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Answer:
• Carries nutrients throughout the body and waste products to be excreted out of the body
Example: The bodies of patients in renal failure cannot control fluid function; therefore, waste products
build up in their bodies and their ability to carry nutrients throughout their bodies is compromised.
3. Discuss the relationship among the members of the following groups of minerals: (1) sodium, chloride, and
potassium; (2) calcium, phosphorus, and magnesium. Within each group, discuss how the minerals are related
and how the body will react to a deficiency of the minerals vs. a toxicity.
Answer: (1) These minerals are often associated together, and all are involved in fluid and electrolyte balance.
Sodium and chloride often are attached to each other in foods as sodium chloride, which is found in salt. They
become dissociated in the body but are still important in fluid and electrolyte balance. Sodium is a positively
charged mineral, chloride is a negatively charged mineral, and both are found in the extracellular fluids.
4. How would you determine a patient’s fluid balance?
Answer: Your text outlined the input and output method or the I & O which is a good means of determining a
patient’s fluid status or balance. To do this the dietitian or nursing assistant must determine all fluids going into
the patient and all those that are excreted from the patient.
5. Bone health is influenced at a young age. What can college students do to maintain excellent bone health now
and into their older adult years of life?
Answer: Bone health is best influenced in the years of childhood and through the teen years. In the years
between ages 8 and 12, the young child is accruing approximately 50% of their adult bone. Obviously, this is a
critical period to influence bone growth as well as enhance what is already there.
IM Worksheet Answer Key
Worksheet 12-1: How to Interpret Calcium Serum Levels (“General Research” questions)
262
Worksheet 12-2: Water Recommendations
Worksheet 12-3: Iron and Calcium in Your Diet – Answers will vary.
Worksheet 12-4: Chapter 12 Crossword Puzzle
Worksheet 12-5: Facts about Water (Internet Exercise)
Canadian Information8
12.1 Canadian Recommendations for Intake of Water and Major Minerals for Healthy People
Eating Well with Canada’s Food Guide
• Eat at least one dark green and one orange vegetable each day.
• Have vegetables and fruit more often than juice.
Dietary Reference Intakes
• AI – total water intake – females, 19+ years: 2.7 L/day.
• AI – total water intake – males, 19+ years: 3.7 L/day.
Diet-related Health Claims
• A healthy diet containing foods high in potassium and low in sodium may reduce the risk of high blood
12.2 Water Quality
In Canada, bottled water is considered a food product and is regulated under the federal Food and Drugs Act and
Regulations.9 In 2002, Health Canada and Canadian Food Inspection Agency (CFIA) released a discussion paper on
renewing the federal regulations for bottled water in Canada, Making it Clear – Renewing the Federal Regulations
8 Contributed by Gail Hammond.
263
on Bottled Water: A Discussion Paper.10 Due to technical challenges noted in the paper, Health Canada and CFIA
have been consulting further with stakeholders to determine how to address these technical issues. A summary of the
12.3 Daily Values for Major Minerals
On food labels in Canada, the % Daily Value information provided for major minerals is based on Canadian
reference Daily Values (DV). Similar to the vitamins, the Canadian reference DV for minerals are different from
those listed in the textbook. Reference DV for minerals in Canada are based on the Recommended Daily Intake
(RDI), except for sodium and potassium, which are based on Reference Standards (RS).15 Table 12.1 presents
reference DV for major minerals for persons 2 years of age and older, and compares Canadian and American values.
(Note: As in Canada, the U.S. reference DV are based on 2 different sets of reference values; one for macronutrients,
sodium, and potassium [Daily Reference Values—DRV], and the other for vitamins and minerals [Reference Daily
Intakes—RDI]. Different from Canada, the U.S. reference DV are for people 4 years and older.) You can see that
sodium, potassium, and chloride are major minerals that have the same reference DV in Canada and the United
States, whereas the DV for other major minerals differ slightly between the two countries.
264
Table 12.1 Reference Daily Values for Major Minerals Used in Canada for Persons 2 Years and Older,16
Compared to Reference Daily Values Used in the United States for Persons 4 Years and Older 17
Mineral
Canadian Daily Value
American Daily Value
Calcium*
1100 mg
1000 mg
Phosphorus*
1100 mg
1000 mg
12.4 Sodium and Potassium on Food Labels
The Nutrition Labelling Regulations include sodium as a core nutrient on the Nutrition Facts table found on food
labels, providing the amount of sodium in milligrams and the % DV per serving of stated size.18 As noted in Table
12.1, 2400 mg (RS) represents 100% DV for sodium. Potassium is not a core nutrient found on all Nutrition Facts
tables on food labels. However, potassium content must be declared if the prepackaged food contains added
12.5 Calcium Addition to Foods and Beverages and on Food Labels
Canadian students should note that the regulations allowing addition of calcium to foods and beverages
(fortification) differ from those in the United States. In 1997, Canadian regulations were changed to allow voluntary
fortification of plant-based beverages, such as soy and rice, with calcium, vitamin D, and other nutrients.
Some milk products contain added milk solids, increasing the amount of calcium in milk by up to 33%. Some fruit
juice products have added milk solids or added calcium. Read the labels of these products carefully to compare
calcium % DV and cost for similar products.
As noted above in Section 12.1, the labelling regulations allow the diet-related health claim: “A healthy diet
adequate in calcium and vitamin D, and regular physical activity, help to achieve strong bones and may reduce the
risk of osteoporosis. (Naming the food) is a good source of calcium.”20 When this claim is made on a food label, the
Nutrition Facts table must include the amount of calcium, vitamin D, and phosphorus.
265
Highlight 12: Osteoporosis and Calcium
Instructors can find Canadian approaches to the prevention and treatment of osteoporosis at the Osteoporosis Canada
Canadian Web-Based Resources
1. Brown JP, Josse RG, and The Scientific Advisory Council of the Osteoporosis Society of Canada. 2002. 2002
clinical practice guidelines for the diagnosis and management of osteoporosis in Canada. Available at:
2. The Canadian Dental Association web site offers nutrition information for healthy teeth in the Your Oral
266
Worksheet 12-1: How to Interpret Calcium Serum Levels
Even though everyone recognizes the mineral, calcium, as being extremely important with respect to bone health,
many people do not understand how calcium exists in the body; therefore, this application will help to improve your
knowledge base with respect to serum calcium levels in the body. You will need to either look up the specific lab
values in a laboratory diagnostic textbook or perform a web-based search to obtain the following information.
General Research:
1. What is the total serum calcium level in the body for a healthy adult?
4. What major plasma protein is involved in the interpretation of how calcium is measured?
5. What other minerals, vitamins and hormones play a role in calcium metabolism and should be evaluated for
their impact on serum calcium levels?
Individual Research:
1. Determine how much calcium you take in over a 2-day time period.
267
Worksheet 12-2: Water Recommendations
Please indicate whether or not each individual listed below is meeting, not meeting or exceeding his or her
recommended daily fluid intake. (Assume they are not obtaining a significant amount of water from foods.)
• An easy way to determine water needs is to take your weight and divide it in half, then divide that number by 8
to arrive at cups per day.
• Also, activity levels influence the amount of fluids that you will need on a daily basis.
3. An adult male who drinks 16 cups of fluids during the day.
5. A 9-year-old female who drinks 16 cups of fluids a day.
7. An adult female who drinks 1.5 liters of fluids during the day.
268
Worksheet 12-3: Iron and Calcium in Your Diet
The two minerals most likely to fall short in the diet are iron and calcium. Interestingly, both are found in protein-
rich foods, but not in the same foods. Meats, fish, and poultry are rich in iron but poor in calcium. Conversely, milk
and milk products are rich in calcium but poor in iron. Including meat or meat alternates for iron and milk and milk
products for calcium can help defend against iron deficiency and osteoporosis, respectively. Determine whether
these food choices are typical of your diet.
Food choices
Frequency per week
Calcium-fortified foods (such as corn tortillas, tofu,
cereals, or juices)
Dark green vegetables (such as broccoli)
1. Do you eat a variety of foods, including some meats, seafood, poultry, or legumes, daily?
2. Do you drink at least 3 glasses of milk—or get the equivalent in calcium—every day?
269
Worksheet 12-4: Chapter 12 Crossword Puzzle
Across:
Down:
3. the major anion in the extracellular fluids of the
body
4. the most abundant mineral in the body, found
primarily in bones and teeth
6. a disease in which the bones become porous and
fragile due to a loss of minerals
1. a hormone secreted by the adrenal glands that
stimulates the reabsorption of sodium by the
kidneys
2. a compound with the formula HCO3 that results
from the dissociation of carbonic acids
5. a major mineral found mostly in the body’s bones
1 2
3
4
5
6 7
8 9
10
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Worksheet 12-5: Facts about Water (Internet Exercise)
Go to the following website to answer questions 1-6:
are done answering the questions.
1. Water constitutes approximately 60% of body weight.
a. True
b. False
2. Which one of the following statements is true?
3. Thirst sensations are triggered by decreased osmolality and increased extracellular volume.
a. True
b. False
4. Infants, elderly adults, and athletes are all at risk for developing dehydration.
5. In terms of water content, an egg contains a greater percentage of water than does a tomato.
6. Which of the following statements is true concerning water requirements?
271
Handout 12-1: RDA/AI and UL for Major Minerals Compared
