Min trace elements

Minerals and trace elements Dr K N Prasad MD., DNB Community Medicine Seven Food Substances Dietary Fibre Water Minerals Food Substances Proteins Vitamins Fats Carbohydrates Minerals  50 chemical elements are identified  Important for Growth, Development , regulation of vital functions  Major : calcium, Phosphorous, Sodium, Potassium, Magnesium  Minor: Required less than a few milligram per day Ex Iron, Iodine, Fluorine, Zinc, Copper, Cobalt, Chromium, Manganese, Molybdenum, Selenium, Nickel, Tin, Silicon, Vanadium Trace elements  A naturally occurring, homogeneous, inorganic substance required in humans in amounts less than 100 mg/day Bioavailability of minerals are low in vegetarian diet Excess amounts are injurious to health Iron  Adult human body contains 3-4 Gm  60-70% is present in Blood and rest in storage form  Each Gm of Hb contains 3.34mg of Iron Requirement :  mg per day for Male  2.5 mg for Females  3.5 mg for Females in Physiological stress conditions Functions of iron  Iron is a part of all cells and has many different functions  Hb Carries of oxygen to the tissues  Brain development along with Folic acid  Myoglobin Facilitates oxygen use and storage in muscles  An integral part of enzyme reactions in various tissues ( Cyotchromes, Catalases, etc)  Regulation of Body temperature  Catecholamine metabolism  Susceptibility to infection Sources of iron  Haem Iron:  Liver, meat, poultry, Fish  Non Haem Iron:  Cereals, GLV, Legumes,, Nuts, Oil seeds, Dried Fruits, Jaggery  Factors interfere in absorption are enzymes in the food – Phytates, Oxalates, Phosphates, Dietary fibres  Ascorbic acid is the most potent enhancer iron Public Health problem  Categorized as one of the top ten most serious health problems in the modern world (WHO)  As many as 4-5 billion people (66-80% of population) may be iron deficient  billion people (>30% of population) are anemic  Iron deficiency in young children is the rule rather than the exception (from 45 to 70 percent prevalence  Anemia is a fact of life for almost 500 million of women of childbearing age(~40% of 15 to 40 y old females in developing world)  More than 1,000 severely anemic young women die every week in the perinatal period because of inadequate iron status Iron loss In adults – mg per day Menstruating women – mg per day Hemorrhages are common causes IUCD may loss result in blood loss Storage Stored in Liver, Spleen, Bone marrow, Kidneys Iron Deficiency  Occurs in stages:  First Stage: Decreased storage without any other detectable abnormalities  Second Stage: stores are exhausted, serum Ferritin level decreases  Third Stage: Decrease in Hemoglobin percentage  Functional disturbances: decrease in resistance to infection, increase morbidity & mortality, decreased work performances, impaired cell mediated immunity Iodine  Essential Micronutrient  Body normally has 20-30 mg of iodine and more than 75% is in the thyroid gland,  rest is in the mammary gland, gastric mucosa, and blood  it’s only function is related to thyroid Hormone  Required for synthesis of thyroid hormone  Thyroxin (T4) – atoms of iodine per molecule  Triiodothyronine (T3) – atoms of iodine per molecule Requirement per day is 150 micrograms Iodine  Food Sources – 90% intake  Foods of marine origin (seaweed), processed foods, iodized salt  Fresh Water – small & Variable  Small amounts in Milk, meat, Vegetables, Cereals etc Goitrogens occurring naturally in foods can cause goiter by blocking absorption or utilization of iodine (cabbage, turnips, peanuts, soybeans) Iodine - Absorption and Excretion  Iodine is absorbed in the form of iodide  occurs both as free and protein-bound iodine in circulation  iodine is stored in the thyroid where it is used for the synthesis of T3 and T4  hormone is degraded in target cells and in the liver and the iodine is conserved if needed  excretion is primarily via urine  small amounts from bile are excreted in the feces Iodine - deficiency  Goitre—enlargement of the thyroid gland  deficiency may be absolute—in areas of deficiency,  or relative—adolescence, pregnancy, lactation  goiters are more prevalent in women and with increased age  Iodine deficiency is the world’s most prevalent cause of brain damage  Serious iodine deficiency during pregnancy may result in stillbirths, abortions and cretinism  the less visible, more pervasive form of iron & iodine deficiency that lowers intellectual performance at home and school may have far greater global and economic impact Public Health problem of Iodine  By the year 2000,  Global prevalence of iodine deficiency from 30% to 3mg causes flourosis  Foods: Sea fish, cheese, Tea  It is a two edged sword ( deficiency or excess) Zinc  Adult body contains 1.4 to 2.3 gms of Zinc  Plasma level- 96Microgm per 100 ml ( adults), 89 Microgram per 100 ml (children) Functions are  Active role in metabolism of glucose and proteins  Synthesis of insulin by pancreas  Immunity functions Food sources :  meat, milk, fish  Plant sources have low bioavailability Zinc  On of the ten biggest factors contributing to burden of disease in developing countries  Zinc interventions could reduce child deaths globally by 63%  South East Asia and Sub-Saharan Africa highest risk of zinc deficiency:  Inadequate intake – 1/3 of the population  Stunting – 40% of pre-school children  Zinc used as a (part of) curative intervention for severe malnutrition and diarrhoea Zinc deficiency Growth failure Sexual infantilism in adolescents, loss of taste, delayed wound healing, decrease in immunosynthesis Spontaneous abortions, stillbirths, congenital malformations, anencephaly LBW, Intra Uterine deaths, premature labour Requirement is 15mg for men 12 mg for women, 10mg for children Thought for the day An advice is like snow, the softer it falls, the deeper it penetrates and the longer it dwells Thank you [...]... environmental iodine deficiency  Serum T4 is more sensitive indicator among adults Fluorine  It is found in combined forms  96% of fluorides in the body found in bone and teeth  An essential for normal mineralisation of bones and formation of dental enamel Source:  Drinking water : Fluorine in the drinking water is 0.5 mg per ltr Excess of fl > 3mg causes flourosis  Foods: Sea fish, cheese, Tea 