This Document Contains Chapters 7 to 8 Chapter 7: Water and Electrolytes Overarching Concepts 1. Fluid balance involves both water volume and solute concentration. 2. The amount of water and electrolytes in the extracellular fluid is influenced by water intake and loss, sodium intake and loss, and compensatory physiological mechanisms. 3. Exercise, especially in the heat, is a substantial challenge to the body’s ability to maintain homeostasis. 4. Hypohydration is a threat to the maintenance of proper body temperature and endurance performance. 5. Fatalities can occur in extreme circumstances because water and electrolyte balance is critical to survival. 6. Each athlete must have an individualized plan for fluid and electrolyte intake before, during, and after exercise. The plan is tested and refined through trial and error. 7. Once fluid and electrolyte replenishment goals are established, specific foods and beverages can be chosen to meet those goals. Learning Objectives LO 7.1 Describe the approximate amount, distribution, and roles of body water and the processes by which water movements occur between compartments in the body. LO 7.2 Define hypohydration, euhydration, hyperhydration, and dehydration, and identify avenues of water and sodium loss and intake. LO 7.3 Discuss the effect of exercise on fluid balance and the role fluid plays in body temperature regulation, performance and health during exercise. LO 7.4 Outline strategies for maintaining fluid balance before, during, and after exercise, explain the phenomenon of hyponatremia, and outline a strategy for its prevention in endurance and ultra endurance athletes. Chapter Outline I. Introduction A. Pre-test assessment B. Introductory concepts 1. Water is a critical nutrient 2. 60% of adult body weight is water 3. Functions of water (thermoregulation, medium for chemical reactions, etc.) 4. Too great a water loss is detrimental to performance and health 5. Electrolyte balance is important 6. Each athlete must have an individualized plan 7. Importance of CHO in making water recommendations II. 7.1 Overview of water and electrolytes • An adult’s body is approximately 60 percent water. • Water is distributed between two major compartments in the body, intracellular (ICF) and extracellular (ECF) water. • Water may move from an area of higher pressure to an area of lower pressure (hydrostatic pressure). • Water may move from an area of higher solute concentration to an area of lower solute concentration (osmotic pressure). A. Two major aspects 1. Water volume a. Euhydration is the goal b. Imbalance 1) Hyperhydration 2) Hypohydration 3) Dehydration 2. Concentration of solutes a. Tonicity (referenced in Figure 7.5) 1) Hypotonic 2) Isotonic 3) Hypertonic b. Electrolytes (listed in Table 7.1) 1) Cations 2) Anions B. The amount of water in the body depends on many factors 1. Amount of water varies a. Body size 1) Larger people have more body water b. Gender 1) Males have more body water c. Age 1) Younger adults have more body water d. Body composition 1) Leaner individuals have more body water 2. Average amounts a. 42 L (70-kg male) b. 30 L (female) C. Body water is distributed as intracellular or extracellular fluid (see Figure 7.2) 1. Intracellular fluid (ICF) a. All water within cells b. ≈2/3 of all body water c. ≈28 L (assumes 42 L total) 1) Individual cells vary greatly a) Muscle is ≈75-80% water b) Bone is ≈22% water 2. Extracellular fluid (ECF) a. All water not within cells b. ≈1/3 of all body water c. ≈14 L in the average male (assumes 42 L total) d. Two major subdivisions 1) Plasma a) ≈20% of ECF b) Contained in the vascular system c) Fluid reservoir d) Critical for thermoregulation 2) Interstitial fluid a) ≈80% of ECF b) Surrounds cells c) Avenue for exchange e. Transcellular fluids – found in specialized cells, joints, areas around internal organs, heart, lungs, eyes, & digestive juices 3. Water movement between compartments a. Water must pass through ECF into ICF b. ECF is the “gateway” for water entry into the body c. Stimulus for water movement 1) Hydrostatic pressure a) Difference in fluid pressure between two areas b) Used by cardiovascular system to move blood (1) Water in blood plasma (higher pressure) to interstitial spaces (lower pressure) 2) Osmosis (Figure 7.3) a) Difference in solute concentration between two areas (1) Water in area with lower solute concentration will move to area of higher solute concentration b) Measurement and terminology (1) Measured in milliosmoles (mOsm) (2) Osmolality (3) Osmolarity c) Composition of ECF (see Figure 7.4) (1) Sodium is major cation (2) Chloride and bicarbonate are major anions d. Composition of ICF (see Figure 7.4) (1) Potassium is major cation (2) Phosphate and some proteins are major anions (3) Sodium tends to leak into cells and must be pumped out (4) Potassium tends to leak out of cells and must be pumped in (5) Sodium-potassium pumps in cell membranes pump Na out and K in e. Under normal conditions (see Figure 7.5 a) (1) Osmolarities of ECF and ICF are the same (2) No net movement of water f. Changes in osmolarity result in fluid shifts (see Figure 7.5 b & c) (1) If sodium in ECF increases, water moves out of cells (2) If sodium in ECF decreases, water moves into cells g. Conditions that affect homeostasis (1) Heavy sweating results in loss of water from ECF (2) Consumption of large amounts of water in a short period of time results in a temporary increase of water in the ECF (3) The amount of water in the ECF is controlled by intake in the GI tract, losses, and regulatory mechanisms in the kidneys Questions for discussion: (1) Where in the body is the majority of water found? (2) An athlete consumes a supplement that results in an increase in solute concentration in muscle cells. Describe any subsequent movement of water in the body (assume the athlete continues to consume an adequate amount of water). III. 7.2 Water loss, intake, balance, and imbalance • Water is lost from the body by noticeable means (for example, sweating, urination) and by less noticed avenues such as ventilation. • Diuretics are substances that increase water loss through an increase in urine output. • Water loss from sweat may range from 100 ml to several liters per day. • The main avenue of water intake is the consumption of fluids and food. • Having an appropriate amount of body water to support fluid balance and body functions is called euhydration. • A state of too little body water is called hypohydration, and too much body water is called hyperhydration. • Excessive hypohydration or hyperhydration can adversely affect physical performance and can potentially be dangerous to one’s health. • The average daily intake of sodium in the United States is over 3,000 mg for women and over 4,000 mg for men. • Approximately 40 percent of salt intake is sodium. • The majority of excess sodium consumed is excreted in the urine. • A low daily intake of fruits and vegetables may result in a mild potassium deficiency. A. Water is lost in a variety of ways (see Figure 7.7, page 246) 1. Insensible a. Ventilation b. Non-sweat losses via the skin c. Average daily insensible loss is ≈1,000 ml 2. Sensible a. Urine 1) Major mechanism for controlling fluid balance 2) ≈1,500 ml daily but can vary considerably 3) Affected by fluid and sodium intake, renal function, hormones, and consumption of compounds with diuretic effects a) Mild diuretic effect (1) Large volume of water (2) Daily caffeine intake of 3% of body weight d. In high temperatures, VO2max max may be reduced if loss of water is > 2% of body weight e. In strength and power athletes, anaerobic performance or muscular strength is not reduced if loss of water is up to ≈3 to 5% body weight; however, thermoregulation is affected D. Electrolyte loss, particularly sodium loss, during exercise can be substantial 1. Sodium is predominant electrolyte in sweat 2. During light sweating, sodium and chloride are reabsorbed in the tubules 3. During heavy sweating, tubules cannot reabsorb sodium and chloride fast enough 4. Normal rate of sodium lost in exercise 2 hr may result in a need for sodium during exercise a. Sodium in beverages b. Salty-tasting snacks 6. Exercise > 4 hr may result in losses even in those who do not sweat heavily 7. Prolonged exercise by those who sweat heavily can result in substantial losses of sodium and other electrolytes 8. Large losses of sodium may be offset by ingestion of specially formulated beverages or salt tablets (see Table 7.5 for a list of Na-containing products) E. Exercise-related muscle cramping (EAMC), often associated with dehydration or electrolyte loss, may have other causes 1. Many athletes believe that dehydration and electrolyte loss are the causes of EAMC but the scientific literature is limited 2. May be a result of non-nutritional causes 3. Trial and error are recommended for individual athletes 4. Heat cramps a. Total body cramping when exercising in the heat b. May be a result of rapid and large fluid and sodium losses c. Individualized plan for sodium and fluid during and after exercise is needed Question for discussion: Why is exercise in a tropical environment (hot and humid) more challenging than exercise in a desert-like environment (hot and dry)? V. 7.4 Strategies to replenish water and electrolytes • Athletes need to monitor their hydration status in a practical, easy, and understandable way. • Urine color and changes in body weight are not as precise as some laboratory methods but may be practical methods for athletes to assess their hydration on a daily basis, particularly when combined with their perception of thirst. • Every athlete should develop an individual plan for fluid and electrolyte consumption before, during, and after exercise with the goal of preventing or delaying dehydration that will adversely affect performance and/or health. • The amount of fluid consumed before exercise should achieve and maintain euhydration without stimulating excessive urine production. • The amount of fluid consumed during exercise should match water losses from sweat as closely as possible, but overconsumption of water should be avoided during prolonged exercise. • Fluid should be consumed after exercise to replenish water losses and return the athlete to euhydration. A. Hydration status should be assessed and monitored 1. Precise measurements used in research settings a. Isotope dilution b. Plasma osmalarity c. 24-hour urine collection d. Expensive, time consuming, and/or require laboratory equipment 2. Urine analysis a. Measurement of specific gravity and osmolarity b. Subjective analysis of urine color (Figure 7.19, page 263) c. Practical, less expensive, and/or reasonably accurate 3. Acute changes in body weight a. 1 L of water lost = ≈1 kg (2.2 lb) b. Tracking daily weight c. Tracking pre- and post-exercise weights d. Not recommended for use with those struggling with disordered eating 4. Simple hydration assessment tool (Figure 7.12) a. Weight loss b. Thirst c. Urine color B. General guidelines have been developed for the type, timing, and amount of fluids and electrolytes consumed before, during, and after exercise 1. Individualized plan a. Plan must be tested during training under various environmental conditions b. Plan may differ from training due to stress of competition 2. Intake prior to training and performance a. Be adequately hydrated before exercising b. If adequately hydrated 1) Slow intake of fluids 2) ≈5-7 ml/kg at least 4 hours prior c. If not adequately hydrated 1) More aggressive approach needed 2) ≈5-7 ml/kg at least 4 hours prior + ≈3-5 ml/kg 2 hours prior 3) Some sodium may be beneficial to stimulate thirst d. Practical issues 1) Plan must be individualized 2) Gastrointestinal distress is a potential problem 3) Account for and adjust to the stress of competition 4) CHO may be included in beverages for endurance athletes (see Table 7.6, page 265) 3. Intake during training and performance a. Goals are to replace fluid lost and maintain fluid balance if possible 1) Delay dehydration 2) Avoid overconsumption of water 3) Replace sodium if losses are large or rapid 4) Consume carbohydrates if appropriate 5) Avoid GI upset 6) “Voluntary dehydration” may make it difficult to reach goals 7) Rate of gastric emptying may limit intake and/or absorption 8) May not be physically possible to maintain fluid balance b. Individualized plan must consider: 1) Sweat rate 2) Composition of sweat 3) Duration of exercise 4) Clothing 5) Environmental conditions 6) Potential dangers of water overconsumption and hyponatremia 7) Practical issues a) Cool fluids are typically better tolerated than warm fluids b) Small amounts are typically better tolerated than large amounts c) Account for and adjust to the stress of competition 8) ACSM recommends a starting point of 0.4-0.8 L of fluid per hour for endurance athletes. c. Sodium replenishment may be necessary if: 1) Exercise duration is > 2 hours 2) Large losses of sodium in sweat a) General recommendation is 1 g/hr d. CHO replenishment may be necessary for endurance athletes 1) General recommendation is 6 to 8% 2) Beverages > 10% often cause gastrointestinal distress 3) Trial and error will help determine “gut tolerance” 4) Table 7.7, page 267 Composition of Various Beverages Consumed during Exercise 4. Replenishment after training and performance a. Typical goals include: 1) Restoring lost body water to achieve euhydration 2) Replacing sodium and other electrolytes lost 3) Consuming adequate carbohydrate to fully restore muscle glycogen 4) Consuming adequate protein to build and repair skeletal muscle 5) Avoiding gastrointestinal upset b. General recommendation is 1.5 L fluid for each kg of weight lost c. Begin fluid replenishment as soon after exercise as possible d. Sodium-containing beverages increase drive to drink e. Table 7.8, page 268 Composition of Various Beverages Consumed Post Exercise C. Each athlete should develop an individualized plan for choosing foods and beverages that meet fluid and electrolyte needs – Application of fluid and electrolyte guidelines 1. Assessment 2. Goals – Assessment and establishment of a replenishment plan to assist athlete in meeting his/her goals (Figure 7.22, page 269) a. Is the athlete generally euhydrated? b. What are the goals prior to exercise? c. What are the goals during exercise? d. What are the goals after exercise? e. What products are available to help athletes meet these goals? 3. Action plan a. Help athlete choose appropriate beverage, rate of consumption b. Assist athlete with hydration assessment c. Individualize hydration plan d. Reassess throughout phases of training and competition e. Commonly consumed fluids (see Figure 723, page 270) 1) Water a) Advantages: Noncaloric, refreshing, widely available b) Disadvantages: No CHO, electrolyte content often not known 2) Sports beverages a) Advantages: Contains CHO and electrolytes, rapid CHO absorption, sweet taste b) Disadvantage: May be easy to overconsume 3) Fruit juices a) Advantages: Contains CHO and other nutrients, sweet taste b) Disadvantages: High CHO concentration and GI distress, may be easy to overconsume 4) Soft drinks a) Advantages: Contains CHO, sweet taste, widely available, caffeinated b) Disadvantages: High CHO concentration and GI distress, may be easy to overconsume, low nutrient density, caffeinated f. Specific products should be judged on: 1) Energy (kcal) content 2) CHO content (g) 3) CHO source 4) CHO concentration (%) 5) Electrolyte content (mg) 6) Caffeine content (mg) 7) Inclusion of other compounds (glycerol, herbs, etc.) 4. Reassessment D. In the process of replenishing fluids and electrolytes, athletes may be consuming other nutrients 1. Sugars in sports beverages 2. Caffeinated “energy” drinks E. Hyponatremia, or plasma sodium being too low, is a serious electrolyte disturbance that can be fatal 1. Plasma sodium concentration < 135 mmol/L 2. Very serious when drop is rapid and concentration is 200 mg/day may increase oxidative damage 5) Regenerated by vitamin C 6) Dose may be listed on label as IU or mg 7) Featured in Spotlight on supplements: Applying Critical Thinking Skills to Evaluating Dietary Supplements 3. Vitamin C a. Functions independently in extracellular tissue b. Functions in conjunction with vitamin E, reacting with oxidized vitamin E c. Dietary intake of fruits and vegetables on a daily basis is essential 1) DRI is 75 mg daily for nonsmoking females 2) DRI is 90 mg daily for nonsmoking males 3) Most athletes meet the DRI 4) Adequate daily intake is important because it is water soluble d. Supplementation 1) Popular, especially to self-treat colds 2) Does not prevent colds but may reduce the duration 3) Current evidence for enhanced need by athletes and benefit of supplementation is mixed 4) Excessive intake may increase oxidative damage 5) Regenerated by niacin 6) Spotlight on supplements: Vitamin C and Colds 4. Vitamin A as carotenoids a. Term vitamin A includes both pre-formed and precursors 1) Pre-formed a) Retinol 2) Precursors a) Carotenoids: Beta-carotene, lycopene, lutein, many other compounds b. Weak antioxidant compared to vitamins C and E c. Dietary intake 1) DRI is 700 mcg daily for nonpregnant, adult females 2) DRI is 900 mcg daily for adult males 3) Low intake due to energy restriction and lack of fruits and vegetables 4) Diets rich in foods containing beta-carotene are associated with lower risk for heart disease d. Supplementation 1) Popular in the past 2) Supplements may actually increase risk for premature mortality 3) Supplements not recommended for those who smoke 4) Excessive intake may increase oxidative damage 5. Spotlight on supplements: Quercetin (and phytochemicals) D. Vitamin B12 and folate are two vitamins associated with red blood cell function 1. Blood cells a. Red blood cell production (erythropoiesis) b. Rapid turnover c. 120-day lifespan d. Vitamin-related anemia 2. Vitamin B12 a. Water soluble but some stored in liver b. Deficiency usually a result of poor intake or poor absorption (lack of intrinsic factor) 1) Vegans who do not use fortified products or supplement B12 2) Age – Pernicious anemia c. With folic acid, forms coenzyme needed to produce RBCs d. Dietary intake 1) Found naturally only in foods of animal origin 2) Several vitamin B12-fortified products are available 3) DRI is 2.4 mcg daily for adults (very small amount) 4) Deficiency would take years to develop (unless there is an underlying medical condition) e. Supplementation 1) Necessary if absorption is impaired 2) B12 injections in athletes do not “boost energy” 3) Some risks associated with B12 injections 3. Folate a. Also known as folic acid and folacin b. With vitamin B12, forms coenzyme needed to produce RBCs c. Deficiency 1) At conception, results in neural tube defects 2) Megaloblastic anemia d. Dietary intake 1) Found naturally in green, leafy vegetables 2) In U.S., mandatory fortification of cereals and grains 3) DRI is 400 mcg daily for adults 4) UL is 1,000 mcg daily from fortified foods and supplements e. Supplementation 1) No evidence to suggest improved athletic performance 2) May be warranted for female athletes who restrict calories 4. Interactions between vitamin B12 and folate E. Many vitamins are associated with growth and development, including vitamins A and D 1. Table 8.7, page 308 Role of Vitamin D in the Prevention and Treatment of Disease 2. Vitamin D a. Calcitriol helps regulate blood calcium levels b. Ensures proper bone development c. Regulates cardiac and skeletal muscle d. Involved in cellular growth e. Deficiency 1) Dietary assessment is sometimes difficult 2) UV light exposure is difficult to estimate 3) Measured through blood levels of 25-OH D3 4) Widespread deficiency has been reported in the United States (90% of Asian, Black, and Hispanic populations and 75% of Caucasian population) f. Obtained in three ways 1) Consumption of vitamin D-rich foods such as fortified dairy products and some meats and fatty fish 2) Ingestion of vitamin D supplement 3) Exposure to UV light (which varies considerably from person to person; see Table 8.6, page 307) g. Supplementation – Widely recommended (because of reported deficiencies) 3. Vitamin D and athletes 4. Vitamin A a. Vitamin A involved in growth and development b. Growth and development of specific tissues through cell differentiation c. Deficiency rare in developed nations, but is a marker of disease risk in other nations d. Supplementation – Not recommended beyond the DRI e. Toxicity – Can become toxic in large doses 1) Taratogenic 2) Liver damage Question for discussion: Which vitamins play a role (1) as coenzymes, (2) in cell growth or development, (3) in energy metabolism, and (4) as antioxidants? IV. 8.3 Sources of vitamins • Vitamins can be obtained naturally in food, from fortified foods, and in vitamin supplements. • Low caloric intake usually means low vitamin intake from food. A. Each person must decide the best ways to obtain an adequate amount of vitamins 1. Naturally occurring a. Nutrients put in food by nature b. Each vitamin has naturally occurring food sources c. Advantages 1) May be an excellent source of a single vitamin 2) May contribute several vitamins 3) Contain other nutrients 4) Good absorption 5) Total diet approach may prevent chronic diseases 6) “Food first” recommendation d. Disadvantages 1) Variety of nutrient-dense foods essential 2) Adequate energy intake needed 3) Time and effort required 2. Fortified a. Vitamins are lost with food processing b. Some of the nutrients are added back c. Advantages 1) Excellent source of certain vitamins 2) Prevents widespread deficiencies 3) Well absorbed d. Disadvantages 1) Not all vitamins lost are replaced 2) Not necessarily as nutritious as original product 3. Supplements a. Concentrated source b. Amount in supplement may be more than could be consumed from food c. Bioavailability may be high d. Advantages 1) Excellent source of one or more vitamins 2) Prevents or reverses deficiencies 3) “Insurance” policy e. Disadvantages 1) Excessive amounts 2) May not be needed or beneficial B. The vitamin content of a diet can vary tremendously based on the amounts and types of food consumed 1. Determining vitamin content of current diet a. 3- to 7-day food records b. Dietary analysis of current intake c. Comparison to DRI and UL 2. High-sugar/fat diet vs. nutrient-dense diet a. High-sugar/fat diet 1) Adequate kcal but not adequate vitamins 2) Some vitamins very low (e.g., E, C, B6) 3) Associated with higher risk for some chronic diseases b. Nutrient-dense diet 1) Adequate kcal and vitamins 2) Emphasizes fruits, vegetables, legumes, nuts, whole grains, minimally processed foods C. Vitamins are added to many foods marketed to athletes 1. In the past, few foods were vitamin fortified 2. Many foods are now vitamin fortified 3. May obtain more than DRI or UL for some vitamins D. The dose and potency of a vitamin supplement can vary substantially from brand to brand 1. High-potency vitamin supplements may contain excessive amounts 2. Consider amount and bioavailability 3. Megadose (use of supplement several times higher than the DRI) Questions for discussion: How do the DRI, UL, or DV help an athlete make decisions about vitamin supplements? VI. Summary and review A. Chapter summary B. Post-test assessment C. Review questions D. References Supplementary Teaching Materials and Classroom Activities Note: The text chapter includes an application exercise requiring selection and evaluation of a vitamin supplement for a high school gymnast (p. 317). Activity 8-1 Have students bring in an empty bottle for a vitamin supplement that they are consuming now or have consumed in the past. For those students who do not buy vitamin supplements, have them bring in a label from a highly fortified food that they eat. Many students consume energy bars or fortified cereal, so it is not difficult for each student to find one product label. Students can then compare the amount of vitamins they consume from fortified foods and vitamin supplements to the DRI and the UL. They can also compare the amount in the fortified foods and supplements to naturally occurring sources of vitamins. Activity 8-2 Continue to have students evaluate their own 24-hour dietary intake over a period of 1 to 3 days (see Chapter 4, Activity 4-3), this time for vitamins. There are numerous in-class activities available if students have completed the dietary analysis and bring it to class. Some suggested activities include having students: 1. Gather data about the average vitamin intake of students in the class. Using a show of hands of those students who wish to participate, determine the number and/or percentage of students who met the DRI for the 10 vitamins analyzed (thiamin, riboflavin, niacin, folate, and vitamins A, B6, B12, C, D, and E). Sub-divide the group into those that consumed sufficient kilocalories daily and those that did not. Have students draw conclusions about the relationship between caloric and vitamin intakes. 2. Estimate intake of vitamins from naturally occurring food sources only. Compare to the DRI. Estimate intake of vitamins from naturally occurring and fortified foods. Compare to the DRI. 3. Compare vitamin intakes from all sources to the Tolerable Upper Intake Levels (UL). 4. Identify foods consumed that were excellent sources of a particular vitamin. 5. Identify foods that are nutrient dense. 6. Discuss strategies for changing fruit and vegetable intake. List strategies that students have used successfully in the past as well as barriers they have encountered. Thorough evaluation of the dietary analysis to determine if vitamin needs were met or well matched to the training cycle requires more time and is generally completed outside of class. Activity 8-3 Have students evaluate websites associated with vitamin supplements targeted to athletes. This can be an in-class demonstration with websites pre-selected by the instructor or an out-of-class assignment. Student Assignment The purpose of the assignment is to evaluate the content material of a website selling vitamin supplements to athletes and active people. Using a search engine, enter the words “vitamin supplements + athletes” into the search box. Choose one commercial site (.com) and answer the following questions about the website. 1. What is the URL of the website? 2. Describe the product being sold. Who is the target audience? How is the product supposed to work? 3. Describe the objective information found on the site (e.g., ingredients, dose, physiological or biochemical roles, scientific evidence). 4. Describe the subjective information (e.g., advertising, testimonials). 5. Evaluate the objective information (e.g., comparing factual information on the site to information found in the textbook). 6. Describe the subjective information that you think would influence someone to purchase vitamin supplements from this website. In your opinion, what is most influential? 7. What information would you like to have seen on the website? 8. Was the following statement clearly visible on the website: “This product is not intended to diagnose, treat, cure or prevent any disease. These statements have not been evaluated by the Food and Drug Administration.” 9. Is the product being sold legal, ethical, safe, and effective? If not, why not? 10. Write a one-paragraph summary of this website. Crossword Puzzle Answer Key 1. erythropoiesis 2. subclinical 3. phytochemical 4. carotenoid 5. retinol 6. catalyze 7. whole 8. antioxidant 9. free radical 10. vitamin 11. bioavailability 12. megaloblastic 13. pernicious Word Find Puzzle Answer Key • 2 vitamins needed in greater amounts to support strenuous activity: vitamin B-six, riboflavin • 3 examples of vitamin deficiency diseases: beriberi, rickets, pellagra • 2 common roles of vitamins in the body: coenzymes, antioxidants • 3 vitamins that protect against oxidative damage: vitamin C, vitamin E, beta-carotene • 3 excellent food sources of vitamin E: oils, seeds, nuts • 2 vitamins necessary for erythropoiesis: vitamin B-twelve, folate • 2 vitamin sources with significant toxicity risk: fortified foods, supplements V L O X L F O L A T E A N U T S S V T I I E I S O H C R E V E N I W O I N K T A B S L S D O O F D E I F I T R O F A U O B Y S E D I S B A N O A K I C U M T C N I M A T I V E S T M O G B I D I E S I U F N O C S R T I E R G O R E N S E M Y Z N E O C I N G N I A F E P E R U A O Y Y M E N B E N A C T L U E O B E T A C A R O T E N E H K T A I L S W E I S U A C W D R E S U E G V N L E I E V B E R E U O I Y K N T I I H A E T S U P P L E M E N T S U S O N Y G D L I T E V G A T N A V D A E K A T R S L L U E O Y S T N A D I X O I T N A Chapter 8 Crossword Puzzle Across Down 6. Increase the rate of, such as speeding up a chemical reaction. 7. A _____ food is unprocessed or minimally processed. 8. Substance that inhibits oxidative reactions and protects cells and tissues from damage. 11. The extent to which a nutrient can be absorbed, metabolized, and utilized by the body. 12. A type of anemia characterized by large red blood cells. 13. A type of anemia caused by a lack of intrinsic factor, which is needed to absorb vitamin B12. 1. The production of red blood cells. 2. A type of nutrient deficiency in which medical signs and symptoms are typically not present or are difficult to recognize. 3. Plant compound that has biological activity but is not currently known to be required for normal functioning of the body. 4. A precursor to vitamin A, characterized by an orange or red pigment. 5. Preformed vitamin A. 9. An atom or group of atoms with at least one unpaired electron. 10. Essential organic compound necessary in very small quantities for proper physiological function. Chapter 8 Word Find Puzzle V L O X L F O L A T E A N U T S S V T I I E I S O H C R E V E N I W O I N K T A B S L S D O O F D E I F I T R O F A U O B Y S E D I S B A N O A K I C U M T C N I M A T I V E S T M O G B I D I E S I U F N O C S R T I E R G O R E N S E M Y Z N E O C I N G N I A F E P E R U A O Y Y M E N B E N A C T L U E O B E T A C A R O T E N E H K T A I L S W E I S U A C W D R E S U E G V N L E I E V B E R E U O I Y K N T I I H A E T S U P P L E M E N T S U S O N Y G D L I T E V G A T N A V D A E K A T R S L L U E O Y S T N A D I X O I T N A Instructions: In the grid above, find the following words or phrases, and then write them beside each clue. • 2 vitamins needed in greater amounts to support strenuous activity: • 3 examples of vitamin deficiency diseases: • 2 common roles of vitamins in the body: • 3 vitamins that protect against oxidative damage: • 3 excellent food sources of vitamin E: • 2 vitamins necessary for erythropoiesis: • 2 vitamin sources with significant toxicity risk: 1 Crossword and word find contributed by Elesha Feldman Instructor Manual for Nutrition for Sport and Exercise Marie Dunford, J. Andrew Doyle 9781285752495
Download
Close
Close
