110/4/2015. 2 inorganic elements or salts bind with enzymes or other organic molecules help to...
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Inorganic elements or salts Bind with enzymes or other organic
molecules Help to regulate many body functions Building blocks for many body structures Required for intracellular and
extracellular body fluid electrolytes Macrominerals Microminerals, or trace elements
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Most abundant mineral element in the body
Accounts for 2% of body weight Highest concentration in bones and
teethEfficient absorption requires
adequate amounts of vitamin DFound in many foods especially milk
and dairy products404/19/23
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SOFT TISSUE100,000 mg
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Calcium requirements high for Growing children Women who are pregnant or breast-
feeding
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Essential for normal maintenance and function of: Nervous, muscular, skeletal systems Cell membrane and capillary permeability
Catalyst in many enzymatic reactions Essential in many physiologic processes
Transmission of nerve impulses Contraction of cardiac, smooth, and skeletal
muscles Renal function, respiration, and blood
coagulation704/19/23
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Calcium deficiency: hypocalcemia Infantile rickets Adult osteomalacia Osteoporosis Many other conditions associated with
calcium deficiency
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Inadequate intake of calcium or vitamin D
HypoparathyroidismMalabsorption syndrome Many other causes
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Used to treat various deficiency states Dietary supplement for women during
pregnancy and lactation Toxicity: Hypercalcemia may occur
with therapy Anorexia, nausea, vomiting, constipation Stone formation
Physical drug interaction: Calcium salts will bind (chelate) with tetracyclines to produce an insoluble complex
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Main source of dietary Ca in industrialized societies is milk which contains ~1150 mg ca/L.
Other good sources of calcium include milk products except butter and cream, sardines, salmon, shellfish (oysters, tulya), dried dilis, green vegetables that do not contain much phytates and oxalates like mustasa, malunggay, petsay, saluyot, and gabi leaves calcium set tofu, some legumes, canned fish, seeds, nuts, and fortified food products. Breads and cereals, although relatively low in calcium, contribute significantly to total calcium intake because of the frequency of consumption. Fish and other seafoods contain more calcium than pork, beef, or chicken.
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Menopausal women should take at least 500 to 2000 mg of calcium daily for minimum of 2 years to prevent bone loss.
It is also recommended that dose of 400 to 800 iu of vitamin D3 be given with 1000 mg calcium to reduce hip fracture risk of older individuals esp those with limited sun exposure, ie. housebound.
It is not routinely recommended to give vitamin D analogues.
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% Elemental Calcium
Cost Convenience Absorption
CaCO3 40 Inexpensive Convenient Adequate when taken with food
Ca lactate 13 Inconvenient: need more
tablets
Adequate when taken with food
Ca gluconate
9 InconvenientIV
Adequate when taken with food
Ca citrate 21 Expensive Well absorbed
Levine In: DeGroot, 2001 1404/19/23
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One of the principal cations of intracellular fluid
Essential for enzyme systems associated with energy metabolism
Required for: Nerve physiology Muscle contraction
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Dietary sources Vegetables and other foods
Required in higher amounts in those with diets high in protein-rich foods, calcium, and phosphorus
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Hypomagnesemia Malabsorption Alcoholism Long-term IV feedings Diuretics Metabolic disorders (hyperthyroidism,
diabetic ketoacidosis)
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Nutritional supplementTreatment of magnesium deficiencyAnticonvulsant in magnesium
deficiencyPreeclampsia and eclampsiaTocolytic agent for inhibition of
uterine contractions in premature labor
Many other uses1804/19/23
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Adverse effects are due to hypermagnesia Tendon reflex loss: form of paralysis Difficult bowel movements CNS depression Respiratory distress Heart block Hypothermia
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Infants (0-5 mos): 26 mg6 to < 12 mos: 54 mg Children (<10 years): 65-100 mg10-12 yrs: 155-160 mg; 13-18 yrs 220-260 mg Male adults: 235 mgFemale adults: 205 mg Pregnant: 205 mg Lactating: 250 mg
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Widely distributed in foodsDietary deficiency is rareDeficiency due to non-dietary causes
Mal-absorption Extensive diarrhea or vomiting Hyperthyroidism Long-term use of aluminum or calcium
antacids Hepatic disease
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Required precursor for the synthesis of essential body chemicals
Responsible for cellular energy transfer Necessary for the dev’t and maintenance
of the skeletal system and teeth Building block for body structures Required for the synthesis of:
Nucleic acid – AMP ADP – ATP
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Treatment of deficiency statesDietary supplement
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DiarrheaNausea and vomitingOther GI disturbancesConfusionWeaknessBreathing difficulties
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Infants (< 6 mos): 90 mg 6 to < 12 mos: 275 mg Children: 460-500 mg 10-18 years old: 1250 mg adults: 700 mg Pregnant and Lactating: 700 mg
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Trace elementEssential in metabolic reactions of
proteins and carbohydrates Important for normal tissue growth
and repair, especially wound repairRecently recognized as important for
the prevention of recurrent diarrhea
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Infants (<6mos): 1.4 mg 6- <12 mos: 4.2 mg Children: 4.5-5.4 mg Male adults: 6.4 mg Female adults: 4.5 mgPregnant 1st trim 5.1 mg, 2nd trim 6.6, 3rd trim 9.6 Lactating: 11.5 mg
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Appendix C: Food Tipsa. Food based solutions are preferable to help ensure a
balanced diet and good eating habits.b. 2 glasses of high calcium milk each day is a guaranteed way
to meet all your calcium requirements. In addition, milk provides large amounts of phosphorus and components such as lactose and casein phosphopeptides which may enhance calcium absorption.
c. Some fortified milks also supply adequate amounts of vitamin D, zinc, and magnesium for optimal bone health.
d. Other sources of calcium include green leafy vegetables and soy products, although calcium is less well absorbed from these sources.
e. Eat green vegetables cooked, rather than raw, to boost their calcium content. Cooking releases some of the calcium that’s bound to a compound called oxalic acid.
f. Don’t take iron supplements with calcium-rich foods, since these minerals compete for absorption.
g. Drink tea and coffee between, rather than during meals. Natural compounds in these beverages inhibit calcium absorption.
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