Chapter 8 Minerals

Chapter 8 Lesson 8.1 Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved. 2

Key Concepts The human body requires a variety of minerals in different amounts to perform numerous metabolic tasks. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

The Nature of Body Minerals Classes of body minerals Major minerals (>100 mg/day) Trace elements (<100 mg/day) Functions of minerals Mineral metabolism Digestion Absorption Transport What are the four fundamental elements that make up most living matter? Hydrogen, carbon, oxygen, and nitrogen Ask students to name a trace element or a major mineral. Explain that unlike carbohydrates, proteins, and fat, minerals do not require a great deal of mechanical or chemical digestion before absorption. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Chapter 8 Lesson 8.2 Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved. 5

Key Concepts A mixed diet of varied foods and adequate energy value is the best source of the minerals necessary for health. Of the total amount of minerals a person consumes, only a relatively limited amount is available to the body. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved. 6

Major Minerals Calcium Phosphorus Sodium Potassium Chloride Magnesium Sulfur Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Calcium Functions Bone and tooth formation Blood clotting Muscle and nerve action Metabolic reactions Absorption of B12 Activation of pancreatic lipase Secretion of insulin Cell membrane permeability What does the absorption of dietary calcium depend on? The food form and the interaction of three hormones that directly control absorption, along with indirect metabolic stimuli from the estrogen hormones Where can most of the body’s calcium be found? Bones and teeth Explain that calcium in the bones acts as a pool for calcium that can then be used to maintain blood calcium levels. Calcium is essential for muscle contraction. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Calcium, cont’d Requirements Deficiency states Toxicity symptoms 1000 mg/day Deficiency states Osteoporosis Toxicity symptoms Food sources Milk is the major food source Green vegetables, fish with bones, fortified food What can reduce the risk for developing osteoporosis? Diet, especially during childhood and adolescence, physical activity including weight-bearing exercises, not smoking How many in the class drink milk or eat dairy products? Name some of the green vegetables that are good sources of calcium. Broccoli, spinach, kale Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Osteoporosis Left side: normal, healthy bone Right side: osteoporotic bone Which bone looks easier to break? Figure information: Normal bone (left) versus osteoporotic bone (right). From Mahan LK, Escott-Stump S: Krause’s food & nutrition therapy, ed 12, Philadelphia, 2008, Saunders. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Phosphorus Functions Bone and tooth formation Energy metabolism Oxidation of carbohydrate, fat, and protein Energy and protein metabolism Cell function and genetic inheritance Component of enzymes, thiamin, DNA/RNA Acid-base balance What other mineral is essential for bone and tooth formation? Calcium DNA has phosphorous in its backbone. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Phosphorus, cont’d Requirements Deficiency states Toxicity symptoms 700 mg/day Deficiency states Toxicity symptoms Food sources Milk, milk products, fish, eggs If a phosphorus deficiency does develop, what are the characteristics? Weakness, loss of appetite, fatigue, pain Is it difficult for most Americans to meet the requirement for phosphorus? Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Sodium Functions Water balance Acid-base balance Muscle action Nutrient absorption What is the main function of sodium? Water balance Explain that sodium is needed for glucose to be absorbed. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Sodium, cont’d Requirements Deficiency states Toxicity symptoms AI: 1.5 g/day UL: 2.3 g/day Deficiency states Toxicity symptoms Salt sensitivity and hypertension Food sources Table salt, cured meat, canned soups, processed food Excess sodium can lead to what chronic disease? Hypertension What is the main dietary source of sodium? Table salt What is salt sensitivity? Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Potassium Functions Water balance Metabolic reactions Muscle action Conversion of blood glucose to glycogen Storage of nitrogen in muscle protein Production of energy Muscle action Insulin release Blood pressure Explain that sodium and potassium work with each other to maintain water balance. Mention that sodium is extracellular and potassium is intracellular. Does potassium raise or lower blood pressure? Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Potassium, cont’d Requirements Deficiency states Toxicity symptoms AI: 4.7 g/day Deficiency states Toxicity symptoms Food sources Fruits, vegetables, whole grains, fresh meats When are potassium deficiencies more likely to occur? During clinical situations such as prolonged vomiting or diarrhea, during use of diuretic drugs, during use of hypertension drugs, as a result of severe malnutrition, or after surgery What is the result of extremely high potassium levels? Fatal arrhythmia Do most Americans meet the AI for potassium each day? Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Chloride Functions Digestion Respiration Key element in hydrochloric acid secretion Respiration Emphasize that chloride is needed for digestion of all foods through hydrochloric acid. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Chloride shift Chloride is needed to maintain charge balance. Both chloride and the bicarbonate ion have a negative charge and must change places, or shift, in a red blood cell to maintain equilibrium. Figure information: From Thibodeau GA, Patton KT: Anatomy & physiology, ed 6, St Louis, 2007, Mosby. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Chloride, cont’d Requirements Deficiency states Toxicity symptoms AI: 2.3 g/day Deficiency states Toxicity symptoms Food sources Table salt What is the primary reason for chloride deficiency? Excessive fluid losses through vomiting, which leads to metabolic alkalosis The only known development of toxicity is through dehydration. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Magnesium Functions General metabolism Protein synthesis Muscle action Necessary catalyst for ~300+ reactions in cells Protein synthesis Activates amino acids Role in synthesis and maintenance of DNA Muscle action Basal metabolic rate Influences secretion of thyroxine Where in the body is magnesium found? In all body cells; it has widespread metabolic functions. Review what a catalyst is. Why are catalysts important? Discuss basal metabolic rate and how magnesium deficiency could influence it. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Magnesium, cont’d Requirements Deficiency states Toxicity symptoms ~300 to 400 mg/day Deficiency states Toxicity symptoms Food sources Nuts, soybeans, cocoa, seafood, peas, green vegetables What are some of the deficiency symptoms? Muscle weakness and cramps, hypertension, and blood vessel constriction in the heart and brain Which individuals are at greater risk for developing magnesium toxicity? Those with renal insufficiency Which sources are relatively poor sources of magnesium? Most fruits, except bananas; milk; meat; and fish Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Sulfur Functions Hair, skin, and nails General metabolic functions High-energy bond Transfer energy Vitamin structure Collagen structure Where is collagen found and what is its function? It is a connective tissue found in the gums and joints. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Sulfur, cont’d Requirements Deficiency states Toxicity symptoms Not stated, obtained through amino acids methionine and cysteine Deficiency states Toxicity symptoms Food sources Meat, nuts, soy, fish, cheese, eggs Because sulfur is obtained through amino acids, many of its functions are the same as protein (e.g., maintenance of hair and nails and collagen formation). What are other food sources that contain protein, and thus sulfur-containing amino acids? Are methionine and cysteine essential or nonessential amino acids? Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Chapter 8 Lesson 8.3 Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved. 24

Key Concepts A mixed diet of varied foods and adequate energy value is the best source of the minerals necessary for health. Of the total amount of minerals a person consumes, only a relatively limited amount is available to the body. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved. 25

Trace Elements Iron Iodine Zinc Selenium Fluoride Copper Manganese Chromium Molybdenum Cobalt Boron Vanadium Nickel <100 mg/day needed. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Iron Functions Hemoglobin synthesis General metabolism Proper glucose metabolism Antibody production Drug detoxification in the liver Collagen and purine synthesis Conversion of carotene to vitamin A 70% of the body’s iron occurs where? In red blood cells Iron is most well known for its role in hemoglobin and therefore its essentiality in oxygen transport. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Iron, cont’d Requirements Deficiency states Toxicity symptoms 8 to 11 mg/day for males 8 to 18 mg/day for females Deficiency states Anemia Toxicity symptoms Hemochromatosis Food sources Heme Nonheme What is one clinical test to determine iron-deficiency anemia? Hemoglobin levels, hematocrit Why do women need more iron than men? Menses Explain that hemochromatosis is a genetic condition enabling the body to retain more iron than needed. Discuss the signs and symptoms of iron-deficiency anemia. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Heme and Nonheme Iron Sources Food sources Animal sources only, such as meat and poultry; 40% of iron in animal sources Absorption rate: rapid Nonheme All iron in plant sources; 60% of iron in animal sources Absorption rate: slow Explain that heme iron is only found in animal products, whereas nonheme iron is found in animal and plant products. Nonheme iron is more tightly bound than heme iron. What are plant sources of iron? Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Iodine Functions Requirements Participation in thyroid gland’s synthesis of thyroxine Requirements 150 mcg/day What is the function of thyroxine? Regulates metabolic rate Where is the thyroid gland located? Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Uptake of Iodine Guide students through the diagram, explaining that iodine is needed in the regulation gene expression. Figure information: From Guyton AC, Hall JE: Textbook of medical physiology, ed 12, Philadelphia, 2006, Saunders. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Iodine, cont’d Deficiency states Toxicity symptoms Food sources Goiter Cretinism Hypothyroidism Hyperthyroidism Toxicity symptoms Food sources Iodized table salt, seafood; depends on soil content What is the difference between hypothyroidism and hyperthyroidism? Cretinism results from a mother eating insufficient amounts of iodine during fetal development. What are the characteristics of cretinism? Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Goiter Describe the process of how iodine deficiency leads to goiter. Figure information: B, From Swartz MH: Textbook of physical diagnosis, ed 5, Philadelphia, 2006, Saunders. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Zinc Functions Requirements Enzyme constituent Immune system Other functions Requirements 11 mg/day for males 8 mg/day for females Zinc is especially important during what growth periods? Pregnancy, lactation, infancy, childhood, and adolescence Who reported the lowest zinc intake on the National Health and Nutritional Examination Survey? Children aged 1 to 3 years, adolescent girls, and persons older than 71 years Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Zinc, cont’d Deficiency states Toxicity symptoms Food sources Poor wound healing Impaired taste and smell Toxicity symptoms Food sources Meat, seafood, legumes, whole grains Zinc is often supplemented for patients with open wounds. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Selenium Functions Requirements Deficiency states Toxicity symptoms Aids in protection from free radicals Requirements RDA: 55 mcg/day Deficiency states Toxicity symptoms Food sources Seafood, kidney, liver; depends on soil content Selenium functions with specific proteins as an essential part of an antioxidant enzyme, glutathione peroxidase, which protects cells and their lipid membranes from oxidative damage. It also functions as a part of the protein center of teeth and participates in the regulation of thyroid hormone action and vitamin C activity. A mild selenium deficiency can have what effect? It may decrease a person’s ability to fight infection. Severe deficiency may put individuals at risk for certain types of cancer. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Other Trace Elements Fluoride Copper Manganese Functions by preventing dental caries Exceeding UL may cause fluorosis Copper “Iron twin” Manganese Inhalation toxicity What is fluorosis? When is it critical to watch fluoride intake so fluorosis does not occur? Explain why copper is called iron’s twin. They have many of the same functions. Manganese toxicity can result from mining. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Other Trace Elements, cont’d Chromium Previously thought to reduce insulin resistance Molybdenum Inadequate dietary intake improbable Other essential trace elements Aluminum, arsenic, boron, nickel, silicon, tin, vanadium A recent clinical trial showed no effect with chromium supplementation and reduced insulin resistance. Molybdenum is needed in minute amounts. What are food sources of the other trace elements? Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Chapter 8 Lesson 8.4 Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved. 39

Key Concepts The human body requires a variety of minerals in different amounts to perform numerous metabolic tasks. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved. 40

Mineral Supplementation Life cycle needs Pregnancy and lactation Adolescence Adulthood Clinical needs Iron-deficiency anemia Zinc deficiency Special needs during growth periods and in clinical situations may require individual supplements of specific major minerals or trace elements. Ask students to name five high-risk groups that may need to supplement their diet and explain why. Adolescent girls on poor diets, low-income adolescent boys, athletes, vegetarians, and elderly persons on poor diets Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Summary Minerals are single, inorganic elements. Minerals are classified according to their relative amounts in the body. Major minerals make up 60% to 80% of all inorganic material in the body. Trace elements make up less than 1% of the body’s inorganic material. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.

Summary, cont’d RDAs have not been set for all minerals. Als or ULs have been set for almost all essential minerals without RDAs. Mineral supplementation is still under much debate. Copyright © 2009, by Mosby, Inc. an affiliate of Elsevier, Inc. All rights reserved.