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Yr 1 Nutrition Vits and Mins Lecture > Minerals only lecture Dec 2017 > Flashcards

Minerals only lecture Dec 2017 Flashcards

1
Q

What % of body weight do minerals represent as body weight in adults

A

4.5%

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2
Q

How much of that is Ca P and other macro and micro minerals

A

50% Ca (90% of this found in bones)
25% P ( 70% of this found in bones)
25% others

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3
Q

Name the other macrominerals

A

Mg, Na, K Cl and S

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4
Q

Name the other microminerals

Name two of the ultratrace minerals

A

Fe, Zn, I, Se, Mn, F, Mo (molybdenum) Cu, Cr, Co and B

Al (aluminium) Ni (nickel)

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5
Q

Which mineral is the most abundant in the body

A

Ca

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6
Q

Food containing calcium has little affect on serum Ca levels so how are Ca levels maintained

A

Bone tissue is the reserve site for Ca maintaining muscle, intercellular fluid and blood
Approx 99% of Ca is in the bones and teeth to support function and structure

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7
Q

How is Ca absorbed and used

A

Body imports Ca into the enterocytes, facilitates across cell membrane and sends out into extracellular fluid and blood. Ca then enters the epithelial cells in the intestine via TRP channels , and pumped out via Calcium-ATPase

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8
Q

Dairy has always been seen as a good calcium source for protecting the bones. Is this actually true

A

There is evidence that dairy does not reduce fracture risk - countries with high fracture rates are regularly consuming dairy. Most important factor is exercise to protect bone health

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9
Q

What other functions is Ca particularly important in

A

Nerve transmission

Ca regulates heart muscle and smooth muscle contractability

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10
Q

What are some good food sources of Ca

A

Milk and dairy are most concentrated sources
All foods of Veg origin contain Ca and although not as concentrated as that in dairy, it is often more bioavailable
Dark leafy greens
Kale, collard, broccoli, sprouts,
Soybeans, dried figs
Ca fortified orange juice
Small bones in sardines, salmon

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11
Q

What is the RDA (PRI) for Ca in an adult

What is the supp range

A

950mg

1000-2500mg

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12
Q

What % of ingested Ca is usually absorbed

A

about 30% average

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13
Q

By what methods is Ca absorbed and what other very important Vitamin is associated with absorption

A

Active and passive transport

1.25-dihydroxyvitamin D takes part in the ACTIVE absorption of Ca
Vit D stimulates the production of calcium binding proteins called calbindins (when intakes of Ca are low)
PASSIVE absorption takes place without Vit D (when there is a lot of Ca being consumed , eg, dairy foods

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14
Q

What main factors can affect the bioavailabilty of Ca

A

The greater the need and/or the smaller the dietary supply, the more efficient the absorption
Pregnancy
lactation
Resistance training (leads to higher bone density)

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15
Q

What affect does low Vit D intake and/or inadequate sunlight exposure have on Ca absorption

A

Low levels of Vit D reduce Ca absorption esp in elderly

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16
Q

In what form is Ca absorbed and what other factors influence absorption

A

Ca only absorbed in its ionic form - an acidic medium increases its absorption

HCI secreted by stomach lowers pH of duodenum, increasing absorption, therefore taking Ca supps with meals increases absorption

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17
Q

What affect does aging have on gastric acid secretion and thus, Ca absorption

A

Achlorhydria (lack of gastric acid) is coming with ageing = reduced Ca absorption

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18
Q

What else can increase absorption

What else can decrease Ca absorption

A

Lactose (sugar in milk) but only sig in infants

Oxalic acid found in rhubarb, spinach, chard, can decrease Ca absorption (Ca oxalate)
Phytic acid (phytate) found in outer husks of grains forms Ca phytate - cannot be absorbed
Dietary fiber may decrease absorption in higher meals
Medications
Fat malabsorption

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19
Q

After the onset of menopause, and the rapid loss of oestrogen, what happens to calcium levels

A

Rapid loss of oestrogen causes high bone resorption and therefore increased serum calcium levels and decreased intestinal absorption of Ca at that time

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20
Q

What is the typical % rate of bone loss per year in postmeno women who do not supplement Ca

A

2% per year

For optimal results, Vit D and avoidance of Ca wasting lifestyle factors should be recommended

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21
Q

What are the specific therapeutics for Ca

A

Foetal bone mineralisation for women with low Ca intake
PMS
Dyspepsia
High BP

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22
Q

What is the DASH diet and what does DASH stand for

A

DASH diet has been seen to lower BP
Dietary Approaches to Stop Hypertension - high fruit, vegetable whole grains and beans with low meat intake and adequate Ca through plant foods and low fat dairy

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23
Q

Who may be suffering Ca insufficiency

A

Those who are lactose intolerant (no lactase - it is needed to break down dairy foods to glean Ca)
Those low in Vit D
PTH insufficiency or hormone imbalance
Menopausal females - Ca levels critical to maintain bone health Oestrogen promotes bone formation and lowering levels can precipitate osteoporosis

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24
Q

Calcium wasting factors can be due to what different lifestyle factors?

A

Low sun exposure or limited Vit D consumption
Phytic acid and oxalic acid found in plants - binds to calcium and could inhibit absorption
Caffeine intake - can reduce absorption
High alcohol intake (inhibit enzymes that convert Vit D to its active form)
Ageing - achlorhydria = reduced Ca absorption
Moderate/higher protein intake in maturing years

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25
Is Ca toxic? Name 3 medications that can interact with Ca
Ca intake at extremely high doses (supps) linked to constipation, ability to absorb Mg, Fe, Zn, heart disease and kidney stones (more research is needed) Metformin OCP Diclofenac
26
Mg needs to be bound to something - what does it need to bind to
Oxide (good general purpose Mg, muscle relaxer) Citrate - bonded with citric acid, higher abs rate. Used in laxatives Glycinate and amino acid chelate - bonded to the AA glycine. Muscle relaxer Taurate - bound to taurine, muscle relaxer, increased quality of heart contractions so best for heart conditions Sulphate and Chloride - mainly found in topical preps or Epsom salts. Not normally ingested. Good for aches and pains. Threonate - can cross BBB and being studied for Alzheimers disease
27
Where is Mg found in the body
Mg is abundant in the body. Vast majority of it is found in muscle cells, bone, skeletal and soft tissue. Extracellular Mg accounts for about 1% of total body Mg found in serum and RBC's
28
Where is Mg absorbed and stored
Mg is absorbed in the gut, stored in bone mineral
29
How is excess Mg excreted
Excess Mg is excreted via kidneys in urine (primarily) and in stools
30
How does the body transport Mg
Transported by a passive paracellular transporter called TRPM - TRPM is also involved with intestinal absorption
31
How is the absorption rate of Mg depicted
Mg itself depicts absorption rate - the lower the level the more absorbed in the gut
32
What is the main role of Mg in the body
It plays a major role in the reaction that adds the last P to ATP making Mg essential for energy production. Mg is also required for the active transport of Ca and P ions across cell membranes facilitating nerve impulse, muscle contraction and normal heart rhythm.
33
Together with Ca what other functions is Mg involved in
``` Blood clotting (Ca promotes whilst Mg inhibits Dental cavities - Mg holds Ca in tooth enamel Essential for function of immune system ```
34
In foods, where is Mg most concentrated What are the richest sources of Mg
Most concentrated in plant foods Richest sources inc dark leafy greens, and all green veg Nuts and seeds Whole grains Soybeans and Tofu
35
What is the AI for Mg in an adult What is the supplement range
300mg F/350mg M 300-1000mg in divided doses
36
Where is Mg absorbed | What is the absorption rate ranges in a healthy person from a meal
Most Mg is absorbed in the terminal ileum | 20-70%
37
What can affect absorption of Mg
LARGE changes in Vit D status affect Mg P and Ca may also inhibit Mg absorption Protein and fructose (monosac) may enhance absorption
38
How can Mg help therapeutically
Mg can help to relieve constipation (citrate, sulphate and hydroxine salts typically used) Dyspepsia - taken as an antacid, Mg can reduce gastric hyperacidity - carbonate, hydroxide and oxide are used Diabetes - higher dietary Mg associated with reduced risk of T2DB - just 100mg increase of dietary Mg might give a 15% reduction for development of the disease (1/4 cup nuts, 1/2 cup spinach) Kidney stones - oral Mg may prevent recurrance Metabolic syndrome Migraines Osteoporosis PMS Stroke High BP Coronary heart disease
39
What can lead to insufficiency of Mg
Alcoholic Poor diet Malabsorption from GIT - Crohns Coeliac Bypass of resection of SI - particularly the ileum
40
How common is actually deficiency of Mg
Deficiency is rare as kidneys limit amount of excretion when intake is low. However, low intakes over time could induce high BP, CV disease, T2DM, osteoporosis and migraines
41
What role does Mg play in bone health
Mg regulates bone formation and influences osteoblast and osteoclast activity Mg can also influence concentrations of PTH and Vit D - important in bone homeostasis
42
What medications can interact with Mg Is Mg toxic
OCP, muscle relaxants, Warfarin to name a few Over consumption via food or supps - no health risk but can cause nausea and diarrhoea
43
ZINC | Zinc is not well absorbed and like Mg it has to be attached to another molecule. Name those molecules
Chelated Zn - electric charge been administered to Zn (chelation) so now it is a charged mineral. Orotate - chelated to orotic acid. Orotic are more neutrally charged - pass into cell more easily Picolinate - chelated to picolinic amino acid Gluconate - fermented glucose - product with a long shelf life, mainly chemical substitute. Not readily absorbable Acetate - chemically altered form or Zn - has been found to lower common cold problems Oxide - non chelated inorganic form or Zn. Used in topical preperations Sulphate - non chelated and water soluble inorganic form
44
Where is most Zn stored in the body
2.5g of zinc are stored in a variety of tissues - most popular storage spots are skeletal muscle and bone. 85% of all Zn ends up in these places. P209 SHWN
45
Where is Zn most concentrated
Zn is most concentrated in the prostrate and semen which suggests its tie to male sexual function (impotence can be related to low Zn) Other areas of most concentration are the heart , spleen, lungs, brain, adrenals and retina P209 SHWN
46
What are Zn's main functions
Cell growth and replication Sperm formation Skin integrity Cell-mediated immunity Carb metabolism (Zn insufficiency decreases insulin response) BMR - decrease in thyroid hormones and BMR seen in subjects on a zinc restricted diet Common cold - reduces severity and duration Decreases acne AMD (age related macular degen) high levels of dietary zinc shown to reduce risk
47
What are good food sources of Zn
Highest in protein rich foods - Oysters, meats, poultry Legumes and wholegrains are good eaten in considerable quantities Pumpkin seeds, sunflower seeds, cashews
48
What other mineral does Zn affect the absorption of
Zn interferes with Cu absorption and metabolism
49
The bio-availability of Zn depends on dietary enhancers and inhibitors. Explain the meaning of both
Enhancers - low Zn status - the more is needed, the more is absorbed Inhibitors - Phytates, oxalates and polyphenols bind Zn making it less available. Excess Fe, Cu, Ca may also inhibit Zn absorption
50
How does the absorption of Zn through mixed animal and plant based diet compare with that from a plant based only diet
Absorption from a mixed animal/plant diet 20-30% | Absorption from a plant based diet (high in phytates) 15%
51
Taking Zn orally prevents and treats its deficiency but is routine supplementation recommended?
No, due to its mineral-mineral interactions
52
How can Zn be used in specific therapeutics
Acne (supplementation) AMD (age related macular degeneration) from DIET ADHD - supplementation and alongside conventional Common cold - oral lozenges - decreases duration Hypogeusia - lack of taste (supp) Osteoporosis - lower dietary zinc serum levels associated with lower BMD (bone mineral dens) in men and women
53
What can contribute to Zn deficiency
Diet high in unrefined grains + high levels of produce containing phytates Malapsorption Starvation Wilson's Disease (genetic disorder - high levels of stored Cu)
54
Name some deficiency symptoms
``` Decreased taste Delayed wound healing Alopecia Alcohol intolerance Mild anaemia Infertility in male and female Decreased immune cell activity ```
55
Who may be at risk of Zn insufficiency What are the signs of insufficiency
``` Alcoholics Pregnant women Older adults Athletes PMS Sleep disturbances, slow wound healing, dandruff, reduced appetite, skin disorders ```
56
Name 3 medications that interact with Zn Is Zn toxic
Aspirin OCP PPI's Zn fairly non-toxic but excess can lead to nausea, vomiting, loss of appetite, abdominal cramps, diarrhoea and headaches.
57
PHOSPHORUS Name the two forms of P and state which is the least stable
Red and White White is the least stable and therefore the most volatile
58
Where can P be found in the human body
P is essential for life and can be found in every cell in the body. It is mainly found to be a catalyst in the formation of teeth and bones
59
P is cotransported into the epithelial cells with what other mineral Where is P mainly absorbed
Na co transports P into the epithelial cells. The expression of these transporters are enhanced by Vit D Small intenstine
60
P is found mainly bound to oxygen as what What are these components of
Found mainly bound to oxygen as phospate. Phosphates are components of DNA and RNA, ATP and phospholipids
61
P works alongside what other Vitamin group and what is their role together
``` P works alongside the B Vits for efficient functioning of: Kidneys muscle contraction nerve signalling heartbeat ```
62
List the metabolic functions that require P
``` Bone growth Intracellular fluids Ca homeostasis - maintains blood pH Component of DNA RNA ATP phosphoproteins (cell membranes), nucleic acids Muscle contraction, creatine phosphate Phosphorylation reactions ```
63
What are good food sources of P
P is widely distributed in all foods (plant and animal) Dietary deficiencies of P are unknown as diets that provide enough energy and protein supply adequate P Foods high in P - beans and legumes, dairy, meats, processed foods (esp soft drinks)
64
P absorption ranges between what %
50-70%
65
How is absorption of P regulated
Absorption is regulated by the amount in the diet , the type (plant v animal) and ratio to other dietary components as well as Vit D and PTH
66
What can reduce the absorption of P
aluminium containing antacids | excessive consumption of calcium carbonate supplementation
67
What can affect P insufficiency/deficiency
Diseases affecting the bones, intestine, kidney can facilitate hypo or hyperphosphataemia.
68
What main Vitamin is imperative for P homeostasis
Vit D is imperative for P homeostasis along with PTH Deficiency levels are linked to rickets and osteomalacia due to improper balance of Ca/P
69
Is P toxic when taken in from natural foods | Is P toxic when taken in from processed foods
No P from regular consumption of processed foods (mainly soft drinks) could lead to hyperphosphataemia (high P in the blood) ***RED FLAG*** Polyphosphates from food additives can interfere with Zn, Cu and Fe absorption
70
POTASSIUM Where is K mainly found
K is found mainly in skeletal muscle. K is the primary cation regulating and maintaining cell function It is also found in extracellular fluid Pg 169 SHWN
71
K is one of the main blood minerals called electrolytes name the other two
Na and Cl | They carry a small electric charge (potential) Pg 169 SHWN
72
Out of K Na and Cl which is the primary cation within the cells
K is the primary cation (positive ion) found within the cells K in RBC's is the best indicator of K levels in the body
73
In what foods can K be found
``` K is widely distributed in natural, unprocessed foods. The richest source are fruits and vegetables: Apricots Avocado Banana Citrus fruits Dates and raisins Potatoes almonds and sunflower seeds Also in herring, sardines and milk ``` Food processing and the addition of salt decrease K
74
What can K be used for specific therapeutics
Low K contribute to development of high BP High food intakes (fruits, veggies, beans) both prevent and correct high BP K rich fruits and veggies also appear to reduce risk of stroke Decreasing salt intake combined with increasing K is more effective in correcting high BP than decreasing salt intake alone
75
What can cause K insufficiency What are the symptoms of K insufficiency
BP/hypertension High salt intake Muscle cramps, irregular heartbeat, insomnia, insatiable thirst, mental confusion, mental fatigue, dry skin, diarrhea, low BP
76
How common is deficiency of K and what is deficiency mainly due to
Quite common in western world Deficiency mainly due to hypokalaemia due to Cushing's disease, diuretics, chronic renal disease, diarrhoea, vomiting or laxative abuse
77
SODIUM AND CHLORIDE Na and Cl are 1:1 ratio ions in what ?
Edible salt
78
What is salt used for in foods In what foods can Na and Cl be found
To modify flavor and control microbial growth They can be found in most natural foods
79
Through what system s plasma sodium regulated
Through a hormone system which also regulates water balance, pH and osmotic pressure
80
What two hormones conserve Na and how do they do this
Angiotensin and aldosterone - they conserve Na by increasing re-absorption by the kidneys
81
What hormone is released when Na levels are low
``` When sodium levels reduce, renin is secreted that generates active angiotensin in the circulation which: Stimulate vasoconstriction Increase BP Decrease water loss Stimulate aldosterone release ```
82
What are good food sources of Na and Cl
Both are present in most natural foods Richest sources of both are processed foods where NaCl has been added. NB - diets consisting of natural foods with no salt added will provide adquate amounts of both Na and Cl!!!
83
What are the average min requirements for Na and Cl
Average minimum requirements Na 500mg/day Cl 750mg/day Average western Na intake - 2000-14000 mg/day Recommended Na intake 2300mg/day No current UL set
84
Where are Na and Cl found in the body Are they easily absorbed
Na is the major extracellular electolyte and exists as a water solubble cation Na+ Cl is also found mainly in extracellular fluid as the chloride anion Cl- Both are easily absorbed from digestive tract with a 95-100% absorption rate
85
Na is considered the primary factor for high BP. Certain individuals seem to be more sensitive to high salt intakes...who are they
Salt (NaCl) has a greater effect on BP than either Na or Cl alone ``` Those particularly sensitive to high salt intake include those with: Family history of hypertension Chronic kidney disease Diabetes African origin People over 50 Overweight people - additionally, low Ca K and Mg intakes encourage the Na-induced hypertension ```
86
What can insufficiency of NaCl lead to How common is deficiency
Trauma, cachexia, anorexia, ulcerative colitis, liver disease, oedema and infection Deficiency in the WW uncommon

Yr 1 Nutrition Vits and Mins Lecture (2 decks)

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