1. NUTRITION Level 4, Academic Year (AY) 1435—1436 H Ahmad Albalawi MSN Lecturer

2. Learning Objectives: Describe water and Fluids Identify fluid sources; Calculate body fluid requirements; Identify the different minerals; their sources and recommended intake and their corresponding toxicities and deficiencies; Identify the health effects of the different minerals Department of Nursing2

3. Topic Outline Water and the Body Fluids Sources Requirements

4. Water and fluids 50-70% of the body is fluid fluid content differs among tissue: – muscle tissue ~ 70% fluid – fat tissue ~ 10-20% fluid therefore: – leaner people - proportionally more fluid – total body fluid is lower in females – total body fluid decreases with age

5. Sources Food sources: – solid foods contribute ~20% intake – ~250 ml produced by metabolism – remainder from free water and/or other fluids

6. Sources Balance of water Fluid Input: – beverages – food – metabolic water Fluid Output: – Urine – Faeces – insensible evaporation – from lungs – sweat

7. Requirements specific to each individual – influenced by: – age – body size – health status – environmental conditions – physical activity level – Individual metabolism

8. Requirements Fluids (plain water, milk and other drinks) Total Water (food and fluids) 2.6 L/day(10 cups) 3.4 L/dayMen 19+ 2.1 L/day (8 cups) 2.8 L/dayWomen 19+

9. Requirements excess water intake can cause hypernatraemia but occurrence is rare in general population

10. Major minerals

11. Topic Outline Overview Major and minor minerals Sources Roles in the body Dietary recommendations and management Deficiencies and toxicities

12. Overview Minerals are inorganic elements that originate from the earth’s crust, not from plants or animals

13. Major and minor minerals Major minerals Calcium Phosphorus Magnesium Sulfur Sodium Potassium Chloride Minor minerals – Iron – Iodine – Zinc – Selenium – Copper – Manganese – Fluoride – Chromium – Molybdenum

14. Sources Food – Unrefined or unprocessed foods have more minerals than refined foods Soil – Trace mineral content varies with the content of soil from which the food originates Processed Foods – Within all food groups, processed foods are high in sodium and chloride Drinking water – Drinking water contains varying amounts of calcium, magnesium, and other minerals; sodium is added to soften water. – Fluoride may be a natural or added component of drinking water

15. Roles in the body Structure to body tissues Fluid balance Acid-base balance Nerve cell transmission Muscle contraction Vitamin, enzyme, and hormonal activities

16. Dietary recommendations and management of some major minerals

17. Sodium (Na + ) Adult AI: 19–50 yr: 1.5 g 50–70 yr: 1.3 g 71 + yr: 1.2 g Adult UL: 2.3 g 1 tsp salt = 2400 mg Na 75% of Na intake is from processed foods Functions: 1.Fluid and Electrolyte balance 2.Acid-base balance 3.Maintains muscle irritability 4.Regulates cell membrane permeability 5.Nerve impulse transmission Deficiency Rare except with chronic diarrhea or vomiting and renal disorders; nausea, dizziness, muscle cramps, apathy Toxicity Hypertension, edema

18. Sodium (Na + ) Food labeling (servings) Sodium free <5 mg Very low sodium <35 mg Low sodium <140 mg

19. Potassium (K + ) Adult AI: 4.7 g No UL Sources: Fruits and vegetables Dried peas and beans Whole grains Milk Meats Functions: 1.Fluid and electrolyte balance 2.Acid-base balance 3.Nerve impulse transmission 4.Catalyst for many metabolic reactions 5.Involved in skeletal 6.Cardiac muscle activity Deficiency Muscular weakness, paralysis, anorexia, confusion (occurs with dehydration) Toxicity (from supplements/drugs) Muscular weakness, vomiting

20. Calcium (Ca) Adult AI 19 – 50 yr: 1000 mg 51 + yr: 1200 mg Adult UL: 2.5 g/d SOURCES : Milk and milk products, fortified orange juice, green leafy vegetables, small fish with bones, dried peas and beans FUNCTIONS 1.Bone and teeth formation and maintenance 2.Blood clotting 3.Nerve transmission 4.Muscle contraction and relaxation, Cell membrane permeability 5.Blood pressure Deficiency Children: impaired growth Adults: osteoporosis Toxicity Constipation, increased risk of renal stone formation, impaired absorption of iron and other minerals

21. Department of Nursing21 Phosphorus (P) Adult RDA Men and women: 700 mg Adult UL: To age 70: 4 g/d 70 + yr: 3 g/d SOURCES: All animal products (meat, poultry, eggs, milk), bread, ready-to-eat cereal FUNCTIONS: 1.Bone and teeth formation and maintenance 2.Acid-base balance 3.Energy metabolism, 4.Cell membrane structure 5.Regulation of hormone 6.Coenzyme activity Deficiency Unknown Toxicity Low blood calcium

22. Department of Nursing22 Magnesium (Mg) Adult RDA Men: 19–30 yr: 400 mg 31 + yr: 420 mg Women: 19–30 yr: 310 mg 31 + yr: 320 mg Adult UL: 350 mg/d from supplements only (does not include intake from food and water) SOURCES: Green leafy vegetables, nuts, dried peas and beans, whole grains, seafood, chocolate, cocoa FUNCTIONS: 1.Bone formation 2.Nerve transmission 3.Smooth muscle relaxation 4.Protein synthesis 5.CHO metabolism 6.Enzyme activity

23. Iron is a mineral found in every cell of the body. it is needed to make part of blood cells. The human body needs iron to make the oxygen-carrying proteins hemoglobin and myoglobinhemoglobin RDA: Adults- 11-18 mg Pregnant- 250 mcg 23 The best sources of iron include: Dried beans Dried fruits Eggs (especially egg yolks) Iron-fortified cereals Liver Lean red meat (especially beef) Poultry, dark red meat Salmon Tuna Whole grains

24. Iodine is an essential component of the thyroid hormones that regulate many important biochemical reactions required for proper skeletal and central nervous system development in fetuses and infants RDA : 120 mcg- 150 mcg - adults 220 mcg- Pregnant Sources: Seaweed, seafood, dairy products, grain products, and eggs Department of Nursing24

25. Post-Lecture Evaluation All of the following are considered as fluid output, except? A.Urine B.Insensible evaporation C.Sweat D.Food Department of Nursing25

26. Post-Lecture Evaluation Identify the minerals perform the following roles: 1.Structure to body tissues 2.Fluid balance 3.Acid-base balance 4.Nerve cell transmission 5.Muscle contraction 6.Vitamin, enzyme, and hormonal activities Department of Nursing26

27. References Dudek, S.G (2006). Nutrition essential for Nursing Practice. 5 th edition, Lippincott, Philadelphia, USA. Whitney, W & Rolfes, SR (2008) Understanding Nutrition (11 th ed), Thomson Higher Education, Belmont, CA, USA.

28. Topic for the Next Session Unit IV. Nutrition Across Lifespan