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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