NBCD - Macrominerals

Calcium (Ca)

This mineral is important for hydroxyapatite formation of bones and teeth, vitamin B12 absorption, neurotransmission and muscle contraction, blood coagulation and BP control

Calcium

Facilitates the absorption of Fe and Vit B12

Excessive fat intake (formation of insoluble salts), lack of exercise, poor fat digestion, oxalic, phytic acid, Vit D deficiency, caffeine

Factors depressing absorption of Ca

Dietary intake, gastric acidity, Vit D, Lactose, Protein and Phosphorus, Ca:P ratio, Fat in moderation

Factors favoring absorption of Ca

1/3 temporarily stored in the bones

How much of Ca is stored in bones which can be mobilized to maintain normal blood Ca levels?

PTH with Vt D

What favors intestinal absorption and renal reabsorption of Ca

Lysine and arginine

AA that enahces Ca absorption

Ca deficiency

Stunted growth, rickets, osteoporosis, osteomalacia, tetany, hypertension, colon cancer

Chlorine, Sulfur, Phosphorus

Acid-forming minerals that can combine with H+

Na and K

The exchange of these two minerals across the cell membrane is responsible for the transmission of nerve impulse

Ca

Stimulates muscle contraction

Na, K, Mg

Exerts relaxing effect on muscle

Sodium, Potassium, Magnesium , and Calcium

Alkali forming minerals which can combine with OH- ions. They are cations.

False: 99% of the mineral is present in bones and teeth; 1% is distributed throughout the blood and soft tissues (muscle, liver, heart) necessary for metabolic processes

True or False: All 100% of Ca in the body can be found in the bones and teeth as a component of hydroxyapatite crystals and amorphous CaPO4

1200 g

The body of an adult usually contains about how much Ca?

Troponin, calmodulin

Two enzymes working on blood pressure (hemodynamics) control which requires calcium

Acetylcholine

a neurotransmitter that, among its functions, triggers muscle contraction. Regulation via calcium

peak bone mass

the maximum bone density attained at any time in life, usually occurring in young adulthood (20s-30s)

9-11 mg/dL

Normal serum values of calcium to maintain proper function of the cells

1.5:1

Proper Calcium:Phosphorous ratio for infants

1:1

Proper Calcium:Phosphorous ratio for adults

Calcitonin (CT)

Inhibits the breakdown of bone; causes a decrease in blood calcium concentration

parathyroid hormone (PTH)

regulates calcium and phosphorus metabolism by increasing renal reabsorption and intestinal absorption of calcium

Osteoporosis

A condition in which the bones (usually the trabecular bones) become fragile and break easily due to diminished bone density

Phytates, oxalates

Substances found in foods which can decrease bioavailability of calcium and other minerals (Mg, P) by forming insoluble precipitates or salts and thus preventing its absorption

thyroid gland

Parathormone and calcitonin are synthesized in _______________.

Vitamin D

A fat-soluble vitamin, which in tandem with calcium and phosphorous, is necessary for bone calcification. Helps absorption of aforementioned vitamins

Fat

Excess or impaired digestion of this macronutrient can lead to depressed calcium absorption

Rickets

Softening of bones in children associated with impaired calcium homeostasis

osteomalacia

decalcification of bones in adults which lead to bone softening and related deformities

Tetany

reduction in circulating ionized Ca which leads to increased excitability of the nerve and uncontrolled muscular spasms and contraction

Teenagers,

Older women,

Pregnant and lactating women

Physiologic population groups at risk for calcium deficiency

hypercalcemia

Excess of calcium in the blood

Calcium rigor

A state of tonic muscle contraction due to increased calcium levels brought by abnormality in parathyroid functioning

hypercalciuria

Also called renal calculi; stones made from calcium salts

Ca food sources

Milk, milk products, calcium-set tofu (bean curd), legumes, spinach, chinese cabbage, kale, broccoli, alamang, shellfish and crustacean, leafy veggies and dried beans

Magnesium

A divalent cation which competes with calcium and phosphorous for absorption

Na

Essential to ensure optimum phosphorus absorption

1000 mg/day

RNI on calcium for Filipinos aged 10-18, or pre-adolescents to adolescents, based on PDRI 2015

Dairy products, small fishes, shellfishes and cream

Rich sources of calcium according to the NGF 2012

Phosphorus

The prinicipal intracellular anion. Essential component of ATP, nucleic acids, and phospholipids. Acts as cofactor in a number of enzyme systems involved in CPF metabolism; involved in renal excretion of H+ ions

80%

How much of Phosphorus is found in bone as calcium phoshpate and hydroxyapatite?

Function of Phosphorus

Calcification of bones and teeth, metabolism of E, absorption and transport of nutrients; regulation of acid base balance, essential component of ATP, coenzymes and some Vitamins

Phosphatases

Intestinal enzymes which releases phosphorous from food or dietary sources

Hyperphosphatemia

Excess of phosphorous in the blood. Associated with hypocalcemia since excess phosphates interfere with calcium

1250 mg/day

RNI on phosphorous for Filipinos aged 10-18, or pre-adolescents to adolescents, based on PDRI 2015

Aluminum & strontium

Minerals which bind to phosphorous rendering it unavailable for absorption

Nonabsorbable antacids

A group of drugs, which when take excessively, known to be associated with phosphorous deficiency

Phosphorus deficiency

muscular weakness, bone pain, anorexia, malaise

Hyperphosphatemia

excessive phosphate in the blood; associated with certain disease states such as hypoparathyroidism or chronic renal failure; often associated with hypocalcemia since excessive phosphate interferes with ca utilization; symptoms: tetany and convulsions

Dairy and protein foods

Richest source of phosphorous

Magnesium

The second most abundant cation in the intracellular fluid of the body. High intakes of such are said to be cardioprotective. Also found in bones.

True

True or False: half of the body's Mg is in the bones, the rest is found in muscle; 1 % is in the ECF

jejunum and ileum

Where is Mg absorbed?

Active transport

The absorption mechanism of magnesium at low levels; transported by specific carrier and vit D-sensitive transport system

Passive diffusion

The absorption mechanism of magnesium at high levels

low magnesium tetany

Tetany associated with low plasma magnesium: irritability, nervousness, and convulsions due to overstimulated nerves and increased muscular contraction

Mg Deficiency

hypocalcemia, hypokalemia, affects GI, neuromuscular, cardiovascular, and hematologic systems, dysphagia, anemia, cardiac arrhythmia, tremors, weakness, failure to thrive, and psychiatric disturbances may be present

Mg toxicity

Nausea, vomiting, flushing may manifest, severe cases may lead to paralysis, cardiac arrest and death

Hypermagnesemia

Results in hypotension and may cause decreased tendon reflexes

4 mg/kg

Requirement per body weight/day for magnesium for adults

Renal failure

Clinical condition (disease) associated with increased risk for magnesium toxicity due to the decreased ability to metabolize and excrete Mg

Green leafy vegetables, chocolate, cocoa

Good sources of magnesium

All protein-containing food

Rich source of sulfur

Sulfur

a mineral present in the body as part of some proteins, amino acids (met, cys) and vitamins (B1, B5, and B7); particularly found in cartilage and keratin of skin, nails, and hair

Met, Cysteine and Cystine

S-containing AA

Sulfur

A constituent of vitamins B1, B5, and biotin, vitamin-like lipoic acid, insulin, heparin, glutathione, and coenzyme A

Severe protein deficiency

Sulfur deficiency occurs only in times where this macronutrient deficiency occurs

Excessive sulfur-containing amino acids intake

Only factor which leads to sulfur toxicity

Sodium

Major cation ECF

True

True or False: 50% of the total body sodium is found in the ECF, 40% in the skeleton, and 10% inside the cells

Sodium Functions

Maintenance of normal ECF balance;

Maintenance of normal pH value of ECF;

Needed in the absorption of glucose and in the transport of nutrients

Aids in nerve impulse transmission and muscular contraction

Sodium (Na+)

facilitates absorption of CHO

Renin-angiotensin-aldosterone system (RAAS) and sympathetic nervous system

Two systems which regulate the concentration of sodium in the ECF

Sodium food sources

Salt, soy sauce, and processed foods, milk, dairy, meat, fish (ocean fish), seafood, poultry, and eggs

sodium deficiency

muscle cramps, mental apathy, loss of appetite, persistent vomiting or diarrhea, coma

Hyponatremia

deficient sodium in the blood; caused by heavy sweating or diuretic therapy

Osteoporosis

Bone condition which can manifest with sodium toxicity

Potassium (K+)

Major intracellular cation; involved in regulating water and acid-balance together with Na

~250 g

Amount of K+ concentrated in the ICF

Potassium Function

Cell integrity; participates in many biochem rxns; maints normal fluid balance; maints acid-base bal; act along with Mg as a muscle relaxant

Potassium

Important in the release of insulin by the pancreas

Diffusion

Potassium is absorbed in the intestines by

Potassium

The level of this mineral in the blood is carefully maintained because if it rises more than 3-4x above normal, the beating fo the heart will cease and may lead to death

Active transport mechanism

The mechanism which permits the entry of potassium (against concentration gradient) into the cell

Protein energy malnutrition

Form of undernutrition which may result to potassium deficiency

Potassium Deficiency

Muscular weakness, paralysis and confusion and cardiac arrythmia, heart may develop a gallop rhythm

Prolonged vomiting or diarrhea, regular use of certain drugs, severe PEM

At risk for K+ deficiency

K+ toxicity

muscular weakness, vomiting, cardiac arrest

potassium food sources

Citrus fruits and dried fruits, Bananas, Watermelon, Potatoes, Legumes, Tea, Peanut butter, and Spinach

Surgery

A procedure which may result to potassium deficiency

Fresh, unprocessed food

Food items considered as richest sources of potassium

Chloride (Cl-)

Major extracellular anion. A constituent of hydrochloric acid which maintains gastric acidity

Function of Cl-

Maintains normal fluid and electrolyte balance; a constituent of hydrochloric acid which maints the strong acidity of the stomach

GI tract

Cl- is readily absorbed in the ______

chloride food sources

Salt, soy sauce, meat, seafood, milk

Chloride toxicity

Some symptoms include vomiting causing dehydration