Blood Health Fluid Balance

Blood Health & Fluid Balance Nutrients Important in Blood Health ● Vitamins K, B12, & folate ● Minerals zinc & iron Vitamin K ● Major physio functions - normal blood clotting & role in bone mineralization ● Symptoms of deficiency - hemorrhaging & poor bone mineralization ○ Causes - diseases that cause lipid malabsorption bc fat soluble vitamin & prolonged antibiotic use which kills bacteria in large intestine that normally produce K ● Food sources - green leafy veggies, oils, & margarine ● Synthesized by bacteria in intestine ● Supplements are prescription only bc excess can interfere w/ meds that prevent blood clotting ● Endogenous synthesis - bacteria in colon ● Clinical application - deficiency & infants ○ Born w/ sterile gut & can’t synthesize vitamin K ○ Takes weeks to populate large intestine vitamin K producing bacteria ○ Infants born w/ low stores of vitamin K ○ Human milk contains low levels of K ○ Immature infant liver impacts bile production → decreased absorption of K ○ Infants given dose of K at birth prevents hemorrhage (uncontrolled internal bleeding) ● Clinical application - coumadin (generic for warfarin) ○ Coumadin prevents blood clots in those w/ CVD - decreases activity of K ○ Sudden increase or decrease in K can interfere w/ action of coumadin ○ Recommendation - eat balanced diet & limit high amounts of K to 1 serving/day Iron ● Trace mineral that helps accept, carry, & release oxygen in cells ● Releases oxygen to cells when needed for ATP production & muscle contraction ● Men - 8 mg/day & women - 18mg/day ● UL - 45 mg/day ● Vegetarians & athletes need careful assessment ● Major physio functions - component of hemoglobin which is necessary for oxygen & CO2 transport, component of enzymes necessary for cellular use of oxygen, & immune system functions ● Symptoms of deficiency ○ Mild deficiency - fatigue, impaired physical work performance, behavioral abnormalities, impaired intellectual abilities in kids, body temp regulation, influences immune system ○ Severe - microcytic hypochromic anemia, small pale RBCs, inability to produce enough heme, decreased ability to carry oxygen, & decreased ATP synthesis ● Symptoms of toxicity - GI distress, if over absorption then excess iron storage in liver → liver dysfunction (hemochromatosis) ● Health promotion & disease prevention - adequate intake daily necessary for good health & to prevent anemia, always keep supplements away from kids to prevent overdose, never self prescribe iron supplements bc of risk of overload (hemochromatosis) ● Food sources - well absorbed (heme) sources like clams, oysters, liver, meat, fish, & poultry & lesser absorbed (nonheme) sources like dried beans, legumes, green leafy veggies, dried fruits, & fortified ● ● ● ● ● ● ● ● Zinc ● ● ● ● grains ○ Heme/ferrous iron (FE2+) - more absorbable form of iron (2-3 times more bioavailable than non heme iron) bc no chemical modification needed prior to absorption ○ Non heme/ferric iron (FE3+) - ionic state, chemical mods required before absorption, reduced (+ e-) to ferrous iron ✰ Vitamin C enhances absorption by converting FE3+ → FE2+ @ intestinal lumen Clinical application - choose a supplement ○ Ferrous fumarate, ferrous sulfate, ferrous gluconate are all ferrous & more readily absorbed Clinical application - detecting severe deficiency ○ Blood tests ○ Hematocrit (HCT) - <39% for males or <36% for females ○ Hemoglobin - <13 gm/dl for males or <12 gm/dl for females Clinical application - pica ○ Abnormal eating behavior that involves consuming nonfood substances such as clay or dirt ○ Replete iron & behavior stops Increase iron in your cooking ○ Spaghetti sauce - 100g iron but down to 3 when simmered in glass dish but 87g when cooked in black iron skillet Inhibitors of non heme absorption ○ Tannins (found in tea) so drink tea between meals (doesn’t apply to herbal tea) ○ Oxalates - spinach, rhubarb, & chard ○ Phytates - whole grain, bran, soybean ○ Megadose of zinc, calcium, or copper Vegans - may have difficult time meeting needs due to no consumption of heme iron sources ○ May require supplementation ○ Encourage iron fortified/enriched products Endurance athletes - increased blood loss in feces/urine, chronic rupture of RBCs in feet, needs are 70% higher Anemia - many nutritional causes ○ Blood loss due to hemorrhage - vitamin K ○ Decreased synthesis of RBCs - iron, B6, folate, B12 ○ Hemolysis - vitamin E ○ # of RBCs below normal → reduced delivery of oxygen to body cells ○ Symptoms - fatigue, weakness, shortness of breath Cofactor for over 300 enzymes in the body Research active on its needs Important for growth, reproduction, immunity, gene expression, & protein synthesis Major physio functions - component of 100s of enzymes, proper cellular function, & proper immune function ● Symptoms of deficiency ○ Mild deficiency - growth retardation, sexual organ immaturity, poor immunity, taste alterations, & decreased appetite ○ Severe - dwarfism (middle eastern diets low in zinc high in phytates) ● Symptoms of toxicity - immunosuppression, decrease in HDL, impaired copper metabolism ● Health promotion & disease prevention - adequate daily intake is necessary for good health, mild deficiency is assoc w/ immune sys dysfunction ● Food sources - animal foods like meat & milk, whole grains, wheat germ, fortified cereals/foods Nutrients Involved in Fluid & Electrolyte Balance ● Minerals sodium, potassium, chloride, & phosphorus ● Water ● Processed foods increase sodium & decrease potassium content of foods Hypertension ● 1/3 adult americans have hypertension ● Another 1/3 have prehypertension ● Rates vary by age, gender, & race/ethnicity ● Silent killer ● Risk factor for many CVDs as well as kidney disease ● Direct & indirect costs in US = $47.5 billion/year ● Increases one’s risk of heart disease, stroke, & kidney disease ● Causes - family history, age, heart disease, overweight, inactivity, excess alcohol, & high sodium intake ● Recommendations for reducing BP - weight loss, increased physical activity, decreased alcohol intake, reduced sodium intake & increased potassium intake Sodium ● Functions ○ Fluid balance - major extracellular cation ○ Absorption of nutrients - glucose & AAs ○ Muscle & nerve function ○ High sodium intake increases BP ● Symptoms of toxicity - elevated BP ● Health promotion & disease prevention - high intake is assoc w/ high BP, esp in those w/ salt sensitivity; as BP increases, risk for stroke & CVD also increase ● Food source - table salt (NaCl) & addition of sodium to processed foods ○ Majority from food processing & restaurant foods ● Recommendations ○ General public - <2300 mg ○ History of hypertension - <1500 mg Po Potassium tassium ● Functions ○ Fluid balance - major extracellular cation ○ Transmission of nerve impulses ○ Muscle contraction ○ Proper cellular function ○ High potassium decreases BP ● Health promotion & disease prevention - adequate intake daily necessary for good health, low intake assoc w/ high BP, glucose intolerance, & increased risk for kidney stones ● Food sources - vegetables (esp green leafy), dried beans & peas, orange juice, bananas, melons, potatoes, milk & yogurt, & nuts