chapter 8

The DASH Diet

An eating pattern proven to help people to reduce their sodium intake and control blood pressure is DASH (Dietary Approaches to Stop Hypertension). This pattern calls for greatly increased intakes of potassium-rich fruit and vegetables, adequate amounts of nuts, fish, whole grains, and low-fat dairy products, while restricting intakes of processed foods, red meat, solid fats, and sweets.

Mental Symptoms of Anemia

Apathy, listlessness Behavior disturbances Clumsiness Hyperactivity Irritability Lack of appetite Learning disorders (vocabulary, perception) Lowered IQ Reduced physical work capacity Repetitive hand and foot movements Shortened attention span

chromium

Chromium works with the hormone insulin to control blood glucose concentrations. •Chromium is present in a variety of unrefined foods. •It is estimated that 90 percent of U.S. adults consume less than the recommended minimum intake of 50 micrograms a day. •carbohydrate and lipid metabolism •Enhances insulin activity & glucose uptake •Sources: variety, unrefined foods best roles; Chromium helps regulate blood glucose by enhancing the activity of the hormone insulin, improving cellular uptake of glucose, and other actions defiecency When chromium is lacking, a diabetes-like condition can develop with elevated blood glucose and impaired glucose tolerance, insulin response, and glucagon response. Chromium Sources The best sources are unrefined foods, particularly liver, brewer's yeast, and whole grains

Calcium-most abundant mineral in the body

DRI Adults: 1,000 mg/day (men and women, 19-50 yr; men, 51-70 yr) 1,200 mg/day (women, 51-70 yr; men and women, >70 yr) Tolerable Upper Intake Level Adults: 2,500 mg/day (19-50 yr) 2,000 mg/day (>50 yr) Chief Functions Mineralization of bones and teeth; muscle contraction and relaxation, nerve functioning, blood clotting -Ca combines with P to form hydroxyapatite, the crystalline structure of bones and teeth -Ionized, Ca ++ serves these functions: -muscle contraction -transmission nerve impulses -activation of enzymes -blood clotting -fluid movement across membranes -Skeleton is a bank from which the blood can borrow and return calcium as needed Deficiency Stunted growth and weak bones in children; bone loss (osteoporosis) in adults Toxicity Elevated blood calcium; constipation; interference with absorption of other minerals; increased risk of kidney stone formation -Most adults absorb about 20 to 30 percent of the calcium they ingest -breastfed infants absorb about 60 percent of the calcium in breast milk. -Children in puberty absorb almost 35 percent of the calcium they consume. -Sometime around age 30, the skeleton no longer adds significantly to bone density. After about age 40, regardless of calcium intake, bones begin to lose density. Those who regularly meet calcium, protein, and other nutrient needs and who perform bone-strengthening physical activity may slow down the loss

zinc

DRI Men: 11 mg/day Women: 8 mg/day Tolerable Upper Intake Level Adults:40 mg/day Chief Functions Activates many enzymes; associated with hormones; synthesis of genetic material and proteins, transport of vitamin A, taste perception, wound healing, reproduction Deficiency Growth retardation, delayed sexual maturation, impaired immune function, hair loss, eye and skin lesions, loss of appetite Toxicity Loss of appetite, impaired immunity, reduced iron absorption, low HDL cholesterol (a risk factor for heart disease) may cause vomiting, diarrhea, headaches, exhaustion, and other symptoms. OYSTERS (steamed) 3 oz BEEF STEAK (lean) 3 oz YOGURT (plain) 1 c SHRIMP (cooked) 3 oz ENRICHED CEREAL (ready-to-eat) 3/4 c PORK CHOP 3 oz

Sodium Recommendations and Blood Pressure These upper limits are recommended to help control blood pressure.

Dietary Guidelines for Americans, 2015-2020 Consume less than 2,300 milligrams per day of sodium (ages 14 years and older). Further reductions to 1,500 milligrams of sodium may produce greater benefits in people with hypertension or prehypertension. UL 2,300 mg/day, adults. average U.S. sodium intake nears 3,500 milligrams per day DRI 1,500 milligrams for healthy, active young adults; 1,300 for people ages 51 through 70; 1,200 for the elderly people with hypertension, diabetes, or chronic kidney disease should take in no more than 1,500 milligrams per day reducing sodium by at least 1,000 milligrams per day reduces blood pressure.

iron- Iron is clearly the body's gold,

Every living cell, whether plant or animal, contains iron. Most of the iron in the body is a component of two proteins: hemoglobin in red blood cells and myoglobin in muscle cells. Roles •Carry oxygen •Make new cells, amino acids, hormones, & neurotransmitters -The bone marrow uses large quantities of iron to make new red blood cells, which live only for about 4 months, recycle to be used back in the bone marrow -Bleeding, however, can cause significant iron loss from the body.

surface water

Exposure to contamination •Filtered by plants •Aeration and sunlight cleanse water that comes from lakes, rivers, and reservoirs.

Exercise-Deficiency Fatigue

Few realize that too little exercise over weeks and months is as exhausting as too much—the less you do, the less you're able to do, and the more fatigued you feel. The condition even has a name: "sedentary inertia. -Put your diet in order. Get some exercise. If fatigue persists for more than a week or two after making simple changes, consult a physician for a diagnosis.

iodine

Found in soil near oceans, iodized salt and seafood Iodine Roles Iodide is a cofactor that works with the hormone thyroxine, made by the thyroid gland. Thyroxine regulates the body's metabolic rate, temperature, reproduction, growth, heart functioning, and more. Iodine must be available for thyroxine to be synthesized. •Deficiencies: hypothyroidism, goiter and cretinism •Goiter Belt in U.S. lead to iodized salt -People with iodine deficiency this severe may feel cold, may become sluggish and forgetful, and may gain weight. Iodine deficiency affects more than 2 billion people globally, including hundreds of millions of school-aged children. -Iodine deficiency during pregnancy causes fetal death, reduced infant survival, and extreme and irreversible mental and physical retardation in infants, known as cretinism. *****It constitutes one of the world's most common and preventable causes of mental retardation Intake- Although average U.S. intakes are generally above the recommended intake of 150 micrograms, they are still below the UL of 1,100 micrograms per day for an adult food sources- The iodine in food varies with the amount in the soil in which plants are grown or on which animals graze. Because iodine is plentiful in the ocean, seafood is a dependable source. -iodized salt

copper

Hemoglobin formation, iron metabolism, enzyme cofactor •Deficiency rare; malnutrition, Zn supplements •Toxicity rare, supplement megadose cofactor for many enzymes. Among their tasks, these enzymes assist in the absorption and use of iron, and in synthesis of proteins such as hemoglobin and collagen. Another of these enzymes helps to control damage from free-radical activity in the tissues. Copper deficiency is rare -severely malnourished infants fed a copper-poor milk formula. Deficiency can severely disturb growth and metabolism, and in adults, it can impair immunity and blood flow through the arteries. -Excess zinc interferes with copper absorption and can cause deficiency. -Two rare genetic disorders affect copper status in opposite directions—one causing a functional deficiency and the other toxicity. Copper toxicity from foods is unlikely, but supplements can cause it. - The UL for adults is set at 10,000 micrograms (10 milligrams) per day. The best food sources of copper include organ meats, seafood, nuts, and seeds. Water may also supply copper

How Are Salt and "Water Weight" Related?

If blood sodium rises, as it will after a person eats salted foods, thirst ensures that the person will drink water until the sodium-to-water ratio is restored. Then the kidneys excrete the extra water along with sodium. Overly strict use of low-sodium diets can deplete the body of needed sodium; so can vomiting, diarrhea, or very heavy sweating. Dieters sometimes think that eating too much salt or drinking too much water will make them gain weight, but they do not gain fat, of course. They gain water, but a healthy body excretes this excess water immediately. Excess salt is excreted as soon as enough water is drunk to carry the salt out of the body. From this perspective, then, the way to keep body salt (and "water weight") under control is to control salt intake and drink more, not less, water.

Source of Iron is Important

Iron absorption varies depending on the source of the iron Vegetable sources: 2-20% of iron absorbe Animal sources: 10-35% of iron absorbed What can you do to increase iron absorption? •add foods rich in vitamin C to iron rich foods to increase their bioavailability. •drink glass OJ with cereal; add sesame seeds to salad; add wheat germ to cereal. This produces 3-fold increase in nonheme iron absorption

Iron Absorption Enhancers in Food heme and nonheme

Iron occurs in two forms in foods. Some is bound into heme, the iron-containing part of hemoglobin and myoglobin in meat, poultry, and fish. Some is nonheme iron, in plants and also in meats. The form affects absorption. Healthy people with adequate iron stores absorb heme iron at a rate of about 23 percent over a wide range of meat intakes. People absorb nonheme iron at rates of 2 to 20 percent, depending on dietary factors and iron stores. -Meat, fish, and poultry also contain a peptide factor, sometimes called MFP factor, that promotes the absorption of nonheme iron from other foods, as depicted in Figure 8-16. Vitamin C also greatly improves absorption of nonheme iron, tripling iron absorption from foods eaten in the same meal. The bit of vitamin C in dried fruit, strawberries, or watermelon helps absorb the nonheme iron in these foods.

mineral salts

Mineral salts form electrolytes that help keep fluids in their proper compartments.

Phosphorus

Phosphorus is the second most abundant mineral in the body. More than 80 percent of the body's phosphorus is found combined with calcium in the crystals of the bones and teeth also:•Helps maintain-acid base balance•Part of genetic material•Assists in energy metabolism•Forms part of cell membranes Deficiencies unlikely-prevalent in diet & preservatives •Excess phosphorus in the blood is associated with indicators of heart disease and osteoporosis roles; Acid-Base buffers•DNA and RNA component (essential for growth and renewal of tissues).•Energy release (ATP).•Enzyme cofactors.•Phospholipid component of cell membranes.•Part of some proteins DRI Adults: 700 mg/day Tolerable Upper Intake Level Adults (19-70 yr): 4,000 mg/day Chief Functions Mineralization of bones and teeth; part of phospholipids, important in genetic material, energy metabolism, and buffering systems Deficiency Muscular weakness, bone pain Toxicity Calcification of soft tissues, particularly the kidneys cottage cheese- 1 c milk- 1 c navy beans(cooked)- 1/2 c SALMON (canned, with bones) 3 oz SIRLOIN STEAK (lean) 3 oz SUNFLOWER SEEDS 2 tbs

The Dietary Guidelines for Americans committee names four minerals as shortfall nutrients—most people's intakes are too low:

Potassium. Calcium. Magnesium. Iron (for some people).

selenium

Roles in the Body Selenium works as a cofactor for many enzymes that, in concert with vitamin E, limits the formation of free radicals and prevents oxidative harm to cells and tissues chronic diseases; In cancer studies, adequate blood selenium seems protective against cancers of the prostate, colon, breast, and other sites. Should everyone take selenium supplements to ward off cancer, then? No. Selenium deficiency may increase cancer risk, but U.S. intakes are generally sufficient, and excesses may harm healthy, well-fed people Deficiency •Muscle disorders with weakness and pain •Specific type of heart disease Toxicity •Due to supplements •Hair loss and brittle nails •Diarrhea and fatigue •Bone, joint, and nerve abnormalities Toxicity is possible when people take selenium supplements and exceed the UL of 400 micrograms per day. Selenium toxicity brings on symptoms such as hair loss and brittle nails; diarrhea and fatigue; and bone, joint, and nerve abnormalities. •Sources •Meats and shellfish -

sodium

Sodium is the main positively charged ion outside the body's cells. •In 1 gram of table salt, NaCl, there are 400 milligrams of sodium and 600 milligrams of chloride. chief ion used to maintain the volume of fluid outside cells •Is a major part of the body's fluid and electrolyte balance system .•Helps maintain acid-base balance. •Is essential to muscle contraction and nerve transmission.

Iron Absorption Inhibitors

Some food substances inhibit iron absorption. They include the tannins of tea and coffee, the calcium and phosphorus in milk, and the phytates that accompany fiber in lightly processed legumes and whole-grain cereals. -Ordinary black tea excels at reducing iron absorption—clinical dietitians advise people with iron overload to drink it with their meals. For those who need more iron, the opposite advice applies—drink tea between meals, not with food. Thus, the amount of iron absorbed from a regular meal depends partly on the interaction between promoters and inhibitors

sulfate

Sulfate is a necessary nutrient used to synthesize sulfur-containing body compounds. Sulfur-containing amino acids play an important role in helping strands of protein assume their functional shapes. Skin, hair, and nails contain some of the body's more rigid proteins, which have high sulfur contents. There is no recommended intake for sulfate, and deficiencies are unknown. Too much sulfate in drinking water, either naturally occurring or from contamination, causes diarrhea and may damage the colon.

An Iron-Regulating Hormone—Hepcidin

The hormone hepcidin, secreted by the liver, is an important regulator of blood iron. Hepcidin reduces iron absorption from the small intestine and also reduces iron release from body stores, thereby keeping the blood iron concentration from rising too high.

Iron Recommendations and Sources

The typical eating pattern in the United States provides about 6 to 7 milligrams of iron in every 1,000 calories. Men need 8 milligrams of iron each day, and so do women past age 51, For women of childbearing age, the recommendation is higher—18 milligrams—to replace menstrual losses. During pregnancy, a woman needs even more—27 milligrams a day; to obtain this amount, pregnant women need a supplement. If a man has a low hemoglobin concentration, his health-care provider should examine him for a blood-loss site. Vegetarians, because iron from plant sources is poorly absorbed, should multiply the DRI value for their age and gender group by 1.8 -CLAMS (steamed) 3 oz BEEF STEAK 3 oz NAVY BEANSb (cooked) 1/2 c BLACK BEANS (cooked) 1/2 c ENRICHED CEREAL (ready-to-eat) 3/4 c SPINACH (cooked) 1/2 c SWISS CHARD (cooked) 1/2 c BEEF LIVER (cooked) 3 oz Dried figs contain 0.6 mg per c; raisins contain 0.8 mg per c.

Promoters and Inhibitors of Iron Absorption

These dietary factors increase iron absorption: Heme form of iron Vitamin C Meat, fish, poultry (MFP) factor These dietary factors hinder iron absorption: Nonheme form of iron Tea and coffee Calcium and phosphorus Phytates, tannins, and fiber

Sodium, Potassium, Chlorine

These minerals are called electrolytes because they are dissolved in the body as ions (atoms with + or - charge) establish proper electrical gradient across cell membranes (transmits nerve impulses, stimulation and contraction of muscles, proper functioning of glands) -modulate fluid exchange within the body's various fluid compartments (intra-and extracellular)

Electrolyte Balance

Transport proteins in cell membranes maintain the proper balance of sodium (mostly outside the cells) and potassium (mostly inside the cells) Water follows salt •Electrolytes •Water flows toward greater concentration

What is osteoporosis? low bones loss= osteopenia

When calcium is deficient, the bones "give up" their Ca to try and restore the deficit. The bones literally become "hollow" or porous, leading to breaks and fractures -The hormone estrogen is linked to osteoporosis (because estrogen enhances Ca absorption; a decrease in estrogen no longer offers a protective effect) Who Gets the Disease? By age 50, men lose about 0.4% bone each year; in women, the loss is about 0.8% starting at age 35 (double the loss 15 years sooner!) -During menopause, bone loss accelerates to between 1% to 3% each year. Thus, by age 60, a woman can lose about 15% of her bone mass, and by age 70, bone loss can be as much as 30% Where Does The BoneLoss Occur? •Most occurs in the vertebrae (person shrinks in stature by up to 6 inches from age 45-50 to age 70). •The "spongy" bone (trabecular bone) loses its mineral content, causing the bone to crumble. The inside of the bone becomes honeycombed (like a beehive) and porous Worldwide, osteoporosis causes more than 8.9 million fractures annually, resulting in an osteoporotic fracture every 3 seconds •An estimated 75 million people in the U.S. - the majority of them women over 50 - have or are developing osteoporosis. Each year, 9,000,000 people break a hip, leg, arm, hand, ankle, or other bone due to osteoporosis. -Of the more than300,000 Americans 65or older who fracture a hip each year, 20 to 30 percent will die within 12 months, and "many more will experience significant functional loss," according to a 2009 study published in The Journal of the American Medical Association (JAMA).

Who Is Most Susceptible to Iron Deficiency?

Women in their reproductive years. Pregnant women. Infants and toddlers. Adolescents.

Symptoms of Iron Deficiency

Worldwide, iron deficiency is the most common nutrient deficiency, affecting more than 1.2 billion people •Usually caused by malnutrition •Either from lack of food or from high consumption of the wrong foods Long before the red blood cells are affected and anemia is diagnosed, a developing iron deficiency affects behavior. Even slightly lowered iron levels cause fatigue, mental impairments, and impaired physical work capacity and productivity. -Children deprived of iron become restless, irritable, unwilling to work or play, and unable to pay attention, and they may fall behind their peers academically. -pica—the craving for and intentional consumption of ice, chalk, starch, clay, soil, and other nonfood substances.

iron-deficiency anemia

a form of anemia caused by a lack of iron and characterized by red blood cell shrinkage and color loss. Accompanying symptoms are weakness, apathy, headaches, pallor, intolerance to cold, and inability to pay attention. Fact: Typical Western diet provides only 6 mg iron per 1000 calories of food intake•Hemoglobin (Hb) reduced to low levels and produces sluggishness, loss of appetite, reduced exercise capacity •Thus, a female who consumes 1700 kcal daily only consumes 10.2 mg iron daily •Recommended intake for females: 15 mg/day •Recommended intake for males: 12 mg/day

water

body needs more water each day than any other nutrient—50 times more water than protein and 5,000 times more water than vitamin C Makes up about 60 percent of an adult's weight •Water content; •Brain and muscle: 75 to 80 percent •Bones: 25 percent •Acts as a lubricant and shock absorber around joints and organs •Primary component in amniotic fluid •Aids in regulating the body's temperature •Carries nutrients •Solvent for minerals, vitamins, amino acids, glucose, and other small molecules •Active in many chemical reactions •Cleanses the tissues and blood of wastes

major minerals

essential mineral nutrients required in the adult diet in amounts greater than 100 milligrams per day. Also called macrominerals. (>100mg/day) •sodium •potassium •calcium •phosphorus •magnesium •sulfur •chlorine

trace minerals.

essential mineral nutrients required in the adult diet in amounts less than 100 milligrams per day. Also called microminerals (<100mg/day) •iron •zinc •copper •selenium •iodine •fluorine •chromium •molybdenum •manganese

fluid and electrolyte imbalance

failure to maintain the proper amounts and kinds of fluids and minerals in every body compartment; a medical emergency Rapid fluid shift causes an imbalance

bottled water

impacts environment -80 percent of the 35 billion plastic water bottles purchased in the United States each year end up in landfills, in incinerators, or as litter on land and in rivers, lakes, and oceans.

How Are Salt Intake and Hypertension Related?

increased Na+ intake correlates with hypertension, heart disease, and stroke 1/3 U.S. adults have HTN 42% U.S. African American adults have HTN Prehypertension: in additional 30% U.S. adults (BP between 120/80 and 139/89

minerals

naturally occurring, inorganic, homogeneous substances; chemical elements -all added up weigh about 5 pounds -4% of body mass consists of minerals

sodium deficiency

no known human diet lacks sodium. Most foods include more salt than is needed, and the body absorbs it freely. -The kidneys filter the surplus out of the blood into the urine. -If blood sodium drops, body water is lost, and both water and sodium must be replenished to avert an emergency. can lose sodium when, low-sodium diets, as can vomiting, diarrhea, or extremely heavy sweating hyponatremia an abnormally low concentration of sodium in the blood.

magnesium

only about 1 ounce is present in the body of a 130-pound person, over half of it in the bones 1/2 in the bones; other muscle, heart, liver, body fluids •Bone Mg++ can be used when body levels low; •kidneys can conserve if deficient functions; Bone mineralization, enzyme action, heart function, immune function, muscle contraction, nerve function, protein synthesis, and tooth maintenance Magnesium is a part of chlorophyll, the green pigment found in plants, so green leafy vegetables are one good source. The magnesium content of refined foods is usually low. Although magnesium is present in many foods, it usually occurs in small amounts. conduction of nerve impulses and muscle contraction Serves as a cofactor for hundreds of enzymes. Is needed for the release and use of energy from the energy-yielding nutrients. Is a necessary part of the cellular protein-making machinery. Is critical to normal nerve transmission, muscle contraction, and heart function defiecency; -chronically low intakes are associated with diabetes, heart failure, hypertension, inflammation, and stroke. The Dietary Guidelines list magnesium among the shortfall nutrients for the U.S. population. -An acute magnesium deficiency may occur with alcoholism, prolonged diarrhea or vomiting, or severe malnutrition. It may also occur among people who take diuretics or other medications that cause excessive magnesium loss in the urine. Its symptoms include a low blood calcium level, muscle cramps, and seizures. Magnesium deficiency also impairs brain functioning and may cause hallucinations that can be mistaken for mental illness or drunkenness. toxicity; Magnesium toxicity is rare, but it can be fatal. Toxicity occurs only with high intakes from nonfood sources such as supplements. Accidental poisonings may occur in children with access to medicine chests and in older people who take too many magnesium-containing laxatives, antacids, and other medications. The symptoms can include diarrhea, acid-base imbalance, and dehydration. DRI Men (19-30 yr): 400 mg/day Women (19-30 yr): 310 mg/day Tolerable Upper Intake Level Adults: 350 mg/day food; SPINACH (cooked)- 1/2 c BLACK BEANS (cooked)- 1/2 c SOY MILK 1 c BRAN CEREAL (ready-to-eat) 1 c- Whole wheat and wheat bran provides magnesium, but refined grain products are low in magnesium. SUNFLOWER SEEDS (dry roasted kernels) 2 tbs YOGURT (plain) 1 c

acid-base balance

or the pH, of the body's fluids. -the positive charges exactly equal the negatives sometimes making water acid or basic -Minerals act as buffers to help maintain body fluids at the correct pH to support life's processes. Hydrogen or hydroxide ions •Buffers

flouride

present in virtually all soils, water supplies, plants, and animals. -To prevent fluorosis, young children should not swallow toothpaste. rolls; In developing teeth and bones, fluoride replaces the hydroxy portion of hydroxyapatite, forming fluorapatite. During development, fluorapatite enlarges calcium crystals in bones and teeth, improving their resistance to demineralization. -Fluoride's primary role in health is prevention of dental caries throughout life. Deficiency Where fluoride is lacking, dental decay is common, and fluoridation of public water is recommended for dental health weak bones toxicity -Excess fluoride discolors teeth; large doses are toxic. -fluorosis white flecks; in severe cases, the enamel becomes pitted and permanently stained -occurs only during tooth development and it is permanent prevention during the first 3 years of life a high priority Sources of Fluoride Drinking water

foods rich in calcium

sardines with bones - 3oz milk- 1c tofu calcium set- 1/2 c yogurt plain-1 c -Broccoli, kale, and some other cooked green leafy vegetables are also Almonds Spinach and chard contain calcium in an unabsorbable form. Some calcium-rich mineral waters may also be good sources. -cheddar cheese- 1.5 oz turnip greens cooked - 1 c 1 whole grain waffle

overconsumed

sodium

soft water

water with a high sodium concentration. -makes more bubbles with less soap -may aggravate hypertension (higher blood pressure) -dissolves cadmium and lead from pipes. -Lead is particularly harmful to children

hard water

water with high calcium and magnesium concentrations. -leaves a ring on the tub, a jumble of rocklike crystals in the teakettle, and a gray residue in the wash

groundwater

wells •Contamination water that comes from underground aquifers.

chloride

•Chloride is the body's major negative ion; it is responsible for stomach acidity and assists in maintaining body chemistry. •No known diet lacks chloride. -responsible for the stomach's acidity.

ZINC functions

•Combines with insulin in the pancreas to form the storage form of insulin •Heals wounds and burns •Required for normal taste with copper •Carries CO2 in the rbc's •Found in oysters, red meat, dark meat poultry, egg yolks -Zinc works with protein in every organ, helping nearly 100 enzymes and regulating gene expression. It acts as a cofactor for more than 300 enzymes to: Protect cell structures against damage from oxidation. Make parts of the cells' genetic material. Make the heme of hemoglobin. -Zinc also assists the pancreas with its digestive and insulin functions and helps metabolize carbohydrate, protein, and fat. Affects behavior, learning, and mood. Assists in proper immune functioning. Is essential to wound healing, sperm production, taste perception, normal metabolic rate, nerve and brain functioning, bone growth, normal development in children, and many other functions.

body's water balance

•Dehydration •Water intoxication •Body water varies by pounds •Thirst and satiety govern water intake •Hypothalamus signals the pituitary gland that instructs the kidneys •Caffeine acts as a diuretic;is a compound that causes increased urinary water excretion.

Potassium

•Potassium is the principal positively charged ion inside the body's cells •Plays a major role in maintaining fluid and electrolyte balance and cell integrity, and is critical in maintaining a heartbeat DRI Adults: 4,700 mg/day Chief Functions Maintains normal fluid and electrolyte balance; facilitates chemical reactions; supports cell integrity; assists in nerve functioning and muscle contractions Deficiency Muscle weakness, paralysis, confusion -The sudden deaths that occur with fasting, eating disorders, severe diarrhea, or severe malnutrition in children may be due to heart failure caused by potassium loss. Toxicity Muscle weakness; vomiting; when given in a supplement to an infant or when injected into a vein in an adult, potassium can stop the heart foods; Most vegetables and fruit are outstanding potassium sources. Bananas, spinach, cantaloupe, and almonds ORANGE JUICE 1 c BUTTERNUT SQUASH (baked) 1 c LIMA BEANS (cooked) 1/2 c WILD SALMON (cooked) 3 oz BAKED POTATO whole potato AVOCADO 1/2

Public water systems

•Risk of contamination increases •Purifying equipment can remove many hazards

Why is Dietary Calcium Crucial?

•Shockingly, about 30% of college-age females consume only 400 to 500 mg of calcium daily (RDA = 1200 mg daily) •Calcium rich foods (dairy products) contain vitamin D (not truly a vitamin), and this increases Ca absorption into the bones •Adequate Ca intake, begun at an early age (6-14 years old), increases bone density

Sodium in Foods

•The major source of sodium in the diet is salt. •Salt enhances flavor and texture, and serves as a preservative. •High amounts of sodium are found in processed foods and restaurant foods—where 80 percent of your sodium intake comes from.

Sodium and Blood Pressure

•The relationship between salt intakes and blood pressure is direct - the more salt a person eats, the higher the blood pressure goes. •Stronger effect among people with diabetes, hypertension, kidney disease, African descent, history of parents with hypertension, and anyone over 50 years of age .•Higher blood pressure is related to heart disease and strokes.

Factors That Increase Fluid Needs

•These conditions increase a person's need for fluids •Alcohol consumption •Cold weather •Dietary fiber •Diseases that disturb water balance, such as diabetes and kidney diseases •Forced-air environments, such as airplanes and sealed buildings •Heated environments •High altitude •Hot weather, high humidity •Increased protein, salt, or sugar intakes •Ketosis •Medications (diuretics) •Physical activity •Pregnancy and breastfeeding •Prolonged diarrhea, vomiting, or fever •Surgery, blood loss, or burns •Very young or old age

Too Much Iron

•Toxicity•May promote cancers of the colon and rectum •Damages the liver, joints, or heart •Susceptibility to infections •Can harm the immune system •Poisoning can be fatal •Symptoms •Fatigue, mental depression, or abdominal pain

How Much Water Do I Need to Drink in a Day?

•Water needs vary •Influenced by various factors •Fluids and foods •D R I recommendations •Metabolic water: Water generated in the tissues during the chemical breakdown of the energy-yielding nutrients in foods •Sweating; •Fluid loss in a day

Recommended Milk Intake

•Young Children- 3 cups •Teens- 4 (boys until 21 4-5) •Adults- 3 cups •Pregnancy/Lactating- 4 cups