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Earth, Wind, Fire, & Water:The Elements, Hydration, & Nutrition
Four “Elements”o Earth
o Wind
o Fire
o Water
Our Relationship With the Elements
o Earth provides minerals
o Wind (air) supplies our oxygen
o Fire provides heat, a form of energy
o Water is necessary for body functions
Key ObjectivesDescribe the role that minerals play as an essential nutrient in the body.
Recognize the function of the major minerals in the body and what occurs with deficiencies.
Explore how sources of real food can be incorporated as a vital role in hydration.
Caves serve as:
o Shelter
o Cold storage
o Air conditioning
o Source of water and minerals
What are Minerals?
Minerals are inorganic substances that are found in the rocks of the earth.
Dietary minerals:
o Major minerals, e.g., calciumo Trace minerals, e.g., iron
A Winning Combination
Nutrient needs:
o Vitamins
o Minerals
o Water
o Macronutrients:
Carbohydrates
Fats
Proteins
Essential Minerals
MAJOR MINERALS
Calcium
Chloride
Magnesium
Phosphorus
Potassium
Sodium
Sulfur
TRACE MINERALSChromiumCopperFluorideIodineIronManganeseMolybdenumSeleniumZinc
What Do Minerals Do?
Calcium: Mega Mineral
o Build strong, dense boneso Build and maintain healthy teetho Help nerves transmit signals throughout the bodyo Help muscles work (including the heart muscle!)
Calcium: Rich Foods
o Milk approx. 240 mgo Turnip Greens 99 mgo Sardines 500 mg o Broccoli 34 mgtain healthy teeth
Calcium & Osteoporosiso 99% of calcium is in bones
& teeth
o Osteoporosis: 10 million adults, mostly women
o Susceptible to fractures
o Vitamin D, hormones, exercise, and diet are all involved in bone health
A Dash of… Calcium?
o Dietary Approaches to Stop Hypertension (DASH Diet)
o High calcium
o High potassium
o Low sodium
o High in fruits, vegetables, low-fat dairy products
Dash Diet
Food GroupDaily Servings Significance to the DASH Diet
Grains and grain products 7 – 8 Carbohydrates and fiber
Vegetables 4 – 5 Potassium, magnesium and fiber
Fruits 4 – 5 Potassium, magnesium and fiber
Low-fat or fat free milk or milk products
2 – 3Calcium, protein, potassium and magnesium
Meats, poultry and fish 2 or less Protein and magnesium
Nuts, seeds and beans 4 –5 a week Magnesium, potassium, protein and fiber
Source: “A Clinical Trial of the Effects of Dietary Patterns on Blood Pressure.” New England Journal ofMedicine. 1997.336:1117-1124.
Minerals & Fluid BalanceMinerals help maintain fluid balance
inside and outside of body cells.
Fluid Balance: PotassiumMinerals
o Regulates Fluid inside of Cells
o Important for Heart Function
o Maintain Blood Pressure
o Needs Increase with AGE
Fluid Balance: Sodium
Minerals help maintain fluid balance
instside of body cells.
o Found in the blood and fluid around cellso Maintain Fluid Balance, Blood Volume and Blood Pressureo Aid in absorption of water, nutrients and glucoseo Help muscles work (including the heart muscle!)
Fluid Balance: Magnesium and Phosphorus
s help maintain fluid balanceiPPhosporus:
Healthy Bones and MusclesCellular Energy Metabolism
MagnesiumProtein Synthesis
Bone , Nerve and Muscle Developmentnside and outside of body cells.
A Trace is Still Important
o Cellular energy production
o Enzyme cofactors
o Iron transports oxygen
Mineral Deficiencieso Calcium – osteoporosis, inability to form blood clots
o Magnesium – kidney stones
o Potassium – affects nervous system
o Phosphorus – poor appetite, fatigue, stiff joints
o Iron – anemia, tiredness, shortness of breathoZinc – wounds heal more slowly.
How Much is Enough?oDIETARY REFERENCE INTAKES:
Adequate Intakes (AIs)
Upper Limits (ULs)
o Considered a healthy amount to eat daily
o Not a requirement (but more)
o Vary with gender and ageo For healthy people, but not disease states
Adequate Intakes (AIs)
* Indicates an RDA value; AI not yet set.National Academy of Sciences - National Research Council, Washington DC. www.nap.edu
NUTRIENT MEN, age 70+ WOMEN, age 70+
Water 2.6 liters 2.1 liters
Potassium 4700 mg 4700 mg
Chloride 2000 mg 2000 mg
Sodium 1300 mg 1300 mg
Calcium 1200 mg 1200 mg
Phosphorus * 700 mg 700 mg
Magnesium * 420 mg 320 mg
Iodine * 150 mg 150 mg
Zinc * 11 mg 8 mg
Iron * 8 mg 8 mg
Fluoride * 4 mg 3 mg
Copper * 900 mcg 900 mcg
Selenium * 55 mcg 55 mcg
Chromium 30 mcg 20 mcg
Can You Get Too Much?
Bioavailability
Nutrients are not 100% available because:oNot all of a nutrient is absorbed from the GI tract.
oOther dietary components can interfere.
oInside the body, other factors can take them out of use.
The Spring of Life!
Water in the Body
Why Water is Essential
Food Sources of Water
Food % Water
Milk 88-91
Cheddar Cheese 37
Cottage Cheese 79
Ice Cream 61-66
Asparagus 91
Carrots 88
Cucumber 94
Lettuce 96
Spinach 90
Sweet Potato 73Sources: Nutrient Data Laboratory: www.nal.usda.gov/fnic/foodcomp/American Egg Board. www.aeb.org
Food % Water
Apples 84
Grapefruit 90
Grapes 81
Melons 90
Beans (cooked) 60-70
Bread 30-40
Gelatin 84
Meats 50-60
Eggs 75
Poultry 65
Egg Composition
Egg NutrientsNutrient Amount Function
Folate 24 mcg Required for the synthesis of amino acids
Thiamin .031 mg Coenzyme in energy metabolism
Riboflavin .24 mg Coenzyme in release of energy from nutrients
Phosphorus 95 mg Bone and tooth formation; important in acid-base balance
Zinc .55 mg Cofactor for more than 200 enzymes
Iron .91 mg Transports oxygen in hemoglobin
Choline 125 mg Found in lecithin in the yolk; works with memory functions
Lutein & Zeaxanthin
165 mg Keeps eyes safe from oxidative stress; decreases risk for macular degeneration
Dehydration
o A deficiency of a basic nutrient − water
o Can be inside or outside the body’s cells
Symptoms of Dehydration
o Poor skin turgor
o Dry mucous membranes
o Concentrated urine/dark color
o Oliguria (low output of urine)
o Sunken eyes
o Rapid heartbeat
o Low blood pressure
Dehydration: A Major Problem
o Common reason for hospitalization
o 18% of LTC residents will not survive a month
o Preventable hospitalizations for a five-year period in New York cost $1.24 billion
Life Cycle Changes
o Decreased thirst with aging
o Physiologically less lean body mass to hold water in the body
o Kidneys less efficient – lose extra water & sodium
o Cognitive impairment
o Dysphagia > reduced intake
o Reduced mobility
o Fear of drinking due to incontinence
o Depression, social isolation
o Medications, fever, diarrhea
Disease/Environmental Changes
o Changes in Healthcare Setting
o Insufficient Caregivers
o Room Temperature is Hot
o Alzheimers and other forms of dementia
o More than five chronic diseases
o Fluid loss (draining wounds)
o History of Dehydration
o Highly concentrated Protein Supplements.
CMS Weighs In
“The facility must provide each resident with sufficient fluid intake to maintain proper hydration and health.” - F327
~“Each resident must receive, and the facility must provide, the necessary care and services to attain or maintain the highest practicable physical, mental and psychosocial well-being, in accordance with the comprehensive assessment and plan of care.” - F309
NAS Adequate Intake:Total Water
Age Range Males Females
19-50 years 16 cups: 3.9 liters 11.5 cups; 2.8 liters
51-70 years 16 cups: 3.9 liters 16 cups: 3.9 liters
> 70 years 13 cups: 3.2 liters 9 cups: 2.2 liters
Encouraging Fluid Consumption
o Drink more when close to home/restroom
o Take frequent bathroom breaks
o Stop drinking fluids a few hours before bed
o Have water readily available
o Drink between meals
o Make water attractive and appealing
o Eat fruits and veggies
o Enjoy frozen fruit bars & smoothies
Summary:Water + Earth = Health
Physical Health Body movement and functions
Intellectual Health Aid cognitive functioning
Emotional Health Mental clarity and well-being
Social Health Enhances our interactions with world and people around us
Your Calling
“Each food, dining environment, and staffing decision made will serve to either limit or expand the nutrition and eating pleasure available to the resident for a significant portion of their remaining life.”
Source: ADA: Liberalization of the Diet Prescription Improves Quality of Life for Older Adults in Long Term Care. (2005)
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