Mineral Requirements of the Older Adult - Chapter 5
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Transcript of Mineral Requirements of the Older Adult - Chapter 5
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Chapter 5Mineral Requirements of the Older
Adult
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Minerals
• Inorganic• Essential• Regulatory processes• Structural functions
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Minerals
• Major minerals– Electrolytes
• Calcium, phosphorus, magnesium, sodium, chloride, potassium
• Important for action potentials of cells, nerve conduction, and muscle excitation
• Part of metabolism• Body water and blood volume regulation, blood
pH, nerve conduction, and muscle contraction
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Minerals
• Major Minerals– Calcium, phosphorus, magnesium, sodium,
chloride, and potassium– Recommended intakes expressed as
• DRIs, RDA, AI, ULs– Have antioxidant properties– Amounts in food varies– Cannot be destroyed with cooking or processing
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Calcium
• Functions– Maintain structure of bone– Vasodilatation and vasoconstriction– Muscle contraction– Blood clotting– Nerve transmission
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Calcium
• Absorption and Metabolism– Saturable
• Increases calcium uptake
– Nonsaturable
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Calcium• Absorption
– Negative effect• Fiber, oxalic acid, Phytic acid, Caffeine, Fat, and
Phosphorus– Calcium balance
• Urinary loss–Sodium intake–Protein intake
• Calcium intake• Calcium in blood
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Calcium
• Recommendations– 1,200 mg/day– Supplements may be required
• Typical Intakes of Older Adults– NHANES III findings below AI
• Food Sources– Dairy, fortified foods, dark green leafy vegetables,
shellfish, tofu
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Nutrition Facts
• Calcium on Food Labels– Calcium as percent– 40% = 400 mg of
calcium
© Eugene Feygin/Dreamstime.com
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Calcium
• Deficiency– Osteoporosis
• Toxicity– Adverse effects
• Kidney stones, kidney damage, and alteration in absorption or metabolism of other minerals
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Calcium
• Special Considerations– Calcium absorption requires Vitamin D– Osteoclasts are stimulated by Vitamin D– Lactose intolerance considerations
• Lactase– Serum calcium maintained in narrow range
• Parathyroid hormone (PTH)
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Phosphorus
• Hydroxyapatite• Phospholipids• Roles
– As acid-base buffer– In enzymatic reactions– In energy transfer
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Phosphorus
• Absorption and Metabolism– From 55% to 70%– Can be reduced by aluminum-containing antacids
or medications, and by calcium carbonate– Hormone and kidney regulation
• Recommendations– RDA 700 mg/day
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Phosphorus
• Typical Intakes of Older Adults– Generally meet the RDA
• Food Sources– Found in nearly all foods
• Meat, milk products, eggs, grains, legumes, soft drinks
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Phosphorus
• Deficiency– Known only to occur with starvation– Refeeding– Very high intake of aluminum-containing antacids
• Toxicity– Not known to occur in persons with healthy
kidney function• Special Considerations
– Persons with renal disease
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Magnesium
• Roles– Found in the bone– Cofactor for enzyme reactions– Needed for DNA and RNA synthesis– Required for muscle contractions– Maintain cellular ionic balance
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Magnesium
• Absorption and Metabolism– Proportional to the amount ingested
• Recommendations– Men 51 or older – 420 mg/day– Women 51 or older – 320 mg/day
• Typical Intakes of Older Adults– Mean intake ~ 300 mg/day– Varies with calorie intake
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Magnesium• Food sources
– Green leafy vegetables, fruits, grains, nuts– Milk, meat, eggs, shellfish
• Deficiency– Rare
• Toxicity– Occurs only with renal disease
• Special Considerations– Risk of toxicity in those with impaired renal
function
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Sodium
• Roles– Extracellular cation– Required for maintaining extracellular fluid
volume and plasma volume– Membrane potential – Active transport of nutrients
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Sodium
• Absorption and Metabolism– Renin-angiotensin hormonal system
• Recommendations– AI age 51 to 70 years is 1,300 mg/day– AI age older than 70 is 1,200 mg/day
• Typical Intakes of Older Adults– Generally higher than recommendations
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Sodium
• Food Sources– Sodium chloride, or salt
• Processed meats, snack foods, canned soups, cheese, canned fish, salted nuts
• Deficiency and Toxicity– High sodium intake – hypertension– Low blood sodium – hyponatremia
• Special Considerations– Salt sensitivity
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Chloride
• Roles– Anion in extracellular fluid– A main determinant of extracellular volume– Important in digestion
• Absorption and metabolism– Renin-angiotensin hormonal system
• Recommendations– AI for age 51 to 70 is 2.0 g/day– AI for age older than 70 is 1.8 g/day
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Chloride
• Food Sources– Sodium chloride, or salt, salted foods, snack foods,
salted nuts, processed foods
• Deficiency and Toxicity– Attributable to sodium intake
• Special Considerations– Excess vomiting – Diuretics use
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Potassium
• Roles– Main intracellular cation– Role in Cardiac function, neural transmission,
muscular contraction, vascular tone, acid-base metabolism, glucose metabolism
• Absorption and Metabolism– Kidney maintains potassium balance– Serum levels do not reflect potassium status– Large amount in the muscles
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Potassium
• Recommendations– AI for age older than 50 is 4.7 g/day
• Typical Intakes of Older Adults– Generally less than the AI
• Food Sources– Fruits and vegetables, meat and dairy products,
and tea and coffee, can be added as a preservative
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Potassium
• Deficiency and Toxicity– Hypokalemia results from increased potassium
excretion
• Special Considerations– Increased losses through sweat– Diuretics use can increase potassium losses
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Iron
• Functions– Essential for oxygen transport
• Hemoglobin• Myoglobin
– Cellular respiration and metabolism• Cytochromes
– Energy metabolism– Immune function
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Iron
• Absorption and Metabolism– Recycled– Absorbed
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Iron
• Absorption and Metabolism– Stored as ferritin and as hemosiderin– Present in hemoglobin in RBC
• Recommendations– RDA for adults older than 50 is 8 mg/day
• Typical Intakes of Older Adults– Mean intake 14.9 + 36.9 mg/day
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Iron
• Food Sources– Heme iron
• Animal products– Nonheme iron
• Cereal and vegetables
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Iron
• Deficiency and Toxicity– Three stages of deficiency
• Depleted iron stores• Early functional iron deficiency• Iron deficiency anemia
• Special Considerations– Chemotherapy medication– Dialysis patients– Inflammation/infection
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Zinc
• Roles– Catalyst for about 100 enzymes– Structural component in many proteins– Regulator of gene expression– Essential for immune function and growth– Required for normal smell and taste– Required for skin integrity
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Zinc
• Absorption and Metabolism– Higher absorption from meat products– Phytic acid (in vegetables) reduces absorption
• Recommendations– RDA for men older than 51 is 11 mg/day– RDA for women older than 51 is 8 mg/day
• Typical Intakes of Older Adults– Generally meets RDA
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Zinc• Food Sources
– Meat, seafood, whole grains, legumes
• Deficiency– May result in alopecia, dermatitis, and impaired
immune function
• Toxicity– Possible from supplementation
• Special Considerations– Vegetarianism and alcohol may impair absorption
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Copper
• Role– Co-factor in a number of enzymes
• Absorption and Metabolism– Varies with intake– Circulates in blood
• Recommendations– RDA for age 51 and older is 900 mg/day
• Typical Intakes of Older Adults– Generally meets RDA
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Copper• Food Sources
– Organ meats, seafood, nuts, seeds, liver, mixed nuts, peanut butter
• Deficiency– May result in anemia and reduced WBC
• Toxicity– May result from contamination of food or
beverages• Special Considerations
– Supplemental zinc intake or penicillamine decrease copper absorption
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Chromium
• Absorption and Metabolism– Poor absorption– Trivalent chromium is most common form
• Recommendations– AI for men 51 years or older is 30 mcg/day– AI for women 51 years or older is 20 mcg/day
• Typical Intakes of Older Adults– Amount in foods not quantified
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Chromium
• Food Sources– Contamination by stainless steel containers– Food sources: bran cereals, beer, wine, fruits and
vegetables, eggs, meat
• Deficiency and Toxicity– Rare
• Special Considerations– Increased losses in type 2 diabetes
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Selenium
• Roles– As an antioxidant– Role in detoxification
• Absorption and Metabolism– Most that is ingested is absorbed
• Recommendations– RDA for persons over 55 years is 55 mcg/day
• Typical Intakes of Older Adults– Generally meets RDA
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Selenium
• Food Sources– Variable in plants– Found in garlic, broccoli, meat, and seafood
• Deficiency– Not common in the U.S.
• Toxicity– Can result from food sources or supplements
• Special Considerations– Can be linked to Vitamin E
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Aluminum
• Role– No physiologic role– Possible role in Alzheimer’s disease
• Absorption and Metabolism– Small amount is absorbed
• Recommendations– No recommended intake levels
• Food Sources– Water, foods cooked in aluminum cookware
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Aluminum
• Deficiency and Toxicity– Has negative effects on several other minerals– Hypothesized to interfere with normal brain
function
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Molybdenum
• Role– Involved in oxidation and detoxification reactions
• Absorption and Metabolism– Rates from 50% to 93% absorption
• Recommendations– RDA for older than 51 years is 45 mcg/day
• Typical Intake of Older Adults– Unknown
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Molybdenum
• Food Sources– Leafy vegetables, grains, legumes, kidneys, liver,
and milk
• Deficiency and Toxicity– None reported
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Manganese• Role in
– Protein, fat, and carbohydrate metabolism– Enzyme reactions– Bone formation– Normal immune function, reproduction, digestion,
blood clotting• Absorption and Metabolism
– Small amount is absorbed• Recommendations
– AI for men older than 51 is 2.3 mg/day; women 1.8 mg/day
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Manganese
• Typical Intakes of Older Adults– Generally meets AI
• Food Sources– Unrefined grain products, tea, nuts, leafy
vegetables• Deficiency
– Due to poor intake has not been reported• Toxicity
– Due to inhaled manganese dust
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Nickel
• Role– No biochemical role in humans
• Absorption and Metabolism– Typically less than 10%
• Recommendations– No recommendations
• Typical Intakes of Older Adults– Median intake of 80-97 mcg/day
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Nickel
• Food Sources– Mixed dishes and soups, grain products,
vegetables, legumes, desserts, meat
• Deficiency and Toxicity– Not been found in humans
• Special Considerations– Those who are nickel sensitive, or with renal
disease
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Iodine
• Role– Part of thyroid hormones
• Absorption and Metabolism– Almost completely absorbed
• Recommendations– RDA for older than 50 years is 150 mcg/day
• Typical Intakes of Older Adults– Generally higher than RDA
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Iodine
• Food Sources– Dairy products, marine fish, foods grown in
iodine-rich soils, seaweed, some salt
• Deficiency and Toxicity– Early symptoms show as enlarged thyroid
• Special Considerations– Rare in U.S.
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Fluoride
• Role– Bone and teeth structure
• Absorption and Metabolism– About ½ of ingested is absorbed
• Recommendations– AI for men 4 mg/day; women 3 mg/day
• Typical Intakes of Older Adults– Not reported
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Fluoride
• Food Sources– Water and foods or beverages made with
fluoridated water
• Deficiency and Toxicity– Toxicity is called fluorosis in tooth enamel and
bone
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Conclusion
• Major Minerals• Trace Minerals• Mineral requirements for older healthy people• Chronic conditions associated with aging that
alter several mineral intake needs– Osteoporosis– Hypertension– Diminished renal function