Lecture 13 Mineral Deficiencies 1

8/16/2019 Lecture 13 Mineral Deficiencies 1

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Consequences of Mineral and

Deficiencies

Part I


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Rule: There is no stronger evidence of a mineral’s necessity than thesymptoms one observes when the dietary levels are below adequacy

Rule: hereas a biomar!er can assess the early consequences of a

deficiency" a pathology that develops as a result of the deficiency is a

defining factor

Rule: #bserving the consequences of a severe omission is secondary in

importance to easing or removing the symptoms upon repletion of the

mineral

$%& '(CT#)* I+ MI+%)(, )%*%)(C-


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$ey 'actors in Mineral Deficiencies

Rule: .nli!e vitamins mineral deficiency symptoms tend to be ambiguous

with the same symptom appearing for more than one mineral

Rule: Many macrominerals have no deficiency signs

Rule: Most of the attention in nutrition is on micro/mineral deficiencies


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Typical *igns of Mineral Deficiencies

01 *tunted growth

21 *!in rash

31 Pigment change

41 (lopecia 5hair loss6

71 Physical stamina

Outward Signs Inward Signs

01 (nemia

21 +eutrapenia

81 *!eletal wea!ness

91 Impaired mobility

1 ,oss of mental acuity

;1 ,ac! of coordination

31 -ematocrit

0pression

0


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Potassium

$


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Potassium Deficiency

? Potassium deficiency is the most common electrolyteimbalance1

? It is more often caused by e>cessive losses than bydeficient inta!es1

? Conditions such as diabetic acidosis" dehydration" orprolonged vomiting or diarrhea can create a potassiumdeficiency1 'or this reason" many physicians prescribepotassium supplements with these potassium/wastingdrugs1

? #ne of the earliest symptoms is muscle wea!ness

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Potassium @ -ypertension

? Diets low in potassium seem to play animportant role in the development of high bloodpressure1

? ,ow potassium inta!es raise blood pressure"whereas high potassium inta!es appear to bothprevent and correct hypertension1

? Potassium/rich fruits and vegetables also

appear to reduce the ris! of stro!e/more so thancan be e>plained by the reduction in bloodpressure alone1

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Calcium

Ca


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Deficiency? ( negative Ca balance occurs when net Ca absorption is unable to replace losses

? The most dramatic symptoms are stunted growth" poor quality of bones and teeth andmalformation of bones

? -ypocalcaemia 5low serum Ca in the blood6 cause the hypere>citability of the nervoussystem

? #steomalacia 5softening of bone6" tetany 5muscle spasms6 and !idney stones are other

calcium related disorders

? #steoporosis occurs when bone resorption e>ceeds formation

Mainly in women

Increases in age

May be related to a low Ca inta!e

Ca


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Calcium Deficiency and Bone

Calcium supplements can help preventosteoporosis" which is a condition that

occurs when bone brea!s down more

quic!ly than it is replaced1 In this

illustration" the bone above is normal"

but the bone below is more porous

and therefore more susceptible tofracture1

Ca


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Magnesium

Mg


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Rule: Aecause of its wide variety of uses in a biological

system" a deficiency in magnesium can lead to a multitude of

biochemical and symptomatic changes1

)ule: (lthough magnesium deficiency is not li!ely to occur inhealthy people" it is still be at the root of many clinical

disorders

Mg


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Defciency Mg


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Mg


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Causes o Defciency•Chronically low intake o Mg•Gastrointestinal system disorders that cause

a loss o Mg or limit Mg absorption

•Excessive loss o Mg in the rine which couldbe due to!

"se o Diuretics# some antibiotics# and somemedicines used to treat cancer

"$lcohol consumption"%oorly controlled diabetes

Mg


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Iron

and (nemia

'e


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01 Iron deficiency 57


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(nemia and pregnancy

)ule: Pregnant women have double the adult requirement

01 Most of the additional iron is transferred to the fetus

#ther Causes of anemia:

01 ,ac! of vitamin A02 or folate

21 Megaloblastic anemia: release of precursors megalo!aryocytes into the blood

31 Pernicious anemia: antibodies to intrinsic factor 5A02 absorption6

41 Aeta Thalassemia: imbalance in the production of alpha and beta subunits of

hemoglobin

71 ,ead poisoning

81 Intrinsic copper deficiency

'e


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Mineral Composition of Mammalian Milk

Calcium 7847 ± 9;

*odium 022 ± 028

Potassium 288; ± 42;

Iron 15 2

Copper 9 ± 2

inc 2;± 8Manganese ;9; ± 383

Mg,iter

after

Reichlmayr-Lais and Kirchgessner

Rat

Calcium 27; ± 7; 00<

*odium 2


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Consequences of n Deficiency

%arly observations

01 *tunted growth

31 *!in rash 5acrodermatitis enteropathica6

More )ecent

01 (poptosis induction

41 Impaired genetic e>pression

n

71 Immune system compromise 5anergy 6

81 Impairment in cognitive development and awareness

21 (rrested se>ual maturation 5hypogonadism)

21 D+( stability

41 -air loss 5alopecia6

31 Malignant transformations


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inc

n


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(merican Eournal of Clinical +utrition" Fol 2


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-n and Skin Ras)

n


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n and Cognitive Development

n is involved in all phases of mental development and function

Testament to this is seen in brain disorders and cognitive development

arrest in malnourished individuals1 These individuals regardless of age

seem to gain bac! their mental acuteness when given supplements of

n1

n


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n from vesicles in presynaptic terminals of certain

glutaminergic neurons modulate postsynaptic receptors for

glutamate1 ,arge amounts of n released from vesicles by

sei=ures or ischemia can !ill postsynaptic neurons1 (cute n

deficiency impairs brain function of e>perimental animals

and humans1 n deficiency in e>perimental animals during

early brain development causes malformations" in later braindevelopment it impairs cognitive function1 This could occurs

in humans1

-arold *andstead

n


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Eames G1 Penland

n supplementation of young children was assessed

in Chinese children 5aged 8/; years6 treated daily with 2< mgn alone 5n6" n plus micronutrients 5nHM6 or

micronutrients alone 5M6 in a double/blind manner for 0< w!s1

In 94< urban children" compared to treatment with M"

treatment with nHM or n was associated with improved

attention 5continuous vigilance tas!6" reasoning 5oddity tas!6

and psychomotor function 5tapping and trac!ing tas!s61 In74< rural children" compared to either M or n alone"

treatment with nHM resulted in greater improvement in

perception 5obect search6" reasoning 5oddity tas!6 and

manual de>terity 5finger tapping61 Compared to M alone" n

alone resulted in greater improvement in memory for both

obects and comple> shapes1

n


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.ffects of -n supplementation on cogniti'e function in )ealt)y middle#

aged and older adults: t)e -.I/& study

Maylor" %(" *impson" %%(" *ec!er" D," Meunier" +" (ndriollo/*anche="

M" Polito" (" *tewart/$no>" A" McConville" C" #JConnor" EM" Coudray" C

Aritish Eournal of +utrition" ;8" 546" 2


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n and Cell *urvival

hy a n deficiency" severe or moderate" is detrimental to cells is aproblems that is yet to be resolved1

It is clear that n is involved in the ebb and flow of nutrients in a cell

that strives to maintain homeostasis as it carries out its essential

functions1

Interrupting the flow of n or adding more free n to the internal milieu

somehow sends a distress signal

Most of the n in a cell is located in the cell nucleus" which bespea!s

strongly for the n as a factor in chromatin stability and genetice>pression

n


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Inadequate dietary n can also lead to lymphopenia

5reduced number of lymphocytes in the blood6 which is a

consequence of impaired lymphopoiesis 5white blood cell synthesis6

related to an increase in apoptosis 5cell death6 among precursor T

and A/cells1 This may reflect chronic production of glucocorticoidsinduced during n deficiency1

+anomoles of free n can induce apoptosis in a variety of

cells1 )elease of n within cells may cause neurological damage and

other situations where cells are under stress1

Pamala E1 'ra!er

Professor

Michigan *tate .niversityn


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n and Malignant Transformation

Combining human and animal studies with cell culture studies hasestablished a lin! between n deficiency and cancer1

Compared with healthy people" n status is compromised in

cancer patients1 (s yet it is not !nown if compromised n status is before

or after the fact1

(ccording to one theory" o>idative D+( damage and chromosome brea!s

that have been reported in animals fed a low n diet lead to an increased

susceptibility to tumor development when e>posed subsequently to carcinogens1

n supplementation beyond a dose of 4< mgday or for long duration at

lower levels may induce cancer

n


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n and the Prostate Gland

n appears to be important for maintaining prostate health" but the precise function of n in the

prostate is un!nown1 'or reasons not yet clear" a normal human prostate accumulates the highest level of

n of any soft tissue in the body1 -owever" cancerous prostates have much less n than normal prostates"

and several studies have implicated impaired n status in the development and progression of prostate

malignancy1 There is also some evidence that increased dietary n is associated with a decrease in the

incidence of prostate cancer1

Chromosomal *tability and n *upplementation

In various cell types changes in intracellular n dramatically affects D+( damage and repair"

and" hence" the ris! of cancer1 uite possibly dietary n deficiency will increase the ris! of o>idative D+(

damage in prostate cells1 n supplements may not only aid in the prevention of cancer" but could also playan important role in limiting its malignancy1 (s an antio>idant and a component of many D+( repair

proteins" n plays an important role in protecting D+( from damage1 n also functions as an anti/

inflammatory agent1 Thus" n supplementation has the potential to target multiple points of the

carcinogenesis cascade1

-ow effective n supplements are in preventing prostate cancer is controversial1 (lthough

several studies have shown that high cellular n levels inhibit prostate cancer cell growth" a recent

epidemiological study showed an increased ris! for prostate cancer in men who too! high/dose nsupplements1 Increased cancer ris! was seen with over 0ic range of n inta!e1 (s with most therapeutics" higher doses do not always equate with an

increase in efficacy1

n


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-inc* infections* and wound )ealing

The immune system is adversely affected by even moderate degrees of n

deficiency1 *evere n deficiency depresses immune function1 n is required for

the development and activation of T/lymphocytes" a !ind of white blood cell that

helps fight infection1 hen n supplements are given to individuals with low n

levels" the numbers of T/cell lymphocytes circulating in the blood increase andthe ability of lymphocytes to fight infection improves1 *tudies show that poor"

malnourished children in India" (frica" *outh (merica" and *outheast (sia

e>perience shorter courses of infectious diarrhea after ta!ing n supplements

52;61 (mounts of n provided in these studies ranged from 4 mg a day up to 4<

mg per day and were provided in a variety of forms 5n acetate" n gluconate"

or n sulfate6 52;61 n supplements are often given to help heal s!in ulcers or

bed sores 53


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Stinky ;inc pro+lem

Is your cologne too strongN If so you

may have a =inc deficiency1

.niversity of Tennessee research

discovered that nearly

Lecture 13 Mineral Deficiencies 1

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