A presentation for my nutrition and diet therapy class the presentation is on Vitamins,Mineral and Water.
This is the textbook: Dudek, Susan. (2022). Nutrition Essentials for Nursing Practice, 9th edition. Lippincott Williams & Wilkins ISBN-13: 978-1-975161-12-5, ISBN-10: 975161-12-2
I. Introduction
Definition and importance of Vitamins, Minerals and Water in maintaining a healthy body
Overview of the chosen disease/condition and its pathophysiology
II. Nutritional Factors of the Disease/Condition
Explanation of how vitamins, minerals and water play a role in the development or management of the disease/condition
Detailed discussion of the specific vitamins, minerals and water involved
Water and Minerals
Chapter 6
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Water
• Functions of water
– Occupies essentially every space within and
between body cells
– Involved in virtually every body function
– Largest single constituent of the human body,
averaging 60% of total body weight
– Provides shape and structure to cells
– Regulates body temperature
– Aids in the digestion and absorption of nutrients
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Water—(cont.)
• Functions of water—(cont.)
– Transports nutrients and oxygen to cells
– Serves as a solvent for vitamins, minerals,
glucose, and amino acids
– Participates in metabolic reactions
– Eliminates waste products
– Is a major component of mucus and other
lubricating fluids
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Water—(cont.)
• Water balance
– Total body water balance is tightly regulated
within ±0.2% of body weight.
– Sensation of thirst and the action of the hormone
vasopressin control our daily fluid balance.
o Water output
❑ Adults lose approximately 1750 to 3000
mL of water daily.
❑ Insensible water losses
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Water—(cont.)
• Water balance—(cont.)
o
Water output—(cont.)
❑
Sensible water losses
• Water intake
o Drinking water
o Other beverages
o Solid foods
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Water—(cont.)
• Water recommendations
– Body cannot produce as much water as it
needs.
– For men ages 19 to older than 70 years,
the Adequate Intake (AI) is 3.7 L/day.
– For women of the same age, the AI is 2.7
L/day.
– Daily intakes below the AI may not be
harmful to healthy people.
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Water—(cont.)
• Water recommendations—(cont.)
– Osmoregulatory system
– Fluid intake is assumed to be adequate when
the color of urine produced is pale yellow.
– Elderly and children
o Drinking fluids should not be delayed until
the sensation of thirst occurs.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Water—(cont.)
• Water recommendations—(cont.)
– Increases in water loss
o Vomiting, diarrhea, and fever
o Thermal injuries, fistulas, uncontrolled
diabetes, hemorrhage, and certain renal
disorders
o Use of drainage tubes contributes to increased
water losses.
o Intake and output records are used to assess
adequacy of intake.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Water—(cont.)
• Alterations in intake
– Dehydration is characterized by
o Impaired mental function
o Impaired motor control
o Increased body temperature during exercise
o Increased resting heart rate when standing
or lying down
o Increased risk of life-threatening heat stroke
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Water—(cont.)
• Alterations in intake—(cont.)
– A net water loss of as little as 1% of body weight
increases plasma osmolality.
– A loss of 20% can be life threatening.
• Hyponatremia
– At risk patients include infants; psychiatric patients
with excessive thirst; women who have undergone
surgery using a uterine distention medium; and
athletes in endurance events who drink too much
water, fail to replace lost sodium, or both.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Water—(cont.)
• Hyponatremia—(cont.)
– Symptoms
o Lung congestion, muscle weakness,
lethargy, and confusion
o Can progress to convulsions, prolonged
coma, and death
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
• Insensible water losses are those that cannot
be measured. Insensible water losses occur
through what?
a. Urine
b. Feces
c. Respirations
d. Diaphoresis
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
c. Respirations
Rationale: Extreme environmental temperatures
(very hot or very cold), high altitude, low
humidity, and strenuous exercise increase
insensible water losses from respirations and the
skin.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Keys to Understanding Minerals
• Major minerals are present in the body in
amounts greater than 5 g.
• Calcium, phosphorus, magnesium, sulfur,
sodium, potassium, and chloride are major
minerals.
• Iron, iodine, zinc, selenium, copper,
manganese, fluoride, chromium, and
molybdenum are classified as trace minerals or
trace elements.
• Both groups are essential for life.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Keys to Understanding Minerals—(cont.)
• General chemistry
– Minerals are inorganic elements that
originate from the earth’s crust, not from
plants or animals.
– Minerals do not undergo digestion, nor are
they broken down or rearranged during
metabolism.
– Minerals are not destroyed by light, air, heat,
or acids during food preparation.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Keys to Understanding Minerals—(cont.)
• General functions
– Minerals function to provide structure to body
tissues and to regulate body processes.
• Mineral balance
– Maintained by
o Releasing minerals from storage for
redistribution
o Altering rate of absorption
o Altering rate of excretion
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Keys to Understanding Minerals—(cont.)
• Mineral toxicities
– Stored minerals can produce toxicity symptoms.
– Toxicity related to excessive use of mineral
supplements, environmental or industrial
exposure, human errors in commercial food
processing, or alterations in metabolism
• Mineral interactions
– Mineral status must be viewed as a function of
the total diet.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Keys to Understanding Minerals—(cont.)
• Sources of minerals
– Unrefined or unprocessed foods have more
minerals than refined foods.
• Major electrolytes
– Sodium
o Salt (sodium chloride) is approximately 40%
sodium.
o Wide variations in sodium intake exist
between cultures and between individuals
within a culture.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Keys to Understanding Minerals—(cont.)
• Major electrolytes—(cont.)
– Sodium—(cont.)
o Major extracellular cation
o Largely responsible for regulating fluid balance
o Almost 98% of all sodium consumed is
absorbed.
o Adequate Intake for sodium is set at 1500
mg/day for young adults.
o One hundred percent of adult men and women
exceed the AI of 1500 mg of sodium per day.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Keys to Understanding Minerals—(cont.)
• Potassium
– Major cation of the intracellular fluid
– When potassium excretion is impaired, such as
secondary to diabetes, chronic renal insufficiency, endstage renal disease, severe heart failure, and adrenal
insufficiency, high potassium intakes can lead to
hyperkalemia and life-threatening cardiac arrhythmias.
• Chloride
– Major anion in the extracellular fluid
– AI for younger adults is 2.3 g/day.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
• Is the following statement true or false?
Potassium is the major extracellular cation.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
False.
Rationale: Most of the body’s potassium is
located in the cells as the major cation of the
intracellular fluid.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Major Minerals
• Calcium
– Most plentiful mineral in the body
– Probably protects against colorectal cancer
– Calcium balance in the blood is achieved through the
action of vitamin D and hormones.
– Three daily servings of milk, yogurt, or cheese plus
nondairy sources of calcium are needed to ensure an
adequate calcium intake.
– An adequate calcium intake throughout the first three
decades of life is needed to attain peak bone mass as
determined by genetics.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Major Minerals—(cont.)
• Phosphorus
– After calcium, the most abundant mineral in the body
is phosphorus.
– About 60% of natural phosphorus from food sources
is absorbed.
– Dietary deficiencies of phosphorus do not occur.
• Magnesium
– Fourth most abundant mineral in the body
– Mean magnesium intake among American adults is
approximately 80% of the RDA.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Major Minerals—(cont.)
• Sulfur
– Does not function independently as a
nutrient but is a component of biotin,
thiamin, and the amino acids methionine
and cysteine
– There is no RDA or AI for sulfur.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Trace Minerals
• Impact on health is significant
• Too little of a trace mineral can be just as deadly as too
much.
• Iron
– Approximately two-thirds of the body’s 3 to 5 g of
iron is contained in the heme portion of hemoglobin.
– Iron in foods exists in two forms: heme iron, found in
meat, fish, and poultry, and nonheme iron, found in
plants such as grains, vegetables, legumes, and nuts.
– Overall rate of iron absorption is only 10% to 15% of
total intake.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Trace Minerals—(cont.)
• Iron—(cont.)
– Only 1% to 7% of nonheme iron is absorbed
from plant foods when they are consumed as
a single food.
– RDA for iron is set at 8 mg for men and
postmenopausal women and at 18 mg for
premenopausal women.
– Iron deficiency anemia
o Microcytic, hypochromic anemia
o Pica
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Trace Minerals—(cont.)
• Iron—(cont.)
– Potential for toxicity is moderate to high.
– Hemochromatosis
– Acute iron toxicity
• Zinc
– A regular and sufficient intake is necessary.
– Plays important roles in immune system
functioning and in wound healing
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Trace Minerals—(cont.)
• Iodine
– Essential component of thyroxine (T4) and
triiodothyronine (T3)
– Approximately 50% of the population uses iodized
salt.
– Goitrogens
• Selenium
– A component of a group of enzymes that function as
antioxidants
– Selenium deficiency is rare in the United States.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Trace Minerals—(cont.)
• Copper
– Distributed in muscles, liver, brain, bones, kidneys,
and blood
– Involved in hemoglobin synthesis, collagen formation,
wound healing, and maintenance of nerve fibers
• Manganese
– Dietary deficiencies have not been noted.
– High manganese intake from drinking water also
produces neuromotor deficits similar to Parkinson’s
disease.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Trace Minerals—(cont.)
• Fluoride
– Promotes the mineralization of developing tooth
enamel prior to tooth eruption and the
remineralization of surface enamel in erupted
teeth
– Fluoridation of municipal water
• Chromium
– Enhances the action of the hormone insulin to
help regulate blood glucose levels
– Appears that average intake is adequate
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Trace Minerals—(cont.)
• Molybdenum
– Plays a role in red blood cell synthesis
– Dietary deficiencies and toxicities are
unknown.
• Other trace elements
– Evidence is difficult to obtain and quantifying
human need is even more formidable.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
• Which major mineral is the most abundant in
the human body?
a. Manganese
b. Selenium
c. Calcium
d. Sodium
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
c. Calcium
Rationale: Calcium is the most plentiful mineral
in the body, making up about half of the body’s
total mineral content.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Water and Minerals in Health Promotion
• Water
– Recommended that thirst be the guide to
consuming adequate fluid; specific amounts or
types of beverages to satisfy fluid need are not
suggested
– For healthy people, hydration is unconsciously
maintained with ad libitum access to water.
• Sodium and potassium
– Recommendations
o Less sodium
o More potassium
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
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