Minerals

Minerals perform several vital functions which are absolutely essential for the
very existence of the organism. These include calcification of bone, blood
coagulation, neuromuscular irritability, acid-base equilibrium, fluid balance and
osmotic regulation.

The minerals are classified as principal elements and trace elements.

The seven principal elements (macro- minerals) constitute 60-80% of the

body’s inorganic material. These are calcium, phosphorus, magnesium,
sodium, potassium, chloride and sulfur.

The principal elements are required in amounts greater than 100 mg/day.

The (microminerals) are required in amounts less than 100 mg/day. They are
subdivided into three categories

1. Essential trace elements : Iron, copper, iodine, manganese, zinc,

molybdenum, cobalt, fluorine, selenium and chromium.

2. Possibly essential trace elements : Nickel, vanadium, cadmium and barium.

3. Non-essential trace elements : Aluminium, lead, mercury, boron, silver,

bismuth etc.

Calcium
Calcium is the most abundant among the minerals in the body. The total
content of calcium in an adult man is about 1 to 1.5 kg.

Biochemical functions

1. Development of bones and teeth : Calcium, along with phosphate, is required

for the formation (of hydroxyapatite) and physical strength of skeletal tissue.
Bone is regarded as a mineralized connective tissue. Bones which are in a
dynamic state serve as reservoir of Ca.

2. Muscle contraction : Ca2+ interacts with troponin C to trigger muscle

contraction. Calcium also activates ATPase, increases the interaction between
actin and myosin.

3. Blood coagulation : Several reactions in the cascade of blood clotting process

are dependent on Ca2+(factor IV).
4. Nerve transmission : Ca2+ is necessary for the transmission of nerve impulse.

5. Membrane integrity and permeability : Ca2+ influences the membrane

structure and transport of water and several ions across it.

6. Activation of enzymes : Ca2+ is needed for the direct activation of enzymes

such as lipase (pancreatic), ATPase and succinate dehydrogenase.

7. Calmodulin mediated action of Ca2+ : Calmodulin (mol. wt. 17,000) is a

calcium binding regulatory protein. Ca-calmodulin complex activates certain
enzymes e.g. adenylate cyclase, Ca2+ dependent protein kinases.

8. Calcium as intracellular messenger : Certain hormones exert their action

through the mediation of Ca2+ (instead of cAMP). Calcium is regarded as a
second messenger for such hormonal action e.g. epinephrine in liver
glycogenolysis. Calcium serves as a third messenger for some hormones e.g.
antidiuretic hormone (ADH) acts through cAMP, and then Ca2+.

9. Release of hormones : The release of certain hormones (insulin, PTH,

calcitonin) from the endocrine glands is facilitated by Ca2+.

10. Secretory processes : Ca2+ regulates microfilament and microtubule

mediated

processes such as endocytosis, exocytosis and cell motility.

11. Contact inhibition : Calcium is believed to be involved in cell to cell contact

and adhesion of cells in a tissue (Refer p. 692 also). The cell to cell
communication may also require Ca2+.

12. Action on heart : Ca2+ acts on myocardium and prolongs systole.

Dietary requirements

Adult men and women — 800mg/day

Women during pregnancy, lactation and post-menopause =1.5gm/day

Best sources Good sources

Sources

Milk and milk products , Beans, leafy vegetables, fish, cabbage, egg yolk.
 Absorption

Factors promoting Ca absorption

1. Vitamin D (through its active form calcitriol) induces the synthesis of calcium
binding protein in the intestinal epithelial cells and promotes Ca absorption.

2. Parathyroid hormone enhances Ca absorption through the increased synthesis

of calcitriol.

3. Acidity (low pH) is more favourable for Ca absorption.

4. Lactose promotes calcium uptake by intes- tinal cells.

5. The amino acids lysine and arginine facilitate Ca absorption.

Factors inhibiting Ca absorption

1. Phytates and oxalates form insoluble salts and interfere with Ca absorption.

2. High content of dietary phosphate results in the formation of insoluble calcium

phosphate and prevents Ca uptake. The dietary ratio of Ca and P—between 1 : 2
and 2 : 1—is ideal for optimum Ca absorption by intestinal cells.

3. The free fatty acids react with Ca to form insoluble calcium soaps. This is
particularly observed when the fat absorption is impaired.

4. Alkaline condition (high pH) is unfavourable for Ca absorption.

5. High content of dietary fiber interferes with Ca absorption.

Hypocalcemia

Hypocalcemia is a more serious and life threatening condition. It is characterized

by a fall in the serum Ca to below 7 mg/dl, causing tetany. The symptoms of
tetany include neuromuscular irritability, and convulsions.

Hypocalcemia is mostly due to hypopara-thyroidism. This may happen after

an accidental surgical removal of parathyroid glands or due to an autoimmune
disease.

Rickets

Rickets is a disorder of defective calcification of bones. This may be due to a low

levels of vitamin D in the body or due to a dietary deficiency of Ca and P — or
both. The concentrations of serum Ca and P may be low or normal. An increase
in the activity of alkaline phosphatase is a characteristic feature of rickets.

Renal rickets

Renal rickets is associated with damage to renal tissue, causing impairment in the
synthesis of calcitriol. It does not respond to vitamin D in ordinary doses,
therefore, some workers regard this as vitamin D resistant rickets. Renal rickets
can be treated by administration of calcitriol.

Osteoporosis is characterized by deminera-lization of bone resulting in the

progressive loss of bone mass.

Phosphorus

An adult body contains about 1 kg phosphate and it is found in every cell of the
body. Most of it (about 80%) occurs in combination with Ca in the bones and
teeth.

Biochemical functions

1. Phosphorus is essential for the development of bones and teeth.

2. It plays a central role for the formation and utilization of high-energy phosphate
compounds e.g. ATP, GTP, creatine phosphate etc.

3. Phosphorus is required for the formation of phospholipids, phosphoproteins

and nucleic acids (DNA and RNA).

4. It is an essential component of several nucleotide coenzymes e.g. NAD+,

NADP+, pyridoxal phosphate, ADP, AMP.

5. Several proteins and enzymes are activated by phosphorylation.

6. Phosphate buffer system is important for the maintenance of pH in the blood

(around 7.4) as well as in the cells.

Dietary requirements

The recommended dietary allowance (RDA) of phosphate is based on the intake

of calcium. The ratio of Ca : P of 1 : 1 is recommended (i.e. 800 mg/day) for
an adult. For infants, however, the ratio is around 2 : 1, which is based on the
ratio found in human milk. Calcium and phosphate are distributed in the
majority of natural foods in 1 : 1 ratio. T
Sources

Milk, cereals, leafy vegetables, meat, eggs.

Absorption

Phosphate absorption occurs from jejunum

1. Calcitriol promotes phosphate uptake along with calcium.

2. Absorption of phosphorus and calcium is optimum when the dietary Ca : P is

between 1 : 2 and 2 : 1.

3. Acidity favours while phytate decreases phosphate uptake by intestinal cells.

Excretion

About 500 mg phosphate is excreted in urine per day. The renal threshold is 2
mg/dl. The reabsorption of phosphate by renal tubules is inhibited by PTH.

Disease states

1. Serum phosphate level is increased in hypoparathyroidism and decreased in

hyperpara- thyroidism.

2. In severe renal diseases, serum phosphate content is elevated causing

acidosis.

3. Vitamin D deficient rickets is characterized by decreased serum phosphate

(1–2 mg/dl).

4. Renal rickets is associated with low serum phosphate levels and increased
alkaline phosphatase activity.

5. In diabetes mellitus, serum content of organic phosphate is lower while that

of inorganic phosphate is higher.

Magnesium

The adult body contains about 20 g magnesium, 70% of which is found in bones
in combination with calcium and phosphorus. The remaining 30% occurs in the
soft tissues and body fluids.

Biochemical functions
1. Magnesium is required for the formation of bones and teeth.

2. Mg2+ serves as a cofactor for several enzymes requiring ATP e.g.

hexokinase, glucokinase, phosphofructokinase, adenylate cyclase.

3. Mg2+ is necessary for proper neuro- muscular function. Low Mg2+ levels
lead to neuromuscular irritability.

Dietary requirements

Adult man — 350 mg/day Adult woman — 300 mg/day

Sources

Cereals, nuts, beans, vegetables (cabbage, cauliflower), meat, milk, fruits.

Absorption

Magnesium is absorbed by the intestinal cells through a specific carrier system.

About 50% of the dietary Mg is normally absorbed. Consumption of large
amounts of calcium, phosphate and alcohol diminishes Mg absorption. PTH
increases Mg absorption.

Serum Mg

Normal serum concentration of Mg is 2–3 mg/ dl. It is present in the ionized

form (60%), in combination with other ions (10%) and bound to proteins (30%).

Disease states

1. Magnesium deficiency causes neuro- muscular irritation, weakness and

convulsions.

Sodium

Sodium is the chief cation of the extracellular fluid. About 50% of body
sodium is present in the bones, 40% in the extracellular fluid and the remaining
(10%) in the soft tissues.

Biochemical functions

1. In association with chloride and bicarbonate, sodium regulates the body’s

acid- base balance.
2. Sodium is required for the maintenance of osmotic pressure and fluid
balance.

3. It is necessary for the normal muscle irritability and cell permeability.

4. Sodium is involved in the intestinal absorption of glucose, galactose and

amino acids.

Absorption

5. It is necessary for maintaining heart beat.

Dietary requirements

initiating and

Sodium is readily absorbed in the gastrointes- tinal tract and, therefore, very
little of it (< 2%) is normally found in feces. However, in diarrhea, large
quantities of sodium is lost in feces.

Plasma sodium

In the plasma (serum), the normal concentration of sodium is 135-145 mEq/l.

Sodium is an extracellular cation, therefore, the blood cells contain much less
(35 mEq/l). The mineralocorticoids, secreted by adrenal cortex, influence
sodium metabolism. A decrease in plasma sodium and an increase in its urinary
excretion are observed in adrenocortical insufficiency.

Excretion

Kidney is the major route of sodium excretion from the body. As much as 800 g
Na/day is filtered by the glomeruli, 99% of this is reabsorbed by the renal
tubules by an active process. This is controlled by aldosterone. Extreme
sweating also causes considerable amount of sodium loss from the body

The common salt (NaCl) used in the cooking medium is the major source of
sodium. The ingested foods also contribute to sodium.

The good sources of sodium include bread, whole grains, leafy vegetables, nuts,
eggs and milk.
 IRON

The total content of iron in an adult body is 3-5 g. About 70% of this occurs in
the erythrocytes of blood as a constituent of hemoglobin. At least 5% of body
iron is present in myoglobin of muscle. Heme is the most predominant iron-
containing substance. It is a constituent of several proteins/enzymes
(hemoproteins)—hemoglobin, myoglobin, cytochromes, xanthine oxidase,
catalase, tryptophan pyrrolase, peroxidase. Certain other proteins contain non-
heme iron e.g. transferrin, ferritin, hemosiderin.

Biochemical functions

1. Iron mainly exerts its functions through the compounds in which it is present.
Hemoglobin and myoglobin are required for the transport of O2 and CO2.

2. Cytochromes and certain non-heme proteins are necessary for electron

transport chain and oxidative phosphorylation.

3. Peroxidase, the lysosomal enzyme, is required for phagocytosis and killing of

bacteria by neutrophils.

4. Iron is associated with effective immuno- competence of the body.

Dietary requirements

Adult man
Menstruating woman
Pregnant and lactating woman — 40 mg/day

Sources

Rich sources — Organ meats (liver, heart, kidney).

Good Source—Leafy vegetables, pulses, cereals, fish, apples, dried fruits,

molasses.

Poor sources -Milk, wheat, polished rice.

Absorption, transport and storage

Iron is mainly absorbed in the stomach and duodenum. In normal people, about
10% of dietary iron is usually absorbed. However, in iron deficient (anemic)
individuals and growing children, a much higher proportion of dietary iron is
absorbed to meet the increased body demands.
Iron is mostly found in the foods in ferric form (Fe3+), bound to proteins or
organic acids. In the acid medium provided by gastric HCl, the Fe3+ is released
from foods. Reducing substances such as ascorbic acid (vitamin C) and cysteine
convert ferric iron (Fe3+) to ferrous form (Fe2+). Iron in the ferrous form is
soluble and readily absorbed.

Factors affecting Fe absorption

1. Acidity, ascorbic acid, alcohol, fructose and cysteine promote iron

absorption.

2. In iron deficiency anemia, Fe absorption is increased to 2-10 times that of

normal.

3. Small peptides and amino acids favour iron uptake.

4. Phytate (found in cereals) and oxalate (found in leafy vegetables) interfere

with Fe absorption.

Transport of Fe in the plasma : The iron liberated from the ferritin of mucosal
cells enters the plasma in ferrous state. Here, it is oxidized to ferric form by a
copper-containing protein, ceruloplasmin which possesses ferroxidase activity.
Another cuproprotein ferroxidase II also helps for the conversion of Fe2+ to
Fe3+.

Ferric iron then binds with a specific iron- binding protein, namely transferrin
or siderophilin (a glycoprotein with mol. wt. 90,000). Each transferrin molecule
can bind with two atoms of ferric iron (Fe3+). The plasma transferrin
(concentration 250 mg/dl) can bind with 400 mg of iron/dl plasma. This is
known as total iron binding capacity (TIBC) of plasma.

Storage of iron : Iron is stored in liver, spleen and bone marrow in the form of
ferritin. In the mucosal cells, ferritin is the temporary storage form of iron. A
molecule of apoferritin (mol. wt. 500,000) can combine with 4,000 atoms of
iron. The maximum iron content of ferritin on weight basis is around 25%.

Hemosiderin is another iron storage protein which can hold about 35% of iron
by weight. Hemosiderin accumulates in the body (spleen, liver) when the supply
of iron is in excess of body demands.

Iron is a one-way substance

Iron metabolism is unique as it operates in a closed system. It is very efficiently
utilized and reutilized by the body. Further, iron losses from the body are
minimal (< 1 mg/day) which may occur through bile, sweat, hair loss etc. Iron is
not excreted into urine.

Disease states

1. Iron deficiency anemia : This is the most prevalent nutritional disorder

worldover, including the well developed countries (e.g. USA). Several factors
may contribute to iron deficiency anemia. These include inadequate intake or
defective absorption of iron, chronic blood loss, repeated pregnancies and
hookworm infection

Iron deficiency anemia mostly occurs in growing children, adolescent girls,

pregnant and lactating women. It is characterized by microcytic hypochromic
anemia with reduced blood hemoglobin levels (<12 g/dl).

Treatment : Iron deficiency is treated by supplementation of iron along wih

folic acid and vitamin C.
2. Hemosiderosis : This is a less common disorder and is due to excessive iron
in the body. It is commonly observed in subjects receiving repeated blood
transfusions over the years, e.g. patients of hemolytic anemia, hemophilia

Hemochromatosis : This is a rare disease in which iron is directly deposited

in the tissues (liver, spleen, pancreas and skin). Hemosiderosis is sometimes
accompanied by hemochromatosis. Bronzed-pigmentation of the skin, cirrhosis
of liver, pancreatic fibrosis are the manifestations of this disorder.
Hemochromatosis causes a condition known as bronze diabetes.

Copper

The body contains about 100 mg copper distributed in different organs. It

is involved in several important functions.
Biochemical functions

1. Copper is an essential constituent of several enzymes. These include

cytochrome oxidase, catalase, tyrosinase, superoxide dismutase,
monoamine oxidase etc.

2. Copper is necessary for the synthesis of hemoglobin (Cu is a constituent

of ALA synthase, needed for heme synthesis).

3. Lysyl oxidase (a copper-containing enzyme) is required for the

conversion of certain lysine residues of collagen and elastin to allysine
which are necessary for cross-linking these structural proteins.

4. Ceruloplasmin serves as ferroxidase and is involved in the conversion of

iron from Fe2+ to Fe3+ in which form iron (transferrin) is transported in
plasma.

5. Copper is necessary for the synthesis of melanin and phospholipids.

6. Development of bone and nervous system (myelin) requires Cu.

7. Certain copper-containing non-enzymatic proteins have been identified,

although their functions are not clearly known. These include
hepatocuprein (storage form in liver), cerebro- cuprein (in brain) and
hemocuprein (in RBC).

8. Hemocyanin, a copper protein complex in invertebrates, functions like

hemoglobin for O2 transport.

Dietary requirements

Adults — 2-3 mg/day

Infants and children — 0.5-2 mg/day

The copper concentration of plasma is about 100-200 mg/dl.

Disease states

1. Copper deficiency : Severe deficiency of copper causes

demineralization of bones, demyelination of neural tissue, anemia,
fragility of arteries, myocardial fibrosis, hypopig- mentation of skin,
greying of hair.
2. Menke’s disease : This disorder is due to a defect in the intestinal
absorption of copper. It is possible that copper may be trapped by meta-
llothionein in the intestinal cells.

3. Wilson’s disease (hepatolenticular degeneration) : It is a rare disorder

(1 : 50,000) of abnormal copper metabolism.

Sources -Liver, kidney, meat, egg yolk, cereals, nuts and green leafy
vegetables. Milk is a poor source.

Absorption

About 10% of dietary copper is absorbed, mainly in the duodenum.

Metallothionein is a transport protein that facilitates copper absorption.
Phytate, zinc and molybdenum decrease copper uptake.

IODINE

The total body contains about 20 mg iodine, most of it (80%) being

present in the thyroid gland. Muscle, salivary glands and ovaries also
contain some amount of iodine.

Biochemical functions

The only known function of iodine is its requirement for the synthesis of
thyroid hormones namely, thyroxine (T4) and triiodothyronine (T3).
Functionally, T3 is more active than T4.

Dietary requirements

About 80% of body’s iodine is stored in the organic form as

iodothyroglobulin (a glycoprotein) in the thyroid gland. This protein
contains thyroxine, diiodotyrosine and triiodothyronine in different
proportions.

Excretion of iodine mostly occurs through kidney. It is also excreted

through saliva, bile, skin, and milk (in lactating women).
 ZINC

The total content of zinc in an adult body is about 2 g. Prostate gland is

very rich in Zn (100 mg/g). Zinc is mainly an intracellular element.

Biochemical functions

1. Zn is an essential component of several enzymes e.g. carbonic

anhydrase, alcohol dehydrogenase, alkaline phosphatase, carboxy-
peptidase, superoxide dismutase (cytosolic).

2. Zinc may be regarded as an antioxidant since the enzyme superoxide

dismutase (Zn containing) protects the body against free radical damage.

3. The storage and secretion of insulin from the -cells of pancreas require
Zn.

4. Zn is necessary to maintain the normal levels of vitamin A in serum. Zn

promotes the synthesis of retinol binding protein.

5. It is required for wound healing. Zn enhances cell growth and division,

besides stabilizing biomembranes.

Dietary requirements

Zinc requirement for an adult is 10-15 mg/ day. It is increased (by about
50%) in pregnancy and lactation.

Sources

Meat, fish, eggs, milk, beans, nuts.

Absorption

Zinc is absorbed mainly in the duodenum. Zn from the animal sources is

better absorbed than the vegetable sources. Zn absorption appears to be
dependent on a transport protein—metallo- thionein. Phytate, calcium,
copper and iron interfere while small peptides and amino acids promote
Zn absorption.

Serum Zn
The concentration of Zn in serum is about 100 mg/dl. Erythrocytes contain
higher content of Zn (1.5 mg/dl) which is found in association with the
enzyme carbonic anhydrase.

Disease states

Zinc deficiency is associated with growth retardation, poor wound

healing, anemia, loss of appetite, loss of taste sensation, impaired
spermatogenesis etc. It is reported that Zn deficiency in pregnant animals
causes congenital malformations of the fetus.

Molybdenum

Molybdenum is a constituent of the enzymes xanthine oxidase, aldehyde

oxidase and sulfite oxidase. Nitrite reductase (containing Mo) is a plant enzyme,
required for nitrogen fixation.

The requirements of Mo are not clearly known. However, it is widely

distributed in the natural foods. Dietary Mo is effectively (60%-70%) absorbed
by the small intestine.

Some workers have reported that Mo decreases the mobilization and utilization
of copper in the body.

Molybdenosis is a rare disorder caused by excessive consumption of Mo. Its

manifestations include impairment in growth, diarrhea and anemia. Intestinal
absorption of copper is diminished.

Fluoride

Fluoride is mostly found in bones and teeth. The beneficial effects of fluoride in
trace amounts are overshadowed by its harmful effects caused by excess
consumption.

Biochemical functions

1. Fluoride prevents the development of dental caries. It forms a protective

layer of acid resistant fluoroapatite with hydroxyapatite of the enamel and
prevents the tooth decay by bacterial acids. Further, fluoride inhibits the
bacterial enzymes and reduces the production of acids.

2. Fluoride is necessary for the proper development of bones.

3. It inhibits the activities of certain enzymes. Sodium fluoride inhibits enolase
(of glycolysis) while fluoroacetate inhibits aconitase (of citric acid cycle).

Dietary requirements and sources

An intake of less than 2 ppm of fluoride will meet the daily requirements.
Drinking water is the main source.

Disease states

1. Dental caries : It is clearly established that drinking water containing less

than 0.5 ppm of fluoride is associated with the development of dental caries in
children (Refer Chapter 13).

2. Fluorosis : Excessive intake of fluoride is harmful to the body. An intake

above 2 ppm (particularly > 5 ppm) in children causes mottling of enamel and
discoloration of teeth. The teeth are weak and become rough with characteristic
brown or yellow patches on their surface. These manifestations are collectively
referred to as dental fluorosis.

Selenium

Selenium was originally identified as an element that causes toxicity to animals

(alkali disease) in some parts of USA, containing large amounts of Se in the
soil. Later work, however, has shown that Se in smaller amounts is biologically
important.

Biochemical functions

1. Selenium, along with vitamin E, prevents the development of hepatic

necrosis and muscular dystrophy.