Minerals

Learning objectives
 To understand the importance of micronutrients.
 To recognise the difference between water-soluble and fat-
soluble vitamins, major minerals and trace elements.
 To learn the functions and sources of the micronutrients.
 To learn the problems caused by deficiencies.
 To understand some interactions between nutrients.
 6.In the end students can explain individual nutrient

Micronutrients
Micronutrients are needed in much smaller amounts than
the macronutrients.
In general vitamins and minerals are needed to regulate
the maintenance and growth of the body, and to
control metabolic reactions in cells.

MINERALS
 More than 50 chemical elements are found in the
human body, which are required for :
 growth
 repair
 regulation of vital body functions.
3/17/2017DR:RIAZ A.MANGI
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Major groups(03)
 (a) MAJOR MINERALS :
calcium, phosphorus, sodium, potassium and magnesium.
 (b) TRACE ELEMENTS: These are elements required by the
body in quantities of less than a few milligrams per day, e.g.
iron, iodine, fluorine, zinc, copper, cobalt, chromium,
manganese, molybdenum, selenium, nickel, tin, silicon.
(c) TRACE CONTAMINANTS WITH NO KNOWN FUNCTION :
These include lead, mercury, barium, boron, and aluminum.
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Epidemiology
 As a result of consistently consuming monotonous diets based
predominantly on staple crops such as maize, wheat, rice, etc., which
provide large amounts of energy but relatively low amounts of essential
vitamins and minerls.
 Roughly more than one-third of the world’s population is at risk of one or
more micronutrient deficiencies. The most common trace element
deficiencies in order of prevalence are iron (~1. 6 million) (1); iodine (~2. 0
billion) (2); and zinc (~1. 5 billion)
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CALCIUM
 Calcium is a major mineral element of the body.
 It constitutes 1.5-2 % of the body weight of an adult human.
 An average adult body contains about 1200 g of calcium of which over 98 per
cent is found in the bones.
 Calcium in the blood is usually about 10 mg/dl.
 The developing fetus requires about 30 g of calcium.
 There is a dynamic equilibrium between the calcium in the blood and that in the
skeleton; this equilibrium is maintained by the interaction of vitamin D, parathyroid
hormone, and probably calcitonin.
 Taking high doses of calcium supplements can cause stomach pains and diarrhoea
while def:may lead to osteoporosis,Tetany etc.
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FUNCTIONS
 1.Formation of bones and teeth
 2.Coagulation of blood
 3.Contraction of muscles, cardiac action,
 4.Milk production,
 5.Relay of electrical and chemical messages that arrive at a cell's surface membrane to the
biochemical machinery within the cell, keeping the membranes of cells intact .
 6.Metabolism of enzymes and hormones.
 7.It also plays a crucial role in the transformation of light to electrical impulses in the retina.
 In short, the calcium ion controls many life processes ranging from muscle
contraction to cell division.
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SOURCES CALCIUM
Best natural sources :
 milk and milk products, eggs and fish. ragi“(bajjra)
 A liter of cow's milk provides about 1200 mg of calcium, and human milk
about 300 mg.
 Calcium occurs in milk as calcium caseinogenate which is readily assimilated
by the body.
 The cheapest dietary sources are green leafy vegetables, cereals and millets.
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Limiting factors of CALCIUM
oxalic acid with which calcium forms an insoluble compound Calcium oxalate
(from green leafy vegetables (e.g., spinach) which interferes with the absorption
of calcium.
 Phytic acid which forms an insoluble compound with calcium, calcium
phytate.
 An additional source of calcium is drinking water which may provide up to
200 mg/day.
 Some fruits (e.g. Sitaphal or sugar apple)contain good amounts of calcium.
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PHOSPHORUS
 Phosphorus is essential for the formation of bones and teeth.
 It plays an important part in all metabolisms.
 An adult human body contains about 400-700 g of phosphorus as
phosphates, most of this occurs in bones and teeth.
 its deficiency rarely occurs. A large part of phosphorus present in
 vegetable foods occurs in combination with phytin and is available to the
body only to the extent of 40-60 per cent.
15

SODIUM
 Sodium is found in all body fluids.
 The adult human body contains about 100 g of sodium ion.
 Sodium occurs in many foods, and is also added to food during cooking in the form of
sodium chloride[NaCl].
 Sodium is lost from the body through urine and sweat; that which is passed out in urine is
regulated by the kidney but that which is lost by sweating is not controlled.
 Depletion of sodium chloride causes muscular cramps.
 The requirement of sodium chloride depends upon climate, occupation and physical activity.
 Adult requirement is about 5 g per day.
 A strong relationship between hypertension and dietary salt intake has been
 observed and intake of more than 10 g of salt per day is considered to have definitive
tendency to raise blood pressure .
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POTASSIUM
 The adult human body contains about 250 g of potassium.
 Potassium occurs widely in foodstuffs.
 Potassium is vasoactive
 High dietary sodium, low dietary potassium have been implicated in the
etiology of hypertension.
 The ideal desirable sodium : potassium ratio in the diet is1:1 (in mmol).
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MAGNESIUM
 Magnesium is a constituent of bones, and is present in all body cells.
 Human adult body contains about 25 g of magnesium of which about
half is found in the skeleton.
 Essential for the normal metabolism of calcium and potassium.
 Deficiency may occur in chronic alcoholics, cirrhosis of liver, toxemias of
pregnancy, protein-energy malnutrition and malabsorption syndrome.
 The principal clinical features attributed to magnesium deficiency are
irritability, tetany, hyper-reflexia and occasionally hypo-reflexia. Requirements:
340 mg/day for adults.
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SOURCES OF MAGNESIUM
 High magnesium foods include
 dark leafy greens,
 nuts,
 seeds,
 fish,
 beans,
 whole grains,
 , yogurt,
 bananas,
 dried fruit,
 dark chocolate.
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Warning sign of Mg Deficiency
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IRON
 Iron is of great importance in human nutrition.
 The adult human body contains between 3-4 g of iron, of which about
60-70 per cent is present in the blood {Hb iron) as circulating iron, and
the rest [l to 1.5 g] as storage iron.
 Each gram of hemoglobin contains about 3.34 mg of iron.
 FORMS:
 haem-iron and non-haem iron.
 Haem-iron is better absorbed than non-haem iron.
 Foods rich in haem-iron are liver, meat, poultry and fish.
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Functions
 formation of haemoglobin,
 brain development and function,
 regulation of body temperature,
 muscle activity
 catecholamine metabolism.
 Lack of iron directly affects the immune system; it diminishes the number of T-
cells and the production of antibodies.
 Besides haemoglobin, iron is a component of myoglobin, the cytochromes,
catalase and certain enzyme systems.
 Iron is essential for binding oxygen to the blood cells.
 The central function of iron is "oxygen transport", and cell respiration.
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SOURCES OF IRON
 Iron content of breast milk averages less than 0.2 mg/dl.
 Foods containing non-haem iron are those of vegetable origin,
 e.g., cereals, green leafy vegetables, legumes, nuts, oil seeds, and dried fruits.
 phytates, oxalates, carbonates, phosphates and dietary fibre which interfere with
iron absorption.
 Other foods which inhibit iron absorption are milk, eggs and tea .
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Absorption of IRON
 Duodenum and upper small intestine in the ferrous state.
 The presence of inhibitors {e.g., phosphates), and promoters {e.g., ascorbic
acid and ascorbic acid-rich foods) of iron absorption, and disorders of
duodenum and jejunum (e.g., coeliac disease, tropical sprue).
 Physiologically iron demand ↑ during pregnancy.
 The bioavailability being poor.
 The absorbed iron is transported as plasma ferritin and stored in liver, spleen,
bone marrow and kidney.
 When red cells are broken down, the liberated iron is reutilized in the
formation of new red cells.
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Iron losses
 1.The total daily iron loss of an adult is probably 1 mg.
 2.About 12.5 mg per 28 days cycle in menstruating women.
 Major routes of iron loss are :
 (a) through hemorrhage: physiological (e.g., menstruation, childbirth) or
pathological (e.g., hookworms, malaria,
 hemorrhoids, peptic ulcer);
 (b) basal losses, such as excretion through urine, sweat and bile, and
desquamated surface cells.
 The widespread use of IUDs in the family planning programme is an additional
cause of iron loss.
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Clinical features
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Diagnosis of anemia
 A WHO Expert Group proposed that "anaemia or deficiency should be considered to exist"
 when haemoglobin is below the following levels.
 Cut-off points for the diagnosis of anaemia
 Adult males 13 .34gm/dl
 Adult females, non-pregnant 12. 34gm/dl
 Adult females, pregnant 11. 34
 Children, 6 months to 6 years 11. 34gm/dl
 Children, 6 to 14 years 12. 34gm/dl
 At all ages the normal MCHC should be 34; values below that indicate that red cells are
hypochromic, which occurs in iron deficiency anaemia.
 A haemoglobin level of 10 to11 g/dl has been defined as early anaemia; a level below 10 g/dl
as marked anaemia .
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IODINE
 Iodine is an essential micronutrient.
 It is required for the synthesis of the thyroid hormones, thyroxine (T4 )
and triiodothyronine (T3) .
 Iodine is essential in minute amounts for the normal growth and
development and well-being of all humans.
 The adult human body contains about 50 mg of iodine, and the
blood level is about 8-12 micrograms/di.
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IODINE SOURCE
 The best sources of iodine are sea foods (e.g., sea fish, sea salt) and
cod liver oil.
 Smaller amounts occur in other foods, e.g., milk, meat, vegetables, cereals,
etc.
 The iodine content of fresh water is small and very variable, about 1-50
micrograms/L.
 About 90 per cent of iodine comes from foods eaten; the remainder from
drinking water.
 The deficiency is geochemical in nature.
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• Endemic Goiter
• Hypothyroidism
• Retarded physical
development and impaired
mental function
• increased rate of spontaneous
abortion and stillbirth
• Subnormal intelligence
• Delayed motor milestones.
• Mental deficiency
• - Muscle weakness in legs, arms,
trunk
• Nystagmus
• Strabismus (squint)
• Spasticity (extrapyramidal)
• Neuromuscular weakness
• Endemic cretinism
• Intrauterine death
• - Spastic diplegia &quadriplegia
• Hearing defects
• Speech defects
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IODINE DAILY REQIURMENT
 for adults
 150 micrograms.
 250 mcg per day for iodine during pregnancy(WHO)
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FLOIRINE
 Fluorine is the most abundant element in nature
 Found in combined form
 About 96 per cent of the fluoride in the body is found in
bones and teeth.
 Fluorine is essential for the normal mineralization of bones
and formation of dental enamel.
33

Sources of Fluorine
 The principal sources of fluorine available to man are :
 {a) Drinking water : fluoride content of drinking water is about 0.5
mg/L, but in fluorosis-endemic areas, it may be as high as 3 to 12
mg/L
 {b) Foods :Fluorides occur in traces in many foods, but some
foods such as sea fish,, cheese and tea are reported to be rich in
fluorides .
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Requirements
 The recommended level of fluorides in drinking water
in
 India is accepted as 0.5 to 0.8 mg per litre
 In temperate countries where the water intake is low,
the optimum level of fluorides in drinking water is
accepted as 1 to 2 mg per liter.
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OTHER MINERALS-Zinc
 Zinc is a component of more than 300 enzymes. It is active in the metabolism
of glucides and proteins and is required for the synthesis of insulin by the
pancreas and for the immunity function.
 Zinc is present in small amounts in all tissues.
 Zinc-plasma level is about 96μg per 100 ml for healthy adults,
 and 89 μg per 100 ml for healthy children .
 The average adult body contains 1.4 to 2.3 g of zinc .
 Zinc deficiency has been reported to result in growth failure and sexual
infantilism in adolescents, and in loss of taste and delayed wound healing .
36

Zinc-Functions
 Adequate zinc intake is essential for maintaining the integrity of immune
system.
 Zinc affects multiple aspects of the immune system, from the barrier of the
skin to gene regulation within lymphocytes.
 Severe maternal zinc deficiency has been associated with spontaneous
abortion and congenital malformations like anencephaly.
 Milder forms of zinc deficiency has been associated with low birth
weight(LBW).
37

ZINC Deficiency
 There are also reports of low circulating zinc levels in clinical disorders such as
 liver disease,
 pernicious anemia,
 thalassemia and
 myocardial infarction.
 Zinc deficiency is common in children from developing countries due to lack of
intake of animal food, high dietary phytate content, inadequate food intake and
increased faecal losses during diarrhoea.
 Zinc supplementation in combination with oral rehydration therapy has been
shown to significantly reduce the duration and severity of acute and persistent
diarrhea.
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Zinc Deficiency
 intrauterine growth retardation and preterm delivery.
 Zinc plays an important role as antioxidant agent.
 These reports suggest that zinc deficiency may not be uncommon in
man.
 Zinc is widely distributed in foodstuffs, both animal and vegetables. -
39

Zinc
 Suggested daily intake for adults is 12 mg per day
 for men, 10 mg per day for women, 10 mg per day for
 children and 5 mg for infants.
40

Copper
 The amount of copper in an adult body is estimated to be between 100-150
mg.
 Hypocupremia occurs in patients with nephrosis, Wilson's disease and
protein-energy malnutrition and in infants fed for long periods exclusively on
cow's milk.
 Hypercupremia result from eating food prepared in copper cooking vessels,
or it may be associated with several acute and chronic infections {leukaemia,
Hodgkin's disease, severe anaemia, haemochromatosis, myocardial infarction
and hyperthyroidism
 Estimated copper requirement for adults is about 2.0 mg per day.
41

Cobalt
 The only established function of cobalt in the human is as a part of the
vitamin B12 molecule, which must be ingested
 There is no evidence as yet of cobalt deficiency in man
 Recently cobalt deficiency and cobalt iodine ratio in the soil have shown
to produce goiter in humans.
 It is suggested that cobalt may be necessary for the first stage of hormone
production. i.e., capture of iodine by the gland
 . Cobalt may interact with iodine and affect its utilization.
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Chromium
 Total body content of chromium is small, less then 6 mg.
 Current interest in chromium is based on the occurrence of
 unusual glucose tolerance curves that are responsive to
chromium .
 Thus there is suggestive evidence that chromium plays a role in
relation to carbohydrate and insulin function.
43

Selenium
 Little attention had been given earlier to selenium in human nutrition.
 Selenium administration to children with kwashiorkor resulted in
significant weight increase.
 Studies indicate that human selenium deficiency may occur in
protein-energy malnutrition .
 Selenium deficiency especially when combined with vitamin E
deficiency, reduces antibody production.
44

Molybdenum
 Excess absorption of molybdenum has been shown to
 produce bony deformities.
 On the other hand, deficiency of molybdenum is associated
with mouth and esophageal cancer
45

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