How much of a healthy adults body weight is fluid?
50-70%
2/3 of body fluid is ___________ fluid
Intracellular
1/3 of body fluid is ___________ fluid
Extracellular
Lean tissues (muscle) is made up of ____% fluid
70%
Fat tissue is made up of ___ % fluid
10-20
What are electrolytes?
Mineral salts that dissolve in water and separate to form ions
T/F: There is a slight difference in electrical charge on either side of the cells membrane that is needed for the cell to perform normal functions
True
What are the predominant intracellular ions?
Potassium and phosphate
What are the predominant extracellular ions?
Sodium and chloride
Water has ______ capacity for heat.
High. It takes a lot of energy to raise it’s temperature and because the body has a lot of water, only prolonged exposure to heat can increase body temp
T/F: Cell membranes are freely permeable to electrolytes so they generally go where they want.
False
Cell membranes are NOT freely permeable to electrolytes so they generally stay where they are unless actively transported.
What is a side effect of severe diarrhea/vomiting, in regards to fluid balance?
The body loses a lot of both water and electrolytes
What is the result of water/electrolyte loss with severe diarrhea/vomiting in regards to solute concentration?
Sometimes the water loss is much greater than the electrolyte loss. Therefore the extracellular electrolyte concentration becomes very high which pushes fluid out of the cell. Dehydration.
What is the result of water/electrolyte loss with severe diarrhea/vomiting in regards to the heart?
These changes in fluid and electrolytes can change the flow of electrical impulses through the heart –> irregular heart rate –> fatal if untreated
Which two electrolytes play a big role in nerve impulse conduction?
Sodium and potassium
What happens during depolarization re: sodium?
Stimuli (ex: hand on burner) prompts changes in membrane allowing influx of sodium into nerve cell and causing it to be slightly less negatively charges. If enough sodium enters, an electrical impulse is generated along the membrane.
What happens during repolarization re: potassium?
Returns to normal electrical state by releasing potassium to ECF
What happens during muscle contraction, re: calcium?
Occurs in response to stimulation of nerve cells
Increase flow of calcium from storage site in muscle cell triggers muscle contraction.
What happens to calcium as the muscle cell relaxes post-contraction?
Muscle cell can relax once electrical signal is complete and calcium pumped back into storage.
What part of the body regulates thirst?
The hypothalamus
Name 3 situations in which the body is triggered to increase thirst
- Increased salt concentration
- Reduced blood volume and pressure
- Dry tissues in mouth/throat
What happens when ADH is released from the pituitary?
Kidneys reabsorb more water and return it to blood. Decreased urine output.
What is metabolic water?
Water formed from body’s metabolic reactions
How much water is produced from metabolic water/day?
10-14% of water needs per day
During breathing, when water continuously exhaled from lungs during expiration, how much water do we lose?
Less than 1 L /day
How much water does the body lose through heavy exercise or hot weather?
2 L/hr
How much water loss is experienced through feces?
150-200 mL /day
Name some common routes of fluid loss
- Illnesses involving fever, coughing, vomiting, diarrhea, runny notes
- Traumatic injury - internal bleeding, blood donation, surgery
- Exercise
- Environmental conditions
- Pregnancy
- Breastfeeding
- Diuretics
What is the daily water requirement for adult men aged 19-50?
3.7 L /day
What is the daily water requirement for adult women 19-50?
2.7 L/day
8 oz = ____ mL
240 mL
What vitamins/minerals are found in milk?
Protein, calcium, phosphorous, vitamin D and A
Specialized - additional calcium, vitamin E, fatty acids, sterols
What good good is found in coffee?
Phytochemicals that may lower risk T2D, liver, heart disease and stroke
1 cup of coffee/day associate with _____ decrease in total mortality
3-4%
Of what does the consumption of green tea decrease the risk?
Cardiovascular disease, is also antiplaque (in green tea mouthwash)
Dark chocolate contains a phytochemical called _______ that helps reduce risk of heart attack/stroke, onset of age-related cognitive decline
Flavanol
Only people doing rigorous exercise for ____ mins benefit from sports drinks
60
What is the recommended intake/day of sodium for aged 19-50 folks?
AI = 1.5g/day
What is the recommended intake/day of potassium for aged 19+ folks?
AI = 4.7g/day
What is the recommended intake/day of chloride for aged 19-50 folks?
AI = 2.3g/day
What is the recommended intake/day of phosphorus for aged 19+ folks?
RDA = 700mg/day
What is the major positively charged electrolyte in ECF?
Sodium
How does sodium help regulate BP?
In kidneys via excretion/reabsorption
When is it common to see hypertension?
When people consume high-sodium diets, esp. if potassium intake is low
What is hypernatremia?
High blood sodium concentration
What are the symptoms/results of hypernatremia?
- Congestive heart failure
- Kidney disease - not able to excrete sodium
- High blood volume because it pulls water from intracellular environment to the intravascular space. Leads to edema and election of blood pressure
Why can sodium toxicity lead to high blood volume?
Because it pulls water from intracellular environment to the intravascular space. This leads to edema and elevation of blood pressure
What is hyponatremia?
Low blood sodium concentration
What are the symptoms/results of hyponatremia?
Causes severe diarrhea, vomiting, prolonged sweating.
Symptoms are headaches dizziness, fatigue, nausea, vomiting, muscle cramps and can progress to seizures, coma and death
Can happen with intense physical activities and large volume of water intake
What is the function of potassium in the body re: fluids?
- Works together with sodium to maintain proper fluid balance and regulation transmission of nerve impulses and contraction of muscles.
High potassium actually helps maintain _________?
Low blood pressure
What is hyperkalemia?
High blood potassium
What are some symptoms/results of hyperkalemia?
- Can alter normal rhythm of heart resulting in heart attack and death
- Kidney failure: must monitor potassium intake carefully and avoid consuming salt substitutes
What is hypokalemia?
Low blood potassium
What are some causes of hypokalemia?
- Extreme dehydration, vomiting, diarrhea, alcohol abuse, laxative abuse
- Many deaths attributed to extreme dehydration or eating disorders are caused by abnormal heart rate due to hypokalemia.
Symptoms of hypokalemia?
Confusion, loss of appetite, muscles weakness
People on _______are at risk of hypokalemia because promote excretion of fluid as urine through kidneys and excrete potassium with it.
Diuretics
What is the primary role of B-vitamins?
To act as a coenzyme to aid with metabolism
What is the RDA of Thiamin (B1 )?
Women: 1.1mg
Men: 1.2 mg
What is the RDA of Riboflavin (B2)
Women: 1.1mg
Men: 1.3 mg
What is the RDA of Niacin (nicotinamide and nicotinic acid)?
Women: 14 mg
Men: 16 mg
What is the RDA of B6 (pyridoxine)?
W + M age 19-50: 1.3 mg
Over 51
Women: 1.5 mg
Men: 1.7 mg
What is the RDA of folate (folic acid)?
Both: 400 ug
What is the RDA of B12 (cobalamin)?
Both: 2.4 ug
What is the RDA of pantothenic acid?
Both: 5 mg
What is the RDA of biotin?
Both: 30 ug
Of what coenzyme is thamin (B1) a part?
Thiamin pyrophosphate (TPP)
What are some functions of thiamin?
- Metabolism of glucose
- Metabolism of essential amino acids : leucine, isoleucine, valine
- DNA and RNA synthesis
- Synthesis of neurotransmitters
Where can you get thiamin in your diet?
Enriched grains, wheat and yeast, pork, greens
A deficiency in what causes Beriberi?
Thiamin
What causes Wernicke-korsakoff syndrome (a brain disorder)?
Thiamin deficiency. It may result from alcohol abuse, dietary deficiencies, prolonged vomiting, eating disorders, or the effects of chemotherapy
S/s of thiamin deficiency?
- Since involved in energy generating processes the s/s are things like fatigue, muscle weakness, apathy
- Since involved in neurotransmitters: muscle wasting, nerve damage, paralysis
- Heart failure
What is an important component of the following coenzymes: flavin mononucleotide (FMN), flavin adenine dinucleotide (FAD), and the antioxidant coenzyme glutathione peroxidase.
Riboflavin
One of the functions of Riboflavin is the __________ of carbohydrates and fats
Metabolism
What is the best way to get riboflavin?
Animal products are the most significant source, also green veggies and enriched grains
What is the name for riboflavin deficiency?
Ariboflavinosis
What are the s/s for riboflavin deficiency?
Riboflavin is involved in energy metabolism so s/s are general i.e. fatigue, weakness
Extreme deficiency: irritation, inflammation, ulceration, anemia
Can impair metabolism of B6 and niacin
T/F There is no known toxicity for Riboflavin
True
Function(s) for niacin (B3)
Converted to coenzymes
Metabolism of carbs and fats
DNA replication
Cell differentiation
What nutrients are involved in energy metabolism?
Thiamin (B1), riboflavin (B2), niacin, B6, folate, cobalamin (B12), pantothenic acid, biotin
What minerals are involved in energy metabolism?
Choline, iodine, chromium, manganese, sulfur
What are good sources of niacin?
Animal products, enriched grains, leafy veggies, coffee, and tea
What is Pellagra?
A systemic disease that results from severe vitamin B3 (Niacin) deficiency. Means “angry skin.” Seen mostly in developing countries or people who abuse alcohol
S/s of Pellagra?
4 D’s Dermatitis (rash) Diarrhea Dementia Death
What is the other name for B6?
Pyrodoxine
Niacin toxicity deets?
Only seen with supplements
Which vitamin was discovered after noting that it’s deficiency was associated with convulsions in in birds and dermatitis in rats, and then later that infants fed formulas lacking this also had convulsions and dermatitis?
B6
What are some functions of Vitamin B6?
- Coenzyme for over 100 enzymes
- Amino acid metabolism: does transamination
- Neurotransmitter synthesis
- Carb metabolism: helps break down stored glycogen during exercise
- Heme synthesis
- Immune function: maintains lymphocytes, helps produce antibodies
Which vitamin helps with the metabolism of niacin and folate?
B6
What is homocysteine?
Gay cysteine
j/k: an amino acid you get mostly from meat
What vitamins are important to regulate levels of homocysteine?
B6 & B12
high levels of homocysteine can cause CVD
Deficiency in B6 causes what symptoms?
Anemia, convulsions, depression, confusion, skin issues, increased risk of CVD
T/F B6 toxicity comes only from supplements.
True
S/s of B6 OD?
Sensory neuropathy (damage to sensory nerves): numbness, tingling, difficulty walking
Which vitamin is involved in any function in the body which requires adding 1 carbon units to other organic compounds “ 1-C metabolism”?
Folate
More functions of folate?
- Nucleotide synthesis: DNA synthesis, cell division; especially important to lil’ fetuses – spina bifida :(
- Amino acid metabolism
- Normal RBC synthesis
- Prevent accumulation homocysteine, lower risk of CVD
Good sources of folate?
Fortified grains, eggs, meat, fruit, veg
Which vitamin is important during first days/ weeks of pregnancy, lack of can cause neural tube defects → spina bifida
Folate
OD of folate via supplements can cause damage to what system?
Nervous
B12 is important for the metabolism of ________?
Amino acids
B12 can also help absorb __________
Folate: Can cause folate deficiency if deficient in B12
Other functions of B12?
- Important for myelin sheaths - nerve conduction
- Prevents accumulation homocysteine, lowers risk of CVD
- Formation of RBC
Good sources of folate?
Animal products, fortified soy milk and cereals, vegans at risk for deficiency
What is Atrophic gastritis?
Caused by malabsorption of B12, low stomach acid secretion, occurs in 10-30% of adults 50+ y/o.
Most commonly caused by infection with H. pylori or autoimmune. pH too high = too little B12 freed up from food
Inadequate production of intrinsic factor (normally secreted bu the parietal cells of the stomach) causes what? And why?
Pernicious anemia.
Intrinsic factor binds to B12 and aids in absorption in the small intestine. When not bound, B12 is not recognized/absorbed by the enterocytes.
Deets of B12 toxicity?
None, you all good
WTH is Pantothenic Acid?
Coenzyme for all energy producing metabolic pathways: ensures the foods we eat are converted to energy or stored as chub
A diseases characterized by low bone mass
Osteporosis
The single most common cause of hip and spine Fx in adults
Osteoporsis
The most important nutrients to consume to prevent osteoporosis
Protein, Calcium, and Vitamin D
“Hunching” of the back is called
Kyphosis
2/3 or iron in in the body is found in the
Hemoglobin
Iron is recycled by these organs
Liver and spleen
Heme iron is found only in
Animal based foods
Non-heme iron is found in
plant and animal based foods
Phytates and Polyphenols have this effect on iron absorption:
Reduce absorption
Iron OD in children can be caused by
supplements mistaken for candy
Three stages of iron deficiency
- Depletion of stores 2: Decreased transport and heme production 3: True anemia
A trace mineral required in more than 300 different enzymes
Zinc
A trace mineral that stabilizes the structure of proteins
Zinc
A trace mineral that regulates gene expression
Zinc
Diets low in this trace mineral can cause growth retardation, delayed sexual maturation, and increased infections
Zinc
A trace mineral that is a component of ceruloplasmin, which is important for iron transport
Copper
A trace mineral required for superoxide dismutase antioxidant enzymes
Copper
B6, folate, and B12 are the three ______ _______ B vitamins
water soluble
Vitamin ___ is an important coenzyme to synthesize clotting proteins
K
Low Vitamin K will result in ______ clotting times.
increased
Vitamin C is also called:
Ascorbic acid
This vitamin is an important coenzyme to enzymes that synthesize collagen
Vitamin C
A disease where protein synthesis fails, and was responsible for many deaths on long sea voyages
Scurvy
Minerals such as calcium and phosphorus account for __% of bones, and provide hardness
65%
Organic substances such as collagen make up __% of bones, and provide strength, durability, and flexibility
35
These tiny crystals cluster around collagen fibers in the bone and provide strength
hydroxyapatite
Two types of bone tissue
Cortical (80%) and Trabecular (20%)
This type of bone forms the outer surface of bones:
Cortical
This type of bone is spongy, and forms the ends of long bones
Trabecular
The breakdown of older bone tissue to form new tissue is called
Remodeling
The __ _____ calculates bone density, and the normal range is -1 - +1
T score
The four major minerals in the bones are:
Ca, Phosphorous, Mg, Flouride
Vitamin that regulate Calcium
Vitamin D
Vitamin D deficiency in children is called ______, and caused deformities such as bowed legs and knocked knees:
Rickets
Vitamin D deficiency in adults is called _________, and increases the risk of Fx due to weak bones
Osteomalacia
