Week 11: Minerals

Section 1: Sodium, Potassium, Hypertension (Ch 10)

Section 2: Major Minerals & Bone Health (Ch 11)

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Inorganic elements needed by the body in small amounts
Week 11: Major Minerals Week 12: Trace Minerals or Elements
-required amounts > 100 mg - required in amounts < 100 mg

 Sodium  Iodine
 Potassium  Iron
 Zinc
 Calcium  Copper
 Phosphorus
 Manganese
 Magnesium
 Chromium
 PART 1
 Supporting Documents:  PART 2
 Intro to Minerals  Supporting Documents:
 Water  Zinc-Copper-Iron Interactions

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Section 1: Sodium, Potassium, & Hypertension

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 10.2 Electrolytes: Salts of the Internal Sea
 To maintain fluid balance
 potassium is the major cation in
the cell
 sodium is the major cation
outside the cell
 Na-K-ATPase pump maintains
this balance

Fig 10.13

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10.2 Electrolytes:
Salts of the Internal
Sea

Figure 10.12
Effect of food
processing on
sodium and
potassium

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New DRI: CDRR
 Current DRIs: EAR, RDA, AMDR, UL
 New DRI established 2014-2016: CDRR
 Chronic Disease Risk Reduction Intake
 Methodology:
 Determine the scientific literature to review – emphasis on RCTs and
causal links
 Translate evidence into a recommended intake

 to determine a CDRR for a nutrient that reduces risk with increased intake,
the scientific literature would be reviewed to determine the intake that is linked
to a meaningful reduction in disease risk
 for nutrients that increase risk with increasing intake, an upper limit for a
nutrient can be set, an intake above which the risk of disease noticeably
increases

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Methodologies established for CDRRs
 Test these new methodologies on sodium and potassium
 Why sodium & potassium? Strong link to hypertension
 Also re-assess AIs and ULs for Na & K since first introduced in 2005
 Evaluation of literature since 2005
 Results
 Sodium → establishment of new AI, a new CDRR & elimination of the UL
 Potassium → establishment of new AIs; insufficient evidence to
determine a CDRR

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 Sodium
NEW DRIs OLD DRIs
 Is the only nutrient with a CDRR  UL = 2300 mg
 CDRR = 2300 mg
 Intake above which the risk of disease  AI
noticeably increases  Adults: 19-50: 1500 mg
 Replaces the UL because the old UL was
based on hypertension  Adults: >50-70: 1300 mg
 Adults: >70: 1200 mg
 Sodium has an AI= 1500 mg for all adults
 based on combined assessment:
 1) balance studies: sodium required to
replace losses in urine, feces and sweat
under normal levels of physical activity
 2) intakes in RCTs that examined benefits
of sodium reduction
 3) any evidence of adverse effects of low
sodium
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10.2 Electrolytes: Salts of the Internal Sea
 Critical Thinking: How are Canadians doing with respect to their
intake, from food, of sodium and potassium?

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Potassium
OLD NEW
 AI = 4700 mg  Men: >19 yr: AI= 3400 mg
 Women:> 19 yr: AI = 2600 mg

 To evaluate AIs:  Potassium intake of normotensive

 Population has an adequate intake if > populations in US and Canada
50% of the population has an intake
greater than the AI

 <50% then population intake may or

may not be adequate
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10.2 Electrolytes: Salts of the Internal Sea
 Critical Thinking: How are Canadians doing with respect to their intake,
from food, of sodium and potassium?

Based on AI = 4700 mg Men: >19 yr: AI= 3400 mg

Women:> 19 yr: AI = 2600 mg
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Blood Pressure
 Sodium & Potassium have counterbalancing effects on blood pressure
 Sodium → Increased blood pressure
 Potassium → Decreased blood pressure
 Foods high in calcium, magnesium also lower blood pressure

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10.2 Electrolytes: Salts of
the Internal Sea

 Figure 10.15
Regulation of blood
pressure

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 10.3 Hypertension
 Figure 10.17
 Salt
Sensitivity:

Salt sensitivity
and high
sodium intake
increase blood
pressure

RAAS does not

switch off
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 AI = 1500 mg
CDRR = 2300 mg
Hidden Sodium in Food
 Which has the most sodium?
 A) Whole Grain Carrot Orange Muffins 470 mg

 B) Small bowl of chili 1180 mg

 C) Big Mac 1020 mg

 D) Chipotle Chicken Snack Wrap 680 mg

 E) Garden Veggie pizza slice 1110 mg

 F) Pepperoni pizza slice

1600 mg

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Diets high in potassium can counterbalance the effects of sodium:
 Which has the most potassium?
 A) 1 banana
422 mg

 B) 1% milk (250 ml) 387 mg

AI:
 Navy beans, canned (175 ml) 558 mg Men: 3400 mg
Women: 2600 mg
610 mg
 D)1 baked potato

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Health claim: A healthy diet high in potassium and low in sodium reduces the risk of
high blood pressure, which is a risk factor for stroke and heart disease.
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 Required Reading pg 471-472 (3e) only
 Science Applied: A total dietary
approach to reducing blood pressure

 DASH eating plan

 High in foods that contain
potassium, calcium and magnesium
 High in dairy products and
vegetables
 Be sure you understand the effect of the
DASH plan on blood pressure and the
impact of combining it with reductions
in sodium
 Compare the results from RCTs and
cohort studies on DASH. What
outcomes are measured in each type of
study. Are the results between the two
types of studies consistent?
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https://www.health.harvard.edu/diet-
and-weight-loss/dash-or-mediterranean-
which-diet-is-better-for-you
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Section 2: Major Minerals and Bone Health (Ch
11)
Calcium
Phosphorus
Magnesium

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11.2 Calcium
 Structure to bones and health
 Calcium levels in the blood must be maintained in a very narrow range
 When calcium blood levels are low, calcium is taken from bone
 Over a lifetime → osteoporosis

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 11.2 Calcium
 Fig 11.6
 Calcium
Absorption

1) Vitamin D promotes synthesis of calcium transport proteins

2) Calcium is carried across enterocyte
3) Calcium pump, that requires energy, moves calcium into the blood
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 RDA takes into account the low absorption
11.2 Calcium rates
e.g. if body needs to absorb 300mg/day to
meet needs, then RDA = 1000mg
Absorption Bioavailability
 Infants: 60%  Decreased by tannins, fibre, phytates
 To absorb calcium for bone and oxalates
 Adults: 25-30%  Vegetables low in oxalate are good
 Adults with Vitamin D deficiency: as low sources of calcium
as 10%  kale

 During Pregnancy  collard greens

 Calcium absorption increases so that  turnip greens

RDA for calcium in pregnancy is  mustard greens
unchanged  chinese cabbage

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11.2 Calcium
Fig 11.7 Regulation of blood You don’t need
calcium levels
to know
functions of
+ Vitamin D parathyroid and
calcitonin
hormones.

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11.2 Calcium
 Non-bone related functions of calcium
 Muscle contraction
 Neurotransmitter release
 Required for blood clotting
 Blood pressure regulation
 Observational studies
 Inverse association between calcium intake and colon
cancer
 Hypothesis: Calcium binds with toxins in the colon making
them insoluble and biologically inactive

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11.3 Calcium and Bone Health
 Mineral component of
bone
 Hydroxyapatite
=inorganic matrix
 Ca5(PO4)3OH
 Mineral
 Strength, rigidity
 Protein –collagen
 Organic matrix
 Hydroxyapatite
 deposits on protein
 Flexibility

Fig 11.8 Types of Bone 28

11.3 Calcium and Bone Health
Fig 11.9 Bone
remodelling

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11.3 Calcium and Bone Health
 Osteoporosis
 Loss of both protein (organic matrix) and inorganic
matrix (mineral/ hydroxyapatite) conponents from bone

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11.3 Calcium and Bone Health

Fig 11.10a Which is the healthy bone?

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Case Study
 Margie 75 years old
 “Margie felt a searing pain in her hip when her foot struck the pavement
and the next thing she knew, she was lying in the street.”

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11.3 Calcium and Bone Health

Fig 11.10 b: Bone

mineral density
scan
Which one is
Margie?

Margie

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11.3 Calcium and Bone Health
Cortical bone

Trabecular bone
-crushed

Note decline
in height

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11.3 Calcium and Bone Health

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11.3 Calcium and Bone Health

Accretion:
uptake and
accumulation of “Bones love estrogen”
calcium from
the diet Estrogen stimulates
osteoblast activity

Age-related bone loss

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11.3 Calcium and bone health
 Age-related bone loss
 Osteoclast activity exceeds osteoblast activity

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11.3 Calcium and Bone Health
Maximize peak bone mass when you
are young so you don’t cross the
fracture threshold as you age
Two individuals with
different peak bone mass
Maintain calcium and vitamin D
intake over lifetime to reduce the
rate of bone loss

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11.3 Calcium and Bone Health
 Understanding Osteoporosis in Canada -CaMos
 Bone fractures → 3-4 times more likely to die within a year of fracture
 Immobility → pneumonia → death in 20% of hip fractures
 Loss of muscle mass
 Added stress for individuals already in poor health

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11.3 Calcium and Bone Health
 Preventing and Treating Osteoporosis
 Maximizing dietary calcium & vitamin D
 Reduce the rate of bone loss
 Exercise
 Stress on bone stimulates mineralization

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11.4 Phosphorus
 Deficiency is very rare

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 11.5 Magnesium
 Part of
inorganic
matrix of
bone
 needed for
vitamin D
function

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