Nutrition Exam 3 - Part 1: Major Minerals

What is the requirement difference between major and trace minerals?

Major >100 mg/d

Minor <100 mg/d

What are the 6 major minerals?

Calcium (Ca)

Phosphorus (P)

Magnesium (Mg)

Sodium (Na)

Chloride (Cl)

Potassium (K)

NOTE: + Sulfur (S)

What are the 9 Trace Minerals?

1) Copper (Cu)

2) Iron (Fe)

3) Chromium (Cr)

4) Manganese (Mn)

5) Molybdenum (Mo)

6) Zinc (Zn)

7) Fluoride (F)

8) Iodine (I)

9) Selenium (Se)

NOTE: + Co, B, V, & Ni

How do you identify what is a metal vs a nonmetal? What is the one exception to this rule?

Metals = minerals w/ + charge

Nonmetals = minerals w/ - charge

H+ is a NON-metal (even though + charge)

What are proteins that contain a metal such as hemoglobin, myoglobin, or cytochromes?

Metalloproteins

What are enzymes that contain a metal, such as catalase and superoxide dismutase?

Metalloenzyme

What are the 3 most common functions of minerals?

1) Bone

2) Electrolyte

3) Cofactors

How are most minerals digested?

Very little required

- some may require only liquid to dissociate from salt, some require stomach acid

How are most minerals abosrbed?

in an IONIC STATE

What 4 criteria does absorption of minerals depend on?

1) food form (higher abs from animal products)

2) body requirement

3) tissue health

4) Intake of binders

How are most minerals transported?

Require plasma proteins (MC albumin)

The tissue uptake of some minerals is controlled via what?

hormones

What are the two ways minerals can occur in the body?

1) free ions

2) covalently bound minerals (proteins/salts)

What binder is found in whole grains, legumes, nuts, and seeds?

Phytate

What binder is found in spinach, brassicas, beets, legumes, berries, nuts, rhubarb, tea, and cocoa?

Oxalate

What binder is found in tea, coffee, chocolate, wine, grapes, and rhubarb?

Proanthocyanins (Tannins)

What 4 minerals do all three binders bind? Which extra mineral does phytate bind in addition to the others?

Ca, Mg, Fe, Zn

Phytate + Cu

What form is Calcium found in nature/supplements? What must happen for Ca to be absorbed?

Found as a salt

Must be released form salt to be absorbed

Out of the three types of Calcium (Ca Carbonate, Ca Citrate, Ca Lactate), which one(s) require 1 hr in acid to digest/absorb? Which one(s) do NOT require acid to digest/abosrb? Which is the MC type of Ca?

Ca Carbonate (MC) --> 1hr in acid

Ca Citrate & Lactate --> NO acid

What two mechanisms are used in order to absorb Ca?

1) Active transport in SI using Ca-binding transport protein

2) Passive diffusion through paracellular absorption in SI

What is the Ca-binding transport protein involved in active transport?

Calbindin 9k

What is the 3 step process by which Ca is absorbed through active transport in the SI?

1) CaT1 transports Ca across brush-boarder membrane

2) Calbindin 9k binds 2 Ca and transports to basolateral membrane

3) Ca pumps in basolateral membrane to pump into blood

CaT1 synthesis is enhanced by what two compounds? Why is this improtant?

Calcitriol (Vit D) & Estrogen

-- this is why synthesis decreases w/ age, so Ca requirement increases w/ age

Calbindin 9k synthesis is enhanced by ____________?

Calcitriol (Vit D)

Passive Diffusion of Ca occurs when calbindin 9k is _____________.

Saturated

- when large amounts of Ca consumed

A typical adult will absorb ___-____% of Ca, with periods of growth having absorption up to ____%

15-30%

60%

T/F: Together, the two types of Ca absorption mechanisms allow as much Ca to be absorbed as necessary by the body, since passive is used once active is saturated?

FALSE

-- Together they only allow about 500 mg at a time, so its best to space intake throughout day

T/F: Active Diffusion of Ca does not require Vitamin D, but Passive Diffusion of Ca does require Vitamin D for stimulation

FALSE

Active Diffusion = YES Vit D (stimulated by)

Passive Diffusion = NO Vit D

What three ways is Ca found in serum?

1) Free calcium (controlled by pH)

2) Calcium-anion complexes

3) Calcium-protein complexes

Starting w/ low blood Calcium, what is the 7 step pathway of calcium regulation, to bring that Ca level back to normal?

1) Low blood Ca

2) PTH secreted from parathyroid gland

3) PTH induces hydroxylase in kidneys

4) Hydroxylase activates calcitriol (Vit D)

5) Calcitriol (Vit D) stimulates synthesis of Ca-binding proteins

6) Ca-binding proteins increase Ca absorption in SI (calbindin 9k) & decrease Ca excretion in kidneys (calbindin 28k)

7) Bring blood Ca back to normal

What two compounds increase the absorption of Calcium (+)?

Vit D & Estrogen

What 6 compounds decrease absorption of Calcium (-)?

1) Phytate & Oxalate

2) Alcohol

3) Divalent minerals (2+)

4) Fa in GI

5) Caffeine

6) Phosphorus

What compound increases urinary excretion of Calcium (-)? What two compounds decrease urinary excretion of Calcium (+)?

(-) High Na diet

(+) Potassium, Fruits & Veggies

When it comes to Serum Ca, PTH & Calcitriol will ______________ Ca levels, while Calcitonin will ____________ Ca levels

INCREASE

DECREASE

When it comes to Bone Ca, PTH & Calcitriol will ______________ Ca levels, while Calcitonin will ____________ Ca levels

DECREASE

INCREASE

When it comes to Renal Ca, PTH & Calcitriol will ______________ Ca levels, while Calcitonin will ____________ Ca levels

INCREASE

DECREASE

When it comes to Intestinal Calcium absorption, PTH & Calcitriol will ______________ Ca levels, while Calcitonin will ____________ Ca levels

INCREASE

NO EFFECT

What is the most important organ for minerals?

Kidneys

What are the 4 major functions of Calcium?

1) Bone Mineralization

2) Clotting

3) Muscle & Nerve action

4) Metabolic Reaction

99% of Calcium is stored where?

Bones & Teeth

What 5 vitamins are involved in bone mineralization, along with Ca?

Vit A (osteocyte maintenance)

Vit D (Ca abs)

Vit K (protein formation)

Vit C & B6 (Collagen synth)

In the function of clotting, Calcium is involved in formation of what compound?

Fibrin

For muscle & nerve action, Calcium is required for ________, and the release of ________ from the synapse

Contraction & NT release

For metabolic reaction, Calcium is a cofactor for ______ digestion, ______ secretion, and _______

Lipid digestion

Insulin secretion

MMPs

What is the RDAs for Calcium for Men according to age? Women according to age?

Men

<70 = 1000 mg/d

>70 = 1200 mg/d

Women

<50 = 1000 mg/d

>50 = 1200 mg/d

What are the 4 dietary sources of Ca?

1) DAIRY

2) Fish (canned)

3) Tofu (Ca precipitated)

4) Fortified grains, juices, milks

What is the name for Ca deficiency? Ca Toxicity?

Deficiency = Hypocalcemia

Toxicity = Hypercalcemia

What are 4 symptoms of Hypocalcemia?

1) Tetany (muscle spasm)

2) Paresthesia (tingling in extremities)

3) Hyperexcitability of nerves (spontaneous discharge)

4) Osteoporosis (long-term)

Who is most at risk for Hypocalcemia? (4)

- Postmenopausal women

- Women w/ amenorrhea or female athlete triad

- Lactose intolerant patients or milk allergy

- Vegetarians

What are two distinctive signs of Hypocalcemia? What motion/feature does each show?

Trousseau's Sign (Hand like shadow puppet)

Chvostek sign (corner of lips contract w/ tapping)

What are the 5 symptoms of Hypercalcemia?

1) Fatigue

2) Hallucinations

3) Constipation

4) Kidney Stones

5) Ca deposits in soft tissue

What are some causes of Hypercalcemia (6)?

1) High dairy/supplement intake

2) Fat malabsorption

3) Hyperparathyroidism

4) Bone CA sarcoidosis (increased Vit D activation)

5) TB (increased Vit D activation)

What are the 4 major functions of Phosphorus?

1) Structure

2) Energy metabolism (ATP)

3) Signaling

4) Other (Acid-base balance; buffering in kidney)

With Phosphorus function in structure, what 3 things is it a part of?

1) Bone mineralization

2) Part of DNA/RNA backbone

3) Part of phospholipids

With Phosphorus function in signaling, what 3 parts is it involved in?

1) Second messengers (cAMP)

2) IP3

3) Enzyme regulation (kinases/phosphatases)

What are the 5 sources of Phosphorus?

1) Meat

2) Poultry

3) Fish

4) Eggs

5) Dairy

ANIMAL

What is the name for Phosphorous Deficiency? Toxicity?

Hyperphosphatemia = Toxicity

Hypophosphatemia = Deficiency

What are the 2 symptoms of Hyperphasphatemia?

1) Hypocalcemia & Tetany

2) Contracted hand

What are the 3 symptoms of Hypophosphatemia?

1) Bone loss

2) Loss of appetite

3) Weakness (lack of ATP)

With nutritional secondary hyperparathyroidism, it starts with dietary ____ P and _____ Ca. With intestinal absorption, this will ___________ plasma P and ___________ plasma Ca. This leads to ____________ which signals the Parathyroid gland to ________ PTH levels. This increases _______ loss and causes an _________ of Ca levels to restore it.

High P & Low Ca

Increased plasma P

Decreased plasma Ca

Hypocalcemia

Increase PTH

Bone

an efflux of Ca

What are the 2 functions of Magnesium?

1) Bone

2) General metabolism

When it comes to the bone function of Magnesium, it induces _______________ crystal formation, and 30% is found on the surface of the bone to maintain plasma _______ concentrations?

Hydroxyapatite

Mg2+

For the metabolism function of Magnesium, it stabilizes what important structure? This allows it to be a cofactor for what type of enzymes?

ATP

(otherwise negative phosphates will repel eachother)

-- Cofactor for mostly kinases that use ATP or ADP

For the metabolic function of Magnesium, what 4 other functions does it perform?

1) Protein synthesis

2) muscle/nerve function

3) blood glucose regulation (insulin)

4) control of blood pressure

Why is magnesium used to stop pre-term labor?

Calcium channel blocker

(moves Ca back into SR)

-- behaves like muscle relaxer

Magnesium will secrete ________ to help maintain a normal BMR, is required for secretion of __________, and controls the _____________ pump in order to maintain the ____ gradient.

Thyroxine

PTH

Na/K ATPase pump

K gradient

What are the 4 good sources of Magnesium? What are 2 moderate sources?

Good:

1) nuts/seeds

2) whole grains

3) legumes

4) dark green leafy veggies

Moderate:

1) milk

2) tofu w/ Mg precipitate

NOTE: Plant products! (> animal prods)

What salt form of Magnesium is hardest to absorb?

Oxide sulfate

What are the 5 salt forms of Magnesium that are easier to absorb?

Orotate

Citrate

Lactate

Glycinate

Carbonate

What 3 things increase the absorption of Mg?

1) Vitamin D

2) Protein

3) Carbs (fructose)

What 5 things decrease the absorption of Mg?

1) Phytate

2) Fiber

3) Divalent molecules

4) Phosphorus

5) FA in GI

What is magnesium deficiency called? What are the symptoms?

Hypomagnesemia

muscle weakness, tremor, muscle cramps, seizures, tetany, higher BP, tachycardia, irregular heartbeat, headache, irritability, mental confusion

What two mineral deficiencies usually precede tetany in hypomagnesemia?

Hypocalcemia & Hypokalemia

What three categories are most at risk for hypomagnesemia?

1) inadequate intake (elderly/alcoholics)

2) malabsorption

3) excessive excretion

Who is most likely to be magnesium insufficient (subclinical; inadequate)?

Chronic inflammatory conditions

What is magnesium toxicity called? What are the symptoms?

Hypermagnesemia (NONFOOD sources)

Diarrhea/Nausea, flushing, slurred speech, migraine

Who is most at risk for hypermagnesemia?

Patients w/ kidney disease (since main regulator of Mg levels)

What is the major cation in extracellular fluid?

Sodium

What are the 3 major functions of Na?

1) Fluid balance

2) Muscle action

3) Nutrient absorption (biomolecular transport)

With Na's involvement in Fluid balance, it maintains the osmotic pressure w/ what two ions?

K+ and Cl-

With Na's involvement in muscle action, what pump is required for nerve transmission and muscle contraction?

Na/ATPase pump

What are the 5 dietary sources of Na?

1) NaCl (salt)

2) Processed/canned foods

3) condiments

4) cured meats

5) meats/veggies/grains (natural)

What are the SALTY SIX?

1) Bread/rolls

2) Cold cuts/cured meats

3) Sandwich/burger

4) Pizza

5) Canned soup

6) Tacos/Burritos

T/F: Switching to sea salt will significantly improve blood pressure

FALSE

- NOT recommended to drop BP (no evidence; both NaCl & sea salt have 40% Na)

--> also only some forms of sea salt are ionized

What is the name for Sodium deficiency? Sodium toxicity?

Deficiency = Hyponatremia

Toxicity = Hypernatremia

NOTE: HypoNAtremia = Na = Sodium

What are 6 symptoms of Hyponatremia?

1) Muscle cramps

2) Nausea

3) Vomiting

4) Dizziness

5) Coma

6) Seizures

What are 2 risks of Hyponatremia?

1) Excessive sweating

2) Severe trauma (head trauma)

What are 4 symptoms of Hypernatremia? Is there a TUL level, and if so what is it?

1) HTN

2) HYPOcalcemia

3) Osteoporosis

4) Tetany

TUL = NONE

What are 2 risks of Hypernatremia?

1) Elderly (impaired thirst)

2) Kidney disease

Why does hypernatremia cause HYPOcalcemia?

Excessive Na increases Ca excretion (leading to hypocalcemia)

Who would benefit from decreasing sodium intake?

Elderly & HTN decrease Na intake

NOTE: decreasing Na & increasing K may have the most benefit

Salt-sensitivity is MC in what group?

African Americans

What is the major cation in intracellular fluid?

Potassium

What are the two main functions of Potassium?

1) Na/K action

2) K+ channels

When it comes to the Na/K action of potassium, what two functions is it involved in?

1) Maintain osmotic pressure

2) Nerve transmission/muscle contraction

When it comes to the K+ channel action of Potassium, its involved in _____ generation, ________ storage, _________ synthesis, and _________ release.

ATP generation

Glycogen storage

Muscle protein synthesis

Insulin release

What are some sources of potassium?

Fruits and veggies (bananas and oranges, avocado, squash, sweet potato, tomato)

salt substitutes (potassium chloride)

Why is potassium amounts limited in foods?

Increased risk of small intestinal lesions (leaky gut)

What is Potassium deficiency called? What are the 3 major symptoms?

Hypokalemia

1) Cardiac arrhythmias

2) Muscle weakness

3) Respiratory muscle weakness & cardiac arrest

What is Potassium toxicity called? What are the 4 major symptoms?

Hyperkalemia

1) Cardiac arrhythmias

2) Muscle weakness

3) Cardiac arrest

4) Paralysis

NOTE: SAME AS THE DEFICIENCY