Water and Minerals: The Ocean Within

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Water and Minerals The Ocean Within
Chapter 8
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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
  

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Water

• 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
  bodys chemistry and metabolism
  
• Water makes up 60 of an adults body weight
• Water is found in--Blood vessels, cells, chemical
  structure of cells, tissues, organs
  
• Water participates in many chemical reactions

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• 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
  
• Bodys cleansing agent
• Removes nitrogen wastes, before they build up to
  toxic levels
  
• Kidneys filter wastes and excrete them as urine

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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
  

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Water
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• 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
  

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The Bodys Water Balance

• Bodys 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

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How Much Water Do I Need to Drink in a Day?

• DRI meets 80 of days 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

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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
  

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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

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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
  

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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??????

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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

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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

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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

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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?????

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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)

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The Major Minerals

• Calcium
• Chloride
• Magnesium
• Phosphorus
• Potassium
• Sodium
• Sulfate

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Calcium

• 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

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Calcium

• 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

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Calcium

• 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

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Calcium

• 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

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Calcium

• 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

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Calcium

• 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

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Phosphorus

• 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

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Phosphorus

• Need and deficiency
• Needs are easily met by almost any diet
• Deficiencies are unknown
• Source
• Animal protein is the best source

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Magnesium

• 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

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Magnesium

• 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
  

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Magnesium

• 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

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Sodium

• 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

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Sodium

• 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

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Sodium

• 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

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Sodium

• 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

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Sodium

• 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

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Sodium

• Low potassium intake raises blood pressure
• High potassium intake helps prevent and correct
  hypertension
  
• Physical activity also lowers blood pressure

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Sodium

• 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
  

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Potassium

• The main positively charged ion inside the bodys
  cells
  
• Role
• Maintenance of fluid balance
• Maintenance of electrolyte balance
• Maintenance of cell integrity
• Maintenance of heartbeat

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Potassium

• 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

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Potassium

• 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 physicians advice
  

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Potassium
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Chloride

• Major negative ion in the body
• Role
• Accompanies sodium in fluids outside cells
• Acid-base balance
• Electrolyte balance
• Component of hydrochloric acid
• Source Salt
• Deficiency No known diet lacks chloride

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Sulfate

• 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

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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
  

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Iodine

• 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

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Iodine

• 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

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Iodine

• Sources
• Seafood
• Iodine is plentiful in the ocean
• Iodized salt less than a half-teaspoon meets an
  entire days recommendation
  
• Liberal use of iodized salt in fast-food and
  other restaurant establishments
  
• Bakery products
• Milk 1 cup supplies nearly half of a days
  recommended intake
  
• Toxicity
• Like chlorine and fluorine, deadly poison in
  large amounts
  

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Iron

• 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

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Iron

• Food sources
• Red meats, liver, seafood
• Deficiency
• Iron-deficiency anemia
• Toxicity
• Poisoning in children
• Hemochromatosis

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Iron

• 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

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Iron

• 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
  

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Iron

• 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
  

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Iron

• 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

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Iron

• 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
  

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Iron

• 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

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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

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Iron

• 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

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Iron

• 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
  

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Iron

• 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

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Iron

• 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

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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
  

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• 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

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Zinc

• Role
• Works with proteins in every body organ
• Helps nearly 100 enzymes to
• Make parts of the cells 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

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Zinc

• Role (continued)
• Sperm production
• Taste perception
• Fetal development
• Growth and development in children
• Produces the active form of vitamin A in visual
  pigments

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Zinc

• 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

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Zinc

• 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

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Zinc

• Food Sources
• Meats
• Shellfish
• Poultry
• Some legumes
• Whole grain
• Requirements
• Men 11 mg/day
• Women 8 mg/day
• Vegetarians are advised to eat a varied diet that
  includes whole-grain breads leavened with yeast

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Selenium

• 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

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Selenium

• 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

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Fluoride

• 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

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Chromium

• 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
  

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Copper

• Role
• Formation of hemoglobin and collagen
• its oxygen-handling ability
• the bodys handling of iron
• the release of energy
• Deficiency
• 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

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Copper

• 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

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Other Trace Minerals

• Boron
• Influences the activity of many enzymes
• Molybdenum
• Functions as a part of several metal-containing
  enzymes
  
• Manganese
• Works with dozens of different enzymes

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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
  

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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

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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

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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

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Food Feature Meeting the Need for Calcium

• Sources
• 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
  

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0

• Food Feature Meeting the Need for Calcium
• Sources contd
• 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
  

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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 dont
  drink milk
  

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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

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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

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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 cows milk
  
• Supplements
• While useful are not guaranteed to ward off bone
  loss
  

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ControversyOsteoporosis 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
  

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Osteoporosis

• Causes of osteoporosis
• Insufficient dietary calcium plays a role
• Lack of Physical activity
• Gender
• Advanced age
• Genetics
• Environmental factors

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Osteoporosis

• 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
  

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Osteoporosis

• Causes of Osteoporosis
• Gender
• Advanced age
• Genetics
• Environmental factors

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Osteoporosis

• 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

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Osteoporosis

• 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

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Osteoporosis

• 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

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Osteoporosis

• 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
  

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Osteoporosis

• 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

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Osteoporosis

• 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
  

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Osteoporosis

• 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
  

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Osteoporosis

• 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!!!!!

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Osteoporosis

• 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
  

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Osteoporosis

• 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

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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

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Osteoporosis

• 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

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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

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Osteoporosis

• 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

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Osteoporosis

• 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

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Osteoporosis

• 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

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Osteoporosis

• Calcium Supplements
• Purified calcium compounds
• Calcium carbonate
• Calcium citrate
• Calcium gluconate
• Calcium hydroxide
• Calcium lactate
• Calcium malate
• Calcium phosphate
• Calcium with amino acids

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Osteoporosis

• 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