegetables –Vitamin A & K are critical for bone health –Contribute to maintenance of bone mineral density

Question 26

Calcium Supplement Considerations: There are 3 supplements what do they need and do?

Answer 26

•Calcium carbonate –Needs acid for absorption –with meal –Less stomach acid as we age •Calcium citrate –Doesn’t need stomach acid for absorption –Can be taken anytime –May cost more •Avoid calcium supplements from natural sources

Question 27

Physical Activity Recommendation for Osteoporosis Prevention

Answer 27

•Stress forces bone to lay down new bone itself •Do activities that “surprise” and add weight to the bone. •Need to do “weight bearing” exercise and “strength training” for at least 30 minutes daily, > 3 times weekly

Question 28

Iron: What is its functions, there are 3

Answer 28

•Cofactor for enzymes •Immune function •Oxygen transport as part of hemoglobin –Hemoglobin is the iron-containing protein in red blood cells –Most of the body’s iron supply (80%) is found in hemoglobin

Question 29

The Role of Iron in Hemoglobin: What is the process?

Answer 29

•Iron readily combines with oxygen •In the lungs, oxygen attaches to the iron in the hemoglobin molecule in the red blood cells •Hemoglobin carries bright red, oxygenated blood from the lungs to cells throughout the body •After releasing the oxygen, the free iron in hemoglobin then picks up carbon dioxide –Carbon dioxide is a waste product of energy formation from the cells •When CO2 attaches to iron, blood turns from bright red to dark bluish red •Blood then circulates back to the lungs, where carbon dioxide is released from the iron and exhaled into the air •The free iron attaches again to oxygen that enters the lungs, and the cycle continues

Question 30

Iron Deficiency and Symptoms: What is iron deficiency? What are the 5 symptoms? Consequences of deficiency?

Answer 30

•A disorder that results from a depletion of iron stores in the body •The most widespread nutritional deficiency in both developing and developed countries •About one out of every four people in the world is iron deficient •Mostly affects very young children and women of childbearing age •Serious iron deficiency leads to iron-deficiency anemia, in which hemoglobin content in red blood cells is reduced due to lack of iron –Characterized by the signs of iron deficiency plus pale appearance, easily exhausted, and a rapid heart rate •Symptoms –Weakness, tiredness, irritability –Behavioral disturbances –Impaired performance in cognitive tasks

Question 31

Food Sources of Iron: High sources (4)? Good sources (3)? What increases absorption?

Answer 31

•High sources: clams, beef, liver, oysters •Good sources: lentils/ beans, poultry, fish •Vitamin C increases absorption •Absorption increases when body stores are low

Question 32

Iron Toxicity: What happens and what are the causes?

Answer 32

•Excess iron is not easily excreted •Deposited in liver, pancreas, and heart –Damage that can cause liver disease, diabetes, and heart failure •Causes –Hemochromatosis •One in every 200 people in the United States has an inherited tendency to absorb too much iron