MineralsMineralsBy EBTESAM ALSHEDDI

What are mineralsWhat are minerals??

Small, naturally occurring, inorganic, chemical elementsRegulate body processesGive structure to things in the bodyNo calories (energy)Cannot be destroyed by heat

Categories of mineralsCategories of minerals

Major minerals◦ Calcium◦ Phosphorus◦ Magnesium◦ Electrolytes (sodium,

chloride, potassium)◦ sulfur

Trace minerals◦ Chromium◦ Copper◦ Flouride◦ Iodine◦ Iron◦ Manganese◦ Selenium◦ Zinc

• Major minerals are needed in the diet in amounts greater than 100 mg per day or are present in the body in amounts greater than 0.01% of body weight.

• Trace minerals are required in the diet in amounts less than 100 mg per day or are present in the body in amounts less than 0.01% of body weight.

Figure 12.1

The Minerals in Your Body

Copyright 2010, John Wiley & Sons, Inc.

Minerals in the Diet

Copyright 2010, John Wiley & Sons, Inc.

Major Minerals

Copyright 2010, John Wiley & Sons, Inc.

Electrolytes: Sodium, Potassium and Chloride

The correct combination and amounts of electrolytes are essential for life.

Distribution of electrolytes affects the distribution of water throughout the body.

Sodium, potassium and chloride are the principle electrolytes in body fluids.

Sodium (Na)Sodium (Na) Sodium is the principal

cation in extracellular fluids

functions include: osmotic equilibrium

(fluid balance) acid-base balance carbon dioxide

transport cell membrane

permeability muscle contraction Nerve impulse

transmission

food sources: table salt, salty foods (potato chips, pretzels, etc.), baking soda, milk.

RDA for adults: 1.1 to 3.3 gm/day

deficiency:• dehydration• acidosis• tissue atrophy• Mental confusion• Muscle cramps

excess:edema hypertension

Potassium (K)Potassium (K)

•Food sources: vegetables, fruit (bananas), whole grains, meat, milk•RDA for adults: 1.5 - 4.5 gm/day

•Food sources: vegetables, fruit (bananas), whole grains, meat, milk•RDA for adults: 1.5 - 4.5 gm/day

•The principal cataion in intracellular fluid•functions:

• Buffer constituent• Acid-base balance• Water balance• Muscle contraction• Nerve impulse

transmission

•The principal cataion in intracellular fluid•functions:

• Buffer constituent• Acid-base balance• Water balance• Muscle contraction• Nerve impulse

transmission

Deficiency (hypokalemia):

Muscle weakness, Paralysis, Mental confusion and Irregular heart beat. causes:

increased renal excretion (diuretics) primary aldosteronism severe vomiting and diarrhea cutaneous losses via perspiration

• Excess(hyperkalemia):Muscle weakness, Irregular heart beat, vomiting

• causes:sudden increased intakesevere tissue trauma and burnsacute and chronic acidosis

Deficiency (hypokalemia):

Muscle weakness, Paralysis, Mental confusion and Irregular heart beat. causes:

increased renal excretion (diuretics) primary aldosteronism severe vomiting and diarrhea cutaneous losses via perspiration

• Excess(hyperkalemia):Muscle weakness, Irregular heart beat, vomiting

• causes:sudden increased intakesevere tissue trauma and burnsacute and chronic acidosis

Chloride (Cl)Chloride (Cl) An essential anionAn essential anion Closely connected with sodium in foods, body tissues Closely connected with sodium in foods, body tissues

and fluids and excretionsand fluids and excretions readily absorbed along with sodiumreadily absorbed along with sodium important for osmotic balance, acid-base balance, in the important for osmotic balance, acid-base balance, in the

formation of gastric HCl,formation of gastric HCl, muscle contraction and nerve muscle contraction and nerve impulse transmission impulse transmission

Deficiency of chloride:Deficiency of chloride: hypochloremic alkalosishypochloremic alkalosis hypovolemiahypovolemia pernicious vomitingpernicious vomiting psychomotor psychomotor

disturbancesdisturbances

Deficiency of chloride:Deficiency of chloride: hypochloremic alkalosishypochloremic alkalosis hypovolemiahypovolemia pernicious vomitingpernicious vomiting psychomotor psychomotor

disturbancesdisturbances

Major Minerals and Bone Health

Minerals Make Up Bones and Minerals Make Up Bones and TeethTeeth

Minerals make up the crystalline structure that gives strength to bones and teeth◦Major minerals

Calcium, phosphorus, and magnesium◦Trace mineral

Flouride

Calcium (Ca)Calcium (Ca) the most abundant of the mineralsthe most abundant of the minerals the 5th most abundant element in the 5th most abundant element in

the bodythe body needed by all cellsneeded by all cells found in largest amounts in bones found in largest amounts in bones

(99%)(99%)

Three hormones involved in regulation Vitamin D3

from kidney Parathyroid hormone (PTH)

from parathyroid gland Calcitonin

from thyroid gland PTH and Vitamin D3 act to increase plasma Ca, while

calcitonin acts to decrease plasma Ca

CalciumCalcium

function of calcium:◦structural unit of bones and teeth◦contraction and relaxation of muscles◦stabilizes nervous tissue

low calcium --- irritable nerves --- tetany high calcium --- depresses the nervous irritability

◦required for blood clotting◦activates various enzymes

RDA◦ adult: 800 mg/day◦ pregnancy and lactation: 1200 mg/day

Deficiency Osteoporosis, convulsion and heart failure .ToxicityMineral imbalance, shock, kidney failure, mental confusion

Deficiency Osteoporosis, convulsion and heart failure .ToxicityMineral imbalance, shock, kidney failure, mental confusion

Regulation of Calcium Regulation of Calcium HomeostasisHomeostasis

-parathormone (PTH) by the parathyroid gland and thyrocalcitonin secreted by the thyroid gland maintain serum levels

-with decreased serum calcium levels, PTH increases and causes transfer of calcium from bone to blood to increase serum levels

-decreased levels also cause kidney to reabsorb calcium more efficiently (might normally be excreted in the urine) and to increase intestinal absorption

-when blood levels are increased, calcitonin acts by the opposite mechanisms as PTH to decrease serum levels

Copyright 2010, John Wiley & Sons, Inc.

Osteoporosis RiskOsteoporosis Risk

Gender and Bone MassGender and Bone MassCopyright 2010, John Wiley & Sons, Inc.

Phosphorus is the second most abundant mineral in the body

required in many phases of metabolism foods rich in calcium are also richest in phosphorus (milk,

cheese, eggs, beans, fish)RDA for phosphorus is established on the basis of a 1:1

relationship with calciumAdults: 800 mg/dayPregnancy and lactation: 1200 mg/day

Phosphorus is the second most abundant mineral in the body

required in many phases of metabolism foods rich in calcium are also richest in phosphorus (milk,

cheese, eggs, beans, fish)RDA for phosphorus is established on the basis of a 1:1

relationship with calciumAdults: 800 mg/dayPregnancy and lactation: 1200 mg/day

Fluid balanceFluid balance Regulate energy metabolismRegulate energy metabolism Component of bones, teethComponent of bones, teeth Part of DNA, RNA (cell growth, repair)Part of DNA, RNA (cell growth, repair)

PhosphorusPhosphorus

Deficiency Muscle weakness, bone pain and dizziness.ToxicityMuscle spasm, convulsion and low blood calcium

Deficiency Muscle weakness, bone pain and dizziness.ToxicityMuscle spasm, convulsion and low blood calcium

MagnesiumMagnesium-FunctionFunctionbone, muscle contractility, nerve

excitability-antagonistic to calcium--in a muscle contraction, Mg relaxes,

and calcium contracts--low Mg can cause pregnancy induced

HTN Part of 300 enzymes (regulates body

functions) Best sources are all green plants

(chlorophyll); meats RDA: 350 mg/day

◦ pregnancy and lactation: 450 mg

Deficiency -anorexia, growth failure, cardiac and neuromuscular changes—

weakness, irritability, mental derangement -tetany, muscle cramps

Toxicity -respiratory depression,

apnea -CV—hypotension,

cardiac arrest, -GI—N/V -neuromuscular—

paresthesias, confusion, coma, hyporeflexia, paralysis

SulfurSulfur

Component of amino acids◦cystine, cysteine, and methionine for bioactive

and structural proteins wool contains about 4% sulfur

Chondroitin sulfate is a constituent of cartilage

Deficiency is related to protein deficiencySulfur is widely available in meat, eggs,

milk, cheese, legumes, and nuts.

Copyright 2010, John Wiley & Sons, Inc.

Summary of Calcium, Phosphorus, Summary of Calcium, Phosphorus, Magnesium and SulfurMagnesium and Sulfur

The Trace Elements

Copper (Cu)Copper (Cu)

important trace important trace mineralmineral

component of several component of several enzymesenzymes

Increases iron Increases iron absorptionabsorption

needed to form needed to form hemoglobin and hemoglobin and collagencollagen

Deficiency◦ Aneamia ◦ neutropenia ◦ bone demineralization ◦ failure of

erythropoiesisToxicityNausea, vomiting and

diarrhea.

sources liver, shellfish, whole

grains, cherries, legumes, nuts

FluorideFluoride

Considered essential because of its beneficial effect on tooth enamel

Benefits include: less dental caries, stronger bones, reduction in osteoporosis and calcification of the aorta

In large quantities it is deleterious to teeth; dental fluorosis: pitting, chalky, dull white patches and mottling of teeth

1 to 2 parts per million is adequate for drinking water

Main sources include drinking water and plants Main sources include drinking water and plants (spinach, lettuce, onions)(spinach, lettuce, onions)

Average daily intake: 1.5 – 4.0 mg/dayAverage daily intake: 1.5 – 4.0 mg/day

IodineIodineIodine is necessary for :The formation of thyroid hormones (T-4 and T-3)Temperature regulationdeficiency of iodine (hypothyroidism) is

manifested by a goiter (enlargement of the thyroid gland)

salt water fish and seaweeds are a good source of iodine

to prevent the development of endemic goiter, table salt has been spiked with sodium iodide

ChromiumChromium

Cr III may act as a cofactor for insulin, enhancing glucose utilization

deficiency leads to impaired glucose tolerance (glucose tolerance factor)

sources: corn oil, whole-grain cereals, clams, drinking water (variable)

forms a coordination complex with micotinic acid and the amino acids glycine, glutamate and cysteine

chromium may have a role in type 2 diabetesRDA: 0.05 – 0.2 mgfrequently available in pharmacies as

chromium picolinate

Manganese (Mn)Manganese (Mn)

Deficiency leads to:• Weight loss• Transient dermatitis• Nausea and vomiting• Changes in hair color• Reduced bone density• Impaired lipid and glucose

metabolismToxicity

• Impairment of neuromuscular system

Sources: blueberries, wheat bran, beet greens, lettuce, legumes, fruitRDA: 2.5 – 5.0 mg

Manganese is an activator of several different enzymes.

Synthesis of protein found in bone and cartilage

Manganese is an activator of several different enzymes.

Synthesis of protein found in bone and cartilage

IronIron

heme iron◦meats◦poultry◦fish

20-23% of heme-iron is absorbable

non-heme iron◦vegetables◦fruits◦ legumes◦nuts◦breads and cereals

only ~ 3% on non heme iron is absorbed

Iron absorptionIron absorption

occurs in upper part of small intestineabout 10% of food iron is absorbedrequires gastric HCl (releases ionic iron)also requires copperferrous is better absorbed than ferric formFe++ forms chelates with ascorbic acid,

certain sugars and amino acid

Iron distribution and storageIron distribution and storage

stored in 2 forms: ferritin (a water soluble complex consisting of a

core of ferric hydroxide and a protein shell (apoferritin)

hemosiderin (a particulate substance consisting of aggregates of ferric core crystals)

stored in liver, spleen, bone marrow, intestinal mucosal cells and plasma

IRON DEFICIENCYIRON DEFICIENCY

Initial symptoms easy fatigability lack of appetite headache dizziness palpitations

then: hypochromic-microcytic anemia microcytosis (small RBCs) hypochromia (poor fill of hemoglobin) poikilocytosis (bizarre shapes) anisocytosis (variable sizes)

IRON DEFICIENCYIRON DEFICIENCY

Causes:◦excessive blood loss (parasitic, accidental,

menstrual): is most common cause◦rapid growth in children with limited intake of

iron◦malabsorption

gastric resection sprue

◦increased metabolic requirement pregnancy, lactation or neoplasia

Diagnosis of iron deficiencyDiagnosis of iron deficiency

hematology (microcytic hypochromic cells)low serum ironlow serum ferritin( indicates low body

stores)low hemosiderinhigh total iron binding capacity (TIBC)

Iron absorptionIron absorption

average diet contains 10 - 15 mg of iron per day

a normal person absorbs 5 -10% of this iron or 0.5 - 1.0 mg daily

iron absorption increases in response to low iron stores

menstruating women: 1 - 2 mg per daypregnant women: 3 - 4 mg per day

Treatment of iron deficiencyTreatment of iron deficiency

give 200 - 400 mg of iron per dayup to 25% of the iron preparation may be

absorbedgive on an empty stomachenteric coated iron tablet should not be

taken

Treatment of iron deficiencyTreatment of iron deficiency

parenteral iron is used in patients who have had bowel resections or in cases of inflammatory bowel disease◦normally given IM (painful)

oral iron causes black stools, constipation, cramping

do not administer with antacids or metal chelators (tetracyclines)

Acute iron toxicityAcute iron toxicity

common in small children ingesting large doses of soluble iron compounds

seleniumselenium

Required for carbohydrate and fat metabolism

Toxcity:Brittle hair and nailsSkin rashNausea and vomitingWeaknessDifeciencyHeart diseaseArthritis Impaired immune functionMuscle pain and wastingDepression

•Food sources: nuts, shellfish, meat/fish poultry, whole grains, meat, milk•RDA for adults: 55ug/day

•Food sources: nuts, shellfish, meat/fish poultry, whole grains, meat, milk•RDA for adults: 55ug/day

Zinc Zinc

Toxicity:Nausea and vomitingDiarrheaDepressed immune functionHeadachDecrease absorption of

copper

Assist more than 100 enzyme systemsRequired for proper immune functionGrowth and sexual maturationGene regulation

Deficiency •Growth retardation•Delayed sexual maturation•Eye and skin lesions•Hair loss•Increase incidence of illness and infection

•Food sources: meat/fish poultry( best absorbed form of zinc), fortified cereals and legumes•RDA for man: 11mg/day•RDA for woman: 8mg/day

•Food sources: meat/fish poultry( best absorbed form of zinc), fortified cereals and legumes•RDA for man: 11mg/day•RDA for woman: 8mg/day