Chapter 11: Water and the Major Minerals

1
B
A
C
D
2
Recap of last lecture

• Water-soluble Vitamins
• Folate, B12, C
• Water

3
19 Outline for today

• Minerals major
• Hypertension
• Bone health
• Next week Minerals Alcohol

4
Minerals

• Various functions
• Major minerals
• Require gt100 mg /day
• Calcium
• Trace minerals
• Require lt 100 mg/day
• Iron, zinc
• Inorganic substances, not changed by digestion etc

5
Risk for Mineral Deficiencies

• Calcium
• Iron
• Zinc

6
Bioavailability of Minerals

• Not all ingested minerals can be absorbed in
  part varies with need
• Presence of binders (phytates, oxalate) and
  dietary fiber (Fe,Ca,Zn,Mg)
• Animal products are better absorbed
• Soil content affects levels in plants
• Mineral/mineral competition excess of one
  mineral from supplement messes up absorption and
  function of others

7
Toxicity of Minerals

• Trace minerals are more toxic
• Usually the result of supplementation
• Presence of contaminants in supplements
• Look for the United States Pharmacopeia
  (USP)-approved brands of supplements

8
(No Transcript)
9
Table 11.6a
10
Table 11.6b
11
Sodium

• Table salt (NaCl) 40 sodium, 60 chloride

12
Sodium

• 95 of ingested sodium is absorbed
• Positive ion in extracellular fluid
• Aldosterone regulates sodium balance
• Key for retaining body water
• Excretion regulated by the kidneys
• Muscle contraction
• Conduction of nerve impulses

13
Deficiency of Sodium

• Rare
• Persistent vomiting/ diarrhea
• Excessive perspiration (losing 2-3 of body
  weight)
• Muscle cramp, nausea, vomiting, dizziness, shock,
  coma
• Normally kidney will respond by conserving sodium

14
Food Sources of Sodium

• 1/3 - ½ of intake is added to food by individual
• ½ - 2/3 is added by food manufacturers
• Lower salt products available
• Processed foods contribute to much of the sodium
• Sodium content listed on labels

15
Sodium Needs

• Minimum requirement is 500 mg/day
• Daily Value is 2400 mg/day
• Typical intake is 4000-7000 mg/day
• 1 dill pickle 1700 mg Na
• 3 ozs ham 1200 mg
• ½ cup commercial spag. Sauce 500 mg

16
(No Transcript)
17
Table 11.3
18
Salt Sensitive

• 10-15 of adults
• High sodium intake leads to high blood pressure
• Recommend 2-3 gm sodium per day
• High intake of sodium increases calcium loss
• Check your blood pressure regularly

19
Potassium

• Positive ion in the intracelluar fluid
• I. e. mostly inside cells
• Functions in fluid balance and nerve impulse
  transmission
• Associated with lowering blood pressure
• 90 of potassium consumed is absorbed

20
Food Sources and Need for Potassium

• Found in fruits, vegetables, milk, grains, meats,
  dried beans (bananas, yogurt)
• Minimum requirement is 2000 mg/day
• Daily Value is 3500 mg/day
• Typical intake is 2000-3000 mg/day
• Excess potassium is excreted by the kidneys

21
Potassium Deficiency

• Rare
• Use of diuretics
• Alcoholics, anorexia nervosa, bulimia nervosa
  (vomiting, diarrhea)
• Loss of appetite, muscle cramp, confusion,
  constipation, irregular heart beat
• Can be fatal

22
Chloride

• Negative ion for the extracellular fluid
• Component of hydrochloric acid (HCl) in stomach
• Excess is excreted by the kidneys/perspiration
• Minimum requirement is 700 mg/day
• Most is obtained from salt consumption
• High intake may cause high blood pressure

23
Hypertension

• Systolic blood pressure/diastolic blood pressure
• Optimal is less than 120 / 80 mm Hg
• HTN is a sustained pressure of gt140 mm systolic
  or gt90 mm Hg for diastolic
• 95 of all HTN have no clear cause (called
  primary or essential HTN)

24
(No Transcript)
25
Why Control Blood Pressure?

• Silent disease
• To prevent cardiovascular disease, kidney
  disease, stroke, decline in brain functions
• African Americans most at risk

26
Causes of HTN

• Aging
• Atherosclerosis
• Obesity
• Elevated insulin (insulin resistant adipose
  cells)
• Inactivity
• Excess alcohol (usually reversible)

27
Sodium and Blood Pressure

• Unclear if it is sodium or chloride that is
  responsible
• Increases blood pressure with intake
• Consume no more than 2400 mg/day
• Fluid retention leads to increased blood volume

28
Medication and HTN

• Diuretics
• Reduce blood volume
• Increase urine output
• ACE inhibitors
• relaxation of the blood vessels

29
Calcium

• 99 is in bones and teeth
• Makes up 40 of all the minerals present in the
  body
• Blood level highly controlled

30
Absorption of Calcium

• Amount absorbed varies
• Requires a slightly acidic environment
• Upper part of the small intestine is the site of
  absorption
• Availability of vitamin D
• Normally absorb 25 of calcium in food
• Increase to 60 during time of need (pregnancy,
  infancy)
• Estrogen increases absorption
• Parathyroid hormone

31
Decrease Absorption of Calcium

• Rapid intestinal motility
• High fiber intake
• Excess phosphorus
• Vitamin D deficiency
• Presence of polyphenols (tannins) in tea
• Menopause
• Aging
• Achlorhydria

32
Blood Calcium is Regulated

• Blood level is maintained at the price of bone
  calcium
• Blood level will be maintained despite inadequate
  calcium intake
• Setting stage for future bone fractures

33
Fig. 11.8
34
Fig. 11.9
35
Functions of Calcium

• Blood clotting
• Nerve impulse transmission
• Muscle contraction
• Cell metabolism
• Activates various enzymes

36
Fig. 11.10
37
(No Transcript)
38
Calcium Supplements

• Calcium carbonate, the most widely available form
  of calcium (found in Tums and other supplements),
  is absorbed more consistently with meals
• for a high-dose calcium regimen, divide the
  doses. If youre taking 1,000 to 1,200
  milligrams of calcium a day, you should divide
  the doses in half, one in the morning, one in the
  evening, to get the best absorption, The body
  may not be able to absorb larger doses all at
  once.

39
Calcium contd

• Also, its a good idea in many cases to choose a
  calcium supplement that contains vitamin D,
  without which calcium cannot be efficiently
  absorbed. People who live in northern latitudes
  and may not get enough sun are at the greatest
  risk for not getting the 200 to 600 International
  Units of vitamin D they need each day.
• It should be noted that a significant portion of
  the population (an estimated 20 percent of people
  over 60 and 40 percent of people over 80) cannot
  absorb some kinds of calcium supplements unless
  they take them at mealtime. These people have a
  condition called atrophic gastritis, in which
  they dont secrete enough stomach acid in between
  meals to break down calcium carbonate.

40
Building Higher Bone Mass

• Adequate diet
• Healthy body weight
• Weight-bearing physical activity
• Moderate intakes of protein, phosphorus, sodium,
  caffeine
• Non-smoker

41
Other Roles of Calcium

• May lower blood pressure
• May reduce colon cancer
• May reduce PMS symptoms
• May lower blood cholesterol
• May reduce kidney stones
• Reduce lead absorption

42
Osteoporosis

• Calcium deficiency
• A pediatric disease with geriatric consequences
• Leads to 1.3 million fractures / year
• Slender, inactive women who smoke are most at risk

43
Osteoporosis
44
Bone Growth and Mass

• Rapid and continual throughout adolescence
• Peak bone mass
• Determined by gender, race, familial pattern,
  other genetic factors
• Bone loss begin age 30
• Women experience increase bone loss after
  menopause

45
Types of Osteoporosis

• Type I (postmenopausal)
• Occurs after menopause
• Type II (senile)
• Occurs with age in men and women

46
Medication

• Estrogen
• Slows bone turnover
• Fosamax (bisphosphonates)
• Slows bone breakdown
• Evista (selective estrogen receptor modulators)
• Slows bone turnover
• Calcitonin
• Inhibits bone breakdown
• Side effects

47
Diet and Lifestyle Factors

• Adequate diet (Ca, vitamin D)
• Healthy body weight
• Normal menses
• Weight-bearing physical activity
• Dont smoke
• Limit excessive intake of protein, phosphorus,
  sodium, caffeine, wheat bran, and alcohol

48
Food Sources of Calcium

• Dairy products
• Kale, collard, mustard greens
• Calcium fortified foods
• Tofu (if made with calcium carbonate)
• Canned fish

49
Calcium Supplement

• Recommended for people who cannot incorporate Ca
  into their diets
• Not recommended with high iron meal
• Calcium carbonate (40 calcium)
• For those with ample of stomach acid
• Found in antacids
• Calcium citrate (21 calcium)
• Enhance absorption due to acidity content
• Recommended for elderly

50
Risk With Calcium Supplements

• Lead contamination
• No FDA regulation
• Oyster shell
• Bonemeal
• Look for United States Pharmacopoeia seal of
  approval

51
Calcium Needs

• Daily Value is 1000 mg/day
• Adequate Intake is 1000 -1200 mg/day for adults
• Adequate Intake is 1300 mg/day for adolescents
  (9-18 yrs. old)
• Average intake range from 600-800 mg/day for
  women and 800-1000 mg/day for men