MINERALS

Dr. Babiker Mohamed Ali Rahamtalla

1 Department of Community Medicine - FoM - UMST

 Introduction
 Minerals are required in small quantities and constitute only a small
portion of the body weight but enter into the metabolism to a much
greater degree than their mere weight indicates.
 A large portion of the ash of the body is composed of calcium,
magnesium, sodium, potassium, phosphorous, sulphur and chlorine.
 The main functions of the minerals include: providing rigidity and
relative permanence to the bones and teeth; providing essential elements
for the formation and activities of the muscular, glandular; neural, and
epithelial tissues; forming components of enzyme systems; and
providing dynamic characteristics to the intra and extra cellular fluids
for regulation of pH, osmotic pressure and electro-neutrality and those
of secretion and excretions
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 Introduction
 Minerals like zinc, molybdenum, copper, manganese and magnesium
are either structural parts or functionally activate many enzyme
systems. Iodine is a part of hormone, thyroxine.
 Sodium and potassium are important in fluid dynamics and energy
transfer.
 They along with chloride, carbonates and bicarbonates maintain the
acid base balance.
 Some amount of minerals is excreted daily through urine, sweat, skin
and intestinal exfoliations and thus has to be replaced.
 Growing infants, children, pregnant and lactating women require a
higher quantity of some of these minerals to meet the physiological
needs.
 Deficiency, leads to a deranged function of systems and various
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pathological states in extreme conditions.
 Classification
 Minerals can be classified into macrominerals and microminerals.
 Macrominerals also referred to as major minerals are distinguished
from the microminerals by their occurrence in the body.
 Taking this as criterion, various definitions of macrominerals have
evolved, such as “those which constitute at least 0.01% of body weight
(5g in a 60 Kg man)” ; or a more quantifiable and unambiguous
definition like “mineral whose requirement is more than 100mg per
day”.
 Calcium, phosphorous, magnesium, sodium, potassium, chloride and
sulphur are the macrominerals
 As a corollary microminerals or trace elements can be defined as those
comprising less than 0.01% of total body weight or more appropriately
those which are needed in a concentration of less than 1ppm.
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 Classification
 These were initially known as trace because their concentration in
tissues could not be easily ascertained by early analytic methods.
 Classically, iron appears to be the mineral that divides the
macrominerals from microminerals.
 Thus a trace element (or micromineral) can be defined as one that is required by the
body in the concentration equal to or less than that of iron.
 Microminerals include iron, zinc, iodine, copper, manganese,
molybdenum, selenium chromium and flourine.
 Cobalt, nickel, tin, silicon, vanadium, arsenic and boron can be
classified as ultra-trace elements.
 An element is termed ‘essential’ if a dietary deficiency of that element
consistently results in a suboptimal biological function that is
preventable or reversible by physiological amounts of the element.
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 Calcium (Ca)
 Calcium is essential for the building of bones and teeth. It is the most abundant
mineral in the human body. Most is deposited as hydroxyapatite, in bones and teeth.
Constant levels of calcium in the body/plasma is maintained under the influence of
parathyroid hormone and calcitonin. Factors promoting absorption of calcium are
vitamin D, proteins and lactose.
 Rich sources of calcium are milk and milk products, ragi, fish (if eaten whole), dried
fruits such as raisins, apricots and dates, and betel leaves with lime, pulses and tofu.
 Functions are bone formation ,nerve conduction ,blood coagulation and as a
cofactor for a number of enzymes e.g. Lipase.
 Reduction in the level of circulating ionised calcium produces a clinical condition
known as tetany.
 A long term calcium deficiency during the bone formative age can cause stunted
skeletal growth and a low bone density.
 Vitamin D deficiency leads to rickets in children due to poor calcium absorption.
 Osteoporosis results from conditions leading to chronic calcium deficiency.
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 Phosphorus
 The role of phosphorus in bone formation is almost as important as
calcium and so it is a macromineral of extreme value.
 It gets deposited in bones and teeth as calcium phosphate.
 An adult human body contains about 400-700 g of phosphorus as
phosphate mostly in bones and teeth.
 Milk, milk products cereals, meat, fish, nuts, fruits and vegetables are good sources.
 Functions: bone formation, energy metabolism as ATP ,acid base balance and it is
an important constituent of nucleic acids, phospholipids and membranes.
 Phosphorus deficiency is unlikely to occur as it is widely available in
foodstuff. However hypophosphataemia may occur in pathological
conditions (sepsis, liver disease, alcoholism, diabetic ketoacidosis)
patients on prolonged parenteral nutrition, hypophosphataemic rickets
and excessive use of aluminium-containing antacids.
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 Sodium
 Sodium is one of the most abundant minerals present in the human body. An adult
male has total body sodium of about 92-110 g, almost equally divided into the
Extracellular Fluid (ECF) and bone. In the blood and interstitial fluid it is found to
be largely combined with chloride and bicarbonate. Intracellular fluid contains
about a third of the sodium content of the extracellular fluid.
 Common salt (sodium chloride) is the cheapest, best and most widely available
source of sodium.
 Sodium is the main cation in the ECF of human body. It takes an important part in
osmotic processes. It is important in the blood pressure regulation along with
potassium. Acid-base regulation is a function of sodium. It also maintains the
osmotic pressure. Sodium is also a vital component of the electrophysiological
control of muscles and nerves.
 Excessive sweating as in hot and humid climates and extreme exertion, diarrhoea
and dehydration can lead to sodium deficiency. This may be manifested as muscle
cramps and severe dehydration and hypovolemia.
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 Potassium
 The adult human body contains about 250 g of potassium which is twice
the amount of sodium.
 Potassium occurs widely in foodstuffs, so there is little likelihood of its deficiency.
 It is the principal intracellular cation.
 Fruits like melons, apricots, fruit juices, vegetables including potatoes,
pulses, meat and whole grain cereals are good sources.
 Functions are :major intracellular fluid component, acid-base balance
,nerve transmission and muscle action.
 Dietary deficiency is not common.
 However deficiency could be caused by diarrhoea, vomiting,
dehydration, purgatives, chronic acidosis or alkalosis, diuretics, etc.
 Potassium deficiency affects the electrophysiology of cell.
 It may cause cardiac arrhythmias and muscle weakness.
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 Magnesium
 Magnesium has wide ranging body functions.
 The adult body contains about 25 g of the metal and greater part of this
amount is present in bones in combination with phosphate and
bicarbonate.
 Inside the cells, the metal is concentrated within the mitochondria.
 Green vegetables, pulses, meat, nuts and whole grain cereals are good
sources.
 Hard drinking water may make a significant contribution to magnesium
intake.
 Functions as a coenzyme in metabolic reactions and in nerve
conduction.
 Magnesium deficiency leads to apathy and muscular weakness and
sometimes to tetany, convulsions, cardiac arrhythmias and cardiac
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arrest.
 Iron
 It is one of the most important micronutrients and is of fundamental importance to
life. The body of an adult human contains iron equal in weight to a large ‘nail’
(about 4 g), of which more than two thirds (about 2.4g) is present in haemoglobin.
The rest of the iron in the body is present as a reserve store in liver and to a lesser
extent in other organs.
 The sources of iron are meat products, Liver and green leafy vegetables.
 Iron is a component of haemoglobin and myoglobin .Also functions in cellular
oxidation reactions and antibody formation.
 Iron deficiency anaemia is the most common nutritional deficiency in the world.
 It is estimated that up to half of all women and two-thirds of all pregnant women
have anaemia esp. in developing countries.
 Contrary to common belief, the prevalence of anaemia in males is also of a very high
magnitude of about 40%.
 The major cause of iron overload is hereditary haemochromatosis, another cause
could be transfusion overload.
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 Iodine
 Iodine is an essential trace element because it is an integral component of the
thyroid hormones.
 Among the natural foods the best sources of iodine are seafoods and vegetables
grown on iodine-rich soils.
 Dairy products, eggs, cereal grains, legumes and green leaves (spinach) are also
reasonable sources of iodine. Water contains traces of iodine which contributes to as
much as 10% of our total iodine intake.
 Iodine is an integral component of the thyroid hormones thyroxine (T4) and tri-
iodothyronine (T3).
 In addition, the fetus and neonate normal protein metabolism in the brain and CNS
requires iodine.
 The deficiency of iodine leads to various deficiency disorders, commonly termed as
Iodine Deficiency Disorders (IDD) that shows a wide spectrum of picture ranging
from goitre, cretinism, hypothyroidism, infertilty to still births.

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 Fluorine
 It is normally present in the bones and teeth and is essential for the normal
mineralisation of bones and formation of dental enamel.
 The main source of fluorine to man is drinking water.
 The fluoride content of drinking water should be about 0.5 mg/l but in fluorosis
endemic areas, the natural waters have been found to contain as much as 3 to 12 mg
of fluoride/l.
 A concentration of 0.5 to 0.8 mg/l in water is considered a safe limit.
 In temperate climate where the intake of water, is low, the optimum level of fluorine
in drinking water is accepted as 1 mg/l.
 Deficiency of fluoride in water below 0.5 mg/1 is usually associated with dental
caries.
 Ingestion of large amounts of fluorine (>2-3ppm in water) is associated with dental
and skeletal fluorosis.
 Scientists found new form of fluorosis characterized by genu valgum and
osteoporosis of the lower limbs in some countries.
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 Zinc
 Zinc is present in small amounts in all tissues of the body. Total content of the body
is over 2.0 g.
 Zinc is widely distributed in food stuffs of both animal and vegetable origin.
 Good sources of zinc are meat, whole grains and legumes. Its bioavailability in
vegetable foods is poor due to presence of phytates which impair its absorption.
 Zinc functions as: essential enzyme constituent, protein metabolism, immune
function, insulin storage and sexual maturation.
 Severe zinc deficiency results in growth retardation, failure to thrive, delayed sexual
maturation esp. in children.
 Deficiency of zinc impairs cellular immune mechanism while excess of it may
depress neutrophils.
 Zinc deficiency may present as a tetrad of symptoms comprising of neuro-
psychiatric changes, dermal lesions, diarrhoea and alopecia (Acro-dermatitis
Enteropathica).
 Zinc supplementation has been found useful in these conditions
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 Copper
 It is an essential trace element as it is a component of many metallo-enzyme systems
and iron metabolism is closely dependent on it.
 The amount of copper in the adult body is estimated to be 80-100mg.
 Copper is widely distributed in nature and therefore primary copper deficiency in
adults has never been reported in adult man.
 Even poor diets provide enough copper for human needs. Meat, nuts, cereals and
fruits are good sources. Many metalloenzymes which have various functions contain
Copper.
 Copper deficiency is rare. Hypocupraemia occurs in patients with nephrosis,
Wilson’s disease and sometimes in protein energy malnutrition. Neutropaenia is the
commonest documented abnormality of copper deficiency. Infants, especially those
who are premature, may develop copper deficiency which usually presents as
chronic diarrhoea. Neutropaenia and later anaemia develop and they do not
respond to iron.
 Copper deficiency may be a risk factor for coronary heart disease as it has been
associated
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with raised plasma cholesterol levels and heart-related abnormalities.
Department of Community Medicine - FoM - UMST
 Selenium
 There is a resurgence of interest in the mineral selenium due to its antioxidant
properties. It is an essential component of glutathione peroxidase, an important
enzyme. It is present in all body tissues except fat.
 Meat, fish, nuts and eggs are good sources. Lacto-ova vegetarians and vegans may
be at risk of deficiency.
 Selenium is an integral part of over 30 selenoproteins; the most important of which
are glutathione peroxidases and iodothyronine deiodinases.
 It also contributes to antibody responses, the production of eicosanoids as well as
cytotoxicity of natural killer cells.
 Selenium deficiency has a wide range of symptoms, not all attributable to
glutathione peroxidase.
 Its deficiency is associated with increased coronary artery disease. Keshan disease
(endemic cardiomyopathy) in China and Kashin Beck syndrome, an osteo-
arthropathy in children of 05-13 years age is seen in selenium deficient areas

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 Thank you

17 Department of Community Medicine - FoM - UMST