1. Vitamins, Minerals, and Water Micronutrients Fluid and Electrolytes Balance. Nutrients Involved in Bone Health
Chapter 8, 9,10 (cont.), 11
BIOL1400
Dr. Mohamad H. Termos

2. Open Book Quiz List the functions of water in human body
Classify minerals into major and trace minerals
List the types of mineral interactions in the body. Give one example on the importance of such interactions.
Which minerals are important for the bones?
Which minerals are important for nerve impulse conduction and/or nerve function?

3. Open Book Quiz List all minerals with their respective symbols
How tea and sweets affect calcium absorption?
What is hypertension? What are the possible causes that may lead to it? Which minerals are good?
Compare and contrast between heme and non-heme irons
In general which food is rich in trace minerals?

4. Water
Introduction:
- Water is a solvent dissolving many body components
- 50% to 70% of the body's weight
- Lean tissue: 73% water
- Fat tissue: 20% water
- Humans can survive only a few days without water

5. Water
Water flows freely in and out of the cell through cell membranes by osmosis
Ion or electrolyte concentrations control the amount of water in the inside and the outside of cells
- Ions are electrically charged molecules that attract water

6. Water - Water contributes to temperature regulation
- Water helps remove waste products
- Most unused substances in the body can dissolve in water and exit in the urine
- Healthy urine output: 1 liter or more per day
Less than 500 milliliters (2 cups) forces kidneys to excessively concentrate the urine
Heavy ion concentration in urine increases risk of kidney stones
Generally, the amount of urine we excrete is determined by the amount of sodium and protein we need to excrete

7. Water Other functions of water:
Helps form lubricants found in knees and other body joints
Basis for saliva, bile, and amniotic fluid

8. Water: Need per day
- Adequate Intake for total water intake: including fluid from food and beverages
Women: 2.7 liters (11 cups)
Men: 3.7 liters (15 cups)
- Water losses
Urine production: 500 or more milliliters
Lungs: milliliters
Colon: milliliters
Skin: milliliters
Coffee, tea and soda or any other beverage containing caffeine increases urine output
Above values are estimates affected by altitude, caffeine, alcohol, and humidity

9. Too Much Water?
- An amount above what the kidneys can excrete can cause low blood concentrations of electrolytes
- Excessive amounts would be many quarts each day
- Blurred vision can result

10. Minerals General functions:
- Roles: cofactors, nerve impulse transfer, growth and development, and water balance.
- Categorized by the amount our bodies need
Major
Trace

11. Mineral bioavailability
- Is the capability of our body to absorb and use minerals in our food
- Food composition tables generally do not reflect bioavailability
- Only 5% of calcium in spinach is absorbed because oxalic acid in spinach binds the calcium
- Minerals from animal products absorbed better than from plants because fewer binders and dietary fibers to hinder absorption

12. Fiber-mineral interactions
- Phytic and oxalic acid
- High-fiber diets (greater than 25-35g) can decrease the absorption of iron, zinc, and probably other minerals
- Yeast used in bread making releases enzymes that break the bonds between the minerals and phytic acid

13. Mineral-mineral interactions
- Minerals with similar size and charge compete with one another for absorption such as magnesium, copper, iron and calcium
- Taking excess zinc can decrease copper absorption

14. Vitamin-mineral interactions
Vitamin C enhances absorption of iron
Vitamin D enhances absorption of calcium

15. Major minerals: Sodium (Na)
Functions:
- Fluid balance: water retention in extracellular fluid
- Nerve impulse conduction
- Aid absorption of some nutrients (e.g. glucose)
- Diet low in sodium with increased losses can cause cramps, dizziness, shock and coma
Sodium in foods and needs
- Table salt, White bread and rolls, Cheese, Potato chips and French fries
- DV is 2400 mg/day, UL is 2300 mg per day
- Body adapts to sodium intake with excess output in urine. - 10% to 15% of adults are sodium-sensitive, experience increased blood pressure from too much sodium

16. Potassium (K) Functions: Deficiency is life-threatening:
Fluid balance: maintains intracellular fluid and decreases blood pressure
Nerve impulse conduction
Deficiency is life-threatening:
Muscle cramps
Confusion
Constipation
Irregular heartbeats

17. Potassium (K) Potassium sources and needs People at risk of deficiency
Fruits and vegetables
Milk, whole grains, dried beans, and meats
DV: 3500 mg
People at risk of deficiency
Alcoholics
Taking diuretics
Low calorie intake or eating disorder
Athletes who exercise excessively
No UL set, if kidneys function normally, excess is excreted.

18. Chloride (Cl) Functions: Deficiency unlikely because of salt intake
Component of stomach hydrochloric acid (HCl)
Nerve function
Deficiency unlikely because of salt intake
Chloride sources and needs
Fruits and some vegetables
Table salt (sodium chloride) is 60% chloride
DV is 3400 mg
UL is 3600 mg

19. Calcium (Ca) Functions:
- Forming and maintaining bones and teeth: 99% of Ca is in bones
- Blood clotting
- Muscle contraction: low calcium causes tetany (muscles cannot relax)
- Normal nerve transmission
- Decrease risk of colon cancer and kidney stones
- May reduce blood pressure
- Promote weight loss
- Dietary glucose and lactose enhance absorption.
- Phytic acid, Tannins in tea, andvitamin D deficiency inhibit absorption

20. Calcium in foods and needs
Food sources: Dairy products, bread, leafy greens, broccoli, sardines, and canned salmon
Adequate Intake: 1,000 to 1,200 mg/day
- Upper Level: 2,500 mg/day
- Greater than UL increases risk of Kidney stones, and kidney failure

21. Phosphorus (P) - 70% is absorbed, Vit D enhances absorption
- Deficiency leads to bone loss in older women
- Functions: Component of enzymes, DNA, all cell membranes, and bone
Sources: Milk, cheese, bread, meat
Need: DV: 1000 mg
- Upper Level: 3 to 4 g/day, impairs kidney function
- Too much P (usually from too much soda) coupled with not enough Ca leads to bone loss

22. Magnesium (Mg) Functions: - Nerve and heart functions
- Maintenance of bone.
- Cofactor for many enzymes
Deficiency symptoms:
- Irregular heartbeat and muscle pain
Benefits:
- Decreases blood pressure
- Prevents heart rhythm abnormalities
Sources: Whole grains, broccoli, beans, milk, and coffee
Average intake: Males: 320 mg/day, Females: 220 mg/day, UL is 350 mg/day

23. Sulfur (S) Functions: - Acid-base balance
- Part of liver's drug detoxifying pathways
- Used in food preservation
- Found in foods with protein

24. Minerals and hypertension
Introduction:
- One in 5 adults has hypertension
- Systolic blood pressure
Higher number
Pressure in the arteries when the heart is contracting
Optimal is 120 mm Hg
- Diastolic blood pressure
Lower number
Pressure in the arteries when the heart is at rest
Optimal is 80 mm Hg
- Silent disorder, usually no signs, get checked often

25. Minerals and hypertension
Why control blood pressure?
- Prevent cardiovascular disease, kidney disease, strokes, poor circulation, vision problems and sudden death
- Smoking and elevated blood lipids increase risk even more
Causes of hypertension:
- Risk factors
Family history
Age
Overweight
Inactivity
Excessive alcohol intake
- Build up of plaque in arteries
- Sodium sensitivity

26. Minerals and hypertension
- Other minerals and blood pressure
Diets rich in calcium, potassium and magnesium and low in sodium can decrease blood pressure
Diet rich in low fat dairy products, fruits and vegetables, whole grains and some nuts decrease risk of hypertension and stroke

27. Trace minerals - Also called microminerals - Need 100 mg/ day or less
- Iron, Zinc, Selenium, Copper, Iodine are all trace minerals.
- Seafood is rich in trace minerals.

28. Iron (Fe) Absorption and distribution: 1- Heme Iron:
Iron from animal flesh, (i.e. hemoglobin, myoglobin.
2- Non-heme iron:
Iron primarily from plant food, and eggs.
- Heme iron are absorbed more efficiently than non-heme ones.
- Heme iron increases non-heme iron absorption.

29. Iron (Fe) : Absorption and distribution
1- Factors that can increase non-heme iron absorption:
Iron-binding meat protein.
Vitamin C.
More absorbed during pregnancy and growth
2- Factors that reduce non-heme iron absorption:
Phytic acid, oxalic acid, tannins in tea, and zinc

30. Functions of iron - Component of hemoglobin and myoglobin
- Oxygen transport
- Component of enzymes
- Brain and Immune function
- Drug detoxification in liver
- Bone health

31. Iron-deficiency anemia
Decreased oxygen-carrying capacity
High risk categories
- Childbearing years because of menstruation
- Pregnancy
- Blood loss from ulcers, colon cancer, or hemorrhoids
Clinical signs and symptoms
- Pale skin
- Poor temperature regulation
- Loss of appetite
- Reduced amount of red blood cells and hemoglobin

32. Iron in foods and needs Food sources: - Animal products; best sources
- Iron-fortified formulas and cereals for children
- Milk is a poor source
Recommended Daily Allowence:
- Males: 8 mg per day
- Females 19 to 50 years old: 18 mg per day
- DV is 18 mg/d

33. Iron: Upper level Upper Level: 45 mg/day - Stomach irritation
- Single 60 mg dose can be life threatening to infant
- Iron deposits in heart, muscles and pancreas can lead to severe organ damage

34. Zinc (Zn) Absorption - High calcium intake decreases absorption
- Zinc competes with iron and copper absorption
Functions
- Cofactor for many enzymes
- DNA synthesis, wound healing and growth
- Proper bone and sexual organ development

35. Zinc (Zn) Deficiency - Symptoms Acne like rash
Reduced sense of taste and smell
Hair loss
Growth, sexual development, and learning ability may also be hampered

36. Zinc sources and needs Food sources RDA
Animal foods are primary source because they don’t contain phytic acid (Beef, milk, and poultry)
Plant sources: whole grains, peanuts, legumes
RDA
Males: 11 mg per day
Females: 8 mg per day
DV is 15 mg

37. Zinc (Zn) Toxicity: - Upper Level: 40 mg/day
- Possible increased risk prostate cancer
- Inhibits copper metabolism
- Depressed immune system function

38. Selenium (Se) Function - Antioxidant
- Contributes to thyroid hormone metabolism
Deficiency
- Muscle pain, heart damages
Food sources
- Fish, meats, eggs, organ meats
- DV is 70 microgram/day
Toxicity:
- Upper Level 400 micrograms /day
- Hair loss

39. Iodine (I) Function: - Synthesis of thyroid hormones
- Regulate metabolic rate
- Promote growth and development
Deficiency:
Goiter (enlarged thyroid gland from iodine deficiency)
Food sources: Iodized salt, saltwater fish, and seafood
DV: 150 microg/day,Upper Level: 1.1 mg/day
- Thyroid hormone synthesis inhibited
- Thyroid gland enlarges as it attempts to take up more iodine from the blood stream
- Painless but can put pressure on trachea

40. Copper (Cu) Functions - Metabolizes iron - Immune system functions
- Blood clotting
Absorption
- Higher intake leads to lower absorption
- Absorbed in stomach and small intestines
- Phytic acids, fiber, zinc and iron interfere with Cu absorption

41. Copper (Cu) Symptoms of deficiency
- Anemia, low white blood cell count, bone loss, poor growth, and some forms of cardiovascular disease

42. Copper (Cu) Copper in foods and needs
- Liver, seafood, cocoa, legumes, nuts, dried fruits, whole grains
- DV is 2 mg
Toxicity
- Upper Limit: 10 milligrams per day
- Toxicity can occur from a single 10 mg dose
- Vomiting
- Liver toxicity

43. Fluoride (F) Functions - Strengthens the structure of bones and teeth
- Decreases the rate of dental caries
- Also inhibits growth of bacteria causing caries
Fluoride sources and needs
- Tea, seaweed, seafood
- Toothpaste
- Adequate Intake: 3.1 to 3.8 mg/day for adults

44. Fluoride (F)
Toxicity
- UL is mg per day for young children, 10 mg per day for children over 9
- Mottling (white or yellow spots) of the teeth
- Can occur from swallowing toothpaste also
- Mottling occurs during tooth development, can not occur in adulthood

45. Chromium (Cr) Functions
- Glucose entry into cells by aiding insulin function
- Deficiency leads to high serum cholesterol and triglyceride levels, as well as poor blood glucose control
Food sources and needs
- Egg yolks, mushrooms, nuts, and yeast
- Daily value is 120 mcg
Toxicity
- No UL set
- Liver damage
- Lung cancer

46. Manganese (Mn) - Functions Cofactor of enzymes Bone formation
- No known deficiency
- Food sources: Nuts, rice, oats, whole grains, beans, leafy vegetables
- DV is 2 mg
- Upper Level: 11 milligrams per day, higher amount would damage nerves

47. Molybdenum (Mo) - Functions
Cofactor of enzymes
- Food sources: Milk products, beans, whole grains, nuts
- DV is 75 mcg

48. Minerals and Osteoporosis
Osteoporosis: Definition
- Decreased bone density
- Caused by
Vitamin D deficiency, osteomalacia
Use of drugs like cortisol and anti-seizure medications
Cancer

49. Minerals and Osteoporosis
Introduction to osteoporosis
- Leads to about 1.5 million bone fractures per year in US
- Slender inactive women who smoke are most susceptible
- Spine fractures can cause pain and deformity
- Fracture related complications can lead to death in elderly

50. Minerals and Osteoporosis
- Bone strength is dependant on mass and density
- Bone mass: total amount of mineral in a cross section of bone
- Bone density: grams of mineral per cubic centimeter of specific bone
- The more densely packed the bone minerals, the stronger the bone.
- Bone mass is related to gender, race and familial pattern

51. Minerals and Osteoporosis
- Peak bone mass
By age 20
Affected by dietary intake of calcium, protein, phosphorous, Vitamins A, D and K, magnesium, iron zinc and copper
More bone mass in youth means more can be lost without consequences
- Bone loss begins at 30 and speeds significantly after menopause

52. Preventing Osteoporosis
- Once present, not reversible
- For young women three main elements:
Meet calcium, vitamin D, protein and other nutrient needs
See physician if irregular menstruation
Weight-bearing and resistance activities
- Once reached menopause
Discuss therapies with physician
Weight bearing activity
Adequate calcium intake and sun exposure or consumption of Vit D
Minimize risk of falls
Avoid smoking and excess alcohol
Avoid excess phosphorous, caffeine, sodium