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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
Q

Is Ca toxic?

Name 3 medications that can interact with Ca

A

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

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26
Q

Mg needs to be bound to something - what does it need to bind to

A

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

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27
Q

Where is Mg found in the body

A

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

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28
Q

Where is Mg absorbed and stored

A

Mg is absorbed in the gut, stored in bone mineral

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29
Q

How is excess Mg excreted

A

Excess Mg is excreted via kidneys in urine (primarily) and in stools

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30
Q

How does the body transport Mg

A

Transported by a passive paracellular transporter called TRPM - TRPM is also involved with intestinal absorption

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31
Q

How is the absorption rate of Mg depicted

A

Mg itself depicts absorption rate - the lower the level the more absorbed in the gut

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32
Q

What is the main role of Mg in the body

A

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.

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33
Q

Together with Ca what other functions is Mg involved in

A 
Blood clotting (Ca promotes whilst Mg inhibits
Dental cavities - Mg holds Ca in tooth enamel
Essential for function of immune system
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34
Q

In foods, where is Mg most concentrated

What are the richest sources of Mg

A

Most concentrated in plant foods

Richest sources inc dark leafy greens, and all green veg
Nuts and seeds
Whole grains
Soybeans and Tofu

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35
Q

What is the AI for Mg in an adult

What is the supplement range

A

300mg F/350mg M

300-1000mg in divided doses

36
Q

Where is Mg absorbed

What is the absorption rate ranges in a healthy person from a meal

A

Most Mg is absorbed in the terminal ileum

20-70%

37
Q

What can affect absorption of Mg

A

LARGE changes in Vit D status affect Mg
P and Ca may also inhibit Mg absorption
Protein and fructose (monosac) may enhance absorption

38
Q

How can Mg help therapeutically

A

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
Q

What can lead to insufficiency of Mg

A

Alcoholic
Poor diet
Malabsorption from GIT - Crohns Coeliac
Bypass of resection of SI - particularly the ileum

40
Q

How common is actually deficiency of Mg

A

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
Q

What role does Mg play in bone health

A

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
Q

What medications can interact with Mg

Is Mg toxic

A

OCP, muscle relaxants, Warfarin to name a few

Over consumption via food or supps - no health risk but can cause nausea and diarrhoea

43
Q

ZINC

Zinc is not well absorbed and like Mg it has to be attached to another molecule. Name those molecules

A

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
Q

Where is most Zn stored in the body

A

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
Q

Where is Zn most concentrated

A

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
Q

What are Zn’s main functions

A

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
Q

What are good food sources of Zn

A

Highest in protein rich foods - Oysters, meats, poultry
Legumes and wholegrains are good eaten in considerable quantities
Pumpkin seeds, sunflower seeds, cashews

48
Q

What other mineral does Zn affect the absorption of

A

Zn interferes with Cu absorption and metabolism

49
Q

The bio-availability of Zn depends on dietary enhancers and inhibitors. Explain the meaning of both

A

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
Q

How does the absorption of Zn through mixed animal and plant based diet compare with that from a plant based only diet

A

Absorption from a mixed animal/plant diet 20-30%

Absorption from a plant based diet (high in phytates) 15%

51
Q

Taking Zn orally prevents and treats its deficiency but is routine supplementation recommended?

A

No, due to its mineral-mineral interactions

52
Q

How can Zn be used in specific therapeutics

A

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
Q

What can contribute to Zn deficiency

A

Diet high in unrefined grains + high levels of produce containing phytates
Malapsorption
Starvation
Wilson’s Disease (genetic disorder - high levels of stored Cu)

54
Q

Name some deficiency symptoms

A 
Decreased taste
Delayed wound healing
Alopecia
Alcohol intolerance
Mild anaemia
Infertility in male and female
Decreased immune cell activity
55
Q

Who may be at risk of Zn insufficiency

What are the signs of insufficiency

A 
Alcoholics
Pregnant women
Older adults
Athletes 
PMS
Sleep disturbances, slow wound healing, dandruff, reduced appetite, skin disorders
56
Q

Name 3 medications that interact with Zn

Is Zn toxic

A

Aspirin
OCP
PPI’s
Zn fairly non-toxic but excess can lead to nausea, vomiting, loss of appetite, abdominal cramps, diarrhoea and headaches.

57
Q

PHOSPHORUS

Name the two forms of P and state which is the least stable

A

Red and White

White is the least stable and therefore the most volatile

58
Q

Where can P be found in the human body

A

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
Q

P is cotransported into the epithelial cells with what other mineral

Where is P mainly absorbed

A

Na co transports P into the epithelial cells. The expression of these transporters are enhanced by Vit D

Small intenstine

60
Q

P is found mainly bound to oxygen as what

What are these components of

A

Found mainly bound to oxygen as phospate.

Phosphates are components of DNA and RNA, ATP and phospholipids

61
Q

P works alongside what other Vitamin group and what is their role together

A 
P works alongside the B Vits for efficient functioning of:
Kidneys
muscle contraction 
nerve signalling
heartbeat
62
Q

List the metabolic functions that require P

A 
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
Q

What are good food sources of P

A

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
Q

P absorption ranges between what %

A

50-70%

65
Q

How is absorption of P regulated

A

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
Q

What can reduce the absorption of P

A

aluminium containing antacids

excessive consumption of calcium carbonate supplementation

67
Q

What can affect P insufficiency/deficiency

A

Diseases affecting the bones, intestine, kidney can facilitate hypo or hyperphosphataemia.

68
Q

What main Vitamin is imperative for P homeostasis

A

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
Q

Is P toxic when taken in from natural foods

Is P toxic when taken in from processed foods

A

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
Q

POTASSIUM

Where is K mainly found

A

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
Q

K is one of the main blood minerals called electrolytes name the other two

A

Na and Cl

They carry a small electric charge (potential) Pg 169 SHWN

72
Q

Out of K Na and Cl which is the primary cation within the cells

A

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
Q

In what foods can K be found

A 
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
Q

What can K be used for specific therapeutics

A

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
Q

What can cause K insufficiency

What are the symptoms of K insufficiency

A

BP/hypertension High salt intake

Muscle cramps, irregular heartbeat, insomnia, insatiable thirst, mental confusion, mental fatigue, dry skin, diarrhea, low BP

76
Q

How common is deficiency of K and what is deficiency mainly due to

A

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
Q

SODIUM AND CHLORIDE

Na and Cl are 1:1 ratio ions in what ?

A

Edible salt

78
Q

What is salt used for in foods

In what foods can Na and Cl be found

A

To modify flavor and control microbial growth

They can be found in most natural foods

79
Q

Through what system s plasma sodium regulated

A

Through a hormone system which also regulates water balance, pH and osmotic pressure

80
Q

What two hormones conserve Na and how do they do this

A

Angiotensin and aldosterone - they conserve Na by increasing re-absorption by the kidneys

81
Q

What hormone is released when Na levels are low

A 
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
Q

What are good food sources of Na and Cl

A

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
Q

What are the average min requirements for Na and Cl

A

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
Q

Where are Na and Cl found in the body

Are they easily absorbed

A

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
Q

Na is considered the primary factor for high BP. Certain individuals seem to be more sensitive to high salt intakes…who are they

A

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
Q

What can insufficiency of NaCl lead to

How common is deficiency

A

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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