Nutrition Mineral

Front 1

What is the importance of minerals

Back 1

Essential for many vital biological fxns although they rep. a small amt. of total body tissue
- Cofactors in enzymes
- Components of body fluids (electrolytes)
- Sites for binding oxygen (transport) – hemoglobin binds iron (2 binding sites)
- Structural component of non-enzymatic macromolecule

Front 2

Reason for mineral deficiency

Back 2

Usually secondary causes: malabsorption/excess loss via bleeding/renal disease
□ Rare if variety of foods in diet
□ Trace element deficiency due mainly to prominence of refined processed foods in diet

Front 3

Function of Ca in the body

Back 3

Constituent of bone/teeth = 99% of body Ca
® Activity of heart/nerves/muscles = memb. excitability, muscle contraction
® Blood clotting mechanisms
® Regulate cell fxn: mediate action of hormones, enzymes, NT via calmodulin

Front 4

Calcium Functions

Back 4

Constituent of bone/teeth = 99% of body Ca ® Activity of heart/nerves/muscles = memb. excitability, muscle contraction
® Blood clotting mechanisms
® Regulate cell fxn: mediate action of hormones, enzymes, NT via calmodulin

Front 5

Calcium Metabolism

Back 5

Absorption = Ca-binding protein requirement ® Regulation of balance in body
◊ Factors: (1) Bone metabolism = deposition/resorption
} (2) Kidney = reabsorption of Ca
– Loss enhanced by acidosis, high protein intake, high phosphate intake
} (3) Parathyroid hormones (PTH: released due to dec. plasma Ca++)
} (4) Result: increased rate of 1,25 (OH)2-D3 (Calcitrol) syn.
– Bone: release Ca/PO4 from bone
– Kidney: increase Ca resorption/PO4 excretion in kidney
– Intestine: stimulate syn. of Ca binding prot.
– Calcitonin from thyroid (CT: released due to inc. plasma Ca++)
– Bone: enhances rate of bone mineralization by stimulating osteoblasts

Front 6

Intestinal Calcium

Back 6

Dietary factors promoting absorption ◊ pH – increased acidity promotes absorption
◊ Ca:P ratio of 2:1: American diet = 1:1.2 to 1:1.5; if higher Ca, P precipitates in GI tract
◊ Vitamin D (1,25 dihyroxycholecalciferol)
} Required for synthesis of Ca-binding protein

Front 7

Dietary factors regarding absorption of calcium

Back 7

– Fatty acids – forms insoluble soaps
– Oxylates from grn. vegis: spinach, rhubarb, beets
– Phytates in cereal grains
◊ Yogurt = “probiotic” – allows a better absorption of Ca
} Get epigenetic effect through probiotics; 70% of immune system is in gut (more serotonin produced in GI than in brain)

Front 8

blood serum concentration of Calcium

Back 8

Blood serum conc. 8.5-10.3 mg/dL
□ Chemical forms – ionized (diffusible) Ca (4.25-5.25 mg/dL in blood)
◊ Bound to plasma protein (albumin)

Front 9

Decreased Concentration of Calcium

Back 9

tetany
} Causes (Due to…):
– (1) Vitamin D deficiency = Ca-binding prot. syn. decreased
– (2) Hypoparathyroidism = dec. parahormone
– (3) Renal insufficiency = inc. renal excretion
– (4) Dec. dietary content

Front 10

deficiency in Ca

Back 10

Ca/P/Vit. D deficiency } Rickets = children
◊ Causes = low plasma Ca/P due to lack of Vit. D
– Results = poorly mineralized bone (osteoid Matrix) associated w/ skeletal deformities
} Osteomalacia (softening of bones) = adults
– Cause = decreased bone mass
w High prot. intake along with low Ca intake
w Malabsorption of Ca/Mg/Vit. D

Front 11

High concentration of clucocorticoids

Back 11

– Result = inhibit bone cell repl and fxn as well as enhance PTH action
w Dec. estrogen levels (post menopausal women)
w Estrodial – important in premenopause

Front 12

osteoporosis

Back 12

– Bone resorption faster than deposition
– Ca:P ratio normal in matrix
– Coincidental appearance of severe PD with disruption of trabecular bone structure

Hierarchy of demineralization: dec. in bone density of jawbone then vertebrae

Front 13

Pagets Disease

Back 13

osteitis deformans – Cause: unknown but generally attributed to chronic inflammation, developmental defects, hereditary factors and aging process
– Results: Excessive bone resorption and bone deposition
w Replace normal bone by osteoid tissue
w Serum Ca and P normal although inc. alkaline phosphatase

Front 14

C reactive Protein

Back 14

inflammatory protein synthesized by liver and arteries; if have any infection this factor increases inflammation and is the cause of all types of diseases } Enamel hypoplasia = hypocalcified
– Cause = interruption in ameloblast formation
– Reasons: deficiencies of Ca/Vit A/Vit. D; hormonal imbalance
– Result = defective enamel formation

Front 15

Phosphate functions

Back 15

Functions (4) Structure of bones/teeth = 85% of total amount in body

Front 16

Phosphate Intermediary metabolism

Back 16

® Intermediary metabolism: Energy currency: ATP, creatine phosphate
– High energy intermediates
– Regulation of metabolism
– Phosphorylation/dephosphorylation of enzymes – fastest way cells can communicate from outside to inside the cell through the nucleus
w ex. insulin receptor – outside phosphorylates to inside

Front 17

phosphate metabolism blood concentratio levels

Back 17

3-4.5 mg/dL
regulatory factors
® Bone metabolism: released with calcium as PTH increases dissolution of mineral matrix
® Nutrition: different types of phosphate compounds using various food vehicles (flour/bread/cereal/gum)

Front 18

Phosphate regulatory factors

Back 18

1) Renal function = tubular resorption (primary organ) ◊ (2) Hormonal = parathyroid gland – parathyroid hormone (PTH)
◊ (3) Hyperparathyroidism = increased renal clearance of phosphate
◊ (4) Hypoperathyroidism = decrease renal clearance
◊ (5) Vitamin D: increases tubular resorption in kidney, increases intestinal absorption
◊ (6) Intestinal absorption = optimal ratio of Ca:P of 1:3 at adequate Vit. D levels
} Inhibitory factors (ex. phytates of cereal grains, Fe, Mn, unsaturated FA, Al- base antacids)

Reason = forms insoluble phosphate salts (enhancing factor: active Vit. D)

Front 19

Phosphate deficiency

Back 19

Rickets and Osteomalacia

Front 20

Magnesium function

Back 20

(importance: 10x amount in ICF compared with ECF) § Function Structure of bones/teeth = 60% of total magnesium present in body
® Enzyme activator = all reactions involving ATP
® Neuromuscular transmission and activity

Front 21

Mg absorptive values

Back 21

§ Metabolism Absorption values 50% of Mg present in average Mg diet
} 75% of Mg present in low Mg diet

25% of Mg present in high Mg die

Front 22

Mg- Ca antagonism

Back 22

Result = competition in absorption, membrane transport, crystallization of bone

Front 23

Mg blood serum levels

Back 23

Increased Causes: renal failure (renal insufficiency) – excess use of Mg salts } Results: paralysis of voluntary muscles
} Reason = antagonism between Mg and Ca

Front 24

Mg Decreased sensitivity at neuromuscular junction

Back 24

□ Reason = competition with Ca
® CNS depression Decreased: cause = diuretic drugs
} Results: osteoporosis/osteomalacia; degenerative changes in ameloblasts/odontoblasts
} Enhanced muscle irritability tetany if severe enough deficiency

Front 25

Mg and Dental Health

Back 25

Location = enamel/dentin (1:2 concentration gradient) ® Deficiency = degenerative changes in ameloblasts/odontoblasts

Front 26

Na Function

Back 26

(importance = major cation of ECF – 30-45% total Na found in skeleton)…1200mg of Na+/day – 3x more K than Na+ § Functions Acid-base equilibrium = exchanged in kidney for H+ ion
® Fluid osmolarity (O.P) = osmotic pressure homeostasis – hypertension in adults (Blood vol. inc.)
® Normal irritability of nerves/muscles
® Glucose absorption across intestinal membrane – energy dependent Na+/K+-ATPase pump

Front 27

Na Blood Plasma Levels Increased

Back 27

§ Blood Plasma Lev. Increased Causes: Hyperactive adrenal cortex = Cushing’s disease
w Reason = excess pituitary ACTH (Adrenal Cortex Tropic Hormone) production causing excess minerocorticoid (aldosterone) formation; made in the hypothalamus and stored in the Post. Pituitary
– Dehydration (water deficit)
– Excessive intake
} Result = hypertension

Front 28

Na Blood plasma levels decreased

Back 28

® Decreased Causes: Hypoactive adrenal cortext = Addison’s disease – lack of aldosterone
– Lack of antidiuretic hormone (ADH): result = inc. loss of water via kidney (polyuria)
– High temperature with inadequate Na replacement: results = muscular cramps/ nausea/diarrhea

Front 29

Potassium (K) Function

Back 29

(importance = major cation of ICF) § Functions Normal muscular/neuromuscular activity = cardiac muscle
® Fluid osmolarity (O.P.) = osmotic pressure homeostasis
○ Energy dependent Na+/K+-ATPase pump
® Acid-base equilibrium
® Enzyme activity = pyruvate kinase

Front 30

K blood plasma levels increased

Back 30

Increased = hyperkalemia ◊ Causes: Inc. rate of tissue catabolism (damage) (ex. renal failure; myocardial infarct)
} Adrenal insufficiency (Addison’s disease) = dec. sodium
– Result = electrocardiac changes leading to cardiac arrest

Front 31

K blood plasma levels decreased

Back 31

® Decreased = hypokalemia (rare)
◊ Causes: Hyperactive adrenal cortex (Cushing’s disease) = increased plasma sodium
} Aciduria
} Diuretic agents
} Liquid protein diets = low K+
◊ Results: Muscle weakness/paralysis
} Cardiac abnormalities
} Respiratory failure

Front 32

Sulfur

Back 32

(Importance = major anion along with bicarbonate ion in ECF) § Functions Water balance: osmotic pressure regulation
® Electrolyte balance: intra-/extra-cellular distribution; ionic strength
® Acid-base equilibrium = oxygen transport (chloride shift)
® Digestive processes: HCL of gastric juice
• Microminerals: Less than 100mg/dL

Front 33

Fluoride function

Back 33

(Importance = unquestioned in development of teeth/bone) § Functions Improved/enlarged crystal structure of bone/enamel: fluroapatite
® Decreased bone resorption
® Decreased solubility of bone/enamel
® Increased remineralization phenomenon on enamel surface
® Inhibit glycolytic activity of certain bacterial enzymes

Front 34

fluoride requirement

Back 34

§ Requirement = 1-2 mg/day available in water containing 1ppm F
® Excess = fluoride (endemic dental fluorosis)
◊ Amount = 10-45ppm during childhood
◊ Results: Enamel mottling/discoloration
} Increased bone density
} Calcification at point of muscle insertion
® Deposition methods
◊ Systemic route = during tooth development/maturation
} Result = stabilization of apatite crystal Ca10(PO4)6(OH)2
◊ F exchange for OH of hydroxyapatite lattice
} Result = decreased acid solubility of enamel

Front 35

F physiochemical mechanism

Back 35

§ Physiochemical mechanism = concentration gradient from oral environment
® Factors involved Occurs mainly when crown erupts into oral cavity
} Mainly CaF2 precipitate on surface with fluorapatite as secondary reaction
} More soluble the fluoride compound, greater % uptake

Front 36

Use of NaF/Na silicofluoride in water supplies

Back 36

} Result = inhibition of bacterial growth
} Reason = inhibition of enzyme systems
– Examples = enolase, aconitase
– Result = decrease acid production from glycolysis

Front 37

Iron (fe) Function

Back 37

Requirement 10-16mg/day dependent on age/growth status/sex (babies need iron, women need iron) § Function Cellular respiration
◊ Reason = component in poryphyrin structure involved with respiration
◊ Examples = hemoglobin/myoglobin/cytochromes (60-70% of Fe in body)/catalase/peroxidase/cytochrome P450 (metabolism of drugs)

Front 38

Fe absorption requirement

Back 38

§ Absorption Requirement = ferrous iron
◊ Reason = more soluble
® Inhibitory factors
◊ Oxalates/phytates (grains)/tannins (tea)
◊ Reason = insoluble iron precipitates
◊ Neutral & alkaline environment
◊ Example: achlorhydria
◊ Reason: insoluble iron hydroxides
® Location = mucosal cells of stomach/duodenum (major site)
® Results = ferrous iron (+2) converted to ferric ion (+3) to be combined with intracellular carrier molecule (apoferritin) for storage in mito.

Front 39

Fe (iron) Regulation Mucosal block theory

Back 39

§ Reasons Number of iron receptors on cell surface of G.I. tract mucosa
® Amount of iron-binding protein in mucosal cell
◊ Metabolic forms
} (1) Plasma transport = transferring (siderophillin): ferric ion combines with beta globulin of plasma (2 atoms/molecule)
– (2) Storage forms (2)
w (a) ferritin = 4300 atoms Fe+++/molecule
w (b) location = intestine/spleen/bone marrow (to make RBC)

Front 40

Hemosiderin in Fe

Back 40

Location = liver/bone marrow/pancreas/skin/joints ® Results = hemochromatosis
◊ Property = microscopically visible colloidal iron oxide associated with protein
◊ Reason for formation = iron present in excess of ferritin storage capacity due to genetic defect in mucosal absorption
◊ Abnormal amounts = hemosiderosis
® Reasons = frequent blood transfusions
® Lysis of RBC
® Increased Fe absorption

Front 41

Fe deficiency

Back 41

§ Deficiency Cause = inadequate intake & absorption/substantial losses from body
® Result Hypochromic microcytic anemia
◊ Decreased oxygen transport capacity
◊ Oral involvement: glossititis (cuts on corner of mouth) as well as cheilosis
– mucous membranes appear ashen grey
– mucous membranes atrophy

Front 42

Cupper Function

Back 42

(Importance = 90% of oxygen utilized by body dependent on Cu++ - antioxidants, removes reactive oxygen in body) § Functions Oxidase enzymes
◊ Cytochrome oxidase = terminal enzymes in electron transport chain
◊ Lysloxidase = formation of cross linkages in collagen
◊ Monoamino oxidase (MAO)
◊ Catalase = destruction of H2O2
◊ Tyrosinase = synthesis of melanin pigments
® Hemoglobin/myelin synthesis

Front 43

Cu metabolism

Back 43

Copper-containing proteins ◊ Ceruloplasmin = 95% plasma Cu++ associated with alpha2-globulin for transport
◊ Cu++-albumin = 5% plasma Cu++ for transport
◊ Erythrocuprein = red blood cell protein
◊ Cerebrocuprein = brain protein

Front 44

Cu blood serum levels decreased

Back 44

Decreased = Wilson’s disease ◊ Cause = deficiency of ceruloplasmin synthesis
◊ Result = tissue deposits of copper

Front 45

Cu location

Back 45

liver – leading to cirrhotic changes ® Brain – neurological degeneration

Front 46

Cu deficiency

Back 46

Hypochromic microcytic (RBC enlarge) anemia of infants

Front 47

Cu metabolism

Back 47

Copper-containing proteins ◊ Ceruloplasmin = 95% plasma Cu++ associated with alpha2-globulin for transport
◊ Cu++-albumin = 5% plasma Cu++ for transport
◊ Erythrocuprein = red blood cell protein

Cerebrocuprein = brain protein

Front 48

Cu blood levels decreased

Back 48

Decreased = Wilson’s disease ◊ Cause = deficiency of ceruloplasmin synthesis
◊ Result = tissue deposits of copper

Front 49

Cu location

Back 49

liver – leading to cirrhotic changes ® Brain – neurological degeneration

Front 50

Cu deficiency

Back 50

Hypochromic microcytic (RBC enlarge) anemia of infants

Front 51

Iodine function

Back 51

Microminerals- Iodine
Function = thyroid gland activity via iodination of tyrosine to form T3/T4
Actions (3)
regulation of metabolic rate (BMR)
anabolic effect in moderate concentrations
increase intestinal absorption of glucose

Front 52

Iodine metabolism

Back 52

Metabolism
Hypothyroidism
Cretinism
simple (endemic or colloidal) goiter
Myxedema

Front 53

Iodine oral problems

Back 53

oral problems
small jaws
tooth eruption retarded
root resorption
Hyperthyroidism
Exophthalmic goiter

Front 54

Selenium Function

Back 54

Functions (2)
1) glutathione peroxidase component
function =catalyzes destruction of H2O2/lipid hydroperoxides by reduced glutathione
G-SH + H2O2 = G-S-S-G + 2 H2O (glutathione peroxidase)
G-S-S-G + NADPH + H+ = 2 G-SH + NADP+ (glutathione reductase)
importance= RBC membrane stability/anticancer effect
Vitamin E sparing effect = protects vitamin from being oxidized

Front 55

Selenium oral involvement

Back 55

2) oral involvement = during active tooth development, increased Se leads to increased caries incidence
reason = change in protein component of enamel
The Deiodinase enzyme that converts Thyroxine to tri-iodothyronine is selenium dependent. 

Front 56

Molybdenum Function

Back 56

Molybdenum
Function = oxidase enzymes (FAD flavoprotein)
xanthine dehydrogenase (oxidase) = uric acid formation (gout)
aldehyde dehydrogenase (oxidase) = liver metabolism of acetaldehyde arising from ethanol metabolism

Front 57

Molybdenum oral involvement

Back 57

Oral involvement = increased Mo leads to decreased caries incidence enhancing beneficial effects of fluoride

Front 58

Manganese Function

Back 58

enzyme activator: glucokinase, pyruvate carboxylase, isocitrate dehydrogenase
glycoprotein/proteoglycan synthesis: cartilage; connective tissue
gamma-carboxylation of glutamic acid: blood clotting; calcium metabolism

Front 59

Mangenes deficiency

Back 59

cause: inadequate intake
Results
decreased osteoblast/osteoclast activity leading to osteoporosis
impairment of glucose tolerance

Front 60

Cobalt function and deficiency

Back 60

Function = constituent of vitamin B12 (cobalamin)
Importance = hemoglobin synthesis
Deficiency = pernicious anemia due to lack of vitamin B12

Front 61

Zinc Function

Back 61

Functions (2)
Enzyme activator = over 20 different enzymes
carbonic anhydrase: CO2 transport by blood
lactate dehydrogenase
carboxypeptidase of pancreas: G.I. tract protein degradation
RNA/DNA polymerase: regulatory action of enzyme
collagen synthesis
Insulin activity = structural component

Front 62

Zinc Deficiecy

Back 62

growth failure
poor wound healing
loss of taste and smell acuity

Front 63

Strontium

Back 63

Importance = similar properties like calcium
result = toxic effects, if radioactive, since deposited in bones

Front 64

Lead Function

Back 64

Distribution: 99% of total body lead in skeleton; remainder in rbc, liver, kidney
Function: hematopoietic system

Front 65

Lead Toxicity

Back 65

Toxicity:
Cause: excessive intake
canned foods/evaporated milk in cans where lead solder still used
calcium supplements made from bone meal
sweet-tasting white paint of old buildings
Results:
inhibition of heme biosynthesis
result: microcytic, hypochromic anemia
decreased activation vitamin D
result: decreased calcium uptake resulting in decreased growth
brain function: hyperactivity, behavioral problems, stunted intellectual development

Front 66

Chromium Function

Back 66

Function: prevention of glucose intolerance
reason: Cr part of or necessary for glucose tolerance factor (GTF)
mechanism: increases number of glucose transporters/insulin receptors

Front 67

Chromium Deficiency

Back 67

Chromium deficiency & disease:
decreased glucose intolerance leading to elevated blood glucose
elevated serum cholesterol & TAG

Front 68

Lithium

Back 68

Function = controls manic-depressive psychosis mood swings

Front 69

Aluminum distribution

Back 69

Distribution: 45 mg in body
most abundant natural elements; pans/foils for food preparation

Front 70

Aluminum function

Back 70

Functions: relatively inert biologically
Molecular actions
bind to brain calmodulin: interferes with Ca activation of numerous enzymes
enhance activity of cholinesterase: increase turnover of acetylcholine
associated with brain chromatin

Front 71

Aluminum food sources

Back 71

additives in processed foods: "American cheese“
ingredient of antiacids/analgesics
major contaminant to patients during kidney dialysis

Front 72

Aluminum toxicity

Back 72

Bone: inhibit mineralization at boundary between mineralized/unmineralized hydroxyapatite
reduce proliferation/activity of osteoclasts
acutely depresses intestinal phosphate absorption

Front 73

Aluminum disease

Back 73

Bone: inhibit mineralization at boundary between mineralized/unmineralized hydroxyapatite
reduce proliferation/activity of osteoclasts
acutely depresses intestinal phosphate absorption

Front 74

Cadmium

Back 74

Toxicity:
Causes:
Widespread industrial use of cadmium contaminates environment, foodstuffs
Smoking (tobacco use) doubles average Cd intake
kidney damage: steadily increases with age due to accumulation in the kidney causing proteinuria
Osteomalacia
Impaired reproduction
Hypertension: injury to arterial wall by cadmium
Teratogenesis
Cancer