SAS 9: Water and Minerals

Water Quality

● Hard water- water that contains high amounts of minerals such as calcium and magnesium

● Soft water- water replacing water minerals with sodium

Functions of Water

● Water is an important structural component in the body giving shape and rigidity to cells

● Water assists in regulating body temperature

● Water acts as a lubricant in the form of joint fluid and mucous secretions (amniotic sac, spinal cord and eyes)

● Water is a component of blood, lymph, saliva and urine

● Water may supply trace minerals such as fluoride, zinc and copper

● Water also participates as a reactant

Regulation of Fluid and Water in the Body

● The intake of fluids is balanced with the output through urine, sweat, feces, and insensible perspiration.

Homeostasis (physiologic equilibrium)- is maintained by electrolytes that include minerals and blood proteins.

Electrolyte – salt that dissolves in water and dissociates into charged particles called ions

Two important minerals are sodium and potassium.

The extracellular distribution of fluid depends on sodium, potassium influences intracellular water.

Water moves within and between the cells in interstitial fluids in response to the levels of these minerals.

Fluid & Electrolytes

Electrolytes – are minerals that carry electrical charges or ions (particles) when dissolved in water

These minerals separate into cations or anions

The primary extracellular electrolytes in body fluids are sodium (cation) and chloride (anion) and the primary intracellular

electrolyte- potassium (cation)

Moving electrolytes in and out of the cell membrane requires transport proteins

The Na-K pump is a transport protein that works to exchange Na from within the cells to potassium.

Fluid Volume Deficit (FVD)

● A person experiences vascular, cellular or intracellular dehydration

● Severe FVD- when body fluid levels fall by 10% 0f body weight (medical emergency)

● Occur from diarrhea, vomiting, or high fever, sweating, diuretics or polyuria

Characteristics are: (FVD)

● Infrequent urination

● Decreased skin elasticity

● Dry mucous membranes

● Dry mouth

● Unusual drowsiness

● Lightheadedness or disorientation

● Extreme thirst

● Nausea

● Slow or rapid breathing and

● Sudden weight loss.

❖ Older adults and infants are at risk for FVD

Fluid Volume Excess
This is a condition in which a person experiences increased fluid retention and edema.

● Minerals
▪
Provide rigidity and strength to the teeth and skeleton

▪ Serve as a storage depot for other needs of the body

▪ Allow proper muscle contraction and release

▪ Influence nerve and muscle functions

▪ It is associated with compromised regulatory mechanism, excess fluid intake or excess sodium intake

MINERAL CATEGORIES
❖ 16 essential minerals are divided into two categories
1.Major Minerals are needed daily from dietary sources in amounts of 100mg or
higher
2. Trace Minerals are required daily in amounts less than or equal to 20 mg.
Minerals are stable when foods containing them are cooked.

MAJOR: TRACE:
● Calcium Arsenic
● Chloride Boron
● Magnesium Chromium
● Phosphorus Cobalt
● Potassium
Copper
Fluoride
● Sodium
Iodine
● Sulfur Iron
Manganese
Molybdenum
Nickel
Selenium
Silicon
Zinc

1. CALCIUM

❖ Owns the distinction of being the most abundant mineral in the body

❖ 99% - stored in the bones

2 Important Roles:
a. Integral part of bone structure
a. Serves as a Ca bank available to the body fluids if blood Ca drops

Ca in Bone
Calcium salts form crystals on a matrix of the protein collagen
As the crystals become denser, they give strength and rigidity to the maturing bones
Ca in Body Fluids
● 1 percent of calcium circulates in the body fluids as ionized Ca
● Helps regulate muscle contractions, transmit nerve impulses, blood clot, secrete
hormones (parathyroid hormone), digestive enzymes, and neurotransmitters.
● Ca is a cofactor for several enzymes as well.
Hormones that Regulate Ca Balance
● Calcitonin = decreases blood Ca levels
● Parathormone = increases blood Ca levels
● Vitamin D – promotes Ca deposit into the bones.

When hypocalcemia occurs:

Blood Ca levels increase thru:
1. The small intestine absorbs more Ca
2. The bones release more Ca
3. The kidneys excrete less Ca
● Ca Rigor – blood Ca above normal
- muscles contract and cannot relax, hardness/stiffness
● Ca Tetany – blood Ca below normal
-characterized by uncontrolled muscle contraction
Ca+ and Hypertension
● Evidence suggests that Ca may protect against HPN.

DASH diet is not particularly low in sodium, but it is rich in Ca+, as well as K+ and
magnesium.
● Adolescence - 1300mg/day
● 19-50y/0 - 1000mg/ day
● Over 50 y/0 - 1200mg/day
Calcium Sources:

● Milk and milk products = the most abundant source of Ca

● Dairy products (cheese, yogurt,
● Oysters, salmon, small fish
● Vegetables, such as mustard greens, kale, parsley, watercress and brocolli
● Tofu
Factors that hinder CA Absorption
Aging
Binders such as phytic acid and oxalic acid
Dietary fat
Drug use (anticonvulsants, tetracycline, antacids etc)
Excessive phosphorus intake
Laxative use
Sedentary lifestyle

Calcium & Osteoporosis

 ❖ Characterized by reduced density of the bones. Bones become porous and
fragile and fracture easily
❖ A.K.A. Adult Bone Loss

Factors related to the development of Osteoporosis

Nutrition/ Ca intake
Alcohol
Smoking
Caffeine
Sedentary Lifestyle

TOXICITY

Over Supplementation may cause

● Constipation
● Urinary stone formation affecting kidney function and
● Reduced absorption of iron, zinc and other minerals

2. PHOSPHOROUS
❖ 2nd most abundant mineral in the body

❖ 85% - is in our bones and teeth

❖ Part of the body’s buffer systems (phosphoric acid)

The other 15% of phosphorus functions in:
● In energy transfer
● Part of DNA and RNA, the genetic material in every cell
● Component of phospholipids used for transportation and structural
functions
● RDA- 700mg/day for men/women, 19yrs. old and older
Sources are: dairy foods, eggs, meat, fish, poultry and cereal grains,
soft drinks
Ph Deficiency- unknown
Toxicity- possible from Ph supplements cause Ca excretion from the body

3. Magnesium
● RDA- 420mg/day for men, 32omg/day for women
● Sources are: unprocessed foods including whole grains, legumes, broccoli,
leafy green vegetables and hard water
● Magnesium is easily lost from foods during processing, so unprocessed
foods are the best choices.
Magnesium Deficiency
 ❖ Result from vomiting, diarrhea, alcohol abuse or CHON malnutrition, use of
diuretics, who have been fed incomplete fluids IV for too long after surgery
(TPN)
❖ Severe Mg def. – Tetany = an extreme and prolonged contraction of the
muscles similar to Ca tetany.
Mg Toxicity
When taken with Ca supplements will cause diarrhea and dehydration.

4. Sulfur
Present in all CHONs and plays its most important role in shaping strands of CHON,
thiamine and biotin
No DRI- sulfur is found in all CHON containing foods, also no deficiencies develop
Toxicity of sulfur is not a health issue

5. Sodium
● Principal electrolyte in the extracellular fluid (fluids outside the cells), BP and
volume are maintained
● Primary regulator of all body fluids in and out of the cells
● Helps maintain normal fluid & acid-base balance
● Essential to muscle contraction and nerve transmission
● Na RDA

❖ AI- 1,500mg/day adults

❖ 3/4 tsp of salt/day

▪ Too much sodium can contribute to high BP

▪ The more a foodstuff is processed, the higher the sodium content becomes

▪ Processed foods contain not only more sodium, but also less potassium.
Na Food Sources
● Salt, soy sauce, processed foods – highest sodium
● Whole, unprocessed foods, such as fresh fruits and vegetables – lowest
sodium
Na Deficiency
● Headache, muscle weakness, reduced ability to concentrate, loss of memory
and appetite
● Hyponatremia- concern for endurance athletes
● Secondary hyponatremia- neurologic and kidney disorders
Na Toxicity
● Hypertension and edema
DASH diet
Dietary Approaches to Stop HPN:
● Emphasizes fruits, veggies, low-fat dairy products
 ● Which includes whole grains, nuts, poultry, fish
● Calls for reduced intakes of red meat, butter other high-fat foods
● Done in combination with reduced Na intake Potassium
● Principal positively charged ion inside the body cells
● Critical to keeping the heartbeat steady
● The sudden deaths that occur in severe diarrhea and in children with
kwashiorkor or people with eating disorders are likely due to heart
failure caused by potassium loss.

6. POTASSIUM
Adults: 4700mg
K Sources
Whole unprocessed foods
White potatoes with skin
Tomatoes, bananas, oranges
Dairy products, legumes
K Deficiency (Hypokalemia)
● Results more often from excessive losses than from deficient intakes
Arises from:
● DHN
● Prolonged vomiting or diarrhea
❖ Symptoms of deficiency are similar with toxicity, these include muscle
weakness, confusion, loss of appetite, cardiac dysrhythmias
Hyperkalemia (Potassium Toxicity)
● Does not result from overeating of foods high in K+
● Can result from overconsumption of K+ salts or supplements and from
certain diseases or medications
● Potassium injection should not be directly injected into the vein, because it
can stop the heat beating.

7. Chloride
● Major negative ion of the extracellular fluids, where it occurs primarily with Na
● Part of HCL acid = which maintains the strong acidity of the gastric fluids
● RDI- 2,300mg/day for adults
Cl Food Source
salt = major food source
Processed foods = major contributor of Cl to people’s diet
Cl Deficiency
● Would occur from the same circumstances as sodium deficiency
or from excessive vomiting
● Toxicity may occur because of dehydration causing imbalance of chloride to
the other electrolytes.
Trace Minerals
Needed by the body in tiny quantities

8. Iron
● Component of hemoglobin in RBC and myoglobin in muscle cells
 ● Helps them carry and hold oxygen and then release it
● Hemoglobin carries oxygen from the lungs to tissues throughout the body
Myoglobin holds oxygen for the muscles to use when they contract
Vital to the processes by which cells generate energy
Needed to make new cells, amino acids hormones, and neurotransmitters.
Types of Protein Iron
❖ Transferrin = the blood protein that carries the iron to tissues throughout the
body
❖ Ferritin = a special storage protein in the liver, bone marrow, and other
organs.
❖ Liver is the main site of iron storage in the body.

❖ Hepcidine = a hormone produced by the liver that are inversely related to

the efficiency of iron absorption
❖ High blood concentration of the hormone is associated with low iron
absorption.
Fe Deficiency
● Most common nutrient deficiency worldwide
● Depletion of Fe stores

At risk:
▪ Women pregnancy

▪ Infants & young children

Causes of Iron Deficiency
▪ Inadequate intake

▪ Blood loss = is the primary non-nutritional cause

▪ Parasitic infection of the GI tract may lead to blood loss

Iron Deficiency Anemia

❖ Iron deficiency = refers to depleted body iron stores without regard to the
degree of depletion or to the presence of anemia.
❖ Iron deficiency anemia = refers to severe depletion of iron stores that results
in a low hemoglobin concentration.
❖ RBCs are pale and small
Also called microcytic hypochromic anemia

Iron Deficiency Anemia

Manifestations:
Fatigue, weakness, headaches, apathy, pallor, and poor resistance to cold
temperatures
The skin becomes noticeably pale
Dark-skinned person, the tongue and eye lining, will be very pale
Children: irritable, restless, and unable to pay attention
PICA
Craving for non-nutritious or harmful substances, such as ice, clay, paste, grass,
stones, or clothing r/t Fe or Zn deficiencies
A.K.A. Geophagia, clay-eating behavior
Results in Iron or zinc deficiency
Fe Overload
Hemochromatosis
Caused by genetic d/o that enhances Fe absorption
Other causes:
Repeated BT
Massive doses of Fe supplements
Manifestations:
Apathy, lethargy, and fatigue
Fe Poisoning
Toxicity from excess Fe
Rapid ingestion of massive amounts of Fe causes DEATH
Fe Recommendation
Men 19 above: 8mg/day
Women 19-50y/o: 18mg/day
≥50y/o: 8mg/day
Iron absorption from foods can be maximized by two substances that enhance iron
absorption: MFP factor and Vit. C

Some substances can impair iron absorption:

Tannins of tea and coffee
Calcium in milk
Phytates that accompany fiber in legumes and whole-grain cereals.

9. Zinc
● More than 200 enzymes throughout the body depend on it
● Affects our growth process, taste and smell ability, healing process, immune
system and carbohydrate metabolism by assisting insulin function
Needed to produce the active form of Vit. A in visual pigments and is
essential to wound healing, taste perception, the making of sperm, and fetal
development.
Zn Recommendation
RDA
Men: 11mg/day Women: 8mg/day
Zn Sources
Foods high in CHON, such as shellfish, especially oyster, meats, fish, poultry, liver,
whole-grain products, legumes and eggs breast milk is also a good source of zinc for
infants.

Albumin – Zinc’s main transport vehicle in the bloodstream

Zinc Deficiency
Commonly seen in Egypt, Iran, and Turkey where diets are high in fiber and phytate.
Marked by dwarfism, or severe growth retardation, and hypogonadism or
arrested sexual maturation, reduced ability to taste (hypogeusia), and reduced
ability to smell (hyposmia)
Zinc Deficiency
At risk:
Pregnant teenagers need zinc for their own growth as well as the developing fetus.
Vegetarians = increase fiber in the diet may contain phytate
Zn Toxicity
From supplementation produces GI distress leading to vomiting and diarrhea, fever
and exhaustion (similar to flu)
Decreases iron, copper and HDL

10. Iodine
Integral part of the thyroxin, which regulate growth and development, basal
metabolic rate, and body temperature
Iodine Recommendation
RDA: 150mcg/day for men and women
Tolerable Upper Intake Level: 1,100mcg
Iodine Sources
Iodized salt, seafood
Iodine Deficiency
This deficiency reduces thyroxin produced
Goiter = an enlargement of the thyroid gland due to iodine deficiency
Cretinism (mental and physical retardation)
Simple goiter – caused by iodine def
Toxic goiter – caused by a substance called goitrogens ( a substance that suppress
the actions of the thyroid gland)
Foods like cabbage, kale, brussels sprouts, cauliflower, brocolli, and kohlrabi.
Iodine Toxicity
Thyrotoxicosis (hyperthyroidism) with the symptoms sweating, palpitations,
sudden weight loss, tremors, fatigue, muscle weakness

11. Fluoride
❖ Element involved in the formation of bones for mineralization and helps make
teeth resistant to decay
❖ Part of tooth formation
Fluoride Recommendation
RDA
Men: 4mg/day
Women: 3mg/day
F Sources
Fortified water
F toothpaste
Tea, sea food
F Toxicity
Fluorosis = mottling or brown spotting of the tooth enamel from ingestion of too much
fluoride during tooth development
Prevention:
Monitor F content of the local water supply
Supervise children
Use F supplements as ordered
Fluoride Deficiency
Susceptibility to tooth decay

12. Selenium
Assists a group of antioxidant enzymes called glutathione peroxidases
Glutathione peroxidases and Vit. E work together to prevent cell and lipid membrane
damage.
Plays role in converting thyroid hormone to its active form

Se Recommendation
RDA: 55to 70 ug/day
Se Sources
Organ meats
Fish, eggs
Whole grains, vegetables
Se Deficiency
Associated with heart disease. (Keshan disease) in children and young women which
includes cardiomyopathy and heart failure
Se Toxicity
Hair and nail brittleness and loss
Other effects are liver damage, vomiting, and diarrhea

13. Copper
A coenzyme involving antioxidant reaction and energy metabolism
Component of wound healing
A constituent of nerve fiber protection
A required element for iron use
One of the most vital roles is to help cells use iron

Sources:
Organ meats, legumes, whole grains, seafood, nuts, and seeds and water flowing
through copper pipes
Cu Deficiency
Bone demineralization and anemia
Can be caused by zinc toxicity
Copper Toxicity
Some genetic disorders create a copper toxicity
Wilson’s disease (prevent the body from getting rid of copper)
Jaundice, liver cirrhosis, hypoglycemia, brownish-yellow ring around corneo-scleral
junction

14. Manganese
❖ Is a cofactor for many enzymes, helping to facilitate dozens of different
metabolic processes
Mn Toxicity
Seen in miners who inhale large quantities of manganese dust
Causes symptoms of brain disease (dementia and Parkinson’s disease), along with
abnormalities in appearance and behavior.
Mn Recommendation
RDA
Men: 2.3mg/day
Women: 1.6mg/day

15. Chromium
Associated with insulin and required for the release of energy from glucose
Main component of GTF (Glucose Tolerance Factor)
Cr Recommendation
AI
Men(19-50y/o): 35ug/day
(51above): 30ug/day
Women (19-50y/o):25ug/day
(50above): 20ug/day
Other Trace Minerals
Molybdenum - works as a part of several metal-containing enzymes, for
Deficiency and toxicity are unknown
- RDA: 45ug/day

Nickel – important for the health of many tissues

Nickel deficiencies harm the liver and other organs.