Minerals, Deficiency Diseases, and the DASH Diet

• Students will learn about diseases and deficiency diseases associated with different minerals.
• Osteoporosis, risk factors, prevention methods, and associated nutrients to be covered
• Learn the principles of the DASH diet and its relationship with blood pressure and the Roles of sodium and potassium in the body.
• Learn about Heme and non-heme iron
• Also learn the food sources, deficiency reasons, roles, toxicity and deficiency symptoms for the minerals.

Minerals

• Minerals remain behind after death, all that is left is minerals (about 2.3kg)
• Minerals are chemical elements, inorganic, and micronutrients
• Minerals don't yield energy

Major and trace minerals classification

• Major minerals are essential nutrients and their required consumption exceeds 5 grams
• Trace minerals are essential nutrients and their required consumption is less than 5 grams

Major Minerals

• Calcium
• Phosphorus
• Potassium
• Sulphur
• Sodium
• Chloride
• Magnesium

Calcium

• Most abundant in the body
• 99% stored in bones and teeth
• Integral part of bone structure
• Bones serve as a calcium reserve
• Bone minerals have constant flux
• It is essential for both bone and teeth formation

Bone formation

• Calcium and phosphorus crystallize on collagen to form hydroxyapatite crystals
• These crystals add rigidity to the bone

Teeth formation

• Fluoride hardens & stabilizes teeth crystals, making enamel resistant to decay
• Fluoride displaces the "hydroxy" part of crystals, making fluorapatite for resistance to bone-dismantling

Calcium and Blood/Bones

• Constant access to calcium is needed, hence the body maintains constant concentration in the blood
• Blood calcium is regulated by hormones, not daily intake
• During inadequate calcium intake, blood calcium is maintained at the expense of the bones

Calcium Need Increased

• Calcium absorption from the intestine increases
  • EX: infants & children ≈60%, pregnant women ≈50% and adults ≈25% of dietary calcium
• The loss of calcium via the kidneys is reduced
• Percent absorbed increases as dietary intake decreases with the help of vitamin D

Bone loss and Aging

• Peak bone mass is reached in the late 20s
• Bone density loss begins at about 40 years of age
• This loss can be slowed by a calcium-rich diet and sufficient physical activity

Bone Loss Protection

• A calcium-poor diet during the growing years may prevent peak bone mass
• Insufficient bone calcium heightens the risk for osteoporosis ("reduction of the bone mass of older persons")
• 1% is in body fluids and is important for muscle contraction, nerve functioning, and blood clotting

Calcium Sources

• Milk and milk products
• Fortified soy beverage and other fortified milk alternative beverages
• Fish with bones (ex. canned salmon and sardines)
• Calcium set tofu
• Broccoli, legumes, and some leafy greens
• Fortified juices
• Canadians do not meet the recommended intakes on average

Calcium Deficiency

• Adults experience bone loss
• Children exhibit stunted growth and weak bones
• Milk consumption has declined
• Soft drink consumption has increased greatly
• Milk alternatives are now often fortified

Milk and Milk Replacements

• Those who do not use milk due to lactose intolerance, preference, dislike or allergy must obtain calcium from other sources (Vitamin D?)
• Children who do not drink milk often had lower calcium intake
• They also often have poorer bone health from not drinking milk

Vegetables and Calcium

• Rutabaga, broccoli, beet greens, collards, and kale are good sources of calcium
• Spinach, Swiss chard, and rhubarb are poor sources of calcium
• Binders in some vegetables inhibit calcium absorption
• Spinach, Swiss chard, and rhubarb Provide little calcium

Spinach benefits

• Still a good food to eat
• Iron-rich and beta-carotene rich
• Includes other essential nutrients and potentially helpful phytochemicals
• Dark greens are superb sources of riboflavin
• they are indispensable for vegans or those who don't drink milk

Calcium Toxicity

• Constipation and kidney stones
• It can interfere with the absorption of other minerals, like iron

Osteoporosis

• Osteomalacia is caused by vitamin D deficiency, which causes overabundance of unmineralized bone protein symptoms:bending of the spine and bowing of the legs, low ratio of bone mineral to bone matrix
• Osteoporosis is a reduction in bone mass, making the bone porous and fragile with a decreased bone mass but a normal ratio minerals-matrix

Osteoporosis Prevalence

• 2 million Canadians are affected
• 1 in 3 women and 1 in 5 men have osteoporotic fractures
• Treatment costs $2.3 billion annually

Osteoporosis: Hip Fractures

• Hip fractures are rarely clean breaks; bone often breaks into fragments
• Hip replacement usually requires major surgery
• Many elderly with hip fractures never walk, live independently again, and 1/5 elderly with hip fractures will die within a year

Osteoporosis Development

• It develops silently until it gives way
• It is called the “silent thief” because of its decreasing bone density
• Break a hip and fall easily

Osteoporosis risk

• Risk factors with a high correlation include:
  • Advanced age
  • Being female
  • Heavy drinking
  • Chronic steroid use
  • Rheumatoid arthritis
  • Being underweight/weight loss
  • Removal of ovaries or testes
  • White race
  • Genetics causing a family history
• Risk factors with moderate correlation include:
  • Chronic thyroid hormone use
  • Smoking
  • Type I diabetes
  • Insufficient dietary calcium and vitamin D
  • Physical inactivity/sedentary lifestyle
  • Excessive antacid use

Osteoporosis:Race/Sex/Hormones

• Black women have fewer hip fractures than white women and a slower rate of bone loss
• Females account for more than 2/3 of osteoporosis cases
• Males have greater bone density than women at maturity
• Females experience greater bone loss during menopause
  • Accelerated losses continue for 6-8 years with menopause, then taper off
• Males produce little estrogen, but resist osteoporosis better than women
• Testosterone may play a role: Reduced testosterone results in more fractures
  • ex. after removal of diseased testes or decreased function with aging

Osteoporosis: Physical activity

• Without physical activity, the bones lose strength
  • ex. Astronauts experience rapid bone loss due to no gravity
• Muscle use seems to promote bone strength
  • Active people have bones that are denser than bones of sedentary people
  • Flexibility & muscle strength gained through physical activity also improve balance & prevent falls
• To keep bones healthy and to prevent falls, include weight-bearing activities every day. Some examples include calisthenics, dancing, jogging, vigorous walking and weight training
• Being underweight or losing weight is connected
• Heavier body weights and higher body fatness stresses the bones and promotes their maintenance, but obesity may a negative effect

Body weight, tobacco/alcohol, and protein effects on osteoporosis

• Bones of smokers are less dense
• Alcohol addicts experience more frequent fractures
• Excess dietary protein causes the body to excrete calcium in the urine
• Sufficient dietary protein is essential to bone health

Sodium effects on osteoporosis

• High sodium intake is associated with urinary calcium excretion
• Lowering sodium intakes seems to lessen calcium losses
• To lower sodium & increase potassium intake choose a diet rich in unprocessed foods like vegetables and fruits or restrict highly processed foods

Caffeine, soft drinks, and Vitamins/Minerals effects

• Heavy consumption of caffeinated beverages link to osteoporosis but are also contradicting evidence
• Soft drinks may have adverse effects on calcium because the high concentration of fructose or phosphoric acid may cause calcium loss
• Displace milk from diet in children and adolescents
• Vitamin K plays important roles in the production of osteocalcin that participates in bone maintenance
• People with hip fractures often have low Vitamin K intakes
• Magnesium helps maintain bone density
• Vitamin A is needed in the bone-remodelling process and too much may be associated with weakening bones

Phosphorus

• The second most abundant mineral in the body
• Majority is found in bones and teeth
• Roles include maintain acid-base balance, part of DNA and RNA, part of the molecules of the phospholipids, metabolism of energy yielding nutrients, and assist many enzymes and vitamins which are extracting energy
• Needs easily met by almost any diet, best source is animal proteins but also found in cola drinks.

Phosphorus Toxicity/Healthcare

• Calcification of soft tissues
• Kidney disease may require a phosphorus-controlled diet.
• Calcium carbonate (Tums) with meals acts as a phosphate binder

Magnesium

• Half of the body's magnesium is in bones
• Remainder is in muscles, heart, liver, and soft tissues
• Only 1% is in the body fluids

Blood Magnesium

• Magnesium can be taken from bones to maintain concentration in the blood
• Kidneys can also conserve magnesium

Magnesium Roles

• Works with calcium for the proper functioning of muscles
  • Calcium promotes contraction
  • Magnesium has to help muscles relax afterwards
• It is in bone mineralization by holding calcium in tooth enamel and allows tooth decay resistance
• Release and use of energy from energy-yielding nutrients assists in the functioning of more than 300 enzymes

Magnesium toxicity/deficiency

• Sources are easily washed and peeled away from foods during processing. Unprocessed foods (or slightly processed foods) are the best sources, as well as nuts, legumes, whole grains, dark green vegetables, seafood, and chocolate
• Magnesium deficiency is a result of inadequate intake, vomiting or diarrhea, alcoholism, or protein energy undernutrition symptoms: Muscle weakness or related to cardiovascular disease, heart attack, or high blood pressure.
• Intakes are often above the EAR but below recommended levels, causing over-deficiency symptoms being rare healthy people

Magnesium Toxicity

• Can be caused by laxatives and antacids, which cause diarrhea and acid base imbalance
• Only occurs with high intakes from nonfood sources like supplements or magnesium salts

Sodium

• Positive ion in sodium chloride
• 40% of sodium chloride weight
• Roles include fluid and electrolyte balance, muscle contraction and nerve transmission, and acid-base balance

Sodium Deficiency

• Diets generally include more sodium than needed
• The strict low-sodium diet for hypertension, kidney disease, or congestive heart failure can deplete the body of sodium
• Vomiting, diarrhea, or extremely heavy sweating can be the cause
• Endurance athletes can lose so much salt and drink so much water and become hyponatremic, which might cause headache, confusion, stupor, seizures, or coma
• The amount of sodium excretion and intake in a day is equal

Body Sodium

• As blood sodium rises, thirst ensures that water is consumed until a sodium-to-water ratio is restored
• Kidneys excrete the extra water along with extra sodium
• Too much salt or water increases weight, but Body salt and water weight can be controlled by controlling sodium intake and increasing water intake

Sodium Intake

• Adequate intake is 1500mg for individuals 14 and up
• Chronic Disease Reduction Risk (CDRR): 2300mg (14 and up)
• Daily value is now 2300mg
• Mean Canadian Intake: 2760mg/day (CCHS 2015)
  • Females 19-30: 2270 mg/day
  • Males 19-30: 3420 mg/day

Hypertension and Sodium

• Salt seems to have a greater effect on blood pressure than sodium or chloride
• Hypertension Canada recommends limiting daily sodium to 2000mg/day

Sodium rich foods

• Canned soup
• Processed cheese
• Deli meat/processed meats/hot dogs
• Dill pickles and olives
• Soy sauce and other condiments

Sodium and blood pressure

• High salt intakes associates with high rates of hypertension, disease, and cerebral hemorrhage
• Blood pressure is in direct correlation with sodium intake
• Greater salt intake is related to higher blood pressure
• Increased blood pressure is related to an increasing risk of death from cardiovascular disease

Sodium/Salt Sensitivity

• Some individuals are more sensitive to the blood pressure-raising effects of sodium: increased salt => increased blood pressure for females, black people, those with decreased estrogen with ageing, people with some genetic variations

Reducing Salt

• Argued that only salt-sensitive people advised to cut down on salt
• Non salt-sensitive people with hypertension unlikely to benefit from limiting
• Weight loss
• Add vegetables, fruits, fatty fish and milk
• and other milk products
• Reduce alcohol
• Increase physical activity

DASH Diet

• Helps salt sensitive and non-salt-sensitive people
• Dietary reduction of sodium alone
• Dietary approaches to stop hypertension (DASH)
  • greatly Increased intake of vegetables and fruits
  • Adequate amounts of nuts, fish, whole grains, low-fat dairy products
  • Occasional small portions of red meat, butter, and other high-fat foods/sweets
  • salt and sodium greatly reduced

Potassium Intake

• With DASH, blood pressure drop responsively
• As well as adequate protein & fibre, the average blood pressure drops even at each level of sodium intake. Sources -> whole grains, fruits, vegetables, seeds, nuts, legumes
• Low potassium raises blood pressure
• High potassium appears to help prevent and correct hypertension
• Physical activity also lowers blood pressure
• Older without clinical hypertension can experience strokes and stress and weaken the heart or it may make kidney problems worse and possibly contribute to stomach cancer

Contol Salt Intake

• Tastes adjust to lower salt intake
• Sodium contributors consist of 15% Unprocessed Foods, 10% Salt, and 75% Processed Foods

Chloride

• The major negative ion in the body
• acid-base balance
• electrolyte balance
• component of hydrochloric acid
• Sources are salt which could be added or naturally occurring
• there is no known diet that lacks chloride

Potassium

• Positivity charged ion inside a cell is made up of fluid balance, electrolyte, and heartbeat maintenance
• Deficiency can cause heart failure and can result from:
  • Fasting
  • Severe diarrhea
  • Kwashiorkor
  • People with eating disorders
  • Dehydration and use of some diuretics can increase
• Hypertension can worsening with low potassium intake

Potassium Facts

• In healthy people, any reasonable diet provides enough potassium to prevent dangerously low blood potassium
• food processing reduces the potasssium in foods. Oranges (juice), bananas, potatoes, tomatoes, avocados, strawberries, spinach and cantaloupes are particulary rich
• Potassium found in food is safe, if injected it can stop the heart. High amounts can be found in salt as a substitute with the only exceptions being with physicians/nurse practitioners/pharmacists
• Kidney Disease, some medicaitons and some diuretics may increase loss

Sulphate Structure

• Required for synthesis of sulphur-containing compounds such as amino acids
• They help stand up protein with hair /nail strength at each sulphate origin
• Protein-containing foods have deficiencies that result in diarrhea

Trace Minerals

• Iodine
• Iron
• Zinc
• Selenium
• Fluoride
• Chromium
• Copper

Iodine

• Necessary for hormone of basal metabolic regulation (thyroxine) in the thyroid
• Deficiencies are an enlarged "trap" of iodine known as goiters because of weight and sluggishness gain during pregnancy
• Severe cases can lead to infant congenitaly hypothyroidism which include irreversible mental and physical developmental delay

Iodine Prevention

• Can be treated with lodine intake. Some sources are sea food or sea weed in plants
• To get a recommendation try 1/2 teaspoon of food/salt, and drink 250 ml of milk that provide half of a daily recommended amount
• Over consumption can cause enlarged thyroids or depressed activity

Iron

• It is a major compenent with protein in myoglobin and blood (hemogoblin) that help oxygenate cell activity in every organ
• The liver helps iron go into red cells sent from marrow which lasts abouts 3-44 weeks until released through iron recyclables
• Can be found throusgh small losses like shaving. Nail clippings, skin and menstruation cycles.

Factors with Deficiency

• They stem from absorption and decrease with iron intake in the body
• Levels of fatgue and work capacity are effected
• One can develop pica eating habbits of substances with inharent contaimaints/ soil with inhebators
• Malnutrion, blood loss and poor eating habits and diet/nutritents are all sources. World wide numbers is 1.2 Billion especially through parasidic infections through preschoolers
• Iron is a power oxidant

Iron Comsumption

• It is highly toxic
• The body limits the absoption using a hormine called hemiciden through cells that collects and excrets/ or not absorb
• Most common amongst causcasian with infections related to bacteria and heart issues.
• Overdose is not recommended for people with a low Iron deficiency cause an accidental posioning

Recommendations

• Eat high in the foods is not enough as adult men rarely have defincy with veggie diet.
• Vegatrian is advised to consuem 1.8X more from Iron foods and a pregant need an iron source to absorp in her body

Types of Iron

• Heme Iron*
• Bound to heme
• Part of hemoglobin & myoglobin in meat, poultry, & fish
• Nonheme Iron*
• Not bound to heme
• Found in foods from plants & meat, poultry, & fish

Iron absorption

• Absorbed better
• Healthy people with adequate stores absorb heme iron at 23%
• People absorb nonheme iron at 2-20%
• Dietary factors/iron stores
• MFP factor

Vitamin C and Iron

• Help absorb iron from food
• found in tea, and coffee
• helps block fibres from legumes to not block iron

Zinc

• Quantity is small, the major sources (protein) help with body organs / enzymes and pancreas with vitals, carbohydrates, protein, fat & Liberation with Immune ,sperm production, fetal and growth development.
• Can cause diarrheic, and immune response impairment as well as poor and unkown healing factors.
• Severe deficicies lead to many underdevloping nations misdiagnosed and vast symptom.

Over Consuming Zinc

• Excess may lead to serious sickness or death reduce blood pressure and blocks iron
• It contains proteins in the body but not used well with animal or legume and whole grain source
• It is related by working with a protein related to Wilson
• Some with the aid of selenium which shares sulphur can help a patient with cancer, or heart disease that can cause selenium deficiney like keshan disease
• Some sournces to be from Meats, shellfish, and Grains but bests are from the China region

Floride

• Helps the benifits to teeth and bone
• From decay deposit
• Replaces hydroxyapatitic and are sourced from drinking water as they are not a nutrirents

Chromium

• Helps regulate inslun with energy glucose and blood as a result.
• There are suplement of this as they cannot be cured
• This can be found from all sorts of grains that are processed

Other Minerials

copper, and arsinic And wilson effects the ability to absoprtion