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Chapter 8. Water and Minerals: The Ocean Within. Water and Minerals. Minerals Naturally occurring Inorganic Homogenous Chemical elements Major minerals Essential nutrients Found in the body in amounts exceeding 5 grams Trace minerals Essential nutrients

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water and minerals
Water and Minerals
  • Minerals
    • Naturally occurring
    • Inorganic
    • Homogenous
    • Chemical elements
  • Major minerals
    • Essential nutrients
    • Found in the body in amounts exceeding 5 grams
  • Trace minerals
    • Essential nutrients
    • Found in the body in amounts less than 5 grams

With death all that we leave behind is about 5 pounds of minerals

  • The body needs more water per day than any other nutrient
    • You survive a deficiency of any other nutrient for months or years
    • You only survive a few days without water
    • In less than a day, a lack of water alters the body’s chemistry and metabolism
    • Water makes up ≈60% of an adult’s body weight
    • Water is found in--Blood vessels, cells, chemical structure of cells, tissues, organs
    • Water participates in many chemical reactions
Why Is Water the Most Indispensable Nutrient?

Almost a Universal solvent

  • Dissolves amino acids, glucose, minerals, etc. for transport
  • Fatty substances are packaged with water-soluble proteins

Body’s cleansing agent

  • Removes nitrogen wastes, before they build up to toxic levels
  • Kidneys filter wastes and excrete them as urine
why is water the most indispensable nutrient
Why Is Water the Most Indispensable Nutrient?
  • Water resists compression
    • Acts as a lubricant and cushions joints
    • Cushions spinal cord and fetus
    • Lubricates the digestive, respiratory tract, and tissues that are moistened with mucus
    • Keeps pressure on the retina and lens
  • Maintains body temperature
    • Sweat cools the body via the skin, exhaled breath and feces


  • Water balance
    • Intake needs to equal water loss
  • Dehydration
    • Water loss
    • Progression of symptoms: thirst  weakness  exhaustion and delirium  death
  • Water intoxication
    • Dilution of body fluids from excessive water ingestion
    • Symptoms: headache, muscular weakness, lack of concentration, poor memory, loss of appetite
the body s water balance
The Body’s Water Balance
  • Body’s water content
    • Varies by pounds at a time
      • Especially in women who retain water during menstruation
      • High-salt meal leads to water retention
      • Fluctuation in water weight does not reflect gain or loss of body fat
how much water do i need to drink in a day
How Much Water Do I Need to Drink in a Day?
  • DRI meets ≈80% of day’s need for water
    • Men: 13 cups of fluid from beverages and drinking water
    • Women: 9 cups of fluid from beverages and drinking water
    • Remaining water need is met from consumed foods
    • Body produces water from the breakdown of energy-yielding nutrients
how much water do i need to drink in a day10
How Much Water Do I Need to Drink in a Day?
  • Sweating increases water needs
    • Doing physical work outdoors in hot weather
    • An athlete in training
  • Caffeine behaves as a diuretic
    • The results of research is mixed
      • People who habitually consume caffeine may adapt to its diuretic effects
      • An occasional caffeinated beverage can contribute fluid to the body
are some kinds of water better for my health than others
Are Some Kinds of Water Better for My Health Than Others?
  • Hard water
    • High calcium and magnesium concentrations
  • Soft water
    • High sodium concentration
    • There is some evidence that soft water may aggravate hypertension and heart disease
    • Mineral contaminants are more easily dissolved in soft water--Cadmium, lead

EPA is responsible for ensuring that public water systems meet minimum standards for protection of public health

consumer corner bottled water
Consumer Corner: Bottled Water
  • ≈1 in 15 households use bottled water
    • 250-10,000 times the cost of tap water
    • Not safer than tap water
    • ≈25% of bottled water is drawn from the tap
    • FDA tests bottled water
    • Standards substantially less rigorous than those applied to U.S. tap water
body fluids and minerals
Body Fluids and Minerals
  • Cells cannot directly regulate the passage of water across their membranes
  • Water content of cells is regulated by major mineral salts dissolved in body fluids Salts are charged articles (ions) called electrolytes
  • The pumping of salts across their membranes regulates cells’ water balance

What are the salts??????

body fluids and minerals14
Body Fluids and Minerals
  • Salts are composed of charged articles (ions) called electrolytes -potassium chloride, sodium chloride
  • When dissolved particles are separated by a membrane water will flow to the side of greater dissolved particle concentration
  • This is how cells regulate their water content
body fluids and minerals16
Body Fluids and Minerals
  • To control the flow of water, cells must expend energy moving electrolytes from one compartment to another
    • Proteins pump mineral ions across cell membranes
    • The result is fluid and electrolyte balance
body fluids and minerals18
Body Fluids and Minerals
  • A disturbed fluid balance can cause a severe illness
    • In vomiting or diarrhea
      • The loss of water from the digestive tract pulls fluid from between the cells in every part of the body  water is lost from cell interiors
      • Kidneys conserve water by increasing sodium concentrations outside of cells  more water loss from cells
      • Result: fluid and electrolyte imbalance
body fluids and minerals19
Body Fluids and Minerals
  • Minerals play a role in acid-base balance
    • In pure water H+ and OH- ions exist in equilibrium
    • When minerals are dissolved in water
      • Some major minerals give rise to acids; increased H+
      • Other minerals give rise to bases; increased OH-
  • The maintenance of a nearly constant pH is critical to life

How much does the pH of the blood vary?????

body fluids and minerals21
Body Fluids and Minerals
  • Some proteins and some mineral salts act as buffers, molecules that gain or lose H+ ions as needed to correct pH
  • Kidneys help by excreting more or less H+
  • Lungs help by excreting more or less carbon dioxide

(Dissolved in the blood, carbon dioxide forms carbonic acid)

the major minerals
The Major Minerals
  • Calcium
  • Chloride
  • Magnesium
  • Phosphorus
  • Potassium
  • Sodium
  • Sulfate
  • Role
    • Most abundant mineral in the body
    • ≈99% stored in bone and teeth
      • Part of bone structure
      • Bone serves as a calcium reserve, releasing or removing calcium from the blood
      • Minerals of the bone are constantly forming and dissolving
  • Role In Body Fluids
    • ≈1% of calcium is in the fluids outside and within cells
    • Regulates the transport of ions across cell membranes; important in nerve transmission
    • Helps maintain normal blood pressure
    • Essential role in blood clotting
    • Essential for muscle contraction (heartbeat)
    • Secretion of hormones, digestive enzymes, and neurotransmitters
    • Activates cellular enzymes
  • Role of calcium
    • The body maintains a constant calcium concentration in the blood
    • The skeleton serves as a calcium reservoir
    • Blood calcium is regulated by hormones
    • When calcium intake is inadequate normal blood calcium is maintained at the expense of the bones
  • When calcium need increases
    • Calcium absorption from the intestine increases
    • Loss of calcium from the kidneys is reduced
    • Adults absorb ≈25% of dietary calcium
      • Percent increases as dietary calcium decreases
  • Some bone loss is an inevitable consequence of aging
    • By the late 20s or 10 years after adult height is reached, the skeleton no longer adds significantly to bone density
    • After ≈40 years of age, regardless of calcium intake, bones begin to reduce density
      • Loss can be slowed by a diet and physical activity
  • To protect against bone loss, high calcium intakes early in life are recommended
    • A calcium-poor diet during the growing years may prevent achieving peak bone mass
    • Insufficient bone calcium increases the risk of osteoporosis (adult bone loss)
    • Recommended intakes are high for children and adolescents
  • Second most abundant mineral in the body
    • Concentration in the blood is less than half that of calcium
  • Role
    • ≈85% is combined with calcium in the crystals of the bone and teeth
    • Phosphorous salts are buffers that help maintain the acid-base balance of cellular fluids
    • Part of DNA and RNA
    • Phosphorus compounds carry, store, and release energy of energy nutrients
    • Phosphorous compounds assist enzymes and vitamins in extracting the energy from nutrients
    • Forms part of phospholipids
    • Present in some proteins
  • Need and deficiency
    • Needs are easily met by almost any diet
      • Deficiencies are unknown
  • Source
    • Animal protein is the best source
  • Barely qualifies as a major mineral
    • Only ≈1 ounce is present in the body of a 135-pound person
      • Half in the bones
      • The rest in muscles, heart, liver, other soft tissues
      • 1% in body fluids
  • Role
    • Assists in the functioning of more than 300 enzymes
    • Releases energy from energy-yielding nutrients
    • Directly affects the metabolism of
      • Potassium, Calcium, Vitamin D
    • Acts in the cells of all soft tissue
      • Making protein
      • Releasing energy
    • Works with calcium for the functioning of muscles
    • Promotes resistance to tooth decay by holding calcium in tooth enamel
  • Deficiency
      • Inadequate intake, Vomiting, Diarrhea, Alcoholism, Protein malnutrition, Diuretic use
    • Deficiency symptoms are rare in healthy people
  • Toxicity
    • Rare but can be fatal
    • Only occurs with high intakes from Supplements or magnesium salts
    • May occur in older people who abuse magnesium-containing laxatives, antacids, etc.
  • Toxicity symptoms
    • Severe diarrhea
    • Acid-base imbalance
    • Dehydration
  • Positive ion in sodium chloride (table salt)
    • 40% of the weight of sodium chloride
  • Role
    • Fluid balance
    • Electrolyte balance
    • Maintenance of extracellular fluid balance
    • Acid-base balance
    • Muscle contraction
    • Nerve transmission
  • Deficiency
    • No known human diet lacks sodium
      • Most foods include more salt than is needed
    • Body absorbs sodium freely
    • Kidneys filter excess sodium out of the blood into the urine
    • Kidneys will also conserve sodium
    • Small sodium losses occur in sweat
  • Sodium Intake
    • Adults in the U.S. exceed the Tolerable Upper Intake Level by more than a third
    • Asian peoples, whose staple sauces and flavorings are based on soy sauce and MSG, may consume the equivalent of 30 to 40 grams of salt per day
  • Sodium and Blood Pressure
    • Communities with high salt intake experience high rates of hypertension, cardiovascular disease, and cerebral hemorrhage
    • As sodium intake increases, blood pressure rises
      • death from cardiovascular disease increases
    • In salt-sensitive people, the more salt they eat the higher their blood pressure
        • People with diabetes, hypertension, kidney disease
        • People of African descent, those whose parents had high blood pressure, and anyone over the age of 50
  • A dietary approach that may help salt-sensitive and non-salt-sensitive people is the DASH diet
    • This diet often achieves a lower blood pressure than restriction of sodium alone
  • DASH diet
    • Greatly increased intake of fruits and vegetables
    • Adequate amounts of nuts, fish, whole grains, low-fat dairy products
    • Small portions of red meat, butter, and other high-fat foods and sweets
    • Salt and sodium are greatly reduced
  • Low potassium intake raises blood pressure
  • High potassium intake helps prevent and correct hypertension
  • Physical activity also lowers blood pressure
  • Controlling Salt Intake
    • The salt shaker may contribute as little as 15% of total salt consumed
    • Processed and fast foods are the source of nearly 75% of salt in the U.S. diet
  • The main positively charged ion inside the body’s cells
  • Role
    • Maintenance of fluid balance
    • Maintenance of electrolyte balance
    • Maintenance of cell integrity
    • Maintenance of heartbeat
  • Deficiency
    • Causes sudden death

Fasting or severe diarrhea in children with kwashiorkor and people with eating disorders are thought to be due to heart failure caused by potassium loss

  • Low potassium intake
    • Salt-sensitive hypertension becomes worse
    • Metabolic acidity increases
    • Calcium losses from bones accelerates
    • Kidney stone risk increases
  • Potassium intake
    • In healthy people a reasonable diet provides enough potassium to prevent dangerously low blood potassium
    • The typical U.S. diet, with low intakes of fruits and vegetables, provides ≈50% of the DRI
    • The richest sources of potassium are fresh, whole foods
  • Toxicity
    • Potassium from food is safe
    • Over-the-counter potassium chloride pills should not be used except on a physician’s advice
  • Major negative ion in the body
  • Role
    • Accompanies sodium in fluids outside cells
    • Acid-base balance
    • Electrolyte balance
    • Component of hydrochloric acid
  • SourceSalt
  • Deficiency No known diet lacks chloride
  • Role
    • Required for the synthesis of sulfur-containing compounds
      • Antioxidants
      • Thiamin, Biotin
      • Sulfur-containing amino acids (cysteine)
        • Help strands of protein assume their functional shape
        • Skin, hair, and nails
  • DRI-none
  • Deficiencies-Unknown
  • Toxicity
    • From too much sulfate in water contamination
the trace minerals
The Trace Minerals

Role of trace elements – often unknown

  • An obstacle to determining the roles of trace elements is giving an experimental diet lacking the element to humans
  • Most research has been limited to laboratory animals
  • Intake recommendations have been established for nine trace minerals
  • Others are recognized as being essential for some animals but not proven required for humans
  • Role
    • Component of thyroxin
      • Made in the thyroid gland and is responsible for the regulation of basal metabolic rate
  • Deficiency
    • Enlarged thyroid (goiter)
    • Sluggishness
    • Weight gain
  • Severe deficiency during pregnancy
    • Cretinism
      • Irreversible mental and physical retardation of the fetus
      • Can be prevented if the deficiency is detected and treated within the first six months of pregnancy
    • Iodine deficiency is one of the most treatable and preventable causes of mental retardation
  • Sources
    • Seafood
      • Iodine is plentiful in the ocean
    • Iodized salt: less than a half-teaspoon meets an entire day’s recommendation
    • Liberal use of iodized salt in fast-food and other restaurant establishments
    • Bakery products
    • Milk: 1 cup supplies nearly half of a day’s recommended intake
  • Toxicity
    • Like chlorine and fluorine, deadly poison in large amounts
  • Functions
    • Oxygen transport as part of hemoglobin the oxygen-carrying protein of red blood cells and myoglobin the oxygen-holding protein of muscles
    • Cofactor for enzymes
    • Helps many enzymes use oxygen
    • Needed to make
      • New cells
      • Amino acids
      • Hormones
      • Neurotransmitters
  • Food sources
    • Red meats, liver, seafood
  • Deficiency
    • Iron-deficiency anemia
  • Toxicity
    • Poisoning in children
    • Hemochromatosis
  • Iron loss
    • Small amounts in
      • Nail clippings
      • Hair cuttings
      • Shed skin cells
    • Loss from bleeding can be significant
  • Obtaining iron
    • Only ≈10%-15% absorption rate
    • Rate increases with diminished body supply and need (e.g. pregnancy)
    • Decreases when iron is abundant

Iron deficiency

Result of absorption not compensating for losses or low dietary intakes

Iron deficiency anemia

Depletion of iron stores resulting in low blood hemoglobin

  • Symptoms of iron deficiency are often mistaken for behavioral or emotional problems
  • Some symptoms disappear when iron intake improves
  • Causes of Iron Deficiency and Anemia
    • Malnutrition, inadequate iron intake
      • Due to either a lack of food or high consumption of the wrong foods
      • In developed countries: over consumption of foods rich in sugar and fats and poor in other nutrients
  • Non-nutritional causes of anemia
    • Most often: blood loss
      • Due to menstrual loss, women lose 1.5x as much iron as men
  • Causes of Iron Deficiency and Anemia
    • Women are at greater risk of an iron deficiency than men
      • Need more iron-- menstruating and pregnant women have increased iron needs
      • On average, eat less food
    • Infants over 6 months of age, young children, adolescents, have increased iron needs
      • To support growth of new tissue
  • Worldwide, iron deficiency is the most common nutrient deficiency
    • Affecting more than 1.2 billion people
    • In developing countries: parasitic infections of the digestive tract cause people to lose blood daily
    • In the digestive tract, ulcers, sores, and inflammation can cause blood loss
  • In developing countries, almost half of preschool children and pregnant women suffer from iron-deficiency anemia
  • In the U.S., iron deficiency affects 10% of toddlers, adolescent girls, and women of childbearing age
    • The iron status of infants and young children has improved over the last decade
      • Due to increased breastfeeding, which promotes iron absorption, and greater use of iron-fortified infant formula and cereals
      • For low-income families, WIC provides coupons redeemable for foods high in iron
  • Can a Person Take In Too Much Iron?
    • Iron is toxic in large amounts
    • Once absorbed it is difficult to excrete
    • The body defends against iron overload (hemochromatosis) by controlling its entry
      • Intestinal cells trap some of the iron and when these cells are shed the excess iron they collected is lost from the body
      • When iron stores fill up less is absorbed
      • Iron overload has a strong genetic component
    • May occur more often than previously expected
      • Especially among Caucasians
  • In hereditary iron overload, the intestine continues to absorb iron at a high rate despite excess iron building up in body tissues
    • Early symptoms are fatigue, mental depression, abdominal pains
    • Later, tissue damage occurs, with liver failure, abnormal heart beats, diabetes
    • Infections are likely because bacteria thrive on iron-rich blood
  • The danger of iron overload is an argument against high-level iron fortification of foods
    • Susceptible people would have trouble following a low-iron diet if most foods were dosed with iron
    • There is a tendency in the U.S. to take vitamin C supplements, further increasing iron absorption
    • Iron-fortified foods pose no risk for healthy people
  • Iron Recommendations and Sources
    • Vegetarian sources of iron are not well absorbed
    • Vegetarians are advised to obtain 1.8 times the normal requirement
    • To meet iron needs, is best to rely on foods
      • Iron from supplements is not absorbed as well
    • Pregnant women need an iron supplement
    • Iron supplements should be taken when recommended by a physician
    • Iron supplements can reverse iron-deficiency anemia from dietary causes
  • Absorbing Iron
    • Iron occurs in two forms in foods
      • heme iron
        • The iron-containing part of hemoglobin and myoglobin in meat, poultry and fish
        • Heme iron is more easily absorbed than nonheme iron
      • nonheme iron
        • Found in foods from plants
        • Vitamin C can triple absorption of nonheme iron
  • Interference of iron absorption
    • Tannins
      • Found in tea and coffee
    • Calcium and phosphorus
      • Milk
    • Phytates
      • Found in the fiber of lightly processed legumes and whole-grain cereals
    • Black tea reduces iron absorption--people with iron overload are advised to drink it with their meals
Cooking in an iron pan adds iron to food
    • This iron is in the form of iron salts somewhat like those in supplements
    • The iron content of 100 grams of spaghetti sauce
      • Simmered in a glass dish = 3mg
      • Cooked in a black iron skillet = 87mg
  • Role
    • Works with proteins in every body organ
    • Helps nearly 100 enzymes to
      • Make parts of the cell’s genetic material
      • Make heme in hemoglobin
      • Assist the pancreas with its digestive functions
      • Metabolize carbohydrate, protein, and fat
      • Liberate vitamin A from storage in the liver
      • Regulates gene expression in protein synthesis
    • Affects behavior and learning
    • Assists in immune function
    • Assists in wound healing
  • Role (continued)
    • Sperm production
    • Taste perception
    • Fetal development
    • Growth and development in children
    • Produces the active form of vitamin A in visual pigments
  • Deficiency symptoms
    • Adverse affects on growth
    • Alters digestive function
      • Causes diarrhea, worsens malnutrition
    • Impaired immunity
    • Abnormal taste
    • Abnormal vision in the dark
  • Toxic in large quantities
      • In high enough doses, supplements can cause serious illness or death
      • Cause infections
      • High doses can also inhibit iron absorption
  • Zinc and iron are are often found together in foods
    • Food sources never cause imbalances in the body
    • Zinc from lozenges and spray, sold for the treatment of the common cold, may or may not provide the intended relief
      • Contributes supplemental zinc to the body
  • Food Sources
      • Meats
      • Shellfish
      • Poultry
      • Some legumes
      • Whole grain


    • Men: 11 mg/day
    • Women: 8 mg/day
    • Vegetarians are advised to eat a varied diet that includes whole-grain breads leavened with yeast
  • Role
    • Protects body chemicals against oxidative damage
      • Assists a group of enzymes that, in concert with vitamin E, work to prevent the formation of free radicals and prevent oxidative harm to cells and tissues
    • Plays roles in activating thyroid hormone
    • Low blood selenium correlates with the development of some forms of cancer
      • Especially prostate cancer
  • Sources
    • Widely distributed in foods such as
      • Meats
      • Shellfish
      • Vegetables and grains grown in selenium-rich soils
  • Toxicity
    • Long-term supplementation
    • Symptoms
      • Hair loss
      • Diarrhea
      • Nerve abnormalities
    • UL: 400 micrograms/day
  • Not essential to life
  • Only a trace occurs in the human body
  • Role
    • Helps prevent dental caries
  • Sources
    • Primary source: fluoridated drinking water
      • 65+% of U.S. population has access to water with optimal fluoride concentration
      • Rarely present in bottled water
  • Role
    • Works closely with insulin to regulate and release energy from glucose
  • Deficiency
    • Impaired insulin action
    • Supplements cannot cure diabetes
      • Research is being done on the role of chromium supplements in the management of type 2 diabetes
  • Source
    • Widely distributed in the food supply
      • Especially in unrefined foods and whole grains, liver, nuts, cheeses


  • Formation of hemoglobin and collagen
  • its oxygen-handling ability
  • the body’s handling of iron
  • the release of energy


  • Rare
  • Seen in severely malnourished infants fed a copper-poor milk formula
  • Excess zinc interferes with copper absorption and can cause deficiency
  • Symptoms
    • Can severely disturb growth and metabolism
    • In adults can impair
      • Immunity
      • Blood flow through arteries
  • Toxicity
    • Unlikely from foods
    • Can be caused by supplementation
    • UL for adults: 10 mg/day
  • Sources
    • Organ meats
    • Seafood
    • Nuts
    • Seeds
    • Water may supply copper
      • Especially where copper plumbing pipes are used
other trace minerals
Other Trace Minerals


Influences the activity of many enzymes


Functions as a part of several metal-containing enzymes


Works with dozens of different enzymes

other trace minerals94
Other Trace Minerals
  • Cobalt- Part of B12/Cobalamin
  • Nickel- Important for the health of many body tissues
  • Silicon- Bone calcification in animals
  • Future research may reveal key roles played by
    • Barium, Cadmium, Lead, Lithium Mercury, Tin, Vanadium, Arsenic
trace minerals
Trace Minerals
  • Research on trace minerals
    • Uncovering interactions

An excess of one may cause a deficiency of another

        • For example, a slight manganese overload may aggravate an iron deficiency

A deficiency of one mineral may cause another to have a toxic reaction

        • For example, iron deficiency makes the body more susceptible to lead poisoning
food feature meeting the need for calcium
Food Feature: Meeting the Need for Calcium
  • Calcium consumption
    • Average woman consumes one-third of her recommended calcium intake
    • Average man consumes close to three-fourths of recommendation
food feature meeting the need for calcium97
Food Feature: Meeting the Need for Calcium
  • Deficiency
    • Associated with all sorts of major illnesses including
      • Adult bone loss
      • High blood pressure
      • Kidney stones
      • Lead poisoning
    • Consumption of milk, one of the best sources of calcium, has declined
      • While the consumption of beverages such as soft drinks has dramatically increased
food feature meeting the need for calcium99
Food Feature: Meeting the Need for Calcium


  • Milk, Yogurt, and Cheese Group
  • Yogurt, Kefir, Buttermilk, Cheese
    • Especially low-fat or fat-free varieties
  • Ice cream
    • For those who can afford the calories
  • Cottage cheese and frozen yogurt desserts contain about half the calcium of milk
  • Butter, cream, and cream cheese are almost pure fat and contain negligible calcium


Food Feature: Meeting the Need for Calcium

Sources cont’d

  • Add cocoa to milk
    • Sugar adds both sweetness and calories
  • Add fruit to yogurt
  • Make fruit smoothies from milk or yogurt
  • Add fat-free milk powder to any dish
  • Rutabaga, Broccoli, Beet, Collard Greens, Turnip Greens, Bok Choy, Kale Greens, Cabbage, Kohlrabi, Watercress, Parsley, Some Seaweeds
  • Small fish such as sardines and other canned fish their bones are rich sources of calcium
  • One-third cup of almonds supplies ≈100 mg calcium
food feature meeting the need for calcium101
Food Feature: Meeting the Need for Calcium
  • Spinach, Swiss chard, rhubarb
    • Provide little calcium to the body because they contain binders that prevent calcium absorption
  • Spinach good source of
    • Iron, Beta-carotene, and dozens of other essential nutrients and phytochemicals
  • Dark greens good source of
    • Riboflavin --Good for vegans or persons who don’t drink milk
food feature meeting the need for calcium102
Food Feature: Meeting the Need for Calcium

Sources continued

  • Stocks or extracts made from bones
    • Vietnamese tradition of making fish stock from the bones helps account for their adequate calcium intake without the use of milk
  • Calcium-rich mineral water may be a useful source
    • Recent evidence seems to indicate that calcium from mineral water, including hard tap water, may be as absorbable as the calcium from milk
food feature meeting the need for calcium103
Food Feature: Meeting the Need for Calcium

Sources continued

  • Processed Food
    • Soybean curd
    • Tofu
      • Calcium salt is often used to coagulate it
    • Canned tomatoes
      • Firming agents donate about 63 mg/cup
    • Stone-ground and self-rising cornmeal
    • Blackstrap molasses
food feature meeting the need for calcium104
Food Feature: Meeting the Need for Calcium
  • Fortified sources
    • Calcium-fortified orange juice
      • 300 mg/8 ounces
      • Bioavailability is comparable to that of milk
    • Milk fortified with additional calcium
      • 500 mg/8 ounces
    • Soy milk
      • Can be prepared so that it contains more calcium than cow’s milk
    • Supplements
      • While useful are not guaranteed to ward off bone loss
controversy osteoporosis can lifestyle choices reduce the risks
Controversy:Osteoporosis: Can Lifestyle Choices Reduce The Risks?

More than 28 million people in the U.S. suffer from osteoporosis

    • Many of them women
    • Men are not immune to this disease
    • Each year 1.5 million people suffer broken hips , 30% are men
  • As a result of osteoporosis people also suffer breaks of the pelvis, legs, arms, hands, and ankles
  • Causes of osteoporosis
    • Insufficient dietary calcium plays a role
    • Lack of Physical activity
    • Gender
    • Advanced age
    • Genetics
    • Environmental factors
  • Trabecular bone is more metabolically active than cortical bone--Calcium loss begins in mid-twenties for men and women
  • Cortical bone --Calcium is lost slowly and begins at about age 40

As bone loss continues and osteoporosis progresses

Vertebrae may disintegrate, wrists may break, teeth may loosen or fall out, breaks often occur in the hip

  • Causes of Osteoporosis
    • Gender
    • Advanced age
    • Genetics
    • Environmental factors
  • Environmental factors under study for their role in lowering bone density include
    • Poor nutrition
      • Lack of calcium and vitamin D
    • Estrogen deficiency in women
    • Lack of physical activity
    • Use of tobacco and alcohol
    • Possibly: excess protein, sodium, caffeine, soft drinks
    • Inadequate vitamin K intake
    • Underweight
  • Genetics studies include identical twins
    • A study of elderly Finnish twins suggests that fracture rates vary between twin siblings

Your genes may provide an inherited tendency for strong or weak bones

      • But is affected by individual life experiences
  • Risks of osteoporosis differ by race and ethnicity
    • People of African descent have denser bones than do those of northern Europeans
    • Mexican Americans’ bone density falls somewhere between
    • Hip fractures are 3x more likely in 80-year-old white women than in black women of the same age
  • Women who seldom drink milk as children or teenagers
    • Have lower bone density and greater risk of fractures than those who drank milk regularly
  • In childhood, those who avoid drinking milk may be more prone to fractures than their milk-drinking peers
  • Dietary calcium and vitamin D in later years cannot make up for earlier deficiencies
  • Older people take in less calcium and vitamin D than others
    • After about age 65, people absorb less calcium
      • Aging skin is less efficient at making vitamin D
      • go outdoors less
  • Some of the hormones that regulate bone maintenance and calcium metabolism also change with age and accelerate bone mineral withdrawal
  • Gender and Hormones
    • Men have greater bone density than women at maturity
    • Women have greater bone loss during menopause
    • Women account for more than 2/3 of cases of osteoporosis
  • Bone loss is rapid when estrogen drops during menopause
  • Accelerated losses continue for 6 to 8 years following menopause and then tapers off but continues
  • Men produce only a little estrogen, but have less osteoporosis than women
    • Testosterone may play a role
      • Men suffer more fractures after removal of testes or when their testes lose function with aging
  • Physical Activity
    • When people are idle the bones lose strength just as the muscles do
    • Astronauts who live without gravity for days or weeks at a time experience rapid and extensive bone loss
  • Muscle use promotes bone strength
    • The bones of active people are denser than those of sedentary people
    • Hormones that promote synthesis of new muscle tissue also promote the building of bone
    • Flexibility and muscle strength improve balance and help prevent falls

Do weight bearing activities and exercise!!!!!

  • Body Weight-- Heavier body weights and higher body fatness stress the bones and promote their maintenance
  • Tobacco Smoke and Alcohol --cause bones to be less dense
  • Protein Excess --causes the body to excrete calcium in the urine especially when calcium intake is low
  • Sodium, Caffeine, Soft Drinks, Vitamin K, Homocysteine

There is research associated with the effects of each of these substances and their possible link to osteoporosis

  • Homocysteine
    • Elevated blood levels of this amino acid indicates a dietary deficiency of Folate, Vitamin B12, Vitamin B6
  • Netherlands study
    • People with the highest homocysteine levels experienced 2x as many hip and wrist fractures as people with lower levels
  • U.S. study
    • Rate of hip fractures quadrupled in men and doubled in women with the highest homocysteine levels
  • Homocysteine

Not clear if elevated levels contribute to osteoporosis or if it exist as an innocent bystander

  • Magnesium
    • Helps maintain bone density
  • Vitamin A
    • Needed in the bone-making process
    • Too much may be associated with osteoporosis
  • Diagnosis
    • Use of DEXA or ultrasound as well as
    • Men with a family history of osteoporosis and all women should have a bone density test after they reach age 50
  • Medical Treatment
    • Estrogen therapy for non-menstruating women can help prevent further bone loss and reduce the incidence of fracture
      • Such therapy may increase the risks for heart disease and breast cancer
  • Several drugs are available that can help reverse bone loss
    • These drugs inhibit the activities of bone-dismantling cells
  • Calcium Recommendations
    • Adequate calcium nutrition during the growing years is essential to achieving optimal peak bone mass
      • Only 10% of girls and 25% of boys meet the recommendations for calcium during their bone-forming years
  • DRI:
    • 1,300 mg/day for ages 9-18 years
      • Amount of calcium in ≈4 cups of milk
    • 1,000 mg/day through age 50
    • 1,200 mg/day after age 50
  • Calcium should be obtained from foods and beverages
  • Calcium and vitamin D supplements after the age of 50 produce small but beneficial effects on bone mass and fracture rates
  • During the menopausal years, calcium supplements of 1 gram may slow, but cannot fully prevent, bone loss
  • Calcium Supplements
    • Purified calcium compounds
      • Calcium carbonate
      • Calcium citrate
      • Calcium gluconate
      • Calcium hydroxide
      • Calcium lactate
      • Calcium malate
      • Calcium phosphate
      • Calcium with amino acids
  • The UL for calcium is set at 2,500 mg
    • Supplements should provide less than this
      • Foods also provide calcium
    • The Consensus Conference on Osteoporosis recommends milk
    • The American Society for Bone and Mineral Research recommends foods as a source of calcium in preference to supplements
    • The NIH concludes that foods are best and recommends supplements only when the intake from food is insufficient