nutrition final review

list the fat soluble vitamins (4)

Vitamin: - A - D - E - K

Define: free radical

an uncharged molecule (typically highly reactive and short-lived) having an unpaired valence electron.

Define: hyperkeratosis

Hyperkeratosis is thickening of the stratum corneum (the outermost layer of the epidermis), often associated with the presence of an abnormal quantity of keratin, and also usually accompanied by an increase in the granular layer

list the - function - sources (food and other) - deficiency - toxicity symptoms (if present) - diseases of each vitamin (if present) of the following MINERAL: magnesium

Magnesium, an abundant mineral in the body, is naturally present in many foods, added to other food products, available as a dietary supplement, and present in some medicines (such as antacids and laxatives). Magnesium is a cofactor in more than 300 enzyme systems that regulate diverse biochemical reactions in the body, including protein synthesis, muscle and nerve function, blood glucose control, and blood pressure regulation [1-3]. Magnesium is required for energy production, oxidative phosphorylation, and glycolysis. It contributes to the structural development of bone and is required for the synthesis of DNA, RNA, and the antioxidant glutathione. Magnesium also plays a role in the active transport of calcium and potassium ions across cell membranes, a process that is important to nerve impulse conduction, muscle contraction, and normal heart rhythm [3]. An adult body contains approximately 25 g magnesium, with 50% to 60% present in the bones and most of the rest in soft tissues [4]. Less than 1% of total magnesium is in blood serum, and these levels are kept under tight control. Normal serum magnesium concentrations range between 0.75 and 0.95 millimoles (mmol)/L [1,5]. Hypomagnesemia is defined as a serum magnesium level less than 0.75 mmol/L [6]. Magnesium homeostasis is largely controlled by the kidney, which typically excretes about 120 mg magnesium into the urine each day [2]. Urinary excretion is reduced when magnesium status is low [1]. Assessing magnesium status is difficult because most magnesium is inside cells or in bone [3]. The most commonly used and readily available method for assessing magnesium status is measurement of serum magnesium concentration, even though serum levels have little correlation with total body magnesium levels or concentrations in specific tissues [6]. Other methods for assessing magnesium status include measuring magnesium concentrations in erythrocytes, saliva, and urine; measuring ionized magnesium concentrations in blood, plasma, or serum; and conducting a magnesium-loading (or "tolerance") test. No single method is considered satisfactory [7]. Some experts [4] but not others [3] consider the tolerance test (in which urinary magnesium is measured after parenteral infusion of a dose of magnesium) to be the best method to assess magnesium status in adults. To comprehensively evaluate magnesium status, both laboratory tests and a clinical assessment might be required [6]. Recommended Intakes Intake recommendations for magnesium and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by the Food and Nutrition Board (FNB) at the Institute of Medicine of the National Academies (formerly National Academy of Sciences) [1]. DRI is the general term for a set of reference values used to plan and assess nutrient intakes of healthy people. These values, which vary by age and sex, include: Recommended Dietary Allowance (RDA): average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%-98%) healthy individuals. Adequate Intake (AI): established when evidence is insufficient to develop an RDA and is set at a level assumed to ensure nutritional adequacy. Estimated Average Requirement (EAR): average daily level of intake estimated to meet the requirements of 50% of healthy individuals. It is usually used to assess the adequacy of nutrient intakes in population groups but not individuals. Tolerable Upper Intake Level (UL): maximum daily intake unlikely to cause adverse health effects. Table 1 lists the current RDAs for magnesium [1]. For infants from birth to 12 months, the FNB established an AI for magnesium that is equivalent to the mean intake of magnesium in healthy, breastfed infants, with added solid foods for ages 7-12 months. Table 1: Recommended Dietary Allowances (RDAs) for Magnesium [1] Age Male Female Pregnancy Lactation Birth to 6 months 30 mg* 30 mg* 7-12 months 75 mg* 75 mg* 1-3 years 80 mg 80 mg 4-8 years 130 mg 130 mg 9-13 years 240 mg 240 mg 14-18 years 410 mg 360 mg 400 mg 360 mg 19-30 years 400 mg 310 mg 350 mg 310 mg 31-50 years 420 mg 320 mg 360 mg 320 mg 51+ years 420 mg 320 mg *Adequate Intake (AI) Sources of Magnesium Food Magnesium is widely distributed in plant and animal foods and in beverages. Green leafy vegetables, such as spinach, legumes, nuts, seeds, and whole grains, are good sources [1,3]. In general, foods containing dietary fiber provide magnesium. Magnesium is also added to some breakfast cereals and other fortified foods. Some types of food processing, such as refining grains in ways that remove the nutrient-rich germ and bran, lower magnesium content substantially [1]. Selected food sources of magnesium are listed in Table 2. Tap, mineral, and bottled waters can also be sources of magnesium, but the amount of magnesium in water varies by source and brand (ranging from 1 mg/L to more than 120 mg/L) [8]. Approximately 30% to 40% of the dietary magnesium consumed is typically absorbed by the body [2,9]. Table 2: Selected Food Sources of Magnesium [10] Food Milligrams (mg) per serving Percent DV* Almonds, dry roasted, 1 ounce 80 20 Spinach, boiled, ½ cup 78 20 Cashews, dry roasted, 1 ounce 74 19 Peanuts, oil roasted, ¼ cup 63 16 Cereal, shredded wheat, 2 large biscuits 61 15 Soymilk, plain or vanilla, 1 cup 61 15 Black beans, cooked, ½ cup 60 15 Edamame, shelled, cooked, ½ cup 50 13 Peanut butter, smooth, 2 tablespoons 49 12 Bread, whole wheat, 2 slices 46 12 Avocado, cubed, 1 cup 44 11 Potato, baked with skin, 3.5 ounces 43 11 Rice, brown, cooked, ½ cup 42 11 Yogurt, plain, low fat, 8 ounces 42 11 Breakfast cereals, fortified with 10% of the DV for magnesium 40 10 Oatmeal, instant, 1 packet 36 9 Kidney beans, canned, ½ cup 35 9 Banana, 1 medium 32 8 Salmon, Atlantic, farmed, cooked, 3 ounces 26 7 Milk, 1 cup 24-27 6-7 Halibut, cooked, 3 ounces 24 6 Raisins, ½ cup 23 6 Chicken breast, roasted, 3 ounces 22 6 Beef, ground, 90% lean, pan broiled, 3 ounces 20 5 Broccoli, chopped and cooked, ½ cup 12 3 Rice, white, cooked, ½ cup 10 3 Apple, 1 medium 9 2 Carrot, raw, 1 medium 7 2 *DV = Daily Value. DVs were developed by the U.S. Food and Drug Administration (FDA) to help consumers compare the nutrient contents of products within the context of a total diet. The DV for magnesium is 400 mg for adults and children aged 4 and older. However, the FDA does not require food labels to list magnesium content unless a food has been fortified with this nutrient. Foods providing 20% or more of the DV are considered to be high sources of a nutrient. The U.S. Department of Agriculture's (USDA's) Nutrient Databaseexternal link disclaimer Web site [10] lists the nutrient content of many foods and provides comprehensive list of foods containing magnesium arranged by nutrient content and by food name. Dietary supplements Magnesium supplements are available in a variety of forms, including magnesium oxide, citrate, and chloride [2,3]. The Supplement Facts panel on a dietary supplement label declares the amount of elemental magnesium in the product, not the weight of the entire magnesium-containing compound. Absorption of magnesium from different kinds of magnesium supplements varies. Forms of magnesium that dissolve well in liquid are more completely absorbed in the gut than less soluble forms [2,11]. Small studies have found that magnesium in the aspartate, citrate, lactate, and chloride forms is absorbed more completely and is more bioavailable than magnesium oxide and magnesium sulfate [11-15]. One study found that very high doses of zinc from supplements (142 mg/day) can interfere with magnesium absorption and disrupt the magnesium balance in the body [16]. Medicines Magnesium is a primary ingredient in some laxatives [17]. Phillips' Milk of Magnesia®, for example, provides 500 mg elemental magnesium (as magnesium hydroxide) per tablespoon; the directions advise taking up to 4 tablespoons/day for adolescents and adults [18]. (Although such a dose of magnesium is well above the safe upper level, some of the magnesium is not absorbed because of the medication's laxative effect.) Magnesium is also included in some remedies for heartburn and upset stomach due to acid indigestion [17]. Extra-strength Rolaids®, for example, provides 55 mg elemental magnesium (as magnesium hydroxide) per tablet [19], although Tums® is magnesium free [20]. Magnesium Intakes and Status Dietary surveys of people in the United States consistently show that intakes of magnesium are lower than recommended amounts. An analysis of data from the National Health and Nutrition Examination Survey (NHANES) of 2005-2006 found that a majority of Americans of all ages ingest less magnesium from food than their respective EARs; adult men aged 71 years and older and adolescent females are most likely to have low intakes [21]. In a study using data from NHANES 2003-2006 to assess mineral intakes among adults, average intakes of magnesium from food alone were higher among users of dietary supplements (350 mg for men and 267 mg for women, equal to or slightly exceeding their respective EARs) than among nonusers (268 mg for men and 234 for women) [22]. When supplements were included, average total intakes of magnesium were 449 mg for men and 387 mg for women, well above EAR levels. No current data on magnesium status in the United States are available. Determining dietary intake of magnesium is the usual proxy for assessing magnesium status. NHANES has not determined serum magnesium levels in its participants since 1974 [23], and magnesium is not evaluated in routine electrolyte testing in hospitals and clinics [2]. Magnesium Deficiency Symptomatic magnesium deficiency due to low dietary intake in otherwise-healthy people is uncommon because the kidneys limit urinary excretion of this mineral [3]. However, habitually low intakes or excessive losses of magnesium due to certain health conditions, chronic alcoholism, and/or the use of certain medications can lead to magnesium deficiency. Early signs of magnesium deficiency include loss of appetite, nausea, vomiting, fatigue, and weakness. As magnesium deficiency worsens, numbness, tingling, muscle contractions and cramps, seizures, personality changes, abnormal heart rhythms, and coronary spasms can occur [1,2]. Severe magnesium deficiency can result in hypocalcemia or hypokalemia (low serum calcium or potassium levels, respectively) because mineral homeostasis is disrupted [2]. Groups at Risk of Magnesium Inadequacy Magnesium inadequacy can occur when intakes fall below the RDA but are above the amount required to prevent overt deficiency. The following groups are more likely than others to be at risk of magnesium inadequacy because they typically consume insufficient amounts or they have medical conditions (or take medications) that reduce magnesium absorption from the gut or increase losses from the body. People with gastrointestinal diseases The chronic diarrhea and fat malabsorption resulting from Crohn's disease, gluten-sensitive enteropathy (celiac disease), and regional enteritis can lead to magnesium depletion over time [2]. Resection or bypass of the small intestine, especially the ileum, typically leads to malabsorption and magnesium loss [2]. People with type 2 diabetes Magnesium deficits and increased urinary magnesium excretion can occur in people with insulin resistance and/or type 2 diabetes [24,25]. The magnesium loss appears to be secondary to higher concentrations of glucose in the kidney that increase urine output [2]. People with alcohol dependence Magnesium deficiency is common in people with chronic alcoholism [2]. In these individuals, poor dietary intake and nutritional status; gastrointestinal problems, including vomiting, diarrhea, and steatorrhea (fatty stools) resulting from pancreatitis; renal dysfunction with excess excretion of magnesium into the urine; phosphate depletion; vitamin D deficiency; acute alcoholic ketoacidosis; and hyperaldosteronism secondary to liver disease can all contribute to decreased magnesium status [2,26]. Older adults Older adults have lower dietary intakes of magnesium than younger adults [20,27]. In addition, magnesium absorption from the gut decreases and renal magnesium excretion increases with age [28]. Older adults are also more likely to have chronic diseases or take medications that alter magnesium status, which can increase their risk of magnesium depletion [1,29]. Magnesium and Health Habitually low intakes of magnesium induce changes in biochemical pathways that can increase the risk of illness over time. This section focuses on four diseases and disorders in which magnesium might be involved: hypertension and cardiovascular disease, type 2 diabetes, osteoporosis, and migraine headaches. Hypertension and cardiovascular disease Hypertension is a major risk factor for heart disease and stroke. Studies to date, however, have found that magnesium supplementation lowers blood pressure, at best, to only a small extent. A meta-analysis of 12 clinical trials found that magnesium supplementation for 8-26 weeks in 545 hypertensive participants resulted in only a small reduction (2.2 mmHg) in diastolic blood pressure [30]. The dose of magnesium ranged from approximately 243 to 973 mg/day. The authors of another meta-analysis of 22 studies with 1,173 normotensive and hypertensive adults concluded that magnesium supplementation for 3-24 weeks decreased systolic blood pressure by 3-4 mmHg and diastolic blood pressure by 2-3 mmHg [31]. The effects were somewhat larger when supplemental magnesium intakes of the participants in the nine crossover-design trials exceeded 370 mg/day. A diet containing more magnesium because of added fruits and vegetables, more low-fat or non-fat dairy products, and less fat overall was shown to lower systolic and diastolic blood pressure by an average of 5.5 and 3.0 mmHg, respectively [32]. However, this Dietary Approaches to Stop Hypertension (DASH) diet also increases intakes of other nutrients, such as potassium and calcium, that are associated with reductions in blood pressure, so any independent contribution of magnesium cannot be determined. Several prospective studies have examined associations between magnesium intakes and heart disease. The Atherosclerosis Risk in Communities study assessed heart disease risk factors and levels of serum magnesium in a cohort of 14,232 white and African-American men and women aged 45 to 64 years at baseline [33]. Over an average of 12 years of follow-up, individuals in the highest quartile of the normal physiologic range of serum magnesium (at least 0.88 mmol/L) had a 38% reduced risk of sudden cardiac death compared with individuals in the lowest quartile (0.75 mmol/L or less). However, dietary magnesium intakes had no association with risk of sudden cardiac death. Another prospective study tracked 88,375 female nurses in the United States to determine whether serum magnesium levels measured early in the study and magnesium intakes from food and supplements assessed every 2 to 4 years were associated with sudden cardiac death over 26 years of follow-up [34]. Women in the highest compared with the lowest quartile of ingested and plasma magnesium concentrations had a 34% and 77% lower risk of sudden cardiac death, respectively. Another prospective population study of 7,664 adults aged 20 to 75 years in the Netherlands who did not have cardiovascular disease found that low urinary magnesium excretion levels (a marker for low dietary magnesium intake) were associated with a higher risk of ischemic heart disease over a median follow-up period of 10.5 years. Plasma magnesium concentrations were not associated with risk of ischemic heart disease [35]. A systematic review and meta-analysis of prospective studies found that higher serum levels of magnesium were significantly associated with a lower risk of cardiovascular disease, and higher dietary magnesium intakes (up to approximately 250 mg/day) were associated with a significantly lower risk of ischemic heart disease caused by a reduced blood supply to the heart muscle [36]. Higher magnesium intakes might reduce the risk of stroke. In a meta-analysis of 7 prospective trials with a total of 241,378 participants, an additional 100 mg/day magnesium in the diet was associated with an 8% decreased risk of total stroke, especially ischemic rather than hemorrhagic stroke [37]. One limitation of such observational studies, however, is the possibility of confounding with other nutrients or dietary components that could also affect the risk of stroke. A large, well-designed clinical trial is needed to better understand the contributions of magnesium from food and dietary supplements to heart health and the primary prevention of cardiovascular disease [38]. Type 2 diabetes Diets with higher amounts of magnesium are associated with a significantly lower risk of diabetes, possibly because of the important role of magnesium in glucose metabolism [39,40]. Hypomagnesemia might worsen insulin resistance, a condition that often precedes diabetes, or it might be a consequence of insulin resistance [41]. Diabetes leads to increased urinary losses of magnesium, and the subsequent magnesium inadequacy might impair insulin secretion and action, thereby worsening diabetes control [3]. Most investigations of magnesium intake and risk of type 2 diabetes have been prospective cohort studies. A meta-analysis of 7 of these studies, which included 286,668 patients and 10,912 cases of diabetes over 6 to 17 years of follow-up, found that a 100 mg/day increase in total magnesium intake decreased the risk of diabetes by a statistically significant 15% [39]. Another meta-analysis of 8 prospective cohort studies that followed 271,869 men and women over 4 to 18 years found a significant inverse association between magnesium intake from food and risk of type 2 diabetes; the relative risk reduction was 23% when the highest to lowest intakes were compared [42]. A 2011 meta-analysis of prospective cohort studies of the association between magnesium intake and risk of type 2 diabetes included 13 studies with a total of 536,318 participants and 24,516 cases of diabetes [43]. The mean length of follow-up ranged from 4 to 20 years. Investigators found an inverse association between magnesium intake and risk of type 2 diabetes in a dose-responsive fashion, but this association achieved statistical significance only in overweight (body mass index [BMI] 25 or higher) but not normal-weight individuals (BMI less than 25). Again, a limitation of these observational studies is the possibility of confounding with other dietary components or lifestyle or environmental variables that are correlated with magnesium intake. Only a few small, short-term clinical trials have examined the potential effects of supplemental magnesium on control of type 2 diabetes and the results are conflicting [40,44]. For example, 128 patients with poorly controlled diabetes in a Brazilian clinical trial received a placebo or a supplement containing either 500 mg/day or 1,000 mg/day magnesium oxide (providing 300 or 600 mg elemental magnesium, respectively) [45]. After 30 days of supplementation, plasma, cellular, and urine magnesium levels increased in participants receiving the larger dose of the supplement, and their glycemic control improved. In another small trial in Mexico, participants with type 2 diabetes and hypomagnesemia who received a liquid supplement of magnesium chloride (providing 300 mg/day elemental magnesium) for 16 weeks showed significant reductions in fasting glucose and glycosylated hemoglobin concentrations compared with participants receiving a placebo, and their serum magnesium levels became normal [46]. In contrast, neither a supplement of magnesium aspartate (providing 369 mg/day elemental magnesium) nor a placebo taken for 3 months had any effect on glycemic control in 50 patients with type 2 diabetes who were taking insulin [47]. The American Diabetes Association states that there is insufficient evidence to support the routine use of magnesium to improve glycemic control in people with diabetes [44]. It further notes that there is no clear scientific evidence that vitamin and mineral supplementation benefits people with diabetes who do not have underlying nutritional deficiencies. Osteoporosis Magnesium is involved in bone formation and influences the activities of osteoblasts and osteoclasts [48]. Magnesium also affects the concentrations of both parathyroid hormone and the active form of vitamin D, which are major regulators of bone homeostasis. Several population-based studies have found positive associations between magnesium intake and bone mineral density in both men and women [49]. Other research has found that women with osteoporosis have lower serum magnesium levels than women with osteopenia and those who do not have osteoporosis or osteopenia [50]. These and other findings indicate that magnesium deficiency might be a risk factor for osteoporosis [48]. Although limited in number, studies suggest that increasing magnesium intakes from food or supplements might increase bone mineral density in postmenopausal and elderly women [1]. For example, one short-term study found that 290 mg/day elemental magnesium (as magnesium citrate) for 30 days in 20 postmenopausal women with osteoporosis suppressed bone turnover compared with placebo, suggesting that bone loss decreased [51]. Diets that provide recommended levels of magnesium enhance bone health, but further research is needed to elucidate the role of magnesium in the prevention and management of osteoporosis. Migraine headaches Magnesium deficiency is related to factors that promote headaches, including neurotransmitter release and vasoconstriction [52]. People who experience migraine headaches have lower levels of serum and tissue magnesium than those who do not. However, research on the use of magnesium supplements to prevent or reduce symptoms of migraine headaches is limited. Three of four small, short-term, placebo-controlled trials found modest reductions in the frequency of migraines in patients given up to 600 mg/day magnesium [52]. The authors of a review on migraine prophylaxis suggested that taking 300 mg magnesium twice a day, either alone or in combination with medication, can prevent migraines [53]. In their evidence-based guideline update, the American Academy of Neurology and the American Headache Society concluded that magnesium therapy is "probably effective" for migraine prevention [54]. Because the typical dose of magnesium used for migraine prevention exceeds the UL, this treatment should be used only under the direction and supervision of a healthcare provider. Health Risks from Excessive Magnesium Too much magnesium from food does not pose a health risk in healthy individuals because the kidneys eliminate excess amounts in the urine [28]. However, high doses of magnesium from dietary supplements or medications often result in diarrhea that can be accompanied by nausea and abdominal cramping [1]. Forms of magnesium most commonly reported to cause diarrhea include magnesium carbonate, chloride, gluconate, and oxide [11]. The diarrhea and laxative effects of magnesium salts are due to the osmotic activity of unabsorbed salts in the intestine and colon and the stimulation of gastric motility [55]. Very large doses of magnesium-containing laxatives and antacids (typically providing more than 5,000 mg/day magnesium) have been associated with magnesium toxicity [56], including fatal hypermagnesemia in a 28-month-old boy [57] and an elderly man [58]. Symptoms of magnesium toxicity, which usually develop after serum concentrations exceed 1.74-2.61 mmol/L, can include hypotension, nausea, vomiting, facial flushing, retention of urine, ileus, depression, and lethargy before progressing to muscle weakness, difficulty breathing, extreme hypotension, irregular heartbeat, and cardiac arrest [28]. The risk of magnesium toxicity increases with impaired renal function or kidney failure because the ability to remove excess magnesium is reduced or lost [1,28]. The FNB has established ULs for magnesium that apply only to supplemental magnesium for healthy infants, children, and adults (see Table 3) [1]. Table 3: Tolerable Upper Intake Levels (ULs) for Supplemental Magnesium [1] Age Male Female Pregnant Lactating Birth to 12 months None established None established 1-3 years 65 mg 65 mg 4-8 years 110 mg 110 mg 9-18 years 350 mg 350 mg 350 mg 350 mg 19+ years 350 mg 350 mg 350 mg 350 mg Interactions with Medications Several types of medications have the potential to interact with magnesium supplements or affect magnesium status. A few examples are provided below. People taking these and other medications on a regular basis should discuss their magnesium intakes with their healthcare providers. Bisphosphonates Magnesium-rich supplements or medications can decrease the absorption of oral bisphosphonates, such as alendronate (Fosamax®), used to treat osteoporosis [59]. Use of magnesium-rich supplements or medications and oral bisphosphonates should be separated by at least 2 hours [55]. Antibiotics Magnesium can form insoluble complexes with tetracyclines, such as demeclocycline (Declomycin®) and doxycycline (Vibramycin®), as well as quinolone antibiotics, such as ciprofloxacin (Cipro®) and levofloxacin (Levaquin®). These antibiotics should be taken at least 2 hours before or 4-6 hours after a magnesium-containing supplement [55,60]. Diuretics Chronic treatment with loop diuretics, such as furosemide (Lasix®) and bumetanide (Bumex®), and thiazide diuretics, such as hydrochlorothiazide (Aquazide H®) and ethacrynic acid (Edecrin®), can increase the loss of magnesium in urine and lead to magnesium depletion [61]. In contrast, potassium-sparing diuretics, such as amiloride (Midamor®) and spironolactone (Aldactone®), reduce magnesium excretion [61]. Proton pump inhibitors Prescription proton pump inhibitor (PPI) drugs, such as esomeprazole magnesium (Nexium®) and lansoprazole (Prevacid®), when taken for prolonged periods (typically more than a year) can cause hypomagnesemia [62]. In cases that FDA reviewed, magnesium supplements often raised the low serum magnesium levels caused by PPIs. However, in 25% of the cases, supplements did not raise magnesium levels and the patients had to discontinue the PPI. FDA advises healthcare professionals to consider measuring patients' serum magnesium levels prior to initiating long-term PPI treatment and to check magnesium levels in these patients periodically [62]. Magnesium and Healthful Diets The federal government's 2015-2020 Dietary Guidelines for Americans notes that "Nutritional needs should be met primarily from foods. ... Foods in nutrient-dense forms contain essential vitamins and minerals and also dietary fiber and other naturally occurring substances that may have positive health effects. In some cases, fortified foods and dietary supplements may be useful in providing one or more nutrients that otherwise may be consumed in less-than-recommended amounts." For more information about building a healthy diet, refer to the Dietary Guidelines for Americansexternal link disclaimer and the U.S. Department of Agriculture's MyPlateexternal link disclaimer. The Dietary Guidelines for Americans describes a healthy eating pattern as one that: Includes a variety of vegetables, fruits, whole grains, fat-free or low-fat milk and milk products, and oils. Whole grains and dark-green, leafy vegetables are good sources of magnesium. Low-fat milk and yogurt contain magnesium as well. Some ready-to-eat breakfast cereals are fortified with magnesium. Includes a variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), nuts, seeds, and soy products. Dried beans and legumes (such as soybeans, baked beans, lentils, and peanuts) and nuts (such as almonds and cashews) provide magnesium. Limits saturated and trans fats, added sugars, and sodium. Stays within your daily calorie needs.

Define: neural tube defect

Neural tube defects are birth defects of the brain, spine, or spinal cord. They happen in the first month of pregnancy, often before a woman even knows that she is pregnant. The two most common neural tube defects are spina bifida and anencephaly.

briefly explain how vitamins/minerals work together or against one another and how that may affect health

Nutrition's dynamic duos Published: July, 2009 We spend a lot of time fretting about individual nutrients, but often they work in tandem. Nutrition guidelines and labels sometimes seem to have been written one nutrient at a time. We're advised to get this amount of that vitamin and that amount of this mineral. Separating out nutrients this way makes the guidelines relatively easy to understand and probably does help us avoid the classic diseases of nutritional deficiency, such as scurvy (not enough vitamin C) or pellagra (not enough niacin). But good nutrition — and the way in which in our bodies absorb and process nutrients — is a much bigger puzzle than a nutrient-by-nutrient tally sheet suggests. Most nutrients don't fly solo: they interact, join forces, cancel each other, jockey for position on metabolic pathways. One reason food is so often nutritionally preferable to pills or supplements is that food contains a mixture of nutrients, so we benefit from their interactions with each mouthful. The following is a list of nutrients that work in pairs. It's just a sampler, and far from a complete catalog. Even so, it may help inform some food choices — and give just a taste of the cruel complexity of the nutrition lurking behind guidelines and easy-to-read labels. Vitamin D and calcium Like most nutrients, calcium is absorbed primarily in the small intestine. If large quantities are present, much of the bone-strengthening mineral diffuses across the inner lining of the intestine on its own. But in smaller amounts, the mineral gets absorbed with active assistance from vitamin D and several of its metabolic offspring. D also lends a helping hand in the absorption of phosphorus, another mineral important to keeping bones strong and healthy, and magnesium. The evidence that D may have wide-ranging benefits, including offering some protection against heart disease and some forms of cancer, has piled up lately. Some of these benefits may be the result of the vitamin's absorption-related duties, but it may have a more direct effect on disease processes and the immune system than previously believed. Right now, the official nutrition guidelines recommend that adults get 1,000 milligrams (mg) of calcium and 400 international units (IU) of vitamin D daily. For older adults, it's a bit more: 1,200 mg of calcium starting in your 50s and 600 IU of vitamin D starting in your 70s. To give you an idea of how much that is, an 8-ounce glass of milk contains 300 mg of calcium and, because of fortification, 100 IU of vitamin D. There's debate these days about whether to revise the recommendations to reduce the goal for calcium intake (or at least de-emphasize it) and raise the goal for vitamin D (to 1,000 IU or even more). Sodium and potassium About 90% of the sodium we ingest comes in the form of sodium chloride — salt, in common parlance. Sodium and chloride are essential nutrients — we need them to maintain fluid levels in the body — but the average American consumes thousands more milligrams of sodium daily than he or she will ever need. Excess sodium interferes with the natural ability of blood vessels to relax and expand, while also encouraging the body to hang on to water, so blood volume increases. "Uptight" blood vessels with more blood flowing through them: that's a formula for cardiovascular woe. Blood pressure goes up, and with it, the chances of having a stroke or heart attack. But potassium, because it encourages the kidneys to excrete sodium, counters the harmful cardiovascular effects of sodium surplus. Many studies have shown a connection between high potassium intake and lower, healthier blood pressure. Several have dug a little deeper and found that the potassium-to-sodium ratio may be more important than potassium — or sodium — alone, although precisely what the ratio should be is uncertain. According to the current guidelines, American adults are supposed to get 4,700 mg of potassium and 1,200 to 1,500 mg of sodium daily, which works out to a ratio of somewhere between four-to-one and three-to-one. The average American intake is about half that amount of potassium (2,500 mg) and at least double that amount of sodium (2,500-7,500 mg). But time for a reality check: how many people are going to do the math and keep track of their potassium-sodium ratio for the day? It's enough for most of us just to count calories. Fortunately, the take-home message is simpler. Almost all of us need to have more potassium in our diets and a whole lot less sodium. And the best way to do that is consistent with the standard good nutrition playbook: load up on fruits and vegetables (prime sources of potassium) and cut back on cookies, salty snacks, fast foods, and ready-made lunches and dinners (prime sources of sodium). Vitamin B12 and folate Vitamin B12 and folate form one of nutrition's more estimable couples. They work together to support some of the most fundamental processes of cell division and replication. They also metabolize homocysteine together. And folate, which is itself one of the eight B vitamins, depends on B12 to be absorbed, stored, and metabolized. All this togetherness, despite the fact that these two nutrients hail from different sides of the animal-plant divide: vitamin B12 occurs naturally in meat, eggs, milk, and other foods of animal origin, while the best natural sources of folate include hard-core veggie fare like leafy green vegetables, beans, and legumes. Fortification has blurred these lines. Breakfast cereals with added vitamins and minerals contain B12, and in the United States, by law, cereal grains are fortified with folate. Indeed, because of fortification, it's fairly easy to get the recommended amounts of B12 (2.4 micrograms) and folate (400 micrograms) by eating a reasonably well-balanced diet. Strict vegans, who shun all animal-based products, may sometimes struggle to get enough B12. But for the most part, it isn't for lack of intake that B12 deficiency develops. It typically occurs because of shortages of substances inside the digestive system. Some people lack intrinsic factor, a protein made by stomach cells that's needed for B12 to be absorbed further down the pike, in the ileum, the end portion of the small intestine. And many older people secrete fewer of the gastric juices that break down B12-containing compounds because they have atrophic gastritis, an inflammatory condition that affects the lining of the stomach. Folate deficiencies occur for a number of reasons, including poor diet, too much alcohol (alcohol interferes with the absorption of folate), and B12 deficiency, because folate needs B12 to be metabolized. Deficiency in either or both vitamins may cause macrocytic anemia, a form of anemia that results in enlarged red blood cells. Remedying a B12 deficiency can be pretty straightforward. You can get injections every few months or take a pill daily. Even if you're low on intrinsic factor or have atrophic gastritis, the dose in the pills is often large enough (1 mg) that an adequate amount of the vitamin gets absorbed. Folate deficiencies can be corrected with multivitamins or folic acid pills. In fact, folate from fortified food or a pill is absorbed and metabolized almost twice as well as folate found naturally in food. Similar to the B12-intrinsic factor dynamic, if you ingest large amounts of folate, some manages to get absorbed even if levels of its B12 partner are low. There is an interesting twist to the B12-folate story. Doctors often stumble upon the existence of a B12 deficiency by finding macrocytic anemia after ordering a routine blood test. Tests for folate and B12 aren't usually ordered. When someone with a B12 deficiency takes folic acid supplements, those supplements can make the macrocytic anemia go away — or prevent it from happening. But that eliminates the most common clue to B12 deficiency, and the deficiency itself may continue. B12 deficiencies cause neurological problems, which range from mild tingling sensations to memory loss, in addition to anemia. So people live with neurological problems that might have been easily and inexpensively treated with some extra B12. Zinc and copper We associate copper with pennies, wire, and pans, but it's also an essential nutrient. Zinc is a little more familiar as an edible substance, partly because people take zinc lozenges in the belief that extra zinc shortens the duration of a cold (the evidence is mixed on whether it actually does). Adults are supposed to get 900 micrograms of copper daily. The daily zinc goals are 11 mg for men and 8 mg for women. Neither mineral is rare in the American food supply, so copper and zinc deficiencies don't loom large in the nutritional worriment — with a couple of interesting exceptions. Copper and zinc compete for absorption sites in the small intestine. If there's a lot of zinc around, copper tends to lose out and a copper deficiency may develop. Some people in the early stages of macular degeneration, an eye condition that can lead to blindness, are prescribed a special vitamin-mineral combination, called AREDS, which has been shown to slow down progression of the disease. The AREDS pills include 80 mg of zinc, enough to cause a copper deficiency, so 2 mg of copper were added to the pills. Another possible source of zinc overload is, of all things, denture cream. A report published in 2008 in Neurology described four cases of denture wearers with neurologic abnormalities. Their problems were ascribed to a copper deficiency from zinc exposure that came from using very large amounts of denture creams. A neurologist at Harvard-affiliated Beth Israel Deaconess Medical Center diagnosed a similar case of denture cream-induced neurologic abnormality in 2009. Niacin and tryptophan Niacin is one of the B vitamins, although it rarely goes by its B vitamin moniker, B3. These days, it's probably best known for its cholesterol effects. Large doses (500 mg to 1,500 mg per day) lower "bad" LDL cholesterol and increase "good" HDL cholesterol. Those pharmacological doses far exceed the amounts needed for nutritional purposes. The daily niacin requirement is 16 mg for men and 14 mg for women. Amino acids are the building blocks of protein, and tryptophan is one of nine that we need to ingest because the body doesn't synthesize them on its own. Tryptophan is important for several reasons, but chief among them is its role as a supplier of niacin, courtesy of some rather complicated metabolism. So one way to avoid niacin shortfalls is to eat foods that contain a lot of tryptophan. Chicken and turkey are high on that list. Pellagra, now held up as the classic disease of niacin deficiency, was once thought to be caused by a tryptophan deficiency. The disease, which causes a bad rash, diarrhea, and dementia, was common in the American South in the early 20th century. How researchers traced it back to a niacin deficiency and a corn-based diet is one of the great tales of nutritional epidemiology. Question: Please tell me which types of vitamins should not be taken together and which should be taken together for maximum effect. Answer: The question of when to take vitamins together or separately is an excellent one and which we address in the "What to Consider When Using" and "Concerns and Cautions" sections of our Reviews of vitamin or mineral supplements. How you take a supplement can be just as important as which product you take -- both may impact how much of a nutrient your body actually gets. A few rules of thumb: If you take a large dose of a mineral, it will compete with other minerals to reduce their absorption. The mineral most often taken in large amounts is calcium: The dose is usually several hundred of milligrams, compared to doses of just a few milligrams or even microgram amounts (1,000 micrograms = 1 milligram) of most other minerals. So if you take a calcium supplement, take it at a different time of day than other mineral supplements or a multivitamin/multimineral supplement. Doses of magnesium can also be relatively large and should, ideally, be taken apart from other minerals. If you take high doses of zinc long-term (50 mg or more per day for 10 weeks or longer ), be aware that it can cause copper deficiency, so you may need to supplement with copper as well. Some vitamins can actually enhance the absorption of other nutrients. Vitamin C, for example, can enhance iron absorption from supplements and plant foods. The fat-soluble vitamins (A, D, E, and K) are likely to be better absorbed if taken with a meal that contains fats. In fact, one study found that taking vitamin D with dinner rather than breakfast increased blood levels of vitamin D by about 50%. However, evidence (mainly from animal and cell studies) suggests that moderate to large doses of fat-soluble vitamins reduce absorption of other fat-soluble vitamins - by about 10 to 50% - due to competition. Absorption of vitamin K appears to be particularly reduced by other fat-soluble vitamins, while vitamin A absorption is least affected and may actually be better absorbed when taken with vitamin E (Goncalves, Food Chem 2015). Taking vitamins D, E, or K several hours before or after other fat-soluble vitamins would seem to maximize their absorption. Taking certain supplements with food can reduce gastrointestinal side-effects. For example, taking magnesium with food can reduce the occurrence of diarrhea, and taking iron with food can reduce the chance of stomach upset. Be aware that vitamins and minerals can also affect the absorption and effectiveness of medications. You'll find more specific information about this in the "Concerns and Cautions" section of each of our Reviews. You can also look up these drug interactions by drug name in our Encyclopedia. Keep in mind that these issues are not of significant concern when consuming a multivitamin providing up to the recommended daily intakes (RDAs) of vitamins and minerals -- as long as it does not contain more than 250 mg of either calcium or magnesium.

Define: dehydration

The process of losing or removing water or moisture. A condition caused by the excessive loss of water from the body, which causes a rise in blood sodium levels. Since dehydration is most often caused by excessive sweating, vomiting, or diarrhea, water loss is usually accompanied by a deficiency of electrolytes.

list the - function - sources (food and other) - deficiency - toxicity symptoms (if present) - diseases of each vitamin (if present) of the following VITAMIN: K

Vitamin K is a fat-soluble vitamin, so your body stores it in fat tissue and the liver. It is best known for its role in helping blood clot, or coagulate, properly. The "K" comes from its German name, Koagulationsvitamin. Vitamin K also plays an important role in bone health. It is rare to have a vitamin K deficiency. That's because in addition to being found in leafy green foods, the bacteria in your intestines can make vitamin K. Sometimes taking antibiotics can kill the bacteria and lead to a mild deficiency, mostly in people with low levels to begin with. Vitamin K deficiency can lead to excessive bleeding, which may begin as oozing from the gums or nose. Other things that may lead to vitamin K deficiency include: Health problems that can prevent your body from absorbing vitamin K, such as gallbladder or biliary disease, cystic fibrosis, celiac disease, and Crohn's disease Liver disease Taking blood thinners, such as warfarin (Coumadin) Long-term hemodialysis Serious burns Other conditions that benefit from vitamin K include: Excessive Bleeding Vitamin K is used to reduce the risk of bleeding in liver disease, conditions where your body doesn't absorb enough vitamin K, or if you take antibiotics for a long time. In the U.S., Canada, Great Britain, and many other countries, all newborns receive vitamin K injections to prevent the possibility of bleeding, particularly in the brain. Babies are born without any bacteria in their intestines and do not get enough vitamin K from breast milk to tide them over until their bodies are able to make it. Even though vitamin K deficiency in newborns is very rare, it is dangerous enough that doctors give the injections. Newborns at greatest risk for vitamin K deficiency are premature or those whose mother had to take seizure medications during pregnancy. Mothers on seizure medications are often given oral vitamin K for 2 weeks before delivery. Osteoporosis Your body needs vitamin K to use calcium to build bone. People who have higher levels of vitamin K have greater bone density, while low levels of vitamin K have been found in those with osteoporosis. Similarly, some studies suggest that low levels of vitamin K are associated with a higher risk of osteoarthritis. There is increasing evidence that vitamin K improves bone health and reduces the risk of bone fractures, particularly in postmenopausal women who are at risk for osteoporosis. In addition, studies of male and female athletes have also found that vitamin K helps with bone health. However, some studies have found that vitamin K didn't help with bone density. Dietary Sources Foods that contain a significant amount of vitamin K include beef liver, green tea, turnip greens, broccoli, kale, spinach, cabbage, asparagus, and dark green lettuce. Chlorophyll is the substance in plants that gives them their green color and provides vitamin K. Freezing foods may destroy vitamin K, but heating does not affect it. Available Forms There are 3 forms of vitamin K: Vitamin K1 or phylloquinone, the natural version of K1 and phytonadione, the synthetic type of K1 Vitamin K2 or menaquinone Vitamin K3 or menaphthone or menadione Vitamin K1 is the only form available in the U.S. as a supplement. It is available as part of multivitamin complexes or alone, in 5 mg tablets. Water-soluble chlorophyll is the most common form of vitamin K found over the counter. It is available in tablet, capsule, and liquid forms. How to Take It As with all supplements, check with a health care provider before taking vitamin K or giving it to a child. People whose bodies can't absorb enough vitamin K, because of gallbladder or biliary disease, cystic fibrosis, celiac disease, or Crohn's disease, will probably get more benefit from a multivitamin containing vitamin K than an individual vitamin K supplement. In certain circumstances, your doctor may give you a vitamin K shot. At recommended doses, vitamin K has few side effects. Vitamin K crosses the placenta and is also found in breast milk. Pregnant women and women who are breastfeeding should talk to their doctor before taking vitamin K supplements. People with a rare metabolic condition called Glucose-6-phosphate dehydrogenase (G6PD) deficiency should avoid vitamin K. People who take warfarin (Coumadin) should not take vitamin K (see "Possible Interactions"). People who are receiving dialysis for kidney diseases can have harmful effects from too much vitamin K.

Define: lactation

the secretion of milk by the mammary glands

Define: cretinism

Cretinism is a condition of severely stunted physical and mental growth owing to untreated congenital deficiency of thyroid hormone (congenital hypothyroidism) usually owing to maternal hypothyroidism.

Define: critical period

The embryonic period of development spans from week 3 through week 8 of pregnancy. The embryonic period is termed the critical period of development, because during this time all of the baby's organs begin to develop and function at a basic level. The developing baby undergoes very, very rapid cell differentiation during this time.

Deine: fetus

The unborn offspring of a mammal at the later stages of its development, especially a human from eight weeks after fertilization to its birth. In a fetus, all major body organs are present

Define: scurvy

a disease caused by a deficiency of vitamin C, characterized by swollen bleeding gums and the opening of previously healed wounds, which particularly affected poorly nourished sailors until the end of the 18th century.

Define: beriberi

a disease causing inflammation of the nerves and heart failure, caused by a deficiency of vitamin B1

Define: rickets

a disease of children caused by vitamin D deficiency, characterized by imperfect calcification, softening, and distortion of the bones typically resulting in bow legs.

Define: hemochromatosis

a hereditary disorder in which iron salts are deposited in the tissues, leading to liver damage, diabetes mellitus, and bronze discoloration of the skin

Define: oxytocin

a hormone released by the pituitary gland that causes increased contraction of the uterus during labor and stimulates the ejection of milk into the ducts of the breasts.

Define: goiter

an enlargement of the thyroid gland on the front and sides of the neck, usually symptomatic of abnormal thyroid secretion, especially hypothyroidism due to a lack of iodine in the diet.

Define: embryo

an unborn or unhatched offspring in the process of development, in particular a human offspring during the period from approximately the second to the eighth week after fertilization (after which it is usually termed a fetus).

list the - function - sources (food and other) - deficiency - toxicity symptoms (if present) - diseases of each vitamin (if present) of the following VITAMIN: B5 (pantothenic acid)

source: - grains - vegetables - meats deficiency: - fatigue - depression - insomnia functions: - sex and stress hormones - RBC production

Define: enrichment

the action of improving or enhancing the quality or value of something. "enrichment of the soil for more plant growth"

list the water soluble vitamins (8)

- Niacin - B6 (pyridoxine) - B12 (cobalamin) - Folacin (Folate or Folic Acid) - Vitamin C (ascorbic acid) - Vitamin B Complex - B2 (riboflavin) - B1 (thiamin)

Define: osteoblast

A cell that makes bone. It does so by producing a matrix that then becomes mineralized. Bone mass is maintained by a balance between the activity of osteoblasts that form bone and other cells called osteoclasts that break it down

Define: cofactor

A cofactor is a non-protein chemical compound or metallic ion that is required for a protein's biological activity to happen. These proteins are commonly enzymes, and cofactors can be considered "helper molecules" that assist in biochemical transformations.

Child nutrition: - what to provide - what to avoid

A healthy diet helps children grow and learn. It also helps prevent obesity and weight-related diseases, such as diabetes. To give your child a nutritious diet Make half of what is on your child's plate fruits and vegetables Choose healthy sources of protein, such as lean meat, nuts, and eggs Serve whole-grain breads and cereals because they are high in fiber. Reduce refined grains. Broil, grill, or steam foods instead of frying them Limit fast food and junk food Offer water or milk instead of sugary fruit drinks and sodas Learn about your children's nutrient requirements. Some of them, such as the requirements for iron and calcium, change as your child ages.

Infant feeding: - formula vs. breastmilk - ntroduction of solid foods

A big decision new moms must make for their little one's nutrition is breast vs. formula. Some people can be uncomfortable around women while they are breastfeeding. However, if you pull out a bottle of formula, there are those who may criticize you for not feeding your baby what they might consider "nature's perfect food" -- breast milk. Welcome to mommy guilt. No matter what you decide, other people will surely have an opinion. Only one thing really matters: Which choice is right for you and your baby? Breastfeeding The American Academy of Pediatrics (AAP) recommends breast milk as the best nutrition for infants. Babies should be breastfed exclusively for the first six months, according to the AAP. After other foods have been introduced, the AAP encourages mothers to continue to breastfeed until baby is at least a year old, and as long after that as both mother and child are willing. Breast milk is good for your baby in many ways: It provides natural antibodies that help your baby resist illnesses, such as ear infections. It's usually more easily digested than formula. So breastfed babies are often less constipated and gassy. It may lower the risk of sudden infant death syndrome in the first year of your baby's life. It may raise your child's intelligence. Studies show breastfed babies have higher levels of cognitive function. Breast milk may even help your child in later years, by reducing the risk of being overweight, and of developing asthma, type 1 and type 2 diabetes, high cholesterol, Hodgkin's disease, leukemia, and lymphoma. Breastfeeding is good for moms, too. Women who breastfeed have a reduced risk of breast cancer, diabetes, heart disease, osteoporosis, and ovarian cancer. But let's not forget a key reason many new moms want to breastfeed. It's a wonderful bonding experience with your baby. Breast milk can also be pumped which will allow for public feedings and other family members to participate in feeding. Formula Feeding Formula feeding is also a healthy choice for babies. If you use a formula, your baby will get the best possible alternative to breast milk. (You should not attempt to make your own formula or feed an infant cow's milk.)Introducing solids Solid Food Charts for Baby and Introducing Solid Foods to Your Baby Introducing Solid Foods to Your Baby - Tips, Solid Food Charts For Babies and Other Useful Information about Starting Solids Introducing solid foods to your baby is a really big milestone. This milestone is a lot of fun and a lot of worry as well. One of the most important things to keep in mind is that your baby has so many years of food experiences ahead that there is no need to rush things! Remember, you are taking the first steps to helping your little one develop healthy eating habits that will last a lifetime. Here you will find pages of useful information and solid food charts for you to review and get a sense of what your baby may be eating at a certain age or stage. This information will help ease your mind as you are introducing solid foods and will also ease the transition to solid foods for your baby. Current Recommendations for Introducing Solid Foods Current recommendations indicate that breast milk or formula should be baby's main source of nutrition until at least 6 months of age. While many pediatricians recommend starting solid foods sometime between 4 and six months of age, the earlier introduction of solid foods may have certain risk factors; consult your pediatrician. For example, the "Introduction of complementary feedings [solid foods] before 6 months of age generally does not increase total caloric intake or rate of growth and only substitutes foods that lack needed nutrients and the protective components of human milk (and formula). AAP Policy Note - 194" Is Your Baby Ready for Solid Food? How do you know if your baby is ready for solid foods? There are many signs to look for that will indicate that your little one may be ready to begin the journey into solid foods. Your baby may be 3 months old or 4 months old when you start to feel she may need "something more" than formula or breast milk. Maybe she is beginning to awaken more often at night or eat more often than "usual" and you wonder if introducing solid foods may be what she needs.Please keep in mind that a growth spurt will occur between 3-4 months of age. Your baby may begin to wake more frequently at night for a feeding and/or may being to eat non-stop (cluster feed) as she once did as a newborn. image: http://cdn1-www.wholesomebabyfood.momtastic.com/assets/uploads/2015/04/hint.gif hint Read more at Is Your Baby Ready for Solid Foods? Beginning Solid Foods When you find that your baby is ready for solid foods, consider skipping the boxed cereal and starting out with avocado, sweet potato, banana or pear! You should give your baby one new food at a time, and wait a a minimal of 2 to 3 days before starting another. Many parents follow the "4 day wait rule" and choose to wait 4 days between introducing new foods. After each new food, watch for any allergic reactions such as diarrhea, rash, or vomiting. If any of these occur, stop using the new food and consult with your child's doctor. Within a few months of starting solid foods, according to the AAP, you should offer your baby a variety of foods each day that may include the following: Breast milk and/or formula Meats Cereal Vegetables Fruits Eggs and fish Introducing Allergenic Foods to Babies and Food Allergies Changes to how to introduce allergenic foods to your baby are slowly taking place. "Many pediatricians recommend against giving eggs and fish in the first year of life because of allergic reactions, but there is no evidence that introducing these nutrient-dense foods after 4 to 6 months of age determines whether your baby will be allergic to them." view report Visit the Allergies & Baby Food page to learn more about these changes as well as about allergenic foods. Remember, the World Health Organisation, the American Academy of Pediatrics, Health Canada, Health Insite - Australia and the Department of Public Health (U.K.) as well as the CDC all recommend that babies receive nothing but breast milk and/or formula for the first 6 months of age. What does the WHO say? "Complementary feeding should be timely, meaning that all infants should start receiving foods in addition to breast milk from 6 months onwards. It should be adequate, meaning that the nutritional value of complementary foods should parallel at least that of breast milk. Foods should be prepared and given in a safe manner, meaning that measures are taken to minimize the risk of contamination with pathogens. And they should be given in a way that is appropriate, meaning that foods are of appropriate texture and given in sufficient quantity." WHO Complementary Feeding Further, the "WHO recommends that infants start receiving complementary foods at 6 months of age in addition to breast milk, initially 2-3 times a day between 6-8 months, increasing to 3-4 times daily between 9-11 months and 12-24 months with additional nutritious snacks offered 1-2 times per day, as desired." image: http://cdn1-www.wholesomebabyfood.momtastic.com/assets/uploads/2015/04/stop3.gif stop3 Remember, always consult with your pediatrician regarding introducing solid foods to your baby and specifically discuss any foods that may pose allergy risks for your baby.

discuss the following pregnancy risks: - mother's age - gestational diabetes - preeclampsia/eclampsia - things to avoid

As the average age at marriage rises in the U.S., so does the average age of new mothers. If you're an older mom, you're not alone. About 11 percent of babies born in the U.S. each year have moms over the age of 35. Recent studies, however, have shown that women who postpone childbearing do face some special risks, including: infertility and miscarriage, premature delivery and stillbirth, gestational diabetes, bleeding complications, hypertensive disorders of pregnancy, C-section, chromosomal abnormalities in babies, growth retardation in babies, and delivering multiplesWhat is Gestational Diabetes? Pregnant women who have never had diabetes before but who have high blood glucose (sugar) levels during pregnancy are said to have gestational diabetes. According to a 2014 analysis by the Centers for Disease Control and Prevention, the prevalence of gestational diabetes is as high as 9.2%. We don't know what causes gestational diabetes, but we have some clues. The placenta supports the baby as it grows. Hormones from the placenta help the baby develop. But these hormones also block the action of the mother's insulin in her body. This problem is called insulin resistance. Insulin resistance makes it hard for the mother's body to use insulin. She may need up to three times as much insulin. Gestational diabetes starts when your body is not able to make and use all the insulin it needs for pregnancy. Without enough insulin, glucose cannot leave the blood and be changed to energy. Glucose builds up in the blood to high levels. This is called hyperglycemia. You may also be interested in our book, Diabetes & Pregnancy: A Guide to a Healthy Pregnancy. How Gestational Diabetes Can Affect Your Baby Gestational diabetes affects the mother in late pregnancy, after the baby's body has been formed, but while the baby is busy growing. Because of this, gestational diabetes does not cause the kinds of birth defects sometimes seen in babies whose mothers had diabetes before pregnancy. However, untreated or poorly controlled gestational diabetes can hurt your baby. When you have gestational diabetes, your pancreas works overtime to produce insulin, but the insulin does not lower your blood glucose levels. Although insulin does not cross the placenta, glucose and other nutrients do. So extra blood glucose goes through the placenta, giving the baby high blood glucose levels. This causes the baby's pancreas to make extra insulin to get rid of the blood glucose. Since the baby is getting more energy than it needs to grow and develop, the extra energy is stored as fat. This can lead to macrosomia, or a "fat" baby. Babies with macrosomia face health problems of their own, including damage to their shoulders during birth. Because of the extra insulin made by the baby's pancreas, newborns may have very low blood glucose levels at birth and are also at higher risk for breathing problems. Babies with excess insulin become children who are at risk for obesity and adults who are at risk for type 2 diabetes. What Are Preeclampsia and Eclampsia? Preeclampsia and eclampsia are diseases of pregnancy that involve the development or worsening of high blood pressure during the second half of pregnancy. Preeclampsia, formerly called "toxemia of pregnancy," may develop into the more severe condition called eclampsia. Eclampsia includes symptoms of preeclampsia, along with seizures. These conditions, when they develop, occur after 20 weeks of pregnancy. They also may develop shortly after delivery. In very rare situations, they occur before 20 weeks of pregnancy. High blood pressure is dangerous during pregnancy because it may interfere with the placenta's ability to deliver oxygen and nutrition to your fetus. Your baby may be born weighing less than normal, may have other health problems, and may need to be delivered early. If your blood pressure continues to climb higher, your kidneys may have trouble functioning. You may have changes in the makeup of your blood, such as a destruction of red blood cells (causing anemia), as well as disturbed liver function and decreased platelets (the blood cells involved in clotting). Too few platelets can increase your risk of bleeding uncontrollably during delivery, or even spontaneously. In addition, the high blood pressure may cause the placenta to begin to separate from the wall of the uterus, called a placental abruption. This can cause severe bleeding and even death of the fetus and possibly the mother. If you begin to have seizures with a severe form of preeclampsia, you're considered to have eclampsia. This is a life-threatening situation for both you and your baby. During a seizure, you and your baby are at risk of being deprived of oxygen. Who Gets Preeclampsia and Eclampsia? Preeclampsia affects 3% to 5% of all pregnancies in the U.S. Any pregnant woman can get preeclampsia, but you're at increased risk of developing preeclampsia if: This is your first pregnancy Your mother or sister had preeclampsia or eclampsia during pregnancy You're carrying twins You're African-American You're under age 20 or over age 40 at the time of pregnancy You already have high blood pressure, kidney disease, or diabetes You have a pre-pregnancy body mass index (BMI) greater than 30 You had preeclampsia in a previous pregnancy What Causes Preeclampsia and Eclampsia? The cause of preeclampsia is still unclear. Most theories focus on abnormal placental development, blood vessel disruption, immune system, or genetic factors. Eclampsia usually develops when preeclampsia goes unnoticed and untreated. What To Avoid During Pregnancy—and How Not To Miss It Too Much NOW THAT YOU'RE EXPECTING, THESE ARE THE FOODS, ACTIVITIES AND MEDICATIONS TO STEER CLEAR OF. First off, don't dwell on the fact that you have to give stuff up. "Instead of being negative, use this as an opportunity to do healthy things we all know we should be doing," says Laura Riley, MD, ob-gyn, director of labor and delivery at Massachusetts General Hospital and author of You & Your Baby: Pregnancy. Plus, when you step back and really think about it, it's not really that much that you have to give up. Here are a few strategies to help you cope while you detox from your old routine. Get an energy boost without a bunch of caffeine Try: Six small meals a day. Some experts swear by "the six-meal solution." The idea is that, instead of three big meals, you eat a bunch of little, healthy ones throughout the day to keep your blood sugar from spiking and dipping—which could prevent your energy levels from plummeting. The bright side: "You're pregnant—you're supposed to be tired," says Riley. In other words, it's also okay to give yourself permission to take a nap and to take things easier than you used to. Don't feel guilty about it, and make it a rule to always get a full night's sleep. Calm down without smoking Try: Yoga breathing. Smoking-cessation programs teach that deep breathing, stretching and relaxation techniques can help quitters cope with the urge to smoke. Yoga's a great combination of all three. It's also a great way to deal with stress! Enroll in a prenatal yoga class to learn some moves. The bright side: If you've tried to quit smoking in the past with no luck, this time you have a better reason than ever to stop—baby's health. Think about it this way: Once you've given it up for nine months, it will be so much easier to stay smoke-free. Forever. ADVERTISEMENT Grab lunch without deli meat Try: Roasting your own turkey. Yeah, we know, it's a big bummer that you can't eat a simple sandwich from your favorite deli, but listeria poisoning—which is caused by bacteria that could potentially live on deli meat—could really harm your baby. In the worst cases, it could lead to miscarriage, premature delivery or stillbirth. "I've seen those cases of listeria and it is such a sad outcome, and people feel so incredibly guilty," says Riley. But making your own food and knowing that you cleaned it and the utensils properly will give you peace of mind that your food is a-okay to eat. Heating your meat to the point where it steams can kill the listeria bacteria too. The bright side: You'll save money by eating out less. Ease a headache without ibuprofen Try: Acetaminophen (aka Tylenol) is completely okay to take, as long as you follow the recommended dosage on the bottle, says Riley. The bright side: It's not like you can't take anything. Look hot without sky-high heels Try: Wedges, kitten heels, lower heels (under three inches) that are thick. Your center of gravity is off now that you're pregnant, and you just don't want to risk wobbles and falls. The bright side: These are all super-stylish options! Enjoy girls' night without a cocktail Try: A mocktail, of course! Here are a few favorite nonalcoholic drinks. Basically, anything sweet and bubbly (just add seltzer) with a lime perched on the end will still feel festive, despite the lack of booze. The bright side: You may not be able to drink, but at least you can order some tasty bar food to nibble while you're out with your friends.

Define: calcitrol

Calcitriol: The active form of vitamin D. Calcitriol is formed in the kidneys or made in the laboratory. It is used as a drug to increase calcium levels in the body in order to treat skeletal and tissue-related calcium deficiencies caused by kidney or thyroid disorders.

Define: colostrum

the first secretion from the mammary glands after giving birth, rich in antibodies

Nutrient needs: - macronutrient - micronutrient - special concerns over the course of life stages (including pre-natal, pregnancy, and post-natal)

(this is not answered well) Nutritional Requirements Throughout the Life Cycle: Pregnancy and Lactation Pregnant and lactating women have increased requirements for both macronutrients and micronutrients. The failure to achieve required intakes may increase risk for certain chronic diseases in their children, sometimes manifesting many years later.10,11 For instance, studies of the Dutch famine during World War II (in which rations were progressively cut from 1,400 kcal/day in August 1944 to 1,000 kcal/day in December, and ultimately to 500 kcal/day) found that undernutrition during mid- to late pregnancy increased the risk for glucose intolerance and resulted in greater progression of age-related hypertension.27 Malnutrition of women during early pregnancy correlated with higher body weights of their offspring as adults, along with increased risk for coronary heart disease and certain central nervous system anomalies.10,27,28 Protein requirements in pregnancy rise to 1.1 g/kg/day (71 g), amounting to more than a 50% increase in protein intake to allow for fetal growth and milk production. The source of protein may be as important as the quantity, however. Some evidence suggests that protein requirements can be more safely met by vegetable than by animal protein. Meat is a major source of saturated fat and cholesterol; it is also a common source of ingestible pathogens29 and a rich source of arachidonic acid, a precursor of the immunosuppressive eicosanoid PGE2. Pregnant women also should not meet their increased need for protein by the intake of certain types of fish, such as shark, swordfish, mackerel, and tilefish, which often contain high levels of methylmercury, a potent human neurotoxin that readily crosses the placenta.30 Other mercury-contaminated fish, including tuna and fish taken from polluted waters (pike, walleye, and bass), should be especially avoided.31 There is no nutritional requirement for fish or fish oils. Vegetable protein sources, aside from meeting protein needs, can help meet the increased needs for folate, potassium, and magnesium and provide fiber, which can help reduce the constipation that is a common complaint during pregnancy. Pregnant and/or lactating women also require increased amounts of vitamins A, C, E, and certain B vitamins (thiamine, riboflavin, niacin, pyridoxine, choline, cobalamin, and folate). Folate intake is especially important for the prevention of neural tube defects and should be consumed in adequate amounts prior to conception; evidence shows that average intakes are only ~60% of current recommendations.32 Folate intakes were noted to be poorest in women eating a typical Western diet and highest in women eating vegetarian diets.33 Pregnant women also require increased amounts of calcium, phosphorus, magnesium, iron, zinc, potassium, selenium, copper, chromium, manganese, and molybdenum.1 Prenatal vitamin-mineral formulas are suggested to increase the likelihood that these nutrient needs will be met.

Define: dental fluorosis

Diuretics are used to treat the buildup of excess fluid in the body that occurs with some medical conditions such as congestive heart failure, liver disease, and kidney disease. Some diuretics are also prescribed to treat high blood pressure. These drugs act on the kidneys to increase urine output.

Define: diuretic

Diuretics are used to treat the buildup of excess fluid in the body that occurs with some medical conditions such as congestive heart failure, liver disease, and kidney disease. Some diuretics are also prescribed to treat high blood pressure. These drugs act on the kidneys to increase urine output.

Define: development

Embryonic Development (embryogenesis) is the series of changes an embryo undergoes, prenatal development, as it grows toward a mature organism.

list the - function - sources (food and other) - deficiency - toxicity symptoms (if present) - diseases of each vitamin (if present) of the following MINERAL: electrolytes: sodium, potassium, chloride

Electrolytes are minerals found in bodily fluids that carry an electric charge and are essential to keeping the heart, nerves and muscles functioning properly. As such, it is important to maintain a precise and constant balance of electrolytes to stay healthy. The kidneys play an important role in ensuring that electrolyte levels remain invariant despite any changes the body may undergo. Having an excess or an insufficiency of electrolytes in the body can be dangerous and in some cases fatal. Electrolyte Function One of the major roles of electrolytes is to ensure that fluid levels inside and outside the cell are balanced. The cell can adjust its fluid levels by changing the concentration of electrolytes. For example, an increase in electrolytes within the cell draws more fluid in whereas a decrease in electrolytes promotes an efflux of fluids. Sustaining this type of osmotic gradient is essential for nerve and muscle function, hydration, and maintaining blood pH levels. Additionally, electrolytes carry electrical impulses across the cell and to neighboring cells in order to promote muscle contractions and nerve impulses. The most common electrolytes found in the body are calcium, sodium, potassium, phosphate, chloride and magnesium. The serum values and individual functions for these electrolytes are: Calcium is the most abundant electrolyte in the body. 99 percent of calcium is stored in the teeth and bones where it helps to make and keep them strong. Moreover, calcium is also critical for muscle contraction, nerve signaling, blood clotting and maintaining normal heart function. Normal serum calcium values range from 8.5 to 10.2 milligrams per deciliter (mg/dL). Sodium is the major cation (positively charged ion) found outside the cell. It regulates the total amount of water in the body and plays a major role in neuronal and nerve signaling. Normal serum sodium values range from 135 to 145 milliequivalent/liter (mEq/L). Potassium is the major cation inside the cell. Potassium is essential for the proper functioning of the heart, kidneys, muscles, nerves, and digestive system. The normal blood potassium level is 3.5 to 5.0 mEq/L. Phosphate makes up one percent of a person's total body weight. A majority of the body's phosphate is found in the bones and teeth where it promotes their formation. It also plays an important role in the body's utilization of carbohydrates and fats. Phosphates are also critical to the synthesis of proteins that promote the growth, maintenance, and repair of cells and tissues. Normal values range from 2.4 to 4.1 mg/dL. Chloride is the major anion (negatively charged ions) found outside the cell. Chloride plays a critical role in keeping the proper balance of body fluids and maintaining the body's acid-base balance. The normal chloride values are 96 to 106 mEq/L. Magnesium is the fourth most abundant mineral in the body. Half of the body's magnesium is found in the bone and the other half is found mainly within the cells of body tissues and organs. Magnesium is needed for more than 300 biochemical reactions in the body. It helps maintain normal muscle and nerve function, keeps the heart rhythm steady, supports a healthy immune system, and keeps bones strong. Magnesium also helps regulate blood sugar levels, promotes normal blood pressure, and is also involved in energy metabolism. Normal serum values of magnesium are 1.7 to 2.2 mg/dL. Electrolyte Imbalance An electrolyte imbalance can develop as a result of either having excess or a deficiency of electrolytes in the body. An electrolyte imbalancemay be caused by: Loss of body fluids: may be caused by prolonged vomiting, diarrhea, sweating or high fever Poor diet Malabsorption: the body may be unable to absorb electrolytes due to a variety of stomach disorders Hormonal or endocrine disorders Kidney disease Certain medications: chemotherapy drugs, diuretics, antibiotics, and corticosteroids A majority of the electrolyte related health problems occur when levels of sodium, potassium or calcium are unbalanced. Hypernatremia (having an excess of sodium) is the most common type of electrolyte imbalance. Treating an Electrolyte Imbalance: Treatment of electrolyte imbalance may vary depending on the underlying cause or which electrolyte is imbalanced. Treatments include: Intravenous fluids Dietary changes. Minor electrolyte imbalances may be remedied by dietary changes. For example, consuming more potatoes, bananas or avocados will increase potassium levels. Eating more leafy green vegetables will increase magnesium levels. Increasing your intake of celery and yogurt will increase sodium and calcium levels, respectively Maintaining Electrolytes In order to stay healthy, it is critical to replace electrolytes lost through sweat or as a result of a poor diet. A diet that includes whole grains, leafy greens, fresh fruits and vegetables usually provides the electrolytes your body needs. It is also important to supplement your diet with sports drinks or fruit juices when participating in strenuous activity.

Define: ferritin

Ferritin is a universal intracellular protein that stores iron and releases it in a controlled fashion. The protein is produced by almost all living organisms, including algae, bacteria, higher plants, and animals. In humans, it acts as a buffer against iron deficiency and iron overload.[3] Ferritin is found in most tissues as a cytosolic protein, but small amounts are secreted into the serum where it functions as an iron carrier. Plasma ferritin is also an indirect marker of the total amount of iron stored in the body, hence serum ferritin is used as a diagnostic test for iron-deficiency anemia.[4] Ferritin is a globular protein complex consisting of 24 protein subunits forming a nanocage with multiple metal-protein interactions.[5] It is the primary intracellular iron-storage protein in both prokaryotes and eukaryotes, keeping iron in a soluble and non-toxic form. Ferritin that is not combined with iron is called apoferritin

Define: anemia - hemolytic - megaloblastic - macrocytic - microcytic - hypochromic - pernicious

Hypochromic anemia is a generic term for any type of anemia in which the red blood cells (erythrocytes) are paler than normal. (Hypo- refers to less, and chromic means color.) A normal red blood cell will have an area of pallor in the center of it; it is biconcave disk shaped. In hypochromic cells, this area of central pallor is increased. This decrease in redness is due to a disproportionate reduction of red cell hemoglobin (the pigment that imparts the red color) in proportion to the volume of the cell. Clinically the color can be evaluated by the Mean Corpuscular Hemoglobin (MCH) or Mean Corpuscular Hemoglobin Concentration (MCHC). The MCHC is considered the better parameter of the two as it adjusts for affect the size of the cell has on its color. [1] Hypochromia is clinically defined as below the normal MHC reference range of 27-33 picograms/cell in adults or below the normal MCHC reference range of 33-36 g/dL in adults.[2] Red blood cells will also be small (microcytic), leading to substantial overlap with the category of microcytic anemia. The most common causes of this kind of anemia are iron deficiency and thalassemia. Hypochromic anemia was historically known as chlorosis or green sickness for the distinct skin tinge sometimes present in patients, in addition to more general symptoms such as a lack of energy, shortness of breath, dyspepsia, headaches, a capricious or scanty appetite and amenorrhea. Contents [hide] 1 Historical understanding 2 Acquired forms 3 Hereditary forms 4 See also 5 Notes 6 External links Historical understanding[edit] Pandar Now, the pox upon her green-sickness for me! Bawd 'Faith, there's no way to be rid on't but by the way to the pox. Here comes the Lord Lysimachus disguised. Shakespeare (attrib). Pericles Prince of Tyre[3] In 1554, German physician Johannes Lange described a condition, which he called "the disease of virgins" because, he said, it was "peculiar to virgins". The symptoms were wide-ranging, including an appearance which is "pale, as if bloodless", an aversion to food (especially meat), difficulty in breathing, palpitations and swollen ankles.[4] He prescribed that sufferers should "live with men and copulate. If they conceive, they will recover." The symptom picture overlaps to some extent with an earlier condition described in English medical texts, "the green sickness", which was a form of jaundice.[5] However, Lange shifted the cause from digestive errors to the sufferer remaining a virgin, despite being of the age for marriage. The name "chlorosis" was coined in 1615 by Montpellier professor of medicine Jean Varandal from the ancient Greek word "chloros" meaning "greenish-yellow," "pale green," "pale," "pallid" or "fresh". Both Lange and Varandal claimed Hippocrates as a reference, but their lists of symptoms do not match that in the Hippocratic Disease of Virgins, a treatise that was translated into Latin in the 1520s and thus became available to early modern Europe.[4] In addition to "green sickness", the condition was known as morbus virgineus ("virgin's disease") or febris amatoria ("lover's fever"). Francis Grose' 1811 Dictionary of the Vulgar Tongue defined "green sickness" as: "The disease of maids occasioned by celibacy."[6] In 1681, English physician Thomas Sydenham classified chlorosis as a hysterical disease affecting not only adolescent girls but also "slender and weakly women that seem consumptive." He advocated iron as a treatment: "To the worn out or languid blood it gives a spur or fillip whereby the animal spirits which lay prostrate and sunken under their own weight are raised and excited". Daniel Turner in 1714 preferred to term chlorosis "the Pale or White Sickness ... since in its worst State the Complexion is rarely or ever a true Green, tho' bordering on that Hue". He went on to describe it as "an ill Habit of Body, arising either from Obstructions, particularly of the menstrual Purgation, or from a Congestion of crude Humours in the Viscera, vitiating the Ferments of the Bowels, especially those of Concoction, and placing therein a depraved Appetite of Things directly preternatural, as Chalk, Cinders, Earth, Sand, &c". One of his case studies was that of an 11-year-old girl who was found, on investigation, to have been eating large quantities of coal.[7] Chlorosis is briefly mentioned in Casanova's Histoire de ma vie: "I do not know, but we have some physicians who say that chlorosis in girls is the result of that pleasure onanism indulged in to excess". In 1841, the Bohemian doctor and pharmacist Albert Popper published a treatment for Chlorosis containing Vitriolum martis (sulfuric acid and iron) and Sal tartari (potassium carbonate) in Österreichische medicinische Wochenschrift which was republished and refined in the following years.[8][9][10][11][12] In 1845, the French writer Auguste Saint-Arroman gave a recipe for a treatment by medicinal chocolate that included iron filings in his De L'action du café, du thé et du chocolat sur la santé, et de leur influence sur l'intelligence et le moral de l'homme[13] and in 1872, French physician Armand Trousseau also advocated treatment with iron, although he still classified chlorosis as a "nervous disease".[14][15][16] In 1887, physician Sir Andrew Clark of London Hospital proposed a physiological cause for chlorosis, tying its onset to the demands placed on the bodies of adolescent girls by growth and menarche. In 1891, Frank Wedekind's play Spring Awakening referenced the disease. In 1895, University of Edinburgh pathologist Ralph Stockman built upon experiments demonstrating that inorganic iron contributed to hemoglobin synthesis to show that chlorosis could be explained by a deficiency in iron brought on by loss of menstrual blood and an inadequate diet. Despite the work of Stockman and the effectiveness of iron in treating the symptoms of chlorosis, debate about its cause continued into the 1930s. A character in T. C. Boyle's The Road to Wellville suffers from chlorosis, and the narrator describes her green skin and black lips. In 1936, Arthur J. Patek and Clark W. Heath of Harvard Medical School concluded that chlorosis was identical to hypochromic anemia.[17] More recently, some people have suggested that it may have been endometriosis, but the historical descriptions cannot easily be mapped on to this condition.[18] Acquired forms[edit] Hypochromic anemia may be caused by vitamin B6 deficiency from a low iron intake, diminished iron absorption, or excessive iron loss. It can also be caused by infections (e.g. hookworms) or other diseases (i.e. anemia of chronic disease), therapeutic drugs, copper toxicity, and lead poisoning. One acquired form of anemia is also known as Faber's syndrome. It may also occur from severe stomach or intestinal bleeding caused by ulcers or medications such as aspirin or bleeding from hemorrhoids.[19][20] Hereditary forms[edit] This section does not cite any sources. Please help improve this section by adding citations to reliable sources. Unsourced material may be challenged and removed. (June 2016) (Learn how and when to remove this template message) Hypochromic anemia occurs in patients with hypochromic microcytic anemia with iron overload. The condition is autosomal recessive and is caused by mutations in the SLC11A2 gene. The condition prevents red blood cells from accessing iron in the blood, which causes anemia that is apparent at birth. It can lead to pallor, fatigue, and slow growth. The iron overload aspect of the disorder means that the iron accumulates in the liver and can cause liver impairment in adolescence or early adulthood.[21] It also occurs in patients with hereditary iron refractory iron-deficiency anemia (IRIDA). Patients with IRIDA have very low serum iron and transferrin saturation, but their serum ferritin is normal or high. The anemia is usually moderate in severity and presents later in childhood.[22] Hypochromic anemia is also caused by thalassemia and congenital disorders like Benjamin anemia.[23]Everything You Need To Know About Microcytic Anemia Symptoms Types and causes Diagnosis Treatment Outlook Prevention Microcytic anemia definition Key points In microcytic anemia your body has fewer red blood cells than normal, and the ones it does have are too small. It's most often caused by iron deficiency. Many cases can be treated with supplements and diet changes to increase your iron intake. Microcytosis is a term used to describe red blood cells that are smaller than normal. Anemia is when you have low numbers of properly functioning red blood cells in your body. In microcytic anemias, your body has fewer red blood cells than normal. The red blood cells it does have are also too small. Several different types of anemias can be described as microcytic. Microcytic anemias are caused by conditions that prevent your body from producing enough hemoglobin. Hemoglobin is a component of your blood. It helps transport oxygen to your tissues and gives your red blood cells their red color. Iron deficiency causes most microcytic anemias. Your body needs iron to produce hemoglobin. But other conditions can cause microcytic anemias, too. To treat a microcytic anemia, your doctor will first diagnose the underlying cause. SYMPTOMS Microcytic anemia symptoms You may not notice any symptoms of microcytic anemia at first. Symptoms often appear at an advanced stage when the lack of normal red blood cells is affecting your tissues. Common symptoms of microcytic anemias include: fatigue, weakness, and tiredness loss of stamina shortness of breath dizziness pale skin If you experience any of these symptoms and they don't resolve within two weeks, make an appointment to see your doctor. You should make an appointment to see your doctor as soon as possible if you experience severe dizziness or shortness of breath. TYPES AND CAUSES Microcytic anemia types and causes Microcytic anemias can be further described according to the amount of hemoglobin in the red blood cells. They can be either hypochromic, normochromic, or hyperchromic: 1. Hypochromic microcytic anemias Hypochromic means that the red blood cells have less hemoglobin than normal. Low levels of hemoglobin in your red blood cells leads to appear paler in color. In microcytic hypochromic anemia, your body has low levels of red blood cells that are both smaller and paler than normal. Most microcytic anemias are hypochromic. Hypochromic microcytic anemias include: Iron deficiency anemia: The most common cause of microcytic anemia is an iron deficiency in the blood. Iron deficiency anemia can be caused by: inadequate iron intake, usually as a result of your diet being unable to absorb iron due to conditions like celiac disease or Helicobacter pylori infection chronic blood loss due to frequent or heavy periods in women or by gastrointestinal (GI) bleeds from upper GI ulcers or irritable bowel syndrome pregnancy Read more: 3 ways to prevent anemia in pregnancy » Thalassemia: Thalassemia is a type of anemia that's caused by an inherited abnormality. It involves mutations in the genes needed for normal hemoglobin production. Sideroblastic anemia: Sideroblastic anemia can be inherited due to gene mutations (congenital). It can also be caused by a condition acquired later in life that impedes your body's ability to integrate iron into one of the components needed to make hemoglobin. This results in a buildup of iron in your red blood cells. Congenital sideroblastic anemia is usually microcytic and hypochromic. 2. Normochromic microcytic anemias Normochromic means that your red blood cells have a normal amount of hemoglobin, and the hue of red is not too pale or deep in color. An example of a normochromic microcytic anemia is: Anemia of inflammation and chronic disease: Anemia due to these conditions is usually normochromic and normocytic (red blood cells are normal in size). Normochromic microcytic anemia may be seen in people with: infectious diseases, such as tuberculosis, HIV/AIDS, or endocarditis inflammatory diseases, such as rheumatoid arthritis, Crohn's disease, or diabetes mellitus kidney disease cancer These conditions can prevent red blood cells from functioning normally. This can lead to decreased iron absorption or utilization. 3. Hyperchromic microcytic anemias Hyperchromic means that the red blood cells have more hemoglobin than normal. High levels of hemoglobin in your red blood cells makes them a deeper hue of red than normal. Congenital spherocytic anemia: Hyperchromic microcytic anemias are rare. They may be caused by a genetic condition known as congenital spherocytic anemia. This is also called hereditary spherocytosis. In this disorder, the membrane of your red blood cells doesn't form correctly. This causes them to be rigid and improperly spherical shaped. They are sent to be broken down and die in the spleen because they don't travel in the blood cells properly. 4. Other causes of microcytic anemia Other causes of microcytic anemia include: lead toxicity copper deficiency zinc excess, which causes copper deficiency alcohol use drug use ADVERTISEMENT DIAGNOSIS Diagnosing microcytic anemia Microcytic anemias are often first spotted after your doctor has ordered a blood test known as a complete blood count (CBC) for another reason. If your CBC indicates that you have anemia, your doctor will order another test known as a peripheral blood smear. This test can help spot early microcytic or macrocytic changes to your red blood cells. Hypochromia, normochromia, or hyperchromia can also be seen with the peripheral blood smear test. Your primary care doctor may refer you to a hematologist. A hematologist is a specialist who works with blood disorders. They may be able to best diagnose and treat the specific type of microcytic anemia and identify its underlying cause. Once a doctor has diagnosed you with microcytic anemia, they will run tests to determine the cause of the condition. They may run blood tests to check for celiac disease. They may test your blood and stool for H. pylori bacterial infection. Your doctor might ask you about other symptoms you've experienced if they suspect that chronic blood loss is the cause of your microcytic anemia. They may refer you to a gastroenterologist if you have stomach or other abdominal pain. A gastroenterologist might run imaging tests to look for different conditions. These tests include: abdominal ultrasound upper GI endoscopy (EGD) CT scan of the abdomen For women with pelvic pain and heavy periods, a gynecologist may look for uterine fibroids or other conditions that could cause heavier flows. TREATMENT Microcytic anemia treatment Treatment for microcytic anemia focuses on treating the underlying cause of the condition. Your doctor may recommend that you take iron and vitamin C supplements. The iron will help treat the anemia while the vitamin C will help increase your body's ability to absorb the iron. Your doctor will focus on diagnosing and treating the cause of the blood loss if acute or chronic blood loss is causing or contributing to microcytic anemia. Women with iron deficiency from severe periods may be prescribed hormonal therapy, such as birth control pills. In cases of microcytic anemia so severe that you're at risk for complications like cardiac failure, you may need to get a blood transfusion of donor red blood cells. This can increase the number of healthy red blood cells that your organs need. OUTLOOK Outlook for microcytic anemia Treatment can be relatively straightforward if simple nutrient deficiencies are the cause of microcytic anemia. As long as the underlying cause of the anemia can be treated, the anemia itself can be treated and even cured. In very severe cases, untreated microcytic anemia can become dangerous. It can cause tissue hypoxia. This is when the tissue is deprived of oxygen. It can cause complications including: low blood pressure, also called hypotension coronary artery problems pulmonary problems shock These complications are more common in older adults who already have pulmonary or cardiovascular diseases. ADVERTISEMENT PREVENTION Preventing microcytic anemia with your diet The best way to prevent microcytic anemia is to get enough iron in your diet. Increasing your vitamin C intake can also help your body absorb more iron. You can also consider taking a daily iron supplement. These are often recommended if you already have anemia. You should always talk to your doctor before you start taking any supplements. You can also try to get more nutrients through your food. Foods rich in iron include: red meat like beef poultry dark leafy greens beans dried fruits like raisins and apricots Foods rich in vitamin C include: citrus fruits, especially oranges and grapefruits kale red peppers Brussels sprouts strawberries broccoliMacrocytic Anemia Symptoms Types and causes Diagnosis Treatment Complications Prevention Overview Key points Macrocytic anemia is a condition in which your body produces too few normal red blood cells. You also produce red blood cells that are larger than normal. It's most often caused by not having enough vitamin B-9 (folate) and vitamin B-12. Many cases can be treated by using supplements and diet changes to increase your folate or vitamin B-12 intake. Macrocytosis is a term used to describe red blood cells that are larger than normal. Anemia is when you have low numbers of properly functioning red blood cells in your body. Macrocytic anemia, then, is a condition in which your body has overly large red blood cells and not enough normal red blood cells. Different types of macrocytic anemia can be classified depending on what's causing it. Most often, macrocytic anemias are caused by a lack of vitamin B-12 and folate. Macrocytic anemia can also signal an underlying condition. SYMPTOMS Macrocytic anemia symptoms You may not notice any symptoms of macrocytic anemia until you've had it for some time. Symptoms include: loss of appetite or weight brittle nails fast heartbeat diarrhea fatigue pale skin, including lips and eyelids shortness of breath poor concentration or confusion memory loss If you have several of these symptoms, make an appointment to see your doctor. It's important to make an appointment as soon as possible if you have the following symptoms: increased heart rate confusion memory problems TYPES AND CAUSES Types and causes of macrocytic anemia Macrocytic anemia can be broken into two main types: megaloblastic and nonmegaloblastic macrocytic anemias. Megaloblastic macrocytic anemia Most macrocytic anemias are also megaloblastic. Megaloblastic anemia is a result of errors in your red blood cell DNA production. This causes your body to make red blood cells incorrectly. Possible causes include: vitamin B-12 deficiency folate deficiency some medications, such as chemotherapy drugs like hydroxyurea, antiseizure medications, and antiretroviral drugs used for people with HIV Nonmegaloblastic macrocytic anemia Nonmegaloblastic forms of macrocytic anemia may be caused by a variety of factors. These can include: chronic alcohol use disorder (alcoholism) liver disease hypothyroidism ADVERTISEMENT DIAGNOSIS Diagnosing macrocytic anemia Your doctor will ask about your medical history and lifestyle. They may also ask about your eating habits if they think that you have a type of anemia. Learning about your diet can help them find out if you are deficient in iron, folate, or any of the other B vitamins. Microcytic Anemia Iron deficiency causes microcytic anemia, in which the red blood cells are too small. Iron deficiency anemia is the most common type of anemia. Blood tests Your doctor will order blood tests to check for anemia and enlarged red blood cells. If your complete blood count indicates anemia, your doctor will do another test known as a peripheral blood smear. This test can help spot early macrocytic or microcytic changes to your red blood cells. Additional blood tests can also help find the cause of your macrocytosis and anemia. This is important because treatment depends on the underlying cause. While nutrient deficiencies cause most macrocytic anemias, other underlying conditions may cause the deficiencies. Your doctor will run tests to check your nutrient levels. They may also do blood tests to check for alcohol use disorder, liver disease, and hypothyroidism. Your primary care doctor may also refer you to a hematologist. Hematologists specialize in blood disorders. They can diagnose the cause and specific type of your anemia. TREATMENT Treating macrocytic anemia Treatment for macrocytic anemia focuses on treating the cause of the condition. The first line of treatment for many people is correcting nutrient deficiencies. This can be done with supplements or foods like spinach and red meat. You may be able to take supplements that include folate and other B vitamins. You may also need vitamin B-12 injections if you don't absorb oral vitamin B-12 properly. Foods high in vitamin B-12 include: chicken fortified grains and cereals eggs red meat shellfish fish Foods high in folate include: dark leafy greens, such as kale and spinach lentils enriched grains oranges COMPLICATIONS Complications Most cases of macrocytic anemia that are caused by vitamin B-12 and folate deficiencies can be treated and cured with diet and supplements. However, macrocytic anemias can cause long-term complications if left untreated. These complications can include permanent damage to your nervous system. Extreme vitamin B-12 deficiencies may cause long-term neurologic complications. They include peripheral neuropathy and dementia. ADVERTISEMENT PREVENTION How to prevent macrocytic anemia You can't always prevent macrocytic anemia, particularly when it's caused by underlying conditions out of your control. However, you can prevent the anemia from becoming severe in most cases. Try these tips: For Healthier Red Blood Cells Add more red meat and chicken to your diet to increase your vitamin B-12 intake. If you're a vegetarian or vegan, you can add beans and dark, leafy greens for folate. Try fortified breakfast cereals for vitamin B-12. Reduce the amount of alcohol you drink. Talk to your doctor if you take antiretrovirals for HIV, antiseizure medications, or chemotherapy drugs. These may increase your risk of developing macrocytic anemia.What Is Hemolytic Anemia? Hemolytic anemia (HEE-moh-lit-ick uh-NEE-me-uh) is a condition in which red blood cells are destroyed and removed from the bloodstream before their normal lifespan is over. Red blood cells are disc-shaped and look like doughnuts without holes in the center. These cells carry oxygen to your body. They also remove carbon dioxide (a waste product) from your body. Red blood cells are made in the bone marrow—a sponge-like tissue inside the bones. They live for about 120 days in the bloodstream and then die. White blood cells and platelets (PLATE-lets) also are made in the bone marrow. White blood cells help fight infections. Platelets stick together to seal small cuts or breaks on blood vessel walls and stop bleeding. When blood cells die, the body's bone marrow makes more blood cells to replace them. However, in hemolytic anemia, the bone marrow can't make red blood cells fast enough to meet the body's needs. Hemolytic anemia can lead to many health problems, such as fatigue (tiredness), pain, irregular heartbeats called arrhythmias (ah-RITH-me-ahs), an enlarged heart, and heart failure. Overview Hemolytic anemia is a type of anemia. The term "anemia" usually refers to a condition in which the blood has a lower than normal number of red blood cells. Anemia also can occur if your red blood cells don't contain enough hemoglobin (HEE-muh-glow-bin). Hemoglobin is an iron-rich protein that carries oxygen from the lungs to the rest of the body. Anemia has three main causes: blood loss, lack of red blood cell production, or high rates of red blood cell destruction. Hemolytic anemia is caused by high rates of red blood cell destruction. Many diseases, conditions, and factors can cause the body to destroy its red blood cells. These causes can be inherited or acquired. "Inherited" means your parents passed the gene(s) for the condition on to you. "Acquired" means you aren't born with the condition, but you develop it. Sometimes the cause of hemolytic anemia isn't known. Outlook There are many types of hemolytic anemia. Treatment and outlook depend on what type you have and how severe it is. The condition can develop suddenly or slowly. Symptoms can range from mild to severe. Hemolytic anemia often can be successfully treated or controlled. Mild hemolytic anemia may need no treatment at all. Severe hemolytic anemia requires prompt and proper treatment, or it may be fatal. Inherited forms of hemolytic anemia are lifelong conditions that may require ongoing treatment. Acquired forms of hemolytic anemia may go away if the cause of the condition is found and corrected. HealthLine ADVERTISEMENT Megaloblastic Anemia Causes Symptoms Diagnosis Treatment Outlook Q&A What Is Megaloblastic Anemia? Highlights Megaloblastic anemia occurs when your body produces red blood cells that are larger than normal and you have a low red blood cell count. The most common symptom of anemia is fatigue, but symptoms can vary from person to person. Treatment plans for megaloblastic anemia may include dietary changes, oral vitamin supplements, and in some cases, vitamin B-12 injections. Megaloblastic anemia is a type of anemia, a blood disorder in which the number of red blood cells is lower than normal. Red blood cells transport oxygen through the body. When your body doesn't have enough red blood cells, your tissues and organs don't get enough oxygen. There are many types of anemia with different causes and characteristics. Megaloblastic anemia is characterized by red blood cells that are larger than normal. There also aren't enough of them. It's known as vitamin B-12 or folate deficiency anemia, or macrocytic anemia, as well. Megaloblastic anemia is caused when red blood cells aren't produced properly. Because the cells are too large, they may not be able to exit the bone marrow to enter the bloodstream and deliver oxygen. CAUSES Causes of Megaloblastic Anemia The two most common causes of megaloblastic anemia are deficiencies of vitamin B-12 or folate. These two nutrients are necessary for producing healthy red blood cells. When you don't get enough of them, it affects the makeup of your red blood cells. This leads to cells that don't divide and reproduce the way they should. Vitamin B-12 Deficiency Vitamin B-12 is a nutrient found in some foods like meat, fish, eggs, and milk. Some people can't absorb enough vitamin B-12 from their food, leading to megaloblastic anemia. Megaloblastic anemia caused by vitamin B-12 deficiency is referred to as pernicious anemia. Vitamin B-12 deficiency is most often caused by the lack of a protein in the stomach called "intrinsic factor." Without intrinsic factor, vitamin B-12 can't be absorbed, regardless of how much you eat. It's also possible to develop pernicious anemia because there isn't enough vitamin B-12 in your diet. Folate Deficiency Folate is another nutrient that's important for the development of healthy red blood cells. Folate is found in foods like beef liver, spinach, and Brussels sprouts. Folate is often mixed up with folic acid — technically, folic acid is the artificial form of folate, found in supplements. You can also find folic acid in fortified cereals and foods. Your diet is an important factor in making sure you have enough folate. Folate deficiency can also be caused by chronic alcohol abuse, since alcohol interferes with the body's ability to absorb folic acid. Pregnant women are more likely to have folate deficiency, because of the high amounts of folate needed by the developing fetus. SYMPTOMS What Are the Symptoms of Megaloblastic Anemia? The most common symptom of megaloblastic anemia is fatigue. Symptoms can vary from person to person. Common symptoms include: shortness of breath muscle weakness abnormal paleness of the skin glossitis (swollen tongue) loss of appetite/weight loss diarrhea nausea fast heartbeat smooth or tender tongue tingling in hands and feet numbness in extremities ADVERTISEMENT DIAGNOSIS Diagnosing Megaloblastic Anemia One test used to diagnose many forms of anemia is the complete blood count (CBC). This test measures the different parts of your blood. Your doctor can check the number and appearance of your red blood cells. They will appear larger and underdeveloped if you have megaloblastic anemia. Your doctor will also gather your medical history and perform a physical exam to rule out other causes of your symptoms. Your doctor will need to do more blood tests to figure out if vitamin deficiency is causing your anemia. These tests will also help them find out whether it's a vitamin B-12 or folate deficiency that's causing the condition. One test that your doctor may use to help diagnose you is the Schilling test. The Schilling test is a blood test that evaluates your ability to absorb vitamin B-12. After you take a small supplement of radioactive vitamin B-12, you'll collect a urine sample for your doctor to analyze. You will then take the same radioactive supplement in combination with the "intrinsic factor" protein that your body needs to be able to absorb vitamin B-12. Then you'll provide another urine sample so it can be compared to the first one. It's a sign that you don't produce intrinsic factor of your own if the urine samples show that you only absorbed the B-12 after consuming it along with the intrinsic factor. This means that you're unable to absorb vitamin B-12 naturally. ADVERTISING inRead invented by Teads TREATMENT How Is Megaloblastic Anemia Treated? How you and your doctor decide to treat megaloblastic anemia depends on what's causing it. Your treatment plan can also depend on your age and overall health as well as your response to treatments and how severe the disease is. Treatment to manage anemia is often ongoing. Vitamin B-12 Deficiency In the case of megaloblastic anemia caused by vitamin B-12 deficiency, you may need monthly injections of vitamin B-12. Oral supplements may also be given. Adding more foods with vitamin B-12 to your diet can help. Foods that have vitamin B-12 in them include: eggs chicken fortified cereals (especially bran) red meats (especially beef) milk shellfish Some individuals have a genetic mutation on the MTHFR (methylenetetrahydrofolate reductase) gene. This MTHFR gene is responsible for the conversion of certain B vitamins, including B-12 and folate, into their usable forms within the body. Individuals with the MTHFR mutation are recommended to take supplemental methylcobalamin. Regular intake of vitamin B-12-rich foods, vitamins, or fortification is not likely to prevent deficiency or its health consequences in those with this genetic mutation. Folate Deficiency Megaloblastic anemia caused by a lack of folate may be treated with oral or intravenous folic acid supplements. Dietary changes also help boost folate levels. Foods to include in your diet include: oranges leafy green vegetables peanuts lentils enriched grains As with vitamin B-12, individuals with the MTHFR mutation are encouraged to take methylfolate to prevent a folate deficiency and its risks. OUTLOOK Living with Megaloblastic Anemia In the past, megaloblastic anemia was difficult to treat. Today, people with megaloblastic anemia due to either vitamin B-12 or folate deficiency can manage their symptoms and feel better with ongoing treatment and nutrient supplements. Vitamin B-12 deficiency can lead to other problems. These can include nerve damage, neurological problems, and digestive tract problems. These complications can be reversed if you get diagnosed and treated early. Genetic testing is available to determine if you have the MTHFR genetic mutation. People who have pernicious anemia also may be at higher risk for weakened bone strength and stomach cancer. For these reasons, it's important to catch megaloblastic anemia early. Talk to your doctor if you see any signs of anemia so you and your doctor can come up with a treatment plan and help prevent any permanent damage. PERNICIOUS ANEMIA Overview Pernicious anaemia is a condition in which the body can't make enough healthy red blood cells because it doesn't have enough vitamin B12 (a nutrient found in certain foods). People who have pernicious anaemia can't absorb enough vitamin B12 due to a lack of intrinsic factor (a protein made in the stomach). However, other conditions and factors can also cause vitamin B12 deficiency. Causes A lack of intrinsic factor is a common cause of pernicious anaemia as the body can't absorb enough vitamin B12. Some pernicious anaemia occurs because the body's small intestine can't properly absorb vitamin B12 which may be due to the wrong bacteria in the small intestines; certain diseases that interfere with vitamin B12 absorption; certain medicines; surgical removal of part of the small intestine; and tapeworm infection. Sometimes people develop pernicious anaemia because they don't get enough vitamin B12 in their diets. Signs and symptoms Apart from the symptoms of anaemia (fatigue, dizziness, etc.), the vitamin B12 deficiency may also have some serious symptoms such as Nerve damage Neurological problems such as confusion, dementia, depression, and memory loss. Symptoms in the digestive tract include nausea and vomiting, heartburn, abdominal bloating and gas, constipation or diarrhoea, loss of appetite, and weight loss. An enlarged liver A smooth, beefy red tongue Infants who have vitamin B12 deficiency may have poor reflexes or unusual movements, such as face tremors. Treatment Pernicious anaemia is treated by replacing the missing vitamin B12 in the body. People who have this disease may need lifelong treatment. Risk You are at higher risk for pernicious anaemia if you Have a family history of the condition. Have had part or all of your stomach removed. Have certain autoimmune disorders that involve the endocrine glands, such as Addison's disease, type 1 diabetes, Graves' disease, and vitiligo. Have had part or all of your small intestine removed. Have certain intestinal diseases or disorders that prevent your body from properly absorbing vitamin B12. Take medicines that prevent your body from properly absorbing vitamin B12. Are a strict vegetarian who doesn't eat any animal or diary products and doesn't take a vitamin B12 supplement, or if you eat poorly overall.

dehydration symptoms

Increased thirst Dry mouth Tired or sleepy Decreased urine output Urine is low volume and more yellowish than normal Headache Dry skin Dizziness Few or no tears

list the - function - sources (food and other) - deficiency - toxicity symptoms (if present) - diseases of each vitamin (if present) of the following MINERAL: iron

Iron is an essential element for blood production. About 70 percent of your body's iron is found in the red blood cells of your blood called hemoglobin and in muscle cells called myoglobin. Hemoglobin is essential for transferring oxygen in your blood from the lungs to the tissues. Myoglobin, in muscle cells, accepts, stores, transports and releases oxygen. About 6 percent of body iron is a component of certain proteins, essential for respiration and energy metabolism, and as a component of enzymes involved in the synthesis of collagen and some neurotransmitters. Iron also is needed for proper immune function. About 25 percent of the iron in the body is stored as ferritin, found in cells and circulates in the blood. The average adult male has about 1,000 mg of stored iron (enough for about three years), whereas women on average have only about 300 mg (enough for about six months). When iron intake is chronically low, stores can become depleted, decreasing hemoglobin levels. When iron stores are exhausted, the condition is called iron depletion. Further decreases may be called iron-deficient erythropoiesis and still further decreases produce iron deficiency anemia. Blood loss is the most common cause of iron deficiency. In men and postmenopausal women, iron deficiency is almost always the result of gastrointestinal blood loss. In menstruating women, genitourinary blood loss often accounts for increased iron requirements. Oral contraceptives tend to decrease menstrual blood loss, whereas intrauterine devices tend to increase menstrual bleeding. Other causes of genitourinary bleeding and respiratory tract bleeding also increase iron requirements. For blood donors, each donation results in the loss of 200 to 250 mg of iron. During periods of growth in infancy, childhood and adolescence, iron requirements may outstrip the supply of iron from diet and stores. Iron loss from tissue growth during pregnancy and from bleeding during delivery and post partum averages 740 mg. Breastfeeding increases iron requirements by about 0.5 to 1 mg a day. Iron Requirements Your "iron level" is checked before each blood donation to determine if it is safe for you to give blood. Iron is not made in the body and must be absorbed from what you eat. The adult minimum daily requirement of iron is 1.8 mg. Only about 10 to 30 percent of the iron you consume is absorbed and used by the body. The daily requirement of iron can be achieved by taking iron supplements. Ferrous sulfate 325 mg, taken orally once a day, and by eating foods high in iron. Foods high in vitamin C also are recommended because vitamin C helps your body absorb iron. Cooking in iron pots can add up to 80 percent more iron to your foods. Consult with your primary care provider before taking iron supplements. Some foods rich in iron include: Meat and Poultry Lean beef Veal Pork Lamb Chicken Turkey Liver (except fish liver) Seafood Fish Mussels Shellfish Vegetables Greens, all kinds Tofu Broccoli Sweet Peas Brussel Sprouts Kale Bean Sprouts Tomatoes Lima Beans Potatoes Green Beans Corn Beets Cabbage

Define: menopause

Menopause (AKA: climacteric) is the time in most women's lives when menstrual periods stop permanently - no longer able to bear children - occurs between 49 and 52 years of age

list the - function - sources (food and other) - deficiency - toxicity symptoms (if present) - diseases of each vitamin (if present) of the following MINERAL: phosphorus

Next to calcium, phosphorus is the most abundant mineral in the body. These 2 important nutrients work closely together to build strong bones and teeth. About 85% of the body's phosphorus is in bones and teeth. Phosphorous is also present in smaller amounts in cells and tissues throughout the body. Phosphorus helps filter out waste in the kidneys and plays an essential role in how the body stores and uses energy. It also helps reduce muscle pain after a workout. Phosphorus is needed for the growth, maintenance, and repair of all tissues and cells, and for the production of the genetic building blocks, DNA and RNA. Phosphorus is also needed to help balance and use other vitamins and minerals, including vitamin D, iodine, magnesium, and zinc. Most people get plenty of phosphorus in their diets. The mineral is found in milk, grains, and protein-rich foods. Some health conditions, such as diabetes, starvation, and alcoholism can cause levels of phosphorus in the body to fall. The same is true of conditions that make it hard for people to absorb nutrients, such as Crohn disease and celiac disease. Some medications can cause phosphorus levels to drop, including some antacids and diuretics (water pills). Symptoms of phosphorus deficiency include loss of appetite, anxiety, bone pain, fragile bones, stiff joints, fatigue, irregular breathing, irritability, numbness, weakness, and weight change. In children, decreased growth and poor bone and tooth development may occur. Having too much phosphorus in the body is actually more common and more worrisome than having too little. Too much phosphorus is generally caused by kidney disease or by consuming too much dietary phosphorus and not enough dietary calcium. Several studies suggest that higher intakes of phosphorus are associated with an increased risk of cardiovascular disease. As the amount of phosphorus you eat rises, so does the need for calcium. The delicate balance between calcium and phosphorus is necessary for proper bone density and prevention of osteoporosis. Uses Phosphates (phosphorus) are used clinically to treat the following: Hypophosphatemia, low levels of phosphorus in the body Hypercalcemia, high blood calcium levels Calcium-based kidney stones These conditions require a doctor's care. Phosphates are also used in enemas as laxatives. Most people get plenty of phosphorus in their diets. Sometimes athletes use phosphate supplements before competitions or heavy workouts to help reduce muscle pain and fatigue, although it is not clear how much it helps or if it improves performance. Dietary Sources Protein-rich foods are good sources of phosphorus, such as meat, poultry, fish, eggs, dairy products, nuts, and legumes. Other good sources include whole grains, hard potatoes, dried fruit, garlic cloves, and carbonated beverages. Available Forms Elemental phosphorus is a white or yellow, waxy substance that burns on contact with air. It is highly toxic and is only used in medicine as a homeopathic treatment. You should only take elemental phosphorus under the guidance of a qualified professional. Instead, health care providers may use one or more of the following inorganic phosphates, which are not toxic at typical doses: Dibasic potassium phosphate Monobasic potassium phosphate Dibasic sodium phosphate Monobasic sodium phosphate Tribasic sodium phosphate Phosphatidyl choline Phosphatidyl serine How to Take It Most people do not need to take phosphorus supplements. Recommended dietary allowances (RDAs) for dietary phosphorous are as follows: Pediatric Infants, 0 to 6 months: 100 mg daily Infants, 7 to 12 months: 275 mg Children, 1 to 3 years: 460 mg Children, 4 to 8 years: 500 mg Children, 9 to 18 years: 1,250 mg Adult Adults, 19 years and older: 700 mg Pregnant and breastfeeding females under 18 years: 1,250 mg Pregnant and breastfeeding females, 19 years and older: 700 mg Precautions Because of the potential for side effects and interactions with prescription and non-prescription medications, you should take dietary supplements only under the supervision of a knowledgeable health care provider. Too much phosphate can be toxic. It can cause diarrhea and calcification (hardening) of organs and soft tissue, and can interfere with the body's ability to use iron, calcium, magnesium, and zinc. Athletes and others taking supplements that contain phosphate should only do so occasionally and with the guidance and direction of a health care provider. Nutritionists recommend a balance of calcium and phosphorus in the diet. The typical Western diet, however, contains roughly 2 to 4 times more phosphorus than calcium. Meat and poultry contain 10 to 20 times as much phosphorus as calcium, and carbonated beverages can have as much as 500 mg of phosphorus in one serving. When there is more phosphorus than calcium in the body, the body will use calcium stored in bones. This can cause osteoporosis (brittle bones) and lead to gum and teeth problems. A balance of dietary calcium and phosphorus can lower the risk of osteoporosis.

Define: nonheme

Non-heme iron comes from plant sources that do not naturally contain hemoglobin. Examples include soybeans, lentils, peas, spinach, raisins, sugarcane and whole grains. Only about 2 to 20 percent of non-heme iron is absorbed while 15 to 35 percent of heme iron is absorbed

Water requirements

Now the Institute of Medicine sets general guidelines for total water intake. It recommends that women consume a total of 91 ounces (that's about 2.7 liters) per day - from all food and beverages combined. For men, it's about 125 ounces a day (or 3.7 liters). (lots of numbers here...this is more or less the average, so don't go with exact numbers)

Define: pellagra

Other features are ulcerations within the mouth (glossitis), nausea. vomiting, seizures and balance disorder (ataxia). Pellagra is now rare in developed countries which enjoy balanced diets and fortified foods, but it was once a huge public health problem in the US. Three million Americans contracted pellagra and 100,000 died of it from 1906-40. Pellagra was especially a problem for the poor in the South whose meals usually consisted of the "three M's": meat (pork fatback); molasses; and meal (cornmeal). Today pellagra continues to be a problem in developing countries where there is significant malnutrition or where niacin-deficient foods such as corn and rice are the primary sources of nutrition

Define: low birth weight

a birth weight of a liveborn infant of 2,499 g or less, regardless of gestational age - normal weight at term delivery is: 5 lbs 8 oz - 9 lbs 4 oz

Define: pre-eclampsia

a condition in pregnancy characterized by high blood pressure, sometimes with fluid retention and proteinuria.

Define: gestational diabetes

a condition in which a woman without diabetes develops high blood sugar levels during pregnancy

Define: prolactin

a hormone released from the anterior pituitary gland that stimulates milk production after childbirth

Define: osteoclast

a large multinucleate bone cell that absorbs bone tissue during growth and healing

Define: osteoporosis

a medical condition in which the bones become brittle and fragile from loss of tissue, typically as a result of hormonal changes, or deficiency of calcium or vitamin D.

Define: coenzyme

a nonprotein compound that is necessary for the functioning of an enzyme

Define: hemoglobin

a red protein responsible for transporting oxygen in the blood of vertebrates. Its molecule comprises four subunits, each containing an iron atom bound to a heme group

Define: intrinsic factor

a substance secreted by the stomach that enables the body to absorb vitamin B12. It is a glycoprotein

Define: hypokalemia

deficiency of potassium in the bloodstream

Define: evaporative cooling

reduction in temperature resulting from the evaporation of a liquid, which removes latent heat from the surface from which evaporation takes place. This process is employed in industrial and domestic cooling systems, and is also the physical basis of sweating.

Define: gestational age

the common term used during pregnancy to describe how far along the pregnancy is. It is measured in weeks, from the first day of the woman's last menstrual cycle to the current date. A normal pregnancy can range from 38 to 42 weeks. Infants born before 37 weeks are considered premature

Define: senescence

the condition or process of deterioration with age. loss of a cell's power of division and growth.

Define: placenta

the organ in most mammals by which the fetus is joined to the uterus of the mother and is nourished.

Define: puberty

the period during which adolescents reach sexual maturity and become capable of reproduction.

Define: bioavailability

the proportion of a drug or other substance that enters the circulation when introduced into the body and so is able to have an active effect.

Define: ariboflavinosis

A condition caused by the dietary deficiency of riboflavin that is characterized by mouth lesions, seborrhea, and vascularization of the cornea

list the - function - sources (food and other) - deficiency - toxicity symptoms (if present) - diseases of each vitamin (if present) of the following VITMAIN: B2 (riboflavin)

source: - almonds - yogurt - wild rice/whole grains deficiency: - fatigue - slow growth - digestive problems functions: - makes RBC - growth - changes B6 and B9 (folate) into forms the body can use

list the - function - sources (food and other) - deficiency - toxicity symptoms (if present) - diseases of each vitamin (if present) of the following VITAMIN: C

source: - kiwis - strawberries - mangos - bell peppers deficiency: - scurvy - atherosclerosis - gallbladder disease - high blood pressure functions: - repair / maintenance of teeth - helps in healing - collagen - growth / repair of body tissue

list the - function - sources (food and other) - deficiency - toxicity symptoms (if present) - diseases of each vitamin (if present) of the following VITAMIN: B9 (folate)

source: - leafy greens - kale - beets - spinach deficiency: - poor growth - diarrhea - gingivitis - tongue inflammation - birth defects (in pregnant women) functions: - DNA/RNA production - mental/emotional health - brain fxn

list the - function - sources (food and other) - deficiency - toxicity symptoms (if present) - diseases of each vitamin (if present) of the following VITAMIN: B3 (niacin)

source: - organ meats - beets - fish deficiency: - fatigue - depression digestive problems functions: - sex and stress hormones - suppresses inflammation

list the - function - sources (food and other) - deficiency - toxicity symptoms (if present) - diseases of each vitamin (if present) of the following VITAMIN: B1 (thiamine)

source: - pork - legumes - milk deficiency: - fatigue - depression - nausea functions: - muscle function - electrons going in and out of the nerve & muscle cells

list the - function - sources (food and other) - deficiency - toxicity symptoms (if present) - diseases of each vitamin (if present) of the following VITAMIN: A

source: - yellow/ orange vegetables - fortified skim milk - cod liver oil - eggs deficiency: - eye problems (night blindness, xeropthalima) - hyperkeratosis functions: - helps form & maintain: * skeletal muscles * teeth * soft tissue

list the - function - sources (food and other) - deficiency - toxicity symptoms (if present) - diseases of each vitamin (if present) of the following MINERAL: zinc

Zinc is found in cells throughout the body. It is needed for the body's defensive (immune) system to properly work. It plays a role in cell division, cell growth, wound healing, and the breakdown of carbohydrates. Zinc is also needed for the senses of smell and taste. During pregnancy, infancy, and childhood the body needs zinc to grow and develop properly. Recent information from an expert review on zinc supplements showed that: When taken for at least 5 months, zinc may reduce your risk of becoming sick with the common cold. Starting to take zinc supplements within 24 hours after cold symptoms begin may reduce how long the symptoms last and make the symptoms less severe. Back to TopFood Sources High-protein foods contain high amounts of zinc. Beef, pork, and lamb contain more zinc than fish. The dark meat of a chicken has more zinc than the light meat. Other good sources of zinc are nuts, whole grains, legumes, and yeast. Fruits and vegetables are not good sources, because the zinc in plant proteins is not as available for use by the body as the zinc from animal proteins. Therefore, low-protein diets and vegetarian diets tend to be low in zinc. Zinc is in most multivitamin and mineral supplements. These supplements may contain zinc gluconate, zinc sulfate, or zinc acetate. It is not clear whether one form is better than the others. Zinc is also found in some over-the-counter medicines, such as cold lozenges, nasal sprays, and nasal gels. Back to TopSide Effects Symptoms of zinc deficiency include: Frequent infections Hypogonadism in males Loss of hair Poor appetite Problems with the sense of taste Problems with the sense of smell Skin sores Slow growth Trouble seeing in the dark Wounds that take a long time to heal Zinc supplements in large amounts may cause diarrhea, abdominal cramps, and vomiting, usually within 3 - 10 hours of swallowing the supplements. The symptoms go away within a short period of time after the stopping the supplements. People who use nasal sprays and gels that contain zinc may have side effects such as losing their sense of smell. Back to TopRecommendations The Recommended Dietary Allowance (RDA) for vitamins reflect how much of each vitamin most people should get each day. The RDA for vitamins may be used as goals for each person. How much of each vitamin you need depends on your age and gender. Other factors, such as pregnancy and illnesses, are also important. Women who are pregnant or breastfeeding need higher amounts. Ask your health care provider which amount is best for you Dietary Reference Intakes for zinc: Infants 0 - 6 months: 2* milligrams per day (mg/day) 7 - 12 months: 3* mg/day *Adequate Intake (AI) Children 1 - 3 years: 3 mg/day 4 - 8 years: 5 mg/day 9 - 13 years: 8 mg/day Adolescents and Adults Males age 14 and over: 11 mg/day Females age 14 to 18 years: 9 mg/day Females age 19 and over: 8 mg/day The best way to get the daily requirement of essential vitamins and minerals is to eat a balanced diet that contains a variety of foods.

Define: blastocyst

A thin-walled hollow structure in early embryonic development that contains a cluster of cells called the inner cell mass from which the embryo arises. The outer layer of cells gives rise to the placenta and other supporting tissues needed for fetal development within the uterus while the inner cell mass cells gives rise to the tissues of the body

Define: spina bifida

a congenital defect of the spine in which part of the spinal cord and its meninges are exposed through a gap in the backbone. It often causes paralysis of the lower limbs, and sometimes mental handicap.

list the functions of water

Fast Facts The body loses water through breathing, sweating, and digestion, which is why it's important to rehydrate by drinking fluids and eating foods that contain water. Most people who are in good physical health get enough fluids by drinking water and other beverages when they're thirsty, and also by drinking a beverage at mealtime. Women who are pregnant or nursing may want to consult with their physician about increasing fluid intake. Did you know that your body weight is approximately 60 percent water? Your body uses water in all its cells, organs, and tissues to help regulate its temperature and maintain other bodily functions. Because your body loses water through breathing, sweating, and digestion, it's important to rehydrate by drinking fluids and eating foods that contain water. The amount of water you need depends on a variety of factors, including the climate you live in, how physically active you are, and whether you're experiencing an illness or have any other health problems. Water Protects Your Tissues, Spinal Cord, and Joints Water does more than just quench your thirst and regulate your body's temperature; it also keeps the tissues in your body moist. You know how it feels when your eyes, nose, or mouth gets dry? Keeping your body hydrated helps it retain optimum levels of moisture in these sensitive areas, as well as in the blood, bones, and the brain. In addition, water helps protect the spinal cord, and it acts as a lubricant and cushion for your joints. Water Helps Your Body Remove Waste Adequate water intake enables your body to excrete waste through perspiration, urination, and defecation. The kidneys and liver use it to help flush out waste, as do your intestines. Water can also keep you from getting constipated by softening your stools and helping move the food you've eaten through your intestinal tract. However, it should be noted that there is no evidence to prove that increasing your fluid intake will cure constipation. Water Aids in Digestion Digestion starts with saliva, the basis of which is water. Digestion relies on enzymes that are found in saliva to help break down food and liquid and to dissolve minerals and other nutrients. Proper digestion makes minerals and nutrients more accessible to the body. Water is also necessary to help you digest soluble fiber. With the help of water, this fiber dissolves easily and benefits your bowel health by making well-formed, soft stools that are easy to pass. Water Prevents You From Becoming Dehydrated Your body loses fluids when you engage in vigorous exercise, sweat in high heat, or come down with a fever or contract an illness that causes vomiting or diarrhea. If you're losing fluids for any of these reasons, it's important to increase your fluid intake so that you can restore your body's natural hydration levels. Your doctor may also recommend that you drink more fluids to help treat other health conditions, like bladder infections and urinary tract stones. If you're pregnant or nursing, you may want to consult with your physician about your fluid intake because your body will be using more fluids than usual, especially if you're breastfeeding. How Much Water Do You Need? There's no hard and fast rule, and many individuals meet their daily hydration needs by simply drinking water when they're thirsty, according to a report on nutrient recommendations from the Institute of Medicine of the National Academies. In fact, most people who are in good physical health get enough fluids by drinking water and other beverages when they're thirsty, and also by drinking a beverage with each of their meals, according to the Centers for Disease Control and Prevention. If you're not sure about your hydration level, look at your urine. If it's clear, you're in good shape. If it's dark, you're probably dehydrated.

list the differences and similarities between fat soluble & water soluble vitamins

Fat-soluble vitamins (A, D, E, & K) are absorbed in the small intestines. Once in the body, they are stored primarily in the liver and in fatty (adipose) tissueso not consume these vitamins in excess because they stay in the body longer and can more easily lead to toxicity. A well-balanced diet will not lead to toxicity, but vitamin supplementation might. Water-soluble vitamins, including vitamins C and B, are excreted much more quickly than fat-soluble vitamins, and they need to be replaced more frequently.

list the - function - sources (food and other) - deficiency - toxicity symptoms (if present) - diseases of each vitamin (if present) of the following MINERAL: calcium

Function Calcium is one of the most important minerals for the the human body. Calcium helps form and maintain healthy teeth and bones. Proper levels of calcium over a lifetime can help prevent osteoporosis. Calcium helps your body with: Building strong bones and teeth Clotting blood Sending and receiving nerve signals Squeezing and relaxing muscles Releasing hormones and other chemicals Keeping a normal heartbeat Back to TopFood Sources CALCIUM AND DAIRY PRODUCTS Many foods contain calcium, but dairy products are the best source. Milk and dairy products such as yogurt, cheeses, and buttermilk contain a form of calcium that your body can absorb easily. Whole milk (4% fat) is recommended for children ages 1 to 2. Adults and children over the age of 2 should drink low-fat (2% or 1%) or skim milk and other dairy products. Removing the fat will not lower the amount of calcium in a dairy product. Yogurt, most cheeses, and buttermilk are excellent sources of calcium and come in low-fat or fat-free versions. Milk is also a good source of phosphorus and magnesium, which help the body absorb and use calcium. Vitamin D is needed to help the body use calcium. Milk is fortified with vitamin D for this reason. OTHER SOURCES OF CALCIUM Green leafy vegetables such as broccoli, collards, kale, mustard greens, turnip greens, and bok choy or Chinese cabbage are good sources of calcium. Other sources of calcium that can help meet your body's calcium needs: Salmon and sardines canned with their soft bones Almonds, Brazil nuts, sunflower seeds, tahini, and dried beans Blackstrap molasses Calcium is added to several food products, such as orange juice, soy milk, tofu, ready-to-eat cereals, and breads. These are a very good source of calcium for persons who do not eat a lot of dairy products or who are on a vegan diet. Ways to make sure you receive or absorb the calcium in your diet: Cook foods in a small amount of water for the shortest possible time to keep more calcium in the foods you eat. Be careful about what you eat with calcium-rich foods. Certain fibers, such as wheat bran and foods with oxalic acid (spinach and rhubarb) can bind with calcium and prevent it from being absorbed. DIETARY SUPPLEMENTS Calcium is also found in many multivitamin-mineral supplements. The amount varies depending on the. supplement. Dietary supplements may contain only calcium or calcium with other nutrients such as vitamin D. Check the label on the Supplement Facts panel to determine the amount of calcium. Calcium absorption is best when taken in amounts of no more than 500 mg at a time. Two commonly available forms of calcium dietary supplements include citrate and carbonate. Calcium citrate is the more expensive form of the supplement. It is taken up well by the body on a full or empty stomach. Calcium carbonate is less expensive. It is absorbed better by the body if taken with food. Calcium carbonate is found in over-the-counter antacid products such as Rolaids or Tums. Each chew or pill usually provides 200-400 mg of calcium. Check the label for the exact amount. Other types of calcium in supplements and foods include lactate, gluconate, and phosphate. Back to TopSide Effects Increased calcium for a limited period of time does not normally cause side effects. However, receiving higher amounts of calcium over a long period of time raises the risk of kidney stones in some people. Those who do not receive enough calcium over a long period of time can develop osteoporosis (thinning of bone tissue and loss of bone density over time). Other disorders are also possible. Persons with lactose intolerance have trouble digesting lactose, the sugar in milk. Over-the-counter products are available that make it easier to digest lactose. You can also buy lactose-free milk at most grocery stores. Tell your health care provider about any dietary supplements and medicines you take. Your provider can tell you if those dietary supplements might interact or interfere with your prescription or over-the-counter medicines. In addition, some medicines might interfere with how your body absorbs calcium. Back to TopRecommendations The preferred source of calcium is calcium-rich foods such as dairy products. Some people will need to take calcium supplements. The Recommended Dietary Allowance (RDA) for vitamins and minerals reflects how much of each vitamin or mineral most people should get each day. The RDA for vitamins and minerals may be used to help create the goal for each person. How much calcium you need depends on your age and gender. Other factors, such as pregnancy and illnesses, are also important. Infants (Adequate Intake) 0 - 6 months: 200 milligrams per day (mg/day) 7 - 12 months: 260 mg/day Children and Adolescents 1 - 3 years: 700 mg/day 4 - 8 years: 1,000 mg/day 9 - 18 years: 1,300 mg/day Adults 19 - 50 years: 1,000 mg/day 50 - 70 years: Men - 1,000 mg/day; Women - 1,200 mg/day Over 71 years - 1,200 mg/day Pregnancy and Breast-feeding 14 - 18 years: 1,300 mg/day 19 - 50 years: 1,000 mg/day Up to 2,500 - 3,000 mg a day of calcium from dietary sources and supplements appears to be safe for children and adolescents, and 2,000 - 2,500 mg a day appears to be safe for adults. The following list can help you determine how much calcium you are getting from food: 8-ounce glass of milk = 300 mg of calcium 2 ounces of Swiss cheese = 530 mg of calcium 6 ounces of yogurt = 300 mg of calcium 2 ounces of sardines with bones = 240 mg of calcium 6 ounces of cooked turnip greens = 220 mg of calcium 3 ounces of almonds = 210 mg of calcium Vitamin D is needed to help the body absorb calcium. When choosing calcium supplements, look for ones that also contain vitamin D.

list the - function - sources (food and other) - deficiency - toxicity symptoms (if present) - diseases of each vitamin (if present) of the following MINERAL: sulfur

Sulfur is an interesting nonmetallic element that is found mainly as part of larger compounds. It is not discussed much in nutrition books, mainly because it has not been thought to be essential—that is, sulfur deficiency does not cause any visible problems. Sulfur represents about 0.25 percent of our total body weight, similar to potassium. The body contains approximately 140 grams of sulfur-mainly in the proteins, although it is distributed in small amounts in all cells and tissues. Sulfur has a characteristic odor that can be smelled when hair or sheep's wool is burned. Keratin, present in the skin, hair, and nails, is particularly high in the amino acid cystine, which is found in sulfur. The sulfur-sulfur bond in keratin gives it greater strength. Sulfur is present in four amino acids: methionine, an essential amino acid; the nonessential cystine and cysteine, which can be made from methionine; and taurine, which is not part of body tissues but does help produce bile acid for digestion. Sulfur is also present in two B vitamins, thiamine and biotin; interestingly, thiamine is important to skin and biotin to hair. Sulfur is also available as various sulfates or sulfides. But overall, sulfur is most important as part of protein. Sulfur has been used commonly since the early 1800s. Grandma's "spring tonic" consisted mainly of sulfur and molasses. This also acted as a laxative. Sulfur has been known as the "beauty mineral" because it helps the complexion and skin stay clear and youthful. The hydrogen sulfide gas in onions is what causes tearing. This gas can also be made by intestinal bacteria and is absorbed by the body or released as gas with a characteristic odor. Sulfur is absorbed from the small intestine primarily as the four sulfur-containing amino acids or from sulfates in water or fruits and vegetables. It is thought that elemental sulfur is not used by the human organism. Sulfur is stored in all body cells, especially the skin, hair, and nails. Excess amounts are eliminated through the urine or in the feces. Sources: As part of four amino acids, sulfur is readily available in protein foods-meats, fish, poultry, eggs, milk, and legumes are all good sources. Egg yolks are one of the better sources of sulfur. Other foods that contain this somewhat smelly mineral are onions, garlic, cabbage, brussels sprouts, and turnips. Nuts have some, as do kale, lettuce, kelp and other seaweed, and raspberries. Complete vegetarians (those who eat no eggs or milk) and people on low-protein diets may not get sufficient amounts of sulfur; the resulting sulfur deficiency is difficult to differentiate clinically from protein deficiency, which is of much greater concern. Functions: As part of four amino acids, sulfur performs a number of functions in enzyme reactions and protein synthesis. It is necessary for formation of collagen, the protein found in connective tissue in our bodies. Sulfur is also present in keratin, which is necessary for the maintenance of the skin, hair, and nails, helping to give strength, shape, and hardness to these protein tissues. Sulfur is also present in the fur and feathers of other animals. The cystine in hair gives off the sulfur smell when it is burned. Sulfur, as cystine and methionine, is part of other important body chemicals: insulin, which helps regulate carbohydrate metabolism, and heparin, an anticoagulant. Taurine is found in bile acids, used in digestion. The sulfur-containing amino acids help form other substances as well, such as biotin, coenzyme A, lipoic acid, and glutathione. The mucopoly-saccharides may contain chondroitin sulfate, which is important to joint tissues. Sulfur is important to cellular respiration, as it is needed in the oxidation-reduction reactions that help the cells utilize oxygen, which aids brain function and all cell activity. These reactions are dependent on cysteine, which also helps the liver produce bile secretions and eliminate other toxins. L-cysteine is thought to generally help body detoxification mechanisms through the tripeptide compound, glutathione. Uses: In its elemental form, sulfur was used for many disorders during the nineteenth century. In the twentieth century, the focus is more on the sulfur-containing amino acids, used internally; or as elemental sulfur-containing ointments used for skin disorders such as eczema, dermatitis, and psoriasis. Psoriasis has been treated with oral sulfur along with zinc. Other problems of the skin or hair have been treated with additional sulfur-containing compounds. Joint problems may be helped by chondroitin sulfate, which is found in high amounts in the joint tissues. For centuries, arthritis sufferers have been helped by bathing in waters that contain high amounts of sulfur. Oral sulfur as sulfates in doses of 500-1,000 mg. may also reduce symptoms in some patients. Magnesium sulfate, which is not absorbed, has been used as a laxative. Taurine, another sulfur-containing amino acid, has been used in epilepsy treatment, usually along with zinc. A physiologic form of sulfur called methylsulfonyl methane (MSM) has recently become available and may be helpful in patients with allergies (see Chapter 7, Accessory Nutrients). If we need additional sulfur, we can get it by eating an egg or two a day or eating extra garlic or onions, as well as other sulfur foods. There is no real cause for concern about the cholesterol in eggs if the diet is generally low in fat and blood cholesterol level is not elevated. Deficiency and toxicity: There is minimal reason for concern about either toxicity or deficiency of sulfur in the body. No clearly defined symptoms exist with either state. Sulfur deficiency is more common when foods are grown in sulfur-depleted soil, with low-protein diets, or with a lack of intestinal bacteria, though none of these seems to cause any problems in regard to sulfur functions and metabolism. Requirements: There is no specific RDA for sulfur other than the amino acids of which they are part are needed to meet protein requirements. Our needs are usually easily met through diet. About 850 mg. are thought to be needed for basic turnover of sulfur in the body. There is not much information available on sulfur content of foods, nor are there supplements specifically for sulfur. I have found that it is not really a nutritional concern.

what are the nutritional needs of mother during breastfeeding?

A nursing mother's diet can have a profound effect on her baby. A good rule of thumb to keep in mind is that whatever you eat, your baby eats, too. Healthy nutrients and contaminants alike pass from breast milk to baby. Energy and Nutrient Needs while Breastfeeding Calorie and protein needs continue to be high during lactation, as they were in pregnancy. The breastfeeding mother requires an extra 300 to 400 calories above her pre-pregnancy needs for the first 12 months of breastfeeding. Fortunately, eating well and fulfilling the needs of your newborn child are really quite easy. The healthiest diets derive their nutrients from these sources: vegetables (fresh or frozen), fruit (fresh or frozen), legumes (beans, peas, or lentils), whole grains, and nuts and seeds. There is no need to eat fatty, sugary, and refined packaged foods, nor fish, meat, eggs, and dairy products. A vegan diet, supplemented with vitamin B12, helps keep you slim and resistant to illness while providing all the nutrients necessary for optimal health. Contrary to popular belief, vegan and vegetarian diets have plenty of protein to meet your needs. Caring for a newborn child is an exciting, rewarding, and at times exhausting experience for most parents. As a parent, you have accomplished the amazing feat of giving life to a new person. You now have the opportunity to offer your baby love and care as well as the gift of good health. Studies show that vegan moms (who do not consume any animal products) have lower levels of environmental contaminants such as pesticides in their breast milk compared with meat- and dairy-eating moms. Do yourself and your baby a lifelong favor by choosing a clean, safe, healthful, and delicious vegetarian diet while breastfeeding.

Disscuss the following: - changes with aging - nutrient needs for seniors

Do you need to change what and how you eat in your 50s, 60s, and beyond? Yes, though maybe not in ways you might think. You need fewer calories every decade, says Connie Bales, PhD, RD, associate director of the Geriatric Research, Education, and Clinical Center at Durham VA Medical Center. "We move around less, we have less muscle, and our metabolic rate goes down." The challenge while eating less overall is to eat more nutrient-rich foods, such as fruits, vegetables, whole grains, nuts, beans, fish, low-fat dairy products, and lean cuts of meat. As you age, your body needs the same amount of protein, vitamins, and minerals and, in some instances, even more nutrients. Take vitamin B-12, for example. After age 50, your body's ability to absorb the vitamin often fades because you don't have as much stomach acid, which is needed to break B-12 down from food sources. The same holds true for vitamin D. Aging skin is less able than younger skin to change sunlight to the vitamin. That, in turn, affects the body's ability to absorb calcium. You need both vitamin D and calcium to prevent bone loss. Ask your doctor if you are getting enough of those must-have nutrients, and if you aren't, what foods you should eat and whether you need a supplement. If your doctor isn't sure, ask for a referral to a dietitian. Also, make sure you drink water. That's important at any age, but in your later years, you may be less likely to notice your thirst, Bales says. Perhaps the biggest myth about nutrition and aging? That older people are set in their ways. "That really is not true," Bales says. "I've found that most are really motivated about their health, and many of them are quite willing to try to change."

Define: hyponatremia

Hyponatremia, also spelled hyponatraemia, is a low sodium level in the blood.[3] Symptoms can vary from none to severe.[1][6] Mild symptoms include a decreased ability to think, headaches, nausea, and poor balance.[2] Severe symptoms include confusion, seizures, and coma.[1][6] Normal serum sodium levels are 135-145 mmol/L (135-145 mEq/L).[7] Hyponatremia is generally defined as a serum sodium level of less than 135 mmol/L and is considered severe when the level is below 120 mmol/L.[2] The cause of hyponatremia is typically classified by a person's fluid status into low volume, normal volume, and high volume. Low volume hyponatremia can occur from diarrhea, vomiting, diuretics, and sweating. Normal volume hyponatremia is divided into cases with dilute urine and concentrated urine. Cases in which the urine is dilute include adrenal insufficiency, hypothyroidism, and drinking too much water or too much beer. Cases in which the urine is concentrated include syndrome of inappropriate antidiuretic hormone secretion (SIADH). High volume hyponatremia can occur from heart failure, liver failure, and kidney failure.[3] Conditions that can lead to falsely low sodium measurements include high protein levels such as in multiple myeloma, high blood fat levels, and high blood sugar.[8][4] Treatment is based on the underlying cause.[3] Correcting hyponatremia too quickly can lead to complications.[8] Rapid partial correction with 3% normal saline is only recommended in those with significant symptoms and occasionally those in whom the condition was of rapid onset.[3][4] Low volume hyponatremia is typically treated with intravenous normal saline. SIADH is typically treated with fluid restriction while high volume hyponatremia is typically treated with both fluid restriction and a diet low in salt. Correction, in those in whom the low levels have been present for more than two days should generally be gradual.[3] Hyponatremia is one of the most commonly seen water-electrolyte imbalances.[4][5] It occurs in about 20% of those admitted to hospital and 10% of people during or after an endurance sporting event.[2][8] Among those in hospital hyponatremia is associated with an increased risk of death.[8] The economic costs of hyponatremia are estimated at $2.6 billion in the United States

explain the stages of pregnancy vs. trimesters and what occurs during each

Pregnancy is measured in trimesters from the first day of your last menstrual period, totaling 40 weeks. The first trimester of pregnancy is week 1 through week 12, or about 3 months. The second trimester is week 13 to week 27. And the third trimester of pregnancy spans from week 28 to the birth. Your baby will change from week to week. To learn more about how your baby is changing each month and about what tests you might think about having, see the Interactive Tool: From Embryo to Baby in 9 Months. First trimester During the week after fertilization, the fertilized egg grows into a microscopic ball of cells (blastocyst), which implants on the wall of your uterus. This implantation triggers a series of hormonal and physical changes in your body. The third through eighth weeks of growth are called the embryonic stage, during which the embryo develops most major body organs. During this process, the embryo is especially vulnerable to damaging substances, such as alcohol, radiation, and infectious diseases. Having reached a little more than 1 in. (2.5 cm) in length by the ninth week of growth, the embryo is called a fetus. By now, the uterus has grown from about the size of a fist to about the size of a grapefruit. The first trimester is a time of amazing development camera.gif. The embryo starts out looking like a tiny seed, then a tadpole with a tail, and then more human. Second trimester If this is your first pregnancy, you'll begin to feel your fetus move at about 18 to 22 weeks after your last menstrual period. Although your fetus has been moving for several weeks, the movements have not been strong enough for you to notice until now. At first, fetal movements can be so gentle that you may not be sure what you are feeling. If you've been pregnant before, you may notice movement earlier, sometime between weeks 16 and 18. During this time, the fetus is still building up body fat and starting to put on a lot of weight. By the end of the second trimester camera.gif, your fetus is about 10 in. (25.5 cm) long and weighs about 1.5 lb (680 g). Third trimester The third trimester of pregnancy spans from week 28 to the birth. Although your due date marks the end of your 40th week, a full-term pregnancy can deliver between week 37 and week 42. During this final trimester, your fetus grows larger and the body organs mature. The fetus moves frequently, especially between the 27th and 32nd weeks. After week 32, a fetus becomes too big to move around easily inside the uterus and may seem to move less. At the end of the third trimester camera.gif, a fetus usually settles into a head-down position in the uterus. You will likely feel some discomfort as you get close to delivery.

Define: Antioxidant

Your body is in a constant battle against infection, diseases and the formation of free radicals. However, there's a secret weapon that can help you fight against these things: antioxidants! Antioxidants are elements such as vitamins A, C and E that counteract the damage caused by free radicals and help protect your healthy cells. Free radicals are molecules that contain unpaired electrons, which make them highly reactive. In this form, they can cause damage by attacking healthy cells, and when these cells grow weakened, you become more vulnerable to disease. Diagram of Free Radicals Free Radicals Free radicals may be produced from normal body functions such as breathing or physical activity, but they are mainly formed from your exposure to environmental hazards, such as pesticides, air pollution and cigarette smoke. Antioxidants work to disable the disease-causing free radicals, thus preventing the damage from occurring. Although your body naturally produces antioxidants, it doesn't produce enough to protect you from free radicals, so that is why it is important to include antioxidant-rich foods in your diet on a regular basis.

list the - function - sources (food and other) - deficiency - toxicity symptoms (if present) - diseases of each vitamin (if present) of the following VITAMIN: B6

source: - fish - fowl deficiency: - irritability - muscle weakness - depression functions: - brain development / fxn - development of neurotransmitters

list the - function - sources (food and other) - deficiency - toxicity symptoms (if present) - diseases of each vitamin (if present) of the following VITAMIN: B7 (biotin)

source: - milk - organ meat - soy deficiency: - intestinal issues - nervous tract issues functions: - maintains nervous fxns - adrenal fxns

list the - function - sources (food and other) - deficiency - toxicity symptoms (if present) - diseases of each vitamin (if present) of the following VITAMIN: E

Function Vitamin E is an antioxidant that protects body tissue from damage caused by substances called free radicals. Free radicals can harm cells, tissues, and organs. They are believed to play a role in certain conditions related to aging. The body also needs vitamin E to help keep the immune system strong against viruses and bacteria. Vitamin E is also important in the formation of red blood cells and it helps the body use vitamin K. It also helps widen blood vessels and keep blood from clotting inside them. Cells use vitamin E to interact with each other and carry out many important functions. Whether vitamin E can prevent cancer, heart disease, dementia, liver disease, and stroke is still not known. Back to TopFood Sources The best way to get the daily requirement of vitamin E is by eating food sources. Vitamin E is found in the following foods: Vegetable oils (such as wheat germ, sunflower, safflower, corn, and soybean oils) Nuts (such as almonds, peanuts, and hazelnuts/filberts) Seeds (such as sunflower seeds) Green leafy vegetables (such as spinach and broccoli) Fortified breakfast cereals, fruit juices, margarine, and spreads. Fortified means that vitamins have been added to the food. Check the Nutrition Fact Panel on the food label. Products made from these foods, such as margarine, also contain vitamin E. Back to TopSide Effects Eating vitamin E in foods is not risky or harmful. In supplement form, however, high doses of vitamin E might increase the risk for bleeding and serious bleeding in the brain. High levels of vitamin E may also increase the risk of birth defects. Back to TopRecommendations The Recommended Dietary Allowance (RDA) for vitamins reflect how much of each vitamin most people should get each day. The RDA for vitamins may be used as goals for each person. How much of each vitamin you need depends on your age and gender. Other factors, such as pregnancy, breast-feeding, and illnesses may increase the amount you need.

list the - function - sources (food and other) - deficiency - toxicity symptoms (if present) - diseases of each vitamin (if present) of the following MINERAL: iodine

Iodine is needed for the normal metabolism of cells. Metabolism is the process of converting food into energy. Humans need iodine for normal thyroid function, and for the production of thyroid hormones. Back to TopFood Sources Iodized salt is table salt with iodine added. It is the main food source of iodine. Seafood is naturally rich in iodine. Cod, sea bass, haddock, and perch are good sources. Kelp is the most common vegetable-seafood that is a rich source of iodine. Dairy products also contain iodine. Other good sources are plants grown in iodine-rich soil. Back to TopSide Effects Lack of enough iodine (deficiency) may occur in places that have iodine-poor soil. Many months of iodine deficiency in a person's diet may cause goiter or hypothyroidism. Without enough iodine, the thyroid cells and the thyroid gland become enlarged. Deficiency happens more often in women than in men, and is more common in pregnant women and older children. Getting enough iodine in the diet may prevent a form of physical and intellectual disability called cretinism. Cretinism is very rare in the U.S. because iodine deficiency is generally not a problem. Iodine poisoning is rare in the U.S. Very high intake of iodine can reduce the function of the thyroid gland. Back to TopRecommendations The best way to get the daily requirement of essential vitamins is to eat a balanced diet that contains a variety of foods from the food guide plate. A 1/4 teaspoon of iodized table salt provides 95 micrograms of iodine. A 6-ounce portion of ocean fish provides 650 micrograms of iodine. Most people are able to meet the daily recommendations by eating seafood, iodized salt, and plants grown in iodine-rich soil. When buying salt make sure it is labeled "iodized." The Food and Nutrition Board at the Institute of Medicine recommends the following dietary intake for iodine: Infants 0 - 6 months: 110 micrograms per day (mcg/day) 7 - 12 months: 130 mcg/day Children 1 - 3 years: 90 mcg/day 4 - 8 years: 90 mcg/day 9 - 13 years: 120 mcg/day Adolescents and Adults Males age 14 and older: 150 mcg/day Females age 14 and older: 150 mcg/day Specific recommendations depend on age, gender, and other factors (such as pregnancy). Women who are pregnant or producing breast milk (lactating) need higher amounts. Ask your health care provider which amount is best for you.

explain the - process of lactation - the hormones responsible - breastfeeding recommendations & benefits

Lactation, secretion and yielding of milk by females after giving birth. The milk is produced by the mammary glands, which are contained within the breasts. (See also mammary gland.) The breasts, unlike most of the other organs, continue to increase in size after childbirth. Although mammary growth begins during pregnancy under the influence of ovarian and placental hormones, and some milk is formed, copious milk secretion sets in only after delivery. Since lactation ensues after a premature birth, it would appear that milk production is held back during pregnancy. The mechanism by which this inhibitory effect is brought about, or by which lactation is initiated at delivery, has long been the subject of an argument that revolves around the opposing actions of estrogen, progesterone, and prolactin, as studied in laboratory animals, goats, and cattle. During pregnancy the combination of estrogen and progesterone circulating in the blood appears to inhibit milk secretion by blocking the release of prolactin from the pituitary gland and by making the mammary gland cells unresponsive to this pituitary hormone. The blockade is removed at the end of pregnancy by the expulsion of the placenta and the loss of its supply of hormones, as well as by the decline in hormone production by the ovaries, while sufficient estrogen remains in circulation to promote the secretion of prolactin by the pituitary gland and so favour lactation. It is also possible that a relative increase in the blood level of adrenal hormones favours the production of milk. For lactation to continue, necessary patterns of hormone secretion must be maintained; and disturbances of the equilibrium by the experimental removal of the pituitary gland, in animals, or by comparable diseased conditions in human beings, quickly arrest milk production. Several pituitary hormones seem to be involved in the formation of milk, so that it is customary to speak of a lactogenic ("milk-producing") complex of hormones. To some degree, the role of the pituitary hormones adrenocorticotropin, thyrotropin, and growth hormone in supporting lactation in women is inferred from the results of studies done on animals and from clinical observations that are in agreement with the results of animal studies. Prolactin, growth hormone, and adrenal hormone seem of greatest value in restoring lactation after removal of the pituitary, although the precise response varies from species to species. The stimulus of nursing or suckling supports continued lactation in two ways: it promotes the secretion of prolactin (and possibly other pituitary hormones of value in milk formation), and it triggers the release of yet another hormone from the pituitary gland—oxytocin, which causes contraction of special muscle cells around the alveoli in the breast and ensures the expulsion of milk. It is in this way that a baby's sucking at one breast may cause an increase in milk flow from both, so that milk may drip from the unsuckled nipple. About 30 seconds elapse between the beginning of active suckling and the initiation of milk flow. The nerve supply to the mammary glands is not of great significance in lactation, for milk production is normal after the experimental severing of nerves to the normal mammary glands in animals or in an udder transplanted to the neck of a goat. Milk ejection, or "the draught," in women is readily conditioned and can be precipitated by the preparations for nursing. Conversely, embarrassment or fright can inhibit milk ejection by interfering with the release of oxytocin; alcohol, also, is known to block milk ejection in women, again by an action on the brain. Beyond its action on the mammary glands, oxytocin affects uterine muscle, so that suckling can cause contractions of the uterus and may sometimes result in cramp. Since oxytocin release occurs during sexual intercourse, milk ejection in lactating women has been observed on such occasions. Disturbance of oxytocin secretion, or of the milk-ejection reflex, stops lactation just as readily as a lack of the hormones necessary for milk production, for the milk in the breast is then not extractable by the infant. Many instances of nursing failure are due to a lack of milk ejection in stressful circumstances; fortunately, treatment with oxytocin, coupled with the reassurance gained from a successful nursing, is ordinarily successful in overcoming the difficulty. Suckling can initiate lactation in nonpregnant women. This has been seen most often in women of childbearing age but also has been observed in older persons. A baby who had lost his mother was suckled by his 60-year-old grandmother, who had borne her last child 18 years before. The grandmother produced milk after a few days and continued to nurse the baby until he was a year old and could walk. Rarely, lactation has been reported to set in after operations on the chest; in such instances it is attributed to injury or irritation of the nerves in this region. Such observations argue against the possibility that lactation continues simply as a consequence of emptying the breasts. Composition And Properties Of Milk Milk can be regarded as an emulsion of fat globules in a colloidal solution of protein together with other substances in true solution. Two constituents of milk, the protein casein and milk sugar, or lactose, are not found elsewhere in the body. In the United States the frequency of breast-feeding has risen sharply in the past 25 years. Its advantages include nutritional, immunologic, and psychological benefits. Human breast milk is superior to modified cow's milk formulas, which may lack essential and beneficial components and are not absorbed as easily or as quickly by the infant. Maternal breast milk provides vitamins, minerals, protein, and anti-infectious factors; antibodies that protect the infant's gastrointestinal tract are supplied, resulting in a lower rate of enteric infection in breast-fed than in bottle-fed babies. The bonding that is established through breast-feeding is advantageous to building the parent-child relationship. The nutritional status of the mother is important throughout this period. The Food and Nutrition Board of the National Research Council recommends a daily caloric increase of approximately 400 kilocalories over nonpregnant diet. Most drugs that are taken during this time are secreted through the milk, and smoking reduces breast-milk volume and decreases infant growth rates. The milk released from the breast when lactation starts differs in composition from the mature milk produced when lactation is well established. The early milk, or colostrum, is rich in essential amino acids, the protein building blocks essential for growth; it also contains the proteins that convey immunity to some infections from mother to young, although not in such quantity as among domestic animals. The human infant gains this type of immunity largely within the uterus by the transfer of these antibody proteins through the placenta; the young baby seldom falls victim to mumps, measles, diphtheria, or scarlet fever. For a short time after birth, proteins can be absorbed from the intestine without digestion, so that the acquisition of further immunity is facilitated. The growth of viruses and bacteria in the intestines is probably inhibited by immune factors in human milk. After childbirth the composition of milk gradually changes; within four or five days the colostrum has become transitional milk; mature milk is secreted some 14 days after delivery. Some variations between human colostrum, transitional milk, and mature milk and cow's milk are shown in Table 2. The greater amount of protein in unmodified cow's milk is largely responsible for its dense, hard curd, which the infant cannot digest; the difficulty can be avoided by heat treatment or dilution of the milk. Ordinarily, when cow's milk is fed to young infants, it is modified so as to match its composition as far as possible to breast milk. Some constituents of human colostrum, transitional, and mature milk and of cow's milk (average values per 100 millilitres whole milk) colostrum (1-5 days) transitional (6-14 days) mature (after 14 days) cow's milk energy, kcal* 58 74 71 69 total solids, g 12.8 13.6 12.4 12.7 fat, g 2.9 3.6 3.8 3.7 lactose, g 5.3 6.6 7.0 4.8 protein, g 2.7 1.6 1.2 3.3 casein, g 1.2 0.7 0.4 2.8 ash, g 0.33 0.24 0.21 0.72 Minerals calcium, mg 31 34 33 125 magnesium, mg 4 4 4 12 potassium, mg 74 64 55 138 sodium, mg 48 29 15 58 iron, mg 0.09 0.04 0.15 0.10 *Kilocalorie; sufficient energy to raise the temperature of 1 kilogram of water 1 degree Centigrade. Weaning And The Cessation Of Lactation There is no typical age at which human infants are weaned, for this varies from country to country and among the social classes of a nation. In India women in the higher socioeconomic groups tend to use artificial feeding, while the reverse relationship holds in Britain and the United States. Most commonly, weaning is a gradual process, with a gradual increase in the proportion of solid food supplied to the infant together with breast milk. Pediatricians in general have concluded that, on the basis of present knowledge, no nutritional superiority or psychological benefits result from the introduction of solid foods into the infant diet earlier than the age of 21/2 to 31/2 months and that normal full-term infants can be expected to thrive for the first six months of life on a diet consisting exclusively of milk, either normal human milk or properly modified milk from other sources. With the reduced demand of the baby, lactation slowly declines and stops. Estrogen treatment is often used to suppress lactation, and the high doses used may accomplish this; but there is often a rebound effect at the end of treatment. Lactation may be slightly depressed when oral contraceptives are being taken in high dosage. Although ovulation is less frequent during lactation, it does occasionally occur. Breast-feeding should not, therefore, be used as a method of contraception. Menstruation usually resumes within six to eight weeks in women who are not breast-feeding; the length of its absence varies in women who breast-feed.

Define: heme iron

Plant foods are definitely different from animal foods when it comes to their iron content. In animal foods, iron is often attached to proteins called heme proteins, and referred to as heme iron. In plant foods, iron is not attached to heme proteins and is classified as non-heme iron. Heme iron is typically absorbed at a rate of 7-35%. Non-heme iron is typically absorbed at a rate of 2-20%. You can see that even though there is better overall absorption of heme iron, there is also a fairly large range for absorption regardless of the iron form involved. This absorption range is large because iron absorption is influenced by many different factors. For example, our bodies absorb more iron when we are iron deficient, and they cut back on iron absorption when plenty of iron is already available. Dietary factors are among the many factors that affect iron absorption. However, dietary factors appear to play a greater role in non-heme iron absorption from plant foods than they do in heme iron absorption from animal foods.

list the - function - sources (food and other) - deficiency - toxicity symptoms (if present) - diseases of each vitamin (if present) of the following MINERAL: flouride

Small amounts of fluoride help reduce tooth decay. Adding fluoride to tap water (called fluoridation) helps reduce cavities in children by more than half. Fluorides also help maintain bone structure. Low doses of fluoride salts may be used to treat conditions that cause faster-than-normal bone loss, such as menopause. Back to TopFood Sources Fluoridated water is found in most community water systems. (Well water often does not contain enough fluoride.) Food prepared in fluoridated water contains fluoride. Natural sodium fluoride is in the ocean, so most seafood contains fluoride. Tea and gelatin also contain fluoride. Infants can only get fluoride through drinking infant formulas. Breast milk has a negligible amount of fluoride in it. Back to TopSide Effects A lack (deficiency) of fluoride may lead to increased cavities, and weak bones and teeth. Too much fluoride in the diet is very rare. Rarely, infants who get too much fluoride before their teeth have broken through the gums have changes in the enamel that covers the teeth. Faint white lines or streaks may appear, but they are usually not easy to see. .

list the - function - sources (food and other) - deficiency - toxicity symptoms (if present) - diseases of each vitamin (if present) of the following VITAMIN: B12 (cobalamin)

source: - fish - shell fish - meat - eggs - dairy products deficiency: - shortness of breath - nervousness - fatigue - diarrhea functions: - maintains healthy nerve cells - makes RBC - helps in DNA/RNA production