fnes 263 exam 2

I R O N

Food sources Absorption/Transportation/

Storage/Excretion Function Deficiency/Toxicity RDA

1. Mollusks

2. Liver

3. Pumpkin seeds

4. Nuts

5. Beef/Lamb

6. Beans/lentils

7. Whole grains

8. Leafy greens

9. Dark chocolate

10. Tofu

↑ Vit. C, AA, sugar

↓ phytic acid & milk

A: in duodenum Fe(III)Fe(II)

T: transferrin in blood to liver,

Bone marrow, muscles, etc.

S: in mucosal cells & liver

(liver & spleen recycle iron)

E: mucosal cells thru feces,

Blood loss, sweat

Function:

- Oxidation-reduction

- Aerobic metabolism

(Kreb’s Cycle, ETC)

- Electron carriers in cytochromes

- O2/CO2 transporters in hemoglobin

- Catalase & collagen synthesis

Assessment:

- Serum iron

- Total iron binding capacity

- Transferrin saturation

- Hematocrit % of blood that is RBC

- Hemoglobin

At risk:

- Infants, young women, children, pregnant

women, malabsorption

Symptoms:

- ↓work/exercise capacity

- Impaired immune function

- Iron deficient anemia

- Pica – ice eating, geophagia

- Spoon-shaped nails

- thyroid hormone, EEG abnormalities

19y/o +

M: 8mg/d

F: 18mg/d

Toxicity:

>40µmol/l

cirrhosis, diabetes,

arthritis, skin

pigmentation

1. Based on data of bioavailability & iron losses, the amount of iron required daily is greater than the actual value that your body need, because iron absorption is

compromised when you consume phytic acids from greens and milk proteins. There is also iron loss from blood, sweat, and feces.

2. Iron supplementation is usually done with ferrous sulfate, 325mg per day. A young mother would have to take those oral supplemens for about 2 months to

replenish her bone marrow.

3. Iron containing enzymes listed & function: cytochrome c & NADH ( ETC), mellaprotein (storage/transport of proteins)

4. Elderly patients may show normocytic anemia, even without blood loss, because the absorption in the intestines are compromised.

I O D I N E



1. Sea vegetables

2. Yogurt

3. Milk

4. Nuts

5. Eggs

6. Cheese

The older an exposed soil

surface more likely

iodine leak (Himalayas,

Andes, Alps, etc.)

A: rapid through small intestines

Cell Uptake: enormous

concentrating power, active

transport regulated by TSH from

pituitary, competes with

thiocyanates (cruciferous, cassava)

T: transthyretin (prealbumin)

S: 70-80% in thyroid gland in

T3 (active) & T4

Thyroglobulin (colloid that

fills thyroid follicle)

Function:

- Regulates body temperature

- Stimulates protein synthesis

- Regulates carb/lipid catabolism

Assessment:

- Serum iron

- Total iron binding capacity

- Transferrin saturation

- Hematocrit % of blood that is RBC

- Hemoglobin

Deficiency:

- Goiter (↓T4↑TSH↑uptake iodine into

thryroid↑turnoverhyperplasia of cells

- Cretinism: dwarfism, mental retardation

- Selenium/Vitamin A worsen retardation

Hyperthyroidism:

- ↑metabolic functions & metabolism

- Weight loss, hot, tremor, restless, diarrhea

Hypothyroidism:

- ↓metabolism, mental process

- Weakness, constipation, cold/dry skin

14y/o +

M: 150mcg/d

F: 150mcg/d

Preg: 220mcg

Lact: 290mcg

Toxicity:

1100mcg/d

5. Investigate iodine content in soil where crops are grown,

iodine in diet, thyroid hormone levels, malabsorption

disorders, thiocynates in diet, and stress levels.

6. Measurements of TSH and T4 required determining if patients

with symptoms of hypothyroidism are iodine deficient b/c low

if it is caused my iodine deficiency then T4 will be low while

TSH is high. If TSH and T4 are both low then it may be an

abnormality in the pituitary gland.

C H R O M I U M



1. Brewer’s yeast

2. Meat (Liver)

3. Fish

4. Eggs

5. Whole grains

6. Broccoli/Mushrooms

7. Nuts & legumes

8. Dark chocolate

A: ↑ by Vit. C / ↓ by phytates

T: transferrin & albumin

S: bones, liver, kidneys, spleen

E: in feces & urine

Function:

- Insulin action (macro metabolism)

- Improved glucose tolerance in

children with PEM & diabetics

Deficiency:

- Weight loss

- Glucose intolerance

- Nerve damage

Toxicity (1100mcg/d):

- Trivalent Cr highly tolerable

- Allergic dermatitis, skin ulcers,

bronchogenic carcinoma (airborne)

AI for 19+

M: 35mcg/d

F: 25mcg/d

AI for 50+

M: 30mcg/d

F: 20mcg/d

C A R N I T I N E



- Biosynthesis from

lysine & methionine

(liver/kidney)

- Depends on ascorbate,

Fe, PLP, folate

D: some by microflora in GI tract

A: passive & active transport into

Portal circulation, then liver,

Then into systemic circulation

Regulation: renal clearance,

reabsorption, decline w/ blood lvls

Cell uptake: specific L taken, D

not

S: skeletal muscles (95%)

Function:

- Transports FA in mitochondria &

acyl residue from 1 cellular

compartment to another

Conditioned:

- Reduced capacity for biosynthesis

- Subnormal CPT I

- Alterations in cellular mechanisms

- Excess loss (hemodialysis, etc.)

- Raised tissue requirement (infants, neonate)

- Vegetarian lower carnitine plasma levels

NO RDA

7. Carnitine status is altered in patients with renal disease, because it is regulated by renal clearance. There may be excessive excretion of carnitine.

8. Nutrients required for carnitine synthesis are lysine and methionine. It also depends on ascrobate, Fe, PLP, and possibly folate.

C O P P E R

Food sources Absorption/

Transportation/Storage Function Deficiency/Toxicity RDA

1. Shellfish/nuts/seed/

legumes/grains/organ

2. Grains/chocolate/fruits/

vegetable/mushrooms

tomatoes/bananas/grape/

most meats/potatoes

3. Very low: cow’s milk

A: small amounts in stomach,

Small Intestines

Regulation: by need, MT

intestines absorption doesn’t

increase linearly

T: ceruloplasmin, albumin,

transcuprein, some into MT

for detoxification (possibly)

S: skeletal muscles (95%)

Function:

- Enzymes: shift back/forth Cu2+/+

- Amine oxidases:

o Mono-inactivation of serotonin, norepinephrine, tyramine,

dopamine

o Di-inactivates histamine & polyamines, cell proliferation

o Lysyl-bone, blood, skin, lungs, teeth; essential for bone

formation, skeletal mineralization & integrity of connective

tissue in heart/vascular

- Ferroxidases

o Ceruplasmin (Ferroxidace I): inc. inflammation

o Ferroxidase II: anemia in copper deficiency, necessary for

bone marrow formation

- SOD: scavenge radicals, brain, liver, kidney, etc.

- Cu-proteins:

o MT (rich in cysteine, storage metal ions)

o Albumin (binds/transports copper, against toxicity)

o Blood clotting factor V

o Required for myline, nerve tissue

- Thermal regulation, cholesterol metabolism, glucose

metabolism, immune fnx. Cardiac fnx.

Interation w/ other nutrients:

- Iron & zinc

- Molybdenum- Cu deficiency

- Ascorbic acid- ↓ceruplasmin

- Carbs- SOD levels low

- No reliable biomarkers

- Ceruloplasmin, leukopenia,

neutropenia, osteoporosis

- Anemia, arthritis, arterial

disease, loss of pigmentation,

cholesterol, heart irregularity,

glucose tolerance ↓

- Menke’s disease, Wilson’s

Disease

19 y.o +

M: 900mcg/d

F: 900mcg/d

DV: 2mg/d

BONE FORMATION

C A L C I U M



1. Yogurt

2. Tofu

3. Sesame seeds

4. Milk

5. Collard greens/kale

6. Spinach

7. Cheese

8. Scallops

9. Beans

10. Blackberries

11. Almonds

12. Oranges

A: depends on Vit. D &

↓ by fiber, phytate, oxlic acid

↑ by sto. acid, lactose, protein

Reduce w/ diarrhea, tannins

Increase with need growth, etc.

Along small intestines (25-35%)

S: bones

Function:

- structural function in bones/teeth

- blood clotting, cell metabolism

- transmission of nerve impulses

- muscle contractions

-

Hypercalcemia (too much)

- risk of kidney stones, HTN, kidney failure

Food effects

- ↓risk of colon cancer, kidney stones, bp.

19 y.o +

M: 1000mg/d

F: 1000mg/d

70+: 1200mg

P H O S P H O R U S



1. Milk, cheese

2. Meat, poultry

3. Bakery products

4. Cereal, bran

5. Additives: modosodium,

monocalcium

A: Upper Small intestines

↑ Vit. D / ↓ phytates

T: active transport/diffusion

E: by kidneys, reg by PTH

Function:

- Major component of bones & teeth

- Intracellular anion, buffer in blood

- Part of RNA, DNA, ATP, etc.

At Risk:

- Preterm infants, alcoholics, elder, poor diet,

long term diarrhea, weight loss

Deficiency (RARE):

- Bone loss, decrease growth, poor teeth,

rickets, anorexia, weight loss, weakness,

irritability, stiff joints, bone pain

19 y.o +

M: 700mg/d

F: 700mg/d

DV: 1000mg

UL: 3-4g/d

Calcification

V I T A M I N K



1. Cruciferous vegetables

2. Green peas

3. Soybean oil

4. Canola oil

Bioavailability influenced

by accompanying fat

A: bile & pancreatic juice (15-20%)

chylomicrons, appears lymphs

T: chylomicrons liver

S: small, 2/3 of liver, lost in 3 days

E: feces & urine

* vit. E increases vit. K req.

* vit. A reduced abs. of vit. K

Function:

- Prothrombin: coagulation

- Bone proteins (BGP/MGP)

- Proteins are inhibited by warfarin in

their synthesis & regulated by D3

- Brain sphingolipid synthesis

- Induce apoptosis in leukemia

At Risk:

- Preterm infants, alcoholics, elder, poor diet,

long term diarrhea, weight loss

Deficiency (RARE):

- Bone loss, decrease growth, poor teeth,

rickets, anorexia, weight loss, weakness,

irritability, stiff joints, bone pain

AI

M: 120mcg/d

F: 90mcg/d

DV: 80mcg

UL: 3-4g/d

Calcification

1. New borns are low in Vitamin K, because the placenta is not a good transmitter for vitamin K so the fetus did not absorb enough vitamin K. Breast milk is also low in Vitamin K

and the infant gut is sterile and may lead to hemorrhagic diseases of the newborn.

2. Warfarin therapy may lower bone mineral density and result in calcification of bones, which in turn causes brittle bones

3. Cheese is a good source of calcium because absorption of calcium is increased with lactose and protein, which are both in cheese. Cheese also does not contain much fiber, phyttic

acid, or oxalic acid, which are factors that decrease absorption of calcium.

4. Patients with copper deficiency are enemic because by accumulation of iron in the liver. Ferroxidases are copper containing enzymes that are needed to oxidize ferrous iron and

ransfer iron from storage to sites of hemoglobic synthesis. If there is a copper defiecieny, then there will be a decrease in ferroxidases, which will in turn create a build up of iron in

the liver, because it cannot be oxidized or transferred to produce hemoglobin.

5. When calcium is low the parathyroid gland releases parathyroid hormones which then stimulate calcium release from bones to increase blood calcium, calcium uptake in intestines

to increase blood calcium, calcium retention in kidneys to increase blood calcium. & increase in Vitamin D3 helps in absorption of calcium in the GI tract

When calcium is high the thyroid gland releases calcitonin, which decreases calcium release from bones to lower blood calcium and increase calcium secretion in kidneys to lower

blood calcium.

6. Osteoblasts:

synthesize, transport, and arrange matrix proteins

receptors for PTH, vit D, estrogen, cytokines, growth factors, extracellular matrix proteins, leptin, LDL receptor-related protein 5

initialize mineralization

Osteoclasts:

bone resorption

RANKL: produced by osteoblasts, marrow stromal cells, stimulates osteoclast formation, fusion, differentiation, activation, survival blocked by osteoprotegrin (OPG), from

multiple tissues incl. Immune cells from hematopoietic progenitor cells

7. What functions does phosphorus have in the body? (Know the main functions for all the nutrients.)

Major component of bones & teeth, Intracellular anion, buffer in blood, Part of RNA, DNA, ATP, etc

8. Vitamin K function in gamma-carboxylation of the glutamic acid residues. Low vitamin K is associated with low bone masss, risk of hip fractures and cardiovascular mortality.

fnes 263 exam 2

Documents